When the Shift Hits the Fan.

It is inevitable. It will happen to you.

No matter if you are a new graduate or veteran nurse, there will be that shift that will almost break you. Staffing is short. Your patient is crashing. Maybe it’s downtime to boot. The stress is overwhelming. You are heading to the med room to cry.

I have been there and shed those ugly tears. You feel like you’re drowning, and there is never enough help. I wanted to write a quick post with some advice about stress-management strategies that have helped me cope during those really hard moments when the shift is really hitting the fan.

Remember - You can’t do it all.

That moment when you start to feel like you need to clone yourself 10 times, stop and remember that you cannot do it all. THAT IS OK. You are a single human with a maximum capacity to take on tasks. Luckily, nursing is a team sport. Reach out to others and throw up the S.O.S. signal. Get some help. This is not a sign of weakness. This does not mean that you are not a good nurse. You are recognizing your limitations in the moment and putting patient safety first. It is appropriate to ask for assistance. If you try to do it all alone, you are putting yourself and your patients at risk. Don’t do it. That is never OK.

Take a deep breath. Try counting to 100 by threes.

Victor Lipman wrote for Psychology Today – “Get your body in hand first, and the mind will have a better chance to follow.” By using distraction techniques (like breathing and counting), you start to take control of yourself physically. This will help slow down your racing heart, help you avoid hyperventilation and allow you to think clearly. Nursing is a high-stress job. We are asked to do an impossible number of tasks (see the previous section) as fast as possible with less and less support. And not to mention, we are responsible for human lives. It’s normal for you to physically respond to that kind of stress. To succeed in a time of crisis, you will need to calm the body as well as the mind.

Triage. It is time to triage.

I am 100% an ER RN, so I am going to preach the importance of triaging your situation. It is time to get organized. You need to sort out what are the tasks that need your immediate attention, what you can delegate out to others, and what can go on the back burner. We already established that you cannot do it all. By triaging the urgency of your duties, you will complete the super STAT things quickly and figure out a way to get the other things finished without losing your mind. There is the possibility that you might not get it all done. And that is also OK. If all your patients are alive, your documentation is done, and no one is yelling at you, then all that extra stuff probably was not as necessary as you thought.

Don’t buy into the crazy.

When it’s busy, everyone gets stressed out. Emotions will be running high and sometimes, logic starts to fly out the window. It is SO important to not start down the road to Senselessville. Medicine has standards of care. Hospitals have policies and procedures. There is always structure to be found, even when it seems like the walls are crumbling around you. Let those rules guide you in the times of chaos. It can be very comforting (not to mention extremely helpful) to tap into those policies and procedures when the shift is blowing up. If you’re not sure if what is happening is kosher, take a minute and check the rules. You may be surprised at what you find.

Thank your coworkers.

Gratitude works magic. If you had someone come help you in a pinch, find them later and give them a “thanks” and a high-five. Nurses and other healthcare workers do not appreciate each other enough. We do some amazing work in ridiculous conditions. Find a minute to tell your colleagues that they did a good job. I find that appreciated coworkers are more apt to help in the future. 

Take time to decompress.

This is for after the shift-show has calmed down. You need to take some time to process. Whether it is in the car on the way home, in the shower after your shift or during a run the next day, find some quiet and let yourself go through the stress of the day. When we carry around too much stress, it can manifest as physical symptoms. By allowing yourself to work through the bedlam of your nurse life, you will find better balance in your personal life.

Have a great shift!

Sarah @ New Thing Nurse

About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



An Interview with the Interviewer: Elizabeth Scala

This week has been very exciting here at New Thing Nurse.

On Wednesday, April 25th, an episode of the nursing podcast "Your Next Shift", hosted by the imitable Elizabeth Scala, MSN, RN, MBA, went live. This episode features an interview with myself, your New Thing Nurse friend and founder, and Elizabeth where we talk about all things nursing, self-care, travel, rugby and of course, New Thing Nurse.

LISTEN TO MY INTERVIEW ON "YOUR NEXT SHIFT" WITH ELIZABETH SCALA HERE!!

I have never been on a podcast before, this again making me a #newthingnurse. I was SO nervous when we recorded the interview last month as I have been a fan of Elizabeth Scala's for quite some time. If you are not already familiar with her work, Elizabeth is a Johns Hopkins-trained Registered Nurse, best-selling author, keynote speaker, and consultant on burnout prevention for nurses in all specialties. She is the CEO of ElizabethScala.com and founder of The Art of Nursing - a Nurse's Week program providing education and inspiration to thousands across the country. Elizabeth also hosts the incredible podcast "Your Next Shift", where she interviews nurses from diverse roles from across the spectrum of nursing.

I mean SWOON, right? #nursecrush

In addition to inviting me to be on her podcast "Your Next Shift", Elizabeth was also game to play a little "Interview the Interviewer". Below is a brief interview between myself, Sarah @ New Thing Nurse, and the "Your Next Shift" hostess with the mostest - Elizabeth Scala, MSN, RN, MBA.


Sarah @ New Thing Nurse (NTN): I have been a big fan of yours for a long time but for those who aren't familiar with you and your work, can you introduce yourself and tell us about your work?

Elizabeth Scala (ES): Sure, Elizabeth Scala here. Professionally, I work as a Registered Nurse. Personally, I love gardening, jigsaw puzzles, my pup and dancing to jam bands all over the country! I have my dual masters' degree in nursing and business. And even though I am quite the homebody - I do love to travel and teach others.

NTN: I love hearing about other nurses' professional journeys. How did you fall into nursing? And what area of nursing did you start in?

ES: Great question! And totally worded appropriately for me. I definitely am on that "fell" into nursing. It was NOT my agenda;  growing up, hospitals would scare me! So, senior year of college I was moving into my apartment off campus with three other girls. Two of my roommates were in nursing school. One of my roommate's mothers was a nursing faculty. And the three of them, along with my own mother, decided that after I graduated with my psychology degree that I could go straight into the accelerated nursing program. I didn't have concrete plans yet after college so I thought, "Why not!?!" I started out in psychiatric nursing, worked some in the community, and am currently a research program coordinator at a large academic medical center.

