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When I was a young girl I dreamed of being a nurse.  I wrote an essay in third grade about my dream job.  The idea of helping others and wearing crisp white uniforms was my idea of the perfect life.

Getting a degree would be a huge challenge for me as a child with no parents being raised by retired grandparents.  With the help of grants, student loans and working as a nurses aid I made it happen.  These circumstances made it even more sweet when that BSN was placed in my hand.

This newly minted nurse was over the moon excited to accept a position on the high risk antepartum unit of a large prestigious hospital in the Texas medical center in Houston.  I learned so much at that first job. (Don’t we all truly learn to be a nurse at our first job?)  Life changes and unexpected events carried me through an adventure of many different jobs and specialties.  Learning and becoming more knowledgeable and capable along the way. I just assumed it would always get better and better!

Reality however along the way things happen that could easily crush your spirit if you let them.  Any position that puts you in a large group of mostly women can be challenging.  I think these bumps and bruises to my ego made me stronger and wiser. But now nearly 30 years into this morass with healed wounds and callused ego I am struggling. Where is that joy that the younger me felt to put on the fresh white coat?  Are patient’s less grateful, feeling empowered with their Google knowledge?  It’s difficult to put my finger on the problem but I know I cannot be the only disenchanted nurse in wonderland.

I still give all I have to each and every patient that I see however it is difficult to pull water from a well that is not replenished.  What is the source of refreshing that well?  Education? self-care? I honestly do not know. I will push forward in search of that fountainhead.

 

It can cure a whole host of maladies. It can make you feel better and look better!  If taken properly is has little to no side effects.  It’s FREE!!!

So why don’t more people have it in their life?

Because it is EXERCISE.

Current recommendations found a heart.org are 30 min 5 days a week.  This can be in one 30 minute or 3- 10 minute spurts.  Very do-able.  Our watches even tell us how many more steps we need and keep track of steps for us.  It is simple, right?!  Yet we find so very many excuses.

When it is broken down and made to sound so simple we might feel a li

 

There continues to be a fair amount of push-back from M.D.’s who do not think a Nurse Practitioner who earns a terminal degree (DNP or PhD) should be called “Doctor”.  Some M.D.’s believe that it will cause too much confusion for the patients because a provider is “just a Nurse Practitioner” and not a Doctor.   They often site the fact that Nurse Practitioners do not receive a comparable amount of training (not really true).

To practice as a Nurse Practitioner an experienced nurse must go on to obtain a Master’s Degree and participate in hundreds of hours of clinical training. Then after passing a standardized examination he/she can obtain a license to practice as a Nurse Practitioner.   Some NP’s choose to go further and obtain a doctorate and can indeed be called Doctor at that point.  So one would then assume all those called “doctor” hold a terminal or the highest possible degree in a field.

Hold on to your hats, because I’m about to blow your mind.  Medical Doctor’s  are not required to hold a terminal, or doctorate degree.  Some physicians do go on to obtain a PhD, but not all.  There are several professions that receive this title ‘Doctor’ as an honorary title and not a degree.   Some of them are  Medical Doctor, Dentist, Veterinarian and Chiropractor.  So next time you hear “just a nurse practitioner” do your own ‘pushing-back’ and ask the question “just a NP as opposed to what?…”

As a nurse I have done all I can to protect myself from hazards at work.  By vaccination, personal protective gear and extreme hand washing I feel I’m in a safe little cocoon.  Little did I know I could expect my personal safety to be at risk!

The Occupational Safety and Health Administration (OSHA) reports that healthcare workers are at a markedly increased risk for WORKPLACE VIOLENCE.  From 2002 to 2013 violent incidents (those serious enough to require days off to recuperate) were “four times more common in healthcare than in private industry” (Caring for Caregivers, OSHA website).

The majority of the incidents (80%) were from patients!  The people we come to work every day to care for and for whom our job is to make more comfortable and healthy.  Please keep in mind that theses are incidents that were serious enough to 1. be reported and 2. require days off be taken afterwards.

So if you are reading this, thank a healthcare provider in your life.  If there’s not one in your life, find one and thank him/her for risking their personal safety to help others feel better!

