Two nurses who consistently had numerous stars worked another department and shift. I was only blessed to meet each in person only once as each was admitted to our facility before they bravely lost their battles with cancer. I was shocked to realize many of the comments patients offered occurred at a time these nurses were probably much sicker than the patients for which they cared.

Our small hospital is also still reeling from the loss of another co-worker who went home one day and killed herself. We are all still shocked our co-worker felt such despair and pain that suicide seemed her only hope.

Another co-worker is a 50 something who finds herself living at home with her parents due to life’s hard knocks. For the last year or so, she would work her long 12 hour night shifts only to go home and care for her dying father. I will attend his funeral today.

As I ponder this I am reminded of two things. First, I must look past the patients and really see my co-workers. There really is no “us” on this side of the bed caring for the hurting “them” in the bed. We are all fragile, precious humans in need. Second, there can be beauty for ashes. The same unfair hand life dealt my friend allowed her to be home to care for her father when he needed her most.

There really is no “us” or “them”. Take time to be kind and tender-hearted; let’s be good to each other out there.

This is very discouraging. If I had been a military or school nurse I would be eligible for full retirement now. A patient actually said to me, “Don’t worry. The next 22 years will go by quickly.”

The physical toll alone is daunting. How many people (and backs) can withstand the rigors of 47 years of nursing? One out of 10 serious work-related back injuries involves nursing personnel, and about 12 percent of nurses leave the profession because of back injuries. “No lift” policies have been adopted in other nations such as the United Kingdom and Australia but have yet to be accepted in the US.

In addition to this danger, the Federal Bureau of Labor Statistics, half of all nonfatal injuries resulting from workplace assaults occur in health care and social service settings.

An average of 429,100 nurses per year reported that they were victims of violent crimes in the workplace. 25 injuries annually result in missed work days for every 10,000 full-time nursing personnel, 12 times the rate of the overall private sector. Fifty percent of nurses surveyed by the Massachusetts Nurses Association (MNA) and the University of Massachusetts said they had been punched at least once in a two-year period. Some reported being strangled, sexually assaulted or stuck with contaminated needles. In a 2006 survey by the Emergency Nurses Association, 86 percent of respondents said they had experienced violence in the previous three years, and a fifth said they encountered it frequently. A 2004 survey of 6,300 randomly selected nurses in Minnesota, found 13 percent of respondents reported having been physically attacked during the previous year and 39 percent reported having been threatened, verbally abused or sexually harassed. Patients committed almost all of the physical assaults and two-thirds of the verbal ones, with visitors as well as physicians and other staff members responsible for the rest.

I realize I have not been pacing myself well for the LONG haul. As a result I have been more cautious at work regarding personal and back safety. I obtained my BSN after twenty years of nursing; after twenty five years I have decided to pursue my MSN. I would encourage those entering the profession to seriously consider military or school nursing.

Perhaps I should consider opening a “nursing” home to care for nurses such as me who retire after 47 years of service.

At the same time I presented a program for the American Heart Association on “Women and Heart Disease”. A common obstacle was that women tend to worry about their husband’s health but their figure.

I had a friend die of ovarian cancer. She said her initial symptoms were diarrhea and a 10 pound weight loss. She didn’t go to the physician right away saying, “What woman wouldn’t be happy to lose 10 pounds?” She carried the regret of not seeking treatment sooner to her death.

Later I had an unexpected weight loss of 10 pounds and went to my physician. His response? “Good!” No work up was done.

A few years ago I experienced pain in my left arm and neck while running on the treadmill. I attributed it to muscle strain from having just bench pressed. When the pain persisted I saw my physician. He agreed it was from the bench-press. I asked if he didn’t think we should do an EKG just to be sure. He reluctantly agreed. Later came back in carrying the EKG saying, “If you were a man I would say you had a heart attack.” I have T wave inversion in all leads except AVR. It took three months to get a referral to a cardiologist and have a cardiac catheterization. The cath was normal; evidently it’s just an idiosyncrasy of mine. I later asked my physician why he said “If you were a man” He replied, “Woman don’t have traditional symptoms……..yada, yada, yada” I replied, “Yes, but EKG changes are not unique to either sex though.” He admitted if I were a man he would have immediately rushed me to a cath lab.

