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Melissa Mills BSN

Nurse Case Manager, Professor, Freelance Writer

Hi there! I'm Melissa and I'm a skilled writer, editor, and content manager and I would love to help you with your next project. I specialize in healthcare and women's content

Content by Melissa Mills

  1. Melissa Mills

    5 Reasons Nurses Get Fired and How to Avoid Them

    Dear Truth66 - I am so sorry you endured this horrific event. I used to case management worker's compensation claims here in the states, so I appreciate how difficult it is to maneuver through this system. I don't know the ins and out of the Canadian system, but I can tell you that it is a broken system in the U.S. Stay strong, best of luck, and thanks for sharing your story. Melissa
  2. Melissa Mills

    7 Writing Tips for Nursing Students

    Nursing school is full of dosage calculations, clinicals, and writing assignments. You were probably prepared for the first two, but writing might not be your strong suit. If your palms get sweaty when you hear things like term papers, capstones, or dissertations, no worries! This list of 7 writing tips will have you succeeding on those dreaded assignments in no time - here's how. Understand the Goal of the Assignment When you're preparing for a written assignment, be sure you understand all the details. There is nothing worse than pouring your heart into an assignment to be later told that you missed the purpose and won't receive full credit. According to Walden University, there are five common goals of nurse assignments: Demonstrating critical thinking skills Documenting your knowledge Expressing ideas or opinions Showing your understanding of nursing literature Demonstrating your understanding of activities Know Your Audience Writing requires you to know and understand your target audience. In school, you're writing for your professor with the express intent of demonstrating your knowledge about a subject. But, don't be mistaken - even though you are writing for your professor - be sure to express your thoughts openly and don't assume they fully understand the subject. Here are a few things you need to know about the professor's expectations before you begin your assignment: Should you write in first, second, or third person? Do they have a sample of a paper or writing style they prefer? What style of citations do they prefer? Is there a preferred format for papers? If you have multiple audiences, how do you meet the needs of everyone? Do Your Research Research in nursing school is essential to your success. You will need to become very familiar with the online library and how to perform a search for topics. Many of the library systems have multiple ways to search for articles, save them for later reference, download and print them. When you search for nursing research, be sure the information is: Current - You professor might provide guidance on this, but if not, always try to find research no more than 10 years old and preferably within 5 years. Credible - Credibility is essential in nursing research. Be sure to know the author, journal, and publisher. Always steer clear of websites like Wikipedia, blogs, and magazines for academic papers. If you want to search the web for articles, try Google Scholar for academic sources. Peer-Reviewed - Nursing is founded on evidence-based research, which means that finding articles that have been peer-reviewed is critical. If you haven't heard of this term before, it means that the item has been reviewed by a board of experts on the subject matter. Peer-reviewed articles are considered to be a high quality of research and adhere to strict editorial standards. Execute a Brain Dump There's nothing scarier than a blank page, especially, when you know that you need 10-15 pages filled with stellar content in a short amount of time. But, as scary as it might be to get started, that is precisely what you need to do. As someone who writes often, I have learned that you must do a draft to "get the garbage out," as I say. Once you get all of the garbage out and onto a document, cleaning it up and adding to it is easier than creating those first few sentences. Keep the Fluff to a Minimum Nursing school assignments are not like writing poetry. You want to be very clear in your writing. There is no need for a lot of descriptions and flowery wording. Do your research and be sure you understand the material thoroughly. Write using clear language. Once you're finished with your paper, read it aloud, which will help you to identify areas of flowery wording that isn't necessary for nursing school. If you need extra help, find a classmate who is good at writing and have them read over your work. Another option is to use an online editor such as Grammarly or Hemingway. These tools are not perfect, but they can help find common errors and offer solutions. Avoid Passive Voice This takes practice. If you struggle with passive voice, just know that most writers struggle too. Limiting passive voice is very important to academic writing. It's a simple guide to keeping your language simple and easy to understand. So what is passive voice? According to the Writing Center at The University of North Carolina at Chapel Hill, passive voice is when you make the object of an action into the subject of the sentence. For example: Active Voice: The chicken crossed the road. Passive Voice: The road was crossed by the chicken. When you write in active voice, the ideas you are expressing are clear and easy to understand. In passive voice, it might be a bit more challenging to understand the meaning. Practice, Practice, Practice If you're struggling with assignments and your papers are coming back with lower scores than what you want, try practicing. Now, this might not sound like much fun, but you don't have to do extra term papers. Try writing a journal or start a blog about nursing school. The more you write, the easier it will become. If you need a bit more discipline to get this practice, take a writing class. It might not be required, but it will help you throughout your college and professional career. Do you have other writing tips for nursing students? Are you a student and have found something else that seems to be helping? Let us know your thoughts.
  3. Hi Wolfbuddy! You raise some excellent points about the nursing shortage and the motivations of those entering the profession. The wages have increased over the last 20 years, or so, however, I agree that there are other professions that you can come out of college making significantly more money. The nursing shortage is a complex issue with many moving pieces. I'm not sure there will ever be a real solution. Instead, we have to attempt to solve the problems as they arise and see how the whole thing turns out. Thanks so much for your insightful comments. Melissa
  4. Melissa Mills

