Women represent nearly 80% of the healthcare workforce, and they represent 77% of hospital employees. Also, 26% of hospital and health system CEOs were women in 2014. Statistics show the number of women in healthcare is rising, but there are still challenges. One of the most widely talked about challenge is gender inequality, including the lack of women in leadership positions. While gender inequality is important, this issue is not why women in healthcare are an endangered species.
Women in the healthcare industry are just as likely (if not more) to suffer from anxiety, stress, depression and other mental and emotional issues. Like most healthcare workers, women who are physicians, registered nurses, home health aides and more enter the field with a passion to help others. But if you fall into these categories, how many times have you neglected your own needs? Shouldn’t you treat yourself with the same care as a patient?
While the term endangered is normally used in reference to animals, you’re surrounded by just as many threats as a leopard in the wild. For decades, women in healthcare have suffered from stress, fatigue, strain due to schedule, insufficiency in internal training, and injuries from physical tasks. According to the American Foundation for Suicide Prevention, female physicians die by suicide at a 400 percent higher rate than women in other professions. One article posed the question “who takes care of the caregivers?”
The answer is YOU!
There are some issues in healthcare that is a work in process, but you have the power to positively influence your well-being today. Your patients need you. Your family needs you. And, you need you. So, treat yourself with proper rest, prayer, stress management techniques, supportive relationships, and be the first thing on your to-do list by adhering to your discovery checklist.
Top 5 Tips for Graduate school
So, you are thinking about completing your Master’s degree. You may be just graduating with your bachelor’s, established in your career, seeking career advancement, or an overall career change. You should commend yourself wherever you currently are in your professional journey. Graduate school is essential for career progression and as daunting as the challenge may be it is feasible and worthwhile. However, there are certain things that I wish I had known previously to enrolling in my first graduate courses that would have saved me a ton of grief on this grad school journey.
Learn the APA Manual
Do you briefly remember being introduced to this in your undergraduate English and Research classes? You know, the blue book that you couldn’t wait to toss as soon as you completed those courses! Well, don’t get too excited and toss that manual out just yet. The APA manual will be your bible at the graduate level. It is best to not only familiarize yourself with it but read it cover to cover. In all seriousness, there will be no mercy for APA formatting issues at the graduate level, and failure to comply will hinder your ability to graduate. Let’s be honest; graduate school is very expensive so do not lose points over APA errors and get your bang for your bucks when it’s time to cash in on that top G.P.A.
Grad school will push your writing capabilities to the maximum. When I first started, I went in under the false pretenses that I was a decent writer. After all, my highest scores were always in English and Language Arts. However, never underestimate the power of proofreading your document, or having someone else review it. It is important to remember that you are not supposed to be writing as if you are talking in scholarly writing. Read every single thing you submit out loud at least two times before turning it in. You will be surprised at some errors you will find in your documents once you hear it out loud. I swear by Owlet Purdue, Grammarly, and PERRLA to assist with the completion of my papers.
One of the biggest mistakes that I made during my Grad school journey was “taking a break”. Apparently, life happens to everybody, but if you can help it, you should stay on the course to graduate on time. While taking a leave of absence is certainly an option, there are some universities have a time limit on the amount of time you can spend on the completion of your master’s degree. Taking a leave of absence sounds a nice break until you return and you are under even more pressure to complete your degree. Stay on track and graduate on time. Put yourself out of grad school misery. Try not to prolong it.
My zodiac sign of a Libra makes finding balance very high on my priority list. Regardless of your sign, it is essential to find a way to balance everything you have going on in life. Many of us are career focused, have spouses or partners, children, and community obligations. There are going to be some times that you will simply have to say no to others as well as avoid taking on too many additional duties. You have to be able to take care of yourself before you can take care of others. Do not feel guilty about taking a step back or going on a much need hiatus to keep everything together. Remember that this is temporary, and there will always be opportunities to restock your plate once you have graduated.
