DiversityNursing Blog

The Nursing field offers many Nursing specialties to choose from depending on your interests and skills. And, there are plenty of opportunities to get the necessary training to move on to a different specialty.

The stress of the pandemic has increased Nurses' interest in positions beyond the hospital setting. 

Some of those opportunities include:

Nurse Educator

Nurse Educators don’t work in a traditional hospital or medical facility. They teach in universities, technical schools, and hospital-based Nursing programs. They can also work as administrators, consultants, or independent contractors.

Forensic Nurse

According to ForensicNurses.org, Forensic Nurses provide specialized care for patients who are experiencing acute and long-term health consequences associated with victimization or violence, and/or have unmet evidentiary needs relative to having been victimized or accused of victimization. In addition, Forensic Nurses provide consultation and testimony for civil and criminal proceedings relative to Nursing practice, care given, and opinions rendered regarding findings.

Many Forensic Nurses work in hospitals but they also work in community anti-violence programs, coroner’s and medical examiners offices, corrections institutions, and psychiatric facilities.

Health Policy Nurse

A Health Policy Nurse (HPN) plays an active role in forming and communicating public health policies with the goal of improving the overall well-being of society. With a strong background of hands-on Nursing expertise, HPNs are able to aid and act as policy makers within our government and healthcare systems, according to Johnson & Johnson Nursing.

Flight Nurse

Flight Nurses provide care onboard medical helicopters, airplanes, or jets often used in emergency situations to get patients to the best hospital as quickly as possible.

Flight Nurses also transfer patients between facilities. Patients might need to be moved to obtain lifesaving treatment unavailable at the original facility or to relocate to another part of the country. They also communicate with medical professionals at the receiving facility, to ensure all case notes and patient files get to the right person.

Nurse Writer

Nurse writers educate readers on healthcare topics through their personal knowledge and experience.

According to RegisteredNursing.org, they can freelance for medical journals, guides, and other health-related publications (newspapers, magazines, websites, etc.) that require accumulated knowledge, education, experience, and objectivity. Nurses can also write academic papers, write grants for hospitals or programs, coordinate programs, or assist the Communications Department in hospitals or other organizations.

Camp Nurse

Camp Nurses typically serve children or teens, in a camp environment. This can include summer camps or other camps that last from days to weeks to even months at a time, but are usually temporary.

Depending on the size of the camp, Nurses could be required to work alone or as part of a team, making critical decisions on patient care. They may also be required to obtain and keep records on allergies, medical histories, and medications of all camp participants.

Dialysis Nurse

Dialysis Nurses work with patients suffering from kidney diseases and illnesses. They administer dialysis to patients at dialysis centers, nursing homes, or at the patient's home.

Yacht Nurse

As a Nurse/Stewardess, you will be expected to maintain the on-board medical ward and Nursing station. This includes overseeing stock inventory, ordering supplies, and recording inventories. Depending on the yacht owner's health, you may be required for certain medical duties.

Although long working hours are required, the benefits are amazing with salaries often higher than other Nursing positions. Yachting is not for the faint-hearted though and you must have a sense of adventure and an urge to travel.

A Nursing career isn't always a straight path. You have the opportunity to work in a variety of different environments and grow your skills and knowledge. Take a chance and use that degree to explore your options. Discover what Nursing path fulfills and challenges you.

Even before the pandemic, healthcare providers experienced burnout and other negative mental health issues. Now more than ever, it is critical health systems take steps to support their staff's well-being.

Recently, more healthcare organizations have started to hire Chief Wellness Officers (CWO), as a strategy to address burnout, mental health, and compassion fatigue.

Jonathan Ripp MD, MPH, Chief Wellness Officer at the Icahn School of Medicine at Mount Sinai, said there were only a handful of Chief Wellness Officer positions when he was appointed to the role in May 2018. “There has been at least a dozen more who have been named in the past year, and several more places that are looking to create the position,” said Dr. Ripp. “I would not be surprised if, 10 years from now, it's commonplace for most large organizations to have a Chief Wellness Officer or equivalent, taking this challenge on, and doing so in a way that is effective.”

The ultimate goal of this role is to aid system-wide changes that enable staff to practice in a culture that prioritizes and promotes mental health and well-being.

The CWO is responsible for measuring well-being across their organization. Then, they create and implement wellness programs that address the current environment causing burnout and stress.

The hiring of a CWO is not a remedy all on its own. The CWO works in collaboration with other leaders and staff to prioritize well-being and would ultimately lower costs and improve patient care.

