DiversityNursing Blog

BOSTON (AP) — The screams and cries of bloody marathon bombing victims still haunt the
nurses who treated them one week ago. They did their jobs as they were trained to do, putting their own fears in a box during their 12-hour shifts so they could better comfort their patients.

Only now are these nurses beginning to come to grips with what they endured — and are still enduring as they continue to care for survivors. They are angry, sad and tired.  A few confess they would have trouble caring for the surviving suspect, 19-year-old Dzhokhar Tsarnaev, if he were at their hospital and they were assigned his room.

And they are thankful. They tick off the list of their hospital colleagues for praise: from the security officers who guarded the doors to the ER crews who mopped up trails of blood. The doctors and — especially — the other nurses.

Nurses from Massachusetts General Hospital, which treated 22 of the 187 victims the first day, candidly recounted their experiences in interviews with The Associated Press. Here are their memories:

THEY WERE SCREAMING

Megann Prevatt, ER nurse: "These patients were terrified. They were screaming. They were crying ... We had to fight back our own fears, hold their hands as we were wrapping their legs, hold their hands while we were putting IVs in and starting blood on them, just try to reassure them: 'We don't know what happened, but you're here. You're safe with us.' ... I didn't know if there were going to be more bombs exploding. I didn't know how many patients we'd be getting. All these thoughts are racing through your mind."

SHRAPNEL, NAILS

Adam Barrett, ICU nurse, shared the patient bedside with investigators searching for clues that might break the case. "It was kind of hard to hear somebody say, 'Don't wash that wound. You might wash evidence away.'" Barrett cleaned shrapnel and nails from the wounds of some victims, side by side with law enforcement investigators who wanted to examine wounds for blast patterns. The investigator's request took him aback at first. "I wasn't stopping to think, 'What could be in this wound that could give him a lead?'"

THEIR FACES, THEIR SMILES

Jean Acquadra, ICU nurse, keeps herself going by thinking of her patients' progress. "The strength is seeing their faces, their smiles, knowing they're getting better. They may have lost a limb, but they're ready to go on with their lives. They want to live. I don't know how they have the strength, but that's my reward: Knowing they're getting better."

She is angry and doesn't think she could take care of Tsarnaev, who is a patient at another hospital, Beth Israel Deaconess Medical Center: "I don't have any words for him."

THE NEED FOR JUSTICE

Christie Majocha, ICU nurse: "Even going home, I didn't get away from it," Majocha said. She is a resident of Watertown, the community paralyzed Friday by the search for the surviving suspect. She helped save the lives of maimed bombing victims on Monday. By week's end, she saw the terror come to her own neighborhood. The manhunt, she felt, was a search for justice, and was being carried out directly for the good of her patients.

"I knew these faces (of the victims). I knew what their families looked like. I saw their tears," she said. "I know those families who are so desperate to see this end."

On Friday night, she joined the throngs cheering the police officers and FBI agents, celebrating late into the night even though she had to return to the hospital at 7 a.m. the next day.

Source: Times Union

In March 2013, Dr. Donna Shalala, the longest-serving secretary of the Department of Health and Human Services, and chair of the Institute of Medicine (IOM) committee that produced the report “The Future of Nursing: Leading Change, Advancing Health”, addressed hundreds of health care leaders at the American College of Health Care Executives (ACHE) Annual Congress. Dr. Shalala provided her reflections on the removal of barriers to practice and care and the future of health care delivery. Dr. Shalala underscored the need for nurses to play a lead role in all aspects of the health care debate, ensuring that patients and families have access to timely, effective care; and outlined specific steps that health care executives should take to fully maximize nurses to meet patient care demands.

Donna Shalala Addresses American College of Healthcare Executives

By: Jacqueline Ingles, WFTS

Nicole Turner is calling her neighbor Aly Smith a miracle and a savior.

Smith, a nurse, came to the rescue of her 2-year-old daughter Ireland after her legs were severed in a tragic lawn mower accident Wednesday night.

"It was horrible," explained Smith.  "It's the scariest thing I have ever seen."

A labor and delivery nurse for nine years, Smith's training kicked in and got her through it.

