Holiday Traditions

The holidays have always been my favorite time of the year. My family is spread out all over the country and the holidays are the only time of the year that we all get together to celebrate.

A large part of my family’s holiday traditions revolve around food. Coming from a diverse European ancestry, my family has accumulated countless “secret recipes,” ranging from my Czech grandmother’s stuffing to my German grand mother’s Christmas cookie recipe.

For the past several years, I have hosted Friendsgiving, which has been a really cool experience. Everyone brings a dish that is part of their family tradition. It’s really great to experience different cultures this way.

Working in healthcare does cause some scheduling difficulties when it comes to the holidays. I have gotten into the habit of celebrating Thanksgiving a week early with my family so that I can work the holiday. It has worked out pretty well and has formed a new family tradition! I don’t get too upset about not being able to celebrate on the actual holiday because I feel like any time my family and friends are together, that’s the real spirit of the holiday.

Kate Best is 2015 graduate of The Ohio State University College of Nursing. 

Relighting Your Nursing Passion

Career burnout is a hot topic with almost any profession, but it seems burnout is more common with nurses. Working 36 to 40 hours a week, whether it be in three 12-hour increments or four 8-hour increments, it is very easy to get tired of what we do every day, and sometimes our work takes a toll on our everyday lives — that’s usually how you know burnout is approaching.  I recently found myself coming home after a typical shift (which usually last around 13 or 14 hours by the time I get to clock out) and sprawling across my bed unable to move.  Nurses stand on their feet, sometimes sprinting around a hospital, for over 12 hours a day.  I come from a background where I used to workout every day while in school, but I didn’t realize how much more exercise I would be getting at work.  Also it’s not just a physical burnout some nurses feel — they also feel emotional and mental burn out as well.  I won’t go into details, but we all know the types of things we can encounter at work. It can be super tough.

I have found a couple ways that I try to prevent burnout from happening and keep the spark for what I love doing every day alive.  Sometimes the best thing to do is take some time off.  Most workplaces allow for PTO to be accrued and taken as long as it’s available.  I have planned a getaway trip to Nashville in January where I am allowing myself to take much deserved time off from work.  I also periodically request random days off, obviously in advance according to hospital policy, where I can spend time with my family or have a day to myself to do school work or things that I enjoy.  I find that when I have a week where I don’t work nearly as much as a typical week, I start to miss being there and it excites me to go back to work the next shift.  More importantly, if you are having a bad or stressful day at work – which I’m sure we all have or soon will have – I find that it’s best to take a quick break, calm down with some deep breaths, talk it out with a coworker, and quickly pick yourself back up and move on.

We have learned to be resilient as nurses and when we encounter very hard things at work — whether it be with a patient or personal news we may receive at work — we all know that we can’t bring emotions into the patient care area. I find the same adage helps with dealing with a stressful day at work that typically could be the breaking point with nurse burnout.  I recently had a very stressful day at work the other day, on the verge of tears, so I talked it out with a coworker to let out my emotions, picked myself back up, and went on in to the next patient room.  As long as we are caring for ourselves first and foremost, nurses are typically able to handle all facets of the job that are thrown our way.  Don’t forget, we’re just superheroes disguised in scrubs.

Sydney Adelstein is 2016 graduate of The Ohio State University College of Nursing. 

Fighting Self Doubt

As a novice nurse, I experience a fair amount of self doubt. I work among some extremely talented and knowledgeable nurses. When I compare myself to these nurses with decades of experience, I sometimes feel discouraged and inadequate. I have been able to combat these feelings of self doubt with a few steps:

