Never Ignore Your Nurse’s Intuition: One Nurse’s Story

Never Ignore Your Nurse’s Intuition: One Nurse’s Story

There’s no better time than during National Nurses Week to pay attention to the skills nurses have that aren’t acquired in any classroom. Kristi Tanisha Elizee, RN, BSN, and a current master’s degree student focusing on Clinical Nurse Leader (CNL), knows first-hand about the power of a nurse’s intuition.

This past February, Elizee was working the NICU night shift of a Kansas hospital and had been assigned to a mother-baby pair. From the hand-off report with the previous nurse, she had been told, and was able to observe, the baby had head-molding after delivery. Although Elizee noticed the baby’s head looked strange, continued observation revealed only typical behavior. The baby slept, woke, and breastfed well about every three hours.

When she went to perform a head-to-toe assessment of the baby (after notifying the parents), Elizee became alarmed. “When I assessed this baby’s head I could not believe what I felt,” she says. “This baby’s anterior fontanelle was very wide and bulging which extended to her forehead. On top of her head felt soft, the posterior fontanelle was not palpable, and in the same area where the posterior fontanelle was supposed to be, instead the skull was protruding.”

All the baby’s vital signs were good as were the other assessments of the baby, but Elizee knew something was wrong. She also knew she had to trust her intuition. “For me, this was not head-molding,” she says. “I brought the baby back to her mom’s room and immediately went to review the doctor’s documented assessment again on this baby.” Everything appeared to note head-molding, so Elizee, who would need to perform another assessment in four hours began researching information while monitoring the baby and her other patients.

Persistence Works

“I saw a variety of problems including pictures of the way this baby’s head was shaped, and it was called ‘Craniosynostosis,’” she says. According to the Mayo Clinic, “Craniosynostosis (kray-nee-o-sin-os-TOE-sis) is a birth defect in which one or more of the fibrous joints between the bones of [a] baby’s skull (cranial sutures) close prematurely (fuse), before [a] baby’s brain is fully formed. Brain growth continues, giving the head a misshapen appearance.”

Elizee wasn’t sure if what she found was the problem, but she had to speak up. “I was not sure what this baby was diagnosed with but I knew this baby’s head was not normal,” she says. She notified the other nurse on the NICU shift, then her supervisor, and the providing physician was immediately called. The physician initially believed the baby had head-molding as well. “I started to doubt myself again, but I knew deep down this was not normal,” Elizee says. After performing her own assessment, the physician agreed with Elizee. From there, a pediatrician came onboard, and Elizee says she carefully documented everything.

The experience has been simultaneously transformative and heartbreaking. “I have never cared for a baby diagnosed with this condition before so this was my first time,” she says. “The day after when I came back to work, the nurse whom I gave report to about this baby, told me that my assessment findings were right. They had to do a head CT scan and it revealed that this baby had ‘Craniosynostosis.’” The baby was referred to a different hospital, and although Elizee doesn’t know her current story, she’s confident that her persistence made a huge difference in the baby’s life.

“I just had a gut feeling that what I felt was not normal and knew I had to speak up,” says Elizee. Although she doubted herself based on what others were saying, Elizee says she had to honor her intuition. “Nurses just need to follow their instincts,” she says. “Once you know it is not normal or not right, then take action. Do not second guess yourself.”

Big Move for Her Career

Elizee hails from St. Lucia. “I made the decision to move to the U.S.A for growth and development through Avant Healthcare Professionals, an international nurse recruiting agency,” says Elizee, who says she initially considered a career as a veterinarian. “I want to take my nursing career to the next level.”

Oddly enough, Elizee had been considering a switch out of NICU because she was struggling with the role. “When I first started working as an RN new grad, I worked on the medical unit for a month, later I was sent to work in the NICU which I have been in for eight years,” she says. “The first few months being there was tough, and I almost made the decision to go to another unit to work. I was just not enjoying it.” But her NICU nurse-manager noticed and became Elizee’s mentor.

Under her guidance, Elizee says she gained confidence working with these tiny babies—none of whom can tell their caregivers what is bothering them. The experience made all the difference. “NICU is a challenging place to work,” she says now, “but I love the challenge. Every day is a learning experience, and I am embracing it. Now I want to become a neonatal nurse practitioner.”

Charge Nurse Work: What You Need to Know

Charge Nurse Work: What You Need to Know

How to be a charge nurse may not be part of your nursing school curriculum, but it will likely become part of your nursing career, particularly if you are working in a hospital. Generally, it’s a position that appeals to only a few nurses because it comes with a tremendous amount of responsibility, both clinical and logistical.

