Monday, September 24, 2018

Day Shift vs. Night Shift: A Consistent Nursing Dilemma

As a career coach for nurses, I receive a lot of questions and complaints about nursing careers, and one of the most contentious and confusing issues for many nurses is whether to work days or nights. Perhaps you, dear Reader, have experienced such confusion yourself.

Days vs. nights is an old nursing puzzle that so many nurses face: Do I work nights and get the differential while ruining my social life, or do I work days and run my tail off when the residents, surgeons, NPs, and doctors are on hand all day to send me running with new orders and admissions?

When I was decided to go to nursing school, my wife was very supportive but she issued one warning: I could never work nights, and I promised her I never would. So, 22 years later, I've fulfilled my promise to the letter.

In the end, days vs. nights is the nursing conundrum that never gets old.

day and night

Monday, September 17, 2018

Nurse, Throw Your Hat Over the Wall

In your nursing career, have you ever wanted to get something done but never had the gumption to make the commitment and just do it? Well, there's an old Irish proverb that says, "When you come upon a wall, throw your hat over it and then go and get your hat."

In the context of your nursing career, I like to think of this saying in terms of you putting some skin in the game and making a commitment to do what needs to be done, no matter what obstacles may appear to be in your way. What are you avoiding? What are you waiting for? Is there a deep end you just need to dive into?

throw your hat in the air

The Deep End

Many of us have a history of playing it safe in our lives in one way or another. Maybe you went to college right out of high school because it was what you were expected to do, even though it went against every fiber of your being to do so. (This is my story, for sure.) Or maybe you're too scared to pursue a nursing certification because you can't make up your mind whether it's a good idea or not.

the deep end of the pool

As a child, I hope you weren't aggressively thrown into the deep end by your father so that you could have the chance to either sink or swim -- that's generally a cruel thing to do to an innocent and frightened kid. However, now you're an adult with a very grown up career in nursing, many responsibilities, and important decisions to make at every juncture of your professional and personal lives. Avoidance won't cut it in the long run, so is there a proverbial deep end you need to dive into?

Your deep end may be graduate school (also my story!), a certification, starting your own business (this used to be my story), applying for a promotion, or asking for a raise. You may be scared to death of having your first patient on a vent, or maybe it's your first shift as charge nurse and you feel like a total impostor and phony. Whatever it may be, sometimes the best recourse is to take a deep breath, plug your nose, and jump.

Throw Your Hat

Let's say you have some interest in computers and software, but you know there's a lot more to learn. You're afraid to be seen as incompetent or not tech-savvy enough, especially because you're a Millennial who's not as comfortable with tech as some of your generational peers who can seemingly navigate any tech issue without a trace of stress.

To continue the story, let's also say that your nurse manager asks for volunteers for a program to create a small army of EMR super-users in your facility. Your first thought is that you'll be found to be an impostor and that you should avoid that program at all costs. On the other hand, you realize that you could simply raise your hand and volunteer before your better judgment kicks in -- this is a prime example of throwing your hat over the wall and then going after your hat.

Several months ago, I was contacted by a very large law firm here in New Mexico who wanted to hire me to present a workshop for lawyers on the savvy used of LinkedIn. Now, I know absolutely nothing about the world of attorneys, but I knew that this gig could open some interesting doors. Despite my misgivings and fear, I just said yes when they asked if I could deliver what they were asking for. I had to work very hard to educate myself about what lawyers need to know about LinkedIn -- it was a learning curve that took me out of my comfort zone, but I'm glad I did it, and I can now chalk that one up to experience.

My friend and colleague Donna Cardillo, one of the most successful nurse entrepreneurs in the world, has told many stories about the ways in which she has thrown her hat over the wall on numerous occasions. Donna's modus operandi is just say yes and ask questions later, including figuring out how to do what she already said she was fully capable of -- scary, isn't it?

For you, simply going to nursing school may have been a matter of throwing your hat over the wall and then chasing it. Perhaps you never felt qualified to be a nurse and you figured they just made a mistake when accepting you. Your fear may have held you back from taking initiative for a very long time. In fact, your fear may still be holding you back in this very moment.

