DiversityNursing Blog

The Difficult Decisions of an ER Nurse

Posted by Alycia Sullivan

Wed, Jul 24, 2013 @ 11:45 AM

by Angela Stevens

I’ve known a few ER nurses over the years, and all of them have told me that, no matter how much training they have had, how their teachers and textbooks tried to prepare them, and even how much experience in other fields of nursing…nothing prepared them for the reality of working in an emergency room. When choosing any nursing specialty, it is important to test drive the environment before making a final decision. This can easily be accomplished by taking a position as a traveling nurse and visiting different areas of the country as well as different nursing environments. In fact, one of the girls I went to high school with did this, and she found her great love was in pediatrics. Janey, the friend who became a pediatric nurse, actually did a stint in an emergency room for several months and told me some of the hardest things she had ever had to do occurred during that time. Don’t get me wrong, she said that the heartbreak in pediatrics could be excruciating, but that – more often than not – it was a happier place to be.

sunbelt-er-nurse

One of the difficulties she faced in the emergency room was not being able to make a personal connection with the patients. She was with them for only a brief period of time, usually a few hours, before they were discharged or sent to another floor of the hospital. She rarely found out what happened to the patients, even those she felt a connection to. Being able to move on to the next patient and distance yourself from previous patients is difficult. Another difficulty of being an emergency room nurse comes when there are more patients than there are people available to help them. At this point, the nurses, usually the first to see and evaluate a patient, have to decide who is in the most critical condition and get them to see a doctor. Making the decision of who gets medical treatment first was overwhelming for many of the nurses I knew, at least initially. One told me that she finally realized that, the more quickly she was able to make her assessment, the faster everyone would receive the care they needed. This is what stopped her from “hemming and hawing,” as she put it, and put on her decision making cap. While it was true she had to leave some patients in the waiting room who were miserable, they were seen as quickly as she could process those with more pressing conditions. Seeing it in this light made perfect sense to me, and it made me realize that, when I visit the emergency room as a patient, it isn’t that the nurses don’t care. Quite the opposite, really; sometimes they may care too much. I now know that if I’m waiting, there is usually someone with a much more serious problem who is receiving care.

Why did you, or do you want to, become an ER nurse? How has it changed your perspective?

Source: Sunbelt Staffing 

Topics: challenges, ER nurse, nursing specialty

The Joys and Challenges of Men in Nursing

Posted by Alycia Sullivan

Wed, Feb 06, 2013 @ 11:12 AM

BY DARIA WASZAK, RN, MSN, CEN, COHN-S

The Joys and Challenges of Men in Nursing

Gerardo Gorospe, RN, BSN, MSN, is frequently mistaken for a physician — not necessarily due to his skillset, expertise, white coat or bedside manner, but because of his gender.  “I am often asked why I am not a doctor. I politely say, ‘Because I wanted to be a nurse.’” 

Gorospe is the clinical nurse manager in the Department of Hematology and Hematopoietic Cell Transplantation at City of Hope in Duarte, Calif. He has been an RN for over 21 years and has his MSN in education and nursing administration. Although nursing is a predominantly female profession, he decided to become a RN because of his interest in health and science, helping patients achieve wellness and the “personal interaction aspect” of being a nurse.

He spends his workday managing a team of transplant coordinators and hematology clinical trial nurses, resolving problems, supervising staff and managing projects, among many other tasks. “I think because we are in a female-dominated environment, there is, in the community at large, not a great understanding of who we are and what we do,” he says. “There are some gender stereotypes when it comes to the territory of nursing.”

That couldn’t be more evident than when you take a look at older nursing textbooks, like a 1962 edition of Mosby’s Practical Nursing that Gorospe recalls picking up from a thrift store; the cover featured a picture of a woman in a white nursing dress, white cap and heels, holding a tray. “There is certainly gender bias in our early textbooks of nurses as women,” he says.

Heavy Lifting
So, does there continue to be a social stigma surrounding being male in a predominately female profession? What difficulties do men in nursing face today? Gorospe, 45, who went to nursing school in the early 1990s, says his patients never had a problem with his gender, but he did remark that since he is often the only male on duty, his female colleagues frequently turn to him for his physical strength. “I think when it comes to the physical work — lifting patients and heavy equipments — male nurses are often asked to assist,” Gorospe says, adding that his colleagues would often exclaim, “We are glad you are here today, so you can help lift.”

A Need for Role Models
Samuel Gomez, MSN, RN, PHN, CENP, was one of only two men in his nursing program in the early 1980s. Since men were even more uncommon in nursing at that time than they are now, he, like Gorospe, was frequently asked why he didn’t just become a doctor instead of a nurse.

Gomez, 48, explains that he was inspired to choose nursing as a career by a high school guidance counselor who was also a RN. “She told me that as a man, nursing was a great profession for me to explore and that it had many possibilities and opportunities,” he says. “She was absolutely right.” 

Now, Gomez is the one inspiring other men to join nursing. He is currently the executive director of cardiovascular services at Mission Hospital Regional Medical and Trauma Center in Mission Viejo, Calif., but he often speaks to medically underserved middle school youth. When he was a professor at the University of Southern California, he even started a special interest group for male nursing students. 

“What is most important to me as a nurse who is male is the importance of role-modeling for others, the importance men have in nursing and that as a profession, it is open and ready for more men to join,” he says. “I am always sure to point out to male students that nursing has been an outstanding career for me and it can be for them as well.”

