Category: Nurses

How Nurses Can Help after a Hurricane

As a nurse, a healer at heart, you may have watched with wide eyes as people were pulled from the floodwaters of Hurricane Florence on the news, and felt just a little bit helpless. There are ways you can help.

Last week, the whole east coast of the United States closely monitored the path of Hurricane Florence, before she settled over the Carolinas and dropped monumental amounts of rain, displacing, trapping, injuring, and, sadly, claiming the lives of the people in her path. As a nurse, you may have sat there, watching with wide eyes as people were pulled from the floodwaters on the news, and felt just a little bit helpless, itching to be on the “front lines.” After all, it is in your nature to help people. You wouldn’t be a nurse, otherwise.

There are ways for you to help, if you want to.

While in most cases, it may be too late to volunteer in the face of this particular natural disaster, as a medical professional with invaluable skills and expertise, your help will be needed in the future. There are multiple organizations you can register with to volunteer to support medical preparedness and response for future public health emergencies or disasters.

Emergency System for Advanced Registration of Volunteer Health Professionals

The Emergency System for Advanced Registration of Volunteer Health Professionals (ESAR-VHP) is a federal program that was created to support states in establishing volunteer programs for disasters and public health and medical emergencies. By registering with ESAR-VHP, your credentials and qualifications will be verified in advance, so you will be cleared to serve at a moment’s notice, wherever the next catastrophe strikes. Registration is free, and by registering, you are by no means obligated to help in any disaster—it solely gives you the ability to do so quickly, if you so choose. For more information or to register, please visit https://www.phe.gov/esarvhp/Pages/about.aspx.

The American Red Cross

In the event of a domestic or international disaster, the American Red Cross is quick to the scene, providing health and mental health support, as well as food and shelter, to those affected. On average, they respond to 64,000 disasters per year, and 90% of their humanitarian efforts are done by volunteers, including 15,000 nurses and nursing students. Licensed RNs, LPNs, LVNs, PAs, NPs, and APRNs are all in demand and are encouraged to volunteer. To learn more about the relief efforts of the American Red Cross, as well as their eligibility requirements, please visit https://www.redcross.org/volunteer/become-a-volunteer.html.

Medical Reserve Corps

The Medical Reserve Corps (MRC) is comprised of volunteer medical and public health professionals, such as physicians, nurses, physician assistants, pharmacists, and more, who assist with emergency medical response and public health initiatives. The MRC was formed after the 9/11 terrorist attacks, when it became clear that medical professionals had no organized way to volunteer for emergency relief efforts and many were turned away, as a result. The MRC now exists due to the willingness of volunteer medical and public health professionals to serve their communities in times of need. To learn more and sign up to volunteer, please visit: https://mrc.hhs.gov/HomePage.

No matter which organization you choose to volunteer with, be it listed above or another, be sure to do your research to ensure sure you will be partnering with an organization that is a good fit for you. The American College of Emergency Physicians has compiled a list of questions all health professionals should ask and/or consider when joining a disaster relief agency, which can be viewed here.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Nurse-to-Patient Ratio Debate Heats Up – Again

Mandated staffing ratios are set to head to a vote in November in one state, after years of nurses fighting for safer nurse-to-patient numbers, but it may not be an easy win.

There is a battle brewing in Massachusetts, and it will be decided at the ballot box this November. Question 1, also known as the Nurse-Patient Assignment Limits Initiative, was proposed by the Massachusetts Nurses Association, and is part of a larger fight nurses nationwide have been waging for years in an effort to secure safer staffing ratios.

A summary of the question that will go to a vote this November reads:

This proposed law would limit how many patients could be assigned to each registered nurse in Massachusetts hospitals and certain other health care facilities. The maximum number of patients per registered nurse would vary by type of unit and level of care, as follows:

  • In units with step-down/intermediate care patients: 3 patients per nurse;
  • In units with post-anesthesia care or operating room patients: 1 patient under anesthesia per nurse; 2 patients post-anesthesia per nurse;
  • In the emergency services department: 1 critical or intensive care patient per nurse (or 2 if the nurse has assessed each patient’s condition as stable); 2 urgent non-stable patients per nurse; 3 urgent stable patients per nurse; or 5 non-urgent stable patients per nurse;
  • In units with maternity patients: (a) active labor patients: 1 patient per nurse; (b) during birth and for up to two hours immediately postpartum: 1 mother per nurse and 1 baby per nurse; (c) when the condition of the mother and baby are determined to be stable: 1 mother and her baby or babies per nurse; (d) postpartum: 6 patients per nurse; (e) intermediate care or continuing care babies: 2 babies per nurse; (f) well-babies: 6 babies per nurse;
  • In units with pediatric, medical, surgical, telemetry, or observational/outpatient treatment patients, or any other unit: 4 patients per nurse; and
  • In units with psychiatric or rehabilitation patients: 5 patients per nurse.

