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Interview – Humanitarian Nursing

I had the opportunity to interview Sue Averill RN, BSN, MBA, CEN who is the president of One Nurse At A Time.  The goal of the organization is this: “to reach out to nurses and help them get involved in the humanitarian and volunteer arena.”

Sue is a 32 year veteran of Emergency Room nursing.  She also worked in the business world as a manager for a cruise line and in that role created the medical department for ships, designed ship hospitals, hired staff, and wrote protocols.  For the past 13 years she’s done volunteer humanitarian nursing all around the world.

Sue started in the ER as a senior for her student practicum in 1979.  “Those were the days before certification, before ACLS or PALS when the only ‘specialty’ areas of nursing were cardiac, surgery and pediatrics.  I thought doing a semester in the ER would give me a well rounded view of all aspects of nursing and then I could choose.  But I fell in love with ER and stayed.”

As a volunteer humanitarian nurse, Sue works for Doctors Without Borders and other non profit organizations as nurse, Medical Coordinator (program in charge), or Project Coordinator.  Since starting as a humanitarian in 1999, she’s worked mostly in subSaharan Africa, but also in Asia and Latin America.  She’s done about 25 missions so far and has loved most.

Tell me about your missions:  how long is a typical mission?

Surgical and teaching missions are typically 1-2 weeks.  Disaster response will usually be a month or more at a time.  MSF/Doctors Without Borders missions are minimum 6 months, although I’ve gone as a “troubleshooter” for 1-4 months. When I first started in 1999, I went for 1 week trips.  In 2004 I went to Liberia for 1 month and thought that was nearly impossible to be gone from home for so long and work so intensely.  Later that year, I committed to 6 months in Darfur with MSF and did four 6 month missions back to back.

What do you do during a mission?

On the surgical missions, I normally work PACU (Recovery Room).  When I’m on MSF missions I’m normally the medical coordinator – this is the highest level medical position as it’s the person overall in charge of all the projects in a given country.  This position sets policy and sets the medical objectives for the field teams.  I’ve also worked as a field nurse and project coordinator.

How many other nurses are with you? 

On surgical teams, there’s usually a scrub and circulating nurse, perhaps one other PACU nurse.  Most organizations try to use local staff to work alongside to share out knowledge and the workload.  In MSF, the number of nurses varies by size of the project.  Most I’ve worked have been just one nurse per project.

What’s been a favorite place to go?

I absolutely love Guatemala.

What’s the worst/scariest thing you’ve seen?

I stumbled into a war zone in south Sudan and triaged and treated 100 wounded soldiers.  We were in the area to help civilians displaced by the resurgence of armed conflict between northern and southern troops, but was faced with immediate livesaving needs of these individuals.

Is there an example of something you’ve done where you saw an immediate benefit? 

Probably the difficult delivery situations stand out in my mind the most.  On hands and knees helping women with troubled labor in dark huts with dirt floors.  I saw some successful outcomes, and some not.  One of my biggest joys was taking lay population in our remote village in Darfur and training them to become medical personnel.  It was an amazing transformation to be part of.

What would someone who’s interested in humanitarian work need to do to get started?

Take that leap of faith!  Know your skills are adequate to the task, steel yourself for leaving home, comfort, and everything you love – know that this will be a life changing experience!  Find an organization that fits your beliefs and skill base (see “Organizations” on this page).  Learn as much as you can about the country, people, society, culture, and language of where you plan to go.  Research common diseases in the area.  Stay flexible and have fun!

What frustrates you about your job?

Politics.  It’s there in hospitals, the humanitarian world, business.

Was there any extra training besides on-the-job learning that you were required to complete? 

In humanitarian work, I’ve done many tropical medicine courses, security training, infectious disease, etc.

Curious to read more personal accounts from people who have volunteered abroad?  You should definitely check out Nurses Beyond Borders, which is an anthology of international nursing stories.  I myself am about halfway through the book – if you’re more into electronic reading, you can pick up the Kindle version at Amazon.com: Nurses Beyond Borders: True Stories of Heroism and Healing Around the World. (affiliate link)

Thanks to Sue for her insights about humanitarian nursing!

If you are or know of a nurse that works in a nontraditional setting and are interested in being interviewed, email me at codeblogrn@gmail.com.  My post about this project and a list of interviews done so far is linked here.

 

 

 

 

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Interview – OR/Assistant Clinical Nurse Manager

“Molly Brown, RN” (aka “Unsinkable MB” – both are pen names) blogs at Blood, Guts, and Coffee.  She works in the Operating Room (OR) as an Assistant Clinical Nurse Manager.

Molly has been in her current position for over 6 years.  “My cousin who is an OR nurse peaked my interest in surgery while I was in nursing school.  During my leadership clinical, I observed a few surgeries.  The first one was a CABG (heart bypass surgery); it was love at first incision.  I started in the OR right out of school, moved up the ranks in my hospital system from Staff Nurse to Specialist (over one service), then was promoted to Assistant Clinical Nurse Manager (over 4 specialties).”

