Every April, the sponsors of National Minority Health Month call attention to the prevalent health conditions of minorities. But the month is also about spreading information to improve the health of these communities.
This year’s theme for Minority Health Month is “Active and Healthy,” and brings a focus on how an active lifestyle can reap true rewards in overall physical and mental health.
As a minority nurse, the information is personal. You can take a look at your own lifestyle and any inherited or existing risk factors you have in your own life to make changes. But you can also use that information and your own experiences to help your patients who might be struggling to have a healthier life.
Luckily, helpful information is plentiful and easy to find. You can work with your patients to find a plan that is achievable for them. Making small adjustments and changes that they are willing to implement is the first step.
Through the Centers for Disease Control and Prevention’s Office of Minority Health and Health Equity (OMHHE) or the Department of Health and Human Services’s Office of Minority Health, minority health disparities become clear. Minority populations disproportionately suffer from high blood pressure, diabetes, heart disease, and higher rates of obesity. Because of cultural taboos or attitudes in some minority communities and combined with a lack of nearby high-quality care, mental health struggles go untreated. All of these things can lead to a decline in health and contribute to lifelong, serious diseases.
An active lifestyle impacts both physical and mental health in all populations. After treating many patients, however, any nurse knows you can’t just tell someone to start jogging and enjoy the benefits. You have to fine-tune your approach, taking into account their existing health conditions, so they will be motivated and can do what you are suggesting. Remind them that any activity is good. A sustained and consistent active lifestyle is optimal, but even small changes can make a big difference.
Here are some ways to encourage your patients (and yourself) to get active:
- Walk whenever you can
- Take the stairs – if you can’t do three flights, just do one
- Stretch when watching TV
- Take a couple of laps around the mall when you go
- Think of all the ways you move – cleaning, gardening, walking the dog – increase it
- Walk in place when talking on the phone
- Meet a friend for a walk instead of meeting for a coffee
- Do activity that is fun—dancing, swimming, hiking, yoga
- Think of “active” as just moving and move more whenever you can
Getting active feels good (maybe not at first!) and can prevent or help many health conditions. Encouraging your patients to get moving and finding a plan they can manage is a great start.
Obtaining an Associate Degree in Nursing (ADN) or Baccalaureate of Science in Nursing (BSN) is the pre-licensure pathway to becoming a Registered Nurse (RN). This is the required academic path for entering into the nursing profession. Earning a Master’s in Nursing (MSN) leads to many new paths and opportunities.
An MSN prepares practicing RNs for advanced practice by developing skills and knowledge in specialized areas of nursing. The nurse’s scope of practice expands with increased autonomy and expanded practice roles. The health care delivery arena broadens beyond acute care hospitals and other traditional healthcare settings. The MSN contributes to the financial, social, emotional, and professional worth of the individual. The experience will both challenge and change you.
Some practical and significant rewards associated with the MSN include:
Employment options increase. With an MSN degree, a wide variety of career opportunities become available. A nurse can specialize in a particular area or take a leadership role. If being the boss and leading others is appealing, then you should strongly consider earning a master’s in nursing. MSN programs teach the advanced clinical skills and management strategies that can help an individual supervise employees.
Master’s degree prepared nurses will lead nursing teams, manage departments, and may become part of the hospital’s executive team. Many MSN degree holders choose to become nurse educators. Nurse educators work in nursing schools, universities, hospitals, and vocational schools. The shortage of nurse educators is increasing with the average age for nurse educators being approximately 50. A nurse educator will directly influence how professional nursing is practiced in the future as they direct and guide the pre-licensure education of future RNs. These individuals mentor others who are just beginning their nursing career. As a nurse educator there is an opportunity to positively influence an entire generation of novice nurses.
A MSN who prefers to advance their clinical practice opportunities will be able to consider becoming a Certified Nurse Midwife or Nurse Anesthetist. In these, and other clinical specialties, the nurse works closely with medical physicians to serve women’s health needs or administer anesthesia for surgical patients. Many MSN programs offer specialized tracks that prepare students to apply their advanced skills to psychiatric nurse practitioner, acute care nurse practitioner, or family nurse practitioner. Job opportunities for master’s educated nurses are expanding rapidly with an expected increase for MSN graduates to exceed 30% by 2026.
