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Nurse on the Run

Share Your Nurses Week Celebration Story & Enter to Win!
April 14, 2014 9:46 AM by Linda Jones
Posted on behalf of Dansko

Shift after shift, week after week, we know you work hard and we want to recognize you! Tell us why you celebrate Nurses Week. Share your story for a chance to win a Dansko Appreciation event - shoes and lunch for you and your nursing team! (See rules and regulations on the Dansko site.)

Deadline is April 28; winners will be announced April 30.

Click here to enter.


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Nursing as a Team Sport
April 10, 2014 9:59 AM by Lorettajo Kapinos

I often find myself witnessing different specialties of nursing tear each other apart. The ED nurse curses the home care nurse or the long term care nurse for not recongizing a problem before it became an emergency. Inpatient, ICU and OR nurses grit their teeth in frustration because the ED nurse isn't able to provide details about the patient's history or related health issues. Finally, home care nurses and long term care nurses pull their hair out in frustration at the lack of education a patient receives while in the hospital.

This is not a new phenomenon, but has made me crazy since the day I started nursing school. It's like each group refuses to see care from any perspective other than their own.

I believe nursing works best when it's viewed as a team sport.

Each specialty can be a player, with their own skills, strengths and assets. At every stage of care, something different is spotlighted making an entire patient experience whole.

One wouldn't expect a pitcher to do the job of a catcher with every play, right? A pitcher can catch and often does, just like a catcher can throw but doesn't pitch. Both players have the same basic skills, but once specialized it wouldn't make sense for them to be expected to do it all. That's why there's a team. Teams work together to play the game the way it was designed.

So, why do we as nurses not see our team in the same way? We all have roles that matter during the course of the patient's stay. Nursing can be and should be a team sport. Maybe then we can all get along.

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The Path of Least Resistance
March 27, 2014 9:38 AM by Lorettajo Kapinos

I believe everyone wants to do a good job. Maybe I'm a fool, but I can't imagine ever saying, "Today, I am going to do something terribly wrong, on purpose."  Usually there's a reason people diverge off the path. Maybe they need something they aren't getting. Maybe they are seeking to hide something. Maybe they are desperate or frustrated or overwhelmed.

But most often, I think people stray from doing the right thing, because it's easier and no one is going to call them out on it.

Say for example, you are an ED nurse. You know you should document vital signs every two hours, but to document the results is cumbersome and time consuming. If something goes wrong with the patient, the vitals are stored in the monitor--everyone knows the ED monitors all their patients all the time, right?-- you can enter them later if necessary.

You don't actually NEED to enter vitals. No one audits charts. No one really cares, unless there's a problem. And problems are what ED nurses handle best.

Some people call this behavior lazy or careless.There's all sorts of negative terms we can use to judge this nurse, But in reality, she or he is taking the path of least resistance. Not charting, unless something, is wrong is easier. For a while, that was actually the type of documentation I was taught to do. It had a name: charting by exception. Nurses only documented abnormalities. If it wasn't documented, then it was normal. It left a lot of room for omission errors.

Today's hospital culture has shifted into electronic documentation.  The time saving capabilites and potentials are often proven to be a myth. In fact, many experienced nurses struggle to utilize the tool, ending up overwhelmed and exhausted.  Good nurses cut corners not only because they can, but because they have to, in order to survive.

How do we fix this? I think first, we need to recognize the behavior. Electricity will naturally choose the path of least resistance. Humans, I believe are no different.  

I believe it's the job of nurse leaders to not only esure a job is done well, but to strive to make success as easy as possible. How do we do that? Does anyone have any ideas or things that they have tried that worked?

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Who Leads the Leaders?
March 10, 2014 3:45 PM by Lorettajo Kapinos

A few weeks ago,  I wrote a blog on Violence in the Workplace. It posted one day before a violent event occurred at an  ED near me. That event saturated the media. Fortunately, no staff, patients or visitors were injured, though the situation ended with a person taking his own life.

As I watched the event unfold, I thought about what I had written. I worried that I went too far, that I said too much. I thought maybe we should be used to violence by now and get over it. However,  my blog received many  responses, all very passionate.

It also seems that nurses feel violence from many different angles: co-workers, visitors, patients and managers.

This raises the next question in my mind: Who leads the leaders?

I know there are education tracks one can take to learn about hospital administration, but what's in those lessons? Are managers taught how to deal with and decrease workplace violence or do they feel it too? Often, bullies are victims of being bullied.  They act out because that's what they know. Is that what managers are--bullies who have been bullied? Is that how they got to the top of the food chain--by eating their young?

I'd like to believe that is not the case. I want to think managers are guided and nurtured and can pass that down to their staff.

