Friday, November 28, 2008

Average Nursing Salary

It is commonly known that there is a significant shortage of nurses not only in a specific country, but throughout the world. To all those who are interested and most importantly qualified in the field of nursing, you are all welcome.

Just like in any other profession, it is not all the time that professionals think of how much money they will be getting once they pursue a certain career. Though, let’s face it, it matters. Additionally, in most career fields, a person’s salary depends on certain factors. You may be receiving bigger pay than what your friend is getting from other place. This thing applies also in the world of nursing.

If you want to know how much the recent average is nursing salary, you are on the right page. However, you should know that an average nursing salary can be determined by the needs and capabilities of a community, work schedule, training, skills, and experience, which means that the information you will get from this article maybe a little different from place to place.

For registered nurses (RNs) working in the US, the average nursing salary is a little over $ 41, 600 every year. RNs with more than 3 years of experience are getting more than $ 47, 000, while those who are in the entry level are receiving more or less $ 39, 000 a year. Depending also on the position, the higher position, the average nursing salary could go as high as $ 60, 000 a year and over.

In a hospital setting, an average nursing salary is also affected depending on the specialization. Also, working in various healthcare institutions with different specializations could also mean different average nursing salary. The lowest annual average pay you can get is not less than $ 33,500 and the highest can reach up to $ 65,000 and more.

Even for the hourly paid nurses, there is also a variation on the rates. Depending on the demand of a nurse’s specialty and the kind of responsibilities she/he is tasked with, the rate could go up much higher. The entry level nursing salary per hour is approximately between $17.65 to $19.75 If basing on hospital bed size, hospitals with more than 500 bed size, the possible average nursing salary at an hourly rate can be $ 21.00.

Based on the range of the average nursing salary, it is clear that salary of nurses is dependent on a lot of factors, such as training, the kind of institution you are working with, your position, and the location of your work.

Wednesday, November 26, 2008

Critical Care Nursing

If you are to describe the job of a nurse, what comes to mind first? For some people, they would probably think that a nurse is someone who provides the care you need when being hospitalized, while other would see a nurse as someone who works side by side with physicians in providing care. There could be truth on those answers, but there is actually more to nursing than just giving care to patients. And if you think you have seen what a nurse can do, better think again.

There is this specialty within nursing that deals specifically with human responses to life-threatening situations and that is critical care nursing. As the name implies, critical care nursing is indeed a serious job that requires all your skills to be able to save the lives of those people who are in a life-threatening condition. As a critical care nurse, you should be a licensed professional nurse who is responsible in making sure that acutely and critically ill patients as well as their parents receive the best possible care.

To get a clearer picture as to how grave critical care nursing is, let us define what a critically ill patient is. Critically ill patient is someone who is at high risk for actual or potential life-threatening health condition. The more serious the condition of the patient is, the more extremely vulnerable, unstable, and complex he or she becomes and the more extreme and watchful nursing care is required. Being in a situation like that, where there’s no room for errors, it is just right to get the right training and exposure to obtain the skills needed to be able to respond to the specific needs of critically ill patients.

Critical care nursing are given in the hospital setting where critically ill patients are being treated and where the real action is, such as in the intensive care units, cardiac catheter labs, telemetry units or ICUs, pediatric intensive care units, neonatal ICUs, cardiac care units, progressive care units, emergency departments and recovery rooms. In addition, critically care nursing can also be provided in home healthcare, managed care organizations, outpatient surgery centers and clinic, and nursing schools.

Because critical care nursing requires stern expertise, critical care nurses have gone through an intensive practice in settings where patients need complex assessment, high-intensity therapies and intervention, and continue nursing care. With constant exposure to these situations, a critical care nurse will be able to work in different settings. They can be bedside clinicians, nurse educators, nurse researchers, clinical nurse specialists, nurse managers, and nurse practitioners. With the arrival of managed care and the resulting transfer of patients from hospital settings to healthcare institutions, critical care nursing is more in demand.

Monday, November 24, 2008

What is Holding You Back?

