DiversityNursing Blog

When Nurses decide to be educated in a certain area, it is very likely they will acquire a position that allows them to utilize the skills and knowledge obtained during school and training. While many continue on in their area of expertise, some decide to change specialties and focus on another area.  

With the human body being so complex and so much to learn, some Nurses may decide to work in a number of specialties throughout their career. For some, it can be exciting and rewarding to switch things up. However, before deciding to switch specialties and take on a new list of duties and responsibilities, please consider the pros and cons before doing so. 

What are the Pros of Changing Specialties? 

* Adding to your Skill Set

Working in one specialty may become boring because you are doing the same thing every day and perhaps not learning anything new. Changing specialties will allow you to put an end to that boredom, add to your skill set, challenge you, and give you a reason to love your work more. It looks good on a resume to be someone who is versatile and able to work in more than one area of the medical field. 

* Potential Opportunity for a Higher Salary

There are many things that factor into what makes someone change their specialty. Money is possibly one of them. Changing specialties doesn't always mean you'll make more money, but there is a chance you will. Be sure to check the average income of someone working in the specialty you're considering.

* Opportunity for Growth

With some specialties, there is no room for growth or advancement. This is acceptable for some people, but a lot of Nurses want a job where they can be promoted and continue to earn more money. Take a hard look at where you were when you first started working and where you are now. If your current specialty doesn't offer the type of advancement opportunities that another specialty would, it may be time to make the switch.

What are the Cons of Changing Specialties?

* Decreased Chance of Promotion

Oftentimes, when a company promotes Nurses, they look for Nurses who have been with them for several years, and who are knowledgeable and experienced in their field. Even if you've worked for the same company, changing specialties can be like starting out as a new employee. Before a promotion becomes a possibility, you'll most likely have to work your way up and gain experience in your new field. This could take years, depending on the difficulty of the your new specialty.

* Stress

A new specialty means you'll be doing things you're not used to doing. This can lead to an extreme amount of stress because you want to perform well and be noticed for the great work you're doing. Being the new kid on the block means every move you make will be monitored closely. It can be uncomfortable and stressful to be in this situation. 

* Financial Instability

Higher pay is possible, but it may not happen right away. Because you have to learn the ropes and gain experience in your new specialty, you may not make the salary that everyone else in this specialty is making. This is especially true if you need to go to school for a year or two. 

When you change your specialty, it doesn't always mean you can't go back to working in the specialty in which you started. Ideally, people making this change are hoping for the best and plan to stay in the specialty for some time. Whatever is decided, the goal is to be happy in what you do.

 Have questions about changing your specialty? Ask one of our Nurse Leaders! Click below.

The Nursing profession is notoriously high-pressure. Many patients that Nurses encounter are in a grave state of need, and Nurses may not always meet their patients' needs, despite their best efforts. With so many individuals needing a coping mechanism, it's no wonder that many people turn to the power of humor and laughter.

The Benefits of Humor

To no one's surprise, humor has shown itself to be a powerful tool in the Nursing profession. Humor can increase a Nurse's happiness in his/her position and help to avoid burnout.

Sociological and psychological studies have shown that humor can diffuse tension in a situation, help lower blood pressure, ease stress and generally produce a feeling of well-being. Laughter and smiling create comparable positive effects.

Inappropriate Humor?

People in the medical profession are often familiar with a kind of dry, morbid humor. Medical professionals deal with matters of life, death and pain, with great immediacy. To give themselves some emotional distance from the matter, many medical professionals utilize this kind of humor among themselves.

But this kind of humor can seem cynical at best. It can alienate or appear disrespectful to patients. It's important to use it with care, if at all, and to remember that all individuals involved are human beings worthy of respect. As a rule of thumb, it's never acceptable to make jokes at a patient or colleague's expense (even if the individual isn't present, or if the humor would go over their head); this is doubly true with the kind of dry humor that can be common in Nursing.

Using Humor with Patients

Maintaining boundaries and being professional is key when engaging with patients and their families. But that doesn't mean that a Nurse isn't able to use humor in these situations.

It's important to use a delicate touch when joking with patients. Nurses may not get to know them or their sense of humor very well, and they're typically involved with patients during times of great emotional vulnerability, including fear or pain. But so long as a Nurse adheres to basic rules of interpersonal sensitivity, caring and respect, a little humor may go a long way to aid in bonding and the creation of empathy between patient and caregiver. It may defuse tension in situations that are otherwise very stressful.

