Nursing - Healthy Work Environment

A Healthy Work Environment is one that's protected, empowering, and satisfying. Parallel to the World Well being Group definition of well-being, it isn't merely the absence of actual and perceived threats to well-being, however, a spot of “bodily, psychological, and social well-being,” supporting optimum well-being and security. A tradition of security is paramount, through which all leaders, managers, well-being cared employees, and ancillary employees have accountability as a part of the affected person-centered group to carry out with a way of professionalism, accountability, transparency, involvement, effectively, and effectiveness. All should be conscious of the well being and security for each the affected person and the well-being care employee in any setting offering well-being care, offering a way of security, respect, and empowerment to and for all individuals.

Ebright gives new perception about the necessity to perceive the cognitive work of nursing and the advanced environments during which RNs present care. In The Complicated Work of RNs: Implications for Healthy Work Environments, she describes new understanding concerning the complicated cognitive work of nursing known as ‘”stacking” - the invisible, cognitive work of steady organizing, re-prioritizing, and decision-making for the administration of labor stream and care supply. She additional describes the worth of viewing healthcare supply via the lenses of Complexity Science, an interdisciplinary area of inquiry targeted on how advanced adaptive techniques, similar to nurses and sufferers, evolve, work together, and keep order. Analysis findings on the precise work of RNs in healthcare settings have significant implications for supporting the brand new RN, specializing in the direct care operate, designing and implementing expertise, and “designing-out” system boundaries to care. The creator notes that additional focus and analysis are wanted on the present complexity of direct care.

In Combating Disruptive Behaviors: Methods to Promote a Healthy Work Atmosphere, Longo offers a summary of the character of disruptive behaviors and the methods members of the healthcare staff can use to formally deal with such behaviors. Acknowledging the impact of disruptive behaviors on affected person security and the properly being of healthcare staff, the Joint Fee lately instituted a management normal mandating that services looking for accreditation institute insurance policies to handle disruptive behaviors. Longo recommends that organizations take a zero-tolerance stance in the direction of disruptive behaviors and that sound insurance policies and processes be in place to deal with such behaviors. Training to develop the expertise to confront disruptive behaviors is essential, and all healthcare members have a duty to accumulate these abilities. The creator cautions that disruptive behaviors if gone unchecked, can grow to be ingrained into the tradition of the group. She notes that the presence of disruptive behaviors threatens collaboration amongst healthcare suppliers and has been linked to hostile occasions. It's the accountability of all members of the staff to develop self-awareness about their very own behaviors and to turn out to be adept at expert communication to stop disruptive behaviors.

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Help! How to Pass NCLEX Exam

I wasn't the highest achiever in nursing school. I went in to it with straight A's, but I'm a mother of 3 and couldn't stand the thought of not devoting at least some of my time to my family throughout school. I worked part time, went to school (BSN) full time, spent as much time as I could with my little family, and studied when I could shove it in.

A little background - Nursing is a second career for me. I use to HATE my job and was devastated every morning when my alarm went off. In 2009, when the economy fell, my husband lost his job and it fell to me to keep up on all the bills - which only made the situation less joyful (if that was possible.) During that time we fell behind on all our bills - I hated money and the crappy situation we were in. So in 2010 when my husband started working again I decided I wasn't going to continue to be miserable and I would do something meaningful with my life - so I started on the road to nursing school.

During nursing school I wasn't the smartest student in class, but I had an intuition when working with patients and received praise during / after most of my clinicals. After graduation I felt invincible - I made it through nursing school and finally, in my 30's got my BSN. After graduation I applied and was accepted to a Versant program. Only one last hurdle - the NCLEX!

I opted to take the Kaplan review and studied that for 2 months before taking the NCLEX. My Kaplan scores ranged from the high 40's in the beginning, to the mid 60's toward the end of the program (my readiness score was 66.) So, In early September, I felt as though I was ready (according to Kaplan anyway) and set off to take THE test

Now, I am NOT an anxiety plagued test taker - in general. However, the moment I sat down to take the NCLEX my anxiety went through the roof! 6 years of school, 6 years of not giving my all to my family, 6 years of working part time (and living pay check to pay check), landing my dream job / after graduation situation, all came down to this one test.

By the time I hit 75 questions I felt like I could melt in to the floor. I got up, went to the bathroom, dried my arm pits as much as I could, cried a little, gave myself a pep talk, and went back in to the test. The anxiety never went away. I sat there sweating, heart racing, vision going blurry for the WHOLE 265 questions!!

I walked out of the test in a haze having no idea what had just happened to me. I felt euphoric (that word always seemed nice to me - euphoria - but crap.... this sucked.) Later that evening I tried that PVT and did not get the "good pop up". A week went by in absolute agony. When my letter came my husband called me, asked for my permission to open it, and broke the bad news to me "We're sorry to inform you..."

I was devastated. When I called the hospital to let them know my results - they said "Thank you very much, please apply again during the next cycle." I lost my dream job. Over the past couple of weeks I've given the situation a lot of thought (It's consumed me, really) trying to figure out what happened, where did I fall short, and WHY ME?! Today I am still a little embarrassed that I did not pass. All my friends are starting their new jobs and I feel left behind - that's the hardest part. My kids are still young enough that they really don't have any idea what's going on or how hurt I've been - which I am very very grateful for. I feel like I have I let them down (which, to see them, really isn't the case.)

However, know this: I am not ashamed, and if you find yourself in my shoes, you shouldn't be either. I believe we all have a purpose in this life - it's up to us to figure out what it is. Maybe my not passing this time will lead me down the path for which I am meant - the path where I can do the most good. The same is true for you. Do your best. Pick up the pieces that all fell apart and get back at it. You are on this path for a reason - follow through with it! I know in my heart that I will be a great nurse some day and so will you. I don't know you, but I feel your pain - I wish I could take it all away and show you your happy ending.

You are going to be OK! Truthfully - this bump in the road is only a few months delay. You're going to get another chance at this god awful test and you're gonna punch it in the face! Figure out where things went wrong. You graduated school, so you've got the "stuff" - you just need to figure out how to show it. Many fantastic nurses did not pass the NCLEX on the first try. Lets be those fantastic nurses together!! Buckle down and I'll see you when we both have RN after our names.

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Bachelor's Degree in Nursing Profession Info

Nurses holding a Bachelor of Science in Nursing (BSN) are registered nurses. They work with physicians and different healthcare professionals in offering medical care to sick, injured or disabled sufferers. Nurses are found working in several environments, including hospitals and nursing homes, and may select to work in a specialized space, equivalent to emergency room care or surgical procedure.

During the ten-year period of 2014-2024, the U.S. Bureau of Labor Statistics (BLS) predicts a 16% improve in employment for RNs.The BLS explains that a part of this progress is because of a rising senior inhabitants, which could require extra care, in addition to technological advances in remedy choices that permit extra well being challenges to be medically addressed. A further issue of this development is likely to be an increase in preventative care.