Cost vs. Reputation
This has been an ongoing debate for such a long time. I will give you my honest opinion and say that it is best to go for value in regards to selecting a school to attend. There is absolutely nothing wrong with investing yourself, but please do not break the bank along the way. Try your very best to avoid debt, save up, and develop a reasonable budget that you can use to finance your educational goals. If you are shelling out a ton of money, ensure that the institution has a reputation that fits your tuition bill. Student loan debt is a serious problem. Remember that you will need to pay that money back, and if this degree does not make a high paying job seem promising to you it may be necessary to scale back. Remember, grad school isn’t cheap!
Wrapping it All Up
I hope that you avoid the pitfalls that I incurred during my grad school journey and that these tips will help ease you in your transition and prepare you for entry into grad school. A graduate degree is totally obtainable; it’s just a different academic dynamic. I’ll see you on the other side!
“ Once you know yourself, in this living stillness, there is nothing in this world that is greater than you”
One of the elements of discovery is “stillness”… I am sure you are thinking, ” What does that really mean? As healthcare professional, how can I incorporate STILLNESS into my life when I have been trained to move and move fast because it is the difference between life and death?”
Guess what, IT IS POSSIBLE! Let’s break this down a little bit more.
Many people see the word “stillness” and automatically think it means to have no movement which is true to a certain point, but from the perspective of discovery, “stillness” is the state of being or being one with yourself. Not thinking about the kids, what you have to cook for dinner, the bills you need to pay, but can’t… the job you dread, the co-worker or friend that gets on your nerves, etc. I mean you DO NOT think about any of that, just simply BE!! In the state of being is where we really and truly get to “know thyself” and not what everyone else tells us about ourselves. In stillness we allow the voice of the holy spirit, which is our GPS navigation system, to guide us through the streets called life. In stillness we learn to quiet the mind and not allow anything that is going on around us affect us. So when you are in a state of stillness, it doesn’t mean that things are not going on around you, it means that they are not going on within you. Let me make it a little clearer for you, you can be at work on a 35 bed med-surg unit with 10 physicians and 3 respiratory therapist on the unit, family all over the place, a supervisor who is screaming at staff, and a co-worker who scrolling through her social media timelines chilling while you have 10 outstanding task and not let ANY, I mean ANY of it affect you internally. The key is to create an intention of stillness which can be achieved by having some intentionality about how you are carrying yourself in a given moment and focus on what is within your control.
Now that we have what stillness means from the perspective of discovery out of the way, I can hear you saying “ Nicole I don’t have time for that”, I have to take care of my family, walk the dogs, manage all the household chores, manage the financial accounts, and I am sure that the list could go on and on but guess what you CAN practice stillness through all of this (I am not telling you what anyone told me but what I know)!! And to be honest if you want to live a life purposefully as a healthcare professional according to Gods’ will then it is a non-negotiable.
So let me share 4 tips that helped me to begin my practice of stillness and make the practice of stillness a ritual in my life.
1. Deep Breath- Yep simply deep breath! I hear you saying “and what is that going to help”? When we take deep breaths it induces the parasympathetic system and slows down your heart rate, which leads to a state of relaxation (use this one when you have trouble going on all around you so that it is not going on in you).
2. Schedule Time to Be- Look lets keep it real we all live busy life’s that pull us in 50 directions and many us live by a Google calendar which tells where to be and when. Well guess what place your “Be Time” on there too. It has been proven that anything we do for 21 days becomes a habit.
3. Get off Social Media- Yep I said it!! Get off Facebook, Instagram, Snapchat, etc. stalking pages and looking at fairytale lives that often don’t exist and practice just “ Being” (I was once guilty of this one, LOL). With the hours we spend on these sites weekly, we can really get to “know thyself” and find our purpose as a healthcare professional.
4. Find a Location that brings you Serenity- Know I know I said the state of being can happen when trouble is all around you which means we can have stillness anywhere but to get to a place where we can do this, we can get practice by doing it in areas where we find peace. So that may be by the water, outdoors with the birds chirping, a certain room in your home, etc. Practicing stillness in a location that brings you peace prepares you to be able to do it anywhere.
