Happy Nurse’s Week!

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The Nurse Who’s There After Sexual Assault

Here is an article from the Atlantic that includes an interview with a SANE nurse.  This is the nurse who works with the police and takes care of the victim of sexual assault.  This nurse has received hours of extra education related to forensics and the damage to the body and mind of the survivor.

This nurse is usually the first contact with healthcare for the victim.  This nurse is responsible for the collection of evidence as well as caring for the body/psyche of the victim.

This nurse acts as the conduit between the victim and the justice department, at least while in the hospital.

Please be sure to read this article in its entirety.  After reading this, you will have a really good grasp on what it is like to be a sexual assault nurse examiner.

The Nurse Who’s There After Sexual Assault

Arlette Stevens Castaño talks about her experience treating survivors and working with police in Tucson, Arizona.

The public discussion over how to think about and address sexual violence has heated up in recent years, prompted by high-profile allegations like those against Nate Parker, Woody Allen, and Bill Cosby, as well as increased attention to sexual assault on college campuses. The increased coverage has also brought attention to widespread problems in how sexual assault is investigated. Across the U.S., there is a backlog of tens of thousands untested rape kits—evidence collected during examinations following sexual assaults—that are currently in police custody. In 2015, the police department in Tucson, Arizona, received a grant of more than $1 million to test its more than 1,000 backlogged kits.Arlette Stevens Castaño, a sexual-assault nurse examiner in Tucson who conducts these examinations, acknowledges the challenges that crime labs and police departments face in getting them tested promptly. I spoke with Stevens Castaño about what inspired her to work with sexual-assault survivors, a nurse’s relationship with law enforcement, and the problem of untested examination kits. This interview has been lightly edited for length and clarity.

Adrienne Green: What made you choose nursing as a career?

Arlette Stevens Castaño, a sexual-assault
nurse in Tucson, Arizona

Arlette Stevens Castaño: Even back in high school, I knew that I wanted to take care of people. I was leaning toward health care, but I wasn’t really sure if I would become a nurse or a physician. After learning more about nursing, I decided that I liked it because I wanted to spend more time educating patients. I’ve always been a person who wanted to prevent bad things from happening, and that tied into the career that I chose. I still feel that preventing infection and disease is very important, not just treating things with medication.

I am a first-generation Mexican-American and I grew up in Tucson, Arizona. I’m bilingual—Spanish is my first language, and I still use it on a daily basis—and I wanted to be out more, working in the community. I attended the University of Arizona, and I have been a registered nurse now for 16 years. Working with the sexual-assault nurse examiner team was a life-changing event…(read the rest of this interview here)

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101 Things We Should Teach Every New Nurse

Here is an article from NurseBuff.com that delineates all the important things we need to teach every new nurse who comes to your floor.

When you graduate from nursing school, you think you are ready to take on the world; the truth of the matter is that you are just getting started and have many things to learn and skills to develop.  It is a fact that many new nurses are no longer working after the first year, at least not in the same capacity.

Being a nurse is hard and it is hard work, but most nurses wouldn’t be found doing anything else.  Therein lies the enigma.

Please read all of these things and see if you agree with this author about what new nurses need to know.


101 Things We Should Teach Every New Nurse


It sucks to be a new nurse, but no one is immune to that period of adjustment. It may take a year or two before you finally get the hang of the nursing practice, but you will get there. Here are 101 essential survival tips every new nurse must know:

1. Never be afraid to ask questions. There is always something to learn in the field of nursing.

2. Learn to admit your mistake. If you plan to keep it forever, bigger problems may arise in the end. You colleagues will understand if you admit your mistake, and they will help you solve it.

3. Always clarify if you have doubts. Never hesitate to clarify a detail regarding your patient’s care if you are unsure about it.

4. Always think before you answer. Whenever the patient, the relative or the doctor is asking you some questions, think of the safest way to answer first. This is also the best thing to do if you are not sure about your response.

5. Plan for the worst and hope for the best. You cannot always predict how peaceful or how chaotic your shift will be, so always be prepared.