Academic Info

There are three typical educational routes to acquiring a bachelor's degree in nursing, including a first-time bachelor's, an accelerated second bachelor's and an RN-to-BSN degree track. First-time degree and second bachelor's degree nursing packages are designed for college students with no prior nursing coaching. These applications introduce college students to the nursing subject through nursing coursework and, usually, hands-on nursing experience. The second bachelor's packages for nurses may be available at an accelerated fee, as a result of coursework outdoors of nursing will not be required in these packages. Graduates of those to program varieties can take the Nationwide Council Licensure Examination (NCLEX-RN), administered by the Nationwide Council of State Boards of Nursing (NCSBN), to turn out to be registered, nurses.

Designed for already-licensed RNs who want to earn a bachelor's degree, RN-to-BSN programs usually require supervised medical work along with coursework in nursing and normal training subjects. Admission to those applications normally is dependent upon a certain quantity of nursing work expertise along with present RN licensure. These levels can also be out there on an accelerated monitor, and should present versatile class schedules for working nurses.

License Info

In response to the BLS, nurses are required to be licensed by the state wherein they intend to work. RN license candidates often want a level in nursing and should additionally cross the NCLEX-RN, in addition, to fulfill some other state obligations. States differ on necessities, says the BLS, however continuing education coursework is widespread for license renewal.

Bachelor's Diploma in Nursing Payment Info

In Might 2015, registered nurses introduced in a median wage of $67,490 per yr, with the bulk making from $46,360 to $101,630 yearly, in response to BLS knowledge. Nurses working at hospitals made a imply annual wage of $72,980 a yr, whereas physicians' places of work paid a mean annual wage of $65,350.

The demand for registered nurses is high. The 16% job progress projection for registered nurses from 2014-2024 is way faster than average when in comparison with all occupations. Nurse provide direct care to patients under the guidance of a doctor and play a vital position within the well-being care area. They might work in hospitals, docs' workplaces, clinics, and nursing properties, or present in-home patient care services.

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Is the BSN for Everybody? Things to Consider when Considering School

How important is schedule to you?

If you’re the kind of nurse who loves working three 12s and having the rest of your week off, you might find that options are limited away from the bedside. Many non-clinical positions are Monday-Friday, daytime operations that only offer 8 hour shifts. Some may offer 4-10s or rotating shifts, but 3-day work weeks are hard to come by outside of direct patient care.

What part of nursing do you enjoy?

If you really love taking care of patients, and really loathe sitting in meetings and doing paperwork, that’s something to consider when thinking about your BSN. Leadership and education positions tend to involve a lot of writing and speaking; if figuring out schedules, sending emails, and giving presentations is not your thing, most administrative BSN roles won’t be a good fit.

On the other hand, if the clinical aspect of nursing is your passion and you intend to eventually pursue an advanced practice role as a nurse practitioner or nurse anesthetist, you will absolutely need your BSN first. CRNA programs also require at least a year of recent critical care experience, so you won’t want to stray far from the bedside once you have your BSN.

Is your goal to get a raise?

If you’re thinking of getting a BSN just to earn more and become more marketable, it helps to have the facts. In many hospitals, there is no wage increase for earning your BSN. Most facilities determine pay based on the job description, more so than the credentials. For instance, the administration looks at market values and determines that RNs at the bedside should make X dollars an hour. Some may add a bit to the hourly wage for a BSN, but many do not; a bedside nurse is a bedside nurse and they are paid as such even with a BSN.

This is certainly something many would like to change, but before that can happen there will need to be a fundamental change in BSN education. Currently, a nurse can earn a BSN in a matter of months online without a single live lecture or any hands-on learning. Few, if any, BSN programs require a clinical component or practicum. There are no advanced clinical skills, no new knowledge significant enough to affect performance at the bedside, and therefore no real justification for an increase in pay. An overhaul to existing BSN programs, including advanced clinicals, might help to change that and make BSNs more marketable.

If you do intend to transition into a higher-paying leadership role with your BSN, go for it; just bear in mind that most management and education roles are salaried, not hourly, so figure that into your calculations. If you’re someone who relies on occasional overtime or likes to pick up holidays for the premium pay, these differentials usually don’t apply to salaried (aka “exempt”) positions.

Are you hoping for a competitive edge in the job market?

If you’re trying to get ahead, continuing education and impressive credentials will certainly help. Bear in mind, though, that the BSN is becoming very commonplace now among bedside nurses. Many hospitals strongly encourage, and even require, nurses to obtain a BSN within a certain number of years after hire or in order to apply for transfers within the organization. In the recent past, BSN nurses were in leadership roles as nurse managers, directors of nursing in long-term care, and nursing instructors in diploma and ADN schools. Now that the average bedside nurse has, or is expected to earn their BSN, leadership and advanced roles are requiring even higher levels of education. You should absolutely pursue the degree if you want to advance, but many nurses now are also seeking additional certifications in various specialties like diabetes, oncology, or wound care, in order to stay competitive.

Is money no object?

One more thing any nurse should consider before returning to school is the matter of finances. Some may qualify for federal grants or full scholarships, but most working nurses will end up paying at least part of their tuition and fees out of pocket. If you’re lucky enough to get a free ride, take full advantage of it. If you’re like most nurses and have to rely on student loans and/or tuition reimbursement, take all the factors into account before you decide. For instance:
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What is your current financial situation? Even with student loans and tuition reimbursement, many nurses often have out of pocket expenses for every semester. If your nursing job lands you a certain income bracket, you may only receive partial student loans and have to pay the remainder of tuition yourself. That’s something to consider if money is already tight. Also remember that currently, getting your BSN does not guarantee an increase in monthly income. All too often BSNs find themselves in the same job making the same money, but now with a student loan payment to contend with every month.

How close are you to retirement? The repayment period for most student loans is 10 years, so it may not be worth it if you plan to retire in 6. However, if your finances are such that you could pay extra or pay the loan off early, you might want to go ahead.
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Are you planning to relocate or change employers after graduation? Employer tuition reimbursement usually exchanges financial aid for months or years of continued service post-graduation. If you leave your employment before the debt is worked off, the benefit has to be paid back to the facility. Read the tuition assistance policies carefully to determine how long you’ll need to stay on after graduation and what your payback amount would be should you choose to leave early.
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Is your projected BSN salary enough to balance out the student loan debt? Most BSNs end up paying around $240 per month for their student loan after graduation, so bear in mind that you’ll need to make at least that much more per month just to break even. The sad truth is that as it stands now, many BSNs find themselves struggling to make that monthly payment when there is no wage increase for earning the extra degree. Leadership roles will usually pay you a bit more, but remember to think about the schedule requirements and exempt/non-exempt status of those positions.

What’s the bottom line?

Generally speaking, you almost can’t go wrong with more education. The more letters behind your name, the better your resume looks, and there is also a sense of personal achievement. Still, when considering a BSN program, it’s important to examine all the pieces: your goals, your finances, your lifestyle and family situations, as well as your likes and dislikes when it comes to work. Do you need to be home with your kids more? Do you rely on overtime or shift differential to make ends meet? Do you love patients but hate paperwork? These are all things to consider.

