It happens every time…I’m in a hospital helping a friend or family member navigate their healthcare, and the doctors always asks me if I’m a doctor. No, I say, I’m a nurse.
This just happened yesterday. Last week my mom had a terrible fall, resulting in a bad fracture requiring emergency surgery. She is an elderly woman, frail and medically complex. Most doctors who encounter my mother are not prepared to address all her medical issues because, simply put, there is no way they can possibly “study up” enough to be “caught up” on her many problems. That’s where I come in. I do know my mom’s many, many complex medical conditions, and can speak about her recent surgeries and medical activities, complexities and medications. So when physicians come into my mom’s hospital room, truth is, I’m more an expert that they are—at least when it concerns my mom.
And in this situation, like what happened yesterday, where I am able to give the new physician a comprehensive patient history and post-operative report, he assumed I was a fellow physician…I mean, what kind of nurse could do that?
Nursing Is Actually A Very Technical Profession
The fact is nurses are extremely sophisticated health care professionals whose knowledge spans across all aspects of health care and medicine. Nurses need to understand general physiology, pathophysiology, treatment for diseases, and management of diseases through acute and chronic stages. Not only do nurses need to know these broad reaching medical skills but they also need to understand how to coordinate care, how to ensure the treatment plan for the patient makes sense and ensure that a patient’s care is coordinated and communicated between professionals in a timely manner—both in and outside of the hospital setting. Nurses need to represent the views and wishes of the patient and family to the physicians (and other care providers), as well as make sure the physician’s goals are agreed to by the patient. (Whew—that’s a lot of stuff nurses need to know and do!)
At the center of all health care are nurses. Nursing done right (which it does not always accomplish) is simply one of the most valuable roles in healthcare.
Why Then Is There A Nursing Shortage?
So why does the Bureau of Labor Statistics anticipates a nursing shortage in the coming years?
During my long career as a nurse, I’ve lived through nurse surplus, nurse shortage, nurse identify crisis, nurse role expansion. I think this point-in-time for the nursing profession is the most exciting I’ve ever seen. There are new positions and new roles and positions that have not existed before for nurses to work with patients, with providers, with healthcare systems, with biotech companies.
How Nurses “Make or Break” Care
We (as a society) need to understand extremely valuable the role of nursing, otherwise, fewer bright young people will enter the profession. Nurses are responsible for over 85% percent of patient care and, importantly, they help ensure miscommunication does not occur between the health care providers—and let’s pause to focus on this for one moment. According to reputable sources (The Joint Commission) up to 80% of serious errors are due to miscommunication, which lead to a failure in ordering important tests or reviewing important findings, etc… So properly sharing of information in a timely manner is critical to patient safety. This is where nurses come in: because nurses are the ones most familiar with the patient and help push care along to make sure the “ball is not dropped.”
Nursing is “Fungible”
In financial circles people talk about how money is “fungible.” Meaning it is fluid—a dollar can be used to buy a piece of equipment or to pay a staff salary. Well, I say nursing is fungible since the Registered Nurses’ license allows the nurse to be a bedside nurse, a clinic nurse, a hospice or home nurse, or a care coordinator, or an advisor to technology companies or to health insurance companies, or work with local, state or federal agencies developing new and important public health policies. Nurses can work in real time, remotely, or telephonically. Nurses are running companies and are CEOs of hospitals and health systems.
Nursing Has Been Good To Me
While I think the work of other health care professionals is extremely worthy and at times enviable (I mean, it would be fun to be a surgeon for a few days, or an anesthesiologist…) I think for those of us that imagine many different careers over one life time, there is nothing like nursing.
For decades, scrubs have been used by nurses in health care. They replaced the image of a female nurse decked out in a white dress, with the sensible white shoes, stockings, and white hat. While originally used mainly by surgeons and surgical staff in operating rooms, they are now used by nurses, techs, and other health care workers.
Although you can now find scrubs in all the colors of the rainbow as well as with fun patterns on them—everything from cartoon characters to butterflies and flowers to shapes and the like—one thing has remained the same: they’ve tended to come in sizes small, medium, large, extra- large, and so on. They are comfortable, yet loose.
Now that’s all changed as some companies have started designing fitted scrubs for women and men.
