Workplace culture can be a hard-to-define concept, but it nevertheless affects every minute of your working life. Culture encompasses elements such as business values, management styles, physical environment, and even dress codes. Each hospital has its own unique culture that you’ll have to adapt to whenever you start a new job. Here are eight tips to help nurses acclimate to a new workplace culture:
1. Pay attention during orientation.
At the start of each new job, you’ll probably have to attend some kind of orientation or training for new hires before you can grab your nursing bag and start seeing patients. Even if there’s not a presentation that explicitly describes the culture and values of your new employer, you should have a good grasp of what is expected by the end of orientation. While culture has many layers that go far beneath the surface—each nursing unit has its own individual way of doing things, for example—wrapping your mind around the facility’s overall culture will give you a good framework for figuring out what does and doesn’t trickle down into your unit.
2. Observe how others behave.
Especially during your first days on the job, keep a sharp eye out for your coworkers’ behavior and watch how they interact with each other and supervisors. Do they engage in small talk as they walk together, or is everyone all business, all the time? Are they warm and friendly with the nursing unit manager, or do they hang back and treat them with deference? While some of this will depend on the personalities of your individual coworkers, observing this behavior will give you examples to fall back on as you start to build relationships at your new workplace.
3. Don’t be afraid to ask questions.
However, sometimes you won’t be able to glean everything you need to know from observation alone. Maybe your coworkers act totally different with two different supervisors, or one person in your unit hardly talks to anyone else unless necessary for unknown reasons. When it feels natural, you can ask your coworkers for more details in a non-nosy way. This also goes for procedures and other non-people related matters. If the unit does things differently than you’re used to, don’t hesitate to clarify what the preferred process is. Better that you ask for clarification ahead of time than try to puzzle your way through and mess things up.
4. Try to withhold judgment and assumptions.
Every workplace, including hospitals and other facilities, have their quirks. Especially if you’ve worked in several other facilities before, these idiosyncrasies might seem annoying and downright strange—but there’s often a reason for them. Instead of dismissing these quirks outright or grumbling about them, try to withhold judgment at the beginning and seek out underlying reasons. Maybe that unsociable coworker is dealing with a sick parent or child, or the “high strung” supervisor is under a lot of pressure from higher-ups. Even the most off-the-wall behavior often has an explanation if you look deeply enough.
5. Don’t constantly compare things to your old job.
Speaking of comparing your new job to your old one, don’t do it–at least not out loud. It’s super annoying to have a coworker who won’t shut up about how great their old employer was and how they did everything much better than their new facility. This behavior is not just bad for unit morale, it also won’t do you any favors as you try to build relationships with your new nursing coworkers. Just like your mom used to tell you when you were a kid: If you don’t have anything nice to say, don’t say it all.
6. Be judicious with vertical relationships.
Whether you’re a supervisor or a director report, vertical relationships can make or break your work experience. If you’re a supervisor, the performance of your team depends on your nurses. On the flip side, your supervisor holds great influence over your career as a nurse. Whatever position you will be in, try to figure out supervisor-direct report expectations early on in your new job. In an ideal world, your new employer will encourage close, supportive relationships between supervisors and nurses, but this isn’t always the case. The earlier you figure out the lay of the land, the sooner you’ll be able to start mapping out a plan for your career and your team.
7. Acknowledge your mistakes.
No matter how careful you are, you’re bound to make some slip-ups at any new job. When you do make a mistake, own up to it rather than trying to hide it and ask for pointers on how to do things better next time. See each mistake as a learning experience and an opportunity to grow as both a nurse and an employee. Apologize if necessary, and try to find humor in the situation when appropriate. Your coworkers will appreciate that you don’t take yourself too seriously. There’s no use crying over spilled milk or stained scrubs, so if the mistake is small in the scheme of things, try not to dwell on it and focus on moving forward.
8. Educate rather than accuse.
Sometimes, you’ll be on the receiving end of a mistake rather than the instigator. Maybe a new coworker calls you by the wrong name, or makes assumptions about you based on your appearance. While this isn’t okay, try not to assume the worst and jump to conclusions about ulterior motives. If you can, gently but firmly correct the other person while offering them an out like so: “I know names can be tough to remember sometimes, but just so you know my name is actually _____.” You won’t earn any points for being combative from the start, so do your best to be gracious and understanding when you start a new job, even if you want to be anything but.
