Sherry A. Holden, BSN, RN, Associate Partner

Sherry A. Holden, RN, BSN, Associate PartnerSherry has worked for Clarian for over 15 years, and currently works as a bedside nurse on the 4-Medicine unit at IU - a 48-bed unit with several medical specialities: renal, including hemodialysis, CAPD & next stage patients, pulmonary, hepatology, GI, including a very specific ERCP service, general medicine, endocrinology, and neurology. She has served in managerial roles, but her first love has always been bedside patient care.

“When I was 3 years old, I declared to the world, "I am going to be a nurse" and I’ve never looked back. I have been a registered nurse for 41 years. I started my career as a "cleaning lady" in a nursing home and advanced to a nursing assistant during my high school years. Then I went to college, and the rest is nursing history!”

Sherry spends as much of her free time as possible with her children and grand-children. She loves to garden (“in my mind I am a master gardener, but in reality I am more of a master "putterer"). She enjoys reading, writing and traveling, and can be perfectly content just watching people for long periods of time!

You can read more about where Sherry works at Clarian's ACallToChange.org website: Find Registered Nurse Jobs in Indiana

Nurses, Go for the Gold!

Wednesday, February 24, 2010 by Sherry Holden, BSN, RN, Associate Partner

Like most of you, I have been watching the Olympics. Every venue has its awe - except Curling. I don’t seem as thrilled about a broom and a stone as I do watching Shaun White fly out of the half pipe! I suppose the badgers and the Canadians would disagree. I imagine that is part of the lure of the Games - we all have our preferences. One thing I am acutely aware of is the training and commitment required of each of these athletes. It is truly amazing. I heard the interview with Apolo Anton Ohno regarding his regime and agreed with Brian Williams’ over-all assessment when he said, “These people have DNA that the rest of us do not have”! Apolo not only talked about his preparation but he talked about his goals. He has daily, weekly, monthly, and yearly goals that culminate with the ultimate prize that happens every four years.

I’ve been thinking about goals. Without them, it seems life just happens. In reality, perhaps I could be a curler in the next Olympics - if I start soon. Or, maybe, I could just get my life in order and have a goal for the day! Clarian has been presenting Forums this month about our accomplishments and goals on the road to preeminence and I have the new Joint Commission goals ever present on my name tag. Every day when I arrive at work, I set up a care of plan for each patient that contains two goals for the day. It seems everyone has goals but me.

I did a random, non-scientific pole of my peers the other day and asked the simple question, “What is your goal for today”? Responses:

  • Survive - be happy - keep my patient from falling.
  • Get through the day! Keep my sickle cell happy and my other patient’s wife from being mad at me.
  • To leave here and go home happy.
  • Get out on time.
  • To be organized and not become stressed-out.
  • Do no harm.


I guess I am a bit naïve. I thought someone would say, “I have been reviewing the Synergy Model for Patient Care and my goal for the day, probably the week, is to enhance my communication skills and become consciously aware of the manner in which I interact with people.” That didn’t happen. I didn’t even come up with that idea until right now. But, I think it is a stellar goal.

This whole goal business has me thinking, planning and pondering. For starters, I have set my retirement date. It will come before the next Winter Olympics; the next Magnet Review; and the end of the Mayan calendar. But, sadly, I will not see the day that 4-medicine has all private rooms! So, what do I want to accomplish? My time is limited. Lately, I have had goals like those above: be safe, get out on time, survive! I’m wondering if there isn’t something more? What is it that I would like to do before I end a nursing career spanning four decades?

And, my questions to you are the same, whether your career is just starting, waning, or coasting: What are your goals? What do you want to accomplish? Is there something more? What is it that you really want to do? I say, go for the Gold!

Sherry

To be a registered nurse at Clarian, visit Registered Nursing Position Indiana.

Beyond Schatzki to Maglinte

Wednesday, January 20, 2010 by Sherry Holden, BSN, RN, Associate Partner
This is a multi-faceted blog. I think I know the point I want to make but the angles have the possibility of aligning under these categories:
  • Just When You Think You Know Something
  • Gerontological Bliss
  • Lifelong Learning
  • Medical Nursing: Priceless
This week, I met the most delightful 90-year-old woman, who has been married to a most delightful 96-year-old man for 61 years. Naturally, I was delighted! I have enjoyed every minute I have had the privilege of caring for her. She is bright, witty, engaged, and very interested in whatever I was up to regarding her care and my days in general. At this point in time, her life is getting very complicated and there are many decisions to be made. I could continue with several little vignettes regarding Ms. N, so you could be delighted too, but I am now going to make an abrupt detour to one of her maladies known as Schatzki ring.

It was 0630. It’s not always easy for me to engage my brain at that time of day. I was reading history notes on my patients and discovered one of them has a Schatzki ring. I drew a blank. Then, for some odd reason, I thought “Final Jeopardy” and I end up with no money because I bet it all on medicine and suffer a terrible defeat at the hand of the Schatzki ring. So I place this on my “need to know list” and begin the day feeling a bit more ignorant than when I started.

A quick look-up reminded me that a Schatzki ring is simply a ring of tissue that forms where the esophagus and stomach meet. A little dilation now and then seems to work wonders for most people. One would think that would placate my curiosity but I started to wonder, “who is Schatzki and how does someone get a piece of tissue named after them?" So I read a condensed Google version of his biography, and I found it to be quite fascinating.

First of all, Richard Schatzki was born in Germany, not Poland. Having lived in Wisconsin, I thought I could tell the difference based on spelling: wrong. As a GI/Liver nurse, I was particularly interested in learning that “in 1931 he presented the first in-depth discussion of esophageal varices and the initial description of gastric varices.” Varices have been my life for 30 years! Why have I not equated it with Schatzki? He also described that esophageal ring in great detail so, of course, his name is attached to it. That is just the tip of his iceberg. This man has made an incredible contribution to medicine; specifically, gastrointestinal radiology /fluoroscopy. In 1992, he died at the age of 90 and my 90 year old has his ring! This seems to be an ageless blog! He was also an accomplished pianist. I found that dimension of the man to be quite fascinating. His life really is worth a Google.

