Nursing is constantly evolving, and what nurses need to know to succeed today is not what it was a decade ago. So, we recently sat down with The Nurse Informant, RN Nurse Terri, to talk about all the things that many nurses don't talk about, but are so important for everyone in the field to overcome current issues, move forward in their careers and become successful.
This is what The Nurse Informant told us:
"It's easy for an individual to get overwhelmed when caring for someone who is sick. Just imagine having to care for four to six individuals who are acutely ill, needing hourly care while wearing 'space gear' here lately and doing mandatory overtime, 12 hours... So, I believe that the number one reason that they're leaving now is compassion fatigue, working long shifts and, addressing those complex patient's needs, including treating patients with immense pain and traumatic injuries. That causes a lot of distress to health care providers, not just nurses, who are at the bedside. And a lot of people, I think, believe that nurses are mad. I don't think they're mad. I think they're tired. And, self preservation always wins, so they have a fight or flight response, just like everyone else. And once they realized they couldn't win the fight, they started catching flights and this is why travel nurses have increased in tremendous numbers. Who wouldn't want to get paid $10,000 a week here, in America, right?"
"I would just like to add that nurses were leaving the bedside before the pandemic, but no one noticed as much, however, if we consider the nursing shortage before the pandemic, I would have to say that nurses were leaving the bedside because individuals who were admitted to the hospital were sicker with added co-morbidities, with added issues and problems. Plus, the word got out through social media, TikTok, and Instagram of other nurses showing off their nursepreneur skills, side hustles, businesses, and most of all, the freedom to be able to do all that. So, I think nurses are just leaving for various reasons. But one, the main ones are just compassion fatigue. They're tired," explains Nurse Terri.
"I've seen nurse bullying and I've experienced it. I dealt with my bully by explaining my perspective because, just like everything else, nurses come from all different kinds of cultural backgrounds. So they may think that taking care of the patient one way is the best way, but maybe it's not. And lot of that comes from different perspectives of how to care. And I think that some nurses are intimidated by new nurses and their new knowledge. I went to school in 2001. Medicine and health overall has changed so much since then. And I love new nurses because they tell me what's the new thing that's coming. They tell me what's the new medicine, what's the new skill set, right? But lot of nurses who have those old skill sets, they look at the nurses that come in with the new skill set, and a lot of it is intimidation and jealousy. And they take that and project this bullying type of attitude. That's why I think that a lot of bullying in the workplace comes from how nurses see care different from new nurses."
"Now, for overcoming the bully issue, I would definitely say mediation. I think it's important to pull someone else that can help you deal with that situation because it shows the nurse that is behaving in an unprofessional way that you're not afraid to let others know of her behavior. Some of that, you know, is done in secret. So, the person who is the victim should reach out to either the supervisor or someone that can help mediate the differences, even to the point of separation. Now, when I was a new grad, I worked on a unit and the nurse that was supposed to orientate me, she did not want to have anything to do with me and she told me that. What I did, I went back to nurse recruitment and I said, 'this is what she said to me, I'm afraid that I'm not going to get the orientation that I need to help take care of the patients, please move me.' And I got an immediate transfer, and I think every hospital and every unit in the hospital should have that option for people, to able to transfer people to places where they are comfortable with the environment."
"Most definitely is standing up for yourself. And I've done this before, and I've just told my manager, 'look, I'm not a robot. I'm a human, I need food, I have to go to the bathroom. This is something that is overwhelming to me.' First you have to address what's going on at the workplace. You can take time for self care and all that on your one day off, but you still going back to a place that is very uncomfortable and just overwhelming to you. I used to work at a facility where they had a form. If you came in and you were the only nurse on that floor, you had a form to fill out this form to let others know that I was the only nurse on this floor. And you had to call all the executives, all the administrators and the doctors and say, 'I'm the only nurse on this floor and you have a patient here. What are you going to do about it? Who can help me? Who can speak up for me?' Those things need to be happening inside of healthcare organizations so that we can protect our nurses and our family members who need that care. But nurses have to tell the organizations what they need. So, overcoming that compassion fatigue is basically starting with telling the whoever's in charge, 'this is too much... I'm going to take these days off' because you can get excuse days for mental health now, more than ever. And once they get enough nurses getting off mental health days, they'll have to address the issue."
