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.
From January 22 to 28, the American Association of Nurse Anesthetists (AANA) is sponsoring National CRNA Week to honor nurse anesthetists.
John Bing, BSN, CRNA, AANA Region 6 director, and national AANA board of directors member, says most people don’t quite understand what a nurse anesthetist does and, in fact, there are not very many of them.
Many people believe a nurse anesthetist puts them to sleep, leaves, and then returns to wake them. Far from it, says Bing. “The job of a nurse anesthetist is always assessing,” he says. They are with the patient all the time, from the moment they greet the patient, through the entire procedure or surgery, and when they are brought out of anesthesia.
The job, says Bing, is like no other. “We are there pre-, inter-, and post-op,” he says. But he understands why the job is mysterious to some. Even Bing’s mom thought he just gave people a pill to make them go to sleep, he says with a laugh.
But nurse anesthetists appear happy with their jobs. On the just-released 2017 U.S. News and World Report Best Jobs list, a nurse anesthetist’s job placed fifth on best health care jobs and placed sixth on the best jobs overall. The reported salary median salary is $157,140.
Bing says he appreciates being able to develop a relationship with a patient in such a short amount of time. Being present through the entire procedure gives nurse anesthetists the ability to monitor every nuance of the patient’s reactions and behavior, he says. And the interactions before the anesthesia is administered means nurse anesthetists have the chance to build up trust and get to know a patient as a person. The patients remember that, says Bing, and you get to know them as a person.
And this field rarely gets stale, he says. CRNAs have to be recertified every four years, so continued learning is mandatory. One of the special draws for nurse anesthetists is the ability to work with people from the moment they are born until the day they die, says Bing. These nurses work with all ages and have to know the intricacies of how the human body reacts to the anesthesia at each age and with virtually any condition. “We get everybody,” says Bing. “And it is all acute.”
As a group, nurse anesthetists stick together, says Bing. With as high as 89 percent reporting approval for their job satisfaction, he says, they enjoy the work. And the AANA doesn’t encourage sub groups, he says. The group acts as one. “Eighty-five percent of our professional nurse anesthetists belong to our parent professional organization,” says Bing. “We don’t want to go out and have splinter groups. We are better together.”
The AANA is urging nurses to spread the word during National CRNA Week and suggests things like career days in schools, inviting legislators to a breakfast or coffee gathering, or even casual and formal public speaking opportunities to let people know about the profession. And use #crnaweek to spread the word o a wider audience.
It’s also a good time to celebrate what nurse anesthetists do. “In this country 100,000 people give anesthesia,” he says. “That means there are 3.5 million people per anesthetist. That makes [them] pretty special.”
On January 25, IV Nurse Day celebrates the infusion nurses who complete the high-tech and exceedingly patient-sensitive process of infusion care.
The 2017 theme, “IV Nurses: Outstanding Skills. Outstanding Care.” gives acknowledgment to the specific skills IV nurses bring to a care team. Sponsored by the Infusion Nurses Society, this day has been an annual international event since 1980, says Mary Alexander, MA, RN, CRNI, CAE, FAAN, and chief executive officer of the society and of the Infusion Nurses Certification Corporation.
The IV Nurses Society has 7,000 members across the globe in more than 40 countries and territories outside the US. Approximately 3,500 of the members are certified as well. And they work in many settings—about half of infusion nurses work in hospitals and the other half work in alternate sites like infusion centers, physicians’ offices, or in home care settings.
“The care we provide is something all patients can relate to,” says Alexander. “Patients go into a hospital and almost everyone gets an IV.”
While IV certified nurses are not the only ones who can place an IV, the additional training gives the nurse the skills and the experience to do it well, she says. To place an IV properly, nurses must asses the patient, determine the appropriate device, and the proper management of care once the IV is in place.
