Steps to Moving on From Your Current Healthcare Provider
If you’ve been around long enough, you’ll know that change is a constant in life. People come,
and people go; perhaps your doctor is one of those individuals. From Cup Of Nurses, here’s
how to move on to a new healthcare provider if this is the case.
Check their credentials
Apart from checking the credentials of your next doctor to see that they have the relevant skills
and education, you’ll also want to check that their area of expertise is a close match to what
you’re looking for and need in a healthcare provider.
Check how soon they’ll be able to squeeze you in
If you have been referred to a doctor by your current health practitioner, there is probably a
high chance that they are well in demand. And while this may be a positive thing because it
points to how popular they are, it may also be challenging for them to take on a new patient
simply because their schedule might be jam-packed. Therefore, you may want to keep your
option open, i.e., look out for other healthcare providers who can accommodate patients outside
regular office hours.
How much can you afford?
It might be a good idea to reassess your budget to see if you can afford to increase your
insurance premium if need be. If not, then eHealth notes that sticking with ‘in-network’ doctors
may be the most financially sound decision. However, if you’re a freelancer or self-employed,
you could take advantage of affordable healthcare coverage if you join a Freelancers Union or
your Chamber of Commerce.
Keeping your documents up to date
It will also be helpful to ensure your medical documents are always up-to-date and ready for
when you find your ideal match. If your documents are difficult to find because they are in
multiple places on your computer, then a tool that converts various file formats like Word to PDF
might help. With this tool, a PDF converter will let you convert from other files so you can select
only the PDF pages you wish to use and then combine them into one file, making this easier to
find when you need it.
Meet them before you make a decision
If you want to get a more accurate picture of what your doctor-patient relationship will be like,
then there’s no better way to do this than an in-person meeting. This way, you can assess
whether your interaction with each other shows the potential to progress into the type of
doctor-patient relationship you desire it to be.
Don’t feel pressured to rush the process
The National Institute on Aging points out that when it comes to choosing a doctor you’ll feel
comfortable around for years to come, you need to be absolutely sure about your final choice.
Therefore, don’t put pressure on yourself to rush the process. Instead, use all the resources
around you to help expedite the search if time is of the essence.
Apart from asking your doctor for any referrals, you could also use your own network to ask around and see who comes out on top as far as recommendations from friends and family go. Reach out to past acquaintances in the area, especially those who are around the same age as you, to see if they’d recommend their primary care doctor or another reputable physician. A great place to start is with old schoolmates.
Certainly, finding a new doctor when you’re used to your current one will probably feel a little
unsettling at first. Making sure you can afford the healthcare provider you want should help remove some
of the worry associated with this stressful search.
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Nurses are resilient beings. Out of all professions, nurses have the most contact with the sick. They constantly face difficult situations regarding patient care, comforting families, and communicating with healthcare providers to deliver quality patient care. Nurses are there, ever-present, and ready to help because they love their jobs. But who takes care of the nurses? What happens when nurses are battling their mental health issues?
What Causes the Stress in Nurses?
Being a nurse is both physically and psychologically demanding. The amount of stress is always high at any given shift. All of which can affect the mental health of nurses. But what are the causes of these stresses?
Long shift hours
Some hospitals run short of nurses, and because of this, many nurses must extend their working hours to provide round-the-clock patient care. This includes overnight shifts, which could take around 12-16 hours. working hours affect the natural sleeping pattern. It leaves them feeling fatigued and exhausted even before their actual shift starts. Although nursing is a 24-hour job, there are no resources to help nurses. The expectation is to figure it out and show up.
Heavy workload
The increase in demand for health care services and the number of nurse retirees are among the many reasons why the usual workload of many nurses doubled. This situation has forced many hospitals and healthcare settings to function with skeleton crews. As a result, this makes the workload for existing nurses much heavier. The lack of nursing staff leads to picking up overtime, further increasing their weekly workload and leading to burnout.
Death of a patient
Losing a patient can also take a toll on nurses. It is one of the most challenging parts of this job, especially when the nurse and patient form a bond. Although some nurses understand that they will lose some of their patients, it can still affect a nurse’s emotions. After all, nurses are human beings too. Nurses face a constant emotional toll. They work with people in some of the worst times of their lives; no one ever wants to be in a hospital. Nurses feel those emotions, and it can be hard to separate them. While nurses are resilient, there is only so much they can take.