NTN: The focus of New Thing Nurse is supporting nurses as they fine their "new thing". What made you step away from the bedside? And what was your first "new thing"?

ES: Gosh - what made me step away from bedside nursing was me. I wasn't taking any care of myself. My health was in the toilet; my emotions were on a roller coaster ride. I felt miserable and one night - since I RARELY slept through a night - I was having another sobbing tantrum. My husband and I both agreed that I could not keep going at the pace I was at. I needed to take a break, and I needed to focus on myself. I left my psychiatric nursing job and made a risky decision to work just part-time at a local wellness center. I was still able to work as a nurse - as they needed a RN to head up a physician referral program - so that was kind of neat! And during that time I had many "new things". To thing about what was the first... hmm. I think it was remembering that I was an athlete growing up. I loved sports, was always in good shape, and highly competitive (smile). Being at the wellness center and around all of the equipment, personal trainers, and healthy bodies - I was like "Ohhhh yeah..." It woke me up first physically to the shape I was in. After that, more and more started to unfold and I started to feel healthy, happy, and whole again.

NTN: What helped you make that transition into your "new thing"?

ES: I would say that many things helped me. My husband being supportive and allowing me to leave my full-time job with all of the perks that went along with it. Boy, I do NOT know how we made it financially - but we did! Then, my own curiosity. My own pause and need to do things that I enjoyed. Being at the wellness center, I was surrounded by resources. I asked for help, hired a trainer myself, and got back into shape. My boss at that job was super helpful. He introduced me to the concept of "coaching" and I went into a certified coaching program. Then, even one of my clients at the wellness center helped! She was a marketing specialist and started to talk to me in between her sessions about social media, blogging, and all sorts of things I never had heard of. I guess the main thing that I believe helped is an open mind and a desire to learn more. Even if I didn't know how something would work out, saying "yes" without hesitation was super productive in taking the next step!

NTN: Do you have any tips for anyone out there who might be considering jumping into a "new thing" of their own?

ES: Hmm, interesting question. I think that it depends on what their "new thing" is. For some new things, you definitely need to wait before jumping. What I mean by that is I have done a TON of things wrong in my online work. And even now, I am at a place where I am assessing and re-assessing decisions and plans. So, if you are considering a new thing that you know nothing about, do your research. Learn more before taking a plunge.

Next, I would say to the person considering a new thing... is it YOUR thing? So often we get wrapped up in what we think we "should" be doing. I think of all the dirty words - SHOULD should be at the top of the list (LOL). That being said, I mean is the new thing something that you desire or something you are going to do for someone else? I have learned along the way that when I get into something new that isn't 100% my true heart's desire... it doesn't work out all that well. Now, other "new things" that are a bit less heavy (like trying a new hobby, such as tango dancing) - for something like that, jump in head first! I do think we need to do more new things that are fun, adventurous, and will fill our spirits!

NTN: You have been a self-proclaimed warrior against nurse burnout for a long time. What drives your work to help the nursing community fight burnout? Did you have a personal experience with nurse burnout?

ES: As shared above, yes. Yes. And, yes again. In fact, to be honest, I am noticing that I may be back in burnout again. I think from everything I have shared above speaks to this questions, but to state it another way... Burnout happens when we are riding on someone else's train. When our values, desired, strengths, and assets are not being actualized. When we are living life along the "should" of what other people want and need. Now, I do agree that we all report to somebody - at work or at home. Sure, there are things that we may not 100% enjoy. And yes, work is work, and there will be stress on a job. However, when we get away from our true heartfelt desires, then we find ourselves in trouble. Couple that with working too hard, not getting a break, or forgetting to do things that are good for your mind, body, and spirit - all of this added up leads to burnout. I do agree that the workplace needs to be supportive and help us be happy and healthy professionals. At the very same time, it is up to us to stand up and take responsibility for our own well-being.

NTN: If you could give our readers your top tip or tips towards avoiding burnout, what would they be?

ES: Do what you enjoy. Set healthy boundaries. Schedule down time, me time, and non-work time. Change it up. If you are stuck in a rut - figure out why and what needs to shift. Focus on the positive. Sure, there is a tone out there that is scary, miserable, and bad. And, even through the greatest of tragedy we can learn, grow, and transform our lives. Live as much as you can in the moment. It is when our mind wanders to the "what if" or the "should, could, would" is when we get into trouble. Stop and breathe. And don't take yourself or your life so seriously. Smiling and laughing - that can be some of the very best medicine!

NTN: Do you have any "new things" on the horizon? New Thing Nurse readers want to know!

ES: I believe that I do, but most I am not even aware of yet. As I honestly (and maybe for the very first time) shared above - I am a bit into burnout right now. And, being someone that knows the signs, causes, and what to do about it - I need to stop. Really stop everything and take pause. What are my next steps? What lights me up? How can I best serve others? I can say that I have a very special course coming out soon. The content is done, and we are working on some of the aspects of how folks will be able to interact with and enjoy the program. I also know that some of my other "new things" involving ending some things that I hae been doing for several years now. In a way, ending things is the first step to the new beginnings, right?

NTN: How can our readers find out more about you and your work?

ES: Sure, well the easiest place to find me is at ElizabethScala.com. I also have a Facebook page and community. I do hang out quite a bit on LinkedIn. And, if you're looking for resources you could check out Nursing from Within or Your Next Shift - two of my very favorite books!

Oh, and I cannot believe I forgot to mention this at all so far... my podcast! Now that I am assessing where I am at and what I enjoy - I can tell you. The podcast is NOT going anywhere. I LOVE to interview other nurses - highlighting their triumphs and lifting the profession of nursing up!! So, definitely check that out. I am sure that you'll see some familiar faces, smile.

NTN: Do you have any other advice for our readers?

