A Thank You to Nurses

[Sorry for the delay in getting this up. We ran into some problems with Blogger, our blog host. Thanks for understanding!]

Over the years throughout my journey into the health care industry I have been lucky enough to meet hundreds of nurses, maybe even thousands. Sometimes they pick me up at airports and drive me back to their hospitals. They give me hospital tours, taking me from floor to floor, introducing me to their nurse friends along the way. I have lunch with them. We sit in meetings together. Most of the time I meet them at patient safety conferences where I am a speaker. The nurses are the ones sitting in the front rows, who come up to me after I speak, shake my hand, give me a hug and tell me their own stories of medical errors. They tell me about their patient safety work- the things they are doing to make care safer on the unit.

I am grateful to nurses for many reasons, first of all, for the simple fact that they are nurses. They wake up each day and go to work with one goal in mind- to make someone’s life a little better. They work long hours and are on their feet all day or all night. Sometimes they are short staffed and have to work extra hard. They are being pulled in a million different directions, but they seem to do it all with a smile on their faces. Wherever I go, I always come home with little tidbits of wisdom that I pick up from the nurses I have met:
-When you are on your feet for long hours like they are, the most comfortable shoe is a good quality tennis shoe. The Skecher brand is a favorite, especially the kind with the curved sole. Several nurses I’ve met call them “butt-lifters”. I bought a pair for myself and have not noticed the butt lifting aspect of them, but they are very comfortable. Birkenstocks are also popular, as are the Dansko clogs, which seem to be worn more often by the OR nurses than the floor nurses.
-When I was in Ohio I met a nurse named Mary. She had the prettiest, whitest teeth, so I complimented her on them. She laughed and told me she used the Crest Whitening Strips. A week after I returned from my visit she sent me a package with a box of the advanced formula strips. I’m not sure if she sent them because she thought I needed them or just to be nice- maybe a little of both. I have been using them everyday for a month now, and I really do notice a difference.
-Once I was at lunch with some nurses in Dearborn, Michigan. Chris, the nurse next to me, asked how I was doing with all of the travel and work. I told her I was trying to step back from it all and that I hated leaving my family and that even when I was home I felt like I was working all the time. She suggested that I bake cookies when the children come home (it makes the house smell good and homey), put a flower next to the computer (so I could have something pretty to look at when I work), and to start using a crock pot (to save time on cooking healthy meals for my family). I did all of the things she told me to do, and I continue doing them- except for the crock pot thing. That never really worked out for me. Maybe I need to ask her for some good recipes.
-Sometimes when I am visiting hospitals there are medical terms I don’t understand- like c. diff or BPOC. My nurse friends always give me a thorough, easy to understand explanation.
-Nurses have taught me how to deal with stress and difficult situations. Exercise and reflecting on what went well, what didn’t go so well, and what can be done to make things better tomorrow are just two of the many recommendations they have shared with me over the years.
If I could do it all over again, I would like to join the ranks of this very noble group whom I greatly admire and who have taught me so much, not only about the health care industry, but also about life.
Thank you to all of the wonderful nurses who inspire us to be better, stronger, happier people. Thank you for all that you do for patients and their families. Thank you for your friendship to me and the Josie King Foundation. You are an honorable, humble, smart, wonderful, fun-to-be-with bunch and I am lucky to have met so many of you.
Happy Nurses Week.
Many thanks,
Sorrel
Read More

