Nurses are on the front lines quite a lot. And they’re known for
being strong, forging ahead, and getting the job done.
But everyone facing this pandemic is dealing with something we’ve
never experienced before—not on this level. Nurses often put everyone else in
their lives first and themselves last.
It’s important, now more than ever, to keep calm and use self-care. If you’re not at your best, you won’t be able to take care of others.
Natalie Dinkins, Psychotherapist, MHC-LP, Bethany Medical Clinic, gives great tips on keeping calm and caring for yourself as we navigate the future.
How can nurses keep calm during this uncertain and tough time?
We all have our unique ways of handling stressful situations and it is important to take a daily personal inventory on how you are processing and coping with stress. During this time, it is natural to feel a wide range of emotions from fear, anxiety, sadness, irritability, or even feeling detached and numb. It’s important to note that we all deal with stressful life events differently, but the one thing we do know is that as humans we all thrive on feeling validated and supported. Here at Bethany Medical Clinic we would like to take a moment to let you know that you are not alone. As a result, we would like to share some helpful tips you can consider while you are at home or work.
- Actively participate in self-care activities. This could mean taking a pause to do something mindful — boil a hot cup of tea and sip it slowly engaging your five senses, write in a journal, meditate/yoga, exercise, or engage in a nice cleansing breath.
- Acknowledging your stress and coping with it as you continue to provide care will help you and your family stay well.
What can nurses do to keep calm if there are scared and are being
called into work?
- Always check in with coworkers on their emotions and have them check on you. Find ways to support the community.
- Form a buddy system. You are not alone during this. Work as a community to maintain a healthy balance.
- Try to separate emotions from facts. When discussing COVID-19 it is important to discuss feelings and validate others’ concerns.
- Allow yourself and your family time to recover from responding to COVID-19. This also means allowing yourself time after shifts to process, decompress, or just sit before heading home.
What should they not be doing?
Providing care to individuals during crisis can be just as stressful as rewarding. It is important to remind yourself to:
- Don’t over work. Try to keep reasonable working hours to lessen overall exhaustion. It is never selfish to engage in small breaks to ensure time to rest, eat, and relax. There is power in time we take for ourselves, even if it’s 5 minutes.
- Don’t push your limits. With the myriad of platforms for social media and instant fact gathering, it is important to limit saturation of media exposure i.e. print news, TV, radio, pod casts, online discussion forums that promote fear/panic, and overly utilizing search engines to research.
- Don’t engage in unhealthy coping skills. Try to limit or avoid the amount of alcohol, caffeine, or nicotine intake.
There are many job-related stressors that nurses may face while providing care during COVID-19. These include intense work hours, overwhelming responsibilities, lack of a clear direction, poor communication, and work environments that are not secure. Providing patient care during stressful situations can take an emotional toll on you. This can lead to burnout or secondary traumatic stress. Being able to recognize the signs of these conditions in yourself and others is important to ensure breaks and additional resources one may need. These signs may be physical (fatigue, poor hygiene, racing heart, nightmares) and mental (fear, withdrawal, guilt). Most importantly, if you find yourself experiencing a shift in your mood that does not feel like your typical self, and you find yourself struggling to cope, please reach out and seek out treatment for further support.
With the closures of universities and colleges due to the spread of COVID-19, life is unlike it’s ever been for students and nurse educators. While some classes are held online anyway, there are many that take place in person.
Julie K. Stegman, Vice President, Nursing Segment at Wolters Kluwer, Health Learning, Research & Practice, took time to answer our questions about what you can do to continue learning or teaching during this time.
of colleges and universities have closed or are closing. Nursing students may
be looking for ways to study while at home. Until their professors/instructors
begin offering online classes, what should they do?
This is an incredibly challenging time. Nursing students face mitigating circumstances for completing their clinical hours, and nurse educators are pivoting to a fully online teaching format that many are not accustomed to. From discussions with nurse educators, we know they are facing challenges with the typical steadfastness and resilience we see from nurses daily.
