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.

Can We Talk about Health Care?

In my years of nursing I have seen many things.  Some of these things make me laugh, some make me cry, some make me down right angry and some just leave me shaking my head.

Our governments are trying to feed us the line that our Canadian public health care system is no longer feasible,and that we must introduce private health care.  I say phooey on them.  The public system is sustainable what we need to do is look at how and where the monies are being spent and start to get some kahunas and make some real hard ethical decisions on how health care is delivered.

We are all going to die, that is inevitable.  Some of us are going to die sooner than others.  Heart breaking as that is, it's just the basic and simple truth.  So why do we as a society insist on prolonging something that is inevitable?

I know this topic is going to get some folks backs up, but really, we have to look at some of the things we do in health care to prolong life.

Let's look at one area in particular.  Dear beloved grandma or grandpa who is 80, 85 or maybe even 95 years old who have severe dementia have fallen and fractured their hip.  They are rushed to the hospital and now put in a very strange environment, they become increasingly more confused and in some cases combative.  The surgeon tells the family he can fix grandma's hip and of course the family go along with what ever the surgeon says.  So grandma under go's surgery, oh did I mention that grandma also has severe cardiac issues and COPD?  Yes well grandma goes and has her surgery and comes out on a ventilator, the doctors tell you oh that it will only be temporary, but grandma now has to go to the ICU.  Do you really think this is what grandma wanted?  Grandma makes it off the ventilator and out of the ICU, but she is by no means ready to go back home.  She goes to a surgical ward and then a medical ward, where because she is now demonstrating that there is no way she can go back home she sits in a hospital bed waiting for placement.

Not long ago the health care system would have just given grandma medication to keep her comfortable.  Yes she might have been bed ridden  but she would be made comfortable.  Think about this, grandma had to have surgery and so did the young 48 year old who fell off a ladder while working and got a head injury...he came into the hospital hours after grandma but grandma took the last ICU bed so now what?

WE as a society have to start making some tough decisions on where we will allow our health care practitioners to take us.  Ethics enters this arena. When you become a doctor you take an oath to sustain life at any cost.  Well I think it is this oath that has skewed how care is delivered.  Again, please don't get me wrong but I look back 25 years ago  when my sister went into premature labour at 5 and 6th months. Three times this happen to her.  She endured labour like any other woman but the outcome was not the delivery of a healthy child.  In those days it was unheard of for babies to live at 23 or 26 weeks.  Now days they are saving babies some as young as 20 weeks gestation.  Mom's and dad's are thrilled that the technology is there to save their precious bundle, but what about the long term effects?  Research is now showing us that even though these babies are being saved the long term health effects are huge and hence a cost on the health care system.

So let's ask ourselves, where do we draw the line, when do you say enough is enough, when do we allow nature to just take it's course?

I have never spoken as blatantly about this as I have today. I have eluded to this topic when I posted about Living Wills and Code status.  We as a society need to take a good hard look at where we draw the line. It's not an easy decision or topic to talk about but we have to.  Death is part of living, we know at some point we are all going to die.

I think we all need to start talking about this, don't you?

Lest We Forget

This Friday November 11th is Remembrance Day.  A day dedicated to our war veterans.  A day where we take a moment  to remember those who lost their lives to keep our country safe.  My daughters grandfather is a WWII veteran.  He was in the navy.  My father in law is a Korean veteran.  Both of these men put their lives on the line for their country, and for that I am thankful and thanks doesn't seem to be enough.  How many of us would voluntarily sign up for something when you knew you might not return?  I don't think to many.

On Friday my father in law will attend our local Remembrance day celebration and lay a wreath in remembrance of his fellow soldiers who lost their lives in the Korean war.

Thank you Bill and Reg for your service and dedication to your country.  We will never forget!

Happy Birthday Big Guy!

Today it's my sweethearts Birthday.  I won't say how old he is because....well he is younger than me and he takes great pleasure in reminding me of that.

I chose this Birthday header because I am actually making him a cake for his birthday.  It's a recipe I haven't used before and I am hoping it turns out(picture to follow).

It's been a busy work week and I haven't finished my gift for him either, I'm hoping he will get his silly butt out of the house and go do what he said he was going to do so I can get on with finishing his gift.

 So  honey please get your butt moving so I can finish what I should have started a week ago!  Here's to you hun....hope you have a super terrific.  Love you!