ES: Boy, I could go on and on, for sure. I think I shared a lot above. To close it out, just be yourself. And, if you don't know who that is or what that self wants, take the time to figure that out. First off, you will be happy that you did. Things will go so much smoother. It gets easier when you live life as your best you. If you get off course, it's all good. Even the best of us experience burnout! And guess what? We can thank it. It is that gentle reminder that we are not living life as our highest self.

Thanks for the opportunity to hang out with y'all! I hope to "see" you online. Enjoy YOUR new things!!


ISN'T SHE AMAZING??

Hear the "Your Next Shift" podcast episode featuring the interview between Sarah K. Wells, MSN, RN, CEN, CNL and Elizabeth Scala, MSN, RN, MBA in its entirety below.

A Shift In Perspective with Sarah K. Wells - Your Next Shift with Elizabeth Scala

- Sarah @ New Thing Nurse

About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



FOLLOW NEW THING NURSE ON INSTAGRAM - @NEWTHINGNURSE

How Travel Makes Me a Better Nurse.

I want to go everywhere.

Since I was a wee child, my parents were always ready to pack me and my sister into the car for a road trip. I grew up in a small town in southern Georgia, but we left as often as we could. My family caravanned up and down the east coast, once in a school bus that my mom bought (a long story). My dad drove me from Georgia to the Grand Canyon and back along historic highways, making sure to stop in musical meccas like New Orleans and Graceland along the way. I was a veteran car co-pilot by middle school, adept at navigating on the giant, paper atlases that dominated our dashboards. The GPS years did not come until my mom bought a new-fangled TomTom that always seemed to want to take the shortcut through a cotton field. Travel was a part of my life early on, but it was definitely limited to ground transport on four wheels - unless it was the school bus which had a lot more (again, long story).

Everything changed in Paris.

Just before I started at the University of Georgia, I got the opportunity to study abroad on a college program in Paris (France, not Texas) for 6 weeks in the summer. I became an instant Euro-nerd. The food, the art, the wine and the people had me enamored from the start. I started freshman year at UGA feigning extensive knowledge of the world. Posters of the Eiffel Tower covered my walls. I bemoaned the lack of Fanta Limon in our cafeteria. In short, I was an intolerable person to be around. My dorm roommate was a saint for not throwing me out the window.

I had the travel bug, BAD.

The following summer I returned to Europe but this time chose Madrid as my destination under the pretense of practicing my terribly accented Spanish that I was just starting to learn. Tapas, flamenco, siestas… it’s pretty hard not to love Spain. My Spanish got a little better. The travel addiction worse.

Over the next few years, I spent a lot of money on plane tickets.

A semester in Valencia, Spain was followed by a gap year in Monteverde, Costa Rica where I also backpacked from Panama to Mexico. Plus I met a boy who lived in Germany, which led to many transatlantic voyages validated by love. Then there was a volunteer trip to Peru for nursing school, followed by graduation which lead to a real job and a real paycheck. Then the flood gates were open. I have now been to Colombia, Thailand, Australia, Argentina, Hong Kong, Italy, Brazil, England, Cuba, Japan, Guatemala, Switzerland, Cambodia, Wales, Morocco, the Czech Republic and many more fantastic (and not so fantastic) destinations. The travel bills have been large, but out of it I got a husband (the boy who lived in Germany), a new language (Spanish), many new friends and memories, plus a global perspective that has made me more aware of myself and the world that I live in.

We get it. You’ve been a lot of places. What does this have to do with nursing?

Healthcare is as diverse as the world we live in. Our patients and colleagues come from everywhere. In my emergency department alone, we have at least a dozen nations represented by our staff at any given time. By experiencing more places and cultures, one becomes better able to navigate the individual needs of each of our patients and are able to work more cohesively with their care team. Culture drives so much on how we approach healthcare. Our personal perspectives, biases and opinions are all shaped by our own cultural experiences. When you put yourself in a foreign environment, you are forced to see things in another frame of reference. That may be the same frame of reference as your patient. If you can relate to their point of view, you will become a more effective healthcare provider.

Nursing varies globally.

Another thing that I like to do when I travel is find my way into healthcare facilities (hopefully not as a patient) or hear about the healthcare experiences of people from those new countries. I have been in hospitals, clinics, ambulances and local traditional healer’s homes. I LOVE seeing how other countries approach healing. The greatest experience, in my opinion, is to find the person called “nurse” and see who they are. Sometimes they are heavily educated practitioners who work with incredible autonomy. In other instances, nurses have very little training and work heavily in the homes instead of clinics or hospitals. Some cultures approach medical care similarly to the United States, with great beliefs in pharmacological and surgical treatments for ailments. In other places, traditional medicine is the standard with much more spiritual-based health practices. However, all of these providers may go by “nurse”. It is a powerful word with many definitions and meanings depending on where you are.

The experience of seeing all of these variations in the role of nurses and the structure of healthcare helps me better understand the expectations of my patients. Often our patients have just arrived in the United States and come to the emergency department with very specific ideas of what their care experience will be. Not only do I then have to treat the patient in the American medical approach, but also educate our patients on what their experience will actually be. I also have to meet their emotional and cultural needs to the best of my ability, using the resources that I have available. Those resources are often few and far between, so frequently the best available resource is me.

By traveling, my nursing practice has evolved.

I feel that I can provide much more holistic and culturally sensitive care as I often have a personal point of reference of where my patients are coming from. I just as frequently have no idea how the patients are feeling as I have never seen their home country or experienced their native traditions. This motivates me to continue to experience the world for myself, but also for my patients and colleagues. I am a better nurse with every new experience that I have.

So now I have to experience the world to be a good nurse? SUPER!

I am definitely not saying that one needs to visit every country in the world to be a good nurse. Some of the BEST nurses that I have ever worked with have never left the state where they were born. What I AM encouraging you to do is to take opportunities to experience other cultures and consider other perspectives. That can mean going out and trying a new cuisine. Food is such a strong part of cultures. Knowing the common dietary options from other countries can help you better determine what food recommendations to make for your uncontrolled diabetic from El Salvador. Maybe you could watch some international movies. Or go to a concert with music from another country. Read a book set in a foreign land. Even just talking to your colleagues who might be from other cultural backgrounds can help you expand your point of view.

