Nursing for me is about making a difference — and every day I’m making a difference in the lives of the people I care for. Take a Monday earlier this month. A patient of mine living with cerebral palsy was struggling to complete her therapeutic exercises. Her mother, clearly frustrated, feared her daughter wasn’t making sufficient progress. Dedicated and caring, the mother also worried that she wasn’t doing enough to help her daughter improve and succeed.
But this young woman was improving — slowly, surely, in ways imperceptible to the untrained eye. “Your daughter can now open both of her hands; all of our hard work is clearly paying off,” I explained, as the mother’s face transformed from hopeless to full of hope. “Your daughter just wants to be independent,” I continued, “and she obviously gets this spirit from you.”
Independence – as much as making a difference – is becoming a bigger focus for me in my career. The freedom to control my schedule. The freedom to control my income. The freedom to care for my three children. The freedom to care for me.
Until recently, I didn’t really have that choice.
For too long nurses have been treated like afterthoughts. We’re burned out and stressed out – from Covid, from our home lives, from feeling like our needs are always considered last. And this not only impacts our ability to perform, it threatens the effectiveness of the entire healthcare systems we’re so passionately committed to supporting. Yet, the working conditions and rigid schedules have not changed with the world around us.
Over my six-year career in nursing, I’ve witnessed both the indifference and abuse that has become too common in our industry. As a result, our community is suffering. Less than half of the 12,000 nurses recently polled by the American Nurses Association (ANA), for instance, believe that their employers care about them – a mere 19 percent for nurses 35 and under. More than 50 percent of all nurses are also thinking about leaving nursing; a figure that rises to 63 percent for nurses under 35. The latter numbers particularly worry me; with so many of my younger brothers and sisters ready to give up on nursing – and a national nursing shortage only expected to get worse – the future of the profession I love has never felt grimmer.
I know what it’s like to be undervalued in the workplace. I’ve been told by nursing agencies to wait in the cold if my patients are running late. Then when they finally do arrive, I’ve been expected to wash their clothes – even though I’m a nurse, not a housekeeper. I’ve been berated by patients for “moving too slowly” and battled with administrators for adequate PPE safety gear during the height of the pandemic. I’ve been made to feel like a number – a body – by nursing agencies just focused on profits and disrespected by patients and family members aggressively insistent I could just “do more.”
But more must be done to consider our needs, too – both by the nursing industry and the community of nurses to whom we all belong. What we seek is to be seen, valued, and supported in ways that matter. To be listened to if we are struggling during a hard shift. To hear “thank you” instead of being ignored. To give us tools and resources to take care of our mental health because after the past two years, we need it.
I experienced this kind of support unexpectedly when I found connectRN, a new platform that matches nurses with health care facilities that need our services. The ability to work when I want, where I want has given me the independence I was seeking, and an opportunity to step away if I need to recharge. As a mother, this flexibility is more important than ever. I can take on shifts that work with my child-care needs, eliminating the stress that usually occurs when making money and being a Mom collide. This should become an industry standard, rather than a perk from a digital start-up.
One of the things I value most about connectRN is that they are nurse-first and care as much about our community as the shifts they post. When I joined the platform, I was given access to The Beat, a private community of nurses who also work with connectRN. It is a safe space to chat with your peers about the things only nurses can truly understand – without the fear of reprisal or retribution. We share stories about hard shifts, give each other support to keep going, and often find “work buddies” in the places we work often. As debates rage around the role of nursing unions, hospitals and agencies must understand that a united nursing community is a better nursing community – better equipped, better prepared, and far better focused on the needs of our patients. With my life far more than just nursing – kids (both teens and a toddler), my extended family, a bit of me time – I feel lucky to be part of this community
For me, personally, The Beat proved particularly helpful when dealing with mental health concerns. At the height of Covid, the community offered telehealth therapy sessions through a partnership to use at our discretion. To be honest, I never considered I might need this kind of help — no one had ever asked me. But the death of a colleague — a young mother who passed away shortly after giving birth — hit me harder than I’d initially expected. I needed help to process how I was feeling and I took advantage of the offer. To have that support – for free – made me feel worthy and valued.
Over the past two years, I’ve been struck by a newfound respect for nurses as the Covid crisis continues unabated. Patients and families recognize our role at the frontlines of the pandemic and understand the risks taken daily to help their loved ones survive. What’s needed now is a parallel boost in understanding and appreciation from the hospitals and nursing agencies that power our profession. Because fairer pay, added flexibility, stress reduction, and self-care won’t just improve the lives of nurses, they’ll help ensure the positive patient outcomes we all desire. As nurses, we intuitively understand the necessity of these demands; it’s time for staffing agencies and health facilities to embrace this mindset with equally open hearts and minds.
