Nursing Voices

Friday, September 29, 2006

Dying to be Beautiful

Margie from admitting was on the phone. Her usual bright and bubbly phone voice was subdued. My new patient was down stairs ready to be picked up and she added with a whisper to bring a wheelchair. This girl was in bad shape. Her name was Lisa.

I grabbed a wheelchair out of the hall and scurried down to admitting. Lisa was waiting for me with her parents in a side office. She weighed just over 80 pounds and looked like a refuge from a concentration camp. She was weak. The muscles in her neck could hardly hold her head up. Her face was ashen . Her legs were swollen and red. Her blond hair was dry, brittle, and falling out. She could hardly speak. After signing voluntary admission papers for the psychiatric unit, I took her up stairs to her room.

Lisa typifies so many young women in this country who starve themselves to be beautiful. What is anorexia? Simply put it is the refusal to maintain a body weight at or above a minimally normal weight for age and height. There is an intense fear of gaining weight or becoming fat even though the person is under weight. How common is anorexia? There are many idea about that, but no one really knows for sure. It’s prevalence in the United States is around 0.1%to 0.6% in the general population and several times higher in adolescent girls. In this country women are getting heavier each generation while the concept of beauty is getting slimmer. More than half of American women say they are on a diet. In recent surveys of 5th to 8th grade girls, 31% said they were on a diet, 9% said they had sometimes fasted, and 5% had deliberately induced vomiting.

Lisa was more than a statistic. I was new to the psychiatric nursing field and she was my first anorexic patient. Why did this happen to her? Lisa was the only child of highly educated parents that were both highly respected professionals in the community. They treasured her. She had majored in the arts and was on her way to a highly successful career. She had everything to live for - and she was dying.

I worked with Lisa for 2 years. Her disease even baffled her. She wanted to be “normal” again. She didn’t know how she had become sick. She would look at her frail body in the mirror and see rolls of fat hanging off of her withering frame. I remember her saying “I just want to be beautiful”. Her parents felt guilty. She felt ashamed. We worked with the entire family. She would reach 98 pounds, and be discharged. After a month or two she would come back to us, weaker and more depressed then ever. This was her cycle until she died of a cardiac arrest in her sleep.

Lisa gave me insight on caring for patients with anorexia. She and I took our victories where we could. Instead of allowing her to focus on her guilt, for not gaining enough weight to meet her goal, we would celebrate the six ounces she did gain by taking a short walk around the block. We would take this private time to focus on the future,discussing what she wanted for herself. This was how I got her to focus on living another day. When she met her goal we really celebrated. I kept two plastic champagne party cup in the nurses station and we would toast her triumph with Perrier water, her favorite.

The use of visualization worked well at times. I would assist Lisa by aiding her with progressive relation techniques and then have her visualize her body as healthy again. She would tell me later that during those sessions she could feel her physical and emotional energies recharging themselves. Because Lisa found this technique to be useful, I continue to use it with all my anorexic patients.

During Lisa’s illness her parents were fighting two battles - the anorexia and their insurance company. The treatment of anorexia is a long and expensive one. Their insurance company threatened to cut off paying for Lisa’s care. I went to the hospital’s utilization review coordinator to see what the insurance companies target in the nursing notes that would determine the status of a claim. These are points I address in all my care plans. This points assure good patient care, and help patients and their family members when dealing with their insurance company. All entries must show in a measurable way the success or failure of the patient’s treatment. Calorie counts and daily weights are done accurately and documented. Any quotes the patient gives during therapy can be important especially if the patient is depressed and suicidal. Monitoring the patients medical condition including vitals every shift, intake and output, observe for signs of infection, and for any signs of stress fractures or organ failure. All patient and family teaching done must be documented in detail.

I was Lisa’s nurse, but she was my teacher. I keep her alive in my heart by using what I learned from her to help others.

Tuesday, September 26, 2006

Give Me That Old Time Rock And Roll

I’ll give that song a ninety-five; it has a good beat and it’s easy to dance to.

