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If you’re a nursing student, there are exams to study for and papers to write, but sometimes your brain just needs a break. These tips will help you unwind (and maybe put off that last paper!) productively—and, okay, give you an excuse to nap, too!

1. Update your resume to begin looking for jobs. As nursing students, clinical experiences are constantly being acquired and need to be documented on your resume.

2. Begin looking for summer nursing externships or patient care technician jobs. These are hard to come by, so the earlier you start looking, the more likely it is you won’t have to babysit the terrible twins next door for the entire summer.

3. Clean up your emails. Your school probably has bombarded your inbox with paperwork needed to begin clinicals and career fair fliers. Take a little downtime to delete those unnecessary emails and organize the ones you need. The more organized you are, the less unnecessary stress you’ll have (and we all know there’s no shortage of stress as a nursing student!).

4. Keep networking. Send an email to that nurse manager you worked for over the summer, make a phone call to your family friend who’s an RN or send some snail mail—it still exists! Like any other field, nursing isn’t all about what you know; it’s also about who you know. A simple reminder that you’re an interested and eager nursing student keeps your name fresh in their minds, and hopefully with a job in the future.

5. Go to a professor’s office hours. We all know nursing classes can be a killer sometimes. Check when your professor’s office hours are and stop in for some assistance with the last lecture material. Those 20 minutes can help you with that next test, as well as build a lasting relationship with your professor!

6. Create a spa day for yourself and your friends. Give yourself a break, stop studying and get a much-needed manicure and pedicure. A good laugh and a healthy do-it-yourself cucumber facial can be the cure to all!

7. Visit an online scrub shop! We all love a fresh new pair of scrubs. Shopping online may be the perfect distraction when you’re in a homework rut. Not only does a new pair of scrubs make you all giddy inside, but it may provide some retail therapy as well.

8. Work out. It’s almost inevitable that nursing school will make us gain weight. Ample gym time is not only crucial for your physical health, but also will allow your mind to stay sharp when memorizing all of the side effects of beta blockers.

9. Learn to cook. I see in your future…very little time to cook. Start whipping up quick and healthy 15-minute meals now. By the time you graduate, you’ll have perfected that yummy lemon baked chicken or gourmet hamburger.

10. Take a nap. The ultimate power nap can rejuvenate your body and give you ample energy to power through those care plans. Twenty minutes of shuteye is all you need to be ready to tackle new tasks.

What’s your favorite way to productively procrastinate?

Melanie Chang is a nursing student at Boston College in Massachusetts.

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There’s been a recent surge and great interest in the “incivility in nursing.” I dare ya to do a quick search–go ahead and Google it. I’ll be here when you get back…

Incivility = violence = lateral violence = disrespect = offensive= etc, etc. In fact, I read an article that spoke of incivility as simply being mean. Mean? Really?

Better yet, I read another article that talked about actions that can be interpreted as ‘”uncivil” (incivil?), such as tardiness or sending an email without a greeting (be still my heart!).

I’m poking a little bit of fun at a real and serious problem. For some strange reason, the world of nursing thinks the problem is unique to its profession. Or that the lateral violence we experience is new or, dare I say, different.

I spent a good amount of time reading some of the leaders’ opinions, blogs, articles and presentations online. I have to admit, I’m still trying to understand the uproar here.

Incivility in the workplace is as old at time. The only difference is how it gets handled and whether or not it’s tolerated. The truth of the matter is that lateral violence or incivility will never go away. It’s everywhere–not just in the workplace, but also in our social circles, in our classrooms and in our homes. It can be less prominent or more severe no matter where you go.

I think therein lies the problem. Lately it’s become more severe in the nursing world. There are a lot of theories as to why, and they are all equally entertaining (at least to me).

1. Men vs. women (nursing is a female-dominated career)
Women are more sensitive and thus are “hurt” easily.

• How is it that women all around the world have survived in the medical community, then? Are you saying physicians are insensitive?

2. Women by their very nature can be catty
I have a hard time refuting this theory, since you don’t hear construction workers complaining about incivility. Men may resort to physical violence, but they aren’t diabolically vengeful (mostly!).

