From a student nurse deciding on a career path to a seasoned nurse looking to advance into administration, each step along a nurse’s career is filled with questions. Fortunately, mentors in the nursing industry are becoming a more visible presence.
The Nurse Mentorship Program at Stanford Health Care is one such valued and valuable mentoring program. Introduced in 2004 for graduate nurses, the program now encompasses a range of nurses in different areas of their careers.
Minority Nurse spoke with associate chief nursing officer for inpatient services and magnet program director at Stanford Health Care at Stanford University Anita Girard and with Stanford’s program manager of nursing excellence Kevin Tsui about the distinct benefits of this kind of program.
Girard and Tsui say many nurses seek mentoring for varied reasons. They might seek leadership advice or they might want guidance for switching specialties. Still others may be looking for assistance with specific tasks such as writing or giving a top-notch presentation at a conference.
Any nurse can gain from a mentoring relationship, says Girard, but a specific benefit is one that will help a nurse professionally and personally. “The biggest benefit is the networking nurses have being in a mentoring program,” she says. “Mentoring opens you up to a whole new world.”
Tsui agrees and notes the satisfaction nurses reap from establishing a firm footing in their careers and having someone who can help guide them. The resulting good feelings lead to happier nurses, and the benefits stretch far. “Those mentoring connections streamline goals, build positivity and retention, and nurses feel a sense of control,” he says.
Nurses, says Girard, can feel siloed. Despite being in the same profession, nurses have varying specialties and may not have opportunities to hear from nurses in different areas. Mentoring includes both the one-on-one discussions and the larger access to others in the industry that becomes available. “Mentoring gets you out of that box,” says Girard.
So how does a mentoring relationship benefit the nurses and their organizations? According to Tsui, “It’s crucial. By sharing an organization’s mission, vision, and values, it makes transparent the format for mentoring,” he says.
Nurses in a mentoring relationship within the same organization are working within the same culture, so are able to set clear goals and create objectives that are going to be important to the nurse’s career within that organization and in the larger industry. Often, says Girard, mentors will give guidance based on what they already know about the organization. They will be able to help a nurse put priorities in order for certification, advancement, skills development, and personal improvement.
Mentors are also able to be objective about a nurse’s path, so they can help nurses align their goals and use their own knowledge to help a nurse achieve those goals, says Tsui.
A mentoring relationship is definitely a give and take, says Girard. “You really need to make an effort to understand why you want to get into a mentoring relationship in the first place,” she says. And mentees need to make a solid commitment and understand that any mentoring activity needs to be given top priority, she says.
Mentees are responsible for reaching out, setting up clear timelines, and even using tools to streamline online tasks such as emails and calendar appointments. Any communication should have an agenda with clear and succinct ideas and questions. By doing this, the mentee shows the mentor clear goals and intentions mean they have a goal for mentoring and that it will be productive.
Tsui says that sometimes mentees are not clear about the process and expect the mentor to initiate or complete tasks for them. Instead they need to keep in mind they need to be committed to change and driven to use the guidance of the mentor to advance their goals.
At Stanford Health Care, the mentoring program satisfies a magnet hospital requirement, but the benefits have been extensive. “We are driven to excellence,” says Girard. “It is a journey of innovation and inquiry and what we can do to make things better.”
On January 25, IV nurses around the country will once again be recognized with a day in their honor. Since 1980, the Infusion Nurses Society has sponsored IV Nurse Day has called attention to the nurses who specialize in infusion nursing.
This year’s theme “It’s About Us. It’s About Infusion.” highlights IV nurses’ dedication to their professional careers and their commitment to their patients’ health and safety.
Infusion nurses are drawn to the specialty for various reasons. Many enjoy the direct patient care and their essential place in a medical team. They are able to offer patient and family education for those who are seen in offices and centers and to those who require infusions out of a clinic or hospital setting. And they are also able to remain current on innovative practices and medication management.
IV nurses must know how to properly place infusion equipment to reduce pain, increase accurate placement, and prevent infection. They need to understand what medications (antibiotics to chemotherapy) and fluids (blood to saline) they are administering and keep tabs so they know which medications might interact. Infusion nurses keep track of infusion sites for any signs of infection, poor placement, or discomfort.
According to Salary.com, infusions nurses make anywhere from $78,550 to $94,136 annually. IV nurses who want to remain at the cutting-edge of the industry and who want to provide the best possible patient care should become certified as a CRNI (Certified Registered Nurse Infusion). Certification requires extra training and a deeper dive into the details of this specialty. Obtaining certification means you have the latest tools to help your patients.