Up before the voters in November is the issue of assigning patient limits for registered nurses working in hospitals. A “yes” vote approves of establishing limits and a “no” vote opposes the limits. Essentially, a “no” majority would leave things as they are in the state now.
The issue is hotly contested in the state and will be closely followed by the nation. As hospitals, nurses, and patients seek to provide and receive the best care possible, there are still increasing costs, more complex patient conditions, and staffing challenges to face.
In Massachusetts, the Committee to Ensure Safe Patient Care is supported by the Massachusetts Nurses Association and seeks to limit the number of patients one registered nurse in a hospital setting may care for.
The Coalition to Protect Patient Safety is in opposition to Question 1 and is backed by the Massachusetts Health and Hospital Association. They seek to make no changes to Massachusetts’ legislation.
Both sides of the issue have several well-known associations, organizations, and individuals behind their stance. Both sides have also spent millions of dollars to call attention to their views. With similar campaign names and representative colors, the messaging is similar for two distinct messages.
In units with step-down/intermediate care patients: 3 patients per nurse;
In units with post-anesthesia care or operating room patients: 1 patient under anesthesia per nurse; 2 patients post-anesthesia per nurse;
In the emergency services department: 1 critical or intensive care patient per nurse (or 2 if the nurse has assessed each patient’s condition as stable); 2 urgent non-stable patients per nurse; 3 urgent stable patients per nurse; or 5 non-urgent stable patients per nurse;
In units with maternity patients: (a) active labor patients: 1 patient per nurse; (b) during birth and for up to two hours immediately postpartum: 1 mother per nurse and 1 baby per nurse; (c) when the condition of the mother and baby are determined to be stable: 1 mother and her baby or babies per nurse; (d) postpartum: 6 patients per nurse; (e) intermediate care or continuing care babies: 2 babies per nurse; (f) well-babies: 6 babies per nurse;
In units with pediatric, medical, surgical, telemetry, or observational/outpatient treatment patients, or any other unit: 4 patients per nurse; and
In units with psychiatric or rehabilitation patients: 5 patients per nurse.
Taylor Maher, a media spokesperson for the Committee to Ensure Safe Patient Care says the issue is a matter of patient and nurse safety. “The negative consequences of not having staffing limits are clear,” she says. “Patients are sicker and nurses have too many patients to care for. There’s a detrimental effect on patient outcomes.”
The Coalition to Protect Patient Safety did not respond to Minority Nurse’s repeated requests for comment. According to their website, a “no” vote would keep hospitals from closing or sliding into longer wait times for patients.
California is the only other state in the nation that has passed legislation and imposed limits on nurse staffing. In Massachusetts the issue is not entirely new, but the scope is. ICU nurses in the state do have staffing limits that were prompted by a past ballot question although the limits were agreed to, not voted upon.
As a nurse, what are your views of establishing legal patient limits?
With nursing shortages a pressing issue throughout pockets of the country, one branch of nursing could help remedy the solution, says Marcia Faller, PhD, RN, and chief clinical officer of AMN Healthcare. Travel nurses can fill short-term needs while organizations are able to assess, stabilize, and hire permanent nurses without compromising patient care during a staffing shortage.
Faller says travel nurses can help fill the gaps while providing high-quality, reliable care. She points to a study slated for summer publication in the peer-reviewed journal, Nurse Leader, that reveals that patient outcomes for travel nurses and staff nurses are no different. In fact, the study asserts, travel nurses might help ease the staffing burdens and contribute to less error and nurse burnout. Using data sources from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and National Database of Nursing Quality Indicators™ (NDNQI®), the study looked at a U.S. hospital to assess patient outcomes when using both core nurses and travel nurses.
According to Faller, most travel nurses work in temporary job assignments of three months at a time. After their rotation is done, they might stay for another three months, sign on for a permanent position, or move on to another assignment in a new location.
“It’s very appealing,” says Faller. It’s a quick and easy way to get a new job and gain both professional experience in a new area while also having the chance to travel. Some nurses want to shift their location for a life event—a child is getting married across the country or has a new baby, for instance. Or a nurse from a smaller community might want to gain experience in a larger academic center, Faller says. Maybe they have a list of places they want to see and travel nursing will help them do that while also working at a job they enjoy.
Travel nurses only account for two percent of all nurses, says Faller, but they offer both a distinct nursing career opportunity and a boon for organizations who need more nurses.
Different organizations find travel nurses help their staffing needs in varied ways, says Faller, and help keep the quality of care high. “Travel nurses give them the ability to fill vacancies where they are finding themselves short staffed,” Faller says.
Organizations can fill the positions while continuing to focus on recruiting. Travel nurses are also especially helpful when it comes to covering non-productive hours, says Faller. For instance, known times when nursing staff members are taking PTO, jury duty, has a leave of absence, or even needs educational time off are all good times for travel nurses to fill in. Travel nurses can also help offset overtime costs and hours. “Those have to get covered somehow,” says Faller, and helping ease up on too much staff overtime can also help offset nurse burnout and eventually retain nurses and keep turnover down.
