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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

    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
  2. 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
  3. You have been visiting Mrs. Smith for two home care certification periods. Over the last few weeks, you've noticed that she doesn't seem to be talking as much, eating regularly, or even going outside of the apartment to see her friends. You ask her if something is bothering her, and she quietly responds, "Honey, I'm old and don't feel like doing much anymore. Being sad and lonely is just part of growing old." Sound familiar? Whether Mrs. Smith is your patient or your family member, you've probably seen a slow decline in happiness for the seniors in your life. The CDC estimates that somewhere between 1% and 13% of seniors struggle with depression. But, what can you do? As long as Mrs. Smith is doing basic self-care activities and is safe at home, is there really anything you can do? Here are a few simple things you can do to help increase the quality of life of your senior patients. Know How to Spot Depression Older adults might have to deal with retirement, the death of loved ones, chronic health problems, or other stressful events. But, depression doesn't have to be the new normal. Here are a few things to assess for: Loss of interest in hobbies or activities they once enjoyed Feelings of worthlessness, hopelessness, or pessimism Difficulty concentrating or making decisions Decreased appetite or unintentional weight loss Reports of always feeling sad, empty, or anxious Lack of energy, extreme fatigue Interrupted sleep patterns - early morning waking, oversleeping, or difficulty sleeping Irritability Restlessness Increase in complaints of pain, cramps, or stomach problems with no physical cause Thoughts or verbalization of death or suicide Suicide attempts If you recognize these signs of depression in your senior patient, call the doctor right away to report the symptoms. They will need further screening to determine what is causing the symptoms. They may also need antidepressants, counseling, or therapy. Include Them in Activities As nurses, we often get so caught up in doing our assessments and getting to the next patient that we forget the little things. If you notice a patient not engaging like they use to, try to think of something they enjoy doing and join them during the activity. A few ideas include: Helping them write a letter to a child or grandchild they may be missing Fold a load of laundry Make a grocery list Pack your lunch and eat with them once a week These may seem like small, menial tasks, but getting them to engage in a normal activity of daily living helps give them purpose and hope for tomorrow. Provide Brain Games Some older folks love to do crossword puzzles, word searches, or other brain activities. And, these are not just fun games, they help to keep your mind sharp and focused. But, normal vision declines may make it difficult to see standard print. Try to find them large-print versions of these activities to keep their minds sharp and challenged. Individualize their Care Plan OASIS can be a pain, but it really does give you the opportunity to cover all the bases of the patient's care. If you have to complete this lengthy assessment - you might as well use it to your advantage, right? Create your goals and interventions to be meaningful. I remember having a patient that had plateaued in her functional abilities, and no matter what the physical therapist and I tried, she was not interested in ambulating. During a Recertification assessment, I started talking to her about her goals. I was to the point that if she didn't improve, I would have to discharge her from care. While we talked, she told me how much she missed walking out to get her mail each day as this gave her a chance to chat with the neighbors and feel the sunshine on her skin. After the assessment, I collaborated with the Physical Therapist to create goals and interventions that would get her back to doing what she enjoyed. And, would you know that once we engaged with her on this specific goal, she began to work hard to achieve it? I learned a simple lesson that day - goals must be individualized and meaningful to make them achievable. When she finally made it to the mailbox, we celebrated! Listen to Their Wishes As we age, making hard decisions just seems like it's part of life. But, even after our senior patients have made their choices, they need to be heard and respected. Sometimes these decisions can be difficult for the family to accept. So, it's your role as the home care nurse to listen to what the patient wants, facilitate any documents that need to be created, and help the family understand and respect the decisions that are made. Tell Them What They Mean to You Nothing helps boost the spirits of anyone from age 2-100 quite like being told you're appreciated, loved, needed, and respected. Never underestimate the importance and power of your words, smile, or gentle touch to let your patients know you enjoy your time with them. Do you have other thoughts about easy ways to increase the quality of life in your senior patients?
