EP 133: The Human Design With Nicole Garritano

EP 133: The Human Design With Nicole Garritano

The Human Design With Nicole Garritano

In this episode, we would like to introduce our guest Dr. Nicole Garritano. Nicole Garritano is an energetic intuitive coach and consultant that uses human design, subconscious transformation techniques, and healing modalities to help others step into their full potential. Prior to starting her business Nicole held various nurse faculty and academic administrative positions and practiced clinically as a pediatric nurse practitioner.

Nicole gladly answers the following questions with us and shared her real-life experiences about nursing and business.

  1. Tell us a little bit about yourself, your nursing career, and how you ended up where you are today?
  2. How do you help people achieve their full potential, is there a way to measure someone’s potential?
  3. What is human design and what are some subconscious transformation techniques?
  4. What are some ways you personally prevent burnout? 
  5. What is the hardest part about running your business?
  6. From your clients, what seems to be the biggest hurdle?  
  7. Nurse Practitioners and administrators are leaders, what is the most important aspect of leadership?
  8. Are there ways to become more of a leader?  
  9. What is your current obsession?

 

Guest promo links: 

FB

https://m.facebook.com/nicole.garritano.902?ref=bookmarks

FB Group

https://m.facebook.com/groups/384767219612994/?ref=group_browse

Instagram

@nicole.garritano.coach

Website

www.nicolegarritano.com

https://www.nicolegarritano.com/sales-page

https://www.nicolegarritano.com/store 

 

SHOW NOTES:

0:00 Cup of Nurses Introduction
1:50 Guest Introduction
2:27 Nicole Garritano’s Background
5:00 Learnings in Nursing experience
6:00 What made you switch from nursing to running your own business?
8:55 Do you feel the same gratification with nursing & business?
10:11 What is the Human Design?
20:04 How do you do the mental work to program from 0 to 7 years?
35:58 What is the first step to start healing?
40:08 How do you get past burnout?
46:19 What is the subconscious level of nurses with the pandemic?
48:55 What is the paradigm shift
51:13 What is the end goal?
54:33 What are you currently obsessed with?
57:33 Where can people find Nicole Garritano?

EP 132: Women’s Health With Isabella Bogdan

EP 132: Women’s Health With Isabella Bogdan

Cup of Nurses Episode 132: Women’s Health with Isabella Bogdan

In this episode, we would like to introduce our guest Isabel Bogdan, the owner and founder of belev.co. Isabel is a women’s health nurse practitioner with a doctorate in nursing practice. Dr. Bogdan has the vision to intertwine traditional medicine with a holistic approach for transformational change.

Join us as Isabel shares with us the importance and the different ways to maintain women’s health and the answers to the following questions:

  1. How did you get involved in women’s health?
  2. What is holistic and preventative medicine to you? Body, mind, soul
  3. H b 
  4. What is the biggest concern for women? What are the highest comorbidities?
  5. How important is mental health for women?
  6. How do you help someone boost their mental health? Yoga, meditation?
  7. What are some things every woman should know? 
  8. What is belev.co?

SHOW NOTES:

0:00 Cup of Nurses Introduction

1:28 Guest Introduction

1:55 Isabella Bogdan’s Background

7:14 How do you Assess Spirituality

12:22 How to switch from being a victim to being in control?

14:21 What is the biggest impact of the pandemic on women?

18:10 How do you keep the mind, body, and soul connected?

25:00 What do women have to change for their health?

28:30 What do a lot of women suffer from?

33:31 How to keep motivated

39:45 Why do you celebrate the equinox?

EP 131: Travel Nursing and Recruitment With Justin Allison

EP 131: Travel Nursing and Recruitment With Justin Allison

Travel Nursing and Recruitment With Justin Allison

In this episode, we would like to introduce our guest Justin Allison who is currently the Chief Growth Officer at Lead Healthstaff. Justin has been in the travel nursing industry since 2001. He has been the #2 employee at a startup prior to opening up his own company. 

Justin answers the following questions in the podcast:

  1. Justin, give us a brief introduction about yourself?
  2. Based on your expertise, how do you cultivate a good nurse/recruiter relationship?
  3. How is the travel nursing job outlook for this upcoming winter and 2022?
  4. What do you think are the biggest challenges for travel nurses starting off?
  5. What is the mindset you need to continue overcoming obstacles the way you did in working and opening startups?
  6. Why do you need to start with WHY?
  7. What are your current obsessions?

SHOW NOTES:

0:00 Cup of Nurses Intro

0:53 Episode Introduction

2:00 Guest Introduction

2:27 Justin Allison’s Background

5:43 What does it take to do what you do?

6:44 Are you into starting and creating things?

8:22 Do you look for traits as a team player?

10:24 How do you figure out a toxic person?

11:55 What are the characteristics of a good travel nurse?

14:00 What annoyed you as a recruiter?

16:38 Are there penalties when you backed out a contract?

17:10 Have you seen an increase in the jobs available for travel nurses?

21:25 What to look out for a good recruiter?

29:08 What is it important to start with why?

35:24 How often do you assess your why?

36:38 What is the hardest obstacle that you ran into?

38:47 What is the hardest things that you’ve seen travel nurses struggle with?

42:31 Why do they not give out the hospital where you’ll be working?

