When the Shift Hits the Fan.

It is inevitable. It will happen to you.

No matter if you are a new graduate or veteran nurse, there will be that shift that will almost break you. Staffing is short. Your patient is crashing. Maybe it’s downtime to boot. The stress is overwhelming. You are heading to the med room to cry.

I have been there and shed those ugly tears. You feel like you’re drowning, and there is never enough help. I wanted to write a quick post with some advice about stress-management strategies that have helped me cope during those really hard moments when the shift is really hitting the fan.

Remember - You can’t do it all.

That moment when you start to feel like you need to clone yourself 10 times, stop and remember that you cannot do it all. THAT IS OK. You are a single human with a maximum capacity to take on tasks. Luckily, nursing is a team sport. Reach out to others and throw up the S.O.S. signal. Get some help. This is not a sign of weakness. This does not mean that you are not a good nurse. You are recognizing your limitations in the moment and putting patient safety first. It is appropriate to ask for assistance. If you try to do it all alone, you are putting yourself and your patients at risk. Don’t do it. That is never OK.

Take a deep breath. Try counting to 100 by threes.

Victor Lipman wrote for Psychology Today – “Get your body in hand first, and the mind will have a better chance to follow.” By using distraction techniques (like breathing and counting), you start to take control of yourself physically. This will help slow down your racing heart, help you avoid hyperventilation and allow you to think clearly. Nursing is a high-stress job. We are asked to do an impossible number of tasks (see the previous section) as fast as possible with less and less support. And not to mention, we are responsible for human lives. It’s normal for you to physically respond to that kind of stress. To succeed in a time of crisis, you will need to calm the body as well as the mind.

Triage. It is time to triage.

I am 100% an ER RN, so I am going to preach the importance of triaging your situation. It is time to get organized. You need to sort out what are the tasks that need your immediate attention, what you can delegate out to others, and what can go on the back burner. We already established that you cannot do it all. By triaging the urgency of your duties, you will complete the super STAT things quickly and figure out a way to get the other things finished without losing your mind. There is the possibility that you might not get it all done. And that is also OK. If all your patients are alive, your documentation is done, and no one is yelling at you, then all that extra stuff probably was not as necessary as you thought.

Don’t buy into the crazy.

When it’s busy, everyone gets stressed out. Emotions will be running high and sometimes, logic starts to fly out the window. It is SO important to not start down the road to Senselessville. Medicine has standards of care. Hospitals have policies and procedures. There is always structure to be found, even when it seems like the walls are crumbling around you. Let those rules guide you in the times of chaos. It can be very comforting (not to mention extremely helpful) to tap into those policies and procedures when the shift is blowing up. If you’re not sure if what is happening is kosher, take a minute and check the rules. You may be surprised at what you find.

Thank your coworkers.

Gratitude works magic. If you had someone come help you in a pinch, find them later and give them a “thanks” and a high-five. Nurses and other healthcare workers do not appreciate each other enough. We do some amazing work in ridiculous conditions. Find a minute to tell your colleagues that they did a good job. I find that appreciated coworkers are more apt to help in the future. 

Take time to decompress.

This is for after the shift-show has calmed down. You need to take some time to process. Whether it is in the car on the way home, in the shower after your shift or during a run the next day, find some quiet and let yourself go through the stress of the day. When we carry around too much stress, it can manifest as physical symptoms. By allowing yourself to work through the bedlam of your nurse life, you will find better balance in your personal life.

Have a great shift!

Sarah @ New Thing Nurse

About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



March - A Blue Month for Colorectal Cancer

Most people think of green, four-leaf clovers and leprechauns when they think of March.  

But since November 2017, March only makes me think of blue.

March is National Colorectal Cancer Awareness Month, represented by the color blue. Colon cancer became a very personal topic for me in November of last year when my mom was found to have a cancerous tumor in her colon at age 57.

My mom, Debra, is an awesome human.

She is a vibrant, funny, ass-kicking lady. She has always been her own boss. Mom owned her own store for nearly 30 years, then decided to open her own wholesale business so that she and my stepdad could live life on their own terms. Debra is amazingly cool, if you haven’t drawn that conclusion on your own yet.

As a patient, it was hard for my mom. She likes to be in control and suddenly, she was not. But Mom could control how she approached cancer, so she did it with an amazing sense of humor.