If an organization is launching a new event, like electronic medical records, travel nurses can help cover staffing while regular staff is undergoing training.
And Faller notes that travel nurses are held to the same high standards as staff nurses. They need to have the same credentials as other nurses for whatever location they are going to, she says. And while approximately 25 states are part of the multi-state contract that allows nurses to use one license for many states, the rest of the states do require independent state licenses. Travel nurses also must pass background checks, drug screening, and any other requirements for hiring. And travel nurses are well-educated, she says, with 64 percent of travel nurses having a BSN or higher.
A nurse with a couple of travel experiences under his or her belt has some valuable skills, says Faller. These nurses are adaptive by nature, learning quickly how an operation is run and how to find what they need to do their jobs well.
As the demographics of the country continue to change and become increasingly diverse, travel nurses can help fill a gap and provide a service that many organizations need. Nurses who speak multiple languages or who fit with the cultural background of the patient population being served are especially valuable, says Faller. “There is a large demand for that cultural matching,” she says, noting that even a familiarity with a certain culture can help organizations align with their patient populations in a way that helps everyone.
Whether you are considering travel nursing for a career move or are an administrator assessing the best way to fill in the gaps, travel nursing is an option that’s both viable and valuable.
Health care facilities occasionally experience shortage of staff. In such situations, they turn to travel nurses from other locations to fill in for their permanent staff. There are several travel nurse staffing providers in the country to help hospitals/clinics to find temporary nurses and vice versa.
The United States offers opportunities to travel nurses in all specialties. At the global level, health care facilities are in a constant need of efficient nurses to manage clinical and administrative duties. Nurses who are willing to take up assignments in international locations can get in touch with companies who facilitate these programs.
As a travel nurse, you need to research the job description, organizational culture, and stay updated with important on-the-job skills. Even on the personal front, there are several factors you need to consider when embarking on a new assignment. You should be willing to adjust to a new area, use interpersonal skills to form cordial relations with new coworkers, and improve your nursing skills.
If you are a nurse planning to take up a new travel assignment in the near future, then you can make use of the following tips to make it a successful stint.
1. Complete the Paperwork
Amidst your excitement to start traveling, do not neglect the documentation required by the travel nurse staffing agency and the assigned hospital. Do not forget to submit all forms on time with complete and accurate information. Maintaining a checklist of the required documents can help you keep tabs on the process.
You will be asked to include application forms, skills checklists, license verification, and letters of recommendation from your previous employers. You may want to consult a lawyer if you are planning to travel to another country for your assignment. They can help you know about the laws that are applicable to travel nurses.
Make sure that there is no discrepancy in the details you provide as the staffing agency will use them for arranging for your interviews, placements, and onboarding with your new employer.
2. Be Adaptive
As the new nurse in the health care facility, you will have to make additional efforts to adapt to the new environment. It will be easier once you are acquainted with the rest of the staff. A good attitude and a positive approach can be helpful.
It is quite common for travel nurses to experience nervousness and face difficulties at some point during their assignments. Get in touch with fellow nurses and other staff members for solving your queries. The key is to treat others like you would like to be treated.
Remember that you were hired for your nursing skills, and these would remain the same across all geographical locations. So, even if you are facing initial glitches, keep your spirit up when dealing with patients.
3. Carry All Necessary Items
As far as possible, try to keep your luggage light and easy-to-carry. At the same time, do not leave important items behind. Among the essentials to take along are a copy of all your documents and the approved scrubs/uniform for your assignment. As you’d be living in a new location, you may not know much about the cost of living. It is, therefore, better to keep some spare money, your financial records, key emergency contacts, IDs, and credit/debit cards handy.
Make sure you don’t overload your luggage with excessive clothing items. Try to stick to a reasonable number of personal items and clothing, keeping in mind the weather at the new location. You may also want to take a few favorite photos and mementos to make the new place feel like home. It is advisable to ask your recruiter for a more detailed list of items that you should carry.
4. Let Your Learning Curve Grow
Try to use all the time you have during your travel stint to learn as much as you can. But, before heading to the new place, make sure you study about your assignment facility. You may be taken through a traveler orientation to know more on the facility’s management policies. Make sure you that you take enough notes, study procedure manuals, ask questions, and clarify all doubts.
You may be assigned a short-term mentor, who you can shadow for a few days, but make sure you know who you can contact on the floor with questions at all times. Some travel nurse staffing agencies, such as Onward Healthcare, also have clinical liaisons their travel RNs can get in touch with around the clock, if necessary.
5. Make Use of Technology for Assistance
Technology can be a great aid for travel nurses as they can use information from the Internet to learn more about their new location. Whether you want to find the route to the local market, read restaurant reviews, or locate the nearest health care facility, your laptop, tablet, or smartphone can help you find answers to these queries.
