This year’s presidential election is affecting just about everyone. It’s causing so much stress, arguments, and overall negativity, that we couldn’t even get any nurses to go on record with tips on how they remain less stressed in this crazed political time and help their patients remain so as well. Many were concerned that if they gave their opinions—even about how to help others—that because it had to do with politics, they may be reprimanded or even possibly lose their jobs.
That says a lot. Most nurses love to help other nurses. But in this case, the fear was tangible.
Instead, we contacted professionals in the mental health field to get their advice on what you can do to reduce your stress in this final week before the presidential election and how to keep it reduced after it’s over.
Use the Oxygen Mask First
If you’ve ever flown on an airplane, you know that the flight attendant always instructs people that in case of an emergency, to put your own oxygen mask on first. You won’t be any good to others, if you can’t breathe yourself.
The same case applies with lowering your stress. “In ‘helping’ professions, it is common for providers to ignore their own needs. Focusing on self-care, though, is critical during high-stress times like election season,” says Lisa Long, PsyD, a licensed psychologist, executive coach, and interventionist as well as owner of a private practice in Charlotte, North Carolina. “Taking a personal inventory of one’s stress level and well-being is a good start. Paying attention to yourself is a major aspect of doing and feeling your best. If you notice changes in yourself and how you are feeling, make the time to get connected with people you can talk to. Keep a list of things that make you feel relaxed, and make time to do at least one—even when you feel you have the least amount of time for it. Listen to your own body and needs—just like you do with your patients.”
Laura Dzurec, PhD, PHMCNS-BC, ANEF, FAAN, a dean and professor of the Widener University School of Nursing in Chester, Pennsylvania, says that recognizing that an individual, emotional response is not going to change the election is an important first step in lowering your stress. “The stresses accompanying the debates, deliberations, discussions, and arguments surrounding the presidential election have encouraged emotional responses,” she explains. “One important tip to use in lowering stress is to pay attention to personal responses. Are they defensive? Angry? Anxious? By backing away from pointless debates and thinking through responses that are immediate, nurses can lower their own stresses regarding what’s happening with the election.”
Tips To Help You Reduce Your Stress
Let’s face it—although we’ll get some relief after Election Day, there will still be fallout for some time no matter which candidate wins. Now that you have been reminded to take care of yourself first, what can you do?
“Humor is a fantastic coping strategy when it comes to situations that seem out of our control. Think of all the political parodies at the current time. Turning to humor helps reduce the experience of stress,” says Marni Amsellem, PhD, a licensed psychologist with a private practice specializing in health psychology. “Another great strategy—regardless of the stressor—is trying to tune out or take some time away from the stressor. For example, if the negativity of the conversation happening around you is becoming overwhelming, temporarily remove yourself from the situation, turn off the TV, take a social media holiday, and the like.”
One of the easiest things you can do is just breathe. “My tip for all nurses is to set the alarms on their watches or cell phones to remind themselves several times per day to perform two activities—breathe and practice mindfulness. Three nice deep breaths several times a day can do a world of good to clear the mind and refresh the body. As for mindfulness, take a few seconds, clearing the mind of all thoughts except for noticing the temperature in the room and being mindful of all safely and calmness,” recommends Mary Berst, PhD, the associate program director of Sovereign Health Group in Palm Desert, California.
Amy Oestreicher, a PTSD peer-to-peer specialist, health advocate, and speaker for TEDx and RAINN, suggests deep breathing as well and agrees that humor works. “Humor creates a common language the breaks barriers,” she explains.
Oestreicher also suggests that nurses try a couple styles of management with themselves, two of which are Active Management and Calming Management. With Active Management, she says, you take all of the energy that’s fueling that stress and use it—exercise, run, shout, or scream. Do whatever makes you feel better.
With Calming Management, you do just that—take actions that will work to keep you calm. That might be breathing deeply, meditating, getting a massage, or even taking a warm bath.
