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Nursing tips

Palliative Care: A Day in the Life

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“Life is pleasant; Death is peaceful. It’s the transition that is troublesome”- Isaac Asimov

Palliative care is a field of medicine that focuses on an individual’s and family’s quality of life as they suffer from a chronic illness. It involves ensuring the individual is knowledgeable about their disease process, has all of the resources they need to succeed, and can ultimately end with Hospice care.

Palliative care candidates are those who suffer from chronic illness such as heart failure, COPD, multiple sclerosis, cancer, etc. Hospice is a subset of the umbrella of palliative care, but not all palliative services involve hospice.

Palliative care enables individuals to have the best quality of life for their illness. With the knowledge they need to succeed, individuals with palliative care often live longer, go to the hospital less, and have a higher life satisfaction.

The team involves MDs, RNs, social workers, case managers, and more. They all work together to provide an extra layer of support and listening ears. The team may assist with arranging resources, pain control relating to the illness, advanced care planning, end of life wishes, among many others things.

Today, I got the opportunity to witness a beautiful conversation between a palliative care nurse and a wife of her very ill husband at the bedside in the ICU. The RN opened the conversation to the wife and the wife had unrealistic beliefs regarding her husband’s medical condition. The RN was able to answer questions regarding his diagnosis/prognosis, provide options, pray, and truly listen to the wife’s concerns. Here are a few questions/concerns the wife had that were answered:

  • What will happen if we turn off the machines?
  • Will the doctor say, ‘I told you so’?
  • Will he gasp for air?
  • How will I live without him?
  • I never lost hope in God. This just isn’t in his plan and that is so hard.
  • How do I tell my 3.5 year old granddaughter that papa is not coming home?
  • How do I call and start this conversation with my family?
  • He isn’t getting any better, but my heart hurts so much.
  • I know he wouldn’t want to be on life support, but how do I know when to stop it?

The Palliative Care team gives families and individuals the opportunity to discuss their concerns in a safe environment and the support when they may not even realize they need it. It is a heartbreaking field to be in, but it is truly a calling and the opportunity to witness this interaction was such a blessing.

Do you have any patients or family members that may benefit from palliative care?

Until next shift,

Shania

A Glass Half Full

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“For what you see and hear depends a good deal on where you are standing: it also depends on what sort of person you are.” 
― C.S. Lewis

I sit here alone with my two dogs on a snowy afternoon. My alone time often brings on my anxiety as my mind is able to wander. I am stuck inside with a frozen tundra outside. My breakfast plans have been canceled. My husband was picked up to work at the hospital and will be remaining there for 1-2 days. So, I sit. The dogs start barking because they hear kids screaming outside. That is when I think of perspective.

When I was younger, snow days were the best. We got to get off school, enjoy the one time a year we could sled and build a snowman, while my parents were upset because the roads were icy. At that time, we were young and didn’t care because we got to play all day. As an adult, I observe the snow from afar and sit in my cozy home with my anxiety creeping in as I know I’ll be sleeping alone and forcing myself to keep busy. But that is all perspective. Why am I anxious that it is snowing as an adult when before it brought so much joy? How selfish it is of me to be experiencing these feelings when I am resting in a warm home on my day off. I can drink as much coffee as I want to. I can cuddle with my pups and watch as much Netflix as I want. Why does my mind immediately go to anxiety-provoking thoughts? It is all about perspective.

I choose to find the joy in everything. Those kids’ screams are so happy as they get to sled down the parking lot. I get to blast worship music and sing as loud as I want to (and not well) because my husband is not home. I can choose a chick-flick if I want to. I choose to enjoy the beauty of the white blanket of snow (and ice) that is out my window because I have no responsibilities today. I choose to see an unfortunate situation from a positive perspective. I choose to always see the glass half-full.

Until next shift,

Shania

A Passionate Purpose

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“If you can’t figure out your purpose, figure out your passion. For your passion will lead you right into your purpose.” —Bishop T.D. Jakes

Wasted time is my biggest fear. Time only moves forward and you cannot get it back. So many people simply settle for the ordinary, go the safe or easy route, and fail to really question what they want to accomplish in their lives.

Begin by exploring what you love to do, then figure out how to make that a career. Anything done with true passion, will make you so much more successful. Even if you have to study extra hard or work longer hours, pursuing your passion will lead you to your purpose and all of that time is time well spent.

The biggest breakthrough I had as a nurse was that the bedside is not where I saw myself forever. I often would have feelings of anxiety, fatigue, and just not looking forward to going into work. Living a life with that constant rotation “just gotta get through these 3 shifts, then it’s the weekend” is not a healthy way to live. We spend a majority of our lives working, why should it be something that is only done to live for the weekend? Why not pursue a career that does not even feel like we are working? That is a life I want to live. Sure, a job is a job and must make ends meet, but it does not have to be stressful or anxiety-provoking 100% of the time.

Recognizing my thoughts and feelings led me to pursue a job change and my voice acting career. I love nursing, but the bedside was burning me out. I was offered a night charge position and really enjoy it so far. The change of pace and daily routine have improved my anxiety and does allow more time for acting auditions!

My ultimate career goals in life are to allow voice acting to be my main source of income and work PRN at the bedside. Nursing is a career I enjoy, but acting is my passion and I will live to pursue it.

