Tuesday, November 20, 2012

I'm back, Jack!

It's been a long time since I've posted a blog. It's been too long. So, I'm going to attempt to catch up.

I don't know if Ive mentioned it here before but my wife is also an RN. She graduated last May. Just before she graduated and at her behest, we moved out of our 100 year old apartment to a house in a very small town about 45 min away. She continued to commute to her last few days of classes and clinicals and I commuted to work while looking for a job some place closer to our new home. Wait, back up... I forgot to mention that she was 5 months pregnant when she graduated. So, she quit her job when we moved and being 5 months pregnant couldn't find work anywhere. Although they don't discriminate against pregnant women, she never seemed to get interviews. So, I took on all the bills and expenses of moving on my own. To make that worse we found out we were pregnant 1 week after I bought my new truck.

 So, naturally, cuts had to be made. I couldn't get rid of the truck or the gas needed to drive 45 min one way to work. I had to cut the internet and the cable. Well, I didn't cut it so much as I never started it at the new house. How exciting for my pregnant wife to sit at home with no cable and no internet in a town smaller than Mayberry with nothing to do. Thank God for Smartphones and 3G signal in the boonies. So, having no access to the internet on my computer, I couldn't write the blog anymore. I certainly wasn't going to try to type it out on my Droid.

My job search went well, interviews left and right, I finally landed on a small hospital about 30 mins away. Didn't improve my commute much, did I? But they really liked me and the CEO was so positive and energetic and likeable, the new Nurse Manager (who has an MBA to go with her BSN) was awesome too, and she told me all about the new ideas and plans she and the hospital had in store. I'll be honest, it sounded like I was getting in the door at the right time. I took that job but didn't quit my other job, figuring I'd have to make up for my wife's missed salary. Then I got a call from my former DoN asking me to come help her out as she had recently been hired as a regional director for a home health company that worked with Peds. She had been doing all the infusions herself on top of her administrative duties and wanted me to jump in and do some infusions. I said "Ok", and then I had 3 jobs! I really didn't have time for blogging then. I worked my tail off all summer until late August. I stopped scheduling myself at my original job and became extremely PRN. The infusions slowed to a crawl because eventually you worked yourself out of a job because your Pt's got better from the infusions, or they died. I know, that's a downer but it's true.

Sept 27th, my wife gave birth to my daughter


 A few days prior to that I had finally gotten cable and Internet and was all ready to get back in to blogging. Then I stopped sleeping! My God! Do people know how needy these babies can be? This has been a whirlwind of emotions and a physical strain. I will tell you that I have served in an active combat zone, I have stayed awake (my longest stretch) for 55hrs and finished it off with a convoy through a heavily populated area, and of course I have graduated Nursing school. NONE OF THESE THINGS PREPARED ME FOR FATHERHOOD!

That should catch y'all up for a while. I really enjoy my Twitter Anon shenanigans and I enjoy giving out advice and guidance. There is someone on twitter now that is almost a blatant copy of my account and I don't know whether to feel flattered or angry or threatened. I now that it's pissing me off so far and I'm refusing to follow him because if I see him tweet something that I've tweeted before I will lose my shit and probably hundreds of followers in the process.

I'm debating doing one of these Google Hangouts with the other Anons, I just recently bought a web cam so I can talk to my parents over Skype and they can see the baby. It would just be really awkward to jump on there and recognize someone.

Ok, I'm sorry that wasn't a comedic post. I'll be funny next time.

Until next time...

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And leave a comment so I know you guys are reading this!


Monday, July 23, 2012

Gender Bias in Nursing??

@nurseofdoom wrote a research paper regarding gender bias in nursing.  It was so good, we wanted to share it with everyone.

Do you agree?  Disagree?  Comment - discuss


(I posted it on google docs as it was fairly lengthy)


and follow the #MurseMafia - @MurseWisdom @JustSomeMurse and myself.

Tuesday, May 22, 2012

Reflections from the Joplin Tornado

As I start this off, I want to make one thing perfectly clear please.  I’m not a “Hero”.  I never have been.  Please don’t call me that.  I’m a man that did what anyone else in my role and my skillset would have done.  @MurseWisdom is a Veteran that served in a war zone.  @MurseWisdom is a hero.  Both of my parents proudly served in the military.  They are heroes.  

