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Nurse Beth MSN

Med Surg, Tele, ICU, Ortho

Hi! Nice to meet you! I love helping new nurses in all my various roles. I work in a hospital in Staff Development, and am a blogger and author.

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Nurse Beth has 30 years experience as a MSN and specializes in Med Surg, Tele, ICU, Ortho.

I love helping new nurses, and I blog about how to get hired and all things nursing at my award-winning blog,  http://nursecode.com. I authored the popular "Your Last Nursing Class: How to Land Your First Nursing Job" on Amazon! It's the ultimate guide with insider tips to land your nursing job!  Look for my latest book First-Year Nurse: Advice on Working with Doctors, Prioritizing Care, and Time Management,  published in 2020.

Here is a great & detailed review of my first book from Kyle Schmidt at BluePipes.com. http://blog.bluepipes.com/nursing-job-search-book/ I've worked Med Surg, Tele, GI, and ICU. I spent several years in Nursing Management, and currently work as a Staff Development Specialist. Plus a lot of fun side jobs 🙂


Nurse Beth - Career Columnist / Author
Read My Book: Your Last Nursing Class - How to Land Your First Job..and Your Next!

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Nurse Beth's Latest Activity

  1. Nurse Beth

    Graduating with MSN

    Dear Nurse Beth, I will be graduating my MSN program (leadership and management) next year and I would like to know what jobs would be available to me as far as leadership and possibly education. Dear Graduating, Congratulations! Your MSN qualifies you for many roles and opens many doors. Holding an advanced degree definitely adds credibility and confers expertise. There's management, nursing professional development, academic roles as a nursing professor, and more. Nursing professional development specialists work in acute care as educators. But it can take time to find the right job. One nurse I precepted through her MSN program believed she'd easily get any high-level job she applied for as soon as she graduated. It doesn't work quite like that, as advancing in your career is a function of experience, credentials, and opportunity. For example, if you've served as Charge Nurse and now have a master's degree in Leadership, you now have both the experience and credentials to apply for manager. If you've been a manager, you could apply for Director. What is your previous experience, and what are your interests? Activate your network and let them know you are looking for a job in your identified field, and start searching job boards for opportunities. All things being equal, having your master's degree will make you more competitive. Best wishes, Nurse Beth
  2. Nurse Beth

    Crushing Burden of Regulatory Compliance on Healthcare

    There definitely comes a time! Best wishes 🙂
  3. Nurse Beth

    Crushing Burden of Regulatory Compliance on Healthcare

    Amen. It's so litigious and fear-based.
  4. Nurse Beth

    Are Nurses Superstitious?

    Suspend Your Disbelief Some of us have cognitive dissonance around superstition. Meaning we both believe and don’t believe. How can that be? It’s knowing a superstition is irrational and performing the action anyway. On some level, we know that knocking on wood is not going to keep the status quo such as “no one coded so far”. So why then do we look around for some wood and then rap on it if we know that it cannot possibly prevent a code from happening on our shift? Can we actually prevent bad events by what we say or do? It seems the hotel and high-rise building industries think so. Most builders wouldn’t think about having a 13th floor in a high rise or hotel. In superstitious hotel math, if a hotel boasts 16 floors, there’s really only 15. There are no 13th floors because we all know that the number 13 is unlucky. If a guest had a heart attack on the 13th floor, it would be because of the unlucky number 13, unlike having a heart attack on the 13th floor that was misnamed as the 14th floor. Control Maybe we need to feel in control because it’s difficult to comprehend that we have little, if any, control. We can’t control earthquakes and losses and heartbreak and disappointments in life, for the most part. But we can avoid walking under a ladder and opening an umbrella indoors. It’s a false sense of control bought with a wish, but hey, we’ll take it. Fear Many of us wouldn’t necessarily say we’re superstitious people, but when faced with the opportunity to prevent bad luck, why tempt fate? Rock the boat? Jinx good luck? Who wants to tempt fate by saying the Q word at work? No one I know. Who wants to “Step on a crack and break your mother’s back or step on a line and break your mother’s spine?” Far be it from most of us to taunt the universe. There’s some sense of relief in doing everything you can to ward off bad things, just in case they work. Tradition Sometimes superstitions are borne of tradition, such as blowing out birthday candles on a cake and making a wish. It’s almost impossible not to say “Bless you!” when someone sneezes. "Something old, something new, something borrowed, something blue" is a tradition that brings good luck to a marriage and has the extra benefit of rhyming. Other Countries and Cultures Sometimes when we hear about others’ superstitions we dismiss them as ignorant or false conceptions. Who in the western world possibly believes that the number 4 brings bad luck? That’s clearly just as silly as believing that the number 8 and the color red are lucky. We do, however, believe that a rabbit’s foot can bring good luck while wondering how others believe evil eye jewelry can protect one from negative energy. Americans agree that Friday the 13th is unlucky but sticking chopsticks upright in a bowl of rice can’t cause misfortune, right? Come to find out, chopsticks should not be stuck upright into food, especially rice. Chopsticks are only stuck upright into rice in the bowl on the altar at a funeral or when paying respects to the deceased. Nursing Superstitions and Beliefs Baseball players and other athletes are known to be superstitious. Many nurses are as well. Are you superstitious? Here are a few nursing superstitions or if not superstitions, illogical beliefs: The Q word. Most of us will never say “It’s quiet” because we all know it will cause an influx of patients. Power of 3’s. Many nurses will tell you “Deaths (and codes) come in 3’s” Delaying charting is bad luck. If it’s a slow day, and you wait to chart, then all heck will break loose. More codes happen at change of shift (I’m convinced of this one). Full moon and babies. If there’s a full moon, the floors will be crazy and we’ll have lots of babies Superstitions are pretty harmless and can relieve anxiety while bonding with colleagues. How about you, are you superstitious? If so, what superstitions do you believe in? Best wishes, Nurse Beth
  5. Nurse Beth

