5 Keys for Dealing with Difficult Patient/Family Situations

June 10, 2014 in On the Job

nurse-upset-with-visitors2With nursing comes all types of patients and family units, and in this profession you are likely to come across a tough situation once in a while.  Whether it be overbearing loved ones, cases of abuse or neglect, or the sensitivity surrounding death and dying, as nursing students and new nurses, there will be many new scenarios that you encounter and you will need to quickly learn how to best deal with them.  Soon I will be beginning a nurse residency program on a Labor & Delivery Unit, and though the joy of new life is a happy area to work in at most times, I am sure I will occasionally face difficult issues such as fetal demise, teen pregnancy, and poor parenting.

Here are a few things to keep in mind when you find yourself in a sticky situation:

  • I think that one of the first things to remember is to be patient with yourself.  There will be lots of new territory, and it’s okay to feel like you don’t have the answers to everything.  If you need help, use your resources, and ask your preceptor, manager, or peers how to approach a tough situation because they’ve probably been there before.
  • These situations may come with emotions you didn’t expect to feel.  Many think you need to mask your feelings, but as long as you remain professional, it’s okay to cry in the moment.  Don’t be afraid to grieve with your patient or family – it shows that you care and feel a connection to your patient.
  • If things get messy and there is a disagreement, be sure to maintain good communication.  Being clear and concise prevents miscommunication.  If the situation has left you frustrated, take a moment to collect yourself and gather your thoughts before engaging with your patient or family.  If there is conflict in the family, be diplomatic but remember to advocate for your patient, as your patient’s safety and well-being is your first priority.
  • Sometimes the time following a difficult event can be the hardest and it is easy to carry it with you even when it’s passed, especially if you have regrets about the way you handled the situation.  It is important to talk with someone in these instances, because self care is essential to your ability to perform your job well.  Many hospitals, especially new graduate programs, offer group discussions that serve as a forum of exchange among nurses, and can be beneficial to learning.
  • Stay resilient to adversity.  It is one of the skills that you will quickly acquire as a nurse, and though not every day will be good, the challenging days will undoubtedly make you a stronger nurse for the next obstacle that comes your way.

I hope that this post brings you comfort in knowing that you are not alone in the struggles of nursing.  Please feel free to comment below any personal tips that you’ve found helpful.  Keep calm, and nurse on!

 

What you really need to know about charting!

May 31, 2014 in On the Job

charting-is-my-favorite-part-of-my-job-said-no-nurse-ever-234c5

 

During nursing school, I didn’t comprehend the significance of nursing documentation. During my 3rd semester, the faculty chose to give us a short lesson on nursing documentation. The instruction lasted two hours, and I was glad because I had more important things to worry about, like passing tests!

Most schools still don’t adequately prepare their graduates to chart with a legal dilemma in mind. Now as a staff RN in a busy ICU, it’s easy to see the importance of having clear and concise documentation.

There are many reasons to be competent within your documentation. What you chart has considerable bearing on future assessments by the interdisciplinary health care team and your patient’s plan of care. Accurate charting can also assist in the development of research to improve future charting practices. Finally, what you chart can have a major impact on your life and whether you keep your license.

Everything you type or “check box” in the electronic medical record stays in that patient’s chart for years to come. If a legal situation ever arises, anything that you have written may be presented as evidence before a judge and jury. Depending how much time has passed, you may not even remember the situation very well and will have to rely on what you wrote to defend your actions.

Accountability

Regardless of where you work, a deteriorating patient condition requires you to elicit help and obtain a response from the physician or advanced practice nurse.

If you document anywhere in the chart that your patient’s condition or overall status has declined in any way (nausea, pain, fluctuation in blood pressure, fever), make sure you chart the details surrounding your assessment along with your intervention and follow up evaluations. If you only chart that the patient has a problem, but no other notes regarding what you did for your patient, a court of law will likely find you negligent. Make sure you note the times and dialogue of your physician notifications and the telephone orders they gave you (or if they didn’t).

