After successfully completing your nurse practitioner education and passing your certification exam, you’ve finally been granted an interview to work for a prestigious organization in your desired specialty.
The last thing that stands in your way, however, is the dreaded interview.
As a newly minted DNP (Doctor of Nursing Practice) graduate and psychiatric-mental health nurse practitioner, I understand that the days leading up to an interview can evoke a plethora of emotions ranging from excitement to nervousness.
Luckily for you, I have compiled a list of six steps that may be helpful in preparing you for your first Nurse Practitioner interview.
1. Update your Resume or Curriculum Vitae (CV)
One of the things that many new grad nurse practitioners tend to neglect in their professional development is ensuring that their resume or curriculum vitae (CV) is updated consistently.
When you don’t take the time to update your resume regularly, it becomes very difficult to precisely remember notable achievements or projects that you may have already completed.
Therefore, having an updated resume or CV is extremely important because it demonstrates your commitment in showcasing your experience and accomplishments as accurately as possible to your future potential employer.
2. Do your Research
Just like studying for an exam to get a good grade, doing your research is also good practice prior to participating in an interview.
What is the mission and vision of the company that you’re applying for? What are their core values, and do they align with yours? What are the goals and purpose of the company?
These are all critical questions that you must ask yourself, and more importantly be comfortable answering prior to your interview date.
The more you know about a company and what they stand for, the easier it is for you to determine if it’s truly the right fit for you and your professional aspirations.
3. Dress for Success
Studies have long demonstrated that people make a judgment based on their first impression of you within the first seven seconds of interaction. This means that whether you’re on a job interview, at a business meeting, or attending a networking event, you have just a few seconds to make a good first impression and establish yourself as the successful person you strive to be.
Dressing for success means not only dressing well but also understanding the subtle messages you’re conveying based on your overall appearance.
Dressing well is crucial to the interview process because wearing the right clothes can ultimately make a strong visual statement on how you view yourself and the world around you.
4. Be your Authentic Self
Channeling your authenticity is a trait that many organizations and companies look for when interviewing potential candidates.
Being authentic is not just about what you think or say but also what you do and how you choose to function in the outside world.
As you interview, use this opportunity to really let your personality shine and don’t be afraid to be yourself. In the end, the most successful people are those who can tolerate and absorb criticism, admit their faults, and be accepting of others because they are not threatened by the fear of failure.
5. Ask Questions
When interviewing for a position, it’s important to remember to not be afraid and ask questions.
Asking questions is vital because it not only demonstrates your interest in the position but also your willingness to excel in the role that you’re applying for.
Keep in mind that the best questions to ask are focused, open-ended questions that provide greater insight into the company’s day-to-day operations as well as their culture.
6. Say “Thank You”
Lastly, once the interview is done, it is important to show your gratitude by sending a thoughtful email or thank you card.
Writing a thank you message is a great way to differentiate yourself from other candidates because it demonstrates your willingness to go the extra mile to show your appreciation for the time the interviewer spent with you.
Writing a good thank you note can be pivotal in demonstrating not only the caliber of your work but also the characteristics you may claim to have, such as: attention to detail, ability to communicate effectively, and professionalism.
It is also important to note that employers tend to view thank you notes as a visual representation of who you are as a potential employee.
Therefore, prior to sending a thank you note, take the time to reread it thoroughly to ensure that it is professional and uses proper spelling, grammar, and syntax.
According to a recently released report, nursing salaries has remained fairly steady, but the wider averages in pay depend on where the nurse works.
The Medscape RN/LPN Compensation Report, 2019, collected information from the 7,145 nurses (5,143 RNs and 2,002 LPNs) who responded to the online survey over an 11-week period this summer. The nurses were asked questions about their earnings, workplaces, and general hours (about 75 percent worked full-time as opposed to part-time or per diem) for 2018.
The compensation report found that RN earnings averaged $80,000 (down from $81,000 in 2017) while LPN earnings rose from $46,000 to $48,000 over the same period. Employees who are paid with an annual nurse’s salary earn more than those who are paid an hourly rate. Salaried RNs report earnings that average $83,000 vs. hourly RNs who make $78,000. A salaried LPN reports an average annual pay of $53,000 compared to the hourly earnings of $47,000.