Medical nursing is sort of a mental melting pot - a junkyard of information, perhaps. I can substantiate that statement by telling you it is now 0700 on a Saturday morning – my day off! And, I am musing beyond Schatzki to Maglinte. He has his own tube. How did that happen? I use that tube and find it quite useful, but who in the world is Maglinte? Another gastrointestinal radiologist who just happens to reside at IU! I wonder if he plays the piano?

Sherry

To be a registered nurse at Clarian, visit Jobs for Registered Nurses.

I Wonder What the Parrot Says

Thursday, January 7, 2010 by Sherry Holden, BSN, RN, Associate Partner
Monday was a Mad-Hatter Day; a perpetual swirl of activity. I had a patient who verified throughout the day the reason I am not a psych nurse; a very bizarre admission; a very productive discharge; and one who taxed my vocal chords for twelve hours. Nonetheless, she turned out to be the highlight of my day.

Miss M. is 75 years old. She has progressive COPD and was admitted for a severe Upper Respiratory Infection - tough combination. In addition to her hearing loss, her eyesight is compromised due to cataracts and glaucoma. In this case, my Synergy mindset was thinking discharge-predictability-involvement in care. Every opportunity I had throughout the day, I asked questions that would allow me to have insight into that plan of care. I learned she has four doting daughters, two spoiled grandsons, a parrot and two dogs. She lives with one of her daughters in a situation that is very comfortable for both of them. She is tethered to oxygen but can do a few jobs at home in the course of the day, including caring for the animals. She is fiercely independent, has a wonderful sense of humor and a very realistic concept of living and dying. In time, she should be good to return home. I felt pretty smug about having a discharge plan ten minutes before it happens: one little accomplishment for me.

Per usual, at the end of my shift, I was re-hashing the day, looking for the positive, the negative, and the possibilities that could make things better for the next shift. Then, like a ton of bricks, a moment of “latent curiosity” hit me: I wonder what the parrot says? Miss M. is very attached to her parrot. She has had him for a long time. Dogs can yip and cats make a lot of weird sounds, but a parrot talks - a much better companion for a life of limitations. You can bet, if I get another opportunity, I’m going to know what the parrot knows.

Sometimes, we think we are asking all the right questions, when in reality we are missing the obvious.

Sherry

To be a registered nurse at Clarian, visit Registered Nursing Position Indiana.


December 24, 2009

Tuesday, December 29, 2009 by Sherry Holden, BSN, RN, Associate Partner
Over the past 42 years, I have spent more than 20 of them working! That seems an interesting reality to me on several levels. As a family, we have dealt with the “designated holiday” and have never really missed Christmas, we have just planned a bit differently. And, the years I was not scheduled to work were always grand and glorious!
 
I have also discovered that the work place has never disappointed me at Christmas. In some dysfunctional way, our units become family and we create a certain atmosphere for every holiday. Over the years, the decorating crews seem to jump out of some magical box and think they are Disney Designers and create a festive atmosphere for all of us. And, the food fairies think we need a month of sugar to survive. People have great food traditions, other than my Beef Brownies. AR should be a pastry chef in her next life and KT’s husband just needs to open a cookie shop! I was at work very late last night and was more than tempted to take the entire box under cover of darkness. Those night people party with too much flare as it is and I’m a little behind on baking. I’m thinking a dash of Grinch activity would have been fun. This morning I’m regretting I didn’t do the deed! I think we should do a holiday cookbook next year on 4-Medicine. JS makes a mean cheesy potato thing and MS is always concocting something unique! What a tasteful idea! I didn’t make it to the boss's Christmas Party this year, but I’m sure it was another good gathering. Next year I’m going to take the string game so all my colleagues will verify that I really am an unusual and fun-loving person.
 
This was also a special year of sharing on 4-medicine. SW is a person who has a heart as big as the universe. She orchestrated a memorable Christmas for one of our staff who is having a difficult health year: food, gifts, money, cards… the staff response was over-whelming. Why do I work on 4-medicine? Pretty obvious.
 
Those that work on Christmas Day give the gift of caring on a plane very few understand. It is a gift of sacrifice and love; hand delivered to those in need. The nurse-patient bond on Christmas is only understood on a heart-level and I have some very fond memories of years past and the people who have touched my life. Priceless.
 
When I sign off, I’m headed to Walkerton. Grand-babies and my children, who are still kids at Christmas! It is going to be wild! Christmas through the eyes of a child gives a whole new meaning to the word JOY, so I’m preparing to be blessed.
 
 Sherry
 
 To be a registered nurse at Clarian, visit RN Job Opportunities Indiana.

I Miss Your Mustache

Wednesday, December 9, 2009 by Sherry Holden, BSN, RN, Associate Partner
I find people very interesting. The big dichotomy of humanity is that we are all very different and very much the same. All one has to do to prove that theory is watch and listen. It will not require a government grant to collect a large amount of data nor a team of experts to publish the results. A few days on 4-Medicine at IU will suffice. Last week I had two fun encounters that have swirled in my head regarding people and how we relate to one another.

I had a patient who was quite ill and had no definitive diagnosis. We finally decided to put her in respiratory isolation for a few days until some things had been ruled out, or in, whatever your preference. I was in her room when she called her husband to inform him not to visit that evening for safety reasons. Her closing comment to him was, “I love you and I miss your mustache!” The other situation involved a man who was admitted for twenty-four hours with chest pain. When his wife came to take him home, her parting comment to me was, “I’m glad he is coming home. I miss his noise.”