6. Keep up with your charts and task as they come up. If you save them for later, there might not be enough time to complete them. Remember that you cannot fully anticipate when you will be really busy.

7. Don’t be too hard on yourself. If you need to pee, don’t hold it as it will just take few minutes of your time. If you need to hydrate yourself, drink before continuing with your tasks. Most nurses delay the little things they need because they focus on finishing a task but in reality, if you are too hard on yourself the work you do will be greatly affected.

8. Stay away from negative people at your area. Being a nurse is already a tough job and it will be helpful to have a positive outlook in your work.

9. Eat between tasks. Nurses are usually deprived of precious time to eat so learn the trick of eating between tasks.

10. Before calling a doctor, always make a list of the things you need to mention. You can’t fully trust your memory when talking through a phone call especially when the doctor is always in a hurry.

11. Invest in your footwear. You will walk a lot in your entire nursing career so wear appropriate nursing shoes that are made for ultimate comfort and durability.

12. Always be on time. Being late is an addicting habit and you need to break it early. No nurse wants to get home late – keep that in mind when receiving the nurse from the previous shift.

13. Learn to be assertive. You must be always confident with what you are doing even if you have little idea about it. How can the patient trust you if you are not confident?

14. Avoid being involved in workplace gossips. It will do nothing good to your career as a nurse.

15. Get some sleep whenever possible. Inefficiency at work happens when there is lack of sleep. You are also more prone to medical errors when you don’t have enough rest.

16. Never leave a room saying that you will be back in a minute. That minute might never come as you can’t predict when you will be busy.

17. If you are unfamiliar with the drug you are about to give, always take time to look it up. The patient has the right to know about the drug he/she will receive so you should be armed with the correct information and the precautions to take.

18. Keep in mind that a good conversation is better than medicine.

19. No one has the right to make you feel incompetent unless you allow them to. Whether you are a new graduate or a veteran nurse with 20 years of experience, there is no reason for someone to make you feel incompetent.

20. Make your statement short and precise when calling a doctor in the middle of the night. These doctors are usually sleepy and you will need to relay your concern straight-to-the-point so they can quickly…(read the rest here)

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15 Reasons to Date a Nurse

Here is a cute article about why you should date a nurse from EHarmony.  I thought something light and fun was called for because we take ourselves too seriously.

So please read and enjoy!


15 Reasons to Date a Nurse

Your crush is a nurse. We say stop nursing that crush — pardon the pun — and ask him/her out!



Here are 15 reasons to date a nurse:

1. Nurses are compassionate and patient, and are often great listeners.

2. Nurses are super-smart. If you’re into both brains and beauty, your date can deliver.

3. Tired of nursing that hangover? Let an actual nurse work his/her feel-better magic.

4. Nurses have seen bodies of all shapes and sizes — and witnessed every kind of bodily function imaginable. Your insecurities and body quirks will likely leave your date unfazed.

5. No waiting in line. You’ll get a quick diagnosis every time you feel under the weather.

6. The uniform. It’s not just sexy on Halloween. (Translation: those scrubs just look so cute and comfy.)

7. Impressive nerves. Nurses remain calm and collected in pretty stressful situations. You want to be dating a nurse in times of emergency and chaos.

8. Nurses work long hours. So if you want a little alone time, a nurse’s crazy schedule might suit you just fine. (Also, with odd hours come odd date times.  Monday afternoon might become the new Friday night.)

9. Nurses make great future parents. No pressure or anything.

10. You’ll be safe. Date a nurse and you’ve got instant access to CPR, safety advice and

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Nurses Say Stress Interferes With Caring For Their Patients

Here is an article from NPR about how stress interferes with patient care.  It also addresses the nurse’s desire to provide ethical care to the patient.  This is a dilemma that all nurses face at one time or another and so far there is no solution.

As long as administrators view nurses as interchangeable and a drain on their budgets, this problem will continue.  Doctors and nurses both have little say in hospital policies in most cases.