These tips are the very tip of the iceberg for practicing stillness because stillness goes much deeper but I wanted to start with building a foundation for you to build upon.
Remember in Psalms 46:10 we were told to “ Be still and know that I am god”.
No one can say nursing is a stagnant profession. Even freshly minted grads can feel they are scrambling to keep up with new procedures, technologies, treatments, and processes. If you’re a nurse, you might start to wonder what skills you will need to succeed and stay current in the coming years.
There are a few qualities shared by all successful nurses. Being an excellent multitasker, having empathy, and being nearly obsessed with details never failed a nurse. No matter what your specialty, your location, or your aspirations, experts agree that a few skills in your wheelhouse will not only advance your career, but also help you satisfy your goals of being the best nurse for your patients.
“The first thing you have to have if you want to be the best nurse possible is you have to really want to do it,” says Leigh Goldstein, assistant professor of clinical nursing at the University of Texas at Austin School of Nursing. “You really have to want to be a nurse and not just bring people pills and plump pillows. To get there, you have to put in the hours and put in the study. There’s that little thing in you that tells you, ‘This is it,’” says Goldstein. “It makes learning all the other skills easier.”
LaDonna Northington, DNP, RN, BC, professor of nursing and the director of the traditional nursing program at the University of Mississippi Medical Center, agrees that nurses need a passion for the job. “This is not for the faint of heart,” she says.
Looking ahead, here are some of the essential skills nurses will need to meet job demands at any career juncture.
Develop Critical Thinking/Critical Reasoning
The best nurse thinks outside the box. Adapting to changing situations, unique patient presentations, unusual medication combinations, and a rotating team takes awareness. Assessing and evaluating the whole picture by using the critical thinking developed in school and on the job is essential to success.
“Nursing is not like working in a bank,” says Goldstein. “It’s not 9 to 5. It’s always a unique set of circumstances. You have to tailor and adjust the care you deliver based on the picture the patient is giving you.”
According to Northington, nothing in nursing is static. Nurses can’t usually just treat one patient issue—they have to determine how the patient’s diagnosis or disease has affected them across the lifespan, she says. And nurses have to consider not just the best choice for the patient and the best option for the nurse right now, but they also have to consider those things in light of the city they are in, the timing, and the resources they have at hand or that are available to them.
Make Friends with Technology
Nursing moves fast, but technological advances are sometimes even faster. While new nurses might lack years of direct patient experience, they often have essential technological familiarity. “Most nurses are probably aware that the world of electronics has just taken over,” says Barbara Vaughn, RN, BSN, BS, CCM, chief nursing officer of Baylor Medical Center in Carrollton, Texas. “The more senior nurses who didn’t grow up in the technology world tend to struggle more than nurses who grew up with that.”
With apps that allow nurses to determine medication dosages and interactions and websites that allow patients access to electronic health records, technology is an integral part of modern nursing. “Technology is changing how we practice and will change how nurses function in the future,” says Vaughn.The benefits are incredible. Instead of having to make the time-consuming drive into the ER when needed for an emergency, a specialist might now be able to save precious minutes by first examining a patient remotely with the help of monitors and even robotic devices. Nurses will have to adapt to this new way of doing things.
Nurses have to practice with technology to gain a fluent understanding, says Vaughn. Vaughn, who is studying for her PhD, says she didn’t grow up with online training as the norm, so when her new classes required online work, she wasn’t prepared. Realizing this could be a hindrance, Vaughn asked newer nurses about how to do things, and she practiced navigating the system until she became better at it.
Whether you are accessing patient records, navigating online requirements for a class, or learning a new medication scanning program, technology will improve your work day and help you take better care of your patients. In the meantime, Vaughn just recommends playing around with the computer when faced with something new. In her own department, Vaughn recalls some nurses who were especially stressed out about learning the new electronic health records system. With training and practice, they excelled. “They were later identified as superusers for their unit,” says Vaughn with a laugh.
