Setting Boundaries as a Nurse Working with COVID Patients

Setting Boundaries as a Nurse Working with COVID Patients

When you were in nursing school, your professors and your mentors undoubtedly warned you about the hard times. They said you’d be tested. They told you there would be times when you wanted to quit, times when you just didn’t think you had the strength to go on.

But no one could have prepared you for the test that is COVID-19. In your worst dreams, you never could have seen this coming.

Now it’s here, though. And you’re slogging through one day, one hour, sometimes one minute at a time. But with infection rates surging, there doesn’t seem to be an end in sight, at least not anytime soon.

If you’re going to make it, then you’re going to have to take care of you. And that begins by setting boundaries, even with your precious COVID patients and their families.

Claiming Your Right to Self-Care

As a nurse, it probably feels only natural to put other people first. It’s what you do every working day of your life, after all. And that habit likely doesn’t change when you’re off the clock.

That’s not a healthy or sustainable way to live in the best of circumstances. Lack of self-care, especially as a result of overwork, can take a devastating toll not only on your physical health but also on your mental and emotional health. It’s also debilitating to your relationships, those emotional support systems that keep you strong in body, mind, and spirit.

One of the greatest risks, of course, is that the demands placed on you as a pandemic nurse is that you might easily lapse into work addiction. You might find yourself unwilling, or even unable, to leave your work behind you when you come home. You might feel as if the only “right” or “noble” thing to do is to work yourself beyond all reason, giving yourself wholly to your work, supposedly for the sake of your patients but, really, for the sake of your addiction.

But whether you are simply facing extreme overwork, or you are falling into a full-fledged work addiction, as a nurse in the age of coronavirus, failure to practice self-care by nurturing your mental health isn’t just hurtful, it’s downright destructive. Right now, you are bearing physical, mental, and emotional burdens that you never thought possible.

Recognizing the signs that you are struggling and you need help is neither weakness nor selfishness. It means valuing yourself as much as you value those under your care. It means allowing yourself the right to the same kind of love and care that you give your patients. It means taking care of yourself so that you can take care of them.

But How?

You’ve probably been taking care of others for so long that you’ve forgotten how to prioritize your own needs. You might never have learned how to protect your well-being by setting boundaries. When you have boundaries, you’re going to have more emotional energy and a stronger sense of agency and power, something that this pandemic has taken from far too many of us.

Setting boundaries, though, is not rocket science and it doesn’t have to be hard. You can start simply, by ensuring that when you’re off the clock, you’re actually off the clock. That means that when you get home, you need to turn off all the COVID coverage and you need to let yourself be taken care of for a while.

If you’ve been working with COVID patients, unfortunately, you’re probably not going to be comfortable being physically close to your family and loved ones. But you can still let them nurture you from a distance. Get your kids to make dinner and do the laundry. Have your spouse draw you a warm bath and turn your bathroom into the perfect spa retreat.

Above all, make it clear that no pandemic talk is allowed unless and until you want and are ready to share. And that also means resisting the urge to constantly check on your patients. For the sake of your physical and mental health, when you are off duty, you must do your utmost to get away from thoughts of the virus and to nurture yourself, instead, with the things that you love in the best way you can.

Get Out(side)

Setting boundaries as a COVID nurse means standing up for your right to take time away. Scheduling a weekend getaway to the outdoors is good for your physical health, reducing your stress, and boosting your immunity. But it’s also ideal for your mental health, helping you to rest and decompress, to calm your mind and regroup.

Studies show that spending time in nature can help nurses build resiliency and avoid burnout. And there’s never been a greater need for that than right now.

Seeking Help

No one needs to tell you that the pandemic is one of the worst health crises in modern history. You’ve been on the frontlines for months now. You know the score. And because you know the score, you also know that this crisis isn’t something you can, or should, handle alone.

If you are 65 or older and have Medicare, you likely qualify for mental health care coverage. And if you’re covered under your employer, then mental health benefits are also likely included in your group insurance plan. On the other hand, if you’re uninsured or your plan doesn’t include mental health benefits, you can still reach out for free or low-cost care in your community.

