Nursing & Healthcare Provider License Law Blog - Page 35 of 47

Dirty Little Secrets

September 10, 2015 by LORIE A BROWN, R.N., M.N., J.D. 1 Comment

It is with a bit of embarrassment that I share this story with you but in my opinion the teaching points are important.

Those who have read my books have heard of the man who coded early in my nursing career. While the more experienced nurses went to his aid, I was asked to watch the other patients on the floor. I was new, I was scared and glad it wasn’t my patient.

In the midst of this crisis, one of the nurses came out and asked if I could go to central supply and pickup some equipment. I called and told central supply that we had a code and we needed some life-saving equipment. To my surprise, the person on the phone told me, “We don’t deliver.”

I was shocked! I could not believe that this man’s life was endangered and central supply would NOT bring life-saving equipment while I was still responsible for all the other patients on the floor. Apparently, I was not so diplomatic in my telephone conversation which resulted in my ending up in my head nurse’s office the next day having to account for my response.

I was devastated. I had never been in trouble, never been written up. I had always been somewhat of a rule-follower and never got into trouble only to find myself being written up about this incident.

As a new nurse, I was scared and felt “What am I going to do if something happens to my job? Who’s going to hire me?” I felt ashamed and alone with no one I could turn to. More so, I felt completely unsupported and like I couldn’t confide with anyone. My head nurse even failed to point me in the direction of classes that I could take to improve on my communication skills. I had a dirty little secret.

What I realized and fully understand today is that most nurses feel this way if they are in trouble. The emotion is that they are alone and their life and career are over. However, you do not have to be alone and there is no pride in keeping a secret. As nurses, we need to collaborate and share our challenges to get support from others who have not only already been there but have learned to overcome the feelings. Perhaps had I shared my situation with a co-worker, they might have been able to turn me in a direction to get the help I needed.

As nurses we take care of everybody else but ourselves. And this is one of those situations where, by sharing, we allow other people to give to us and possibly help with a solution to what troubles us. Nurses tend to keep any discipline as a deep, dark secret instead of sharing with others and making it a learning experience. Keeping it as a secret can be more harmful to you than sharing.

I would love to see nurses come together to share their struggles … and solutions, because it does take a village, and a team, to be strong. Sometimes we just can’t do it ourselves.

I invite you to open up and share your struggles with a co-worker for support, compassion, understanding and even assistance because you know you would be there for them if they asked and shared.

There Is No Shame

September 3, 2015 by LORIE A BROWN, R.N., M.N., J.D. 1 Comment

As a nurse, our identity is so tied with our profession. If there is any question about how we are doing our job, we take it personally. If you have been written up or have been disciplined as a nurse, I would encourage you to look at things differently. View it as a learning opportunity.

If you recall, I’m sure you will find times in your life which were difficult or hard but you managed to come through them. My guess is that you came through for the better.

I also have had very difficult times in my life, especially two instances where I thought my life was over. The first time was when I got divorced and that was certainly a life-shattering event. However, I had a great divorce attorney who so impressed me that I decided to go to law school.

The second time was after leaving a law firm where I had been a partner for almost 8 years before my largest client, an insurance company, went out of business. Losing that client and that position with the firm was devastating. The events forced me to start my own successful law office which, of course, allowed me to form Empowered Nurses.

Although both of those times were extremely difficult to go through, those paths led to very positive results for which I remain thankful to this day.

We add meaning to everything in our life. By looking at the good that comes out of it is a much more healthy and positive approach. But with uncomfortable events, looking at things as “neutral” will make life so much easier. We can give a negative meaning to an event and sure, you have to feel your feelings to get through the rough time but, again, make it neutral rather than “bad.” Not only does it make life so much easier but you’ll find that you’re not always at the effect of everything.

You are NOT a bad person because you got a write-up. You’re not a bad person because you had a discipline against your license. Think about the event that caused the discipline or the license question. In all likelihood, it was a one-time isolated event or over a short period of time. But that does not define all the good that you’ve done or all the great care you’ve given your patients and all the ways you’ve contributed to your unit.

You do have a choice of how you look at things. You can look at things as positive or negative or just neutral. The choice is yours! I suggest choosing the one that empowers you.

Fitbits in Nursing

August 27, 2015 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

I guess I’m a little bit of a techie and just got a Fitbit which monitors my steps and activities. I enjoy watching my number of steps throughout the day. When I was a nurse, I would spend my time walking down large halls to see my patients and back to the nurse’s station to chart.

Once I became an attorney and sat at a desk, things changed. Not only did I lose my figure but my nursing bladder as well!