Are you happy with your present job, employer, and income? Are you living the lifestyle you desire? Do you feel the self-satisfaction and gratification you are looking for, maybe not at the end of each and everyday, but at the end of the week or even the month? How about self-esteem? If you answered yes, congratulations. For those that can not answer yes to these questions, where are you headed? Have you thought about what you want to do and where you want to go? What are your goals? Do you have a plan? Most important, what is your next step?! Undoubtedly, there are some obstacles.

Procrastination and Complacency

There are two very formidable opponents that face us on a human level: Procrastination and complacency. While there are similarities between the two words, they are two different conditions. The common theme of these two conditions is a lack of results.

Complacency is usually the result of accomplishment or achieving a certain level of success. Complacency is defined with “an unawareness of actual dangers.” Complacency creeps up on us unexpectedly, and most times we do not realize that we suffer from this condition until we are faced with the actual danger. The danger we could very easily face is allowing a lapse in our education, such as the mandatory continuing education required for re-licensure as talked about in a previous article dated October 31st on this site by Margaret Lyons, program coordinator at Villanova University.

Perpetual goal setting is one of the best practices we can employ to prevent complacency from setting in. Using a benchmark set by others can further insure that we will never have a goal in which we are satisfied. Tell yourself there is always someone doing it better, and find that someone.

We also need to create our own mechanism that will prevent complacency. It can be something simplistic such as an office bulleting board (hand-written to do list with due dates), or something more sophisticated employing technology (timed reminders on your computer). Keep your goals in front of you - carefully measured in achievable steps - so that you face them everyday. Choose the mechanism that will best work for you; just be sure to implement something. While at this juncture (nurses in Pennsylvania, California, Kansas and Delaware), have you addressed the mandatory continuing education for re-licensure?

Procrastination can be a byproduct of complacency however it has many sources. Unlike complacency, procrastination does not necessarily (and most times probably does not) result from success. It is a factor that prevents accomplishment.

Procrastination is a more conscious opponent usually a result of fear or poor prioritization. Concerning fear, it is never personal; identify and face your fear in order to alleviate anxiety. Our prioritization sometimes needs to be scrutinized. Life in nursing gives us a work load with more than our fair share. We begin to juggle instead of prioritize, and I am not referring to patient care here. When prioritizing, be sure your personal and professional advancement weighs in.

Time and Money

Now for the proverbial obstacles: Time and money. As you address procrastination and analyze your prioritization, commit the time needed for continuing education. Visualize where you will be and of the advanced opportunities afforded you once you have gained the desired (and necessary) degree. Do not let the economy be your excuse. Our profession is experiencing a shortage with a projected increase for the next 12 years. Nonetheless, by the time the economy improves, you could have positioned yourself for the place you want to be, rather than it being too late.

If you still have unfulfilled dreams and aspirations, take the first step to get started.

The Pennsylvania Higher Education Foundation is the first place to look. See if you qualify for the financial assistance they offer. Simply click on their link at left. And do not stop there. Schools of nursing often have assistance for those in need as well. As an example, visit Villanova’s College of Nursing, link at left, to see what they have to offer and peruse their site to learn more about their programs to see if their program may be right for you.

As this site continues to build its resources, please visit frequently for opportunities in education, advancement and employment.

As always, thank you for visiting and please share your comments.

Friday, November 21, 2008

Nurses Who Serve Those Who Serve

By Linda S. Smith, MS, DSN, RN, CLNC
Professor and Director of the Associate Degree Registered Nurse Program at the College of Technology, Idaho State University

Last year, New Jersey born Army Captain Maria Ines Ortiz was the first army nurse to be killed in Iraq since the 2003 US invasion. She was killed during a mortar attack in Baghdad’s Green Zone. Ortiz was doing what military nurses do best – caring for the sick and wounded on or near enemy lines. She was survived by her parents, four sisters, and a fiance’. Ortiz gave her professional nursing skills and dedication, as well as her life, to serve those who so selflessly and heroically serve us.

