Category: Nurses

When Nurses Receive Their Due

Athletes and entertainers rake in millions—multimillions, actually—while those who save lives, such as nurses, struggle to make ends meet, put food on the table, and repay their student loans.

From Nurse Keith’s Digital Doorway

Most nurses will readily admit that they didn’t choose nursing because of the astronomically high paychecks. Sure, nursing can be a relatively remunerative career, but there are plenty of other professions that are significantly more financially rewarding (and free of some of the challenges that nurses face on a daily basis). So, what if nurses were paid a whole lot more in exchange for saving—and otherwise improving—the lives of a grateful public?

Multimillion Dollar Players

We all know that entertainers and athletes make a lot of money, whether it’s deserved or not. NFL players sign multimillion dollar contracts in return for throwing and catching a ball (and, admittedly, running a lot), and singers and entertainers rake in millions in exchange for strumming their guitars, singing, dancing, and cavorting on stage and in music videos. Meanwhile, we all know that actors also make multimillions—and let’s not forget those lucrative product endorsements.

Don’t get me wrong—sports and the arts contribute greatly to the fabric of societies the world over, and there are many individuals who could honestly say that a song or movie saved their life (whether literally or figuratively). While I’ve never followed sports, many fans would likely share that the joy of watching a very exciting game allows them to forget their troubles for a few hours, transporting them to a blissful realm of communal celebration.

So, if those who entertain us and thrill us earn millions per year, why is it that those who are so-called “angels of mercy” or “lifesavers” frequently struggle to make ends meet, put food on the table, and repay their exorbitant student loans?

How Do We Measure Value?

Granted, we place a very high value on entertainment and sports, and I, like millions of others, flock to the movies, download music, and stream movies, and otherwise support the careers of artists, actors, musicians and others whom I admire. While I can’t say that David Byrne’s music has ever saved my life, his music is indeed a part of my personal soundtrack, and the value of that is difficult to measure.

Do nurses deserve to earn more? Absolutely. Can our healthcare infrastructure afford to offer multimillion dollar contracts to every nurse? We’d all likely agree that that would cripple the system overnight. Still, do we value certain services and professions enough to make sure that they are compensated appropriately? Probably not.

Cognitive Dissonance

This modest blog post is not written in the spirit of having any answers to the largely rhetorical questions that it raises, but the questions are well worth considering.

Of course, when millions of people buy the new Rolling Stones CD and pay several hundred dollars each to watch Mick Jagger strut his stuff live on stage in some massive arena, it follows that the Stones’ individual and collective wealth will be mushrooming as the fans scream for more.

I don’t begrudge Mick or his fellow bandmates their wealth, but I also wonder why an ER nurse who plunges her gloved hand into the gaping wound of a patient to stop a life-threatening hemorrhage and save a life doesn’t earn more than $40 per hour (and in some cases much less than that). And if that nurse was saving the life of said Mr. Jagger, for instance, does that make her actions more valuable than if she were holding the severed femoral artery of a carpenter, hairdresser, or homeless person?

This is where I experience cognitive dissonance while still having no answer to the question of why that disparity of income truly exists—and what can be done about it, if anything.

I Have No Answers

Truly, I have no answers, but I certainly have many questions.

The communal experience of a Rolling Stones concert (which I’ve never had the pleasure to attend, mind you) could indeed give a concertgoer such transcendent pleasure that her emotional wounds of the day could very well be assuaged for a brief time as she falls under the Stones’ well-rehearsed magical spell. The reverberations of that experience could also positively impact her well-being for days or weeks to come.

Now, if that same individual was in a car accident and a nurse or paramedic was able to reverse her flatline and bring her back from the brink of death, is that experience more important or life-changing than the Rolling Stones concert? I would imagine it probably is. Still, the earning potential of that nurse or paramedic would not generally be impacted by having saved that life, while the aforementioned Mick Jagger would settle into his limousine, stopping by the bank to deposit another check for $3 million. (Actually, I’m sure Mick hasn’t set foot in a bank for decades.)

Can this playing field be leveled? I doubt it. Should it? Yes, indeed. But this is actually a societal issue in the largest sense of that notion, and the answers are obviously very elusive, at best.

An Endless Conundrum

Sure, nurses will never earn as much as brain surgeons, and that’s okay since brain surgeons undergo a great deal more education and training while also carrying an astronomical liability for the work that they do.

Nurses will also never earn as much as Mick Jagger, and they certainly won’t receive the adulation that good old Mick receives, even though they’ve held those severed arteries and saved lives galore.

This question of relative value and income is one worth considering, and readers’ responses are welcome. Again, I have no answers&mash;only more questions—but conversations about such issues are a valuable exercise in measuring and assessing our individual and collective values.

So, the next time a nurse saves your life or the life of a loved one, consider how much that means to you as compared to, say, watching Mike Jagger strut and crow like a rooster. A front row seat to see the Rolling Stones is exhilarating, but so is the sight of a nurse saving the life of the person you love the most.

What is value? What is valuable? And how do we measure relative value of those who touch our lives in one way or another? The conundrum remains unanswered.

