The National Institute of Nursing Research has given the University of Alabama at Birmingham (UAB) a four-year, $1.3 million grant to study how parents should encourage responsible self-care in adolescents with chronic illnesses such as diabetes.
“This is the first study of its kind to look at the development and self-care of adolescents with insulin-dependant diabetes in relation to family interactions and to follow these families for an extended period of time,” says Carol Dashiff, PhD, professor and chair of nursing graduate studies at UAB.
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The study will include 274 adolescents, ages 11 to 15, with Type 1 insulin-dependent diabetes. The disease, which affects approximately 1.2 million children in the U.S., requires daily injections of insulin. “If not properly managed, it can lead to serious health problems and can be life threatening,” Dashiff says. “The demands of daily monitoring are stressful for adolescents and parents.”
The study will include a group of African-American teens with Type 1 diabetes. “This is significant because African Americans are often not well represented in studies done in this area,” Dashiff states. “It’s important because what fosters responsible independence and self-care among black teens may be different than among white adolescents, so we will be looking at cultural differences and what impact they have on adolescents’ development.”
During home visits researchers will evaluate how teens and their parents discuss and resolve typical adolescent-related issues and diabetes management issues. “This will help us identify some characteristics of families that help facilitate responsible independence and self-care,” Dashiff says. “It will provide us with insight into parents’ and adolescents’ perspectives, how they differ and how these differences may affect development of independence and self-care.”
As a result of the study, researchers hope to develop programs and material to help parents foster their children’s independence in diabetes control. “Parents of chronically ill children often ask for guidance in making decisions about how much independence to give their adolescents and in what areas,” Dashiff says. “This study will help us develop those guidelines.”
When you earn a nursing degree — an ADN, BSN, MSN, or beyond — you signal to the world that you’re a professional who values education and advancing your career. Consistently reaching for increased expertise is a goal for individuals working in almost any discipline, and nurses are no exception.
Beyond your formal education, you have other opportunities to expand your knowledge, and certifications are one such avenue for demonstrating dedication to having the most up-to-date, evidence-based information possible in your area of nursing practice.
Why Get Certified?
If you haven’t yet pursued nursing certifications, now may be the time to consider the possibility. Certification can serve many purposes, each of which holds value for you and your career.
Validated commitment to mastery: Your potential capacity to grasp the subtleties of your chosen nursing specialty is limitless. There’s no end to how much you can learn by digging deeper and deeper into the nuances of a particular branch of nursing and the clinical judgment that comes with it. Many certification processes are no walk in the park, and if you want validation of being the best you can be, certification can accomplish that goal.
Enrich your marketability and earning potential: In the job market, you need every advantage to stand out from the crowd. Certification shows a potential employer that you’re serious about your career and have gone above and beyond. Being certified could be the thing that gets your resume noticed. You may also enjoy increased earning potential.
Augment your sense of pride and empowerment: Some nurses rest on their laurels, others keep learning, and your accomplishments say a lot about your ambition to be the best you can be. As you gain knowledge, skill, and expertise, you can be proud of who you’ve become, and having those extra letters after your name is something you earned by going the extra mile.
Other benefits of certification include the respect of your colleagues and the benefits experienced by patients in the care they receive.
Popular Certifications
There’s an enormous and growing list of certifications available to nurses. Remember that to sit for certification exams, you’ll need to have logged a certain amount of clinical experience in that specialty, so research is essential.
Here are a few popular certifications for your consideration:
Pediatric Advanced Life Support (PALS) can be attained through the American Heart Association, the Red Cross, and several other organizations.
Certified Emergency Nurse (CEN)is available through the Board of Certification for Emergency Nursing (BCEN). Two years of emergency experience is recommended but not required.
Critical Care (CCRN) from the American Association of Critical Care Nurses (AACN) is geared towards those working as intensive care and critical care nurses. There are specific clinical hour requirements in direct critical patient care before sitting for the exam: 1,750 hours during the previous two years, with 875 of those hours in the most recent year, or 2,000 hours in the last five years, with 144 of those hours in the most recent year.
