Dear Breast Cancer Patient

Dear Breast Cancer Patient,

I have to admit that I feel like the world doesn't have a complete understanding of how bad this disease still can be. Thankfully, because of research and screenings many women can battle this disease and still have a long healthy life, but that isn't the case for everyone.

I was a new grad and I had yet to see a breast cancer diagnosis when I opened the chart, but I can remember you, my first breast cancer patient. You were a young women in your 30's and your disease was everywhere. You were in severe pain from bone mets and my heart broke for you. All you did was stand on your leg to go to the bathroom and it cracked in half because of disease eating away at your bones. It was there in your room as you cried out in pain that I, a new grad nurse, learned a new side of breast cancer, the side that is not often seen, the side that needs to be spoken about.

As I continued my inpatient journey I continued to meet you. Some of you were paralyzed and your life was forever changed due to your mets. Some of you had infection due to tumors. Some of you I met at the end of your battle as you took your last breaths on this earth. You have all impacted me.

Source

At this stage in my career I am walking with you as your chemo nurse. My eyes are opened more than ever to how horrible this disease can be. Breast cancer patient you are that 1 out of 8 women diagnosed with breast cancer. You have the cancer that is most commonly diagnosed in women. You unfortunately have been handed the disease that is the 2nd leading cause of death of women.

I've changed your dressings from your tumor that is bursting through your skin. I've comforted you as your pain is so severe because of the cancer eating away the skin on your chest. I remember that time when I had to send you to get a stat CT because we were afraid you had a pulmonary embolism, but in the end it was the sad news that the cancer had spread to your lungs and there was a large amount of fluid build up.  I'm seeing more sides of your disease every week, and they are ugly.

Source

Breast cancer patient, you amaze me. As you are crying in pain, hating the fact that you have to take oxy to keep your pain at bay, you still smile at me and say to me "my nursey". You sit with me and look at pictures of my niece and nephew and tell me about all the things your beautiful young kids are doing. You are my hero. I learn a whole new side of what love looks like from you and your husband. The look he has in his eyes is one of the deepest of love I have ever seen. The way you and he work as a team and know each other so well is incredible.

Breast cancer patient, don't lose your spunk. Keep wearing your crazy hats, keep rocking that G.I. Jane look, and don't you ever lose your ability to look at the bright side.  But know this, it is perfectly ok to have bad days. It is perfectly ok to be in a funk.  It is more than fine if you need to cry your eyes out during each chemo treatment. Know this, that through every good news I will rejoice with you, through every bad news I will cry with you, and throughout the days of my life, I will fight this battle alongside you and fight for a cure for this disease. Thank you for blessing my life breast cancer patient. Thank YOU for fighting with grace and passion. Thank you for being you.

Be brave. Be bold. Be beautiful.

With a grateful heart,

One of your nurses

Informational Resources:

1. Basic Facts of Breast Cancer

2. Cancer.org Facts and Figures

3.  Breast Cancer Symptoms

4. Breast Cancer Genetics

Little Warriors-Pediatric Cancer Awareness

Source

My goal as nurse has always included pediatric oncology. While I have not worked with anyone younger than 18 with cancer, pediatric cancer is still a strong passion of mine. September marks the time for pediatric cancer awareness. This week I'm so excited to focus on educating each of you about pediatric cancer. There are many ways to support research for pediatric cancer and support those children and their families who are walking through this battle.  Below is a video that outlines the basics of pediatric cancer facts and figures currently.

Very little progress has been made in research and proper treatment.  Statistics don't tell the whole story.  We have such a long way to go and I'm hoping through the blogs this week, each of you will be made more aware of how deep the need is in the pediatric cancer world.  Cancer is the leading disease cause of death in children ages 1-14.

Alex's Lemonade Stand is one of the ways you can start to make a difference.  Continue to read the blogs this week and videos posted to educate yourselves.

Let's fight for our little warriors together!