The mantra of legal nurse consultants is: “if it wasn’t documented, it wasn’t done”.

Abbreviations

I try to stay away from abbreviations. Typing out the whole words takes very little time and ensures definite clarity. Abbreviations saved time when documentation via pen and paper was commonplace, now not so much. There are so many revisions of institutional and JCAHO “Do Not Abbreviate” lists, today, that it has become hard to pinpoint the most current version. I simplify my practice by refraining from using most abbreviations. If there is any chance of a jury misunderstanding a term, use specific descriptors and non-abbreviated words in your charting.

Double Charting

Redundant charting can set you up for an inadvertent discrepancy and furthermore, it is a waste of your time. If I write in a nurse’s note that my patient has received a PRN medication, I direct anyone reviewing the chart to simply “see eMAR”. If there is a change in a body system assessment: “See ICU Assessment”. If any part of your testimony in court (including your documentation) is proven to be incorrect or negligible, the entire record you have created and account for becomes questioned. Any error in your charting can become the weakest link, causing major consequences for you and the defense.

Just the Facts…

This is probably the most commonly made mistake in documentation. Until recently, I would often type “patient resting comfortably in bed.” How do I know if that patient is resting comfortably? What if (s)he is intubated and sedated? Is there any reasonable way for me to really be sure that my patient is resting comfortably? If you think your patient is sleeping peacefully, are you going to tell a future jury with 100% certainty that (s)he was sleeping and not playing possum, sedated, or in a coma?

I also used to type “patient tolerated _______ well”. Did you ask the patient? Did they tell you how they tolerated the walk?

Instead of these general assumption phrases that are based only on subjective data, describe the objective data you notice that enables others to draw their own subjective conclusions. “Patient lying in bed, snoring, eyes closed, respirations regular with rate of 16, skin warm and dry.” That sentence tells anyone reviewing the chart that the patient was probably sleeping or at least resting in no apparent distress. Your patient tolerated a walk well by “denying shortness of breath, verbalizing no discomfort, and ambulating without assistance around nurse’s station and back to room”.

Don’t use labels such as ‘violent’, ‘inebriated’, or ‘delirious’; instead, describe what the individual is doing that would paint a picture of that state of being.

If the patient is angry, chart the specific body language cues that tip you off: voice intensity increasing to shout/yell, face turning red, arms shaking, fists clenched, cursing loudly, and posturing aggressive stance in front of nurse.

If the patient is drunk, document the clinical symptoms being exhibited (slurred voice, stumbling gait, smell of alcohol on breath).

If the patient is confused, note what the patient said (in quotation marks) that would lead a jury to believe the patient was indeed confused.

Your reporting should reflect objective clinical nursing judgment and data; chart what is, not what “appears” or “seems”.

A good way to chart only facts is to only record information that you observe and collect through your senses. If you directly see, hear, smell, or touch the occurrence and chart without creating an assumption, it’s probably going to be seen as objective.

When you hear pertinent dialogue by a patient, their family, or a doctor, chart their statement verbatim in quotations, identifying the individual by name.

Risky Words

RN.com (2012) published a list of words to avoid using in your nursing notes:

Accidentally
Apparently
Appears
Assume
Confusing
Could be
May be
Miscalculated
Mistake
Somehow
Unintentionally

These descriptors paint you in a negative light and raise doubt towards your competency.

In today’s era, being sued for frivolous reasons has become somewhat of a norm. The longer you practice nursing, the more likely you (and your documentation) are to become part of a legal action. The best way to prepare is to enhance your documentation now while correcting any bad charting habits you currently practice.

Also keep in mind that it is always prudent to confirm that the way you are charting is in accordance to the policies of your institution.

Keep your license safe from lawsuits – paint a clear and objective picture now for that future jury!

Reference

RN.com (2012). Professional Documentation: Safe, Effective, and Legal. AMN Healthcare Education Services.

