Sometimes nurses know they are destined for a lifelong nursing career; for other nurses, it’s as if the career chooses them.
That’s how Jonathan Llamas DNP (c), BSN, RN-BC, PHN, found his way to nursing. Knowing the career would be a good fit for his compassionate nature and his innate ability to have empathy for others, Llamas applied for nursing school right out of high school.
“I knew the work was selfless and inspiring,” he says, “but I went into nursing school with some naiveté. I knew I had the qualities to be a successful nurse, but I didn’t understand the amount of hard work and dedication required for me to excel in the heavily science-based coursework.”
Llamas was unprepared and struggled with the demands of the course load. Looking back, Llamas sees how his path started to become rockier, even as he wanted to succeed. He lacked the mindset to focus on his work. “I didn’t commit the time necessary for me to be successful,” he says.
Transferring to community college, Llamas finished his prereq courses, but says his lackluster GPA set him up for a cycle of rejections from other nursing programs. Determined, Llamas pressed on but struggled with setbacks that would have had other students choosing another path.
“Based on my GPA, my community college counselor said, ‘You don’t have what it takes to be a nurse,’” says Llamas. Feeling demoralized by the comment, Llamas still felt that nursing was his calling. He just had to find a way to get there. “I had to prove to myself I could do it,” he says, “and that I could do well under pressure.”
The toll from the rejection was growing though. As a first-generation college student from a supportive Filipino family, Llamas recalls his mother’s upset at all the rejection for him and it struck a nerve.
“I looked in the mirror and thought, ‘How do I want to be remembered? Do I want to be a father who inspires his kid to rise above adversity or fold under pressure?’” Llamas says. “I didn’t want to be the latter. I wanted to make something of myself.”
Determined to succeed, Llamas applied to West Coast University’s nursing program, and they gave him another chance. He didn’t throw it away and graduated in 2013. I learned that if I wanted to be successful, I have to apply myself,” he says. “I carry that now. If you want something, you have to work for what you want. We are all different in terms of the resources we have initially. We are not all starting at the same starting line.”
“Hopefully my story will inspire others,” says Llamas. He wants students to be academically and mentally ready at the outset so they aren’t surprised by the intensity and high expectations of nursing school. “You have to sacrifice to be successful,” he says. “It’s hard, but it’s temporary. Do your research, and know why you want to be a nurse. Have a vision for yourself and your future.”
As Llamas has learned, there is a level of commitment to nursing that is necessary to be an exceptional nurse. “There’s a difference between your passion and your purpose,” he says. Having the inherent ability to be a successful nurse often makes one’s passion for nursing grow stronger, he says. “I understand that nursing requires sacrifice, but the most rewarding thing you can do is provide such incredible care to a patient.”
For Llamas, persistence has paid off. He is set to graduate this spring with his DNP from Loma Linda University and juggles his academic load with a full-time schedule as a psychiatric mental-health nurse. “I am fortunate to have hit this stride in my career,” he says. The advanced degree will help him reach his future goals of influencing change in nursing by providing a different form of influence beyond the bedside. He envisions working as an NP, becoming an educator to help future nurses, and using his platform to help other nurses.
“If you had said to me 10 years ago that I would accomplish this, I would have said you were crazy,” he says. “If I have impacted someone’s life for the better, then I have lived a life worth living. I feel blessed, humbled, and grateful for the opportunities that have come my way.”
Although many people don’t like to think about death and dying, it will happen eventually. When it does, those who are fortunate enough to have hospice and palliative care nurses caring for them will understand the importance of these nurses’ roles.
Palliative and hospice care nurses provide care for those who are the end of their lives. They are there for the final transition and use an entire array of medical knowledge and tools, skills, compassion, and life experiences to help in the best ways they can. Hospice and palliative care nurses strive to make patients as comfortable as possible both physically and emotionally. As their physical body shuts down, these nurses can use a combination of medication, music, talk, touch, and companionship to make the process something the patient is comfortable with.