Dear Ovarian Cancer Patient

Dear Ovarian Cancer Patient,

It was with you that I got to start my nursing career.  It was your cancer that I first got to know at an in depth  view. I was there with you has you came back from your TAH/BSO and whatever else they felt needed to be done. As you rolled up to the floor from the PACU in so much pain I was immediately running to get pain meds.  I was there with you as you could barely keep your eyes open from the pain medication but you were also anxiously waiting to see what the doctors found in your abdomen.  I was there with you holding your hand as the doctors told you it was cancer.  I was there holding your hand as we rejoiced over the news it hadn't spread.  I was also there holding your hand as you were told it had spread farther than they had thought.  I was the one annoyingly asking you to sit on the side of your bed when the thought of even lifting your hand was terrifying. Because a nursing manager took a chance on me as a new grad, I was there in your world... walking with you... and learning about how hard a diagnosis of ovarian cancer is.

 Source

At a very young age cancer was part of my vocabulary.  Before I was even born my paternal grandma battled ovarian cancer and lost. It is such a rare diagnosis, and is so hard to detect.

I've been a few places since that first job.  But I still walk with you.  Now my job is to walk with you day in and day out as you deal with chemo.  As you get your scans back.  I'm still there holding your hand through good news and bad news. And I'm so thankful for the opportunity to walk with you through your battle.  Thank you, ovarian cancer patient, for letting me walk with you. To learn so much about love, drive, and fight through your own battle. To learn what it means to have grace. To learn what it means to be hopeful in the hardest of situations.

It is for you I am writing this blog.  To get the word out there about ovarian cancer.  Together, let's fight this thing!

With greatest gratitude,

One of your nurses

Quick Facts and Figures:

* 1 in 72 Women will be diagnosed with ovarian cancer in her life (ovariancancer.org)
* It is the 5th leading cause of cancer deaths in women (ovariancancer.og)
* Most women are diagnosed in late stage which has a lower survival rate

More Information about Ovarian Cancer:

Test and Diagnosis outline

CA 125's Potential for Earlier Detection

Potential signs and symptoms of ovarian cancer

Facts and Figures of Ovarian Cancer

Ovarian Cancer Statistics

A Note to the New Grad Nurse Part 2-Things we wish we knew as new grads

I can still remember the day I got my acceptance letter almost 4 years ago like it was yesterday.  It was a crisp fall day when that letter arrived in my mailbox. While in many ways it feels like just yesterday, in reality it was almost 4 years ago.  Since then I've finished my masters, gone through an accelerated nursing program, and now have 2 years of nursing under my belt.  Every day I am still learning a ton, but there a few things my now "experienced" nursing friends and I wish we had known when we first put on those scrubs and proudly put on that badge saying boldly and loudly "RN".

27 Things We Wished We Knew as New Grad Nurses

1. If you feel like you are going to puke before every shift or drive to work in tears... don't worry you aren't alone. Same thing if this is what happens after your shifts. You are most definitely NOT alone.

2. Don't accept just any job.  While it is hard as a new grad to find experience, you will be spending  A LOT of time there it is ok to wait for the right fit.

3. On that same note though, your dream job may take time, but a good fit is a GREAT place to learn.

4.  Confidence in yourself. It takes TIME. And that is ok.

5.  Sometimes SBAR isn't all you need to tell the MD, PA, or NP.

6.  Those silly code runs that are fake and make you feel ridiculous. They actually are REALLY helpful!

7.  The field of nursing is wide and broad. Don't limit yourself to just bedside nursing if it isn't your passion, that is ok.

8.  You DON'T HAVE TO KNOW EVERYTHING. It is ok to say "I don't know" and learn for next time.

9.  Asking questions doesn't make you a bad nurse or make you stupid, it makes you SMART. That is the absolute best way to learn.

10.  Every place has its own "Policies and Procedures".  Realize that how you learned something in nursing school may change during your first job... and your second... and your third... and so on.

11. You aren't going to like every patient you take care of and that is OK. You just have to give every patient the best quality care you can.

