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ElizabethScala1 BSN, MSN


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  1. Nursing can be difficult work. It's hard on the body, draining on emotions, and can be tiring to the soul. And still- we LOVE it! I'd imagine you would agree- we love being a nurse, but our joy of nursing can wax and wane, depending on our current career circumstances. Rather than allowing external influences to impact your Nurses Week- you have an opportunity. You can choose to enjoy your career and celebrate your nursing experiences thus far. Now, before we get to some practical strategies, I do think that taking time to pause and reflect can also empower us, nurses. I encourage you to think about the following questions Why did you go into nursing in the first place? What do you love about being a nurse? How has your nursing career made you a better human being? Spend time with these. Even journal your responses, as you approach this special time of Nurses Week. After you've had time to marinate on the above, I've also got some innovative strategies for a fun Nurses Week, whether your organization celebrates or not. Here are 3 ways for nurses to celebrate nursing during National Nurses Week Treat yourself like a dog. Yup, you read that right. In the book, Stop Nurse Burnout, I talk about the nurse superhero. We all know him/her. And let's be honest- we've all been him/her! You know the drill. Always volunteering when help is needed. Coming to a teammate's rescue during a chaotic shift. And even saying things like "I was just doing my job" when we receive any type of recognition or compliment. Well, this has got to stop! In fact, if you have a dog, cat, or other types of animal for a pet... you can use your interactions with them as a guide. Picture this. You get home from work and there is your cute puppy. He's wagging his tail furiously at the door, waiting for you to come over and say "Hello". As you approach, you start to smile and speaking in a high-pitched sing-song voice, you say: "Where's my good boy? You're such a good boy! Look how great you are today!!" You pet him, smile, and continue to whisper love notes in his ears. Now- what about you? Have you ever talked to yourself in this way? Have you ever come home from work, patting yourself on the back, saying how good of a job you did? Or looked in the mirror, telling you that you love yourself?? I doubt it! This type of self-recognition and praise is often difficult for us to do. We weren't taught these practices in nursing school, but they sure can come in handy. And here's what you can do to celebrate yourself and your nursing career this Nurses Week... From this point, going forward, keep a "Great Job" journal. Every time a nurse, patient, family member, or leader praises you for a job well done come home and write it down. In fact, you can even write experiences down without the formal praise from others. Keep track of the positive work days in a journal, notebook, or even placing single papers in a cubby or box. Then, each year during Nurses Week, take the box or notebook off of the shelf. Refer back to it and read through all of the kind words that you've noted throughout the year. Make this an annual ritual to reconnect you with the joy of the nursing job again. Bless your team Many nursing teams celebrate Nurses Week with a blessing of the hands. You can do this too and without bringing in a formal ordained minister or chaplain. In fact, I like to call this "Blessing of the Hands- With a Twist!" Here's what you do. Get your nursing team together and perform the "blessing of the hands" with each other. Gather in a circle and go around the room, passing the blessing clockwise throughout the group. Let the person to your right look at you, tell you something that they appreciate about you, and gift you with a short word, phrase, or mantra of encouragement. Then, you turn and do the same to the person on your left. Pass the blessing down and around until everyone in the group has experienced it. This is not only an energy booster for you- but a great way to have the entire team recognize and appreciate each other this Nurses Week. Enroll in your life curriculum Just a few weeks ago, I interviewed a fitness nurse on the Your Next Shift podcast. When I asked the question related to professional development and reaching career goals, she shared the most amazing practice! Think about it this way. During nursing school- what happens? You have a curriculum to follow, semester after semester until you've graduated. And then after nursing school? No more formal agenda with a professor or advisor telling you what to do. While this is very nice- to be out, enjoying the independence of your career- it also can cause us to fall behind. Most nurses are often lifelong learners. We want to read, study, and gain new information that will support us in our roles. Nurses become certified in specialties and attend conferences so that they can continue to develop and grow. Why not set up a routine that supports your professional growth and personal development? This is where a "life curriculum" could come into play. And Nurses Week is a wonderful time of year to remind us to do just that! So, going forward, each year during National Nurses Week you may reflect upon your current skills, training, and knowledge related to nursing. Then, as you realize gaps or opportunities for growth, you can set out to enroll in a course, read a new book, or get some other type of training that will support your nursing career. Trust me. In my work with the online Art of Nursing program, I have asked nurses what they want and do not want for Nurses Week gifts. The days of trinkets or unhealthy foods are over. Nurses want to be appreciated with meaningful recognition. And often, nurses prefer to learn and gain knowledge that will support their careers! Well, you can take ownership of that very easily. Make this time of year a habit. Look back on your growth as a nurse to where you are now. And figure out what else you'd like to learn about. Treat yourself to professional development and personal growth. Invest in yourself and set goals for your personal nursing career curriculum. As you continue to develop as a nurse, you celebrate the profession of nursing and the patients and families that you care for! What have you done to reflect upon and celebrate your nursing career? We'd love to hear from you! Be sure to drop us a line. Thanks for reading; and Happy Nurses Week to you! Be sure to check out more from the first issue of allnurses Magazine. About the Author Through her work on burnout prevention and career resilience, Elizabeth Scala, MSN/MBA, RN, supports nurses to reconnect to the joy of nursing. Additionally, Elizabeth is the creator and founder of the annual Nurses Week online program, The Art of Nursing. This will mark the fifth year that Elizabeth and nurses from across the country have celebrated professional development and personal growth during this very special time.
  2. ElizabethScala1