Finally, A.J. Marsden, PhD, a former Army surgical nurse and current assistant professor of psychology and human services at Beacon College in Leesburg, Florida, suggests that nurses encourage optimism and refute negative thoughts. “Smile! Research shows that people who smile really will feel better,” says Marsden. “Focus on all of the good work you’re doing. When we feel that our work is making a positive difference and an impact on the world, we feel more positive and happier.”
While the nursing field is still comprised primarily of women, the male percentage has continued to grow over the years. Minority Nurse interviewed four men, including one nursing student, to ask why they chose this profession. Here’s what they had to say.
After high school, Jesus Adaniel, RN, CRNI, CCHW, wasn’t planning on being a nurse. He joined the military and became an Army Reserve enlisted personnel and trained as an operating room technician. While there, Adaniel discovered that he loved caring for patients, and between that and the influence of his adopted mom, who is a nurse, he changed his college major from pre-engineering to nursing.
Today, Adaniel is the director of nursing and co-owner of BrightStar of Delray Beach as well as an assistant nurse manager for the Trauma Intensive Care Unit of a hospital in Delray Beach, Florida. “Caring for patients is my calling,” he says. After graduating from nursing school, Adaniel became a commissioned officer in the Army Nurse Corp. “I always wanted to work in the critical care and trauma area early on in my career,” he says. “I love the feeling of excitement and the fast-paced atmosphere.”
But it’s not all about how nursing makes him feel. “I am passionate about making a positive impact in the lives of my patients by ensuring and delivering the best care possible,” Adaniel explains. “[Being a nurse] is what I want and love to do. I bring a lot of passion and inspire a desire to make a meaningful change in someone’s life. I value each of my patients as individuals with unique needs.”
Adaniel isn’t the only nurse who came to the field by changing majors. Daniel Satalino is currently a nursing student at Seton Hall Nursing School in South Orange, New Jersey. Satalino began college as a biology-PT dual degree major. But after one semester, even though he did well, he knew nursing was for him. His peer advisor was a nursing student, and he encouraged Satalino to make the switch to nursing. Satalino is glad that he did.
“The thing I love most about nursing is the wide range of opportunities available for you. Whether you love bedside nursing, research, documentation, or want to take it a step higher and become a mid-level provider, there are many specialties that are fit for different personalities, which makes nursing a very diverse field,” says Satalino. “The greatest thing about the profession I have chosen is the ability to help people even if the help may seem minor. The patient will always remember who was at the bedside during their hospital stay.”
Bobby Lucia, MA, RN, LCPC, CT, thought he had found his calling in life. After earning a Master’s in Clinical Mental Health Counseling, he worked as a pediatric counseling specialist at the Children’s Hospital of Illinois, providing counseling services to patients and families affected by chronic and terminal illness. “I loved that counseling had a strong teaching component, and I was able to spend one-on-one time with people,” recalls Lucia.
While working in this hospital setting, he says he was really exposed to nursing. “I liked the unique role that a nurse serves as a care provider, educator, counselor, role model, and advocate,” Lucia says. “The more I became exposed to the nursing profession, the more I knew the nursing profession was my calling.”
About four years into his career as a counselor, Lucia made the decision to become a nurse. He attended Methodist College in Peoria, Illinois, and earned his BSN in the school’s Accelerated Second Degree BSN program.
Lucia now works as the RN clinical coordinator for the Pediatric and Adult Cystic Fibrosis Center at the Children’s Hospital of Illinois at OSF Saint Francis Medical Center in Peoria. “I love that I work with a variety of people—both patients and medical professionals. I get the opportunity to work with pediatric and adult patients in both the inpatient and outpatient settings,” says Lucia. “I love the critical thinking involved with nursing. Taking care of complex patients is like figuring out a jigsaw puzzle. All the pieces are in front of you, but you have to figure out how they all fit together.”
In addition, Lucia loves his co-workers. “I have a great supervisor and fantastic core team,” he says. “I think that having a good support system at work is essential to be successful as a nurse.”
