Dr. Sandra Lindsay made headlines around the world (and in DailyNurse) for being the first person—and first nurse—in the US to hold out her arm for a vaccine that was regarded by many with uncertainty. How could they produce a vaccine at such a ferocious pace? (How? To paraphrase Samuel Johnson’s famous remark, when scientists fear that they or their loved ones will be killed by a virus, it concentrates their minds wonderfully). When people’s perspectives on the mRNA vaccines were clouded by fear and political biases coming from every angle, our Nurse of the Week stood up for non-immunocompromised nurses everywhere when she rolled up a sleeve and said, “I trust science.” The Jamaican-born nurse with many letters after her name is an important symbol and one that should be remembered. Nursing is about caring, but it is also about leadership, science, lots of hard work, and engaging in an endless war against ignorance.
So, what has Sandra Lindsay, DHSc, MS, MBA, RN, CCRN-K, NE-BC done in 2021? Well, she received her booster shot in January… We’re not certain about anything particular she did February through May, but she was probably preoccupied with her job as Director of Nursing at the Northwell Health Long Island Jewish Medical Center, waiting for the daily SARS-CoV-2 case rate to fall, and—because she really does trust science—preparing to add a Doctor of Health Sciences (DHSc) degree to her cv.
Then, this month, Dr. Lindsay responded to the request of a determined new grad, Tracey Smith, president of the Borough of Manhattan Community College (BMCC-SUNY) Nursing Students’ Association. Smith, who describes Lindsay as “the face of the Covid-19 vaccine,” was bent on getting the iconic nurse to speak at the pinning ceremony at the school, which is where she had earned her own first nursing degree in 1994 (and was valedictorian of her class, of course). “She can attest to the safety of the vaccine,” said Smith, who plans to earn a Master’s Degree in Pediatric Nursing. “She can help our new graduate nurses and the BMCC community at large to understand how this vaccine is working to protect us and the importance of mass vaccinations nationwide.”
After somehow finding time for her own new pinning, Lindsay spoke to Smith and the other BMCC nursing grads. She more than fulfilled Smith’s hopes: “It should be the natural choice for us to get vaccinated because it’s how we look out for each other. It gives us a chance to protect ourselves, our healthcare workers and our family and friends. It’s an opportunity to grab onto a much brighter future after a very dark year.”
During commencement, Dr. Lindsay was also awarded the BMCC President’s Medal for 2021, “which expresses the College’s admiration and appreciation for extraordinary service and leadership.”
At the ceremony, Lindsay said of Covid-19, “It’s not gone. I was vaccinated back in December and here I am today, feeling well, doing well. All BMCC graduates are role models. Nurses going out into the field are role models for patients who will look up to you as you model the behavior you want to see in the world.”
It happens to everyone, but nurses grit their teeth and bear with it every day. “It” is, of course, the profligate, Gaia-trashing cousin of the Missing Sock Phenomenon: The Redundant Glove Problem.
This is the dream: Your mask is on, and you reach out to grab a disposable glove. A single glove separates itself from its mates as you pull it out of the box. You pull it on, reach out, and swiftly extract another SINGLE GLOVE from the box. The other gloves remain inside the box and patiently wait for hands that want them. There are no wasted, now-useless single gloves littering the floor, and we have entered a world that doesn’t incessantly force health care workers to squander essential supplies.
New grad—Nurse of the Week Ellen Quintana, RN—is the nurse who just might make this dream a reality.
Luckily, when Ellen was still a freshman, she could not easily dismiss her first encounter with the Redundant Glove Problem (or RGP) during a chem lab class at University of Connecticut School of Nursing. As she told UConn Today’s Mikala Green, “No one could get just one glove out of the box, and there were gloves everywhere. We were told that once they fell out, we couldn’t put them back; it was really wasteful.”