  4. Daisy4RN - Thanks for your thoughts! Yes, a lot of the best info we get as nurses is not rocket-science. But, reminders like these are good for all of us. :). ~Melissa
  5. It seems many people label themselves an introvert these days. Some even use terms like, "extroverted-introvert" to further specify the type and kind of social interaction they enjoy. But, regardless of what you are like in your personal life, when you have to network for your career, it can be downright torturous. Whether you are looking for a new job or just looking to increase your network for more opportunities related to school or volunteer opportunities, here are a few tips that you can use to enhance your comfort and increase your network. Create an Elevator Pitch If you've ever worked in sales, you may have heard this term. An "elevator pitch" is a short, persuasive speech used to sell yourself which can be delivered in the amount of time it takes to go up one floor in an elevator. It should be succinct and highlight the best aspects about yourself and your career. To create your elevator pitch, answer these five questions: Who am I? What do I do? How do I do it? Who do I do it for? What do I want to do in the future? After you have answered these five questions, sit down and take a few minutes to create your pitch. It may end up something like this: Hi, I'm Sally. I am an ICU nurse at the University of the World Hospital. I've been there 10 years, and I'm certified. I work first shift, and I cover as the charge nurse for 75% of my shifts. I am here to find new career opportunities that will allow me to explore leadership role in an ICU setting further. This is short and sweet and lets anyone you talk to know who you are and what you are looking for while you are the networking event. Bring a Pal Networking is always more comfortable when you have a trusted friend who is there to offer support and assistance. Bring someone that knows their role and is not afraid to help you along the way. You want someone who will provide support and even fill in the blanks if they see or hear you struggling to find the right words. Network Online Many nurses think of LinkedIn as the best place for online networking. And, of course, LinkedIn is a great place to start. But, don't forget about Twitter. You can establish an active Twitter feed full of insights related to your field and people will begin to notice you and interact with you. You can also reach out to others in your specialty on Twitter to start to make real connections. These connections can also help you with face-to-face networking events in the future. If you connect with someone online, invite them to the next in-person event you attend. Make a Connection Goal You don't have to walk out of the networking event with 15 names of people to follow up with afterward. Set a realistic goal. Maybe your goal is to leave with 1 name of a recruiter and 1 name of a fellow nurse who is also looking for the same thing. Creating a network takes time. Add names slowly and really connect with the people you meet. The day after the event, be sure to email, call, or text the people you connected with and thank them for their time and information. Following up and fostering a relationship will help to move you to the next level. Be Present During the event, be fully present. Turn the phone off and put it in your purse or pocket. Once you start a conversation, be sure to fully engage by maintaining eye contact, smiling, and asking questions. Remember That Everyone is in the Same Boat Everyone at the event is there to meet other too. And, they may be dreading it just as much as you are. Try to remember this as you are standing in a corner by yourself. Move around the room and find another person who is standing alone. Make eye contact, offer a smile, and then start up a conversation. They will be thankful you did. Set a Time Limit If the event goes on for 2 hours, set a time limit. Tell yourself you will stay for 60 minutes. After that time, re-evaluate how things are going. If you have maxed out on your networking possibilities, go ahead and leave. If you are deep into a great conversation after 60 minutes, add an extra 30 minutes and see how things are going at the end of that time. Giving yourself a time limit helps to get you in the right mindset. You work 12-hour shifts - you can handle one hour of networking, right? Now that you have a few tricks to help out at your next networking event, get ready to shine! Do you have a few other tried-and-true tips you use when you have to network? Put your ideas in the comments, we would love to hear them and keep the conversation going.
