CNA Blog

Like many of you, I have been following the Amanda Trujillo case. I will take a stance; a neutral stance and I will tell you why. So often the media has a way of skewing authenticity of any situation. This case is no different. I do believe this case is definitely worth investigating. Yes, I do believe Amanda Trujillo’s punishment to be harsh. Yes, I do believe she could have communicated with the physician. There appears to me, which I see as highly frightening, an overall lack of communication all around. This case is one we can all learn from, patient, nurse, and physician. A story, if that is what to call it, that will surely mold the future of all within health care and rightly so.

The facts are the facts. However, I believe we do not have all of the facts to conclude a case in either direction. After reading numerous blogs, posts, petitions, there appears to be an outrage amongst nurses. To me, this is signaling more than the obvious this case presents. It is showcasing the undertone of how nurses feel, neglected, unworthy, uneducated. It is almost as if this case has opened the stream of feelings and opinions of those working beside physicians and the lack of respect demonstrated towards nurses. Nurses believe, and demand, the freedom to engage with patients and inform according to the patients desires. In theory this does not seem like a problem. In reality it is. Further more, it is clear neither the nurse nor physician communicated. I believe the only person in this situation who was neglected was the patient. Both Amanda and the physician need to be aware of their actions and help accountable.

Physicians do have immeasurable expertise and are the one responsible for patient care. Nurses work side by side with physicians to help carry out the demands of a physician. Again, in theory this would work. In reality, more often than not, physicians have an alarming amount of patients they must monitor, which makes it physically impossible to meet every demand. This is when physicians must place confidence in their nurses. It would be alarming if physicians believed they were the only capable individuals to provide care and knowledge to patients. They should have faith their nursing staff is highly educated, motivated, and committed, to the overall objective of patient care and safety. I believe a great leader educates to the point that they are no longer necessary for operation. A true leader takes pride in having a staff with such expertise and wisdom. It does not appear this is the case in this scenario. Again, hard for me to conclude a true response to a situation I feel does not have all the facts presented.

In conclusion, this case will be remembered and talked about for years to come in all of healthcare. Should a physician outweigh the rights of a patient? Was it appropriate for the physician to cancel the consult with the hospice case manager? I strongly believe the answer to these questions is no. I also strongly believe communication and trust must be established way before a patient is even in the picture. Build a team, not a segregated staff. I presume the results would be astonishing.

Today it is apparent hospitals need assistance in “cleaning up their act”, so to speak. We’ve all heard about the numerous cases where people go to a hospital to seek medical aid and leave with a staph infection or something worse. The amount of waste that comes from hospitals, as well as the products used to create excess waste. We can talk about the negligence throughout a hospital staff when handling medical records, updates, and patient care. There is always room for improvement in any sector; hospitals desperately need attention merely for the fact people put their trust and faith in them.

Previous generations may not have foreseen the issues today surrounding the issues above as well as many other very serious issues. After all, many hospitals were focusing on lowering infant mortality rates, pain management, and advancements in surgical practices. Naturally, waste control management was not at the top of a hospitals priority list. With modern medicine steaming ahead, I believe it is safe to say we need to reestablish new guidelines and practices that fit today’s modern advances. This includes the people within as well as the medical companies on the outside. This begins with learning and engaging in sustainable practices and living. Modifying leadership to fit new standards and goals. Fortunately, there is someone else who is also taking this step but in a very major way, The Healthy Hospital Initiative.

The Healthy Hospital Initiative focuses on green living within a hospital. Implementing the following practices will prove worthwhile and I’m sure, beyond expectations. Below are the six key steps to achieving these goals (http://healthierhospitals.org/hhi-challenges).

• Healthier Food
• Less Energy
• Less Waste
• Safer Chemicals
• Smarter Purchasing

Taking a moment to learn how one hospital, person, company, at a time can begin to transform the future of healthcare is imperative to succeed at this mission. After all, it was only a matter of time before hospitals would be “green” and sustainable. Thankfully, the time is now. Be a leader and take on the Healthy Hospital Initiative!

I am always wondering how other nurses manage their daily life outside of work when essentially a nurse never turns off. That said, I begin thinking how I help with my own stress and time management of being a mother, wife, and full time employee.