So the question is, "What do we like about one another enough to miss?" I have been thinking about many people in this context: family, friends, colleagues, and acquaintances. I love my children and grandchildren dearly, but what is there that I really like about each of them? I have friends that I went to kindergarten with fifty years ago. Why have we maintained a life long connection? I enjoy the people I work with every day. Why? When I arrive, why am I glad to see the people of the night and always happy to work with the people of the day? I especially like the banter in the med room. Uncensored! When I gave report yesterday I told my replacement, “You will really like this patient.” What was there about that person that I liked enough to feel confident that someone else would like them too? Do I just like people who are like me or do I like people who are really different than I am? In order to answer that question, I have to know what I like about me.

The reality is this: there are many people that I genuinely like; more and more I am discerning why. And, that adds a richness to my life. However, at this moment, I am not sure what I think about mustaches and noise.

Sherry

To be a registered nurse at Clarian, visit Registered Nursing Position Indiana.


When the Power Goes Out, We are Empowered

Monday, November 16, 2009 by Sherry Holden, BSN, RN, Associate Partner

Instantly, the power is gone. Darkness prevails. If you think about it, most of us are not comfortable with darkness – we are hard-wired for light. Twenty-three hours of darkness at IU Hospital this week was an interesting challenge. I’m sure debriefings have run the gamut of every department within the system. I’d like to add my two cents with a few observations from my perch on 4South.

There is a plan. Disaster drills are such a nuisance – especially when you are in charge and the day is horrendous. So are fire drills when it is 0705. And, code drills. Nonetheless, they are all the foundation of preparedness. I suppose the people who are responsible for all of this stuff are going over the details with a fine-tooth comb. From my vantage point: It’s a good plan, and it worked.

People become very resourceful and depend on one another when it is dark. Night shift people can verify this in particular. I understand morning blood draws were more than interesting. So once again we revert to what we learned in kindergarten: “Hold hands and stick together.” Teamwork is a great force.

4South had the benefit of a few working computers. We had to share. It worked well. By and large, people do not want to PAPER CHART. I even found myself being one of them – imagine that!

Patients are very resilient. Given the appropriate information they respond in kind. From the moment a patient is admitted to the hospital, they become dependent. I find it amazing how people respond in that state when given “appropriate information.” I also find it interesting how communication and relationships change when we are all in the same boat: We bond quickly.

Management was right there with us. They were visible, available, resourceful, dependable and appreciative – working for the common good. Why is it that we don’t always see them in that light? I even had a few personal minutes with the Chief of Staff. How special was that!? What he offered was encouragement.

During the day, the unit was quiet. We had limited light, fewer people using our space and a slower pace. It was nice.

We will all have stories to tell. Over the years I have endured many situations without power – some of them lasting for several days; most of them weather-related. We will have fun remembering.

Without electricity, how would we function? Think about that for a minute. And then, think about this: When the power goes out, we are empowered, and the power of the individual is endless.

Sherry

To be a registered nurse at Clarian, visit Registered Nurse Job Opportunities.
 

Medical-Surgical Nurses Make a World of Difference

Tuesday, November 3, 2009 by Sherry Holden, BSN, RN, Associate Partner

November 1-7 is designated Medical-Surgical Nurses Week. This is a time set aside to celebrate and appreciate Med-Surg nurses. When I first became involved in the Academy of Medical Surgical Nurses and became aware of this week, I wondered why we needed another week in addition to Nurses Week in the spring. Over time I have grown to appreciate the difference.

During Nurses Week, I set aside a bit of time to reflect on why I became a nurse. During this period of time, I think about why I am a medicine nurse. Why did I choose this specialty, and why in the world have I stayed with it for forty-two years?!? Medical nursing is never really a comfort zone. Just when you think you know something, it changes. There are many specialties that are more glamorous than medicine. And there are many places in the system where people don’t have to work at such a crazy pace or have an odd appreciation for chaos.

Over the years I have done many interesting things within the framework of medical nursing, and I have had opportunities to do numerous things in other areas, but have never made the leap. Four years ago, after my round with cancer, I was sure I would never be able to keep up with 4-medicine again. I interviewed several places and was offered a couple of very interesting jobs, but I couldn’t make the move; just couldn’t imagine myself without liver patients!

Medicine is always a challenge. It is about critical thinking, honing one’s senses and developing keen assessment skills. It’s about team-work at its finest. Many years ago I referred to medicine as the “theater of dependency.” We like to think of ourselves as very independent practitioners, but in reality we rely on each other constantly. Medicine nurses have very distinctive personalities - need I say more? Let’s just consider IU 4-medicine for a brief moment... (How wild and whacky was that?!?) I guess medical nursing gets in your blood. Over the years, I have had three criteria for staying the course in any position I have held: am I learning, am I having fun, and am I making a difference. If all of those things are operational, I am pretty content. Medical nursing has been a place of satisfaction for me.

I was pleased with the slogan for this year: "Medical-Surgical Nurses: Making a World of Difference." Medicine Nurses share an umbrella with Surgical Nurses. Somewhere along the line, I have made a distinction because I am pretty much a pure medical nurse. I hope I haven’t slighted any surgical nurses in this blog, because I can tell you right now, I have a great appreciation for what you do. Actually, I pretty amazed at what you do! I think you know that as truth because when I float to your areas a lot of hand holding occurs to get me through. For some reason it is hard for me to wrap my brain around all that cutting and pasting! So, to all of my colleagues in Medical-Surgical Nursing, enjoy the week, share your stories. re-commit to your specialty and never doubt for one moment that you indeed “make a world of difference.”

And, if you are out there as an “undecided,” consider Medical-Surgical Nursing, because it could make a world of difference in your life, too.

Sherry

To be a registered nurse at Clarian, visit Registered Nursing Position Indiana.
 

Have Fun, But Get Your Mandatories Done First

Thursday, October 15, 2009 by Sherry Holden, BSN, RN, Associate Partner
Sometimes you look back over the past month and say to yourself, “What just happened?” You discover that you have compacted time and squeezed every minute to its limit. Instead of taking a breath and enjoying a bit of fall, you ratchet it up a notch and say “what’s next?” I’m doing spin-off lists now so I can basically keep track of who I am, what I’m doing and where I’m going. Maybe I need a blueberry!
 