There are so many ways of looking at the world. Challenge yourself to see things in a new way.

-       Sarah @ New Thing Nurse


Want to travel with Sarah & New Thing Nurse?

Sarah will be heading to Puerto Vallarta, MX with ExpeditionEd in July. Join the fun for adventure & 12 CEs while enjoying a relaxed environment, engaging in some self-care, invigorating beach activities and networking with other emergency nurses in beautiful Puerto Vallarta, Mexico.

Check out the ExpeditionEd website for more details - www.expedition-ed.com


About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



The Future of Nursing is Looking BRIGHT!

The next generation of nurses is looking strong.

I had the opportunity to give a workshop to members of the East Bay Student Nurse Association in Hayward, California this week. There was a great turnout of enthusiastic recent graduates and current nursing students. They were excited. They were eager. They were looking for help on how to jump headfirst into their nursing careers.

The title of the workshop is “I survived nursing school! Now what?”. It focuses on how to navigate that stressful transition from nursing school to new grad nurse in regard to self-care, stress management and all things related to getting that first job – networking, the job search, resumes and interviews. It was a great session. The participants were so interested in how to shift from successful nursing student to successful new nurse.

I love working with nursing students. In my opinion, nursing students are the toughest, most flexible and resilient students out there. They are asked to do the impossible – manage full-time clinical rotations, class time and personal lives – all while paying for the privilege to do it. These students were no exception. They arrived telling me stories of how they juggled their clinical rotations, nurse internships, volunteer work, classes, and part-time jobs. Each of them had incredible perspectives on patient care and the ever-evolving landscape of the American healthcare system. I was overwhelmed with their passion and determined spirits. The future of nursing is looking bright.

How can we help future nurses?

The major need that I hear from nursing students everywhere is that they need more opportunities. Nursing students need good preceptors and clinical rotations. If you are approached to precept, think about offering to help. New graduate nurses need to be considered for nurse positions. There needs to be more new nurse training programs and budgets to support them. New nurses need good mentors.  If you work with a new grad nurse, offer supportive guidance and a sympathetic ear when they need to talk to someone. Help them grow and avoid the burnout that so many new graduates face in their first jobs.

Our next generation of nurses is excited to get to work. Let’s help them be the best nurses that they can be.

- Sarah @ New Thing Nurse


About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



March - A Blue Month for Colorectal Cancer

Most people think of green, four-leaf clovers and leprechauns when they think of March.  

But since November 2017, March only makes me think of blue.

March is National Colorectal Cancer Awareness Month, represented by the color blue. Colon cancer became a very personal topic for me in November of last year when my mom was found to have a cancerous tumor in her colon at age 57.

My mom, Debra, is an awesome human.

She is a vibrant, funny, ass-kicking lady. She has always been her own boss. Mom owned her own store for nearly 30 years, then decided to open her own wholesale business so that she and my stepdad could live life on their own terms. Debra is amazingly cool, if you haven’t drawn that conclusion on your own yet.

As a patient, it was hard for my mom. She likes to be in control and suddenly, she was not. But Mom could control how she approached cancer, so she did it with an amazing sense of humor.

I give you her social media post soon after her colon cancer diagnosis –

Mom: “I look forward to my phone's predictive text suggesting ‘colorful’ rather than ‘colorectal’. #EffCancer

Mom also started a line of buttons from her business The Word Emporium to sell to people who want to tell the world how they really feel about cancer.

My mom was also incredibly lucky.

She had an amazing GI surgeon who did a partial colectomy that not only removed ALL of the cancer, but also left mom without the need for a colostomy. Mom also did not need radiation or chemo. She is scheduled for annual imaging and bloodwork screenings to ensure early notification if the cancer does come back. My mom is happy and healthy. I could not be more grateful.

Sadly, colorectal cancer is on the rise.

By going through this experience with her, I learned a lot about colorectal cancer that was extremely disheartening, especially as it relates to patients under 50 years of age. Here are some fast facts provided by the incredible Colorectal Cancer Alliance -

  • Young-onset colorectal cancer is on the rise in the United States.
  • 10% of new colorectal cancer patients are under 50 years old.
  • Young-onset patients are often misdiagnosed due to vague symptoms and assumptions that young patients are not at high-risk for colorectal cancer.

Then in December of last year, I became acutely aware of just how young patients dealing with colon cancer can be.

While helping my mom recover from her own colon surgery, I learned about the achingly early passing of a high school classmate, Christopher Roberts, from colon cancer.

In high school, Christopher and I were in several honors classes and band together. He was one of those rare adolescent male specimens who was an extremely nice guy that also played on the football team and had incredible intellect in the classroom. We lost touch after graduation, but learning of his death made my heart hurt. It would make anyone’s heart hurt.

Christopher was only 31.

It was only after his death that I found out that Christopher had been battling colon cancer very publicly. He was interviewed for the Colon Club blog and in the New York Times. Christopher candidly shared his story and helped reach many young people who might otherwise not be aware of the risks of colorectal cancer.

I cannot thank him enough.

Christopher continues to help educate the public. He taught me. Read about him here so that he can teach you.

The New York Times - Colon and Rectal Cancers Rising in Young People

The Colon Club - Christopher Roberts

Let’s think of blue this March.

I write this for my mom, Christopher and all the others out there battling colorectal cancer.

Consider making a donation to the Colorectal Cancer Alliance. This organization works to support the needs of patients, caregivers, and survivors, raise awareness of preventative screening, and fund critical research.

You can donate in tribute of those who have lost the fight with colorectal cancer. Last year I donated in the memory of Christopher Roberts. I will again this month. Want to join me?

-       Sarah @ New Thing Nurse

More resources about colorectal cancer -

The Colorectal Cancer Alliance

CDC - Colorectal Cancer Awareness

Fightcolorectalcancer.org


About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



FOLLOW US ON INSTAGRAM - @NEWTHINGNURSE

Nurse Mental Health - Let's Talk About It.

