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The physician versus the advanced practice nurse…it’s mudslinging at its best these days. I’m reading a lot of bickering, backstabbing, finger pointing, blame placing and fear mongering between these two professional groups.

Are advanced practice nurses (APN) trying to replace physicians? Do APNs think they are equal to physicians?

An APN’s total amount of education and training is approximately 1/4 of a physician’s. If you’re kind enough to factor in the possible number of years of experience as a nurse, you could argue that number up to 1/2, but we’re talking advanced education and training, so years as a bedside nurse probably shouldn’t count.

Or should they?

I recently read an article by an anesthesiologist titled “Mean doctors and nice nurses: It’s time to change our brand.” The article’s introduction talked about how a patient thought her physician must have been a nurse prior to becoming a doctor simply because that physician was “nice.”

Hmm.

Why do patients find nurses “nice” and doctors “mean”? Do the sentiments in that article really mean that nurses market themselves better? Or is it something else?

Let’s be honest here: I have a bit of a biased opinion. I’m a nurse. I’m a nurse who will soon be filling the shoes of an advanced practice nurse. So, yeah, I’m a little biased (I thought I’d openly admit that to clear up any confusion).

Do I think nurses have a higher education or are “above” our physician partners in some way? No.

But I strongly believe that physicians doesn’t know everything, and they could learn a thing or two from our amazing culture of professionals. Here are five reasons we nurses are viewed as “nice” and the physician as “mean”:

We treat the whole person, not just the disease

Everyone loves to proclaim they are treating more than just the disease, but the truth is that nurses look at the entire patient. There is more to illness and the healing process than medications, external interventions and diagnoses. Emotional health and healing takes more than just a new prescription.

We know their name, not just their bed/room number

It’s Mr. or Mrs. Smith, not the lady in room 202. Not the diverticulosis by the door. We all can be overwhelmed with our patient load and patient census, but somehow nurses can figure out how to call a patient by their name.

We use proper personal communication etiquette

Nurses have this amazing ability to speak TO a person, not AT them. We speak with a person, not down at them. My advice? Grab a chair and converse with your patient at eye level. Standing while they lie in bed is just mean.

We make the time, even when we don’t have the time

Nurses are equally overwhelmed and overworked. Do you think we have acquired the Winnebago bladder by accident? We don’t have the time to sit with every one of our patients, either, but somehow we find those few extra minutes. Those 2-5 extra minutes mean the world to your patients.

We tell them what they need to hear, not what they want to hear

I’m not sure why, but nurses are perfectly OK with delivering the tough love that many non-compliant patients need. There is no doubt that we as nurses don’t have the hammer of a lawsuit hovering over us like our physician partners do, but we have to both figure out how to stop enabling those patients who need a good swift kick in the you-know-what.

I personally don’t believe that nurses are nice and doctors are mean. We nurses can’t shake the “doting handmaiden” stereotype, and doctors can’t seem to shake the overbearing mean patriarch image. I think we’re both ready for some change–how about you?

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Happy Nurses Week, everyone! It’s the one time of year where we hopefully get recognized for the grueling, selfless work we do every day. While I’m sure your employer will be planning some much-needed festivities during the week, I think this is a great time for us to do something for ourselves, for each other and for our profession. Here are five great ways to celebrate our week:

1. Recognize the past, but don’t get stuck in it:

Don’t get me wrong, I’m eternally grateful for Flo and her lamp. Without her and her amazing courage, I would not be living my dream today, but we need to step beyond the “traditions” of nursing and courageously take the next step. We need to get outside of our comfort zones and tackle new ground, expand our horizons and be on the forefront of healthcare.

2. Thank every non-nurse you work with:

I’m talking EVERYONE. The security guard, the housekeeper, the food service personnel and beyond. This list is endless. Without them, our jobs would be exponentially more difficult.

3. Thank and recognize a student:

Don’t EVER forget how you got where you are. Always remember the fear you had as a student and as a new nurse. Always remember that suffocating feeling. Remember it and share in it with those who are experiencing it. Without their courage, our profession would suffer.

