EP 106: Oncology Pediatrics with David Metzger

EP 106: Oncology Pediatrics with David Metzger

In this episode, we would like to introduce you to our guest David Metzger who is a pediatric oncology nurse and father. He is the author of the upcoming book, Nurse Papa: 16 Meditations From A Pediatric Oncology Nurse, an exploration of his role caring for sick children while raising healthy kids. He is also the host of the new podcast, also called Nurse Papa. 

IG page: @nursepapathebook.com Book Available August 2021 

What do you do as a pediatric oncology nurse? 

What is the biggest reward that you get working with pediatrics?  

What is one of your greatest challenges you face as a pediatric?

Do you think young kids understand what cancer is and the situation that they are in?

How do you leave work behind taking care of ill children and transition into raising healthy kids as a parent?

What have you learned on our journey being a father and what it takes to create a fruitful relationship with your kids?

Can you share some of your favorite meditations from your book? 

How do you create your work/life balance? 

If your experience is different from being a male nurse working with pediatrics?

EP 41: Covid 19 vaccine passports and gun laws

EP 41: Covid 19 vaccine passports and gun laws

Are Covid Vaccine passports the next push?

The little paper card you got with your Covid shot could be your passport back to normal life

“Whether it’s school, entertainment venues, or travel, there’s going to be an expectation that to resume these activities you have to be retested and enter quarantine or produce proof of immunization,” Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital, told ABC News.

In other words, people trying to do the kind of things they did before the pandemic – like a fly on a plane or see a movie in a cinema – may soon be required to prove they’ve been vaccinated. 

One of the executive orders President Biden signed in January, called for government officials to “assess the feasibility of linking Covid-19 vaccination to International Certificates of Vaccination or Prophylaxis (ICVP) and producing electronic versions of ICVPs” – all your Covid-related health records, together in one digital document.

Airlines are working on something similar. The International Air Transport Association has developed the “IATA Travel Pass,” a smartphone app that compiles a traveler’s vaccination status and Covid test results into easily scanned QR codes.

“A vaccination card is a tool that people can use to declare that they have some level of protection against COVID,” Dr. Brownstein said. “Being able to assess immunity to Covid is a critical part of trying to resume our daily lives.”

In addition to I.A.T.A., IBM has been developing its own Digital Health Pass that would enable individuals to present proof of vaccination or a negative test to gain access to a public location, such as a sports stadium, airplane, university, or workplace. The pass, built on IBM’s blockchain technology, can utilize multiple data types, including temperature checks, virus exposure notifications, test results, and vaccine status.

The World Economic Forum and the Commons Project Foundation, a Swiss nonprofit group, have been testing a digital health passport called CommonPass, which would allow travelers to access testing or vaccination information. The pass would generate a QR code that could be shown to authorities.

Counterpoint

There already is a vaccine passport. It’s easy to get. And its source is impeccable. As of June 15th, 2007. 

Nicknamed “the yellow card,” it’s a small, passport-sized yellow pamphlet officially titled “International Certificate of Vaccination as approved by the World Health Organization.”

The yellow card is an official medical record, recognized worldwide, of the diseases you’ve been immunized against.

The yellow card started due to yellow fever, the WHO reported that “32 African countries are now considered at risk of yellow fever, with a total population of 610 million people, among which more than 219 million live in urban settings. Some countries won’t let you in without medical proof that you’ve had the right vaccines or gotten them far enough in advance of your trip for them to be fully protected when you arrive. 

Vaccine passports being sold on darknet

Fake vaccination certificates are also being sold by anonymous traders for as little as $150 using the hard-to-trace cryptocurrency Bitcoin as the payment method.

Researchers at cyber-security company Check Point have monitored hacking forums and other marketplaces since January, when vaccine adverts first appeared.

They say the number of adverts they have seen has tripled to more than 1,200.

