The Relationship Nurse

Hello, I am Richard, RN. a nurse who works with Michelle and who coined the phrase, The Relationship Nurse for Michelle.

I noticed the other nurses speaking quietly with her on a frequent basis and the sudden silence when I approached. OK, I'm the charge nurse and this happens, but I also knew about Michelle's joining an origination called Slumber Time Parties about a year ago.

I did not connect the sudden silences with her out of the hospital activities until last week when one of our coworkers complained about the loss of excitement in her 4 year old marriage and Michelle responded, "I have an idea that could help. Let's chat." When I allowed the two of them to withdraw into a quiet area without shadowing or teasing I became "an OK" guy to talk with about something that had been for "women only" until that moment.

We don't share the nitty gritty details, but Michelle began to share some of her journey with me. She had discovered a way to help others in a compassionate, caring manner that was supportive, non judgmental This perfectly describes the Art of Nursing.


Some nurses find a way to help others when away from work. Extra income, something they enjoy or just because they feel better when then give emotionally to others are some of the reasons they find secondary occupations. (Occupation means jobs to me, but the long word sounds better in the sentence. Ha!! Take that 4th grade English teacher)

The stories they share should be sold to TV. I laugh until I cry or cry until I laugh at some of their stories. One of our Nurses, Michelle, has started working with Slumber Parties. She likes to solve "Relationship Issues" for her clients and she enjoys working with other women to improve the quality of their relationships. (yes, sometimes the men, but the men usually just follow the woman's lead. Yep, that's true for me.)

Michelle was sharing with us the other night and I laughed until I cried. As I listened I believed others would enjoy her stories as well. I am going to help her start a blog about her stories. The names and enough details will be changed to protect privacy, but the stories will all be based on real life stories. I hope you find them worthwhile.

I hope you all laugh, enjoy and learn from her as I have. She is a fabulous lady and a natural nurse. Michelle is an excellent bedside nurse. Intelligent, compassionate, skilled and hard working.

She is a tiny little bundle of energy. She says she's five feet, but I think she's closer to 4 ft 10. She is small enough to still fit in her high school jeans even after 2 boys who are now in high school. Her high schools jeans just went to Good Will last summer because they were "out of style, not because they had grown too small. (I just want to scream with envy over that, don't you?...)

She is still married to the father of her boys. He is over 6 feet tall and they look like an "odd couple" indeed. She started to work with Slumber Parties while trying to bring new life into her own relationship and has enjoyed the results and working with others so much she now spends as much time with her fun job (Slumber Time Parties) as she does on her "real job." I have watched her personality change and improve over the last year while she worked on her relationship and helped others.

I recall what I thought when I first heard her describe Slumber Time Parties. I thought "OOOOKK, a bunch of women sitting around laughing about sex toys while they bashed their men and got bashed on margaritas."

I did not want any part of that scene and felt that it was an example of dysfunctional relationships.

I was wrong.

OK I'll repeat that: I WAS WRONG.

Michelle has used the information and tactics to repair her damaged marriage and is now teaching others to do the same. I would not have expected this behavior from her and I have been astounded.

Michelle has expanded her nursing. She now provides excellent nursing for those who need a medical nurse and for those who need a relationship nurse.

Check out her blog Michelle, The Relationship Nurse. E-mail her and ask for her advice. She is better than Ann Landers ever was because she can be realistic and funny.

Long Term Acute Care

What is Long Term Acute Care? There is a lot of confusion about what an LTAC is and what they do for patients. I hope this helps some people understand the function of LTACs better.

First let me explain what an LTAC is not.

LTACs are not nursing homes.

LTACs are not rehab centers.

LTACs are not assisted living centers.

LTACs ARE acute care hospitals (similar to a regular hospital). They are designed to provide care for the patients who are too fragile or ill to recover in the time allotted by Medicare at a regular hospital. A simple version is that they are the sickest of the chronically ill patients found in any normal hospital.

We provide care for the patients with multiple illnesses that play against each other such as the patient with heart failure who needs to have excess fluid removed from their bodies and is also a kidney patient who is difficult to remove fluid from. The diabetic patient with multiple complications such as heart disease combined with poor circulation in their legs along with open wounds that do not heal. The patient who has been paralyzed for many years and now has multiple wounds, bladder difficulty, infection issues and problems associated with a lifestyle that prohibits physical activity. The patient with lung disease that the regular hospitals cannot get off of a ventilator. The patients with infection in their bones who need complex and long term antibiotic therapy along with complex wound care. These are just some of the typical patients seen in an LTAC on a daily basis.

Our patients are always fragile and it becomes a challenge to provide the best care. Each patient and their care is different, challenging and requires daily review and revision. Nursing becomes critical for these patients in order to provide them with the best chance of healing and returning to their home. (or nursing home).

Our patients are with us for an average of almost 4 weeks. Our staff, our patients and the patients family get to know each other much better than in the typical hospital where the patient only stays an average of 3-5 days. We become attached to most, tolerant of a few and we get to understand almost all of our patients and their families. The emotional rewards of practicing the ART of nursing with our patients are enormous. The feelings of accomplishment when one of our ventilator patients speaks for the first time in weeks cannot be explained. The "warm and fuzzy" feelings when we finally stop wound care on patient whose wounds have been open for over a year are incredible. The wounds are finally closed. Seeing a patient go home that none of us believed would survive is an indescribable sensation. This is why we have chosen to work in an LTAC.

The hardest part of our jobs are the patients who do not respond to treatment. Those who continue to get worse until physicians and nurses can no longer help. We see many more of these patients than the normal nurse. We become closer to them and their families. We cry when they pass.

And yet, I find rewards even when a patient does not survive. I know that we have done everything we could. I feel we have provided some dignity for the patient and the family. I know we often provide comfort, acceptance and closure for the families. Acceptance and closure are frequently impossible to provide in a fast paced Short Term Acute Care hospital. (a normal hospital).

I hope this helps others to understand what an LTAC is and why I find the work so very rewarding after 20 years of working in World Renowned ICUs and ERs.