The Takeaway

Nurses are superheroes and the world knows it now more than ever. But even superheroes need caring for. And that begins, above all, with recognizing your right to self-nurturing and setting the boundaries you need to ensure that the one who cares for everyone else finally gets the TLC she or he deserves.

4 Reasons Why There Is a High Demand For Psychiatric Nurse Practitioners

4 Reasons Why There Is a High Demand For Psychiatric Nurse Practitioners

Nursing is a versatile profession that offers many options to build your career. There are many variables to consider when choosing a path and committing to it—one of them being demand. This is especially true for nurses who want to advance their careers by becoming a psychiatric nurse practitioner.

Nurse practitioners possess a higher level of autonomy and a larger scope of care than registered nurses. This position also has additional educational requirements and training certifications for qualification. Simply put, becoming a nurse practitioner requires time and resources—something that not all people are willing to give if they feel uncertain about the demands for this particular role.

The fact is, there is currently a high demand for nurse practitioners in the mental health industry. Let’s take a closer look at the factors that have contributed to this demand and clear up any misconceptions about future employment outlook.

Factors That Have Led to High Demand for Psychiatric Nurse Practitioners

1.    More Accessible Mental Health Care

The biggest factor being looked into is the impact of the Patient Protection and Affordable Care Act (PPACA of 2010), making mental health care more accessible for millions of Americans. Since its signing, there has been a significant rise in patients who received quality health care covered by the reform. In the upcoming 2020 presidential elections, many presidential hopefuls have presented new platforms to extend the Affordable Care Act’s health care coverage. Other candidates are also looking to provide more health care options for people under the age of 65. Regardless of who will succeed in the campaign, we can expect an increased demand for health care providers, including psychiatric nurse practitioners.

2.    Mental Health Awareness

Mainstream media also contributed to the rise in demand and future projections for this career. The media’s action of raising awareness about mental health and tackling issues about depression and suicide has contributed to the de-stigmatization of mental illness among the masses. Thanks to these efforts of disseminating content about mental health issues, many people view mental health more seriously and treat it as something that needs to be addressed.

3.    PTSD Treatment for Veterans

Another factor that led to this increase in demand is soldiers returning from Iraq and Afghanistan that need mental health care. Many of these modern-day heroes suffer from the effects of the war, such as PTSD, and require support.

4.    Caring for Aging Baby Boomers

The aging baby boomer populace is another issue that is being taken into consideration for this projected rise. All health care roles are expecting a significant increase in demand within the coming years due to a large number of boomers entering the ages of 50-60. Due to advancements in health care and their active lifestyles, the majority of this generation is expected to live longer. As medical care aims to address all aspects of health, there is an expected growth in mental health services for the elderly, as more and more people are currently placing importance on mental health.

5.    Forecasted Demand

Due to these factors, the U.S. Bureau of Labor Statistics projected a 28% increase in the demand for nurse practitioners along with nurse anesthetists and nurse midwives. The employment rate for these jobs is expected to grow to 31% by 2024, notably faster than the average growth rate of other professions.

In preparation for this forecasted demand, many organizations and institutions are currently offering more educational opportunities for this specialty. From traditional academic education to online programs, there are many options to fit different individual needs. Aspiring psychiatric nurse practitioners should take a look at the list of offered PNP programs before choosing a suitable learning curriculum.

In 2016, the American Association of Nurse Practitioners reported that 11,988 out of more than 222,000 licensed nurse practitioners are specialized in mental health. This number is just a small percentage of all the nurse practitioners registered in the U.S. Considering there are also opportunities for this career outside the U.S., the psychiatric nursing field is already experiencing this projected increase in demand.

Despite the ongoing COVID-19 pandemic, there haven’t been any new announcements that there would be a change of trajectory for the demand for psychiatric nurses. The World Health Organization has reported a lack of 6 million nurses worldwide before the pandemic hit the world. This report compels governments in all countries to invest in accelerating nursing education.

