Sky Watch Friday

Hubby and I had been travelling on the logging roads on Mt. Arrowsmith. The view is looking West towards Port Alberni and the Wild Westcoast of Vancouver Island.

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Healthy Choices....food for thought

They say life is made of choices. We've all made some good and bad choices.  Some of those choices not only have an impact on us but those around us.  Others are small  but even those small choices can have a ripple effect.

When we think about choices we often think about things like, should I take that job even though it means moving either yourself or your family or moving away from loved one.  Do you buy that house in another province or state?  You really want that car but it's just a tad out of your price range.  Or what about that new suit and those shoes you always wanted should you buy them even though you know it might leave you a bit short on paying your bills this month.  Or you have fallen in love and believe you have met your match yet others oppose the union and you go with it anyways knowing that is could have long term effect on your family relationships.

Yes choices they aren't easy, but we do make them, every day of our lives.

I'd like to talk about those health choices we make.  Most of us I think have a pretty good idea of what a leading a healthy life style means.  I think if we are savvy enough to be able to access the Internet, read blogs, post a blog and the myriad of  other things we do on the Internet we should be able to access information that would help guide us to leading a healthy life style.

Being a nurse I see folks everyday that as a result of their "choices" of life style have brought them to the hospital. The hyper or hypoglycemic diabetic patient, the alcoholic, the drug addict, the over indulgent overweight orthopedic patient, the type "A" personalities and their increased risk for cardiac events.  Some folks fall into all of these categories.  And I bet that every one has a reason or excuse for why they are in the state that they are in, most of them not taking responsibility for the life style choices they make.

We are all human, we innatley make mistakes or bad choices.  I would like to think that we could learn from our mistakes or bad choices and move forward to making positive good choices for ouselves.

We've just come through the overindulgent season of Christmas.  All the parties, the sweets, the snacks and huge dinners, the being pressed for time and not being able to excercise or plan a wholesome meal.  Ah it's easy to slip into the "oh I'll just pick something up at the fast food store", it's quick it's simple and little clean up.  How convenient.  However, there does come a time or should I say I hope there comes a time when we just have to say ENOUGH.  It's time to get back on track.  Why does it take a visit to the hospital to give people a wake up call about taking responsibility for their health issues and the choices they make.

Back in the later part of October I watched a movie it was the opposite of "Super Size Me". It was an Australian fellow who was morbidly obese and realized he had to change his ways.  Long and short of it, he lost his weight by going on a Juice diet.  Along his journey he helped countless others do the same thing.  The wonderful thing about this movie was that he just asked people to try it for a week.  One week, I think most of us can do something for one week.  I was hitched.  The next day I started.  I lost 6lbs in my first week. I was estatic with the results.  I continued and lost 10lbs.  I'm now eating solid foods and I have lost 18lbs. and I feel fantastic.  Now this isn't about me and my weight loss it's about taking control and being responsible for the food choices I make in my life.

I have changed my diet completely and I have seen the increased energy and I thank myself for making positive choices for ME.  Sure I am human, I still like sweets and I do eat them occassionally, but then it's time to get back on track.

Let's acknowledge the choices we make good and bad.  What I'd love to see is more folks taking responsibility for their own health and I'd love to see a lonely quiet ER one day as a result of it.

SkyWatch Friday

This photo was taken last weekend.  Hubby and I decided to travel up some logging roads.  I just loved the clouds.

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She entered my life....

She entered my life only briefly.  She lay there quietly resting, only speaking when spoken too, yet in those brief moments of interaction her simple words, gentle smile and a quick retort touched me more than she will ever know.

Have you ever been touched by the gentleness of another?  They completely unaware of the impact they  have on your life?

I experienced that yesterday.   I had admitted a patient who had undergone a very large bowel surgery for the removal of cancerous tumour.  This patient had already had her share of cancer and surgeries having undergone mastectomy for breast cancer and esophageal cancer.

It makes me wonder how one person can undergo and withstand so much and still be positive and bring joy and happiness to others with their simple smile.

Her quick wit and soft sweet smile touched me.  She never complained and never asked for a thing, she was just simply appreciative of the care she was receiving.  She spent a good portion of my shift in the recovery room.  There were many things that needed to be done for her before I could send her to the ward.

When she was ready to go and the porter was wheeling her away  she thanked me.  I wanted to say no Thank you I didn't know how.  I don't think I realized until I got home the impact she had on me.

