Tuesday, May 21, 2013
My mother was a nurse, the old-fashioned kind without a college degree, first in the class of 1935 at the Lenox Hill Hospital School of Nursing in New York City. Her graduation was announced in The New York Times, and her name was listed in the commencement program — Estelle S. Murov, in gold letters on ivory vellum —as the valedictory speaker, to be followed by the Florence Nightingale Pledge, presentation of prizes and diplomas, benediction, recessional and a reception and dance at the Hotel Astor.
In the dozen years that followed (until my birth), she wore a blue flannel cape and a starched white cap while presiding over the preemie nursery at Lenox Hill, long before the days of neonatal intensive care units. The glory years for nurses, my mother always told me, were during World War II, when most of the doctors were away and real responsibility replaced being a handmaiden.
With this as my background, I am hardly a disinterested reviewer of a new anthology of essays by 21 nurses. It is beautifully wrought, but more significantly a reminder that these “semi-invisible” people, as Lee Gutkind calls them in this new book, are now the “indispensable and anchoring element of our health care system.”
Today, there are 2.7 million registered nurses working in the United States, compared with 690,000 physicians and surgeons. That number is expected to grow to 3.5 million in the next half dozen years, Mr. Gutkind writes in his introduction, as members of the baby boom generation require hospitalization and home or hospice care.
After he had selected 21 essays from more than 200 submissions, Mr. Gutkind had personal experiences that drove home the very thing the nurses wrote about over and over. He spent several months at others’ hospital bedsides — his mother, 93; his son, 21; his uncle, 86; and a friend, 72 — and rarely saw a physician.
Though it is the doctors who are considered “deities,” he writes, it was the “irreplaceable” nurses who were a source of comfort and security during his family’s multiple trials. And yet by his own admission he took them for granted — “I cannot not tell you what any of the nurses looked like, what their names were, where they came from” — which is exactly the state of affairs my mother described 65 years ago.
She would have loved this book, and no passage more than the one in which Tilda Shalof, a nurse for 30 years and also a best-selling author, describes “the ongoing tension between the university-educated nurses like me and the old guard, the hospital-trained, diploma-prepared nurses.”
The latter, she argues, are preferable. “Maybe those veterans didn’t know much about research or nursing theories, but they sure know how to care for patients,” she writes. “They knew how to get the job done. I wanted to be like them — a nurse who could start IVs on anyone.”
Many of the nurses who have contributed to this anthology are also part-time writers or bloggers. I would have welcomed some information from Mr. Gutkind, the editor of a literary magazine and writer in residence at Arizona State University, about whether nurse/writers are common and if so why. Perhaps many of them write because they rarely talk about their work, as they point out in these essays, and are encouraged in training and by the medical hierarchy to be tentative, even submissive, in their communication with doctors.
Several of the essayists describe their duties as tedious but the implications as profound. Eddie Lueken, a nurse of 30 years who also has a master of fine arts in creative writing, described her student years, earning tuition money busing tables at a steakhouse where she had to wear a cowboy hat and went home smelling like A.1. sauce. She yearned for the adrenaline rush of paddling people back to life; instead, she wound up mastering bedmaking, denture care for the terminally ill and measuring the diameter of bed sores.
Tuesday, May 21, 2013
I graduated with my BSN degree- a Bachelor of Science in Nursing - 17 years ago. At the time, the debate over entry-level nursing degrees had been raging for three decades. The American Nurses Association officially recommended the baccalaureate degree in nursing as the minimum degree required for entry into practice in 1964. But in 1995, the year of my graduation, there were still three distinct paths into nursing: a two-year associate degree in nursing, a three-year diploma in nursing and the four-year baccalaureate degree in nursing. All three led to the exact same professional designation: RN, or Registered Nurse.
So why in the world did I opt for a BSN degree? Because I wanted to keep my options open. My mother had been a nurse before me, and always told me that advanced education was the key to advancement. She was right.
Push Toward Advanced Education
In the years since I’ve graduated, nursing has become an increasingly complex profession. Patients today present to hospitals and nursing homes with a multitude of health problems, as well as a vast array of socioeconomic concerns. Nurses now understand that a basic understanding of the patient’s environment and current health policy goes a long way toward helping patients achieve good health, and these days national nursing organizations and healthcare employers almost universally recognize the role nursing education plays in preparing nurses to work in our current healthcare system.
