To Overtime, or Not to Overtime?

To Overtime, or Not to Overtime?

That is the question, my friends. I recall receiving this piece of advice in nursing school: “The secret to nursing is to never work overtime. Work 3 days a week and only 3 days a week.”

Unfortunately, this piece of advice was coming from my favorite nurse that i had worked with in clinicals, the one that never had a bad attitude, was a team player, and was down for whatever came his way. So what to believe??!

Here’s the thing. Nursing is crazy. It’s all so different, yet so similar. For instance, an ED nurse or a NICU nurse might feel differently than an adult med surg nurse. The ED and the NICU carry on around the clock. Babies don’t know the time difference, and the ED sometimes gets crazier at night. But during my practicum I learned that med surg units often have quiet hours for their patients from midnight to 0600. So, in this case, discussing overtime with a night shift NICU nurse might not be as daunting as it is for a med surg nurse to stay awake for a fourth night of the week. So, definitely do your research and get to know your unit and your position before tacking on a bunch of overtime. What is the night shift vibe for overtime? What’s your day shift vibe like on your fourth shift? I personally found on night shift I really wasn’t able to work a lot of overtime because it just exhausted me, but on day shift I don’t have any problems as long as my shifts aren’t all in a row!

The whole “getting to know your unit” concept brings me to what I believe to be the most important aspect when deciding whether to pick up overtime. It worries me to no end when brand new nurses two weeks post NCLEX are picking up four and five shifts a week. Even nurses a few months into it. I urge you all to give yourselves time; you are adjusting to far more than you realize. The biggest harm I think we can do to our patients as nurses is not taking care of ourselves. There is obvious harm like forgetting a med, but the biggest harm is when stress builds up, and fatigue piles on, and before you know it, your attitude about your patients, your mission, and your duty has changed for the worse. It doesn’t happen overnight; it happens over time. Just be mindful. Know your boundaries, and take your time. Quite honestly, even nurses with ten years of experience scare me when they pick up five or six consecutive shifts. There is no rush whatsoever for overtime. If you’re a new grad you likely have 40+ years for overtime anyway!

And finally, your motivation for picking up extra. Watch out for becoming dependent on overtime. I personally am guilty of this to the extreme. It’s really easy to plan a few trips and pay for them with overtime, but ideally you’re not paying for your car payment or your rent with extra shifts. Make sure you are living within the means of your normal paychecks and using any extra cash for trips, treats, holidays, etc.

So, I didn’t end up following that nurse’s advice after all. I do pick up overtime. Sometimes I pick up a lot. Ultimately, I had to use discretion about who I took advice from and what their role is. This nurse happened to have a wife and three kids at home, which isn’t my current situation. Be mindful of who you’re speaking to. In fact, be mindful of my advice! Maybe my situation isn’t the same as yours right now. Talk to people who are in similar situations as yourself or who have been in your place. Find out what works for them and sit down and think through the benefits and risks for yourself.

While we may all be nurses, we’re all different. And worst case scenario, you’re just not sure if it’s right for you, then give it a try! One shift wont hurt. See how you feel and go from there.

Precepting, Part 2: Inside the Student Experience

Precepting, Part 2: Inside the Student Experience

You’ve read my thoughts on being a preceptor, but now it’s time to explore things from the other side: as an orientee. In the last two years, I’ve had the opportunity to orient as a student in nursing school, as a precepting practicuum student, and as a new graduate orienting to my current position in the NICU. It certainly doesn’t take much to channel these inner thoughts from what was not so long ago timewise, but feels like ages ago when I think back to where I was with my nursing skills. Here’s what I learned from the student experience.

1. I’m sorry for a lot of things.

“I’m sorry! I’m sorry! I’m sorry!” is all I can think. I’m sorry I didn’t remember to run a flush, I’m sorry I just kicked the back of your foot. I’m sorry! I know it’s annoying to keep apologizing, but I’m just very nervous and I’m sorry! I feel like I’m annoying you, I’m really worried you’re gonna tell my professor I did something wrong, and they’ll tell the hospital and then I won’t get hired and I won’t have a job! Point being, I’m a nervous wreck and I’m sorry I keep saying I’m sorry.