4. Thank and recognize those who are more seasoned than you:

Don’t EVER forget where you are going. Always remember the education, comfort and training you received from those before you. Always remember how good it felt to have a resource. Without their insight, our profession would suffer.

5. Promote our profession:

It’s not enough to just show up for work. It’s not enough to just clock in and out. You are never “just a nurse.” It’s time to help your profession grow and flourish. It’s time the professional in you stepped up to the plate and helped plant a few seeds. Take pride in what we do, and be sure to spread the good word.

This is the one time of year that we should lean into the spotlight. We’ll spend the other 51 weeks out of the year avoiding recognition, because it’s just what we do. For the next several days, be sure to celebrate how great we really are.

Happy Nurses Week!

Image: Peter Dazeley | Digital Vision | Getty Images

In the working world of being a nurse we evolve into our own niche of things. We give and take report a certain way, we have certain ways our patient’s rooms need to look, we carry around a lot of paper, or we have our ‘brain’ attached to a clipboard.

This list of tendencies, habits and preferences is endless. I find there are ‘trends’ depending on where you work, who you work with and just what kind of nursing you are doing.

With all that in mind there are just certain things that are a ‘must’ when riding the nursing roller coaster. There are just some ‘must haves’ when you’re out there doing your ‘thing’. These ‘must have’s make life just a lil easier on you through the course of your day. Once you have them, you don’t know why you never had them in the first place!

Stethoscope

Ok this sounds like a ‘no-brainer’, but I’m talking about a GOOD set of ears. Not they playskool kind, or those darn stethoscopes they try to sell you while you’re a nursing student (those horrible double lumen stethoscopes). How are you to properly care for your patients, if you can’t hear abnormal heart beats, murmurs, or specific adventitious lung sounds?? I will say the type of stethoscope is purely site specific. If you work with Pediatric patients, then by all means make sure you have the correct diaphragm for your work. My advice is to spend the extra money on the higher quality (psst… the name begins with an L), you’ll be thankful later.

Shoes

Once again, you’re probably thinking… seriously? Shoes? You need a GOOD pair of shoes. The kind that fit comfortably, have breathing room, good support and of course can withstand the wear and tear of your daily duties (I found a great pair of ‘walking’ shoes myself). I would caution you with these ‘slider’ type shoes and those highly touted ‘slip-on’ ‘throw them in your dishwasher to clean them’ shoes. While they are great for the simple bodily fluid clean up, they will eventually be murder on your feet, your ankles, your knees, and finally your back. Those type of ‘shoes’ offer no long lasting support for your feet. I don’t know about you, but after a 12 hour shift my back can use all the support it can get.

Writing Utensils

Nurses and their pens. Need I say more? Take a nurse’s pen and see what happens – I dare ya. We hoard our pens because once we find ‘that’ pen that writes nice, doesn’t smear or leak we think we hit a gold mine! Throw in a ‘Fat’ pen with some cushion and there is not turning back! And of course we can’t just have a black pen, we need a red one as well and a permanent marker and possibly a highlighter or two!

Scrubs

This goes without saying. “Heeeello!” Look at the name of our magazine and website?? Heh heh. Once again this is all about comfort and utility. I am a ‘pockets’ person. I love my pockets. I have had a total of 10 pockets on my scrubs at times depending on the style I wear. I use/abuse and utilize them all for one thing or another! I am a plain and boring type scrub wearing fool – solid colors for me. I don’t wear the patterns or cool themes. I’m sounding like a broken record here, but it’s all about the function and utility of the scrubs. Will they withstand the wear and tear, as well as be ‘stain free’ after a good washing. Just because it looks good and is a popular name brand doesn’t mean it will work well.

To go along with this list there are a myriad of other pieces of equipment that I myself ‘need’ and use. I took a couple quick ‘poll’s on Twitter last night and found I wasn’t the only one.

Plus…

I always have a pair of scissors with me. I prefer a nice pair of small bandage scissors (some call them trauma shears). And I always have a pair of clamps / hemostats with me for those unbearable tops and caps that need a lil extra grip. In the end the frills, thrills and prices come down to one thing – functional on the job capacity.

