NursingLink

Thanksgiving: Cut Costs, Not Flavor

Kayla Baxter | NursingLink — Thu, 19 Nov 2009 15:59:00 -0800

The holidays are stressful enough without worrying about money, too. If you're a little tight on cash this season (or just want to save a few bucks!) we've researched the top ways to get the most out of your Thanksgiving feast.

Just because you're saving money doesn't mean that you're losing flavor. In DIY Turkey's case, you're actually adding your own flavors and creating a more delectable bird — and at the same time saving yourself some dough.

A DIY Turkey

Premium heritage turkeys can go for $50 and upwards — sure, they’re organic, sustainably farmed and taste heavenly — but you can make your own delicious gourmet turkey by brining it yourself, for less than half the price and just a little bit more effort.

The steps to a great turkey:

• Comparison-shop at your local markets, and remember, the bigger markets will likely have the best prices. Safeway (also known as Vons, Dominick’s, Jewel-Osco, etc), Costco, Smart & Final are good places to look. Remember that the closer it gets to the actual holiday, the cheaper the bird will be – so this is one of those times when waiting until the last minute works best.

Better yet, use coupons to get a free one! Check your Sunday paper the weekend before and look for the specials in your area.

• Brine your own bird — it isn’t difficult, and the benefits far outweigh the effort: the salt changes the texture of the bird, allowing the white meat to stay moist and delicious until the da. You can find delicious brining recipes and techniques here.

Tip: The single biggest challenge in brining your own bird is finding a place for it in the refrigerator. Try a brining bag instead of a container, which can be found at most supermarkets or home goods stores (Bed Bath and Beyond, for instance, has a great brining bag, that comes with recipes!) that will keep the liquid in place as well as free up refrigerator real estate. You can also brine your bird in a regular cooler outside the refrigerator, creating even more space.

IMPORTANT NOTE: If you’re brining your own bird, DO NOT buy a bird that's already been plumped with a salted, seasoned solution, such as a self-basting or kosher bird. Check the label for added salt information.

On the next page: Cheap Tricks->

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Cheap Tricks

• Serve a soup to start. It will give those kitchen lurkers something to snack on (therefore getting them out of your way!) and it has the added bonus of filling up your guests early on, so that your likelihood of turkey leftovers increases. We like butternut squash soup, which can be made from dirt-cheap squash (easily microwaved to soften, then blended with warm spices like nutmeg and clove, salt and pepper.) You can find lots of variations on recipes here.

• Make your own stuffing. With a couple loaves of stale bread and some basic veggies, chicken stock and butter, you can create a delicious stuffing for under $10. Cubing bread can be delegated to the little ones, too, reducing your workload and keeping them occupied! Find recipes here.

• Buy canned or frozen veggies. Canned and frozen vegetables are packaged at the peak of their ripeness, so you get maximum flavor without a lot of prep work. Can you imagine cleaning, trimming and chopping hundreds of fresh green beans for the traditional green bean casserole? You’re easily saving yourself half an hour and at least a few bucks, too. Don’t forget about canned pumpkin, which lends itself easily to pies, soups and casseroles. You might even find canned butternut squash!

• Go to farmer’s markets and small local markets for produce. Fresh herbs are especially great to buy at farmer’s markets; fresh rosemary, sage, and other great Thanksgiving herbs can often be found for under $2 a bunch. Russet and sweet potatoes often go for a bargain, too. Look for what’s in season and you’ll always get a better price than the supermarket.

• Create atmosphere with free outdoor finds. This is another task for the little ones: ask them to create a Thanksgiving centerpiece with whatever is lying around the yard — brightly colored leaves, flowers, pinecones, bark. They’ll stay entertained and out of your hair, and you’ll get an adorable centerpiece made with love.

• Make your own pie crust. This one is so easy, and so worth it. Buying a crust could cost you $5-6 dollars, and they tend to be crumbly, hard and grainy. Making your own crust can be done using just flour, sugar, salt and butter which you likely already have on hand, and produces a crust so light, buttery and flaky, you’ll never go back to store-bought again.

NOTE: The recipe (found here) mandates that you use ice-cold water — it’s the secret to getting the flakiness right! You also don’t need a food processor; you can use the same instrument you mash potatoes with to get the right consistency.

• Send for help! There’s no reason not to ask people to chip in and bring at least a bottle of wine. You can’t be expected to do absolutely everything yourself, so entrust the help of your friends and family and assign dishes out.

6 Rewarding Specialties

NursingLink — Tue, 17 Nov 2009 10:15:00 -0800

Nursing is one of the most in demand professions in America. There is a projected need for 1,001,000 Registered Nurses and 309,000 LPNs / LVNs ending in the year 2016. The nursing shortage gives potential nurses leverage when deciding the location of the hospital they want to work. The shortage also means there is a greater chance you will be hired (assuming you pass the NCLEX); thus, providing a great return on invested capital.

Most registered nurses choose to follow a career path focused on a specific nursing specialty that fits their personality and intellectual interests. Some specialties involve being certified by a professional board or association which will often increase a nurse’s wages and long-term promotion potential.

Not sure where your niche lies? Take one of these short interactive quizzes to see what nurse specialty is the right fit for you.

• Cardiac Care Nurse

•
Geriatric Nurse

• Nurse Anesthetist

• Plastic Surgery Nurse

• Pediatric

• Psychiatric

Five Spa Deals and Discounts for One Stressed Out Nurse

Tue, 17 Nov 2009 09:54:00 -0800

At the end of a long shift, your body and mind are usually thinking one thing: serenity. NOW.

Some medical studies have proven that an aromatherapy massage can help relieve stress and tension in emergency room nurses.

And our own personal studies show that any massage can relieve stress…in just about anyone.

While tight economic times may make you think you can’t splurge on this luxury, with a few tricks a massage or spa trip can be within your reach!

Here are five tips for getting the relaxation you definitely deserve! Book a treatment for yourself or make a day of it with friends or favorite relatives. And don’t forget: With the upcoming holidays, a gift certificate to a spa is the ultimate thank-you gift for a hardworking coworker!

1. Call ahead: If there’s a spa in your area that you would like to attend, call and ask if there are any specials. You’ll find that many places are running package deals and services at significant reductions due to tough economic times.

2. Peruse Spafinder.com: This is a great resource no matter where you live. Not only will it help you locate spas in your neighborhood, but it also has a section aptly called Spa Deals that lists the great offers that spas nationwide are offering. You can also buy gift certificates that are redeemable at any of the 5,000 spas listed on the site.

3. Subscribe to Goldstar.com: While you may already go to this site to secure great deals on theater tickets, you may be surprised to find that it’s a great way to get discounted spa treatments, too! Currently, Goldstar services Los Angeles, San Francisco, New York, Chicago, D.C. Metro, Las Vegas and San Diego. You’ll need to become a member to get the deals, but membership is free.

4. Use a storefront like “Massage Envy”: This is a no-nonsense approach to massage. No bells and whistles here—just clean massage rooms and great rates. Massage Envy stores can be found all around the country. Most first hour-long massages cost just $49, and if you become a member, the prices go down from there. Massage Envy is another great option for gift-giving to a friend or coworker.

5. Go to a massage school: Most massage schools give significant discounts to people who let their students practice on them. No need to worry—massage students are supervised by licensed instructors who ensure the quality of care you’ll receive, and they all have had many hours of training before they ever get their hands on a real patron. To find a list of schools in your area, go to NaturalHealers.com.

More on ScrubsMag.com:

• *In Nursing Blogs:* How Do You Recognize Excellence?

• *In News:* Recession Keeps Shortage in the Shadows

• *In Career:* Yes, We Can! (Find a Job, That Is)

So You Want to Be A Male Nurse

Sean Dent | Scrubs Magazine — Mon, 09 Nov 2009 16:17:00 -0800

Yes. It can and does happen. Contrary to popular belief and myth, there really are male nurses out there!

And yes, we do encounter discrimination every so often – some greater than others, and some more severe.

I can remember when I first made the decision to be a nurse…

“You want to be a Murse?”
“I guess you didn’t want to be a doctor?”
”...Are you gay?”

I have seen and heard it all from all walks of life. You would be surprised at some of the reaction and interaction I have experienced being a ‘male’ nurse.

Even after I made it through nursing school and started working, the stereotyping continued in some small way. This time it was from my co-workers…

“Oh, I’m so glad you’re here. Now we have some muscle on the floor.”
“You’re so great to work with, lifting my patients is so much easier when you’re around.”
“The doctors like you better – it’s a guy thing.”

So my gender as a nurse has been a blessing and a curse. And there really is no rhyme or reason, no prediction, and no preparation. Some patients/families out there simply do not like nor want a male nurse, while some prefer them. Same goes for the doctors, some will unconsciously treat me ‘better’ or ‘differently’, while others will make my life difficult. Is it simply because I’m a guy? And some co-workers will also unconsciously ‘like’ me simply because I have muscles. God-forbid I bring skill and knowledge to the table?!

All of these ‘challenges’ still are manageable. All of these so-called difficulties can be ‘worked around’ in most cases. Even at its most severe, I’ve only had to change patient assignments due to a patient/family/physician nursing gender preference. But, I’ve never had to worry about not practicing as a nurse.

I have balked at some things I’ve experienced. I’ve moaned and groaned at past interactions. But mostly I just let it roll off my shoulders and simply move on – because in all instances I still get to practice as a nurse in this wonderful field of nursing. I still get to do the job I love in the setting I prefer and love.

Others are not so lucky.

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It seems in India – for a particular diploma nursing program – they will not accept male candidates for their program!? In fact this discrimination was petitioned – and lost! It seems that males are being prohibited to enter because the diploma program’s course work involves mid-wifery as well as pre and post-natal care?!

(insert facial expression of shock and disbelief??!!)

To make matters worse, the higher court ruled that there is a sufficient number of male nurses already working in the areas they are needed – like jail, ortho department, mental health hospitals and operation theatres??!!

Wow.

As a nurse, male or female, we are taught to be culturally diverse – including transcultural nursing. We are encouraged and trained to be culturally competent practitioners, but this – in my humble opinion – is astonishing.

How can you judge or even pre-judge, and ‘genderize’ the practices of a profession that works side by side with the field of medicine?

Correct me if I’m wrong, but do they discriminate female candidates who have an interest in being an orthopedic physician? Or a male candidate wanting to pursue obstetrics?

Original story from ‘The Times of India’ here.

As well as the original commentary from ‘The Truth About Nursing’ here.

Things that make you go hmm.

More on ScrubsMag.com:

• *In Nursing Blogs:* 3 Male Nurse Myths

• *In News:* Recession Keeps Shortage in the Shadows

• *In Career:* Yes, We Can! (Find a Job, That Is)

Thinking on "Thankful"

Prisca Smith | Scrubs Magazine — Mon, 09 Nov 2009 15:26:00 -0800

I guess this is the month to talk about being thankful, which is an area I struggle with and need to continuously work on in my own life. It is so difficult for me to look beyond what I have—and yes, I have everything I need—and instead look for the stuff out there that I really, really want.

I really believe that our society helps us out with our discontent—we are told we can be anything we want, have anything we want—and that happiness comes from having it all. It’s difficult to fight against that mentality. Take my job for instance. Right now things are not easy in that arena. I’m still the new girl, working on my confidence, my autonomy, my rapport with other nurses, docs and patients. To me it feels like I am fighting a battle with myself just to go to work each day. I have so much to be thankful for, but how do I do that when I am not feeling that way?

Recently I was looking at the unemployment numbers in the U.S. (it’s easy to see that our country is under a ton of economic hardship) which then led me to peek at the want ads. Right now escaping my current job feels like the simple way out, even though I know that is not true.

But here is what I found out when searching for a way out: First, there are few jobs in my specialty out there. The more I read about and see what has happened to the nursing industry because of the financial climate, I realize that my landing a job when I did and where I did is nothing short of miraculous. I must believe I am where I am at for a reason!

And secondly, the unemployment rate in this country is 10.2%, according to various news publications around the ‘net, jobs are still being cut in every industry, and the fact is that there are more qualified people than there are good jobs. Those of us with jobs can’t afford to let hardship put us into a tailspin because really, escape is not an option! (Plus, there are no guarantees the next job will be any better.)

I’m realizing that much like real love, being thankful is more of an action than an emotion. And I can be thankful for my job despite my current negative emotions and feelings. How?? By continuing to work with excellence and integrity, treating others with respect and dignity and valuing my job like the prize and blessing it truly is. Much like love, it is the actions that breed the emotions. The better I work as a nurse striving for excellence in all I do (excellence—not perfection), the better the outcomes for my patients and the more my job satisfaction grows. Just acting thankful leads to true thankfulness and gratitude.

Daniel Defoe once said: “All our discontents about what we want appear (sic) to spring from the (lack) of thankfulness for what we have.” Daniel, I’m with you–and I’m setting out to change that for myself! It’s time for this new nurse to act more thankful.

More on ScrubsMag.com:

• *In Nursing Blogs:* How Do You Recognize Excellence?

• *In News:* Recession Keeps Shortage in the Shadows

• *In Career:* Yes, We Can! (Find a Job, That Is)

8 Friends to Make at the Hospital

Nina Kim | NursingLink — Wed, 04 Nov 2009 17:00:00 -0800

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Hospitals can be crazy places. From ambulances rushing in patients and nurses shouting vitals to security having to deal with frantic family members, you may blink and find you miss an important moment.

But for many health care professionals, hospitals are their second home. With all the different departments and types of health care workers in hospitals, it’s not uncommon for newbies to feel a bit lost and overwhelmed at first.

Whether you are a seasoned health care veteran or a just-starting-out amateur, it’s always a wise idea to make friends with some allies and get better acquainted with the inner workings of the hospital.

To help you maneuver your way around the hospital network, NursingLink spoke to a physical therapy doctorate student and an ER receptionist on the front lines at Kaiser Permanente. With their insights, we’ve developed this list of eight must-have friends in any hospital. Get the inside scoop on who to buddy up with and how they can help you out!

Friend #1: Security >>

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Security

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While medical professionals are trained to remain calm under pressure, you can’t always predict how incoming patients — and their caretakers — will react.

As a hospital employee, you’re probably well-equipped to handle the actual patient, but sometimes the friends and family of said patient can be frustrating to deal with. A million different thoughts and emotions are probably running through their heads as they stress about whether or not their loved one will be okay.

