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Nurse wants to "kill" Happy Hospitalist
1 hour ago
Thursday, November 05, 2009
Sunday, November 01, 2009
Happy Trails...
It's time... I've been thinking about this for a while now. The proverbial writing is on the wall. It's time for me to retire from nurse blogging.
I've been doing it for seven years (3 years with my student blog, 4 on this one). I don't know if I have anything worthwhile left to say when it comes to life in the OR. Honestly, I've been trying to focus more on my life outside of it (there's another blog for that).
I've looked back on some of my posts and, geez, you would think I needed some serious pyschotherapy or some very, very strong drinks.
Anyway, I'll still be online reading all my favorite nurse and medical blogs, but as my real self - not the Unsinkable Molly Brown.
Special thanks to Kim from Emergiblog and Geena from Codeblog who were there with me from the very beginning of my nurse blogging (and my path to becoming a nurse). You two really helped me through some tough times...
If you're interested at all (and I totally understand if you're not), you can e-mail me at unsinkablemb (at) gmail (dot) com to request the link to my "normal" - where I truly live large - blog. Occasionally, I write about life as a nurse, but mostly I write about things that give you a clue as to who I am - "behind the mask." (Don't worry, it's not THAT scary!)
Take care!
Happy Trails...
P.S. This will be completely OFF Blogger by December 31, 2009.
Friday, October 30, 2009
The Path to Leadership
Leadership. I've been thinking about this a lot. Perhaps it stems from me trying to figure out my next move. I want to grow as a nurse leader, but the path isn't clear. Good examples of a nursing leadership track I have yet to discover.
* * * * *
SCENARIO #1 - The Corporate World:
In the corporate world, Camille gets a job - low chick on the totem pole - and she pays her dues. She types memos, create spreadsheets, collates and copies, and formats presentations for her boss. She might even organize team outings. By luck or because of company culture, someone recognizes her hardwork and gumption. The next thing she knows she is asked to do more, take on small but key roles on committees, and maybe even take the lead on part of a project.
Evaluation time comes around and, not only does Camille get a 5 star rating, she's been given a raise and promotion. The next step is not only more money, but more responsibility, more visibility, and a chance to continue developing her leadership skills. The company starts sending her to seminars on public speaking and how to facilitate meetings.
The growth process continues and before she realizes it, years pass and she has accumlated layers of skills that equal credibility and proven leadership. Camille is ready to play with the Big Dogs.
SCENARIO #2 - Surgical Nursing World
(may possibly apply to other nursing units - I'm not sure):
Carina gets a job out of nursing school in a busy surgical unit. In orientation, for the next six to seven months, she learns how to scrub and circulate in a variety of specialties (General Surgery, Neurosurgery, Orthopedics, etc.). When she finishes her intro to surgical nursing, Carina is assigned to the General Surgery team.
She works hard and becomes more efficient as time goes on. A couple of years pass and Carina wants to grow as a leader. Unfortunately, the OR is way too busy and her manager cannot set aside time to talk about career development. Who can do that when there are high case volumes and only a limited amount of nurses to staff the rooms?
Carina thinks that maybe she can be active on unit committees, only to find out that those groups have little or no activity. The nurses involved have trouble getting out of rooms because there isn't enough staff to relieve them and run the OR schedule. Sorry! The patients come first. Don't forget that's how they pay your salary. Oh well...
A nurse educator position opens up and Carina applies for the job despite her lack of experience. How else is she supposed to get her experience aside from getting it on the job? Somehow Carina gets the nurse educator job --- good interview, the right people on her side, the promise of signing up for grad school, or whatever the case may be.
Now what? She has no idea where to start. The pressure is on and lots of things start falling through the cracks. For example, new nurses are starting, no one knows where the certifications records are from the last nurse educator, and who knows if the RNs are keeping up with their CEUs. Oh and don't forget all those meetings she has to attend. It's big load to carry... Can Carina do it and do it well?
* * * * * *
Perhaps I'm oversimplifying things, but these are two scenarios that I have personally witnessed. Unfortunately, I have yet to see how nurses, who want to develop into nurse leaders, get their actual leadership experience especially if they are strictly in a room being clinical.