What are your best? What are your ‘must haves’?

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Stepping out of your student nurse shoes is much tougher than your teachers lead you to believe. Upon completion of your nursing program and successfully passing your national certification exam, you would think things might get a littler easier? Nope. Sorry.

Starting that very first nursing job brings a whole new set of challenges. Here are 20 brief tips I think every nurse “noob” should read as they start their nursing journey:

  1. Get used to being scared; it’s your best ally.

  2. Ask more questions than you answer.

  3. Don’t ever fake it. If you don’t know something, tell someone. It’s OK.

  4. You have to earn respect; don’t just expect it.

  5. Avoid all gossip. If you want to gossip, go back to high school.

  6. If you’re not early, you’re late. Timeliness is next to godliness.

  7. Write everything down. You will forget 80 percent of what you hear. (“What you do not keep in your head, you will keep in your feet.”)

  8. When you want to run: Stop, walk and listen. If you hurry, you will make a mistake.

  9. Put your own mask on first. Take care of yourself before you take care of others.

  10. Learn how to say NO to overtime. Learning your job does not require living at your job.

  11. DO NOT rush orientation. Make your mistakes with your preceptor.

  12. It’s OK–in fact, it’s expected–that you make mistakes. Don’t dwell on them; learn from them and don’t repeat them.

  13. Find a mentor. Your mentor may NOT be your preceptor.

  14. Surround yourself with people who love your profession. Don’t let the naysayers ruin it for you.

  15. The grass is NOT greener on the other side. Don’t be too quick to play the job hopscotch game.

  16. Grow a thick set of skin, and do not back down when advocating for your patient.

  17. Become a premiere team player. You cannot and will not survive this job otherwise. Play nice in the sandbox.

  18. Thank all those who help you, including the transporter, the aide, the secretary and the housekeeper. Remember your TEAM.

  19. Never apologize for doing your job…and that includes calling a physician in the middle of the night.

  20. Never stop learning something new, ever. Seek it out. Pursue knowledge and career advancement. Contribute to the growth of our profession.

 Care to add to the list?

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The influx and popularity of technology within the world of healthcare can sometimes overshadow its developing dominance at the bedside. Everything from the electronic health record all the way to real-time point-of-care delivery systems are the wave of the future.

The immediacy, convenience and potential for seamless care cannot be ignored. But is this technology all good? Could the technology be impeding the care nurses give?

The introduction of technology to the bedside is unarguably changing the delivery of care, but is it all progressive?

Not many will argue that the delivery of our care has to change with the changing patient population. Patients are living longer and often beating some of the worst illnesses, and we are faced with new and more virulent strains of illness. So the advancement of technology has better prepared us to keep doing the best job we can.

But is the technology itself creating a new barrier between the nurse and the patient that never existed before? The barrier of impersonal interaction that has cropped up in our social circles may become prevalent at the bedside.

With the advent of social media platforms, we spend less time conversing with real human beings and more time staring at our impersonal and non-human screens of technology. Is the technology at the bedside distancing nurses from their patients? Instead of nurses giving that personal attentive care that includes the power of touch, are nurses resorting to their screens of technology?

Some are of the opinion that newer nurses have welcomed the technology with open arms, because that’s all they have ever known. Newer nurses have never learned to appreciate the potent healing power of the human hand.

Others claim that seasoned nurses are (maybe) threatened or simply overwhelmed by the brute-forced wave of technology. Seasoned nurses just don’t understand how the immediate connectivity and education available at a patient’s fingertips is the true definition of patient advocacy.

So, is technology friend or foe? Why or why not?

Is there a happy medium? Or are we destined to sacrifice the power of touch for the power of the touch screen?

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“Is graduate school difficult?”

A nurse currently completing his bachelor’s degree asked me this question recently. He has an interest in continuing on with his nursing education, and was trying to get a sense of what to expect.

