Jump to content
Ashley Hay, BSN, RN

Ashley Hay, BSN, RN BSN, RN

Pediatric & Adult Oncology
Member Member Columnist Expert Nurse
  • Joined:
  • Last Visited:
  • 89


  • 36


  • 20,570


  • 1


  • 0


Ashley Hay, BSN, RN has 10 years experience as a BSN, RN and specializes in Pediatric & Adult Oncology.

Over 10 years of nursing experience in several areas of Pediatric & Adult Oncology including clinical research, chemotherapy, transplant, hematology, proton therapy, GI surgery, wound care, post anesthesia recovery, etc. I really enjoy reading, cooking, yoga and the beach during my time off. Becoming a writer has been an aspiration of mine for many years - I'm so glad allnurses was willing to give me my start in a field I am so passionate about. Looking forward to getting to know all of you in this great online community. :: Visit my website at AHayWriting.com ::

Ashley Hay, BSN, RN's Latest Activity

  1. Ashley Hay, BSN, RN

    Travel Nurse Turns to Career in Functional Medicine

    Thanks for reading! I'm glad to read of your interest in functional medicine too. As a HCP I find it a fascinating field of study. If you want to learn more, I'd recommend checking out the Institute for Functional Medicine Website (The Institute for Functional Medicine | Information and educational seminars and conferences on functional medicine.), they have a conference coming up in June related to autoimmunity. I'd say that seeking out any knowledge of specialties in addition to one's nursing expertise makes you a powerhouse of information. Having a nursing degree as your baseline is a great idea. Nursing is so versatile, you can branch out in to many different sectors of healthcare from there. Good luck!
  2. Ashley Hay, BSN, RN

    9 Tips for Communicating Under Pressure

    Great topic, Melissa!
  3. Ashley Hay, BSN, RN

    Travel Nurse Turns to Career in Functional Medicine

    Her compassion for oncology patients was clear, however, exposure to a nurse practitioner program with a focus in integrative medicine began to change her course. After dedicating the first twelve years of her nursing career to oncology care, Bryant found herself increasingly interested in a field foreign to many healthcare professionals...functional medicine. How did you first learn about functional medicine? "I seem to naturally gravitate towards alternative medicine. I have always hated the statement 'there's nothing else we can do', I believe that there is always something to be done if you just shift your focus a little. I learned about functional medicine in my first nurse practitioner clinical rotation with Dr. Cheng Ruan. He put a name to my developing medical philosophy. This rotation was the turning point in my career from traditional to functional and it seemed to be right in line with the way I wanted to practice medicine." Bryant adds, "Functional medicine focuses on the root cause of disease rather than symptoms. It is like lifting the curtain on chronic disease, once you do you can never go back to just treating symptoms. The body is an amazing thing, when you give it the fuel it needs you can do so much more than just put a band aid on health problems. I work with an amazing group of people collaborating in the care of many complex and seemingly 'hopeless' cases. Most patients I see have been to several different doctors from specialists to naturopaths searching for an answer." Tell us a bit more about the types of patients you currently treat. "One example would be someone who has complained of debilitating fatigue for most of their life, however, lab work and traditional diagnostic tests can find nothing wrong with them," Bryant states this theme is common amongst many of her intakes. "Fatigue is a vague symptom with a lengthy list of possibilities. The functional medicine approach focuses on repairing foundational defects that may have led to the development of the disease. "A diagnostic workup for this type of patient might begin with laboratory (serum) testing of: Thyroid function Hormone levels Glucose regulation Cholesterol CBC Liver function Fatty acid levels Autoimmune panels Food/environmental allergies Micronutrients (this test examines how the body uses each vitamin, mineral, and amino acid) Bryant continues to explain, saying, "Testing gets more individualized from there, mostly in the direction of investigating possible environmental toxins that can many times be at the crux of chronic disease. Another avenue that we often explore is to look at an individual's genetic SNPs (also known as single nucleotide polymorphisms). These are variations in genes that affect the way the body processes internal and external toxins, (like heavy metals or BPA). Treatment plans can be personalized from these tests once you have identified where the holes are." Can you explain the focus on the gut? Many avenues of medicine seem to lean in that direction recently. "Functional medicine can be as complex or as simple as you make it. The truth is, most issues can be improved by healing the gut. Digestion and elimination are the mainstays of treatment initially. Without repairing the integrity of the gut and absorption of nutrients it is extremely difficult to correct larger issues. This is why traditional management of chronic disease only works for a limited amount of time. If you don't address the soil, the tree can't grow strong," says Bryant. Let's talk about your current NP role. What are your daily responsibilities? "I am a primary care provider at the Texas Center for Lifestyle Medicine with a special focus on issues with detoxification. Impaired elimination of everyday internal and external toxins is at the heart of every chronic disease that we know of. My job is to identify where the impairment is and optimize the patient's diet and lifestyle with personalized protocols to help the body function like it is supposed to. Although detox usually ends up being my main focus, I also provide traditional primary care services such as preventative screening referrals, physicals, and sick visits." Bryant also had many years of infusion nurse experience, having worked in many outpatient chemotherapy infusion centers. She was expected to use her expertise to develop the infusion center, a complementary offering to the existing functional medicine clinic. When asked about taking on that role she states, "I had to quickly shift from my nurse brain to my undeveloped business brain."When discussing struggles with adapting to her new role in a new specialty area, Bryant states, "Transitioning from nurse to nurse practitioner has been a challenging new frontier. The safety net has gotten further away, and the responsibility has gotten closer. Practicing primary care with a functional medicine twist adds another layer of complexity. This field is fairly new and guidelines are a bit more gray than traditional medicine. There is no mundane, you always have to be creative and work with the patient to develop a treatment plan that works for them. I compare this process to staring at a magic eye picture book. You have to stare at each case and slightly 'unfocus' your eyes in order to see the pattern and identify the hidden picture. This is an art form, and I feel very fortunate that I have the opportunity to develop my craft among like-minded practitioners who I can learn from." Were you given any helpful guidance throughout your nursing journey? "Mentorship is an important and necessary component to any new role. I am eternally grateful for the teachers I have met along my career path. My mentors have come in surprising packages; patients, coworkers, nurse managers, family, doctors."She adds that one preceptor, Dr. Ruan, helped foster professional confidence while opening her eyes to the world of functional medicine. "He was an internal medicine physician tired of practicing within the constraints of mainstream medicine. I was hooked immediately, watching how he practiced medicine using a lifestyle approach. It was amazing to see a doctor focus on more than just diagnosing and prescribing. He was just starting out in functional medicine and in the process of opening his own clinic. Fortunately for me, the timing was right to jump on the bandwagon. I quit my job after that rotation to help him open his clinic." What is one important takeaway for others who are looking to dive into a new area of nursing? "This experience has highlighted the importance of having a mentor that sees a potential in you that you don't always see in yourself right away. I would not be where I am at right now without standing on the shoulders of people greater than me who have taken the time to support my growth. I only hope I can do the same for someone else in the future."
  4. Ashley Hay, BSN, RN