The proposed law would require a covered facility to comply with the patient assignment limits without reducing its level of nursing, service, maintenance, clerical, professional, and other staff.

The proposed law would also require every covered facility to develop a written patient acuity tool for each unit to evaluate the condition of each patient. This tool would be used by nurses in deciding whether patient limits should be lower than the limits of the proposed law at any given time.

The proposed law would not override any contract in effect on January 1, 2019 that set higher patient limits. The proposed law’s limits would take effect after any such contract expired.

The state Health Policy Commission would be required to promulgate regulations to implement the proposed law. The Commission could conduct inspections to ensure compliance with the law. Any facility receiving written notice from the Commission of a complaint or a violation would be required to submit a written compliance plan to the Commission. The Commission could report violations to the state Attorney General, who could file suit to obtain a civil penalty of up to $25,000 per violation as well as up to $25,000 for each day a violation continued after the Commission notified the covered facility of the violation. The Health Policy Commission would be required to establish a toll-free telephone number for complaints and a website where complaints, compliance plans, and violations would appear.

The proposed law would prohibit discipline or retaliation against any employee for complying with the patient assignment limits of the law. The proposed law would require every covered facility to post within each unit, patient room, and waiting area a notice explaining the patient limits and how to report violations. Each day of a facility’s non-compliance with the posting requirement would be punishable by a civil penalty between $250 and $2,500.

The proposed law’s requirements would be suspended during a state or nationally declared public health emergency.

The proposed law states that, if any of its parts were declared invalid, the other parts would stay in effect. The proposed law would take effect on January 1, 2019.

A YES VOTE would limit the number of patients that could be assigned to one registered nurse in hospitals and certain other health care facilities.

A NO VOTE would make no change in current laws relative to patient-to-nurse limits.

There are strong opinions on both sides of the issue.

Donna Kelly-Williams, president of the Massachusetts Nurses Association, said, “Setting maximum patient limits will put patients before profits — where they belong. Right now, decisions about patient assignments are made by hospital executives focused solely on reducing costs and increasing profits. We’re going all the way to the November ballot. And we’re confident that the voters understand how important this issue is to public health.” Kelly-Williams also said, “Hospital executives are the reason that we need safe patient limits in the first place. Hospital executives are the ones who have ignored nurses’ concerns, claiming a lack of resources for safe patient care, while pocketing seven-figure salaries.”

The opposition, which includes hospitals and nursing groups such as Organization of Nurse Leaders and the American Nurses Association Massachusetts, claim mandatory nurse ratios are not the answer, and that they do not improve patient outcomes and that some organizations would be negatively impacted by the cost of hiring more nurses.

Where do you stand on patient ratios? Tell us in the comments below.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Your Nursing Job: The Same Old Bed of Nails or a Comfortable Old Shoe?

Complacency be just as bad for your career as outright misery. Whether you’re stuck in a rut or actively feeling pained by your job, it might be time for a change.

From Nurse Keith’s Digital Doorway

Some of us have nursing jobs that are feel like a bed of nails, and some of us nurses have jobs that feel like comfortable old shoes. Have you ever fallen into either of these categories in terms of your work experience as a nurse? I posit that either one can be detrimental to your career in the long run.

The Old Shoe Nursing Job

If you’ve been working at a decent enough nursing job for a number of years, it can begin to feel like an old worn shoe: comfortable, fraying at the edges, and perhaps less supportive than it used to be.

Perhaps you’ve had a work experience that reflects at least several of the following characteristics:

  • You like your colleagues well enough
  • Your bosses are decent
  • The work you do is relatively enjoyable — or at least tolerable
  • The salary is stagnant
  • Benefits (if you have them) are acceptable but not overwhelmingly generous
  • You’re not learning very much over time
  • You feel like you’re just this side of career stagnation

I hear from many nurses who are in a nursing position that matches a number of the above-named aspects. When a nurse feels stuck and in a rut, there are plenty of questions to ask, including but not limited to:

  • What about your current job is and is not satisfying?
  • What kind of learning happens for you on the job?
  • Do you feel like you’re growing professionally or just marking time?
  • Are you treated well enough? Could you find a more positive and supportive workplace culture?
  • Do you feel that you’re valued for what you do, or are you just a cog in an organizational wheel?
  • If you think about leaving for another opportunity, what kinds of thoughts and feelings do you have? Is it just too scary to consider?
  • Are you afraid to leave because it’s relatively comfortable? Are you avoiding looking for another job because you feel beholden to stay for your colleagues and/or your patients?
  • Do you simply not know what you’d rather do otherwise?

