The critical care transport nursing specialty offers variations of work settings so nurses can work in settings including air transport, ground transport, and military transport. Critical care ground transport nurse Casey Green, BSN, RN, CCRN-CMC, CTRN, CFRN, CEN, TCRN, CPEN, CNRN, NRP says the skills and approach to nursing care in this specialty appeals to her.
“I really enjoy the autonomy of nursing care in the emergency department and the intensive care units, and transport nursing is a combination of using both skill sets to assess, monitor, and treat patients safely,” she says.
Because critical care transport nurses work in ambulances, helicopters, or on ships, they are often the nurses who reach remote areas, trauma situations on roadways, and work in areas that are unfamiliar. They could transport one patient to a hospital or be part of team that needs to transport many people out of an area. The challenge appeals to Green. “I like the variety of patients and just how complex their care is,” she says.
As with any nursing situation, things can change quickly and nurses have to be ready. But transport nursing poses additional challenges including vehicles, weather, and terrain. Green says that transport nurses need to be aware of any potential situation. “To prepare myself for this line of work, I took a lot of courses in patient care for all patient populations, especially those who are critically ill,” she says. “Each shift I work I refresh myself on equipment, medication, or a patient population that we may have not transported recently just to keep the information fresh in case we have a request during my shift.”
Nurses who are interested in this specialty should enjoy the physical challenges, fine tune their critical thinking, and have an ability to read and react to a situation immediately. “Two of my biggest takeaways are to develop strong assessment skills because they help guide your intuition if something feels or seems off during transport,” says Green.
As with other nursing career paths, transport nurses don’t operate in a vacuum even though their work is done outside of a typical hospital or health care facility setting. “Teamwork needs to be at the forefront of your mind when you step on a transport vehicle,” Green says. “Often, your team is all you have between hospitals, and all levels of patient care have a say in patient care during transport.”
Critical care transport nursing is an exciting career path, and Green says if a nurse is interested in pursuing it, preparation is key. “Get experience in the ICU and the ED and apply,” she says. “Don’t worry that you may not have what an employer is looking for; get your experience and develop strong critical thinking and assessment skills.”
What inspired you to have a career in cardiac nursing? I was inspired to become a cardiovascular nurse in nursing school. I remember learning about heart failure in my pathophysiology course for the first time. I was fascinated by learning how the heart works, and the effect it has on our bodies when it isn’t working properly. I was surprised by how, when the heart fails, it creates a domino effect on our circulatory system, impacting other vital organs such as lungs and kidneys. It was then that I realized that I wanted to always care for patients who required care and treatment for heart problems. I wanted to become a part of the solution and prevention of cardiovascular disease.
What are the most important nursing skills for cardiac nurses to have? One of the most important skills for a cardiac nurse is physical assessment. For some patients, their cardiovascular issues aren’t immediately identifiable by vital signs or diagnostic tests. Nurses must have very sharp assessment skills to detect when their patients are experiencing an issue. Physical assessments such as listening to the heart with a stethoscope, and assessing for changes in color of skin (paleness or bluish undertone) can tell us a lot about our patients. Also, asking the right questions about pain and symptoms can tell us a lot about what’s happening with our patients. Active listening is a great nursing skill that has proven to save lives. When nurses listen to their patients, they are more likely to detect that something is going wrong.
As a cardiovascular nurse, I have always relied on my assessments, diagnostic labs, and exams, as well as my patient’s verbal accounts to develop a safe plan of care to support good health outcomes.
With so many advances in cardiovascular health, how do you stay current on new trends, nursing techniques, or evidence-based practices? As a cardiovascular nurse, it is imperative that I stay abreast to the latest evidence-based literature and guidelines to support safe and efficient care, and education for patients. As a nurse and researcher, I follow the most up-to-date treatment national guidelines published by the American Colleges of Cardiology (ACC) and American Heart Association (AHA) and PCNA. These organizations are committed to providing the best practices, based on research to ensure good health outcomes for all.
I also attend ACC/AHA and PCNA conferences and continuing education programs to ensure that I’m learning the latest research-based guidelines. As a researcher, I conduct research and publish articles to contribute to the cardiovascular science. Finally, I also serve on writing committees for the above noted organizations, where I have the opportunity to contribute to the development of guidelines for nurses and other cardiovascular healthcare providers. All of these activities are a part of my commitment to lifelong learning and the enhancement of cardiovascular care of patients with cardiovascular diseases.
What do you most enjoy about your career as a cardiac nurse? As a cardiac nurse, I have the privilege of meeting and working with wonderful patients and colleagues. While working in community outreach, I meet the most dynamic patients. I found that through the years, I enjoy speaking with individuals living with cardiovascular disease. There is so much to learn from them as they share their experiences and wisdom.
What would you want other nurses to know about this career path? Almost 50 percent of individuals in the United States are living with some form of cardiovascular disease. There is much opportunity for nurses to enter the cardiovascular field. Cardiac nurses are not limited to hospital inpatient units, they can work in outpatient clinics, operating rooms, cardiac cath labs or rehabilitation units, nuclear medicine procedure areas, and critical care units, among others.
I want nurses to know that among several nursing specialties, they can choose any area of their choice, whether that is oncology, obstetrics, surgery, pediatrics, or neurology. What I’d like nurses to remember is that every patient has a heart, and the heart serves as the center for all functions. With that being said, every nurse is a cardiac nurse. All nurses are trained to take care of the heart.
Meet Farah Laurent, DNP, RN, NEA-BC, NPD-BC, CPXP, TCRN, CPEN, CEN. She is a nurse career coach and passionate about helping other nurses achieve their career goals. Dr. Laurent is a former level 1 trauma emergency nurse and a strong advocate for nurses. She is the director of nursing for a nursing program at a community college and an active member of various nursing organizations such as the National Nurses in Business Association, ENA, ANA, NLN, DNP of Color, and AONE. Her goal is to make a positive impact in the nursing profession every day.