    Get the Nursing Career You Crave

    Nurses enter the profession for a variety of reasons with the most common being a desire to help people. Another might include a nurse relative extolling the positive aspects of a nursing career: good wages, steady job, autonomy in most aspects of the job, variety of types of nursing jobs, ability to travel, and opportunity for good retirement benefits. What isn't often said is: the hours can be long, bedside nursing can take a toll on a nurse's health, patients with several comorbidities complicate nursing care, doctors and co-workers can have difficult personalities, family members may question everything the nurse is doing, patients and families sometimes believe the hospital is more like a hotel than a care facility, violence against nurses by patients occurs, and a perhaps the most dangerous aspect of all...high nurse to patient ratios. Topping all that off is nurses are often called on to do better patient care with fewer tools to accomplish it. With all that said, it's a wonder why so many students still enter nursing school each year that many schools have waiting lists, and we have a shortage of nursing faculty! So how can the advantages of nursing be weighed against some of the more unattractive aspects of the job so students and also veteran nurses get the nursing career they crave? Using the tips below, many preconceived notions could be mitigated before they lead to unhappy nurses in a job they feel was not what they expected. Craft Your Ideal Vision To know what you want and what you don't want in a nursing career, make of a list of each. The 'Don't Want' list is the easiest to write first as most people are fairly clear on what they do not want in their lives. When you think about yourself in your role as a nurse, what is it that you don't want to do and where don't you want to be doing it? Include work hours, work uniform (not all nurses wear scrubs), your surroundings, team members, and anything else you know you don't want in your career. Then make the 'Do Want' list. For every don't you listed, write a do. Use a "not that, but this" type of statement. This vision statement technique not only empowers you to attract the type of career you want, it helps you keep your list in the back of your mind. When faced with something you don't want, you'll recognize it immediately based on your list. Make a Timeline Not everything you want is going to be immediately available to you. Some of your wants may entail further education, and before you set your timeline, do your research. You may find that some of your wants become don't wants, if they lead you down a path that you don't want to travel. Reassess and adjust as needed. Grow Your Professional Network I can't stress this enough. With social media, this is much easier and faster than it was even 10 years ago. Other nurses can tip us off to opportunities we've never dreamed of and help us connect to nurse professionals nationally and even internationally. Want to work in a balmy climate and leave cold winters behind? Connect with other nurses online. You can already have a network of friends in the new area you move to. Social media has a variety of great channels for connections to people with like interests and occupations. Ask for Help Use social media or people you already know, but talk to others who have done what you want to do with your nursing career. Trust me, someone has traveled a similar, if not exact, path you want to go down. As the expression goes: don't reinvent the wheel. Pick up where someone else left off, and you'll be that much farther ahead. Tap into the wisdom, experience, and expertise of nursing career mentors, such as academic advisers, colleagues, and nurse leaders. Read, Read, Read Amazon and libraries carry a variety of books on nursing career guidance. There are nursing career books on every topic, and if you can't find one, start Googling. Google alerts will send you an email every time someone publishes on the topic, which can cut your research time and deliver the content directly to your inbox. Try Something On, First Many facilities offer shadowing opportunities where you can shadow a nurse in the type of role you want before making a change. Some facilities offer internships and also volunteer opportunities. Think of it as "a try before you buy" opportunity, to see if the job is a good fit for you. If you get these types of opportunities, go with a list of questions in mind to ask someone or to discover the answers through the experience. I wish you good fortune in getting the nursing career you crave. Let us know in the comments what you have done to get the nursing career of your dreams. Did we miss anything that could be helpful to others?
  3. ElizabethScala1

    5 Tips to Handle Stressful Times as a Nurse

    We already know that caring for patients comes with a tremendous amount of stress. Nurses are regularly charged to be the calm face in the room with patients, family members, and even doctors. Who among us hasn't had to remain steady and focused when faced with a daunting task or emergency event that would cause a non-nurse to curl up in a ball on the floor? So how do nurses remain that tower of strength in stressful situations? Is it built-up callousness because we've seen so much? Perhaps for some, but others may use something deeper, more meaningful so patients and family members feel they can put their faith in the nursing staff -- the staff who remain so strong when others feel their worlds crumbling down around them. From my own experience and that of nurse friends and colleagues, I've pulled together a list of tips and techniques for nurses to use in those moments where high anxiety may threaten our resolve, but where we must keep ourselves together. Call on your spirituality One of the strongest tools, no matter our belief system, is our spirituality. This belief that there is a force bigger than ourselves that connects us to our fellow humans can help us lower our stress levels in moments of great crisis in nursing. Our spirituality gives us hope, which we can then pass on to patients and family members through calming words and presence. Keep a talisman in your pocket One of my nurse friends had a "worry stone", a polished stone with a slight groove in the middle of it, that she holds in her hand when she has to have a difficult talk with a patient or family member. She says the cool, smooth surface of the stone helps ground her and no one ever sees how nervous she may be. Use essential oils In one Planetree Hospital where a nurse colleague works, the nurses use a few drops of lavender essential oil on cotton balls placed around the room instead of always using Ativan to calm patients. The same can work for nurses with a few drops of lavender on the inside of a scrub top or on a cotton ball pinned to the inside of the scrub. Body heat will naturally carry the scent upward. Any essential oil with a pleasing scent that calms can be used discreetly. There are also beautiful aromatherapy necklaces, bracelets and earrings that allow the scent to rise, but not mushroom around you so others will not inhale the fumes. Build your support team Have you ever worked with a fellow nurse who appeared not to have one friend on the nursing team? That's a tough way to practice nursing. Your support team will not only step in to help you with a patient when needed, but also be there to build you up and stay strong during stressful times. A cardiac care nurse I know says she thanks the heavens for her team when there is a code blue because she's nervous every time. She knows she can lock eyes with one of her nurse friends on the unit enabling her to keep herself together and focused during the code. Knowing which people are going to have your back, not simply to assist with tasks, but also give you that emotional support when needed, gives nurses a sense of security in knowing they are not alone. Focus on the joy and privilege of nursing This isn't always easy, especially when nurses are in an active code, in the middle of a surgery that's not going well, or in any other life and death situation, but focusing on the amazing privilege we have to affect someone's life... to touch so many lives in a meaningful and deep way, can help us call upon that part of us that patients and families look up to for help. Not everyone can do what we do. Not everyone has the dedication to learn ALL that we must learn AND keep learning in order to care for patients. Not everyone has the resolve to keep caring, day after day, year after year. But we have that. We have those incredible gifts. And they are not small gifts. Sometimes knowing how much we are needed and that we have these things to share with our fellow human beings that could change their world helps us build our own resolve in this incredibly stressful and rewarding career. Let's hear from you! What would you add to the list above? What's one thing you can share with everyone reading, as another tip for dealing with stressful situations? Leave your comment below, and as always, thanks for reading!
  4. ElizabethScala1