Is there such a thing as a hospital that has a leadership track for nurses? If more hospitals had one, maybe there wouldn't be so many Director and Manager positions posted on the job boards!
Is the only way to get a leadership job to go back to school to get a Masters in Nursing? I personally don't think that having an MSN qualifies a person as a leader. There's more to being a leader than having another degree behind your name. You have to know how to talk with people, be able to conduct conflict resolution, understand how to interpret various reports, and be brave enough to stand up - professionally, of course - to other leaders for your staff or for what's right. Let's face it, there are some things that a Masters program just doesn't cover.
How can nurses participate in unit committees when there is short staffing in the OR? It's a difficult task to figure out staffing for lunch relief and change of shift in a busy surgical unit. What more if we added professional development to the list? Yikes! I think our charge nurse would have a coronary.
I've been talking to a very reputable institution in the heart of Big City. They don't have a leadership track in place, however, they do support their surgical RNs in advanced learning. Whether I would pursue a masters degree in nursing, an advanced nursing certification (like RNFA), or take a computer skills class, this facility tells me that they would do their best to work with me. Sounds like the opportunity I've been waiting for...
* * * * *
SCENARIO #1 - The Corporate World:
In the corporate world, Camille gets a job - low chick on the totem pole - and she pays her dues. She types memos, create spreadsheets, collates and copies, and formats presentations for her boss. She might even organize team outings. By luck or because of company culture, someone recognizes her hardwork and gumption. The next thing she knows she is asked to do more, take on small but key roles on committees, and maybe even take the lead on part of a project.
Evaluation time comes around and, not only does Camille get a 5 star rating, she's been given a raise and promotion. The next step is not only more money, but more responsibility, more visibility, and a chance to continue developing her leadership skills. The company starts sending her to seminars on public speaking and how to facilitate meetings.
The growth process continues and before she realizes it, years pass and she has accumlated layers of skills that equal credibility and proven leadership. Camille is ready to play with the Big Dogs.
SCENARIO #2 - Surgical Nursing World
(may possibly apply to other nursing units - I'm not sure):
Carina gets a job out of nursing school in a busy surgical unit. In orientation, for the next six to seven months, she learns how to scrub and circulate in a variety of specialties (General Surgery, Neurosurgery, Orthopedics, etc.). When she finishes her intro to surgical nursing, Carina is assigned to the General Surgery team.
She works hard and becomes more efficient as time goes on. A couple of years pass and Carina wants to grow as a leader. Unfortunately, the OR is way too busy and her manager cannot set aside time to talk about career development. Who can do that when there are high case volumes and only a limited amount of nurses to staff the rooms?
Carina thinks that maybe she can be active on unit committees, only to find out that those groups have little or no activity. The nurses involved have trouble getting out of rooms because there isn't enough staff to relieve them and run the OR schedule. Sorry! The patients come first. Don't forget that's how they pay your salary. Oh well...
A nurse educator position opens up and Carina applies for the job despite her lack of experience. How else is she supposed to get her experience aside from getting it on the job? Somehow Carina gets the nurse educator job --- good interview, the right people on her side, the promise of signing up for grad school, or whatever the case may be.
Now what? She has no idea where to start. The pressure is on and lots of things start falling through the cracks. For example, new nurses are starting, no one knows where the certifications records are from the last nurse educator, and who knows if the RNs are keeping up with their CEUs. Oh and don't forget all those meetings she has to attend. It's big load to carry... Can Carina do it and do it well?
* * * * * *
Perhaps I'm oversimplifying things, but these are two scenarios that I have personally witnessed. Unfortunately, I have yet to see how nurses, who want to develop into nurse leaders, get their actual leadership experience especially if they are strictly in a room being clinical.
Is there such a thing as a hospital that has a leadership track for nurses? If more hospitals had one, maybe there wouldn't be so many Director and Manager positions posted on the job boards!