Bullying at workplace
Nurses also experience bullying at work. It usually comes from co-workers with seniority privileges and even patients. A toxic workplace and coworkers can impact a nurse’s mental health. Sometimes nurses forget that their coworkers are human too. The expectations are high, and some nurses forget that they don’t always know what they know now.
Safety and health concerns
The lack of adequate personal protective equipment, as seen during the Covid-19 pandemic, inadequate staffing of nurses, and insufficient resources can cause safety and health concerns. When hospitals do not provide nurses with protection during a health crisis or an adequate amount of staff, stress is inevitable. It also puts the health and safety of nurses at risk, putting the healthcare system in an even deeper hole.
How can nurses manage stress?
Stress will always be present no matter what we do; the key is to learn how to manage it more effectively.. . Here are good examples of what you can do when you feel stressed at work:
Aromatherapy has proven to be effective in calming the nerves. It also reduces anxiety. Essential oils like lavender can help lower stress, so having a diffuser at work can help. Smelling something that’s nice will always boost your mood, even if you are not a big believer in aromatherapy.
Eating healthy can also help lessen stress. Start eating more fruits and vegetables to help increase your energy. Caffeine is helpful, but make sure not to overdo it. . It would also help to keep yourself hydrated by drinking lots of water, especially if you have long shifts. The rule of thumb is to drink half of your body weight (in pounds) in ounces of water before your 12-hour shift. But if you can’t drink all that water, bring some to work.
Be sure to engage in activities that help stimulate your mind, like puzzles, crosswords, or books. It helps reset your mind and keeps it busy but in a healthy and enjoyable way.
Take time out to meditate. Align your thoughts and mind to focus on what you need to do. A good 10-minute break to meditate will help shift your mind into a better place and lifts your brain fog.
Lastly, get enough sleep. Adjust your sleep schedule to get at least 6-8 hours of sleep each night, and try to sneak in a nap during the day or your shift. It will help improve your concentration and reduces the risk of making impulsive decisions. When your mind has rested, it can help you see things more clearly.
When Should Nurses Seek Help for Their Mental Health?
Stress is almost synonymous with being a nurse. It comes with the job, and while many can adjust, some find it difficult to ask for help. So, when should you ask for help? Nurses are resilient people, but burnout can also take a toll on them.
Nurses should seek help once they’ve developed these signs and symptoms:
Rapid heart rate
Muscle tension
Headaches or frequent migraines
Difficulty breathing
Having nightmares
Trouble sleeping for days
Quick to anger or irritability
Feelings of guilt
Confusion or trouble concentrating or staying focused
Have difficulty remembering instructions
Being forgetful
Nurses with more pronounced mental health issues may also experience depression, inability to cope, and social withdrawal. They may also feel compassion fatigue or experience burnout, leading to a lack of empathy for patients. When you’ve experienced these symptoms, seeking professional mental health assistance or support would be best.
What are the lab values to know as a nurse? Lab values and what they show could mean so many things. They are used to determine the patient’s overall well-being and health and on nurses to base their care plan. Different factors affect the patient’s lab values result, but the most common factors affecting it are the patient’s age, race, gender, medical history, and presence of any underlying conditions. Knowing and understanding lab values is essential in your nursing career.
There are different lab values to know as a nurse. In this episode, we will talk about all the different labs we look at in the hospital. We will go over their normal values, what they signify, and what can happen if they are out of their normal range.
This will be a good refresher episode for everyone who deals with labs and a great one for any nursing students because these are the labs you’ll need to know to pass some of your classes and the NCLEX.
Electrolytes
Potassium K+
Potassium is one of the most important minerals in the body. It helps regulate fluid balance, muscle contractions, and nerve signals.
Normal level: 3.5-5 mEq/L
Hyperkalemia signs: heart arrhythmias, numbness, and tingling, breathing problems
Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance.
It is a mineral that is necessary for life. In addition to building bones and keeping them healthy, calcium enables our blood to clot, our muscles to contract, and our heart to beat. About 99% of the calcium in our bodies is in our bones and teeth.