Like Lucia, Ryan Pettit, DNP, CRNA, says that his first career wasn’t nursing either. In fact, he worked in commercial real estate finance and development. So what made him make the change?
“My mother received incredible nursing care during her battle with esophageal cancer. It was then that I realized I wanted to do something in health care,” says Pettit. “Seven years later, I finally took a leap of faith and went back to nursing school. I was attracted to the many opportunities within the nursing profession. My ultimate goal was to become a Certified Registered Nurse Anesthetist (CRNA).”
Pettit achieved that goal and now works as a CRNA at both Parkland Hospital in Dallas, Texas and CHRISTUS Trinity Mother Frances Hospital in Tyler, Texas. “I love being able to take care of people during surgery. Anesthesia is a scary thing for most people, and I have the unique opportunity to care for someone during this vulnerable time and allay some of their fears,” says Pettit. “I also do obstetric anesthesia, where I have the privilege of making women more comfortable during their vaginal deliveries by managing their pain.”
He adds, “Taking care of people is incredibly fulfilling. Each shift, nurses have the opportunity to make a difference in their patient’s lives. We have the opportunity to be there during a baby’s first breath and a dying person’s last breath. Not many people can say that.”
While nursing still has many more women working in it than men, more and more men are entering the profession each year. Minority Nurse spoke with some men working in the field to find out what they believe could be done to help recruit more men to work in this great career.
Overall, one of the first things that those in the profession need to do, some say, is eliminate the misconceptions about the field. Daniel Satalino, a nursing student at Seton Hall University in South Orange, New Jersey, says that there aren’t as many men in nursing because of an ongoing stereotype that nursing is solely a feminine field. “Historically, caregiving was thought to be a primarily female responsibility because the female in the family would nurture infants and be responsible for childrearing, while the male would be responsible for hunting,” says Satalino. “However, many men also participated in caregiving as shamans and spiritual healers.”
Satalino also explains that the roots of nursing come from the Catholic Church and the expansion of the Roman Empire where both nuns and monks alike assumed nursing roles in the hospital setting. Likewise, he says, as the plague spread throughout Europe, the Parabolani—a group of men who assumed nursing roles—were the primary nurses for infected people.
“Despite this, many people proclaim that the rise of nursing came with Florence Nightingale, a well-known English nurse who founded standards for nursing care in the mid-1800s, which are still used today. Nightingale also provided education for nurses. However, no males were allowed to enter the profession at this time,” says Satalino. “An influx of males into modern nursing came during and after the second World War, where male nurses were primarily needed in field hospitals and in psychiatric nursing.”
It’s important to know this history, Satalino says, because men have assumed nursing roles in the past, and they can provide great care like their female counterparts. “There have been many campaigns to increase female participation in STEM fields; however, there have been little-to-no campaigns to increase male participation in nursing,” he explains.
Another misconception is the “old school” view that nurses are physician helpers who give baths and hand out medication, says Larry G. Hornsby, CRNA, BSN, senior vice president of operations for the southeast division of NorthStar Anesthesia in Birmingham, Alabama (the company’s home office is in Irving, Texas). “[It] is simply inaccurate and misleading to what this profession has to offer,” he explains. “It is hard to convince the public of the opportunity that exists today with a degree in nursing and the tremendous variation of work choices and the varied job opportunities that exist.”
Besides getting the word out about men working in nursing and what nursing offers, what else can be done to encourage more men to enter the field?
Recruiting more men into nursing begins with educating them. And the earlier, the better.
Carl A. Brown, RN, BSN, is director of patient care services for BrightStar Care of Central Western Riverside County in Menifee, California. Brown has been in nursing for 27 years, having started as a U.S. Navy Hospital Corpsman and a CNA. “It all starts with education. The younger we approach males about choosing nursing as a career path, the more likely they will consider it,” says Brown. “It should be known that nursing is not a female-only career choice. To counteract this notion, I think more male nurses need to participate in community events, career days, or job fairs. More of us need to be out in our communities advocating on behalf of this profession for males. Furthermore, there should be national campaigns launched by nursing organizations to help create more incentives—like a scholarship—to entice more males into the field.”
