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Book Review: Your Next Shift by Elizabeth Scala

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Fellow Nursepreneur, Elizabeth Scala, has captured the nursing spirit again with her second book, Your Next Shift.  This is a great read for any nurse, wether you have found your career bliss or are still searching.   

Elizabeth Scala shares her own savvy advice while managing to tie in philosophies from great thinkers from Churchill to Green Day.  Scala gives us a sneak peek into her personal reflections in which we easily can recognize our own struggles and fears.

“When you are OK with where you are currently at, you are able to celebrate everything about you and then exude that energy out into the world.” Elizabeth Scala

Your Next Shift is not a blueprint for becoming someone else. Scala guides her fellow nurses through a journey of self awareness while sharing her steps to success, however you define it.

I recommend this book for every nurse that feels that there must be more to nursing, happy nurses that want to level-up their careers, and nurses that feel the call of a slightly different path.

-Carrie Sue Halsey

 

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Nurse burnout: When passion isn’t enough

A few months ago I was asked by the editor of Sigma Theta Tau’s online magazine, Reflections on Nursing Leadership, to write an article about nurse burnout. They published it as a part of their Nurses Week line up. In the article I share my personal struggle with nurse burnout and how I overcame it. I am very pleased to have my writing published in Reflection on Nursing Leadership.

Please take a few minutes to read and share with your nurse friends.  Chances are you have felt burned out in your career.  Share in comments how you renewed your passion for nursing.

 

 

 

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13 Fundamentals for Practicing Nursing

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National Nurses Week is a time set aside for the public to recognize the amazing work of nurses.  Nurses will be the topic and focus of hospitals, newspapers and media outlets.  Our accomplishments, character and hard work will be applauded and we will receive all kinds of tokens of appreciation from employers, patients and family.

This year instead of another pen, coffee mug or tote bag, I want to give nurses something that that won’t end up in the summer yard sale.

 

Rosemarie Rizzo Parse’s 13 Fundamentals for Practicing Nursing

 

  • Know and use nursing frameworks and theories.

You can begin with Parse’s theory of Humanbecoming, which is an insightful nursing theory that describes how nurses and patients co-create the health experience.  Parse marries the art and science of nursing in a beautiful and applicable way.

 

  • Be available to others.

Nurses are busy.  Do not let the fast pace of healthcare prevent you from being available.  Remember to be available for the nurses around you. No one understands you quite like a fellow nurse. Take the time to listen, help and care for one another.

 

It is a poor coping mechanism to view patients as diseases, room numbers or annoyances.  Nursing is stressful, people are not always kind, and you may never hear a thank you, but it is important to value everyone as a human presence.

 

  • Respect differences in view.

Whether you are a new graduate or about to retire, you are a nurse with opinions.  Differences in opinions are good!  Respecting differences of view is important too.  Creating a safe and welcoming environment, for everyone to share their view, will allow nursing knowledge to evolve and grow.

 

  • Own what you believe and be accountable for your actions.

If you believe in something or someone, stand up and speak up.  If you turn out to be wrong, admit it and move on.

 

  • Move on to the new and untested.

Change is hard.  No one likes it, but change is necessary and good for us and nursing.  If we did not push forward and try new nursing interventions we would still be sterilizing our own needles and fetching coffee for physicians. Parse’s theory is a paradigm shift away from medical thinking that embraces nursing as a standalone science.

 

  • Connect with others.

Compassion, caring, respect, understanding are all qualities that nurses help nurses to connect with the healthcare team, including the patients.

 

  • Take pride in self.

You are not “just a nurse.” Being a nurse is exceptional.  Don’t shortchange your contributions to healthcare.  You are brilliant, own it!

 

  • Like what you do.

If you hate your job, find one where you can be happy.  There are endless opportunities in nursing.  You owe it to yourself and your patients to like coming to work every day.

 

  • Recognize the moments of joy in the struggles of living.

Life is hard.  Take time to recognize and feel joy when you find it.

 

  • Appreciate mystery and be open to new discoveries.

Nursing is a beautiful work. We are the companions to humanity throughout the life span and in every imaginable condition. We continue to discover what it means to be human day after day.  Be open to the mysteries of life and embrace what you find.

 

  • Be competent in your chosen area.

