I’m orienting as a charge nurse at a clinic. A middle-aged gay man (well, late middle age), surrounded by young women. Something odd happened that I want to share. My clinical partner, a charge nurse with 35 years of experience, pulled me into a room. “I’m going to tell you something awkward. Some of the nurses have said they feel uncomfortable when you touch them on the shoulder.”
You could have knocked me over with a feather. I honestly didn’t remember ever touching anyone and said as much. However, later that same day I actually caught myself just as I was about to touch a coworker on the shoulder and say, “Thanks for helping me with that patient.” So I had touched someone….without their permission, without thinking about it. I really had to rethink my behavior toward the opposite sex in the current climate.
Women are finding their power. Things that might have slipped by in the past are no longer going to get a pass. Frankly, I think it was a long (centuries) time coming. I hope it continues. I know it will. I’m excited to live in a time where women’s rights and female empowerment is in ascendancy.
I guess I just thought that being gay somehow made me immune from charges of sexual harassment (from women at least). This is just not the case. Harassment is in the eye of the beholder. If someone is uncomfortable with something, he or she has a right to their feelings, even if, from the other side, he/she/we may feel that nothing was done wrong (or at least intended). It’s hard to grasp, but important. Harassment is whatever someone says it is.
I admit, my feelings were hurt. I did not intend to make a coworker uncomfortable. My being gay or straight has no bearing on the issue of someone else’s feelings. I won’t argue that I didn’t mean to. I won’t say that I’m a hugger, or come from an affectionate family. Whatever my reasons for touching someone without their permission are not pertinent. All I can do is identify the behavior that caused the problem and fix it going forward.
Some might argue that the pendulum of women’s rights has swung too far. Anyone can say they feel harassed about anything. Any innocent touch, a pat on the back, is harassment and it’s just too crazy. That’s not the way to look at it. The #MeToo movement did not happen in a vacuum. It takes place in the context of an entire human history of women being treated as property and all that entails. There was a time when gay-bashing was, if not a national past-time, at least a frequent diversion, and I’ve been the victim of it several times. Gay rights didn’t happen in a vacuum, either. The broken body of Mathew Sheppard brings to mind exactly why we are fighting. Now, women are fighting.
What I’m saying is that I understand that women have a right to be seen and heard, respected, and not touched in the workplace. They have a right to pick and choose how they will be interacted with and what is appropriate. They fought for that right and continue to do so.
I’m glad that someone thought enough about me to point out something I could improve upon in my work life. I’ll keep an open mind, and my hands to myself in the future.
It might seem ironic that the kickoff of the National Sleep Foundation’s Sleep Awareness Week starts with an hour less of precious shut eye.
While Daylight Savings Time has most of us springing our clocks ahead one hour early in the morning of Sunday, March 11, it also means we are losing that extra hour of snoozing.
But paying attention to your forty winks is nothing to slack off on. Nurses, traditional whirlwinds chameleons thanks to long shifts, nighttime hours, family and school obligations, and just plain stress, are typically fairly sleep deprived. Known to fit amazing amounts of tasks into one day, nurses often accomplish these things while shorting their bodies of necessary sleep.
Here are four reasons to pay more attention to your sleep.
1. Your Work Performance
According to the American Sleep Association, lack of dreamtime contributes to big problems on and off the job. You know you’ll feel sleepier during the day, and that’s a problem for nurses when they are working. Given the fast pace of the job and the critical thinking necessary to dose medications or provide care, chronic sleepiness will impact your patient care negatively.
2. Your Health
Not getting enough slumber can also lead to potential health problems. A body that is sleep deprived gets the hormones that regulate appetite mixed up. Not only are you awake extra hours, but you are hungrier during those hours as your body tries to stay alert. If you aren’t careful, this can quickly lead to weight gain and associated problems like high cholesterol or high blood pressure. Lack of sleep can even trigger an improper processing of glucose and can make you more prone to developing Type 2 diabetes.
3. Your Mood
Sleepiness can easily turn to crankiness as your body craves needed rest. Sleep gives you the extra cushion against the things in the world that irritate you. When you haven’t had enough good rest, your mood takes a nosedive and everyone around you notices it. You might be more short-tempered with your friends and loved ones, but it can also impact your attitude with your patients and with your colleagues.
4. Your Quality of Life
As a nurse, you work hard for everyone else’s well being. You spend your days taking care of other people and other needs, often while neglecting what you need. Not getting enough sleep is a sure-fire way to put a wrench into your forward momentum and finding a balance that is sustainable.
