Saturday, December 31, 2011

Nurse Keith Coaching is Born!

In the last few days, my new website and coaching venture was officially birthed! Nurse Keith Coaching is now live, and the process of making it a reality has paid off! There has been a great deal of support from my community of friends, family and colleagues. Now the task is spreading the word that I am now available to provide professional coaching for nurses and nursing students who want more out of their lives and their careers.

As I say on my website:

As nurses, we spend a great deal of time caring for others and precious little time caring for ourselves. Our work can be all consuming, and in that process we can easily lose touch with our own health, happiness, and sense of balance. Toxic workplaces, heavy workloads, stressful work conditions, mandatory overtime and unhappy, cynical colleagues can all leave us feeling undermined in our attempts to be healthy and happy in our work and at home. 

Nurses are caregivers, but we can only provide the best care when we are also taking care of ourselves properly. Exercise, nutrition, weight loss, stress management, leisure and fun, work-life balance, spirituality, financial prudence, relationships—all of these aspects of our lives impact our ability to be at our best when we engage in our work. 

My skills allow me to hold space for where you currently are in your life, but also to challenge you to dig deeper and find the places where you still want to grow. 

So, please stop by, visit and "Like" my Facebook page, and let me know how I might be of service to you. 

Tuesday, December 27, 2011

Nursing and Transformation in the New Year

As the dawn of 2012 beckons, I hold a new vision for the nursing profession.

Along with the rest of large segments of humanity, nurses are waking up. Nurses are realizing that the old paradigms no longer apply, and that the vestiges of Old World thinking (when it comes to nursing and medicine) are dying as we speak. Health care must be transformed, and since nurses are the largest segment of the American health care industry (and perhaps in the world), we nurses could indeed "occupy" health care in a way that could potentially turn the entire industry on its head. The political will of nurses will be tested, and I am encouraged by the rumblings that I hear as I put my ear to the virtual tracks.

Contrary to popular images propagated by the media (in Hollywood, television, the news, and other sources), nurses are not handmaidens to doctors, sex kittens in white uniforms, or background characters who simply serve as foils to George Clooney and other TV doctors. (Although we may notice on close inspection that only actors who play doctors on shows such as "ER" ever seem to move into the limelight.)  Nurses are more than this, whether the media wish to portray us realistically or not.

As usual, nurses have ranked as the most trusted professionals in the United States yet again in the most recent Gallup poll. This is the 12th time out of 13 years that nurses have earned this honor from the American people. The only occasion when nurses were not the number one most trusted professionals was in 2001 when firefighters earned that top spot following their heroic efforts in the aftermath of the September 11th terrorist attacks.

From my own perspective, one way for nurses to be more effective is to be more vigilant in their own self care. That's why I have decided to offer my own coaching services for nurses to assist them in living the healthiest and most satisfying lives possible. Nurses can impact the health care industry when they are healthy and balanced. Thus, preventing burnout and adopting a healthy lifestyle can have a far reaching impact on patients, fellow nurses, other colleagues, and beyond.

I am proud to be a nurse, and I can see that the nursing industry is still in it infancy when it comes to embracing change, championing that change, and subverting the dominant paradigms that keep nurses and nursing care relegated to the past rather than focused on the future. Still, I'm hopeful, optimistic and looking forward to the ways in which nursing---and the world at large---will transform in 2012. These are momentous times, and we have only seen the tip of the iceberg as Americans---and people all over the world---wake up to the many disparities that are crying out for transformation. Nurses can lead the way in health care, and I hope to be part of the actions and conversations that bring that transformation into being.

Wednesday, December 21, 2011

RN.FM Radio is Coming!

On January 9th, 2012, several esteemed nurse entrepreneurs and I will officially launch RN.FM Radio: Nursing Unleashed, a new internet radio station on Blog Talk Radio!
Our mission is to shake up the nursing profession and blow the roof off of the idea of a nurse as just a humble bedside servant. We're here to prove that you can be a nurse, be ultra-savvy and innovative, make a huge difference in patients' and other healthcare providers' lives, and improve your own life and experience of the profession of nursing, all at the same time.

We want to support bedside nurses in re-engaging their creativity and innovation to generate solutions to today's complex healthcare challenges, thereby improving patient and healthcare provider experience, while also elevating their own status, well-being and income as business owners and entrepreneurs.

RN.FM Radio will be hosted by Kevin Ross of Innovative Nurse, Anna Morrison of I Coach Nurses, and yours truly. I am so lucky to be collaborating with these two nurse entrepreneur and blogger powerhouses! 