    Five Nursing Myths... Untruths Disproved

    It is hard to believe that is has been two years since the 2015 Miss America scandal. If you are a nurse, you know the one. Daytime television hosts from the show, 'The View', mocked Miss Colorado and the fact that she was wearing a stethoscope on stage. So, it was no surprise that after these comments were aired, nurses were in an uproar about the profession of nursing and the value nurses bring to healthcare. In fact, nurses across the country came together in an unprecedented way. The#NursesUnite hashtag blew up on social media and nurses from all over shared photos of themselves, proudly wearing the stethoscope at work. And even though I felt so inspired by my nursing colleagues, I wondered... are we leaving something out? Yes, nurses do wear stethoscopes at work. But not all of us do. You see, nurses are found in places beyond hospital walls. Nurses work at jobs outside of the doctor's office. Nurses are involved with more than reading orders and passing meds. So let us remember that there is so much more to nursing. And when we are out in the public, talking about what a nurse does... let's be mindful of the myths about nursing. Speak up to squash these false perceptions! Here are 5 Myths about Nursing We Can Educate the Public On Nurses only work in hospitals, emptying bedpans and following doctors' orders As we know, this is not true at all. Nurses are business owners, researchers, speakers, and authors. Nurses can work in prisons, schools, religious institutions, and any branch of the military. Nurses can own nonprofits, volunteer on voyages abroad, work with computers, and even patent medical devices. Nurses are everywhere! Nurses are people who were not smart enough to become doctors As we know, this is totally false! In fact, many of the nurses that I have interviewed on the Your Next Shift Nursing Career podcast, tell me that they actually did consider medical school. And guess what? It was not the training required or the educational milestones that turned them away. It was the fact that they chose nursing because they saw it as a career that would allow them to do MORE for their patient. They felt that by becoming a nurse, and not a doctor, they would actually get to impact patient lives on a much larger scale. Nurses are tired, unhealthy, stressed out people No way! I see more and more nurse coaches, nurse fitness instructors, and nurses who are yoga teachers than ever before. Nurses are online teaching the public the importance of healthy eating. Nurses lead meditation classes and teach mindfulness workshops. In fact, organizations are starting to hire nurses (both in healthcare and non-healthcare settings) to help their employees be happy and healthy too! Nurses do not have emotions and can handle it all While a nurse is a very resilient being, they too feel things. When a patient dies, a nurse may mourn. When a new life is born, a nurse might see it as the most beautiful thing on earth. A nurse has feelings and needs downtime to recharge. In fact, recent studies on compassion fatigue and secondary trauma syndrome tell us that, like 'non-nurse' people, a nurse needs time to process what they are seeing at work and deal with their emotions. Nurses have feelings too! Nurses wear scrubs Sure, nurses who work in certain patient care settings will wear scrub uniforms. And you will also see a nurse wearing a lab coat. In fact, if you are treated by an Advanced Practice Nurse, such as a Nurse Practitioner, they may wear professional clothes with a white lab coat (just like a doctor may). So be careful when judging a book by its cover and stop with the Halloween nursing costumes. Nurses do not look like that! Have you ever heard of a myth about nursing that was not true? What did you do to educate the public on the profession of nursing?
  5. ElizabethScala1