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.

Summer Reading for the Stressed Out Healthcare Practitioner

There is no time like the present to start practicing self care, and Debut A New You, a new book by Mimi Secor, is a fantastic place to begin.

Are you tired of feeling unhealthy, stressed out, overwhelmed, but you don’t know where to start? Well, guess what? In my NEW #1 International Best-Selling book, Debut a New You: Transforming Your Life at Any Age, I teach you how to change your life, become healthier, build your confidence and become more successful than you ever imagined possible.

As a nurse practitioner for the past 41 years I know what it’s like to be stressed out and unhealthy while meeting everyone else’s needs. But you can’t serve from an empty vessel. It’s time for you to become healthy so you can be a role model for your patients, family and community and, most of all feel, good about yourself. That’s powerful medicine. So, join me as I challenge you to jumpstart your health and new life TODAY.

To order my book, just go to DebutANewYou.com. Join my mail list by texting “DrMimi” to 36260.

Dr. Mimi Secor is a board certified Family Nurse Practitioner specializing in Women’s Health for 36 years and is a popular National Speaker and Consultant, educating advanced practice clinicians and consumers around the country and the world.

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.

10 Interview Tips for Nurses

Interviewing for a new nursing job? Here are 10 tips to help you make sure you are well-prepared and set up for success on the big day.

by Deborah Swanson

Interviewing for a job can be nerve-wracking, especially if it’s your first job out of nursing school. However, there are several steps you can take to make sure you are well-prepared and set up for success on the big day. Here are 10 tips that can help make any nursing interview go smoothly:

1. Plan Ahead for the Interview

Research parking options and plan out your route beforehand. Google Maps desktop version has a feature that lets you forecast how long it will take to get your destination at particular times of day, such as rush hour. Check the weather and try on clothing the night before to decide on an outfit. You should wear professional clothing — suits for men and a dress or a blouse and skirt or pants for women — rather than scrubs to the interview.

If the clothing needs to be washed, ironed, steamed or starched, starting the night before will give a chance to take care of that. If you wear jewelry or makeup, choose what you’re going to wear so you’re not scrambling to figure it out the morning of.

2. Get Plenty of Sleep

Interview jitters can keep you up at night, but try to sleep as much as possible the nights leading up to the interview so you can look fresh and think more clearly. If you have trouble falling asleep, a hot bath, caffeine-free tea, eye mask and melatonin can help you relax and fall or stay asleep. Try to avoid drinking alcohol, watching TV right before bedtime and other activities that can decrease or disturb your sleep.

3. Eat and Drink the Smart Way

You don’t want your stomach to growl loudly during the entire interview, so even if you’re nervous, try to eat a few hours before the appointment. Stick to nourishing foods that you know won’t upset your stomach or otherwise cause discomfort. Try not to overly caffeinate yourself, as this will only make you jittery, and drinking too much soda can cause belching and other stomach upset. Bring a bottle of water with you in case your mouth gets dry during the interview, and get there early enough that you have time to use the bathroom if necessary.

4. Research the Company and/or Position

Knowing as much as you can about the facility and the nursing position will give you concrete information to ask questions about during the interview. It will also demonstrate to the interviewer that you are truly interested in the job and did your research beforehand — they won’t hire someone who didn’t care enough to learn about the company before the interview.

5. Ask Your Network for Advice

If you have nursing contacts who have worked at this particular company or facility, reach out to them to ask about their experience and what you should know about the company going into the interview. Even if you don’t know anyone who works at the place you’re interviewing, you should still reach out to your more experienced nursing friends for advice, especially if you’re interviewing for your first nursing job after school. They’ll be able to advise you on what questions to prepare for.

6. Practice Your Interview Answers

No matter what kind of job you’re interviewing for, you can expect some questions to pop up over and over again: Why do you want this job? What makes you qualified for this position? What are your strengths and weaknesses? Why did you choose to become an RN? Where do you see yourself in five years? Make a list of expected questions and outline some bullet points that you can use to answer them. Then practice your answers, either by yourself or with a willing helper. The point is not to memorize the answers, but rather to feel comfortable discussing the content so you won’t suddenly go blank during the interview.

7. But Remember There Will Be Some Curveball Questions

There’s no way to anticipate every single question an interviewer might ask you, so no matter how much prep work you do in advance, there will probably be one or two surprises. When this happens, take a sip of water or write down a note to give yourself a moment to think. If that’s not a possibility, you can even tell the interviewer, “That’s a really good question; give me a minute to think about it,” to buy yourself a few seconds to gather your thoughts.

8. Be Prepared to Ask Questions of Your Own

In most job interviews, the hiring manager will leave time at the end to answer any questions you may have. If you don’t have any questions ready to ask, it can seem like you haven’t done your homework on the company or that you weren’t paying attention during the interview — neither of which makes a good impression. Using your research, make up a list of questions you can ask beforehand about relevant topics, such as training programs for new nurses or scheduling requirements and patient ratios.

