Geriatric Nursing: The True Underdog of the Healthcare Field

From the time I began my nursing career, I knew that I would work in Geriatrics. When expressing this to many of my friends, colleagues and even professors I received the astounding response “Why?”. Many nurses I meet have a goal of working in Pediatrics or OB so that they can be a part of the innocence and beauty associated with childhood, but many view geriatrics as the unglamorous world of bedpans and adult briefs! When I am tasked with answering the questioning of my field choice I immediately begin expressing how I possess a deeply rooted passion for the geriatric population that sometimes can’t be explained by words
As a child, I was raised by my Great Grandmother. The generational gap between us presented many problems and I probably wasn’t participating in some of the same after school and weekend activities as my peers. My great grandmother is a true saint spent most of her time visiting nursing homes to volunteer and visit her family members and friends that were in facilities. During this time I had the opportunity to volunteer as well. Although I was a small child, I connected with the residents in the homes we visited and they took to me and enjoyed my weekly visits. I can truly say that this experience led me to where I am now. As my great grandmother grew older I eventually had to move with my mom and I then found myself visiting my grandmother to take care of her. Just as she had dedicated her life to helping others I found that I became passionate about caring for her. Up until her recent death I vowed to make her golden years her best years.
 

Today I am proud to say that I have dedicated most of my nursing career to geriatrics. Right out of high school I became a Certified Nursing Assistant and worked in a nursing home as well as a Geriatric Psychiatry Unit. After graduating from nursing school my professors advised me to spend at least one year in the Emergency Department so that I can gain skills to prepare me for my Geriatric career. I literally completed one year and then began working in the Home Health setting where my clients were all 65 and older. I enjoyed educating seniors about chronic conditions and each visit felt like a visit to Grandmas! Recently, I completed my Masters and became an Adult-Gerontology Nurse Practitioner (NP). I currently work in a long term care facility in the specialty of Geriatric Psychiatry. I provide medication management of psychotropic drugs to the residents there. I also educate the staff in the facility on non-pharmacological methods for handling conditions such as dementia. I work tirelessly to ensure that the facility is in compliance with current Medicare Guidelines and prepare them for visits with state agencies. Not a moment goes by that I don’t feel like I am walking in my purpose!

Geriatrics is a field that often is forgotten and I must say I do not see how! I find my job to be very rewarding and I often feel connected to the patients I serve. The benefits of working with this population are vast. There is a true need for those passionate about working with this very vulnerable population. There is always an opportunity to teach these patients, but what is most rewarding is that they often teach you! I find that my patients are at a place in there lives where they may require assistance with care, but their wisdom simply amazes me.

The American Association of Nurse Practitioners reports that, “there are more than 270,000 nurse practitioners (NPs) licensed in the U.S., however, only 1.8% of those providers are certified in Geriatrics (2018 AANP National Nurse Practitioner Sample Survey).
These figures are very alarming considering that,  “one in 5 Americans will be eligible for Medicare by 2030, with people 65 and older expected to account for almost 20 percent of the nation’s population by then” (Magaly Olivero, 2015). Equipped with this information, I feel that there is a need to access the reasons that providers do not choose Geriatrics. Wether it is related to a lack of knowledge about the field that is not being addressed in nursing programs or a fear of the field that also needs to be addressed through clinical rotations or patient experience opportunities, we as providers owe it to these individuals to address the need.

As with any field, you have to find the area that most interests you, but I encourage anyone that finds geriatrics the least bit interesting to investigate a career in the field! If you are looking for something that is challenging and structured this is a great fit. The field is mostly preventative and if you are like me and love the aspect of preventing health conditions you will find yourself constantly educating, patients, staff and family members and working to connect your patients with the many resources available to them. Another bonus is that you can work in a variety of settings including hospitals, home health, long term care facilities, assisted living, nonprofit organizations and so on. There is currently a huge demand for geriatric providers and I can guarantee that working in the field will not only be a career reward but also a personal one that will inspire the values of humility and advocacy.

Breonna Leon is a Geriatric Nurse Practitioner in the Atlanta Area who currently serves as a consultant for long term care facilities in the specialty of Geriatric Psychiatry. She holds a M.S. in Adult-Gerontology Primary Care from George Washington University. Breonnabelieves in providing care that is both patient focused and in accordance with the most recent evidence based practice. She works tirelessly to ensure that this vulnerable population is cared for in ways that are holistic in nature. You can find Breonna on Instagram  and reach her via email

Reality Shock: What They Didn’t Teach You in Nursing School

Reality shock is something that you may have heard about in nursing school, but know very little about. Most nursing programs do not adequately prepare their students with coping mechanisms to effectively manage each phase of reality shock. 

Once you start your new job as a nurse, having straight A’s or being the most popular student among your professors won’t matter. You’ll have to establish credibility among all your new colleagues and that’s not an easy task. In fact, it can be shocking and quite intimidating.

Let’s discuss what reality shock is, and tips for managing each phase.

The Four Phases of Reality Shock In Nursing

The idea of reality shock is applied to those who are new to the nursing profession or new to a nursing speciality, where they go through a learning and growing transition. This process has four phases: honeymoon, shock, recovery, and resolution.

 

Honeymoon Phase

The honeymoon phase is a period of excitement for new graduates. You may be very excited to be joining the profession and find yourself eager to learn as much as possible. You will be guided by your desire to do your very best and become confident in your new roles and responsibilities. 

Tip: It is important to establish working relationships where trust and respect are demonstrated between you and your preceptors during this phase. This will help to minimize complications in the following phases of reality shock.

 

Shock Phase

The new nurse is the most vulnerable in the second phase – the shock phase, as this is when negative feelings towards your new role may surface. This is often when the new nurse realizes that the expectation of their new role is inconsistent with the day-to-day responsibilities and work flow. When nurses find themselves in the shock phase, they are at risk to quit, leave their unit, or experience burn out.