    5 Tips to Halt Nurse Burnout in Its Tracks

    As nurses, we know that nurse burnout pervades the profession. Insufficient staffing, long work hours, phone calls to come in to work on your days off, and a growing nursing shortage all contribute to nurse burnout. Sounds ominus, doesn't it? So given the cards that are stacked against nurses, is it inevitable for every nurse to suffer from nurse burnout in their career? Below are some tips and tricks to halt nurse burnout in its tracks before it gets a firm hold on you! Stop with the Brave Face and Admit There is Something Wrong When nurses are on the job, we put others' needs before our own; frequently not even stopping to go to the bathroom. But when we constantly push down our needs for a break or won't admit to ourselves (or others) that we're overworked and overstressed, we're setting ourselves up for failure. Nurses in direct patient care face tough jobs at the bedside. Stretched thin through insufficient staffing, nurse-to-patient ratios that are unsafe, patients with so many co-morbidities that it's impossible to address them all -- nurses' stress levels don't just put nurses' mental and physical health at risk, they also put the patient at risk. The most effective way to deal with burnout before it becomes a problem is to talk to someone. The department manager or nurse supervisor is the first stop. Yes, they have heard complaints about nurse staffing before, but management can't help a nurse suffering from burnout unless it's known to them. Every facility handles nurse burnout differently, and some, unfortunately still have no programs in place to help alleviate the burnout problem. The first step in addressing the problem, in any case, is to speak up. Second Line of Defense: Relationships with Coworkers In the event that a facility lacks a program, plan, or resources to alleviate nurse burnout, the relationships that nurses have with their co-workers can often relieve some of the more detrimental effects of nurse burnout. A nurse friend of mine never dreamed she'd ever been a person that fished (yes, I mean with a fishing pole and a tackle box), but after learning that so many of her coworkers got together on off days to go fishing and raved about how much of a stress reliever it was, she decided to give it a try. She said that dark cloud she felt constantly hanging over her head at work was suddenly not so dark after all. All the normal work stressors were still there, short staffing, sicker patients, but she didn't feel they weighed so heavily on her because she felt closer to her co-workers. She felt there were people who had her back. Engage in mindfulness and take a pause When work and life in general becomes too stressful and nurses know they are burned out, it is time to take a pause and look at the big picture. Quiet time -- when there is no "mind" noise from technology, family, patients, but just time to breathe in and out and be quiet -- creates a space to be able to see problems, possible solutions and even long-held desires for the nursing career you'd dreamed of having. It may take some practice to see what you wanted when you began your nursing career and what you need to do in order to get it back on track. Approach the situation looking for possibilities. The path to get to the goal(s) may be reveal itself in time, or you may know immediately the steps to take to get there. Let go of what no longer serves If you've been a night shift nurse your entire career and now you need to transfer to the day shift, ask to be switched. If you've had your fill of your nursing specialty and think a change may refresh you, check the job board at your facility. If your normal stress relieving activities are no longer working, try new tactics. Even simply taking up a new hobby or sport can refresh your mind and stop the overwhelm from overtaking you. In the same vein, if you haven't had made time to engage in your favorite hobbies or activities, schedule them on your calendar like an appointment. And then, keep the appointment. You'd do it if it were a doctor appointment or one with your child's school, right? Give appointments with yourself the same respect and reverence. Watch ants I don't mean that you have to literally watch ants, just observe nature. Whether it's watching ants build an anthill -- something you may have done as a child -- or a spider build a web, or simply noticing the different shapes clouds make. When you're observing this amazing planet, it's tough to think about all the stressors at work. Taking a few minutes or hours in nature helps us slow down the world a bit and take a look around. I'll bet there may be a few places that you used to go and enjoy spending time in that you haven't seen for a while. Could you schedule a date on your calendar to revisit one? Take a friend or loved one who has never been there and make a new memory. Sometimes in all the stress swirling around us, we forget to notice some things that have been missing for a while. Reconnecting with nature or a favorite place helps us fortify ourselves against burnout and as stated above, helps stop it in its tracks. OK, so what did we miss? If you were talking to a nurse who was looking for answers on how to deal with stress what would you tell them? What are some other ways to cope with and shift nurse burnout?
  6. ElizabethScala1

    When You Can't Stop Thinking About Work

    No matter how hard you try, there will be times when a nurse just can't stop thinking about work. We've all taken that ride or drive home and replayed our entire shift, or last several shifts, in our heads. It plagues us during dinner, our shower, and even interrupts our sleep -- if we're able to sleep at all. If a lobotomy could erase just the last shift, we'd sign up to get one! Short of a drastic measure involving surgery, check out the tips below to put work out of your mind, so you can enjoy the present more! Give Yourself a Time Limit Just telling you to leave work at work and that's that, isn't empowering you. But allowing yourself time to replay the day, while also setting some parameters to do so, allows you some time to sort out issues, strategize if needed, and then file it away until further action is required -- if it's necessary at all. Whether it's the time it takes to get home, or just until you hit the shower, set a time limit of an hour, tops. The shorter the better, but make certain that you can really retire the subject and feel good enough about the time limit, so you're not constantly trying to work in "just a few more minutes and then I'm done... no seriously, I'm done... wait I forgot about....." Thinking about work when you're not actually there creates nurse burnout because you never truly leave the job. There is a point at which done needs to be done, because the rest of your life is waiting. Replace Negative Thoughts with Positive Truth Statements Constantly thinking about work can put us in a negative frame of mind. Whether we consider a negative interaction with a patient or staff member or our overall feelings about the job, negative thinking impacts our personal and professional satisfaction with our lives. If we can reframe our negative feelings with some positive truth and value statements about work, e.g., "I'm so happy to have the opportunity to make a positive impact on patients' lives", "I'm happy that my profession gives me job security and helps me provide for my family", we start to look at our workplace with gratitude instead of dread or animosity. Check out this article from Forbes, "Positive Thinking Doesn't Always Work, But Negative Thinking Does: The Power of Truth Statements" to learn about replacing negative thinking with truth statements. Move that body! Get some fresh oxygen into your brain and body with an aerobic activity. You don't have to jump around. Even rigorous housework or gardening can be aerobic, and if done long enough, those feel good endorphins will kick in and immediately pick up your mood. When you engage in an activity that feels good, who wants to think about something that drains energy? I'd rather be in my garden or hula hooping than thinking about some negative experience at work, because the garden and the exercise make me feel better. Remember, It Will Be There Tomorrow There will always be a next shift and another chance to work out whatever is plaguing you about work. Whenever you have a shift where you feel like a "bad nurse" (and with the demands on a nurse's work day, we've ALL had those types of days), remember that another nurse will pick up where you left off and patients will be cared for. When you leave work there is nothing you can do to change anything until your next shift, so leave it there. You punched out. You are no longer required to be "at work," you'll get another chance to change things, readdress an issue, or simply regroup and reframe your feelings about the job. The only thing you can do about work is to think about it once you're off the clock. I'm betting you can probably find a few activities more worthy of your time and attention and that they'll be a lot more enjoyable! Let's hear from you. What would you add to the list above? How do you leave work where it belongs? What are some ways that you deal with stress in nursing?
  7. ElizabethScala1

