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Perhaps the following scenario sounds familiar: You’ve graduated from nursing school and landed your first job as a nurse. The salary isn’t quite what you were hoping for, but with some extra shifts or overtime—or maybe by furthering your education—your financial future looks pretty good.

Or…

Let’s say you’ve just gotten a promotion and with seniority you have that nice salary increase to boot. You’re feeling pretty comfortable and heck…what with the nursing shortage you’ve got some job security, right?

It’s tempting to spend your money as you get it—after all, you’ve worked hard to get to where you are, and if you’re like many nurses, you probably scrimped and did without a lot of things while in nursing school and while working your way up the ladder. Plus, you may have student loans to pay off and your salary may not leave you with that much of a monthly cushion.

So why are financial advisers telling you that you should start paying yourself (i.e., saving) right away?

Why you should save

• Good habits die hard. We all know that bad habits are difficult to break, whether it’s chewing your nails or snapping gum. So the best way to avoid a bad habit is not to begin it at all. In fact, why not start good habits? Unlike bad habits, you won’t want to break these! Amy Buttell, coauthor of Personal Finance: The Missing Manual, explains that saving money for yourself and for your future is a way of taking care of yourself—something nurses do well for other people, but not always for themselves. “Saving money can help you feel psychologically secure, even feel more empowered,” she says. Knowing that you have money to fall back on can take a lot of stress out of your life.

• Rainy days will come. When you start putting money aside into an emergency savings account, you’re preparing for anything that may pop up, such as a car accident, where you may have to pay a $500 deductible. Having some savings means you don’t need to use your credit card or take out yet another loan. “Saving money is a bulwark against catastrophe,” says Buttell. “Something always happens. Spending every dime means you’re always on the financial edge when something bad happens.”

Once the emergency fund reaches a certain point, you’ll see that saving works, and because you’re now in the habit, you can continue saving for something fun, such as a vacation, a wedding or even a new home.

Three tips for saving

1. Save even when you don’t have much to spare.

Buttell says that it doesn’t matter how much money you start putting aside—it’s the act of putting something aside that helps you get into the savings habit. Whether you call it an emergency fund or just a savings account, the whole idea is to help you get used to setting aside $10 or $20 a week, if you can. If even that is too much, $20 or $30 a month is better than nothing.

2. Have the money automatically rerouted into a separate account.

Instead of physically moving the money into a savings account, Buttell suggests that you “set up a payroll savings account, if that’s possible, to have the money deducted from your paycheck. If that’s not possible, have your bank or credit union do it.” Just as we arrange to have bills automatically paid from an account, we can arrange for automatic savings withdrawals. “Sitting in the checking account, [the money is] going to be spent,” Buttell says. Also, she points out, if the money is automatically rerouted, “it gets a little rewarding when you check your [savings] account online or you check your bank statement and you can see, gradually, over time, that account accumulate into something.”

3. Don’t try too much too fast.

When starting a new phase in life, it’s easy to get overly enthusiastic and maybe try a bit too hard. Just like joining a gym and burning out because you go too often and do too much, trying to do too much with your money too quickly may get discouraging. “When people are on very tight budgets and try to do too much, they’re going to end up giving up and it’s not going to work,” Buttell explains. So, set a realistic goal of how much you will save. You can always increase the amount of money you set aside, but it’s harder to decrease it without being left with the feeling that you’ve gone backwards.

What about paying off loans?

Paying off your student loans and other debts is important, but there isn’t a lot that is satisfying about paying off loans while you’re doing it. By setting up a small savings account on the side, you can see what you’re saving, and this can be very satisfying. If you save $100 a month for two years, that’s almost $2,500. Not too shabby for money you’re not touching.

Bite-size tips for saving money

• When you’ve saved enough to open a certificate of deposit (CD), get one. The money stays yours, but you can’t spend it on the spur of the moment. It also gains a bit of interest while it’s in the CD.

• Consider using an online bank, like ING, for your savings. When your money goes into an online bank, it takes a few days to get it back into your brick-and-mortar bank. Therefore, you may think twice before withdrawing the money.