Recently I was bit by a tick. About a week later I had a sore throat, achy joints, and extreme fatigue. Concerned I may have Lyme’s disease, I made an appointment with my physician. He proceeded to scold me about my weight gain over my seven year course of treatment with him. He informed me I should go to a Chinese labor camp for two years and then I would be a size two (I am now a size 10-12).

So, more than 14 years after the study saying women are discriminated against in health care, we are still judged by our figure not our health. I may be a size two after two years in a labor camp, but would I be healthy? Would he have made this comment to a man? Would he have said to a man “Two years in a labor camp would lower your weight, blood pressure, and cholesterol”? My son’s girlfriend is a size two. I imagine if she complained of fatigue, he would tell her she is malnourished and rule out anorexia.

So my question is, what size does a woman have to be to be taken seriously? When will it be about our health and not our figure?

If I had to suffer sensory deprivation, loss of smell is not so bad. I can still see and hear. It has been quite an adjustment, however.

My sense of taste is not as acute anymore. I threw away a gallon of milk one day past the expiration date rather than use it when I was home alone. Clothes on the floor automatically go to laundry (No way to sniff out the clean from dirty). I can no longer enjoy the smell of rain, line dried clothes, or babies. I stick with a spritz of my tried and true perfumes. I count on my co-workers to detect GI bleed breath or the need to change an incontinent patient.

As I pondered this I recall a blog I wrote and would like to share.

I am incredibly honored to have been a nurse for well over half my life. I take great pride to be included in a profession named the most trusted profession every year for the last ten years except 2001 when fire fighters claimed the honor.

For years I have been on a personal crusade to get people to quit saying “just”. “Just” diminishes and demeans. I “just” have 3 kids. I “just” have a bachelor’s degree. I am “just” a nurse. I am the proud mother of three boys and am proud to be a nurse with a BSN.

A friend recently commented I could have been a doctor. I explained I did not SETTLE on being a nurse, it’s what I CHOSE to do. I wanted a profession that would satisfy me and allow me to be home with my children, work flexible, part time hours, and contribute significantly to the household budget.

Recently I have been speaking with nursing leaders from all levels of nursing. I was dismayed when speaking with several nurse practitioner leaders to hear comments such as “We are not nurses, we are nurse practitioners” or “We are not just a nurse”. OUCH!!

I recognize the spirit of the comment. Nurse practitioners are advanced practice nurses who have taken rigorous courses and serve the patients in a completely different role than the traditional bedside nurse. As such, they have different educational needs as well. As a mother of a college age son, I found the comment as painful as the growing pains I feel as my son naturally distances himself from the parents who birthed and nurtured him.

The entry level debate has caused so much division over the years; let us not make advance practice cause further division. We are all proud to claim the title of the most trusted profession. We obtain our license are governed by the same boards of nursing.

I have been a nurse for 25 years. I have sat through countless and seeming endless required competency classes offered by other nurses. In fact, I was able to immediately take life saving measures for that same college age son when he was a toddler with an obstructed air way because of what I learned from another nurse. I was honored to provide care for my mother as she died from cancer and to provide the 6 weeks of IV therapy for my son when was treated for osteomyelitis. Just being a nurse made a world of difference for me and my loved ones. I would like to think it has for my patients as well.

To illustrate my point, I’d like to take 1 Corinthians 12:15-31 and apply it specifically to nurses: The nursing profession is one and yet has many members. All the members of the nursing profession, though they are many, are one profession. By our various education we were all entered into the profession, whether LPNs, or RNs, whether BSN or MSN, and we were all made to serve the patient.