Smith was sitting at home with her husband when she heard screams coming from outside.  Her husband ran outside first and she followed.  That's when she came face-to-face with a horrific scene.

"He kept saying, 'Her legs are gone, her legs are gone.'  And I said that can't be possible."

Jeremiah Nugent, 47, was swaddling his daughter whose legs were both severed below the ankle.  Just minutes before Nugent accidentally ran over his daughter with his riding lawn mower.

According to Ireland's mother Nicole, Ireland darted from the backyard into the front yard.  Then, when she saw her father, she ran to him and began calling out, 'Daddy, Daddy.'

Nugent never heard his little girl because the lawn mower drowned her out.

Nicole tried to flag her husband down to warn him.  Thinking he was about to hit something moving forward, he put the mower in reverse.

Ireland's mother watched the horrific accident.

"Why couldn't it have been me?" Nicole Nugent asked during a press conference at Tampa General Thursday afternoon.  "Why did it have to be her?"

Smith said she helped wrap the little girl in towels and put pressure on her legs to help stop the bleeding.  Smith was also comforting the little girl.

"She kept saying, 'I want to go to bed. I want my daddy and I want to go to bed,' anything to keep her talking," Smith explained.

Smith said she was surprised at how calm Ireland remained.  She stayed with the little girl while her mother called 911.  Fire crews responded and then Ireland was airlifted to Tampa General.

"It felt like an eternity," Smith said.

Ireland remain in the ICU tonight and is in serious condition.  Doctors said she will recover and will walk again.  And while Ireland's parents are thankful to Smith for all she did, she is remaining humble and said she was just doing what she was trained to do.

" I'll never forget it but it could have been a whole lot worse," she said.

Ireland has already undergone two surgeries, one to clean her wounds and a second to put a pin in her thumb.  Doctors initially thought her hand needed to be amputated but only her thumb was broken.

The Nugents say Ireland will undergo several more surgeries in the coming days.  She will also need skin grafts.

Steve Chamberland with 50legs visited Ireland in the hospital Thursday.  He arranged for Ireland to get fitted for prosthetics for free.  He says once doctors close her leg wounds Monday, she'll recover for four to six weeks before heading to Orlando.

He says they will fit her and she will be back on her feet the next day.

"To see a 2-year-old walk again, it's pretty much her first step and life," explained Chamberland.  "Her father was so funny.  He was ready to go.  He was like, 'Can we get legs now?'  He just wants to see her run again and be normal.

Source: WPTV

By: STACIA GLENN

Florence “SeeSee” Rigney brushed off retirement as easily as she does the good-natured jabs from co-workers at Tacoma General Hospital for being the oldest nurse in recent memory.

Rigney, who will turn 88 next month, still bustles around the operating room wing with the energy of a woman half her age. She expects to be working at least another year.

More than 20 years older than the next senior staff nurse, Rigney is respected, revered and relentlessly teased.

“I kinda keep them in line,” joked Rigney, who blushed in embarrassment and dismissively waved her hand at fellow nurses who call her everything from a star to their hero.

Rigney got her nickname as a kid. She kept telling a teacher, “See, see,” to show how well she knew her lessons. The teacher started calling her “SeeSee” and the name stuck.

In 1946, she donned the stiff white uniform of a student nurse. In her home, she has a framed photo of herself as a fresh-faced nursing student, next to an old black-and-white image of what Tacoma General looked like back then.

Her career crisscrosses the map.

She started in Tacoma General’s operating room before going to work for a private doctor. She had stints in operating rooms in Atlanta and San Antonio, Texas, before her husband deployed for the Korean War and Rigney returned to Tacoma General. She spent a spell in Cheyenne, Wyo., but once again came back to Tacoma.

The couple adopted their first child in 1958, and Rigney shifted to working on an as-needed basis to fill shifts when the hospital was short-handed. When her daughter reached college and her son was in high school, Rigney was needed at home less so she worked more.

