Most people are familiar with a board of trustees. These are the leaders who advise, guide, direct, and lead businesses large and small while keeping the organizations’ best professional, financial, and strategic goals in mind. Members of a board of trustees are a diverse group with broad expertise; these varied backgrounds allow the group to look at problems or issues through several different lenses.
As a professional nurse, having your own board of trustees is one way to help your personal and professional growth flourish. Your board doesn’t need to sit around in a conference room (or, today, on Zoom), your own group can be informal, and they can actually be a mutually supportive group who has each member’s best interests in mind.
Who will you invite into your board of trustees? Here are a few things to consider.
Those You Admire and Respect
Nurses who hold leadership roles and who perform their work duties in a way you want to emulate are excellent people to have in your corner. Asking for their advice and guidance or just watching how they approach their responsibilities is going to help your career.
Those Who Don’t Know the Industry
Your board of trustees shouldn’t include only those in the medical industry. Professionals in other industries—from banking to teaching to construction—are going to help you. They can offer perspectives of patient personalities and what might be percolating for the general public. They may offer insight into business practices that could help your own work flow be more efficient or could boost the morale of your unit. They can also give you tips on salary negotiation or interviewing.
Those Who Help with Nitty Gritty
Your alma mater can help you with a career search or with a resume review. The neighbor or cousin who can watch your kids while you finish up a grant proposal is worth more than gold. Your colleague who motivates you to exercise or take a break when you‘ve hit a wall is going to watch out for you. These people belong on your board and you belong on theirs. These are all great opportunities for reciprocal relationships—you can help them as much as they help you.
Those You Network With
Colleagues who are active in nursing associations can help you network to find a new professional opportunity. These are the people who can help you pinpoint excellent presentation topics or give you insider information on how to navigate a particular conference. They can guide you to elevate your visibility in the industry.
Those Who Know You Best
An opportunity might look so-so on paper, but your best friend might be the one to point out how it matches your passions and gives you a launching pad. Or a job offer might be weighed by your sister who asks if you’ll be able to move the 1,000 miles required to make it happen and then cheers you on when you figure out how to do exactly that. This is the crew who will tell it like it is and who always have your back.
Having a board of trustees—or really a board of trust—in your corner is a way to ensure you aren’t going it alone. People are often willing to help. It’s important to offer something in return and to understand you also bring value to the relationship.
If you’re hoping to ask for advice about a career switch from a nurse who is in that specialty, make an offer to take them out to lunch. If someone is watching your kids, offer to watch theirs or to pick up some groceries the next time you go to the store. There are many ways we can all support each other. Start building a circle of trusted people and see the impact it has on your well-being and your career.
Community-based hospice nursing is one of the many areas in which nurses can practice the art of caring towards others. It is somewhat of a non-traditional specialty, given that it takes place outside the walls of hospitals and facilities, but it is definitely rewarding. But becoming a successful community-based hospice nurse has its own challenges. It requires a certain set of skills for those who choose to pursue it.
1. The ability to work with little supervision.
Working in the community means spending most, if not the entire day, working alone. This means that nurses need to be able to hold themselves accountable in getting things done in a timely manner. There are no managers to watch what they are doing, but they are still expected to accomplish what they need to do for the day.
2. The ability to cope with solitude.
Humans are built to be social beings, and that applies to work settings. Workplaces can function as social settings, which can provide the interaction people need on a day-to-day basis. As a community-based hospice nurse, social interaction may be very limited, and those who wish to try it must learn other ways to meet this basic human need to connect with others. There are many ways to do this, including participating in meetings and gatherings at the office, connecting with other community-based nurses through various associations, and maintaining communication with colleagues who work in other places. Working alone does not need be a cause for social isolation.
3. Being a diligent communicator.
Community-based hospice nurses may spend most of their time alone, but much of what they do is actually in coordination with a team. Hospice nurses are part of an interdisciplinary team that includes, licensed practical/vocational nurses, home health aides, social workers, chaplains, among others. In order to be effective, community-based hospice nurses must be able to communicate with these other disciplines when necessary to ensure proper delivery of care to patients and families.
4. Being culturally sensitive.
Cultural sensitivity is an important aspect of nursing practice and this applies to hospice nursing in the community. Hospice nurses must be keen to ask and know about any religious, cultural, or social practices that patients and families may have towards the end of life. Doing this helps ensure that patients die with the dignity they deserve.
