New nurse graduates have a lot on their plate. With diploma in hand, they can barely shout a celebratory “woo hoo” before passing the NCLEX becomes the next focus. But this early time in your nursing career is an especially important time to begin laying the foundation of the kind of nurse you want to be.
Nursing students often say connecting with patients is what makes their long days worthwhile. No matter what population you will be working with, finding a way to bridge the gap and connect with patients makes your job easier and builds confidence and satisfaction for your patients.
Here are a few ways to start building relationships—whether they last for hours or years—it makes a difference.
1. Introduce Yourself
Your patients have medical professionals coming in and out of their rooms all day long. Don’t take it personally if they don’t remember your name or when you first came in or even what you need to do. Tell them your name and what you will be doing. Let them know how long you’ll be taking care of them.
2. Be Present
With all the hectic happenings in a healthcare setting, nurses have to have eyes and ears open to everything. Sometimes that means when you are with a patient, you aren’t 100 percent focused on them. Making the effort to bring your attention to the patient in front of you helps. “Be present in the moment,” advises Pamela Chally, Dean Emeritus, Brooks College of Health, University of North Florida. “Even something nonverbal does a lot for being present. It can be a touch or eye contact,” she says.
3. Keep Them Updated
Let your patients know what to expect. If you know they’ll have a CAT scan later in the day, let them know the approximate time. If that time changes, pass that information along. They might have questions about what’s going on and why they need certain tests or procedures. Let them know or, if you don’t know all the details, find out for them.
4. Spend Some Time
This is the most difficult piece because time is one thing nurses don’t have to spare. But making the most of your time with a patient can help overcome the quantity of the time you can offer. You can’t sit in the room and chat the afternoon away, but you can ask them about their outside life. Talk about the latest baseball game, their scrapbooking habit, or what they like about their job.
5. Learn About Them
If they have family in the room, try to learn a little about them and about your patient as well. Be mindful if a family doesn’t want to talk, but also listen for small details that aren’t volatile. Hobbies, favorite places, favorite foods, or upcoming events they are looking forward to are all great ways to connect and will help break the ice.
6. Have Patience
In addition to their professional skill and their calm demeanor, nurses’ patience is legendary. But having patience isn’t always easy, and when you have patients who are scared, in pain, or just not particularly pleasant, it can be downright difficult. Watch the nurses around you to see what coping techniques they have developed to deal when tempers flare in your setting. Do they deflect with questions? Do they ignore the situation and continue on calmly or do they address it directly? What does your manager recommend when you encounter a situation that’s not easy? And find your own way of bringing yourself back to a calm place when things get tough.
7. Make It Personal
With so many people to care for, it’s not going to be easy to remember small details about everyone. But if you can remember your patient is especially nervous about blood draws, has very particular food preferences or issues, or is more modest than most (or not!), you can be prepared for those situations. Showing that you care about them as a person will help build a mutual trust.
Building relationships with patients, no matter what setting you see them in, has a ripple effect. You’ll make their stay or visit more pleasant, but you’ll also feel more satisfaction from having connected with them, too. And if your patient trusts you and feels like you are advocating for their interests, they are more likely to listen to what you say and ask questions when they don’t understand something.
Building a relationship with a patient can lead them on a path to better health overall and a better quality of life—what nurse doesn’t want that?
In hopes of gaining a breadth of experience, many nursing students immediately look for a job in a hospital setting upon graduation. But Judy Liesveld, associate professor at the University of New Mexico’s College of Nursing, encourages students to look past the typical offerings.
Working on a “Nurse Education, Practice, Quality and Retention-Bachelor of Science in Nursing Practicum” grant from the U.S. Department of Health and Human Services, Liesveld runs a program in which selected nursing students from the University of New Mexico and San Juan College in Farmington, New Mexico, work twice a year (once in fall and once in early spring) in the Chinle Indian Health Service Unit on very rural Navajo Nation Reservation located in Arizona, three hours outside of Albuquerque.
In their two-week stay on the reservation, the students are immersed in an unfamiliar culture and with medically underserved people who need healthcare that runs the gamut from minor to serious. Students who want to return are able to complete a senior capstone in the following term.
“When they are in this setting, they are in a very rural setting where it’s a totally different culture with a vulnerable population,” she says. “This totally helps to expand their world view. This is a robust, rich experience for them.”
And the experience the nursing students get in a short time rivals intense clinical experience in a larger healthcare setting, she says. Liesveld should know—her first job out of nursing school was working in Chinle Health Services.
The Chinle clinicals, as they are called, bring students through things like the emergency department, obstetrics, urgent care, and pediatrics. There are primary care clinics that the students participate in as well as home visits where many residents live without running water or heat in extremely remote areas where dirt roads are common. Even in living conditions that aren’t what they are used to, students see the human bonds that make the community what it is, Liesveld says. They see an incredibly close family structure and a culture that is powerful and strong.
The nursing students give presentations on health topics to different populations increasing both their presentation capabilities and their understanding of the different needs throughout a community.
“They presented at a senior center on smokeless tobacco and at a middle school on self esteem,” she says. Through the presentations, the nursing students interacted with people and felt like they were making a difference.
“The hope is students will love the experience and will work in rural settings,” says Liesveld. But if they never work in a rural setting again, she says the experience they gain on the reservation is one they will never forget and one that will offer them skills they will use throughout their careers.
“They learn they have to be resourceful and they learn how to think on their feet,” says Liesveld. Students quickly develop authentic rapport with the residents and they use nursing skills they might not have a chance to use in other places. “It changes their world,” she says.
If they stay in the region, they are likely to work with a Native American population, so the exposure to their culture will give them a cultural competency that can only be gained by such an immersive experience.
