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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.

 

Nurse Blog Carnival

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Nurse Burnout: 12 Ways to get Your New-Grad Happy Back

Nurse burnout happens.  No nurse is immune.  If you are a nurse you are at risk for burnout.

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Remember how it felt to be a brand new nurse?

The only thing more shiny than your new stethoscope was your happy face.

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I diagnosed myself with nurse burnout when I started thinking that driving my car off a cliff sounded better than going to work.

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I was able to get back to my nursing happy place and I am in love with nursing again.

Here are some ways to get you back to happy-dancing your way to work.

 

 

1.  BLOG!  I love it and I’m not the only nurse on the interwebs!  If you are not a writer then read nursing blogs.  There are all flavors of nursing blogs, from informative to hysterical.

Some suggestions to get you started: Mine of course!   Adventures of a Labor Nurse   The Nerdy Nurse     Nurse Together     Mighty Nurse     Scrubs     Digital Doorway

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2. Go back to school.  Getting your BSN, MSN or DNP will make you more marketable and open up more options.

Going back to school will reenergize you about nursing.

You will read a LOT about new nursing research, which will get you out of a nursing rut.

You will be so busy making powerpoint presentations and writing discussion posts, you will have no time to think/complain about work.

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3. Get certified in your specialty.  If you are burned out then you probably have been a nurse more than 2 years.  Congrats!

That means that you are qualified to become certified in your specialty.

There is a certification for just about everything nursing related.

Look for your specialty on ANCC or NCC to start.  You will be recognized for your knowledge and add to your credentials.

Maintaining certification means that you will need to keep up continuing education in your speciality, which will prevent you from becoming stagnate.

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4.  Take your vacation days!!  Everyone needs a break.  Nursing is stressful.

If you don’t take vacation for yourself, then take it for your patients.  Being a relaxed and refreshed nurse will benefit them.

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5. Celebrate wins.  We are always focused on what we need to improve and what we are doing wrong.

When you or your team have a win, celebrate!

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6. Take some time for yourself.  Nurses know how important self-care is, but its difficult to find the time. Find it!

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7. Join a committee.  Make changes.  Give your input.  Does your hospital have shared governance or unit representation to make decisions?  If yes, join.  If no, start it! You can change nursing practice.

 

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8.  Be active.  Exercise can help improve mood and is a great outlet for work frustrations.

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9. Go to a Nursing Conference.  

There is nothing better than going to a conference full of nurses.  People think that ComicCon is weird, but they have never been to a nursing conference! We have crazy nurse fun!

It is a great time and it is a place where you are reminded why the heck you became a nurse.

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10.  Spend some time with your work buddies away from the call lights and nurse rounds.

You know you love your team.  An out of work activity can remind you that your work pals are awesome.
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11. Attend a continuing education course or webinar about a topic that interests you.

Will you be inspired by experts talking about the topics that they love.

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12.  Quit.  Not nursing, but quit your job.  Sometimes you really don’t have nurse burnout, but job burnout.

One of the best things about being a nurse is the vast opportunities you have for employment.

If you need a change of pace, location or specialty do it.  Give a proper notice and leave on good terms.

You never know when you may work with those nurses again.  (It will happen.)

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Nursing is a rewarding profession.  If you feel yourself getting disenchanted, actively try to get the magic back.

 

If you are successful you will be back to the new grad feeling which is good for you and your patients.

 

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How do you beat the nurse blues?  Leave your suggestions in comments.

 

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Post Conference Tool: Delegation

Two challenging concepts to master, as a new nurse, are prioritization and delegation.  I am sharing the attached tool for anyone that teaches nursing students or new grads.  Its a quick delegation activity to get a discussion going on prioritzation and delegation.  There are suggested answers, but of course there will be more than one way to delegate the tasks.

 

Enjoy and I hope that at least one of your post conference activities will be covered.

 

Click for the Free PDF: Delegation activity

 

 

Delegation activity

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There are No Guaranties in Pregnancy

Moms are brave.

Pregnancy is a normal function of life.  Most pregnancies proceed on a predictable course and result in a healthy baby. Although it is a normal part of life, pregnancy is unpredictable. There are no guarantees.  Some of the bravest people I have met have been mothers that were facing unknown outcomes.  Women that faithfully endure days, weeks or months of bed rest amaze me.  Mothers whom have lost babies in previous pregnancies bravely try again, and again.  Starbucks and sushi are passed over for the health of the baby.  All these sacrifices and more moms willingly make. Moms bravely face the unknown with faith in the future.

