emilyanthonycfstuff-blog

[emilyanthonycfstuff-blog]

Compassion In The Chaos

My name is Emily Anthony; I am an Emergency Department RN at North Florida Regional Medical Center. This blog is for my Mass Communications class at the College of Central Florida. This blog will discuss the not-so-typical night of the night shift in the ED. Why we do what we do, along with the nights that break us, and the nights that build us.

I am a brand new nurse, graduated nursing school in October of 2016. Many hospitals don’t allow new nurses in the ED because majority of the patients are very ill and require quick, critical thinking and actions. North Florida hired two groups of new graduate nurses in the hope of changing the culture of their department. North Florida put these groups through multiple simulations where they had to demonstrate how a code should be ran, in the video linked below these are nurses I currently work with, all new graduates.

https://www.youtube.com/watch?v=wGrDX6II_E8

To better understand how we feel about our job, you must understand a basic day. Those of you have never seen an ED and the chaos it contains this is for you.

Every day in the ED is a roller coaster. On a typical day we walk in to the staff lounge at 1840 ready to hear the scoop on what happened during day shift.  The pre shift meeting typically begins with how many patients we have Baker Acted, this could be violent, suicidal, drunk, arrested,  or in police custody. A baker acted patient must be stripped of all clothing, not have an IV present, if medical monitoring is necessary a sitter, security guard, or police officer must be at the bedside to maintain safety while the patient is hooked up to the monitors.

Shift report will continue with any ICU contenders, patients who had heart attacks, strokes, are severely sick with infection, patients who are intubated and any patients who require one-on-one nursing. On a good day we will come into work with one to two ICU contenders, but the past two months has been anywhere from two to even one day we had twelve.

Next on our list is our room assignments, if we are short nurses this can be tricky on the charge nurse. Rooms 1-8 are our critical care rooms, with rooms 1-3 fully stocked for any emergency situation, ventilators, saws, intubation set ups, catheters, drills, clippers, every needle size made, blood tubes, refrigerated fluids for core cooling and cooling and heating blankets. These rooms are our CODE rooms. Rooms 1-8 are worked as team rooms, the two nurses in 1-8 don’t have set rooms they just work together.  Rooms 6 and 7 are our Baker Act safe rooms, cameras installed in the room, no lock on the door, no supplies, and steel cages that can be pulled down to isolate the patient away from the mounted monitor if necessary.

One nurse in 1-8 is the designated stroke nurse, they have a special phone, they are responsible for going to cat scan with the patient, call the neurologist and stroke coordinator. Rooms 9-12 are isolation rooms, 9 and 12 have a joined bathroom for patients who are experiencing illness requiring a nearby bathroom. Rooms 10 and 11 are negative air pressure rooms for patients who have tuberculosis or any respiratory virus. Rooms 13-24 are everyone else, depending on how full the department is any of these rooms can be a critical room. All stocked with basic supplies, suction, and monitors. Rooms 17-24 also work as a team, these nurses are Code nurses, any cardiac arrest or CODE BLUE on the first floor of the hospital, these nurses are responsible to respond. When times get tough in the ED every nurse, every room, is now a team, a nurse in 21-24 can help the nurses in 1-8.  

This is only a glimpse of the atmosphere in the ED, but I hope it set up a good visual for how we are set up and how we function

First nurse I interviewed is new-graduate Adrienne RN. Adrienne began working just two months before myself and is in the video above. I have worked side by side with Adrienne multiple times. I asked her four questions, which may seem simple but it allows insight into why she chose this challenging career.

Why did you become a nurse?

Adrienne stated, “ I became interested in issues such as women’s health and human trafficking. My eyes were opened to the universal need for medical and emotional attention. I felt led to partake in medical mission trips around the world and share my traits of compassion and empathy with others in a practical way.”

What made you choose the Emergency Department?

Adrienne answered, “ All I really knew when I graduated was that I wanted broad, critical care experience. The opportunity for my job came about in an unexpected way, and I felt sure that it was the right choice. I knew that the ED would be a challenge, but I was excited to take the leap.”

Describe your best day as an ED nurse?

Adrienne said, “I could come at this question from many different angles depending on if I was focusing on the teamwork, the rewarding feeling from helping patients, or my own personal performance. If I had to pick one, it would probably be a rewarding memory of a patient She had just been assigned a clean bed on the floor. She knew she would be transported soon, so she repeatedly thanked me for my compassion and hugged me. She was so moved by the care I had given her that she started crying. Moments liker these are rare, and I son’t even look at it so much as praise on my part, but praise on the part of the patient to have the capacity of thankfulness she had. It was touching and rewarding to know that at least this one person understood  my vision and that I had accomplished it with her.”

