EMS week

I don't know how the call came in over their pagers the morning of December 15 or what ran thorough their heads as they neared the school.
I can't begin to imagine how they felt when they encountered all those injured first graders and educators, most of them from their own neighborhoods.

But I do know that they responded.

I know that they responded in Boston, in Texas, in Superstorm Sandy, on Sept 11, and most recently at the Metro North train crash.

They ALWAYS respond.

They are the men and women of our EMS system.

How do you say thank you to those who respond to danger and tragedy while others flee from it?
How do you say thank you to those who awaken in the middle of the night and go out into the cold, the rain, the heat, to serve their neighbors?

I have no adequate answer to this, and they ask no thanks.
But we should say thanks, we must say thanks.
This week is EMS week, it's a good time to stop, reflect, and say thank you to the neighbor you know is part of EMS, to the Cop or Firefighter you see on the street or store, to all of our brave and dedicated neighbors who our angles, always looking out for us.

Happy EMS week, and thank you.

Crappy

C/O   N/V/D
(complains of nausea, vomiting and diarrhea)
Without this chief complaint there would be little need for Emergency Rooms.
The causes are varied.
Bad food, too much eating or drinking, IBS, and the most usual, a stomach bug.
When people start to ask the question, "Is there something going around?", the answer is always the same, "Yes."
There is always something going around.
The biggest problem is that N/V/D can be caused by so many things and occasionally they are serious.
Appendicitis, colitis, obstruction, diverticulitis, etc.
So everyone gets a workup, because to miss something serious would be bad.
So, blood work, urine analysis, IV fluid, nausea medication and sometimes pain meds.

Many times it's hard to come up with a definitive diagnosis.
You, the public, can help.

We will ask a series of questions and your answers will guide us.

The following is not helpful:
"How many times did you vomit?"
"Once."
"Is there any blood in your diarrhea?"
"I don't know, I didn't look."
OK, people, you gotta work with me here.

It's not that I don't care, I really do.
You wanta know what the worst case of N/V/D I ever saw was?
It's when I had it.
I am NOT a good patient, I don't do "sick" well.

So, if you ever have N/V/D, stop on down, we'll take a look and help you feel better and if there is something serious, we'll try and fix it.
Because having N/V/D really makes for a crappy day.

"Just Culture"

There is a saying in carpentry, "measure twice, cut once."
It would apply to nursing as well. That's exactly why there is a "time out" before surgery. Once it's done, it's done.
Human beings are, well, "human."
That's why we have so many protocols and why we try to build safeguards into our systems.

It's also why I believe strongly in developing a "Just Culture" in the workplace.

In a "Just Culture" workplace, human nature is recognized and accepted.  Mistakes happen, and the emphasis isn't on fixing the blame, it's on fixing the problem.

It was noted that in the airline industry, "near misses", or 2 planes coming within 1 mile of each other, were under reported due to the fear of discipline.  However, when discipline was taken out of the equation, reports increased, systems were improved, and the flying became safer.

The same needs to happen in health care.

The ANA supports the development of "Just Culture" in nursing, more information is contained in the link http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/Just-Culture.html

Learning to follow

"I had been sitting under the tree for a long time, talking to God, when I heard God speak to me."  said the commencement speaker.
He was a minister and had gone to help at the rehab center because these men had been beaten down by their disease and had learned to rely on the God of their understanding for their very life.
"God spoke to my heart and told me that I had put my ministry ahead of my mission."

He wept.

He said we all have a ministry, be it as a parent, grandparent, nurse, teacher, clergy, business person or grocery clerk.
More important, we all have a mission.
That mission is the same for all of us.
It is to listen and follow the will of our Higher Power.
Our ministry my be wonderful. We may help many people. But if we impose our will, instead of listening and following the will of God, then we are not fulfilling our mission.

I have many ministries.
Father, grandpa, husband, son, nurse, union president, writer.
When I am not listening, when I am not following, then I am not fulfilling my mission.
If I try to do it my way, if I believe I have the answers, then my ministry has become more important than my mission.
None of us can lead if we are not willing to listen and follow.

A time for everything

To everything there is a season....
So it says in the Book of Ecclesiastes and in the song written by Pete Seeger and made popular by the Byrds.
In many cultures its call finding one's balance or being centered.
I struggle with this.
I tend to go all in when I go, to become consumed.
It's how I got through nursing school.
That's one reason why it's important for me to get away from time to time.
I can't paint the bathroom, mow the lawn, or meet for a grievance when I'm away.
My wife and my executive board are in agreement on this.
"Go", they say, " spend some time with your wife. Relax."
They are more than qualified to watch the shop, that's not the problem. The problem is me.
Anyway, it's good to be in Florida for a few days for my niece's graduation. Good to get away.
I could go on and on about the values of a vacation, but that would kind of defeat the purpose, wouldn't it.
Instead, I think I'll go for breakfast.