Simulation sessions can help maintain clinician proficiency and prepare staff members to be part of the multidisciplinary team during high-risk procedures that happen suddenly and infrequently.
One such situation is an emergency resternotomy in the intensive care unit (ICU) for patients recovering from cardiac surgery who experience cardiac arrest. The surgery involves reopening the patient’s chest after defibrillation did not resuscitate them. It is performed in the ICU, without transferring the patient to an operating room, and can be challenging for all clinicians involved as they race to save the patient.
The cardiovascular ICU at the University of Mississippi Medical Center, Jackson, developed a three-part program to improve clinicians’ ability to recognize clinical signs that would prompt an urgent sternotomy for a postoperative cardiac surgery patient and to clarify individual roles during the emergency procedure.
Co-author Athanasios Tsiouris is an assistant professor of cardiac surgery at the medical center.
“These events are fortunately rare, but when they do occur, staff members need to be familiar with the surgical instruments and techniques needed,” Tsiouris said. “Ongoing education and simulation training allow them to rehearse these situations as a team and have hands-on experience prior to a real-life patient emergency.”
The program began with one-hour didactic education sessions that included guidelines from the Society of Thoracic Surgeons for this patient population, clarification of team roles, and logistics, such as the contents and location of emergency carts and surgical packs.
The second phase focused on procedures to improve nurse-surgeon communication and increase the speed of establishing a sterile field and wire removal. Equipment and supplies were reviewed, and naming conventions and surgeons’ preferences for procedural details were standardized.
The final phase placed the participants in various simulated scenarios with postoperative cardiac surgery patients who may need emergency resternotomy.
After the sessions, 95% of the 41 individuals who completed both surveys agreed that they were prepared to be part of the team for the emergency ICU sternotomy, compared with 52% of respondents before the sessions. In addition, 95% strongly agreed or agreed that they could identify patients who might need an emergency sternotomy, compared with 50% before the intervention.
The results also showed improvement in staff members’ understanding of team roles and activation and use of the emergency sternotomy protocol. Participants also indicated understanding the differences between guidelines for resuscitating patients who experience cardiac arrest after cardiac surgery and the more commonly used Advanced Cardiovascular Life Support protocol.
In addition, the simulations helped proactively identify equipment or systems issues that may arise during a real-life situation, leading to quality improvement in the ICU and streamlining of established protocols.
Members of the ICU nursing staff now participate in the didactic and simulation sessions twice a year to ensure that those new to the unit have taken them and that everyone is prepared for the next time a patient requires this emergency surgery.
Nurse Jackie Stange sprang into action when she saw 19-year-old Giustino Racchini collapse on the street, knowing she had to help.
Racchini, a dedicated runner and Penn State freshman, had his run cut short by a sudden blackout, leaving him unconscious in the middle of the road.
Stange, a trauma nurse at UPMC in Pittsburgh, Pennsylvania, was on her way to drop off her daughter, Eloise, at gymnastics class, didn’t hesitate to pull over and rush to Racchini’s side. With no pulse or breath, she immediately started performing compressions, pleading for him to breathe. Time seemed to stretch as she tirelessly worked to revive him, not even noticing the blaring sirens approaching.
Her efforts paid off as Racchini’s heart was restarted, and he was swiftly transported to the hospital. It was later revealed that he had suffered a cardiac arrest, likely due to genetic factors. After a few days of sedation, Racchini woke up eager to learn about the stranger who had saved his life.
Daily Nurse proudly acknowledges Nurse Jackie Stange as the Nurse of the Week for her compassion and quick thinking, which transformed a chance encounter into a life-saving miracle.
Thanks to a phone call from a concerned neighbor, Stange and Racchini’s mother, Heather, were able to connect and meet at the hospital. Overwhelmed with gratitude, Racchini thanked Stange for her quick actions, but she humbly insisted she was just doing her job.
Doctors fitted Racchini with a defibrillator for future safety, and after a brief recovery period, he was able to return home, thankful for Stange’s intervention. Reflecting on the experience, Stange expressed her relief that everything had worked out and was grateful to have been in the right place at the time to save a life
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
A study by the American Nurses Association shows that over half of the nurses feel swamped with heavy workloads. They deal with patient care, paperwork, and emergencies all at once, so it’s no wonder that this constant responsibility leads to stress beyond your usual job worries. The pressure to consistently provide flawless care is overwhelming, to say the least – and the truth is, this kind of stress isn’t something they can leave at work – it follows them home, affecting their mental and emotional health and spilling into every part of their lives, including their family time.
Emotional Exhaustion
Dealing with life and death on a daily basis leaves a mark. When one witnesses pain and suffering day after day, it accumulates into emotional exhaustion. The Journal of Occupational Health Psychology reports that nurses very frequently experience burnout. They carry the weight of their patients’ conditions long after the end of their shift. In a perfect case scenario, when a doctor or nurse exits the hospital, and the door closes behind them, they can leave work at work. However, on most days, this is easier said than done. This emotional toll that’s not easy to shake makes it difficult to unwind and recover, and over time, this can lead to a decline in their well-being and affect their ability to cope with stress effectively.
