DiversityNursing Blog

At the beginning of your Nursing career, you have many decisions to make. One of the biggest is what shift works for you. When you’re first starting out, you may not have a choice. You have to take what is available. However, if you do have a choice, this information provides what each shift has to offer.

Day Shift 

More activity 

Day shift Nursing is more active. Patients are awake, phones are ringing, more call lights are going off and families are visiting patients. If you enjoy the fast paced environment then you should consider working the day shift. 

More staff present

According to an article by Nurse Blake, there is help and different opportunities for learning during day shift because more people work during the day. Have an urgent question for the physician, dietitian, wound care specialist, or physical therapist? No worries, most departments have staff available during the day to help assist with any questions. Also, numerous procedures/tests take place during the day which can provide opportunities to observe and learn new skills.

Fits in with regular daily schedules

It's easier to maintain a social life because you'll be able to attend more nightly or weekend activities with family and friends. You'll also be able to keep an ordinary sleep schedule. 

Cafeteria is open

Sometimes the cafeteria isn't open 24/7. So during the day shift you don't have to worry about forgetting a lunch! You can grab a snack whenever if you become hungry.

Team bonding 

It's nice to go out with your coworkers after a long shift and grab dinner or drinks to unwind, have a few laughs and get to know each other outside of the work environment. If you work night shift, you have less opportunities to go out somewhere besides a breakfast place. 

Night Shift 

More money

An article by Nursingjobs.com said, many hospitals offer shift differentials at hourly rates to help supplement a Nurse's income in return for working night shifts.

According to PayScale, the average hourly rate for an RN working the day shift is between $22.54 - $40.69/hour, depending on geographical location, experience level, and medical facility. A night Nurse, on the other hand, can expect to make up to $41.03/hour, which is slightly higher. The added night shift differential varies by facility type, but it can make a big difference over long-term periods.

Less traffic and better parking

You can get your errands done during the day while most people are at work. Your drive to work should be shorter because there are less people on the road at night. A shorter commute means more sleep! There will be less people parked at your job so that means better parking. 

Quieter

Usually during the night shift, patient volumes are generally lower. It can be busy during the first few hours of the shift but as the night goes on it settles down. So you'll have fewer distractions, less discharges to process, and fewer medications to administer. Also, you'll have more time to spend with each patient as there are limited visitors and family members present.

2 or 3 Days a Week

A Shorter Work Week

According to an article from Nurse.org, usually working three days a week means having four days off. This is a great option for Nurses with a long commute because it translates into less hours on the road. Also, those requiring child care prefer this option instead of the traditional 8-hour schedule.

Reducing Errors and Providing Better Care

Rather than having three Nurses in a 24-hour period, a patient will have two, a day Nurse and a night Nurse. Since only two Nurses are transferring information, there is less risk for miscommunication errors. The Joint Commission reported that at least 80% of serious medical errors result from a miscommunication between caregivers during handoff.

Flexible Schedule 

Most Nurses working 12-hour shifts group their work days together and have longer periods of time off. This leaves time for traveling, a side job, education, or time with family and friends. 

What is your current schedule? Have you worked different shifts? If so, which do you prefer and why? We would love to hear what you think! Please comment below! 

According to a U.S. News article, over 100 million Americans are dealing with some form of chronic pain, and is the leading cause of disability among adults in the U.S.

Opioid drugs are a safe and effective treatment for pain relief when used properly. However, many people have difficulty accessing medication and others have concerns about addiction so they seek alternative therapies. 

Below are some of the most popular alternative therapies for chronic pain.

Cannabidiol (CBD)

According to a health.com article, Daniel Clauw, MD, professor of anesthesiology at the University of Michigan, believes that CBD may have real benefits for people living with chronic pain. “I don’t think we have that many good drugs for pain, and we know that CBD has fewer side effects than opioids or even nonsteroidal anti-inflammatory drugs, which can cause bleeding and cardiovascular problems,” he says.