The next time you find yourself skimping yet again on crawling into bed, think of how often you tell your patients they need rest to heal and rest to recover. Treat yourself the same way and see if it makes a difference in your life.
Prescribing is not a responsibility to be taken lightly. Prescribing a drug to any person – even as a “one-time favor” for a coworker, relative, friend, or neighbor – establishes a patient-practitioner relationship. Prescribe the right drug, for the right patient, in the right dose, by the right route, at the right times, for the right duration, and for the right indications.
As health care delivery has continued to evolve, many Americans are using nurse practitioners for much of their health care needs, making NPs a critical component of the modern system. This growth in demand and responsibility has also increased and evolved the many risks NPs face in their work environments.
The Nurse Practitioner Claim Report: 4th Edition from CNA and Nurses Service Organization (NSO) took a deeper look at those risks by analyzing 287 closed professional liability claims against nurse practitioners (claims that resulted in an indemnity payment of $10,000 or greater) over a 5-year period.
Five allegation categories accounted for 95% of all the closed claims in the analysis: diagnosis, medication prescribing, treatment and care management, assessment, and scope of practice. A detailed view of the allegations related to medication prescribing/management show that within this category, the top three allegations involved improper prescribing or management of controlled drugs (27.7%), improper management of medication (24.7%), and wrong dose (15.4%).
The following strategies can help nurses reduce the likelihood of drug-related errors:
- Review current allergy information.
- Learn about medication allergies, side effects and interactions, including how to screen patients for potential allergic or other adverse reactions, recognize an allergic response, and treat serious reactions.
- Review previous medication orders alongside new orders and care plans, and resolve any discrepancies each time a patient moves from one care setting to another.
- Use developed standard order sets to minimize incorrect or incomplete prescribing, standardize patient care, and clarify medication orders.
- Emphasize the importance of keeping follow-up appointments, especially when the patient is discharged on warfarin or direct oral anticoagulation therapy and there is a transition of care process.
Nationwide, the Centers for Disease Control and Prevention (CDC) reports that overdose deaths related to prescription opioids were five times higher in 2016 than 1999. Nurses can play an important role in reducing these deaths, as well as addiction problems, through their assessments and monitoring of patients.
When prescribing opioid drugs:
- All patients suffering pain should be given a thorough physical and have a history taken, including an assessment of psychosocial factors and family history. Reevaluate the level of pain and the efficacy of the treatment plan at every visit.
- Conduct an opioid risk assessment and depression scale test before prescribing opioids and perform periodic screening thereafter.
- Use an appropriate opioid dose based on patient age and opioid tolerance.
These claims and recommendations demonstrate the importance of the responsibility for properly evaluating each patient prior to prescribing, following up, and documenting the results of appropriate tests and consultations in a timely manner. While rare events may be difficult to prevent, nurse practitioners can glean lessens from the experiences of their colleagues to help enhance their own clinical, patient safety, and risk management practices.
Disclaimer: This article is provided for general informational purposes only and is not intended to provide individualized business, risk management or legal advice. It is not intended to be a substitute for any professional standards, guidelines or workplace policies related to the subject matter.
This risk management information was provided by Nurses Service Organization (NSO), the nation’s largest provider of nurses’ professional liability insurance coverage for over 550,000 nurses since 1976. Reproduction without permission of the publisher is prohibited. For questions, send an e-mail to [email protected] or call 1-800-247-1500. www.nso.com.
The health care industry is expected to grow over the next decade, and some of the top gainers are either entry level or early career jobs with only a few years of experience required, which is good news for prospective nurses looking to gain some experience while studying to become a nurse and for those who already have their licensure and are looking to launch their career.
HospitalCareers.com recently put together a list of some of the best early career hospital jobs for health care professionals. Here are five of the best hospital jobs to consider as a minority nurse.
1. Home Health Aides
Home health aides help play an important role in providing care for patients who are stuck at home. These patients still require careful monitoring, and assistance doing basic tasks that others would normally take for granted. Some of these basic tasks include helping patients with bathing, dressing, bathroom assistance, eating, and repositioning. The training that nurses receive will pay off in this entry level career as home health aides are also asked to check vital signs and record pulse, respiration patterns, and temperature readings from time to time.
In addition, nurses are needed for these roles as increasingly home health aides need to spot more symptoms. The training that registered nurses receive help spot symptoms with greater efficiency than those who just receive a certification. In this role, you can help identify challenging care behaviors, home safety, and aging disorders such as dementia.
Typically, home health aides will transit back and forth between a hospital to update necessary physicians and maintain close contact with those who oversee the care plan of individual patients.
