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  1. My family had humble beginnings. As a child, we were working class. My father had only graduated from high school and my mother, who was an immigrant had only completed elementary school. However, they worked hard and by the time I was in high school we were solidly middle class. In high school, I was a stereotypical nerd who got straight A's. However, I had a terrible secret. I was being horribly physically abused. One night, I remember being struck 700 times with a board about 1/2" thick and 3" wide. Actually multiple boards, because they kept breaking and then being replaced. I lost count at 700, so it was way more than that. And that was typical for me. I learned that after repeated blows, I would go numb physically and I also learned to transport myself mentally to a different place. I kept going by telling myself I would get into an Ivy League college and get away from my home and never go back. Well, I did! I got into Yale. As a college freshman at Yale, everything was wonderful! I couldn't believe I had made it and I got decent grades. My parents were happy they could brag to all their friends that I was at Yale. After I made it clear that I would no longer accept any beatings, they cut me off financially. I was only 17. Yale was supportive, but explained that because I had entered school as a dependent, I would have to leave school, be self-sufficient for 2 years, and then Yale could give me a full ride so I could finish school. Well, I was so young and completely heartbroken that I fell into a deep depression and failed 2 classes my last semester. (The first of several episodes of major depression). I had nowhere to go, so returned home. Because I refused to be beaten, my mother threw me out of the house with nothing but the clothes on my back. She also stole my savings. So I was now 18 and homeless. Fortunately, some kind friends took me in for the Summer and I worked 2 jobs to save as much money as possible. Then I was able to get a secretarial job that paid well. I ended up getting married at the age of 21 and becoming a stepmother to 2 wonderful children. However, the only job I could get as an Ivy League dropout was secretarial work and many employers humiliated me by saying "My secretary went to Yale" and laughing at me. I remember burning with shame and anger and vowed to finish my BA. After a couple of years of working and saving, my husband and I were in a position to allow me to finish college at a state university. My GPA was bad at 2.9 because I would get A's in the classes I enjoyed and bad grades in the classes I didn't like. I was young and my study habits were poor. However, I did graduate. But I had earned a liberal arts BA, and in the 1980s, for most women that meant starting out as a secretary. I ended up working for a very nice Chief Technology Officer who noticed I was good with computers, so he suggested I get a BS in a computer related field and the company would pay for it. So, I would drive an hour or more each way 2 nights per weeks to school and earned my BS in Computer and Information Systems Management. However, my GPA was again mediocre because I was working full-time and still did not have good study habits. Then I was able to start a career in high technology, ultimately working my way up to Director and Vice President level positions, making about $175 K per year. I traveled all over the world and lived all over the US - Washington DC, Silicon Valley, and Los Angeles. But I felt unfulfilled and increasingly miserable in my job. (BTW - it was common in my field to work 60 to 80 hour weeks, 6 to 7 days a week and traveling on top of that - so no personal life! I could go for several months being out of town M-F and only coming home on weekends) Fast forward to 2008, when the Great Recession hit. Like many people, I was laid off. At the same time, I was helping to take care of my mother, who was by then an invalid. I began thinking of my future - I had always regretted not becoming a doctor. I did some research and realized healthcare was a great field and I could apply my business and technology skills. So I used my savings to attend a two year executive education program at UCLA in Healthcare Management and Leadership and I got straight A's. Along the way, I realized I wanted to provide hands-on patient care, and based on my new knowledge, nursing seemed like the best fit. I took a Red Cross CNA course to make sure I could handle the patient care. It was soooo hard, but every day after clinicals, I would arrive home exhausted, but feeling fulfilled and happy that I had helped people that day. So I decided to pursue becoming a Nurse Practitioner. Unfortunately, my mediocre undergraduate grades were now an issue. In addition, in California, the colleges were impacted, which meant you had to take nursing prereq's wherever you could win a "lottery" and get into one of those classes. I took my prereq's all over - various community colleges and also through UCLA Extension. I did well, getting all A's except for Chemistry (got a B). However, I did have to withdraw from Anatomy and retake that because I just was not prepared for all the memorization. So, I applied to nursing schools. My father was skeptical, due to my advanced age, but I figured I had some valuable experience as a manager and leader, and I also understood technology (software like EMRs/EHRs), plus had general life experience. I was accepted by the UCLA Direct Entry MSN program and also by Johns Hopkins' ABSN program. I decided to attend Hopkins and started the ABSN at age 53. Nursing school was the hardest thing I had ever done! Many times I cried by myself, wondering if I could survive. While I was strong academically, I struggled with skills such as setting up IVs, etc. I was always one of the slowest students in learning skills. A couple of instructors told me I wasn't cut out to be a nurse. I also struggled with depression and anxiety. (Interestingly my best support during this period was from MDs I knew, who said I had what it took to be an NP and were annoyed I hadn't gone to medical school). After graduating, I immediately started the MSN program and found myself comfortable and confident in my physical exam skills! (I'm not sure what happened there). However, the Summer we had off from school, I had a major issue with my father which threw me into the most severe depression of my life and I had to be hospitalized for 5 days. When I started school again, I got C's on a couple of exams, which shocked my professors. I asked for help. Fortunately, they were very supportive and made sure I got the support and care I needed so I could regain my academic footing. I also had to repeat one clinical and will be forever grateful for the professor who went to bat for me so that I could graduate with the rest of my cohort. I graduated at age 56 with my MSN and was hired in 2 months for my dream NP job, starting at $95K and increasing to $140K within 18 months, based on performance. I also won a HRSA scholarship, which paid for the last 18 months of my MSN, along with a small stipend, in return for 2 years of public service. If I could have stayed in Baltimore, my preceptor on my last rotation would have hired me. My advice: hang in there and work hard! And ask for help as soon as you run into trouble - my only mistake at Hopkins was not asking for help soon enough due to panic and embarassment. Apply to the best schools and don't be afraid of the price tag - many of the expensive schools have a lot of scholarships and good financial aid, so they are actually cheaper than some state schools. That is why I chose Hopkins over UCLA - it was actually cheaper with the financial aid I received and I am a California resident! Apply for every scholarship you can and ask all your professors and the financial aid people what is available - sometimes the professors know about scholarships that financial aid does not, or vice versa. If I were younger, I would have joined the military to get loan repayment. In addition, at Hopkins we had students who had been corps men in the military who were going to Hopkins full time and the military was paying for everything. With regard to looking for a job, be flexible on location. I live in California and everyone wants to live in San Francisco, LA, or San Diego. Yet, there are many jobs in other parts of the state that are begging for candidates! I got a job in a stunningly beautiful area with a population of about 100,000 and a very low cost of living. For example, to rent a one bedroom apartment in San Diego area is now at least $2,000 a month (and much more in SF or LA). Where my job is, you can get a nice 1 BR place for $600 to $700 (on the water!) a month. The downside is I will have to live there for 2 years and can only drive to my home (I own a home) on the weekends. So, research where nurses and NPs are needed and be willing to go there. Hope this helps some folks. Best wishes to all.
  2. Okey Foley

    Hardest Thing to Learn

    What is the thing that has been the hardest to learn for you as a nurse over your career? Early on, midway, or late. I've been an RN just over a year now, and for me one of the most difficult things has been learning to be assertive. I still find it difficult as I was very timid growing up. I'm getting better especially when I keep in mind it's for my patients' well being (I.e. ambulating after surgery, sc heparin/injections, q2 turns, etc).
  3. I am a 39 year old second year nursing student. To nurses and fellow nursing students, how old do you think a student entering nursing school for her or his RN degree should be? What kind of personal characteristics should she or he have?
  4. SilverBells

    How Long Do You Expect To Be a Nurse?