We all eagerly look forward to the day when the BSN translates to tangible benefits for the average nurse. Sadly, as it stands right now, for many there is no life-changing advantage and the BSN serves only as a stepping stone to an even higher degree or advanced clinical practice. The information here is not meant to discourage anyone from pursuing higher education, only to help put the undergraduate degree and its pros and cons into perspective.

If your facility requires the BSN for bedside nurses, then your choice is simple. However, if you just really love taking care of patients and have no desire to enter leadership or administration, you may fare better with a specialty certification in an area that interests you. The cost is far less, and the BSN does not focus on clinical skills. If you do want to qualify for entry-level leadership and education roles, then the BSN is the way to go. In future we hope to see the BSN carry more weight and offer more leverage, but to do so it must also provide increased skills and greater knowledge. Changes in education are likely the only thing that will translate into changes in benefits. Still, the great thing about nursing is that we have a wide-open, versatile field where there is something for everybody. Hopefully the information included here can help you decide which of those somethings is right for you in your own nursing practice.

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The Cost Effectiveness of Nursing Services

The American Association of Colleges of Nursing has long reported that nurse practitioners preparation value 20-25% that of physicians. In 2009, the full tuition price for nurse practitioners preparation was lower than one-year tuition for medical (MD or DO) preparation). Comparable financial savings are related to nurse practitioners compensation. In 1981, the hourly value of a nurse practitioner was one-third to one-half that of a doctor (OTA). The distinction in compensation has remained unchanged for 30 years.

When productiveness measures, salaries, and prices of training are thought-about, nurse practitioners are efficient price suppliers of well-being providers. Primarily based on a scientific assessment of 37 research, Newhouse et al. (2011) discovered constant proof that cost-related outcomes equivalent to the size of the keep, emergency visits, and hospitalizations for nurse practitioners care are equal to these of physicians.

Nurse Practitioners cost-effectiveness is just not depending on precise observe setting and is demonstrated in primary care, acute care, and long run care settings. As an example, nurse practitioner practicing in Tennessee's state-managed managed care group (MCO) delivered well-being care at 23% beneath the typical price related to different main care suppliers, reaching a 21% discount in Nurse practitioner-patient hospital charges and 24% decrease lab utilization charges in comparison with physicians (Spitzer, 1997).

Plenty of research has documented the cost-effectiveness of nurse practitioners in managing the well-being of older adults. Hummel and Prizada (1994) discovered that in comparison with the price of physician-only groups, the price of a physician-nurse practitioner workforce long run care facility had been 42% decrease for the intermediate and expert care residents and 26% decrease for these with long-term stays. The physician-nurse practitioner groups additionally had considerably decrease charges of emergency division transfers, shorter hospital lengths of the keep, and fewer specialty visits.

A one-year retrospective research of 1077 HMO enrollees residing in 45 long run care settings demonstrated a $72 month-to-month achieve per resident, in contrast with a $197 month-to-month loss for residents seen by physicians alone (Burl, Bonner, Rao, and Kan, 1998). Intrator (2004) discovered that residents in nursing houses with nurse practitioners have been much less more likely to develop ambulatory care-sensitive diagnoses requiring hospitalizations. Bakerjian (2008) summarized a evaluate of 17 research evaluating nursing house residents who're sufferers of nurse practitioners to others, discovering decrease charges of hospitalization and general prices for the nurse practitioners patients. 

The potential for nurse practitioners to regulate prices related to the healthcare of older adults was acknowledged by United Well-being (2009), which beneficial that offering nurse practitioners to handle nursing dwelling sufferers might end in $166 billion healthcare financial savings. Nurse practitioners-managed care inside acute-care settings can also be related to decreasing prices.

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Ways to Strengthen Nursing Profession

To develop into a professional nurse requires that you simply be taught to assume like a nurse. What makes the pondering of a nurse totally different from a physician, a dentist or an engineer?  It's how we view the consumer and the kind of issues we take care of in follow once we have interaction in shopper care. To assume like a nurse requires that we be taught the content material of nursing; the concepts, ideas and theories of nursing and develop our mental capacities and expertise in order that we develop into disciplined, self-directed, important thinkers.

Essential considering is the disciplined, mental strategy of making use of skilful reasoning as a information to perception or motion (Paul, Ennis & Norris). In nursing, crucial pondering for medical decision-making is the flexibility to suppose in a scientific and logical method with openness to query and replicate on the reasoning course of used to make sure protected nursing follow and high quality care (Heaslip). Crucial pondering when developed within the practitioner consists of adherence to mental requirements, proficiency in utilizing reasoning, a dedication to develop and keep mental traits of the thoughts and habits of thought and the competent use of pondering abilities and talents for sound scientific judgments and protected decision-making. 

Intellectual Requirements for Reasoning

Practitioners in nursing who're vital thinkers worth and cling to mental requirements. Vital thinkers attempt to be clear, correct, exact, logical full, vital and truthful after they hear, communicate, learn and write. Vital thinkers assume deeply and broadly. Their pondering is satisfactory for his or her supposed goal (Paul, Scriven, Norris & Ennis). All pondering may be examined in mild of those requirements and as we mirror on the standard of our considering we start to acknowledge after we are being unclear, imprecise, obscure or inaccurate. As nurses, we need to eradicate irrelevant, inconsistent and illogical ideas as we purpose about shopper care. Nurses use language to obviously talk in-depth info that's vital to nursing care. Nurses are usually not targeted on the trivial or irrelevant.

Nurses who're crucial thinkers maintain all their views and reasoning to those requirements in addition to, the claims of others such that the standard of nurse's pondering improves over time thus eliminating confusion and ambiguity within the presentation and understanding of ideas and concepts.

Elements of Reasoned Thinking

Reasoning in nursing includes eight parts of thought. Vital considering includes making an attempt to determine one thing; an issue, a difficulty, the views of one other individual, a principle or an concept. To determine issues out we have to enter into the pondering of the opposite particular person after which to grasp as greatest we will the construction of their considering. This additionally applies to our personal pondering as nicely. Once I learn an writer I am making an attempt to determine what the creator is saying; what downside or concern the writer is addressing, what perspective or body of reference he's coming from, what the objective or goal is of this piece of writing, what proof, knowledge or information are getting used and what theories, ideas, ideas or concepts are concerned. 

I wish to perceive the interpretations and claims the creator is making and the assumptions that underlie his pondering. I would like to have the ability to observe the creator's strains of formulated thought and the inferences which result in a selected conclusion. I want to know the implications and penalties of the creator's pondering. As I come to grasp the creator in-depth I will even start to acknowledge the power and weak spot of his reasoning. I can provide my perspective on the topic at hand with a transparent understanding of how the creator would reply to my concepts on the topic.

The Elements of Thought

All pondering, whether it is purposeful, consists of the next components of thought (Paul, 1990).