The Hospice & Palliative Nurses Association and the National Hospice and Palliative Care Organization offer resources and education about this nursing specialty. Palliative and hospice nurses often provide education to the public as many people think of nurses as providing life-saving care and aren’t sure what end-of-life care entails. If they haven’t had interactions with hospice care, they may not comprehend all that goes into the nursing practice as someone approaches end of life.
While many find the end-of-life stage difficult to cope with, these nurses often consider it a supreme privilege to be present during someone’s last days. Nurses often develop deep connections with these patients as they try to meet their wishes and help them die with a sense of dignity and control. They also become close to families and even provide guidance and education to help families cope and to make them feel like they can take an active part in offering comfort and acceptance.
Hospice and palliative care nurses deal with grief, often very profound grief, on a daily basis. While the dying patient is coping with life coming to an end, a circle of loved ones is doing the same and trying to prepare for life after the person’s death, while also making the most of the final days. These nurses are especially skilled in managing grief and helping others learn coping skills while they still focus fully on the patient.
Hospice nurses need to take special care to make sure they are also able to cope with profound levels of grief and death in their lives so they don’t get burned out or experience compassion fatigue. Forming strong relationships with other nurses in this specialty is important as is joining professional organizations devoted to hospice and palliative care and even continuing education like certification or additional coursework or conferences. There is much to be learned from others in similar work and hearing how they cope and even what might be a red flag to take notice of. Turning to others and counseling professionals if needed can help nurses stay focused while acknowledging and honoring the challenges of providing end-of-life care on a daily basis.
This career path is one that offers great rewards and hospice nurses are often remembered as a steady presence in a chaotic time.
This week, the American Association of Nurse Practitioners (AANP) leads the celebration of National Nurse Practitioners (NP) Week to mark the distinctive benefits of this career path.
According to the AANP, approximately 248,000 nurse practitioners hold an NP license in the United States. The career is especially appealing as NPs generally have more autonomy than other nurses. In some states, NPs are able to practice on their own without physician oversight, and, in doing so, can provide a full spectrum of care. They assess, diagnose, treat, and make a continual care plan for patients, so they are involved in each step of the patient’s care. Because of that, NPs often form close, long-lasting relationships with those they care for. NPs are able to prescribe medications across the US and almost half hold hospital privileges as well.
Nearly 98 percent of NPs hold graduate degrees and more than 8 in 10 hold some kind of primary care certification. For all the education NPs earn, the Bureau of Labor Statistics reports that they are rewarded with a salary that hovers around $111,000 annually. The job outlook is growing faster than average with a 31 percent growth predicted by 2026.
If you’re interested in this in-demand career path, you’ll need to obtain a master’s in nursing degree along with plenty of extra credentials like certifications. NPs often hold more than one certification and the credentials can be in related areas like neonatal care and pediatric care. You’ll need to pass an NP state licensing exam so you can be registered to practice in your state.
Many nurses find the NP role helps them make a positive impact when access to healthcare is essential and sometimes not in easy supply. NPs can make big inroads into the health of communities as they are able to care for patients in a variety of settings and situations. Nurse practitioners who want to practice autonomously need to have the extra information to know how to do that while protecting themselves and their patients.
NPs can and should connect with peers and colleagues to share the challenges of the role and talk about the satisfaction of this role. Networking will help their professional development and the information learned will often improve their patient care as well.
When patients need care as a result of a violent or abusive situation, they often rely on forensic nurses to help provide a knowledgeable and compassionate bridge between the legal and health systems.
Today celebrates Forensic Nurses Day, and there is a continued need to understand the valuable work they perform and why forensic nurses are a crucial part of any hospital team. The day wraps up a week-long recognition by the International Association of Forensic Nurses (IAFN) to call attention to the work they do.