You can even store e-books on these devices for leisure or professional reading. This way you will be more prepared to live comfortably at the new place, which can help you focus more on your professional role and adapt to the new facility faster.
Many nurses are gradually warming up to the idea of traveling for business. The great thing about being a travel nurse is that you can blend fun and work and make the most of your professional stint. As long as you have the above considerations in place, you can look forward to a successful and prolific career as a travel nurse.
Every May, National Nurses Week brings an opportunity for nurses nationwide to unite, share their pride in their profession, and have their voices heard about any concerns. This year’s National Nurses Week theme, “Culture of Safety…It Starts With You” focuses on the safe practices that protect nurses and patients.
A grassroots nursing movement advocating for safe nurse-to-patient staffing ratios is inviting all nurses to gather at the Rally for National Nurse-to-Patient Ratios in Washington, DC, on May 12. Other events will take place nationwide including state rallies in North Carolina, South Carolina, Arkansas, and Texas.
“We want to generate more dialogue about the problem and for nurses around the country to be empowered and feel they are not alone in this struggle,” says Jalil Johnson, BSN, MS, RN, ANP-BC, PhD(C), national director of Show Me Your Stethoscope (SMYS), which is sponsoring the event in conjunction with Nurses for National Patient Ratios, A Voice for Nurses Now, Illinois Nurses Association, and HireNurses.com. “There is a nation of nurses facing this struggle.”
In addition to bringing nurses together to call attention to safe staffing, the rally will raise awareness and support for two pending federal legislation items: S. 864 (National Nursing Shortage Reform and Patient Advocacy Act) and H.R. 1602 (Nurse Staffing Standards for Patient Safety and Quality Care Act). According to SMYS, “These bills seek to establish a federal standard for safe nurse-to-patient staffing ratios in acute care hospitals, setting a maximum number of patients for which nurses would be allowed to care during a given shift.”
Johnson says standardizing safe nurse-to-patient ratios doesn’t mean focusing on one number. Each unit, each organization, and each assortment of patients needing varying levels of care makes it tougher to mandate a specific ratio that can be deemed safe. And there are huge disparities seen across the nation, says Johnson, as each state has very different struggles with health care. “We want to level the playing field,” he says. “Or at least start the conversation to level the playing field.”
Johnson hopes the rally will raise awareness and get this important issue on the radar of legislators who can implement nationwide change.
According to SMYS, several speakers are slated to address rally attendees including Andrew Lopez, RN, CEO of NurseFriendly; Sandy Summers, RN, MSN, MPH, executive director of The Truth About Nursing; and Janie Garner, RN, founder and executive director of SMYS.
Nurses who attend the rally or get involved in other ways can then share their stories long after the day is over. “We want to get the public involved,” Johnson says. “Whether you are a nurse, a patient, or anyone who is in a hospital setting, at some point in your life, you will feel the effects of this one way or another.”
As one of many groups working on safe staffing issues, Johnson says SMYS emphasizes that the focus is not on individual people or organizations. Getting safe ratio legislation implemented means standard safe ratios are in place at federal or state level which protects patient and nurse. Right now, California is the only state with mandatory safe staffing ratios.
“We are not against any hospital or any organization,” he says. “We just want institutions to follow the models known in science.” He refers to many studies that have shown the more patients a nurse has to care for, the less positive outcomes are and the less safe both nurses and patients are.
Nurses are often afraid to speak up about unsafe ratios for fear of retaliation. Despite the labor laws in place, Johnson says many nurses have this concern, making a common discussion that much more essential. “We want to empower nurses to think they can do something,” he says. “We have to raise the level of the discussion. This isn’t about your charge nurse or about your unit manager. They are working in a broken system.”
With the rally being a gathering point to launch the issue, Johnson says it’s only the beginning. State chapters are forming their own plans as many aren’t able to hold rallies on the same day as the national rally, so that gives nurses across the country many chances to get involved.
If you can’t head to the nation’s capital, Johnson says you can still get involved by showing up or connecting with your local chapters of SMYS for Change. You can participate in any of the media campaigns, he says, by following on Twitter, and sharing, liking, or tweeting about any articles written on the topic.
And to have the most impact, just start talking. The more you talk about the issue, the more likely you are to realize just how much this is on the minds of all nurses.
“It’s empowering to have a bunch of people who share your problem and are working on it,” says Johnson. “What we’ve started is not funded by major companies, but started by passionate, dedicated people. That’s what drives us. This will continue on.”
Johnson says the rally is a starting point for nurses, organizations, patients, and lawmakers nationwide.
“The rally will not make any legislation pass, but it will bring attention to the need for safe ratios,” says Johnson. “If we do this enough, we will get results. What happens on the nurse-patient basis affects everyone across the country.”