Oncology Certified Nurse (OCN) requires a minimum of 2,000 hours of adult oncology nursing practice (clinical, administration, education, research, or consultation) in the previous four years, two years of experience as an RN, and 10 hours of continuing education in oncology in the last three years.
Certified Diabetes Care and Education Specialist (CDCES) is a specialization that gives the successful applicant the tools to work with patients facing the challenges of life with diabetes. Applicants must have two years of RN experience, at least 1,000 hours providing diabetes care and education in the previous five years, with 20% of those hours in the most recent year.
At this point, it’s important to note that all areas of advanced nursing practice (family nurse practitioner, pediatric nurse practitioner, adult-gerontological nurse practitioner) are considered specialty certifications, and NPs trained in one area of practice can take an exam and receive post-graduate certification in another advanced practice discipline at their discretion.
Since many certifications require significant experience in the designated specialty to sit for the exam, some employers will support and pay their nurses to become certified once they have sufficient experience. Certain employers may even make pursuing certification within a set period a part of your contract.
Of course, paying for your certification and recertification is a significant benefit, although paying for the process yourself wouldn’t be the end of the world. Nothing stops you from getting the certification if you want to demonstrate your commitment and sharpen your expertise. Train yourself in the interest of your professional development and career.
The nursing certifications list is long, and you can decide what makes sense for you. The validation of your expertise that certification confers is real, as is the increased marketability. Certification is a powerful avenue to accomplishing that goal if you take pride in your nursing specialty and want to take your knowledge and skill as far as you can.
Are you the tech-savvy nurse on the unit? Do your colleagues seek you out with questions about the quirks of your electronic health record (EHR)? If so, consider turning that know-how into a career in nursing informatics.
A background at the bedside is critical for a successful nursing informatics role. “There’s typically some kind of clinical experience involved before jumping into an informatics role,” said Christy St. John, MSN, RN, NI-BC, CPHQ, president of the American Nursing Informatics Association (ANIA), in an interview. “To come straight from your studies into informatics is fairly rare.”
A combination of clinical nursing experience and education in informatics is essential, according to Melinda L. Jenkins, PhD, FNP, associate professor and director, nursing informatics specialty, Rutgers School of Nursing. Experience with patient care in the clinical setting is essential to the nursing informatics role because this role is the connection between the clinical setting and the technology piece of healthcare, says Lori Martone-Roberts, DNP, RN, CHSE, director of simulation and professor of the practice of nursing, Wheaton College.
Although training and hands-on experience with technology is important, Michael Mickan, chief nursing informatics officer at Memorial Hermann Health System, looks for experience using the tools on hand and a natural curiosity that leads to self-teaching. He feels that a nurse with that kind of informal experience is usually more successful as a nurse informaticist than those who wait to be formally trained before exploring a new technology.
Range of Skills
You’ll need to bring many skills to a nursing informatics role. Mickan outlines a variety of abilities:
Communications: Nurse informaticists must be able to provide “translation” of patient care, and clinician needs to technology partners as well as technology concepts and requirements to clinical users and communicate with various disciplines.
Problem-solving: Informaticists must be able to identify the real problem with astute observation and critical thinking encompassing people, processes, and technology.
Change management: Nurse informaticists must understand change management strategies and be comfortable facilitating, guiding, and managing change.
Project management: Often, a nurse informaticist facilitates collaboration between clinical and technology partners to solve problems and support the optimal use of technology. To do this effectively, proficiency in project management is a must.
Data analytics: Nurse informaticists must have a solid grasp of the data that validates the problems to be solved and provides the baseline for measuring progress.
Day-to-Day Projects
What kind of work will you do on a daily basis? An example, notes Martone-Roberts, could be to evaluate workflows or improve usability and streamline processes, leading to improved functioning and efficient data capture.
She notes that nurses in the nursing informatics role will work with EHRs in various ways, including managing information and troubleshooting issues when healthcare professionals use the system. Other projects involve training, validating, and reporting data and ensuring the collected data is useful.
She suggests that one example of a project could involve using chatbots to keep a patient engaged and decrease re-hospitalization. Similarly, Mickan outlines workflow analysis and optimization projects, working with clinical decision support systems and EHR implementation and optimization.
