don your bonnet

Here I am doing a dress  rehearsal for the big day tomorrow.

will nursing unions survive?

I'm probably the biggest union advocate you could find.  I grew up with a mom who worked in factories all her life and was the sole support of my brother and I.  She was a fierce union advocate and she passed that on to me.

Without unions, nurses wouldn't have what we have today: somewhat decent wages, benefits.  Nurses worked hard to get to this point, they sacrificed.  However, I am beginning to wonder whether our unions need to change in order to deal with a changing health care environment, otherwise they might cease to exist.

I think a lot about what is the future of nursing in health care.  I see the health care system painfully changing to adapt to less reimbursement, patient satisfaction, obamacare.  Hospitals are quickly changing to adapt.  I see our doctor group adapting.  Then there are nurses.  As usual, we sit back and let it all pass us by.  We resist change for the most part. We aren't proactive, but reactive.

These days our unions settle contracts that try to keep what we have, forget about getting anything more. Unions have rigid contract provisions, necessarily so.  They have to be clear cut.  The thing is, how does that fit in with a changing health care environment?  How does nursing adapt and change and prosper within this rigidity? It doesn't.

If we don't change, adapt, we will be left by the wayside, replaced by cheaper workers.  An example of this: there is a new program in my city that is called community paramedics.  It is just starting. The goal of this, bottom line, is to keep people out of the hospital.  They will do followup, do preventative care, anything they can to maintain peoples health. This fits right in with obamacare, medicare changes.  In other words, they are doing a lot of what home health care nurses are already doing.  The thing is they can be paid half of what nurses do.  This is an example of things to come as health care systems look for ways to decrease costs.

Can our unions become more flexible or will they cease to exist? Are unions outdated?  Will nurses care enough about our profession to wake up and take control of our future?  Only time will tell. Any thoughts?

       

the spice of life

The thing about working in the ER a certain amount of time is you could walk in with two heads and I would say: okay...what can I for you? Just when you thought you seen it all, in walks somethin' you ain't never seen before.

So I'm sitting at the triage desk and you walk in. To say that you are "different" is to understate it. Shall we say that your fashion presentation is a little out there on the edge? The edge where no one else has been and won't go.  Lets put it this way:  You are a combination of lady gaga and cindy lauper with a dash of street hooker thrown in.

You are, shall we say, UPSET?!!!!  Only your upset is different than other peoples upset.
Your upset is theater.  The angst is off the charts.  Your arms flail, your face contorts. You tell me your problem which is equally bizarre.

You are eventually discharged after being evaluated mentally and physically.   I love people like you .  Variety is the spice of an ER nurses life.

when life ends

As a nurse, you don't think much about what you are witness to on regular basis.  Birth, death, trauma...life changing events.

One of the things we see as nurses that most people don't, is death.  A lot of the time it isn't pretty.  A lot of the time its not like in the movies where someone just goes and its over quick. Sometimes it takes a while.  Sometimes a family sits waiting for death, watching their loved one gasp. Sometimes that goes on for a while.  Its difficult to witness.  To see you mother or father seem to struggle for breath for a while.

As a nurse, to be honest, you just want it to be over.  For them.  Those are the times you pray for the end to come.  So they won't have to remember an awful end.

Nurses stay with families as death nears.  Its part of what we do.  We don't want them to be alone. Its too hard for them to be alone. So we stand there while they talk about mom or dad or grandma. You learn a lot about the person at times like that.  

Its hard to watch people cry.  Its doesn't matter how old the person is, they are still mom or dad.

be humble

One thing you have to learn as an ER nurse is humility. I see some young nurses with say a year under their belt, overconfident.  Its like they say to themselves: I've done this a year, I know it all.  Here's the thing: That kind of attitude will eventually bite you.

There's nothing wrong with confidence.  Its a good thing.   I have a lot of confidence. The thing is I have been doing this a long time.  But there is one thing I know: I don't know everything and I never will.  On a regular basis, I ask my co-workers for help.  I depend on them. If I've never done something, I know one of them will help me do it.  If I need help, I ask for it.

The longer you work in ER, the more humble you become.  The more you see, the more you realize you will  never see it all.  Overconfidence leads to mistakes.