I’ve been trying to complete my MANDATORIES. I can never seem to get them done during patient care time, so I have to wander in at strange times on my days off. I consider mandatories a necessary nuisance, especially now that I have to go in to do them. I liked the good ole days when I could do them from home in my pajamas on a Saturday night at midnight. I am one of those people who actually read every word and often take notes on things that are new. I also find interesting stuff at times that I might have known at some point in time and have totally forgotten or find that it really is new and I either like it or I mull it over in wonderment. I’ll not expound on the latter but can give you a prime example of the former. Did you know that the brain is 2% of the total body weight, uses 20% of cardiac output at rest, utilizes 500ml of oxygen and 75-100mg of glucose/min and requires optimal perfusion of 50ml of blood/100gms of brain tissue /min.? No one thinks about this stuff until October; unless, of course, your world is neurology.
 
My world is not neurology. I spent last week working in Video Seizure. I find it all very fascinating but I am not comfortable with it. I am getting better but I can tell you that Nik & Marz are pretty impressive with the whole scene. They are finite in reading the monitors and responding accordingly. It is the one great thing I like about the nursing profession, we all seem to find a niche over time and have the ability to excel in that arena. I even have trouble answering the phone in seizure! Try this a few times: "Video Seizure, this is Sherry." That must do something odd to brain waves!
 
I also managed to go to Reno this month for a long weekend to visit my college roommate and a grade school friend. What a great interlude! You can’t beat spending time with people you have known for 46 and 55 years. We went to Tahoe, Virginia City, Carson City and the unexplainable Harrah Auto Museum. Couple that with airplane snafus and every weather pattern imaginable, and there are great stories to be told.
 
I am a great believer in managing time to allow for fun as often as possible. We clog our lives with so much it is imperative we find time to make a few memories. As my sister would say, “We all need marker days”.
 
(Good rates to Florida - temp is 90; check it out! But, get your mandatories done first!)
 
Sherry
 
To be a registered nurse at Clarian, visit RN Job Opportunities Indiana.
 
Search for available Nursing Jobs at Clarian Health by Nurse Specialty
 

What Do Nursing and Catching Chickens Have in Common?

Monday, September 28, 2009 by Sherry Holden, BSN, RN, Associate Partner
Staff nursing is challenging and intense. It requires physical, psychological, mental and spiritual prowess, and stamina. In order to survive, one must find a bit of levity in any given day, recognize it as such, savor it for a moment, exhale, refresh, regroup, and move along. In current terms, that would be known as the “levity bundle.” Levity is spontaneous and fleeting so one must grab its nuances and quickly partake of its benefits. Sometimes we are so stressed and overwhelmed we totally miss our moment of reprieve. I’m embracing levity nowadays as a survival technique, and it is interesting to me where I find it.

I floated to O.T,U. this week; a fish out of water. I’m always amazed that I function quite nicely on my unit, but when I go to another unit I might as well be in a foreign country and not speak the language! My first patient’s chief complaint was listed as 129.9! I kept that little number in my head throughout the day; chuckling and scheming. I have no idea what it means but I will not miss an opportunity to take advantage of it in the future.

We had a pitch-in last week, mostly sweets, because everyone knows that stressed spelled backwards is desserts. I missed a great opportunity to make my infamous “Beefy Brownies,” but many good bakers provided wonderful treats. It was an appreciation/farewell for one of our favorite physicians - a very special interlude with a lot of banter and one moment that was quite hilarious; one that shall always be remembered. Levity.

Sometimes these levity moments are long remembered. When I first started working at IU, I worked nights. I was reading the nurse’s notes from the day and a student nurse was caring for an elderly gentleman that was learning the art of walking with a 4-prong cane. The entry: patient abel to use cain. Priceless.

And, then, there is the “Chicken Catcher.” One day a group of us converged at the nurses' station and started talking about the program America’s Got Talent. I stated that I liked the “Chicken Catcher.” The conversation that ensued went fifty directions regarding the job of a “Chicken Catcher.” Wikepedia finally gave us the job description: A chicken catcher is one who catches chickens. OK then. In the final analysis we decided there was a need for such a job because chickens cannot be herded.

The next day our conversation centered around the fact that the chicken catcher had won the million dollars and a show of his own in Vegas. He was a quiet, shy man that had moved way out of his comfort zone to catch a dream. It changed his life completely.

Chicken catching and dream catching have enough merit to be independent blogs, our reality is “levity catching,” and when we accomplish it, we can exhale.

Have a nice day.

Sherry

To be a registered nurse at Clarian, visit Registered Nurse Jobs Indianapolis.

Search for available Nursing Jobs at Clarian Health by Nurse Specialty.

Nursing Defined

Monday, September 14, 2009 by Sherry Holden, BSN, RN, Associate Partner

I like words. I like concept analysis. I like it when I discover the “right” word. I like new words. I like words that I always pronounce wrong or words that roll off my tongue. I’m actually looking for a certain word. Here’s the challenge: if you could define nursing in one word, what would it be? I would much prefer we were having this as a round table discussion so each of us could have the opportunity to expound, because I am going to give you my word, which I, of course, think is the best - and the only way I will have “thought variables” is if you send me a reply. Otherwise I am going to be pretty smug about my choice.

Nursing is "relationship." A cascade of other words are contained within relationship. Thus, one could define nursing in great detail based on a single word. Try it for a little word exercise and see where it takes you.