            What have you been doing since you graduated nursing school?  Have you been to a conference, read a journal, taken a class?  Choose your nursing niche and keep learning.

 

Taking time for self is vital in order to prevent compassion fatigue and nurse burnout.  Nurses are known for putting themselves last.  Their own health, spirituality, emotion and mental needs are often put aside in order to care for others.  Take care of yourself!  Take a few minutes to meditate, pray or sit quietly during a hectic shift and you will feel the difference, and so will your patients.

 

Thank you to all my nursing colleagues around the world!  This is the week that everyone remembers that nurses are a special kind of awesome. 

Let’s remember this about ourselves the other fifty-one weeks of the year!

 

 

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Bournes, D., & Mitchell, G. (2014). Humanbecoming. In Nursing Theorists and Their Work(8th ed., pp. 464-495). St. Louis: Elsevier Mosby.

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3 Small Ways to Bring Mindfulness to the Bedside

Nurses multitask.  We are expected to be flexible.  We accomplish more than any one person should be capable of achieving in twelve hours. We do it all with a smile on our face, at least most of the time.  Behind the smile, our minds our often far from the bedside.  We are thinking about the patient in another room, when pharmacy will tube up the medication that is late, whether our lunch buddy is back from eating, and the charting that needs to be finished from morning assessments.  It is difficult to be truly present with the people that we provide care.  There are many distractions for our attention and energy.  Nursing is also an emotional career.  Supporting, caring and healing people exposes nurses to intense emotion from patients, family and friends of the patient and the nurses own emotion.  Stress, crazy workloads and intense emotions can be huge barriers to nurses having mindfulness at the bedside.

Three tips to put mindfulness in action at the bedside:meditation-clipart-meditation-clipart-animal

 

  1. It is what it is This is one of my go-to-mantra’s.  This is not a surrender to fate, it is an acceptance of the limits of my power as a nurse.  When I truly have done all the intervening and advocating possible, I accept the outcome.

 

  1. Being present Mindfulness requires us to pull up a stool, sit down and be with our patients.  It is letting go of everything else in the world for a small space of time in order to be present.  It is important to connect with each other human to human.  Being present also allows our attention to focus on this patient’s needs, fears, wants and hopes.  Not being present causes errors and decreases the trust from the patient

 

  1. Suspending judgement Being critical of our patient’s actions, feelings, choices or lifestyle prevents us from being present and having mindfulness. It is important to meet people where they are in life.

 

We will not always be able to be 100% mindful as a nurse.  These three tips can help us be more mindful with our patients for their benefit and ours.

 

This post was written as part of the Nurse Blog Carnival. More posts on this topic can be found at The Balanced Nurse Blog. Find out how to participate.

 

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Nursing is Bigger on the Inside

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I love Doctor Who.  For anyone that is not familiar with this British television program, the basic premise is as follows.  There is a cool alien that looks human, but regenerates every few season to look like the next actor to play him.  This alien is called the ‘Doctor’ because no one can know his real name.  The Doctor is a time lord from a planet called Gallifrey and he travels in what looks like an old police call box, much like a telephone booth.  This police box, the TARDIS, takes the Doctor anywhere in time and space, but that is not the only amazing thing about the it.  The TARDIS is bigger on the inside.  We don’t know how big, but imagine the Star Trek Enterprise stuffed into a telephone booth and you get close. 

Nursing is like the TARDIS.  

People think they know about nursing.  The public only sees the outside. They see that nurses work 3 days a week and are paid well. They see that nursing is not a glamorous job. They see smiling faces and skilled hands.  

Nursing is bigger on the inside. 

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A lot of nurses look cute in scrubs, but even those scrubs lose their appeal when they are covered in various bodily fluids.  I am frequently told by family, friends and random strangers that they could never be a nurse.  I get it.  Nursing is not for everyone.  

Some of us do work 3 shifts a week.  Those 12 hour shifts stretch into 14 or 15 hour days when you add in lunch, report, extra charting and commute time.  The majority of nurses that I have known work much more than 36 hours a week.  

For the most part nurses can at least fake a good mood and do their best to smile.  Smiling and chatting with patients they perform the technical skills that keep patients safe and comfortable.  

