School Nurses Help Their Communities

School Nurses Help Their Communities

School nursing today is nothing like it was a generation ago, and today’s National School Nurse Day is a time to recognize all the contributions school nurses make to their communities. Some things are a school nurse’s constant—there are always scrapes to be cared for, nervous tummies to settle, and accidents that can happen on the playground or in the hallways. But no one would argue that the landscape of a school’s environment has evolved to mirror the growing unrest in the larger society.

With so much going on, it’s no wonder that school nurses can never expect to have a typical day.

As a school nurse, you offer physical and emotional care, education, stability, and guidance to the kids you serve and to their families as well. School nurses today see children of all ages who cope with greater anxiety and depression. Greater numbers of children are exposed to trauma than they were 30 or 40 years ago. They are coping with social media and all the struggles to understand the open and unspoken social rules that surround the technology that is available at their fingertips. And the increasing episodes of school violence, from terrifying school shootings to dating violence to tensions between students within a school, are becoming more prevalent than ever before.

How can a school nurse be prepared?

Honor your knowledge

As a school nurse, you know your student population. You know what they are dealing with and what the predominant struggles are within your school and district. Keep in close contact with the other nurses in your school and your district if possible. That open communication can help you keep current with issues that may begin to bubble up in your own school.

Stay connected

As much as you can, stay in touch with town leaders, especially the emergency responders and police. Monitor social media to learn what is trending among the age population you serve. Vaping is a big problem among even younger students right now. Try to learn about what kids are doing.

Continue your education

Attend seminars, watch online tutorials, gain certification through the National Board for Certification of School Nurses and any other areas that may help you care for students. If you are seeing high rates of anxiety and stress, learn about how kids can cope and even how technology can help them. Are you seeing more diabetes or cancer in your school population. Learn how to best help and educate them and even what barriers they may have to remaining healthy. Check resources through the National Association of School Nurses to continue learning.

Care for yourself

School nursing is challenging, rewarding, and extremely tough. The needs of the students and the hard times they may be faced with can sometimes overwhelm even the strongest nurse. You have to help without being pulled under, so take the time to find a way to relieve your own stress. Find a hobby that captures your attention enough that you can really focus. Incorporate purposefully stress reducing activities into your life—yoga, exercise, meditation, dance, cooking, spiritual gatherings, gardening, roller derby—whatever activity helps you get away from your thoughts for a bit.

Reactions to Senator Maureen Walsh’s Remarks

Reactions to Senator Maureen Walsh’s Remarks

During a recent Washington State Senate floor debate, Senator Maureen Walsh said, “By putting these types of mandates on a critical access hospital that literally serves a handful of individuals, I would submit to you those nurses probably do get breaks. They probably play cards for a considerable amount of the day.”

To say that nurses were upset is the understatement of the year. We asked some nurses for their reactions to the Senator’s quote. Here’s what they had to say.

Sandy Summers

“Walsh’s comment infuriates nurses because it reflects dangerous ignorance, at best. The very reason for the kind of legislation she is opposing here is that, contrary to the implication of her comment, nurses today struggle with rampant understaffing that pushes them to burnout. Research shows that puts their patients at higher risk of suffering, complications, and death. It’s one thing to claim that more regulation will harm a particular industry. But for a comfortable state legislator to tell an exhausted health professional that she has lots of time to play cards highlights a huge failure of understanding. No surprise: The entertainment media presents nurses as low-skilled servants who sit or stand around waiting for orders (or maybe thinking about their bridge club!), while physician characters do the work that nurses do in real life.

We think Walsh’s comment shows the need to establish a “Nursing Awareness Certificate” for decision-makers. Anyone who wants to make health-related policy or media should have to complete a “Follow a Nurse” program that we are initiating at The Truth About Nursing. That would involve following a hospital nurse with an average workload for a typical 12-hour day of clinical practice: arriving and leaving when the nurse does; staying side-by-side with the nurse for every step of the nurse’s day; eating, drinking, resting, and getting a rest room break only when the nurse does; no special meetings with administrators. We will help find the nurses for them to follow.”