Acupuncture

Acupuncture has been growing in popularity in the United States. This ancient Chinese form of alternative medicine involves thin needles being inserted into the skin. Research from the  National Center for Complementary and Integrative Health suggests it can be used to manage certain pain conditions especially back and neck pain, osteoarthritis pain, and headaches.

Mindfulness Meditation

Mindfulness meditation helps the individual gain psychological control over his or her pain. Stress and depression amplify pain. This therapy teaches you how to understand the different types of pain and how to control your body's reaction to the pain. A U.S. News article reported, mindfulness meditation has been shown in clinical trials to reduce chronic pain by 57 percent, and some experienced meditators can reduce it by over 90 percent.

Chiropractic Therapy

A Harvard Health article explains, Chiropractic therapy is focused on the structure of the body, particularly the spine. Chiropractors manipulate the body's alignment to relieve pain and improve function and to help the body heal itself. As one of the alternatives to pain-relieving drugs, the American College of Physicians recommends spinal manipulation along with heat, massage and acupuncture. 

Neuromodulation

According to an article by Jon Hagedorn, MD, Neuromodulation refers to spinal cord stimulation (SCS) when discussing chronic pain treatments. It consists of applying electrical current to the dorsal columns of the spinal cord in an attempt to block or decrease the pain signals to and from the brain. This is accomplished by placing stimulating electrodes in the epidural space, the implantable pulse generator (IPG) in the subcutaneous tissue of the lower back or abdomen, and wires to connect the IPG to the electrodes.

Physical Therapy 

Smart phones help Nurses stay on top of their game. You can download apps that help you study for an exam or find out information about a specific drug. Mobile apps have provided a variety of tools for Nurses. Below you will find some of the top mobile apps for Nurses. 

NCSBN flashcard 

This app is a medication library for your phone. Great for students studying for exams or Nurses who need a quick reference point.

iOS and Android

This app provides detailed information for all elements of patient care. Students gain a credible and complete resource guide for coursework, lab exercises, and clinical practice.

iOS and Android

Is a medical reference app that searches for information on prescription drugs, drug interactions, and a directory of providers.

iOS and Android

Provides access to a pill identifier, medical directory, continuing education, medical news, and clinical reference library.

iOS and Android

App version of WebMD website. You can research conditions, access drug and treatment information, get first aid essentials, check local health listings, and find the latest health news on the go.

iOS and Android

Over 1,500 acronyms, rhymes, and memory tricks to help Nurses learn medical conditions, symptoms, and other terminology.

iOS and Android

A mobile version of one of the best medical dictionaries. Includes photos, videos, audio pronunciations, and functionality to save favorite entries. This dictionary has 65,000 definitions to help Nursing students study for tests.

iOS and Android

Information and reference for diseases, drugs, and tests for Nurses, as well as a literature search function. Includes access to Davis’s Drug Guide, Taber’s Medical Dictionary, Diseases and Disorders, and MEDLINE Search and Journals, among other databases.

iOS and Android

NurseGrid

This app was developed by Nurses to help manage the scheduling process. The app lets you schedule across all worksites, view who you’re working shifts with, message other Nurses, and much more.

iOS and Android

Diseases Dictionary

This dictionary app is a great reference for medical disorders and diseases. Learn all information about symptoms, treatments, and medical terminology.

iOS and Android

Nurse’s Pocket Guide 

This app includes 440 medical conditions with associated Nursing diagnoses, care plan guides, and NIC and NOC labels for each diagnosis.

iOS and Android

Black’s Medical Dictionary 

This app has over 5,000 definitions. It also has a social media feature allowing you to share information with friends.