This urgent need for more nurses is also addressed to nurse specializations such as psychiatric nurses, which further supports the fact that the forecasted demand for psychiatric nurse practitioners will stay its projected course through the coming years. Aspiring psychiatric nurse practitioners can remain optimistic about this career’s future possibilities, even during this global pandemic.

Thinking of a Career Move? Here’s How to Stand Out

Thinking of a Career Move? Here’s How to Stand Out

When you’re thinking of a career move, you know your success depends on more than an impressive resume. Standing out from a crowd of highly qualified nurses takes a combination of professional skills, personality match, networking contacts, and knowing how to promote your best qualifications and qualities.

Minority Nurse recently caught up with Marisa Streelman DNP, RN, CMSRN, and director of the Academy of Medical Surgical Nurses (AMSN) to find out how nurses can emerge as front runners when they’re applying for a new role and seeking the best career move.

Q: When a nurse is thinking about starting a job search, what are the top three areas of a job history to really focus on?

A: When nurses are thinking about a job search there would be a different approach to job history depending on where they are in their career.

New graduate nurses would need to focus on their clinical experiences and highlight the skills they improved upon, location of their clinical, number of hours spent with direct patient care, and if they took a full patient assignment, specifically during their final clinical experiences.

For experienced nurses, the job history they would want to highlight would be dependent on the job they are seeking. I would recommend including areas that match the job they are seeking, as well as leadership roles, clinical or patient awards, quality improvement projects, and committees they have been a part of in their most recent roles.

For both the new graduate and the experienced nurse, highlighting any volunteer nursing work is also valuable, as it could resonate with the hiring manager and make the individual stand out from the other candidates.


Q: What are some of the qualities and skills recruiters or hiring managers notice and want to see in a job candidate?

A: Hiring managers today are looking for job candidates who can discuss—and have participated in—quality improvement projects either in school or in their most recent positions. A nurse candidate who understands nursing quality indicators, such as Central Line Associated Blood Stream Infections (CLABSI), Fall Prevention, or Catheter Associated Urinary Tract Infections (CAUTI), and the evidence-based practice which is needed to improve patient outcomes, would be valuable to a hiring manager.

Leadership skills, precepting other nurses, teamwork, and being on a unit or hospital-wide committee are also valuable for a hiring manager. Many hands-on skills in nursing can be taught, some of the softer skills in nursing such as having a positive attitude, a good bedside manner, and working well within a team, are what hiring managers would be looking for during the interview process.


Q: How can nurses translate those good qualities and skills in a job search so they can stand out?

A: It can be hard to stand out in a job search, especially for new graduate positions. Adding bullet points or a cover letter to describe their nursing skills and attributes in a narrative form can help the hiring manager get a better sense if they would be a good fit for the position. It is important to always list the place they worked or completed clinical, their role, and time they were there—either years or clinical hours.

Many times new graduate candidates stood out to me with listing their non-nursing experience as well as their clinical information. For example, if someone managed in a restaurant, that tells me she is a leader, can multi-task, and probably has good customer service skills.

As I mentioned earlier, adding volunteer experiences can also make a candidate stand out to a hiring manager, even if it is not all nursing-related. This lets the hiring manager know a little more about the candidates and their skills for the position.


Q: What are the best ways nurses can leverage all the job hunting tools at their disposal—LinkedIn, Indeed, job boards, networking, etc.—and how can they do that to get the best results for a good career move?

A: There are so many different sites and job hunting tools out there to use it can be very daunting to nurses starting their job search. Being a part of a professional nursing organization, like the Academy of Medical Surgical Nurses (AMSN), is one way to narrow the search to areas which you are familiar, or you are looking to go into, and can network with other nurses within the organization.

Many professional organizations have career centers and resources that provide current openings from around the country, as well as networking areas on their websites so nurses can ask questions of other members. AMSN has an entire web section devoted to med-surg specific career development.

LinkedIn and Indeed can be a quick way to find positions and alerts can be set up when new jobs post. AMSN and several of our partner nursing associations recently worked with on a new nursing-specific part of their site.