2. My preceptor is a bear tonight.

I get that it’s not always the most exciting gift to be given a student or a new grad to orient, especially when you’re not expecting it, or if your baby kept you up all night and you didn’t sleep, or if you had extensive plans to Facebook message and Tinder all day long. But… I’m here and I’m excited to learn…. and my preceptor is being a bear! If you could please try to not hate me and teach me something I would really appreciate it. Also, when you answer my question with an attitude I can’t help but feel like I shouldn’t ask any more questions, so please try to be understanding! P.S. We all know the look of a nurse that didn’t want a nursing student so please don’t think it’s not visible! Also, feel free to tell me to go sit at another computer while you’re charting if I’m not needed to help. Odds are that I want a break from you, too, and I could probably use some time to look things up!

3. I’m not as smart as I think.

I’m definitely not as smart as I think or act. I definitely don’t know all (or any) of the acronyms you’re using so please treat me like I know nothing and I can tell you if there’s something I’ve already learned. Further, please don’t leave me alone in a patient room while drawing labs off a central line for the first time (not that that’s happened to me or anything…). There will also be times when I’m acting like a know-it-all, but it’s probably just me overcompensating for realizing how little I actually know. If you work in a specialty unit, AKA anything other than med/surg, don’t forget that nursing school wasn’t focused on your specialty! So, no, I don’t know anything about your 23-week-old baby! Specialties are just that, specialties, so help me learn them!

4. These uniforms will never be less humiliating.

I feel like whenever anyone sees me in my student nurse uniform it’s a shout-out like “hey, ask me to come position your patient” or “I’m free to help transport patients—pick me!” When in reality, I’m here trying to learn. I do enjoy understanding that nursing isn’t all exciting procedures and numbers and diagnoses to learn; half the battle is balancing all of those things and still having time to turn your patients and meet their psychosocial needs, but my time is valuable and if I’m still in school I’m technically paying to be here, so I want to learn the skills I don’t know! Also, my uniform definitely does not mean that anyone can make jokes about what I don’t know or treat me like less of a person. I trust you and you are my guiding light for the day. Knowing that you have my back will help me relax and forget about the sign hanging around my neck that says “student”!

5. The elephant in the room: Lunch!

I promise it’s really OK if you don’t want to eat lunch with me. If you don’t and you do it out of obligation, I’ll know and feel uncomfortable, especially if it’s me, you, and eight of your friends all talking about your weekend plans that I’m not apart of. I’d honestly rather go eat with a fellow student at that point. Plus, I may be a vulnerable student, but I’m also an adult and can handle and enjoy eating on my own. And likewise, I’ll let you know if there’s a night when I really need to sit down with you and talk something through or talk about my experiences.

Ultimately, I’m stoked to be with you as a student, intern, or new grad. I look up to you, trust you, and likely want to be just like you. I know it’s hard having a student, but it’s hard to be one, too. Work with me so I can work with you. After all, nurses eating their young is so prehistoric, don’t you think?

Precepting, Part 1: The Trials of Teaching

Precepting, Part 1: The Trials of Teaching

I had the opportunity to precept a nursing student this month and I thought it would be a perfect blog post to share with you all, from my perspective as a nurse, and that as a student who not too long ago completed the preceptorship process myself. As it turns out, both parties have a lot to teach, a lot to learn, and a lot in common.

Here are six things I learned from my precepting experience.

1. I am tired.

No matter how hard I tried to be wide awake and energetic for my student, I realized I am just exhausted. My life is exhausting, my job is exhausting, and frankly, my student is exhausting. Lesson to be had from this slew of exhaust: space out your days when precepting a student. There are sacrifices to be made when precepting, and giving up the 3 on, 4 off perfect schedule is one worth making. The weeks where I was 2 on, 2 off, 1 on were refreshing for both my student and myself, even if we had different patients. In all reality, my student needed more variety in patient load anyhow, so it’s a win-win.

So, if you’re shadowing me and I’m visibly exhausted, hold me accountable! Don’t let me slack on teaching, but do realize there are times when you can use your resources to look things up, too. Sometimes I just need my morning coffee, too, so don’t worry if at 6:35 am I’m not bright eyed and bushy tailed—I’ll get there by 9, I promise!

