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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 awrd-winning blog,  http://nursecode.com. I authored then 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!

Here is a great & detailed review of my 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's Latest Activity

  1. Nurse Beth

    The Stigma of Men in Nursing

    Dear Readers, thank you for the comments. Your feedback is right on. I went back and added a paragraph at the beginning of the article thanks to your input. I hope you’ll read it- Nurse Beth
  2. Nurse Beth

    The Stigma of Men in Nursing

    Here is a prelude which is actually a prologue. I am writing this edit after the article below was published, based on the well -written feedback. While I pinged off a recent article and point of view written by a nursing student at Penn State, my sources, as pointed out, are old, and don't reflect the current state. As a writer, I intend to bring forward more well-researched info, and this article missed the mark. There is far less stereotyping, especially at the clinical level, where male nurses are often embraced, than at the social level. One reader did say, however, that more often that not, he is asked if he's the MD or if he's going to become an MD. I don't believe that men in nursing is a non-issue. Perhaps at the individual experience level at the bedside...but the bigger picture to me is how the slow but steady influx of males will influence the profession. I think more men will benefit the profession in many ways, and I also think gains will be made that a feminized profession was unable to accomplish. As one reader said, male privilege does exist. The comments so far have been well-thought out and respectful. I appreciate the feedback. “Caring, nurturing, comforting...healing touch. Women's work.” These are words and feminine imagery used to describe nursing, a profession so strongly identified as female that it’s odd to realize, in ancient times, nurses were men. However, since the time of Florence Nightingale, males have been a minuscule minority in nursing. What holds men back from becoming nurses, even in this modern day? One reason is the fear of almost certain stigma. Taking on a feminine role affords men an ambiguous social status. Family and friends may disapprove. As a result of stigma, role strain, and isolation, very few men join the profession. Of those that do, more than 85% as compared to 35% of women drop out or fail (Poliafico,1998). Men in nursing are at once advantaged and disadvantaged. While nurses are considered subordinate to doctors, male physicians treat male nurses better than females or at least with more respect. Ironically, male nurses command higher salaries than their female counterparts and hold proportionately more prestigious positions (Evans, J., & Frank, B. 2003). This may partially be due to the fact that males gravitate to the highest-paid specialties, such as nurse anesthetist. Stereotypes and Barriers In healthcare, men are expected to be doctors. Not only is nursing female-identified, but it is also considered by many to be gender-inappropriate for males. Hiring male nurses in labor and delivery and nursery is close to taboo in many places. Male nurses are expected to work ED and highly technical or high-acuity areas such as ICU. Men who choose nursing face questionable social status as many people do not consider nursing a respectable role for males. Some believe male nurses are misfits who aren't successful or capable in any other career. Media portrayal perpetuates the image of nurses as exclusively female. Male nurses are non-existent or ridiculed, as in the movie Meet the Parents with Ben Stiller. Male nurses may be subjected to curiosity and even suspicion as to why they are a nurse from their patients. They may feel they have to defend their masculinity and may distance from their female colleagues in order to do so. Homosexual Even though men choose nursing for career opportunity, salary, and job security, they can be categorized as homosexual based on their career choice. The excerpt below is taken from a study of men in nursing. Robin: “There’s sometimes I’ll go in and see a large male that’s used to looking after himself and he has a cardiac problem. I’m not going to go in and wash his back...it comes back to this whole homophobic thing” Evans, J., & Frank, B. (2003).p. 282 Touch Touching is an accepted form of caring, but men are stereotyped as sexual aggressors and fear being accused of sexual misconduct. Unlike female nurses, who are free to touch and show emotion, male nurses have to be careful with touch. Nursing school does not equip males to negotiate such gender conflict, and trains them from a completely female perspective. Acceptance by Female Nurses Male presence in a female-identified profession creates tension between the sexes on the job. This is partly handled by the women expecting traditional behaviors from the men- help with physical tasks such as lifting, and acknowledging them as leaders. But whether or not female nurses are ready to accept large numbers of men into the profession is unclear (O’Lynn, C. E. 2004). Would men take over the only feminine stronghold in the paternalistic field of healthcare, climbing the career ladder at a fast pace, on the backs of females? Would the nursing profession benefit from more males and do female nurses expect men to improve the status of nursing? Will it bring respect and gains that have been lacking because nursing is a female profession? And if so, is that not a sad commentary? Future of Men in Nursing The United States Census Bureau in 2016 reported 11% of the nation’s 3 million nurses to be male. While a small percent, it’s a significant increase from the 1970 statistics where only 2.7% of nurses were male. The American Assembly for Men in Nursing, together with the IOM, has set a goal of 20% male enrollment in U.S. nursing programs by the year 2020. To help encourage men into nursing, it’s important to speak up about negative media portrayals and make nursing education truly male-friendly, addressing their needs. Men need role models and mentors. High school guidance counselors have a part to play in introducing nursing to all young people. In the end, men bring a different and enriching perspective. Perceptions take a long time to change but will change by sheer numbers of males in the field as it did with female doctors. The presence of male nurses is no doubt increasing, and patients benefit from the increased balance.
  3. Nurse Beth

