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Retention of Staff is One of the Biggest Challenges for Nurses

Posted in Nursing, Nursing Jobs, Uncategorized

Retention of Staff is One of the Biggest Challenges for Nurses

Nursing is one of the most versatile professions, and yet if you ask a disgruntled nurse why s/he is thinking about leaving nursing instead of changing specialties, the answer will more than likely be that s/he feels stuck.

In the midst of a severe nursing shortage, retention is one of the biggest challenges the nursing profession faces. In 2000, for example, it is estimated that 500,000 nurses in the U.S. were not working as nurses. They were either staying home raising children or working in other fields such as real estate, retail sales and education. If all of those nurses had been working as nurses, there would have been no shortage of nurses.

The advent of managed care in the nineties brought about so many drastic cuts and changes that resulted in some of the worst working conditions for nurses in the history of the profession.

Studies proving high nurse-to-patient ratios negatively impact patient safety and outcomes also helped convince insurance companies and facility administrators that work conditions had to improve. The unionization of the nursing workforce, helped to improve many of these situations, but much more has yet to be done.

Now Medicare has implemented stringent rules for not paying for additional patient expenses related to specific medical errors. This should be driving the point home even further that nurses need better working conditions if the quality of patient care is to improve.

The financial downturn in the past couple of years has brought many nurses back into the field, but with a shortage of over 800,000 nurses in the U.S. being predicted by 2020, retention of nurses is more important than ever.

Helping nurses to transition to new fields when they are burned out or no longer physically or emotionally capable of working in a particular area is one of the ways we can and must work to help to solve the nursing shortage.

Using older, retiring nurses as mentors for new nurses for example will keep the masses of Baby Boomers ready to retire from leaving the profession all together. The valuable resources from the wealth of knowledge and experience these nurses have to share should not be lost.

Most new grad nurses are encouraged to spend a year in basic med/surg nursing before seeking out a specialty. This helps to provide them with a broad background of experience and confidence in their skills.

However, in recent years, many more nurses have chosen (and been allowed) to go straight into a specialty. This can be very stressful for the new grad, but many times they would prefer the stress to being “bored” with a more mundane experience. A few years down the road they may live to regret this decision. More often than not, these nurses seem to be the ones who feel stuck because they are too specialized.

Some specialties naturally lend themselves to others better than others, but if you want out of the high stress of the ICU, moving into the ER isn’t necessarily going to reduce your stress. The hospital may only allow this transition however because of the skill levels involved. They may frown on losing such a technically skilled nurse to the Labor and Delivery team. And so instead of retaining the nurse, s/he decides to move on or leave nursing all together in order to reduce the amount of job related stress.

Stress is relevant, and each field of nursing has varying levels of stress. Being able to transition to another department, or to move into another field such as public health, home health or forensic nursing can afford nurses the opportunity to remain a nurse, while making the lifestyle changes necessary for their own physical and emotional health.

The nursing profession has to learn not only to think, but to live, outside the box in order to retain the nursing workforce we have as well as to attract new nurses to the profession.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and is the author/owner of TheNursingSite.com.

Nursing School Admission Requirements

Posted in Nursing, Uncategorized

Nursing School Admission Requirements

Many nursing programs require an essay on why you want to become a nurse as part of their admission requirements. Each of the requirements is scored or carries a weight which, when combined with the other requirements, will determine whether or not you get into the program, get put on the waiting list, or rejected all together. You will want your essay to stand out. Don’t just say “because I want to help people.”

Altruism is an inherent characteristic for nurses. Everyone wants to help people, and there are thousands of other jobs where you can “help people.” Don’t state the obvious.

Be creative. Was there a nurse who influenced your decision? What about that person impressed you and why? Did you learn how to give your father insulin shots? Were you a primary caregiver for your grandmother? Are you interested in research? Would you like to become a nurse educator? Do you have a desire to learn about juvenile diabetes and teach children how to control their disease? Do you have experience in the health field and are looking to expand your role?

Your essay should reflect your desire to become a nurse and to meet the challenges of the profession. Nursing is not an easy job. It is physically and emotionally exhausting. Are you sure you can do this? Tell them why you are sure. Your essay may mean the difference between getting in or being rejected.
The nursing shortage has impacted nursing schools. There is a shortage of nurse educators which means that nursing schools have a finite number of spaces for students. This often means nursing schools have long waiting lists and many qualified students are turned away each term.