More Great Advice from Nurses

Hello again-

The rejuvenating tips from nurses on how to cope with work-related stress keep rolling in. I just wanted to share the latest bits of advice with you.
Keep ’em coming! Keep spreading the word about this project!
-Sorrel
“I de-stress by dancing at least once or twice a week. I love dancing – it is something that helps keep me sane and gives me something to look forward to outside of work. One tip for work stress: Don’t take things personally. If a patient/colleague/family member/MD snaps at you, it’s not you – they are stressed out too. I find laughing defuses the situation – it helps them relax. It also prevents me from getting angry – which would just escalate the situation. Yeah, don’t take things personally is the best advice I’ve been given. I also vent to my nursing colleagues – it helps to know that other people are sharing your pain.” – C. Rae
“Take a moment everyday to reflect on what went well, what didn’t go so well, and what you can do better tomorrow.
Always take a moment to take a deep breath when the world is moving quickly by you and you can’t keep up. Who knows your speed might be what everyone should be moving at throughout the day.
Baking fresh treats for your co-workers is the best medicine and always makes a nurse’s day brighter.” – Sheryl C., RN, MSN, Washington, DC
“I find that in order to care well for others, I must first take care of myself. Without my health, I wouldn’t have the strength to perform the hard work nursing requires. Daily exercise and good nutrition are essential to helping me cope with stress. I love group fitness classes, weightlifting, and ‘clean’ eating!
I also set aside one night a week to relax and have a date night with my husband.” – Kathryn A., BSN, RN, South Lyon, MI
“As a NP I try to remember to always thank everyone for helping me to help my patients. It really is a group effort. And thanking people is a great way to defuse stress as it makes people feel appreciated. Surprising the staff every once in awhile with cookies or another treat goes a long way to making people feel appreciated. Praying with patients and staff is a great way to lessen stress.” – Kimberly B., MSN, CRNP, Pittsburgh, PA
“I know that it sounds sappy but…I try to appreciate all the good things, my family, my health, my job, etc. I don’t want to be in the position (like some of my patients and families) of having regrets (the could of, should have syndrome) in life. I am not waiting for retirement to care for myself, to tell my husband or children that I love them, or to just be in the moment. Life will probably always be too short but my glass is more than 1/2 full.” – Maureen
“I find good friends to be the best stress relief. I love my coworkers and we go out regularly to debrief about work and personal lives. I also value my non-nurse friends that I don’t talk about work with. They help me remember there is more to life.” – Anonymous
“We go through so much each day. I have been a nurse for many years, most in the Baltimore area. What really helps me is thinking about how the families and patients feel, particularly after losing a child. Sometimes we get so wrapped up in the technology and what we have to get done each shift. However, when I start feeling that way, I think, if this was my family, how would I feel and what can I do to make it better. That is how I cope.” – Joanne M., RN, MSN, NE-BC, FABC, Newark, DE
Read More

Nursing Project Update

Thank you to all of the nurses who sent us their words of wisdom on how they deal with work-related stress. We are compiling these tips into a toolkit specifically for nurses. This project is under development.