Normal level: 8.5 to 10.2 mg/dL
Hypercalcemia signs: bone pain, muscle weakness, excessive thirst, lethargy, nausea
Hypocalcemia signs: numbness and tingling in digits, muscle cramps, wheezing, fatigue
Clinical problem
Increased level: Hyperparathyroidism, malignant neoplasm of bone, lung, breast, kidney, multiple myeloma, and prolonged immobilization.
Decreased level: Diarrhea, malabsorption of calcium, Hypoparathyroidism
Chloride CI-
Chloride is one of the essential electrolytes in the blood. It helps keep the amount of fluid inside and outside of your cells in balance. It also helps maintain proper blood volume, blood pressure, and pH of your body fluids.
It helps to maintain normal nerve and muscle function, supports a healthy immune system, keeps the heartbeat steady, and helps bones remain strong. It also helps adjust blood glucose levels. It aids in the production of energy and protein.
Normal level: 1.5-2 mEq/L
Hypermagnesemia: diminished deep tendon reflexes, flushing, headache, nausea, drowsiness.
Hypomagnesemia: muscle weakness, twitches, or tremors; irritability, insomnia, drowsiness
Clinical problem
Increased level: Severe dehydration, renal failure, leukemia
Decreased level: Protein malnutrition, malabsorption, cirrhosis of the liver, alcoholism, hypokalemia
Phosphorus
It is a mineral that makes up 1% of a person’s total body weight. It is the second most abundant mineral in the body. It is present in every cell of the body. Most of the phosphorus in the body is found in the bones and teeth.
Decreased level: Severe liver damage, overhydration, malnutrition
Specific Gravity
A urine-specific gravity test compares the density of urine to the density of water. This quick test can help determine how well your kidneys dilute your urine.
Normal level 1.010-1.030
High signs: Dehydration, Diabetes, Proteinuria, SIADH
Low signs: Polydipsia, Diabetes Insipidus, Diuretics, early stages of CKD
LDH
Lactic dehydrogenase (LDH) is an intracellular enzyme in nearly all metabolizing cells, with the highest concentration in the heart, skeletal muscle, liver, kidney, brain, and RBCs.
Hemoglobin responsible for the transportation of oxygen
Normal level
male 13-17 g/dL
female 12-15 g/dL
Increased level: Dehydration, polycythemia, COPD, HF, severe burns
Decreased level: Anemias, Hemorrhage, cirrhosis of the liver, Leukemias, Hodgkin’s disease, kidney disease
Hematocrit
The hematocrit is a ratio of the volume of red blood cells to the volume of all these components, called whole blood. The value is expressed as a percentage or fraction.
Normal level Male 40%-52% Female 36%-47%
Increased level: Dehydration/hypovolemia, severe diarrhea, diabetic acidosis, burns.
Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem or if your blood doesn’t clot properly.
Normal level 25-35 sec. If on Heparin 1.5-2.5x normal
Increased level: Hemophilia, cirrhosis, vitamin k deficiency, Von Willebrand disease, DIC.
PT
Prothrombin Time. It is synthesized by the liver and is an inactive precursor in the clotting process.
The international normalized ratio (INR) is a laboratory measurement of how long it takes blood to form a clot. It is made to monitor patients receiving warfarin.
Normal level 0.9-1.2 If on Coumadin 1.5 – 3
Reticulocytes
Reticulocytes are immature red blood cells (RBCs).
Normal range 0.5-1.5%
Neutrophils
Are the most numerous circulating WBCs, respond mainly to inflammation & tissue injury.
Normal range 2-8 x 10^9/L
Bands
Basophils increase during the healing process
Basophils are white blood cells that defend your body from allergens. Basophils release histamine
Normal Range < 1 x 10^9/L
Lymphocytes
Increased during chronic and viral infections
Normal range 1-4 x 10^9/L
Monocytes
The second line of defense. More extensive and more substantial than neutrophils can ingest large particles and debris.
Normal range 0.2-0.8 x 10^9/L
Eosinophils
Increase during allergic and parasitic conditions
Normal level < 0.5 x 10^9/L
HBA1C
The hemoglobin A1c test tells you your average blood sugar level over the past 2 to 3 months. It’s also called HbA1c, glycated hemoglobin test, and glycohemoglobin.