I have been sitting on this post.

I wrote this post recently, but was not planning on sharing it. I was not sure how I felt about sharing my personal story on the blog. There is a lot of stigma related to mental health in the healthcare community (and world) and while I am pretty open about my own nursing journey, I was not confident yet that I was ready to put my mental health story out in the great, wide world of the interwebs.

However yesterday there were some comments made on the New Thing Nurse social media that reminded me why it is so important to share our stories. There is an expectation that nurses need to have a "thick skin" to be successful in medicine, or it might not be the career for you. That people with anxiety or depression or other mental health diagnoses cannot be strong, capable & amazing nurses.

I THINK THAT IS CRAZY.

Nurses don't need thicker skins. They need better support. They need better coping strategies & stress management techniques. They need better work conditions. They need to know that their job is hard, that what they're feeling is normal, and that it is OK to admit if you're struggling and to talk about it.

Nurses, like all humans, have mental health. We should be concerned about their mental and emotional wellness. Nurses have to take care of themselves, so that they can take care of others.

Now, let me tell you a story.

Let’s start with a story, my story.

I was born a baby ER nurse in 2011, and it seems like only five minutes ago. 

I remember being a newly-minted nurse, hyperventilating on my way to those first night shifts. I had finished nursing school in an accelerated 16-month, master’s-entry program. It was disorganized. It went by way too fast. I did not feel prepared to save lives.  

During nursing school, I was anxious.

I was nervous about classes and tests. I was terrified during my first weeks of clinicals. The first time I went to take vital signs on a patient, I went with my classmate to record a blood pressure, heart rate, SAO2 and respiratory rate. We divided and conquered the tasks, and I almost passed out while trying to put on the patient’s blood pressure cuff. I am sure that the poor patient thought we were completely inept, but she was kind enough not to tell me to buzz off during the encounter.

Most people would say that some academic anxiety is normal. Sure. It probably is, but I have always been a nervous person. My anxiety was magnified by a million in nursing school. Because everyone kept telling me that it would get better, I shook off the fact that I cried constantly when I was alone and stress ate like it was going out of style. I once showed up at my classmate’s house and just ate a whole cheesecake. That isn’t normal.

Then I started my first job.

I was working nights, like everyone does when they start out, and was SO excited about being in the ER. It was my dream, and I was working in a great department with a very supportive staff. Yet I was barely sleeping. I was still stress eating, and sometimes I liked stayed in bed for days at a time when I was not working. When out with a crowd, I was usually fine, but I was frequently tearful at home. My then boyfriend, now husband, dealt with extreme mood swings and many crazy, sleepless days/nights. I thought it was all because I was working night shift, so I made excuses and soldiered on.

I moved to California and worked as a traveler, then as a staff nurse at several ERs. I continued to work nights. I had a terrible time sleeping, continued to be anxious and tearful when home alone and had many days where I could not get out of bed. I blamed everything and everyone for my continued anxiety and down moods. There was no way that I had a problem. It was always situational, at least that is what I continued to tell myself.

Then one day about three years ago, I was at home, an anxious, hot mess.

I was working 4-6 shifts a week at two jobs that I was juggling while trying to pay off my student loans. There had been a string of really brutal patient cases that had made me sad to the core of my being. I had not worked for several days yet at home that day, I was jumpy and crying. My husband was away on a business trip. I started looking for something to blame my mood on, but I could not think of anything - I had stopped working nights. I had gotten married. I had an amazing community of family and friends. I had a job that I loved.

So, I did what any good nurse does. I got a consult.

I found a therapist. She changed my life.

Through a lot of talking, time, exercise, mindfulness work, self-care and medicine (YES – I take medicine for my mental health), I have come to realize and accept that I have problems with depression and anxiety. For most of you reading this, you probably could have told me that years ago just by reading my story. That would have been great! But when you are on a journey of mental health self-assessment, it usually takes a lot of time to come to accept help and realize the deeper causes of your problems.

But I work in healthcare, so why didn’t I figure this out sooner?

Nurses and other healthcare workers historically HATE talking about their own mental health. We will diagnose and treat others ‘til the cows come home, but we will not discuss our own feelings for a million dollars. ER nurses may be some of the worst. We are so cowboy and pride ourselves on our ability to see the saddest, grossest, most traumatic cases and just keep going. That’s why we like to binge eat/drink/exercise/Netflix/craft. Call it what you want, but a lot of that is coping mechanisms in the extreme. I mean, have you ever seen any stress eating like a night shift pot luck? Think about it.

Things are changing.

The healthcare community is starting to talk more and more about the relationship between our work and our mental health. There are many organizations and foundations working to advocate for increased awareness of healthcare workers’ mental health needs (see below). Self-care and stress management is becoming more a part of the conversation, in addition to the need to combat compassion fatigue and burnout. This is a positive evolution for nurses and other healthcare providers everywhere. The world is starting to take note of the toll that our work is taking on us.

What else can we do?

I personally have made stress management and self-care a part of all of my education for both nursing students and veteran nurses. While awareness is the first step, we have to actively engage in self-care to protect ourselves from the negative effects of the stress of our jobs. Humans are incredibly resilient, and nurses are super stars in the resiliency game. However even super stars can burn out. We have to take the steps to not just continue to make nurse mental health a part of the conversation, but also to actively work to making self-care, mindfulness and stress management a part of our daily nursing and personal practice.

So, am I all better?

My anxiety and depression are going to be my forever friends. Sometimes they hang out with me, while other times they go on vacation. I have to continuously work on the things that keep me mentally well so that I do not backslide into the depths of Depression Town. I see my therapist regularly. I take my medicine. I (try to) eat well, sleep enough and exercise. I have started to try to meditate and stretch more.  I surround myself with positive humans. I travel. I read. I stay engaged with my professional and personal community. I continue to do work that I love – ER nursing, ENA volunteering & of course, New Thing Nurse. However, I am human, and I do not always succeed. I love donuts and cookies. I do not like to work out in the cold. I sometimes get too affected by things outside of my control (i.e. politics, family, donuts). But I do my best and most of the time, I feel like a fulfilled and happy person.

