I don’t know too many health care professionals who couldn’t sit down and write a book about their job. After all, we have a ringside seat to one of the greatest shows on earth. Now, with the advent of blogging and social networking sites like Facebook, many health care professionals are bypassing book publishers and are taking their stories straight to the Internet. Blogging and having “friends” can be a lot of fun, but remember, what you put out on the Internet can affect your career.

Here’s a case in point. I just read a story today about a Swedish nurse who used her cell phone to take pictures of surgical procedures, and then published them on her Facebook page. Apparently, she did it because she wanted to impress her high-powered Facebook friends. Her employer wasn’t impressed, and now the nurse is facing dire consequences for her actions. An investigation is underway and her employer will decide whether to fire her or turn her over to the police. She’s in deep trouble. Cameras are banned from operating rooms unless the pictures are specifically intended to be used medical research, and for educational purposes. More importantly, she violated patient confidentiality.

Other cases illustrate the pitfalls of writing about what’s going on at work. The blogosphere was buzzing when Dr. Robert P. Lindeman settled a malpractice lawsuit after opposing counsel outed him on the witness stand as Flea, the author of drfleablog. Lindeman, a graduate of Yale University and Columbia University’s College of Physicians and Surgeons, had posted scathing entries on his blog about his trial, and his uncensored comments about lawyers, jurors, and the legal process ultimately sealed his fate. During an interview after the trial, Lindeman stated that this incident has had a huge impact of his professional and personal life — he said that his wife threatened to divorce him — and that he is never going to blog again.

There are certain things you must keep in mind when you write a blog. The first thing to remember is that you can be identified as the author of your blog, even if you write under a pseudonym. There are ways of tracking an author down, so be careful when you put your thoughts and feelings out on the Internet. Keep in mind that your boss and coworkers may be reading your posts. Check to see if your employer has a policy about blogging before you put up your first post. You must also protect patient confidentiality. Do not publish any identifying information such as names, specific times, places, or procedures, and never refer to an exact diagnosis. It’s always a good idea to post a disclaimer on your blog.

If you’re a blogger, or what to learn more about blogs, join the conversation at NursingVoices. We’re waiting to hear from you.

There is such a demand for nurses these days given the tremendous shortage that it’s becoming a very popular move for people to switch careers and go down the nursing path. Conservative estimates figure that there will be a shortage of almost 10,000 nurses within the next ten years which makes the switch a very attractive one for many people looking to change careers. However, there are always drawbacks to any thing that seems too good to be true. We’ve come up with a list of the pros and cons of a nursing career to help someone decide if this rewarding career is exactly for you…

The Pros:

Making a difference in people’s lives — This is the number one reward of being a nurse. You are being counted on to help improve people’s wellbeing and it is right there in the job description. When a sick person is in a position where they cannot take care of themselves they turn to caregivers that know all the tricks to improving their way of life.

Flexible scheduling — Many nurses are able to make a schedule that will work best for their families. Maybe the 9-5 routine doesn’t fit your needs, so you work a couple overnight and pull double shifts to free up your schedule later in the week. You can also choose what type of institution you work in. Do you want to work with the elderly? Apply to a nursing home. Do you love working with kids? Work in a pediatric section of a hospital.

The benefits are phenomenal — Working as a nurse provides you with a very comfortable salary. It’s worth it after three grueling years of post-baccalaureate study. Most institutions offer excellent healthcare benefits and retirement packages that make this career very appealing.

The Cons:

The stress can be overwhelming — The more you get attached to your patients the more difficult it is to deal with their suffering. Many nurses will talk about the burnout they feel after even a year or two in the field because of the recurring stress that comes with each and every patient that comes into your care.

Dealing with difficult people — You’re working with people that don’t feel well and it’s human nature for people in this position to be cranky and irritable. They may be the greatest people but they’re coming to you when the feel lousy and they can make your job much harder just because of their attitude.

There is no time to zone out — You know people that work in cubicles all day and surf the net and waste hours a day doing nothing at their jobs. This doesn’t happen when you’re a nurse. You have to be ready for anything at all times.