Actress Sofia Vergara launched Careisma, a line of scrubs that is, as the website states, “contemporary medical apparel featuring bold colors, chic prints, and figure-flattering styles.” According to Vergara, Careisma is “designed to bring more personality and style to medical apparel. I’ve always admired nurses and health care workers…Health care professionals deserve fashion options that fit their personalities and figures.”
They come in a lot of unique patterns not normally seen, such as leopard print and lace. The colors are bright as well. The sizes still come in XS-XL, but the scrubs also contain spandex, which would make them more form fitting.
Frank Flores, the owner and co-founder of the FrankyRay line, has been in the medical apparel business for more than 13 years. According to the company’s website, the scrubs are made of premium fabrics, but what sets them most apart is the sizing: the men’s scrub pants have true waist and inseam sizing as well as a button and zipper. Scrub shirts that are athletic fit are also available. They are said to be “fashionable and functional.”
Whether you stick with your old scrubs or want to try something different, you now have more options.
How do you feel about form-fitting scrubs? Let us know in the comments!
Do you feel exhausted, anxious, or dread the thought of going to work each day? In last month’s article, we discussed these subtle signs (and more) which indicate your body may be headed for burnout. Already feeling burned out? Let’s look at some steps you can take to overcome this chronic, stressful state and begin thriving again.
1. Identify the source of the stress.
The Mayo Clinic offers this tip for pinpointing the circumstances that are causing you to feel overwhelmed: “Once you’ve identified what’s fueling your feelings of job burnout, you can make a plan to address the issues.” If you have trouble recognizing the cause, try tracking your job responsibilities for a few days, and write down how you feel after you’ve done each activity. Tracking your feelings will help you concentrate your efforts on the areas that are truly quelling your passion for nursing.
2. Minimize your time with these stressors.
Harvard Business Review (HBR) suggests you may need to consider reducing your workload or taking a vacation as ways to recover from burnout. HBR also recommends limiting your interaction with people who leave you feeling drained and delegating the tasks that don’t require your personal touch to other people. Furthermore, they advise to disconnect from your work when you finish your shift and on your days off. Bottom line: Don’t take your work home with you. What happens at the hospital (or another facility), stays at the hospital.
3. Find a support network.
Perhaps you have supportive colleagues, friends, or family members who can help you through this challenging time. However, for some nurses, the level of burnout requires the assistance of a professional. Try not to view your quest for help as a sign of weakness, but rather, a bold step forward toward creating the life and the working environment you want. Additionally, many employers will offer an Employee Assistance Program to help you resolve personal and work-related problems. Take advantage of whatever services are available to you.
4. Practice self-care.
An article from Sanford Brown College makes this observation regarding workplace burnout in nurses, “Even the strongest nurse who puts too much devotion into her work faces the risk of ‘compassion fatigue.’” It’s easy to get caught up in taking care of others and neglecting your needs. But cultivating a balance between work and your personal activities will go a long way in helping you heal from burnout. Sanford Brown offers these pearls of wisdom for struggling nurses:
“Good self-care for nurses includes eating well, getting enough sleep, avoiding harmful substances and staying physically active. You may be on your feet all day at work, but the rest of your body needs a different kind of workout. Maintaining strong mental and spiritual health (if appropriate) is also essential. Whether it is meditation, yoga or prayer, set aside a part of the day to find a calming moment that belongs only to you.”
5. Find a creative outlet.
When you’re in a state of burnout, you’re more prone to making mistakes, losing focus, and feeling unhappy. Research suggests creative endeavors can enhance your mood, increase your energy, boost your immune system, lower stress levels, and provide a positive distraction from the things that are weighing you down. Been itching to try a writing class? Maybe you’ve been eyeing a community pottery class for several months. Now, is the perfect time to tap into your creative side and reconnect with the joy and wonder of life.
6. Consider your options.
Have an honest talk with yourself. If you’ve tried the above tips to no avail, it might be time for you to consider a job change. While it’s not an easy decision to make, you may find you’re more fulfilled in a less demanding job that supports your values and beliefs.
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:
Turkey or chicken
Hard boiled eggs
Tuna and crackers
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.