These types of questions can lead to very interesting discussions about self worth, career development, personal and professional history, and how you view yourself as a healthcare professional and nurse.

An old shoe may be comfy and familiar, but it can lose its supportive structure and allow your feet to really take a beating. Is your current job kind of like that old running shoe you just can’t let go of?

The Nursing Bed of Nails

A nursing job that feels like a bed of nails is just a bad fit. In this scenario, it hurts to get up and go to work. You feel pained, uncomfortable, and vaguely aware that this is a form of torture that would probably be good to escape from, but you may very well feel stuck and unable to move.

Don’t get me wrong: a challenging job that pushes you beyond your current comfort zone isn’t necessarily a bad thing. This type of situation can be good for your career as it can often motivate you to learn, grow, and take your skills and knowledge to the limit without violating your scope of practice or endangering your patients or your nursing license.

Having said that, many of us have likely been stuck in jobs that felt dangerous, edgy, beyond our ken, and simply too much to handle. A nursing job that pushes you too far and feels unnecessarily painful and difficult can have some of the following characteristics, as well as others not listed:

  • You feel as if you’re regularly pushed to work beyond your scope of practice
  • A bully (or bullies) stalk the halls and make people’s lives miserable
  • Management is inept, if not downright hostile
  • The workplace is riddled with gossip and backbiting
  • You don’t readily connect with the patient population and feel like caring for them is like nails on a chalkboard
  • You don’t feel challenged, and your skills, knowledge, and expertise are stagnating
  • You feel nauseous, anxious, or plainly fearful when you arrive to work
  • Overall, work is just a consistently unpleasant slog

Being miserable, stagnant, and pained at work is no picnic. And you know what? It’s not necessary at all — you always have the choice to make a move, look to a new horizon, or otherwise exit gracefully, stage left.

Do you have the gumption and wherewithal to leave? Even a bed of nails can feel oddly comfortable and familiar — after all, the devil you know can sometimes be better than the devil you don’t. Right?

Finding a New Career Frontier

Whether your job feels like a bed of nails or a comfortable old shoe, there’s often something that needs to change. If you’re not making plans to leave, consider where your resistance is coming from. Is it fear? Is it discomfort with change? Or is there a lack of self-confidence that needs to be overcome?

Whatever the feeling is that’s keeping you from busting out and moving on, consider the notion that change can be exciting, renewing, and occasionally revelatory. Fear can either be motivating or demotivating — which would you prefer?

Consider that if early homo sapiens and other ancient human species were overly afraid of change, they never would have crossed the Bering Straight and populated far-flung continents. If Civil Rights leaders had been too fearful of the reactions of white supremacists, they never would have marched, boycotted, and pushed back against the egregiously racist status quo. And if Florence Nightingale didn’t have the courage to buck the system of the good ol’ boys of medicine and create biostatistics and crucial practices of infection control, modern nursing might still be in the Dark Ages, serving coffee to physicians who see us as nothing but unskilled non-professional handmaidens.

Consider these questions:

  • Is your current job satisfying?
  • Are you learning enough to keep engaged and interested?
  • Does your workplace feel congenial enough?
  • Is the workplace culture positive and supportive?
  • Is management responsive and self-reflective?
  • Is this job leading somewhere in the context of your career?

A bed of nails and a comfy old shoe can be equally difficult to disengage from, albeit for different reasons. If you’re stuck in either of these scenarios, what would it take to get out of bed or throw that old shoe in the trash? What would you need in order to take that leap of faith and move on?

Nimbleness, professional and personal growth, forward movement, and the willingness to pivot throughout your nursing career are hallmarks of living and working in the 21st-century healthcare universe — are you ready for nice new nursing shoes and a more comfortable bed? If you’re feeling like you’re at the end of your rope, I’ll hazard a guess that you’re more than ready. What are you waiting for?

Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is co-host of RNFMRadio.com, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses.

A widely published nurse writer, Keith is the author of “Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century,” and has contributed chapters to a number of books related to the nursing profession. Keith has written for Nurse.com, Nurse.org, MultiViews News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog, Working Nurse Magazine, and other online publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, online nurse personality, podcaster, holistic career coach, writer, and well-known successful nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Tricky Nursing Interview Questions (And How to Answer Them)

The pay may be great, but that isn’t the answer to give when asked, “Why do you want to work here?” Here’s how to answer that and other hard interview questions.

