This is a condensed excerpt of the chapter on health and well-being from the new book Evidence-Based Leadership, Innovation and Entrepreneurship in Nursing and Healthcare: A Practical Guide to Success. Click here for free access to the full chapter through 02/15/2020.
Although nurses, other clinicians, and healthcare leaders
take great care of others, they often do not prioritize their own self-care.
Burnout and depression now affect over 50% of clinicians in the United States and compromise the quality and safety of healthcare, as nurses and physicians who are experiencing poor mental and physical health are at greater risk of making medical errors. A recent national study of over 2,300 nurses from 19 healthcare systems throughout the country found that depression was the leading cause of medical errors. In this study, nurses who reported poor mental or physical health had a 26% to 71% higher likelihood of making medical errors. It is critical that healthcare leaders and clinicians prioritize their own self-care so that they can achieve optimal health and well-being for themselves, support a high level of wellness in their staff, and deliver the highest quality of safe care to others.
The Nine Dimensions of Wellness
Taking time each day to monitor and attend to your own well-being can have multiple rewards for you, from physical to emotional and financial health and well-being.
Presented here is an overview of the nine dimensions of wellness, designed to start you on your journey toward optimal well-being. Each dimension of wellness is vital and interconnected. Just as you are told by a flight attendant to place an oxygen mask on yourself first before you put one on your child, you cannot take good care of your family, your staff, or your patients unless you first prioritize your own health and well-being and engage in good self-care.
Physical wellness is not just limited to exercise; it includes healthy eating, engaging in regular preventive care and health screening, proactively taking care of health issues that arise, and sustaining healthy lifestyle practices on a daily basis. Focusing on self-care now will have lasting positive effects on your long-term health and well-being.
Emotional wellness includes the ability to identify, express, and manage the full range of your feelings. It also includes practicing techniques to deal with stress, depression and anxiety, and seeking help when your feelings become overwhelming or interfere with everyday functioning.
Financial well-being includes being fully aware of your financial state and budget, and managing your money to achieve realistic goals. When you analyze, plan well, and take control of your spending, you can make significant changes in how you save, spend, and feel. Almost three in four Americans surveyed in a recent American Psychological Association (APA) study (2015) said they experience financial stress. Financial stress can affect your physical and emotional well-being. According to the APA, high levels of financial stress are associated with an increased risk for ulcers, migraines, heart attacks, depression, anxiety, and sleep disturbance, and may lead to unhealthy coping mechanisms, such as binge drinking, smoking, and overeating.
Just as a flexible body indicates physical health, a flexible mind indicates intellectual health. When a person is intellectually healthy, he or she has a value for lifelong learning; fosters critical thinking; develops moral reasoning; expands worldviews; and engages in education for the pursuit of knowledge. Any time you learn a new skill or concept, attempt to understand a different viewpoint or exercise your mind with puzzles and games, you are building intellectual well-being. Studies show that intellectual exercise may improve the physical structure of your brain to help prevent cognitive decline.
Engaging in work that provides personal satisfaction and enrichment and is consistent with your values, goals, and lifestyle will keep you professionally healthy. After sleep, we spend most of our time at work, so ask yourself if your work motivates you and lets you use your strengths or abilities to their full potential. Burnout, stress, and dissatisfaction at work should prompt an evaluation of your career wellness. Even if you cannot change where you work right now, you can change your approach to the stressors and challenges you face at work.
Social wellness can be defined as our ability to effectively interact with people around us and to create a support system that includes family and friends. Evidence shows that social connections not only help us deal with stress but also keep us healthy.
A review of more than 100 studies of the benefits of the
arts (music, visual arts, dance, and writing) found that creative expression
has a powerful impact on health and well-being among various patient
populations (Jacobs, 2015). Most studies agree that engagement in the arts
decreases depressive symptoms, increases positive emotions, reduces stress,
and, in some cases, improves immune system functioning.
Creative wellness means valuing and participating in a diverse range of arts and cultural experiences to understand and appreciate your surrounding world. Expressing your emotions and views through the arts can be a great way to relieve stress. Do not let self-judgment or perfectionism get in the way. Allow yourself creative freedom without worrying about whether you are doing it well, and take time to appreciate the creative efforts of others.
Increasing awareness of your surroundings can improve overall well-being. Being environmentally well means recognizing the responsibility to preserve, protect, and improve the environment, and to appreciate your connection to nature. Environmental wellness intersects with social wellness when you work to conserve the environment for future generations and improve conditions for others around the world. Research has demonstrated that green space, such as parks, forests, and river corridors, is good for our physical and mental health. Your environment is not limited to the great outdoors though; it also includes everything that surrounds you—your home, your car, your workplace, the food you eat, and the people with whom you interact.
Spiritual wellness is largely about your purpose, not religion. You can seek spiritual wellness in many ways, including quiet self-reflection, reading, and open dialogue with others. A spiritually well person might explore the depth of human purpose, ponder human connectedness, and seek answers to questions like, “Why are we here?” Spiritual wellness includes being open to exploring your own beliefs and respecting the beliefs of others.
Protect and Cultivate Your Health and Well-Being
Changing your wellness habits is not easy; it typically takes 30 to 60 days to make or break a new habit. Setting goals for your well-being can make a significant positive difference in your life and in the lives of others. When trying to make changes, set SMART goals: goals that are Specific, Measurable, Achievable, Realistic, and Time-bound. Most people are not successful with their health and wellness objectives because they set goals that are unrealistic. For example, if you only exercise for 15 minutes, twice a week, do not set a goal to exercise for 30 minutes 5 days a week. A more realistic goal is 15 minutes three times a week or 20 minutes twice a week.
Click here for free access to the full chapter through 02/15/2020.
Baby boomers – the generation born immediately after World War II – have left their mark on the US and will undoubtedly leave their mark on the future of the nursing profession as they enter retirement age. According to the US Census, by 2030 all members of this generation will be 70 years and older. As this large segment of the population ages and starts to utilize more medical care, many predict this will increasingly burden and stress the healthcare industry. Here are a few ways the aging population will impact the nursing profession.
1. Magnifying the forthcoming nursing shortage
patients are in need of acute and chronic care management than ever before, and
there are fewer experienced nurses to do the job. Due to advances in modern
medicine and care management, many of these individuals are expected to be living longer with multiple chronic
comorbidities; in the next ten years, the percentage of Medicare
beneficiaries living with three or more chronic conditions will reach 40%. The increased
complexity of care associated with chronic care management means that not only
will this large population begin requiring more geriatric services, but it will
also likely require care for a longer period of time. This will demand an
increase in health care providers, which will only further exacerbate the acute
and post-acute nursing shortage.
this aging and retiring population are nurses themselves. Research indicates that by 2030, one million nurses
will retire. This exodus of skilled nursing professionals due to retirement is
projected to occur at precisely the worst time – the nursing shortage will be
at its height just as a large population segment will begin requiring care.
To make matters worse, research shows that the nursing workforce is already well below the recommended amount of baccalaureate and doctoral prepared-nurses in the workforce – which indicates that it is highly unlikely these nurses will be able to fill all the shoes of their predecessors.
2. Generating higher volumes of burnout and turnover rates
As acute and post-acute facilities become inundated with the ailments
of an aging population, facilities will struggle to fill shifts with a
shrinking workforce. Rather than operate under-staffed and risk being caught
out of compliance, facilities will be forced to mandate their internal nurses to
work overtime to cover the gaps in their schedule. Unfortunately, this is a
temporary fix and not a long-term cure. These internal nurses will inevitably become
exhausted and overworked – and that’s where burnout sets in and staff turnover
the World Health Organization (WHO) finally recognized “burnout” as an official
medical diagnosis after decades of debate. Someone with burnout typically
experiences feelings of irritability, exhaustion, and a checked-out
mentality. Shockingly, one-third of nurses in the US already report experiencing burnout.
This does not bode well for the nurse or the patient, as exhaustion and
disengagement from their job leads to poor patient experiences and an increase in mistakes.
Further compounding the nursing shortage is an increase in turnover. An RN Network study found that 50% of nurses have considered leaving their profession, citing burnout as a critical reason. Turnover makes it more difficult to safely staff, which places a burden on internal staff and can negatively impact the patient experience. It can also be costly to facilities: between the extra cost of overtime, loss of organizational knowledge, and decreased productivity, studies have estimated that turnover costs facilities anywhere from $22,000 to $64,000, per nurse.
3. Setting the scene for new ways of nursing to emerge
are to remain in the profession, and patients are to receive adequate care, facilities
need to find new ways to manage their workforce.
innovative change currently underway is the emergence of the gig economy in the
healthcare space. The gig economy – and gig work – fosters the freedom and
flexibility for nurses to build their own schedule. Accepting shift
opportunities via staffing apps is much like an Uber driver accepting requests
from a user looking for a ride. This model allows nurses to build their work
schedule around their own personal schedule, not the other way around, and be
able to decide for themselves if they want to work overtime or cut back on
shifts to take care of their own health.
intelligence (AI) is emerging as a viable tool to help augment the workforce. Some hospitals have already
that were built to complete nurses’ tasks that required precision but did not
require the human touch. These tasks have allowed nurses to spend less time
dispensing medication, and more time checking in on patient’s well-being.
While these technologies are a promising start for the profession, there is much more that can be done to combat the nursing shortage amidst the US’s aging population. Over the next decade, the facilities that embrace workforce flexibility and technology-driven change will put themselves in the best position to overcome these challenges.
Chris Caulfield, RN, NP-C is Co-Founder and Chief Nursing Officer at IntelyCare
For the 18th year in a row, Americans have rated the honesty and ethics of nurses highest among a list of professions that Gallup asks U.S. adults to assess annually.
In 2019 nursing once again topped the poll, with nurses ranking
19% ahead of engineers and 20% ahead of doctors. The results—85% of responses display
regard for nurses’ honesty and ethical standards as “very high” or “high”—show that
over four out of five Americans still regard nursing as the most trustworthy
among the major professions.
Compared to other professions, the trust ranking for nurses is
now 31% above police officers, 45% above clergy, and 57% above journalists in
this year’s poll. Among the other professions included in the poll, there is finally
some good news for members of Congress—who from last year’s 8% trust rating have
leapt ahead to 12%. As a result, congressional representatives have been nudged
out of last place for 2019 by car salespeople, who are now trusted by only 9%
of Americans polled. For more details, visit
the Gallup site.
Nurses have the opportunity to take on new and advanced roles through certifications and degree programs. For nurses working in maternal/child health, a lactation consultant is one such role to pursue. A lactation consultant, formerly titled IBCLC (International Board Certified Lactation Consultant), is a health care professional who may work in a variety of health care settings and specializes in the clinical management of breastfeeding. IBCLCs have been proven to improve breastfeeding rates, lower health costs, and improve consumer satisfaction and trust.
Many nurses and the general public may not know exactly what a lactation consultant does on a daily basis. Daily Nurse interviewed Robin Franzoni, a lactation consultant at a teaching hospital in central New Jersey. Robin worked as a NICU nurse for many years before she became an IBCLC. Here is what she had to say.
What first sparked your interest in becoming a lactation consultant?
When were you first exposed to an IBCLC?
My passion reaches back to when I was a new mom and getting ready to nurse my first child. My mother nor my aunt ever breastfed. I was one of the first one of my friends to have any children. My exposure to breast milk and pumping while working in the NICU was what really spurred my own decision to breastfeed. There were no lactation consultants at that time, but I saw how much better the babies did on their own mothers’s milk. I had horrible pregnancies and preterm labor with all three of my kids but I felt like the one thing I was successful at was nursing my own kids. So my success at breastfeeding and exposure in the NICU is what kind of gave me the interest.
What would you say your typical
day is like? What are your day-to-day responsibilities?
I see my discharge patients first and make sure they’re going home with all their questions answered and information for follow up after discharge, especially the ones who have had some difficulty latching or feeding or are losing too much weight. Then I see all the first time moms and assess the latch and get them motivated to start positioning the baby themselves. A large part of it is preparing them for what’s expected at home because they have such a short time in the hospital. Then after I’ve gotten through most of the first time moms, I see any other mothers having difficulty or who have asked for a consultation. But really my first priority is seeing, stabilizing, and supporting the first time mother.
What’s your favorite part of
I think being the person who has gotten a baby on for the first time or seeing a baby who’s been struggling and all of a sudden it clicks and they start eating. And the look of mom’s wonder on her face like, “Oh my gosh, it’s kind of happening.” I’ve been to hundreds of deliveries over my career and it used to be so exciting to watch a baby being born and they take that first breath. Seeing that baby eating for the first time is just as thrilling as watching the baby being born. It’s the culmination of many different things that are finally in perfect sequence and everything clicks and to me it’s really wonderful. It’s establishing that connection with the baby by nursing that is not only for the nutrition but the connection with the baby.
What’s the most challenging part
of what you do?
It’s the preconceptions people have that negatively impacts nursing. It’s unrealistic expectations and misinformation the mother has received from family members or friends. It can be like trying to knock down a barrier that’s been erected around themselves. But I think it’s mostly the lack of good education about breastfeeding.
How do you work together with
nurses when giving care to a patient?
Well, I feel that I’ve been really fortunate. I developed this routine that after I’ve seen the mother and the baby I usually go to the bedside nurse. And I think it’s just evolved into what I do because I’m counting on the bedside nurse to carry the ball after I’ve left. The reality is I’m probably only going to see that patient once on day 1 postpartum and at discharge. So the rest of it falls onto the bedside nurse. Teamwork gets it done. I want every nurse to feel that she is part of the breastfeeding support and that I’m depending on them and trusting them.
Do you have any advice for
nurses who may want to become an IBCLC?
I think they need some really good mother/baby or NICU experience first. I think you need a base and then after building that base then think about doing it. It’s something I really think you have to have a passion for because it’s one of the toughest things I’ve done to date. I thought it would be less stressful than the NICU, but it’s just a different kind of stress. You’re shouldering not only the baby and assisting them, but you’re also responsible for the emotional well-being of the mother and part of the physical well-being.
If you are interested in learning
more about the professional role of a lactation consultant you can visit www.uslca.org or www.ilca.org.
Information about obtaining certification can be found at www.iblce.org.
Cannabis and politics are at an intriguing crossroads as we creep ever
closer to the next election year. Politicians must decide how to position
themselves on the hot-button issue of cannabis legalization. Many potential
legalization bills have been proposed in the House of Representatives but very
few have ever made it out of committee. National legalization bills have a
history of facing intense scrutiny in the houses of Congress. There are a
number of reasons for this but the vast differences in political opinions of
members of Congress makes compromise on any bill, let alone one about a hot
button issue like cannabis legalization, very difficult.
However, on Wednesday, November 20th, a new bill that would decriminalize cannabis nationally, allow states to make their own laws on full-scale legalization, and create the potential for expunging criminal records related to cannabis arrests passed in the House Judiciary Committee.
Chances of the Bill Passing
Though it is tough to envision a cannabis bill actually seeing the light of
day, there is hope for this most recent iteration. The bill already has 50
co-sponsors, bipartisan support from notable pro-cannabis legalization
Republicans like Matt
Gaetz of Florida, and passed the House Judiciary Committee with a vote of
24-10. It is always encouraging when Republicans and Democrats can agree on
legislation, especially when it comes to a potential cannabis legalization
bill. Recently, the House of Representatives passed the SAFE
Banking Act with bipartisan support. The bill allows for cannabis
businesses to bank safely and discreetly. Its passage shows the willingness of
Congressional Republicans and Democrats to work together to pass a cannabis
The House cannabis bill is undoubtedly an exciting moment for those in the legalization movement. As promising as the bill seems, it is unlikely that it will be passed without major changes. It may pass the Democrat-controlled House of Representatives, but will face an intense battle in the Republican-controlled Senate. As unlikely as the bill’s passage is, those investing in the cannabis industry seem to believe the bill has a chance to become a part of American law soon.
Impact On The Cannabis Industry
As news of the forwarding of the house cannabis bill was announced, cannabis
company stocks soared. The three biggest cannabis stocks, Canopy Growth, Tilray
Inc., and Aurora Cannabis all saw prices rise between 8% and 15% on Wednesday,
according to Reuters. Investor excitement is palpable, but some experts
warn about the long term future for the House cannabis bill. Alan Brochstein,
managing partner at New Cannabis Ventures, cautioned that the bill is, “such an
early step in a long process that there are no near-term implications for
The merits of the House cannabis bill will likely debated for the next few
months. Changes will be made and votes will be cast before anything is set in
stone. Whether or not this iteration of a legalization bill becomes law is
unknown, but the fact that some politicians continue to fight for cannabis
legalization is tremendously promising.
The key to finding work as an ER nurse is to be proactive before and during nursing school. Keep reading for pro tips on how to position yourself during school and after graduation.
The availability of ER nursing jobs—especially for new graduates—depends on the needs and financial status of the institutions and geographic area in question. As reimbursement becomes more and more dependent on patient reviews, hospitals strive to update the accommodations and technological capabilities to satisfy their patient populations. The expense of these updates can limit the hospital’s ability to hire or even cause a hiring freeze.
Most managers would prefer to hire a nurse experienced in the ER because it is very time-consuming and expensive to train a new nurse. Furthermore, it delays the increase in staff numbers that the nurse is hired to relieve. Many hospitals have created fellowship programs, which include a stepwise process of training for new grads to fully integrate them into the world of ER nursing. These are valuable programs for nurses who seek a comprehensive understanding of emergency nursing and an ongoing support system.
They are, however, pricey to the hospital, and lengthy: nurse fellows receive full salary and benefits, and these programs last between six months and two years. For new nurses, these fellowship programs can be very competitive.
As with any professional field, building bridges is a key to success. For ER nursing hopefuls, forming relationships within the ER can be a very strong indicator for acceptance into the fellowship program. This can be done by finding work at the ER as ancillary staff or volunteering.
Working as a nursing assistant before and during nursing school is a great way to expose an individual to the life of a nurse, and either reinforce or redirect their goals. If a position working directly in the ER isn’t available, then employment in other parts of the hospital can still build those relationships and improve your chances of getting a job in the ER.
Although acute care is a part of every nursing school curriculum, emergency room nursing is not. Nursing students interested in the emergency room can find out if their school has a relationship with a site that might allow them to shadow in the ER. They can also request through their nursing school administration to do requisite clinical work there.
A capstone in the ER is a highly effective way to set oneself up for employment there. It introduces the nursing student to nurses and management, which gives the student an opportunity to demonstrate work ethic and nursing acumen.
If opportunities for work, volunteering, or clinical shadowing are not available, developing relevant skills for the ER is another way to make oneself more marketable for work there. Many emergency medical technicians (EMT) go on to become nurses and already have highly sought-after skills when they graduate. Similarly, medical assistants, phlebotomists, radiology technicians, and scrub technologists all have skills and experience that are valuable to the ER.
Because nursing schools follow a general curriculum, there is no formal way to get into the ER as a nurse. The individual who hopes to be an ER nurse must take it upon themselves to be proactive in learning about the ER, building relevant relationships, and developing the skills necessary to be successful. Being proactive during training is a skill-building opportunity in itself, as the best ER nurses are highly motivated, humble enough to remain teachable, and bold enough to advocate for a seemingly unlimited range of patient populations.