Without specific explanation, the report says it’s difficult to determine the root cause of the nearly flat earnings, especially for RNs over the past three years of surveys. Because the results are the average, meaning some nurses make more and some make less, the flat levels could reflect higher paid experienced nurses retiring or it could be a result of stagnant wages for nurses.
Despite all those fluctuations in nursing salaries, it is the type of workplace that drives the higher wages. Traditionally, the report states, RNs in hospital settings earn the largest salaries ($83,000) and nurses who work in non-profits or in school settings earn the lowest salaries ($65,000).
On the higher end of the earning spectrum are nurses in industry settings (insurance or health plans), an occupational health setting, a hospital-based outpatient clinic, a home health or visiting nurse position, or an academic faculty role all earn an average of at least $80,000.
RNs in hospice or palliative care, in non-hospital medical or urgent care, in a skilled nursing facility, or in a public health setting earn somewhere between $72-80,000. For LPNs, working in a skilled nursing facility brought in an average full-time nurse’s salary of $51,000 as compared to the lower earnings of an LPN in a school or college setting who earned an average of $36,000.
One finding that repeats yearly is the distinct gender pay gap that persists in nursing salaries. Male RNs report earning an average of $3,000 more than their female counterparts while a male LPN reports earning an average of $4,000 more than female LPNs. The report points to variations in how men and women work—with more men reporting working overtime, working on inpatient units, working high differential shifts, and working paid weekend or evening hours—that could account for the higher earnings.
As expected, the greater the education level, the higher the earnings with nurses with a doctoral degree reporting average earnings of $94,000 vs. $75,000 for an associate’s degree level. And, as with many industries, workers with more years of experience, with professional certification, and in higher-paying regions will earn more.
The Medscape report, like Minority Nurse’s annual salary reports, offers points for nurses to think about when choosing a location to live, when considering getting additional education, or when thinking about what type of facility matches their interests and can support their cost of living.
This week’s observance of National Orthopaedic Nurses Week from October 28 through November 1 calls attention to the work of nurses who care for patients with problems related to their muscles and joints.
Sponsored by the National Association of Orthopaedic Nurses (NAON), the week salutes nurses who work in this field and change the lives of their patients every day. Orthopaedic nurses specialize in treating patients with musculoskeletal problems and all the associated tasks with their treatment.
Because of the wide range of issues that come with musculoskeletal development and use, these nurses may work with patients of all ages.
Orthopaedic nurses may treat patients with any of the following conditions:
- Sports injuries
- Pediatric disorders such as osteogenesis imperfecta
- Broken or fractured bones
- Carpal tunnel syndrome
- Back pain and injury
- Strain and resulting inflammation around tendons and joints
Nurses may diagnose and treat patients with immediate injuries in hospital or emergency department settings. They might also work with a rehabilitation or physical therapy facility to help patients regain their strength, flexibility, and full range of motion. They may work with patients who need various castings to keep bones in place and will help them manage getting around or coping with the casting restrictions.
Every nurse is an essential source of information and for someone who has a mobility-limiting injury or condition, the education provided by nurses can be a true lifesaver. Patients will learn from their nurses about how to control and manage any pain, how to prevent further injury, and what to expect during different stages of healing. If a patient has had any surgery, for example a hip replacement, they will help with plans for how to care for themselves during the healing process and progress through a faster recovery. They will even learn about how to cope with an itchy cast or gain real-life tips for soothing arthritis flare-ups.
As with virtually any nursing specialty, professionals in this nursing path are encouraged to obtain certification through the Orthopaedic Nurses Certification Board. Certification keeps your knowledge and skills current so you’re able to take your experiences, combine it with the latest evidence-based practices, and give your patients the best possible care. Nurses may also continue their quest for lifelong learning with recertification, so even nurses who have obtained this credential can continue to learn more.