Also, I am, and continue to be, a strong and awesome nurse.

Having my own struggles with depression and anxiety have never made me a weak or bad nurse. On the contrary, I feel that I am a better nurse and advocate for both my patients and colleagues because of it. Additionally I have lead a successful ER nursing career, started a business to support the nursing community, lectured at the local, state and international level, and supported nurses and nursing students all along the way. My mental health challenges have never stopped me from being successful or effective in any role. I just have had to work harder and overcome more to achieve my goals.

Final Thoughts.

If you have read all of this, I commend you and thank you for sharing in my story. I want to make nurses everywhere realize that if you are feeling anything on the spectrum of anxious, self-doubting, irritable or sad, YOU ARE SO NOT ALONE. I have been there. I will be there again. There are so many more of us out there than you think. There are lots of other nurses talking about their own mental health journey on social media. Check them out! Let’s not keep how we are feeling a secret anymore.

Let’s keep the conversation going about our nurse mental health.

Let’s talk about it.

- Sarah @ New Thing Nurse

Want to read more about Nurse Mental Health & Wellness?

American Nurses Association - Healthy Nurse, Healthy Nation Campaign

Elizabeth Scala - Nursing from Within Blog

Nurse.org - Nurse Wellness: Not an Oxymoron

The Code Green Campaign - A First Responder Mental Health Advocacy Group


About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



Like! Love!! Repost!!! - RNs Using Social Media

I love social media.

I do. It's obvious. I use Instagram, Facebook, Blogs (Follow/Like/Read New Thing Nurse!) & listen to sooooo many podcasts.  A 2014 study of nurse social media use found that approximately 94% of participants reported using some form of social media. It is happening. Nurses are using social media to network, educate, advocate & respond to issues in real time. It can be so useful & efficient. Many large health organizations - like the CDC, the WHO, ENA, AACN & so many more letter combinations - have their own social media accounts (that you should be following). It is an incredibly easy & fun way to stay up-to-date with healthcare trends.

But with all the good, comes the bad.

As healthcare providers, we nurses are responsible for many things & are held accountable for what we say & do while on & off the clock. In addition to all laws that we have to follow (ahem - HIPAA), we are representing our ourselves, our unit, our employers & our profession at all times whether we realize or not. This extends to our online presence. Many employers are starting to monitor social media accounts for potential & current employees. Plus almost all facilities now have a social media policy in addition to a professional policy that all employees must follow. Check out the policies of your facility.

While one of the main words in social media is social, nurses also have to keep the social posts professional. The risks for not doing so include potential professional repercussions from employers or state licensing boards. In plain speak, you can lose your job or your RN license. Not worth it.

And are you a student? This applies to you too! Universities check social media when looking at student applications & almost all educational institutions have both the social media & professional policies in place for their students. So think thrice about your next post.

How do I use social media without getting in trouble?

I know you're thinking - "Great. Now I can't post anymore. THANKS A LOT!"

Relax. I am not going to leave you high & dry. You can still use social media, but I just want you to review your posting practices & think about it from a professional point of view -

Would this content be concerning if I were an employer?

Does this make me look like a competent nurse... or human?

Would my patients feel good seeing me drinking those six shots 6 hours before my shift starts?

How would my grandma feel about that dress?

With these points in mind, let's review some social media best practices for nursing professionals.

Privacy Settings

The first step to making your online presence more secure is to max out your privacy settings. Try to Google yourself & see what comes up. If you don't like your results, consider increasing the privacy settings on your accounts. All social media platforms have privacy settings which frequently change, so it's a good practice to recheck yours every 3-6 months. This does not mean that you are excluded from the "professional posting" rule. People can still see what you are posting. This will just decrease the possibility of your boss randomly stumbling upon your birthday party bus posts.

Use A Different Name

Like increased privacy settings, using a different name WILL NOT protect you from unprofessional posts. However it can deter unwanted folks from finding your more personal social media activity. Some nurses that I have met have a personal social media account with a nickname & a professional social media account with their legal name. Again you still have to keep it professional, but it is a common approach to enhancing your privacy.

Would You Be OK with the Whole World Seeing This?

You should just assume that EVERYONE is going to see what you just posted. Would you be ok with your grandma & your boss checking that outfit from last night? If not, you might want to make some choices on what you're posting. Also consider that if 94% of nurses are using social media, you can assume 98% of patients are too. If they didn't like their care or something you said, bet your Christmas bonus that they are going to try to find you online & find other things that they don't like. Then they are going to file a complaint. It happens. Don't let it happen to you!

Photos of Work

Don't do it. Just don't. I know you think that it will be ok, but I feel really strongly that you should never post specifics about your job, photos from work, what happens on shift or complain in any way about your employer or patients. Never post photos of you socializing in your scrubs. Don't post your badge. Don't post where you work unless it's a professional profile used for specifically professional purposes. I know that I have not been perfect about this. Facebook went public while I was in college, & we all had to learn. But photos & posts about work can be very quickly turned against you. My motto - just be positive about work or don't mention it at all.

HIPAA & Posting

Patient confidentiality is a BIG DEAL & federally protected by law. You need to be really careful about telling stories, posting on social media or texting out any tales from the patient care world.
Think about it! Even if you change patient identifiers, don’t most people know where you work? Plus what kind of floor you work on? & how hard would it be to figure out the day this happened? That’s a lot of identifying information. I used to work in a small town & some of the Nosey Neds & Nancies of that town could figure out a lot from less than that.

Many Schools & Employers Do a Social Media Check

We touched on this earlier, but it bears repeating. It is happening. During job & school application processes, many institutions are doing social media checks on their applicants. I recommend doing a review of what's out there on you before applying to schools or new jobs & consider deleting questionable photos (especially with nudity or alcohol), de-tagging yourself from off color status updates or de-activating accounts while in the application process.

