Saturday, September 3, 2011

12 Tips for a Rewarding Nursing Career

12 Tips for a Rewarding Nursing Career

Every once in a while it's a good idea to take stock of your life and your career, and take steps to get yourself back on track, or even change direction if that is what is needed.  

Here are 12 things you can do for yourself, as a nurse, to make your career more fulfilling and to avoid nurse burnout:

  1. Nurse stress management is a must.  Learn techniques that work well for you and use them routinely.
  2. Managing your time efficiently and effectively is vital.  Become organized, stay on top of things, and do not procrastinate!
  3. Replenish yourself.  Make time for yourself and do it often!  Nursing is a demanding/giving profession.  If you have given all you have to give, then you have nothing left for yourself, and you can't continue to give - you'll have nurse burnout.
  4. Nursing is a lifelong learning process.  Use your continuing education opportunities to stay up to date with your selected field and to learn and hone new skills.  Secondly, make sure to learn something about other fields of nursing whenever you can.  Know your options and keep them open. 
  5. Nurses are overachievers.  Strive for excellence and set the bar high.  Do not settle for mediocrity.  Encourage others to do the same. 
  6. Be a nurse mentor.  Help those around you to strive for and achieve excellence as well.  Always being a nurse mentor throughout your career is the key to providing excellent quality care with the best possible outcomes. 
  7. Be a sponge.  Learn from others.  Pick up on their tips and tricks and then share them with others.
  8. Always be a part of the solution and not part of the problem.  Get involved in strategic planning for your workplace and help to make it a better place.
  9. Be a good TEAM player.  Be a nurse leader when you need to be and a nurse supporter always.  There is no “I” in TEAM.  Be good role model to others who “just don’t get it,” and help them to become team players too. 
  10. Learn your limitations and how and when to say "No."  Respect yourself and always set a good example for others.  It’s simply not possible to say “yes” every time and not get burned out!
  11. Remind yourself often WHY you became a nurse.
  12. Encourage others to become nurses and to strive for excellence. 
Nursing is one of the most rewarding careers you can find, but it is also physically and emotionally demanding and draining.  Take time for yourself so that you have something more to give when it is needed.  And when you find yourself stressed and burning out, remind yourself why you became a nurse.

About the Author: Kathy Quan, RN, BSN, PHN is an accomplished writer and author of four books including: The Everything New Nurse Book and 150 Tips and Tricks for New Nurses.  Kathy has been in the nursing profession for over thirty years, and is very passionate about patient education and mentoring new nurses.

Sunday, August 28, 2011

Nurses Heal Thyself: A Culture of Silence

Nurses Heal Thyself: A Culture of Silence

By: Kathleen Bartholomew

When Shelli was a new scrub nurse with only six months experience, she failed to anticipate that the surgeon would need a particular scalpel. Immediately, her preceptor deftly slapped the correct blade into the impatient surgeon’s outstretched hand with a glare in Shelli’s direction.   The surgeon said nothing, but a look of disappointment briefly flashed across his face. At that moment, Shelli learned that if she was not on top of the surgeon’s needs, she would end up feeling embarrassed and looking incompetent. Shelli did not find this information in her orientation manual. 
We learn these unspoken rules very quickly in order to survive.  We know which physician not to ever call in the middle of the night, which nurse talks about us behind our back when we ask a question, and whether we should even bother to write up an incident report or approach a coworker with a concern we have about ‘their’ patient.  This knowledge is vital to our survival because it determines whether or not we will be accepted by the group. 
It’s called culture.  Human beings rarely, if ever, succeed at accurately perceiving their own culture. Anthropologists say, “It’s like a fish talking about water.  It’s the last thing the fish ‘sees’ because it constantly surrounds him.”   Yet nothing is more powerful than this unseen force.  So deeply entrenched is culture that no one talks about it:  the unspoken rules and behaviors (called ‘norms’) are never written down, and yet everyone knows them.   We learn these norms the hard way by the process of assimilation – like Shelli’s story above.
When individuals merge and form a group, there are always things they can do, things they must do and things they can never do.  For example, healthcare workers do not typically share their feelings in high-tech, high-pressure environments because feelings are perceived by the general culture to be ‘soft stuff’.  Ironically, this belief couldn’t be further from the truth.  Feelings not only matter, but are conveyed unconsciously because 93% of all communication is non-verbal.   In a study of collaboration among residents, nurses and physicians the single most important factor to producing positive collaborative outcomes turned out to be affect – our bodies consistently express what we feel  (McGrail).  For example, think of your own workplace.  Is there someone you work with who you think doesn’t like you?
They don’t. 
The feeling you are getting that someone doesn’t like you –even if they’ve never said anything- is dead on correct.   Herein lays the problem and the biggest contributor to nurse to nurse hostility – a culture of silence.  We don’t check out the intended message in the non-verbal interaction. Nurses rarely if ever confront each other because their main style of communication is passive-aggressive and nurses are known to be conflict avoidant.   When over 4,000 nurses were asked why they don’t speak their truth, the answers were consistent (Bartholomew):
1.    Fear of retaliation:  someone refusing to help me, a bad assignment, denied a vacation day, a bad schedule
2.    Fear of hurting someone else’s feelings or making the situation worse
3.    Why bother? Nothing is going to change anyway
4.    Fear of isolation, rejection, gossip
5.    They’ll turn it around and it will be my fault; it’s not worth it.     
First, we have to admit that having some conversations requires courage – especially if the conversation should have happened a long time ago.  And then, we need to learn a new communication model – like the “Juice Pull Conversations” -which allows us to confidently speak our truth.  Remember starting your first IV?  Remember the nervous fear of hurting someone unnecessarily, of puncturing the vein?  But after starting a hundred IV’s, you feel skilled and competent.   The same is true for the skill of engaging in difficult conversations – the first one is always the hardest.  But the damage of not having the conversation is far worse - like gangrene for our profession because we don’t sense the urgency or see the damage.
This is what Ghandi meant when he said, “You must be the change you want to see in the world”.  We could complain for years about staffing grids, missed meals or stressful work conditions.   Or we could start a tsunami of change for our profession and our patients.    If every nurse spoke their truth, we would heal ourselves; and thereby become a blazing beacon of healing for a wounded world.

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