Nursing Side Gigs: Women of Integrity Inc.

Nursing Side Gigs: Women of Integrity Inc.

This is part of a monthly series about side gigs—nurses with interesting side jobs or hobbies. This month, we spotlight the founder of the nonprofit Women of Integrity Inc.

Shantay Carter, BSN, RN
Founder of Women of Integrity Inc.

For her full-time job, Shantay Carter, BSN, RN, works for Northwell Health Systems. But in her free time, she works for the nonprofit she founded in 2010, Women of Integrity Inc. in New York.

Carter says that she founded the organization because she was experiencing a tough time in her life and wanted to work with youth, which she’s always enjoyed. “I decided to channel that negative energy into something positive,” Carter explains. “I created WOI so that it would be a resource and support system for the women in the community. Our goal is to empower and educate women of all ages and ethnicities.”

WOI holds a number of events throughout the year to help both girls and women. They hold an annual prom dress drive, a prom dress giveaway, a prom makeover project, a women in business brunch, educational workshops, mentoring, and a Galentine’s Day celebration. Carter says that they also partner with other local community organizations to help host girls’ empowerment events.

WOI Prom Dress Giveaway

“I think it’s necessary to have an organization like WOI because our young girls and women need a safe place, they need support, they need to know that they are loved and worthy, and that their voices are being heard. We provide them with the tools necessary to achieve their goals and aspirations,” says Carter. “Through WOI, we have been able to create a platform that has helped many entrepreneurs start or grow their businesses, and we have mentored so many young women over the years. We have also hosted numerous educational workshops on health, etiquette, and finances. We have created a network/sisterhood of like-minded, positive women who enjoy giving back to their community and want to make a difference.”

WOI Mentoring Program

Carter admits that she’s experienced some challenges. She needed to select the right team members to help, gain the support of the community, and raise money. “There are times when you may feel like giving up, but then you have to remind yourself of your purpose and why you are doing this,” she says.

If you’re a nurse and want to start a nonprofit, Carter has some advice:

  • Find your passion first, and then it will lead you to your purpose.
  • Research your target group or area that you want your organization to serve.
  • Get a lawyer when it comes time to get your 501 (C) (3).
  • Learn to network strategically and intentionally.
  • Support those who support you.
  • Know your competition so that you can learn how to stand out.
  • Have a great team behind you.
WOI Galentine’s Day Celebration

“The vision for the organization has to be bigger than you because it’s not about you,” Carter says. “It’s about the community and the people you serve. Don’t try to compete with others. Just focus on what you are doing and your end goal. You may feel like giving up and become frustrated, but you have to keep pushing. What’s meant for you will be for you.”

Self-Care Tips for the Holiday Season

Self-Care Tips for the Holiday Season

The holidays are a great time, but let’s face it, they’re also exhausting. As nurses, you already focus on taking care of others, sometimes to your own detriment. To avoid burnout, we consulted a fellow nurse to offer you self-care tips for the holiday season.

Anna Rodriguez, creator of The Burnout Book

Anna Rodriguez, BSN, RN, PCCN, CCRN, works in Endoscopy at University of Utah, but also is the creator of The Burnout Book, a website and blog with the mission to help her fellow nurses find the tools and resources they need to avoid burnout in their profession, while helping them keep their spark for nursing. She also focuses on how health care organizations can create healthy work environments and support their staff.

Rodriguez took some time to answer our questions and offer her fellow nurses some self-care tips for the holiday season.

Why should nurses be sure to practice self-care over the holidays?

It’s so easy to get sucked into your work and forget to take care of yourself! You’ve heard all the sayings: you can’t pour from an empty cup, put your own oxygen mask on first, recharge your batteries, fill your emotional bank, etc. The thing is, all of those sayings are 100% accurate. You can give so much of your time and energy to others at work and come home feeling drained and empty and unable to give any time and energy to your family. This is why we need to take care of ourselves. The holidays are especially important because there are extra layers of stress on top of the day-to-day stress. Events to go to, food to make, gifts to buy and wrap, pictures to take…it’s one of the most wonderful and busiest times of the year!

