Whether you know Nurse Blake (Blake Lynch) from his Facebook videos, podcasts, live comedy shows, or cruises, he’s proven that he’s a nursing force to be reckoned with using his humor to bring nurses together.
After graduating with a BSN from the University of Central Florida, Orlando, Florida, and working in trauma centers around the country, Nurse Blake started posting original comedy videos to cope with the stress of his nursing job. His lighthearted videos connect with nurses, nursing students, and healthcare workers worldwide, and he entertains almost four million followers on social media while lifting healthcare workers across the globe.
But Nurse Blake is more than comedy.
He’s the creative force behind NurseCon at Sea, one of the largest and most popular nursing conferences, and the NurseCon app, which provides free continuing nursing education courses.
Meet Nurse Blake, a nurse, creator, internationally touring comedian, healthcare advocate, keynote speaker, and creator of NurseCon at Sea.
Minority Nurse talked with Nurse Blake about running one of the most popular nursing conferences and his plans for NurseCon at Sea 2024 in Mexico.
Where did you go to nursing school, and what was the experience like for you?
I graduated from Seminole State College and the University of Central Florida in 2014. I was in a concurrent program. So, I got my ADN through Seminole State and my bachelor’s through the University of Central Florida.
Nursing school was hard, challenging, and not easy, and I had a lot of meltdowns, but I did it. And when I was about halfway through my program in 2013, I became president of the Florida Nursing Student Association. And that sheds light on gaps in education for nurses. I attended many nursing conferences; they were all so boring in these hideous corporate centers. So, I knew back in nursing school that I wanted to shake up the nursing conference world, but I didn’t know what that would look like. I thought about taking over one of the state nursing conferences, but zooming ahead to 2019, I decided to create my conference, NurseCon.
What was your inspiration to create one of the largest and most popular nursing conferences, and what goes into planning such a big event?
When people ask if I’m still a nurse at the bedside or in a hospital, I’m not anymore because I’m not only busy with my comedy tour, which takes me away multiple months out of the year, but I also manage and run NurseCon with a team of 90 people, including full-time and part-time employees and contractors. NurseCon is a massive team effort; I couldn’t do it alone. I have an office in Orlando, Florida, which is convenient because our cruises sail from Miami. So, in addition to the 1,000 staff members, we have a team of almost 100 NurseCon at Sea people trying to make this conference the best experience for our guests. So, we have educators and customer service, and we bring in our dancers, DJs, and production. So, if you look at our pictures from NurseCon at Sea and say, “Wow, that pool is so lit,” it’s because we bring our fog machines, lasers, and lighting. We have a huge production team and staff that helps elevate the regular cruise ship experience, which is already so amazing and epic, but we want to put the NurseCon at Sea touch to it.
Education is the most important. NurseCon at Sea isn’t a nursing conference without education. So, we are accredited by the American Nurses Credentialing Center (ANCC) and the California Board of Nursing. I have three DNPs that run and manage nurse candidacy education full time. We are super committed to it, and we’ll probably bring on 30 educators on our next sailing to deliver over 70 hours of CNEs. That number has gone up every year. Our first year, it was 20 hours of CNEs. Then it was 36. And now we’re jumping to almost 80, which is pretty impressive. And it’s all included in the price of the conference. We also specialize in continuing nursing education for nurse practitioners and the pharmacology track. CNEs are expensive, hard to find, and nurses need many hours. So, that’s also something we provide, and that’s included. We’ll probably have about 150 nurse practitioners in our pharmacology track on the cruise ship, which is incredible.
Do NurseCon participants request course offerings that you incorporate into the nursing conference?
Yes, we have education committees made up of some of our educators and also participants of NurseCon at Sea. This is their experience. We provide the venue, the CNEs, and the entertainment, but the guests make it an experience. So, we also always value our feedback and survey our guests after our cruise sails and even on the ship to make it the experience that nurses deserve and the experience they want. It’s such an inclusive, happy conference. And it’s all because of our guests. They make it such a safe space for everyone to be themselves and talk about the issues they’re facing, and to me, that’s the most extraordinary thing about NurseCon at Sea. We have nursing students that come on. We have retired nurses and nurses from around the world attending many specialties. Everyone in the nursing world can learn from each other even though you’re not from a specific specialty. And no matter your age or status. We’re all here to learn from each other. No matter how many degrees you have or certifications, no one’s better than anyone else.