    3 Steps to Connecting with Patients

    Distractions abound on every nursing shift. Nurses are constantly pushed and pulled in every direction with numerous interruptions. Call lights, doctors' questions, new orders, phone calls, colleagues needing help, patient family members... the list is endless. And every once in awhile, we get a moment -- maybe a magical moment? -- to connect with our patients. Really connect. But do we have the energy? Or even remember how? Given the swirl of activity in direct patient care, it is easy to miss the moments when a patient wants or needs a deeper connection to their caregiver. Signs, unless overt, are often overlooked when we've got our minds on everything going on both inside and outside the patient's room. If nurses can slow their minds down in the moment when they approach a patient for the first time, and remember connection first, questions second, we have a greater chance of making that deeper connection to a patient. This practice not only builds trust between the patient and nurse, it also works to reduce on-the-job stress for nurses who think they have little time for patients because of all the required behind-the-scenes work. One Deep Breath One nurse I know closes her eyes for a brief second and takes a deep breath before entering a patient's room for the first time. Working on a critical care unit, she says it helps prepare her for the care this patient population demands. The one deep breath practice is a great tool to center yourself before any situation that requires you to be fully focused and allows you that moment to connect with yourself before trying to connect with another person. Eye Contact This seems a rather simplistic tip to creating a connection, but people -- not just patients -- feel honored when you look them in the eyes when you first meet. Nurses should introduce themselves when meeting a patient for the first time and look the patient in the eyes when doing so. How many of us walk into a room, glance at the patient, say our names and then begin writing on the dry erase board with our backs to the patient as we launch into our litany of questions? How many can raise our hands to that one? No judgment here. My hand is in the air as well. Would you want any meeting with anyone caring for you to start this way? Think of going to a new doctor or even sitting in a bank manager's office for the first time. Would you feel confident that the person was going to have your best interests at heart, if this was your first impression of them? Your discomfort might be abated in the next few minutes, but already the seed of doubt is planted. It will be easier to find fault with the care, and you will repeat your first impression to others should anything go wrong. It doesn't take 30 seconds to walk over to a patient's bedside, look them in the eyes, and introduce yourself before starting that writing. Empathy Laying a trusting foundation makes segueing into the last step of connection building so much easier. We can demonstrate empathy through our common experiences, knowledge, humor, and even shared interests. Empathy not only strengthens the bond between patient and caregiver, it also improves outcomes for the patient. Some may lament it's all about the Press Ganey scores. Well, yes, that's part of it, but focusing on the patient and building that connection makes caregiving a better experience for both patient and nurse. One nurse I knew said she preferred working nights even though it wrecked havoc on her melatonin levels because she had more time to make a connection to her patients. She said she heard more "stories" on the night shift than she ever had time for on dayshift and that building that connection, she felt, kept patients off their call lights and built assurances that she'd be back to check on them. This is not to say that it is not possible to build a connection on any other shift, it is simply what worked for her. So, how do you build connections with your patients? Is there anything you experienced that works well?
  8. "I quit. I don't want to be a nurse anymore." How many of you have had that very thought during a shift or while walking to your vehicle or while getting ready for work? You think it is time to quit nursing and find something else to do. We have all had those days, but when days turn into weeks and months of consistent ruminating over the thought of leaving your nursing career behind, it's time to look at the bigger picture of the root cause of those feelings and how you could possibly stay in the profession and possibly use all your nursing knowledge to your best advantage in a new role. Where are the feelings to quit nursing coming from? Are you exhausted? Unhappy with unit/management? Or simply disenchanted with the entire nursing profession? Frequently, it's not one thing that gives rise to a nurse entertaining the idea to leave nursing. We are, after all, conditioned to withstand a great deal of things that other people would never consider enduring for a paycheck. Before turning in that letter of resignation, nurses should take a step back and consider if the desire to quit is a symptom of real dissatisfaction with the field of nursing, or is it a result of neglecting self-care? Is it family obligations? Disagreement with management? Stuck-in-rut feelings? Or perhaps having to do more with less (as bedside nurses often lament) has taken its toll. There is no blame here. As nurses, we can get wrapped up in caring for others, which oftentimes results in putting ourselves and our health, both mental and physical, second. Identifying the cause(s) can lead to better insight as to whether or not it is time to quit or instead, regroup and refocus your nursing career. Before you make any decisions or start exploring your options, check in with yourself on your self-care rituals: Are you getting enough sleep? It is restful or are you tossing and turning much of the night? Are you staying hydrated? Nurses know all the pitfalls of dehydration, yet it's easy to fall victim to it. Are you getting the proper nutrition? How often are you exercising? How often are you getting out into nature and soaking up some Vitamin D from warm sunshine? The Mayo Clinic reports that some studies suggest a link between low Vitamin D and mood/depression. Do you engage in personal hobbies that bring you joy? How often are you taking vacation days? Are you picking up extra shifts at the cost of your mental and physical health? Would quitting nursing make me happy? If you can identify the causes of the desire to quit and recognize some easy fixes that help you stay in your current position, GREAT! You're on your way to reframing your feelings and easing your mind. If that's not the case, then it is time to start a pro and con list and give a point value to each. The point value is whatever you want it to be. Your instincts already know how to rank characteristics of your nursing job that you love or loathe. If your list indicates that quitting nursing is your best course of action, try this next exercise to narrow your focus and reveal what's the next best step for you. A nurse friend of mine designed this exercise for herself, and it helped her stay connected to the nursing field, but in a role of her own making. My friend made a list of questions to help her determine what type of career she wanted: What time do you want to get up for work? What clothes do you want to wear? Do you want to drive or walk to work? How many hours a day do you want to put in? When you look out the window at your job, what do you see? What are you surrounded by at work? What are the everyday tools you use? Do you want to work independently or as part of a team? What do you love to do that you can get lost in for hours, and it doesn't feel like work? Do you want to work for yourself, or have the stability of a regular paycheck? Can you see yourself doing this job for the next 10 years or more? What are your strengths? Your weaknesses? What do you do better than anyone else? My nurse friend determined that she still loved healthcare, but wanted to work for herself helping other nurses start and market their businesses, as she had worked in the business world before becoming a nurse. She also found two "gig" jobs - one, writing responses to patient reviews of doctors, and two, researching, writing, and publishing content for medical sites. She works in her pajamas sometimes, makes her own schedule, and loves her day. Consider all possibilities Is there something that you've always wanted to explore and try in nursing? A new specialty maybe? Before you make the leap into a different side of nursing, remember to ask questions of those already working in that vein. You could also consider shadowing opportunities that are often given to nurses exploring specialties. The more knowledge you gather, the greater the feeling that you are making the right decision for you and fewer surprises you'll encounter in the new role. Remember too that simply because a role does not exist in nursing, it does not mean you cannot design it. Nurses work in every industry in roles many people have never heard of. Plumb the depths of alternative nursing career paths on job boards using several different geographical locations. Job titles and responsibilities vary state to state and country to country. It doesn't mean you need to move. The possibility may be that you could invent a similar job in your current location. What else? Have you ever considered quitting nursing? What did you do when you felt that way and can you share any additional tips? If you did leave nursing, what did you choose to do instead?
  9. ElizabethScala1

