It’s a fact: Nurses are caretakers, but do they take care of themselves? Nope. That’s probably why we see the high numbers of nurses with depression, anxiety, burnout, and fatigue. Ultimately, that leads them to leave the bedside or the nursing profession altogether.
Maybe you’ve been seeing the term “self-care” a lot recently but aren’t totally sure what it means. Basically, it relates to ways to take care of your time, your body, and your health, which is essential if you’re to remain strong enough to take on whatever life throws at you.
It may be especially difficult for nurses to think of “looking after number one” in terms of taking care of yourself. But remember that when you take care of your own needs, your patients will benefit, and ultimately, so will your family and other loved ones.
It’s like what flight attendants say in their airline pre-flight safety speech—“put on your own oxygen mask on before attempting to assist others”—in case of an emergency. The same safety strategy applies to self-care. It takes the most consistent and conscientious acts of kindness to self before you’re rested enough to handle the crushing patient load you sometimes must carry.
What exact type of act constitutes self-care will vary from nurse to nurse. Each individual has to try to wrap his or her mind around this slippery concept, but know that you’re not the only one to struggle with something so seemingly simple. A Swedish massage with warm, scented lotion may stress you out while a sweaty, muddy mountain-bike ride may make you feel positively pampered.
How do you know where to begin your self-care efforts?
Choose an area of life that will make the biggest impact: Weight-bearing exercise, healthy eating, managing stress, getting more shut-eye, connecting to your values and dreams, etc.
Then try to determine what self-care activities would be rewarding as well as pleasurable. Psychologists at the University of Plymouth in England found that there is a “pleasure zone” or life satisfaction we experience when regularly engaging in those activities that combine reward and pleasure.
Here are some common examples which hit the sweet spot: Volunteering, praying, meditating, time with children, cooking, exercising, socializing, reading, Internet use, and outdoor activities.
Compare those items to the two most often-cited activities that are neither pleasurable nor rewarding: Shopping and commuting. (For most of us, these are two of the top time drains, too.)
Unfortunately, it’s usually not possible to radically change your schedule or commitments to pump up self-care—though if you can swing a shift change or house move for a shorter commute, more power to you! For the rest of us, we can get the best results from being creative and exploring simple ways to create positive new routines for a happier, healthier life.
But try not to become frustrated or disappointed with yourself if you sometimes aren’t able to get off the hamster-wheel and achieve some work-life balance. Self-care is all about taking positive and sustainable action and shouldn’t cause you more anxiety or require you to upend your life, either.
As you may know, the American Nurses Association (ANA) designated 2018 as the “Year of Advocacy.” These past 10 months, they’ve encouraged nurses to influence and bring about change at the bedside and beyond by engaging in “moments of everyday advocacy.”
As Election Day approaches, now is the time to end this year of advocacy on a strong note by demonstrating the political leadership skills that are unique to nursing. Make your voice heard! It will go a long way toward benefiting your local community, the nation, and potentially, the entire global community.
Political advocacy and nursing are not mutually exclusive, and every day nurses influence elected officials at the local, state, and federal level. The ANA encourages nurses to stand shoulder to shoulder to defend health care and make a difference on these significant policy issues:
- Set safe staffing levels to save patient lives and reduce nurse attrition at the bedside.
- Support nursing education and specifically, funding for Title V11.
- End the gun violence and restore CDC research on how to stop this epidemic.
- Stop physical and verbal abuse of nurses in all health care settings. Every employee deserves a safe workplace.
Here’s what you, as an individual, can do to make an impact:
Vote! And help get out the vote by encouraging friends, family, and coworkers to do the same. Some clinics have even conducted nonpartisan voter registration drives and reminded patients to cast a ballot. The volunteer providers who run the drives compare helping patients with voter registration to assisting them get insurance coverage.