I have been thinking about the nurse-patient relationship a lot this past week. Over the past few months I have had a wonderful relationship with CW and his wife B. It all started with, “Hello, my name is Sherry and I am going to be your nurse today.” That introduction has forged great relationships over time. CW was special. He endured many difficult medical interventions, numerous trips to the hospital, and was forced to make choices and decisions that were very challenging. Each time he came to 4-medicine, I wanted the privilege of caring for him. I learned a lot about his history, his family, his life, their great 4th of July Celebrations, his daughter’s wedding, his children, the wonderful home he loved on the Ohio, and a wife who sacrificed beyond his expectations. I have his address and phone number on my dresser. I had planned to visit CW & B after his surgery this summer; maybe go to a horse race. It was not to be.

On September 4th, I went to Ohio for his funeral. I wanted to see him one more time, say good-bye and connect with B. She is a special, gifted woman and I think we will maintain a relationship, too.

There was never a time that I cared for CW that he didn’t ask about me: what was new, how were the kids, the grand-babies, the garden... He always made me feel good. He was a joy to care for and always appreciated anything done for his well-being. I told B the other day, “People like CW are the reason I am a nurse.”

With relationship comes joy and sadness; the memory of both will linger in the case of CW. Understanding that full scope of involvement, tomorrow I will once again walk into the room of a stranger and say, “My name is Sherry and I’m going to be your nurse today.” Nursing defined.

Sherry

To be a registered nurse at Clarian, visit Nursing Jobs Indianapolis.

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“Are you there? Are you there?”

Thursday, August 27, 2009 by Sherry Holden, BSN, RN, Associate Partner
When I was growing up in North Dakota a few decades ago, we had one telephone. It was the basic black desk phone that was housed in a specific little phone alcove. We had one outlet so it couldn’t travel very far. We were on a party line - each family had their designated number of rings, but the whole world had the same ring tone. I can remember hearing people on the line when I was talking, and often they would request that someone hang up so they could place an emergent call. When you were on the party-line, there was a code of telephone ethics that was respected. Because we were sharing the air-waves, our phone time was limited. I can remember our phone number was 1173J. We had that number for years until things started to change. The party-lines gave way to private numbers and we all had new seven digit numbers - that seemed to be a real challenge for everyone for awhile. Then they came out with a line of phones known as “princess phones.” They were multiple-colored and stream-lined. People thought that surely signaled a moral change in society. We never owned anything but the desk phone - eventually we switched from black to beige. When Ma Bell “broke” it seems to me that everything went “nutz.”

In my life, some things die hard. Today I still have one beige, desk-top phone at home and a hand-held connection that I can take a short distance. I don’t much like the thing because I have a tendency to turn my head ever so slightly and invariably I disconnect during most conversations - some of you are well aware of that annoyance. I much prefer the desk model with the giant colored buttons. (That’s another story!) I do have an answering machine but that is the extent of my bells & whistles. In May, my daughter provided me with my first “cell-phone”. It is a Tracfone to be used for emergencies when I am out wandering alone & find myself in some kind of trouble. I have yet to use it in the produce department at WalMart. It is incredible what I learn about the love life of absolute strangers when I am innocently trying to select a head of lettuce! Maybe I’ll progress to that phase, but for now, I am still in the education phase of learning how to use the thing. This is the bottom line: if you want to call my cell, I need to call you first so you can get the number. And, I have the standard ring on my phone so I will recognize that it indeed is a phone call. I don’t have music or strange noises or a code for everyone that calls me. My son has song lyrics for his wife, mother, sister and friends. He always knows who is calling and can decide if he is going to answer immediately. Who in the world needs to make a decision when it comes to talking to their mother!?!

And that is the point of this entire tale: RING TONES! On 4-Medicine we all have phones now. I guess it is supposed to be a time saver but it doesn’t cut down much on noise. My favorite feature is the text message. Mind you, I can’t send a text message but I like receiving them: to the point and no noise! At the beginning of my shift, I am designated a specific number and have to log it in. Each day I have a new number that I tape on the back of the phone so I know it when I need a call back. I really need my own personal number but that doesn’t seem to happen. I think it is a flaw in the system. Then, I select a ring tone. I ALWAYS go to the classic ring because then I seem to recognize when the phone is actually ringing. I have about 30 ring choices: saxophone, chime, clockshop, Jamaica, mucic box, drums, Koto effect, and, a parrot-like voice that abruptly shouts “Are you there? Are you there?” When I here all these weird sounds throughout the day, they seem to be an intrusion into my “designated oto space” And, in the middle of the day when I hear that lonesome saxophone, I think I am on Beale Street, alone in the rain on a Saturday night - you get the picture.

I’m not sure what happened with the telephone. It is now a camera, a computer, a music machine... It gives you the time in London, the temperature in Japan and pork belly futures from the Board of Trade. The telephone is used far beyond my wants, needs or desires. In reality, I am like that crazy parrot - I am out here in the wilderness shouting, “Are you there? Are you there?”

Sherry Holden

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Join a Nursing Organization - It’s a Gift You Give Yourself

Tuesday, August 18, 2009 by Sherry Holden, BSN, RN, Associate Partner
Last week, 4-Medicine at Clarian-IU hosted the August meeting of the Central Indiana Chapter of the Academy of Medical-Surgical Nurses. Our guest speaker was Dr. James Watkins, Associate Professor of Medicine at the IU School of Medicine in the Division of Gastroenterology/Hepatology. In keeping with the education tenet of the organization’s mission, the presentation was on Pancreatitis: Cause, Current Treatment and Specific Care. When one cares for this specific population on a daily basis it is interesting to note that “just when you think you know something, you don’t.” I was fascinated with treatments on the horizon for this disease and a bit surprised with what I don’t know regarding the pancreas. I guess that is the necessity of “continuing education.”

The Academy of Medical-Surgical Nurses is the “only national professional nursing specialty organization dedicated to adult health medical surgical nurses.” It was formed in 1991 with the goal of nurturing medical-surgical nurses as they advance their careers. Their motto is “Nurses Nurturing Nurses” and the organization is available to assist with everything from education to research to networking to legislation. They provide a journal, newsletter and an endless resource of information on their website at AMSN.org.