Tip: Critical strategies to ease through the shock phase include: finding a mentor for guidance, taking care of yourself physically and emotionally, being sure to get adequate sleep, eating a balanced diet, exercising regularly and having fun with family and friends. It is also essential that you develop a strong support network, and workplace buddies that have your back.

 

Recovery Phase

During the recovery phase, new nurses begin an upward climb back to the positive side. Now able to  consider all sides of your new role as a nurse, you will begin to see the job realities with a more open perspective. You can begin to accept the challenges of your day-to-day responsibilities, and find creative solutions to barriers in providing safe and effective nursing care. 

Tip: To ensure that you do not move back to the shock phase, it is important to seek out constructive criticism, and let your preceptors and mentors know where you are having trouble adjusting. Seek out clarification, and be sure to always work within your limitations. Don’t be afraid to admit that you don’t know. Once you become confident in your roles and responsibilities, you will move to the resolution phase. 

 

Resolution Phase

The fourth and final stage, which is typically after one year of nursing experience, is the resolution phase. During the resolution phase the nurse fully understands their role and fully contributes to the delivery of safe and effective patient care. 

Tip: It is important that you continue to focus on the positive aspects of your job in order to maintain ongoing satisfaction and career success. Engage in continuing education by earning an advanced degree, or becoming certified. When you remain engaged in your own professional development, you are sure to find fulfillment within the nursing profession. 

 

Here are some additional coping skills that you may find helpful as you transition into your new role as a nurse:

Focus on mastering your skills

Making sure that your nursing skills are being performed in the way that follows facility and state regulations will help you to avoid mistakes and help to build confidence. The first six months to a year is an important time for you to work on improving your ability to perform all client care and administrative skills independently, thus boosting your confidence and satisfaction within your new role.

Seek Guidance from experienced nurses 

Just because you finished orientation at your new job does not mean that you are all alone in providing client care. In fact, nursing is always a team effort, and you are encouraged to seek guidance and resource experienced nursing staff to help you when you need it.

When juggling the complex treatments, and patient care of today’s healthcare system, we all rely on one another to deliver the safest and most effective client care possible. Be sure to identify your learning needs as they arise and seek the expert guidance you will need to feel confident in your roles and responsibilities.

Find a nursing specialty that fits 

Not all nursing specialty areas are created equal. The expectations and responsibilities of nurses in an emergency department are very different than those of a medical-surgical unit. In many cases, new graduate nurses are eager to begin working and accept the first specialty that they are offered.

In the event that you find yourself really struggling with the specialty you are working in, be sure to discuss your concerns with your supervisor before deciding to quit. They will be able to identify your struggles and may offer effective coping strategies and/or specialty alternatives accordingly. Switching specialties within the first six months to a year is quite common, and many times healthcare facilities will accommodate your requests to keep you on staff.

We hope that these tips for managing reality shock help you as you transition from student nurse to professional nurse. If you have any additional tips you’d like to share, please leave your thoughts in the comments section below!

New Grad Nurse Tips: How to Safely and Effectively Delegate Tasks

When we ask new graduate nurses what they find to be most difficult as they are transitioning from student nurse to professional nurse, the majority say that it is delegation. This is because the artful skill of nursing delegation is one that can take years of experience to master. It involves transferring responsibility from one individual to another, while retaining accountability for the outcomes. This is a completely different role for the new grad nurse to get used to, especially since the opportunities to practice delegation are very limited during nursing school.

Since new graduate nurses are often hesitant in giving the responsibility of carrying out patient care tasks to others, this brings on additional stress to the transitioning nurse, which can result in poor time management and overwhelming workloads.

Let’s face it – nursing is not a one person show. It takes a team to safely and effectively care for patients. Since nursing is a team effort, it is vial that the new nurse master strategies for safe and effective delegation. To help new grad nurses better manage their roles and responsibilities,  we’re dropping gems on strategies for safe and effective delegation below. 

Decide when delegation is appropriate

Okay new nurses, here’s the scoop – You should NEVER delegate what you can E.A.T. The nurse is responsible for Evaluating, Assessing and Teaching. These are specific responsibilities of the Registered Nurse and should always be carried out by the RN. Delegation can begin after the RN has assessed the patient, and the condition and needs of the patient have been considered. The RN will prioritize the patient’s needs based on their condition, and differentiate between nursing and non-nursing tasks. Let’s not forget that initial assessment (including vital signs) are to be done by the RN, and therefore should not be delegated to the nursing assistant. Once you have assessed your patients and have considered their needs, now you can begin to think about whom you may delegate to.

Determine adequate skill levels 

It’s up to the RN to choose the appropriate person for the task. It is essential to know the skill level of each team member to match the task assignment appropriately. One easy way to accomplish his task is by getting to know your co-workers. Here are some questions you may want to ask to help you feel more confident about your decision in choosing:

Is this person licensed or unlicensed?
How long has this person worked within their role?
Has this person been validated for competence in performing the task?
Does the person feel confident that they can safely and effectively perform the task?
Does the person need additional training or instruction to complete the task independently?

Once you have asked yourself these questions, you will be able to move into the next phase of safely and effectively delegating.

Use clear communication when delegating tasks

In order for any task to be effectively delegated, nurses must give clear, concise and detailed instructions. This includes the purpose, any identified limits, and expected outcomes of the task. Also, the nurse must ensure that the person to assume the task can complete it within the expected time frame established. Nurses should consider that the person you are delegating to will be working with several other patients, so be mindful and set realistic, attainable goals. Finally, the nurse must always ask if there are any questions or concerns which promotes clarification and opportunity for the supportive personnel to disclose concerns related to the tasks.