Normal level <6.5%
Glucose
Simple sugar is used as an energy source and is stored as glycogen in the liver and skeletal muscles.
Bilirubin is formed from the breakdown of hemoglobin by the reticuloendothelial system and is carried in the plasma to the liver. Bilirubin (unconjugated or indirect) is bound to serum albumin and transferred to the liver, which is conjugated to glucuronate by glucoronyl transferase. Conjugated (direct) bilirubin is excreted into the bile.
Normal level
Direct Bilirubin 0-6 µmol/L
Total Bilirubin 2-20 µmol/L
Increased level: Obstructive jaundice caused by stones, hepatitis, cirrhosis, liver cancer
Decreased level: Iron-deficiency anemia.
Albumin
Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn’t leak into other tissues. It also carries various substances throughout your body, including hormones, vitamins, and enzymes.
Normal level 35-50 g/L
Increased level: Dehydration, severe vomiting, severe diarrhea
Decreased level: Cirrhosis of the liver, acute liver failure, severe burns, severe malnutrition, preeclampsia, renal disorders, prolonged immobilization.
ALT/AST
ALT/AST is an enzyme found primarily in the liver cells and is effective in diagnosing hepatocellular destruction.
Normal level 5-30 U/L
Increased level: Acute (viral) hepatitis and liver necrosis (Drug or chemical toxicity).
Amylase
Amylase is an enzyme derived from the pancreas, the salivary glands, and the liver. Its function is to change starch to sugar.
Normal level: 30-125 U/L
Increased level: Acute pancreatitis, obstruction of the pancreatic duct, acute cholecystitis, diabetic acidosis, diabetes mellitus, renal failure.
Lipase
Lipase, an enzyme secreted by the pancreas, aids in digesting fats. Appears in the bloodstream following damage to the pancreas.
Normal level: 10-150 U/L
Increased level: Acute and chronic pancreatitis, cancer of the pancreas, and obstructions.
Hormones
Hydroxyprogesterone
IHydroxyprogesterone is a hormone made by the adrenal glands, two glands on top of the kidneys. A 17-OHP test is used for Hydroxyprogesterone levels to help diagnose a rare genetic disorder called congenital adrenal hyperplasia.
Normal level: 0.2-1 mg/L
Adrenocorticotropic ACTH
Adrenocorticotropic hormone (ACTH) is made in the pituitary gland. It is needed for your adrenal glands to work properly and help your body react to stress. ACTH stimulates the release of another hormone called cortisol from the adrenal gland’s cortex (outer part).
Congenital adrenal hyperplasia (CAH) refers to a group of genetic disorders that affect the adrenal glands, a pair of walnut-sized organs above the kidneys. The adrenal glands produce essential hormones, including Cortisol, which regulates the body’s response to illness or stress.
TSH
Thyroid-stimulating hormone is a pituitary hormone that stimulates the thyroid gland to produce thyroxine (T3), and triiodothyronine (T4) which stimulates the metabolism of almost every tissue in the body.
Serum T4 levels are commonly used to measure thyroid hormone concentration and the function of the thyroid gland.
So, if your T3 and T4 levels are too low, the pituitary gland will release more TSH. If they’re too high, the gland will release less TSH — but this give-and-take system only works if everything functions properly.
Decreased level: Hypothyroidism, Protein malnutrition.
Follicle-stimulating hormone
FSH, a gonadotropic hormone produced and controlled by the pituitary gland, stimulates the growth and maturation of the ovarian follicle to produce estrogen in females and promote spermatogenesis in males.
Normal level:
(FSH) 1-10 IU/L (M/F)
5-25 IU/L (ovulation)
30-110 IU/L (postmenopause)
Increased level: Gonadal failure such as menopause, Pituitary tumor, Turner’s syndrome, Klinefelter’s syndrome
Decreased level: Neoplasms of the ovaries, testes, adrenal: polycystic ovarian disease, hypopituitarism; anorexia nervosa.
Growth Hormone
Human growth hormone (hGH), a hormone from the anterior pituitary gland, regulates the growth of bone and tissue.
Normal level: (fasting) 0-5 ng/m
Increased level: Gigantism (children), Acromegaly (adults), major surgery.
Decreased level: dwarfism in children, hypopituitarism
Progesterone
It is secreted by the corpus luteum, a temporary endocrine gland that the female body produces after ovulation during the second half of the menstrual cycle.