Nurses need to be smart, caring, brave, strong willed, strong stomached and have a sense of humor.  We see the worst and best of humanity in our work.  We are happy when our patients do well and cry when they are not.  Nurses monitor, clean, feed, medicate, assess, educate, entertain, console, listen, advocate for and document about patients day and night.  After doctors, therapists, family, friends and even dietary leave for the night, nurses remain at the bedside.  

Caring for patients is rewarding, gratifying and exhausting.  To be trusted to such a degree by a stranger is an honor.  Helping people meet health goals or guiding them through milestones is an amazing feeling.  Even when our patients pass away, helping the patient and family through the process is fulfilling.  

Nursing is much bigger on the inside.  It is easy to get lost in charting, policy reviews and quality audits and forget the art of nursing.  Nurses need to be reminded of the amazing impact that we have on peoples lives.  Nurses not only impact health at the bedside, but have the power to transform healthcare practice.  

 

Take time to remember how big nursing is and why you do it. Energize and renew your yourself at the Art of Nursing 2.0 event from anywhere in the world.  

 

 

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This post was written as part of the Nurse Blog Carnival. More posts on this topic can be found at ElizabethScala.com. Find out how to participate.

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The Secret Awesomeness of Night Shift

The hospital feels different after 5 PM.  

The scheduled surgeries are finished for the day.  The short stays and clinics are emptied and closed.  Administrators, executives and their assistants all begin vanishing like the sun over the horizon.  The last few tired nurses clock out and the hectic cloud of day shift follows them into the elevator.  What is left behind is an alternate hospital universe that only true night shift staff discover and appreciate.

The bright lights are dimmed to signal to patients, visitors and staff that night has arrived.  The coffee and tea come out to greet the healthcare team to another night.  Some nursing units brew their own caffeinated delights,  others take turns making massive runs to Starbucks, Dutch Bros or another favorite coffee spot.  Patient assessments are completed and medications are passed.  Nurses and ancillary staff move quickly to check off all the tasks on their lists.  If they are lucky they will be able to tuck themselves in to the nursing station to chart and chat the hours away until dawn.

Everything is more a little more relaxed.  No topic is taboo by 4 AM.  Night shift staff know each other, the good, the bad and the unmentionables.  If a manager or administrator happens to come in on night shift, the news spreads quickly and the books, smart phones and uncovered cups disappear in an instant.  Those late night visits from administration are rare. Night-shifters learn to depend on each other like family.   

The calm can be misleading.

In the darkened corners of the nursing unit lurk the possibility of chaos.  Disaster can interrupt the laughter at the nursing station, despite the careful observation and care of patients.  When emergencies occur, the night shift team leaps into action.  The juicy conversations and cat videos are abandoned and the only priority is the patient.  An outsider may not see an emergency on a nursing unit as seriously as the team working in it.  It does not usually look like it does on television.  There are a lot of people.  Everyone is in motion.  It is often quiet with one or two people calling out times and actions.  Faces are focused.  Minds are alert and assessing, searching for causes and solutions within milliseconds of coming to the bedside.  They have done this before and settle into their comfortable roles.  The night shift team are a little more earnest and confident.  They know that reinforcements are not coming.  This is night shift.

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When the emergency has passed, for better or worse, the team returns to its tasks.  The work and night continue.  

Despite the craziness and sleep deprivation, night shift is awesome.  Most people dread working at night and do not understand why any sane person would choose to work the late shift.  It is not the frappicinos.  It is not the chance of watching cat videos for hours.  It comes down to the men and women sharing the nursing station with you.  They don’t always get along, but they are always in it together.  They create the secret awesomeness that is night shift.  

Shhhhhh don’t tell the boss! 

 

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Private Fears of Healthcare Workers

I saw the tweet shoot across my phone during a meeting.  Someone had walked into Brigham and Women’s Hospital and shot a surgeon.  I did not know the story.  I did not need to read the details to feel the familiar terror creep into my heart.  It is not something that nurses often talk about.  In the privacy of break rooms, during whispered conversations and in our own minds we admit that patients sometimes scare us.

