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Answers to Your Nursing Career Questions

3 ideas for hungry nurses at work

March 14th, 2011 by – Marijke Durning

Eating a good diet is important for good health: We know that and it’s something we preach to our patients. But nurses work very odd hours and eating in a healthy way can take a back seat to eating whatever is at hand. So what can nurses do to ensure they eat in a healthy manner?

The best approach is to be prepared. Much of our unhealthy eating patterns stem from lack of preparation or lack of food on hand particularly if we have only small windows of opportunity to get something down. Here are three healthy snacks for work:

Popcorn

Many work places, including hospitals, have banned the use of microwave popcorn in the building. The main reason for banning popcorn is it’s too easy to burn and can cause a fire. And, if it doesn’t cause a fire, it creates a strong smell that is quite far-reaching.

You can get around that by popping your own popcorn at home and just putting it in a reusable container. Keep it in your bag and you have a healthy ready snack. Air-popped popcorn has the least number of calories. But be aware that if you start piling on butter, you’re defeating the purpose of the snack!

Fresh fruit

Not many things beat fresh fruit. They’re low in calories and high in nutrition – something that nurses constantly recommend to their patients. You don’t have to spend a fortune on fresh fruit. If you stick to in-season fruits, costs are generally lower. Another tip: Many supermarkets will reduce fruit prices drastically when they are ripest but still very usable.

You can also combine some fruit, like apples, with peanut butter for extra filling and protein.

Low-fat instant oatmeal

Most work places have kettles for boiling water or a microwave. If you keep a microwavable bowl and a few packets of oatmeal in your bag, you’ve got a filling, hot, and quick-to-prepare meal.

Check labels

If you’re not sure about the food you want to eat, be a label reader. Check to see how many calories are in one serving and be true to the servings! Look to see how much fat is there and avoid trans fats. You also want to see fiber. If you’re not sure what the numbers mean, check the percentages along the side. These will tell you how much of the ingredient makes up the daily recommended amount.

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6 ways nurses can help the American Red Cross

March 9th, 2011 by – Marijke Durning

Thankfully, disasters like earthquakes and floods don’t occur every day, but they still occur more often than we’d like. With the news of floods in Australia, earthquakes in Haiti and New Zealand, extreme winter weather in Europe – and more – we can also feel helpless. We don’t even have to look abroad to feel helpless. Focus on national news and you find floods, storms and tornadoes happening right here in the United States as well.

As nurses, we are well placed to help people affected by disasters, both natural and man-made if we choose to do so. Hundreds of American nurses headed down to Haiti when they learned of the devastation in that country. Some still go as part of different organizations that want to help the Haitian people. Other nurses volunteer their work locally, helping if there are  fires or other emergencies.

There are many organizations to help nurses find a cause that they would like to work on. The American Red Cross is one of the most widely known.

If you are considering volunteering as a nurse or applying to work for the American Red Cross, here are 6 ways your nursing license and skill can help:

1- Be part of the Disaster Action Team

The DAT responds to disasters across the country including building collapses, floods and fires. The care the people need varies from helping them to get hold of lost prescriptions to caring for life-threatening injuries.

2- Participate in health fairs

Health fairs can take place anywhere including at a local mall or a community event. These fairs can help raise awareness of medical topics such as diabetes, hypertension and well baby care.

3- Promote blood collection

Blood is needed in hospitals around the country on a daily basis. Some nurses in the Red Cross participate in blood donation awareness and collection.

4- First Aid

At many events, people trained in First Aid are at standby to help in the case that something happens to participants.

5- First Aid and/or CPR instruction

Teachers are always needed to show community members how to provide First Aid and CPR to people in need.

6- Babysitting courses

Red Cross babysitting courses are increasingly popular as parents look for qualified teens to care for their children. Teachers are always needed for these courses.

There are, of course, other things nurses can do for the Red Cross. If you are interested in working or volunteering, call your local office to see what you can do.

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Nurses: It’s work your proper hours day!

February 25th, 2011 by – Marijke Durning

It’s February 25, 2011 and today is Work Your Proper Hours Day in the United Kingdom. Maybe with all the overtime nurses are expected to do here in North America, it’s time to introduce the day here, too.

In some parts of the United States and Canada, nurses are obliged to work overtime hours. It’s not easy to think of any other profession that would have such a requirement. Can you imagine a pilot being told she must fly an extra flight across the country despite the fact that she’s exhausted?

Nurses who are tired can  make more mistakes than ones who aren’t. More medication errors are possible, fatigue may make it so you aren’t as observant as you could be and you may not move as quickly:  all things that affect patient care.

Even if you’re not working 16 hours straight, how effective can you be if you get home from working from 4 p.m. to midnight and you get called early in the morning to come in for an 8 a.m.-to-4 p.m. shift?