There are 50 Chapters throughout the United States and local chapters are designed to provide educational meetings with CEU’s, networking opportunities, professional support, volunteer leadership opportunities and input into national issues and program planning. The Indiana Chapter includes a local charity emphasis at each meeting. Last week school supplies were given to the Riley School at the Riley Hospital for Children. Each year AMSN members convene for a national convention. This year the convention will be held in Washington D.C., September 9-14. They have also designated a time of celebration each fall as Medical-Surgical Nurse’s Week. This year it will be held November 1-7 and entitled Medical-Surgical Nurses: Making a World of Difference.

I provide this information because I am a major proponent for professional nurses aligning themselves with a professional organization in their area of specialty. These organizations are the voice of nursing and will hopefully have input in health care decisions that effect nursing in the present upheaval. Membership seems to me to be timely. I have had the privilege of attending four national conventions - I hope I can attend at least one more! I went to my first convention in Florida as a recruiter representative and enjoyed it so much I joined on the spot. I also had the privilege of doing a Synergy Poster Presentation at the Chicago Convention. Someday I would like to be a presenter, but so far they haven’t jumped at my ideas for a break-out session!

Let me encourage every nurse to join a nursing organization - it’s a gift you give yourself. The things I have learned, people I have met and places I have been have added greatly to my career and my respect for medical-surgical nursing.

Sherry

To be a registered nurse at Clarian, visit Registered Nursing Position Indiana.

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Registered Nurse Gone Crackers

Sunday, July 19, 2009 by Sherry Holden, BSN, RN, Associate Partner
People like plain old soda crackers, especially when they are sick. Recently I became intrigued with this fact because I had a barrage of cracker requests and an encounter with a man who wasn’t grasping my explanation of NPO when he said, “I understand all of that, but can I have a cracker?” People always want crackers when they can’t have anything else. They seem to get focused on crackers and don’t consider them food. “Why would it hurt to have just a couple of crackers?” People want crackers when they aren’t really hungry but would like “a bit of something.” We need crackers with soup; likewise with a salad. We need crackers and 7-Up for an upset stomach. Pregnant woman want crackers and water. People that are nauseated for any reason want a soda cracker. The lowly cracker consists of flour, shortening, salt and baking soda. In and of itself, that combination doesn’t sound very inviting. Bicarbonate of soda is the key ingredient. It will heal you inside and out! There must be a book out there on all its uses - nothing better to clean a kitchen sink than bicarb and vinegar. Maybe it helps our inner pipes also. Sorry, I digress.

As you can tell, I have spent an inordinate amount of time thinking about soda crackers. My plan is to purge my mind in this space and transfer the topic to you so you can get it stuck in your head - like an old song that you can only remember the first line.

In the midst of my cracker intrigue, I went to Southern Indiana to visit a nursing friend of mine who has just moved to the “burbs of Evansville.” We spent some time in Newburgh at the Newburgh Country Store - a fascinating place worthy of a day trip. In the middle of the store was an old cracker barrel filled with soda crackers - naturally! As we munched, I asked Nathan, a third generation proprietor of the store, what was up with the soda crackers. He proceeded to point out the fact he had a rare original balsam cracker barrel in the store - it was a dandy. He explained how crackers were transported in these barrels and arrived here with the British. He considered the soda cracker a comfort food and stated that people enjoyed the combination of browsing, snacking and reminiscing. He reminded us that crackers have a unique bond with our childhood. Of course, they are the right size for a little hand, they have fun little holes, they crunch when you eat them and they make a mess and leave a trail. What more could a kid want. It seemed a fitting treat in the midst of an old general store; clever and a source of conversation.

That encounter led me to learn a bit more about crackers. After all, we are a generation of people who have embellished the cracker to the point of selection that includes an entire aisle in the grocery store and so much variety we are "paralyzed with choice!” And there is absolutely no end to what we can use as toppers! Here are a couple of fast facts courtesy of the Internet and Time/Life books: Cookies and Crackers, 1982. Premium saltines first hit the market in 1876 in St. Joseph, Missouri. However, “10,000 years ago, Neolithic farmers were making a grain-water-paste baked on hot stones.” ( Soda crackers are 32% water.) “A flour paste, cooked once, then cooked again to dry it thoroughly, becomes a hard, portable victual with an extraordinarily long storage life—perfect for traveling. For centuries, no ship left port without enough bone-hard, twice-cooked ship’s biscuit. The word biscuit comes from the Old French 'biscoit,' meaning twice cooked…to last for months, or even years. While sailors and other travelers chewed their way through unyielding biscuits, cooks of the ancient civilizations of the Middle East explored the culinary possibilities of sweetness and richness.” Of course, now we move into the area of cookies. I will certainly not go there today! Nor will I entertain discussion about whether crackers are a French or British original!

The morale of this entire rambling is the fact that the little square soda cracker seems to bind us with all of humanity. Bicarb may not be the key ingredient after all. Soda crackers provide a little comfort and seem to have healing powers that soothe the body, mind and soul.

Sherry

To be a registered nurse at Clarian, visit Nursing Jobs Indianapolis.

Registered Nurse Receives Gift from Vietnam Veteran on America's Birthday

Friday, July 3, 2009 by Sherry Holden, BSN, RN, Associate Partner
Embedded within the Nurse Characteristics of the Synergy Model of Nursing is a fine thread of gold that allows me to weave a picture of my nursing practice whenever I deem it necessary. Perhaps, it is a little PRN reality review that allows me to evaluate my practice, set goals and discover something special.

I’ve done a little weaving today because the week has been brutal. I hit a little negative snag yesterday as I was overtime more than I ever wanted to be in my whole life! I was in good company with several other people. We were all physically, mentally and psychologically exhausted and I can tell you there was not a lot of positive conversation and none of us were looking for a thread of gold or a silver lining!