How to Help the Even Newer Nurses!

May 17, 2014 in Nursing School, On the Job

Nursing is a work of loveHi all you new grad nurses!  So we’re all familiar with the ABCDE’s of the primary assessment.  I now aim to give you the ABCDE’s of helping the nurses that are even newer than you are.  Of course, these tips can also be applied to nursing students that may have their clinical rotation or preceptorship on your unit or sometimes to float nurses as well.

A Always Ask! – You know how helpful it was for you when you were just out of the gate when more experienced nurses checked in on you and asked what they could do for you.  Or maybe that wasn’t your experience but you wished it was!  Even if the newer nurses don’t need anything from you at the moment, at least asking will let the new nurse or nursing student know that someone is watching out for them and that they have someone to whom they can turn if they have an issue or question.

B Be a good tour guide – Be proactive and show them the unit essentials: the med room, the clean supply room, the soiled utility room, the codes they may need, the nurses station, and the break room.  Also introduce the new nurses to those who are available to help and to answer questions; teach them how to get in touch with their resources.  If you both have time, give a tour of other departments or areas of the hospital with which they will need to be familiar depending on the unit where you work such as radiology, pre-op department, main help desk, etc.

C Check your policies and protocols – Cover yourself, your patients, your colleagues, and the organization for which you work by checking the policies, procedures, and protocols related to capabilities of the nursing student or new nurse specific to your organization.  This step is particularly important for and pertinent to nursing students as they are not employees of your organization and operating under the license of another registered nurse.  Knowing what both nursing students and what new nurses are allowed to do and what each is prohibited from doing protects everyone involved.

D Duplicate! – Repeat the learning techniques that you had found to be most helpful when you were on orientation.  Throughout my clinical rotations I was the recipient of a variety of education techniques.  For example, various nurses would quiz my knowledge and supplement it; others would show me the resources on the unit to look up that which I did not yet know; and still others would take me through their thought processes in order to show how a nurse operated throughout the duration of a shift.

E Expose! – Think back to your clinicals.  Didn’t you love and appreciate it when the unit nurses or your instructor pulled you in to see a procedure or a case that you’ve never seen before?  Didn’t it open your eyes and provide a prime learning opportunity?  Now you have the chance to do that for your newer staff and students .  If you have a particularly interesting or unique case or need to complete a nursing task that new nurses would benefit from observing or performing, invite them! The earlier and more often the new nurses are exposed to new things, the quicker they are able to learn and the sooner it can become not so new.

We all remember how difficult and overwhelming it can be when you are just starting out since for a lot of us, it was only a short time ago.  So the more we are able to help the newer nurses, the more we contribute to improving the profession of nursing as a whole.  If any of you have been fortunate enough to have welcomed nursing students or newer nurses already and have anything to add that helped you help them, please feel free to leave those tips in the comments so that many generations of future nurses may benefit.

Nursing love <3

What’s It Like to Be a New Graduate Nurse? – Part II

May 6, 2014 in On the Job

I have been working as a nurse for six months already: half-way through my first year of nursing.  I can’t believe it!  The time has gone by so fast!  I had the opportunity to re-read the article that I had written when it was my first week off orientation.  I have grown so much as a professional and become more confident and comfortable in my abilities and in this work environment.  It was exciting to see such growth in a relatively short time period, so if you have the opportunity to journal throughout your first year of nursing, I would recommend it!  I’ll expand upon some of these changes in hopes that they are a helpful look into the career trajectory of a new graduate nurse.

At this six-month mark, several things occurred. First, I am now eligible to float to other units.  The first time I floated to another unit was a good learning experience.  I familiarized myself with another unit, worked with an entirely new set of a patient population, met some new nurses, and had the capacity to apply my skills in a different environment.

On that same day, a group of nursing students had their pediatric nursing clinical rotation on the unit to which I floated.  It was really rewarding and affirming to be able to educate a future nurse.  I was confident in the skills and parts of the nursing process that I taught, and I enjoyed implementing teaching techniques that I had remembered being most effective when I was a nursing student only a few short months ago.