Dr. Kevin Kikta is a hero.  He wrote a story called 45 seconds about his night in the ER that night.  It’s a chilling read.  http://statemagazine.org/?p=531

Dr. James Smith is a hero.  He was doing surgery when the tornado hit and ran over 7 miles home to check on his family.  http://www.outpatientsurgery.net/news/2011/05/24-Operating-Through-the-Tornado

The countless, unnamed nurses, RTs, Rad techs, and all the medical personnel that covered both hospitals that night and continued to staff them until everyone was taken care of are the heroes as well.
Please save that prestigious title for them … they deserve it.

With that being said, here we go.  I’ve debated the last few days what exactly I wanted to say. I figured I would say, what I felt, what I did.

It was 5:41 p.m. and it was 32 seconds that would forever change the lives of people that lived anywhere near Joplin, MO.  I was watching the coverage on The Weather Channel.  There was discussion that Joplin and possibly a hospital had taken a direct hit; however, I knew this to be true well before it was confirmed on the air.  Facebook literally blew up.  I knew that St. John’s had taken a direct hit because of Facebook.  But when the weather channel cut live to a Mike Bettes standing in front of what used to be the hospital; my heart sank.  “I have friends and classmates that work there” I thought and then Mike came on the air and pleaded for doctors, nurses, medical personnel to please come to Joplin.  http://www.youtube.com/watch?v=r8kg2dEJo_Y&feature=related

It was all I could take, myself and several other nurses loaded up to make the drive to Joplin not knowing what the hell we would find but knowing that we had to do something.  We arrived about 4 hours post touchdown and went to Memorial Hall where the medical triage was.  Upon arrival there, we found them fully staffed and they suggested we go to another secondary site.  We got there and waited about an hour before I finally was able to get through to the Red Cross.  They basically said that if we were already in Joplin that we should go to Freeman hospital.  

Driving to Freeman hospital was problematic to say the least as we had to drive past what was St. John’s hospital.  We were stopped 3 different times at three different roadblocks, one being right next to St. John’s hospital.  I do have to say that this was one of the most amazing experiences as a nurse.  The police officers stopped us, I said “We’re nurses” and they screamed “nurses” and opened the roadblocks for us.  Once we got to St. Johns we had to drive around the back of the hospital. Pictures will NEVER do this justice.  I’ve heard it described as what pictures of the atomic bomb in Hiroshima looked like and I’d have to agree.  It was complete and utter devastation.  People were wandering around aimlessly obviously in shock of what had happened and the place smelled of strong, strong natural gas.  We arrived at Freeman hospital finally and walked into the ER lobby.  It was one of most surreal scenes I’ve ever seen.  The lobby was literally overflowing with people and I would estimate approximately 1,000 people waiting to be seen.  I found a friend of mine that worked there and he said they were out of most every supply except gauze and gloves mostly so if we could do some basic first aid and try to find the most ill patients to be seen first.  We walked around and spoke with people, treated and cleaned bumps and bruises, and found severely injured people to pull back the moment ER beds opened up.  On the ambulance side of the ER they had a convoy of over 100 ambulances and they were literally loading people up and dispatching them to hospitals in a 200 mile radius.  There were buses loading up less severely injured people and transporting them as well. 
The looks on the faces of the people in the lobby is something I will never forgot.  It was disheartening seeing the look of pure shock at what had happened and trying to make sense of it all.  How could 32 seconds completely change their lives like that.  While we treated the bumps, bruises, and lacerations; we were not able to treat the mental issues that were filling that hospital and that town.  We stayed until about 4 am and then went home knowing that as much as we felt we did we probably didn’t do enough.  Little did I know at the time, but my ex’s brother was frantically searching for his daughter who was working at a local restaurant at the time.  Unfortunately, while they found her; her injuries were too severe to survive.  However, she died a hero as well.  She was working to keep customers and other employees calm before the tornado hit the establishment… she wasn’t even 18 yet.  

I’ve talked to employees from both hospitals and some still have trouble sleeping or still have mental issues relating to that 32 seconds.  