9. Don’t Forget That You’re Interviewing Them, Too

During interviews, it can feel like you’re on trial for a new job. But don’t forget that you’re also interviewing the company or facility to figure out if the job would be a good fit for your professional goals and interests. Asking questions will not only show that you’re active and engaged in the interview; it will also help you determine if the culture and job duties are in line with what you’re looking for.

10. Send a Thank You Note

If you have a phone interview, a quick email thank-you within 24 hours will show that you’re still interested in the position and grateful for the interviewer’s time. If you were called in for an in-person interview — especially if it’s the final round — you should send an email thank you within 24 hours as well, followed by a written thank-you within the week if you haven’t heard back.

Some people advocate for only handwritten thank-yous, but if the hiring manager is trying to make a decision within a few days, snail mail might not reach him or her in time. In all thank-you notes, be sure to reference something specific that you talked about to jog the interviewer’s memory.

Planning ahead can make the day of a big interview much less stressful. Follow these 10 steps to make sure you’re prepared to ace your nursing job interview.

 

Deborah Swanson is a Coordinator for the Real Caregivers Program at allheart.com. A site dedicated to celebrating medical professionals and their journeys. She keeps busy interviewing caregivers and writing about them and loves gardening.

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 On Travel Nursing

Jennifer Corona, BSN, RN, CCRN, sat down for an interview with us to offer some insight into the trials and triumphs of her experience with travel nursing.

We spoke with Jennifer Corona, BSN, RN, CCRN, about her decision to give travel nursing a try. Read on for some insight into the trials and triumphs of her experience.

Why did you decide to get into travel nursing?

I worked as a nurse in Connecticut for 5 years, splitting my time between Medical-Surgical nursing and Intensive Care nursing. As I was going through the nursing program, I’d encountered several experienced nurses who taught me about what travel nursing entailed. It intrigued me, as a single woman, to go see the world and enhance my career while traveling to different areas, and seeing how policies/procedures may differ. For me, the straw that broke the camel’s back was a particular shift I had in the ICU that led me to actually start researching travel companies. I got tired/burnt out of having, at times, 3 ICU patients. No matter how critical, if it’s your turn to triple, it’s your turn. We did not have laws regarding nurse/patient ratios, nor a union to fight for such a law. Later, I learned this to be true in other states.

Could you us a bit about your first assignment, and what the process was like?

My first assignment was in Los Angeles. I was annoyed at first, because I wanted to be in San Diego, which was tough at the time of the year I was trying to get there. (November was when I had inquired about travel). I knew nothing about the areas. Did not know much about the hospitals at all. I took a CCU/ICU float pool travel position. I once flew to Anaheim, CA for a nursing conference while in nursing school, but didn’t know enough about anything in CA. I knew, however, with my short stay for the conference, it was definitely something I wanted to explore further. I just didn’t know when I would pull the trigger on actually going. Once I signed the contract, I was nervous and scared. That meant it was final, and that it was time to give my notice at my job in CT, which was hard because it was my first nursing job ever. It was where I met my friends and learned everything I knew. Just picking up and moving across the country alone isn’t easy. I kept telling myself, “It’s only 13 weeks. I could always come back.” In fact, I kept my apartment in CT, just in case I hated it, so I could move back. However, it worked out. 13 weeks turned into me living in LA for 6 years and meeting my husband.

What are the benefits and drawbacks of being a travel nurse? What was most challenging? Most rewarding?

The benefit of being a travel nurse is that nothing is permanent. You’re only there for as long as you signed your contract—8 weeks, 13 weeks, not forever. The most challenging is adapting to the new hospital. Nursing is nursing, no matter where you are. As long as you know where supplies are/code cart/med room and how to get a hold of the doctor, you’re golden. It can be difficult, if you don’t have a good team of people working with you, though. A good charge nurse and fellow nurses make all the difference. When a patient acutely declines, you cannot do it all, you depend on your fellow coworkers to help, and you have to instill trust in these people, who you may have just met when you started the day before. The challenge is trusting their knowledge. The rewarding factor is the same, no matter where you work. It’s the foundation of why we become nurses. It’s all about helping and advocating for patients. Guiding them through their hospital stay. Teaching them what needs to be done or what they need to watch out for when they leave the hospital. Rewarding is watching a patient, who you thought may not make it, or someone who just arrested in front of you, end up walking out of the hospital weeks later. Knowing you were a part of that puts a reward in your heart that can’t be explained.

What surprised you the most about travel nursing? What did you learn from being a travel nurse?

I learned you have to make sure you research your travel company to the fullest. The big names aren’t always the best companies. Some of them may try to withhold money from you. You have to be firm, more direct, when negotiating your contracts with your recruiter. If not, you may be walking away with the bare minimum for pay. We, as the nurses, are the middle people; we are the demand or the pawn, in the eyes of the recruiter/hospitals, so our moves are very important, as far as what we want in our contracts.

What advice do you have for those considering becoming a travel nurse? What questions should someone ask before taking an assignment? Any tricks of the trade? Any common misconceptions about travel nursing you want to clear up?