The experience also gave me an idea of how I may progress in my career path.  It gave me the chance to consider pursuing preceptorship or nursing education in the not-so-distant future.  Since six months have gone by so quickly, the full-year will be just around the corner!  So, I have been looking into graduate school programs and advanced nursing positions to continue my nursing professional development (and will definitely continue to refer to RNDeer blogposts for references and inspiration!).  I guess the take-away here is to keep an open mind as you never know where your keenest interests in nursing may exist.  Nursing roles are extremely versatile, an exciting part of this chosen profession.

Additionally, since I have become much more comfortable with the time management piece of nursing and balancing patient care, I felt like I could start to contribute even more to my unit.  So, I have recently joined a committee that reviews current issues on our unit and takes an interdisciplinary approach to problem-solve.  For other new grad nurses and for nursing students, I would highly recommend getting involved in extra committees, councils, or clubs about healthcare that interest you.  It gives you a new perspective and a fresh way to contribute to the systems to which we are so dedicated and ultimately to serve and advocate for our patients.

All in all, happy studying to the nursing students: you have so much to look forward to in your future career, and best wishes to fellow new graduate nurses.  I hope you’ve been able to share some of these rewarding experiences as I have.

Nursing love <3

Katie O’C

ASN vs. BSN: What’s Best for You?

April 15, 2014 in Licensure, Nursing School

With the completion of either degree, you have the opportunity to take the NCLEX and become a Registered Nurse.  The Bachelor’s (BSN) degree is typically 4 years of classes that include nursing skills and assessment, as well as extended curriculum in nursing research and community health. Prerequisites are fulfilled within this timeframe, as well. There are an estimated 800 BSN programs in existence. The Associate’s (ASN/ADN) degree is half as long (2 years, without prerequisites) and encompasses the practical patient-care realm of nursing curriculum. ADN programs focus only on basic nursing care (such as assessment and clinical skills). There are about 1,100 of these programs in the US.

As a new or upcoming graduate, finding a job is probably on your mind (after passing the NCLEX!). (Learn How to Pass the NCLEX) It is fairly common for large hospitals to state preference for “BSN prepared” RNs. Others require it. A main reason for this change in hiring practice stems from hospitals’ attempts to achieve Magnet Recognition, a national credentialing program governed by the American Nurses Credentialing Center, which deems a hospital’s overall competence.

Most institutions offer a small pay differential to employees who have a BSN. In most parts of the country, floor nurses typically see increased pay in correlation to higher experience and tenure at the specific institution.

So, aside from getting that job, why should you continue on from an Associate to a Bachelor? If you already have the job of your dreams and only went to school for an Associate’s degree, you may still need to go back to school. Many medical centers are considering requiring all of their nurses to be Baccalaureate prepared. With more BSN nurses employed, a hospital has an easier time attaining funding and prestigious laurels such as Magnet Recognition and the Beacon Award. The Institute of Medicine campaigned in 2010 for an 80% baccalaureate-prepared nursing workforce by 2020. Although it hasn’t been passed as a law anywhere yet, it is being lobbied for in a few states’ legislation.

Another reason to further in your education would be to advance your career. Do you plan on staying at the bedside forever? If not, you’ll need your BSN. Most hospitals now require their managers, directors, and nursing educators to have at least a BSN. If you are interested in becoming a FNP, CRNA, or nursing instructor you’ll need a masters; you need to earn your BSN first, though.

If you’re not enrolled in a nursing program already and you have a bachelor’s degree in some other field, you can apply to an accelerated BSN program. These are only 18-21 months long.

If finances play a major role in your decision of which program to attend, an Associate’s degree is probably a better choice. Tuition generally costs much less, and you’ll be able to start working as a nurse faster.