So there are a few things that I learned from this event: 1.  Social Networking is a must.  As I said, I knew that Joplin and St. John’s was hit long before it was announced.  Facebook was also a lifeline for people looking for loved ones at that time because if you couldn’t make a phone call you could send texts a little easier and a text to a loved one or facebook was a welcome sight for families.  2.  If you don’t know how to text – learn.  And teach your parents, grandparents, anyone with a cell phone to text.  To put it into perspective, I tried over 100 times to call the Red Cross that night.. I got through once.  Text messages were going after only a few times of trying to send.  3.  NO HOSPITAL IS PREPARED FOR A DISASTER OF THIS MAGNITUDE.  Freeman was out of supplies initially within a few hours.  Our hospitals are trained to keep supplies on hand for anticipated need.  Not for 1,000 people showing up in your lobby to be treated in a few hours.  I have disaster training and used to work in that field.  This last one scares me the most because I used to think our hospital is ready, but I think we would run through supplies in a matter of hours as well and then would have to get inventive like Freeman staff did.

However, Joplin doesn’t want to be known for that.  They want to be known for their drive to rebuild and they have done an amazing job.  It should be an inspiration for everyone of how to overcome adversity.


Sunday, May 20, 2012


So I mentioned in my post that I was a hypomaniac, which sounds funny but true. 
An ER doc one night said you are a hypomaniac and I laughed.. until I pulled up the DSM-IV criteria and met most if not all of them.  Anytime I walked in dragging ass he'd laugh and say you got too much sleep didn't you.  I truly function better on 4 hours of sleep than 8 hours of sleep.
So here are the DSM-IV criteria for hypomania:
DSM-IV-TR defines a hypomanic episode as including, over the course of at least four days, elevated mood plus three of the following symptoms OR irritable mood plus four of the following symptoms:
Hypomania isn't a bad thing though usually.  Dr. John Gartner wrote a book about how hypomania actually is what drives America.   His book is called "The Hypomanic Edge" http://www.hypomanicedge.com/

There are advantages of hypomania as well:
For me personally, I've learned how to read people.  I've also learned the rules for work.  I was approached a few years ago and asked to take a semi-management position.... except I was told that I will befriend the current person, learn as much as I can, and then watch them take the fall.  It was that moment, that I realized administration is three steps in front of everyone and I vowed to be at least two from that point on.  I'll do what I have to do to succeed.  Callous... probably.  I don't fail.  I refuse to fail. 
I've also considered a career in politics.. because I have no doubt that I can do it.

"Some commentators believe that hypomania actually has an evolutionary advantage.[5] People with hypomania are generally perceived as being energetic, euphoric, visionary, overflowing with new ideas, and sometimes over-confident and very charismatic, yet—unlike those with full-blown mania—are sufficiently capable of coherent thought and action to participate in everyday activities. Like mania, there seems to be a significant correlation between hypomania and creativity. A person in the state of hypomania might be immune to fear and doubt and have negligible social and sexual inhibition. People experiencing hypomania usually have very strong sex-drive. Hypomaniac people are often the "life of the party." They may talk to strangers easily, offer solutions to problems, and find pleasure in small activities. Such advantages may render them unwilling to submit to treatment, especially when disadvantages are minimal."

Disadvantages though means that I drag ass for a few days if I sleep too much and of course foolishness can be a double edge sword.  It can ruin relationships as well as ruin you financially (if you make a bad business move)... but that's a chance you take cause the payoff can be huge.

Tuesday, May 15, 2012

Defense Mechanisms

Sorry it's been a while.  You know how it is with finals and all.  

So I’ve posted some “#BeingAnERNurse means” and it got me thinking about ER nursing.  One of the things that came with working in a smaller community is that there is a better than average chance that I’ll know my patients, their families, or will see them out and about.  This can be a double edged sword. 
Every time that ambulance rolled through the doors, there’s a piece of me that wondered if it was someone I love.  I heard a story of a nurse working in an ER like mine and the ambulance rolled in with a severe trauma… It was her husband.  She literally went catatonic and woke up several weeks later in the hospital. 
With this fear comes the point of my blog post tonight, defense mechanisms.  One of the defense mechanisms that I have (and I only know this cause I can willing admit it) is that I don’t look at faces, unless the injury is specific to the face.  I know this sounds weird until I explain it. Hell, then it might still be weird.  If I don’t look at the face then I don’t know whether I know that person (yes, I know you literal people will say look at the name and to you I say shut up, LOL… Actually, traumas come in John Doe so it doesn’t help anyone).  I have literally taken care of people for 2 hours and when they get admitted to the hospital I realize that I know and recognize them.
This does make for two strange situations though: 
  1. I’ve had people come up to me in Wal-Mart and say “Thanks for taking care of my husband so well”  and I look at the them and how no idea who they are.  But if they tell me what room they were in and a little about the case, I can tell them exactly what we ordered, the diagnosis, and the disposition… Strange I know
  2.  I have a hard time recognizing faces outside of work.  I see people and think.. shit I know them from some place but I can’t pinpoint where.  It usually takes me seeing the person 5-6 times consistently before I can remember their face.