    7 Writing Tips for Nursing Students

    Hi masonicus! I am so glad you found this to be helpful. Yes, academic writing is totally different and can be difficult for even the best of writers. Best of luck to you on your journey - I'm sure you'll CRUSH it! Melissa
  5. According to a 2017 report by the World Health Organization and the World Bank, at least half of the world's population lacks access to essential health services. As more people than ever are facing health conditions without adequate access, many nurses are called into mission here and across the globe. Have you ever considered going on a medical mission trip? Do you wonder what a typical day would be like if you were to go? I had the pleasure of speaking with Elaine Alston, founder of Nurses with Purposes (NWP) who told her story and answered several questions that might help you decide if a medical missions trip is right for you. History of Nurses with Purpose Before she ever took her first nursing class, Elaine wanted to give back. She contacted the local hospital, but she wasn't eligible to work as a nursing assistant quite yet. Not to be discouraged, Elaine signed up as a personal touch volunteer. She reminisced that it was in those one-on-one interactions with patients where she fell in love with volunteering. After graduating from nursing school, she began working but quickly realized how easily nurses could suffer from burnout. She started feeling this way herself but used her volunteering opportunities to combat these discouraging feelings. Elaine knew she had to stay connected with volunteering and began working with local organizations and events. She became known for this work on her unit and started organizing events for other nurses too. This is when she first realized how much she loved connecting other nurses with volunteer experiences that kept them grounded in their love of the profession. In 2010, Elaine's love of volunteering received a new calling - Johannesburg, South Africa. She visited as a part of a homecoming trip. You see, she was from Johannesburg, but had never visited. When she met her family, she learned that she was like her grandmother, who was also a nurse. Her father told stories of her grandmother bringing the sick home to care for them when they couldn't care for themselves. Elaine left Johannesburg knowing she needed to continue her heritage of caring for the sick in this part of the world. She saw this as yet another opportunity to connect others to people in need which led to the creation of NWP. NWP Today Things worth working for never happen quickly, right? And, Nurses with Purpose is no different. It took Elaine several years and multiple trips to South Africa to build the infrastructure for the program that would support and foster medical care provided by American nurses in Johannesburg. She created the organization, board of directors, and began recruiting for her first team trip in 2017. Today, she is working to grow the organization to take more nurses on a mission to a city she loves. NWP combines the medical mission with opportunities to learn more about the culture and people by organizing excursions and celebratory dinners throughout their time serving. If you have ever wondered about taking a medical mission trip, here are a few things you should consider. Typical Day The team's days start early. Most days, you work in a local health clinic that sees 350-500 patients each day. Because there is little use of technology, they are highly organized and run patients through quickly. As a team member, you will work in the ED, triage, health screening, mental health, and postpartum and antepartum units. NWP also works with a mobile health unit to visit rural settlements to provide healthcare to villages and local townspeople. One or two nurses will go with a local healthcare team each day to experience healthcare outside of the city. You will also provide psychosocial care to children in a local orphanage. Elaine explained that a significant portion of the orphans in S. Africa has lost their parents to HIV or Aids. She said that this day is a great way to connect with the children and the people serving them in the orphanage. How Does it Differ from Care in the States? Besides the use of technology, caring for patients in South Africa is entirely different. Elaine described one cultural difference as the "respect for the ill." Healthcare teams are dedicated to taking care of the ill in a different way than what we are used to here at home. "In the clinic, it is normal for 4 out of 5 patients to be HIV positive. Many women do not want to discuss their illness with their spouse or partners for fear of them leaving them due to being unclean," said Elaine. She expressed how integral the NWP team of nurses has become in offering education, support, and compassion for women who might not receive it otherwise. Your Investment Medical mission trips aren't cheap. But, if you look at the trip as an investment in your career and the care and welfare of others who might never receive it without you - it might just be worth it. Your trip to Johannesburg will cost you $1913.38. This includes your lodging, transportation, 2 celebratory dinners, 3 excursions, and a few other incidental charges. For more details on the application, cost, and how to become an NWP team member, follow this link. If you would like to consider a few other medical missions trip options, consider these as well: Why Medical Missions? Do you often wonder where the romance went in your nursing career? Elaine believes that a missions trip will remind you why you chose this caring, compassionate, yet difficult career path. "Completing a missions trip will be your nursing revival," said Elaine. If you have been on a mission trip and have experienced a nursing revival, share your story with us in the comments below. Did you love it? Do you want to go back? Did you have any bad experiences? We want to hear it all.
  6. BostonFNP - I wish there was a way to "double like" this!!! I agree 100%!
  7. Hi there Katillac - Thanks so much for your comments. If you follow the links in the OP, you can see that I have used various articles as evidence that students are being turned away. I agree that graduating more students is not likely not going to solve anything. The issues related to nursing shortages and other staffing issues go far deeper than one area, like education. However, I think it is imperative that we learn more about the issues, form our own opinions, and decide how best to act to make a postiive impact for our healthcare industry and the future of nursing. Thanks again for your thoughts. ~Melissa
  8. You've finally figured out what makes your millennial co-workers tick. Time for a breather? Not a chance! Right on the coattails of the millennials is the next generation - the Zees. Generation Z is made up of people born between 1996 and 2010. There are currently over 23 million Zees, and they will be the fastest-growing generation in the workplace over the next five years. Every generation is given a few nicknames - so, besides Generation Z, you may also hear this generation called the iGen, Zeds, Zees, and Centennials. To make sure you understand this generation, here are a few traits and characteristics: They don't remember 9/11. Some of them were born, but none of them were old enough to remember it happening. They are cloud-natives. Their world has been full of "iEverything." While many of their characteristics are still being defined, what we know so far is that they are self-reliant, self-aware, goal-oriented and appreciate diversity. They don't remember a time before social media, so they live their lives online. This includes friendships, family, and education. Now that you know the basics let's explore what you need to know about them as they enter the nursing workforce. iGen as Learners They were raised and educated in settings of inclusivity and diversity, which has formed them to be the most diverse and open-minded generation ever. They are changing our nursing classrooms and will likely change the workplace too. Because they are technologically savvy, they want to use the internet to help them learn. Whether in college-level courses, orientation programs, or certification classes, they expect that the internet will be part of the curriculum. And, you need to know that it is estimated that they only have an attention span of about 8 seconds - so, let them multi-task - they have been doing it their whole life. Zees as Professionals They have grown up watching their Baby-Boomer grandparents work well past 65 years of age. Their Generation X parents have gone into debt with school loans that are still being paid off today. Where does this leave Generation Z as professionals? There isn't much data on the Zee's concerning professionalism as they are just entering the workforce. But, so far, it looks like they are going to be more entrepreneurial, educated, and diverse than any generation before them. They find honesty as the most important quality for leadership. They desire work-life balance while making money at a stable job. And, they want to have face-time with management. Because of their comfort level with technology, image what this generation could do with advancements like telehealth and Artificial Intelligence (AI) as they join the nursing workforce. One potential concern is their ability to critically think because of the amount of interruptions and multitasking they have been doing their entire lives. However, this is merely anecdotal due to little research into the actual abilities of this generation. As we watch the iGen enter the workforce, what can current nurses do to help? According to Priscilla Smith-Trudeau, "Putting diversity to work in the workplace, understanding each generational cohort, and accommodating generational differences so as to capitalize on these differences in attitudes, values, and behaviors must be the common goal of all nurses." This means we must be ready to embrace, foster growth and mentor these new nurses who will be joining the ranks over the next few years. Here a few ways to help the Zee's enter the nursing workforce: STEP 1: Provide Technology Incorporate internet learning into orientation. Understand that their lives are lived on their phones and other devices. Be sure to educate them on expectations of when and how to use social media and technology appropriately. Incorporate simulation, problem-based learning, games, and case studies into the curriculum to keep this generation engaged. STEP 2: Show Respect for Diversity Be sure to include them in groups and committees at work. And, be ready for them to expect these groups to show diversity in gender, race, ethnicity, and sexual orientation. STEP 3: Foster Retention With every generation, we want to foster retention as nurses. Much information floats around about bullying in nursing. Let's get it right with this generation by welcoming them with open arms and helping them remain in nursing for many years. STEP 4: Appreciate their Respect They respect authority. Show them you appreciate it by fostering strong mentorships with them early on in their careers. STEP 5: Empower their Practice You know they are different than any other generation of nurses you have encountered. Their world has been far more technologically-savvy and quite frankly, scarier than what we experienced as children. So, let's empower them to be the best clinicians possible. Are you a Gen-Z nurse or do you work with a Gen-Z nurse? What can you tell us about them? How do you feel we can support and foster this generation of nurses?
  9. Melissa Mills

