DiversityNursing Blog

In an environment where moments can mean life or death, it is undeniable that communication greatly matters. If the same message can be conveyed without losing meaning in a shorter or more efficient way, then it's a duty of the messenger, especially in a professional medical setting to optimize their communication skills. Speaking is literally only half of the equation, with great listening skills and information retention skills being able to effectively make repeated statements unnecessary. There are some ways to think critically about a healthcare organization to determine where it stands as a team regarding their communication abilities. Taking this closer look at the state of communication at a given facility is the crucial first step towards improving the communication therein. Increased efficiency in communication will result in saved time and increased focus that can be dedicated to the needs of patients, where it ultimately should.

Determining the state of the team's communication skills:

• Turn culture clash into culture strength: If there was no top-down strategy around cultural diversity as a marker of strength, then little petty fights about minor topics could escalate into all-out cultural clashes among a workforce. By the promotion an ideal of strength through unity, the team as a whole has the chance to get in front of any potential culture clash issue rather than chasing the problem, always trying to put out fires.
• Hold group meetings to discuss the overall state of communication at the facility: Management can play a massive role in putting the correct, positive spin on the topic of diversity in the workplace. The larger part of any staff will often be found to be on the same page about the acceptance, curiosity and positive interest in new cultures being integrated into the workplace at all times. By it being an official part of a corporate brand message and identity, the company embraces the diversity perspective even further.

Starting to help create a positive communication culture:

• Create regular workshops to go over basic principles in communications: Different individuals from diverse backgrounds will have unique perspective to share on the same topics, even if they technically speak the same language. Then, of course, there are the actual boundaries that exist between nations and languages that are completely distinct. If the staff of a healthcare facility can say "Hello" in ten distinct languages, that group brings themselves one step closer to the perfect awareness and diversity in their facility. 
• Hold regular cultural show and tell days within the staff: Each staff member, once they share their true selves, are going to have their own special cultural tale to share. If there is an encouraging environment in this way, it becomes natural and easy to leverage this diversity to enrich the staff with increased knowledge and awareness. Patients come from all over the world and there's never any way to predict who will become a patient next. With these principles in mind, a staff trained in cultural sensitivity and awareness will be better prepared to interact with new international cultures.
• Leverage modern and inexpensive tools: Any healthcare facility staff member is going to be all too familiar with the app store on their smartphone, but sadly quite few have downloaded any translation or language-learning app onto their phone. When these powerful and groundbreaking tools are now available and often for no outright cost, it's usually just a matter of pointing this out and creating a culture of support towards adopting these excellent tools to enable a team to begin using them.

Once the realization hits that communication is mostly a function of awareness, effort, empathy and genuine bonding experiences with groups, it becomes much easier to cultivate this environment of abundant and fruitful communication. If the entire healthcare facility can start to treat the state of communication at their facility as a togetherness exercise and a mission dedicated to a better experience for the patients, then the real results can start to be noticed.

Individual differences can make a group stronger and more powerful or they can also tear groups apart. The key to ensuring a positive outcome is to apply conscious effort around fostering excellent communication in any arena or avenue possible.

Related links:

4 nurse communication startups to improve patient outcomes

Three Tips for Better Nurse–Physician Communication In The Digital Age

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By Dr. Melissa DeCapua, DNP, PMHNP via www.bartonassociates.com

This article about “what’s in a name” caught our attention. We’re sharing it with you to find out if you’ve run in to this situation where you work. If you’re an NP or a PA, we know you’ve worked very hard to accomplish your degree requirements. Where you work, is your position sometimes referred to as “mid-level”? If so, read on and then tell us of your experience. Have you pointed out to Human Resources that this is a confusing term?

I had just graduated from nurse practitioner (NP) school and was on the job hunt. Skimming through a few job descriptions the word “mid-level provider” caught my attention. Having never heard that word, I assumed the job wasn’t meant for an NP. The next time it happened, a recruiter called my cell phone telling me there was an open position for a “physician extender” in rural Colorado. A what? It’s interesting how you can be an extension of someone who isn’t even present.

Then, a naive new-graduate, I didn’t quite grasp the scope of the problem. Although I did know one thing, neither of those titles captured who I was or what I did. As I’ve progressed through my career, I’ve heard myself called a “mid-level provider,” “physician extender”, and “non-physician” over and over again. Now-a-days my jaw tightens, and I gauge whether this is an appropriate situation to explain why these terms are offensive.

