Nurses as Teachers - a Magnet force

Well almost everyday I work, I have a student assigned to my patients. Sometimes I enjoy the students and sometimes I just wish they would go away! This past week I went 2 for 3. So I have decided to take a new approach with them. First thing in the morning I ask them what they would like to get out of the day, and what they expect from me. Essentially asking them their personal objectives for their clinical experience. Working in mother/baby, often the students have no interest in that department. So given they don't really want to learn about the nursing process related to that patient population, what else can I teach them?

So yesterday I had a fun loving, outgoing male 26 year old, working on his second degree. He doesn't intend to work mother baby so I taught him time management and critical thinking. I made him think through things: Me: "Can you get the patient some jello" Student: "Sure, where is it?" Me: "In the pantry behind the desk" Student:"There wasn't any in there" Me"Where did you look?" Student:"In the fridge" Me:"Try looking in the door of the fridge" Student: "Oh, OK"
He returns victoriously with the jello in hand. Me:"What is she going to do with that jello" Student: "eat it????" Me: "Is she going to do some Jello shots?" Student:"Ohhh, a spoooon!"

Eventually the patient got the jello and a spoon! Actually the critical thinking came with the diabetic patient who prior to pregnancy had been on oral meds with insulin therapy started during pregnancy. She was post op 12 hours on clear liquids 1800 ADA which was presented on a tray as non-diabetic juice, jello & popsicles....Me: "What do you think about this tray?"

So going the extra mile to teach while providing patient care and learning an ever evolving process related to the EHR, is exhausting! But very rewarding...and at the end of the day my student said "I really learned a lot today. Thank you" He was surprised and grateful and I realized I like teaching! Oh oh...double masters??? FNP and Education?

Crunch Time

Well at this point in the semester it begins to feel like you are home free. This feeling is deceptive. It is actually the busiest time of the semester. All papers start coming due, while the weekly work stays on pace. Meanwhile I am feeling more ahead than before, wrong! I am feeling the presence of these five classes waiting anxiously to register for the final 2 this summer. Mentally there is something to registering for the final step! Of course for me that the end of the beginning and in the fall the Masters program. I have applied and await notice of acceptance.

Spring What?

That was anything but a break! I am worn out. We are in a very busy season of back to back out of town guests, school and health issues. We might have a surgery coming up and I am not sure I have time for that. I am hoping our family can put off the surgery until May 19th! Well see? In the mean time, time management is the key.
I continue at work to brainstorm regarding the communication problems that I will be addressing in my paper. I have been discovering some of the communication requirements that our facility requires but that our unit is neglecting. I am excited about making a difference.

Spring Break

For the first time since 1989 I lucking forward to spring break! I am taking my children to San Antonio which will be our first visit. Sometimes good leadership means knowing when to put work aside and have some fun!

Discipline

All lives have seasons. This for me is a season of discipline. I must be disciplined to manage my responsibilities or I will succumb to faulty time management. Sitting at the computer to write DB postings, blogs, papers etc...puts you in the vulnerable position of searching the Internet. I keep multiple windows open at a time, pandora for music, blackboard of course, TWU email, and Facebook! Although I have to say I am sort of over FB, I still check it a couple times a day. Yesterday, I ended up on Ebay looking for some computer software which led to looking for a computer...which led to me saying, "What are you doing?".
For the most part I am disciplined with my time, out of necessity. One of my coworkers asked how school was going, what was I taking etc...when I told her she said, "what are you trying to do kill yourself?" Absolutely not! Honestly, the only way I am surviving this season is by relying on others. My husband, daughters and most importantly my Savior - Jesus. He is the God of my days, the God of my nights, the Divine of my discipline and the Peace in my peril. In my weakness He is made strong. By his Holy Spirit, I will be led back to my task from Ebay or FB, and given clarity to see it through until the end.

2 hour Wait for a Rapid Strep Screen?!

My youngest daughter had a sore throat the other day and woke with a mild temperature elevation. So I took her in to make sure it wasn't strep. Everyone knows that when you present to the office for a sore throat, they are going to swab for a rapid strep and culture. The rapid strip takes 5 minutes for results. Why is it that we must continue the culture where the DR is the expert who I will have to wait for patiently. Can't we run an office where you walk in, c/o sore throat get swabbed by assistant, put in room for exam, when the "expert" comes in results are there, exam done out in 30 minutes.
Wednesday I waited 20 minutes to go to the back room, 40 minutes for Dr. to come in, 15 minutes for swab to be done, 10 for lab to give results, 10 minutes for Dr to come back in. That is 1 hour 35 minutes. How much is my time worth? How much is the exam room worth per hour? Why are we okay with the wastefulness?
My plan is to be an FNP, can I set up a protocol that says I want the swab done after the patient signs in? I want result on chart when the patient is brought back. I am in that room once and my patient is on their way home to rest. Next patient, next billing code, next reimbursement. Efficiency, rather than pomp and circumstance. What do you think?

Week 5 - Paper Planning

I have been considering an identified change needed on my unit. The problem is there are so many to choose from. My unit is in such a state of flux and has been through so much over the past couple of years, the last thing anyone wants is more CHANGE. What we need is consistency and predictability.
One of the consistent problems on the unit, even through the other changes, is poor communication. Every time we go to work there is a new policy or procedure in place that has not been communicated to staff. So we play a version of the game telephone that is very dangerous.
My goal is to address the communication and bring about standardization to our unit. I will use the Unit Based Council of our unit as the means of bringing about the change. All of this will be consistent with the facility goal of re-designation as a Magnet facility. Hey I think I just came up with my proposal. Cut, paste, email, and check off another assignment. :)