    Staffing Ratios in the ED

    You enter the emergency department (ED) right at shift change. But, tonight's different - instead of going to work - you signed in as the patient. As you register, you hear one of the nurses state that there were two call offs and no staff available to float from another department. As you look around, you don't notice anyone in the waiting area reacting, except you. You even quietly wonder if it would be best to go home and wait it out until the morning to see your primary doctor. As a nurse, you know that limited nursing staff will probably mean you are in for a longer than average wait time. One recent study has confirmed what you already knew - poor nurse staffing numbers in the ED increases patient length of stay and decreases patient satisfaction. The Findings This study was conducted in a high-volume, urban public hospital. The researchers conducted a retrospective observational review of the electronic medical record database for a 12-month period in 2015. They reported nursing hours, door-to-discharge length of stay, door-to-door admit length of stay and the percentage of patients who left without being seen. The mean number of daily visits in the ED was 290, with a range of 219 - 425. The median number of nursing hours per day were 464.7 hours. The study found that poor staffing models in the emergency department increased the door-to-discharge length of stay and increased the number of patients who left without being seen. No change in door-to-admission rates was observed. Could this be because the receiving unit was adequately staffed? There was no reason given in the study, but it makes sense that if the receiving unit was fully staffed, they could receive the patient timely from the poorly staffed ED. Other variables, such as the daily ED volume, hospital census, and ED admission rate did not change the length of stay statistics observed in the study. What We Know About Staffing Ratios Nursing ratios equate to positive patient outcomes and safety. Adequate staffing has been proven to show a reduction in: Patient mortality Patient readmission rates Medical and medication errors Patient length of stay Patient costs related to unplanned readmissions Preventable events, such as pressure ulcers, falls, and other hospitalization complications Not only does poor staffing affect patients, but it also affects nurses too. A Medscape survey found that 57% of nurses polled believe that patient care is suffering. And 53% of said that at the end of a typical shift, they don't feel satisfied with the care they provided. This is a problem that can't be ignored. So, we know that safe staffing levels are a requirement for quality patient care. But, whose responsibility it is it to enforce? Federal Rules Medicare-certified hospitals are required by law (42CRF 482.23(b) to "have adequate numbers of licensed registered nurses, licensed practical nurses, and other personnel to provide nursing care to all patients as needed." This regulation can provide some guidance to hospitals but leaves quite a bit of room for interpretation. In fact, because of the loose language in the regulation and the lack of enforcement by Congress, many states have started taking the matter into their hands by creating safe staffing laws. Staffing in Your State Does your state have a mandatory staffing law? There are currently fourteen states that offer official regulations for nurse staffing. These states include California, Connecticut, Illinois, Massachusetts, Minnesota, Nevada, New Jersey, New York, Ohio, Oregon, Rhode Island, Texas, Vermont, and Washington. Seven of these states also require hospitals to have staffing committees who are responsible for nurse-patient ratios and creating a staffing policy. These seven states are Connecticut, Illinois, Nevada, Ohio, Oregon, Texas, and Washington. While it's good that many states are adopting regulations, it seems there isn't any consistency from one state to the next. Massachusetts requires a 1:1 or 1:2 nurse to patient ratio in the ICU. Minnesota requires that the Chief Nursing Officer develop a staffing plan and California stipulates a minimum nurse to patient ratio be maintained. And, five states require public reporting of staffing ratios. Nurses Taking Action Like many issues - if you want something done right - you have to do it yourself. This may be the motivation behind recent movements. The American Nurses Association (ANA) supports the empowerment of nurses to help solve staffing issues by creating staffing plans specific to each nursing unit. They have identified key factors that influence nurse staffing, which include: Number of admission, discharges, and transfers Skill level of nursing and non-nursing staff Patient complexity, stability, and acuity Layout and physical space of the nursing unit Availability of resources and other technical support Another recent movement in the battle to find common ground on the subject of nursing ratios is NursesTakeDC. This nurse-driven movement strives to make safe staffing ratios a reality for nurses across the United States. You might think that this was just a one-time event that happened earlier this year, but NursesTakeDC is committed to planning future events, providing further education, and supporting current and future legislation. Where Does This Leave Us? It may seem we're still a long way from making real change and impact on nurse-patient ratios. But remember - we've made strides in the past 10 or 20 years. Today more than ever, we need education on this topic to the general public, the healthcare community, and lawmakers. How do you feel about the staffing assignments in your facility? Do you have any personal stories about how staffing impacts patient care? We would love to hear more about your thoughts on this critical issue.
  10. Melissa Mills