12.  Driving home from work... crawling into bed after a long night shift you're going to realize "OH MY GOODNESS I DIDN'T CHART THAT 300 mL OF URINE!". You aren't perfect. If it is something that needs attention you can call in to the nurse who followed you, but if it is something that can be let go... let it go. Learn from your mistakes of not charting in the moment and figure out a system of remembering that works for you.

13.  You have to come up with your own system of writing things down, charting, doing assessments, and managing your shift. It is perfectly ok if it isn't like anyone else's as long as it works for you and you can get everything done.

14. The first few shifts on your own you're going to feel like a truck hit you and you're never going to make it. But you will.

15.  Don't be afraid to go in the bathroom, sit on the toilet, and take some deep breaths.  In the end every nurse has taken extra time in the bathroom just to catch their breath for a minute.

16.  When possible.... waste the medications that needed wasted right then and there.  That is just something you don't want to even chance forgetting.

17.  You are your patients's ADVOCATE. Don't be afraid to stand up for them.  And if you're wrong... oh well... at least you can leave knowing you fought for your patient.

18.  Keep your social life.

19.  Try as best as possible to lead a healthy lifestyle outside of work.  13 hour shifts are brutal.

20.  If you're in MedSurg... we feel your pain. But know this. YOU ARE GOING TO LEARN A TON!

21.  There is a person beneath that rude and frustrating patient.  Do the best you can to find that person and care for their soul too.

22.  Find hobbies outside of work that help you unwind.

23.  This is a 24 HOUR institution if you are in a hospital.  Leave the patients with the other nurses. They are trustworthy and capable :-).

24.  Don't be afraid to stand up for yourself.  You went to school for this. You've done your training. You've come this far. You don't need to be walked all over.

25.  As you learn your area of specialty things will really start to fall into place. You'll understand things better and you'll be able to tell earlier and earlier when something is wrong in a patient.  Never underestimate the little things. They can in the end be warning signs for something much much bigger.

26.  You are only one person. Do not be afraid to ask for help! And one of the best things you can learn how to do is delegate appropriately... but don't forget to double check that things that have been delegated are done.

27.  When you're tired, warn out, smelly, dehydrated, not sure what is on your shoes, and squinting at the sun light as if you were a vampire know this. YOU ARE GOING TO MAKE IT! You are an incredibly intelligent person who has fought hard to get this far in your dream.  Keep running after it with your whole heart!  And don't be afraid to try a few different areas until you find your passion (but make sure you give each area an ample amount of time before moving on).

We hope this helps,

Some slightly more experienced nurses

P.S. It is true the more you know... the more you realize you don't know anything :-).

Just because you are a nurse...

Today's post is dedicated to the nursing crew today!  Although this post is applicable for anyone.  I have had a few nursing friends that were specifically asking me about hair styles that they could try to shake it up when they are working.  They were tired of the same old drab ponytail.

Usually when you are working, you typically want your hair to stay out of your face.  It needs to be low maintenance and easy to do or else you aren't going to want to do it.  It needs to be pulled back and last for hours at a time.  Typical shifts for my nursing friends could be anywhere from 8 to 12 hour stints with limited breaks.  Clearly, the last thing they need to worry about or should be worrying about is their hair.

1. Ponytail with hair wrap
This is so very simple.  Pull your hair into a ponytail.  It is your preference of whether you want this to be a low ponytail or if you want it up a little higher.  I would recommend using a thicker elastic band even if your hair is fine and thin it will make a huge difference in stability.

Then take a section of hair (as seen below) and you will wrap it around the elastic band as a covering around it.  When you get to about an inch or so of hair left reach under and tuck the end of the hair through securing it.  You will still have a little bit of hair left, you can tuck it in the lower part of the ponytail where it magically disappears.

https://www.youtube.com/watch?v=yzqpfjEeWf4

2. Braids
French braids are great for keeping your hair back and out of your face.  There are many variations to which all ages can wear.  You can secure your hair in a ponytail first, then braid the remainder of the hair.  Secure with a secondary elastic band.

