I have a couple of examples of what I am talking about, I am sure you will see what you should be looking for in a manager, and what can hold you back in your career goals.

When I am welcoming new employees to my unit, I meet with them on the first day to discuss my expectations of them, and to learn about what their goals are.  I make it clear that I know that they are not going to be working for me for ever, and that I want to help them grow as a nurse while they are on our unit so they can reach those goals.  Whether that is moving to the ICU, the ED or L&D, I know they have goals, and if I know those goals, I can help them achieve them.

This is new for a lot of nurses who are used to their managers expecting them to stay on the unit forever.  They are not used to a leader helping them and coaching them to meet and hopefully exceed those goals they have set for themselves.

Contrast that to my situation.  My organization is going though a lot of changes in the department of nursing.  There are directors and higher up the organizational chart that have left opening new opportunities for those managers that are looking go move up to these positions, like myself.

Last week I sent an email to my boss explaining that I am interested in moving up the ladder.  I explained my goals and asked her if she could support me and mentor me in these new positions.  I explained why I felt that I would be the perfect candidate for one of these positions and the positive changes I could make.

I received an email back that really just shot me down.  She was completely unsupportive and did not provide any positive support or feedback.  I am disheartened, and disillusioned with her and this organization that I have put some many years into.  I am seriously considering leaving because of the lack of support given to me.

Which one would you like to have?  Somebody that wants to know your dreams and helps you to achieve them, or somebody that doesn’t ask, and doesn’t seem to care or support you when you tell them?

Pretty easy choice for me.

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Sometimes at the end of a long shift, your head is ringing from all the beeping, pages and chatter you hear.

As an antidote to this ear fatigue, we at Scrubs have created a soothing playlist that we hope will help you release the stresses of your day. And every one of these songs was recommended by nurses.

So treat yourself and download one or all ten! Then take a deep breath, press play and relax.

1. You Raise Me Up – Josh Groban
2. Say – John Mayer
3. Somewhere in New Mexico – Jill Sobule
4. Society – Eddie Vedder
5. Walking in Memphis – Marc Cohn (or anything by Marc Cohn)
6. Angel from Montgomery – Bonnie Raitt
7. Good People - Jack Johnson
8. When You Say Nothing at All – Alison Krauss
9. Early Winter – Gwen Stefani
10. The River of Dreams – Billy Joel

And here are a few of our favorite relaxing albums:

Quiet Nights by Diana Krall

9 by Damien Rice

Love Is the Answer by Barbra Streisand

An Education OST by Various Artists

Want more? We’ve also created another fun playlist of songs to inspire you, comfort you, or just make you smile.

Thanks to the students at Frances Payne Bolton School of Nursing at Case Western Reserve University, Kate Genovese, RN, Megan Gilbert, Student Nurse, April Chandler, RN, and Patrycja Mahdavi, Staff Nurse, for their help on this list. Have a relaxing song or album to recommend? Leave a comment here or write to us at hello@scrubsmag.com.

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We’ve all got those teachers we love, the ones that make us look at nursing in a different light.  And then there are those instructors that we just don’t get. When you just don’t understand each other, and the more you have to work together, the worse it gets. What do you do? This instructor is plays an integral part of your nursing career, but you’ve also got to do what’s best for you. So what happens?

For me it was a clinical instructor. I will spare all the little details, but it was my second quarter (of 3) in my med-surg rotation.  Things were going well, but I was still feeling very nervous before each clinical day. I confided in my instructor that I was feeling anxious, and that even though I was very prepared for class each week, I felt like I had forgotten something. She was a very laid-back instructor, and so I thought that in telling her this, she would be able to help me out and that maybe I would start to feel a bit more confident.

Wrong! I guess she thought she was helping me, but she ended up babying me. Not having me take on challenging cases, or perform new skills. I felt lazy because I really wasn’t being challenged any more. As the quarter was coming to an end, my instructor basically told me that if I didn’t hurry up and “get more confident,” I would probably fail the next quarter. WHAT?  Really? No one had ever told me I was going to fail before. And it wasn’t like I was doing poorly, I was performing skills well and taking good care of my patients, but because I told her I was nervous, she’d lost confidence in me.

