Preventing Falls: A Crucial Skill

Preventing Falls: A Crucial Skill

Helping to prevent patient falls is absolutely crucial, as one simple fall can cause so many problems—everything from broken hips to traumatic brain injury.

Michele L. Kimball, RN, BSN, Senior Director of Nursing at Bethesda Dilworth, knows why it’s so important to keep patients from falling and assessing their risks. She took time to give us information about what nurses can do.

What are the most important things that nurses need to know when working with patients in health care facilities?

The most important thing for a nurse to remember when assessing for fall risk and developing a fall prevention plan is that the first step is “getting to know your patient.” But without knowing what places them at risk and knowing their routine, your plan will fail. Patients come to health care facilities for so many different reasons. Staff should consider in the beginning that getting acclimated to the routine of a facility is stressful and, depending on the patient, can be confusing.  Restoring as much of their daily routine as possible can lead to success.

What can nurses do when they have stubborn patients who may insist on getting out of bed without assistance?

Allowing them to make as many decisions that they can and restoring as much of their daily routine as possible can minimize risk. 

Involve family and educate, educate, educate.

For patients who are in their own homes—in the case of home health care nursing—what tips can nurses give to these folks to prevent them from falling?

The key is beginning the discharge process prior to them going home on home health through home evaluations and assessment of daily routines. Knowing where and how the patient would need to navigate inside their home is key. Educating them on needed adjustments to their home and warm hand offs to the home health nurse on outcomes of the assessments and recommendations is vital.

The patient’s willingness and ability to take in this education as well as support systems should be considered when developing a plan. 

What kind of health issues can lead to more falls? What information can nurses give to patients so that they can prevent these health problems?

A lot of fall prevention is learning what places them at risk in the first place.

Patients with high blood pressure need to routinely take their medications as prescribed and continue to monitor their blood pressures. These medications can cause dizziness and at times orthostatic hypotension.

Patients with heart failure should continue to take their medications as prescribed and monitor their heart rate, blood pressure, and fluid status. They should contact their doctor if they become short of breath, seem tired more than usual, or notice swelling in extremities. These symptoms can develop quickly and lead to a major health set back, but most importantly lead to weakness, dizziness, and unsteady gait all key contributors to falls.

Patients with diabetes should ensure that they are controlling their blood sugars and taking their medications as prescribed. Low blood sugars could lead to dizziness and fainting, placing them at a risk for falls. Glucose is food for the brain, and if your blood sugar is low and your brain isn’t getting fed, it leads to being tired and increases risk for poor decisions, lack of concentration, and black outs — again contributing to the risk of falls.

Tell patients not to take their health conditions lightly, to notify their doctors when symptoms occur, and if they feel “funny” or something “doesn’t feel right” err on the caution side and ask their physicians. Falls are dangerous, and for the elderly population they can lead to major injuries such as fractures and even death. There is almost always some functional decline after a major fall, and this decline can be the difference of a patient being able to stay in their home or have to seek out a long-term care facility.

Nurse-Entrepreneur Brings Essential Oils into US Hospitals

Nurse-Entrepreneur Brings Essential Oils into US Hospitals

For nurses, therapeutic inhaled essential oils (TIEO) provide a welcome solution; there is no need to get a doctor’s order, administer a pill, insert an IV or monitor for drug interactions. Because it is a designated nursing intervention and not a drug, essential oil inhalers can be stocked as a regular supply item that doesn’t need to be dispensed from the pharmacy. In addition, patients can administer it themselves whenever needed, decreasing the amount of time nurses are required at the bedside. TIEO has an outstanding safety profile that allows its use with patients of any age or medical condition. In fact, multiple studies have shown that therapeutic inhaled essential oils not only improve patient outcomes, they also significantly increase patients’ satisfaction with their care.