I highly recommend researching multiple companies. Write out what each is offering—bonuses, housing stipend, moving expenses, parking, etc. You can use what other companies offer as a bargaining tool. I suggest getting your own housing. Going with the housing offered through the travel company will usually use the entire stipend—a mistake I, admittedly, made. It was nice not having to worry about paying rent, because the travel company handled that, but if you take the housing stipend, they will send you a full check and you keep whatever is left over, even if your rent is cheaper. As a former traveler, you do get floated a lot. You’re normally first to go. That is a drawback. I didn’t know that when I signed up. Also, the hospital that I first signed with is notorious for such behavior—I would even float 3-4 times a shift. Not every hospital is like this, though. I strongly recommend travel nursing. You get to see the world—literally. What other position will provide the relocation, housing, and the job? None. I encourage nurses to take this opportunity and see how other hospitals function, other parts of the world. For me, I learned the West coast is the place for me, including their nurse/patient ratio laws. Hence the reason a 13 week assignment turned into 6 years for me.

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.

Should I Quit This Darn Nursing Job?

Have you ever wondered when it’s time to quit your nursing job and move on? Are you stuck in a job, uncertain where to go next as a nurse? Or do you just need a change of scenery?

From Nurse Keith’s Digital Doorway

Have you ever wondered when it’s time to quit your nursing job and move on? Are you stuck in a job, uncertain where to go next as a nurse? Or do you just need a change of scenery? It’s all about timing, self-care, finances, lifestyle and workstyle, career development, and other factors that impact how long you stay and when (and why) you go.

Ready to Move On or Not?

Making the choice to move on from a nursing job you’ve had for a while is not always an easy choice. There are multiple reasons to move on, just as there may be a myriad of reasons to hang in there.

What has led you to quit jobs in the past? Was it money? Was it health insurance or other benefits? Were you mistreated, overworked, burned out, or underpaid? Did you receive an offer you simply couldn’t pass up? Did you need to relocate? Were there other reasons you left for greener pastures?

Sometimes we feel we should move on but something stands in our way. Is it the money or the benefits? Is it pressure from our spouse or family to not undergo the stress of a job change? Or is it just regular old lack of motivation and career lethargy?

Whether you currently need to move on or not, it’s always good to be prepared for the eventuality that a change may be on the horizon.

Some Reasons to Quit That Job and Move On

How many reasons are there to quit your nursing job? Let me count the ways.

Poor leadership/management: One of the top reasons that people leave jobs is poor management and leadership. When you don’t feel supported by those who you report you, the game’s over and it’s time to jump ship.

Your nursing license is endangered: If your work environment is such that you feel that your nursing license is at risk, leave that job today and don’t look back. No amount of money or benefits or prestige is worth the risk of losing the license that you’ve worked so hard to earn and maintain. An untold number of circumstances or conditions can endanger your license, patient care, and perhaps even your safety. My advice: don’t compromise on this ever! It’s just not worth it.

You are physically unsafe: An unsafe environment where you’re physically in danger and have little or no protection is a workplace that simply doesn’t deserve you. If your workplace doesn’t offer the resources to be physically safe from harm, grab your parachute and leap from the plane before you experience unnecessary and wholly preventable injury.

Mistreatment/bullying/harassment/etc: Mistreatment and aberrant behavior thrive in nursing and healthcare for some reason. Bullying is rampant, and discrimination and harassment are common. The presence of such behavior, when it goes uncorrected, is a sure sign that you need to exit, stage left as soon as possible. In the presence of persistent on-the-job bullying or harassment, I generally advise clients to leave their job immediately since that type of toxic environment eats away at the soul and psyche in very unhealthy ways that can be more damaging than being unemployed for a period of time between jobs. Bullying can cause you to make errors and lose confidence, and no one needs that kind of energy running in their work lives.

Overwork/staffing issues/burnout/unhealthy environment: This is so common it’s almost laughable if it wasn’t so tragic. California is the only state in the U.S. with mandated nurse-patient ratios, although some other states are moving in that direction. Legislation to mandate safe ratios nationwide makes its way through Congress every year but has yet to come down for a vote. Burnout often results from overwork, the pressures of mandatory overtime, long hours, high ratios, and unsafe staffing that can result in nurse or patient injury, medication errors, and many other less than positive outcomes.

Pay and benefits: With the cost of living as it is in the 21st century, it’s understandable that some nurses choose to leave their jobs in pursuit of more pay or improved benefits. Health insurance and your personal healthcare can be expensive, and some employers offer much more robust health benefits that others. Healthcare and childcare savings accounts help employees shelter more of their money from taxation, and other benefits like time off and money for continuing education can be attractive.

A better opportunity: Sometimes we leave jobs because something better came along. You never know when a new opportunity may cross your path, so be ready to jump when the jumping is good. New opportunities can lead to more responsibility, new clinical skills, a shot at a new circumstance that lends itself to career-building, or a host of other potential positive outcomes.

Relocation: Moving to a new home in a new town, city, or country is a common reason to leave your job. Relocation is common, and sometimes we just have to move for a variety of reasons, even if we’re happy in our work.

