Happy New Year

 

 

7 qualities define what makes a good nurse

7 qualities define what makes a good nurse | Nurse.com

20 Tips for Nurses in Their First Year of Nursing

Tips for New Nurses 

 

 

15 things every nursing student needs to know

As new students prepare to start their nursing career, I believe the writer makes some really good points you should keep in mind. Nurse Kim

15 Things Every Nursing Student Needs to Know

September 3, 2013 by Brittney Wilson 

When I entered nursing school I knew very few people who were nurses. I questioned everyone that I thought might know anything about nursing on what I needed to know to do well in nursing school. Honestly I was given very little practical advice. But I don’t think it was the fault of the people I asked. I honestly think that many in nursing school struggle to make it through and wipe many of those memories from their brain. But I’m a firm believer that the nursing school experience doesn’t have to be a terrible one. And even though it’s going to be hard, you will be tired, and you’re probably not going to have a great social life, you can make it through nursing school while enjoying the experience (or at least not completely hating it!).
One of my personal goals in nursing has been to help mentor new and emerging nurses to give them the knowledge they need to be successful. I want to share what I’ve learned with you to make nursing school a little more tolerable.
The following represents 15 things that I feel every nursing student needs to know.

1. Nursing is nothing like you think it will be.

Even if your life is filled with nurses and you think you know exactly what you will encounter when you hit the floor you will soon find that you know nothing. I could give you a hundred examples but you won’t get it until you’ve been there. There are so many facets or nursing that you just can’t understand until you have lived it. Don’t feel bad about it just see it as an opportunity grow and learn.

2. You don’t need nearly as many books as is on your syllabus.

Although many may not agree with me on this, in my humble opinion that $1000 in text books per semester is outrageous and unneeded. Most of the information you need will be delivered in class and you might only look at them for a sentence or two. I suggest finding out who your instructors are and asking them if you really need 4 books for the 2 credit class you are taking. If you can’t reduce the amount of books you need to buy then you should partner with a friend and each buy half the books then share. If you’re working together as study buddies then you won’t miss the books that you didn’t purchase. Also, you should buy your nursing textbooks online from somewhere like Amazon. Most of the time you get free 2-day shipping and it’s usually much cheaper than the college bookstore.

3. You probably won’t keep your 4.0

If you’re a perfectionist then you are among your people. Many nurses have type A personalities and strive for their best. This often includes making good grades. But alas, dear nursling, you might not be able to maintain that immaculate 4.0 you’ve had throughout the rest of your college experience. Nursing school is a different brand of difficult and incredibly smart young men and women find it very difficult to maintain the same grade point average they had going in. You might make a B or two. Heck you might even make a few Cs. That’s ok. As you will find out soon enough, what doesn’t kill you will make you stronger. And I haven’t met a nurse yet who was asked for his or her transcripts when applying for a job.

4. Study groups will help you keep your sanity

On the very first day of nursing school our teachers highly recommended that we find people to carpool with and study with. While I didn’t take them up on this suggestion initially I really wish I had. It wasn’t until my second year in nursing school that I found a group of friends to study with and it really was a huge life saver. I would have done so much better the first year if I had just done this in this first place.

5. Every answer is correct. Your job is to know what is “most” correct.

One of the most difficult things for nursing students to grasp is how to answer NCLEX style test questions. What nursing school is really all about is teaching you how to critically think. This means that the answers aren’t always on the surface and you really have to know how to think about the bigger picture to know what answer is correct. In nursing there are many ways you can take care of patients and perform the same task but there are methods that work best. Nursing school is meant to try and teach you this skill. One of the best things you can do for yourself is find yourself an NCLEX strategy guide (I used Saunders Strategies for Test Success: Passing Nursing School and the NCLEX Exam) and study it before you even start nursing school. This will help you retrain your brain to answers the types of questions that will appear on tests in nursing school and the NCLEX and will really give you an edge in school.

6. If it feels like the teachers are trying to weed you out it’s because they are.

Not everyone is cut out to be a nurse. The hoops you jump through to get into and complete nursing school are not put in place simply to amuse your instructors. Nursing schools are ranked based upon their NCLEX pass rates and they only want students to make it through their program if they are sure they will be able to pass the NCLEX and work as a nurse. Think about all the responsibility a nurse has. Do you want just anyone taking care of you or your loved ones?

7. Your definition of busy will change.

Your priorities will shift and you will determine what is really important to you. Because of this you will have a new definition for what it really means to be busy. In the past you might have said you were busy because you didn’t “feel” like going out. Now you’ll actually be busy because you need to study the entire weekend to pass the test that is scheduled on Monday. You’ll regret many events and outings you blew off before because they won’t even be an option any more.

