Workplace violence and bulling in nursing

Workplace violence and bullying is sometimes not clear to identify and at the same time this type of harassment happens frequently. Usually the victim happens to be new hires and the perpetrator is someone who has been doing this harm occasionally and has never been caught and reported. What is even possible is that the perpetrator does not realize it is harsh comments, gossip, a piece of information made up and not true, and this behavior is called UNCONSIOUS BIAS.

Unconsious bias is PREJUDICE which means a preconceived opinion that is not based on reason or actual experience (definition from Oxford languaged).

Workplace violence is not tolerated in big retail stores the same thing inside hospitals or healthcare facilities. All new hires and  all employees must go through mandatory training courses and must report this type of violent behavior to the open doors, and the theme for that is called "If you see something say something.

What are some of the situations that are considered violent?

"Intimidating or undermining employee by demeaning their work standards, not giving them credit, setting them up for failure and constantly reminding them of old mistakes" 

"Threatening employee personal self-steem and work status. Isolating employees from opportunities, information, and interaction with others" . Source: Google Search "What are the bully tactics at work?'

"Examples of bullying in the workplace:

Constantly criticising someone's work

Spreading malicious rumors about someone

Constantly putting someone down in meetings

Excluding someone from team-workload then everyone else  

Deliberately giving a heavier workload than everyone else

Excluding someone from team social events" Source: Google search

Gossip is related tp parrots, if has been dreams with those birds it is a sign someone might be gossiping about you. Look up spiritual meaning of dream with parrots. 

The best is to address with the perpetrator if he or she keeps saying these malicious comments he or she will be reported. 

Finally, I'm going to end this post by quoting some wise quotes by Florence Shinn:

"There is a supply for every demand".

"There is a place that you are to fill and no one else can fill, something you are to do which no one else can do". 

"The first start toward success is to be glad you are yourself"

"Every person is a golden link in the chain of my good"

"Gratitude is the law of increase and complaint is the law of decrease"

"What is really yours? The blessings you bring to yourself through your spoken or silent words, the things you see with your inner eye".

Forgive it, realiase it, and  move on, if that looks like a not very  welcoming enviornment, let it go. Something greater and much better is been prepared. 

What is malignant hyperthermia?

 Malignant hyperthermia is an emergency that needs to be recognized during the assessment and notifying the doctor and/or immediately stop surgery also stop the anesthesics agents and start treatment with Dantrolene 2.5mg/kg  

What are the signs and symptoms? The earlier symptom is a sudden increase of the CO2,  jaw rigidity, rise in skin temperature and rise in the core body temperature, acidosis (when arterial blood pH is lower than 7.35 nEq/L), increase in heart rate, cyanotic skin, mottled skin, intense diaphoresis.

How does Malignant Hyperthermia happen? It is an inherited muscle disturbance that unfolds a hypermetabolic cascade when the patient is exposed to triggering substances in certain inhalation anesthesic and depolarizing muscle sbstances or breaking down muscles, (aka rhabdomyolysis).so the combination of muscle rigidity, acidosis, and hyperthermia causes cell death. Muscle rigidity is caused by the calcium that escapes from the skeletal muscle cells, ATPase starts off metabolic activities, use up all available  O2. From these activities can occur internal bleeding, cardiac arrest, failure of vital organs such as the kidneys. Pre-operative assessment is important questioning the history of sudden death during surgery of a relative, is important to know the history of high temperature and dark urine(coca-cola color) after anesthesia procedures, including dental anesthesia. (this does not rule out a present crisis of malignant hyperthermia. There are tests available called caffeine halothane it's a contracture test, the classic signs and symptoms followed by exposure to the triggering anesthesic agents are the important clues.  While using Dandtolene avoid calcium channel blockers. Max titration dosage of Dantrolene is 10mg/kg.  Sodium bicarbonate is also used to treat acidosis. Another important plan of care is to monitor urine output, both color and volume.

#malignanthyperthermia #rhabdomyolysis  #anesthesiology #criticalcare  #Hyperkalemia

Sources: Wikipedia and HealthStream

What does it look like shadowing the nurse?

 Often times when applying for a job as a nurse it usually starts with shadowing the nurse during her/his day.

Shadowing means following the nurse being her shadow for 2 to 4 hours, or even for 12 hours just watching everything with no interference, no hands-on, just observe, unless he/she asks for help, please help, it feels amazing. All paperwork, kardexes, or notes you wrote down regarding the Pacient of his or her care must be thrown away at the end of the day in a proper place that's designed to shred into tiny pieces - the papers with sensitive information,  information like name, date of birth, lab results, and diagnostics. All information that is confidential, regarding HIPAA rules.

What is HIPAA? HIPPA means Health Insurance Portability and Accountability Act it is a law enacted in 1996 that protects the client's privacy, it's a law regarding healthcare, health plans, healthcare insurance, electronic signatures, electronic transactions, the client's health information, so HIPAA ensures the privacy of individual information.

Do you get paid for shadowing the nurse?  Sometimes yes, sometimes no. It is all very worth it, it's a lot of new information you will have the chance to learn, so it is always a very positive experience!

To get ready for the shadowing day, wake up a little earlier have breakfast first, and take your phone and a small thin wallet with you in your pocket, I recommend that because you're always ready to go anywhere including going on luch and buying your lunch at the cafeteria, the locker rooms are usually locked and it needs someone to open it for you to access your bags, having your items with you saves you time if you have only your essential belongings with you.

Good luck on your first day shadowing the nurse.