The American Nurses Association still believes that the BSN degree should be the minimum degree required for entry into the profession. Others have since added their voices to the chorus. In 2011, the Institute of Medicine (IOM) released its report The Future of Nursing, and stated that “The ways in which nurses were educated during the 20th century are no longer adequate for dealing with the realities of health care in the 21st century.” Today’s nurses need education in “leadership, health policy, system improvement, research and evidence-based practice, and teamwork and collaboration” - topics routinely covered at the BSN level. That’s why the IOM recommends increasing the proportion of BSN nurses in the workforce to 80 percent by 2020. (The number of BSN-prepared nurses currently hovers around 37 percent.)
Many states agree, at least in principle, with the IOM’s recommendation. At least two states, New York and New Jersey, are currently considering BSN-in-10 legislation, which would require nurses to obtain their BSN degrees within 10 years of licensure as a Registered Nurse.
Tuesday, May 21, 2013
Certified nurse-midwives (CNM) have been active in the United States for nearly a century. The specialty began in 1925, when British-trained American public health nurses were sent to health centers in rural Appalachia. In addition to childbearing and delivery, they also provided health care services for entire families.
The Maternity Center Association of New York City began the first U.S. nurse-midwifery education program for public health nurses in 1932. By the mid-1970s, nurse-midwives had become a popular option for women seeking a less clinical, more “natural” maternal experience. Today, nurse-midwives incorporate best practices from English midwifery, American nursing and Western medicine to span traditional hospital-based care through family planning and increasingly popular home-based childbirth.
What is Midwifery?
As defined by the American College of Nurse-Midwives, it is:
“the independent management of women’s health care, focusing particularly on common primary care issues, family planning and gynecologic needs of women, pregnancy, childbirth, the postpartum period and the care of the newborn.”
A certified nurse-midwife is educated in the two disciplines of nursing and midwifery and practices according to ACNM standards. IThey offer highly personalized care, and encourage activities that promote women’s health and reduce health risks.
Midwives believe that birth, puberty and menopause are normal processes in a woman’s life-- not conditions that need to be “fixed,” but rather ones that women should be educated about, so that they can make their own informed health decisions.
Studies over the last several decades confirm that nurse-midwives can manage most perinatal, family planning and gynecological needs of women. They have become an especially vital health care link for underserved women in rural and inner-city areas. The National Institute of Medicine recently recommended that nurse-midwives be given more responsibility for delivering women’s health care.
Certified nurse-midwives work in individuals’ homes, private practices (either alone or with a physician, usually an OB/GYN), public clinics, hospitals and birth centers. When necessary, CNMs refer women to specialists, such as in the case of a high-risk pregnancy or a pregnant patient with multiple chronic diseases.
Tuesday, May 21, 2013
I didn’t know what I wanted to be when I grew up. Some kids claim to have felt the pull toward medicine or mechanics at a young age, but I had no idea what I would like to do. I knew college was part of the equation, but beyond that? Not a clue.
My mom was a nurse, so I knew something about the profession. Her nursing magazines lay around our house, and I’d pick them up and read them when I ran out of text on the back of the breakfast cereal box. Some of the stories were pretty interesting. So between my freshman and sophomore years of college, a friend and I enrolled in a nurses’ aide course.
My friend, a doctor-to-be, wanted the health-care experience; I figured the class was a chance to explore the world of nursing while earning money for college. (At that time, many nursing homes still paid students to obtain their nurses’ aide certifications, on the condition that the new aides work for the nursing home after graduation.)
If I liked the class, I told myself, I’d major in nursing. After all, it was a stable, respectable, in-demand profession—and as a recently-engaged, soon-to-be-Marine-bride, I knew I needed a profession that would travel well.
People, Not Procedures
To be honest, the class wasn’t always exciting. We learned how to make beds! (And actually took a test to demonstrate our competency.) But we also learned about diseases, dementia and documentation. We learned how to assess vital signs, how to help patients with activities of daily living, and how to communicate to our supervising nurses. Before long, we were released onto the floor to practice our new skills—and that’s when things got interesting.