At first I was devastated, and I started to lose confidence in myself. But after mulling it over for a few days, I really started to get angry, and then I was just out right determined to prove her wrong. We didn’t click. She’s a smart woman, but I couldn’t have faith in an instructor that gave up on students so easily. I worked my but off to prove to her that I was confident enough and skilled enough to survive. And when the next quarter brought on a very challenging instructor, I knew that the only thing that would boost my confidence was not to prove it to my instructor, but to prove it to myself that I could handle it.

We don’t have much say when it comes to our instructors, and when you get stuck with one that you just don’t click with, there isn’t much that you can do.  If they’re telling you you’re not cut out for this, or that you won’t make it, remember why it is you are in nursing school. Don’t prove work to prove it to the instructor that you’re competent, prove it to yourself and in the end, no-one can doubt you.

Nursing Students: What are your thoughts? What has happened or what did you do when you didn’t click with an instructor?

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Is it true that nurses are just doctor wannabes? Find out the statistic about nursing education that handily debunks this myth, plus four more fun facts that will prove to be food for thought the next time you set foot in a classroom.

1. First, let’s debunk a myth. Ever heard the phrase “Nurses are just doctor wannabes”? If this is true, why are nurses almost 100 times more likely to go on to graduate from nursing school than medical school?

2. Just a century ago, nurses weren’t allowed to be married…and certainly not pregnant. It was almost 100 years ago (in 1919) that Great Britain established the first oversight nursing training and standards. Conditions have certainly changed since then—nurses are now allowed to be married and even work while pregnant.

3. Meet the first U.S. nurse. In 1873, Linda Richards became the first nurse to earn a nursing diploma in the United States. The first hospital nursing school on record was established in Germany in 1864.

4. And the first nursing masters degree? Columbia University School of Nursing was the first university to offer a master’s degree in a clinical nursing specialty, in 1956. It’s estimated that 13 percent of the nursing population, or 377,046, have a master’s or doctoral degree.

5. Nursing is a popular choice of study. Nursing students make up more than half of all students in all health programs. This shouldn’t be surprising. Nurses comprise the largest group of healthcare professionals in primary and long-term care.

How many of those nursing students do you think actually end up working as nurses? Leave us your best guess in our comments section.

Sources:
www.nursingadvocacy.org
www.aacn.nche.edu
www.nmc-uk.org
www.northnet.org
www.nursing.hs.columbia.edu

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Nurses may have a good job outlook through 2018…but maybe your budget is a little tight on your nurse’s salary alone. Or perhaps you’re looking for a fun way to relax on the weekends—and make a little extra cash on the side. We asked our Facebook fans what kind of side jobs they have (or have had) to make some extra dough; check out their answers for some inspirations and, occasionally, warnings!

Medical
I give flu shots during flu season!
—Mary Buchman

Teaching childbirth classes.
—Kelly Eisenhardt Vittoria

Gave nightly injections to someone going through infertility treatments for both of her pregnancies.
—Stacey Trapp

I work per diem as a nurse at a correctional facility. I start training tomorrow.
—Martine Levy

Doula!
—Shari Camarata

I keep a side job, always have. I like to do home care through an agency. It’s flexible—I schedule patients around my work and life!
—Mandi Fay

Retail
I worked at a local gas station in the morning making breakfast foods and doughnuts! It was quite a change from nursing, but I totally enjoyed it. I still had a lot of interactions with people in the morning on their way to work…that made it fun!
—Dena Kerschner

Walmart—hated it!!!
—Sandra Rojas Chamberlain

The Disney Store.
—Denise Adams

Business
I’ve been a tax preparer at Jackson Hewitt every year for the past three tax seasons.
—Vicki Bockheim McDaniel

I help my husband with our photography business.
—Mary K. Miller

Party planner.
—Aminah Roberts

Have my own business…stripping and waxing floors. It’s mindless and therefore enjoyable.
—Corinna Laub Barger

Food Industry
Vegetarian/vegan catering and holistic pet food rep.
—Michelle Lippe

Helping a vendor sell produce and plants on the local farmers’ market.
—Sandra Collins