The charge nurse can be described as the sieve through which all information and people must pass on a given unit. The role may have mild variations depending on the type of unit, but ultimately, the charge nurse oversees the nursing staff, patient bed assignments, and almost anything that affects those two factors. The nurse in charge is the first tier in the “bumping up” process, whether it be a staff grievance, patient complaint, near miss, or sentinel event.

Needless to say, one of the prerequisites is relatively thick skin. However, if you are the sensitive type, acting as charge nurse need not be faced with dread; it can either be the bane of your existence or perhaps simply a valuable exercise in character development.

When a patient is scheduled for admission to the unit, whether immediately or with just several hours’ notice, the charge nurse finds and assigns the patient a bed and a nurse. The process is hardly ever simple. If the unit is full, the charge nurse must find a way to either justify another patient’s discharge or to fight the incoming patient’s admission. One rarely finds a consensus among stakeholders in this situation: the receiving unit of your discharged patient may push back, the incoming patient’s team may hurry you, the staff nurses may argue for changes to their assignment, and the patient’s physicians or families will have their own agenda. Depending on where you work, this may all be happening while you manage your own patient load.

There is good news. The key to success for any charge nurse is awareness, namely awareness of resources. It is absolutely essential that every charge nurse knows the boundaries of his or her scope. That will likely be institution-specific and thus easily accessible. For example, if you are a charge nurse in the OR and two surgeons try to book emergency cases at the same time, it behooves you to know who makes the call of who goes first. (Hint, it’s probably not you.)

Navigating your work within the confines of the boundaries established by your employer will arm you with the tools necessary to find the sweet spot between authority and your peers as a charge nurse. And no matter how pressured the work may feel, you must always take time for a deep breath.

The Road to Resilience: Nurses Week Edition

The Road to Resilience: Nurses Week Edition

Overcoming adversity is a demanding task that requires a great deal of emotional resilience and mental toughness. While many people react to such circumstances with a flood of emotions and a sense of uncertainty, others may choose to adapt positively in response to their life-changing situations and stressful conditions. As a medical-surgical nurse, Jamie Davis, RN, understands the meaning of handling adversity both professionally and personally. In this Q&A interview, Davis discusses the importance of emotional resilience and how rising above adversity ultimately shaped her into the nurse that she is today.

Jamie Davis discussing her road to resilience

Jamie Davis, RN

How did you become a nurse?

In 2006, I attended college in Michigan with a major in cosmetology. I met someone who was working as an LVN at the time who asked if I needed a job. During that moment, I did not have any intention of working in the health care industry. But during the interview however, I was asked, “how would you feel if you were unable to help someone you were caring for?” Surprised by this question, I simply responded, “I would feel horrible, but in the end, I would do everything in my power to assist them and make them feel better as a person.” It was at this moment that ultimately began my journey as a future nurse.

Why did you choose the specialty you currently work in now?

In 2007, I received a distressing phone call from my parents informing me that my brother was admitted into the ICU. After hearing the news, I booked a flight to California and headed straight to the hospital where he was staying at. When I walked into the room, I saw my brother lying lifeless in bed with machines hooked up to him. At that moment, so many memories rushed through my head and I began to have all these endless questions – What am I going to do if he doesn’t come out of this bed? How are we going to move on? How are we going to make it through this? Luckily, my doubts and fears went away when he began to improve so I decided to fly back home.

A few months later around Christmas time however, I received another troubling phone call from my mother telling me that my brother got readmitted again to the ICU but this time with worsening complications. As I rushed to the hospital, I distinctly remember seeing all the tubes hooked up to my brother and the nurses working tirelessly to save him.

Unfortunately, the following morning, I received the phone call that nobody ever wants to hear – my brother has passed away. It was a life changing moment that my family and I will never forget, but ultimately inspired me to become the nurse that I am today.

Therefore, although I currently work on the medical surgical unit, my dream is to one day work in either the ER or ICU settings to one day help those patients who are also in critical need.

How has your brother’s passing impacted the care you give for your patients? 

Although my brother’s passing continues to affect me each and every day, I’ve learned to keep his memory with me every time I come to work and care for my patients. Despite his unexpected death, I’ve learned to understand that being resilient is learning how to not only live with those painful memories but also deal with it in a positive way.

