Katie Duke, DREAM JOB RN, BSN, CEN, CCRN Emergency Room New York City Toxic Nursing the Stories

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A V A I L A B L E A T F I N E M E D I C A L U N I F O R M S T O R E S Too Many HOURS Too Little SLEEP Are you putting yourself and your patients at risk? 44 MEET SPECIALTIES THE STAR OF NY MED FIND YOUR Katie Duke, DREAM JOB RN, BSN, CEN, CCRN Emergency Room New York City Toxic Nursing The stories,

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01.21.2014 10:53 27 Career-minded { CONTENTS SPRING 2014 } nurses consider their personal needs and personalities when choosing You deserve a break! their specialties. 8 WELL-BEING Win a spa weekend from Too Many Hours, Too Little Sleep Researchers and government agencies have been sounding the alarm for years: The long hours so many nurses clock in are bad for their health and the safety of their patients. Is anyone listening? We want to give back to By Mary Duffy nurses who give so much. 12 FINDS California Casualty, Treasures Under $50 The Scrubs team searched which provides nurses with for little gems that are right up your alley— auto and home insurance, some save time, some de-stress, some give back would like to show to others and all have great style. our appreciation for all 2 LETTER 14 SCRUBS CHIC you do by offering To be continued...the Bright, Bold, Beautiful New directions for the chance to win a stories you love extend to everyday workwear. Spa Getaway the web. Weekend for four. 20 ALL ABOUT YOU 3 VITAL SIGNS The Irrepressible Katie Duke She’s got strong News for nurses on life, opinions and the resolve to make them known. style and work. Catch her infectious spirit and jump on her bandwagon by proudly proclaiming, “I am a 6 FIRST PERSON nurse!” By Catherine Ettlinger Why I Love Nursing Sure, it’s not all a bed of roses, 22 ON DUTY but most days I wouldn’t Toxic Nursing Don’t wait for total turmoil trade my job for any other. to hit your workplace. Check out the experts’ Relax. Rejuvenate. Refresh. By Nurse Jo advice on how to handle various real-life ® Unwind at The Hotel Hershey in Pennsylvania, where 8 The more scenarios so you can survive and, yes, thrive in ® comfy your you’ll be pampered at the world-famous Chocolate Spa. bed, the more your job. By Cheryl Dellasega, PhD, RN, CRNP, likely you’ll and Rebecca L. Volpe, PhD Enter to win at giveanurseabreak.com/scrubs. fall—and stay—asleep. 27 WORK-STUDY Total prize value is up to $5,500 and includes: Suit Yourself Nursing isn’t just a career—it’s ■ Round-trip airfare for you and three a collection of careers, with specialties that have specialties. Ready for a job change? We’ve coworkers to The Hotel Hershey. done some of the legwork for you. ARE TRADEMARKS USED WITH PERMISSION. ARE TRADEMARKS BATH AND WHIPPED COCOA SPA, CHOCOLATE HERSHEY, ■ Accommodations for three days 14 New styles! New colors! New 32 LOOKING BACK and two nights. 12 Liven up brands! Check out ■ your drinks— the best of the A Decade of Style Classic, dependable, All meals. season’s scrubs, and your durable…Cherokee Workwear has been a favorite ■ A full spa day where you can choose among party!— like this Dickies with great Performance of nurses for 10 years. treatments like the Whipped Cocoa Bath™, balls of ice. System top and pants. Chocolate Bean Polish and Chocolate ON THE COVER Katie Duke, starring in NY Med this summer and right now Fondue Wrap. Who said chocolate in RN I.D. Scrubs. Read “The Irrepressible Katie Duke” wasn’t good for you? beginning on page 20. Photography by Lionel Cassini.