Born in an Operating Room…

New wellness brands are rarely conceived within a busy operating room. Soothing Scents was officially launched in 2004, but really started a few years before, when a nurse anesthetist from Maine was trying to figure out a way to lessen the discomfort of post-op nausea experienced by her hospital patients. That nurse anesthetist was Wendy Nichols (BSN, APRN, CRNA), founder of Soothing Scents Inc. DailyNurse had questions for Wendy about Soothing Scents’ flagship product, QueaseEASE, and how she developed it within her cottage industry, whether essential oils are gaining acceptance in hospitals, and the safety of essential oils.

DailyNurse: What causes nausea in the operating room?

WN: Nausea is a pretty big problem in anesthesia. So many things cause it in the perioperative environment, and it’s our job—along with the nursing staff—to relieve it. An age-old technique for nausea is inhaling the vapor of isopropyl alcohol. Unfortunately, patients have negative associations with the smell.

One night while using the alcohol vapor with a nauseated c-section patient, I had a sudden thought about essential oils. I knew they contained high amounts of natural alcohols, and obviously smelled significantly better than alcohol prep pads, so I figured they may be a more effective option.

DN: So that gave you the idea to create an alternative to the alcohol pads?

WN: So that night I went home to get a product that I was sure someone had, but couldn’t find anything. There were essential oil companies that bottled oils, and there were studies on the efficacy of essential oils in reducing nausea, but no one had combined the two, and no one had provided a delivery method that would pass the safety test of the medical sector. So, it became an obsession, something I researched extensively for months, after which I felt bold enough to start blending.

DN: How did you go about finding the right delivery and storage system?

WN: The original homemade QueaseEASE was made in round tins I bought from Amazon. I fashioned a round screen over a cotton pad that held the oil blend, separating the user from contacting the oils even in the early prototype days.

To make the product suitable for use in a healthcare environment, we did the following:

  • Spent many months sourcing the purest, highest grade essential oils that provided gas chromatography and mass spectroscopy testing (GC/MS) to verify the constituent levels.
  • Worked with container material specialists to design inhalers that were made from appropriate materials to prevent the essential oil vapor from diffusing through the walls of the container.
  • Designed a variety of single-use containers that were leak-proof, provided low ambient aroma for the users’ immediate vicinity only, and prevented the user’s skin and eyes from contacting the essential oil at any time.
  • Had the blends/inhalers tested by a microbiology lab to see if they supported any microbial growth; bacterial, fungal or viral. (They don’t). The hospital I worked at gave me the green light to use [QueaseEASE and other blends] with my patients.

After a few weeks, I couldn’t keep enough of the inhalers in the hospital, they had become so popular. So I asked my entrepreneur brother for advice, and he immediately got the product, and what I was trying to do. So, we met up in Idaho and agreed to start this little business together, and how we were going to go about it. And that’s how it all started.

DN: What’s been the response of the medical sector? Are they receptive to the idea of essential oil therapy?

WN: Surprisingly, the general attitude has been overwhelmingly positive. In fact, the most prevalent question we get is how quickly we can get it to the nurses.

Most nurses are familiar with positive attributes of essential oils for wellbeing, and that vapor inhalation is the safest and fastest route for the healthcare environment. But I have been surprised (and gratified) to see how easily and quickly QueaseEASE gained traction in venerable institutions like the Mayo Clinic. In fact, they were one of the earliest adopters of our product.

DN: You seem to feel a mission to educate people in the field of essential oil therapy…

WN: Essential oil therapy for the healthcare environment requires competency, just like any other patient intervention. For instance, nurses and other healthcare providers rely on evidence-based practice standards to ensure their patients’ safety. A key mission of ours is to promote and support studies and referenced educational material for hospital-based essential oil use, which we have proudly done since our inception.

Our latest initiative, in collaboration with the American Nurses Credentialing Center (ANCC), is a certified nurse competency course that provides up to date research and evidence-based practices for using therapeutic inhaled essential oils (TIEO) for nausea and anxiety in the healthcare environment. We are extremely proud of it and feel incredibly fortunate to be able to offer it free to our nursing colleagues.