    Advice for ED Interview

    Dear Nurse Beth, I am an RN-BSN with three years experience on medical-surgical. I have an interview for Emergency with another hospital. I meet with Human Resources December 4th. I have switched hospitals 3 times already with good reason (mostly due to relocation). Any advice for interview preparation specifically related to Emergency, or in general? Dear ED Interview, You have solid experience with 3 years in, and you landed the ED interview. These are both in your favor. So far, so good. The most obvious challenge is responding to the 3 hospitals in 3 years question. Re-location is a good reason, as is "it wasn't a good fit". Avoid saying anything negative about a previous employer. If you have family or close ties nearby, it would be good to let them know as you'll be seen as more likely to stay in the area. Be prepared to ask questions of them, when they invite you to. You could ask what opportunities exist for advancement, for example. Research their mission and values. Find out if they have any disease-specific certifications, such as a Chest Pain Center, or Stroke Center. Find out what computer system they are using, such as Epic or Cerner, and if you are experienced, let them know. Is there a prominent second language spoken in your area, and are you fluent? Have you had any customer service training, such as AIDET? Are you aware of which conditions are targeted to reduce re-admissions, such as heart failure? If you are given a clinical scenario, know that they are not looking for a clinical expert in emergency nursing, but for a safe practitioner. Your response should always include staying with the patient, calling for help, providing support and performing an assessment. If you are able to anticipate interventions, such as obtaining ABGs and CXR for respiratory distress, even better. Be prepared for "tell us about yourself" (short and pertinent to staying in the hospital, such as "my goal has always been to work ED"). Include a short story if able as stories are memorable. Likewise, be prepared for "what's your greatest weakness" (segue into an actual value, such as "I tend to work overtime, but am actively working on work-life balance as I feel I have more to offer my patients and the team when I make my health a priority. I just joined a yoga class." Avoid appearing timid or retiring in your interview as nurse managers look for a good fit for their units, and ED attracts strong personalities. Good luck! Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next! Read Are You Cut Out to be an ED Nurse?
  4. Nurse Beth