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01/29/14 9:42 01.29.2014 12:33 { LETTER} To be continued... V ITAL S I SNG The stories you love AvAiLAbLe At Fine medicAL uniForm stores { news for nurses on life, style and work extend to the web

Editor-in-chiEf MOST prinTed MAGAZineS have companion websites, Catherine Ettlinger and we are so proud of scrubsmag.com, which now crEativE dirEctor Maxine Davidowitz ScrubS in counts more than one million site visits every month. ExEcutivE Editor The Bearable Lightness of Being foREign Mary Dufy Our magazine articles are archived online, and we AN INCREASED SENSE of calm—couldn’t every nurse use LanguagEs! dirEctor of PhotograPhy always help direct you to web stories that relate to our Lila Garnett that? One way to get it is through meditative breathing and For our Latina coPy Editor printed pages. You will find these relevant references nurses, we’ve Melissa Brandzel stretching exercises, which have even been shown to reduce rEsEarch Editor to scrubsmag.com all through this issue. created Scrubs Tajinder Rehal nurses’ symptoms of post-traumatic stress disorder. en Español at contributors And there is more good news: now, many of our Theresa Brown, RN; Daryn Eller; During an eight-week study, nurses with PTSD performed print stories will actually continue online at scrubsmag. scrubsmag.com/ Hillary Quinn meditation-stretching exercises for 60 minutes, twice a THE BEST Alarmed by all the espanol. We alarms in hospitals? com/magazine; the site will showcase our writers’ work vP, digital MEDICINE? There’s help from the Miriam Bookey week. By the end, their stress hormones were more normal invite our of AACN for every nurse! in even greater detail. Take “Too Many Hours, Too vP, contEnt and brand stratEgy and they were sleeping better, were more resilient and Music, multilingual Jenna Briand course, can Little Sleep” on pages 8 to readers to suPErvising ProducEr felt more energetic. Sang H. Kim, PhD, lead author of the Malinda Lloyd You’ll be 11. You can access further translate your study and an exercise scientist at the National Institutes soothe the markEting dirEctor seeing lots Tavaner Sullivan savage beast research from reporter Mary favorite articles of Health, has some ideas on why meditation is ideal for Fight Alarm into any digital crEativE dirEctor of this arrow duffy, plus more suggestions Marie Barr nurses. Trauma, and even compassion fatigue, can cause inside you, language and throughout wEb Editor but that’s not for ensuring better sleep, in- we’ll post them Kirsten Withrow a separation of the self from one’s physical and emotional Fatigue these pages— all it can do. If you’re constantly cluding strategies to survive right away—go community EngagEmEnt experience. “A mindful component added to exercise links Marie Khris Pecjo hearing ringing in your it’s pointing the night shift. to scrubsmag. the mind and body and restores a sense of self,” says The right tune advErtising salEs dirEctor ears, it’s probably not you straight to in “Toxic Nursing” on pages com/translate Susan Bunting 630-926-1816 Kim. “In addition, deep breathing promotes relaxation can get your [email protected] tinnitus. Technology, for all our exclusive 22 to 25, you’ll find nurse-to- for details. mojo working rEcruitmEnt and IMAGES MEDIOIMAGES/PHOTODISC/GETTY LIONEL CASSINI; FROM LEFT: and increases oxygen [flow] to the brain.” That’s where its beneﬁ ts, has dramatically web extras. Education salEs dirEctor nurse advice about how best to Heather Lagergren the increased sense of calm, lightness and energy comes again during increased the number of dirEctor of manufacturing a break and alarms in hospitals. In just handle rude doctors, nurses who pull rank, rampant pol- Jo-Ann Keith in. Doesn’t that sound good?! Check out meditation and the ICU alone, the number itics, shameful bullying and idle gossip. We invite you to markEting sErvicEs managEr stretching videos at scrubsmag.com/magazine. help you wind Susan Pekich down on the of alarms has risen from an share your own on-duty toxic experiences at scrubsmag. Join the ongoing markEting coordinator Erin Yarbrough way home. average of six in 1983 to 40 