I am your nurse, not your doc

It's been a trend lately that I've been mistaken as a the doctor or the kid that his mother knows that he's playing Army (I really get patients that tell me that). I do make sure I introduce myself and my position of the day (nurse or charge nurse), but most of the time I'm referred to as "the doc."

I do make sure to correct my patients for legality reasons, but also for identity reasons. Patients should know who they are coming into contact to and what their title and role they have in managing their health care. I would also like to know who is involved in my patients care. Sometimes I have new residents that come up to the floor at 0500-0600 going through files, folders, my paper work, then asking me about patient-so-and-so. I've also seen random people go through the files on occasion. When this happens I make sure to stop that person, have them introduce themselves, state what role they have in my patient's care, then drive on to the point of the conversation. Very simple, no?

I feel the real reason why I correct my patients is because I feel nurses are under-appreciated. This may seem like a self-esteem boaster to say it, but let me explain.

The past week the surgical floor felt like the psych ward. I don't know if it was because it was full moon phase, but most of the patients had a lot of issues, not just medical. One of my co-workers had a 300 lbs patient that enjoyed sitting in her urine and wouldn't call us to help clean her up unless we checked on her. It takes 3 people to help move due to her fractured left leg.

Another co-worker had a patient who was getting so anxious that ativan wouldn't couldn't calm him down. We felt that he was going to be a danger to himself. We got the on-call doc to let finally let him go smoke outside with an escort so that he'd finally calm down.

I had a young 17-week pregnant G3P1011 20-year old female with abdominal pain tell me everything that was going in her failing marriage. I made sure the consult for chaplain services was put in for her so that she could get seen in the morning.

These are just some of the things that happened just in the past week. Was there a magic pill/medication/treatment that a doctor could do to fix these problems? No. The solutions we had to do were all initiated by nurses. This is not a put down post about doctors. The surgeons that I work with go through many surgeries a day and also work long hours on the weekends. But as the floor nurse, I handle the pain issues, the family issues, and the discharge issues. When the doctors are finished closing up, the nurses take over from the PACU to the ward.

I'm not looking for a gold medal or a plaque. I just want my patient to know what my role is. From their stay, I hope that they realize the person who responded to their pain and their needs was the nursing staff.

I am your nurse.

Froggy Style

This was an email I sent out to some of my colleagues in response to our CSM not allowing the Vibram Five Finger shoes to be worn with the PT uniform or even for the APFT.

I feel that CSM [*] take on the design of the Vibram Five Finger
shoes not being for running using quotes from the VFF website is taken
out of context.

The original text from the company's website is as follows with
reference:
"Outdoor enthusiasts have found FiveFingers to be the ideal crossover
shoe for multiple sports and activities-from ChiRunning and bouldering
to kayaking and windsurfing. Fitness enthusiasts use FiveFingers for
core strength training, yoga and Pilates. Our customers continually
discover new and creative uses for our alternative performance
footwear." http://www.vibramfivefingers.com/barefooting/index.htm

Note that the following statement from the VFF site indicates the
various uses that consumers use their products, not the sole intent of
what the product is intended for by the company. The uses for VFF from
the company's website are: barefoot running, water sports,
trekking/traveling, yoga, and fitness. The information for using VFF for
barefoot running is located here:
http://www.vibramfivefingers.com/barefooting/barefoot_running.cfm

The Air Force allows their soldiers to wear VFF with their PT uniform,
but with socks (which defeats the purpose of the shoes, but that's for
another conversation). Reference here:
http://militarytimes.com/blogs/afteraction/2010/07/15/barefoot-running-a
llowed-at-air-force-gyms/

The Army Times has an article about the benefits of barefoot running,
the idea in which VFF were created. Reference here:
http://www.armytimes.com/offduty/sports/offduty_barefoot_032210w/

Despite all the research in the world that show that VFFs can be
beneficial to runners, I understand that the commander has the final
say. However, I hope CSM [*] will reconsider. I prefer my VFF because
I do not have shin splints after I run with them. How many other
soldiers also reap of the health benefits of utilizing these shoes?
Research has been shown that these types of shoes help reduce injury
(http://www.wired.com/wiredscience/2009/07/barefoot/) and pain in lower
extremities
(http://www.fitnessspotlight.com/2009/09/10/barefoot-running-injuries/).

What are the benefits at the unit level? Reduced profiles related to
foot injuries (we know several of our peers who constantly have these),
available able soldiers to completed the task/mission at hand (jumps,
training, morning PT, etc.), and a physically stronger fighting force.

My argument is not just for the use of VFF for the APFT, but for the
idea of barefoot running. If this concept can be used to help better
train soldiers to be better fit and able soldiers, why not support it?
It can start with the approval of shoes such as the VFF at the APFT (I
know the Huarache Running Sandals won't be approved:
http://barefootted.com/MakeHuaraches.pdf).

Just some thoughts.

I love my Vibram Five Finger shoes.

Me @ Grandfather Mountain, NC

Update 01SEP2010: Army policy is very difficult to change. Don't question it and drive on. Hooah.

C4 and other things

Whoa it's been a while! I'm going to do my best to update this blog more often. Lots of stuff going on!

I just got my class confirmation for C4: Combat Casualty Care Course in Camp Bullis, TX for September. I'm excited to be in Texas again. I miss the authentic Mexican food. All the Taco Bell in the world cannot compare to the burritos and chimichangas of Texas. I can't wait!

C4 has students from Army, Navy, and Air Force attending this course. Here's a description from Army Training Requirements And Resources System (ATRRS):

The Combat Casualty Care Course (c4) is a tri-service, continuing medical education course designed to enhance medical readiness of physicians, physician assistants, nurses, dentists and other medical specialties by providing training in field leadership, knowledge and skills that may be necessary for direct medical support in conditions related to any combat situation or contemporary Operational Environment. Training is based on multi-phased scenario-where students must perform the duties of their respective careen fields as well as the duties of 1st responders in a simulated combat environment.

From the welcome packet my packing list seems light. I'll be getting TA-50 from the course and my meals will be MREs. This should be a fun course to go to.

Other things going on:
WSMNi - We go live at the hospital at the end of the month with our new patient acutity system. Scheduling will also be handled by this system. I spent the last week or so learning its interface. For the most part it's mostly user friendly. Just a couple of objects resized to fit the screen so I don't have to scroll within a scrolled object would be really helpful.

Thinking about:
I really need to pick up my med-surg certification study book. There is a review course on October 18 in Fayetteville. If I start studying for it I can take the test before the end of the year.

Also,
I want to deploy. Just say'n.