Everyone attending NurseCon looks like they’re having a great time. Talk about what a nurse attending NurseCon can expect.
It’s epic. Vacations sometimes are once in a lifetime for people, and for them to connect with friends and family or coworkers is super special. We’ve done three cruises since we launched and had groups of nursing students who graduated together 20 years ago. Now it’s their annual trip, and they’ve been on all three. So, now it’s becoming a tradition for some people, and that’s special.
People make T-shirts, go all out on our theme nights, and are already getting their outfits ready. So, it’s a community within a community. And not even I am in all these special groups where they talk about what they’re going to do for next year. So, it’s so cool that it even lives outside of me, and NurseCon at Sea has become its own culture created by the guests.
Next year’s NurseCon event is in Mexico. Can you talk more about the courses and features?
Mexico’s going to be great. We always want to provide a new incredible location or port. So, people can get off the ship and choose whatever activities they want to participate in. We also have two full days at sea, so it’ll be our longest one yet. And that’s because people wanted it to be longer. And our theme nights are sports night and fairy tales. So, everyone will be super busy, and I can’t wait to see everyone’s outfits. I know the dancers are so excited and already rehearsing and working on the production. We meet every day about NurseCon at Sea, so as soon as the last one is over, we’re already preparing for the next one. I will be working on booking our 2025 cruise later this month.
The NurseCon at Sea app provides users with their continuing education for free. But it’s more than education. Please talk about your inspiration to create the app and its impact on nurses.
We have the NurseCon app; you can also access it on NurseCon.com. If you can’t attend the conference or need CNEs, we have a library where nurses can get them for free. I know a lot of other websites out there that say it’s free, but then you take the course, and then you have to pay for this certificate, or only one course is free. Ours is free, which is cool. I decided to launch this during the pandemic. I knew nurses were working so hard going through that, and I wanted to provide them with an education platform so they can get their courses for free. So, that stayed consistent. Once nurses attend our cruise, they can get their CNEs through that platform. And we will also be putting our courses from the cruise on that platform. If you can’t attend the event for whatever reason but are interested in those courses, you will take them and get the CNEs for free after the ship has sailed.
We like to talk about topics that many other conferences don’t necessarily talk about, and that’s so special. The coolest part is that you don’t have to be a nurse to attend. You have to be a guest of a nurse. And we were doing a course on pediatric trans health, and a nurse attended with her husband, who was just on as her guest. And he’s not in healthcare at all, but he sat through the course and came up to the educator afterward and cried. And they thanked the educator because their child is trans, and they learned so much from a non-healthcare perspective just from being on the ship and attending a CNE that the nurse didn’t have to attend. Knowing that it’s going to have a positive impact on their child’s life and their life as a family unit is what makes continuing education for nurses the most special.
What makes NurseCon at Sea different from other nursing conferences?
It’s the diversity on the ship. It’s incredible. I’ll look around a room, and this is what nursing is supposed to look like. This is what nursing is supposed to be, just like this in this positive environment with nurses of all ages and backgrounds coming together and learning from each other. That’s all the community. It gets back to all our guests, making it a safe space for everyone.
Ashley Merida BSN, RN is the president of the Phoenix chapter of the National Association of Hispanic Nurses and talked with Minority Nurse recently to help mark Hispanic Heritage Month, held annually from September 15 to October 15. She says the organization’s advocacy for nursing in general and Hispanic nurses in particular has been a building block for her personal and professional growth.
Merida, who works in solid organ transplant of the Mayo Clinic Hospital in Phoenix, says she has known nursing was the career path for her since she was a child. “My younger brother was sick and in and out of the hospital, and I spent lots of time in the hospital visiting,” she says. For a while, Merida shifted her career aspirations to firefighting, but, she says with a laugh, “my heart went back to nursing.”