5. Being emotionally strong.
Nurses, in general, deal with people at their most difficult times. This is especially true for hospice nurses. Visiting patients in their homes requires great emotional resiliency. Hospice nurses may find themselves dealing with patients who are in distress or are living their last days or hours. In some cases, hospice nurses may be the only person besides family members present when a patient dies at home. Nurses must not only come to terms with their feelings about mortality, but also being able to provide comfort to families who have just lost a dear loved one.
Being a community-based hospice nurse is fulfilling in many ways, and those who possess the right skills may find this to be viable long-term career.
Are you looking to overhaul your budget, but don’t have lots of wiggle room for savings? Even if your employment is solid right now, it doesn’t mean you’re not nervous about your cash flow. Your costs might have gone up or your hours might have been reduced (or both). Or maybe you’re just trying to build a savings safety net or to fortify one you had to dip into.
Whatever the reason, there are some easy tweaks you can make in your daily spending habits to boost your bank accounts without too much effort. These steps are easy and can add up to significant cash savings with little change to your daily life.
1. Take a Look at Your Fees
If you own a home, now is an excellent time to refinance. Rates are low and you can save a bundle of cash over the course of your loan period. You might be able to shave years off your mortgage—who can’t use that kind of extra money? And take a look at your car insurance or home insurance. Do some comparison shopping and see if you can find better rates for the same coverage. Don’t forget to check if your employer has any kind of discount program for insurance coverage.
2. Ditch the Extras
Like a leaky faucet, small cash drains can lead to financial problems. Where are the possible leaks in your budget plan? The monthly charge for Spotify. The magazine subscription that renews automatically. The phone plan that is out of step with what you need. The bank fee every month. The three streaming subscriptions you haven’t had time to watch lately. The gym membership that you aren’t using. The monthly fee for a service plan you meant to cancel last year. All those small leaks can add up to a big cash drain. Check your monthly expenses for at least one or two things you can cancel.
3. Find Your Perks
You’ve heard your friend talk about her credit card extras. How’s your credit card matching up? You don’t need (and really shouldn’t hang onto) a handful of credit cards, but you should make sure the ones you have are working for you. Perks like extra mileage, money back, or discounts on things you use frequently come with certain credit cards. If your credit is good and your credit card isn’t offering you some real benefits (and a low interest rate), ask for them to give you an upgrade or look for a new card.
4. Sell Your Stuff
Do you have clothes you don’t wear or lamps just taking up space in your closet? Why not sell them and make some cash? Online resale retailers like Poshmark or your local consignment shop are a boon to people who want to sell their gently used (but in good shape) clothes, jewelry, bags, shoes, and sometimes even household items. You’ll earn a percentage of the sale price and will probably never miss what you got rid of. And springtime inspires lots of people to clean out and have a big yard sale. Join forces with people in your neighborhood and make some extra money for things you no longer want.
Look for the leaks in your daily spending and you might be able to save hundreds of dollars over the course of the year.
If you consider yourself highly empathetic, adaptable, and patient, crisis nursing might be the right field for you. This ever-growing nursing niche involves administering care to patients experiencing issues with mental health, substance abuse, trauma and co-occurring disorders. Each day, crisis nurses hop into action to help de-escalate and diffuse crisis situations while providing essential medical care, proving that some heroes wear scrubs, not capes. But we already knew that!
Before you determine whether this is the right nursing job for you, you want to figure out what crisis nursing is all about and do a deep dive into some of the things these patient professionals do daily. Read information on crisis nursing and discover some of the key skills, traits, and qualifications below to help you determine if you should become a crisis nurse.
What Is a Crisis Nurse?
To put it simply, crisis nurses work in situations of emotional turbulence and disturbance, such as when a person is depressed, suicidal, grieving, or displaced from their home. Additionally, crisis nurses are often asked to travel to provide care after natural disasters and health care emergencies, such as during a particularly destructive hurricane or during the COVID-19 pandemic.
These nurses are adaptable enough to fit in where needed and can help address some of the unique challenges of patients suffering through a crisis, from grief and suicidal thoughts to traumas such as job loss and homelessness. Like standard travel nursing assignments, crisis nursing jobs typically last for 13 weeks, but they can be anywhere from eight and 26 weeks long, depending on the specific needs of the area.
Yes, It Pays More
So does crisis nursing come with a monetary incentive? Yep! Because of their willingness to adapt, travel, and work in turbulent situations, crisis nurses earn a higher salary than nurses who work in non-crisis environments. In fact, many nurses in these roles earn something called a “crisis rate” or “crisis pay” which can be up to $20 more per hour than the standard rate for the hospital.