  6. Are you not sure nursing is for you? Have you made a recent job change only to find that the new company is worse than the last? Or, maybe you made your first med error at work, and you are dreading talking to the nurse manager or family member about it. I remember my first med error and the first time I felt like a total failure at a job. They are memories that even after years have gone by can stir up lots of emotion. But, what I have learned over the years is that failures don't define me. And, quite honestly, neither do successes. They help to tell the story of who I am as a nurse, but certainly do not singularly define who I am. Guess what? Failures don't define you either! So, no matter what happened yesterday, last week, or last month that you are still beating yourself up over - it's time to move on! Let's discuss a few things you need to remember when dealing with failure so that it is something useful to you for years to come. It's Okay to Fail No one likes failure, but it's not always a bad thing to experience. How you react to the failure is the bigger issue. Are you going to allow it to cripple you or empower you? After a bad workplace situation, I felt like a complete failure. One day while wallowing at the bottom of the "career failure" bucket, I made a simple list of my "dreams." One of them was to become a freelance healthcare writer. That was more than a year ago. If I hadn't failed, I might still be in that same thankless job doing the same boring things I had been doing for the three years before that. It was okay to fail. Own the Failure Before It Owns You One of the best ways to change the negative energy after a failure is to simply own it. Yes, you messed up. But, unless someone died or you did something illegal, it will likely be okay. You must own up to failures to move on. It happened. It's awful. You can't change it, but you can learn from it. Learn From Your Mistakes Some of the most successful people in the world have made mistakes. Consider this: Oprah was fired from her first job as a TV anchor in Baltimore Walt Disney was told he lacked imagination and had no good ideas Albert Einstein was thought to be mentally handicapped as a child None of the people gave up. They learned from their mistakes and kept on moving. Now, learning from your mistakes doesn't always mean you should get back on the same horse. Sometimes, learning from your mistakes means it's time to move on. The lessons in mistakes are not always easy to learn, and they are not the same for every person who makes the same mistake. So, don't judge yourself against others, discover your own lessons. Stop the Negative Self-Talk When you mess up, do you immediately start a mental barrage of negative self-talk? Me too! I have caught myself saying things like "you're so dumb" or "what an idiot" after making a mistake. It's an easy trap to fall into. The problem with negative self-talk is that you are always listening. The more you tell yourself you are dumb, the more you will believe it. But what if the mistake was dumb? Well, then call the mistake dumb, but you my dear, are a fantastic nurse who needs to learn from this and move on! At Least You Tried I've talked to several people over the years who have left jobs because they thought they were in a bad one, only to find out that not only was the grass, not greener, it was downright pungent. But, most of these people I know have come out better in the end. Learning a new lesson is always valuable. If you never tried, you definitely would not have learned any lessons. Take a med error for example - I can almost guarantee you that not many nurses make the same med error twice. Lessons learned save us from the same pain down the road. Don't Relive the Failure It's okay to think about it, after a healthy amount of space and time. Reliving it over and over is not okay. At some point, you have to move on from the failure and so do others around you who were involved. If you find yourself being reminded of the failure by others, meet with them and ask them to set it aside so that you can move on. If you keep beating yourself up about it, you need to stop. Write down a few affirmations and keep them in your pocket. When you start beating yourself up, pull one out and read it. Some of my favorites are: I'm the perfect combination of mistakes and perfection. I am strong and smart. I am an awesome nurse. Have you made any mistakes lately that you're having trouble getting over? Or, maybe you have a few other pieces of advice for those who have made mistakes. Whatever your thoughts may be, we want to hear them. Share your thoughts in the comments below.
  7. Melissa Mills