In addition, write, email, or call national lawmakers and your local representatives to express your views. Or tweet them out. Best of all, show up in person at town halls, congressional meetings, or even on Capitol Hill. Political marches are also effective in persuading lawmakers—elected officials want to keep their constituents happy, and nurses make up a noteworthy voting block.
Sign up for the ANA’s text alerts so that you’re kept in the loop on what’s happening in Washington. You’ll be ready to respond to any pertinent policy developments with this news and information update service.
You might be asking: Can nurses really make a difference in the political process?
This answer is a resounding “Yes!” Governmental representatives and policymakers do value the unique expertise that nurses bring as health care professionals and patient advocates.
In annual opinion polls, nursing almost always rates as the most trusted profession among the general public. That esteem goes a long way toward encouraging decision makers to listen when nurses talk and to take what they say seriously.
Who knows, maybe you’ll decide to run for an elected office yourself or to accept an appointed position. There’s been a groundswell of grassroots political involvement and women and minorities running for office recently, and the field is wide open for new voices.
Regardless of your political party affiliation and where you stand on certain issues, most likely you’re in agreement with other nurses on these challenges to our nation. We all want to protect health care benefits for all (and especially vulnerable populations), cut health care costs and administrative expenses, reduce excessive prescription drug costs, and completely eliminate fraud, waste, and abuse.
Make your voice heard! Get involved at the local, state, or federal level to support or oppose proposed legislation that could affect health care. Advocate for nurses and patients everywhere as a political block through your union, your specialty nursing association, or ANA.
By becoming a nursing champion, you can influence lawmakers to become health care champions that strive to meet the pressing medical needs of our patients and health care staff.
For advocacy tools, visit the ANA website.
As a nurse, you know that preventative medical tests and other measures can help fight disease and possibly even save lives. Your professional life is focused on taking care of the health and well-being of patients. Even in your personal life, you may be the family member who keeps track of routine medical appointments and schedules tests, vaccines, and checkups for everyone.
Question is, do you take the same care to maintain your own health?
For example, the CDC advises health care personnel to get one dose of influenza vaccine each year. Now is the time to get that flu vaccination but so many nurses, and other medical employees, don’t get around to it.
Some have objections to vaccination and want to exercise their civil rights by abstaining. Their concerns are usually related to religion, health, or safety, but that’s not true for the majority of nurses.
Most nurses who don’t intend to get vaccinated this flu season either aren’t convinced this vaccine works, or don’t believe that they personally require vaccination. (Superhero complex, perhaps?)
Infectious diseases professor experts insist that though the flu vaccine missed the mark last year against those influenza strains, it’s been up to 60% effective in recent years.
Maybe you’re ready to take your chances with your own health, but consider that a bout of flu means you risk infecting patients or going out of commission and not being able to care for patients at all.
Most likely, the bulk of nurses would get vaccinated if it were easy and convenient to fit it into their busy lives. Hospitals that make vaccines more accessible to their employees by setting up on-site stations for free vaccinations during every shift have high participation rates.
Almost as high as workplaces that mandate vaccination as a condition of employment or otherwise pressure nurses to comply by requiring unvaccinated personnel to wear a face mask, say.
If your health care workplace hasn’t made it easy to get vaccinated, take matters in your own hands. Commit to a day and time to stop at a clinic or pharmacy that offers drop-in vaccination. Most insurance plans will fully cover the cost of a flu vaccine, which isn’t expensive anyhow. Don’t put it off too long – make sure your protected before flu season is in full swing.
And of course you should continue to wash your hands often at work and to stay home if you do come down with the flu.
But don’t stop your self-care with a flu shot. Ask your health care provider what preventative care is necessary for you based on age, gender, family history, and other health risk factors.
For example, here are some of the screenings that may be appropriate for a woman between the ages of 18 and 39, according to the National Institutes of Health:
- Blood Pressure Screening
- Cholesterol Screening
- Diabetes Screening
- Dental Exam
- Eye Exam
- Physical Exam
- Breast Self-Exam and Mammogram
- Pelvic Exam and Pap Smear
- Skin Self-Exam
Stick to the same time of year for these routine tests, so you remember to schedule them and to make sure your insurance coverage applies. (An annual well-woman visit may be fully covered, for example, but only within 30 days of last year’s appointment.)