The nursing shortage creates a sort of Catch-22 situation for nurse educators. Simple economics means that to meet demands, hospitals and other employers have increased salaries and benefits for nurses far above what most schools are able to pay nurse educators. Consequently, nurse educators are hard to find and to retain and schools have to turn away students.

In order to improve the process of selecting students, many schools have instituted various additional entrance requirements such as an essay. Other requirements may include specific nursing entrance exams, and previous health care experience.

Schools have found that the success rate for nursing students is enhanced when they have some previous health care experience such as becoming a CNA, working as a medical assistant or volunteering in a hospital or clinic setting.

Entrance exams which test reading and language skills as well as math and science preparation are also good indicators as to which students will stick it out, graduate and successfully pass the NCLEX.
The entrance essay gives nursing students the opportunity to seriously consider why they want to become nurses and to express this desire.

Gaining entrance into a nursing program can prove to be a competitive experience. Understanding why you want to become a nurse and being able to express that reason may be one of the most important steps you will take.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and the author/owner of TheNursingSite.com.

Are You Ready for an Online Course?

Posted in Nursing, Uncategorized

Are you ready for an online course?

Online education is a popular alternative to traditional learning. In some instances, a few on-campus sessions are required for various reasons such as an orientation, exams, or labs. For the most part, however, online programs are conducted strictly online. This affords students from all over the country or world to take a particular class in the same time period.

Not all classes or subjects lend themselves easily to an online opportunity. Much of the basic nursing education process does not. Theoretically you can learn how to give an injection, insert a Foley catheter, start an IV line, and perform a head to toe assessment from written and audiovisual materials. Would you want that nurse to start your IV?

In some instances, a video which can be played over and over may indeed be one of the best learning opportunities. However, the boards of nursing have established rules to protect the public which state that to become a nurse, the student must participate in a set number of hours of hands-on learning under the direct supervision of a qualified nurse educator.

In the future, perhaps more of the nursing theory classes will be available online and afford schools to accept more students into their programs by using their nurse educators to conduct more clinical education opportunities. Currently, online nursing programs are reserved for those advancing their education. Non-nurses must take on-campus nursing classes to become nurses.

Are you ready for online learning? Do you meet the criteria to make a good student? Here are a few things you need to consider. You may find you need to work on some in order to better prepare yourself.

  • Are you a self-starter?
  • Can you organize your life and use your time wisely?
  • Can you work independently?
  • Do you often complete tasks before they are due?
  • Are you able to figure out instructions on your own or with a little help?
  • When reading something, are you a quick reader and able to grasp concepts and meaning easily?
  • Can you work with others you have never met or don’t ever see in person?

If you require a great deal of motivation from others to get you started you may not be ready to successfully complete an online class. If you need multiple reminders or are one to procrastinate until the last minute, an online class may not be good for you either.

If you’re a social butterfly and need interactions with others to flourish, the isolation of an online class may not work well for you.

For those who are slow readers and need help to understand the concepts, an online class may not be well suited for you. And if you have to interact with others face to face, then an online learning environment will not work well either.

Online education offers students the opportunity to study at their own pace and “attend” classes in their own time frame. You can sit at you computer at 1 AM in your pajamas and take an exam, or watch or listen to a lecture. You can email your study group or group project members who may scattered all over the world and not awaken anyone.

But you do have to be motivated to sit down and focus for a set period of time. It can be easy to get distracted by friends and family, television, phone calls, etc. It isn’t like going off to class and sitting there until the bell rings.

If you think you’re ready to engage in an online learning experience to further your nursing education and career, there are many opportunities available ranging from continuing education courses, certificate programs to advanced degrees.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book, and owner/author of TheNursingSite.com

Patient Safety Threatened by Unprofessional Behavior

Posted in Nursing, Uncategorized

Patient Safety Threatened by Unprofessional Behavior

JCAHO (Joint Commission) has issued a Sentinel Alert based on findings that rude behavior undermines patient safety. The alert is an effort to change attitudes and promote safety by educating all health care professionals about the consequences and effects of their behavior with other health care professionals and with patients.

As of January 1, 2009, all JCAHO accredited facilities will be required to take action to create a code of conduct and establish a process for educating staff as well as identifying and managing unacceptable behaviors with a “zero tolerance” policy.

Accredited organizations will need to establish an education process to help health care professionals understand that although historically there has been a culture of tolerance of intimidating and disruptive behavior that this can no longer be.

According to JCAHO, these “intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, administrators and managers to seek new positions in more professional environments.”