While infusion nurses are masters at the task of establishing a line or a catheter with minimal discomfort and excellent placement, they are also doing it all while talking with and often comforting a patient and any present loved ones. They are able to distract with words and actions, to establish a trust and connection with their mannerisms, and reassure with their knowledge. All of this direct patient care is what makes an IV nurse’s job different every day.
Take the time today to thank the IV nurses in your life!
Sponsored by the American Association of Nurse Anesthetists (AANA) , this week of celebration was once known as National Nurse Anesthetists Week. The Additional of “certified registered” helps people understand the rigorous training and continuing education for this specialty.
Nurse anesthetists work closely with a medical team and in some states, they are often the sole anesthetist on a team. According to the AANA, nearly 53,000 certified nurse anesthetists and student nurse anesthetists provide care throughout the country. Career growth in the field continues to attract top talent as the opportunities for lifelong learning and fast-paced advancements offer a dynamic environment. In addition, nurse anesthetists are among the highest paid nurses with a median annual salary of $165,000.
CRNAs have a vital role in patient care at all stages of surgery or a procedure. They assess patients prior to anesthesia, monitor them during the procedure, and continue to watch for any difficulties or problems after they come out of anesthesia. In this role, nurses offer compassion, comfort, and an intense focus on the details of medical care. They must assess visually and with equipment readings to understand how a patient is tolerating anesthesia.
In this career, CRNAs can work with a wide range of medical teams. They can practice in hospitals, stand-alone facilities, dentist offices, trauma teams, surgical facilities, military units, or pain management clinics to name only a few areas. The variety of settings means a CRNA can choose to work in specialties that hold particular interest or match an educational background or a life experience best.
Anyone interested in this field should have the correct path of educational attainment. According to the AANA, “graduates of nurse anesthesia educational programs have an average of 9,369 hours of clinical experience.” Programs for nurse anesthetists can range from 24 to 51 months. Program requirements can vary with the university, but will include essential clinical placements. Certification and recertification are also required to become a CRNA and maintain that professional standing. By 2022, students will be required to enter doctoral programs for this field.
Many CRNAs say the direct patient care, the satisfaction of being an essential part of the medical team, and the technical challenges of the work make this an exciting career path. In some states, CRNAs provide the majority, if not all of, the anesthesia care. Anesthesiologists work with patients of all ages and in settings so varied, their days are never the same. But the responsibility of keeping patients safe and being their advocate in a vulnerable time is rewarding.
The holiday gift buying season is upon us! You’re probably going down your shopping list and trying to find just the right gift for friends and family. You may even have nurse friends and colleagues that you want to gift with fun nurse-themed items you hope they’ll love.
But what about you? Maybe you, like many nurses, have a tendency to forget to take care of yourself. (It’s hard for many caregivers to remember that they need to take care of #1!)
When you’re in the thick of a crazy work shifts and off-duty holiday goings on, it’s easy to become overwhelmed. You need a little break, though you may not know the exact remedy that your mind and body needs in hectic moments.
So, why not find some go-to self-care items for whenever you need a pick me up in 2019? Have fun doing your self-gifting by shopping online (Amazon is the biggest bazaar!) or at local independent shops and craft fairs. You can combine convenience and also support makers on Etsy. It’s like a massive online craft pop-up with thousands of amazing shops from around the world. Not only can you find one of a kind pieces, but you’re also supporting small creative enterprises.
Here are some favorite gift ideas on many nurse wish lists this season.
Socks, footies, and shoe inserts—not glamorous but oh so comfy.
If you’re on your feet all day long, a great gift idea may be a thick pair of warm footie socks for the winter season, or a pair of compression socks (there are some stylish choices out there!), or a foot massager and DIY pedicure kit. Shoes need some cush? Try a comfort insert from a drugstore or specialty shoe store that stocks the Birkenstock brand.
Warm, snuggly blanket for hygge comfort, or a weighted blanket for stress-relief.
Enjoy your days off under a perfectly knitted wool throw, chunky or light as a cloud—the type of knit that invites you to snuggle in with a good book. Or try one of the new weighted blankets that are gaining popularity for their health benefits. They help many people reduce workplace stress and improve sleep, especially nurses on shift work suffering from off-kilter circadian rhythms.
Healthy snacks for the active nurse, or artisan food and drink for foodies.
Being a nurse means being on the go, so nurses may not have extra time to pack a lunch or snack to bring to work. That often means relying on a vending machine or cafeteria to fuel up for long shifts. Disaster! A gourmet gift basket of healthy treats like nuts and dried fruit may help you hold out until you can enjoy a nutritious meal. On your days off, sip on a favorite at-home drink, such as a matcha green tea latte. And savor it in an encouraging mug, with a witty or wise nurse-life quote and graphic.