It seems sad to me when a nurse must be trained to deal with moral distress.  Why do we have to have the distress in the first place. Please read this article and see what you think about the points brought up by this author.


Nurses Say Stress Interferes With Caring For Their Patients

April 15, 2016    5:00 AM ET


Jordin Purcell-Riess has worked as a registered nurse at the emergency department at St. Francis Hospital in Hartford, Conn., for three years. She describes her workplace as phones going off, voices everywhere, every room full. “You look around and the hallways are full of patients on stretchers; you walk out to the waiting room and you can see on our board that there’s 15 people signing in,” she says. “The second you can get your ICU patient upstairs, there’s another one waiting for you.”

She typically doesn’t get a chance to eat or drink or go to the bathroom during her 12-hour shift, Purcell-Riess says. And she’s not alone. Her nursing manager points out that a 2007 study in the American Journal of Respiratory and Critical Care Medicinefound that 24 percent of ICU nurses and 14 percent of general nurses tested positive for symptoms of post-traumatic stress disorder.

Nursing has long been considered one of the most stressful professions, according to a review of research by the National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention in 2012. Nurses and researchers say it comes down to organizational problems in hospitals worldwide. That includes cuts in staffing; some California nurses struck last month for a week over low staffing and wages.

But some researchers say that just hiring more people won’t fix things. Other proposed solutions include restructuring hospitals so that administrators pay more attention to what nurses have to say about patient care and work flow, and training programs to help nurses relieve their stress and deal with ethical dilemmas.

Theresa Brown is a clinical nurse in Pittsburgh who has written two books about what it’s like to be a nurse. She says nurses are often stretched to the limit.

“A friend said when she started working as a nurse, when she would drive, she would vomit on the way in to work just because of the incredible level of stress,” Brown says.

“One of the senior nurses said there is no place we can go to just be alone and be in a quiet room for five or 10 minutes, except for the bathroom … you could have a patient get really really sick, you could have a patient die, and there’s no break,” she says.

She adds that whenever hospitals start adding new forms of documentation or electronic health records, that work is often given to the nurses so their workload just gets larger. “It shouldn’t be this way, but the patient demands are the ones that can get put off.”

It’s not just a problem in the U.S., either. A recent study in Hong Kong found nurses to be at much higher risk for stress, depression and anxiety compared to the general population. The Guardian reported last January that the number of nurses in the U.K. taking time off due to stress has soared — 1 in 29 are off because of stress. The problem is that most hospitals aren’t organized to support nurses, or even doctors, says Linda Aiken. She is a professor of nursing and sociology at the University of Pennsylvania. “They’re highly bureaucratic, they’re very top-down organizations, they don’t really seek out clinicians’ solutions for solving problems in patient care,” Aiken says. “Therefore the problems exist over decades, and they’re basically not solvable by any individual nurse.”

If the work environment at a particular hospital is bad, just adding more nurses won’t address the problem, Aiken says. As an example of what hospitals…(read more here)

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Doctoring, Without the Doctor

Here is a great article in the NY Times about the struggle Advanced Practice Nurses have waged to be allowed to go where no doctor wants to go–rural America.  These specialized nurses have gotten additional education to enable them to work independently in remote areas.

Since the very beginning of the idea of APN’s, the AMA has been up in arms about nurses who want to be doctors!  They are missing the real point.  Nurses will never aspire to become doctors, period.  They just want to take better care of those patients that need them.  They are willing to go into the rural areas to see patients that would otherwise never receive any medical care.  Doctors don’t want to do that because there isn’t enough money in it.

Whether you agree or disagree with the use of advanced practice nurses, please read this entire article so you will be better prepared the next time you are asked your opinion.

Doctoring, Without the Doctor

It wasn’t. A state law required nurses like her to get a doctor to sign off before they performed the tasks for which they were nationally certified. But the only willing psychiatrist she could find was seven hours away by car and wanted to charge her $500 a month. Discouraged, she set the idea for a practice aside and returned to work on her ranch.