Normal level 70-280 ng/dL
Increased level: Ovulation, pregnancy, ovarian cysts, tumors of the ovary or adrenal gland.
It is a hormone produced by your pituitary gland, which sits at the bottom of the brain. Prolactin causes breasts to grow and develop and causes milk to be made after a baby is born.
Testosterone is the primary male sex hormone and an anabolic steroid. In male humans, testosterone plays a crucial role in developing male reproductive tissues such as the testes and prostate and promoting secondary sexual characteristics such as increased muscle and bone mass and body hair growth.
Normal level: 10-25 nmol/L
Increased level: Adrenal hyperplasia or tumor, polycystic ovaries in females
LDL stands for low-density lipoproteins. It is sometimes called the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
Normal level: 85-125 mg/dL
Saturated fat and cholesterol in your food make your blood cholesterol level rise.
HDL
HDL stands for high-density lipoproteins. It is sometimes called the “good” cholesterol because it carries cholesterol from other parts of your body to your liver. Your liver then removes the cholesterol from your body.
Normal level: 40-80 mg/dL
Triglycerides
Triglycerides are a type of fat (lipid) found in your blood. When you eat, your body converts any calories it doesn’t need to use right away into triglycerides. The triglycerides are stored in your fat cells.
Decreased level; Hyperthyroidism, hyperparathyroidism, and protein malnutrition.
Total chol
A measure of the total amount of cholesterol in your blood. It includes low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol.
Normal level: 3-5.5 mmol/L
Cardiac Markers
Creatine kinase
Creatine kinase is an enzyme found in the heart, brain, skeletal muscle, and other tissues. Increased amounts of CK are released into the blood when there is muscle damage.
Normal level: 25-200 U/L
Increased level: exercise and inflammation of muscles, called myositis, and myopathies such as muscular dystrophy. Rhabdomyolysis.
Troponin
Troponins are a group of proteins found in skeletal and heart (cardiac) muscle fibers that regulate muscular contraction—used for cardiac disease diagnosis of acute MI.
Normal level: 0-0.4 ng/mL
Increased level: MI, myocardial damage
C-reactive protein
It is produced in the liver in response to tissue injury and inflammation.
D-dimer is a fibrin degradation product, a small protein fragment in the blood after a blood clot is degraded by fibrinolysis.
Normal level: < 500 ng/mL
Increased level: DIC, P.E, Thrombosis, COVID
BNP
Brain Natriuretic peptide is a neurohormone secretion primarily in the cardiac ventricles and will increase in response to volume expansion and pressure overload.
Serum alpha-fetoprotein (AFP), a screening test, is usually done between 16 and 20 weeks gestation to determine the probability of twins or to detect low birth weight or severe birth defects, such as neural-tube defects.
Normal level: 0-44 ng/mL
Increased level: Cirrhosis of the liver, hepatitis, Spina bifida, Fetal death, fetal distress, Turner’s syndrome
Decreased level: Down’s syndrome, absence of pregnancy
HCG
Human chorionic gonadotropin is a hormone produced by cells that surround a growing embryo, which eventually forms the placenta after implantation. The presence of hCG is detected in some pregnancy tests. Appears in the blood and urine 14-26 days after conception.
Normal level: <5 IU/I
Increased level: Pregnancy, Chorionepithelioma of pregnancy is a malignant tumor originating in connection with pregnancy.
Decreased level: Nonpregnant, dead fetus, postpartum (3-4 days)
CA 19-9
Cancer Tumor Markers (CA 19-9) is a cancer antigen in diagnosing pancreatic, hepatobiliary, gastric, and colorectal cancer.
Normal level: <40 U/mL
Decreased levels = Effective response to treatment, benign disease
There are also different tumor markers. You won’t need to know all of these, but we thought we should include them.
CA 15-3: Metastatic breast cancer, ovarian, lung, pancreas, cirrhosis, colon cancer.
CA-27.29: Recurrence of breast cancer
CA 50: Gastrointestinal tumor, biliary tract tumors
CA 125: Ovarian breast cancer, uterine tumors, pancreas, breast, colon, lung, cirrhosis, pancreatitis.