When I was a girl growing up in Iowa, I remember watching American Bandstand with my mom every Saturday morning. We would watch the show on our small screen, black and white TV, and Mom would adjust the rabbit ears on the antenna as I danced around the living room in my bare feet. Mom and I listened to the music and critiqued the latest fashion trends. We both loved poodle skirts. I remember my favorite song was something about a one-eye-one-horn-flying-purple people eater. Yes, really! As the years passed the music changed, and I now have a long list of music favorites. I’ve been tagged, and these are my seven favorite songs.

Angel: by Sarah McLachlan. Don’t ask me why I like a song that makes me cry. Even nasty Simon Cowell loves this song.

Just to be Loved: by Al Jarreau. Listening to smooth jazz while sipping a glass of wine. It's heaven.

Peacekeeper: by Fleetwood Mac. This is the best anti-war song recorded since Woodstock.

Imagine: by John Lennon. World Peace.

Sad, Sad, Sad: by the Rolling Stones. I like it because it’s loud, loud, loud!

Simply Irresistible: by Robert Palmer. Cool clone chicks.

Bolero: by Maurice Ravel.
Do I really need to explain this one?

Scapel, you're tagged and so is anyone else who wants to play:-)

Sunday, September 24, 2006

An Old Dog Learning New Tricks

I just started learning about blogs a few months ago, and I’m still learning new things about the blogosphere everyday. Emergiblog is one of my all time favorite nurse blogs, and I want my sidebar to look like emergiblog's, but I don't know what to do. Where do all those cute little icons like “My Yahoo” and “newsgator” come from? And what is a RSS feed and how do blogs get hooked up to them? How do you increase traffic on your blog? In a modified version of Dr. McCoy’s famous Star Trek quote, “I’m a nurse, not a computer geek.”

Is there anyone out there willing to help an old dog err... nurse learn some new tricks about blogging?

Friday, September 22, 2006

Here Comes the Bride

There’s a tradition on every nurses station when a nurse gets engaged. You know the drill, the bride-to-be prances into the nurses station and whips out her hand, revealing her engagement ring. Then, with great fanfare, everyone at the nurses station starts jumping up and down, and squealing with delight. Soon after, there’s a stack of wedding magazines spread around the nurses station as preparations for the big day begin.

After watching this tradition for many years, I’ve learned a bride must possess three qualities when planning a modern wedding: she must be organized, have nerves of steel, and very deep pockets. But thanks to Vera Wang, a popular wedding gown designer, planning a wedding is now easy. Wang not only designs stunning wedding gowns with equally stunning price tags, she has a full line of wedding products to meet your every need.

To make planning easier, Wang sells her own line of china, crystal, flatware, footwear, lingerie, cosmetics and perfume, and jewelry. Needless to say, none of this stuff is sold at Ikea, so you can expect to go broke if you buy Wang’s products. And remember, no wedding is complete without an expensive honeymoon, and for $4,000 a night, the happy couple can stay in the Vera Wang suite at the Halekulani resort in Waikiki, Hawaii.

Every time I see a stack of wedding magazines in the nurses station, I toss a Home Depot catalog on top of the pile, and tell the bride-to-be that if she picks out a ladder, I’ll buy it for her so she can elope. So far, no one has taken me up on my offer. Maybe they would if Vera Wang designed hardware.

Wednesday, September 20, 2006

Looking for a Few Good Men

Nursing: It's A Guy Thing

Nursing isn't looking for just a few good men, our profession is looking for a lot of good men. Being a nurse doesn't make a guy a "sissy," it’s for anyone with intelligences and integrity that’s willing to work hard to care for others. Look at this group of guys. Do they look like girly-men to you? This poster is a favorite of mine and was published by the Oregon Center for Nursing.