Conclusion

Humor can't solve all problems within a workplace. If a Nurse is having serious problems on the job, or if they're going through a crisis outside of work, humor won't be enough to relieve stress and encourage them to stick around. But as an emotional release valve in a potentially grueling profession, occasional moments of humor can have a surprisingly powerful effect.

Is humor a tool you use often as a Nurse? Let us know in the comments below! 

As the growing baby boomer generation begins their retirement, so too begins a wealth of golden opportunities for investors and job seekers in the senior care industry. Of particularly exciting growth are the providers of in-home health care services. This includes people who specialize in everything ranging from medical assistance to basic health assistance like bathing and grooming, keeping up with housekeeping, and meal preparation.

So just how many of the baby boomers can in-home care providers expect in the coming years? There are an estimated 75 million baby boomers currently alive and contributing to our society, with an estimated 10,000 baby boomers turning 65 and retiring every day (starting 2010 and lasting until 2029).

In a recent survey conducted by NBC News, 89 percent of baby boomers that were age 50 and older stated that they would prefer to stay in their current home as they aged. Additionally, a whopping 95 percent of those surveyed who were 65 and older were adamant that they would rather stay either in their own home or near relatives and hoped they wouldn't need to live in a nursing home.

With such incredible growth in those needing home care services, it should come as no surprise that there's been likewise growth in individuals seeking careers within this industry. In addition to incredible career opportunities, there are also the following benefits of entering the home health care industry:

• Make a real difference in peoples' lives.  A career in home health care services enables you to make a real and meaningful difference in the lives of your clients and their families. Empathic individuals thrive in this profession as they are able to enjoy personal relationships with their clients and enjoy a sense of accomplishment coming from knowing that you are greatly improving another person's quality of life. 
• Work on a flexible schedule.  Not everyone adapts well to a 9 to 5 job. As a home health care Nurse or in-home caregiver you get to enjoy working on a schedule that fits your needs. So whether you want to work part-time or full-time, whether you're also pursuing another degree or raising a family, as a home healthcare employee you can choose the hours that fit your schedule.
• Deliver complex care to relieve the burden on families.  While seniors are a primary component of the growth in home care services, it isn't just aging baby boomers who are calling for a more diverse array of services. From infants with special needs to adults suffering with chronic conditions and those requiring specialized high-tech medical equipment, all of these individuals and their families depend upon home health care professionals for daily and ongoing support. As an in-home health care Nurse or aide, you make it possible for your clients to avoid expensive and potentially embarrassing institutionalization in an outside facility. 
• Specialize your skills.  Just as there is a diverse array of services you can provide within the in-home care industries, you can also choose to focus your care to meet the specialty service of your choice. For instance, if the idea of assisting baby boomers inspires you, then you can opt to build a career designed to work exclusively with geriatric care. This means that you can choose what you love about home health care services and follow that specialty for greater overall career success.

Take advantage of the growing home health care service industry to jump start your own rewarding career or make a change in your current career. 

Related Article: Life in progress: RNs can help baby boomers find funding for promising cancer treatments

Have questions about Home Care Nursing? Ask the Nurse Leader below!

Over the past 60 years, both private and government third-party payment policies have shaped our health care system.  Medicare hospital inpatient payment policies during the mid-1980s set a precedent for most payers to change cost-based to prospective payment systems and resulted in hundreds of hospitals closing or merging.

Until 1990, private and public third party payers had no explicit policy to pay for telehealth or telemedicine services.  Medicare reimbursed services that did not require face-to-face contact between a patient and practitioner, such as radiology or EKG/ EEG.  Reimbursement was idiosyncratic depending on policies of Medicare.
The Balanced Budget Act of 1997 (BBA) signaled a change in Medicare payment policies that opened the door for telemedicine reimbursement. This article will describe current Medicare telemedicine policies and discuss how the growth of telemedicine affects our current and future career Nurses.

Who Can Receive Services
Under the BBA, only services provided to patients in federally-designated rural Health Professional Shortage Areas were eligible. These generally lack primary providers. For example, a community may have a Nurse or GP, but no specialists such as cardiologists, psychologists or even dermatologists. These communities greatly benefit from telemedicine, but the telemedicine providers who served them could not be reimbursed under the BBA.