CEA
Carcinoembryonic antigen (CEA) has been found in the gi epithelium of embryos and has been extracted from tumors in the adult gastrointestinal tract.
Normal level: <4 ug/L
Increased level: GI tract (esophagus, stomach, small and large intestine, rectum cancer), leukemia, Ulcerative colitis.
PAP
Prostatic acid phosphatase (PAP) originates in the prostate and usually is present in small amounts in the blood.
Normal level: 0-3 U/dL
Increased level: prostate cancer, testicular cancer, leukemia, and non-Hodgkin’s lymphoma.
PSA
Prostate-specific antigen (PSA) is always present in low concentrations in the blood of adult males.
Normal level: <4 ug/L
Increased level: Prostate cancer
Vitamins
Folate
Folate is one of the B vitamins needed to make red and white blood cells in the bone marrow, convert carbohydrates into energy, and produce DNA and RNA.
Normal level: 7-36 nmol/L
Increased level: Pernicious anemia (is a deficiency in red blood cells caused by lack of vitamin B12)
It is a Fat-soluble vitamin absorbed from the intestine in the presence of lipase and bile. Vitamin A moves to the liver and is then stored in the body as retinol.
Vitamin A is vital for normal vision, the immune system, reproduction, and growth and development.
Decreased level: Night blindness, liver, intestinal, or pancreatic disease, chronic infections, cystic fibrosis, protein malnutrition, malabsorption, celiac disease
Vitamin B6
Vitamin B6, also known as pyridoxine, is a water-soluble vitamin your body needs for several functions. It’s significant to protein, fat, and carbohydrate metabolism and the creation of red blood cells and neurotransmitters.
Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia.
Ascorbic acid is a water-soluble vitamin important for forming collagen and certain amino acids for wound healing and withstanding stress, injury, and infection.
Normal level: 0.4-1.5 mg/dL
Decreased levels: Scurvy, malabsorption, pregnancy, cancer, and severe burns.
Vitamin D
Vitamin D is a fat-soluble vitamin occurring from exposure to the ultraviolet rays of sunlight and is absorbed in the presence of bile and stored in the liver. Vitamin D helps regulate the amount of calcium and phosphate in the body. These nutrients are needed to keep bones, teeth, and muscles healthy.
Normal level: 5-75 ng/mL
Decreased level: Malabsorption, cirrhosis of the liver, rickets, osteomalacia, hypoparathyroidism, celiac disease, inflammatory bowel disease
Miscellaneous
Rheumatoid Factor
RF factor is a screening test used to detect antibodies (Igm, IgG, or Ig)
An erythrocyte sedimentation rate (ESR) is a type of blood test that measures how quickly erythrocytes (red blood cells) settle in unclotted blood in millimeters per hour.
It can show if you have inflammation in your body.
6 Things That Will Happen When We Don’t Have Enough Nurses
The nursing shortage has been an ongoing issue for many years, but this is all propaganda. We now know that there is no real shortage of nurses. But then again, what will happen if we are short on nurses? What happens when there are not enough nurses in the healthcare field? Here are six things that will happen.
When Nurses Disappear
Nurses are the jack of all trades in the healthcare industry. They do almost everything. From completing their front desk duties to transferring patients, and laboratory work, nurses, are there, working all the time. But when nurses are gone, will the world still be the same? Six things could happen when nurses are no longer here to do their job.
There will be more burnouts
When there are not enough nurses, more nurses are compelled to work more and stay on longer shifts. There’s no more downtime, and spending time with their family and friends is little to none. Tasks will pile up, and the remaining nurses will feel overwhelmed. This will drain them more to the point that they are no longer happy to do their job. In time, they will also quit, leaving fewer nurses to do the same routine and heading to the same route as their former colleagues. If no more nurses are left, this cycle will continue until no one is left to care for the sick and dying.
Low-quality patient care
Burnout causes nurses to lose patience quickly. When you’re always tired, dealing with difficult patients is challenging. And worse, burnout nurses won’t bother getting to know their patients or their cases any longer. This could affect the kind of care they give to their patients. And as a result, this could lead to poor quality care and many problems for patients and nurses.
More medical errors
No other healthcare professional stays with the patient longer than nurses. We are the ones who take care of the patient when the doctors are not around, and we make sure that all of them are taken care of. But what happens when a nurse is burned out? Tending to one patient can take around 15-20 minutes tops.