com/vent, where you can have a virtual dialogue with conversations Take a break with or more today. And it’s far scrubsmag. fellow nurses who have been there, done that. at Scrubs. mind ovEr mEdia, llc music from To see what 702 16th Street com's nurse-selected more than just annoying. We’re also proud to print scrubsmag.com’s beloved Every month, Santa Monica, CA 90402 playlists. Find HeartSoul songs other Alarm fatigue can affect mindovermedia.net millions of nurses scrubs (shown) at nurses turn patients’ comfort (noise is nurse Jo, whose articles consistently rank among the PartnErs heartsoulscrubs.com. interact with us Susan Gates; Amy Rappeport one of the biggest patient most popular on the site. in “What I Love About to in times of on our website, complaints) and even lead stratEgic mEdia grouP need—and Nursing” on page 6, she offers 10 reasons why she scrubsmag.com, 9800 De Soto Avenue to patient deaths. Forging Chatsworth, CA 91311 to add yours loves her job and asks you to share yours. Tell us and on our social 818-671-2100 the way to help RNs cope is at scrubsmag.com/lovetowin and you might win your media streams PublishEr to the mix— the American Association Michael Singer (facebook.com/ check out our of Critical-Care Nurses. entry-reason on a custom T-shirt or mug. chiEf crEativE officEr scrubsmagazine Stephanie Kraus The AACN now offers (to So, if you love the print version of Scrubs, which nurse-selected and twitter.com/ ExEcutivE dirEctor, markEting members and nonmembers publishes twice a year, you can still enjoy fresh scrubsmagazine Kay Heitzman playlists ). dirEctor communications alike) a free 30-minute, information, inspiration and great doses of humor & industry rElations at scrubsmag. Wendell Mobley on-demand webinar called every single day at scrubsmag.com. distribution managEr com/music. “Managing Alarm Fatigue: Vicki Kadosh New Approaches and Scrubs magazine is published for Strategic Media Group by Mind Over Media, LLC, Best Practices,” as well as copyright ©2014 Strategic Media Group. All rights reserved. Scrubs magazine is a trademark of Strategic Media Group. a detailed downloadable Printed in the USA. All correspondence should be directed Catherine Ettlinger, Editor-in-Chief to Mind Over Media, LLC, 702 16th Street, practice alert on alarm Santa Monica, CA 90402. management systems. Go [email protected] Copies of the magazine are available for $4.50 per copy Email me at or post or bulk at $0.40 per copy in boxes of 30, to their website, aacn.org, or at the subscription rate of one year (two issues) for $7, facebook.com/scrubsmagazine. all at scrubsmag.com/getscrubs. your thoughts on CREDIT PHOTO for more information.

2 scrubsmag.com•spring 2014 SPRING 2014 •scrubsmag.com 3

02.03.2014 09:53 01.21.2014 10:54 { VITAL SIGNS } FOUND! What’s the Lesser of Two Evils? You may be short on time, but that doesn’t mean you don’t have an eye for a good buy. Here, we do the legwork for you; You’re on all you have to do is click away. They're or available at scrubsmag.com/found. the Air

Would you rather work at Princeton Teaching (the hospital in House, left) or Seattle Grace (the hospital in Grey’s Anatomy, right)? Would you rather be married to a doctor or another nurse? You can fi nd these and other hypothetical, all-in-fun questions—as well as pose some of your own—on the Scrubs website. Go to scrubsmag.com/would-you-rather. Radio hasn’t gone the way THE SECRET LIFE OF of dial telephones—some of the The Good Nurse: A True shear beauty update NURSE MORGAN best shows have just migrated to Story of Medicine, Could that nurse with the gentle touch, the Internet. That’s the location Madness, and Murder Trauma is serious business, of course, but Do you have Scrubs’ Code there’s nothing wrong with tools—like these of Kevin Ross and Keith Carlson’s Happy? It’s the app that the one with such a calm and kind manner, The Secret Rescue: An by Charles Graeber bling-y trauma shears—that brighten the RNFM Radio (rnfmradio.com), takes the word “code” be the same man who threw a guy named Untold Story of American You might think you mood. They’re a place where nurses can tune in perfectly from a negative to a “Disco