Below this note are some of the great comments we have received. Please take a look. I hope you find them as helpful and inspirational as I do. Please, please keep the comments coming and spread the word to other nurses who many have a helpful tip they want to share. Remember, you can post your advice directly on the blog, or you can send an email to nursing@josieking.org.
Thanks, too, to everybody who has helped us spread the word about this project. Your efforts are really making a difference!
-Sorrel
“Having spent most of my nursing career working in Adult ICU, I find that staying ‘grounded’ literally helps keep me sane! I like to spend time outdoors – whether trout fishing on a beautiful stream or lake, working in my yard or garden, or just taking a walk really helps puts things in perspective. I especially find sharing time and talking with my family helps maintain balance.” – Tamma
“I think my staff is just the greatest. When our work life becomes very challenging I like to have lunch with the staff and catch up on what is happening in their home life. It does help maintain balance. We have mini “Lunch and Learns”; we lunch and learn that life does not have to be all serious.” – Mary Ann, Pittsburgh, PA
“One of the things that I feel has the most impact on helping nurses to cope with the everyday stress is the fact that we are a team of professionals and when push comes to shove, stand together and help each other – basically we are each other’s counselors. We openly discuss our feelings with our co-workers and cry together while giving each other hugs and letting each other know we are here and that we all understand what each other is going through. That kind of support is not felt in many other professions. We are a team of support and care for all!” – Tracy N., RN, BSN, MSN, Pittsburgh, PA
“Learning to de-stress, by spending time with my daughters or just me by reading a good book or going for a run with my dog. In my dream world every healthcare facility would have a gym and a massage parlor to help encourage all healthcare workers to take a moment to de-stress so we can think clearly.” – Kimberley S., RN, Ontario, Canada
“I try to look for the humor in an otherwise difficult situation, to make myself laugh and others laugh, and to remind us all to not take ourselves TOO seriously. Laughter IS the best medicine and a unifying force in the midst of stress.” – Sue
“I’m an optimist and try to maintain that optimism while working in a ‘negative’ or stressful environment. I like little quotes that I can hold onto. Sir Winston Leonard Spenser Churchill states, ‘A pessimist sees the difficulties in every opportunity, an optimist sees the opportunity in every difficulty.’ Thoughts like Churchill’s keep me going. Here is another one: ‘In order to succeed, your desire for success should be greater than your fear of failure,’ from Bill Cosby.” – Laura S., Lewes, DE
“I love to sew- especially baby quilts or crafts. While I’m sewing, I’m thinking about the new baby- and am always amazed by the miracle of new life and I know I have the opportunity to touch ‘life’ while I work. I am filled with wonder!” – Anonymous
“As a pediatric nurse, some days are definitely better than others. When the stress seems like it has taken over my life some strategies I use to cope include; having a good hearty belly laugh in the company of good friends, taking a trip to the playroom for some BINGO with the kids during a break, and remembering to step back for a minute to remember WHY I am a nurse and what my purpose is.” – Alicia
“I recently started beading and I love to see what my imagination can create. I also have done scrapbooking for many years. I love to recall the memories of the event. I have recently been asked to teach scrapbooking to middle school age children who attend after school activities programs.” – Lori
“I started exercising. Now to burn off stress, I run. In fact, I am running my first 5k this spring. I am also a bit (45 lbs) lighter, which is great, too. I feel so much better now that I have consciously taken my stressors off of me.” – Elizabeth, Michigan
“Exercise always makes me feel best – I love riding my bicycle and get together with a co-worker that lives close by. We’ll get together and chat and ride at the same time. I belong to a hiking/biking group. If I can get to a hike or ride once a week, I’m happy. The rest of the time is spent walking my dog when I have time to get out.” – Dorothee K., Pittsburgh, PA
“I think stress relief depends on the energy needed to be expelled or reversed.
When I need to de-stress and calm down, walks in the forest and on the beach of Lake Michigan can be the best (especially with the dog). Other calming activities have included yoga, reading a novel by the fireplace, and cooking with family/friends.
The other spectrum, of energy “release” needs, can be best met by a workout at the gym, working in the yard, cleaning the car or the garage, and my favorite of all, is going out after work with a fun group of friends for munchies and cocktails (try to do that every couple months!).” – Todd K., RN, Holland, MI
“As a pediatric nurse working in ICU and the Peds ER for over 25 years I have seen more than a lifetime’s share of tragedy and sadness when children are severely injured or killed. I have found peace in the ability to return to work to face another day only through the faith I have in God. I try to pray every day. I especially pray during a code – for the doctors and nurses administering care to the child, and for the parents. I found taking a walk or a drive and being quiet with God allows him to minister to my heart and heal me.” – Ann D., RN, Copiague, NY
“My faith has carried my through my nursing career for 30 years and it has never failed me. Surrounding myself with my family and a few close friends has also been very important in coping.” – Sandy
“I cope by listening to those who trust me enough to share their pain. Just by having someone open their heart to share the pure emotion, all of my stress seems to melt, and I find myself feeling very thankful and at peace with my life.” – Anonymous
“Personally, I make sure I stay in contact with those I love the most during the week. My children and grandchildren all live out of town. A phone call to any one of my grandchildren always lifts my spirits. Their energy is contagious, even over the phone.” – Kathy, Harper University Hospital
“I take my dog on a long walk and then once home drink a large glass of ice water to flush out any remaining stress hormones.” – Shelley, RN, Pittsburgh, PA
Read More