Describe your worst day as a nurse?

Adrienne admitted, “ I will never forget that night, my team of patients were angry and seemed impossible to make content. I was doing 100% the most I could possibly do for them, yet they were constantly displeased. One patient actually made a personal stab at me, despite what lengths I was going through to help them. At this point I had to step away and take a five minute cry break. This was the first time I cried at work. I learned that in this profession you give so much mentally, physically, and emotionally to total strangers. The majority of the time you will not receive recognition or appreciation that is well-deserved. I had to decide to keep treating people well, the way I would want my family members to be treated, despite not receiving appreciation. To continue being a caring nurse, I had to find a different motivator other than praise from my patients. This was key for me to not burn out instantly gain compassion fatigue.”

The next nurse I asked is Tara, also a new nurse who is in the video from the previous post. Tara is always a helping hand, first  on the spot when needed, and doesn’t back down from a challenge. I asked Tara the same four questions as Adrienne to get an idea of the differences in these two nurses.

Why did you become a nurse?

Tara states, “ I became a nurse because my grandmother was a home health nurse. I used to go to work with her often when I was younger. I was in a way born into nursing, it was all I ever knew I wanted to be.

Why the ED?

Tara admits, “ It was not a big discussion honestly, I applied for the job, as I did for many others. Mrs Vickie ( our manager) was convincing, positive, and gave off the mother bear feeling which I really liked.”

Describe your best and worst day?

Tara replies, “ I don’t really have a single best or worst night at work. I will say the best nights are hen I can really tell that I made a difference for someone. Shen I see family members a few days after taking care of their loved ones and they remember me and thank me again for all the help I gave them.

The worst nights are the nights I feel like I’m just chasing my tail. The nights when we are just so busy I fell like I ca’t give the care that I know I should be giving, and not able to take the time to connect with the patients.”

I became a nurse to help others. I originally planned a career in Criminal Justice with the desire to be a Deputy. I met my boyfriend in a math class at the College of Central Florida. His older sister was an RN at the time, she would talk about her day when she got home, it always fascinated me. He pointed out that he thought my personality was better suited for nursing rather than criminal justice. I spoke with his sister more, the friends I knew that were nurses and those pursuing nursing. I decided he was right. I began my journey to nursing within months at Rasmussen College of Nursing.

During my clinicals I was able to go to Ocala Regional’s Emergency Department and work as a student for a day. I fell in love immediately, the constant rush, always on your feet never having a minute to over think your actions. It was a simple kind of crazy that was almost relaxing to me.  The Emergency Department is my calling, the rush of being among the first set of hands on a patient as their body fails them. My hands, my brain and my actions save a life every shift I work.

My best day is easy for me. I walked into my shift being put in 1-8 for the first time. I was receiving shift report from a previous classmate. The patient came in with altered mental status, covered in blood and pitch black fecal matter. Which any nurse would start to ponder the idea of a bleed internally. after changing the patient I went and spoke the the doctor who was not convinced it was a gastro intestinal bleed. After simple test it was confirmed, a CT was ordered. I enter a nasogastric tube to decompress his belly, which decreased his pain. Getting all the toxic waste out of his body, he began to regain his mental status. He began telling us about his life and how he has been sick for a very long time and it was his time. My best day isn't about saving a life, it was allowing a man to pass with his mental sanity, being himself one last time. I made it my mission that night to make it his best stay in the hospital. The doctors told me he wouldn't make it to midnight. I was able to get him to our 0700 A.M. shift change happy, talking, and on the phone with family. I was able to give a man his life for one more night. He constantly thanked me for me giving him so much care with no judgment. My best night as a nurse was being there for someone as they passed. Being a happy, smiling face that sat with him and talked about horses, and our favorite vacation spots, I learned that night being a nurse was about being human.  Being vulnerable and allowing another persons pain to become your own. He left the world content and at peace with himself and in his right mind. Easily my best night as a nurse.

My worst night similar to Tara’s have been a few nights. The nights we have standing room only in the waiting room, no rooms available upstairs. We are now gridlocked with nowhere to go. These are the nights our patients are unhappy with us despite all of our efforts, we feel as if we never get caught up with our work. The nights we constantly chase our tails never feeling successful. There are many nights like these, and they never get easier, we just become numb to the rude comments. We all learn to just duck our head and keep trucking along with our duties and our responsibilities to our patients.