8. If bodily fluids make you queasy nursing isn’t for you.

There’s always at least a few students who make it into nursing school with a deadly fear or blood or an utter revolt for urine and feces. While I can tell you it isn’t all about poop, pee, blood and vomit, I’d be lying if I didn’t say that at least some portion of your nursing school experience will involve these lovely liquids. If you can’t cope with the sight of blood you need to some some serious emersion therapy to get over it now. Your clinical rotation is not the time to come to term with these fears.

9. You will have to give bed baths, wipe butts, and take vital signs.

Someone keeps spreading the rumor to nursing students, especially RN and BSN nursing students, that they won’t have to give bed baths, handle a code brown, take vital signs, and other ‘menial’ task. They’ve been told that nurses aides will take care of this and they will mostly be responsible for ‘paperwork.’ Let me be the first to give you a reality check: you’re gonna do all those things AND do paperwork. You don’t graduate from these responsibilities once you become a nurse. You own them. If you are lucky you might have a nurses aide to help you, but you better appreciate him/her for anything they assist you with. And you should never ask them to do something you have plenty of time to do yourself.

10. Your sense of humor will expand.

While my sense of humor has always been on the dry side, nursing school gave me a new appreciating for quick a wit and the ability to find humor in any situation. Nursing is stressful, emotional, and can be extremely tragic at times. Sometime in your life you will find yourself in the middle of a code situation with several nurses laughing and carrying on a conversation. You will learn that they aren’t doing this to be cruel or disrespectful. Nurses just have to find ways to cope with the tragedy and pain you will experience. Having a good and expanded sense of humor is a great way to do this.

11. Start networking now!

Do you know 10 people who could help you get a job if you were in a pinch? No? Well you need to start working on it. Yes? Well add 10 more.
Finding a job as a new nurse can be very difficult. And while many would have you believe there is a nursing shortage there are many new nurses who go months without securing employment. You need to make sure you have a good network so you can get your foot in the door and get your first nursing job.

12. Your first job probably won’t be your dream job.

I know you’re still in nursing school, but the time will come when you are seeking employment. The ‘exciting’ areas and specialties in nursing are usually very desirable and don’t often take new graduates. You might get lucky and land your dream job, but if you don’t then don’t let it get you down. With just a few few of years of experience under your belt you should be able to transfer into just about any nursing specialty you desire. And if you hate your first nursing job, after a year most will hire you readily.

13. Being a team-player is critical.

If you’re a introvert the time is now to get comfortable working with others. No nurse can operate on an island. You will often need help from your peers. In nursing school you will need help with studying, group projects, and graduating preparation. On the job you will need the help giving baths, answer call lights, and any number of things you may be too busy to tackle that way. Be prepared to give what you expect to get back or else you’re going to have a miserable experience in nursing school and as a nurse.

14. Maintain contact with your non-nursing friends.

The time will come when you are no longer in nursing school and you may or may not maintain contact with your nursing school classmates. If you do, that’s awesome. Even so, you need to be friends with people who aren’t nurses. Not every conversation has to focus on bodily functions or nursing horror stories. It’s nice to have a friend who doesn’t want to talk about nursing because moments with him or her are moments when you can truly escape from being a caregiver.

15. It’s okay to enjoy nursing school.

There are a million and one things that will irritate you and stress you out in nursing school. There are probably also a million and one articles and books about doing well in nursing school. Many of these tend to focus on the ‘work’ related with nursing school. But don’t let the ‘work’ of nursing school ruined the entire experience for you. While nursing school is hard it can also be fun! You gain an education and experience that will mold you into a nurse. You will make memories that you can get nowhere else. As a nursing student you need to make sure you work hard but you also need to play hard. Don’t forget to take time to enjoy this exciting milestone on your nursing journey!

From Medscape.com Definitely worth the read!

Has 'Patient Centeredness' Gone Too Far?

by H. Jack West, MD

"Well, the person I want managing my cancer is me," my patient told me in no uncertain terms.

We were discussing the growing sense, felt mutually, that our therapeutic relationship was not working as we both would have liked. I told her that I felt I had the expertise to manage her case without taking direction from other doctors from whom she had solicited opinions or medical information she found online. That said, I never felt that I was dismissive of her questions or suggestions. She wanted to be in control and for me to write the orders for the lab tests, imaging, and treatment that she decided she needed.

Cases like this embody how the patient-physician relationship has evolved remarkably over the past few decades and even noticeably over the course of ongoing careers for many of us currently in practice. In fact, even the name for this relationship has flipped from the "doctor-patient" relationship we contemplated during my medical school years.