Matt George, CNA, at the Hospital of the University of Pennsylvania, agrees. “The nursing field could attract more men by such measures as having a mentorship program for male high school students—allow high school students to shadow male nurses. This way, they can see what a male nurse does,” he says. The same thing could be done for freshmen at college. In order to attract more males, they need to see males working and achieving in the field. The only way to get more men interested in nursing is by reaching them at a young age and showing them this is a career where men work and can be great at it.”
Hornsby also agrees that reaching high school students would help. Aggressive marketing to the male population is needed as well. “Certainly, the growing need and the autonomy for advanced practice nurses is exciting news that everyone, including men, should hear,” explains Hornsby. “Salaries and benefits have improved over the years, and the opportunities for special work are ever-expanding.”
Explain the Benefits
Another way to help recruit men to nursing is to have male nurses explain why they love being in this type of work. Learning from someone doing the work already can be quite influential.
“For me, the greatest thing about nursing has been my ability to be successful outside the ‘traditional’ role of a nurse. The ability to become a Certified Registered Nurse Anesthetist and practice to the full scope and licensure in hospitals, ambulatory surgery centers, and physician offices afforded me a tremendous challenge, opportunity for professional growth, and great personal satisfaction,” says Hornsby. “Then moving into a business role and a managing partner/owner of a successful anesthesia management company allowed me to acquire new skills and knowledge, but the opportunity to remain grounded in my nursing roots. Patient care is always at the top of a nurse’s education, clinical training, and a top priority each day. These helped carry me through the business decisions. Other men should really look at the variation of practice roles and how they could fit into an exciting career with growing opportunity.”
Brown has already spoken with a few men who have asked him why he is a nurse. “I tell them that because of my military training, I learned the value of human life and protection our soldiers and sailors. Without those available to fight our enemies, we could not fight to protect those at home,” he says. “In turn, as a nurse today, I tell them that nurses are the most trusted profession there is—more than police, fire fighters, clergy, and educators. We are responsible for ensuring that a father or mother gets back to their children or grandchildren…that we are responsible for ensuring that a family is relieved of the stress of watching their family member pass in distress. Nursing is a field that provides the satisfaction that you have made a difference in someone’s life every day.”
When Jannel D. Gooden, BSN, RN, was a new nurse, the first six months were traumatic for her. Her short-lived time in an adult oncology unit had her second-guessing her decision to become a nurse.
“I went through a spectrum of emotions and confusion, and at the time, I felt very isolated in the experience,” Gooden recalls. “I now know that it is a common thread all nurses share. The novice nurse journey is difficult.”
After she left her first position, Gooden says she made it her mission to create and expand on helping guide new nurses. She currently works as a travel nurse in the pediatric critical care setting throughout California. In her free time, she makes videos which she posts on her Instagram account @NoviceIsTheNewNurse to give advice to new nurses so that they learn and no longer feel alone.
Some of Gooden’s videos came about because she read through the journal notes she kept during her first three years in nursing and came up with a topic. She will share what was troubling her at the time in a way that she feels will help other nurses. Other times, she makes videos in response to questions that new nurses have emails or messaged to her. Sometimes, she simply speaks directly from her heart.
“I believe everything I went through in my first few months as a new nurse shaped my passion for helping new nurses in their journey,” says Gooden.
Some of her videos even feature doctors giving advice to new nurses. But she has a specific reason for including them. “We work with physicians every shift, no matter what specialty of nursing we are in. It is vital to patient care that we learn to effectively communicate with our physicians, that we are not intimidated by them, and that we develop a healthy working relationship,” explains Gooden. “Using a physician to offer advice to new nurses softens their identity. It gently takes them down from that unapproachable platform and allows a new nurse to hear advice in their safe place. It allows the new nurse to receive the advice without the nerves of the workplace or the pressures of pending orders that need to be carried out. It provides a new perspective on how they are viewed in the workplace and what is expected from them as a team member.”