I have found the best way to apply for nursing positions is to apply directly to positions on companies’ websites, and follow up with the nurse recruiter via phone. Also, referrals from friends, co-workers, or classmates are helpful to hiring managers.  As a manager, nurses would refer someone they used to work with or a friend, and I would always complete an interview with them. Sometimes they worked out, and sometimes they didn’t, but referrals are one way to get your resume looked at by a hiring manager.

Another way to check out an organization is to attend a career fair, which many organizations have. These are a great way to talk directly to nursing recruiters and hiring managers. At times they complete an interview on the spot.


Q: How is the job search process for a career move changing right now and what do job seekers need to know to help them?

A: The major way the job search process is changing would be the number of positions in nursing may be lower than usual due to the coronavirus and the financial impact healthcare systems are experiencing currently and throughout the last five to six months. Some areas of the country are working on recovery while others are now dealing with a new surge of cases.

Candidates may need to widen their view of what they are looking for as the “perfect” job might not be available in this current environment. Certain units within organizations are so consumed by caring for COVID-19 positive patients they do not have time to respond to inquiries or interview requests, while others are actively hiring to fill vacancies, and still others are on a hiring freeze.

As a candidate, research is needed to understand how the pandemic is impacting their local area or the place they are looking for a new position. Another item to consider would be that many career fairs are now virtual. Candidates will need to have access to technology to attend and if selected for an interview, it might be virtual as well.


Home Health in the Time of COVID-19

Home Health in the Time of COVID-19

The office is closed. The door is locked. If you need supplies, you make a request by email 24 hours in advance. Text when you get there and the supplies will be placed outside the door. Maybe by elves.

I’m in my car. The air conditioner is blowing. I’ve been waiting for 20 minutes for my bag of hand sanitizer, chucks, gloves, masks, gowns, booties, and various dressings and accouterments of wound care. My next case is across town and I’m not getting paid to sit around.

Across the parking lot is Regional Medical Center’s Emergency Room. They’ve closed the waiting room and put up tents in the parking lot with chairs placed well away from each other. I watch as people drive up to be tested for COVID-19 or to unload someone needing emergency care. A tech in full PPE walks out and waives a thermometer across the forehead…OK, next station. Such is medicine in the age of COVID-19.

My first “official” case of COVID-19 is a man in his early 60s. He shuffles to the door with a walker. His skin is hanging off of him in folds. He looks like one of those dogs with droopy flaps around his face. He got sick in February, a construction worker with a cold before we really got the news of a brewing pandemic. Three months he lived on a ventilator.  He points proudly to his tracheostomy scar. “It couldn’t kill me,” he says.

I say “official” because you never really know who may be contagious since so many people show no symptoms. I’m standing outside the door of his house at 2 pm on a hot California day wearing a yellow gown, a mask, face shield, blue gloves, and blue knee high paper boots that are making my feet itch like crazy. Sweat is dripping down my forehead onto my glasses and I can barely see a thing. Sweat is also dripping down my back and arms. I think my gloves are full of sweat. I should have drank more water.

He lets me into the house. There is no air conditioning. The windows are all open. The living room and dining room have been stripped bare for remodeling. There are boards piled up, things in boxes, a new floor. It’s going to be nice. He’s staying with his daughter while he recovers and he’s anxious to get back home but still too debilitated to take more than a few steps.

The home health start of care evaluation is 29 pages long—29 sweaty, hot pages. We are sitting on those cheap folding camp chairs. The only other furniture is a small fish tank on the mantle that needs water.  The pump is sucking air and making a sound like a jet engine. I rock the fish tank gently back and forth and get enough water to the pump that it starts working quietly again. He looks at me. The fish look at me. I sweat. I hope he’s not noticing the growing splatter marks on his new hardwood floors.