“Do you see a psychiatrist around here? I don’t!” said Ms. Osburn, who has lived in Wood Lake, population 63, for 11 years. “I am willing to practice here. They aren’t. It just gets down to that.”

But in March the rules changed: Nebraska became the 20th state to adopt a law that makes it possible for nurses in a variety of medical fields with most advanced degrees to practice without a doctor’s oversight. Maryland’s governor signed a similar bill into law this month, and eight more states are considering such legislation, according to the American Association of Nurse Practitioners. Now nurses in Nebraska with a master’s degree or better, known as nurse practitioners, no longer have to get a signed agreement from a doctor to be able to do what their state license allows — order and interpret diagnostic tests, prescribe medications and administer treatments.

“I was like, ‘Oh, my gosh, this is such a wonderful victory,’” said Ms. Osburn, who was delivering a calf when she got the news in a text message…(read the rest of the article here)

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A Hit Man Came to Kill Susan Kuhnhausen. She Survived. He Didn’t.

Here is an article from the Willamette Week that shows how nurses are different from other people in that they have to train how to protect themselves from violence at work and sometimes that becomes useful at home. It is because of this training that she survived.  She had to take a life to do so, but she did survive.

Another interesting thing about nurses is that we do not always have good luck when it comes to finding a partner.  Because of the weird schedule most nurses have and the amount of time they spend at work, there is little time or energy left to seek out a suitable mate.  And then there is the nurse’s need to FIX things and HELP others that set them up to be taken advantage of.

Please read this article and see if you agree with me that this nurse is amazing.  I am sorry she had to go through this, but I am happy she survived.

A Hit Man Came to Kill Susan Kuhnhausen. She Survived. He Didn’t.

Ten years later, she tells her story.

Updated August 17
Published August 17

“We have an intruder in the house next door.…The intruder was in the bedroom with a hammer. The woman who lives there thinks she may have strangled him. He was down when she left.”

“Can you put her on the phone?”

“She’s bleeding.”

“Does she need an ambulance?”

“No, she’s a nurse. She says call an ambulance for the guy. He may be dead.”

—Portland 911 call on Sept. 6, 2006

Susan Kuhnhausen took her time going home.

 On the evening of Wednesday, Sept. 6, 2006, the 51-year-old emergency room nurse ended her shift at Providence Portland Medical Center on Northeast Glisan Street and headed to Perfect Look hair salon on East Burnside Street.

As she waited for her turn, she picked up a copy of Oprah magazine and read a poem.

“I will not die an unlived life,” it began. “I will not live in fear.”

One hour later, rested and relaxed, she drove to her blue, one-story Cape Cod with a gray picket fence in the Montavilla neighborhood of Southeast Portland.

In the mudroom at the back of the house, Susan found a note by the microwave from her husband of almost 18 years, Mike. “Sue, haven’t been sleeping. Had to get away—Went to the beach.”

He added that he’d see her on Friday or Saturday. “Luv, ME,” he signed off.

Unlocking the door to the kitchen, Susan heard the beeping of her security alarm. She disarmed it, walked through the house to the front door and then went back outside. It was clear and warm at 6:37 pm that day, and she stood for a minute or two in the front yard, flipping through her mail.

When she came back inside, she kicked off her Birkenstocks and noticed how dark it was in her bedroom on the first floor. Had she forgotten to open the curtains that morning?

Suddenly, from behind the bedroom door, a man lurched toward her.

At 5-foot-9, the 59-year-old stranger weighed 190 pounds. He wore Dockers, a blue-striped shirt and a tan baseball hat pulled down low over his eyes. His long hair was in a ponytail tucked into the cap. He wore yellow rubber gloves on his hands and carried a red and black claw hammer…(read the rest of the article here)

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What Nurses Stand For


Here is a rather lengthy article from theAtlantic.com.  I know it is long, but it is definitely worth the time it takes to read.  This writer captures exactly what it is to be a nurse, using vignettes from different specialties to do it.  The author knows what nurses stand for.