How to Leave Gracefully (or Not)

It’s almost always preferable to leave on a good note in the interest of relations and your reputation. If possible, you also may want to line up your next position before handing in your resignation. Of course, this is an optimal situation, and sometimes optimal is just not what presents itself. Here are some pointers for how to exit as gracefully as possible:

Give ample notice: I always recommend telling your boss that you’re leaving before you tell your colleagues (unless you have a peer in whom you’ve been confiding your plans). In terms of avoiding the unnecessary burning of professional bridges, try to give at least 2 weeks’ notice. However, it’s my humble opinion that giving notice isn’t totally necessary for a variety of reasons. For example, if you’ve documented bullying and reported it to your supervisors or managers, you deserve to leave stat if they’re consistently unresponsive. When you first report the situation, consider telling them that you’ll need to leave forthwith if the situation isn’t addressed appropriately and quickly. If you report it more than once and nothing happens, you’re in your rights to get out of there.

Request an exit interview: Exit interviews happen routinely in many industries, but I don’t really hear about them much in the healthcare setting. When preparing to leave, request an exit interview where you can give your employer or your supervisors feedback. If no exit interview is granted, put it all in writing, keep a copy for your records, and distribute it to as many key players as you like (e.g.: CEO, CFO, CNO, nursing director, charge nurse, supervisor, etc).

Connect with colleagues: A big order of business is connecting with friendly and supportive colleagues on LinkedIn throughout your career. It’s advisable to keep in touch with colleagues and peers over time for a variety of reasons, and LinkedIn is a great way to organize them all in one place. If you’re planning to quit or resign, begin connecting with your colleagues who you like and respect the most. Your ongoing job will be staying connected with those peers with whom you have the most positive rapport — you may need each other in the future. A nice gift to your best colleagues is to write them a recommendation on LinkedIn, which may be reciprocated. You can even ask to exchange recommendations with those with whom you share mutual respect and admiration. You can also ask certain individuals to serve as references in the future.

Offer to train your replacement: If you’re in a position with unique responsibilities, offer to train your replacement (if it’s at all possible). Sometimes we’re the holders of important knowledge or skill that needs to be passed on to the next person when appropriate.

Be self-contained: When you’ve decided to leave, play your cards close to your chest and don’t blurt it out everywhere at once. Be sensitive to your colleagues who may want to leave but can’t yet do it — they may be envious of your escape plan. Be empathic with those you’re leaving behind, especially if it’s a toxic or difficult work environment. Share the news of your leaving quietly and gracefully.

Document: If you wrote articles, co-authored studies, took part in committees, or otherwise got involved at work, save copies of anything you were a part of (unless, of course, it’s protected proprietary information that can’t legally leave the workplace).

Pat yourself on the back: You deserve it. Period.

As you can see, there are plenty of things to do in order to move forward into a brighter future.

Summing Up

Once you decide to leave, update your resume and LinkedIn profile with your new data. (If you’ve been following my advice all along, the job you’re leaving has been on your resume and LinkedIn profile since you first started that gig.) If you’re starting a new position right away, add it now.

If you’re leaving without the safety net of another job, you may have some budgeting to do. If you have a spouse or partner, make some plans — if you’re single, you’ll have to be even more diligent in terms of managing a period of unemployment on your own.

Once you start a new gig, begin forming relationships with fellow colleagues, connect on LinkedIn, and otherwise set the table for success.

When interviewing for your next position, you’ll most likely need to explain why you’re planning to leave your current job or why you already left. Have your authentic story ready — every circumstance is different, so there are no cookie cutter answers here.

If you need help in such an important transition, make use of a career coach, mentor, trusted colleague, or counselor. It can be a lonely and stressful time, so ask for support from whomever would be most effective at being present for you when you need it the most.

Leaving a job is a potentially stressful time, especially if you don’t have anything else lined up quite yet. Be thoughtful, circumspect, kind, strategic, organized, and gentle with yourself, and things will fall in place as you do your due diligence and move forward into an even more promising future.

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.

Travel Nursing: The Answer to Curing Nurse Burnout?

Burnout remains a common problem within nursing. Is travel nursing the cure?

By Guest Author: Deb Wood, RN, NursesRx Contributor

Burnout remains a common problem within nursing, driving nurses from a rewarding profession and negatively affecting patient safety.

“This is an ongoing problem, and we have to do something about it,” said Diana J. Mason, PhD, RN, FAAN, senior policy service professor at George Washington University School of Nursing in Washington, DC.

Vicki S. Good, DNP, RN, CPHQ, CPPS, past-president of American Association of Critical-Care Nurses (AACN), called burnout a “silent epidemic.”

A condition ACCN member Anna Rodriguez, BSN, RN CCRN, PCCN, began to experience while working at a hospital in Idaho. She began traveling, avoiding management responsibilities, colleagues calling off and hospital politics and, eventually, found a permanent position in Washington State she feels good about.

“[Travel nursing] was my way to recover from burnout,” Rodriguez said.

Rodriquez also blogs about burnout as a way for her and other nurses to become more resilient. She writes about patient compliments or something meaningful and then when she starts to feel burned out, she reads through it and reflects on what brought her to nursing.