Our inaugural broadcast will air at 9pm EST on Monday, January 12th, 2012 and every Monday thereafter. We plan to feature engaging and lively interviews with prominent nurse entrepreneurs, bloggers, writers, researchers, activists and thought leaders from the nursing world.

You can find us on Facebook, follow us on Twitter, or join us on Monday evenings (or listen to our podcasts and archived shows) beginning January 9th as we forge a new vision of the future of nursing! See you there!

Saturday, December 17, 2011

National Nurse Act of 2011 Introduced


Washington, DC – (Friday, December 16) – Yesterday, Congresswoman Eddie Bernice Johnson (D-TX) introduced the National Nurse Act of 2011, HR 3679. The bill, co-led by Congressman Peter King (R-NY), has garnered eighteen original co-sponsors. It would designate the Chief Nurse Officer of the U.S. Public Health Service as the “National Nurse for Public Health.”
The National Nurse would function alongside the Surgeon General and focus on health promotion, improving health literacy, and decreasing health disparities.
“The National Nurse Act of 2011 is an important piece of legislation that would establish a focal point for promoting health and disease prevention. There are currently 3.4 million nurses, making the demographic the largest sector of healthcare workers in the United States.
“As the first registered nurse in Congress, I believe that having a National Nurse focused on prevention activities will help reduce illnesses and decrease the costs for care and services,” said Congresswoman Johnson.
The National Nurse Act of 2011 is currently endorsed by dozens of prominent nursing organizations and key stakeholders.

Friday, December 16, 2011

Nurses' Voice, Nurses' Image: Nurses' Power

Since it feels timely to do so, I am choosing to republish a previous blog post from 2009 that I feel is still poignant and worthy of discussion. Here is the post in its entirety, originally published  under the auspices of the nurse blogger scholarship which I received from Value Care, Value Nurses, the nursing arm of the Service Employees International Union (SEIU).


I have recently been re-reading From Silence to Voice: What Nurses Know and Must Communicate to the Public, by Bernice Buresh and Suzanne Gordon. What I am most struck by is that nurses still have not necessarily found their collective voice, and despite the media attention given to the global nursing shortage, I still believe that Buresh and Gordon's thesis still holds true: the public still does not fully understand what nurses do, and until that day comes, nurses' real value as clinicians will not be common knowledge.

Buresh and Gordon touch on many themes and areas of interest vis-a-vis nurses and their relation to the public, to doctors, and to one another. While I will not provide a review of the book---nor a comprehensive enumerating of its content---there are certain area which pique my interest, and I encourage curious readers to order a copy of the book and explore some of these issues for themselves.

Doctors Cure, Nurses Care

When I first heard this phrase, I was moderately disturbed by it for several reasons. Doctors, by and large, receive the lion's share of praise and gratitude when a sick patient is cured of an illness. Granted, doctors undergo a great deal of training and education in order to offer curative treatments for a variety of diseases, yet all too often, the work of nurses is grossly overlooked when it comes to successful treatment. While nurses do indeed carry out many orders originated from doctors, nurses use their own brand of critical thinking and autonomous action in order to perform specialized patient care. The public may not be aware of this fact, but many actions taken by nurses are initiated by nurses themselves, and the professional clinical assessments performed by nurses will often lead to changes in treatment and greater overall success.

Sure, nurses care, and nursing is seen by the public as a "caring" profession. However, nurses utilize scientific methods, skilled observation, and keen assessment skills to monitor patients' progress. Nurses are not just "the caring eyes and ears of doctors"---nurses are skilled professionals fully involved in patient care---and patient cures.

The Nurse as Angel, Teddy-Bear, and Child

In their book, Buresh and Gordon make one thing clear: nurses' self-presentation says a great deal to the public, and images of nurses that instill themselves in the societal zeitgeist are difficult to dispel.

Somewhere along the line, the "angels of mercy" moniker became attached to nurses as a group. Granted, in the early days of nursing, nurses' ability to act autonomously was extremely limited, and we were, by and large, the handmaidens of deified doctors. However, as much as that regrettable history has largely changed, the image of the nurse as angel unfortunately persists quite widely in our culture and websites galore promote gifts and baubles that continue to diminish nurses' professionalism. Images such as this one drive home the point: nurses are childlike individuals with starched white hats who love teddy-bears. Adding insult to injury, nurses can actually be depicted as winged angel/teddy-bears, further enforcing the infantilization (and deprofessionalization) of our profession. Would doctors allow themselves to be thus represented to the public?

Rather than being perceived as cherubic angels and childlike creatures, this writer feels that being perceived as the valuable and skilled professionals who we truly are would allow the public to have a much more accurate perception of what we do, and our importance to the care of millions.

