A good friend of mine used to work shift work, and when the night shift rolled around, she always had problems eating. Some foods made her too tired, while others (like food or drinks with caffeine) gave her problems after her shift was over. She never quite got the balance that she had hoped for, and she also had no idea what to eat for snacks.
For all you nurses working the night shift—and especially those of you who are new to it—here are some ideas to keep in mind and some snacks that you can turn to that will help keep you moving and not make you feel tired.
Get Your Protein
You know that if you eat carb-rich foods or sugary beverages at the beginning of your shift, you will crash in no time. So when looking for snacks, choose those with lots of protein, such as:
- Peanut butter
- Turkey or chicken
- Hard boiled eggs
- Greek yogurt
- Tuna and crackers
- String cheese
Consider grabbing a handful of nuts at the beginning of your shift to help keep your energy up.
Suppose you took on an extra shift or an extra few hours and are now working at night? If you have time before the extra work, head to the cafeteria and get some high-protein snacks. And if you know about it ahead of time, always try to bring your snacks from home. If snacks from vending machines are your only option, go for the granola bars or even peanut butter crackers. While prepackaged foods aren’t the best, sometimes you have to go with them just to eat something to give your body fuel.
When you get home after a long night of work, then you can eat some carbs. If you want to have some cereal before you go to sleep, feel free. The carbs will help you to relax.
Surgeries often involve a number of nurses, all with specific duties to perform in order to ensure the safety and care of each patient. Theresa Clifford, MSN, RN, CPAN, CAPA, is the perioperative nurse manager at Mercy Hospital in Portland, Maine. In honor of PeriAnesthesia Nurse Awareness Week, she shares a little information about what it’s like to be a perianesthesia nurse.
As a perianesthesia nurse, what does your job entail? What do you do on a daily basis?
For the past 26 years, I have been privileged to call the PACU my “home” and have functioned in a variety of perianesthesia roles, including a clinical bedside nurse, a clinical resource nurse and most recently as a perianesthesia nurse manager.
As the manager for perioperative services, I am responsible for the staff and the quality of care that the staff provide throughout all phases of perianesthesia care. First, I manage the staff in a preoperative clinic. This unit is responsible for the preanesthesia assessment of all surgical patients. As soon as a surgery is booked, the work of putting together the preoperative story of the patient begins by a gathering of relevant patient data and calling the patient for an extensive nursing history. The workflow includes an algorithm that helps to identify patients at high risk for surgical or anesthesia-related complications. The main objective throughout this process is to help optimize the patient’s baseline status for the safest perianesthesia experience.
I also manage the staff in the same-day “Ambulatory Care Unit.” Here, we greet the patients on the day of their surgery and continue the process of providing high-quality preoperative care that includes verifying patient information, confirming surgical consents and procedures, and initiating the IV and preoperative therapies. Some of the preoperative interventions are aimed at preemptive pain management and include the provision of preoperative nerve blocks. This is also the unit where patients returning home on the same day of their procedure will be brought for discharge preparation and teaching following recovery from anesthesia (the Phase II unit).
The last unit I manage is the post-anesthesia care unit (PACU) where patients receive Phase I level of care. In the 1960s, the courts deemed the PACU as “the most important room in the hospital,” and I could not agree more! During this phase of care, the nurse is responsible for monitoring patients for airway, ventilation, and hemodynamic stability. In addition, the ongoing management of pain and comfort is actively carried out by the PACU nurses. Once the criteria for safely moving the patient from this intensive level of care has been met, the perianesthesia nurse will hand off care of the patient to the next level of care required.
Why did you choose this field of nursing?
“Curious indeed how these things happen. The wand chooses the wizard!” (J.K. Rowling). I always knew that I would be a nurse. My mother was an incredible nurse, and while I knew I didn’t want to work in her specialty field, I knew I wanted to grow up to be able to help people and touch their lives the way she did.
What are the biggest challenges of your job?
Honestly, the most difficult part of my job in health care today is remaining current with constant external and internal pressures to provide high quality, safe patient-oriented care within restrictive budgetary rules.
What are the greatest rewards?
The surgical experience for most patients is at the least, a memorable event, and at the most, life changing. It is a privilege to be able to participate in the experience as a guide, a knowledgeable professional, and as a source of compassion and care during a time when an individual can be most vulnerable.
What would you say to someone considering this type of nursing work?
I think perianesthesia nursing is a well-kept secret within the profession of nursing. There is a saying—do what you love, love what you do. There are a wide variety of opportunities within the perianesthesia practice to find a niche, a chance to “do what you love!”
Is there anything I haven’t asked you about being a perianesthesia nurse that is important for people to know?