When you are a patient it can be stressful and overwhelming.  You need to communicate all of your woes and symptoms but let me give you a few hints on being our favorite patient.

1. Answer our yes or no questions with YES or NO please.
2. please keep your list of woes to 3 or less, we cannot solve all your problems in 15 minutes.
3. When I ask you to take a DEEP breath open your freakin’ mouth and TAKE A DEEP BREATH.  Little tiny nasal inhales are impossible to hear.
4. Know you medications or bring a list.  The “little green pill” could be anything.
5. When I ask if you’ve had surgery I mean all of them no matter when.  Just because it was 20 years ago doesn’t mean it didn’t happen.
6. And finally, please don’t argue with me that you need x or y medication because Google or Dr. Oz said so…….

Antibiotic resistance is real. Drugs that were once our ” go to ” for community acquired pneumonia or bacterial respiratory infections are not even on current algorithms. We are having to return to older antibiotics with more side effects to eradicate bacterial infections.

Scary fact number two is that the drug pipeline for antibiotics is sparse if at all. What does it all mean? I’m afraid to connect those dots….

I’ve been providing healthcare in some form since I was a teen. This year it was my turn to be cared for. What I learned is that hardly anyone listens to the patient.  It was a very frustrating. There was one sweet angel of a nurse that listened AND actually heard what the patient was trying to communicate and acted to improve the situation. One shift out of 5 is not acceptable to me. I was able to speak with a supervisor who was making rounds. She was very professional and employed active listening but nothing changed in my care after our conversation. 

So, how do I make this a learning experience? The quick and dirty lesson is the oldest and most basic. COMMUNICATE! Even if you cannot do a thing about the predicament BE HONEST.  If you’re unable to do a darn thing to help me; tell me! At least I’m not waiting for an answer / outcome that’s never coming. 

There is an exciting growing trend in healthcare that is economical and convenient for the provider and patient.  I am referring to online healthcare visits.  There are many choices but I am most familiar with the Maven app (https://www.mavenclinic.com).  Please download it and explore.

You can have a confidential quick sick visit, or have a long term medication refilled to name a few options.  You will speak with a licensed provider as if you were in their office but you are in the comfort of your own home. Maven not only has nurse practitioners and physicians but psychotherapists, nutritionists, and physical therapists to name a few.  The fees are reasonable and you can even make an anonymous appointment if you prefer.  Of course not everything can be done online there is still a need for hands on care but the virtual options are great for unburdening the overtaxed healthcare system.

Do you have that one friend, or that relative that does nothing but create chaos in your life?  If you do then you know how disruptive and hurtful they can be. It puts everyone involved in a bad position. Do you choose sides or remain neutral? To the “offended ” person there may not feel like neutrality is possible. If you associate with the one with a grudge you have actually chosen a side. 

Now the one who has been shunned by the toxic person is utterly alone because others choose not to choose which in reality is a choice. 

A whole army of suffering patients that often go under treated. The Invisible Disabilities Association [https://invisibledisabilities.org] defines an invisible disability as follows:

“symptoms such as debilitating pain, fatigue, dizziness, cognitive dysfunctions, brain injuries, learning differences and mental health disorders, as well as hearing and vision impairments.  These are not always obvious to the onlooker, but can sometimes or always limit daily activities, range from mild challenges to severe limitations and vary from person to person.”

Patients who suffer with these impairments often hear the cringeworthy statement “but you look good” which can add to the anxiety or depression because others offer no empathy or understanding.  An individual with a visible challenge  may be offered special accommodation by employers where a sufferer of an invisible disability will be judged as lazy or a whiner

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Imagine telling a paralyzed individual to stop being lazy and get up and walk!!  This is essentially what some who suffer with invisible disabilities are subjected to when their limitations are considered fake or “all in their head”.  So before we judge try to imagine what life is like for those whose suffering is called into question on a daily basis.  Statements like “your pain is way out of proportion for your injury” or ” you shouldn’t be having those symptoms” are not useful & do not contribute to a trusting relationship between patient and provider.  The patient is thinking “then please tell my body that”!!!  Treating patients this way is  not compassionate and shouldn’t be used by empathetic providers.