What are some things that nurses can do to be sure to remember self-care and to fit it into their busy days?

Anna’s dog and his elf

I think it’s important that we first identify what self-care is. It isn’t about giving yourself permission to do whatever you want or lie in bed all day watching your favorite streaming service (although there’s a time and place for that!). It isn’t all glamorous like a spa day or a weekend getaway either (although I certainly enjoy those too). It isn’t isolated to bubble baths, meditation, and essential oils either. Self-care is about taking advantage of small moments throughout your day to improve your physical, emotional, or mental well-being. For example, some of my favorite self-care moments during my day include listening to my favorite music or podcast while I get ready for the day, prepping my lunch so I don’t have to waste 10 minutes of my break walking to the cafeteria, greeting my dog when I get home and taking him on a walk, cooking dinner with my husband, and taking my daily medications every night. These are all pretty ordinary, but they are good for me physically, emotionally, and mentally, so I make time for them.

My mom-friends will often talk about their self-care moments as sitting the kids down with coloring books from the dollar store while they take a few minutes and do something for themselves: read a fun book, work on a hobby, take a shower, or sneak into the pantry and enjoy some leftover Halloween candy.

Is there anything they can do at work, if they have a break or something? Or something they can do at home?

Absolutely, there are lots of little self-care moments that can happen during your shift!

  • Monitor your own intake and output (I&O) status. Patients don’t want nurses who are dehydrated and hypoglycemic.
  • Take your break! As a new nurse, I was notorious for working through my breaks or cutting them short because I didn’t want to get behind in charting or tasks. When in reality, taking that 30-minute lunch break does more for me and my patients in the long run. A 12-hour shift is a long time to be going non-stop, and more errors happen when staff are feeling fatigued.
  • Be prepared. There are some days when it’s hard to catch your breath, let alone take a break. These are the shifts when I’ll grab a protein bar from my work bag, and that helps. This ties into the next tip…
  • Speak up! Let your charge nurse/co-workers know if you’re drowning in your work and need help. When my patients’ care is being negatively impacted, that’s my trigger to delegate and ask for help, because part of being a patient advocate is recognizing when you can’t do it all.
  • Get outside. There’s an interesting study published in the American Journal of Critical Care about a group of nurses in Oregon who looked at the benefit of taking their breaks in an outdoor garden and the impact it had on reducing burnout. Even if you don’t have access to a garden at your hospital, or you’re risking hypothermia whenever you venture outside this time of year, finding a few minutes to enjoy nature, sunlight, and fresh air can make a big difference in your mindset.
  • Debrief on the hard days. Sometimes you need to debrief with someone (a loved one or co-worker) at the end of your day in order to move on. Journaling can be a form of debriefing too.
  • Disconnect mentally when you clock out. When you’ve had a particularly challenging day, this is easier said than done. Some strategies nurses can use to “let it go” is to listen to their favorite music on the commute, take a hot shower when they get home, or just visualize leaving everything at the door when they leave the hospital.
  • Prioritize. It’s hard when you work 12-hour shifts in winter. The days feel shorter, and all you want to do when you come home is eat dinner (cold cereal), and go to bed. And that’s okay. Work is the priority for that day. If your to-do list feels too overwhelming on your days off, prioritize one or two things you want to accomplish and just focus on that.

What are some absolute must-dos regarding self-care?

Two things come to mind when it comes to the basics of self-care: boundaries and self-compassion.

Boundaries in your life are important, especially during the holidays because they allow you to choose how you want to invest your time and energy and say “no” to the extra things.

It’s okay to say no to picking up an extra shift: you’ve already worked your obligated hours, and those days off are important so you can recharge and come back to work as a better nurse.

The concept of self-compassion comes from Dr. Kristin Neff. It’s the concept of allowing ourselves to be human and give “the same kindness and care we’d give to a good friend.” It means not beating yourself up mentally for any mistakes and choosing to see them as learning opportunities. It means not dwelling on the negative moments of the day and focusing on the positive. Self-compassion is something that a person can develop with practice.