2. I will never get to bed “early.”

All that being said, I will not and cannot get into bed as early as I wish every night. I definitely have my nights where I go to town and make it happen, but that’s not going to be every night before precepting, and that’s OK. I spent so much time beating myself up about not getting into bed early enough and not packing my lunch ahead of time so I could get more sleep that I could’ve just been taking a power nap. Chances are, students probably don’t go to bed before midnight, either.

3. I’m not that smart, and I probably won’t ever be, and that’s OK.

Nope. I don’t know. I don’t know the obscure gene correlation between the microorganism and its vectors or whatever mumbo jumbo there is to know. But you can absolutely ask! Please ask me, but please don’t judge me when I don’t know! Let’s look it up together and learn together. I would be a bad nurse if I told you I knew every single thing.

Further, quite honestly, there is nothing worse than a know-it-all, and we all know that. When you come into work with the idea that you know more than me, need to teach me, and want to point out in rounds that you know more than me, it just turns me off to teaching. I do believe you really know more than me and have lots to teach me, just remember that there is a time and a place for everything. Let’s have a “think through” discussion where we sit down and get a break, instead of debating in front of a family. Even a healthy debate about medical treatment can come across as inconsistency and lack of confidence to a family who doesn’t know the terms that we’re speaking about.

You are smart—this I know—but I am also here to teach you about my experiences, and that I do have more of, so allow me to help you put all of your awesome knowledge into clinical experience, too!

4. I make a lot of mistakes. And I don’t enjoy having those pointed out to me.

So if I dial up the IV pump for 35 ml instead of 36 ml, please don’t say so very dramatically in front of the patient or the patient’s parents. Instead, calmly remind me when we step to the side or calmly suggest adding an ml to the pump. If I make an urgent mistake please tell me immediately, but handle all with caution. Patients, especially children, pick up on the mood in the room. If you look worried, they will too. Confidently and calmly reminding me is a good way to keep everything under control.

5. I should’ve taken it easy on my teachers when they didn’t sign that form in 24 hours.

Let me tell you, it’s hard. I already get 15 emails a day from work, and when I get another email asking me to sign and fax a form, sometimes it just gets lost in the virtual pile. Don’t be afraid to remind me, and please be forgiving! I would prefer to be asked about these things while I’m at work, but if I’ve forgotten something you need immediately, you can absolutely reach out when I’m not at work. I would double check this with all of your preceptors, though, to make sure they are comfortable with being reached off the clock. Point being, it’s never malicious if we forget to respond to your email, forget to fill out your paperwork, or sign a form. That being said, there’s nothing worse than waiting till the last minute to hand it all to me and tell me it’s due tomorrow!

6. Learn, learn, learn. . .and then learn some more.

The experiences you’ll have as a student, a new graduate nurse, or an intern are some of the best experiences. We intentionally put you with patients that present learning opportunities. So please take them and love them! Your day isn’t over at 7 pm; you should go home and look up 3 things you didn’t know—just 3! Don’t study medical textbooks for hours on end, but google things, read opinions, read facts. In nursing we don’t always have to know down to the microbe, but we need to know the big picture. Ask yourself: Could I teach a parent how to feed through a g-tube? Could I explain necrotizing enterocolitis to a friend? Save the specifics for nursing school exams; focus on learning how all of the systems work together and the bigger picture when you’re at clinicals or with your preceptor. Always ask yourself why while you’re learning. Why are we doing this? Why does this child have this condition? Why is the doctor changing this order? Try to look things up on your own when you can, or ask me while we are charting or breaking!

Overall, having a student is an awesome experience. It is refreshing to have such a bright, eager mind, it is humbling to have someone remind you that you’re not that far from when you were a new grad, either, and it’s invigorating to watch your student grow and succeed. I am happy to have you, but every student has a different learning style and that takes me time to learn, too. Be patient with me, be kind to me, and let’s conquer this together. Understand that I’m human too—I get stressed, overwhelmed, and tired, too. With open communication we will be able to get to know each other and grow together!