Intimidation and disruptive behaviors includes:

  • Verbal outbursts and physical threats
  • Passive/aggressive behaviors such as refusing to perform assigned tasks or subtly exhibiting an uncooperative attitude during routine tasks
  • Refusal or reluctance to answer questions, return phone calls or pages
  • Using a condescending tone or verbiage
  • Showing an impatience with questions

Research conducted with physicians and nurses has revealed that this behavior is not rare and that administrators, pharmacists, support staff and therapists are also widely involved in demonstrating such behaviors. Furthermore, the problem is not limited to a small number who habitually exhibit such behavior. The fact that the behavior has not been stopped has eroded the professionalism across the board. This is a big factor in why nurses leave nursing.

Other factors such as fatigue, pressures from cost containment requirements and the need for improved productivity, fear of litigation, as well as highly emotional situations often contribute to these behaviors.

A survey conducted by the Institute for Safe Medication Practices found that 40% of clinicians admitted having remained quiet about or during an intimidating or disruptive episode rather than confront the offender.

All too often the offender is in a position of power. The behavior is never reported and therefore never addressed because of a fear of reprisal or of the stigma of being a “whistle blower.”

Most nurses, physicians, therapists and other health care professionals entered the field for altruistic reasons. They have a strong desire to care for and help others. Most conduct themselves in a professional manner. Those who don’t, are eroding the professionalism and creating an unhealthy and often hostile environment.

According to the JCAHO alert, individuals who exhibit immaturity, self-centeredness or defensiveness are most often guilty of these intimidating or disruptive behaviors. They often lack coping, interpersonal and conflict management skills. Staff education can help set the standards and improve these skills.

The alert further states that it is the behavior which threatens patient safety and not the person engaging in the behavior. This is an important point for all to remember. Behavior and skills can be modified.

In the interest of patient safety, JCAHO has issued the new requirements for January, 2009. These new mandates for educating staff, and reporting and addressing behaviors should help to remove the stigma and improve working conditions.

For further information see: http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_40.htm

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book, and is the owner/author of TheNursingSite.com

How Medicare Reimbursement Changes Affect Nurses

Posted in Nursing, Uncategorized

How Medicare Reimbursement Changes Affect Nurses

In August, 2007, CMS, the Centers for Medicare and Medicaid Services, instituted reimbursement rules known as a “do-not-pay list” for which they will no longer pay hospitals for extra care fees involving several preventable conditions. On October 1, 2008, that list will expand to include two additional conditions.

The original set of preventable conditions includes:

  • Falls
  • Mediastinitis (an infection which can occur after heart surgery)
  • Urinary tract infections from improper use of catheters
  • Pressure ulcers
  • Vascular infections from improper use of vascular catheters

The list also includes three items better known now as “never events.” These are:

  • Objects left in the body during surgery
  • Air embolisms
  • Blood incompatibility (transfusing the wrong blood type)

The conditions being added to this list of preventable conditions are:

  • Blood clots in the leg after knee or hip-replacement surgery
  • Complications resulting from inadequate control of blood sugar levels

Along with these new conditions, CMS is expected to expand the “never events” list to include surgical site infection resulting from certain elective procedures.

CMS had been considering seven new items, but reduced the list to only two after careful consideration of concerns raised by the AMA and hospitals that quality of patient care could be reduced significantly at a time when concerted efforts are being made to preserve and improve quality of care.

CMS has recommended to the states that they adopt similar do-not-pay categories for Medicaid reimbursement. Many private health insurance companies have implemented similar rules for reimbursement and are expected to expand them to coincide with the changes Medicare is making now.

How does all this affect nurses?

One might expect that the hospitals would “wake up” and realize that they need to have better staffing ratios and working conditions, along with staff education so that nurses can ensure patients have the quality of care needed to prevent these complications. Studies have proven that nurse to patient ratios directly affect quality of care.

Continuing education is also important. For example, there has been much said in nursing literature recently about patients in the ICU developing pressure ulcers. With all the tubes and wires, it can be difficult to rotate positions. The problem however is that many nurses believe that the patient won’t be in that state long enough to develop a decub. But pressure ulcers can develop very quickly and especially in the very debilitated.

While it may be true that a patient doesn’t stay in the ICU long enough for the ICU nurses to have to treat a pressure ulcer, that time lying on their back 24/7 has set in motion an ulcer that will need to be treated on the medical floor and probably even at home after discharge. It’s only when risk management carefully tracks the data and provides feedback and education that the ICU nurses would even know that their patients developed the decubs from their ICU care.

