Work – Anna BSN, RN

Frontline

April 18, 2020June 10, 2020by Anna BSN, RN2 Comments

I recently volunteered to exclusively work in our main adult COVID ICU (on my old general care peds unit). There are multiple COVID-19 ICUs and moderate care floors throughout the health system. It is terrifying to see two critically ill adults in each room when there used to be one isolette or crib for relatively healthy children. Every night I learn how to do more and more ICU care to help the primary nurses as much as I can. My first night I helped get a bagged body ready for the morgue. My second night I saw family come to the bedside of a man in his 30s to be with him before he passed. Most patients are intubated and several are on continuous renal replacement therapy (CRRT). None of this is fair. None of it seems real. It is very surreal to see room after room with patients maxed out on ventilator settings, sedation, pressors, and barely surviving. In some rooms you can hardly move with all of the IV pumps, machines, supplies, and equipment. I cried the first time I walked the RICU halls, but now feel somewhat immune to the trauma we see at work or watch on TV every day. Then, I find out patients I helped bathe, turn, or draw labs for died that next day and I break down again. My emotions, probably like yours, are all over the place. I can’t always label them but I do know a lot of what I’m feeling is grief. Grief from what our lives were supposed to be like this spring, grief from cancelled events or missed trips, grief from not seeing friends/family, grief from actual death around us, and grief from our old way of life as we transition to a ‘new normal.’

I am thankful however, to have all of the PPE I need to safely enter patient rooms. The entire unit is negative pressure too. This is NOT the reality for many nurses across the US and now some are even getting fired for refusing to work without N95s. While we did sign up for this job to help others, we did NOT sign up to do it without the equipment needed to protect ourselves. Our country was completely unprepared for this pandemic and its essential workers are feeling its detrimental effects the most. The good news is that the curve is flattening thanks to successful mitigation. Please continue to do your part by STAYING HOME until it is deemed safe to leave. You are helping save the world by doing so and the frontline can’t thank you enough. The next time you venture out don’t forget to thank our other crucial frontline staff ~ grocery store employees, postal carriers, truck drivers, bus drivers, chefs, janitors/EVS, and more! Stay strong, we will get through this.

#HAILtotheFrontline

“Just going to hold his hand for a bit, I don’t think he has long.”

FYI

“We know from history that when citizens become restless and protest to their leaders about lifting these sanctions too early, another rise in cases invariably occurs. In some places it was worse than the first peak.” -Howard Markel MD

African Americans represent 40% of COVID-19 deaths in MI but only represent 14% of our state’s population. The reasons for this can be attributed to multiple social determinants of health such as having a job that doesn’t allow ‘work from home’, lower income, fewer community resources, comorbidities etc. (this is Nursing 101)!

Proud of our Governor for creating a task force to help understand why these racial disparities are occurring and how we can remedy them.

Please remember you don’t have to be productive during quarantine. We are experiencing a trauma and your only job is to stay home and take care of yourself. Mental health is as much of a priority as physical health so don’t feel pressured into doing anything you aren’t comfortable doing right now. Two articles helped me understand this: A Trauma Psychologist Weighs In & Don’t Feel Like ‘Getting Things Done’?

*Jaanuu is selling cute reusable, antimicrobial masks for when we all have to wear them 🙂
*Love Your Melon also has a face mask/headband collection and FIGS has a mask waitlist
*What I use to sterilize my phone & watch (PhoneSoap) after work, also sold on Amazon

Health, Nursing, Social, Travel, Work

Coronavirus (COVID-19)

March 20, 2020April 18, 2020by Anna BSN, RNLeave a Comment

Flattening the Curve

Flattening the Curve

The best way to prevent illness is to avoid being exposed to this virus.

Clean your hands often (for 20 sec) or use hand sanitizer (at least 60% alcohol).
Social distance (at least 6 ft). Stay away from those who are sick.
Stay home if you are sick (for at least 14 days). If not sick, only leave the house for essentials.
Ensure you are reading/sharing credible information via CDC & WHO.

John Hopkins Global Interactive Map

CDC COVID-19 Facts Download

Social Distancing Metaphor Download

Encouragement

Free lunches for Michigan children found here

Distillers making hand sanitizer found here

Starbucks offering free coffee found here

Crocs donating free shoes found here

Italians singing

Be thankful for your thoughtful professors/teachers who are working hard to make sure you can still learn during this time.

Friendly Reminders

*There is an extreme blood shortage. You can save a life by donating today via the Red Cross*

Protect your mental health during quarantine

Don’t just “look for helpers.” Be a helper by doing your part to combat COVID-19.