    Nurses and Bullying: 4 Things You Can Do

    Great article, thank you. I was a new nurse manager when a doctor who was a well-known bully began to berate me at the nurses station bc a lab was not resulted. It was so humiliating. He was tall, imposing, and absolutely withering in his manner. I asked him if we could speak in private and amazingly, he agreed. He followed me to my office. I said "Dr. Baker, we both want the same thing. The best for your patients. I will do everything I can to provide the best patient care on this floor, but you cannot undermine me in front of my staff. If you ever have a problem, let me know. In private". To this day I have no idea where those words came from! But it worked and he gave me nothing but respect from then on. I learned a lesson that day that I had to use later on with a nurse colleague who bullied me. Another story :).
  5. My answer would be the same, as in more details are needed. Culpable in what way for what mistake?
  6. Dear Nurse Beth, What responsibility does the clinical nurse educator have to their student? If the student does something wrong, is the educator culpable for it if they observed it and did nothing? Dear Wondering, I'm an educator in the hospital setting, and if I or my colleagues observe a nurse doing something wrong, we have a responsibility to do something. Let's say the nurse inserted a nasogastric tube and was about to administer medications through it, but had not checked placement. Or the nurse was leaving the room with the bed in high position. Both of these scenarios involve patient safety. The educator would immediately stop the nurse from administering medications, and lower the bed. The primary responsibility is patient safety. I would do these things as naturally as possible, with the goal being neither to shame the nurse nor alarm the patient. Then I would take the nurse aside privately and coach him/her. Let's say it's not an immediate patient safety issue. If a nurse hung a secondary addit, such as an antibiotic, and left the roller ball clamped (common rookie mistake), I would just watch and say nothing. Within a short amount of time, I would encourage him/her to go in the room and check on their antibiotic. At this point they will see their mistake and correct it. The rationale is self-discovery, and active vs passive learning. Very effective. If you as a bystander were observing the antibiotic scenario, you might think I was doing nothing. Likewise, if I decided to speak to a nurse in private, you may think I had done nothing, when in fact, I had. Without knowing the details, I can't really answer your question about culpability. At a high level, though, yes. Students do not have a license, so the educator would have ultimate responsibility. However, newly licensed nurses do practice under their own license. Culpable as in a lawsuit? Perhaps. Culpable to the BON? Depends. To the organization? Most likely. Best wishes, my friend Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  7. Dear Nurse Beth, I'm a CNA at a nursing home, and some of my coworkers have shared resident obituaries on Facebook after they passed. I've thought about doing this a few times, especially with those residents I formed a closer bond with, but have always hesitated and decided against it in fear it would be a violation of privacy. My question is - is sharing a resident/patient's obituary on social media a violation of HIPAA? Dear CNA, It's not technically a HIPAA violation, especially if the obituary was published in the newspaper. Obituaries typically don't include protected health information (PHI). Still, it's not a wise decision. Your employer most likely would not sanction this, which could place your job in jeopardy. It could also violate the wishes of the family. While your co-workers make have been very close to the deceased person, and feel grief when they pass, it's still a business relationship, not a personal friendship. This is more of a boundary issue that a legal issue, and you are right to pay attention to your inner voice of caution. Best wishes my friend, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  8. Nurse Beth

    Should I go to 12 hr shifts?

    Dear Nurse Beth, I want to continue to learn new things in the nursing field however I have many hard feelings about wanting to change to 12 hours shifts if I apply at the hospital. I am newly married and we have just started talking about having kids and I don't want to miss out their big events when they come along. If I worked 7 to 7 I wouldn't be able to get them to school or help them with homework. I have thought a lot about working in a clinic were i would have day time hours but I don't want to miss out on opportunities to learn if i did that. I am currently a second shift, 230 to 11, SNF nurse where I have been since I graduated in 2018. Dear Newly Married, Congrats on getting married! I wouldn't not work in a hospital because of kids you don't have yet. Once you get pregnant, you have plenty of time to take stock of your options. Once you have the baby, you still have time because all shifts work for a newborn As your raise your children, you can continue to adapt to what works for you and your family. For example, before they start school, working weekends may be a good fit. But once they have soccer games and activities every weekend, you may want mostly weekends off. You can't control or predict everything ahead of time, but you are in a career that has more options than most. Best wishes, my friend Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  9. Dear Nurse Beth, I have a co-worker who constantly violates our policy on Professional Behavior. She too is an RN and we work in a clinic. This RN has befriended patients and/or their spouses on social media (Facebook, IG). She has given patients her personal cell phone and home address. And she over shares what's going on in her personal life whether it's about her or her kids and/or grandkids. We've told our manager about her inappropriate behavior and we did have a RN meeting so that it was addressed to all of us so that it didn't make it seem she was being singled out. But the inappropriate behavior continues to happen. When is it enough already. I'm at the point that I want to transfer out of my department and go somewhere else because it seems like management is doing nothing and this RN believes this is acceptable behavior. We do have union representation with this company. Dear Inappropriate, Managers who can't differentiate between individual performance issues and general group behavior are not effective managers. Or they're just not equipped for their job. Have you tried just focusing on your own job and not this other RN? It is not your problem, it's your manager's problem. It is also possible that discipline is taking place behind the scenes and you are not privy to it. You may be happier working in an environment where you can trust the manager to address and resolve performance issues. If so, and if this continues to cause you great stress, look for another position. Best wishes, my friend Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  10. Nurse Beth