More staff and better staff education would seem a natural order of progression in preventing the complications that result in reimbursement losses. In reality, more often than not hospital administrators have, and will likely continue to pressure nursing administration to put the responsibility on the staff nurses to improve the care and not offer much in the way of support.

How has your facility dealt with these changes in reimbursement?

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and the owner/author of TheNursingSite.com

Nurses Don’t Need to Feel Stuck

Posted in Nursing, Travel Nursing

Nurses Don’t Need to Feel Stuck

Historically, workers hired on after high school or college at the plant, the office, the mill, the mines. etc. and worked there until they retired. This loyalty was expected and those who didn’t follow this rule were scrutinized. Typically a gold watch was the prize for years of service upon retirement.

A couple of decades ago, workers began to figure out that the power to negotiate better benefits and higher salaries was to change jobs every few years. Slowly, nurses have begun to learn this as well.

It’s still easier for many nurses to hire on at the local community hospital and work there until they retire. And no doubt, there are some perks and advantages to longevity and seniority. However, there are still far too many nurses who are unhappy in their job and underpaid because they have worked there too long.

When there is only one community hospital in your hometown and you’re a nurse, that’s generally where you work. That comfort zone is hard to break out of. But nursing offers so many more options.

Nurses often love being nurses, but they don’t like their jobs. They don’t like their boss or some co-worker(s). They don’t like the days and shifts they have to work. They always get stuck working holidays and weekends. They miss out on their children’s activities. They never seem to get a full thirty-minute meal break, much less have two-hour power lunches.

Too many nurses feel stuck. They have worked on the same unit for so long they don’t think they can do anything else. The only option is to quit; and all too often that happens.

This has created a tremendous problem in the nursing profession and it is finally beginning to be explored. A significant number of nurses are not working as nurses, and yet we are approaching a critical shortage of nurses.

Unhappy nurses and those who are burned out, present a significant patient risk. Health care has no room for apathy. Burn out is stress taken to the nth degree. Stressed out workers make mistakes.

Continuing education providers and many employers are beginning to implement better programs to assist nurses to transition to other roles and fields. Nurses who have spent their career working with adults often pine for pediatrics, but feel completely incompetent and vice versa.

ICU nurses finding themselves completely depleted of adrenalin may be looking for something a little less stressful and yet need a mentor to help them slow down in the world of med/surg nursing or even home health care.

Home health agencies have begun to discover a gold mine in bringing retired nurses back into the field. Many of these nurses retired from nursing to raise families and now in their late forties and fifties, are ready to return to the workforce, but reticent to return to the hospital floor. Agencies have developed return to nursing programs to retrain these nurses and are finding them to be terrific employees.

Travel nursing can be a great option as well. It doesn’t always mean leaving home. If you live in or close to a large metropolitan area, you can explore the assignment opportunities at a hospital across town. Certain mileage restrictions apply, and high prices of gasoline can be an issue. However, living in your own home, you may receive a stipend for housing that you can apply to you gasoline costs.

If it’s time for a change in your career, don’t burn out. Move on!

By Kathy Quan RN BSN
Kathy is the author of The Everything New Nurse Book, and the owner/author of TheNursingSite.com.

The Nurse Practice Act

Posted in Nursing, Travel Nursing, Uncategorized

The Nurse Practice Act

Have you read your Nurse Practice Act lately? Do you understand your Scope of Practice? The Nurse Practice Act is a set of laws which protect the public from harm. It defines the formal education needed for a particular level of nurse and sets the regulations for licensure.

Click here for info on YOUR STATE’S nurse practice act.

The NPA defines the nurse’s scope of practice based on the content of the formal education and level of nurse. It is different for an RN and an LPN/LVN. It is also different for a Nurse Pratitioner.

Know Your Scope of Practice
The Scope of Practice defines your role as a nurse for the locality where you are presently practicing. This can vary from one state or province to another. If you are a travel nurse, or are moving to a new state, you need to read and familiarize yourself with the NPA and Scope of Practice for that state or province before you begin work.

You may not use the excuse that you aren’t familiar with your scope of practice as it is part of your role as a nurse to know and understand it. The NPA and scope of practice can be changed as education requirements change. Read your NPA often and stay abreast of changes in your state or province.

Take note that just because you acquire a set of skills or knowledge base from experience or observation in the course of your job, it does not mean you may perform them without certain limitations. In addition to your NPA you also need to be familiar with your present job description and the rules of your facility.