Growing Field
When it comes to future demand for nursing informaticists, “I see it as a growing sector,” says St. John.
“I think sometimes it’s a matter of being a little bit more broad in the way we think about nursing informatics,” she notes. Instead of simply searching for the term on a job site, a job search can be more about “opening my eyes to things that might include AI, analyst, or health informatics roles. I think nurse informatics roles will be more in demand in the bigger picture of health technology.”
Education and Certification
According to Martone-Roberts, you’ll need an RN and BSN to serve in a nursing informatics role. Also, she says, a nurse with a master’s degree in healthcare informatics, nursing informatics, or data management will be better positioned to succeed.
Although one of the more technical roles in nursing, nursing informatics still has patient care as the end goal. “At the end of the day, what we’re after is better outcomes for the populations that we’re serving, whether that’s in the inpatient setting, whether that’s in an ambulatory setting, whether that’s in our communities,” says St. John.
In the vast and varied landscape of healthcare careers, long-term care is sometimes overlooked. However, this sector, which provides sustained assistance to individuals with chronic illnesses or disabilities, offers a unique and rewarding path for nurses.
The field challenges nurses’ medical expertise and calls on their deepest reserves of empathy and understanding. Clinicians who choose this path will find it as rewarding as it is demanding.
What is Long-term Care?
Long-term care (LTC) refers to a range of services to meet a person’s health or personal care needs for an extended period. These services help people live as independently and safely as possible when they can’t perform everyday activities on their own.
This care can be delivered through:
Home-based care: Having nurses or therapists visit patients in their homes is suitable for patients who prefer to receive care in a familiar environment or for those who find it challenging to travel to healthcare facilities. Home care is different from home health.
Community services (adult day care centers): Community-based facilities that provide care and activities for older adults, typically during daytime hours. They are for older adults requiring supervision and social interaction but not round-the-clock care.
Assisted living: Residential communities that offer a balance of independence and support. Residents are usually seniors who require assistance with activities of daily living but not intensive medical care.
Memory care: Specialized residential communities for those with memory problems who require intensive, specialized care.
Skilled nursing communities: Also known as skilled nursing facilities, these provide comprehensive, 24/7 medical care for individuals with complex healthcare needs. Residents often have chronic conditions, disabilities, or advanced age or diverse demographics, requiring nursing care and medical supervision.
What it takes to work in LTC
Clinical skills for long-term care nurses encompass a broad range of abilities and competencies tailored to the unique needs of elderly and chronically ill patients in long-term care facilities. These skills are essential for providing comprehensive care, promoting residents’ quality of life, and ensuring their safety and well-being.
LTC nurses must possess specific skills to care for residents with complex, long-term health needs. Here’s what’s typically required:
Clinical Skills
Patient assessment and monitoring
Medication Management
Chronic condition management
Disease-specific knowledge
Fall prevention and mobility assistance
Infection control
Dementia care
End-of-life care
Communication and interpersonal skills
Effective communication
Active listening
Cultural sensitivity
Conflict resolution
Empathy and compassion
Team collaboration
Respect for privacy and dignity
Organizational Skills
Time management
Record keeping
Multitasking
EHR knowledge and competency
Rewards and Challenges
LTC jobs can be gratifying, offering the chance to forge meaningful relationships and make a tangible difference in patients’ lives. However, they also present unique emotional and physical challenges that require resilience, empathy, and a strong commitment to patient care. Understanding this is crucial for anyone considering this field.
Rewards
Meaningful relationships: One of the most rewarding aspects is the opportunity to develop deep, meaningful relationships with patients over time.
Making a difference: Significantly improving patients’ quality of life is deeply satisfying.
Professional growth: LTC offers diverse learning opportunities and the opportunity to broaden clinical knowledge and skills.
Team collaboration: LTC often involves being part of a multidisciplinary team, offering collaboration and learning opportunities from peers in various specialties.
Job stability: The demand for LTC care is steadily increasing, providing job security. According to the U.S. Bureau of Labor Statistics, the employment of home health aides is projected to grow more than 20% year over year. Similar projections are seen for other LTC professions like nurse aides and licensed practical nurses.
