A strong connection with an anesthesiologist at the mechanic shop he worked in inspired Chris Graham to pursue nursing school, but little did he know that years later, he would inspire his son to do the same thing.

Graham, a 48-year-old resident of Baton Rouge, walked across the stage to graduate from Our Lady of the Lake College in 1999, and a few weeks ago, his second son, Stefin, accomplished the same feat when he received his diploma from the newly dubbed Franciscan Missionaries of Our Lady University.

Chris serves as the director of Nursing at Jefferson Oaks Behavioral Health, and Stefin has been hired to work in the intensive care unit at Our Lady of the Lake Hospital.

In 1995, Chris was working at BMW of North America as a mechanic, married to a schoolteacher and the proud father of two sons, but he knew that eventually he wanted to pursue another career path.

Although he didn’t know exactly which field he would pursue, Chris began taking prerequisite courses at night while working a 40-plus hour workweek at the mechanic shop.

It wasn’t until he struck up a relationship with a local anesthesiologist who became a regular at the shop that he decided to turn toward the medical field.

“I said, ‘Doc, I can’t go to nursing school with these kids,’ and he said, ‘Aw, yeah you can. Just put your mind to it.’ Long story short, I ended up registering at Our Lady of the Lake College, and in 1996, I took my first nursing class,” Chris said.

Being accepted into the program was only the first of many hurdles he had to overcome on the long road to graduation.

“Once I got accepted into nursing school, we had two more children,” said Chris. “My wife, Jeri, was a full-time teacher, and I quit working for BMW North America and put all my efforts into nursing school. At that point, I became a stay-at-home dad, and we went from having my six-digit salary to living on a teacher’s salary, which was tough with four kids and a house. Somehow, we got through it, though, and I love what I do.”

Chris’ hard work did not go unnoticed, since he was the first person to receive the Dr. John Beven Award for graduates who exemplify the art and science of nursing, and years later his second son, Stefin, chose to pursue the same career path.

Stefin said, “I was maybe 8 or 9 years old when my dad graduated from nursing school, and I didn’t realize what a big feat that was until I was older. He didn’t just have me, he was also taking care of my two younger brothers and my older brother, so he graduated nursing school with four kids.”

Although watching his dad was inspiring, for Stefin, the decision to pursue nursing was solidified while doing service hours as a high school senior.

Stefin said, “When I was in high school, I had to do service hours, and my dad helped me get those by bringing me with him to work. He worked in a surgery center, and I would go with him to see the patients. I loved seeing what he did as a nurse, and I felt like that was the type of trade I could enjoy and pursue.”

Growing up, Stefin always felt drawn toward caretaking roles, so the unit he chose to work on was a natural fit for him.

Stefin said, “I feel like I was always called to be a caregiver to other people, and my faith teaches me that in serving others we are served. About halfway through school, we did our ICU rotations, and I really fell in love with it. You get to take care of the most vulnerable patients who often can’t speak for themselves.”

The nursing legacy of the Graham family will be continued when the fourth Graham son, 18-year-old Austin, starts classes in the fall at Franciscan Missionaries of Our Lady University.

For Chris, seeing his sons follow in his footsteps is an honor unmatched by little else.

Chris said, “It makes you wonder: Did they mimic and learn from me, and did I help to encourage this somehow? I teach my children to go after their own aspirations, not what other people tell them to do, so it’s been humbling to see them pursue nursing.”

A grant from the National Science Foundation has led engineering and nursing students at Duke University to create a robotic “nurse” to assist human nurses, according to an article published in the News & Observer. The robots are being tested as “alternatives to human contact to diminish risks for providers,” who are caring for patients with infectious diseases.

The first-generation robot called “Trina” (Tele-Robotic Intelligent Nursing Assistant) can perform tasks, albeit clumsily at present, such as delivering a cup, a bowl, pills and a stethoscope to a patient. Its face is a computer screen on which an actual nurse’s face appears.

In the fall, students conducted a simulation with a fake patient using the remote-controlled robot, which has a price tag of $85,000.

Plans for the next generation of Trina include giving her a “more friendly and human-like appearance” and enabling her to collect and test fluids, the article stated.

“We need to establish a better interface with the human and the robot to make them work together and be more comfortable,” Jianqiao Li, engineering student, said in the article.

A Business Wire article stated that by 2021 robots will be a growing presence in the healthcare system, surpassing 10,000 units annually.

“More than 200 companies are already active in various aspects of the healthcare robotics market,” said principal analyst Wendell Chun, in the article. “These industry players are creating highly specialized devices for a wide range of applications, and the use cases will continue to expand as costs decline and healthcare providers recognize the early successes of robots in supporting high-quality care and a range of ancillary services.”