Many of us consider great military nursing to have originated with Britain’s Florence Nightingale. It is true that the events in Scutari, Turkey gave birth to professional nursing. It is not true that Scutari was the first military location for nurses. For America, military nursing officially began with the birth of our country - the revolutionary war.

Nursing during the Revolutionary War (1776) was not recognized as a separate and distinct service. It was often included and described along with such tasks as cooking, cleaning, washing, and sewing. “Nursing” was designed to keep sick men clean, well fed, and comfortable. Camp followers on both sides of the war effort were women who washed, cleaned, cooked, and “nursed” the men. And medical care given to the wounded included purging, blistering, and bleeding. Most battle wounds were followed by uncontrolled infections, forcing surgeons to amputate. Over 90% of deaths were caused by disease – 10% by battle wounds. Wounded men would be placed side by side with men suffering typhoid and typhus, thus wiping out whole wards.

The Civil War

In 1861, President Abraham Lincoln called for volunteers to help care for sick and injured Union Soldiers. Simultaneously, women in the north began to organize relief societies. Dorthea L. Dix came to Washington, DC to volunteer her services and was immediately appointed superintendent of women nurses of the Army. (Dix had already made significant contributions to the improvement of care for the mentally ill). Dix established strict criteria for her nurses, with the idea that these women would be nursing supervisors. Her nurses were sent to Bellevue Hospital New York City, for one month of training. Clara Barton, founder of the American Red Cross, began her Civil war work in 1861 when she established an agency to distribute medical supplies to wounded soldiers.

Though enormously dedicated, hardworking, and successful, the idea of female nurses was met with opposition from male doctors and military personnel. These nurses were often outspoken about incompetence, pilfering, and corruption among army surgeons. Many hospitals had little food and even fewer supplies. Nurses wrote to their contacts and reported these terrible conditions – further angering the male physicians. They took cleanliness and organization into their own hands.

Transport services for sick and wounded men were available via railroad, steam ships and wagons, often taking days and even weeks to reach hospitals. Tents were pitched along waterways where a corp of male and female nurses worked. Religious sisters also became a vital part of the nursing staff.

Importantly, medical efforts during the Civil war led to many scientific improvements and paved the way for a new profession of nursing in the US.

Scutari and Florence Nightingale

Florence Nightingale’s best-known triumph, the organization of military nursing, took place during the Crimean War (named after Turkey’s Crimean Peninsula). In 1854, Great Britain and France declared war on Russia in order to protect Turkey from Russian attacks. Due to poor military decisions, fierce fighting and enormous numbers of causalities from wounds, cholera, and dysentery, men were dying by the thousands. Four miles of the Turkish “Barrack Hospital” housed Great Britain’s sick and dying soldiers. British people were outraged, as news of these atrocities reached England, and the Secretary of State Sidney Herbert asked his long time friend Florence Nightingale to organize a group of nurses for war service in Turkey.

Nightingale saw four miles of rat-infested corridors filled with starving, freezing men. They had no blankets, beds, or bandages. Amputations were performed without anesthetic or even the crudest sanitation. Nightingale and her 38 nurses arrived on November 5, 1854 and were given charge of 1,500 patients. In only a few months, Nightingale decreased the death rate from 42% to 2%. She transformed the Barracks into efficiently run hospitals and won the admiration and respect of the world.

Nightingale understood medical and military politics and the scientific method for gathering and reporting data. Advocating for the sick and wounded soldiers, Nightingale used her statistical and writing skills to influence increased funding and appropriations of supplies. The grateful British people donated $200,000 to her, which she used to start the Nightingale School of Nursing four years later in 1860.

Spanish American War

For the first time in US history, professionally trained nurses were accepted into military hospitals. During the Spanish American War, these contract nurses became forerunners to our present military nursing corp. The Spanish American War took place against Spain (Cuba) in 1898 and the first call for nurses came on May 7, 1898 because of the 30% sick rate among American troops. Typhoid patients would remain for hours and even days without care. Some had bedsores down to the bone. Because of the resistance to having female nurses, these health professionals knew they had to excel in every possible way. One single nurse often had to care for 40 or more delirious typhoid patients per day. Nurses worked at a frantic pace in unfurnished facilities. They also helped gather statistics and medical data related to typhoid – statistics implicating the contaminated water, food, and insects.