—Sandy Summers, RN, MSN, MPH, executive director of The Truth About Nursing, and coauthor of Saving Lives: Why the Media’s Portrayal of Nursing Puts Us All at Risk

 

S. Carter

S. Carter

“I have been a Registered Nurse for the past 19 years. I found it to be very insulting that Senator Walsh would suggest that all we do is play cards all day. Clearly, she has no idea what our profession is about or even has walked in our shoes. I am a very hard-working, dedicated, and caring nurse, who doesn’t have time to play cards, because I am too busy saving lives.

Patient care is a nurse’s top priority. This type of ignorant statement feeds into the stereotype that nurses don’t do anything or that our job is so easy. I would love for Senator Walsh to have an area with 6-8 patients, who may be confused, or on a tube feeding, or have wound dressing changes, or getting a post op or ER admission. Let’s see how she would feel about being a nurse then.

Her statement also showed her lack of respect for the profession. If you do not work in a profession, then you should not be able to pass judgment on a profession.”

—S. Carter, BSN, RN, nurse entrepreneur, public speaker, mentor, and founder of Women of Integrity Inc.

 

Ashley Wood

Ashley Wood

“I’ve been a nurse for over 10 years and have worked in various different roles from the emergency room to orthopedics. During all of this time, I’ve never had a break other than a lunch break (some days, not even that). Some days at the end of my shift (12 hours or more), as I was getting ready to leave, I would realize that I hadn’t even gone to the bathroom because I hadn’t had time.

From the reactions I’ve seen on social media and heard from my current colleagues, there’s no question that the Senator’s remarks have sparked an outrage among the nursing community. I personally feel that they show ignorance on her part in regards to what we actually do. They also show a lack of respect for people who go to work every day where our job is to take care of other human beings during which, for many of them, is the most unpleasant moments of their lives.

I think I can speak for most in the profession that each one of us cares enormously about our patients and feel what we do is important to helping others feel better. This is what drives us to go to work each day even though we know we probably won’t have a break and are lucky if we get to go to the bathroom. Granted there are some areas of the profession that aren’t this way and even if the nurses who work in these areas are able to have breaks, I highly doubt they are playing cards.”

—Ashley Wood, RN, BSN, nurse and contributor at DemystifyingYourHealth.com

 

Robert Smithing

Bob Smithing

“The unfortunate comments by Senator Walsh were uninformed and reflect a profound disrespect for nurses. Despite her mother being a nurse, it seems she is not aware of how hard nurses work at helping their patients. While her stated goal of keeping small rural hospitals is laudable and a goal shared by nursing, her attack is not the way to do so.

Nursing is the largest health care occupational group and, as such, are privileged to be there when babes are born and at the end of life. That Senator Walsh believes we spend our time playing cards shows how little she is aware of what nurses actually do.”

Bob Smithing, MSN, FNP, FAANP, clinical director at FamilyCare of Kent and executive director of ARNPs United of Washington State 

 

Tiffany Montgomery

Tiffany Montgomery

“Senator Maureen Walsh’s comment that nurses ‘probably play cards for a considerable amount of the day’ was insulting to say the least. Nurses who work in direct patient care are among the hardest working members of the health care team. We often forgo breaks and stay extra hours because of short staffing. My labor and delivery colleagues and I spend our time charting, monitoring fetal heart strips, coaching patients as they push for hours, helping new moms breastfeed, assessing newly delivered patients for signs of postpartum hemorrhage, among many other responsibilities.

Although the comments were made in regards to the necessity of mandatory overtime among hospital staff nurses, Senator Walsh’s statement overlooks the many nursing roles beyond the bedside such as nurse educators and nurse researchers. My days as an Assistant Professor of Nursing at Widener University are filled with preparing the next generation of nurses and advancing the field through lecturing, creating exams, holding office hours, grading papers, prepping for future lectures, designing research studies, submitting research grants, and writing manuscripts for publication.

There is no time for a game of spades, Uno, or even solitaire. It is clear that Senator Walsh does not understand the vast role nurses play, none of which include dealing cards.”