How many times in our lives do we just decide to do something despite our fear and perceived limitations? How often do we hide our light under a bushel and stay in the shadows? In your nursing career, I can guarantee that nothing very exciting will happen when you do this. The nurses who do cool things are doing so because they took risks -- where can you take a risk right now, personally or professionally?

Hiding Your Light

When your light is bright, you're visible, approachable, and owning who you are and what you're all about. When your light is hidden away, people can't see who you truly are, and your talents and skills are remain obscure and in the shadows.

Don't hide your light
Photo by Julia Florczak on Unsplash
In your nursing career, the last thing you need is to make yourself invisible. You may feel the need to do so, but in the big picture, you want to be seen, heard, valued, and understood -- this takes a willingness to demonstrate your passions, your strengths, and your failings and foibles.

Being vulnerable certainly opens you up to criticism, but staying small doesn't necessarily serve your goals and what you're wanting out of your career. Do the people who keep themselves small get recommended for a promotion? Are people who hide their light away seen as natural leaders? Is the person sitting in the corner not voicing their opinion going to be asked for their thoughts? In all of these scenarios, the answer is by and large no -- those who hide away will stay hidden until they step out of the shadows and own who they are.

Playing Full On

At this point, I want you to ask yourself some questions:
  • Is there is a wall I failed to throw my hat over? 
  • Have I shrunk from an opportunity and played it safe when I could have taken a risk? 
  • Where in my nursing career do I keep my light hidden away? 
  • Am I not allowing certain aspects of my professional self to be seen? 
  • Where and how do I need to step out of the shadows? 
Depending on your answers, you may have some major personal work to do in terms of your self-confidence as a professional, or maybe you've realized that you already play full on in your career and you're going for it in a really big way.

Here's something to do:
  • Decide where you are in terms of owning and maturing into your professionalism and expertise
  • Choose an area where you've been keeping your light hidden and haven't been challenging yourself 
  • Create a conscious plan to bring more of that hidden part of yourself into the light of day
  • Find a friend, colleague, or family member who can act as your accountability buddy regarding your goal(s)
  • Check in on a regular basis about how you're doing
Playing full on is a choice and it doesn't necessarily happen overnight, especially if you've been keeping things hidden away in the shadows. Be patient, kind, and compassionate with yourself. Set goals that are measurable, realistic, relevant, and time-dependent. Assess your progress regularly. Rinse and repeat.

When you throw your hat over the wall, you're taking a calculated risk. Take the risks that make sense for you, your career, and the life you want to lead. You'll know when you're on the mark and stepping up to the plate in profound and important ways.

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Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.

Keith is the host of The Nurse Keith Show, his solo podcast focused on career advice and inspiration for nurses. From 2012 until its sunset in 2017, Keith co-hosted RNFMRadio, a groundbreaking nursing podcast.

As of May of 2018, Keith is the host of Mastering Nursing, an interview-style podcast showcasing inspiring, forward-thinking nurse thought leaders and innovators. 

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the  nursing profession. Keith has written for Nurse.com, Nurse.org, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog, NursingCE.com, American Nurse Today, Working Nurse Magazine, and other online and print publications.


Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality, social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives, and his adorable and remarkably intelligent cat, George.

Monday, September 10, 2018

Are You a Nurse Job Hopper?

Nurses leave jobs for innumerable reasons, and sometimes circumstances cause those of us in healthcare and nursing to only stay at a string of positions for relatively short periods. Job-hopping has generally been frowned upon in human resources circles, but generational changes and new attitudes about work and careers are slowly altering the landscape. However, job-hopping continues to have its ups and downs, and being a nurse job-hopper still comes with significant career liability.

Rabbit in tall grass
Photo by Gary Bendig on Unsplash

Monday, September 03, 2018

Six Reasons to Love Millennial Nurses

The Millennial generation (those born between approximately 1980 and 2000) are the new majority in the 21st-century workforce (see this Pew research study identifying this cohort as 35% of the overall workforce), and Millennial nurses are on their way to dominating the nursing profession.