Supervise the delegated work and provide feedback

To ensure the delegated work has been completed appropriately, nurses must offer direct supervision and feedback as needed. They must also be available in case an unexpected outcome occurs. You should never assume that the task was completed without validating it by checking that all components of the task have been accurately carried out. Be sure to build strong relationships with your nursing support staff by identifying areas of success and offering suggestions for improvement. And don’t forget to say “thank you”—it goes a long way!

Evaluate task outcomes

To ensure that the patient received the care needed and that the team worked together efficiently, RNs must evaluate the delegation process upon task completion. If an unexpected outcome occurs, it is essential that RNs develop a plan to correct the deficiencies if possible.

As you hit the floor running, please remember that learning to delegate effectively takes time and practice. Reflecting on the process of delegation and identifying areas for improvement will help you develop this important skill. Good luck —we know you got this!

If you have any further tips or suggestions to promote safe and effective delegation, please share your thoughts in the comments section!

5 Tips for NCLEX Success!

Congrats for getting through the many trials and tribulations of what we like to call Nursing School – you rock! Now that you have proven your competency in the classroom and clinical setting, you must now focus on getting past the final academic hurdle to becoming a licensed, practicing nurse – the NCLEX.

In order to begin your professional journey in nursing, you must be able to pass the NCLEX. This standardized, computerized adaptive test (CAT) is offered year-round, and is administered by Pearson Vue, and governed by the state board of nursing in which you choose to practice in.

With the right preparation and study plan, passing the NCLEX is absolutely attainable. Although passing the NCLEX is attainable for everyone who takes it seriously, it is important to understand that the NCLEX does not measure your intelligence, nor does it predict how successful you will be within your nursing career. In fact, the NCLEX only measures your ability to critically think through the questions and answer choices to arrive to the best answer. Typically the best answer is the safest, most patient-centered, most therapeutic, and within the scope of nursing practice.

Whether you are preparing to take the NCLEX for the first time, or you are repeating the exam, here are five tips for NCLEX success:

 

Understand what the NCLEX is and how it is formatted

Remember us mentioning computerized adaptive test (CAT) earlier? It means that no single exam is identical, and that questions provided are based on how you are answering previous questions. For example, if you answer the very first question on the test correctly, you will receive a question that is a little bit harder. If you answer the first question incorrectly, then you will receive a test question that is a little bit easier. The computer will select questions based on areas of strength and weakness throughout the exam. 

 

The test will ask you a minimum of 75 questions, and a maximum of 265 questions. The test determines if you pass when you stay above the passing line with a 95% confidence interval. This does not mean that you have to answer 95% of the questions correctly. What it does mean though is that the computer must be 95% confident that you have remained above the passing threshold. The candidate will fail the test when they do not rise above the passing line with 95% confidence.

 

To help you better understand, think of it this way – there is a horizontal line on an axis and we will call it the “pass line.” Anything above it is passing, and anything below it is not passing. You start exactly on the line at question one, and with each correct and incorrect answer, you get bumped up a notch or down a notch. With each correct answer, the computer will provide progressively more difficult questions. To pass, you must ultimately rise to a point above the pass line that demonstrates competency with marginal doubt. It is important to know that the test can end at any number between 75 and 265 when this determination is made, or when you have met the maximum time allowed – which is six hours.

 

Find ways to reduce your Stress Levels

For all of the anxious test-takers out there – don’t fret. We know of many ways to manage your stress. Test-anxiety is a very real, very common thing. It is important that you understand that you are not alone when it comes to feeling nervous and even doubtful when testing. Even if you don’t typically have test anxiety, there is a chance that you will be nervous just from the pressure of passing the NCLEX.

Let’s take a look at some ways you can reduce your stress levels and stay focused on becoming a licensed nurse:

 

Find test-taking strategies that work for you

There are many helpful tools and methods that can assist you in choosing the correct answer choice on the NCLEX. Mastering individualized test-taking strategies and applying them to every single test question can help reduce distractions caused by your racing mind. Using a systematic approach rather than relying on your memory may prove to be very helpful in reducing your anxieties.

Get plenty of rest before the exam
It is important that you refrain from staying up all night studying before the NCLEX. Knowing that NCLEX questions are written in a way that requires critical thinking and a great deal of focus. Being tired only inhibits your brain’s ability to make clear decisions. Be sure to engage in the number one preferred self-care activity of all time – adequate sleep and rest. 

Eat a healthy breakfast and avoid too much caffeine

For a week or more leading up to the day of the exam, it’s important that your body and mind are well-nourished. That’s why it’s important to eat a healthy diet. On the day of the exam, you will want to eat a brain powering breakfast such as egg whites, fresh fruit, and water or herbal tea. Having one cup of coffee in the morning is fine, but overdoing the caffeine can cause you to feel jittery and could make your test anxiety worse. 

Close your eyes, take a deep breath and regain your focus!
At times you may feel your nerves starting to get the best of you during the exam, so it’s important to regain control. Closing your eyes and taking a deep breath is a simple and effective way to calm your nerves and regain your focus.

Don’t fixate on not knowing the answer – Just take an educated guess and move on

Sometimes we get to a point to where our best test-taking strategy doesn’t help us choose the right answer on the NCLEX exam. If you find yourself in this situation, don’t freak out – it happens to us all. Just take an educated guess and move on. Dwelling on the fact that you do not know the answer will provide unnecessary distractions that could send you down the wrong path. Simply accept that you don’t know, select the answer that makes the most sense, and move to the next question.

Don’t let real-world experience or past clinical experiences trick you

It is very important to understand that the creators of the NCLEX write questions and answer choices in a way that will make you immediately react. This reaction is generally the cause of real-world experiences that you are familiar with. Selecting an answer choice based off of this gut feeling is typically a grave mistake. Borrowing from your past experiences as a nursing assistant or during your clinical rotations in school will set you up for failure.