Humour Thursday......

This being the last Thursday before Halloween I thought I would do my Humour Thursday with a bit of a Halloween twist.  I've also decided to throw into the brew a little Halloween political humour...enjoy!

Do the Clothes really matter?

A while back I was reading a post done by one of my favourite bloggers StorytellERdoc his post was titled "He is Loved".  It's a must read if you ask me.  I believe the Doc was trying to demonstrate the old saying "Don't judge a book by it's cover".  In my comment to the Doc I said his post was heartfelt and it reminded me of a paper I had written when I was working on my degree.

My paper was titled "Do the clothes really matter".  It was a reflection on how the nursing uniform has changed from the time of Florence Nightingale.  It posed the question on whether wearing a uniform makes for better nurse and or nursing care.  While doing my research for this paper I came across many articles written about the patients perception of the nurse and the care they received or would receive.  One of the papers I read  the author had interviewed psychiatric patients and asked them their perception on whether they felt they would receive better or worse care dependant on the nurses attire.  Their response was that they appreciated the nurse wearing a uniform as it distinguished them from others in their environment and they knew that would be a person they could go to.

Today as you know it can be difficult to identify your nurse and I think we have become a little lack in what is acceptable.   I am not sure it is the lack of uniform to blame but rather a lack of identification.  At the facility I work the official identification card lumps RN's, LPN's and RCA's all under the title of "Nursing".  So from a patients perspective they don't know who they are dealing with unless the individual identifies themselves. I remember when I was in nursing school my instructor always said to us  that when we go to a patients bedside we should identify ourselves i.e. Good morning Mr or Mrs ..... I am .......and I will be your RN for today.  That has stayed with me and to this day even with my barely conscious patients I tell them who I am and what my name is.

This brings to mind another topic on clothing and attire.  Multi coloured hair and tattoos seem to be the norm.  Not a very professional look if you ask me.  Don't get me wrong I don't have a problem with either, but I do think it looks less professional.  I have seen RN's and other healthcare providers with tattoo "Sleeves" and almost rainbow hair.  Do these interfere with their care....I would hope not, but from a patients perspective they might feel a little put off and wonder about the care they are receiving.

Maybe I am old school, but we certainly have come a long way from the white uniforms and caps.

What are your thoughts.....Do the clothes really matter?

Password

Do you remember the 1960's game show called "Password" with host Allen Lunden?  It was a game show where celebrity guests would give a word clue to a contestant and the contestant had to guess the word.

That game  is what came to mind yesterday when I am trying to remember my password and secret reminders for one of accounts.

It seems that  with all the computerization, ATM's, chip cards, now days a  password or code is required.   Now I don't know about you but I can only remember so many of these passwords and codes, especially if they aren't ones that I use very often.  I appreciate the security aspect of all these codes but boy is it making it difficult to remember them all.

At my work  I have a password to log into the computer, every three months we have to change our password....pain in the butt.   It's not a simple password either, the password must contain a capital letter, small case letter and number and it is case sensitive.  Ok so I do this....now on our internal job positing which of course are all on the computer you have to have a different password and a different log in name...geesh.

So yesterday, as I was saying I was trying to log into this account online, an account that I generally get sent to me in the mail, but my hubby who is a computer whiz thought I should have all my accounts online so I could have immediate access.  Well of course that sounds all well and good until such time you have to remember the Password!  Needless to say I ended up locking myself out of the system because of my "3" failed attempts so off to customer support I had to go.  I spoke with two agents who of course were very helpful but still all the numbers they had me enter and screens I had to look at was all a bit mind boggling, but I did it.  The funny thing was at the end of my tutorial with the agent, he said to me if I had an iPhone or the likes I could access my accounts via my cell phone... are you kidding! I just laughed

Decisions, Decisions

They say that one thing in life that is for certain is "Change".  Working in health care is no exception.  I have worked as an RN for over 20 years and in that time I have certainly seen my share of change.  With the continual technological and pharmaceutical advancements in health care one sometimes feels overwhelmed with the attempt of trying to stay on top of current treatments and drug regimes.

With the advancement of technology nurses are forced to learn and maneuver their way through the world of computers.  For younger nurses this is almost 2nd nature.  Many nurses now entering the health care field grew up using computers and think nothing of searching the Internet to research a medical issue.  When computerized documentation for nursing came into vogue many senior nurses were intimidated.  They were or are winding down their nursing careers and are forced to learn not only the nuances of the computer but for some the basics of "typing".