Starting a new job can feel like entering a black box, but if you keep your ears and eyes open, you’ll quickly pick up on expectations and values. Follow these eight tips to help you adjust to a new work culture as you ease into your new nursing position.
’Tis the season to be jolly, and to have your festive follies land you in the emergency room. Holiday cheer can dissolve into tears after any number of seasonal accidents around Christmas time, from falling while hanging lights to cutting yourself with a knife while cooking. Below, we’ve rounded up eight major reasons for the seasonal injuries that often happen in the last few days of December. If you’re working in the ER on or around Christmas Day, keep these causes in mind as you put on your holiday scrubs.
Wrapping and Unwrapping Gifts
As mundane as these tasks seem, wrapping and unwrapping gifts is a major cause of injury around Christmas—and there’s a huge spike in cases on Christmas Day in particular. Knives, scissors, and box cutters can easily slip, resulting in lacerations. Even those awful hard clamshell plastic cases can pose a risk if you catch your skin on a jagged edge. Wrapping gifts can also result in lacerations and even major paper cuts if people aren’t careful. If this sounds silly to you, just wait until you work Christmas morning in the ER and watch the patients come through the door.
Decorating the House
Deck the halls with boughs of holly, but just be sure not to injure yourself in the process. Decorations pose all sorts of dangers. You can shock yourself while putting up lights, fall while hanging a garland over a door, or cut yourself on a broken ornament or figurine. In particular, children can get into a lot of trouble around decorations, such as swallowing small ornaments, hurting themselves on heavy stocking holders, and tripping over ground-level decorations. Keep that in mind when you’re decorating your house, or while you’re treating a patient who injured himself or herself doing these very things.
Hanging the Lights
Hanging lights inside or outside may be a time-honored tradition, but it’s also a dangerous one. Like decorating the house, hanging Christmas lights comes with all sorts of hazards. There’s the obvious risk of falling off a ladder or roof, resulting in bruises, broken bones, and/or a concussion. But you can also throw out your back while reaching up high or blow out your knee while climbing a ladder. Plus, there’s always the chance of cutting yourself on a broken bulb or shocking yourself with electricity when you plug in the lights. Around Christmas time, you may find yourself wishing your patients had simply put some battery-powered candles in the window and left it at that.
Trimming the Tree
Trimming a Christmas tree holds all the dangers of putting up decorations and hanging Christmas lights, all at once. If you manage not to throw out your back or pull a muscle while getting the tree into the house and setting it up in the stand, there’s still the possibility of falling off the ladder while you drape the lights or put on the tree topper. Of course, you can shock yourself while plugging in the lights as well. If you get through that unscathed, there’s still the chance that you will cut yourself on a busted ornament or lightbulb or trip on the tree skirt. Trimming a tree is all fun and games, until it isn’t.
Getting the Flu
Okay, so the flu isn’t related to Christmas directly, but December does fall right within the window for flu season. (The extended flu season for 2017-2018 lasted all the way from November to March and was the worst outbreak in the U.S. in almost a decade.) Flu viruses will already be circulating by Christmas, and the stress and travel of the holiday can wear down people’s immune systems, making them more prone to contracting the flu. Expect to see severe cases of the flu starting in November and continuing through the rest of the winter holidays, including Christmas—and be sure to encourage any healthy patients you see to get the vaccine!
Cooking the Food
Cooking that delicious Christmas dinner can also prove harmful to your health. Knife lacerations are a common injury around the holidays, as cooks are often distracted while chopping and inexperienced chefs find themselves pressed into cutting vegetables. Burns also happen often due to splattered oil or gravy, as well as brushing up against a hot pan or stovetop burner unknowingly. Less common are full-on cooking fires, which are thankfully more rare but more serious when they do occur. Come Christmas, you’ll probably find yourself patching up more than one overambitious chef, so brush up on your burn and wound care skills.