  1. Ask questions. If you don’t understand something- just ask. This is the easiest way to learn new things. If I’m getting shift report and someone uses an abbreviation I don’t understand, I’ll ask for clarification. If doctors order an intervention that I’m not familiar with, I’ll ask for the meaning behind the intervention. A lot of the times this occurs during bedside multidisciplinary rounds, so it creates a learning moment for everyone.
  2. Educate yourself. A major perk of working at a teaching hospital is the large amount of continued education and specialization classes offered. If I feel inadequate in a certain area of my practice, there is always an educational opportunity available to help me combat that inadequacy. For example, last year I took care of several immigrant patients, which I had minimal experience with. I found a continued education class on providing care to the immigrant population and now feel better prepared to work with this population.
  3. Get involved. I recently joined the Critical Care Quality and Education committee and am working with other ICU nurses to provide education to our units to improve care. For example, OSUWMC just rolled out the Yale Swallow Evaluation, which is a tool developed to determine whether patients are able to swallow safely or if they need a formal speech therapy consult and swallow evaluation. Our committee received education on the evaluation and we in turn presented the material to our units. In other words, the best way to learn is to teach!

In summary, be proactive in your practice. When you feel inadequate, reflect and determine why. It’s scary being a new nurse, but you’ll have tons of resources at your fingertips and lots of people to help you along the way!

Kate Best is 2015 graduate of The Ohio State University College of Nursing. 

Why I Became A Nurse

I had switched jobs — not only type of nursing but health system as well. I loved where I left and loved even more where I came to.  I started out my nursing career in an emergency department, which was where I had been throughout college, which is very different than the basic nursing we are all taught in nursing school, and very different than med-surg nursing.  Since you are with patients for a short time, you don’t get that one-on-one bonding with the family you get in med-surg since you typically receive the same assignment day-in and day-out as long as you are working.  That’s one of the big differences.  But there are always the instances where you have special encounters with patients and you realize that it doesn’t matter what type of nursing you do, you still come into contact with patients who you not only make a difference in their life but ones who make a difference in yours.

I had had a patient/family who was very emotional with new diagnoses and issues being hospitalized, so needless to say, she was very vulnerable.  I remember caring for them at change of shift, so all I mainly did was start an IV and draw bloods and do an assessment.  Within that 15-minute time frame, I was able to sit down at the bedside and interact with them as I did what I needed to do.  When I left, the patient’s wife was in tears and “had” to give me a hug “even though [she] wasn’t supposed to” just because of the compassion, time, and attention I had devoted to them during such a difficult time.

About 5 months later, I was at my new job on a night shift.  I was at the nurses’ station and someone had popped their head around and said, “Wait! I know you! Oh my goodness!” and put her hands to her mouth and got teary eyed.  We both remembered each other.  This time she was there with her father, so again it was another emotional time for her.  She proceeded to let me know how happy it had made her feel to see me during such a difficult time and continued to reiterate to all of my coworkers how amazing I was that first time I took care of her family.

This woman having remembered the impact I had on her and her family, along with praising me to my new coworkers about something so personal was a very fulfilling experience to reflect back on why I became a nurse.  Everyone hears people, particularly nurses, say how they’re always reminded why they chose this profession, and this is one of the simplest and purest examples of why.  I have been in the field of nursing for about 3 years (working as nurse for 1) and have experienced many, many joys and reinforcements as to why I became a nurse, but this interaction is the one that will leave a smile on my face for a lifetime.  People aren’t lying when they say to “do what you love and you’ll never have to work a day in your life.”

Sydney Adelstein is 2016 graduate of The Ohio State University College of Nursing. 

There’s An App For That!

What a time to be a nurse! You can have entire textbooks digitally compressed into the palm of your hand! There are several apps I use frequently- UpToDate, Figure 1, Sound Builder by Littman, and NurseGrid.

UpToDate provides the latest in evidence-based practice relating to all aspects of patient care- from medications to nursing interventions. It breaks down information by specialty and has a section for patient education. It’s very nifty. UpToDate even has a section that shows the very latest publications in evidence-based studies, giving you access to breakthroughs in medicine.

Figure 1 is like Instagram for health care professionals. Medical professionals from all over the world post anonymous (patient identifiers removed) photos of various cases. Followers are able to comment on the posts, creating a unique learning opportunity. This app is also sorted by specialty. I have mine set to show photos tagged with “critical care”, allowing me to test my clinical skills. For example, I can see an EKG strip, identify the rhythm, name the interventions needed, and then look to see if others agreed with that diagnosis and intervention. It’s really cool!