Rodriguez is not alone in having felt burned out. Good reported that 30 percent to 50 percent of nurses exhibit characteristics of burnout, which is related to working in a high-stress environment. However, she added that most nurses do not realize when they are developing signs and symptoms of nursing burnout.

“Critical care nurses are at especially high risk for developing burnout syndrome, due to the high-risk and high-stress environment where they are asked to care for patients during a vulnerable time in the patient’s life, and often at the end of life, with the accompanying ethical issues,” Good said.

What is Nursing Burnout?

Burnout happens when clinicians are emotionally exhausted and feel alienated from their job-related activities.

“Nurses experience moral distress when they go home at the end of the day feeling that they were not able to do a good job, because they had too many patients and could not give them the care they needed and wanted,” Mason said. “Moral distress is tied with burnout and leaving [the profession].”

Many nurses experience burnout and leave nursing after one year, said Cynda H. Rushton, PhD, RN, FAAN, a professor of clinical ethics at Johns Hopkins University.

“Nurses’ work is intense,” Rushton said. “The suffering and conflicting values about patient care and the healthcare system can deplete people’s energy and make it difficult for them to feel they are making a difference.”

Nurses experience emotional, physical and spiritual depletion, Rushton said. People may shut down and go through the motions. Nurses may have difficulty sleeping or develop somatic symptoms or become cynical.

Repeated stressors lead to anxiety or disconnecting from work and losing passion, Rodriguez said.

“You lose whatever drive you had and you just don’t care anymore,” Rodriguez said.

Multiple research studies support that burnout presents a threat to patient safety. A 2016 paper from the Agency for Healthcare Research and Quality reported that it’s because of depersonalization that results from burnout.

What to Do About Nurse Burnout?

“A lot can be done, starting with recognizing it and secondly being open to learning new ways of managing,” Rushton said. “Nurses have to practice in a way they feel is consistent with their ethical values.”

First of all, take care of yourself. Eat healthy, get enough rest, exercise, meditate, take breaks during your shift and time off for vacations, and put things in perspective.

“The better shape you are in, the better able you will be to withstand the physical, emotional and intellectual challenges of the job,” Mason said.

Joy Jacobson, MFA, at George Washington Nursing Center for Health Policy and Media Engagement, and Mason have worked to develop reflective writing initiative for nurses to reconnect with the meaning and value of their work and cope with burnout.

“Reflective practice helps nurse cope,” Mason said.

Rushton recently developed the 24-hour, in-person Mindful Ethical Practice and Resilience Academy to give nurses tools to combat burnout.

“It focuses on building skills in mindfulness, ethical competence and resilience,” Rushton said. “This was designed to give nurses the skills they need to address the inevitable ethical challenges at the bedside and be able to do that with more ease and not so much cost to self.”

Rodriguez called early recognition of nursing burnout key to dealing with it. She recommended developing a good support system. She also suggested talking to others, reflective journaling, self-care, and making a change to a “different role at work or changing locations.”

That may be time to travel. Nurses can work with their recruiters to ensure they fill assignments in facilities that staff adequately and value their nurses.

“Many nurses like the idea of seeing other parts of the country, find a place they like and stay there,” Mason said. “There are so many opportunities out there.”

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One Nurse Per 4,000 Pupils = Not The Healthiest Arrangement

School nurse shortages have been reported in recent years in California, Oregon, Idaho, Utah, Montana, Colorado, North Dakota, Oklahoma, Illinois, Wisconsin, Michigan, Ohio, and Florida.

By Ana B. Ibarra

During a 15-minute recess, the elementary school students trooped from the playground toward nurse Catherin Crofton’s office — one with a bloody nose, a second with a scraped knee and a third with a headache.

Kids quickly filled a row of chairs. Staffers brought paper towels for the bleeders and tried to comfort the crying.

“We’re here for first aid, emergency, counseling,” said Crofton of the Mount Diablo Unified School District. “There is always something to do.”

Mount Diablo and other districts around the nation can use all the help they can get. Many suffer a severe shortage of nurses, and money to hire more is scarce.

Outside of California, shortages have been reported in recent years in Oregon, Idaho, Utah, Montana, Colorado, North Dakota, Oklahoma, Illinois, Wisconsin, Michigan, Ohio and Florida.

Last year, Crofton saw 20 to 30 children a day at Cambridge Elementary, located in eastern Contra Costa County in the San Francisco Bay Area. Some were first-timers, others her regulars — those with chronic conditions such as cystic fibrosis who need daily medication. Crofton said there are dozens of diabetic kids in the district, a huge change from 20 years ago, when they were rare.

Before taking a leave earlier this year, Crofton was on site at Cambridge Elementary three days a week and at Meadow Homes Elementary, about six blocks away, the other two weekdays.

Desperate to fill the nursing gap, the Mount Diablo district partnered with John Muir Health, a local health system of doctors and hospitals, to pay for her position. Other districts are also addressing nursing shortages creatively — and with mixed success — by opening school-based community clinics, conducting video sessions with faraway doctors and even training office staff to dress wounds or check glucose levels of diabetic children.