The time is now. This post will explore the words “mid-level provider,” “physician extender,” and “non-physician”, describing their historical uses and detailing three key reasons why this vocabulary should be eliminated.

Historical Use

These terms were originally created by physicians, and they are perpetuated by physician-led organizations and physician-centric corporations (Hoyt, 2012). The U.S. Department of Justice’s Drug Enforcement Administration uses “ mid-level practitioner” to describe professionals other than physicians, dentists, veterinarians, or podiatrists who dispense controlled substances. The Centers for Medicare and Medicaid have also referred to NPs and PAs as “physician extenders” but has more recently used the term “ non-physician practitioners.”

Why these terms should be eliminated

• Devalues Expertise

Describing NPs or PAs as “mid-level” doesn’t just imply, it asserts that they are providing something less than “high-level” care. However, ample evidence demonstrates that the services offered by these professionals is just as safe and effective as those provided by their physician colleagues.

Both NPs and PAs earn advanced degrees and undergo exhaustive course work, high-tech patient case simulations, and extensive clinical practice hours. Moreover, both clinicians pass national board certification exams and may specialize in any variety of medical specialities. The terms “mid-level provider,” “physician extender,” and “non-physician” undermine the expertise and contributions of NPs and PAs.

• Confuses Patients

Imagine you are a patient and being told, “The mid-level will see you now.” Naturally, you might wonder, “Who?” Using vague, collective vocabulary to describe NPs and PAs can confuse patients. When receiving healthcare services all patients expect and deserve the highest level care no matter who they are seeing. NPs and PAs are held to the same standard of care as physicians, offering the similar services of assessing, diagnosing, and treating medical conditions. By using more accurate terminology (i. e. NP and PA), patients can be assured they are receiving the best care at all times.

• Impedes Teamwork

In their seminal publication, Crossing the Quality Chasm, the Institute of Medicine called for interdisciplinary collaboration to solve the significant problems facing modern healthcare. Using a term like “mid-level” perpetuates a hierarchical healthcare system which impedes this need for teamwork. Most NPs and PAs dislike the terms “mid-level,” “physician-extender,” and non-physician. When they hear themselves described this way, it decreases morale and divides the team.

Take a Stand

To stop the use of these terms, everyone must take a stand. First, recruiters should remove this language from job descriptions, contracts, and business discussions. Employers and administrators specifically need to demonstrate their respect for NPs and PAs expertise by removing this language from the company website. Other healthcare professionals should stand up for their colleagues if someone uses this degrading language. Finally, both NPs and PAs should never allow someone to call them something that undermines their unique contribution to healthcare.

NPs and PAs Weigh In

I recently started a discussion thread about this topic on the American Association of Nurse Practitioners LinkedIn page. The overwhelming majority agreed that these terms should not be used to describe NPs or PAs. Some of the comments that stood out the most to me:

• I will not apply for jobs using mid level provider, or extenders. It’s insulting to my profession and education. – Nurse Practitioner in Florida
 
• It would be nice if nurse practitioners received the respect and recognition they’ve earned through good patient care. -Nurse Practitioner in New Hampshire
 
• I have been truly blessed to work with MDs that actually appreciate, value, and acknowledge what we do and who we are. -Nurse Practitioner in India
 
• How do you extend a physician? It is suggesting that somehow we are not capable of working independent and we must be attached to a physician. I am a Nurse Practitioner of the highest level, and I am an extension of no one. -Nurse Practitioner in Florida 
 
• I am fairly certain they are not referring to us as mid-level providers to degrade us, but rather they’re unaware of how offensive it can be. -Nurse Practitioner in California 
 
• The term “mid-level ” is often used in a denigratory manner, lessening our worth and contribution to health care. This term should be retired and the contribution to healthcare overall made by all professionals should be recognized and validated. Nurse Practitioner in Texas

Barton Associates also conducted a poll on its Facebook page, asking NPs and PAs which term were most offensive. Approximately 1,380 NPs and PAs weighed in on the discussion. Here are the results:

• Mid-level (487 votes)
 
• Noctor (356 votes)
 
• Physician Extender (335 votes)

The poll also asked which term was the preferred term (other than NP or PA). Here are those results:

• Provider (919 votes)
 
• Healthcare Professional (122 votes)
 
• Clinician (115 votes)

Let’s be straight; if there is ever a group of people who are called a name that makes them feel disrespected or devalued, the solution is always to stop. If you’re in doubt as to what you should call an NPor a PA just use “NP” and “PA.” Now let’s get back to patient care.

