People who teach those who come after them often do so because they want to give back or have a positive influence on upcoming students in the field. That’s exactly what Susan Zori, DNP, RN, NEA-BC, an assistant clinical professor in the College of Nursing and Public Health at Adelphi University in Garden City, New York, does.
Zori took some time to explain to us what she does, why she does it, and what she would recommend to those thinking about becoming a professor at a nursing school.
What follows is an edited version of our Q&A.
What does your job entail? Do you specialize in specific topics that you teach? How many courses do you teach each semester?
My job is to inspire the next generation of nurses. I teach theory courses for Fundamentals of Patient Centered Care, Care of Adult 1, and Care of Older Adult, and I teach 2 to 3 courses per semester.
I constantly challenge myself to instill concepts and safety while bridging knowledge to actual clinical situations. I believe in active learning and incorporate active learning into classes.
Why did you choose to teach?
I have had an extensive career in clinical nursing and nursing administration. I am passionate about nursing and love teaching. I love seeing students light up as they make connections and become passionate about caring for patients. I find great satisfaction in “paying it forward” and preparing the next generation of nurses for a very different health care environment.
What are the biggest challenges of your job?
The biggest challenges are preparing students to pass NCLEX, with all that is entailed in writing tests, administering tests, and grading tests.
What are the greatest rewards?
I still work occasionally at a hospital in an administrative role. I sometimes come across an RN that I had as a student. When I do, it is wonderful to see them and know that I had a very small part in helping them in their journey.
What would you say to someone considering this type of work?
Nursing is a wonderful profession that gives one the opportunity to make a difference in patients’, students’, and nurses’ lives every day.
Being successful in nursing requires intelligence, perseverance, and passion. It is one of the hardest courses of study, but it is rewarding and offers one many different opportunities such as masters and doctorate level study as well as opportunities to continually learn, and truly shape health care.
Nurses are the perfect professionals to engage patients in wellness, manage chronic illness, coordinate care, and thus shape the current health care system into one that is accessible and equitable for all. Nurses can and will do this.
Nurses choose the area of nursing they want to work in for many reasons. Sometimes, though, they choose the patients they want to treat because the disease affecting the patients also affected their family in some way. That’s exactly what happened with Melisa Fincher, RN, charge nurse at Black Bear Lodge (BBL) in Cleveland, Georgia.
“I personally chose to work with these types of patients due to my family being affected many times by addiction. My husband has also been in recovery for 12 years from addiction,” says Fincher.
Fincher took time to answer our questions about her line of work. What follows is an edited version of our Q&A.
As a nurse who specifically deals with patients going through opioid withdrawal, what does your job entail? What do you do on a daily basis?
I do daily nursing assessments of patients in withdrawal to include vital signs, withdrawal assessments such as (CIWA/COWS), AIMS assessments, pain assessment, and assessment of patient’s emotional state. I give patient detox medications, regularly scheduled mental health meds, and regular medical medications. I do admission assessments on new admission of patients coming off the streets in active addiction. I discharge patients to home and educate patients on their discharge medication regimen. I provide ongoing education with my patients about their disease processes and recovery.
What ages of patients do you work with?
BBL treats patients of all ages above 18 years of age.
What are the biggest challenges of your job?
Helping patients get through the physical and mental challenges that detox from opiates and other drugs and alcohol cause them to go through. They often come across as angry and unappreciative, when in reality they are just so sick they can barely stand. The emotional dysregulation that a person goes through when in detox can be very difficult to deal with. And one of the biggest challenges is when a patient isn’t quite ready to do the work that it takes in recovery and then wants to leave against clinical advice. It is very difficult to see a patient leave before their treatment is complete because I know where the life of addiction is going to lead them back to if left untreated.
What are the greatest rewards?
There is nothing like seeing a person leave BBL healthy and happy again after most of the world has seemingly given up on them and most of the time they have given up on themselves. It is amazing to see them have hope again and to hear stories of how their families have been restored and how they have become productive members of society again.
What would you say to someone considering this type of nursing work?
Addiction is real, and it is a disease process that needs to be treated just like any other diseases of the body that we treat. Leave any preconceived ideas or prejudices about addiction being a “choice” at the door or don’t choose working in addiction medicine. Be ready to face some of the most challenging, but most rewarding times of your career.
The Maryland R Adams Cowley Shock Trauma Center (STC) in Baltimore has always been known as a fast-paced place that saves lives of people who are in the most dire condition and often near death. After a brutal accident or other occurrence, Marylanders will often see the STC helicopters flying overhead. They know where they’re going, even if they don’t know what has happened.
