This week marks the 40th anniversary of Nursing Assistants Week and brings with it a great time for healthcare teams to reflect on how all the members of a team help it run smoothly.
This year’s theme for National Nursing Assistants Week is “Specialists in the Art of Caring,” and the theme is one that resonates with nursing assistants. Nursing assistants are essential members of the team and often work especially closely with patients who are disabled or elderly and live in long-term care facilities or are in rehabilitation facilities. They often spend their days caring for patients who may have very limited mobility or have severe dementia or other conditions that may prevent them from performing tasks for themselves. The hands-on care they provide helps people feel better and also provides the comfort of companionship.
Many nursing assistants are so devoted to the caregiving role that they will become certified in their field. The National Association for Health Care Assistants is also joining in the celebration by honoring certified nursing assistants who have taken the extra step toward professional development and education to become certified.
With nearly 1.5 million nursing assistants in the national workforce, the field is one that is growing and in need of additional professionals. With a high school diploma, prospective nursing assistants can gain additional training and certification through many local sources including community colleges and often the Red Cross. Nursing assistants have a physically demanding workload. They frequently move people all day long and so have to be especially careful about proper movement, getting help instead of hoping they can lift or move someone, and using available equipment to assist them in the physical tasks of the job.
Despite the rigor of the typical day, nursing assistants are especially devoted to the people in their care and strive to give them understanding and dignity at a time when they are especially vulnerable. The conversations they provide, even if they are one-sided at times, are an important and uplifting part of a patient’s day. Conversations about everything from the day’s weather to the political state of countries half a world away to comparing family traditions, all help take care of the whole patient, not just their physical needs.
This week is a time to call out the nursing assistants in your organization or on your team to thank them for the caring job they are doing. They are an essential part of making a team run, and because of what they do, the licensed nurses and physicians are able to take care of the pressing medical needs of the patient better, knowing the patient is comfortable and their needs have been met.
Honor this important direct care role by saying thank you to the nursing assistants in your organization and by holding events throughout the week to let them feel appreciated. Flowers, gift cards, a surprise coffee and cake or unexpected refreshments for them, and signs marking the week help make the week special, but can also start some important conversations about the essential teamwork and high-quality caregiving that goes on thanks to this important role.
Dealing with negative patients is never easy. They can monopolize your time, make you angry, and frustrate everyone they come into contact with. What can you do?
According to a number of experts, quite a lot.
“I approach patient interactions using the nursing process of assessment, planning, intervention, and evaluation. These steps are taken with patience and understanding,” says Cynthia Rochon, MBA, BSN, RN, Director of Nursing, Behavioral Health Services, Largo Medical Center. “In order to assist with a problem, you first have to understand the root cause. Never make assumptions because that can lead to more negativity. After gaining a clear understanding of the problem or patient care need, you provide an explanation of how the nurse can assist to remedy the problem or facilitate access to the resource who can provide further assistance. The last step is evaluation—validate that the patient has a clear understanding of how to follow up on directions that have been provided. Patient education is an important component of nursing care. When communicating with empathy, the patient experience will usually change from a negative experience into a positive interaction.”
Oftentimes, patients become negative because they are scared, says Jodi De Luca, a licensed clinical psychologist working in the Emergency Department at Boulder Community Hospital in Colorado. “Firm empathy and compassion are an example of setting structure and limitations. Be kind, respectful, and validate the patient’s feelings, but remain professional and clarify unacceptable behavior and/or unrealistic patient expectations.”
“Although it’s true we deal with these patients in the same manner we would other patients, it does take a lot of listening on our end to determine where the negativity is coming from,” says Debra Moore, RN, Director of Nursing of the BrightStar Care Edmond/Oklahoma City as well as the Midwest Region Nurse of the Year for 2017. “They could feel mad because they’re sick, missing a spouse from a recent death, or they may have just heard some bad news or had a frustrating experience in some other area of their lives. After we determine the cause, we talk with the patients and reassure them that we are going to care for them as much as they will let us. These patients may also need a lot of education on their diagnosis and what we can do to help. While it may take time for them to trust us, they will see that we are there for them and that they still have free rein over their lives. We honor them. It will take them sitting back and observing exactly what great care we can provide them. This will, in turn, help them relax and trust us in the end.”