That’s why it’s always a good idea to get close with the security guards just in case things get out of hand.

“Just last night an 18-year-old girl was brought in by ambulance, and her husband and father almost got into a full-on brawl in the middle of the department over who got to go in and see her first,” Sino says. “She only really had a fever!”

Remember: Just keep your empathy handy, but security on speed dial.

Friend #2: ER Technicians >>

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ER Technicians

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The more calm and collected patients admitted to the ER are generally able to wait for the next available doctor. Because they don’t require immediate attention, the ER techs are the first to begin their treatment.

“Patients will beg us for help with wheelchairs or pain killers, but once again, receptionists are not allowed to play doctor even in life-threatening situations,” Sino says. “Making friends with the ER techs, who are usually floating around the department anyway, would only benefit our flow.”

An ER tech is basically a greatly expanded nursing assistant, so they can be a big help. They perform nursing assistant tasks, like cleaning up and transporting patients and running lab specimens. They can also do whatever they’re trained in, including running EKG's, applying splints, teaching crutch walking, doing compressions, bagging patients, and drawing blood.

Friend #3: Financial Counselors >>

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Financial Counselors

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Financial conversations can be confusing, stressful or just downright awkward for not only the patient but for hospital workers as well. For this, befriending financial counselors can really help clear the air. Financial counselors are trained to professionally and efficiently take care of any legal issues for each patient, like insurance, co-pays, guarantor accounts, and workers compensation cases.

“Asking sick patients (or their family) for money makes all of us very uncomfortable,” Sino says. “Financial counselors are really good at showing empathy while getting the job done and collecting hospital fees at the same time.”

Friend #4: On-Call Contract Employees >>

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On-Call Contract Employees

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Even though it’d make everything so much easier, life doesn’t always go as planned. From family emergencies to unexpected illnesses, it’s not uncommon for hospital workers to have to take an unanticipated day off.

That’s why cozying up to the on-call contract employees can make your job at the hospital run a bit more smoothly. Your child has the flu? Your dad’s been in a car accident? The on-call employees have got you covered.

“Just in case we can't come in for work or need the rest of a shift covered, these people are always happy to help, especially if you’ve built a rapport,” Sino says

Friend #5: Medical Receptionists & Secretaries >>

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Medical Receptionists & Secretaries

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Since medical receptionists and secretaries perform administrative tasks to keep hospitals running smoothly, getting to know them will probably help your job run more smoothly as well.

“They work behind the scenes and are the gatekeepers with all the doctors and nurses,” says Anna Sirotin, a physical therapy doctorate student at the College of Mount St. Joseph. “If you get on their good side, they will be more then willing to help you with scheduling, the best time to reach the doctor, and work around your schedule.”

Medical receptionists and secretaries are also frequently privy to the inner workings of the hospital, and may know what’s happening before everyone else — making them a very good person to know.

Friend #6: Interpreter >>

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Interpreter

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Since America is one of the most diverse countries in the world, not everyone’s going to have mastered the English language. But as a healthcare professional, you’re useless unless you’re able to communicate with patients and see what’s troubling them.

That’s why an interpreter could be one of your best friends at the hospital. Interpreters not only speak other languages, they understand other cultures, so they can be sure what they’re saying is not only correct but sensitive and appropriate for the given situation. They can ask the questions you need to ask and get the answers you need, all while keeping your patient at ease. After all, that’s what it’s all about, isn’t it?

Friend #7: Medical and Clinical Lab Techs >>

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Medical and Clinical Lab Techs

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Medical and Clincal Lab Techs are responsible for performing laboratory tests on patient samples in an accurate and timely manner. They play a crucial role in the detection, diagnosis, and treatment of disease, and doctors heavily rely on their tests to properly care for their patients.

Therefore, getting friendly with medical and clinical lab techs can only help you get your results faster. The technical experts in the chemistry department are there to answer any questions you may have about the lab tests and results, so a gregarious relationship with them can make this exchange more natural and productive.

Since Medical and Clincal Lab Techs understand the inner workings of the lab, buddy up with them, and they’ll probably tell you the ideal times to submit lab tests, how best to submit lab tests, and who knows, maybe some other secrets they may have.

Friend #8: Other Nurses>>

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Other Nurses

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The final person you'll want to consider buddying up with is probably the most important: other nurses!

When a patient is rushed to the ER in an ambulance, the blur of events and high-intensity adrenaline can be quite overwhelming. What are his vitals? What needs immediate attention? Which doctors are available? Miscommunication and confusion can occur – especially as the patient is handed off from reception to the nurses.

Teaming up with other nurses, especially the triage nurses, can ease tensions between the different hospital departments. Because the nurse manager has the most leverage with the nurses directly involved with patient care, it’s also probably not a bad idea to solidify this relationship as well. But don’t make the mistake of only befriending the manager. You probably won’t get much help if you neglect the workers in the trenches.

“We, as receptionists, aren't allowed to administer any care whatsoever since we're not licensed, so we really need a nurse's help for those patients who come to the department screaming and bleeding.” says Kathleen Sino, an ER receptionist on the front lines at Kaiser Permanente in Anaheim, Calif. “It would lessen the stress in our environment if we could communicate better as far as anything missing on charts and printing out patient labels, armbands, and legal paperwork.”

More Resources

• 3 Easy Ways to End Workplace Hostility

• 8 Ways to Network in Health Care

• 6 Ways to Beat Compassion Fatigue

• 8 Things to Never Say to a Patient

• Battle Nursing Burnout!

• 7 Mistakes to Avoid in Your Nursing Career

• Informative Quiz: How Do You React to Stress in the Workplace? [PhD Certified Quiz]

Some images provided by: Creative Commons

Introducing Care4Dystonia and Beka Serdans, RN, MS, NP

Care4Dystonia.org — Mon, 02 Nov 2009 18:25:00 -0800

Beka Serdans, RN, MS, NP carries multiple hats - that of being a patient diagnosed with dystonia and that of being an active healthcare professional and strong patient advocate. She has developed the innate ability to see all sides of dystonia - creating Care4Dystonia, Inc. in 2000 as an avenue to help publicize dystonia to the media. Beka appeared on the first ever television story on dystonia NBCs Dateline in 1998 with Dr. Mitchell Brin, MD in a story covering the use of Botox for dystonia.

Since then she has appeared in multiple media venues, more often writing about her own experiences and battles with the disease in the 2 popular books I’m Moving Two and I’m Moving On…Are U??. Both books have received wonderful reviews from several nonprofit groups including The Parkinson Disease Foundation based in NYC, acclaimed writers and journalists, NBC’s Robert Bazell and New York’s own Jimmy Breslin. Beka was a recipient of the NY Times 2008 Tribute to Nurses Award.

Her hobbies including writing, biking, gardening, reading, and most certainly traveling — “gallivanting across the Pond and elsewhere”. She works in multiple areas within Manhattan and resides in the “daily grind and highlife” of Manhattan in NYC. She completed her Masters’ degree studies as an Adult Nurse Practitioner in April 2006 . Her third book, a memoir, will be published in 2009, titled “Two Households, One Life.” She is a recipient of the 2008 Tribute to Nurses Awards New York Times. She is also moderator of the Wego Health Dystonia Ed Forum as well as a weekly blogger-moderator on all Nursing Medscape BBs.

Read her introductory article, Nursing with a Movement Disorder.

Nursing with a Movement Disorder

Beka Serdans | NursingLink — Mon, 02 Nov 2009 18:21:00 -0800

Intensive Care nursing with dystonia is not for the faint of heart, but it's really doable.

Okay, so how did a wannabe artist/photographer end up working nights surrounded by medical equipment and really sick people?

I blame it on my father. Of course, he's not here to defend himself anymore, but take my word for it, there was no way that he was going to let any of his three daughters become starving artists.

So now I'm a semi-starving nurse. When I started (not all that long ago…in dog years), my salary was $8.65 an hour. I do earn a bit more these days but Bernie Madoff never solicited me for investment opportunities.

What's rather interesting is that we seem to pay more for interior decorators than we do for the people we depend on to save our lives.

Anyway, I put aside artistic dreams for the reality of mastering the science and art of critical care nursing. There was this side of me that was fascinated by some of the "big" questions in medical care, like "What do you do when all the body's organs start failing? How do you help those people who are truly suffering without resorting to Jack Kevorkian measures?" Solving analytical problems humanely seemed (and seems) far more rewarding than photographing magnificent images (although I still find tremendous pleasure stealing away and capturing the world through a view finder).

Oddly enough, my professional journey through medicine intersected with a personal medical condition… one that would remain undiagnosed and treated for five years. Some doctors said that my facial tics (hemifacial spasms) and strange pains were due to stress or some hysterical "woman's disease." Yes, we're talking this century.

Finally I picked the right door (it happened to be at Mount Sinai in New York City) and walked out with a few names and treatments for a disease that affected my head but was not "in my head."

I started my nursing career with dysphonia, cervical dystonia and even general dystonia (too bad they didn't give medals for ranks; I'd have been able to pin a few ribbons on my scrubs). Early treatments might have been much more fun if they were given for cosmetic reasons but the Botox, Myobloc and eventually the Deep Brain Stimulation (DBS) were prescribed to ease some less than glamorous symptoms.

Now, how much trust would you put in a nurse who twitched and twisted (and not to dance music)? Not much. So, at first, I worked in a soft cervical collar that allowed me to perform sensory tricks that convinced me that my body was aligned and not twitching and twisting.

Well, that didn't last too long. I thought I was doing a terrific acting job (perhaps even considered for a Tony or an Oscar) but as patients began asking me "What's wrong with you? Are you in pain? Should I call a doctor, a nurse?" I knew the gig was up…at least when it came to sensory illusions.

What next? Retirement at 30 was not exactly an option so I figured out a way to continue doing what I loved despite the pain and the drugs and the brain surgery. Has it been worth it? Yes. Am I an effective nurse? Ask my patients. Do I wish I could wake up and discover this has only been a long, bad dream? You bet.

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However, until magic wands reappear, you can find me at an intensive care unit doing what I love despite my physical limitations.

How do I manage? I've got the system semi-figured out. No one wants to work nights and weekends. I do. It's not easier or quieter or better paying, it's just makes me that much more valuable.

What's it like to work from seven at night to at least 7:30 in the morning (nurses never have had the luxury of just saying, "Oh, my shift is over, see you."? Let me take you with me as my shift begins.

First, you should know that when you start at seven you have to be at the hospital way before then. And, if you live in NYC and happen to have dystonia, like I do, you should probably start out the day before. Find me a day without gridlock and I'll bet it's either a national disaster or a holiday weekend.

Within the first half hour, we have the changing of the guard. The night team leader makes assignments and reports are exchanged.

A Typical Day:

1930 hours - I have two patients, one who is on a ventilator and will probably be bleeding all night since a drug she has been taking for migraines (methotrexate) has eliminated more than her headaches… it has eliminated the ability of her blood to clot. Oh, and her mouth is filled with packing material. My other patient weighs about 300 pounds, has pneumonia and is in the second stage of lung cancer. How in the world am I going to turn her over? I should tell you that despite my height (very tall), I weigh slightly more than 100-pounds. I also have wires in my neck (no, you can't see them) that connect a pacemaker to my brain. These wires are not industrial grade…they can snap. This would not be a good thing for me or my patient. I will deal with this issue later. I have work to do.

1945 hours - I review the computerized Order Checklists to make sure what medications are due at 10 p.m.

1950 hours - A family member asks for coffee. This is not a big deal except that walking with a steady, even gait is not my strong suit. With a rather interesting weave (not ever to be confused with a runway model stroll), I deliver hot coffee. No spills, no burns, no thanks.

2030 hours - I stop in to see patient #1. The oral packing is bloody. The bed is bloody. It's time to call the Ear, Nose and Throat (ENT) residents. Her platelet count is only seven. Luckily, she is sedated (with IV Versed and IV Fentanyl) and her vital signs are holding steady.

2050 hours- I see patient #2 and hear gurgling sounds. She is not gargling. This is not good.
You do not have to be a medical whiz to know that this is not a good noise. Should you have a medical background, you might recognize the sound as a signal that there's water in the lungs. I call it a "wet" sound and since this patient has also refrained from urinating for most of the day, I'm betting that she will be much, much happier if I suction her. I do. She is…and I even hear a faint, "Thank you." I like this lady (but please, please don't fall on the floor).

2100 hours - The ENT residents have ordered platelets for patient #1. Does that mean that I get them asap? No. That means I now have to call the blood bank and grovel. "I need them in a hurry." Translation to their reply of "Yeah, yeah" (and in a Jamaican accent it sounds like "Ya-di-dah"): "You'll get them when I get to you on my list of things-to-do, people-to-see and dinner-to-order." Am I happy? No. Is this stressful? Yes. Does this make my straight hair curl and my dystonia symptoms go away? Guess.

2130 hours- I have got to work on my begging and pleading skills. They do not teach this in nursing school. The platelets have yet to be delivered and no on has even called from the blood bank to say "Come and get them" or even more unlikely, "We're on our way." So, I call them again. Were they (a) Delayed or (b) Forgotten? My hunch is that the order was still sitting on the "to do" pile.

2200 hours - This is not good…my 300-pound patient needs to be turned over for a skin assessment. They can send men to the moon, why can't I have a robotic arm here to help me now? Before getting a chance to figure out this physics problem, I add two bags of antibiotics to her IV. As I'm doing this, it occurs to me that I've been on duty for a while but I haven't had a chance to enter anything about my patients into the computer. I'll do it now. No I won't. Alarm bells go off. My other patient's blood pressure is dropping (falling through the floor would be more accurate). This is when all the years of training and experience pay off. I react automatically.

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2210 hours - I run into the drug room (and if you've ever seen someone with dystonia run, it is not going to rate an Olympic-scored 10 for style points). I grab a bag of pre-mixed intravenous Levophed (a medication that's administered to raise blood pressure… something I surely do NOT need. My heart is pumping away like I might actually have to break the sound barrier). Dash back to my patient's room, hook it up and remain by the bedside for the next half-hour.

2245 hours – The bells are ringing…and they are all for me. Has anyone done a study on how many things a single person can do at the same time? Multi-tasking, my eye, I need to clone myself (this time without dystonia, please). Okay who gets priority, the bed pan seeker or the hungry patient? No contest.