She of course was not my only patient and as I went back and forth from my patients there was such a contrast in coping skills. I wondered how does someone find that place of acceptance, and control.  Some have better coping mechanism than others.  Maybe she was one of those people.

It was a great day to be a nurse.

Patience

They say that Patience is a Virtue.  Well I suppose it is.  My husband often tells me I am not a very patient person. I tell him I beg to differ.  I tell him spend one day walking in my shoes and  then tell me I am not a patient person.

In nursing school they taught us about compassion, caring, empathy, and therapeutic communication just to name a few.   Yet I don't recall them teaching us about having patience.  Which one would think they would as that is a number one skill you use every day in your nursing career.

Maybe it's one of those skills you innately have.  I don't know.  What I do know is that you won't survive very long in the nursing profession if you don't have it.

There's the times when your unit is running short staffed.  You have a heavy patient assignment and you are trying to juggle getting patients fed, bathed, medications dispensed, orders reviewed and processed, assisting with other health care professionals who are working with your patient, changing dressings, answering questions of family members and if you are lucky holding the hand and spending some time with your dementia patient.

You have to have patience in order to and achieve any of the above with a certain amount of  empathy, caring and compassion.  It's not easy some days.

In the recovery room you have to have patience.  You have to patiently wait and assess patients for the effects of the anesthetic to wear off.  Assessing pain levels and medicating frequently and evaluating outcomes, being on the alter to change the course of action when the desired outcome is not achieved.  Then throw in the juggling of Operating Rooms and sometimes having to put them on hold, lack of beds to move post operative patients to, and of course the unexpected cardiac or respiratory arrest.

Yes you MUST have patience in order to survive your day.

So I started to think about what my husband has said to me, and I think, maybe he's right.  Maybe I don't demonstrate a lot of patience when I am at home.  Maybe that's because I have used it all up at work!

I remember reading on another nursing blog, where the nurse said that before she goes home she almost has to desensitize herself from the work environment and put on her mom/wife hat.  Some days it's easier said than done.  Some days  your family have no idea what your eyes have seen and what you have experienced, nor in some cases do you really want to share that with them.  I think what I need to remember is that I am only human, I can not be everything to all people at all times. I have to start to use some of that therapeutic communication on myself and be a little kinder and gentler to myself and then I think the patience my husband says I lack demonstrating at home just might come out.

I was on Facebook today and I noticed one of my colleagues had posted a video from YouTube titled Being a Nurse. In this video they say being a nurse is 90% and 10% job, I think I would agree with that.  I went and checked out other YouTube videos about nursing and what it is like to be a nurse and the one I linked to below title To Be A Nurse really kinda of spoke to me.
To Be A Nurse

Sky Watch Friday

I love clouds. I love how the take shape, tell a story, predict the weather.  I love how they just seem to magically take me to a happy place.

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Happy Friday All!

Did we not explain ourselves?

As a Recovery Room nurse, not only do I recover patients who have had major surgeries, but I also work in our Ambulatory Recovery room.

In the ambulatory recovery I am recovering patients who have had primarily IV sedation for colonoscopies, gastroscopies, bronchoscopies, eye surgeries and general sedation for ECT's.

It's the IV sedation patients that I want to talk about.  Prior to their procedure they are told that they MUST have a responsible adult driver to take them home post procedure or alternate arrangements made for going home, ie taking a taxi.  The driver must report to the recovery to physically escort the patient to the car and ensure that they take the elevator and NOT the stairs.

When these patients come to the admitting area I know the clerk asks the patient who is driving them home.  She also asks for the persons phone number, or will that person be staying or do the nurses have to call for their ride. The clerk also advises them that the person who is providing the ride MUST report back to the unit to come and physically pick the patient up.   The clerk diligently writes this information down in the chart, so I as the recovery room nurse know what arrangements have been made for this individual person to get home.

It never ceases to amaze me how many patients still think that it is ok for them to drive home post procedure, and never follow one thing we tell them NOT to do.

Let me share with you some simple stories.  We had a husband and wife in. Both were from out of town, both were having a procedure that required IV sedation.  When they were coming around we asked about their ride and if there ride has a ways to come so we can give the individual enough time to get to the hospital to pick the patient up.  This particular couple's idea of having arrangements being made were to take a cab to the pub where they were to meet their friends. Hmmmmmmmm.

