For my nurses

September 25, 2007

I have always had a large number of nurses in my client list. I have some theories on why that might be.

First I will tell you that my grandmother was a nurse. She started working at St. Joseph’s hospital before there was an LPN classification and was grandfathered in when that licensing began. She worked at that hospital for her entire career, and when she passed, they had a lovely service for her in the hospital chapel. Now, I loved my grandmother, but she wasn’t the warm and fuzziest person you’ll ever meet. She kept her feelings held pretty deeply inside. I’ve even heard people say that she didn’t cry at her husband’s funeral. Once when I did see her cry (I lived with her while I was in college) she seemed irritated that she was so visible with her tears. She uttered the one curse word for which she was famous. Shit.

She worked for decades in the burn unit. It’s a tough place to work. You have to be tough. Debriding wounds is a painful but necessary part of the healing process. When she left the burn unit, I asked her why. She told me she got tired of hurting people. Perhaps it was those years of having to hurt people for their own good that made her toughen up. I’m inclined to believe that the “tough” was just a wall she put up to protect a soft heart. (I have been accused of such things, myself.)

So, my theory on why I have a lot of nurses as clients is this: Nurses have to be tough to be good at their job. They also have a long list of things that needs to be accomplished each day. I think they appreciate my efficiency (get in, get done, get out) and my directness. There are no office politics at Azarra. There is no subterfuge. You always know where you stand. I think nurses appreciate that.

As technology has reached its tentacles into medicine, I have heard the comments (and sometimes complaints!) from my nurses. When one local hospital went live with computer charting (no more paper charts, yikes!) I heard lots of apprehension. I can’t help but wonder, if the technology can help make painful treatments less traumatic, if it would be easier on the nurses as well as the patients.

And as long as I am on my soapbox, I will bemoan the short-sighted hospital administrators who, when faced with budget choices, often decide to cut the nursing staff. When people are admitted to the hospital, they need nursing care. If they didn’t need it, their insurance company wouldn’t let them stay! If I find myself in the hospital, I am glad to see the cranky, old broad in scrubs. She’s tough enough to do what needs to be done, and that’s my kind of gal. And inside, she’s probably a marshmallow.
19 Technologies That Changed Nursing Careers Forever (from http://www.thenurselady.com/)

sphygmomanometerFrom the very beginning of nursing as a formal career with standardized education programs in the late 19th century, there have been several points of rapid change thanks to new health-related technologies. What has been called the “germ revolution” and the understanding of the sources of infection was one such turning point, the introduction of antibiotics, another.

Today, as the demand for nurses skyrockets, the field itself is experiencing radical change. With the combined forces of medical advancements and information technologies, the field of nursing has experienced yet another substantive transformation, changing nursing careers forever. Here are 19 of the technologies that have contributed to this dramatic change.

  1. Electronic IV Monitors. There was a time when IVs had to be administered with a nurses constant attention to ensure a steady flow. Manual IVs were highly sensitive to a patients movement and the flow of the IV could be sped up or slowed to a crawl by a subtle movement. To prevent this, nurses had to directly administer an IV from beginning to start. With the advent of IV pump infusion and electronic monitoring, nurses are freed up to initiate an IV and allow a machine to monitor and regulate the process. If there is an error, the system tries to correct it, and otherwise contacts the nurse via remote monitoring.
  2. The Sphygmomanometer. The sphygomomanometer is simply a fancy term for electronic blood pressure cuffs that also measure heart beat rate: automatically. Gone are the days when a nurse had to measure blood pressure manually. According to one nurse, this is the technological change that makes the biggest daily difference.
  3. Information management. As computer technologies become the primary means of managing patient information, nurses have had to adapt their record-keeping practices and increase their computer skills. Nursing informatics is a specialty that has emerged, combining IT skills and nursing science.
  4. portable defibrillator

  5. The Portable Defibrillator . Manual CPR can only do so much and for the longest time this was the only method available to many nurses for reviving someone’s heart. Now, even school nurses stand a fighting chance to save the life of a person who’s heart has failed. The few minutes after heart failure are critical, and the portable defibrillator allows for immediate resuscitative action.
  6. Sturdy, portable IT devices. Tablet computers and mobile wireless computer stations are now a standard part of the day-to-day methods of delivering care to patients, with paper and pen charting becoming rapidly a thing of the past. Charts are updated continuously, in real time, providing nurses with immediate access to essential patient information.
  7. Readily accessible base of information. Wireless Internet connections quickly place reference materials of all sorts easily at the fingertips. This can prove very helpful for diagnosis, especially when using a resource like WebMD.
  8. sonogram ultrasound

  9. The Sonogram/Ultrasound. Ultrasound devices provide nurses working with pregnant patients the ability to see inside the womb. Ultrasound has been nothing short of revolutionary in the field of Women’s Health and pregnancy, allowing nurses and doctors to noninvasively identify the health of the baby throughout pregnancy. Now, with the advent of 4-D ultrasound, unprecedented detail is available for diagnosing fetal well-being. In addition to pregnancy monitoring, sonogram technology also offers many other new diagnostic advances such as the ability to easily identify cancer tumors in the bladder, and to tell whether the liver is enlarged.
  10. Local wireless telephone networks. These systems significantly reduce communication delays. Not only is this type of communication technology being utilized between nursing staff, but also between patients and staff, changing the dynamics of the relationship between patients and their nurses.
  11. Hands-free communication devices. Hands-free devices such as Vocera’s Call Badge provide the ultimate in communication while a nurse is engaged in active patient care or associated tasks.
  12. Communications options. It is not uncommon for patients and nurses (and doctors) to communicate via e-mail or even web cam, a practice that is becoming common for parents of children in neo-natal intensive care units.
  13. Improved patient (remote) monitoring. In addition to high tech and ultra-sensitive tech vital signs monitoring equipment, web cams and other technologies make the close monitoring of multiple patients much easier, changing how care environments are staffed and operated.
  14. RFID Technologies. RFID-enabled devices make monitoring hospital assets easier, ranging from drugs and equipment to records and patients, enhancing safety and security with less effort and lower long-term cost.
  15. Compact and portable medical devices. Combined with portable IT and communication equipment, these small, high-tech types of devices allow well-equipped nurses to take their skills on the road. They can travel to patients’ homes and treat conditions that once had to be treated on an in-patient basis.
  16. Neo-natal nursing advancements. New, more affordable and even portable devices all for the care tinier and more health compromised babies.
  17. Drug management technologies. High-tech systems of medication retrieval and delivery, such as bar coding and verification, have greatly reduced the potential for dangerous error. Infusion equipment advances have made the delivery of slow-administer drugs much easier, with computerized machines able to control dosages and rates.
  18. Configurable nursing environments. Configurable work spaces increases efficiency and safety, reduces stress, and prevents accidents and injuries.
  19. Learning technologies and options. The availability of individual and off-site learning opportunities and degree programs, via specialized software and online classes, allows for a more rapid career advancement.
  20. Videoconferencing. The ability to interact with nursing professionals throughout the world, through such means as video conferencing, offers advantages and opportunities like never before, both in terms of the further development of the nursing profession and the continued improvement in patient care outcomes.
  21. The blogosphere. Medical technologies have brought changes to the process of life and death and the role of the nurse. The Internet allows nurses to share their experiences and feelings.

As technology transforms the profession, nurses adapt and change as well. Many in the field regard the nursing career as a whole as being in transition, especially as new means and methods of patient care are balanced with the core concerns and traditional philosophies of this essential medical profession.

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