• If you’re using your regular bank for the savings, don’t allow the staff to connect that account with your bank card or allow checking privileges. You need to make the money as inaccessible as possible.

• Set goals. If you’ve already built an emergency fund, set goals for your money. When your bank account gets to your first goal, treat yourself to something as a reward.

• Play mind games with yourself. I know of one nurse who would take an extra $20 from the ATM whenever she withdrew money. That extra cash would go into an envelope in her filing cabinet, and by December, she had plenty of money to do her Christmas shopping and pay for everything in cash.

Do you have any special saving tricks?

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While driving home today, I was distracted by the commotion outside my car. Tractor trailers were banging and clanging quickly past me. On the sidewalk, construction workers were shouting to one another. Radios and car horns were invading my quiet space. I was having a hard time concentrating and my mind was racing. Then I realized it: This reminded me of a busy day on a nursing unit!

We’ve all had experiences like these: getting interrupted while calculating medication dosages, being called to the telephone during patient teaching, or hearing a bed alarm and rushing away from talking to a family member about a loved one. And it can get a bit chaotic and stressful!

One way to decrease distraction is through positive affirmations. Stating positive declarations can create greater focus and concentration, and give you a sense of balance. Taking time out each day to sit quietly, breathe and state mantras to yourself can have a deep impact on your happiness, peace of mind and health.

Research has shown that stating mantras has positive effects on stress reduction. In a 2007 study conducted at Duke Medical Center, researchers found significant reductions in stress and negative emotions in participants who used meditation techniques that focused on mantras.

When you do this, you quiet the mind. You create a space that is free from disruption. And then, with practice, you can call upon this state of mind at any point during a busy shift.

Picture this: You have been running all day. Patient after patient needs you. The older gentleman in 312A fell down. Your chronic pain patient in 316B will not lay off the call bell. Any time you think you have five minutes to sit down and chart, another person is calling your name. This has been the longest shift of your life.

Instead of creating more stress, anxiety and disappointment by focusing on the hours ahead, try something different. Take a deep breath and say to yourself: “I have the strength and energy to see this through. I enjoy helping others.” Repeat this until you stand up, ready to give that final medication and discharge that last patient—feeling revitalized and ready to go!

Make time each day, either in the morning or the evening, to quietly state affirmations. Take a slow and deep breath in and out through your nose between each of the affirmations. Become aware of how you feel and start to notice any shifts in energy, mood or stress levels.

Here are some statements I use that can help you get started:

• I am exactly where I need to be as my journey in life reveals itself to me.
• I honor my mind, body and soul and treat each aspect of my being with respect.
• I am a confident, knowledgeable and successful role model as I inspire others to be the same.
• I know great joy and peace and therefore have wonderful energy.
• My speech is a form of love.
• I am limitless in my capacity for joy, healing and happiness.
• I will achieve perfect balance and be successful in all that I take on.

You can add some of your own affirmations as you become comfortable with the process.

Taking the time to sit quietly with your own positive thoughts will greatly affect your life. You’ll create a way to cope with distraction during your busy days. You’ll generate a calmer presence by slowing down and breathing with yourself. You deserve great happiness, peace and love in your life. Make room for yourself!

Elizabeth Scala, MSN/MBA, RN, is a health and wellness coach who owns Living Sublime Wellness, a company that provides holistic coaching for mind, body and spirit. She coaches nurses and caregivers who are stressed, burned out and overwhelmed to make time for self-care and healthy balance in their busy lives. Scala offers a holistic newsletter and supportive monthly calls. Visit livingsublimewellness.com for more details.

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I’ve always envied those who can flip flop back and forth between day shift and night shift. How do they do it?

I think I’ve nailed down some of their secrets, and in so doing have been able to work both day shifts and night shifts in succession. Happily! Nights are often a more peaceful time in the hospital and it’s definitely a nice change in my routine.

So, need some tips on how to survive the “dark side”?

Surviving the night shift.

Here are steps to jumpstart your circadian rhythm and allow for easier transitions from the normalcy of day shift to the non-so-routine night shift.