Make a note in your planner to call a few months in advance of when you’d like an appointment to be sure you can book it.
Take your preventative health care as seriously as you do that of your loved ones. That way, you’ll remain in good shape for a long time for them.
We tapped recruiters, HR pros, career coaches, and others who regularly hire nurses for their insights on navigating the job search maze. We asked for their guidance on everything from tracking down job openings to advice for hard-to-place nurses, such as new graduates and returning nurses. Here’s what we learned—it may surprise you.
Finding a Job
Creating a Linkedin profile, blogging, and using social media professionally is a great way to actually bring jobs to you without any work on your behalf. You can also connect directly with recruiters to help find the perfect career opportunity. Twitter is also a great resource for finding employment. You can connect with companies and recruiters directly and build relationships that can help get you hired.
–Brittney Wilson, RN, BSN, informatics nurse, social media influencer, and blogger at TheNerdyNurse.com
When doing the clinical rotations, network with everyone you meet—connect on LinkedIn, and get business cards. Think of your rotations as working interviews. After graduation, use your network, including professors. Call and ask, “Hey, do you remember me? Do you know of any openings?” They’re more likely to help you because of your connection.
—Amanda Bleakney, senior managing director, The Execu|Search Group
In the VA system, many jobs are posted online via USA Jobs. This national system allows nurses to apply for federal jobs all over the country. For USA staffing postings, there is always a VA contact person listed on the posting. You can contact that person (the HR specialist) and ask any questions. For all other inquiries, a general call to the VA and ask for HR usually can get you to the right person. I often get calls from the outside for people looking for information on how to apply and/or what nursing positions are currently open.
—Linda Zaneski, RN, MS, BSN, nurse recruiter, Wilkes-Barre VA Medical Center
Call the nurse manager with an opening after hours and leave a message: “Hey, Jebra, I have great news for you. I heard that you’re short staffed, and I know you’re spending a lot of money calling in extra people to come in. I’m available and I have [these wonderful qualities] that you’re looking for. By the way, my name is Carmen and I’ve already applied in HR. If I don’t hear from you, I’ll drop by and I’ll leave my resume for you with someone in the department, but it’s already at HR. I’ll come by in three days.” Don’t show up when the nurse manager is there—give it to a staff member instead. Then call again: “I have great news for you again. I talked to your staff and they were so excited about my background and they put my resume under your door.” You can’t interrupt the business process [and] have to follow guidelines, but you’re doing something that will stand out. Show up; tell her what’s in it for her; follow through.
—Carmen Kosicek, RN, MSN, nursing career coach and author of Nurses, Jobs and Money
Don’t be afraid to reach out to your network for referrals to recruiters; they benefit too. I know of many travelers and other nurses receiving a referral bonus—$500-$1,500 for a travel nurse is standard, but staff nurse jobs in critical-need locations and specialties can easily earn a bonus of $15,000 if the new nurse stays for an extended time, typically two or more years.
—Jake Schubert, RN, BSN, travel nurse and executive director at Nursity.com, a NCLEX prep course
Volunteering is my secret to success. I learned about a group fighting childhood obesity and offered to take blood pressure at their annual event. I’ve been doing that eight years now. That’s lead to experiences and activities that I couldn’t have imagined. For instance, I met other nurses that I ended up working with later.
—Christine Mathurin, RN, director of clinical services, The Execu|Search Group
As a travel nurse, we work with a multitude of recruiters. It’s important to find a recruiter that you connect with and more importantly trust. Ask for recommendations from peers, join in on the online resource groups, and ask about the agency and recruiter. Know the right questions to ask; find them here.