Nursing, I learned, is not about the rote application of procedures; nursing is about people. Out on the floor, I worked with a 90-year-old woman who’d come over on a boat from the Old Country, alone, at the age of 13. I cared for a man who’d reverted to his native language, and quickly learned that I could ease his confusion by telling him “Guten Nacht” ("good night") before tucking him into bed.
Wednesday, May 15, 2013
Positive psychologists have been studying happiness for about 30 years. And guess what, nurses? You can control your own happiness!
Here are 5 concrete things you can do to boost your happiness score:
Hang out with happy people. It rubs off.
Cultivate an attitude of appreciation. Begin to notice the positive moments and events of your day. Write down three to five positive events/experiences each evening. Even fleeting moments of joy count here! Keep the list daily for at least two weeks and you are likely to notice a change in your happiness. Then continue on - gratitude and appreciation are proven paths to happiness.
Live in the moment. Yesterday is gone. Tomorrow is tomorrow. You only have right now. Enjoy the “now.”
Decide to be happy and act that way. Do it again tomorrow. Over time you will build new pathways in your brain and it will be easier to control your mood. What are you waiting for?
Wednesday, May 15, 2013
Going to work is kind of necessary for most of us. Unless you are independently wealthy, have a sugar daddy, are still in school, or just make a lot of sacrifices and frugal choices to stay at home, you probably work. Usually it’s around 40 hours a week, some more, some less. That’s a huge chunk of time, so it makes sense that how you feel while at work is going to have a big impact on your overall happiness.
I’d say the best way to stay happy at work is to love what you do. I’m a registered nurse, and I’m really glad I can say that I do love it. I work in outpatient oncology, and the bulk of what I do is administer chemo, blood products, and other IV medications. It’s different every day so I don’t get bored, challenges me mentally, and best of all allows me to meet people and affect them positively in the midst of tough circumstances. I’ve started making it my mission to give them a good experience in our clinic and hopefully begin or continue a positive relationship with them. When my patients are happy, it’s easy for me to be happy too.
Wednesday, May 15, 2013
You may feel pressured to be more outgoing and extroverted, especially during your job search. Don’t despair: Introverts possess many strengths, many of which are even admired by employers.
If you haven’t already admitted you’re an introvert, you may need to recognize the characteristics of one. They prefer to think before they act. They regain energy by being alone. They need time to formulate ideas in their heads before talking about them. They prefer depth over breadth; this is true of relationships and information. An introvert prefers fewer deep and meaningful relationships over hundreds of contacts. Introverts also tend to dive deep into topics they’re interested in. Creativity, strategizing and remaining calm under pressure are several other strengths not to overlook. Self-awareness is the first step to appreciating the desirable qualities and overcoming those that limit your career and job search.
Meet people one-on-one. The thought of networking in a big crowd is scary, repulsive, intimidating and many other less-than-positive descriptors to an introvert. It isn’t as though they can’t network—they can—they’re just more comfortable meeting individuals one at a time. And because introverts are good listeners, they come across as likable. The secret to maximizing your listening skills is not to worry about what you will say next. Conduct research on the person you will be meeting with and construct a list of questions you want to ask. Feel free to write these questions down and refer to them if you need to. Introverts sometimes become sidetracked in their own thoughts. A list of questions will help you feel more confident.
You are not shy. Introverts tend to dislike small talk and this often leads to the perception that they’re shy or unfriendly. Shoot down this misconception by developing a repertoire of questions you can use to make small talk. When you use these questions, you won’t feel the pressure of not knowing what to say and you can move on to building rapport. This is particularly important when you’re meeting someone for the first time. A little sleuthing on social media might also provide some details that make it easier to engage in small talk.
Share your ideas. Introverts are strong at ideation, that is, the creative process of generating, developing and communicating new ideas. They just need time to think. In an interview situation, you may not have as much time to process your ideas and answers and formulate a confident response. With a little planning, an introvert can anticipate likely scenarios he or she can prepare for in advance. It is alright to ask for time to respond during an interview. You may even want to explain that you need a moment to formulate your answer before you speak.
Avoid back-to-back scheduling. When possible, build time into your day to recharge. That means scheduling an interview or meeting and allowing yourself time after the event to be alone and recharge. Be sure you ask how much time to allocate for an interview. It will help you gauge how much energy you will need to store up.
