5 Things No One Ever Tells You About Nursing School

5 Things No One Ever Tells You About Nursing School

Thinking about going to nursing school? You’re headed for a great career, one that’s rewarding, challenging, and always exciting. But nursing school is notoriously difficult. Most nursing programs require high GPAs and impressive scores in math, chemistry, biology, psychology, and other demanding subjects. It’s also extremely fulfilling. These are things most people already know about nursing school, but what about the things no one ever tells you? Here are a few of those things.

1. You Will Pull All-Nighters

Nursing school isn’t for the faint of heart. In fact, it can be extremely challenging. Just take a look at the curriculum for the Johns Hopkins School of Nursing—a school that, by the way, is consistently ranked in the top three nursing schools in America. Master of Science in Nursing (MSN) candidates at Johns Hopkins must complete nearly 50 credits and 500 clinical hours to finish their master’s program.

Bachelor’s candidates take longer to graduate than ever before, with most nurses spending more than four years earning their undergraduate degree. Because nursing programs tend to be more demanding in terms of credits, many students are forced to fast-track their degrees by taking multiple hard classes at once. If you’re in nursing school, that means several of the most stressful mid-terms and finals at the same time.

Because of these factors, all-nighters are inevitable. But nursing students know better than everyone else that staying up all night to cram isn’t good for your health. Getting a good night’s sleep before a big exam will help you retain memory and stay focused. Make sure that when you go into nursing school, you don’t bite off more than you can chew. Try to alternate those tough classes so you don’t have competing exams.

2. You Will Experience Burnout

Nursing school burnout is real. But don’t take it from us. There have been numerous studies indicating that nurses-in-training feel burnout at a higher level than students seeking other career paths. One study found that nursing students in the U.K. felt increasing levels of stress and used negative coping methods as their programs progressed.

The same study found that as nursing programs got harder, students experienced physiological morbidity, meaning they developed health issues as a result of their stress. But don’t let the prospect of burnout deter you from pursuing a nursing degree. Researchers are working to develop new programs that deter fatigue and burnout.

With the risk of burnout and fatigue higher for nurses, how do they stay positive? It all comes down to focusing on the end goal. Nurses enjoy myriad benefits compared with other career paths, including greater job stability, stronger personal satisfaction, the ability for career mobility, and the potential for higher salaries.

3. You’ll Have to Spend Money Out of Pocket

With the average cost of a bachelor of nursing science (BSN) degree quickly creeping up well into six figures (the average cost of a BSN is somewhere between $40,000 and $200,000), it’s important to remember that nursing students also have to spend more out of pocket than many other students seeking a bachelor’s degree. In addition to the cost of tuition and housing, nursing students incur additional costs associated with licensure exams, text books, and medical supplies.

When you prepare for your clinicals, internship, or lab courses, you may also be required to invest in nursing scrubs or uniforms. This isn’t such a bad thing, though. Think of your scrubs, stethoscopes, and everyday equipment as an investment in your future. And when you look the part, you’re more likely to succeed. Make sure that you invest in high-quality medical uniforms and durable shoes (we recommend Dansko) so that your wardrobe will stay with you until you’ve graduated and passed your licensure exam.

4. You Will Become Cynical

Here’s the thing: nursing and nursing school are stressful, and part of that feels out of your control. When you’re doing your internship or certification hours, you’ll be faced with a wide range of scenarios that feel utterly impossible: a patient with an illness that has no clear treatment track, the notoriously difficult bureaucracy of hospital administration, the inequalities of health care. All these things can contribute to cynicism over time.

Another phenomenon among nursing students and professionals is the experience of becoming desensitized to people’s trauma and suffering. Ask any child of a nurse and they’ll tell you that their parent rarely panicked over a bloody injury or a particularly gross illness. That’s because the more you’re exposed to medical conditions, the more normalized they become. Over time, it may feel like nothing shocks you anymore.

Studies show that this phenomenon occurs because nursing students are forced to “compartmentalize” their emotions. In other words, they separate the natural human reaction to a person bleeding from their immediate need to provide life-saving care. Newer nursing pedagogies put a serious focus on empathy to help deter nursing students and professionals from becoming desensitized on the job.