When considering the NCLEX world versus the real world, you should understand that the NCLEX world is 100% perfect. You only have one patient at a time. You have an LPN and a nursing assistant that you can delegate tasks to. You are well-staffed, with all the working equipment you need to provide the BEST care possible. The NCLEX world operates in black and white – textbook standards at all times. There are no cutting corners, or taking shortcuts. Unless the question offers select all that apply answer choices, there is only one correct answer.  

As you move through each NCLEX question, you should remind yourself that the creators of the NCLEX want you to use textbook nursing standards as your guide for action. Nurses assess before they implement. Nurses always consider what is most therapeutic for the patient. Nurses always consider the least invasive treatment option first. Nurses always advocate for patient-centered care practices. The nurse can always do something before relying on other members of the healthcare team. Before you answer each question, you should ask yourself – “Is this textbook nursing practice?” 

 

Practice, Practice, Practice 

By answering at least 25 NCLEX questions per day, and completing weekly practice exams leading up to sitting for the NCLEX is one of the most important ways to prepare for NCLEX success. It is important to note that simply answering questions and taking the practice exams is only half of the process.

You must also: 

Look up questions that you answered incorrectly, and review that nursing topic or content. Every practice question bank provides rationales as to why each answer choice is correct or incorrect.

Jot down notes of which concepts you want to revisit, so with your next study session, you can focus on problem areas.

It is especially useful to take at least 1 or 2 full online mock NCLEX exams so you are used to the experience of computer testing. Go through as much of the question bank as you can before exam day and you will be miles ahead.

Practice applying test-taking strategies learned to every single question. This will help you to master the strategies so that you have a systematic process of approaching each question. This is especially helpful when you may not remember certain topics or content.

 

Most importantly – BELIEVE IN YOURSELF!

Everyone who graduates nursing school deserves to pass the NCLEX and you are no exception! You have already proven your potential as a nurse by graduating nursing school. You did more than complete your coursework. You have proven that you are resilient, creative, caring, and intelligent. Your flexibility, dedication and desire to successfully complete nursing school is far more impressive than passing the NCLEX. Now, you must transition from nursing student to nurse. The NCLEX is your final academic hurdle to earning the right to practice as a licensed, professional nurse – so get out there and rock it – You got this!

If you have any additional recommendations or tips for NCLEX success, please leave your thoughts in the comments section below!

5 Reasons You Didn’t Get Into Nursing School

You’ve received that dreaded letter from your nursing school informing you that you will not be starting your nursing program next semester and there are one million things running through your mind.  Where did I go wrong? How did I overlook that? What I am going to do now…?

Here are a few common mistakes pre-nursing students make when applying to nursing school and a guide on how to improve your next nursing school application. 

 

1.You Put All Your Eggs in One Basket                                                                                                                                          While attending your university’s nursing program is ideal, it may not be likely. Nursing is highly competitive and most programs have very limited seats. Applying  solely to your university could be a critical mistake and cost you a semester’s wait -or more.  

Play it safe and begin preparing your application to multiple schools in your immediate and surrounding areas to make the most of your investment. All nursing programs aren’t created equal so your application may vary from program to program. The first step is scoping out your potential transfer school for accreditation, credit transferability, and tuition costs. 

After you have found a good match,  a general admission application to your potential transfer school of choice is usually necessary. Additionally, some schools require additional courses that are only specific to their school and require completion of said course(s) by program admission deadline. Iron out all of the details by scheduling or attending an information session with a nursing school advisor. Once you’ve been accepted to the university! Apply! Apply! Apply!  Casting a wider net always equates to better results.

 

2. Your Application Wasn’t Competitive                                                                                                                                      You’ve done the hard part of getting all the many criteria of the application together- but does your application stand out? The highly competitive nature of nursing school makes it imperative that you have a standout application in areas outside of your coursework. 

Volunteer hours and great letters of recommendation are a necessity; however, there are ways to take it even further. Step your application game up by getting a job as a CNA or nurse tech. Hands on experience is invaluable and is sure to make you stand out among the rest. Also, get your application in as soon as possible to show your dedication, timeliness and commitment to the process.

 

3. Your Science GPA Wasn’t Strong Enough                                                                                                                                There are many aspects of the nursing application that are considered during the admission process; however, the science GPA holds major weight in most programs. These classes (Anatomy & Physiology l & ll, Microbiology, Chemistry and  Bio sequence) are literally the foundation of nursing curriculum and scoring high in these courses are a surefire way to get the attention of the admission committee. It shows that you are not only serious about these courses but sets the tone that you’ve got what it takes to succeed in the nursing courses ahead. If you got an average grade in one of these courses it might not be a bad idea to repeat it and shoot for an A!

 

4.Your Entrance Test Score Was Too Low
Nursing entrance tests are hard work. They can be expensive, confusing and time consuming. Nonetheless, a good score could change the dynamics of your application and catapult you into a front row seat in your program of choice.

If your score didn’t make the cut or improve your application, a retest may be your only option. Avoid frustrating yourself by creating a strategy for success. Even the worse test takers have found ways to ace these exams and continue their nursing journey. More appropriate study-guides and test quizzes may help your score improve drastically. Preparing using the test taker’s materials are efficient way of understanding the test requirements. Additionally, don’t wait until the last minute to complete this exam. Give yourself time to retest in the event you aren’t pleased with your initial score. 

 

5.You Got Waitlisted                                                                                                                                                                         While getting waitlisted isn’t the “yes” you were hoping for, lets face it, it’s better than “no.” As aforementioned, most nursing programs have limited seats; however, the applicant pool plays a major part in the chance of a seat opening up. 

If you’ve found yourself in this tricky middle-ground, remain hopeful. Some accepted applicants won’t choose to attend your program while life circumstances may happen to others, thus delaying their attendance. If things don’t work out in your favor, be sure to check out numbers 1-4 to make sure you’ve given yourself the absolute best chance of getting an absolute YES! next time. 