2300 hours – A knight in shining scrubs appears: Stu. He helps me turn my 300 pound patient. That's the good news. Why is there always the bad news? Suddenly her oxygen level is doing that downward slide. Please, please, please…don't make her need to be intubated or put on a ventilator. I call the resident on duty and ask for a C X-ray order. I hope she is not retaining fluid. I am retaining stress. This does not bode well for my next activity; writing status reports.

2320 hours - I start off with a bang but my hands have a mind of their own. I think write. They think "I'm cramping up, honey." They win. Writing will come later.

2342 hours– Half a miracle: C X-ray done. Patient's blood pressure has stabilized. The blood bank remains a "no show," and I really have to eat something and/or go to the bathroom. Can you get scrubs from NASA? Those space suits could work.

2355 hours - I make executive decision: I'm going to the blood bank for my patient's platelets. If we needed them before, we really need them now. This isn't an order for pizza.

0010 hours – Talking about pizza, I'm still hungry but if I don't sit down for five minutes I may fall over. ICU nurse hits the floor. Patients and co-workers not impressed Okay, now that I'm sitting, I look up at the clock (I'm here to tell you that "time does not always fly.") and realize now would be a good time to start all the chart work. For most nurses, this would be slightly more relaxing than the dramas taking place at the bedsides but with dystonia it's not quite so easy. In fact, it's more than just a "pain in the neck," it causes hand cramping and pain. So I've learned to master the art of two-fingered-typing (no speed records will be broken tonight).

0015 hours – The formerly illusive platelets are now finding a new home in Patient #1's blood stream. However, Patient #2 doesn't look good and her breathing is labored, I think she needs more than suctioning, an order goes out for a diuretic to get rid of some that water. This time we go for something a bit more formidable: 40 mgs of IV Lasix.

0110 hours - Some of my charting is completed, the platelets have infused, the Lasix seems to be working, but it's time to turn both patients over. I still haven't eaten. In the background, I hear a nurse arguing with the resident-on-call about an Emergency Room admission. What's new? There are not enough nurses on duty tonight (are there ever?). We are so short-staffed, that I already know that coming off duty in the early morning is not going to be on my chart. Why? If you're not in nursing, you might not know the mantra: "NOT documented, NOT done." Remember my typing skills? This is an obstacle to nursing with dystonia. Who knew that typing could be so hard?

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0130 hours - I notice bloody urine coming from Patient #1. Wondering if her liver is failing, I decide to draw her blood and send her lab work off early. She will need more platelets - she is not clotting well.

0140 hours - A patient is dying at the other end of the unit. He's only 20 years old. The family is living by the bedside. No matter how many times I've seen this drama unfold, it never gets any easier.

0210 hours - Now that all the "labs" (as we call them) and diagnostic tests are completed, Patient #2 (the 300-pound woman) raises my blood pressure to a nightly high. Her heart has gone into a lethal arrhythmia. Running into the room, I pound her on the chest, hoping beyond hope to get a normal rhythm to return. My neck is killing me. The precordial thump works. EKG and complete labs are ordered. Uh oh, her oxygen level has dropped again. Does she need even more Lasix?

0240 hours – As I've now become to feel quite possessive of Patient #1's platelet activity, I feel like celebrating as her number goes up from seven to twenty-four! Just for good measure, the ENT guys order more platelets and some liver function tests. Her blood pressure has been stable. I finish my computerized charting entries. However, due to the dystonia, MY arms hurt from hanging bags of platelets on a barely unreachable ceiling pole. What do shorter nurses do?

0300 hours– The few of us on the unit tonight have been running, for what seems like, forever. I do not want to come back as a hamster. Forget ordering take-out dinners, forget about even eating the healthy snacks that some of us have packed. In between ringing bells and critical care nursing, we gulp down chips, soft drinks and the unhealthiest snacks imaginable. What if a dietitian happened to decide to spend the night here? We'd have to find her a bed.

0310 hours - The 20-year old patient dies. I feel sad. His parents were at the bedside. Morgue care is ordered.

0330 hours – "My" platelets are ready. I ask the Unit Clerk to pick them up as well as stop by the pharmacy for some newly ordered antibiotics. This is not a medical mercy mission to a third world country but you'd never know that. The pharmacist, right here in this very large, very busy NYC hospital decides to let us know in no uncertain terms (read: "venting") that they don't have the variety that was ordered. Am I in a new "Twilight Zone"? What kind of pharmacy is this?

0400 hours – Meanwhile back on the floor, patient turning is the next activity. What could be worse than trying to perform this task alone? Finding the bed and its surroundings soaked with diarrhea. This is a job for the true angels of nursing: Housekeeping. I clean the patient, giving her a back rub as well as a respiratory treatment. Before leaving the room, I do a platelet check.

0430 hours - Platelets are done. Will this shift ever end? Whatever could go wrong has already happened…I think. My feet hurt. Note to self (and other would-be nurses with dystonia: Clogs might as well be 3" heels …my feet turn inwards, my clogs do not)). A new ER admission arrives on the unit. So much for the lack of staff. The few of us left standing; all help the patient settle in. Do you think that any of us are contemplating "Nurses Week" in early May? No. We just want to sit down and go home.

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0445 hours – Some of the routine things that nurses do are no longer easy for me to accomplish without help. Night nurses are responsible for changing IV tubes for new ones. This used to be a non-event but now I can't open the packaging without using scissors or a clamp or a helping hand. It's frustrating.

0510 hours – A minor miracle: My paperwork is up-to-date and there are only two more hours left to this awful night.

0522 hours - A colleague is having trouble inserting an IV. I offer to help. Even though I am unable to turn my head the "right way," anymore, I can do IVs by instinct. With dystonia, you learn to make accommodations and work around the physical limitations. A secret: I usually rearrange the patient's room so that everything is in my line of sight.

There's another thing that I have to constantly be aware of since I had DBS; electromagnetic interference. All those security devices may be great but they can cause havoc with my pacemaker (mine goes to my brain rather than to my heart). This, among other things, is anxiety-producing so my neurosurgeon has me taking a mild dose of Klonopin to reduce stress. Did I remember to take it this evening/morning? No. I will pay for it on the bumpy bus ride home.

0547 hours - An alcoholic in withdrawal wanders out of his room. His IVs are in disarray, he has a bloody gown, his EKG monitor is off and he announces to all of us that he is ready to leave. Perhaps we should call the bellboy for his luggage and have the front desk prepare his bill. He resists our cajoling him back to bed and then hits one of the nurses. We call security and the docs. He ain't listening to anyone.

0600 hours – Perfect timing, the Head Nurse is now walking down the hallway as the alcoholic is making his way to the nurse's station. He is using four-letter words and making comments that will not be printed in The New York Times (or any other publication). Where is security? Are they in cahoots with the blood lab people? I really don't want to be a punching bag even if I'm beginning to feel like one. If my muscles get any tighter, I may explode.

0610 hours - Security arrives. Using less than spectacular intervention skills, they tackle the patient. Now what? We decide to ship him to the Psych Ward…stat!

0624 hours – Check Patient #2 and discover more diarrhea. . She is producing the type of diarrhea that is irritating to the skin and induced by antibiotics. To make matters worse, this 300- pound lady can't breathe when she is in a prone position. Getting her out of bed would be impossible. I only weigh 115 lbs. Can it get better than this? Sure. There's no protective cream available. I call my knight in scrubs, Stu, and we clean her up once again. Now I do the "uh oh" check. Are my neck wires still intact? Yes. I can exhale.

0645 hours – Go back to the charts and enter final vital signs. Also need to compute things like intake and outtake of fluids. Have you ever had to estimate the amount of diarrhea produced? I must have missed this lecture in nursing school.

0710 hours - Patient #1 needs extra IV potassium. I grab a bag from the drug room and hang it on the IV pole. The day shift staff begins arriving. I actually have a minute to swallow my dose of Klonopin.

0726 hours – Before giving a verbal report to the day shift, review any last minute Orders to make sure that nothing was missed. Nothing missed. It's going to be a good day!

0745 hours Shift over.

Scalp pain erupts. Neck twisting and turning begins. I just want to sleep.

But nursing with a movement disorder is possible, rewarding and do-able!

Real Nurse Issues: Ambulatory Care

AAACN Viewpoint — Mon, 26 Oct 2009 19:42:00 -0700

Only an ambulatory nurse could transition from working in a jail, to a childbirth center, a family practice clinic, telephone triage, and finally to ambulatory clinical education without breaking a sweat.

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Meet Renee E. Maynes, BSN, RN, BC, AAACN member, and currently the Ambulatory Clinical Educator at Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire.

Renee admits that she has had a very interesting career that began twelve years ago when she graduated from an ADN program. After two years of inpatient medical-surgical nursing, Renee was ready to try something new and different. She took a position at a county jail and loved it! "It was a great experience, and I learned a lot about preventive care, health education, and psychiatric and emergency assessment. I also decided it was time to return to school to obtain my BSN degree," Renee remembers.

To help finance her education, Renee went back to the hospital setting where she would qualify for tuition reimbursement. At that time, the hospital was having a critical shortage of nurses in the childbirth center, and they offered to provide Renee with all the training she would need if she made a two-year commitment. Renee felt she was ready for the challenge and plunged into the uncharted waters of labor and delivery. She recalls, "Labor and delivery was a whole new skill set, and I worked with a wonderful group of nurses who were very proactive and practiced shared governance. They were strong patient advocates, and I learned a great deal in the two years I was there."

As our lives and priorities change, so do our jobs. Renee needed a position with a little more flexibility so she could spend more time with her teenage children. Keeping to her ambulatory roots, she began working in a small family practice office. Thinking back on that position, Renee wonders how she was able to do it all. "The providers really believed in providing one-stop shopping. I learned how to perform hearing tests, strep throat cultures, and pulmonary function tests, and assisted with sigmoidoscopies. I also became the vaccination expert," Renee recalls.

After four years in family practice, Renee decided that it was time to begin work on her master's degree in nursing education. She accepted a position with her current employer, Dartmouth Hitchcock Medical Center, working in the area of telephone triage. Renee admits that it was truly a culture shock. She was one of only two nurses with 13 providers and "the phones never stopped."

Renee has tremendous respect for those nurses who have chosen to work in telephone triage because "it utilizes all your nursing knowledge, and every call is a new challenge." After one year in telephone triage, a new position was developed, and Renee became the Ambulatory Clinical Educator. Renee is thrilled with this new position because she feels she can make a positive impact on ambulatory nurses in the clinics. She states, "Prior to my current position, new nursing staff were given a one-day general orientation and were then left to sink or swim. The clinics were so busy that no one really had time to orient new people. My first priority was to develop a centralized nursing orientation for ambulatory nursing staff, and we are now in our second year."

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Renee joined AAACN because she wanted to belong to a professional organization that shared her passion for ambulatory nursing and where she could stay current with all the latest information. She credits AAACN with helping her obtain her current position. Renee remembers, "Prior to my interview, I purchased the AAACN Guide to Ambulatory Care Nursing Orientation and Competency Assessment and studied it thoroughly. When asked during the interview what my plan was for developing an orientation program and what I saw as the priorities, I was able to draw from all the information I had read. I would discuss what I had observed in the clinics with the lack of orientation and then relate it back to the text. I believe it gave my employers confidence that I was serious about the job and was knowledgeable about professional resources, which would help me to accomplish the goals for the organization."

For nurses who may be transitioning from the inpatient setting to ambulatory nursing, Renee offers some sage advice. "It is a difficult transition for many nurses because in the hospital setting, nurses are accustomed to being in control of the care. Nursing interventions are provided at a time set by the provider, the hospital, or the nurse. The idea that the timing of our nursing care is dictated by the patient and/or family is a difficult concept for many nurses to understand. We must always remember that it is the patient's decision. We can provide patients with the tools to make good choices, but ultimately, the patient is in control. I love it when new ambulatory nurses have that "aha" moment and realize that we can't force the patient to do anything; we have to work with them to find out what they are willing to do. Therein lies the challenge and the joy of being an ambulatory care nurse."

Our AAACN spotlight remains on the east coast, but moves southward to Duke University Medical Center in Durham, North Carolina. Meet Mary Vinson, MS, RN-BC, CMPE, Clinical Operations Director of the McGovern Davison Children's Health Center. Mary began her nursing career in the U.S. Navy Nurse Corps in 1972 and served for five years on active duty at the end of the Vietnam War. Over the next decade, she worked in a variety of settings while raising a family and finishing her masters degree.

Following the completion of her MS degree, Mary took a position as a Clinical Nurse Specialist at East Tennessee Children's Hospital. Her love for pediatric nursing grew, and she headed off to North Carolina in 1990, where she began her long career at Duke University Medical Center. Mary remembers, "I have had many opportunities to grow and learn at Duke, including the opportunity to serve on a team that designed and opened an outpatient Children's Health Center. The health center is now home to 23 subspecialty pediatric practices, numerous diagnostic services, a day hospital, a pharmacy, and procedure/perioperative units. The center sees about 75,000 visits per year along with another 25,000 visits at our sister clinic a mile away."

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A typical day for Mary can lead her in many different directions. As a Clinical Operations Director, she is responsible for nursing, support services, operations, and facility management. Like many in management, much of the day can be spent in meetings related to safety, recruitment, and retention, Magnet and other quality initiatives, or daily operations. However, Mary's role is unique in that she is able to remain involved in the clinical aspects of her job. She explains, "I enjoy collaborating with my team regarding patient care issues, patient flow, or customer service, which is always a priority. I love to connect with patients and staff. My days go by quickly with continuous opportunities for learning, problem solving, and communication. I have been blessed to work with intelligent, energetic, committed nurses, and my managers are a joy to work with. I learn from them every day. My passion for the profession and my desire to serve continue to drive me to do my best and remain positive every day, no matter what issue I may be facing. I am extremely fortunate to be able to do what I love, and I love what I do at Duke."