Machine” to the floor the previous Nurses and Medics know the story of functional, too; positive. When you “Call evening? Indeed, James Morgan, RN, is also to hear lively conversation and THE RN Behind Enemy Lines serial killer Charlie the glitter is a Code” on this app, James “The Main Event” Morgan, one of connect with one another. Ross BOOKSHELF by Cate Lineberry Cullen, the nurse sealed in. you’re seeking (and Championship Wrestling from Hollywood’s and Carlson—nurses themselves— Nurses make for The daughter and whose lethal quickly receiving) help pepper their weekly broadcasts just in from those who truly “get brightest stars. The 30-year-old Morgan, the stuff of good granddaughter of injections led to 40 it”—your fellow nurses. who works in outpatient recovery in with topics ranging from nurse stories (think nurses, Lineberry (or possibly more) case The latest version has a entrepreneurship, self-care and Need a mantra? Orange, Calif., while pursuing his DPN, has Atonement) and, tells the harrowing deaths, but Here’s one that whole new look, with been in the ring for 13 years, pounding improving workplace commu- occasionally, nurses tale of the survivors Graeber unearths multiple updates based you can see every opponents (and getting pounded himself) nication to writing fi ction and are the storytellers of a 1943 plane crash the fascinating time you look at on user feedback. in professional wrestling. Is it as far a cry creating art. In fact, some of their (and poets and in Nazi-occupied details behind your smartphone, Here are the top two shows have been ripped from while giving it requested innovations: from nursing as it appears? Actually, no. self-help authors) Albania. Fear of en- Cullen’s madness, drop insurance at MORE SUPPORT Thou- “When someone is going to code and I’m the headlines—of Scrubs —with themselves. Here’s dangering those who the blunders of the the same time. sands of nurses message doing chest compressions and feeling our writers and editors weighing a little of each for helped them, led the medical system requests for advice and scared inside, I can project calm and in on hot topics. The station was your real or virtual survivors to keep and the story of the support every day. confidence to the patient launched in 2012 and designed to shelf. All are avail- their story secret for nurse who helped Now you can fi lter by give nurses a chance to hear from specialty, city, workplace, and his family,” says able at scrubsmag. years. Now Lineberry bring him down. well school and profi le Morgan. “I learned that leaders and innovators in the fi eld com/bookshelf. tells the tale of Yoga XXL: A Journey to organized (student or nurse). from wrestling.” as well as take part in discussions The Daughters of Mars uncommon bravery. Health for Bigger People In life you carry MORE MESSAGING themselves. “We often have by Thomas Keneally Scissored Moon by Ingrid Kollak, RN, PhD Nurses can now send a purse; why not roundtable talks where listeners From the acclaimed by Stacy Nigliazzo, RN Yoga should be for while on the job? a thank-you message can call in,” says Ross. “It’s like It just makes to others who’ve sent author of Schindler’s In this collection everyone, and now a virtual meetup.” You can listen so much sense. them advice, then Ark (the book behind of poems, ER nurse Kollak ensures that Everything you continue a private live to RNFM Radio shows or click the movie Schindler’s Nigliazzo turns both it is. Her poses have James Morgan, RN, need goes in this conversation. on podcasts to hear those you’ve multi-pocketed works overtime List), The Daughters the cruel reality and modifications to suit Available on as a professional nurse’s purse, missed; shows are also posted on of Mars centers on magnificence of bigger bodies while PRINCETON: THORALF SCHADE; SEATTLE GRACE: CRISSY TERAWAKI KAWAMOTO; WRESTLER: ADRIAN SANCHEZ; NURSE: MATT BURNS NURSE: MATT ADRIAN SANCHEZ; WRESTLER: KAWAMOTO; TERAWAKI CRISSY GRACE: THORALF SCHADE; SEATTLE PRINCETON: iPhone, iPad wrestler. PURSE: ANDREA MAIOLANO OF DAYLORS/ETSY; PHONE: COURTESY ELIZABETH PATTON; SCISSORS: meaning no more their YouTube channel. two sisters, both medical care into art. providing the same running in and out and Android For the station’s greatest hits, nurses, who serve You’ll nod knowingly stretching, strength- of patients’ rooms at scrubsmag. go to scrubsmag.com/rnfm. looking for the com/code on the Western Front and shiver at the ening and relaxation right stuff. happy. during World War I. poems’ beauty. benefits. ●