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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

Depression is a common situation dealt with on a daily basis. Most patients that Nurses find themselves coming in contact with have some form of illness or injury. This makes depression among patients common. Knowing how to spot it and how to react to depressed patients can help you handle the situation properly and deal with it with minimal stress.

What is Depression

Depression is a common disorder that affects many people every day. It affects all age groups, males and females, although females are more likely to suffer from it than males. Stress contributes to depression, making this illness more common in the last few years. The amount of stress an individual handles on a daily basis is on the rise and can contribute to depression.

What Contributes to Depression

There are a number of factors that contribute to depression. Stress is a huge factor. Debt, work and family can weigh heavily on the amount of stress someone experiences today. Age also plays a major role in depression and sickness in the elderly can increase the chances of them suffering from depression. This is a main factor as to why Nurses experience depressed elderly patients the most. Some elderly patients are forced to relocate to a new residence, while others become ill and are unable to live the life they are accustomed to. Some can feel abandoned by their loved ones and find themselves feeling alone. Leaving people without a strong social support network increases the chances of developing depression.

Signs of Depression

There are many warning signs of depression, although some may not be so easy to spot. A feeling of hopelessness or helplessness can lead to depression. Nurses often see this in elderly patients who don't have a lot of family support. A loss of interest in daily activities is another sign of depression. These signs can become apparent when patients are no longer able to get around on their own. Loss of mobility can make a patient no longer want to engage in activities for fear of embarrassment.

Changes in sleep patterns or appetite are another sign of depression. Nurses have to watch this sign as well, because certain medications can interfere with sleep and appetites of patients. Frequent physical complaints or ailments, anger or rage toward others and feelings of anxiety are other signs of depression. Many of these symptoms Nurses experience in their patients frequently. The key is determining when they start happening and ruling out any other possible causes. When there are no other possible causes, depression could be the reason.

How Can Nurses Help or Prevent Depression

Nurses play a vital role in their patient's lives, no matter the age of the patient. There are certain things that Nurses can do to help prevent depression altogether. Encouraging outdoor activities, even when your patient doesn't feel like doing them, is an excellent way to combat depression. A healthy diet and a regular eating schedule helps to recognize any changes in eating patterns. New hobbies help patients realize fun activities they can engage in to be entertained, even though they may not be able to do everything they could once do.

How Nurses Play an Important Role in Depressed Patients

Nurses are the people that patients see the most throughout the day, so it only makes sense that they play an important role dealing with depressed patients. Many things Nurses do can help a depressed patient not feel so worthless, and sometimes even lift their spirits. Talking to patients about their feelings is a good first step in dealing with their depression. Being sympathetic helps them know that you understand their feelings rather than judge them for how they feel.

Be careful about any advice you offer and always refer them to their doctor for specific medical advice. Accept their feelings toward the rest of the world. Trying to reason with them may make it seem like you are just another person who is against them or doesn't care about them. Reassure them of depression treatments and how effective they are. Let them know that treatment has high success rates, and they can work with their doctor to find the best treatment options.

It is common for Nurses to deal with depressed patients on a regular basis. Despite this, it is still important to remember to treat them as if they are all individual cases, and never group them together. A little reassurance could make all the difference in a depressed patient's outlook. The caring compassionate attitude that Nurses are known for could be exactly what a depressed patient needs.

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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.

Social media can and is a wonderful and easy way to connect with people on a personal or professional basis. Most platforms are free and easy to use. It's not difficult to find people and topics of interest. People can find and connect with their peers, family, and friends. They have unlimited access to the entire world.

Before anyone begins (or continues) their adventures into the world of social media, there are a few points to be aware of as a healthcare professional. With freedom comes advantages and disadvantages.

Advantages:

• Connecting with anyone in the world. Simply Googling a word, topic, business, or an individual will give anyone complete access to anything they want to know. Whether they are blogging, using Twitter, Facebook, LinkedIn, or any other social media platform, there are people there to talk to.
• Networking has never been easier. Sharing information and learning is at anyone's fingertips. Whether they are talking to someone local or across the world, social media brings you together. Distance is no longer a problem.
• Since 80% of all internet users are looking for health information, anyone can and will reach a large audience with their outreach and posts. People want information and Nurses have plenty to give them. They are able to correspond at their convenience and have the time to do so.
• Education for Nurses and others is available. There are numerous groups and programs that offer classes and give them opportunities to learn and interact with their peers and other students.