From this conundrum came the telecommunication consult, fee splitting and general chaos regarding defining the services a patient received, and from whom, and how it was to be compensated. The command to follow the money was not only difficult, but so was finding the money in the first place.

Telecommunication Finally Recognized
The awesome superiority was clear in many instances where personal contact by physicians was not necessary but exchanged technology was vital. There was a flurry in the field of home health care Nursing, which suffered horrendous setbacks in funding during the 90s and the services that survived were cut back in quantity.

Technology changes all businesses and how we conduct them. No better can this be seen than in the growth of the Internet. Developments in bio-informatics, miniaturization, and computer chip design promise major advances in prevention and treatment of disease, including providing health education and counseling in patients’ homes.

Should Nurses Be Concerned?
This new world of health care is not universally available in the USA. The telecommunications for telemedicine are still inadequate or unaffordable in many rural areas. So why should Nurses be concerned? Nurses have much to gain.

1. Telehome care is a Nursing industry.
2. Nurses play a key role in all telemedicine, usually managing.
3. Nurses have been at the forefront of video teleconferencing for preventive services and advocating for policies at national, state, and institutional levels;
4. Nurses often are the key providers of preventive services, many of which would be enhanced by access to telemedicine services.

Given the concerns of third party payers as to whether to pay, the voice of Nurses must be heard. The question for Nurses is: Will we be at the table when decisions setting telehealth payment policies are adopted? The future Nurses’ role must be acknowledged and categorized efficiently as new telemedicine legislation is entered in states like AK and CA.  Emphasis must be equal for preventative as well as curative medicine.

Growth of Nursing Responsibilities
Nurses usually have the management and technological administration of both preventative care duties and the tech equipment and shared information with other professionals.  This acknowledgement should result in a categorizing of new Nursing skills relative to the technological needs of medicine. As technology in medicine grows, so should the field of RN’s as it embraces additional functions and departments.

Follow the Money to Nursing?
Incredibly, it could be that the future decade will promote the values of the requirements of RN’s to the point that the skills receive increased compensation on a level with their increased duties.  Payment of their skills by Medicare and other third party insurers will open a floodgate of better and more efficient medical care for patients and in time will increase the health care of our nation. The USA is considerably behind other countries in this regard despite having the resources and expertise in medical specialization.

The senior population is more likely to need Nursing care, yet the population of qualified Nurses in diminishing.  There is increased opportunity for young men and women to enter the Nursing profession as an upwardly mobile career.

Related Articles:

Do People Trust Telemedicine? [INFOGRAPHIC]

With Telemedicine as Bridge, No Hospital Is an Island

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Last year the Green Valley Fire District began what is best described as a "mobile urgent care" and next month they will be sharing it in Washington D.C.

The fire district has four nurse practitioners on staff to help respond to medical calls that do not require a trip to the emergency room. They can treat patients in home whether that be giving someone stitches or prescribing antibiotics.

"In essence we are a mobile urgent care," said Battalion Chief Dan Modrzejewski.

He is one of two chiefs with GVFD that will travel to Washington D.C. at the end of March to present their program to the American Society of Aging. They will show how their program works, why they started it, and its success with a group that includes the Centers for Disease Control, the Center for Medicare and Medicaid, among others.

Modrzejewski says he hopes other agencies around the country will adopt their program. Similar programs are already in a handful of jurisdictions.

The Green Valley program, less than a year old, has been a success according to Modrzejewski. He says before they began, a quarter of their 911 calls could have been handled by a nurse.

"They don't necessarily need to go to the emergency room," he said.

Last year, their nurses responded to 170 calls and were able to treat all of them in home instead of transporting them to the emergency room. Modrzejewski says an emergency room transport could cost between $3,000 and $4,000 while their program is much cheaper on the patient.

"The most we charge insurance is going to be $300 or $400," he said.

He says when they began they had one nurse, but now they have four on staff. Additionally, the program has decreased the number of 911 calls they receive because people are calling their appointment line for the nurse. That number is 520-428-0550.