Eating the Food
You’ve managed to get through cooking all the food without burning or lacerating yourself, so you’re home scot-free, right? Wrong. Food poisoning can happen during holidays due to undercooked meat–which harbors salmonella–or any dishes left at room temperature for too long, which allows nasty bacteria to grow. There’s a high likelihood you’ll see patients with nausea, vomiting, diarrhea, abdominal cramps, and/or fever, all classic signs of food poisoning. You might also get some cases of more mild gastrointestinal distress (“mild” being relative) with symptoms such as severe gas, bloating, constipation, and abdominal pain. Traditional Christmas dishes are full of fats, oils, sugars, spices, and other irritants, and many people overindulge on the holiday, leading to seriously upset stomachs.
Drinking Too Much
Just as many people overindulge in food over the holidays, so they also overindulge in alcohol. While alcohol-related incidents are a bit more common on New Year’s Eve, many people also imbibe to excess during other winter holidays, including Christmas. Drunk driving is obviously a major concern, but plenty of other minor mishaps can result from drunkenness, such as slips, falls, and injuries caused by sluggish reflexes.
While some of these resulting injuries might not be so different from ER visits the other 11 months out of the year, it helps to know the possible cases that might walk through the door, especially if you’ve never worked a holiday shift in the ER before. Keep these eight injuries in mind as you treat patients, and consider rewarding yourself with a nice Christmas gift, such as sturdy nursing shoes or a new stethoscope once you get through the craziness of holiday injury season.
In many people’s minds, the “typical” nursing student is an 18- to 22-year-old enrolled in a bachelor of science in nursing (BSN) degree program at a college or university. However, there are many degree options available for aspiring nurses at all stages of life—even if you’re a nontraditional student—and you’ll be graduated and putting on your scrubs before you know it.
According to the National Center for Education Statistics, a nontraditional student meets one of seven criteria: delayed enrollment into postsecondary education, attending college part-time, working full time, financially independent for financial aid purposes, dependents other than a spouse, single parents, or those without a high school diploma. If any of these describe you and you’d like to go back to school to get your nursing degree, here are seven online programs that anyone from around the country can take.
1. St. Xavier University
St. Xavier has numerous online options for those looking to earn nursing degrees. It offers an RN-to-BSN program for currently licensed registered nurses who have completed an associate degree in nursing (ADN) from an accredited school of nursing and are looking to take the next step in their education. St. Xavier was also named the best online master’s nursing program by U.S. News and World Report, and it offers three master of science in nursing (MSN) tracks online: clinical leadership, executive leadership, and nurse educator. If you’re not looking for the full degree, St. Xavier also offers certificates in clinical leadership and nurse educators.
2. Medical University of South Carolina
The Medical University of South Carolina (MUSC) offers an online RN-to-BSN program, which is a 12-month program that covers three consecutive semesters, allowing registered nurses to earn their bachelor’s degrees in just a year. The online program is designed specifically for working adults. MUSC also offers several online advanced degrees in nursing, including a doctor of nursing practice (DNP) and a PhD in nursing science, though some of the courses may require a visit to campus.
3. Johns Hopkins
Johns Hopkins is an incredibly well-respected name in the medical community—and you can earn a graduate nursing degree from the university online. Johns Hopkins provides an MSN in health systems management both by itself and in combination with an MBA. It also offers a DNP in three specialties: adult-gerontological health clinical nurse specialist, adult-gerontological critical care clinical nurse specialist, and pediatric critical care clinical nurse specialist. You can also earn a DNP Executive Track, either on its own or in combination with an MBA. Finally, Johns Hopkins offers a couple post-master’s certificates for nurses looking for even more education.
4. George Washington University
George Washington offers a wide range of online programs for nurses of all experience levels. It has both RN-to-BSN and RN-to-MSN programs, as well as four other master’s programs for adult-gerontology primary care nurse practitioners, family nurse practitioners, nurse-midwifery, and nursing leadership and management. Other options include three post-MSN certificate opportunities, two post-BSN doctoral degrees, and two post-MSN doctoral degrees, including a DNP degree.