    Nurses - Increase Your Productivity

    When my productivity was declining (but I felt as though I was hustling hard all day) I knew it was time to find a new way of accomplishing my daily goals. I very much enjoy my freelance lifestyle and working from home, but without some self discipline and productivity tools, the day can be a total wash. I needed to start assessing what I was dedicating my time to all day. Here, is where I came across the idea of time-tracking. While this may not be a new idea, I've had a lot of success using this practice and you can too! The best part? It can be used for almost all the roles you juggle. "Time is money, an old saying, has been widely used in most cultures and languages for ages. Today, in a world of business and a crazy pace, time is more valuable than ever. The rhythm of our century puts us in a place where we have no choice but to start planning and tracking our time. It becomes really crucial when you build your business or start off as a freelancer." (Forbes.com, 2016) How it Works To put it plainly, time tracking is the documenting of your daily activities.The general idea of time tracking is you record what you are doing, as you do it. Then one can analyze how much time is being spent per task versus your goals for the day. However, it can also be used as a way to plot out your desired schedule and timeline for future workloads, ensuring you stay efficient. Several systems exist to aid you in your quest for productivity. Ways to track your time include: Old School (Pen & Paper!) Electronic Spreadsheet Mobile App Download Automatic Tracker Software (On Your Computer) My favorite? A blend of the spreadsheet and paper method. I simply went to Google Sheets and found the Daily Schedule template (feel free to choose whatever online template suits you best). The form is broken down by half hour. I made a few tweaks to fit my personal needs, re-labeled it Time Tracker and hit print. I have it on my desk each week and fill out as I go. Little tip - use a pencil. Save yourself the despair of having the page stare back at you through a quarter pound of white out. Plans change. Erase, rewrite, move on! Benefits Measuring your time and efforts can go a long way. Seeing on paper how much time you are dedicating to one task can help push you into high gear. Without plotting out your activities (either ahead of time or as you go) can lead to a lot of floundering, especially if you work from home. It's incredibly easy to get distracted from a task you might not really be motivated to finish in the first place. For example, if you know you have a writing deadline approaching but are having trouble finishing the piece, it somehow gets really easy to put any other possible task in the way. Children, housework, pets, phone calls, emails, social media accounts, exercise - while all important, can be massive distractions that would otherwise be limited if you were working anywhere but your home. Put these tasks in their place, along with others that are work related. Putting time aside to complete work related tasks can actually provide you with more time to do what you really enjoy. Using time tracking can increase your efficiency, productivity, interest, and confidence. It feels good to beat the clock! Multiple Uses Tracking your time works wonders for freelancers working from home. However, this simple practice can be utilized for a number of different daily activities. Students can benefit from taking all of their upcoming daily tasks (class, study, assignments, etc) and plotting out how much time they would like to dedicate to each. This can help to assure no area is lacking and also motivate to complete work to be done. Many nurses balance their career with family and home life. This approach can even be used to manage tasks around the home. Have you ever had a day where the whole house needs cleaning but you find yourself organizing a single closet or drawer for way too long? Not anymore. It could even be used to help organize you when planning an event. Time tracking will help you stay focused on your original goals and keep you moving through your list of tasks. Other nursing roles away from the bedside, such as case management or leadership can also benefit from the time tracking habit. What are your methods for keeping yourself accountable and productive? Have you ever used time tracking? References: Forbes: 20 Of The Best Time Tracking Tools To Increase Your Productivity Hubstaff: What is Time Tracking?
  5. Ashley Hay, BSN, RN