This makes crisis nurses among the highest-paid nurses. But higher pay doesn’t automatically mean a better situation. As we learned from the measurable spike in nurse burnout during the COVID-19 pandemic, crisis environments can take a serious toll on health care professionals. It’s not for everyone, but if you’re willing to hop in where needed and know how to manage feelings of burnout, the additional pay may be worthwhile.
How Do You Become a Crisis Nurse?
The required qualifications of crisis nursing vary widely from one system to the next, but all employers require you to start out by obtaining your registered nurse (RN) degree and license through an accredited nursing program. From there, you may be required to complete at least a year of related work experience in a role within psychiatric, addiction, or mental health. You’ll also want to prepare yourself for the potential of periodically relocating and how that could affect your personal life and housing.
Qualities Required of a Crisis Nurse
All RNs know that even non-crisis nurses occasionally face crises in virtually every health care environment. It just comes with the territory of working in medicine and no one should become a nurse without understanding that. With that being said, crisis nurses are specially trained in things such as de-escalation, passive non-compliance, and trauma-informed care. Some of the key personality traits required for these skill sets include:
- The willingness to be ready for anything. Because of the aforementioned crisis pay, these kinds of nursing positions are highly competitive and get snatched up quickly. One of the key characteristics of a successful crisis nurse is his or her ability to drop everything and spring into action to fill a vacancy.
- Empathy. Crisis nurses can’t just be in it for the money. They have to be willing to relate to what patients and their families are going through in order to provide adequate care. Empathy is key for nurses because it helps them build trust with patients and in turn strengthens communication, which is extremely critical during those essential crisis moments.
- Interpersonal skills. Knowing how to communicate with others—especially those who are in states of crises—is crucial to helping people in these scenarios because it helps with de-escalation, motivation, and understanding key indicators of broader issues. Plus, like having empathy, it helps patients and their family members trust you so that you can provide adequate care.
- Physical fortitude. All nurses need to be able stay on their feet—and their toes—for long shifts, but a good pair of comfortable nursing clogs are designed to help those working in crisis scenarios. This field puts nurses in the most demanding and busy workplaces, so physical endurance is key.
- Adaptability. One of the many things we learned during the COVID-19 pandemic is that health care systems require extremely flexible and adaptable staff during crisis situations. For example, as many individuals opted out of elective surgery, the demand for critical care nursing grew and nurses had to hop into the chaos wherever they were needed.
- Good judgment. Things move fast in crisis scenarios, and providing successful patient care requires nurses who are able to think critically on their toes, making good decisions along the way. They need to know how to respond and when to bring in additional resources.
- The willingness to support your coworkers. Being a team player is absolutely essential in crisis nursing when things are changing rapidly and there isn’t always enough support. The willingness to dive right in and assist where needed is especially important in situations where you’re brand-new to the environment and your coworkers may not automatically be comfortable leaning on you.
A Rewarding Nursing Niche
You already know that our communities are facing a large, looming nursing shortage, and it’s likely that the shortage will involve a lack of nurses trained in crisis and trauma. For nurses who want to work directly with the community and make a measurable difference in their patients’ lives each day, crisis nursing is a fantastic opportunity!
Every year, February 18 is designated as Critical Care Transport Nurses Day to bring attention to this nursing specialty. Minority Nurse asked Lisa Pruitt, RN, BSN, C-NPT, and a board member of the Air & Surface Transport Nurses Association about her career in this field, what makes her devoted to her work, and how nurses interested in this field can get started on this career path.
Please tell me how you found this nursing specialty and why it appealed to you.
I started my nursing career in the Pediatric Intensive Care Unit (PICU). I knew from the time I was a small child I wanted to be a pediatric nurse. I felt right at home in the setting of critical care. I loved the challenge, the critical thinking, and attention to detail involved. But, most of all the reward of helping these children and their families during quite possibly during the worst times in their lives, is an honor. Some of the nurses I admired most and learned from and aspired to be like, were critical care transport nurses. I was drawn to critical care transport because I wanted to be a part of a team that could give these patients the chance to receive the necessary care they needed. A critical care transport for many of these patients can mean the difference between life and death and to be able to offer that service to a child/family in need is inspiring.
What kind of nursing training did you complete for your current role?
I worked several years in pediatric critical care (PICU) before applying/accepting my first critical care transport position. My training prior to my current role included years of critical care experience in a high acuity PICU and an extensive orientation to pediatric and neonatal transport. This training included several advanced certification classes, simulation, didactic, OR, and other department rotations led by physicians as well as operational, safety, and survival training in each of the three modes of transport (fixed wing, rotor wing, and ambulance).