Seeing direct patient progress is one of the best parts of being an orthopaedic nurse. It’s especially gratifying to see a patient progress from a badly broken bone to a strong recovery. Helping a patient with a condition that causes painful joints, tendons, and muscles find exercises and treatments that can reduce pain is extremely rewarding.
If you’re an orthopaedic nurse, celebrate with your colleagues this week. Spread the word about what you do so people understand the broad scope of this nursing path—this kind of visibility helps elevate the nursing profession. If you are a nurse leader in your team, continue to offer mentorship to new nurses or those wondering if this career path would match their career goals.
Many nurses are pursuing advanced education. Expanding knowledge is always a good thing—for them, for their employers, for their patients, and for their careers. But what happens if you’re going back to school while you’re also working full-time and raising a family? Perhaps it’s challenging, but it’s definitely doable. These nurses have done it and have tips to help you do it too.
When Catherine Burger, BSN, MSOL, RN, NEA-BC, was asked by her employer to return to school to earn her bachelor’s degree in order to remain in an executive leadership position, you might say that it wasn’t the perfect time. “I was working over 60 hours per week as a nursing leader for a complicated department; we had five kids at home—all with multiple sports and commitments—ranging in age from 1 to 17 years old,” recalls Burger, a media specialist and contributor for www.registerednursing.org. “There is no perfect time to start back to college.”
But Burger and many others made it work, and you can too.
Do Your Homework Before You’re Doing Your Homework
Before you jump right into a program to earn another degree, Simendea Clark, DNP, RN, president of Chamberlain University’s Chicago campus, says that you need to do some homework. “If you’re thinking about going back to school, do your homework first. Everyone has a different set of circumstances, so it’s crucial to research programs and schools that best fit your needs. Many schools offer online modalities that allow you to take some or all of your coursework from the comfort of your home, saving you travel time to and from school,” says Clark.
Be sure that the educational program you select is something that you love—not just something that will bring in the bucks. “The key for those who want to advance their education is to make sure it is something that drives your passion for nursing,” says Adam Kless, MSN, MBA, RN, NEA-BC, vice president of clinical operations for Avant Healthcare Professionals. “Selecting an educational path for mere money will leave one hollow and disappointed in the long run.”
If it will help you, see if you can spread out your coursework. “I chose to take two classes per semester, including the summers. That helped me stay full-time in the graduate program,” says Valerie C. Sauda, PhD, MSN, RN-BC, MGSF, an assistant professor at Husson University’s School of Nursing. “Although it lengthened my study a little, it definitely helped me maintain the work/life balance. I also feel that I learned the material more thoroughly and was more engaged in the classroom and online group activities. A shorter program may not always be best for learning and life. Enjoy the journey!”
Tell Your Family and Your Boss
Now you’ve found the perfect program for you. What’s next? Your best bet is to tell the people closest to you: your family and your boss.
Your family probably already knew that you were looking into an advanced degree, but if they didn’t, be sure to tell them. You may need their support and the best way of getting this is to be honest and transparent. “Have conversations with the key stakeholders in your life—your current boss, your spouse, and your children. Creating ways for them to give you critical feedback in the moment can save a lot of heartache later. When you are under a lot of stress, it can be difficult to maintain a good communication feedback loop,” says Melissa McClung, MS, LPC, a professional career advisor and owner of LBD Careers, LLC. “Setting this up in advance can preserve your important relationships when there are inevitable conflicts.”
There are many reasons why it’s crucial to tell your boss. “Getting your boss involved will allow you to successfully incorporate your education into your work life by scheduling around class, providing you extra learning opportunities while at work, or benefit from finding a mentor at work who is already doing what you desire to do,” says Kless.
“At the outset, you may need to negotiate with your employer for some flexibility with your work schedule,” explains Divina Grossman, PhD, RN, APRN, FAAN, president and chief academic officer at the University of St. Augustine for Health Sciences. “Solicit the support of your supervisor or mentor at work so that you can have more flexibility in your schedule so you can prioritize your classes, clinicals, or to write papers and projects.”