Health, Nursing, Social, Travel

New Year, Improved Me

December 30, 2019January 3, 2020by Anna BSN, RN5 Comments

I used to think that the New Year was the only time to start over. While it can be a good time to make a major change in your life, it is not the only time you can choose to be a better you. Each new month or even new week can be a time to restart. We need more than one time a year to recharge and rechannel our energy. New Year’s resolutions often fail in January and become a distant thought by March. We end up disappointed if we did not lose a certain number of pounds or follow through with a gym membership, finish a diet, repair a particular relationship, learn a new skill, save more money, get the new job etc. I’m tired of beating myself up for not achieving every single one of my resolutions. This year, I am choosing to be aware of what I do have and focus on gratitude instead. I like who I’m becoming and want to be more aware of my blessings this up coming year. I challenge you to do the same. By being consciously aware of all that you have in your life, you can improve almost every situation you’re in. Don’t think of it as a new you, but an improved you.

With a new decade comes even more pressure to have even bigger and better resolutions. I want to assure you that gratitude and developing/using affirmations are the best changes you can add to your routine for an improved life. Choose to be thankful for one thing each day or up to ten things each day, whatever makes the most sense to you. Maybe choose to make a list at the end of the week or month. I was gifted a New Year’s gratitude journal a few years ago and didn’t fill out more than two pages. Even that was too much pressure. However, this year (and decade) I am taking that pressure away. Even if I just say to myself what I am thankful for each day, tell someone close to me, or write it on a sticky note, that will be enough. The feeling I get when telling a friend ‘I’m so happy we’re catching up and having dinner together’, outweighs anything negative that happened to me that week. As silly as it sounds, even stress from school is a privilege. Not everyone has the opportunity to go to college or graduate school, so stressing over exams isn’t the worst thing you could stress about.

As a nurse (or any healthcare provider), we have the privilege of taking care of people in their most fragile state. For the most part, our health is intact and we have a job that pays well. No matter how tired, we get to come home to our families after work. Our patients on the other hand, may spend the night in the hospital without their parents, parents may wonder how they will pay for the hospital bills, some may be newly diagnosed with a chronic illness, and some may be at the end stage of their illness. We are likely seeing them during the most difficult part of their lives. This is especially hopefully true for our littlest ones. I don’t say this to compare yourself to people in crisis or serious situations, but to be thankful for all you do have; most importantly, your health. If there is no other change you make in the New Year, make it a priority to remember all that you were given.

10 things I am grateful for in 2019:

Reuniting with old friends. I took the leap and reached out to friends who I lost contact with years ago. I am extremely glad these women are back in my life and couldn’t imagine my life going forward without them.
Starting yoga again. I stopped after undergrad and am glad to have found such a welcoming, inclusive, inspiring, and impressive studio. It’s DYL!!
Whale watching with my mom in Mexico. Enough said.
Seeing Hamilton. It was on my bucket list and it lived up to absolutely everything said about it!
Spending my birthday in Traverse City. I went to my favorite wineries with my favorite people and parasailed for the first time since I was 18.
Going to Sicily with my uncle and cousins. I am reminded why I am grateful for my uncle almost every day, but these trips make me just even more grateful to be alive. The boat rides and swimming with Mount Etna in the background made up for my jellyfish sting on our 1^st day haha.
Purchasing a car. I’ve driven a lease jeep since I was 16 so it was a huge accomplishment to finally buy one of my own (also shout out to my dad for guiding me through the whole process).
Surviving my 1^st acute care clinical. I was in a pediatric ED and pleased with the confidence I gained and all that I learned.
The health of myself, friends, and family.
Starting my blog. I was hesitant about writing again and making my posts public for everyone to judge. However, I’m so glad I overcame this fear and here we are 😊

I encourage you to create a similar list of ten (or more) things you are grateful for in 2019. Share it on Facebook or read it aloud to your family and friends. Make a list together or keep it private. Let’s also share positive new stories that show the good around the world and in other people. Start your New Year and new decade with a grateful heart and peaceful mind!

“Wear gratitude like a cloak and it will feed every corner of your life,” -Rumi.

Health, Nursing, Social, Work

To Weigh or Not to Weigh?

December 24, 2019January 3, 2020by Anna BSN, RN1 Comment

Throughout my life I have been both overweight and underweight. I have loved how I looked and hated how I looked. If you’re like me, the holidays are an especially difficult time for body image and food guilt. You might be exercising a little more or plan to immediately start dieting in January. However, I just want to send a gentle reminder that food is not the enemy. What you eat fuels your body and mind. What you say to yourself about your body fuels your soul. You are not what you eat, not how you look in a bathing suit, and you are not defined by your clothes size.