—Tiffany Montgomery, PhD, RNC-OB, C-EFM, a labor and delivery nurse at Einstein Medical Center and assistant professor at Widener University

 

Kim Dupree Jones

Kim Dupree Jones

“Nurses are too busy caring for patients to even sit down, no less play cards.”

—Kim Dupree Jones, PhD, FNP-BC, RN, FAAN, dean of the Linfield College School of Nursing

 

Catherine Burger

Catherine Burger

“What is important for nurses is to go to the source of the information directly in order to put the comments into context. While her flippant comment was unnecessary and insulting, I understand Sen. Walsh’s frustration with a bill that will significantly impact the staffing model of critical access hospitals. As she was referring only to those nurses who may work an entire shift with only one or two patients in the facility, I am sure many of those nurses are aware of how they spend their hours of down time.”

—Catherine Burger, RN, BS, MSOL, NEA-BC, media specialist and contributor at RegisteredNursing.org 

Tell us what you think in the comments below.

Sexual Harassment by Patients: What Every Nurse Needs to Know

Sexual Harassment by Patients: What Every Nurse Needs to Know

Especially since the #MeToo Movement began, sexual harassment has been in the spotlight. We spoke with nurses who have been harassed, legal experts, and nursing professionals to determine what you should and can do if this happens to you.

Celia,* RN, a longtime hospice nurse, remembers it like it was yesterday. A younger man, at least younger for hospice, had been admitted with terminal cancer. While Celia says she recalls other nurses talking about the patient having made “inappropriate comments,” she had never experienced it herself.

Until she did.

The patient had been angry and struggling with what he deemed the unfairness of dying young and leaving his wife and child—and knowing that he wouldn’t be able to take fun trips or do things with his daughter. Because he had a trach, which requires frequent suctioning and medication, he felt like the staff was treating him like a leper—when actually, they were simply following all safety precautions.

“Once trach care was completed, I sat down, took my gloves off, and offered him a hand to hold—this is standard practice between hospice staff and patients, and it’s not frowned upon,” says Celia. At the time, the patient held her hand, cried, and expressed gratitude for the time to talk. “I felt we had a nice, professional, and therapeutic rapport.”

A few weeks later, a couple of days after Christmas, Celia was caring for the patient, and he asked if she was married. When she responded that she was in a long-distance relationship, he asked how she took care of her sexual needs—and asked using inappropriate, graphic sexual language.

Celia replied, “One—that is none of your business. And two—It’s not appropriate conversation between a patient and a nurse!” Then, Celia calmly informed him that this was harassment and abuse. With one word to her managers, she told him, she would never have to be his nurse again. She says that the patient was contrite and apologized. Celia passed it off as a one-time thing and let it go.

Unfortunately, that wasn’t the end of the harassment. After a couple of weeks, Celia was the patient’s nurse again. While taking care of his trach, she talked with him. When he could speak, they discussed their favorite kinds of music. She recalls, “It was a nice interaction, as I grew up in a musical home, and discussing this was special to me.”

Near the end of the treatment, though, everything changed. The patient told her lots of things that he would like to do with her sexually, in graphic detail.

Celia recalls, “I was horrified. I was angry. I felt nauseated. I felt ashamed about my body, and I wanted to cry. I was shaking, inside and out.”

She told the patient that he was so far out of line. He was shocked that she was so rattled and tried to justify it by saying that it was a compliment. Celia left his room immediately.

The first thing she did was post on the staff’s white board that she would no longer care for this patient. When she calmed down, she emailed her managers and then communicated with them in person the next day.

Celia’s managers were supportive. She never saw the patient again, and he left the facility a few days later.

Harassment is Prevalent

A Medscape.com survey published last year revealed that the majority of nurses—71%—say that they had been sexually harassed by a patient. Of those responding, 90% were female nurses, 10% male.

But male nurses get harassed as well. They may, however, be even less inclined to report it. In the same survey results, it states, “By gender, female nurses…were much more likely to say they had been sexually harassed than their male counterparts (73% for female nurses vs 46% for male nurses).”