(1) If you are strictly a night shift nurse and you are having problems adjusting to the schedule, try a couple weeks of grouping all of the shifts together, three in a row. That way you can completely convert to night owl status for half of the week and then have four days to recover back to normalcy (that being if you indeed do work three 12-hr shifts).

For those who rotate and really cannot stand working three nights a week, ask your scheduling manager if you can split up your weeks into day and nights (be sure to work your days towards the beginning of the week and allow ample time for recovery after night shifts). For example, you would work Monday day shift and Wednesday and Thursday night shifts.

Wake up early on the day of your first night shift and take a nap in the afternoon. This strategy allows you to have a bulk of the morning to get stuff done and having some decent sleep prior to going into the long shift. I have heard people that just sleep in late (until like noon or 1 in the afternoon) crash around 3 or 4am because they have been up for so long.

My technique for the last day is to return home post last night shift, sleep for about four hours, then force yourself to wake up! You’ll be so tired by that night that you will be able to sleep during the night and be back on a somewhat normal day routine by the next morning.

(2) Right before a night shift, eat a substantial dinner prior to going into work (even if it is “breakfast-like”). That will hold you over for hours and give you a boost of energy to get the shift started. Try your best to avoid the comfort foods of night shift and bring a light meal full of protein and complex carbs that will fulfill your midnight munchies.

(3) Exercise! This not only applies to those working normal business hours. It becomes extremely important for those on night shifts because working out allows you to have more energy and creates for more sound sleep. I have friends that exercise after they get off their shift in the morning (I’ve always been too tired for that). If that is your preference, be sure to take time to wind down and drink a warm, non-caffeinated drink prior to going to sleep. I tend to exercise after I wake up – the beauty of that being that as opposed to working out early in the morning like a “normal” shift worker may do, you will be inundated with daylight hours for a nice run, pleasant early evening temperatures, and you will most likely beat the post 6pm rush at the gym. Hitting a wall at 4am? Run the stairs, it will most certainly wake you up

(4) Isolate yourself! Be sure to tell your loved ones, your neighbors, and your kids that just like they don’t like being woken up at 2am, you don’t like to be disturbed during your “night”. Turn your phone off, buy dark curtains that will keep the daylight out of your room, wear an eye mask, lock the dog out of your room, tie up the children (kidding), and for goodness sake don’t drink coffee within four hours of going to sleep. If you “need” coffee to get through the shift, drink it early in the shift and combine water with a stair run later in the shift as an energy boost.

You mind is a powerful tool. Keep in mind all of the positives of night shift. It can be extremely conducive to family life if you are a working parent. The shift differential is an added bonus in the bank account. You typically have more autonomy as a nurse on the night shift and have ample time to develop skills and master your assessments. With the pace of the shift usually being slower, you have more time to develop close relationships with your coworkers because you are relying on each other for second opinions, assistance with tasks, and camaraderie in staying awake when everyone else is snug in their beds.

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Does zucchini bread land on your list of daily vegetables? Is the peanut butter in a Reese’s cup your afternoon dose of protein?

Find out how good you are at counting calories with these nurse-favorite break room treats and vending machine snacks.

Image: Blend Images Photography | Veer

Everyone knows the jet-lag feeling of dragging through the day without having had enough sleep. Nurses are especially vulnerable to lack of sleep when assigned to shift work.

In fact, so many nurses suffer from sleep deprivation that it has turned into one of the most widespread issues affecting patient care and a nurse’s own health. Without enough sleep, nurses are at increased risk for obesity, heart disease and diabetes.

And really, aside from the jolt provided from multiple cups of java or taking medication prescribed for “shift work sleep disorder,” there is really only one cure for sleepiness: Sleep.

So the next time you’re feeling low on energy before or during your shift, try taking a restorative nap to refresh your senses. The 30-minute investment in your health will pay big dividends in your quality of life.