The issue, query, concern or subject being mentioned or thought of by the thinker. What the thinker is making an attempt to determine.
The aim or purpose of the pondering. Why we are trying to determine one thing out and to what finish. What can we hope to perform.
The body of reference, factors of view and even world view that we maintain in regards to the difficulty or downside.
The assumptions that we maintain to be true concerning the difficulty upon which we base our claims or beliefs.
The central ideas, concepts, rules and theories that we use in reasoning about the issue.
The proof, information or data supplied to help the claims we make in regards to the challenge or drawback.
The interpretations, inferences, reasoning, and contours of formulated thought that result in our conclusions.
The implications and penalties that observe from the positions we maintain on the difficulty or downside.

When nurses motive they use these parts of thought to determine troublesome questions and acknowledge that their considering may very well be flawed or restricted by lack of in-depth understanding of the issue at subject due to this fact, they critically monitor their pondering to make sure that their pondering meets the requirements for mental thought.

In abstract, as a crucial thinker, I'm able to work out by studying or listening critically what nurse students imagine about nursing and on what foundation nurses act as they follow nursing. To do that I have to clearly comprehend the pondering of one other individual by determining the logic of their pondering. I have to comprehend clearly the considering of myself by determining my very own ideas on the topic at hand. Lastly, I need to use mental requirements to gauge my considering and the pondering of others on a given drawback such that I can come to a defensible, effectively reasoned view of the issue and due to this fact, know what to consider or do in a given circumstance. To do that I have to be dedicated to growing my thoughts as a self-directed, impartial essential thinker. I have to worth above all else the mental traits and habits of thought that vital thinkers possess.

Intellectual Traits and Habits of Thought

To develop as a important thinker one have to be motivated to develop the attitudes and inclinations of a fair-minded thinker. That's, one should be prepared to droop judgments till one actually understands one other standpoint and might articulate the place that one other individual holds on a problem. Nurses come to reasoned judgments in order that they'll act competently in apply. They frequently monitor their considering; questioning and reflecting on the standard of pondering occurring in how they motive about nursing follow. Sloppy, superficial pondering results in poor observe.

Essential inquiry is a vital high quality for protected observe. Nurses should pose questions on observe and be prepared to aim to hunt solutions about apply. Nurses have to be prepared to aim to hunt solutions to the tough questions inherent in follow, in addition to the plain. Query posing presupposes mental humility and a willingness to confess to at least one's areas of ignorance in addition to, mental curiosity and perseverance and willingness to hunt solutions. Important thinkers in nursing are fact seekers and display open-mindedness and tolerance for others' views with fixed sensitivity to the opportunity of their very own bias.

Nurse's who're crucial thinkers worth intellectually difficult conditions and are self-confident of their effectively reasoned ideas. To motive successfully, nurses have developed abilities and skills important for sound reasoning.

Essential Pondering Expertise and Talents

Vital thinkers in nursing are skillful in making use of mental abilities for sound reasoning. These expertise have been outlined as data gathering, focusing, remembering, organizing, analyzing, producing, integrating and evaluating (Registered Nurse's Affiliation of British Columbia, 1990). The main target of classroom and medical actions is to develop the nurse's understanding of scholarly, educational work via the efficient use of mental talents and abilities. As you encounter more and more extra advanced observe conditions you may be required to suppose via and motive about nursing in higher depth and draw on deeper, extra subtle comprehension of what it means to be a nurse in scientific follow. Nursing is rarely a superficial, meaningless exercise. All acts in nursing are deeply vital and require of the nurse a thoughts absolutely engaged within the requirements of nursing. That is the problem of nursing; important, reflective observe based mostly on the sound reasoning of clever minds dedicated to secure, efficient consumer care.

To perform this goal, college students can be required to purpose about nursing by studying, writing, listening and talking critically. By doing so you'll be considering critically about nursing and guaranteeing that you simply achieve in-depth data about nursing as a follow career.

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Nursing Job Responsibilities

Nurses play significant roles in hospitals, clinics and private practices. They make up the biggest health care occupation in the United States. Nursing job duties include communicating between patients and doctors, caring for patients, administering medicine and supervising nurses' aides. The educational path for becoming a nurse vary depending on the type of nurse one hopes to become, but all nurses must be licensed.

Degrees of responsibility vary between nursing levels, job duties are principally similar. Daily duties involve activities such as:

Administering medications
Managing intravenous (IV) lines
Caring for patients
Observing and recording patients' conditions
Communicating with doctors
Providing emotional support to patients and their families
Advising patients on how to self-administer medication and physical therapy
Educating patients and the public on disease management, nutritional plans and medical conditions

Because nurses may choose to specialize in specific types of treatments, health conditions, patient populations or body systems, specific job duties can vary amongst specialties. Advanced practice nurses can work independently and have additional job duties, such as prescribing medications, examining patients and making diagnoses.

Nursing Career Information

Nurses may work in a variety of health care settings, such as hospitals, private physicians' offices and nursing facilities. In some cases, they run immunology clinics, general health screening clinics, public seminars and blood drives, as well as working in emergency departments. Nurses can also have uncommon schedules, working long hours in numerous facilities, based on need as well as their understandings of care types.

The U.S. Bureau of Labor Statistics (BLS) predicted that over the 2014-2024 decade, employment of LPNs and LVNs and RNs will grow 16% Job growth is expected to be fueled by a growing aging population. The BLS reported that RNs earned median annual wages of $67,490 in May 2015. LPNs and LVNs earned a median salary of $43,170 annually, as of May 2015

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Factors responsible for Nursing recruitment and retention

The Nursing Scarcity: Options for the Quick and Long Term

Each article, speech, and interview in regards to the nursing scarcity notes that it's a completely different kind of scarcity than before now. Some contributing elements stay the identical, reminiscent of girls having extra selections for a profession. Key differentiators from the earlier two shortages are the growing older of nurses, the final workforce shortages in ancillary professions and help labor, and the worldwide nature of this scarcity. As well as, the basic modifications in how sufferers are cared for in a managed care surroundings is compounding the scarcity. With decreased size of hospital stays and extra acute care within the ambulatory and residential settings, the necessity for skilled, extremely expert nurses is unmet. A numerical evaluation could point out sufficient present numbers. However the stage of experience could also be the reason for the issue.

From a financial perspective, this scarcity is being pushed extra by the availability facet of the provision/demand equation than the demand aspect. Thus, this can be an extra advanced scarcity, which guarantees to worsen through the subsequent decade as extra nurses retire. Previous financial options comparable to sign-on bonuses, relocation protection, or new premium packages could have restricted and short-term impact as a result of they merely redistribute the availability of nurses, not improve it.

Nonetheless, these options are already gaining in reputation once more as evidenced by advertisements in native newspapers. The options to create a sustained enhancement to the nursing scarcity will should be extra radical than previous shortages and should deal with many long-term points.

Along with the worsening nurse, scarcity is the scarcity of different workers together with numerous allied well-being professionals, secretaries, and help workers. The shortages of different employees are adversely impacting nurses who've essentially the most steady and closest relationship with sufferers and their households. Within the early 90's, for value slicing causes, there was an elevated use of unlicensed assistive personnel. Nevertheless, these fashions have failed on account of rising affected person acuities, the issues over medical errors, and the declining numbers of ancillary personnel.