Needed: Advice from Nurses

I need your help. We’ve been struggling with something here at the Josie King Foundation. Here’s the deal: we are creating a toolkit for nurses, something that will help nurses cope with the stresses of the job, something that will make their days a little better, something that will let them know how much we appreciate them. I know lots and lots of nurses. I’ve seen them at work in hospitals around the country. I’d like to think that I sort of have a notion as to what it must be like to be a nurse, but the truth of the matter is- I don’t REALLY know.

So, I am asking all of you wonderful nurses to help. Here’s what I’m looking for: quick tips on how to cope with the challenges of being a nurse. What do you do that helps you do your job well? What have you discovered that helps you deal with stress? It could be anything like:

  • “Once a week I buy fresh flowers to put in the nurses’ snack room.” – Sandy K., RN, Grand Rapids, MI
  • “When I come home after a long day on the job, I like to bake cookies with my eight-year-old.” – Sue S., RN, BSN, Tampa, FL
  • “I just started walking for forty minutes every day with my neighbor. It really helps clear my head, and my jeans fit a little better.” – Tamara M., RN, Houston, TX

Please post your tried and true tips below. You can also email your tips to nursing@josieking.org. We want to collect and share your great ideas with other nurses. If you would like to, please include your city and state, too.

I’ll be sure to share updates on this project as it progresses, but right now we need as many tips as possible from nurses. Spread the word to your nursing friends and colleagues, and have them post their tips, too.

Thanks so much for your help with this, and for all of your hard work with patients,

Sorrel

Read More

Josie King Foundation and the Johns Hopkins Hospital Department of Nursing Patient Safety Heroes

On Wednesday the Josie King Foundation and the Johns Hopkins Hospital Department of Nursing recognized nine nurses, one clinical technician and one support associate for their work in patient safety at Hopkins Hospital. These professionals were nominated by peers in their unit for their outstanding work and are true patient safety heroes. I’d like to introduce them:

 

Maxine Bell-Trusty, Support Associate – Neurosciences

Maxine has taken a special interest in preventing hospital-acquired infections. She is what the literature calls a “positive deviant”- someone who does the right thing and is an agent for good. She single handedly advocated for two new practices in the Neuro Critical Care Unit: 1) using a fresh rag to clean each separate piece of equipment in isolation rooms and 2) requiring terminal cleaning of the patient’s room once they were taken out of isolation. We know from lab cultures that Bell-Trusty has reduced the prevalence of multi-drug resistant organisms on her unit. While we often worry that the “bugs” are winning, Maxine has won the battle in her unit.

 

Kelly Creighton, BS, RN – Medicine

After a serious event involving a monitor alarm in 2006, Kelly’s unit set out to improve the safety of patients on physiologic monitors. They determined that 27,000 alarms were set off on their 15-bed unit every 24 hours- that’s one alarm every three seconds. Creighton worked with her committee and the Clinical Engineering team to improve the situation, reducing “nuisance alarms” by 26%. Kelly literally took the noise out of the system, so that nurses could respond more quickly to patients in trouble.

 

Catriona Henderson, RN – Oncology
As part of her night shift routine as a charge nurse, Cat reviews all lab values for the patients on

her unit. She found inexplicable changes in a number of patients’ sodium values. So she followed her instincts (and her intellect) that something was wrong with the laboratory findings being reported in a large series of patients. Working with the lab, an investigation found that more than forty patients in the Cancer Center had incorrect sodium calculations made. But thanks to Henderson’s astute observation and quick action, only one patient was treated for the incorrect results (without any adverse effects).

