Rmooney

Great article and wonderfully written. You did a nice job explaining what CC is in a way that is easy to understand.

There’s no heartbeat. You’ve had a miscarriage. I’m sorry, but she didn’t make it. These are the words that expectant parents never want to hear. Some women may go through pregnancy with no complications, while others struggle with fertility and miscarriages. Pregnancy can be an incredible experience but may also cause a lot of worry and stress on the expectant parents. What is a Miscarriage? Miscarriage is defined as the spontaneous loss of a fetus before the 20th week of pregnancy. About 10-20% of known pregnancies end in miscarriage. This means that 10-20 women out of 100 who know they are pregnant will experience a miscarriage. Many women may unknowingly have a miscarriage, as many miscarriages happen very early in pregnancy before the woman even knows she is pregnant. If the baby is lost after the 20th week of pregnancy, it is termed a stillbirth. An early stillbirth is when fetal death occurs between 20-27 completed weeks of pregnancy. A late stillbirth is when fetal death occurs between 20-36 completed weeks of pregnancy. And a term stillbirth occurs between 37 or more completed pregnancy weeks. About 1 in 175 births result in a stillborn baby in the United States each year. What Causes a Miscarriage? Most miscarriages result because the fetus isn’t developing as expected. It is rarely due to something that the expectant parents did. It most often occurs for things beyond your control. About 50% of miscarriages are due to chromosomal abnormalities in the first trimester of pregnancy. When the egg and sperm join, there are two sets of chromosomes that join. If there is an abnormal number of chromosomes in either the egg or sperm, the fetus will have an abnormal number of chromosomes. As the fertilized egg grows into a fetus, its cells will divide and multiply several times, which can lead to a miscarriage if abnormalities occur during this process. It is not well understood why chromosomal abnormalities occur but thought that most happen by chance. Other factors that may contribute to a miscarriage include: Infection Hormonal imbalances Uterine abnormalities Incompetent cervix Smoking, drinking alcohol or using recreational rugs Immune system disorders Severe kidney disease Congenital heart disease Unmanaged diabetes Thyroid disease Radiation Certain medications Severe malnutrition What are the Symptoms of a Miscarriage? Symptoms of miscarriage include the following: Bleeding that progresses from light to heavy Passing grayish tissue or blood clots Cramps and abdominal pain similar to menstrual cramps Low back ache that ranges from mild to severe A decrease in pregnancy symptoms What Should I Do if I Think I’m Having a Miscarriage? If you think you are having a miscarriage, you should notify your doctor right away. They will want to determine if you did have a miscarriage and may recommend further testing like blood work and an ultrasound. Completing the ultrasound will also confirm that no parts of the fetal tissue remain in your body, as this could cause infection, bleeding, or other complications. If it is determined that the miscarriage is complete and your uterus fully expelled the fetal tissue, no further treatment is usually needed. If it is not complete, your provider may recommend removing the fetal tissue with medication or surgery. How Soon Can I Get Pregnant After a Miscarriage? Most women who experience a miscarriage have subsequent normal pregnancies and births. The decision to when you should try to get pregnant again is between your provider, you, and your partner. Providers normally recommend one normal menstrual period before trying to get pregnant again. While experiencing a miscarriage at any point in your pregnancy is incredibly difficult, remember that it does not mean that you cannot get pregnant. Many women experience successful pregnancies and deliveries after having a miscarriage. If you are concerned about your ability to get pregnant or carry a baby to term in the future, make sure you speak with your provider about this. References/Resources CDC: What is Stillbirth? Mayo Clinic: Miscarriage Cleveland Clinic: Miscarriage

I also make every effort to do med pass with each if my students. However, I can have up to 8 students on the floor at a time and I make two of them team leads. My students get at least 2 patients, sometimes 3 because this is their last clinical before their preceptorship and then they graduate. I can’t pass meds on 12+ patients. I pick one patient for each of my students to complete their med pass with and ask them to communicate with their nurses which patients they will pass meds with me and which they would need to do with them if the nurse is available. I never expect the nurses to do this and there are times when they have to pass the meds without the student and that is just fine. But then I pass meds with the students for 6 of the patients on the floor, which is still a lot. Some days I’m able to do more than that depending on how many medications each patient has. It isn’t ideal, but l I’m only one person and can only be in one place at a time. I’ve had nurses comment that they appreciate how hands on I am with my students. They have seen instructors just sit at the computer the entire shift while they pair their students with a nurse on the floor. I definitely don’t agree with that practice. I think instructors should be hands on and with their students the entire shift. But with 8 students on the floor, there are times the instructors may appreciate the RNs being willing to give the students additional learning opportunities.