    Black Plague

    Black Plague Recently it’s been in the news that two people from the Chinese province of Inner Mongolia have contracted the plague and are being treated in Bejing. The plague has been with us since biblical times. The Black Plague is known as being one of the most devastating pandemics in all of history. The Black Plague killed millions of men, women, and children in Europe from 1347 to 1351 and is estimated to have wiped out 30-60% of Europe’s population. The Black Plague originated in Central Asia where rodents carried it to Crimea and beyond. It’s believed black rats carried the fleas that carried the bacteria. Black rats, also called ship rats and roof rats, inhabited almost all merchant ships. The plague is caused by an organism called yesinia pestis. Back when the plague was rampant it turned people’s fingers, nose, and toes black, which is why it came to be known as the Black Death and the Black Plague. It’s a swift but painful, horrifying death- victims vomit, bleed, and develop gangrene of the extremities. Types Humans are extremely susceptible to the plague. There are 3 types: the pneumonic plague, the bubonic plague and the septicemic plague with pneumonic plague being the deadliest form. Bubonic plague affects the lymph glands while septicemic plague affects the bloodstream. Symptoms appear 2-5 days after exposure. The bacteria quickly multiply in the lymph nodes closest to the flea bite and spreads to other parts of the body. Tender, painful lymph nodes, called buboes, are a hallmark of bubonic plague. Bubonic plague can lead to septicemic plague once the bacteria crosses to the bloodstream. In septicemic plague, patients present with fever, chills, extreme weakness, abdominal pain, shock, and possibly bleeding into the skin and other organs. Septicemic plague can occur as the first symptom of plague, or may develop from untreated bubonic plague. The time between being infected and developing symptoms is typically 2 to 8 days. While all 3 are deadly, the pneumonic plague affects the lungs and can be contracted through infectious droplets coughing or sneezing. Anyone who inhales the droplets can become infected. The incubation period can be as short as 1 day for pneumonic plague. Victims are lucky to live more than 48 hours. Pneumonic plague can often be mistaken for the flu. People with pneumonic plague must be isolated. People who have had contact with anyone infected by pneumonic plague should be watched carefully and given antibiotics as a preventive measure. Transmission Plague is vecxtor-borne, carried by fleas that cling to the fur of rats and other animals, and infecting humans through flea bites. Plague cannot pass from human to human, with the exception of the deadly pneumonic plague. Outbreaks While most think the plague is extinct, it has not been eliminated and is very much alive today. The bacteria lives on rodents in most all continents, but outbreaks typically occur in poverty-stricken rural areas. It is found in Africa, Asia and South America. The WHO has classified the plague as a re-emerging infectious disease. There was an outbreak of bubonic plague in New Orleans back in 1914. Rat containment prevented it from becoming a pandemic. In Honolulu in the early 1900s, firefighters burned the houses on either side of a plague victim's home in an attempt to stop the spread of the disease. In recent times in the United States, plague is rare, but not non-existent. Approximately 10 cases are still reported each year. It has been known to occur in the western states of California, Arizona, Colorado, and New Mexico. Treatment People with the plague need to be treated right away. If treatment is not received within 24 hours of when the first symptoms occur, the risk for death increases. Antibiotics such as streptomycin, gentamicin, doxycycline, or ciprofloxacin as well as supportive measures are used to treat the plague. Outlook While antibiotics are life-saving, some fear that if the bacteria develop resistance, another pandemic could occur. How likely are the chances of an epidemic or pandemic in the United States? Not very. But because it is so deadly, awareness is important. Early detection is key.
  11. Nurse Beth

    Should I go for my LVN or RN?