For starters, I would like to say we somehow manage it all. I remember the college days when all I had to think about was preparing for the next test and myself. Today, a much different picture is painted. Nurses, regardless of the field one works or the shift, have one of the most demanding careers out there. Just how do we manage it all? Below are some strategies I have incorporated into my daily routine that not only help with stress, but also keep me happy and thriving as a nurse, mother, and wife. Enjoy!

• Yoga – Bikram yoga has been my favorite, but if you don’t like the heat, any yoga will do! I always leave a class feeling beyond refreshed and ready for any challenge. The other benefit is you get an amazing work out while clearing your mind, body, and soul. Most studios offer schedules that can be worked into every lifestyle or career. Remember, there is nothing more important than your health. You can learn everything there is to know about Bikram here: http://www.bikramyoga.com/
• Family time – this sounds like common sense but trust me, too often I find myself coming home, tired, and sitting in front of the TV or computer. Take this time to sit at the table with the kids, take the dog for a walk, or if you’re lucky enough, poor a bubble bath. Take this time to focus on what matters most, you and your family.
• Learn to turn off electronics – Again, learning to not answer every text, call, or email as soon as one arrives. If a true emergency is happening, they will call (not text or email) and they will call again! It is so easy to let electronics rule your time, on or off shifts, learning to slow down is essential. I have learned it is impossible to slow down, take time for my family, or myself if I am constantly connected.
• Finally, but not last, take time to remember why you entered the nursing profession. Whatever the reason, you will be that much better and skilled if the above steps are achieved and enjoyed. If yoga is not your idea of relieving stress, do what it is. Maybe you do not know, take a class at a local community college on pottery design. Bottom line, your health is essential in order to continue your passion as a nurse, mother, and wife.

Ever stop and wonder how small towns, large cities, or communities are educated on health? You can thank your local public health nurse. These amazing individuals seek out public health nursing careers to work within communities, educating people on general health and trends that pertain to each environment. Public health nurses take into account several factors: environment, genetic make-up, lifestyle, and common knowledge within the area of specific illnesses or diseases. Public health nurses work hard to prevent disease, ensure everyone has access to local healthcare regardless of socioeconomic background, and takes pride in doing so.

One major difference of a public health nurse compared to a nurse working in a hospital setting; they are continually striving to prevent illness and disease before it happens. Public health nurses may also be a person’s only interaction with for health check-ups for those who cannot afford routine hospital visits. Public health nurses believe through education, prevention, and awareness, some common illnesses and diseases can be avoided.

Becoming a public health nurse generally focuses on researching trends, communities and the resources available within that specific area. The primary motive behind a public health nurse is to improve community health and safety through education and prevention. Common examples are immunizations, disease prevention, educating on specific needs, such as taking care of a disabled person or an elderly. They also handle prenatal check-ups, care for baby after birth, and care of mother. Public health nurses are also advocates at local and state levels. Often, they are the only voice for people of lower income status or rural areas. Public health nurses work hard to bring health care into every community.

I wonder, what would our country be without these angles? I can only imagine and thankfully, careers in public nursing are growing and increasing throughout the country. Everyone deserves healthcare. Everywhere. Thank you to all the public health nurses who have been caring for our communities.

There is a strange parallel between a night nurse and survival. I’ve heard stories of those working night shifts and learning how to manage “day life” while working nights. Learning to retrain your body to function on off hours, working these off hours and enjoying the journey, is close to survival in my book. I believe there are advantages to being a night nurse, if they are important to you. These advantages are critical to not only succeed as a nurse, but to do so with passion and enjoyment.

Often you hear of day shift nurses having little compassion for night shift nurses simply because they do not feel night nurses have the same amount of work. Or night shift nurses commonly say they are “always cleaning up after day shift nurses mistakes”.  However, a nurse is a nurse regardless of the hour worked. Furthermore, nurses should be a team. Period. This is not about which nurse is working more, harder, or is more of a nurse. They are both equally as important to one another and hospitals depend on both. This is about learning to work together as a team, techniques to stay thriving if you are a night nurse, learning to communicate, and creating solutions together that fit all.