    Just curious, how long you expect your nursing career to last? When I became a nurse almost 7 years ago, I did so with the intent that I would be a nurse for rest of my working career. Lately, I've been questioning whether or not that will still be the case. I'm at the age where I still have 30+ more years of working, so obviously a retirement is not an option at this point. With that said, I've been stressed lately and am unsure whether or not I can actually make it through another 30 years of nursing, or even want to. I'm not ready to make any fast career changes simply because I've had a few stressful moments recently, but I'm wondering whether I will keep my goal of remaining a nurse for my entire working career. How about the rest of you? How long do you expect your nursing careers to last?
  5. Have you ever thought about leaving a job for something better but never put effort into “feeling out” the job market? Most of us have been in a career rut at some point and felt trapped in an unfulfilling job role. We wake up dreading the workday and literally countdown the days and hours until time off. If this describes you, it is possible to become “unstuck” and regain passion for your current job or move forward with finding a future job. The first step is to take a look at what barrier (or barriers) is keeping you trapped and career stuck. You’re Bound By Golden Handcuffs In nursing, recruitment and retention strategies may include pay incentives that keep you pulled in, such as with sign-on bonuses or baylor pay. However, money that is too good to resist can become golden handcuffs that keep you in a job that no longer makes you happy, affecting your overall quality of life. In this case, you can work on an exit plan, a budget and timeline, such as “Over the next year, I will cut back and live on a budget to save money. Then, I will look for a job that will give me a better work-life balance.”. Your Confidence is Wavering Sure, there will always be someone else with flashier skills or with a different talent than your own. But, this doesn’t mean you are less capable or your talents are not as important. Everyone, at some point, has compared themselves to their coworkers. Focus on your strengths while working on weaknesses to build your confidence and keep forward momentum. You’re Just Waiting…. Have you ever found yourself waiting “just until”? Perhaps you are waiting until your next evaluation to see if you receive a raise. Some nurses wait to see if “things get better”, such as a change in management, better staffing or a work culture overhaul. But, the waiting game can lead to significant amounts of time passing with the expectations of change falling flat. Not Sure What You Want In nursing, there are endless career options and job types. However, it is hard to your dream job when you aren’t sure of what you want. In order to move forward, it is important to ask yourself some questions, such as: What do I want from my career? What are my job “deal-breakers”? What am I most passionate about? What are the things I must have in a job? What skills do I have to offer? What skills do I want to improve or learn? What type of work culture and environment do I want? What is my expected salary? You may find the article “9 Questions That Will Help You Find Your Dream Career” helpful, even if you just want to stay in nursing but try something different. Your Job is Familiar and Comfortable A simple Google search will yield an endless amount of motivational quotes about stepping outside of our comfort zones. Although you may be unhappy in your current job, you know what to expect during the workday… you duties and interactions are familiar. Most likely, you have working relationships with co-workers and understand all the nuances specific to your work environment. The fear of the unknown keeps us trapped in unfulfilling work comfort zones. To offset your fear, it is important to determine if your fear is based in reality. For example, you may tell yourself “I will never find another job with hours similar to the job I have now.” and never explore other job openings or career opportunities. You Put Self Care on the Back Burner If you feel trapped at work, there is a chance you are not consistently practicing self-care. Have you lost work-life balance and burning the candle at both ends? It is easy to lose perspective and motivation when we are mentally and physically tired. Try simple acts of self-care, such as meditation, going for walks, taking a class or relax doing something you love to keep yourself centered. You Need to Expand Your Network Talking to nurses working in other settings and environments may shed light on career options you find interesting. There are several ways you can build your professional network. Online networking through LinkedIn or other professional networking sites Reach out to your existing contacts to ask for help, seek advice or look for inspiration. Attend a local nursing association meeting or conference The goal of networking isn’t just expanding your number of professional contacts but to also focus on a vision for yourself. Looking for a nursing job? A better career is out there... Visit allnurses Jobs Are you feeling trapped in a job? If so, what is keeping you from moving forward?
  6. I read my email and felt that sinking sensation—change is coming and fast. The memo stated that in 7 days we would be changing over to the new system. Despite months of preparation, the looming deadline was anxiety-provoking. Would it go well? Would I be able to adapt? Would our patient care suffer? These and many other questions repeated in my mind as I clicked my laptop shut for the day, hoping that I would be OK with the changes. Nursing is all about change, isn’t it? Just when we feel we have adjusted to the new technology, system, machine, arrangement, we get the memo from administration, “Be aware that we will be converting to xyz next week.” Adapt accordingly. Some change is good and leads to improvement. Some change is pretty neutral and some is just plain old bad. The fact remains that we all have to learn to cope with changes and to keep our morale and practice intact no matter how much change comes at us and how fast. How do we stay on an even keel when faced with change? Stay centered When change comes, we all hope to be that unflappable nurse that handles everything with grace, quietly, serenely coping with the new skill or information that he/she is required to master. But no. Reality rarely resembles the dream and most of us struggle mightily to keep our composure, to learn the new way and to not allow our patients to experience any adverse effects. I recently attended a memorial service for a Jewish friend. The rabbi spoke eloquently and wisely about life truths. One thing he said really stayed with me, and compelled me to go back later and listen to the recorded service to capture accurately what he said. Here is the quote from Rabbi Wolfe Alterman from Asheville, North Carolina: “If you see what is in need of repair and a way to repair it, then you are seeing what God has called you to do. If you only see what is wrong and ugly in the world then it is you yourself that is in need of repair. And all of us are in need of repair in one way or another. There is so much in need of repair that this task feels overwhelming.” He finished with a quote from the Talmud: “You are not required to complete the task, neither are you free to ignore it.” Whether or not you are religious in any way, it is possible to see the thread of truth in both statements. We live in a broken world where people get sick and often die; where tragedies happen but where goodness also abounds. When we are able to stay centered on who we are, what our skills are, what our goals are, we are better able to identify our role in the change process and help in the repairs the change is attempting to make. The second quote is also freeing because it helps us shake off the guilt when the desired change doesn’t turn out as we had hoped. We have to continue to try; we cannot quit. Not every change is going to go well or produce the desired results. By not ignoring the problem and doing our best to effect change, we may have at least improved some part of the issue by trying. Stay flexible We have all heard the refrains, “That is not the way we do things,” or “The administration doesn’t care about nursing” or “I wish we could go back to the good old days of nursing.” When we read these phrases we hope that we are not the ones speaking them but, truth be told, we all struggle from time to time when asked to do something new or to endorse and support change when it doesn’t seem to be for the better. Staying flexible and seeing new possibilities is hard, especially as we gain age and experience. Becoming more set in our ways can go hand in hand with being around for a while and it can also mean that we run the risk of being the “stick in the mud” when it means adapting to a new EMR or to a new staffing system. In Simon Sinek’s book, Better Together, he encourages, “Don’t complain, contribute.” It is up to each of us to seek out the positive. Complaining can be a bad habit that threatens our well-being and the general feeling on our unit or office. Sometimes we think that venting our concerns helps to release tension and provides us with much needed psychological relief but the opposite may be true. Complaining can be a habit that drags us down and pulls those around us with it. On the other hand, making a contribution, or suggesting a positive change can do a lot for our job satisfaction and help to influence our whole workforce. I remember working with one of the women from housekeeping that was particularly upbeat. No matter how many rooms were switched out, no matter how much extra she had to do, she seemed to find a way to keep her comments positive and to refrain from complaining. And people noticed. We all loved working her hall! As we face repeated change, it may help us to look back and see times when change did turn out for the better; we can take encouragement from those times and be those nurses that smile and say, “Let’s see what we can do with this!”
  7. This article is featured in the Fall 2018 issue of our allnurses Magazine... Download allnurses Magazine As A Conventional Nurse... When I began my nursing career, becoming a nurse entrepreneur was not in my field of vision. I mean, I didn't even know that term existed. Like most of my colleagues, I began working with Med/Surg patients and personally, I had no further thought other than being thankful I passed the NCLEX and prayed I would never harm a patient by being so green. I started and ended my clinical experience working Med/Surg and had a few years of critical care nursing in the middle. This is when nurses worked eight-hour swing shifts, which felt completely normal to me, having a father that worked forty years in the steel mills. Back then, you had to select your holidays and you could not have the same holidays the following year. And we weren't given any option to try to arrange for someone to take our shift. You know it is funny, I loved providing nursing care for my patients, but my favorite part of caring for my patients was hearing their stories. I also believed in getting my patients involved in conversation since it had therapeutic effects of decreasing their anxiety and discomfort. My co-workers teased me about this, but it was good-natured teasing. I loved the nurses I worked with. They were the ones to teach me the ins and outs of nursing, you know, nursing in the real world versus what we all learn in nursing school. We enjoyed each other, and socialized outside the hospital setting. Many nights after working 3-11 we would go to the Hilltop Lounge and have steak salads piled with french fries, (it's a Pittsburgh thing). Even the married nurses would join us for decompressing and laughing. We had nurse bowling leagues with the different units challenging each other. When you see someone outside of a work setting you have the opportunity to see different aspects of their personality, and I believed that's why we all pulled for one another more. I don't know what is currently going on with the amount of friction in the workplace. Is it due to stress levels being so high because of increased patient loads? Is it due to keeping up with technology? Are twelve hours shifts hurting nurses or serving them? My colleagues were wonderful, and were the main reason I kept going to work when it became apparent to me that it was time to find something new. After several years, of swing shifts, working weekends and holidays, and missing so many family get-togethers I started looking for what else I could do. Transition towards an unconventional path... It was very interesting trying to find something different because I didn't know any nurses that weren't working in a traditional setting. I had recently moved to the Chicago area because the guy I was dating asked me to. He didn't want a long distance relationship. So, add finding an apartment and a new job. This was when you saw classified ads in the newspaper and went in personally to interview for a job. A major insurance company was looking for a Health Care Resource Specialist, so I thought, why not? I went in for the interview, met with the manager and left with starting a job in Case Management. I didn't realize at the time that this would be a pivotal moment in my nursing career. I was only looking to work nine to five and have my weekends off. My new job included educating about a hundred claims processors on the medical aspects of reports they would be processing. I worked with beneficiaries to help them understand the short term and long term implications of their chronic conditions, and what resources were available to them. I also worked for the first time on a computer to input healthcare data and run reports for the manager. In trying something new, I found a passion that I never saw coming, case management and healthcare data analysis. I came to a realization that I have come to many times since: you don't know what you don't know and that in itself is the very reason to try new things. I didn't know I would enjoy being a health care data detective, analyzing reports and trending results. I didn't know I would love educating beneficiaries and claims processors about health and optimum outcomes. This came even more into play in my next job with the Georgia Medical Care Foundation which was the state peer review organization for all the Medicare beneficiaries on their inpatient and outpatient health records. Due to willingly working crazy hours to catch up a backlog with the state, I was given my first role as a manager. Being a utilization review manager, I managed the staff doing pre-certifications, concurrent reviews and retrospective reviews. I was flat out horrible as a first-time manager and it's a wonder that I remained in management. I was extremely fortunate that our nursing director cared enough to inform me of the mistakes I was making and mentored me during this time. Journey to today... In this role, I also had the responsibility to recruit Georgia physicians to GMCF's peer review group. While I was recruiting Earl Kolb, MD, for one of our peer reviewers, he turned around and recruited me to help him implement software he was working on for Crawford & Company's corporate office in Atlanta. I entered into the corporate world where I remained for over ten years and began my transition into entrepreneurship. Crawford had an amazing training department. What I learned served me well throughout the remainder of my career. The training was a week long, and besides learning the structure of the company, we learned time management and goal setting. It was a very exciting time and when I first starting working with programmers. It was still a ways to go before hiring my own programmer group in the future, but the path was opened with the role of product manager. Basically, the software was a medical bill auditing program that accurately priced claims to the workers' compensation fee schedules. The software edited out about 20% of medical bills that appeared to be fraudulent, and those bills were reviewed by nurses to ensure accurate payment. Crawford's claims processors would no longer have to flip through volumes of paper-based documents. This is a great example of intrapreneurship: creating a completely new revenue stream within a corporation. I worked with nurses showing them how to use the software in four offices around the country which were producing a revenue of several million dollars. Segway a couple of years later and it dawned on me that I could earn a six-figure income going out on my own. When I informed the VP of the health care division of my plans to resign and to start my own business, he asked me to hold off for a couple of weeks. He was good at securing funding and asked that I join him in creating a new entity, General Care Review. We provided medical bill review services to the Property and Casualty industry. In three years we had over 14 offices around the country, a couple of hundred employees, and 24 million dollars in revenue. This was an exciting time and I found out the next new thing, I loved growing businesses. We ended up merging with General Rehabilitation Services into Genex where I was the VP of medical bill review operations. After five years and now part of a very large organization, I started to feel it was not the right fit for me. And by this point, I wasn't afraid of trying something new. I was being heavily recruited at the time by major executive recruiters. One of the offers I received was from a programmer that I had worked with in the past that co-owned a software company in California. He really wanted me to come out there and run their company, and position it for a future acquisition. So many times during my career, I have been asked: "How does a nurse end up being the president of a multi-million dollar software company?" "How does a nurse end up in boardrooms across the country with Fortune 500 clients?" Very clearly, it was an evolution, not a leap for me. I was a nurse that had a solid foundation in nursing. I was able to synthesize my healthcare background with IT knowledge (programmers) to impart useful information for decision-making. I have a knack for problem-solving and ability to define and manage the processes, programs