Now, in the stillness of the morning, I can think about my day and the culmination of the week in the light of Synergy and I am actually feeling pretty good about nursing and pretty good about what I accomplished this week. I looked at my clinical practice and clinical judgment: wanting but intact. I can think of situations where I have been a good patient advocate and a good nurse advocate. I always try to maintain a high level of caring practice and respond to diverse needs. I have to remind myself that when I am tired and have multiple tasks to do that I have to always keep that aspect fine- tuned. I strive to incorporate communication and collaboration because they can make or break a day.

Looking back on this day I find it ran the gamut from rewarding to hilarious! Perception is the tricky part. And, today I was a facilitator of learning as a preceptor. I hope Miss S. was not too overwhelmed. She had good opportunities to do new hands on things and certainly was challenged to figure out how to organize a day. I can see areas where I was more of a help than a hindrance; albeit I was both! Sometimes preceptors get in the way and sometimes they need to be there to help find the way. I need to find that balance.

The Synergy Model always helps me find new energy, new perspectives, new challenges.
Today I found a little nugget that is my reward for the week. It may actually be a reward for a very long time. I cared for a VietnamVet who had a few bumps in the road this week on his way to a transplant. He was a bright spot: always cheerful, wondering how MY day was going, amenable to having a new nurse, and along with his wife, provided a little levity in my chaos. I’m thinking about Mr. M as I prepare to go north this weekend to celebrate the Fourth of July with family and friends. I am thankful for all the freedoms and privileges that America still embraces and I am thankful for men and women like Mr. M who have sacrificed to secure them. This week he put his life in my hands and I tried to handle it with care.

In spite of a horrendous week, the thread of gold continues to weave a pattern of my nursing practice: not a finished product, but a work in progress that requires a little attention now and then, for within the weave is the reward.

Happy Birthday America! And thank you Mr. M.

Sherry

To be a registered nurse at Clarian, visit Registered Nurse Job Opportunities.

Hurdling to Nursing Success

Wednesday, June 17, 2009 by Sherry Holden, BSN, RN, Associate Partner
I personally do not know many people that get really pumped for the Track & Field season. Few people speculate during the week about the next great pole-vaulter or the hottest shot putter on the planet. There are not packed stadiums and cheerleaders but the fans that do partake are never disappointed. These events all seem to showcase during tournaments or the Olympics. Individual Track & Field events have always intrigued me, particularly the hurdles. First of all, I cannot, and never could imagine how one could co-ordinate the speed, steps, rhythm, efficiency and technique that hurdles require. Timing is everything. There are many factors that slow a hurdlers performance and I have seen some nasty falls that end the race in a second. The higher the hurdle and longer the race, the more impressed I am. My legs hurt and I am out of breath just writing this paragraph!

I was thinking about hurdles last week in the context of what we have to overcome in life in order to finish the race. I was thinking about nursing specifically as I watched the new grads prepare for the State Boards. They had overcome many obstacles and endured many sacrifices to get to this one big hurdle that all registered nurses have to clear. Everything depends on one test! Until one passes that test, there is no moving forward! It is demanding and stressful. It is the culmination of years of preparation. Each one runs their own race in their own time and waits for the results. I have seen the exhilaration, relief and sense of accomplishment that comes with one word: "Pass," and the total devastation that accompanies "Fail." Completing this one hurdle means that EVERY nurse begins their career as a success, with endless opportunities to develop and own their own practice.

Kudos to all of you who have completed the challenge, and welcome to the nursing profession.

Sherry

To be a registered nurse at Clarian, visit Registered Nurse Career Job Search.

The Mere Presence of a Nurse Makes All the Difference

Sunday, May 31, 2009 by Sherry Holden, BSN, RN, Associate Partner
At dawn on a glorious Sunday morning in Dakota, my mother died. Fitting for a master gardener, May 24 was the new strawberry moon - a time to grow. Ironically, my mother was highly allergic to strawberries! However, she spent her entire life as a part of the prairie. She lived and died by the rhythm of its seasons.

This blog is one of my observations on life and death.

MAKE PLANS FOR DEATH
I was amazed how prepared my parents were for a time such as this. My mother was 86 and my father is 90 - sharp as a tack. They had planned for death. When my mother endured a sudden event that entailed making very hard decisions very quickly, my father knew her wishes and was able to make those decisions with a clear head, albeit a heavy, heavy heart. Death is a hard conversation and most of us avoid it. I certainly experienced the benefits of the many details my parents had settled beforehand.

RESPECT AND HONOR CHOICES
There are 11 children in my blended family. Trust me, we are all very opinionated - especially my parents. They made some end-of-life choices that even surprised the funeral director! They certainly surprised us! But, in unity, we respected and honored their wishes. Many families have a difficult time with this and often divisions ensue. At Clarian we talk about “crucial conversations.” I guess if we have those in life, they aren’t as necessary in death.

MAKE PLANS FOR LIFE
Within the hour of my mother’s event, she was making plans for her garden. She was moving plants and fussing with her cactus. They were planning to attend the graduation of a great grand-daughter the day she died. Life has gotten so busy and demanding we live by reaction most of the time. I asked people on my unit this week what their plans were for fun this summer. Interesting, we don’t seem to plan for fun. I think I’m going to get a new planning strategy and live life a bit differently.

DON’T FORGET LOVE
I have no doubts my mother loved me, and in kind, she knew that I loved her. It was a relationship of “show and tell.” She had a great capacity for loving her family - especially the grand and great grand children. Never miss an opportunity to let someone know they are loved before it is too late.

NURSES MAKE ALL THE DIFFERENCE
I was a part of a rotating vigil at my mother’s bedside. The situation was surreal; full circle. It was the hospital I worked at as a student - 45 years ago! My mind covered a lifetime during those quiet hours. I had the opportunity to share that time with a kind and caring physician and some pretty remarkable nurses: Michelle, Katie and Bonnie were very special people. My sisters and I did many of my mother’s cares while the nurses cared for us. (The Clarian philosophy of patient, family and community.) It was validation for me that a nurse doesn’t have to be DOING - mere presence sometimes makes all the difference in life and death.