I believe, of course easier said than done, communication is key in revolutionizing nursing. If nurses who work only day shifts are complaining of night shift nurses, or vice versa, the best solution is to have these nurses work the opposite schedule for one month. This would automatically eliminate some of the most common issues because there is nothing better than actual experience. Once a nurse has worked both shifts for long enough to truly understand each advantages and set backs, forming a team with great communication will be achievable task.

If you are working solely as a night nurse, the only way to remain excellent within any nursing profession is to stay balanced and get adequate sleep. As easy as it sounds, creating balance is not easy. Learning the advantages of working nights, one can participate at their children’s school, may work fewer days per week, and have opportunities to work closely with patients due to the mellower paced environment.

Again, there are pros and cons to working day or night shifts; finding the ones that make you tick is key to success and happiness. After all, nurses are a special group of individuals who care for the common good and health in all. It should not stop at patients. Communicate. Be a team. Be a nurse.

The time has come. You are pondering joining a professional nursing organization, weighing out the reasons to join, not to join. Let me tell you a little secret, organizations are essential for career growth. They pave the path for those who do not have the time to dedicate learning of possible job openings, networking, and most importantly, earning credits towards continued education.

Starting with continued education, the benefits are clear. Belonging to a professional organization allows one to attend conferences or conventions to earn the required on-going education requirements for nurses in the United States. By participating in these courses, events, conferences, one is fulfilling their personal and professional needs at the same time! It does not get much better than that.

Networking is major, regardless of the field or profession but especially in nursing and healthcare. Dedication to your profession comes in many forms and by showing your support for nursing organizations; you’re contributing to an ever-lasting partnership. Learn new ways to network. If moving, find new job openings and organizations in a new city or town. The possibilities are endless. Networking is the key to unlocking your future.

Lastly but not finally, research the benefits of joining a professional organization outside the obvious. Would you be supporting your profession on multiple levels? Do you have a voice in areas you could not otherwise? Do you have access to other professions outside of nursing? This is known; healthcare professionals and professional organizations need each other. Be apart of the bigger picture. Be a leader in your own way. Join a professional organization!

Here are some industry leaders in healthcare professional organizations for nurses:

• American Academy of Nursing
• American Association of Colleges of Nursing
• American Nurses Association
• Canadian Nurses Association
• International Council of Nurses
• The American Assembly For Men in Nursing
• Association of Women’s Obstetric and Neonatal Nurses
• The Council for the Advancement of Nursing Science

Ever find yourself not so keen on working in the same work environment day after day? Or maybe you prefer new challenges and strive to avoid job burnout? If so, becoming a travel nurse may be a wonderful fit both personally and professionally. Today, the job growth outlook for those entering the nursing profession as a travel nurse is growing rapidly and expected to continue. This is a wonderful adventure while gaining invaluable experience as a nurse.

Travel nurses benefit from a wide range of assignments and the durations can last anywhere from one month to a year (sometimes longer). Often a travel nurse will have the advantage of working with people from all around the country and often around the world. Those who experience working in various environments have greater exposure to multiple situations, while strengthening a work portfolio. Nurses in this field are exposed to labor and delivery, pediatrics, ER, operating rooms, and more.

Nurses seeking this type of career tend to be independent, have excellent communication skills, dependable, experience working in multiple scenarios, and enjoy working in new situations. A travel nurse can enjoy generous benefits and pay, flexible schedules, and the option to move or relocate after the completion of an assignment. Nurses in these work settings almost always live free while on assignment and enjoy outstanding benefits, often free of charge.

The process to become a travel nurse is much like any other nursing profession. Earning a bachelor’s of Science degree is the most popular option, as it opens several doors within a nursing profession. An associate’s degree is an option, but often nurses who take this route resume schooling at a later date to complete a bachelor’s of science degree to pursue career advancement opportunities. After completion of a suitable degree program, one must complete the nursing board exams. The final step in becoming a travel nurse is working in a hospital setting for at least one year.

Completion of the above will begin an exciting, fast paced, journey for any nurse seeking to do what they love most while seeing the world. Gain experience, travel, and become a leader as a travel nurse!

