It is an unprecedented time in the lives of nurses working in hospitals worldwide. Nurses face evolving obstacles on a daily basis. They must contend, as always, with complications that include last-minute shift cancellations, extended work hours, continuing education needs, and other established practical considerations. At the same time, COVID-19 illnesses have brought a host of historic challenges for those in the profession.
Consequentially, it is easy to lose sight of nursing’s essence: it stands as one of the most dynamic, stimulating, fulfilling, and important career-choices in 2020; nursing means taking part in a noble pursuit dedicated to healing the sick and providing a personal touch to the vulnerable. If you are considering joining the ranks of hospital nurses, you can hold on to that ethos even as you focus energy toward dealing with day-to-day working challenges. By taking the following actions you will thrive in the field.
Practice What You Preach
Projections show that nursing employment should increase at a faster rate than the combined average of other professions. If you are employed where supply does not yet meet demand, you may face long shifts with large patient loads. Combine this scenario with a job profile that includes your continually facing the unexpected, and you will see that you have to take care of yourself around the clock.
Practicing good sleep hygiene may be one of your greatest challenges, yet you need to make this a priority. Sleep deprivation is a leading cause of working errors and job burnout. Unfortunately, when you experience multiple nights of reduced slumber you build sleep debt, a condition that compounds mental and physical fatigue.
You must also pay attention to your nutritional needs. The job’s unpredictability means that finding the time to eat well can be unpredictable too. As a health professional, you are aware of what constitutes a good diet, particularly for you. While you may not be able to sit down to a relaxing lunch or dinner, you can prepare good snacks ahead of time that you grab throughout the day. Also, you may find you have gone a whole shift without drinking. Pack a water bottle, since hydration is important.
Dress the Part and Fit in the Fitness
Working in a hospital, you will find yourself on your feet far more than behind a desk, and some of your duties will involve moving and lifting patients and equipment. You must work to prevent injury and wear to your body.
While you may not be able to choose your uniform top and pants, you can wear the most comfortable shoes for your situation. They will need to fit well, of course, but they also must provide support, stability, and traction. They should be durable, too, so that they do not shed pieces in the middle of rounds, and you don’t have to waste valuable time looking for replacements several times a year.
You must be fit to handle the job’s physical demands. Developing a workout routine consisting of strength, flexibility, and aerobic conditioning will reduce your chances of spending off days in the hospital’s rehab department. Also, the better your conditioning, the better you will feel when you settle in at home at day’s end. As part of your healthy-lifestyle approach to the job, try to eliminate smoking and reduce your alcohol consumption, if either is a significant part of your day.
Be a Lifelong Learner
Your learning begins when you prepare to enroll in an accredited nursing program. It continues throughout your time taking classes, but knowledge acquisition does not end when you receive your certificate or diploma.
For example, the continual growth of advanced technologies for use in medicine is one of the bigger changes to nursing in recent years. If you are not comfortable using technology, you will become a liability. You need to be able to keep up with the revolution by continuing your education every year of your career.
Be the Part and Be in the Moment
Patients can create their own challenges. You may not be certain of a patient’s mood, mental state, or overall temperament as you enter the room. It can be difficult at those times to face upset or frustrated ones. However, it helps to be open to your patients’ points-of-view. Many are understandably anxious and uncertain, and in a bureaucratic hospital setting, they can feel particularly dehumanized.
Your own mood and behaviors go a long way toward easing a patient’s fears. To put on your optimistic game face, remind yourself of the importance of your role in the whole care of each person in every room on your floor. This is backed up by polls that show nurses rate highest in areas of honesty and ethics among professions. Your patients trust you and, they rely on you to be partners in their care.
Your ability to step back and take stock of your worth is an asset you should bolster throughout your career. By being proactive in facing and addressing the expected and unexpected challenges nurses face, you can be certain to enjoy a long, successful career.
I received a call from Dr. Gloria Rose, my former professor at Prairie View A&M University College of Nursing, asking me to be the keynote speaker at the Pinning and Hooding Ceremony on May 9, 2018. After taking a breath, I accepted the offer and stated, “Yes, I am honored to do it.” As soon as I got off the phone with Dr. Rose, I called my mother and she was so proud of me.
As a nurse practitioner (NP), my work experience includes opening a clinic and managing house calls, as well as serving in homeless shelters, skilled nursing facilities, pediatrics, family practice, community, personal care homes, private homes, weight management, pain management, and the Redi-Clinic. Throughout my sixteen years of practice, I have developed four rules which have assisted me to accomplish success. The following rules have supported my differential diagnoses and plan of care for clients.