I think you’re misinterpreting what I’m saying here. I’m not blaming the MNA. My point was that it is unfortunate that the issues have gotten to the point where nurses feel the only option is to strike to get leadership to listen. And I’ve seen how burnt out they are by their reaction to us on the floor. Also, the nurse that snapped at me about the med pass didn’t even have to give meds with my student. As the instructor, I make every effort to pass meds with my students so the nurses don’t have to. My goal is to take some of the work load off of the nurses while providing a great learning experience for my students. In the past, nurses have recognized that as a benefit of having students on the floor. But recently, I’m seeing and hearing from my students that they don’t feel as welcome. This is an issue because without students, we won’t get more nurses. I do know the hospitals are working on solutions to create better staffing for their teams that doesn’t rely on getting new nurses . No one can change the amount of time it takes for someone to complete their program.

I agree, nurses eating your young creates a toxic work environment. It's noticed by student nurses too. And guess what? When those students see this happen on the floor they have clinical on, that is a unit that they will not be applying to work on some day. I teach in an associate degree nurse program in Northern WI and Northern MN. We have seen the negative impacts of the MNA going on strike and the long, drawn out process of negotiating their contracts. Staffing has been terrible, nurses are frustrated and feeling burnt out. This has resulted in nurses not being as accepting to having students on the floor. They've been overheard complaining about students being on the floor and how much longer it takes them to do everything and have even yelled at them and me, the instructor, for allowing them to do a med pass for a patient with a lot of meds. I'm seeing nurses eat their young before they even become RNs. When this happens, my students tell me that they don't feel welcome or comfortable on the floor and would never apply to work on that floor. If nurses want staffing issues to improve, they need to take an active role in being part of the solution. They need to be willing to teach students and be welcoming to them on the floor. Yes, sometimes this means it will take longer to do a med pass, but it's the only way the student nurse is going to learn. And if there's an emergent situation, guess what? It's okay to ask the student to observe and take over the task. It's still a learning opportunity for that student. But if they choose to complain about students and make them feel unwelcome, they will continue to to struggle with safe staffing.