Molly starts her morning by doing rounds and helping her services get their day started.  She helps to open sterile instruments, gets supplies and equipment, assists with positioning patients and checks in with surgeons and staff.  Throughout the day she offers support when needed by troubleshooting issues with instrumentation, equipment, and supplies.  She also tends to anything that comes up with patients, staff, and physicians.  She provides lunch relief when short-staffed.  When she finally makes it to her desk, she works on various department and hospital initiatives, writes staff evaluations, tries to answer voice/email, and coordinates with vendors who might have to bring in instrumentation/equipment that has been requested by surgeons.

What frustrates you about your job?

No matter how hard I try, sometimes I just can’t make everyone happy.

What about your job makes you proud to be a nurse?

Although my direct patient care is a bit less than when I was a staff nurse, I am proud to know and to see that I can still make a difference in the quality of care by being a voice when decisions are being made at the administrative level.  Also, I’m proud that with my experience of working at Level I Trauma Center, I still have the critical skills of being a scrub nurse or circulating nurse when an emergency case comes in.

Do you feel you receive adequate support for your responsibilities?

My manager has been my mentor for quite a while.  She understands the challenges I face because she has been in my position before and has helped in my transition into this role.

What is something a nurse who does not work in your particular field might find surprising about your job?

In other departments, many nurses don’t consider surgical nursing “real nursing.” I suppose it’s because we don’t do what people typically think of as nursing – passing meds, taking vitals, etc.  Spend a day with us and you will find that we still have to perform assessments throughout our care, understand positioning (since we can’t turn patients in the middle of a long surgery), as well as maintain normothermia.  While we don’t pass meds, we utilize medications intra-operatively, which requires an understanding of contraindications as well as what to administer in case of toxicity.  Surgical nurses use their nursing knowledge to be a voice for the patient who is sedated and can’t speak for themselves.  Like our colleagues in other units, we perform the most important nursing skill — provide comfort at the bedside before patients “go to sleep” and again when they wake up from anesthesia.

Staff nurses are paid by the hour, plus call pay (when “on call”).  If they’re called in, then it’s time and a half (with or without differential, depending on what time).  I am an Assistant Clinical Nurse Manager – paid by the hour, but no over time (just straight time).  My official hours are 6:45AM to 3:30PM.  Because our department is undergoing a lot of change, I’ve been known to work a few 12 hour days here and there (self-imposed!).  Managers and Directors are salaried.

Molly says that for the most part she’s able to accomplish almost everything she needs to do in the time she has, but adds that surgical nurses tend to be perfectionists and she tends to stay over.  She further states that “teamwork is crucial in the surgery department and not just in the actual operating rooms.  For our unit to run smoothly, we need to work closely with the staff, surgeons, anesthesiologists, and other departments (Sterile Processing, Radiology, Pharmacy, ICU).”

As for extra training or certifications, Molly says that her hospital system provides frontline leadership training in the first six to seven months of the job as well as ongoing mentoring.  She also has a business degree and previous experience in Corporate America, which has proven to be an asset to her in her current position.

And lastly -

One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom. Do you find that to be the case with your job as well?

Surprisingly, yes!  With all the troubleshooting that I do between operating rooms (supporting my team) and the meetings I have to attend, someone has to remind me to slow down and take care of myself.

 

Thanks to Molly for answering my questions about what nursing is like in the OR from the perspective of an assistant manager!

If you are or know of a nurse that works in a nontraditional setting and are interested in being interviewed, email me at codeblogrn@gmail.com.  My post about this project and a list of interviews done so far is linked here.

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My turn to be interviewed!

Online Nursing Degrees is doing a series of interviews on nurse bloggers.

To learn more about how nursing students mature into seasoned healthcare providers, we studied popular nursing bloggers to see what they had to say on the subject.

We found the voices of dedicated professionals with intelligent conversations and compassionate stories illustrating what is happening: in hospitals, classrooms, organizations, public health, state-run or federally sponsored institutions, private hospice care, and more. These are nurses (some currently students themselves) who intimately understand the questions, concerns and the feelings shared by many nursing students: they embody the statement, “Been there, done that.”

You can see the whole series here (we are at the midpoint now, each day another link will go live).  My interview was posted today.  Enjoy!

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Interview – School Nurse

Well, what better time to post my interview with Erin at Tales of a School Zoned Nurse than now, when everyone’s headed back to the classroom?

Erin is a school nurse in the “cash strapped state of California.”  Her position covers two elementary schools and a middle school – almost 2000 students!!  She has been blogging since last year and her blog has definitely become one of my favorites.

She says she was never too set on working in a hospital.  After nursing school, she worked at a couple of summer camps, which gave her the idea to look into being a school nurse. She was hired right away and “leapt in without a second thought.”  She is starting her second year in this position.

