(10) The pay. Yes, nursing is a job, and yes, I do appreciate the income I receive for working hard. The latest statistics on the Internet state that after around five years, nurses make a median income of about $55,000/year. For me that means that my initial investment of 3 years time in nursing school and about $12,000 tuition has resulted in a pretty nice return.

(9) Job security. Despite the arguments for and against the reality of a nursing shortage, my recent job search exemplifies what I believe: that nurses are in high demand. Searching for a job in a bad economy showed me that even a nurse with an associate degree and less than two years experience can get a job across the country (after multiple offers) sight unseen! The reality is that experienced nurses seem to be a hot commodity in any economy.

(8) Continual learning. It amazes me that no matter if I am on the job or working on an advanced degree, the amount of knowledge I gain in my vocation is truly limitless. If anything, my brain has too much info to absorb! And isn’t continued, lifetime learning a key to staying young…at mind?

(7) The wardrobe. I had a classmate say at graduation—in front of an auditorium full of people: “I know you are all jealous that I get to wear my pajamas to work.” Seriously, could scrubs be more comfortable?

(6) The hours. There aren’t many professions with such flexible hours—from the 8 hour shifts, the 3 or 5 days a week shifts, PRN shifts, 12 hour shifts day or night, office hours, etc.—we nurses have a lot to choose from which makes our lives outside work that much more manageable.

(5) The benefits. As a fulltime nurse, I get great benefits for little out of pocket pay. In this healthcare climate…enough said! (And probably a great topic for another blog!)

(4) The pens! As someone who is a penophile (look it up in the urban dictionary) I have a honest-to-goodness excuse for my love affair with all things that write. Most nurses will protect their pen as vehemently as they protect their stethoscopes—and yes, sometimes their patients. (And dare I say docs pose a threat to at least two of the aforementioned? *wink*)

(3) The people. Specifically, the people I work with are amazing. All kidding aside, working with good doctors is a wonderful collaboration most of the time—and the team of nurses I work with makes my job doable AND enjoyable.

(2) My patients. Yes, the reason I work is ultimately all about serving my patients. If all of the above stuff disappeared, I would still work hard to serve my patients. Without them I wouldn’t have a job, a vocation, or a profession I am growing to love.

(1) Me, the nurse. At the top of the list is who I have become because of nursing. I have learned organization, discipline, deepened my beliefs, held new life in my hands and held the hands of women who have experienced tragedy. I am a changed person—for the better, I believe—because I am a nurse. I thank God every day for this opportunity I have been given. I am a nurse.

Here is a fun list of my favorite nursing-related comments and the tongue-in-cheek comebacks I have managed to bite back in order to remain professional. Yes, some things are better left unsaid:

My top 10 responses to annoying patients

10. “Those scrubs make you look fat.”

Comeback: “You’re just jealous that I get to work in something akin to my pajamas!”

9. “All nurses are overpaid, fat and lazy.” (Yes, had a patient say this to me once. Then she gave me a “thank-you” gift.)

Comeback: “This fat, overpaid, lazy nurse just saved you and your baby’s life.”

8. “The floor is so quiet and peaceful!” (Especially irritating when yelled at 3AM by a newly admitted patient to a full floor.)

Comeback: “I have Micropore tape and I’m not afraid to use it!”

7. Patient states, “The nurses just hang out at the nurses station and play on their computers.”

Comeback: “If 14 hours of continuous charting, about you, on the computer amounts to play, I’d like to know what you think work is?”

6. “It must be so cool to work in an environment like  _____.” (Insert TV shows like House, ER, Grey’s Anatomy, Scrubs, etc.)

Comeback: “No, what would be really cool is if there was a TV show that showed the reality of nursing minus the soap opera–’cuz it ain’t sexy.”

5. “The doctors are so cute! Is it true they only date nurses?”

Comeback: “The doctors don’t look so cute at 2AM when they are disheveled, covered in blood and screaming at the nurses. Just sayin’.”

4. After getting a patient something to drink or eat; “Wow, you are just like a waitress.” Or even better, “This place is just like a hotel!”

Comeback: “A waitress in a hotel wouldn’t put up with your crap. Literally.”

3. “It must be so nice only working three days a week.”

Comeback: “It must be so nice not to be burned out due to sleep deprivation and stress.”

2. “#$@% ^&^ %**&^!!!!!” (insert expletives, possibly in combination with rude hand gestures)

Comeback: “#$@% ^&^ %**&^!!!!!” (insert expletives, possibly in combination with rude hand gestures)

1. And lastly, the ultimate “compliment”:”You are so good, you should have become a doctor!”

Comeback: “Honey, you couldn’t pay me to become a doctor!”

Runner up: “We all ordered out but forgot to ask you because you looked so busy!”