I give you her social media post soon after her colon cancer diagnosis –

Mom: “I look forward to my phone's predictive text suggesting ‘colorful’ rather than ‘colorectal’. #EffCancer

Mom also started a line of buttons from her business The Word Emporium to sell to people who want to tell the world how they really feel about cancer.

My mom was also incredibly lucky.

She had an amazing GI surgeon who did a partial colectomy that not only removed ALL of the cancer, but also left mom without the need for a colostomy. Mom also did not need radiation or chemo. She is scheduled for annual imaging and bloodwork screenings to ensure early notification if the cancer does come back. My mom is happy and healthy. I could not be more grateful.

Sadly, colorectal cancer is on the rise.

By going through this experience with her, I learned a lot about colorectal cancer that was extremely disheartening, especially as it relates to patients under 50 years of age. Here are some fast facts provided by the incredible Colorectal Cancer Alliance -

  • Young-onset colorectal cancer is on the rise in the United States.
  • 10% of new colorectal cancer patients are under 50 years old.
  • Young-onset patients are often misdiagnosed due to vague symptoms and assumptions that young patients are not at high-risk for colorectal cancer.

Then in December of last year, I became acutely aware of just how young patients dealing with colon cancer can be.

While helping my mom recover from her own colon surgery, I learned about the achingly early passing of a high school classmate, Christopher Roberts, from colon cancer.

In high school, Christopher and I were in several honors classes and band together. He was one of those rare adolescent male specimens who was an extremely nice guy that also played on the football team and had incredible intellect in the classroom. We lost touch after graduation, but learning of his death made my heart hurt. It would make anyone’s heart hurt.

Christopher was only 31.

It was only after his death that I found out that Christopher had been battling colon cancer very publicly. He was interviewed for the Colon Club blog and in the New York Times. Christopher candidly shared his story and helped reach many young people who might otherwise not be aware of the risks of colorectal cancer.

I cannot thank him enough.

Christopher continues to help educate the public. He taught me. Read about him here so that he can teach you.

The New York Times - Colon and Rectal Cancers Rising in Young People

The Colon Club - Christopher Roberts

Let’s think of blue this March.

I write this for my mom, Christopher and all the others out there battling colorectal cancer.

Consider making a donation to the Colorectal Cancer Alliance. This organization works to support the needs of patients, caregivers, and survivors, raise awareness of preventative screening, and fund critical research.

You can donate in tribute of those who have lost the fight with colorectal cancer. Last year I donated in the memory of Christopher Roberts. I will again this month. Want to join me?

-       Sarah @ New Thing Nurse

More resources about colorectal cancer -

The Colorectal Cancer Alliance

CDC - Colorectal Cancer Awareness

Fightcolorectalcancer.org


About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



FOLLOW US ON INSTAGRAM - @NEWTHINGNURSE

Nurse Hearts - Big, Strong & Never Alone

<3 February is Heart Month <3

I just wanted to write a quick note about the most incredible heart out there - the heart of a nurse.

Nurse hearts are big.

Nurses can work 12+ hours and provide care and support for patients and their families going through the best and worst moments of their lives. Nurses will give and give. Their hearts are a bottomless wells for caring for others.

Nurse hearts are strong.

Nurses see the utter horrors of the world. Death, betrayal, poverty, violence & hatred can come across a nurse's path at any time during a shift. Often it is not the medical issues of the patients that are the hardest thing to see. Usually it is the impossible social situations that they come from that the nurse has to navigate. Nurse hearts see it all and keep going.

Nurse hearts are never alone.   

Where there is one nurse heart, there is always another. We don't travel alone. Nurse hearts will help support each other in their times of need, because nobody knows how hard it is to nurse except another nurse.

This month is coming to an end, but take a moment to appreciate your own nurse heart. It's pretty incredible.

- Sarah @ New Thing Nurse

About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



The Importance of Learning & Self-Care for the Nursey Soul - My Week in Mazatlan, MX with ExpeditionEd

Is there anything better than a week at the beach?

Answer – YES! I am spending a week at the beach with a #newthingnurse & my nurse mentor - Allison Shuttleworth - and the crew of ExpeditionEd - a tropical destination continuing education company for nurses - in beautiful Mazatlan, MX. We have an incredible group of passionate nurses here with us who are learning, networking & taking time for self-care during a week at the beach.