Erin’s daily schedule is quite varied:  hearing and vision screenings, cleaning up playground accidents, making various referrals for a number of issues (such as dental and vision checks), scoliosis screening, making sure the school in compliance with state mandates (e.g. immunization requirements), checking on diabetic children and dealing with whatever else arises during the course of her day.

She blogs a lot about the parents of her students and I am almost always blown away by her Scary Parent stories.  She says incompetent and neglectful parenting is by far the most frustrating part of her job.  (Read Exhibit A, Exhibit B, and the continuing saga of Exhibit C)

One of the highlights of Erin’s job is her ability to be a good role model to the kids.  She’s spent time in the classrooms and after-school programs talking about her job and as a result, the kids got to know her and look up to her.  “It feels good to be someone kids turn to when they need someone to talk to or confide in.  It’s satisfying when I’ve made a different to someone, like seeing a student with glasses after making a vision referral.”

Being rather new, Erin does have other experienced nurses she can go to if she has questions.  She is the only nurse at her 3 schools, but there are 10 other nurses spread throughout the district.  They stay in contact often by phone and email.  But other aspects of her job aren’t as supportive – the computers she has to use are “from the dinosaur era” and she carries her audiometer and vision charts with her because there aren’t enough to go around at the schools.

Her position is salaried on a teacher contract, so she works 7.25 hours per day.  The timing is left up to the nurse since they cover different sites on different schedules.  Depending on what school she’s going to that day, her schedule is generally 8-3:15 or 7:30-2:45.  She’s able to accomplish what she needs to do in those hours, but not everything she wants to do.  “I can finish the required health screenings and state mandated requirements, but there is never enough time in the day for the other stuff that I want to do:  get new shoes for the girl whose mom won’t take her in, diabetes teaching for my newly diagnosed diabetics, following up on referrals so kids can get the glasses they need.”

To prepare for her job, Erin became a certified school audiometrist (a 4 unit class).  If she decides to remain a school nurse, California requires a separate license, which requires more education.

And of course, my favorite question:  One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom. Do you find that to be the case with your job as well?

“I don’t always get to eat when I want to, but there is time during the day – eventually – to do so. I’ve learned if I bring a hot lunch I’ll probably need to reheat it at least once during my meal, because I usually take lunch at my desk and am frequently interrupted by tetherball accidents.”  (How many nurses can say that??)

My son will be starting Kindergarten this year and one of my main concerns is his peanut allergy.   His preschool was peanut-free and this will be the first time that he’ll be out in the peanut-filled world for such a long period of time without my own constant vigilance.  So of course I wanted to get Erin’s take on the current allergy situation:

“Food allergies are definitely a big concern, and though I haven’t myself, I know many school nurses that have had food allergy related 911 calls. It’s a huge gap in our care: nurses are technically the only epipen trained staff (just starting this year other school staff can volunteer to become trained, but most I’ve talked with don’t want that responsibility), and when we have three school sites we obviously might not be at a school site when an incident occurs. I do my best to reduce any incidents by first calling the parents to find out exactly what kind of reaction they might have – sometimes parents claim allergies when their kid just doesn’t like the food.  [Ed:  ARRRGGGGGHHHH!!!!!]  At the school, I notify the staff and call the student into my office so I get an idea of how well they understand their allergy. Then…. Then I just hope for the best. For parents, I really recommend talking directly with your child’s teacher and nurse – please! And bring in those Epipens!”

(Not only do I have 2 separate boxes of Epipens; one for the classroom and one for the office, I have a brand new bottle of Benadryl that I’ve already opened, taken all the plastic off and marked the appropriate dosage on the medicine cup.  I also have his photo taped to each bag of meds, which includes a copy of the doctor’s orders.)

And this is what Erin wants you to know about school nurses: “The job is what you make of it. I think there’s a reputation that school nurses have that is undeserved: we’re practically retired nurses working a boring job. There are certainly those nurses that do this job for the schedule, just like there are those hospital nurses that just do it for the money, but we’re not all like that. It just depends on how involved you are with your schools and kids; the more involved you are, the more you see there is to do, the more there is to keep you busier than you have time to be…but the more involved you are, the more rewarding it is, too, even if exhausting.”

Thank you, Erin, for giving us some insight about being a school nurse!

(My post about this project and a list of interviews done so far is linked here.)

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Opening My Heart & An Interview with Tilda Shalof

Well, not my heart.

I was contacted awhile ago and asked if I wanted the chance to read and review Tilda Shalof’s new book, Opening My Heart.  (Amazon link, but NOT an affiliate link – I live in California and due to a new law, Amazon has cut all ties with us).

I had the chance to include a story in a book that Tilda edited a couple of years ago called Lives in the Balance.  So I had fond memories :)

I’ll say up front that I enjoyed the book.  I had a range of emotions while reading it – frustration, worry, happiness.  Frustration because although Tilda is a very experienced ICU nurse, she doesn’t take her own health seriously at all.  I read with disbelief as she described her incredible denial of the obvious need to treat the heart condition she was born with.

