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EKG Interpretation: The Tap Dance Way

Check out this cute video of University of Pennsylvania School of Nursing faculty and students demonstrating the art of EKG interpretation through tap dancing. Now if they could throw a Wenckebach in there, I’d really be impressed. (via Beka at Medscape Nurses)

It was recently brought to my attention by my dear friend Max that I haven’t blogged in over two weeks. Just wanted to let you all know that I am still alive and kicking. I’m picking up a shift here and there in the Recovery Room, but also working on some web-related projects which I will hopefully be posting about soon. In the meantime, I will leave you with a picture of a Bonsai tree I’ve been working on in illustrator:


Back to the MICU

So I’ve had an ab fab week of being a stay at home mom, and caring for my one year old wonder. I’ve also made some progress on my Orientedx3 redesign, and I hope to be able to launch it in a week or two. I won’t get into too much detail here, but suffice it to say that it’s going to be a very cool way to explore nursing related content, with blogs in the forefront.

I’m also working on building some WordPress themes from scratch and it’s been a really fun and invigorating project. A project that makes me feel as though I am getting closer to being a successful web designer, and farther away from being an unhappy nurse.

One kind of cool but geeky thing I realized is that PixelRN is on page one of a google search for “nursing websites.” It’s kind of meaningful to me because I’ve always believed that nurse bloggers are putting out the best nursing related content on the web, and most of the other nursing websites are light years behind us. It’s also meaningful because the way I discovered nurse blogging was by doing a google search on “nursing websites.” In a way it makes me feel like this blog has come full circle.

At any rate, I am working a shift in the MICU tomorrow, my first time since last summer. I have a feeling it’s going to be a make or break kind of a shift, in that I am either going to rediscover my passion for working in the ICU, or I will be reminded why I wasn’t so keen on going back there in the first place. More importantly, I hope I remember how to care for really, really sick people. I’ve been fetching ginger ale and crackers for post cardiac cath patients for far too long now, and I’m worried that I might have lost my edge.

On the other hand, I may have gained an edge. I can now start IVs, and the turn ‘n’ burn atmosphere of the recovery room has made me hone my time management skills. Either way it should be interesting, but not too interesting, if you know what I mean.

Should a Nurse have a Mission Statement?

I’ve been reading a lot of books lately on successful business strategies and the topic of mission statements often comes up.

It got me wondering, can nurses benefit from having a mission statement? Many of you already do, but you don’t even realize it. A mission statement can be derived from your philosophy of nursing. For example, what does being a nurse mean to you? What makes a good nurse? Answer these questions and there is the beginning of your mission statement.

Why Would a Nurse Want a Mission Statement?

Quite simply, because it adds meaning to what you do. This can be a great help, especially to those who are suffering from nurse burnout. If you take a moment to reflect on your mission statement, it could serve as a source of inspiration on those days when you just feel like you are just running around in circles, and not really accomplishing anything.

Here’s an example: As a recovery room nurse I often felt dragged down by all the repetitive, meaningless tasks that I was required to do (charting vitals Q 15 minutes, fetching ginger ale and crackers, removing IVs, etc). What if instead of dwelling on these things, instead I focused on the following mission statement:

For all of my patients, I am going to help them to be in control of their health care process. This would include:

  • Making sure they know when and with whom to schedule a follow-up appointment.
  • Making sure they have the proper educational tools; e.g. if they have a nephrostomy tube placed, do they know how to care for it? If they have a pacemaker placed, are they aware of what the settings are, and what these settings mean?
  • Do they need copies of their lab values for their personal records?
  • Have the doctors answered all of their questions related to the procedure?

Sure, most of these things are part of the job anyway, but if I view them in the context of my mission statement, it might make my job more meaningful, and hence, more satisfying.

If you had to choose a mission statement as a nurse, what would it be?

Cherokee Scrubs: A Test Drive

orangesToday I will be reviewing the Cherokee V-neck tunic scrub top and the Cherokee v-neck scrub pant, both in mandarin orange, from My Nursing Uniforms. It’s taken me awhile to write this review. That’s because there was something slightly unfavorable about these scrubs and I wasn’t sure how to approach it. The color I chose is a little bit “out there,” so to speak. It was described as Mandarin Orange, but I think a more apt description would be Safety Belt Orange. In fact, the first time I wore them, one of my not so tactful colleagues felt the urge to ask me if I had just gotten out of prison. My not so tactful husband asked me if I was going to work out on the roads that day.