Here are 5 tips for getting the most out of your nap:

1. If you work day shifts, nap early—before 5 p.m., if possible.
2. Try not to sleep for longer than 30 minutes, or you may have a difficult time falling asleep when you go to bed for your full seven to nine hours.
3. A combination of a nap and a caffeinated drink can help counteract drowsiness. Do avoid unwanted calories, skip the beverage containing sugar and opt for coffee or tea instead.
4. If you work at night, try taking a 30-minute nap before heading out to work, especially if your main sleep was earlier in the day. At work, find a quiet, darkened room where you can lie down for 10 minutes during your break. It will help you feel more alert and awake for the remainder of your shift.
5. If you feel drowsy when driving home, pull over to a rest area and take a short nap. It could save your life.

If you have trouble sleeping, visit the National Sleep Foundation’s website at sleepfoundation.org for advice. You may need to consult your healthcare provider to treat underlying health issues that could be causing your insomnia.

Do you have time to nap? If so, where do you nap? Does your workplace offer adequate facilities for catching some shut-eye or are you forced to camp out on an empty gurney?

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When you don’t get enough of it, you suffer. Big time.

No, we’re not talking about money, we’re talking about sleep. And if you’re among the third of working nurses who work the night shift, you probably don’t have the luxury of setting a typical sleep schedule. Sleep expert (and fellow nurse) Terry Cralle helps you identify whether you have what is called “shift work disorder,” suggests ways for night shift nurses (and their managers) to ensure a safe working environment, and offers up the following tips to help you get some shuteye.

Here are 19 things you can do at home to ensure you’re getting the sleep you need:

1. Make sleep a health priority, like diet and exercise.
2. Wear sunglasses if you’re commuting home in bright sunlight. Light is the most powerful zeitgeber, or influencer of the body’s circadian clock, and will negatively impact your ability to fall asleep. In contrast, once you wake up, go outside into the sun to cue your biological clock that it’s time to be awake and alert.
3. Only go to bed when you’re sleepy. Don’t go to bed just because it’s “time.”
4. Your body likes routines. Like light, your bedtime routine is a powerful zeitgeber. Establish a standard, relaxing, soothing bedtime ritual. Put on your pajamas, wash your face and brush your teeth to signal your brain you’re preparing for sleep. Play soothing music; take a warm bath for 30 minutes, one hour before bedtime; read a relaxing book or magazine. Allow enough time to unwind and relax, but try to go to bed as soon as possible after your shift, ideally within two hours. Don’t fall asleep in your recliner or sofa with a television blasting in the background.
5. Try to maintain a consistent and regular sleep schedule on work days AND days off/weekends. Keeping a routine helps your body know when to be alert and when to sleep.
6. Stop working at any task and attempt to resolve anything potentially stimulating, worrisome or upsetting one hour before bedtime. Writing down your emotional worries and thoughts in a journal may help release these concerns from your mind. Learn a relaxation technique, such as progressive muscle relaxation, and practice it in bed.
7. Use your bedroom only for sleeping and sex. Keep it stress and clutter-free. No paperwork, bills, unfolded laundry, TV, electronics or pets.
8. A darkened room signals your brain that it’s time to sleep. So keep your bedroom as dark as possible. Blackout shades, heavy curtains and eye masks can help. Standard window shades let too much light in. Cover an illuminated alarm clock, especially if you’re a “clock watcher,” or remove it, if necessary. If you need to get up, use a small nightlight instead of turning on bright lights.
9. Eliminate noise with earplugs, a fan or a white noise machine. Turn off or unplug the phone. Install carpeting or sound-absorbing curtains, drapes or shades.
   Keep your room well ventilated and the temperature on the cool side, ideally between 60 and 65 degrees (range: below 75 and above 54 degrees).
10. Invest in a good mattress. A poor or an old mattress can disrupt your sleep. The average mattress lifespan is about seven years.