 

We know that denial to the nursing program can be devastating, disappointing and can often come with a ton of embarrassment. Don’t allow negative thoughts to distract you from your calling or  goal to become a nurse. The true test of this minor setback is how you respond. 

 

Stay Lit! 10 Tips for Beating Nurse Burnout

Nurses are known for our selfless work, where we focus on meeting the needs of others. Unfortunately, in our attempts at improving the overall wellness of our patients and their families, we often fail to make our own health needs a priority.

As a result, many of us experience anxiety, dehydration, urinary tract infections, back, joint and foot pain, chronic headaches, and much more. Many of us can even develop more serious complications like diabetes, high blood pressure, and other health issues that can be related to high stress levels, poor diet, and the strenuous physical, mental and emotional labor involved in caring for others.

In this article, we will focus on several strategies where you can find the balance in it all. We will discuss the importance of making self-care your first priority, the importance of building healthy workplace relationships, strategies you can incorporate into your typical workday to prioritize staying healthy while on the job, and explore how leading by the example can be the most effective form of influencing others to remain happy and healthy.

Let’s take a look at 10 strategies that you can use in finding the balance:

Self-Care While at Work

As nurses, we already know what we “should” be doing to maintain optimal health—basically, anything we would tell our patients to do – right!? Thus, our problem isn’t our understanding of what to do, but rather “how” to do it when considering the challenges within the workplace.

Many experienced nurses agree that they need to take care of themselves first before they can adequately care for others. This includes taking breaks, staying hydrated, eating healthy meals and/or healthy snacks throughout our daily grind. It’s crucial to communicate your needs to your colleagues and ask for help. By telling your fellow nurses and co-workers that you need to tend to your own needs, and ask for help, they can step in and cover you while your recharge.

In the event that all of your colleagues are too busy with their own assignments to cover yours, use your nursing judgement before leaving your patient assignment. Make sure your inform your patients and at least two team members of your plan: where you are going and how long you expect to be gone in the event that they need to find you, or step in and help out.

Self-Care For After Hours

In addition to making sure that you are being kind to yourself on the job, make sure to spend quality time time away from work. Get plenty of regular exercise, drink lots of low sugar fluids, eat a well-balanced whole foods diet, get plenty of sleep, seek spiritual fulfillment, engage in healthy and supportive relationships, and surround yourself with positive activities and positive people.

The time you have away from work should not not be considered a luxury, but your responsibility. Your time off should allow for you to recharge and come back to work rested, healthy and able to effectively work through the many stressors of your work day. By focusing on yourself first, you will have the agility and energy necessary to endlessly care for your patients and their families.

Be a Positive Role Model

Professionalism, dependability, and a willingness to provide solutions within the workplace are just a few of the characteristics that help foster healthy workplace relationships. Remember, your actions speak louder than words. By consistently demonstrating these desirable attributes, you will set the tone for how others should work alongside you.

Establish a Strong Support System at Work

Building a strong support system while advocating for peer accountability can drastically improve the work ethics and teamwork effort in any workplace. This is particularly true in healthcare where many different members of the healthcare team have a hand in delivering patient care. Nurses perform at their best when they have a support system that they can depend on, and people they trust to hold them accountable.

Go Beyond Your Normal Duties

The smallest acts of kindness can go a long way. The occasional box of gourmet pastries, or small jars of homemade jellies, are always welcome in a workplace that is often overwhelmed with time sensitive tasks and life or death situations. By doing nice things for your colleagues on occasion, you are showing them that you are invested in them beyond the job and that you care about bringing them a little bit of joy, even if just for a few minutes at a time.

Stay Healthy by Being Well Hydrated

Staying hydrated is one of the most essential components to maintaining high levels of energy and mental clarity. Our own experience shows that nurses are among some of the worst at staying hydrated during their shifts. One of the main reasons is that open drinks or containers near workstations or patient care areas is considered an infection control issue, and we seldom have the opportunity to leave patient care areas.

One way to work around this is to have a completely closed container, such as a sports water bottle or similar that you can keep nearby, in a designated “drink drawer” or cabinet in the nursing station. Not all facilities will allow for a designated drink station on the unit, so another way to stay hydrated is to set reminders on your phone, or watch to drink every hour. If we can’t take care of our basic needs while at work, we won’t be the best nurse for our patients who rely on our expertise and skills to keep them safe.

Eat Healthy Snacks Throughout the Day

Instead of starving yourself all morning and afternoon, then frantically rushing to the cafeteria for a slice of pizza or something fried, you should bring healthy snacks to have throughout your shift. A few healthy foods items that are energy powerhouses and easy to eat on the go include: nuts, cheese, hard-boiled eggs, and fresh fruit. Another option could include things like protein shakes or protein bars, though nutritionists recommend getting energy sources from whole food sources first. By snacking on these nutrient dense foods throughout your shift, you are sure to stay focused and energized.

Avoid Too Much Caffeine

Many of us love our big strong coffee at the beginning of our shifts to get us pumped and ready to go – and that’s just fine. Caffeine is a stimulant, and in small to moderate amounts, it can be beneficial to one’s mental clarity. But like any other good thing, it becomes a problem when consumed in excess. It can cause nervousness, impaired ability to focus, and even worse—dehydration. The best way to prevent caffeine overdosing is to stick to one cup in the “morning” – for those night shifters out there, and follow with lots of water throughout the workday.

Lead by Example

Nurses spend a lot of their time teaching patients about various lifestyle modifications that can be implemented in order to help achieve optimal health. Unfortunately, we don’t always live by our own words. In order to have the greatest impact on improving the health of ourselves and our patients, we must practice leading by example and becoming the change we wish to see.