Dr. Laurent’s mission is to empower nurses, especially nursing students, to advocate for themselves, their patients, and the profession. She amplifies nurses’ voices through her LinkedIn show “The Nursing Dose with Farah,” where she interviews nurses from around the world to speak on different nursing topics such as leadership, mentorship, nurse entrepreneurship, wellness, and career tips. Dr. Laurent is a nursing trailblazer and the founder of Farah Laurent International Nurse Coach LLC, where she provides unparalleled career guidance to help nurses level up and land their dream positions.
She actively mentors for the American Nurses Association and the Canadian Black Nurses Alliance and is dedicated to advancing the profession and increasing diversity in the nursing workforce. Dr. Laurent is not only changing the nursing game, but she’s also transforming the entire industry with her electric energy and unwavering commitment to excellence. She is a force to be reckoned with!
Meet Farah Laurent, DNP, RN, NEA-BC, NPD-BC, CPXP, TCRN, CPEN, CEN, a director of nursing for a nursing program at a community college and a nurse career coach.
What is your title, and where do you work? Feel free to include a side gig, too.
I am currently the Director of Nursing for a nursing program at a community college.
I am the founder of Farah Laurent International Nurse Coach, where I provide career guidance to nurses looking to enter the nursing profession or change careers! I am a dynamic speaker, author, educator, workshop facilitator, and world traveler!
I host my own LinkedIn live show entitled “The Nursing Dose with Farah,” where I interview different nursing guests and cover topics that matter to the nursing community. I plan to turn it into a Podcast in the next few weeks, and it will be available on Spotify.
Talk about your role in nursing
As a Nurse Career Coach, I assist all nurses with career guidance, no matter where they are in their careers. Some of my most popular services include resume and cover letter writing, interview preparation, and career clarity. Most of my clients are new graduate nurses; however, I have also helped nurses land educator roles and leadership roles.
I guide nurses on how to self-promote, communicate confidently, and be more visible! After working with me, most of my clients have one common theme: experiencing a change in mindset and a transformation of increased confidence.
As a nursing student, I did not see faculty that looked like me or had no mentors. One of my clinical instructors once told me in my senior year that I would never be an emergency nurse and laughed in my face. I did not listen to that negativity and passionately pursued my dream of becoming an emergency nurse as a new graduate nurse! I became a very successful emergency nurse with multiple certifications. I was awarded the Emergency Nurses Association (ENA) and Society of Trauma Nurses (STN) doctoral scholarships. I also most recently was allowed to be a peer reviewer for the Journal of Emergency Nursing (JEN), which I am incredibly proud to be a part of.
I am passionate about this career coaching business because today, I am what I need as a new nurse. I am all about empowering nurses and celebrating the nursing profession! I am here to disrupt the status quo and shatter old nursing narratives.
As the Director of Nursing at the community college, I lead a team of nursing faculty and coordinate the nursing program to achieve excellent program outcomes. I am proud that this community college is contributing to increasing the diversity in nursing.
How long have you worked in the nursing field?
Although it does seem like that long ago, I have been a nurse for over 20 years. I started my career in Canada as an emergency nurse. I then combined my love of Emergency Medicine and traveling by moving to New York City as a travel nurse. I worked in various emergency departments and level 1 trauma centers. Naturally, I became a preceptor, mentor, and coach, so I pursued my master’s in nursing education. It took me over 2 years to land an educator role, but I was relentless. I simultaneously accepted 2 positions as adjunct faculty for NYU and as a clinical educator.
Although I had some wonderful experiences as a nurse, I also faced many challenges with bullying, discrimination, and racism. I held various roles in education and leadership. I experienced a blindsided layoff as the Director of Education, which was a complete awakening for me. I realized that there is no such thing as job security and had to rely on my coaching income until I found my next position.
As a recent business owner, I am committed to helping other nurses find their space in entrepreneurship. I wrote a book entitled “Nurses Making Money Moves: A Nurses Guide to Starting a Business.” The traditional education system does not promote entrepreneurship, especially not in nursing. I want nurses to be exposed to different nursing roles and opportunities beyond the beside. Throughout my nursing career, I consistently had 2 or 3 jobs to supplement my income. Sometimes, it can be challenging in these nursing streets, and nurses want to make more money!
Why did you become a nurse?
I was always attracted to healthcare and helping people. I used to use all the Band-Aids for my dolls and would nurse them to health as young as 4. One of my favorite shows was “Trauma: Life in the ER,” so I was meant to be an ER nurse! My career choices were being either a choreographer or a professional photographer, so I chose wisely! My personality is laid back, calm, adventurous, and humorous, so I fit right in!
What are the most essential attributes of today’s nursing leaders?
Leaders should have integrity, empathy, emotional intelligence, patience, and humility. Leaders should be creative, inclusive, transparent, strategic/critical thinkers, optimistic, passionate, and accountable. Nursing leaders should be charismatic, effective communicators, and lead by example. They should have a strong vision that can inspire others into action and create new leaders.
Most importantly, leaders must listen to their teams and collaborate easily.
What does being a nursing leader mean to you, and what are you most proud of?
Being a nursing leader means genuinely caring about people, whether those people are patients, employees, colleagues, or external stakeholders. I am most proud of the values my parents instilled in me. It does not matter who it is; everyone deserves kindness, respect, and understanding.
I am proud of how I connect with people and the relationships I have built, mentoring nurses and empowering them to pursue their dreams, goals, and aspirations. Nursing is not just a profession; it is a calling. I am proud to be a nurse; it is truly an honor and privilege. Nurses make an impact in the world every single day.
I am proud of obtaining my doctoral despite all the hardships I have faced and that I am a role model for my 2 young children. I am proud to be an immigrant and first-gen graduate!
Tell us about your career path and how you ascended to that role.
I sometimes found it very hard to advance to new roles or get promoted even though I was the most qualified candidate. I have fought extremely hard to get to where I am today, and it was a challenging climb. This career path has no linear path and many winds and turns.