What should take 40 minutes takes 90 minutes. Each step of the way I’m double checking what the patient has touched. Did I give him this pen or that pen? I clean the BP cuff twice. Next time I’ll just leave it there. He’s not even shedding virus any more. He’s recovered. Not exactly spry, but he definitely has the air of a man who escaped the tiger’s den. He doesn’t even need oxygen. He’s a lucky dude. I tell him to buy a lottery ticket. One for me too. He laughs.

I ask him who is in the house and I document each person I come in contact with and what PPE I was wearing. It’s a new policy at our company. We document every person and what we were wearing. Let’s face it, sooner or later, one of us is going to come up positive and it will be the unpleasant job of someone in the office to call all of our recent contacts. I can hardly imagine how that conversation goes.

“You know the nurse that came to visit you? We are calling all of the people that she visited because she has COVID-19 and we want to ask you to get tested yourself and self isolate for 14 days.  Also everyone in the household and everyone they’ve come in contact with. Have a nice day.” I pray to God I’m not that one.

So I check everything twice, three times. My next patient is even sicker…and older. I can’t be the dark angel of death. I sanitize my hands again. I stagger out the front door and take off all the gear. Sweat is literally pouring off of me and off the inside of the slick yellow gown. My shoes are soaked. I take a moment to red-bag my PPE and wipe down the outside of my ditty-bag. I have an hour of paperwork to do on this guy. I have to call his doctor and get a verbal order for start of care. I have to drink a lot of water…I mean right now because my vision is getting grey around the edges. The blessed blessed AC is blowing cold in the car. Thank God for small favors.

This is the new normal. Everyone has to make changes. I don’t understand the resistance to wearing a mask that some people have. For some reason, someone in the highest office has decided that wearing a mask makes you liberal. The virus makes no such distinction. I don’t understand how wearing a mask to protect the people around you has any political significance at all. But there you have it—the new normal. Stay safe out there.

A Career of Choices: Where Will You Live?

A Career of Choices: Where Will You Live?

It’s a great time to be a nurse. Especially with the COVID-19 pandemic and as the global population continues to swell, improving public health is paramount. Health care professionals, especially nurses, are essential to helping people establish and maintain healthy lives. Thus, nursing professionals are in high demand. Job growth within the industry is expected at least through 2028, reports the Bureau of Labor Statistics (BLS), at a rate that’s much higher than average.

At its core, nursing is a fulfilling job where you can truly make a difference. But the perks of a nursing career don’t end with humanitarianism. Nursing opportunities essentially span the globe, giving you free rein to comfortably live wherever you want, from dynamic cities to suburban enclaves or rural communities where the pace of life is slower.

So where will you live? It’s in your best interest to find somewhere that you enjoy, and where you can envision building a life over the long-term. In fact, your health may count on it.

Cultivating Happiness at Home and on the Job

Every place we have ever lived has left some kind of an impression on us. Many of those places spark joy and fuel happy memories, aptly illustrating the connection between mood, emotions and place. As a healthcare professional, you may be aware of the ways in which where you live affects your happiness. And where your personal happiness is concerned, it all comes down to well-being: According to NPR, well-being is associated with “longer life expectancy and better health outcomes.” The place we call home has the power to diminish or boost our well-being

Most of us have heard the old cliché, “home is where the heart is.” Or how about “there’s no place like home?” Your hometown and its traditions are the building blocks of your personal identity, influencing everything from your choice of sports team to favorite recreational activities. What’s more, cultivating a sense of place helps us build our identity as we grow older, and make decisions that impact our career.

No matter how much you love the place you call home, however, changes in your work or life situations can lead to a geographical change as well. Sometimes, we outgrow a place, a company, or a once-beloved position and want to start afresh. And figuring out where shouldn’t be done lightly. Start by asking yourself what you want in a city while also looking for employment opportunities that reflect your values. Conducting research into the top states and cities for career growth, including Seattle and Austin, may help you narrow down your choices.

And with a nursing degree, you can broaden your search well beyond jobs in the U.S. Across the world, 6 million more nurses are needed to help fill demand and meet global health targets. The nursing shortage is more prevalent in low- and middle-income countries, the World Economic Forum reports.

