Many nurses work for health care organizations that have social media policies to govern their online behavior in the workplace. It’s navigating social media at home when the risk can increase for inappropriately posting identifying patient, coworker, or hospital information on personal computers or other electronic devices.
The American Nurses Association (ANA) has a social media tip sheet that clearly states what’s at stake when such breaches occur.
”Nurses and nursing students have an obligation to understand the nature, benefits, and consequences of participating in social networking of all types. Online content and behavior has the potential to enhance or undermine not only the individual nurse’s career, but also the nursing profession,” the ANA tip sheet says.
To safeguard patient information, use these guidelines to successfully navigate social media:
- Adhere to the standards of professionalism, which are the same online and off.
- Separate personal and professional information online.
- Do not share or post information or photos acquired through your relationship with a patient as this violates the Health Insurance Portability and Accountability Act (HIPAA) and can lead to such adverse actions as termination, a civil lawsuit, criminal charges, and licensure discipline.
- Never use your personal devices to take photos or videos of patients.
- Do not post negative comments about patients and their families, or your coworkers and employers. Even if you do not use their names, they (and others) may read your postings on Facebook, Twitter, or other social networking sites, blogs, online chat rooms, and forums.
- Promptly report a breach of confidentiality or privacy.
- Avoid posting about a challenging or bad day at work. Again, certain details can help readers identify the place or people you are talking about. Consider recording your experiences in a journal instead.
- Notify appropriate authorities about content that could harm a patient’s privacy, rights, or welfare.
- Consider volunteering to help develop or update social media policies at your workplace.
Be mindful when you post on social media. Nurses are the most trusted health professionals for a reason. Keep it that way.
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.
There is good news about the upcoming holiday-pack-on-the-pounds-season. It’s still many weeks away. That means—at the moment—you can’t use the excuse of “it’s a bad time of year” to justify NOT working on your eating and exercise goals to get healthier.
Imagine this: if you start today, you have a nice head start on your 2018 resolutions.
Now, are you ready? If so, here are 11 strategies toward achieving a healthier body and mental outlook:
1. Reach your ideal weight.
Learn what your BMI is to determine how much you need to lose or gain to improve your health. Anything lower than 18.5 is considered underweight and a BMI over 30 is considered obese.
2. Move into a groove.
What kind of exercise brings a smile to your face? That’s not a trick question. Most of us like doing some kind of activity. The goal is to be active most days of the week for at least 30 minutes. Pump your favorite music and dance while cleaning, watching TV, or lifting weights. Find what works and rock out.
3. Chew more.
Speed eating leads to thicker waistlines. Slow down. Focus on savoring your meals, snacks, and refreshments. Challenge yourself to appreciate every ingredient. Jazz up your table, counter, or island with flowers, candles, or colorful plates and enjoy the view.
4. Minimize stress.
Start with deep breathing, which can lower cortisol levels and blood pressure, studies show. Whether you write in a journal, listen to music, or do an art project, find a way to unwind and relax while enjoying yourself.
5. Maximize positivity.
Your mind is a powerful tool to help you change. Start there. Look for the bright side. Seek out supportive friends. Find ways to reduce stress and increase laughter. Start each day with gratitude and move from there.
6. Get outside.
Fresh air and a brisk walk can be a wonderful combination to lift your mood, increase energy, and burn calories. Consider a picnic while it’s still warm.
7. Ink in play dates (for you, not your child).
You know that pedicure or dinner with your best friend that you keep putting off? Stop doing that. Repeat this: You are allowed to have fun.
8. Keep learning.
Ever longed to play an instrument? Want to learn screenwriting? If not now, when? Keep your mind nimble by stretching your brain. If time is tight, consider online classes.
9. Add vitamin D.
Research shows many of us are vitamin D deficient, which exposes us to all sorts of illnesses and diseases such as an increased risk for coronary artery disease, Alzheimer’s, and early death.
10. Practice mindfulness.
Being in the moment means you are fully present and paying attention to what’s occurring. This type of focus takes practice. Google to learn some exercises to practice mindfulness.
11. Drink lots of water.
Sometimes thirst is mistaken for hunger. Start the day by adding a bit of lemon juice to your water, which aids your immunity and digestion. Carry a water bottle with you to ensure you are hydrated.
Adding these strategies to your daily regimen requires discipline. Aren’t you worth it?
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!
Of the unexpected horrors that may lurk in the workplace, a hostile environment ranks high, especially if you find yourself with a target on your back. When a bully has someone on his or her radar, a dream job can morph into a nightmare. Workplace bullying jeopardizes careers and health. Stress-related health consequences affect the quality of life on and off the job.
According to the Workplace Bullying Institute (WBI), being bullied on the job closely resembles the experience of being a battered spouse.
“The abuser inflicts pain when and where she or he chooses, keeping the target (victim) off balance knowing that violence can happen on a whim, but dangling the hope that safety is possible during a period of peace of unknown duration. The target is kept close to the abuser by the nature of the relationship between them — husband to wife or boss to subordinate or coworker to coworker,” the WBI website says.