For the nursing profession is not one member, but many. If the LPN says, “Because I am not a BSN, I am not a part of the nursing profession,” it is not for this reason any the less a part of the nursing profession. And if the RN says, “Because I am not an APRN, I am not a part of the nursing profession,” it is not for this reason any the less a part of the nursing profession. If the whole nursing profession were APRNs, where would the RN be? If the whole were RNs, where would the LPN be? But now we are all in the nursing profession, just as we desired. If we were all one member, where would the nursing profession be? But now there are many members, but one nursing profession. And the APRN cannot say to the BSN, “I have no need of you”; or again the LPN to the RN, “I have no need of you.” The nursing profession is so composed, giving abundant honor to all members, so that there may be no division in the nursing profession, but that the members may have the same care for one another. And if one member suffers, all the members suffer with it; if one member is honored, all the members rejoice with it.

Now we are the nursing profession, and individually members of it. We are all teachers, with gifts of healings, workers of miracles.

With all the important issues facing us, such as the health care debate, we must unite and speak with one voice. We must find the more excellent way.

Imagine one day as administer the routine CURE for cancer, you notice the active ingredient is derived from your own cells! You are so proud and honored to have played a vital role in curing millions, but suddenly realize the drug company has gotten incredibly rich from marketing your cells as you struggle to work to pay the bills. You did not know and were never compensated.

Sounds far fetched, but The Immortal Life of Henrietta Lacks by Rebecca Skloot recounts the 1951 events in which physicians removed cervical cells without first notifying Ms. Lacks or obtaining her informed consent. The cells were labeled with the first two letters of her first and last name, “HELA.” Since HELA cells never die, they launched a medical revolution. Her family never knew for more than 20 years later when they found out by chance. Finding out their mother’s cells were still living forever changed their lives.

As I read, I thought “This could never happen today with HIPAA and informed consent. (In Katie’s Corner, our pharmacist explores the history of informed consent).

Yet, it was perfectly legal for the physicians to do this then and it still is today. Storing blood and tissue for research does not require consent. Ms. Skloot reports most Americans have their tissue on file somewhere. If you have had a mole removed, tonsillectomy, or appendectomy your tissue may be stored in military facilities, the FBI, or National Institute of Health.

There are many guidelines but few guidelines governing this. Courts have failed to hold up the popular notion of “My body, my choice”, once the tissue is no longer attached to your body. The Federal Policy for the Protection of Human Subjects (The Common Rule) does require informed consent for all human subject research. Tissue research is not covered because it is not federally funded and the researcher does not know the identity of the donor. Gathering tissue strictly for research would require informed consent but storing tissue from diagnostic procedures does not. Consent forms typically have a line that tissue may be used for education or research or stored for future research.

John Moore was diagnosed with hairy cell leukemia in 1976. He later found out his physician patented John’s cancer cells to make valuable proteins, valued at 3 billion dollars. Moore was unable to sell his own cells, because his physician held the patent. In a subsequent lawsuit, the court ultimately ruled against John, stating when tissues leave your body, they are no longer yours.

Most people want to know if and how their tissue is being used. Some may want to opt out of research on issues they find morally reprehensible such as nuclear weapons, abortion, racial differences, and intelligence.

Initials are no longer used to identify tissue, but the technology to sequence genes makes it virtually impossible to make specimens anonymous.

Tissue from a victim of the 1918 pandemic has led to advances. These advances could not have even been imagined in 1918 making informed consent unrealistic for the donor. Others see tissue research as a duty, a moral obligation to benefit society.

This issue will not go away as we make technological advances. We will need to set clear guidelines and nurses must be involved. In Katie’s Corner, Nurses4Nurses gives some practical ways for nurses to engage any such issues. What do you think? What is our obligation as health care providers? What are our rights as health care consumers?

Unbelievably, my youngest son was scolded for riding his bike in the park. 