Somehow, though, I think the old saying "It's lonely at the top" exists for a reason. Have you been or are you currently a manager? Did or do you feel supported?

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Challenging Myself
March 4, 2014 3:31 PM by Lorettajo Kapinos

Today, I registered for my first 10k road race. It's a fairly popular event in my area and celebrates a piece of my heritage. On March 22, 2014, I will run the Holyoke St. Patrick's Road Race.

If my father were still alive, it would be his seventy-first birthday. It occurs eleven days before I turn forty.

The course is famous for its hills, making more than a little nervous. Until recently, I haven't run much over 5 miles, but I can easily complete a 5k race.

But fear is not going to stop me. I am going to face my demons, attack my sense of inadequacy and do it. I won't be the fastest. I will not break any records. But at least I can say I took on those hills. I challenged myself. I can be proud that I tried.

Wish me luck! 

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Violence in the Hospital
February 17, 2014 1:50 PM by Lorettajo Kapinos

This year, I am President of my local chapter for the Emergency Nurses Association (ENA). Close to the end of last year I asked local members what they would like to learn or talk about at meetings for 2014.

I received mutliple requests for a discussion on workplace violence.

While preparing for the meeting, I was overwhelmed with the resources provided by the ENA. There's a whole page dedicated to the topic, including numerous research papers.

I also stumbled upon a blog The First to Say No, written by a veteran ED/Critical Care/Trauma physician who knows what it's like to work in a setting where violence is the norm.

As I sit here now and think about the tagline "Workplace Violence" I come to realize how numb I am to the reality of it.  I see nurses get verbally assaulted everyday. And I have seen my coworkers physically assaulted as well. It doesn't bother me like it used to.

"It's all part of the job," we say as we brush off our wounds and keep trucking along.

That "part of the job" is partially why I had to leave the bedside. The first time sarcasm dripped off my tongue and felt good, I realized I needed to do something. It 's been a few years since then, and I am still trying to heal that part of me.

And from where I sit now, it feels like the violence is getting worse. My colleagues obviously agree.

This frightening reality needs to be addressed STAT.

Do you believe in armed guards and metal detectors?

What other measures is your facility taking to keep you safe?

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A Question of Value in the Workplace--Part 2
February 3, 2014 2:13 PM by Lorettajo Kapinos

Right after I posted last week's blog, I stumbled across a similar one at Psychology Today that also addressed professional value. In summary, the author spoke about the number one thing that makes a job feel meaningful--making a difference in the lives of others.

 Okay. That's great. And that thought makes a lot of sense when applied.  Nurses affect lives every day. From school nurses to public health nurses to bedside nurses to professors--NURSES MAKE A DIFFERENCE.

So, why do we burn out so often?

 One paragraph in the article answers that question:

"Like all things in life, meaning can be pushed too far. As the psychologist Brian Little observes, if we turn our trivial pursuits into magnificent obsessions, we gain meaning at the price of manageability. When the weight of the world is on our shoulders, we place ourselves at risk for burnout."-The #1 Feature of a Meaningless Job by Adam Grant, Ph.D.

How many nurses do you know who carry the weight of the world on their shoulders?

I know a lot--many with multiple life roles: mother, sister, wife, daughter. Often they leave their stethescope on twenty-four hours a day and provide care even when not getting paid. 

It's easy to see why nurses leave a profession that once was their passion.

How do we help them? 

I think the two comments from my previous blog are saying someting important--nurses need to feel supported. They need to be nurtured.

I'd like to know what that looks like. Does it come from your colleagues or does it come from leadership?  In what form can "care" be shared?

Please comment below regarding your thoughts and experience of being nurtured as a nurse.


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A Question of Value in the Workplace
January 27, 2014 10:02 AM by Lorettajo Kapinos

My nursing career has flucuated between years of highs and lows. Some were extreme, while others were mild. But after a serious burnout, I have once again reached a new plateau of job satisfaction.  I find pleasure in my work. I feel like I am accomplishing something. But most of all, I have a strong sense that my effort is of value.

This leads me to wonder about the origin of professional value. I know  I am a person who seeks instant gratification, hence why I have always loved emergecncy nursing. As a new ED nurse, I saw results when I gave a med or performed a task. Once I gained experience, I found immense pleasure in educating my patients about their care.

But at some point that all went away. I was no longer able to sustain my own sense of value and finally had to change jobs.

Now as an educator, I seek to prevent that for my colleagues. I want them to feel valued and important. But how do I do that?

What makes you feel valuable at work?


