I recently changed my role to clinical services manager, where I solely manage the program that focuses on health of individual living with HIV. I started my role as Clinical Practice Manager in Primary Health Care in 2018. When I started my role as CPM, I was beyond excited since my dream to work in community level came true. Today I am beyond excited to share that I have added few more letters behind my name. I am AIDS Certified Registered Nurse (ACRN). Also so proud to say that I am first Nurse in state of Iowa to get the certification.
Smita Sharma (स्मिता शर्मा)
Live and let live
Wednesday, February 9, 2022
Thursday, December 2, 2021
Sunday, August 2, 2020
What I encounter as a Brown Nurse
I have recently started respecting myself and giving a pat
on my back myself for what I have accomplished as an immigrant here in The United
States. There are lots of aww moment in my Nursing carrier that made me feel
that I made a right decision to be a nurse and serve here. I had great
co-workers and leaders whom I worked with. I might not have been so successful
in my nursing carrier if had not worked with my first nurse manager at Mercy
Hospital, Ardmore, Oklahoma. She was always an inspiration to me and a great
mentor. I always wished all my manager were like her, but I do not live in a
fairy tale. This is a real life and both positivity and negativity exist in
this world. I did work with some coworkers who just saw me as a nurse and a
person, they never saw my color, they never noticed my accent and the list goes
on. Despite the great moments during my nursing carrier, I also had lots of
unforgettable gloomy moments that made me stronger and more robust in my views.
I went to one of the finest schools for my nursing degree, I
always wished if there was more cultural diversity in our class. I was one of
the handful who was international, or who looked like me. I always wondered why
I only had three or four friends during my entire undergraduate college.
Believe or not out of those three two of them were born and raised outside of
the States. I believe I talked with handful of students in that class. Now I
wonder why we were not involved in anything that happened in that class. Why I
had such a hard time even to start conversation with them. I always felt
inferior in front of them. Today when I retrospect, I realize why we two were
left out in that college was not only because of our skin color and race but
also due to our socio-economic status, culture, religion, language, and nationality.
We did not grow up watching Batman, Home Alone, Star Wars, friends, and the Office.
When my classmates used to be so excited
about the Christmas break and plans about Thanksgiving break, I spent my time
in a lonely dorm learning about Christmas and Thanksgiving. I wished if I could
get a day off during Dashain and Tihar instead of Christmas or Thanksgiving but
who would change the college policy for one person. Wished I had learnt I would
be able to take days off without getting penalty if I had disclosed as religious
reason. When my classmates planned summer break at beach or international travel
or vacation with family. I was planning where to embark my personal stuffs since
we must leave the dorm during summer. I would load my 1996 Corolla and start
the car without knowing where I was going to crash that night. After summer break
I always had hard time going back to school. Every fall, I will unload my car by
myself, move everything to that third floor I still ask myself why all my dorm was
on third floor. On the other hand, most of the students had their families
seeing them off, helping them to settle in a dorm. During those times I missed
my family so much and asked myself “What am I doing here, what is the point of
this.” I cried alone; of course, long-distance relationship was not helpful at
all.
I have very few positive experiences except I had with Adiza
and Library. Hold on I had more than that, couple of parties I had with other
Nepali speaking students. I was a Mentor for International students, I was
President for Nepalese Student Organization at UVA. Today, I reflect and ask myself
why all my involvement incorporated only international students or minor
students in school. I learned how to cook Thai food, Indian food, Chinese food
at so on but I never learned how to cook American food. We were always left out
in that class which consisted 90+ students. Our last week before graduation,
students went to Myrtle beach, a graduation culture at UVA, but I was just
ready to graduate and leave the college as soon as possible.
By the time I graduated, I was already married to love of my
life. I was complete with him by my side. I started feeling included, I started
feeling respected for what I have accomplished. But I was not aware of the
reality. I faced the truth of being minor or colored person after I started
working as a Nurse. Experience as a Student nurse was different, I just felt I
was not included but I was never abused or any targeted racism.