The vision of those scattered unwanted gloves bothered her. Quintana even surveyed her professors and found that the RGP plagued them as well. Looking ahead at a nursing career that would undoubtedly contribute a mountain of wasted “extra” gloves to the world’s landfills, Quintana realized this was more than a mere annoyance and started to analyze the problem. Even amid the intensity of her BSN program, she pursued a solution. The box opening, she determined, was the pain point—the “weak link” that allows those feckless gloves to flow so promiscuously. An adjunct faculty member suggested the freshman apply for the U Conn Idea Grant Program; she did, and her RGP-Killer project was awarded a grant!
Quintana soon found mentors, who helped her restructure her academic schedule to permit her to continue her nursing studies while concurrently developing her idea. She also partnered with the University of Connecticut Engineering and Design program and performed “pull tests” on proposed models. By spring 2020, she had acquired a partner (Kelsey MarcAurele U Conn NUR ’22), and their concept—now known as ReduSeal, a product in the making—won $10,000 at a university-wide innovation contest (second place). That summer, ReduSeal was also a finalist at the Johnson & Johnson Nurses Innovate Quickfire Challenge, and this year—not long before her graduation—Quintana became one of the few nurses to receive a patent when the US Patent Office awarded her a non-provisional patent for ReduSeal. At commencement, the U Conn School of Nursing presented her with the Regina M. Cusson Student Healthcare Innovations Award.
Ellen Quintana is scheduled to begin work this August as an Emergency RN at Hartford Hospital. And her RGP-killer, ReduSeal, is on its way to a career as well. She told U Conn Today, “I want to strategically license the product so hospitals can save money, reduce waste, and hopefully save time for nurses. Nurses shouldn’t have to clean up gloves.” Amen to that.
Be sure to check out the U Conn Today article on Ellen Quintana. It details the steps she took to develop her product and the resources that the School of Nursing and U Connecticut employed to support her project and her studies.
A nursing educator from a nationally ranked research university shares her timeline for testing success.
As a nursing student, everything you do in school is to prepare for the NCLEX-RN, the most important test of your career. Yet, even though you begin learning the specific information you need to pass this exam on the first day of class, you cannot just rely on retaining this information if you hope to succeed. In truth, it takes quite a bit of practice to get ready for the NCLEX-RN. You need to make sure you understand not only the specifics of the exam but the information it will test. As a result, the only way to ensure you are ready to take this exam is to give yourself enough time to prepare.
It’s Never Too Early to Start Studying
The earliest date to take the NCLEX-RN exam varies depending on your state, but the majority of students test approximately 45 days after their graduation date.
Even though the majority of nursing candidates are able to pass the exam the first time they take it, those who fail are allowed to retake the test after 45 days from their original testing date and can retake the test as many as eight times a year. Each state Board of Nursing has additional standards for testing, so it is important to consult your board individually. To do this search the National Council of State Boards of Nursing, the regulatory organization for the NCLEX-RN.
When it comes to studying for the NCLEX-RN, it is never too early to start preparing for this critical test. No matter where you are in nursing school, you need to start prepping for the NCLEX-RN. Even simply familiarizing yourself with the format and style of questions can help you become more comfortable with what you will see on the exam and benefit you in the long run. That is why it is best to plan ahead and schedule a weekly study time, where you can slowly start reviewing the information and not wait until the last minute to cram everything at once.
However, this does not mean that the test preparation needs to be boring. Beyond taking detailed notes in class and reviewing information weekly, some of the best NCLEX-RN test-taking practices have social aspects, such as:
Studying with other students;
Meeting with peer tutors and mentors; and
Talking to test experts who can help.
Collaboration when studying often has benefits, with studies indicating that collaborative learning is an effective way to engage students, develop higher-level thinking skills, and increase student retention.
What Information to Focus on Six Months Out
If you want to be able to sufficiently prepare for the NCLEX-RN, you need to give yourself enough time to thoroughly review the extensive amount of information that will be tested. Generally, successful candidates will start studying for the exam five to six months before taking it, which is typically the last semester of nursing school. In addition, during a student’s senior year they will also begin to use UWorld, which will help them get prepared to answer questions that require critical thinking skills.