    How to Support the Next Nursing Generation: The Z's

    maji2002 - Could not agree more! :)
  11. Melissa Mills

    How to Support the Next Nursing Generation: The Z's

    I enjoy reading all of the comments. I agree that the "attention span" information is difficult to determine validity. However, I feel that if we step back and look at the issue from a fifty-thousand-foot view - you will not only see the implications for work-life, but you can anecdotally see evidence of this statistic. I see this every day with three teenagers in my home - I wouldn't say that their attention span is always 8 seconds, but I do see that they rely on tech and multi-task with ease. They have grown up with tech in their hands, so relying on it is "normal" to them. This article was in no way criticizing this next generation. I was bringing awareness to the fact that we have a new generation of nurses coming and we need to understand them. I am Gen X'er, and I agree that nurses on my first unit didn't really "understand or accept" me. And, those first few years were even harder because I didn't always feel accepted. Did I survive - HECK YES! :) But, would it have been nice for someone to acknowledge me for who I was based on the time I grew up in - absolutely. Thanks for all of the thoughts and comments. This the reason I love to write - it sparks conversation. And, every time you think and talk about new information - you learn. :). ~Melissa
  12. Melissa Mills

    Exploring the Gender Pay Gap in Nursing

    This article is featured in the July 2018 edition of our allnurses Magazine... Download allnurses Magazine While the number of men in nursing remains low, we have seen growth in recent years. Our 2018 allnurses Salary Survey was comprised of 5.78% male respondents. The U.S Census Bureau released a study in 2013 reporting that there was a total of 3.5 million nurses in 2011. Females made up 3.2 million of these employed nurses, leaving only 330,000 men in the profession (U.S. Census Bureau, 2013). Here are a few things you should know about the numbers and factors that contribute to the current salary gender gap seen in nursing. The Numbers According to our 2018 Salary Survey, the average pay for male nurses with a BSN is $36.70 per hour, while female nurses with the same degree make an average of $35.20 per hour. This is a difference of $1.50 per hour, which equates to an annual difference of $3,120 for a full-time nurse working 40 hours per week. While $3000 may not be that impressive of a number, when you consider this difference over the lifetime of a career, it adds up. If a female nurse works a total of thirty years, they will lose approximately $90,000. This does not include any cost of living raises that may occur. Our survey revealed similar differences between male and female nurses with every license and degree type. What's behind these disparities? Let's explore: Education Men have been going to college in larger numbers compared to women for years. According to Statista, in 1940 only 3.8% of women went to college, compared to 6.2% of men. Today, these numbers have grown considerably. As of 2017, there were more women with a college education compared to men in general, with 34.6% of women completing a four-year college degree compared to 33.7% of men (Statista, 2018). If more women are enrolling in college than men, what could account for the difference? Our survey showed that 53.64% of male nurses hold a bachelor's degree compared to 45.18% of females. When you move up to advanced degrees, the difference remains. A total of 8.1% of men reported having completed an MSN, while 7.9% of females completed the same degree. While there is a small disparity among education, it does not appear that there is a significant difference between the levels of education of male and female nurses. Specialty Our survey results showed that men and women work in different areas of nursing. The top three specialties for male nurses include emergency departments, med-surg, and cardiac units. Women's top three units were med-surg, geriatrics/long-term care, and emergency departments. Could this be powering the salary gap? A recent study by Advance Healthcare Network (2018) indicates that being certified in a nursing specialty could increase your annual salary by as much as 23%. Many specialty areas offer higher base salaries as well, providing a more substantial earning potential. If men work in these more highly-specialized fields of nursing and have a certification, this could account for some of the pay disparities seen in our annual survey. Social Factors Social factors affecting career decisions have been different for men and women for many years. Non-work-related traits like gender, race, or ethnicity affect access to workplace opportunities that create advantages for some while denying these advantages to others (Bishu, Alkadry. 2017). A 2016 article by Stephanie Stephens on healthcarecareers.com revealed that while men make more than women, their satisfaction with salaries was equal at 44%. What social factors influence the gender pay gap and salary satisfaction? Negotiation One social factor found in many studies is simple - men are more likely to engage in salary negotiations than women (Leibbrandt & List, 2014). One study found men were more likely to initiate negotiation conversations than women when no explicit statement was listed on the job description that the salary was negotiable. (Leibbrandt, List, 2014). However, if the job description stated that the wages were negotiable, the likelihood of negotiations was equal (21.2% of women and 21.4% of men). What does this mean? The main finding of this study is that explicitly stating that salaries are negotiable closes the gender gap in job applications (Leibrandt, List, 2014). Career interruptions A 2015 study published by Pew Research Center shows that 42% of women have reduced their hours to care for a child or family member, compared to 28% of men. Another staggering statistic revealed that 27% of women have quit a job to care for children or other family members, while only 10% of men reported doing the same. Women have long been the head of the household when it comes to children and care of the elderly or sick. Could this be decreasing the earning potential of female nurses? If a female nurse experiences a career interruption it will impact her overall wage potential as she works towards retirement. While society's idea of men who stay home with children has changed, it is still a role primarily held by women. Glass Escalator A 2012 Forbes article describes the difficult history of women's success in the workforce. Once a closed door for all careers, women now work in most industries and have even started flooding the male-dominated corporate world (Goudreau, 2012). However, there have been reports that women have hit the "glass ceiling" or an invisible barrier that keeps them from entering into senior-level management positions (Goudreau, 2012). Today, in female-dominated industries like teaching and nursing, women are met with a glass escalator. While women climb the ladder, it appears that men are riding an invisible escalator, straight to the top, taking senior level nursing positions (Goudreau, 2012). Goudreau explains that men tend to be promoted at a faster rate than women in female-dominated professions. Why would there be glass escalator in nursing? One answer is related to career interruptions that women may experience when caring for family. But, if men can rise to higher level position in nursing quickly and make more money, why have we not seen a rapid increase in the number of men in the field? Consider pop culture references of men in nursing. TV shows and movies like Meet the Parents provide a poor representation of the importance of male nurses. When will the social stigma end? Final Thoughts Do male nurses indeed make more than female nurses? It appears that the simple answer is yes. However, there are many workplace and social factors to keep in mind when comparing the bottom line of nursing salaries. Resources: 1. Sheth, S., Gal, S., Gould, S. (2018). Business Insider. Retrieved from: Wage gap, gender pay gap charts show how much more men make than women - Business Insider 2. U.S. Department of Employment Opportunity Commission. The Equal Pay Act Of 1963. Retrieved from: The Equal Pay Act of 1963 (EPA) 3. Anderson, J., Milli, J., Kruvelis, M. (2017). Projected Year the Wage Gap will Close by State. Institute for Women's Policy Research. Retrieved from: Projected Year the Wage Gap Will Close by State | Institute for Women's Policy Research 4. United States Census Bureau. (2013). Male Nurses Becoming More Commonplace, Census Bureau Reports. Retrieved from: The Equal Pay Act of 1963 (EPA) 5. Statistia. (2108). Percentage of the U.S. Population who have completed four years of college or more from 1940 to 2017, by gender. Retrieved from: https://www.statista.com/statistics/184272/educational-attainment-of-college-diploma-or-higher-by-gender/ 6. Stephens, S. (2016) Healthcare Gender Pay Gap Still Significant. HealtheCareers. Retrieved from: Gender Pay Gap in Healthcare 7. Bishu, S., Alkadry, M. (2017). A Systematic Review of the Gender Pay Gap and Factors that Predict It. Sage Journals. Retrieved from: SAGE Journals: Your gateway to world-class journal research 8. Goudreau, J. (2012). A New Obstacle for Professional Women: The Glass Escalator. Retrieved from: A New Obstacle For Professional Women: The Glass Escalator 9. Senior, R. (2018). Nurses Salary by Specialty Certification. Advanced Healthcare Network. Retrieved from: 218 Nurse Salary by Specialization | Nursing 10. Pew Research Center. (2015). Mothers, More than Fathers, Experience Career Interruptions. Retrieved from: >> Mothers, More than Fathers, Experience Career Interruptions 11. Leibbrandt, A. (2014). Do Women Avoid Salary Negotiations? Evidence from a Large Scale Natural Field Experiment. Retrieved from: http://gap.hks.harvard.edu/do-women-avoid-salary-negotiations-evidence-large-scale-natural-field-experiment
  13. Melissa Mills