What kind of advice would you give our readers on how to overcome tragedy as a nurse and develop resiliency? 

One piece of advice that I would like to give the readers on how to overcome tragedy as a nurse is understanding that overcoming adversity is a personal journey. It’s okay to grieve from time to time, but it’s also important to take your sadness and create something positive out of it. Because of this, I have learned to become a more vocal advocate for my patients and their loved ones in times of need. By doing this, I am able to honor my brother’s spirit through my work as a nurse.

Do you have any parting words of encouragement for those interested in pursuing a career in nursing? 

To anyone else who may be going through a difficult time, please don’t give up. Regardless of how difficult and emotionally challenging life can seem, personal success all depends on how you choose to deal with your given circumstances. Therefore, I am a living example that no matter what life puts you through, your dreams can become possible if you believe it.

Celebrate National Nurses Week

Celebrate National Nurses Week

The annual celebration of National Nurses Week from May 6-12 highlights and honors the incredible life-saving work nurses do all year round.

As a nurse, this week deserves your attention. There are many ways you can celebrate loudly or ways you can reflect quietly (or both!). Nurses worked hard to get this week recognized—efforts began in 1953 and slowly incorporated a national day of recognition for nurses. In 1993, the week was made official by the American Nurses Association board of directors. It was first officially celebrated in 1994.

The ANA has chosen “4 Million Reasons to Celebrate” as this year’s theme to call attention to the 4 million registered nurses in this country.

Here are a few ideas to keep your feelings of nursing pride going this week:

Revel in the Celebration

This is a big week for nurses around the nation, and it’s a time when you feel solidarity with nurses around the world. Whether or not your organization makes a big occasion out of this week, it’s a good thing to do for yourself. Seek out ways to join in the conversation. Go out to lunch with your colleagues. If you are a manager, order some goodies for your busy staff to have throughout their shifts. Share the week with your family and friends and talk about what your day is like and why you chose nursing.

Check Out What Others Have to Say

Follow Twitter conversations at #NursesWeek. Comment on the Facebook sites of some of the organizations you belong to. Raise awareness as you mark the week. Show your nursing pride and start conversations where you can. Send a letter to the editor about current news relating to nurses—positive or negative.

Learn More

Nurses never stop learning and this week offers additional opportunities to boost your knowledge in recognition of National Nurses Week. Dial into a webinar offered by the American Nurses Association. You can register for Nurses4Us: Elevating the Profession which will be held May 8 at 1 pm EDT. The webinar, which offers one contact hour, includes a Twitter chat, so follow along or add to the conversation at #NursesWeekLive.

Reflect on Your Nursing Career

Take time this week to think about why you chose nursing as a career. What started you on that path and how has your direction changed? Are you happy with the changes or would you like to get something else from your career? What can you continue doing to gain career satisfaction? What else can you do to improve your nursing skills?

Sometimes reflecting deeply about how your career has made a difference in your life and the lives of others is a morale booster that’s needed in a career where you never slow down.

Happy National Nurses Week!

Report Examines Nursing on a Larger Level

Report Examines Nursing on a Larger Level

Nurses have active roles in all aspects of patient care. A new report by the Robert Wood Johnson Foundation shows how nurses are in pivotal roles that allow for current patient care now and can make enormous impact on the future health of the population.

Nurses have active roles in all aspects of patient care. A new report by the Robert Wood Johnson Foundation shows how nurses are in pivotal roles that allow for current patient care now and can make enormous impact on the future health of the population.

Activating Nursing to Address Unmet Need in the 21st Century,” explores the role of nurses and nursing in addressing the complex, multilayered diseases that are brought on by a combination of medical, social, and economic factors.

Calling these the “diseases of despair,” the report notes how nurses are positioned to assess the needs of patients that go beyond their medical status. The report also calls on nursing education to amplify the attention given to theses diseases of despair and give nurses the tools they need to help make broader and more comprehensive assessments of populations.

To ensure a nursing workforce that can address issues that are not in medical training manuals but have as much of an impact on a patient’s current and future well being, the report’s author Patricia Pittman, FAAN, PhD, professor in the Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, states that the nursing profession can begin to look at how nursing intersects with other professions that offer care and treatment.

For conditions around substance abuse, mental health, and obesity-related issues, policies impacting health equity, community health, and specific demographic challenges are essential. And with a growing demand for nurses who represent the populations they serve, a continuing need for diversity within the nursing workforce is an urgent issue.