Until next shift,

Shania

It is okay to be selfish

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“If you feel ‘burnout’ setting in, if you feel demoralized and exhausted, it is best, for the sake of everyone, to withdraw and restore yourself.”- Dalai Lama

“As you grow older, you will discover that you have two hands, one for helping yourself, the other for helping others.” – Maya Angelou

“For the whole law is fulfilled in one word: ‘You shall love your neighbor as yourself.'” – Galatians 5:14 (ESV)

2020 brought isolation, heartache, loss, and change. It brought anxiety and depression into people who previously never had these feelings, and worsened it for those with these issues chronically. With all of these challenges, it also brought many awakenings and lessons. It forced people to look inward and to question the important things in life. It heightened the importance of self care. I don’t know how anyone would have survived (and continue to survive) this season without properly caring for their body, mind, and soul.

I had to remind myself many times that I cannot pour from an empty cup- meaning that I cannot help/care for others if I am not caring for myself. Here are a few things I have done and continue to do to care for myself in the year of the pandemic:

  1. I started to take acting classes and decided to pursue my passion professionally.- I met a lot of wonderful aspiring actors and have become friends with people all over the world.
  2. My husband and I started doing yoga together.
  3. Sticking to a scheduled workout routine.
  4. Healthy meal prepping.
  5. I recognized my long-time need for anxiety medication.
  6. I appreciate life’s little blessings: grocery shopping/cooking with my love, going out to eat, hugging my grandma, going to the movies, going to concerts, being physically present in community.
  7. Attend church virtually- the church is not a building, but the people in it.
  8. I switched from my day shift RN position into a Charge RN position on night shift- definitely the best career move so far.
  9. I started my voiceover business.- I now have a home studio, coach, and can professionally audition for voiceover jobs. I never would have pursued this without taking the time to truly recognize what I want to be when I grow up.
  10. USE MY TIME WISELY- This has been my motto for life. Always set goals, learn new things, read a good book, watch a tv show, exercise, call your friends/family, cuddle with your dog, sleep. Find things to do that are productive, soul-loving activities that are not simply scrolling social media.

Until next shift,

Shania

I got the COVID-19…

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Speak out on behalf of the voiceless and for the rights of all who are vulnerable. -Proverbs 31:8

After working five 12-hr shifts this week, I was one of the fortunate people to receive the Pfizer COVID-19 vaccine. I choose to receive this vaccine for the return of social gatherings, hugs, concerts, game days, to protect those who are immunocompromised, and to relieve the strain on the healthcare system.

Any new medication or vaccine does have some risks and concerns. After speaking with multiple hospitalists and doing my own research, I am hopeful for better days to come.

What is special about an mRNA vaccine?

  • mRNA vaccines create the same protein (spike protein) that is on the SARS-CoV-2 in our bodies so that we can produce antibodies that will fight an infection if we are infected.
  • This differs from the flu vaccine which is an inactivated form of the virus. This is not the case with the COVID vaccine- you cannot get COVID by simply taking the vaccine.

How is this safe when developed so quickly?

  • Many people, including myself, have been hesitant to accept a vaccine that has been developed so quickly. However, I have learned that scientists have been familiar with  mRNA vaccines for years. Once COVID hit, these scientists were able to identify the spike protein on the actual virus and create that same protein into a vaccine for our protection.

How is it administered?

  • The vaccine is an intramuscular injection like the flu vaccine and is administered in 2 doses either 21 days apart (Pfizer) or 28 days apart (Moderna).

Considerations/Unknowns

  • It is unknown how long natural immunity will last for someone who has already had the COVID-19.
  • mild s/e include pain at the injection site, muscle aches, fatigue, h/a, chills, joint pain, and fever. These were more common with the second dose than the first.

What is vaccine efficacy?

  • A vaccine is shown to be effective if it reduces the chance of becoming seriously ill.
  • Pfizer has shown 95% effectiveness, meaning that 95% of people will not become seriously ill if infected with the virus. This is actually wonderful, considering the flu vaccine is at most around 50% effective.
  • it is unknown whether the vaccine reduces transmissibility- continue to wear masks!

I hope this relieves some concerns about the vaccine. I believe in the science and pray for a happier and healthier 2021.

Until next shift,

Shania

Sources:

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

https://www.mayoclinic.org/coronavirus-covid-19

Mayo Clinic answers questions about COVID-19 vaccine

I Owe You a Coffee

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The hospital has hired several new hospitalists during the past few months. One in particular really clicked with me. I introduced myself to her because she had several of my patients for the day, who required a lot of attention. I had to call her several times regarding discharge planning/issues, a change in antibiotics, and family concerns.

Typically, many doctors seem to get annoyed by patient/nurse concerns and don’t communicate with the nurses as much as we would like. At the end of the week, this hospitalist repeatedly thanked me for “making her first days easier” and for “telling her any issues/concerns so we can solve them.” She even offered to buy me a coffee sometime for her gratitude.

It is really nice to see true nurse-physician communication without feeling overpowered. She valued my opinion/suggestions, took her time to assess the nurse and patient needs, and treated me like we were on the same team (which we are).

Relationships like this are so important in healthcare, yet so minimal. It is so frustrating to be hesitant to call a doctor for a legitimate concern. It’s frustrating to sense that a physician feels like they have all of the power/intelligence. It is important to remember multi-disciplinary care and recognize that each member is on the same team to serve the patient.

Until next shift,

Shania

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615-856-8181
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