    Physically Taxing: Historic Nursing Gender-Discrimination Suit Settled

    Thanks for the story karrikon! And, yes - I'm sure there are more stories than we can imagine! ~Melissa
  14. Women have been fighting for gender equality for decades. These battles have taken the form of the right to vote, the right to control their bodies, and the right to equal pay and opportunity in the workplace. Nursing might be a female-dominated industry, but it's not immune to gender-discrimination against women. A recent historical settlement is raising the bar for female nurses for the future. Is Nursing Physically Taxing? Before we discuss the settlement - let's recognize a fact that nurses have known for generations - nursing is hard work. But, for many years, there has been a perception that because nursing positions are primarily held by women, it is not a physically taxing occupation. However, the statistics tell a different story: Healthcare occupations are among the highest of all U.S industries for musculoskeletal injuries from overexertion The most significant risk factor for overexertion injuries in healthcare workers is manual lifting, moving, and repositioning of patients 1 in 4 nurses have been physically assaulted while at work An estimated 82% of nurses report being at a significant risk of workplace stress Nurses have a high chance of contact with infectious agents such as bacteria, viruses, parasites, and fungi New York City Pension Plan In 1965, New York City, like many other employers, created a pension plan for employees. Under the standard pension, employees could retire with full benefits at the age of 55 or 57. However, some occupations covered by the pension were deemed "physically demanding," by the city. Staff who filled these physically demanding jobs qualified for early retirement with full pensions as early as age 50. Those who qualified had to be employed a minimum of 25 years with the city at the time of retirement. Jobs meeting this classification included Emergency Medical Specialist, Exterminator, Motor Vehicle Dispatcher, Window Cleaner, and Plumbers. All of these positions were primarily filled by male workers. The city also employed nurses, the majority of whom were female. Beginning in 2004, the New York State Nurses Association (NYSNA) became involved with this issue. The NYSNA is a labor union representing city-employed registered nurses and midwives. They requested that the City recognize their members for filling physically taxing positions and allow them to receive full pension benefits at the age of 50. The City denied the request in 2004, refusing to recognize the role of the nurses as physically taxing. The NYSNA requested again in 2006 and 2008, only to be denied both years. Sometime after 2008, the NYSNA and four members filed complaints with the Equal Employment Opportunity Commission (EEOC). It was determined by the EEOC that the city had discriminated against the nurses based on gender in 1968 when the City initially refused to recognize nurses and midwives as a physically taxing occupation and again in 2004, 2006, and 2008. The EEOC sent the matter to the U.S Attorney's Office to be heard. On July 18, 2018, Acting Assistant Attorney General John Gore for the Justice Department's Civil Rights Division and Richard P. Donoghue, United States Attorney for the Eastern District of New York announced a proposed settlement with the City of New York. This settlement awards $20.8 million to a class of approximately 1,665 registered nurses and midwives who were discriminated against because they were women. The court must still approve the settlement which will award between $1000 and $99,000 to the nurses, depending on their years of service to the city. The agreement also covers all attorney's fees and an additional $100,000 to the four nurses who filed the initial complaint with the EEOC. This settlement is historic. Looking Ahead Could nurses finally be recognized for the physically demanding work they perform? Nursing is an honorable profession - regardless of the sex of the nurse. You go to work each day uncertain of the patients who will come through the doors of the ED. You enter buildings that make police officers uncomfortable just to make sure that patients are taking their medicines and participating in self-care. You deal with physically and mentally taxing situations to save the lives of people you have never met before. But, are you given the respect you deserve? Tell us what you think about this settlement. Does it add validity to the physical nature of nursing? Will it help the profession in the future? Leave your thoughts in the comments below.
  15. Melissa Mills