A flexible and extended career. RNs who hold MSN degrees rank among the most experienced nurses in their workplace, they can enjoy more flexibility at work than most RNs or LPNs. MSN practice settings might resemble non-traditional settings that operate during regular business hours. The MSN often is able to perform their job remotely, during shifts that are more convenient and with the freedom to determine the workday schedule. With greater flexibility and greater responsibility associated with an MSN, there is also an opportunity to extend the life of the nursing career as RNs perform the less physical tasks without the advanced education who will be charged with less physically demanding job duties.
Professional respect and networks increase. With a graduate degree, more earning power, greater job flexibility, and opportunity comes added respect from colleagues, other health care professionals, and peers. Nurses are among the most trusted of professionals in the nation and that trust and admiration extends and expands as the nurse extends and expands his/her educational and professional career. Master’s programs in nursing help students establish valuable relationships with other nurses and professors. The connections and relationships established during graduate school can lead to a new job, identify an interesting new field, or help to discern a doctoral program.
Lifelong learning. The master’s degree often becomes the gateway to the PhD in nursing or a Doctor of Nursing Practice (DNP) to further expand career opportunities or achieve new personal goals. Returning to school can seem daunting, but there are strategies that can minimize the fear. Typically, the MSN is a two-year program of study, but there are accelerated options to explore. Prospective students might consider online programs, or take advantage of bridge programs that help students go directly from the pre-licensure program into a graduate program. Future graduate students should explore programs with affordable tuition options as well as the employer tuition assistance.
Making a difference. Often nurses enter the profession to make a difference in the lives of others. While financial compensation, flexibility, and job variety are impressive advantages, most nurses find fulfillment in their ability to influence health care and affect the lives of individuals, families, and communities. Expanding knowledge through advanced education will serve as inspiration to others including others in the profession. The personal fulfillment and professional satisfaction that accompanies the MSN is not measured in the salary increase or multiple job choices but rather in the sense of accomplishment and improved self-esteem.
From the time spent waiting for an organ for donation to the post-surgical recovery, transplant nurses play an integral role in the lives of patients involved in transplants. Today, National Transplant Nurses Day, recognizes that work.
The International Transplant Nurses Society started a national recognition day for transplant nurses in 2006. Since then, they have attracted attention to the day and boosted recognition for all these nurses do in their field. The organization even builds pride with an essay contest in which patients may nominate a nurse who has had a particularly important impact in their lives.
But the day also shines a light on the varies responsibilities of nurses who are an integral part of the transplant team.
According to the Health Career Institute, transplant nurses’ duties can range from prepping patients for transplant surgery and assisting in the transplant surgery itself to monitoring post-surgery for organ rejection or complications.
Before deciding on this career path, prospective transplant nurses generally gain experience in the field by working in a transplant unit. Eventually, certification as a clinical transplant nurse will help you provide the best patient care and will also signal to your organization how committed you are to your job. Certification in the field through the American Board for Transplant Certification shows you are willing to go beyond your job requirements and gain additional training and education to remain on the forefront of transplant-related practices.
Nurses who work with transplant patients and their families may be involved in cases of living donors or deceased donors. They must remain sensitive to the complex emotional environment surrounding the origins of the donated organs while remaining a vigilant advocate for the organ recipient’s health first and foremost.
Transplants are becoming more and more complex, with multi-organ transplants a more common surgery than ever before. Transplant nurses on the leading edge of the field will want to be well-educated on all the body systems involved and the varied ways that can present challenges in the human body. Because the transplant team includes many diverse specialists, transplant nurses have to work well on a fast-paced team where situations change in an instant and the clear path isn’t always obvious. They have to have excellent critical thinking and be knowledgeable and confident enough to make excellent decisions based on the patient in front of them.