Just as children learn by imitating, we are all visual creatures and create habits based on what we see others doing. Thus, when a patient sees a nurse in a cafeteria eating a salad with fruit, they are more likely to take dietary advice more seriously. A patient also benefits indirectly as their nurse is in better shape to tend to their needs.

Join or Create a Healthy Nurses Program

One of the best ways to start leading by example is to either join an existing healthy nurses program at work, or to collaborate with your facility’s management to establish one. Many hospitals have already begun establishing programs that focus on providing wellness activities, education and support that are specific to each discipline staffed within the healthcare organization.

A healthy nurses program may include a variety of services such as: healthy cooking classes, exercise classes, health screenings, smoking cessation services, and mental health workshops. It’s easier to stay on track when you have others holding you accountable, and leading by example for your colleagues will have a trickle down effect for your patients.

It is our hope that you can find great value in these simple, yet effective strategies for maintaining a happy and healthy nursing career! So get out there and be the happiest and healthiest nurse possible!

If you have any additional tips and suggestions for maintaining a healthy nursing career, please leave your thoughts in the comments section below!

The Nurse Link Team

Becoming a Military Nurse

Military nursing shares many similarities to civilian nursing, in which the common goal is to treat patients and promote their well-being. Military nurses may work either at home or in foreign countries and in a variety of setting to include, but not limited to, military bases, military hospitals, and clinics. Military nurses may also work in hospitals or global response centers alongside deployed military personnel during natural disasters or times of war. Military nurses can work in potentially dangerous environments, like foreign war zones, and work under extremely stressful conditions. The benefits of becoming a Nurse in the military are numerous! You are provided with the tools you need to develop your career and continued training and leadership opportunities within your field. In addition to opportunities for continuing education and clinical specialization, you will receive low-cost or no-cost medical, dental and life insurance, generous retirement plan options, housing allowances, food stipends, and paid vacation earned at a rate of 2.5 days a month which you are eligible to take anytime.

In order to become a military nurse, you must earn a Bachelor of Science in Nursing (BSN) or an advanced nursing degree from an accredited school. Military nurses are commissioned officers; therefore, an associate degree will not be accepted. After graduating from nursing school, successfully passing the NCLEX would be the next step. Once you are licensed RN or advanced practice provider you can start your journey into the military with or without work experience. You will want to begin to talk to a Health Professions Recruiter, when you are ready to start this journey! Once you decide on a branch, make sure you meet all eligibility requirements determined by your recruiting branch, and complete the application packet. This process will take about a year from initial onset to final approval from the commissioning board. If you find out your application has been accepted the next major step is the completion of Commissioned Officer Training (COT). You are required to complete this 5-week commissioned officer course which helps you learn the ropes of military life as an Officer in the military. After successful completion of this course, you will graduate and go on to the duty station that you have been assigned to!

The main certifications you will need are a Bachelor’s degree and an active RN license from a non-compact state. You will also need to be certified in Basic Life Support (BLS).

If Acute Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) certifications are required for a particular nursing specialty, you should also have these completed as well. Any other specific certifications relative to your nursing specialty are helpful but not required (i.e. CCRN).

There are many things to consider before making the choice to become a military nurse. There is a huge commitment involved with such a decision. You are not just a nurse, but you are also an active member of the Armed Forces. You will have to be deployed, many times for lengths varying 6 months to a year. Other things to consider before joining the military are your future plans. For example:

  • How will the military benefit you?
  • Do you have plans to further your education?
  • Are you able to live a structured life, taking orders from higher ranking individuals around you?
  • Are you able to be an active member of team and step up to leadership positions?

All these are great questions to think about and consider in your decision to join the military. The field of military nursing is fast-paced and can be emotionally, physically, and intellectually demanding. For the right candidate, it is an excellent opportunity for travel and personal and professional growth.

Jay Nichols known by her audience as Jay Quinn is a Critical Care Nurse in the US Air Force. Jay is currently an Acute Care NP student and also the owner and founder of Nurse Jay Boutique. Jay graduated from the University of South Carolina Mary Black School in Dec 2015 and started her nursing career as a new graduate on the Medical/Surgical ICU unit at the Mayo Clinic in Rochester, MN. 

5 Ways to Identify and Prevent Compassion Fatigue

Hey there nurse. We know you’ve put your everything into helping your patients and their families. Your selfless care and attention to detail often go unnoticed, and most unfortunately – your service to others is often thankless. We feel you. We are you.

We know what it feels like to put your heart and soul into protecting and caring for our patients, and somehow despite the amazing job we’ve accomplished, we still feel defeated by the end of our shift. With the ever-changing healthcare system and the enormous demands that are being placed on nurses in today’s healthcare arena, compassion fatigue one of the many crippling forces that we nurses face on a daily basis.

In this article, we will identify compassion fatigue and discuss 5 ways that you can prevent it.

What is Compassion Fatigue?

Compassion fatigue has been defined as a combination of physical, emotional, and spiritual depletion associated with caring for patients in significant emotional pain and physical distress. The physical, emotional, spiritual, social and organizational consequences of compassion fatigue can be so extensive that they threaten the existential integrity of the nurse. Such consequences include, but are not limited to: decreased level of job satisfaction, decreased productivity, increased rates of absenteeism, burnout, turnover, stress, insomnia, nightmares, headaches, gastrointestinal complaints, anxiety and depression.

Why is Compassion Fatigue an issue?

When healthcare providers such as nurses become depleted of their ability to effectively cope with the amount of stress that is placed upon them, patient care and safety decline. When a nurse suffers from compassion fatigue, it does not mean that they no longer want to care for others, nor does it mean that they are incapable of caring either. Compassion fatigue is not simply a lack of willingness to care, but it is a major barrier to providing high-quality, compassionate care.

