If you’ve ever felt overwhelmed by all the things you need to do and all the tasks you need to catch up on, you’re not alone. Sometimes it can feel like you are scrambling to finish things all the time but nothing really feel completed.
When you add the stress of a global pandemic, upended work schedules and processes, and a family dynamic that may have changed radically amid all the upheaval, it’s no wonder that your productivity feels like it’s taken a hit lately. But there are ways to help get yourself back on track.
If you’ve never tried the SMART approach to productivity and getting things done, now is the time. SMART is an acronym that helps break your goals, large and small, into manageable steps.
SMART stands for
How can you use the principles of SMART to your advantage? Start with thinking of an overall goal and naming it. Think of what you might need to reach that goal—it can be as big as earning an advanced degree and as small as cleaning your closets. Consider your umbrella goal and think of SMART as the step-by-step map of how to get there.
To use SMART, you need to have an idea of your steps—that’s the specific part of the goal setting and how you want to increase your productivity. Be precise on naming what you need to do. Do you want to earn a degree? You’ll have some specific steps to take including researching requirements, finding the right program, and taking any required courses.
When you have some specifics, you’ll need some measureable feedback to see if you’re on track. For an advanced degree, that might mean making sure you have the necessary requirements for a program and a timeline for when you need to have any exams or applications completed. You might need to take a prerequisite course, but to have a measureable goal, you’ll need an application or completion date to stay on track.
Your goals are, of course, goals and they should challenge you. But your goals should also be attainable. Don’t set a goal to earn your PhD in a year because you can’t. Look at your specific goals, establish your measureable results and then realistically figure out how you can achieve them. If a degree is in your sights and you’re concerned about paying for the tuition, for instance, set steps for how you can earn credits through work, earn additional income to afford the tuition costs, or take out loans without going into significant debt. Have a plan that makes your goal realistic and doable.
Your goals should also be relevant to your life and what you want to achieve. Is your goal of an advanced degree going to help your career in the way you expect? Will your current role be expanded and will you achieve a higher pay or get a promotion if you earn this degree? Is an advanced degree relevant to your career right now and to how you define success?
Lastly, be open to the amount of time it takes to achieve this goal. Break it down by courses and by semesters and take into account all the other SMART steps to ensure you have a goal that you can finish in the expected time. If you’re expectations on timing are on target, your other steps will support your actions and help you achieve your goal. With clear goals, your productivity will get a boost.
The SMART approach can be used to many areas of your professional and personal life. Breaking down a goal into steps and strategies helps you consider all angles, predict roadblocks, and set yourself up for success.
Nurses in all specialties and in all areas will, at some point, work with patients who have Alzheimer’s disease or dementia. Because the disease impacts each person in a different way, caring for patients can be challenging, especially for nurses who aren’t used to the intricate interactions that might give them the most success.
Cindy Keith, RN, BS, CDP, owner of M.I.N.D. in Memory Care, and author of “Love, Laughter, & Mayhem – Caregiver Survival Manual for Living with a Person with Dementia,”offered some tips for nurses who work with patients and families about how to find effective ways to care for those with Alzheimer’s disease or dementia.
Families often find out how their loved one responds best through their own trial and error. The music that may soothe one person may trigger agitation in another. A soft wrap that one person finds comforting may feel confining to another. But nurses who haven’t worked with that person before don’t have the same advantage. And sometimes what worked last week won’t work this week with the same patient.
Keith suggests nurses begin by meeting the patient where they are. “First and foremost, they live in an alternate reality, and it does more harm than good to try to orient them to the current reality,” she says. “You must get into their reality and work with them on that level.”
What does that mean for a typical interaction? Keith suggests that when a patient with Alzheimer’s disease repeatedly calls for a loved one, a nurse can ask about that person in a calm manner to redirect the conversation. Sometimes that will redirect a patient enough so that they are able to talk about their loved one and they do not continue to want the person with them, but not always. If, for instance, a patient repeatedly calls out for his wife or wants to see his wife and redirecting doesn’t work, Keith suggests a different approach for nurses who are especially aware of the patient’s memory. “Then if he persists and his mind cannot be redirected, say something like ‘Your wife has told us she is on her way and will be here in an hour or so. She asked that we remind you that she loves you and is on her way,’” she says.