If you have ten patients waiting in line for their medication, you must take time and assess each medication so the right one goes to the correct patient. And when you’re a burned-out nurse, you could miss a small yet important detail about your patient’s medication. It can cost your patient’s life and your job on the line.
Low patient satisfaction
A burned-out nurse cannot provide quality patient care, leading to low patient satisfaction. The lack of available nurses can also affect this; many patients will feel like they are not given the care they came to the hospital for.
High mortality rate
Nurses are the ones who care for the sick and dying. When there are not enough nurses on the floor, emergency patients will be forced to wait longer. Emergency services will be delayed, and medical assistance will also be slow. We know that time is of the essence, especially when it comes to critical patients. When nurses are burned out, the lives of our patients are at stake.
Animosity among nurses
A short-staffed hospital means more work for the remaining nurses. This puts them under a lot of pressure and stress. And when stress takes over, peer relationships can get strained easily. Misunderstandings, like a simple bathroom break, coming in a few minutes late for work, or late endorsements, become a big deal to each other.
Your Takeaway
There is no nursing shortage if healthcare facilities take care of their nurses. Providing them with the help they need when they’re feeling down, like counseling or some needed time off, will make a difference. Nurses are not robots; we must take care of them. If we want nurses to be around longer and happier, we must find a way to help them too.
The renal system produces, stores, and eliminates urine. Kidneys make urine by filtering wastes and extra water from the blood. Urine travels from the kidneys through two thin tubes called ureters and fills the bladder. When the bladder is full of urine, a person urinates through the urethra to eliminate the waste.
Functions of the Kidneys
The kidneys are located on either side of the spine at the lowest level of the rib cage, consisting of the functional unit called a nephron.
There are about one million nephrons in each kidney, consisting of tiny blood vessels called a glomerulus attached to a tubule.
When blood enters the glomerulus, it is filtered, and the remaining fluid passes to the tubule. In the tubule, minerals, elements, chemicals, and water are absorbed or filtered according to the body’s needs to create the final product, urine.
Maintain fluid status balance in the body by holding or retaining water and releasing and removing water from the bloodstream
It maintains the electrolyte balance of the blood.
Maintain acid-base/pH balance of the blood
Assist with endocrine functions such as the production of erythropoietin and calcitriol.
It is needed to produce red blood cells and calcium reabsorption, respectively.
Produce the enzyme renin
Help regulate blood pressure.
Convert vitamin D into its active form
Fun Fact:
Every 24 hours, your kidney filters 200 quarts of fluid. About two quarts are removed from the body, and 198 quarts are returned to the bloodstream.
The right kidney sits lower than the left kidney.
It helps accommodate the large size of the liver, right above the right kidney.
We call it REabsorption rather the just absorption because the substances filtered from the glomerulus were already absorbed through the GI tract and taken into the bloodstream. Then the substances travel through the body via the heart and are sent to the kidneys through the renal artery to be filtered out. Therefore, our body reabsorbs these nutrients based on their needs, and the leftovers are excreted in the urine.
Anatomy of the Kidney
As a nurse and a nursing student, you’ll need to know these most critical parts of the kidney to understand how the renal system works.
Renal Capsule
The outer layer of the kidney protects the kidney from outside organ infections.
Renal cortex:
A layer outside contains the renal corpuscles, which house the glomerulus and Bowman’s capsule, whose primary functions are to FILTER the urine and renal tubules.
The Renal medulla:
The inside layer is located within the renal pyramids. It is hypertonic and very salty. Along with the nephron, these conditions help maintain water and salt balance in our body, specifically the Loop of Henle.
Renal artery:
The renal artery takes oxygenated blood from the heart and moves it to the kidney to be filtered. It branches around the renal columns into the renal cortex, arterioles, and finally to the peritubular capillaries.
Renal vein:
The renal veins take filtered blood to the heart for re-oxygenation and are pumped throughout the body. It comes from the efferent arterioles.
The Renal pyramids:
Lie Within the renal medulla contains the loop of Henle and parts of the collecting tubule.
Renal papilla, minor and significant calyx:
Pointed projections of the renal pyramid play a role in draining urine along with the renal pelvis, ureters, bladder, and urethra.