and projects. I used two nursing constructs in every business setting; the nursing process and Maslow's Hierarchy of Needs. The nursing process for getting the right things done, and Maslow's for getting the right things done in the right order. After substantially growing the company's revenue and succeeding in its being acquired, I decided to resign. Not long afterwards in 2001, I was recently married and the world experienced September 11th. Reflecting on what was really important, I knew being around family was what I valued most and I asked my husband if he would be willing to move across the country so I could be near my extended family. He was a Californian and I knew it was a big ask, but we had another reason soon afterwards which was being pregnant with our daughter. I knew that while I had a great deal of autonomy in executive roles in the corporate setting, I still never was my own boss. So we began discussing starting our own business. I always loved taking care of the elderly patients, and I remembered how much I enjoyed hearing their stories. We knew this was a market that needed services, so we became franchise owners of a Comfort Keepers in the Youngstown Ohio area near my family. For several years we grew our business, a business that allowed us the freedom of being with our daughter and working around our lifestyle. We sold that business in 2010 and when our daughter was ready to start school we moved back west. In 2011, writing a book had always been on my bucket list. I had three questions mounted on the wall of my office: What could I write that would serve others, who could I serve, and how could I reach more of them? As I mulled this over, I thought to myself "I'm just a nurse that did really well in business" and it dawned on me that I could help nurses by writing about the strategies that I learned that made me successful in business. This grew stronger when I started to research the statistics about the high level of burnout in nursing with more and more nurses feeling unappreciated, overworked, and overwhelmed. Why the NNBA... Unconventional Nurse: Going from Burnout to Bliss, outlined ten steps for nurses to re-invent and advance their careers. Prior to the book being published, we created our website that began with my blog. After the book was published, I added coaching services for nurses because I had been coaching managers, executives, and nurses for many years. I had never heard of the National Nurses in Business Association (NNBA) at the time and I came across it while researching what was out there to help nurses that wanted to start their own business. I discovered that the NNBA started in 1985 and is the forerunner of the nurse entrepreneurship movement. Pat Bemis, the former president of the NNBA asked if I would like to speak at the 2013 annual conference. As a result of that first speaking opportunity, Pat and I remained in contact. In every conversation with Pat, she was always knowledgeable and resourceful. I helped make a few suggestions for growing the NNBA and was taken by surprise a few months later when Pat told me she thought I was the person that should take the helm. Keeping up with the changes in nursing... Since 2014, we have run the NNBA which is dedicated to encouraging nurse entrepreneurs and intrapreneurs to start, grow, and manage their own business, finding nurse opportunities locally and nationally, and providing the educational and networking arena for nurses in business. We continue to see membership and participation in our annual educational conference grow. Not only is it an honor to work with such amazing and creative nurses from around the country, but I am continually inspired by the variety of ways nurses are using their knowledge and experience in business. Nurses are creating services, products, and programs to serve needs in the healthcare marketplace. In fact, in our shark tank competition, we have several nurses that have created products to serve a niche in elder care, oncology, nursing, and education. Nurses have tremendous subject matter expertise and can learn ways to monetize that valuable asset. We have nurses that are nationally acclaimed speakers, authors, and bloggers. In 1985 the NNBA started as a grassroots organization, a handful of nurses that wanted to provide information for business minded nurses and a forum for them to connect and share information. NNBA's impact and influence have not only resulted in thousands of nurses starting and expanding their business, we are also seeing more nursing colleges and universities adding entrepreneurship programs. Nurse entrepreneurship is rising, mainly because it allows nurses the freedom, flexibility, and financial control to fully express their potential. When I've spoken on why nurses need a plan B, it is because of the volatility in the healthcare marketplace. Keeping current with legislative, technologic and socio-economic changes can be daunting. For example, patient care is moving out of the acute care setting and into population health settings. Many rural hospitals have closed. Metro hospitals continue to be acquired forming large corporations and many jobs are being consolidated resulting in positions being eliminated. Mega disruptors are entering the healthcare space, such as Amazon and Berkshire Hathaway. So, nurses can protect the longevity of their careers by creating additional income streams for increased financial security. Tips for nurses that are thinking of stepping out and following their dreams... Some nurses dip a toe in the water and others jump right in. As you can see, I didn't jump into entrepreneurship. It became a path that was gradually illuminated through having new experiences in different work settings. It was trying career alternatives before going all in. Jim Rohn, widely regarded as one of the most influential thinkers of our time, and mentor to Tony Robbins said, "Formal education will make you a living; self-education will make you a fortune". With that in mind here are some tips if you are thinking of stepping out. Try new things, you don't know what you don't know. Find, mentors, coaches, and role models to decrease your learning curve and not re-invent the wheel. Learn time management and goal setting to become more productive. Improve communication skills such as writing, speaking, and presenting. Look for opportunities right where you are now to sharpen these skills. Take the time for yourself to clarify what it is you really desire for your life and work. Contribute to your nursing community; all nurses voices are needed to improve the delivery of healthcare and the lives of individuals locally, nationally and globally. I remain a case management consultant for corporate clients, write for various publications and courses, speak, and am interviewed on empowerment of nurses through entrepreneurship. I have the distinct pleasure to serve my nursing colleagues as the president of the NNBA. Every day I am grateful for my nursing education and the tremendous array of opportunities it has provided. Since 1985, the NNBA had helped thousands of nurses launch successful businesses. Each fall, the NNBA has an annual educational conference on nurse entrepreneurship & career alternatives. Try something new and join us next month in Las Vegas, Nevada. Learn more at nursesbusiness.com.
  8. Meet Theresa Puckett If you do a Google search for "nurse fired for being sick" you will be inundated with articles about Theresa Puckett, PhD, RN, CRCP, CNE, a nurse from Northeast Ohio who found herself terminated after a legitimate bout of the Flu during one of the worst Flu seasons our country has seen. According to an article in Becker's Hospital Review, Theresa worked as a PRN Nurse at University Hospitals, based in Cleveland. She called in sick one day at the end of December 2017 with flu symptoms. Theresa visited a physician and tested positive for the flu virus. She was treated with Tamiflu and ended up missing two days of work. Her physician provided a note excusing her from work for these days. She returned to work a few days later and was instructed by a supervisor to leave early due to continued illness. The next day, she saw a Nurse Practitioner who diagnosed her with a sinus infection and provided her with another note stating she should not return to work for a few more days. However, returning to work was never an option for Nurse Puckett because she was terminated. You may be thinking - How does that happen? According to the University Hospitals statement to Becker's Hospital Review, they allow six unscheduled absences for full and part-time staff within a 12 month period, and nine absences may result in termination. For "as needed" or PRN staff, two occurrences of unscheduled absences within a 60-day period may result in termination. Because Theresa returned to work for one shift in between her two absences, this counted as two occurrences and qualified her for termination. Presentism versus Absenteeism If you have ever gone to work sick, raise your hand. As hands of nurses around the world are raised high, let's discuss the reasons we've all done it. To really understand both sides of the issue, you need to understand the difference between absenteeism and presenteeism. Absenteeism is the practice of staying home from work or school when you are ill. Of course, there are other reasons people call off, but for this article, we are only exploring this issue concerning illness. So, what's the opposite of absenteeism? Presenteeism - the act of going to work when you are ill. Nurses have high standards for themselves and the care they provide to patients, even when they are ill. A 2000 study by Aronsson, et al. reported that rates of presenteeism were highest among nurses and teachers. But, we know that presenteeism may result in adverse patient outcomes, poor nurse health, and cost consequences. So, why is it so difficult to take a sick day? Let's consider a few of the most important factors when deciding which side of the issue you support. The Team Needs You Your throat is on fire, your head feels like a giant elephant is jumping on it and crawling back into bed sounds like the best possible plan - but, you know your teammates need you. You don't want to let others down. Staffing on many units is kept to a minimum so even one call off could cause your co-workers to take on larger assignments, be in unsafe situations, or be upset with you for calling off. A February 2018 article by News 5 Cleveland quoted one nurse as saying "Nurses are often commended for coming into work sick, so they don't put their comrades at a disservice for being understaffed." It seems the issues of teamwork, loyalty, and service is a double-edged sword on nursing units. Patients Need You Nurses spend more time with patients than any other healthcare professional. You recognize minor changes in assessments and notify physicians. Yes, the doctors diagnose and order new treatments, but it's the nurses who carry out these orders that are often life-saving treatments. A 2015 study published in JAMA Pediatrics explored the reasons physicians and advanced practice nurses work while ill. While 95% of the respondents believed working while sick put patients at risk, 83% reported working at least one time in the prior year while sick, and 9% reported working while ill at least 5 times. Symptoms reported in this study included fever, diarrhea and acute onset of respiratory symptoms. 92.5% of these clinicians cited not wanting to let patients down as one of the reasons they headed to work with these signs of illness. So, as you lie in bed contemplating calling in - that's what runs through your mind, right? Without you - who will care for your patients? And, what if you are not the only one with this dreaded illness? So, off to work you go. Sick Time Policies Are sick time policies created to protect or punish you? This is a hard question to answer. And, it often leaves nurses faced with difficult decisions that end in absenteeism or presenteeism. Let's explore a few sick time policy practices. Forfeiting Pay Some call-off policies will withhold pay from nurses if you call off at specific times. This might mean that calling off the day before a holiday will result in forfeiture of holiday pay. Or, if you call off on your last scheduled day before a planned vacation or on your first scheduled day after a planned vacation - you forfeit vacation pay. In a world where many people live paycheck to paycheck, this policy might result in nurses putting themselves and their patients at risk to keep pay that many would argue is rightfully yours. You can't plan illness, so if you are sick around these specific time points, what are you to do? Unexcused Absences Most policies give a number of 'unexcused" absences allowed over a period of time, such as 12 months. Typically after missing this number of days, you will be reprimanded. You may also be given a specific amount of time, such as the remainder of the year or 90 days, in which you must not miss any more work. Of course, if you end up legitimately ill during this time, you are probably going to go to work or risk disciplinary action. No Sick Pay Nurses who work a limited number of hours per week or PRN often have no sick time. This leaves you making financial decisions in the face of illness. Or, your policy may require you to use vacation time before using sick pay. This may seem counterintuitive given the fact that nurse burnout and fatigue runs rampant on many nursing units and days off are necessary. Physician Notes Some sick policies require a physician's note for any unplanned absences. Others might state that no MD note is necessary because all unscheduled absences are unapproved. Or, you may also find policies that require a doctor's note after a certain number of days, which may be due to the Family Medical Leave Act. No matter what your policy reads in regards to doctors notes, you need to understand it before you need to use it. Be sure to get notes when they are required to remain compliant with your facilities policies. Termination Almost all sick policies will lead to termination as an end result. And, when such procedures are executed the same across the board, most nurses find these policies to be acceptable. However, when these policies are not carried out consistently, you may feel that they are being used against you or other staff on your unit to force your hand at finding a new job. Some of the allnurses team met Theresa at the NursesTakeDC rally earlier this year. Nurse Beth was able to interview Theresa and learn more about her ordeal. Thank you for sharing with us, Theresa. What are Your Thoughts? So, where does all of this leave you? Do you stay home when ill or head to work in an attempt to avoid discipline, even when you know it is not best for you or your patients? Now it's time for you to decide. Tell us your thoughts and experiences with nurse absenteeism, presenteeism, and termination.
  9. In my current job, I have my own group of 6 and am charge of up to 30 patients on the unit, and one of my coworkers is always behind, so I feel like I have at least 8 patients of my own every shift I work...plus all of the other issues that arise. I never get a lunch, and am just burnt out in this position. I'm holding out for a 5 day/week charge position without patients (most days) on the same unit, but it could be a few more months (The nurse in it now is definitely leaving it once a 3 day/week position opens). We are budgeted for 2 free charge nurses during the week, and it happens most days, but there is always at least 1 free charge. I miss my husband, as we only get from 5:30-9:30 during the week so we can pretty much eat and run an errand since all the baby friendly fun stuff is closed. I get home about 8:30 the weekends I work, so I don't see the baby and I barely see him all weekend. I like being home with the baby, but we have an affordable sitter lined up as soon as I make the switch. But now a school nurse position opened up near me, but in a better school district than we're in, so the baby could attend in that district when the time comes...but going from med/surg to school nursing is intimidating (am I qualified??) and would be a pay cut (like a $10,000 pay cut!). But I'd be off every weekend and extended time for holidays. The start date is in like 12 days so if I was hired, so I'd probably have to work the next month straight (no days off) to work out my 4 week notice for my current job to stay re-hireable. I would feel guilty about leaving my unit though because I've been here for 4 years...plus, my manager gave me an award last year, and also the top award for nurses at the hospital this year for a job well done. The school nurse position would alleviate the eventual stress of finding someone to watch the kid on school breaks though because I would be off, but school for her isn't for another 4 years and the husband thinks I'm crazy for worrying about that now haha (and that means less money we'd have to pay for childcare during those times off). I'm determined to get off weekends to enjoy my marriage and husband more...but do I hold out for the position on my unit, or go for the school nurse position and take a pay cut?? The husband says as long as I'm happy we can make it work financially, as long as it's not more than a $10,000 pay cut. But I really don't know if it will make me happier?? Plus just because I apply doesn't mean I will get the position...I'm just nervous even applying to a job outside of a hospital, especially with a pay cut. Dear Wants to be With my Family More, The school nurse job sounds perfect for you. You will have family-friendly hours, weekends and holidays off...and your little one will be in a better school district as a bonus! It's natural to feel nervous when thinking about a new job, but I have a hunch you will be winning awards and recognition in no time as a school nurse, because it's who you are. I'm not sure why you feel you have to give 4 weeks notice, the standard for non-executive positions is two weeks. Working one month straight with no days off is really not a good choice, please reconsider that. Likewise, there is no basis for feeling guilty, you aren't doing anything wrong. If you have a supportive manager, he/she will be glad for you if you land the new job. Please let us know if you decide to go for it, and good luck!
  10. angeloublue22