With the emotional challenges and complexities around transplantation and the patients and families involved, transplant nurses have to be sure to have resources to deal with the emotional extremes–from grief to joy—that will become part of their daily routine. But they are reassured about the impact they are making for the patients they treat. A lifelong connection often develops from playing such an essential role in someone’s journey.
Today launches the Wound, Ostomy, and Continence Nurses Week sponsored by the Wound, Ostomy, and Continence Nurses Society. Highlighting the important work of WOC nurses, the week also helps nurses in the field celebrate all they do for patients and their families.
WOC nurses treat patients who have unhealed wounds, ostomies, or urinary or fecal incontinence issues, so nurses who are in this field or who are considering entering this specialty will have many areas of focus to work in. Some patients receive care for these conditions throughout their lives while others might be going through the process of figuring out the best care for new conditions. Nurses interested in growing professionally as a nurse in education and in patient interaction will find this field particularly satisfying.
Nurses in wound, ostomy, and incontinence care work with patients of all ages and with different health conditions. From infants with gastrointestinal system disorders to patients who have newly presented urinary incontinence to patients with open wounds, WOC nurses know the medical conditions and help patients understand what is happening. They are able to navigate the incredibly complex conditions that bring patients to them and the different stages of understanding and self-care their patients are capable of.
WOC nurses are mindful of the medical care their patients need and also promote education to make their patients engaged in their own care if at all possible. As with any nursing specialist, certification through the Wound, Ostomy, and Continence Nursing Certification Board is encouraged. With varied conditions requiring treatment in this field, nurses can also look into certification for foot care, as so many patients deal with wounds on their feet that won’t heal.
In the efforts of continuing to gain knowledge and education, the Wound, Ostomy, and Continence Nurses Society is hosting a webinar this week. Kathleen Lawrence MSN, RN, CWOCN presents the webinar “Guiding Your Professional Future with the Scope and Standards for the WOC Nurse” on Wednesday, April 17 from 1-2 pm Eastern. If you participate, you may be eligible to earn one credit hour. The webinar is free but you must register to participate.
For fun, the society is also encouraging nurses to send in photos from this week in a photo contest. You can also tag the photos with #WOCNurseWeek2019 and share them on social media. Your team might also want to host a small celebration at work. Take a few minutes to enjoy some goodies and recognize how deeply your work is appreciated by the people you help every day. And recognize your team members for the way you all work as a unit to help you patients and their families achieve the very best health they can.
Let’s rewind back to the summer of 2014. I
was in the midst of my senior year of nursing school taking classes, working,
and doing my best to survive the New York City summertime heat. While working
on an assignment one evening, my mother called me to say that my uncle had been
in a near-fatal motorcycle accident. He was put onto a ventilator and had to
endure an extensive hospital stay. This news was incredibly upsetting and
unexpected. I have always been close with my uncle and couldn’t help but feel
I pushed on through my classes and day-to-day routine, but I noticed that I was suddenly sleeping more, eating less, and often feeling unfocused and unmotivated. I chalked it up to stress from school and work, especially since it was my last year and I was expected to graduate that upcoming spring. Reaching out for help was a fleeting thought, and I firmly decided that I could handle these feelings on my own.
Turns out, I was wrong. Feeling down, unmotivated, and overwhelmed consumed me. I received a C minus in one of my summer classes, which coupled with a C minus that I had received earlier in my nursing school career. For a while everything felt so slow, but suddenly it was as if I were thrown into a time-lapse getting caught up with reality. I frantically reached out to my academic advisor who monotonously told me that if I was struggling with a personal issue I should have spoken up sooner and that two C minuses are not acceptable in the program, but I could speak with my professor directly about the grade. There was hope. Except there wasn’t, because my professor would not budge on the matter. With that being said, I was kicked out of nursing school the fall of my senior year.
My recently furnished dorm room had to be dismantled—clothing back in suitcases, photos taken off the walls. I had to say goodbye to my roommates who were confused and concerned. I had to say goodbye to my friends of four years. The reality that I would not be graduating after years of hard work crushed me.
