Answers to Your Nursing Career Questions

This is a difficult question to answer as it tries to anticipate work in a specific field. There is no question that mental health or psychiatric nurses are in demand around the nation. Psychiatric services are historically one of the more under-served and under-funded areas of health care in the United States. If you have years of experience in the field, working with various populations and facilitating different group meetings, you should be valued as a veteran in the field of potential employment.

I would start by checking out the American Psychiatric Nurses Association – Louisiana Chapter. Contacting them and inquiring about potential job outlooks in different regions of LA might be helpful to your search. They might have leads on the New Orleans region or at least some contact information for individuals who might be able to help. Also, make sure to check out Medi-smart’s Nursing Careers directory for more information and guidance on jobs in nursing. There are links and you can search for various fields of employment in nursing.

When you’re a nursing student, you have so much to remember and sometimes you wonder just how you’re going to do that. While sometimes you just HAVE to memorize things, other times you can use handy memory tricks called mnemonics. Here are a few that could help:

- Learning how to give IM, or intramuscular, injections to patients in their buttock can be stressful. The nursing instructors have made it so nursing students are terrified of hitting the sciatic nerve. Here’s a hint to help you remember where to place that needle:

“Shut up and butt out“:
The Upper Outer quadrant of the Buttock safely avoids hitting sciatic nerve.

- If you have to remember the components of the bowel, think business:

“Dow Jones Industrial Average Closing Stock Report”

Duodenum
Jejunum
Ileum
Appendix
Colon
Sigmoid
Rectum

- Do you have problems remembering which position is supine and which is prone? This may help:

“Supine is on your spine.
Therefore, prone is opposite.

- Or what about the difference between pharynx and larynx?

Eat Phood with your Pharynx. Sing La La with your Larynx

- Once you begin studying reproduction, there’s a whole new set of things to remember. Here’s something that can help you remember the path that sperm have to take for them to try to impregnate an ova:

SEVEN UP:
Seminiferous tubules
Epididymis
Vas deferens
Ejaculatory duct
Nothing
Urethra
Penis

- And finally, if you’re stuck remembering the six bones of the skull, try this trick:

“STEP OF 6 ”
The 6 skull bones are:
Sphenoid
Temporal
Ethmoid
Parietal
Occipital
Frontal

Your employer will provide malpractice coverage.  You will find that some nurses also carry their own individual malpractice insurance.  As you look at nursing positions, ask about the type of malpractice insurance that is provided by the institution.  Here are some questions to ask:

Am I covered for off-duty situations?  If I am helping a neighbor or volunteering in an activity such as screening clinics, am I at risk?  Is the coverage portable?

What are the liability limits?  Are they comparable with other institutions?  Are the limits shared with other staff named in a lawsuit?  Will a defense attorney defend me or the institution?

Does the policy cover me for claims made about an incident at this institution if I have left employment by the time the suit is filed? (An occurrence policy will protect you at any time in the future as long as it was in place at the time of the alleged incident.)

Is there coverage for defense of my nursing license if needed?

The American Nurses Association recommends that nurses carry individual liability coverage and provides discounted coverage for members.

There are many different ways to pay for nursing school: personal funds, grants, scholarships, government-subsidized loans, and private loans. Personal funds would come out of your savings or checking account. Grants are sums of money that do not have to be paid back and are granted to you usually through an application process or non-profit organization. Scholarships are typically merit-based monies given through an application process. Loans can either be subsidized by the government (where interest is paid and you are responsible for the initial loan amount only) or unsubsidized (you are responsible for paying the interest as well as the loan).

If you are interested in specific scholarships or grants for students studying abroad (from Africa), or looking to study abroad, you should check with your nursing program or institution. Consult your financial aid office regarding your payments or other options for financing nursing school. It can be pricey and finding the best way to pay for your program can save you from long-term loans. Check out the Free Application for Federal Student Aid (FAFSA) website for national financial aid assistance.

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.

Spacers are devices that function as holding chambers for aerosolized medications, typically for asthma.  Spacers improve the effectiveness of medication administration by capturing the medication so that the user does not have to coordinate inspiration as precisely with the puff of medication from the inhaler.  This allows for more of the medication to reach the lungs.  Use of a spacer is helpful in minimizing medication deposit in the oropharyngeal area, which can lead to thrush in the case of inhaled corticosteroids.  The MDI, or metered dose inhaler, fits into one end of the spacer, which is typically a plastic tube like device.  The opposite end is a mouthpiece or a face mask for young children.

To administer the medication, instruct the patient to shake the MDI and insert it into the spacer.  With the mouthpiece or mask in place, depress the MDI to release a puff of medication.  Maintain a seal while taking several breaths.  After a few minutes, the process is repeated.  This video from the Mayo clinic website demonstrates use of a spacer and inhaler.