One brave mom checked herself in to the hospital at the request of her obstetrician.  She was late in the second trimester and her baby was not doing well.  While I asked her the standard questions I saw the tears build in her eyes.  I turned away from the computer and sat next to her.  I asked her why she was being admitted.  I knew, but I wanted her to be able to tell me.  She opened up and began telling me, first her diagnosis, then her fears followed by her hopes.  My eyes stung as I forced back my own tears.  This woman had been smiling and laughing moments before.  She was incredibly brave.  I held her hand briefly and I told her that she was in exactly the right place for her baby.  I assured her that we, as her care team, would do all that we could to help her and her baby through the challenges that they were facing.  Those were not empty words.  I believe that we work miracles in OB every day. I am grateful that brave mamas place their trust and hope in our hands.  I never want to let them down.

 

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10 Nursing Actions to Bring Compassion Back to the Bedside

Even the most benevolent and happy nurse can forget that every patient is someone’s special person. Some days feel like just another ordinary day at work.  Nurses have bad days just like everyone else. The difference is that a nurse’s bad day can darken a patient and family’s already stressful stay.

When nurses begin to lose sight of the how important their role is a patient’s recovery it is important to recharge, refresh and relearn what it takes to make each day special for patients.

 

Here are 1o ways to bring compassion back to your patient’s bedside:

 

1. Identify something you like about your patient. This may be difficult with some patients, but everyone has some redeeming quality. Find it.

 

2. Smile. If you smile your patient will feel welcome and it can change your attitude as well.  Fake it till you make it.

 

3. Acknowledge and speak to all the people in your patient’s room.  The patient’s family is important and they will appreciate being recognized.  Also they can be recruited to help get ice, hold emesis bags and feed the patient.  The people in the room will be the ones that will be there to support the patient at home when he is tired and needs help. Include the whole family in patient education so that the transition back to home be will be successful.

 

4. Include the partner or loved ones in conversations with the patient. A patient’s support person needs to understand and give input on the patient’s plan of care. The decisions are the patients to make, but they often look to their partner or loved ones for guidance.

Including the partner in the conversations with patient establishes trust and is an element of family centered care.

 

5. Take lunch off the unit. This may be impossible at some hospitals.  If at all possible, leave the unit for your break. Go outside and breathe real air. Take a walk in the sunshine and absorb some vitamin D.

 

6. Use your relaxation skills to relax yourself.  You teach these techniques to patients every day, those same relaxation techniques can benefit stressed nurses!

 

7. Use your vacation days! Don’t hoard vacation days. People that take less vacation days have less job satisfaction.

 

8. Join your professional nursing organization. Keeping up to date on new research is exciting and stimulating.  Challenge yourself and continue to grow in your specialty.

 

9. Go out of your way for your patient at least once a shift. They may not thank you, but you will know that you put in extra effort to make your patient’s stay better.

 

10. When the family is visiting take a few seconds to look away from the IV pump, computer and thermometer.  Witness how the family comforts and supports each other. Watch as a daughter holds her mother’s hand for the last time. See the happiness when a husband is told he can take his wife home.  These moments are what make us human.

 

Take the time to make every day special for your patients.

For nurses it is just another day at work, but for each patient it’s a day that can change their life.

 

 

 

 

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23 Ways You Know You Work Nightshift

This was you when you decided to try nightshift.
1. This was you when you decided to try nightshift.
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2. This is how you ask to be low censused after you had to stay up all day.
You avoid the sun.
3. You avoid the sun.
You have become an expert in the art of sarcasm.
4. You have become an expert in the art of sarcasm.
You become like siblings to your nightshift buddies.
5. You become like siblings with your nightshift buddies.
Drinking at 0800 seems perfectly normal.
6. Drinking at 0800 seems perfectly normal.
This is how you greet the dayshift when they are late.
7. This is how you greet the dayshift when they are late.
Your beauty maintenance tends to get behind.
8. Your beauty maintenance tends to get behind.
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9. This is your response when the charge nurse asks where you would like to float.
This is how you feel when you get the message to come in on call.
10. This is how you feel when you get the message to come in on call.