Adapt to the Broader Picture
With all these developments comes new and greater responsibility.
“As an inpatient nurse, you used to worry about the 4 to 6 days when the patient was under your care,” says Vaughn. “Now if you are in a hospital based setting, you are going to be more involved in patient population health.” That means an inpatient nurse not only has to get the whole story of what happened before the patient arrived at the hospital, but also think about working with the care team to give specific instructions for when patients get home that will be practical.
“The more specialized medicine gets, the more fragmented health care becomes,” says Northington. Technology and that broad view can help reign that all in—and nurses need to know how the puzzle pieces fit together and where and how patients are receiving care.
“More patients will be followed in nontraditional health care settings,” says Vaughn. “Our world and the world we know is going to change,” says Vaughn of the health care industry. With more patients being followed by health care centers in easily accessed sites like Walmart and Walgreens, telemedicine is going to become more important to understand and to navigate.
Practice Effective Communication
Thirty years ago, communication about patient care was effective, but certainly not at today’s level, says Northington. “We have to communicate,” she says. “You have to ask, ‘What do you know that I don’t know that can help this patient?’ or ‘Are these therapies contradictory?’ Nurses are in that integral place to facilitate that interprofessional education and communication.”
Good communication isn’t always easy. Beth Boynton, RN, MS, author of Successful Nurse Communication, says the most effective communication is based in speaking up and in listening.
Especially in fast-paced and dynamic health care settings, the underlying interpersonal relationships can have a huge impact on how colleagues communicate and relate to each other. Nurses need to not only recognize the dynamics at play, but also learn how to work within the environment.
“We all think this is easy,” says Boynton, “but we have to recognize this is harder than meets the eye. Be patient with the learning curve.” Nurses might be assertive about speaking up for their patients’ needs, but not for their own, explains Boynton. So, as nurses look to the future, they should be mindful of not only fine-tuning their ability to speak up, but also listening to both patients and colleagues in return without judgment so everyone can work towards the best possible outcome.
“The nurse of the future has to stay committed to learning,” says Northington. “Take what the research is saying and use the best practices. Ask the questions like, ‘Why are we doing it that way?’ and ‘What can I do differently that will produce a better outcome?’”
To be the best nurse, you must stay current in the newest developments. Take the time to learn new procedures, but also recognize where your skills need updating. For example, if you know you’ll need to deal with chest tubes, don’t just assume you’ll know what to do when the time comes. Make an active effort to gain current experience.
Develop Mentoring Relationships
Every nurse needs a mentor. It doesn’t matter what your role is, how many years of experience you have, or even how many months you have been practicing. If you want to advance and learn the intangible skills needed to excel in nursing, you need to actively cultivate a mentoring relationship. Nurse mentors are often found at work, through networks, or within professional organizations.
Refine Your Personal Compass
A little bit of a thick skin will do wonders for any career nurse. “You have to defend your patient from everyone and take care of them,” says Goldstein. That means when a physician makes a call you disagree with or you overhear an unfriendly comment, you need to speak up when it matters and let it roll when it doesn’t.
And some of the personal work nurses have to do isn’t easy, including reflecting on and adjusting for any personal feelings or prejudices they have about patients in an open and honest manner. “We need to be able to take care of people no matter what their circumstances or color or what they did to get here,” says Goldstein. “You can’t treat patients differently. You need to take care of them and not make a judgment.”
Prepare for the Unexpected
You never know what your day will bring, so lots of personal reflection, discussions with others in your profession, and cultivating skills can help you when you are faced with something you’ve never had to deal with before.
“I think whether you are starting out as a new nurse or you are a seasoned nurse, nursing care is constantly changing, and being fl exible to those changes is paramount,” says Princess Holt, BSN, RN, a nurse in the invasive cardiology department at Baylor Medical Center in Carrollton, Texas. It’s not easy, she says, to constantly adapt to new approaches and new practices, but nurses need to sharpen their focus. “When I get frustrated, I always go back to put myself in the mindset of my patient I am caring for or of my physician who is making this order or of the family I am taking care of to find new ways of looking at it. It grounds me and helps me understand.”