Rule 1. Get a
Good History
One of my favorite jobs was working at the homeless shelter. I recall a case that continues to stay with me to this day. The medical assistant presented: “He is here to have his string cut from his chest. The NP before you just cuts it and then he returns again when it gets too long.” I was thinking what is going on with string cutting from the chest.
As the man is sitting on the examination table, I asked how he is doing and right away he states, “I just need you to clip this string and then I will be okay. That’s what they do, clip it.” He removes his shirt and right away I see the healed surgical incision down the middle of his chest, but in the center is dark blue string protruding from a very small hole.
“When did you have the open-heart surgery, sir?”
“I think it has been about three years,” he replied.
“Have you been getting the string cut for the past three years?”
“Yes, ma’am,” he replies.
“I am not going to cut the string today. This is suture string that is hanging out of your chest from the open-heart surgery. We do not have radiology services here. I want to get all of the string out for good.”
Then, I secured the string with gauze and taped it to his chest. I arranged for him to go to a special procedures clinic. I provided cab vouchers and informed him to leave now. A couple of days later, the man returned. He was smiling. He stated that he had a gift for me. He gave me an envelope. I opened it. It was filled with suture string. Then he said, “Thank you! You solved the problem!”
Rule 2. Take Your Time
I learned this in graduate school. I saw a young female who presented with missed periods, vomiting, and fatigue. I was focused on her vomiting, and I was in a hurry. I left the room. I failed! Turned out she was pregnant. They say that you learn from your mistakes. I learned that day to always “take my time.”
Rule 3. Be Professional At All Times
At the homeless shelter, I saw a man and asked him how he was doing. “I am not doing well. The doctor gave me this medication for my blood pressure. Oh man! I keep peeing from left to right. As a matter of fact, I got to pee right now.” I reviewed the chart. The medication was hydrochlorothiazide. It is a diuretic which causes frequent urination. I changed the medication to lisinopril to treat his blood pressure and instructed the man to keep a log of his BP readings by going to the CVS around the corner. I gave him pens and a pad and instructed him to return in two weeks for follow-up. When he returned, I was off. My collaborating physician followed up with the patient. He called my supervisor upset that I changed the medication he prescribed. Upon my return to work my colleagues stated, “Robbie, you are in trouble.” I held my tongue. I remained calm and quiet. As I reviewed the chart there was a copy of his blood pressure log, which showed improvement in his blood pressure since taking the lisinopril. This man is homeless and does not have the comfort of a home with a restroom. He has to locate a public restroom to relieve himself. In my professional opinion, changing the medication was the best treatment for him and improved his quality of life.
Rule 4. Go With Your Gut Feeling
During a house call visit the client stated she had a sore and cannot understand how it got there. She reported, “at first I had pain at that same area.” (gut feeling) “Then this sore appeared. Went to the emergency room (ER) and was told that it was an insect bite.”
“Okay, let me see the sore; lift up your shirt.” I saw a fluid filled lesion on an erythematous base. “You have shingles.”
She looked at me, “are you sure?”
“Yes, I am.”
“But the doctor at the ER said it was an insect bite. You are a nurse.”
“I am a nurse practitioner. I can contact your primary care provider (PCP) to prescribe the medication to decrease the severity of the shingles.” She was still not convinced. “Okay, let’s take a picture with your cell phone and then you can send it to your PCP.” As I was leaving, the doctor’s office called and verified the diagnosis. Pain is a symptom that occurs before the lesion appears.
My four rules of practice have provided me with a solid foundation and are the framework of my practice. Every day, I use my four rules of practice and the outcomes are immeasurable. It’s great to know when you have improved the client’s quality of life. This is the greatest satisfaction of all to achieve as a NP.
Obtaining either an Associate Degree in Nursing (ADN) or Baccalaureate of Science in Nursing (BSN) is a pre-licensure pathway to becoming a Registered Nurse (RN). This is often the required academic path for entering into the nursing profession. Earning a Master’s in Nursing (MSN) may lead to many new paths and opportunities.
An MSN helps prepare practicing Registered Nurses (RN) for advanced practice by developing skills and knowledge in specialized areas of nursing. It can help enhance a nurse’s skills by increased autonomy and expanded practice roles. The health care delivery arena broadens beyond acute care hospitals and other traditional health care settings. The experience will both challenge and change you.
Here are a few of the practical benefits associated with the MSN:
Learn advanced skills. An MSN program teaches advanced clinical skills and management strategies. The nurse’s skills expands with increased autonomy and expanded practice roles. Many MSN programs offer specialized tracks that prepare nurses to learn advanced skills that are applicable to their clinical practice and outside of the normal scope of job responsibilities.
Pursue flexible career options. Nurses who earn an MSN may be able to perform their job remotely, during shifts that are more convenient, and with the freedom to determine the workday schedule. With greater flexibility and greater responsibility associated with an MSN, there is also an opportunity to extend the life of the nursing career as those with an advanced degree are often charged with less physically demanding job duties.