This kind of “therapeutic fib,” she says, can often defuse a tense or ongoing situation. It also helps build trust so you’re able to provide the care they need. The important “if” factor is that you must be sure the patient won’t remember what you told them in an hour. If that approach works, then other staff can use it to help calm the patient at other times. “Remember that a smile and gentle touch go a long way to getting them to trust you,” she says.
Nurses can also use a team approach to help patients cope with processes or procedures they may not understand or may not like. “If the person is in the ER and the lab staff has just drawn blood and the elder is furious about it—then you can be the good guy and tell the elder you’ll make sure that person never touches you again,” Keith says. Having that kind of balance helps caregivers, the patient, and the family who can become upset when their loved one is upset or agitated.
What other tips come in handy? Keith says you don’t have correct patients when they talk about being in a different time. “Get into their reality,” she says. “If the guy thinks he’s back in the war in a POW camp, then act like a comrade who is going to help get him out. Say anything to help calm the person.”
Nurses who work with patients who have Alzheimer’s or dementia, should recognize that delirium is quite frequently present along with the dementia, says Keith. People may think they are in a time that was decades ago—situations like that are common when you’re working with patients with Alzheimer’s disease.
And, says Keith, nurses have to learn that patients aren’t going to always say nice things to you, but it’s best to not take it personally. Again, their reality is altered and they may think they are perfectly healthy or okay and that you are actually the one with a problem or causing a problem.
“They know they are an adult,” she says, “and they will get angry if you treat them like a child. They will do childlike things, but you will make the situation worse if you talk to them or treat them like a child.” So redirect your instructions and continue to check in with yourself to see if you are communicating with respect and humor and with a calm, gentle manner. Watch for how you say something, especially when you’re frustrated. (Saying “No, you can’t do that! You have to do this whether you want to or not!” will probably not result in your patient complying and may, in fact, make things worse.)
As you work with each new patient, you’ll find ways of communicating effectively when you aren’t sure how they are going to present to you. Learning how to navigate each case is going to help your team give the best care which is the end result everyone wants.
As Emergency Nurses Week kicks off on October 11, emergency nurses around the world are reflecting on a year that has been like nothing many of them have ever seen. As the COVID-19 pandemic continues to surge in all corners of the world, emergency nurses continue to see influxes of patients that max out resources and energy. Despite the grinding stress and challenging work conditions, emergency nurses never waver in offering professional and compassionate care to their patients.
Sponsored by the Emergency Nurses Association, which marks its 50th anniversary in 2020, the week’s theme is Heart of Gold. The organization is dedicated to supporting emergency nurses and advancing this specialty. Particularly during this time, the ENA is focused on providing resources and COVID-19-specific information for nurses as well.
The emergency nurse’s specialty has been front and center in 2020, with stories and images from the frontlines of emergency treatment highlighting a powerful story of workers who continue to put their own lives at risk to save others. Nurses have supported each other throughout the months, traveling to high-impact areas as backup help is needed.
Round-the-clock shifts and the severity of illness nurses have seen this year have taken a physical and mental toll. And with a potential second surge looming over the winter months, nurses are stressed and trying to figure out how to manage boundaries between providing care and caring for themselves. This week is a good time to give them extra support and show them how much you appreciate their work and their commitment. If you’re an emergency nurse, being aware of your own response to the pandemic is important. When you’re in the middle of it, it all you can do to treat patients, but when you are able, paying attention to your sleep, nutrition, and mental health will be critical to being able to provide the best possible care.
If you’re a student nurse or even a veteran nurse who has been motivated to pursue this career path, there’s no question that your days will be varied and busy. Because they see patients of all ages, from all racial and ethnic backgrounds, from every socioeconomic standing, and with complex conditions, emergency nurses use all their skills and are learning new skills all the time.
If you are wondering if you’d make a good emergency nurse, there are a few things to consider. This career is especially suited for people who are able to focus in the middle of chaotic situations, who think quickly on their feet, and who rely on their evidence-based practices and instincts to work quickly and accurately.
Emergency nurses need certification and will want to continue with their education throughout their career. Because evidence-based practices change frequently and emergency nurses treat so many different cases, staying current on treatment of the conditions especially prevalent in your population is a good idea.