    What are you doing?

    I got the urge to write this after our new nurse just had her first shift and she group-texted us to see if anyone could call her so she could ask questions, and the entire team said they were ready. It warmed my heart that we were all so willing to jump in and help our fellow nurse. We talked about it later and she said how grateful she was to be part of a truly supportive group of nurses because she knows it's not like that in many places. We had a conversation about why it might be a rare occurrence in nursing because isn't she the one that is taking shifts so we don't have to, and don't other nurses want someone competent to do the job? What a concept! In nursing school, we did have some discussion about dealing with the pitfalls of being the newbie nurse on the job, whether experienced and brand spanking new. I never understood why this was an issue. I mean, wouldn't we want to be supportive and train our colleagues well. That newbie could be the one that saves your butt when you are drowning and thanks to you, has the ability to do so. They could be that nurse that takes your shifts when you need a much-deserved vacation, and you don't have worry about the care they will deliver because he/she was trained well and is confident in their skills. They can prevent you from getting burnt out and hating your job. I have 8 years of nursing under my belt. I've been a caregiver, LPN, RN, charge nurse, lead nurse, and nurse supervisor. In all of my jobs, I've ended up being the main preceptor/mentor. Why, because I love it. I love training the new generation of nurses. I've had a couple of wonderful mentors and I wanted to be that for others. You would be amazed at how much even little interactions can affect a new nurse. Give them some easy way to remember something and they may remember it for the rest of their career and pass it onto to others. We are essentially creating those nurses we want to work with while creating a long-lasting supportive nurse culture, which is why I find it so puzzling that bullying is so prevalent in nursing and in medical teams in general. A negative nurse culture can have long-lasting effects on the entire medical system. The way a nurse was trained or exposed to said culture can affect everyone else he/she interacts with. For instance, if a nurse was not supported at first, they can be unduly stressed, leading to burnout and "whoops we just lost another one", they can become negative about nursing and perpetuate the bullying themselves, and pass that onto the next generation of new nurses, going round and round until we have a larger culture of negativity. This can affect not only the entire medical team but can dangerously affect our patients as well. This culture is not conducive to stable, knowledgeable, and supportive nurses. I experienced these issues firsthand from multiple nurses, and it actually took a lot of work on my part not to become a negative person. When I asked for some pointers from my seasoned nurses, I was treated like I was stupid or threatened with "well, you better figure it out or you're not going to make it." There wasn't much training going on, it felt more like a trial by fire. It made me feel unsupported, stressed, and scared to be on my own knowing that I would have no one to turn to. This was on my first-week training. This was also a place where nurses got into screaming matches, no one helped each other, and everyone was in a battle to write each other up. I was treated better when I worked at a pizza restaurant. I finally decided that I wouldn't let it get me down and instead of dwelling on the negativity I had an innate drive to change it for other nurses, even if it's only in my little neck of the woods. I quit that job and others that had the same culture while trying to remain a positive force wherever I worked. Finally, I had an opportunity to start my own nurse team at a brand new facility. I made it my mission to be that positive, supportive, patient nurse that other nurses would want to learn from, and hopefully pass on to those they train. Then, to my not so surprise, I was able to build a great nursing team, full of happy, competent, solid nurses. You know, the nurses you want to work with. We also have great supportive providers and support staff because, just like negativity is contagious, so is positivity. I want to hear from you. Please tell us what you are doing to make the next and current generation of nurses better?
  11. So I'm a junior in high school, and it's my dream to become a nurse. I want to pursue this career because I love helping people, I love seeing smiles on people's faces, I want to make a direct impact on patient's lives by being there for them, and as self-entitled as this sounds, I think I would make a really good nurse. There are a huge number of problems though... 1. My family is against me pursuing nursing My dad believes that nursing is for people who can't make it to med school, and he said that nurses are equivalent to mechanics is nursing is an "unskilled job," which is so not true! He said in India (where my parents come from) nursing is not considered an honorable career. He thinks I'd be better off in sales/marketing because I am a social person who can talk to anybody and I am really good at selling stuff. My mom has a friend who is a nurse and my mom said that she has to clean poop, so nursing is not fun. I am aware of the difficulties that nurses have to endure, yet I still want to pursue this. They both say that nurses don't earn enough, especially in the SF Bay Area where we live and everything is so expensive. However, I am a frugal person who does not plan on having kids so I think I can make it work. As long as I am making a decent salary, money is not an issue for me. 2. My dad keeps trying to convince me to go into either medicine, dentistry, or business. I can't do dentistry because I do not have the best teeth and I don't have the best oral hygiene practices myself, (I can't even floss!) so how would I be a dentist? I used to want to be an M.D, but after my internet research, I have decided that I would rather be a nurse because of the direct patient contact and care versus the diagnosing. And quite frankly, I have no interest in economics or business. 3. Nursing school in CA is INSANELY competitive I'm not going to sugarcoat it; I'm just not a good student. I immensely screwed (due to sheer laziness)up my freshman and sophomore year, earning GPA's in the 2.7-3.0 range. However, I shaped up my junior year and received a 3.5. I know that's not extraordinary by any means, however next semester is coming up next week and I plan to obtain a 4.0. I received a C in biology my freshman year because I gave up due to my bad attitude, but I plan to take AP Biology my senior year and obviously study very hard, so that I can be prepared. I also received a B and a C in chemistry last year, due to laziness. However, I plan to take Intro to Chem I at the community college this year, since it's a nursing prereq anyway. I know this sounds conceited, but I know I can get an A if I actually study my hardest. Anatomy and Physiology is much, MUCH harder than both bio and chem at my school, yet due to my decent studying habits I obtained an A. However, I'm worried that I won't get into any colleges for nursing due to the B's and C's in bio and chem. I wouldn't mind community college, but my family thinks that it's not a viable option (I disagree!) 4. My parents think this is just a phase and I'm not serious about nursing My mom thinks I won't make it in nursing school due to my lazy study habits in the past, so she said that I have to go through with it. However, I am scared that I just won't make it into nursing school, and then I will lose my family's financial support for college. My mom specifically said that she won't pay for my college if I don't pursue nursing all the way. 5. My mom's friend who was an RN, ADN and now is a professor at CSUEB does not recommend going into nursing. She thinks I won't make it because I'm not aggressive enough and that I'm too nice. She is going to take me with her students to the floor one day so that I can see what the nurses actually do. She said that although nurses make a decent salary and have a lot of flexibility, she did not like it because of the feces and the night shifts. My mom and dad both think that I'm not "rough and tough enough' to make it, this discourages me However there are some good aspects concerning me... ✅ I start volunteering at a nursing home near my house soon! So excited! ✅ I did get an A in Anatomy, which is considered almost as hard as AP Biology at my school. ✅ I am a very patient and caring person which I believe are 2 very important aspects for a nurse. ✅ This is my dream and I am willing to work as hard as it takes. What should I do? How do I convince my parents that I'm serious about nursing? Will I get into any of the colleges as a prenursing/nursing major? What's the stigma behind community college anyway? Thank you, I know this post was extremely long 😁
  12. NurseKymba