I picked up lots of hours and night shifts. One day, around 1:00
AM, alarm went off on one of the medical equipment, so I went to the patient’s
room whom I was not assigned to take care. She was in a deep sleep, I decided to turn the
phone’s flashlight so that I could trouble shoot the machine without turning
bright light and disturbing her sleep. Then I realized that she was already
awake because of the alarm. After she saw me with a flashlight, she told me that
I could turn the light on. I turned the light on, as soon as I turned the light
on, she responded “What the heck you are doing here”. I responded her back that
I was there to stop the alarm. She got irritated since it took little longer
than expected and commented with “You Mexican get out of my room and go back to
your country.” She did not see any of my nice behaviors, only thing she saw was
my color. I felt bad for her and answered myself “Smita imagine what her life
is like if her behavior is like this with someone like you.” I felt bad for her
thinking that every brown person is from Mexico and that brown persons are inherently
bad.
Another story I would like to share. After taking care of an
acutely ill patient for 5 days, I was ready to discharge him. I was so happy
for him and the family that he was finally going back home. I printed out all
the discharge paperwork. Got medication planner, got educational materials so
that he could manage his Diabetes easily. His response to me during his stay
was different from other nurses and I gave benefit of doubt that he is sick and
stressed out. But I was wrong when he commented, “Can you please speak in
English, I do not understand your language.” I was in shock, I was speaking the
same language, English, for last 5 days with him. I was speaking the same
language when I was cleaning him up when he was not even able to get up and
walk to the bathroom. He understood everything what I said when he was ill. Now
he is stronger and better and all sudden I have an accent that even does not
sound English and he cannot understand me.
When I was asked if I was Indian, Mexican or some other
nationalities by patients and co-workers, I feel offended every time. If you do
not know the person, then you do not know where they are from just looking at
their skin and their physical structure. Hence please just ask where that
person is from instead of making assumptions about Indian, Pakistani,
Bangladeshi, Mexican and or any other countries with brown people. I am so
happy to say I am from Nepal rather than, explaining why I am not from the
country they assumed. Other side of the story is why a patient needs to know
where I came from, when I am giving a best patient care they have ever got. Do
not take me wrong, I have taken care of patients who genuinely asked me where I
was from, but majority of the patients ask because of my color. Most of those
questions comes with attitude of “why the heck are you in OUR country”. The
questions do not end there, they continue to ask me questions like “do you not like
your country? When are you going back?” They are not aware that I left my birthplace
15 years ago when I was 18. I am a US citizen now and this is my country, I
belong here but I am not still accepted by public. No matter what my citizenship
status is I am never seen as a US citizen without proving myself by explaining
because of my skin color.
Targeted racism not only come from patients, I sadly have to
say that sometimes it comes from co-workers, leaders too. One day, I was
minding my own business, charting in nursing station. Two of the nurses in
station were having conversation. I heard the conversation and shocked with their
ignorant sense of humor. One of the nurses asked another one, do you know what
25 MPH means in Crawfordsville, IN? and the nurse explains as this, “That means
25 Mexicans per house”, and followed by big laugh. Then I was asked why I am
not laughing at their comment. I responded them back as it’s not appropriate,
and I did not want to participate. Then I left the Nursing station. Refusing
not to participate was the right thing to do but I should have acted on it too.
But I failed to do so.
It was another normal day at work when I arrived at work. I
questioned about my patient assignment sensing favoritism. I got harsh comment
from him “Smita do not complain. If you do again, I will have to call homeland
security and you might get deported.” He did not know that I am an American
Citizen and worked hard to be a citizen. But that was not the point if I was
American or not, the behavior was not right, and that comment was not right. None
of the nurses voiced any concern after that comment or and they did not want to
get involved. I was the only brown Nurse in that floor or may be in that whole
hospital. I had enough after that comment and I left the job. I should have
reported to HR but I was not strong enough to report at that time. I was scared
and I ran away from the situation.