Again I have this defense mechanism in place to protect myself from the inevitability that I will probably work on someone that I know and love. 
So do you have any defense mechanisms in place? 

As always comment here or tweet me. 
And of course follow the me and the rest of the #MurseMafia on twitter.  


Tuesday, April 3, 2012

Kinky, Freaky Nurses

Get into the mind of a nurse and I’d say the majority are kinky, sexually uninhibited, or like to explore sexually… hell they could even be a closet freak and you have no idea.  Why is that?  Well my opinion on the matter is that nurses (and medical professionals in general) deal with death on a regular basis.  We stare death in the face on a regular basis.  Sometimes death wins and sometimes we give a big middle finger to death and save a life.  With all this death floating around, of course we are cognizant of our own mortality.  And with that knowledge comes that fact that we know we only get one trip around this world (unless you believe in reincarnation) and we want to make the most of it.  We take more risks, we drive a little faster, we have freaky, kinky sex.  Maybe you were a freak before you went to nursing school.  Maybe you became a freak while in nursing school.  Maybe it took a few years after you get out… but I truly think that in death we decide to try to live more.  

FYI – Sex is generally a highly pleasurable activity and we want to get the most out of it… and being nurses and having intimate knowledge of anatomy and physiology doesn’t hurt either ;)

The point of this post is if you are questioning why you like kinkier things then you used to blame nursing.  If you are freak already, then at least now you have something to blame it on… If you have kinky thoughts but are afraid to act on them… know that most of the time with nurses you are in mutual company.  So find a slurse or a murse and turn those thoughts into more than thoughts buried in the deep recesses of your mind.

You’d be amazed of the things that nurses at work have talked about doing or offered to do while at work.. Bad slurses ;)  I could talk about it here but it would go from R rated to X rated relatively quickly, LOL

And if you like “vanilla” sex and think you always will, hell at least enjoy it then.   

Agree?  Disagree?  Voice an opinion? Comment?
Follow me on twitter @That1Murse.  Follow my co-blogger, @MurseWisdom


Thursday, March 29, 2012

NSNA Convention/ Election

The 60th Annual NSNA Convention is being held April 11-15 in Pittsburgh. One of the important events that takes place at the convention is the election of the Executive Board, the NSNA's governing body. Running for NSNA President this year is Joseph Potts, a nursing student at the University of North Florida and an avid reader of the @MurseWisdom blog. Joseph is a 12 year veteran of the Navy and lives in Jacksonville with his wife Kimberly. If you would like to find out more about Joseph, his campaign, and his vision for the future of nursing you can check out his Facebook and Twitter pages at: https://twitter.com/#!/NSNAJoe  http://www.facebook.com/NSNAJoe

Monday, March 26, 2012


There is a lot of heated debate, especially amongst current Nursing students as to which education produces better Nurses.  BSN or ADN?  So, let's discuss shall we?

Let me begin by just stating that I am an ADN grad and have worked my way up from CNA to LPN to RN.

No matter what kind of Nursing student you talk to they will tell you the same thing.  An ADN student will tell you that Hospitals would rather hire an ADN nurse, especially from his or her program than a BSN student from a near-by and therefore "rival" program.  And a BSN student will tell you the same thing.  Here is a funny touch of Irony, BSN programs better prepare nurses for the type of nursing required in a long term care setting and ADN programs train their nurses for Med-Surg type units and it is usually the opposite when it comes to job placement.  ADN will end up in long term skilled type facilities where as the BSN nurses will flock to hospitals.  I have a friend working at a nursing home that is completely run by ADN nurses.  Not a single nurse has gone beyond the two year mark.  Yet, I met a BSN graduate working as a CNA at a hospital because she hadn't passed the NCLEX yet and since she hadn't gone to a bi-level ADN program she wasn't eligible to take the LPN boards. I was an LPN at the time, in clinicals, telling someone with a BSN that I needed her to do this or that. It was so strange.