    Simple Ways to Turn Career Failures Into Something Useful

    Jbeaves - Glad you enjoyed the article. Thanks for the comments. Yes, beating ourselves up seems to be the norm for whatever reason. Finding the lesson in failures is the greatest gift we can give ourselves. ~Melissa
  8. Melissa Mills

    Simple Ways to Turn Career Failures Into Something Useful

    Daisy4RN,ADN, Yes! I agree 110% that 90% is how we react. Unfortunately, it can be a difficult thing to control our emotions. :) Thanks for your thoughts. Melissa
  9. Melissa Mills

    Simple Ways to Turn Career Failures Into Something Useful

    Thanks DaveyDo! Love your thoughts and comments. Yes, most mistakes do come out in the wash. But, boy, do we put ourselves through the wringer?! Failure hurts, it's the simple truth. Thanks again for your thoughts. Melissa
  10. 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.
  11. 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
  12. 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!
  13. 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.
  14. 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.
  15. 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
  16. Melissa Mills

    6 Things Your Professor Wishes You Knew

    I've recently started teaching again. As a professor in the Masters of Healthcare Administration Program at the University of Cincinnati, I come in contact with students in many different parts of healthcare. I have nurses, doctors, therapists, and business professionals in my Global Health course. I genuinely enjoy teaching and building into my students. But, it seems that every semester I teach, I say or write the same things to my students. This got me thinking about a few basic things I wish my students knew before they started back to school. I think most professors would agree to at least a few of my thought. And, I know they would have helped me all the times I went back to school over the years. Here Are a Few Things to Consider About Your Professor #1 We want you to succeed I am sure you can think of at least one professor who makes you feel this line is not true. While some professors seem to find joy in making students jump through hoops, I firmly believe that even those professors want you to succeed. As a professor, I often think of a boss I had who was a total bear to deal with on a daily basis. She criticized every project and rarely had any positive feedback to give. I want my students to be ready for this boss in their careers. To do this, I give lots of feedback, even on simple assignments. I always couple negative comments with a few positive ones and let the student know that I am here to help if needed. As professors, we want to be part of your journey to success, and we want you to have positive memories of how we helped you achieve greatness. #2 Online Courses are Hard I think many people believe that because it's all online that you will somehow be able to fool the professor into thinking you read the assignment. This just isn't so. I can almost always pick out the one student that skimmed through the readings. Online courses tend to be reading and writing intensive. We want you to give us your insight so that we know you understood the assignment and can logically apply the information to your daily practices. But, it won't be easy. It is going to require work and good study habits to be successful. #3 We Know What You're Going Through No matter how long ago your professor graduated, they know what you are going through and appreciate the struggle. I graduated from the MHA program in December of 2016, so the hard work is still pretty fresh in my mind. We remember the sleepless nights, confusion when reading the syllabus, and how hard it is to say no to friends when they call you at the last minute to go out on a Friday night. #4 You Must Read the Syllabus I cannot tell you how many times I have had to give a student a lower grade just because they did not follow the details of the assignment. Don't be that student! Read the syllabus, front to back. Reread it to make sure you didn't miss something important. Highlight the sections about your routine work and be sure to highlight the details about papers or other big assignments. #5 Please Participate Whether you're in class with your professor or you post in discussion boards, you must participate. Don't respond only because it is required. Respond because you want to be in class and learn more about this profession you're entering. #6 We Hope You Enjoy the Journey I teach because I love building into my students. I want to hear about their journey. I want them to email me and tell me how the assignment from last week made them think or came into play during an experience at work. This is when I know that you are learning and thinking outside of the discussion board. If you are currently enrolled in school or getting ready to start in the fall, I hope these six things will come to mind the next time you feel your professor doesn't understand or care. If you are a professor, what did I miss? What other things do you wish you your students knew about you or about the college experience in general? I would love to hear your thoughts. Leave your thoughts in the comments below.
