We often make plans for many things in our life, such as buying a first home or car, weddings, graduations, family trips, college applications, and baby showers, just to name a few; but one thing most of us don’t make plans for is “end of life.” As nurses we all have admitted patients to the unit and asked the question “Do you have a living will/advance directive?” This question is asked as part of the routine admission process in the ER, long-term care, or if a patient is having surgery, but how many of us actually have one of our own?
Last month I attended the Black Nurses Rock 3rd Annual Convention and had the opportunity to attend the session “VITAS Advanced Care Planning.” This was a very valuable, informational, and eye-opening presentation. It was amazing that in a room of over 200 nurses, only a handful actually had their own living will/advance directive. As nurses, we always care for others and forget about ourselves. Although we know that death is part of the life-cycle, this is often a difficult topic to discuss. One of the key points that was addressed was “starting the conversation.” We all need to get our affairs in order to make our wishes known to family and friends. There is enough stress with losing a family member, so there does not need to be the added stress of trying to deal with making hard choices without knowing your wishes.
We all need to take the time to address and make sure that family members will not have to guess what is wanted at the end of life. There was a document presented called “Five Wishes,” which is very clear and easy to understand. It is a living will that addresses the personal, emotional, and spiritual needs, as well as the medical wishes that a person wants. This living will is more personal than the standard living will and helps you and your family plan ahead for end-of-life decisions. It is divided into five parts and addresses the following topics: the person that you want to make care decisions for you when you cannot, what medical treatments you want or do not want, how comfortable you want to be, how you want people to treat you, and what you want loved ones to know.
The Five Wishes document is valid in the District of Columbia and 35 states, but you are encouraged to still complete a standard living will/advance directive if your state is not included. One quote that had a great impact from the keynote speaker, Captain James Dickens, DNP, RN, was “Stay ready, so you will be ready.” So, what are you waiting for? Start planning today for the peace of mind for you and your family.
For more info on Five Wishes, visit https://fivewishes.org.
Over the past few months there have been several postings of nurses that have passed their Board or certification exams. Congratulations to you all. Unfortunately, there have also been nurses that have not passed and have been discouraged. This is a message to you to “never give up.” You are not a quitter, you have taken the initiative to choose a rewarding field and have studied long and hard for two to four years.
You made it through course work and clinicals so don’t let this defeat you. Everything happens for a reason, even though we may not understand it. Take this time to step back, regroup, and refocus. Most people do not realize that failure can be a stepping stone to success. During this time you learn about your life, goals, and other things that make you who you are. Failure will actually make you stronger and wiser. You will have more knowledge and will find ways to achieve your goals and success.
There have been several people that failed, but never gave up: Take Bill Gates, at an early age his first computer company failed, but he did not give up and he made billions and gave us Microsoft, Windows, Excel PowerPoint. Colonel Sanders failed at almost everything, but at age 65 he developed his famous chicken recipe that was rejected by over 1,000 restaurants, but was finally accepted by one. Dr. Seuss wrote his first book and it was rejected 28 times, but he did not give up. At the time of his death he had sold over 600 million copies of his books.
Although these people were not nurses, it shows you that even though they failed, they did not stop. According to the National Council of State Boards of Nursing (NCSBN), you can retake the exam 45 days after failing and up to 8 times a year.
The real FAILURE is never trying again, so NEVER GIVE UP!!
We just recently celebrated National Nurses Week and everyone has returned back to their normal work routine. During Nurses Week many received breakfast, lunch, cookies, candy, pens, t-shirts, and other trinkets from their nurse managers or facility. Unfortunately, many nurses did not receive anything. Now that the week is over, does that mean that all of the celebration and appreciation is over?
It is sad that nurses have spent years going to school to obtain degrees and certifications and spend more time with their patients than their own families. Nurses work 365 days out of the year, yet they are only celebrated for seven days. Nurses focus on taking care of patients, being caregivers, nurturers, teachers, and counselors; in addition to providing treatments, performing procedures, and administrating medications. Sometimes they are yelled at by patients, families, doctors, and often by their own colleagues.
Nurses endure a lot of stress on a day-to-day basis. This is not to say that all days are bad; because there are plenty of days when you feel happy and proud to be a nurse. Although money would be welcomed by every nurse, sometimes it is the little things that make a difference. A thank you from a patient when you take the time for a brief moment just to sit and talk with them, from a family member who notices the care that you give their loved one, from a doctor who is notified by you regarding a critical lab value or assessment on a patient, or by your colleagues when they noticed you doing a task well.
Oftentimes nurses take care of others, but forget about themselves or their fellow nurses. There is no rule that says nurses should only be celebrated for one week. Nurses should be appreciated every day. Nurses should find ways to celebrate each other. You do not have to wait for one designated time of the year or wait for management to give recognition.
Although most nurses would welcome a monetary gift, sometimes the simple things are more valuable. Every nurse should start a “Nurse Appreciation” project. This can be done daily and is not limited to your unit. Make it a point to recognize a nurse daily. If you notice great customer service or patient care, let that nurse know immediately. If they help others or volunteer for special projects without being asked, show your appreciation. Create a “Nurse Spotlight” bulletin board, many people like to see their name in print and it shows other staff and patients the positive aspects of the unit. This project could also boost the morale of the unit, thereby increasing nurse satisfaction, which would have a positive effect on patient care.
Thank you all for your compassion, knowledge, and expertise. Let’s make a change and have “Nurses Year” and celebrate each other for 365 days.
I have been a nurse for 30 years and have worked in various areas of nursing: Oncology, Gyn-Oncology, Home Health, TeleHealth, Legal Nurse Consulting, Teaching, and Endoscopy. During nursing school and as a new nurse I thought that I could only work in a hospital as a floor nurse or in a nursing home. As I gained experience and began to grow, I found that there were many other areas that needed to be explored. Nursing is a constantly changing field and in order to grow, you must move and spread your wings. You should never stop learning. Nursing is a rewarding career and if you always remember why you became a nurse (other than for the money), it will help the bad days appear better. If you ever get to the point that you feel stagnate, don’t give up, GET MOVING!! Some ways to help you grow is to go back to school and advance your education, change your specialty, and gain new knowledge and experience.
Too many times nurses are quick to give up after a few years in practice, but with anything that you want to perfect it takes time, commitment, and patience. There is no rule that states that you have to stay in a certain area for years. Oftentimes, nurses stay in the same area and they become frustrated and burned out. This can have an untoward effect on the care that is delivered to patients and affects the morale of the nurse and the unit. These are the nurses that are angry and complain, but they are afraid to change. Often these are the same nurses that are selected to be preceptors for new nurses. This is not a healthy environment for the new nurse, because this can cause them to question if they want to stay in the nursing field.
So as nurses, we need to explore other options to work, without giving up on the career we worked so hard for. One positive change that needs to be implemented in nursing school is for instructors to inform students that there are multiple fields available to them. There are several non-traditional areas to choose, such as doctors’ offices, walk-in clinics, school clinics, insurance companies, and you can even work with attorneys, where they rely on you for your health care background.
If I had never realized that I could work in other areas, without giving up nursing, I probably would not have been a nurse as long as I have. Even at this point in my career, I am still seeking and searching for new learning opportunities. I want to expand my knowledge and experience, and I would encourage other nurses to remember to spread your wings so that you can grow.