Sellers of vaccines appear to be from the US, UK, Spain, Germany, France and Russia. 

https://www.independent.co.uk/news/world/americas/vaccine-passport-us-covid-who-b1821421.html

https://www.who.int/ihr/ports_airports/icvp/en/

https://www.nytimes.com/2021/02/04/travel/coronavirus-vaccine-passports.html

https://www.bbc.com/news/technology-56489574

Boulder, CA shooting

Investigators on Tuesday were trying to determine what motivated a 21-year-old man, charged in the shooting at a Boulder, Colo., grocery store, to take the lives of 10 people, in the second mass shooting in the United States in less than a week.

The gunman was armed with both a military-style semiautomatic rifle and a pistol when he walked into the King Soopers store on Monday and opened fire, officials said. They identified the suspect who was arrested at the scene as Ahmad Al Aliwi Alissa, who lived in Arvada, a nearby suburb; he was charged on Tuesday with 10 counts of first-degree murder, which in Colorado carries a penalty of life imprisonment without parole.

Barack Obama has blasted “cowardly” Republicans for blocking gun control laws limiting “weapons of war” in the wake of the Boulder mass shooting.

Atlanta, Georgia Shooting

On March 16, 2021, a series of mass shootings occurred at three spas or massage parlors in the metropolitan area of Atlanta, Georgia, United States. Eight people were killed, six of whom were Asian women, and one other person was wounded. A suspect, 21-year-old Robert Aaron Long, was taken into custody later that day.

According to police, Long said he was motivated by a sexual addiction that was at odds with his religious beliefs. He had previously spent time in an evangelical treatment clinic for sex addiction. After the shootings, Long was charged with four counts of murder in Atlanta, and four counts of murder, and one count of aggravated assault in Cherokee County.

Although Long has not been charged with a hate crime as part of the ongoing investigation, some commentators have characterized the shootings as a hate crime, noting the backdrop of rising anti-Asian sentiment in the United States during the COVID-19 pandemic.

Biden Administration Urges Supreme Court To Let Cops Enter Homes And Seize Guns Without A Warrant

This term, the Supreme Court has an opportunity to apply the original meaning of the right “to be secure” to clarify the scope of the community caretaking exception to the Fourth Amendment’s warrant requirement.

In Caniglia v. Strom, Edward and Kim Caniglia, husband and wife, had a disagreement in their Rhode Island home. Mr. Caniglia retrieved his unloaded handgun and asked “why don’t you just shoot me and get me out of my misery?” Mrs. Caniglia left and spent the night in a motel. The next morning, Mrs. Caniglia called the police to escort her home. Police believed Mr. Caniglia could be a threat to himself so they brought him in for a psychiatric evaluation, which he agreed to only after police promised not to take his handguns. After Mr. Caniglia was admitted to the hospital—and despite their promise—the officers entered the home and seized the guns, which they returned when Mr. Caniglia sued.

The officers invoked the “community caretaking” exception to the warrant requirement to justify their warrantless entry of Mr. Caniglia’s home.

That exception stems from Cady v. Dombrowski, a case involving a crashed car that police had towed to a private garage and later searched, finding a revolver. The warrantless vehicle search was upheld because (at least according to the majority) police had control of the car and a search was necessary to remove potential safety threats.

The ultimate question, in this case, is therefore not whether the respondent officers’ actions fit within some narrow warrant exception

https://www.forbes.com/sites/nicksibilla/2021/03/23/biden-administration-urges-supreme-court-to-let-cops-enter-homes-and-seize-guns-without-a-warrant/?sh=69128bbd2829

https://ballotpedia.org/Caniglia_v._Strom

EP 104: 5 Challenges in Nursing

EP 104: 5 Challenges in Nursing

Nurses face constant challenges. Nursing can feel like a never-ending struggle. Not many people understand what a nurse actually does and nursing school just brushes the surface of the true reality of what it means to be a nurse. The 5 struggles that nurses commonly deal with are the reversal of DNR orders, job satisfaction, inconsistent workflow, service sector mentality, and hospital politics. 