Stay tuned for Precepting, Part 2: Inside the Student Experience for my perspective as a student! ​

Eating Hacks for the Busy Nurse

Eating Hacks for the Busy Nurse

As nurses, and even nursing students, we all know how difficult it can be to balance eating at work. It should be easy to eat, right? You may be a nurse if you relate to any of the following:

  • What’s eating? There is no time to eat. None. Zilch. Zippo.
  • After you cath someone, insert a rectal tube, and empty a fresh wound vac you simply have no desire (or need at this point) to eat.
  • The cafeteria has served the same taco salad for the last four days that you’ve worked. Does anyone else notice that?
  • You wear Invisalign (like me) and have no desire to put your MRSA covered hands in your mouth to remove your retainer or brush your teeth in a hospital bathroom after you eat.
  • The doctors have been next door rounding for an hour and your patient is next (cue the jeopardy jingle).
  • Your favorite hall buddy has been on her 30 minute break for an hour and 10 now. (The jeopardy jingle continues…)
  • Who even has time to pack a lunch when you get home at 8:30 and have to be back the next day?
  • You get full-blown judged by the “normal suit and tie” people when they see you walk in with a cooler containing a breakfast, a lunch, a snack, an afternoon soda, an afternoon sweet, and a partridge in a pear tree.
  • By the time you finally do get to eat at 3 pm you’re as good as drunk and you go for whatever is in sight in the break room: cake, cookies, chips—and topped off with a grilled cheese and tots from the café.
  • Your “normal suit and tie” friends post IG stories eating an Açaí bowl or a fresh Chipotle bowl or a kale salad with their coworkers (who are also wearing the cutest Banana Republic outfits) while you eat applesauce and PB&J in the break room while everyone around you complains about poop.

So, my friends, it’s time to fix this problem. Here’s another list for you, because all blogs are more fun to read in numerical list form, right?

1. Avoid eating in the break room.

Tag team with a buddy and go eat outside. Seriously, it’s amazing what 30 minutes in the fresh air does for your mind. Northern friends: I have no clue what to tell you right now.

2. Meal prep.

Nothing crazy, but keep reading to learn some legit good and easy meals you can make at home and have ready for three in a row.

3. Order takeout once a month.

Not everyone can get on board with the meal prep, so treat yourself to a real meal once in a while if you are eating sandwiches and café food all the time (and even if you are meal prepping!).

4. Plan a potluck.

Best way to celebrate a holiday as a nurse? Potluck, potluck, potluck. All the luck transfers to your patients so it’s a win-win.

5. Plan your breaks ahead of time if you can with your hall mates.

If you have a mate that doesn’t do too great (ah, poet and I didn’t even know it) with coming back on time, suggest that you go first after you finish this and then you’ll be back by xx:xx. Letting your buddy know that you respect her break might awaken her to reciprocating.

Pro tip: Nursing students everywhere, please don’t be afraid to tell your preceptor you need a break. I almost passed out once waiting for my preceptor to finally take a break. You are a student and you are totally allowed to pull that card and take a full 30-minute break. Believe me, you’ll have your days of missing your break and starving.

And finally, some of my favorite “easy to eat” things to meal prep and pack for lunch include:

  • Egg muffins! One of my friends taught me this recipe. Simply mix up some eggs, ham, cheese, tomatoes (or whatever you like), and pour it into a greased muffin pan for a yummy take-with-you breakfast. If I’m bringing breakfast to eat at work, I usually make breakfast burritos and freeze them or simply make a big batch of scrambled eggs, mixed veggies, and sausage to eat! It’s a small enough meal that can be eaten quickly with roughly the same nutrition in some of these super dense granola bars that aren’t always the healthiest.
  • Pasta and veggies. Pasta sauce and mix veggies (spinach, kale, tomatoes, peppers, etc.) go great together and make a super easy lunch. For a healthy mix up, try pairing it with black bean pasta!
  • Sweet potatoes. Every week I make two sweet potatoes, a big bowl of stir fried veggies, and bake two chicken breasts. Mix it up! Shred the chicken and put it over a sweet potato with barbecue sauce and goat cheese…weird, but delicious! Or chop up your chicken breast and make a southwest bowl with mashed sweet potatoes, corn, black beans, salsa, and lettuce. It’s all about finding foods that you can use for multiple things.
  • A salad bar in your fridge is a great way to mix it up as well. Put items like strawberries, blueberries, slivered almonds, pepitas, dried cranberries, hard-boiled eggs, carrot slices, etc. into tupperware and have your lettuce washed and dried in a big container in the fridge. You can pull out the toppings you want and instantly make a delicious salad and save $7. Pro tip: the cafeteria usually has little 2 oz containers you can use to pre-package your salad dressing!