Nurse educators are keeping their students engaged virtually
by suggesting independent learning activities, such as reading their textbooks
and taking advantage of online videos and interactive exercises. They’re also
making students aware of educational webinars offered by organizations like ours
on key topics such as clinical judgement.
We are also reminding nurse instructors of the tools
and resources they have at their disposal and can make available to their
students virtually. Our Lippincott CoursePoint+ solution for example is an
online program that offers students a lot of opportunity for self-learning,
including applied learning and assessment as well as virtual simulation activities
that mirror real-world practice.
can they determine which websites are providing accurate information or not?
Nursing education has a variety of legitimate sources
for accurate information. In fact, one of the hallmarks of nursing education is
using the latest evidence in making decisions about a patient’s care.
Because of that nursing students typically don’t run into trouble identifying
reputable and authoritative sources of data and information.
Nurse educators are also represented by premiere associations like the National League for Nursing, the American Association of Colleges of Nursing, and the National Council of State Boards of Nursing that are proactively helping instructors guide students toward the latest information. The nursing profession is also represented by premiere associations (including Wolters Kluwer) and publications like AJN: The American Journal of Nursing.
there ways that they can study together online? Should they set up private
Facebook groups with other students they may already be in study groups with?
Are there better ways of doing this? Please explain.
Many nursing schools use learning management systems which provide an opportunity for them to create a forum for discussion topics as well as opportunities to connect students with one another. Because this is all done virtually, it’s one of the best ways students can stay connected and engaged at home.
instructors/professors: what kind of tools can they access online or through
other technology that will allow them to keep teaching? Until they can, what
should they do?
learning has been embraced in nursing education for some time and has had a
positive impact on preparing students for real-world practice. In fact, Lippincott
CoursePoint was the first-to-market integrated, digital nursing education
solution back in 2013 and continues to deliver the industry’s most trusted
content and resources, including case studies and real-time data. Fortunately,
many nursing instructors and professors are familiar with these digital education
tools and it’s been a shorter learning curve.
powerful digital tools and insights allow nursing instructors to adapt their
approach on the fly to meet students’ needs, even if those students are at home.
is so unlike anything any of us have experienced before. Is there anything regarding
what nursing students and nurse educators can do while schools are closed that
is important for our readers to know?
At Wolters Kluwer, we are committed to our nurse educators and supporting them in these challenging times. We have and are continuing to provide resources for our educators for transitioning to online learning including free webinar training, as well as recorded webinars, blog posts and white papers on our Lippincott Nursing Education website. We are also maintaining an information resource about the latest guidance for nurses in practice at Lippincott NursingCenter.com.
than 20 years ago, Veronica Castellana, RN, BSN, EMLS, had been working as an
Emergency Room nurse for several years when she developed a major hypersensitive
allergy to latex. Since it was used extensively in the nursing field at the
time, she needed to leave her job and find another one—preferably in the
needed a new career option to support my kids,” she says. After taking a
beginning course on Legal Nurse Consulting, Castellana realized that she needed
more information in order to make it a long-term career option. She spent a
year developing her own system that worked. When she discovered that other
nurses had the same problems in finding information about this career that she
had, Castellana developed the training as a certification course.
then, I have practiced as a Legal Nurse Consultant and Expert Witness, while
also training nurses to do the same type of work,” says Castellana, who has
worked in this field for the last 19 years.
Castellana answered our questions about what’s involved with this type of career.
this be full-time work?
There are definitely enough cases out there for a full-time case load. Testifying as an expert witness alone would typically not offer full-time work. When combined with behind-the-scenes reviews, the work can definitely be full-time. Those nurses typically work on a contract basis, so they have the freedom to take on as many cases as they wish.
Do nurses need specific training to become Legal Nurse Consultants?
Training is not required to become an Expert Witness or Legal Nurse Consultant. Nurses have extensive medical expertise, and that is why they would be hired by attorneys. However, we do recommend that most nurses receive some training so that they can transition easier into this field and learn the intricacies to this type of work. The transition from medical to legal can be challenging for many nurses, so most new Legal Nurses will benefit greatly from some training. If they are working as an Expert Witness, some sort of preparation is highly recommended so that they know what to expect.