America is getting old. Not the nation itself, but the average age of the citizens that call America home. According to the US government's census and population board, by 2030 the Baby Boomer generation will be over the age of 65 and as such, the shift in demographics will cause many changes to the USA's way of life and tending to the aged. One such area where these changes will see direct effects is in the palliative care and nursing home care for aging and senior citizens.

Available Beds in Nursing Homes
As the American population sees the shift toward having more senior citizens there is going to be pressure on the available nursing homes in the country to expand and provide more beds and spaces to accommodate the change. This is no small task. The two sides of the coin to this have positive and negative effects on the aging population (and indeed, to those under age 65). The positive side of the coin shows projections illustrating increases in the amount of jobs available in the country, especially in the construction, design and nursing fields.

As the American population ages construction of new facilities and assisted living homes becomes critical. As the construction and expansion takes place there will be a need for qualified laborers and construction specialists such as architects and designers. Economists say this will help push the country's economy forward and will help to keep the unemployment rate down.

The flip side of this coin is while the age demographics shift, there is going to be a demand for laborers and constructions workers, but there will be a dip in available hands to actually do the work. This is going to create a demand for higher wages and benefits which will push the already spiked costs for nursing care and elderly services even higher leaving many in tough situations.

Nurses, Doctors and Trained Medical Professionals
With the growing aged population, there is going to be a huge need for more qualified Nurses, doctors and medical professionals who understand and work with the elderly. When this shift occurs, there will be a strain on available medical services and professionals already in the country. The hope is younger generations will go into the needed fields of medicine and technician professionals.

Everything from radiology techs to physician assistants are going to be in high demand. But with the younger generations not growing as fast as the aging, there are valid concerns about available new medical health practitioners and where to find them.

With the continued strain on Nurses and other medical professionals, there is going to be long waits for basic appointments and services as well as increases in the already high costs of American medical services. For many in the aging population, the fear that even with a pension and health insurance, meeting the basic monthly expenses for needed prescription drugs and doctor's appointments may be out of reach for many. This means the aging population will be at risk as they will not be able to afford their needed medical services and drugs.

Some economists argue that as the demand for such services and professionals increase, there will be a huge opportunity for the younger generations to study, train and enter the medical field. Hopefully this will meet the services needed by the aging population as well as increase the economy and push positive growth forward. This is projected to mean better conditions and services available to the growing and aging population of the USA.

The solutions for the aging population are not easy, but hopefully the country will rise to the challenge to take care of it's elderly. They have already given so much to the country and it is important the country rise to meet their needs as they grow old.

Related Article: Aging Population a Boon for Health Care Workers

February 29th is Rare Disease Day- a day celebrated internationally to bring awareness to the 7,000 different types of rare diseases in the world. Globally, 300 million people are affected by a rare disease. Those fighting rare disease face unique struggles.  While there are millions affected by rare diseases- about 50% of rare diseases don't have a disease-specific foundation supporting funds or advocating for the disease. Also, many times common symptoms hide underlying rare diseases, leading to misdiagnosis and uninformed treatment at a later stage. In honor of rare disease day, take a moment to learn more about different rare cancers and diseases such as mesothelioma, a rare cancer caused by exposure to asbestos. 

Written by Edgar Sandoval and Denis Slattery

After an hour that felt like an eternity, Diabate rubbed the ice our of her eyes and face spotted the gates to the nursing home with a sigh of relief.

“When I went out there, the wind it just, hit me in the face,” Diabate recalled on Sunday as she made her way through a second shift. “The winds were strong. The snow was high.”

Diabate said she wore snow boots and a bubble coat with a hoodie as she plowed through threatening strong winds and waist-deep snow.

“She was the only nurse than came in,” Hebrew Home supervisor Mojdeh Rutigliano said.

A few of the medical staffers had spent the night at the facility she added.

But more than 50 nurses that went home Friday were unable to make it back to work.

“The majority of our nurses called in sick. They just couldn't come,” Rutigliano said. “Talk about crisis mode. But it was such a relief to see her come in.”

Diabate said calling in sick did cross her mind, but then her desire to do good got the better of her.

“I really have to love what I do make such a commitment,” she said. “This is what it means to be a nurse.”

The monster storm that shuttered the city was no match for one Washington Heights nurse.

Chantelle Diabate bundled up and braved the worst of the winter weather Saturday to make it to her overnight patients at a nursing home in the Bronx.