–

This article is contributed by Heather Johnson, who regularly writes on online nursing schools. She invites your questions and writing job opportunities at her personal email address: heatherjohnson2323 at gmail dot com.

Look at these nursing students from the Capital City School of Nursing in Washington, D.C. In this picture, taken in 1933, these nursing students look calm, confident, and ready to face the world. I’m going to let you in on a little secret. These nursing students were worried, just like you are about passing their state nursing board examination. I got a headache and was sick to my stomach the day I took my boards. Are you nervous about taking the NCLEX-RN? Never fear. With a little preparation, you, too, can pass your test.

The NCLEX-RN tests your nursing knowledge, as well as your critical thinking skills. The test sounds overwhelming, but you can get ready for the test by purchasing a good book. There are many good study guidebooks available online. These books will help you become familiar with test content and format, and topics covered on the exam. Look for a book that includes at least two practice tests, detailed explanations of test answers, and in-depth analysis of NCLEX-RN exam questions.

Studying in a dedicated room of your home, free of distractions, will help you keep your learning materials in one place and will also help you keep in the routine of studying for your test. It’s important that you study everyday in a well lit area so you feel more confident when you take your exam. Study for an extended period and take short breaks. This will help you focus, and improve your ability to concentrate on the test day. It’s also fun to study with a partner. Study partners can keep you motivated, and they can make studying more enjoyable. Change study topics frequently to help keep the material fresh. Also, let friends and family members know what your study hours are so they can give you some breathing space while you prepare for your test.

Reading the answers in your study guide is a good way of preparing for the test, but don’t over analyze everything in the book. This practice will cause you more stress, and it’s counterproductive. It won’t help you prepare for the test. Read all of the answers when you take your practice tests, whether you got them right or not. This will help you understand the questions that you missed and reinforce in the information that you got right. Use flash cards and always keep them with you if you don’t have a lot of time to study. You can flip through them when you’re on the bus, riding the subway or while waiting in line at the grocery store.

Don’t freak out about taking the NCLEX. You’ve study hard while attending nursing school, and you know more than you think. You’ll get through your exam just like all the other nurses who came before you. Come to NursingVoices to find support while you prepare for your test. There are nurses waiting to give you advice and cheer you on as you enter the nursing profession.

It’s that time of year again when student nursing students start asking me for tips on how to get through nursing school. I received this letter from one of my readers.

I am a 25 year old who has decided to attend school and become a nurse. I started taking core courses back in high school, but I changed to computer science when I couldn’t get through my chemistry class. I currently have a degree in computer science and I am entering nursing school this fall. I couldn’t be happier about my decision to go back to school, but I’m really nervous. Could you give me some tips and advice about getting through nursing school?

Sincerely, Nervous Nursing Student

Dear Nervous,

Congratulations on your decision to become a nurse. You’ve chosen a great career. The next couple of years are going to be challenging, but not impossible, if you follow a few tips.

1. Nursing students don’t have to be perfect

Striving for excellence is an admirable quality in a nursing student, but remember, there is no such thing as absolute perfection. Don’t drive yourself crazy by trying to be the perfect nurse. Just take a deep breath and relax if you forget a lab value during clinical or you miss a question on a test. We all make mistakes and you’re going to make a lot of them while you’re in nursing school.

2. Learn to live in a dirty house when you are in nursing school

I hear you laughing, but the person who said that cleanliness was next to Godliness never attended nursing school. I’m not suggesting that you live in filth, but you need to use your cleaning time to hit the nursing books. So what if the laundry piles up? No one died from lack of clean clothes. Ask your family to pitch in and help with the household chores. Even small children can do their part by picking up their own toys. Lowering your housekeeping standards will help you keep your sanity while you are in nursing school.

3. Get organized before your first day of class

Nothing is as stressful as trying to pull yourself together for nursing school at the last minute. Don’t do it! Organization is the cornerstone of a successful nursing school experience. Get reliable childcare in place, and register for your classes early. Moreover, you may not get what you want if you wait until the last minute to sign up for you classes, and don’t forget to shop early for your nursing books. This not only cuts down your stress level, it will also save you money. Remember, finding a good deal takes time, so start shopping! My favorite online book vendor is NursingJobs.org.