5. You Will Make Friends for Life

Nursing school is a unique environment. There will be few times in your life when you’ll engage so closely with people of the same career path, especially in scenarios where you’re forced to work together and lean on each other so often. Making friends in nursing school isn’t inevitable for everyone, but it can certainly benefit those who prioritize friendships. Close friends will help you succeed when you study together, network together, and confide in each other.

But there’s a flip side to this, too. In any social situation, there’s likelihood for drama and disagreements. Small, insular nursing programs may require you to live, work, and study with your classmates, which can lead to an environment that encourages cliques and bullying. Going into nursing school with a friendly, positive, and focused attitude can help ensure that you stay on the outside of any distracting confrontations. It’ll also help you make friends that you’ll keep for a lifetime.

A New Year’s Resolution: Oatmeal for Breakfast

A New Year’s Resolution: Oatmeal for Breakfast

The alarm goes off; you groan. How can it be time to get up already? You check the clock, hit the snooze button, and decide to skip breakfast in your head. You can eat something later—there’s no time.

Now that a new year is upon us, it’s time to renew some healthy habits. Many people resolve each new year to exercise more frequently or to eat healthier. I’ve got an easy suggestion for your nursing new year’s resolution: One of the best habits you can instill in your day is simply to eat breakfast before your shift.

As nurses, we know and can recognize the symptoms of hypoglycemia in our patients. But so frequently, the symptoms of low blood sugar are manifesting in ourselves and we don’t even notice. It is so important to eat breakfast, as it helps energize your morning, stabilize your blood sugar, and set you up for clear thinking and communicating at the beginning of a 12+ hour day.

Eating something in the morning is better than eating nothing, but some choices are better than others. The best breakfast choices are usually high in protein, fiber, heart-healthy fats, and complex carbohydrates. (And no, that mug of coffee doesn’t count as breakfast!)

Especially during winter, I urge you to try a bowl of oatmeal. Quick-cook oats take just two minutes to cook in the microwave, and they are so versatile. Try adding dried mango and shredded coconut, applesauce and cinnamon, or fresh fruit and Greek yogurt. Top with some raisins or nuts for added protein. Oatmeal is filling: it contains both soluble and insoluble fiber, which helps regulate your blood sugar and reduce your cholesterol levels. Even better, oatmeal is cheap! An entire canister of oats is usually less than $4 at the grocery store.

Oatmeal can be quick and easy to make and prepare (I set mine out the night before in a microwave-safe container, so in the morning I just add water and go), and I guarantee it will keep you full longer than that cup of coffee or berry smoothie. Overnight oats are a unique twist and make prep in the morning even faster. If you aren’t into hot cereal in the morning, try an oatmeal bar, the powerful effects of the oats are still available in bar form too, although be wary of excess sugars.

Whatever you grab as you walk out the door, make sure you’re setting yourself up for the best shift you can possibly have. Our job as nurses is hard enough without doing it on an empty stomach.

Palliative Care in the NICU

Palliative Care in the NICU

Many advances have been made in the last two decades in successfully treating smaller and sicker neonates. Focus on curative care, improvements in technical interventions, and pushing the limits of viability in order to save the most vulnerable life has become the predominance in neonatology. Despite this trend, death in the NICU remains frequent. The babies who die in the NICU account for the majority of infant deaths in this country. Furthermore, many graduates from the NICU have chronic, life-limiting illnesses that contribute to infant mortality after discharge.

Hospice, or the end-of-life care in terminal patients, certainly provides a component of caring for critically ill neonates, though care of this sort is beneficial long before an infant is deemed terminal and curative care is stopped. Palliative care arose for this need. Palliative care is specialized care offered to patients with chronic, life-limiting illness, which focuses on the relief of the physical, psychological, and spiritual suffering from chronic illness, whether death is imminent or not. All hospice care is palliative care, but not all palliative care is hospice care.

Palliative care, hospice care, and curative care all intersect in the NICU while caring for the most fragile and vulnerable patients with limited life expectancy. These small babies are found to have a 40-200 fold increased risk of neonatal mortality. Even among the survivors, however, serious life-long sequelae are common, most notably chronic lung disease, short gut syndrome, and cerebral palsy. Yet, despite the clear benefits to this population, a formal palliative care team is commonly not found in most NICUs in the United States. Resistance is often created by the NICU caregivers themselves, perhaps due to reluctance to acknowledge perceived sense of failure in caring for neonates who do not respond to treatment, reluctance to add another specialist at a time when family is most vulnerable, or simply a lack of understanding of the benefits that can be provided with this focused, specialized support.