It’s not an easy situation. The hospitals need to have nurses covering the floors. The patients need care. However, the nurses have to be in the physical and mental condition to be in those hospitals and to deliver that care safely. Just being there isn’t good enough.

So, what are nurses to do? Some are threatened with their jobs if they don’t work the overtime shifts. Other nurses are made to feel guilty if they don’t accept the overtime hours. And then others need to work them because they need the money: their regular pay or number of shifts aren’t adequate.

What is your solution? What do you think should be done to help ease the situation on nurses who have to work overtime?

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Can pregnant nurses work? Should they?

February 22nd, 2011 by – Marijke Durning

Since the vast majority of nurses are female, it’s not surprising that many nursing units have to deal with pregnant nurses on a regular basis. For some pregnant nurses, life goes on as it did before with maybe a few adaptations to accommodate her changing body. However, for nurses who work in high risk areas or who have difficult pregnancies, there may be other issues, such as trying to find alternative work or having to take time off.

Can pregnant nurses work?

In general, the answer would be “of course.” Pregnancy isn’t an illness and women can do just about anything while pregnant that they could when they’re not. However, the very nature of some nursing jobs, may make working pregnant dangerous.

Some nurses have to work with chemicals that are known to cause damage to a fetus. In these cases, the nurses will have to find alternative work or take preventative leaves if such work isn’t available. In other places, there are only certain types of patients that may not be safe for the pregnant nurse, such as someone who is infected with CMV (cytomegalovirus) – a virus known to cause birth defects. In these cases, the patients cannot be assigned to the pregnant nurse, but she can take other patients who aren’t infectious.

What about shift work?

Anyone who has worked shift work, bouncing from days to nights and back again, knows that it’s hard on the body, no matter how healthy you are. And, while many pregnant women may be able to manage, it may become increasingly difficult as sleep issues and fatigue start to become a problem.

The solution isn’t necessarily to take the nurse off night shifts – in fact, she may be more comfortable working nights as long as she’s always working nights, not bouncing from shift to shift.

12-hour shifts

Some nurses love 12-hour shifts, some hate ‘em. Twelve hours is a long time to be on your feet at the best of times. If you add the weight of pregnancy, it can be near impossible for some women. In those cases, hopefully an eight-hour shift is an option.

What about the other nurses?

Many nurses were pregnant themselves at one time, so they may well understand what their pregnant colleague is going through, however this isn’t always so. Some women breeze through their pregnancies so they don’t understand how difficult it could be for others, while some did have difficult times but managed nonetheless.  Should they have to pick up the slack for the pregnant nurses? That depends on how you look at it.

As caregivers, we care physically and psychologically for our patients – isn’t that something we should do for our coworkers as well? As long as the pregnant nurse is able to do other duties, it shouldn’t be a big issue to take over what she can’t do. It’s called give and take.

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The fatigue factor

February 22nd, 2011 by – Sue Barton

  I’m tired all the time.  I work three 12 hour shifts a week, have two  small children.  Is it normal to be this tired?

Juggling a demanding job with the challenges of a young family is by definition tiring.  Most parents who are employed outside the home can identify with your feelings.  Still, you should rule out any health problems that might be contributing to your fatigue.  Have you been ill recently?  Do you think you are depressed?  Can you improve your nutrition?  Could you be anemic?  Are you getting adequate sleep?  If not, what might you be able to do to change that?  Have you had changes in your weight?  Can you squeeze in some time for regular exercise?  What options might there be to get some help with childcare and household tasks?

Another possible factor may be job burnout.  If  your work is not providing you with a level of professional satisfaction that compensates for the demands of the job, perhaps it’s time to reevaluate your career goals.  Think about what your ideal nursing job would look like.  What skills do you have and what additional skills might you need to get to where you want to be?  Could you leave the workforce short term to go back to school?  Or take online classes to supplement your current skill set?  A new direction in your work might allow you a better work/family balance and be energizing as well.

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Should nurses be allowed to have facial piercings?

February 15th, 2011 by – Marijke Durning

Tattoos are barely raising an eyebrow anymore. People in all professions, including nursing, have tattoos although in some nursing jobs, they are still asked to cover up while at work. But what about piercings? Just as tattoos, piercings are becoming more common now; it’s no longer unusual to have several earrings (both men and women) – not only in the ear lobe but also in the cartilage. And people are getting other body parts pierced – from the visible to the not-usually visible areas. So, how does this relate to nursing?

If a nursing student has a piercing above the bridge of her nose or through his lip, should the school have the right not to allow this? The answer may surprise some people and it is “yes.”

Schools have the right to decide on uniform policy, from telling students what color and type of nursing student uniform they must wear to the amount of jewelry they are permitted. This encompasses how many visible piercings, if any, they are permitted. While some students may claim it’s against their rights to say they may not have piercings, it really isn’t any different than any other uniform requirement.