    New Nurse Struggling With Doctor Calls

    Exactly! You lose credibility if you don't exercise independent judgement.
  6. Nurse Beth

    New Nurse Struggling With Doctor Calls

    If there's a hospitalist on duty, that's appropriate. The challenging part for a new nurse is to differentiate when a patient needs to be seen by an MD and when it can safely be managed by phone.
  7. Nurse Beth

    Texting with Flo

    I love this 🙂
  8. Dear Nurse Beth, How can I become a nurse esthetician? Dear wants to be a nurse esthetician, It's a great question, with lots of opportunities in the field. RNs are performing more and more nonsurgical aesthetic enhancement procedures in this rapidly growing industry. RNs who perform cosmetic procedures such as Botox injections, collagen replacement therapy, sclerotherapy, microdermabrasion, chemical peels, photo facials, tattoo removal, and more are cosmetic nurses, also known as plastic surgery nurses. While some employers prefer to hire nurses with outpatient surgical experience, many hire new grads and train them on the job. How to become a cosmetics nurse A common question is, do I need to be an aesthetician to become a cosmetics nurse? You do not need to be an aesthetician. A registered nurse with specialized training in skincare and cosmetic procedures has surpassed the training of an aesthetician. You also don’t need a special license. Because cosmetic nursing is a relatively new and rapidly evolving field, an industry-standard training path hasn’t been finalized as it has for most other nursing specialties. Currently, there is no separate licensing needed for a Registered Nurse to become a cosmetics nurse. It is within most states’ nursing scope of practice to perform many cosmetic procedures with proper oversight. Training You need training on specific procedures. Product manufacturers provide training and even treatment-specific certification in certain procedures, but most states do not require treatment-specific certification or licensing. Training is also provided on the job under the oversight of a physician. On-the-job training is considered preferable to paid courses by many nurses because it’s free, and learning takes place in a real-life clinical setting. Work settings Many clinics provide multiple services while some clinics specialize in certain procedures, such as IPL photofacials to treat rosacea, light acne scars, tattoo removal, or laser hair removal. Cosmetic nurses can work for a dermatologist, plastic surgeon, or licensed physician who has expanded their services to include aesthetics. Make sure the physicians you work with are board-certified. A people-friendly personality is a plus. The successful cosmetics nurse must relate to people well, and in some settings, be able to guide/upsell and educate clients about products and services. How about specialty certification? Currently, there are no nationally recognized guidelines for nurse aesthetics certifications offered through the American Nurses Credentialing Center (ANCC). While it’s not necessary to have a separate certification to work in cosmetic nursing voluntary certification can help with career advancement as well as professional development. The Certified Aesthetic Nurse Specialist (CANS) credential is available through the Plastic Surgical Nursing Certification Board (PSNCB). Obtaining this specialty certification demonstrates competency in carrying out cosmetic procedures. Eligibility requirements for the CANS exam include an RN license and two years of experience as an RN with one of those years working in facial plastic surgery ENT, plastic/aesthetic surgery, dermatology or ophthalmology. Nurses must re-certify every three years by accruing 45 contact hours through continuing education. The Dermatology Nurses Association also offers a Dermatology Nurse Certification. Join the American Society of Plastic Surgical Nurses (ASPSN) for additional educational resources and information. You can also purchase Plastic Surgery: Scope and Standards of Practice 2nd edition, published by the American Nurses Association (ANA) in conjunction with ASPSN. Can I start my own business? Because Botox, collagen and other soft tissue fillers must typically be purchased under a physician’s license, cosmetic nurses need to align with a provider approved by their state who will serve as their Medical Director. Medical Directors can be plastic surgeons, dermatologists, ophthalmologists or any other licensed physician with an interest in medical aesthetics. Their responsibility is to provide supervision to comply with state laws of medical and nursing practice. Each state has different regulations when it comes to aesthetics, including what is defined as “medical” and which professional can do which procedure or treatment. Some nurses have been successful in opening a medspa and hiring a Medical Director. Typically insurance does not reimburse for cosmetic procedures, so there is no complicated billing and insurance to deal with. Consider consulting an attorney and a business consultant if owning your own business is your goal. Be sure to research the governing laws in your state. Find out: What is considered a medical procedure (can be performed by MD or under MD oversight only) Which products can only be obtained by an MD in your state (Dermal fillers, Botox)? Board of Nursing (BON) regulations in your state to find out what your scope of practice is regarding cosmetic procedures/treatments Coverage provided by your insurance carrier to make sure you are insured for the specific procedures you intend to perform Best wishes and hope this helps, Nurse Beth
  9. Could I make myself love wound care? I'm totally fine with it but wouldn't say I love it, do I need to love it to do it? It's gratifying to help wounds heal and see the results of your efforts. You can always find ways to challenge yourself in your work, and focus on the aspects you enjoy. How challenging is it to be a wound care nurse vs. An inpatient nurse? It's different. You have a lot of autonomy, and you see patients one at a time, instead of having several patients at a time. Providers respect your expertise, which is nice. There's a lot of patient and family education. Any tips or suggestions on any of this information feel free to give. Thank you in advance ☺ Weekends off are a plus-but not a guarantee. Some wound care positions require on call and weekends. Wound care is highly specialized, and requires a big investment of time and education. If you change your mind later, you could have regrets. Best wishes with your decision 🙂
  10. Nurse Beth