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01.21.2014 10:54 01.29.2014 12:52 { FIRST PERSON } Why I Love Nursing We all have those days when we don’t want to hear the word “nursing.” We’d rather be accountants, GRATITUDE administrative assistants or ambassadors to some tiny country that nobody can fi nd on a map. Most days, though, I love my job. Here, a countdown to the top 10 reasons why I do. By NURSE JO It’s a simple word with an even simpler meaning. But for us at The DAISY Foundation, 10. We’re constantly 6. Nothing is a to some who served in both World surrounded by crisis to a nurse. Wars—rodeo clowns, auctioneers, it is our touchstone. smart, funny Unless you’re guys who parachuted into Central people. Nurses, experiencing American countries on covert doctors, EMTs, uncontrolled missions, priests, politicians or Gratitude drives us to honor the extraordinary anybody in the arterial bleeding, just ordinary folks, I’ve had the work of nurses all over the world. We’re proud medical fi eld pleasure of meeting all. Everyone have lost a limb 10 itude that more than 40,000 have received The has to have miles back or are has a story to tell. And I get to Grat brains and a actually in V-fi b, hear them! DAISY Award and over 300,000 have been sense of humor. nurses don’t 2. Death is not an unknown. (n) A feeling of appreciation nominated since 1999.* Sometimes our blink twice. You see good deaths and bad humor is morbid, 5. Nothing is deaths in this business. You learn or thanks but it’s reliable. scary, either. what you want for your fi nal days, Gratitude is also due our 11 national 9. Our profession Audible bleeding and you know how to make your Foundation Sponsors, listed below. They not garners instant might give you own wishes known when your respect. pause, as might time comes. That relieves a lot of only share our passion to recognize nurses, but Tell people you’re a lethal heart lifelong anxiety. through their generous support, enable our a nurse and see how 1. We make a difference. rhythm, but at the efforts to continue. well they treat you. Tell end of the day, you The realization that, even on my people you’re a used car know you won’t be worst day, I made life a little bit salesperson and see how well they scared away…and can deal with better for somebody else? That’s Their commitment makes the circle complete. treat you. Now compare the two almost anything. If an asteroid enough to keep me going, to experiences. were to hit tomorrow, I would want keep me thankful and to make me 8. We cannot be grossed out. nurses on my team. remember why I love nursing. ● Perfect party trick: Someone tells 4. Watches? We don’t need no a story, and no matter how awful it stinkin’ watches! NURSE JO, RN, has is, you can top it. This talent alone We have an innate worked as a neu- has gotten me more free drinks sense of time. This roscience nurse in at parties than I can count. Which is a skill developed central Texas for FOUNDATION SPONSORS brings me to the next point… over years of 10 years. She has 7. Nobody, but nobody—not even having six differ- been a regular residents—parties like nurses do. ent medications contributor to You want a group of smart, funny, to administer to scrubsmag.com no-nonsense people who can three different for over three hold their liquor? Invite nurses to patients in the years, and blogs your next fete. space of half at head-nurse. an hour. blogspot.com. What do you love 3. We meet more Hobbies include about nursing? interesting people toe wrestling, Win your entry on a than anybody else heffalump ® custom T-shirt or mug! in the world. hunting and Go to scrubsmag.com/ Whether it’s other freestyle poutine RN Residencies consumption. lovetowin. nurses—I’ve talked ADAMS KATHRYN *Find and congratulate DAISY Nurses on scrubsmag.com and on the Code Happy app. 6 scrubsmag.com•SPRING 2014