This is the time to start reviewing topics that you may have had issues with during nursing school or ones that you need further clarity in. But it is also the time to start actively learning, becoming engaged in classes, and preparing for unit exams. Our unit tests have similar material to the NCLEX-RN, allowing students to prepare cumulatively for their final exam. Basically, the last six months of nursing school become a continuous study period, where you build on the material rather than take each subject separately and try to connect the dots at the end.
Buckling Down 12 Weeks Out
Around the 12-week mark, it is really time to start dedicating your schedule to preparing for the NCLEX-RN. This means making the most of all the resources you have, including prep tools, practice exams, and tutoring services.
This schedule should work for most students, but of course every aspiring RN is different. As a result, you need to take an active role in your learning by assessing your own strengths, weaknesses, personal learning habits, study skills, and test-taking abilities. From there it is a question of giving yourself ample time to prepare not just for one exam but for a successful career in nursing.
Registered nurses have been in high demand in the United States for over a decade, and projections on the job outlook from 2019-2029 indicate this profession will grow 7% faster than other jobs. In 2019, nurses ranked third as the most in-demand job of any profession in the U.S.
This demand for nursing care reflects employers are not keeping pace in supplying enough nurses to care for our communities. There are several reasons for the shortage of nurses, one being a growing population. As our population flourishes, we need more practicing nurses on the frontlines to care for everyone.
Second, people live longer because there are better medical treatments and medication therapies to help people stay healthier longer. Further, the number of nursing programs positioned to accommodate non-traditional learners may also be adding to the shortage.
Nurses are highly respected and work in various settings such as hospitals, clinics, physicians’ offices, home healthcare services, nursing facilities, schools, and more.1 The nurse works collaboratively with physicians, pharmacists, and other healthcare professionals to provide comprehensive health care.
It should not come as a surprise that nurses have been deemed the most trusted profession year over year. Registered nurses (RNs) are fortunate to be at the center of the care model to care for the sick and promote health and wellness across the continuum.
With the ever-changing technology and advances in research, there are many opportunities for nurses to advance within the profession. From neonatal care, pediatrics into adulthood, and geriatrics, RNs receive the education to care for all ages throughout the lifespan. With experience, RNs can become specialized in an area of nursing such as cardiac care, emergency care, pediatric, or oncology care.
Opportunities exist to close the gap and reduce the growing shortage of RNs, especially in rural areas and the midwestern states. For those who have been thinking of a career in healthcare or a second career change, nursing may be the right fit for you.
RNs typically have enhanced benefits in the workforce that make it more attractive. These include flexible hours to meet family work-life balance, full-time and part-time work schedules, excellent health plans, 401k or other retirement investments, an annual median wage of $75,330, and job security from these high-demand jobs.
If you are interested in a highly respected nursing career, Elmhurst University, located west of Chicago, has a program designed for you. Elmhurst is academically strong and ranked by U.S. News & World Report as a leading Midwest University.
Accredited by the Commission Collegiate Nursing Education (CCNE), Elmhurst University is proud to provide a distance accelerated BSN (ABSN) nursing program. This elite degree is the first of its kind in Illinois. The robust course curriculum is structured to be completed in 16 months, a fast-track for full-time students, with all coursework happening entirely online. Students complete clinicals in their local community and have two campus visits built into the program.
Elmhurst University is dedicated to providing ABSN students with integrated support to foster success. From the moment you begin your application process through receiving your well-deserved diploma at graduation, advisors are assigned to help you navigate and stay on target in meeting degree goals and requirements.
As nurses, we all know that the only thing to expect during our shifts is the unexpected. Especially with the outbreak of COVID-19, we’ve seen this to be especially true. As a result of my nursing career, I’ve learned to roll with the punches, which particularly came in handy as I transitioned to the business side of the field.
When I first became a nurse, I never dreamed of starting my own staffing agency. After several years of working as a long-term care nurse in assisted living facilities around the country, a few fellow nurses gave me the idea. I was told by colleagues and supervisors that I had a knack for managing the team, and those simple acts of encouragement gave me the push I needed. Ever since then, it’s been a rollercoaster ride and a ton of on-the-job training. In honor of Nurses Week, I’ve compiled six key learnings from my experience as a nurse turned business owner.