    Dear Nurse Beth, I am planning on applying to nursing school next year. What are some important things to consider when deciding between LVN and RN career pathways (besides pay, length of schooling and type of workplace desired?) Dear Deciding, LVNs and RNs both provide care. Both pass medications, change dressings, insert nasogastic tubes, and insert foley catheters. Depending on what state you live in, LVNs can hang blood, start IVs and give IV fluid but not IV medications. There are a lot of similar tasks but the responsibility is different. An RN must oversee the care provided by an LVN and retains accountability for the plan of care as well as for patient education. An important consideration is career choices down the roads. As an LVN, your options are mostly limited to bedside care. As an RN with a BSN, you can stay at the bedside but you can choose to go into Infection Prevention, Case Management, and much more. A BSN prepares you to manage pt populations and effect change on a larger scale. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  12. Nurse Beth

    What to say in exit interview

    Dear Nurse Beth, My job as a night shift ICU nurse is challenging to say the least. Morale is low, high stress, no breaks, difficult shifts, at least three patients many shifts, a lot of floating, and some passive-aggressive coworkers stirring the pot sometimes. I have decided to resign as I find it is negatively affecting me. I feel that if I am honest with my supervisor I will be blackballed and put on the no-rehire list which is a common tactic of the corporation I work for. What would be a good reason to tell my supervisor why I am leaving to protect my reputation and job history? I feel she will push for more details if I just say it's because morale is low which is what others have told her to avoid problems. Dear Decided to Resign, Just as it's smart of you to leave this environment for your own well being, try not to stress or use any more energy around leaving. There is a scripture that says "Don't throw your pearls to swine" meaning your insights will likely be wasted. You have identified low morale, high workload, floating and dysfunctional behavior- but they already know this, and so far, are not doing enough about it. While it's not likely you'd be marked as a "do not re-hire" unless they are extremely petty, there is some risk and little, if any, benefit to being honest. Very rarely do employers actually use exit interviews to make improvements. You could instead say you've chosen to broaden your working experience, or that you are leaving to spend more time with family. By making it about you, and not about the organization, your manager is less likely to push for details. Line up another job before you quit, and give the required notice. By doing so, you remain the professional that you are, and leave with dignity. Good luck to you! I hope you are valued in your next job and you land in a better spot. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  13. Nurse Beth

