As a minority nurse, you know diversity and inclusion means much more than what the people in your organization look like and where they have come from.
Diversity and inclusion is absolutely focused on creating a nursing workforce that more closely mirrors the different populations in a given area. But diversity and inclusion also means more because the culture of a workplace needs to feel comfortable to the people who work there.
If you’re a nursing leader you hold a responsibility for hiring the right people, and also for creating an environment where employees feel like they can be their authentic selves. When employees feel like they are able to bring the things that make them different to work—whether that’s their affinity for studying languages or for making cat toys for shelters or for four-wheeling in their spare time—it’s up to the organization to honor what they bring to your organization.
The Society of Human Resources Management (SHRM) offers resources for making sure your workplace is not just diverse on the surface, but also goes deeper to be welcoming to employees.
What can you do to make sure your working environment is inclusive to all your employees?
Find the Right People
Make hiring high-quality workers who are similar to the populations you serve a priority. The more diversity you have, the more perspectives you’ll have. That only results in better care for your patients.
Understand the Concerns
Assess the culture of your workplace with open forums and anonymous comment boxes and bring your talent management team in on the results. Ask your employees for feedback about what feels right and what makes the workplace uncomfortable or unproductive for them.
Listen and Respond
Your team wants to be heard. They have voices and experiences that can make your unit stronger, more efficient, more effective, and more in tune to the needs of your patients. Make sure what they say matters, so listen to their concerns and work with them to develop meaningful solutions.
Keep It in the Open
Whatever changes you make probably won’t make everyone happy, but they should address an identified problem that will move your organization toward its goal of inclusivity. Each solution might look different. Sometimes, education about how different cultures make healthcare decisions will dispel misunderstandings. Sometimes it might be a direct policy that will address blatant mircroaggressions against people on your team. Many times, it is an open and honest celebration of they differences among your team members that will make them feel like they have found a place where they can flourish.
Look at the Outcome
In the end, a diverse workforce is essential and will meet many or your organization’s goals. But being an inclusive team is what makes employees committed to where they work and focused on the job at hand.
The outcome is better patient care, longer employee retention, an increased reputation as a fair employer in the community and the industry, and nurses who become ambassadors for your organization.
If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.
Suicide is one of the most pressing health issues in the country today, but it’s also one many people are reluctant to discuss openly. With September designated as National Suicide Prevention Month, this is a great opportunity to help shed the stigma around suicide.
According to the National Alliance on Mental Health (NAMI) one in five adults will experience a form of mental illness this year. According to the National Institute of Mental Health (NIMH), the 47,173 suicides in 2017 makes suicide the 10th leading cause of death in the nation. But the problem is even more pervasive than even those alarming numbers. NIMH reported that in 2017, 10.6 million adults aged 18 or older reported having serious thoughts about trying to kill themselves.
Those numbers are staggering and reveal a deep level of anguish among the people in this country. Many of those people do not get any kind of professional help and many don’t even tell another person they have had thoughts of harming themselves. That’s why it’s so important for others to recognize, and act on, signs of trouble.
How You Can Help
As a nurse, you have a level of interaction with so many different people every day, so noticing subtle signs is important. It’s essential to know the warning signs of someone in crisis.
Depending on your specialty and your typical workday, your nursing career might not bring people in obvious mental health crisis into your day. That doesn’t mean your patients aren’t struggling. Friends and family might also be hiding their serious despair, so knowing what to look for and how to listen and interpret is helpful.
Suicide Awareness Voices for Education offers the following behaviors as warning signs that someone is in danger and needs help:
- Talking about wanting to die or to kill oneself
- Looking for a way to kill oneself
- Talking about feeling hopeless or having no purpose
- Talking about feeling trapped or being in unbearable pain
- Talking about being a burden to others
- Increasing the use of alcohol or drugs
- Acting anxious, agitated, or reckless
- Sleeping too little or too much
- Withdrawing or feeling isolated
- Showing rage or talking about seeking revenge
- Displaying extreme mood swings
If you notice something is worrisome, for instance a friend’s social media posts have started to mention that “the world would be better off without me” or a struggling colleague’s behavior with drugs or alcohol is increasingly reckless, it’s okay to ask about it.