    New Nurse Making Mistakes

    What great advice you got from JKL33. I'm so glad you gained some perspective! We are here for you at allnurses 🙂
  11. Nurse Beth

    Unhappy with CCU job after one week

    Dear Nurse Beth, I have been a nurse almost 20 years and have mostly done med/surg and step down ICU. Have floated to CCU during Covid. So I moved recently and took a CCU position at this new job. However, already a week into the job I am unhappy with it. I have not gotten any orientation, no training to computer system, just thrown in with a “preceptor” and left to figure it out on my own pretty much. CCU is new to me and uncomfortable. I have plenty to learn and was OK with that at my last hospital because I had the support there. But don’t feel the support now. There’s no techs to help with turns and baths, the computer system is so outdated I can’t figure it out. And the nurses are routinely tripled in CCU which means they don’t have time to really explain or teach. They just jump in and do cause in CCU you don’t have the time to say “wait don’t code while I explain things”. I already want to start looking for a new job at a different facility with an updated charting system and better orientation. Who knows if that’s even out there. And hopefully out of bedside patient care. I only accepted this position because there wasn’t anything available at the time not at the bedside. But now I’m regretting this and so many red flags. Don’t feel like I am giving the best care I can when I feel so much like a fish out of water and without the help I need. I mean what kind of CCU doesn’t use techs to help with daily care? What do I do? I have no clue what I would be interested in or happy doing outside bedside nursing. Never worked in an office to know if I’d like it or what to do. But I am over bedside. And do I job search and put a 2 week notice in and risk being put on a do not hire list with this Health system? Or tough it out longer since it’s only been a week? I need advice of what to do. I’ve always stayed at jobs for years! Never even thought to leave after only a few shifts. But don’t like what I already see. Dear Uncomfortable, You need to make a plan. So while making your plan, stay put. You don't want to jump from the frying pan into the fire, because, as you say, you have no clue what you'd be interested in outside of patient care. Are you sure you are done with bedside nursing? Hopefully you have your BSN because it is required for many non-bedside positions, such as case management, infection prevention, nursing management, public health nursing. Routinely having 3 patients in CCU and no techs is not a good working environment. There are ICUs without techs or nursing assistants, but the combination of no help and 3 patients could easily turn into an unsafe situation. It stands to reason the nurses are too stressed to give you a proper orientation. You could plan to leave as soon as possible and start looking for another position. If there are a lot of options in your area, then being placed on their Do Not Hire list is just the price you pay for getting out of a bad situation, and may not affect you all that much, especially if you plan to never work for that system again. Alternatively, you could give yourself a little more time. You would definitely adjust to the computer system, and even to having no techs, but routinely having 3 ICU level patients is something you may decide is untenable. Whichever you decide, start exploring non-bedside jobs. If you aren't completely sure you are done with bedside patient care at this time, you probabaly will be soon. It's good to plan for that time. Register on indeed.com, using non-bedside as a filter, and you will quickly get an idea of the many different types of jobs out there. Best wishes, Nurse Beth
  12. Dear Nurse Beth, I have been a nurse for almost 20 years but I am still waiting on a job that I truly enjoy. I have worked in various areas mental health, community, acute care, education, clinical informatics, but lacked joy and didn't stay long. I recently received my masters degree in nursing. I really love learning, I could read for days, I love being by myself and making decisions on my own. I don't like high pressure environments. I like routine and clear work duties. I feel a bit lost as I don't know where I fit. I check the nursing job boards but very few jobs interest me. I am a second career nurse, I worked in business in a call centre of I didn't like it. Any advise what I can do to find an interesting job that I enjoy? Thank-you in advance. Dear Lost, Now that is a tough question! What I'm thinking is, if you do not know what you find interesting, I'm not sure how much help I'll be to you. Twenty years is quite an