MIT has been teaching robots to assist nurses with scheduling. A robot can observe humans working on a labor and delivery floor and then formulate an efficient schedule for staff, according to the July 2016 MIT News article.

Nurses’ positive comments about the robot included that it would “allow for a more even dispersion of workload” and that it would be helpful to new nurses who are acclimating to their roles.

“A great potential of this technology is that good solutions can be spread more quickly to many hospitals and workplaces,” Dana Kulic, an associate professor of computer engineering at the University of Waterloo, said in the article. “For example, innovative improvements can be distributed rapidly from research hospitals to regional health centers.”

Another robot project funded by the NSF is developing robots to help nurses lift patients and heavy objects.

“The proposed Adaptive Robotic Nurse Assistants will navigate cluttered hospitals, while equipped with multimodal skin sensors that can anticipate nurse intent, automate mundane low-level tasks, but keep nurses in the decision loop,” according to an award abstract. “Modular and strong hardware will be deployed in reconfigurable platforms specially designed for nurse physical assistance.”

Related Article: A Robot Delivers Meds at Dana-Farber

For many nurses, the time between November and February tends to present times that could offer fun and stress relief. However, for the exact same reasons, stress can mount from various sources.

We look forward to seeing family. Cooking those once a year dishes, to share with others, can invite lifelong memories. Of course, juggling work into the mix is part of the everyday life of a nurse. Then time starts to meander through the calendar of various holidays. A churning stress starts to invade our peaceful thoughts of how events were meant to unfold.

Circumstances can create challenges. A nurse’s schedule is most likely already established before the holiday season arrives. Then reality happens. Family members may alter plans that interrupt a fluent strategy for what happens when. Speaking of schedules, as a nursing supervisor I recall many schedules that were constantly being adjusted depending on staffing needs and various circumstances.

Then that moment arrives. Exhausted and stressed from feeble attempts to micromanage potential new memories, you hear a still small voice in your head say, “I just cannot wait for the holidays to be over.”

Perhaps there may be a side step of planning that helps to keep things in perspective.

A survival strategy could include the following:

1. A calendar.
2. Lists.
3. Willingness to adjust and let go.
4. Breathe.
5. Appreciate moments as they happen.

It all starts with a willingness to be realistic. Planning for all meals, all favorite desserts, all family gatherings... definitive word is “all”... is overwhelming. However, prioritizing may help.

1. Try making a comprehensive list of all you may like to do.
    
2. Then look at the list and mark each item how high a priority it is to accomplish.
    
3. For items that you cannot live without, be honest, and let this be known.
    
4. For other choices that are not as important, rank them lower. Maybe there will be time. But it will be much more rewarding if you are not stressed out.
    
5. Keep your calendar handy and up to date.

A vital tool for staying organized and focused on your priority items is the calendar. If you need to prepare something ahead of time, then schedule it like an appointment on the calendar so that time does not sneak away. If you run out of time, you may rush through an activity, thus experiencing less joy than you may have otherwise. Stress results when trying to fit too many tasks into limited time.

Anything that can be done ahead of time, do not wait until the last minute.  Mark your calendar with tasks that could be done by a certain date to stay on target to enjoy your plans. 

Remember this, when considering your wishes for the season, allow time just to treasure that thing we call “now.”

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An Orlando nurse who helped deliver a premature baby on a Southwest Airlines flight said she didn’t think twice about jumping in to help.

Baby “Jet” was born 14 weeks early on Sunday and remains in the Intensive Care Unit.

Loretta Bledose works on the business side at Orlando Health, but she was a nurse for 40 years.

That experience was crucial on her way home from a wedding in Philadelphia when a woman went into labor on her flight.

“She said, ‘My water broke. I’m pregnant. My water broke.’ I said, ‘How pregnant are you?’ She said, ’26 weeks.’ I said, ‘Oh, my God,’” said Bledose.

A flight attendant handed Bledose some gloves, and minutes later, the baby was born.

“There was a bulge there and I put my hands down and eased the baby out. She had a little two pound baby,” said Bledose.

A doctor on the plane also helped.

The baby wasn’t due until March 8 and had been cleared to fly by her doctor.

The mother is a nurse at Parrish Medical Center in Titusville, and Bledose said she remained calm throughout the ordeal.

“She kept apologizing, and I said, ‘Honey, this is out of your control,’” said Bledose.  

Bledose held the tiny baby in a blanket as the pilot diverted the plane to Charleston, South Carolina.