  17. Being healthy at work takes intention. Nurses in the hospital do not always get the luxury of having a 30-minute lunch away from the commotion of the floor. If you work in an office, it's likely easier to get away. However, our nature is to work, work, and then work some more. Let's explore some easy ways to infuse your work day with nutrition, exercise, and overall healthy habits. Pack Your Lunch Taking the time to pack your lunch can be hard. Between family life and work, who has time for extra meal prep, right? But, packing a healthy lunch helps gives you the energy you need for the day. And, packing your lunch can put a few extra dollars in your wallet compared to eating out! Stretch Remember in grade school when the teacher would start the day with some stretches? Or, maybe after lunch when she saw everyone drifting off? There was a reason behind her madness. Stretching helps to keep your muscles healthy. You will likely go home with tired feet, but a sore neck and back on top of those feet is just no fun. Choose Your Lunch Pals Wisely Eating meals with others has mental, social and biological benefits. It gives a natural rhythm to meal times. Eating with others who pack fruits, veggies, and other healthy snacks can help you eat healthier too. So, go ahead, hang out with the health-nuts at work and watch your habits improve! Walk Away From the Computer If you work in an office, it's easy to get in the bad habit of staring at the computer all day. Try to plan short breaks away from the computer to give your eyes, neck, and back rest. Water If you are anything like me, drinking lots of water all day is boring. Add some fruit, like lemon, lime, or berries to spice it up. Water helps with energy levels throughout the day, brain function, and can even help with weight loss. Avoid Too Much Caffeine Many of us are guilty of grabbing that third or fourth cup of coffee or soda to stay awake. But, too much of a good thing can be dangerous, and caffeine is no different. According to Mayo Clinic, 400 milligrams of caffeine each day appears to be safe. That's about four cups of coffee. Too much caffeine can cause migraines, insomnia, irritability, and tachycardia. Try switching to caffeine free drinks or substituting all together with fruit infused water. Snack Away Healthy snacks are good for you. Eating small meals throughout the day helps keep your blood sugar and energy levels stable. Pack high protein snacks that you can eat on the go, like cheese sticks, trail mix, or peanut butter celery sticks. Manage Stress Life as a nurse is hectic. And, this only accounts for the 8 or 12 hours you are at work. Home life can be stressful too. Be sure to practice self-care for your body and mind too. Meditation can help you be present, control your emotions, and offer a sense of purpose. Take a quick 5-minute break away from the chaos. Close your eyes, and be still. This simple practice can do wonders for your mental health on stressful days. Stand Tall Taking care of your body is important. Whether you are sitting in an office or lifting patients, spine health is essential to your overall well-being. Bend at the waist and knees when lifting. Exercise your core to strengthen your back muscles. Buy shoes that fit properly and support your arch. Take frequent stretch breaks and sit up straight. Adjust your desk and computer height so that you are looking straight ahead while you work. Hand sanitizer If you are in the hospital, this is a no-brainer. Those of us in offices tend to forget how important it is to keep our hands clean. Keep hand sanitizer at your desk and apply liberally. Cubicle spaces are breeding grounds for germs. Get Outside If you have 5 minutes to walk away from the busyness of work, go outside. Breathe in some fresh air and let the sun hit your face. If you have enough time, take a quick walk around the parking lot or block. This will help ease stress and even injects a bit of exercise into your workday. Call it Quits Working too much is a bad habit. As nurses, we often feel that we are needed, which is great. But, too much work leaves you at risk of burnout. Don't pick up the extra shift or task your boss is offering. Enjoy your time off. Practicing self-care at work can be hard. But, if you are not healthy, who will be there to care for patients? Choose one of these habits and put it into practice. Do you have any tricks that help you stay healthy at work? Share in the comments below. We would love to hear how you infuse your work day with health and wellness.
  18. Melissa Mills