    Are You Doing it Right? Taking Accurate BPs

    In my personal healthcare experiences, I've noticed several healthcare providers (HCPs) taking blood pressures quickly and often inaccurately. I'm sure you have too. This simple task can sometimes be rushed due to the lack of time providers have available to spend with their patients. However, a documented blood pressure reading can determine many aspects of future care for the patient, including potential medication dosing adjustments or changes. Blood pressure readings are a measurement of the circulatory system. It is composed of two numbers, the systolic (top number) and the diastolic (bottom number) blood pressure. A simple explanation (useful for explaining blood pressure readings to patients and caregivers) can be found at WebMD.com, "When your heart beats, it squeezes and pushes blood through your arteries to the rest of your body. This force creates pressure on those blood vessels, and that's your systolic blood pressure. The diastolic reading, or the bottom number, is the pressure in the arteries when the heart rests between beats. This is the time when the heart fills with blood and gets oxygen." Proper blood pressure measurements can be indicative of many medical issues. For example, hypertension (elevated BP) can lead to many life-threatening medical conditions, such as heart attack, stroke or kidney disease. Hypertension can also be due to white coat syndrome or high levels of pain and is greatly influenced by a variety of lifestyle factors including, age, weight, medication, alcohol use, tobacco use, and diet. Equally as important, hypotension (decreased BP) can be a warning sign for many health-related issues. Examples of such include septicemia, anaphylactic reactions, dehydration, blood loss, and body temperature dysregulation. Many medications have the potential to cause an unexpected drop in blood pressure, so be sure to educate patients on getting up slowly and reinforce proper oral hydration guidelines. Symptoms of hypotension include nausea, blurred vision, dizziness and even fainting, Many inaccuracies in assessment of this vital sign are avoidable by following some basic guidelines. How To Ensuring Accurate Blood Pressure Readings STEP 1: Correct Cuff Size Using an incorrectly sized blood pressure cuff is one of the most common reasons for skewed results. Many cuffs now have a range marker that indicates if the cuff is a proper fit. A cuff that is too small can result in a false high reading, so ensure that the bladder length encircles 80-100% of the upper arm and the width is about 40%. (Here's a helpful photo to further explain.) STEP 2: Remove Barriers Bare skin is best, despite many patients wishes to not roll up their (sometimes thick!) sleeves. This technique also allows for assessment of anatomical landmarks, ensuring correct placement of artery marker on cuff over the brachial artery. STEP 3: Uncross Legs This bad habit of many (myself included) can produce false high BP readings. Remind your patient to uncross their legs in order to get an accurate recording. STEP 4: Give Rest Time Taking vital signs is typically one of the first tasks many HCPs aim to complete. In a non-emergent scenario, giving the patient adequate time to sit quietly can bring their blood pressure down to a resting rate after that walk from the lobby. Taking other vital signs first is a useful practice. STEP 5: Don't Talk This can be difficult. Patients want to tell you their reason for the visit and you want to discuss symptoms. However, explaining the rationale behind this quiet method can go a long way. In order to avoid a false increase in BP, try not to chat with the patient and encourage them to try and rest quietly for a few minutes. STEP 6: Proper Positioning To obtain the most accurate reading, have your patient sit up straight with their back supported. Let the patient's forearm rest on yours or use a supportive surface to have the upper arm in the ideal position for a blood pressure reading. (See this quick reference by Welch Allyn for helpful photo.) STEP 7: Check Manually Could the monitor be defective? When in doubt, checking manually is best practice. To begin, follow all same steps above. Place bell of stethoscope lightly over the brachial artery. Quickly Inflate the blood pressure cuff to 180 mmHg. Release the air at a steady and moderate pace. The first "bump" sound you hear is your top number (systolic) and the last sound you hear is your bottom number (diastolic). For more detail, visit this page on clinical skills related to BP measurements. What tips or tricks do you use to ensure accurate BP readings? References Healthline: Everything You Should Know About White Coat Syndrome Mayo Clinic: Hypotension (Low Blood Pressure) Practice Clinical Skills: Blood Pressure Measurement Up To Date: Determining appropriate blood pressure cuff size in children WebMD: Know Your Blood Pressure Numbers Welch Allyn: Taking an Accurate Blood Pressure Reading
  6. Ashley Hay, BSN, RN

    Meet Justice Steed, BSN, RN

    Steed saw a need for improvement in the way recruiters and job seekers connected. He created a mobile platform that gives health professionals more control over their desired assignment, while simultaneously easing the load of recruiting for agencies. According to Steed's (well designed & easy to use) website, "SPLASH Travelers is a one of a kind mobile app designed to link the traveling Allied Health Professional to their desired assignment. It is a digital recruiting vehicle that puts the AHP behind the communication steering wheel. The objective is to create a platform for travelers to feel comfortable searching multiple jobs, converse with recruiters all while having their contact information hidden. We have over a 1,000 jobs from multiple agencies in our database. Recruiters can simply enter jobs into the database and sit back and wait for the candidate to contact them, it's digital recruiting at it's finest." Tell me more about your company, specifically how does your company assist travel RN's & recruiters? "The designed mobile app*, SPLASH Travelers, allows nurses to search jobs (including local and per diem positions) using their desired travel state & pay rate. Next, the user can be matched with multiple agencies in our job listing database. Recruiters can view the user's profile but not contact information. Communication remains streamlined through the mobile application, limiting the number of phone calls, text messages, and emails from recruiters until both parties decide they are interested. At that point, a match is created. This allows travel nurses to find the best deal for your needs without the hassle of excessive discussion." *The mobile app is currently in final stages of beta testing and is anticipated to go live within the next three weeks. Sign up for updates at splashtravelers.com. What pushed you to start a travel company of your own? "When I first got into travel nursing, I was completely unaware of all the different agencies available. After I took my first assignment multiple recruiters would call often and I felt very overwhelmed. They are very eager and have many tactics to get the right clients. After having that experience and hearing other travel nurses expressing the same issues, I wanted to create a site where you could have all the best assignments to search in one spot. This assists travel nurses by allowing them to compare & contrast all different potential contracts, locations, and pay rates." What sparked your interest in travel nursing? "Travel nursing fell upon me. I was Looking to move to Pennsylvania from Charleston. Travel positions kept popping up on internet searches. I applied to an agency for a position in Philadelphia. After I took my first assignment, there was no turning back once I learned what travel nursing was all about." What was your favorite travel assignment? "My favorite assignment was a position at Temple University in Philadelphia at time of EPIC [healthcare software] rollout. It was a great time because I was able to connect with a lot of travel nurses that inspired me. We really united and bonded over the limitless opportunities within travel nursing and I'm still friends with many of those nurses today." Let's backtrack a bit... what made you want to become a nurse? "I was always into science. Being able to understand health, learn from the body and then share that information with patients and caregivers was of interest to me. I had many family members in and out of the hospital. I found nursing was a way to teach them and myself, contributing to my family and helping others. My main focus was to help others around me." Where did you obtain your nursing degrees? "I received both my LPN and ADN through Trident Technical College in Charleston, SC. I later went on to an online RN to BSN program through the Medical University of South Carolina (MUSC)." You continued to work while pursuing each degree separately - was this intentional and would you do it this way again? "Yes, I originally selected the LPN program because I wanted to get my foot in the door. By the time I enrolled into the LPN I realized I was eligible to become a certified nursing assistant. I worked closely with many RNs in this role, and nursing really interested me. I then completed my LPN. I would probably go straight to completion of my ADN, looking back. But without any guidance or counseling at the time, I was not fully aware of my options. I feel I received a lot more hands-on experience getting my ADN and working first. Working as a patient care technician, I realized that BSN prepared nurses were getting paid more. However, many managers I spoke to were looking to hire ADNs at the time (it is cheaper for them and ADNs come with more potential hands-on experience)." What advice do you have for new or prospective travel RN's? "There are a lot of different resources to help you prep for your first travel assignment. Doing a little research beforehand can make it a great experience. One specific resource I would recommend would be travelertalk.org with Andrew Craig, RN. It does a great job of laying out your first year as a traveler. In terms of advice for prospective travel nurses, I would add that it is 100 percent your choice where you go. You have control over your desired location. If the company doesn't have a desired position you can look into another company. Be open-minded and keep searching." We're wrapping up. Is there anything else you'd like to tell our readers? "If they are even slightly considering entering nursing, do it. I worked full time and went to nursing school. I know some people put [school] off and wait for the perfect moment, but nursing is a very attainable career. We always need more nurses, travel nurses, male nurses, etc. [A career in nursing] can open so many doors. If you can get into [healthcare] there's always a job. You can do it if you really want. It's an attainable goal, even when working."
  7. Ashley Hay, BSN, RN