Descriptions of the above guys, from left to right:

Sang Kim RN
Cardiac Telemetry Nurse

Terry Misener RN, PhD
Dean, School of Nursing
Retired Lieutenant Colonel, U.S. Army

Yuri Chavez RN, CRNA
Nurse Anesthetist
2:54 LA Marathon

Roland Jomerson RN
Post Anesthesia Recovery Nurse
Decorated Vietnam Combat Medic and Retired Major, U.S. Army

Don Mucciprosso RN
Poison Specialist Nurse
Harley Rider

Walter Moore, Jr. RN
Intensive Care Unit Nurse
U.S. Navy Seal Team One

Bill Maddalena SN
Student Nurse
3rd Degree Black Belt Kenpo

L. Rey Ariola RN
Cardiology Nurse
Rugby Right Prop

Jason Scott Carrick SN
Student Nurse
Basketball Power Forward

Since this post is about men in nursing, I wanted to show you that not all trashy nurse romance novels are about loose women who want to marry doctors. Meet Nurse Gigolo. He’s not only the man of the month, he’s the man of my dreams. He sure is cute, but I wonder what his nursing skills are like. Silly me, I'm sure his "other skills" make up for whatever he lacks in the nursing department. (*Blush*).

A Note to Nurse Recruiters

Move over GI Joe and classic Cylon Minimates, there’s a new action figure in town, and he’s rough, tough, and ready for action. He can do things no other action figure can do; he can work double shifts and save lives without breaking a sweat. And while he doesn’t kill bad guys to make the world a safer place, he’s everyone’s hero….he’s a nurse. If nurse recruiters start passing these out at daycare centers, we will get more men into the nursing profession within the next fifteen to twenty years.

I think the makers of the action figure used this nurse as their model. What do you think?

Monday, September 18, 2006

The Healer

Permabook edition published June, 1956. Cover painting by Tom Dunn

This is a book I recently added to my book collection that was written by one of my favorite cheesy-trash authors, Frank G. Slaughter. A best selling novelist and physician, whose books sold more than 60 million copies, Slaughter said he drew on his experiences as a physician when writing his books. Good grief, if I didn’t know what really went on in a hospital, I’d be afraid to let a doctor touch me after reading one of Slaughter's books. I’ve never been able to figure out why a guy that studied at Duke University, and received his medical degree from John Hopkins Medical School, Baltimore, would write this stuff, but I’m sure the money was good, or else he would have gone back to practicing medicine.

Today’s selection is about a doctor that had to choose between saving his patient, a sexy surgical nurse, and going to jail. The caption reads, “If Dr. Carter saved this woman’s life, her testimony might ruin him." My, my, the decisions some doctors have to make. It sounds so stressful.

Here’s our hero, Doctor Don Carter, fresh from the OR, wearing gross red surgical gloves, and looking dazed and confused. The book is about the “special” relationship Dr. Carter had with his surgical nurse, Laura Jordan. She’s the hot blond sitting in the witness chair. She looks appalled that her coworkers let Dr. Carter leave the hospital while he was still wearing his surgical gown and gloves. Didn't they know he was coming to court? The book describes Jordon as “a grimly efficient surgical nurse,” but a nurse that was “all woman” outside of the hospital.

Here’s the plot:

“Dr. Don Carter opened his gloved palm to receive the scalpel. The steel was cold to his touch. For a moment the knife was poised above Laura Jordan’s skull….

‘If I save her, she may ruin me,’ Don thought. ‘If I don’t, I can never face myself again.’ Suddenly the knife inscribed a long-practiced incision. The operation had begun.

Ever since one of his patients had died, Dr. Don Carter had been tormented by the fear that he might have been careless. Only Laura, his operating-room nurse, could tell him the truth.

Then she lost her memory in an accident. Don Carter faced this terrifying dilemma: could he bring back Laura’s memory and with it perhaps the one fact that could expel him from the medical world forever?”

Like in all of Slaughter’s books, everyone lives happily ever after. Carter learns that he didn’t injure his patient in the OR and the court case against him is dropped, and Jordan gets her memory back and dumps Carter for another man. Now that’s what I call gratitude, but don’t feel bad for Carter, he dumps his bitchy, domineering wife for a beautiful, rich socialite. And so goes the life of a healer.