57:44 Where can people find Justin Allison?

 

EP 129: Things Only Nurses Understand

EP 129: Things Only Nurses Understand

Things only nurses will relate to

Every career has its own insider information and moments only coworkers can relate to. Nursing is the same way. We have ur acronyms and struggles but there is a lot of funny aspects to being a nurse. Nursing can be so stressful sometimes all you can really do is laugh.

    1. Code Browns

      1. 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
      1. Double mask
      2. Vics vaporub
      3. Mouth breathing
  1. The Q word

    1. 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. 
  2. LOLs

    1. 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.
  3. The only compliment a nurse will give

    1. Nurses don’t complement their patients often but the one compliment you’ll hear is “nice veins”. Nurses love good veins because it makes their lives a lot easier. Sometimes we just place a peripheral IV because we can. It’s also a compliment you’ll only hear in the hospital and we do mean it. 
  4. Magical powers on micropore tape

    1. 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.
  5. Full moon

    1. When a full moon is present every nurse is on stand by. This is one of those times where 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. 
  6. Mysterious frequent fliers

    1. 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?
  7. Shift swap curse

    1. For some reason when nurses adjust their schedule 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 for 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. 
EP 128:  Gender Dysphoria & Gender-Affirming Surgeries With Shannon Whittington

EP 128: Gender Dysphoria & Gender-Affirming Surgeries With Shannon Whittington

In this episode, we’d like to welcome Shannon Whittington. Shannon is a speaker and best-selling author of her book LGBTQ ABC’s for Grownups. She is a clinical nurse expert in gender-affirming surgeries for transgender and nonbinary patients. She is an advocate of the LGBTQ community.

Shannon answers the following questions for the viewers:

  1. How much education did you receive in LGBTQ+?
  2. What do transgender and binary mean and what are gender-affirming surgeries?
  3. What are some struggles and barriers the LGBTQ community faces
  4. What is gender dysphoria? What age does it start?
  5. At what age can people be put on hormones or get surgery?
  6. Can you tell us why people switch sexes? What seems to be the main reason?
  7. What are some things we need to be conscious of when providing care to the  LGBTQ population? 
  8. How can I be an ally to the LGBTQ+ pop?
EP 127: Central Lines in Nursing

EP 127: Central Lines in Nursing

Central Lines

Central lines 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. Your job as a nurse will be to assist the person placing the line which can be an NP, MD, PA, and also monitoring vitals. Then the line is being advanced you may see some ectopy on the monitor, this usually happens when the tip of the catheter hits the right atrium (atrial tickle). 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.

PICC lines

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. Usually placed in the upper arm.

Central lines can be inserted through:

  • internal jugular vein
  • common femoral vein
  • subclavian veins
  • basilic vein
  • brachial vein
  • cephalic 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…

Central line uses

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.
  • TPN, Chemo
  • Long-term inotropic therapy, vasopressors
  • Home and sub-acute discharge
  • Blood draws

Hemodialysis Catheter

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. Tunneled catheters are passed under the skin and then fed into a large vein. Tunneled catheters also have something called a cuff which facilitates tissue growth to anchor it in place. 

Ports

Also used for long-term treatment. It is implanted so that it sits underneath the skin usually in the upper chest. They need an occasional flush but otherwise don’t require much care. They 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.

Air embolism

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
  • stroke
  • mental status changes, such as confusion or loss of consciousness
  • low blood pressure
  • blue skin hue

Infection

Infections leading to sepsis can happen during the insertion period and after if proper maintenance isn’t done. 

Signs and Symptoms

  • Fever
  • Chills
  • Tachycardia
  • Fatigue
  • Hypotension
  • Redness or swelling on site
  • Purulent drainage
  • Elevated WBCs

Phlebitis

Inflammation of the vein where the catheter is inserted.

Signs and Symptoms

  • Redness, pain, or drainage at the site
  • Streak formation along the vein

Thrombus formation

Any catheter that is inserted will be at risk for thrombus formation and then embolism.

Maintenance

  • 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. Keep in mind 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 pressures on the side of the line.
  • Always protect the catheter from tugging. 

According to healthypeople.gov the most common HAIs include:

  1. Catheter-associated urinary tract infections
  2. Surgical site infections
  3. Bloodstream infections
  4. Pneumonia
  5. C. diff

CLABSI or Central Line-Associated Bloodstream Infections account for thousands of deaths a year and million dollars in added costs to the healthcare system. 

https://www.cpc.mednet.ucla.edu/sites/default/files/Refresher131112/Day1/Transition/LinesTubesPorts.pdf

https://www.google.com/search?q=how+often+should+you+change+a+central+dressing&rlz=1C5CHFA_enUS947US948&oq=how+often+should+you+change+a+central+dressing&aqs=chrome..69i57j0i22i30j0i390.9250j0j4&sourceid=chrome&ie=UTF-8

https://www.jointcommission.org/-/media/tjc/documents/resources/health-services-research/clabsi-toolkit/clabsi_toolkit_tool_1-3_pictures_of_central_venous_catheters_fpdf.pdf 

https://www.azuravascularcare.com/infodialysisaccess/difference-between-cvc-and-picc/ 

https://www.healthypeople.gov/2020/topics-objectives/topic/healthcare-associated-infections