Back to School: What a School Nurse Does

Back to School: What a School Nurse Does

Remember the school nurse? At the time, they were usually women, and especially when you were a little kid, she made everything seem better when you didn’t feel good.

In honor of National School Nurse Day, we spoke with Brenda L. Brooks, the district head nurse, school nurse-teacher, and coordinator of health services in the Hudson Falls Central School District in Hudson Falls, New York to find out more about what being a school nurse is like today.

What follows is an edited version of our Q&A.

As a school nurse, what does your job entail? What do you do on a daily basis?

We do just about everything. In a typical day, I’m coordinating sports physicals; I might instruct a first grader on hygiene, and then help a student with anxiety issues at the high school. School nursing is way more than band-aids and ice packs. We’re first responders to any sort of issue that happens on buses or outside school.

It’s also working with parents to coordinate medical care. For example, rashes. If a student comes in with a rash, it may need clearance from a doctor before we can get that student back to school. So we’re doing everything we can to get that student back in the classroom as quickly as possible. In all, it’s serving the whole student, and making sure students aren’t missing time from the classroom.

Why did you choose this field of nursing?

I’ve worked in several hospitals specializing in every department except OR/ER and mental health. I’ve also worked in a doctor’s office. When my kids came along, I realized that the part of nursing I liked the best was the teaching. So I went back to school and got my teaching degree and taught science for 15 years. But I felt like I wanted to make more of an impact in my district. When the head nurse job opened up, I jumped on it.

What are the biggest challenges of your job?

Resources are always a challenge—whether that’s staff or things for my students like lice kits, transportation to the doctor, clothing, toothbrushes, etc.

A large challenge for us is getting support from a student’s family. For example, if a student is prescribed an EpiPen, will their parents be able to afford it?

Going along with that, we face the challenge of the mental and emotional obstacles outside school. I have kids who want to be in school, but their parents have mental/emotional or physical issues that keep them from supporting their child. For example, I put in a NARCAN program in the school to get all our nurses and PE teachers trained to use the medication.  I am working on district-wide strategies to address the impact of stress and traumatic events on the minds of our students.

What are the greatest rewards?

It’s a similar reward as when I was a teacher. It’s that moment when you’ve helped a student succeed. Now as a nurse, I’m helping their entire family succeed.

What would you say to someone considering this type of nursing work?

It’s demanding; it’s frustrating, and you’ll pull your hair out. But it’s so worth it. You make a HUGE impact. I tell my staff they’re the little stone thrown into the pond. You may not be able to see the waves far off, but you know you made an impact.

Is there anything else about being a school nurse that is important for people to know?

The most influential person in a student’s school life is their classroom teacher. But if kids are ill, worried about their parents’ health, are hungry, or don’t have clean clothes, they won’t be in that classroom. And many of those responsibilities fall on the school nurse. So we are serving many of the needs outside of class that are just as influential.

Celebrating Transplant Nurses Day

Celebrating Transplant Nurses Day

Established in April 2006, Transplant Nurses Day was created by the International Transplant Nurses Society (ITNS) in order to raise awareness about the tremendous contributions that transplant nurses make in the lives of their patients and the people with home they work. It’s held every third Wednesday in April—this year on April 19.

“The celebration recognizes the skill and commitment of transplant nurses around the world,” says Allison Begezda, senior marketing manager, ITNS. “Transplant Nurses Day is an opportunity to celebrate the contributions our nurses make to patient care, patient and public education, nursing research, and the profession of nursing.”

As part of the Transplant Nurses Celebration, ITNS holds an annual Transplant Nurses Day essay contest. They ask transplant patients to nominate their ITNS Transplant Nurse. This year’s theme was “My Transplant Nurse: Champion of Care,” and six patients submitted essays for consideration.

There are many types of transplant nurses, including transplant coordinators, surgical nurses, post-operative care nurses, research nurses, and more.

ITNS honors its nurses in other ways besides just on Transplant Nurses Day. The society also honors its members each year with two awards that are presented at the Transplant Nursing Symposium.

As Begezda says, with the Transplant Nursing Excellence Award, ITNS “recognizes that the role of the transplant nurse is unique and dealing with patients through the transplant continuum is often complex and challenging. ITNS recognizes a special nurse whose career has exemplified ITNS’s mission: ‘…promotion of excellence in transplant clinical nursing through the provision of educational and professional growth opportunities, interdisciplinary networking, collaborative activities, and transplant nursing research.’ The purpose of this award is to recognize an individual outside the nursing profession who has supported the efforts of ITNS and made an impact in the field of transplant nursing.”

With the Friend of Transplant Nursing Award, ITNS “wants to recognize a friend of the organization who has made an impact in the field of transplant nursing. ITNS recognizes that you do not need to be a nurse to make a difference. The purpose of this award is to recognize an individual outside the nursing profession who has supported the efforts of ITNS and made an impact in the field of transplant nursing.”

This year’s symposium will be held June 24-26. For more information, go to www.itns.com.

Safety First

Safety First

Since we were kids and began to explore our homes and the world around us, we would often be given a caution: safety first.