These trained nurses were considered by the men as angels of mercy. Thus, in December of 1898, a committee of women and nurses moved to establish a permanent Army Nurse Corp. In 1901, the Army Nurse Corp was established. In 1908 the Navy Nurse Corp (the only females in the Navy) became an important component of the US Navy. They won the praise and admiration of navel officials because, for the first time, two large nursing services were made up entirely of graduate nurses.

World War I

The US committed itself to WWI in 1917 and our Army and Navy Nurse Corp increased their numbers significantly to meet the needs of the American soldiers. Unfortunately, as our nation faced a devastating flu epidemic at home, more and more civilian nurses were leaving for military and Red Cross service. Therefore, student nurse recruitment efforts were increased.

Conditions in camp hospitals were difficult. However, World War I provided nurses with experience related to the new projectile bullets, shell fragments, poison gas, explosives, and other injury causing war machines. Nurses learned to use a weak chlorine solution for cleansing wound infections, and developed debriedment operations. Almost 300 nurses died in WW I, mostly due to disease exacerbated by overwork.

World War II

On December 7, 1941, Japanese pilots bombed Pearl Harbor and so began America’s involvement in WWII. Even before that date, however, the Nursing Council on National Defense was organized. Composed of representatives from the six American nursing organizations, this committee set out to recruit more student nurses, improve nursing education, decrease the numbers of inactive nurses, and educate and use voluntary nurses’ aides.

As with WWI, the war effort created a major civilian nursing shortage. A national plan for federal financial aid allowed schools of nursing to provide scholarships to needy student nurses and for refresher courses for inactive nurses. On July 1, 1943, a nursing student could join the Cadet Nurse Corp, receive full scholarships and a small monthly stipend. In return she had to promise to serve as a military nurse after graduation. Thus, students could complete their nursing education AND serve their country. Notably, and as a result of this national effort, nursing schools voluntarily upgraded curriculum and faculty to meet the military standards.

With the Cadet Nurse Corp and its 150,000 members, the concept of aid to nursing education became reality and civilian and military nursing collaborated. WW II also brought about the important idea of placing medical and nursing services as close to the war front as possible. The type of firepower used created more casualties but mortality was decreased because of the high medical standards and nursing services. By the end of the war, 100,000 nurses had volunteered for military service. Nurses went ashore with the invading troops and were placed where their special skills were most needed.


Today, a career as a nurse in the military means that a nurse’s educational advancement and career goals can be met through military service. Experiences in state-side military hospitals and bases, as well as overseas duty positions, are available. Reserve nursing is also available to nurses who choose this type of military service.

American military nurses continue to stand firm in their beliefs and commitments for quality, efficient health care given to our nation’s sick and wounded military personnel. Just as was the case with New Jersey born Army Captain Maria Ines Ortiz, they are proving themselves as expert, valuable, dedicated nurses – they are bravely caring for and serving those who serve us.


Austin, A. L. (1975). Wartime volunteers-1861-1865. AJN, 75(5).
Berges, F. & Berges, C. (1986). A visit to Scutari. AJN, 86(7), 811-813.
Bullough, B. (1976). The lasting impact of WWII on nursing. AJN, 76(1).
Culpepper, M. M., & Adams, P. G. (1988). Nursing in the civil war. AJN. 88(7), 981-984.
Dolan, J. A. (1966). Goodnow’s history of nursing. Philadelphia: WB Saunders Co.
Kalisch, P. A., & Kalisch, B. J. (1978). The advance of American nursing. Boston: Little, Brown, and Co.
Selavan, I.C. (1975). Nurses in American history: The revolution. AJN, 75(4).