Impact on Family Life
The reality is that the stress of the job naturally spills over into home life. Unintentionally, nurses often bring their work worries home, which at times automatically affects their relationships. Then, there are the extended hours and unpredictable schedules that mean nurses miss out on family events and milestones. This absence can create feelings of neglect and even disagreements within families. Partners and children often feel disconnected, which strains familial bonds and creates a gap that feels hard to bridge.
Communication Problems
Work-related stress also affects how nurses communicate with their families. After a taxing shift, discussing the day at work feels like an additional burden. The reason? After they’ve given everything at work, there’s not much (if anything) left in their mental, emotional, and even physical “tank,” so to speak. If not careful, this can lead to miscommunication and misunderstandings at home. Many nurses find it challenging to talk about their day without feeling they are adding to their family’s stress, and as a result, they might withdraw, leading to feelings of isolation for both the nurse and their loved ones.
Solutions for Balance
One of the first and best things one can do is acknowledge the situation for what it is. Nurses and their families must be aware of the circumstances and adjust their expectations accordingly to be there for each other as needed. It might sound simple, but it’s not simplistic. One needs to simply listen, express their needs clearly, and readjust expectations. Once both sides know what to expect and realize their limitations, it’ll become easier to meet goals—both at home and at work.
If necessary, one can always seek workplace interventions or see a professional therapist to mitigate the situation.
The good news is that there are easy steps to better work-life balance without sacrificing family relationships—but it does take some reflection, listening, and clear communication.
The age of new technologies like artificial intelligence is opening new vistas for nurses just choosing their career paths and experienced nurses looking to expand their skills. Over more than 30 years as a registered nurse, I have seen our profession broaden dramatically beyond the traditional bedside role into a wide variety of specialties such as anesthesia, obstetrics, home health, and the growing field of public health informatics and technology.
I have seen a transformation in the field before. When I wrote the “Medication Adherence Algorithm,” I helped engage nurses in medication adherence. Today, professionals across the country use this algorithm to facilitate medication adherence with patients and clients in clinical practice.
In a new age where technology and artificial intelligence seem to permeate every area of our lives, these advances are permeating the field of nursing, too. We rely on data for our jobs now more than ever, so we need to ensure we know how to use it.
For nurses who love caring for people and are interested in data and numbers, there’s a new career path that may have been overlooked, but it’s growing rapidly in importance to healthcare and as a professional path for nurses.
Public health informatics combines public health and data science to improve people’s lives. Nurses in this growing field can connect people, technology, and information to inform decision-making that improves health outcomes across communities.
Public health informatics allows you to analyze trends and utilize the latest technology to make a difference in your community. By pursuing education in this field, you can be at the forefront of the latest digital tools and trends while also helping to improve the lives of others. A report published by the American Association of Colleges of Nursing stated that informatics and technology are essential components of nursing education for the 21st century.
According to the U.S. Bureau of Labor Statistics, the related field of health information technologists and medical registrars has a job-growth outlook of 16% by 2032, which is much faster than average. Various employers, from health IT start-ups to hospitals to public health departments and community health centers, need specialists trained in public health informatics.
Universities nationwide provide nurses opportunities to join the movement to advance public health. Opportunities are available in local communities as universities strive to train a workforce to serve communities that need to ensure local citizens are represented and thus served by data that defines healthcare in this age of artificial intelligence.
Bowie State University in Maryland, where I work, is one example of an outstanding and innovative program in Public Health Informatics and Technology, known as PHIT. The program offers a 120 credit Undergraduate Bachelor of Science Degree in Public Health Informatics and Technology (PHIT) and an 18-credit Post-Baccalaureate Certificate in Public Health Informatics Systems (PHIS) and is well suited to nurses looking to build their skillset at any stage of their career.
This program at Bowie State and across other colleges and universities around the country are funded by the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services (HHS).
Check for a program near you if you’re interested in new career options or expanding your data skills.
Nursing continues to be one of the most rewarding careers available, and people from all backgrounds are drawn to its fulfilling nature. If you’re like many people, you might have always dreamed of becoming a nurse, but you decided to pursue another career instead. If you still have that dream, know it’s not too late.
Nursing has many benefits as a second career, but there are also some challenges. However, a good plan can help you succeed regardless of your age. Here are some considerations to remember when deciding on the next chapter of your life.
Why Nursing As A Second Career Is A Good Idea
If you’re considering working as a nurse later in life, remember that you would not be the first person to make this decision. You should also consider that you can jump to nursing from almost any other field. Some folks have chosen nursing as a second career after working in computer science, theater, and other unique professions. So, don’t let what you’re doing now hold you back.
The career you worked in the past could help you succeed as a nurse. For instance, a career in theater could make you a good speaker, and communicating with others is essential as a nurse. If you’ve previously worked in business, you likely have excellent critical thinking skills, which can help you provide your patients with the proper services and treatments. Many careers require multitasking, and that’s also an essential skill as a nurse, especially when dealing with multiple patients.
In addition to the potential to succeed, there are other benefits to nursing as a second career. Once you have the qualifications, finding work can be very easy. Almost every city has countless doctor’s offices and medical establishments, and most need hard-working nurses. You’ll also likely face many different advancement opportunities during your career. New forms of healthcare are constantly emerging, and if you learn everything you can, you can grow and find new positions.