Mary joined AAACN in 1995 when a colleague brought her to her first AAACN conference in Washington, DC. She admits that she was hooked after that; "AAACN welcomed me and I have continued to feel a collegial, welcoming atmosphere in all the activities in which I have participated." Mary has been active in the Pediatric Special Interest Group (SIG) and regularly uses many of the AAACN products in her daily work. She explains, "I have used the Ambulatory Core Curriculum, the Ambulatory Care Nursing Administration and Practice Standards, and the Telehealth Nursing Practice Administration and Practice Standards for many years. When I decided to become certified in ambulatory nursing, I took the AAACN review course and studied the Ambulatory Care Nursing Core Curriculum. When I took the exam, I felt prepared and supported in my certification journey."

Having been in ambulatory nursing for the majority of her career, Mary reflects upon what her chosen pathway has meant to her. "I receive tremendous satisfaction from being an ambulatory nurse. I believe that we are moving toward greater recognition in the world of nursing and health care in general. I am passionate about defining and recognizing the role of ambulatory nursing. Each day in ambulatory nursing, you have the opportunity to start fresh, prepared, energized, and unencumbered by the previous day. We come each day, ready to serve our patients, knowing that our services are needed and enjoying the opportunity to make a difference."

Nancy Spahr, MS, RN, MBA, CNS Clinical Nurse Specialist

Ambulatory Care

Mayo Clinic, Arizona

Copyright American Academy of Ambulatory Care Nursing Mar/Apr 2008

© YellowBrix, Inc. Copyright 1997-2008

For more information, read our Ambulatory Care Nurse profile.

The 60-Second Stress Buster

Scrubs Magazine | Jeannie Keenan — Mon, 26 Oct 2009 15:06:00 -0700

A little stress can motivate us toward action. It can make us faster and more efficient nurses. But when we’re overstressed, we tend to only use the upper part of our lungs to breathe. This keeps our shoulders tight and slightly raised, and that contributes to our tension.

One of the best ways to reduce stress is to get off of the “treadmill” that is your job and be aware of your position and disposition.

Here’s how to regroup and reduce stress in less than 60 seconds:

1. Pause. Just stop where you are and close your eyes (try not to do this in the middle of a busy hallway).
2. Take a few slow, deep breaths—all the way to the bottom of your lungs.
3. Relax your shoulders and your face, especially your forehead.
4. Make yourself aware of how you’re standing—be aware of your muscles and your attitude.
5. Give yourself a few seconds to get in touch with your mind, body and spirit.
6. Realign, if necessary, then proceed with your day.

Try to do this several times a day. Sometimes the only time to do this is when you’re using the restroom, and that’s okay, just as long as you do it.

Exercise is a great way to keep it all “in check.” If your busy day forced you to miss your favorite physical activity, try this technique while lying in bed before you go to sleep: Take slow, deep breaths. Starting with your toes, consciously relax every toe, then your ankles, calves, etc., working your way all the way up to the top of your head. You’ll find it easier to fall asleep and you’ll get the benefits of taking those nice deep breaths.

Original blog post can be found here.

Nursing Careers Beyond the Bedside

Cindy Mehallow / Monster Contributing Writer — Tue, 22 Sep 2009 14:24:00 -0700

This article originally appeared on Monster Career Advice.

When providing bedside care loses its luster, working in a nonclinical specialty can renew your love for nursing and draw on your clinical experience. The following positions exist at most healthcare institutions and are well-suited to experienced nurses.

h4. *+Case Managers+*

Case managers choreograph all aspects of patient care, coordinating the nurses, doctors, therapists and other practitioners who treat patients. As hospitals discharge patients more quickly and managed-care organizations increasingly oversee patient care, the need for case managers has blossomed. The aging population is generating more opportunities in long-term care and home healthcare as well.

"The demand for nurse case managers is tremendous," says Margaret Leonard, MS, RN,C, FNP, a certified case manager and board member of the Case Management Society of America. She notes that some employers are becoming more discriminating, looking for nurses who have both strong clinical experience and certification in case management.

The two primary certifying bodies are the American Nurses Credentialing Center and the Commission for Case Manager Certification. Other certifications are available through specialty associations, says Leonard, vice president for clinical services for Hudson Health Plan in Tarrytown, New York.

Since they're expected to achieve the shortest possible patient stay with the highest possible outcome, case managers must be proactive and able to evoke change. These professionals should be patient, extremely diplomatic and politically astute.

h4. *+Patient/Staff Educators+*

Clinical nurse educators help patients and their families understand the patient's condition prior to discharge, and they work in such outpatient areas as cardiac rehabilitation, diabetes education or childbirth preparation. Besides orienting and supervising new nurses, clinical nurse educators conduct in-service training for staff nurses.

Most clinical nurse educators possess at least a BSN as well as advanced clinical training in a specialty.

While they must be patient and able to write education plans, nurse educators must enjoy teaching and, above all, have a passion for their profession. "That passion comes through when you teach," says Diane Goodman, BSN, RN, a clinical nurse educator for Lake Forest Hospital near Chicago. "Your students pick up on it and become passionate, too."

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h4. *+Quality Improvement+*

"Is there a better way of doing this?" Nurses involved in quality improvement constantly ask that question as they review a healthcare institution's methods and processes. Their work is evidence-based and outcome-focused. By studying patient populations, they analyze systems to determine how to correct problems and improve quality of care. In short, they strive to prevent future problems by studying past mistakes.

Employers commonly look for a bachelor's degree in a healthcare field and possibly a master's. "Many facilities don't require certification or even realize that it's available," says Joan Boldrey, RN, MEd, MS, a certified professional in healthcare quality (CPHQ). Employers that do know about certification consider it "the gold standard," says Boldrey, senior market medical expense management specialist for UnitedHealthcare in Urbandale, Iowa, and a board member of the Healthcare Quality Certification Board, which oversees CPHQ testing.

h4. *+Risk Managers+*

Closely tied to quality improvement, risk managers also search for the root causes of mistakes to help improve systems and processes. With the upsurge in medical malpractice suits, opportunities for risk managers are increasing at hospitals, insurance companies, ambulatory-care surgical centers, long-term-care facilities and home-care companies.

Working with top medical and administrative staff members, risk-management nurses review patient records before and after lawsuits are filed. These pressure-cooker jobs require immense patience, tact and political savvy plus excellent communication and writing skills. "Risk managers need to be leaders with good conflict-resolution skills," says Kenneth Nanni, PhD, program director of the healthcare risk-management certification program at the University of South Florida Health Sciences Center.

Most risk-management nurses hold at least a bachelor's degree and risk-management certification, which is available from the American Hospital Association Certification Center, the American Board of Quality Assurance and Utilization Review Physicians and colleges, such as the University of South Florida.

h4. *+Other Options+*

Experienced nurses can fill these other nonclinical positions typically found in hospitals:

• Chart Auditors: Financial chart auditors review patient charts after discharge to ensure appropriate documentation for proper billing and coding. Others work in quality management.

• Patient Advocates: Working on the customer-service front lines, patient advocates handle patient complaints.

• Mentors or Preceptors: More and more hospitals are creating formal positions for experienced nurses to guide new nurses through that critical first year on the job.

Related Reads:

10 Steps to Becoming a Nurse

Quiz: Are You Ready for a Career in Nursing?

Top 10 Highest-Paying Nursing Specialties

10 Best and Worst States to Be a Nurse

Information About Nurses Caring for Older Adults in Long-Term Care (LTC): The Coalition of Geriatric Nursing Organizations

Mathy Mezey, EdD, RN, FAAN — Wed, 16 Sep 2009 15:17:00 -0700

Nurses often ask how they can find out what is happening in LTC and how can they get current and reputable information about nursing practice in LTC settings. We suggest that you use a “one-stop” shopping approach and look to the Coalition of Geriatric Nursing Organizations (CGNO) for the information you may need. The CGNO encompasses 8 organizations representing over 28,700 geriatric nurses seeking to improve the health care of older adults across care settings. The Coalition is supported by the Hartford Institute for Geriatric Nursing, New York University, College of Nursing (www.HartfordIGN.org).

The CGNO, organized in October 2001, has chosen two major issues for action that would affect older persons: 1) positively affecting the quality of long term care through improving and implementing quality programs or practices; and 2) facilitating the measurement of quality in long term. While not limited to these areas, participating organizations concentrate their efforts on these issues. The CGNO continues to lead member organizations in shaping policy and legislation and improving regulations to benefit older adults.

Take a look at the CGGNO member web sites to get a sense of the wealth of information that is practically at your finger-tips. CGNO Member organizations are as follows:

AMERICAN ACADEMY OF NURSING (AAN) - EXPERT PANEL ON AGING

http://www.aannet.org

AMERICAN ASSISTED LIVING NURSES ASSOCIATION (AALNA)

http://www.alnursing.org

AMERICAN ASSOCIATION FOR LONG TERM CARE NURSING (AALTCN)

www.LTCNursing.org

AANAC

www.aanac.org

GERONTOLOGICAL ADVANCED PRACTICE NURSES ASSOCIATION (GAPNA)

www.gapna.org

THE HARTFORD INSTITUTE FOR GERIATRIC NURSING

www.HartfordIGN.org

NATIONAL ASSOCIATION OF DIRECTORS OF NURSING ADMINISTRATION IN LONG TERM CARE (NADONA/LTC)

www.NADONA.org

NATIONAL GERONTOLOGICAL NURSING ASSOCIATION (NGNA)

www.NGNA.org

7 Mistakes to Avoid in Your Nursing Career

Georgia Price / NursingLink — Tue, 15 Sep 2009 13:24:00 -0700

Have a happy and healthy work life!

When you first become a nurse, it's easy to believe that you'll always love your job. But there will come a time where burnout, frustration and boredom take their toll. While you can't avoid every pitfall all, there are some mistakes that you can veer around.

Make the most of your career as a nurse by avoiding these seven mistakes.

No. 1: Rushing Into Becoming a Nurse >>

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1. Rushing Into Becoming a Nurse

Sure, some of us are really impulsive and can pull off a career switch or educational 180 with ease. Most of us, though, need a little more preparation. Deciding on a career path is a big decision – whether you’re 17 or 47 – but it’s particularly important to think through your choice to become a nurse because there is so much involved. Pre-reqs. Nursing school. NCLEX. New grad programs. A lot goes into becoming a nurse –which is why not everyone can be one!

If you’re thinking of becoming a nurse, take the time to talk to seasoned veterans and get the inside scoop. Visit nursing schools to learn about pre-requisites. Volunteer at a hospital or clinic to see if you really have a passion for medicine. Nursing is one of the most rewarding jobs out there, but it’s best to be prepared before you dive in.

No. 2: Changing Specialties Too Many Times >>

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2. Changing Specialties Too Many Times

You started in med/surg but soon got bored and moved to L&D. A few months later you got tired of your boss and jumped to same day surgery. A year later you were on to pediatrics. Switching nursing specialties can be a great way to learn what you really have a passion for, but changing areas too quickly or too many times can cause burnout or hurt your career. You might begin to feel like you don’t have a place in nursing and potential employers might wonder why you haven’t committed to one area for very long.

Give each specialty you enter a chance before you take off for something more enticing. Talk to nurses who are currently working in the area you are considering as well as nurses who have left that specialty. They can give you the nitty gritty details on what that area is really like.

No. 3: Not Changing Specialties Enough >>

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3. Not Changing Specialties Enough

On the other side of the coin, you could damage your career by not trying out enough different specialties. Of course, if you love the NICU, don’t leave just to try something else. But if you’re staying in the OR because it’s safe and familiar (but you’re bored out of your mind!), take the risk and apply to another area. You never know what you might be destined to do!

No. 4: Letting Your Job Control Your Life >>

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4. Letting Your Job Control Your Life

With late-night shifts and long hours, it’s easy to let your nursing career take over the rest of your life. Maintaining work-life balance is a key element in being stress-free and loving your job. Sure, there will be times when your 12-hour shift seems to stretch into a 24-hour shift, but leave that pressure at home. Remember to take time for yourself, your friends and your family – even if it’s just 1 night a week.

No. 5: Ignoring Compassion Fatigue >>

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5. Ignoring Compassion Fatigue

Compassion fatigue (otherwise known as “burnout”) can hit even the most conscientious nurse from time to time. The key is recognizing burnout and making a concentrated effort to eradicate it. Of course, there will always be those patients, families, and colleagues that make you want to tear your hair out, but that doesn’t have to ruin your nursing career.

Feeling burned out? Take a step back and think to yourself “What am I worried about? Is something outside work stressing me out?” Look into changing shifts if working in the middle of the night isn’t your cup of tea. Have some vacation time saved up? Take some time off – alone or with family and friends. Lastly, think back to all the reasons you wanted to become a nurse. Make a list of these reasons and look at it every once in a while to remind yourself of all the great things about your job.

No. 6: Believing You're "Just a Nurse" >>

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6. Believing You’re “Just a Nurse”

As featured author Donna Cardillo said, “Just a nurse? No such thing!” Don’t let anyone beat you down and make you feel inferior. You care for the sick. You inspire the down-trodden. And you save lives! There really is no such thing as “just a nurse.” Be proud of what you do and why you do it.

No. 7: Not Gathering Nurse Allies >>

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7. Not Gathering Nurse Allies

We’ve all heard the phrase “Nurses eat their young” and many NursingLink members have said that is definitely true. But even with the drama that may occur, there is always room for friendship. Connecting with other nurses is a great way to avoid burnout, re-ignite your passion for nursing, and expand your knowledge. Whether it’s nurse friends at work or nurses from another facility, they will understand you like your non-nursing friends never will.

Nurse allies can benefit more than your mental health. They can help you advance your career by writing recommendations and finding job openings. It’s always good to have someone who’s looking out for you – and who better to do it than someone who can literally save your life!

20 Career Lessons from Celebrities

Tania Khadder and Zac Frank — Tue, 01 Sep 2009 09:02:00 -0700

Celebrities. We love to hate them. We also love to watch their every move, laugh at their mistakes and scrutinize their decisions.

Like them or not, their celebrity status means not only have they achieved career success, they’ve also got a hell of a lot to lose. And sometimes, whatever actions have helped catapult them to fame or rendered them B-list can provide valuable lessons for the careers of regular people like you and me.

NursingLink presents 20 career lessons from celebrities. Some are good. Some are bad. Some are just plain ridiculous.

#1: Madonna →

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#1: Madonna

Lesson: Reinvent yourself often. Always stay fresh and relevant.

Never one to let things get stale, Madonna has reinvented herself over and over again since she first stepped into the spotlight in the mid 80s.