Examining the varied changes the nursing profession has evolved through, particularly over the last century and a half, Pittman shows how nurses cannot just care for a patient’s health without considering all the other factors that influence the patient.

To do this, the report calls for nursing roles that include time, education, and opportunity to collaborate with other professionals in non-medical areas to help meet these often “unmet” needs that range broadly from healthy behaviors to the physical environment the patient lives in. This kind of innovative approach cares for the patient as an individual and as part of a larger community, thereby influencing a larger population at all levels.

To help move these ideas forward, new tools that help with assessment, implementation, tracking, and additional education need to be developed. With these changes moving forward, the face of nursing can change to bring about even greater health impacts for patients and greater nurse career satisfaction as they see the larger impact they can contribute.

For conditions around substance abuse, mental health, and obesity-related issues, policies impacting health equity, community health, and specific demographic challenges are essential. And with a growing demand for nurses who represent the populations they serve, a continuing need for diversity within the nursing workforce is an urgent issue.

Examining the varied changes the nursing profession has evolved through, particularly over the last century and a half, Pittman shows how nurses cannot just care for a patient’s health without considering all the other factors that influence the patient.

To do this, the report calls for nursing roles that include time, education, and opportunity to collaborate with other professionals in non-medical areas to help meet these often “unmet” needs that range broadly from healthy behaviors to the physical environment the patient lives in. This kind of innovative approach cares for the patient as an individual and as part of a larger community, thereby influencing a larger population at all levels.

To help move these ideas forward, new tools that help with assessment, implementation, tracking, and additional education need to be developed. With these changes moving forward, the face of nursing can change to bring about even greater health impacts for patients and greater nurse career satisfaction as they see the larger impact they can contribute.

A Nurse’s Guide to Understanding Digital Recruitment Trends

A Nurse’s Guide to Understanding Digital Recruitment Trends

 

 

More and more health care organizations are using big data, predictive analysis, and data metrics to streamline the process of recruiting nursing talent. Over one-third of human resources departments rely on analytics to manage staffing, according to the 2017 Deloitte Global Human Capital Trends report. That trend has exploded over the last few years, as organizations lean on technology in earnest. For example, approximately 95% of hospitals use an applicant tracking system (ATS), which is like a gigantic digital filing cabinet full of resumes, according to industry experts.

Big data (or people data) may sound intimidating to nurses who aren’t tech savvy, but the information that they refer to is often quite simple. “Facebook, Google, the U.S. government—even my own tiny website has its own big data,” says Brittney Wilson, BSN, RN, an informatics expert based in Nashville, Tennessee who owns the popular blog The Nerdy Nurse

Big data usually means extremely large data sets, which help reveal patterns and associations, especially relating to human behavior or that look at trends and systems and help make a determination, explains Wilson.

“Data is everywhere and almost all of it is discoverable. I always tell nurses to not post anything online that they wouldn’t put in front of a recruiter when they’re applying for a job. You have to assume that someone is scraping that data and applying it to an algorithm,” she adds.

How Organizations Collect People Dataand What That May Mean for You

In a recruiting context, a nurse’s personal information can be culled from social media profiles, consumer data, and public records, in addition to a hospital’s personnel data or those of a third-party recruiting program vendor. That nurse’s individual data points can then be merged into bigger data sets, so analysts can create algorithms or statistical models that aim to predict which candidates are equipped to succeed in a given role.

For example, automated systems can spit out resumes from applicants in a certain zip code, based on an algorithm set to predict turnover. Perhaps previous employees with that zip code may have been short-timers, due to a grueling driving commute or unreliable mass transit.

Then even if nurses knew why they were getting the cold shoulder from a piece of software, there’s not much they can do about it. Their home address data is out there and available to hospitals, even if they attempted to hide it by using another street address, through a UPS or other office forwarding service, say.

But what if that undesirable zip code is for an area with a large minority population? Recruiters and IT folks are starting to realize how digital “gates,” based on zip code and such, may adversely impact underrepresented populations. The U.S. Equal Employment Opportunity Commission frowns on practices which essentially “profile” applicants and employees.

“We need to attract more racial and ethnic minorities to nursing,” says David Wilkins, chief strategy officer of Woburn, Massachusetts-based HealthcareSource, a provider of talent management systems for hospitals. “We’re thin in labor supply and there’s a high labor demand.” The unemployment rate in health care is so low—RNs at 1.4%, and NPs at 1.1%, according to recent Bureau of Labor Statistics reports. “With such an acute shortage, it’s hard to believe that people are consciously turning away any candidates.” Wilkins wonders if unconscious bias, such as when an applicant has an ethnic sounding name, may be at play.