As some patients can have an IV for a few short hours or in extraordinary circumstances for the rest of their lives, proper placement and care is paramount to patient comfort and safety, says Alexander. Infusion nurses are also then responsible for patient or caregiver education upon discharge. They need to convey accurate information about how to care for an IV and why it’s important for the patient to have it.
“It’s vitally important that clinicians are experienced and know what they are doing,” says Alexander. Because the lines bring solutions directly into a patient’s bloodstream, any complications can be life or death.
Patient safety is every nurse’s top concern, but infusion nurses also have a direct impact on patient satisfaction. Alexander says when patients are asked about their hospital stays, some surveys indicate the quality of food and the experience a patient had with an IV as the top influences of their overall satisfaction with the hospital.
IV Nurse Day recognizes all the work infusion nurses do, says Alexander. “We are all over the place,” she says, “You won’t find us in one specific place. We are an important part of the health care team when we are looking at the overall care of the patient.”
As part of the team, IV nurses can educate others on the team as well. Having an IV nurse on the team means the other team members are able to focus on their own tasks. Because of their experience, IV nurses save costs and labor because they generally get an IV placed correctly on the first attempt. That improves cost, reduces the risk of complications, and makes for a much happier patient.
If newer nurses are interested in this certification, Alexander strongly suggests getting some overall clinical experience prior to fulfilling the IV nurse certification process. And for nurses who are not yet certified, but interested, the Infusion Therapy Standards of Practice outlines some of the common guidelines for this specialty.
“The more you do it, the better at it you get,” says Alexander. “It’s good to recognize infusion nurses do a fabulous job and patients appreciate what we have to offer.”
Alexander notes that while some might expect IVs to eventually be replaced by a different process, she doesn’t see that happening in the very near future. And IV nurses also bring an extra component that’s hard to quantify. “To me, it’s high-touch, hands-on caring as well as high tech,” she says. “That’s extremely important.”
You’re a nurse and you probably talk all day long. You interact with patients, colleagues, and families from the time you get into work until the time you leave. So with all that talking, do you really need to excel at public speaking?
Any professional benefits from public speaking, but especially nurses. If you want to advance in your career or just be a better nurse, communicating effectively is an essential skill. You have to sum up your thoughts, ideas, and solutions faster than most other professionals. If your job (or your dream job) requires any kind of presentation or even mingling, public speaking skills will help you.
Many nursing students have taken a public speaking class or some kind of seminar that helps them polish their presentation skills. Some organizations even offer classes where attendees can sharpen their already good skills or where novices can learn how to not only find their public speaking voice, but to use it effectively.
Even with some public speaking training, stage fright is a real thing. You might be very comfortable speaking in small groups or with people you know, but if you’re put into an unfamiliar situation or in front of many people, you freeze. While that might be common, it doesn’t mean you shouldn’t try to overcome it.
Nurses who are at ease speaking in front of others are in high demand and this skill can open your career prospects greatly. If you’re at ease with public speaking, that means you’re more likely to volunteer to give a talk to colleagues. It might also mean your boss will turn to you to help with a conference workshop on your specialty. You might even be asked to speak by an organization. All of these opportunities get you out in front of people, make you valuable to your employer, and boost your career prospects and experience.
To get started, just look for a local class in public speaking. You can find them at local adult education centers, local schools, organizations, like Toastmasters, or even private coaches. If you think colleagues would be interested, gather some information about teachers, costs, possible times and locations, and present the idea of holding a class at work to your company. You’ll get bonus points for organization and initiative.
And by getting a little professional advice, you’ll also learn tricks and tips to make presentations easier. You’ll discover the way props like slides, photos, and videos can help you feel less pressured. And you’ll probably hear inspirational stories from people who flubbed a big presentation, recovered, and turned it into a success despite the mistakes.
The more practice you have, the more at ease you’ll be with speaking in front of others. And, as a nurse, you need to be able to speak calmly and clearly in an emergency. The more time you have invested, the less time you’ll spend on thinking about what you’ll say and the more time you’ll have to get the the heart of the matter.