    Physically Taxing: Historic Nursing Gender-Discrimination Suit Settled

    dbabz - We can probably all use a little conditioning - but, the interesting point is that most people don't think of nursing as being physically taxing. Doing compressions on an adult is HARD work, and it is easy to pull a muscle, trip, fall, or worse when you are in the middle of a code. Thanks for sharing your story! Melissa
  16. Melissa Mills

    Redirected, Not Rejected: Lessons Learned When the Answer is No

    Have Nurse - Good point! Thanks for your thoughts. :) Melissa
  17. It doesn't matter what kind of person you are - rejection after a job interview hurts. And, it is okay to withdraw a bit and take your time to recover. But, as the old adage goes - you must get yourself back in the saddle again - sooner rather than later. Here are a few ways you can keep moving forward toward redirection after rejection. Give Yourself Permission to be Upset Ok - let's say this and move on - rejection sucks. It hurts. Lance Armstrong summed it up best by saying, "A boo is a lot louder than a cheer." And, even if you didn't really want the job - the idea of moving on from where you are right now was exciting. It's understandable to be upset. Give yourself time to process the emotions after the rejection. It's okay to have a bruised ego, just don't allow it to cause a permanent setback. Ask For Feedback (If you really want it) If you get the opportunity to have actual contact, through email or phone, with the prospective employer - ask for feedback. There are significant benefits to asking, "Can you tell me why I didn't get the job." You may find out that they loved you, but someone with more experience interviewed too. You may be told that the hiring panel was torn between you and another candidate. Or, you may be told that you were not the best candidate. No matter what the reason, there is a lesson to be found in feedback. Just be sure to prepare yourself for whatever answer you might be told. Be sure to let the employer do most of the talking - your role here is to listen and learn for the future. Don't argue or defend yourself. Thank them for the information, then take time to process what they said. Decide if the information was helpful and take action accordingly. Look for Redirection This is hard - but, don't focus on the rejection. Learn how to use the information and gain redirection. Here are a few questions you might need to answer if you're receiving multiple rejections: Are you applying for jobs that are outside of your skill set? Do you need more training, experience, or certification to be ready for the next step in your career journey? Is there something in your career history that is causing future employers to worry? Sometimes, you may be hit head-on with the realization that this is not the right time to change jobs. And, guess what - it's okay. The only way to find out if these jobs are for you is to apply and learn more about the role. You may decide that you need to gain more experience before moving on. Or, you might realize that you are on the right path, but haven't found the right position yet. No matter what conclusions you come to - a little self-reflection can really help you to get on the right path. Don't Take it Personally Job rejection is not usually connected to who you are as a person. It is about your skills and if they match the needs of the employer. They may be looking for someone to stay for the next ten years, and you plan to go back to school. Or, they may need someone who can transition into management, and that's not where you want to be in your career. As you go through the process of finding a new job, remember that with every "no," you are getting that much closer to a yes. Just getting the interview was a success. In fact, according to a job market expert, only about 2 percent of people who apply for a job make it to an interview. By being rejected, you are actually doing better than many folks who never heard anything. Pat Yourself on the Back How many nurses can you think that are in jobs right now that they don't like because they are afraid of rejection or making mistakes? Oh, and, it's not just nurses. Unfortunately, this happens in every industry and job type. Hold your head high. At least you tried and put yourself out there. If the worst thing that happens to you today is that someone else got the job - you are doing pretty good. Keep Applying Now that you dusted yourself off and reassessed the direction you are moving in keep applying. Don't let one or two rejections slow down your momentum towards finding your dream job. It is out there! Have you had a recent job rejection? What lessons did you learn? Let us know in the comments below.
  18. Melissa Mills

    Exploring the Gender Pay Gap in Nursing

    PeakRN - This is a GREAT practice. How do the nurses feel about it? How are high performers rewarded? Would love to hear more. ~Melissa
  19. Melissa Mills

    Exploring the Gender Pay Gap in Nursing

    RubyVee - Thank you for sharing. What an excellent example of the gender pay gap in real-life. There are so many things we can learn from your situation. Thank you for sharing! Melissa
  20. Melissa Mills