Kristin Baird, RN, BSN, MHA, president and CEO of the Baird Group, is a consultant who coaches and trains nurses and nurse leaders. She shares two of her training points:
1. Suspend judgement and assume a neutral position.
By doing this, you position yourself for great empathy. Empathy is portrayed more through non-verbal behaviors than verbal, but both matter. When a patient feels you are showing empathy, they will have greater trust.
2. Use empathy statements and body language that will diffuse anger.
Try sitting by the patient, touching his/her arm or hand, and saying something like, “You sound upset.” By validating them with your words and showing compassion with touch, you are demonstrating that you care.
One of the most exciting aspects of your nursing job search is receiving an invitation to interview. You impressed the hiring manager with your resume and cover letter. Now it’s time to impress them during your job interview.
Job interviews are nerve-racking for sure. But you can calm some of your anxiety by doing these four things before your interview.
1. Company Research
Reading through the job posting isn’t enough to prepare for an interview. Dig deeper and read through the organization’s website and any social media pages they have. Spend some time perusing their press releases to learn about new initiatives the company is working on.
Some companies also have an HR section on their website where they publish their employee benefits information and employee handbook. These documents will give you insight to help you determine if the company is a good fit for you.
Finally, be sure to read their annual reports from the past several years if they are posted online. These reports will give you a glimpse into the company’s financial health as well as key milestones achieved throughout the year.
2. Review Potential Questions
Don’t “wing it” when it comes to preparing for any job interview. It will pay off to spend some time thinking through the possible questions you will be asked as well as how you will answer them.
Be sure you can answer questions about:
- Your education and work experience
- Your strengths and weaknesses
- Your patient care philosophy
- Work/school challenges you have faced and how you worked through them
- Your short and long-term career goals
- Why you want to work for this company/organization
3. Prepare Your Questions
There will usually come a time during your interview when you will have the chance to ask some questions of your own. Be smart and have a few questions prepared. It shows that you’re invested in learning more about the job and company.
These questions will get you started:
- What is the training/orientation process?
- What is the nurse-to-patient ratio?
- What shift(s) will I likely work?
- How long do most nurses work on this unit?
- What career growth opportunities do nurses have?
- Describe your management style and/or management philosophy.
One warning: Don’t ask questions about salary or benefits during your interview. Save those questions for after you receive a job offer. At that point you know they want you for the position and you’ll be in a much stronger position to negotiate your starting salary and benefits.
4. Do a Test Run
One of the worst first impressions you can make is to be late for your interview. Mitigate the risk of being late by asking for directions to the interview site, including parking instructions. It’s wise to also do a test run a day or two before the interview so that you can gauge the time it takes to get there and park.
These tips will save you some stress and help you shine during your next job interview.
Repaying nursing school loans can be a daunting task, especially if you have several loans carrying large balances. If you add in additional debt such as credit card debt and car loans, it gets even more complicated. Which loans should you pay off first? What’s the fastest way to become debt-free?
There are two popular methods for debt repayment – the debt snowball and the debt avalanche, and they both come with pros and cons.
Let’s say you have three outstanding debts – two student loans, plus a credit card. We’ll call them A, B, and C. With both the debt snowball and debt avalanche, you would:
- make the minimum payments on all three loans each month
- cut back and/or eliminate discretionary expenses (e.g. cable TV, eating out) so that you have extra money to pay towards your debt
- use any extra money in your budget to pay down your loans
For example, when you pay off loan A you would roll that payment into your payment for loan B until it’s paid off. Once loan B is paid off you would roll your payments for both A and B to pay off C. Eventually you will build a huge snowball or create an avalanche in loan repayments.
But the two methods differ in their approach in one key way: the order you repay your debts. Let’s take a look at examples of how each strategy works.
The debt snowball strategy was made popular by personal finance radio personality Dave Ramsey. With the snowball, you would list your debts from the smallest to largest balance and then pay them off in that order, one-by-one until all debts are paid.
For example, if loan A is $3,000, loan B is $5,000, and loan C is $12,000, you would pay them in that order, regardless of the interest rates. So even if loan C has a higher interest rate than loan A, you would still aggressively pay loan A until it’s paid off before focusing on loan C.