Technology can be a wonderful thing. It allows us to have a wealth of information at our fingertips and has made many tasks easier. But how much screen time is really okay for kids, and what happens if they are getting too much? Many children 8 years old and under have their own tablets. Many kids are getting their own smartphones1 between ages 6 and 7. According to a study2 conducted by researchers at the National Institutes of Health, the University at Albany and the New York University Langone Medical Center, children’s average screen time per day increases from 53 minutes at age 12 months to more than 150 minutes by age 3. This shows that screen habits begin very early in life. The American Academy of Pediatrics and World Health Organizations recommend that children younger than 18 months should avoid screen time other than the use of video chatting3. Children 18-24 months can be introduced to screens through high-quality programming or apps with an adult, but using these by themselves should be avoided. Children 2-5 years old should have no more than 1 hour of screen time per day of high-quality programming. Children 6-12 years old and teenagers should have no more than 2 hours of screen time daily for entertainment. Data from a National Institute of Health study4 on screen time and the health and well-being of children and adolescents showed evidence that higher amounts of screen time are associated with a variety of health issues that can be harmful to children and adolescents. This evidence showed risks for adiposity, unhealthy diets, depressive symptoms, and quality of life. Another study5 conducted by the National Institute of Health followed 11,000 children at 21 testing sites across the country to assess how screen time impacts their brain development. To conduct the study, children got MRIs of their brains while a screen showed them images from their Instagram accounts. Early data from this study showed negative effects of too much screen time. Children who spent more than two hours a day on screens scored lower on language and thinking tests. Children who spent more than 7 hours a day of screen time showed shrinking of the brain’s cortex, which is the area of the brain related to critical thinking and reasoning. While they are still determining what the results mean, physicians are concerned that screens narrow a child’s focus of interest. While children used to learn by exploring, kids are spending much more time on screens, and are harder to engage in non-electronic activities that foster imagination and creativity and allow them to develop necessary social skills by playing with other children. Studies6 have shown that children under 2 learn better from another person than they do from watching a video. Children don’t understand the content on screens until after age 2, although the colors and music on the screen may catch their attention. Language development happens between ages 1-3. Children learn language best when they are interacting with adults and other children who are talking and playing with them. Talking with children and sharing facial expressions with them in your conversations is crucial in the development of language and communication. This is something that children can’t get from interacting with a screen. Children who watch a lot of television in the early years have also shown to score lower on reading tests and have a more difficult time holding their attention. Sleep6 can also be affected by the use of screens. Our circadian rhythm and production of melatonin begin when the sun sets. However, the blue light from screens inhibits the production of melatonin which can then delay sleep. Our brains are more alert and activated when we are watching tv, playing games, or on our phones and tablets. When we do these activities right before bed, we feel less ready for sleep. The closer the blue light to our face, the more our melatonin production is suppressed, making activities with our smartphones and tablets cause more issues with sleep. Having a lack of sleep may then affect behavior and cognitive performance, which may interfere with learning. Studies have shown that excessive screen time and sleep deprivation are linked to obesity, which can lead to low self-esteem and other mental health disorders. To try to minimize screen time for your children, parents and guardians can implement some strategies6. While it can be convenient to allow your children to have screen time so you can get other things done, it is recommended that you co-watch whenever possible. This allows you to help them understand what they are watching and gives them an opportunity to engage with you and ask you questions. Bedtime and mealtimes should be screen-free times to help balance online and offline time. Set a good example by also limiting your own screen and phone use. Incorporate healthy lifestyle habits that focus on good sleep, healthy nutrition, and exercise. Setting these boundaries and examples can help develop healthy daily routines while also limiting screen time. References/Resources 1Do 6-year-olds need cell phones? 2High amounts of screen time begin as early as infancy, NIH study suggests 3What do we really know about kids and screens? 4Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews 5The NIH Is MRI-ing Kid’s Brains While They Instagram to Study the Effects of Screen Time 6What Does Too Much Screen Time Do to Children’s Brains?

I see this struggle in so many nurses when I bring my students to their clinical rotation. When I meet with each of my students for their mid and final evaluations, I spend time talking with all of them about the importance of showing compassion and empathy towards their patients and taking the time to listen to the patients story and get to know e while they are completing their tasks with their patients. Nursing is SO much more than the skills you learn in school. These patients are trusting their lives in our hands. The least we can do is show them we truly do care about them as a person.

Great article! The level of intensity also makes a difference for those that are trying to lose weight. Definitely interesting to learn more about where the 10,000 steps a day recommendation came from.

Great suggestions! I'm working on starting up my own nurse freelance business right now. I love how it fits in so easily with my nurse educator position AND can actually make me an even better educator.

Love this! This is why being a nurse freelance writer is becoming more popular!