4. Use simple study tools to help you study

Sure, I’d like to own the latest and greatest technology to help me get through my day, but sometimes simplicity is the key to studying for a test. Do you have trouble memorizing facts and statistics? There’s no need for a Palm Pilot when inexpensive note cards can help you remember facts about medications, lab values, and nursing protocols.

If you’re a nursing student with other tips about how to get through nursing school, come over to NursingVoices and tell us about it. We’re waiting to hear from you.

Are you suffering from nursing burnout? If you feel like you’re going crazy, you’re not alone. Countless nurses are leaving nursing because they are tired and worn out. You don’t need to throw away your nursing license in order to avoid burnout. There is a remedy for nursing burnout that doesn’t involve fleeing the profession.

An old adage says variety is the spice of life. Recycling your nursing career will help cure nursing burnout while adding some spice to your professional life. Nursing is full of variety. Many years ago, new nurses would traditionally take jobs as general medical/surgical nurses, and then work their way onto more specialized units. Job options back then were limited, and there weren’t many opportunities for advancement. Today, nurses are leapfrogging from job to job, and are working throughout the entire healthcare arena.

Times are changing, and many nurses are finding exciting new opportunities by venturing into untraditional waters. For example, domestic violence nurses work with children, adults, and the elderly in clinics and at shelters for the abused. They also do research to prevent domestic violence. Complementary health nurses are merging traditional and alternative health practices as a way of providing patient care. Not long ago, alternative health care such as Reiki, acupuncture, massage therapy, and guided imagery were viewed as quackery, but today many nurses are using these methods within their nursing practice. These methods are going mainstream, and becoming more accepted within the health care community. Technology is also changing, and individuals who are interested in nursing informatics are changing with the times. This new emerging field involves all aspects of computerization as it relates to nursing and healthcare practice. Informatic nurses are finding jobs at hospitals and within other healthcare facilities, computer software and hardware companies, healthcare consulting firms, colleges and universities, and at pharmaceutical and research facilities.

There are also exciting nursing opportunities within traditional nursing. Critical care nurses and emergency room nurses are in demand. Critical care nurses care for patients of all ages who are acutely ill or in critical condition. These nurses work primarily in hospital intensive care and cardiac units with sophisticated equipment, and are responsible for the emotional welfare of patients and their families. Emergency room nursing offers nurses the opportunity to think on their feet while they save lives. Emergency nursing focuses on providing quality patient care for people of all ages. Nurses working in an emergency room must have a wide base of knowledge to draw from as they care for patients presenting with illnesses or injury situations, ranging from a scraped knee to a heart attack. There are approximately 90,000 emergency nurses in the US, and more emergency room nurses are needed to meet demand.

If you are bored with current nursing job, it’s time to recycle your nursing career. Start your job search at NursingJobs.org. Once you’ve found your new job, come over to NursingVoices and tell us about your experience. We’re waiting to hear from you.

One day this may happen to you. You land your dream job and it’s your first day at work. You’re excited because you have waited all your life for this job. Then you meet a seemingly satanic character that turns out to be your nurse manager. Before you start looking for the nearest exit, stop, breath, and then take action. By following a few simple steps, you might be able to keep your dream job from turning into a nightmare.

I’ve been a psychiatric nurse for many years, and I’m a great believer that we teach people how to treat us, even in the workplace. However, it’s very important that you take immediate action if you believe that your boss is victimizing you. Be diplomatic, and tell your boss exactly what is bothering you. Use explicit examples, and tell your boss how their behavior is affecting your job performance. Don’t try talking to your boss when they are walking down the hall, or when they are getting ready for a meeting. Timing is everything. Pick a time that is convenient for both of you, and talk in a quiet, private place. Most importantly, remain cool and calm. Don’t confront your boss in an emotionally charged rant. If your nurse manager is a bully, ask your hospital’s human resources director to sit in on the meeting. Hospitals are taking a more active role in employee mediation because they don’t want nurses to quit and leave the nursing profession.