There is also one other less common way to become a nurse: the route of a nursing diploma. Diploma nursing was offered during WWII through the 1970s in order to fulfill the amount of nurses needed. The education was provided by various hospitals and medical centers, instead of traditional colleges. While they are trained extensively by hands-on learning, diploma nurses hold no college degree. There are few institutions that offer this method of attaining your RN, today.

If you have already graduated from an ADN program and are interested in continuing your education, there are “bridge” programs available. RN-BSN and RN-MSN programs (about 700 and 150, respectively) allow you to earn an advanced degree through online classes while practicing as an RN. Many hospitals offer some tuition reimbursement as long as you agree to stay employed with them for a certain period of time; for example, my hospital offers an 80% tuition reimbursement with a 1.5 year contract.

With these facts in mind, it is smart to consider all possibilities to plan for the future. Your career goals can depend on these specific degrees, so hopefully this will help to clarify some of the finite differences between an ASN- and a BSN-prepared nurse.

What’s It Like to Be a New Graduate Nurse?

March 25, 2014 in On the Job

I survived my first week off orientation!!!  I write to give you all a taste of one new grad nurse’s experience throughout the first couple months in the real world of nursing.  I offer my experiences as something to which some of you may relate and something for which others may expect after finishing nursing school.

I am part of a new graduate nurse residency program in a pediatric hospital.  In just starting out, there have definitely been challenges, but overall, I am loving it!  I was extremely fortunate to have a wonderful and patient preceptor, to work on a unit with exceedingly kind and helpful nurses, and to meet several others who constantly offer themselves as resources to me.  I also had bi-weekly meetings with my manager, nurse educator, and preceptor both to check in with me and to see how I was progressing.  Starting my career in such a welcoming and supportive environment allowed my nerves to subside quickly, and I could concentrate on learning well.

However, since I am new to this role and I work in an often confusing and stressful environment of a hospital, there have certainly been challenges.  These have included time management, coordination of care with other disciplines, and literally orientation both to the unit and the system.  In talking with the nurses on my floor and other new grad nurses, time management seems to be one of the most common difficulties at first.  Different aspects of both the environment and this profession can occasionally feel overwhelming; I have found that I just need to stick with it, keep practicing, and continually improve with experience.

Here are a couple things I’ve found to help me not only survive but thrive through these first few months:

  1. Be patient with yourself.  I’ll admit, this is not my strong suit.  I want to be great at everything right away and be able to meet everyone’s needs and exceed expectations.  I often need to remind myself that I won’t be a SuperNurse right away.  There is a learning curve in any new profession, and this is especially true in nursing.
  2. Remain vigilant and keep a questioning attitude.  With several simultaneous demands and pressure to be quick from multiple sources, it is relatively easy to get mixed up and turned around.  Always double, triple, quadruple check everything.  Always ask questions, especially if you are unsure or if something doesn’t seem right.  Being cautious keeps your patients safe.
  3. Know your resources!  It took me a while to figure out who to call for what and when (and I’m still working on it!).  I asked my preceptors for a list of important phone numbers that I keep on my ID at all times, and I use it constantly!  It is a huge time-saver and I highly recommend it.
  4. If you ever feel like you’re drowning or really struggling, ask for help.  It is never worth risking patient safety, your brand new license, or your own mental health to suffer silently.  No one knows to help you if they are not aware of any issues you may be having.
  5. Find enjoyment!  We have a tough job.  When I start to get discouraged, frustrated, or flat-out exhausted, I try to remind myself why I wanted to become a nurse and remember everything that I love about my job.  Also, finally getting paid for the work that you had to pay to do in nursing school is also pretty nice, too.

Best of luck to all my fellow new nurses and future new nurses!  Please leave comments or feel free to send me an email!  I’m happy to help as much as I can and offer any insight I can provide.