It’s also important, as it is within any nursing specialty, to become aware of your specialty practice organization and to be an active member of your local and institutional work teams. The network built among specialty practice nurses, like perianesthesia nurses, allows for the opportunity to share knowledge and experiences and to participate in best practice and educational programs. The American Society of PeriAnesthesia Nurses (ASPAN), is the premiere organization for this specialty and provides an incredible source of information and support for the practice.
There are a lot of actresses and actors who have played nurses or a nursing assistant at one point in their careers. Then there are the celebrities who have actually been one.
We found a number of celebrities who either were nurses or had been studying to be one. Although we’re glad they pursued their other careers—as the entertainment world would be different without them—it’s fun to think that they could have been working side-by-side nurses in health care facilities today.
Here are just some of the ones we found:
- Tina Turner
Before she became a singer (and an amazing one at that!), Tina Turner was planning to become a nurse and even worked as a nurse’s aide in a local hospital. Can you imagine someone else singing her version of Proud Mary while shaking that spangled dress? No, neither can we.
- Bonnie Hunt
While she’s known as an actress, producer, director, and voiceover artist, Bonnie Hunt began her career path as a nurse. Although she really wanted to act, her father told her that she should become a nurse. Having been a candy striper in high school, Hunt listened to him. After graduating from nursing school, she worked for five years at Northwestern University Hospital and spent her nights performing at Second City improv troupe. Finally, she moved to Los Angeles and landed her first role as a waitress in the Barry Levinson movie Rain Man, starring Dustin Hoffman and Tom Cruise. Since then, she’s starred in movies such as Cheaper by the Dozen, had her own TV show, and entered the voiceover realm. She’ll once again provide the voice for Dolly in the next Toy Story movie, Toy Story 4. In the past, she voiced characters in A Bug’s Life and Monsters, Inc, among many others.
- Adrian Holmes
You may know Adrian Holmes as Lt. Frank Pike in the TV series Arrow, as Nick Barron in the series 19-2, or in many other roles he’s played on TV or in movies. But did you know that he started out as a nurse?
Nursing was a big part of his life while growing up because his mom worked as a nurse, and his parents ran a nursing home. Although acting called to him, Holmes earned his RN. Funny thing is that just after he graduated from nursing school, his acting career began to take off.
- Naomi Judd
Before she began performing with her daughter Wynonna to become one of country music’s biggest duos, Naomi Judd worked as a nurse. When Wynonna and Judd’s other daughter, actress and activist Ashley were growing up, Naomi supported their family by working as a nurse in the ICU.
While she stopped performing with her daughter more than five years ago, Judd still gives talks about hepatitis C, and she published her memoir River of Time, in which she discusses her battle with depression.
Maryland resident Dawn Silverthorn-Cerra, RN, BSN, has been a nurse for more than 30 years. For about the last five, she’s worked in home health care. She currently works for BAYADA Home Health Care. “I have to say it’s the best company I’ve ever worked for,” says Silverthorn-Cerra. So what’s it like to work as a home health care nurse? Silverthorn-Cerra took time to let us know. What follows is an edited version of our interview.
As a home health care nurse, about how many patients do you see each day, on average?
On average, I see 4 to 5 patients a day. That number can change, though.
Describe for me a typical day in the life of a home health care nurse?
The day of a home care nurse actually begins the day before. Home care nurses organize their day according to a variety of factors—geography of their patients, etc. Once the day is organized, each patient gets a phone call to confirm the approximate appointment time; I usually give them a 1- to 2-hour window regarding my arrival time.
I am blessed by this job to have flexibility. I drop my daughter off at school and then I head off to see my first patient. Each patient is unique. Some have wounds that need a skilled nurse assessment and wound care, i.e. if they have a wound vac. Many of our patients have just been discharged from the hospital because they have a chronic disease, such as congestive heart failure. These patients often require a lot of education regarding their disease process and medications in order to stop the cycle of them going in and out of the hospital. All of our patients receive education regarding their disease process, their medications, and how to live safely and independently in their homes, among other topics. Our teaching not only involves the patient, but also any family or caregivers that are involved with assisting the patient.
What are the challenges to this type of nursing?
There are always challenges with any type of nursing. Our care of patients is directed by their physician(s), physician orders, and, of course, insurance.
One challenge is communication with a physician. If the patient needs something or if there is a change in their condition, I am responsible for communicating with their physician. Sometimes, it may take a few days before they return my call. Thankfully, this is very infrequently an issue. I am fortunate that I feel like I have a lot of support from my clinical manager and office staff. They are always available to advise me when I am facing a challenging situation. In home care, you never know what you could face when you enter a patient’s home, so it’s good to know you have support when you need it.
Another challenge is the amount of time that documentation of your visits take. Although I have to say that BAYADA is diligently working on this. Every week, I get emails about how the documentation system is being modified to make it more user-friendly. I think this is pretty impressive that BAYADA listens to their clinicians regarding problems we find in the documentation program.