I was amused at her doctor’s and husband’s reactions when she tried to tell them that if anything went wrong with her surgery, she didn’t want to be kept alive on machines.   She explained that she used to have a dog and her husband absolutely refused to euthanize the miserable thing.  I liked this passage in particular:  “To Ivan, love means never stopping love or giving up.  This is what families say.  They can’t let go because of love.  I hope no one loves me this much, ICU nurses often say to one another.”

Amen, sister.

Tilda writes about her surgery and subsequent recovery, which I found fascinating.  I love hearing about patient experiences, and having a nurse tell it from her point of view was pure brain candy to me.

She writes a lot about her friends and coworkers and her interactions with them.  I admit I found those particular parts of the book a bit draggy, but maybe others would find them an enjoyable read.

Lastly, she wrote a lot about depression after her surgery.  I don’t know for sure, but I don’t think this is addressed much when the doctor is informing the patient about what heart surgery will be like.  I think it needs to be given more consideration and that patients need to be told that it’s a completely normal thing that happens after such a big surgery.  Not dealing with it can impede healing and recovery.  I was really pleased with how much attention she gave to this particular part of her experience.

Anyway!  Tilda very sweetly agreed to be interviewed!  I am really excited about posting an interview with her on codeblog.

How did you get started writing books?  Did someone come across something you wrote and suggest you write/publish a book?  Or did you write a book and send the manuscript to agents?

I had been writing for many years before I got published.  Taking writing courses, sending my manuscripts out, and receiving numerous rejection letters from publishing houses was the extent of my writing hobby for years.  In 2004, I got a lucky break when I sent my true stories of being an ICU nurse to one of Canada’s top publishing houses, McClelland & Stewart.  To my surprise and shock, they offered me a book contract on the spot.  They said it was a new perspective, a real insider’s view.  Well, who better to provide that than a nurse, I thought?  I hope with A Nurse’s Story and my other books, that I’ve opened a door to more nurse writers to get their stories out.

Have you always been a writer or is it something you started doing as an adult?

Yes, I’ve always been writing, recording my life and observations, but it was only in the last few years that I have been published.  It took me a long time to be ready to share my stories with the public.  I had a lot to learn about the craft of writing.

Many nurses haven’t published books – what is something we’d find surprising about being a nurse author?

The most surprising thing I’ve learned from being an author is not how many amazing nurses’ stories there are – I knew that – but how few are actually undocumented.  Nurses aren’t speaking up enough and thus their voices aren’t being heard. I hope I’ve started a trend with writing about my nursing life.  Other nurses love to read these stories and the public needs to know what we do. It’s a matter of their health and safety to understand more about the roles and responsibilities that nurses have, otherwise, misconceptions and stereotypes can flourish.  Otherwise, we also run the risk of being invisible and completely overshadowed by doctors who traditionally have had a lot more power and stronger voices.

You mention your coworkers and friends many times in the book – do you use real names?  How do they feel about being mentioned?

Yes, I use real names of friends/co-workers and usually ask their permission to do so.  So far, no one has objected, and most are pleased, or at least in agreement with what I’ve said about them.

Do you do a lot of book promotion (signings, readings, etc)?

Not much book promotion per se, but a lot of speaking to groups of nurses, doctors, and the public at large about what nursing is all about.  Now that my new book, Opening My Heart is out, I enjoy speaking also to patients.  I love to be invited as a guest speaker and wherever I am invited, I am thrilled to go.  Also, I enjoy connecting personally with nurses on my Opening My Heart Facebook fan page and one-to-one emails through my web-site – www.NurseTilda.com.  That’s truly the best part about being a nurse author – connecting with other nurses.  If anyone writes to me, I always write back, usually in a day or two.

Do you have marathon writing sessions or do you write a little every day?

Both!  I love the opportunities to immerse myself in my writing world for extended periods of time, but for an hour in the morning after a night shift, or on a day off from work, in between household responsibilities and being with my kids – two boys, 16 and 14 – I squeeze in some writing, too.  If you wait for the perfect conditions for writing, you might not ever do it.  You just have to plunge in amidst the chaos of a day.

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I thought Opening My Heart was a great read and I recommend it.  And thanks to Tilda for taking a few moments out of her day to answer some questions!

 

(My post about this project and a list of interviews done so far is linked here.)

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Interview: Cardiac Cath Lab Nurse

Ready to learn more about nurses who work beyond the bedside?  Nurses who work in the Cardiac Catheterization Lab (CCL) play an important role in cardiac care.  Amy Sellers, RN BSN CCRN CSC CMC blogs at Nursing Influence and graciously agreed to give us a peek at what a nurse is responsible for doing in the CCL.

Amy has worked in the Cath Lab for about 6 months now.  She previously worked in CVICU for almost 5 years before deciding that she needed a new challenge.  She is paid hourly and works three 12 hour shifts per week (all daytime Mon-Fri) with lots of opportunities for overtime and call shifts.