The term “new nurse” doesn’t just necessarily mean someone fresh out of nursing school. Gooden says that when she switched to the critical care field, she became a new nurse all over again. “Every day was a mental, physical, and emotional workout. The equipment was unfamiliar, the families were scary, the patients and all the wires, the time management skills—some days I was afraid to even tough my own patient,” she says. All that is in the past, but by sharing her experiences with new nurses, she is making a difference.
Gooden gets asked a lot of questions, and Minority Nurse asked her about advice she would give to new minority nurses who might be experiencing discrimination, bullying, and/or stereotypes. “Discrimination and bullying are topics we sweep under the rug in nursing school. No one seems to talk about it, but it is a very real thing for new nurses of all ethnic backgrounds,” Gooden says. “New nurses carry a certain enthusiasm and hope that all nurses need to be reminded of it. My greatest advice is to hold on tight to your light. Try not to get discouraged in your practice during the very inevitable difficult moments. Your work will speak louder for you than any words you could ever speak, so do not get lost in the stupidity of others. Be an advocate for yourself. Do not allow anyone to treat you unfairly. Know when and how to put your foot down, all while maintaining your professionalism.”
Top Five Pieces of Advice for New Nurses
Gooden has top pieces of advice that she would give to new nurses, and they focus on what she believes are not emphasized in nursing school, a consistent part of the nursing curriculum, or ingrained into nursing training.
1. Be Confident.
Your patient cannot trust you, if you cannot trust you.
2. Know How to Delegate.
We are taught the meaning but not taught how to execute the verb. One piece of advice I always suggest? Get to know your CNAs and PCTs. This creates a more comfortable environment for you to be able to ask them to complete a task for you. It also shows your respect for their line of work by getting to know them outside of your needs.
Find a friend and let it all out—preferably a nursing buddy you can trust. If you do not release the frustrating energy in a healthy way, your patients will feel your tension. When you are tense, you are also more inclined to make mistakes.
4. Don’t Be Afraid to Ask Questions.
Question everything! Ask every why and how that comes to mind. The new nurse who does not ask questions is the nurse that scares everyone on that unit.
5. Be an Advocate.
Knowing how to advocate for yourself is truly what makes you a more comfortable advocate for your patients. So please, speak up for yourself.
Gooden is in the process of creating a YouTube channel featuring her advice for new nurses. In the meantime, you can find them on her Instagram. “I want to help new nurses because I am forever that new nurse. If one fails, we all fail because we collectively make up a profession that the world depends on,” says Gooden. “I want new nurses to gain confidence with their practice because people do not stop getting sick because we are afraid. Once you can overcome fear as a new nurse, then the door to growth is wide open.”
In honor of National Neonatal Nurses Day, we interviewed five nurses in different facets of the field to give you a glimpse of what it’s like to be a neonatal nurse, including the challenges and rewards involved in caring for the tiniest patients of all.
A Day in the Life
Rebecca L. Hunt, RN, MSN, APRN-CNP, CCNS, a neonatal nurse practitioner at SSM Cardinal Glennon Children’s Hospital in St. Louis, Missouri, walks us through a typical day in the NICU:
“Generally, each workday starts off by first ‘scrubbing in.’ Then the nurses will begin getting report from the off-going shift. This report will include a brief history of the mothers’ pregnancies, the birth histories, and what occurred in the delivery room. The nurses will
discuss a brief history of the babies’ hospital courses (types of respiratory support, any feeding difficulties, surgical history, etc.). Report will also include the babies’ current clinical status and what type of support they are receiving (respiratory, nutrition, antibiotics, etc.). Finally, the nurses will double check what medications the babies are receiving as well as all infusing IV fluids, including TPN/IL, and any other continuous medications.