It’s Okay to Say Something
Saying something in a nonjudgmental way is best and helping that person find a professional to talk to is going to be helpful. Call a crisis line for immediate help or bring them to the ER, especially if you think they are in imminent danger of hurting themselves. It’s also probably going to be awkward and may not be met with affection, but generally those behaviors are the way someone might ask for help without really asking for help.
In your workplace, see if you’re able to post crisis hotline numbers, so others can have immediate access to the information—either for themselves, their patients, or someone they are concerned about.
September is National Cholesterol Month, making it a great time for nurses to revisit tools for educating patients about maintaining healthy cholesterol levels.
Nurses learn in nursing school about the two types of cholesterol: low-density lipoprotein cholesterols, or “LDLs”, and high-density lipoprotein cholesterol, or “HDLs”. Some cheeky nursing professors might teach their students that LDL’s are lousy, while HDL’s are happy, or the good and the bad cholesterol, respectively.
The goal for many patients is to elevate their HDL and lower their LDL levels, and nurses can play a big part in helping them achieve this. Maintaining healthy cholesterol levels is essential to well-being, and the consequences of not doing so can cause a great detriment to one’s quality of life and even death. The most notable sequelae of high cholesterol are a heart attack and stroke.
The Value of Patient Education
Many nurses take pride in their more technical skills such as phlebotomy, insertion, management of venous catheters, medication administration, and the development of nursing diagnoses and care plans. In many ways, however, patient education is a nurse’s most important task because it can prevent the need to carry out those more technical tasks that treat disease. Patient education instead is wellness-promoting. When it comes to cholesterol, it is a nurse’s greatest asset in assisting patients to avoid the potentially devastating consequences of unhealthy cholesterol levels.
Individualized Lifestyle Patient Education
Perhaps the most obvious factor to focus on regarding cholesterol is diet. For every fad diet, new superfood, and fasting regimen, there is a simple solution suitable for each individual patient. In order to effectively educate a patient about diet, the nurse must be armed with a straightforward understanding of where the patient is both physically and emotionally.
This means the nurse must know the patient’s existing dietary restrictions and needs based on physical conditions, such as carbohydrate restriction related to diabetes mellitus and salt restriction for heart disease. Emotionally, the nurse must also have an understanding of the patient’s dietary preferences and level of willingness.
A patient who claims to hate vegetables is unlikely to comply to eating a healthy cholesterol diet that is predicated on heavy vegetable consumption. This patient might do better if directed toward other dietary sources that support healthy cholesterol levels like oatmeal, berries, and other foods high in soluble fiber. Similarly, if a nurse works with a patient who makes clear that they are unwilling to stop eating fast food, the nurse might suggest a bowl of soup, a large glass of water, or a generous slice of watermelon helps hydrate before a meal. Hydration offers a wealth of health benefits besides relieving thirst, which many dehydrated patients confuse for hunger.
Stress management is not only a tool for a more pleasant daily life, but it is also an essential component of healthy cholesterol levels and overall wellbeing. Chronic stress can throw off our bodies’ cortisol release cycle, and there is a clearly defined relationship between abnormally elevated cortisol and high cholesterol.
Again, individualized patient education is key. Relaxation, sleep, and exercise are three fundamental components of managing cortisol and its effect on cholesterol. This doesn’t mean that every patient will be willing to start meditating, following a strict bedtime, and running marathons. By meeting with the patient and learning about their hobbies, the nurse may discover the patient loves to knit, dance, and read. For this patient, the nurse may recommend knitting to relax, dancing to music for fifteen minutes a day, and going to bed with a good book rather than watching the news.
The Role of the Nurse
Patient education is the nurse’s greatest asset in helping patients to establish lifestyle measures that support healthy cholesterol levels. In order to do this effectively, nurses must establish a rapport with a patient that engenders trust and understanding. This allows both the nurse and the patient to create a plan for the patient that is both effective and feasible to promote a patient’s cholesterol levels. Use September as a time to remind patients they are worth it!
When nurses think about volunteering, they may imagine doing so somewhere in their own backyard. While all type of volunteering to help others is important and valuable, there are many different types—some may even take you across the world. Meggin Tallman RN, BSN, now a Pediatric Critical Care Nurse at Children’s Hospital of Alabama, has volunteered a number of times with Mercy Ships. She wants to spread the word about this amazing organization, so she answered our questions.
What is Mercy Ships?
Mercy Ships volunteer Nurse Meggin Tallman plays the Ukelele with a patient onboard the Africa Mercy.