Another variation which is really fun is creating a braid across the front of your hairline as seen below.  If you need your hair more so away from your face, pulling it into a low ponytail is always a good option.

http://123hipitup.blogspot.com/2009/02/braid-wars.html

Or you could always do two french braids:

http://123hipitup.blogspot.com/2009/02/braid-wars.html

3. Buns

Here is a bun with the front braid idea:

http://www.fashiondivadesign.com/17-hair-bun-models-ideas/

Now, you can also wear a stylish traditional bun.  If you are worried about having enough hair to do this style that is no problem.  There is also a lot of variety seen with wearing buns.  You can wear a high bun, low bun, messy bun...the possibilities are truly endless.  

If you have long hair, you can buy this beautiful little tool called a hair donut.  Here is how it works!  This is so easy to use and makes your bun look flawless every time.

http://www.6footlonghair.com/2011/02/satin-donut-bun.html

4. Shorter Hair
If your hair is not long enough to try any of the above, sometimes it is just easier to invest in some cute headbands.  I have found some that don't squeeze my head and are very chic.  They hold my bangs back without fail and allow me a little bit of flair. 

All in all, there are ways to look and feel good at work without spending a ton of time on it.  A little effort goes a long way!  These are just a few suggestions but you know it could be infinity and beyond...

Beauty knows no limits....

Catie Manning

A Note for New Grad Nurses

I recently ran into a girl who I cheered with in high school.  There is a bond between athletes from any sport that never seems to fade.  It is a pretty incredible thing of what working together as a team can do to bond people together.  As we were catching up, there was another bond that was found. She is a brand new nurse.  She is exactly where I was 2 years ago. No matter what area of nursing or what path you have taken, the letters RN will bring you into an incredible community of people who you will forever have a bond with.

Since 2 years ago I've come a long way.  Recently there was a blog that went viral Not Just a Nurse. I encouraged this new grad RN to read this. I can't tell you how many times "I'm just a nurse" has come out of my mouth. There is such a vulnerable truth that is spoken in this nurse's blog. A truth that needs to be heard.  But it also brings up another truth about being a nurse, it is incredibly hard to be healthy in most nursing jobs.

I started my career 2 years ago as a nurse at the bedside.  I had spent the last 7 years in school. And the summer before working at a teen weight loss camp.  Here I was in my first full time big girl job. Little studying to do, but a ton to learn on the job. I had a brand new schedule that for the first time in my life had no sort of consistency. And I came home from work at least 13 hours after I had left for it. While at work I was constantly stressed and terrified of making a mistake.

Being a new grad nurse was probably one of the absolute HARDEST things I have ever done in my life. All day long my brain was going and my body was moving. You are constantly worried about what you could do to lose your license or worse, lose a life. You have to learn how to best communicate with different types of MDs, PAs, and NPs. You have to learn how to delegate to the nursing assistants and how to keep track of their work along with yours. Your brain doesn't stop going.

On the outside of work it is hard to get patients off your mind. You wonder if you wasted all the medications you needed to. You wonder how you can manage time better. How are you ever going to be fast enough to get all your things done AND all your charting done?

Nursing takes a HUGE emotional  and physical toll on your body. You're going to struggle to figure out how to stay healthy during your shifts and days off. Here are a few tips.

1. Remember to stay hydrated. You have a very physically active job. Your body needs water not just caffeinated beverages.
2. If writing helps, journal. You have a lot going on in your heart and head after each shift.
3. Make your meals ahead of time. Before a long stretch of shifts make your food so you aren't tempted to eat just fried food.
4. Keep a healthy snack in your pocket.
5. Remember you CAN'T do it all.
6. Listen to your body and how much sleep it needs.
7. Find ways for you to unwind when you get home
8. Don't forget to be social
9. Exercise on your days off
10. Develop a support system both inside and outside of work. Do not be afraid after a long shift to call that nursing friend and vent for as long as you need.
11. Don't bee too hard on yourself

You are entering into one of the most amazing careers. You will struggle. You will doubt. You will look at your fellow nurses and ask "why did we choose this?" My dear friend, you are going to see things you never thought possible. You are going to do things that most people would never be able to handle. You were created to do a very unique and incredible job. It is perfectly ok to feel overwhelmed.