I experienced panic like never before. I couldn’t breathe, couldn’t move, couldn’t feel anything but my lungs constricting. I felt like I was going to explode. A counselor diagnosed me with both panic disorder and generalized anxiety disorder.
I moved back home and tried to figure out what to do next in a frenzied state. No nursing school would accept someone who was dismissed for poor academic performance. The panic attacks only got worse. I was having them at least three times per day. Most people would have given up at this point and settled for less, but I had always known that nursing is the only career I wanted for myself. I would not settle, no matter how much I was hurting, no matter how impossible things seemed.
I began seeing a regular therapist in an effort to get my life back on track. Things seemed to be improving. During the winter of 2015, about four months after my dismissal, I was driving home from a therapy session down a road I’ve known my whole life. Suddenly, a car pulled out in front of me, taking me off-guard. I slammed on my breaks, but it was too late. I smashed into the car head on. My insides were screaming panic, but I couldn’t move. Bystanders got out of their cars to help, but my doors were locked and could not be opened. People were asking me through my window if I could move my legs and I didn’t know if I could. I heard sirens and thought to myself, “I have to be dreaming.” Paramedics had to cut through the top of my car, hoist me out, and strap me to a board that was put into the ambulance. More panic.
Though I questioned my faith during that time, I thankfully left the hospital banged up and bruised, but not detrimentally damaged. I sustained a treatable back injury. After my recovery, I applied for a job at an urgent care clinic because I wanted to maintain medical practice in my life. I thought it would help, both with my practice as a future medical care provider as well as my emotional state. I was happy to get the position, but that meant having to drive again. During that period of time, my drives to work consisted of multiple instances of having to pull over and having countless panic attacks. But I got there. I kept up with both my therapy sessions for the anxiety and physical therapy for my back.
That spring, I attended the graduation ceremony of the friends I was forced to leave behind. I can’t begin to describe how happy I felt for them. At the same time, I worried that they would end up leaving me behind. I felt that in a way, they already were. I felt awkward being with them in public because I didn’t want people from outer circles asking questions that I was too embarrassed to answer. I didn’t know how to fit in anymore with my best friends. This caused panic that I cannot forget.
Rather than closing in on myself, I mustered up the courage to apply back to the same nursing school that I was dismissed from for entrance the upcoming fall semester. I was asked back for an interview, which I graciously accepted and prepared for rigorously. On the day of my interview, I walked into a familiar building unable to control my shaking body. As I sat across from my old professors, I was asked what will be different this time around, should they allow me back. I told them the truth. I spoke about my journey dealing with anxiety and ways that I am now able to manage it, though it goes without saying that it is challenging. I highlighted my relentless drive to be a nurse, and that if the past year wasn’t enough to stop me, then nothing ever could. I was accepted back into the program; my faith was slowly being restored.
I was taking classes with students who had known each other their entire nursing school careers. I also struggled to grasp the material at first, being that I was rusty from having to take time off. I felt disoriented and like an outsider, but I didn’t let that distract me from achieving greatness. I made the dean’s list at the university that only a year ago had told me that I wasn’t good enough. I eventually made friends with my classmates and strengthened the relationships with my old friends.
That May, I graduated proudly. All my friends and family were there to support me. Panic took the backseat.
After passing the NCLEX, I worked in a couple of different clinics and health systems gaining invaluable experience. Despite my fear of rejection, I applied and was accepted into a master’s program for midwifery. I now happily work at a fertility clinic and am excited to graduate the midwifery program stronger than ever. I have discovered my interests within the nursing field, which include researching the United States’ shockingly high maternal mortality rates and normalizing breastfeeding, especially among women of color.
Now, I have been invited to become a member
of the Sigma Theta Tau International Honor Society of Nursing. Once more, I
have to ask myself whether I’m dreaming, only this time it’s under completely
different circumstances. I won’t lie, a sense of underlying anxiety persists
within me, but I can now recognize that I have valuable coping mechanisms that
I have learned through therapy, a group of friends and family members who are
my rocks, and a sense of proudness and empowerment in what I have accomplished
that cannot be taken away. I am eager to make my mark on the field of nursing.