This post however, is not about technological  or pharmaceutical changes in health care but rather change as a whole and the impact it has on the aging nursing population.

Nursing is still predominantly a female profession.  However, over the past years with the improved wages and benefits nursing has become an attractive employment option for many men. They say the average age of the nurse today is 48 and most nurses at that age have been nursing for 20 plus years.  We also know that at that age women themselves are going through some major hormonal changes.  These changes can run havoc for anyone, but you add those hormonal changes to someone who is working shift work and for some it is a recipe for disaster. Sleep deprivation is a major concern.

In the area that I work most of the nurses are female, most of the nurses are 50 plus, most of the nurses have worked in nursing for over 25 years, most of the nurse are looking at retirement within the next 5 - 7 years.  In the recovery room we work a variety of shifts. Our first shifts starts at 0800 but we are put "On Call" at 0600 which means we can be called in at 0500 to start work at 0600.  Our latest shift starts at 1600 hrs(4pm) and goes until 2400 plus "On Call" until 0600 the next morning.  I have worked many 14 hours shifts as a result of the "On Call" portion of our rotation.  Our employer is now wanting to initiate a Night Shift  from Tuesday to Saturday.  Most of us on our unit are not in favour of the Night shift primarily for the fact that it would mean 5 night shifts in a row.  I personally  I won't be able to do that.  Not at this stage of my life.  I have worked my share of 12 hour nights and I would be more in favour of doing that with extra days off, but to come off of 5 night shifts and turn around and have to do  day shifts with only a day and half off is not enough recovery time for me or for most nurses.

So I ask myself, what are my options?  I love what I do!  I love the nurses I work with!  I still have 8-10 years before retirement I want to make those the best years I can.  Do I stay in an area I love and work the 5 night shifts in a row and run the risk of ruining my health?  Or do I look for alternate employment?  In the rural area I live my options are limited for working in an acute care environment.  What I do know is that I already suffer from sleep deprivation and as a result I suffer with GI issues, cardiac issues and migraines.  I love nursing but the shift work is taking it's toll on my body and I seriously have to look at what is important for me in my life.

When I entered nursing my 20 odd years ago, I was young and energetic and bounced back after night quickly, not anymore.  I can remember  awhile back my doctor told me that I had to give up night shifts.  I told him "doc that's the nature of the beast".   Night shifts are a reality not only for me but for many nurses and other shift workers.  Our employers talk about the detriments of night shifts and what they say we should do about it, but when it comes to sleeping on breaks and even though all the literature supports it management doesn't.   I'm just not sure what the answer is, I don't think I am ready to be put out to pasture.  I know I still have something to offer I just don't want to do it at the risk of my health.  I never would have thought I would have to make such decisions.

SkyWatch Friday

These photos were taken last January when my daughters were visiting.  We had been out for a drive to one of my favourite spots in Deep Bay.  It was a cool crisp but bright and glorious day. I just loved how blue the sky was. The Light house is Chrome Island one of the few remaining "manned" lighthouses in Canada.







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Ethics

In health care we are faced with many ethical issues.  Some major issues like cryonics for the purpose of banking organs, or freezing embryos,abortion, right to die, no code status and the list goes on.

As a health care professional I have to deal with people who make choices and do things that I don't morally agree with, but as a health care provider I must put my personal beliefs aside and care for these patients.

I remember when I was a nursing student and one of my instructor who use to be an ER nurse would share with us openly how she was sick and tired for caring for patients who tried to commit suicide.  She also made it abundantly clear that she had no time for alcoholics.  At the time I thought she was terribly harsh and thought it was most probably a good thing she wasn't doing direct patient care any longer.

Here I am 21 years later, and I find myself in a somewhat similar boat.  In the hospital that I work we care for psychiatric patients on an in patient and out patient basis.  As a recovery room nurse the psychiatric patients I see are recovering from an ECT(electroconvulsive therapy) . From a personal position I have never agreed with ECT.  I have not seen effective results, although I know their are patients who do benefit from the procedure.  The literature states that the duration for ECT is generally done in a six week series of treatments, so why then am I seeing patients who have been receiving ECTs for longer periods than this?  We had a an outpatient the other day who was so aggressive post procedure we had to call a code white(aggressive patient).  This patient has been receiving ECT on and off  for over three years.  I remember when she started she was thin, appeared well kept  and could actually have a civil conversation with you.  This has progressively not been the case.  This women now is more withdrawn. doesn't care for herself the same as she did and has become increasingly more aggressive after each treatment.