A cath lab is an area of the hospital that uses fluoroscopy and contrast dye to check for narrowing/blockages in arteries or veins in the body. Using special equipment, they are able to perform angioplasty (open the arteries with a balloon), place stents, insert IVC filters (a filter that is inserted into a large vein which prevents blood clots that form in the leg from getting to the lungs) as well as inserting pacemakers/ICDs.  ICDs are Implantable Cardiac Defibrillators.  They detect if a patient’s heart goes into a lethal rhythm and provides a shock to the heart if necessary to get it beating correctly again.

What do you do all day?

I care for patients, of course!  We have 5 cath labs and we have at least one nurse assigned in each lab (a 2nd nurse may be assigned to that room under the role of “scrub”, meaning they prepare the sterile field and assist the physician during the procedures). When I’m assigned to the nurse role, I am responsible for all things related to patient care & medications during all of the day’s procedures. After the physician arrives, I am responsible for administering conscious sedation, performing all of the charting during the case, monitoring patient status during the procedure, as well as giving any emergency medications that may be needed during the case.

Amy says she loves the direct impact that she’s able to have on a patient’s life. For example, patients come in to the cath lab from the ER actively having a heart attack. Within minutes, her team is able to locate the blocked artery in the heart and open it up, restoring blood flow and improving the patient’s clinical symptoms.

“In addition the impact we have medically, I feel like I make a difference each day by helping to calm the nerves of our patients undergoing this procedure. Most patients are pretty nervous as we wheel them into the lab and I really take pride in being able to talk to the patients and help them through education or just small talk.”

Do you feel you receive adequate support for your responsibilities?

I feel like I get a great deal of support from everyone in the team, from the physicians, to the radiology techs, to the scrub techs. It’s the combination of everyone’s skill and experience that makes the cath lab run so smoothly and helps to back up the growing skills of a newbie to the cath lab (like me).

What is something a nurse who does not work in your particular field might find surprising about your job?

I love the positive relationships that the staff in the cath lab have with the cardiologists. Working in the CVICU prior to the cath lab, I felt like I had a good relationship with most of the physicians. They would listen to the observations and suggestions I made about my patient, leaving me feel like I was making a difference for my patients. The relationship between staff and physicians in the cath lab is much closer; it truly is a team. Physicians ask for, and accept, suggestions from staff as far as the best equipment to use for a particular case or which vessel is more crucial to fix before another. Physicians and staff get to know each other to the point that it feels like a second family – they ask each other about their children’s school plays, volunteer activities they’re involved in, etc.

Amy says she finds that she does accomplish her responsibilities in the time frame she is given:  “Working in a procedural area makes this easier as cases are scheduled within a set time frame. When emergencies happen, we have a 3-person call team available at all times during non-work hours.  Working in the cath lab is 100%, without a doubt, a job that requires a great deal of teamwork. Without one of the essential staff members, a case could not be done.”
Was there any extra training besides on-the-job learning that you were required to complete for this job?

As a cath lab nurse, there is no specific training, but experience in the cardiovascular field is highly recommended as advanced EKG recognition and knowledge of hemodynamics are a big part of the nurse’s role. A nurse that is new to the cath lab will more than likely need about 2 months of orientation to be able to function safely and proficiently on his/her own.
One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom. Do you find that to be the case with your job as well?

I always have a few seconds between cases to use the bathroom…. but the problem of using the bathroom can happen during a case that runs unexpectedly long. As the only nurse in the room, we are unable to leave. So, at that point, I’m thankful for the bladder control I developed during my days in the ICU. :)

Thank you, Amy, for sharing what it’s like to work in the Cath Lab!

 

(My post about this project and a list of interviews done so far is linked here.)

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Interview – Nurse Journalist

For this interview, I sent Jamie Davis some questions.  Jamie is the force behind the website The Nursing Show. Jamie’s primary background is in emergency care both as a nurse and a paramedic.  He currently works as a nurse journalist hosting multiple online radio and TV programs on the ProMed Network.

Before he started working in the health care field, he pursued and achieved a media and journalism degree.  He worked in both studio and field production for TV, independent feature films, and on training and industrial videos.  He eventually transitioned from that to a career as Mr. Mom before becoming involved in local volunteer emergency medical services.  He continued to pursue training for a career as a nurse along the way.

When podcasting became a viable programming option in 2005, he discovered that there weren’t that many regularly produced health care programs for nurses, paramedics, or other health care professionals. He began the first of my many shows (the MedicCast) in late 2005 and the Nursing Show was started in 2007.

He has since started the ProMed Network as a location to bring together the best independent health care programming for and by health care professionals in all fields.  With over 40 shows on the network from a variety of disciplines, it is now one of the premier locations on the web for high quality online radio and TV style programming in the health care arena.

What do you do all day?

I spend a lot of my day working on staying up to date on what is going on in nursing and health care worldwide. I record 5 weekly programs on nursing and EMS topics that include discussions and news overviews and I have to be able to spot trends and hot stories each week.