Friday, September 15, 2006

What I Learned in Nursing Boot Camp

Nursing school was boot camp. My classmates and I worked long, hard hours, learning how to take care of our patients. Another thing my classmates and I learned was the secret to nursing longevity. Our teachers said that if we followed three rules, we would stay in the nursing profession forever: Wear comfortable nursing shoes when reporting for duty, work together as a team when giving patient care, and live life to the fullest. Even Florence Nightingale knew how to have fun, and we all know what great things she did as a nurse. Here are some tried and true tips on preventing burnout, while enjoying your nursing career.

Does this look familiar to you? Look at these nurses putting out a fire. They are working as a team.

I worked yesterday evening and I all I did for eight hours was run around in circles, trying to keep the unit from falling apart. Everyone needed PRN medications, the phone wouldn’t stop ringing, two psychotic patients tried running off the unit, and one staff member, a tech, went home without telling anyone he was leaving. We didn’t know he had gone home until a patient told us he saw the staff member leave the unit, carrying his backpack and coat. For the rest of the night I looked at the charge nurse and said,“I go home now, OK?” She bristled and then thanked me for at least asking before I eloped from the unit. We made it through the rest of the shift because we could laugh about what was happening, and we worked together as a team.

Life is a balancing act. I’ve learned to take time for myself during the day as a way of preparing for work. Do you remember that yoga class I told you about? I really love it. Yoga makes me feel twenty years younger and gives me more energy. If you want to get through your shifts without pulling your hair out, find the time to do things that make you happy.

Look, it's nurses gone wild! Ok, so maybe they aren't going wild, but they look like they're having a good time. Laugh with your friends and don't be so serious. So what if people think you’re a little crazy. Do what these nursing are doing, take a walk, climb a tree, and have some fun. Remember, life is too short to be normal.

Uniforms on Parade

Anchors away! Our first group of nurses are wearing stylish government issue nursing uniforms from the turn-of-the-century, complete with corsets, high necklines, and white puffy skirts. Since these gals are the first twenty nurses appointed to the US Navy in 1908, it’s only appropriate that their nursing caps resemble little white sail boats perched on their heads. I bet these uniforms were a real treat to wear during hot weather and high tide.

Excuse me nurse, but are those swastikas on your scarf? This Latvian nurse is modeling a rare type of uniform, which was worn only by Liepaja Brigade of Nurses. Good grief, didn't she know that dressing up like a Nazi nurse is definitely a fashion don’t. Apparently, they didn’t have fashion consultants back then. This photo is from 1928.

This young woman is modeling the popular “Angel of Mercy” look, accessorized with a red cross on her apron, and real angels flying overhead. This uniform is a tribute to French fashion sense.

Our next model looks like a contestant from the old TV show, “Queen for a Day.” She is sitting on her thrown, wearing her cape and white cap that is perched on her head like a crown. There was a time when nurses were treated like royalty. Now nurses are treated like assembly line workers. And people wonder why there is a nursing shortage.

According to the back of this picture, Claudette is wearing a Christian Dior culotte “everall,” in white drill (whatever that is) with a long zipper. Designed by Jorn Lanberg, this outfit was not worn with white nursing shoes—everyone knows you never wear white shoes after Labor Day—or a real nurses cap. The reason this uniform never caught had to do with its price tag. If your patients were throwing up on you, would you wear something expensive? The photo is dated October 17, 1971.

It’s back to the future in this electric dress designed by avant-garde artist, Atsuko Tanakas. The first electric dress was made in 1956, and was a combination of the tradition Japanese kimono and modern industrial technology. The first dress was made entirely of wires and more than one hundred colored light bulbs and neon light tubes that flashed every two and a half minutes. Today’s electric dress would make a great nursing uniform of tomorrow. Nurses could check IV at night without turning on lights and waking their patients.

Monday, September 11, 2006

Don't Mess with Emergency Room Nurses

I think this book was written about the nurse in this news story:

Nurse Strangles Intruder With Bare Hands By Associated Press Fri Sep 8, 3:27 PM

PORTLAND, Ore. - A nurse returning from work discovered an intruder armed with a hammer in her home and strangled him with her bare hands, police said.

Susan Kuhnhausen, 51, ran to a neighbor's house after the confrontation Wednesday night. Police found the body of Edward Dalton Haffey, 59, a convicted felon with a long police record.