One of the most important things you can do to protect yourself from a bad nurse manager is to communicate in writing. Getting things in writing eliminates plausible denial. No one can claim he or she was out of the loop, and it keeps everyone honest. It also keeps the conversation civil. I once told a boss that if she wasn’t willing to put her comments down in writing, she had no business saying them to me in first place. Also, keep a journal of everything that happens at work. Write down times, date, and quotes. It can be used as evidence if you ever have to take your boss to court. Also, ask for a copy of your hospital’s employee handbook. It will spell out your institution’s code of conduct and will tell you how to file a grievance just in case you can’t work things out with your boss.

Take your concerns up the corporate ladder if you can’t work things out with your boss. If your pleas for help fall on deaf ears, it’s time to move on. Life is too short to work in a job that you can’t stand. Remember, there is a nursing shortage and you are in demand. There’s another job just around the corner. Check out the job listings on NursingJobs.org to find your next nursing dream job.

Have you had a bad boss? Are you currently working for a bad boss? Leave a comment or join us in the NursingVoices forum to share your story.

Nursing school is expensive, and just like everything else, the cost of a nursing education is going up. If you are a nursing student, or plan to attend nursing school in the near future, don’t despair. With a little bit of digging, you can find a treasure trove of nursing scholarships that will help finance your nursing education.

There is good news and bad news when it comes to paying for nursing school. Tuition, nursing books, and nursing uniforms are very expensive. That’s the bad news. The good news is that there is a nursing shortage. Yes, it sounds crazy, but the nursing shortage is making it easier for students to find money for nursing school. That’s because the government and private organizations and agencies are putting up the money to help solve the nursing shortage.

The first step in receiving any sort of scholarship or financial aid for nursing school is to fill out the Free Application for Federal Student Aid, or FAFSA form. You can obtain an application at your school, or fill one out online. The information that you enter on your FAFSA form is very important because it determines how much money your family is expected to put towards your nursing education. The difference between what your family will have to pay and the amount of tuition at your chosen nursing school can be covered by federally backed grants and loans. Try to avoid taking school loans out from a bank. Some loans allow banks to raise interest rates on what you owe after you graduate, and you can never default on your loan, even if you ever declare bankruptcy.

The next step is to look for nursing scholarships in the private and government sectors, and since individual scholarships rarely pay for an entire nursing education, it’s a good idea to apply for multiple nursing scholarships and grants. Nursing organizations and healthcare companies are always offering nursing scholarships to deserving students who want to enter the nursing profession. For example, the Robert Wood Johnson Foundation (RWJF) has joined with the American Association of Colleges of Nursing (AACN) to create the Robert Wood Johnson Foundation New Careers in Nursing. The goal of this scholarship program is to help alleviate the nursing shortage and increase the diversity of nursing professionals. The grants will provide nursing scholarships to students who do not have a nursing degree, and who are planning to attend an accelerated baccalaureate and master’s nursing programs. The RWJF funds will support up to 500 scholarships, awarding each $10,000 scholarship to selected schools of nursing annually over a three-year period.

Uncle Sam is also offering nursing scholarships through the arm services. The Air Force Reserve Officers Training Corps (AFROTC) is offering three- and four-year undergraduate scholarships to students who want to become Air Force nurses. Applicants must be U.S citizens, high school graduates, and a cadet in the Air Force Reserves.

Don’t let money stop you from becoming a nurse. The money you need for nursing school is just one click away on the Internet.

My first patient flight of the day was a “stable myocardial infarction” that we needed to take from an outside hospital to the Big Hospital with a cardiac cath. lab. I’ve flown dozens of these patients and normally they only require a bit of pain medication, IV drugs monitored, and reassurance that it’s better to fly than go by ambulance.

Standard Operating Procedure when transporting a patient to the cath lab is to attach hands-free defibrillation pads to the patient, then plug the pads into the defibrillator. Although it isn’t necessary to turn the defibrillator on, just having the “shock” pads ready and plugged in helped keep the bad juju away.

I’ll give you one guess as to where this is going. I forgot to plug them in… again!

A mentor once taught me to “check my own pulse first” when things get ugly on an accident scene, or when a patient starts going bad. If you aren’t aware of yourself and your surroundings, you can’t do a damn thing for the patient.