Interviewing, in general, isn’t easy, but some questions prove tougher than others. Here are three questions that notoriously trip up even the most seasoned nurse and how best to answer them.

“Tell me about yourself.”

While not technically a question, this can be one of the hardest parts of any interview. While some people love talking about themselves (research suggests this is simply because it feels good), others do not, and even if you do like talking about yourself, landing in the sweet spot between giving the interviewer too little and sharing too much can be tricky, especially if you’re an anxious or nervous interviewee.

Instead of sharing your life story, and giving away too many personal details which may reflect poorly upon you, keep in mind that the interviewer is asking this because they want to know your background, more than anything, and a bit about your personality. Cover the basics about your education, professional experience, career goals, and strengths, while tying in some clues about your personality, such as, “I’ve always loved children and I’m upbeat by nature, so pediatric nursing was a seamless fit for me.”

“Why do you want to work here?”

The truthful answer to that may be, “Look, lady, it’s because I need a job,” or, “The pay is GREAT,” but those answers are not what the interviewer is looking for—and should definitely not come out of your mouth at any point during the interview process. They don’t want to hire any ol’ nurse, just as you don’t want to work at any ol’ hospital, so do your research, not only so you can impress them by knowing they were ranked #1 for neurosurgery by so-and-so publication, but so you can see if they are the right fit for you, as well.

Before you interview, Google them and read up on the organization, including their corporate values and culture, and be prepared to tell them why you’d be a good fit to work there. For example, perhaps the facility caters to a population you prefer to work with, they use progressive methods you are eager to learn, or have a reputation for professional advancement that aligns with your career goals. Or maybe it’s something as simple as they are a small practice with a family feel, and you are tired of working in hospitals where you hardly see the same person twice. Whatever it is that truly interests you in working there, from a professional standpoint, find a way to convey that in a way that shows you’re excited to be a part of what they’re doing.

“What are your weaknesses?”

No one likes to own up to their faults, particularly not in a setting where you’re trying to impress. However, we are all human. We all mess up. We all have less than desirable traits. And pretending like you don’t just comes across and being inauthentic and dishonest, and those are not desirable traits in an employee, let alone a nurse.

Whatever your weaknesses may be, find a way to tell the interviewer what you have learned from them, showing you are committed to self-improvement and professional growth. It is a best practice to sandwich your weakness between two positive attributes. For example, if you sometimes feel overwhelmed, try saying something along the lines of, “I’m committed to providing a high level of patient care, but sometimes I find myself getting a little overwhelmed when a patient or their family asks a lot of questions. I know that’s just the patient and their family wanting to be well-informed about their care, though, so I’ve learned to be more understanding, as a result.”

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Nurses Need to Stop “Eating Their Young”

As it was first said in 1986, “nurses eat their young,” and last week, that adage proved true for one young nurse who took her own life. Now is the time to end nurse bullying.

As it was first said by nursing professor Judith Meissner in 1986, “nurses eat their young,” and last week, that adage proved true for one young nurse who took her own life. Rhian Collins, a 30-year-old nurse and mother of two, committed suicide after being bullied by her coworkers at a U.K. psychiatric hospital.

In light of this tragic news, we find it is our responsibility to have a frank and open discussion regarding nurse bullying and suicide. Because, at its core, the nursing profession is a caring one. It takes certain levels of empathy and heart to do what nurses do, day in and day out, and that should not only be reserved for patients, but also for your fellow nurses.

Stress and burnout among nurses are, understandably, pervasive. Shifts are long, hospitals are understaffed, and tensions are high, but to put it in perspective, research suggests that at least 85% of nurses have been bullied at some point in their nursing career, and the number could actually be higher, as it is often speculated that incidents are under-reported. One study has stated that depressive symptoms among nurses clock in at 18%, and another shows that number as high as 41%. Even more alarming, a U.K.-based study published last year found nurses are 23% more likely to commit suicide than women in general, and the BBC has reported that nurses are four times more likely to commit suicide than people working outside of medicine.

All of those staggering numbers, and yet, the culture of nurse-on-nurse bullying has not changed much, if at all, since it was first said that “nurses eat their young.” However, there is hope, as many younger nurses have been put through the paces of school-based anti-bullying initiatives as they have grown up and stigmas of mental health issues have began to lessen. But unless and until a different mindset takes over the nursing profession, the problem will persist.

You cannot eat your young and expect them to survive.