What would you say to a nurse who says s/he doesn’t have time for self-care because too much is going on?

There’s this whole self-care movement happening, which I love! I think now more than ever, people recognize the impact self-care makes on their personal and professional life. If someone doesn’t think they have time for it, I would say it’s a matter of perception. Maybe they don’t identify the things in their life that seem ordinary, but are actually forms of self-care. Or maybe they really don’t have time because they are giving so much of themselves to their patients and family every day. This is the point where I’d encourage them to make time for themselves. Write down a list of all the things that make them happy, and do one of them every day — or on really hard days, do several of them. The point is, if they think they don’t have time to do self-care, maybe they need to reprioritize their day and make time.   

Is there anything else regarding self-care tips for the holiday season that are important for readers to know?

The holidays can be a difficult time for a lot of people. It can make them feel lonely and miss people who are far away or no longer in their life. There’s also the aspect of Seasonal Affective Disorder that Psychology Today says affects more than 10 million Americans. Take your multivitamins and vitamin D, get outside when you can or use light therapy, and consider counseling or consulting your doctor. All self-care at its finest.

Navigating Holiday Parties: How to Respond to “You’re a Nurse? Can You Look at This?”

Navigating Holiday Parties: How to Respond to “You’re a Nurse? Can You Look at This?”

Navigating holiday parties as a nurse can be tough. If you’ve been to a holiday party, cocktail party—or let’s face it—pretty much any kind of party, when someone finds out what you do for a living, the questions begin…

“Can you look at this mole?”

“This rash—do you think I should see a doctor?”

“I think I have a boil on my butt…”

Well, we hope that last one hasn’t happened! But even if it has, we’ve got some ways for you to navigate holiday parties and deal with it all properly and professionally, all while encouraging people to be proactive about their own health.

Ilene Schwartz, RN, LNC, of Pegalis Law Group, LLC, has encountered this a number of times. “Family, coworkers, even strangers at parties have started telling me about their symptoms or ailments! It’s that ‘Oh, you are a nurse! Can I ask you something…’ As soon as I hear those words, I know it is personal. They want a diagnosis, or sometimes directions on what test to get! Sometimes it’s about their medication. ‘Can you JUST look in my throat?’ or ‘Does my leg seem swollen to you?’” says Schwartz. “It’s easy to stop for a second and think – uh oh, here I am off duty, dressed up, trying to enjoy the day. But it is also an opportunity to reinforce what we know — that it is better to check than be sorry. I won’t and can’t give a medical opinion in those instances, but I am quick to offer advice on how they can and should investigate the symptom.”

Schwartz suggests that when people say these kinds of things to you, you be kind and say something like, “I don’t want to steer you wrong, and this isn’t the best place for an accurate medical discussion. But here is what I can tell you—it’s not worth guessing on anything that does not feel or look right to you. Always trust your gut!” In addition, Schwartz says, “I would suggest that they see their dermatologist, primary care physician, cardiologist, etc. as soon as they can.”

One of the reasons why people do this to nurses at holiday parties is because they can sometimes listen better at a casual event than they would do at the ER or in a medical setting, Schwartz says. “So while it is impossible to give a diagnosis at a party, it is an excellent opportunity for caring nurses to potentially save someone from medical errors.  Remind them that as patients, we all need to be proactive—to not to leave things to chance, to always go to the doctor with an updated list for them of their meds and supplements, and recent symptoms and concerns. These become part of your chart/medical records. I remind them that all medical pros can make mistakes, and they need to respectfully ask questions and get second opinions. I have no problem saying that.”

When she’s encouraging people to become more active about their health care, Schwartz also gives them practical advice: “They have to expect and accept the limits on their time with health care professionals. To expect it means to study before you go to the doctor, to have your questions written out, to know your symptoms, when they started, what makes them worse or better,” says Schwartz. “It is ideal to bring a non-emotional person with them who is a good listener to take notes for them, when they have a serious diagnosis. Don’t just bring a bunch of people with you for moral support. Bring one good person who can pay attention and be your advocate when you are too upset or sick to do so.”