To be completely honest, I never cared about my weight until college. I was a competitive swimmer since I was eight years old and on three swim teams during the year in high school. I grew up in a bathing suit and never gave my body shape too much thought. I didn’t grow up with an older sister telling me how I looked or what to wear. My parents never said anything about my weight. I also had practice five to six days each week so I felt like I could eat whatever I wanted. Every Sunday morning after practice I had McDonald’s for lunch as a treat. Whatever I ate was pretty much burned off the next day. Michael Phelps ate over 10,000 calories/day while Olympic training so whatever I ate didn’t compare in my mind haha. I still eat fast food at least weekly and don’t diet. However, I want to make it clear that I never struggled to be an average weight. According to 23andMe (which has been ~95% accurate), I am predisposed to weigh less. I point this out to say that it is not miraculous for me to be average or on the thinner side. I don’t have a great weight loss story and don’t intend to.

My body image journey began around the time I was applying for nursing school. I was struggling with some classes and began seeing a therapist for inattentiveness and OCD-like behaviors. Like Meghan Edmonds recently said, I too am a “stress non-eater.” In combination with a new med I started that had ‘loss of appetite’ as a side effect and drinking coffee for the first time in my life, I began losing weight quickly. I didn’t notice or care at first. However, I decided I was going to try out for the dance team, so I started wearing a leotard again. I would regularly look in the mirror and began enjoying seeing the ribs in my back show. My thighs were thinner than ever and I loved how my leggings looked. The following fall, a friend in my dorm had a scale in her doorway. I truly never tracked my weight until then. I began weighing myself several times a day and panicked if I was over 105. My dorm also had the calories listed for every meal and food item. While this a University initiative to be more transparent, it actually made it a lot easier for me to eat less. I tried to make sure I wasn’t eating more than 1,000 calories a day. This is about half of what someone in their twenties should consume. In addition, I was going to the gym every few days, something I previously hated to do. I tried to wear bigger clothes and hide it as much as possible. My friends and family would make comments about my slim figure, but I usually blamed it on the stress and the questions stopped.

Then, I started dating and began what would turn into a four-year relationship. I slowly put the weight back on. I was eating out a lot, snacking, drinking wine, and pretty much just enjoying life. I didn’t have time to go to the gym and didn’t want to. I started a nurse assistant (tech) job and had a bagel and an Iced Cap every morning before work. I didn’t have my calories listed in front of me anymore, so I lost track of how much I was eating. However, I did have access to a scale. One day at work I decided to look and see. At my highest that summer, I was up to 127. It was surprising, but not enough for me to do much about it. My self-esteem was probably better than at my thinnest. Yet, this weight was not a healthy one for my height. I had a few extra pounds than a “normal BMI” but I was happy. Interestingly, it was the end of this relationship that threw me back in the opposite direction again. I stopped eating, as many people experiencing a trauma do, and lost over 20 lbs. I did not have the intention to lose this amount of weight and I acknowledge that large weight shifts in a short period is not healthy. This is especially true for someone barely over five feet. However, I started to like how I looked in a bathing suit again. I was getting compliments and I felt my self-esteem come back after what was a truly traumatic summer.

As of today, my weight is somewhere in between. I still have my self-conscious days of course, but I am happy with how I look right now. I still occasionally weigh myself, only because I have such easy access to do so at work. I don’t own a scale and never plan to. I don’t think knowing your weight is a bad thing. What is bad, is fixating on the number and affiliating your self-worth with what it says. If weighing your self is good for your own personal goals, then go for it. We all know how to calculate a BMI, so I encourage you to diet or exercise if reaching a healthy BMI is your goal. I don’t belong to a gym but do go to yoga every few weeks. I also have a personal home exercise routine that I do every few days. I try to limit my sweets but treat myself whenever possible. I have been lucky to be able to eat whatever I like since I AM predisposed to weigh less. However, I still try to eat healthy and exercise because it makes me feel strong, healthy, and confident. That is my goal now.

In nursing school, we are taught basic nutrition. In grad school, we have honed in on specific nutritional needs for newborns through young adults. I could tell you all about different formulas, enteral/parenteral nutrition etc. What we have not been taught enough is how to respect your body’s own nutritional needs: how to love and care for yourself in a way that enables you to care for others. We must take care of ourselves before we can effectively take care of our patients. Nurses and other healthcare workers neglect our bodies the most. This has to change or our patients suffer. You have to eat because your brain needs food. Read that again. Your brain cannot survive without food. If you are thinking about skipping a meal because you don’t like what the scale says, don’t. Your body is your prized possession. You will only be hurting yourself, and ultimately your patients, in the long run. Enjoy your holiday potluck without guilt, it’s the best gift you can give yourself.