Sound Builder by Littman is a tool that allows you to hear all of the different types of heart murmurs. I wish I had access to this during nursing school because you rarely hear every type of murmur in clinicals and this gives you every type!

NurseGrid is an app that helps you manage your schedule. You can mark the days you work, mark days you are available to work, education days, meetings, and message coworkers (who are also on the app) to see if they can switch shifts. My favorite part of this app is that all of the scheduled shifts import into your calendar. It’s really convenient.

Technology has really given us some cool tools to use as nurses. These apps have really helped me- maybe they’ll do the same for you!

Kate Best is 2015 graduate of The Ohio State University College of Nursing. 

Surviving the Night

As a young new graduate nurse, most of us know that we will be stuck working the night shift, as those are usually the only job positions open.  When I had my first nursing job after I graduated, I did get hired on the night shift, and boy do I remember being so anxiety-ridden for my first one.  It was different for me because all throughout nursing school I had worked at the same hospital in the same department, but on days; therefore, I did not know the people on nights, let alone what I was getting myself into especially because I was working in an ER/Trauma center.  It’s safe to say though, I fell in love with working nights and now that I am working days at my new job (rotating shifts to be exact, but more time on days), I prefer nights.  For starters, nights work better for us young nurses who have minimal responsibilities (I’m talking no children, no house payments, etc. that is if you live with your parents still) and our bodies can handle it at such a young age, in my opinion.  As to getting myself to the point of loving night shift, I had to start somewhere, so I most definitely can lend a number of good and plentiful tips to survive your first, and succinct shifts thereafter:

  • I found that I was turning the shift into a day shift – meaning, 7pm was 7am for me and dinner time (midnight usually) was lunch time for me.  Once I got used to that, I found that I was splitting the shift into three separate shifts, a chunk of 4 hours each, and I found that I’ve carried that over to working days as well, and it is a good trick for the students who do 12 hour clinicals as well.  It makes the day seem not so long, but as we all know, time flies when you’re having fun, which it most definitely does in this profession.
  • Sticking to a similar routine on your days off of work helps as well.  Stay up until 3/4am on your days off and sleep until 11/noon and go about your day if that is what will keep your circadian cycle on track.  For example, if I wasn’t working the night before I had a shift, I would wake up and work out early (around 9/10, noon the latest), get the things I had to get done for the day, and then come home and “sleep” until 5ish, wake up and go to work!
  • It also can’t hurt to pick up a few preceptor night shift clinicals while you’re still in nursing school (I know that’s what every senior nursing student worries about… getting stuck on the night shift clinical).
  • And lastly, and most importantly, EXERCISE!  When I work back-to-back night shifts, I get home and unwind in bed around 8am, sleep until 2/230ish, go to the gym around 4 until 530/6ish, go and get dinner for work and head back on to save some more lives and do what I love!  Not only is it important for us to exercise regardless, but in this profession, we all know how important it is to unwind and mentally stay on track, so it’s super important to find a way to squeeze in a good hour or two of self-care.

I know most people dread, even fear working nights, but I ended up being one of those people who loved the night shift (most of the people I work with have been on nights for YEARS).  At the end of the day, it doesn’t matter what shift or what day of the week you are scheduled to work; we are doing the career we have long worked hard for and doing what we love, and that’s truly all that matters.  Until next time CON’ers!

Sydney Adelstein is 2016 graduate of The Ohio State University College of Nursing. 

A Letter To My Younger Self

Dear Kate,

Hey, it’s me, future Kate. I’m living in Columbus in a tiny apartment with two cats. Yes, cats. You were always a dog person! I also found a way to deal with our terrible fear of heights because I go rock climbing frequently.  I’m finishing up my second year as an RN in the ICU float pool and I just passed my CCRN critical care certification exam. Can’t believe it? It took a lot of work to get here. Looking back,  there are some things I want to share with you.