No matter the gender of the nurse who experiences it, sexual harassment is wrong. That said, how do you decide if what a patient is doing or saying is sexual harassment?

If it Looks Like a Duck and Quacks Like a Duck

According to Trista Long, RN, DNP, MBA, ON-C, a nurse manager for an inpatient med/surg unit with Blessing Health System, it is easy, most times, for nurses to differentiate between behavior that is appropriate or inappropriate. “The first sign of inappropriate behavior is when patient’s actions or conversation makes the nurse uncomfortable. Patients who are making inappropriate comments will first ‘test the waters’ by making inappropriate jokes or mild comments to gauge the nurse’s response. If the nurse dismisses the comment, the patient will likely continue with the inappropriate conversation or actions.”

If a patient exhibits inappropriate verbal behavior, it’s often easy to recognize, says Long. “Nurses know what crosses a line and what doesn’t,” she says. Because of the physical nature of nursing, however, Long says that inappropriate physical behavior can sometimes be more difficult to recognize.

“I often tell my staff that—again—inappropriate touch is anything that makes them uncomfortable…it’s no different than being in public and having someone touch you inappropriately. Just because you are in a hospital does not give another person the right to touch you,” explains Long. “Most patients will want to hold your hand or touch your arm, but they will not go any further than that. An action or remark could be considered harassment if the nurse directs the patients to stop, but that direction is ignored.”

“A ‘reasonable person standard’ is generally used to determine if conduct is motivated by prurient interests or for a person’s sexual gratification,” says Debra W. Levin, counsel in the health law group at Brach Eichler. She previously served as counsel to the New Jersey State Board of Medical Examiners and was the Assistant Section Chief responsible for legal services provided to more than 50 licensure boards, including the New Jersey Board of Nursing. “If a reasonable person would be offended, then it can be determined to be sexual harassment. Because the standard is subjective, it is often hard to determine.”

“Sexual harassment is generally any unwanted sexual direct or indirect physical contact or comments. Of course, some physical contact may be more overtly ‘sexual’ than other contact, but much of the time, the intent will be evident,” says Jessica T. Ornsby, LL.M., Esq, managing attorney with A+O Law Group. “A good rule of thumb is whether the contact is objectively appropriate under the circumstances. For example, if a nurse is taking a patient’s blood pressure, is it necessary for the patient to place his or her hand on the nurse’s thigh? Probably not. But if a nurse is helping a patient into bed, that patient may need assistance stabilizing himself/herself and may rest his or her hand on the nurse in a way that would otherwise not be necessary.”

She adds, “Sexual harassment is basically a step down from sexual assault. If the action/contact involves force or any kind of penetration, that is most likely assault and should be addressed accordingly.”

What to Do if It Happens to You

Suppose a patient sexually harasses you. What do you do?

“Experts believe that sexual harassment is significantly underreported in health care. For that reason, I believe the best defense for nurses starts with reporting these types of incidents,” says Jennifer Flynn, CPHRM, risk manager at Nurses Service Organization. “No matter who the harasser—whether it be a supervisor, coworker, or a patient—nurses can take steps to address harassment in their workplace.”

“While working in a hospital, the first step is for the nurse to address the behavior. The nurse should tell—not ask—the patient to refrain from the inappropriate comments or actions and to stop immediately. The nurse should then report the behavior to his/her manager so that the leader can be aware. If the behavior stops, it typically will not need to go further,” says Long. “It is imperative that the nurse set boundaries with the patient immediately once s/he recognizes the behavior. If the action is severe or violent, the nurse should report it immediately, and the leader should address it. If the nurse is uncomfortable caring for the patient, the patient can be reassigned to another nurse. There have been times when I have assigned only male nurses to a patient who was harassing the female nurses.”

There may be times in which a patient won’t stop. In this case, Long says that the leader should talk with the patient and stress that the behavior won’t be tolerated and must cease. “If the behavior continues or if the nurse is uncomfortable caring for the patient, the patient should be reassigned to another nurse, and the leader should engage the Risk Management Department and/or the Security Department to assist. Many times, a Security Officer will be asked to speak with the patient and direct them to stop the behavior. Since they are often in uniform, it can be a show of added authority and the behavior will stop. If it does not, the Risk Management Department can speak to the patient and explain any legal consequences to their continued inappropriate behavior,” says Long.

