From ultrasound powered by artificial intelligence to image-sharing tools on the cloud, technology advancements are improving the quality of health care at an unprecedented rate. Yet, when it comes to one of the most universal and compelling health care needs – a smooth and successful pregnancy and childbirth – we still have a long way to go.
Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth. The United States accounts for the highest maternal death rate in the developed world, and the number has been steadily increasing over the last two decades. What should be a moment of joy and celebration can become an unbearable tragedy.
The operative word in these troubling statistics is “preventable.” And one of the keys to avoiding these tragedies is more closely monitoring the health of the mom and baby. The idea that you can’t manage what you don’t measure rings particularly true in pregnancy and childbirth.
Fetal and maternal health monitors provide invaluable data that can support clinicians and health care providers as they need to make quick and accurate clinical assessments throughout a pregnancy and during labor and delivery. However, these health care needs are at odds with recent trends in labor preferences.
For example, increasingly, expectant mothers want to take a more active role in their birth plans, not simply turn over the reins to the care staff. A growing trend among these patients is the desire for more mobility during labor.
The ability to get out of bed, walk around and even bathe can improve their overall comfort and experience – and may help decrease the length of labor. Not only do patients feel a sense of empowerment by choosing their birthing process, increased mobility may also decrease the length of labor.
During labor, women are often entangled in a sea of cords and monitors, significantly limiting their movement. Fortunately, expectant moms now have the option for cordless monitors that replaces the traditional, cumbersome belts, cables to support the traditional transducer system.
But as with many things, there’s still a role for “traditional” practices – including, in the case of childbirth, more movement and engagement on the part of the mother. Pairing this focus on the patient with advanced technology, we can achieve the best of both worlds: safer, smoother births with lower maternal-infant mortality.
July is National Ultraviolet (UV) Safety Month and this presents an opportunity for nurses to educate patients to protect themselves from the harmful effects of UV rays. UV rays not only cause skin damage, but also skin cancer and cataracts. There are three types of UV rays. UVC is absorbed by the ozone layer and does not pose any threat. UVA and UVB radiation, however, have long- and short-term negative effects on the immune system, skin, and vision. The main source of UV rays is sunlight, although they can come from man-made sources such as diagnostic X-rays, tanning beds and booths, and phototherapy. Approximately 90-95% of the UV rays from sunlight is UVA, with the remaining 5-10% being UVB.
Summer is here, which means it’s the perfect time to get more physically active and enjoy being outside. Here are four tips to share with patients to help them avoid damage from UV rays.
1. Avoid overexposure to sunlight.
Avoid being outside for long periods in the sun and heat, especially during the peak hours of strongest UV rays, during the hours of 10 am to 4 pm. Overexposure to sunlight is known as the underlying cause for harmful effects on the skin, eyes, and DNA.
2. Apply broad spectrum protection sunscreen before stepping outside.
A sunscreen with SPF 30 can block out 96% of UV rays, while a sunscreen with SPF 50 can block out 98%. Unfortunately, there is no sunscreen that can provide 100% UV protection. Remember to apply a sunscreen 20 minutes before going out in the sun and reapply after two hours because most sunscreens can last for about two hours on the skin.
3. Wear sunglasses that can filter at least 98% of UVA and UVB rays.
Sunglasses with UV coating, or polycarbonate lenses which have built-in UV coverage, can help prevent UV rays. Photochromic lenses are also a good choice. UV rays can cause a development of cataracts, macular degeneration, and retina damage. It is wise to cover skin with loose-fitting clothing and wear a wide-brimmed hat (3-inch or 4-inch brim all around) when out in the sun.
4. Avoid or limit the use of artificial UV light.
Research has shown the risk of malignant melanoma is much higher in people who use tanning beds. The risk of melanoma increases by 75% when indoor tanning devices are used before the age of 30. Avoid using tanning devices to lower the risk of having melanoma and non-melanoma skin cancers.
Anne M. Cabello, RN, BSN, CRRN, was only 12 years old when she experienced a mild stroke. Luckily for her, with good, acute rehabilitative care—as well as, she says, much love, prayers, and support—she made a full recovery. This experience, though, led her to become a rehabilitation nurse when she grew up.