Social Media & Professional Policies

I know that we touched on this topic briefly, but this also is super important. Social media & professional policies are documents that clearly define an organization's expectations for online & professional conduct. Some are super detailed while others are more vague. You need to read the policies of your facility. When you become an employee or student at an organization, you are agreeing to follow their policies. If you are found in violation of these policies, you can be in deep trouble. Save yourself the pain & find out what the expectations are for you.

More Resources!!

While I like to think of myself as an awesome resource, please DO NOT JUST FOLLOW THIS POST FOR YOUR SOCIAL MEDIA RECOMMENDATIONS. There are many other resources out there. First & foremost, FOLLOW THE POLICIES OF YOUR EMPLOYER, FACILITY & EDUCATIONAL INSTITUTIONS. For further reading, here are a few other resources for you to review -

National Council of State Boards of Nursing - A Nurse's Guide to the Use of Social Media

C. Lee Ventola - Social Media and Health Care Professionals: Benefits, Risks, and Best Practices

Nancy Spector, PHD, RN & Dawn M. Kappel, MA - Guidelines for Using Electronic and Social Media: The Regulatory Perspective

Remember - Social media can be awesome. Just make sure to keep it professional & follow the policy.

- Sarah @ New Thing Nurse

 



HELLO 2018! LET'S TALK ABOUT NURSE SELF-CARE GOALS.

2017 was a year of highs & lows.

The Lows: Mom gets diagnosed with colon cancer & spending Thanksgiving week in the hospital hoping that modern medicine is all it's cracked up to be.

The Super Highs: Mom is found clear of cancer after surgery & doesn't need chemo or radiation!!! Also starting this little company - New Thing Nurse - & finding so many connections & endless support through our #newthingnursetribe during the harder parts of this year has been a great gift. Thank you to everyone who reached out. You guys are amazing. 

A Personal High: I've found so much joy in helping my clients throughout the past year achieve their goals & pursue their new things. Have a new thing? Let's chat.

so what are my goals for the new year?

These past few months have definitely reshaped my goals for 2018. I have been away from the bedside for almost 6 weeks helping with my mom and am returning to work soon. I'm a little nervous, but so ready to see my ER team again. They were constant supporters throughout this whole series of events. I am so lucky & honored to be able to work with them.

However I want to come back as strong of a co-worker as possible. I am almost ready, but there are certain self-care steps that I want to make priorities this year to ensure that I am my best self for home & work. These past few months have been hard, & I have not always excelled at keeping my head level. Now it's a new year, so time to change up my approach.

None of these ideas are revolutionary, but if I achieve a few of them every day, I will be a stronger person & nurse -

Self-Care Goal: Eat better.

This is in no way a unique idea for a New Year's goal. I want to eat better for my health - eat cleaner, less junk & more consistently. My husband & I want to cook more this year. We bought an InstaPot. We will see how that goes. But the idea is to not just eat for physical health, but also for my mental health. I don't want to count calories or be guilty for having a cookie (I really love cookies). I want to support myself in my food decisions not only by what I eat but also, how I feel about what I eat. (If you want to have daily morsels of self-love along these themes, please follow BodyPosiPanda on IG.) I want to be more forgiving of myself. More on that later.

Self-Care Goal: Drink more water.

I am putting myself on notice for being better about carrying around my water bottle & using it. I am a hot mess when I am cracked out on coffee. We have all been there. The shift is going bad. You didn't sleep well the night before. The miracle bean juice smells incredible, so you drink a few cups. Then a few more. The resulting headaches & dehydrated crank are real. Sarah needs to drink more agua.

Self-Care Goal: Stretch.

Along with working out (which I need to be better about), I want to stretch more. As nurses, we carry a lot of stress in our bodies. We also have very physical jobs. I sometimes come home with aches & pains that make me feel like an old woman. Last year I got a roller, which has changed the game, but I need to use it more consistently. I want to make time in the morning & evening to stretch it out on my new yoga mat. It's time to make the pain nothing but a 2017 memory.

Self-Care Goal: Be more forgiving of myself.

I am a worrier. I worry about my patients, their families, my co-workers, my job, my family, my husband, myself, my extended family, my neighbors, my stuff, my community, my country & the general state of the world. And this is just the short list. I worry about all of these things, want to fix all the problems & then feel an amazing amount of guilt related to my inability to fix the planet.

This is not healthy.

I want to try to be more forgiving of myself. This goes along with being more patient with myself. I am a super type-A, self-critical human. I want to relax those personal characteristics a little. To achieve these goals, I hope to slow things down, be more honest with myself & others, be a better communicator, go talk to my therapist (I love my therapist.) & try some things like yoga & meditation. This is a big goal, which I know I won't fully achieve this year or the next, but if I can make some progress, I know that I will be a better me.

Self-Care Goal: Meditation.

I'm putting it out there. I'm going to try to meditate this year. There is so much sadness & emotional dreadfulness that we see as nurses. It's time to try to learn how to help clear my mind. Did you know that 1 in 10 emergency workers suffer from PTSD? Nurses see tragedy so often that it doesn't even register sometimes. It is so important to take care of our minds along with our bodies to make it possible to have long & healthy nursing careers.

2018 - Let's see what we can do.

I've never been big on being hard & fast on my resolutions. They always seem like rules that I am doomed to break as soon as I set them. This year, I want to go for these big, general goals. If I don't fulfill them every day, no worries. But if I can get a few right most days, I will be a better person & stronger nurse for it.

I want this year to be about building a stronger foundation of ME. That way I can be a strong foundation for YOU. Want to do it together?

Happy New Year!!! Let's help each other succeed & grow throughout 2018.

- Sarah @ New Thing Nurse



Nurse Gratitude.

The holidays can be rough.

The hospitals are full with patients who need care, & the staffing is short because of co-workers who are not there....