1. You won’t have much time to be a nurse
While I will always be a nurse at heart, I am now very much a businesswoman. At first, I continued to work as a traveling nurse as I was afraid to give all my time to this endeavor – I still had many bills to pay and picking up extra shifts gave me steady income. Eventually, I hit a tipping point as I was completely overwhelmed, which wasn’t healthy. Now I run the company’s operations and spend most of my time in an office. While I love it, it’s a huge transition from being a nurse but the core of providing care for others is still there and that passion is what keeps me going.
2. Fail quickly, but never give up
Going from a nurse to a business owner was a tough transition, and I almost quit on more than one occasion. But I knew I had to keep going for my community, and I realized I’m passionate about providing jobs for other nurses. Hearing from those nurses and seeing the bigger picture helped me put one foot in front of the other, no matter the barriers I hit. Once I took the leap of faith and gave my business 100%, I’ve never looked back.
3. You’ll have to make an investment to grow
Facilities usually have 30-60 days to pay their invoices, while most nurses are paid on a weekly basis. The startup money I had went quickly, which meant I had to get creative with funding solutions. I had trouble getting a traditional bank loan, but instead came across an alternative financing company called FundThrough, which I still use today to keep my nurses paid and help bridge the gap between invoices.
4. Keep track of your books
When I first started, one of the hardest things I had to learn was the financial side of the business. Because I’ve never run a company before starting Nurses at Heart, I didn’t know the best way to track my expenses and income. When it came time to file my taxes, I realized I needed help and enlisted an accountant who showed me how to use QuickBooks. Now we meet every three months to review the books together and ensure everything is on track. It’s important to know your strengths and weaknesses as a business leader and get the help you need from other professionals.
5. Surround yourself with the right people
I realized quickly that I can’t do everything on my own. Today, my agency employs more than 100 people spanning two states, which requires a lot of coordination and management on my part. I’ve been lucky to build an incredible team that I lean on daily, but I have to put trust in my team and let them do what I hired them to do.
6. Your nursing experience will always come in handy
From my experience, I’ve found that those running the business side of the staffing agencies often don’t have prior nursing experience. Because I started my career as a nurse, I know how to speak to administrators, other nurses, and patients. I can relate to nurses and understand their unique challenges, while my bedside manner helps me navigate difficult conversations with ease. I’ve found that both my clients and employees respect me because I know how the healthcare system operates. This experience is what helped make my staffing agency stand out from the competition.
As a proud nurse and newfound business owner, I can tell you that making a paradigm shift wasn’t easy. But along the way, I found success and happiness by following my gut and persisting through the tough times. Similar to the characteristics that make a great nurse, business owners also need to stay calm, level-headed and trust their team. You never know what life is going to throw at you, but with your experience and skills as a nurse, you’ve been given training for so many other situations. You can overcome any challenge with perseverance and trust, and by remembering you have an army of supportive nurses behind you.
This is the second part of a two-part article on the aims and practice of palliative care and its essential philosophy and concepts.Originally published by the Vermont Nurse Connection, DailyNurse thanks the ANA-VT and the authors for graciously allowing us to re-post this. Click here to read Part One.
There is a growing body of evidence showing that palliative care results in an improved quality of life for people with serious illnesses. It’s also been shown to result in higher levels of patient satisfaction and improved outcomes at the end of life. While it’s not hard to understand why a palliative approach might improve someone’s quality of life or lead to greater satisfaction with care, it’s also been found that the costs associated with someone’s care usually decrease as a result of palliative involvement. This is likely due to palliative care’s emphasis on uncovering a person’s goals and values and then building a care plan to which these goals are central.
For example, the standard treatment offered by our healthcare system is aggressive, disease-directed care right up until the moment of death, which is fine, but is not what everyone wants. Collaborating with patients and offering care based on their values (instead of the system’s), especially when those values mean something other than intensive hospital-based care, inevitably results in lower costs. But one of the more unexpected benefits of palliative care turns out to be longer life: which has been found in a few studies in both the cancer and heart failure populations.