As one generation wanes and the other rises, power changes hands, and this is happening at this very moment as Generation X and the Baby Boomers reach retirement age and leave the workforce in droves.

Every generation is disparaged and criticized by the generations that came before, and Millennials are no exception. However, I hypothesize that the Millennial generation is going to positively transform nursing, medicine, and healthcare for the better, not to mention society at large.

(Please note: writing about any generation as a whole is potentially problematic due to the fact that generalizations must be made. My apologies in advance for any statements that don't quite apply to everyone -- this is simply an attempt to capture observations of the power and potential that this enormously influential generation holds in its collective hands.)

Young Millennial woman
Photo by William Stitt on Unsplash

Monday, August 27, 2018

Your Nursing Career and The Skill of Writing

When we think of the skills that make a nurse a nurse, writing is not the first one that may come to mind. PICC lines, wound care, ventilators, IVs, and physical assessment are the kinds of things we think of, but the power of the pen, as it were, is definitely not in the running (except, of course, for basic nursing documentation). However, I'll posit that writing is a skill that can serve your nursing career in both mundane and powerful ways throughout the years. What's your level of skill as a writer, and do you want to improve?

writing
Photo by Thought Catalog on Unsplash

Monday, August 20, 2018

Words as a Barometer of Your Nursing Career

At no matter what point you find yourself in your nursing career, the words you use are powerful. How you talk to your patients and colleagues says a lot about you, and how you talk about your career, your work, and your life says even more. And we also need to consider how you talk to yourself. Are you choosing words that are empowering, positive, and indicative of your passion, expertise, and professionalism? Or are you stuck in a negative and defeatist loop?

We all have bad days, and we also need to be careful when we're at risk of falling into negative language traps that paint us into corners filled with bad feelings, resentment, and negativity -- all of which can contribute to burnout and compassion fatigue.

What words do you choose when it comes to your nursing career and your work as a healthcare professional? Even if things are bad, can you reframe your experience and find ways to see it in a different light?

passion led us here
Photo by Ian Schneider on Unsplash

Monday, August 13, 2018

Your Nursing Job: The Same Old Bed of Nails or a Comfortable Old Shoe?

Some of us have nursing jobs that are feel like a bed of nails, and some of us nurses have jobs that feel like comfortable old shoes. Have you ever fallen into either of these categories in terms of your work experience as a nurse? I posit that either one can be detrimental to your career in the long run.


Monday, August 06, 2018

Defining Nursing Career Success on Your Own Terms

Every nurse and healthcare professional has the opportunity to define success in their own way. However, how many of us allow our nursing careers to be defined by someone else. How can we seize control of our careers and define success on our own terms?

How do you define nursing career success?
Photo by Jamie Street on Unsplash

Monday, July 30, 2018

Making the Case For Your Nursing Expertise

In nursing job interviews and other high-stakes career-related interactions, it's your responsibility to make the case for why you're an amazing nurse and the perfect fit for a particular position or healthcare organization. How do you make the case for who you are and what you bring to the table?

Make the case for who you are

Monday, July 23, 2018

When Nurses Receive Their Due

Most nurses will readily admit that they didn't choose nursing because of the astronomically high paychecks. Sure, nursing can be a relatively remunerative career, but there are plenty of other professions that are significantly more financially rewarding (and free of some of the challenges that nurses face on a daily basis). So, what if nurses were paid a whole lot more in exchange for saving ---and otherwise improving---the lives of a grateful public?

money
Photo by Thought Catalog on Unsplash

Monday, July 16, 2018

Nurse, What's Your Personal or Professional "Everest"?


Speaking with a nurse colleague the other day, she was referring to something she’s attempting to do in her life outside of nursing as her “personal Everest”. These types of endeavors can be scary, and they can cause you to question yourself along the way. Is there something you want to conquer or master, either personally or professionally? Is there something in your sights that you just can’t let go of until you do it? 

