With dozens and dozens of nursing specialties, some nurses take varied paths to end up in the specialty that is the best fit. Many try different health care situations or medical training before deciding that one area of nursing is the career where they will make the impact they want and will satisfy their professional goals.
Jose M. Maria, MS, FNP, RN, CEN, director of emergency services at Brookdale Hospital and Medical Center in Brooklyn, New York, says he came to emergency nursing after gaining training and experience as an EMT and paramedic. “Emergency medicine was the next logical choice in starting my nursing career,” he says. “I haven’t looked back since.”
Maria, a native of the Dominican Republic, says his specific EMS experience really gave him a solid foundation to know what he wanted and provided him with the essential capability for any emergency nurse. “It allowed me to develop the skills to adapt to any situation while keeping a cool head,” he says.
But emergency nurses also benefit from having more than a cool head and a great skill set, says Maria. The flexibility to move from one situation to another one that is entirely different is essential for a successful emergency nurse. And then there’s the part where you work your tail off. An emergency nurse who doesn’t complain about the task (or 20 tasks) at hand and does what’s needed will have a much easier time working in such a fast-paced environment.
And when it’s time to transition a patient to inpatient nurses, challenges remain. In fact, Maria says that transition point is one of the most challenging aspects of emergency nursing. “This is a common challenge at every organization I have been a part of,” he says.
Preparation and planning, as with any part of the emergency nurse’s job, can help. And finding out how other nurses work also helps inform your own practice. “I try to stay current in practice and use resources like ENA CONNECT and to speak with colleagues across the states,” says Maria. “Like many professions, preparation is key for success in the emergency department.”
But with those skills and responsibilities, emergency department nurses encounter a lot of critical and crisis situations to adapt to. For Maria, those situations reveal why he does what he does. “The most satisfying and most important part of my job is to save lives,” he says. “It’s a powerful and overwhelming feeling to have brought someone back from death and see them walking out of the hospital.”
Anyone considering emergency nursing as a career path can follow Maria’s advice to rotate through other specialties before deciding on the ED. Each area offers you a new set of experiences and training that will be useful in the emergency department.
“Because we see a wide range of complaints, we can actually help our patients,” he says. “Working in psychiatry for example, helps you build conflict resolutions skills, improve communication techniques, and builds patience needed in the acute psychiatric emergency. Working in the ICU, with their attention to detail, improves your documentation. Working on a medicine floor helps in time management skills. Working a surgical unit, improves your teaching techniques with patients.”
And while the emergency department is intense and fast, emergency nurses do find a way to offer each other the kind of support and camaraderie that is distinct. Their humor might even be considered dark, says Maria.
“People have a hard time understanding that even in the darkest of times, humor helps us deal with our internal anxiety about the cases we work,” he says.
Having a strong mentor and academic advisor can make a huge difference in the lives of undergraduate and graduate nursing students. Being that mentor is what motivates Ronald Hickman, PhD, RN, ACNP-BC, FNAP, FAAN, associate professor of nursing at the Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland, OH.
Hickman has been honored with two esteemed awards for student mentorship at Case Western Reserve University: the John S. Diekhoff Award for Excellence in Graduate Mentoring, which is presented to four full-time faculty members who make exemplary contributions to the education and development of graduate students; and the J. Bruce Jackson Award for Excellence in Undergraduate Mentoring, which celebrates faculty and staff who have guided a student in their academic and career paths; fostered the student’s long-term personal development; challenged the student to reflect, explore, and grow as an individual; and supported and/or facilitated the student’s goals and life choices.
“Mentoring has been a cornerstone approach to making a difference in the lives of undergraduate and graduate nursing students,” says Hickman. “The receipt of two of the university’s top honors for mentoring undergraduate and graduate students is a testament to my commitment to making sure that I pay it forward.”
Hickman says the mentorship he received across his undergraduate and graduate studies has been invaluable. “My mentors shared their lived experiences and lessons learned to help me avoid pitfalls and inspire me toward a career in academe. These honors highlight my commitment to mentoring and acknowledge the impact of effective mentorship on the lives of emerging leaders in nursing practice and research.”