Help celebrate emergency nurses this week with #ENWeek and #HeartofGold in your social posts, writing to your legislators to support emergency workers, and offering a thank you for what they do.
While industries attempt to address the spread of COVID-19, nurses have been working long hours, many times with insufficient personal protective equipment (PPE) and constantly changing state and federal requirements. They are also having to make ethical decisions about patient privacy, informing others of likely exposure, and patient treatment, and as the fight against the virus continues, we are seeing new and changing ethical issues arise.
The Code of Ethics for Nurses is the standard for ethical training and decision making, and is a resource that nurses are taught to know and implement. However, as the day to day operations of hospitals continue to be fraught with unexpected challenges, it is up to the frontline workers to fight for the ethical treatment of patients, families, and even themselves. As the front line personnel most intimately familiar with COVID-19 cases, nurses have a unique perspective on the effects that this pandemic is having on their communities and patients.
Knowing the available ethics resources, standing as an example of ethical conduct, and staying as up to date as possible on regulatory changes, are just the first steps in fighting for quality of care during this turbulent time. As a nurse in the midst of it, you can use the following tools to hold yourself, your colleagues, and your organization accountable.
Know Your Code of Ethics and Related Resources
The first step in being able to fight for strong ethical standards is knowing those standards yourself. Ethical nursing practices are taught using The Code of Ethics for Nurses, and there are now supplemental texts to deepen your understanding of how to apply them. Among them, The Code of Ethics for Nurses with Interpretive Statements, published in 2015, addresses especially difficult ethical situations such as crisis management and pandemics.
Staying up to date with the standardized documentation available will provide you with a framework for addressing new situations in conjunction with the help of your hospital or organization’s ethical resources. Organizational ethical support for nurses is a major necessity that your organization is obligated to provide, and institutions are not allowed to retaliate against nurses who bring concerns about their working conditions to management. These concerns may include unsafe exposure risks, physical safety, and the quality of ethical decision making by other personnel.
While simply knowing your ethical code cannot prepare you for all of the possible decisions you will have to make as a nurse, make sure to utilize the resources you can and bring any concerns to the attention of your organization’s management. By continuing to develop your understanding of ethical standards as they apply to the crises we are experiencing, you are better prepared to argue for both your and your patients’ safety.
Stay Up to Date and be Vocal
By staying as up to date as you can on your hospital’s current regulations, as well as government regulations, you can foster transparent communication between yourself and the organizations you interface with, making sure that you are working with the most recent information available. It is a difficult task as these regulations are changing daily, but keeping an eye on current regulatory requirements is important. This knowledge is the main factor in staying vocal in the workplace.
Addressing the ethical decisions of your colleagues can help save a patient’s life, limit spread to others in the hospital, and evaluate new symptoms of the virus. In the high-tension, high-stress situations that we are seeing right now, nurses are in a position to utilize strong ethical convictions and honesty to uphold their obligation to their patients and themselves. By staying vocal when you see a questionable decision made, bringing the information to management, and holding others accountable, you can be a force in maintaining an ethical workplace.
Part of ensuring the safety and well-being of patients is to ensure that those you work with are not endangering them. This could be simply a matter of fatigue, or of an inexperienced person attempting to complete a new procedure, but either could lead to a patient being injured or worse. Being aware of the ethical practices of those around you as well as their level of experience, is another way to help ensure that high-quality ethical practices are in place.
Stand as an Example
If you are working as a CNA, or in any other advanced position, new employees will look to you as an example of how to conduct themselves. After all, the codes of ethics apply not only to patient care, but to a nurse’s responsibilities to themselves and their team. By setting an active example for your colleagues, you can help create an environment founded on ethics that support the well-being of both patients and nurses.
There are basics of care that all nurses are trained in, including ways to protect a patient’s privacy, but we are experiencing a massive event that has taxed our medical system and its practitioners beyond any in recent history. Organizations are experiencing a lack of resources, personnel are working extremely long hours in high-risk environments, exhaustion is at a high, and newly trained medical professionals are being called on to make difficult decisions. In this environment, holding yourself to high ethical standards can help provide a path for others to follow.
Education, training, understanding, and action are all required to ensure the health and safety of patients, communities, and staff alike. While the mainstays of health and wellness are still important, the environment and stakes that medical professionals are working with have changed drastically. By fighting for ethical practices, you can become a part of the solution, and help ensure that patients, both yours and future ones, get the treatment that they deserve.