    Finding the Time for Self-Care

    "You cannot serve from an empty vessel." -Eleanor Brown As nurses and healthcare providers, time for ourselves often comes in scant quantities. Patients and our own family's needs frequently take center stage because we are so good at putting others and their needs first that our needs simply get lost in the shuffle of our lives. But there's a cost to pay for this perpetual dysfunction. In caring for our patients, our homes and families -- with the endless cleaning, cooking, errands, etc., -- attending classes and training, and preparing mentally for our next shift, it feels like we're constantly at work. Without "filling up our vessel" as the above quote states, we risk our health, happiness, feelings of self-worth and self-esteem and unwittingly prime the pump for nurse burnout. We need time to decompress and facilitate our own healing, if we are going to give adequate care to anyone else. Taking care of ourselves makes us better caregivers for others, and quite simply, we'll be happier and experience more satisfaction in our careers and personal lives when we put self-care practices into place. Here are some strategies for getting those moments of self-care into your life as a busy nurse: Advocate for Yourself Nurses are natural advocates for their patients, so turn that service towards yourself. Figure out what your needs are for better self-care and prescribe them for yourself. What favorite activities do you LOVE to do, but haven't done in a while? Look through the newspaper for activities or events that you would like to attend, but haven't in awhile. Make a list of all the places you've wanted to see or activities you'd want to do if you had a three-day weekend. Your list is your starting point for the self-care appointments you will place on your calendar. Follow the 1:1:1 Rule One thing a day. One thing a week. One thing a month. Look at your week and plan your self-care rituals. Set them as appointments on your calendar. The daily rituals can be short 10-15 minutes or whatever you can work in. Some days are busier than others. For a weekly ritual, set aside a longer period of time. The same with the monthly appointment, and look at doing something really big once a year. Plan out self-care rituals for a month and then take a look at the calendar. Look at all the time you've made yourself a priority! Feels kind of good, doesn't it? Now the trick will be to keep your appointments! Remember Self-care Doesn't Have to Mean Self-Only Care Many people, not just nurses, think self-care rituals need to have a selfish benefit of only yourself benefiting from the ritual. A self-care ritual can bring peace of mind and reduce stress. I have a friend that detests unorganized closets and to her, even though she is not the only person in her house that benefits from an organized closet, it certainly decreases her stress when she can reach for something in the closet and not have 10 things fall down on top of her. Closet organizing is a favorite self-care ritual that she also sees as an indulgence, because she gets to do it alone with her favorite music blaring away and no one interrupts her or they know they'll be forced to help (not really, but it's that little threat that ensures she has all that time to herself). Another nurse I know likes to take Sunday afternoons to make a breakfast baked good and a few family meals for the week ahead, so she doesn't have to think about dinner or breakfast during her work week. "At least I know we're eating healthy most of the time and that I won't be tempted to order a pizza on the way home or stop at McDonald's for breakfast because I'm pinched for time. Peace of mind is what I get, and I'll take that any day." Know That Little Things Count if They Matter to You If it's tough planning the everyday self-care rituals, know that even giving into a pet peeve counts as self-care if it lowers your stress level. A nurse friend of mine detests when her nail polish is chipped. She can wear her hair up in a messy bun or leave the house happily without makeup, but chipped nail polish aggravates her. "It just reminds me of all those girls in high school that would run around with chipped polish for days and weeks or they'd sit in class and pick half of it off and then wear it half picked off for days. Just don't wear it if you can't keep it up." To her, taking a couple minutes to take off old chippy nail polish is a stress reliever and one of her easy methods of self-care. For others, it may be not to leave one dirty dish in the sink before retiring for the night, setting the timer on the coffeemaker, packing a lunch the night before. The little daily rituals are self-care that don't even have to be scheduled. They just have to be noted and appreciated as filling up the vessel in order to care for others too. I'd love to hear from you! What self-care rituals do you use to "fill up your vessel"? How do you unwind and recharge? Leave a comment below on how you carve out time for yourself to promote the 'life' portion of work-life balance!
  10. ElizabethScala1