The 32-year-old single mother was hailed as a hero for walking more than a mile during the debilitating snow storm that dumped 26.8 inches of snow to reach the Hebrew Home in Riverdale.

“I walked for about an hour and all I kept thinking was, I really love my patients,” Diabate said.

The snow angel has been working at the facility, which houses more than 840 elderly patients, for a little more than six months.

“We see them a lot. We’re like family,” Diabate said. “I’m tired but I decided to work a double shifts. They need me.”

Diabete said she found someone to care for her 3-year-old girl and then found a place to stay in the Bronx to be close to work. But she couldn't believe her eyes when she saw on the news that public transportation had been canceled and the storm was picking up speed.

“A friend walked with me and fell. At first I started out kind of like speed walking on ice. But then I realized this is like a workout and it's dangerous,” she said. “Then I thought, you know what? A slow and steady pace is going to get me there, eventually.”

After an hour that felt like an eternity, Diabate rubbed the ice our of her eyes and face spotted the gates to the nursing home with a sigh of relief.

“When I went out there, the wind it just, hit me in the face,” Diabate recalled on Sunday as she made her way through a second shift. “The winds were strong. The snow was high.”

Diabate said she wore snow boots and a bubble coat with a hoodie as she plowed through threatening strong winds and waist-deep snow.

“She was the only nurse than came in,” Hebrew Home supervisor Mojdeh Rutigliano said.

A few of the medical staffers had spent the night at the facility she added.

But more than 50 nurses that went home Friday were unable to make it back to work.

“The majority of our nurses called in sick. They just couldn't come,” Rutigliano said. “Talk about crisis mode. But it was such a relief to see her come in.”

Diabate said calling in sick did cross her mind, but then her desire to do good got the better of her.

“I really have to love what I do make such a commitment,” she said. “This is what it means to be a nurse.”

Related Link: 

Boston Hospital Medical Staff Brave Blizzard On Skis

Written by Laurie Mason Schroeder 

SALISBURY TOWNSHIP — With his wide blue eyes, unruly hair and bashful grin, 26-year-old Justin Smith looks perpetually, happily surprised.

Doctors at Lehigh Valley Health Network describe the Penn State student from McAdoo, Schuylkill County, as a "medical miracle," perhaps the only person in history to survive hypothermia so extreme that he was literally frozen solid after falling unconscious in a snow bank while walking home in subzero temperatures.

"It's still sinking in, I guess, so it's hard to think of it as a miracle," Smith said. "I'm lucky. That's all I can say."

Smith and his family traveled to Salisbury Township Monday to thank the doctors and nurses at LVHN who saved his life. His father, Don Smith, wept as he described finding his son in the snow on the morning of Feb. 21.

"I remember holding him. He was so cold, frozen. He was like a block of concrete," he said.

Justin Smith's ordeal began around 9:30 p.m. Feb. 20, as he was walking home from the Tresckow Fire Company, a social hall where he and his friends often spent Friday nights having a few drinks.

It was a 2-mile trek that Smith had made countless times, he said, to avoid drinking and driving. Smith does not recall slipping and hitting his head, but doctors believe that's what happened as he walked along Tresckow Road.

He landed face up in a snow bank, eyes open, staring at the sky.

That's how Don Smith, a Hazleton Area High School teacher, found his son the next morning around 7:30 a.m., alerted by one of Justin's friends who had called to say that she had not heard from him and was worried. The temperature overnight had fallen to 4 below zero.

Don Smith gathered his son in his arms and sobbed as he rocked back and forth in the snow. Justin wasn't breathing and had no pulse. His eyes were still open and his arms and his feet had turned black from the cold.

"I just kept praying to the Lord, 'Bring him back, just bring him back'," Don Smith said.

Paramedics believed Justin Smith was dead and called the coroner. A sheet was pulled over his head.

Dr. Gerald Coleman, an emergency room doctor at LVHN's Hazleton campus, urged paramedics to transport Smith by helicopter to LVH-Cedar Crest, where he was revived with a procedure called extracorporeal membrane oxygenation in which blood is removed, oxygenated and warmed, then returned to the body.

Dr. James Wu, a cardiothoracic surgeon, performed the delicate procedure, which is typically used to save patients whose lungs and heart are damaged by the flu or a heart attack.

Smith spent the next 15 days in a coma. When he woke up, doctors were amazed to find that he had suffered no apparent brain damage.