Nurses know first hand just how exciting, unpredictable, and satisfying the career can be. No two days are the same, you’re constantly learning new things, and you have opportunities to connect with and help people in ways you never imagined.
But how can you explain all that to kids so they think of nursing as a career?
Sharing your excitement and your satisfaction over your career is the first step. And then letting them know the detailed reasons (given their ages, of course!), is the next step.
The easiest advice is to just start talking with the kids in your life. Ask them questions. What do they think nurses do? What equipment do they think nurses work with? What do they think might be interesting about a nurse’s job?
A great way to spread the word about nursing is to offer to give a presentation in a local school, library, or youth organization. You would have to tailor your words to the specific ages, but there are lots of ways to do that.
Bring relevant and approved equipment and show kids how it is used. Bring in books (Dr. Scharmaine Baker’s Nola the Nurse books are great for the younger kids) and coloring pages.
While some kids know what nurses do, many don’t have a real understanding of the job and duties. You can explain there are different types of nurses. Talk about your specialty and how you help people. Think of one or two stories that really show how your job is meaningful.
Teens will appreciate stories with more intensity, especially if they can relate to it somehow. You could even base part of the presentation on media images of nurses. The Truth About Nursing is a great resource for that topic. And everyone loves something that will make them laugh, so if you can offer up a story that shows the job is fun, that’s an attention getter.
Make sure kids know what it was like to be in nursing school. Describe what clinicals are like and how you can be out doing real work during your college years. Some kids are especially drawn to the “doing” more than the books, so if you can work in how your student nursing work really helped you and related to what your professors were teaching, it makes the idea of nursing school that much more appealing.
Lastly, think of a quick elevator pitch that can be used for kids. We all know how you should be able to sum up what you do and why it’s important in a quick elevator pitch to colleagues or at a networking event. But if you’re in your scrubs and a youngster unexpectedly asks you what you do, it’s great to have a response. Start by saying, “I’m a nurse. Do you know what a nurse does?” Then sum it up in one or two sentences.
Getting kids interested in a nursing career helps the younger generation understand nursing. More importantly, getting them interested will help ensure a steady pipeline of younger nurses to meet the real growing need for qualified nurses.
A new year often inspires us to think about fresh starts, new opportunities, and big changes. Some people use the clean calendar for the push they need to get them into a new or more satisfying career or role.
But if you like your job or aren’t quite ready to make a big change, there are ways you can make your old job seem new to you. It’s not always about your job duties, as it is the attitude you use to approach each day at work.
Here are a few ways you can make your old job feel like new.
Remember What Brought You to Nursing
What made you apply to nursing school in the first place? Try to revisit all the reasons you knew a nursing career was a good fit for you. Reflect on the positive experiences you have had that just affirm what you knew when you started on this path.
Recommit to Your Career
Vow to stop feeling lackadaisical about going into work. Take a new approach to decide that you will actively seek out experiences and opportunities that will make you a better nurse. Either change or make the best of the job duties you don’t love, but really enjoy the ones where you get the most satisfaction.
Treat Today as Your First Day
Imagine today is your first day on the job. What are you looking forward to? What do you like about the organization you work for? What are you unsure about or confident about? Asking all those questions can sometimes give your attitude a jolt.
Talk to Nursing Students
Students offer a lot of enthusiasm and energy for the job. Talking with them and hearing their thoughts, their new approaches to tasks, and their hopes for nursing’s future can inspire you in your own career path. They might show you a new way to do something or you might be motivated to even become a nurse activist.
Find Your Weakness
Be honest with yourself – what is your weakest nursing skill? If you can identify it (and everyone should be able to), then it’s time to fix it. We can all get better at something. Find what you can improve and do it. It will make you a better nurse and give you a confidence boost. And you’ll probably improve your work reputation, too.
You don’t have to change your job to make things feel different and new. Take the time and energy to bring a different approach to each day and you might be surprised at the long-lasting and positive results.