    The Importance of Networking as a Nurse

    "Networking? But I'm not looking for a job! Who has time anyway?" I thought that way once. I was a novice nurse and just trying to learn the ins and outs of nursing in my new job. As I became comfortable in my nursing role though, I found I wanted more, and networking helped (and still helps) propel me to where I am today and hopefully beyond! Networking is something all nurses owe to themselves to do. In a changing economic climate, workplaces can change quickly (and sometimes without notice). Hospitals close or merge with other healthcare systems. Jobs are cut. Departments shuttered and staff redistributed, and nurses can find themselves out of work. When the latter occurs en masse, you and your colleagues might find yourselves competing for a few jobs, in the same area, at the same time. So how do you go about networking? It's actually easier and less time-consuming than you might think. Check out the ideas below to network your way to a new job, a new adventure, and new friends! Here are 4 ways to build your professional nursing network. Social Media You're probably already on social media through Facebook or Instagram, but do you have a LinkedIn profile? If yes, are you a member of any nursing professionals groups? LinkedIn and its nursing groups have members that are the Chief Nursing Officers and Nurse Recruiters of many health care systems. You never know whose eye you will catch. Also, LinkedIn will send you notifications of companies and healthcare systems currently hiring. Knowing which employers are looking for new nurses cuts out a lot of the guesswork that a job search entails. Join an Association There are local and state chapters of many organizations. You probably have a few members of different associations in your workplace. Check bulletin boards or in your Director of Nursing's office, and join a group aligned with your interests or passions. Don't be intimidated by an area of nursing that you don't know or have experience in. Many groups are welcoming of nurses of every type, no matter your background, if you have an interest in the type of nursing the group represents. Joining an association is a great avenue for information gathering on a new path in your nursing career. Volunteer in Your Community Networking doesn't have to be limited only to nursing circles. Have a passion for theatre? Gardening? Working with your hands? Lots of professionals give their time to local causes and with "six degrees of separation" working for you, you may find yourself with a new contact that sets your nursing career on an unexpected and exciting new adventure. One nurse I know volunteered her sewing talents to a local theatre and met an executive that organized humanitarian groups that traveled to Central America to give dental care to poor communities. She went on her first trip, made a lot of new friends and contacts in the healthcare world, and was asked to come work at a major healthcare system in Cleveland. Showcase Your Strengths We all have strengths. We're nurses after all! But how often do you showcase your strengths at work? This is one of the most important things you can do for your networking efforts. People take notice when employees shine at work. Go the extra mile. Offer to handle something that someone else does not like to do. Are you passionate about writing? Public speaking or presenting? Be innovative in showcasing your talents and passions. Start a blog or a YouTube channel. If you detest being in front of the camera, how about starting a Podcast? There are all sorts of ways you can put your talents and passions front and center so they'll get noticed. A byproduct of your efforts is all the positive energy you create around your nursing career. People automatically start to think of you as a possible go-to person for projects or a new position. And that is a great benefit of networking because you've left such a positive impression that people seek you out for your talents. Do you have a process for networking your way through your nursing career? What steps have you taken to network in your community? In your state? I'd love to hear of your experiences and find out what has or hasn't worked for you!
  11. ElizabethScala1