Through a bilingual nurse fellowship program at Phoenix College, Merida started her nursing education and became passionate about giving back to her community. “It was a calling for me,” she says. She found both an opportunity to do that and a new core community when she accompanied a friend to a NAHN meeting in 2017. “I heard the president at the time, Veronica Vitale, speak and she was so inspiring and motivating,” she says. “I found a new family in that moment.” With less than 10 percent of nurses identifying as Hispanic, Merida says she’s often the only Latina nurse in a room. But at the NAHN meeting, she was surrounded by others who shared her heritage and had so many accolades. “I felt like I belonged,” she says.
From her first NAHN meeting, Merida set a goal to become a leader in the organization and to eventually lead as the chapter president. As she became a regular at NAHN meetings, Merida says her fellow NAHN members were an excellent support during times when things got tough. “They helped me keep going during the times when I wanted to quit,” she says. The chapter members have an energy and warmth, she says, that includes checking in on each other, asking about their families, and understanding their nursing lives.
NAHN’s members set high goals for themselves that are modeled by their own work and advocacy. They work with nurses and nursing students to connect preceptors with students, to offer DACA-friendly scholarships, to advance financial literacy, and to offer CEUs. They also partner with schools so nurses can speak to younger children and tell them about nursing careers.
Merida recognizes the efforts of Hispanic nurses before her including Dr. Ester Ruiz, a co-founder of NAHN’s Phoenix chapter. Ruiz made an impact for the entire community, says Merida, and is still on NAHN’s Phoenix chapter’s board. Merida feels the responsibility to honor Ruiz’s work and that of other Hispanic nursing leaders who struggled for equity for nurses and Hispanic patients. “It’s important,” she says, “to pave the way.”
In today’s climate, nursing is everywhere. It’s in the news and social media, but the coverage is rarely positive. Nursing has been America’s most trusted profession for years, but COVID-19 changed the perception of nursing.
No longer are nurses viewed as the safe harbor for patients who were battered by the winds and wrath of an industrial health care complex. Instead, nurses are publicly placed on trial for system errors and named in lawsuits for medical malpractice. What does the future of nursing look like in America? No one knows for certain, but I do know who can reframe the perception of nursing, and that is the nurse educator.
Soul of Nursing
The nurse educator is truly the master of the soul of nursing. Still, they are rarely esteemed for the critical work accomplished. The nurse educator takes the raw material of an eager student and pours endless knowledge and skills to form the building blocks of a nurse. There is not a single nurse in existence who has not passed through the skilled hands of a nurse educator. The educator can genuinely alter the perception of a new nurse before the nurse even realizes they have been altered. The nurse educator can transfer tolerance and understanding through their formative teachings, prejudice, and judgment. The responsibility to develop the future of the entire profession rests on a select few, rarely acknowledged, who guard our profession with love and passion.
It is passion that drives the nurse educator. It surely is not the ability to earn a high income. According to the Bureau of Labor Statistics, the average nurse educator earns an annual income of $78,000. For a job that requires an advanced degree, any nurse educator could be better served with more lucrative uses of their degree, such as a nurse practitioner or joining an organization’s nursing leadership. It’s not the hours that drive the nurse educator. Is getting Christmas off a perk? Absolutely! Is waking up to 13 texts from a student who could not upload an assignment a benefit! Absolutely not. As a nurse educator, the breaks from classes are spent reworking material, developing new experiences, and continuing to grow professionally. It is truly a passion and a calling that drives the nurse educator.
Need for Nursing Faculty
Why should every nurse be aware of the need for nursing faculty? According to the American Association of Colleges of Nursing, a faculty vacancy rate of 8.8% nationwide has remained. This has resulted in a horrendous outcome of over 91,000 qualified applicants being turned away from nursing programs. Turning away applicants continues to exacerbate the nursing shortage. With the current projection from NCSBN of close to one-fifth of the nursing workforce looking to exit in the next five years, every applicant to a nursing school is a building block to the solution.
Know Your Influence
So why consider nursing education? The nurse educator is an artist. They take a piece of unformed clay and place pressure to mold and change the clay into a beautiful vase. With every student, educators leave a tiny part of themselves to transform a corner of the world. As a bedside nurse, I touch a few lives every shift. But if, as an educator, I have taught the floor of nurses, my reach is far greater than I will ever know. Knowing that your influence can affect the health care of a region, state, or nation is a pride and privilege few know. Nursing education is a beautiful profession that is far too often overlooked but should be dutifully considered.