“Rehabilitation nursing allows me to give back what I have been given and to provide nursing care to a patient for a significant period of time, often watching them progress to a lesser dependent state than what they were at when the stroke first occurred,” Cabello says.
Since 1995, Cabello has worked for Burke Rehabilitation Hospital in White Plains, New York, and she is a staff RN on an acute rehabilitation stroke unit. “The majority of my patients have suffered some form of a stroke resulting in impaired mobility usually on one side of their body—affecting their arm, hand, and/or leg, impaired speech and swallowing ability, impaired cognition, impaired vision, and impaired bladder and bowel function,” explains Cabello.
Working the 7 p.m. to 7 a.m. shift, Cabello says that being the primary nurse for neurology patients means that she cares for people who have worked hard during the day doing intense physical, occupational, and speech therapy. Her role, she says, includes doing an ongoing assessment of their conditions and reporting the results to the physician, medication administration by oral, IV, or via feeding tube, and overseeing the care associated with activities of everyday living including: assisting patients with eating, transfers to the toilet or in and out of bed, helping them change into night clothes, showering/bathing, wound care, tracheostomy care, incontinence care, and bladder catheterizations for those who need it.
Cabello says that the greatest reward for her in her job is “job satisfaction—knowing that I have given the best care I can to a patient.”
If you’re considering this type of nursing work, Cabello says that you must be compassionate. “Care for each patient as if they were your own loved one. That is what will cause you to give special attention to all your duties.”
“Nurses are vital team members of the health care team and are the ones on the frontline in providing direct care for patients. The stroke patients on the unit are still at the phase of their illness where they are at a high risk for a stroke progression,” says Cabello. “The nurse’s strong assessment skills coupled with identification of sudden changes in the patient’s condition can lead to the quick treatment and health care management of the patient.”
So you’ve been fired by a patient. It’s not pleasant. But the good news is that you are not the only one who has had this experience. Getting fired is a natural part of patient care. Not everyone that you interact with will like you or the experience you provide for them. How you respond in the aftermath of being fired can make or break you as a nurse. Here are five steps to help you handle being fired by a patient gracefully.
1. Don’t fight back.
Chances are that when a patient fires you, they will be angry and maybe even shouting. If you fight back and try to defend yourself, things are likely to escalate further. The best thing to do in this situation is to walk away. Go visit or call your charge nurse and see what your next steps should be. While you are doing this, the patient may calm down and potentially be more reasonable. If not, then hopefully your charge nurse will be able to switch around the assignments.
2. Reflect on the situation.
After you have calmed down and had some distance from the event, try to reflect on the situation and learn from it. Consider the root cause of the event and then think back to see whether there was anything you might have said or done differently. If so, then use this unfortunate event as a learning experience for your future patient care.
3. Try not to take it personally.
You may not ever truly understand the reason a patient fired you. There may be a variety of circumstances beyond your control that are affecting your patient. Take a moment to put yourself in the patient’s shoes. Are they in a lot of pain? Have they recently gotten upsetting news? If this is the case, remember that this could have happened to any of your coworkers. The patient most likely isn’t lashing out at you personally, but rather, they are upset by their situation.
4. Grieve, be upset and vent.
It is completely okay and normal to be upset about being fired by a patient. Take some time to grieve and vent in a healthy way to your coworkers. Chances are, they have been there too and will be empathetic to your situation. If you don’t feel like talking to your coworkers, write down your thoughts, and after you are done, tear the paper into a million pieces! Not only will you get a mental release from the writing, but you will also be able to express your anger or sadness in a healthy way as you tear up the paper.
5. Accept it and move on!
The last step to dealing gracefully with being fired by a patient is very simple: Accept the things you cannot change and move on. If you obsess about and dwell on the event, it can wear you down and cause burnout. Take heart in knowing that this happens to every nurse at some point in their career, and that it most likely won’t happen to you again for a long time!