    7 Things You Weren't Taught in Nursing School

    All the things you were not taught in nursing school could probably fill a few volumes, but here are a few that I have collected from emails and conversations with colleagues over the years. Importance of a Mentor New nurses orient with one or maybe a couple different nurses, but new nurses could also benefit greatly from having a nurse mentor for their career. Having someone to offer advice on the best career moves and discuss how the new nurse is experiencing nursing as a whole, can keep nurses satisfied in their nursing career by having a sounding board and a guide to help them grow in their careers. The rate of new graduate nurses who leave the profession in their first year of nursing is astronomically high and having a confidante within the profession can help the new nurse navigate the ups and downs of the first year or two and mitigate some of the stress. This is a service-based profession That means in service to other people, and that's not always a cake walk. Being a nurse carries prestige, but it's not just about that and the fairly decent paycheck. Sometimes it's about the grunt work too. After a nurse friend of mine told a new nursing student about cleaning up a patient after a "brown" accident, the student said, "but nurses don't do that, that's an aide's job." After schooling the student on just what constitutes nursing care, the student changed her major the next week. She said no one told her she'd have to do those types of things, and she wasn't about to do them for any amount of money. Patients will insult, kick, hit, bite and sometimes throw things at you Nurses see patients at a point of vulnerability. Some act out due to frustration. Some medications have side effects that include irritability and anxiety. Other patients are simply unhappy people or are mad at the world. As a nurse, you are the person in front of them and can bear the brunt of their reaction to their circumstances. A thorough report from the previous nurse can eliminate surprises when it comes to patient behavior. Never hesitate to ask for someone, an aide or another nurse, to accompany you into a patient's room. Losing a patient is never easy... and there's lots of paperwork to do when it happens Nurses work hard to keep patients alive, and whether a patient codes or passes away from a terminal illness, nurses give all of themselves to counsel loved ones through the beginning stages of grief. I have watched nurses with tears welling up in their eyes making phone calls to physicians, completing paperwork, and just managing the loss while still also caring for other patients. A patient's death may not be a personal loss for the nurse, but sometimes the grief feels the same. All the nursing roles/jobs that are available to nurses Although nursing school does provide clinical rotations in several areas of nursing, there are far more than new grads can ever imagine. Nurses are found in every spectrum of the working world from corporations to engineering, industry, and government. The world is a nurse's oyster when it comes to finding a path that interests them. Nurses can also carve out their own niche for a job that suits them to a "T." Nurse to nurse bullying is real The old adage that "nurses eat their young" can feel very real, and it has the potential of turning off new grads and good nurses that the profession needs. Dealing with a nurse bully is tough, and if new nurses do not feel confident in standing up to a nurse bully, it is best to talk it over with a supervisor. No nurse should have to tolerate bullying from a co-worker, no matter if you're a new grad or a seasoned professional. Everyone met the same requirements to become licensed. Everyone has a right to be there. Advocating for your patient when you disagree with the doctor is part of your job No. Matter. What. New nurses are not taught, at least not effectively enough, that there will be times when they have to challenge a doctor's order. Questioning a doctor may not be comfortable, but remember, you are the last line of defense a patient has. If you don't feel comfortable in carrying out a doctor's order, talk it over with colleagues or a supervisor. You may get some insight on how to approach the doctor and feel more supported, if you're concerned about the order. One Extreme Example: One nurse I know that was still in training, questioned an order of insulin that had to be specially prepared by the pharmacy. She looked at the syringe and determined that it was simply far too big a dosage. She took her concerns to her preceptor. He advised her to call the pharmacy. The pharmacy confirmed that the dosage was correct. She still did not agree. Her gut told her the order was wrong. Her preceptor said that she could call the doctor, but warned that she would be waking him up. She pressed on and called the doctor. The doctor was fine with being questioned, but stated that the dosage was correct. She again felt that it was absolutely wrong. She called the pharmacist again and asked him to please redo his math. She went back to her preceptor and told him the doctor had confirmed the order and that the pharmacy also recalculated the dosage with her on the phone and that it was correct. The preceptor said she needed to give the insulin. She said she would if he would check to make certain there was enough D50 on the unit in case they needed to push it twice. He assured her there was. She gave the insulin. Within 15 minutes, patient's blood sugar bottomed out and she and her preceptor ended up pushing D50 three times before getting the patient's blood sugar stabilized. The next day when she had the same patient again, the dosage in the syringe was much smaller, and the patient thanked her for trying to look out for him in the face of all the opposition she encountered. This new grad nurse was not taught that she may face such a rough time in questioning an order, and she felt completely guilty about causing the patient distress. She thought she had done the best she could given the situation and three people telling her the order was correct, but she never again distrusted her gut when questioning an order. The bottom line to remember You really are the patient's last line of defense. As stated previously, the list for things you weren't taught in nursing school could be endless. So, expect a part two, and possibly three, as future posts!
  12. ElizabethScala1

    6 Resiliency Tips for Your Nursing Staff

    Resiliency keeps your nursing staff on the job. It staves off stress, illness, and burnout. A resilient nursing staff builds strong teams able to respond to the demands of this noble profession through long hours, patient and family needs, and... aching backs! Check out these tips to share with your nursing staff to keep them resilient and strong: Nurture with Nature On those shifts where breaks are few or nonexistent, taking 30 seconds to get some fresh air, even if it's just sticking your head out the door to remind yourself that there is a "world out there" and breathing in some fresh air, can reset your mood and lower the stress response -- meaning lowering your heart rate, blood pressure, and cortisol levels. Pack Your Lunch With Quick Snacks If you are able to take a full lunch break - GREAT! But have a snack-type lunch on hand just in case. A few grapes, apple slices or a banana, an organic juice box, crackers, cheese, and nuts allow you to eat quickly and nutritiously as well, in order to get you through your shift. Also pack your locker with quick snacks just in case you do not have time to pack a lunch -- a small jar of a nut butter, crackers, nuts, dried fruit, juice boxes, and granola bars can get you through a shift easily enough. Just don't forget to restock your stash! Focus on the Patient in Front of You This is a case of easier said than done, unfortunately. Nurses often have overwhelming patient loads, but only one patient can be tended to at a time. Focusing all your energy on the patient in front of you prevents mistakes and often helps you catch things that you might miss if your mind is on your other patient(s), rather than the one in front of you. Mistakes are costly to nurses not only in their self-confidence in their ability to do the job, but also in their co-workers' confidence to be a strong and trustworthy team member. Give yourself the benefit of full focus. The next patient will still be there when you are finished with the one in front of you. Keep a Reminder of Joy in Your Pocket or Locker Some nurses decorate their lockers with pictures of their children or pets. One nurse I knew kept a small seashell in her pocket that her young son had picked up on their last vacation. Another sometimes brought her lunch in a Barbie lunchbox because her daughter packed it for her. A small touchstone of a reminder of the joy in your life can alleviate stress and bring a smile to your face and heart to power your through some tough shift hours. As a Nurse Manager, you can..... Plan Some Fun Outings Great teams do not limit bonding to work alone. Great teams can bond over dinner and a movie, ice skating, hiking, the beach, and all sorts of other activities. You get to see your co-workers in a whole new light and some regular clothes. How many times have you run into a co-worker outside of work and almost not recognized them without their scrubs on? One guideline to follow during the outing: keep the shop talk to a minimum. We are never not nurses, but reserve the outing time as bonding and fun time. After all, you're not clocked in for work. Educate New Nurses on Self-care Strategies New nurses may believe that in order to be a good nurse they must give 110% of themselves at all times and forget that nursing is not a perfect profession. New nurses may be at greater risk for making mistakes if they feel stressed and are not taking care of their needs while also caring for patients. Although the media sometimes portrays nurses as SUPERHEROES (but of course!), we are human with human needs of rest, relaxation, and forgiveness of ourselves when we make a mistake. And one of the best self-care strategy tools a new nurse can have is not holding herself/himself to an impossible standard of perfection. I hope you have enjoyed these tips and can put some of them to use on your nursing unit. What other tips have you employed that have been successful with your nursing team?