My grit and conviction in my abilities have gotten me this far. I always had a passion for learning and continuous improvement. I would create goals, smash them, and move on to the next. I hold 6 board certifications. I recently graduated from a DNP program in organizational leadership. I started my doctoral program while working full-time when my daughter was just a few months old, and my son was 4. Everyone thought I was crazy, including some of my family members, but I was determined to do what I wanted.
I have some great preceptors and mentors along my nursing journey. This is why I am such an advocate for mentorship. I serve as a mentor for the American Nurses Association and the Canadian Black Nurses Alliance. Representation matters, so I like to make myself visible to other nurses.
I love sharing my nursing journey because many other nurses can relate, and it can give me the strength to keep moving forward. I have participated in many nursing organizations, such as the ANPD, ENA, STN, AONL, NLN, and most recently, the DNP of Color. I am committed to advancing our profession and working to increase diversity in our workforce.
I am a passionate and dynamic speaker. I have spoken at many different nursing conferences and events. I recently spoke at the National Nurses in Business Association about nursing entrepreneurship. I love positively representing the nursing profession and recruiting for our profession. I have been featured in different nursing media/podcasts and always look for ways to collaborate.
What is the most significant challenge facing nursing today?
In the spirit of full transparency, nursing issues are very complex. I will discuss a few problems from my perspective working in Canada and the USA.
Nursing retention crisis: There is a lot of talk about the nursing shortage. However, there is a more significant issue with nursing retention. Nursing organizations must make a considerable commitment to creating healthy work environments. I believe inadequate staffing is one of the most complex global issues nursing faces.
Education: Organizations need to create supportive structured orientations for novice nurses and nurses transitioning to different areas of nursing. Nurses want professional development and growth opportunities.
Leadership: Nurse leaders need leadership training like nurses transitioning into any other specialty. There needs to be more nursing leadership training. Nurse leaders need to lead with more empathy and kindness. We desperately need diverse leaders.
Racism in healthcare: There are many issues surrounding racism in healthcare that are deeply rooted in structural racism. We need more nurses to be involved in policy on a national level. The nursing profession must create strong nurse advocates that challenge the status quo. There needs to be more diversity in the nursing workforce and more grants/scholarships. We need more diverse faculty in nursing academia.
Mental health: Mental health is such an important topic in healthcare. There has been more attention and efforts to mitigate burnout. Even though I loved working in the emergency department, there came a point after 13 years that I was feeling the burnout. In my doctoral studies, I created a toolkit with stress reduction strategies for nurses. Wellness remains the number one priority for nurses.
Compensation: Nurses need to get paid more, PERIOD. Nurses need better benefits, more days off, and flexible schedules.
As a nursing leader, how are you working to overcome this challenge?
My contribution to improving the complexities of these challenges is to bring awareness to them and advocate, educate, coach, and mentor them. I can make an impact by educating nurses by speaking at events, networking, and being on various nursing media. Sharing my own personal nursing journey and experiences can help the new generation of nurses.
What nursing leader inspires you the most and why?
Dr. Katie Boston Leary inspires me because she is a true leader and advocate for our profession. She is a trailblazer who is fearless in her pursuit to address issues such as racism in healthcare. She is currently the Director of Nursing Programs at the American Nurses Association.
What inspirational message would you like to share with the next generation of nurses?
I want to tell Nurses that they can accomplish anything they want. Surrounding yourself with positive people and having multiple mentors is vital to success. Be a mentor and a mentee. You always have something to share, even as a nursing student.
Get involved in your community and professional nursing organizations. Networking will have a significant impact on your professional advancement. Do not be afraid to promote yourself and celebrate your accomplishments. Negotiate your salary. Learn to ask for what you want and need.
There is no right way or no one way. You do not have to do just one thing and be put in a box. Please do what YOU want to do. Do not listen to negativity. Nursing is the best profession in the world, with over 100 different roles! Nursing will open so many doors. No decision is final. Enjoy the journey and make an impact. Take care of yourself first.
Patients are often aware of all the nurses who care for them during a medical procedure, and particularly the perianesthesia nurses who are fierce patient advocates during a time when patients are under and emerging from sedation.
As PeriAnesthesia Nurse Awareness Week (this year from February 5-11) celebrates all the work nurses do in this specialty and helps raise awareness of perianesthesia nursing as a career path.
A perianesthesia nurse has diverse responsibilities that can change instantly. They assess patients as they are preparing for a procedure, as they begin, undergo, and emerge from anesthesia–and the process is different for every patient (even if they have worked with the patient previously). The skill set in this specialty is vast and includes an ability to use critical thinking to identify, prevent, or manage a potential crisis.
Perianesthesia nurses care for patients in the time before a procedure during what might seem like a hectic time for patients. As patients are answering questions, getting ready for the procedure, and meeting the medical team, the perianesthesia nurse is developing a rapport and gathering valuable information that can help keep the patient as safe as possible while they are under sedation.
Perianesthesia nurses are also right at the patient’s side during recovery keeping a close watch to assess patients as they are emerging from of the effects of anesthesia. This is an important time because although the procedure may be over, patients are just beginning their recovery process. Their bodies might react in different ways as the anesthesia wears off, so nurses have to be ready for anything from a patient who is crying to one who might be shouting. And during that time, they are constantly assessing the patient for their levels of pain so they can most effectively establish a pain management plan and ensure patient safety.
An essential part of perianesthesia nursing is to develop a fine-tuned awareness of each patient, even during hectic times. Perianesthesia nurses scan patients to take a comprehensive inventory of their vital signs, skin color, breathing patterns, and subtle body movements to ensure that a patient feels safe and has the very best outcome.
Perianesthesia nurses are often passionate about the work they do and the way they are able to connect with patients and their families in a short time. They develop an intuitive approach to patients–from their anxiety level before a procedure to their process in recovery. They are advocates for their patients and are also aware of the important professional connections they make with their other health care team members and with each other.