For example, the NPA may state that RNs can give IV push medications, but if your facility says that all IV push medications are to be given only by a certain level RN or even a physician, then you are not allowed to give that medication if you don’t meet the criteria set by the facility.

Each state board of nursing in the U.S. develops the NPA for that state. You can find a link to each state’s board of nursing here.

Don’t Overstep Your Scope
You are also responsible not to overstep your scope of practice regardless of what your employer may ask of you. This can be especially important if you don’t work in a traditional healthcare setting. Even within a healthcare setting, employers are notorious for asking nurses to stretch beyond their scope of practice to perform duties which can be questionable. Your responsibility as a nurse is to protect the safety of your patients.

DO NO HARM
New nurses in particular can often be intimidated into performing skills that they have not performed before, or not been checked off on, because the unit is short staffed and there isn’t time to find a preceptor or supervisor to help you with the procedure. This is really unacceptable and nurses need to remember the first rule of all healthcare, DO NO HARM. Don’t perform something you have never done before without appropriate supervision!

If you are a travel nurse and your skills need to be checked off before you are able to perform a procedure independently be sure you do so.

By Kathy Quan RN BSN
Kathy is the author of The Everything New Nurse Book and author/owner of TheNursingSite.com.

Do You Love Nursing and Hate Your Job?

Posted in Nursing, Nursing Jobs, Uncategorized

Do you love nursing and hate your job?

Most nurses will tell you that they love being a nurse, but they don’t like their job. Being a nurse is never easy. No one ever said it was going to be. It can be one of the most rewarding and yet physically and emotionally draining professions.

Then add in the fact that there is shortage of nurses so you’re bound to be overworked and inevitably underpaid. So what can you do if you don’t like your job? Try a new one, or change something about your job that makes it better for you.

Change is never an easy thing to live through. The degree of change will directly affect the degree of difficulty. So sometimes just a little change is all you can handle. However, sometimes a big change is what you really need. Avoiding change is not the answer.

Deciding what and how to change things can be frustrating and all too often, nurses just give up all together and leave the nursing profession. This happens most often when the nurse is completely burned out. S/he has nothing more to give and has no energy to focus on what to do and how to make things better.

Before you get to this point, stop and take care of you! Nurses are great at teaching others how to care for themselves, but they don’t listen to their own advise. You have to put yourself first and take care of you so that you can continue to take care of others.

You must do something everyday to replenish yourself. Take fifteen minutes to do something just for you. If that means locking yourself in the bathroom with a good book, a piece of chocolate cake, some knitting, crochet or other needlework, or just a few minutes of piece and quiet; just do it. Soak in the tub, or give yourself a facial. Or just sit and take deep cleansing breaths.

Men seem to be natural at doing this regularly. They often burn off their frustrations shooting some hoops or lifting weights. Exercise is a great way to leave your frustrations behind you. A run or a brisk walk can do wonders for anyone’s spirit. Whatever you do to make a little time for yourself, do it regularly and look forward to it each day. Reward yourself.

You may find that you like your job after all. If not, you’ll be better able to focus on what you need to do about it. Begin by making a list of the things you like about your job (if anything) and then the things you don’t like.

See if you can focus in on what it is that you need to change. Look at the things on your list. Is it the people you don’t like? Or one person in particular? Is it the days or the hours? Is it the kind of patients? Is it the setting? Is it the money?

All of these things you can change. Some you may be able to change more readily than you think. But do something about it. The longer you stick it out, the more unhappy and frustrated you’re going to be.

The nursing shortage works in your favor because you have options. A transfer to another department may not be easy because your boss will probably try to block it and not lose your warm body. But talk to him/her and explain your frustrations. Perhaps a trade can be made with another unit for someone who’s unhappy there.

If the main problem is your boss, you can always say that you’re burned out and you need a change. You don’t have to point fingers. That’s not going to change things. You are the one who needs a change and you’re asking for his/her help to do it.

Sometimes you may have to quit the job outright and find another. The beauty of the nursing profession is that it offers so many choices. Don’t let yourself believe that you’re stuck! Try something new. Browse choices here.

By Kathy Quan RN BSN
Kathy is the author of The Everything New Nurse Book and author/owner of TheNursingSite.com.

The New Kid on the Block

Posted in Nursing, Travel Nursing

Are you the new kid on the block?

Whether you’re a travel nurse starting your first or a new assignment, a new nurse grad, a float nurse, or you’re starting a new job, being the newest nurse on a unit can be intimidating.