The theory of the snowball method is that by paying off the smallest loan first, you will gain momentum and experience success along the way. How awesome would it feel to pay off a student loan? With the snowball method you get to experience paying off the $3,000 loan much quicker than you would pay off the $12,000.
Many people have successfully paid off their loans using the debt snowball. But many others think the debt avalanche is the smarter way. Here’s how it works.
Let’s say you have those same three loans, but the one for $5,000 happens to have the highest interest rate. You would start your avalanche by paying the minimum payments on all three and then throwing any extra money at the $5,000 loan since it carries the highest interest rate.
The debt avalanche is all about the math. You could save thousands of dollars in interest payments using the debt avalanche. But again, you may have to wait quite a while before you experience any repayment victories.
Since personal finance is indeed personal, you should choose the method that you will stick with. If you choose to do a debt snowball you may end up paying higher interest, but if that’s the strategy that will keep you focused, it’s the best one for you.
Conversely, if you’re the type of person who is good at delayed gratification or you’re more motivated by saving money on interest, the debt avalanche would work best for you.
The key is to remember the importance of repaying your student loans and other consumer debts so that you’re free to make career and life decisions without being tied down by debt.
Many rural and urban communities face a shortage of qualified health professionals to meet the population’s needs. These underserved communities face unique challenges and nurses working in these areas need unique skills to meet those challenges.
What’s it like working as a nurse in an underserved community? What skills and qualities should nurses have in order to succeed in this area?
Amanda Buccina, BSN, is an RN for the Street Outreach Nurse Program for WellSpace Health in partnership with Sutter Health. She says that nurses should have a passion for working with underserved communities, possess strong coping skills, and understand the importance of self-care. She also notes that nurses working with underserved populations should be interested in and willing to make deep connections with people from all walks of life.
If you are thinking about pursuing a career as a nurse in an underserved area, these tips will help you succeed.
Understand the Culture
Erin G. Cruise, PhD, RN, NCSN, associate professor, Radford University School of Nursing, who has worked in public health and school nursing in rural areas and small hospitals for more than 10 years, says that nurses wishing to work in rural, underserved areas, and/or with vulnerable populations need to have a good foundation in clinical skills, organization, and communication. Cruise also emphasizes the importance of understanding the cultural dynamics of the community.
“Small hospitals and community agencies generally found in rural areas are often part of a close-knit community,” says Cruise. “People know each other and they want to know the nurse caring for them on a more personal level.”
Cruise says that new rural nurses can be taken aback by the expectation of openness. “Some nurses are not comfortable with having their personal lives become an open book,” she says. “It can be a thin line between patients just being friendly and curious and the nurse feeling that he/she lacks the privacy and anonymity found when working in larger agencies and big cities.”
People in rural or small town communities are also more likely to ask questions about private health information regarding their neighbors. “While neighborly concern and curiosity are usually quite innocent, nurses in these settings must be very careful and familiar with HIPAA and their own hospital or agency policies on confidentiality to avoid sharing that information inappropriately,” warns Cruise.
Build Strong Patient Relationships
A typical day for Buccina includes walking and driving around Sacramento, CA, meeting with patients on the streets, without the convenience of a full clinical facility. She works hard at building trust with her patients.
“A lot of my job is relationship building,” says Bucinna. “I work to build trust and rapport with my clients so even if they don’t need me in that exact moment, we have a relationship and familiarity with one another. I’m there when clients do want and need support, like medical advice, an advocate at a doctor’s appointment, help getting into an alcohol or drug rehab program, or just general wound care.”
Provide Judgment-Free Care
Cruise notes that many vulnerable people lack the resources that allow them to manage their health effectively, and nurses should be prepared to meet these patients right where they are, without judgment.
“They may have low literacy, live in poverty, live in environments that are polluted, run down, or crime-ridden; and work in jobs with low pay and dangerous conditions,” says Cruise. “People in these situations will pick up on a disapproving attitude by the nurse and shut down, shut the nurse out, and be less likely to follow his or her health care directions. Nurses should adopt a caring approach. While not condoning negative or criminal behaviors, accepting clients as they are and demonstrating concern for their health and well-being are more likely to motivate them to listen to the nurse’s advice and make positive changes.”