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Goals Keep Me Running
January 14, 2014 2:00 PM by Lorettajo Kapinos

As a nurse, I was trained to plan care based on patient goals. That has always made sense to me, yet I rarely apply it in my personal life.  Often when I set a goal, my anxiety level goes through the roof.

What if I don't achieve it?

Worse yet, what if I DO achieve it? Then what will I do?

I have learned, through running, to deal with that anxiety. The physical exertion eliminates a lot of the negative feelings while creating a sense of well-being. In addition, it taught me to appreciate the process reaching that tangible goal. 

My  love of running was born out of need to challenge myself. With the burden of smoking behind me, I wondered if I could longer than ten seconds on the treadmill. After I accomplished that, I wanted to see how often I could do that. Once I knew I could handle jogging a bit, I became hypnotized with controlling my heart rate. I loved watching it go up slowly and quickly come back down.

Eventually, I grew bored. My mind wandered.  It was then I realized, I needed a new goal. I had taught myself to run. So, now what to do with that?

I decided a 5k was the next logical step.

That was nearly two years ago. Today 5k races are pretty easy for me. I am not a winner, but I find my mind wandering once again. I lose focus on my runs. I don't push myself to get outside as often as I used to.

But then, along came another runner who said "Hey, Loretta, want to run a marathon with me?" 

My first response: "No. I can't do that."

But I can.

And I might.

Because this is the year I want to run my first half marathon.

And that is how a goal is born.

Now please excuse me while I lace up and head outside. How far will I get this time? It all depends on how hard I focus on my goals. 


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In the New Year
January 6, 2014 4:42 PM by Lorettajo Kapinos

I love beginnings. It's a time when everything is exciting and new. The world is open to possibilities. Nothing can hold me back. Those thoughts are the ones that surround me when I think about New Year's Eve. To me, every start of a new year is a chance to make a change. It doesn't always have to be huge; often it's not concrete. A few years ago, I vowed to stop feeling guilty all the time. Last year, I didn't want to start anything new. 

This year, I pledge to "Be Ready."

 What does that even mean?

Often in my life, I find myself paralyzed by self-doubt. Other people tell me something positive about my abilities, but I struggle to believe them. A few years ago, however, I decided to listen to their opinions, even if I doubted them. That opened up possiblities I could not have anticipated.

This year's goal is to be ready when opportunities, whatever they may be, arise. I will fight the thoughts that I'm not good enough and try it anyway. Even if something doesn't work out, at least I gave it an effort. This concept makes me extremely uncomfortable. But it's in our discomfort that we truly grow, isn't it?

I'll let you know how it goes.


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Thank You Readers
December 24, 2013 3:09 PM by Lorettajo Kapinos

I am honored to write this blog. I love hearing from nurses everywhere. My only wish was that I could be a little more interactive. And writing has taught me how much I've learned over the years. I don't want to stop now that I've started.

 So, thank you everyone. Please know I read each and every comment, even if I don't respond. Often, what you have to say drives my blogs. If my writing impacts you, please let me know.


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A Year of the Unexpected
December 23, 2013 5:03 PM by Lorettajo Kapinos

As I look back on 2013, I feel overwhelmed at  what this year has brought me.  2013 started with a resolution of "Keeping My Status Quo." I had friends argue with me that was a bad idea. It meant I was complacent or selling out or giving up. But that wasn't my intent at all. It was just a fancy way of verbalizing I did not want to take on any new or major projects this year. I sought to live a year where I didn't climb any new hurdles.

I declared my desire to rest because I had accomplished so many things in years prior, I needed a break.  For example, I began running (after quitting smoking) in 2011. I ran my first 5k and started a brand new job in 2012. I really needed 2013 to be the year things settled down. It was time I caught my breath.

 Well, apparently, those two years had increased my stamina and improved my endurance, because 2013 has been a year of constant growth for me. Take for example, this blog. I almost turned it down because of my resolution, however, I accepted, because the offer came the day before my rule took hold--on January 31st. It didn't officially "count" because I said yes in 2012.

Late last winter, I accepted the post of President for the Pioneer Valley Chapter of the Emergency Nurses Association. I knew this went directly against my resolution, but if I didn't do it, the chapter would fold. I couldn't let that happen. As a result, I attended two ENA conferences and participated in meetings with the Massachusetts State Council. I have met some amazing nurses and learned a ton. I love it so much, I am doing it again for another year.  

Finally, in September, I began teaching a writing class. I didn't count as "new" because I was already a member of the class. But moving from student to teacher was a bigger leap than I imagined. Yet, this role has provided me with more than I've given. My skills as a writer feel more solid now. My confidence is taking root. I feel more like a writer than ever.