    When You're the Patient

    A wonderful example of this was discussed in a recent article detailing one oncology nurse's blog post. It was written as an apology letter to her past patients. This after she, herself was diagnosed with cancer and realized her perspective may have been skewed. The article states, "In a blog post published on Nov. 14, titled 'Dear every cancer patient I ever took care of, I'm sorry. I didn't get it,' Norris, 33, who was diagnosed with stage III colorectal adenocarcinoma in September, apologized to every patient she's treated since she went into nursing." Norris continues on to say, "I didn't get what it felt like to actually hear the words...I didn't get how hard the waiting is...I didn't get how much you hung on to every word I said to you." Having been on both sides frequently, I can tell you firsthand it is different. The setting somehow feels unfamiliar, despite having worked in various healthcare settings for over a decade. I find myself eyeing up my husband, making sure we look presentable (what's with that?!). I feel a general sense of unease, subconscious (or very present!) anxiety and an eagerness for every provider I encounter to view me as the "easy" patient. One who doesn't ask for too much. One who is not too opinionated and has unwavering compliance. One who has a positive attitude despite circumstances. One who maybe isn't really me at all that particular day. When you are the patient a few things might seem a bit different... You're Extremely Observant When you're not the one completing tasks and running around in it, you realize just how much overstimulation there is in healthcare settings. I become incredibly hypervigilant and easily distracted. My brain is programmed to answer beeping IV pumps, buzzing beepers and ringing phones. Today, my role is different - but I still hear them and it drives me crazy. It's not easy to admit, but it may stem from feelings of being out of control. A stark contrast from working as a nurse in this very setting, where I am confidently calling many of the shots. You may find yourself reading into body language and facial expressions, heavily. I frequently feel overly sensitive to any slight whiff of annoyance from any healthcare provider. Did I say too much, go on for too long? Will my care be compromised... maybe they will come around less often if they think I'm annoying? You Notice the Chatter We're all guilty of it - after all, we're people too! Chatting quickly with a coworker about a recent TV episode, their family members, weekend plans, etc., seems harmless enough. But I can tell you, your patients are watching (and listening) way more than you may realize. This can be especially true when they are waiting for you to hang that IV bag in your hand. Talk of being overworked, lack of breaks and low staffing census can have major impacts on patients within earshot. It can increase their anxiety levels and leave them wondering if they are in safe hands. Wait Times We've all gone to welcome that patient to the unit - the one who is incredibly frustrated at the wait time. Patients can be upset when their appointment time is delayed over a multitude of reasons; childcare issues, time off work, inconveniencing caregivers, etc. What many of us don't consider is exactly what nurse Norris mentions in her blog post - how difficult the wait can be. This is especially true when patients are anxiously awaiting potentially bad news or worse... to be told their physician is out of ideas and doesn't know. Having to sit for any extended period of time can cause a major spike in stress levels, anxiety and mood swings. This can also be true with patients waiting for responses via telephone, email or online healthcare portal. Having been on the nursing end of telephone triage, I understand that messages need to be prioritized. However, being the patient feels very different. You are less concerned with the volume of calls the office may have to return because you want your important question answered. What doesn't seem pressing to you as the provider may be a pressing issue to the patient. After all, it was important enough for them to reach out. Every patient's experience is different. All should be valued and provided with compassionate & attentive care. Having a nurse with an open and empathetic state of mind can resonate deeply with many patients. What's your experience with being on both sides? Do you feel some nurses get too comfortable in their settings - forgetting about how the patients might feel? Share your story below! References: Oncology Nurse Diagnosed with Cancer Writes Apology Letter to Patients: 'I'm Sorry, I Didn't Get It'
  8. Ashley Hay, BSN, RN