 

Vicki Jackson, Clinical Technician – Emergency Department

Vicki championed doing “re-vitals”- that is reassessing patients in the emergency department. In the past two years, she identified significant changes in patients. One was having a heart attack, and the other a stroke. Because of Vicki, these two patients received the required treatment from the heart attack team and the brain attack team earlier than they would have. When minutes count, Jackson’s vigilance was life-saving.

 

Sara Nakamoto, RN – Gynecology and Obstetrics

Sara is a new graduate who joined Hopkins in March 2008 and she has already demonstrated an aptitude for promoting the safety and well-being of the very ill patients under her care. For example, Nakamoto discovered that a pre-mixed IV solution had one medication label applied over another label. The IV bag actually contained the solution noted on the hidden label, and this drug was contraindicated for the patient. Nakamoto’s patient had impaired renal funcation with only one kidney, and could have suffered significant complications had the drug been administered. For this patient, Sara was a hero.

 

Liza Raymundo, BSN, RN – Ophthalmology

Working the tail end of the night shift, Liza was preparing a surgical patient as the first case for the operating room one morning. The patient complained of not feeling well. Liza assessed the patient, whom she identified as having symptoms indicative of an impending stroke. She organized the ophthalmology team and facilitated the patient’s transfer to the Emergency Department where the required treatment was rendered in a timely fashion. Her quick assessment and critical thinking provided an immediate intervention so that the patient with an impending stroke was managed in a controlled environment.

 

Kathleen (Kathy) Robertson, MSN, RN – Surgery

The Hospital has been implementing an electronic provider order-entry system requiring all physicians to enter their orders online, and all nurses to document administration of medications in an electronic record. While the system was designed to be safer than paper-and-pencil versions, it was not fail safe. Robertson orchestrated the collaboration between physicians and nurses that was needed to develop the order sets, and implemented the change across the Department of Surgery. Many safety issues have arisen during this process. Robertson monitors these, and drives safety issues to the top of the priority list for system modifications. While many of our safety heroes have prevented individual patients from being harmed, Robertson is working to make the whole system safer.

 

Gloria Scott, BSN, RN – Pediatrics

On a unit where children and adolescents are treated for psychiatric illnesses that cannot be managed safely out of the hospital, security is a critical concern. Gloria Scott worked with the Pediatric Safety Team to add a security officer to the unit. The lay security officer could maintain a presence at the front door; identify visitors to determine if they are authorized; check visitors’ belongings; and lock away valuable or unacceptable items. However, the security officer was also needed to help with patients in a clinically appropriate manner. Scott explained the unit to the officer, taught the officer how to handle patients, and otherwise implement this new role.
Because of Scott, the environment is secure and the patients are safer.

 

Melinda Walker, RN – Psychiatry

The stories about Melinda are legion. In summary, she “sees” problems and fixes them. To give one example, Walker recognized a set of safety concerns in the electroconvulsive therapy (ECT) suite. She subsequently prepared a 30-minute educational program covering how to prepare patients for ECT; transport anesthetized patients safely; and maintain a smooth flow of patients through the recovery phase. Her educational program has been incorporated into the annual review that all RNs must complete. Walker is a safety hero for preventing harm from befalling
her patients.

 

As you can see, their work covers the gamut from actually saving a life to improving the systems so that errors can be caught before it is too late. Each had a different story to tell, but one thing that they all had in common was that in going the extra mile, in going beyond the call of duty they often faced push-back. They each persevered and fought for what they truly believed needed fixing. Some of these system changes have been adopted in other units, some will be published in medical journals, and I believe that all of them will make care safer for the patients of Johns Hopkins. It was an honor to acknowledge the work that they did- not to receive awards- but because they were simply compelled to do what they felt was right. I know that Karen Haller, Vice President of Nursing and Patient Care Services at Hopkins, joins me in sincerely thanking them for their commitment to patient safety.

(Thanks to Hopkins for providing the safety heroes’ stories!)

Read More