A variety of brands of spacers are available.  Spacers should be cleaned with mild soap and water weekly and air dried.  When your patient understands how to use the inhaler and spacer most effectively, they are on their way to better asthma control.

Becoming a registered nurse, or RN, after high school can take as few as two years! During your final year in high school, it might be a good idea to take some nursing-oriented courses like anatomy or biology. The next step toward becoming an RN would be to attain your GED certificate or high school diploma.  From there, you will have several different options for becoming an RN:

• Applying to four-year nursing school programs
• Applying to two-year diploma nursing programs
• Applying to two-year community college nursing programs

While all tracks listed above will allow you to practice nursing as an RN, with a four-year nursing degree or bachelor’s of science nursing, or BSN, you can become a nurse leader, administrator or supervisor. Although tw0-year tracks tend to be less expensive than the four-year tracks, if you might want a master’s or PhD nursing program in the future, a four-year track is the way to go.

Make sure you check out Medi-Smart’s Nursing Schools directory. There, you can filter nursing schools by locations, type of degree received and type of program.

We can’t avoid it: news of Charlie Sheen’s behavior is all over  – and not just in entertainment news. But maybe instead of laughing at him, we should be concerned about him. Although he hasn’t been diagnosed, many who are familiar with bipolar disease and mental illness feel that this is exactly what is happening to him.

Maybe it’s not easy to identify with someone who has millions of dollars and lives life like Sheen does, but you don’t need to be famous or rich to suffer from mental illness.  One of the nurses you work with could be living with a mental illness. And when we laugh at public personalities who may be mentally ill, what does that say to the person next to you who may be fighting the same demons?

The most common types of mental illness are depression and anxiety. In fact, a study published in 2009 in the American Journal of Nursing, found that mild-to-moderate depression was common among nurses. According to the study:

“Somatic symptoms, stressful major life events, greater occupational stress, and lower income were correlated with the presence of depressive symptoms. Fatigue and low energy were bothersome to 43% of nurses; pain in extremities and joints, trouble sleeping, and back pain were also common. Having a mortgage or loan of more than $10,000 within the previous year was the most commonly reported (43%) stressful major life event. Others included changes in sleeping habits, vacation, and holidays. The most highly ranked occupational stressors were having insufficient time to provide emotional support to a patient and to complete nursing tasks, being required to complete many non-nursing tasks (such as paperwork), and inadequate staffing.”

What about other mental disorders?

According to the National Institutes of Health, one in four American adults have a mental disorder. There are so many mental disorders that it would be impossible to list them all, but some of the more common ones include:

- Bipolar disorder

- Eating disorders

- Obsessive-compulsive disorder

- Panic disorder

Mental illness is a hidden disease. It’s highly unlikely that a nurse with a mental disorder will share this with his or her coworkers because of the prejudice often seen towards people living with these illnesses. Perhaps we should all take a step back and look at  how we react to the different news stories that we see and hear about personalities and how they’re behaving. Our reactions to them may be very telling to those around us.

Cafe au lait spots are flat light brown macules that can occur in normal skin.  They may run in families , and if they are small and not numerous, are insignificant.  Larger and more numerous cafe au lait spots are worrisome not for malignancy but because they may be a sign of neurofibromatosis.

According to the National Institutes of Health, neurofibromatosis is a genetic disorder that causes tumors to grow in the nervous system.  While many people with neurofibromatosis have mild cases that minimally disrupt their lives, others have more significant disability based on the location and extent of tumor development.  Because some cases of neurofibromatosis occur spontaneously, the development of new cafe au lait spots, especially during childhood, should be carefully monitored.

Cafe au lait spots are not typically treated because by themselves they are not symptomatic.  If the spots are felt to be cosmetically unacceptable, a dermatologist should be consulted for treatment options.  If they are present in association with neurofibromatosis,  the person should be under the care of a neurologist with other specialists involved as needed.

Methicillin-resistant Staphylococcus aureus is a highly contagious and infectious bacteria that lives on and underneath the skin. Normally, you carry around certain strains of S. aureus on your body. This is why people get pimples and blemishes. Sometimes, the staph infections people pick up from the community (Community-Acquired MRSA, or CA-MRSA) turn into inflamed, swollen, and erythematous pustules that require treatment with antibiotics.

As the nurse, it is your job to perform wound care on this patient. The provider might excise and drain some of the infection. You are responsible for dressing the site with a topical antibiotic (bacitracin) and making sure the wound heals from the inside out (packing the wound with gauze if needed). The dressing should be checked throughout the shift and changed every 12 hours.

A lab specimen might be ordered by the primary care provider to test for the strain and for resistance. This will help to determine which antibiotics to use. You also want to manage the patient’s pain associated with the localized inflammation. Consulting with the provider about obtaining a PCA (patient-controlled analgesic) might be in order, depending on the pain level.