    Meet Maureen Bonatch, MSN, RN

    You're probably wondering, how did she get to this point of multiple ventures in her career? Let's find out! Bonatch has over 20 years of nursing experience. However, she graduated high school with initial plans to enter the world of business. She describes how working in a women's health & family planning setting influenced her decision to seek a career in nursing, "I was employed as a clinic assistant, helping with labs, etc. Working with nurses and nurse practitioners, seeing what they do, inspired me to apply to nursing school." She went on to graduate from Indiana University of Pennsylvania (IUP) with a Bachelor of Science in Nursing (BSN) degree, while continuing to work. Her nursing career began as a bedside nurse in psychiatric care. Maureen practiced in a state psychiatric hospital on a chronic long term treatment ward, specializing in dialectical behavior therapy (DBT). She admits that while psych was always of particular interest to her throughout nursing school, it was not something she actively sought out and that it was the position that was available at the time for a new graduate. Bonatch remained in psychiatric care for about 9 years and remains on a board for residential psychiatric care. One of the activities she most enjoyed was teaching crisis management for staff. She says, "I still really enjoy so many aspects of psych and continue to use much of what I learned in several aspects of my career." She says concerns as a bedside RN related to poor morale, scheduling, and staffing issues all lead her to pursue a Master of Science in Nursing administration degree (MSN) along with the potential for increased job opportunities in the field. While she had been in an administration role as a private duty director for 15 years, she states the initial decision was difficult, as she struggled to decide between teaching and administration. Maureen learned you don't always have to choose. As a career consultant, she continues to teach by spreading her vast knowledge of nurse recruitment and retention, while remaining in an administration role. After conducting over 1500 interviews during her time in administration, she has a few helpful tips. "Little things can make a big difference in retaining staff. I know what it's like to work with a crappy boss at a crappy job. This combined with my psych background really influenced my interest in nurse recruitment. It's beneficial in terms of communication skills with staff and the key to why we have good staff retention. No one is perfect. If there is an issue with staff...address it. Bring them in and talk about it before jumping to disciplinary actions, unless severe. Give them the benefit of the doubt instead of always assuming people are doing wrong."She adds the importance of nurturing the staff you have. Bonatch gives the following example of monitoring staff satisfaction combined with transparent discussion and acknowledgement of a job well done. "We did a large study with groups of staff including many questions like, What satisfies you? We continue to do quarterly surveys, particularly because [being in the homecare realm] many of my staff are out in the field, so checking in with them is important. I've found that many managers don't really want to know what their staff is unhappy with, because it requires attention and action". Her team's research found that a popular favorite method of recognition meant the most to her staff. "We give out candy notes. It's a nice note of acknowledgement paired with a candy bar and might say something like you're worth a grand or you were a lifesaver. People really appreciate the unexpected, showing that we notice and appreciate them." She states, "I find that if you do things for staff that cost a lot of money you can do them only so often, so smaller, more frequent gestures work really well. After all, it's not just a job... it's how they are treated." When discussing the use of interview questions to discover how to recruit staff you want and retaining those you have, Bonatch explains, "People can interview well or poor, you never really know what you're getting. Having done so many interviews over the years, I tend to use my own behavior based interview questions. Like, Name some characteristics of your best & worst boss, or Tell me about your favorite and least favorite job. [This is] to see how they will fit in & work within our agency and if it would be satisfying for them, also." She describes how staff can burn out rapidly when constantly seeing turnover and being asked to precept/train new staff. "It can be exhausting for them. It leads to an infectious cycle of low morale and decreased productivity. This is one reason why I like to retain staff by having a conversational re-interview. This gives an opportunity to address issues they may not have been speaking up about and many concerns are easily addressed". Switching gears, Maureen describes how she started writing for a living. She began as a fiction writer, inspired by her longtime love of writing. "I always wanted to be an author, but never thought it was possible or achievable". Bonatch is the author of 6 published books. She found freelance writing three years ago and moved toward healthcare topics, given her extensive background, adding "I didn't realize there were so many opportunities in healthcare writing!". Describing how she really enjoyed the admission psych unit years ago, "I used to love hearing patient stories. I think that interest really plays into [my] writing." Maureen's wide array of opportunities within the nursing profession relays an inspiring message. You don't always have to choose. It is possible to wear several hats...and wear them well. You can make your own career path, even if it may seem outside the box. Maureen Bonatch MSN, RN is a fiction author and a freelance healthcare writer specializing in leadership, careers, and mental health and wellness. She is the owner of CharmedType.com and MaureenBonatch.com
  9. A language barrier can add even more complexity to the situation. However, ensuring proper translation between you and your patient is crucial to all involved in the conversation. It is imperative that the provider, patient, and caregiver are all able to understand what is being told to them as well as ask informed questions.Medical interpreters have a difficult job. They are responsible for actively listening, interpreting and relaying back medically complex information. According to an article from verywell.com, "Interpreters can work in hospitals, clinics, or medical offices, with the greatest demand being in urban areas where the population tends to be more diverse. They may also work in courtrooms, conferences, and other non-medical settings." Author Santiago adds, "medical interpreters may decrease the physician's malpractice liability and risk. Bridging the language gap can decrease the opportunities for medical mistakes to happen." Several types of medical interpreter services and devices exist. Which one will work best for your patient's needs? Types of Medical Interpreter Services/Devices Live Interpreter These are on-site/in-house interpreters. This is considered an ideal choice for interpretation as they can sit face-to-face to provide their services. This can sometimes help to comfort the patient, who is relaying their personal information to a third party. Unfortunately, this service typically does not have a large pool of interpreters. The patient may have to wait for an interpreter to become available and certain languages may not be available. Double Phones This can be a very efficient way for you and your patient to speak to each other seamlessly, despite not having an interpreter physically in the room. Both you and your patient each have a cellular phone. Once the call to the interpretation line is placed, you can both speak directly to each other through the interpreter, without having to pass one phone back and forth between you. Telephone Hotline Many hospitals have an interpreter hotline service available for use. If you do not have access to the double phone system noted above, the land-line phone can be passed between the two of you - or better yet, use speakerphone feature to include all caregivers on the conversation. Most of these telephone service lines offer 24/7 availability. Video conferencing system Some hospitals have a mobile tablet type system that allows for you to call into an interpreter service line with the added benefit of being able to see your interpreter. This can be the next best option if an in-house interpreter is unavailable or a more rarely spoken language is needed. What's Not Ideal Having friends, family members, or even other providers who aren't certified to translate medical terminology may sometimes seem like a quick fix to a simple problem. However, there is very little room for error when explaining complex medical terminology and many who are not certified may not be familiar with all terminology - especially in two languages. Some hospital systems have even developed policies/standards against using family members or other non-certified persons for translation.More information on medical interpreter certification can be found here. General Tips When Working With a Translator Speak slowly and clearly Only speak 1-2 sentences at a time (allowing translator to capture and relay all necessary information) Avoid using slang or abbreviated terms Re-word sentences if needed for the interpreter (so that it can be best translated) Speak directly to the patient (not the interpreter - this may feel awkward at first but it helps to confer body language & facial expressions) What are you experiences with using medical interpreters & devices? References: Overview of Medical Interpreters' Careers The National Board of Certification for Medical Interpreters
  10. Ashley Hay, BSN, RN

    To Keep or Ditch Past Certifications?