Is the only way to get a leadership job to go back to school to get a Masters in Nursing? I personally don't think that having an MSN qualifies a person as a leader. There's more to being a leader than having another degree behind your name. You have to know how to talk with people, be able to conduct conflict resolution, understand how to interpret various reports, and be brave enough to stand up - professionally, of course - to other leaders for your staff or for what's right. Let's face it, there are some things that a Masters program just doesn't cover.
How can nurses participate in unit committees when there is short staffing in the OR? It's a difficult task to figure out staffing for lunch relief and change of shift in a busy surgical unit. What more if we added professional development to the list? Yikes! I think our charge nurse would have a coronary.
I've been talking to a very reputable institution in the heart of Big City. They don't have a leadership track in place, however, they do support their surgical RNs in advanced learning. Whether I would pursue a masters degree in nursing, an advanced nursing certification (like RNFA), or take a computer skills class, this facility tells me that they would do their best to work with me. Sounds like the opportunity I've been waiting for...
Thursday, October 29, 2009
Tuesday, October 27, 2009
Soccer Socks And Other Survival Tools
As I was trying to organize my locker today, I realized that I'm a little quirky. Yes, I admit it. There are items specific to me that help me survive my workday. Some nurses can't live without their Hello Kitty scrub jackets. Some techs can't live without their special eye protection; they can't stand masks with the plastic shields. For me? That stuff doesn't matter. Here's what I need to get through my day.
MB'S SURVIVAL TOOLS FOR SURGERY
Soccer/Futbol Socks - I LOVE SOCCER SOCKS! I prefer them to compression stockings sold in uniform stores. Futbol socks give my legs enough pressure that I feel great at the end of a busy day. If I forget and wear my little ankle running socks - I'm miserable by 3:30pm. (My favorites have extra padding on the bottom of the feet.)
Danskos - So far these have proven to be the best shoes for orthopaedic surgery. Sure they might be a little hard - even after they're broken in. But those babies support my back AND protect my tootsies if anything drops from my mayo stand/back table. They are hard enough to withstand MOST of the dangerous items. Just don't drop a drill on your foot!
Ponytail Scrub Caps - I have long, straight, hard-to-control hair that has a mind of its own. The best way to keep it under my blue surgical bonnet is to round it up in a ponytail and stick it into one of these.
Toolbox - Throughout the day, you might not have time to run to your locker for that emergency piece of candy (when the front desk says that there is no lunch relief), an extra pen, bandage scissors, etc. This is why I keep a little toolbox onhand. Anesthesiologists and CRNAs carry one around for medications and supplies. I figure, why not? There are only two small pockets in my surgical scrubs... Where am I supposed to fit everything?
Personal Lead Apron for X-ray - Because I am usually in orthopedics, I decided to invest in my own lead apron. First of all, I am the only who uses it, so it's my germs on it (who knows when and if those things get washed). Secondly, it's my size - SMALL; not very common in our unit. Finally, I don't have to fight with other rooms or other services just to get one stinky, heavy, gross lead apron for a case or two. It was worth every penny!
Favorite Pen - When I am in the role of circulator, I fill out forms for specimens and implants, take messages for surgeons and residents, and take notes for myself. An old nursing professor used to say to me, 'What is a nurse without a pen?' Then again, she used to say that about everything... But anyway... A pen that flows helps your day flow. (Hmmm... I'm sounding a bit OCD there, huh?)
So what's on your list?
MB'S SURVIVAL TOOLS FOR SURGERY
Soccer/Futbol Socks - I LOVE SOCCER SOCKS! I prefer them to compression stockings sold in uniform stores. Futbol socks give my legs enough pressure that I feel great at the end of a busy day. If I forget and wear my little ankle running socks - I'm miserable by 3:30pm. (My favorites have extra padding on the bottom of the feet.)
Danskos - So far these have proven to be the best shoes for orthopaedic surgery. Sure they might be a little hard - even after they're broken in. But those babies support my back AND protect my tootsies if anything drops from my mayo stand/back table. They are hard enough to withstand MOST of the dangerous items. Just don't drop a drill on your foot!