You've just heard back from a job you applied for and scheduled an interview. You have no idea how many candidates there are for the position or how many they are interviewing, but you want to make sure you stand out as the best candidate. There are many things you can do, and things you shouldn't do that will make you stand out. How Do You Prepare For Possible Responses To Questions? When you are preparing for an interview, try to think of questions that they may ask you. Things like, what are your strengths, what are your weaknesses, give an example of how you displayed teamwork, etc. In a professional binder, write down some notes of things you may want to use during the interview. Make a list of your strengths to highlight and then a list of your weaknesses along with what you are doing to improve them. Think back to your experiences that are applicable to the position you are applying for, and write some notes down about the examples you can use that may be applicable during the interview. It's okay during the interview to leave this open in front of you to either take notes during the interview or glance down at your notes in case your nerves get the best of you and you suddenly can't remember your examples. How Do You Practice Potential Responses? Practice your potential responses ahead of time. You can do this by standing in front of the mirror and rehearsing the examples you've thought of ahead of time. You may also choose to ask someone to do a mock interview with you. This will help calm your nerves on the day of the interview and allow your answers to be more polished. How Do You Dress to Impress? Dress in business professional attire. This means that all cleavage and cracks should be appropriately covered. You should be well groomed with no heavy perfumes or cologne. If you choose to wear make-up, it should be light and not excessive. Some jewelry is okay, but nothing that is too big and distracting. You don't want to stand out because of how you look; you should stand out because of the well-prepared responses you give during the interview that show your experiences and hard work ethic make you the best person for the position. How Do You Get To The Job Interview On Time? It's always a good idea to drive to the location of the interview prior to the day of, especially if you aren't familiar with the area. Try to drive to the interview location during the same time of day you would be driving the day of your interview. This will help you determine if there is any heavy traffic that you need to consider leaving earlier for or if there is any construction that you need to be aware of. It is always better to be early than to be late. If you arrive late to an interview, the employer may not even interview you. Being late to the interview gives the impression that you will also be late for your shifts and are unreliable. How Do You Prepare For Questions to Ask? After they've asked you all of their questions, they will likely give you an opportunity to ask them questions. Make sure you prepare questions to ask them ahead of time instead of not asking them anything at all. This shows you are really interested in the position. Some questions that you may consider asking: What are some quality improvement initiatives that your team has been working on? OR What are the current goals of the unit/department? What has the turnover been on this unit/department? (High turnover is a red flag, and if it is high, ask why people are leaving) How do you onboard new employees? What challenges has your unit/department been facing recently? What's different from working here than anywhere else you've worked? What do you enjoy most about working here? (Ask each person to go around the room to answer this question) What learning and development opportunities will I have in this role? What have successful employees moved onto? What are the next steps in the hiring process? There are also questions that you should avoid asking in an interview. While it may be important for you to know what the starting salary is or how much vacation time you have, especially if you already have a trip planned, these are questions that you should wait to ask HR after you've received an offer. If you do have a trip or medical leave already planned, you can let your employer know after you've accepted the position so they can work out the logistics of that with you. Here are some questions to avoid asking during the interview: What is the starting salary? How much vacation and sick time do I get and how soon can I use it? What are your paid leave policies? What is your late policy? How Do You Follow Up with a Thank You? After the interview, send a follow-up thank you email to the interview committee. In this thank you, thank them for the time they spent with you, reiterate why you are excited about this position and why you think you would be a great fit, and let them know you are looking forward to hearing back from them. If you don't have the contact information for everyone on the interview committee, you can email your HR contact and ask them to please forward it to the interview committee. Reference(s) 38 Smart Questions to Ask in a Job Interview

I teach nursing students in their last semester of school. One of my students asked for tips as a new grad. One piece of advice that I gave her was to not be afraid to try a different area of nursing if she felt like she wasn’t loving her first job. There are so many opportunities out there, start looking to see what else might be a better fit. That being said, I would also recommend meeting with your direct supervisor. As a new employee, you should feel comfortable asking questions. Let your supervisor know how you’re feeling and that you’re not sure this department is the best fit because of it. The problem will either get fixed or it won’t, and then you’ll know what to do next.

Thanks for sharing your experience! I’m glad you were able to break that habit. It’s really amazing the negative side effects unhealthy foods and drinks can have on our bodies. I hadn’t heard of people using topamx before and am interested in learning more about this! Great advice!

I know, seems “silly” yet so many people I know will spend hours working out and not get any results because they have the misconception that if they are working out they can eat anything they want. They are always surprised on the amount of weight they lose just from making changes in their diet and making no changes to their workout routines.

Thank you! I agree that when people bring in food for nurses, they all seem to be j healthy options! My clinical groups usually bring in something as a thank you for the nurses on our last day. I’ve been encouraging them to bring a mixture of healthier options and something sweet fir those that want it.