When George Mallory was asked why he was going to attempt to summit Everest, he allegedly said, “Because it’s there”. Whatever it is you want to do, I bet you have a better reason that that. Can you find it?

climbing a mountain
Photo by Jackson Hendry on Unsplash

Monday, July 09, 2018

APRNs and 21st-Century American Healthcare

Advanced Practice Registered Nurses (APRNs) are an increasingly important fixture within the 21st-century American healthcare system and nursing profession. Full practice authority is a central key to APRNs’ ability to fulfill the needs of the American public, and it’s time for such authority to be granted nationwide.

Nurse practitioner

Monday, July 02, 2018

Should I Quit This Darn Nursing Job?

Have you ever wondered when it's time to quit your nursing job and move on? Are you stuck in a job, uncertain where to go next as a nurse? Or do you just need a change of scenery? It's all about timing, self-care, finances, lifestyle and workstyle, career development, and other factors that impact how long you stay and when (and why) you go.

Exit
Photo by Bernard Hermant on Unsplash

Monday, June 25, 2018

Nurses: Come Out of the Woodwork

Although Nurses Week is long over, the public face of nursing still needs a regular shot in the arm so that the public knows what nurses actually do. As nurses, do we describe our work in a way that gets the point across? Does the public know that we're more than the media makes us out to be?

come out of the woodwork
Photo by Dmitry Ratushny on Unsplash

Monday, June 18, 2018

The Tapestry of Nurse Collaboration

Collaboration among nurses and other healthcare professionals is central to the delivery of patient care. According to Merriam Webster's online dictionary, collaborate is defined "to work jointly with others or together especially in an intellectual endeavor". This particular definition is perfect for our purposes where the work of nurses is concerned.




Monday, June 11, 2018

Non-Traditional Nursing Careers: Where There Is No Box

Ask just about anyone what a nurse does and where a nurse works, and the general response is, "Oh, she works in a hospital." Apropos of that statement, when I tell someone I'm a nurse, they generally say, "So, do you work at the hospital?" I have nothing against hospital nursing, but there's more to our profession than meets the eye, and many of us are waking up to the multiplicity of non-traditional opportunities just waiting to be grasped by the savvy nurse.

Monday, June 04, 2018

Nurses, the Best Selfie is Internal

At a time in history when "selfies" are dominant in the depiction of our lives (and the potential measurement of our worth), the most important selfie for a nurse to take is on the inside, not the outside.

Selfies are part of our 21st-century culture, and there's no denying their popularity. In essence, it's our way of presenting a self-portrait to the world just like Van Gogh or Rembrandt would, except we can  effortlessly make dozens per day that can potentially be seen by hundreds or thousands of people. 

We have the habit of posting photos of ourselves having dinner with friends, walking on the beach with our dog, or relaxing on the hammock with a book and a glass of wine. In terms of our personal development and how we see ourselves as nurses and human beings, what if we shifted to taking "selfies" of what's going on inside of us? Rather than focusing on the outward appearances of our lives and careers, what if we delved more deeply into our motivations, fears, and joys? What if that which made us tick -- rather than the brightness of our smile or our curated life -- became the measure of our lives as nurses, human beings, and citizens?

more than just selfies
Photo by rawpixel on Unsplash

Monday, May 28, 2018

New Grad Nurse Confidence: Stoking the Flame

Graduating from nursing school and becoming a new nurse is a remarkable accomplishment that can generate excitement, fear and loathing, anxiety, joy, and all manner of both positive and negative emotions.

With new nurses abandoning their nursing careers within the first 1-3 years at alarming rates, the nursing profession itself needs to wake up and smell the coffee regarding how crucial it is to support, nurture, and grow our new nurses into seasoned and confident professionals.

New grads need to pass the NCLEX, of course, and when that hurdle is accomplished, landing and starting a first nursing job is the order of the day. Where does new grad self-confidence come from, and how is it inspired and retained for the long haul?