He also taught me to always, “practice like you play.”

I’m bad about plugging in the pads. Usually, I would get busy, distracted with other things and forget, just as I did this time.

Apparently, three strikes and I’m out.

I don’t care who you are, or how long you’ve worked in healthcare, when your patient’s heart stops right in front of your eyes, you can’t help but want to panic.

The doc began chest compressions and I pulled out and turned on the defibrillator. At that time we flew with two monitors. One, our primary, didn’t have defibrillation or pacing capability. Our secondary monitor did, though and I flipped it on to shock the patient.

Now, at 160 miles an hour and 2,000 feet above the ground, when I needed the pads I fumbled with the pigtail, unable to figure out how to use the adaptor so I could plug it in.

I fought with the adapter cables for just a moment and thought I had them connected correctly. The monitor charged, so I got the doc off the patient’s chest and punched the shock button.

Nothing happened.

I rechecked it, trying to control my panic.

Then the inner voice started in on me.

How could you forget to do something so simple? This mistake could very well keep you from saving your patient.

As a flight nurse, I’m required to be prepared for the unexpected. I truly do believe that complacency kills. Although the outcome of this flight was positive, a simple oversight could have cost this patient his life.

While working in the hospital, I saw this kind of oversight on a daily basis. Running a code, especially on a medical-surgical floor, was a challenge. In general, nurses are minimally prepared to handle a stable patient who codes.

Hospitals are following a trend of “Rapid Resuscitation Teams,” who are available for consultation when a healthcare provider (nurse, medical assistant, etc.) feels that a patient is unstable. Rapid resuscitation and code teams in some hospitals have critical care or emergency room nurses, and physicians. In other hospitals, they actually staff with at least some paramedics. That’s important, medics are taught from day one how to handle a crashing patient.

Why aren’t nurses?

On the medical-surgical floor where I worked as a nurse practitioner, I often randomly asked the nurses about the code cart. Many had no idea where it was, let alone what was on it. When a code occurred, I often watched a nurse fumble opening the patient’s airway, and stare blankly at me when I asked for the bag-valve-mask.

Not all floors or ICUs are like this.

My guess is, however, that more resemble this than don’t.

Each nurse needs to take responsibility for their response and own ability to handle a “code.” Some problems are, I believe system issues. However, this one boils down to each one of us learning a few, somewhat-simple things.

Where is the code cart, and what is in it? If you don’t know where the important stuff is before the panic ensues, you won’t find it when you really need it.

How do you call a code? There are usually buttons at each bedside. You should know where they are and who will respond to help you.

What do you need to do before the team arrives? Airway, Breathing and Circulation. If you do nothing else, go through your CPR algorithm. That’s 50% of ACLS anyway. Lay your patient flat. If they are in bed, put a compression board under their back, and begin pumping their chest. Don’t forget to open their airway and check for a pulse as well. A bag valve mask works almost as well as the patient being intubated, so do good CPR and begin to think about where your IV lines are.

What does the code team need to know? Have your patient’s history, diagnosis, allergies, and hospital course ready to report. Only give the important information, ignore the rest, or the critical information could get lost in the shuffle.

Mock-codes, a common way to train, are a good idea, when done properly. Nurses have a way of not running at full speed during training, though. Getting participation in a training session is also difficult when it’s a busy shift. Run through mock codes on a consistent basis, and as the teams get better, increase their intensity. If you can run a code when practicing, you have a much better chance of doing it right when it matters.

Regardless of job requirements, try to take an ACLS class. Although you may not be responsible for running a code, knowing the basis for treatment and the algorithms makes you a much more effective team member.

Take the time to run through the basics and picture yourself grabbing that BVM, or running to get the code cart. Knowing what you will do ahead of time can make all the difference. Don’t let something simple trip you up and make a bad situation worse.

When all else fails, don’t forget: check your own pulse first.

Have you looked at the want ads lately? The help wanted section is full of nursing positions, and the need for nurses keeps growing every day. Hospitals and other health care facilities are scrambling to find more nurses to fill the gaps in staffing schedules. Many employers are taking a lesson from the past, and are hiring LPNs to meet their staffing needs.