Mercy Ships is an international faith-based organization bringing hope and healing to the world’s forgotten poor. As many as 5 billion people lack access to safe, affordable surgical and anesthesia services worldwide, and less than 6% of all operations are delivered to the world’s poorest countries. Marginalized populations continue to suffer due to a lack of trained health care providers, inadequate infrastructure, and disproportionate out-of-pocket healthcare costs.
Mercy Ships programs offer holistic support to developing nations striving to make health care accessible for all. Since 1978, Mercy Ships has delivered services to more than 2.56 million direct beneficiaries. Mercy Ships owns and operates the Africa Mercy which is the world’s largest non-governmental hospital ship and is dedicated to the continent of Africa. Mercy Ships has an average of 1,000 volunteer crew, from up to 40 nations, serving onboard the Africa Mercy each year.
How did you get involved with Mercy Ships? Why did you decide to volunteer?
I had always had a dream to serve in developing countries upon completion of my nursing degree. I just really have a service heart, and I feel that I now have a set of skills that are desperately needed all over the world. If I am called to help and have the ability to, then how could I not volunteer?
As a new graduate, I got the opportunity to serve with the hospital I worked for, for a month in Zambia. Following that trip, I knew this was something I was uniquely called to do. When I got home, I really jumped into researching organizations doing medical missions on the continent of Africa, and when I discovered Mercy Ships, my mind was blown that they could do all the things that they do and help the amount of people they do. I instantly applied.
How long were you a volunteer? How did you get time off work?
My first service on the Africa Mercy was in Madagascar for just under four months and the second was just under three months in Cameroon. Those trips were somewhat easier to manage as I was a travel nurse at the time and could plan trips in between contracts. This last service with Mercy Ships was for six weeks in Guinea, and I, thankfully, have a boss who has a heart for missions as well. We were able to work together to help me take a leave of absence so I could fill a critical need the ship had for a pediatric ICU nurse.
What did you do with Mercy Ships? How many people did you help (estimate)?
On board the Africa Mercy I worked in D ward, which is the maxilla-facial ward, and my role was a pediatric ICU nurse. That being said, I treated kids and adults alike with ailments ranging from large tumors of the face and neck to cleft lips and palates to things as serious as neural tube defects.
In terms of how many people I specifically have helped, I don’t think that is calculable. Sure, I had my patients that I helped with medicines and wound dressings and those types things, but we also played games with patients and colored and sang songs. It’s just impossible to truly know the number of hearts and lives you affect both in the profession of nursing and just in life in general. That fact is even more so true on board the Africa Mercy, as it truly is a floating metal box of hope and healing…the patients aren’t the only people who leave the ship changed for the better.
What did you enjoy most about your experience?
Meggin Tallman, Ward Nurse (Paediatric ICU), with a patient on Deck 7.
I think if I had to choose one thing I liked most, it would be that we got to see the healing effects of love and compassion. All the interventions on the ship are surgical, so we have an instant gratification factor where the patient goes into the OR looking one way and comes out looking better. But many of these patients have endured terrible hurt and pain that surgery and medicine can’t fix. That’s where the games and songs and love come in. When you see that healing, you never forget it.
What were your greatest challenges?
I would say probably everyone who has ever served on board the Africa Mercy would say that the number one challenge is living in a tin box with 400 other people from 40 different nations. It is a challenging experience, but it grows on you.
What were your greatest rewards?
It is just such an honor to be able to be a part of the work of Mercy Ships and to play a small role in the life changes that take place on board the Africa Mercy.
What would you say to someone who was considering volunteering for Mercy Ships?
Do it! Not only will you be a part of changing people’s lives in a way that you could never have imagined, but you will come away changed too. I know it sounds crazy and scary and way too big for you–I’ve been there. But take the leap of faith; you won’t regret it.
My work overseas has made it evident that pursuing an advanced practice degree would make me that much more helpful in developing countries, which is why I am now earning my FNP at the University of North Alabama. Education is truly the greatest resource that you never have to worry about fitting in a duffle bag. I think that is an important thing to note when considering working in a low-resource setting.
Nurses have enormous impact on lives and in ways they can probably never imagine. Although neonatal nurses care for newborns and infants, their lasting impact is often remembered over decades.