“I just kept praying, and every breath, I just kept saying, ‘Keep doing it baby, keep doing it,’” said Bledose.

When it was time for landing, Bledose was on her knees, holding the baby tight.

“I was just hanging on to mom and baby, and I said, ‘Just land, and we’ll be OK,’ and we were,” Bledose said.

The mother and baby were rushed to the hospital. Bledose continued on to Orlando, thankful she played in a role in what she calls a miracle.

“I believe that God puts you where you need to be. I truly believe that,” Bledose said. 

 

Thanks to a technologically advanced society and easy access to digital sources of communication, social media is becoming an increasingly effective, wide-ranging tool for nurses. However, with this resource comes great responsibility. As nurses navigate social networking sites, chat rooms, blogs and public forums, there is a dangerously thin line between professional and personal online etiquette. Health care employees must maintain patient confidentiality and privacy at all times, as well as serve as a positive representation of their place of employment. Inappropriate use of social media often leads to disciplinary action; and in the most serious cases, can negatively affect a nurse’s career and license.

Privacy Issues Regarding Nurses Using Social Media

“Nursing is a profession that is laden with risks related to disclosure of protected information,” says Jonathan Greene, social media expert and author of Facebook is a Pub Crawl: 15 Simple Strategies for Social Media Excellence. “For that reason, nurses have to be careful about anything that would violate HIPPA standards.”

According to the National Council of State Boards of Nursing (NCSBN), confidential information should be shared only with the patient’s informed consent, when legally required, or where failure to disclose the information could result in significant harm. Any breach of trust associated with a nurse-patient relationship has damaging repercussions, and often winds up hurting the overall trustworthiness of the nursing profession as a whole.

Breaches of patient confidentiality or privacy on social media platforms (whether intentional or inadvertent) can occur in many different ways, such as:

• posting videos or photos of patients – even if they can’t be identified
• posting photos or videos that reveal room numbers or patient records
• descriptions of patients, their medical conditions, and/or treatments
• referring to patients in a degrading or demeaning manner

A violation of patient confidentiality takes place as soon as a nurse shares information (or even the slightest bit of details – no matter how insignificant they may seem) over the Internet with someone who is not authorized to receive such information. Examples include reflecting on the severity of a car accident victim’s injuries, or even commenting on the number of medications that a patient has to take.

Beneficial Ways that a Nurse Can Use Social Media

With the ability to establish positive interaction and communication with patients (and their family), Debi Deerwester, DNP, FNP-BC, Chief Clinical Officer/Chief Nurse Practitioner Officer/Vice President of Clinical Operations at WhiteGlove Health, says there are many ways a nurse can utilize social media to a healthcare advantage, such as promoting the profession through educating the public.

Social media outlets and actions beneficial to nurses include the following:

• Blogging: “Blogging on the industry they love in a positive and thoughtful way, [nurses] can become subject matter experts,” says John Lincoln, of Internet marketing company Ignite Visibility. “Having an individual blog and social media presence shows their dedication to the field, helps them stay on top of trends in the industry and looks great to employers.”

He also suggests that increasing visibility through an online presence can help nurses get ahead in their career, which in some cases, could lead to a higher position and/or a raise.

In addition to promoting their value within the workplace, nurses can also use social media to promote their outside, health-related endeavors and interests. “Usually I reserve public posts about health care to try convincing colleagues to buy my books,” says Nick Angelis, author of How to Succeed in Anesthesia School (And RN, PA, or Med School).

• Twitter: Offering a popular real-time form of communication, Twitter is often seen as one of the easiest ways to maintain contact with people, especially in times of crises. From posting health safety notices to explaining drug recall information to answering emergency questions, nurses can provide quick responses and critical assistance to the public.

Twitter is also an effective way to create a health-related conversation with the public, or get a healthcare-related topic trending. “…nurses can probably capitalize on social media as an excellent tool for creating awareness about preventative health campaigns, general flu/pandemic information, educational tidbits…,” says Greene.

• Facebook:With the ability to leave messages (both public and private), upload videos, and post photos, nurses are able to connect with others on many different levels when using Facebook, and can also help bridge the information gap between health care providers and patients.

“There is an inherent need within healthcare to pass information on to a particular patient and to connect with a patient on a level that promotes not only biological health, but also psychological health and community health,” says Ben Miller, a student at Vanderbilt Law. “In this sense, a nurse Facebook messaging a teenage patient about medicine changes is easy and builds trust within the system.”

• YouTube: The visual and audio aspect of YouTube has a profound effect on a viewer’s understanding of health care, medical concerns, surgical procedures, and other treatments.