01.21.2014 10:56 01/24/14 9:32 { WELL-BEING} Too Many Hours, Too Little Sleep

RESEARCHERS time after a 12-hour shift, and that means well under Safety Last TAKING CARE ON six hours of sleep. Not enough when seven to nine is It’s been more than a dozen A 12-HOUR SHIFT AND GOVERNMENT the recommended amount. On top of that, “Sleep loss years since Ann E. Rogers’ When duty calls for an extended AGENCIES HAVE is cumulative,” explains Rogers. “So nurses who work landmark study—“The shift, play it safe by following Working Hours of Hospital Staf 12-hour shifts on consecutive days and are sleep these tips: BEEN SOUNDING THE Nurses and Patient Safety”— Ration your coffee. ALARM FOR YEARS: deprived become more and more affected cognitively.” found that nurses who work On the face of it, the sensible solution would seem more than 12½ hours at a Caffeine should be on a PRN THE LONG HOURS to be a return to the eight-hour shift, but as Rogers stretch are three times more basis, especially if you work SO MANY NURSES explains, that’s not likely to happen. “Nurses like the likely to make a patient care the night shift. By caffeinating 12-hour shift, and while they don’t like mandatory error than those who work yourself judiciously, says Rog- CLOCK IN ARE BAD eight hours. A few years after overtime, they don’t want any restrictions on their ers, you’ll be getting maximum its publication, the Institutes of FOR THEIR HEALTH ability to work overtime.” One study showed that 80 Medicine sounded the alarm effect when you need it most— AND THE SAFETY percent of nurses are happy with current scheduling about the correlation between those times when you’re drag- OF THEIR PATIENTS. policies. Results from the same study, however, showed nurses’ extended hours and ging at work. And you should that levels of job dissatisfaction and burnout increase insuf cient sleep, and the close the coffee bar at least four subsequent threat to patient IS ANYONE with an increase in the shift hours. hours before you go to sleep. safety. In 2011, The Joint LISTENING? While the evidence clearly points out that the ex- Commission issued a Sentinel Prioritize your duties. tended hours nurses work pose a threat to patient safety Event Alert (reserved for When possible, restrict the and to their own health, there are ways to mitigate “events [that] signal the need cognitive heavy lifting to those By MARY DUFFY some of those effects. Most importantly, says Rogers, for immediate investigation hours when you’re wide-awake— recognize your own limitations; make sleep a priority. and response”). Both the first few hours on shift. If organizations made evidence- the action slows down just as Some experts based recommendations, but nothing has changed. Now, the you’re slowing down, don’t let recommend abolishing American Nurses Association yourself fall asleep (unless, of the 12-hour shift. (ANA) has convened an expert course, you’re allowed to nap Where do you stand on panel to address the issue. during breaks). Get up, have a Rogers, who’s on the panel, is extended work hours? snack, stay where it’s brightly lit. Weigh in at hopeful that the guidelines scrubsmag. that the ANA develops will Take your breaks. A recent com/magazine. ignite action. University of Pennsylvania THERE’S A LOT OF TALK these days about how shift), the rotating shifts, the propensity to work detrimental it is for hospital patients to have their through breaks and the stress of the job create the sleep interrupted. Given all we know about the health perfect storm for sleep deficiency in nurses, says Why a good night’s sleep is a necessity, not a luxury cortex, and you start storing fat and ramifications of shortchanging sleep, it’s a topic that Rogers. “Our studies show that nurses devote half their All systems no-go: Sleep plays a Learn more pivotal role in keeping your endocrine, craving sugary food. Oh, and since the ex- deserves discussion. But there’s another sleep issue free hours to sleeping. In other words, if you have 12 about the metabolic and immune systems function- ecutive function isn’t running at full speed, with implications for patient welfare that’s