How do you train nurses how to do this?
My course is called LNC STAT (www.LNCSTAT.com).
We train nurses how to utilize their medical expertise in legal cases, and act
as expert witnesses. It is home study
format. Nurses learn at their own pace using online training and some printed
manuals that are included. They practice with real cases from start to finish. We
include mentoring and support throughout the entire process. After they work
through much of the course, they can choose to attend a live event where we
review the content.
Most people only know what they see in trials on TV
dramas. Is that what it’s really like?
definitely add some unrealistic drama. While some trials can be very emotional
for the parties involved, most expert witness work is rather straight forward,
especially for nurses. When nurses act as expert witnesses, they are typically
used for medical clarification, so very little drama is involved. They are
asked to explain the events in the medical records, explain the medical
standards of care, and discuss any failures to adhere to those standards of
care. These are topics that nurses are very familiar with, so it isn’t very
difficult for them. Just like anything else, the first time can be
intimidating, but most nurses get used to it very quickly.
What did you enjoy most about working as a nurse in
the legal field?
Most nurses cannot work clinically for their entire
career because of the strenuous physical requirements. This career option
offers some great alternatives for these nurses. They have the freedom to work
as much or as little as they want. This career path allowed me to continue
working in the medical field. Most nurses really enjoy the positive impact that
they have on people’s lives. Legal Nurse Consultant and Expert Witness work
allows me to continue helping people in another way, and allows me to see the
direct results of my efforts.
What would readers find most surprising about the work
Many nurses don’t really
understand how valuable their medical expertise is in the legal field. Most
Legal Nurses earn $30-$150 per hour reviewing medical records and around $300-$500
per hour acting as expert witnesses. After many years in a hospital setting,
nurses are often surprised to hear that their expertise is worth so much. They
would also be surprised as to how many legal cases need their expertise.
What would you say to someone who was considering getting
into this kind of work? What would they need to do to prepare themselves? What
skills do they need?
Their medical expertise is
what is in demand. If they have 2 or more years as a nurse, they are already
qualified. We recommend completing a training course so they can make the
transition easier and understand what is expected of them in this new field.
When it comes to choosing a course, the most comprehensive training will
benefit them the most, so they know exactly how to find the cases and work them
from start to finish.
This career path can be very
exciting, rewarding, and challenging, but it is usually something that requires
nurses to take an active approach to implementing. They should be motivated,
willing to learn something new, and willing to step outside of their comfort
physician residencies have been the norm seemingly forever, nursing residencies
are still fairly new. If you’re interested in one, you need to know basic info
about what you’d experience.
McGill, MSN, RN, CCRN, Chief Nursing Officer, Norman Regional Health System in
Norman, Oklahoma says that nurse residencies are new, having been around in
their current form for about the last decade. However, in the last five years,
they’ve become quite common in acute care nursing.
“The Nurse Residency Programs are designed to establish a smooth transition from student life to professional practice. These programs seek to establish clinical competency, provide emotional support through the transition, and facilitate recruitment and retention of strong nurse beginners who are committed to the nursing profession and the hospital,” says McGill. “The residency program is meant to build on the foundation provided by nursing schools and unit orientation through reflection, case reviews, and critical thinking that strengthens what it means to be a professional nurse.”
At Norman Regional Health System, McGill says nurse residents receive both formal as well as informal learning opportunities. “[They] focus on our institutional policies, procedures, and standards of care while introducing them to key persons and structures needed to execute the institutional and departmental routines,” she explains. “Our Nurse Residency Program includes an evidence-based practice project and presentation of that projection. The purpose is to ensure the residents are fully aware of the process that results in continuous learning, developing, and enhancing patient care based on evidence. The learning never stops.”
Nursing residencies last anywhere from six months to one year, but most are a year long. They should encompass unit-specific orientation, hospital orientation, be paired with a preceptor and a mentor, include a peer support component, and should focus on developing the skills that nurses need to grow as professionals.