Despite these snarky comments, I also got many compliments on the color. Whether these people were just being polite, or they think that neon orange is a good color on me, I will never know. I can safely say, however, that this shade of orange is definitely a conversation starter.

There are also some things that I really like about these scrubs and I would definitely purchase them for myself, but perhaps in a more muted color. What else did I like? Two things: the cut and the pockets. If you’ve read my other reviews, you know how I feel about pockets, I need them to do my job. The Cherokee tunic top actually has two deep pockets and an inner longer pocket that is great for storing pens. I also like the tunic cut. It is a little longer, going down a little past the waistline. The pants were slightly too long for me. They are mediums and I am 5’4″ and the hem drags on the floor.

All of this considered, I would definitely consider these scrubs PixelRN-worthy – just in a different color and a slightly shorter pant.

(In the interest of full disclosure, I will let you know that my friends at My Nursing Uniforms are compensating me for this review, although the compensation was not dependent on a positive or glowing review – what I am telling you here is my honest of opinion of these scrubs.)

Chez Recovery and Beyond

So two more weeks left of working at Chez Recovery, and I am ready to move on to bigger and better things. The funny thing is, after all the complaining I’ve been doing, the job is really starting to grow on me. I think this has something to do with the law of leaving a job – the closer you get to the end, the more you start to like it. I think it also has to do with the great group of nurses that I met there, and have really enjoyed getting to know.

Anyhow, I think my complaints can all be boiled down to 3 neat little concepts:

  1. 40 hours a week is too many hours to work as a nurse. 20-24 would be more like it.
  2. I would like the job a lot more if I had some added responsibilities like say, training as a charge nurse. Since I’m leaving in two weeks, this most likely will not happen.
  3. I am not sure I still have a passion for nursing.

I’ve been toying with the idea of picking up where I left off with web design, and thinking about doing some freelancing. I’d like to start setting up sites for businesses using WordPress, and help these businesses to get more traffic by adding blogs, as well as other types of Web 2.0 apps to their sites. If you own a business and think you might be interested in this sort of thing drop me a line (Beth-AT-pixelRN-DOT-com) and we can discuss some ideas.

AND on another exciting note I am planning on relaunching OrientedX3, but in a in a much different form. More news to follow in the weeks to come.

And then there’s this guy. I’m looking forward to spending a lot more time with him. He just celebrated his first birthday and has the cake on his face to prove it:


Nurses: Let the Bidding Begin

Here’s one approach to ending the nursing shortage. Nurseauction.com is a new site that features an auction style marketplace where nurses can bid for shifts that employers have posted. Also, nurses can post when they will available to work, and set their price.

As you can see, I’ve already gotten in on the action:


All kidding aside, I was irked lately by something an agency nurse told me. She said she was asked not to discuss her wages with her co-workers. My feeling on that was that it’s your business if you want to discuss your wages. If a hospital will pay a nurse $33/hour for a shift and an agency will pay a nurse $46/hour for the exact same shift, who are you benefiting by keeping quiet about it? It’s really no secret that agency nurses make gobs more than staff nurses. It’s a trade-off. You trade job security, upward mobility, benefits, and vacation time for higher wages. It would be interesting to see an open market like this one show what a nurse’s services are truly worth.

So if any hospitals administrators are reading this, and know that they will have a vacant shift on April 21st, I will gladly come and work in your ICU for $1893 an hour. In fact, I’ll be there with bells on.

The Anger is Coming From Within


I read this post last night and realized it could have been written about me. I certainly have been doing a lot of complaining lately. A nursing student reading my blog might think twice before continuing with their nursing degree. My question is, what’s wrong with thinking twice about something?

I’ve seen a lot of angry nurse blogs and it concerns me too, but I don’t think the answer is to discourage angry nurses from blogging. To me, angry nurse bloggers = angry nurses, and so there are a lot of unresolved issues within the profession.

John says: “By presenting such a negative picture of our lives, aren’t we, as nurses, beating up those who read our blogs who may be just starting in the profession, or worse, considering joining the profession?”

To me, this couldn’t be further from the truth. When I voice my complaints about the profession, I feel I am doing a service to my readers who are thinking about entering it. I am telling the real story of what it’s like to be a nurse in the hospital. My BSN program did their best to fill my mind with nursing theory, nursing politics, and nursing lingo, but they did very little in explaining what it is actually like to be a nurse, and for that I feel a little cheated at times.

Another thought. The majority of these “angry nurse bloggers” work in hospitals, and hospitals are where the nursing shortage exists. To suggest that all nurses who are unhappy should simply find another specialty, is not really going to do much in the way solving the nursing shortage. There are some very real problems with hospital nursing, and within our health care system in general, and these things issues need to be addressed, not hushed up.