3. It’s the generation (Generation Y vs. Generation X vs. Baby Boomers)
Newer nurses feel “entitled”–they are “above” the basic bedside skills.

• I would have picked the word “spoiled.” And it’s not just the younger nurses who are guilty.

4. BSN graduates are entitled and have an ego
So you think because they advanced their degree, they forgot what it was like at the bedside? Or that they would treat a bedside nurse poorly because they have more letters after their name?

5. Newer nurses preoccupied with leapfrogging
Apparently, it’s viewed as an offense if a young nurse wants to advance his or her education? While neglect is rampant (no argument there), how is pursuing a higher education a bad thing?

6. Newer nurses have no respect
Have you heard the saying “nurses eat their young”? Since when is a bad thing if the young fight back? Respect is a two way street.

•  I think it has everything to do with you as a person (and professional) and how you deal with challenges. Period. It’s that simple. If you don’t want lateral violence to snowball, figure out a way to challenge it and deal with the root of the problem.

REALITY CHECK

We all need to grow some thicker skin
If someone offended you, don’t go tattling on them to your supervisor. Have the self-indignation to confront the assailant as a professional with your views, interpretations and explanations as well as suggestions to alleviate the occurrence from repeating. Do not turn into a high school teenager.

There should be zero tolerance from anyone holding a supervisory or leadership role
This includes every nurse who has more experience than the nurse next to them. I’ll say that again: You assume a leadership role the minute you are no longer the rookie. Period.

Newer nurses: Quit being so spoiled rotten
Just because you were coddled doesn’t give you the right to whine every time something didn’t go according to plan. Learn to roll with the punches. There is definitely a difference between self-assertiveness and immaturity.

Seasoned nurses: Quit being so vindictive and insecure
Leaving the bedside is neither good or bad, it’s just a decision to further one career. If you find it so offensive or appalling, keep it to yourself. Better yet, I dare you to try to take the same leap.

And lastly, this is for all the nurse leaders out there. If you really want to effect change, then quit with the academia-babble
Get out there in the trenches. Get your hands dirty (figuratively and literally). Quit creating new employer-based committees and developing action plans with continuum manifestos and evidenced-based theories. Walk the walk, folks.

Am I being blasé? A little too laissez-faire? Insensitive? Is it because I’m a man??!! (Ohh let the hate mail begin!) Or maybe, it’s because I don’t tolerate or accept the incivility when it shows its face.

I take a professional, head-on approach instead of whining, crying wolf and pleading with a “woe is me” attitude. There is a profound difference between being a victim and acting like one.

Let’s all put on our big-girl and big-boy pants and learn to play nice in the sand box.

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This topic in Medscape has stirred up a real hornet’s nest since two researchers published it in April 2011. It is a huge and VERY volatile issue and, like Pandora’s Box, once you open the lid…

The latter posts (since the authors “reset” the conversation due to the very large number of responses) are more of the opinion that women in the workplace generally cause the problem and that it crosses ALL professions.

Many nurses, both old and young, have experienced abuse at the hands of other nurses.

In spite of all of the advances that women have made, the problem appears to be getting worse instead of better. Perhaps it is simple biology, in which the females in the lion pride vie for top status and bite, scratch, and even kill others to achieve Alpha Female status.

Another possibility is that it’s a side effect of the overall deterioration of behavioral norms and work ethics in the post Baby Boomer generations. “Failure to parent” and “spoiling the child” have been cited as causative factors

Researchers have noted a general decline in basic manners, disregard for others and a strong sense of entitlement in the children and grandchildren of the Boomers.

Nursing education programs have changed significantly from the two- and three-year associate and diploma programs to the bachelor’s degree for licensure. A great many of nursing’s most revered traditions and expectations fell by the wayside in the process.

And very few people who have a four-year university degree want to do basic nursing care (i.e. cleaning up poop!). Many feel that their BSN entitles them to a “more important level” of nursing than bedside clinician, regardless of their lack of experience or expertise in the work environment.