Suzette Porter, MBA, BSN, RN, is an elder care nurse manager and adjunct faculty member who has been with Hackensack University Medical Center (HUMC) for over 25 years.
Porter says she got into healthcare because her great-grandmother raised her and was the Florence Nightingale in their small town in Jamaica. She would take Porter to help the sick, elderly, and needy in their hometown.
Now, as a nurse manager at HUMC, Porter’s great-grandmother’s influence is at work caring for elder care patients and as an adjunct clinical instructor for Muhlenberg Nursing School, part of JFK University Medical Center in Plainfield, N.J.
Through Porter’s leadership as a nurse manager, her unit was awarded the Team Daisy Award in 2021 for teamwork. She’s an American Organization for Nursing Leadership member and an alumna of the University of Arizona School of Business Global campus.
Porter is genuinely beloved by her colleagues and patients and is a proven leader who knows the importance of teamwork.
Suzette Porter is an important nursing leader, and we’re proud to profile her as part of the Champions of Nursing Diversity Series 2024. The series highlights healthcare leaders who are prominent figures in their organizations and are making transformational impacts in nursing.
Meet Suzette Porter, MBA, BSN, RN, an elder care nurse manager at Hackensack University Medical Center, and an adjunct instructor for JFK Muhlenberg Nursing School.
What is your title, and where do you work?
I am a Hackensack University Medical Center’s Med-Surg Elder Care nurse manager.
Do you have a Side Gig?
Yes. When I saw that, I smiled because I took on an adjunct instructor for JFK Muhlenberg Nursing School last semester, so this is my second-semester teaching first-year nursing students. They’re first clinical.
What do you love about your role as an adjunct instructor?
It’s so important to give back. So important. I remember taking my first day, first clinical day, and every time they came in, like last semester, they reminded me of their first impression of me. I just made them feel at ease because I was so nervous and overwhelmed, and I didn’t have that person to say, you know what? It’s okay. Put your bags away. Let’s take a breather. It’s going to be okay. It’s going to be a great semester. So that’s what I’ve been doing. So, this semester that ended in December, they sent me texts and emails. They’re like, “Professor, I remember what you said on the first day.”
Tell us about your role in nursing and how long you’ve been at HUMC?
So this is my 10th year. I worked in the institution since 1998 in guest services before returning to nursing school. (Been at HUMC for a total of 26 years)
I have always believed in mentorship, and I have always sought mentors. I had a mentor in nursing school, and when I got into nursing, I knew Raminita from when I was in guest services because she used to walk by. She was a nurse manager on Pavilion, one of the Pavilion floors. And she always walked by and said good morning. Then, one day, when I was on, it was 4 Link, which is where I’m at right now. I was in the hallway waiting to start my clinical rotation, and she saw me and said, “I didn’t know you were in nursing school.”
I said, “Yes.” Because I didn’t tell too many people, and she said, “You know what? When you’re done, just let me know.” And that’s what I did. So I got that position in 5PE, and she always asked, “What are your plans?” Because in guest services, I was a supervisor, so I had a leadership background, and I told her, I said, “You know what? I want to get back into it, but I know I need to get a master’s degree, further my education.” So, at the time, the hospital had, I think we still do because that’s where I graduated from in 2021, Ashford, where you’ll go to school to further your education. I obtained a master’s degree. They changed from Ashford to the University of Arizona. I started in 2019 and graduated in 2021 with my MBA.
So from there, from 5 PE, I went over to 4 St. John in 2017 as a supervisor, which is, in essence, an assistant manager to the nurse manager there. Then COVID hit in 2020, and my manager decided she would retire. Then, I just went right into the role of nurse manager. So on 4 St. John, we moved from 4 St. John last April to 4 Link North and South. So it was one unit with 41 patients, and now we are split in two. So now we are 24 and 24 or 48 patients on 4 Link North and South. So I managed both units with three of my nurses who became assistant nurse managers because they saw me, always asked what it’s like to be a manager, and wanted to do what I do. So, I mentored them. These assistant nurse managers are just so efficient because they were on the floor with me at 4 St. John, and now they’re assistant managers here with me.
Why did you become a nurse?
It’s always been a dream of mine. My great-grandmother raised me, and I called her the Florence Nightingale of our town in Jamaica because she would take me and visit her older family members. Sometimes, when she would visit them, they would be in deplorable condition, and she just took this on as nothing and just took care of them and cleaned them up. And that inspired me to be a nurse when I was younger. I always wanted to be a nurse, but when I migrated here, my mom and dad had a lot of responsibilities, and I just decided that you know what? I’m going to get a job. And I got a job. But nursing was always in the back of my head. And after I had all of my kids, I said, okay, it’s time for me to go back to school. And I went back to school.
How old were you when you went back to nursing school?
I went back to nursing school when I was 31, when I had my last son. I have 3 boys, and I’ve been married for almost 27 years.
What are the most important attributes of today’s nursing leaders?
Mentorship. I think we have to mentor nurses because when you think about nursing, the future of nursing, and how much this has changed over the years, we have to mentor new nurses because we want to keep some of the core values of nursing that we practiced over the years. We want to ensure that it continues. Mentorship is one for me. Ensure you have a succession plan, especially in my leadership role. I feel so gratified if I’m out on vacation. Last year, unfortunately, I had to be out on disability for a little bit because I had surgery. And to see how my two nurses took charge of the unit and ran it in my absence.
So when I came back, my leader, Dena Egbert, nursing director, told me how great they did. I think that’s very, very important, having succession planning. You have to develop your nurses; develop them. Right now, we have a lot of new grads on our floor and are partnering with our educators or med-surg specialists on the unit to ensure that we’re developing them into nurses. It’s very important to me.
Communications skills. Communicate effectively, making sure that everything that needs to be said is said and how we say it, and how respectful we have to be respectful to each other while we’re communicating.
How did you ascend to this latest role as nurse manager?