    Art of Nursing

    Nurses are old and young, tall and short, skinny and wide. We come from all walks of life. Some choose to enter the nursing profession for job security, others to help those around them. Throughout our schooling, we are taught and tested on the science of nursing. Our primary focus is the ability to recall important facts, to think ahead of the current situation, and to understand interactions between the patient and the interventions we provide. Elusive, yet widely recognized, the art of nursing is our ability to connect with those around us. It is only when we begin direct patient care that we become aware of the art of nursing. The word art can be used to describe the results of a particular task as well as the knowledge and skill required to perform that task. Like other more fashionable art forms, nursing can be dramatic, inspirational, comedic, relaxing, comforting, joyful, and even sad. Nursing is also creative, existential, and has a particular rhythm. This intangible connection can create an environment of healing, one that allows patients to fully participate in their own recovery process. My great-great-aunt Mae was a nurse at the turn of the 19th Century. Seven days a week, she hitched-up her horse and buggy to provide medical care and comfort in her rural community. When the local veterinarian was busy, she would also help care for local horses and cattle. Later, she became a psychiatric nurse, and even later a nurse educator. Nursing allowed her to travel, meet new people, and provide for independence that most women couldn't attain in that time period. For her, nursing meant freedom and the ability to be her own person. My great-aunt Marge became a nurse in the late 1930s. She initially worked in a small country hospital. When World War II erupted, she moved to a bigger city to care for veterans on a medical ward. As she provided these brave men with physical care, she also performed assessments and interventions to help relieve their psychological pain. She felt that her calling at that time was to heal their damaged spirits. Though her career spanned many decades and various nursing specialties, it is this work that brought her the most joy and great professional pride. When I decided on a career in nursing, I knew none of this. I had worked in healthcare settings since I was 15 years old, and always knew I wanted to work in a patient care environment. I readily learned the tasks I needed to perform whatever job I was assigned. But more than that, I could easily connect with my patients on a level deeper than I expected. Patients would open up to me. Even at the tender age of 16, I had elderly patients share their fears of death and dying with me - seeking comfort Nurses teach, support, communicate, medicate, and coordinate patient-care events. Nurses are patient advocates who provide comfort and hope to our patients and their families. The art of nursing is in play when we just 'know' what to do to meet a patient's emotional needs: when to hold a patient's hand, stroke their brow, crack a joke or even just sit and listen. Most of this is being accomplished simultaneously during each patient interaction. The science of nursing allows us to care for our patient's bodies, but it's the art of nursing that calls me to the profession and allows each nurse to touch souls.
  13. vadushkas_nurse

    Tips for Human Nursing

    REALLY LISTEN AND REFLECT, THEN YOU WILL LEARN: First of all I was very fortunate to have the opportunity to complete a grad initiative in acute care. This was an experience where I am paired with staff RN's for six months and in a way be mentored by them. At the time, having a new RN with me every shift was somewhat stressful until I opened my eyes and realized that I was actually very fortunate for this change. Each shift the nurse I was with would start out by saying "I start my shift by..." and it was then that I realized these nurses were sharing with me their best practice and their experience. I finally came to the conclusion that I was lucky to be a recipient of so much knowledge. I then developed my own best practice and nature of nursing from these professionals. TREAT PEOPLE HOW YOU WOULD WANT YOUR FAMILY TREATED: As an ER RN you see a variety of patient populations. This can sometimes be very challenging when you are caring for someone that makes poor lifestyle decisions. In nursing they teach you not to be judgmental and treat everyone equal. But this should be taken one step further. Treat people how you would want a health care professional to treat you or your family. With this in mind, it is easier to remove yourself from your judgments and bias. Every person is human and deserves respect, care and dignity. ITS THERE IF YOU WANT IT TO BE THERE, GOSSIP THAT IS: Gossip seems to coincide with the nursing profession. At least from my experience it seems to be there if you are looking for it or starting it. Each nurse makes a conscious decision when contributing or refuting gossip. Everyone you work with deserves the benefit of the doubt. You never know what someone is dealing with outside of the workplace. So next time, before you start contributing to the gossip train, think twice, maybe that energy is better off somewhere else. EMBRACE THE INTRODUCTION: The first few minutes of meeting your patients are crucial. This interaction sets the tone for how the rest of the shift will go. If you can get eye level with your patient, introduce your self by name and find out what their expectations are things will go smoothly. These first few minutes makes a difference. It shows respect and initiation of rapport with people. It wouldn't hurt to try and proof its effectiveness. DON'T SAY IT: "I'll be back in a minute". This phrase can be a real turn off to patients. A minute to you may feel like a minute. But in reality, it's probably been five or ten minutes. In the meantime, you have probably answered call bells, been interrupted, finished off another task you working on or who knows what, while your patient is still waiting. The truth will go a long way. Let them know you will do what they need as soon as you can. Most patients have a pretty insightful idea to how busy you really are. DO THE LITTLE THINGS: Little things go a long way in the clinical setting. Brushing care, giving back care, warm blankets and tea can really have a positive impact on your patients experience. Time is a commodity for everyone, but these things don't take long and make a world of a difference for those needing some human connection and attention. DO THE BEST YOU CAN: Lack of everything is probably a big concern for all departments. Staff, resources, time, room etc. These are system issues and they are long term issues. It is important that you go to work and do the best that you can. There is no point in going home guilty or feeling upset because you couldn't do this or that. Just always keep in mind, that if you do the best you can with what is available, that is all you can do. Patients appreciate you doing what you can, not complaining about what you can't. LEARN AND USE NAMES: Being able to address people by them is a form of respect. It doesn't take much time, especially if people are wearing name tags, but this one will go a long way in the workplace. EVERYONE MATTERS: Treat all those you work with, with respect. If it weren't for the janitor, lab tech, volunteer, unit clerk, or student the setting wouldn't be what it is. Clinical areas are a place for caring, healing, teaching and respect. It takes a large diverse group of people to care for patients. Everyone plays a role and deserves a smile or helping hand. BE CREATIVE: Textbook interventions may not work for everyone. Clinical settings are full of wonderfully creative scenarios. From call bell set ups, to oxygen placement to gown closures. It really can make a big difference if you find a unconventional but effective way to assist with caring for your patient.
  14. There are several reasons I chose to pursue nursing. I wanted to enter the medical field, and I didn't want the risk of going for med school at my age. 26 when I started back to college. I wanted a career path where I could go back to school at anytime to self actualize. As I learned about nursing LPN programs, ADN, BSN, MSN, and DNP programs I realized it was perfect for me. The many ways to advance my education, and career the more I thought it was perfect. Most importantly I wanted to be on the front lines of the medical field, and nurses are exactly that the front lines. I could break my education into chunks. I could do LPN, and contribute to the medical field. I could become a CNA, and get tuition reimbursement on some level. I could do amazing things pursuing nursing on any level, and most importantly I wouldn't have to stop. I could continue to self actualize every step of my life. The more I learn about science, mathematics, and the future/ specializations nursing offers the more I fall in love with everything that goes along with it. Well maybe except humanities, I want more math and science. I could do LPN, and then LPN to BSN. I could do ADN, and then get a MSN. I could go for a BSN. I could take my time. Get my finances in order. Work then go back to school. Work while in school. All I had to do was give it everything I had. I have loved every moment. The thought of being denied the ability to further my education is the most abhorrent thought I could imagine, but it is always in the back of my mind. I have fallen in love with A and P, Microbiology, algebra, statistics, Gen Chem, and more. I love what I am doing. Part of me wishes I could just sit in a classroom forever, and just learn. Another part of me is so eager to put what I am learning to practice now. I have to remind myself patience is a virtue. I know with nursing the sky is the limit (not monetarily, but self actualizing). I can take my education all the way with a DNP program. Way down the road, and honestly I would be grateful to hold any nursing degree, I am a CNA, and I take great pride in starting from the "bottom". I want more, so much more. I want the knowledge. I have an insatiable desire for it. My goal when I started was to shoot to a MSN as fast as I could. I now realize what an incredible disservice I was doing myself, and the education system. I am now learning the basis for so much to come (I hope), I apply to LPN, ADN, and BSN programs in the fall, and I am so much closer than I even thought myself capable of in the fall. I have learned so much in such a short period of time, and it has left me wanting more. Everything the field I have chosen to pursue has to offer. I want to learn solve problems. I want the knowledge, I want to apply what I am learning. I have so much to learn about all of this, but every step leaves me wanting more. I cannot imagine me doing anything, but science/ applied science. That is what nursing is to me, and that is why I want it so badly. The real difference I could make in my own life, and the lives of others. It means absolutely everything to me. It is quite personal for me. I have experienced disease more than I would care to. The old adage I wouldn't want any of you as my nurses, because I would just as soon not have fallen ill applies to me, but the fact remains I did fall ill. I cannot say I am necessarily grateful to have become ill, but I am glad it lead me here. I would never have considered nursing before I fell ill with a chronic illness, and a lung abscess. Now I wonder what in God's name was wrong with me. Why was I not doing this seven years ago. Where could I be today at 27 if I had started seven years ago? I cannot quantify what science, and medicine has done for me. More than just twice saving my life. It has given me a life to pursue. Something to strive for. Something to stand in awe of. The miraculous power of nature, and modern medicine. I am a living testimony to both, and I am deeply grateful to be here. My life was defined by bitter disappointment, and regret. Letting life's hurdles such as illness get the best of me. Of giving up, of settling for less. Once I decided to puruse something incredibly difficult that was nursing I sprang out of bed each day before class. What pursuing nursing has done for me remains the best decision I ever made regardless if I ever pass the nclex. The pursuit of knowledge that I have found in my classes even in pre-nursing, and in my CNA course has made me a much better person. I can say with pride, I am a CNA, I am striving to go further, and I love life.
  15. traumaRUs

    Nursing Career Adventures

    This article is featured in the Winter 2019 issue of our allnurses Magazine. Download allnurses Magazine Karen K. Wiley, MSN, RN, CEN is the immediate past president of the Emergency Nurses Association (ENA). We recently spoke with her about the changes that have occurred in nursing over the years. Ms Wiley introduced herself: “I have been in nursing for 40 years. My first job was on a 55-bed orthopedic floor where I worked for 8 years. I then worked in various positions including the Intensive Care, Coronary Care Unit and Post Intensive Care. In 1993 I transferred to the emergency department where I worked until December of 2017. I consider myself semi-retired. Currently, I am the 2018 Immediate Past President for the Emergency Nurses Association. My master's degree in nursing was in Nursing Administration.” There are many reasons for choosing nursing as a career. “I chose nursing for a career because it is what I always wanted to do. However, I did not go into nursing until after I was married and had 3 children. When I graduated from high school I did not want to go back to school, at least not right away. I worked in an office.” We have all faced hurdles in nursing too. “My biggest hurdle during my nursing career was working in the emergency department and keeping everyone safe. Patients as well as nurses. Often you work short staffed and you are caring for psychiatric patients and medical patient who remain in the emergency room because there are no beds in the hospital or no staffing on the psychiatric floor.” Nursing continues to change and evolve as our patients become more complex. “The biggest changes that I have seen in the nursing scope of practice include standardized nursing protocols for stroke, chest pain, and sepsis, In addition, we now have Nurse Practitioners, and Physician Assistants.” She went on to discuss that team nursing was the approach to care when she first started in 1978. This consisted of her responsibility of 21 patients along with 2 nursing assistants and 1 RN who cared for the more acute post-operative patient. While working in the emergency department, acuity needed to be considered as the usual workload was 4 patients While that number seems desirable, 4 very ill patients (think diabetic ketoacidosis) are quite labor intensive versus 4 relatively stable patients (think sore throat, well baby checks). Ms Wiley has experienced many changes over the past 40 years. “The changes I have seen in my career that have impacted the profession include computers, (order entry, nurse and physician documentation, medication, any surgical and x-ray reports) The benefit is that nurses and physicians can work in the patient chart at the same time. The negative aspect is when entering the information live, patients do not feel you are talking or listening to them, but the computer. Legal issues have occurred when important information is not documented or the supporting documentation is not there. Another change is 12-hour shifts. Patient satisfaction surveys, and violence in the work setting are others.” Media portrayal of nursing has changed over the years too. It was common to see “physicians defibrillating the patient or doing CPR but now we do defibrillation hands-free. The media also portrays nurse and physicians in a steamy love affair. Our international nurses watch American TV programs and they do not have a very honest view of how we truly practice. The physician and nurse practice as partners in providing care for patients.” She experienced nursing care overseas via an exchange program sponsored by ENA. Ms Wiley visited Norway and Poland and made the following observations: In Poland, EMS has more control of care. It is very unusual for patients to come by themselves to seek care in the ED. This only occurs when a physician has called ahead to inform the ED that the patient is coming. EMS is the usual mode of arrival even though the patients are triaged upon arrival and may still sit in a waiting room. In Norway, she noted that care was very physician-driven and nurses lacked autonomy. However, they are starting nurse practitioners and are working to integrate this into practice. We ended our discussion about how to feel valued at your job. Her words echo many of us; “I feel valued in my job when patients tell me thank you. Also when I walk out the door, I know that I did my best.”
  16. corne