"Another thing is you have to recognize you have compassion fatigue, because what happens is when you lose that compassion you're not able to care for those patients like you really should. So you'll have to say, 'look, I need to step away. I don't care about this job as much as I should, which, you know, patients won't be getting their medicine, et cetera, et cetera.' So I think just recognizing where you are in your career at the moment, you're there is one way to kind of, you know, nip a tragedy in the bud."
"Well, I would definitely say continued education. A lot of old nurses think the way we did it back then is the way we're going to do it for 100 years, when that's not necessarily the case. There's a new evidence base every day coming off and being reported for us to update our skills and new methods for administering medications and just different ways that we can do things better. And in that, they need to make sure that they are updating their skills and getting these new certifications that are available to us."
"And another thing I think is I think just self-awareness and making sure that that this is something you love to do, right? Because you're probably going to make more mistakes than it's worth if it's not. So I say self-awareness is probably number one. And then, being able to claim your limitations, you know, if you got two broke arms, then you probably shouldn't be an orthopedic tech or something. If you don't like needles, don't become a phlebotomist, right?"
"And I think being brave enough to speak up for yourself is definitely a skill that you probably should have. Learning more about cultural backgrounds and other differences. The LGBT community, the transgender community, for example, wasn't there ten years ago or 20 years ago. It was there, but it wasn't something that was being taught in nursing. Well, now they're here. The patients are here and we need to learn about how to treat those individuals and how to address them and how to show compassion to them, regardless of what you feel and think about it. I think just learning more about what's going on in the present moment in nursing and health care is the best skill."
"I'm one of those people. I can do anything and I probably have done everything. Now, I do confess to not going into L and D because I don't like that part. However, I am a full script practitioner and I like to do holistic health consulting. I am also a CPR instructor servicing mostly community daycares because it is mandated in the state of Arkansas that 50% of daycares have to be or their staff has to be CPR certified, and they do have certain programs that 100% have to be CPR certified, and it's important because they're caring for other people's children. I go to doctor's offices and clinics, as well. I'm a mobile CPR business, so I go to wherever they are, set up, do the CPR class and usually sign with them every two years. I'm with the American Heart Association and I'm connected to one of the larger hospitals here in my state. So, I do that as well," says Nurse Terri, hoping to inspire other nurses who maybe want to branch out and discover other areas of work within healthcare.
Terri Evans MSN-Ed, RN, is a Registered Nurse Educator, Holistic Health Consultant, CPR Instructor, and Doctoral Candidate at Capella University in the United States.
"In 1993 I actually walked into a nursing home, after being newly divorced, and asked if they were hiring and that I would love to work there. And the director of nursing said 'Would you like to be a CNA?' So a CNA is a Certified Nursing Assistant and what she did was send me to training and once I was done with that I was able to take care of the elderly population in the nursing homes and in hospice care. So I did that for about eight years, and then I moved on to become an LPN. Here in the States, we call it a Licensed Practical Nurse (In Canada this role is called Registered Practical Nurse or RPN.) And so I did that for five years, which I worked in the hospital setting, and I worked in nursing homes as well, doing wound care and just taking care of the geriatric patients."
"And then I moved forward to get my associate's degree in nursing in 2005. Then I moved forward to get my bachelor's in 2012. And then I moved forward in nursing education because I was one of the ones who precepted, and I loved nursing so much. I wanted to teach everybody how to do it compassionately. And so I would always be the one who precepted other nurses and trained other nursing students, so I decided to get my degree in nursing education, a master's in nursing education. I did that, I completed that degree in 2018. And so I'm currently working towards my DNP, which is the highest level that you can get to in nursing practice and it's a doctoral degree. I started that journey in 2020 and I'm expected to graduate in the fall of this year," she adds.
"It's been a long journey and a lot of places that I've worked; different areas, medical, surgical areas, and everywhere. And so right now I'm working from home as a case manager with a large insurance company. So that's my journey so far. But hopefully, I can continue to do nurse education after I am done with my doctorate degree," she concludes.
To listen to the full interview with The Nurse Informant, RN Terri Evans, visit our Podcast page or YouTube channel. And to learn more about all things nursing, visit our blog and click on "Nurse" at the top of the page.
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