There was the virgin, the “material girl,” the Evita era, and her disco-fabulous look and sound of 2005. She’s had as many new looks as she has albums, and always manages to stay fresh and relevant. Reinvention is so central to her career, she named a tour after it. And 30+ years after her debut, she still manages to be at the forefront of the global music industry.

Elaborate personal transformations may not be realistic (or helpful) for mere mortals. But there’s a lesson to be learned from this pop icon. In order to thrive in a rapidly changing economy, it’s important to stay fresh, keep your skills up to date and be adaptable to new directions in your career.

#2: Christian Bale →

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#2: Christian Bale

Lesson: Don’t crack under pressure.

If you haven’t heard the audio, you’ve been living under a rock.

The action movie star famously lost his temper on the set of this year’s Transformers sequel, shouting countless profanities at the film’s director of photography, Shane Hurlbut.

His fit of rage was caught on tape, and of course, a YouTube video quickly circulated the internet. His reputation went from sexy, brooding screen legend to world class A-hole (still kind of sexy though).

Getting worked up at work is not uncommon or unexpected. But keeping your cool in the face of blood-pressure raising circumstances is essential, not just to your reputation at work, but to your overall health and happiness. Lose your temper like Mr. Bale and you may never live it down.

#3: Britney Spears →

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#3: Britney Spears

Photo courtesy of Loveyousave, Creative Commons

Lesson: You can make a comeback, but be prepared for a long — and sometimes ugly — road to recovery.

The past five years have been tough for this former teen pop starlet. She was in the midst of a custody battle with estranged husband (and total leach) Kevin Federline, had been deemed an unfit mother, battled drug addiction and once famously shaved her head for no apparent reason.

She’d hit rock bottom. And thanks to the paparazzi, she did so right before our prying eyes. In 2007, her attempt at a comeback at the MTV Video Music Awards was panned by critics and fans alike; onstage, she appeared detached, disinterested, drugged. Simply showing up for the gig was not enough.

But two years later, she’s back. She may not be the mega star she was before her fall from grace, but she’s no longer a media laughing stock. Her latest album is doing respectively well, she’s on tour, has her post-meltdown body back, and looks healthy and happy. With a little bit of hard work, she's managed to get her career back on track, at least for the time being.

#4: Simon Cowell →

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#4: Simon Cowell

Lesson: Sometimes, it pays to be a hard ass.

The notoriously straight-faced American Idol judge earns a reported $34 million a year (said to be bumped up to a whopping $144 million next year).

While Paula Abdul gives endless (and often unintelligible) praise, Randy Jackson looks for the silver lining, and Kara Dioguardi strips to outdo Bikini Girl, Cowell tells it like it is (and sometimes, much worse). Viewers love to hate him, but the fact remains: contestants respect his opinion more than that of the other three. And so does America. More often than not, Cowell's feedback directly impacts the shows votes and consequently makes or breaks a contestant’s shot at winning.

Simon may take brutal honesty a little too far, but he teaches us that sugarcoating your opinions and backing down when challenged won’t earn the respect of your peers, your reports or even your superiors. Stand up for yourself or you might just find yourself in your rightful place as the office doormat.

#5: Kim Kardashian →

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#5: Kim Kardashian

Lesson: It is who you know.

Long before she was known for her “assets,” Kim Kardashian came into the spotlight as the BFF of celebutante and tabloid favorite, Paris Hilton.

She now has her own reality show (Keeping Up With the Kardashians), a workout DVD and of course, a sex tape. In addition to being friends with Paris, Kardashian is the daughter of late OJ Simpson lawyer Robert Kardashian and the stepdaughter of Olympian Bruce Jenner.

Is it fair that she rakes in millions for no other reason than who she knows? Of course not. But life rarely is. And nepotism is not exclusive to the entertainment industry.

Most people get jobs through someone they know. Who you know may not make you millions or snag you your very own TV show, but he or she can help you get a foot in the door and set you on your path to career success.

#6: Kate Moss →

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#6: Kate Moss

Lesson: Be discreet about your "extracurricular activities." And please, stick to the legal kind.

The English supermodel came onto the scene in the early 90s. Since then she’s become the face of numerous beauty products, launched her own clothing line, and dated just about every scruffy man in Britain. But of all her high profile love interests, none has been more controversial than Libertines front man and known drug addict Pete Doherty. In 2005, photos of her snorting cocaine were all over Britain’s Daily Mirror. Allegedly, one of Doherty’s friends snapped the footage with a cell phone and sold it to the tabloid.

Drug use in the modeling industry isn’t exactly breaking news. But stills of Moss ingesting copious amounts of cocaine were rattling – especially after she’d vehemently denied drug use throughout her career. She lost several multi-million dollar modeling contracts and checked into rehab shortly after. She bounced back, but she'll always be remembered as "Cocaine Kate."

While Kate’s example is a bit extreme, it does remind us that any questionable activity we engage in off the clock — even binge drinking — can come back to bite us.

#7: George Lucas →

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#7: George Lucas

Lesson: Don’t be afraid to take risks.

The creative genius behind Star Wars and Indiana Jones didn’t get to where he is today by following the rules. Sure, he went to USC Film School, and yeah, he interned at Warner Brothers, but so did countless other filmmaking hopefuls. Lucas was fearless in the face of risk. Combine this fearlessness with a knack for innovation, and you’ve got a recipe for multi-billion dollar success.

Early on in his career, while negotiating his director’s fee for Star Wars, he agreed to take a $500,000 pay cut in exchange for all sequel rights and ownership of the film’s merchandising – things the studio thought were pretty much worthless. Silly studio! He made tens of millions of the merchandising and financed the making of the sequels himself. Which, as you can imagine, had a huge return on investment.

He also took a break from movie-making to pour his fortune into other projects – namely, his digital effects and innovation studio Industrial Light and Magic. The studio began taking on special effects work for other filmmakers at $25 million a pop. He then went back to produce his Star Wars “prequels,” which went on to break box office records. Taking risks early on in his career made him the success story he is today.

#8: Susan Boyle →

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#8: Susan Boyle

Lesson: It's never too late to fulfill your dreams.

Susan Boyle had a difficult start to life. She was born oxygen deprived, was later diagnosed with learning disabilities, and suffered incessant name calling as a child. She lived in her family’s Council Estate (the UK’s version of social housing) for the bulk of her life and was chronically unemployed.

She almost didn’t audition for Britain’s Got Talent, fearing she was “too old and that it was a young person's game." It’s a good thing she did. Her audition stunned the judges and audiences alike. Although she did not win the competition (she came in second), Ms. Boyle has seen a rapid rise to global fame and is now recording her first album.

Sometimes, just when you think you’ve missed the boat, you get a second chance to turn your life — and career — around. Don’t ever let your age or past experiences stop you from trying.

#9: Joe Biden →

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#9: Joe Biden

Lesson: Think before you speak.

He once called “jobs” a three-letter word. He urged wheelchair bound Missouri State Senator Chuck Graham to “stand up.” He’s even referred to John McCain both as “George” and “McLain” on two separate occasions. Vice President Joe Biden has made his fair share of embarrassing speech blunders, earning him a reputation for being gaffe-prone. At times, his carelessness has driven the normally even-tempered President Barack Obama to appear visibly annoyed.

Our VP might be lovable, but he's still a liability.

Everybody makes mistakes here and there, but you don’t want to be careless about your remarks or make jokes at the most inappropriate times. Especially when they’re not funny.

Think before you speak and avoid being known as the “Joe Biden” of your workplace.

#10: Oprah Winfrey →

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#10: Oprah Winfrey

Lesson: Build a strong personal brand.

The talk show host and entrepreneur built a muli-billion dollar empire, thanks largely to her strong personal brand. In addition to an award-winning talk show, she has channeled her fame and fortune into a highly successful magazine and a television network set to launch this year. She ranks #165 on Forbes list of the 400 richest Americans.

Oprah transformed the talk show genre by bringing it into to a more personal, confessional realm. She interviews mega celebrities, experts and average Americans with a story to tell. But she doesn’t do so objectively. She shares own personal issues, struggles and adventures with her audience. American women have grown to trust her on anything from kitchen appliances to spirituality.

Not bad for a girl who was born into poverty, was allegedly raped at 9 and was pregnant (but miscarried) at 14.

Building a personal brand sets you apart from the competition. And thanks to the internet, cultivating and promoting your brand is easier than ever.

#11: Barack Obama →

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#11: Barack Obama

Lesson: Inexperience doesn't mean you shouldn't reach for the top.

Regardless of your politics, there's no question that Barack Obama had less experience than his two challengers—Hillary Clinton in the primary and John McCain in the general election. In fact, Obama's decision to run for president is something that people in any profession should keep in mind. If you want to get to the top, you can follow the traditional route. Build your experience and gradually work your way up the ladder. You have to content yourself, though, to reaching the highest rung pretty late in life.

Some people have what it takes to rise to the top sooner rather than later. There are three keys to making that move a success. First, think above your pay grade. Even if you are better than anyone else in your current position, you need to think outside of it. Think about the larger organization and ways it could be better. Try to think of big ideas that could change the rules of the game. Next, carpe diem. If you're going to leap frog over pay grades, you have to seize the moment when the opportunity presents itself. Finally, be confident and don't underestimate yourself.

#12: Angelina Jolie →

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#11: Angelina Jolie

Lesson: Personal generosity can be more important than professional accomplishment.

Angelina Jolie is arguably the most famous actress in the world right now. Why? She's been in so many of the best films of the decade like Sky Captain and the World of Tomorrow, Alexander, and…oh wait…

For someone who normally stars in some of Hollywood's worst movies, how is Jolie such a megastar?

She is the quintessential master of personal PR. Jolie's movies are incedental, they are mere backdrop to the brand that is Angelina. Celebrity cum International Relations wonk.

Beauty and the Adopter-of-Disadvantaged-Children. If you can turn your personal brand into such gold, any professional foibles matter a lot less.

#13: Sarah Palin →

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#13: Sarah Palin

Lesson: Do your homework.

Repbulican? Democrat? Independent? Whichever, you have to admit that Sarah Palin was something unique in American politics. When she was announced as John McCain's running mate she and his campaign quickly regained the momentum they had lost over the week of the Democratic National Convention and pulled even or ahead in most polls.

Then came Palin's immolation in a series of interviews with the major news networks. When Charles Gibson asked her what she thought about the "Bush Doctrine," it was evident she did not know what it was. When Katie Couric asked her for an example of how John McCain had pushed for more regulation of Fannie Mae and Freddie Mac in his 26 years in the Senate, she said she'd have to go look them up and bring them back to her. After their loss, McCain's advisors took to the press to claim that Palin didn't do her homework.

#14: Maureen Dowd →

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#14: Maureen Dowd

Lesson: Find your schtick. Ride it to the top.

Maureen Dowd, an op-ed columnist for the New York Times, reached journalism's peak in 1999 when she was awarded the Pulitzer Prize for Commentary. How did she become a professional juggernaut? Take the average political knowledge of a Washington D.C. resident, throw in some cutesy nicknames, blend with obvious jokes, send to a personal trainer and you've got a Maureen Dowd column.

Dowd captures the mood of a certain class of people and makes them chuckle at just how right they are. This clearly hasn't served her poorly. Her columns are regularly the most-e-mailed articles on the Times website and she has commanded an op-ed column at the country's most prestigious paper for 15 years.

#15: Martha Stewart →

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#15: Martha Stewart

Lesson: A conviction isn't a career killer.

Martha Stewart is easily one of the most recognizable names in America. And with good reason. After graduating from Columbia University, she began her professional career as a successful stock broker in the 1960s. Later, following her move to Westport, Connecticut she started a catering business, restored a farm house, and ran a gourmet food store in 1976. From there, she built her business juggernaut, Martha Stewart Omnimedia and by 2001 was considered one of the most powerful (and richest) women in America.

Then in 2004 things hit the skids. Following a questionable sale of stock in one of her business ventures, she was convicted of lying to investigators and sent to prison for five months. While that could have been the end for her celebrity-based lifestyle business, Stewart re-emerged and recovered quickly. By 2006, her company had returned to profitability and she is one of the most ubiquitious food and lifestyle personalities on television today.

#16: Dick Cheney →

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#16: Dick Cheney

Lesson: You don't have to be popular.

Dick Cheney left the Vice Presidency with one of the lowest favorable ratings in American history. Throughout the Bush presidency, though, Cheney never cared about and often scoffed at his low approval ratings. He wasn't interested in making friends.

Cheney wanted to reshape the role of the executive branch in American government and in many ways, he was extremely successful, consolidating more and more power in the White House.

Many people didn't like him or his methods, but he stuck single-mindedly to his goals. Even after he lost some of his influence in the later years of his term, the changes he had effected remained in place.

#17: Donald Trump →

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#17: Donald Trump

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Lesson: Even if you're a failure, you can still be a success.

Donald Trump is one of the best known business moguls in the world, but his "empire" seems to be a house of cards built on sand. Trump's business ventures have filed for bankrupty not once, not twice, but three times, most recently in February of this year.

So how does Trump continue to maintain his mystique as a formidable tycoon, telling contestants on The Apprentice , "You're fired!" because they can't cut it? He has several tricks up his sleeves.

If you're going to take on debt, don't take on a little, take on a lot. A whole lot. When the "Trump Debt Crisis" first appeared in 1990, Newsweek reported that "the banks are owed so much by Trump…that they have no choice but to try to keep him going."

While his name may be gaudily splashed across most of his ventures, it doesn't actually appear on the companies' paperwork. The companies he starts file for bankruptcy, not the Donald himself.

Fight, fight, fight for your place on Forbes. It has been reported that Trump and his associated badger the people who rank personal wealth so that he appears to have more money than he actually does.

#18: Mark Sanford →

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#18: Mark Sanford

Lesson: If you're caught lying, apologize without qualification.

Not long ago, Mark Sanford's name was thrown around as a potential Republican presidential candidate in 2012. Then he went missing on a hiking trip to the Appalachians which actually turned out to be a visit to a long-time mistress in Argentina. The lying and philandering alone shouldn't have necessarily sunk his chances. After all, Bill Clinton did both while he was president and emerged fine politically.