More tips:

1. Make your sleep time sacred. Enlist the help of your family and friends and request that they respect your sleep. Put a “Do Not Disturb” sign on the front door, so friends and delivery people won’t knock or ring the doorbell. Have family and friends wear headphones when watching TV or listening to music. Ban vacuuming, dish washing, lawn mowing, loud games and any other noisy activity.
2. Tell your kids not to go into your room unless it’s an emergency, and be sure to specify exactly what is and is not an emergency. Schedule appointments outside of your sleep period.
3. Get at least 7.5 to 8.5 hours of sleep per day. Try to make up for lost sleep on days off.
4. Nicotine and caffeine are stimulants. Alcohol, while initially a sedative, causes arousals and awakenings, sweats and nightmares after it’s metabolized. Ideally, avoid caffeine-containing beverages and food such as coffee, tea, sodas and chocolate at least six to eight hours before bedtime. If you’re having problems falling asleep in the morning, avoid caffeine after midnight. Avoid cigarettes before bedtime and during awakenings, and alcohol at least five hours before bedtime.
5. Don’t go to bed too hungry or too full. Avoid eating two hours prior to bedtime. If needed, have a glass of milk or light snack before bed. Milk contains the amino acid L-tryptophan, which research has shown helps people fall asleep. Avoid consuming protein at bedtime, which may be harder to digest. Don’t drink excessive fluids prior to bedtime to avoid having to get up to urinate.
6. Don’t lie awake in bed for more than 20 minutes to avoid developing a negative association between your bedroom and sound sleep. After 20 minutes, leave the room and do something relaxing, such as reading, listening to music or watching television. Don’t return to bed until you feel sleepy.
7. Schedule 20 minutes of regular aerobic exercise and work it into your normal routine, but not within three hours of going to bed. Exercising raises the body temperature and can be alerting too close to bedtime. Walk or bike to work instead of driving; climb the stairs instead of taking the elevator. Consider exercising before work or during breaks to help you stay alert on the job. Keep a resistance band or hand weights at work for strength training. Find an exercise buddy to make exercising more fun and keep you motivated. Exercise will improve your sleep, energy level, mood, stress and cardiovascular fitness.
8. Address your partner’s sleep issues, if present. One partner’s sleep problem causes the other to lose, on average, nearly one hour of sleep a night.
9. Begin altering your sleep schedule three days in advance of a shift change. On the third day prior to the shift change and each subsequent day, postpone your bedtime and wake time by one to two hours compared to the previous day. By the time you begin the new shift, your circadian sleep-wake rhythm will be reoriented. For example, if you’re on a 5 p.m. to 1 a.m. shift and moving to an 11 p.m. to 7 a.m. schedule, do the following:

• Three days prior to your shift change, rather than sleeping from 3 a.m. to 11 a.m., postpone your bedtime to 5 a.m. and sleep to 1 p.m.
• Two days prior to the shift change, sleep from 7 a.m. to 3 p.m.
• One day prior to shift change, sleep from 8 a.m. to 4 p.m.
• On the day of the shift change, sleep from 9 a.m. to 6 p.m.

To learn more about shift work disorder and what you can do to make your work environment safer and more productive, read all three parts of our Shift Work Disorder series!

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A good night’s sleep is an elusive dream for many nurses. Rotating shifts, night shifts, double shifts, 12-hour shifts…these all play havoc with your circadian rhythm—your built-in 24-hour clock that determines the daily patterns of your life.

So, even though you know you should be sleeping, your mind and body simply can’t do it. Add in the stresses of your nursing job and the emotional baggage that you often bring home with you. You worry about that patient who wasn’t doing so well when you got off shift. You regret something you said to a patient or coworker. You can’t remember if you charted everything you were supposed to. If your mind is still going over what happened at work, falling asleep is going to be a real challenge. It might seem as if your nursing career is simply not conducive to restful sleep.

It’s time to spend some time exploring ways you can sleep better every day—and every night—and not only during your nursing career, but well beyond.

Here are three suggestions to get you started.

Next: 1. Cognitive behavioral therapy (CBT) →

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“I am the only medical professional in both my and my husband’s family so I do field a number of calls and requests. Most are for very basic advice and generally anyone who asks is very respectful of my time. They’re careful not to call me chronically!

“I’m careful to point out that since I’m unable to examine the patient myself, the advice must be taken with a grain of salt.

“The funniest requests are always things like rashes three states away – as you can imagine it is a bit difficult to diagnose a rash without being able to see it. I once even had a friend e-mail me a picture of a scalp wound to see if I thought it needed stitches!”

Do people you love ask for diagnoses? Do you have different advice for us?