Beyond tending to minor scrapes, school nurses see many kids with chronic, potentially life-threatening illnesses that need medication and monitoring. Sometimes they are a child’s only regular link to medical care and often are the first to spot emerging disease outbreaks.

Last year, the American Academy of Pediatrics called for a minimum of one full-time registered nurse in every school. Before that, the recommended nurse-to-student ratio had been 1-to-750.

California, the nation’s most populous state, is far from hitting either goal. It had one registered nurse for every 2,592 students in the 2016-17 school year, according to the latest state data. In many districts, one nurse must cover two or more schools. (Districts don’t report their use of licensed vocational nurses, who are not as highly trained but are sometimes hired to fill in the gaps.)

At Mount Diablo, the ratio is 1 registered nurse to nearly 4,000 kids. Figures for the smaller, neighboring district, Antioch Unified, show 1 nurse per 17,326 students.

California, like most states, doesn’t have a specific budget for school nursing, and it doesn’t require schools to have a full-time nurse. Yet schools are obligated to provide certain health services to students, such as vision and hearing tests and medication monitoring.

“Obviously a nurse has to be on board to do that, so we kind of come in the back door that way,” said Pamela Kahn, president-elect of the California School Nurses Organization.

The organization has tried several times to get the state legislature to set minimum nurse-to-student ratios with no luck so far. “When you crunch the numbers, it’s overwhelming what it would cost to provide that kind of service in the state,” Kahn said.

In the meantime, some districts are looking beyond the traditional model of bringing health care to school kids.

Last year, the Sacramento City Unified School District experimented with telehealth, which gives school staffers electronic access to a doctor to guide them, but as of the beginning of this school year, district officials had not decided whether they’d continue.

Telehealth works well if there is a school nurse, not a school secretary, consulting with the doctor, said Nina Fekaris, the president of the National Association of School Nurses and a school nurse in Beaverton, Ore., outside Portland. “It can’t be viewed as a replacement of [nursing] services,” she said.

In some instances, clerks and other school staff have been assigned medical duties in the absence of nurses, with disastrous results. In Washington state, a girl reportedly died of an asthma attack in 2008 under the watch of a playground supervisor when no nurse was around.

Partnerships between school districts and health care organizations are among the most promising approaches because schools don’t have to bear the full costs of hiring nurses.

Besides building goodwill, nonprofit health systems like John Muir can count their contributions of nurses and free student services toward the “community benefits” they must provide to retain tax-exempt status. Under this model, they cannot collect reimbursement from Medicaid or private insurers for seeing the students.

Since 2008, John Muir Health has donated two nurses in schools where the need is the greatest. One of those is Cambridge Elementary, which is in a densely populated area, next to a busy corridor dotted with fast food joints and apartment complexes. Many families are first-generation immigrants and English learners who don’t have an established health care provider, said Chris Grazzini, John Muir’s clinical program manager.

Such partnerships, however, tend to be more popular on the East Coast. Schools in Toledo, Ohio, for example, hired 12 school nurses through a deal with a local health care system in 2015. As part of the three-year agreement, ProMedica, a local nonprofit health system, invested $1.8 million to hire nine nurses. The school district, Toledo Public Schools, pays for the others.

Ann Cipriani, the health coordinator at Toledo Public Schools, said the arrangement allowed the district to attain its goal of having one nurse in each of its 50 schools — meeting the Academy of Pediatrics’ recommendation. “It has made an amazing difference,” she said.

Schools in the Bronx partner with medical organizations to open health centers on campus. One partner is Montefiore Medical Center, which has established 25 school-based health centers, serving about 30,000 children.

Montefiore covers the cost of services by billing Medicaid or other insurance. State grants and private donations also help. The medical center is responsible for providing a doctor, nurses and a mental health provider at each center.

Similarly, Fresno Unified School District in California’s Central Valley aims to have seven health centers on campuses operated by Clinica Sierra Vista, a local group of health clinics and Valley Children’s Health Care. The first opened in 2014 and draws close to 500 visits a month. A second is scheduled to open next year.

Even with money in place for clinics and additional nurses, however, finding qualified professionals to fill the positions can be tough.

The 10-month work schedule is great, said Gail Williams, director of student health services at Fresno Unified, but it’s tough to compete with hospitals open year-round, 24/7. For a nurse, especially one with student loans to pay off, those jobs can be more enticing.

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

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.

Jump Aboard the Nurse Wellness Express

Nurses are renowned for not taking good care of themselves, ostensibly because they’re so busy taking care of others and living the lives of the saints that they are perceived to be.

From Nurse Keith’s Digital Doorway

Once upon a time, I was talking on the phone with a colleague who is not a nurse himself but who interacts with nurses on a regular basis in his professional life. His comments about nurses and their self-care (or lack thereof) were extremely thought-provoking.

Like I’ve said on this blog many times before, nurses are renowned for not taking good care of themselves, ostensibly because they’re so busy taking care of others and living the lives of the saints that they are perceived to be.

Let’s face it. We all know that nurses aren’t saints, while we also acknowledge that many nurses come close to sainthood vis-a-vis their compassion and their seeming ability to give until it hurts — and then give some more, either in their professional roles or in their personal lives.