* Portions previously published Journal of Military Nursing Research, 1(2), 12-13, 1995

Thursday, November 20, 2008

Formidable Career – Forensic Nursing

With crime scene dramas accounting gun shots and autopsies, most people acquire the misconception that forensic nursing has something to do with a special ‘medical detective agency’ out in action for the next murder case. Forensic nurses can go out for action, especially if one with American Forensic Nurses or the International Association of Forensic Nurses; however, a forensic nursing job is mostly focused on patients (not necessarily carcasses awaiting justice) and not on suspects to be hunted down.

Although forensic nursing also touch upon medico-legal death investigation, forensic nurses are most of the time involved in a much needing task of treating victims of a sexual assault or performing examinations for a child abuse or domestic violence case. Forensic nursing involves the proper collection of evidence upon suspecting an assault on their patients and then preserving the critical chain of evidence. Forensic nursing then requires a special training on valid data collection and producing legal testimonies. Aside from their nursing background, the forensic nurses combine a bio-psycho-social education in the scientific investigation and treatment of trauma and/or death of victims of abuse and traumatic accidents.

Forensic nurses are experts in clinical diagnosis, providing care to sexual assault victims, as well as legal nurse consulting and assisting in criminal prosecution cases. Forensic nursing then applies the nursing science in public and legal proceedings involving patients of special case and care. Forensic nurses may also go deeper in a critical investigation as they are susceptible to encountering also the crime suspects or perpetrators of violence and criminal activity. Nurses treat wounds yet may precariously compromise valuable evidence.

The complex yet crucial job of forensic nursing plus the fact that it’s only a fairly new field, make it complicated for those considering a specialization in this field. Aspiring forensic nurses may find that there is currently no national standard whatsoever when it comes to the licensing and designation of a ‘Forensic Nurse’ and that there are actually many acronyms often used by each state but are interchangeably pertaining to the same forensic nursing position. Some are called SANE/ Sexual Assault Nurse Examiner, SAE/ Sexual Assault Examiner, SAFE/ Sexual Assault Forensic Examiner, SANC/ Sexual Assault Nurse Clinician, or FNE/ Forensic Nurse Examiner. Each is quite similar, yet each certification may have greater areas of focus.

Even so, the various career specialties within forensic nursing – sexual assault examination, emergency room investigation, medico-legal death investigation, evidence collection training, medical examiner’s office study, medical legal consulting, or working with or on behalf of federal, state and local law enforcement agencies – are all formidable both in the medical and legal field.

Tuesday, November 18, 2008

Certified Nurse Assistant’s Duties

Certified Nurse Assistant (CNA) is the Direct Care Giver to many.

Among the vast array of health care careers lies the area of direct care giving. These professionals are often Home Health Assistant (HHA) or Home Health Aides, Personal Care Assistants, Nurse's Aides, Patient Care Technicians and several other titles, depending on the work environment and the region.

Certified Nursing Assistants work closely with patients and provide assistance with daily living tasks, such as: dressing (according to patients' needs, ranging from minimal assistance to totally dependent); bathing (bed baths, tub baths, showers); feeding (serving meals, physically feeding patients who are unable to do so themselves); toileting (assisting with bedpans & urinals, help to the bathroom, provide incontinent care for patients who need it); vital signs (Blood pressure, pulse, etc); Catheter caring (emptying, upkeep of Intake & Output sheets when necessary); answering call lights in a timely fashion; assisting patients with ambulation, when needed; range of Motion Exercises, as prescribed by physical therapy; assisting residents in wheelchairs (a lot of heavy lifting at times); making beds and keeping the patients' rooms and belongings neat and organized; ensuring that bedridden patients are turned at least every two hours, to ensure comfort and to prevent bedsores; reporting all changes, physical and mental, of the patients to the nurse; Post Mortem Care; safety awareness - keeping an eye on wanderers and watching for potentially dangerous situations; Documentation - daily documentation on the care provided to each patient; and anything else that needs to be done.

Certified Nurse Assistants are required to lift patients, assist a patient that is falling and carry heavy medical equipment. They should have the physical dexterity to perform skills that require fine motor movement. Basic observations are made by the CNA; therefore they should possess the senses of sight, hearing, smell, and touch.