We know you are stressed out. We know your hours are long, your back is aching, and you probably didn’t get to have a real lunch break today. We are not negating those stresses in any way. However, it doesn’t take much effort to just be kind—to yourselves and to your fellow nurses. You may just save another life in doing so, and that is what nursing is all about, saving lives.

If you are having thoughts of hurting yourself or others, we encourage you to seek help by calling the National Suicide Prevention Lifeline at 800-273-8255 or by texting 741741 to have a conversation with a trained crisis counselor via the Crisis Text Line.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Mindset of Millennial Nurses

Millennials are quickly becoming the most dominant generation in nursing. What is their collective outlook on their professional futures? Take a look.

Millennials, as a whole, tend to get a bad rap. The generation, born in the 1980s and 1990s, is often stereotyped as being selfish and entitled, more interested in popular culture and handouts than hard work and drive. However, a recent survey by AMN Healthcare of nurses who fall into that age bracket shows that is not the case.

The Survey of Millennial Nurses: A Dynamic Influence on the Profession collected responses from 3,347 RNs, and compared the views of Millennial nurses (those aged 19 to 36) to those of Generation X (aged 37 to 53) and Baby Boomers (aged 54 to 71) in regards to their expectations of their work environments and professional futures.

The survey results show that Millennial nurses are more eager than their Gen X and Baby Boomer counterparts to seek new employment, including taking on travel nursing opportunities, pursue a higher degree or become Advanced Practitioners, such as Nurse Practitioners or Physician Assistants, and strive to obtain nursing leadership roles.

When asked about how the improving economy might impact their career plans, about 17% of Millennial RNs said they would seek a new place of employment as a nurse, as opposed to 15% of Gen X RNs and only 10% of Baby Boomer RN, and 10% of millennial RNs said they would work as a travel nurse, which is nearly the combined amount (11%) of Gen X and Boomer RNs who would consider the same.

The results also show that Millennial RNs are keen to obtain higher degrees and become APRNs. 70% of Millennial RNs said they want to pursue a higher degree, such as a BSN or MSN, which is significantly higher than the 56% Gen Xers and 20% Baby Boomers who would pursue the same, and 49% of Millennial RNs indicated becoming an Advanced Practitioner is a career path they want to consider. Only 35% of Gen X RNs and 12% of Baby Boomer RNs said they had the same APRN career ambitions.

Millennials are also more eager to lead, with 36% of Millennial RNs saying the pursuit of a nursing leadership role is something they are interested in, as opposed to 27% of Gen Xers and 10% of Baby Boomers.

With results like these, and Millennials quickly becoming the most dominant generation in nursing, it seems like there are a lot of bright futures to be had.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Tips to Craft Your Best Nursing Resume

At first glance, what impression does your resume make on your behalf? Could it impress a hiring manager or recruiter in six seconds? If not, read on.

On average, your resume has about six seconds to make a good first impression, and that is only if it’s being seen by a living, breathing human being, not a machine, such as an ATS. Then, if it is good enough to pique their interest, one in five recruiters will make up their mind about you and your qualifications in less than a minute, and over all, employers will spend, on average, only three minutes and 14 seconds reading your resume. Those numbers shouldn’t scare you, but they should definitely make you think. At first glance, what impression does your resume make on your behalf? Could it impress a hiring manager or recruiter in six seconds, a minute, three? If the answer is no, here are a few tips on how to make it shine.

Keep It Clean and Professional

If your resume only has a very brief period of time to catch someone’s eye, it’s best to find a layout that doesn’t look like the rest, while still retaining a professional design and having clearly marked sections of information. Look to websites such as Creative Market or Etsy for inspiration, or download some modern templates you can use for a small fee.

If you don’t use a readymade layout, make sure whatever layout you use is free of photos and “fancy” fonts, as those may not render properly across all platforms, and over 40% of recruiters are put off by the use of them. Stick to standard fonts, such as Arial, Calibri, or Helvetica, have clear section headings, and make use of bullet points to draw the eye to important pieces of information.

Also, be sure that your contact information is easy to find, and that it is professional. You should include your full name, with your credentials listed after it, address, telephone number, and an appropriate email address—because 32% of recruiters will reject someone simply for having an inappropriate email address.

While we are all taught not to judge a book by its cover, you also need to get noticed for the right reasons, and the first impression your resume makes could make all the difference.

Your Objective Is Already Clear

The Objective section of the resume is dead. If you are submitting a resume, it is common knowledge, and can very easily be assumed, that you are trying to “obtain a position within [your] field to further [yourself] personally and professionally.” Call the time of death on that and send it on down to the morgue—it’s dead.