For those who are not familiar with nursing compassion fatigue, consider that you are a nurse on a busy acute care unit, and it is going on 4 o’clock in the afternoon. You have been at the hospital since 6:45 in the morning and you have not stopped delivering direct patient care once to drink water, eat, or use the restroom. While your very own basic needs are not being met, you are doing your best to provide compassionate care to your patients and their family members. Some of your patients are easy to please and care for, while majority of your other patients are very sick, emotionally unstable, and require a tremendous amount of your time. You have so many things to do – documentation, wound care, and discharge teaching, but you can’t even think straight. You’re beginning to have an internal conflict, where you are trying to decide what’s more important at this moment – drinking water so you don’t pass out, or using the restroom so you don’t have an accident. Now you’re distracted. You are no longer focusing on your patient’s status, as you are consumed by your own internal conflict.

While you are deciding that using the restroom takes priority, one of your patients comes into the hallway and yells “NURSE! I need my pain medication!”. Your colleagues look at you like you are crazy for not giving the patient their pain medication, and then suddenly you feel a little bit of urine trickle down your leg, and you think to yourself “I just can’t even right now.” Many of us have been that nurse. Tired, hungry, and now ashamed because we are trying our very best to meet the needs of our patients before we meet our own needs.

It’s only a matter of time before situations like this will cause compassionate nurses to become cynical, apathetic, and afraid of the consequences of putting the needs of their patients first. This in itself becomes a dangerous situation and should be prevented at all costs!

What can be done to prevent it?

Although the risk of compassion fatigue is inherent in helping others who have experienced illness, loss & trauma, experts and researchers in this area provide some guidelines for managing the demands of the work while protecting ourselves.

Here are 5 ways that we can safeguard ourselves against compassion fatigue:

Practice self-care

Self-care includes activities, rituals and routines that help to promote individual holistic wellness. Some examples of self-care include:

  • Getting plenty of rest and relaxation
  • Getting plenty of exercise and physical activity
  • Participating in prayer or spiritual ritual
  • Consuming a healthy diet
  • Surrounding yourself with people who love and support you

Set emotional boundaries

Providing care for patients who are healing requires empathy and emotional involvement on the part of the caregiver. These qualities of care providers are what makes such interactions so supportive and meaningful, but they can also become overwhelming if we become too involved. It is essential to establish boundaries with our patients so that we do not assume their pain and experiences as our own. The challenge is to demonstrate compassion while being mindful that we are different people with different needs. This awareness can help to secure the space that exists between the care provider and the person receiving the care, which helps the provider to justify putting their basic needs and safety before that of the patient’s.

Rely on support from peers and co-workers

It is essential to develop an organizational culture that normalizes grief and other reactions that we may experience while working with those who are ill and dying. Rather than assuming that negative reactions are a sign of individual weakness or an inability to fulfill the responsibilities of the caregiver role, we should rely on the support from our peers and co-workers when we are dealing with heavy emotions. Cultivating this kind of work environment can be very helpful in reducing stress and feelings of helplessness for care providers who are overwhelmed with negative feelings related to the caregiver roles and responsibilities.

Use active coping strategies

We all have our usual ways of coping with stress or difficult situations. Which coping strategy we choose to utilize appears to make a major impact in managing our stress levels. Studies have shown that using active coping strategies such as humor, social support, taking charge, and planning your time and schedule are more effective than negative or avoidant coping strategies. Choosing to cope by engaging in substance abuse, withdrawing from others and activities, or by using acts of aggression do nothing but exacerbate stress levels and can put your patients and your professional license in jeopardy. When you are feeling overwhelmed, a quick, on-the-spot strategy to reduce your stress is to close your eyes, take a deep breath and count to ten. This simple, yet effective stress reducing technique can save you from making bad decisions, or losing focus of what’s most important at that moment.

Keeping it all together

Managing the impact of caregiver role strain and stress requires a daily and ongoing commitment to self well-being. It is easy to live in the tunnel vision of “caring for others”, and we know too well that it can feel impossible to take time out for ourselves to be refueled and replenished. Just remember that holistic self-wellness should NEVER be considered selfish. By taking care of ourselves as we care for others, we are protecting our valuable personal assets that support us in delivering high-quality care for our patients, their families and our communities.

Have you ever experienced compassion fatigue? Do you have tips or recommendations to prevent compassion fatigue? If so, please feel free to share your thoughts in the comments section below.

Advocating for Increased Nursing and Patient Satisfaction

While our healthcare system continues to assess and identify barriers to nursing staff and patient satisfaction outcomes, we must consider the roles and responsibilities of nurses and the environments in which we force nurses to work in. In this article, we will identify why nurse staff and patient satisfaction continue to be a challenge, and provide recommendations for corrective action.

Identifying Barriers to Satisfaction

Nurses are the “face” of the healthcare institution in which they work and are often burdened with managing all nursing staff and patient discrepancies, in addition to their clinical and administrative responsibilities. Since nurses spend the most time with patients in a hospital setting, nurses are able to build relationships with patients that allows for holistic assessment data collection, individualizing treatment plans, and establishing trust, which are three components that are unambiguous to the discipline of nursing.

It is this distinctive relationship that allows nurses to collect patient data, interpret the data to develop personalized plans of care, implement treatment, and evaluate the effectiveness of treatments — after they have first worked diligently to solace their overwhelmed colleagues and bring reassurance to their anxious and upset patient(s).

Additionally, nurses are widely utilized by hospitals to develop, implement and evaluate new-hire training programs, manage clinician competencies and credentialing, regulate departmental budgets, interview, hire and terminate employees, create institutional policies and protocols, direct equipment inventory and repairs guidelines, perform janitorial duties, oversee hospital ward operations, initiate, analyze and interpret research to improve outcomes, uphold quality assurance measures, update computerized documentation processes, and fill in as needed for social work, case management, physical therapy, speech language therapy, occupational therapy, respiratory therapy, massage therapy, spiritual therapy, dietary services, etc. The list goes on and on (Jenkins, 2015).