Roughly one-third of the nursing workforce is over 50 years of age and the typical age of full-time nursing school is 49 years. Research revealed within the July, 2000, the challenge of JAMA predicts that 40% of nurses by 2010 will probably be 50 years outdated or older (Buerhaus, 2000a). The problem is for the redesign of affected person care supply fashions which might be constructed to help the follow of an older workforce. Nursing, a bodily demanding occupation, should handle this problem by initializing new know-how into observing. Hospitals should help the getting old nurse by providing flexibility in scheduling, elevated break day, and sabbaticals.

In a Lexis/Nexis evaluation of 6 months of stories articles all through the US in regards to the nursing scarcity, each story famous the necessity for inventive methods. Disappointingly, few described any new interventions. The aim of this text is to evaluation some components contributing to the scarcity and current potential methods to deal with them. The authors have chosen to evaluate: developments within the common work setting, the picture of nursing, recruitment of scholars, retention of present nurses, and regulatory and coverage points. Options, some already underway within the U.S. are highlighted. Main nursing and affected person Targeted Care are mentioned, and a most popular mannequin of care is described. They hope that this text will create a fast communication of concepts to colleagues and stimulate others to construct upon these concepts.

Developments to Think about

The overall work setting within the U.S. is completely different than on the time of the final scarcity and must be considered when creating methods to handle the scarcity. There's the blurring between what has been the standard position of supervisor and the managed and between work and residential. Fast technological advances are altering the way in which through which work has been completed. Organizations in all industries are coping with a decent labor market and competing aggressively to rent the very best and brightest. The next traits have an effect on all work environments and supply a context through which the nursing scarcity is evolving
Time to Cash - Staff as we speak search extra private time versus monetary compensation.

Skilled versus Private Position - Workers need to be energetic each at work and at the residence, not selecting between the 2.

Rising Superclass of Workers - As extra staff goes for much less hectic work/extra private time, a subgroup of staff, typically characterized as extra pushed, are carrying the load of journey, relocation, and lengthy hours

Integration of House and Work - Employers are more and more providing companies to scale back the stress of managing skilled and private lives. These providers embrace youngster and elder care, dry cleansing, housecleaning, on-site full-service banking, and yard care.

Gen X Entrepreneurs - Staff of their twenties and thirties view the office in a different way, preferring larger autonomy and fewer forms. They're "loyal" to the work versus the employer. Thus, many are selecting impartial work/freelancing, such because of the momentary companies in well-being care.

Collaborative Administration - Conventional fashions of administrative constructions are additionally in flux with flattening of hierarchies and elevated group constructions. Individuals who can create environments of teamwork and creativity are the definition of sturdy managers. Now not is high down management is seen as fascinating.

Given these developments, the next sections current the problems influencing the nursing scarcity and describe potential options together with efforts underway for addressing the scarcity.

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Nursing Degrees: The Hospital-Based Nursing Diploma (RN)

Persons who wish to become registered nurses in the US have four prelicensure academic options from which to choose: diploma nursing programs, associate's degree programs, baccalaureate degree programs, or entry-level master's degree programs. This piece will explore the diploma nursing program, which is the only type of non-degree program remaining in the US that results in professional licensure as an RN.

A registered nurse (RN) is a multifaceted healthcare professional who has satisfactorily completed a nursing program and obtained occupational licensing to render care to patients across the life span. The RN has a myriad of responsibilities including collaboration, health promotion, patient advocacy, disease prevention, client and family education, and formulation of the plan of care.

RNs who provide bedside care complete assessments, monitoring, documentation, reporting of changes in condition, interventions, procedural skills, medication administration, treatments, education, discharge instructions, and continual evaluation of progress toward goals. RNs can be found working in various healthcare settings such as acute care hospitals, extended care facilities, hospice, home health, private duty, psychiatric hospitals, clinics, doctors offices, occupational health sites, birthing centers and virtually any place where nursing care is needed.

On the other hand, RNs who do not work in direct patient care can be employed as hospital/unit educators, professors, clinical instructors, case managers, unit managers, directors of nursing, chief nursing officers, staff development coordinators, researchers, state surveyors, infection control clinicians, and a whole host of other non-bedside positions. Non-healthcare workplace settings that utilize RNs include schools, laboratories, insurance companies, jails, prisons, private homes, military deployments, office parks, research centers and an entire multitude of other locations.

People who are interested in becoming RNs in the United States have four educational options from which to select. Students may choose to apply to a diploma nursing program, an associate's degree program, a baccalaureate degree program, or an entry-level master's degree program. Graduates of all four types of prelicensure programs must achieve a passing score on the same national exam to obtain nursing licensure. This piece will discuss the diploma nursing program, which is the only type of non-degree program remaining in the US that leads to licensing as an RN.

The three-year hospital-based diploma nursing program is the oldest kind of prelicensure training in existence today, dating back to the 19th century. The typical diploma program lasts anywhere from two to three years in length, is conducted in a hospital school of nursing, allows students to amass a very high proportion of clinical hours compared to other types of training, and results in conferral of a diploma upon satisfactory completion. Keep in mind that the number of diploma nursing programs has been diminishing gradually over the past few decades; as a matter of fact, they now make up less than 10 percent of all prelicensure nursing programs in the US. This is because nursing education and training has largely moved away from the hospital setting and into the college setting.

Nursing programs that lead to the diploma normally consist of curriculum that includes a blend of classroom theory and hands-on clinical practicum to adequately educate and train minimally competent, generalist nurses for all types of healthcare settings. The coursework usually includes subjects such as:

* Hands-On Clinical Practicum
* Medical-Surgical Nursing (Adult / Pediatric)
* Psychiatric / Mental Health Nursing
* Pediatric Nursing
* Pharmacology
* Nursing Fundamentals
* Geriatric Nursing
* Maternal Health / Obstetric Nursing
* Pathophysiology

Most modern-day hospital-based diploma nursing programs have articulation agreements with nearby colleges and universities to promote seamless transfer of credits and facilitation of admissions to degree completion programs.

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Nurses Continue to Experience Discrimination in the Workplace - When to Seek Legal Help

Nurses play an important role in delivering healthcare to patients. It is the nurse who tends to a patient first before seeing a doctor. It is the nurse who answers many of the questions for you and your loved ones. It is the nurse who assists a doctor in surgery or non-invasive procedures. Simply put, we need nurses to have a functioning healthcare system. Nurses must also be able to work in an environment free from discrimination, as they will not be able to do their jobs as best they can if they are constantly confronted with workplace discrimination.