Above examples are just some comments and behaviors that I
encountered during my school and work. There is so much to change on healthcare
provider abuse as a whole and mainly racism towards colored nurses. Often, our
ideas are overlooked by leaders but when the same idea comes from the white colleagues,
they get recognized for similar idea. We must prove ourselves to patients and
our leaders that we are asset to the general population and to the organization
whom we work for. Proving once is not enough. We must prove every step during
our career and life just because of our color. Struggle goes on. Hope our next
generation do not have to struggle for this and face this. Am I asking too much
from the society where we are and where we belong to?
Tuesday, June 18, 2019
Answering Priority NCLEX style questions
Good Luck
Monday, February 8, 2016
All you need about ECG (Electrocardiogram) information
Thank you ECGguru.com
All about Cardiac Rhythm (Ecgguru.com)
Sunday, December 7, 2014
Kaplan's free RN Prep Study
NCLEX RN Prep Free Seminars
Wednesday, June 18, 2014
Whose fault is it? and what is wrong if you think little outside the box?
Here are the some scenarios that I want to talk about:
1) " I once had a 20 year old female patient who didn't know that having sex would lead to pregnancy. She had no idea."
After reading this point thousands of people might have laughed and shared the story to other coworkers. That 20 year old female may be from different culture or may follow different religion. She might have been not only in abstinence but also restricted from sex education. If someone does not tell you or if you are not allowed to learn about something, how are you going to learn about sex? For those girls, someone who knows about sex when they are 12 years old and gets pregnant when they are 13-14 are crazy and dumb. But in reality no one is dumb or crazy, it is just the reality of different culture, level of education, and their experience of life.
2) " After looking at the patient's chart and seeing she had diabetes
Me: Do you have any medical conditions?
Patient: No
Me: Are you sure, you've never been told you have any disease
Patient: Never
Me: What Medications do you take?
Patient: Insulin, for my diabetes
What you all think about this conversation, your first reaction may be what?, really? seriously? lol? and so on...... but think from the other side, think as a patient perspective. That patient did not go to medical school or nursing school nor worked in a medical field. None of her family members have any experience about medical terminology. When patient was first diagnosed with diabetes, did any of the medical person sat down and educated the patient about his new diagnosis. Did anybody informed the person that diabetes is a medical condition, or a disease. May be those nurses or doctors were too busy saving lives, that is our excuse most of the time. Whose fault is it now in this situation and who is dumb or crazy. Hence, before you laugh and say someone crazy/dumb please try to think out of the box and try to stand on their feet.
3) "A middle aged lady in the operating theater once told us at the last minute (as she was being wheeled in) that she's allergic to latex. Everyone freaks out cos so much of the stuff we use in theater has latex in it, so we take her to the latex free theater and do her surgery there. When she's in recovery and awake I enquire as to what reaction she has to latex. " I just don't really like the sound the latex gloves make, dear". I just turned around and walked out."
If I was that nurse/medical personal who heard that little lady saying she is allergic to latex, I might have same reaction or I might have walked out. But, if we think and evaluate it it is nurse's or that medical personal fault, who asked if patient have any allergic reaction or but does what kind of reaction, or verify it with patient chart. If someone at least had asked what kind of reaction? then they would not have gone through extra hassle.
4) "20- something year old patient comes to ER, chief complaint on the board is "private." This should be good. Go in, he is visibly depressed and sad. Tells a story about how he slept with a women, didn't use protection, and after he noticed she had a "plastic box on her." When she told it was an insulin pump for diabetes he was mortified. Came in immediately to be tested for diabetes. "
This is similar to the first point I discussed here. It is lack of education. That patient is not aware of disease process of diabetes. If you think as a normal person without any knowledge of medicine, if you get HIV through sexual transmission why not another disease like diabetes. What is our responsibility here? provide education. There is still stigma around HIV it gets transmitted through mosquito, by sharing room and personal items with patients etc. Shouldn't we provide more education.