Developing all the coping skills to deal with job stress is a personal approach that nurses will cultivate as they go.
“New nurses don’t always take care of themselves and the emotional baggage you take with you,” says Goldstein. “You have to incorporate those experiences into a coping strategy that you have to develop on your own. Every nurse needs to fi gure out what they need to do to handle that.” And if you aren’t able to really learn how to cope, nurses must have the skills to either recognize that some kind of career shift is necessary (maybe even just moving from the ER to postpartum, suggests Goldstein) or to be open to hearing it when others recognize it.
Recognize Your Private Life Impacts Your Career
Nurses have to realize their career choice is 24/7. And while you have to balance your life and leave the hospital behind, you also have to somehow adapt to always being a nurse first. Family picnics can turn into a mini diagnosis session, neighbors might ask you to look at a child’s rash, and your private life can impact your job very directly in a way that won’t happen in other professions. “Nurses are held to a higher standard than the average citizen,” says Goldstein.
Learn Where to Learn
Yes, nurses in school learn the hands-on nursing skills like hand hygiene and infection control, says Goldstein, but, like any nursing skill, mastering them takes time.
Some hospitals have new nurse orientation programs that help new nurses acclimate to the setting, but if you don’t have that option, rely on your own observations, ask questions, and take classes to help get you up to speed. When you’re on the job, watch others to see how they incorporate things like patient safety into their routine interactions with patients. And Holt, who has worked in departments from ER to interventional radiology, says moving around builds skills. “I have seen it all,” she says, “and there is still more to see.”
Put It All Together
When nurses consider all the skills they need to succeed, some are easier to gain than others. “You need to understand what goes on behind all the mechanics,” says Northington. “It’s the knowledge behind the skills you need. They can teach nurses things. Nurses have the rest of their lives to learn things. We need nurses who know how to think, to problem solve, [and] who know when they are in over their heads to call for help. The most dangerous nurse is one who doesn’t ask a question.”
And nurses must keep moving forward and adapting even when the pace seems relentless. “We’ve come a long way,” says Northington. “And in 20 years, nursing won’t look like it looks now. Nursing is one of the best careers because it’s always evolving.”
With all the choices nurses have in the nursing field, teaching is one many options nurses enjoy. And with a major nursing faculty shortage looming, now is a great time to consider teaching. Is a faculty position in your future? Can you teach nursing to the next generation of nurses?
With nursing schools in need of teachers to meet the volume of students and applicants, teaching might be worth your while. If you have the advanced degrees and the drive, getting in front of a classroom will enrich your life and help ease the faculty shortage and boost the number of nurses prepared to enter the workforce. Lastly, switching between a healthcare setting and an academic setting is often invigorating and reminds many nurses why they got into the field in the first place.
Faculty Is Needed
With many older faculty retiring or approaching retirement age, nursing faculty positions are opening up and need to be filled. If you think teaching might be something you like, now is a great time to try it. And, no, you don’t need to commit to a full load of classes your first semester teaching. Try teaching one night class, an online class, or even a few seminars to see if you like the responsibility and the interaction.
You Can Effect Change
Do you have nursing school professors who changed your way of thinking or who influenced your career path? You could be that person for other nursing students. Are you passionate about family involvement in patient care or are you a big advocate of nursing legislation? Nursing students want to know all this information. They aren’t there just to learn how to do a proper trach (although, of course, they need to know that!). They want to know what makes a great nurse. If you think you have something to offer, you can do that.
You Don’t Need to Go Back to School
At the university and college level, you don’t have to obtain a teaching degree or certification like you might if you taught in elementary or public schools. But if you have advanced nursing degrees (MS or DNP), there’s a good chance you can find a teaching position. See what’s required by an organization, but often your degree(s) and your experience will suffice. On your own, you’ll probably need to talk to other faculty and do some research for pointers on running your first class.