Yes, working as a nurse is frustrating, even infuriating at times. But it’s also exciting, meaningful, and extremely rewarding. And you can find all of these points of view by reading nurse blogs.

Nursing students and novice nurses, take these angry nurse blogs with a grain of salt. People will always complain about their jobs, no matter what profession they are in. On the same token, I would encourage you to take these complaints very seriously because they are real and legitimate. Perhaps a new generation of nurses is needed to actually change things, and to create an environment where nurses aren’t so angry all the time.

Makeover Madness

Let’s face it. I’ve been blogging about some pretty frustrating topics lately. I think it’s high time we start having some fun around here. With that in mind I will offer you the following warning about this post:

a. It’s not at all about nursing,
b. It may entice you to waste huge amounts of time,
c. It’s unabashedly girly so if you’re not into that sort of thing, feel free to check back later.

So some of you may have noticed that I created a new profile picture. In the process of doing so, I came across this incredibly addictive site, Taaz.com. It’s basically a site that allows you to upload a picture of yourself, and then try out different make-up and hairstyles.

So my first instinct was to try it out and see if it really worked, and I was pleased to see that it did! You can add lipstick, eye make-up, and foundation, and it actually looks somewhat real:


But then I got all crazy and tried to make myself look like a goth girl. Instead I think I ended up somewhere between Loretta Lynne and Kate from the B-52’s:


Then I got even crazier and started photoshopping my new goth girl look:


And now I’ll probably spend the rest of the day playing with this totally addictive site, because that’s just the kind of self-absorbed girl that I am. Hey, at least you will be spared another rant as to why I want to leave nursing, right?

16% of the US economy runs on scrawly, handwritten notes.

From A Scanner Brightly:

“Health care currently consumes 16 out of every 100 dollars in the USA, but electronic health records are next to non-existent. The few that are in existence don’t talk to any of the others.

If we ran banking like that we’d be… oh wait a minute, we did run banking like that. About a million years ago. Well, thirty anyway.

16% of the US economy runs on scrawly, handwritten notes.

I would like to expand this thought to computerized physician order entry systems and here’s why:

I made a mistake yesterday. I didn’t just miss one order. I missed A WHOLE PAGE OF ORDERS.

Why? Because the doctor wrote them on a separate page and stuffed them into the side pocket of the binder, rather than putting them in the proper place.

I looked through the chart five different times, looking for an order and I couldn’t find one. There was nothing but blank orderset sheets, and a blank order page. I wasn’t too surprised though. This kind of made sense to me because there was no fellow in the case, and usually the fellow writes the orders. In fact, if you ask an attending to write an order they kind of turn away in a huff and say “I don’t do that. Get the fellow to do it.” In this particular case, I just followed the basic (unofficial) protocol for this procedure (Vital signs Q 15 minutes x 4, then q30 minutes x2, then Chest X-ray after 2 hours, then page the physician after the CXR has been read.)

I did all of that and paged the Radiology attending. He never responded. So after about 20 minutes I paged the urology attending. He called me right away and asked, “What about the CBC?”

“I didn’t draw a CBC.”

“Well I ordered one hours ago.”

“I’m sorry but I didn’t see any orders in the chart.”

“Well I ordered it.”

“Okay, well I’ll check the chart again, and in the meantime I’ll draw the CBC.”

I went back to the chart and low and behold there was an entire page of orders, stuffed into the side pocket, where miscellaneous patient info usually goes.

Fortunately no one was harmed, although the patient did have to stay in the recovery room for an additional hour because I didn’t see the order.

This was my mistake and believe me, I owned up to it. I apologized to the patient for creating this delay and I apologized to the attending for missing his order, but I know that this mistake could have been avoided if the recovery room used a computerized ordering system.

So this brings me to reason #2 I am thinking about leaving nursing: Being a nurse in the hospital is essentially about carrying out orders. You can sugar coat it all you want, and talk about how there’s a big difference between nursing care and medical care, but in the end, physicians write orders, and nurses carry them out. (And by the way, my BSN program did their best to convince me that this is not the case, but after three years of working in the hospital, I’m pretty certain that this is the case.) And yet there is such a lack of standardization in the way that doctors write their orders, so it can be difficult to carry them out. Do the recovery room nurses care about this? The answer appears to be no. Whenever I ask the nurses about this situation their reply is this, “Oh we’ve been fighting this battle for years. Nothing ever changes.”

How do you get beyond that kind of apathy?