New grad nurse
Photo by Ani Kolleshi on Unsplash

Monday, May 21, 2018

Build a Firewall Against Negative Nurse Syndrome

As nurses, we see the good, the bad, and the ugly of life, society, and humanity. In the course of our nursing careers, we can encounter belligerent patients, impatient families, nurse bullies, arrogant surgeons, uncaring managers, and generally miserable nurse peers. So how do we stay positive amidst such negativity? How do we protect ourselves against those who would prefer to drag us down with them -- including other nurses?

Watch your mouth -- words matter
Photo by Makhmutova Dina on Unsplash

Monday, May 14, 2018

Your Nursing Career: Attention and Intention

As a career coach for nurses, I frequently hear from nurses who feel they've been ignoring their own nursing career development for far too long and they're ready to give it the attention it deserves. Do you regularly give your nursing career focused intention and attention? If not, how can you begin?

Photo by Olloweb Solutions on Unsplash

Monday, May 07, 2018

Change, Personal Agency, and Wellness -- Celebrating Nurses Week 2018

As Nurses Week begins, what does the idea of nurses and nursing conjure for the majority of people when they think about nurses? Obviously, the public trusts us immensely (the Gallup Poll confirms that every year), so there's a lot behind who we nurses are and why we're so special.

Photo by Aditya Romansa on Unsplash

Monday, April 30, 2018

Nurses Take DC 2018: Nurses' Voices Matter

On Thursday, April 26th, 2018, I had the distinct privilege and pleasure of speaking in front of the United States Capitol Building at the annual Nurses Take DC Rally for Nurse-Patient Ratios. With the iconic Capitol dome in the background and the Washington Monument directly in front of me as I spoke to hundreds of fired up nurses, it was a powerful moment for me as a nurse and as a motivational public speaker.


Monday, April 16, 2018

Your Nursing Career's Differential Diagnosis

In medicine, nursing, and healthcare, a differential diagnosis refers to the process of differentiating between two or more conditions sharing similar signs and symptoms. In the context of your nursing career, this process can be equally elucidating. Is there a careful career examination in your future? If so, what would your differential diagnosis be?

your nursing career's differential diagnosis
Photo by rawpixel.com on Unsplash

Monday, April 09, 2018

Nurses: Moving at the Speed of Trust

Seeking a career in nursing could be characterized as an exercise in trust. We nurses willingly endure a grueling educational experience; place ourselves in the hands of nursing professors and professional nurse preceptors; and otherwise trust that the blood, sweat, tears, and expense of pursuing our goal is worthwhile. In essence, we move at the speed of trust as we enter the universe of a nursing career.

moving at the speed of trust
Photo by Alternate Skate on Unsplash

Monday, April 02, 2018

Nurse Innovators and Trailblazers: An Embarrassment of Riches

I recently spoke with a nurse career coaching client who's thoughtfully searching for what she should do next with her nursing career in order to more fully reach her potential as a healthcare professional.

As I've previously discussed on both this blog and my podcast, the sky's the limit in terms of what nurses are capable of, even though nursing schools (and by extension many of your nursing colleagues) will lead you to believe that acute care is the only place where "real" nurses choose to make their professional nest.

Photo by Riccardo Annandale on Unsplash

Monday, March 26, 2018

Nurse Bullies: A Plague On Our House

Sadly, there appears to be a desperate need for a continued conversation about bullying within the nursing profession. One would hope that the dawning of the 21st century would have seen a decline in such old school behaviors, but there are obviously those among us who haven't yet learned the lesson that collaboration and cooperation are the true keys to success.

bullying definition

Monday, March 19, 2018

A Shot of Nursing Self-Esteem

Do you hold yourself and your nursing skills in high esteem? Do you internalize and embody your value as a nurse? If not, it's high time that you did.

a shot of self esteem

Monday, March 12, 2018

Escape Velocity

There are many of us who desire change during the course of our nursing careers, but change can be hard to manifest for a variety of reasons: boredom, ennui, limiting beliefs, lack of imagination, low self-esteem, difficult life circumstances, finances, burnout, or perhaps a rut so deep that we can't dig ourselves out.