Android

Pill Identifier 

Provides a quick way to identify more than 12,000 medications. You'll be able to easily identify pills by imprint, shape, color, or drug name.

iOS

Pedi STAT 

A quick reference for RNs caring for patients in a pediatric, emergency, or critical care environment.

iOS and Android

IDdx: Infectious Disease

This app allows users to search by description and lists many infectious diseases that could relate to it. Currently, you can segment more than 250 illnesses by 39 epidemiological factors and 16 world regions.

iOS

MediBabble Translator

This translator app helps you communicate with patients and improve care. Currently 7 languages are available: English, Spanish, French, Cantonese, Mandarin, Russian and Haitian Creole.

iOS

Eponyms

Hundreds of obscure medical eponyms (person after whom a discovery, invention, place, etc., is named or thought to be named) for easy searching.

iOS

Skyscape Medical Resources

Provides drug information, access to medical journals, and the latest industry news, Skyscape Medical Resources is an all-in-one resource.

iOS and Android

NCLEX Flashcards 

This app has over 2,400 premade flashcards that covers all aspects of the National Council Licensure Examination.

iOS and Android

Are you using an app that we didn't mention above? Please share with us in the comment section below! 

According to Gallup, for the last 16 years, Americans' ratings of the honesty and ethical standards of 22 occupations found Nurses at the top of the list. Doctors and Pharmacists are also at the top of the list. 

The Gallup poll results showed more than eight in 10 (82%) Americans describe Nurses' ethics as "very high" or "high."

In an American Nurses Association (ANA) article, Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, President of the ANA said,  “Nurses provide much more than bedside care. We advocate for patients, deliver primary care, meet the complex needs of patients with chronic conditions, volunteer for disaster relief efforts, and are a trusted voice in boardrooms across the country." 

This poll reflects the trust the population has for Nurses. Patients rely on Nurses during their most vulnerable times and year after year Nurses show us that they do deserve that trust. 

Doctors manage the overall healthcare plan but, Nurses are the ones who implement it and in doing so they spend the most time with patients. 

Since Nurses spend the most time with patients, and they know the health care system’s limitations, they're in the best position to speak up about their patients’ needs and safety concerns and advocate for them. 

Audrey Wirth, MSN, RN-BC, CVRN-BC, Nursing instructor at Aurora University told travelnursing.com, “In the Nurse-to-patient relationship, there is a fundamental trust that occurs. Nurses must serve as advocates for both their patients and for better health care in general.”

 In 1999 Gallup began asking about Nurses, and the profession has topped the list every year except for 2001 after the 9/11 terrorist attacks, firefighters topped the list that year.

We know you put your patients first every day. We’re delighted that you are recognized for the important and vital work you do. Pat yourself on the back that you continue to make Nursing the most trusted profession! To learn more about what it takes to be a great Nurse check out the blog, Traits Every Great Nurse Has

You may want to consider a career as a Nurse Educator if you're interested in teaching or passionate about medical research and public policies.

Nurse Educators are faculty members in Nursing schools and teaching hospitals, they share their knowledge and skills to prepare future Nurses.

According to allnursingschools.com, you’ll be responsible for designing the curriculum of your students. You’ll set the structure and pace of your classroom and decide what textbooks and other materials your students will need. These curriculum decisions will need to meet accreditation requirements and be in line with the most up-to-date professional standards.

More people are becoming interested in joining the Nursing field. Faculty positions are not being filled because there aren't enough educators to meet the demand. 

The U.S. Department of Labor reports that 1 million new and replacement Nurses will be needed by 2020. But, according to the American Association of Colleges of Nursing, almost 65,000 qualified applicants were turned away from Nursing schools last year because Nursing schools don’t have enough Nurse Educators to educate all the students who want to become Nurses.

Becoming an educator broadens your employment opportunities.

Palliative care, end-of-life care, and hospice care share a common goal: to relieve suffering. But there are also important distinctions.

Both palliative care and hospice care provide comfort. But palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness.

Palliative services are typically provided by a team of interdisciplinary providers, including Physicians, Nurses, counselors, social workers, and chaplains. The team works together to assess and develop treatment plans with the patient and family that can provide the best possible quality of life.