So, you’re a sophomore in college and just starting your first year in the nursing program. I know freshman year was crazy hard. It was your first year away from home, you struggled to adjust to the big city, and you had an impossible schedule of classes. Your hard work paid off and you’re now in the nursing program! Congrats!

I know it feels like you’re in the clear because you made it into the program, but it only gets harder. Don’t let that discourage you- you have all of the friends you made freshman year and a whole bunch of nursing professors to help you along the way. Your classes will be difficult, but just remember- these are things you’re actually going to use. They’re relevant to your career. All of the new skills that seem so intimidating at first (head to toe assessment, PEG tubes, dressing changes, catheters) will become part of your daily routine. It gets much less scary with time. Once you get those skills down, you’ll start on newer, harder ones- PA Catheters, chest tubes, and cardiac drips. Don’t worry- you’re never alone. There are so many seasoned nurses around you to help you.

There are going to be hard times.  You’re going to staunch bleeding and wipe tears. You will see traumatic, terrible things happen to people and work to fix them. How do you get through all of this- why would you want to put yourself through this?  Just remind yourself- if you can give comfort to help someone having the worst day of their life, it’s worth it. If you can hold someone’s hand so they know they’re not alone, it’s worth it.

There will also be great times. You’re going to see patients heal with a new lease on life. You’ll feel joy when your lung transplant wants to walk 15 laps around the unit. You’ll wipe away tears of happiness when a young trauma patient starts giving you thumbs ups when she previously couldn’t move at all. You’ll have so many great conversations with patients and their families and learn all of their stories.

So, yeah, we’ve accomplished a lot in five years. You had a lot of help and support to get here. You’ll gain so many friends- your coworkers will become a second family. You’re going to have a spectacular manager who fosters your inquisitive nature, working with your awesome educator to find you additional educational opportunities. Finally, you’re going to be happy. That depression that always lingered around you in college will break up and dissipate. Every patient helped, every small difference you can make to improve someone else’s day gives your life meaning. You’ve found your happiness.

Kate Best is 2015 graduate of The Ohio State University College of Nursing. 

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Give Back, Get Involved

I always tried to volunteer and stay involved throughout college as much as I could.  Although I was in a sorority and held officer positions, it was too time consuming for me to juggle both, being in nursing school.  (Although I did partake in the PLAN mentoring group within the CON). So, I knew that I was going to carry that on during post-grad being a new graduate nurse.  I have stayed involved with the College of Nursing via the Alumni Society (I serve as a regional ambassador back here in Cleveland) and also by doing these blogs to share my experiences to other people who are soon following in my footsteps.  I’ve always been the type of student and person who enjoys sharing my experiences with other people, so this has always been a perfect fit for me.  Aside from being able to donate as a CON Alumni, being involved with the regional side of the alumni society enables me to stay involved specifically with the CON and speak on behalf of the new grads that come back to Cleveland or move here post-grad.  It’s a cool way to be a little bit more involved than just rambling on about being a nurse :).  If you are interested in checking out some of the volunteer opportunities associated with OSU CON, here’s a link to current opportunities.

Although these two opportunities are the only volunteer work I am doing at the moment, I plan to do more.  With the possibility of going back to NP school this coming fall, I hope to get involved with a committee or group for school.  I’ve always felt that being involved is a good way not only enhance your resume, but to also get your name familiarized within the community, because as we all know, a lot of the healthcare industry is about who you know!  Another good way to stay involved within the field of nursing, which I plan to do so as well, is to enroll in the ANA (Nurses Association) and if you work in a specialized department, like an ED for example, enroll (for $$) within that association as well. You’ll stay in the loop on medical and nursing practice as well as receive discounts on CE courses, etc.

There’s many extracurricular and volunteer opportunities to partake in during school and post-graduation, and it’s such a good way to keep busy in your time off from work, since we only work 3 days of the week anyways :).