Palliative care is rendered in a team approach and can extend throughout the life of the patient, beyond the NICU, both while both inpatient and outpatient. The multidisciplinary team is led by a board certified physician trained in providing pediatric palliative care, joined by specially trained nurses, social workers, and clergy. The parent becomes an integral partner within this team who, after education and identification of what defines quality of life for their infant, guides decisions regarding the course of treatment. The palliative care team, working in conjunction with the medical or curative team, develops unique goals of care with the patient’s family, providing support in relief of physical pain and discomfort of the infant as well as spiritual end-of-life care when appropriate. Care is a planned intervention with consistency in the message provided, which assists the family when making care decisions for their child and gives dignity and meaning to this young life. Unlike hospice care, palliative care can be provided in conjunction with ongoing curative care and continued beyond the discontinuation of curative care. Ideally, the relationship between family and palliative care team begins early, so trust is well established when moving towards decisions to end curative treatment.

An additional benefit provided by the palliative care team is support of the NICU staff caring for these complex patients. For those professionals who commit their skills to caring for these precarious lives, grieving the many losses encountered throughout their career creates susceptibility to moral distress or moral fatigue, apathy, depression and burnout. Those trained in palliative care are capable of supporting not only families but also NICU staff in many ways. First, by providing interventions that diminish suffering and helping families give meaning to their infant’s life, the suffering witnessed by caregivers is minimized somewhat. Second, they provide conflict resolution measures when parents and caregivers are not in agreement of the course of action that is warranted, thus minimizing aggressive and inhumane treatment in the face of futility. Further, the palliative care team arranges formal debriefing sessions for NICU staff after difficult cases. These measures are important in acknowledging grief reactions in the providers and assisting in healthy resolution.

Appropriate patients for referral to palliative care team can be decided by each NICU, but generally the list includes infants born at the edge of viability, infants with chromosomal or anatomical abnormalities known to be life-limiting, infants with significant neurological injury requiring gastrostomy or tracheostomy, and any other infant with multiple anomalies that are life-limiting. Referral should occur with a prenatal diagnosis or as soon as the condition is identified in the NICU. Early establishment of support for the family facilitates improved connection and communication between the team and the parents. The transition from curative to comfort care is more seamless when this relationship is established early, and parents are educated and supported in making decisions with priority given to reality rather than unrealistic hope.

In conclusion, together with many advances in neonatal care, we continue to be responsible to provide the best care possible. This includes appropriate and unselfish end-of-life care when curative treatment fails. Instead of saying “there is nothing more we can do,” we need to say “it is time to redirect care and focus on providing a peaceful and meaningful death for this baby and its family.”

Creating a Better World: Working with Refugees

Creating a Better World: Working with Refugees

Raya Cupler, a pre-licensure nursing student at Chamberlain University’s Columbus campus, didn’t think twice about heading overseas to help refugees. During a time when all of her nursing classes were online, Cupler volunteered for two-and-a-half months at refugee camps in Lebanon and Jordan. While there, Cupler worked in primary care as well as women’s health and surgery. Due to limited resources, she learned to think outside the box and improved her critical thinking skills. When there aren’t enough resources available, you have to get creative.

“I decided to work with Syrian refugees because of my own,personal experiences as a child growing up in the Middle East. I experienced first-hand the effects of war from terrorist activity, resulting in my family being quickly relocated to the United States,” says Cupler. “I was also raised by my mum, who was a child of the Lebanese civil war, and she inspired me to be a part of the relief effort.”

Cupler didn’t travel to the Middle East with any specific organization. But upon arriving, she worked with local non-government organizations and international non-government organizations.

Here is an edited version of our interview:

Raya Cupler

Raya Cupler

What did you hope to accomplish while there?

I realize that my contribution is only a drop in the bucket for what refugees of war need. However, I hoped to show the refugees compassion that they did not receive prior and hoped to better understand how health care works within refugee camps and during times of war.

