DiversityNursing Blog

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.

Many people interested in a career in healthcare originally think they’ll go to medical school and become a Doctor, but ultimately end up becoming a Nurse. Choosing between Nursing and Medical school depends on each person's career goals and what kind of studies they'd be most interested in.

It's important to explore both options because while they can be similar in some aspects, they are very different in others.

Length of Training

The length of training is a major difference. Nursing programs range from 2 years for an Associate's degree, to 4 years for a Bachelor of Science in Nursing, to 6 years for a Master's. Medical school requires a minimum of 8 years of education plus residency.

Time Spent With Patients

Witnessing a loved one be taken care of by a medical professional is one reason many people choose to start a career in healthcare. If building a strong relationship with patients is meaningful to you, a career in Nursing is probably a better choice.

Often Doctors are in and out of the patient's room while the Nurse spends their entire shift taking care of a handful of patients. 

Like many of our Annual DiversityNursing.com $5,000 Education Award Winners, Shelah Roanhorse, our 2021 Winner, initially wanted to be a Doctor, but after her brother Nate became sick with cancer, she witnessed the dedication and care the Nurses gave him. She saw how involved his Nurses were with his day-to-day care. This greatly influenced her decision to become a Nurse.

Career Opportunities

There is a high demand for healthcare professionals.

The Association of American Medical Colleges (AAMC) projects a shortage of between 54,100 - 139,000 Physicians by the year 2033.

And, According to the U.S. Bureau of Labor Statistics (BLS), employment of Registered Nurses is projected to grow 7% from 2019 - 2029, faster than the average for all occupations.

Doctors may be limited by their specialty area. A Nurse could be limited too depending on the specialty, but Nurses can work both in and out of the hospital in a variety of settings including...

• Educators at Schools of Nursing
• School Nurses
• Insurance companies as health coaches, case managers and Nurse navigators
• On-staff Nurses at non-healthcare companies
• Law firms as medical forensics investigators

Leadership Roles

There is a misconception that leadership opportunities are limited in Nursing.  

Many Nurses lead initiatives to improve quality of care and patient safety. Some Nurses join their healthcare organization's C-suite and become Chief Nursing Officers or Chief Diversity Officers.  

With ongoing healthcare reform and new models of care delivery across the U.S., the role of Nurses is likely to further expand and allow them to take on new and dynamic roles in healthcare.

Whether you choose to become a Nurse or a Doctor, both careers are extraordinarily rewarding. Try to learn as much as you can about both avenues of healthcare before making your big decision.

LGBTQ+ Pride month is celebrated every June in honor of the 1969 Stonewall riots, and works to achieve equal justice and equal opportunity for Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) Americans.

Pride month celebrations include parades, parties, concerts, educational events and speeches. Memorials are also held to honor members of the community who have been lost to hate crimes or HIV/AIDS.

Hospitals around the nation are taking this opportunity to show their support. 

The Downtown Somerville Alliance joined with Robert Wood Johnson University Hospital/Somerset and the Babs Siperstein Proud Center unveiled a 75-foot mural to celebrate influential figures in the LGBTQ+ community. 

The installation features icons like Harvey Bernard Milk, state icons like Christian Fuscarino of Garden State Equality, local icons like LGBTQ+ rights attorney Frank Morano of Bound Brook and many more.

Newark Beth Israel Medical Center and Children's Hospital of New Jersey, held a flag raising ceremony. President and CEO Darrell Terry Sr. said, "This month we are proud to raise the LGBTQ+ flag and to raise awareness about the disparities that impact this community."

The following flags will be on display in one of the hospital's main corridors throughout the month of June: Transgender Pride Flag, Philadelphia People of Color Flag, Gender Fluid Pride Flag, Intersex Pride Flag, Coexist Flag, Progress Pride Flag, Ally Flag, Pansexual Pride Flag, Nonbinary Pride Flag, Equality Pride Flag, and the Bisexual Pride Flag.

The University of Kansas Medical Center is hosting a Biographical Posters event where you can learn about the background and careers of several LGBTQIA+ community members as well as their journey to KU Medical Center. Spotlights will be shared via social media and the diversity intranet site. Digital posters can be seen here.

Johns Hopkins Medicine is hosting discussion panels, workshops, film screenings and listening sessions covering important LGBTQ+ topics.

As well as hosting educational awareness programs, UNC Health and UNC School of Medicine are handing out “Ask me about my pronouns”, “LGTQ Ally” and other pins and badges with information on LGBTQ Health Disparities.

More than half of patients in the LGBTQ community report having faced discrimination in a healthcare setting. In order to improve LGBTQ+ care, hospitals must become allies for this community and combat any discrimination. 

1. Set your phone or digital watch to military time. In healthcare, the 24-hour clock is generally used in documentation of care as it prevents any ambiguity as to when events occurred in a patient's medical history.

2. Get to know your team. Don't hesitate breaking the ice, introduce yourself, others are probably wondering who this new person is! Once you get to know everyone, try keeping a close group of people you can rely on and talk to when need be. Every one needs a helping hand or shoulder to lean on time and again. 

3. Don't be afraid to ask questions, no matter how small. It's better to not know and ask, than act like you know and risk a patient's safety. Listen, watch and learn from seasoned Nurses. Learning is a never ending part of the job. 

4. Seek a mentor. This one-on-one experience provides a safe space for new Nurses to ask questions and learn the social and professional inner workings of their profession.

5. Self care is important. If you aren't caring for yourself, you won't be able to care for others.  Be mindful of how you feel and recognize when you need to give yourself some extra love and attention. Even small 15 minute breaks during shifts can make a world of difference. 

6. Never stop learning. Invest in continuing education, keep certifications up to date and seek knowledge in places outside the hospital setting. 

7. Buy good shoes! Nurses are on their feet constantly so invest in a pair that are comfortable and durable. Also try wearing compression socks.

8. You may not be able to do everything yourself, but together we can do anything. Offer help when you can and accept help when you need it. 

9. Carry many pens with you!

10. Remember why you started. It will help you get through tough times or when you're feeling down or burnt-out. Nursing is stressful, but also rewarding.