From report, the nurse will prioritize which of the babies will need to be cared for first. The remainder of the day will include performing complete assessments on the babies being cared for every one to four hours depending on how critically ill they are, what types of interventions and care are required, and what type of feeding schedules they are on. All assessments, feedings, and medications given are charted into the electronic medical record in real time. The nurses will also do IV fluid changes and mix feedings as requested by the NICU care team.
Throughout the shift, the nurse will continually work with parents and family members on how to properly care for their babies. Feeding a premature infant is very different than feeding a baby who is born at term gestation and healthy. The nurses will also work with families on providing care (feeding, bathing, etc.) to babies who may be on a ventilator or have a tracheostomy in place. The nurses will also educate the families on signs and symptoms to look for to help distinguish if their babies are doing well or may need to be seen by a member of the health care team once they are home. The nurses will teach families about home oxygen, home apnea monitors, and how to safely put their baby to sleep at home. They will also take photos and help the families document the small victories their babies achieve, such as the first time wearing clothes, the first time taking a bottle, the first bath, etc.
During the nurses’ shift, they will also participate in rounds. The entire medical team (neonatologist, fellow, nurse practitioner, resident, dietician, and pharmacist) will gather at each baby’s bedside and discuss the infant and the expected plan of care for the next 24
hours. The nurses are major advocates for the babies and actively participate in making critical care decisions, such as whether babies should or shouldn’t have their respiratory support weaned, receive more food, or attempt to bottle feed more. The nurses will let the team know if they believe babies are showing signs and symptoms of becoming sick. Finally, the nurses will also encourage the parents to be an active participant in bedside rounds and provide their own observations of how their baby is doing.”
One of the biggest challenges in being a neonatal nurse is maintaining the professional boundary between yourself and the family says Gail A. Bagwell, DNP, APRN, CNS, the clinical nurse specialist for perinatal/neonatal outreach at Nationwide Children’s Hospital in Columbus, Ohio. “The babies are in a NICU for long periods of time, and you get to know the parents very well. Learning to be caring and compassionate, while maintaining a professional relationship is a learned skill and difficult for many nurses,” explains Bagwell. “I learned it early on in my career when a baby I was caring for developed some severe complications that led to her death. The pain of getting close to the baby and the family taught me that in order to survive in this field, I would need to learn to be caring and compassionate while maintaining a distance.”
Kim Guglielmo, BSN, RNC-NIC, Clinical Nurse III in the Newborn Critical Care Center at the University of North Carolina’s Children’s Hospital in Chapel Hill, North Carolina, agrees that losing patients is one of the toughest experiences as a neonatal nurse. “Those are the days that hurt my heart,” she says. “At the time before, during, and after the passing, I am there to support the family however they may need it. My goal is to make this last involvement with their baby the most beautiful experience ever.”
For Taryn M. Edwards, MSN, CRNP, NNP-BC, a surgical nurse practitioner of general, thoracic, and fetal surgery in the NICU of The Children’s Hospital of Philadelphia, sharing setbacks and obstacles with families is her biggest challenge. “The reality is that some of the most vulnerable infants do not make it. Supporting families through that difficult time is always challenging,” she explains.
While there are a lot of challenges and sad times in neonatal nursing, there are lots of great times as well. “There is nothing quite as rewarding as handing a mother her premature infant, sometimes still attached to a ventilator, and helping her position the baby for skin-to-skin time on her chest,” says Sherri Brown, MSN/Ed, RN, RNC-NIC, staff nurse at the Neonatal UCU at the University of Kansas Hospital in Kansas City, Kansas. “Or in watching parents’ faces light up when their infant curls his tiny hand around their fingers or helping them give their baby a bath for the first time or change a diaper. These things are taken for granted in the healthy newborn world, but they take on extreme importance in the premie world.”
Guglielmo says she feels blessed to care for the smallest and most fragile of patients and have an impact on their lives. “I get to meet so many brave, courageous families who go through so much and teach me more than they ever know,” she says. Many NCCC units and NICUs have reunions in which former NCCC or NICU babies and their families return to the hospitals to celebrate. “I can’t wait to see them all!” says Guglielmo.