Increase professional networks. A graduate degree can help provide added respect from colleagues, other health care professionals and peers. Nurses are among the most-trusted professionals in the nation and that trust and admiration can extend and expand as nurses pursue educational and professional growth. Master’s programs in nursing help students establish valuable relationships with other nurses and professors.
Partake in lifelong learning. The master’s degree often becomes the gateway to the PhD in nursing or a Doctor of Nursing Practice (DNP). Prospective students might consider online programs, or take advantage of bridge programs that help students go directly from the pre-licensure program into a graduate program.
Make a difference.Often nurses enter the profession to make a difference in the lives of others. Expanding knowledge through advanced education can serve as an inspiration to others, including others in the profession. The personal fulfillment and professional satisfaction that accompany the MSN can be measured in the sense of accomplishment and improved self-esteem.
Are you a seasoned nurse applying for jobs and finding it difficult to get interviews? You are not alone. Understanding job market demands and the differences of the multigenerational workforce are among the tips for older nurses who are job hunting.
Target your searches
While seasoned nurses are valued, leveraging your experience may depend on where you look. Before applying, understand market changes and assess what a facility is looking for and match your experience with those needs.
“A lot of the magnet facilities want staff nurses to have a BSN or at least be working on it,” says Al Rundio, PhD, DNP, RN, APRN, CARN-AP, NEA-BC, and associate dean at Drexel University College of Nursing and Health Professions.
Experienced nurses with an associate degree are at a disadvantage at these hospitals. “The reality is they may not hire them, even though they have a wealth of experience. The best advice I give people is learning is lifelong. You want to add on a degree that will help you the most.”
Some job markets prefer experience, says Rundio, who works as a nurse practitioner in a residential addiction treatment center that is not tied to a bachelor’s degree. “Certainly a nurse there with experience would get a job sooner than someone brand new out of school,” he says.
Stay current
Older nurses will benefit if they understand technology and how things have evolved in the nursing world, advises James Ballinghoff, chief nursing officer of Penn Presbyterian Medical Center.
“A good thing for [older nurses] to probably be prepared for during an interview is to understand the different generations,” and how they communicate and work, he says.
Read journals and attend seminars to learn each generation’s strengths and workplace styles to be better prepared to work side by side with them, Ballinghoff suggests.
Embrace your strengths
While some nurses may feel the need to dye their gray hair or weed out phrases and resume information that dates them, Ballinghoff suggests that mature nurses should “be yourself and be proud of the experience you have and what you bring to the table.
“I always look for experienced nurses. Although things do change and evolve rapidly, there is still that core skill of caring for a patient. They have that and they should be proud of what they have,” Ballinghoff says.
Patients appreciate the maturity of older nurses, says Deb Zimmerman, DNP, RN, NEA-BC, FAAN, vice president and chief nursing officer at the VCU Medical Center.
“In the health care world I think the more senior nurse actually has an advantage,” says Zimmerman, noting older adults who graduate from the university’s accelerated nursing programs tend to do well in the job market.
Instead of viewing your age as a liability, accentuate your experience and capitalize on it during a targeted search.
Robin Farmer is a freelance journalist with a focus on health, education and business. Visit her at RobinFarmerWrites.com.
Are you a seasoned nurse interested in returning to school, but feeling unsure about your ability to handle the demands of work, life and studies?
Going to nursing school as an older student requires commitment and planning. If you’re on the fence, start with being honest about your feelings. Is your reluctance to earn a B.S.N. or master’s degree rooted in fear?
Dealing with long study hours and difficult courses as a middle-aged student juggling a hectic schedule can be scary. But consider this: as an experienced nurse you bring advantages to the classroom. Older students possess maturity and relevant life and work skills, which help you relate to the course material better.
Consider your learning style. Explore whether the best fit for you is to take classes online, enroll in a traditional bricks- and -mortar university or an accelerated BSN or master’s degree program.
Think about your career goals. Even if you have a well-established career, pursuing a degree can boost your confidence, change your outlook, provide job security and make you more marketable for other opportunities down the road. Advanced education can also improve your nursing skills. Research links better-educated nurses to better patient care.
Another major perk mature nursing students cite is the positive message earning a degree sends to their children.
Other critical factors that will play a role in your decision include family support, flexible job scheduling, finances and stress management.
As you weigh your options, make a list of the advantages and disadvantages of going back to school. Whatever your decide, learning is a lifelong process. And people are living and working longer than ever.
Five years from now, you will be five years older, that much is a given. But will you have that first, second or third degree you wanted, too? Only you can decide.
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