Types of Discrimination Nurses Continue to Face 

Discrimination is widespread throughout society, but nurses tend to experience particular discrimination that may not be as prevalent in other professions. Many nurses have reported the following types of discrimination in the workplace:
• Race – Even though we have come a long way, racial discrimination is still a big problem. Many nurses do not receive pay raises or promotions due to their race. Many nurses are not receiving equal pay because of their race.
• Age - It is important to understand that The Age Discrimination in Employment Act (ADEA) prohibits discrimination against people who are 40 years old or older.
• Gender – Many people are accustomed to seeing female nurses more so than male nurses. Both female and male nurses may experience discrimination based on their gender, but because there are more female nurses than male nurses, some male nurses experience discrimination for simply being a male nurse, taking the position that only females should be nurses.
• Sexual Orientation – While sexual orientation should never be an issue in the workplace, many nurses suffer from discrimination and harassment for having certain lifestyle choices that have absolutely nothing to do with their jobs as nurses, including marital or partnership status. It is illegal in New York to discriminate against a person in compensation, conditions or privileges of employment because of their marital status or because of a domestic partnership.
• Religious discrimination - Unfortunately, nurses have also reporting religious discrimination, which is when a person is being treated unfavorably because of his or her religious beliefs. The law protects not only people who belong to traditional, organized religions, but also others who have other sincerely held religious, ethical or moral beliefs.
• Demeaning Behavior – In addition to being discriminated against for race, gender, and sexual and religious discrimination, nurses may generally be seen as submissive assistants who have no other purpose aside from following a doctor’s orders or instructions. This prevents or at least minimizes a nurse’s ability to have a leadership role in the workplace.

There are countless ways in which nurses may suffer from workplace discrimination. Acts of discrimination against nurses may be both isolated and systematic, meaning that discrimination can be widespread. Systemic discrimination against nurses has made it difficult for the profession to evolve. As such, there is a lot of work that still needs to be done to change the culture of nursing and to promote a healthy and safe workplace environment.

How an Attorney Can Help 

Workplace discrimination can make it very difficult for you to do the job you love. A lawyer can help with your employment law claim. If you or someone you know has suffered from any form of harassment or discrimination while on the job, do not hesitate to speak with a legal professional as soon as possible. An experienced attorney will be able to review your situation, determine if your rights have been violated, and provide you with the guidance you need to make an informed decision moving forward.

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Coping up after Job Rejection

I am an international graduate that migrated in US way back 2012 and I've always been dreaming of continuing my dreams and be able to practice nursing again. I've been thru a lot of rejection in the past. But yesterday was the most painful one.

I am writing so I can put all my emotions in here and help myself from falling apart.

It's been 5 years since the last time I practiced in the nursing field. It wasn't my choice to stop and be away from field for that long. being an international graduate, there was a lot of obstacles before I was finally able to take my NCLEX. and so last year, I was able to pass my NCLEX for LVN in California and my NCLEX-RN for New York.

I am a big dreamer so I decided to give it a try in leaving California and go to New York to be able to practice as a Registered Nurse. I was full of hope and very grateful when a hospital in upstate New York accepted me and gave me an offer.

I left my job as a school nurse, wellness nurse and caregiving job in order to move to New York and give it a shot in this hospital. I was ready and I prepared myself in staying for over 3 years even if I get a smaller Salary. I signed for a 3 year contract for an apartment as I planned of enhancing my skills in that hospital and get into a specialty. I gave up my relationship, I invested money and time and so last month, started to work and get into the orientation phase.

I was very much overwhelmed. New environment, New people, New machineries. I thought I was doing very well in adapting this new environment until last week I received a call saying that I don't have to work on the coming weekend and I will have a meeting instead on a Monday. I was nervous. I was thinking though that maybe they would want me off orientation phase already. But then that Monday, they said that it was my last day at work already and they decided that maybe I should try to work to a less acute area first. I asked if I did something wrong but they said, I just needed to enhance my skills a little more and be back in the hospital after a year and they let me signed an involuntary termination papers.

I shattered in tears. I feel broke and helpless. My dreams and goals got all ruined. I walked for 5 miles while crying not knowing where to go. I am like a butterfly that's all starting to fly then suddenly somebody cut my wings and I can't move.

a lot of things come to mind specially on how to pay my bills. I am in a place that I'm not familiar. I have no car and there's not much option or place for me to apply that is close to the area. I spend my day crying and not eating, I can't move my body. I do not know what to do.

Then this morning I opened up my face book and saw an article about how Albert Einstein even got rejected. I got inspired by it and read inspirational quotes. I start moving again and decided to walk about 8 miles and drop a resume to a nursing home. I cannot even call a taxi as I was saving my remaining money. Tomorrow I will walk again to another nursing home and I needed all your prayers for me to be able to make it and get accepted to a new job opportunity.

My self-esteem has been lowered and I'm afraid that these nursing homes would not accept me as I was rejected by the hospital. I'm afraid that no one will trust me and so I needed words of encouragement from all of you wonderful nurses! I needed your prayers and I need to put back my self myself confidence and believe that I can survive all of these and show the world how capable I am in becoming a good Nurse!

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Collaboration: The key to healthcare transformation

Transforming health care is a complex challenge that can best be met through a coordinated response from academia and clinical practice. Working together, chief nursing officers (CNOs) and academic leaders ensure that clinicians are prepared to provide high-quality patient care and influence the systems where they practice.

To better understand how academic nursing can drive change, the American Association of Colleges of Nursing (AACN) commissioned a study on how to maximize nursing’s role as a catalyst for transforming health care and improving health. The genesis of this report, released in March, came from nursing school deans whose programs are located in academic health centers (AHCs)—large teaching institutions that comprise a nursing school, a medical school, another health profession school, and an affiliated health system. These nurse leaders began a robust dialogue on how to optimize nursing’s contribution to improving patient care while positioning nursing schools to thrive and achieve long-term sustainability.

The resulting report, Advancing Healthcare Transformation: A New Era for Academic Nursing, identifies best practices and effective models for fully integrating nursing schools into the operation of AHCs and other collaborating health systems. Prepared in collaboration with Manatt Health, the report provides recommendations to key decision makers and guidance to schools on how to fully realize their missions. Although AHCs were the initial focus of this work, lessons learned from this study can be applied to all nursing schools with baccalaureate and higher-degree nursing programs seeking to maximize their contribution to serving the public good.

Recommendations for CNOs

Threaded throughout the report is the theme that durable change can’t occur without buy-in from all stakeholders connected to AHCs, including top university officials, nursing and medical school deans, and practice leaders. The authors recognize the critical role that CNOs and health-system chief executive officers (CEOs) must play in reorganizing the health enterprise to better leverage the contribution of academic nursing. CEOs and CNOs are responsible for all clinical nursing services and the broader AHC operation, and health systems have needs and challenges that nursing may help meet and solve. Health-system leaders can promote development of the right organizational mechanisms to link academic nursing faculty and leaders into the operations of the health system in a way that allows them to contribute to innovative solutions. Also, academic leaders can promote the participation of CNOs and practice representatives into the nursing school’s structure and governance. Thus,academia informs practice, and practice informs academia.

Advancing Healthcare Transformation makes five specific recommendations for top health-system executives, highlighting academic nursing’s involvement in governance, clinical decision making, workforce development, team research, and revenue sharing. The specific recommendations below can help CNOs and other executives forge a new partnership model with academic nursing, with examples of how this new level of collaboration can be operationalized.