I have long supported the transition away from a paternalistic model of medicine wherein a doctor tells a patient what to do without additional explanation or context, and toward one that welcomes and encourages questions from patients and a thorough discussion of different treatment options. Ideally this leads to shared decision-making, where we mutually arrive at the best course of care based on my presentation of the anticipated benefits and risks of each option and the patient's personal preferences. I am deeply committed to the concept that patients can become sophisticated participants in their own care, so much so that I started an online cancer education nonprofit more than a decade ago that is dedicated to equipping patients with the tools to shape their conversations with their cancer care team.

I think it's a mistake to belittle the efforts of patients who learn what they can online with mugs that say "Don't confuse your Google search with my medical degree." But at the end of the day, only the physician has the license and responsibility to order tests and treatments for a patient, and they should feel that they are the ones with their hands on the steering wheel. I fear that the rallying cry of "patient centeredness" is creating a sentiment in some patients that they are the customer and the customer is always right.

I still believe that patients can become extremely sophisticated, thoughtful participants in their care. But the reality is that when you survey the many information sources that patients may use, some are far more credible than others. The website for the nonprofit I founded, Global Resource for Advancing Cancer Education, discusses current views on the best treatments in the context of appropriate molecular testing, randomized trial results, and the ambiguity of potential alternatives. What patients find in the mass media or online chat groups may occasionally be informed, but more often it features recommendations for supposed "game-changers" or "breakthroughs" based on early-phase or even preclinical study results, alternating with patient testimonials and admonishments to "not let them tell you no."

It is vital for patients to feel comfortable asking questions, but they also need to accept a physician's recommendation for or against something without it being perceived as a failure to accede to their demands. Similarly, we need to set limits acknowledging that we have other patients to see on a given day.

In these discussions, far too few patients understand that the bottom two thirds of the fine print enumerating a drug's many, many potential side effects are listed by the pharmaceutical company's legal team simply as a "cover-your-ass" maneuver to absolve them of responsibility for possible negative outcomes with their treatment. They are not hidden clues that explain multifactorial, nonspecific symptoms like fatigue.

We also need to remember that the tenacious foothold of fake cancer remedies in the minds of the lay public—as well as the entire existence of the antivaccine movement—is predicated on disinformation, along with a view that "science" and "evidence-based medicine" should be considered pejorative terms. There is great harm in elevating these patient perspectives as appropriate for medical decision-making.

Of course, like so many complex issues, the answer remains a shade of gray. It was long overdue for the medical community to recognize the importance of educating patients and welcoming their participation in shared decision-making. But only one side of the patient-physician relationship has the experience and medical training, as well as the legal responsibility, to direct care. The patient should be at the center, but that shouldn't sideline the physician.
 
H. Jack West, MD, is an associate clinical professor and executive director of employer services at City of Hope Comprehensive Cancer Center in Duarte, California. He founded the Global Resource for Advancing Cancer Education, co-hosts the "West Wind" podcast, and regularly comments on lung cancer for Medscape.

Quote From Ralph Marston

Set a small goal, and achieve it. Then immediately set another small goal, and achieve that.

Occasionally you'll have the opportunity to make big, sudden improvements. Yet always, in every moment, you are able to make small improvements.

There's great power in doing so. Because those small improvements add to each other, and build on one another.

The long and inexorable march of progress is not, by and large, a history of quick advances. It is a story of small improvements, and improvements on the improvements, made again and again.

Today you can continue that beneficial story. Right now, several small improvements await your attention, your action.

You don't have to wait one more moment for the chance to make a meaningful positive difference. Where you are, with what you have, make a small improvement, and set the process in motion.

#ralphmarstonquotes

11 Tips to Stop Stress Eating During Shelter-in-Place

By Zoe Davis, MA, LMHC, MS, CNC While this is a stressful time for many, it is also an opportunity to practice mindfulness and deep compassion for ourselves and our community. Food choices may be more emotional at this time as people look to food for comfort to lower anxiety and mitigate feelings of a loss of control. I hope some of these ideas for managing stress eating will be helpful to you and will provide their own source of comfort.

1. Try the H.A.L.T. method for emotional eating.

When going to get something to eat, simply check in to gauge what your real need is by asking yourself: “Am I Hungry, Angry, Lonely, Tired?” If you’re hungry, eat some nourishing food. If you’re angry (or stressed or anxious), do something to attend to that emotion, such as journaling, meditation, diaphragmatic breathing, drawing, or coloring (even adults can do this!). If you’re lonely, reach out to a friend or family member, and make regular social engagements a priority (virtually for now). If you’re tired, rest, drink some water, do some mild stretching, or get some fresh air with a walk to replenish your energy. When we create more space between the thought of eating something to soothe our emotions and the actual consumption, we create awareness of our true need and increase the likelihood of doing something to attend to that actual need.