The Mayo Clinic defines workplace burnout as “a state of physical, emotional or mental exhaustion combined with doubts about your competence and the value of your work.” While burnout can happen after a traumatic event, often, it’s the discrete signals your body gives you that go unnoticed as you strive to care for others. In other words, you may not even notice you’re headed for burnout until it’s too late. Let’s examine some of the subtle signs of workplace burnout before it poses a threat to your health or your employment as a nurse.
1. You’re tired all the time.
Initially, you may feel lethargic and lack energy on most days. However, as burnout progresses, you’re likely to experience a constant state of depletion and have difficulty mustering up the stamina you need to stay attentive on the job. Furthermore, you’ll find it takes a long time to restore your energy reserves from one day to the next.
2. The idea of going to work each day seems dreadful to you.
As burnout progresses, your sense of optimism diminishes, and your mental state is more likely to be negative. If you feel dread settling into the pit of your stomach whenever you think about work, it’s a good indicator you’re in burnout mode.
3. You have an increase in physical symptoms.
In a November 2013 article in Psychology Today, author Sherrie Bourg Carter, PsyD, notes a range of physical symptoms linked to burnout. These symptoms include (but aren’t limited to) insomnia, loss of appetite, chest pain, heart palpitations, shortness of breath, gastrointestinal pain, dizziness, fainting, and headaches. However, Bourg Carter acknowledges these complaints can overlap with other medical problems, and she recommends being medically assessed to rule out other factors besides burnout.
4. You’re forgetful or have difficulty concentrating.
Does your usual, sharp memory seem a little fuzzy? Perhaps you’re not able to do as much during your shift as you used to do. When your work drains you, it becomes more challenging to concentrate and remember specific details. Your focus decreases, and you may feel overwhelmed as your nursing duties suddenly seem more taxing to manage.
5. You feel anxious.
Chronic stress can lead to anxiety, restlessness, and tension. If the mere thought of work invokes worry and makes you unable to relax, this could be your mind and body giving you a much-needed wake-up call if you don’t make some serious changes.
The good news is that you can prevent workplace burnout. Bourg Carter offers this sound advice regarding this condition, “Its nature is much more insidious, creeping up on us over time like a slow leak, which makes it much harder to recognize. Still, our bodies and minds do give us warnings, and if you know what to look for, you can recognize it before it’s too late.” The key to preventing burnout is to notice how you’re feeling each day, regularly practice self-care, take inventory of the priorities in your life, set boundaries, and don’t be afraid to ask for help.
Sense.ly, a San Francisco startup that has created a virtual nursing app to help physicians stay in touch with their patients and prevent readmission to the hospital, has recently raised $8 million from investors in its most recent round of venture funding. The new funding from investors like the Mayo Clinic will be used to bring the virtual nurse technology to a wide array of clinics and patients.
Designed for both patients and healthcare professionals, the app asks patients to tell the nurse avatar how they are doing by simply talking through a 5-minute “check in.” Patient check-ins are then stored as medical records that only authorized physicians can view. The medical reports also include device data that the app pulls from medical devices and wearables (like Fitbits or Apple watches) that patients use day-to-day.
Using artificial intelligence, Sense.ly’s nurse avatar speaks to patients in empathetic tones about their healthcare concerns, and uses emotional analysis to alert a patient’s care provider when the app detects that a patient is in need of mental health counseling or feeling symptoms of depression or anxiety as a side effect of medications or lifestyle changes.
The Sense.ly app is designed around commonly accepted medical protocols for diagnosis and treatment of chronic illnesses. So far, the company has focused on patients 60 and older who are suffering from health problems like COPD, heart failure, diabetes, and other age-related issues. But ultimately they want the app to work for people from all age groups and populations dealing with a variety of health issues. They are improving their analysis capabilities by adding new protocols and content from partner hospitals and clinics.
Adam Odessky, Chief Executive Officer and founder of Sense.ly, believes in the platform’s potential help people live longer and healthier lives and make quality healthcare more affordable and available. When asked if virtual nurses might “steal” jobs from human nurses in a discussion with TechCrunch.com, Odessky says no: “There aren’t people doing this job already…This is a technology to help medical professionals do their jobs more effectively, and not one that threatens their livelihood.”