Officer Katherine Kent said homicide detectives have determined that Kuhnhausen killed Haffey in self-defense. She said a prosecutor is investigating but that the case is not expected to go to a grand jury.

Police said there was no obvious sign of forced entry at the house when Kuhnhausen, an emergency room nurse at Providence Portland Medical Center, got home from work shortly after 6 p.m.

Under Oregon law people can use reasonable deadly force when defending themselves against an intruder or burglar in their homes. Kuhnhausen was treated and released for minor injuries at Providence.

Haffey, about 5-foot-9 and 180 pounds, had convictions including conspiracy to commit aggravated murder, robbery, drug charges and possession of burglary tools. Neighbors said Kuhnhausen's size _ 5-foot-7 and 260 pounds _ may have given her an advantage.

"Everyone that I've talked to says 'Hurray for Susan,' said neighbor Annie Warnock, who called 911. "You didn't need to calm her. She's an emergency room nurse. She's used to dealing with crisis."

After reading the story my first thought was, “She sure was loaded with adrenaline. I bet she had a bad night at work.” Afterall, there are days when I feel like killing something after I've had a stressful shift. Then I did a Google search and found that this is not the first time Kuhnhausen has been in the news. The Portland Business Journal published a story in 2005 about Kuhnhausen and an Oregon bill she tried to get passed that would have protected nurses from violence in the workplace. Kuhnhausen stated in the article that while working at Providence Portland emergency department, she had been punched in the face and bitten by patients, and once watched an enraged motorist drive his car though the wall of the hospital into the emergency department after his girlfriend opted not to leave the hospital with him.

Maybe that explains why she killed the guy. She was determined she wasn’t going to be a victim of violence in her own home, and prehaps pent up rage gave her the strength to defend herself. Thank God she wasn’t the one the police carried out in the body bag.

Saturday, September 09, 2006

How to Solve the Nursing Shortage

Everyone we met on Capitol Hill is concerned about the nursing shortage. There's a crisis looming, so I’ve been giving a lot of thought to ways of dealing with the shortage. The best way to solve the nursing shortage is to pass the National Nurse Act, but until then I've come up with some inventive ways of dealing with the nursing shortage.

Fast Tract Nursing Programs:

One solution to the nursing shortage is to produce nurses more quickly. I suggest getting rid of all nursing programs, and replacing them with a condensed ten-week course. We can start by placing this ad in Nursing Spectrum Magazine, Nurse Week, and Advance Magazine for Nurses. Then I think we should follow up by getting a study published in one of the nursing journals touting the advantages of Fast Track nursing programs.


If mankind can clone sheep, why not clone nurses? This scientific break through would allow hospitals to get the nursing staff they need while saving money. Nurse recruiters would be obsolete, and hospitals would no longer have to offer competitive salaries to attract qualified nurses to their facilities. Need a nurse? Just add water to a prepared petre dish, stir gently, and incubate!

Recycling Retired Nurses:

It's a fact, if everyone with a nursing background got back into the profession, the nursing shortage would be over. I think the first step we should take is to draft retired nurses and put them back to work. Look at this nursing home administrator. She’s telling a retired nurse living at her facility that she is passing meds today. Doesn’t our little old nurse look surprised? The administrator better look out. That nurse looks feisty.

Friday, September 08, 2006

Back From Washington, DC

I just got back from Washington, DC, and I’m happy to report that our elected officials love nurses. I think everyone we spoke to told us a personal story about how a nurse helped them or a member of their family. Things are looking up, and we will continue to work to get this bill passed. I'll write more later, but now I have to go to bed. Tomorrow I'm working my 16 hour shift.

Kim, we missed you!

Tuesday, September 05, 2006

Mother Jones RN Goes to Washington

Just like Mr. Smith, nurses are going to Washington, DC, to advocate for their patients.

I believe that every citizen has an obligation to get involved in solving our nation’s problems, and as a nurse, I'm focused on improving the lives of my patients. That’s why I’m joining my nursing colleagues this week in Washington, DC, to lobby for the passage of H.R. 4903: The National Nurse Act of 2006. Most members of Congress don’t have a health care background, and they are interested in hearing from nurses.