I found the perfect term to sum up my thoughts on graduate school:

Autodidacticism (also autodidactism)

• Self-directed learning that is related to but different from informal learning. In a sense, autodidacticism is “learning on your own” or “by yourself,” and an autodidact is a self-teacher. Autodidacticism is a contemplative, absorptive procession. Some autodidacts spend a great deal of time reviewing the resources of libraries and educational websites. One may become an autodidact at nearly any point in one’s life.
• Autodidactism is only one facet of learning, and is usually, but not necessarily, complemented by learning in formal and informal spaces: from classrooms to other social settings. Many autodidacts seek instruction and guidance from experts, friends, teachers, parents, siblings, and community. Inquiry into autodidacticism has implications for learning theory, educational research, educational philosophy and educational psychology (via Wikipedia).

Nurses are no strangers to self-directed learning. We were gently introduced to this strategy during our entry-level nursing program. Everything from simple math concepts all the way up to assessment skill technique uses the concept of self-directed learning.

In my humble opinion, graduate school takes this concept and magnifies it to the n^th degree [more math for ya...(insert sarcasm)].

You will be required to know a lot about a lot of information in a short amount of time. And I’m not just talking per year or per semester. Each individual class is overwhelmingly heavy. If I had to make a comparison? Take the number of hours spent on a single concept in class and multiply that number by at least 5 and in some cases 10. That is how many hours you will spend figuring it out on your own.

This type of learning strategy has an unfair, unkind learning curve. Some concepts will “click” for you, and others will be like learning a new language.

Now, don’t get me wrong. You still have multiple resources at your fingertips–everything from your course textbooks to picking up the phone and conversing with your adviser or professor. But the take home-message is the same. YOU need to figure it out. Whatever way that happens, you have to keep in mind that NO ONE will be holding your hand. NO ONE will be giving you a “pass” since they know you’re a good student. You earn everything.

Which leads me to another point.

During your entry-level programs, you had a minimal level of understanding to complete. That concept and requirement carries over into your graduate studies, but the stakes are just a tad higher. The expectations and that “minimum level” is now almost a maximum (for some).

They call it an advanced level of education for a reason. I like to think it’s similar to the pride we have in calling ourselves nurses. Becoming and practicing as a nurse is not easy. If it were easy, wouldn’t everyone be doing it?

RNFM.com | Scrubs

We came, we saw, we rocked!

This past Monday evening I was joined by three other members of the Scrubs magazine team as guests on the highly popular Blog Talk Radio Podcast: RN.FM Radio: Nursing Unleashed!

Catherine Ettlinger, the editor of the print edition of Scrubs, Paris Lia Hyun, the editor of the digital scrubsmag.com edition, and poet/writer and nurse practitioner Cortney Davis, who contributes to the print magazine, joined me to discuss the partnered relationship of the online and print magazine, and what it offers to the nursing profession.

It was a lively and enlightening podcast. I was extremely nervous about the whole experience, but once Keith and Kevin introduced us, it was as if we were all sitting at the same table having a friendly chat (even though we were scattered across the continental U.S.).

I’ve never felt more welcomed. Keith and Kevin have an amazing ability to make their guests feel right at home. I highly encourage you to subscribe and listen to their show; they’re doing some amazing things to help our profession reach new heights as well as facilitate conversations on some great topics that need discussing.

Catherine and Paris introduced the goals of the magazine and gave a brief synopsis of its history and future direction. Scrub steps away from the traditional magazine format by providing a print edition as well as an online presence in a complimentary fashion. Both have the same common goal of supporting nurses fully, both personally and professionally. As both Paris and Catherine said, their goal is to “care for the caregiver.”

Cortney and I read some works that we wrote. I, of course, read a blog post, and Cortney read a poem. This particular poem has been published in a book and will be published in the fall issue of Scrubs magazine’s print edition.

I was not prepared for Cortney’s poem. It was emotionally moving and so eloquently written–she was a very tough act to follow! It took me a brief moment to collect my thoughts and composure. It truly was a breathtaking poem. If you find any time, please listen to the archived episode simply to hear her poem. It’s worth it.

We packed in so much information on so many diverse topics during this podcast. Everything from nurses as storytellers to technology’s effect on the intimacy of nursing care was discussed.