A British study published in 2009 reflects this attitude and is entitled “Too Posh to Wash”(“Nursing Times,” November 2009).

Fair warning: The Brits are not nearly as politically correct as Americans are!

The British report was quite condemning and very pointedly described comments made by students and their attitude toward basic nursing tasks. It even described the modern nursing student thus:

Nowadays, they get up at 11am from a drunken stupor and, on the rare occasions that they can be bothered to go to work, demand a lift from their long-suffering parents and show up in hotpants and leather boots.

A gross exaggeration? Perhaps. But the attitude of superiority is still there, just under the surface. We have all seen these people as new grads. Unfortunately, many of today’s young nurses are going back to obtain master’s degrees and move into positions which are far beyond their level of experience and knowledge to get away from basic patient care.

The danger lies in patients being subjected to advanced caregivers who have more ego than ability, but who will aggressively push their way to the top because they believe that they are superior to other, more experienced nurses.

This is, of course, one way to view the issue. Blogger Sean Dent also offers his thoughts on this topic.

What are the answers? If there are any?

What started as a whisper, slowly turned in to a scream. Searching for an answer where the question is unseen (Ben Harper).

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I have one more year left of being a student, and still have a ton of knowledge to consume. But one thing I know for sure: Being a nurse practitioner student is equal parts excitement and aggravation.

The excitement is seeded in the information-laden state I’m in. Every day I learn something new and cutting edge, and yet so basic and simple to advanced practice. I’m a nurse learning to dip my feet in the deep, deep waters of medicine.

Just when I think I’ve got a hold on a subject, I get that slap in the face from reality. It’s tough being the new kid on the block sometimes.

The aggravation stems from the resistance nurse practitioners have been fighting for years. Being mid-level providers, the world of medicine seems to have drawn a line between support and rejection. To them, we are either here to help them deliver the very best evidenced-base care, or we are here to step on their toes.

I’m not sure why. I’m guessing some of the states that are lobbying for independent practice have struck a nerve in some areas. But once again, I’m still a student, I’m still learning.

Then there’s the offensive and degrading position some physicians have taken. I’m wondering if it’s a defense mechanism?

Today I was told by a physician that NPs are simply hired to do all the “scut-work” that physicians don’t want or like to do. In the physician’s words, “You guys do all the crap/garbage stuff we don’t like or have time for. Is that what you really want to do?”

It took everything I had to not resort to physical violence and/or verbal rampage. (Sorry, folks.)

No doctor, my career and my (soon-to-be) position in the healthcare system is not as your receptionist or your transcriptionist. I actually DO have a set of skills that can not only help you, but may, in fact, elevate the delivery of care to your patients. I am here to help you, not replace you or fill your shoes. I know my limitations.

Today’s healthcare team is supposed to be filled with forward thinkers. Unfortunately, this physician wasn’t one. It may be presumptuous of me to say this, but I think it had something to do with an “old dog learning a new trick.”

Am I wrong to think this way? I know that NPs and their function are gaining popularity and are becoming more widely acknowledged, but we aren’t that new to the block. In fact, NPs have been around for just shy of half a century. I suppose I shouldn’t be too upset by my experience, since it’s the first one of its kind. I guess the edge of the blade was just sharper than I expected.

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I actually read a post a while back from some nurse who wanted to know “the best place to work so that I can find a doctor to marry.” Seriously?

Those of us who have worked with doctors wonder WHY? After all, doctors are “on call” and, especially when in residency, often see more of the hospital than their own apartments. Women are always around and temptation is everywhere. A single male MD, for whatever reason, is a prime target in any town.

And nothing is worse than seeing someone go after a doctor who is already married. If he will leave his wife for YOU, the day may very well come when you find yourself on the other side of the fence, being traded in for a “newer” model.

The societal prestige held by MDs is widely perpetuated by the medical associations and local communities. A doctor can build a fine home in the “right” neighborhood and belong to the local country club the minute he sets up shop, especially in the Deep South. Naturally, his wife is accorded the same considerations. What woman wouldn’t want a piece of THAT?