I also spend a lot of time mentoring and educating others about online media, social media, and using them in relation to a business and health care practice.  In addition to this mentoring work, I am proud to be able to work with several corporate partners to help them create their own high quality medical content. These include Physio-Control, Inc. and Johnson & Johnson’s Campaign for Nursing’s Future (DiscoverNursing.com).

I record shows two days a week for editing and release on their respective release days later.  I currently work almost entirely from a home based studio I built myself slowly over the last 6 years. I also am able to employ my children in the “family business” and it gives them a steady job with more flexible hours than most teens can find. I’m looking forward to the fact that because my business is online, my son will be able to continue to work with me while away at college next year.

I continue to be active in my community, volunteering as both an active paramedic and an nurse in various capacities.

Jamie has been involved in nursing for 6 years and was an EMT and paramedic for 10 years before that.

He loves being able to care for patients in some very special ways. While he enjoys the face to face patient contact he gets in his clinical activities, he is most excited about the opportunities he’s had to influence and instruct so many in the nursing and health career fields via his programs. He says he is passionate about providing high quality patient care and improving outcomes and believe it is important to spread news and information via online programming targeted at health care professionals like nurses.

What frustrates you about your job?

I wish I had more time in the day. As an entrepreneur who has built a business with very little starting capital and expanded slowly, I have to be careful about how I spend my time. While I’m working on several exciting partnerships and enjoying a lot of success, there is so much I’d like to do.

As advertisers in the nursing and health care marketplace begin to move in to supporting and advertising on our programs, I hope that the podcasters and hosts on the ProMed Network (myself included) can expand the scope of their content and continue to create a 24/7 resource for high quality, trusted programs in their fields.

What about your job makes you proud to be a nurse?

It makes me most proud when I get an email from a listener or viewer who tells me about some way I influenced them to improve their patient care or their studies (in the case of students). When I cover a news item, I try to convey my commentary about why it’s important to the individual professional and how they might apply that knowledge in patient care and education.  When I hear that this goal carries through and actually works for someone, I’m ecstatic!

Do you feel you receive adequate support for your responsibilities?

Being the boss, I’ve got no one to blame but myself.  I will say that this is going to be one of the biggest issues for nurses moving forward. As we continue to have to work harder and harder to care for a larger patient load, workplace support is going to be vital for the nurse involved in direct patient care.

What is something a nurse who does not work in your particular field might find surprising about your job?

I think that those nurses whom I have helped to become involved in blogging, social media, or podcasting (creating online shows like mine) are most surprised at how easy it is to get started. When I tell someone that they can create their own webshow and talk to nurses worldwide for about $100 using their home computer, they are amazed. When I take the time to show them how easy it is to set up and do, it empowers them to begin sharing their nursing experiences with a broader audience and help more patients by default.

Are you salaried or paid by the hour? What are your hours?

As an entrepreneur, I’m salaried but it will vary from month to month.  Most weeks, I work about 40 – 50 hours. I’m paid through advertising and consulting revenue primarily.

While I started working on my programs alone, they have all become a team effort. I value the input from my listeners and viewers for their insights in to what is going on in their areas.  I also work closely with the team of programmers and hosts at the ProMed Network to continue to build the audience for everyone.

Was there any extra training besides on-the-job learning that you were required to complete for this job?

My B.A. in communications and training in the media field was instrumental in helping me work in the field I am today.  I think that one of the biggest strengths in nursing is the capability to carry your career in so many directions based on your passions and experiences. I don’t know of any others that provide that kind of range.  I truly apply my entire scope of learning and experience in my nursing career.

One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom. Do you find that to be the case with your job as well?

I have no one to blame but the boss when I work through meals (which I do too often).  In the hospital arena, and in my experience, this is largely based on an antiquated expectation and tradition that has no place in the current workplace. It is not healthy or productive to care for patients this way. Unfortunately, nurses are great at caring for others’ needs but not so great at caring for our own.  This needs to change and it is up to the nursing supervisory staff to change this paradigm and become advocates for their nurses.

Thanks to Jamie for giving us a glimpse into the world of nursing journalism!  If you are a nurse who works in a non-traditional setting and would like to be interviewed, send me an email at codeblogrn at gmail dot com. My post about this project and a list of interviews done so far is linked here.

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Interview – Correctional Nursing

Before we get to the interview, I have to say I’ve been fairly overwhelmed with responses to my request for nurses to interview.  I didn’t exactly mean for this to morph into an interview site, but I have had no interesting experiences of my own at work lately, and I have plenty of people to interview, so this is definitely going to become a regular feature.  I hope you like it.  I am having a blast learning all about the different types of non-bedside nursing.

For this interview, Lorry Schoenly at correctionalnurse.net very kindly answered my questions.

Lorry defines “correctional nursing” as nurses who take care of inmate-patients in jails and prisons.  She got the position by responding to an ad on monster.com when she was exploring new employment options.  She says that before reading the advertisement she didn’t even realize there were nurses in jails and prisons!  She has worked in corrections for 6 years.