I am here as an instructor with my bestie and nurse gal pal, Sarah Goss (same name = no one forgets what to call the teacher), and we are having a blast teaching in a casual and relaxing atmosphere for a few hours each morning as we all sip our coffee and gaze out at the waves. Our curriculum includes topics such as Pediatric Triage, Cultural Considerations for the Emergent Patient, Peds Mock Codes, Essential Spanish for the ER, How to Tell When a Psych Patient isn’t a Psych Patient, Self-Care for the ER RN and much more. I am learning. I am teaching. I am loving this program.

And if all of this wasn’t enough, our program participants are teaching Sarah and me as much as we are teaching them! These strong and inspiring nurses come from a variety of nursing backgrounds, but have all had ER experience which has brought us close together as only a common nursing unit can. We have almost 100 years of nursing experience between us. Let me tell y’all - the stories have been soooooo good.

The best part of this week, besides our amazing group of new nursey friends, has been all the encouragement of self-care activities. Allison does an amazing job of balancing our class time with play time. Yoga, hula-hooping and tourist-ing are a huge part of the ExpeditionEd’s curriculum. Allison believes in holistically treating the nursey soul to build a strong personal foundation to enhance your nurse practice as well as fostering a stronger sense of self. Allison wants each of us to be happy, balanced and successful as a person and a nurse.

I personally believe that travel, professional development and collaboration with others make each of us a better nurse, colleague, friend, family and community member. By putting yourself in new environments, you expand your personal perspective and ability to understand the world. Without discomfort, there is no growth.

This week ExpeditionEd and New Thing Nurse have both grown along with our fantastic group of new nurse friends.

- Sarah @ New Thing Nurse

        You can follow Allison, husband Dave & pup Chacho on their sailing adventures -         

Instagram - @sailepifania

Want to learn more about ExpeditionEd?

Check out their website - www.expedition-ed.com



My Holiday Wish List - Clean Hands, IV Normal Saline & Full Staffing for All.

Christmas is almost here!

Everyone keeps asking me what I want under my tree. My list is going to challenge Santa because there are some supply issues this year, but I'm hoping that he can place all these items under my hospital tree & all the other nurses who made his "Nice List" this season - 

Please make everyone wash their hands with soap & water.

Soap. It's a simple & beautiful idea. Everyone wash your hands with soap & water. Anti-bacterial gel is ok, but there is nothing better than plain, old soap & hot water. Imagine a world of snotty kids, homeless patients & confused elderly patients all with pristine & germ-free hands. I wouldn't be afraid to let people use my pen or touch door knobs. Maybe.

IV Normal Saline

You may or may not know that there is a shortage on IV Normal Saline injection bags. I work in the ER, so we use A LOT of IV NS. It is the miracle fluid. It cures everything from hangovers to the dehydration effects of GI bugs. There are so few interventions that make a universally positive impact on patients. Santa, please bring me some extra 1000 cc NS bags this year.

Full Staffing

Cue Mariah Carey voice - "Alllll I wantttt for Christmasss is full staffffinnnnnnggggg!"

I am lucky enough to work in California where we have state mandated nursing ratios.  These ratios put a max number of patients assigned to each RN based on their patients' acuity or the unit specialty where the RN works. This makes busy days more manageable because you know that there is a limit to how many train wrecks that you may have to take on during a shift. But California is the exception & not the norm. I worked in Georgia for several years & know how crazy the holidays can be in the ER with 8 hour wait-times & ambulances flying in faster than you can count. Some shifts I would have a dozen patients, all with active orders & no help because of call-outs... AHHH! Even with patient ratios in California, staffing is often short in other departments during the holidays making everything a challenge. You've never appreciated EVS or lab staff more than when there isn't enough of them & suddenly everything is taking twice as long to get done.

That's why this year for Christmas, I hope that staffing is full for all departments across the land! May your care team be plentiful & your patients kind.

Now - A GIANT SHOUT OUT TO EVERYONE WORKING THIS HOLIDAY!!!

THANK YOU to everyone working, on-call, who just got off or if you're getting ready to go in! You guys are the heroes that make it possible for the healthcare machine to keep going during the holidays & enable so many to be home with their families. You guys & gals are incredible & deserve all the love <3

Lastly, I want to thank all the readers & #newthingnursetribe members who have started reading this little blog. I know that there are millions of medical bloggers out there & knowing that you are taking the time to read over my musings means so much this holiday & every day.