Your objective is clear; why you are the right person for the job is not. Which is why the Summary section has replaced the Objective, and is alive and kicking. Instead of using a bunch of regurgitated, standardized language about why you are trying to find a job in your field, show off your qualifications. Talk about your accomplishments and how you add value to the facilities you’ve worked for and the lives of your patients, or how you excelled in nursing school.

Give them the most impressive bits of your history right up front and make them want to learn more of your details by reading on to your Professional Experience and Education sections.

Show Your Strengths and Avoid Being a Cliché

Over 50% of recruiters will reject a candidate if their resume is full of clichés. Everyone is a hard worker, a team player, is motivated, driven, and works well under pressure—particularly, if you’re a nurse. Soft skills, such as those, may sound good to you, but they are really just filler for those on the hiring end of things, and they add no value to your resume.

If you are going to highlight your strengths, do so in concrete ways.

What states are you licensed in and what certifications do you have? What professional associations do you belong to? Which EMR/EHR systems are you familiar with? What caseload have you handled and in what unit? Which industry-wide protocols, processes, and procedures do you have experience with? Are you bilingual? What skills set you apart from every other nurse?

Also, don’t be afraid to use industry-specific terminology. These people are hiring nurses, after all. They’ll know what you mean when you say you’re experienced with Level I Trauma, da Vinci Surgical Systems, balloon pumps, 12-lead placements, and so on.

Check Your Spelling and Grammar, Then Check It Again, and Once More

59% of recruiters will reject a resume based solely on spelling mistakes and poor grammar. Which may seem silly to some, but attention to detail is important, not only in writing your resume, but in your nursing career, itself. Read through your document multiple times to look for spelling and grammatical errors, or ask a friend who is good with words to do so on your behalf.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

One Nurse’s Take: Working in the ICU

“Since beginning my RN journey, my outlook and perspective on life have changed dramatically,” says Jamie Dupont, RN, in this look at her life in the ICU.

We spoke with Jamie Dupont, RN—and a relatively new RN, at that—about about her choice to become a nurse in the ICU, and what she has learned since. Read on for some insight into the trials and triumphs of her experience.

You’re an ICU nurse, and a relatively new one. How are you liking your job so far? Is it different than you expected it to be? What are the major differences between nursing school and being a nurse?

I am new to the field of nursing; however, I am experienced in the medical field as a paramedic. I enjoy the ICU aspect of medicine. It is very challenging not only physically and mentally, but emotionally, as well. I am used to dealing with a patient for a very short, limited amount of time, whereas being in the ICU, I can have a particular patient and their family for up to four twelve-hour shifts. It is definitely different than I expected it to be. One wrong decision or error on my behalf, and I could have a serious problem on my hands. It is more high stress than when I was in school. While in school, you have an instructor to look over all of your medications and watch how you perform your skills, so that you do them correctly. Once you are on your own, there are resources all around you, but it’s pretty much up to you to make things happen.

Is working in the ICU the specialty you wanted to get into when you started the process to become a nurse? If not, how did you end up there? What drew you to working in the ICU?

I worked pre-hospital for 7 years and wanted to explore my options as a RN. I did not want to work somewhere that I would be comfortable and not allow myself to broaden my knowledge base. I also was considering moving on in the near future to become a CRNA or ACNP. I am still unsure if graduate school is in my future, however, I start my BSN in August. I figured that critical care is another challenging way to build my knowledge, as an emergency provider. It is also a great way to become a well-rounded RN. If you can hack it in the ICU as a new graduate nurse, you can hack it in any department, at any hospital, in my opinion. I chose to work for a Level 1 teaching hospital. This means that we have the highest inpatient acuity. We admit some of the most sick and unstable patients in the area, which allows me to see some cases that no one else may ever see in their lifetime. Not even as a seasoned nurse, with many years of experience.

What are the challenges you face working in your specialty, and what do you find most rewarding?

One of the biggest challenges in the ICU, especially in a neurosurgical unit, is the amount of mortality that we deal with. Even when patients end up surviving, they have major life altering deficits that affect not only the patient, but their family and friends, also. I see many families that have to make very difficult decisions regarding loved ones, and sometimes you see the results of these decisions. Families go to extreme lengths to keep a family member alive. However, the long-term effects can be detrimental to the patient and the family. It is unfortunate and can be very upsetting to witness what these individuals must go through. Since beginning my RN journey, my outlook and perspective on life have changed dramatically.

Can you describe your typical day on the floor?

