Sometimes as nurses, we are the bowel movement supervisors. A code brown is different from other codes but is definitely the smelliest one. Every nurse will experience a code brown.
A code brown is a situation that all nurses will find themselves in, it is a situation where a patient has made a large fecal mess in the bed. A code brown usually calls for a clean-up crew.
Don’t deal with a code brown alone; get your coworkers involved. They’ll love it.
Tips on feeling with a code brown
The Q word
No one is allowed to say it; we don’t even like saying it at home. The Q word is worse than swearing, and no one is to mention it. The Q word puts negative energy in the air and usually curses the unit.
Everyone knows remembers who said it and what has come of it. It’s a weird nursing superstition that, unfortunately, comes true more often than you like.
Nurses are not supposed to mention a slow shift. I think it is a yin and yang thing, stillness and chaos. One comes with the other.
Sometimes Little Old Ladies will make you laugh out loud. Only nurses will believe you when you tell them how your 87-year-old female patient weighing in at 45 kg tried to take on the whole unit. It is always the little old grandmas that cause the most destruction.
These innocent ladies can be their loving selves during the day, but once it starts to get dark, their minds may follow. The hardest sundowning patients we’ve dealt with have been little old grandmas.
The only compliment a nurse will give
Nurses don’t complement their patients often, but you’ll hear one compliment “nice veins”. And this is something that only nurses understand. We love good veins because it makes their lives a lot easier.
ometimes we just place a peripheral IV because we can. It’s also a compliment you’ll only hear in the hospital, and we mean it.
Magical powers on micropore tape
Just like Frank’s red-hot nurses put micropore tape on everything. Securing limbs for line placements, holding dressings in place, taping foleys, and everything in between. We use micropore tape for everything.
When a full moon is present, every nurse is on standby. This is one of those times when you are not just expecting one patient to go nuts; it’ll be a portion of the unit.
Somehow the bright light of a full moon wakes up the worst in our patients. Make sure to pack some extra snacks or extra coffee because it’s going to be a long shift.
Mysterious frequent fliers
This will forever be a mystery. We cannot understand how patients keep coming back with the same problems, and we offer the same solutions.
A patient comes in, we fix their problem, give them instructions on how to move forward, tell them exactly what made them sick, and still, they come back.
We don’t get it. Do people not want to live?
Shift swap curse
For some reason, when nurses adjust their schedules and swap shifts, they end up getting the short end of the stick. No one knows why it happens, but for some reason, when you try to accommodate your social life, you end up paying for it.
This is why it is important to choose your schedule wisely and try to not switch it once it is finalized.
Learn about the things that only nurses understand here 😎👇
0:00 INTRO/ AFFILIATES/UPDATES/ START OF SHOW 0:10 Things only nurses will relate to 1:53 Code Browns 3:43 Tips on feeling with a code brown 8:20 The Q word 9:45 LOLs 13:23 The only compliment a nurse will give 16:01 Magical powers on micropore tape 18:02 Full moon 23:04 Mysterious frequent fliers 26:38 Shift swap curse
Learn more about gender-affirming surgery by watching this entire episode here 👇👇👇
0:00 Intro 01:40 Start of Show 01:58 Question for guest 07:35 Gender dysphoria 09:25 Gender-affirming surgeries 16:17 Covered by insurance in New York 17:17 How early do people experience gender dysphoria? 18:26 Social pressure 19:37 The struggles of people with gender dysphoria 24:19 Reprogramming the mind 25:47 How do we take care of people in this population? 31:43 Educating the community 38:28 Promoting the course 41:13 How do transgenders develop as a child? 45:49 Enlightenment 46:57 Where to find Shannon 47:18 End of show
Central lines in nursing are any line that is placed into the larger vessels of the heart. Any catheter that is inserted and sitting in the superior or inferior vena cava is considered a central line.
Central Line Insertions
It is an invasive and sterile procedure that requires consent. The pt will be draped and the nurses and physicians will gown up their sterile gowns.