It’s also worth knowing that age is just a number, especially in nursing. The average age of nurses in the U.S. is 45, meaning that many nurses are older than that, and they do fantastic work, so this is the time for you to jump.
Monetary Considerations
There are several challenges and rewards associated with money that you’ll want to keep in mind as you pursue your nursing career. The great news is that you can make good money in this profession. As is the case with many medical carers, you’ll likely earn an income that’s above average. Currently, the average salary for a nurse in the United States is around $43 per hour.
When deciding if you want to pursue nursing, you’ll also want to consider if you canafford to change careers. You’ll likely need to return to school before becoming certified and becoming a nurse. That may require that you cut back on your hours at your current job. Can you afford to make modifications? To help make a decision, do your research. Are you eligible for financial aid? Would your current employer offer tuition reimbursement? Remember that you may not need to quit your job to return to school. Ask your current management about the possibility of a flexible schedule so you can fit in-person nursing classes into your routine.
Another monetary concern is the potential hit to your retirement savings if you quit your current job or use any of your savings to pay for schooling. Luckily, there are ways to boost your retirement fund in these situations.
One way is to increase your current contributions on your existing 401(k) until you leave your company. Or you can choose the highest contribution level when you get your nursing job. In addition to adding more, you also want to be wary of taking money out. Early withdrawal can result in some pretty hefty tax penalties, so if you do go that route, it’s essential to research to know what you’re in for. Another option is to open a separate high-yield savings account and earn money there over time.
Overcoming Challenges
You’ll want to prepare for some other challenges during this exciting transition, and a big concern may be continuing your education. Attending a four-year university may seem daunting, but that may not be necessary. Many schools offer an Accelerated Bachelor of Science in Nursing (ABSN) program for people with a bachelor’s degree in a different field. Most people go through this program in about two years.
Nursing also has unique challenges that may differ from what you’re used to at your current job. Mentally preparing is smart, so you’ll be ready when you start your new career. One may involve the physical demands that often come with nursing, including standing for long periods and lifting and repositioning patients. To prepare while in school, start an exercise regime that includes cardio and lifting weights. That way, you’ll equip your body, and it won’t be such a struggle.
Communication is also key in nursing, as you work with patients, fellow nurses, and doctors. If your communication skills can use some help, start working on them now. Learn to ask for help when you need it. Also, learn how to speak to others and actively listen because that’s important in nursing. You can also make it a habit to participate in team meetings at work to get used to speaking up.
Conclusion
There is nothing wrong with becoming a nurse later in life. Many professional nurses have followed this path. Do your research and find an excellent educational program, and you can achieve your dream of nursing as a second career.
Janet H. Davis, PhD, RN, CNE, MBA, an associate professor of Nursing at Purdue University Northwest (PNW) has been awarded a U.S. Fulbright Faculty Scholar award for the 2024-25 academic year. She will work at the University of Colombo in Sri Lanka to enhance nursing leadership and teaching.
During her time in Sri Lanka, Dr. Davis will focus on using evidence-based practices to improve nursing leadership and practice in academic and applied settings. She will also collaborate with the Sri Lanka Nurses Association to provide continuing education for nurses in the country.
This achievement has resulted in Dr. Davis being recognized as the Nurse of the Week by Daily Nurse for her work in evidence-based nursing and leadership education in Sri Lanka.
Dr. Davis expressed her gratitude for the opportunity, highlighting the valuable training and experience she has received and her excitement to share her knowledge abroad.
“I am honored to be selected for this opportunity to engage in impactful scholarship and collaboration abroad,” says Dr. Davis. “The training I have received in the College of Nursing in evidence-based methodology and the experience of teaching our students have truly been gifts. I look forward to this opportunity to share our PNW accomplishments abroad.”
Her scholarly background focuses on evidence-based practice for minority registered nurse (RN) workforce development, health disparities, community health nursing, and community-engaged education.
The Dean of the PNW College of Nursing, Amy Fry, commended Dr. Davis for her achievement and expressed confidence in the positive impact of her work abroad.
“We are so proud of Dr. Davis receiving the prestigious Fulbright U.S. Faculty Scholar honor, as it is a recognition of the high-quality teaching and scholarship occurring at PNW’s College of Nursing,” says Fry. “She will be a great resource for the University of Colombo, bringing knowledge in evidence-based-practice nursing and leadership education. We look forward to seeing the positive impacts through this international exchange.”
The Fulbright program, administered by the U.S. Department of State’s Bureau of Educational and Cultural Affairs (ECA), is among the most prestigious exchange programs supporting international research and partnerships between higher education institutions worldwide. Fulbright scholars build connections and collaboratively address challenges, sharing expertise to benefit their host institutions and their own upon their return.
Nominate a Nurse of the Week! Every Wednesday, DailyNurse.com features a nurse making a difference in the lives of their patients, students, and colleagues. We encourage you to nominate a nurse who has impacted your life as the next Nurse of the Week, and we’ll feature them online and in our weekly newsletter.