In this role as a nurse manager, when my nurse manager at 4 St. John decided to retire, she always talked to me about succession planning, and she would always pull me into things like leadership things that sometimes I feel uncomfortable. I wasn’t confident in it. And she always said, “What happens if I was supposed to be out of here for a little bit or on disability or if I decide to leave?” And she’s like, “You need to know these things. You need to know these things.” So, by the time she decided to retire, I was comfortable and confident enough to say, I can do this. I like working with people, working. I love working with patients. Geriatric is my love. Like I said, my great-grandparents raised me, so geriatric is my first love. So, none of this is a coincidence.
What is the most significant challenge facing nurses or the nursing field today?
The significant challenge we’re having right now, for me, I can talk about because I was just on the floor with the nurses. We had workplace violence in the unit. I noticed an uptick with it because we are working closely with Ramonita and our director, Dena. We have a workplace violence team that comes to the unit to help the staff de-escalate issues and protect themselves in case that happens. That’s one of the challenges we face here in the unit. And I’ve heard of other units, too, but I can only speak for myself. There’s also the situation with exposure. Since COVID, there are many different things that our nurses are exposed to safety-wise, such as viral bacteria.
So those are some of the challenges that we’re facing. But we always have someone to support us. Infection prevention also comes on the unit to help with the new team members, how to protect themselves when going in and out of patient’s rooms, and what to do. So yeah, those are some of the things. And physical demands. Physical demands. I think a lot of our patients they’re heavy. There’s a lot of stuff going on with them. There are a lot of issues. I always encourage my team to practice safely. When rolling in a patient, you’re moving a patient; you’re helping a patient in a bathroom to protect themselves because they’re out often because they got hurt or they have injuries.
As a nursing leader, what do you do to help overcome these challenges?
So what I do with my team is I huddle with them. I huddle with my staff in the morning at the beginning of a shift. Remind them of the important things. Our quality metrics are critical, but at the end of the day, they also need to go home to their family. So I always tell them to practice safe or work smart, not work hard. Work smart. Working smart, I always encourage them to do it. If other issues are going on in the unit, I always partner with med, or I partner with security for safety. I’ll partner with workplace violence to come in and do regular in-services.
Whatever affects us, I always find someone to partner with as my leader. Right now, we have executive sponsors on the floor. I don’t know if you’ve heard about where our executive leaders like Dr. Tank, Jason Kreitner, and Ramonita will adopt the unit, and they will round on the unit on Mondays, Wednesdays, and Fridays to improve patients’ experience. So, with that said, if anything is going on in the unit, the team or I can bring it up to them, and they will support us and help us with whatever issues we’re dealing with.
What nursing leader inspires you and why?
I have a few nurse leaders over the years who have inspired me, but now, Dena Egbert, my director, because I like her leadership style with us as leaders reporting to her and Ramonita Jimenez, CNO. Here’s why I chose both of them. Dena, I appreciate it when leaders give you that autonomy to practice because she always encourages us to lead, and if there’s anything that she can support, we should go to her, and she stays firm with that. It’s always there. If I need anything from Dena, I can go over and knock on her door, and she’s available, or I can text her or, email or call her. She’s always available. I always see Ramonita as that leader who develops you. And I like leaders who, if they see an untapped talent in a nurse, I always go to them and say, “I see you. You like to do this. Let’s talk about ways that you can grow that or develop that.” Ramonita is like that.
And that’s what I like about Ramonita. Over the years, when she used to see me on 5PE, now in a different role as a bedside RN, she knows me from downstairs, a supervisor in guest services. But now, as a role, she asked me, “What do you plan on doing later in your career?” And I said to her, “I think I probably just want to stay in leadership, but I want to see how it is first.” And she did stay on top of me with that. She did stay on top of me with that over the years.
What inspirational message would you like to share with the next generation of nurses?
I look back at myself and always say this to new nurses. Even the new batch that I had. I have four at night, and I have four new nurses during the day shift. I always tell them to approach every patient as their family, as someone you know. I said it would take some of the anxieties because they often have anxieties, especially the newer nurses. Approach your patients as if they are family, and also practice humility. Humility is a virtue that many people do not have but practice. Practice humility because when you do that, you can sit there or stand there and talk to your patient, and it’s just like you’re having a conversation with anyone. Also, listen. We have to listen to our patients because we often miss stuff if we don’t listen to our patients.
Nurses need a supportive community to thrive in their field, especially nurses of color, mainly because of a lack of Black representation in the field. Caucasian nurses make up around 80% of the total nursing workforce, but Black nurses only comprise 6% of total registered nurses.
However, nurses are influential in advocating for minority communities and reducing healthcare disparities around the world. These same nurses are also ones who may still face racism at the workplace or struggle to find a sense of belonging with other nurses who share the same struggles, but that’s where these organizations can come in.
Joining a Black nursing organization or attending an event focused on diversity and celebration for Black nursing can foster community and engagement. Plus, these organizations also bring a level of professionalism to your career.
If this sounds promising, then these resources could be for you. Learn some of the most active Black nursing events and organizations today.
Black Nurses Rock is one of the largest minority nursing organizations in the country, representing nurses across the world with over 174,000 nurses and nurse students from the USA, Canada, the Eastern Caribbean, Japan, and Germany.
The organization also has an active online community on social media. Nurses who want to learn more or start with a nursing organization can join their closed Facebook group, a popular forum that shares advice and stories from nurses across the county.
If you’re a student, one of the benefits of becoming a member of Black Nurses Rock is that you can apply for scholarships, awards, and discounts on university tuition. There are also local chapters in over 25 states so that nurses can get connected and network.
Founded in 1971, the National Black Nurses Association (NBNA) is one of the oldest nursing organizations, with over 200,000 members. They focus on ensuring their members have equal access to healthcare opportunities, education, and professional growth.
They have different membership levels for registered nurses, licensed nurse practitioners, and students, with benefits such as association partnerships with other federal and national organizations and speaking engagements at national conferences.