Sanford's problem? Rather than unequivocally admitting to a mistake, promising never to do it again, being contrite and recommitting himself to his wife, he held a series of philosophically and emotionally meandering press conferences where he didn't offer clarity but confusion.

A short apology might not have been able to save him, but it would have offered him at least a fighting chance.

#19: Ellen Degeneres →

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#19: Ellen Degeneres

Lesson: Be yourself.

Ellen DeGeneres rose to fame as a standup comedian and eventually secured her own sitcom in 1994. While the show did well, DeGeneres was not content. In a speech to the graduating class of Tulane university in 2006, DeGeneres described how hard it was to have to hide her sexual orientation from the public.

Finally, in 1997, she came out on Orpah Winfrey's show and her character on her show followed suit. The coming-out episode garnered the shows highest ratings ever, but then the quickly tailed off and the show went off the air in 1998.

Did being honest with herself and her audience ruin her career? Not in the least. DeGeneres returned to television on a daily basis in 2003 with The Ellen DeGeneres Show, a day-time talk show that consistently gained in the ratings and won 25 Emmy Awards in its first three seasons.

Now she has both a successful television show and personal happiness.

#20: J.K. Rowling →

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#20: J.K. Rowling

Lesson: Don't ever count yourself out.

In 1993, J.K. Rowling was diagnosed as clinically depressed and thought about suicide.

She battled the depression but in 1995 was living on welfare as she worked to complete a teaching certificate and finish her first novel. That novel, as most people now know, would be Harry Potter and the Philosopher's Stone.

Rowling summoned her creativity to become one of the richest women in Britain. A mere five years after being on welfare, she was worth hundreds of millions of dollars.

The Nurse Expert Witness: A Professional Legal Nurse Consultant Practice

Elizabeth Rudolph, JD, MSN, RN — Mon, 31 Aug 2009 10:03:00 -0700

Q: So who is an expert witness, and can I be an expert witness?

A: There is a difference between a witness and an expert witness. As a general rule, a lay witness, as opposed to an expert witness, usually testifies as to facts and does not give his/her opinion. A jury, however, normally does not have extensive scientific knowledge as pertains to nursing or medical issues. Because nursing activities commonly involve the exercise of professional judgment and the application of advanced knowledge, how the nurse deviated from the standard of care is often difficult for a jury to decide. An expert witness, therefore, is often used to assist the jury by offering an opinion as to whether the nurse committed malpractice or not. Specifically, expert testimony will be required to show the nursing standard of care, how the nurse deviated from or breached that standard, and how the nurse’s breach in care caused the patient’s harm. Any nurse may be able to qualify as an expert witness in nursing malpractice cases especially if the nurse has attained certification as a Professional Legal Nurse Consultant (PLNC).

Q: I have heard of a “Professional Legal Nurse Consultant” and was wondering what that is.

A: A Professional Legal Nurse Consultant (PLNC) is a nurse who is paid to review medical records and give an opinion about the standard of nursing care. The PLNC does not have to testify unless she/he wants to. Certification as a PLNC gives the nurse credibility.

Q: How do I become certified as a Professional Legal Nurse Consultant (PLNC)?

A: The two-day PLNC certification program by Jurex Center for Legal Nurse Consulting is offered in four formats: Live Course, Video Course, Audio Course or E-Course. Get certified as a PLNC at www.jurexnurse.com or call (901) 496-5447.

5 Signs Your Resumé is Passé

Tania Khadder — Mon, 24 Aug 2009 01:30:00 -0700

The workplace is not what it was five years ago. Neither is the job hunt.

The most successful candidates are those who are ready and willing to adapt to a changing landscape. But it doesn’t matter how ready you are for the modern workplace if your resumé’s straight out of 1994.

And sometimes, it's the most minute details that make all the difference.

Does your resumé speak to the modern hiring manager? Or does it need a serious makeover?

Your resumé might be passé if…

#1: You’ve forced it to fit onto one page

You’ve reduced your font size to eight, eliminated margins altogether and left out key information about yourself, all to conform to that age-old “one page resumé” rule. Big mistake. After all, would a recent college grad really need the same amount of resumé real estate as someone who’s been in the workforce for 20 years? Of course not.

Don’t get me wrong: Your resumé should be concise. Recruiters are busy people – they don’t have time or the patience for long-winded career chronologies. But if your experience warrants two pages, by all means, don’t limit yourself to one.

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#2: You list an objective

Of course you’re looking to gain more experience in the field/sector/type of company to which you’re applying. Your interest in the job implies that. Do you really need to say it at the very top of your resumé?

At this point in the selection process, hiring managers are far more interested in what you can do for them than what they can do for you.

If you want to explain why you’re applying for the job, say so in your cover letter. Resumé space is far too valuable to waste on information that is both redundant and inconsequential.

Continue reading on next page →

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#3: You write “References available upon request” at the bottom

Once again, a waste of valuable space. Do you really need to say so? The hiring manager can only assume that if they ask you for references, you’ll provide them. What, are you going to say “no?”

Instead, prepare a list of references with contact details and your relationship to each. Hold onto it until you’re further along in the selection process — you don’t want to annoy your referees with repeated contact by employers who are less than serious about you. Most respectable employers wouldn’t bother to contact a reference until they are fully ready to make you an offer.

#4: You attach it to your email as a Word document

While you’re unlikely to be penalized for emailing a Word document, there’s a lot to be said for converting it to a PDF before sending.

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A PDF document just looks neater. And even if you’ve gone crazy with the formatting, it will show up correctly on the hiring manager’s computer no matter what their settings, Word version, or font inventory. Besides, do you really want those squiggly red lines showing up under your former company’s name?

Stick to PDF. It’s the only surefire way to display your resumé exactly as you intended it.

#5: You list every job you’ve ever had in chronological order

In the olden days, the person with the most experience got the job.

Nowadays, the person who’s most talented, has the most relevant skill set, and has proven to be most valuable to his or her former employers gets the job.

If you want to be that person, make sure your resumé says so. Don’t list jobs that are irrelevant to the one you’re applying for just to fill up space. Instead, expand on the jobs that are relevant. Focus on measurable achievements in each role as opposed to a play-by-play of your daily responsibilities.

5 Ways to Combat Loneliness When You're Jobless

Tania Khadder — Thu, 06 Aug 2009 09:10:00 -0700

Sit in front of laptop. Lie on couch. Eat pickles for lunch. Back to laptop.

Feel sorry for self. Feel sick of self. Tear hair out in frustration. And ... back to couch.

If this is your 9-to-5 routine, you're probably like 14 million other Americans: unemployed. And in addition to the frustration of looking for work, you might find yourself feeling a little lonely.

Sure, you chat with friends online all day. And you may have a family or significant other who comes home in the evening. But good old fashioned, face-to-face contact with another human being before dinner? Kind of rare these days.

In running my unemployment blog, I’ve received plenty of emails from readers. And although many of them were lighthearted in nature, a number of them were quite the opposite. One of the saddest read: “You're the first person I've spoken to in days.”

Unemployment can make a recluse out of even the most social of butterflies. After all, you want to spend as much time as possible looking for work. And where do you look for work? Online. And where do you go online? At home.

But spending too much time alone can be detrimental, not just to your emotional well-being, but to your job search too! Staying connected with the rest of the world is not a luxury. It's a necessity!

Work from a coffee shop.

Find a coffee shop with WiFi in your neighborhood (even better if it’s free WiFi!). Grab your laptop and go. You may not be striking up conversations with fellow coffee shop patrons, but it’s nice to be in the presence of other human beings. It’s also nice to have a change of scenery; one that doesn’t include Oprah on mute and swag from your previous employer.

Next Page: More Ways to Fight Loneliness ->

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Team up with other jobseekers.

Chances are, you know others who are unemployed. Instead of each working alone in your respective homes, why not team up? Agree to meet at someone’s house, and look for jobs together. After all, misery loves company. Not only will you have others to talk to who are in the same situation, you might just find that your jobless friends make good leads. You never know who might know of a job that isn’t quite right for them, but fits you perfectly.

Go to networking events.

Whatever your industry, there are probably relevant networking or trade association events taking place locally. Not only will you keep abreast of changes in your field, you’ll get to rub elbows with living, breathing, hiring members of the work force. We all know that spending hours and hours online every day is not the most efficient way to get hired. The majority of jobseekers find work through a contact. You need to get out there and network!

Get a (night) life!

Spending eight dollars on an Apple Martini may be the furthest thing from your mind right now. And rightly so. But maintaining and growing your social network (and we don’t mean Facebook) can be a valuable part of your job search. And you don’t have to spend exorbitant amounts of money (or borrow cash from friends) to go out. Especially right now, there are plenty of extended happy hours and recession specials. Check out sites like My Open Bar to find a local spot that’s offering free (or seriously discounted) drinks tonight.

Volunteer

I’ve said this before and I’ll say it again: You can’t spend all day, every day, looking for work. Volunteering a couple of days a week will give you something else to do, a fresh perspective and a chance to spend time with others who share your passion for a cause. And depending on the type of volunteer work you choose, it may even help keep your career on track (and your resumé strong). I know a laid-off writer who started volunteering in the communications department of a non-profit agency. She says it’s keeping her busy, helping her develop her writing skills, and preventing her from sticking her head in an oven. Not bad for a dozen or so hours a week, which would have otherwise been spent obsessively surfing the web.

Stalk Your Way to a New Job

Tania Khadder — Thu, 06 Aug 2009 09:09:00 -0700

The internet has made stalkers out of all of us. You know exactly what I'm talking about.

But instead of stalking your ex-boyfriend's new girlfriend, consider using your newfound detective skills for more productive (i.e. less emotionally jarring) purposes, like snagging the job of your dreams.

Interested in a company and need to find a person to contact? Google away. Trying to suss out the guy who’s interviewing you next week? Facebook him!

Within minutes, you can find out where he's from, how to reach him, where he's worked in the past, and – perhaps most importantly – what his favorite movie is. The more you know about him, the better your ability to sell yourself.

We’re not suggesting you cultivate an entirely false personality to match your interviewer -- that would be disingenuous and would surely come back to bite you.

But knowing a bit more about someone can help you find points of commonality you might otherwise have missed. If you find out they went to your alma mater, you can ever-so-subtly work that into the conversation in an interview. Or maybe you share the same taste in music? Find an appropriate way to bring it up. We all know that getting hired has a lot to do with likeability. And fair or not, people generally like other people who are similar to them. Why miss out on an opportunity to highlight these similarities?

Are you ready to do some in-depth detective work? Luckily, you've got an extremely powerful investigative tool right at your fingertips. Abuse it wisely!

Next Page: Start with Google Stalking →

*Disclaimer: These tips were designed to help you stalk in the most legal, non-creepy way. We do not encourage or condone harassment, obsessive behavior or any kind of physical stalking.

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Google

What did people do before Google? They used encyclopedias. And fold-out maps.

They also had a lot less information on potential employers.

Embrace this search engine giant. For jobseekers, it's an absolute godsend.

Maybe you already know the name of the person who’ll be interviewing you and you just want to know a little more about them before the face-to-face interrogation. Or perhaps you want to send someone your resume and cover letter but need to track down contact details and some background information.

If Googling your person of interest is limited to a simple full name search, you’re missing out on lots of prime stalking potential. Try adding other relevant keywords to maximize your results. Where did they go to college? Where do they live? Where have they worked? By adding these items to the search terms, you’ll likely get more relevant results.

Here are some other Google tips:

• Make sure you search their full name in quotation marks: “John Doe”

• Try searching for possible alternative names, usernames, and nicknames. You can sometimes find their favorite username by finding them on Facebook, then using the beginning of the email address listed. So, if John Doe’s email address is johnnydoeeyes@gmail.com, search for: johnnydoeeyes and see what comes up.

• If you know where they work or went to college, look for any mention of them on that particular site. So let’s say they work for Apple. You would google: site:apple.com “john doe”.

• If you know where John Doe works, you can easily figure out his email address. Let's say, once again, that he works at Apple. Search: “john doe” email, @apple.com. You may want to try various name combinations (i.e. first initial plus last name, or last name first)

• If a page has come up in your search but it is no longer available, try hitting “Cache” — often that will bring up the expired page.

• Don’t forget to try Google Images: this is especially useful if you’re unsure of the gender of your person of interest.

Next Page: Facebook Stalking Is Such Fun! →

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Facebook

While it can be an incredibly useful tool for tracking people down, Facebook can also be incredibly useless – it all depends on a person’s privacy settings.

The first step is to search the person in question's name. Make sure you try any nicknames, in addition to their full name.

You may get several people with the same name (and you may or may not know what they actually should look like). Try narrowing it down using networks. If you know they live in Los Angeles, set the network appropriately and see what comes up.

Other tips for optimizing your Facebook search:

• When you find your “stalkee,” you may be able to get into their profile page right away. If you can’t, try changing your network to match theirs – they may have set their profile to only allow access to people in their network. You can only do this a few times, so make sure this person is truly stalk-worthy.

• Alternatively, you can set up a fake profile solely for the purpose of modifying your network where necessary and view their profile that way.

• Still can’t get onto their profile? Check to see if you know any of their friends. If you do, invite that person to be your friend. Once they accept, you may be able to find information on your stalkee in your mutual friend’s feed. For example, you can look for any wall posts your stalkee might have left on their page.

• Want to know who’s stalking you? Try the new Facebook application that allegedly gives you a ranked list of your “stalkers.” Whether or not it actually legitimately tracks who visits your profile — or simply how many times they’ve commented, messaged, tagged, etc –- is still up in the air.

• Want to know what your friends can and can’t see? Go to your privacy settings, type in the name of your friend and view your profile just as they see it.

Next Page: Tweet Stalk Your Prey →

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Twitter

Twitter may not reveal the information you’re looking for in the most organized, upfront way (a la Facebook), but following someone over time can give you a very intimate glimpse into their daily life and personal character.

If you know how to use it, Twitter can be a very fruitful stalking tool.

One of Twitter's greatest assets is that it has made it perfectly acceptable to "follow" strangers without seeming creepy –- especially if they are visibly part of your industry. (For more on how to use Twitter, go here).

Once you're following your person of interest, you can "retweet" their tweets, or reply to their tweets if they are of interest to you. An appropriate retweet would be responding to an article in your industry. An inappropriate retweet would be responding to that person’s tweet on how much they love their wife or what they had for breakfast. Keep it professional or you’ll earn a reputation for being creepy.