Another patient tells us that her husband is at the Pub and to call him there to come get her.  Sure enough we call the pub and the waitress tells us that well she doesn't see him at the moment but his "beer" is still on the table.

Another, a young fellow says he didn't realize he had to have someone drive him, we tell him we can't let him go until someone comes to get him.  He gets on his cell phone to get a hold of a friend, someone eventually shows up, the patient doesn't take the elevator as instructed but rather walks down the stairs, then once out of sight(or so he thought) he jumps into his vehicle and drives off.

Then there are the patients who have arranged a drive and the person who comes to pick them up appears to be in worse condition than the patient.  Sometimes the person arrives being short of breath and on home oxygen, so they are dragging their oxygen tank beside them.  Others have their ride arriving walking very slowly either utilizing a cane or a walker. Many many patients rides think they can just wait in the car, even though they have been told they MUST come to the unit to pick up the patient.  You can't imagine all the stories we get regarding patients rides, I think I could write a book on all the excuses or stories.

My point is that all of these folks are told prior to the procedure that they will need a RESPONSIBLE, capable and able adult to get them home.  We tell the patients that they are legally impaired, we tell them not to drink alcohol and the list goes on.  But I guess human nature being what it is, they will do what they want to do regardless of being advised not to do something.

I don't tell patients these things to ruin their day, on the contrary there are risks involved when you have had IV sedation and I must make ensure they are aware of these risks.  I personally would think that one would want to take those precautions.

Just a few things that just make me shake my head.

Appropriate Care in the Appropriate setting....fact or fiction?

I'm sure you have heard the saying "It's only a matter of time before something happens", and don't you hate to  be the one who says "I told you so".

Two weeks ago an elderly female dementia patient was admitted to a small community hospital.  This woman was placed in a co-ed room. At the time of her admission there were 2 males and another female in the room.  A few days later this changed and a young 43 year old drug addict male was admitted to the room..  This young male sexually assaulted the elderly female dementia patient. You can hear more about it on this news clip.

 http://video.cheknews.ca/services/player/bcpid1011606683001?bckey=AQ~~,AAAA4mHNTzE~,ejlzBnGUUKY1gXVPwEwEepl35Y795rND&bclid=975107450001&bctid=1365974421001 

The hospital administration initially was trying to point fingers at the nurses for not keeping a closer eye on the patients.  With hospitals running at over capacity and working short staffed on a regular basis, it becomes difficult to observe all patients at all times. The nurses union for sometime  has been telling the administration that co-ed rooms are a recipe for disaster. It's unfortunate that it took an incident such at this for the administration to realize that they needed to do something about how they were assigning beds.  My heart goes out to this woman and her family. To me they are a casualty of part of the health care crisis.

I have been a patient in the hospital where I have been placed in a co-ed room.  I can tell you that I do not like co-ed rooms.  My last experience in the hospital and I had to share a room with two men and another woman.  On my second day in the hospital the woman was discharged and another male was admitted to the room.  The only redeeming thing was that my bed was next to the door and I kept my curtains closed most of the time for privacy purposes.  I had no problem with my male room mates but it was more a sense of not having any privacy and I was forever having to lower the toilet seat in our shared bathroom.

As one of the people in the news clip says, hospitals have been running at overcapacity/disaster levels for sometime now and there doesn't seem to be any light at the end of the tunnel.

I was watching the news yesterday and heard about  another hospital on the mainland.  This hospital is one of the major trauma hospitals in BC and is very busy.  Last year this hospital made the news because it was caring for patients in the adjacent Tim Horton's restaurant.  Now we are hearing that nothing has really changed and that once again staff are having to care for patients in corridors and make shift units.

Almost simultaneously I watch a documentary about  patient placement, and  in particular seniors who they identify as "Bed blockers".   This story coincides with my last post about how we have patients in hospital who are in the wrong setting for the care they need.

In the documentary the journalist spoke to the chairperson of the committee who was faced with the  task of looking at  health care and seniors.   This committee came up with many recommendations none of which the  Federal or Provincial governments have initiated.  This documentary focused on a family who's husband/father had dementia and had been in an acute care hospital for 6 months waiting placement.  It was an inappropriate environment for this man, but because there were no resources in the community he had to stay in the hospital until they found him appropriate placement..

The governments have known for a very long time that they need to put resources in the community but they don't.  Why?  I think because they are on a mission to destroy the publicly funded health care system.  destroying the current system would open the doors to private health care.   They can fix this if they really wanted to I'm not convinced they do.