A smile and a positive attitude go a long way in breaking the ice and starting off with a good impression. Take the lead and introduce yourself. Shake hands if appropriate. Remember this is not always acceptable for cultural reasons, for the germaphobe and for those who don’t like having their space invaded. But offering a hand even when not taken can be seen as a warm gesture.

There will almost always be at least one nurse who is cold and indifferent. The one who resents you being there for whatever the reason. Typically this is because the travel nurse makes more money, a new grad knows nothing, a float nurse will take no responsibility, or a new nurse threatens her territory. Sometimes you can melt the ice and other times you just have to let this person be and stay out of her way.

Your presence on this unit represents a double-edged sword. They obviously need your warm body, but they fear being burdened by a newbie who needs extra help. You can help to ease this situation by first recognizing this dilemma and then dispelling their fears by showing that you are here to help and not to be a burden.

Arrive early and be prepared. Bring your lunch, snack foods and a water bottle. Don’t bring all of your valuables and expect to have a safe place to put them. Lock them in the trunk of your car or leave them at home. Your essential licenses, ID and a few dollars can fit easily in a small pouch or wallet that fits in your pocket.

Make sure you have pens and your own stethoscope. A small notebook or PDA will show that you’re organized and ready to take a few notes. Ask for a quick tour of the unit and make note of where things are such as the linens, the kitchen, the med carts, the crash cart, the charts, and general layout of the unit. Then as you have time, explore these areas and familiarize yourself with the unit.

Hospitals sometimes divide floors into units with no clear delineation. Patients and visitors are often confused and go to the wrong nurse’s station. If you have a list of room numbers that belong to your unit, you’ll be able to sort it out more easily.

Observe the staff and learn about the “culture” of this group. Do they work together as a team? Do they all get along? Or do they all just do their job and not interact unless absolutely necessary? Who are the natural leaders? Who are the trouble makers?

Get your own work done and if you have time, offer to help others. If you have to ask for help with something, come prepared to return the favor. Remember that when a nurse has to stop and help you, his own assignment will be impacted.

Finally, don’t engage in gossip. You will hear plenty. Listen politely and go about your business. If co-workers pressure you to comment or take sides, just say you understand their positions, but you’re too new to have an opinion and get back to work.

By Kathy Quan RN BSN.
Kathy is the author of The Everything New Nurse Book and the author/owner of TheNursingSite.com.

Is Organization on Your Skills List?

Posted in Nursing, Travel Nursing

Is organization on your skills list?

Organization is an essential skill for nurses. Whether you are planning out your day, providing patient education or preparing to call a physician about a patient, having “all your ducks in a row” is of extreme importance.

Yes, many nurses are not organized and somehow they do manage to get through the day, but their stress levels are usually quite high. Taking the time to make sure you have dotted all the i’s and crossed all the t’s the first time around can save you a lot of heartache and frustration.

For example, you know that whenever you have to call a physician, he’s going to want more information. If all you can say is that your patient is still having pain after one dose of Tylenol #3 (acetaminophen with 30 mg. codeine), you’re going to be bombarded with questions.

If you’re prepared and provide the physician with a complete report of recent vital signs and a list of other pain measures you’ve tried along with a complete pain assessment, you’re likely to have an easier time requesting a repeat dose or additional medication.

When completing your charting, if you have a list of notes to review, chances are that your documentation will go faster and be complete and accurate.

In addition to your daily routine, keeping track of your professional information is important too. Learn to organize these items. A small file box or even a shoe box can be an easy way to keep track of this information. Make copies of your license(s). Put reminders on your calendar about renewals. Create a file for your ceu information and certificates. Keep a copy of your skills list and resume in a file and review/update them quarterly. Include any new skills, education, and experience you have gained.

You can and should also have electronic copies of all of this information. Scan paper copies such as licenses and certificates. Keep this information updated and accessible on your computer. Add a password to the file if necessary. You can also copy these files onto a CD which can be password protected as well. Put a copy in a safe deposit box or other safe place.

If you are a travel nurse, you will need access to this information often. Keeping it all together in one place will assist you in applying for new assignments efficiently. If you have access to both hard copies as well as electronic copies (i.e. .pdf or .doc files) of your information you will have options for emailing or FAXING the information quickly.

Keeping your CV or resume updated can be very rewarding. You never know when someone will ask for it and offer you an exciting opportunity. If you have to stop and create one, you might lose out.

While you’re at it, be sure to include organization to your skills list as well as your computer skills and proficiency with various software.

By Kathy Quan RN BSN.
Kathy is the author of The Everything New Nurse Book and author/owner of TheNursingSite.com

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