As a hard-working and successful nursing professional examining your career, you might reflect on your nurse mentor. The person who inspired, guided, advised, and kept you on the straight and narrow path, and ask yourself if you’ve ever been one yourself.
Was there someone who took you under their wing? Was there an individual who counseled you on your choice of master’s degree program? Did a colleague serve as an example of the kind of nurse you aspired to be? And if you’re a new nurse and can’t make heads or tails of this new career, where have you turned for guidance?
Sometimes, a mentor appears when you least expect it, and sometimes, you proactively go out and find one. Either way, the mentoring relationship can be life-changing, which sets you on the course of greater success, satisfaction, and confidence.
Mentors are Everywhere
Mentors are everywhere and can be sources of great inspiration who utilize their personal and professional experience as examples for others.
However, mentors are distinct from preceptors. A preceptor is a nurse you’re paired with to learn the ropes of a particular position or unit. Being precepted means that you’re being shown the ropes of where things are and how things are done. Mentors offer broader professional guidance; although they may be employed by the same institution where you work, that isn’t always the case.
According to Johnson and Johnson, where they match nurse mentees and mentors in hopes that these relationships will empower them to reach greater heights in their careers, “When you’re thinking about a potential mentor, you’ll obviously want someone you like and look up to. But it can be even better if they have skills that apply to your own career goals.”
And for the mentor, J&J states, “Sharing your experience with a new nurse can make all the difference to their career and help create a new generation of confident and well-prepared nurses.”
The American Nurses Association (ANA) is also a strong proponent of mentoring, outlining the many benefits of this special relationship for both the mentee and the mentor. Benefits may include:
Receiving honest feedback from a seasoned professional and role model.
Learning from generational differences.
Giving back to the next generation of nurses.
Gaining insight into a particular specialty or career path.
Finding a Mentor
Some institutions have official mentoring programs. While this may be rare, there are pros and cons to this type of situation. The required documentation can sometimes be so burdensome that it detracts from the creativity the pair could otherwise cultivate if left to their own devices.
The ANA offers a mentoring program that matches volunteer mentors with new nurse mentees seeking guidance and support as they launch their careers.
If joining an official mentoring program isn’t available to you or your cup of tea, there are plenty of ways to find one on your own.
There may be a nurse in your life whom you admire and would give anything to follow in their footsteps. You may be inspired by their work, accomplishments, and successes, or simply for the kind of person they are.
Aside from people you know, there’s also the riskier option: approaching someone you don’t know. You may encounter someone you admire at a conference, on LinkedIn, or through networking. While it may feel scarier to ask a stranger to be your mentor, taking that risk could lead to amazing things.
If you choose to approach someone about being your mentor, keep several things in mind:
Make sure they know that you greatly value their time and expertise
Come to them with a specific problem or issue that you’d like to tackle
Outline your initial goals for the relationship
Offer for the mentoring relationship to be time-limited (e.g., perhaps 3-6 months)
When you set parameters from the outset, the mentor knows you respect their time and expertise. And there’s always the possibility that the relationship may last much longer than initially proposed, including budding into a lifelong friendship.
The Magic of Mentoring
Mentoring can be magical for both the mentee and the mentor. Camaraderie, inspiration, friendship, professional connection, and mutual learning can all result.
While the relationship is by and large about the mentee learning from the mentor, there can be plenty in it for the mentor, too. After all, the mentee is human with their own experiences, skills, and knowledge, and the mentor may come out of the relationship equally enriched.
Every relationship has risks, advantages, and potential downsides, but the mentor-mentee relationship can be a highly inspiring experience for all involved.
If you’re interested in taking your nursing career to the next level, becoming professionally re-inspired, or launching a special project, engaging the support and guidance of a mentor may be just what the nurse ordered.
“Equity should mean that people have the opportunity to get what they need when they need it,” notes Alicea-Planas, associate professor of nursing at Egan and practicing nurse at a community health center in Bridgeport, CT. “That’s something that has historically been lacking for certain communities within our healthcare system.”