5. The University of Texas at Tyler
The great state of Texas has equally great online programs for nursing students through the University of Texas at Tyler. Its RN-to-BSN track has a flexible schedule and graduation date, so you can proceed through the coursework at your own pace as your current job allows. Their graduate options include four MSN programs (administration, dual MSN administration/MBA, education, and family nurse practitioner), four certificate programs (post-master’s administration, post-master’s education, post-master’s family nurse practitioner, and post-baccalaureate health care informatics), two PhD programs (MS-to-PhD and BSN-to-PhD) and one doctor of nursing practice (DNP). As an added bonus, the University of Texas at Tyler was named the #1 most affordable online master’s in nursing program.
6. Duke University
Duke’s School of Nursing has been using distance-learning education strategies for more than two decades, and the school has honed its creative approach to distance teaching and learning over the years. Some programs do include a few short on-campus intensive sessions, usually two to three days in length, but the commitments are minimal. Duke offers a doctor of nursing practice as well as eight different nurse practitioner tracks for their master of science in nursing: adult-gerontology (primary and acute), family, neonatal, pediatric (primary and acute), psychiatric mental health, and women’s health. It also offers three systems MSN degrees in nursing and health care leadership, nursing education, and nursing informatics.
7. University of Cincinnati
Cincinnati’s reputation as a great online nursing school has spread: The school’s number of distance learners has been increasing, and the website boasts that more than 62% of the student body is now enrolled in online classes. Most of its graduate nursing degrees are offered completely online, though a few courses do have minimal on-campus requirements for clinical or lab work hours, so don’t forget to pack your nursing bag. The school offers four MSN specialty programs (adult-gerontological primary care nurse practitioner, family nurse practitioner, nurse midwifery, and women’s health nurse practitioner) as well as two post-master’s certificates (psychiatric mental health nurse practitioner and family nurse practitioner).
If online classes don’t appeal to you, see if any schools in your area offer a nursing degree for working adults who usually rely on night and weekend classes in order to accommodate work schedules. And no matter how your get your degree, you’ll have to study for and pass the National Council Licensure Examination for RNs (NCLEX-RN) exam if you haven’t already and perhaps pass additional licensure requirements depending on your state.
Whether you’re a working nurse looking to take the next step or a young professional looking to switch careers, there’s a nontraditional degree program out there for you. Thanks to the recent breakthroughs in education technology, students can now attend nursing degree programs online anywhere, anytime, and these seven well-respected programs are a great place to start.
Working overnight shifts is a big change for many nurses, but it’s also extremely common. With the 24-hour demands of the bustling, modern health care system, there’s a good chance you’ll have to work the night shift at some point in your career, especially when you’re starting out. But don’t fret! There are many ways to ensure that the transition from day to night goes as smoothly as possible.
All nurses need to be on their A-game with technical medical skills and emotional resilience no matter what time of day they’re working. Night shift nurses have to shoulder even more burdens because they often work mostly or entirely alone for their shift. While there’s no one “right” way to adapt to the night shift, there are several common mistakes that you’ll want to avoid to build good habits.
Common Mistakes to Avoid When Switching to the Night Shift
Going against your circadian rhythm is no small task. However, resorting to quick fixes will only make your shifts more difficult in the long run. Avoid these five common mistakes and you’ll adapt to the swing of a night shift quickly.
1. Not getting enough rest before starting a shift.
As a nurse, it’s important to always be sharp on the job. The staff at Gurwin Jewish Nursing and Rehabilitation Center emphasize that not getting enough rest is the number one mistake that new night shift workers make, and it’s one of the most dangerous. Since shifts are often upwards of eight hours long, there’s no safe way to “power through” on too little sleep. This goes for both on-shift work and driving when sleep-deprived.
How to Avoid It:
- Install blackout curtains where you sleep and get a fan or white noise generator.
- Turn off your phone, get a “Do Not Disturb” sign, and inform loved ones of your schedule.
- Staying up for a few hours to relax and take care of yourself may be easier for some nurses than going straight to bed at the end of a shift. You’ll figure out what works for you with time, so don’t be afraid to experiment.
- Take proper care of your legs and feet while on your shift, so you won’t be troubled by pain or soreness when you’re trying to sleep.