  1. Reversal of a DNR order
    1. Dealing with noncompliance
  2. Job satisfaction
    1. Inadequate staffing
    2. Heavy workloads
    3. Stress doesn’t equate to pay
    4. Night shift and holidays
  3. Inconsistent workflow
    1. You never know what is going to happen
    2. The pressure to know everything
    3. exhaustion
  4. Service sector mentality
    1. The customer is always right
    2. Lack of respect from families and physicians
  5. Hospital politics

Reversal of DNR orders

One of the hardest things to deal with in the hospital, especially in the ICU and especially as a new grad, is when a family decides to reverse the patient’s DNR orders. When this happens the family is going against the patient’s wishes and as nurses, we are patient advocates. We try to stand up for our patients but the majority of the time it is of no use. The family decides to change their loved one’s code status, this is usually during the time that the patient themselves is not able to vouch for their decision. This usually happens when a patient is brought to the hospital in an unstable condition or during a patient’s decline at a hospital. 

Dealing with noncompliance

To a certain extent reversing a DNR order for someone who established it is in a way noncompliance. But what is hard to deal with in nursing is patients coming to the hospital and then refusing everything. They don’t want their medication, don’t want any procedures, and they just want to go home. If you don’t want anything why did you come to the hospital? 

There are also those patients that are compliant when in the hospital but when they leave it all drops off. We call those frequent fliers, they build up their hospital miles and you build up your frustration. They come in in a very critical state, we literally save their lives and they go back to what they were doing and not adhering to their medical plan. It makes you feel worthless and useless as a nurse, your role almost seems pointless. 

Job satisfaction

As nurses, we go into nursing with the hope of having a meaningful and impactful career. As new grads, we still haven’t been beaten down and you can tell when someone still has that new grad face and mentality. Over time the job satisfaction we felt in our early years starts to dwindle and slowly disappear. 

Inadequate staffing

Staffing is an ongoing issue in nursing. You can feel the drastic difference between having adequate staff and being short. It’s night and day. You feel it even harder when you work at night and especially when your outside of work-life is not where it needs to be. This is the main reason nurses leave the bedside and sometimes nursing altogether. 

Heavy workload

You feel this the most when you’re short-staffed. A heavy workload can be anything from having a really sick patient with a lack of support to having a 400lb patient that just breaks your back from the physical labor you have to do. Even when there are set ratios the workload gets heavy. Ratios, unfortunately, don’t always account for acuity, and there’s a discrepancy between having 4 patients that are decently stable vs having 4 patients and 3 of them are struggling to breathe. This goes for all units. The ICU may seem simple enough to handle 2 patients but there have been a handful of times where the workload was so much that you’re still sitting at work an hour after your shift to catch up on charting. 

Stress doesn’t equate to the pay

Nurses are undervalued in the financial aspect. Most careers and jobs get rewarded with higher pay or some sort of financial bonus, do you know what nurses get? Food, we get fed as our bonus. That should just show you how unwilling hospitals and other places are in increasing nursing pay. There is a different kind of stress that comes with working with people. Many times we carry life and death decisions, we aren’t managing someone’s finances or getting someone’s internet up and running, nurses deal with lives. When you are a nurse for a few years you truly start to recognize this. I wouldn’t be surprised if nursing was the number 1 most underpaid career, but no one will come to that conclusion because that would mean raising wages. 

Night shift and holidays

The healthcare field is a unique field in which work does not stop. It is a 24-hour job which means night shift, someone has to work the night shift. No matter what kind of a nurse you are or how long you’ve been nursing for there have been many times that night shift has negatively impacted your life. As humans we are not made to work nights, our circadian rhythm makes us most functional during the day. 

Many people get to enjoy every holiday with their families, nursing is one of those fields that doesn’t adhere to those guidelines. The nurse is required to work certain holidays, usually 50% of them. If you work nights there are some holidays, even though you’re off, you can’t really enjoy because you’re coming off a shift. 