Over the next decade, home health aides are expected to grow roughly 47%, which makes it a great hospital job to consider for nurses looking to get their career started.
2. Medical Assistant
Medical assistants work closely with physicians in hospitals, medical offices, and smaller clinics. Currently, there is a surge of elderly patients who will require care from medical assistants, and nurses can find a great career starting point as a medical assistant. Medical assistants typically play a key role in preparing patients for examinations.
In addition, medical assistants help with measuring vital signs, maintaining accurate medical records, authorizing prescription refills with the authorization of a physician, and the collection and preparation of a laboratory specimen.
New nurses are needed for medical assistant roles to help assist physicians during examinations, draw blood, remove stitches and dressings, and instruct patients about medications and diet plans.
Nurses can start a career with a positive trajectory by becoming a medical assistant, as they are expected to grow roughly 29% over the next decade.
3. Licensed Practical Nurse
Becoming a licensed practical nurse is perfect for those who would like to start their career in nursing and garner some experience with an entry level job. Licensed practical nurses (LPNs) typically work under the supervision of a registered nurse.
Working under the supervision of a registered nurse is great for those nurses who would like to gain some valuable experience working firsthand with patients, and also see the future opportunities that their nursing career might hold.
LPNs typically take vital signs, provide treatment for bedsores, prepare and administer medications, monitor catheters, observe patients, collect lab samples, and record food and fluid intake/output.
According to the Bureau of Labor Statistics, the employment of LPNs is projected to grow 12% over the next decade.
4. Health Coach Nurse
Health coach nurses are essential in educating patients about taking care of themselves moving forward. Often referred to as health coaches or wellness coaches, health coach nursing is a great way to gain some experience interacting with patients. Health coach nurses provide vital education to patients about their future treatment plans, and how they can best stick to those plans.
Essentially, health coach nurses educate patients on dealing with chronic conditions, improving overall well-being, and promoting various healing options. Health coach nurses typically work closely with physicians to ensure that the recommendations and coaching they provide are accurate and best meet the patient’s treatment needs.
To become a board-certified nurse coach, you’ll need: a current RN license, a minimum of 2 years of experience as an active RN, a minimum of a bachelor’s degree in nursing (BSN), and completion of at least 60 CNEs in order to be eligible for the exam. To learn more, visit the American Holistic Nurses Credentialing Corporation’s website.
5. Informatics Nurse
Becoming an informatics nurse is a great way to combine big data and nursing expertise for those who are looking to have a job that combines technology and patient care. Informatics nurses incorporate big technology from various clinical settings into readable data that can help predict future care trends or opportunities to change existing care.
As more health care facilities and hospitals look to treat patients more efficiently, informatics nursing will continue to become more vital. While informatics nurses typically don’t work closely with patients, they do work with data that will impact patients in the long run. You will get to see firsthand why some policies are implemented based on data trends.
While some informatics nurse jobs may not require clinical experience, employers often prefer to hire a licensed nurse who has a few years of clinical experience under his or her belt and at least a bachelor’s degree in nursing (BSN). You will also need to become certified through the American Nurses Credentialing Center. For those interested in advancing in this field, you may also wish to pursue an advanced degree, such as a master’s in health informatics.
As you can see, there are plenty of great early career jobs to consider as you begin your nursing journey. These jobs offer a great way to gain experience that can be useful for finding future RN positions that require more experience and offer additional skills that can be used to separate yourself from other qualified candidates when job hunting.
As Black History Month closes, Minority Nurse interviewed Martha Dawson, DNP, RN, FACHE, and assistant professor in the Nursing and Health Systems Administration at the University of Alabama at Birmingham School of Nursing (UABSON). Dawson is also director for the Nursing Health Systems Leadership (NHSL) Division at UAB. The NHSL division includes nursing administration, clinical nurse leaders (CNL), and nursing informatics students. She is also the historian for the National Black Nurses Association.
Dawson, who knew early on that nursing was her path, earned her doctoral degree in nursing after many of her colleagues encouraged and prodded her to advance her studies. The challenges she faced, the experiences she had and her determination will resonate with many minority nurses.
“As I would mentor younger nurses and encouraged them to continue their education to the doctorate level many would say, ‘But, you don’t have a doctorate,’” says Dawson. “I knew then that I had to be the role model and earn a doctorate so I would not become a barrier to young nurses seeking higher education. I have always enjoyed learning and sharing my knowledge.”
The following is our Q&A with Dawson.
Why did you choose to become a nurse?
Becoming a nurse was just something I wanted do from a very young age because I could help people from birth to end-of-life. I can recall telling my father that I wanted to be a nurse. When he asked me repeatedly what type of nurse, I kept replying an RN—I had no idea about the vast career options at such a young age.