Certified Nursing Assistants can be found in nursing homes, hospitals, adult day health centers, assisted living facilities, even personal homes. Wherever there is a need for personal care, Certified Nursing Assistants are the ones who, for the most part, perform the most basic needs for patients, young and old alike. They work under the supervision of a nurse. Since aides have extensive daily contact with each patient, they are keys to providing vital information on the patients' conditions to the nurse.

A certified nursing assistant's job does not end with the physical needs of the patients. This is a job which requires compassion and a desire to make people comfortable and happy. Residents of nursing homes often suffer from depression and/or dementia, and the certified nursing assistant is often the closest human contact afforded to many of these people. A sense of humor helps in this field.

Article Originally Published by Staff Quest

Monday, November 17, 2008

Nursing Education in the United States

Nursing education is a field that combines nursing with the teaching of students of nursing and, for some, with the administration of educational programs.

A high proportion of the teachers in nursing education programs teach in clinical situations, in which students learn to care for patients and families in hospitals, at home, and in other situations. Universities or associations usually offer teaching by nurses in staff-development programs of hospitals and other health agencies and in continuing-education programs. The basic educational program for nurses in many countries is scientific and humanistic in content. All educational programs include experience with patients in hospitals, homes, or other settings.

In almost all countries with nursing education there are at least two kinds of programs – those leading to diplomas and those that train auxiliaries, though a large portion of auxiliaries in some countries are untrained.

The development of nursing education in any country is affected by the developments in general education. In the United States and some other countries, for example, high school graduation or its equivalent has for many years been a requirement for admission to schools preparing registered nurses. In the United States this is also a requirement for admission to practical nurse programs. In some countries fewer years of previous education are required.

Nursing education in the United States has undergone tremendous changes in recent years. In order to prepare nurses for beginning and advanced levels of practice, educational programs also have undergone tremendous changes. Many curricula are creative and interactive, rather than rigid and proscriptive. Education is more learner-focused than teacher-centered. Clinical experiences for students reflect a greater emphasis on community-based care, health promotion, disease prevention, family involvement, and self-care. And the integration of technology and the use of distance learning strategies are more evident in nursing education programs.

Nurse educators are realizing that there is an art and a science to teaching nursing – just as there is an art and a science to practicing nursing – and they are seeking preparation in curriculum development and evaluation, creative teaching/learning strategies, student and program evaluation, and other areas that complement their clinical specialization and expertise.

Post-basic programs for nurses with diplomas have been established in the United States and in many countries. Some programs offer courses in general education, as well as nursing courses, and some, in universities, may become programs leading to a bachelor’s degree. The purposes of such programs vary and include the preparation of teachers, supervisors, or administrators and of nurse specialists in various fields, including midwifery, public health, and teaching of auxiliaries. Some augment the education received in other programs. Enrollment is generally small in relation to the need for their graduates.

Article Originally published on Staff Quest

Thursday, November 13, 2008

Facts about Nursing Shortage

A report entitled “Projected Supply, Demand, and Shortages of Registered Nurses: 2000-2020” alleged:

Based on what is known about trends in the supply of Registered Nurses and their anticipated demand, nursing shortage is expected to grow relatively slowly until 2010, by which time it will have reached 12 percent. At that point demand will begin to exceed supply at an accelerated rate and by 2015 the shortage, a relatively modest 6 percent in the year 2000, will have almost quadrupled to 20 percent.

American hospitals are in a serious crisis, from large numbers of uninsured patients to spiraling costs, from outlandishly expensive prescription drugs to a severe and dangerous shortage of nurses. Emergency rooms are shutting down, surgeries are delayed and, most disturbing of all, patients are sometimes not getting the critical care they desperately need.

There are many factors behind the nursing shortage. Unlike a generation or two ago, young women with an aptitude for sciences now have a multitude of career opportunities to choose from. Many of the other career choices today involve less stressful and less strenuous work than bedside nursing. Generally speaking, a position with a managed-care company or a pharmaceutical sales job is less physically demanding than nursing.