However, nursing was not Hickman’s original career plan. “As an undergraduate student, I majored in biological sciences with the intention to attend medical school after graduation.”
He was not admitted to medical school, but upon reflection about potential career paths he decided to pursue nursing because it aligned with his personal philosophy of health. “Although nursing was not my first choice for a career, it was the right choice for me,” he says.
Hickman acknowledges that pursing a nursing career can be challenging for minorities.
“Many minority nurses are the first in their families to attend college and are standouts in their communities,” he says. “When entering the nursing profession, the academic preparation is challenging and, in most instances, the diversity of nursing faculty is often not representative. This can create situations where minority nurses do not wish to speak up and seek help when needed. Whether you are pursuing a nursing degree or transitioning to a new role in nursing, do not suffer in silence. Asking for assistance often facilitates your success and delivery of safe nursing care.”
Another key to success that Hickman recommends for minority nursing students is to find a strong mentor and strongly consider pursing a doctoral degree in nursing.
Hickman is truly paying it forward. “As a nurse educator, I am inspired daily by helping students develop as competent nurse clinicians and scientists,” he says. “Helping others achieve their goals is an invaluable and enduring experience for most educators. The opportunity to inspire and challenge future nurse leaders is a priceless reward.”
Hickman sees himself in a senior leadership position in a school or college of nursing in the future. “My aspiration to secure a senior leadership position aligns with my commitment to help an organization and its’ faculty achieve their goals and impact the health of Americans.”
There are lots of health tips that men and women can both benefit from. Getting enough sleep and exercise and eating a well-balanced diet are some good all-around health tips everyone can use. But the genders have some pretty diverse health challenges. For example, did you know men die, on average, five years sooner than women?
Whether you are a man looking into your own health concerns or a woman with men in her life, Men’s Health Week (June 12 to 18) is celebrating its 23rd anniversary this year and comes right in the middle of Men’s Health Month. If you’re a nurse and a man, use this opportunity to talk to your male patients about the specific health problems men face and what to do to help prevent them or cope with them.
How can men make sure they are doing the best they can for their own health? Here are some pointers from the Centers for Disease Control and Prevention and MensHealthMonth.org.
One of the best ways to stay healthy is to get regular screenings for diseases and conditions that can be detected and therefore treated, early. Get an annual checkup so you can stay on top of your blood sugar levels, your weight, your cholesterol, and your blood pressure. Get a colonoscopy if you’re past age 50— earlier if you have a family history of colon cancer or if you have certain conditions that could increase your risk. Be sure a prostate screening is part of your annual exam and examine your testicles at least every month to notice any changes or lumps and bumps. Check your skin regularly for new moles or those that seem to have changed size, shape, or color. If you notice any unusual changes on your body, bring it to the attention of your physician.
Play Hard, But Play Safe
Whatever your interest—biking, running, flying, rock climbing—make sure you practice basic safety rules. Use proper protective gear and equipment. If you’re swimming, go with someone. If you’re hiking or camping, let people know where you’ll be. Bring along extra provisions and proper weather gear. Basic safety considerations can go a long way toward keeping you healthy.
Men tend to let their social relationships slide when life gets busy. With work and family obligations, it’s tough to carve out time with friends. But social connections and solid friendships can help ward off many health problems including depression, heart disease, and even dementia.
Make Healthy Choices
All the basic health tips hold true because they work. Eat a diet rich in fruits, vegetables, and plant proteins. Ease up on meats, cheeses, butter, fried foods, and treats like full-fat ice cream. Get daily or near-daily exercise. Get enough sleep. Keep your vaccines up to date. Use protection during sex. Don’t smoke anything, ever. Drink alcohol in moderation. Wear sunscreen. Protect your heart health (and keep inflammation down) by keeping your stress under control. Find help for your stress if you can’t manage it on your own.
Wear Blue to Start the Conversation
The Friday before Father’s Day is traditionally a Wear Blue Day, when anyone concerned about men’s health can wear blue clothing or blue ribbon pins to show support of Men’s Health Month. You can also give a shout out on social media with #MensHealthMonth or #ShowUsYourBlue.