Crowdsourcing, One Surprising Cyber Trend in Recruiting

Relode is an innovative crowdsource referral platform for health care recruiting. “In 2014, we saw there were lots of inefficiencies in the hiring process and wanted to use software to solve this problem,” says Joe Christopher, chief technology officer at the Brentwood, Tennessee-based firm. “The platform allows our small team to work on thousands of jobs. Health care is profession-centric, so staffing agencies are ultimately working with the company. We’re trying to help you, as a nurse, to take your next step.”

A nurse can sign up on the Relode portal, then work with a talent adviser who will set up a profile and then make a match with an appropriate job opportunity based on the nurse’s experience, skill set, goals, and other desires. “As a new grad, you may have to take what’s available, but if we know you ultimately want to go back to California, we can help. What if we can connect you to this great employer [in another state] who can train you? And then after a year or two, you can go back home to California or wherever. Or you might like it and want to stay longer.”

Relode offers nurses a way to earn side income through its crowdsourcing platform. “Nurses are used to thinking, ‘if I need extra money, I need to work an extra shift.’ But we believe the best nurse knows another best nurse. So as a travel nurse, for instance, you may know nurses in Dallas and Phoenix, and if you connect us and that person gets hired, we pay $3,500 directly into your account,” says Christopher. In fact, one nurse signed up with Relode and referred seven other nurses, earning money for connecting people she already knew to new opportunities, he adds.

Make Sure Your Online Application is Optimized for Search Engines

Human resource experts claim that very little recruiting happens without technology anymore. “Your first point of entry is very likely going to be a piece of software, an applicant tracking system. It has to determine the degree of fit between you and the job. So, make sure your resume is well-structured, clean, and easy to parse for an applicant tracking system,” says Wilkins. “Focus less on making it look pretty, and instead, make it very scannable and readable. The average time someone is going to look at it is six seconds.”

A big part of what applicant tracking systems search for is keywords and phrases. Recruiters may be carrying 100 plus openings at one time so they can’t look at all the resumes for each position. “In order to be seen, yours must be in the top 10 or top 20 ranking,” he says. “You should have multiple resumes to make sure the keywords match. Most of the time organizations tailor job titles and descriptions to a particular opening.”

A Travel Nurse Weighs in on High-Tech, Low-Touch Recruiting

Jake Schubert, RN, BSN, travel nurse and owner of Nursity.com, an online NCLEX prep course, is no stranger to the recruiting process and shares a few key insights.

1. The nurse-recruiter relationship is becoming less and less personal.

I get hundreds of emails from travel nurse recruiters all saying basically the same thing: “would love to work with you… would love to work with you… would love to work with you…” Don’t spam nurses with phone calls and emails. You don’t like it when people do that to you, so why would you do it to them? But if you really want to be effective, stop with the spam and make your message personal. For example, you can go to my Instagram and you’ll see that I love to scuba dive. Then reach out to me there with something personal like, “Hey I noticed you like to dive. We have contracts with three hospitals in Florida that are close to some great dive sites.” But no, they don’t do that. Instead they fall back on the same line: “Let me know when you you’re ready to start traveling with the best recruiting company!” I feel like responding: “Let me know when I’m relevant to you.”

2. Many nurses are naïve about a recruiter’s role and motives.

New graduates and some other nurses may think: “This recruiter is really on my side.”  But they’re not—they’re being paid by their company so that’s where their loyalty lies. They know when you’re not asking for enough money, for instance, but they won’t tell you where you’re leaving money on the table. It’s not like other industries where people are required to disclose a conflict of interest—when real estate brokers represent both sides in a transaction, they’re legally required to disclose their dual agency.

3. Nurses have the power to create better relationships with recruiters.

I’m one of the thousands of nurses working with Kaiser Permanente right now. You go online and create a profile on their portal, and they email you when an appropriate job pops up. But that’s not how all jobs get filled in a hospital. It’s all about relationships. Managers are always asking me “Jake, do you know anyone who’s looking for a job?” Every hospital is looking for good nurses, and nurses who have good communication skills are hard to find. If I had one piece of advice for new graduates, it’s “Don’t text a recruiter, and don’t think of email as a long text. Email is an online version of a letter, so don’t leave out the niceties.” When you communicate fully, you show that you’re different and that you have professional communication skills.