    12 Healthy Workplace Habits for the Busy Nurse

    LunaTunaPineapple - Glad you enjoyed them!
  19. Melissa Mills

    Understanding Health Disparities: A Case Study of Jane and June

    It's so important to be aware of and to provide the level of care each patient needs. Reaching out to our colleagues in social services can be so crucial for patients with disparities as well! This is the most important thing! Individualize your care to meet the patient where they are when you care for them! Melissa
  20. When you meet a new patient, do you consider all the things that affect their health choices and overall health status? Of course, there are those things like race, sex, and age that the patient has no control over. But, have you ever considered those things that they do have some control over and how deeply it can affect a patient's health? Let's Meet Jane and June You have two white female patients. Both are 47 years old and newly diagnosed with diabetes. It catches your attention that these two patients are so similar on the surface. Let's see what we find when we dig deeper. Jane Jane lives in an affluent part of your city, has been married for 20 years, is a non-smoker, drinks socially only, and is an attorney. She lives in a single-family home with her spouse and three children. She has access to a private health insurance policy through her employer and can pay all of her bills each month. She attends a local gym for exercise and purchases food at an organic grocery. She struggles with her weight and does make poor food habits at times due to her busy lifestyle. She has a personal history of hypertension and a family history of Type II Diabetes. She takes a daily anti-hypertensive and sees her family physician annually and as needed. June June lives in public housing. She is divorced but lives with her boyfriend and his parents. She has three children that live with them, along with two of his five children. She states that she has been married three times and all her children have different fathers. She is a smoker, drinks a pack and half a day, and admits to recreational drug use at times. She has no insurance and is in between jobs right now. They often attend a local food pantry for staples and receive food stamps. She has a personal history of hypertension and a family history of Type II Diabetes. She takes no medications and does not have annual check-ups. She tells you multiple times that she needs to go home because she has no way of paying for this care. You can see the obvious differences, but what role does this play in their ability to care for themselves? Understanding Health Disparities A type of difference in health that is closely linked with social and economic disadvantage is known as a Health Disparities. These differences negatively affect groups of people who have more social and economic obstacles than others. These are "preventable" differences in the burden of disease, injury, violence, or even health opportunities. These obstacles can be related to race, ethnicity, religion, socioeconomic status, gender, mental health, sexual orientation, or geographic location. Sometimes, things like cognition, sensory, and physical disabilities can be liked it health disparity as well. Health disparities can be related to many factors. But, in the US, most health disparities are linked back to what is known as social determinants. What are social determinants of health? All of the factors that contribute to your overall state of health are known as determinants of health. Researches recognize five social health determinants in the U.S. Economic Stability - Economic stability hinges on your ability to pay for health care and good health decisions? Things that determine your economic stability include employment, access to food, access to steady housing, and poverty. Education - All U.S. citizens are guaranteed a basic education. However, not all people complete high school. This affects your ability to access healthcare in many ways. Specific areas of education that are health determinants include early childhood education and development, enrolling in post-secondary education, high school graduation, and language and literacy. Social and Community Context - How and where you live impacts your ability to care for yourself. It also impacts your ability to access healthcare services. If you choose to live in a rural community that has no local hospital, this could affect your ability to survive emergency situations or illnesses. Social and community context also includes other topics like participation in community organizations, discrimination, incarcerations, and social cohesion. Health and Health Care - Even though all people in the U.S. are entitled to healthcare, many remain uninsured or underinsured. This social determinant includes access to health care, access to primary care, and health literacy. Neighborhoods and Environment - If you have limited access to food, your overall health status will suffer. Other areas related to this social determinant includes your environment, such as living in an area with high crime and violence rates. Your environmental conditions and quality of your housing impact your ability to be healthy. Revisiting Jane and June You were likely able to identify most of the social determinants, simply because you have been in nursing for awhile and it becomes second nature. It is important as a nurse to consider these things from time to time and truly understand the barriers that patients encounter. Jane is likely going to do better with the new diagnosis of diabetes compared to June. She has a support system, access to healthcare, higher education, and access to food. June may struggle from day one with understanding and managing her new diagnosis due to her lack of education, access to healthcare and lack of consistent and healthy food sources. Have you ever seen health disparities in action in your practice? Can you think of a patient that you knew was likely doomed to be a "frequent-flyer" to the hospital due to their social determinants of health? Leave your thoughts, comments, and stories below. Would love to hear them.
  21. Melissa Mills

