A growing number of nurses and other healthcare workers have been fired from their jobs for postings on social media sites deemed to violate patient privacy.  This is a real concern and will be the subject of another post. But here’s another scenario that needs to be addressed – private conversations held in public places in healthcare facilities.

My husband was recently an in-patient in a hospital. While I was visiting him, a psychiatrist came into the room to have a consultation with my husband’s roommate. In the course of that interaction, the roommate admitted he was depressed and had thoughts about suicide. I felt so uncomfortable and embarrassed to overhear this. It was impossible for me to tune it out because of the small size of the room and volume of their voices. I would have had to leave my husband alone if I chose to leave the room (my husband was bed-bound) and he would have heard it even if I had left. This is one reason why the trend in hospital design is to have all private rooms!

I also overheard conversations in this and other healthcare settings, while visiting a loved one, that should have been held in private.

If I had been the man in the next bed, I would not have been willing to discuss such personal health matters in ear-shot of strangers. But he was older and perhaps didn’t consider his privacy or didn’t feel comfortable asking for a private setting in which to talk. Some folks do not always assert themselves in healthcare situations and accept things as they are even though they feel uncomfortable in some way.

With all of our concerns about HIPPA regulations and the privacy of what is in writing in medical records, reports, and social media sites, perhaps we all need to take a good hard look at what we say out loud in healthcare settings and even in public/social settings.  These might include patient room communication, conversations behind the nurses’ desk and in the charting/break room when the door is open, discussion over meals and breaks in caferterias, and even when out to dinner with a friend. You just never know who is listening.

Every healthcare consumer has a right to safe and confidential care and should be able to feel confident in knowing that their personal information is respected and kept private by all healthcare workers in all settings.

I once heard someone say, “Life is not boring; people are boring.” The implication is that if someone feels bored, it is his or her own fault because there is always something interesting to do, see, and learn in life. The same could be said for nursing. Yet I often hear nurses say, “I’m in a rut. I get up and go to work everyday, do the same thing, eat, sleep and do it all over again.” If you are feeling bored in your job or career create some positive momentum to liven things up and breathe fresh air into your world. How can do that? Read on.

Look for a project at work (or through volunteer work or your professional associations) that showcases your special talents or where you can develop a new skill set. For example, if you like teaching or would like to gain some teaching experience, volunteer to be a preceptor, present at grand rounds, or do some community education. Don’t do it for your employer; do it because of what’s in it for you.

Look into furthering your formal education. Learning keeps you young and makes you feel alive. It keeps the blood coursing through your veins and stimulates those brain cells. When you cease to learn you cease to live. And if you’re not growing, your stagnating. Education is a gift you give yourself.

Get out to a networking event be it a career fair, nursing association meeting (you can attend as a guest if not a member) or seminar. Meet some new people and get a fresh perspective. Practice your communication skills on subjects other than your clinical specialty! 

Take a risk and try something you haven’t done before but would like to do. Consider submitting an article for publication, running for office in a professional association, applying for another job, or getting on a committee at work that interests you. Every time you push yourself and step out of your comfort zone, you get a little braver, a little wiser, and a little more aware of youself, your capabilities, and the world around you.

And last but not least, nursing offers virtually endless options of specialties, types of employers, work settings, schedules, employment vs. self-employment, etc. If you’re not fully aware of all the opportunities available to you in this profession or aren’t sure where you’d fit in, take steps to learn more by reading, surfing the Internet, attending related seminars, talking to nurses doing something different from you and so on. You never know where the spark, the idea, or the inspiration – not to mention the opportunity – will come from.

If you’re feeling bored, it’s time to shake things up a little. Life is too short and too precious to not feel excited, even if a little scared, about facing a new day and looking toward your future with eager anticipation. If you’re in a rut, start moving in a positive forward direction and experience all that nursing - and life - has to offer.

I recently came across the Florence Nightingale pledge, the one I took 35 years ago when I graduated from a hospital-based diploma nursing program. When reading it on the eve of the year 2010, it occurs to me that it needs to be updated to better reflect where nursing practice is today.  Here’s the original composed by Lystra Gretter, an instructor of nursing at the old Harper Hospital in Detroit, Michigan, and was first used by its graduating class in the spring of 1893. It is an adaptation of the Hippocratic Oath taken by physicians : “I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.” The pledge is still widely used at nursing graduation/pinning ceremonies.

Here’s my updated version: “I solemnly pledge myself  before God and in the presence of this assembly, to live my life with integrity and to practice my profession faithfully. With dedication will I endeavor to uphold the ethical, scientific, and legal standards of my profession, and devote myself to the welfare of those committed to my care.”