Grossman says that when you tell your boss, you may also be able to streamline your schoolwork by having “your course requirements, such as term papers or special projects, be about topics or issues that you are dealing with at work. This way, you are not only meeting the requirements for your advanced degree, but also are resolving issues in the work setting through your research and projects. Your supervisor will be thrilled to know that you are doing research-based practical work that advances them and you.”
Plan Your Schedule, But Be Flexible
When Sauda was earning her PhD in nursing/education, she planned daily, weekly, and monthly schedules. “I prioritized time for family, time for work, and time for myself, while ensuring that I blocked out time for study and research during the school year. I had to ‘give up’ a few things, including binge-watching TV, checking my social media multiple times a day, and participating in nursing groups as a volunteer,” she says. “Creating and sticking to a daily schedule is crucial for success in an advanced degree program.”
Terri Bogue, MSN, RN, PCNS-BC, a consultant to hospitals and health care through her company, Thor Projects, LLC, planned her time as well when she returned to school. “I scheduled time to study after family dinner and on weekends. I knew that my degree would open doors and opportunities that would benefit my family as well as myself. This knowledge helped me to keep focused on my goal,” she says.
“It’s also helpful to set reminders for assignments and tests on your phone’s calendar as soon as you learn about them. Review your calendar at the beginning of each week and mark down pockets of time when you will study and do the same for spending time with your family,” says Clark.
Besides having a schedule, it’s also important to be flexible. Because, let’s face it, life happens. “The most important thing to remember about balance is that it is constantly about reevaluating and making changes,” says McClung. “I suggest developing a systematic way to check in with your priorities to ensure that you are prepared to flex when you need to. For example, this can be as simple as using a planner and scheduling out time for the important things: work and school obviously, but also family time, meal planning and preparation, exercise, and household chores.”
Have Some Space
Setting up a particular area in your home can help when it comes to doing your schoolwork. “Create a study space that helps you focus. For me, it was one corner of our dining room where I had a small bookcase for my textbooks, all the study materials I needed, and good computer access,” says Sauda. “I also set up a corner in my office at work to house my short assignment work that I could complete during breaks. Whatever you decide, do what works for you and make it a pleasant experience. You’ll accomplish more in the available time that you have.”
Bogue says that she would also set aside both time and a consistent place in her room to study. That helped her to balance it all.
“It is important to have a quiet place to study and complete coursework. A private, dedicated space will allow you to get work done, free from distractions. It is also important to get an early start on assignments, give yourself extra time to complete tasks, and seek help if needed,” says Clark.
Ask for Support
All our sources say that having a support network is crucial when you work and are going back to school. Your network can be family, friends, or even colleagues.
“Surrounding myself with people who were not in the program, but who cared and encouraged me either in person or via email, made all the difference—especially when I went through those difficult courses or when I felt like I couldn’t do it all. It’s the network that made a huge difference,” says Sauda.
Grossman takes it one step further. “You cannot be all things to all people. If you are usually the designated parent for carpool, can your spouse or a friend or neighbor help you out? I learned as a parent that if I can involve other parents in a way that we can help each other, both of us can be successful,” she says. “For example, I can do the morning pick-ups, and they can do the afternoons so that I could attend my classes and do my writing. If I am in charge of cooking meals at home, can I cook in bulk on weekends and freeze the meals or can my spouse help with the cooking?”
If you still need more help, Grossman says, think about hiring someone occasionally to clean or get your kids to help so that your work is reduced.
“Keep your lines of communication open to ask for help when needed and to keep instructors, your boss, and your family informed of any last-minute changes in schedule or areas where you need help,” recommends Clark.
Don’t limit your network to just family, friends, and coworkers. “I was scared when I took my first doctoral class. I had been out of school for over 15 years, and I was afraid that I couldn’t do the work. What I learned quickly was to ask for help, use the learning resources available online and at the campus, and develop a relationship with the faculty. As a faculty member myself, I can tell you that faculty want to help you reach your advanced education goals. They want you to be successful. Asking for help can really make a difference,” says Sauda. “One of my best experiences was in doing a literature search for a paper. I was not getting the articles that I needed to complete the paper, so I finally reached out to the university librarian. Within an hour, I had more than 20 articles that I was able to look at with her support. Not only did it save me time, but I learned the value of a librarian and library services when doing my research.”