My Fitbit is helping me be conscious of my activity. Earlier this week, I was with a friend in an emergency room. The nurse who started the IV was wearing a Fitbit. I asked him how he likes it? He said he loved it and that he gets in his 10,000 steps usually by three o’clock. This means that although the nurses are active and on their feet all day, it takes an entire shift to get in 10,000 steps. Can you believe that 10,000 steps is equivalent to approximately 5 miles?

As I was researching this for my blog today, I noted there was an orthopedic nurse who also got in about 10,000 steps during the average shift. She mentioned her problem was trying to continue getting 10,000 steps on her off days.

While Fitbits are great and I am enjoying mine, I wanted to share with you a study. Harvard conducted a study of the placebo effects on overweight hotel maids. The surveyors told the maids that because of the amount of activity (exercise) they had in cleaning the rooms, they must be really fit.

They apparently had never considered doing their job as being an exercise regimen but once the seed was planted in their heads, their blood pressure decreased as did their cholesterol and the result was a loss of weight.

What if, as nurses, we believed how physical our job is, will it lower our cholesterol, blood pressure and weight?

In addition to wearing a Fitbit, you are being proactive and adding to your healthful wellbeing because the mind serves a large component and is just as important as the exercise.

If you want to learn more about the Harvard study I mentioned, just go to this link:

http://dash.harvard.edu/bitstream/handle/1/3196007/Langer_ExcersisePlaceboEffect.pdf?sequence=1

You just might be surprised by what you learn.

I would love to hear your thoughts about Fitbits in Nursing. Do you have one and how has it helped you?

Communication In Nursing

August 19, 2015 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

It is really sad to listen to the stories I hear from some of my clients about communications in nursing. Nurses talk behind each other’s back, complain about each other and, sometimes, have no hesitation in putting down others, right in front of each other. It’s sort of like middle school. I know I used to be quiet and keep things in which really bothered me. Now my motto is if it crosses my mind, it crosses my lips if my comments can be a contribution to the other person. Remember you cant put toothpaste back in the tube so blurting things out when your emotionally charged does not help either.

What a difference it would be if nurses could communicate with each other using their GIFTS; giving to each other and talking in integrity.

Here is a system that helps me when I need to communicate with someone. If I am upset with a person, I try to talk with them within 24 hours or, at least, try to schedule a time to speak with them. I do not e-mail, I would rather speak to the person directory. I also don’t gossip and tell anyone else who cannot do anything about the situation.

I then facilitate the conversation by saying, “Here’s what I need support with,” or “Here’s what we can do to work together better,” or “Here’s how you can support me …” By starting with stating your needs makes for a less intimidating presentation to the other person.

When I get their response, I follow up with, “What I hear you saying …” or “I take responsibility for …”

And then I always end with, “Going forward, how can you count on me and how can I count on you?”

Making this agreement will help you to communicate better in the future and establish what you need from each other to have a healthy relationship.

Even though these strategies are good in the workplace, try them at home too. You will see a big difference when you communicate in a giving, authentic manner. I’ve tried it with my teens and it makes a BIG difference.

Are You Practicing Outside The Scope Of Your Nursing License?

August 13, 2015 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

As a registered nurse, do you know the scope of practice? Have you reviewed the Nurse Practice Act of your State? Even with the Nurse Practice Act, what does failure to keep abreast of current theory and practice mean?

The policies and procedures of the facility at which you work are your guiding source. If your policies and procedures covers you, and you are following them, you are practicing within the scope.

However, if there is no official policies and procedures, you may not be practicing within your scope.

If a physician offers to teach you how to suture in place a PICC line, is that acting within the scope? Check you policies and procedures!

If it is the norm in the emergency room that when a patient with abdominal pains arrives to start an IV, draw labs and order a flat plate of the abdomen before the physician sees the patient, do you have standing orders to cover you or is this just a unit norm? Again, your policies and procedures will guide you.

What if a physician orders a medication that is contraindicated and, without speaking to the physician, you write an order to discontinue it and planning to speak with the physician later? I am sure that your policies and procedures do not allow you to discontinue orders without speaking with the doctor.

You may think you are helping the patient in expediting the health care process but, once again, if your facility does not have policies and procedures to cover you, you are practicing medicine without a license and practicing outside the scope of your nursing license.

When a physician issues a verbal order, make sure that you review and verify the order with the doctor. Also, document your conversation in the nurse’s note because, if the physician does not remember giving you that order, by placing a summary of your conversation in the nurses’ notes will help prove that the conversation indeed took place.

Remember that each facility has its own policies and procedures. At one facility, you may be able to do something which is not allowed at another. So, make sure that you not only know your facility’s policies and procedures but that you follow them.

If you are asked to do something that just doesn’t feel right in your gut, talk to your risk manager. The risk manager is here to help and make sure that the patients are getting the best of care.

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