investment as is earning your master's degree. What specialty track is your master's degree in? Leadership, education...gerontology? Surely at the time you decided to pursue higher education, you had a goal in mind. Can you rediscover that desire? Have you thought about legal review? You have a wide background and love to read. You could apply your experience and expertise to consulting on legal cases. If you find you love it, you could go on to become a legal nurse consultant. You love learning, can you see yourself being a teacher and sharing your love of learning, inspiring others? You mention you've been in education, but staff development in a hospital is very different than being an educator in an academic setting. If you live near a large university, there may be opportunities for research, since you are studious. Many people who love reading have good writing skills. Companies such as Lippincott (Wolter-Kluwer), HealthStream, and Relias, employ nurses who can write test questions (items) and develop content. Case management and utilization review allow you to work independently, often remotely, while making decisions in a well-defined framework. If you have a lack of joy in all areas of your life, consider that you may have a low-level depression. Or maybe you have just been picking jobs that aren't the best match for you. I really hope you find something that brings you fulfillment. Best wishes, Nurse Beth
  13. Hello, I have been an ICU RN for several years now and I absolutely love bedside Critical Care. My 10 year plan was to get my AGACNP and work as an NP to our CC Intensivists group for a decade or so, while pursuing my doctorate in Nursing education (local university requirement for for educators). However, I have recently been diagnosed with a degenerative spinal condition that causes me extreme pain with ambulatory, leaning, bending, lifting, pushing or pulling. (It hurts to lift a gallon of milk, or push an empty shopping cart). I don't want to leave the bedside, as I love direct patient care, but I don't see how I can physically continue to do my job without being able to reach up to hang IV drips, lean in to push IV meds or help adjust patients in the bed. Any advice for (nearly) sedentary nursing positions while I pursue further education? Dear Loves Critical Care, I'm sorry to hear about your diagnosis, and it will change what you're able to do, but there are many options in nursing. There are absolutely jobs you can do from a desk. There's telephonic nursing, such as advice nurse, triage nurse and utilization review. Some case management jobs can be performed remotely on the computer. Target employers such as insurance companies and register on indeed.com to get an idea of what's available. You can also consider an ICU educator job which would enable you to remain in acute care, if you are able to manage some walking. Unlike direct patient care, you could schedule your walking times and sit when needed. Once you get your doctorate you'll be well qualified for academic positions that don't require direct patient care. Best wishes, Nurse Beth
  14. Nurse Beth

    Nursing Intuition- What Is It, and Do You Have It?

    Wow! Being competent in a code is one thing, preventing codes is awesome!
  15. Nurse Beth

    Nursing Intuition- What Is It, and Do You Have It?

    That's so true. I would always wait a bit to get an H&H after a transfusion bc the value would be higher after an hour than right away. I also would be concerned about a drop in temperature and a low white count bc sometimes it was a drop just before a rise=sepsis
  16. Nurse Beth

    Should I join LinkedIn?

    I am starting nursing school in a month and I have no online presence. Should I create a LinkedIn or an Academia.edu profile? My nursing school has a strong focus on research, and I plan to take my education further than a BSN. Dear Nursing Student, Congrats on starting nursing school! I'm not sure if Academia.ED will be super helpful to you as a nursing student, but you could always try it out. It is a commercial social networking site for academics where people can upload their research papers and read others' papers. You are going to have a lot of assigned reading in nursing schoool, and typically your school will provide you student access to any databases you need. Establising a professional presence on LinkedIn is a great idea. Recruiters use LinkedIn and it's excellent for networking. Networking is key to a successful career. You'll be surprised by how many you'll find that you know on LinkedIn- educators, nursing instructors, and hiring nurse managers. Also consider joining your professional organization, the National Student Nurses Association. It looks good on a resume. Best wishes, Nurse Beth