Today is National Neonatal Nurses Day and the end of National Neonatal Nurses Week, and is a tribute to the ways these nurses change the lives of the tiniest patients. But it’s not just the babies these nurses save—the families of those babies never forget the nurses who cared for their children when they were at their most vulnerable.
If you’re a neonatal nurse, today’s a good day to reflect on how your efforts have a ripple effect. As you care for your patients, think of all the families you have worked with and helped over your career. Then think of all the people who loved those babies as that child grew to a toddler, teenager, or adult and went out into the world.
If that’s an emotional thought, that’s the reason why neonatal nurses are so passionate about and committed to the sometimes joyous sometimes heartbreaking work they do. They care for the newborns who need medical care for a range of medical issues. Their life-saving work is generally done in neonatal intensive care units (NICU), but they may also work in varied level nurseries. Some of these nurses will also make home visits and work in the community to care for sick infants. The infants can range from the tiniest premature baby to a full-term baby born with a critical illness.
If you are interested in a career in this nursing specialty, the National Association of Neonatal Nurses is an excellent resource. Nurses can work as a registered nurse or as a neonatal nurse practitioner. Your educational path will include a master’s degree and potentially a PhD if you want to work as a neonatal nurse practitioner, while a bachelor’s if often sufficient as a registered nurse level. Responsibilities increase between the registered nurse and nurse practitioner levels, as do salary rates.
Neonatal nurses are expected to have a high level of technical competency, and they must remain up-to-date on the constant advances in the field. Certification, as with any nursing field, is always recommended. Certification gives you the advantage of keeping your skills and your knowledge current. The American Assocation of Critical Care Nurses offers three separate certifications for neonatal nurses: CCRN (Neonatal), Acute/Critical Care Nursing; CCRN-K (Neonatal) Acute/Critical Care Knowledge Professional; ACCNS-N (Neonatal), CNS Wellness through Acute Care. There’s no shortage of the ways you can continue your professional and academic path after you earn your degree.
Nurses in this specialty must also have a level of empathy and compassion to care for the tiny babies and the people who love them. You are, in essence, treating the entire family. Helping them navigate the scary ups and downs of daily life in the NICU isn’t easy and is sometimes distracting, but families look to neonatal nurses to guide them. The bond many nurses develop with the families they work with are often strong and lasting. Some of the biggest rewards are hearing back from families years later of the positive effect you had in their lives.
No matter how hard you try to avoid it, it happens. The nurse becomes the patient. Whether you’ve given birth, had surgery, or a horrible case of the flu, there are times in life when conditions will send you to the hospital. And being on the proverbial other side of the hospital bed, as Jenny Ang, MSN, ARNP, FNP-BC, an NP in Washington State, says. So how can nurses be good patients?
“When the caregiver suddenly becomes the one who needs care, it’s an extremely unsettling, vulnerable, and helpless feeling,” says Ang. “Nurse can be good patients by showing patience, kindness, and compassion to their caregivers, while trying not to micromanage their health care professionals.”
Over the years, Ang has cared for many doctors and nurses in the ICU for a number of diagnoses in critical situations. She says that, for the most part, these patients have been good ones. But it’s because they had their questions answered, were updated regularly on their care, and understood both the risks as well as the rationale behind what was being done for them. So what is a “not good patient” in Ang’s opinion? “Someone who requires an excessive, grossly unfair amount of time and resources from a nurse, compared to a patient in a similar circumstance,” she says. “I have had only one patient who was a nurse act this way, but countless other non-health care people behave like this.”
Ang says that as nurses, you tend to advocate for the best care for your patients. “When we become the patient, we tend to advocate for ourselves like a mama grizzly bear protecting her cubs.”
What can you do to be a good patient? Ang has some tips:
- Remember that your professional judgement is clouded when the case is personal.
- Remember that you’re in a vulnerable state.
- Don’t lash out at your health care providers out of defensiveness.
- Don’t micromanage your health care professionals. Remember they are pros, and have sworn the same oath to do no harm, just like you have.
- You are a professional. Remember to act like one.
“It makes many nurses defensive when they are suddenly in the position of being the patient. Like in any other field of work, it is not wrong to question a health care professional, but how you ask your question is key. Don’t be accusatory,” recommends Ang. “It is most appropriate to maintain positive, clear communication with the health care professionals caring for you when they come to check on you in your hospital room. Nurse know how the system works.”