Members can also attend their annual summer conference to see exhibitors for employment opportunities and attend sessions with prominent speakers on diabetes, breast cancer, women’s health, cardiovascular health, and more.
Look at their chapter directory to see if there’s a chapter near you.
The National Coalition of Ethnic Minority Nurse Associations (NCEMNA) is a nonprofit made up of the largest five-member organizations for nurses:
The NBNA
The Philippine Nurses Association of America (PNAA)
Asian American/Pacific Islander Nurses Association (AAPINA)
The National Alaska Native American Indian Nurses Association (NANAINA)
Its goal is to create a unified community with other nurses of color for more culturally appropriate health care and to foster alliances with other professional organizations.
Individual nurses cannot apply, but if you’re a member of any of the five member organizations, you can access NCEMNA’s resources through their sign-up page. NCEMNA is active in health equity and policy advocacy, and its annual conference centers around public policy solutions and speakers with experience in social justice and health disparities among the BIPOC community.
From July 26 to August 1, Black Nurses Week is a conference dedicated to uplifting the Black nursing community professionally and personally. Black Nurses Week was founded by Tauquilla Manning, a nurse travel leader who saw a need for an event like this after being told at work that her natural hairstyle was unprofessional.
Since 2022, the nationwide event has focused on business, health, and wealth, putting Black nurses at the center as they learn from nurse leaders on topics such as entrepreneurship, financial wellness, and healthcare. This year’s Black Nurses Week will be held in Washington, D.C., allowing attendees to attend sessions with nurse leaders, earn continuing education credits, and meet fellow nurses through daily breakfast and coffee breaks.
Black Nurses Meet is an online community and website for Black nurses to find resources and advice to help their careers. Black travel nurses especially can find this community helpful for sharing healthcare-related tips and advice online.
Their memberships are cost-friendly, with their lowest tier at only $25 for nurses and nurse influencers who want to build their content. For nurses who don’t like to spend money, their Instagram account offers tips on burnout and career motivation for Black nurses.
Although Black Nurses Meet is primarily active on social media, they also have in-person events such as their yearly gala designed for the professional community and their travel group trips with other Black nurses.
Health disparities have historically impacted multiple populations throughout the U.S. When it comes to health and access to healthcare, consider the plight of Native Americans, undocumented immigrants, people experiencing homelessness and the chronically mentally ill, and rural communities in places like Appalachia, and we see a picture of what’s broken. The undeniable disservice that continues to millions of the most vulnerable is inexcusable, yet this legacy is slow to overcome.
In terms of Black communities and people of color, the disservice is centuries-old. To this day, the legacies of structural racism live on in health disparities that would have no place in 21st-century America if we had already learned our lessons and lived up to the potential outlined in our country’s founding documents.
Nonetheless, disproportionately negative statistics don’t lie. We know beyond the shadow of a doubt that Black Americans have received short shrift in the realms of health and healthcare since the first days of the American colonies, and the work to undo these wrongs is daunting and ongoing.
Distrust, Disparities, and Deceit
The Kaiser Family Foundation website states, “While Black people have made great contributions and achievements in the United States, they continue to face many health and health care disparities that adversely impact their overall health and well-being. These disparities have been exacerbated by the uneven impacts of the COVID pandemic, ongoing racism and discrimination, and police violence against and killings of Black people. Moreover, the long history of inequitable health outcomes among Black people reflects the abuses faced during slavery, segregation, mass incarceration, and their persistent legacies.’
Kaiser’s statistics point out that Black people face more significant financial obstacles to receiving appropriate healthcare and have a higher uninsured rate than white people. And with higher rates of poverty and food insecurity, it’s clear that many factors contribute to this calculus.
“The growing gap of health disparities within the American healthcare system is resulting in the unnecessary deaths of people of color and the continued mistrust of the healthcare system,” states Jasmyn Moore, MBA, BSN, RN, co-host of the Distrust and Disparities podcast.
“If you take a deep look into most health disparities that plague communities of color,” Ms. Moore continues, “you will see that the root cause is systemic racism. The medical field was built off experimenting on Black bodies.” In this statement, Ms. Moore is referring to a legacy exemplified by the Tuskegee experiments, where Black men were misled by researchers to believe that their syphilis was being treated, but in actuality, the course of the disease could be observed by scientists from the U.S. Public Health Service.
“We have all heard the negative statistics surrounding the health of Black, Indigenous, and people of color,” Moore states. “Black mothers are three times more likely to die during childbirth. Black infant mortality is twice as high compared to white babies. African Americans are more than twice as likely to die from cancer.”
Disturbing statistics are nothing new in the world of racial minorities in the United States. Moore comments that “the life expectancy gap between marginalized ethnic groups continues to widen despite health advancements. We are constantly bombarded with those negative and disheartening statistics. The blame is often placed on individuals and families versus a health care system that was not designed to promote and protect our health and livelihood.”
Moore concludes with the following food for thought: “Behind each of those statistics, racism plays a big factor that is often ignored. A report released by the National Academy of Medicine in 2003 pointed out how, in America, race is a determinant of health quality. Their study detailed how Black people and other ethnic minorities receive lower quality of health care than white people even when age, income, insurance status, and severity of conditions are comparable.”
Heightening the Focus
“The COVID-19 pandemic and nationwide racial justice movement over the past several years have heightened the focus on health disparities and their underlying causes and contributed to the increased prioritization of health equity,” states the Kaiser Family Foundation. “These disparities are not new and reflect longstanding structural and systemic inequities rooted in racism and discrimination.”
Aggressively addressing disparities at their root — including police violence against Black citizens, maternal-infant mortality, discriminatory housing policies, income inequality, the impact of climate change on vulnerable populations, and access to care — can lead to us cooperatively working together to find multifaceted and forward-looking solutions.