After her husband died in 1977, Rigney started full-time again, working 10-hour shifts three days a week. She found it kept her mind occupied and surrounded her with a second family. The hospital gave her plaques to mark her long-running career – five years, 10 years, 15 years. She can’t recall getting the 20th-year plaque.

When she was 67, she thought it time to retire.

“I stayed retired for about five months then I came back and here I am,” Rigney said. “I always thought I’d come back and work but I never thought I’d stay this long. I’m really very blessed my health is good and they want me to work.”

Supervisors and co-workers describe Rigney as one of the best.

Julie Christianson, who has worked with Rigney since 1980, said she is a “crack-up” who is full of great tales about what nursing used to be like.

She regales them with times before computers when charts and records were all hand-written, when staff nurses helped out in the emergency room delivering babies, before technology and equipment became so advanced.

Rigney is not an operating room nurse, handing doctors various instruments. She’s the nurse who sets up patient rooms and keeps track of supplies. Fellow nurses insist Rigney will knows half the patients and has a soothing effect on those she interacts with.

It’s difficult sometimes to keep up with the advancements, Rigney said, but she’s always learning.

“She can still run circles around people half her age,” Christianson said. “She’s very inspirational for the rest of us because she’s still working and she’s still sharp.”

 By Robin Farmer for HealthCallings

If Janet Patterson, RN, could go back in time, she would learn the answer to a simple yet overwhelming question: What exactly do nurses do?

For most people, images of bedpans and needles pop into their minds, says Patterson, a nurse for 33 years who now works as a home care nurse at Maxim Healthcare in Santa Rosa, Calif. “We think we know [before going to nursing school] what [nurses] do, but we really don’t. I became a nurse and I couldn’t talk about it with anyone who wasn’t one.”

A realistic job description tops the list of information veteran nurses say they wished they had known before embarking on their careers decades ago. Experienced nurses recommend that new nurses and students talk to people doing the job they want. Ask questions in person, by phone or online in chat groups for nurses.

Nursing is intimate

Nancy Brook, MSN, RN, NP, wished she had known that “I would be changed as a human being because of the intimacy of the moments that you share with patients.” New nurses must prepare for this, she says. The impact of witnessing many life-changing experiences such as birth, death and serious diagnoses lingers beyond the workday, says Brook, a nurse practitioner at Stanford Hospitals and Clinics in Redwood City, Calif. After the workday, “It’s not your muscles that are sore, it’s the mental muscles,” Brook says.

It’s important for new nurses to create a routine to unwind, learn healthy habits and stay socially connected, seasoned nurses advise.

Keep learning

When Cynthia Ringling, RN, BSN, started nursing in 1990, she had no idea “that the personal touch of nursing would have changed with the age of computers. It made the RN much more of an administrator and documenter,” says Ringling, a chief clinical officer at Interim Healthcare in Colorado. “A lot of the personal tasks we did have been pushed to unlicensed or trained people.”

Nursing is an evolving profession with changing technology. New nurses must stay open to learning from patients, peers, physicians, professors and other professionals.

Squash conflicts

Another discovery Brook wished she had known before pursuing her career are the challenges of working with colleagues. “It’s not the patients who are hard, it’s the other nurses, managers, physicians — that whole interplay that professionals experience, unless you are working independently,” she says.

Ask for help. Make building a support system a priority, veteran nurses recommend.

Remain flexible

Adjusting to an intense work schedule also topped the wish-I-had-known list for longtime nurses. Meeting the demands of patient care can be exhausting. Add nights, weekends and holidays to the mix and maintaining a social calendar requires patience and flexibility. Brook says she wishes someone had told her in advance she would be late for every party because her shift did not end on time.

Accept that people get sick every day and require care. Imagine patients as your own loved ones who need care, says Sheri Cosme, MSN, RN-BC, a clinical educator at MedStar Georgetown University Hospital.

“Nurses work 365 days a year, 24 hours a day. So to think as a new graduate nurse that you will only work days, Monday through Friday, is not realistic,” advises Cosme.

The demand for nurses has significantly increased over the past few years and while the profession is mainly represented by females, more and more men have started to join the field as well. 

According to a study by the U.S. Census Bureau, male nurses are becoming increasingly more commonplace. 