    Reasons to be a Nurse

    Some people where forced by their parents to become nurses because it's an opportunity to go to countries like UK, Canada, and USA. Some people see it as a profession to earn a lot. I don't know the statistics, but there are people who really want to become a nurse because they have a genuine love and passion to take care of sick people. Whatever reason we may have why we became a nurse, we must keep in mind that this is a vocation and not only a profession. If you're forced into Nursing, don't make it as an excuse to give less quality care to your patients. It's not their fault if you're a nurse, you alone made that choice whether you were forced or not. Being a nurse must come from the heart. Patients can see right through you if you're really concerned, or just doing your job because of the pay. When you really care, other people will feel the warmth and love that goes with it. You might not expect it but the care you give can change a patient's life. I can still remember the time when I was hospitalized because of typhoid fever, I was just 16 then. I was depressed because I was absent for 2 weeks and classes for my last year in high school was just beginning. Missing a lot in school was stressful for me, and not having control over the situation made it more difficult for me. There was this nursing student who was taking my vital signs for several days. In that period, she never even said "hello" or gave me a smile. It was that time that I said to myself "I will never be like her". So when the time came that I was the nursing student, I made sure that every patient I deal with will feel my sincerity. I ask how they feel, listen to their concerns, and I never forget to smile. You know what, everything I did paid off. A patient told me that I was the best nurse she had, and I was only in third year in Nursing at that time. Nursing should be a profession that you really can commit to and not only see it as an opportunity to get big bucks. The monetary gain should be just an incentive, and not your primary concern. When you take care of patients just for the dollars, then you will get tired easily, burn-out, stressed, and will not find contentment in what you do. But if you take care of patients because they need you and you want to help, at the end of the day you will go home with a smile on your face because you have taken good care of someone. I'm not saying that our work as a nurse is not stressful, but you can alleviate that if you love your work and not see it as a daily routine or task. Your patients' smile, 'thank you', and to the extent of friendship can be most rewarding for a nurse. You may never know that you are already touching a person's life. So, love your profession as a nurse, take it as a vocation, do your work with sincerity, and have passion in taking care of your patients.
  17. Nurse_Advocate

    Fight Nursing Stress Through Inspiration

    In other words, as nurses, we see the terrible effects of disease on the human body and the human spirit. And sometimes it's easy to slip into focusing only on the negative. But if you do that, then you're at risk of becoming bitter and resentful and missing out on a priceless opportunity to see the triumphant human will at its best. There are always going to be those patients that have embraced their illness like it's their best friend...the ones that know that their hospitalization is sort of like a free pass to getting as many narcotics and other drugs as possible. They are the patients who carefully calculate when their next dose of Benedryl and Dilaudid are due and then asked you to post it on the dry erase board in their room so they don't forget when to call you. Patient like these can make nurses skeptical and hardened. Remember, the nurse was taught in nursing school that the patient's perception of pain is always right...but these types of patients just seem to cause her busy work through their selfish manipulation of her time. Slowly, if she doesn't watch herself closely, the nurse can sink into the feeling that all she's doing is catering to a population who represents the worst of human will. Instead, the nurse must look around her environment and really take in all the victories on display. The nurse needs to recognize the glorious human spirit embodied in the other patients she takes care of who is truly in the hospital to heal or to make peace with their diagnosis and somehow make the best of it. Let these patients be your teachers! They may come in the form of your 78-year-old patient with a new colostomy and a new terminal diagnosis of ovarian cancer. See how she gracefully pushes her IV pole through the hallway, smiling and making kind small talk with the staff. Notice it when she later requests a chair to be set up near the picturesque window down the hall so that she can do some free-hand painting. Watch as she sits there near the window in all her glory as she treasures the here and now. Listen to her as she explains, "I told the doctor that I don't want chemo. I'm 78-years-old. My quality of life is more important to me than trying to squeak out a couple more years with chemo. I know what I want. I want to travel a little more and do my painting. I love to paint and if I can do that I will be happy." Instead of wanting her perception to be dulled and drugged, she demands that her full faculties are present and available to her so that she can "catch the light just right" as reflected in her painting. One glance at her artwork and you'll know she is your teacher and you are her student. Although she's only seven days post-op, she denies any pain and requests no pain medication whatsoever. She's not there to use the system and ultimately lose part of her dignity...she's there to recover and then go home where she can cherish each moment of the rest of her life with her dignity INTACT. This is the human will at its best. This is the combination of courage and self-respect that we, as nurses, have the privilege of witnessing. We are the chosen spectators. We get to see the splendor of human will at its best as it embraces life and richly appreciates what time it is left. As nurses, we have a choice of which patients we learn from. Will we learn from the patients who are teaching us about the dark side of the human will? Or will we learn from the patients who are teaching us about the victorious side of the human will? Ask yourself which patients will I remember? And Why do I remember them...what did they teach me about the human will? How did they inspire me and what will I do with that inspiration in their honor... Recognize that behind all the stress of bedside nursing is an opportunity to get a glimpse at human will as it triumphs over adversity with dignity intact. Take a moment to realize that you chose to be out there for a reason. You are an honored guest in the theater of the unsung hero.
  18. If you've only watched Captain Corelli's Mandolin, please do not continue to read this. The movie hardly captures the vivacious, relentless, and jocular spirits of the characters and their stories. However if you have read it, then you understand and hopefully empathize with my deep admiration of the characters, particularly Dr. Iannis and his daughter, Pelagia. Throughout the saga, their interactions, values, and experiences interwove with my own, building the basis for my aspiration to become a nurse. It's in these two characters I am able to envision my reasoning for wanting to dive into the medical field and major in nursing. The greatest relation, I discovered, was between Dr. Iannis' and my love of learning. Pragmatic or trivial, I enjoy expanding in knowledge, under the obscure assumption that eventually, that bit of knowledge will come in handy. In this way they are my tools for success, just as they are the tools for Dr. Iannis' success. As an autodidact, his whole career is based off his passion, as I parallel my major in nursing to be for me. In studying the sciences and other critical thinking courses, I will hope to build a foundation for a lifetime activity of learning. Dr. Iannis says," Every man needs an obsession in order to enjoy life, and it was so much the better if that obsession was constructive." In a vast and continually changing field, keeping updated with the new medical advances and discoveries, as well as using my already acquired knowledge to build on, I will, like Dr. Iannis, be living a life of learning. Also, displayed by the characters is the lack of expiration in the usefulness of their knowledge. Nursing and anything in the field medically, for the most part, has a lifetime warranty, given said person keeps their certifications up to date; they are professions that will continuously be in use because of the overwhelming and augmenting need for them. While Dr. Iannis lives off of his doctoral career, the reader sees Pelagia sustain herself off of her learned knowledge, as well. Her need in the community never ceases and in that field, she is able to sustain her and her unwonted family. In studying nursing, I am hoping to build the basis of knowledge that will last me a lifetime. The roles both characters hold in their community holds my reverence because as utilities, they also become leaders. As an honorable, respected, and learned man, Dr. Iannis is seen as an authority figure and leader amongst his community, arbitrating arguments, offering wisdom, and keeping acquintances in good standing with eachother. In one particular incident, two neighbors ask for his permission to attack the enemy, indicating his position as higher than the governor and priest. Dr. Iannis is also a role model to Pelagia, as she aspires to follow his path. As the older sister of three, former captain of two sports, avid volunteer, and daughter of an Army Officer, I welcome the responsibility of taking initiative and being an exemplar. Nursing holds a certain prominence because of their essentiality, in a promising position to become role models and leaders in the community. In the nursing career, I hope to be an active member of my community, as Dr. Iannis and Pelagia are. In addition to being a utility to a community, I am fond of the idea I can be in any community to do so; as a nurse, I'd be permitted mobility. Mobility is important, personally, because having lived a military lifestyle, mobility has been the provider of the greatest experiences I've had. Because of its innumerable benefits, such as shaping my character, personality, and perspective fervently, I'd value a career that has the possibility of an itinerant lifestyle. Dr. Iannis' worldliness is attributed to his travels outside of Greece, offering him more open- minded knowledge to impart on Pelagia. By being able to travel as a nurse, I'd be able to develop into a better person and better provider. The greatest image Pelagia and her father have offered me is their ability to fix, heal, and restore friends, family, and those in need. This is the core of my aspirations because the ability to heal is a beautiful responsibility and momentous power. With this healing power, a deafness is (accidently) cured and two loved ones are restored from desperate states. By majoring in nursing, I could help people become a better, more functional version of themselves they otherwise wouldn't have been able to become. I'm excited, eager, and anxious to learn the healing trade of nursing, so one day I will be able to heal as Pelagia and Dr. Iannis do. Nursing is a valuable career and by majoring in nursing I hope to become a member of the nursing community one day. Dr. Iannis says, "Every man needs an obsession in order to enjoy life, and it was so much the better if that obsession was constructive." By dedicating my life to the health and improvement of others, I'd truly be doing, as Dr. Iannis also recommends, "my duty to do my utmost."
  19. vadushkas_nurse