Some reasons schools may be against piercings

Nursing schools and hospitals usually maintain their ban on piercing because of the “professional appearance” aspect. While there is no doubt that some lawyers and doctors may get away with piercings, they are very few and far between. Right now, piercing – other than in the ear lobe – is not considered to be professional. Of course, you could argue that how you look has no bearing on how you behave, but that is the way piercing is generally looked upon at this point.

The administration also fears patients, particularly older and/or conservative patients, aren’t used to seeing piercings and they have certain beliefs about them. Again, you could argue that it’s your right to wear the piercings, but what about their rights? That’s where the issue is. Someone with a piercing can choose to work in a certain field or area – someone who is receiving care because they are ill or injured generally don’t have a choice.

Finally, another argument that facilities may make against piercing is the safety aspect. If a nurse works with a population that could grab at the piercing, the result could be the piercing being ripped from the face.

Is a piercing worth your career? Only you can answer that.

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Pregnancy and nursing school

February 10th, 2011 by – Sue Barton

 I just found out that I’m pregnant and I’m in my junior year of  a BSN program with lots of clinical rotations ahead of me.  Is this going to work?  Is it safe for me to be doing clinicals if I’m pregnant?

Congratulations!  I’m sure you can make this work.  Start prenatal care right away, of course, and make your doctor or nurse midwife aware of your situation.  Also make your nursing instructors, particularly in the clinical settings, aware of your pregnancy so that accommodations can be made when necessary.

Pregnant nurses do need to take precautions in the areas of exposure to infections and to toxins.  Exposure to radiation is also potentially a concern.  Be sure your own immunizations are up to date, and be rigorous in the practice of universal precautions to prevent exposure to infectious agents.  This AJN article by Marion Rita Alex details occupational hazards for pregnant nurses and also gives links to the National Institute for Occupational Safety and Health.  Certain drugs, such as those used in chemotherapy, aerosolized drugs such as Ribavarin, and waste anesthetic gases are known to  be hazardous.  Pathogens such as influenza, Parvovirus 19, and Cytomegalovirus are also known risks to pregnancy.  You should be able to modify your clinical assignments to avoid settings where these risks are present during the duration of your pregnancy.

If you need time for “maternity leave” from school, it’s possible that you may have to extend your academic timetable a bit, but hopefully you will be able to complete both your degree and your pregnancy without complications!

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Nurses, it’s heart month, but are you healthy?

February 9th, 2011 by – Marijke Durning

So much is being written these days about the declining state of health among Americans. The obesity rate is sky rocketing, children are developing lifestyle-related diseases like type 2 diabetes, hypertension, and high cholesterol, and there are dire predictions that this generation of children will become the first one to have a shorter predicted lifespan than that of the generation before them.

And what of the nurses? For sure, we are doing what we can to try to get our patients to be healthy. We preach healthy diets, increasing exercise and eliminating bad habits, like smoking. But many of us don’t practice what we preach. We don’t eat properly, abuse our body, don’t exercise and many smoke. If nurses behave that way, how can they expect their patients to even consider changing their lifestyles?

Smoking

Although there still are nurses who smoke, the number has dropped significantly. According to an article on Tobbacco.org, smoking among nurses has dropped from 33.2 percent in 1976 to 8.4 percent in 2003. Now we just need to get it down even more.

The problem is, as nurses do continue to smoke, many will develop the smoking-related diseases that plague the country. And, by going out to smoke outside the hospital at break time, they are projecting an image of “do what I say, not as I do,” to the outside world.

Obesity

Unfortunately, the number of obese and overweight nurses aren’t as good as the dropping numbers of smokers. A study that was published in the Journal of the American Academy of Nurse Practitioners in 2008 found disturbing results from a self-reported survey among registered nurses. While the vast majority of nurses who responded said they had to counsel patients on lifestyle issues, 22 percent of the nurses were obese themselves and 32 percent considered themselves to be overweight. Breaking down this number even further, of the nurses who specifically counseled obese patients on losing weight, 18 percent were themselves obese and 34 percent overweight.

These numbers should be surprising, considering the role that nurses play in our society, but they’re not shocking. Not at all. Nurses are under the same stresses as the rest of society – they do shift work, they have stressful jobs, they juggle too many things that they don’t have enough time for. Or, at least, these are some of the excuses that people use.

Nurses don’t have to be “better” than their patients – but they are the public eye of health care. But even more than that, how can a nurse live a healthy life if she doesn’t choose a healthier lifestyle?

Nursing is a demanding job – there’s no doubt about that. So wouldn’t it make more sense for nurses to make the effort to take care of themselves? After all, don’t we tell family of patients to rest and take care of themselves or they won’t be any help to the patient?

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Should nurses HAVE to go to work during a blizzard?