Another great aspect of the podcast was the real-time audience on Twitter that joined us via the Twitter hashtag #RNFMRadio

Here is a quick approximate time breakdown of the podcast if you are limited on time:

Start – Introductions as well as brief overview of Scrubs Magazine

28:00 – Nurses as storytellers

34:00 – Cortney reads her poem “How I’m able to love”

40:00 – Sean reads his blog post “15 ways nursing will change your life”

55:30 – Social media, nurses and patient privacy

57:30 – Technology replacing the intimacy of nursing hands-on care?

59:00 – Patients using social media

1:00:00 – Social media, informatics and educating the less tech-savvy

1:17:00 – Nurses week and new guides online on scrubsmagazine.com

My breakdown is brief and extremely generalized, so if you have the time, please listen to the entire podcast. You can listen to it online, download it, or use iTunes on your computer or mobile device (don’t you just love technology?!).

This experience has rejuvenated my passion for nurses and their contribution to blogging, social media and patient advocacy. I’m looking forward to any additional experiences like this one.

I want to extend a warm and passionate thank you to the co-hosts as well as my fellow team member guests–thank you for the opportunity and the inclusion.

So Scrubs readers, did you listen? Will you listen? I’d love to hear your thoughts!

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This is an exciting time for the world of nursing. The public’s interest in choosing nursing as a career continues to climb and now, more than ever, many nurses are stepping away from the bedside and venturing back into the academic world to advance their careers.

Many of those individuals, like me, are considered “adult learners”–there has been some sort of delay in their educational journey. Some students are returning to the classroom after decades have passed.

Returning to the classroom after years away can be difficult and stressful, but there are ways to make sure your academic endeavors are a success! Here are some tips I think can help ease the transition:

Rediscover the internet

• It’s one thing to be well versed in how to “surf” the internet and navigate your way through your social networks; using the internet to augment your learning requires an entirely different set of skills. Learn how to efficiently manage your way through web portals, properly use a web browser and become very familiar with internet security. Google is not the only tool out there.

Rediscover mobile technology

• As healthcare and its delivery continue to advance and become more complex, mobile devices are becoming a required piece of your toolkit. Long gone are the days of lugging around 75 pounds of books–now you refer to your mobile device.

Master mathematics

• This is a very neglected skill of the seasoned nurse. Out in practice, we can sometimes get complacent with the abundance of support at our fingertips. If pharmacy hasn’t already calculated it, your IV pump usually can do it for you. Be sure you can calculate a weight-based drip rate on your own.

Learn how you learn best

• Everyone learns differently. For instance, I’m a visual learner. If I can draw it in a diagram, graph or mind map, it’s much easier for me to learn the material. Some simply need to hear the lecture, some need to read the chapter page by page. Whatever is your strength, find it and then use it. Don’t expect to learn and study in the same manner as your classmates. There is no wrong way to learn, as long as you are assimilating the needed material and remembering it. Be sure to figure this out BEFORE your grades start to suffer.

Sharpen your organization skills

• Everyone thinks that if they can organize their day as a staff nurse, then they have the organizational skill set needed to stay on top of their studies. While nursing does require a high level of organizational skills, don’t make the mistake of thinking those skills translate into the academic world. Keep a calendar, an appointment book or track your duties electronically. The schedule of classes and assignments can very easily get the best of you. Be prepared.

Going back to school is an exciting and fun time. While I’ve commented many times on the roof-shattering levels of stress, it really is a great time. Just be sure you have the weapons necessary to survive the battles that lie ahead of you.

What other tips would you add?

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Great news, Scrubs readers! We’re being interviewed on “RN.FM Radio: Nursing Unleashed!,” the newest internet radio station for nurses.

The LIVE interview was on Monday, April 8 at 9pm EST/6pm PST.

You can listen in here: http://www.blogtalkradio.com/rnfmradio

Keith and Kevin over at RN.FM Radio will be conducting the interview with the editors from both the print magazine and our amazing online version. Oh, and did I mention I’ll be a part of it?! I’m going to discuss a previous blog post and maybe even a lil’ bit about me and my history of blogging as a nurse. (How cool is that?)