Health equity means that “everyone has the ability and opportunity to be healthy and to access healthcare to help them maintain health,” says Latina Brooks, PhD, CNP, FAANP, associate professor at Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio. Brooks also directs the MSN and DNP programs at Frances Payne.
The CDC notes that achieving health equity requires ongoing efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities.
Health equity isn’t just about access to healthcare, notes Elaine Foster, PhD, MSN, RN, vice president of nursing, Education Affiliates. It can also relate to whether a diabetic patient, for instance, knows what to get checked. “I think sometimes we’ve put a very narrow description on health equity, and I think if you were to flesh it out, it goes beyond that accessibility,” Foster notes.
“You can even take health equity that next step and say, Do you have an advocate or do you have someone who knows to push the envelope?” says Foster. “We have to be active participants in our healthcare these days to get what we need.”
Besides accessing resources, health equity involves “understanding how to navigate our healthcare system,” says Alicea-Planas. “It is understanding the information that’s being provided to us by healthcare providers and being able to use it for patients to do well on their health and wellness journey.”
At various schools, health equity is integrated throughout the course of study. For instance, at Adelphi University College of Nursing and Public Health, Long Island, New York, health equity is threaded throughout the undergraduate and graduate curriculum in various courses, notes Deborah Hunt, PhD, RN, Dr. Betty L. Forest dean and professor. For example, in the school’s community health course, there is a focus on vulnerable and underserved populations. In the childbearing course, Hunt notes, there is a focus on health disparities and maternal and infant mortality.
Foster notes that health equity is threaded into the curriculum at the 21 nursing schools within the Education Affiliates system. Likewise, at Frances Payne Bolton, health equity is integrated into courses. However, Brooks notes that some courses go more in-depth, such as discussing health equity in vulnerable populations.
At Egan, introductory courses talk a lot about health equity and social determinants of health, notes Alicea-Planas, as do clinical courses. “I think a big part of understanding health equity is also understanding social determinants of health,” says Alicea-Planas. “I am super excited that now in the nursing curriculum, we have lots of conversations around those social determinants of health and how they influence people’s ability to attain their highest level of health.”
One crucial learning that Alicea-Planas hopes students take away is that for students who haven’t been exposed to many people from different backgrounds, it’s essential “to understand how historically our healthcare system has treated certain communities of color. That factors into people’s feelings about how doctors or nurses treat them, influencing their ability to seek care.”
Foster hopes that students learn that no matter what the patient’s background, “Everyone is entitled to good, nonjudgmental care within the healthcare system.” Students must learn “not to impose our beliefs, our judgment on someone. Because until we get rid of that type of judgment, we will never overcome issues with health equity because we’ve got to first check our beliefs and opinions at the door and say I’m going to give the best care possible to these patients.”
As the population in the United States ages, healthy aging is going to become a concern for a growing segment of people and the healthcare teams that care for them. September’s Healthy Aging Month designation brings an awareness for nurses who want to offer appropriate care for their aging patients and who also want to be mindful of healthy aging practices for their own health.
“Gerontological nurses can promote healthy aging by assessing and evaluating the body, mind, and spirit of each individual older adult,” says Bronner, who has been a gerontological nurse for four decades. “The keys to promoting healthy aging start with food choices, healthy life choices, movement of the body, and socialization.”
Gerontological nurses also adapt their approach to tune into the ways older adults thrive, she says. For instance, older adults respond to compassionate listening, social engagement, complementary alternative modalities, and holistic care. Promoting healthy aging means that gerontological nurses want to acknowledge cardiovascular and cognitive decline and give patients information and education to help them in those areas.
“Physical activity daily can go a long way with facilitating healthy aging,” she says. “Some physical activity can include walking, mindfulness movements, yoga, qigong, light weight training, and movement of the body energy. Movement that is conducted three times a week would be ideal for healthy aging.”
For example, Bronner says, yoga can assist with regulating the autonomic nervous system, which can decrease anxiety, increase spinal flexibility, and correct spinal imbalances. Strengthening and protecting the spine can help reduce falls, which often become a traumatic event for older adults.