You Don’t Have to Fast Track
Many nursing professors are not on a tenure track and often teach part time (which is a problem if your goal is to a full-time professor). If you’d be happy to teach a class while continuing your current career, you can do that. You’d get a little extra income, a lot of new experience, and would form lasting relationships with your students.
You Are Continuing a Tradition
Remember being inspired in classrooms when you were a nursing student? New nurses want to hear your stories from the trenches. They want to know what they might encounter as an ER nurse, what makes an excellent pediatric NP, and how you manage the stress of tough cases or even of losing a patient. Here’s your chance to tell those stories and impart real-life wisdom and academically oriented knowledge at the same time.
Do you think you could teach nursing?
Avis Johnson-Smith, DNP, RN, CNS, CPNP-PC, FNP-BC, recently received the 2015 Outstanding Faculty Practice Award by the National Organization of Nurse Practitioner Faculties (NONPF) in recognition of her work with patients and as a clinical professor in the department of nursing at Angelo State University in San Angelo, Texas.
For Dr. Johnson-Smith, who also heads up Angelo State’s online Family Nurse Practitioner graduate program, the NONPF Faculty Practice Award is a reflection on the work she loves to do. As a sole practitioner in Georgia, with her husband, a respiratory therapist, as a partner, Dr. Johnson-Smith keeps busy with the academic and direct caregiving sides of her career.
“I have the best of both worlds,” she says. “I practice and I also teach students so that when they go out into the world they truly understand the practice.” And Dr. Johnson-Smith knew the more information she had, the better she would be able to care for her patients, so she saw getting her doctorate in nursing as a top priority. “I wanted to give the best possible care within the community and look beyond my community and shape other practices and patients,” she says.
Dr. Johnson-Smith says running her own practice is about her work with patients and not being forced to cram patients through a fast-paced environment. She wants to be able to take the time to speak with them and not feel like everyone is on an assembly line of care.
Being able to practice in a clinical environment and teach future nurses offers Dr. Johnson-Smith the chance to bring her real-world experience into the classroom. “I bring back cases I’ve had that [looked like] textbook cases, but were not textbook,” she says. So she can present unusual symptoms or presentations to her students and see what they come up with for a diagnosis.
She also offers students real-life nursing skills. She makes sure they have experience doing the more day-to-day work as well as the clinical skills. Her students have experience with dictating patient histories and physical conditions so when they are required to do that upon a patient’s discharge, for example, it will be familiar. “They will be expected to know that in practice and have that kind of experience,” says Dr. Johnson-Smith, but often new nurses don’t have that kind of skill. Dr. Johnson-Smith didn’t either when she started and that’s why she knows how important it is for new nurses.
Like many other healthcare professionals, Dr. Johnson-Smith first considered nursing a career after her own hospital stay as a child. After toying with the idea of going into ob/gyn or pediatrics, another nurse mentioned the idea of becoming a nurse practitioner. The fit was perfect.
And while Dr. Johnson-Smith says she never intended to become a teacher, she enjoys the process of teaching and the interaction with students. She especially likes hearing from former students who have gone on to establish their own practices or even the ones who are practicing and want her professional opinion. Shes thrilled that former students are comfortable enough to call her and say, “I’m stumped. What do you think I should do?”
Dr. Johnson-Smith says the ever-changing world of nursing is always challenging. “The nurse practitioner role is evolving, even over the last several years and definitely since I started looking at a nurse practitioner role,” she says. One of the biggest challenges for nurses today is to make sure everyone understands what their role is and that’s vital as healthcare moves toward an interdisciplinary approach in many places.
“It’s collaboration,” she says. “We are all looking for the same thing – that our patients and families have the best possible outcome.”
And Dr. Johnson-Smith also appreciates the role she has in her community. “Many times, my husband and I will say at some point this is more of a ministry,” says Dr. Johnson-Smith. “It seems like when we say we aren’t going to do this anymore, a patient comes in, in tears, and says, ‘I knew if I could just make it here and get here everything would be all right.’ It’s not always about what you can do to treat a physical problem.”