According to Beckers Hospital Review, burnout and depression result in major costs to health systems due to an increase in medical errors, reduced quality of care, and turnover. Research has found that for every dollar invested in wellness, hospitals can see a $3 to $6 return on investment.

Medical Schools are also following the hiring trend.

Holder said, "Mental and emotional wellness is essential to complete health. We simply cannot ignore this fact. I view my role as another way to serve the students, faculty and physicians in Brown’s medical school, and aid them in not just meeting their immediate self-care needs but also creating and developing plans that can help them learn more about how to take care of themselves in a way that's sustainable for a profession that demands a lot."

“Wellness and self-care is more important than ever before. These next few years will be critical for health care workers as we address the mental and physical burdens from COVID-19,” said George Washington University's Chief Wellness Officer, Lorenzo Norris, MD.

Hopefully this position sticks around, even after the pandemic passes, because burnout and mental health have been issues in the healthcare field all along.

Healthcare organizations must ensure Nurses are equipped with resources and the support they need to provide quality care. Hospitals must invest in initiatives that attract and keep Nurses, such as:

• Developing An Employee First Culture

Dr. Linda Shell, DNP, MA, BSN, DNS-CT, Chief Learning Officer suggests Nurse leaders cultivate an “Employee First Culture” approach in their facilities.

“An Employee First Culture is built on the concept that employees are the best asset of any company, and they need to be encouraged and appreciated,” says Dr. Shell. “When appreciation goes up in an organization, quality tends to go up. I really believe that for us as Nurses, the more we can do to create a positive work environment and develop our leadership skills, the more opportunities we are going to have to improve the quality of care that we provide every day for patients, as well as the residents that we serve.”

• Staff Recognition Programs

"A person who feels appreciated will always do more than what is expected." This quote has been scientifically proven to be factual. 

According to research, giving thanks can have important implications for encouraging actions that promote cooperation.

Whether it be a hand written note, or a brief one on one meeting, managers should take the time to recognize the hard work Nurses are putting in.

Recognizing Nurses on their birthdays and work anniversaries is a simple way for organizations to show appreciation for their staff.

Celebrating Nurses with a themed party or gift bags is another way to give thanks.

According to Nursing Management, realistically, quarterly recognition will suffice for larger units; however, if you have a small unit, monthly recognition is recommended.

• Mental Health Resources

Many Nurses are experiencing severe, adverse mental health effects as a result of the pandemic, and a lot of them are considering leaving the profession entirely.

Organizations must support employee self-care by establishing evidence-based preventive strategies, providing mental health resources, and demonstrating that leadership supports and prioritizes mental health and well-being.

Some health systems are hiring a Chief Wellness Officer (CWO) to support their wellness initiatives.

Dr. Maureen “Mo” Leffler, the first enterprise-wide CWO at Nemours Children’s Health said, “The goal of the Chief Wellness Officer is to promote professional well-being, which is characterized by having everything in place in both the individual and in the system, so those two things work together optimally. When we do that, we can provide the highest quality of care, the safest care, the best care. We can derive meaning in the work we’re doing.”

• Tuition Assistance Programs

Tuition reimbursement is becoming a popular way for hospitals to attract and retain quality Nurses, especially in areas where demand is high. 

These programs are designed to help Nurses continue their education by relieving some of their financial stress.

• Good Communication

Routine unit or individual staff meetings should be held to discuss any issues or concerns. Nurses want to feel heard. So it's important management truly listens to what they have to say and then set up action plans and follow up.  

• Flexible Work Hours

According to a recent McKinsey survey, Nurses that experienced more flexibility in hours and scheduling during the pandemic were highly interested in retaining that flexibility going forward. For Nurses who indicated plans to stay in their current direct patient care role, flexibility in hours and shifts was an influential factor.

Bottom line, health systems must prove to their Nurses that they are Valued, Appreciated, Heard, and Supported if they want to keep them. There are thousands of Nursing opportunities out there and you must work to retain the Nurses you have. This is just as important as recruiting Nurses.

It's no secret Nursing is a stressful and physically demanding career. High stress levels can affect your health and well-being. However, there are ways to manage your stress. Consider some of these techniques.

Try keeping a journal, or note times when you don't feel your best and jot down what might be contributing to that feeling. For example, if you're running low on energy it could be from lack of proper sleep or nutritional foods in your diet. 

Some breathing techniques developed to reduce stress include:

• 4-7-8 technique: Breathe in for four seconds with the nose, hold for seven, and breathe out for eight through the mouth.
• Belly breathing: Place one hand on the belly and one on the chest, feeling the belly move and the chest remain still while breathing in through the nose and out through the mouth.
• Breath focus: Use a picture or phrase to aid in relaxation, such as picturing the air as calmness.
• Equal time: Count the breaths in equal time, such as five seconds, for inhaling and exhaling.
• Modified lion’s breath: Breathe in through the nose, and out through a wide open mouth with a “ha” sound.
• Progressive muscle relaxation: Tense and relax muscle groups in succession while breathing in and out.