Hope you enjoy these tips! Please share your favorite recipes with us in the comments.

How to Create a Nursing Portfolio

How to Create a Nursing Portfolio

Prior to starting my first nursing job, I hadn’t heard of a nursing portfolio. As far as I was concerned, all the important documents representing my nursing career were a mumbo jumbo pile somewhere in between my nursing school books and my long lost social security card on my black hole of a bookshelf. Every time someone asked me for my CPR card it was a five-day task that got moved to the bottom of my to-do list each day. When I started my nursing residency at my new job, I was told i was going to have to create a portfolio. I dreaded this, too. I continued to put everything in a pile on my bookshelf until the week before it was due. While that wasn’t the best idea, the outcome was fantastic. I now have a large binder that is my go-to for anything nursing related.

So what is it, and how do you make one?

A nursing portfolio is a compilation of anything and everything nursing related. The idea is to have everything in one place so that when you apply for a new position, apply for certification, or are asked for a copy of your CPR card, you’ve got it in a second! Some items that I included in my portfolio are:

  • Nursing license
  • College diplomas
  • BLS Card, ACLS Card, PALS Card
  • Letters of recommendation
  • Copy of resume & CV
  • Copy of Daisy nominations
  • Copy of recognitions from coworkers
  • Copy of all certificates for training, classes, etc.
  • A collegiate writing sample
  • Evidence of committee/hospital involvement
  • Thank you notes from coworkers and families of patients
  • CEU certificates
  • Transcripts from nursing school
  • Evidence of community involvement
  • Copies of evaluations
  • Copy of professional presentation posters

Start by gathering items like these. Place them all in a box if you need to, or spread them out over your entire dining room table and drive your family crazy (like I did). Then, start organizing them into sections like professional development, community involvement, education, recognition, CEUs, etc. I strongly recommend organizing your portfolio using labeled tabs so you can easily find something or easily open up to a specific document if asked to do so in an interview. I stuck to six sections total so I wasn’t overwhelmed.

Other hints from my residency director (also known as the lady who knows this stuff inside and out!) include remembering that nursing portfolios are professional—they are not a scrapbook! As tempting as it is to add decorative pages, pretty colors, etc., do keep in mind that this portfolio is to be used as a collection of all of your professional accomplishments. As such, a handy dandy tool for your portfolio are page protectors. I went ahead and invested in a 500 count box and placed several extra at the end when I was finished. When i get a certificate now, instead of throwing it on my bookshelf, I at least put it in a page protector in the back so I can organize it the next time I sit down to refresh my portfolio.

Feel free to add anything relevant to your career, whether it be work-related or not. For instance, if you work on a neuro unit and volunteer with children with spinal cord injuries, you would definitely want to include something about your experience. You can type a simple word document outlining your duties, role, hours spent, etc. and have it in your portfolio. This would be a place that would be acceptable to place a picture or two of your volunteering experience.

Finally, get creative! Think: if everyone else had a portfolio, what would make mine stand out? While your nursing license and college degrees are essential, everyone has these items. Don’t forget the little things that make your career special—notes from families and patients, pictures and articles of you in your hospital newsletter, and so on. These not only make your portfolio more appealing and personal if you utilize it in an interview or professional setting, but also will make it that much more memorable in 20 years when you can look back on everything you have accomplished.

I hope these tips will help you get started. Feel free to comment any other suggestions you have or questions you have for me. Good luck and happy organizing! I guarantee you’ll thank me next time you have to provide your CPR card.

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