Ponytail Scrub Caps - I have long, straight, hard-to-control hair that has a mind of its own. The best way to keep it under my blue surgical bonnet is to round it up in a ponytail and stick it into one of these.
Toolbox - Throughout the day, you might not have time to run to your locker for that emergency piece of candy (when the front desk says that there is no lunch relief), an extra pen, bandage scissors, etc. This is why I keep a little toolbox onhand. Anesthesiologists and CRNAs carry one around for medications and supplies. I figure, why not? There are only two small pockets in my surgical scrubs... Where am I supposed to fit everything?
Personal Lead Apron for X-ray - Because I am usually in orthopedics, I decided to invest in my own lead apron. First of all, I am the only who uses it, so it's my germs on it (who knows when and if those things get washed). Secondly, it's my size - SMALL; not very common in our unit. Finally, I don't have to fight with other rooms or other services just to get one stinky, heavy, gross lead apron for a case or two. It was worth every penny!
Favorite Pen - When I am in the role of circulator, I fill out forms for specimens and implants, take messages for surgeons and residents, and take notes for myself. An old nursing professor used to say to me, 'What is a nurse without a pen?' Then again, she used to say that about everything... But anyway... A pen that flows helps your day flow. (Hmmm... I'm sounding a bit OCD there, huh?)
So what's on your list?
Monday, October 26, 2009
If I Were A Patient...
Despite all the stupid politics of MSTH, I love surgery. One of the qualities of my job that keeps me going is that I learn something new every day, especially working at a teaching institution. I suppose you could say that about any job, but the stuff I see only reinforces that it is a miracle that we are all alive.
Over the years, I've accumulated quite a bit of knowledge. This is great while I'm working as a surgical nurse, but how about when I switch roles and play the part of patient? If you want to know the truth, I'd be terrified. I'm beginning to think I know too much.
If I needed surgery, I would require answers to the following questions:
Over the years, I've accumulated quite a bit of knowledge. This is great while I'm working as a surgical nurse, but how about when I switch roles and play the part of patient? If you want to know the truth, I'd be terrified. I'm beginning to think I know too much.
If I needed surgery, I would require answers to the following questions:
- Is the anesthesiologist gentle or is he just going to shove that tube down my throat?
- If she's going to do a spinal, does she usually get it on the first try or is there lots of poking around?
- Is the anesthesiologist going to wake me up too early and am I going to remember being extubated?
- Is this surgeon recommended by the techs and nurses? After all, they know how this guy works better than anyone.
- How about the techs and nurses? How many years of experience and what are their specialties?
- Do I need a foley catheter? If so, who is going to put it in? I'd prefer a nurse to do it over a resident, thanks.
- Speaking of residents, who is going to be assisting? What year is he or she? The surgeon had better stay the whole time - even when they're closing - especially if the resident is still early in his/her residency.
- And by the way, what are you going to use to close my wound? Can you use 4-0 Monocryl instead of staples?
- How big will you make the incision?
- Are your instruments sterilized down in Sterile Processing or do you "flash" (autoclave) it up in surgery?
- What is the infection rate?
The nice part about working at MSTH is that, God forbid I need surgery, I can actually handpick my team. I can select the surgeons, staff (techs/nurses), and anesthesiologist. Luckily, I have the inside scoop on the surgeons and anesthesiologist. As for the techs and nurses, I would pick anyone on staff because I know they would take good care of me.
Folks who work outside of surgery and healthcare in general may not have the inside scoop. But they can! They just need to do their homework. In my opinion, word of mouth is the best. There are also websites that give physician reviews; not sure how much value I would put into those.
At MSTH, if you know someone who works in surgery you can request them. You CAN request your tech/nurse (I've been requested before). You CAN request your anesthesiologist. This is a great thing! Can you imagine being able to request your entire surgical team?
I don't know if they do this at other hospitals, but it doesn't hurt to ask. Why not??? Don't be afraid to do it! If it's going to make you feel better going into surgery, JUST DO IT.
This is YOUR health. This is YOUR life. You're worth it.