I can recall begging my mom one Christmas for a doll that had a medical kit including syringe, stethoscope, bandages, clutches, and arm and leg casts. Nursing provides me with so many career options from providing hands-on care, teaching, mentoring, research, and leadership, and most importantly paying it forward to help others become nurses. Then, there were the times when I took care of my grandmother when she broke her knee and my father when he burned his back. I can also recall when my brother dislocated his leg and I my big toe—mom reset or aligned them using wood splints without us going to a doctor. I was impressed and hooked on being a nurse.
How did you choose your path?
For me this a limiting question because nursing offers pathways, not just a path. Currently, I guess one would say that I am an educator.
I am a planner and strong believer in career mapping and progression. My current educator role is the result of taking a systematic approach to my nursing career by setting short- and long-term goals. I decided early in my nursing career that I wanted to teach, but only after I acquired the expertise to share both lived experiences and book knowledge—in short, I wanted to walk in the shoes of those I would be educating. Therefore, my nursing career started as a BSN nurse in a cardiovascular open-heart intensive care unit where I provided direct care and worked as relief charge nurse and then charge nurse.
Then, like many nurses, after transferring to a pre- and post-cardiovascular unit, I was asked to step into the nurse manager role with no preparation. Management and leadership came naturally to me, but I knew that I needed business and organization skills and knowledge. Therefore, I completed a dual master’s as a cardiovascular clinical nurse specialist (CNS) and in nursing administration that required completion of a 10-month hospital residency certificate program.
By the time I started the nursing administration studies, I had become hooked on leading and influencing change, plus being a voice for nursing both internal and external to the organization. Nursing administration became my passion, and I committed myself to learning as much as I could. I have held positions at the director level, associate chief operating positions, chief nurse, and executive VP level in practice setting, mostly academic medical centers. These roles provided me with the experience to teach the next generation of nurse leaders. I am still growing and determining the next chapters in my career.
I am a life-long leader and forever a student of our great profession.
What kinds of challenges did you face in your career and how did you overcome them?
My challenges would fill a book. There were very few minority students in my school, and it was rarely that more than two of us would be assigned to the same clinical group. In addition, there were very few African American faculty. During my BSN and MSN studies, I did not have a faculty member of color from any ethnicity. Most of the time, I felt the grading was fair, but then I had experiences where I would receive a B on a paper with no correction or remarks only the letter grade. Yes, I did follow up with the faculty and administration as needed.
My advice, and what helped me, is that challenges are there to overcome and to be used as stepping stones. When someone said that I could not do something or advance my career, I felt that it was my God-given right to prove the person wrong. My faith has made and kept me strong. I really try to set my goals and pathways in life and not allow others to determine my destiny. I know and respect that this approach and mental model will not work for everyone. Therefore, I try to help others find their voice.
Mentoring is important for any nurse, but especially for minority nurses. Did you have any kind of mentoring relationship?
I really did not have a mentor(s) early in my career, as I progressed in my career there were leaders that I would say have served as good coaches for me. During my doctorate education, I had my first African American nursing faculty—31 years after becoming a nurse.
Do you mentor young (or new-to-nursing) nurses now?
I mentor everyone that will allow me, from elementary school to doctorate level students. Giving back and investing in others is a personal charge that I have accepted to afford others a smoother path. I mentor nurses, other healthcare professionals and those who aren’t nurses/healthcare professionals. Mentorship is a bidirectional relationship.
However, as a mentor it has to be about the mentee and their career goals. For me as a mentor, the relationship keep me current with professional and society issues, and it improves my listening skills so I can hear and support the mentee. It is key that mentees come to the relationship with a desire to focus and put in the time. Too often, I believe the mentees fail to appreciate the work that will be required of them. However, a good mentor will help mentees step outside of their comfort zones and encourage them to excel beyond the level of the mentor.
True mentorship must include self-assessment, self-reflection, and the willingness to change and reinvent oneself if necessary. It is a learning and growing process that never ends. I encourage my mentees to outgrow me and seek advice from others. In addition, I tell them that if I can only get them to my level of performance, accomplishment, or achievement, then I have failed them because it is not about me, but them. I should help them do more, give more, achieve more, and go further. The mentees help and allow me to sow into their success and support them as I transition into a different phase of my career.
In short, each mentee is a part of my succession plan to ensure that the profession and world are in good hands with the next generations of nurses, nurse leaders, and teachers.
What is the most beneficial outcome of increasing the diversity of the current nursing workforce?