Be Good to Yourself
To balance work, school, and life, self-care is essential. “Be patient and compassionate with yourself—this is hard work,” says Bogue.
McClung says that you have to make sure that the other areas of your life are good. To succeed, you have to make sure that you also take care of your health, relationships, and anything else that is important to you.
“Eat well, exercise by taking a walk before or after completing an assignment or after dinner with your family, and make sure to get proper rest,” advises Clark.
Grossman adds that, if you’re a parent, you keep tabs on any guilt feelings—and be easy on yourself. “Do not feel guilty about not being there when you can’t be and having your spouse or relative take over for you. This period is time-limited—not forever,” she says. “When my daughter ran track and field, they knew I could not be there for all the meets, but I could be present for some of them. I could do more on weekends than during the week because of my work and graduate school schedule.”
Totally Worth It
While this time may be difficult, it will also be memorable and fun. “The most important strategy for success is our attitude. Give yourself time to adjust to your new role as a graduate student. Like anything new, you will get the hang of it in time. Above all, make the most out of it, and enjoy the experience,” says Grossman.
Clark says to stay focused on both short- and long-term goals. “Be patient with yourself as you ease into becoming a student again.”
“The challenge and personal growth that came with pursuing an advanced degree helped me find my focus for future research and teaching,” says Sauda. “Always remember that the journey to advanced degrees is worth it!”
You may have heard the term moral injury more frequently these days than ever before. Between the TEDx talks, the YouTube rants, and the LinkedIn articles, moral injury is being compared to post-traumatic stress disorder (PTSD) symptoms and is heading to replace one of our favorite words in the nursing world: burnout. However, there is a growing movement that believes that moral injury is the root-cause of burnout and PTSD. In other words, if burnout or emotional exhaustion is organ failure, moral injury is sepsis.
In the August 2018 issue of STAT News, Dr. Simon Talbot and Dr. Wendy Dean associated the term moral injury as the true cause of burnout; the cynicism, emotional or physical exhaustion, and diminished productivity that can be prevalent in many health care organizations. However, burnout implies that the clinician is not resilient enough to manage the components of the job, or perhaps is not participating in enough hot-yoga-self-care practice, whereas the actual root cause of the emotional discord is moral injury.
Historically, moral injury is associated with military personnel who have witnessed, participated in, or failed to prevent transgressions against humanity or acted contrary to “deeply held moral beliefs and expectations” according to a study published in 2009 in Clinical Psychology Review. While civilian clinicians in the U.S. are not necessarily bearing witness to the horrors of war, they are attempting to provide care, compassion, and healing in health systems that are broken and, oftentimes, focused on compensation rather than the patient or clinicians.
The slope of document-for-maximum-reimbursement vs. document-the-excellent-care-provided is slippery. The fact is, health care is a business. To take it one step further, given the publicly reported information on patient satisfaction scores, readmission rates, infection rates – not to mention social media – health care is a commodity and patients can trade their provider with the click of a mouse. Organizations simply must maximize revenues from the ever-changing world of insurance coverages to keep the doors open, let alone to fund strategic initiatives to make improvements or plan for growth.
Clinicians find themselves in the middle of the battle between care and compensation. For example, when a patient presents with a wound and, after they are seen and treated, the nurse knows the patient cannot afford the appropriate dressings, but the organization does not allow staff to offer long-term supplies (brown-bagging). Or a patient who needs an expensive biologic medicine that the clinician knows is the best on the market for the diagnosis yet is required to order the cheaper medication that is on formulary. These betrayals to the calling of medicine to provide excellent care in and of themselves are not impactful. But numerous and repeated injuries to the morality of health care takes a toll.