    Understanding Health Disparities: A Case Study of Jane and June

    There is definitely a stigma and it's easy to see why some patients have better outcomes. They may not have a support system but for crying out loud I'll try to be the best support system I can be as their nurse. TruvyNurse - Yes, there is a stigma. And, even beyond the stigma, we each have biases we bring to the table, whether we want to admit or not. As a nurse, we have to recognize our biases and attempt to set them aside for the betterment of the patient. Not always an easy task, but as you said - you have to the best support system you can be as their nurse. Thanks for your thoughts! Melissa
  22. Being a nurse leader is stressful. You lead a team of nurses who have hard jobs. They deal with death and sadness on the daily. Oh, and let's not even start the discussion about staffing issues. It may seem that every time you step out of your office, you are only there to deliver bad news. Well, let's change that (at least for today)! Let's talk fun. Yes, fun and nursing do go together, it is just hard to remember it sometimes. Let's replenish your nurse leader "fun bucket" with some ideas to bring fun back to your unit! HOW TO MAKE WORK FUN 1. Team Building Activities Most people, will scrunch their noses up at the idea of playing games in meetings, but they work! Let's face it, your staff are busy and may find it hard to connect with other members of the team. Team building activities push their hand at learning more about the people they serve with every day. 2. Nurse Centered Culture Do everything you can to make your unit about your nurses. They will appreciate it more than you may know. Plan events and be intentional in recognizing success both at work and in life. 3. Give Back as a Team Nothing builds camaraderie quite like volunteering together. Here are few ideas: Adopt-a-Family at Thanksgiving or Christmas - Find a local family that needs a little help during the holiday season. Create a fun bulletin board to list the items they need or decorate a tree with ornaments with gift ideas written on them. Let the staff buy gifts and then deliver them together to the family. Health Fairs - Represent your hospital at the local health fair by organizing a small team of nurses to work together. You can provide health screenings and enjoy some stress-free time together as a team. Support Others - Organize a team for a local 5K that aligns with your unit, such as a breast cancer walk for an oncology unit or diabetes walk for a clinic. Events like these allow your team to work together to raise awareness while building relationships. 4. Food Nurses love food, this is no secret. And, you barely get it most days. So, organize a potluck once a month and let them eat! 5. Fun Awards You don't have to be serious about stats and surveys all that time. Create some fun awards that you can give out at staff meetings. Here are a few creative ideas: Flexibility Award - Got a nurse who will bend over backward to help others? Give him or her play-doh or a slinky. Bright Idea - Foster creativity by asking for bright ideas. When you chose one, give them a pair of cheap and fun sunglasses for their "brightness." Keep a running supply of sweets - Everyone having a rough day? Hand out a pack of lifesavers or crack open a bag of bite-size candy bars and add a little sweetness to their day. 6. Motivate You don't have to have a meeting to offer encouragement. Hang motivational quotes around the nurse's station, in the staff bathroom, and on locker doors. Make sure to have a variety of fun, serious, and downright hysterical quotes to keep them smiling! 7. Celebrate Don't miss the opportunity to celebrate with these lovely people. Have a list of birthdays and plan a monthly cake and ice cream day. If you have staff going back to school, getting married, or having babies: plan a celebration! 8. After Work Adventures Yes, someone will always have to work in this crazy 24/7/365 world of yours, but that is no reason not to plan outings. Plan a trip to a local sporting event, casino, amusement park, or bowling alley. Whatever sounds like fun for the majority of your nurses, plan it. Oh, and attend! Nurse leaders often feel like an outsider when staff gets together. The only person that can change that is YOU! Go with them. Get involved. Connect with these people that help you meet unit goals every day. 9. Build Community Yes, you can recognize them all you like, and they will appreciate it. But, nothing says recognition quite like getting it from your peers. Facilitate their ability to thank one another with a simple "Pat on the Back" bulletin board. Decorate a bulletin board. Cut out some brightly colored hand shapes, buy some fun colored pens and let them give each other a "pat on the back" that others can see. It will be everyone's favorite place to spend a few minutes each day for encouragement. 10. Ask for Feedback No matter what activities you do, ask for their help and feedback. It is their unit too, and they can tell you what they like and don't like. You may even find that everyone participates more if you have a "Fun Committee" that plans activities for each shift. Nurse leaders have stressful jobs and can get lost in the rules, data, and goals. Don't forget to have fun with your nurses. Do you have a great idea to share with other nurse leaders who need a new way to add fun to their unit? Share in the comments below and get the creative juices flowing!
  23. Melissa Mills

    10 Ways Nurse Leaders Can Make Work Enjoyable for Staff

    Thanks for your honesty Poneymom. Melissa
  24. Melissa Mills

    10 Ways Nurse Leaders Can Make Work Enjoyable for Staff

    But gah, I freeze when walking around a room trying to find someone who grew up halfway around the world or who might have a sister whose name starts with the letter "Z." PixieRose - this made me chuckle! Yeah, I know that some people really do not like team building, but sometimes it is the only way to get everyone to contribute. But, I would say, given your sense of humor, you probably get to know others pretty easily. :). Thanks for the comments and the chuckles! ~Melissa
  25. Melissa Mills

    10 Ways Nurse Leaders Can Make Work Enjoyable for Staff

    Thanks for the comments NightNerd! Cheesy awards still get the appreciate across. :)
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