I can’t wait for what will come next.
Many people feel called into nursing careers. Nurses get the
unique opportunity to directly serve people in achieving better health. But
while nursing offers many rewards, the stress of the job can also lead to
burnout. Left unchecked, career burnout can drive even the most dedicated
nurses to leave the profession altogether.
Anyone considering a nursing career should start by having realistic expectations of what day-to-day life is like as a nurse—especially in acute care settings.
Ingrid Flanders, RN, BSN, MN, FNP-C, a visiting assistant professor at the Linfield-Good Samaritan School of Nursing in Portland, Oregon, says sometimes the job is different from what a nurse might expect. “Maybe they don’t have a full understanding of the role and the responsibilities that go with it,” says Flanders. “Then they’re surprised at the level and intensity of the workload. Maybe they haven’t prepared themselves physically, mentally, and emotionally for the work involved; because a nursing role, regardless of what setting you’re in, is really demanding.”
Flanders notes that patients have high expectations of nurses’ proficiency, which can create pressure. There’s also the pressure that many nurses put on themselves. “Generally, the people who are drawn to be nurses have high expectations of ourselves and so we try to give it all away and we don’t always have enough left for ourselves,” explains Flanders.
What starts out as a passion for helping people can soon lead to chronic job stress or what Vicki S. Good, DNP, RN, CPHQ, CPPS, vice president of quality and safety at Mercy Hospital Springfield Communities in Springfield, Missouri, calls burnout syndrome (BOS)—work-related stress that remains unresolved. “BOS has three elements: exhaustion, depersonalization, and perception of decreased personal and professional accomplishment. BOS is directly related to stress at work and not related to stresses outside of work, although outside stresses may impact the stress at work,” explains Good.
Good says that nurses in high-risk, high-stress work environments (such as critical care nursing) are at especially high risk for developing BOS, where they are asked to care for patients during a vulnerable time in the patient’s life, and often at the end of life, with the accompanying ethical issues.
“Nurses are engaged in high-stakes decision making on a daily basis,” says Good. “The nurse is the clinician who is constantly at the bedside of the patient, giving their entire physical and emotional self to care for their patient and their family. Combine this with one of the most challenging workforce shortages in nursing and nurses have rates of BOS equal and often higher than their physician colleagues.”
One extreme consequence of nursing job burnout is nurses deciding to leave the profession—a choice that nurses are making in unprecedented numbers according to Good.
“By raising awareness and educating nurses on how to respond and mitigate symptoms of BOS we hope to prevent nurses from leaving the profession. BOS has been called a ‘silent epidemic’ because nurses and other clinicians have been afraid to speak up about their feelings, and instead the nurse ‘votes with their feet’ by leaving the unit and/or profession,” says Good.
Warning Signs of
Because nurses invest vast amounts of time, education, and money into entering the field and growing their careers, it’s important that they practice good self-care and watch out for the warning signs of chronic stress and burnout.
Nursing career burnout can be sneaky, warns Anna Rodriguez, BSN, RN, CCRN, PCCN, a critical care nurse who launched TheBurnoutBook.com to help nurses combat burnout. “It comes on so gradually, one bad shift at a time, and before you know it, you dread clocking in to work,” says Rodriguez. “Early recognition is key. You need to pause and assess yourself frequently for signs of fatigue, depression, or feeling cynical or apathetic toward your work. You might go home feeling emotionally or physically drained more days than not. You might feel anxious and find your mind racing, thinking about work. These are all unhealthy signs that the work is getting to you and, if it continues, will lead to full-blown burnout.”
Good says that unfortunately, most nurses do not realize when they are developing the signs and symptoms of BOS. “This is one reason that raising awareness of this syndrome is so important to our profession. As a professional nurse, it is critical to be able to recognize the warning symptoms so that one can then take action to mitigate the potential outcomes of the syndrome,” says Good.
So, what do nurses need to watch out for as they go about their daily work?