Jan Jones-Schenk, national director of Western Governors University’s (WGU) College of Health Professions and chief nursing officer for WGU, encourages nurses working with underserved populations to avoid making assumptions about their patients.
“Don’t label or assume individuals who don’t follow prescribed advice are non-compliant,” says Jones-Schenk. “There may be financial, social, physical, or cultural reasons why individuals do not follow the advice given. In such cases, the problem can easily be that it’s the wrong advice for that patient. Taking a patient-centered approach means the advice given has to be something the patient thinks makes sense too.”
Jones-Schenk advises nurses to remain open to listening carefully to understand the barriers and limitations individuals may be facing.
Gain Mental Health Experience
Buccina says that her best advice for nurses considering working in underserved communities is to gain some experience in mental health in order to understand human growth and development from a psychological perspective, and to become well-versed in social issues in order to avoid judgment and approach the population from a place of knowledge and compassion.
Finally, Cruise advises nurses working with vulnerable populations and/or in rural areas to find the time and space to take care of themselves.
“Because these communities are close-knit and vulnerable populations, they may mistake the nurse’s caring approach for a desire to have a more personal relationship. The nurse will have to set boundaries in a way that is kind and not perceived as rejecting of the client, yet allows the nurse to be seen as a professional and not just a friend,” says Cruise.
When many people think of a nurse, they most likely picture someone wearing scrubs and working directly with patients in settings such as hospitals, clinics, and doctor’s offices. But there are nursing careers that don’t focus on providing direct patient care, but still greatly impact the health outcomes of communities.
If you’re a brand new nurse, a few years of clinical experience can be great training ground in gaining valuable first-hand knowledge of the issues, challenges, and best practices that nurses can only learn in the field. But keep in mind that there are many rewarding careers outside of clinical settings.
Here are a few careers to consider to take your nursing career beyond the bedside.
Nurses in leadership roles perform a wide variety of duties and need many skills beyond providing patient care. Positions in nursing leadership include nurse manager, health care administrator, or care manager. These roles are more administrative and require strong leadership, financial and strategic planning skills.
Nurses working in leadership positions manage nurses, create budgets for their departments, and develop, plan, and implement programs and procedures for improved patient outcomes.
If working in a leadership role interests you, be sure to develop your leadership skills early. Get involved with nursing associations and seek out leadership roles whenever you can. And be sure to look for opportunities to mentor other nurses. If you’re still in school, look for leadership opportunities within your student nursing association.
If you’re serious about a career in nurse leadership, consider earning an MS in Nursing Leadership degree.
If you are interested in one day teaching the next generation of nurses, consider a career as a nurse educator.
Nurse educators teach nursing to college students and practicing nurses in academic and/or health care facilities.
Nurse educators develop curriculum and must have a high level of nursing experience and expertise. You will be required to hold a bachelor’s degree in nursing, be an RN, and complete a graduate-level nurse educator program to succeed in this specialty.
If you have a passion for advocating for legislative change, a career in health policy may be for you. Health policy nurses work on a variety of public health issues such as tobacco control or care for the aging.
According to DiscoverNursing.com, health policy nurses work to create an overall healthier society through advocacy, research, and analysis. They work in health service research firms, legislative offices, health care provider associations, or hold elective office.
In order to succeed in health policy, you’ll first need to obtain a master’s degree in nursing and complete a 10-week health policy program. You’ll also need strong leadership, communication, and analytical skills.
Gain experience by getting involved in nurse advocacy as a volunteer. The American Nurses Association is a great resource to get started in advocacy work.
Transitioning from direct patient care to nurse recruiting can be a fast-paced and exciting career for nurses who are interested in the human resources side of health care.
In a nutshell, nurse recruiters screen, interview, and recommend candidates for open positions in the health care industry. Recruiters also provide career guidance to candidates, negotiate job offers and stay up-to-date on the latest job search trends.
Nurse recruiters possess strong communication and sales skills. You’ll need a bachelor’s degree in nursing, as well as a strong clinical background to gain entry into this field.
Thinking about career options beyond patient care can open up many opportunities for nurses and may just be the perfect fit for you.