Think on your feet. There will be times when you are asked an unexpected question or put in an unanticipated situation. The more practice and experience you have interviewing and networking, the more comfortable you will be in crafting your response. You can and should roll play interview scenarios and craft accomplishment stories to answer questions.
The phone is your friend. Introverts prefer to text or email rather than speak on the phone. But you can take advantage of the fact that you’re masked behind the phone. You can have your notes, script and research in front of you to reference without notice. Remember to smile while you talk and add more inflection to your voice than you may normally do in person. You want to make sure the caller can hear your interest and enthusiasm. If caught off guard by a phone call, be sure to ask for a minute so you can gather your materials.
Friday, May 10, 2013
When you’re competing against so many other talented job seekers, it’s hard to have the confidence that helps you get the job. And while plenty of other candidates will spend as much time as you carefully crafting their application letters and resumes, others will sloppily send them out to every job that interests them. With a little extra attention to detail, you can better position yourself to move to the call-back list.
1. Use words from the job description. When you write your application letter, carefully reread the job description and pull out points you can make in your letter that relate to what the company is looking for. Do the same for your résumé. Hiring managers may not even notice if you use similar verbiage as the job description, but they’ll like your application better if the language is familiar. For example, if the description asks for someone with extensive experience managing teams, mention that and highlight your experience to show this off on your résumé.
2. Keep your ear to the ground. Don’t let the job description from a company be your only knowledge of the brand. See what the company is saying on social media and search for news online. This will give you a bigger picture of what’s happening at a company where you want to apply to work. That knowledge can help you look sharp in an interview.
3. Tweak your online brand. Since you know employers will Google you to see what you’ve got going on online, it’s in your best interest to make sure what’s out there puts you in a positive light. Keep a steady stream of content on your personal/professional blog to show you’re tapped into your industry, and keep your social updates professional enough to not turn off a hiring manager.
4. Get out there. Meeting people at networking events can work wonders. Start by connecting with people on LinkedIn, then see what types of events they attend. Find a way to introduce yourself, then start building the relationship.
5. Volunteer. Not every company is hiring much this year, so one way to get your foot in the door is to volunteer or intern with the company or an organization with which it’s associated. For example, if you know a company has strong ties to the local Humane Society, helping out there might be a way to meet people you need to know.
6. Stay on top of job listings. Yes, looking at job boards every day makes your eyes cross. But you never know when “the one” will pop up. Keep up with which jobs you’ve already applied for so you can easily see which ones are new and worth exploring. Use the email subscription features to be alerted for new posts in your area of interest.
7. Make friends with recruiters. Recruiters often know about jobs you won’t see online, so keep your information updated with those that work in your industry. Let them know you’re actively looking so they can keep you on their short list.
8. Be patient in the follow-up. Whether you’re anxious to find out if the human resources manager has reviewed your résumé, or you’re waiting to hear if you got the job post-interview, it’s tempting to call too soon to follow up. Follow up to thank everyone for their time and reiterate your interest and then let the company come back to you. If you got the job, they’ll let you know. It’s very important to show your interest, but bugging them every day for a decision won’t make anything speed up.
Friday, May 10, 2013
Why in-person communication is still vital in the digital era
Asking for help. Saying goodbye. Requesting feedback. They’re all basic communication skills, yet employees often fail miserably when it comes to using them, says communications expert Jodi Glickman.
First a Peace Corps volunteer, then an investment banker, Glickman today becomes an author with the release of her first book, Great on the Job. The story of what to say and how to say it, the book is full of tips for communicating in the workplace, strategies Glickman teaches to business students around the country.
U.S. News asked Glickman to share some of that advice with our readers. Excerpts:
Why write a book about personal communication when online networking is all the rage?
Even though online networking is all the rage, business still is and always will be a personal thing. I wrote this book because I believe that more than ever, face-to-face, one-on-one conversation is the key to success at work. You will never close a deal via email. You will never hire someone via video or email.
I think of technical proficiency in whatever your job is as your baseline of competency. Then, in order to be a star performer, you need to be able to talk to people. You need to be able to sell your ideas, you need to be able to build consensus, you need to build rapport and trust with people. And all of that happens from one-on-one personal dialogue.