Someone I know scored a writing gig by following the editor of the target publication for a few months. From time to time, and where appropriate, she would reply to the editor’s tweets with links to her own articles. She was simultaneously emailing the editor, pitching story ideas and requesting an interview. Eventually, the editor agreed to meet her and she got the job. Not bad for a few tweets.

Twitter is also helpful because, unlike Facebook, it allows you to follow people without their consent or reciprocation. And now, thanks to the new app Tweet Stalk, you can follow people without them even knowing.

Finally, Twitter can be used to track down leads. You can search for the name of the company you’re interested in to see if anyone in the Twitterverse is affiliated with it. Once you find them, begin following and ask if they have contacts. They may ignore you altogether, but they might just help you out. Either way, there’s no risk in trying.

Next Page: Two More Stalking Tools →

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LinkedIn

This professional networking tool can be a fantastic stalking tool. For example, you’re looking for a contact at XYZ company. You search that company on LinkedIn and find names of relevant hiring managers.

Using the tools we showed you in the Google section of the article, you may be able to find said hiring manager’s email address. Now you can email them directly regarding the position — which means that instead of getting lost in the internet abyss, your resume might actually be seen.

You may also be able to use your own LinkedIn network to track down leads. Check to see who your connections’ connections are. If you see anything interesting, ask for an introduction. Too shy? Nonsense! There's no room for shame in a job hunt.

Jigsaw.com

Got some money to spend? For $250 a year, you can get access to up to 250 business cards (out of 14 million) on Jigsaw.com. How does it work? Members share data from business cards they’ve collected. Once you join, you gain access to the growing database. If you’re serious about your stalking, are desperate for a lead and have some disposable income, this site might be the way to go.

In this day and age, there's just no excuse for not having an arsenal of information on your job leads. At the very least, you should be scouring the company's website for inside information. But if you really want an edge on the competition (and I'm pretty sure you do!), you should be doing some more in-depth detective work.

Now leave your ex-boyfriend alone and get to work!

*Disclaimer: These tips were designed to help you stalk in the most legal, non-creepy way. We do not encourage or condone harassment, obsessive behavior or any kind of physical stalking.

9 Ways to Wake Up Earlier for Your Morning Shift

Tania Khadder — Fri, 24 Jul 2009 15:09:00 -0700

Some of us are night owls. Others, early birds.

Apparently, based on your chronotype, you will be more naturally alert earlier or later in the day. And your type may dictate when and for how long you sleep. But while a natural variance in sleep patterns is natural, it appears that the early bird is indeed the more coveted of the species.

We’ve heard it time and time again: most CEOs wake up before 6am. It’s often said that the most successful people are early risers – and it makes sense. Chances are if you get up early you spend less time sleeping, which frees up more time for other, more productive activities.

In addition, the early morning is often the time of day you have most control over. Unlike later in the day, very little happens between 5am and 8am that can throw a wrench in your plans.

But how does one go from night owl to early bird? And can you?

The truth is, no matter what your natural rhythm, many people have been able to train themselves to become early risers and/or need less sleep. We'll show you how.

First Tip: Sleep when you're tired >>

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1) Go to bed when you’re tired, and wake up at the same time every day.
You might be thinking, “duh." And you’d be right. But as obvious as it sounds, it can be harder than you think.

Just last night, I was ready for bed (which, for me means dozing off on the couch) around 10pm. But being the sucker for bad television that I am, I got sucked into watching a new show. By the time it was over, I was no longer sleepy. I ended up staying up until well after midnight. And for what? Mindless television I'll have forgotten about by the end of the week? Great. I would have much rather had two or three more hours of sleep.

And what if you’re not tired until 1am? That’s okay too. Just make sure you still set your alarm for the new, earlier time. The next day you’ll likely be tired earlier than usual, and a new, more steady sleep pattern will begin to take shape.

What you don't want to do is try to force yourself to sleep when you're not tired. You'll just end up feeling frustrated. You'll waste valuable time in bed not sleeping. And you might develop an anxiety around not being able to sleep, which can lead to insomnia. So wait till you're tired, wake up at the same time every day, and eventually, your new cycle will fall into place.

First Tip: Know the 90-minute rule >>

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2) Know the 90-minute rule.
We’ve all heard that eight hours sleep is the ideal, but this theory goes against sleep research that says human sleep cycles occur in 90-minute intervals.

This hour-and-a-half is said to include two doses of REM sleep, separated by one of non-REM. Therefore, the best way to get the most of your sleep time is to make it a multiple of 90 minutes. And it makes sense. I’ve noticed that when I sleep a full eight hours, I wake up feeling groggier than I do when I sleep for six, even though I’m missing out on two whole hours of shut-eye.

Next Tip: Cut down slowly >>

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3) Cut your sleep time incrementally.
You might be used to sleeping eight hours a night. But the truth is, you may be able to get by on less if you train your body to do so. And it’s not about getting used to surviving the day on less fuel. It’s about training your body to squeeze more quality sleep (REM) into the time allotted.

In order to make this process as painless as possible, cut down 30 minutes at a time. Plan to sleep for 7 ½ hours one week, then seven the next week, and so on and so forth until you’re down to your ideal sleep schedule.

Next Tip: Have a good reason >>

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4) Give yourself a good reason to get up.
If you’ve got no good reason to get out of bed at a certain time, you’ll never do it. It can be a 6am gym class, a project you need to get a head start on or a delicious cup of coffee and the New York Times.

It doesn’t really matter what it is, just that its benefits outweigh those of your evil but oh-so-tempting snooze button. If it’s something you look forward to doing, even better. Tip: If you’re a coffee drinker, invest in a percolator with an automatic timer. Set it to brew at the time you’d like to get up. The smell of freshly brewed coffee, first thing in the morning? It really is the best part of waking up.

Next Tip: Wake up with light >>

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5) Let the sun shine in.
Unless you have a stalker or a peeping tom, leave your curtains or blinds open so as to let in light in the morning.

When it’s dark, your body responds by producing sleep hormone melatonin. On the other hand, light discontinues this process and provides a natural cue to your brain that it’s time to wake up. Does your window face a brick wall in a dark alley? Worried about that peeping tom? Or maybe (hopefully) you just prefer to have more control over the time in which light floods your room? No problem! The people at Phillips have made an alarm clock with a large lamp that gradually increases the amount of light in your room to simulate the sunrise. Genius!

Next Tip: Move your alarm clock >>

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6) Move your alarm clock.
Often, the hardest part of getting up early is actually getting out of your warm, comfortable bed. So if you have to get up to shut off your alarm clock, you’re already halfway there! Move it to the other side of the room, and set it to a truly intolerable sound at a high volume. For you, that might be the sound of a buzzer. For me, it’s the sound of deep house music.

Whatever it is, it needs to drive you crazy enough to make you need to get up and shut it off. And once you’re up, you’ll likely stay up (thanks to all those great things you need to get up for – see #4).

Next Tip: Don't snooze! >>

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7) Don’t let yourself snooze.
You know the drill. You keep telling yourself “just 10 more minutes." The next thing you know, it’s been an hour-and-a-half and not only did you miss out on your precious morning time, but you're now late for work. And the worst part? That hour-and-a-half was absolute torture, thanks to the blaring sound of your alarm clock, which has been disrupting an otherwise pleasant dream at 10-minute intervals.

Just say no to snoozing! It’s no longer an option. Think about it: if you’re going to snooze that long, you might as well have set your alarm an hour-and-a-half later and gotten some quality shut-eye.

First Tip: Drink up >>

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8) Drink a glass of water.
If the excruciating urge to urinate doesn’t get you out of bed, you’ve got much bigger problems than sleeping in. Drink a glass of water before going to bed and you’ll naturally get up early.

After you drink that evening glass, refill it and leave it on the night stand for the next morning. A glass of water first thing in the morning will kick start your metabolism and get you up and running, even before you’ve had your first cup of coffee.

Next Tip: Wake yourself up>>

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9) Be your own alarm clock.
It may sound crazy, but if you tell yourself you’re going to get up by a certain time, often your body will wake you up naturally.

If you haven’t experienced this, try it some time. Tell yourself you need to get up at 5:30am. Set your alarm clock for 5:45am (just in case!). You may be surprised to find that you wake up right on time, give or take a few minutes. This will be especially more doable once you’ve gotten into the habit of going to sleep and waking up early for a few days or weeks.

When you do manage to wake up without an alarm clock, you'll find the transition back to full consciousness much more pleasant.

22 Affordable Ways for Nurses to De-Stress

Nina Kim, Georgia Price | NursingLink — Mon, 20 Jul 2009 14:30:00 -0700

Whether you’re an palliative care nurse dealing with end-of-life care, or a nurse educator teaching the next generation of RNs, any job in nursing can be overwhelming and stressful. Learning how to manage stress and channel it through positive means is vital, not just for a successful career, but for your happiness and well-being too.

If you don’t take time to unwind, constant stress can lead to a number of physical and psychological problems, like poor concentration, depression, back pain and weight gain. It also weakens your immune system and increases your risk for cancer and cardiovascular disease.

That’s why NursingLink came up with these 22 different ways to de-stress without breaking the bank. So hit pause, relax and indulge in some much needed (and affordable!) R&R. A hardworking nurse like you deserves it!

Next Page: Stress Reliever #1 >>

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1. Do Something You Did All the Time as a Kid

Do you ever long for those days when your biggest concerns were nap time, recess and Saturday morning cartoons? You’d build pillow forts at slumber parties, climb the biggest tree in your neighborhood and catch fireflies at night. It’s amazing how much less complicated life was back in the day.

Just because you’re all grown up now doesn’t mean you can’t still partake in the simple joys of childhood. Turn off your Blackberry, disconnect from the internet, and act like a kid whenever you can. Revel in the refreshing nostalgia, and feel the positive associations and memories melt away your stress.

If you have kids of your own, have them participate in these activities with you. Ride a bike to the park. Start a pick-up kickball game with your family or friends. Make a snowman in the wintertime. The possibilities (and your imagination) are endless.

Cost: Free

More Info: Think of your favorite childhood pastimes

Next Page: Stress Reliever #2 >>

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2. Volunteer Your Time or Expertise

One of the best feelings in the world is giving back to others. As a nurse, you have tons of knowledge and experience, so why not share your skills with someone else? Volunteering can be something small – like reading a story to young cancer patients one day a month – or something bigger – like serving as a disaster relief nurse. No matter what you do, you can be content to know that you’ve made a difference in someone’s life.

Not only is volunteering incredibly fulfilling, it’s also a great resume builder. If you’re a recent grad or career changer, volunteering can give you valuable training and hands-on experience to jump start your career in nursing.

Non-profit associations are always looking for more help, so even if you can only donate 5 hours a month, your time will be very much appreciated and well worth the effort.

Cost: Reading at your local hospital or cleaning up litter at your favorite park costs next to nothing (just factor in the transportation costs and pack your own lunch). Volunteering abroad may cost the price of airfare and lodging.

More Info: Google “volunteer” and your town and state or visit Volunteer.gov, American Red Cross, Serve.gov, Volunteers of America, and Habitat for Humanity.

Next Page: Stress Reliever #3 >>

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3. Stretch, Breathe and Meditate

It’s hard not to feel stressed and overworked by the hectic pace of a hyper-connected society that moves at the speed of MyFaceTwitSpaceBlackBookBerry. Before you go into meltdown mode, hit pause, relax and take a breather.

Even if yoga’s not your thing, basic meditation, stretching and breathing techniques, though seemingly simple, can work wonders for your stress relief. When you stress out, tension is stored in your body, causing pain and tightness, especially in your back and shoulders. Stretching will get your body loose and your circulation flowing in full force again.

To meditate, find a relaxing atmosphere, sit on level ground (find a cushion if uncomfortable), close your eyes, relax every muscle and breathe deeply with your abdomen, not your chest. Focus on each inhale and exhale to exclude other thoughts and quiet your mind.

Cost: Free

More Info: Google “how to meditate” or visit How-to-Meditate.org

Next Page: Stress Reliever #4 >>

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4. Hang Out With Your Funniest Friend

It’s been scientifically proven that laughter is both preventive and therapeutic. It decreases your stress hormone levels and boosts healthy hormones, like endorphins, strengthening your immune system. You even get a mini workout for your abs, diaphragm and your shoulders.

Not only will laughing with your friend boost your mood, it’ll take your mind off all the stressors in your life. It offers a release from the pent-up emotions and frustrations you may be feeling, and the emotional bonding will boost your self-esteem and feeling of connectedness to others.

Laughter really is the best medicine, so call up your funniest friend and hang out. You’ll be glad you did.

Cost: Free

More Info: Call your funniest friend

Next Page: Stress Reliever #5 >>

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5. SLEEP

Nothing beats a good night’s rest. Patients buzzing you non-stop? Holier-than-thou doctors bossing you around? Many nurses bring their troubles home with them and that equals more stress for you and your loved ones. Why not sleep it off? Getting even 30 minutes of shut eye can help you relax and put your problems in perspective.

If you’re going to try to sleep off your stress, make sure you’ve got surroundings that promote good quality rest. A dark, cool, quiet room with few electronics is best. Feeling antsy but still want to rest? Try a cup of Valerian Root or chamomile tea. A warm bath can also help put you in a restful state of mind.

Cost: Free

More Info: National Sleep Foundation

Next Page: Stress Reliever #6 >>

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6. Visit the Shooting Range

Does your stress ever turn into rage, and you want to rip your hair out and scream? Before you tear down your curtains and punch that hole in your wall, consider paying a visit to your local shooting range.

There’s something curiously calming about loading a gun, aiming, squeezing the trigger and hearing the bullets rip holes into a paper target. Not only does it release the physical tension that’s been building up from your stress, but you also get the satisfaction of taking home your target and showing off your killer aiming skills to your friends.

Shooting ranges generally charge by the hour, and the prices are reasonable if you have your own gun. Renting a gun isn’t that much more expensive, but if you wanted to take a class, they’re a bit pricey, ranging from $40 to $65.