But there will be moments when the patient breaks down in tears and you are there holding their hand. When the family member hugs you after their loved one has passed and says "I'm so glad you were their nurse". When the new baby is born and you get to help see that beautiful life come into the world. When the patient goes into remission and you are the one rejoicing with that patient as if you were in remission. When the patient hears they are getting the organ they've been waiting for.  You are there to walk through the valleys and mountains with these patients and their families. When it gets tough, remember the reasons why you chose nursing.

That RN is an incredible gift that means more than you could ever imagine. My dear new grad nurse, its your time to shine! Take it one step at a time. You. can. do. this!

Working Out Barefoot

I still remember standing in my boss's office at Rutgers as she explained barefoot workouts to me. This is before Vibrams were popular or it was all over fitness news about people running around barefoot. Her interest in barefoot workouts started from the class WillPower & Grace. It was here my interest was sparked and I was hooked on this barefoot concept. I began my research and as a science brain I really liked what I saw!

For the general public, working out barefoot can be a great addition! However, if you have had foot problems in the past make sure to consult a podiatrist on whether or not it is a good idea for you (1).

Source

Shoes have not always been around, and it is this idea that appears to be at the core of working out barefoot. Without even researching I thought about it, so why do we wear shoes? In the medical world we wear shoes to protect us from a lot of things, including needles and random flying bodily fluids. On the street we wear them to protect ourselves from the many random objects lying around. While running we wear them to support our feet. But why do we insist on wearing shoes all the time? In one foot alone there are 26 bones (or one quarter of all the bones in the body in both feet), 33 joints, and over 100 muscles, tendons, and ligaments (2). So as a personal trainer who is BIG on training all the muscles, especially the small forgotten about muscles why was I NOT focusing on training all those muscles in the feet?

That was a good question I started to ask myself. So after some research and making sure it was safe for me to try working out barefoot because of an abnormality in my back, off I went to try barefoot training. You want to know what I found out? I LOVED it and still do to this day!

What are the benefits I have found from it? As I strengthened my feet outside of my 13 hour shifts in my workouts, not only did I have the support up my supportive shoes as I walk 6+ miles per shift, but I also have the support of all those strengthened muscles in my feet. Barefoot workouts is something I highly recommend for anyone who is in a job that demands them to be on their feet for long hours! I have found that my back that has always hurt, hurts less because of the support that is provided by my feet now that I have strengthened the muscles in my feet. I also love the feeling of working out without shoes or with my Vibrams. It is so nice to not feel completely constricted!

It is recommended that when you can, take off your shoes to continue to strengthen those muscles. If your feet are in poorly fitted shoes for too long, it may even weaken your arch (3). The best way to strengthen your foot is to take away the support and allow it to strengthen from within (4)!

Some suggestions I have for if you are thinking about going barefoot:

1. Make sure it is safe for you as an individual.
2. Do it with your safety in mind. Don't go running outside without shoes in a place where there could be sharp objects.
3. Start slowly. Don't just jump right into an hour workout without shoes, start with 10 minutes and continue to work your way up.
4. Stretch out your toes and feet and do exercises that focus on strengthening your feet. Here are some examples of Feet Exercises. As your feet get stronger don't be afraid to do things like jumping squats, burpees, and mountain climbers barefoot! Also, look at your local gym for barefoot classes!
5. I recommend getting a pair of barefoot shoes such as the Vibrams so that as you advance in your barefoot training, you are not limited to places where your feet will not run into sharp objects.
6. If you're lifting heavy weights, please where shoes. We don't want any of those many bones broken!

Erica, The Mastermind

Sources:

1. http://healthyliving.azcentral.com/working-out-barefoot-anything-2371.html
2. http://www.healthcommunities.com/foot-anatomy/foot-anatomy-overview.shtml
3. http://www.dailymail.co.uk/health/article-2005272/The-barefoot-gym-workout-cures-arch-enemy--flat-feet.html
4. http://www.livestrong.com/article/477630-can-strengthening-foot-muscles-change-the-arch-of-the-foot/