Whether you are a new or experienced nurse, protect yourself from workplace bullying with the following strategies.
1. Address the issue of being harassed whenever it happens.
Always respond in a professional manner. An emotional confrontation will go nowhere fast. Stay calm but be firm, whether bullying occurs in public or during a private one-on-one encounter. Consider saying, “Please don’t talk to me like that” or “Your comment is unacceptable.”
2. Create a record.
Write down each incident and include such details as time, date, place, and witnesses. You may need to present this document to Human Resources.
3. Seek out other victims.
There is strength in numbers when documenting a problem. You and your colleagues can work together to address the issue with your manager or HR. Request a safe and healthy work environment. Schedule follow-up discussions.
4. Take stock of your workplace culture.
Bullies often have exceptional skills and provide value to their organization. Answer some hard questions: Are employees pitted against each other? Are bullies promoted, punished, or unpunished? Who are the bullies’ best friends?
5. Seek professional help.
If you feel emotional or psychological harm, seek help from a mental health professional or your company’s Employee Assistance Program.
6. Seek a legal resolution.
If you decide to stay and fight, contact an employment lawyer to explore the possibility of legal action. But know this: according to the WBI, “U.S. labor laws provide embarrassingly few worker protections. Lawsuits are expensive.”
If despite your best efforts to avoid or deal with a bully you find it necessary to seek a new job, you should. No one deserves work trauma.
Consider your last visit to a doctor’s office or emergency room. Whether it was delivering your second baby, getting your father’s blood pressure checked, or removing a fish hook from your son’s eye brow as a result of a scout camp blunder, chances are a nurse helped you better cope with the experience. It’s what we do, and it’s part of what attracts new students to this profession every year.
All nursing fields are in need of smart, caring, dedicated people, but one field, in high demand but often overlooked, is public health. While more community-based rather than focused on individual care, the public health realm is ideal for nurses who enjoy designing cause-driven contributions in health care services within communities. It’s not glamorous, but the work is incredibly gratifying.
If you love the idea of working in the health care profession, but find yourself leaning toward the research, social cause side of health, here are four reasons why being a public health nurse is a great career choice.
1. Provide help where it is most needed.
As of 2014, 15% of the country’s population lives in rural areas, and many of these communities lack proper health care resources. Studies show that the per capita rate of primary care physicians is lower in rural areas of the country with 40 physicians per 100,000 rural Americans compared to the 53.3 physicians available in urban and suburban areas.
However, the need for services in these areas is much higher. Rural residents are more likely to suffer from chronic health conditions like diabetes, cancer, heart disease, depression, drug abuse, and viral outbreaks. Also, these communities need education on social and lifestyle changes that can influence drug abuse, child neglect, and self-sufficiency challenges.
2. Create positive inroads within local communities.
Whether it’s addressing high rates of drug addiction, unplanned pregnancy, hunger, or even suicide, it’s moments like these that remind us why we chose this profession in the first place. Being a public health nurse fosters our desire to help people and make a positive impact. “The community-based interventions used by public health nurses have amazing reach and impact,” says Marni Storey, BSN, MS. “Almost every strategy has potential to improve multiple health outcomes.”
Storey referred to campaigns such as improving prenatal care or reducing child abuse and neglect as examples of the positive influence a public health nurse generates. For example, by building awareness and providing resources to address these challenges, you are also increasing the likelihood of the parents’ economic success, the child’s success in school and future employment, and reducing future risks for depression, substance abuse, and chronic conditions like obesity and heart disease.
3. Take part in progressive research.
Not all nursing roles are seen by the public. In many cases, a nurse’s greatest influence happens behind the scenes, particularly in matters of research. In this field, you are developing an understanding of an entire community to uncover solutions to social challenges.
“Using epidemiology and research, we are developing and testing interventions that address social determinants of health,” says Storey. “Prevention at this level means addressing problems by asking ourselves what is the root cause of the problem, and how can we prevent it.” Unlike other nursing fields where patients come and go, a public health nurse witnesses transformation within communities on a regular basis. And that is extremely gratifying.
4. Be part of the movement toward health education and prevention.
When the Zika virus outbreak made national news, most people figured it was an issue limited to other countries. But, in fact, there was 36,986 symptomatic Zika virus disease cases reported in the U.S. territories. While doctors find solutions to control further outbreaks of Zika and other global threats to our health, it’s up to the public health sector to build awareness of the risks and educate communities on preventative measures.
Many believe that the trend in health care will shift from illness treatment to health education and prevention. According to Nurse Journal, “the profession is going to start to play an even bigger role in ensuring that the well stay well and the sick get better.” That means the role of a public health nurse will expand to accommodate these exciting new ventures, particularly in the rural communities.
So, you may not see a public health nurse star in a dramatic TV series anytime soon, but the positive work carried out by public health is transforming the lives of communities every day. And that performance is worthy of a lifetime achievement award — minus the red carpet and paparazzi, of course.