What are the most common mistakes you see people make when it comes to communicating at work?
Junior people [are often] afraid to ask for or get the help they need … If you’re working on something and you either can’t finish it because of time constraints or because you don’t have the appropriate resources or know-how, you need to fix that problem … Say to your manager, “Look, I’m really excited about this project, I’m new at working on it, I want to produce a stellar product for you. Here’s what I need to get the job done well” ... Those conversations don’t happen as often as they need to.
You write about the importance of mastering the hello and goodbye. Are you saying a simple “Good morning” doesn’t cut it?
It may, in certain situations … When you start a phone conversation with someone, the way you start the call is your introduction, your purpose for the call, and the key question. And the key question is, “Do you have a minute to speak?” I’m sure you’ve received a call from someone when they started talking and you weren’t expecting their call or ready for their call, you maybe didn’t want to speak to them, and all of the sudden you’re thinking, Oh my gosh, how do I get off the phone?
Being generous when you begin a conversation with someone is giving them an out. [Ask], “Is this a good time to speak?” [Or] “Do you have a few minutes?” If they don’t, [say,] “When is a good time for us to catch up?”
And on the goodbye, the goodbye is not an ending. It’s a beginning. It’s all about keeping that door open for future conversation … [When] you finish a conversation, you say, thank you, [and] you normally thank them for their help. If they haven’t been helpful … you thank them for their time, no matter what.
How do you keep the door open?
Keeping the door open is [saying], “Thanks so much, it was great speaking with you. I look forward to keeping in touch. Would it be okay if I shot you my contact details?” [Or] “Please let me know if you have any additional questions for me” or “I may reach out to you and have some follow-up questions” … It’s all about, what’s the next step?
Friday, May 10, 2013
If you recently graduated, you’re probably aware that you’re going to have to do something different to stand out from all the other job candidates you’ll compete against. What you lack in experience you’ll have to make up for in innovation.
Prezi is a presentation tool that has changed the way we view and create presentations. Peter Arvai, CEO and co-founder, offers the following tips for how new grads may use Prezi to get the attention of hiring managers:
1. Seek an alternative to the traditional résumé. Job seekers and human resources managers alike are over-saturated with the standard Microsoft Word template résumé. With more easy-to-use tech and design tools accessible to professionals, we’re starting to see more interesting alternatives to the paper résumé.
Prezi, which was originally adopted by people sick of PowerPoint presentations, is now adopted by job seekers using it to create “prezumés.” Part presentation, part social profile, these visual and interactive résumés are getting the attention of employers.
When Michael Dwyer was invited for an interview for a teaching position at Arcadia University, a small private university located outside Philadelphia, he used Prezi to present his job history. Now, he’s the assistant professor of media and communications at the school.
Prezi can be used for more than just résumés: After Nicole Plati had an interview with the public relations firm Borders + Gratehouse, she used the site to send a thank-you note and reiterate her interest in the company. The note helped her receive an offer with the firm.
2. Don’t just tell your job history. We’ve been trained to focus on where we’ve worked and what we’ve done in our résumés and LinkedIn profiles, but another way to stand out is to tell your unique story. Who you are is as important to employers as what you’ve done, especially if you have little job experience. After all, if you’re hired, you’ll need to mesh with the company culture.
The prezumés, as well as tools like About.me, provide you the opportunity to share more of your personality than you could with a standard résumé. Charity Temple is a multimedia producer and freelancer designer. In addition to providing all the expected info about her job history in her prezumé, Temple also included a few images and details about what she does in her spare time. Making paper models and traveling might not relate to the job she wants, but it gives employers a better sense of her personality, making her more affable and appealing as a job candidate.
3. Be active on Twitter. If you’ve used Twitter for fun, now is the time to take a more professional approach. Arvai says: “A professional and well-rounded social media presence gives potential employers greater insights into your personality and interests outside of the workplace.”
Find companies you admire or would love to work for, and follow and retweet what they’re sharing on Twitter. Also follow companies in your industry so that you stay well-informed on your field. Be aware of what you’re posting, and keep it professional. Don’t post anything you wouldn’t want a potential employer to see.