    Doesn't Want 12 hr shifts

    Dear Nurse Beth, I am an RPN, currently on maternity/parental leave. I got my RN LICENSE too recently. I don’t feel like going back to the 12-hour shift in the hospital, is there another option for shorter shifts or an alternative job for a nurse. Dear Another Option, In the States we have LVNs (licensed vocational nurses) and LPNs (licensed practical nurses). They are the same, and the title varies by state. I understand in Canada RPNs (registered practical nurses) are equivalent to LPNs or LVNs. Not everyone loves 12 hr shifts because they aren't a good fit for everyone depending on your family situation, and your stage in life. Twelve hours can easily equate to being gone from your child 13-14 hrs or longer, which is a long time for a little one and for Mom or Dad. Long shifts can lead to fatigue and even errors caused by fatigue. Continuity of care is more difficult with 12 hr shifts than 8 hr shifts. Twelve-hour shifts became very popular years ago and now are considered the norm in acute care. Hospitals believe it would be difficult to attract nurses and be competitive without them. This despite the fact that it takes more FTEs (full-time equivalents) to run a unit with 12 hr shifts than it does with 8 hr shifts. Twelve hr shifts are expensive for employers, but overall, nurses want them. Typically, 8 hr shifts and 10 hr shifts can be found in procedural areas, such as Cath Lab, Surgery and Peri-operative, GI Lab, Interventional Radiology, and Infusion clinics. Home Health is usually 8 hrs, and many non-bedside jobs such as Case Management and Documentation Specialist are as well. RNs have more job options than do RPNs, and congrats on getting your RN! You are a newly licensed RN, so you will need 1-2 yrs experience at the bedside to qualify for non-bedside jobs. This makes it a little more difficult to find an 8 hr job. Not knowing your location, check on acute re-hab facilities. Some SNFs also have 8 hr shifts. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  14. Dear Nurse Beth, I have questions about conflict of interest. I am offered to work as a staff nurse in a hospital. It will be my primary job. But I also want to work for a skilled nursing facility as a PRN nurse at the same time. Am I allowed to do that? I reside in Tennessee. I am not sure where to look for related information about working for multiple facilities and whether they are in conflict of interest. Dear Not Sure, The law does not prohibit you from having two jobs. Conflict of interest between employers usually means that your employer is concerned about you sharing trade secrets with a competitor, or setting up a competing business. This is not common in nursing, and you would have been required to sign a non-compete clause. Tennessee, like the majority of states, is an "at-will" state, meaning employees can be fired, suspended, or disciplined for any reason. (Read at-will employment and right-to-work article to learn more). Travelers sometimes run into situations where they are not allowed to hire on to an employer until a certain length of time has passed since their contract employment, but that is not your case. A lot of nurses have two jobs with two different employers. Usually, like you, they consider one job their primary job, and the other one their secondary or side job. Employers do not like to hear that your second job interferes in any way with primary job. For example, your employer may not be sympathetic if you can't make it to staff meetings because of your second job. It is wise to manage both schedules independently and never use one job as an excuse for not fulfilling your obligations at the other job. There's no reason you can't work both places. As long as you are not showing up for work overly tired because of your second job, you shouldn't have a problem. Best wishes, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  15. Dear Nurse Beth, I am agonizing over a section of an application for a new position. With each prior job there is a box titled "achievements" instead of duties or responsibilities. I am at a loss, I haven't really received any recognition or awards except one for checking my meds at the beside. Any suggestions? Thank you for your time, This Nurse Dear Agonizing, There probably is more than you realize that can fit in this box. They are giving you a chance to show your value. Above all, do not leave this field blank. Let's find something. Here's a few things to consider. Did you have perfect or near-perfect attendance? Have you oriented a new employee, or served as a preceptor? How about your unit, what performance improvement initiatives has your unit worked on? For example, have your HCAHPS scores improved in any way, such as "quiet at night", or in how "nurses explained things in a way you could understand?" Has your hospital achieved any disease-specific certifications, such as a stroke designated center, or a chest pain center? If so, and if it pertains to your unit, you were part of it. "Participated in stroke designation recognition". If your hospital was so designated, all appropriate staff received extra education and skills. Did your hospital provide any extra training, such as AIDET or LEAN, or Six Sigma Yellow Belt? How about shared governance? Are you a member of your unit council? Are you certified in your specialty? Have you earned any extra certifications, such as the National Institute of Health Stroke Scale (NIHSS) from the American Heart Association (AHA)? Have you attended a nursing conference? If so, you invested in your professional development and obtained extra education. Have you volunteered for anything, such as a homeless clothing drive, or taking blood pressures at the local fair? Without knowing your specialty, I hope it's prompted you to reflect on things you have achieved. As nurses we often don't give ourselves enough credit. Best wishes to you, Nurse Beth Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!
  16. Thanks for your point of view. While employers have to provide length of employment, rate of pay and title, disclosing re-hire status is not required. She could go to HR and ask them to change the status, and if that doesn't work, she could contact an attorney. She can also put "No" when asked if her previous employer can be contacted for a reference. Litigation has its drawbacks and can backfire. Suing a former employer is a red flag for potential employers. Deciding to sue is a big decision because it's emotionally and financially draining, and holds you back from moving forward. She would need to be clear on what she hopes to gain, is it worth it, and how much of a chance would she really have in a "he said, she said"?