Please take the time and read this article.  I know it is old, it is from 1997, but the message is timeless.  Nurses around the world all do the same job without any recognition or praise.   Nurses do their job because they were called to help others and this is their way of doing that.

If you understand what is happening in healthcare today, please tell someone who matters about your thoughts on it.  Until and unless we all voice our thoughts and worries, nothing will ever change.


What Nurses Stand For

Sitcoms satirize them, the media ignore them, doctors won’t listen to them, and now hospitals are laying them off, sacrificing them to corporate medicine — yet their contribution to patients and families is beyond price.

AT four o’clock on a Friday afternoon the hematology-oncology clinic at Boston’s Beth Israel Hospital is quiet. Paddy Connelly and Frances Kiel, two of the eleven nurses who work in the unit, sit at the nurses’ station — an island consisting of two long desks equipped with phones, which ring constantly, and computers. They are encircled by thirteen blue-leather reclining chairs, in which patients may spend only a brief time, for a short chemotherapy infusion, or an entire afternoon, to receive more complicated chemotherapy or blood products. At one of the chairs Nancy Rumplik is starting to administer chemotherapy to a man in his mid-fifties who has colon cancer.

Rumplik is forty-two and has been a nurse on the unit for seven years. She stands next to the wan-looking man and begins to hang the intravenous drugs that will treat his cancer. As the solution drips through the tubing and into his vein, she sits by his side, watching to make sure that he has no adverse reaction.

Today she is acting as triage nurse — the person responsible for patients who walk in without an appointment, for patients who call with a problem but can’t reach their primary nurse, for the smooth functioning of the unit, and, of course, for responding to any emergencies. Rumplik’s eyes thus constantly sweep the room to check on the other patients. She focuses for a moment on a heavy-set African-American woman in her mid-forties, dressed in a pair of navy slacks and a brightly colored shirt, who is sitting in the opposite corner. Her sister, who is younger and heavier, is by her side. The patient seems fine, so Rumplik returns her attention to the man next to her. Several minutes later she looks up again, checks the woman, and stiffens. There is now a look of anxiety on the woman’s face. Rumplik, leaning forward in her chair, stares at her.

“What’s she getting?” she mouths to Kiel.

Looking at the patient’s chart, Frances Kiel names a drug that has been known to cause severe allergic reactions. In that brief moment, as the two nurses confer, the woman suddenly clasps her chest. Her look of anxiety turns to terror. Her mouth opens and shuts in silent panic. Rumplik leaps up from her chair, as do Kiel and Connelly, and sprints across the room…(read the rest of this article here)

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The dirty secret that is destroying nursing

Here is a post from The Mighty Nurse that I feel bears sharing here.
This is written by someone in the field and expresses the concern of many if not all in healthcare today.  This writer understand that this particular dirty secret is not harmless.

I understand that there needs to be some criteria for reimbursement for services given, however, I don’t think it needs to be based on the patient’s satisfaction survey.  What can the survey say about a patient who cannot get better no matter what?  That the nurses were not nice?  That the trash did not get taken out enough?  What?

I agree with this writer that something akin to infection rates, sentinel events, and general nursing care are much more important when I look for a hospital for me or my families.  I also think staffing ratios should be a part of the criteria.  An overworked nurse cannot give quality care no matter that the nurse wants to.  It just isn’t humanly possible.

Please read the entire post and see what you think about this issue.

The dirty secret that is destroying nursing

by on November 19, 2014 in Nurse Stories

Let me begin by saying this is just my beliefs and thoughts on the subject.

I love being a nurse and I love working at the facility I am at. However, there is a major injustice being done to nurses and all medical staff right now.

Let’s begin by looking at medical staff. Nurses and Certified nurses assistants are a special breed of people.

Any of us who work in the medical field will agree you must have a special personality and strength to work with sick people.

Not just nurses but doctors, nurse practitioners, physician assistants….even those who clean the hospital or transport patients.

We all chose to go to work every day and put ourselves at risk to catch diseases in order to help those who need us.

