Compassion and Caring

"Love and compassion are necessities, not luxuries.  Without them humanity cannot survive." ~ Dalai Lama

Compassion is something that one would thing is a given with nursing and the medical system.  Compassion is the one thing that is not delivered in a pill, an IV push in a manufactured way.  Compassion is genuine.  Compassion is ignited from within.  Compassion in the one thing that we can give of ourselves to comfort those who are suffering, as we give it, we also receive great benefits in return.

Why is it in our field there is a lack of compassion.  In order to provide compassionate care we must have received compassion. As we care for our patients and provide compassion it is equally important that we treat the members of our hospital teams with compassion.

http://www.ted.com/talks/view/lang///id/1216

Joan Halifax highlights this concept in a short Ted Talks episode.

2013 ENA President-Elect Deena Brecher speaks at 2013 ENA General Assembly

Incarceritis And New Onset Suicidal Thoughts at Time of Discharge

There is this amazing phenomenon  in the emergency room that results when a patient arrives in the ER while in custody of law enforcement with a new onset of incarceritits.  The symptoms of incarceritis include chest pain, shortness of breath and syncope.  Upon a full medical work up, which often includes lab tests, EKG and x-rays medical findings are usually negative for MI or other life threatening emergencies.  As the patient is discharged they miraculously develop new onset suicidal thoughts.  

Lucky for them they are usually handcuffed to a stretcher and have no personal belongings.  

Thankfully there is a cure for this!  Swift discharge and a bail bonds business card.  

The Waiting Room---- Why do you wait to be seen in the ER?

I have to give PBS props for airing what has to be the most honest look into life in the ER, for the patients that wait to the team that works to care for what is an endless stream of pictures.

If you haven't had a chance to view this gem, I encourage you to click on this link and give it a view!

http://video.pbs.org/video/2365092060/

While MTV shows the party life of nurses on their new show, essentially Jersey Shoring nursing, this is PBS docu is a real look, the real deal!

Who Dat?

I ran into a former manager today and it was an interesting experience.  I hadn't seen her in a while.  When I worked under her she was always well dressed, poised, professional in appearance....  when I saw her today in my former ED I hardly recognized her.  At first I thought she was one of the girls from the hood.  Then I thought she was a visitor.  Maybe it was the bad wig, the overly tight attire, the lab coat the unprofessional lab coat or the fact that she was literally hanging on some guy in the ED.  This was not the same former manager who was well dressed, professional and poised that I once knew.  I stand by my earlier post, leadership is lost!

Leadership Is A Lost Art In The Wake Of Middle Management

Many, many years ago the career field of nursing had leadership as a core value, but over the years reorganization and redefinition of management has suffocated the concept of leadership.  Gone are the days when you looked to your fellow staff nurses for mentorship.  Today's concept of nursing has ultimately killed the bond that drew us all together and it is weakening our very foundation.

When I look around at work there are very few leaders.  By leaders I don't mean managers.  In my opinion the two words have completely different meanings, although in today's hospitals nursing leadership is comprised of managers which is unfortunately an oxymoron most of the time because nursing managers rarely lead, they follow the hire up administration's agendas.  Perhaps that is why there are floors closed to accepting patients because there "isn't enough staff" which causes emergency department patients to sit waiting for hours for beds.  Lean staffing was a concept of management, certainly not nursing leadership.  What good nurse would ever want to subject patients to the hell of the dreaded hallway bed for hours?  Where is leadership advocating for the patient's safety and wellbeing?

I recently had an experience with three nursing managers.  Two of the managers were assistant nurse managers and the other a supervisor in the ED.  I had a critically ill patient who was bottoming out.  The patient's heart rate dropped to 32.  I had five patients to contend with at the time, and my neighbor, a new graduate just off orientation had five patients of her own.  Having informed the three managers who were sitting at the nurses station of the situation with my patient, and seeing how my neighbor looked a bit like a deer in the headlights, I asked my neighbor to ask one of the three manages to come over and assist me.  When my neighbor returned she informed me that they refused to help.  Wow was I blown away, well not really.  This is how our management is.  They are managers not leaders.

About an hour into pacing this patient and starting dobutamine, yes DOBUTAMINE, on this patient, one of the managers shows up.  She is eating popcorn, and coughing.  She tells me, "I'm choking on my popcorn", I shoot her a look which probably included an eye roll and I inform her that I needed her help an hour ago.

Her response to me is cold.  She lashes out that "I'm here now".  My response to her was "I needed you an hour ago".

During this hour that has transpired I had patients who were in pain, physicians trying to call in orders and other patients who had room assignments that needed report called, but I was tied up with a critically ill patient who was in dire need, yet for that hour my patients' needs, my call for assistance was less important than popcorn.

Just because one holds the title of manager does not make one a leader.  Leadership comes from within, regardless of rank, title or pay status.  Unfortunately true leadership has been left to the waste side, abandoned for some alien concept of leadership.

50 Year Old Stripper

Our ER has a special place for the party people in da house.  It's the drunk hall.  Forrest Gump's line of "Life is like a box of chocolates, you never know what you're gunna get" totally describes it perfectly.  Work is nothing less than an adventure when you're working that assignment.

On one particular night I was greeted by some very happy EMTs.  "What are you'll smiling at", I asked.
"You'll see", they replied.
"Can you give me a hint", I ask.
"Drunken stripper", the respond while laughing.

As I walk down the hall to meet Jane Doe Drunken Stripper, she hops off the stretcher naked as the day she came into this world and sacheyed over to another stretcher and began her bump and grind.  Wow, the boys who dropped her off weren't kidding, this chic had moves.

A very nice security guard looked at me while he was putting on his gloves and says, " I guess we won't be fighting this one to get her cloths off."  When folks come back to the drunk hall we change them into gowns, so if they try to wander out the door they can be easily identified.  This practice also helps  us reduces the fragrence in the ER.

We start to approach our naked patient.  She takes a look at the security guard and turns her attention to him.  He's a big guy and hard to miss.  As she begins her floor routine  a crowd of young surgical inters find themselves captive behind her, they look scared, they didn't know where to go, so they just froze.  Stripper lady continued shaking her money maker and then did something that stunned everyone, a gymnast type move, she stretched her leg straight up to the side of her head, the poor residents looked mortified. I was a little jealous I couldn't do that myself after years of yoga, and the security guard just shook his head uttering, "I didn't need to see that".

We managed to get her into gown number 1 out of 8 for the night, and she was moved back to the stretcher.

Throughout the evening she would get her gown off and then slide herself off the stretcher and start her routine.  At one point she started a lap dance on a sleeping orderly, which woke him up real quick with the look of panic on his face.  There were other times when her stretcher was her stage and she was dancing on top of it and asking for money.

A few hours into her stay she was becoming more lucid. When I asked her what her name was she gave me I can only assume was a stage name.

Eventually an older man showed up, saying he had called the ambulance for her. She worked in his strip club.  He had recently demoted her from a dancer to a bar tender because of her age, because she had turned 50.  I asked him if she was depressed about turning 50, he said, " No, she's  pissed at me because I don't want her dancing anymore, I thought I was doing her a favor".

The gentleman was kind enough to leave contact information so she had a ride home after she woke up.