Sherry

To become a Registered Nurse at Clarian, visit Nursing Jobs Indianapolis.

As We Celebrate Nursing and Nurses: The Florence Nightingale Pledge

Thursday, May 7, 2009 by Sherry Holden, BSN, RN, Associate Partner

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully.

I will abstain from whatever is deleterious and mischievous,
and will not take of knowingly administer any harmful drug.

I will do all in my power to maintain and elevate the standard of my profession and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling.

With loyalty will I endeavor to aid the physician in his work,
and devote myself to the welfare of those committed to my care.


I attended Jamestown College in North Dakota. The Nursing Department was steeped in tradition and our nursing ceremonies were conducted with great fanfare and significance. We memorized and recited “The Pledge” during our capping ceremony, we received our lamps, Bibles and stripes with great pride and at graduation, our “Pinning Service” was the creme de la creme of pomp and circumstance surrounding that day.

We bring all of our history and traditions forward during the month of May as we celebrate nursing and nurses. Today is May 6, 2009. In 1982, by a joint resolution of Congress and the signature of Ronald Reagan, this day was set aside as a day of Recognition for Nurses. Traditionally, it began a week of celebration that culminated on May 12, the birthday of Florence Nightingale.

Today, my mind is flooded with memories of the many, many wonderful nurses I have worked with over the years. Nursing is a profession like none other and I am glad that each year we take time to recognize each other and the incredible work we do. To all of my colleagues at Clarian and beyond, I say ,“Well done!”

I encourage you to think about these statements from “The Pledge” sometime during this month as we blend our new traditions with some very old tried and true fundamentals:


I will practice my profession faithfully.

I will do all in my power to maintain and elevate the standard of my profession.

With loyalty will I endeavor to aid.

With loyalty will I devote myself to the welfare of those committed to my care.

Sherry

To join the Registered Nurses of Clarian, visit Jobs for Registered Nurses.

Registered Nursing Highs & Lows On a Busy Day

Saturday, May 2, 2009 by Sherry Holden, BSN, RN, Associate Partner
Tuesday was a very difficult day for me on 4-medicine. The emotional high & low provided such a contrast I will have to go into a mulling phase to put it all in perspective.

It all has to do with the intricate nuances of our units: the patients, the staff, the delicate balance it takes to maintain… The challenges, obstacles, personalities, and stressors are overwhelming. It is interesting over time to look at how our units evolve. Who decides to combine certain patient populations and who decides what type of individual is best suited to manage that creation, and how does that person decide who will be the best people to keep the thing running. Somehow, at some point in time, everything clicks and somehow it all works quite nicely.

And, then of course, things change.

On Tuesday, one of our finest left, and, one of our finest returned. What an emotional dilemma! Selfishly, I was very sad to see Miss M. depart. We knew when she arrived it would be for a season and then she and her husband would pursue their careers beyond IU. But over the months, relationships develop and Miss M. was a vibrant part of our unit. She is a very kind and gentle person whose presence calmed and cured not only the patients but the staff. She brought us a fine combination of professionalism, fun and laughter. On the day she left, there were tears. Miss M. was a person who made an impact in a short period of time. It is hard to let go but we are all excited for her because she is on a wonderful journey and is someone we are not going to forget. She left a void.

Last year, Miss E. left us and pursued a dream of travel. She did some nursing along the way and covered the country and beyond. I oriented Miss E. as a SNE, SNEM, SNG. She provided 4-medicine with a personality like none other and developed into a very good charge nurse and excellent team player. I was sad to see her leave but have an album of pictures with details of her adventures. It has been wonderful staying connected with her.

Now, she is back. It was Tuesday. In the midst of a busy, busy day, she asked me what she could do to help me, and in an instance, I realized now much I had missed her and how very, very glad I was to have her back.

In the scheme of things, it is all about people. Ask any nurse why they work on their particular unit and they will respond, "because of my patients and my colleagues." We have strong unit bonds that go far beyond the borders of the workplace and forge timeless friendships.

Sherry

To join and bond with the Registered Nurses at Clarian, visit Registered Nurse Career Job Search

Cheese and Change for a Registered Nurse

Wednesday, April 22, 2009 by Sherry Holden, BSN, RN, Associate Partner
Dr. Spencer Johnson wrote a little book in 1998 entitled Who Moved My Cheese. It is a timely-timeless parable about change: two mice and two humans. When change is upon me I often return to this tale; perhaps, because I lived in Wisconsin long enough to fall in love with good cheese and never want it to move very far away from me. I am also a creature of habit and do not adapt well to constant change. I’m not against change, but I like to adjust to one thing before rapidly moving on to the next. I’m sensing I might be losing my cheese. Read the book, about 40 minutes of your time, and I am sure you will recognize which character I am. But, who are you? Who would you like to be?

I address the issue of change because we are once again in the midst of a major change in the system. Tomorrow we will begin using the CareMobile System for passing medication. I realize patient safety is the major benefit of the system but it is new and requires time I don’t perceive I have to invest. Added to our new computer system, I think I am about as challenged as I want to be for the rest of the year! My brain wants to be “unplugged” or at least put on pause for awhile. I wonder if it is really thinking or just reacting.

This brings to mind a story I read years ago about a man who started out in life as a migrant worker. Picking beans was his specialty. He enjoyed picking beans and felt he was good at his job. He was very content. One day, very abruptly, without discussion or training, he was told that he would no longer be picking beans but he would now pick peas. He recalls what a major change issue this was for him. He could not explain it, but with a degree of trepidation, he wondered if he would ever be able to pick peas.

So, on the eve of another change in my life, I’m wondering where my cheese is exactly and if I will ever be able to pick peas? Food for thought.

Sherry

To help our nursing team bring positive changes to Clarian Health, visit Jobs for Registered Nurses