    30 Safety Tips for the Home Care Nurse

    Home care nurses have a unique and rewarding job. You provide skilled care where the patient lives. You get to experience their everyday life and impact their overall health and well-being. But, there are dangers when traveling all day in and out of homes and in new neighborhoods. This isn't just anecdotal, consider stories like the New Orleans home health nurse who was abducted at gunpoint in 2012. Safety concerns for home health nurses are real. As a former field nurse in home care and hospice, I have had my fair share of stories of family members that gave me the creeps, "tomato plants" that looked very much like marijuana plants, and patients with guns hidden under mattresses. Even though there were times I felt unsafe, I loved my patients and the unique perspective I was given into their lives. But, you do need to implement simple ways to stay safe. Safety Tips and Tricks for the Home Care Nurse Keeping yourself safe doesn't take a lot of work, but it does require intention. Here are a few easy ways to increase your safety knowledge. 1. Know your workplace policies for safety and violence prevention. Don't wait until you are in the middle of a crisis to understand how to activate your company's safety program. 2. Report any unsafe situations as soon as possible. Even if it is just a feeling, be sure to report it to your supervisor. You may not be the next staff member in that home. It is your responsibility to keep others safe too. 3. Be active in your agencies safety committee. 4. Map out your visits so that you know where you are going. Wandering around new neighborhoods looking lost is not safe. 5. Be sure your car is full of fuel and in good working condition. 6. Create a car emergency kit that includes: Candle to keep you warm Band-aids, hand sanitizer, antibiotic ointment Road flares Rain poncho Rags Duct Tape Baby wipes Whistle to signal for help Non-perishable foods or snacks Water Ice scraper Kitty litter for slick roads Blanket and warm clothing Flashlight and extra batteries 7. Park on the street if possible. You don't want to be blocked in if you need to leave quickly. 8. Trust your gut. If a situation feels unsafe, it probably is, and you need to get out quickly. Make sure the patient is safe, leave the home, and call your supervisor. 9. Set boundaries. If a patient or family member starts saying things or acting in a way you do not like, tell them. Be polite and direct. Avoid being argumentative. 10. Keep your cell phone on you at all times. Make sure it's fully charged before you leave in the morning and charge it throughout the day. 11. Know your company's policy on joint visits and behavioral contracts. Contact your supervisor if you need to implement either of these interventions. 12. Start your visits early. Avoid nighttime visits if possible. 13. Take a self-defense course. 14. Don't carry large amounts of cash on you. 15. Always wear your agency badge and carry your driver's license or other ID. 16. Watch your step. Be sure to pay attention to the ground and floors in homes so that you don't fall, trip, or become injured in other ways. 17. Be alert, but not nosey. You're there for the patient. If you are unsure what others in the home are doing, don't go snooping around. Do your job and leave the home. Remember, if the patient is in their right mind, they have the right to live however they desire. 18. Ask your patient to contain any aggressive pets before you enter the home. 19. Keep your sharps container in your nursing bag for easy access when you are in the patient's home. 20. Carry spray or 91% alcohol to fight against bed bugs and other critters you may come in contact with in patient homes. Wipe down the bottom of your nursing bag, soles of your shoes, and any equipment that may have come into contact with surfaces in the patient's home. 21. Always have hand sanitizer in case the patients home doesn't have running water. 22. Document in the patient's home when possible. Don't sit in their driveway or on the street for long periods of time finishing up your charting. 23. Know your service area. Learn the unsafe neighborhoods and find out where the closest police stations are in the areas that you serve the most. 24. Be prepared. Set up your visits and supplies the night before. If you must take supplies into a home, put them in bags and label them with the patient's name the night before. This allows you to gather your supplies and get into the home quickly. Don't make multiple trips back and forth to your car and don't rummage through your car getting ready for the visit. You must be alert at all times. 25. If you are confronted by someone who asks for your money, nursing bag, or other belongings, hand it over! 26. Make sure someone in your company has your schedule, just on the off chance that someone can't find you. 27. Keep trash bags in your trunk. If you go into a home that you suspect may have an insect infestation, don't take your nursing bag into the house. Place the necessary equipment into a trash bag and only carry in what you need. 28. Buy a plastic stool that you can keep in your car. During your visit, set your bag on the stool use it to take a seat. This prevents you from sitting on plush furniture that may be soiled or infested. 29. If there are safety concerns in a patient's home or building, call ahead and let them know you are coming. Most patients will be more than happy to open the door or keep an eye out for you if possible. 30. Don't talk or text while you are driving. If you are a home care nurse, do you need other resources for safety? Check out this great list of OSHA resources specifically for home healthcare workers. Do you have other safety tips that you use when making home visits? Put your suggestions in the comments below. You could save someone else just by sharing the things you do every day to keep yourself safe.
  21. Melissa Mills

    30 Safety Tips for the Home Care Nurse

    Kitiger, RN - Duct tape tended to be a standard item in most of the safety kits I researched when doing this article. You can use it if you are broken down to hold things together or even if something breaks in a patient's home. It's a pretty versatile tool. Personally, I have used it in Homecare to reinforce things in patients homes. Just a standard safety kit item. :) Melissa
  22. Melissa Mills