“I use YouTube to broadcast educational videos about anesthesia school…,” says Angelis. “In general, social media can be a positive force to enhance the role of nursing in the community and the perception of nursing among our friends and the public at large.”

• Discussion Groups & RSS Feeds:Social media also provides nurses with an outlet to connect with other healthcare professionals for personal, emotional, and educational reasons. From getting tips on how to cope with workplace stress to answering questions about advanced nursing degree programs, there are many nurse-specific online groups to join or participate in.

“Social media groups can provide support and help nurses stay positive even in hard times,” says Lincoln. “By following the right social media feeds on sites like Twitter, Facebook, Google + and LinkedIn, nurses can get the latest medical news.”

According to Greene, nurses who interact with others across social media channels also have an opportunity to “humanize the nursing profession.” Examples include spotlighting employer achievements, sharing nurse profiles, and providing one-on-one communication.

How Nurses Should NOT Use Social Media

“From a legal perspective, nurses using social media to reach out to patients pose a few major privacy issues,” says Miller. “Since most social media systems present security problems (in how they’re “built”, infrastructure, and/or how the user interacts with the specific social media system), open sharing of sensitive and confidential information leads to conflict with HIPAA.”

“Most of these social media systems (such as Facebook) are not as privacy forward as we believe,” Miller says. “Even something as simple as texting among nurses about a specific patient raises huge privacy issues.”

Also, social media platforms tend to create a false sense of security for nurses who often believe they are voicing their opinions, engaging in discussions, and posting images under the protection of privacy settings. Anything sent privately to an individual or posted on a closed forum has the potential to become public knowledge. Additionally, deleting statements and images from a social media account does not mean they have been completely removed from the Internet.

As a rule of thumb, nurses should not use social media to:

• Complain About or Comment on the Health of Patients: The American Nursing Association warns against making disparaging remarks about patients (even if they’re not identified) in order to avoid problems with social media. “Do not talk about how rude a patient is, how bad they look or unhealthy they are…it will find a way to leak out, and even if it doesn’t, it causes others to view you in less professional nature, as well as the institution you are associated with,” says Lincoln. “It can also damage others perception of your character.”

• Post Photographs of Patients: After posting a picture of a young cancer patient on Facebook, a nursing student was expelled from school, and the nursing program barred from using the pediatric unit for teaching after the administration was alerted. The hospital and patient were easily identified through the picture, which is a violation of HIPAA.

Even if a nurse gains permission from a patient to take pictures, employers can still take action. Despite getting the consent of a patient to photograph an injury, an emergency room nurse who shared the images on a nursing forum for learning purposes was disciplined even though the patient’s face was not visible; the type of injury made it easy to identify the patient.

• Rant About Place of Employment: Because of the nature of work that a nurse does, speaking negatively on social media about co-workers, administrators, job duties, their place of employment, and/or workplace policies can lead to disciplinary actions. These types of negative online comments also place a hospital or doctor’s office in a bad light, as well as jeopardize a nurse’s job security. Even when opinions are voiced under the strictest privacy settings, there is always the possibility that online commentary can reach unintended readers.

To minimize the chances of violating workplace policies, using a personal email address as a primary means of identification on social media accounts instead of an email address associated with a hospital or place of employment is highly recommended.

Additionally, when writing a blog or participating in online activities that have the potential to negatively impact the reputation (or go against the policies of a healthcare employer), avoid establishing a direct connection to the place of employment. For this reason, many nurses comment anonymously or write blogs using a pseudonym.

• Blow Off Work-Related Steam: Because of the visibility that social media platforms provide, Lincoln says it is critical for nurses to maintain composure and professionalism at all times.

“One of the most important things for a nurse to avoid is speaking negatively about a patient on social media,” he says. “This might seem like a no-brainer, but everyone gets frustrated at times and in many cases in medical situations, a nurse may feel overwhelmed.” Lincoln stresses to refrain from saying anything negative about “patient interaction, the prospect of patient recovery, or even just a general bad day on the job.”

• Use Offensive Language and/or Voice Offensive Comments: Since nurses work with a diverse flow of patients that come from a wide range of economic-, racial-, ethnic- and religious backgrounds, making social media comments that are threatening, harassing, profane, obscene, sexually explicit, racially derogatory, homophobic, or deemed controversial are often grounds for discipline at the workplace.