The Clothes on Our Back

Nurses' uniforms have certainly changed over the years, and as scrubs have become the norm for nurses in most clinical settings, many companies have capitalized on the popularity of such utilitarian clothing. Now, designer scrubs covered with angels, teddy-bears (there they are again!), and any number of cartoon-like images adorn the hard-working bodies of nurses around the world. If nurses want to be taken seriously by the public---and by doctors and other professionals---how does the wearing of such (in my opinion) unprofessional clothing help our cause?

Picture this: a team meeting occurs midday to discuss a patient on the adult oncology floor. Present at the meeting: a medical resident, a medical student, the attending doctor, the oncologist, two unit nurses, a social worker and a respiratory therapist. Of all of the professionals in the room, who would possibly be wearing pink scrubs covered with teddy-bears and hearts, and a pin on her chest saying "Doctors Cure, Nurses Care"? And what message does this convey about the nurse's self-image and how the other professionals present in the meeting should perceive him or her?

What's in a Name?

In From Silence to Voice, Buresh and Gordon make their case that nurses being addressed by first name only is also a major image problem when it comes to the public's perception of us a collective whole.

When doctors introduce themselves to patients or other professionals, they always do so by using the title "Doctor" before their name. This practice immediately creates an impression that the doctor is a professional, that he or she has a name that should be remembered, and a hierarchy of power and authority is clearly established from the start.

Conversely, we nurses almost ubiquitously introduce ourselves by first name only, ostensibly to break down the barriers between patients and nurses, assisting the patient in overcoming fears and anxieties related to their treatment. While this tactic may have some limited benefit, Buresh and Gordon argue that "if nurses introduce themselves by their first names only, they are asking to be regarded as nonprofessionals because that is the conventional way that nonprofessionals present themselves."

The "first-name only convention", as the authors have named it, makes it significantly more difficult for individual nurses to receive recognition for their work when only their first names are known. It also creates a hierarchical structure in which the doctor stands alone as a figure of authority, towering above the patient and nurse with (patriarchal or matriarchal) power and authority.

Interestingly, many nurses will argue that introducing ourselves as "Nurse Smith" or "Nurse Cadmus" is awkward at best, but also brings to mind the infamous "Nurse Ratched" from "One Flew Over the Cuckoo's Nest". Granted, Nurse Ratched is a mythic and hated figure in the pantheon of film and modern literature, yet do we see doctors eschewing their well-earned title due to historical figures such as Dr. Kevorkian or Dr. Mengele (of Auschwitz fame)? Absolutely not. Doctors use their title so commonly and so frequently that the word "doctor" simply holds too much cultural power to be diminished by one literary (or real-life) character who used that title for ill.

As for "naming practices" between doctors and nurses themselves, further examples of an unequal playing field emerge, with nurses almost continually subjugated to a diminished status by always being addressed by first name by both patients and doctors, whereas doctors maintain their professionalism and authority through the use of their title and last name.

Taking Credit Where Credit is Due

All too often, the work of nurses is diminished by nurses themselves. When thanked for their work, nurses will frequently say, "Oh, I didn't do much. The doctors really did the hard part." Or when a nurse is asked what he or she does, the answer will often be, "I'm just a nurse." This diminution of nurses' worth does little to cement in the public's collective mind the utter importance---the crucial presence---of nurses in the healthcare system. The "just a nurse" phrase---used all too painfully often---hurts nurses' cultural standing and diminishes the profession in the public's eye.

Nurses need to stand up and take credit for the work that they do. Buresh and Gordon urge nurses to say "You're welcome" when they are thanked. "I am so glad that I could assist you in learning so much about your diabetes, Mr. Smith" or "It was my pleasure to provide your post-operative nursing care, Mrs. Jones"---these are statements that take credit for nurses' actions, acknowledge patients' gratitude, and accept responsibility for providing crucial nursing care that directly impacts patients' recovery and health.

Nurses' Agency

Buresh and Gordon recommend that nurses discover their "voice of agency". According the authors, "the voice of agency is the voice that says: 'I helped the patient to walk after surgery so that she wouldn't get blood clots in her legs' or 'I taught the patient how to take his medications so that they would be effective and produce fewer side effects.' The authors further illustrate their point by reminding us that "the voice of agency is the voice that conveys the message, 'I'm here. I am doing something important.' "

For nurses to develop their own agency---their own power---nurses must first claim and recognize the importance of what they do. As Buresh and Gordon elucidate so clearly in their book, patients do not learn self-care skills in a vacuum. Someone must teach them those skills, and it is nurses who bring their knowledge and education directly to patient care. When recovering from surgery, it isn't doctors who monitor patients every fifteen minutes, using a lifetime's worth of learning to perform important expert assessments. Nurses use a wide variety of skills---often on an autonomous basis---to provide patients with the care and attention they need for optimal health.