I believe the greatest benefit of having a diverse nursing workforce is the role model and mentoring that can be provided to students of different races and ethnicities to help them enter, matriculate, and graduate from nursing programs. Next, if the profession truly wants to improve population health, then we must have nurses that have lived experiences of the populations we are trying to help.
In the same manner, if we want to create a culture of health, it is important that the owners of culture are engaged on the front end and that the engagers look like them and understand them. There is also a business and economic case to be made that we rarely read about in the literature; nursing is a great profession and one of the few occupations that can continue to earn a livable wage during an economic recession. Nursing as a career can help improve the economic status of families and improve the long-term health outcomes of whole communities for generations. I appreciate diversity at all levels. However, we have to be careful of the global approach to diversity, i.e., where we are counting everything to avoid addressing the real issues of race and ethnicity.
We need more men in nursing but not to just increase the “diversity count.” In other words, I still want to know the breakdown of male nurses by age, race, and ethnicity. Then, we have to address the issue of diversity and inclusivity. Diversity without inclusivity is just a pen, paper, and number game. My motto is that diversity is the quilt that creates a beauty pattern, but inclusivity is like tapestry, many different colors of threads creating a picture. Therefore, an organization has to ask, “Is our vision of diversity a pattern or a picture of interconnectivity?”
What are the biggest barriers for young students of color to become nurses and how can that be changed?
After serving as the principal investigator for two HRSA workforce grants, I am convinced that if we want to increase diversity in nursing and the medical field, we have to start with pre-K through 7th grade.
Nursing is a science-based discipline, and students must be introduced to the profession with the understanding that they have to take the STEM-related courses. The lack of preparation in math and science is the biggest problem facing our students. Prerequisite courses derail many of our pre-nursing students of color. Therefore, they cannot wait to take chemistry, advanced math, anatomy, and physiology, and other related science courses. These courses are needed prior to college entry.
The second major problem is related to high school and freshman counselors. Top performing high school students are receiving information on nursing as a career option. Then many students of color, even some with the GPA, are being mis-counseled and advised against nursing because of the rigor of the program. In addition, many schools of nursing that are concerned about their NCLEX pass rates are growing and holding more and more seats for their “honor programs” thus making it more difficult for that pre-nursing student with an ACT of 20 and GPA of 3.5 to even be considered for the nursing program.
Finally, we still have the issue of lack of diversity among SON faculty. Nursing must become more committed to developing a diverse academic workforce. A great starting point would be to increase faculty diversity to be 10% higher than the state demographic profile because we have a lot of catching up to do.
I still love nursing and think it was the best choice for me. I am not sure what I will be when I grow up, but it will have something to do with nursing. Oh, not grow up, but when I retire.
If you ever need a reason to feel proud of the lifesaving treatment and the compassionate caregiving, you offer every day in your nursing career, the launch of Nursing Now on February 27 is a big one.
In an effort to raise the profile of nursing as a career and as a worldwide factor in improving health, the International Council of Nurses and the World Health Organization are launching Nursing Now across the globe.
Nursing Now is organized by the Burdett Trust for Nursing, a UK-based charitable trust. As nurses’ status increases, their influence will be felt in policy, reputation, and the status of the professional nurse. Nurses themselves can begin to tackle some of the biggest challenges that are facing humanity in the next century.
No matter what location nurses practice, they face similar challenges. They want the best opportunity and training to offer their patients top-notch care so they can lead better and healthier lives on their own and within their communities. Nursing Now will push for those changes, but nurses will see them happen slowly in their own communities and then on a broader national level before becoming a worldwide trend.
The launch is the first step in an initiative that runs through 2020. Nursing Now will support other programs around the world and hep nurses become more able to influence the ways in which they work and effect change with patient and community health.
The initiative has five stated goals:
1. Greater investment in improving education, professional development, standards, regulation and employment conditions for nurses.
2. Increased and improved dissemination of effective and innovative practice in nursing.
3. Greater influence for nurses and midwives on global and national health policy, as part of broader efforts to ensure health workforces are more involved in decision-making.
4. More nurses in leadership positions and more opportunities for development at all levels.
5. More evidence for policy and decision makers about: where nursing can have the greatest impact, what is stopping nurses from reaching their full potential and how to address these obstacles.
Nursing Now recognizes that global change begins as people work together in each and every community. As nurses band together for change, the momentum will grow and impact greater people and reach into higher changes.
The University of North Carolina Chapel Hill School of Nursing will host with United States launch event, and nurses will be able to check the main website throughout the day to learn about other events worldwide.
On February 27, check out Nursing Now and envision and even stronger and more influential nursing future.