 

This is the look  you give the  person that asks you to stay 4 more hours after your shift.
11. This is the look you give the person who asks you to stay 4 more hours after your shift.
What you say to every meeting that is scheduled at noon.
12. What you say to every meeting that is scheduled at noon.
Running to codes is a breeze.
13. Running to codes is a breeze.
You have seen so much that in emergencies you are eerily calm.
14. You have seen so much that in emergencies you are eerily calm.
This is how your family feels when someone rings the doorbell during the day.
15. This is how your family feels when someone rings the doorbell during the day.
No topic seems inappropriate after 1 AM.
16. No topic seems inappropriate after 1 AM.
When you hear that one of your best friends is going to dayshift.
17. When you hear that one of your best friends is going to dayshift.
This is how you feel when someone tells you how nice it must be to sleep at work.
18. This is how you feel when someone tells you how nice it must be to sleep at work.
Everything is funny at 4 in the morning!
19. Everything is funny at 4 in the morning!
Your bedroom has black out curtains, blankets, or tinfoil on the windows.
20. Your bedroom has black out curtains, blankets, or tinfoil on the windows.
How you feel when your lunch/nap alarm on your phone wakes you up.  Back to work!
21. How you feel when your lunch/nap alarm on your phone wakes you up. Back to work!
How you feel after working a 6 night stretch.
22. How you feel after working a 6 night stretch.
No matter how crazy working nights can be, you are grateful to work with the best people ever!
23. No matter how crazy working nights can be, you are grateful to work with the best people ever!







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Acknowledgements: All gifs were found on google 🙂
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Men Need Not Apply

 

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If we, as women, want equality in the workplace, why are we sabotaging our fellow nurses? Why do we call males in the nursing profession “male nurses”? Using this phrase insinuates that nursing is a female profession. It is true that in recent history nursing has been dominated by females. Currently about 10% of nurses are male, but that number is growing. Women have fought for status among our male physician colleagues. We wanted to be respected for our knowledge, training and experience. Our sisters, daughters and friends became medical doctors by an increasing number. Gender stereotypes in medicine have been torn to bits. We do not refer to women MDs as “female doctors”.  Yet we cling to our gender biases in the nursing field. This bias is clearly evident in the obstetrical field. In the land of labor and delivery, female nurses continue to dominantly out number male nurses. This may be more design than accident or patient preference.

It starts in nursing school.

Beginning in nursing school, men are cautioned to be respectful of mother’s wishes to be cared for by women only. This warning is appropriate and justified as some cultures and religions forbid men from caring for women. Other women may have experienced sexual violence or simply prefer women only care givers. Outside of these exceptions, it should be presumed that the gender of the nurse does not matter. The hypocritical bias against men in labor and delivery is especially apparent during nursing school.  It is common for a male student to be shooed out of a patient’s room that not only has been to a male doctor, but has male residents rounding on her. The message that we are giving our fellow nurses is clear.  Male doctors are respectful and take care of patients appropriately, but a male labor nurse is, for lack of a clinical term, creepy.

I have heard the argument that men don’t understand what women need in labor, because they can’t have babies. This is a belittling and backwards notion.  If that concept is extrapolated out to other fields of nursing, then only cancer survivors can work oncology, the mentally ill can only work psych and diabetics only can teach about diabetes. There are many women that have never, and will never, have babies that are wonderful labor nurses. I have met many of these ladies and I am proud to call them friends and colleagues.

As a clinical instructor, I spoke to a patient and asked permission for a male student to take care for her during her delivery. This is not an action that I wanted to take, but what was required of me by the unit. The sweet lady agreed graciously. Her labor nurse went right in after me and sabotaged the whole plan by “clarifying” that this was a MALE nurse and he would be there for the delivery and was she SURE that she wanted a MAN in her room. When the question is posed in that way, patients may begin to feel embarrassed and feel like they should say no. Her doctor was male, which made the situation more preposterous. The student was gracious about the situation, but his learning suffered because of a nurse that felt justified in blocking him from the experience.

Is our culture biased against male nurses?