not getting hours free between shifts, you sleep about six hours.” side effects of ing properly. Deep sleep triggers the your self-control fades and your emotional nearly enough attention, says sleep expert Ann E. Rogers, But who has 12 hours free between shifts? On average, insufﬁ cient release of growth hormone, which in reactivity is heightened. (One study even sleep—and PhD, RN, FAAN. That’s nurse fatigue. Rogers, the Edith nurses put in an extra 50 minutes after their shift adults helps repair cells and tissues and found that people who cheat sleep are F. Honeycutt Chair in Nursing at Emory University’s Nell officially ends, so the hours on duty are much closer more likely to act unethically at work.) take our sleep boosts muscle mass. survey—at Hodgson Woodruff School of Nursing in Atlanta, says to 13. Tack on the commute time (on average, about 25 Starved for sleep: Our bodies go into On the face of it: New studies show it’s a critically important issue because it affects the minutes each way), do the math and you’ll find there’s starvation mode when sleep deprived. So that cheating sleep can affect your skin scrubsmag.com/ health and safety of nurses, their patients and the public. not a lot of time left over for shut-eye. In fact, using glucose—the fuel we run on—gets diverted (and not in a good way) and shorten magazine. away from your energy-hogging prefrontal telomeres—in other words, it ages you. The long hours (75 percent of nurses work a 12-hour Rogers’ formula, that leaves about 10½ hours of free IMAGES/CORBIS ER PRODUCTIONS LTD/BLEND T8 scrubsmag.com•SPRING 2014 9

01.21.2014 10:54 01.21.2014 10:53 { WELL-BEING}

doing any exercise within the previ- Nurses who work more than 12 ½ hours ous month were one-third less likely to report problems sleeping, and half at a stretch are three times more likely to You should be as likely to report daytime sleepi- spending one-third ness. Research indicates that exercise make a patient care error. of your life in bed. It pays to make it might also help relieve sleep apnea. comfortable. 3. Make sleep a priority. as it’s not stimulating. An hour before bed- WHAT ABOUT THE The wash, those bills, an episode of time, shut down the computer, have sex, do Under the NIGHT SHIFT? Homeland—none are more important whatever it is that will help you relax. Avoid inf luence The human body was built to be awake than your sleep. Period. bright light and stress-inducing thoughts. You wouldn’t think of going during the day and asleep at night. You 4. Lights out. Since light cues 8. Set a bedtime. And a wake time. Your to work tipsy, would you? pay a price when you try to fool Mother the body to stay awake, make your body likes consistency. Well, from a neurobehavioral Nature with a counterclockwise approach to bedroom as dark as possible. (Black- 9. Lay off the stimulants. For at least standpoint, being awake for your circadian rhythms. A slew of studies 17 consecutive hours is like out shades or an eye mask, anyone?) four hours before bedtime, institute a indicate that working the night shift is having a blood alcohol level Sleep experts also recommend prohibition on caffeine (even if you can fall of 0.05—the legal limit for hazardous to our health. Besides the banishing the television, phone and asleep after a double espresso, caffeine can driving in many countries. side effects that are part and parcel of anything with LED lighting from the affect melatonin production and the quality Awake for 24 hours? That’s shortchanging sleep, shift workers also are study shows that nurses often work through room. In fact, your bedroom should be of your sleep). Also, while alcohol may make similar to someone with a more likely to experience pregnancy blood alcohol level of 0.10 lunch. Anecdotal evidence suggests they are Did you reserved for two activities—sleep and sex. you fall asleep, it has a stimulant effect after complications and may be at higher risk (grounds for arrest for a reluctant to take breaks because they would know? 5. Keep it cool. Your bedroom should be your blood alcohol level drops, so it can DUI in the United States). for some kinds of cancer. All the more impose on colleagues