Have you ever wondered what it was like to work in such an environment? Brad Antlitz, BSN, RN, a clinical nurse on Multi Trauma IMC6 (MTIMC6) at the University of Maryland R Adams Cowley Shock Trauma Center, took time from his schedule to answer our questions.
What follows is an edited version of our Q&A:
As a Shock Trauma Nurse, what does your job entail? What do you do on a daily basis?
The Shock Trauma Center is a unique place to practice as a nurse due to the innate fluidity of the environment. The expected response to this question is typically wound dressing changes, trach care, or assessing chest tubes. While yes, we do follow our orders and perform exciting nursing skills, a richer peek into MTIMC6 is rooted in the powerful connections we form with our patients.
In my experience, those first few moments with the patient during nurse-to-nurse hand-off are crucial. Simultaneously, I assess the room and the patient, and I develop the connection. On any given day, we care for a variety of patients ranging from those joyfully being discharged whom require extensive education to those on the brink of death. In between are a myriad of events which take a true team mentality. This forces our team of nurses, patient technicians, and unit secretaries to constantly work together and remain five steps ahead.
MTIMC6 is known for high standards of care, thus earning the Beacon award from the American Association of Critical-Care Nurses for unit excellence and outcomes in 2015. However stressful and fast-paced, among the predominant signs of a patient enduring their injuries are the nuanced vulnerabilities we sense from a patient during the hustle of our day. It’s in these moments where the real care takes place—the holding of a hand for reassurance, a late-night back scratch during a bed bath with their favorite music playing, or even more simple, truly listening to the patient.
Why did you choose to work at Shock Trauma? How long have you worked there? What prepared you to be able to work in such a stressful environment?
I chose to work at Shock Trauma because I appreciate the mindset of team and the long legacy steeped in leadership. I have always been drawn towards great leaders. Throughout the entire organization, leadership is fostered. We are a Magnet organization, designated by the American Nurses Credentialing Center, where the true sense of the magnet perspective is found.
Nurses are happier because we’re empowered. We strive to improve upon nursing practice through our nurse residency program and the organization’s professional advancement model including evidence-based practice and nursing research. This type of environment fosters a culture of learning and inquiry, which in turn positively impacts patient outcomes and enhances the unit standards and cohesion.
Collectively, the strengths of the organization elicit pride in what we do so that we can remain committed to each other and the patients. This sense of pride can be felt throughout the halls of the Trauma Center. My military experience prepared me for the stressful environment. I was a Sergeant in the Marines, where a much younger version of myself was first exposed to the importance of strong leadership despite the chaos experienced when deployed. While compassion was instilled by my parents and extended family, I like to think I have a healthy balance of protector and caregiver—my Dad calls me the Warrior Poet.
What are the biggest challenges of your job?
The biggest challenge to the job is when I leave knowing I was unable to reach one of my patients, due to another patient requiring more of me. I rationally know that I am only one person, but my heart on these days departs heavy.
What are the greatest rewards?
The greatest reward is being a part of something much bigger than me. What occurs inside these walls is remarkable.
What would you say to someone considering this type of nursing work? What kind of training or background should he or she get?
You cannot be an individual in the Shock Trauma Center—first and foremost. It truly is built and sustained with team in mind. Most of the nurses are driven to expand their knowledge and are constantly achieving professional and personal goals. The moment someone feels they’re no longer growing, they typically move onto a unit of greater acuity or accomplish scholarly ambitions.
In preparation, I would suggest seeking a student nurse or certified nurse assistant position. At that position, seek out a mentor, and soak up all the knowledge and behaviors you can. Pay special attention to: how the nurses interact with each other and the physicians, the resources they utilize during their shifts, and how they interact with a patient’s family. These three behaviors can get you a long way and are often overlooked when orienting as a new nurse!
In October 2012, Rebecca Lee, RN, was working at Bellevue Hospital in New York City. Hurricane Sandy hit, and it hit hard. Lee recalls that all the subways, highways, tunnels, and bridges were closed. Streetlights were out. Robberies and looting was rampant throughout the city. “We had to walk in the middle of the street to stay safe in the meager moonlight,” says Lee.
But she wasn’t outside much. She stayed at the hospital for five days and four nights, working, as she says, “24/7.”