Each one of us has our own special qualities that makes it possible for us to be unique care givers. Some of us are good at holding someone’s hand, encouraging them, praying with them, some are great at starting IV’s, some are your go to person for any question you can think of.

In all we each are a piece of a puzzle that provide specialized care to you, your family and friends. We go to work for 12 plus hours. We spend on average 13 hours a day with our patients.

We hold our bladders to help others empty theirs. We clean up unspeakable things all while reassuring someone  it is ok. You can’t do this job and not be super human.We walk out of one room watching someone die to walk into your room with a smile on our face to encourage you. We stand up for our patients and do everything possible to keep them safe. Always making sure we do no harm…(read the entire article here)  

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When Burnout Takes its Toll

Here is an article that addresses the issue of burn-out in nursing.  This is a real issue and it is one that affects all aspects in healthcare.  When a nurse becomes burned out, it will affect patients, other nursing staff, nursing management and can actually create a dangerous situation.

I enjoy reading articles and blog posts written by Beth Boynton, RN, MS and I hope you will become familiar with her and her writing.

Please read this entire article and then take your own personal inventory to check to see if you are in danger of being burned-out too.

When Burnout Takes its Toll

Aug 8, 2016 8:30:00 AM / by Greg Hunter & Beth Boynton, RN, MS

It doesn’t take much effort to see that burnout afflicts healthcare workers, not only nurses who take the bulk of bedside care but all care givers.  Just stand near the nurses’ station, in their lounge area or in a corner of one of the wards and you can often see or feel their exhaustion.
I remember meeting up with a nurse friend of mine who came to me one day looking haggard after work. She not only looked exhausted, she sounded despairing.  She told me that she could handle long shifts and overtime. She understood that overly stressful shifts were part of the reality of nursing, but there was never any break in the pressure. She was sorry she was late and wanted to have dinner together, but asked if we could reschedule so she could go to bed early. Of course, I understood and felt worried for her emotional and physical health.
Unfortunately her story is becoming more common, while the versions are different, the theme is the same.  Burnout among nurses is taking its toll, and the result is never good for anyone!

What are the Signs of Burnout?

You know you are burned out when you feel you are not rested. There never seems enough time to do the things that you enjoy, like spending time with family and friends. You sleep late, and wake up still feeling tired. You feel like your life is composed of your job and little sleep. You cringe when  your phone rings and upon answering, hear the charge nurse asking you to fill in a shift. Reluctantly you say yes and then find yourself going back to work.

There is also emotional exhaustion, where the emotional and physical stressors take a toll on you. These include having patients dying on your shift or someone lashing out at you and leaving your dignity smashed to pieces. Then you have to deal with someone who makes everyone’s day extra stressful, and as if not content with his or her bullying behavior, your inadequacies are all thrown at your face. Would the student nurse you snapped at earlier think of you as a bully? She looked so hurt.
In time, you see yourself changing. The once enthusiastic learner and compassionate care giver has become irritable, cynical, overcritical, uncaring, indifferent, and distant. You realize that your frustrations at work are piling up. You don’t finish your tasks on time because there is just too much paperwork to be done and too many protocols to keep up with and follow. Help, equipment, supplies and verification measures are constantly unavailable or not working properly. There are too many memos and too little recognition. And the rare recognition, such as, “Thanks for staying on the extra shift” doesn’t even feel good anymore!

What is the Result of Burnout?

The ultimate result of burnout, according to research, is poor patient outcome or dissatisfaction. The consequences could be a myriad of problems that becomes cyclic. Burnout leads to more absences, resignations and legal disputes. Nurses who decide to stay are burdened with more work because of turnovers, and again burnout looms in. The cycle goes on, and like a tornado, more healthcare workers are caught in its path. With the aftermath resulting in poor service and negative patient outcomes.

How to Reduce or Prevent Burnout in the Workplace?

Because burnout is a result of many factors, addressing it poses a great challenge both to nurses themselves and to the management. Although nurses may feel a lack of control over their work conditions…(read the rest of the article here)
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