Cost: $10-18/hour if you have your own gun; Renting a gun can be $10-20/hour extra; Classes run $40-65

More Info: Google “shooting range” and your town and state

Next Page: Stress Reliever #7 >>

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7. Buy Cheap Paints or an Art Project at a Hobby Store

Looking at art definitely has its calming effects, but it’s not always just about the product. You don’t have to be Picasso to get the health benefits of producing beautiful works of art either. People who make art as a hobby find that the process of self-expression through unwinding and creating art can be extremely soothing as well.

Artistic self-expression originates from Sigmund Freud and Carl Jung, who theorized that the power of imagery could tap into the thoughts, memories and feelings of a person, whether conscious or unconscious. Art therapy is thus frequently used in hospitals, clinics and rehab facilities to promote physical, emotional and mental wellbeing via creative expression.

Making art helps lessen anxiety, stress and depression, and promote self-awareness, self-esteem and insight into your life. You can pick up reasonably priced art supplies or art kits at any hobby store. Just set aside an art space, turn on some relaxing music and paint to your health.

Cost: $7-25

More Info: Google “art store” or “hobby store” and your town and state

• For art techniques or ideas, visit ArtBistro’s Training Center

• For more info on art therapy, read Mending the Heart--Calming the Mind With Art Therapy

Next Page: Stress Reliever #8 >>

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8. Cook a Delicious Dinner with Items You Have in Your Fridge

America’s “Fast Food Nation” mentality has us plowing through processed, barely digestible microwave dinners and super-sized extra value meals. Not only is our physique suffering, our stress and anxiety levels are off the charts. Everything around us, even food, is moving at the speed of light.

Back up, slow down and consider taking the time to cook your next meal with simple items you already have in your fridge and cupboards. Cooking takes patience and persistence. The process of chopping, measuring, stirring and sautéing can be incredibly therapeutic.

Check what ingredients you have in your kitchen, and look up a recipe (see below). Pick something simple to make, so the preparation and cleanup don’t stress you out. Let the culinary sensations, like scent, sight and touch mesmerize you. Finally, take pride in the sense of accomplishment as you slowly enjoy your delicious meal.

Cost: Free

More Info: Visit any of these websites to get recipes based on ingredients that you have:

• Allrecipes.com

• Cookingbynumbers.com

• Bigoven.com

• Recipematcher.com

• Supercook.com

Next Page: Stress Reliever #9 >>

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9. Go on a Hike or Go to the Park

Sometimes we get so caught up in traffic, shopping malls and the hustle and bustle of everyday life that we forget to stop and smell the flowers. But when Ralph Waldo Emerson said “adopt the pace of nature,” he wasn’t being poetic—he was being entirely scientific.

Science has proven time and time again how the psychological benefits of nature can calm the brain and better your mood and concentration. Hospital patients recover faster when they have a view of trees and flowers from their window, and children with attention-deficit disorder exhibit less symptoms in a natural environment.

So get back to basics, and enjoy nature. Bring a blanket to the park and lie out, or go for a hike and take in the scenery. Bask in the sun, breathe in the fresh air, and appreciate all the colorful simplicity of the outdoors. Your brain’s health depends on it.

Cost: Mostly free (Some parks/hiking grounds may charge $3-5)

More Info: Check out this great interactive park directory or just Google “hiking trail” or “park” and your town and state

Next Page: Stress Reliever #10 >>

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10. Take a Bath with Candles and Aromatherapy

The recuperative and healing properties of water have many stress-relieving benefits and allow the body to fall into a deeper sleep. Submerging in a bath tub relieves your body from the constant pull of gravity, and heated water relaxes muscle tension, improving circulation, range of motion and energy flow.

Melt away your stress by creating a mini spa in your bathroom. Turn on soothing music, dim the lights, light candles and prepare fresh towels. The music will drown out household sounds that you may associate with everyday stressors, and relaxed lighting can go a long way when creating a peaceful mood. You can pick up high-end aromatherapy bubble bath soap, skin-moisturizing oils and exfoliating body scrubs on the cheap at your local T.J. Maxx, Marshalls or Ross.

Most importantly, make arrangements for your well-deserved uninterrupted solitude. Turn off your cell phone, log out of email and if you have roommates or family around, tell them to leave you alone for an hour or two. Be sure to prepare your bed beforehand so you have a nice, comfy space to crawl into after your bath.

Cost: $4-18, depending on how many spa items you want to buy

More Info: High-end spa items are always available at deep discount at stores like T.J. Maxx, Marshalls, and Ross

Next Page: Stress Reliever #11 >>

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11. Get Your Adrenaline Pumping!

Whether you’re exhausted, frustrated, or just plain stressed-out, nothing beats the blues like getting your blood pumping. Exercise, and the adrenaline it produces, has been proven to help people relax – probably because you’re so tired afterward! The thought of dragging your tired behind to the gym after a 12-hour shift might sound awful, but that’s not your only option. There are tons of great ways to exercise that don’t involve weights, spandex, or protein powder.

Got a dog? Take him for a nice, long walk. Slip on your sneakers and you’re good to go! Looking for something a little more exciting? Try a class like kickboxing or spinning. You can punch and kick your stress away, or imagine yourself cycling toward your next vacation!

Cost: Free if you do something outdoors or at the community center. Gym memberships generally start around $30/month. With this economic climate, you can negotiate a good deal.

More Info: Gym.com, your local community center

Next Page: Stress Reliever #12 >>

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12. Make “To-Do” Lists and Actively Check Off Items

I don’t know about you, but I love to be organized. Even if my “To-Do” list consists of things like “take a shower” and “walk the dog,” I feel like I’ve accomplished something once I’m able to check an item off my list. Try making a “To-Do” list for simple things, like folding laundry and running errands. Each time you complete a task, check it off. The action of crossing something off a list is a tangible way to see how much you’ve accomplished in a day.

Cost: Using a scrap of paper won’t cost you a thing, but you could also splurge for a cute notepad or colored Post-It notes. Don’t want to use paper? Invest in a white board ($5-$12 at your local office supply store) and hang it on the fridge.

More Info: Papyrus Stationary, Office Depot

Next Page: Stress Reliever #13 >>

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13. Get a Free or Discounted Massage

Massage therapy has a rich history across several cultures. Hindus, Persians, Egyptians and the Chinese have been healing ailments with massage for thousands of years. Hippocrates even wrote papers recommending massage to treat joint and circulation problems.

The physical and psychological benefits of massage are plentiful. It reduces anxiety and the level of stress hormones in the body, improves circulation and your immune system, and increases your self-esteem via direct contact with another person through touch.

Your body can go through significant wear and tear from being on your feet tending to patients, or hunched over a desk all day. Relax by recruiting the soothing hands of a significant other or look up a massage school near you for a discounted massage. Massage students must practice their skills for their training, so they offer their services for about half the cost of a regular massage.

Cost: $15-30

More Info: Google “massage school” and your town and state, or use this nationwide massage school finder.

Next Page: Stress Reliever #14 >>

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14. Organize Your Living Space

Ever have one of those mornings where it feels like someone came in during the night and stole your keys, work badge and wallet? From unearthing the heaps of laundry scattered about your room to digging through each of your four work bags, there’s no doubt about it: your house is a mess. And you feel like your life is kind of a mess too because of it.

Take a Saturday afternoon to roll up your sleeves and get your living space in order. It’s amazing what coming home to a clean, organized home can do. If you can control the area you live in, you feel better equipped to control other factors in your life. Plus, you don’t waste time having to look for everything all the time.

Cost: Free

More Info: Check out WomenCo.’s Stress Relieving Home Décor Ideas on a Budget

Next Page: Stress Reliever #15 >>

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15. Try At-Home Yoga

Yoga has been practiced for more than 5,000 years. Close to 11 million Americans practice yoga to calm their mind, relieve and prevent chronic medical conditions, and increase flexibility and strength. Yoga harmonizes the mind with body, decreasing anxiety and stress hormone levels and promoting concentration and a good mood.

Focusing on your breathing during yoga disengages you from your thoughts and helps to calm the mind. Each yoga session ends with five to ten minutes spent relaxing in corpse pose, or “savasana,” and you finish with a sense of well-being and feeling of “oneness” with the world around you.

Yoga in the studio can burn a big hole in your pocket, so try at-home yoga with a video. Some libraries carry yoga videos, or you can get cheap yoga videos from Amazon.com or Half.com. If you need to buy a yoga mat, opt for larger, discounted sporting good stores instead of studios or boutiques.

Cost: Free (borrow from library) or $1-20 (on Amazon.com and Half.com)

More Info: Visit Amazon.com or Half.com to get cheap yoga videos or your library may have videos to check out.

Next Page: Stress Reliever #16 >>

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16. Crank Up the Music and Dance

The idea of dancing, especially with a partner, can make some people break out in a cold sweat. But dancing can be a great stress reliever by renewing your sense of creativity, revitalizing your energy and boosting your confidence. It even strengthens your immune system, reduces anxiety and floods your body with serotonin.

Because of its health benefits, dance movement therapy is often used in schools, hospitals and rehabilitation centers to treat conditions, like eating disorders, sexual and physical abuse, autism and substance abuse.

So cast those inhibitions aside, crank up the music, and dance in the privacy of your own home. You can even slip on an oversized dress shirt and socks and rock out like Tom Cruise did in Risky Business.

Cost: Free

More Info: Crank up the music and dance

Next Page: Stress Reliever #17 >>

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17. Build a Garden

Starting and maintaining a garden takes great patience and nurturing from the first step of buying the materials to taking the first bite of your hard-earned work. But the process of digging, planting, watering, feeding, trimming and watching your plants grow can be amazingly beneficial as stress relief.

Gardening gets you out of the house, away from distractions, and basking in the sun – heck, just being in the sun improves your mood drastically. Building a relationship with the outdoors and creating natural beauty helps you feel more at one with your environment and calms your mind.

You don’t need an acre of land or very much money to start a garden — most seeds only cost a couple of cents. Just visit your local garden supply, and pick up some tools, soil, fertilizer and seeds. If you don’t have a yard, buy a window box and place it in the sunniest window sill.

Cost: $5-30 (for a basic garden)

More Info: Google “gardening guide” or visit GardenGuides.com

Next Page: Stress Reliever #18 >>

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18. Take a Long Drive

You may have negative associations with your car if you only use it to drive through rush-hour traffic to get to work or car pool the kids to Little League practice. Consider taking your car out for a spin during the night to relax, have time to yourself, and just drive with nowhere in particular to go.

Either drive in silence or turn up your favorite album, whichever is more relaxing. Roll down all your windows, and let the wind blow through your hair. The most important part is to keep driving, though, so hop on the freeway or take back roads to avoid stoplights. (Having to wait at a stoplight might increase your stress!)

Having time to yourself and the absence of traffic at night will calm your mind, as will the accompanying music or silence. Safety first, though! Always drive the speed limit and obey traffic laws.

Cost: $5-8 for gas

More Info: Take your car out for a spin or borrow a friend’s or family member’s car.

Next Page: Stress Reliever #19 >>

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19. Borrow a Book or DVD From the Library

Picture this: a cool summer evening, a glass of your favorite beverage, and a beloved copy of Harry Potter. Or Anna Karenina. Or the latest John Grishman novel. Whatever your preference, a book is a great way to unwind at the end of the day. What’s better? Books are easy to get and you can get them for free. That’s right. Sign up for a library card (if a membership isn’t free, it's most likely a one-time fee of less than $5) and you can check out hundreds, even thousands, of books.

Many libraries even give away books that aren’t being checked out anymore or are an older edition. Ask your library if they ever have any book fairs or give-aways, and pick up some great classics!
Looking for something a little less literary? Many libraries now carry a large selection of DVDs. Pick up an old classic or the latest hit, and unwind in front of the tube. Renting a DVD from a library is usually free or at most half the cost of renting one from your local video store.

Cost: $0-5

More Info: Google “library” and your town and state or visit American Library Association

Next Page: Stress Reliever #20 >>

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20. Spend the Day as Mrs./Mr. Fix-It

Remember those flowers that need replanting? Or that loose board in the deck that should probably be replaced? How about the Christmas lights you still haven’t taken down? Small tasks like these might seem daunting, but dedicating a day to fixing up your home can help you de-stress and manage your life. You’ll be getting things done that have been in the back of your mind (or your spouse has been nagging you about!). Plus, cleaning up your home can reinvigorate you. Even painting one wall a new color can breathe new life into your house.

Completing projects is also a great way to spend time with your family. Dad can dig holes for new flowers while mom repots the dahlias and the kids decide where they go. Looking for some “me time?" Stay focused (and avoid negative thoughts) by concentrating on one project at a time. Even if you only fix one thing this weekend, you’ll feel better for accomplishing something.

Cost: Just the money you spend on supplies

More Info: Visit Fixya.com, Home Depot or Lowes, DoItYourself.com

Next Page: Stress Reliever #21 >>

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21. Attend Free Community Events

Summertime means community festivals, street fairs, and celebrations – most of which are free. Take advantage of these fun events by gathering a group of friends together to peruse craft fairs or sample tasty treats. You don’t have to spend any money, but if you see a beautiful hand-painted teapot that you can’t live without, you’re welcome to splurge a little.

Many free community events include music or movies. Davis, California hosts “Movies in the Park” all summer long. The city erects a giant projection screen and invites the community to bring their lawn chairs and sleeping bags to Central Park for a free movie.

Cost: Free or however much you want to spend. Walk or take public transportation to save money and reduce emissions

More Info: Check your local community center or City Hall. Google “summer festivals” and your town and state

Next Page: Stress Reliever #22 >>

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22. Go On a Picnic

The NursingLink Team Picnic
A picnic is a relaxing (and affordable!) way to spend quality time with your friends and family. You don’t have to pack a fancy spread or bottle of champagne to make it a worthwhile trip. Ask everyone to sign up to bring a dish, and turn it into a potluck. Looking for something on the romantic side? Stop by your local farmer’s market and pick up some strawberries and melt your own chocolate for a delicious treat.

Cost: Finding a shady patch of grass and laying down a blanket doesn’t cost a thing. Pony up the dough for store-bought goods, or make something at home on the cheap.

More Info: Find a park

Next Page: Don't Stress Out! More Stress Management Resources >>

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More Stress Management Resources

• 6 Ways Nurses Can Beat Compassion Fatigue

• Need a vacation? Check out The Best 25 Vacation Cities for Healthcare Workers

• Informative Quiz: Are You at Risk for Burnout?

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**4) Give yourself a good reason to get up.**