Getting back to my phone call with my colleague, he told me that a dentist friend of his made an interesting comment about nurses. He said (and I paraphrase):

Nurses are my worst patients. They spend so much time taking care of others that they’re very good at neglecting their own health, especially their teeth! Do nurses floss? I bet that the majority think they’re too busy to take the time!

So, what does this say about nurses? Well, first it says that many nurses potentially have very bad dental hygiene and may be at risk of gingivitis. (Remember the old saying, “You don’t need to floss all of your teeth—only the ones you want to keep.”)

This also tells me that there are non-nurses out there who recognize nurses’ predilection for caring for others while neglecting themselves, and that this self-neglect is not always a mark of sainthood. Did Mother Teresa take the time to floss? That question will need to remain rhetorical. In the time of St. Francis of Assisi, floss had not yet been invented, and we might assume that Francis mostly eschewed the self-indulgence of self-care beyond the very basics. But we’re not St. Francis, are we?

The (Nurse) Gods Must Be Crazy

Whether it’s teeth, lungs, liver, heart, or kidneys, nurses can certainly be neglectful of themselves. Poor dental hygiene, smoking, not enough rest and sleep, poor diet, lack of sleep, alcohol and drug abuse, insufficient hydration — it all adds up to a portrait of a very unhealthy nurse.

We all hear about nurses who don’t have time to drink water or urinate during 12-hour shifts; so, without self-catheterization, a leg bag, and/or a CamelBack water hydration system, it seems many nurses might as well just send out an invitation for the gods of urinary tract infections to have a field day. (And maybe they can place a call to the gods of antibiotics at the same time.)

Heroism, Stoicism or Stupidity?

All joking aside (but it’s so easy to make fun of us nurses, isn’t it?), self-care for nurses is essential yet such uncharted territory for a vast number of hard-working nursing professionals with boots on the ground out there in the world.

Whether the wider culture or our profession’s internal culture is responsible for these images of nurses as self-neglecting saints, we all know that unhealthy nurses can’t really perform all that well in the long run (although running on caffeine and adrenaline may seem heroic).

I’ve personally known a number of nurses who appear to run on fumes most of the time, and I’ve seen some of them crash and burn in ways that were certainly not pretty.

I was myself once a heroic, self-neglecting nurse, and I paid a price (as did my family and loved ones). Eventually, I wised up and got on the self-care bandwagon (with enormous pressure and loving ultimatums from my devoted wife), a wagon upon which I still proudly ride to this day.

Sure, back then I did indeed think of myself as a nurse hero, stoically (or stupidly) crashing through my stressful days with little thought for myself. It was sometimes exhilarating in a sick way — condemning myself to poor self-care in deference to caring for my patients was an extraordinary ego trip that fed some part of myself that was at once stoic, heroic, and stupid.

But that was then, and this is now.

The Self-Care Bandwagon

Whether it’s flossing, jogging, getting some sleep, taking breaks at work, or playing golf every weekend, nurses can take their own self-care into their hands, deciding for themselves that it’s important and healthy to do so.

Nurses can fight the stereotypes, and they can also fight the powers that be (and the dominant nursing culture) that insists that we sacrifice ourselves on the altar of patient care. Such self-sacrifice is old hat, and we 21st-century nurses can teach ourselves that self-care is a good thing, that it’s actually better for patients, and that supporting one another to take care of ourselves makes sense, both in the short term and long term.

If you’re a nurse who has yet to jump on the self-care bandwagon, realize that there are no tolls for climbing aboard, but the price you’ll pay for staying on the Self-Neglect Express is higher than you can ever imagine.

So, instead of trying to be a hero to others through sacrifice, be a hero to yourself through self-care and wellness. Your patients will benefit, your family will benefit, and your happiness, well-being, and quality of life will improve astronomically.

Go ahead, nurses. Take off the hair shirt, put down your cross, and dispose of your bed of nails. The self-care train is always at the station, and all you have to do is climb aboard.

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.

Study: Nursing Workforce Is More Diverse, Educated and Male than Before

There is increased diversity in gender and race/ethnicity within the nursing workforce, according to a new study.

from Becker’s Hospital Review

A study, published in Nursing Outlook, found more males are becoming nurses: 8.8 percent of males became licensed in the 2004 to 2005 cohort compared to 13.6 percent in the 2014 to 2015 cohort. There has also been more diversity in the nursing workforce. The report found the percentage of white-non-Hispanic nurses who were licensed was 78.9 percent in 2007 to 2008 compared to 73.8 percent in 2014 to 2015.

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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.

Nursing Degrees Increasing, but Not on Track to Meet Goal for Acute Care

Based on current trends, it’s estimated that 64% of nurses in acute care hospital units will have a degree by 2020—falling short of the 80% goal.

from Reuters

The proportion of registered nurses with nursing bachelor’s degrees has climbed in recent years to 57 percent in U.S. acute care settings, but it’s not rising fast enough to reach a goal of 80 percent by the year 2020, researchers say.

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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.