Finally, Schwartz tells them that being proactive is crucial. Being proactive “includes really preparing for your doctor’s appointments, asking about screening and tests, asking for copies of lab results, keeping a health care diary and your records. Generally, treat your health like any important project, not one you will just hand over to someone else, but a project you will be involved closely with every step of the way. There is no more important a project than your own health and people have been lulled into thinking ‘other’ people will take care of the details,” she says.

For tips on encouraging others to be proactive about their health, visit here. 

Detecting Breast Cancer by Hand: MammaCare Discusses

Detecting Breast Cancer by Hand: MammaCare Discusses

The MammaCare Foundation recently issued a statement saying that according to recent studies, most breast cancers are found by hand. Mark Kane Goldstein, PhD, a MammaCare Foundation senior scientist stated, “A palpable lump, detected by hand is the most common symptom of breast cancer. Although mammograms—x-rays of the breast—can be useful, their images are masked by breast density in nearly 50% of women. Physical examination, however, is unaffected by density.”

Goldstein took time to answer questions for us about MammaCare and the foundation’s mission to help train every hand that examines a woman, including her own.

Why was the MammaCare Foundation established?

Our research on early breast cancer detection began at the University of Florida and Malcom Randall VA Medical Center because mortality from late stage breast cancer was an epidemic that continues to this day. We reported in a series of studies supported by the National Cancer Institute that properly trained hands will reliably detect small early, 3mm, pea-sized breast cancers (suspicious palpable tumors) without increasing false positive detections. Our original intention was simply to publish and promulgate the evidence and standards knowing they would enable clinicians and women to detect small early cancers.  

We assumed, naively, that the training procedure would be integrated into practice because it was an easily teachable skill that could have a meaningful positive impact on women’s morbidity and mortality from breast cancer without the dangers and expense or radiation. Sadly, resistance from the imaging and radiological industries, and surprisingly from public and private women’s health care agencies as well as U.S. Government health agencies impeded training progress for a number of years as data accumulated.

Currently, breast cancers first detected continue to remain 5 to 10 times larger and at a later stage than necessary. So, in response, and with support from scientific agencies, the original research team formed MammaCare to make the skills and standard for breast exam competency universally available.  

What is MammaCare’s mission?

MammaCare’s mission is to train every hand that examines a woman for breast cancer. When the team of scientists, physicians, and biomaterial engineers began investigating the capability of fingers to detect breast cancers at the University of Florida, we were surprised that there were no prior evidence-based standards — no published research on the subject existed. We also learned that most women received clinical exams that were random or deficient, incapable of palpating small, suspicious tumors. We were puzzled by opinion and conclusions in the medical literature that the tactile sense was limited to feeling large, late-stage lesions. The only clinical papers published at the time reported that breast cancers discovered by hand and were late stage, large, 3-3.5 centimeters (about the size of a ping pong ball).  

Our data from experiments found that with a brief training session using tactually accurate breast models, all hands were able to reliably detect 3-millimeter tumors, 10 times smaller than reported without increasing false positive detections. It was clear that breast cancer detection would be the province of the growing imaging, radiological industry. So, we created MammaCare to assure that a standard for a universal, safe, cost-effective standard of physical examination of the breast would be available.

Fingers feel and read sub-millimeter Braille dots with absolute accuracy.  

Many of the reports and studies on MammaCare are here.

Most women—and probably most nurses, female or male—believe that mammograms are the best way to find lumps. What does the MammaCare way offer that regular self-breast exams don’t?

Mammograms and increasing use of radiological imaging are widely available and most often used. It is puzzling, however, to note the evidence that indicates these technologies are not the most likely way breast cancer is first found. Moreover, numerous landmark studies by colleagues such as Joanne Elmore point out in a series of studies that mammography is only as good as the training and experience of the radiologist who reads them with his eyes. The same is true of untrained and trained hands with an important exception — the exam is free of ionizing radiation — an increasing concern — and mammograms often miss palpable tumors. Finally, between 40 and 50% of all women have dense breast tissue that clouds mammograms making interpretation difficult or impossible.

