Florida Nurse - August 2022

Page 2 The Florida Nurse August 2022
Notes from the Executive Director
“I was TODAY years old when….”
T H E
FLORIDA
NURSE
Willa Fuller, BSN, RN
Executive Director, Florida Nurses Association
Have any of you social
media mavens seen this phrase
come across your feeds? It’s
just another fun way of sharing
life experiences on social
media. It highlights moments
when someone either learns
something that is surprising
that they never knew, OR
when they discover something
they have thought to be true
their entire life is not accurate
Willa Fuller
at all. In my career, I call these
moments my nursing epiphanies and as a preceptor (a
role that I loved), I used these experiences to enhance
my practice and to teach my orientees. We come to
these moments in many different ways and we all have
these stories. I thought it might be fun to share some of
mine with you and maybe jog your memory about some
of yours.
I had been a very sheltered child with a helicopter
mom whose goal was to get us all through school with
good grades that would lead to scholarships. My mom
intervened and did many things FOR ME and I have a
theory that it kind of delayed my critical thinking abilities
for a time. I am not criticizing my awesome mom, just
stating what I think about my cerebral development. I
often had to see something or have it pointed out to me
to make the next logical leap. For example, I knew what
congestive heart failure was, I knew the symptoms, but
in my task-oriented brain, I could only be concerned
about hanging up all the IV’s at change of shift even one
that was going 100cc an hour even though the patient
was rattling like a baby with croup! I had a grumpy nurse
who often followed me that complained bitterly about
everything I did wrong and nearly empty IV’s were the
flavor of the week so that was my focus! I had a “cream
of the crop” preceptor who identified every teachable
moment and pulled me aside to make sure I captured
the impact and importance of the event. She connected
the dots with me. My epiphany for that moment?
What I was doing mattered. If I do the wrong thing, my
patients will be affected. I knew that of course, but this
moment put it directly in my view. What that did for
me was make me view every patient interaction as an
opportunity to gather information. We move so rapidly
to get things done, sometimes forgetting that every
action has an impact.
One of my first epiphanies in nursing was that I could
learn from other peoples’ mistakes. I experienced several
devastating occurrences or heard about others that I
filed away into my nursing databank so that I would
integrate it into my practice as a matter of routine. One
morning I came into work to a patient that was bitterly
complaining of pain after a knee surgery. Apparently,
she had been asking for pain medicine all night and
she had received it but it was not relieving her pain.
The nurse, who was excellent, was very distressed, but
this was a physician that everyone was terrified to call.
So when he came in in the morning, he was informed
about her complaint. (There had been a call during the
night to get additional pain meds). When he unwrapped
her dressing, he found that the blood had hardened like
concrete and created great pressure behind her knee.
As a result, she had experienced a permanent foot
drop, due to peroneal nerve damage. What I learned
there was that fear cannot override your obligation to
your patients. What happened to that patient made me
fearless in my advocacy.
Another epiphany came when my preceptor and I
were taking care of a new quadriplegic patient who
was experiencing a crisis of unknown origin. We were
frantically checking everything and finally we flung back
the covers and started manipulating his Foley catheter.
She flushed it with saline and he felt immediate relief
as it began to empty and he felt immediate relief. We
identified it as autonomic dysreflexia after the fact and
shared the information with all of the staff to make sure
they were educated about it. That day, I learned that
nurses really do save lives on a daily basis. What’s funny
is that I didn’t think much about that until much later.
There were many incidents like this over the years
but the next memorable moment came when I was
shopping in the mall and a woman came up to me
and informed me that I had been her nurse. I have
shared this story before. One part of me knew I was
making a difference as a nurse, but I felt like I was
on sort of a treadmill just churning out patient care
“tasks.” This patient who I did remember, said to me,
I would feel so comforted when I would hear your
voice in the morning, I would always hope you were
my nurse because when you were there, I was never
in pain. I remembered her because I felt like she
had more anxiety than actual pain and I gave her
some relaxation techniques I had learned at a pain
management conference. She utilized them all and as
a result, she asked less frequently for pain medication.