According to the World Health Organization, palliative care:

• provides relief from pain and other distressing symptoms
• affirms life and regards dying as a normal process
• intends neither to hasten or postpone death
• integrates the psychological and spiritual aspects of patient care
• offers a support system to help patients live as actively as possible until death
• offers a support system to help the family cope during the patients illness and in their own bereavement
• uses a team approach to address the needs of patients and their families, including bereavement counselling, if indicated
• will enhance quality of life, and may also positively influence the course of illness
• is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

Jean Farley, DNP, RN, PNP-BC, assistant professor at Georgetown University School of Nursing & Health Studies said, “Think of palliative care as a value-added layer to typical care for an individual experiencing a serious or life-limiting illness,” like cerebral palsy or amyotrophic lateral sclerosis (ALS), “especially when that illness carries a heavy symptom burden that will persist over time.”

Ellen Goodman, co-founder of the Conversation Project is raising awareness about the importance of having conversations about end of life care and wishes.

“Patients who have end-of-life discussions are much more likely to be satisfied with their care, die at their place of choosing, and have markedly less distressed relatives,” said Thomas Smith, MD, the Director of Palliative Medicine and Professor of Oncology at Johns Hopkins. “In fact, looking at people who use hospice, the survival of their spouse is higher. It is really fascinating.”

In the last 15 years, the field of palliative care has experienced stunning growth. Over 1,700 hospitals with more than 50 beds have a palliative care team today. And, palliative care is spreading beyond the hospital into community settings where people with serious illnesses actually live.

Any information or experiences you’d like add, please share it below. Thank you.

NPR and ProPublica launched an investigation on America's rising maternal mortality rates. More American women are dying of pregnancy-related complications than any other developed country. 

The United States saw a 26.6% increase in maternal deaths from 2000 to 2014, according to a recent study published in Obstetrics & Gynecology.

Racial disparities make these trends even more distressing. According to the Centers for Disease Control and Prevention, African-American women are almost four times more likely to die of pregnancy complications. Maternal mortality is also more common for low-income women and women living in rural areas.

Only about 6 percent of the nation’s Ob–Gyns work in rural areas, according to the latest survey numbers from the American Congress of Obstetricians and Gynecologists (ACOG). Yet 15 percent of the country’s population, or 46 million people, live in rural America. As a result, fewer than half of rural women live within a 30-minute drive of the nearest hospital offering obstetric services. Only about 88 percent of women in rural towns live within a 60-minute drive, and in the most isolated areas that number is 79 percent.

The ProPublica investigation shows, America has not published official maternal mortality statistics in more than a decade. So we are forced to rely on incomplete estimates because the data needed to determine exactly how many women are dying, and from what causes, go uncollected.

Many states have created Maternal Mortality Review Committees (MMRCs). Maternal and public health experts analyze maternal deaths and propose ways to prevent similar deaths. The data from these MMRCs have revealed that more than half of maternal deaths are preventable. 

California created its MMRC in 2006 and reduced its maternal mortality rate by more than 55% to 4.5 per 100,000 live births, far lower than the national average. It was accomplished by using its data to design safety resources and tool kits aimed at the most common causes of maternal death in the state. For example, excessive bleeding and complications of high blood pressure, such as preeclampsia are common causes. Many states have not set up MMRCs due to lack of funding.

There are multiple reasons for a rising maternal mortality rate in the U.S. New mothers are older than they used to be, with more complex medical histories. Half of pregnancies in the U.S. are unplanned, so many women don't address chronic health issues beforehand. Greater prevalence of C-sections leads to more life-threatening complications. The fragmented health system makes it harder for new mothers, especially those without good insurance, to get the care they need. Confusion about how to recognize worrisome symptoms and treat obstetric emergencies makes caregivers more prone to error.

While most developed countries are making strides in preventing maternal-related deaths, the United States is falling behind. Addressing the causes of maternal mortality as well as contributing factors and underlying problems is a national concern. Health care professionals are the first line of defense for reversing this lethal trend.