—Candy Treft, RN, aka Gypsy Nurse at TheGypsyNurse.com
Join industry groups. Women in Health Management is an ideal group to network with because it’s made up of hiring managers. Nurses can be members too, since it could be considered that they’re managing the health care of patients. Or maybe the National Association of Hispanic Nurses is a good group for you. Or the New York Association of Ambulatory Care. Be sure to network on the local level especially.
The Application Process
Make sure that you have outstanding references. Nursing is a field with high integrity. If you are in the job market or looking for advancement, references can take you a long way. If you’re good at your job, try to get a reference from your DON or nurse manager. Also, get a charge nurse to give you a reference. They can directly talk about your clinical skills and “sell you” to your future employer. Sometimes I get references that just shine, and it makes a great impression on the manager who is considering you.
—Sunny Gray, health care recruiter, Advantage RN
Put it in business terms for the recruiter: “As a nurse, you know that I provide such great care that patients can go home early, saving the hospital money.” Call up the business department and ask for DRG’s—for gallbladder surgery, say—they generally know. Look at your own EOB’s or your family’s. If you’ve been a consumer of health care you know how much it costs.
I really like using tools like Streak (a free Gmail CRM) to help me see whether or not emails have been opened and to set reminders to follow up if I haven’t already received a response. You can also use Streak to create templates for emails that you can easily recall later. This is a great way to save the general form for a thank you email that you can customize for any interviews or phone calls you have.
The biggest mistake is not submitting a complete application package. There are many things required—an application, federal form, resume, license, CPR card, transcript, etc.—and many job announcements are very specific with what they require. Nurses need to go back in and check that every document was uploaded or faxed and received.
Be ready to give clear examples to show how you go above and beyond, how you deal with difficult customers, how you collaborate with others, etc. Having those examples gives you something to talk about and shows the interviewers that you have already faced these situations. Talk about what you did and what was the outcome. The interview is your time to brag and promote why they should pick you!
It’s not your mother’s nursing career anymore. Most women in the 60s and 70s who became nurses were not the breadwinners in the family. Now most nurses are, whether they’re men or women. Hospitals see constant turnover—two out of five nurses leave within three to four years of entering the field. Nurses who stay can expect only a 2.5% annual raise, so you have to learn salary negotiation. It’s a mind shift, but those who get it will do very well.
I’m turned off when I hear “How much is it paying?” We don’t always pay the highest wages. What you get out of a job is more than that, though. Employers are looking for someone who isn’t driven by salary. We’re looking for a nurse who is internally motivated, a team player, someone who gives to the community.
You’re interviewing the employer, as much as they’re interviewing you. New graduates should ask about the orientation program, nurse support, the preceptor, internship and transition training programs, number of nurse educators, etc. Experienced nurses, ask about continuing education, tuition reimbursement, performance and wage reviews, whether you’ll work rotating shifts, weekends, or on-call, and about the retirement plan.
Advice for Nurses Struggling to Find Work
My advice to new nurses: Be flexible in what’s offered to you. If someone offers you a job in a developmental disabilities group home, take it! My advice to returning nurses: It’s almost as if they’re starting over. Hospitals will turn them down because their clinical skills aren’t fresh. They should investigate refresher courses and other training.
Some nurses have so much experience that they’re locked in by that experience. For example, I work with some older nurses who won’t get a Gmail address because they don’t like the Internet. I try to encourage them to get past that; it’s keeping them stuck.
Make sure all of your certifications are up to date. It can be difficult to locate a PALS or NRP class, especially in a rural area. If you let them lapse, it could hinder you when you are applying for positions.
New nurses may need to relocate to other areas, with better odds for employment, such as Texas and Arizona. Don’t overlook: schools, community clinics, hospices, prisons, group homes, military, reserves, VA hospitals, military bases, underserved areas, and reservations.