To remember this stressful time, Lee, who runs natural health remedies resource RemediesForMe.com, wrote a memo to herself on October 31 of that year so that she would never forget. The following is what she wrote:
“While the storm worsened, staff secretly stole peeks out the darkened windows, trying hard not to let our fear show to the patients. Most of my patients were bedridden and kept asking how the conditions look outside. All I could say was, ‘it looks okay,’ as their concern wrinkles on their faces momentarily smoothed out.
They must’ve known the storm was getting bad because the rain was beating the windows hard, and their televisions now showed nothing but static. I tried to keep them as comfortable as possible as I saw the batteries on their machines running low, lights suddenly shutting off, and phone lines being disconnected.
After a few short hours, the FDR had completely disappeared under the east river, and the water was quickly reaching Bellevue doors. The scariest thing I saw that night was cars that had been parked next to the FDR were being swept away by the waves. We also lost contact with the outside world. We worked while wondering about the status of our families, friends, cars, and homes. The staff began to wonder how long they would be trapped for.
The next day, it became clear that we had lost all power, food, water, and each minute became more precious than the next. The coast guard, along with hospital staff, formed human assembly lines on the dark stairway, all the way up to the 21st floor. They helped transfer patients by hand, and gave out food and water. Manual machines were utilized, and critical patients were transferred to other hospitals that still had working power.
During the storm, some units pulled together and worked odd shifts to relieve one another from exhaustion and hunger, while other units fell apart and became fierce and chaotic. We had no food, no running water, and no running toilets. After a few days, we were running low on options. Thankfully we had an endless supply of gloves and masks.
Thank you for anyone who volunteered during this time to do all the heavy lifting and dirty work, to make sure everyone was fed, hydrated, and less stressed. I am re-thankful for family, friends, health, food, water, showers, music, clean beds, working toilets, and electricity. On Halloween 2012, I celebrated Thanksgiving.
What I’ve learned through all this: You give and take away.”
Thanks to Lee for sharing her experience.
Have you ever had to work during a natural disaster? Share your experience in the comments.
When Teri Dreher, RN, CCRN, iRNPA, owner of NShore Patient Advocates, LLC in Chicago, Illinois, was still working as a nurse, she remembers when a patient kept having massive hemorrhagic episodes after a routine surgery. Despite this, the doctor wasn’t running tests to determine what was happening. When she questioned him, he yelled at her, became defensive, and threatened her. But that wasn’t the end of it.
“The next day, he transferred the patient out of ICU. She went into shock, and the family begged me to intercede. I told the daughter what I would do if it was my family member: insist she be transferred back to ICU and get a CT scan for an interventional study to find the cause of the bleeding,” recalls Dreher. Turns out that the patient had a bleeding splenic artery aneurysm that could not be accessed by the interventional radiologist to stop the bleeding.
Teri Dreher, RN, CCRN, iRNPA
“When the patient came back to ICU, she immediately started bleeding again, and we coded her for four hours, transfusing more than 30 units of blood. During the CODE, I had missed scanning out a narcotic, and 10 days later was charged with being a drug-abusing nurse,” says Dreher. Although her urine test was clean, she was put on 10-day suspension. This convinced her that she would never be happy again working as a bedside nurse. Her nurse manager had warned her not to tell the family member what to do to force the issue.
“I took a course in patient advocacy and started my own business. I vowed that no one would ever tell me not to advocate for a patient again,” says Dreher.
“Nurses today are taught to question, speak up, and challenge when they feel something is not right,” says Dreher. “Decades ago, the system was much more patriarchal, and nurses were frowned upon when questioning doctors. Doctors are human and make mistakes. Nurses spend more time with patients—we are the doctors’ eyes and ears.”
She says that good doctors generally listen to nurses, and nurses are free to speak with physicians as well as mid-level practitioners. If you don’t get a response from the doctor, she suggests speaking with the nurse manager, supervisor, and even the risk management department.
Dreher admits, though, that nurses who are “whistle blowers” can be at risk even with the nursing “bill of rights.” “Everything in hospitals is focused on data, stats, and money. If a nurse goes up against a physician, just do the math regarding who is more valuable to that hospital: a nurse who makes 80K annually or a doctor who makes millions per year for the hospital,” says Dreher. “I almost got fired for strongly advocating for a patient. Even though I was right, I was almost fired by a hospital that I had served well and faithfully for over 23 years.”
As a result, Dreher suggests that nurses still speak up, but tread carefully while doing so. “I think it is important to be humble and go up the chain of command carefully. Doctors have more training than nurses, and sometimes there are things we do not know,” she explains. “Communication is key—as well as respect. None of us knows everything, but if we have the courage to confront and work together collaboratively, everyone wins—especially the patient!”