When catheters are placed the patient is lying flat and given a numbing medication called lidocaine and pain medication. Make sure to have some sterile flushes handy in case you need to flush the line.
If there is some ectopy let the physician know so they can pull back on the catheter. Once placed it is then sutured and anchored in place.
Some common central lines are PowerPICC, Hickman, Broviac, Groshong.
A PICC is a peripherally inserted central catheter.
PICCs are narrow flexible catheters usually inserted through a vein in the peripheral region. It is slid through until the tip reaches a large vessel in the heart called the superior vena cava. They are usually placed in the upper arm .
Central lines in nursing can be inserted through:
internal jugular vein
common femoral vein
The major benefit to PICCs is that they allow for the administration of drugs that would not be able to be given through a peripheral line. They also give the patients the ability to have a long-term catheter for continuous use, for chemo, hemodialysis, etc…
Uses of Central Lines in Nursing
Central lines can have multiple lumens or be single. The most common ones are a single lumen, double, and triple lumen.
Prolonged IV antibiotic use
Long Term medication infusions
Multiple access was obtained with one line.
Long-term inotropic therapy, vasopressors
Home and sub-acute discharge
Thicker than a PICC and temporarily used for hemodialysis or CRRT. a fistula is preferred over this method. It can be tunneled or temporary and should only be used for dialysis but can be used in emergent situations for medications.
Tunneled vs Non-tunneled Catheters
Tunneled catheters are placed for longer-term use, and many times patients can be sent home with them. These types of catheters are passed under the skin and then fed into a large vein. They also have something called a cuff which facilitates tissue growth to anchor it in place.
Also used for long-term treatment. It is implanted so that it sits underneath the skin usually in the upper chest. They need occasional flushing but otherwise don’t require much care. It can also be multiple.
Risks and Complications
Central lines are great; they provide critical access during critical times however, there is some risk associated with central lines.
Rare but can occur during insertion and when giving medications.
Air bubbles enter the bloodstream and can travel to the brain, heart, or lungs causing a MI, stroke, or respiratory failure.
Signs and Symptoms
difficulty breathing or respiratory failure
chest pain or heart failure
muscle or joint pains
mental status changes, such as confusion or loss of consciousness
low blood pressure
blue skin hue
Infections leading to sepsis can happen during the insertion period and after if proper maintenance isn’t done .
Signs and Symptoms
Redness or swelling on site
Inflammation of the vein where the catheter is inserted.
Signs and Symptoms
Redness, pain, or drainage at the site
Streak formation along the vein
Any catheter that is inserted will be at risk for thrombus formation and then embolism.
After insertion, you will need to get an x-ray to confirm placement. Daily x-rays are not needed unless you are having problems with the catheter. One thing that can happen is catheter malposition, which will be revealed on the x-ray.
A central line can be pulled back if it migrates but should not be pushed further in.
Dressing changes are sterile procedures. Dressings need to be kept dry and changed if wet.
The dressing should be changed per hospital policy, some places change them weekly, and some every 72 hours. Remember that every time you do a dressing change you expose the line to infection, so they should not be done whenever.
Some catheters need to be flushed with heparin.
Keep lumens patent by flushing at least once a shift or keep a KVO going.
Clean lumens with alcohol before using or keep caps on them.
Using a 10 ml syringe generates the proper intra-lumen pressure.
Catheters that have clamps require heparin flushes, if clamps are not present it is a saline-only catheter.
Avoid blood pressure on the side of the line.
Always protect the catheter from tugging.
According to healthypeople.gov the most common HAIs include:
Catheter-associated urinary tract infections
Surgical site infections
CLABSI or Central Line-Associated Bloodstream Infections account for thousands of deaths a year and million of dollars in added costs to the healthcare system.