Calm the mind. Mediation goes hand in hand with deep breathing. One of the biggest barriers to meditation is that people don’t know where to begin. Start with small goals like 2 minutes every day for a week, then increase your time slowly from there. 

Find a quiet space, get comfortable, then set your timer. Focus on your breathing or chosen mantra. A mantra is a word, phrase, or sound repeated it in your mind continuously. 

Thoughts will float in and out of your mind. Acknowledge them then let them go. The goal of meditation is to keep your focus on one thing. 

If you have trouble practicing on your own, there are many guided mediation apps and online videos to help. 

Recharge your batteries. As you know, lack of sleep is a major stress factor. To achieve better sleep, try the deep breathing and meditation exercises mentioned above, right before bed, as well as these suggestions:

• Don't consume caffeine, alcohol, or food for at least 3 hours before bedtime.
• Establish a consistent sleep schedule/routine.
• Avoid electronics for at least 1 hour before bedtime.
• Try rubbing lavender essential oils on your temples or pillowcases. 

Get your blood pumping. Almost any form of exercise or movement can increase your fitness level while decreasing your stress. The most important thing is to pick an activity that you enjoy. Exercise boosts your endorphins and helps release physical tension.

Enjoy A New Hobby. Hobbies are a great way to relieve stress because it shifts your focus on to something that makes you happy. It doesn't have to be time consuming. It could be watching a funny movie/tv series, reading a book, or knitting. 

Seek Help. If the stress is becoming too much for you to handle on you own, it's okay to seek advice or counsel from a loved one or a trusted mental health professional.

Because you are a Nurse, you often care for others without stopping to care for yourself. This ideology needs to change. It's extremely difficult to provide quality care for others when your own mental health is suffering. Be sure to take care of YOU too!

The School Nurse shortage is not a new issue. The pandemic highlighted the importance of having School Nurses. As schools across the nation open back up,
concerns are again rising.

The US Centers for Disease Control and Prevention (CDC) recommends schools have one full-time Nurse for every 750 students.

The latest data from a study, published in the Journal of School Nursing in 2018, found approximately 39% of schools employ full-time Nurses and about 35% employ part-time School Nurses, while 25% do not employ School Nurses.

With out School Nurses, teachers and staff with no medical training would be responsible for providing care such as dispensing medication, managing allergies and asthma, and monitoring blood glucose levels.

Not only are School Nurses responsible for providing care, they also play a vital role in the management of COVID-19 safety protocols and updating staff and parents.

According to a survey from the National Association of School Nurses (NASN), 78% of School Nurses say they took time to review data to see new trends in COVID infections. The survey shows 43% of Nurses spent time updating and developing school health policies and nearly half said they were spending time answering phone calls from parents and the community.  

“I spend most of my day dressed up as a ghostbuster in personal protective equipment,” Rhonda Cranford, a School Nurse at Northside Elementary with 34 years of experience, shared. “I’m answering the phone constantly with questions regarding isolation and quarantine. I spend hours documenting and sending emails. Ninety-five percent of my day is consumed by COVID activities.”  

Many schools have a tight budget and can lack the funding needed to hire a School Nurse.

Laurie G. Combe, NASN President said, “When budgets are tight, administrators make decisions to hire Teachers over Nurses, but what many administrators don’t understand is that having a Nurse on staff can actually save dollars."

A glimmer of hope arose in May when the Biden administration announced the American Rescue Plan. The Plan includes dedicated funding of at least $500 million to hire School Nurses to help schools safely reopen and remain open for in-person instruction.

It’s important to remember there is a Nursing shortage across the country. School districts are competing against healthcare organizations for Nursing applicants where wages in hospitals and other settings tend to pay more.

Between the Delta variant, mask protocols, and vaccine mandates, schools need Nurses now more than ever. 

As the U.S. population becomes more racially and culturally diverse, having a workforce that mirrors the diversity of your community can improve the quality of care offered at your facility.

Ensuring diversity is incorporated in healthcare hiring practices requires understanding and combatting unconscious biases.

Bias is a prejudice in favor of or against one thing, person, or group compared with another usually in a way that’s considered to be unfair.

Unconscious biases are social stereotypes about certain groups of people that individuals form outside their own conscious awareness.

An example of unconscious bias during the hiring process is when you form an opinion about a candidate based solely on first impressions, such as their LinkedIn photo, their first or last name, or their hometown.