Friday, October 23, 2009
It Only Takes Five Minutes
I've be told by nurses from other units, "You're so lucky that you're in surgery --- your patient is asleep." (FYI - they are referring to the amount of interaction I have with patients.)
Huh? Who me? Lucky?!?
Honestly, I don't think they understand what I do. That's OK... I know it's hard to think about what other nurses do when you're up to your eyeballs in your own specialty.
In the operating room, nurses (specifically when you're the circulating nurse) get plenty of time with patients and their families. Enough time to make a connection, that is.
There was one day when I was pulled out of my normal service - orthopedics - to circulate in a general surgery room. All the cases for the day happened to be patients newly diagnosed with breast cancer.
My scrub nurse and I set up the room for the first case --- a complete mastectomy. I went to the holding area to pick up my patient, "Gloria". When I walked into her room, I gave my usual toothy grin and introduced myself.
"Hello! I'm Molly... I'm one of the nurses in surgery."
Gloria was flanked by her two daughters, one who is a nurse at the connecting children's hospital. The first thing that came out of the peds nurse's mouth was, "Thank God - a friendly nurse!!!"
"Gee thanks..." I said, wondering what kind of interactions they had prior to my arrival.
I did my usual assessment, asking the questions that at least two or three other people had already asked her. Then I did my Julie McCoy thing, explaining all the stuff that would happen --- giving her warm blankets, putting monitors on her, etc. I promised Gloria and her daughters that I was going to be in the room the whole time.
"Any questions for me?" I asked.
No questions. After I announced that it was time for some hugs and kisses before we left, the tears began to well up in all three ladies' eyes.
I thought, 'Aw man... Tears??? Please don't... Oh please... Geez. Here I go...'
My tears were threatening to appear. My heart was breaking as I witnessed this scene: the daughters who were so scared, worried, feeling so helpless and their mother trying to be so brave. What could I say to make it better? Nothing...
I promised to take good care of their mother and reassured them that she was in good hands with her surgeon and the rest of the team. The daughters were grateful that I was going to be in the room with her, they told me. It took everything for me not to cry.
Maybe for some people it takes a few days to make a connection, but for me it only takes five minutes.
Huh? Who me? Lucky?!?
Honestly, I don't think they understand what I do. That's OK... I know it's hard to think about what other nurses do when you're up to your eyeballs in your own specialty.
In the operating room, nurses (specifically when you're the circulating nurse) get plenty of time with patients and their families. Enough time to make a connection, that is.
There was one day when I was pulled out of my normal service - orthopedics - to circulate in a general surgery room. All the cases for the day happened to be patients newly diagnosed with breast cancer.
My scrub nurse and I set up the room for the first case --- a complete mastectomy. I went to the holding area to pick up my patient, "Gloria". When I walked into her room, I gave my usual toothy grin and introduced myself.
"Hello! I'm Molly... I'm one of the nurses in surgery."
Gloria was flanked by her two daughters, one who is a nurse at the connecting children's hospital. The first thing that came out of the peds nurse's mouth was, "Thank God - a friendly nurse!!!"
"Gee thanks..." I said, wondering what kind of interactions they had prior to my arrival.
I did my usual assessment, asking the questions that at least two or three other people had already asked her. Then I did my Julie McCoy thing, explaining all the stuff that would happen --- giving her warm blankets, putting monitors on her, etc. I promised Gloria and her daughters that I was going to be in the room the whole time.
"Any questions for me?" I asked.
No questions. After I announced that it was time for some hugs and kisses before we left, the tears began to well up in all three ladies' eyes.
I thought, 'Aw man... Tears??? Please don't... Oh please... Geez. Here I go...'
My tears were threatening to appear. My heart was breaking as I witnessed this scene: the daughters who were so scared, worried, feeling so helpless and their mother trying to be so brave. What could I say to make it better? Nothing...
I promised to take good care of their mother and reassured them that she was in good hands with her surgeon and the rest of the team. The daughters were grateful that I was going to be in the room with her, they told me. It took everything for me not to cry.
Maybe for some people it takes a few days to make a connection, but for me it only takes five minutes.
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