I work at a gourmet cupcake shop on weekends. I make some extra money, get to do something that I enjoy and get out my creative energy (and it doesn’t involve any life-or-death decision making on my part!).
—Andrea Barnes

Cook at major pizza chain through nursing school.
—Rene W. Neville

Fitness
Certified personal trainer.
—Jeannine Quinn-Metz

Scuba instructor.
—Megan Ballard

Other
Taught English subjects (grammar, creative writing, American accent training, speech and pronunciation classes, and English as a Second Language) to foreign university, kids and adults. I loved doing it!
—Marygrace Garde

Shoveled horse manure. Top that one.
—Les Seay

Aesthetician and nail tech.
—Laura Lee Miracle

I make and sell baby quilts and memory quilts.
—Cynthia Friend Thomas

I was a CNA for years before going on to get my LPN, but I’ve also worked second jobs as an auto mechanic (helped me through nursing school—I’d find a car part that matched functions with human organs and simplify the human organ down to the same thing as the car part) and sold auto parts at a national chain.
—John Mansky

What kind of side jobs do you have (or have you had) to make some extra dough?

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Licensed practical nurses (LPNs) are some of the most important people in the nursing care schema. They pass meds, perform rounds and help the RN in his or her job. A great LPN makes an RN’s life a little easier and brings a great set of skills to the care of the patient. Some facilities would be lost without their LPNs pulling the weight of the care.

Unfortunately, LPNs do face certain challenges when they attempt to perform their jobs. Some of these challenges are surmountable with good communication among all members of the care team, and some are consequences of the legalities of nursing. LPNs are limited in what they can do, and that sometimes presents challenges to an LPN who has to depend on the RN for so many things. With some persistence, though, an LPN can find a way to overcome these challenges and care for patients with skill.

1. Restrictions on job opportunities
One of the challenges for LPNs, especially in this tight job economy, is finding a place to work. Many hospitals restrict their hiring for floor nurses to RNs, and this can be frustrating for LPNs who want to work in acute care settings. Some hospitals do hire LPNs, but usually in roles that have less authority and are task-oriented. For instance, some hospitals can hire LPNs for the IV team or to draw blood for the lab.

LPNs can find jobs in nursing homes, but they often will not be the one in charge of the floor. They will have to answer to an RN and will not have the autonomy that a registered nurse has. Again, the LPN could be reduced to roles such as medication nurse or treatment nurse instead of having full care of the patients. Some centers, such as dialysis facilities, will only hire RNs to work the dialysis machine and care for patients. For some LPNs, this lack of diversity in job opportunities can be a challenge that propels them back to school.

2. Delegation issues
LPNs are often restricted in what they can do because, legally, they are faced with the challenge of delegation. An LPN cannot assess, diagnose or evaluate care because this is the realm of the RN. Sometimes, this can be frustrating for an LPN who may know what needs to be done and cannot actually do it. An LPN can even disagree with his or her supervising RN, but will be powerless to change the tasks he or she is delegated to complete.

This challenge is surmountable, though. You cannot change the laws regarding patient care, but you can develop a good working relationship with the RN in charge to provide the best care for the patient. Just because an LPN is delegated a certain task such as med pass doesn’t mean that he or she can’t notice that a patient is having difficulty breathing. If the charge RN does nothing or ignores the situation, the LPN can follow the chain of command upward to help the patient. Even though LPNs are technically below the RN in the chain of command, they can still impact a patient’s care.

3. Experience vs. education
In some situations, an LPN with 20 years of experience might find that a new grad nurse is his or her supervisor. This is a challenging situation because the LPN likely knows much more about patients, their illnesses and how to react than an RN who has only limited experience. Again, it is a legal anomaly that requires the RN to delegate to the LPN. If an RN does not have a great deal of experience, an LPN needs to know how to approach the situation.

Communication between the RN and LPN is vital to the proper care of the patient. An LPN who assumes the RN knows what he or she is doing—or stubbornly does only what he or she is told to do—can cause harm to the patient. An LPN needs to be an expert communicator and a nurse who knows how to work with people. It is often the realm of the LPN to act as a bridge between the patient and the overextended RN. This is where teamwork becomes the solution to this very common problem.