Don’t dismiss a temporary assignment. Often it’s a long-term, indefinite, full-time opportunity. ‘We need people for a year because we’re going through an ERM implementation and we need to cover shifts for nurses in training.’ When they have a permanent role that opens up, they’re not going to hire from the random applications they get online. They want someone who knows the policies, knows the protocol already.
The dynamic nursing field now has over 200 sub-specialties, and is adding more daily. Which one will you choose? It’s not easy to decide on a niche to settle in for the long-term, especially when you factor in your evolving self and the breakneck pace of change in the health care landscape. But if done right, the promise of specialization is a nursing career with a healthy salary, plentiful job openings, and greater job satisfaction.
For instance, the most recent occupational employment statistics from the U.S. Bureau of Labor Statistics (BLS) reports that registered nurses earn a mean wage of $69,790 annually, while nurse midwives earn $97,700; nurse practitioners earn $97,990; and nurse anesthetists earn even more at $158,900.
Additionally, the BLS projects that demand for registered nurses will increase an impressive 19% from 2012 to 2022, while the news is even better in some specialty areas. Demand for nurse midwives, nurse practitioners, and nurse anesthetists, the advanced nurse specialties cited earlier, is slated to rise 31%.
But there are other important factors to consider in deciding on a specialty, such as job satisfaction and barriers to entry. Turn-over statistics and requirements for previous work experience or advanced education are some of the big-picture signs to look out for here. But on a personal level, you are more likely to find satisfaction in a specialty that leverages your favorite skills and preferred work role or environment. The challenge of figuring all that out can be daunting. Here are the steps to help you get where you want to go in your nursing career.
Don’t Hurry, Don’t Worry
Once, nurses were pressured to choose a niche early on and stick with it for their entire career, but no more. “We’re going to work in many different specialties and work settings. It’s common to weave in and out of specialties all the time,” says Donna Cardillo, RN, MA, keynote speaker, author, and columnist. She cautions that the whole concept of specialization is outmoded, and advises nurses to instead “think more about the opportunity itself—the support they will get and the opportunity to grow personally and professionally.” Donna herself has explored many specialties in her nursing career, and is still eager to see what’s around the next corner.
Do a Self-Assessment
Check out the online resource DiscoverNursing.com, sponsored by Johnson & Johnson. Perusing this site is almost as good as having a personal career coach by your side, but you can explore on your own schedule and from your own home.
Start with their five-minute quiz, Find Your Specialty, which asks about education, skills, and how and where you like to work. You will get a couple of niche recommendations based on your answers. From there, you can look over their database of 104 specialties to find out more about these and other possibilities, whether patient-facing jobs in a hospital or outside of it (where hiring is booming in long-term care, inpatient rehab, subacute care, and long-term subacute care). Even if your aim is a research, managerial, or entrepreneurial nursing niche, you’re likely to find something that fits you to a T.
If you want to explore the “nurse anesthetist” specialty, for example, the site reports $98,000 to $129,000 as the average salary, with 22% more jobs projected from 2008 to 2018. It also lists a dozen or so links to helpful resources, including a few professional associations. That’s a great jump-off point for finding experts to talk to, in-person or online, for answers to your specific concerns.
Follow Your Dream
Some nurses go to nursing school specifically to prepare for a certain role in a favorite niche—pediatrics, ER, or labor and delivery, say. Their challenge may be blocking out the voices of teachers, friends, and family who admonish them to do otherwise.
“I always knew I wanted to help moms and babies, because of a nurse who took care of me when I had my older child,” says Lisa Pacheco, RN, BSN, director of maternal child services at Children’s Hospital of Nevada at UMC. She started her nursing career in a medical-surgical unit, though, because she was advised to get broad experience first. She doesn’t regret taking a detour, but her satisfaction soared when she circled back to her passion, a women’s care unit, and “realized my love of taking care of women and children.” For over two decades, Pacheco has explored the many facets of this broad specialty, from antepartum, NICU, women’s care unit, and community nursing.