Do you have any experiences or thoughts you’d like to share on this topic? Perhaps something you practice that would be helpful to other Nurses in a critical delivery situation?

RALEIGH – The North Carolina Nurses Association (NCNA) and its charitable arm, the North Carolina Foundation for Nursing (NCFN) are announcing an emergency campaign to provide support to nurses who have suffered loss or damages from Hurricane Florence. The NCFN - Nurse Recovery Fund seeks tax-deductible donations whose sole purpose is to help nurses get back on their feet sooner; NCNA and NCFN believe that helping nurses return to their normal lives will benefit the entire state.

“It is immensely harder to focus on patient care if you are reeling from your own losses, so we see this as a chance to support our fellow nurses and try to help them get back to normal,” said NCNA President Elaine Scherer, MAEd, BSN, RN. “Caring for each other is a vital part of being a nurse. We saw an opportunity to step up and have a positive impact on a terrible situation. Doing nothing was simply not an option.”

• People interested in donating can click here:
  https://portal.ncnurses.org/donate-now
• Nurses who need to apply for relief aid can click here:
  https://ncnurses.org/foundation/ncfn-nurse-recovery-fund/

All money collected by NCFN for this fund will be given directly to the people in need. NCNA is donating all of the staff time required to set up the campaign’s infrastructure and administer funds.

“We are so grateful to our colleagues at the Texas Nurses Association, who were already offering advice before the storm arrived last week,” said NCNA CEO & NCFN Executive Director Tina Gordon. “They launched a similar campaign in the aftermath of Hurricane Harvey, and the lessons they learned have been invaluable as we prepared to roll out the NCFN - Nurse Recovery Fund.”

Donations to this special fund will be distributed to actively-licensed Registered Nurses in North Carolina who have been impacted by Hurricane Florence. NCNA & NCFN will review applications from affected nurses and determine who receives assistance based on a sliding scale of needs. Funds will be collected for a limited time and distributed on a first-come-first-serve basis.

MEDIA CONTACT
Chris Cowperthwaite, APR
Manager of Communications & Outreach
(919) 821-4250 or chriscowperthwaite@ncnurses.org

ABOUT NCNA
As the leading professional organization for North Carolina’s registered nurses, we equip nurses at all stages to thrive in an ever-changing healthcare environment. NCNA helps keep North Carolina nurses on the cutting edge of nursing practice, policy, education, and more. Join us as we work to advance nursing and ensure high-quality healthcare for everyone. For more information, please visit www.ncnurses.org.

ABOUT NCFN
The North Carolina Foundation for Nursing is a nonprofit, 501(c)(3) corporation. Funding to support the Foundation and its activities comes from individual contributions, business donations, bequests, recognitions, and memorials.

The purpose and goals of the Foundation are to secure and administer funds directed toward:

1. education that assures that registered nurses are prepared to meet the current and changing health care needs of North Carolina citizens;
2. research that identifies the value of registered nurses in health care delivery; and,
3. activities that publicize the value of registered nurses in health care delivery.

Forensic Nurses provide healthcare to those incarcerated in the criminal justice system in a variety of settings such as jails, prisons, and juvenile detention centers. Many Correctional Nurses feel safer in this environment than working in traditional settings where security may be less vigilant.

The inmate patient population has many distinct characteristics to keep in mind when providing care. Although each patient is an individual, the population, as a whole, is likely to have these characteristics that should be taken into consideration when providing care.