5) " Don't eat or drink anything after midnight" Before his 3 year old daughter's surgery the next morning (tonsils and adenoids). While intubating his daughter the next morning, she vomited scrambled eggs, causing her to aspirate them into her lungs. Her heart stopped, and I did chest compressions on her for 25 minutes. We got her back, aborted the surgery, and transferred her to pediatric ICU on a ventilator. Her father's response..." she said she was hungry. I thought you were being too hard on her. It must have been something you did to her."
We provide education in a way how we want to hear, but providing education means to provide education in the way how that person is going to take it. Do not eat or drink anything after midnight. That is not a education that is instruction or better an order that you are giving to the patient/ family members. You should provide an education when you verify with the patient/family members did they really understood what you are trying to teach. That medical doctor/nurse/ medical representative should have given extra 2 minutes to describe reasons for not eating before surgery. Also another questions arise, did anyone asked the father if patient have eaten anything that morning before surgery. May be not, because we think according to our way, if I said not to eat, patient might not have eaten, right?
6) "The best was the women who was feeding her 3 month old dog every few days for no other reason than she thought a dog should only eat that often. Came in for hypoglycemia(0f course).
The nurse who spoke with her has no patient for this kind of jacked ignorance, and actually shouted at her "DO YOU EAT EVERY THREE DAYS!?""
May be she has dementia like our grandmother or grand father have, may be that patient have some psychological problems that might have been ignored by the medical personals. And she might have genuinely thought that's how you feed dog.
7) "Once had a patient who was prescribed an inhaler for his cat allergy. He came back a week later saying he was none the better. Turns out he was spraying the inhaler on his cat.
--see below
8) " My favorite was when someone was prescribed estrogen patches and told a stick one patch on herself every other day. At the next follow-up she said she didn't like the patches because she had been running out of space." I didn't think to clarify to her that she should have been placing a new patch and removing the one from yesterday each day. Very amusing. She indeed was covered in sticky patches.
During my last three of nursing career, I had a great group of co-workers, leaders and supervisors. I learned a lot from them, and still I have to learn more. One of the story that one of my supervisor shared was almost the same like above two. This gentleman came back to ER stating that he did not liked taking suppository for his constipation because it tasted bad. (By the way suppository should be inserted anally.) While she was saying the story she was not laughing and she was not pointing that patient as a dumb or crazy. She had a chance to learn something new during her initial nursing career and teach us about nursing education citing the story. In all the stories described above in points 7 and 8 and story of my supervisor's patient reflects that we are still lacking with good education in healthcare for our patient population. It's not even education. it's 10 second instruction. We still need to be more clear and concise with our patients. Put a patch every other day means putting a patch every other day, we also need to explain them that old patch needs to be taken out before patient applies the new patch. If that inhaler was the first prescription for that patient, we lacked to provide education how to use the inhaler, that's why patient came back to ER. That is not good for patients and also not good for the hospitals. We are using the resources that are always in shortage for some of the stuff that did not need us due to our own fault or negligence.
Out of those 15 examples, I talked about 8 of the above, that I thought there is lack of education for our patients, and lack of our common sense, since we do not think out of the box. Please start thinking something different than you think and please at least start to think what's going on the other end. It is just a feelings and thoughts that I shared here, no one have to think like me and no one have to agree with me too. I may not know how the plants of my favorite foods look like and I still enjoy it and I think a farmer does not expect me to know how those trees look like.
Thank you
Smita Sharma
Indiana.
Thursday, June 5, 2014
Kaplan's Video about NCLEX RN test.....
Thursday, May 22, 2014
How to Transfer your RN license to Indiana from other states
1) Indiana does not have a separate website for Board of Nursing it is under Indiana Professional Licensing Agency (PLA). And here is the link
http://www.in.gov/pla/nursing.htm
2) Transfer of license is called endorsement application. Here is the link below with instructions and it is pretty detailed in the website itself.
http://www.in.gov/pla/2506.htm
3) After you get into the link above application form is underlined as completed application which is on PDF file.