“Nursing residencies can be administered differently across hospital settings. The NRHS Nurse Residency Program includes all new graduate nurses hired into the acute care hospital setting regardless of specialty. This allows relationship building across units and service lines enhancing teamwork and collaboration,” says McGill.
If you’re looking into a nurse residency program,
McGill suggests that you do your research. Be sure to ask recruiters about
nurse residency programs. If you’re looking for nursing positions, search for “New
Graduate RN” or “Nurse Resident” listings. And during job interviews, be sure
to ask questions about a health care system’s nurse residency programs.
The greatest rewards of nurse residencies, says McGill, are “the peer support the nurse residents receive during the program and the lifelong connections formed with the nurses from different departments. The ability to learn about the hospital as a system and not just the unit they work on,” she says. “This helps build the interdisciplinary component that health care is striving to achieve. The nurse resident can also get a perspective of the care a patient receives on other units and how each area impacts the patient’s care overall.”
If you love being a nurse, but also love to travel and fly like Sue Treseder, BSN, RN, then being a commercial flight nurse might just be a great gig for you.
Founded in November 2016, Flying Angels is a medical escort service that provides nurses to fly with patients who are stable but have medical needs. They travel on commercial flights with patients all over the world. Treseder, a charge nurse at Virtua Memorial Hospital’s Emergency Department, has been working with them since their inception. Overall, she has been doing this kind of work for about 12 years. Averaging about 20 trips per year, Treseder says that she has been all over the United States and all over the world.
“These patients have a wide range of medical issues.
Typically, they fall ill or sustain an injury while they’re away from home and
need assistance getting back. We also transport patients who need to get to a
different hospital for specialized care. For example, we might take someone
with a spinal cord injury to a facility that specializes in that particular
niche,” explains Treseder.
Here’s how it works: a coordinator with Flying Angels
makes sure that everything with the sending and receiving parties is arranged
so that all patients have what they need at all times. They get special
clearance from airlines if they have to bring equipment along such as oxygen. And
nurses travel the entire way with the patients—from one bedside to the next.
Before they can work for Flying Angels, nurses are
trained in flight physiology and also have to pass a test before flying. Once
this is done, they can fly with patients.
“It is a paid position, although most of us love what we
do so much that we would probably do it for free!” says Treseder.
While flying with patients, Treseder says that she talks
with a lot of them. “We’re usually like best buds by the time I drop them off,”
she says. “Often there are hugs, tears, and pictures at the end of the trip.”
There are reasons why they can become so close, so soon. “Most
of our patients find themselves in seemingly impossible situations. Often, they
are in hospitals in a foreign country where they don’t speak the language and
the care may be of significantly lower quality than they would receive at home,”
Treseder says. “They’re frightened and overwhelmed, as are their families. A
huge weight is lifted off their shoulders once we get involved.”
Although she loves what she does, Treseder has had some
challenging experiences. She’s flown with patients who have psychiatric
problems or dementia. “They sometimes act out during a flight and are difficult
to redirect,” she says. “Human behavior is always the toughest thing to prepare
Sometimes, she says, the most difficult cases can also be the most rewarding. “I had one patient who was in Atlanta visiting his nephew when he tripped and fell, and sustained a spinal cord injury that left him a quadriplegic and on a ventilator. He lived in a remote part of China. The logistics of getting him home were formidable, between getting the stretcher and ventilator through the two airports (connecting through Seoul), carrying all the equipment (we had to buy extra seats on the plane just to accommodate all the medical gear), to arranging the 12-hour ambulance ride through the back roads of China — this was a really tough case,” admits Treseder. But the payoff was worth it. “When we finally got there, the family was waiting, along with a crowd of locals and the news media. The outpouring of love and gratitude was overwhelming, and it was just such a great feeling to know we had performed this service for this man and his family.”
One place Treseder hasn’t been to yet is Australia. “But
I’ll get there one of these days,” she says. Besides just seeing new places,
though, Treseder has also learned a lot. “Although cultures around the world
are very different, we have more in common with each other than you might think,”
To learn more, visit www.FlyingAngels.com.