Reference:

“Remedying role confusion: Differentiating RN and LPN roles” by Lisa M. Shaffer, BSN, RN; Kathy Johnson, BSN, RN; and Carolyn Guinn, MSN, RN; American Nurse Today, March 2010
http://www.americannursetoday.com/article.aspx?id=6382&fid=6276

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Things are changing. Fast. It seems like every time you turn around at work, there’s new technology: new ways to document, upgrades to the medication-dispensing machines or a new social media platform the company encourages you to “like” or join. Is your head spinning or what?

Many days, you spend so much time fiddling with the new technology that you wonder if time and care is being taken away from the patient, or if the patient feels left out or dehumanized. But none of the changes are intended to negatively affect your patient care (as ironic as that may seem).

There are ways that a busy nurse can handle the changes and still stay safe, sane and patient-focused. Here are five etiquette tips to help you navigate around all the new gadgetry while making your patient your number one priority.

1. Scan the barcode, not the patient
People don’t want to feel like a product at the grocery store. Most hospitals now use some form of barcode/scanning system for patients’ medication and supplies. I’m sure many of us have seen nurses silently walk into a room, scan a patient and then hand the patient something. Not a good scene.

Technology is just a tool we’re using. We need to remind ourselves of this. It cannot take precedence over care, touch, presence and empathy.

Remember:

• Make eye contact
• Smile
• Introduce yourself
• Explain what you’re going to do

Sounds like Nursing 101, right? But in a rush, these highly important basics can be forgotten.

2. Remember your telephone etiquette
The telephone is obviously a major means of communication. In many hospitals, you have a portable phone you carry throughout your shift. This phone becomes the primary way for patients, other nurses, physicians, family members and others to reach you. They’re very convenient and they lower the “yell” factor—if you’re out of earshot, someone can call you instead of calling out for you or searching the halls and rooms needlessly.

Nevertheless, basic phone etiquette rules need to be remembered. Here are just a few:

• When speaking on the phone with a patient, remember confidentiality and be aware of your physical location (in another patient’s room, in a hallway, etc.)
• Be mindful of nonverbal communication, especially if you’re in front of another patient. Do not roll your eyes or display any other derogatory behavior. This sounds simple, but sometimes when we’re busy our bodies react quickly to added pressure and stress. These reactions may include outward displays of negativity. What do you think the patient in front of you will think if she sees you rolling your eyes or crossing your arms while speaking with another patient or family member?
• Be considerate of the amount of time you are on the phone, particularly if you’re in another patient’s room. Do you need to excuse yourself to see the other patient immediately or resume the conversation after you finish caring for the patient in front of you?

Next: Tips 3-5 →

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For anybody that has been a nurse for a few years you have already learned this, especially if you have worked at more than one hospital.

Nurses, or even healthcare is general, is a pretty small and close knit group. If you are working in the same town you went to school in, then you probably know at least one nurse at every hospital in your town. If you have worked at other hospitals, then you probably know somebody at every hospital in your town. But it is definite that somebody you work with now knows at least one other nurse at every hospital in your town.

For this reason, I tell my nurses, don’t burn your bridges. What you say or do here will eventually make it to the hospital on the other side of town.  Here’s an example…with some details changed to protect the parties involved:

When I was staffing in the ED, the manager was interviewing a nurse. This nurse was somebody I went to school with.  She was an average student, but the know-it-all in the class (we all had one of those, the phlebotomist or EKG tech who think they know everything). She was a complete pain in school.

When he was giving her a tour of the unit, we ran into each other. She came over gave me a hug and was sweet as pie, although we never got along in school. After her interview, the manager came and asked me about her.  I told him the truth, I don’t know about her nursing skills, but she was a difficult person to deal with in school and I don’t think she would be a good fit for the team.

She didn’t get the job. This happened with two other people that I was asked about that I worked with in other EDs.

I don’t feel bad about it, because I don’t think they would have been successful here, and I don’t think they would have been a good fit for the team. It was their behavior that caused me to give a bad reference.

What I am saying is….we have hard jobs already. When you are feeling stressed and having a bad day, learn how to keep it in check. Because one day, you may not get a job in another department or hospital because of how you acted on your unit today.