Sydney Adelstein is 2016 graduate of The Ohio State University College of Nursing. 

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Maintaining Wellness

I have struggled with stress for as long as I can remember. As many know, nursing school can be extremely stressful. When I accepted my job as an ICU RN, I became stressed about how stressed I imagined I would be. Thankfully, I’ve found several methods of calming myself and coping with this stress to maintain wellness.

Although I was eager to get involved in my new career, I was careful not to overbook myself. The first year of practicing nursing is very stressful and full of extra classes and meetings, so I waited to join unit committees and such until I had my feet on the ground and could handle the extra time commitment. Second, I began reflecting on my day each night before sleep. I think about my day- what I’m thankful for, what went well, and what I can improve on. This helps me be more mindful of myself. I also ensure that I keep time for myself. This can mean a lot of things- going to the climbing gym with friends, planning a hiking trip, or even a Netflix binge. When I have free time, I try to do stress-relieving activities to combat workplace stress.

Healthcare is a field full of stress. When I find myself in the middle of a particularly stressful situation, I always take time to breathe. I take deep breaths with my belly while focusing on the problem at hand. I’ve been incredibly lucky in that my coworkers and I are firm believers in teamwork, so when one of us has a busy and stressful day, there is no hesitation for others to come in and help. Remember your support systems- your coworkers, your family, your friends, and in my case, my cats.

Kate Best is 2015 graduate of The Ohio State University College of Nursing. 

NCLEX, NCLEX, OH NO!!

I had many thoughts before starting to prepare for this exam, and I like to think I had the same typical fears as most of us nursing students did: not having enough time to take it, what if I don’t pass, etc.  Specifically the day of the exam and the days leading up to it, I’d say most of my worries and fears related to the timing and what number I would get.  Almost everyone’s fear is when the exam shuts off, regardless of the number!

I always have been the type of student who bought every textbook needed for every class, which is pretty much what I did for the NCLEX too, regardless of whether they were used or not.  I started out buying a basic NCLEX book that explained the style and familiarized me with the exam probably beginning of senior year, and then slowly accumulated flashcards and more study manuals.  I really recommend Lippincott books and the Saunders Q&A and Comprehensive book. I called it my book of nursing school knowledge and I would use it as a basic reference guide when I would study a topic that I felt I needed to brush up on.

I studied using the main resource from one of the NCLEX classes I took and periodically took a practice exam. When there was something I wanted to freshen up on, I looked up in the comprehensive book, and just kept doing that until I felt confident.  I also would make flashcards of information that stuck out to me as something I’d want to review before my exam.  I remember Professor Donegan had said that you should be exhausted from practicing the NCLEX, as you should have at least done 50,000 questions come exam time.  Also, the good thing about taking the NCLEX classes is they likely recommend some books to use outside of the class.

Speaking of NCLEX review classes, I took the Mark Klimeck and the Hurst Review course.  I HIGHLY recommend the Hurst Review course.  It was what I needed the most – a content refresher with 24/7 access to the videos and materials covered in class, along with resourceful handouts on their web portal.

The number one test day advice I can give is to not overdo it.  Most people will tell you not to touch ANYTHING the day of, but I had scheduled my exam at 2pm so that I could wake up at a normal time and go over materials I had like flashcards I made throughout studying.  More importantly, take deep breaths and pace yourself during the exam.  The mental health and mental relaxation is key during test day.

I bought my results a couple days early which is a feature the Pearson website has so you can see your results online and not wait for the official email and license to come in the mail.

The number one advice I have for the seniors taking it this year, is do not wait until the last minute to study. Practice a chunk of questions every day.  I recommend the NCLEX Mastery App because you can keep it on your phone and use it on your computer as well and go over specific material questions, mini-exams, flag questions as “somewhat know, don’t know, or know” and review them as such. The app also has a NCLEX-style exam you can buy which tests your readiness.  In other words, practice every day!!

Sydney Adelstein is 2016 graduate of The Ohio State University College of Nursing.