    So, is it worth it? Benefit Becoming certified in your area of expertise has many benefits to both the nurse and his/her patients. Obtaining certification demonstrates to your peers, management and patients that you are an expert in the field and have taken additional steps to solidify your comprehensive knowledge of this healthcare specialty. An article from workingnurse.com titled, The Power of Nursing Specialty Certifications states, "While specialty certification is voluntary, obtaining it can be a tremendous benefit to almost any registered nurse. Nurses who validate their expertise through specialty certification set the standard for the profession" and adds, "Don't be surprised if your next patient asks if you're certified. A 2002 Harris Poll found that 78 percent of consumers were aware of nursing certification. Seventy-three percent said they'd prefer to receive care in a hospital filled with certified nurses." The article also discusses another important potential benefit to nurses seeking specialty certification - confidence. Workingnurse.com goes into more detail, explaining, "studies show that nurses who are certified in their areas of specialty reported feeling even more confident in their work and more satisfied with their jobs. Even if you know your specialty inside and out, improving your credentials can give your confidence a boost and help you enjoy the work you do even more." With all the given potential benefits of certification - an vast knowledge of the specialty, personal growth, professional confidence, increased patient satisfaction and maybe even improved job satisfaction - you may be asking, why don't we all get certified? It's complicated. Let's dig a little deeper. Relevance One of the awesome benefits of entering the healthcare industry as a nurse is the flexibility this profession can provide. We are able to work in many different settings and in multiple roles. If you (like many) enjoy the freedom of changing your specialty every few years, specialty certifications may not be relevant at your next position. A personal choice - is seeking certification worth my time and money? Will it continue to serve me and my career? These, among others, are important questions to ask yourself when considering pursuing additional certs. Really assessing your current and potential future healthcare setting can help to determine if this path is worth your efforts. Finances Keeping multiple certs can be expensive to maintain, especially if your employer is unwilling to assist financially. Some institutions value the voluntary educational efforts of their nurses and provide partial/full reimbursement upon proof of passing. However, there are many hospital systems that, unfortunately, do not have the funds or desire to assist staff financially with additional certification(s). Let's be real - being a nurse can be expensive. Depending on your area of work, many nurses are required to purchase things like: attire (scrubs, shoes, surgical caps, etc), accessories (stethoscope, pen lights, scissors, clamps, etc), fee to maintain state licensure (sometimes multiple), and also potentially pay for continuing education credits to keep said licensure active (if not offered for free at place of current employment). Fiscally assessing your budget may prove helpful in your decision to seek, maintain or get rid of your specialty certification. How much will the exam cost? What is the estimated cost of required study materials? Will you need to miss a day of work to take the exam? Letting Go If you are/have ever been certified, you know the time, effort and funds required. Weighing out the pros and cons to keeping or obtaining your cert can be more difficult than anticipated. Is it ever worth letting go? If so, isn't there a potential for regret in the future? Yes, there is... After about eight years in oncology I decided it was time to pursue my OCN (Oncology Certified Nurse) certification. I had historically bounced back and forth every few years between adult and pediatric care. I bore very easily, but it was clear to my I would always be in some facet of oncology care, so pursuing certification made sense to me. It required a considerable amount of study time and funds. The exam was definitely not a breeze, but I passed. Years later, I was (again) back in the world of pediatric oncology, so, when my certification was due to renew, I didn't think much of it. To be honest, I was uncharacteristically lazy about it. I felt like it wasn't of value to me anymore and the "hassle" of looking into what was required to renew was not something I thought I had time for. (Oh, if I had a crystal ball.) Fast forward, my OCN lapsed one year ago. Now, working as a freelance writer and consultant, I regret letting this certification go. I had worked quite hard to obtain it and believe those extra letters can convey the wealth of knowledge I possess to others. Lesson learned. You don't have to keep them all, but some are worth it. Do you have any specialty certifications? Have you ever let any go? If so, do you regret your decision to do so? References: Montgomery, S. (n.d.).The Power of Nursing Specialty Certifications.Retrieved December 11th, 2017 from The Power of Nursing Specialty Certifications - Articles Archive - Nursing Jobs, RN Jobs, Career Advice at Working Nurse
  11. When I began writing from home, I had a sluggish ten year old laptop and my tiny desk was shared with my less than organized husband, the conditions were not ideal. The funny part is, at the start, I didn't even realize what I needed to be more efficient. After taking some time to cultivate my perfect setup, my days and creative process now seem to go a bit smoother. Where to Start It can be hard to imagine all the items you might need to work from home if you've never done it before. While a separate space is key, it may not always be possible. However, if a full office space/room is not available, setting aside a relaxing and comfortable workspace can keep distractions down and create workflow ease. Potential expenses for your first year are also quite difficult to imagine (especially if you're anything like me and unsure of what you might even need to start). Here's a general list to help give you an upfront idea of what you might need... Laptop While my old laptop was technically in working condition, it wasn't very conducive to getting much done. Despite cleaning it up, it was painfully slow and many tasks took twice as long. Time is money, especially when you're paid to create content and expected to be on the computer for most of your workday. Get a current & updated laptop or computer (with virus protection!) The money spent on my new laptop was one of the best investments I could have made. Not only did my new toy inspire me to write more, but it's cool features help me get so much done in half the time. I personally work on a Surface Pro Laptop. The screen in big enough to read/view work, yet easily portable to make my office mobile. My other favorite features include the detachable screen (turns into a tablet - you're allowed to have a little fun too!) and the touchscreen capabilities, including being able to take on-screen notes. I find this feature particularly helpful when researching multiple sites for information to be included in an upcoming article. Keyboard While the keyboard on my laptop is great, typing all day requires a proper, full keyboard (unless you want your wrists to whimper by lunch every day). I use a Logitech K120. Do a little research and see what setup you might prefer - there are many different orientations of keys available. If possible, test drive it at the store before you buy. While there were other keyboards I had my eye on, this one's key placement works best for me and far reduces my rate of typos. Hey now, don't go digging through this article looking for typos... a tired nurse writer can easily defy the rules of any helpful keyboard. Bonus feature of the K120 keyboard - it's quiet and doesn't have that extra loud clackety-clack noise that could drive me to the brink of insanity. Get Comfy Make your setup work for you and as ergonomic as possible - your body will thank you. If working on a laptop, elevate it to eye level (lots of cool setups to choose from online... or a huge med surg book works well, too!) Ensure your chair has great back support, elevate feet if space permits Lower the keyboard so your shoulders don't ride up to your ears (yikes!), keeping a near 90-degree angle in elbows Invest in proper lighting for your workspace (I see you squinting...) Stay Organized I'm definitely an office supply nerd. It's quickly become one of my favorite things to shop for. Aside from the basics (pencils, steno pads, paper clips & post its - among my frequently used items), you may also need: File folders Separate office calendar to plot out due dates for work ahead Small dry erase board (to keep track of potential pitch ideas, to-do list, or business goals) Templates Getting your hands on some pre-formatted templates can save you a ton of time. (You guessed it, I learned this one the hard way.) To find these formats, dig around online, in the Microsoft Office suite, or reach out to other helpful colleagues. Examples of some frequently used templates include: Invoices, expense sheets, time tracking sheets, contracts, pitch formats, etc Employee ID Number (EIN) Obtain an EIN from the IRS While the options of LLC, Inc. and other business structures exist - that's a whole topic for a whole other day. What I can tell you is obtaining an EIN is a great starting point for any new freelancer and the online process is actually quite easy. The benefit to having an EIN is it prevents your social security number from floating around on invoices and other forms exchanged between you and clients. The application form takes less than 10 minutes. The best part? It's free. Ambiance One of the benefits of working from home is being able to tailor your space to your needs... and likes! Include some fun stuff that will keep you happy & motivated. Here are a few examples of things I love to have/frequently use in my office: "Focus & Patience" scented candle, made by Chesapeake Bay (Target.com) Fresh Flowers Essential Oil Diffuser (Amazon.com) *I like to use an energizing citrus scent when working Music Application (Pandora.com) Note cards of encouragement from friends Surrounded by books (inspiration, humor, nursing research, etc) What are your favorite things that make your work-from-home day a little easier or more enjoyable?
  12. Ashley Hay, BSN, RN