This one never warrants a comeback–just payback for next time!

Jupiterimages | Photos.com | Getty Images

Here are some ways to really tick off your fellow nurses.

I’d suggest entering into the following bad behaviors at your own risk!

20 bad behaviors that will tick off your coworkers!

1. Order out for a meal but don’t ask anyone if they want anything (and/or taking a trip to the vending machine without notice)

2. Add your two cents about everything without being asked

3. Sit on your butt the entire shift when everyone else is running around working like dogs

4. OR, better yet, sleep at the nurses station when everyone else is overwhelmed

5. Put your bare hands in the snacks at the nurses station—especially if you haven’t washed them

6. Use the Q word because you hate it when things are the S word

7. Complain that you “always get the worst assignments”

8. Leave stuff for the next shift to do when you really did have time to do it

9. Give only half the story in report

10. Forget to wear deodorant and neglect to wash your uniform

And what about calling in sick? See the final ten behaviors…

Image Source Photography | Veer

The other night my husband told me that he has a new dream for our lives: that I would get a day job.

I had to laugh a little, because as we nurses know, switching from days to NOC or vice versa is a difficult task. Having all the pros on the night shift in mind (it works well with my kid’s schedule, the money is better, I love my night team and the night environ), I also had to sit back and count the cost of nights at my husband’s urging.

A coworker told me recently, “So what if NOC takes seven years off my life–working with the day crew would probably take off ten!” I laughed and laughed, but the fact remains: NOC is really hard on the body. Scientific research aside, I can personally attest to the fact that nights has completely jacked up my sleep cycles (I take Unisom with a vengence).

Another issue I can attribute to working the night shift are my weird midnight eating habits, which I am convinced has messed up my metabolism. And dieting is almost impossible for me: if the schedule doesn’t throw me off, the stress does! I wonder if statistically speaking, night nurses are fatter than day nurses? Hm?

And then there are my emotions: only nurses who work three and four night stretches know how crazy they can feel after such a run. I usually have a crying jag when I try to turn myself around, and am somewhat irrational, plus I laze around in my PJs and have trouble feeling really awake on my days off! And just when I get turned around and feel human again, I have to go right back to a night regimen.

The solution is to switch to a day job. Yeah, not so easy! Day jobs are the last to open up–and working days brings with it its own nightmares (think waking at 5AM, morning traffic, management on the floor, and visiting hours with consequent family members everywhere).

So yeah, my body is feeling it and is telling me to do something. In the next year I see myself making the change and going to days.

Would you ever make the big switch?

Photos.com | Thinkstock

For nurses, being thankful is a state of being. We spend our time at work and away from work thinking on how fortunate we are to be “ok.” Here are my top ten reasons to be extra-thankful at this time of year when the Thanksgiving holiday is on my mind:

I am so thankful I have a paying job. Looking at the economy, both nationwide and within my own healthcare system, I’m thankful to be able to punch in when so many people can’t claim a paycheck.

I am thankful for my patients. Constantly I am educated and humbled by them. I meet some amazing people and am so happy to care for them.

I am thankful for my co-workers. My team and how well we work together is crucial to my success as a nurse.

I am thankful for my specialty. I am one of those nurses who got a job right away in the area of nursing I love. I have friends who are “stuck” in a job they hate in healthcare and that is a really hard path. It makes our already difficult profession almost impossible to bear! I love what I do, which is a huge reason to give thanks.

I am thankful to be alive. Life is so much more precious to those of us who see people losing it while we are “just at work.” Nursing has taught me to cherish not only my life, but all the lives around me.

I am thankful for my able body. How often have I seen nurses injured on the job or because of the job which makes it impossible for them to work? Thank God I am healthy right now!

I am thankful for health insurance. Part of being a nurse is having good benefits, and in our world today, that means a lot! With the healthcare crisis looming and my own encounters with patients that don’t have the luxury of health insurance, I am frequently reminded of how valuable being able to obtain healthcare for myself and my family is.

I am thankful for my faith. I believe that not only do nurses need faith, nursing builds our faith. Thank God for prayer–it gets me through every shift.

I am thankful for my education. If I hadn’t made it through nursing school, I wouldn’t be here today! I am so thankful for the people and the school that provided my good foundation in nursing. I use their wisdom every shift. And every time I pay my student loan I am reminded of just how valuable my education is to me and my loved ones.

I am thankful for comfortable shoes. It may seems like a small thing, but only other healthcare professionals know what I mean when I say, “God bless supportive shoes.”

I am thankful for all the people in my life who love me. They put up with a lot. ‘Nuff said.

iStockphoto + Scrubs

How do you know when your innocent passing of seemingly harmless information about others is gossip? I have been thinking about that a lot as of late. Here’s why: we have recently had some pretty malicious gossip that has severely impacted some of my coworkers’ lives. I am bothered by it!