1. Establish participation for academic nursing on governing bodies and within health-system leadership by appointing nursing school leaders to key governing boards and committees.

According to a Manatt Health survey, only 29% of nursing school deans and 10% of associate deans serve on the governing body of a collaborating health system. Health-system executives acknowledge that nursing deans and faculty are underrepresented in major leadership roles and sometimes aren’t involved in health-system strategic initiatives. Clearly, nursing needs a seat at the table to enhance its role in driving change. Systems that do engage academic nursing leaders at the highest levels find this integration enhances AHC operation.

Example: At the University of Rochester (Rochester, New York), the nursing school dean serves as vice president of the medical center, sitting at the senior leadership table with the hospital CEO, chief operating officer, and chief medical officer for faculty practice. The dean also sits on the medical center executive team and the nursing practice executive council. This structure allows the collaborative thinking, planning, development, and evaluation of initiatives that support and enhance the functioning of the larger healthcare system.

2. Integrate the nursing school into applied programs for clinical innovation where possible, with appropriate financial support to sponsor services provided by nursing faculty and leaders.

Too often, nursing schools aren’t fully integrated into the clinical and research operations of affiliated health systems. When nursing schools work independently, the contributions they can make to the larger healthcare enterprise are minimized, resources are exhausted, and opportunities can be missed. In contrast, when nursing schools are more fully integrated into the AHC, an environment of enhanced collaboration and shared innovation often results.

Example: At Rush University Medical Center (Chicago, Illinois), faculty from the college of nursing operate within a teacher-practitioner model and are responsible for leading multiple aspects of both the college’s and the medical center’s missions. The unit-based teacher-practitioner typically is a jointly funded role that oversees clinical experiences for nursing students while filling a significant service-based role in the medical center, which includes providing consultation, patient care, and quality improvement.

Example: In terms of research coordination, Penn Medicine at the University of Pennsylvania (Philadelphia) funds a director of nursing research and science position tasked with leading nursing research activities within the Hospital of the University of Pennsylvania. This position reports directly to the CNO and chairs a shared governance research core, which is charged with advancing a culture of scholarship and inquiry as well as developing strategies to integrate with the nursing school.

3. Enhance academic nursing’s role in primary care and community clinic network development and workforce preparation.

Nurse-managed clinics are flourishing nationwide in response to the growing demand for primary care services. These settings are important for preparing future nurses, as they give students opportunities to dispense an array of community-based outpatient services. Although a Manatt Health survey found that 51% of nursing schools within AHCs run nurse-managed clinics, many of these clinics were small in scale and, in some cases, were limited to narrow populations, such as employees and students. To fully address community needs and maximize academic nursing’s mission related to workforce development, leaders from education and practice need to partner to promote more widespread adoption of nurse-managed clinics.

Example: The University of Colorado College of Nursing operates a completely nurse-staffed clinic under the name Healthcare Partners at Belleview. The clinic provides mostly preventive and primary care services as well as basic laboratory services and some in-office procedures. It accepts insurance but also charges a monthly flat fee for access to all services, with no additional copays or cost-sharing requirements for patients.

4. Advance programs for enhancing nursing professional billing within developing practice models that combine academic- and community-based clinicians in a growing, distributed network model.

For organizations where the health system and nursing school are willing to collaborate in providing community- based services, the AACN-Manatt report exploring shared efforts to achieve desired clinical and financial results. These efforts may include:

• health system contracting with the school to provide care-coordination services
• nursing faculty participating as clinical leaders in accountable care organization (ACO) efforts
• participating in shared savings efforts
• collaborating on staffing the ACO’s primary care clinics with advanced practice registered nurses (APRNs)
• contracting directly with nursing faculty for service provision.

Example: The nursing school at the University of Texas Health Science Center at San Antonio has developed a faculty practice plan that leverages the strong relationships formed with the school’s affiliated health system. The plan focuses on providing care for the underserved and runs several clinics in partnership with community agencies. In addition to collaborating with the medical school for billing support for services, the plan has secured funding from other sources, such as foundations and community-based projects focused on Medicaid beneficiaries.

5. Promote efforts of academic nursing faculty to meet certification requirements for clinical practice through the health system by way of providing expanded positions for clinical faculty.

Because clinical nursing faculty must maintain their certifications, health systems seeking greater integration with academic nursing can provide clinical settings and compensation models that allow faculty to meet this need. Currently, only about one-third of faculty maintain clinical certifications via practice within an affiliated health system. CNOs seeking to promote this link can pursue joint faculty appointments and integration of nursing faculty into established practices (such as internal medicine, family medicine, and pediatrics) to expand capacity and create new opportunities for team-based practice and research.

Example: Academic and practice leaders at the University of Virginia (Charlottesville) have developed a joint appointment model to support collaboration and integration between the full-time faculty of the nursing school and the health system. One faculty member serves as associate dean for strategic partnership and innovation and holds a joint appointment, which is supported 20% financially by the health system. In that capacity, the associate dean works with the palliative care service and assists clinicians and students to foster quality patient care, education, and research. Many of these joint appointments have been a critical element of the university’s collaborative model, which provides an avenue for faculty to maintain strong clinical skills while meeting certification requirements.

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Why I Chose Nursing

Why I choose nursing is a question I get asked quite often and here I explain why. It took me longer than some to figure out my career choice and I finally found my calling. No matter what, I will always choose nursing.

I am sure every nurse and nursing student can assume the question I am about to answer. “Why nursing?” is a question we get asked quite often, and for a while, it was a question I really had to think about how to answer. There are so many ways you can answer this question, and whenever I am asked it, I try to think about the reason that makes me so passionate about this healthcare profession.

The nursing profession is all-around incredible. From the science and research aspect of the field to holding someone’s hand at their bedside, there is nothing about this career that does not leave me fascinated. You never know what is going to come through the door every day because there is always something new. There are tons of specialties you can explore, too. Nursing is always in high demand and you are pretty much guaranteed job security. You can find a job anywhere you go, and the salary is pretty decent; however, nursing is much more than wearing cool scrubs, using a stethoscope, and receiving great pay. Here is the answer to the question I am dying to answer.

I was not following the footsteps of someone, but rather came to the realization that nursing would be the perfect profession for me. I did not choose nursing because of the salary or because “it is easy.” I did not choose nursing because pre-med is too hard, because in reality, I could be a doctor if I really wanted to be. Nursing is a difficult program and profession, too. There will be days that leave nurses drained, exhausted and broken, but there are also days that leave nurses joyful, excited and proud of their patients and work. So, what exactly drew me into this career?

Nursing is about having the innate desire to want to help other people in a time of need. I choose nursing because I want to dedicate my life to helping people. I love working hard to make a difference, and what better way to do it than to help people who truly need it? When your hard work is paying off in such a rewarding way, it is the most amazing, selfless experience you will ever get. It is a privilege and honor to know that I will have the power to heal someone and be by their side helping them through their vulnerable moments. Nurses have such an intimate relationship with their patients and this interaction is absolutely beautiful and inspiring at times. There is much joy to be derived from making a patient smile after helping them get through difficult times and experiences in their life. You are not only helping the patients, but you are also helping their family and friends. It is important to help the people that care about your patient because they are confused and worried too. Sometimes it is even harder for them. Nurses have such a huge impact on the lives of other people. Our patients and their families rely on us way more than we think. I am ready to make a difference. By being compassionate and helping others in need, we can learn to pay it forward.