Nursing in public schools in nothing new. History shows nurses have been providing care in educational settings as early as the 1800’s. What is new is the ongoing issue surrounding the shortage of nurses in public schools. There are many theories to why nurses have steered clear of schools and prefer hospital settings. However, with the shortage of nurses all together, working within the public school system has many perks unavailable to nurses in traditional hospital settings.

School nurses are vital to the overall well being of students. I find it interesting this topic isn’t more frequently discussed within public education issues. In low-income areas, a school nurse is commonly the only health care professional a student will see. Another important reason for school nurses is assisting children who have disabilities that require aid, for example a child who has a tube for feeding. Food allergies have been on the rise and often a school nurse is vital at keeping children alive during critical moments. According to the National Association of School Nurses, “only 45 percent of the nation’s public schools have a full-time on-site nurse. Thirty percent have one who works part-time — often dividing her hours between multiple school buildings — and a full 25 percent have no nurse at all.” This illustrates not only the high demand of the school nurse shortage, but the seriousness it carries for all.

Today, nurses who work within the education system have more clear, defined roles than the past. Often focusing on children with a specific need – special education, high-risk behavior, elementary children, and so on. Furthermore, those who become school nurses build a strong, well-varied work portfolio. Another perk to working as a nurse in education is the schedule compared to one working in a hospital setting. Those who work in a school environment never works nights, weekends, and has summers off!  To me, there is nothing better than helping children and becoming a school nurse does just that and much more.

One day, you may find your self dreaming of a world where women are not only helping women and babies but doing so in a modern world complete with doctors, machines and modern day medicine. This is the first step in the journey to becoming a CNM (Certified Nurse Midwife). The second begins with earning a nursing degree and venturing on to a master’s degree in nursing, as well as passing the American College of Nursing Midwives examination. Many women today are deciding a midwife is exactly how they envision their pregnancy and delivery.

Something worth noting is the dedication CNM’s have to their professions. It is true like many nurses they care for patients but what makes a CNM so special is they often form relationships after the patient and baby are no longer needed. Midwifes feel connected on multiple levels of care for both mother and baby. Their dedication is proving true when they know a hospital is in the best interest of the mother or baby, or both. It takes a certain type of person to take on the challenges of working with and against modern day medicine and procedures. One many find beyond rewarding and exciting.

Entering the field can be daunting but fortunately there are several people willing to mentor and the practical, hands-on training received prior to working, will provide a strong backbone for the road ahead. Midwives are essentially like a mother with a nursing background. They provide not only care but also advice throughout the entire pregnancy and beyond.

As there are several professions within nursing, there are a few types of midwifes. Learning the differences is essential to knowing the path you want to navigate as they all come with different requirements and pathways to achieving them. The three main are:

• Certified Nurse Midwife (CNM), which receives a nursing degree with additional study of midwifery.
• Certified Professional Midwife (CPM), which has passed the midwife training and North American Registry of Midwives (NARM) competency test and is awarded the CPM Certificate.
• Direct Entry Midwife, who is someone with practical experience through various methods such as study, apprentice, and a midwifery school that is not affiliated with a nursing program.

All programs can lead one in a direction filled with happiness, passion, and dedication to providing an alternative method to the standardized approach of pregnancy and childbirth. Thankfully, women come together to provide choices for all.

Nurses are required to communicate everything. That said, every nurse should learn to over communicate, rather than just reciting instructions. Taking the time to truly understand what is being said can remove future complications due simply to communication error. Too often nurses are faced with rushing around delivering news to each patient prescribed by their doctors. Interestingly enough, it is the nurse who must thoroughly know and understand the message to be delivered. Nurses are also faced with properly passing information to the next nurse on shift. The communication torch is critical on every point. This is where over communicating is the only way.

A few simple steps can ease transition periods, as well as learning to effectively communicate with patients and doctors. Too often we get into routines that is to repeat what the paper states; make no mistake this is still very important. What should be added is the proper knowledge and understanding of these notes. Doing so will keep you as a nurse not only up to date, but able to catch errors and make further suggestions to the patient. This could be to ease comfort, what foods to avoid or add, etc.

Bottom line, the more one communicates, the better the outcome. Speaking up when something does not seem protocol could save a life. Keep your mind fresh and in tune with your surroundings. Enjoy being the amazing nurse you are!