My oldest son had his skateboard confiscated by the local police for merely having it in his possession.  He represents 12.3 million skateboarders in the United States who deserve a place to skateboard without causing a problem for local business owners and pedestrians. Skateboarding is illegal in my county and skateboarders face fines or loss of their skate board for riding skateboards in public. There is no public transportation, leaving many skateboarders unable to afford traveling the 40 miles to the nearest skate park.  Parks in the same town are “Passive Parks” which mean active sports may not be played there.  Active Sports include but are not limited to: Football, Frisbee (Ultimate or otherwise), Baseball, Basketball, and Golf.  A toddler was reprimanded by the police for playing with a ball in this park.

Skateboarding burns over 430 calories an hour; bicycling leisurely burns over 200 calories per hour.    

 Why in this day and age when obesity is so prevalent would communities support passive parks?

In Katie’s Corner, occupational therapist, Tobi Barnett has a feature on Skill Building in the Outdoors.  This is a timely topic, in keeping with First Lady Michelle Obama’s goal to end child obesity in a generation. 

The CDC reports childhood and adolescent obesity is a serious health concern which increases risk for cardiovascular disease (such as high blood pressure, high cholesterol, and Type 2 diabetes) and with an increased risk to become obese adults.

This month in Nurses4Nurses you’ll learn about Roslyn Pruitt, one of the nurses from Nursing in the Storm who needed to draw on tremendous physical reserves after Hurricane Katrina. The average nurse is over 40 years old. My personal observation is that we tend to be codependent and not take care of ourselves. Roslyn has committed to being in shape to face the next disaster. She is running 4 miles a day and goes to the gym regularly.

As nurses we can model healthy behaviors and motivate others to adopt a healthy lifestyle.   What are you doing to promote a healthy lifestyle for yourself or others?

I am thrilled to be hosting Change of Shift.  While I do not always share the opinion of my colleagues, I learn so much and am challenged to view my profession in a new and different light.

We are expecting Joint Commission at my facility any day now. We are brushing up on all the regulatory guidelines. In The second coming? RehabRN shares a recent Joint Commission survey and practical tips to survive your own.

Off the Charts explores the controversial practice of recruiting foreign-educated nurses in International Recruitment of Nurses: a Look at the Industry and Voluntary Codes of Ethics.  This is sure to be a hot button topic as graduates struggle to find jobs.

The Bloom Is Off by The Makings of a Nurse reminded me of a comment a nursing leader once made to me.  Patients are in the hospital because they need 24 hour nursing care. We try so hard not to leave anything for the next shift, we forget we will never get it all done; the patient requires constant care.  While I am not encouraging anyone to slack, the reason there is a next shift is to continue care.

As an ICU nurse I really connected to the GeriPal – Geriatrics and Palliative Care Blog’s  feature The Opposite of Love by Brad Stuart.  Brad reminds us the opposite of love is fear. Love connects; fear alienates and fosters abandonment.  We abandon patients to treatment that may or may not extend their lives without asking how they feel. We must hold the difficult conversations to honor our patient’s wishes and decisions. My mentor as a house supervisor once cared for a dying patient who wanted comfort measures only.  The patient deteriorated with the physician en route minutes away to write the “Do not Resuscitate” order (this was before phone or fax orders were accepted).   When the patient coded, she barred the door from the code team as the physician arrived to write the order, placing herself in liability to honor the patient’s dying wishes.

Running Wildly describes the angst mothers feel in deciding to stay at home or work in SAHM vs. WM.  Women are known to be more social and value relationships.  Why then do we attack other mothers and eat our nursing young? Why can’t we show each other some of the unconditional respect we show patients?

The Muse, RN develops the RN Mouth Moving Theory which will immediately remind you of at least one long winded, opinionated colleague and leave you laughing at the conclusion.   Unless……….

A Mother, Author and Activist for Neurofibromatosis Shares Her Story reflecting how much their lives have changed since her daughter’s diagnosis. To help other parents and children know they are not alone she created  the Bur Bur and Friends stories.