A licensed practical nurse (LPN), also known as a licensed vocational nurse (LVN), provides basic bedside patient care under the direction of physicians and registered nurses. The position of LPN was established during the last major nursing shortage that occurred after World War II. States amended their Nurse Practice Act in order to regulate the practice of a Licensed Practical Nurse. This enabled RNs to care for a larger number of patients with the assistance of educated and licensed personnel. LPNs work in many different settings, but typically work in hospitals, physicians’ offices, outpatient care centers, nursing care facilities, and home health care. LPNs are also in demand by travel nurse agencies.

LPNs attend training programs that last about a year, offered by community colleges, vocation schools, and technical colleges. An individual must pass the NCLEX-PN, which is a state licensing examination, before working as a licensed practical nurse. LPNs provide a large portion of direct patient care within health care institutions. Duties include passing medications, taking vital signs, monitoring catheters, applying dressings, collecting samples for testing, feeding patients, monitoring food and liquid intake and output, and assisting patients with other activities of daily living. LPNs also work directly with physicians during medical procedures.

There were about 700,000 LPNs in 2000, and over the past 20 years, LPNs have seen major changes in the location of their employment opportunities. More LPNs are finding employment in community agencies, such as health departments, mental health facilities, hospice and home care, and fewer jobs within hospitals. The US Bureau of Labor Statistics predicts that there will be a continuing demand for LPNs in medical offices and clinics, ambulatory surgical centers, and emergency medical centers. They also predict that LPN employment in nursing homes will also grow due to the advancing age of Baby Boomers. Currently, 29% of LPNs work in nursing homes, 28% work in hospitals, and 14% work in physicians’ offices and clinics. Others work for home healthcare services, residential care facilities, schools, temporary help agencies, or government agencies. In 2002, the U.S. Department of Labor listed the median income for LPN as $31,440.

Are you an LPN looking for a job? You can find LPN jobs listed by state or job function on the NursingJobs.org website. And, don’t forget to join us at the NursingVoices forum. We are waiting to hear from you!

When I went to nursing school many years ago, there was no such thing as the Internet, and everyone attended a traditional nursing school. School was tedious, and the class schedule was rigid. Today, students are attending LPN to RN degree programs, RN to BSN programs, and many other online nursing schools with a click of a mouse. These programs are gaining in popularity, and offer nursing students a way of going to school that fits into their busy lifestyle. It’s been estimated that nearly 50% of nurses further their nursing education by attending online nursing schools.

It’s not surprising that online nursing schools are popular among nursing professionals. One of the biggest advantages of an online class is convenience. Nurses work crazy shifts, seven days a week, and online classes offer flexibility not found in traditional nursing programs. Nurses can log onto the Internet day or night, and work at their own pace on classroom assignments. In addition, many online nursing schools are less expensive than traditional nursing programs. Online classes cost anywhere from $100 to $300 per credit hour, with the average tuition for programs sponsored by state and public universities generally averaging around $110-$200 per credit hour. Students usually do not pay out-of-state tuition fees for online classes, and they are eligible for the same types of scholarships and financial aid as students enrolled in traditional nursing programs.

Online nursing schools offer their students excellent educational opportunities while incorporating the latest technology within their nursing curriculum. Online students communicate with their nursing instructors and fellow students through live-chat, and by participating in video conferencing and discussion forums. Nursing students work on group projects and individual assignments, and students email their assignments to their instructors in addition to completing clinical hours at an approved clinical site. However, there is one downside to these types of programs. Online nursing schools are challenging, and they are not for procrastinators. Students must be self-motivated in order to graduate from an online nursing school.

Individuals wishing to enroll in online nursing classes must fulfill prerequisites before they can begin classes, and since prerequisites vary widely by school, it’s a good idea to shop around before deciding on a program that’s right for you. RNs wishing to obtain a BSN or MSN should look for an online nursing school that offers school credit for work experience. Now is the time to expand your horizons by attending an online nursing school. You can find more information about online nursing schools on the NursingJobs website, and if you are already a nursing student, come over to the NursingVoices forum and tell us about it. We’re waiting to hear from you!