The podcast is titled: A Scrubs Magazine Extravaganza!:

This episode we’ll be joined by Catherine Ettlinger, the editor of the print edition of Scrubs Magazine and Paris Lia Hyun, the editor of the digital edition, scrubsmag.com.

We’ll also be joined by popular scrubsmag.com nurse blogger Sean Dent, and poet/writer and nurse, Cortney Davis, who contributes to the print magazine.
Please join us for a “Scrubs Magazine Extravanganza” as we explore the influence and power of this most popular nursing magazine!

Here’s some background on the RN.FM Radio podcast and the co-hosts:

RN.FM Radio Co-Host, Keith Carlson, RN, BSN has been a nurse since 1996, with a depth of experience on the front lines, focusing on community health, public health, home health, and the management of chronic disease.

Keith is the well-known blogger behind the award-winning nursing blog, Digital Doorway, and he is the founder of Nurse Keith Coaching and NurseKeith.com. He is currently an editorial contributor for Working Nurse Magazine and LPNtoBSNonline.org, and has also been a featured author in several non-fiction nursing books released by Kaplan Publishing. Keith is a Certified Kripalu Yoga Instructor, Swedish Massage Practitioner, and Certified Laughter Yoga Leader.

Keith’s passion is coaching nurses and helping them to find balance and satisfaction in their personal and professional lives by preventing burnout and fostering optimal health and well-being!

RN.FM Radio Co-Host, Kevin Ross, RN, BSN has a range of experience in health care and human services, including a couple of years as a nurse in the Cardiovascular Surgical Intensive Care Unit (CSICU) at Johns Hopkins Hospital in Baltimore, MD. Never one to settle also meant a strong desire to combine his nursing experience and passion with his interest in technology and enthusiasm for entrepreneurship. These seemingly disparate interests are what led him to start a medical consulting company, Spire Health Partners in 2007. Kevin is passionate about helping underserved people and communities get the medical care and attention they deserve and need. To that end, he is involved in a variety of projects from small and grassroots to larger scale initiatives all with the focus of? ensuring the health and safety of the clients being served.

Kevin started Innovative Nurse as a side project to share his experiences on “the road less traveled” as a nurse entrepreneur. The goal of Innovative Nurse has been to build a strong community for nurses to better realize their true potential in the health care field. The project only launched at the end of 2011, but in just a short time the response has been overwhelmingly positive proving the theory that nurses are receptive to, and even seeking out, information and resources of this kind.

If you didn’t hear it live, the show will be immediately archived and available for listening on Blog Talk Radio and also will be quickly available as a free, downloadable podcast on iTunes.

I would love for you to join us!

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This past week I turned the big FOUR-OHHH. Aside from constantly wondering if I’m going to have the traditional mid-life crisis, turning 40 wasn’t all that bad. Of course, people made the traditional jokes and puns. As a freshly minted 40-year-old, I thought I’d comically reflect on what it’s like to be an “over the hill” nurse.

When did the monitors get smaller??

• I find myself squinting a lot lately. Did Zoll and Phillips get together to pull an April Fool’s Day prank on me? Maybe it’s my old age?

The elevator looks more appealing.

• Though the stairs are so much better for my health, the elevator seems much more appealing to my crack-a-lackin’ knees and my popping ankles. Maybe it’s my old age?

What call bell? I didn’t hear anything!

• My co-workers seemed annoyed and the patients are angry. Apparently, there was a call bell ringing for the past 30 minutes. I swear I didn’t hear it. Maybe it’s my old age?

What department meeting?

• I missed this month’s meeting? It was yesterday? I told you I would be there? You saw me write down the date? Hmm, I’m pretty sure I would have remembered. Maybe it’s my old age?

I hope you caught on to my sarcastic undertone. Truth be told, not a darn thing has changed for me as a nurse. If anything has changed, it’s my outlook on what it’s like to be 40 (boy, was I wrong).

I can remember thinking turning 40 was like punching the last hole on your ticket. Game over. It’s all downhill from that point forward. Turning 40 had to be the worst!

Did I mention how wrong I was? Turning 40 is the new 30, folks. I can’t wait to see what the next decade has in store for me!