    30 Safety Tips for the Home Care Nurse

    Fibroblast - Yes! Great tips. I have worked in rural areas too and you are right, it is different. Stopping on a country road is not safe, but yeah, no one will be watching you. LOL. Thanks for the comments!
  23. Do you ever consider the possibility of being hurt at work? We often take for granted that we are safe and sound as we do our job. But, the national numbers for workplace injuries are staggering. According to the Bureau of Labor Statistics, 2.9 million workers were involved in nonfatal workplace injuries and illnesses in 2016. Another 5,190 workers died due to injuries sustained at work during the same year, which was up 7% from the previous year. You may think that most of these injuries occur in high-risk careers, like law enforcement, construction, or transportation. And, while those industries are laden with injuries, nurses are not immune. The Occupational Safety and Health Administration (OSHA) reported that in 2011, hospitals had more workplace injuries that resulted in lost-days worked than construction or manufacturing industries. Why should we focus on safety now? Safety is a 24/7/365 business. Every June is National Safety Month, which gives you a great time to assess your workplace safety. This year, the National Safety Month theme is "No 1 Gets Hurt". Here are a few simple things you can do at work to make this theme work for your workplace. Workplace Safety Tips Adopt a Culture of Safety Whether you're the director, a staff nurse, or certified nursing assistant, you can adopt and promote a culture of safety in your workplace. Be sure that everyone understands the importance of safety and follows the rules. If you're a decision maker for your unit's safety policies, here are a few easy ways to create a culture of safety: Post the number of "injury-free days" for the hospital or unit in an easy to see place in the breakroom. Share safety tips at every nursing meeting. Be sure all new staff members are aware of workplace safety policies. Review them annually at meetings too. Create a safety committee to help with the identification of potential safety concerns and implementation of safety practices. Report Safety Concerns Immediately If you notice that the ice machine is leaking water - report it. If you come across an unsafe situation, don't walk away. Find another person to protect others from coming into contact with an unsafe environment while you alert the right people for help. Remove non-working equipment If you see that the Hoyer lift is not working properly, report it and remove it. If you can't remove non-working equipment from the unit, place a sign on the equipment that it is not working. Be sure to report this to your charge nurse or nurse manager as soon as possible. Report Injuries Have you ever been lifting a patient only to feel that pop, twist, or burn in your back? Did you report it? Most workplace injuries are minor and can be treated with some rest, ice, and over-the-counter anti-inflammatories. But, what if you wake up tomorrow and can't move? Even if it seems like a "small" injury - report it right away. You don't have to seek immediate attention for the injury to be reportable. Be part of the solution You walk down the hall and see a new CNA turning Mr. Smith, a 350-pound bedridden patient. The CNA is a petite woman in her early 20's. She is leaning over the bed that has not been raised to her height. What do you do? Don't be afraid to speak up and help others out if you see them doing something that could cause them or a patient physical harm. It is always best to stop and help someone who may need more education. Be part of their safety team, even if it means it will take you a bit longer to walk down the hall. Have a safety buddy Whether it is on the unit or in the parking lot, having a safety buddy helps keep everyone safe. Your buddy may be the first person you go to when you need help moving a patient. They may also walk with you to your car late at night or during severe weather. Safety buddies help keep you safe through accountability. Be Safe As you go through the rest of June, be sure to think about your safety. If you see something unsafe at work, follow your facility policy to ensure the right people know about the issue. Do you have other workplace safety tips? Share your suggestions in the comments. We would love to hear them.
  24. Do you cringe at the idea of having to look for "evidenced-based research" for assignments or work? The term itself can be confusing and finding it can be down-right hard. If the thought of perusing through page after page of online journal articles does not sound like fun, this article is for you. Let's dive into a few things you should look for when searching for evidenced-based research. What is evidence? Evidence is examples, facts or sources you search for and use to support your ideas or hypothesis. This information comes from studies, data, or journal articles. Evidence can be further broken down into two kinds - primary and secondary sources. Primary sources are first-hand experiences. They provide an account of the observations seen by the researchers who conducted the study. Examples of primary sources in nursing include pilot studies, cohort studies, survey research, and dissertations. Secondary sources are critiques of primary sources. They may summarize or compare the results of studies to draw their own conclusions on a particular subject. According to the University of Washington, Tacoma, examples of secondary sources in nursing include reviews, newsletters, clinical care notes, patient education information, and entries in nursing or medical encyclopedias. What do you look for in a source? Choosing the right evidence can be difficult. You need to make sure the evidence you use fits the standards of the assignment, industry, or discipline. When looking for evidenced-based evidence in nursing, be sure the source is: Credible Credibility in sources means they are peer-reviewed and scholarly. This is a fancy way of saying that an expert wrote the article and other experts reviewed it before it was published. Why should it be peer-reviewed? Having several experts review the article increases its quality and research conclusions, making it more scientific. How can you tell if it is a credible source? Some online databases can provide searches that deliver anything from a magazine article to a journal article. Here are a few good rules to follow: Websites: If you're using websites in your research, be sure to use the right kind of sites. Use websites with ".gov or .edu" at the end. Stay away from the ".com and .org" sites. The exception to this rule is when you are familiar with the source and know that it is reputable. Examples of this include the American Heart Association or a hospital system like Mayo Clinic, which both have ".org" sites. Journals: According to Emory University, the credibility of a journal is in the following factors: The journal should be indexed in a major database recognized in the field. It should have a long publishing history. Journal articles should be peer-reviewed. The journal should have an impact factor, which is a statistical measurement based on the average number of times articles have been cited over the previous two years. Reliable Evidenced-based research in nursing must be reliable, which means that if the study were done again, it would it have the same or similar results. The peer-review process ensures reliability. When reading studies, be sure to find out the limitations of the study. Reliable research will usually list the limitations seen during the research process. Valid Heale and Twycross define validity as the extent to which a concept is accurately measured in a quantitative study. For example, a survey designed to measure asthma symptoms that actually measured COPD symptoms would not be valid. Appropriate to your subject If you are writing a paper for a masters of nursing program, you are going to want to make sure your evidence is in alignment with the course and subject. Using a blog article in an academic paper is not appropriate. Supportive There are times that you may choose a subject and then find that the supporting evidence is lacking. In these scenarios, do not attempt to make the evidence support your subject when it simply doesn't. Be sure to choose articles that are in alignment with your topic. Finding the sources By using the tips above, you should be able to find evidenced-based sources. If you are writing for a different industry, be sure to research the expectations for that industry, as they can be different from one sector to the next. Do you have other tips for finding evidenced-based sources in nursing? Have you found a great public database that could help other students and medical writers? If so, share your comments, thoughts, tips, and tricks below. We enjoy hearing your thoughts and engaging in conversation about your nursing practice.
  25. Melissa Mills

    6 Things Your Professor Wishes You Knew

    Thanks EricJRN! Glad you enjoyed the article. I love teaching and wish my students knew just how much I want to see them succeed. :) Melissa
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