At the ANCC Magnet conference in Orlando, I heard time and again, how important this course has been in ensuring acceptance of essential oil therapy use in hospitals.

DN: Are there any contraindications for using QueaseEASE and the other therapeutic inhaled essential oils? For instance, should patients with allergies exercise caution?

WN: The composition of essential oils, namely their lack of protein molecules, means there is very little chance they could cause a true allergic reaction. It is not impossible, however. The few allergic reactions that have been reported have almost all been skin-related. People that have a true allergy to any of the essential oils in Soothing Scents products should either exercise caution or refrain from using them.

For more details on Soothing Scents and therapeutic inhaled essential oils, visit the Soothing Scents website. To sign up for the Soothing Scents ANCC-accredited TIEO online training course, which is free for all RNs, visit here.

Stanford Study Finds no Link Between Immigrant Health Coverage and In-Migration Rates

Stanford Study Finds no Link Between Immigrant Health Coverage and In-Migration Rates

Extending insurance coverage to immigrant children and pregnant women did not appear to influence whether they crossed state borders (known as in-migration) to acquire care, according to survey data.

Among 36,438 lawful permanent residents with children, the average in-migration rate 1 year before public health insurance was expanded to cover immigrants was 3.9% and 1 year after the implementation, the rate remained essentially unchanged at 3.7%, reported Vasil Yasenov, PhD, MA, of the Immigration Policy Lab at Stanford University in California, and colleagues.

Similarly, among 87,418 women of reproductive age, the in-migration rate 1 year before expansion was 2.7% and 1 year after it was 4.6%, the team wrote in JAMA Pediatrics.

“No Discernable Association” Between In-Migration and Insurance Expansion

“If an expansion of health insurance coverage was associated with in-migration to another state, the probability of in-migration would have increased in the treatment group compared with the control group,” the researchers wrote. “There was no discernable association between the in-migration from any state among the treatment group relative to the control group and public health insurance expansion.”

The authors compared the group of immigrants with children with a control group of lawful permanent residents without children. The proportion that migrated among immigrants without children was slightly higher before and after expansion (4.0% and 5.9%, respectively), but not significantly different from immigrants with children, Yasenov and his team reported.

Meanwhile, among a control group of post-reproductive women, the rate of in-migration was 3.5% and 3.9% in the years before and after expansion, respectively, which was also not significantly different than the group of women of reproductive age, the researchers added.

“We hope policy makers concerned with spiraling costs and people flooding in from other states will have the evidence they need to make a decision when thinking about extending public healthcare benefits for legal immigrants in the U.S.,” Yasenov told MedPage Today.

Findings Indicate Immigrants are Fleeing Violence and Corruption, Not Chasing Health Coverage

As of 2016, immigrants with children were covered by public insurance in 31 states and pregnant immigrants were covered in 32 states. Many Democratic candidates for the 2020 election support extending healthcare to undocumented immigrants, a policy that has been suggested will increase the flow of immigration within the U.S.

These null findings make sense in the context in which most U.S. immigration takes place, wrote Jonathan Miller, JD, of the Office of the Massachusetts Attorney General in Boston, and Elora Mukherjee, JD, of the Immigrants’ Rights Clinic of Columbia Law School in New York City, in an accompanying editorial.

Namely, many people coming to the U.S. are fleeing from violence or political corruption in their home countries, and “do not seek refuge in the [U.S.] because of potential access to healthcare,” Miller and Mukherjee said.

“Making it easier for immigrant communities to connect to and seek care from physicians will not radically shift migration patterns. Instead, allowing access to the basic human right of health care shows a common commitment to human decency for all who are in the [U.S.],” the editorialists stated.

Immigrants Sampled Were Below 200% of Fed Poverty Thresholds

For this study, data were collected from individuals residing in the U.S. from 1 to 6 years — but who were not born in the U.S. and were not citizens — from the American Community Survey. Notably, the sample was restricted to individuals who were below 200% of the federal poverty thresholds to identify people who would qualify for public insurance if it were extended, the authors noted. Immigrants on student visas, veterans, or those married to U.S.-born citizens were excluded because they qualify for other healthcare benefits, the team added.