During the two-and-a-half months that you volunteered, what were some of the biggest challenges you faced?

As a Chamberlain nursing student, I certainly had a baseline of skills to provide to refugees. However, working in such a complex environment, it was a challenge to enhance my critical thinking skills and provide care to refugees. Additionally, it was traumatic emotionally. There was a set amount of resources available, which are not nearly enough for all the refugees in the camps. Part of my role was to make decisions on who will have the best outcome from a specific intervention, which was extremely difficult.

What were some of the greatest rewards?

The experience forever changed me, as well as my perspective on health care and the world. The greatest rewards were establishing a personal connection with the refugees and having them open up to me. As far as nursing, I gained a lot of confidence in my skills and in my critical thinking, which I will continue to leverage in my nursing career.

What were the most important things you learned while there?

Lately I feel that our world is lacking compassion. And, while we may all be divided by nationality, language, or beliefs, we need to be kind to one another. Any one of us can be a refugee of war, and the experience was eye opening. I realized the impact nurses and nursing students have on people and that we can change a person’s life through care. It is such an honor and privilege to be part of the nursing profession.

Would you do it again? Why? Why do you think other nursing students should do something like this?

Despite the heartache, trauma, and challenges I faced, I would experience it all over again in a heartbeat. While not yet as experienced as practicing nurses and other health care providers, nursing students can serve as a fresh pair of eyes and bring an open mind. Nursing students are not yet accustomed to anything being done a certain way, which uniquely positions us to adapt to a changing environment where you have to think outside the box in order to be successful.

If you are interested in this type of work, an excellent introduction is to start locally. There are a lot of opportunities to take care of international populations in your local community to ensure you are interested in pursuing this type of work before traveling internationally.

Hands-On Learning During Hurricane Irma

Hands-On Learning During Hurricane Irma

When Hurricane Irma hit Florida, Florida International University’s Florida Advance Surgical Transport (FIU-FAST) took action. After the Florida Health Department requested their assistance, the response was interdisciplinary, says Yhovana D. Gordon, EdD, DNP, ARNP, FNP-BC, who is Chair of the Program of Graduate Nursing, Florida International University Nicole Wertheim College of Nursing & Health Sciences, in Miami, Florida.

“Students and faculty from the nurse practitioner program at the FIU Nicole Wertheim College of Nursing & Health Sciences joined forces with FIU Herbert Wertheim College of Medicine physicians, as well as paramedics and others,” explains Gordon.

An all-volunteer response program, FIU-FAST is designed to rapidly deploy when requested. The volunteers add their skills and knowledge to existing health care professionals to help provide critical care following major disasters like Hurricane Irma.

An edited version of Gordon’s interview follows.

How many nursing students came together to work with Hurricane Irma victims? How long did they help? What kinds of things did they do? How were they supervised?

The mix of graduate nursing students (i.e., licensed Registered Nurses), faculty, and others on each FIU-FAST team varied as they were deployed to help hurricane victims at various locations.

For example, when the FIU student and faculty team of six physicians, six nurses, and a paramedic arrived at West Kendall Baptist Hospital on September 11, ninety-two patients were waiting in the ER. Less than three hours later, only 30 remained.

Thanks in part to the extra expertise, FIU also deployed an 18-member team of students and faculty members to assist at Jackson South Community Hospital. Two nurse practitioners and 10 registered nurses worked alongside three paramedics, two physicians, and one physician assistant to alleviate the patient backlog in the hospital’s emergency room.

What kinds of things did they learn? How has the FIU-FAST program gotten nursing students involved in natural disaster assistance like this in the past?

The participants learned how to respond quickly, communicate effectively, and help triage and treat people who arrived at medical centers needing care in the wake of Hurricane Irma. The team focused on treating less complex patient presentations like lacerations, the flu, and other ailments, freeing up the existing medical staff to treat more acute or complex cases.

FIU-FAST formed in April 2016 through a partnership with the Herbert Wertheim College of Medicine and the university’s Department of Emergency Management.

In terms of past deployments, the FIU-FAST team traveled to Puerto Barrios, Guatemala in February 2017. The mission was part of an ongoing project between the military and civilians led by the U.S. Southern Command. The goal was to provide medical and veterinary assistance.