MammaCare training is now being installed in colleges of nursing and medicine providing breast exam skills and standards of practice for  thousands of student nurses and physicians across the U.S. and elsewhere as indicated on the student login page

What should nurses know about MammaCare?

That MammaCare has online and live training and certification programs, recognized continuing education courses and credits, and that new certification courses are conducted via live teletraining at the clinicians’ facility. There is a map on the front page of that should provide access to MammaCare certified nurses and their organizations.  

Many of the colleges of nursing (and medicine) in the competency network are employing a new breast exam simulator that teaches and measures exam performance (the MammaCare Simulator Trainer) that was funded in part by the National Science Foundation. 

In addition to improved detection of suspicious breast tumors, the MammaCare training protocol reduces false positive detections on clinical screening exams that are performed on well women screening.

Preventing Falls: A Crucial Skill

Preventing Falls: A Crucial Skill

Helping to prevent patient falls is absolutely crucial, as one simple fall can cause so many problems—everything from broken hips to traumatic brain injury.

Michele L. Kimball, RN, BSN, Senior Director of Nursing at Bethesda Dilworth, knows why it’s so important to keep patients from falling and assessing their risks. She took time to give us information about what nurses can do.

What are the most important things that nurses need to know when working with patients in health care facilities?

The most important thing for a nurse to remember when assessing for fall risk and developing a fall prevention plan is that the first step is “getting to know your patient.” But without knowing what places them at risk and knowing their routine, your plan will fail. Patients come to health care facilities for so many different reasons. Staff should consider in the beginning that getting acclimated to the routine of a facility is stressful and, depending on the patient, can be confusing.  Restoring as much of their daily routine as possible can lead to success.

What can nurses do when they have stubborn patients who may insist on getting out of bed without assistance?

Allowing them to make as many decisions that they can and restoring as much of their daily routine as possible can minimize risk. 

Involve family and educate, educate, educate.

For patients who are in their own homes—in the case of home health care nursing—what tips can nurses give to these folks to prevent them from falling?

The key is beginning the discharge process prior to them going home on home health through home evaluations and assessment of daily routines. Knowing where and how the patient would need to navigate inside their home is key. Educating them on needed adjustments to their home and warm hand offs to the home health nurse on outcomes of the assessments and recommendations is vital.

The patient’s willingness and ability to take in this education as well as support systems should be considered when developing a plan. 

What kind of health issues can lead to more falls? What information can nurses give to patients so that they can prevent these health problems?

A lot of fall prevention is learning what places them at risk in the first place.

Patients with high blood pressure need to routinely take their medications as prescribed and continue to monitor their blood pressures. These medications can cause dizziness and at times orthostatic hypotension.

Patients with heart failure should continue to take their medications as prescribed and monitor their heart rate, blood pressure, and fluid status. They should contact their doctor if they become short of breath, seem tired more than usual, or notice swelling in extremities. These symptoms can develop quickly and lead to a major health set back, but most importantly lead to weakness, dizziness, and unsteady gait all key contributors to falls.

Patients with diabetes should ensure that they are controlling their blood sugars and taking their medications as prescribed. Low blood sugars could lead to dizziness and fainting, placing them at a risk for falls. Glucose is food for the brain, and if your blood sugar is low and your brain isn’t getting fed, it leads to being tired and increases risk for poor decisions, lack of concentration, and black outs — again contributing to the risk of falls.

Tell patients not to take their health conditions lightly, to notify their doctors when symptoms occur, and if they feel “funny” or something “doesn’t feel right” err on the caution side and ask their physicians. Falls are dangerous, and for the elderly population they can lead to major injuries such as fractures and even death. There is almost always some functional decline after a major fall, and this decline can be the difference of a patient being able to stay in their home or have to seek out a long-term care facility.

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