Unfortunately, these girls are easy to spot. Eternally “stalking” their doctor target, always with makeup and hairdo “just so,” and flirting shamelessly. She most likely will stop working as soon as possible after the wedding, or will work part time in his office. And the poor “mark” never seems to know what hit him!

I have painted a very ugly picture of behavior stemming from a comment that I, frankly, could not believe I was reading.

In my opinion, the whole purpose of going to college is to prepare oneself for a CAREER, and not simply a means by which to marry well. For such a person to take up a nursing school space which might have gone to someone who really DID want to make it his/her life’s work is wasteful at best.

My daughter calls it “seeking an MRS degree.”

This article is by no means intended to convey that all doctors’ wives do these things, but it is a bit of an “expose” on the ones who DO.

What are your thoughts on this, working nurses?

A woman must not depend upon the protection of man, but must be taught to protect herself (Susan B. Anthony).

Image: Warner Bros.

I kind of thought that Nurse Ratched of “One Flew Over the Cuckoo’s Nest” got a bum rap. Until, of course, the last part of the movie when she starts berating Billy by playing the “what will your mother think?” card.

Back in 60s psych wards, there were no counselors who held the group therapy sessions over which Nurse Ratched presided. Shock therapy and/or lobotomy was the usual treatment for extreme depression, suicide attempts, psychoses, and neuroses. The antipsychotics and antidepressants which we now take for granted did not exist.

The depiction was from an era before most modern nurses were even BORN.
A lesser nurse could not have dealt with a unit instigator like Jack Nicholson’s character. Ratched was strong enough to calmly but firmly keep her all-male unit on a schedule (something that certain psych diagnoses need), collaborate with the MD and expect her staff to do their jobs!

Fast forward to 1977: (Future) Nurse Rene is sitting in her psych nursing class with an absolutely phenomenal instructor (who not only has a master’s degree in nursing, but also a huge amount of clinical experience with patients in state institutions and war vets).

So, off the class goes, all fresh and full of textbook knowledge about neuroses and psychoses, on our way to the locked ward in an acute care urban hospital. We are all in street clothes, with only lab coats to distinguish us from the patients.

Our assignment is ONLY to talk with patients and write down what they say. We are not to attempt to treat anyone, give meds, or do any nursing care. We are, however, to report anything like suicidal expressions to the RN in charge.

We sit down at a table with a couple of patients who are sewing leather purses. Cigarettes are handed out only in the day room by staff members for those patients who have smoking privileges. (Obviously this event goes back quite a few years!)

Suddenly, there is a loud crash just behind me. One of the patients hits the floor, face-up, and another stands over him, pumping his chest, shouting, “Breathe! Breathe!”

We looked at each other wondering what to do (and not to do!) in this situation. Finally, one of the staff members comes out from behind the glass-enclosed nurses’ station and pulls the patient up from the floor. He then explains to us: “John does this often just to get attention.”

This all made for a very interesting post-clinical discussion.

Nursing is nothing if not interesting and unpredictable…

“Let us consider that we are all insane. It will explain us to each other; it will unriddle many riddles…” Mark Twain

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This semester starts the strong wave of clinical hours for my Nurse Practitioner program. I’ll be spending many, many hours in the hospital as a student…again.

I’m just a tad bit nervous.

Okay, let me re-phrase that. I’m scared outta my mind!!

I feel like I’m back in nursing school–learning the ropes, talking the talk. Just when I started to find my own walking pace, I’m back to crawling at the next level.

I can’t help but wonder how different things are now from when I was in my diploma program. (I cannot believe it’s been seven years since I became an RN?!)

Here are a few comparisons between me as a basic nursing student and me as an advance practice nursing student:

1. If you don’t know it, know where and how to look it up!

When I was in nursing school, I carried around an average of four textbooks that totaled more than 75 lbs. I lugged my bookbag full of textbooks, notes, and drug reference guides everywhere I went. I can remember trying to figure out how I was going to stash my book bag while on clinicals, because students didn’t get lockers.

As an NP student, I’m still utilizing all the above, but now we have these things called smartphones–all 75 lbs worth of reference material in the palm of my hand. You gotta love technology.