Just a few other blogs that I found in my search that talked about the life of an ER nurse. Some more set in on the crazy, and critical moments, the ER is also about comfort and compassion.

http://errn.blogspot.com

http://ernightlife.blogspot.com

[emilyanthonycfstuff-blog]

Compassion in the Chaos

To better understand how we feel about our job, you must understand a basic day. Those of you have never seen an ED and the chaos it contains this is for you.

Every day in the ED is a roller coaster. On a typical day we walk in to the staff lounge at 1840 ready to hear the scoop on what happened during day shift.  The pre shift meeting typically begins with how many patients we have Baker Acted, this could be violent, suicidal, drunk, arrested,  or in police custody. A baker acted patient must be stripped of all clothing, not have an IV present, if medical monitoring is necessary a sitter, security guard, or police officer must be at the bedside to maintain safety while the patient is hooked up to the monitors.

Shift report will continue with any ICU contenders, patients who had heart attacks, strokes, are severely sick with infection, patients who are intubated and any patients who require one-on-one nursing. On a good day we will come into work with one to two ICU contenders, but the past two months has been anywhere from two to even one day we had twelve.

Next on our list is our room assignments, if we are short nurses this can be tricky on the charge nurse. Rooms 1-8 are our critical care rooms, with rooms 1-3 fully stocked for any emergency situation, ventilators, saws, intubation set ups, catheters, drills, clippers, every needle size made, blood tubes, refrigerated fluids for core cooling and cooling and heating blankets. These rooms are our CODE rooms. Rooms 1-8 are worked as team rooms, the two nurses in 1-8 don’t have set rooms they just work together.  Rooms 6 and 7 are our Baker Act safe rooms, cameras installed in the room, no lock on the door, no supplies, and steel cages that can be pulled down to isolate the patient away from the mounted monitor if necessary.

One nurse in 1-8 is the designated stroke nurse, they have a special phone, they are responsible for going to cat scan with the patient, call the neurologist and stroke coordinator. Rooms 9-12 are isolation rooms, 9 and 12 have a joined bathroom for patients who are experiencing illness requiring a nearby bathroom. Rooms 10 and 11 are negative air pressure rooms for patients who have tuberculosis or any respiratory virus. Rooms 13-24 are everyone else, depending on how full the department is any of these rooms can be a critical room. All stocked with basic supplies, suction, and monitors. Rooms 17-24 also work as a team, these nurses are Code nurses, any cardiac arrest or CODE BLUE on the first floor of the hospital, these nurses are responsible to respond. When times get tough in the ED every nurse, every room, is now a team, a nurse in 21-24 can help the nurses in 1-8.  

This is only a glimpse of the atmosphere in the ED, but I hope it set up a good visual for how we are set up and how we function.

[emilyanthonycfstuff-blog]

Hidden Gem of Marion County

            A small farm that came about in 1988 was the home to Mary and Robert Anthony. The farm began as a thoroughbred farm that bread, raised and trained nearly a dozen horses for the Ocala Breeder Sale. In 1990 the Anthony’s, from Anthony, Fl., welcomed their first child, a son.  As the boy came close to his second birthday, Mary began teaching horseback riding lessons to the young children of Marion County.

           As the years past the farm grew bigger, the Anthony’s were forced to rent a neighboring property to house more horses. The farm gained the name Sunset Stables in 1996, given the name due to the breathtaking view. After 27 years of having horses nibble on the grass, and hay in stalls, Sunset Stables sold its last horse in January of 2015.

March of 2015 a young Angus calf, Bubbles, was brought to Mary, after being abandoned by her mother. Mary took in the calf bottle feeding and training the cow. A few short months later the Anthony’s bought Buttercup a 4-month-old Brahma calf to give Bubbles a friend. Sunset Stables was once again home to animals. After a year of having the animals the Anthony’s began having the cows seen by a vet, to see when a good time to breed them would be.

When I asked Mary why she decided to take in the cows she said, “ They found me, every animal we have ever owned found us. Bubbles found us when the farm needed a new member, Buttercup was not far behind her, and she needed a home, just as Bubbles needed a friend.” A year after having the cows the Anthony’s decided it was time to breed the cows and expand their farm family.

Brahma heifer, Buttercup, photographed above gave birth March 5, 2017 at 9:30 P.M. to her 123-pound calf Beau.

 Just five days later on March 10,2016 at 6:10 P.M., half sister Bell was born.  Bell’s mother, a 3-year-old Angus heifer by the name of Bubbles, gave birth to 68-pound Bell, with friend and pasture buddy, Buttercup by her side.

Bell and Beau are now inseparable.

 Photographed below is Robert Anthony laying in the soft hay with his new calf.