- Light soothing candles and practice stretches to relax yourself before bed.
2. Leaning on sugary foods, alcohol, or caffeine instead of proper nutrition.
It can be tempting to snack on chocolate or chug coffee to keep yourself going through your night shift. Keep in mind that, if consumed in excess, coffee can lead to jitters at first, followed by a crash. You’ll be far better off if you instead focus on getting more sleep.
How to Avoid It:
- Plan and pack your meals ahead of time to avoid relying on vending machines.
- Schedule your heavy meals so they won’t interfere with sleep.
3. Letting your personal life fall into disorder.
Sometimes it’s hard to keep your personal life in order while working the night shift. Errands, social gatherings, and childcare all battle for your attention when you’re not at work. This reduces your ability to get good sleep and, in turn, to focus at work.
How to Avoid It:
- Yoga and meditation help you relax and leave work behind so you can be present when you’re engaging with family or friends.
- Establish a schedule for sleep, chores, and activities. This will reduce the stress of missing out on things.
- Plan gatherings ahead of time with friends and family to ensure you can make it to fun gatherings.
4. Not asking for help or feeling like you have to “do it all.”
Yes, there are fewer resources available overnight at the hospital. This can lead to superhero-esque thinking, where you refuse or even genuinely forget to ask for help. Being honest about needing a hand is better than dropping the ball because you’re juggling while tired.
How to Avoid It:
- Get to know the others who work nights so you can trade favors.
- Get to know the resources available to you during your shift.
- Ensure that your roommates or family are sharing the load with you at home.
- Choose sleep over chores when possible at home. Others can help you with chores, but they can’t sleep for you!
5. Missing out on workplace bonding, training, or resources due to night shifts.
It’s easy to feel forgotten when working the night shift. Try not to miss out on opportunities for bonding, continuing education, or extra support because of your schedule. It can be hard to make time or schedule changes for these opportunities, but they’re integral to your career development down the line.
How to Avoid It:
- Check announcement boards and learn about opportunities available at your workplace.
- Make it known to your boss and coworkers that you’re interested in additional training, support, resources or team bonding even if you work the night shift.
- Ask if there are online resources available for any opportunities that you simply cannot attend.
Your job as a nurse is important. Don’t let working the night shift get in the way of providing the best care possible to your patients and yourself. Getting enough sleep is integral to your job performance and personal health, but that’s not always enough. You also need to make sure you’re practicing good self-care and focusing on your health along the way. With these great tips, you’ll adapt to the night shift in no time!
January 21 through 27 is National CRNA Week, and we’re celebrating by getting up-close and personal with the CRNAs who make the medical world go ‘round! Certified Registered Nurse Anesthetists (CRNAs) safely administer about 43 million anesthetics each year, making surgeries and medical treatments safer. These professionals not only administer anesthesia, but also help ensure patient comfort and security.
CRNAs come from all walks of life and work in a wide range of communities. Interestingly, the American Association of Nurse Anesthetists (AANA) reports that CRNAs are the sole providers in nearly 100% of rural hospitals in some states as well as within the U.S. Armed Forces. Make sure to thank your favorite CRNA during CRNA week and surprise them with something special to say thanks! We love the idea of gifting them a personalized stethoscope with custom engraving as an awesome way to pay tribute.
What Does a CRNA Do Every Day?
What’s life like as a CRNA? Let’s take a closer look. Every day, nurse anesthetists monitor patients during surgery. This requires preparing and administering drugs before anesthesia, managing patients’ airways, and pulmonary status during surgery and closely observing their physical reaction to drugs. They may also perform pre-anesthesia screenings to determine a patient’s risk and administer epidurals in maternity wards.
But there are many other things that CRNAs are responsible for each day, according to Lincoln Memorial University Clinical Coordinator and CRNA Joy Lewis. “We do pre-op and post-op rounds, consults for pain management, place central lines, respond to codes, place and manage labor epidurals, upon consultation implement respiratory and ventilatory management including establish emergency airways,” says Lewis.
Dan Lovinaria, a CRNA with Veterans Affairs at Minneapolis Medical Center, says there’s an emotional aspect to the job, too.