Ornsby says that each work environment, ideally, should have some kind of policy with regard to sexual harassment. “Nurses should make note of these policies and earmark them for future reference,” she says. “If the policy does not specify to whom to report the incidents—ask. If a patient’s behavior…is making you uncomfortable or causing you to feel unsafe, leave the situation immediately. Your personal safety and well-being are the most important. Federal laws on sexual harassment apply regardless of whether the harassment is taking place at a hospital or a doctor’s office.”

Levin agrees that health care organizations should have policies in place. “Larger or licensed facilities may have staff to counsel the patient regarding harassing behavior. Additionally, in regard to patients, the patient can be transferred to another’s care, a chaperone can be provided, and the patient can be counseled. In dramatic situations, the patient can be discharged/terminated from the practice or facility. State-specific laws apply that govern termination of the doctor/patient relationship/discharge so that the patient is not abandoned, and there is a transition of care,” she says.

The American Nurses Association has challenged nursing professionals to end sexual harassment in the workplace by adopting a zero-tolerance policy. “Much has been written lately about the importance of nurses engaging in self-care. Not tolerating sexual harassment is an integral component not only for self-care, but also for self-respect, vital for professional effectiveness. Speak up when sexual harassment occurs and facilitate a civil work environment,” Flynn says.

The Bottom Line

“If the organization is not responsive to the nurse’s claims, s/he should consult legal counsel or their union. No one should be subjected to sexual harassment in the work place,” says Levin.

Long says that harassment, whether physical or verbal, has been perceived in health care as “part of the job.” But it’s not and never should be seen as such. “It is never acceptable to be harassed by anyone at any time. Nurses are an integral part of the health care team and should command the same respect as every other profession,” says Long. “Unfortunately, nurses have been depicted in a sexual manner for ages and that has demeaned the profession. Being a nurse does not negate my rights as a human being to not be verbally or physically assaulted.”

“I took an oath to care for others, but that does not mean that I have to sacrifice my physical or mental well-being,” Long adds.


* not her real name

How to Combat Nurse Burnout

How to Combat Nurse Burnout

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 Impending Burnout

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 nurse:

  • 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 nurses?”

GI Nurses Educate about Colorectal Cancer

GI Nurses Educate about Colorectal Cancer

During the last week of National Colorectal Cancer Awareness Month, the annual GI Nurses and Associates Week highlights prevention and treatment of colorectal cancer, and the care GI nurses provide to all their patients.

Sponsored by the Society of Gastroenterology Nurses and Associates, this year’s theme is about nurses sharing their own stories about working as a GI nurse. This side of the awareness month will give GI nurses a chance to connect with others through sharing how professional membership, knowledge, collaboration, education, and inspiration made their careers in GI nursing a good match for them.

Although GI nurses treat patients with a variety of conditions from Chron’s disease to abdominal injury to diverticulitis, they are also on the front lines of a disease that is the second-leading cause of cancer deaths in the United States, according to the Centers for Disease Control and Prevention (CDC). In the midst of celebrating the nurses who give high-quality and dedicated care to their GI patients, the week closes out a month that calls attention to colorectal cancer awareness.

GI nurses are always on high alert for the prevention and treatment of colorectal cancer. They are also often the professionals who help patients learn to cope with or manage a diagnosis of cancer. They advise them of treatment plans, potential surgical outcomes, and the emotional turmoil that can come from hearing you have cancer.

This is also a great opportunity to remember that lots of people don’t think of their own risk for colorectal cancer, even nurses. While educating your patients on some of the prevention advice and the screenings available, make sure to take the time to take your own advice.

Some of the latest pointers from the CDC are helpful to discuss with your own patients, your family members, and to remind yourself how important it is to make time for your own health.