In 1970, only 2.7 percent of nurses were male, compared to 9.6 percent today, meaning that the proportion of male nurses has more than tripled over the past 4 decades. The male proportion of practical and licensed vocational nurses has also increased over the same period, from 3.9 percent to 8.1 percent. 

The finding comes from a study of the 2011 American Community Survey which measured the proportion of men in each of the following nursing fields: nurse practitioner, nurse anesthetist, registered nurse, licensed vocational nurse and licensed practical nurse. 

The majority the 3.5 million employed nurses in 2011 were women - close to 3.2 million. However, the number of male nurses is on the rise - close to 330,000 at the last count. 

In addition, they analyzed the characteristics of men and women working in these fields, such as age, origin, race, education, earnings, industry, work hours and citizenship. 

The author of the report, Liana Christin Landivar, a sociologist in the Census Bureau's Industry and Occupation Statistics Branch, said: 

"The aging of our population has fueled an increasing demand for long-term care and end-of-life services. A predicted shortage has led to recruiting and retraining efforts to increase the pool of nurses. These efforts have included recruiting men into nursing."

Male nurses typically earn more than their female co-workers. For every dollar male nurses earned, female nurses earned 91 cents. This difference in earnings is a lot smaller than most across all occupations though, with women earning 77 cents for every dollar a man earns.

Healthcare is among the fastest growing industries and as people are living longer there is an increased demand for long-term care as well as end-of-life services. The unemployment rate among nurses is extremely low due to this increasing demand. Only 0.8 percent of nurse practitioners, 0.8 percent of nurse anesthetists, and 1.8 percent of registered nurses were unemployed in 2011. 

Some additional findings of the study, show that in 2011:

• The majority of employed nurses were registered nurses (78 percent), followed by licensed practical and licensed vocational nurses (19 percent).

• 41 percent of nurse anesthetists were male - the occupation with the highest male representation.

• Male nurses earned an average of $60,700 per annum compared to $51,100 per annum among women. 

According to researchers at the University of Pennsylvania School of Nursing's Center, nursing is a profession with an extremely high burnout rate and many nurses report feeling dissatisfied with their jobs. They say that it is imperative that hospital leaders and policy makers improve work environments for nurses, which in turn also improves quality of care for patients.

Source: Medical News Today

BY SCRUBS EDITOR 

It’s easy to forget that so many nurses don’t actually work in a hospital, clinic or school. Nursing is the kind of career that can really take you in several different directions. Case in point? Rose Church, famous for being NASA’s first nurse. But that’s not the only reason we love her–we’re also impressed by how she landed the gig!

An employee of McDonnell Douglas in St. Louis, Mo., Church had heard that the company was hiring an “aerospace physician.” Interested in the gig, she created an opportunity to speak with president James McDonnell and told him, “Where there’s a doctor, there’s always a nurse.” And after that conversation, she was that nurse!

Church went on to serve as the nurse to the Mercury and Gemini astronauts, including John Glenn, Alan Shepard and Gus Grissom. She is remembered as having a smart, quick wit and being super sweet–she would often bring astronauts their favorite training snack, even if it was a doughnut or a beer. Ha!

Church passed away late last year, but her spirit and hard work will always be remembered.

Source: The Aero Experience

District hospitals might soon face minimum nurse-to-patient thresholds, but the facilities are vowing an aggressive fight to defeat the strategy nurses contend will improve patient care.

"We're going to set a priority, and that priority is going to be patient care over profit," said Ward 1 Councilman Jim Graham, one of nine D.C. lawmakers who said they would support the measure when it is introduced Tuesday.

Under the plan, which must still make it through the legislative process but already has enough support to pass, hospitals would have four years to implement stringent nurse-to-patient ratios.

The precise ratios would fluctuate by specialty, but the proposal includes a mandate of one nurse for every two patients in critical care units and one nurse for every trauma patient in the emergency room.

Nurses said the changes are vital to protecting patients.

"Patient safety is regularly threatened because hospital corporations refuse to ensure there are enough registered nurses working," said Bonnie Linen-Carroll, a Washington Hospital Center nurse. "It is an absolute disgrace."