Let's try using some simple math to get an answer.  I googled the number of credit hours required to obtain a BSN. I wanted a middle of the road number so I picked Oklahoma City University which, geographically speaking, is pretty well in the middle.  They say it takes 124 credit hours for a BSN.  Any arguments? My college requires 72 hours of Nursing credits in order to graduate.  I graduated with 129 credit hours.  That's just how the system works, between prereqs and liberal arts/humanities electives needed in order to apply, I ended up with 5 more hours than is needed to hold a BSN. So, mathematically it seems to be no different.  (By the way I suck at Math)

(I really hope to get a good discussion going from this blog)

I have talked to nurses that are just straight snobs about their BSN and others that have flat out told me it isn't worth shit, I have friends that have gone on to complete their BSN after ADN.  Me personally I believe we are all just nurses. I mean an RN is an RN is an RN, right? If I go on the get my BSN I don't take another NCLEX, same goes for my Master's level nursing... No new NCLEX.  (However, there is a board certifiaction for Nurse Practitioners if I were to go that route)Those of you in BSN programs... your NCLEX is no harder than mine was and, not to brag, but, I'm sure you won't/didn't do much better on it either.  Surely, its not just a matter of initials after your name, right?

So, BSN students get more class time and more Nursing Theory, whereas ADN students spend their time hands-on in clinicals, labs, simulation, etc...  As far as who is the better nurse... I think we can all agree that that is an individual assessment.  My nursing program didn't make me the nurse I am today, but they did provide me with the essential information I needed to overcome the first big obstacle, which was the NCLEX. 

In my personal opinion, it is better to go through a 2 yr bi-level nursing program.  You can start as a CNA when you start the program. After a year you can test for your LPN and start earning LPN wages and gaining real world experience in nursing. Then after two years (hopefully) you can test for your RN and begin making RN wages and building valuable experience.  Then if you must have a BSN or MSN or ARNP after your name, you can continue your education while working and earning a living.  It may take a little longer than if you just went straight through but you won't be new to nursing when you get your MSN or BSN you'll be a seasoned nurse. 

But what do I know? 

As always, thanks for reading.  Share with your friends, coworkers, and fellow students. And comment! Subscribe! Let me know if I'm pissing you off or hitting the nail on the head.

Send me pictures of your study group or friends doing something vaguely nursing and I might feature it on the Blog. Please don't violate HIPAA. 

Follow me @MurseWisdom on twitter

And special thanks to co-author @That1Murse and to @bigwesyall for his continued support


Sunday, March 25, 2012

Mursing School by @TMFS786

One of the few things I feel like I have the experience to speak from authority about is nursing school. I just graduated so obviously I'm an expert. There is a lot I read on twitter and facebook about and I think some things need cleared up for those of you that are still inside or maybe this will just be funny to the people who made it through and are looking back.

Stop worrying so much! My friends will laugh about that because I was pretty much a constant wreck because I never felt like I was doing well enough. I somehow yoked myself with this feeling of my entire life was riding on how well I did on the next test. If I passed and didn't do great I still felt like a failure. Well the truth is I did fine. I passed without any real worries, except maybe family nursing that was close, but really I was not in trouble. We were told we were already above average students so maybe when things went from easy to mildly difficult I didn't know what to do. Maybe I just became an asshole, that is still a debate, either way I got worked up over nothing and you probably are too. You need to focus on what you need to learn that week and move on. Trust me in your first year of nursing you are going to feel like you learned little to nothing. So all the little details you forced into your brain (mine was aplastic anemia) will mean almost the same as your ability to speak Sanskrit. You are going to learn a lot of details and the teachers are doing their job, but honestly the majority of that is just stuff you have to learn. A hoop that has to be jumped through, the same one those before you and those after you will have to jump through. The broad strokes are the things I have used the most as a new nurse not stuff like the Parkland-Baxter formula. Not that it matters you will have the deer in the headlights look a minimum of six months on your first job anyways.