Death, birth, illness, surgery, dementia, sleep deprivation, drug induced psychosis, and alcohol withdrawal are examples of the dangerous landscapes that healthcare workers navigate each day.  I have been a nurse in many different situations and types of patients.  Labor and delivery is one of the most volatile units in a hospital.  Emotions run high when mothers and babies are involved.  Babies do not always go home with their mothers.  When child protective services is taking custody of a newborn, there is a palpable stress on the unit.

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Nurses are an easy target for angry parents.  Nurses are blamed, by parents, for reporting mothers who test positive for illegal drugs.  Threats against nurses and doctors are common in these type of situations.  Threats can lead to actual violence.  I have been physically hurt by angry patients.  I have seen nurses punched in the face, choked and pinned against walls.  In the back of my mind I am always planning my escape route.  My internal alarm goes off when I see a father stomping across the unit.  It makes me uncomfortable to see the poster banning guns from the hospital grounds.  Its a daily reminder that we are defenseless against a shooter that disregards that posted warning.

Hospitals practice disaster drills, one of which is an active shooter drill.  We prepare for the worst.  We hope we never have to face what Dr. Michael Davidson did on January 20th.  The investigation in the Brigham and Women’s shooting is still ongoing.  We do not know the relationship between the doctor and the shooter.  Regardless of the relationship, it will not decrease the worry and fear that healthcare workers live with in order to do their work.  Our mission and passion is to care for patients.  Patient safety is our top concern and what we base all care around.  On days like today, we are reminded that we need to also worry about our own safety.

As I was writing this post I recieved another tweet.  The surgeon has died. Dr. Michael Davidson, your colleagues around the nation are thinking about you tonight and mourning your loss.  Our thoughts and prayers go out to his family in this sad time.

 

 

 

 

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When there is No Rainbow after the Storm

I have a large family, by current standards.  I am the proud mother to five beautiful children.  I conceived all of them easily, had uneventful pregnancies and easy vaginal deliveries.  Sounds like a dream come true.  Not exactly.

My husband and I always planned to have six children.  We were happily pregnant, with our caboose baby, when all my good pregnancy mojo disappeared.  We lost our sixth baby at 12 weeks gestation.  I was devastated.  After a few months I became pregnant with my  Rainbow Baby.  I was a few weeks pregnant with baby number 7 when my former due date arrived.  I mourned the loss of my last baby again as that date passed, but I was comforted and reassured by the new baby growing inside me.  My seventh pregnancy only made it to 7 weeks.  A new storm overtook me.  I almost lost myself.  It seemed strange to many people that I was so sad.  It is hard to explain how it feels.  I felt selfish for being so sad, especially when I have friends that struggled to have even one child.  I know that my children are a blessing and I am grateful.  It was impossible to talk my heart into understanding that I should feel grateful and not miserable.

After two losses, we decided to not try for any more rainbows.

I have secondary infertility due to hormone imbalances.  Although it is possible for me to become pregnant, it is difficult to sustain the pregnancy.  When I learned my body was the reason my babies died it felt like my heart had been sucked from my chest.  I hated myself for ignoring every physical symptom that seemed so glaringly obvious in hindsight.  My mind replayed, on a loop, every possible time I could have been diagnosed prior to becoming pregnant.  “If only” became my nemesis.  I mourned my lost babies.  I also mourned my shattered body image.  I had trusted my body.  I owned a strange pride in my ability to conceive and birth perfect babies.  I rocked at baby making.  I gave birth like a boss.  I was a wizard at lactation.  That sounds bizarre perhaps, but I enjoyed my fertility and all the happiness that it brought to me and my husband.

I still have days when the “if onlys” sneak into my mind.  I sometimes think about what those babies would be doing now, if they had lived.  Those times are getting less frequent and I am grateful.  More of my minutes are spent in awe of my amazing five.  More kisses, more hugs, more cuddles are given to the ones that stayed.  

I did not get a rainbow after the storm.  

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My rainbow started with my first son and ended with my sweet baby girl.

This rainbow was made bigger and brighter with each of my five children.

It is not what I imagined it would be, but it is the most beautiful thing in my life.

Perinatal Loss Resources:

https://www.nowilaymedowntosleep.org

http://www.bandbacktogether.com/miscarriage-resources/

http://www.mymiscarriagematters.com

http://www.ahearttohold.org/blog-2/

 

 

 

 

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