As nurses, it’s important to do everything possible to keep yourself as well as your patients safe. Patricia McGaffigan, RN, MS, chief operating officer and senior vice president of programs for the National Patient Safety Foundation (NPSF), took time to answer some questions about safety. What follows is an edited version of the transcript.

What are some of the most important tips that nurses need to know regarding patient safety?

Nurses must know that their safety is essential for patient safety. They should engage in and communicate worries on leadership walk rounds. There are many ways nurses can be involved in safety at their own level. For example, they can look for ways to champion care. Substandard care is not acceptable, and understanding reporting mechanisms for any related concerns is important. Understanding that error/harm is nearly always the result of systems issues.

What should nurses do if they make a mistake that results in possible patient harm/injury?

Typically, it is a chain of events that leads to an error, so the concept of a single person making a mistake is not really how we look at it at NPSF. In my talks, I usually ask folks if they have been involved in the care of a patient where a medical error has occurred, especially at the proximal, sharp end.

The first thing they should do is to ensure that the patient is receiving any immediate care that they need, which may range from observation to serious, high-level interventions necessary to stabilize or save the patient. And they should be honest in reporting all details of what happened to ensure that patients are receiving the most appropriate and comprehensive care. Nurses should understand how to report error, the process for RCAs, and asking for feedback on any outcomes and recommendations from those processes. Then there’s the issue of how to provide accurate and timely communication to patients and families.

Nurses should get help for any emotional distress they may be having, which includes immediate distress, and recognizing that their distress may be long term and require ongoing support to maintain their emotional health.

What are the most common tips that brand new nurses should know so that they can keep their patients safe? What about keeping themselves safe?

All nurses should be aware of practice policies and guidelines of their organization related to all aspects of patient care. They should immediately question anything if they are not informed or are concerned about risk—speak up and don’t be ashamed if you’re worried. They can learn how to appropriately express their concerns using a methodical approach to communications, such as SBAR [Situation, Background, Assessment, Recommendation].

They should include any patient/family reported concerns, because often they are an important barometer of whether a patient may be “different.” This is especially true, for example, in pediatric patients, where parents are often the best early warning system. They should ask more senior nurses or others on the care team for their advice and support. They should complete a foundational safety science course if they have not had one in their training, and look with enthusiasm to education/training/simulation exercises offered by their organization.

All nurses should be trained in ergonomics, safe patient handling, proper use of PPE [Personal Protective Equipment], and disposal of contaminated materials (including needles/sharps). They should come to work well rested, ensure they have time for breaks and nutrition, and that they understand the limits of human fatigue. They should look for and take advantage of peer support programs and training. They should know how to report any harm to themselves.

Some people tend to get scared in the hospital, rehab center, or any place they would be treated by nurses. What can nurses do to alleviate their fears?

Again, communication is important and can help allay fears. We recommend that health professionals get educated about the prevalence of low health literacy and tools and tactics they can use to improve communication with patients/families. Nurses—and all clinicians and staff in a health facility—should be sensitive to cultural issues, language differences, use of translators, and the like.

Like Night and Day: Tips for Working Swing Shifts

Like Night and Day: Tips for Working Swing Shifts

Some nurses work the day shift and others work the night shift. Then there’s an entirely different group who works both day and night: the swing-shift nurses. Working swing shifts—day shifts and night shifts in the same week or even in two-week period—can be tough on your body. So we asked an expert to give some great tips on how to deal with it and stay healthy at the same time.

Julie Aiken, DNP, RN, CNE, AHN-BC, CEO of Ameritech College of Healthcare for night shift nurses, suggests the following for nurses working swing shifts:

1. Practice staying up—and sleeping in.

Leading up to your next shift, push back your normal sleep schedule a few days before that shift. Don’t totally shift your cycle, since after your overnight shift ends, you’ll return to a (more) normal work schedule. If you can stay up and sleep in even an hour later, it can help.

Other adjustments like going to the gym at night, and doing housework like dishes at 10 p.m. or midnight, rather than when you finish dinner, can also prepare your body for standing and working when it’s usually sleeping.

2. Sleep—and nap—beforehand.

On a similar note, get as much rest the day before your shift as possible. Sleep in late that morning, and if you can manage to carve out even half an hour to nap, do so. The more you’ve rested, the more energy you’ll have during your shift, even if your body wants to sleep.

3. Eat well and pack good food.

The food we eat matters—and affects our energy levels. Before your shift begins, eat some high-energy food like vegetables and complex carbs. You should also pack a similarly nutritious meal, because the cafeteria may not be open, and junk food from vending machine can make you sleepier. Eating high-energy snacks throughout your shift will keep your body’s metabolism going and your energy up.

4. Keep your mind alert.

Some nurses suggest wearing a bright digital watch during overnight shifts to stay focused, even when you’re feeling groggy. Some people sing songs to themselves; others engage in conversation every fifteen minutes, and a few nurses take 30-second breaks and use breathing exercises to remain mindful. Whatever works for you, try it. When you feel sleepiness creep in, engage your mind in some way to remain awake.