And the ripple effect of what they have learned can lead to advocacy as well. Students begin to think about health policy on a national level and what that means for the country as a whole and these rural pockets of communities that exist across the nation.
When there is that kind of meshing of skills, understanding, and cultural exposure, nursing students, wherever they land after graduation, will have a broad view that will benefit them and their patients.
On March 19, nurses everywhere can honor the extra work they have put into getting certified as the nation celebrates Certified Nurses Day.
Sponsored by the American Nurses Credentialing Center and the American Nurses Association, Certified Nurses Day offers a chance to acknowledge nurses’ extra efforts to gain the board certification that establishes advanced knowledge and specialization in specific areas.
Nurses can earn certification in everything from national healthcare disaster certification to cardiac rehabilitation to nursing case management, sharpening their skill set and therefore improving the patient care they provide. But certification takes work. Nurses must pass a credentialing exam and complete continuing education to maintain certification every few years.
Registered nurses are able to practice nursing, but nurses who earn certification status in various specialties are valuable to employers for additional reasons. Their extra motivation and willingness to become certified signals a dedication to nursing and to patient care. Earning certification shows they pursue their passions to advance their skills and go above and beyond typical job duties.
According to the ANCC, Certified Nurses Day is celebrated on “the birthday of Margretta ‘Gretta’ Madden Styles, the renowned expert of nurse credentialing. An accomplished advocate for nursing standards and certification, for more than two decades Styles advanced nursing practice and regulation worldwide.”
Nurses who are board certified in any specialty can help educate other nurses of the value of obtaining this extra designation. And the healthcare settings, patients, employers, and others for whom nurses form an invaluable part of the team can bolster the efforts and recognize the extra work it takes to earn and keep that certification.
If you don’t have certification in a specialty you’re particularly interested in or if you want to obtain another certification, the ANCC can help answer questions. Each certification has different testing and renewal requirements, so it’s best to check what you’ll need.
Many certified nurses appreciate the expertise recognition their certification confers. If you are especially interested in an area of nursing and have knowledge that people turn to you for, getting certified makes your knowledge and professionalism recognizable to others. Some nurses say they are reluctant to take the credentialing exam as they aren’t sure if they will pass. If that is your concern, take the extra time to study. If you don’t pass, you can take it again. Not everyone passes credentialing exams on the first try, but that doesn’t mean you shouldn’t refocus and take it again.
On Certified Nurses Day celebrate yourself and your colleagues who have obtained this extra education. Make plans to go out to lunch or just to say thanks to your colleagues who are making an effort to improve nursing care and their own professional skills. If you are thinking about getting certified in a specialty, take steps today to get the process started. You’ll advance your knowledge, your career, and your profession while providing the best possible patient care.
Although patient safety affects each and every one of us, it’s not always a topic people dwell on. But nurses do and they will join the National Patient Safety Foundation (NPSF) in celebrating Patient Safety Awareness Week from March 12 to 18.
“Everyone is a patient and patient safety is a public health issue,” says Sara Valentin, CMP for NPSF, assistant vice president and program lead for Patient Safety Awareness Week. “But unless you are in the health care field or a patient or a family member of someone who has experienced medical harm in some capacity, you wouldn’t know about it.”
Patient Safety Awareness Week aims to educate and inform people about patient safety with tips for taking charge of your own health or for working in a health care setting. “Preventable medical harm is one of our top issues we focus on,” says Valentin. “Wouldn’t that be wonderful if that never happened again?”
One look at the news shows new systems and approaches have significantly reduced the instance of medical harm, but it still happens. “We have made progress, but we still have a lot to do,” says Valentin. “This is a good time to stop and pause and look at the work people have done.”
NPSF generally chooses a few topics to focus on during each annual Patient Safety Awareness Week and communication and medication safety are especially noted this year. And while there are lots of events to participate in and educational and practical tips to learn and share, Valentin says the NPSF also says a little levity helps keep the topic fresh. The organization is encouraging anyone to spread the word that “We are all patients” by posting photos of themselves in hospital gowns or in patient care settings using #WeAreAllPatients.
NPSF is celebrating National Patient Safety Week in many ways. They will host a Twitter chat (@theNPSF), “Patient Safety: What Patients Want (and Need) to Know,” on Tuesday, March 14, from 1 to 2 pm (ET). Use #psaw17chat to participate.
According to the NPSF website, a free webcast, “The Voice of the Patient and the Public,” is set for Wednesday, March 15, from 2 to 3 pm (ET) and includes several prominent panelists. Registration is required online at http://bit.ly/psawweb17.
According to Valentin, “Medication itself is a big topic.” NPSF plans to offer information, resources, and facts to help people protect themselves from medication errors and to make anyone handling medications aware of where things could go wrong.
Good communication is a significant deterrent to medical errors, but in the hectic health care world, it requires constant diligence from everyone. Patients can look at their relationships with health care providers as partnerships where they should ask questions and clarify instructions until they really understand what the final plan is.
Nurses can give their patients the time to ask questions. Even when it seems like you cannot squeeze one more minute out of the day, spending a few extra minutes to make sure a patient understands the proper medication, the correct dose, and instructions for taking it is essential. She says, “You can ask, ‘Do you have any more questions,’ or ‘Are you comfortable with what we have talked about?’” Some patients are especially easily overwhelmed in a medical setting and might not listen to each and every thing you are saying. Giving one last opportunity to clarify things can prevent mistakes.
And nurses can continually tweak their own processes. Nurses also need to listen to each other carefully to make sure they are both communicating and understanding everything that is needed and being said.
And while this one week will highlights the critical importance of avoiding errors, Valentin says nurses know it’s a 24/7 issue. “Every day is patient safety day,” she says. “This is a week to celebrate, but it’s something we work on every single day.”
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.”