Screening Is Essential

The best current tool for colorectal cancer detection is the often-dreaded colonoscopy screening. While it’s a process to go thorough, it’s also the gold standard for catching colorectal cancer in its earliest and most treatable stages. Screenings should begin at 50, and earlier if you have other risk factors like family history or a personal history of things like inflammatory bowel disease.

As a nurse, you can help patients by letting them know what will happen during the actual procedure. Even more valuable is giving tips that will make the preparation easier. If it’s appropriate to their situation, many people can begin eliminating high-fiber foods and increasing their liquids a few days before the preparation begins. This will make emptying everything out the GI system easier.

Screenings can help find precancerous polyps that can be removed before they become cancer. A little inconvenience from a screening can actually be life saving.

Prevention Can Help

As with any cancer, you can’t always prevent the disease. Colorectal cancer often strikes people who have no family history, no personal risk factors, and whose lifestyle and habits would make them seem at low risk. However, there are always things people can do to put the odds in their favor.

Screening, as mentioned, is essential. Otherwise, healthy lifestyle choices can make a big difference. The general advice about staying active, eating a healthy diet, and not drinking alcohol or smoking is repeated so frequently because it’s so helpful.

Watch for Troubling Symptoms

Colorectal cancer often causes no symptoms in the early stages. The CDC and the American Cancer Society offer a few red flags to watch for.

  • Bleeding from the rectum or blood in the stool (sometimes people dismiss this as hemorrhoids)
  • Unexplained weight loss
  • Persistent pain in the stomach, cramps, achiness that doesn’t go away
  • Noticeable changes in your bowel habits that persist after a few days
  • General weakness and fatigue

There is also hope. Colorectal cancer is terrifying, but it is often treatable, especially when it’s caught early. The more people talk about it and learn the importance of screening, the more cases can be prevented.

Nurses Advocate for Patient Safety

Nurses Advocate for Patient Safety

When it comes to patient safety, nurses stand bold as patient advocates. With so much going on and so many people involved in caring for a patient, the potential for something to go wrong is always present. Nurses help prevent that from happening.

This week Patient Safety Awareness Week (March 10 – 16) highlights the importance of patient safety and how healthcare staff and patients and their families can take steps to safeguard against mishaps.

Patients today enjoy more patient safety standards and protocols than patients did even a decade ago. Even the simplest protocol of hand washing has made inroads into protecting patients and healthcare providers from acquiring infections and additional germs. But healthcare today is also much more complex than it ever used to be. Patients have more complex conditions and comorbidities. Progress in treatment means that treatment plans are more extensive and likely involve more medication and/or monitoring.

All of these advances contribute to better treatment and care, but also open up the potential for issues like drug interactions, a missed new symptom, or even a patient who feels good enough to make it to the bathroom alone and exposes a potential fall hazard. In fact, the Institute for Healthcare Safety states that some studies report nearly 400,000 U.S. deaths from medical errors. And that doesn’t include figures for those who are harmed while under medical care.

Nurses provide a fact-checking stance where they can double and triple check medications for the correct med, dosage, timing, and for any drug interactions. They are also the providers who constantly assess a patient’s physical appearance. They can look for breathing changes or skin color changes or injuries on the skin. They are there to talk with a patient and notice any speech changes or cognitive changes that could raise a red flag. They are even there to make sure ill patients are not overwhelmed by visitors.

The Institute for Healthcare Improvement (IHI) and the National Patient Safety Foundation (NPSF) offers excellent and plentiful resources for healthcare providers concerning patient safety. One of the toughest situations is when patients leave a facility to go home, and nurses rightly worry about their home environment and the care they will receive there. This PDF, Engaging Patients and Families in the Safest Care (excerpted from The National Patient Safety Foundation’s Lucian Leape Institute report Safety Is Personal) helps nurses offer realistic and accurate guidelines for continuing patient safety in the home environment.

To help celebrate this week, nurses can make efforts to learn as much as they can about improving patient safety. The IHI is offering a free webinar on March 13 Advancing Patient Safety Beyond the Hospital for those looking to find out more information on how they can help keep patients safe.