What say you – sacrilege or high-time? Perhaps we need something new entirely.  Any takers?

We in the nursing profession spend a lot of time reading clinical journals and books. But an equal amount of time needs to be devoted to personal and spiritual growth and development for balance and harmony. So here are my top ten must reads for nurses (and others, too). Each has been transformational for me in some way and has contributed to my being a better nurse and a better person – more fully engaged in life and work.

1. The Power of Now by Eckhart Tolle

2. The Success Principles by Jack Canfield (note who’s quoted on pg 204)

3. Full Catastrophe Living by John Kabat-Zinn

4. The Second Half of Life by Angeles Arrien (for the over 50 set)

5. Love Yourself, Live Your Spirit by Sonia Choquette

6. The Artist’s Way by Julie Cameron

7. Write it Down, Make It Happen by Henriette Anne Klauser

8. The Gift of Change by Marianne Williamson

9. Transformation Soup by SARK

10. The Hidden Messages in Water by Masaru Emoto

If you’ve already read some of these (or even if you haven’t), consider listening to the book on CD (if applicabale), especially those read by the author. You get a different perspective when listening rather than reading. Besides, there’s always something new you pick up the 2nd or 3rd time around. What are your favorites?

While recently speaking at a nursing conference, the speaker before me was trying to make the point that nurses don’t support each other. One more sweeping generalization to put a negative thought in everyone’s head and start off the conference on the right note! She asked for a show of hands asking, “Who has ever had someone be mean to them in the workplace?” About 1/3 of the audience raised their hands and the speaker acted as though she’d obvioulsy made her point. I almost wanted to laugh – ‘mean to them?’ I felt like I was back in kindergarten with that phrase. Who has lived to 10 years of age and not had someone be ‘mean’ to them? 

I often speak and write on the subject of how nurses treat one another since it frequently comes up in nursing circles. I certainly don’t deny that the phenomenon of horizontal violence exists in high stress work areas, especially in those settings where nurses are not supported and valued by management and administration. But I have always been able to see, and choose to focus on, all the ways that the vast majority of nurses are amazing to one another whether a new grad or otherwise. I know, after 35 years in the profession, that most nurses, including myself, consider it a privilege, a joy, and part of being professional to support and nurture one another. 

Rather than asking, ”Has anyone ever been mean to you,” a more productive, positive and proactive question would be “How do you contribute to the greater good every day in your workplace?” or “How can you support and nurture yourself and thereby those around you?”  (References: Foster Horizontal Respect and Do Nurses Really Eat Their Young?)

How would you answer those last two questions?

My life has been spinning out of control. The entire last year has been particularly “full” with business activities, new products and projects (I worked on 3 book projects this past year!!), volunteer work (I was president of the National Speakers Association – NJ Chapter) and lots of personal challenges. My husband has MS and has had a rough year. I have an elderly mother-in-law and parents that I look after (you know how it is when you’re the nurse in the family) and they have all had medical and surgical issues to cope with. Yet I have a wisdom tooth that needs pulling that I never seem to get around to.

I decided it was time to take back control of my life. So even though my workload and deadlines are piled high, I took a day off yesterday – something I almost never do.  I needed a haircut so decided to get a pedicure and manicure, too. Then I figured that since I’ll be out for half the day anyway, I may as well get a massage. And because I need a new pocketbook, I’ll also do a little shopping. The massage therapist told me afterwards that I am so tight, I really need a 90 minutes deep tissue massage - surprise, surprise!!

I have now made a vow to say NO (capitol letters for emphasis) to all volunteer activities for one year except for what I am already committed to. I have always been very active in various associations, community projects, and other things. And because I am one of those people they are talking about when they say, “If you want something done ask a busy person” everyone asks me to help out.  I love to be involved and help out when I can but I’ve finally come to the realization that I cannot be all things to everyone, try as I may.

I’m having a professional organizer come to my home and office to help me clear out the clutter and create some order.  I’m making room in my life and my schedule for new energy to pursue other big goals I still have for myself.  And while I have always been focused on helping everyone else in my life, often putting my own needs on the back burner, I’m going to make a commitment to honor myself, my body, my time, my life.    

What have you done lately to honor yourself, care for yourself,  and clear a path for your future?