As the Kaiser Foundation pointed out, these disparities are nothing new; thus, dismantling the structural and societal issues that cause them is an uphill battle. That said, many individuals and organizations have set their sights on these issues, and the 21st-century racial justice movement is an intrinsic part of that process.
Those of us in the healthcare industry must maintain awareness, examine our own biases, and demand that our workplaces do their part in decreasing disparities impacting the populations of color that we serve. We carry that responsibility; stepping up and speaking out is our individual and collective moral obligation.
As Certified Registered Nurse Anesthetists (CRNA) Week comes to a close, nurses interested in this career or already working as a CRNA are celebrated for the work they do and the dedication to their patients.
As the primary professional organization for CRNAs, the American Association of Nurse Anesthesiology (AANA) sponsors the annual CRNA Week and supports nurses in this specialty. Nurses who decide on a CRNA path know that it is one that requires years of preparation and education, but that offers a distinctive career.
According to AANA, more than 61,000 CRNAs practice or study in the United States. Their professional specialty requires precise administration of all areas of anesthesiology so they meet with patients before procedures that require anesthesia, monitor them closely while they are sedated, and provide care as they are emerging from anesthesia. They have a patient’s safety as a top priority and must learn to work within the uncertainty of how each patient’s physical state can change their anesthesia reaction.
CRNAs develop a rapport with their patients in a short time. They often meet with patients who are anxious about a procedure and not feeling their best. In a short time, they evaluate the patient while gathering background medical information from the patient and the medical team. They perform an in-the-moment physical assessment that could flag any potential difficulties with anesthesia. This multi-pronged approach requires years of practical nursing experience and the critical thinking skills that can help a CRNA spot and react to any issues.
In many areas, CRNAs provide the anesthesia care available to all residents of a region, particularly the more remote or rural areas. With this option, CRNAs make available a level of care that would otherwise require long travel distances or would remain out of reach. According to AANA, they are also the primary anesthesia providers in the military, especially for hard-to-access field locations, military ships, or other transport modes.
As a CRNA, nurses are able to work in many different locations where anesthesia is used, so the career options are varied and plentiful. In nearly half of the states and all military bases, CRNAs are given full practice authority and they can practice without the supervision of a physician. This designation is given after years of academic work and nursing experience.
CRNAs have a distinct path to achieve the credential. To become a CRNA, nurses first earn a BSN before completing several years of training in a critical care environment. With that combination of school and hands-on nursing work, the next step is to enter a certified nurse anesthesiology program (according to the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA), there are 130 such programs in the United States). Finally, passing a CRNA certification exam is required after finishing a program.
Once in practice, CRNAs need to remain current in the field with certification that is renewed every four years and also pass required periodic retesting. The result is a career that pays highly (the U.S. Bureau of Labor Statistics states a $189,000 mean salary for a CRNA in 2020) and is in demand as more procedures are being offered that require anesthesia. According to the BLS, CRNAs can expect to see 38 percent growth in the next eight years along with nurse midwives and nurse practitioners.
CRNAs are dedicated to a fast-paced career in which lifelong learning is an expectation. They are as intrigued by the science as they are by the human connections and must be able to adapt to, and react with precision and accuracy to, situations that change rapidly.
When new graduate nurses enter the labor market, many will clamor for the chance to land a position in new nurse residency programs. Presented as a game that only a lucky few can win, new nurse residencies provide great career-launching benefits for a small cohort of novice nurses. Meanwhile, their less fortunate new grad colleagues take positions where they may be subject to extremely poor (or veritably nonexistent) precepting and essentially set up to sink or swim.
Why are new nurse residencies so few and far between, leaving countless thousands of new graduate nurses to fend for themselves after being thrown to the lions? Is this seriously how we want our neophyte nurses introduced to their new careers? And who does such a system serve? Indeed, not our patients or our society as a whole.
Feeding Our Young, Not Eating Our Young
When asked about new nurse residencies, some old-school nurses may gruffly say,
“When I graduated, nobody held my hand. It was trial by fire, and I had only myself to rely on. Why should these new nurses be coddled? We never were. Let them sink or swim!”
In these more enlightened times, we realize that just because something wasn’t done in the past doesn’t mean we shouldn’t do it now if it has qualifiable or quantifiable benefits. From the point of view of many nurse educators, new nurse residencies are more than worth the time and effort needed to create and administer them.
“Nurse residency programs are crucial for healthcare organizations to enhance new graduate nurse retention by providing a structured transition from academia to clinical practice,” shares Damion Jenkins, MSN, RN, a nursing staff development and education specialist, NCLEX prep expert, and nurse career coach and mentor.
“These programs offer a supportive environment that fosters professional development, allowing nurses to gain confidence and competence in their roles,” Jenkins adds. “Improved retention translates to a more experienced and skilled nursing workforce, positively impacting patient safety through better continuity of care.”
In terms of the long-term care environment, Jenkins states, “Residency programs often don’t exist [in long-term care], and getting administrators to allow enough staff to manage them is difficult. Long-term care facilities may often only have one nurse educator. Without qualified nurse educators to develop and manage these programs, these facilities will continue to face extremely high turnover rates.”
Jenkins is correct—with the constant threat of nurse turnover amidst a nursing shortage that never seems to go away, we need our new nurses to stay in the profession, not abandon it before they even have a chance to find their sea legs.
If 18% of new nurses leave the profession within the first year (likely a significant understatement), we’re losing nearly one in five of our new nurses just when we need them most. Whether the cause is overworking, stress, understaffing, bullying, incivility, or other factors, the plain fact is this: we should be feeding our young, not eating them, and one way to feed them is through the model of new nurse residencies.
A Culture of Learning
According to Jenkins, new nurse residencies serve multiple purposes, including creating the work environments we want to see in healthcare. “These programs contribute to a culture of ongoing learning and collaboration, ensuring healthcare teams stay abreast of the latest updates in the delivery of care and best practices for optimal outcomes,” Jenkins states.