The need for nurses is often depicted as cyclical in nature. Throughout history, the USA has experienced a series of nursing surpluses and shortages. However, the current nursing shortage has been characterized as being unlike those experienced in the past. Trends of an ageing RN/ Registered Nurse workforce and limited supply to fill the impending vacancies are some of the unique aspects that bring a new dimension to an old problem. Today's nursing shortage will not be resolved by simply returning to the solutions of yesteryear, and strategies to reduce its impact will have to be more creative and focus on the long-term.

The widely publicized nursing shortage in the United States is largely a result of three factors: the aging population of nurses; the aging population in the U.S.; and a shift in healthcare delivery away from doctors, towards skilled nurses. Also are four major contributors to the nursing shortage in the USA: the ageing RN workforce; declining enrolment; changing work climate; and the poor image of nursing.

Solutions to the shortage followed similar themes to the contributing factors and encompassed four main areas: exploring recruitment efforts; exploring retainment efforts; improving the image of nursing; and supporting legislation that helps to rectify the shortage.

As new career options grow for women over the past few decades, and fewer women choose to go into nursing, another shortage begins to emerge. All of these factors point to the fact that the nursing shortage won't be reversed overnight.

Original Post from Staff Quest

Tuesday, November 11, 2008

Different Types of Nursing Careers

Have you been toying with the idea of pursuing a career in the field of nursing? If you have, that is considered good news since there is a desperate need for nurses to fill in the significant shortage in the nursing profession. To help you decide what specialization to choose, you should know the different types of nursing careers.

Critical Care Nursing – among the different types of nursing career, this is a popular one. Critical care nurses provide care for patients and families who are experiencing actual or potential life-threatening illness. As a critical care nurse, you will be assigned to where critically ill patients are such as intensive care units (ICU), emergency rooms, neurological and cardiac surgical ICUs.

Nursing Informatics– this type of nursing career is for those people who both love to provide care and computers. It is actually an extensive field that integrates nursing knowledge with use of computers. Your job in this field could be a nurse programmer, nurse communicator, informatics nurse manager, or nurse vendor representative.

Neonatal Nursing – this is also one of the challenging yet rewarding types of nursing, where in neonatal nurses provide care for new-born and premature babies by ensuring good health, providing preventative care to prevent illness, and caring for the babies who are sick.

Oncology Nursing – nurses in the field of oncology provide health care for patients suffering from cancer at all stages of treatment and remission.Pediatric Nursing – pediatric nurses provide care for children of different ages in all aspects of health care. Its only difference from neonatal is that neonatal nurses provide care for the newly born, especially within the first month after birth and premature babies.

Psychiatric Nursing – this is one of the most important types of nursing as it involves taking care of patients with mental and psychiatric illness. In a society in which physical condition is easier to accept than mental condition, psychiatric nurse plays an important role on this are of nursing.

By knowing some of the different types of nursing careers will make it easier for you to choose what specialization to focus and study. There are different nursing programs offered by some of the many nursing schools in the country for you take up, depending on your preferred specialization. The fact that there is a shortage of nurses all over the country, you certainly have a good shot getting a job upon graduation.


Friday, November 7, 2008

Helping Someone Who Grieves

By Linda S. Smith, MS, DSN, RN, CLNC
Professor and Director of the Associate Degree Registered Nurse Program
Idaho State University

Grief, loss, anger, despair, and guilt are human responses to any tragedy. They are normal, yet entirely unique, because each of us resolves grief and loss in our own way.

Accepting loss and even death is probably the hardest part about being human. When a friend or loved one is grieving, we may be afraid to get involved; to talk about the loss or death; to feel it for and with someone. We may say, "I hate going over there to visit, it's so depressing;" or "Why should I call or stop over; I can't do anything to make it better."

Yet, moods and reactions people have as they grieve a significant loss are often responses to how others react toward them and what others expect. With this in mind, it is easy to see how people "pick up" on the obvious and hidden "expected behaviors" from the persons who are closest to them. Therefore, if someone you know and love is experiencing grief, your reactions and responses to them can improve or worsen the situation.