The data were controlled for personal characteristics like age, race/ethnicity, and marital status, as well as things that varied by state and time such as cash assistance and economic conditions.

In total, 208,060 immigrants — mean age of 33 years, 47% of whom were female — were included. About two-thirds were Hispanic (63%), and the in-migration rate among the entire sample was 3%.

“Near-Zero” Likelihood

Overall, the likelihood that lawful permanent residents would migrate to a state where public health insurance has been expanded to cover immigrants was practically zero before and after expansion was implemented (percentage change from -1.21 to 1.78), the authors reported.

The likelihood was also close to zero among lawful permanent-resident women of reproductive age when compared with a control group of lawful permanent-resident post-reproductive women (percentage change from -1.20 to 1.38).

In a model specifically looking at whether public health insurance expansion would bring in migrants from a neighboring state, no association was found between policy implementation and the rates of in-migration of immigrants with children (–0.03 percentage points, 95% CI –0.5 to 0.44) or pregnant women (–0.02 percentage points, 95% CI –0.48 to 0.09), the researchers reported.

The primary limitation of the study, they said, was the inability to account for time-varying factors that could undermine the analysis, and it was also not possible to isolate states among the border and determine whether there was an association between in-migration and health policy specifically in these states. Lastly, the investigators said, the association was not analyzed among county-level or city-level programs.

The study was funded by the Stanford Child Health Research Institute.

The authors and editorialists reported having no conflicts of interest.

Primary Source

JAMA Pediatrics

Source Reference: Yasenov V, et al “Public health insurance expansion for immigrant children and interstate migration of low-income immigrants” JAMA Pediatrics 2019; DOI: 10.1001/jamapediatrics.2019.4241.

  • Secondary Source

JAMA Pediatrics

Source Reference: Miller J, Mukherjee E “Health care for all must include everyone” JAMA Pediatrics 2019; DOI: 10.1001/jamapediatrics.2019.4247.

by Elizabeth Hlavinka, Staff Writer, MedPage Today

This story was originally published by MedPage Today.

Making the Holidays Fun for Nurses

Making the Holidays Fun for Nurses

Managers and any other health care staff who are supervising nurses—whether it’s in a hospital/medical center, an urgent care, or even at a private physician’s office—should know that holidays can be tough for your employees.

Anytime your staff is working on or around a holiday, that’s time they’re not spending with friends/family. That can be hard on them, no doubt.

But there are a lot of things you can do to make the holidays fun. When your nurses are happy, your patients can be happier. Their families can be happy. And being in the hospital or just being sick becomes easier to deal with.

Kelly Jo Wilson, MSN (Ed), RN, a Quality Nurse Coordinator—Transplant at UPMC Presbyterian Shadyside Hospital in Pittsburg, Pennsylvania, contributed a lot of ideas for how you can make this happen.

Remember, though—the most important aspect to remember is that you have to become involved to make the holidays fun as well.

Par-tay

Wilson suggests that you hold a holiday party for your staff. Most staff won’t mind pitching in with money or food, she says. But you have to head this up. It will mean more if you organize it all yourself, as opposed to dumping it on a staff member.

“Health care staff work hard all year, and a little incentive goes a long way,” she says. “Raise some funds, cook some food, and give the staff a good time!”

Food—and lots of it!

During the holiday season, treat your staff to some surprises. Have a catered lunch or dinner or even organize a potluck.

Cookie Exchange

Most people love cookies—and those who bake like to share their wares. Wilson says, “Cookie Exchanges are wonderful ways to let those staff members who love to cook and share their love of food with everyone else. Then you can exchange the different types of cookies. This is also a team-building exercise.”

Gift Cards

Even giving your nurses a $5 gift card for coffee will make a huge difference. It will give them a boost. Wilson stresses to be sure not to forget anyone or it could backfire.

Contests

Wilson suggests that you hone in on everyone’s competitive side and have some fun contests. Some ideas are: ugliest sweater, best cookie, best-decorated med car, or best holiday scrubs. “It’s a fun way to engage staff during the holidays,” she says.

One thing to keep in mind: “The manager has to be supportive and really the key person to organize. Even if they delegate to a party council or groups within the unit, they must engage in some way to truly show their appreciation and support,” says Wilson.

Various Faiths

Wilson says that if staff are of various faiths, encourage them to bring in a traditional dish that they make when celebrating with their family or friends. But there’s more: “Using a menorah or other decorative items according to their tradition is a great way to include everyone as well,” she says. Acknowledging everyone and their personal traditions is a great way to be inclusive.

“Give back to your nurses/health care staff who work so hard,” says Wilson.

“It’s a beautiful thing to witness…” A Talk with the Director of the VNSNY Gender Affirmation Program

“It’s a beautiful thing to witness…” A Talk with the Director of the VNSNY Gender Affirmation Program

In early 2016, Mt. Sinai Hospital* approached the Visiting Nurse Service of New York (VNSNY) to propose that VNSNY offer home care services to post-operative transgender patients. This was the genesis of VNSNY’s Gender Affirmation Program (known as GAP), which to date has provided home care to over 400 transgender patients.
*a strategic partner of VNSNY

DailyNurse recently interviewed Shannon Whittington, RN MSN PCC C-LGBT Health, the Clinical Director of GAP at VNSNY. We asked her about the nature of gender affirmation treatment, the home nursing care that VNSNY provides, and the outstanding LGBT-friendly services that VNSNY offers to patients across the Tri-State New York area.

 Shannon Whittington, the Clinical Director of the Gender Affirmation Program at VNSNY
Shannon Whittington, the Clinical Director of the Gender Affirmation Program at VNSNY

DailyNurse: What is gender affirmation surgery (GAS)?

SW: A surgical procedure that creates or removes body parts that align with the patients’ gender expression. E.g. vaginoplasty, phalloplasty, metoidioplasty, facial feminization, breast augmentation/masculinization.

DN: Is this the same thing as “sex-change surgery?”

SW: It is the same thing but we don’t use the terms “sex-change surgery” anymore.

Gender Affirmation or Gender Confirming surgeries are the correct terms now.  Understanding that this is a linguistically fluid language, words and meanings are always changing and we need to be mindful of correct terminology.

DN: What are the components of the VNSNY Gender Affirmation Program?

SW: The program emphasizes home care following surgery from other providers. I train clinicians (nurses, social workers, physical therapists, home health aides, speech and occupational therapists) in cultural sensitivity as it particularly relates to transgender patients.  The training is extensive and they are also educated in how to teach the patients to care for their new or altered body parts (i.e. penis, vagina, breast, face)

DN: How did you come to specialize in the treatment of Gender Affirmation surgery patients?

SW: Fortunately, I was chosen for this project by my manager.  I had no idea what I was saying yes to but this has literally changed the trajectory of my career path.  I discovered a passion that I did not know I had!

DN: What sorts of clinical training do nurses in the program need to take care of GAS post-surgery patients? 

SW: They need to know what to assess for and what is normal and what is not.  They learn about vaginal dilation because the patients who undergo vaginoplasty must do this on a regular basis. Patients come home with VACs, JP drains, foleys and supra pubic catheters. Although the nurses are already familiar with these devices, they need to teach the patients how to manage them. The clinicians are also trained in social determinants of health for this cohort.

DN: What sorts of cultural issues do nurses need to learn about before tending to a GAS patient?

SW: We really need to understand that these patients, like all of our patients, are patients first who happen to be transgender. We must respect their chosen names, their pronouns and their gender expression. We focus on getting them better and integrated back into society. It’s a beautiful thing to witness and an honor to be associated in such a transitional journey.

DN: How does the Gender Affirmation Program reflect the larger VNSNY commitment to LGBT patients?

SW: It reflects our commitment to this population on an agency wide basis.  What is great is that we are now getting non-operative transgender patients who are seeking home care services for reasons other than gender affirming surgeries.  They feel safe here and seek care outside of gender affirming surgeries. 

We are initiating various ways to continue to be inclusive along the binary spectrum by hiring gender non-confirming and non-binary individuals. These individuals have a lot to offer and need to be the best expressions of themselves in their work environment just like the heteronormative society we all live in.

DN: And can you tell us something about the SAGE training in your organization?

SW: All divisions of the Visiting Nurse Service of New York have been awarded Platinum certification (the highest level possible) from SAGE, the world’s largest and oldest organization dedicated to improving the lives of LGBT older people.

More than 80 percent or more of VNSNY’s clinical and other staff have received SAGE Care LGBT cultural competency training, further establishing VNSNY as a preferred health care provider for New York City’s LGBT residents.

The SAGE training is designed to increase awareness among VNSNY clinical and administrative staff of cultural issues and sensitivities around sexual orientation and gender identification, so as to ensure a welcoming and respectful health care environment for all individuals within the LGBTQ community.

Among other things, the training stresses the importance of approaching each patient in a non-judgmental fashion and never making assumptions about anyone’s sexual orientation or family structure. We want every patient to feel they can be totally open about who they are with every member of our GAP team who walks through their door.

Nurses: What is Your Pet Peeve About Doctors?

Nurses: What is Your Pet Peeve About Doctors?

Doctors and nurses work together to provide patients the best care. But you know that everyone has a pet peeve. In this six-minute video, new medical resident Siobhan Deshauer, MD talks with nurses about how physicians get on their nerves. What follows is a transcript…

Siobhan: Hey, guys. I’m Siobhan, a first-year medical resident. I figured today we could talk about how doctors and nurses get along, specifically the things that doctors do that really annoy nurses. It’s really tough as residents because we just kind of parachute into these ICU teams, which are really well formed. They all know each other well. They know how things work and we just need to figure out how it goes on the fly really quickly. The reason that I think this is so important is because this is a team. If we work and communicate better together, it should be better for patient care. Let’s go figure this out. The number one pet peeve that doctors will do.

Pet Peeve: Respect Nurses and Patients

Female Nurse #1: Not introducing yourself when you come into a patient’s room. Like I was telling you before, there was a doctor that walked into my room this morning wearing a winter jacket, boots, and no ID on him whatsoever. He came up and started reaching for my chart instantly. I was like, “Hi! Sorry, why are you touching my chart? Who are you?” Like, any indication? Introduce yourself! Introduce yourself to the patient and the nurse.

Siobhan: We can do that. We can do better at that.

In a Shared Workspace, Respect the Nurse’s Computer

Female Nurse #2: Respecting the nurses’ workspace because you do have your own personal workspace.

Female Nurse #3: I was also going to add that it’s a shared workspace. But sometimes when you’re thinking and you’re thinking for a really long time, that space is just…

Female Nurse #2: There’s a lot of people.

Female Nurse #3: Yeah, there is a lot of people and sometimes you just need… we need that space because it’s the only one we have.

Siobhan: Yeah, you’re actually working on a computer…

Pet Peeve: “RING! RING!” Pick up the Phone…

Female Nurse #3: Yeah. It’s kind of like, “Can you do that stuff and get out?” Because I need to be there. But it’s a shared space obviously and we all respect that for each other. I was just going to say pick up the phone. If it’s ringing, pick it up! It’s not my phone.

Siobhan: You mean even if it’s the phone, even if someone is paging us back?

Female Nurse #2: Yep, wherever you are.

Female Nurse #3: Any phone. Any phone. If you’re walking down the hall and the phone rings…

Siobhan: Just like…

Female Nurse #2: You pick it up.

Female Nurse #3: You’re part of the team. Pick it up. “Hello, ICU. Hang on. Okay, I’ll get you somebody else.” Just pick it up. Usually what happens is you’re sitting in the workspace and you’re taking up this workspace, and we’re probably sitting there like, “Okay. Well, fine, I’ll go do something.” You come back and they’re still there. The phone’s ringing and nobody’s answering, but they are still in the workspace. The phone is still ringing. Pick it up.

Siobhan: That’s amazing. Thank you! I will pick it up. Wow! This is actually very useful to hear all these things just even as a reminder. Let’s go see if there are some more nurses that have a minute to give us their feedback. The number one pet peeve, things that doctors do that you just hate, okay.

Pet Peeve: Again, Respect the Nurse’s Computer, Communicate, and Remember That You Are Not the Nurse’s Boss

Male Nurse #1: Maybe not number one. But when residents or doctors just hop on your computer and look up all these different patients under your name, which compromises my license. Thanks, guys.

Siobhan: Yeah, that’s really bad. That’s really bad. What would be the number one piece of advice that you would give to residents?

Female Nurse #4: Just communication is key. Communication, patient safety, and respect for your colleagues. Don’t think of yourself as we’re in a hierarchy. Again, when I worked on a ward, there was definitely a hierarchy between physicians and nursing staff. Whereas, it’s kind of like you’re not my boss. No. We are meant to work together. We’re a team. We all, I think, some doctors forget that I’m here mainly as a patient advocate and I spend 12 hours a day with them. I spend 12 hours a day with their families. Whereas you guys, yes, you’re all highly intelligent, but you have numerous other patients to see. Just kind of taking into consideration what nursing staff and other members of allied health have to say.

Siobhan: What would be your number one piece of advice for new residents like me?

Pet Peeve: Respect Patients’ Privacy

Female Nurse #5: Carry around an awareness of how immune to privacy, invading people’s privacy, nudity, things that are just commonplace in the hospital. You know what? We’re all guilty of it, walking through that curtain that’s drawn, because we’re trying to address a patient issue. Patients and their families, nurses at the bedside, really appreciate just like a quick hello from the other side of the curtain. “Hey! It’s Dr. so-and-so. Do you mind if I come in?”

Siobhan: I wouldn’t walk up to your room and just like walk in your bedroom door. Right? Like that just seems…

Female Nurse #5: That’s what I am saying.

Siobhan: What if you are changing or anything, right? Just knock. It’s the same thing, right? Pet peeve from doctors.

Pet Peeve: Nurses are Not Your Servants. Clean Up.

Female Nurse #6: One of my pet peeves that I have experienced is that the doctor will come in and do a procedure requiring sterile towels, dressing tray, lots of sharps, and sutures, and they’ll leave it all. They’ll do the procedure and then they’ll leave, leaving the nurse to clean up everything. Really, they should take care of the sharps and ask, “Where can I put these things?” I’d be glad to tell them.

Siobhan: Yeah, that’s so incredibly reasonable and a good reminder.

Female Nurse #7: Just being aware of everyone around that’s participating in rounds.

Siobhan: So not like doing this. [TURNS BACK]

Female Nurse #7: That’s right. Don’t turn your back to the nurse.

Nursing Students are Still Naive. Treasure Them.

Siobhan: As a nursing student, are there things that doctors do that just really bother you?

Female Nurse #7: As a nursing student, I wouldn’t say I’ve had too many negative experiences yet.

Siobhan: Yay!

Female Nurse #7: I would say a lot of them are positive. You guys are very informative and easy to talk to, so overall a positive experience with residents.

Siobhan: That’s awesome! We’ll see. We’ll ask you in like 5 years.

Female Nurse #7: Yes, ask me again in 5 years.

Siobhan: Thank you so much to all of the nurses who helped out with this film. It was fantastic. It was really fun and it gave me a lot to sort of think about and good reminders. Don’t forget to subscribe if you haven’t already and I will be chatting with you guys next week. Bye for now.

Siobhan Deshauer, MD, is an internal medicine resident in Toronto. Before medicine, she was a violinist, which is why her YouTube channel is called Violin MD.

Previously published in MedPage Today.

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