5. Don’t rely on caffeine.

If you’ve pulled an all-nighter before, you know the power of coffee—but you may also remember that as soon as its effects wear off, you crash. That’s a risky method when you’re caring for patients and supporting staff during your overnight clinical shift. If you need a boost, try dark chocolate or a little green tea to supplement more natural efforts at staying awake.

6. Remember that tired is normal.

Your clinical supervisor isn’t going to expect you to be as perfectly alert at 5 a.m. as other RNs will seem to be. S/he knows this is practice and experience, so make sure your effort is on your work and assigned tasks rather than fighting off any hint of drowsiness.

Becoming a Certified Nurse: What You Need to Know

Becoming a Certified Nurse: What You Need to Know

March 19th is Certified Nurses Day, the time to specifically honor nurses who have earned certifications. According to the American Association of Critical-Care Nurses, more than 768,917 nurses in the United States and Canada held certifications in 2016 (so said data collected by the American Board of Nursing Specialties).

Ever wonder why you might think about earning a certification? We asked Denise Buonocore, MSN, RN, APRN, ACNPC, ANP-BC, CCNS, CCRN, CHFN, an acute care nurse practitioner for Heart Failure Services at St. Vincent’s Medical Center in Bridgeport, Connecticut and the Chair-Elect of the AACN Certification Corporation board of directors for her thoughts on the matter.

What follows is an edited version of our Q&A.

DeniseHow long have you been in the nursing field, and what certifications do you hold?

I’ve been a nurse for 38 years, with 25 of those years as an advanced practice nurse. I first became CCRN certified after working as an RN in critical care for two years. After completing graduate school and a post-master’s certificate program, I took certification exams for adult nurse practitioner (ANP-BC), acute care nurse practitioner (ACNPC), and clinical nurse specialist (CCNS). My subspecialty is heart failure, so I felt it was important to become heart failure certified (CHFN).

Why do you think it’s important for nurses to get certifications? What does it do for them? For the field?

It is important to become certified because it demonstrates to you, patients and families, and employers and teammates that you have the knowledge, skills, and abilities to meet national standards. Becoming a certified nurse is a mark of distinction and demonstrates excellence. Your RN license demonstrates entry-level competency. Certification validates specialty knowledge. Many employers—especially those on an excellence journey such as Magnet or Beacon—look to hire certified nurses or expect that nurses will become certified as part of the organization’s efforts to build an environment of professionalism and culture of retention.

On a personal level, being certified shows your deep commitment to your profession, lifelong learning, and personal improvement. By becoming certified, nurses may position themselves for appropriate recognition and advancement. As a certified nurse, you are a role model for professional practice and commitment to your team members, and it demonstrates dedication to patient safety and improving patient outcomes.

What’s the difference between board certification and being certified in a specialty?

Board certification is certification that meets the accepted criteria for state licensure. Examples of this are advanced practice exams. Specialty certifications are not required for licensure, but are important in demonstrating the knowledge in that specialty area.


How do you know you’re ready to become certified?

Start by reviewing the qualifying criteria for the certification you want to achieve. Most exams have a clinical practice requirement in the area of specialty before you can apply to take the exam. Then assess where you are on your personal learning journey in your specialty. I believe it is never too early to begin to study for the exam. I think the best part is finding out what you don’t know or what you need to improve on, formulating a plan for learning new information, and then applying new learnings in your clinical practice.

Do you need additional education to become certified? What are the requirements to apply?

RN specialty certifications such as CCRN and PCCN, or subspecialty certifications such as CMC and CSC, have core curriculum knowledge requirements in addition to practice hour requirements. There are many ways for you to gain this knowledge—attending conferences such as AACN’s National Teaching Institute & Critical Care Exposition, taking a live or online review course, reading review books or articles, and taking practice exams to build on your current knowledge and build confidence.

If you want to be certified as an advanced practice nurse (ACNPC-AG, ACCNS-AG, ACCNS-P, ACCNS-N) you will need to graduate from an accredited graduate-level advanced practice education program, and meet specific curriculum and clinical practice criteria to take the exam. The exam qualifying criteria can be found in the certification section of AACN’s website.

What does it take to maintain your certification?

Passing your certification exam is not the end of the road but rather the beginning. Recertification is just as important as your initial certification. It is the mark of true long-term commitment to lifelong learning and improvement. Each certification has specific renewal criteria. Most certifications require a combination of continuing education and professional activities that demonstrate your continuing competency.

What have been the greatest rewards for you that happened because you earned your certification?

The greatest reward for me personally in becoming certified was the validation of my knowledge and a deep sense of achievement and commitment. After I passed the CCRN exam, I remember feeling more confident in my ability to care for critically ill patients. I also felt connected to the community of certified nurses and potential certified nurses. I was fortunate that I had a few colleagues support and encourage me when I was considering taking my first exam. In turn, I have paid that forward to mentor and encourage the next group of potential certificants. That first certification was a catalyst to further my education eventually becoming a nurse practitioner and clinical nurse specialist.

What would you say to someone considering becoming certified in any field?

Do your homework! Look at the test plans, set aside specific time to study, determine how you want to study, and sign up for the exam. If you set up a test date, you are more likely to work toward it. Just do it!