• Inmates have a biological age older than their chronological ages. Many experts consider the incarcerated patient to be 10 years older than their chronologic age when it comes to the ravages of age and illness. So, many correctional settings consider elderly inmates to be 55 years and older.
• Less educated and less health-literate than the general population, inmates are more likely to have learning disabilities and have difficulty understanding basic health information.
• More infectious disease, especially HIV, Hepatitis C, sexually transmitted disease, and tuberculosis are found in this patient population.
• Inmates have higher rates of mental illness than the general public, especially depression, mania, and psychotic disorders. Mental illness can contribute to criminality. Borderline personality disorders that lead to poor impulse control, self-injury, and aggression are often present.
• This patient population also has higher rates of traumatic brain injury and post-traumatic stress disorder that can also lead to poor impulse control, erratic behavior, and inability to concentrate or understand health instruction.
• High levels of drug, alcohol, and tobacco use in this population increases the likelihood of withdrawal issues, liver toxicity, and respiratory conditions.
• Increased risk of suicide is found in this patient population as compared to the general population. This is a concern in any stage of the incarceration but especially of concern at entry into the jail and after sentencing when hopelessness, shame, and guilt are at their highest.

Although graduate Nurses have been successful in assimilating into the role of Correctional Forensic Nurse, the autonomous nature of the role and need for excellent assessment skills warrants experience in general Nursing practice before entry into the specialty. In particular, a background in emergency and/or mental health Nursing is helpful. Currently, certification is not required to enter a position as a Correctional Forensic Nurse, however, certification is available through the National Commission on Correctional Health Care (NCCHC) and the American Correctional Association (ACA).

Are you a Correctional Forensic Nurse? If so, what do you believe Nurses should know before considering this specialty? Please comment below!

An active shooter incident is something no nurse wishes to experience. Unfortunately, these situations can, and do, happen at healthcare organizations across the country.

These incidents are becoming more common, and although they are still rare compared with other shooting sites, incidents have increased in health care facilities. Agencies such as the Federal Bureau of Investigation, The Joint Commission, and the Emergency Nurses Association have emphasized that an action plan and training are essential for hospital preparedness.

Here are some resources to help us all be prepared for an active shooter incident.

• Many victims say, “I didn’t know what to do,” or “I was just waiting my turn to be shot.” The important lesson here is to tell people in an active shooter situation to do something. Time is a valuable commodity, and by doing something, one takes some time away from the shooter.
• 63% of active shooter incidents are in commerce or an education environment, but no place is off limits.
• Active shooter incidents typically evolve quickly and end (historically) within 10 to 15 minutes; 36% end before the police arrive.
• Be prepared:
  • Mental preparation – Chaos and panic will occur. As best as you are able, trust your instincts, breathe, and remain calm.
  • Sounding the fire alarm is NOT recommended. The potential negative consequences outweigh the benefit.
    • People are complacent with fire alarms.
    • People won’t think “active shooter.”
  • Role of police – Police officers are there to neutralize the threat, not treat injured.
• Three options (you may have to do all three):
  • Run – If you have an opportunity to escape, do so.
  • Hide – Don’t let anyone in.
  • Fight – Fight for your life with whatever you have. There is power in numbers and the shooter is typically not looking for a fight.

How to react when law enforcement arrives:

• Remain calm, and follow officers’ instructions
• Put down any items in your hands (i.e., bags, jackets)
• Immediately raise hands and spread fingers
• Keep hands visible at all times
• Avoid making quick movements toward officers such as holding on to them for safety
• Avoid pointing, screaming and/or yelling
• Do not stop to ask officers for help or direction when evacuating, just proceed in the direction from which officers are entering the premises

 
Information to provide to law enforcement or 911 operator:

• Location of the active shooter
• Number of shooters, if more than one
• Physical description of shooter/s
• Number and type of weapons held by the shooter/s
• Number of potential victims at the location

A survey by the Journal of Emergency Nursing shows that out of 202 Emergency Nurses and staff members who participated in active shooter training, 92% felt better prepared to respond if a shooting occurred at their facility.

Every healthcare facility is required to have an emergency action plan. Most of them conduct training exercises to prepare staff for emergency situations such as a fire emergency or bomb threats, but when it comes to dealing with an active shooter situation, most Nurses have no idea how to react because they aren't prepared for it. 

We hope this information is helpful and that you never have to use it. If you have anything you’d like to add, please share it here.