Nurses work as superheroes every day, and the high-performance demands of this profession can lead to side effects such as exhaustion, anxiety, and constant stress. However, as leaders in health care, nurses can choose the way they approach their roles and thrive.
Below are nine strategies that can help nurses manage stress and stay positive all year long.
1. Make Self-Care a Priority
Nurses are inclined to focus on the needs of others. However, the American Nurses Association explains, “Self-care is imperative to personal health and professional growth, serving as sustenance to continue to care for others.” Nurses should make a point to squeeze in at least one self-care activity that makes them happy every day, such as drinking a hot cup of tea or taking a bubble bath.
2. Spend Time With Positive People
When work life feels hopeless, nurses can benefit from reaching out to others to gain some positive energy. Increasing social contact and venting to a good listener are great ways to relieve stress and calm anxious nerves. Sharing work concerns, problems, or thoughts with loved ones can also help build trust and strengthen these relationships.
3. Set Aside Relaxation Time
Practicing daily relaxation techniques, such as prayer, meditation, yoga, or deep breathing, can help nurses achieve a state of restfulness. However, it takes daily practice to reap the full benefits. Getting into a habit of engaging in regular relaxation time can lead to improvements in overall health and happiness. These beginner-friendly guided meditations only take five minutes a day.
4. Begin the Day With Positive Self-Talk
Daily positive affirmations, also known as self-talk, can have a significant influence on how we react to our environment, jobs, and other people. Making a habit of this can help increase self-esteem and reduce feelings of anxiety and depression. For instance, write a positive affirmation and keep it handy at work to refer to when starting to feel overwhelmed.
5. Keep a Consistent Exercise Routine
Regular exercise is an excellent way to manage nursing stress and work burnout. As the Centers for Disease Control and Prevention points out, at least 30 minutes of daily physical activity helps to improve mental health, cognitive function, and quality of sleep, as well as decreases depression and the risk of many cardiac diseases.
6. Just Say No to Extra Shifts
Nurses are often eager to assist when someone asks for help. However, working longer hours and agreeing to take on more shifts than necessary can lead to burnout and even compromise patients’ safety. On the other hand, saying no to extra work means saying yes to more meaningful things in life. This could mean more quality time with family, outdoor nature hikes, or starting a new hobby. Plus, when we achieve a better work-life balance, we become more effective as nurses.
7. Take a Break from Social Media and News
When away from work, set a time each day to completely disconnect from social media, technical gadgets, and the news. Aim to also turn off cell phones, put away the laptop, and stop checking email. Instead, try spending some time outdoors, breathing in fresh air while doing something physically active and enjoyable.
8. Aim for 8 Hours of Sleep
Getting enough sleep every day is paramount—particularly for nurses. An article from health.gov discusses several benefits of sleep. This includes an elevated mood, reduced feelings of stress, improved cognitive function, and better maintenance of a healthy weight. Therefore, it’s important to make time for a few calming activities to help unwind after a stressful day.
9. Start a Gratitude Journal
Writing about what we’re thankful for can encourage feelings of optimism and boost overall well-being. Gratitude journaling works by adjusting our focus, and changing how we perceive situations over time. This type of writing allows us to see more of the world around us, deepening our appreciation for the things and experiences we have.
Stress and overwhelm are an inevitable part of every nurse’s life. However, developing healthy habits and coping strategies can help reduce feelings of burnout and boost resilience. Try to implement a few of these actionable steps every week to maintain a better work-life balance and improve overall health.
Embarking on a job search is often an exciting, and yet exhausting process. Beginning a new role, especially one that matches your professional and personal goals, reminds you of why you started a career in nursing and can restart your passion for what you do.
But a job search takes a lot of work, so some preparation before you begin will save you time and will help you find a good match for your skills and your own needs (a higher salary, a shorter commute, a new location).
Minority Nurse recently caught up with Anne Jessie, DNP, RN, and president-elect of the American Academy of Ambulatory Care Nursing (AAACN), for some tips for nurses who are thinking of making the big move and starting a job search.
Q: Should nurses do any kind of self-evaluation or career evaluation before they begin a job search?