Social Media Policies

An increasing number of hospitals, medical facilities, and healthcare employers are developing and implementing social media policies, including the likes of the American Medical Association, the Cleveland Clinic, the Mayo Clinic, Vanderbilt University Medical Center, M.D. Anderson Cancer Center, Children’s Hospital Los Angeles, and Kaiser Permanente. The National Council of State Boards of Nursing (NCSBN) also offers a white paper titled “A Nurse’s Guide to the Use of Social Media.”

Lincoln feels that Massachusetts General Hospital’s social media policies are an example of having “really done it right.” Not only does Mass General have social media guidelines in place for employees, but also a policy established for those who interact with the hospital on social media.

“I am a strong believer that every company should have a social media policy in place,” says Lincoln. “This can help avoid legal issues, and give employees and clients a clear perspective on what the company is comfortable with being shared online.”

Consequences of Social Media Abuse

The consequences regarding a nurse’s improper or inappropriate use of social media platforms come with varying levels of discipline – all of which are dependent upon the action in question, workplace regulations, and any social media policies already in effect.

For example, not only can a medical facility take action against a nurse who has violated a patient’s privacy, but also the state board of nursing. State laws can additionally come into play, and it is not uncommon for legal and criminal investigations to take place when a nurse crosses the line.

Disciplinary actions that individuals can face include:

• fines
• suspension
• required sensitivity training
• expulsion from nursing school
• being fired from a job
• loss of licensure
• criminal charges
• jail time

The most serious offenses often involve law enforcement, with some cases being referred to the FBI for investigation of HIPAA violations, as seen in the firing of two nurses who photographed and posted the pictures on the Internet of a patient that underwent an X-ray procedure for rather sensitive, easily identifiable circumstances. Incidents of a sexual nature, such as exposing the image of a patient’s buttocks online, can also involve the Sex Crimes unit of the local police department.

Nurses who abuse social media (as well as digital and electronic media while on the job, such as taking cell phone pictures of patients) also cause their employer to come under scrutiny and suffer consequences, such as the admissions ban imposed on nursing home Kitsap Health & Rehabilitation Center for employing workers that took nude photographs on their cell phones of dementia patients. The incident led to an investigation of the facility, and the threat of being cut from the Medicare/Medicaid program, which provides vital reimbursements of funds for the services they offer.

In conclusion, social media policies for nurses will continue to evolve in order to keep in line with advancements in technology and the Internet. The key to successfully navigating the ups and downs that come with having an online presence and identity is to find a happy, safe, and responsible middle between enjoying the personal and professional benefits of social media without breaking the rules of patient privacy and confidentiality.

In addition to being mindful of the importance regarding the disclosure of patient- and workplace-related information via social media…keeping up with workplace policies, relevant state and federal laws, and professional standards as they apply to the nursing profession are just as significant.

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Texas mom Margaret Boemer will have a fascinating story to tell her daughter Lynlee about when she was born.

During her second trimester, Boemer learned during a routine ultrasound that her unborn child had a large tumor growing out of her tailbone. Doctors told her the baby had Sacrococcygeal Teratoma (SCT), a rare birth defect occurring in only one in every 40,000 pregnancies.

“It was a big shock and we were scared,” Boemer told CBS News. “I had just suffered a miscarriage the prior year. To think that I might lose another baby was very hard.”

The large mass was robbing her daughter of blood and would have caused her heart to give out before birth.

But at 20 weeks pregnant, Boemer and her husband Jeff met with doctors at Texas Children’s Fetal Center in Houston, who told her there was an option to perform emergency fetal surgery.

After other specialists advised them to terminate the pregnancy, they decided to move forward with the risky procedure to try to save their baby’s life.

“Lynlee would not have made it without this surgery,” Dr. Darrell Cass of the Texas Children’s Fetal Center told CBS News. With it, she had a 50/50 chance of survival.

At almost 24 weeks, Cass and his team made an incision in Boemer’s abdomen and pulled almost half of Lynlee’s body out of her mother’s uterus to remove the tumor – which was almost larger than the baby herself. Then came the challenge of putting Lynlee back in and closing the uterus. 

“We have to get the tumor away but then we have to make sure the baby can stay safely inside for a number of weeks afterward to have any kind of survival,” Cass said.

After a five-hour procedure, the doctors were able to remove 90 percent of the tumor and safely return Lynlee back inside her mother. Boemer’s uterus was sewn shut and her pregnancy progressed.

Twelve weeks later, Lynlee was essentially born a second time via C-section. At eight days old, she underwent surgery to remove the rest of her tumor. 

Doctors will continue to monitor Lynlee all the way into adulthood. So far she is reaching all her milestones.

“She’s doing great now,” Boemer said. “We’re practicing rolling over.”