“Follow your heart, and then even on that hardest day when you don’t think you can come back to work, you will,” she says.
If you don’t feel passionate about any niche area of nursing, that’s okay. Follow your interests, rather than your passion, and see where that leads you. Who knows, you may fall head over heels in love with a niche when you least expect it.
Alternately, if you have your heart set on a specialization, such as pediatrics, but can’t seem to break in, don’t hold out for your dream job forever. If you’re offered a job in a hospital in telemetry, for instance, “you might consider taking that because it’s easier to get transferred into another unit than hired from outside,” advises Cardillo. Being unemployed for six months or longer is a red flag for many hospitals that require new nurse hires to have recent experience and up-to-date skills, she says.
Try it Out in the Real-World
Sometimes you only know what you like when you see it. So, put yourself in the way of your destiny and fan the flames of your desire with wide-ranging experience in a real-world context. Erik Meyer, RN, BSN, nursing supervisor at the Providence Seaside Hospital in Oregon, wasn’t enthralled with his nursing studies until “I saw a level 1 trauma center in inner-city Detroit…It was just a one-shift visit, but the next day I applied for a two-year internship.”
That rash decision turned out to have real staying power, and he’s served in the ER of a small, rural, critical access hospital for 19 years now. His part-time hours fit in nicely with a busy family life; he and his wife operate a coffee business and care for four young children.
Meyer advises nurses interested in his specialty to be assertive—what some might call aggressive, even—and let the ER manager know you’re ready to help out on the unit when there’s a need. “ER people won’t think that you’re being pushy, they respect that.” To prepare for the time when you get a try-out, start studying to pass the tests for becoming a Certified Emergency Nurse.
Weave Together Your Interests
Two years after starting a career as a bedside nurse, Brittney Wilson, RN, BSN, informatics nurse, social media influencer, and blogger at TheNerdyNurse.com, knew that she couldn’t continue it for long. “It’s backbreaking and emotionally draining,” she explains. She was exploring advanced degree programs when she discovered the nursing informatics niche. “It was like the clouds parted, the sun broke through, the angels began to sing,” she says. The field combines her love of technology with her health care training and experience. Because an MSN degree wasn’t a requirement, Wilson plunged ahead and within three months had a job in hand. Her popular nursing blog was instrumental in showcasing her tech savvy to health care recruiters.
Consider your hobbies and see if you can combine them with health care to come up with your own unique area of specialization. Want inspiration? Nursing blogs are a great way to become familiar with different niches, learn about the career paths of influential nurses, and connect with people who are enthusiastic about what they do.
Refuse to Choose
Not every specialty requires shutting the door on all others. Jake Schubert, RN, BSN, travel nurse and owner of Nursity.com, an online NCLEX prep course, has found his niche as a sort of “generalist-specialist,” the kind of nurse who can walk into a broad range of nursing environments and succeed.
“When faced with the proverbial fork in the road, I typically pick the route that has the most options in the future,” he explains. “I started my career in the float pool at a major academic medical center and floated to 15 different floors of adult medical-surgical specialties. It gave me exposure to a variety of specialties, nurse managers, and other opportunities in the hospital that I had never even heard of, let alone, considered.”
Schubert learned that he enjoyed the variety and dynamic nature of the work. “Going in with a good attitude and a broad set of skills makes me very marketable. I’m offered a full-time staff position on virtually every unit I work on,” he says. What sets him apart is his ability to embrace the new and relish change, which assure an easy ramp-up and short learning curve on each assignment. “Every unit, hospital, and system is different—so you have to be adaptive, flexible, willing to go with the flow.”
After a few years, Shubert decided to expand his “float” to other hospitals in other cities across the country and became a travel nurse. Travel nursing is a great specialty for people with lifestyle as a major motivating factor in their career decisions. “If you stay too narrow you miss out on a lot,” he says, “People who think of themselves first as nurses” can better weather layoffs or other transitions in this fast-changing profession.