Know your central lines and click here for more of the episode 👇👇👇
0:00 A quick word for the sponsors 0:55 Introduction with the Hosts & Affiliates/Updates 3:09 Central Lines 3:26 Central line insertions 8:03 PICC lines 9:30 Central line uses 11:31 Hemodialysis Catheter 14:13 Tunneled vs non-tunneled catheters 15:22 Ports 22:14 Risks and Complications 22:21 Air embolism 23:56 Infection 26:30 Phlebitis 28:07 Thrombus formation 29:25 Maintenance 37:30 Closing thoughts
There are various choices in grocery stores, so there is no excuse for the inability to find one that fits you. You need to watch out for their marketing and what they promote.
Food Labels Explained
Besides the nutrition label for food labels, there is another label to pay attention to. That is the loss of certifications.
We have found that not all these so-called “certifications” are actually certified. That said, it would be best if you pay attention to food labels and what they contain.
USDA’s National Organic Program regulates labeling requirements for organic agricultural products. Organic labels are found on produce, dairy, meat, processed foods, condiments, and beverages.
Food products labeled as “organic” must contain at least 95% organic ingredients. It means no synthetic growth hormones, antibiotics, or pesticides. No biotechnology, artificial ingredients, or irradiation is used in production or processing, too .
Products containing at least 70 percent organic ingredients are produced without synthetic methods. They are labeled “made with organic ingredients. Yet, they cannot use the USDA organic seal on their packaging.
Farmers pay $1,200 and add an extra $700 or more for a new organic farm and organic processor to be “certified”.
Certified Naturally Grown
The food was grown using the same standards as those for organic, but not on a farm certified by the USDA’s National Organic Program.
Some farmers have criticized the cost and process they need to participate in the USDA’s organic program.
It is an alternative, non-governmental certification system where other farmers act as inspectors in a program administered by a non-profit organization called Certified Naturally Grown.
“Natural” is a term present in many food products, so look closely at the label. The Certified Naturally Grown title indicates that someone certifies that it is natural, rather than just using “Natural” for marketing purposes.
Fair Trade USA enforces fair trade standards. Fairtrade products must be produced in accordance with the following guidelines: Workers must receive fair wages, safe and equitable working conditions, and the right to join trade unions; child or forced labor is completely prohibited.
Crops must also be grown, produced, and processed in a manner that supports social development, economic development, and environmental development.
Fairtrade standards have been established for coffee, tea, cocoa, honey, bananas, juices, cotton, flowers, gold, rice, spices and herbs, sports balls, wine, composite products, fresh fruit, and sugar.
Its standards cover the way it’s participating farms raise their animals (including beef and dairy cattle, bison, sheep, goats, pigs, chickens, turkeys, ducks, geese, and rabbits).
AWA states that the basic premise of their standards is that animals must be able to behave naturally and be in a state of physical and psychological well-being.
They only certify family farms (charging no fees to participating farmers) and state that animals must be raised on pasture or range.
American Humane Certified
The American Humane Certified program was created by the American Humane Association in 2000 to ensure that animals raised for dairy, poultry, beef, veal, goat, swine, turkey, and bison products are raised in a humane manner.
These guidelines, created with input from animal science experts, ensure that livestock has access to clean and sufficient food and water.
It also checks the healthy living environment and that staff and managers are thoroughly trained to care for animals in a humane manner.
Non-GMO Project Verified
The Non-GMO Project is a non-profit organization that provides the only third-party labeling program in North America for products grown without using genetic engineering.
They verify that the process products go through, from seed to shelf, are produced according to their rigorous best practices for GMO avoidance.
USDA has a grass-fed standard for ruminant animals like cows and goats, which states that these animals must be fed only grass and forage during the growing season.
The American Grassfed Association is one organization that certifies beef, bison, dairy, lamb, and goat that is fed only on pasture, in addition to being raised without antibiotics, synthetic hormones, confinement, and with standards for high animal welfare.
Other animals, like chickens and pigs, can be pasture-raised (and USDA organic standards require at least some access to pasture).
Still, there are currently no specific certification standards for non-ruminant animals being grass-fed or pastured.
Non-Certified Food Labels
The following nutrition labels depend on farmer and processor information to support the claim that the food products were raised in compliance with each set of standards.
They do not go through third-party testing or certification. They do have certain standards they must prove.
This label means that the farmer has chosen not to inject his or her cows with any artificial growth hormones, like rBGH, a genetically engineered growth hormone.
The nutrition labels are also used on beef and chicken products, where the animal was raised without growth hormones or steroids.
However, the USDA prohibits giving hormones to chickens, so the label doesn’t mean much there — all chicken you buy will be hormone-free whether it’s labeled or not.
Hormones are not allowed in raising hogs or poultry. Therefore, the claim “no hormones added” cannot be used on the labels of pork or poultry unless it is followed by a statement that says, “Federal regulations prohibit the use of hormones.
Raised without antibiotics
Chickens, pigs, and cattle raised on industrial farms are routinely fed low doses of antibiotics (the same drugs we rely on to keep ourselves and our families in good health) to make them grow faster and compensate for overcrowding and unsanitary living conditions.
This label states the meat or dairy was raised without the use of antibiotics.
The following are not certified or tested by any third-party regulatory agency and do not have a set of standards:
While many products have “all-natural” nutrition labels or packaging, there is no universal standard or definition for this claim.
Free-range poultry is poultry that spends part of its time outside and does not live in cages. These could be chickens, turkeys, or ducks. The USDA does not have a legal definition of free-range.
Thus, free-range chicken eggs, beef, or pork are not regulated.
Healthy Snack Bars
There are so many varieties of snack bars it can seem impossible to choose from. With a wide variety, there will also be a variety of healthy choices.
Some use marketing gimmicks that you should stay away from. Just because the box looks nice does not always mean it should be your choice.
While they sound healthy, always pay attention to the nutrition label certifications. It will tell you what you are actually consuming, no matter how healthy it seems.
Labels to Pay Attention To
Before buying food that’s packed, make sure to pay attention to the following. It will give you an idea of what you are actually putting inside your body .
This is the most important place to look in nutrition label certifications. You should always try to avoid ingredients like high fructose corn syrup, soy protein isolate, and inulin (“fake fiber”).
The first ingredient or ingredients should be whole foods like apples, bananas, dates, etc.
Protein and amino acids are the building blocks of your muscle. They are also for optimal organs and function.
Many dieticians recommend getting snack bars with at least 5g of protein. But many protein bars are made of fruits so they also recommend some protein to go with it.
Protein is important because it supports and strengthens your cartilage, bones, and muscles. It also boosts your immune system and regular functions.
It will also up the satisfaction and satiating factor of your snack. Protein should also be a part of the nutrition label certifications of the food you eat.
This is something the majority of people never get enough of; we are even guilty. It is important to try and get as much of it whenever you can.
It will make you feel fuller for a longer period of time. Fiber helps to regulate digestion, improve heart health, prevent type 2 diabetes, combat inflammation, and reduce your risk for cancer.
Beware of added sugar! Try to select a bar that doe not contain any added sugars. There is a difference between natural sugar and added sugar.
Snack bars will always have carbs and sugar because they usually come from fruit but avoid the added ones.
Don’t skip reading the labels. Learn more about them in this video 👇👇👇
What advice can you give to single moms and females in the business world?
Are there stages or steps to becoming a nursepreneur?
What was the greatest struggle in your journey? How did you overcome it?
How do you transition from your career to owning your own business?
Since nurses aren’t bred business professionals, what struggles do nurses face when transitioning into the nursepreneur role?
Why do nurses make great entrepreneurs? Click on the full episode to know why 👇👇👇
0:00 INTRO / AFFILIATES/UPDATES/ Start of show 2:50 QUESTIONS FOR GUESTS 11:07 1. Why do you think nurses are great in Entrepreneurship? 14:13 2. How did you transition away from nursing? What made you leave? 17:30 3. What advice can you give to single moms and females in the business world? 20:04 4. What are the stages or steps to becoming a Nursepreneur? 21:55 5. What was the greatest struggle in your journey? How did you overcome it? 31:50 6. How do you transition from your career to owning your own business?