“Being a VA CRNA comes with a tremendous responsibility and a great deal of accountability,” he says. “Patients are often anxious and nervous about their surgical procedures. It is my duty and responsibility to set the tone and make an immediate connection with my patients upon their arrival in the preoperative phase. Something as simple as providing warm blankets to my patients goes a long way. The little things make a significant impact.”
What’s the Schedule Like?
Surgeons have notoriously demanding schedules, whether they’re responding to emergencies or running on a tight, pre-determined schedule. Since CRNAs are required to be present for many of those surgeries, their schedules may be even busier than a surgeon’s.
“Oftentimes our schedules are busier than the surgeons if we work at a hospital with [obstetrics]. Once you place an epidural you may not be able to leave, and they will still want the operation to start on time,” Lewis says.
Lovinaria says he and his team work various shifts, including 8-hour, 10-hour, 12-hour, and overnight shifts.
Who’s Their Boss?
But there’s good news, too. CRNAs operate on a more autonomous schedule—they’re not required to be supervised by an anesthesiologist in any of the 50 states—so their shifts and schedules vary compared with traditional registered nurses. CRNAs may work as part of an anesthesia care team or as individual providers.
Robert J. Gauvin, a CRNA who’s also the president of Anesthesia Professionals, Inc. in Dartmouth, Massachusetts, says owning an anesthesia care business means more work but even more autonomy.
“Because of my unique position as a business owner and practicing CRNA, a typical day involves the 30-plus CRNAs in my group taking care of one to 45 patients in multiple facilities, followed by two to three hours of administrative duties,” Gauvin says. “On a weekly basis, I try to build in dedicated office days that allow me to focus on developing the business side of my practice.”
What About the Education Factor?
Because CRNAs have a much more specialized skill set than traditional RNs, they’re required to have extra education. Most CRNAs start out as RNs and are then required to complete a master’s degree in nursing (MSN), which typically takes about two years. CRNAs must then pass the National Certification Exam (NCE), which covers the knowledge, skills and abilities needed by entry-level CRNAs.
“Pursuing my studies as a CRNA demanded my efforts and abilities in many ways: mentally, physically, emotionally, financially, and so on,” says Mary Nguyen, a CRNA at Lourdes Hospital in Paducah, Kentucky. “My whole world was completely changed. With that being said, I’d do it all over again to have the privilege to work in my position as a CRNA.”
Nguyen also emphasized the importance of the CRNA certification exam. “The best advice that I can give to others is: ‘Respect the Test!’ The National Certification Exam (NCE) requires a level of thinking and comprehension of anesthesia that is only attained after rigorous clinical experiences paired with thorough reading and studies,” she says.
And then, of course, CRNAs must put a significant amount of time and money into continued education in order to keep their certification active. According to CRNA Bruce Schoneboom, the Senior Director of Education and Professional Development with the AANA, CRNAs must regularly become re-certified.
“The National Board of Certification and Recertification for Nurse Anesthetists’ new recertification program is called the Continued Professional Certification (CPC) Program and consists of eight-year periods. Each period is comprised of two four-year cycles. Every two years CRNAs will check in through a simple, online process known as the ‘two-year check-in,’” Schoneboom says. CRNAs must complete 100 additional education credits in an eight-year period.
Is It as Rewarding as They Say?
Talk to any nurse, and he or she will tell you that there’s a certain pride in putting on a pair of scrubs every morning. But is being a CRNA just as fulfilling as the traditional RN track? Yes, say CRNAs. And the proof is in the pudding: CRNA is a career with one of the highest job satisfaction ratings within nursing.
“There are so many rewarding moments being a CRNA. The one-to-one patient/CRNA interaction is a very valuable experience, and so is engaging the vets’ caregivers or significant others about the anesthesia plan of care,” says Lovinaria, adding that it’s the critical thinking component of the job and its dynamic changes that keep him on his toes.
Nguyen agrees: “I can honestly and wholeheartedly share that even on my worst day, doing what I love is better and more rewarding than a single day doing something else. I would choose this profession over any other option available,” she says.
Make sure to give your favorite CRNA plenty of props during CRNA Week this year!