If new nurse residencies are led and staffed by nurses who feel deeply about the positive aspects of education, learning, and the optimization of care, the culture of the entire workplace will feel the repercussions of that way of looking at the system of which we’re all an intrinsic part.
Back then, a nurse would attend a nursing school run by a particular hospital. In this setting, the student nurse would receive intensive hands-on training and, more often than not, be hired as a staff nurse following graduation. While these diploma programs weren’t degree-based, the clinical training was robust, and one can assume that a new nurse residency wasn’t needed based on the rigors of a hospital-based education.
In the 21st century, with varying degrees of success in integrating didactic university or college-based education with supervised clinical experiences, new graduate nurses need more high-quality hands-on training to succeed.
Healthcare is significantly more complex than in centuries past, and the amount of clinical and didactic knowledge that nursing students need to absorb is astronomical. In other words, new grads need all the help they can get, and we owe it to them, ourselves, and society to ensure our new nurses are fully prepared for the complicated 21st-century care environment we’re hoping to launch them into.
Are Universal Residencies Realistic?
As Jenkins previously shared, new nurse residencies must be fully staffed, and many facilities start from a default position of having too few nurse educators. Hospital budgets are enormous, and the line item of a new nurse residency program is easy pickings when cuts are needed.
However, if the federal government is sincere about its commitment to the nursing workforce and nurses’ central role in American healthcare, funding could be available to create a robust system of nationwide new nurse residencies. Perhaps it could be shown that a massive investment in the retention of new nurses would save even more money over time when it comes to improved quality of care, decreased workforce attrition, and a less severe nursing shortage.
And perhaps, in a historic public/private partnership between the federal government and foundations dedicated to healthcare—such as the Kaiser Family Foundation—funding sources could be found for hospitals to be incentivized to successfully create and maintain new nurse residency programs in the interest of the health of the country.
Some may say that universal new nurse residencies are an unrealistic pipe dream that could never come to fruition. Still, with creativity, forethought, and an eye toward innovation, we could create a system where every new grad nurse who wanted a spot in a residency could have one.
Do we want our new nurses to leave the profession in droves? Doesn’t it serve us all to support our recent graduates and usher them into their new careers with increased confidence and skill?
The days of throwing our novice nurses to the lions need to end. Instead, we need to feed them the educational and experiential nutrition they need for success. After all, every new nurse’s success is one that our society can share.
Read the January issue of Minority Nurse focusing on RN-to-BSN and Nurse Residency Programs here.
Recent nursing school graduates account for the highest number of registered nurses available for recruitment in U.S. hospitals. Yet, they leave the profession at a higher rate than long-term nurses. Many become stressed when they find themselves unprepared for the realities of clinical practice. Many experience additional stresses if they have relocated to a city without friends, are unfamiliar with the local culture, and need more time to explore their new surroundings.
How a Residency Program Can Help Early Career Nurses
. Since then, despite the hospital’s efforts, nurses have been experiencing the same fatigue phenomenon seen at hospitals nationwide.
As a result, St. Jude invited its nurses to reimagine and reenergize the institution’s Nurse Residency Program (NRP), created in 2012 and focused on inpatient pediatric oncology. During its review, a planning team identified barriers to recruiting and retaining new graduate nurses.
The redesigned program, accredited as a practice transition program by the American Nurses Credentialing Center (ANCC), now onboards each resident into a generic graduate nurse role. This shortens delays in licensure, kickstarts their professional development, and helps the new nurses build friendships within their cohort from day one. Following onboarding, the residents participate in a week of NCLEX study preparations, which has resulted in pass rates well above state and national benchmarks.
Clinical Rotations
To ensure that residents find specialties that appeal to them, St. Jude created clinical rotations similar to those employed in medical school. Residents spend 6 weeks in clinical rotations, spending shifts in 12 to 40 patient care areas: inpatient, outpatient, surgical services, and ICU. These rotations introduce the nurse residents to the continuum of care at St. Jude, build relationships across the organization, and allow residents to see all the potential nursing opportunities.
After the clinical rotations, the new nurses are matched to a home unit using the National Resident Matching Program’s algorithm. The entire St. Jude nursing family meets the new team members on Match Day.
Afterward, nurse residents receive a unit-based orientation and complete a 12-month-long curriculum that brings the cohort together for monthly sessions of didactic lessons, simulation, and various activities to assist with transitioning from novice to competent nurse.
Growth of the Whole Nurse
Traditional simulations have been replaced with immersive experiences. NRP leaders built a curriculum that provides growth for the whole nurse, even outside work. Nurse residents learn patient assessment and emergency response skills while consulting with personal finance and wellness experts.
For many new nurses, the workplace isn’t a problem. Nurses relocating from other cities experience a disconnection from unfamiliar local cultures and social life. With a sizable percentage of out-of-state nurses joining St. Jude, the NRP team organizes regular social outings to tour Memphis’ cultural and entertainment venues. The new nurses also participate in community service projects to “pay it forward” and contribute to positive growth within their new environments.
Program Results
The revised program has successfully onboarded three groups of new nurses, bringing more than 60 nurses to the bedside with 100% retention of every cohort after one year, far exceeding the national retention benchmark. Changes to the hiring process allowed for earlier onboarding of high-quality candidates and an increase in cohort size, filling over 90% of RN vacancies with each cycle and allowing expansion into the surgical and ambulatory nursing divisions.
But the support for its residents continues. After the nurse residents graduate from the program, they transition into a mentor program where they obtain support from a senior nurse to help guide them through their second year of professional practice.
A welcome benefit of the revised NRP is the increased diversity within each cohort, bringing critical multilingual skills and new cultural perspectives to St. Jude.
This highly skilled, diverse, and, importantly, satisfied nursing workforce is vital to the St. Jude mission of providing top-flight clinical care while advancing cures and means of prevention for pediatric catastrophic diseases through research and treatment.
Read the January issue of Minority Nurse focusing on RN-to-BSN and Nurse Residency Programs here.