So what’s it like to be a correctional nurse?  Lorry says she has many things to do – some days she may give medications in “pill line” (This is prison lingo for medication administration. The nurse is usually at a window or a special location in the pod or barracks. The inmates are lined up and report to the window to receive their dose of medications they have been prescribed) and other days she may be involved in sick calls.  This is where the nurse visits inmates who have simple illnesses such as a sore throat or a rash.

What frustrates you about your job?

It can be frustrating to not have all the equipment and resources that are available in the hospital. For example, there are no oxygen valves in the walls. We have to roll out a big oxygen tank if an inmate is in need. Equipment needs to be located from outside sources when needed. If we need an IV pump, it may take some time to get it delivered.

What about your job makes you proud to be a nurse?

I am proud that nurses are willing to provide care to the unloved and underserved. Inmates are often from the most disadvantaged of backgrounds. Jails and prisons are not always pleasant work environments. It makes me proud to see how dedicated some correctional nurses are to their patient population.

Do you feel you receive adequate support for your responsibilities?

Generally the support is there. It can make a big difference to have a good relationship with the custody officers and administration. Healthcare is not the primary mission of a jail or prison – safety and security is the main goal.

What is something a nurse who does not work in your particular field might find surprising about your job?

It is surprising how many dental issues nurses get into in corrections. Folks coming into a jail often have bad teeth and mouth infections. This isn’t really something you get exposed to very much in nursing school. You need to be able to differentiate a dental emergency from just bad looking teeth.

Lorry, as management, is salaried, but says that most correctional nurses are paid hourly and work 8 or 12 hour shifts.  As with all jobs, she has to set priorities in order to get everything done; the big things are completed but there are always things left on the to-do list for the next day.

Everyone has to work together to get the job done. Working as a team with the custody staff is important because they make sure the right inmates come to the medical unit for various appointments. Custody also makes sure you are secure when dealing directly with the inmates.

Her position required no extra formal training but the orientation did include security training, personal safety techniques and an understanding on inmate behavior.

One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom. Do you find that to be the case with your job as well?

One of the advantages of correctional nursing is that the pace is a little more manageable. Sure, there are days when it is difficult to get a break, but mostly things are organized enough to get to the bathroom and to actually get out of the medical unit to go to a meal.

Have you ever been scared of an inmate or attacked?

I have never been attacked by an inmate nor have I heard of a nurse attack in the system I worked in. I have been nervous on occasion. Some inmates just look menacing. I am especially careful to be in eye-view of a custody officer in those situations.

 

(My post about this project and a list of interviews done so far is linked here.)

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Interview – Director of Nursing

“NurseExec” is the Director of Nursing (DON) at a 120 bed skilled nursing facility that has a 50/50 mix of patients needing short-term rehab and long-term care.

After working in the OR as a circulator, she started out as a charge nurse in her current building, which entailed pushing a med cart and taking care of 20 patients.  After 9 months, she was promoted to Risk Manager and 3 years later became the Director of Nursing.

She starts her day at 7am by rounding on nursing units, consulting with unit managers on clinical issues, and dealing with grievances and employee issues.  She checks in with the charge nurses and CNA’s, checks shower rooms and utility rooms.  Then it’s off to Morning Standup with department heads, followed by clinical rounds with the interdisciplinary team to discuss new admissions, new orders, and a report for the last 24 hours.  Most days this is all followed with other meetings, lasting until 11 or so.

The afternoon is filled with reports, employee issues, clinical and education issues, pharmacy issues, and another rounding of patients.  She typically ends her day at 4pm.
What do you like about your job?

Every day is a different set of challenges, I have great benefits, and wonderful team to work with.

What frustrates you about your job?

People who know the right thing to do, yet don’t do it.  Makes me crazy!

What about your job makes you proud to be a nurse?

Meeting with residents, and hearing them say “So and So is a great nurse, I love being here”–that makes me not only proud to be a nurse, but proud of the staff member.

Do you feel you receive adequate support for your responsibilities?

I have a wonderful administrator who has been here as long as I have.  She and I are a great team, and we think alike.

What is something a nurse who does not work in your particular field might find surprising about your job?

Skilled Nursing Facilities are more regulated than any other industry (including hospitals) except nuclear power.  We have approximately 530 rules that we must adhere to on any given day, and that doesn’t include the state ones.  My first State Survey was an eye opener, that’s for sure.

Are you salaried or paid by the hour?

Salaried, with a clinical performance bonus.  Some days I come in early to catch the night shift, and some days I come in later to spend time with the 3-11 shift.

As the DON, does the buck stop with you?  Do you get called often on your off-hours to deal with situations?

Yes, the buck does stop with me.  It’s my license hanging on the wall, literally.  I have very competent unit managers and shift supervisors, but there are some things they need to call about.  I usually get a call every other day or so, including weekends.