2. The 7 P’s

Prior Proper Planning Prevents Piss-Poor Performance. (I think there are different versions, some more colorful than others. You can blame my time in the armed services for that one.)

I still remember the sleepless nights prior to a day of clinical. I would be up all hours of the night researching my meds, checking and rechecking contraindications, checking and rechecking the whys and why nots of a patient’s care. Oh, and care plans. Gooooood grief. I remember having to write them out. Objectives, interventions, outcomes…they still haunt me to this day.

Now as an NP student, I’m verifying evidence-based nursing and medical research management of care, risk reduction, test sensitivity, outcomes, and physiological response techniques. The game hasn’t changed, but the level of play is elevated beyond my imagination.

3. Stranger in a strange land

I remember the first time I set foot onto the clinical floor as a new student nurse. I was terrified. People were speaking a different language than me; they had a level of familiarity I could only dream of; and ultimately, they didn’t look scared and nothing shook them. I was in awe.

Boy, I can’t wait to feel that way again, let me tell you. (I hope you caught the sarcasm!)

In the end, I’m equal parts nervous, scared, anxious, excited, eager and motivated. Only time will tell how this first round of clinical rotations will go. Wish me luck.

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Health care is one of the fastest growing professions out there, but every day, prospective students are being turned away because of a lesser-known shortage: there aren’t enough Nurse Educators to teach them all!

As a nurse, you are already ahead of the curve if you’re interested in becoming a Nurse Educator. After all, you already know most of the material. Becoming a nursing instructor is also a great way to change careers into something with more flexible hours, less physical strain, and better pay. Oh, and by the way, if you’re a Nurse Manager, or aspiring to be one, you’ll find these qualities apply to you, too!

Sounds good, doesn’t it? Read on for the 10 qualities that you’ll need if you want to survive and thrive as a Nurse Educator…and a Nurse Manager.

#10: Patience
Patience is one of those obvious traits that is often surprisingly under-cultivated in teachers. Having patience both with students and yourself will create a more disciplined, more rational you. Patience can overcome anxiety, fear, discouragement and failure, which you can apply both to your own teaching style, but also impart to your students.

How to get this coveted quality? Relax! You can immediately make progress by taking a few deep breaths and taking an extra 30 seconds to answer a student’s question, make a diagnosis, or reply to an irate patient. Remind yourself that all things take time.

#9: Emotional Intellect
Part of a teacher’s job is to help a student get through the course with success. Sometimes this means recognizing that specific students need extra help, and sometimes it means giving freer reign to a student who is doing especially well. Research tracking over 160 high performing individuals in a variety of industries and job levels revealed that emotional intelligence was two times more important in contributing to excellence than intellect and expertise alone. Emotional intelligence can help you discern what your students need, but it can also be a valuable tool to help you decide how to react in stressful teaching situations, navigate academic politics, and bond with students to give everyone a richer and more meaningful experience.

#8: Dedication
There is no question about it: nursing is a tough job. To be a nurse, a person needs endless dedication and a real belief that they are changing the world. To see dedication in a teacher inspires the students and shows them that even through many years of nursing, that the instructor has not lost their spark. In some ways, teaching a future nurse the art of determination is even more important than teaching those basic nursing skills. By being an example of dedication, the instructor is able to teach a valuable lesson that will help students break into their chosen profession and stay there.

FIU Nursing Students Perform Simulation - Image: Flickriver.com

The first time I was introduced to the “sim-lab,” I can tell you—I had reservations.

I hadn’t heard much about simulation experiences. It seemed almost like a taboo topic (or maybe I just wanted it to have some mystical appeal so I wouldn’t feel as if I were being robbed of a “real” clinical experience).

Either way, I wondered: Would the sim-lab just be a bad re-creation of a science-fiction movie or is it cutting-edge teaching technology?

I decided to get the most out of this alternative form of education now that my nursing school class was selected to participate in a study that pitted simulation against clinical exposure—which one created better nurses?