Cases of moral injury occur at all levels of the health care organization. While working as a Certified Nursing Assistant (CNA), Doug McGann experienced emotional exhaustion. “I felt very undervalued in my role as a nursing assistant. I knew that I worked hard and provided compassionate care, but the organization really didn’t do anything to recognize the role. In fact, when they removed tasks from the assistants, like measuring and recording vital signs, it felt insulting. We were providing less support to the team when most of us wanted to contribute more. Eventually, I left the role as it became too mundane and repetitive and went to nursing school.”
How do clinicians guard themselves against moral injury? What can organizations do to combat the insult? The answers are still being hypothesized and churned by many articles in the health care space. One answer could be to encourage clinicians to embrace nurturing practices such as meditation and other stress-relieving activities while acknowledging that self-care means something different to each person. But a “Code Lavender” approach to increasing stress is not always that simple, and once again puts the onus on the clinician to improve their coping mechanisms.
What needs to improve are the institutional patterns that perpetrate the moral injuries. Organizations need to reduce the competing demands on health care workers and strive to treat each discipline with the respect it deserves so that providers can practice at the top of their scope. Institutions should provide, advertise, and encourage employees to utilize employee health services that include a behavioral medicine practitioner for debriefing and centering. Also, there is strong data emerging related to the effects of supportive, competent, and empathetic leadership on reducing the effects of moral injury.
By changing the language and mindset of how we approach burnout to address the root of the issue, the business of health care can move away from moral injury and into a place of mutual respect, acknowledgement, and empowerment towards all levels of the medical team.
I just returned from a leadership seminar in Jamaica, which was held at a luxurious resort. The thoughts of gaining leadership knowledge and skills, while on a beautiful island was exciting. Day three of my trip was devoted to community service. It was a satisfying feeling to be able to give back to others. We had the opportunity to visit a primary (basic school), a middle school, and a hospital.
Upon arriving at the schools they were surrounded by large gates. As we drove through the entrance we saw children in uniform and they were carrying their chairs from one building to the next. Despite the condition of the school, which had no air conditioning, no chalkboard, and no visible books, the children were excited to see us. The look on their faces was priceless when we gave them gifts of pens, pencils, markers, crayons, and books. They were very eager to learn about CPR and we had mini-manikins for them to practice on. Talking with many of the kids, their dreams and aspirations were amazing. Many want to be soldiers, police officers, lawyers, beauty technicians, chefs, and a scientist, just to name a few. Even though these children did not have the luxuries that most schools in the USA have, they were still enthusiastic to learn and very respectful to the teachers.
The hospital was another experience, which was very eye-opening, tear-jerking, and gut-wrenching. Although health care is free, the condition of the hospital and lack of supplies was deplorable. Again, just as at the schools, despite the poor conditions the medical staff were very pleasant, had smiles on their faces, and were very engaged in their work. We visited the pediatric unit where there were 45 patients, which normally holds 32 with only three nurses. They did not have IV poles or monitors, things that we take for granted in our health care facilities. The staff does the best that they can with what they have and they welcomed the medical supplies that we were able to donate. Seeing the other areas of the hospital, such as the laundry and central supply was very shocking; without staff there you would not know that you were at a hospital.
I think that every U.S. citizen should be required to visit a third-world country to see the conditions that people have to live and work under. They would see how blessed we are in the United States, even though we have some poor areas here. Driving down the streets of Jamaica there were multiple unfinished buildings, trash, and junk along the road. We saw a car that had caught on fire and was completely burned and charred, the firefighters were there with a hose, but the water trickled out like it was a home garden hose.
This experience was very educational, informative, and enlightening. It made me think of how thankful I am for what I have. My goal is to stop striving for material things and gain more rewarding experiences. Every U.S. citizen needs to reflect before complaining and be thankful for what they have. Be happy with the little that you have. There are people with nothing that still manage to smile. This also reminds me of a quote from Victory Today:
While you complain about your electric bill,
there’s someone with no home.
While you complain about your job,
there’s someone praying for a dollar.
While you complain about the food in your pantry,
there’s someone praying for crumbs.
While you complain about life,
there’s someone who didn’t wake up today.
Your complaints are simply blessings to others.
Be grateful and thankful every day!