Inconsistent workflow

Nursing and the medical field breed unpredictability. You really never know how your shift is going to go, that’s even if you are working 3 shifts in a row. A patient’s condition can drastically change from day to day even hour to hour. There are times where you work 3 shifts in a row and you have different patients each time. Not only are the patients’ statuses inconsistent you’re not even sure if you’ll have enough staff. Sometimes you can’t even plan out your shift with patients transferring, trying to open beds for other patients, the only thing consistent is the inconsistency. 

The pressure to know everything

As inconsistent as a nursing shift and a nursing career is there is this expectation to know everything. “Why is my father’s blood pressure keep going down”? “We’re trying to fix it right now he’s on 20 mcg of levo we’re thinking about adding another pressor”. “Ok well why isn’t the first one working, why isn’t he improving, he was doing a lot better yesterday, do you even know what you’re doing”? Nurses are very knowledgeable and understand what the situation is, the thing is that there is not always a solution for every problem, a lot of the time we are just managing to buy ourselves, doctors, and families sometimes. 

Exhaustion

Inconsistent workflow eventually leads to exhaustion and many nurses leave the bedside and nursing altogether. There is only so much you can take at work, not to mention the stress we still undergo at home and our social lives. Nurses get burnt out and get tired, sometimes it’s hard to recognize. It’s really important to be able to relax and take time for yourself and enjoy life.

Service sector mentality

As much knowledge as nurses has, nursing almost feel s like a service sector. The customer is always right gets turned into the patient is always right. Yes Mr. trout I’ll get that for you right away, ohh you need something else, and another thing, now another pillow, ohh you don/t like the air mattress, you want to go for a walk right now, yes right away. There are shifts where you’re just being bossed around and many nurses don’t know how to handle a really needy patient. It takes a toll because you have more than one patient to worry about and some patients feel that it’s a privilege that you’re their nurse. 

Lack of respect

Nurses are always at the bedside so they’re usually the first ones to get questioned and yelled at. Most families don’t understand what is going on and are usually ignorant to what you explain. Families can talk down to you for no apparent reason, this is really felt when they say you’re just a nurse let me talk to a real doctor.

Many nurses also experience a lack of respect from physicians. Lots of times they talk down to nurses, especially the new residents when they think they know more than you because their years of schooling trump all your years of experience. 

Nurses fear speaking to doctors

One of our biggest challenges as nurses is talking to doctors and it’s worsened when an MD belittles a nurse. As nurses, we feel like we should know what to do in each situation, and unrealistic expectations nurses put on themselves. Usually, when a nurse calls a doctor it’s for 2 things; an update or the patient is deteriorating. This is one barrier a lot of nurses struggle with and it takes time to get past.

Hospital politics

You’d think the hospital and the medical field wouldn’t have as much office politics, boy you are wrong. There always seems to be a day vs night mentality and staff vs management mindset. It’s more pronounced in some places than others but it exists. Instead of everyone working as a cohesive team they talk and stir up drama amongst themselves. This makes a challenging career such as nursing that much harder to work in. 

 

EP 105: Getting Out of Debt With Allie Grotteland

EP 105: Getting Out of Debt With Allie Grotteland

In this episode, we would like to introduce you to our guest Allie Grotteland. Allie is a PICU nurse and owner and founder of the debt-free nurse LLC. She helps nurses pay off debt and save money without sacrificing things they love. We discuss the importance of paying off debt, staying debt-free, and saving for the future. 

IG page: @the_debtfreenurse

The questions below are some we tackled on the show

  1. How did you first become self-aware of investing?
  2. How do you first start teaching people about money?
  3. What is the mindset you should have about saving and investing? 
  4. What is your best advice to start paying off debt? 
  5. What is your best advice to start saving your life? 
  6. How do you create financial goals?
  7. How do you stop impulse spending? 
  8. One of your goals is to retire a millionaire, what systems do you have in place to bring that to reality? 
  9. Difference between Roth IRA vs 401K? 
  10. Tell us your experience with nurse bullying?