A Tailored Fit
According to a 2005 “Men in Nursing” survey conducted by Hodes Research and published on the website of the American Assembly for Men in Nursing (AAMN), approximately 6 percent of nurses are men. Nearly half of the almost 500 respondents to that survey reported experiencing gender-related problems in the workplace, including being stereotyped as “muscle,” being a minority in the nursing profession, being perceived as not caring or having trouble communicating with female colleagues.

Scott Topiol, co-founder of the online men’s scrub store Murse World, adds that male nurses often face an additional problem: Nursing scrub stores rarely have a good selection or variety of scrubs for men. Unisex scrubs, which feature solid colors, a baggy fit and a V-neck cut, are no solution; they only come in a few styles and stores seldom carry all of those.         “Scrubs that are made specifically for men not only fit their bodies better,” says Topiol, “they also offer more masculine styling options that help male nurses and healthcare professionals look and feel their best on the job.“

Topiol says that one of the goals he and co-founder Alex Mayzels had in starting Murse World was to provide scrubs that are more attractive to men. “One thing we've found is that many men are looking for a more athletic, sporty cut and also want color accent options such as contrast color stitching,” he explains.  

Communication Styles
Like the respondents of the 2005 Hodes survey, 38-year-old Troy Gideon, RN, BSN, critical care clinical coordinator at St. Jude Medical Center in Fullerton, Calif., says that one of the biggest challenges male nurses face is continuing to improve their professional interactions with female colleagues. “A man in a female world must learn the intricacies of female communication and the dynamics of their interrelationships to be able to work collaboratively towards a goal,” he explains. 

Despite the communication hurdles, Gideon has seen improvement for men as nursing has evolved over time. “I think that the industry has changed greatly in its social context as the field has become more educated and professional,” he says. “With this change and the financial stability that comes with it, nursing has become a magnet for more males, thus dissolving preconceived stigmas.” 

Managing the Whole Patient
Gomez, Gideon, and Gorospe all spoke about how rewarding their nursing careers have been, whether they have involved teaching, leading and supervising other nurses or performing patient care.

“As nurses, we are for the whole individual, not just managing the medical condition or surgically managing a patient. We manage the patient holistically,” Gomez says. “That was all I needed to know about the profession of nursing — that it was aligned with who I was as a person and as a human being.”

Topics: men, men in healthcare, nursing, benefits, minority, challenges

Comprehensive Review Of Laws And Regulations Affecting Advanced Nursing Practice In Every State

Posted by Alycia Sullivan

Tue, Feb 05, 2013 @ 02:03 PM

The most comprehensive review of new legal and regulatory issues affecting advanced nursing practice across the United States is now available in the "25th Annual Legislative Update," presented exclusively by The Nurse Practitioner: The American Journal of Primary Healthcare.The Nurse Practitioner is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health. 

Compiled by Susanne J. Phillips, MSN, FNP-BC, the annual supplement presents a comprehensive review of the legislative proceedings, bills, and laws pertaining to advanced practice registered nursing (APRN) practice in every state. The 25th Annual Legislative Update is now freely available on the journal website. 

Progress in Evidence-Based Reforms Improving Access to APRN Care 

The 25th Annual Legislative Update incorporates current information provided by state nursing boards and APRN associations about the "hot topics" affecting APRN practice in their states. "Despite attempts by medical boards to limit current practice authority, APRNs succeeded in improving access to APRN care in several states," writes Phillips. 

The special edition provides an essential update on recent legislative and regulatory activity promoting access to APRN care, prompted by decades of peer-reviewed research demonstrating the quality and safety of APRN practice. Efforts are ongoing to standardize laws and regulations governing APRN practice across states, and to establish effective consumer protections. 

Yet legislation continues to be "vehemently opposed" in many states, according to Phillips. She discusses steps APRNs can take to "empower legislators to move beyond the outdated, evidence-lacking arguments that APRNs are not educated enough, safe enough, or credentialed enough to care for the nation's residents." 

This year's update presents a rundown of the latest developments in the areas of legal authority, reimbursement, and prescriptive authority for all 50 states. It also includes a table summarizing practice authority for nurse practitioners in every state and the District of Columbia, along with updated statistics and the total number of APRNs reported by state boards of nursing. 

Nurses Encouraged to Work Together to Meet Challenges 

The past year has seen several important improvements in legal authorization of APRN practice, including passage of legislation and promulgation of regulations in 17 states. In addition, eight states reported statutory or regulatory activity leading to improvements in prescriptive authority. 

But challenges remain, including reports of defeated bills and unsuccessful regulatory reform efforts in five states. In addition, two states - Kentucky and Missouri - passed legislation limiting APRN practice in specific ways. Phillips urges APRNs and others interested in ensuring access to evidence-based healthcare to support state APRN organizations. 

Nurses are also encouraged to check out the Future of Nursing Campaign for Action, supported by the Robert Wood Johnson Foundation and AARP, to see what steps are being taken and participate in efforts to improve nursing practice. Phillips adds, "This is a great way for all of the APRN organizations to work together to implement the recommendations and improve practice in your state."

Article adapted by Medical News Today from original press release.

Topics: laws, United States, challenges, regulations, APRN care, reform

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