In May 2017, the FIU-FAST team also set up a 10-bed critical care field hospital, this time much closer to home. The temporary health care facility was set up on Miami Beach to assist local responders working during the Memorial Day weekend.

Why is a program like this important? Why is it especially important to involve nursing students?

The FIU-FAST program is essential for providing medical assistance in the wake of disasters, times when needs often increase to a point that challenge existing resources. It’s important for nursing students at the FIU Nicole Wertheim College of Nursing & Health Sciences to be involved – part of our mission is to serve communities in need throughout the year, not just in times of crisis. Also, deploying nursing students to assist via FIU-FAST provides them with unparalleled experiences and teachable moments outside the classroom, giving them skills they can use throughout their careers.

What skills can nursing students glean from this experience? What skills have they learned in school that they could apply on the front lines?

Nursing students can learn to work on interdisciplinary teams, to think quickly, to communicate effectively, and, above all, to serve communities in need no matter what the circumstances. Our nursing students learn critical skills through education, clinical rotations, and simulation training, all of which they can apply in real-life situations as warranted.

The program underlines the essential roles nurses play on interdisciplinary teams, whether in day-to-day practice, during times of crisis, or when leadership skills are essential. The student participants also gained invaluable experience by working side by side directly with faculty and collaborating with them onsite. Although it’s difficult to predict when the next disaster will strike that requires a rapid response from the FIU-FAST team, but one certainty is they will be ready to move and make a difference at the community and patient levels.

5 Popular Fitness Trends to Try in 2018

5 Popular Fitness Trends to Try in 2018

In November, the American College of Sports Medicine released the results of a worldwide survey projecting the most popular fitness trends for 2018. Whether you’re looking to get reacquainted with consistent exercise, hoping to spice up your current routine, or searching for workouts that are fast and effective, these forecasted trends offer a little something for everyone. Plus, many of these workouts can be done in the comforts of your home with very little equipment. From a list of 16, here are my top five picks for convenience, affordability, and accessibility.

1. High-Intensity Interval Training (HIIT)

If you haven’t tried a HIIT session before, this time-saving, full-body workout might surprise you. Generally, classes last around 30 minutes, but they could be longer or shorter depending on the repertoire of exercises. HIIT incorporates short spurts of high-intensity training followed by a brief time of rest or recovery. You can find HIIT classes in just about every gym and online. When doing the exercises, concentrate on your posture and form. Because HIIT can be very fast-paced and intense, you want to minimize your risk of injuries.

2. Wearable Technology

Whether you wear a Fitbit or keep your phone in your pocket, counting your steps can help you track how much mileage you’re logging each day. As a bonus, you can monitor your heart rate and time spent sleeping, so you can make sure you’re not just working hard, but getting adequate rest as well.

3. Yoga

Every year, there seems to be something new in the world of yoga—from pool yoga, aerial yoga, and yogalates, to more traditional forms like Hatha, Vinyasa, and Kundalini. Yoga’s staying power lies in its variety, and its ability to challenge both the mind and the body. Since it’s available at nearly every gym and online, this fitness favorite won’t be going away anytime soon.

4. Functional Fitness

The study defines functional fitness as, “using strength training to improve balance, coordination, force, power, and endurance to enhance someone’s ability to perform activities of daily living.” In other words, this type of exercise trains your muscles to work more efficiently in your everyday life, which is why it’s a leading form of exercise around the world. Functional fitness may incorporate props like medicine balls, kettlebells, or your own body weight (to name a few). Additionally, you can complete a functional fitness session in your home, gym, or class setting. Who doesn’t like the sound of strengthening your body to make your daily activities a little easier?

5. Outdoor Activities

If the sound of going to a gym or working out at home has you feeling a little confined, you’re in luck! Outdoor, sporting activities make the list of next year’s fitness trends. Whether you’re into hiking, biking, cross-country skiing, or something else entirely, outdoor activities allow you to enjoy and interact with your natural surroundings. Best of all, they can be done alone or as a group—whatever motivates you to engage in an active lifestyle!

What fitness trends or activities are you looking forward to doing in 2018?

2018 Is the Year to Advance Your Nursing Career

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