While nurses are indeed held in very high esteem by the general public in surveys and polls, most members of that adoring public would be hard pressed to actually describe what it is that nurses do. As Bernice Buresh and Suzanne Gordon make so abundantly clear, it is up to nurses to claim their rightful place of importance in the care provided to patients in a variety of settings. Nurses need to proudly speak of their work with a voice of agency and power, and communicate clearly---to the public, the media, their families, their friends, and their colleagues---that nursing is important, that it is meaningful, and that what nurses do contributes to successful patient care and positive outcomes. We must forgo the teddy-bears, the hearts, the flowers, the useless diminutive statements and self-deprecation, and claim our professionalism for our own.

Nursing's voice must be heard, and Buresh and Gordon feel that the time for that voice to be clearly heard is now.

Tuesday, December 13, 2011

Why Coaching For Nurses?

When I speak with people about my newly launching coaching practice for nurses (which will shortly be live at and, they often ask why nurses might need coaching. There are many reasons that nurses can benefit from coaching, and when you take into consideration the fact that nurses are responsible for the care of millions of people worldwide, it makes sense that nurses should be healthy, balanced and happy at home and at work so that they can perform at their best.
As nurses, we spend a great deal of time caring for others and precious little time caring for ourselves. Our work can be all consuming, and in that process we can easily lose touch with our own health, happiness, and sense of balance.
Coaching with me is meant to be all about you. It’s about rediscovering the things that you love about your work. It’s about reconnecting with what’s underneath your desire to be a nurse. It’s also about finding balance in your life, and making your own health, happiness, relationships and life satisfaction the focus.
Nurses are caregivers, but we can only provide the best care when we're also taking care of ourselves properly. Exercise, nutrition, weight loss, stress management, leisure and fun, work-life balance, spirituality, relationships---all of these aspects of our lives impact our ability to be at our best when we engage in our work. And when our lives are out of balance, we suffer on multiple levels. 
My intention is to provide coaching that lifts nurses' spirits, assists them in identifying their goals, their strengths and their areas of challenge, and creating a life that more clearly resonates with their spirit and their vision of the best possible life. 
If nurses are the backbone of the health care industry, then that backbone needs the support to be the strongest and healthiest it can be. Nursing should be something you do, not just something that does you in!

Friday, December 09, 2011

Nurse Keith Coaching Is On The Way!

Happy holidays, readers of Digital Doorway! I hope this finds you well and happy!

The purpose of this post is to inform you that the nature of my private coaching practice is changing, and I have decided to focus completely on the coaching of nurses. As an experienced nurse and coach, I feel that my coaching skills can serve in their greatest capacity by helping nurses to live the most satisfying and healthy lives possible. I plan to offer services ranging from health and wellness, weight loss and stress management to burnout prevention, burnout recovery and work-life balance, and I am already in discussion with others in the industry to create exciting partnerships and joint ventures to add even more value and power to my offerings.

As nurses, we spend a great deal of time caring for others and precious little time caring for ourselves. Our work can be all consuming, and in that process we can easily lose touch with our own health, happiness, and sense of balance.
Coaching with me is all about you. It’s about rediscovering the things that you love about your work. It’s about reconnecting with what’s underneath your desire to be a nurse. It’s also about finding balance in your life, and making your own health, happiness, relationships and life satisfaction the focus.
Nurses are caregivers, but we can only provide the best care when we are also taking care of ourselves properly. Exercise, nutrition, weight loss, stress management, leisure and fun, spirituality, relationships---all of these aspects of our health impact our ability to be at our best when we engage in our work. And when our lives are out of balance, we suffer on multiple levels.
You can work with me to improve your work-life balance, get your health on track, set personal and professional goals, and make nursing something that you do and love, not something that does you in!
My new website---currently under construction---will be located at and also linked at There will be a frequently updated Facebook page, as well as my continued presence on Twitter (as NurseKeith). My plan is also to eventually offer free downloads, audio podcasts, and perhaps branch into webinars, internet radio and live workshops here in Santa Fe. 
At this point, I am requesting that you hold this endeavor in your heart, knowing that I am creating this coaching practice so that more nurses can be healthier, happier, and more successful and satisfied clinicians. I am so excited about the coming birth of Nurse Keith Coaching, and I will post a formal announcement as soon as the website is live! 

Friday, December 02, 2011

Pathways in Nursing Infographic

The good folks over at have created an interesting infographic on the various pathways of a nursing career, including average salaries and other data. It is well worth perusing, and I include a copy of the infographic here for your enjoyment and edification.
Brought to you by Nursing License Map and Nursing@Georgetown.