    Learning a Life Lesson, The Hard Way

    I started out full time as a new grad in the ER department and casually on a nephrology unit. The completion of a long time goal was finally there and I was awestruck, contemplating what my next goals would be. I loved the experience, meeting new people and making a difference in people's lives. I felt like I was working so much that I deserved a stretcher in the ER... just for some downtime. Little did I know what life had in store for me or that while I was focusing so much on being a good nurse and doing everything the best I could other areas of my life were being sacrificed. My family life, health, and emotional well being were suffering. I was caught in the midst of a confused circadian rhythm that couldn't figure out if it was night or day. Some nights I would be wide awake at 0400 in the morning, feeling guilty because it seemed like no one else was up at such crazy hours. I learned to use this odd time of the day to fulfill my passion for hope. These hours were great for working on projects and acting as an outlet for creativity. Despite the fulfilling time, I would then go to sleep and sleep the day away. I would wake to phone calls in the morning feeling like a zombie and soon return to sleeping my exhaustion away. Somewhere in my first year as an RN I attended a conference called dealing with difficult people. During this event, I heard something from that conference that never left my mind: "Why is it that people you work with get the best side of you and those most important to you get the not so good side"? I have contemplated this for a very long time. After 8 months of fulltime nursing and living tired, a terrible tragedy overcame my life. The unexpected loss of someone close to me shook my world. The following months were overwhelmed with sadness and unanswerable questions of 'why'. This turning point woke me up from what was self-chosen exhaustion and I learned to take control of my life. I learned that only I held THE POWER of CHOICE and LIFE IS TOO SHORT TO live on regrets. It was after this realization that I put those who were closest to me, FIRST, I decided to work part-time in my position where I had ample opportunity to pick up shifts at my discretion, I joined committees and started focusing on what is important to MY LIFE. Really, I did what needed to be done. I took my life into my control. If you don't do it society or your employer will. It is very challenging to be a good nurse when you don't take care of yourself first. The overall lesson that I learned during the first year of my nursing career is that striving for balance is important, those around you love you and you must care for yourself and for them, there is always a CHOICE (even if it means thinking outside the box).
  20. The clock has struck 9 pm; you realize you haven't taken a single bathroom break in the past 4 hours. The last thing you remember eating is the leftover crumbled muffin from two days ago while on your way to work; that was ten hours ago. As you soon as you think you have a break in sight, two patient call lights go on followed by a doctor calling with roughly five new orders on a patient. The bathroom break will have to wait. This is an all too familiar scenario in the nursing profession. There is a saying in the nursing field; Nursing, the hardest job you will ever love. Skills, knowledge and excellent time management are critical components in being a strong nurse. However, one of the most difficult tasks new nurses are required to have is being mentally prepared for such a challenge. The psychological toll can weigh heavy. So how do you prepare yourself? How can you psychologically prepare for such a seemingly difficult task? The first step is digging deep within you and finding that confidence. It is in there, it is what got you through endless hours in nursing school. It is what you had you when you sat down to take your nursing boards. It is within you. You will have to dig deep and conjure it up, but it is there; I promise you. One important thing to know is that not a single nurse, no matter long she/he has been in this field knows everything. It is just impossible. Be confident in what you DO KNOW! If you feel it isn't much at all, that is okay. Hold strong to what you are confident in and build from that. Patients rely on us; they sometimes think we have all the answers. Be okay with knowing we don't. But do your best to find the answers out! Another beneficial psychological component would be humility. A confident nurse is assertive in her knowledge, but has enough humility to know when to ask for help. I honestly cannot stress enough that no one will know everything. Whether you aced every test in school or not it is the application in the field that is an entirely different process. People are different, their bodies, their minds, everything is different. No one can know it all. Having humility can only help you as a nurse grow and learn. Step back and look at a situation and tell yourself, maybe I need some help with this. This will only save you the mental anxiety later as you question yourself over and over on the drive home, did I assess that patient correctly? If you were able to ask other nurses their input, or even the aides their observations, it can only benefit you and the patient. A sense of humor will also save you long hours of beating yourself up over a silly mistake that was maybe just a mere oversight. "There is support in the literature for the role of humor and laughter in other areas, including patient-physician communication, psychological aspects of patient care, medical education, and as a means of reducing stress in medical professionals." (Medscape, Humor in Medicine, 2003) If you can't laugh or enjoy the moment you are in, the passion and fire you have for being a nurse will eventually die out. You will drive yourself down to the point of burn out. Everything will seem like a daunting task. Laugh, smile and remember that a smile can go far. Our patients are already stressed and nervous from whatever ailment they have, a smile will go a long way. Sometimes our patients have nothing medically left we can do for them, but a smile, or holding a hand is the best medicine we have. Remember that old saying, Patience is a Virtue. Notice the difference of patience and patients. As a nurse, you have to have patience in yourself, and your patient. Be prepared for your patient to not always understand their directions or care plans. If it takes five times to explain it, then explain it once more just to make sure they are fully aware of their directions. High patient outcomes are the goals of nurses, so it is critical we are patient with them. It will also only benefit you psychologically if you are mentally prepared to accept not everyone will learn or understand at the same rate. If you are going over and over your mind about what is due or what is next you may let this moment slip by. You need to be able to give your patient your best undivided attention. Be patient with yourself in learning. Be patient with your supervisors, your doctors and your aides. Everyone is going to work at different paces, or have a different way of doing something. Don't stress yourself out trying to change them or modify their approaches. When you grasp patience, you will have a peace within in yourself. To be psychologically prepared for the nursing profession I cannot emphasize one critical component: compassion. Compassion is what drives us in our endeavors. It is the vow you took at graduation. Remember the nursing pledge, ".....With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care." (Lystra Gretter, 1893) Your compassion will take you to a level of care that only a nurse can provide. Compassion will guide you in achieving humility, patience, and even a sense of humor. Holding that compassion will guide you in your bedside care with patients, it will give you the drive to do the best possible care for those you are responsible for. If will keep you focused on the patient and their needs and not your personal desires and beliefs which can often blind many nurses. As a nurse your skills and knowledge will you get you far. But if you are not psychologically prepared, no matter how well you have intellectually prepared yourself there is a little chance of success without a healthy mind, a compassionate heart and desire to make a difference. Keep your mind straight, your confidence strong, your smile bright and your heart open. Go forward and remember; People will forget what you said, People will forget what you did, But people will never forget how you made them feel. (Maya Angelou, 1989) References With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.” (Lystra Gretter, 1893)
  21. gemini_star

    Overcoming Clumsiness

    Commonly Asked Questions How can you become a nurse when you often break the glass? Where is your presence of mind?! Are you sure you can do it without tripping or breaking? Clumsiness, an issue that I have considered as a hindrance in pursuing nursing. Yes, I was once a victim of clumsiness. The most painful part was if the above questions were the same words coming from someone dear to you. With strong desire and confidence, I knew I had to make a major decision. It was not only the glasses, but also the plates, spoon, fork, platter, almost any breakables that I can get hold of consistently get broken. It will accidentally fell on the floor or I would wonderfully trip over. Indeed, it was all act of clumsiness. So I asked myself, how I can truly be a nurse when literally everything falls apart? Up to date, the clumsy person that others knew of is not so clumsy anymore. As nursing school passes by, merely 5 semesters of learning nursing skills, I was not aware that I grew out of clumsiness until for quite sometime now. There are some things that I have learned but not really considered that it would really help me a lot. Hence, I would like to share some tips for those who are in doubt of pursuing or continuing nursing just because of being clumsy. Yes, A Clumsy Person Can Become A Nurse Get a grasp of it. When holding an object, whether a medicine bottle or a thermometer, hold it very well. Take control of what you are holding. Control your thoughts by thinking positive. Clumsiness is all in the mind. If you are receptive of this idea that you are clumsy, then you will. It is all in the thinking process, if you are doing something that involve breakables, think that you will not drop it; think that you will get it done without breaking it and last but not the least think that you are not clumsy. Always think positive! Presence of mind. Look around the environment, the people around you and the path you are walking in to. This is one thing that I was very poor at because I cared less of the people and the things around me which is a bad habit. It may take a while to overcome this and takes a lot of practice. Know what you are doing. In each nursing procedure, every step has a rationale Try practicing before doing it. It will prevent mistakes and lessens the anxiety. Do not skip thoughts or think of more advance thoughts. This is also one bad habit of mine. I usually think of advance steps in the process without paying any attention of what I am actually doing at the moment. For example, while in the act of injecting, do not think of massaging the muscle for this will only distract you. A great deal of attention is important in what you are doing. Think of the next step before finishing or after you have finished a certain step. You can learn thinking in advance when you have overcome clumsiness first. Correcting clumsiness is not a one day process. It will take ample of practice, time, and knowledge of what you are doing and about to do. Organization of thoughts and presence of mind are essential tool. Do not force but give time to learn ways to overcome clumsiness. I believe the tips above may vary from one person to another. You can also add what have worked for you based on your experience.
  22. "The schedule is posted," my friend told me. Her tone indicated that she was not happy about it. When the holidays roll around, special events multiply as family, friends and co-workers gather. Admittedly, it is a difficult time to be at work, feeling that we might be missing out. We look around and see others with jobs that are less demanding during the end of the year rush and we find ourselves doing some wishful thinking or struggling with a serious case of job envy. How can we not just survive working the holidays but also thrive? What can we do to keep from becoming the complaining Grinch that steals the joy of the season from ourselves and others? How can we take the very best care of our patients even when it's not convenient for us personally? Here are some considerations: Attitude matters Every day we have a choice about how we will proceed and how we will view the events of the day. We don't get to control the events themselves, but we do control our reactions to them. When it comes to working on a day when we would strongly prefer to be off, we get to decide how to view that and whether to start out with a positive or negative perspective. This does that mean we have to be that annoyingly cheerful person who sometimes seems a little out of touch with the reality around them, but being Debbie Downer never gains us friends or the admiration of others-even ourselves! Making a conscious decision not to complain can be helpful because it is a decision that can give us the boost we need to get through a tough working schedule. See the opportunities While is it never fun to be the one working on a holiday, it can also be a time when new perspectives open up. It may be a time for you to step up in leadership, to showcase your ability to stay upbeat on a difficult day, and to build team morale. Many times, holidays come with extra pay, a perk that makes the pain of being on duty less acute. Being understanding of leadership and their responsibilities can be a help to the entire work place. As part of the team, we simply do not know everything. We cannot know why we have to work when so-and-so "got the last holiday off, too." Sometimes it happens that way and because of confidentiality issues, we are not part of all that is behind the scenes in the decision making process. Allowing others the benefit of the doubt can take us from a place of bondage to resentment and anger and move us toward a brighter, lighter space where we are free to do the good job we know that we can. Count the good stuff Life is hard, and we all have problems, but it is almost always possible to find someone else who has troubles too, and often they are worse than our own. The fact is, if we are working, then we are not the patient! Being the one in the bed has to be harder than being in a caregiving position. Lee Iacocca once said, "The thing that lies at the foundation of positive change, the way I see it, is service to a fellow human being." Sometimes it is hard to look at the brighter side of things, but this is another area where we can improve with practice. Finding a way to count our blessings puts the brightness and energy back in our work and in our celebrations. Plan alternative celebrations We have friends that always celebrate Thanksgiving on the day after the official holiday. They contend that it makes it easier for everyone to gather and that the designation of a particular date is not that important to them. When they told me about their custom, I was surprised but quickly saw the profound wisdom of it all. Being willing to get together on an alternate day shows a great deal of selflessness and highlights what many holidays are all about -celebrating what is the best in all of us. While missing out on some the customary events of the holidays is definitely hard, work commitments can lead to creative changes that turn out to be keepers and turn into welcome traditions. Professionalism shines when we put our patients first It is during our times of greatest stress and disappointment that our professionalism as nurses has an chance to shine. It's never easy to put our best foot forward when we are not feeling it, but it is the hallmark of a true professional-being able to put our own wants and needs aside-at least during our shift-for the good of our patient. A professional nurse leaves the commentaries and complaints at home, caring for their patients to the very best of their ability, no matter what the day. What helps you to find joy and contentment even when you have to work on a holiday? What suggestions do you have for other nurses as they face these challenges?
  23. ........A little effort can go a long, long way. Investing five or ten minutes in a needy patient at the very beginning of the shift sets the tone for the entire day, and pays dividends in decreased anxiety for them (and less call-light use for you). This principle also works for nightmare-plagued toddlers, frustrated spouses, and picky in-laws. ........Age has its advantages. Having been orphaned at thirty-one, I didn't know how much wisdom and life education I'd missed out on until I began working with the elderly. Through their stories of the past, I've discovered much about where I came from, who I want to be, and the legacy I want to leave my own children and grandchildren. I only wish I could bottle whatever these people are made of because our generation and those coming after us could certainly use a dose or two. ........No situation has ever been made better by panicking. ........If it weren't for drugs, alcohol, fatty foods, and human stupidity, we'd all have to go out and get REAL jobs. ........The longer you're a nurse, the more warped your sense of humor becomes. And a warped sense of humor can get you through almost anything...even the worst code brown in history. ........No matter how crazy your shift has been, there will always come a time when you get to hand over the keys and let someone else take care of the patients, put up with the families, fight with management over staffing, and deal with the paperwork when the 😂 in room 205 is found on the floor for the third time today. Remembering this is the only way I can maintain my sanity and still keep coming back, day after day, to do it all over again. ........Teamwork is a great idea in theory, but rarely practiced in everyday life........and that failure to "jell" as a team is not merely a nursing issue or a female issue. If anything, it's the American way---we're raised from the cradle to value individual achievement and make the attainment of personal goals our driving force. Group-think isn't natural to us---especially Baby Boomers---so I hope we can be forgiven for taking a little while to adjust. ........I finally understand what the expression "thinking outside the box" means. I don't care what the powers that be say---I'm not going to force a 90-year-old nursing home resident to eat his meat and vegetables before he can have his dessert, or put him in a nightgown when he wants to wear pajamas. I'm OK with bending rules, and I've taken my share of "verbal counseling" for doing so, but I'm simply not going to let anything so petty as facility policy trump my patients' rights to determine: a) what they may eat, drink, wear, sleep in, listen to, watch on TV, or read; b) how late they may stay up; c) whether or not they will take a shower on a given day; d) who may visit them; and e) which activities they want to be involved in (or whether they will participate at all). .......People will generally live up---or down---to your expectations. This includes nursing assistants and MDs. .......And yes, I've found that the Golden Rule is applicable to every possible situation, whether in nursing or in life: Treat everyone you encounter with the same respect you would want for yourself or your loved ones. Everyone who ever lived is, or was, someone's parent, someone's sibling, someone's child, someone's friend. What's more, we are all members of the human race---including the three-hundred-pound diabetic who smokes like a chimney and doesn't take her insulin and the homeless alcoholic who hasn't changed his socks in six weeks. We judge them only because we fear, deep inside, that "they" could just as easily be "us...but for the grace of God and perhaps a few strokes of plain good luck. So many lessons...so many opportunities to grow in compassion and wisdom. Thank you, Nursing!
  24. Ashley Hay, BSN, RN