As the nation faces an increasingly older population, Bronner says the biggest challenges in the new millennium are nurses not prepared to work with older adults and a shortage of nursing staff in nursing homes and hospitals. “Older adults have complex medical conditions and a multitude of chronic conditions that often are not managed appropriately,” she says.
And nurses and families can introduce the idea of planning for healthcare emergencies with advance directives. These plans, she says, are often not discussed until there is a crisis or end of life is approaching. This lack of direction can cause upheaval for both the older adult and other family members who might not be sure what to do.
Families and healthcare teams can also help promote healthy aging with the implementation of telehealth monitoring of blood pressure, weight, blood oxygen level, and virtual assessment. Keeping a close eye on conditions with remote telemonitoring, whether in a skilled nursing facility or in a private home improves the patient and provider relationship while also allowing quick intervention for chronic conditions. “Monitoring geriatric conditions and symptoms can aid in the prevention of falls,” she says, “while assessing nutrition could assist with promotion quality of life.”
For nurses considering gerontological nursing, Bronner says the specialty has offered her a nursing career she loves. “Gerontology has been a love of mine for many decades,” she says, “and I am able to holistically incorporate many modalities to assist with healing. The joys that resonate in my entire soul include the autonomy in my practice and the connection with the interdisciplinary team during the development of care plans.”
As a gerontological nurse, Bronner often works closely with an older adult’s loved ones and forms close bonds. That kind of support can help families if they need to navigate the end-of-life stage. “I enjoy when a family member gives hugs and appreciates the compassionate care at the end of life,” says Bronner. “The trauma of death is hard for each person involved. Providing comfort, education, and stillness (mindfulness) is a skill that I feel helps individuals through these difficult times.”
As Vascular Nurses Week comes to a close, the impact of the work vascular nurses perform each day is clear. Vascular nurses work with patients who have vascular disease or who may be at high risk for vascular diseases including everything from blood clots to high blood pressure and other cardiovascular disease to circulation problems.
Patients depend on nurses in this specialty to help them treat and manage their diseases and so will turn to them for education about how to recover from surgery from having a stent or how to manage high blood pressure or peripheral vascular disease. Vascular nurses are also excellent sources of information on how to live with chronic conditions such as varicose veins. For patients whose family history shows a strong genetic predisposition to vascular disease, a vascular nurse will work with the patient’s team to help educate them about medication and surgical options, lifestyle changes and choices, and even symptoms to be especially mindful of.
As a career, vascular nursing offers extensive options and nurses can find the career track that fits their interests, pace, and preferred schedule. Nurses who choose to work in this specialty will see a range of patient ages and conditions, and they have the ability to focus in on specific populations with the choice of work location and setting. Nurses can work in hospital settings where they may assist with surgery, lead patient preparation and recovery from procedures, and be on the medical team with emergency situations. Vascular nurses can also work in outpatient settings and clinics where they will see patients who are coming for routine blood work, post-surgical care, and scans to help diagnose or monitor any problems. Other options can include home care.
These nurses work with a complex network of veins and systems that can change quickly. They need to be current in all the latest evidence-based practices so they can treat patients with the most current knowledge and also let them know about potential treatment options that are on the horizon.
As with other nursing specialties, career choices such as membership in a professional association is especially beneficial. Nurses can look into all the resources the Society for Vascular Nursing offers including mentorship options, patient resources, and conferences. Many nurses use annual conferences as a way to connect with other nurses all across the country and to learn about new developments in their specialty. They can bring those ideas and the energy from the conference back to propose potential improvements in their own workplaces.
For continuing knowledge, obtaining certification is an excellent career move. the Society for Vascular Nursing (SVN) and the American Nurses Credentialing Center (ANCC) offer the Cardiac Vascular Nursing Certification (CV-BC) which gives nurses the professional knowledge and recognition of expertise in the field.
Vascular nursing requires nurses who are dedicated to patient care, lifelong learning, and who have a passion for helping patients live the healthiest lives possible. Rates of vascular diseases continue to rise and the industry needs more nurses in this specialty, so the job outlook remains strong.
Neonatal nursing provides care for the tiniest and most vulnerable infants, and the nurses in this specialty are celebrated this week by the National Association of Neonatal Nurses (NANN) and other organizations marking this year’s National Neonatal Nurses Week.