2. Feed yourself well, and regularly.

Low blood sugar exacerbates feelings of stress and anxiety. Make sure you’re consuming regular meals that include adequate protein, healthy fat, plenty of vegetables, and some low-sugar fruit. Don’t go too long between meals, especially if you’re prone to feeling anxious or stressed. Your brain and body need nutrients regularly throughout the day, and when we are missing key B vitamins, fiber, minerals (like magnesium), and probiotics, we can feel more amped up and have a harder time relaxing.

3. Slow down your meals/snacks.

Take a few deep breaths before eating and chew your food thoroughly. Eating this way engages the parasympathetic nervous system and allows for better digestion and greater benefit from the foods you eat. This practice also naturally moderates the amount and types of food your body actually needs, drastically reducing the need for willpower.

4. Keep non-nutritive “comfort” foods out of your home.

Now is a great time to focus on the essentials and avoid foods that fill you up but don’t actually nourish you. Try making warm broth-based soups, roasted root vegetables, baked pear or apple with cinnamon, and gluten-free whole grains or pseudo-grains like wild rice, quinoa, and buckwheat as part of your comfort foods instead of white flour-based foods or sugary desserts.

5. Avoid stimulants.

Stimulants—such as refined sugars, too much caffeine, dyes, additives, and artificial sweeteners—can irritate or over-activate the nervous system and exacerbate anxiety, making it more difficult to experience a sense of calm.

6. Make time with family or friends to enjoy meals together.

If you live with others, take turns cooking and prepare the table where you will eat as a part of the meal to be enjoyed. Light candles, play relaxing music, and have positive conversations as part of the meal. Avoid stressful conversations with meals, and if you live alone, invite friends to a virtual dinner party via computer or phone. You can enjoy each other’s company even when not in the same space.

7. Practice gratitude.

Consider the work that went into growing or raising your food, the incredible abundance of our planet, and the many people along the way from planting to delivery that work hard every day to keep you nourished. Gratitude keeps us focused on appreciation, which is a boost to our immune system and can significantly lower stress levels.

8. Include intentional movement in some form on a daily basis.

When we move, we’re more in touch with our physical body and tend to choose healthier food options and drink more water. Additionally, exercise is immensely beneficial for lowering anxiety, improving our immune resistance, reducing stress, and encouraging sound sleep. While much of our lives may be more confined than we would like, we can still move every day. Some ideas include going for brisk walks/hikes in our neighborhood, taking dance classes online, doing weight resistant exercises with an app, or completing a regimen of yoga poses from books or instructional videos. 

9. Tap into your creative self or learn something new.

Try a virtual class online, get out your paintbrushes and paper, do collage, sing, dance, write poetry or stories, learn a language (or re-learn one), play a musical instrument if you have one, sew, knit, or anything else you’d like to try. Creativity is a great way to express yourself and de-stress. When we are creative and feel ourselves expressed, we are using energy in a positive way and tend to feel less restless. Decreasing feelings of restlessness can keep us from eating out of boredom.

10. If you have the capacity and aren’t doing too much already, offer to help someone else.

Volunteer in any way that is safe for you. Volunteer Match has thousands of opportunities, and you can do many of them virtually, or you can come up with your own way to help in your neighborhood. When we feel a sense of contribution and connection with our community, we tend to feel more in control and more grounded. This feeling is empowering and often leads us to take better care of ourselves (with food, movement, sleep, and more), as we feel more important to those around us.

11. Practice good sleep hygiene.

Try to go to bed at the same time each night and limit foods at least 2 hours prior to sleep. Use blue-light filters on computers, phones, or tablets if you need to use them in the hour prior to bedtime. Getting at least 7 hours of sleep regularly helps to regulate hunger hormones, improve energy, and increase our stress tolerance.

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About the Author: Zoe Davis, MA, LMHC, MS, CNC, Amen Clinics Northern California

Zoe Davis, MA, LMHC, MS, CNC is a nutrition therapist, integrative health coach, and certified Irlen screener at Amen Clinics, where she has been honored to work with patients over the last four years. Zoe has Master’s degrees in human nutrition and functional medicine, is a licensed mental health counselor, and has a post-graduate certificate in nutritional psychology. This unique combination of education in both nutrition and psychology allows her to use a mind-body approach in a deeply integrated way.
Find out more about Amen Clinics, which offers comprehensive clinical evaluations and remote therapy sessions as well as in-clinic brain scanning, by speaking to a specialist today at 866-319-2743. If all our specialists are busy helping others, you can also schedule a time to talk.