We hope that the two case studies presented below will illustrate a few palliative care interventions as well as highlight the role that RNs and LNAs can have in treating suffering. We hope this article has given you a better sense of what palliative care has to offer, and also how RNs and LNAs, because of their scope of practice, are in a unique and privileged place to provide this care.
Case 1, “Charlie”: Discussing the Future with a Heart Failure Patient
Charlie calls the heart failure clinic with a question about his symptoms. As the clinic nurse you have seen Charlie get all the best possible treatment over the past three years, including a biventricular pacemaker with a defibrillator. You are worried now because despite everyone’s best efforts he is beginning to have more shortness of breath. You talk to his cardiologist to determine next steps, and then phone Charlie back with instructions to increase his torsemide and monitor his symptoms over the next few days. He shares that he’s worried: does this mean that his heart failure is getting worse? You resist the urge to “fix his feelings,” and instead say, “I am worried too, we are going to do our best to help support you and try to improve your symptoms.”
Charlie calls back two days later to say how much better he feels. This is good news, but you decide to deepen the conversation, saying, “I would really like to learn more about you so that we have a better sense of how to care for you going forward. Could I ask you a few questions?“ Charlie welcomes the chance to talk, so you continue: “At this time in your life, what things are most important to you? When you think about your future, what are you hoping for? And what are you most worried about?” Charlie gives you a wealth of information, and you document your conversation in the chart.
The next week Charlie comes in for his routine clinic appointment. He lets you know that the conversation you had with him was very helpful and relieved some of his stress and worry. He asks if there are other things he should be thinking about? You steer the conversation to what’s known as “advance planning”: “Have you completed an advance directive? If you were so sick that you couldn’t make your own medical decisions who would make them for you? Finally, you offer to help him complete his advance directive (this is a document identifying a health care agent as well as what forms of treatment you would/would not want).
Case 2, “Alison”: Providing Comfort and Support for a Stage IV Cancer Patient
Alison is being admitted to the cancer floor with abdominal pain related to stage IV ovarian cancer. Sarah is her nurse for the evening shift. Alison’s pain requires regular use of her PRN dose just to keep it under control. She also shares that she is not sure that she wants to continue chemotherapy. Sarah calls the attending and recommends a palliative care consult. “Alison is using frequent PRN doses and I feel her symptoms could be better controlled. She is struggling with what her care should look like going forward.” The attending physician is convinced and orders a palliative care consultation.
Later that evening Alison’s LNA, Beth, finds her sitting up in the chair crying. Alison shares that she just got off the phone with her teenage son, and she is worried about him. Beth asks Alison if it would be OK if she just sat with her. Alison agrees and they sit in silence for a while until Alison starts sharing about how hard this has been. Beth offers a supportive statement, “I cannot imagine how hard this must be for you.” Beth listens as Alison describes how wonderful her son is and how he has been caring for her. Beth says, “You must be very proud of him… How do you hope he’ll remember you?”
Over the course of Alison’s hospitalization, she is started on scheduled doses of long-acting morphine, and her pain decreases. She rarely requires PRN doses. However, then at a family meeting her oncologist shares that there are no more cancer treatments available. Alison asks Sarah’s opinion about whether or not she should go home on hospice. Sarah assesses Alison’s understanding, asking her what she knows about hospice. Alison answers that she is not sure, but that her doctors said since there are no more cancer treatments she should “consider hospice.” Sarah describes hospice as an extra layer of support to help people make the most of the time they have left, and when they are closer to dying, to ensure they have a peaceful death. Alison starts to tear up and asks, “Does this mean I am dying now?”
In response, Sarah gently asks Alison to say more about what she is feeling. Alison goes on to share that she hopes she has more time to spend with her son, and to be able to see a few more of his tennis matches. Sarah responds, “I hope that you are able to do this too.” Alison goes on to tell you more about her son and her attempts to ask him about her illness. Sarah shares that hospice can also provide support for having these conversations and will also be there to provide bereavement support for Alison’s family after her death. After Sarah spends time addressing Alison’s concerns while also responding to her emotions, Alison seems more at peace.