You’re Going to be Alright

Years ago, following an art reception, my husband and I were enjoying dinner at a restaurant. As the server set our food on the table, we watched through a window as a car hit a bicyclist who had run a red light.

Go Team Oncology by jparadisi

Go Team Oncology by jparadisi

Immediately, we left our table and went to the woman’s aid. She wasn’t wearing a helmet, and her face was bleeding. She was unconscious, but breathing. Besides a possible neck injury, my concern was that she would stop breathing before the paramedics arrived. Despite my fears, I told her over and over, “You’re going to be alright. Help is on the way.” I don’t know if this mantra helped the woman, but it calmed me.

Nurses tell patients, “You’re going to be alright” all the time, whether or not the situation is as dire as the scenario above.

We tell them they will be alright while we are learning a new EHR documentation system at the same time we are administering their treatment. We tell them they will be alright while we struggle to enter lab orders correctly in the new EHR. Fortunately, EHR experts are readily available to answer questions and help us through this transition. They show us the step we missed, which is the reason the order did not go through.

I slap myself on the forehead, and the EHR specialist kindly reassures me, “You’re going to be alright.”

I think this is one of the most special qualities of nurses: Despite our fears and misgivings about a patient’s condition, or our ability to handle a situation, we tell our patients, “You’re going to be alright.” For the most part they believe us, probably because what other choice do they have? What choice do we have? It is what it is. We must move forward, together.

In Human Resource department lingo, focusing either a patient’s or coworker’s attention on the positive is called “managing up.” For instance, instead of telling a patient you are precepting a nurse who’s giving chemotherapy for the first time, you might introduce yourself by telling them they won the jackpot today — two nurses caring for them instead of one! — and that you are helping Nurse B, who is new to the unit. By doing so, you tell both the patient and Nurse B, “You’re going to be alright.”

In what ways do you manage up at work? What techniques have you adopted to promote a patient’s or coworker’s sense of security during a change of condition or a work-related transition?

The Art of Subtraction

Fascinated, I watched as a sculptor created a face from a lump of clay. With deft fingers, he tore into the pliable medium, pulling away bits and pieces. A pair of sightless eyes, cheekbones, a nose, and finally lips appeared out of the shapeless mass. No clay was added to create the facial features. Throughout the process, clay was only removed to reveal a face in the inanimate material. Before this, I added clay to form features and appendages.

Sergei by jparadisi

Sergei by jparadisi

I realized that the art of living well — like sculpting — is a process of subtracting clutter and revealing purpose.

I struggle with clutter. At home, David politely refers to my “three-dimensional filing system.” In part, it’s because I am an artist. I find potential for creating art from the seemingly useless. I don’t expect to change dramatically.

I Googled “creativity” and “clutter.” More than 3.5 million references popped up in 0.19 seconds. A single article embraced clutter. The majority reported that clutter siphons creativity through disorganization and inefficiency. One even linked to poor health and obesity. Clearly, subtracting clutter enhances creativity and efficiency.

In my nursing practice, I strive to remove clutter and maximize efficiency in patient care. Here are a few ideas to reduce clutter and increase efficiency during your shift.

  1. Embrace technology. Using a Smartphone eliminates hunting for calculators. Apps like MedCalc keep calculations for doses, BSA, ANC, and more at your fingertips. Several apps can help your own health by logging calories consumed and burned through exercise, and we all know the benefit of removing the clutter of extra weight. Some companies offer employee discounts for Smartphone plans so check your benefits.
  2. If your institution uses electronic health records, learn to use them. Creating “workarounds” is inefficient and defeats the purpose. Electronic records save time. Charting in real-time prevents the need to reconstruct events from memory at the end of your shift.
  3. Avoid mission creep. Stick to the care plan. In the ambulatory infusion clinic where I work, patients arrive with lists of concerns having little to do with their appointment. It’s easy to start calling physicians’ offices and making unrelated appointments for them. Handle the appointment-related work, and provide resources for the rest. Don’t confuse patient advocacy with enabling dependent behaviors.
  4. Bring your lunch to work. Sit down and enjoy your 30-minute break instead of standing in line buying food. You’ll save calories, and money too. Many nurses spend $5-$15 rapidly consuming a high-calorie takeout meal in a depressing staff lounge. Wouldn’t you prefer saving the money and calories for a leisurely meal with friends or family during off hours? Just saying.

I’ll leave you with one last thought:

The cost of a thing is the amount of what I call life, which is required to be exchanged for it, immediately or in the long run.

 Henry David Thoreau

 Now, if I could only do streamline at home. Any suggestions?