Challenges
Emotional demands: Dealing with patients who have chronic illnesses or who are in the last stages of their lives can be emotionally challenging. It requires managing personal emotions while providing compassionate care.
Physical strain: The job can be physically demanding, involving long hours assisting with patient mobility and other tasks.
Complex care needs: LTC patients often have complex medical and personal care needs, requiring meticulous attention and patience.
Dealing with loss: Handling patient loss can be emotionally taxing for caregivers.
Burnout risk: Due to the high demands of the job, there’s a risk of clinician burnout, making self-care and stress management important.
Navigating family dynamics: Working closely with patients’ families can be challenging, especially when navigating complex emotional situations or communicating about sensitive health issues.
How much do LTC jobs pay?
The average annual salaries for LTC clinicians range from $32,110 for personal care aides to $92,080 for occupational therapists, as shown in the table below. Demand is projected to grow rapidly, driven by the aging population and increasing need for LTC services.
Long-term Nurse Salary Range
*Source: U.S. Bureau of Labor Statistics. These approximate figures vary based on location, experience, and long-term care facility.
The strong demand for LTC jobs and the diverse range of career paths available make it a promising field for those seeking a stable and rewarding career.
Daily Life of LTC Nurses
The daily life of nurses in long-term care is varied and centered around providing comprehensive care to their patients. Their day typically involves a mix of medical and personal care tasks. This includes administering medications, monitoring vital signs, and responding to patient health changes. They also document patient care, update records, and plan care with other team members.
Beyond these clinical responsibilities, nurses engage in meaningful interactions with patients, offering emotional support and ensuring their comfort. They also communicate regularly with families, providing updates about their loved one’s care.
LTC jobs offer diverse work-hour options, catering to various lifestyles and preferences.
LTC nursing offers job security in various settings and the opportunity to develop meaningful relationships with patients and their families while delivering care.
The critical care transport nursing specialty offers variations of work settings so nurses can work in settings including air transport, ground transport, and military transport. Critical care ground transport nurse Casey Green, BSN, RN, CCRN-CMC, CTRN, CFRN, CEN, TCRN, CPEN, CNRN, NRP says the skills and approach to nursing care in this specialty appeals to her.
“I really enjoy the autonomy of nursing care in the emergency department and the intensive care units, and transport nursing is a combination of using both skill sets to assess, monitor, and treat patients safely,” she says.
Because critical care transport nurses work in ambulances, helicopters, or on ships, they are often the nurses who reach remote areas, trauma situations on roadways, and work in areas that are unfamiliar. They could transport one patient to a hospital or be part of team that needs to transport many people out of an area. The challenge appeals to Green. “I like the variety of patients and just how complex their care is,” she says.
As with any nursing situation, things can change quickly and nurses have to be ready. But transport nursing poses additional challenges including vehicles, weather, and terrain. Green says that transport nurses need to be aware of any potential situation. “To prepare myself for this line of work, I took a lot of courses in patient care for all patient populations, especially those who are critically ill,” she says. “Each shift I work I refresh myself on equipment, medication, or a patient population that we may have not transported recently just to keep the information fresh in case we have a request during my shift.”
Nurses who are interested in this specialty should enjoy the physical challenges, fine tune their critical thinking, and have an ability to read and react to a situation immediately. “Two of my biggest takeaways are to develop strong assessment skills because they help guide your intuition if something feels or seems off during transport,” says Green.
As with other nursing career paths, transport nurses don’t operate in a vacuum even though their work is done outside of a typical hospital or health care facility setting. “Teamwork needs to be at the forefront of your mind when you step on a transport vehicle,” Green says. “Often, your team is all you have between hospitals, and all levels of patient care have a say in patient care during transport.”
Critical care transport nursing is an exciting career path, and Green says if a nurse is interested in pursuing it, preparation is key. “Get experience in the ICU and the ED and apply,” she says. “Don’t worry that you may not have what an employer is looking for; get your experience and develop strong critical thinking and assessment skills.”