There are methods healthcare institutions can use to identify and reduce biases within their hiring process.

• Clearly define what Diversity means to your organization. It is important to understand which groups are underrepresented. Then set measurable goals that work toward building Diversity.
  
  
• Most hiring processes are designed from one perspective (e.g., level, function, identity). When creating your recruitment process, make it a group effort using input from different perspectives and identities. 
   
• Ensure Diversity exists within all levels of your organization, especially Leadership roles. The top healthcare organizations leading the way for Diversity, Equity, Inclusion, and Belonging (DEI&B) usually have a leadership position solely focused on Diversity, such as Chief Diversity Officer or a similar title.
  
  
• Offer awareness programs, training, and unconscious bias resources for staff. It's a great opportunity for everyone involved in the hiring process to understand what hiring prejudices are and how they can influence decision making. This allows people to identify their own biases and actively improve their behavior. 

With leadership support, clear communication both internally and externally about your DEI&B initiatives, awareness resources, and a motivated workforce, you can successfully reduce biases and increase Diversity, Equity, Inclusion, and Belonging within your organization. 

Nursing is one of the most highly respected careers, but also one of the most stressful. This kind of stress can lead to compassion fatigue. 

Compassion fatigue is the emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events.

Compassion fatigue differs from burn-out, but can co-exist. It has a more rapid onset while burnout emerges over time.

According to the Nursejournal, compassion fatigue reportedly affects 16% to 39% of Registered Nurses, with most reports coming from Nurses working in areas like hospice, oncology, and emergency care. Since the COVID-19 pandemic, the impact of compassion fatigue is reportedly far greater among Nurses.

Signs of Compassion Fatigue:

• Extreme exhaustion on a regular or daily basis
• Increased anger and irritability
• Diminished sense of self-worth
• Lower levels of job satisfaction
• Reduced ability to feel empathy
• Disruption of world view; irrational fears and extreme anxiety
• Dissociation
• Impaired ability to make well-informed decisions
• Difficulty separating work and personal lives
• Dread going to work
• Increase in work absences and showing up late
• Failure to commit to any overtime when asked multiple times

Compassion fatigue is a treatable and manageable condition. Treating it starts with recognizing and admitting it is a real condition. From here, you can begin the process of healing. 

Education is important for Nurses at risk for or experiencing compassion fatigue. Healthcare organizations should include educational training regarding therapeutic communication, establishing boundaries, conflict resolution, ethical dilemmas, and self-care.

Self-care methods are a great way to combat compassion fatigue. Nurses are constantly concerned with the needs of others and often neglect their own needs.

According to GoodTherapy, those who practice good self-care are significantly less vulnerable to stress and compassion fatigue than those who fail to do so. Generally self-care includes:

• Balanced, nutritious diet
• Regular exercise/meditation
• Routine schedule of restful sleep
• Balance between work and leisure
• Honoring emotional needs
• Journaling/reading 

Set emotional boundaries. Establishing these boundaries between ourselves and our patients is important so we don’t end up carrying their pain and experiences. 

It is a challenge to stay compassionately connected while still remembering that each of us is a different and separate person. This awareness may help to maintain the space that exists between the caregiver and the patient. 

Use a support system. Support can come from family or friends, mental health professionals, or like-minded individuals experiencing the same thing as you. 

“It may not sound fancy or sophisticated, but building community is the most powerful thing you can do,” says Geoffry White, PhD, a private Practitioner in Los Angeles who has worked to prevent compassion fatigue in mental health practitioners responding after terrorism and war. 

Compassion fatigue is a serious problem affecting many Nurses, Healthcare workers, families, and caregivers. You are human, and your work is incredibly demanding. With self-care, boundaries, and support from others, you can manage and ultimately beat compassion fatigue.

To receive Magnet Recognition from the American Nurses Credentialing Center (ANCC) is something most hospitals and healthcare systems strive to achieve. The Magnet Recognition Program states “To nurses, Magnet Recognition means education and development through every career stage, which leads to greater autonomy at the bedside. To patients, it means the very best care, delivered by nurses who are supported to be the very best that they can be.”

The ANCC offers the Pathway to Excellence Program. The Pathway designation recognizes health care organizations that demonstrate a commitment to establishing the foundation of a healthy workplace for staff.