"This case has taught me that sometimes you have to go with your gut, even when all logic demands otherwise," Coleman said.

Both of Smith's pinkie fingers and all of his toes had to be amputated because of frostbite. But the damage could have been far worse, said Dr. John Castaldo, a neurologist at LVH.

While extreme cold can preserve organs by putting the human body in a state of suspended animation, Castaldo said, once ice crystals form in the blood stream, death soon follows.

"Justin was right on the brink," Castaldo said.

Smith spent nearly three months at LVH-Cedar Crest and at Good Shepherd Rehabilitation Hospital in Allentown before returning home May 1.

Smith, who had studied at Penn State's main campus, is now finishing his psychology degree via online classes. On weekends, he works to improve his golf game, a challenge because of his lost fingers and toes.

Smith's mother, Sissy, and sisters Ashley and Sarah have been by his side throughout his recovery. His friends are glad to have him back, he said, and he's earned the nickname "Iceman" from his buddies.

As he took turns Monday hugging the LVHN doctors and nurses who had saved his life, Smith said the enormity of what happened to him hasn't sunk in yet.

"I'm just grateful. I'm proof of what can happen when great people work together," he said.

The healthcare industry is filled with challenging and rewarding job opportunities. For those who are actively pursuing a career in nursing and who eventually wish to acquire leadership roles in that field, striving for the occupation of Chief Nursing Officer is a worthwhile endeavor.  To be a successful CNO in the healthcare system there are specific requirements, qualities, and skill sets that the industry requires of their employees. These attributes can determine the likelihood of potential employment. Along the same vein, what does it really take to become a good CNO (Chief Nursing Officer) in the medical sector?"

Basic Requirements

The requirements for the role of CNO vary depending on the preferences of the employer.  There is, however, a general consensus that to be considered for the position of CNO, the applicant needs years of nursing experience and some form of a graduate degree. Some hospitals or medical affiliates require as little as 5 years of experience while others require applicants have 7 - 10 years of practice in the medical industry. The CNO position is the highest ranking Nurse in administration and that role is not taken lightly.

Taking the right educational journey to a specific career is important. The value and focus a Chief Nursing Officer hopeful applies to their education path speaks volumes to potential employers.  Having a MS Nursing (management and organizational leadership) degree, a MS in Nursing (leadership in health care systems) degree or a Master of Science in Nursing Administration is a common trend among current Chief Nursing Officers. Earning a combination of a science-oriented Nursing degree along with a business emphasis degree is encouraged when seeking a leadership position in healthcare.  

If a healthcare employee is seeking admission into a Master's degree program to aid them in their journey toward career advancement, they have expectations to meet. Those in the Nursing field are required to have an active RN license, a Bachelor's degree, and should be aware that RN clinical experience bears heavily in the admissions process. While there are many technical aspects to attaining the title of CNO, becoming a "good" CNO goes beyond the basic requirements.

 10 Qualities of a CNO

• Has a passion for fulfilling a leadership role
• Desires to be a positive mentor
• Exhibits a conscious concern for patient care
• Focuses on quality and safety
• Enjoys implementing strategies to solve existing problems
• Decisively initiates responses to emergencies
• Displays commitment and the highest level of competency
• Is a proactive force in a hectic environment
• Exudes compassion and dependability on a daily basis
• Has a keen sense for business matters and has developed organizational skills

Skill Sets of a Good Leader

Chief Nursing Officers realize the importance of setting long and short term goals for the betterment of their facility. As a consummate problem-solver, the business-minded and client-conscious leader balances passion for patient welfare with administrative management. Implementing processes that ensure the business side of healthcare runs smoothly, the leadership role of a CNO is fraught with responsibility, but also with rewards.  They are the faculty informers, the interviewers, the proficiency job monitors for Nurses, staff schedulers, and that is just the start to their long list of duties.

Boasting of better pay, job security, and intrinsic rewards, there are many reasons why a CNO values their many-faceted position. Leaders are born through adversity, and a confident Chief Nursing Officer can handle with marked professionalism, the many conflicts that come their way.  A good CNO values people and the efficient processes that bring order to chaotic environments.

Any Chief Nursing Officers looking to grow diversity in their facility can click below for contact information. We would be more than happy to help you.