    "What made you get into this field?"

    I grew up realizing life is not necessarily promised to all. My Dad was lucky to be alive - beating the odds for osteosarcoma in the early 80's was rare. Sure, I saw his struggle everyday. He was a right above the knee amputee. Not something I took lightly, but I'd also never known him any different. Even seeing pictures of him before his surgery still strikes me a bit strange. That didn't look like my Dad. My parents still keep in touch with his favorite nurse - over 30 years later. That stuck with me. What an impression she must have made. What could a bond like that feel like on the other end? What was it like, providing support to young newlyweds during such a difficult (and potentially bleak) time? I wanted to be that person. I wanted to know what that level of rapport felt like. I wanted to be there for people in their time of need and help them through their crisis - just like that nurse had done for my parents so many years ago. I wanted to connect with people. I worked many odd jobs over the years starting in my early teens. I was a cashier, waitress, worked in a laundromat, tanning salon, law office. But the two jobs I loved the most were babysitting and working in a day care center. I liked earning the parents trust and really enjoyed spending time with the kids. Going through high school I had big ambitions and knew I wanted to end up somehow in the realm of pediatrics. But there was more to that story. I had always been a sick kid. Struggling with frequent infections and illnesses. I frequently think back to a nurse I had during my first overnight stay on a pediatric ward at a New Jersey hospital. I remember her so clearly. Her name was Beatrix. With such a beautiful and unusual name, how could I forget it? Her care and kindness has stayed with me - nearly 20 years later. It was the small things she did that made an impression. She was on the day shift - when she came to do my morning assessment I told her I hadn't slept. She asked if the nurses station was too loud (my room was directly across the hall). I told her the noise was okay, I was...afraid of the dark. I thought she might laugh at me. She didn't bat an eye. Before her shift ended, she came by again - leaving my bathroom light on with the door slightly ajar. "Leave this on, it will help you sleep." This seems like such a small gesture, but it made quite the impression on my ten year old self. She remembered! My exposure to pediatric nurses continued throughout my young adult life. Because of a newly diagnosed illness in high school I had need for regular infusions (and nowhere else to receive them other than the Peds Onc unit). I was lucky enough to observe these nurses first hand. The patients, nurses and families all seemed to have quite the symbiotic relationship. I had found my calling. I was going to try my hardest to do it, despite a few setbacks. In high school I thought maybe I wanted to go pre-med and become a doctor. My guidance counselor quickly dismissed the idea and told me I would be wasting my time and should choose another path. I took a week to think about my options. I came back and said, "I'd actually really like to be a nurse". She told me there was "no way... just apply undecided". My grades were fine but I had missed a ton of my junior and senior year. High school can be hard enough to navigate but especially so when you're dealing with a chronic illness. In the end, that counselor shaped my future path. It was the best (and obviously, the worst) advice I ever got. Lucky for me, I'm stubborn. I'm the type of person that loves to prove you wrong. Off to nursing school I went. Well, that is after going to a large state school & dropping out after a semester. Longer path (and extra student loans) but my nursing journey had begun! I met countless patients through nursing school and many more once I started working as an RN. So many of them stick out in my mind on a regular basis. My first patient, my first death, all the big hugs from tiny patients and the thank you's from parents or spouses. Laughter, joy, sadness, comfort and so many more emotions come to mind thinking about all I've experienced with my patients over the years. Nursing is an incredible profession. It has taught me many life lessons I can't imagine learning elsewhere. We all have our own stories, setbacks and struggles. It's important to remember how far we have each come, both personally and professionally. Everyone has taken a journey to get here. We are now the nurses - not just those aspiring to be. Today or someday soon, you may be the one nursing students look up to, the one less experienced nurses ask for help, the one influencing a child's memory of healthcare. No matter how many years you have under your belt, our actions as nurses today can inspire our young patients to be our replacements tomorrow. Let's be sure to leave a lasting impression.
  25. The Developmental Disabilities Nurse Developmental Disabilities nursing covers a wide range of types of nursing. These problems can be mental, emotional or physical. Those with developmental disabilities run the gamut from infants in early intervention programs to seniors who have lived with life-long disabilities. Examples of Diagnoses Down Syndrome/Trisomy 21 Cerebral Palsy Autism Spectrum Disorder Fetal Alcohol Syndrome Anoxic brain injuries Fragile X Syndrome Other chromosomal abnormalities The individuals are usually born with the diagnosed disability but it can also be acquired via trauma both accidental and non-accidental. As these patients survive longer and longer, it is more common for all types of specialty nurses to encounter patients with these disabilities in the community, in-home care, and in all units of the hospital. Work Environment children's rehabilitation unit in a hospital sub-acute facility long-term acute care hospital (LTACH) long-term chronic care private office setting Patients are typically identified at birth or as an infant when they don't meet developmental milestones. Early childhood intervention programs are often the gatekeeper for care. Easter Seals and March of Dimes are both well-known organizations that provide education and care for the patient, family, and caregivers. As developmental disabilities frequently require life long care, it is very important to plan ahead for the next stage of care. Non-accidental trauma is an unfortunate cause of developmental disability. This opens up many other avenues for employment. Some options include: state-funded child protective services police departments volunteer organizations education and prevention care Education Requirements Graduate from accredited Registered Nurse (RN) or Licensed Practical/Vocational Nurse (LPN/LVN) nursing program. Successfully pass NCLEX-RN or NCLEX-PN Current, unencumbered RN or LPN license in U.S. state of practice Certification Certification is available for the RN and LPN/LVN through the DDNA | – Developmental Disabilities Nurses Association. Eligibility (not all-inclusive) Minimum 4,000 hours active developmental disabilities nursing practice as an RN, LPN, LVN within the immediate previous 60 months (five years). Practice requirement may be met in the following roles: Practicing nurse in developmental disabilities in institutional/community setting Nurse administrator in developmental disabilities program Nurse educator in developmental disabilities program Nurse consultant in developmental disabilities Nurse practicing in the expanded role in an IDD institutional or community setting, including Nurse Practitioners (NP) Opportunities or Projected Vacancy Rates The outlook is bright for nurses and ancillary personnel that want to seek employment in developmental disabilities simply because there are many avenues for this position. As the gestational age of viability sinks lower and lower, there are more and more neonates with developmental disabilities. And, at the other end of the spectrum, as patients live longer and longer due in part to better medical care. There are many jobs available for senior care also. Salary (2020) According to ZipRecruiter, the average annual pay in the U.S. is $52,603. Many Developmental Disabilities nurses care for patients confined to home and receive mileage stipends in addition to their salary. Resources Home | March of Dimes | Healthy Moms. Strong Babies Easterseals | Taking on disability together Human Rights Organization for Individuals with Down syndrome | NDSS National Institute of Neurological Disorders and Stroke