Have a support group, and make sure they mean it. I was lucky; I have a wonderful girlfriend who is also in the health field so she understands my anger. My friends are good friends and supported me. I highly suggest you pick people to surround yourself in school for all the basics: Studying, travel, test preparation, and people you can trust to vent to when you feel like you have reached your limit. Nothing will ruin your day like traveling for an hour and a half to clinicals with someone that causes arguments in your group. I guarantee you will loathe your life in a hurry if that is your situation. I had a situation where we couldn't even talk in the car after a few weeks or it was an inevitable fight. Trust me when I say that made a long day even longer. You can't avoid all the arguments, we are human stuff is going to happen but someone with similar views and thoughts can go a long way. Just as important is having a support group outside of class. Pick people in nursing, out of nursing it doesn't matter. Make sure they are people you can talk to that see things from an entirely different point of view and use their advice it will come in handy all the time. I have friends that are nurses and cops, both way removed from class. They were there to balance me and keep me on track when my classmates were just as stressed as I was.

Have an outside life. I know we study a lot, I get it. You aren't going to tell me anything that I don't already know about school and tests. No you aren't different and IT IS the same for me as it was for you. You have got to do something un-school related while in the program. You will go crazy if you don't. Besides you can't study all the time you just cant after a while all the words will just run together and be a blur. Go to the bar, take a day off and go the movies it don't matter but stay away from the books every once in a while to put things in perspective. You can only retain so much information at once anyways don't waste your time beating yourself up over something you won't remember anyhow. When you really want to go out for a few hours with your friends, then do it and don't look back and think about the studying. If you make a decision stick with it and move forward. It's a skill you will have to master when you get onto the floor and they expect you to be in charge of people's lives, start practicing now.

Not all of you are going to make it. That's the breaks and it's the truth. If it was easy everyone would be a nurse and we wouldn't be as necessary. Embrace that truth and realize you are a cut above. You are going to be special and make an impact on people who need you the most. That's why it is tough and you have to go through it. If you want it bad enough, you will do it. I had moments of doubt like everyone else. The difference is we that graduated are willing to pay the price to have what we want, if you aren't then maybe you need to find something else. A lot of people can help and give advice, I know I am and so are most of the murses I know, but you have to use it.

Written by @TMFS786

Saturday, March 24, 2012

Know Your Role

I think it’s important in nursing and life in general to know your role and know your qualities.  Are you are leader or a follower?  A critical thinker?  Someone who just wants to get by and draw a check?

I think the lack of knowing this beforehand can contribute to nurse burnout and people with Nursing Degrees working in banks or not working at all.  There are some jobs based on your qualities that may not work well for you.  For example, if you are going to work in a nursing home or an inpatient rehab your leadership qualities will probably be for naught.. and from the time I worked there the most critical thinking that I did was making sure I didn’t give Gertrude the medicine for Olive.  (Now I’m not knocking nursing home nursing, just saying that if you are a person that wants to grab life my the balls and drag it down… nursing home nursing…probably not for you)

I’ve always seen myself as a leader.  I think this is why I gravitated toward ER nursing or critical care nursing in general.  I knew that when the shit hits the fan, I would have to potentially take control of a situation.  We’ve worked multiple MIs, multiple GSWs, and this with one doc in the ER.  I’ve had the doc approach me ask me to assess a chest pain and decide if it’s legit or not.  

I think this is also why I’ve decided to pursue my Nurse Practitioner.  I want to be the guy in charge.  I want to be the giver of the orders not the taker of the orders.  But I know that’s a quality of mine.
What I think you should do, it take a few moments assess the type of person that you are and learn what qualities make you up?  It will pay off and hopefully make nursing a more enjoyable experience.

And as always, follow me @That1Murse and my blog co-author @MurseWisdom.  Feel free to post questions, comments, bitches, whines, moans, groans, and complaints.

Special shoutouts: 
            @BigWesYall and his website www.weshelton.com  - Thanks for the link to our blog.
@jorrrrd_ (Jordan) and her class at LCCC.  Thanks for posting a link on your FB group page.  Enjoy the read.