Taking the International Leap

Nursing provides plenty of opportunities for adventurous spirits to satiate their wanderlust, in the U.S. and beyond. For many, the international nursing experience is life-changing, broadening your worldview as you build essential skills. Further, nurses with a job history that spans continents may have a leg up when it’s time for a career change.

Employers in the health care industry appreciate a diverse background in their candidates, as well as the ability to quickly adapt to changing environments. Alongside the U.S. and its territories, some of the best countries for nursing include Italy, Canada, and Luxembourg.

International nursing is a great choice for those who are passionate about the humanitarian side of health care. Some international workers may care for refugees or marginalized populations, for example, such as those aboard Africa Mercy, a hospital ship. It’s important to note that international nursing jobs aren’t always paid positions, but volunteer experience in the health care trenches can be an invaluable tool in furthering your education and career.

Reflecting on Your Career Choices

Just as there are different types of nurses, there exists a seemingly endless array of places in which you can practice your craft. Your chosen career field is a guide towards the place that you can call home — For instance, Nurse Practitioners (NPs) may end up working with marginalized populations in a primary care provider (PCP) capacity. Registered Nurses (RNs), on the other hand, primarily work in hospital settings, so city life may be in the cards.

Your nursing career provides boundless gifts. For starters, you can truly make a difference in the world, helping improve quality of life at both the individual and community levels. But nurses also enjoy the freedom to choose where to live, and that gift shouldn’t be taken lightly.

Whether you’re kicking off your nursing career or entering a new field of nursing, it may be the perfect time to upgrade your location as well. You may find that a change of scenery does wonders for your personal well-being, allowing you to thrive like never before.

Nursing Assistants Provide Care and Comfort

Nursing Assistants Provide Care and Comfort

Nursing assistants (NA) have been essential members on healthcare teams throughout the COVID-19 crisis. And while the pandemic continues to spread around the world, National Nursing Assistants Day on June 18 is timed to thank nursing assistants for the care they provide.

For 43 years, the National Network of Career Nursing Assistants has sponsored an entire week to celebrate those who choose this career. This year, that week runs from June 18 to 25 and is being marked as “Celebrate in Place” as many events have moved away from in-person formats.

According to Genevieve Gipson, RN, Med, RNC, and director of the National Network of Career Nursing Assistants, the theme for the week is kindness. NAs are encouraged to focus on a different aspect of kindness throughout the week and focus on events and projects that can continue to have an impact over the course of the year.

The National Association of Health Care Assistants seeks to elevate and promote the professional NA career . Working on teams and with other healthcare providers delivers more consistent and better patient care and nursing assistants are part of the team.

Nursing assistants and certified nursing assistants perform the routine patient care that often allows opportunities to talk with patients and learn more about them. Whether a patient is in a long-term care facility and sees a nursing assistant almost daily or in a short-term hospital stay and only has brief interactions, NAs and CNAs can make an enormous impact on the patient’s general care. By getting to know a patient and listening to them, nursing assistants can pick up on subtle physical or emotional changes or on preferences that could help fine tune such necessities as a preferred meal plan or understand family relationships.

NAs work under the supervision of registered professional nurses and perform duties that can range from basic patient care including bathing, feeding, toileting, grooming, dressing, and answering patient calls for help. They are generally responsible for things that help keep patients comfortable such as changing linens or checking bandages.

NAs can increase their training and competency with certification. Each state determines its own certification requirements, so plan to look into this additional step in whichever state you plan to practice. The extra certification can take a couple of months to complete, but offers additional skills that will be used every day.

The impact of NA-provided patient care can’t be understated. Because of their close interaction, they often help patients who are lonely and can comfort those who may need companionship. During the COVID-19 crisis, many facilities restricted visitors and so healthcare teams were the only people many patients could see for months. Having a friendly person to talk with calms nerves, staves off loneliness, and provides a much-needed human connection.

Celebrate National Nursing Assistants Day and National Nursing Assistants Week and be proud of the much appreciated care you provide.