“As a nurse, the first thing to become keenly aware of are any changes in energy levels related to work—both physical and emotional. Exhaustion is one of the key symptoms. If the thought of going to work makes you exhausted, pay attention, ask questions, and seek intervention,” Good advises.
Flanders agrees that nurses should watch out for fatigue. Another common symptom is a lack of resilience or tolerance for challenging situations where you feel more impatient or more irritable than usual.
This lack of resilience may cause nurses to become disengaged in their work and interactions with coworkers and patients. “If a nurse was previously highly engaged in social events and activities on the unit and stops participating, this may be a sign of BOS development,” says Good.
Finally, watch out for the general feeling that you’re not making a difference as a nurse for your patients/community. Good notes that this lack of a personal and professional sense of accomplishment is a warning that burnout has set in.
How to Avoid Burnout—or Nip
it in the Bud
What can a nurse do if they are on the road to burnout or to prevent burnout from developing? Here are some expert tips from seasoned nurses.
Practice Self-Care. Flanders says it all starts with prioritizing
self-care. This includes reading for pleasure for a few minutes every day,
maintaining a healthy diet, getting regular exercise to reduce stress, and
making sure you get adequate rest. “Even if you’re a nurse working on a night
shift, it’s important to make sure your sleep pattern is one that’s
sustainable,” says Flanders.
Develop Resiliency Skills. “Resiliency is the antidote to burnout,” says Rodriguez. “It’s the ability to bounce back after feeling that emotional, physical, and psychological exhaustion that burnout creates. It’s finding a way to balance the energy you give to others and recharging yourself so that you can continue to care for others effectively.”
Rodriguez suggests the following tips to build resiliency as a
- Be intentional on your days off to regroup and rest so that you can come back a better nurse on your next shift. Don’t say yes to extra shifts if you need to rest.
- Take breaks during your shifts (and practice self-care strategies during your break, such as eating a healthy meal or reading for pleasure).
- Plan unit-bonding activities. Getting together with coworkers outside of work is a great way to fight off burnout.
Talk It Out. Having a support network is vital for nurses. Nurses need to ensure they have other nurses to turn to vent about a bad day, a troublesome patient, or frustrations. Having nursing friends at work and/or joining a professional nursing association dedicated to your specialty, such as the American Association of Critical-Care Nurses, can be an excellent outlet.
“We need a way to talk about the things we see every day,”
says Rodriguez. “There’s a lot of doom and gloom. There are morally distressing
moments. There are times when we’ve given so much of our energy to others that
we develop compassion fatigue and go into survival mode, shutting down our
empathetic side as a coping mechanism. The ability to vent in a healthy way
with our peers is essential to dealing with all of that and maintaining our
empathy. No one understands what you go through better than another nurse.”
Explore Your Options
If you feel that you are already in burnout mode, take some time to explore your career options. Some nurses who experience burnout leave the profession altogether. But that may not be necessary.
Start off by exploring ways you can remain in the field by taking some time off, changing units, or finding a new job in a less stressful environment.
“A sabbatical or some time off may help, but it’s generally not a
long-term fix,” says Paula Davis-Laack, JD, MAPP, owner of Davis-Laack Stress
& Resilience Institute. “Remember that burnout is more about work
systems, cultures, and values creating an environment that breeds burnout, so
until the workplace changes, burnout will likely remain a possibility. You may
just be in an environment that’s a disconnect for you. Can you switch teams,
organizations, or practice settings?”
If a change in work environment or position doesn’t help, then
it’s time to look at nontraditional career tracks such as becoming a health
coach, nurse entrepreneur, or nurse educator.
“One of the things I’ve enjoyed about being a
nurse now for almost 35 years is that there’s a variety of nursing roles within
the profession, and it’s important for young nurses to know that if they’re
getting to the point that they feel like they can’t do it anymore, there are other
options and other roles that might be a better fit for them at that point in
their lives,” says Flanders. “It’s important not to feel like you’re stuck in a
corner and that you don’t have the power or ability to make it different if it
needs to be different. Because when you’re in the role of taking care of other
people, if you’re not doing well, then how can we possibly do our jobs as