When she took some time off to raise her family, Williams decided she was happy with nursing, but not fulfilled with the med-surg role. She decided to try something entirely different and was honest about what would be best for her personally as well as professionally. Caring for a pediatric population was appealing, but Williams knew she would see her own children in her patients and wanted to maintain separation from that age bracket. Neonatal nursing was a good age bracket to alleviate that concerns.
Three months into orientation as a neonatal nurse, Williams was all in. “I thought, ‘This is it. This is where I need to be,'” she says. “It was a real ah-ha moment. I have never experienced that before.”
Williams, who has been a nurse for 24 years and a nurse practitioner for 10, says she grew up with her parents talking about nursing as a great career, but it wasn’t something originally on her radar. “Once I got into it, my passion, goals, and thoughts on it all changed.” Williams current role has her spending half of her time managing a team of 20 nurse practitioners and half of her time spent clinically managing patients. “That means I am responsible for developing a team and still responsible for the care of babies and their families.”
As a nurse, Williams says her goals have always focused on helping people attain success and self-fulfillment. In her neonatal nursing role, working with babies allows her to continue working toward to that goal. “Whenever I have a patient, my goal is to help that patient become the best version of themselves they can be and then we can reunite them with their family.”
Saying she feels constantly rejuvenated by her work in neonatal nursing, Williams feels a strong connection with the families she works with. “Mostly we think of childbirth and pregnancy as a joyous time, and we don’t know how complicated it can be,” she says.
When things don’t go as expected or as planned, the experience is difficult. “Being able to support someone around this process and give them the best version of their child is such a responsibility,” she says. Williams says she has learned how to meet the families and the babies where they are and help them feel comfortable when their child is in intensive care. And while nursing skills in the NICU must be excellent, Williams says the skills required to work with families aren’t necessary clinical but are heavily rooted in empathy.
“These infants are the future and the parents are so invested in these children,” Williams says. She helps them understand they have experienced a loss of their expectation of and hope for a perfect or even a typical pregnancy and birth and a shift is necessary. Very premature infants might require extra care and require extra vigilance, but that doesn’t mean the child will be unable to participate in life. “You just have to pivot,” she says.
And Williams is buoyed by the advances in neonatal care and in neonatal nursing. In addition to the technology and medical care advances, “the focus on the whole baby has improved so much,” she says. Even understanding the downstream impacts of how a baby in NICU is positioned gives the healthcare team a deeper understanding of the whole picture of care.
“I am always talking about how I love what I do,” says Williams. “Neonatal nursing is rewarding. It’s a rollercoaster but well worth it.”
A utilitarian ethical approach views to balance the greatest good over harm to everyone involved while considering the benefits and consequences (Velasquez et al., 2021). Migration occurs when a new circumstance or opportunity is better than the existing situation. The looming shortages in the nursing workforce globally make migration inevitable. It is essential to weigh the benefits and consequences of nurses’ migration.
Nurses can migrate and work in other countries if the country’s visa and employer requirements are met. Frances Hughes, RN, BA, MA, DNURS, FAAN says that nurses in lower-income countries migrate to higher-income countries seeking better career and financial opportunities (Hughes, 2022). Stakeholders directly impacted by the migration process include individual nurses and their families, recruitment agencies, and supplying and accepting countries.
Benefits and Consequences
There are several benefits to migration. Nurses who migrate to higher-income countries are happy with the host countries’ social, financial, and health-related advantages (Hendriks, 2018). One of the greatest benefits of migration is the diversity foreign nurses bring to the workforce. Recruiting foreign nurses also improves the workforce shortage in the host country. A diverse workforce elevates the quality of patient care by ensuring the provision of culturally competent care to a diverse patient population (American Association Colleges of Nursing, 2023). The benefits are not only limited to the host or higher-income countries. The remittance from immigrant nurses financially benefits the supplying countries (Shaffer et al., 2022), families, and individual recruitment agencies.
From a utilitarian view, other consequences of migration are the potential depletion of the workforce in supplying countries due to mass migration and the demand for additional resources by host countries to train foreign nurses to meet the needs of a diverse patient population. It is also important to remember that adapting to a new country and environment could be challenging for individual nurses.