The labor union National Nurses United also pointed to a 2012 survey of D.C. nurses that found 57 percent thought "staffing is inadequate always or almost always."

But the DC Hospital Association, which represents 10 Washington hospitals, said the proposal was misguided.

"This makes no sense. No state in the entire country has taken this approach except for California and that was 10 years ago and no one else is even thinking about it," said Bob Malson, the association's president. "You're going to force the hospitals to hire people where they're not needed."

Both sides said research supports their views.

"The science and the academics and the people who actually do all of this stuff all the time will make the case," Malson said.

Hours earlier, the proposal's backers cited a study that said "outcomes are better for nurses and patients" in facilities that used the requirements codified in California.

Malson, who predicted lawmakers would ultimately spurn the proposal, wouldn't say whether his members might mount a legal challenge against the ratios.

But D.C. Council Chairman Phil Mendelson said he was ready for a confrontation.

"This bill is common sense," Mendelson said. "This bill is today's version of the eight-hour day, something that we will see business resist, but on the other hand makes good sense and will lead to quality care."

Source: Washington Examiner

By Tony Moton

It didn't take long for Annette Staack to realize that making the decision to pursue a career as a registered nurse (RN) was the right one for her.

"It was my calling," says the energetic Staack. "With the first thermometer that I put into my first patient's mouth, I loved it."

A 55-year-old mother of two adult children, Staack earned an associate's degree in nursing from an Iowa community college when she was in her 20s. She says she decided to go to school because she had long had an interest in a career that would allow her to help others.

And while circumstances are different for all nurses, Staack says that she was able to finish her nursing degree in two years, which led to a career that has provided her with a good living and a better work/life balance.

Staack currently holds the title of cardiac liaison and cardiac procedure nurse at her Los Angeles-area hospital, where she has worked for more than two decades. She specializes in testing and assisting in the treatment of patients with heart ailments. And most importantly, she enjoys every moment of it.

"You get to work with patients in all kinds of situations," she says. "You've got emergencies, patient contact, and being responsible for their lives. I like the hands-on aspect of it."

Here's a closer look at how Staack spends a typical day on the job at her hospital.

8:45 a.m. - In the cardiac procedure room, I greet a new patient and call for an Armenian translator because the patient doesn't speak English. I check the patient's vital signs and they are all normal.

9:00 a.m. - The translator explains the process to the patient and she verbalizes her understanding. I finish my computer charting, obtain sedation IV medicines, and wait for the doctor. I text him that we are ready.

9:15 a.m. - The doctor arrives and we begin a procedure to look at the patient's heart and determine whether there are any abnormalities. Within two-to-three minutes the patient is sedated. Images are taken during a five-to-seven minute time period.

9:45 a.m. - The patient slowly wakes up and responds appropriately. I check the patient's vital signs, which are stable. I fill out a patient's chart on the computer. I also provide a written report of meds and findings for the bedside nurse to review.

1:15 p.m. - I go to the surgery room, where a heart surgery is just finishing. The surgery involves another one of my patients, so it's important for me to monitor their progress. I update the patient's family, tell them "all is well," and the MD will speak with them in about 30 minutes. They were so worried, but now are so grateful and give me a hug.

1:45 p.m. - I go to eat my lunch and, sure enough, I get interrupted by EKG. I do three back-to-back-to-back Lexiscan stress heart tests. Today is a pretty hectic day, which is usually the case. But no two days are exactly alike for me.

2:30 p.m. - I head back to my office - to a cold lunch - but I eat it anyway.

3:00 p.m. - I head to Telemetry Unit to speak with a patient and their family about tomorrow's coronary bypass surgery. I need a Spanish translator to help explain and repeat the process to the patient and family. They verbalize understanding and agree to proceed. I schedule the surgery with the OR (Operating Nurse) booking clerk.

5:15 p.m. - I am out of here. Tired but fulfilled! I am thinking about what I might have for dinner and having a relaxing night at home in front of the TV. I'm usually in bed and asleep by 10 during the week because I need my energy for the next day.