I want to help light up someone's life when everything might seem dark. Nursing is not just a job; it is a career that allows you to meet people who need you. I am in love with this profession, and when I realized that, I knew I had found my calling. I could not imagine my life any other way, and no matter what, I will always choose nursing.

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Nothing Like a Nurse Navigator!

“So it’s cancer,” my friend said, telling me the sad news about her recent breast biopsy. “They have been watching this nodule for a little while and it just exploded. The Nurse Navigator just called to set up my PET scan and some blood work before I go to the oncologist next week. She really encouraged me because she had such a ‘can do’ attitude and she helped me feel more in control.”

We talked a while longer and then we hung up. As I put down my cell, I felt a mixture of shock, resolve and gratitude for this person, a Nurse Navigator, who could somehow help during this difficult time. Though my friend lives in another town, I began to want to learn more about our Nurse Navigator and just what the job entails.

Nurse Navigators are becoming more plentiful as our health system shifts from one of inpatient, hospital-based care to a focus on preempting troubling symptoms and managing both complications and treatment on an outpatient basis.

In order to find out more about the Nurse Navigator role, I talked with...Sherri Lawson, RN, BSN, OCN. She graduated from nursing school back in the 80’s and has had a career centered on oncology, starting out an an aide, then an LPN, and going on to serve as a floor nurse, a nurse manager, a resource nurse. While working as a resource nurse Sherri did community outreach, cancer prevention initiatives and cancer education. As the Nurse Navigator Coordinator, she currently is in charge of five other professional nurses who serve in this capacity in two different hospitals.

What population do you serve? 

We work with all the patients who have a medical oncologist referral and we oversee the care of all oncology patients, watching for signs of complications. When a patient first receives their diagnosis, we are often right there, in the room. After the doctor leaves, we answer questions and schedule PET scans, Ports, Chemo Education, follow-up appointments.

Nurse Navigators’ positions developed in response to a need. Patients were getting lost in the system and showing up for their first oncology appointments without the necessary tests, so time was wasted. We want to make sure that treatment begins as soon as is possible, given the patient’s condition. It is our role to keep track of people, to stay connected with them, to help coordinate their care and to take some of the burden of worry away. We also become a person that they can call if trouble arises.

How long have Nurse Navigators been around?

It is a fairly new field in our area, with the first positions starting in the 1990’s. I was the first one and had to work out my own job description. Now we have Nurse Navigators for lung cancer, breast cancer and for lung nodule follow up. There may be more positions opening as the focus on outpatient-centered care continues. We see it as our job to do excellent work in planning ahead, symptom management and appropriate referrals. At times we also serve as informal counselors when patients need to talk and get answers to questions that we are qualified to help with.

What is your favorite part and your least favorite part of being a Nurse Navigator?

Without a doubt, the patients are my favorite part. It is good to feel that they know they have a contact person for questions or concerns. It’s like throwing them a lifeline.

The most challenging part is the sheer volume, trying to accomplish all that needs to be done. In an average day, we have contact with about 20 patients per day and make 30-40 phone calls. The Nurse Navigators generally attend the initial diagnosis-sharing physician visit and help answer immediate questions about what comes next. These appointments vary in duration but can take two hours or more. It is hard to do everything and maintain that high level of excellence that we know our patients deserve.

If you wanted to be a Nurse Navigator, how would you prepare?

In our area, the Nurse Navigators are RNs and have experience in oncology. They also tend to be independent workers, self-starters and people who are truly committed to quality care. Being able to work well with the medical staff, office staff and ancillary providers is also key. My long term experience in this hospital system is a definite asset and helps makes me more effective. But the most important part of being a great Nurse Navigator is doing it with heart and soul, having true compassion for the patients.

Like most nursing jobs, the role of the Nurse Navigator varies from hospital to hospital and area to area. This is a snap shot of one Nurse Navigator’s job, her training and some of what she does day-to-day. You may have a much different experience based on your location and the system you work for. I hope you will feel free to share variations on the role in your responses.

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I survived the Board of Nursing

Where do I begin? I have been following this site for years and it has been a source of both comfort and anxiety. I have been a nurse for over 30 years. I was working as a Nursing Director for a non-profit organization supporting adults with intellectual disabilities. I had worked there for several years but the stress was taking its toll, so I decided to move on to something less stressful. A full two months after I left, I received a letter from the board of nursing stating that there was a complaint against my license.

I was almost physically sick as I read page after page of allegations of neglect, poor judgment, failure to follow nursing standards –the list went on. To be honest I could not believe what I was reading, much less begin to understand where all this was coming from. Many of the complaints were about areas that I was not even responsible for. The letter gave me 10 days to respond to the allegations. My first instinct was to get a lawyer; I let my husband talk me out of it. He was convinced, as I was, that I simply had to respond to the allegations and they would go away. HOW WRONG I WAS!! Foolishly I thought that if I simply explained what really happened the situation would be resolved.

I submitted my carefully crafted response and waited for the board to exonerate me. After four months with no response, I contacted the board to find out what the status of the complaint was. After some transfers, I was informed by the board’s lawyer that they were moving forward with disciplinary action. I did not know what to say or do – I was in complete shock. I managed to ask what recourse I would have, I was told that I would be able to request a settlement hearing once I was formally notified of my charges. I immediately contacted a lawyer. BEST MOVE I MADE. She carefully reviewed the information and submitted a letter to the board that all further communication was to come through her. I then sat and waited for nine long months for the formal charges. I prayed, worried, stressed, and cried my way through those months. If it had not have been for the support of my husband I would not have made it through the whole ordeal.

Finally, I received an email outlining the charges – all eleven of them. I was devastated, but once I got myself together I sat down and carefully read them. Charge, after charge I had clear evidence to refute. I contacted my lawyer who had already requested a settlement hearing. I went over the charges and my evidence to refute the charges. She spent two days carefully crafting a response to each allegation and attaching supporting evidence.

The settlement hearing came a month later – I can’t explain how I felt looking into the faces of the board members and explaining complaint after complaint. I was an exemplary nurse, who had never had a bad report or performance evaluation and here I was practically begging for my license.

The board had not conducted ANY type of investigation, had not contacted my former employer, requested records, or interviewed me –NOTHING! It took all of 30 minutes and I was dismissed to wait for their decision.

Later that afternoon, I got the best phone call from my lawyer, all charges were dropped – case closed. That’s it – it was finally over. Needless to say this has left a bad taste in my mouth. The board could just as easily have taken my livelihood away from me without doing their due diligence. Looking back I am so disappointed in an entity that supposedly is in place to protect the public yet failed to conduct a proper investigation on allegations that turned out be completely false.

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