Communication flows easily and in abundance on the internet and that's also where the disadvantages come into play.

Disadvantages:

• Privacy doesn't truly exist on the internet. Regardless of any and all security features, once something has been posted, it's there forever. Even deleting it doesn't get rid of it. It is still stored somewhere in the clouds and is never truly gone. It's crucial that a person think twice before posting. Screen shots cause the comment or post to remain forever on someone's computer.
• The risk of inaccurate information becoming a "fact" is common. It takes a bit of work and due diligence to research the accuracy of what you’re reading, but it's worth the time. A person should only share or repeat what they themselves have thoroughly researched and confirmed as accurate.
• Not HIPAA compliant. Very few software programs meet the strict guidelines for HIPAA regulations, including but not limited to Skype and Google Hangouts, texting and email. Unless the individual is discussing a patient as a Nurse and on a secure platform, one should never post anything about their patients.

Violating HIPAA regulations has resulted in healthcare professionals facing disciplinary actions such as:

•  Fines levied
•  Suspension from work
•  Being expelled from Nursing school
•  License revoked/fired
•  Criminal charges being brought
•  Incarceration

Abuses on social media as a Nurse are far reaching. Whether a Nurse violates HIPAA or behaves in an improper and unprofessional manner (arguing online, breaching patient confidentiality, harassment, etc.) can and does impact not only them, but their employer and their professional affiliations as well. This can also involve the state board and violate state laws.

Posting the pictures of patients, even when their identity is concealed, has resulted in the above actions being taken against a Nurse and other healthcare professionals.

The best rule of thumb with social media is this: Remember that what you are about to post will be accessible to 7 billion people, so post as if everyone will read it. Social media can be fun as long as you understand the good and the bad.

Related Articles:
As a nurse, how do you use Social Media?

The new year is here and the opportunities for a fresh start it brings shouldn't be cast aside. Nurturing the opportunity as if it were a patient can yield surprising benefits both in and out of the job title. There is always room for improvement in a position that demands the hardest work for the sweetest reward, the gratitude of well-cared for patients.

Mind and Body

It is never too late to get personal health on the right track. Though the push for a healthier lifestyle should come from within, the simple fact is much like fitness instructors or your fellow doctors, patients ultimately expect those in health care roles to be healthy themselves. So whether it involves starting (and sticking to) that new gym membership or curbing poor eating habits, do your best to stand firm.

As a Nurse, the mind is just as important to nurture as the human body. With the continuous implementation of newer technology into the healthcare field, it can never hurt to be one step ahead by taking classes, particularly given the fact they look great on a resume. Focus on adding in new certifications such as those for operative nursing or ACLS, or expanding current skills. Regardless of qualms, continuing your education or taking the plunge on the journey to a BSN, MSN, NP or PhD is a worthy cause for the new year.

Tools of the Trade

Clearly technology is only as effective as the individual operating it, but that doesn't mean Nursing staff don't benefit from productive upgrades in the work space. Many programs and devices can increase efficiency enough to make good Nursing care, great Nursing care. Even if the requests for technology and program upgrades were rebuffed, all is not lost. Focus on using what is available even if it is only yourself. Vow to be more patient focused and less task and goal focused, which is the line that separates the average from the amazing in the eyes of the patient. Spend the new year becoming a better you, as this will ultimately equal a happier and better Nurse.

Related Story:  Nurses' perseverance to be rewarded New Year's Day

Cultural Diversity

The emergence of cultural diversity in today's society has impacted the inner-framework of the healthcare sector. By the year 2043, studies predict that the current ethnic and racial minority group populations will become the new majority. Diversity, Inclusion and Cultural Competence are topics that carry weight and emphasis in many aspects of the healthcare system. Efforts made to exercise inclusion and integrate cultural knowledge into professional environments have become integral in providing quality service to clientele. The practice of cultural awareness and competence in healthcare organizations leads to an encompassing sense of community and corporate respect of all cultures.

Benefiting Organizations

When there is a marked emphasis on cultural competence, diversity, and inclusion in an organization, a myriad of internal and external benefits result. Below is a list of benefits that organizations have experienced after putting pointed emphasis on supporting diversity. 