February 2nd, 2011 by – Marijke Durning

Now that a good part of North America is covered with either snow or ice, there are many nurses who are trying to figure out how they will get in to work for their next shift (and many how to get home). But what do you do if the roads are really too bad to travel, but the hospital or home care patient needs you?

Some nurses are lucky enough to live close to their work that they could get there with public transit or they have access to transportation with four-wheel vehicles. Others work at facilities that will provide overnight accommodation that nurses can use if there has been advance warning of a bad weather system . But not everyone is in that same situation.

As nurses, we work to save lives or to make them as comfortable as possible, given each patient’s individual situation. Yet as employees, we are told to get to work no matter what. During any given snow or ice storm, the emergency rooms become filled with people who were in motor vehicle accidents or who were hurt walking outside in treacherous conditions. Yet, the nurses are still supposed to be there. And if not, they could be fired. Seriously.

According to a news report from HealthLeadersMedia.com, several nurses were fired from Washington Hospital Center in February 2010 for not showing up during a series of two blizzards, which left Washington DC under more than 40 inches of snow. The CEO, Harrison Rider III, was quoted as saying, “…most of us served selflessly, but some chose not to come to work and walked away from the commitment they made to the patients and their fellow associates. We have continued to review each case to assure that those who shared our commitment to our patients are distinguished from those few who did not.”

More than 15 nurses were disciplined with action ranging from outright firing to suspension and the inclusion of disciplinary notes placed in files.

In the article, Rider says that the hospital provided transportation for nurses and that the staff members were advised ahead of the storm to make accommodations that would allow them to stay overnight either in the hospital or close by. The hospital provided meal vouchers for those who stayed at the hospital.

While in an ideal world, the nurses would all have taken advantage of the accommodations, it may not be as simple as it seems. Not everyone can leave home the day before: they may have children or parents to care for. They may have other life obligations other than their work. As for why they may have refused transportation, that remains unreported.

So, should the nurses have been disciplined for not coming in to work during prohibitive weather conditions? What do you think?

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4 ways for nurses to build time management skills

January 31st, 2011 by – Marijke Durning

What is it that makes some nurses so good at managing their time while others seem to be floundering a good part of their shift? Some nurses manage pretty well but wouldn’t say they are either organized or disorganized. They just get by. Which are you?

Being an organized nurse, one with good time management skills, is a gift to yourself, your patients and your coworkers. For yourself, you lower your stress levels because, if all goes well, you have a good idea of what is happening when. If something unexpected happens, then there’s a good chance you’ve gotten some of your work out of the way and you have the time and resources to cope with the unexpected.

Organized nurses are a gift to their patients because their patients will know that the care will be given when it should be and if it’s not, there’s usually a very good reason. Patients who know their nurse will bring them their treatments or medications when they say they will are often less stressed and less demanding than patients who are left wondering.

Coworkers who work with organized nurses feel lower stress levels from them and benefit from a better working environment. Less stressed nurses usually means there is a better workplace for everyone.

But what are the secrets of these organized nurses? Were they born this way? Did they learn it? Is it something that can be learned?

It does seem that some people are born organized. As children, they like things done a certain way and will work to have their environment calm and organized. Other people, learn it later: either because they are forced to or because they have discovered that organization can help them manage their life more effectively.

If you’re in the disorganized category, is there hope? It depends on if you want to change or not. So, assuming that you do want to change, here are some tips that may help you:

1- Admit you are disorganized and target where this is happening the most.

Once you have admitted that you need to get organized, you need to figure out what is keeping you disorganized. Do you get to work just at the very time your shift starts? If so, you’re not allowing yourself time to take a deep breath and settle into your day before taking off at full speed. Do you forget what you need to do? Do you start doing one thing, get distracted by another, only to be doing a third thing when you remember what you meant to do in the first place?

These are things you need to take notice of: why and where you are disorganized.

2- Write things down.

Many nurses have a checklist they make on their own and they use this as their worksheet. By writing down what needs to be done, you have your objectives in front of you and don’t have to try to remember what needs to be done for each patient.

3- Give yourself time.

A task that may take only 10 minutes on a good day may take 15 or even 20 minutes on a not-so-good day. If you organize your day so that you only have the minimum amount of time for tasks, your whole schedule is blown the minute something unexpected happens and throws a wrench in your plans. Give yourself some breathing space when planning your day.

4- Ask for help.

Some people prefer to work alone but people on teams are often more effective at completing tasks in a timely manner. Try to team up with another nurse and to build a symbiotic relationship. This could really help you save time and be more organized. Plus, you would be accountable to your partner.

Time management isn’t magic even for nurses. And if you’re one of those nurses (or nursing students) who find it difficult to keep organized and on time,  you owe it to yourself  and your patients to try to find a way to relearn the way you approach your work and your shifts.

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