So what is gossip? I love how Wikipedia defines it, “Gossip is idle talk or rumour, especially about the personal or private affairs of others. It is one of the oldest and most common means of sharing facts and views, but also has a reputation for the introduction of errors and variations into the information transmitted.”

I think what’s so difficult about gossip it that it interests us so much—no matter if it is about a celebrity you don’t know or your co-worker whom you know too well. We all want to know what’s happening, right? I’m as curious as the next person!

When we haven’t worked with someone in a while, it seems kinda natural to ask, “How is so-and-so doing?” That always seems to come with a genuine level of concern. But it’s when we start taking other peoples private affairs—their financial situations, their relationships with others, their home lives—and start digging into them and dissecting them that we have a problem. When someone starts a conversation with, “have you heard…” I immediately brace myself for gossip and prepare my avoidance.

Speculation on what other people are doing or how they are doing is always dangerous. For example, you know that Nurse A has been hanging around an awful lot with Radiologist B. Talk on the floor is that they are friends, maybe more. Everyone is talking about it—constantly. And when Nurse A is gone from the nurses station, and Radiologist B also can’t be found, someone guesses that they are together. Before you know it, in the minds of everyone, these two people are having some sort of intimate relationship. And things snowball from there. Jobs are lost, people are hurt, friendships are damaged. Seen that happen? I have, and it stinks.

So how do YOU not get caught in the gossip snowball? I can share what’s worked for me:

1) I just don’t even ask. If I want to know how someone is doing, or what is going on with a situation, I talk directly to the person involved.
2) I never repeat gossip. I will state facts if asked—and I am not in the confidence of someone—but unproved gossip goes in one ear and stays there.
3) I ask that others stop gossiping around me or I remove myself from the situation. Really, I DO NOT want to know.
4) I confront people if there is gossip going around about them. I would want to know so I could correct things—especially if it is threatening my job.

Gossip has little place in the workplace—it is damaging and takes our attention off the patient. I’m working harder than ever to eradicate my participation in this harmful practice–look, I don’t like how I feel when I gossip or particpate in gossip! It’s not easy to stop, but it is the right thing to do.

So, how has gossip impacted you or your nurse team?

iStockphoto

New nurses hit the floor running and panicked, often wondering why they feel like they know NOTHING straight out of school. The reality is, grad nurses really don’t know it all. What a let-down for them, huh?

I’ve been out of nursing school 3.5 years now and it has come to my attention that not only did nursing school minimally prepare me for this job, I don’t think there was a way ANY school could have prepared me for nursing. So, here are MY top 10 things they didn’t teach me in nursing school:

1. How nursing will change you. My instructors failed to convey that becoming a nurse would change me in every way: nursing is not just a job because it becomes a part of our personality. That’s hard to explain to students. You have to live it.
2. How to give a good report. Then there are the basics like giving report. No, I did not learn how to give a good report because I just “played SBAR” with my instructors and the nurses I was paired with on the floor. It was only as an RN that I learned how to give/take report, use a “brain” and communicate effectively with docs and other members of my team. It was not easy and I got a lot of grief when I gave a crappy report.
3. The truth about nurses eating their young. Nursing school made me wary of experienced nurses and taught me that “nurses eat their young.” I was in no way prepared for the reality: Nurses don’t have time to eat their young. We have time for team work, excellent patient care, and a whole lotta charting. If other nurses can’t keep up, well, the ship is sailing without them.
4. Time management. Charting efficiently, quickly and thoroughly enough and still getting out at the end of the shift was not a skill I learned in NS. That came later with time management–another hard-earned ability that can only be learned in time.
5. Multitasking and prioritizing. These are also things that nurses learn to excel in OUTSIDE of the classroom. Multitasking is easy-peasy when you have one or two patients in clinical. Yet prioritizing is really critical for an RN who has 6 patients all going down the tubes at once.
6. Healthy modes of stress management. I ate my way through nursing school as a means of coping and stress relief because frankly, we were being weeded out and the pressure was enormous. Eating a bag of Doritos relieved stress faster than going to the gym, okay? I admit it! But nurses can’t live that way after they graduate. RNs learn to cope with stress in a healthy way or they get really sick, gain lots of weight, burn-out or worse.
7. How to deal with death. Can you really be prepared for it? No, and it takes a lot of time to learn how to deal with death in a healthy, professional way. They just can’t teach you that in two years of clinicals.
8. How to deal with feelings. Adrenaline is crazy, and there is nothing like being a new nurse and having to act under pressure in serious situations with adrenaline coursing through your veins. In nursing school, our hands would shake, we would laugh it off, make silly mistakes, etc. With practice, RNs act quickly in emergency situations without regard to their personal reactions — physical or emotional.
9. How to deal with doctors. How to communicate with grouchy, mean doctors was not taught in pathophysiology, people! I was prepared for dealing with people on a professional level during daylight hours, who were not stressed out and in life & death situations. I was not ready to deal with docs who hate their jobs, never sleep, and frankly see me as the bane of their existence. Ok, I’m generalizing here, yet the truth remains: I had little contact with REAL docs and was blown out of the water by the working relationships I would form with them.
10. Unexpected friendships. Lastly I was not prepared for the rich relationships and camaraderie I would form with the doctors and nurses I work with and the patients I care for. We nurses are in a business of people: good, bad, beautiful, ugly, functional, dysfunctional, alive and dead. People are our vocation as RNs and nothing is more rewarding than that!