I was reminded of a shift on oncology years ago when I had a patient die at the beginning, middle, and end of my shift as New Nurse Insanity: Fundus Chop! shares Thoughts on Death with the poignant, twisted humor of a nurse.

The Nurse Practitioner’s Place explores the role of  Nurse Practitioners As Diagnosticians.  As NPs struggle to have prescriptive and practice authority, traditional roles will be challenged by nurses, NPs, and health care consumers. 

Nurse Me explores balancing respect for a person’s mind, body, and spirit in Science vs Jesus.  Much like the books in the book club I have read but wouldn’t have picked on my own, this blog provided a perspective I would not have obtained in my homogenous world. 

Scrubs What I Remember from Nursing School brought back memories of the Sister making me practice turning down covers according to the text book, being afraid of the call light, and pages of calulations to determine the 0.25 mg dose of IV digoxin was one-half of the available 0.5 mg product.   

That’s it for me this edition of Change of Shift. Thanks so much, Kim.

Drop by and visit me at Nurses Network.

Be sure to check out the next edition of COS hosted by Keith at Digital Doorway.

My patient the other night was a World War II fighter pilot. My co-worker, Bea, a certified nurse’s assistant, had cared for him on previous nights, but I was meeting him and his lovely family for the first time. As Bea observed he was significantly less responsive, a son left to share Bea’s observations and update the family.

I was struck by how much I share in common with this elderly couple. They were married on October 5; my husband and I were married October 3. They have 3 sons as do we. They were celebrating 64 years of marriage as we celebrate 23. He served aboard the USS Enterprise, flying a Grumman Hellcat and was among the first to go on night missions. He was shot down twice and received the Distinguished Flying Cross. I stopped to realize he was about the age of my oldest son as he served.

Kim, the day shift CNA, is also a student nurse. She searched the internet for the USS Enterprise and found a photo of our patient with his shipmates aboard the carrier. His wife and sons were able to pick him out immediately and treasured the photo as they had never before seen it.

As we were in report Sunday night, we each expressed conflicting feelings regarding whether we would want to be present when this hero breathed his last breath. We were honored to care for him and wanted to be there for the family, but they had stolen our hearts. The asystole alarm ended our discussion. It was fitting that we were there together. We shared hugs and tears.

As the family left someone asked if the son was OK to drive. Without hesitating or asking, I offered to have Kim drive them home. Without hesitation Kim agreed. That’s the kind of wonderful co-workers I have. Excellent nursing care is not always provided by nurses. I am a richer person for meeting this family and sharing this experience with Kim and Bea. I will never forget the compassion and caring demonstrated by my two co-workers.

Then, one day at a routine OB/GYN appointment, my physician instructed me to return once a week as he was unable to find the baby’s heartbeat. I called my mother from my car, suddenly sobbing. I was so afraid I had bonded with my baby and now I was so very worried. My mother said, “Oh honey, of course you have bonded with your baby.”

Years later as that same son began school, friends would ask if it saddened me to see my baby starting school. I truly was not sad. I imagined the hours of peace, quiet, and freedom I would have as I drove to him to school the first day. It would be the best of both worlds as I looked forward to the children coming home from school. On the way home, I stopped at Wal-Mart to run a few errands. It was definitely easier to shop unencumbered. As I paused to use the restroom, I noticed a pair a chubby little boy legs with little boy underwear around the ankles in the stall next to me. Suddenly I started sobbing.

My middle son will graduate from high school this Saturday. His girlfriend asked if I am sad that he would be leaving home soon. I truthfully answered I am so very proud of the man that he’s become and that it was time for him to enjoy his independence. The other night at dinner he mentioned the caps and gowns are in and that he would be having his cap and gown portrait made. Once again I suddenly started sobbing.

I wonder if this is part of being a nurse, being able to tune out all the emotion and focus on the task at hand, only to be overwhelmed with emotion once we have a chance to breathe.