First, friends and loved ones need to understand the fears of those who grieve. These fears include loneliness, meaninglessness, and continued loss. Families of persons who are dying experience profound grief and loss, anger, despair, depression, and even guilt but these emotions may occur very differently among members.

What to do if someone you know is grieving:

- Reach out to the person who is grieving; don't wait for him or her to come to you. Your presence as a good listener is almost more important than anything else you can do.
- Accept the person as a living, valuable human being
- Anticipate that grief work is extremely physical as well as psychological
- Express the simple yet profound, "I'm sorry."
- Allow the grieving person quiet time
- Listen, support, encourage, and share your own feelings. Be available as someone the person can trust.
- Through your responses, give the person permission to think and feel anything
- Allow loose ends to be tied; spiritual peace, financial matters, and funeral arrangements attended to, etc.
- Help persons review their lives for meaning and purpose. This could be done with a diary, a tape recorder, drawings, scrap books, or a photo album. Remind grieving persons of their accomplishments.
- Use culturally sensitive, appropriate touch as an expression of caring. After asking permission, you may chose to hold their hand, pat their arm, give a hug
- Help persons attend to personal grooming and exercise. Take a walk with the person, listen to music together, play a game, reminisce
- Call in a spiritual consultant if the person wishes
- Use open ended communication lead-ins like: "how…, what…, where…,
- “It sounds like you're feeling…;
- share with me…,
- help me understand…"
- Recognize that persons experiencing extreme grief and loss may have sleeping, resting, and eating difficulties. Therefore, call in healthcare resources and professionals as needed.
- Tell the person that you are interested in what they think and feel. Be receptive and nonjudgmental, acknowledging the actual, potential, or perceived loss
- Recommend support groups and provide this information when appropriate
- Give the grieving person the right to cry
- Allow the person at least a full year before major life-changing decisions are made

What NOT to do when communicating with someone in grief or crisis:

- Don't assume that all questions asked demand answers. A simple, "I don't know, but tell me your feelings” is one response to the unanswerable
- Don't meet anger with anger. Allow the angry, grieving person to express the anger without becoming defensive. Acknowledge and accept the anger by saying, "You sound angry…." "It must be so difficult (frustrating) for you …"
- Don't interrupt, expound, criticize, show impatience, judge, minimize, confront, abandon, or be dishonest.
- Don't ignore the person's mental and physical pain
- Don't try to replace grief with faith
- Don't reject the person's feelings with phrases like, "cheer up…" Everything will be fine…"
- Don’t wait to be asked for help. Often the “If you need anything, call me…” is never acknowledged. Better to say, “I’m picking up some groceries, what can I get for you?” and “Today is wash day, let me do a few loads for you.” Or “I brought over the lawn mower – how do you like the grass done?”

Caring for and about someone who grieves is a great privilege.

As you face someone who is experiencing grief and loss, please believe that your efforts are valued and needed. Your presence has a profound effect on those for whom you care.

Tuesday, November 4, 2008

Need A Change? Maybe Teaching Next Generation of Heroes is Your Calling

I read through many posts in which current nurses are feeling burned out. A common theme among nurses is overworked, underpaid, and underappreciated. Most assuredly you are not underappreciated by your patients who are grateful for the care you provide. But, I can understand that many employers take for granted those who provide such a selfless service as nursing.Maybe the change you need is to take your experience to the next generation of nurses by becoming a nurse educator. This would satisfy both your calling in the healthcare profession and address the shortage of nursing crisis.

I’m not certain if every state has a program to financially assist current nurses to go back to school to become nurse educators, but Pennsylvania has a fine program in place; The Pennsylvania Higher Education Foundation. Several years ago they formed to address the nursing shortage and offered scholarships, grants, and low interest loans to persons looking to become nurses. Now they find that nursing schools in Pennsylvania (and many other states) are turning away nursing candidates due to the lack of nurse educators.If you live or work in Pennsylvania and would like to explore your options for financial aid to become a nurse educator, visit: