How to Balance Continuing Education and a Full-Time Career

How to Balance Continuing Education and a Full-Time Career

It may seem like it would take a superhero to balance full-time nursing work with continuing education and perhaps even a personal life, but take heart. It is possible, even without sacrifice. Continuing nursing education, whether for an advanced degree, studying for specialty certification, or keeping current on evidence-based practice, is a matter of discipline. That life is about quality rather than quantity is also true in the balancing act of being a working student.


The first step in nursing education is organizing the details: What would a full-time course load look like? Will it require cooperation from your employer, and if so, how willing are they to accommodate you? Will your employer help you pay tuition and what are the limits of that? What are your other commitments and how flexible are they?

One suggestion for making it work is to look at a typical week of your life and block out times that you are unavailable. This includes times that you spend with your family, running errands, and yes, even playing and relaxing. Make your class schedule around that, while at the same time remembering that there will be homework.

Into Action

When you apply to school, start the process early and give yourself the luxury of time in the application process; it is easier done in small nibbles than large bites. Your application can be painlessly completed one transcript, personal statement paragraph, and reference request at a time.

Once enrolled, having the discipline to give your schoolwork quality attention will allow you to feel fulfilled and purposeful rather than deprived. When you study, turn your phone and TV off, ask for privacy, set a timer, and focus. And when you’re done, be done. Don’t give up anything important to you. Continue exercising, knitting, playing music, or whatever gives you pleasure and reprieve.

The last thing your patient or your family needs is an angry, tired nurse. Even if it’s one class at a time, you’re doing it. So…do it, but do it as you continue high-quality patient care and high-quality self-care.

Could Dialysis Nursing Be in Your Future?

Could Dialysis Nursing Be in Your Future?

About 650,000 Americans are currently affected by End Stage Renal Disease (ESRD), and this number is increasing by 5% annually. The primary causes of kidney failure leading to ESRD are poorly managed diabetes and high blood pressure, the treatment options for which are limited to kidney transplant and dialysis. Unfortunately, there are currently more than 93,000 potential recipients on the kidney transplant waiting list and 80% of those individuals are on kidney dialysis while they wait.

Demand for Nurses is Growing

The specialty of nephrology and dialysis nursing continues to grow with these rising ESRD numbers. In fact, nephrology nursing is expected to grow over 25% within the next 10 years. These nurses can expect an attractive salary and a diverse working environment. Nephrology nurses might work on a typical hospital unit, but those who perform dialysis also work in dialysis centers, nursing homes, inpatient hospice centers, and even in-home health.

Nurses Develop Deeper Relationships with Patients

Renal failure is a chronic condition, so those who suffer from it must access care frequently. This means nephrology nurses will see their patients regularly. Dialysis nurses often have the ability to work with patients one on one, providing an opportunity to give care in a much more personal, attentive way. They also care for their patients through the continuum of the disease progression, so they get to know their patients quite well.

Certification and Advanced Education for Leadership

A nephrology nurse may elect to pursue certification or even further education and their Nephrology Nurse Practitioner certification. These nurses take their practice deeper, providing primary care for their patients who battle ESRD during dialysis and even after transplant—if and when that becomes possible.

There are plenty of worthwhile opportunities for nurses to make a difference in the lives of renal patients whose prognosis can be dire. Examples of such opportunities and further information on dialysis nursing can be found here.

Nurses’ Attitudes Key To Infection Control?

Nurses’ Attitudes Key To Infection Control?

Changing perceptions of risk could improve compliance with infection-control measures

It’s often said that knowledge is power. But a new study finds that when it comes to nurses’ compliance with infection-control measures, it’s more appropriate to say attitude is everything.

The study, published in the American Journal of Infection Control, examines the relationship between infection-control compliance, knowledge, and attitude among home healthcare nurses. Researchers surveyed 359 home healthcare nurses in the U.S., and evaluated their knowledge of best practices in relation to their compliance with infection-control measures.

Over 90% of nurses self-reported compliance for most of the measured behaviors. The researchers also found there was not a direct correlation between knowledge of infection-control practices and compliance with those practices. However, there was a relationship between the level of compliance and the participants’ favorable attitude toward infection control.

“This study tells us that knowledge is not enough,” said one of the lead authors, Jingjing Shang, PhD, of Columbia University School of Nursing in New York City. “Our efforts to improve compliance need to focus on ways to alter nurses’ attitudes and perceptions about infection risk.”

Common Hurdles

The authors suggest that efforts to improve compliance with infection-control practices should focus on strategies to alter perceptions about infection risk. Changes should start on an organizational level, and seek to create a culture of positivity in relation to infection-control compliance.

Among other takeaways from the study:

  • Protective equipment lapses: While most of the participants reported compliance on most issues, many reported lapses when it came to wearing protective equipment; only 9% said they wear disposable face masks when there is a possibility of a splash or splatter, and 6% said they wear goggles or eye shields when there is a possibility of exposure to bloody discharge or fluid
  • A culture of “presenteeism:” Presenteeism, coming into work despite being sick, has become a patient safety issue over the last few years, especially as it relates to infection control; only 4% of participants felt it was easy for them to stay at home when they were sick, which could be a major contributor to rates of infection
  • Hand hygiene is still an issue: 30% of respondents failed to identify that hand hygiene should be performed after touching a nursing bag, which could transport infectious pathogens as nurses travel between patients

“Infection is a leading cause of hospitalization among home healthcare patients, and nurses have a key role in reducing infection by compliance with infection-control procedures in the home care setting,” Shang said.

This story was originally posted on MedPage Today. 

7 Tips for Transitioning into a New Nursing Specialty

7 Tips for Transitioning into a New Nursing Specialty

Even if you plan to spend your entire career in nursing and never take off your scrubs, you probably won’t work for years and years in the same specialty. While it may seem daunting to change your specialty—especially if you’re early in your career and have never done it before—it’s very common and many nurses do it every single year. If you’re contemplating a specialty switch, here are seven strategies to keep in mind as you prepare for the transition:

1. Take time for self-evaluation.

If you’re thinking about changing your nursing specialty, that’s a pretty clear sign that something about it isn’t working. Before you make the leap, take a deep dive and seriously reflect on why you no longer like your current specialty. Have you hit a plateau and grown bored as a result? Did you realize that you’d rather work in pediatrics as opposed to gerontology? Do you need to transition away from a high-intensity unit such as ICU so you can take care of your own family and health? Switching your specialty is no small task, so doing this self-evaluation upfront will help ensure that you make the right decision.

2. Do your research.

Now that you’ve evaluated yourself, it’s time to start evaluating specialties. Read industry publications, news articles, reputable blogs, relevant journals—whatever materials you think might be helpful. If you can, try attending nursing conferences and job fairs in addition to your online research. These events can often be a really efficient way to explore different career options in a short amount of time, and they’re a great chance to meet colleagues and recruiters whom you would never cross paths with otherwise. You never know–that person you sit next to at a conference panel might one day become your new coworker or boss!

3. Get some hands-on experience.

Once you’ve narrowed down the list of possible specialties that you are interested in, it’s time to get a real-life taste of them. Ask to shadow nurses in the units that are on your shortlist, just as if you were in nursing school again. While it may feel a little weird to go back to shadowing after you’re already an experienced nurse, you simply can’t get a full picture of what it would be like to work in a specialty from reading articles or talking to people. You actually need to be there in the middle of the action. So put on your scrubs and get shadowing!

4. Network, network, network.

The majority of jobs are found through networking and employee referrals rather than traditional job search methods. Estimates for how many jobs are “hidden” (i.e., never advertised) range from 60% to as high as 80%. But don’t get discouraged over their high numbers. Networking with others in your chosen specialty will increase your chances that a colleague will know of a relevant job opportunity they can refer you to. It’s smart to start the networking process early on, before you’ve even necessarily decided on a specific specialty. Reach out to colleagues, tell them that you’re thinking of making a switch and ask if they would be willing to answer some questions about their work. Once you’ve decided on a specialty and built that networking relationship, then you can let them know what sort of position you’re looking for.

5. Consider further education.

Depending on how drastic of a switch you’re trying to make, you might need to get some additional education to help you successfully recruit for a new nursing specialty. This additional education might be as simple as day-long workshops or certification courses, or it might require more work, such as auditing classes at a local college or even getting an advanced degree such as your Master of Science in Nursing (MSN). Look up job postings for positions that you would be interested in and see if any additional educational requirements are listed. If you have a more experienced mentor, you can also ask their professional opinion on whether or not you need more education.

6. Time your transition wisely.

Choosing a time to switch specialties is almost as important as choosing a new specialty itself. Transition too early, and you’ll look like you’re a job hopper with commitment issues—but transition too late, and it might be difficult to catch up with younger colleagues (not to mention you might have to take a significant pay cut, too). Generally speaking, the best time to make the switch is after you’ve mastered your original specialty and your growth has plateaued, but not so late that you’ve moved up the ranks and would have to swallow a significant demotion in title and/or compensation. Of course, major personal events such as moving and having a baby are also part of this equation, so don’t forget to account for those, too!

7. Have your application materials ready to go.

Preparing the basics of your application in advance will make it much easier and less stressful to apply when you do hear about a job opening in your new chosen specialty. Make sure your resumé is up-to-date and proofread, and have the basic outline of a cover letter drafted as well. (However, you will need to customize your cover letter for each individual job posting.) You should also have some answers brainstormed out in advance for common questions, including “Why do you want to switch your nursing specialty?” so you’re not scrambling for answers in the middle of an interview.

These seven tips will help you make the transition to a new nursing specialty as smooth as possible. It may seem like a lot of work—and it is—but it’s far from impossible, and many nurses do it successfully each year. Just think of how much more fulfilled you’ll be in your professional life after you make the switch, and best of luck with changing your specialty!

A Day in the Life of a Medical-Surgical Floor Nurse

A Day in the Life of a Medical-Surgical Floor Nurse

Medical-surgical nursing can be a great field for graduate nurses starting their career. This acute care setting can provide a solid foundation of experience and education for any nursing career.

On a medical-surgical floor, nurses typically have a caseload of patients with more generalized or common diagnoses and/or patients that are scheduled for or recovering from surgery. This provides an excellent opportunity for new graduate nurses to master such nursing competencies as head-to-toe assessments, prepping patients for surgery, ambulating patients, auscultation, and providing pain relief medication.

Often a medical-surgical floor assignment includes being paired with a nursing assistant to help take vital signs and daily weights, give baths, and provide overall patient care.

Preventing pneumonia post surgery will also be covered, as this is an extremely important part of the medical-surgical nurse position. Methods of pneumonia prevention include pain control, deep breathing, use of the incentive spirometer (if available), and ambulation.

Nurse leadership roles are an important part of the medical-surgical team, especially the position of charge nurse. The charge nurse is a registered nurse responsible for administrative tasks like running the unit, managing nurse assignments, maintaining proper organization, and general problem-solving. As such, anyone in this position must have a strong foundation of clinical knowledge.

Some nurses eventually pursue teaching and other educational positions in medical-surgical nursing. Overall, medical-surgical nursing is an excellent field to start your nursing career, as it will provide a base set of skills that can be useful in many other nursing careers.

Graduating from a fully accredited nursing school will qualify one to begin work on a medical-surgical floor. A preceptor program is often used to orient the new graduate nurse in their work. The preceptor will supervise, guide, and teach the new graduate on the unit.

To learn more about becoming a medical-surgical nurse, visit here.

When Compassionate Care Takes a Turn Toward Fatigue

When Compassionate Care Takes a Turn Toward Fatigue

Compassion Fatigue and Its Consequences for Nurses

Fatigue, emotional distress, or apathy resulting from the constant demands of caring for others — today’s nurses are facing new levels of “compassion fatigue.” Empathetic, passionate, and caring nurses can fall victim to the continual stress of meeting the needs of not only their patients but also their families. This can pose serious safety concerns on two sides of the spectrum. It can lead to errors and issues in patient care, and overall nurse burnout can drive more skilled nurses out of the profession.

According to the American Association of Colleges of Nursing, 13% of newly licensed RNs were working in a different career within 1 year of their licensing, and 37% indicated they were ready to change jobs. Lack of staffing, trouble with management, or salary issues aren’t the only things pushing nurses from the bedside. Significant, ongoing emotional stress is a key contributor that can often go ignored.

Defining the Issue

Multiple terms have been used to describe compassion fatigue, but in its simplest terms, compassion fatigue implies a state of psychic exhaustion where caregivers face a severe sense of malaise that results from caring for patients who are in distress over time. Charles Figley, PhD, a trauma therapist at the Figley Institute who is also affiliated with Tulane University School of Social Work in New Orleans, calls this phenomenon the “cost of caring” for others in emotional pain.

While all healthcare providers are subject to compassion fatigue, nurses are particularly vulnerable because they are inserted into the lives of others in an intimate way during a critical time in the individual’s life. They become partners instead of observers in a patient’s journey and are pulled into existential concerns of life, death, sadness, and loss.

In this regard, compassion fatigue could be considered an occupational hazard. Statistics Canada’s first ever National Survey of the Work and Health of Nurses (2005) found that “close to one-fifth of nurses reported that their mental health had made their workload difficult to handle during the previous month.” In the year before the survey, more than 50% of nurses said they had taken time off work because of a physical illness, and 10% had been away for mental health reasons.

Dennis Portnoy, a psychotherapist who specializes in professional burnout, compassion fatigue, and related topics, created a self-assessment tool that caregiving professionals can use to recognize attitudes and habits that perpetuate compassion fatigue. According to Portnoy, nurses who are experiencing compassion fatigue tend to identify very strongly with statements such as:

  • “People rely on me for support”
  • “When I make a mistake, I have difficulty forgiving myself”
  • “My achievements define my self-worth”
  • “I take work home frequently”
  • “I am willing to sacrifice my needs in order to please others”

Not to be confused with “burn out,” where a nurse may gradually withdraw and step away from his or her work, with compassion fatigue nurses may try even harder and give even more of themselves to patients in their care. Both scenarios can leave nurses feeling like they are running on empty, putting themselves, their co-workers, the public, and their patients at risk.

The Consequences of Compassion Fatigue

Nurses have a responsibility to themselves and their patients to ensure they are adequately supported to provide the highest quality and compassionate care possible. Facing multiple workplace stressors, coupled with the demands to respond to complicated patient needs as well as their home life, can negatively impact a nurse’s ability to cope with stress to the detriment of overall patient and nurse safety.

The consequences of such involved, caring work can lead to:

  • Inability to react sympathetically to a crisis or disaster because of overexposure to previous crises and disasters
  • Extreme states of tension and preoccupation with the suffering of those being helped to the degree that it can be traumatizing for the helper
  • Cynicism, emotional exhaustion, or self-centeredness in a healthcare professional who has been otherwise dedicated to his or her work and clients

This emotional exhaustion also can cause breakdowns in communication and build stress that leads to errors by the nurse, which pose safety risk and liability. According to the CNA and NSO Nurse 2015 Claim Report, allegations against nurses involving assessment and monitoring represent 15.7% and 13.8% of total claims, respectively. Compared with the previous data set, both allegation categories increased by 3.1% and 7.0%, respectively. Most of the assessment-related closed claims involved a failure to assess the need for medical intervention where the nurse failed to contact the treating practitioner for additional medical treatment. Over half the monitoring-related claims involved failure to monitor/report changes in the patient’s condition to the practitioner.

Compassion fatigue expert Francoise Mathieu writes that many factors outside of a nurse’s core care-giving work also contribute to the continuum of compassion fatigue. Current life circumstance, coping style and stressors at home from childcare or aging parent care all play a role. Some studies show that “helpers,” such as nurses, are more vulnerable to life changes such as divorce and difficulties such as addictions than people who do less stressful work. Workplace stressors such as managing paperwork, new technology, or organizational realignment can also play a role.

Although nurses are accountable for their individual practice, employers also have a responsibility to help identify and address sources of compassion fatigue in the workplace. Designing schedules and organizing work can be key strategies to help prevent the consequences of nurse fatigue, but early identification of compassion fatigue demands understanding and ongoing assessment. The Professional Quality of Life Scale (ProQOL) can help measure these symptoms and be used regularly to track changes over time, particularly when a nurse is trying prevention or intervention strategies.

Long-Term Solutions

Compassion fatigue and its negative impact on nurses, patient satisfaction, and safety is slowly becoming a better understood phenomenon in the nursing field. Acknowledging the severe emotional impact of a nurse’s obligation to routinely meet a patient’s immediate and comprehensive needs, nurses are in need of more specialized support resources to counter the impact. These can and should involve programming designed to educate nurses about the issue, resources to manage work/life balance, and efforts to design supportive and positive work settings.

Promoting self-care and other healthy rituals is important for preventing or recovering from compassion fatigue. Encourage nurses to participate in activities that can promote physical, emotional, and spiritual well-being. Nurses should also be encouraged to seek out support in the form of Employee Assistance Programs, caregiver or nursing support groups, or other forms of counseling and emotional support. Remember that self-care always includes adequate nutrition, hydration, sleep, and exercise.

The responsibility to solve for these risks relies with the healthcare industry as a whole, as well as management and nurses in the field to foster the environment and demand the resources necessary to overcome the issue.

This story was originally posted on MedPage Today.

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