What makes this nursing path different from other nursing specialties?
The scope of practice and skill set for a critical care transport nurse is much more expansive than other nursing specialties. Being proficient with advanced procedures (endotracheal intubation, central line placement, needle chest decompression), critical thinking and decision making in an autonomous setting is what sets the transport nurse apart from other nursing specialties. We don’t necessarily have a diagnosis when we arrive to transport a patient, and we must rely on our previous experiences and knowledge. We are the eyes and ears for the provider (physician). Ensuring our attention to detail is spot on and anticipating and executing a plan of care is quite different than relying on and carrying out a plan of care already developed (as it is in an inpatient setting).
How do critical care transport nurses adapt to working in such varied environments?
Being adaptable is how I always say critical care nurses “earn their money!” There are no two transport situations ever the same, and often the transport environment can lead to a lot of unplanned situations (unfamiliar diagnosis or illness, unexpected weather, equipment malfunctions, mechanical issues). Contrary to working in a hospital, the transport environment offers less resources—people, hands, equipment, diagnostics, redundancy, etc. Transport nurses are the “MacGyvers” of nursing. You might have a child’s life in your hands, and you and your partner (usually a Paramedic/RT/RN) have to utilize your critical thinking, decision making, and limited resources to adapt to any situation and literally function as a mobile ICU. Often, what we are told en route to a patient is entirely different when we walk through the door and meet our patient, so we have to avoid tunnel vision, change our mind set, and adapt to the new situation we are presented with. This becomes easier as we gain more experiences in our career.
Transport nursing is not black and white; it’s all very gray, and you quickly learn if this career is suited for you!
How has COVID-19 impacted your work?
How hasn’t it?! It seems everything has changed—process, procedures, and (what used to be) routines. The stress and burden of COVID-19 has affected everyone at some level both personally and professionally. That in itself has weighed heavily on many of us. In an already stressful environment, COVID-19 has added another layer of complexity to the mix. With, we are reusing what used to be one-time-use masks. We are making the difficult decisions about whether or not we should or can bring the parent with us. [We ask] where do these patients go? Do we have the right supplies (and what are those?) to protect us, the health care providers, from COVID-19. And what about our own family members who are battling COIVD-19 and/or lost their battle to COVID-19, but we still put ourselves on the front line? How are we caring for ourselves?
Transport nurses are a certain type of person. They tend to carry a lot of weight on their shoulders. So when does that weight cause us to fall? Not for a long time, but when it does, it can be devastating. We are really good at taking care of everyone else, but not ourselves. I have seen the weight/burden/stress of COVID-19 firsthand unfortunately be the cause of that fall. With all this change, I do believe whole heartedly, we will come out of this closer to our partners/colleagues, and be stronger and more resilient. I believe some the processes that have been instituted since COVID-19 will actually continue in our practice, and that’s not necessarily a bad thing! Our infection control practices are on point! And that will continue to benefit all patients and ourselves as health care providers. A lot of good has and will continue to emerge.
What kind of patient interaction tips could you share, especially given the added layer of moving patients from one area to the next?
Communication is key! Making sure our patients and families always know what is going on and what our plan is can offer a patient and/or family the reassurance they need to move forward on possibly the worst day of their life. I also believe strongly (as long as safety is never compromised) that bringing a parent or loved one along on the transport is so important. We can’t ever make promises that an outcome will be what they always want, but I ALWAYS make one promise to every single patient I transport: I will always do my best and I will promise to take care of their baby/child the exact same way I would take care of my own.
If nurses are considering moving into a critical care transport nursing path, what would you like them to know?
Transport nursing is the BEST! When you get jet fuel in your blood, it never goes away! If transport nursing is something one is interested in exploring, then do a ride along. Most transport teams offer a comprehensive ride-along program to potential transport nurses. See firsthand if you could see yourself doing it. It is not a career for everyone, but if it is, then go for it! Establish a strong foundation of critical care nursing experience in an ED or ICU. Take every opportunity to advance your education and skill set. Join professional organizations like ASTNA and network with transport professionals, read transport scholarly articles like those published in the Air Medical Journal, and ask questions. Words of wisdom from my six-year-old daughter London, “Picture it. Do it. Never Give Up.”