    Ways to Unwind

    Self care is certainly not a one-size-fits-all scenario. You may find these are even more effective in a personalized combination effort. Maybe you're well versed in these too, but if not - try something new. My hope is that you are also pleasantly surprised at the results and can achieve a little calmness this holiday season. Massage I know. It seems like just an awesome (expensive) luxury, but the truth is, our bodies may need it more than you think. Nurses put a ton of physical strain & stress on our bodies with bedside care, long shifts & emotionally straining situations. While an hour long massage can work out some of the tightest neck knots and back kinks there are, but it can also be tough to justify spending the money on it and can be difficult to afford, particularly with holiday gift giving around the corner. Here are a few ideas to get you the relaxation you need, without the high price tag: Try Groupon for local spa/independent masseuse deals Talk to your coworkers - Who do they see? Some businesses offer first time customer referral deals. Acupuncture Afraid of needles? Then this next suggestion may not be ideal for you (although a nurse with needle-phobia is somewhat ironic, no?). Despite willingly trying multiple types of Eastern Medicine, I was incredibly hesitant to try this. It wasn't so much the needles as it was the thought of having said needles in me and then having to sit, alone with them left in! What if there's an earthquake? What if I have to pee? What if I sneeze or have an itch?! Luckily, a good friend of mine is very patient and (after hearing all of my laughter producing fears) she suggested we go together for the first time. It was amazing. Soothing music in the background, comfortable recliner chairs, attentive acupuncturists...and all in a community setting. Relaxing, but not alone. Perfect. If nothing else, having a 45 minute acupuncture session forces me to remain still, focus on my breathing and just relax. Limited sessions may be approved by some health insurance companies Look for a place with package deals (buy more, save more) and a comfortable setting you like Enjoy your time to relax & reflect... and not be interrupted. Time with friends Taking time away from family obligations and working to really connect with others you enjoy can be very fulfilling. You may even find that you return to life's responsibilities a little more refreshed. Satisfying conversation and time well spent with others can provide an opportunity to deepen your connections with those who matter most. Take the initiative - don't wait around to be invited. Plan an event for you and your friend(s) to enjoy. It can be anything you like, from dinner out to a night in (sweatpants and wine optional, but also recommended). Meditate Meditation at the start or end of any day can allow a temporary escape from your holiday task list, or at least reframe your thoughts about it. Taking time to mentally assess and clear out your thoughts, while focusing on breathing/stillness, can promote a healthier brain and a happier you! Many find meditation difficult, even after practicing for years. A new app I've been using for a wide variety of guided meditations is called Simple Habit. It even has a great "remind me to meditate" alarm-type feature. Creative Hobby Having a creative outlet can be a great source of stress relief. There's something about making anything with your own two hands that has a way of melting away anxiety and distracting your mind. Here's a few ideas to try: Group hobby: join a book club, host a movie night, etc. Art: take a painting class or simply pick up some cheap art supplies/crafts for home use Cooking: the sounds and scents are cooking can be really enjoyable and therapeutic. If it's something you enjoy, maybe take time to bake/cook your favorite dish. Meal box subscription services are also very popular right now and can help you discover a new recipe. Get Physical Not only is physical activity good for your heart, it's also great for your mind. Getting your blood pumping can provide a great stress release & increase endorphins. You don't have to be an Olympic athlete to enjoy the benefits of a good sweat. Give any of these activities a whirl to wind down: Go for an outdoor walk Join a running club: meet other people in your neighborhood & get a great workout Join a gym: many offer group classes if you're not sure where to start. Bonus- there are lots of deals during the holiday season, some even waiving initial membership fees or offering free trial periods) Try a group sport: another great way to meet others, plus enjoy a little healthy competition What are your favorite ways to unwind from the stresses of work, family, and holiday demands?
  13. Ashley Hay, BSN, RN