No, nursing school can’t teach students this stuff–we are LIFETIME learners. Nursing school gives us a very basic foundation of knowledge and we build, build, build on that knowledge from the ground up. The rule of thumb is that it takes most RNs about five years to even get somewhat comfortable in their specialty–and then they have to be really careful not to get cocky. The reality is that RNs see it all–but it takes an entire career to do so!

2. May I have my (insert loaned item such as pen, stethoscope, chart) back now?

3. How long will you be sitting at (my) computer and when can I have (my) chair back?

4. Do you believe in hand washing?

5. So, do you REALLY like your job? The nurses? Your patients?

More…

Thomas Northcut | Digital Vision | Thinkstock

There has been a constant source of frustration that has followed me since I have finished orientation and become a NOC nurse: the lack of flexibility and accommodation hospitals make for those of us who work all night.

Case in point: today I had to take a day during the business week to go into the hospital to fulfill yet another requirement. I understand the requirement, but the hospital didn’t even try to accommodate nurses like myself who work nights and weekends. And they very well could have—I’m not being unreasonable. This was something that could easily have been done at night.

While I was at the hospital today for 4 hours (after driving 30 mins both ways) I had another educator leave me a note stating I needed to come in during yet another weekday at 11AM to take a 20 question test “that shouldn’t take up too much of your time.”

“Ok,” I wanted to write back, “so why can’t you leave the test w/ the charge nurse on nights for me to take? Do you realize that by me coming in at 11AM to accommodate you I am in fact coming in during the middle of “my” night? 11AM to you is 11PM to me.”

I’ve made this argument before—to no avail. Day people just don’t get what it’s like to work nights. They call me at 2PM (my 2AM) to ask scheduling questions. Or the really annoying phone call at 5PM on my day off asking if I can come in for that evenings shift after I “take a little nap.” How safe is it to work 13 hours on a one-hour nap? Nope, they don’t get it.

This comes with the territory, I am told. So not only do we work with less staffing even with the same patient load, we miss out on all the daytime events that are perks of the job, we also are never accommodated because days just don’t understand. But hey, that 2-buck-an-hour night differential should make it all better! Right?

Next up—the things I love about working nights!

No, you can’t get an epidural yet–you’re not even in labor!

No, I won’t increase the Pitocin on my patient who has an ugly fetal monitoring strip.

No, I won’t work an extra shift this week.

No, I don’t want to order out for dinner.

No, you can’t have ten visitors in your room at 2 AM.

No, eating Mexican food right before pushing your baby out may not be a good idea.

No, I don’t want more coffee at 0600 (though I really did)!

Interestingly enough, my typical response before becoming a nurse was to agree to EVERYTHING—I just didn’t want to upset anyone. When I first started on the floor as a GN I found myself intimidated by certain people and situations and saying, “yes” when clearly saying no was a safer and better answer.

So how have I learned to disagree in a way that is still professional while still getting the point across? I think saying, “nope” can be done in a pleasant way—with patients I always use humor and that seems to go over well (“I don’t think you want to see that Mexican food again anytime soon so let’s make a better choice for refreshment while pushing!”)

The assertive NO to a fellow nurse or doc can be done with firmness and civility. You just have to mean what you say and stick to it! I work with one nurse who instead of disagreeing will tell the docs frequently “I’m not doing such-and-such: if you want it done, do it yourself!” It’s no wonder the docs ask to work with other nurses—saying no is an art form. The admirable thing about this nurse is that everyone knows she means it when she takes a stance: I wouldn’t mess with her!

Sometimes an angry “NO! Absolutely not!” is needed for patient safety. Co-workers need to know I mean what I say and in an emergent moment, I’m not budging. This has been the hardest lesson in saying “No” because I have to have absolute confidence in my choices at the moment—pretty hard for new nurses!

At times I still get really nervous about telling doctors “No” but I am learning that patient advocacy trumps any emotion I have. I’m getting better at refutation and honestly, my practice is improving because of it! In the end, it is all about context—oh, and learning when to say yes!