A critical part of treating patients is identifying exactly what injuries and ailments they are struggling with. To that end, medical professionals rely on a great many diagnostic tools to help them accurately identify patients’ health conditions. Some of the devices are multipurpose, while others are more targeted—but all are important tools in a clinician’s diagnostic kit. Here are nine essential diagnostic tools that all clinicians in scrubs should have.
No clinician can be without their trusty stethoscope. These devices allow medical professionals to listen to the heart, lungs, and other vital organs, helping them give more accurate diagnoses and better treat patients. There are many different types of stethoscopes available for every budget. If you’re looking for something more technologically advanced, you can also look into getting a Bluetooth stethoscope, which offers capabilities such as audio amplification and recording clips. Bluetooth stethoscopes are an especially good choice for providers who have hearing impairments or loss, and thus struggle to use a traditional stethoscope.
2. Pulse Oximeter
Once an afterthought in some circles, pulse oximeters are now experiencing a time in the spotlight due to the ongoing coronavirus pandemic. (Low oxygen levels are an early warning sign that medical intervention may be needed in COVID-19 patients who otherwise seem to be doing well.) Pulse oximeters measure the percentage of blood hemoglobin carrying oxygen by passing a beam of red light through the fingertip and assessing how much light is absorbed. You should absolutely have one of these diagnostic tools in your nursing bag, especially if you work with patients who are likely to have COVID-19.
Speaking of tools that can be used to diagnose coronavirus, you should definitely have a thermometer on hand as well. There are many different types of thermometers available. The fastest and most accurate is a digital thermometer, which uses a metal probe to take the temperature, which it displays on the digital screen readout. However, infrared “no touch” forehead thermometers are also getting a lot of attention these days, as they cut down on the risk of transmission. Whatever type of thermometer you decide on, make sure that you thoroughly clean it before and after each use, even if it doesn’t actually touch the patient.
4. Reflex Hammer
The humble reflex hammer can be used to diagnose joint reflexes as well as bone fractures in the joint. Go with the classic triangle-head Taylor hammer, or choose from several other designs, such as the Buck and Babinski hammers. Most hammers cost only a few dollars apiece, so there’s really no excuse for not having one among your clinical supplies.
5. Blood Pressure Cuff
Blood oxygen levels aren’t the only thing about the blood that can help you diagnose health conditions. Blood pressure is also an indicator of heart disease and stroke risk. Combined with a stethoscope, a traditional blood pressure cuff will help you measure both the systolic and diastolic blood pressure. Alongside a stethoscope, this is one of those diagnostic tools that you should never be without.
Another affordable yet essential diagnostic tool, penlights are used to assess pupil response and check for injuries such as a concussion. They can also be used in a pinch to look into cavities, such as the ears and throat, though dedicated diagnostic tools are more convenient for that. Most pens come with a pupil gauge on the side to help clinicians quickly assess pupil size. If you tend to lose your penlights, look for one with a clip that will help it stay put.
An ophthalmoscope is a specialized light that allows you to look directly into a patient’s eyes—or rather the back of their eyeballs—which can be used to assess the health of the retina, optic nerve, vasculature, and vitreous humor. This specially designed light lets clinicians examine the eye without blinding the patient. Ophthalmoscopes are often sold in a set with otoscopes. These two devices should not be confused for each other, despite the similar names. Otoscopes should not be used in place of ophthalmoscopes and vice versa, as the eye is a very delicate organ that needs to be examined carefully.
An otoscope is a specialized light that clinicians use to examine the ears and sometimes also the throat. The light is focused using a disposable plastic tip, which also helps protect the light from unsanitary ear wax and other substances. Using an otoscope, clinicians can look directly into the ear to assess the health of the eardrum and ear canal, as well as check for any blockages or injuries. Make sure to change out the disposable tip after each time you use the otoscope to keep yourself and your patients safe.
9. ECG Machines
Historically, ECG machines have been large, clunky and expensive. However, thanks to technological advancements, ECG devices are now shrinking and becoming more portable and affordable. One especially exciting development is the Eko DUO Stethoscope, which combines the benefits of a digital stethoscope with the functionality of an ECG machine. With the DUO, you can listen to your patient’s heart and lungs and then immediately take a reading of their heart’s electrical signals. As technology continues to improve, we will no doubt see more and more accessible devices such as the Eko DUO stethoscope come onto the market for clinicians.
Diagnosing a patient isn’t always easy, but diagnostic tools can help aid the process and give more insights into a patient’s state of health. Whether you’re new to the medical field or a seasoned clinician, you should definitely include these nine diagnostic tools among your clinical supplies.