• An increase in recruitment of culturally diverse employees
• Better group process (an increase in creativity/communication)
• Reduction in costs
• Wide-spanning marketing

Employing Cultural Advocates

Caucasians fill the majority of Nursing roles in the healthcare system, with minority groups making up only about 19 percent of the Nursing field. As the number of culturally diverse patients increase in the United States, the need for a diverse culture of healthcare workers grows with it. Organizations that rally their employees and their core values around cultural awareness garner support from other organizations and appeal to diverse potential employees. They are showing the community, through practical application, how support of diversity plays an important role in the quality of care that is given and received by employees and clients.

If policies of inclusion are implemented effectively in healthcare, employees become a creative force in improving communication and conflict-resolution. Because the emphasis in inclusion is cohesion, the medical staff is taught the value of going beyond the confines of their own understanding. They gather information from other staff or diverse sources to supplement what they know with other perspectives and values. Nursing staff that exhibit characteristics of inclusion exude flexibility and model cultural competency. They become powerful advocates for respect of diversity in patient-care.

Cultural Competence

Healthcare leaders that emulate cultural competency focus on one key ingredient, respect. If leaders in healthcare teach by example and pass initiatives to support cultural integration, everyone benefits. By providing ample opportunities for cultural understanding to permeate healthcare, healthcare officials communicate respect for diverse groups of people.

We’ve developed a questionnaire to assist you in evaluating how your healthcare system is doing with regard to Diversity, Inclusion and Cultural Competence. Please take a few minutes to assess your strengths and weaknesses.

Many times, Nurses will choose to pursue a career in healthcare so that they will have the chance to spend their days helping others.  There is an added bonus though.  Many of the Nursing Specialties have a career trajectory of solid growth with a Nursing salary that is well above the income level of the median population.

Which one of the Nursing Specialties will give you the most job security though?  Which one has the highest salary?  The specialties listed below have been in demand the most and have the highest nursing salaries.

CRNA (Certified Registered Nurse Anesthetist)

Nursing Salary: $110,000 with 1,975 job postings annually.  This Nursing Specialty is the main provider for anesthesia in hospitals that have rural locations.  These Nurses assist in administering over 34 million anesthetics to various patients every year in the USA.

Pain Management Nurse

The average salary for this type of Nurse is right at $93,000 annually.  Each year there are around 871 job openings for Pain Management Nurses.  These Specialty Nurses work in tandem with other Nurses and doctors in order to treat patients who suffer from both chronic and acute pain.  They also have the responsibility of educating their patients so they can handle pain management in the future.

Geriatrics Nurse/Gerontology Nurse

The mean Nursing salary for a Geriatrics Nurse is $91,000 and annually there are close to 400 job openings across the US per year.  These Nurses can be the primary provider of health care for elderly patients in a variety of settings.  Their duties include exams and diagnosis to actually prescribing medications.  As the Baby Boomers age, this is an area where there is expected to be growth.

Family Nurse Practitioner

The mean salary for this Specialty Nurse is $88,000 annually and there are more than 7,000 job postings per year for this specialty.  These Nurses are like your family doctor.  They work with the same patients throughout their entire lives.  Many times, they will be the only health care professional for patients.  They conduct exams and can prescribe medications.

Psychiatric Nurse Practitioner

The salary for this type of Nurse is $86,000 annually and each year more than 4,500 job openings for this niche are posted.  This type of Nurse will treat, counsel and even medicate their patients who suffer from mental health issues.  They can work in quite a few different settings from private practices to correctional facilities and mental health clinics.

General Nurse Practitioner

The mean salary for a general Nurse Practitioner is $81,000 and there are more than 85,500 job postings for this specialty each year.  These Nurses are a critical element in regard to the health care industry and they are expected to fill the gap of primary care physicians in the years to come.  They are able to prescribe medicines and many times, they are the only health care professional that some people have.

Clinical Nurse Specialist

The Nursing salary for this specialty is $80,000 and each year there are nearly 7,000 job postings.  This type of Nurse focuses on a single area of expertise and they act as a sort of consultant to all of the rest of the Nurses on staff.  Their specialties can be anything from oncology to pediatrics and they also serve as coaches for both the staff and the patients.

Armed with this information, which one appeals to you?  If you are already on this list, would you switch to another specialty?  Which one and why?

Top 10 highest paying nursing specialties (national average)

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.

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