Wishing all of you & yours a very merry Christmas!

- Sarah @ New Thing Nurse



Nurse Gratitude.

The holidays can be rough.

The hospitals are full with patients who need care, & the staffing is short because of co-workers who are not there....

This holiday season is unusual for me. I am currently with family due to illness, so enjoying doing some private duty nursing & family support this holiday season. But traditionally, this is the time of year when I like to look around the ridiculously full hospital (while I'm doing a million things, haven't had a break & may or may not have peed in the last 11 hours) & focus on all the awesome reasons why I have #nursegratitude.

What is "nurse gratitude"? Great question! Nurse gratitude is the thankful feeling that I get for all things nursing. This can be for simple things like coffee & gloves (essential for each & every shift). Or it can be for things like social workers & child life specialists who make terrible situations more manageable with their wizard-like skills (I LOVE ALL YOU SOCIAL WORKERS & CHILD LIFE FOLKS).  Today, I just wanted to focus on the general aspects of nursing that make me so full of nurse gratitude.

Here is the Top 5 on my Nurse Gratitude List  -

1. Flexibility.

This job has allowed me to travel the world, be available for my family in times of crisis, take classes & start a new business. I have worked full-time, part-time & PRN. As an ER nurse, I have worked ALLLLLL the shifts which has freed me up for many educational, personal & professional opportunities. My colleagues have been able to be daytime parents & nighttime workers, full-time students, fulfilling passion projects & a few have been seasonal athletes while still being fully employed three days a week. There are few jobs with greater flexibility than nursing. Cheers to Saturday on a Tuesday.

2. We have the best stories.

When at a party, dinner out or just a gathering of folks, nurses will always have the best stories. I hate the question, "What is the craziest thing you have ever seen?". Normal folks aren't ready for the real crazy. I usually give them a watered-down rectal foreign body story that gets a lot of giggles & then we move on. What I love is hearing that someone else is in the healthcare field & then getting to compare war stories. Healthcare workers, but nurses especially, have the best, most incredibly, "you can't make this sh*t up" stories. They are best not for general consumption, but get a few jaded nurse hearts together with a glass of whiskey or wine & the night will not disappoint.

3. Nurses are the best people.

I cannot stress enough how generally amazing the people are who are drawn to nursing. I don't know why, but they are the most passionate, hard-working & funny individuals. Almost all my friends are nurses for exactly this reason. Nurses love to help. They are driven by a crazy passion to get sh*t done. No one is better suited for a high-stress, multitasking needed situation. That's why so many are balancing kids, school & a side-hustle. And nurses are HILARIOUS. Nurses can literally be facing some of the saddest & hardest situations that life can offer, but they can make light of it all. I love me some nurses. 

4. Variety.

Have you ever seen such a variety of roles that nursing has to offer? When I meet clients who are burnt crispy & telling me that they are thinking of switching careers, I almost yell - "WHY?". There is an almost endless amount of manifestations of nursing out there. Just when I think that I've heard them all, I learn about something new. Did you know that you can be a camp nurse? Or a toxicology nurse? Or a nurse podcaster? Or an organ donation nurse? Or a nurse historian? YES!!! These are all real jobs. The list goes on & on, but I encourage you to think about your passions & do some research. There is probably an amazing fit (or at least some swag) for even your nursing & knitting interests.

5. We get to help.

We get to help people. Our patients are often in their most vulnerable time of need, as are their family, friends & other loved ones. We get to help our colleagues & communities by donating to fundraisers or working at the medic booth at the health fair. We go home & help our own relatives by taking all their calls related to - "I have this spot on my back....". Our kids & their friends come to us to help with the owies. My neighbor comes by to check in after his hip operation with questions. Nurses are helpers. I live for the helping.

This holiday season you do have the option of just dwelling on how there were three sick calls, two Code 3's in the last five minutes & a laboring mother in the waiting room (where's the partridge in the pear tree?). But why? All that would do is stress me out & make my shift that much worse. Let's choose to BUMP THAT NOISE & instead find some positivity by remembering all the reasons that we can have #nursegratitude this year.

- Sarah @ New Thing Nurse