I just watched the premier of the newest medical drama “Mercy” on NBC which seems to focus on the lives of several key nursing characters. OK so it’s TV and it’s a drama so I shouldn’t expect much reality, right? Both the characters and the medical situations were way over the top - lots of exaggeration, some of it major.  What really grated on me was the fact that physicians were portrayed as being “in charge” of the hospital and that the nurses reported to them and had to answer to them. Why does this myth persist?  In spite of that, there is also a fair amount of physician-bashing.

That being said, the episode had it’s moments, some of them positive ‘nursing’ moments – exaggerated as they may have been. Will I watch it again? I must admit that I will. There are the perfunctory dysfunctional relationships, addiction issues, sex and stereotypes (apparently all necessary for a successful TV drama) but I’m curious to see how the show and the characters develop – and how nursing is portrayed in future episodes. And I’ll be sure to send an e-mail to the producers about the “physician as boss” thing.    

Tell me what you thought of it. If you missed it, you can catch it on nbc.com

I’m finally on Twitter www.twitter.com/donnacardillorn and Facebook  http://www.facebook.com/donna.wilkcardillo. Have been on LinkedIn  but am now actually using it. Twitter is interesting and amazing and I’m enjoying using it. It can also be overwhelming but that is the power of it – the ability to reach so many people, many of  who would never otherwise know about you or you them. It’s a great way for me to dole out short and sweet advice, information and inspiration – and build community.  If you’re on Twitter, please tweet me to say hi.

My latest book, A Daybook for Beginning Nurses is hot off the presses. It was written for new graduates to inspire, motivate, and inform. There are 365 daily quotes, tips, and lessons to carry you through your first year in practice.  Each “chapter” includes a career-related essay to support you along the way.  Journal space accompanies each entry so that you may record your own experiences, thoughts, and reflections.  Find out more here. And although written for new graduates, the book will inspire all nurses who read it. It makes a beautiful gift.

There seems to be a shortage of nursing jobs, as opposed to a shortage of nurses, for the time being. I am receiving many, many e-mails from both new graduates and experienced nurses who want to reenter the nursing work force but are finding traditional hospital nursing jobs in short supply.  And while I cannot answer everyone’s e-mails personally I did want to provide some resources here.

For starters, there are many alternate care settings where patients are seriously ill and require complex care. These include acute rehab, long term acute care (LTAC), and even some long-term rehab facilities. Even some traditional long-term care facilities have an average length of stay of 30 days and have patients of all ages with varying medical conditions. Check them out.

Then there’s out-patient hemodialysis (do an Internet search to find these companies),  correctional health in prisons and juvenile detention centers,  home care infusion therapy and hospice and so much more. Read The RN Jobs Squeeze and New Nurse, New Job Strategies.  And be sure to read The ULTIMATE Career Guide for Nurses www.dcardillo.com for in-depth self-marketing, job finding,  networking skills, and how to find the right nursing job for you. 

And for those of you reentering nursing, read Reentering the Job Market

Some additional tips for new grads: Thriving in a Challenging Job Market

There is an interesting article on lemondrop.com by Laura Gilbert about the recent “run” of TV dramas featuring a nurse as the main character. She begs the question “Why are we suddenly so obsessed with nurses?” and hypothesizes about the answer. Read the post and my response here

How would you answer the above question?

While speaking at an association meeting (non-nursing) someone came up to me and said, “Do you help nurses who want to get out of nursing??” I said “Yes. I help them find another path in nursing if that’s what it takes.” This same person told me that her sister worked in a hospital, was totally burnt out and that she and many of her friends wanted to get out of nursing.

It saddens me that many nurses don’t realize that they have options within the profession – that so many nurses work themselves into the ground and then look for another profession. I can’t even imagine how many good nurses we have lost because of this.

Of course there are many reasons why nurses get burnt out – lack of adequate self-care, staying in a toxic or non-supportive work environment rather than looking for another job, not valuing their work or realizing all the transferable skills they have, getting into a rut and not working on career development.

Unfortunately some of these nurses then go to generic career counselors (rather than RN Career Coaches) who help them find a new occupation because they do not have an understanding of the profession, the skill set that nurses possess, and the vast array of opportunities that exist for nurses.

Be sure to encourage any nurses you encounter (including yourself) who want to leave nursing that they should fully explore their options, get out to nursing career fairs, attend professional association meetings, seminars and conventions to network and meet new people, and talk to folks who work in non-traditional specialties. Many of us need a change of work environment and specialty from time to time – sometimes a dramatic one. We also need to tend to our own self-care and ongoing career development. Consider reading or recommending The ULTIMATE Career Guide for Nurses – Practical Advice for Thriving at Every Stage of Your Career. Find out more here.