In order to break free of the earth's gravitational field, a rocket must reach 25,020 miles per hour. Is your needed escape velocity equally daunting? If you were to gain the momentum needed to make a change, what is the escape velocity you would need to actually make it happen?

Monday, March 05, 2018

A Soft Landing for New Nurses

In speaking with large numbers of new nurses over the years, I consistently hear that novice nurses are not often given the guidance, nurturing, and mentoring that they truly need to move from surviving to thriving in their new nursing careers. New nurses need a "soft landing" as they enter the field, and it's up to us seasoned nurses to make sure they get it.

a soft landing for new nurses
Photo by Alex Lehner on Unsplash

Monday, February 26, 2018

A Message to the Nurse's Future Self

So nurse, it's twenty years in the future, and you have two more decades of nursing under your belt. You've cared for thousands of patients, held thousands of hands, and looked into thousands of pairs of eyes. What do you remember, and what do your patients recall? What stands out for you? How does your career compare to your expectations, dreams and aspirations? How would you like that 20 years to live in your mind and heart? You can create it now.

The road to your nursing career future

Monday, February 19, 2018

Common Questions About Nurse Entrepreneurship

Nurse entrepreneurship is exploding in the 21st century, and many nurses ask me for advice about nursing-based business. So, let's dig into some of the most common questions that nurses have about potentially launching a business or entrepreneurial endeavor.

nurse entrepreneur
Photo by Josefa nDiaz on Unsplash.com

Monday, February 12, 2018

Nursing Trends and the ANA, Part 2 of 2

One of the premier nursing organizations gathering information about nurses is the American Nurses Association (ANA). In my previous post, we delved into the results of a 2017 ANA survey based on responses from approximately 6,000 nurses. Today we're going to dive back in for part 2 of our 2-part series.

Nursing trends 2018


Monday, February 05, 2018

Nursing Trends and the ANA -- Part 1 of 2

In the November and December 2017 issues of American Nurse Today, the ANA revealed the results of a survey of almost 6,000 nurses. This nursing survey explored the state of the profession in relation to trends in nursing salaries, the makeup of the nurse clinician workforce, and workplace culture and environment. Let's explore some of what they found -- we'll explore more in next week's blog post.

nursing salaries and trends

Monday, January 29, 2018

Hispanic Nurses On Fire

I recently spent an incredibly inspiring and powerful weekend with 100 Latino nurse leaders who gathered in San Antonio, Texas for the inaugural National Association of Hispanic Nurses Leadership Institute. This spirited group of forward thinking nurses of all ages clearly demonstrates that unity, organizing, critical thinking, and planning for the future are part and parcel of enlightened 21st-century nurse leadership.


Monday, January 22, 2018

Letting Your Nursing Career Magic Out of the Hat

Nurses, do you need some magic to get your nursing career back on track? Career development for nurses isn't rocket science, but manifesting some magic and joy for the betterment of your career is certainly possible if you want it. Is it time to let the rabbit out of the hat?

Career Magic

Monday, January 15, 2018

Nurses, Gallup, and Amplifying Your Voice

Well folks, nurses did it again. According to the newly released Gallup poll, we're still the most trusted professionals in the United States! Let's face it - the nursing profession rocks.

Gallup poll - nurses are #1

Monday, January 08, 2018

Overcoming Mission Drift in Your Nursing Career

Has your nursing career drifted off course? Do you feel that your current career path isn't aligned with your personal or professional mission? You're not alone, and there's something you can do about it.

adrift at sea

Tuesday, January 02, 2018

The BSN Requirement -- A Legislative Sea Change

Do you believe that nurses should be required by the government to have a BSN? Well, the tide is turning and a massive sea change is inexorably underway since New York State Governor Andrew Cuomo signed such legislation into law on December 19th, 2017. It's called "BSN in 10", and the consequences will be widely felt by the nursing profession in the wake of this controversial move that was 14 years in the making.

BSN in 10?