Nursing, Work

Night Shift

December 12, 2019January 3, 2020by Anna BSN, RNLeave a Comment

I’ve only ever worked night shift (7p-7a or 11p-7a) and have slowly gotten used to the lifestyle. I also don’t anticipate switching to days before I graduate. The most asked questions I get are “how do you sleep?” and “how do you stay awake?” I have to preface that I only work two 12-hr shifts per week now. I used to work 40 hours, then 28, and now 24. So naturally your routine will be different depending on how many nights you work. However, I never stayed on a night schedule. In other words, I always switched back to being awake during the day when I was off. My best advice for switching is going to bed right after work and waking up in the early afternoon if not back that night. That way, I’m usually still tired at a normal hour at night. In addition, try to cluster your days so you work several nights in a row to reduce having to switch back every few days. Obviously, this isn’t always up to you but try to request it if you can. I’m a pretty sleep-dependent person so I don’t even try staying awake the whole day after work. What probably makes me so tired is that I don’t sleep or nap before my first night on. I’m up early in the morning (sometimes even go to class all day, sadly) and then stay up all night. I can’t say this is safe or smart, but it’s what works best for me. I am then exhausted and could sleep all day. Thanks to my Fitbit, I know I get an average of about six hours of sleep in between shifts (~ 9a-3p).

Is night shift awful? No. I do miss out on a lot, especially working weekend nights. On my floor we are required to work every other weekend. Yet, it is when my friends work and sometimes gives me enough downtime to do schoolwork. There is a shift differential $$ for working nights which helps make it worth it. I also don’t miss class or meetings since I am never scheduled to work during the day. We do have more patients and a lot less resources though. I also can’t say I haven’t started to fall asleep on the way home. It is terrifying and always makes me say a prayer when I get there. The best way to stay awake in the car is to open your windows and call someone! Call your mom, a coworker, friend, or anyone who will talk to you to make sure you’re still awake. It is also nice for venting after a rough night. Loud music and snacking on something can help too.

How to stay awake at night?

Drink a lot throughout your shift. A nice cold drink every few hours, I like ice water with a Pedialyte powder packet, will keep you hydrated and going to the bathroom. 😉 Coffee, pop, or an energy drink can also help but may give you a crash in a few hours. I always start my shift with a large coffee but switch to water/Gatorade later on!
Walk around. I like to walk for the steps and sometimes (rarely) will do all twelve flights of stairs down and back up. Walking almost always leads me to other people on the floor who I can sit and chat with for a bit too.
Brush your teeth. It keeps me feeling fresh and like I just woke up. It also helps me forget that I’ve been awake for over 20 hours.
Do a quick mini workout. Whether it’s five push-ups or ten jumping jacks, do what you can to get your heart racing.
Don’t study too much. When I’m already tired, reading or trying to focus on anything other than work will almost always make me close my eyes. Maybe online shop instead? Jk…😊
Bring snacks. I am notorious for bringing a small breakfast-like meal (usually only oatmeal) to eat around 1-2 am. Working for 12 hours is like a marathon so bring enough fuel to get you to the end. Especially if you might end up working for 16, small protein-packed snacks are essential. Try cheese sticks, protein bars, almonds, or espresso beans.

How to sleep during the day?

Blackout blinds! This was one of my first work purchases and one of the best things I could have done for my sleep schedule. I got mine here and thought they were super easy to set up and use right away. If these blinds don’t work for your bedroom aesthetic or you prefer natural light, get a sleepmask. They are cheap and often work equally as well.
Melatonin and an antihistamine. I use Nature Made Melatonin (5 mg) and Zyrtec 10 mg when I really need to sleep. Some of my friends take up to 15 mg of Melatonin and others take Benadryl. I don’t use them every day, but they work when I do. Fun fact, Zyrtec will make you drowsy, so we give it to our kiddos at night and pilots aren’t allowed to take it for that reason. If it has “day” or “D” after the name then it is non-drowsy and will not have the same effect.
Shower before bed. I can’t imagine a lot of people don’t, but I need to emphasize it. I use the best body wash from Bath and Body Works, “Stress Relief” (sage & cedarwood). They also have a “Sleep” aromatherapy collection with lotions and pillow sprays that I’ve heard work great. The new ones are Lavender Vanilla and Black Chamomile. Treat yourself to a relaxing, smell-good shower after a busy shift.
Minimize noise if possible. I personally don’t like white noise or the sound of a fan but know there are several phone apps that create these sounds. I also keep my phone on Do Not Disturb until I wake up. Give your friends and family a heads up when you are on a stretch, so they don’t flip when you don’t answer their texts or calls all day. I can never get back to sleep if I’m up halfway through looking at my phone, so I try to minimize sleep disturbances at all costs. Unfortunately, this is easier said than done.