Manicure, pedicure, massage, or other spa treatment!
Hand lotion gift sets make great gifts to help sooth away skin that gets dry from a grueling hand-hygiene regimen. (Harsh hand cleansers and sanitizers are murder on delicate, weather-beaten skin!) Bubble bath products and spa baskets filled with bath products in a keepsake basket will give you a night of much deserved pampering.
Or better yet, treat yourself to a mani/pedi or an all out body care pampering session at a spa. Men make up a fast growing percentage of spa goers, so don’t let gender stereotypes stop you from getting or giving a gift certificate for spa services.
A journal, some gel pens, and washi tape.
If you equate journal with diary, and you haven’t kept one since middle school, you may be surprised at the popularity of new journaling methods. Bullet journals are one way to goal-set, and keep yourself motivated and organized. Many nurses also love to express themselves in a “bujo” through doodles, watercolor, fancy lettering, or stickers and washi tape.
You can treat journaling as a time to explore your inner life, a form of meditation, if you like. In that case, the Nurse’s Journal from the Josie King Foundation is wonderful. Create an introspective ambience by lighting a couple of candles. Artisan candles—with sparkles, soy waxes, exotic oils, or delicate flower petals— add some magic.
I hope that seeing some of these ideas will inspire you to treat yourself to some self-care. We all need reminders to take time to relax and do what makes us happy!
Of all the various facets of the nursing field, hospice, many people think, is the most emotionally difficult to work in. But Connie O’Malley, RN, a hospice nurse for the past three years at Gilchrist Hospice Inpatient Unit in Towson, Maryland, loves her work.
That’s not to say that the work isn’t challenging; it often is. But it also holds a lot of rewards.
How long have you worked in hospice? Why did you get into this area of nursing? What drew you to it?
I’ve loved hospice for more than two decades. I was a geriatric nursing assistant about 25 years ago and worked on one of the medical nursing home floors. A patient with metastatic bone cancer could no longer live at home, and there was no space on the inpatient hospice unit. His prognosis was approximately four to six weeks. He was 60 years old an army veteran and a really wonderful, beautiful human being.
When I first met him, I didn’t want to bond with him because he was dying. And so I put up a barrier around my heart and gave him good care, but was not my normal self like I was with other patients. I found this exhausting after only a week.
One day when his hospice nurse came to check on him, we spoke about this. I told her that I was holding back from getting to know him and love him because he was dying. But at the same time, I felt like maybe our paths have crossed for a reason. This hospice nurse said, “Don’t think that we don’t love our patients and grieve for them when they die. When we care for people in their homes, we are invited into their families. We sit in their favorite chairs and interact in their lives in a way that is different than any other kind of health care. We grow to love them, and when they die, we are sad. You are allowed to love him, and it is okay if you cry when he dies. You can’t have a meltdown where you need to be sent home or take a bereavement day. But if you go take a 5- or 10-minute break to cry on the patio, that is okay. You will find your own way to grieve the patients you lose—whether it is a special song you listen to on the way home or if you drive home silently. You will make your own way to grieve them and honor them. But please love your patients.”
Some people might say that working with those who are dying is depressing. Do you feel that way? Why or why not? What do you think you bring to people who are dying?
Working with dying people is an honor and completely humbling for me. I get to care for people when they are at the very end of their life, and for their families in one of the hardest parts of life’s journey. The majority of families open themselves up and allow me not only to provide my nursing expertise and care for their loved one, but also love the patient and their family.
When you care for someone for several weeks, nurses and staff become family to the patient and their loved ones. It is an honor that I am aware of every day that I work. It is much like being with a friend who is giving birth—it is a special place between this world and the next. To be able to help someone’s body be comfortable through the process and provide education and support and normalcy to their loved ones is an amazing thing.
When I first came to hospice, a dear friend told me he thought that it was such a depressing job. I don’t allow myself to focus on the fact that I lose patients. I feel the exact opposite—I get people. I get to care for people at their absolute most vulnerable state of being. I get to hold their families’ hands and help them learn how to let go. I get to give them education to make a terrifying situation less scary and a little bit easier. Every family changes my life, and I don’t feel that I lose them when they die. I feel fortunate that our paths have crossed and that I have been able to be their nurse at this time.
How do you keep your spirits up?
Being a hospice nurse is exhausting—especially in the inpatient setting. We care for people of all ages. Young people are especially tough on our hearts and minds, and sometimes when families are struggling, it wears on us.