    Tools to Beat Writer's Block

    I love the freedom (and income) of being a freelance healthcare writer. When bedside nursing full time was no longer an option for me, writing healthcare content satisfied my desire to remain working while still using my hard earned knowledge of medicine. Best of all, I'm still able help to help others (patients, nurses, caregivers), just in a different way. But, all the sunshine and rainbows of being a freelance writer has a way of fading quickly if you feel overwhelmed or unable to start and can't complete the task at hand - create content. The irony of my current situation is not lost on me here. It's actually quite comical that I am experiencing a bit of writer's block (and even mild anxiety) for this very article - procrastination at an all time high in addition to a dwindling clock and a fast approaching deadline. Never fear! This article will be completed (eventually) and here's how: Outlines Personally, I find making outlines to be one of the most helpful tools for writer's block. I've used many different types (and kind of shoot from the hip). Use what feels good and works for you. Here's a great website discussing several different outline options: youngwritersproject.org Go Back to Your Pitch When pitching a client via email, I usually include a few brief bullet points that describe major themes of the potential article. If I'm feeling particularly stuck (or even unable to start) writing an article, I like to have the email pulled up in a separate browser tab and use it to structure my piece into a list type - much like how this article is structured. Your original pitch can serve as a handy outline and contains your initial ideas surrounding the topic. Use it and expand out from there. Change of Scenery Some days I love working from my home office. I enjoy my own routine of lighting a scented candle, turning on the radio and tending to some fresh flowers in my personal workspace before starting my day. However, working from home can also be incredibly distracting. I should really organize that closet, clean those dishes, prep dinner, throw in some laundry. When my home becomes more of a hindrance than a help, I make my office mobile. I'm fortunate enough to live in a temperate climate year round, so heading outdoors is usually an option. On days when it's not (or the outdoors is also somehow a source of distraction) I like to work from a quiet, comfortable cafe that's not too far from home. I find switching up your scenery (even if it's just a different space in your home) can sometimes make all the difference in your overall productivity. Take a Break! When other methods fail, take a break. It's probably your brain's way of screaming for a breather anyway. Many recent studies have found multiple benefits from taking regular breaks from doing anything for too long, studying, sitting, working, etc. For example, this article from PsychCentral.com examines how taking a break can actually improve one's attention span; author Rick Nauert PhD writes, "even brief diversions from a task can dramatically improve one's ability to focus on that task for prolonged periods". Get Moving Expanding on the theme of taking breaks, try stretching your legs. Increasing the flow of blood and circulating oxygen, physical exercise has a way of refreshing the mind. I read several articles by fellow freelancers that discuss scheduling regular gym time into their daily routine. Awesome idea, but let me be honest here, I'm definitely not one of those people. However, whether it's a brisk walk, hike, bike ride, swim, weights or yoga - all are beneficial for both mind & body. Read Something, Anything When I can't seem to write, I like to read...anything. Reading has always been a favorite hobby of mine since I was young. The escapism a well-written novel can provide is something I consider to extremely therapeutic. I find reading a great work of fiction, an interesting online blog or in-print magazine frequently provides inspiration, direction, or a fresh perspective for a piece I'm currently working on. Talk with a Colleague Being a nurse, writing for other nurses...you are surrounded by potential future readers of your work. While at my bedside job I like to sometimes pick my coworker's brains. What are they interested to know on the topic? What clinical questions do they have? Use having unlimited access to your target audience to your advantage. What tips/tricks help you beat writer's block? References: Seven Types of Outlines Taking Breaks Found to Improve Attention
  14. Ashley Hay, BSN, RN

    What Are You Thankful For?

    Thanks for reading - glad you enjoyed it. This is not to say I haven't experienced my fair share of frustrations and struggles with nursing - but I find it helps to look at it from all angles and have gratitude for all it has given me, as well. Thanks for sharing & good luck!
  15. Ashley Hay, BSN, RN

    What Are You Thankful For?

    With the fall season in full swing, themes of pumpkin flavored everything, brightly colored foliage and crisp mornings are all around us. While I will not deny my undying love for pumpkin spice lattes, another important thought also comes to mind during this season - gratitude. When reflecting recently on things I'm thankful for, my nursing career and all it has provided seemed to somehow bubble toward the top of the list. Stability & Opportunity Pursuing a career in nursing gave me a stable income, something I hadn't had previously. Over the years, my earned income has allowed me to provide for my family, travel to amazing places, buy a house and continue to pay the ever-growing list of bills that seem to accumulate with age. While I don't think any bedside nurse is swimming in an excess of cash, a nursing career can provide a steady stream of income and having that comfort is not something I take lightly. I'm grateful to have a solid way to provide for myself and loved ones. The field of nursing is filled with opportunity. This is no longer your grandmother's idea of nursing (so to speak) - where working in a hospital or for a physician is the only possible setting for your hard earned skills. After over a decade at the bedside, I realized there was more this career had in store for me. I've been fortunate enough to utilize and expand my skill set from bedside care and use it in several new roles: case management, clinical educator, healthcare content writer, consulting and more. I'm incredibly thankful I chose a career that could stand the test of time while also allowing me to branch out creatively - and get paid to do it all while still helping others in some capacity. Greater Understanding Going into nursing at a young age, I feel I owe a lot of my character development to this career. You quickly realize what matters and what really just doesn't. Being a nurse has a funny way of putting life into perspective, no matter what age you come into the healthcare setting. Seeing life and death, suffering and joy - all in it's purest, most raw form, first hand, changes a person. If being a bedside nurse doesn't give you a greater understanding of life and true empathy, nothing will. And, for this experience, for being able to be a part of a patient's healthcare journey, I am filled with gratitude. All Kinds of Kinds As the years go by, the number of patients and families I've met seems to blur into an incomprehensible number. Yet so many individuals are still clear as day in my mind - their names & faces, their story, their pain, their successes. Being exposed to so many different cultures, personality types, and temperaments has given me a useful tool to carry with me outside of my life at work. Learning to work together despite our differences is a lesson I'll gladly take a refresher course on time and time again. Being a nurse can frequently mean practicing a delicate balancing act between providing comfort and setting boundaries, a valuable tactic that reaches far beyond just nursing. Life Lessons I've been a type-A personality for as long as I can remember. Nursing has been a wonderful way for me to harness this; teaching me the value of being flexible yet allowing room for my love of organization. We all know time management is key to a good day on the floor - but the truth is sometimes the best-laid plans just don't matter in healthcare. I quickly learned that if I couldn't roll with it - I would be flattened and steamrolled by the nursing powers that be. I'm grateful to have a career where I was able to learn it is possible to loosen up and yet still be effective - as a nurse, wife, entrepreneur, friend, and much more. What are you thankful for this season? What has your nursing career given you?
  16. Ashley Hay, BSN, RN

    The Underestimated Benefit of Ancillary Staff

    Couldn't agree more. Thanks for your comment!