This was probably a couple of years in, but I think
that may have been the moment that I felt like a “real
nurse.” Imposter syndrome is real, folks.
The next standout moment was a time I had to utilize
the chain of command to advocate for a patient that
I knew was in dire straits. The physician kept hanging
up on me and I had critical information to report. The
patient was on anticoagulants which had not been
responding and now all of sudden the patient had a
critical lab value and was experiencing excruciating pain.
On my assessment, it was clear the patient was bleeding
into his surgical site and was quite possibly experiencing
compartment syndrome. I called the partner, then the
medical doctor, then the medical director, and by the
change of shift, he was off to emergency surgery for
a vena-caval umbrella. In this moment, I realized that
nurses have power – power to navigate the system to
advocate for a patient. After that, I made sure I not only
recognized when and how to use it, I mentored others
to do the same.
I have to mention my former preceptor who since
that time became my friend. Diana Vaughan is no
longer with us. But she will always be with me. She
recognized my deficit in connecting the dots early on
and instead of giving up or being frustrated with me,
she coached me through our early situations, which
helped me to develop that skill not only in clinical
situations but in life situations. She was never bullying
or insulting, she was informative and supportive.
Recently, I was watching a “Live” on Tik-Tok where
a patient was sharing about his journey with a blood
dyscrasia. There was another nurse online watching
and he shared his lab results with her. Her response
stunned me. She told him that nurses didn’t bother
with all those values, they only looked at hemoglobin
and hematocrit. “The rest was for the doctors.” I have
seen similar postings on some of social media groups
dedicated to nursing. Fortunately, experienced nurses
chime in immediately and inform them how important
it is for nurses to have a full knowledge about the
total care related to that patient. But this was an
epiphany that after all this time there are still nurses
that do not understand the full breadth and depth of
their responsibility.
I focused on this topic right now because of the
status of nursing as it has evolved and continues to
evolve after the pandemic. It is more important than
ever for nurses to develop these skills and establish
themselves as experts in patient care. As scope of
practice is continually challenged, we need to make
sure knowledge, expertise and continuing education
is a focus for nurses at the bedside as it is critical that
we continue to promote high standards and safety. It is
also important to look at work conditions and practice
models to make sure nurses are supported in order to
provide optimal care. As we start to emerge from the
mental and emotional as well as the physical fatigue
exacted by the devastating pandemic, we must be
mindful of nursing’s journey back, and our goal must
be to make things better than before. We cannot lose
the opportunity this crisis has provided to shed light
on the essential nature of our profession.
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Board of Directors
2021–2023
Officers
Janice Adams, DNP, MPA, BSN, President
Marie Etienne, DNP, APRN, FNP, PNP, PLNC,
President-Elect
Debbie Hogan, RN, BSN, MPH, Vice President
Valerie Halstead, PhD, APRN, FNP-BC, Secretary
Mavra Kear, PHD, APRN, BC, Treasurer
Region Directors
Jake Bush, MSN, RN, Northwest Region
Kellyann Curnayn, DNP, APRN-BC, North Central
Region
Susie Norman, MSN, Northeast Region
Marcos Gayol, EdD, MSN, MPH, RN, East Central Region
Meghan Moroney, BSN, RN, West Central Region
Cynthia Tagliaferri, RN, BSN, DNP Student, Southeast
Region
Camille Baldwin, EdD, MSN, RN, CNE, CHSE,
Southwest Region
Linda Washington-Brown, PHD, EJD, MSN, APRN-C,
FAANP, FAAN, South Region
Director of Recent Graduates
Danielle Weaver, BSN, RN, CEN
LERC Liaison
Marsha Martin, RN
FNA Office
Willa Fuller, BSN, RN, Executive Director
John Berry, Jr., Director of Labor Relations &
Government Affairs
Kaitlin Scarbary, Director of Member Programs,
Technology, and Marketing