There is a cultural bias against males in OB nursing.  It begins in nursing school and is reinforced in the hospital setting. I have had multiple conversations with floor nurses, hiring managers and physicians regarding hiring males into labor and delivery. The push back is quick and strong. We don’t need men here, we don’t want men here and our patients shouldn’t have to have men in their deliveries. A survey was conducted to gauge perceptions of males in obstetrical nursing revealed that this is not what patients, nurses or men prefer (McRae, 2003). According to the study most pregnant women would accept a male OB nurse. Up to three quarters of the labor nurses surveyed had positive attitudes toward male labor nurses. Few men had worked in obstetrics, 6.8% and most said they would not want to work in OB. Male nurses did site nursing school as the reason they were not interested in OB. These results can be viewed as a tremendous positive for men who would like to pursue obstetric nursing. With very little representation in the specialty, men enjoy a favorable opinion from both mothers and current labor nurses.

Social Media weighs in on the topic.

I quick polled two of my online social groups. One is a mothers group and one is for labor nurses. The majority of the mothers reported that they would be comfortable with a male labor nurse. The ones that stated that they would  uncomfortable explained that they were exceptions. They agreed that males should be free to be OB nurses and probably would be good at the job.

Brittany Renee Dunevant summed up her feelings this way, “Women have a male doctor (OBGYN), so what is the difference? If he knows what he is doing, then he is the same as a female nurse to me.”

The labor nurse group had similar feelings. All respondents agreed that males should be OB nurses. About 46% of the nurses had worked with male OB nurses. Half of the nurses said that although there was no official ban on male nurses, it was an unspoken rule in their labor unit.

Erin L. Hollen is a perinatal nurse, certified childbirth educator and  breastfeeding counselor.  Erin discovered that she had some hidden biases that the survey brought to light. Upon reflection she observed that a male nurse may have a positive affect on fathers. Speaking of fathers Erin shares “…if they see that you can still be supportive of a woman in this situation and still be ‘masculine’ maybe they will participate more.”

Is labor and delivery a secret, girls only club?

In many hospitals the answer is yes. The new question is: How will we break down the gender bias that we are perpetuating with each new class of nursing students.

Answer: Let male nurses into OB. No questions asked.

 

McRae, M. (2003). Men in Obstetrical Nursing: Perceptions of the Role. MCN, The American Journal of Maternal/Child Nursing, 28(3), 167-173. Retrieved November 22, 2014.

 

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Being a New Nurse aka The Hunger Games

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All nursing students have heard the saying, “Nurses eat their young.” Being a new nurse is scary.        Your first nursing job may feel  like the Hunger Games.

 

 

 

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You think you nailed the interview when the manager loves your nursing school story about the geriatric patient with the smelly feet.

 

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After your third panel interview in a week, all you can manage is to say thank you and hope that you get a job offer.

 

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This is you nailing your first nursing  job.

 

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This is the firs time you sign your name with RN

 

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The opening ceremony is how you look in your starched uniform and perfect bun.

 

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This is how you look after you’ve been a nurse for 6 months.

 

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Finding a computer to chart is like fighting your way to the cornucopia.

 

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You have never heard so many machines beep at one time.

 

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The reaction you get when you ask for help from the nurse that no one warned you about.

 

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The pep talk your preceptor gives you about caring for the 90 year old, 90 lb woman with dementia who you are just a tad afraid will hurt you, again.

 

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The last 7 minutes of your shift, while you are waiting to clock out.

 

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The minute you finish your shift assessment your charge nurse floats you to another unit.

 

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You and your buddy decide to complain to your manager about your 4 on, 1 off, 4 on night shift schedule. They won’t fire both of you…right?

 

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Haymitch is your veteran nurse friend that gives you advice and is always dragging you out for bloody Mary’s after your night shift

 

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When the doctor belittles you in front of the patient.

 

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This is the key to getting nursing awards.

 

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Losing a patient is difficult, but you have to finish your shift.

 

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This every shift that is short staffed, which seems like every shift.

 

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Getting to know the other staff is not as easy as you think.

 

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Learning how to prioritize patient needs and requests can be overwhelming.

 

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Your family and friends don’t know what you are going through, but they are your biggest supporters.

 

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How you feel when the charge nurse asks you take your 3rd admit of the day.

 

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How you justify playing Candy Crush after you offer to help out your unit.

 

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When you find out your work spouse accepted at another hospital.

 

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Keep smiling! Your bonus is based on the patient satisfaction scores.


 

 

 

 

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This is you realizing you are not a brand new nurse anymore. You actually know what you are doing!  You rock!  Now its your turn to be a mentor to a new nurse.