Forensic nurses have duties that overlap both nursing and legal needs. They provide the specialized healthcare and attention victims of violent acts require. With sensitivity, they help patients through immediate and long-term trauma of the physical after effects of being a victim of violence. But forensic nurses are also the best advocates for these patients in court and legal systems. As a first responder to the patient’s health needs, these nurses collect evidence in a specific way to help the legal system gather needed information and observations to prosecute.
A career in forensic nursing begins with a RN or APN and a desire to help those who have been victimized by violence, sexual assault, or neglect. Forensic nurses work with people of all ages and demographics. As the violence can be within a family (spousal abuse, child abuse, or elder abuse) or among strangers, those requiring care could be anyone. According to the IAFN, forensic nurses’ skills are also needed in corrections facilities, in corrections centers, and in the aftermath of mass tragedies as well.
As with other nursing specialties, certification is a good career move for this field as technology continues to move at a rapid pace. Certification is offered in specialties or in the advanced practice of forensic nursing. Many nurses with significant training in emergency care or critical care become certified Sexual Assault Nurse Examiners (SANE) to provide treatment and collect evidence of sexual assault victims.
When patients receive care from a forensic nurse, they know someone has their back and can help them take steps toward recovery and healing.
November 7 marks the final day of Urologic Nurses and Associates Week, so Minority Nurse turned to Amy Hull MSN, RNC, WHNP-BC and president of the Society of Urologic Nurses and Associates (SUNA) to hear her thoughts on choosing this nursing path for a career.
Hull didn’t start her career in this specialty. She is a women’s health nurse practitioner by training, and she thought she would care for pregnant women for her entire career. About 15 years ago, while still seeking a niche in OB/GYN, a friend convinced her to try continence work, she says.
“I had no real understanding of continence issues and the real, devastating concerns incontinent patients experience,” Hull says. “However, as I stated, my friend and colleague convinced me to pursue this transition. I have not regretted that decision.”
In her practice as a urology nurse, Hull says her work can make a significant impact on her patients’ quality of life. Because patients with urologic conditions are often limited in the activities they can participate in without symptoms, the conditions can impact their physical, emotional, and mental health.
“Urologic concerns can arise during all phases of one’s life and affect men, women, and children,” she says. Hull says those in her profession offer education and care to enhance patients’ well being and sense of control over what may seem as uncontrollable issues and diagnoses.
Urologic Nurses Needed to Meet Demand
With such comprehensive care needed, Hull says urologic nurse staffing issues are pressing. “With fewer and fewer dedicated urology floors in hospitals, the hospital nursing staff are at risk of reduced education and reduced opportunities to achieve the needed skills to enable them to expertly care for their patients,” she says. “Without true, dedicated nursing education within our schools of nursing, the necessity falls to senior nurses to train new staff as well as our nursing organizations, such as SUNA.”
Luckily, Hull says the developments in the field are rapid, but nurses and associates in the field will need to continually fine-tune their skills and expand their knowledge to provide up-to-date care.
“Efforts to better understand the environment of the bladder are helping to better treat and prevent infections,” she says. “New and better surgical and non-surgical techniques are helping to provide improved outcomes for patients with such conditions as urologic cancers, pelvic organ prolapse, and incontinence.”
Getting Ahead in Urologic Nursing
Nurses interested in the career of urologic nursing should seek out mentors they can learn from. Seeking out professional development, education out of the place of work, and networking will help nurses in their careers and will keep them current.
As with other nursing specialties, Hull says urology certification is important. The Certification Board for Urologic Nurses and Associates (CBUNA) offers certification exams for MAs and LPNs, RNs, and advanced practice providers.
“SUNA provides urology education for MAs, LPNs, RNs, and advanced practice providers, such as NPs, PAs, and CNSs,” says Hull. The organization also has 29 local chapters nationwide where urologic nurses can find additional opportunities for education, and they can attend the Annual UroLogic conference or Advanced UroLogic Conference. SUNA has also developed the Scopes and Standards for Urologic Nursing which helps to define the specialty.
Having a positive impact on her patients’ lives keeps Hull enthusiastic and she encourages other nurses to consider this specialty.