Nursing love <3

Katie O’C

How to Get the Most Out of Your Break

February 24, 2014 in Miscellaneous, Nursing School

summervacation1
For those of you in nursing school, winter or summer intercession can be a great opportunity to get ahead, buff up your resume, or simply brush up on rusty material.  We’re all familiar with the rigorous lifestyle required of nursing school, so break is an ideal time to focus on nursing that is outside of your textbook.  Here are a few suggestions for summer 2014:
  • Study abroad – Whether it’s through your school or an independent organization, there’s lots out there involving international travel with a focus on health care.  For example, my school hosted a trip to Guatemala every winter break with an emphasis on the area’s women and children
  • Apply for a hospital internship – Several hospitals offer summer internships to nursing students who have reached a certain year in their curriculum and meet other requirements
  • Work as a CNA/nurse tech – Look into facilities that are seeking temporary help or are nearby your home or school if you plan on working part time when school picks up again
  • Enroll in summer school – Taking a class over break can lighten your work load during the semester or may even allow the possibility of graduating early
  • Take a CPR class – Get certified with BLS, ACLS, PALS/PEARS if you’re interested in pediatrics, and NRP/STABLE if you’d like to work with neonates
  • Volunteer – While you have a little extra time, put in some community service hours at your local hospital, senior home, blood center, soup kitchen, etc. (e.g. Meals on Wheels, Habitat for Humanity)
  • Begin compiling your professional portfolio – Unless your school has a class specifically for career building, it can be hard to find time for this tedious task.  Start working on your resume, asking for letters of recommendations, and looking into RN residency programs
  • Self-study – Most nursing material is built on concepts from fundamental classes, for example advanced pharmacology is based on what you learned in intro to pharmacology, and so on.  It can be easy to fall behind if you aren’t on top of it, so it’s a good idea to stay sharp over break
Some of these options may be more appealing if you’re in your second or third year of nursing school, as they have your career in mind as you get closer to graduation.  No matter what you do with your break, start thinking about it now, because you may need to meet early application deadlines or reserve your place a few months in advance.  Don’t forget to have some fun too!

How to Get a Great Letter of Recommendation

February 10, 2014 in Job Hunt, Nursing School

Letter-of-Recommendation

Are you graduating soon? Or just looking for a job? Asking for references doesn’t have to be a daunting task and I hope these next tips will help you in asking.

The first thing to do is to think about which professors know you well enough to write a reference. Would you want a virtual stranger to write something a potential employer would see? Probably not. Have you asked a certain professor for help on a topic or discussed patients you’ve had in clinicals? Has a certain clinical professor spent time showing you various procedures? Notice I didn’t emphasize all professors had to be nursing – I used professors from both my music and nursing degrees.

In today’s world there are many ways to ask for a letter of recommendation: email, phone, letter, in person. My personal opinion is you should ask in person if they would be interested and then give them a handwritten formal request for a letter of recommendation. If it isn’t possible to give the professor a handwritten request an email request of the same nature would be okay.

The following is the letter I used both in email and handwritten format.

Hi Professor _________,

I am writing to ask if you would be willing to write a letter of recommendation for me. I am currently putting together my nursing portfolio and think a letter of recommendation from you would enhance my portfolio.

I learned a lot during your clinicals and appreciate the time you took to challenge me to think critically. It is a skill I will continue to use. Though the amount of time at clinical was short I hope it is sufficient enough for you to be able to write a letter of recommendation. If you could gear the recommendation towards the __________ and a nursing career there I would greatly appreciate it.

Please let me know if you are willing to write a letter of recommendation for me. If so could you please have it to me by ___________. Thank you for your time and consideration in advance.

Kind Regards,

Notice I explained why I would like the letter of recommendation, and things I liked specifically about their clinical. I also gave them direction to what their letter of recommendation should be about and a deadline for the letter. At the end I signed my name and included my phone number and email.

Your letter doesn’t have to be long, but it should include those key things mentioned in the previous paragraph. Feel free to use the template I included.

Good luck with your coming semester and don’t be afraid to ask for recommendations!

Innovation in Nursing – Not what you would expect!