A typical day on my unit consists of getting report from the night shift RN. We have a unit huddle every morning, where our nurse manager discusses any important unit issues or things that need to be addressed. I assess my patients as soon as I arrive and start to organize my day. Sometimes my day will go as planned, but most of the time it does not. On day shift, we do “rounds,” where the providers, charge nurse, dietary, OT, PT, and case management will come around and get a quick update on each patient. We figure out a plan from there and what the goal is for each patient. How my day will unfold depends on the patient. If my patient is complex and needs more attention, then they will be getting what they need. We act as a team on my unit and if anyone needs help, there are more than enough hands to go around. Meds are given, interventions are completed as necessary, and families are taken care of on an individual basis. I like to involve family as much as possible, as it will help make my day and the patient’s day move along smoothly. If they will help feed a patient that needs feeding, I will show them what to do. If they would like to help suction a patient’s mouth when they need it, I will give them a quick lesson on how to use the suction catheter. It is all about keeping them involved and making them feel like they are able to do something for their loved one. This especially helps in a time when some of these families feel so helpless.

What personal and professional traits do you think qualify someone to work in the ICU as a nurse?

To work in the ICU, you must have patience, first and foremost. There is a saying that ICU nurses are “OCD” and Emergency Department nurses tend to be more “fly by the seat of their pants”. I think someone can find a happy medium between both, and be a great nurse, in both realms. Patience in learning, patience with people, patience with yourself. That is key to becoming a great ICU nurse. It is not an easy path, to choose to work with some of the sickest people on this earth. There are days that are extremely challenging, even for someone who is used to dealing with very sick or injured people. You have to also be able to have good coping skills. If you are the type of person that takes your work home with you, then the ICU may not be a great job for you. Some of the situations you encounter can be trying and you have to be able to handle it in a healthy manner. ICU is not for the faint of heart, but if you are up for the challenge, it is very rewarding.

What advice would you give to someone considering working as a nurse in the ICU?

I think if you are considering working in the ICU that perhaps you should get some experience and shadow someone in that unit, before jumping in headfirst. I believe, in nursing, no matter what you chose as your path, it is always a good practice to shadow and see if it is something you are going to enjoy doing for twelve hours a day. It may not be everything you thought it would be. Make sure it is something you will enjoy. If not, becoming a nurse is a great opportunity to branch out and find something of interest. There are many avenues in this field, which is the main reason I went to school to become a RN. Opportunities are endless! The only quality that all RNs must have is that they must be compassionate and caring. If you are both of these things, then the nursing world is your oyster.

Interested in sharing some insight about your specialty and experience with your fellow nurses? Email us to set up an interview.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

The Best and Worst States to Be A Nurse

Maine is the top place to be a nurse, and D.C. is the worst, according to new survey results. Where does your state land on the list?

The nursing industry is alive and well, and it is expected to grow at more than double the rate of the average occupation through 2026. But where is it best, and worst, to be a nurse?

New findings from WalletHub, as determined by comparing the 50 states and the District of Columbia across 21 crucial metrics, including average salary, average starting salary, nursing job openings, patient ratios, and more, offer some insight. Each metric was graded on a 100-point scale, with a score of 100 representing the most promising conditions to be a nurse.

Below are the top five best and worst states and their scores, as found by the survey, as well as other key findings.

Top Five Best Places to Be A Nurse

  1. Maine (62.96/100)
  2. Montana (62.07/100)
  3. Washington (61.41/100)
  4. Wyoming (61.31/100)
  5. New Mexico (61.11/100)

Top Five Worst Places to Be A Nurse

  1. District of Columbia (33.08/100)
  2. Hawaii (38.49/100)
  3. Vermont (44.88/100)
  4. Alabama (45.58/100)
  5. Louisiana (46.27/100)

Most Nursing Job Openings Per Capita: Vermont
Highest Annual Nursing Salary, Adjusted for Cost of Living: Arizona
Most Healthcare Facilities Per Capita: South Dakota
Lowest Competition by 2024: Nevada
Highest Percentage of Population Aged 65+ by 2030: Florida

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.

Defining Nursing Career Success on Your Own Terms

Your definition of a successful nursing career may look vastly different than that of your fellow nurses, and that is okay, because career success is a personal thing.

From Nurse Keith’s Digital Doorway

Every nurse and healthcare professional has the opportunity to define success in their own way. However, how many of us allow our nursing careers to be defined by someone else. How can we seize control of our careers and define success on our own terms?

Beyond a Cookie Cutter Career

At this time in your life, your definition of success may mean earning your Masters in Nursing by the time you’re 35 and your PhD or DNP by the time you’re 45. For one of your nurse colleagues, success may mean getting a BSN and finding a job that will pay the bills and put a child through college. For another, it’s taking a year off and traveling the globe on an around-the-world ticket. And why not?