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There’s a lot of talk about how nursing is hard on your body. It’s true: Nursing can be very hard on your back (especially), your hips (secondarily), your arms (oh Lord, let’s not even talk about it) and even your neck. Feet are an entirely different subject, and one that deserves its own book. I’m not going to bore you with statistics about how lift teams can make all the difference in keeping nurses healthy, or how nice it is to have a Hoyer on every floor—oh no. I’m here to tell you stories, my Chickadees, of the most amazingly random things I’ve ever seen anybody, including myself, do.

1. I won’t even mention the time I walked into a room that had fresh (and very slippery) stripper on the floor, and how I skated on one foot and, with arms flailing, right into the lap of my patient. Nice way to put down warning cones there, floor guys.

2. One of my coworkers once broke two toes by dropping an IV pump on her foot. This doesn’t sound so crazy until you learn that the IV tubing was still in the pump and the pump was still in use on a patient. At least the pump was cushioned enough by her feet that none of the alarms went off.

3. Another person I know (cough, cough) had several chunks of ponytail pulled out when she walked into the MRI room, having removed all metallic articles from her person except for the barrette holding back her ponytail. There’s a reason I rock a pixie cut now: Barrettes can lift and rotate in a truly astounding manner.

4. Another coworker dropped her beeper into the toilet by mistake, flushed without realizing it, then sprained her ankle trying to get out of the bathroom as the toilet overflowed. It was a long time before we let her forget that.

5. Once, a brand-new nurse I worked with had, for some reason, taken the top and foil cover off of a bottle of tube feeding…and then dropped the bottle. It was like something out of a horror movie, seeing the ProCal fountain up out of the bottle and cascade over her. We had to find a pair of shoes for her in the lost-and-found after she changed from the skin out. It wasn’t an injury, except maybe to her dignity.

6. There was the time that another nurse and I were hauling a patient back from testing on a stretcher. We lost the stretcher at the top of a very long, very gently sloping ramp with a 90-degree turn at the end, and had to chase it frantically in order to catch it before it, and the patient, hit the wall. Again, no harm done to anything but our pride (the patient was sedated).

7. Less amusingly, back in the olden days when we still had chart racks, a friend of mine had a chart rack fall over on her. She, thank Heaven, was unharmed—but the resident who flew to her side and dug her out from under the charts was Our Hero for several days thereafter.

8. In the Unfortunate Accidents to Clothing department, how about these?

> A nurse of my acquaintance once got her scrub pants caught in a continuous-passive-motion machine she was storing away in a utility room. The pants tore, spectacularly and irreparably, when she tried to walk away.

> Or the nurse who discovered that Domeboro solution will indeed bleach clothing if you leave it on too long.

> Or the nurse who discovered (again, cough, cough) exactly why more experienced nurses never stand at the foot of the bed of a patient with a fresh tracheotomy.

9. None of these nurse-accidents match what happened to a doctor friend of mine, now a seasoned and well-respected surgeon, back when I was a new nurse and he was a fresh-faced resident:

A patient coded. He, being the tallest guy in the room and thus having the best reach, started compressions on that patient. He had underslept that morning and so perhaps didn’t tie the drawstrings of his scrubs tightly enough—his pants came down about 30 seconds into his compressions.

And, of course, you can’t stop doing compressions to yank up your pants, even if you are wearing Batman boxer shorts.

The patient lived. The doctor almost didn’t. Be careful out there, people!

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Winter is in full swing right now. Depending on where you live, you could be looking at two to three more months of cold weather. What can you do to keep the wintertime blues at bay and take great care of yourself?

1. Moisturizers
Keeping your hands moist is even more important in winter when humidity is often lower. Constant hand washing can leave your skin chapped and raw. Invest in at least one heavy-duty hand lotion or cream to carry with you on the job and use it every time you wash your hands. Remember to buy a water-based moisturizer for work if you wear latex gloves. Try inexpensive brands like Glove’n Care, Amino+Derm or 3M Cavilon that are designed for healthcare settings. Then use a petroleum-based or oil-based moisturizer at home for maximum skin restoration.

Next: Shoe Covers →