Spread the word about men’s health during the month of June. You never know what kind of lasting impact a few words of wisdom might have,
The American Association of Critical-Care Nurses held its annual National Teaching Institute and Critical Care Exposition this week in Houston, TX. During the four-day event, 25 acute and critical care nurses were presented with the Circle of Excellence Award, recognizing their efforts to achieve optimal patient outcomes.
Jose Sala, night nurse manager, surgical and liver ICU at Houston Methodist Hospital, was among this year’s honorees.
“I feel so honored and privileged to be a recipient of this prestigious award,” says Sala. “I consider it one of my most rewarding accomplishments. I dedicate it to my family, my former professors, and preceptors, and most importantly, the patients whom I’ve cared for at the bedside during the past nine years. They have been my best teachers.”
Sala earned his BSN in 2012 from the University of Texas Health Science Center at the Houston School of Nursing and feel in love with critical care nursing during his capstone preceptorship in a general medical/surgical trauma ICU in South Texas.
“I was awed and impressed by how knowledgeable my preceptor was about pharmacology, pathophysiology, and patient management,” says Sala. “I saw how she was such an integral part of the critical care team, and how she had finesse, confidence, and a strong rapport with the surgeons and intensivists and all the other professionals in the unit. That two-month period played a seminal role in my journey in critical care.”
In his current role as the night nurse manager in the surgical and liver ICU, Sala has had the opportunity to work on initiatives that have improved not only patient care, but the overall work environment for his team. These initiatives led to his Circle of Excellence award.
He is most proud of his work to develop “flash rounds” in his unit – an initiative that directly impacts patient outcomes.
“Together with Dr. Atiya Dhala, one of our intensivists, and with the support of my director, Michele Ramirez, I implemented what we called “flash rounds” in our unit that focused on the ABCDEF bundle,” explains Sala. “This bundle aims to prevent the unintended consequences of critical illness, including delirium, prolonged ventilation, and excessive muscular deterioration. Every morning, at 8 a.m., each and every bedside staff nurse presented their patient to the team – the intensivists, nurse practitioners, residents, physical therapists, and respiratory therapists – as they rounded on the whole unit. Strictly focusing on these components and separate from teaching rounds, the flash rounds set the tone for the day for the team. This was not only met with much enthusiasm and support by most of our staff, but it also helped increase the mobilization rate, decreased our self-extubations, and reduced our ventilator days.”
Sala has also worked hard to improve his unit’s work environment.
“One of our key challenges in our unit was the rocky transition of our new graduate nurses (GNs) into clinical practice,” he says. “I mentored a group of GNs whose project for their nurse residency program was to create a buddy program that paired upcoming GNs with a buddy (who is a different person from their preceptor). This allowed them to integrate more easily into the culture and fellowship in the unit.”
Sala offers this advice to aspiring critical care nurses: “Work hard and study hard, and don’t lose sight of your goals. When you do rotations in nursing school, or work in any unit, find key mentors who can either directly guide you in the process of becoming a critical care nurse, or introduce you to people who can. Be inquisitive, read widely, and always ask questions.”
The nursing program at MidAmerica Nazarene University, with the help of Digital Third Coast, created an infographic depicting data on the perceived stigma of male nurses. Through their research, they gleaned quite a lot of interesting information.
For example, while it’s well-known that mainly men served as nurses in the past, their research indicates that “Due to associations with the military and religious orders, there was significant male representation in the nursing profession through the late 1800s.” The visual even shows a photo of famed poet Walt Whitman with his male nurse, Fritzenger.
When did this all change? According to the graphic, legal barriers in the early 1900s contributed to the scarcity of male nurses. In fact, many nursing schools would not even admit men. This didn’t officially change, though, until 1981 when the U.S. Supreme Court ruled that not admitting men to nursing schools was unconstitutional.