I will be away from my computer for the next few days, but when I get back, I’ll tell you how things went. To learn more about the bill, visit the National Nurse website at
  • Monday, September 04, 2006

    Falling in Love with Patients

    I guess it’s an occupational hazard. Throughout my years as a nurse, I’ve known several nurses who have fallen in love with a patient. One nurse I recall fell for a young, handsome man that had come to the hospital to have surgery on a knee that he had injured while playing touch football with his buddies. This happened before there was same day surgery, and during a time when patients spent WEEKS in the hospital recovering from surgery. I remember him well, and yes, he was a hunk. They married about a year later, and lived happily ever after. I wonder if they would have hooked up if HMOs had been around back then. I guess if a nurse is going to fall for a patient these days, it has to be love at first sight.

    And of course they are tons of cheesy romance novels about doctors falling in love with their patients.

    Daybreak by Frank G. Slaughter is a great example. The book was published in 1959 is about a super doc that finds a cure for Schizophrenia in six weeks, while saving a woman he falls in love with from a court ordered frontal lobotomy.

    “The operation is simple: It’s called a frontal lobotomy, and it’s purpose is to pacify the violently insane. But by no means can it be called a sure cure. It may merely reduce the patient to a willing, thoughtless robot who will do anything he is told.

    As a state-employed doctor, young Jim Corwin was forced to use this technique. But he drew the line with Lynn. She was young and beautiful, and she was a born artist. He would resign as a doctor before he took her wonderful talents away from her with a scalpel.

    But he only had six weeks to find another way to save her. And despite the scoffing of his fellow doctors, those six weeks of continual unrelenting effort to reach an abandoned soul paid Jim Corwin back a millionfold.”

    I told you he was a super doc! And look at Lynn, she beautiful and she doesn’t look hopelessly insane to me. No wonder he wanted to find a cure for Schizophrenia.

    Have you known anyone to fall in love with a patient?

    Sunday, September 03, 2006

    Raise a Toast

    Three cheers, I survived another 16 hour, weekend shift. Come join me in a toast before I drift off to sleep.


    Friday, September 01, 2006

    More Health Tips From the White House Cook Book

    Since so many of you enjoyed the White House Cook Book recipes, I’m posting some of my favorite “health suggestions” from the book. Some of these “cures” are humdingers.

    Diphtheria: A gargle of sulphur and water has been used with much success in cases of diphtheria. Let the patient swallow a little of the mixture. Or, when you discover that your throat is a little sore, bind a strip of flannel around the throat, wet in camphor, and gargle salt and vinegar occasionally.

    Colds and Hoarseness:

    Borax has proved a most effective remedy in certain forms of colds. In sudden hoarseness or loss of voice in public speakers or singers, from colds, relief for an hour or so may be obtained by slowly dissolving, and partially swallowing a lump of borax the size of a garden pea, or about three or four grains held in the mouth for ten or fifteen minutes before speaking or singing. This produces a profuse secretion of saliva or “watering” of the mouth and throat, just as wetting brings back the missing notes to a flute when it is too dry.

    If you’re not in the mood for Borax, here’s another suggestion:

    An old time and good way to relieve a cold is to go to bed for and stay there, drinking nothing, not even water, for twenty-four hours, and eating as little as possible. Or go to bed, put your feet in hot mustard and water, put a bran or oatmeal poultice on the chest, take ten grains of Dover’s powder, and an hour afterwards a pint of hot gruel; in the morning rub the body all over with a coarse towel, and take a dose of aperient medicine.

    Don't forget to stock your medicine cabinet with oatmeal.

    Relief From Asthma: (I swear I’m not making this up).

    Sufferers from asthma should get a muskrat skin and wear it over their lungs with the fur side next to the body. It will bring certain relief. Or, soak blotting paper in saltpetre water, then dry, burning at night in the patient’s bedroom.

    How do you get a muskrat to stay in your medicine cabinet and not come out until you need it?