Due to the fact that nurses have historically demonstrated a willingness to “wear too many hats”, hospital administration holds nursing with the heavy burden of “getting the job done”, regardless of the requirements. It is for this reason that satisfaction levels from both patients as well as nursing staff are on the steady decline. One could only assume that if nurses were provided with fewer patients, that all of the above mentioned nursing responsibilities could be managed at a more effective pace, and patients would receive higher quality care from the nursing staff.

Implementing Strategies to Improve Satisfaction

Until we have federally supported minimum staffing ratio laws to help nurses better care for our patients, satisfaction levels will remain low. However, there are a few short-term strategies that nurses can implement to keep satisfaction levels from plummeting even further.

Here are three strategies that you may find helpful in improving satisfaction levels:

Integrating effective patient to provider communication efforts – can improve satisfaction levels tremendously. Since nurses know that patients are often overwhelmed with fear and doubt, it is crucial for nurses to work with their patients in a way that exemplifies compassion and empathy. For example, one way nurses can make their patients feel important is by asking their patients if they can take a seat while discussing their plan of care, or when performing an interview assessment. This simple act of sitting while collecting patient data is often viewed as a positive experience by patients (Heath, 2017).

Boosting nursing staff teamwork, and patient care coordination – allows nurses to rely on their colleagues to get the job done, despite staffing shortages. Although this is a very short-term solution that will quickly phase out if overall staffing is not improved, it can be utilized as an effective strategy to provide safe and effective patient care. Boosting nursing staff teamwork, and patient care coordination has been shown to improve both nursing staff satisfaction, as well as patient satisfaction.

Engaging nursing staff and investing in nursing staff– helps to create organizational camaraderie and improves nurse retention. Nurses work very hard at taking care of patients, and often times they feel unappreciated by their employers. When healthcare facilities keep their nursing staff engaged, informed, and make valuable investments into their nursing staff, job satisfaction and retention rates improve. Research shows that when nurses are happy, and empowered, they are more likely to help facilities make more money by improving patient satisfaction scores, and reducing other costs such as absenteeism, turnover, and adverse patient care events..

Holding Nurse Leaders and Healthcare Facility Administration Accountable

According to Carolyn Buppert, MSN, JD (2017), 53% of nurses said that at the end of a typical shift, they did not feel satisfied about the care they had provided, and 57% believe that patient care is suffering. Nurses also believe short staffing affects staff, patients, and families in the following ways:

  • Nurse morale is lower
  • Patient satisfaction is lower
  • Nurses transfer or quit
  • More mistakes are made
  • Physicians/other staff complain
  • Documentation is incomplete

In response, nurses in several parts of the country have been protesting inadequate staffing. In January 2017, organized protests took place in California and Pennsylvania. In March 2017, nurses at a Philadelphia-area hospital had a walk-out over staffing issues. Nurses at Kaiser in California and in St. Louis picketed their own hospitals last year to draw attention to staffing levels they said put patients at risk. New York City nurses protested unsafe staffing by going on strike, costing NYC hospitals hundreds of thousands of dollars in agency nurse salary. Most recently, on April 26th, 2018 over 900 nurses assembled in front of the Capitol Building in Washington, DC to rally for minimum staffing ratio legislation. These are all examples of how nurses are holding nurse leaders and healthcare facility administration accountable for adequate staffing.

If you have any recommendations on strategies to improve nurse and patient satisfaction, please contribute to this discussion by leaving your thoughts below in the comments section.

References:

Buppert, C. (2017, April 4). What’s Being Done About Nurse Staffing? Retrieved 9/30/2018, from https://www.medscape.com/viewarticle/877838

Heath, S. (2017, November 6). 3 Tips for Nurses to Improve Patient Satisfaction, Experience. Retrieved 9/30/2018, from https://patientengagementhit.com/news/3-tips-for-nurses-to-improve-patient-satisfaction-experience

Jenkins, D. K. (2015, June 10). Customer service in healthcare: Why hospitals are holding nurses accountable for happy patients. Retrieved 9/30/2018, from http://thenursespeak.com/customer-service-in-healthcare-why-hosptials-are-holding-nurses-accountable-for-unhappy-patients/

The Nurse Link Introduces New Digital Site for Nurses & Students!

 

Welcome the new TheNurseLink.com!  For the past two years we’ve curated events across the country and branded ourselves as the first organization to connect current, future and aspiring nurses to nurse leadership, social media influencers, nurse entrepreneurs, healthcare innovations and more. Now our online community helps us translate our events into a digital space with a one of a kind user experience.  

The Nurse Link Expos have allowed us to meet and interact with so many wonderful nurses, one city at a time; however this new site will allow for unlimited  interactions globally. We believe meaningful connections are integral to success in nursing at all stages, thus  aim to create important dialogue, provide opportunities for mentorship and collaboration amongst nurses all whilst providing much needed resources. Collectively, our efforts positively impact nursing culture. 

Much like our events, this site connects users to statewide leadership, national organizations, nurse centered brands, educational programs, scholarship opportunities, influencers, entrepreneurial resources. Within a click, users can may find themselves in front of hard-to find resources or dialoguing about an uneasy experience.

While the site welcomes and supports nurses at all stages – our content is primarily tailored for nursing students both undergrad and graduate, new nurse graduates and aspiring entrepreneurs. TheNurseLink.com plans to establish themselves as a central location for everything modern in nursing. 

We encourage students and nurses alike to use the platform to address those hard to ask questions in the field, shop or simply to make new friends. Our online platform is a safe environment for nurses and students to not only gather and connect on relevant industry topics but mentor, aid and motivate one another. 

Everyone can contribute to this site by creating a profile and getting started. TNL welcomes nurse writers, bloggers, and entrepreneurs also. Get connected today by clicking here