This holiday season is unusual for me. I am currently with family due to illness, so enjoying doing some private duty nursing & family support this holiday season. But traditionally, this is the time of year when I like to look around the ridiculously full hospital (while I'm doing a million things, haven't had a break & may or may not have peed in the last 11 hours) & focus on all the awesome reasons why I have #nursegratitude.

What is "nurse gratitude"? Great question! Nurse gratitude is the thankful feeling that I get for all things nursing. This can be for simple things like coffee & gloves (essential for each & every shift). Or it can be for things like social workers & child life specialists who make terrible situations more manageable with their wizard-like skills (I LOVE ALL YOU SOCIAL WORKERS & CHILD LIFE FOLKS).  Today, I just wanted to focus on the general aspects of nursing that make me so full of nurse gratitude.

Here is the Top 5 on my Nurse Gratitude List  -

1. Flexibility.

This job has allowed me to travel the world, be available for my family in times of crisis, take classes & start a new business. I have worked full-time, part-time & PRN. As an ER nurse, I have worked ALLLLLL the shifts which has freed me up for many educational, personal & professional opportunities. My colleagues have been able to be daytime parents & nighttime workers, full-time students, fulfilling passion projects & a few have been seasonal athletes while still being fully employed three days a week. There are few jobs with greater flexibility than nursing. Cheers to Saturday on a Tuesday.

2. We have the best stories.

When at a party, dinner out or just a gathering of folks, nurses will always have the best stories. I hate the question, "What is the craziest thing you have ever seen?". Normal folks aren't ready for the real crazy. I usually give them a watered-down rectal foreign body story that gets a lot of giggles & then we move on. What I love is hearing that someone else is in the healthcare field & then getting to compare war stories. Healthcare workers, but nurses especially, have the best, most incredibly, "you can't make this sh*t up" stories. They are best not for general consumption, but get a few jaded nurse hearts together with a glass of whiskey or wine & the night will not disappoint.

3. Nurses are the best people.

I cannot stress enough how generally amazing the people are who are drawn to nursing. I don't know why, but they are the most passionate, hard-working & funny individuals. Almost all my friends are nurses for exactly this reason. Nurses love to help. They are driven by a crazy passion to get sh*t done. No one is better suited for a high-stress, multitasking needed situation. That's why so many are balancing kids, school & a side-hustle. And nurses are HILARIOUS. Nurses can literally be facing some of the saddest & hardest situations that life can offer, but they can make light of it all. I love me some nurses. 

4. Variety.

Have you ever seen such a variety of roles that nursing has to offer? When I meet clients who are burnt crispy & telling me that they are thinking of switching careers, I almost yell - "WHY?". There is an almost endless amount of manifestations of nursing out there. Just when I think that I've heard them all, I learn about something new. Did you know that you can be a camp nurse? Or a toxicology nurse? Or a nurse podcaster? Or an organ donation nurse? Or a nurse historian? YES!!! These are all real jobs. The list goes on & on, but I encourage you to think about your passions & do some research. There is probably an amazing fit (or at least some swag) for even your nursing & knitting interests.

5. We get to help.

We get to help people. Our patients are often in their most vulnerable time of need, as are their family, friends & other loved ones. We get to help our colleagues & communities by donating to fundraisers or working at the medic booth at the health fair. We go home & help our own relatives by taking all their calls related to - "I have this spot on my back....". Our kids & their friends come to us to help with the owies. My neighbor comes by to check in after his hip operation with questions. Nurses are helpers. I live for the helping.

This holiday season you do have the option of just dwelling on how there were three sick calls, two Code 3's in the last five minutes & a laboring mother in the waiting room (where's the partridge in the pear tree?). But why? All that would do is stress me out & make my shift that much worse. Let's choose to BUMP THAT NOISE & instead find some positivity by remembering all the reasons that we can have #nursegratitude this year.

- Sarah @ New Thing Nurse



The Blog is LIVE!! - Now, What Is New Thing Nurse?

The New Thing Nurse Blog is now LIVE! WOOT!!!

Hello!!!

For those of you who know me - HOWDY!!!

First, thank you for reading & following New Thing Nurse! Our #newthingnursetribe is an amazing community of veteran nurses, new nurses & aspiring nurses - plus so many more in the medical field - that come together to create a supportive platform to help each other with their new things!

For first-time readers to the New Thing Nurse community - WELCOME!!

My name is Sarah K. Wells, MSN, RN, CEN, CNL. I am the Owner & Head Coach at New Thing Nurse & the main writer at our newly launched New Thing Nurse Blog.

What is New Thing Nurse?

New Thing Nurse is -

1. The academic & professional coaching service company made by a nurse for the nursing community to help with your new nurse thing! Whether you are thinking about applying to a new school, looking for your new job or have a new passion project that you need help getting off the ground, New Thing Nurse can help!!! New Thing Nurse offers an array of coaching, document preparation, writing editing & mentoring services to meet your professional & academic needs. Check out our Services page to see how we can help you. 

2. An inclusive & supportive online community for the nursing community who are trying new things. It is a forum to discuss ideas, get motivation & gain insider tips on how to succeed. No haters here. New Thing Nurse was created to lift each other up & fight against nurse bullying & nurse burnout.

3. A blog!! New Thing Nurse is now live with its blog! On here I (Sarah) & occasional guest authors will be diving more deeply into topics & trends that explore the great, big world that is the field of nursing. Many people think that nursing is just working at the bedside. However as you follow our social media & blog accounts, readers will quickly see that the world of nursing is a wide & wondrous world of diverse roles & crazy adventure! 

I created New Thing Nurse after seeing too many smart & talented nurses voice frustrations of the limitations of nursing. Many were burnt out. Others were uninspired. Most did not know the many options that are out there. New Thing Nurse is here to help fix that. I want to create a world of successful & fulfilled nurses and hopefully, this nurturing & collaborative nursing culture will extend beyond the healthcare setting for an enhanced professional & personal experience for all.

Thanks for reading & have a great shift!!

- Sarah, Owner & Head Coach @ New Thing Nurse