There are many prescriptions for a successful nursing career, but cookie-cutter solutions are just approximations of what’s possible for you. What works for Jane the nurse doesn’t necessarily add up for Bill the nurse — Jane and Bill have different life histories, goals, professional experiences, family circumstances and responsibilities, so they each need to forge an individualized path forward.

Just because “they” say you need two years of med/surg before pursuing other opportunities doesn’t make that true for you. As a new grad, I skipped med/surg and acute care altogether and never looked back as I created a career focused on community health and home health nursing — did I miss out on some experiences? Sure. Do I care? Not really. It was my choice, and the consequences of that decision are mine to bear, whatever they may be.

Your Own Compass

When a hiker strikes off into the woods, they often use a compass (whether an old-fashioned version or an app) to keep from getting lost. All compasses universally point out where north, south, east, and west are, and the hiker can use those cardinal directions in concert with a detailed topographic map in order to make good decisions about where they’re heading.

Not so with a nursing or healthcare career — true north for one nurse is dead wrong for another. For most new grads, that first professional expedition out of school means marching right into an acute care position — that’s true north in many cases. But for us nurse iconoclasts, rebels, and black sheep, we may very well turn around and march in a completely opposite direction than our peers, and that’s OK.

Wherever you happen to be in your nursing career, it’s your responsibility to find your own compass and solicit the drummer who will play the beat that moves your feet towards your own definition of success.

Defining Your Success

In order to take the bull by the horns and define success on your own terms, you need to know what you think and feel. This may seem rudimentary, but many of us allow ourselves to be buffeted by the winds of opinion that others force on us. We may also be influenced by our peers’ choices, even if they themselves don’t tell us what we should be choosing or doing.

Knowing what you truly think and feel necessitates exploring your motivations, goals, and desires, as well as identifying the preconceived notions that you brought to your professional nursing career. We all have career baggage, as well as self-judgments that hold us back and keep us from making choices that are truest to our nature.

These questions (and others, of course) may hopefully lead to further exploration and the uncovering of what you really want:

  • What are my greatest strengths? What do I bring to the table as a nurse and healthcare professional?
  • What are my “weaknesses”? Where do I need to bolster my knowledge, expertise, and/or experience?
  • What are the things that are potential threats to my success and happiness? (e.g.: Do I lack motivation? Am I going through a difficult divorce? Do I have medical or mental health conditions that impact me negatively at home or at work? Is a lot of my energy taken up by caring for an elderly parent or disabled loved one?)
  • What opportunities are out there just waiting for me to seize them?
  • Who do I know who might be a good networking connection?
  • What are past experiences that can lead to new opportunities in the future?

Staying Focused

Many factors will influence what we do in our nursing careers over time. If your personal circumstances change (e.g.: divorce, marriage, birth of a child, etc), you may need to make some adjustments in your work schedule. If your hospital is bought by a big corporation and heads are rolling left and right, you may need to abandon ship before things get really bad.

Threats, opportunities, and stuff that just plain happens may cause you to lose focus and deviate from a very clear career plan. These abrupt turns can be advantageous happy accidents, but they can also lead you unhappily astray.

Staying focused means you consciously choose to keep your eyes on the prize, maintain the integrity of your plans, and simultaneously be open to serendipity and the unknown. An open mind will serve you best in just about all situations.

Know Thyself

Creating a nursing career on your own terms calls on you to know yourself as well as possible. The aforementioned advice is just the tip of the iceberg: find coaches, mentors, counselors, therapists, colleagues, and/or accountability partners who can listen well, hold your feet to the fire, question your motivations, and otherwise be there when you’re at your strongest or your weakest.

Dig deep and get to know yourself. If you do nothing else, self-reflection and increased self-knowledge will benefit every aspect of your life, not to mention your relationships with those around you.

Defining your nursing career on your own terms isn’t rocket science, but it’s also not as simple as it seems. Do the work, put in the sweat equity, and you’ll be rewarded with self-knowledge, self-confidence, and an understanding of what makes you tick in both your personal and professional lives. The rest is icing on the cake.

Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is co-host of RNFMRadio.com, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses.

A widely published nurse writer, Keith is the author of “Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century,” and has contributed chapters to a number of books related to the nursing profession. Keith has written for Nurse.com, Nurse.org, MultiViews News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog, Working Nurse Magazine, and other online publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, online nurse personality, podcaster, holistic career coach, writer, and well-known successful nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives.

Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.