So I ask myself, what purpose is this serving?  Is she leading a more productive life? Is she enjoying life more?  What I have observed would tell me not.  She is not the only patient I have seen who has and continues to have months and years of ECT with little effect.  So who decides?

According to the literature the patient has the ultimate say but I can't help but wonder if there aren't other factors that make them chose to continue with the procedure.  We treat patients with dementia with ECT, are these patients really making informed consent? Who is making this decision?

What are your thoughts.

Skywatch Friday

A lovely evening out on the water just after picking up the prawn traps.

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Skywatch Friday

Early morning fishing

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The table turns

I have been a nurse now for some 20 odd years and in that time I have seen more than I could ever have imagined or cared to have seen. The human race is an interesting breed.  Just when you think you are losing your faith someone comes along and does something amazing or simple but with an amazing impact.

As a nurse I have strived to be compassionate,empathetic and as caring as possible.  Some days granted my envelope gets pushed  and I may respond to someone or something in as not as a caring manner as I should. I am not perfect, surprise!

I often wonder how my care is perceived by patients, I have been thanked many times and told that I have provided good care, but I wonder was there ever something simple that I did that made a difference for a patient.

Yesterday, I was the patient.  I had to go into the hospital for a test.  This test required that I have IV sedation and hence I was seen by many nurses.

The first nurse greeted me with a smile.  She took me into my cubicle showed me the lovely hospital gown that I would have to put on.  She instructed me to get up on the stretcher once changed and that she would be right back.  Upon her return the first thing she asked me was if I was comfortable and could she get me a warm blanket.  I assured her I was comfortable and that a warm blanket wasn't necessary but thanked her anyhow.  She then went on to ask me the routine health questions and as a prudent nurse she had read my chart and started by saying "I see that Dr.....but is there anything else you would like to add or that I should know?"  I thought to myself, good for you for taking the time to review my chart...good for you for asking me if there was anything to add.  Once we had reviewed the necessary documents she started my IV.  I swear she was so slick she could have found a vein on a corpse.  I was suitably impressed.  Once again she asked me if she could get me a warm blanket, I assured her I was fine but I am sure I would love one post procedure.  I wondered for a moment if she was being so kind because she knew I was a RN or if she was like this with all of her patients.  I soon found out that indeed she was like that with all of her patients.  WOW I was impressed.

It wasn't long after that another nurse came checked my name band and wheeled me into the procedure room, she and her colleague like a well oiled machine went over the procedure with me and told me what was going to happen...my only request was that I didn't want to remember any of the procedure, and I didn't.  Once the Dr. came in we had a little chat, he told me what he was going to do...gave me my sedation and I was out...next thing I remember I was in the recovery room and apparently I had been in recovery for a half hour before the nurse started to wake me up.

It came time for me to get dressed and move over to the area where they give you a snack and then send you on your way.  Well I made it to getting dressed....well sort of and then I felt like I was going to be sick, according to my nurse I went pasty white and then of course I was ill.  She was so kind, she settled me back into bed gave me some medication for my nausea and instructed me to have another little rest. Which I gladly did.  It came time to try getting up once again, it was a no go...I got my head up off of the pillow and began to wretch.  Back to laying down I went.  Finally I was able to get up, but my knees were so weak they decided I needed a wheelchair to take me over to the area where I would have a snack.  Thank goodness I was the last patient of the day.  I get over there and I attempt to have some water...that worked...then a sip of gingerale....oops not a good idea....I vomit again.  More IV medicine for the nausea.  At this point I was feeling so bad for keeping them late.  The nurses were so good, they got me warm blankets, and let me just rest.  Finally, I felt I was ready to leave.  Actually, I kept saying I was ready, but they knew better, they told me I had the look of a deer in headlights.  They insisted my husband use a wheelchair to take me to our vehicle.

It was the little things these nurses did for me that stand out.  The offering of a warm blanket, the mouthwash so I could freshen my mouth after being ill, the simple fact that they weren't rushing me out so they could go home.  They were kind caring and compassionate.

To me it's the little things in nursing that make the difference, the things as a patient you will remember.