As a result, during the 1930s and 1940s, the percentage of nurses who were male decreased to its lowest point, which according to the U.S. Bureau of Labor was 1%. Not surprisingly, that percentage has risen over the years. As stated in the 2013 Census, out of the 3.5 million employed nurses, 78% are Registered Nurses (9.6% of these are male); 19% are Licensed Practical and Vocational Nurses; 3% are Nurse Practitioners; and 1% are Nurse Anesthetists (41% of these are male).
From these statistics, it can be concluded that men are more likely to become nurse anesthetists—which is the highest paid role in the nursing field. With women making up the majority of the nursing field, one would assume that they tend to make more in terms of salary, right?
Wrong. Female nurses make only 91 cents per every dollar that male nurses make.
For more fascinating facts about the perceived stigma of male nurses, check out the infographic here.
During this year’s CRNA Week (#crnaweek), there are many nurse anesthetists who are remembering why they got into the profession, and even more are reflecting on how the face of the profession is changing.
John Bing, BSN, CRNA, American Association of Nurse Anesthetists (AANA) Region 6 director, and national AANA board of directors member, says one of his steadfast missions is to make sure the field continues to attract top nurses, but that it is especially welcoming to aspiring minority nurse anesthetists.
Bing knows first-hand how hard it is being a minority in the field. When he first started out, he was often the only African American in the OR, he says. At times, people assumed he was part of the housekeeping staff. Although he laughs about it now, Bing has made it a direct part of his mission to attract more minorities into this field.
He even takes on leadership positions with the primary goal of making sure he is representing the minorities in the field. “You need to see that in leadership,” he says. “If others don’t see that, they won’t see a place for them. I make sure they see it.”
“Many times you would go in and you were it,” he says of when he started out. “Maybe you were the only one in the hospital or the department. Now you go in and you see a fair amount [of minorities].”
As a president of the Diversity in Nurse Anesthesia Mentoring Program, Bing also makes sure his students know why he enjoys this profession so much.
One of Bing’s specific approaches is to make sure he talks to patients as the anesthesia takes effect. He finds out what they like so they can chat about it—sports, cooking, books, kids—anything that helps them relax. “That’s like a sedative,” he says. “It calms them down and they remember that.”
And while he’s monitoring a patient, Bing does exactly what he teaches his students—he assesses his patient over and over and over. “You must rely on your instinct,” he says. During travels with students to countries like Nicaragua, Bing teaches students that not every machine is calibrated the same or even correctly.
“The machine is a guideline,” he says. “You are ultimately responsible for anything that happens. You can’t blame the machine for anything. Look at the patient.”
Bing says that while he’s checking blood pressure every five minutes or so, he is constantly “circling the block,” as he calls it. All the machines are incredibly helpful, but they should only confirm what a nurse anesthetist is seeing, hearing, smelling, and touching.
And getting stale in this profession is not an option, he says. “I say to my students, ‘Tell me how this patient could die today,’” he says. That forces students to look at the big picture and not just look for complications, but to look for other factors that could impact that patient on that day.
Bing clearly enjoys working with his students, but he understands first-hand how sometimes they are not the ones who chose the profession. “The last thing I thought I would be was a nurse,” he says with a laugh. As an African-American, there were few role models that looked like him.
A chance look at a jobs list that revealed six pages of nursing jobs, convinced Bing, an athlete in high school and college, to take a look. Bing says he turned to his buddy he was working out with and said, “We get to be around girls and have a great job!” But he still didn’t expect to land in this field. Eventually, nurses in the recovery room where he worked nudged him to give it a try.
Now, Bing’s mission is to attract minorities into nurse anesthesiology. He speaks to kids in schools, paying special attention to making the field appealing to boys and young men. As it is, 49 percent of nurse anesthetists are male, he says, which is a high number considering less than 10 percent of all nurses are male.
But Bing lets kids know that there are chances to be out on a helicopter go team or even in the midst of trauma situations. “Men like that kind of stuff,” he says and it certainly gets the attention of younger kids who don’t know those possibilities exist.
Add in the good salary, the camaraderie, and the fair amount of autonomy, says Bing, and a career as a CRNA shows kids who might not initially consider a nursing career that the path is open to more possibilities than they ever imagined.