For starters, I’d heard students’ stories of their first semester of clinicals, and I can tell you, I was highly underwhelmed. It sounded to me like the grunt work of Nursing 101. It was the first time students were exposed to patients in an actual clinical setting, and how they fared ranged wildly. Although there were students who got to sit in on surgeries and circulate ICU, there were just as many who only got the chance to change bedpans the whole semester!

Here’s what happened during my semester: I made it through my first code, my first home visit, my first medication administration, my first encounter with a patient in septic shock. I also got to watch a DNR take its course and was exposed to patients with airborne pathogens—and it was all simulated. When it was over, I was certain I had made it through with enough clinical experience to SAVE THE WORLD! Okay, maybe not to that extent, but I had become extremely confident in my abilities.

Simulation turned out to be an experience that pushed me to think more critically as a nurse. My fear is that clinical settings often only allow you to shadow or follow a nurse on her rounds; rarely do they allow you to play the role of the nurse entirely. In simulation, you are the nurse. Every time I stepped into that simulation room, I went into adrenaline mode. It honestly felt like the life of this robot was in my hands!

Our simulations even included “family members” played by my fellow students (some of whom deserve daytime television award nominations!). Yes, the crying daughter, or the girl in my lecture class, can still invoke a sense of urgency closely resembling what you would actually experience in a clinical setting.

I’m extremely proud of how much my clinical group accomplished. Our simulations went from looking like a community clown academy’s dress rehearsals to Grey’s Anatomy in just one semester.

If you were to ask me now what I think the outcome of the study is going to be, I would say that there is a certain set of skills that, until demonstrated, are not learned. I think simulation training will produce more efficient and proficient nurses than clinical settings alone. I’ll continue to be a member of this study for the next two years and will update you accordingly!

What do you think? Will simulation one day be just as much of a prerequisite as real clinical experience for nursing students?

Julia Ruiz is currently attending a BSN program at Florida International University. She lives to love and laugh. One day, she hopes to be an Acute Care Nurse Practitioner.

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Dear Santa.

I’ve been super good this year.

I went to all my classes, and even when I was going to skip that one Family Nursing Lecture to go to my best-friend’s graduation, I stuck it out and stayed (thank you for canceling class that day!).

I’ve studied hard and worked my butt off coming up with some pretty amazing nursing diagnoses and care plans for my patients. And even though I’ve doodled a bit too much on my notes and maybe spent too much time on Facebook in class, I’ve really been trying to stay awake!

So here’s my Christmas wish-list for this year:

1. Some new scrubs – rotating between 3 pairs is great, but a few more sets would add some variety into my daily routine (no white please!)
2. Really awesome bandage scissors – I know the seasoned nurses have said there’s no point because I will lose them anyway – I would still like a pair that cut well… with pink handles
3. Extra supplies are always good – black pens that write really well that look cute (Hello Kitty!) or maybe some colorful dry-erase markers, a spare pen light is always good too.
4. New hospital shoes – mine are feeling the wear of the last two years and are a lot heavier than I remember. Maybe some Reebok Easy-Tones, so I can go to work and workout at the same time?

I’m pretty much set after that. But if you’d like to send some Christmas magic my way as well, here are a few more things I could use:

1. A good night’s sleep – it doesn’t have to be every night (that would be a miracle!), but if you could work it out so I can sleep soundly the nights before clinical and before work, I would greatly appreciate it. Plus, you know, it will help me be more efficient during the day… so you’d be helping me in the long run too.
2. A confidence boost – I’ve come this far and done pretty well, but that doesn’t mean I don’t forget it all when it comes time to turn in a project or write another case study. If you could just send an extra boost of confidence my way and remind me, that’d be great
3. A pillow that functions as a membrane – you know, so I can stick my text book under it and go to bed and learn through osmosis. Would be particularly awesome for studying for the NCLEX…. I could be learning 24/7!

Now Santa, I hope that’s not asking too much (and if it is, I am fine with using the osmolar pillow only on nights before tests!), but I think I’ve been pretty good this year, and well, some Christmas magic would really help bring some cheer in all this rain – and get me through the home-stretch!