What skills do you need to have for this particular type of nursing?
Organizational skills are important as are strong interpersonal skills. You will come in contact with a lot of personalities, and you need to be kind, caring, and respectful regardless of your patients’ moods or attitudes. Patients are generally very nice and grateful for your help.
You must be able to function independently and have confidence in yourself. You should have excellent physical assessment skills. Venipuncture skills and IV therapy skills are necessary because many of our patients are able to come home and receive their IV antibiotics because of our presence and care. Patience and flexibility are on the list, also.
What kinds of people would do well here?
People who are enthusiastic about nursing and caring for patients, and nurses who like autonomy.
What do you love most about what you do?
Without a doubt, it’s my patients. You develop a relationship with them, and a mutual trust develops. They know you are there to help them, and they appreciate your efforts. We serve a lot of elderly patients, and many of them are on the verge of not being able to live independently any longer. Nurses teach patients about their medications, the purpose and action of them, and what possible side effects may affect their safety. We can make recommendations for assistive equipment that will make them safer in their home and also for other disciplines like physical and occupational therapy.
What do you wish more people knew about your job?
I wish people knew how great it is to be a home care nurse!
National Certified Registered Nurse Anesthetists Week lasts from January 22-28. To recognize those who work in this segment of the nursing field, we interviewed Dan Lovinaria, DNP, MBA, MS, APRN, CRNA, who works at the Minneapolis Veterans Affairs Health Care System (MVAHCA) to find out more about it what it’s like to work as a Certified Registered Nurse Anesthetist (CRNA). Lovinaria has been a nurse for more than 25 years, has been practicing anesthesia for more than 15 years, and is also a clinical assistant professor and an associate program director at the University of Minnesota Doctor of Nursing Practice Nurse Anesthesia Program. What follows is an edited version of our interview.
As a CRNA, what does your job entail? What might you do on a daily basis?
As a VA CRNA, my top priority every day is to provide access to safe anesthesia care for the amazing Veterans who fought for our freedom. I am humbled and honored to hear the Veterans’ stories about their deployments in Vietnam, Iraq, Afghanistan, and the Gulf War, to name a few.
Being a VA CRNA comes with a tremendous responsibility and a great deal of accountability. Patients are often anxious and nervous about their surgical procedures. It is my duty to set the tone and make an immediate connection with my patients upon their arrival in the preoperative phase. Something as simple as providing warm blankets to my patients goes a long way. The little things that make a significant impact.
I also ensure that my patients are well-informed about their procedure, and I answer their questions and reassure them I will be with them from the beginning to the end of the procedure. I will be carefully and vigilantly watching their every vital sign and breath during, and adjusting their anesthesia as necessary.
On any given day, I provide anesthesia care along with my physician anesthesiologist colleagues to our Veterans needing cardiac bypass, joint replacement, cataract extraction, endoscopy, or urologic procedures. We provide various types of anesthesia including conscious sedation as well as regional and general anesthesia techniques.
Why did you choose this field of nursing?
As a young immigrant from the Philippines, I always wanted to pursue a career in health care. Many of my relatives were nurses, physicians, and dentists. It’s in the blood.
When I was a sophomore in college at the University of Hawaii at Manoa, my father was diagnosed with stage 4 lung cancer. I drove him to his radiation treatments. The dedicated nurses who cared for him left an indelible impression on my mind and sparked my passion for nursing. After my father’s passing, this experience solidified my desire to pursue nursing.
What are the biggest challenges of your job?
In today’s ever-changing and ever-evolving health care landscape, it is a challenge finding balance to provide the best and most appropriate anesthesia care while considering the high costs associated with services rendered.
Another challenge with my job is that health policies continue to change and can vary drastically in some instances. Governing bodies continue to dictate what should be done for our patients versus what is the appropriate care for these patients as determined by the providers who care for them.
What are the greatest rewards?
There are many intangible rewards associated with the nurse anesthesia profession. First of all, having the opportunity to care for our nation’s Veterans is the ultimate reward. They are very special, gracious, and always thankful for the care received.
Another reward is when you witness a baby being born and held by their parents for the first time. It is very emotional. I keep telling myself that I am making a difference one baby, one mother, and one Veteran at a time.
What would you say to someone who is considering this field?
Being a CRNA is the best profession. It is challenging, rewarding, and fulfilling all at the same time. CRNAs provide the majority of the 40 million anesthetics in the country and are often the only anesthesia providers in rural America and other medically underserved areas around the country.
CRNAs are highly educated and trained to administer safe and effective anesthesia in every health care setting and situation. CRNAs are no longer the best kept secret in health care.