Do you find that you can accomplish everything you need to do within the hours set for your position?

Some days are better than others.

Does what you do involve a lot of teamwork, or is it more of an individual job?

It’s more individual, with a lot of delegating and having the team follow up and get back to me on certain issues.

Was there any extra training besides on-the-job learning that you were required to complete for this job?

It was strictly on the job for me.

One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom.  Do you find that to be the case with your job as well?

Meetings on top of meetings get me.  I finally just excuse myself.

(I’m sensing a trend here.)

Thank you to NurseExec for her great answers.  If you are or know of a nurse who doesn’t have a traditional bedside job, email me at codeblogrn@gmail.com.  My post about this project and a list of interviews done so far is linked here.

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Interview – Informatics Nurse

Ever wonder how all those hospital systems are created and maintained? (computer charting, systems to report data to national and state organizations, to name a couple)  Sure, they could hire some IT guy to run them, but everything seems to flow better with a nurse’s touch.  After all, we’re the ones using them all the time, right?  Jen C, RN, BSN almost MSN gives us a look into the world of nursing informatics.

Jen has been doing this job for 2 years.  She says she “stumbled into it” when she was interviewing for a new job and mentioned that she was starting her Master’s in Informatics.  Although she was hired to be a staff nurse, within 4 months she was working in Informatics.

What do you do all day?

Each day is different. I do a lot of troubleshooting. I go to a lot of meetings. I do system development and upkeep.  I listen to the nurses and what their issues are with the various systems. I do education. And I still fill in at the bedside (I’m still a NICU nurse at heart).

What frustrates you about your job?

Little definition and recognition as to what my job is. I often seem to be a catch all. I also don’t have a mentor. I’m the only one in my hospital that has formal education in this area and only 1 or 2 in the whole hospital.

What about your job makes you proud to be a nurse?

I still affect patient care. If I do my job well, the nurses at the bedside can do a better job of taking care of patients.

Do you feel you receive adequate support for your responsibilities?

No. I have no backup. I’m essentially on call 24/7.  And don’t get paid for that.  I can’t accomplish all I need to do within the constraints of my hours – I work at home too.  I am paid hourly for now while I’m in school.  I work 4 days a week 9-10 hours a day.

What do you get called about on your off-hours?

Case in point was this weekend. On Thursday night I got a call from the L&D charge nurse.  She told me that the patients weren’t appearing in the charting system they use. No one was moving out of the beds either, despite admissions doing it in their system. The charge nurse had already called the house supervisor who called IT and got nowhere…. So they called me. I was able to troubleshoot over the phone and call the right person in IT directly. Yesterday another charge nurse called me that there were two charts for a patient, and asked if I could fix that.

What is something a nurse who does not work in your particular field might find surprising about your job?

I know more about evidence based practice than most bedside nurses. You can’t expect staff to chart based on evidence based practice if the charts don’t support it. Recently I had to change the way our lactation nurses charted to support the evidence. I’ve done similar things for our neonatologists and gynecology nurses. Often I find out about the changes and pass it on to staff (who usually have no idea).  I also know far more than I ever wanted to know about rules and regulations and core measures. I have to keep my clinical skills sharp. If I don’t do the above, I can’t build an effective system.

Does what you do involve a lot of teamwork, or is it more of an individual job?

It’s both. The actual building of a system is a one man job, BUT getting to that point requires teamwork. I also need the staff to work with me in order to meet their needs.

Was there any extra training besides on-the-job learning that you were required to complete for this job?

You need to be trained on the system(s) you work on. It does help to have formal education in informatics. I see a big difference between myself and those who have no formal education. You get the “big picture” with the formal education.

One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom.  Do you find that to be the case with your job as well?

It depends. When the poop hits the fan, then no, but most days yes. Eating is another story.

What is nursing informatics’ definition of “poop hitting the fan?”

This is a very geeky answer, so bear with me. One system I support runs on a primary and backup server.  This past summer one server started to fail. In layman’s terms, the server is supposed to run on 4 wheels, we lost one, but it was ok to run on 3 wheels. In the middle of a very busy Sunday afternoon, the 3rd wheel blew, killing that server.

It was a hairy couple of hours while we configured everything to run on the one server. (Since it was Sunday I flew into the hospital to start dealing with it). Another time, one system wouldn’t talk to any other system and just froze up.  It was our fetal monitoring system, so it was a crisis.  I got very well acquainted with tech support that day.  We were down for roughly an hour (so no central monitoring for fetal monitoring).

Thanks to Jen for her explanations of what a nurse in informatics does.  Good thing we have someone on the IT inside :)

(My post about this project and a list of interviews done so far is linked here.)

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  • profileI am Gina. I have been a nurse for 15 years, first in med/surg, then CVICU, inpatient dialysis, CCU and now hospice. This blog is about my experiences as a nurse, and the experiences of others in the healthcare system - patients, nurses, doctors, paramedics. We all have stories!

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