To combat the heaviness that I carry, I make sure that when I am off work, I do things that make me happy and are relaxing. I’m a creative person. I like to crochet, and I make sure that I have projects to work on. I spend time with family and friends enjoying them. Simple things like getting coffee at a diner or spending the night at my mom’s apartment and watching movies together are priceless.
What kind of skills do nurses need to be able to work in hospice?
I came to hospice with four years of cardiac telemetry hospital experience. Despite our patients being at end of life, we use all of our nursing skills daily. We still have patients that have complicated care that needs to be given, so anyone with any kind of nursing background would do well. Very often a lot of people have the idea that everything is very low-key in hospice, but honestly there are nights that I am clinically busier than I ever was on a cardiac unit.
What are the biggest challenges of your job?
Families who fear medication interventions for comfort. Even though hospice has been around for 30 years, there is still a lot of fear around administering morphine and other comfort medications to patients. My biggest challenge is to educate families in what pain looks like and reassurance that medication does not accelerate death. The second biggest struggle is educating people about normal end-of-life occurrences—mainly the truth that everyone stops eating at end of life and that it is normal. A lot of families and visitors struggle when our patients stop eating.
What are the greatest rewards?
The greatest reward is to meet a family on their first day who is struggling with a terminal diagnosis for their loved one, and who are so resistant to any comfort measures and any education about what happens at end of life, and to watch them walk the path and see their minds and hearts change and grow in this process.
A lady was with us for 10 weeks, and all of the staff grew to love her and vice versa. When she was in her last few days, I approached her husband to ask for a good time to come say goodbye to her as I did not want to intrude on his and their daughters’ time with her at the end. He put his arm around my shoulder with tears in his eyes and said, “You come when you want to and as often as you’d like; you are family. Please tell all of the staff too. You have loved us all and become our family, and you are welcome at this time just as much as the last 10 weeks.”
If nurses would like to work in hospice, is there any specific training, certifications, or experience that they would need?
A valid nursing license in whichever state you want to work in. I would say that hospice is a field that a nurse has to be drawn to. It is intense and there is a lot of psychological and emotional weight that we carry on a daily basis. A large number of the nurses that I work with have had family members—parents especially—who have died under hospice care, and it seems that we seek out this work to repay that care that we received when our loved ones were dying.
Although many people don’t like to think about death and dying, it will happen eventually. When it does, those who are fortunate enough to have hospice and palliative care nurses caring for them will understand the importance of these nurses’ roles.
Palliative and hospice care nurses provide care for those who are the end of their lives. They are there for the final transition and use an entire array of medical knowledge and tools, skills, compassion, and life experiences to help in the best ways they can. Hospice and palliative care nurses strive to make patients as comfortable as possible both physically and emotionally. As their physical body shuts down, these nurses can use a combination of medication, music, talk, touch, and companionship to make the process something the patient is comfortable with.
The Hospice & Palliative Nurses Association and the National Hospice and Palliative Care Organization offer resources and education about this nursing specialty. Palliative and hospice nurses often provide education to the public as many people think of nurses as providing life-saving care and aren’t sure what end-of-life care entails. If they haven’t had interactions with hospice care, they may not comprehend all that goes into the nursing practice as someone approaches end of life.
While many find the end-of-life stage difficult to cope with, these nurses often consider it a supreme privilege to be present during someone’s last days. Nurses often develop deep connections with these patients as they try to meet their wishes and help them die with a sense of dignity and control. They also become close to families and even provide guidance and education to help families cope and to make them feel like they can take an active part in offering comfort and acceptance.
Hospice and palliative care nurses deal with grief, often very profound grief, on a daily basis. While the dying patient is coping with life coming to an end, a circle of loved ones is doing the same and trying to prepare for life after the person’s death, while also making the most of the final days. These nurses are especially skilled in managing grief and helping others learn coping skills while they still focus fully on the patient.
Hospice nurses need to take special care to make sure they are also able to cope with profound levels of grief and death in their lives so they don’t get burned out or experience compassion fatigue. Forming strong relationships with other nurses in this specialty is important as is joining professional organizations devoted to hospice and palliative care and even continuing education like certification or additional coursework or conferences. There is much to be learned from others in similar work and hearing how they cope and even what might be a red flag to take notice of. Turning to others and counseling professionals if needed can help nurses stay focused while acknowledging and honoring the challenges of providing end-of-life care on a daily basis.
This career path is one that offers great rewards and hospice nurses are often remembered as a steady presence in a chaotic time.