February 7, 2014 in Miscellaneous, On the Job

When one imagines the personality of a typical nurse, terms that usually come up are “caring”, “passionate”, “smart”, or “critical thinker.” It’s a rare occasion that the word “innovative” is used.

However, this is a bit of an oversight. As Nurse Keith mentions in his post, nurses are innovative in paving the way for new nursing paths, whether in informatics, leadership positions, or as independent practitioners with higher degrees. But innovation can even be seen in the day-to-day workings of a floor nurse. From this very essential level of nursing, which every nurse is trained to perform early in their career, nurses must be creative in order to provide care that is above expectations.

Nurses must find a way to combine the wishes of the patient, family, medical team, dietician, pharmacist, physical therapist, respiratory therapist, and other professionals into the care of their patients. As a bedside nurse, the nurse takes on the role of advocate for their patient, ensuring that the patient remains safe and on the road to recovery. It takes quite a bit of creativity in order to respect the wishes of the patient and family and still perform satisfactory care. At this level of nursing, innovation is key for all aspects of care. On the technical side, necessary equipment that may be uncomfortable to the patient can pose a challenge that the nurse must balance. They must coordinate care with procedures that need to be done that day, and may need to find creative solutions that can incorporate all necessary care. Sometimes the care a patient requires in one day would take more than 24 hours in a normal situation! In this case, nurses must be able to find ways to coordinate care in an effective and safe manner.

Those of you who are nurses on a unit in a hospital will understand how much inventiveness you need to use on a daily, if not hourly, basis. One may attribute innovativeness to nurses expanding beyond the level of bedside nursing, but that ability to think outside the box is truly developed as a bedside nurse. This level of nursing, which all of us at one point or another have experienced, helps build the foundation of innovativeness that is vital to the profession of nursing, no matter which avenue of nursing you pursue.

This post was written as part of the Nurse Blog Carnival. If you are interested in participating find out more details and sign up here.

The Top Three New Year’s Resolutions for Student Nurses

January 24, 2014 in Miscellaneous, Nursing School

NewYearsResolutions_main_0Usually I’m not a huge fan of New Year’s resolutions, simply because I like to think working on bettering ourselves is a year round thing, and to be honest, I can’t quite remember what mine were last year.  This year, however, was a bit different.  After taking the time to reflect on 2013, I am proud to say that it’s probably been my most accomplished year yet.  As a BSN graduate, a newly licensed RN, and a working nurse, I can’t complain.  Of course there is tons, and I mean tons, of room for growth and learning, but it’s been a big year.  Although it’s just the beginning, it has been so exciting (and a little scary) launching my career and seeing nursing friends around me doing the same.  This New Year’s was a nice reminder of how important self evaluation is, not only for our nursing, but simply for our health and happiness, and I don’t do it often enough.  So in the spirit of this brand new year, I decided to make a few resolutions for myself as a nurse.
  1. Pay it forward.  There are so many individuals who have been part of my struggle and my success – family, nursing classmates, mentors, etc.  I feel extremely grateful for every single act of kindness, both big and small, and I know when I have the opportunity I’ll gladly reverberate that energy back into the nursing community.
  1. Remember to breathe.  The first year of practice in nursing is undeniably tough, and I aspire to put my heart in my work, be eager to learn, and stay driven through the rough spots.  At the end of a hard day, I hope to push through with a little nursing humor and a lot of chocolate.  Just keep swimming, just keep swimming…
  1. Practice what you preach.  As nurses we spend so much of our time getting others healthy that it can be easy to forget to do the same for ourselves.  A little self care can go a long way.  Exercising and eating healthier is a favorite resolution by many, but now as a nurse, I’m finding it’s more important to me than ever before that I advocate for healthier decisions for myself and those around me.  We’re nurses around the clock, right?
I can’t wait to see what 2014 has in store for me, and I’m wishing you all a wonderful New Year readers!  Best of luck!  Feel free to comment and share some of your own resolutions, as well.