It's funny how our mind rationalizes things, even things we think we don't want.But the truth is, I couldn't be happier. If I had really committed to my New Year's Resolution of status quo, I would have missed out on many opportunities. My growth would have stalled.

And, my New's Resolution for 2014? Yeah, I haven't come up with one  yet. I think that's because I am exactly where I need to be. Anyone have a suggestion or two?


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The Sante Fe Challenge
December 8, 2013 8:49 PM by Lorettajo Kapinos

My feet have changed a lot since I started running. I have tons of old work shoes that used to be the best thing for my feet. Now, they hurt.  I find I wear my work shoes almost everywhere. I've tried multiple different brands, styles, shapes and support types. Some were good. Others were awful. Nothing felt perfect.  So, I kept wearing my Dansko clogs (thank god I have a collection that goes with most of my casual clothes.)

Recently, I decided it was time to try yet another style. I browsed different brands of walking and running shoes, searching for something as supportive as my what I wear to work.  And that's exactly the time Dansko contacted me again. This time, they wanted me and a nurse colleague to try their walking shoes, from the Shayla collection,  Sante Fe. I got to choose the colleague, which was no easy task. I know a lot of ED nurses, many of who would love to try a pair of Dansko shoes. So, I decided to choose someone who has followed my blog since the early days. (I used to write Tales from an ED Nurse,right here at Advance but had to give it up for a while.) Corine, too, is a nurse runner.  I thought she would be the ideal person to test out these shoes for those reasons; not to mention, she's very honest. I knew she'd give a fair review.

Well, within a few days, Dansko sent us our matching Sante Fe walking shoes. We have both had them for a few weeks. Both of us have worn them to work and at home.

And here's the verdict:

Me: I love them. The arch support is just what I needed to help relieve my plantar fascitis and heel pain. The bottoms of my feet do not ache at all when I am wearing them, or the next day. My lower legs feel amazing. The are as comfortable and supportive as "old lady shoes" but don't look it. They are pretty fun looking. My only wish is that they came in half sizes. The whole sizes work well with the clogs and boots, but I like my shoes a little tighter, but that's my preference. It could change.

Corine: Also loves them. She felt the same way about her feet. After two twelve hour shifts in them, she said her back hurt a little, but that could have been from something else.She's going to give them another try.

And since we have started wearing them, many of our coworkers have expressed interest. So, if you are looking for a walking shoe that's as good as your clogs, give the Sante Fe a try. I don't think you'll be disappointed. 

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Dear Nurse Bully...
November 22, 2013 3:01 PM by Lorettajo Kapinos

Dear Nurse Bully,

 The first time I met you, I wasn't even a nurse yet. I was young, struggling to adjust to college life. I thought I went to a college prep high school, but nothing prepared me for the jump in academic challenge. Instead of guiding me, you told me to quit. You said I'd never make it as a nurse.  I thought this was normal.

The second time I met you, I still wasn't a nurse. I was a student nurse assistant, halfway through school. Instead of teaching me the finer points of nursing, you complained about me behind my back. You wrote me up. You shut me out. I thought this was normal.

For a few years, Nurse Bully, I retreated into my own space. I struggled. I lied a few  times because I feared ridicule for not knowing everything. Thank God I didn't make any lethal mistakes. I thought this was normal.

I met you again a few times over the years. Each time, I swam in a pool of confusion, hurt and frustration. I nearly quit nursing altogether because I thought this was normal.

Once, I even tried to join you. I thought that if other successful nurses were tough like that than I should be, too. But, I didn't like it. It did not feel normal at all.

I often wonder, Nurse Bully, if you would recognize yourself if I called you out. I doubt it. I believe bullying is in the eye of the receiver. Maybe my actions were once perceived as bullying. I do not know.  But what I do know, is that I don't want this to be accepted as normal anymore. I don't think anyone does.  

So, please Nurse Bully, stop and think of what you are saying to your coworker. Are you helping him or her with your words? Is it necessary to belittle someone just because you feel stressed? Is it too much to give a little guidance now and again?  Because that is what should be our normal.


Me--Nurse Loretta 


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Get Engaged
November 13, 2013 11:05 AM by Lorettajo Kapinos

When I was in Nashville at the National ENA Conference, the New Jersey Emergency Nurses Association inspired me with their creativity. They handed out oversized engagement rings on a key ring with a ribbon that said "Get Engaged".  My colleague and I fell in love with the concept. We want to bring the idea home to our own Emergency Department.

Our goal is to pull everyone together. This can improve patient care and staff satisfaction. Engagement builds teams that produce positive results.

 Stay tuned for our progess.

 I'd also like to hear about your ideas. How do you involve staff and keep them engaged? What type of projects are you working on?