4) You need PDF installed in the computer if not you can get it from http://get.adobe.com/reader/
5) After you download the application form, application form will look like this:
you can type or print, if you decide to type you can save the data.
6) After application is filled, along with your application you need to submit $50 application fee payable to "Indiana Professional Licensing Agency" , proof of license in another state ie (Scan or print copy of your license from your state) and a photograph as described by Indiana professional licensing agency as below:
Include a photograph, approximately 2 ½ x 3 ½ inches, head and shoulders view, black and white or color, of professional quality. Polaroid type or laminated photographs will not be accepted. Please tape, rather than staple, the photo to the application. Please place your signature on the front of your photograph
Derived from http://www.in.gov/pla/2506.htm
7) Mail to the address :
Professional Licensing Agency
Attn: Indiana State Board of Nursing
402 W. Washington Street, Room W072
Indianapolis, Indiana 46204
8) Send your Transcript: from your college directly sent from college in a sealed envelope from the registrar's office.
9) Request license verification from your state, you have to fill out separate form for this step and form can be found in your board of nursing website.You can find the application form for Oklahoma
https://www.ok.gov/nursing/forms3.html it is all the way down in the list called written verification of Licensure and they will charge you $40 (Fee may change)
10) Wait for response from the staff that they got your application.
11) After you get the response your next step is background check you can call or register at http://www.identogo.com/
12) After all this done now just wait for the result.
Good luck and best of luck for your nursing career, I hope you love your nursing career as much as I do or more that I do (I don't think that is possible just kidding........)
Tuesday, January 21, 2014
Beauty of small hospital.
Saturday, January 4, 2014
I love being a Nurse....
Friday, December 6, 2013
Tips for NCLEX test
Here are some tips for NCLEX test for the process and for the exam itself
1) Decision Tree
Decision Tree
2) Test Taking Strategies for Nursing Students by Caralee Bromme'RN, MSN CCRN
Test Taking Strategies for NCLEX
3) Official website about NCLEX with detail information
Make sure you go through every little bit of information you can find in this website especially tips for Before, During and After the examination
4) National Council of State Board of Nursing
If you want to learn more about NCLEX examination as a whole follow the link below
NCSBN
Please Enjoy and I will keep posting, if you feel like I need to add something more let me know thank you.
Saturday, November 30, 2013
NCLEX Decision Tree (Similar to Kaplan)
Derived from: http://www.slideshare.net/rebeccabowman2/decision-tree-25818301?from_search=11
Top Patient Safety Strategies to implement now
Top Patient Safety Strategies to implement now
References:
Picture: Derived from, http://www.medscape.com/features/slideshow/patient-safety, November 30, 2013, Stokowski, Laura A.
Monday, October 28, 2013
Made my day.....
At the end of the shift, 86 years old cute little lady asked me, " are you going to be here tomorrow, I have to leave hospital for whole afternoon tomorrow, if you are going to be here I can leave him alone,(pointing her 90 yrs old husband, who are married for good 64 years) I know you will take a good care of him, I trust you" made my day.......
Monday, August 19, 2013
Site for NCLEX 3500 is working now
NCLEX 3500
best of luck
More NCLEX RN practice questions: Free NCLEX RN practice questions
Wednesday, July 17, 2013
Pearsonvue Trick for NCLEX
Try to re-register at Pearson-vue website, if you get the message 'our records indicate that you have recently scheduled this exam. please contact your member board for further assistance. another registration cannot be made at this time. That means you passed. if you do not get message and go straight to the credit card information page, that means you did not pass.
I tried it when I tested for NCLEX and it worked, it's working for almost everyone who is giving test this year.
Good luck and have a great carrier in Nursing.
For free NCLEX practice questions follow the link you can find thounds of practice questions for free including HURST and Kaplan resources. Enjoy
Free NCLEX practice questions
Wednesday, August 1, 2012
Sunday, June 24, 2012
Good luck new graduates
Good luck all.....praying for all you.
Enjoy the free NCLEX practice questions: Free NCLEX RN practice questions