So, for instance, if you were applying for a job as a dialysis nurse, Wilkins would advise the use of a preponderance of keywords related to that specialty. “Of course, use the word ‘dialysis,’ but also all the words alongside it and related terms and synonyms.

Dialysis in an elder-care, or long-term care setting, is different than working with general patients at an outpatient dialysis care clinic. Use senior care words, long-term care versus outpatient care words. The care job is probably the same but the stuff on the edges is different.”

Wilkins offers a final caveat regarding online application systems, which sounds basic, but could torpedo your candidacy if ignored. “The average completion for an online application is around 15%, which means 85% of online applications are never completed. While in some cases, this is because a candidate changes their mind mid-process, most of the time it’s just because the process is long and complex,” he explains. “But the really scary data is that 15% of people think they’ve actually fully submitted their application when they really haven’t. Sometimes they just miss the ‘submit’ button at the end. Go back and make sure you completed all the steps.”

Nurses shouldn’t forget to update their own employer’s human resource portal—it makes it easier for the department (or a hiring manager) to identify internal candidates. When there’s a job requisition for an assistant nurse manager with a master’s degree and a set of relevant experience, for instance, a recruiter can look through the hospital’s internal database of qualified nurses before posting the job publicly.

How to Protect Your Online Privacy When Job Searching

“We need to educate nurses that when you put your resume out there on any career site—upload it to CareerBuilder, Monster, Indeed—you’re selling access to that resume,” warns Christopher. An applicant may upload a resume and forget about it, but when they get an email or call from a recruiter, wonder: “How did they get my number?!” When you trace it back, almost always it was that uploaded resume and the terms of service that allow recruiters to contact you.

There are workarounds though, that will protect your privacy without hampering your job search. “Lots of people are able to set up an email address specifically for this use—you’d check it once a day if you’re in the job market, or once a week if you’re not,” says Christopher. “Sometimes the systems also require a phone number. You may be able to set up a Google voice number or use another solution like that.”

When using online job engines and portals, be aware that there are games that some unscrupulous recruiters play, says Christopher. For instance, “a staffing agency that does lots of work with nurses may put up a job listing for an opening that doesn’t exist” at the moment. That gives them a running start for handling hard-to-fill roles, “so that when an employer asks for an ICU nurse, say, they already have 10 nurses that have applied for that. Indeed will no longer host agency jobs, the listing has to be from the employer,” because of recruiter abuses. “Even now Indeed offers applicants a way to filter jobs—there’s an employer of record option.”

Present Your Best Cyber Self to Snag a Job

Nurses and talent recruiters are both figuring out the new communications etiquette, with some stumbles along the way. “I get text messages from recruiters pretty frequently. I was shocked the first time because they contacted me on a very non-professional manner, in my opinion,” says Regina Callion, RN, MSN, travel nurse and owner of ReMar Review, an NCLEX review program.

“Greetings will be skipped, and it will pretty much say ‘Make 10,000 dollars in a month! Sign up today for xyz.’ The lack of formality and information provided is a turnoff.”

That anti-text sentiment is common, even among some Millennial, digital native nurses. “My cell number is the last bastion of privacy for me,” Wilson says. “I don’t want to get a text from a recruiter without my consent. It feels like you entered my living room and sat on the couch and don’t even know who I am.”

But recruiters say that reaching out to nurses in the traditional way isn’t efficient, so they have to employ new channels. “Our team has found that texting is a really great way to communicate for nurses. They’re busy and so instead of leaving a message and waiting for a call back, a text is a brief but direct conversation,” says Christopher. “Obviously, you have to know who the person is and agree to it, but texting is a really efficient way for us to say: ‘Here’s a great opportunity that meets three out of four of your criteria. Do you want to talk about it?’ Or if there’s a simple question from an employer, we can get a quick answer: ‘Are you licensed in California? I know you graduated from school there but …’”

The nurse-recruiter dance requires sensitivity and cooperation from each partner. Recruiters do a service for nurses, exposing them to opportunities they might not otherwise discover and fast-tracking their applications through the hiring process. Nurses can help recruiters by making themselves easier to find and by being open to approach. “It takes a lot of energy to look for a job, and it’s a lot like dating—when you’re not looking, that’s when you’re most desirable,” explains Wilson. “My job before this one was with a startup who found me because I’d SEO’d [search engine optimization, or the process of affecting the visibility of a web page] my profile online so well… I always tell people—take a phone call. You never know.”