Takeaways: Finding Solutions
The migrating nurses bring cultural diversity, unique knowledge, and skills to the nursing workforce in the host countries (Hughes, 2022). It is unethical to prevent migration considering the overall benefits to the individual, host, and supplying countries. However, a utilitarian cannot ignore the other consequences.
Migrating from one country to another comes with challenges, which vary for individuals from different countries. It is essential to identify the unique needs of foreign nurses and distribute resources in a manner that is easily accessible to avoid waste of resources. Most often, it is not the availability of the resources that is challenging but the need for knowledge in accessing them and finding the best resource that works for each individual—having a common website that provides information on the boarding process, eligibility exam centers, financial support, mentoring, and other essential resources during migration.
Regulated and ethical recruitment practices can be implemented to prevent nursing workforce depletion in supplying countries. From a utilitarian view, it is recommended to ensure transparency on the benefits and consequences of each nurse migration experience for all stakeholders. The availability of information on benefits and consequences will allow better planning and implementation of policies, programs, and resources that support migrant nurses and migration.
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Hendriks, Martijn. “Does Migration Increase Happiness? It Depends.” Migration Policy Institute. June 21, 2018. https://www.migrationpolicy.org/article/does-migration-increase-happiness-it-depends.
Hughes, Frances. “Nursing Shortage and Migration: The Benefits and Responsibilities.” CGFNS International. 2022. https://www.cgfns.org/nursing-shortage-and-migration-the-benefits-and-responsibilities/.
Shaffer, Franklin A., Mukul Bakhshi, Kaley Cook, and Thomas D. Álvarez. “International Nurse Recruitment Beyond the COVID-19 Pandemic: Considerations for the Nursing Workforce Leader.” Nurse Leader 20, no. 2 (February 2022): 161–67. https://doi.org/https://doi.org/10.1016/j.mnl.2021.12.001.
Velasquez, Manuel, Dennis Moberg, Michael J. Meyer, Thomas Shanks, Margaret R. McLean, David DeCosse, Claire Andre, Kirk O. Hanson, Irina Raicu, and Jonathan Kwan. “A Framework for Ethical Decision Making.” Santa Clara University. November 8, 2021.
What issues are front and center for nurses in this specialty today? In nephrology nursing, the issues that are front and center are the lack of nephrology nurses going into the specialty. It is a very undiscussed specialty in nursing school which does a disservice to the patients in need. In nephrology nursing, especially dialysis, we are performing an invasive procedure that is life sustaining for patients with end-stage kidney disease. It is the only procedure that a physician orders and a nurse carries out. Bringing awareness to the nephrology nursing specialty is a huge priority for the American Nephrology Nurses Association.
How has technology changed nephrology nursing and approaches to treatment? Technology and innovation are changing nephrology nursing practice and approaches to treatment in so many ways. Dialysis machines are getting smaller and more compact instead of being large and bulky. You can monitor your patients with different technology to allow for better treatments and you are able to spot complications before they occur with the technology coming out.
What medical advances are most exciting and promising for nurses to see? I feel that nephrology nurses love the innovation that keeps coming out with all of these new devices. Dialysis is the same process as it was 40 years ago, but the devices are allowing nurses to use a more individualized patient-centered care approach. Safety on the machines has come a long way, which is great for nurses but most importantly the patients. A new smart patch that uses remote patient monitoring for patients with chronic kidney disease and end-stage kidney disease can read hemoglobin and hematocrit as well as potassium. This can be a game changer for the population we serve.
Why is nephrology nursing such a great career option? Nephrology nursing is such a great career option. It has brought me so much opportunity for growth in my career as well as challenges. Nurses do not realize that nephrology nursing is a broad term as there are so many different things you can do–you can work in dialysis (acute or chronic setting), a nephrology practice, transplant, education, administration, pediatrics, and more. You never get bored and feel complacent.
It is a nursing specialty that is unlike many as you develop such different relationships with your patients. It is the one thing that we, as nephrology nurses, cherish most. You make a difference in these patients’ lives as they see you more than they see their own families sometimes. It truly is the “work of heart.”