nurse

Why isn’t this taught in the nursing textbooks? Where is the skills test for this in nursing school? Making good coffee as a nurse is that important. We’re talking patient safety here!

I ditched my automatic drip coffee maker years ago and traded it in for the pour over method. The equipment involved never fails (ceramic or glass dripper, electric kettle, and a grinder). And with just a little practice, it takes the same amount of time AND tastes 100 times better. I am not kidding.

Try it for yourself and ditch the Folgers!

  1. Determine the type of roast that you prefer and purchase whole bean coffee. Light roasts retain the most coffee flavor and the most caffeine. It is my favorite roast, but can be too acidic for some taste buds. Dark roasts are roasted for a longer period of time and have the least amount of caffeine. Dark roasts usually bring out the flavor of the roast rather than the bean, and they tend to taste smokey, bitter, or even burnt. Medium roasts strike a balance between the two, which appeals to many coffee drinkers.
  2. Grind beans immediately before brewing. Beans contain oils that will go rancid once they are exposed to air. For the freshest tasting coffee, grind immediately before you brew!
  3. Use enough coffee. A general rule of thumb is to use two heaping tablespoons of ground coffee for each six ounces of water. Measure it out the first time and you’ll get a good feel for how to eyeball it in the future.
  4. Add a pinch of salt. I’m serious. Salt brings out the flavors of whatever you are making. If you want your hot chocolate to taste more chocolatey, add a pinch of salt! Want a more savory chicken noodle soup? Add a pinch of salt. Same for coffee! It won’t taste salty, I promise!
  5. Set up your equipment. Place a filter in the dripper. Add the grounds and salt, and place the dripper over a carafe.
  6. Use an electric kettle to heat the water. This is important because you want the water to be at just the right temperature. If it’s too hot (boiling), it will burn the coffee. If it’s not hot enough, it won’t extract the beans properly. Best way to ensure the appropriate temperature is reached is to use an electric kettle and turn it off when you hear the water quiet down just before the boil.
  7. Pour the water. Take 15 seconds to pour just enough water to cover and saturate the beans. When the water drops to the bottom of the filter, pour more water over the beans. Repeat until you’ve used up your water.
  8. Enjoy! And kick that next shift in the butt!
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Airway, ventilator, trach, OH MY! Mechanical ventilation seems scary, am I right?! You’re working with the “A” of the ABC’s, so yeah, it’s normal to have a little extra adrenaline running through your veins. That’s okay! I’m going to walk you through the basics to ease that fear a bit.

I’ve worked with patients on ventilators for a little over a year now. The patients I see are ventilator dependent due to a number of different conditions including muscular dystrophy, cerebral palsy, post-polio syndrome, spinal cord injury, and COPD. When I first started working with these patients, I felt overwhelmed with the ventilator settings and knowing what to do if a problem arose. I now feel like I could handle most situations that come my way.

Here are the three key things every single nurse should know when working with a ventilator dependent patient.

  1. Locate that ambu bag immediately! Before it is needed. You do not want to be the nurse that is frantically looking for the ambu bag while your patient is rapidly de-sating. Your eyes won’t work when you’re in a frenzy, so locate the ambu bag at the beginning of your shift so that if the need arises, you can grab it quickly!
  2. High pressure alarm = blockage. You could also think of a kinked garden hose. If you have a kink in the hose (circuit or airway), the water (air) won’t get through! It could be a complete blockage where no air is getting through, or it could mean that the patient is coughing and there is a temporary blockage of air that will resolve on its own. Most of the time, it will indicate that there are some secretions in the airway that need to be cleared. Get that suction kit ready, and get the job done!
  3. Low pressure alarm = disconnect or leak. This alarm will sound when the circuit has disconnected somewhere along the line, there is a hole in the circuit somewhere, or the circuit connections are loose but not completely disconnected. Run your eyes down the circuit from the trach to the ventilator and see if you can quickly spot the problem. If you are having trouble spotting the disconnect, call respiratory therapy and/or get the ambu bag ready and connect the patient to the back-up ventilator.

Don’t get me wrong, mechanical ventilation is way more complicated than that. I could go on and on about assist control and pressure support and PIP and PEEP and MAP and…on and on.

If you are in the acute care setting, most nurses will not have to know details about ventilator settings because respiratory therapists are circulating the floor to assist the patient and address your concerns.

For most nurses, the three pieces above will be more than enough to begin caring for a patient on a ventilator!

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