A: Yes. Self-reflection is always helpful. It is important to spend time thinking about why you think a job change may be needed or desired. Are you stuck in a place without opportunity? Is the company you currently work for unstable? Is there an unanticipated career opportunity that is too good to pass up? Once you determine your motivation for doing a job search, ranking the following areas in order of importance can be helpful in narrowing your search.
- Company culture
- New level of responsibility
- Opportunity for growth within the new company or new job role
- Pay and benefits
- Company stability
Q: What is the best way to get organized and think about a job search?
A: Ask yourself what you have enjoyed doing most throughout your career, what you’d prefer never to do again, and what areas of career growth opportunities you may have identified. This self-exploration should help you to picture your ideal role more clearly.
- Browse job postings for the different types of roles that align with your identified career goals. Are the responsibilities described in the postings appealing and do you meet most of the qualifications?
- Edit your resume so that prospective employers will understand what type of position you are seeking and how your experience aligns. You may need to edit the content depending on the job you are seeking. Highlight accomplishments and experiences that are most transferrable, listing the most recent and pertinent to the posting at the top of your resume.
- Create a one-page cover letter template that identifies the position you are applying for and clearly demonstrates that you have done research on the company–for example, mention a recent company accomplishment or news story. This template can easily be customized to each job role you apply for. Address the letter to the hiring manager, recruiter, or human resource representative at the company.
- Identify 3-5 people to be your references and ask them if they would be willing to speak to your skills. Consider present colleagues, professors, or supervisors.
- After participating in a job interview, write an amazing thank you note within 24 hours of the interview.
Q: What are the best tools to use in a job search and what makes each one distinctive — for instance LinkedIn, networking, job boards, alma maters.
A: First, consider all your resources: General nurse recruiting websites or agencies, and nursing specialty job boards like AAACN’s Career Center, or those offered by the Organization for Nurse Leaders. Networking is, of course, one of the best ways to find a new position. I’ve heard our AAACN nurses say they found a new job after they joined one of our Special Interest Groups (SIGs), and I see job discussions frequently in our online community. Such new connections can help a nurse discover an area of practice they didn’t know about or had never even considered.
Second, create or optimize your LinkedIn profile. It should be an extension of your resume and cover letter, and should include a professional profile photo and engaging summary that highlights your skills, career achievements, and accomplishments. Also, include volunteer experience as appropriate, as well as education and professional certifications. Maintain your presence by regularly posting and commenting so you appear active and engaged.
Social media can also be a positive platform if used to contribute to conversations regarding timely health care topics. Ensure that you refrain from engaging in conversations that could be considered controversial. Also, make sure your profiles on Facebook, Instagram, and other platforms are set to private.
Q: Should recently graduated nurses conduct a job search in a different way from a more experienced nurse? Are there better approaches for nurses in different stages of a career?
A: While knowledge, skills, and attitudes are important, a positive attitude and ability to communicate flexibility in the acceptance of job assignments is key for the new grad. Content and processes can always be taught, but a positive attitude in an employee can sometimes be hard to find. Take full advantage of job fairs that are organized by your nursing school as well as healthcare systems recruitment events. Employers who offer nurse residency programs as part of orientation and onboarding are committed to hiring new graduates and investing in them as long-term employees.
Q: Is there anything about this time when so many processes are remote, that can impact a job search positively or negatively?
A: The biggest impact is the uncertainty of the impact from COVID-19 on the job market. Many organizations have suspended hiring and have temporarily furloughed nurses. That said, facilities that offer remote work such as nurse call centers have been vital to providing virtual clinical support to vulnerable populations and have expanded during this unprecedented time in health care.
We’ve seen this trend reflected in a jump in demand for AAACN’s telehealth resources and the networking among our AAACN members who practice telehealth. I think telehealth is going to continue to grow significantly in coming years because its value will remain even when COVID-19 has been tamed.
Q: How can a nurse prepare to use this time as an advantage?
A: Self-educate and develop skills that support patient engagement, mutual goal setting, and motivational interviewing that promote patient self-care management. AAACN’s Care Coordination and Transition Management (CCTM) resources can assist in developing these skills and competencies. These skills are especially critical when working with patients virtually but can translate to any work environment to ensure improved disease management and quality outcomes.