Nurses play important roles in all health care access points from hospitals and physicians’ offices to community health centers, school health clinics, nursing homes, and public health departments. Since their roles in patient care across the health system provide significant opportunities to affect health outcomes, nurses at all levels need to open up to new ways of thinking and working to have the confidence and skills to create new ideas and nursing interventions to work on specific issues beyond their typical responsibilities. Here are a few examples of nurses’ innovative thinking: creating a predictive model to prevent hospital readmission by Laura Beth Brown, MSN, RN, president of Vanderbilt Home Care Services; and making pillowcases for patients with cognitive impairments to decrease patient restraint by Jan Bahle, MSN, CNS, and her team at University Hospitals Portage Medical Center in Ravenna, OH.
Innovation consists of enthusiasm and curiosity and innovation comes from creativity. Innovative thinking is not a talent, but it is a skill that needs practicing. Here are four ways to help build your innovative ideas.
1. Build on Existing Questions or Problems.
When developing innovative projects, you need to clearly define the problems that you are attempting to solve and articulate why those issues are important. Always start with the what, why, how, when question and try to answer it. List down each question that comes to mind and determine which one you think is the best. With a thorough understanding of the question or problem you are interested in innovating in, you will have a sharper eye in recognizing possibilities and be more skillful in connecting different ideas together.
“If I were given one hour to save the planet, I would spend 59 minutes defining the problem and one minute resolving it” —Albert Einstein
2. Think Outside the Box.
Encourage yourself to be open to new ideas without setting limiting beliefs. You should write down your thoughts and ideas into your journal or scrapbook, as this will help you keep track of your thoughts and can even stimulate your thought processes and lead to one new idea after another. Creative thinking does not require you to follow all the time; creativity is about how you associate different ideas and facts—look for the unconventional and embrace the difference.
Make the commitment to focus on the present and not let it wander from one thought to another. Do not be afraid of failure. Instead, see mistakes as opportunities or learning process for achieving your innovation.
4. Build a Network.
Strike up conversations with different people and listen to their unique perspectives, which may help you reconstruct your ideas. You may not believe that the greatest insights often come from our interactions with people who hold views opposite from ours. Also, do not forget to have fun with your colleagues as this is a proven and common way to generate ideas.
When Nathan Hansen, RN, was still in nursing school at the State College of Florida, he often used YouTube videos to help him study. While watching videos one day, he saw a story about a young man who got the call to donate bone marrow to help save someone’s life. At the time, Hansen didn’t know it, but one day, he too would get that call.
Hansen, who works in the operating room at Blake Medical Center in Bradenton, Florida, says that after seeing the video, he was moved. “I regularly donate blood and wanted to immediately sign up to be on the list to donate bone marrow,” recalls Hansen. “I wanted to get the call, but I didn’t really expect to.”
After signing up to be a bone marrow donor through Be the Match, the largest bone marrow donation registry, which is run by the National Marrow Donor Program, Hansen went about his life. As he said, he didn’t think he would get called. A few years later, though, Hansen’s phone rang, and he was told that he was a match for a 13-year-old boy in Washington, DC, who needed a life-saving bone marrow transplant.
When Be the Match contacted Hansen, they still gave him a choice. Just because he signed up to be a donor didn’t mean that he absolutely had to. But for Hansen, it was a no-brainer. “I was excited to get the call and definitely wanted to help in any way,” he says.
After going through many lab draws and physicals, Hansen headed to Washington, DC in June 2017, about four months after getting that first call—and he used his Paid Time Off to do it. “Again, this was a no-brainer,” Hansen says. Be the Match covered his travel and accommodations.
Hansen has never met the recipient whose life he saved, as this information is kept confidential. He had no pain post-op, and he says that he was only a little uncomfortable, much like you would feel with muscle soreness.
Because of his compassion, Hansen was nominated to be the New Nurse of the Year at Blake Medical Center—and he won. “I was honored even to be nominated,” he says. “So I was elated when I actually won.”
“I would absolutely do it all over again, and I think that others should sign up too,” says Hansen.
For more information on becoming a bone marrow donor, go to www.BeTheMatch.org.