Nephrons:
The functional part of the kidneys.
Filters the blood via the renal corpuscle
Reabsorbs minerals/water and secretes waste via the renal tubule
Produces urine which drains down into the ureters, is stored in the bladder, and voided out via the urethra.
Each nephron is composed of
Renal corpuscle (glomerulus within Bowman’s capsule)
Proximal tubule
An intermediate tubule (loop of Henle)
A distal convoluted tubule, a connecting tubule, and cortical, outer medullary, and inner medullary collecting ducts.
Glomerulus:
Lies within the nephron
Circular capillaries that have incredibly high pressure helps perform ULTRAFILTRATION.
In the glomerulus, blood will be filtered, and filtrate will be created, a liquid consisting of the collection of fluid and particles from the blood. The filtrate will “drip” down into a capsule surrounding the glomerulus called Bowman’s capsule.
Bowman’s capsule collects the filtrate.
Water, NA, CL, CA, K, Mg, Phos, Bicarb, amino acids, glucose, creatinine, and urea.
Then the filtered blood exits via the efferent arterioles to the peritubular capillaries surrounding the nephrons.
Peritubular capillaries carry the reabsorbed nutrients from the filtrate back into the body’s system to the renal vein. They secrete urea, ions, and drugs in the blood into the tubules.
The created filtrate then flows through the proximal convoluted tubule (PCT); here, the tubule reabsorbs most of the parts of the filtrate that we need to function that just came from the Bowman’s capsule.
Then the filtrate enters the Loop of Henle; we are now in the renal medulla. The loop of Henle has a descending limb and ascending limb. Its goal is to concentrate the urine via the renal medulla. The renal medulla’s interstitial fluid is hypertonic, helping reabsorb water from the filtrate to maintain the body’s water and salt balance.
Descending limb is only permeable to water.
Ascending limb is only permeable to ions.
The filtrate enters the distal convoluted tubule, where more substances are reabsorbed and secreted.
Then it travels to the collecting tubule, where parts of the filtrate are reabsorbed. Finally, the filtrate leaves the collecting tubule as urine which flow through the renal papilla, minor/major calyx, renal pelvis, ureters, bladder, and urethra.
Kidney and Blood Pressure Management
The renin-angiotensin-aldosterone system (RAAS) is the system of hormones, proteins, enzymes, and reactions that regulate your blood pressure and blood volume long-term.
It regulates your blood pressure by increasing sodium (salt) reabsorption, water reabsorption (retention), and vascular tone (the degree to which your blood vessels constrict or narrow). The RAAS consists of three major substances including:
Renin (an enzyme).
Angiotensin II (a hormone).
Aldosterone (a hormone).
RAAS System
Increases blood pressure when it drops too low by activating Angiotensin II
Angiotensin II increases vasoconstriction, causing an increase in blood pressure. Conserves sodium and water to increase volume. Aldosterone and ADH are released.
The sympathetic nervous system sends nerve impulses to Juxtaglomerular Cells in the kidneys to release RENIN.
RENIN present in the blood will activate ANGIOTENSINOGEN in the liver.
ANGIOTENSINOGEN then turns into ANGIOTENSIN I causing a release of ACE
ACE is Angiotensin-Converting Enzyme. ACE converts Angiotensin I into ANGIOTENSIN II
ANGIOTENSIN II activation will cause
Vasoconstriction
Increases systemic vascular resistance (SVR) and blood pressure.
Increase Blood Volume
Kidneys will keep water and sodium.
The adrenal cortex gland will be triggered by angiotensin II to release aldosterone. Aldosterone will also cause the kidneys to keep sodium and water and excrete potassium.
Angiotensin II triggers the pituitary gland to release ADH. It causes the kidneys to keep water.
2. Increased blood pressure
To learn more about the renal system, click here for the full episode 👇👇👇
TIMESTAMPS:
00:00 Introduction 02:10 The functional parts of the kidney 03:18 What does a kidney do 04:40 Kidney fun facts 05:40 Anatomy of the kidney 10:00 The nephron and blood supply 15:48 Kidney and blood pressure management 17:39 How the Renin-Angiotensin-Aldosterone System (RAAS) works 21:50 Further views on the episode 24:02 Wrapping up the show
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