Organizations can establish this foundation by using the ANCC Pathway to Excellence Framework which consists of six standards:

• Shared Decision-Making creates opportunities for direct care Nurses to network, collaborate, share ideas, and be involved in decision-making.
• Leadership supports a shared governance environment by ensuring that leaders are accessible and that they facilitate collaborative decision-making. This standard also emphasizes leadership development, orientation, retention, accountability, and succession planning.
• Safety prioritizes both patient and Nurse safety, and fosters a respectful workplace culture free of incivility, bullying, and violence.
• Quality is central to an organization's mission, vision, goals, and values, and is based on person- and family-centered care, evidence-based care, continuous improvement, and improving population health.
• Well-Being promotes a workplace culture of recognition for the contribution of nurses and the healthcare provider team. Additionally, this standard provides staff with support and resources to promote their physical and mental health.
• Professional Development ensures that Nurses are competent to provide care and provides them with mentoring, support, and opportunities for lifelong learning.

The number of health care organizations to hold both the Pathway and Magnet^® designations simultaneously is growing! To learn more about this program, click here.

To see which organizations have achieved the Pathway to Excellence designation, click this link.

Health care organizations rely on Nurse leaders to manage teams, patient care, and promote organizational goals. In order to meet these goals, a successful Nurse leader must possess certain qualities such as...

Good communication. In healthcare, effective communication can literally be the difference between life and death. 

Nurse leaders should make themselves accessible and establish an environment that promotes an open-door policy so Nurses feel comfortable discussing issues or concerns. Team meetings is another great way to keep regular communication throughout shifts. 

Accountability. Nurse leaders are responsible for creating and maintaining a culture of accountability.

According to Duquesne University, some of the steps to creating a culture of accountability include:

• Building trust: The foundation for successful workplace accountability is trust. Employees who trust each other are more willing to accept and act on constructive criticism rather than assuming it is ill-willed.
• Developing strong communication skills: Individuals who use an assertive communication style can express information in an honest, open, and direct manner. The assertive communication style is not aggressive in tone, but instead is respectful and avoids blame and criticism.
• Developing clear expectations: The American Nurses Association (ANA) outlines the expectations and responsibilities for all Nurses including the overall responsibility for their patients and practice. Nurse leaders should continually remind Nurses of the expectations of practice.
• Modeling accountability: A workplace that has leaders who accept responsibility and hold themselves and others accountable creates a culture of accountability. Nurses who are leading teams of Nurses must be open to feedback and criticism. 

Emotionally Supportive. Without empathy, you can't build a team or nurture a future generation of leaders. 

Empathy in healthcare means more than just being a sounding board. It requires conscious effort to take a step back and respect a coworker's feelings, needs, and concerns. This process requires a skill set that can be developed with time, practice, and instruction. When healthcare workers can discuss and cope with their emotions, they can better care for their patients and avoid or manage stress that leads to burnout.

Goal Getter. A great Nurse leader is always striving for excellence, and that requires evaluating how the organization is doing, identifying priorities for improvement, setting measurable goals, leading teams to achieve them, and then celebrating those achievements.

Adaptable. The role of a Nurse will always be evolving and changing. Nurse leaders must possess the ability to be flexible and adapt to new environments, technologies, policies, and as we've seen over the last year with COVID-19, global health issues.

These qualities are important throughout the entire Nursing industry, regardless of where you are in your career. Even if you aren't a manager, you can use these leadership skills to motivate your team to be more efficient and productive.

The culture of a work place can be described as the vibe of the environment, the day to day experience of staff and patients, and the way practices are implemented and followed. 

According to Beckers Hospital Review, culture can have a direct impact on patient care and patient satisfaction. Hospitals with adaptable culture outperform those without it, as much as 200%. 

To improve your culture, here are some things to consider.

Communication is key. If you’re implementing changes, communicate them to every staff member so they know there are going to be changes. If they have concerns, they should feel comfortable to voice their opinions.

Establish where the organization is now. Determine what problems you want to fix and what areas need improvement. Set clear goals and benchmarks to measure your success along the way.

As you achieve your goals, no matter how small, celebrate them! People want to know they’re doing a great job. It boosts morale and radiates throughout the entire organization.  

Accountability - establish a process for accountability at all levels of the organization in case goals aren't being met. Often, initiatives fail because no one takes the hard job of holding others accountable. Old habits are easy to slip back in to if there is no accountability.

Mission Statement - every hospital should have a clear mission statement. It should define the overall culture and values of the company. It sets the tone of your organization. Hospitals can use these core values as guidelines for employees. 

Never stop improving. As your culture evolves, continue to listen to your employee's concerns and ideas. Listen to their feedback. Acknowledge, assess, and act on it. It’s important your employees know their voices are being heard. This can also help with employee retention too.

Great changes can take a long time. Be prepared for obstacles and setbacks. Keep visiting your goals and believe in your mission statement.