who’d have to cover, The National Highway cool but comfortable, dark and quiet. disrupt your sleep. Drowsy driving is second reason to be vigilant about sleep. says Rogers. Other studies have shown that Traf c Safety Administration 6. Go for comfort. Indulge with 10. Surrender to sleep. That means only to drunk driving as a working 12 hours without a break, even estimates that 1,550 fatalities luxurious linens, cozy PJs, a comfy mattress letting go, not worrying about anything. cause of car accidents in Looking for survival and 40,000 nonfatal injuries when you’ve gotten adequate sleep, can (if it’s sagging in the middle, it’s time for a Attitude counts: If you go to bed believing the U.S. “Unfortunately we strategies for shift duty? per year are caused by drivers don’t have a breathalyzer affect your cognitive skills. new one) and pillows that offer support. you’ll fall asleep, you have a better chance Go to who’ve had too little sleep. for sleepiness,” says sleep scrubsmag.com/ Curtail consecutive shifts. Limit the 7. Establish a ritual. Just as children of quickly nodding off. for evidence- PHOTOS: DIGITAL VISION/GETTY IMAGES. VISION/GETTY DIGITAL PHOTOS: expert Ann E. Rogers. magazine number of consecutive days of an extended settle down to sleep with a bedtime story, based tips to keep you shift to two or three, suggests Rogers. adult bodies also respond to cues. To wide-awake through Leave on time. In order to combat sleep Test your level condition your body to become sleepy, the night and sleeping deprivation, Rogers and other experts advise of sleepiness establish a relaxing nighttime routine, one soundly during the day. limiting work to 12 hours per 24-hour at scrubsmag. that starts 30 to 60 minutes before you head Plus: Check out the period. If the culture at your hospital or com/magazine. to bed. It doesn’t matter what it is—as long Institute of Medicine unit makes that impossible, then work to and Joint Commission’s change the culture. recommendations at THE SIDE EFFECTS OF LACK OF SLEEP PLAN FOR A GOOD scrubsmag.com/magazine. NIGHT’S SLEEP 10 That Can Affect 10 That Can Affect Your Health Patient Care NOT JUST NURSES Here are 10 simple steps to help you get Lack of sleep can put The Joint Commission more ZZZs: you at higher risk for: outlined these as The Centers for Disease Control and 1. Synch up with your circadian • hypertension patient-safety factors: Prevention has labeled insufficient • stroke • inability to stay focused clock. Daylight is key to regulating sleep • cardiovascular disease • reduced motivation sleep a public health epidemic. An patterns. Expose yourself to natural light • diabetes • compromised problem estimated 50 to 70 million Americans each morning. • obesity solving have chronic sleep difficulties, • musculoskeletal • confusion 2. Get some exercise. In one study, and nearly 30 percent of adults get injuries • irritability people who said they worked out vigorously Since there are less than six hours of sleep a night, • needle sticks • memory lapses no limits on also reported they slept better. Another • depression • impaired communication the number of according to surveys. ● hours nurses can study of 155,000 adults indicated that any • increased pain • impaired information • auto accidents processing and judgment work, it’s up to exercise is good for your sleep. Those who you to schedule MARY DUFFY is the executive editor • diminished reaction time enough sleep time reported walking, gardening, golfing or • indifference and loss between shifts. of Scrubs. of empathy

10 scrubsmag.com•SPRING 2014 11

01.21.2014 10:54 01.21.2014 10:56 { FINDS} You can ﬁ nd ➑ 9. DESIGN WITH A ❤ these treasures These chic, sleek pendant TREASURES UNDER necklaces from Hearts (around and win a $20) are made by disabled 10. POP FOR POPS WE SEARCHED FOR STYLISH LITTLE GEMS JUST FOR YOU— basketful of them craftspeople in Mombassa, Kenya, Next time you’re making sweet treats from recycled brass. Hearts products for your unit or your family, surprise SOME SAVE TIME, SOME DE-STRESS, SOME GIVE BACK TO OTHERS. by entering our Finds sweeps come from a three-way collaboration: everyone with these nearly GO AHEAD, INDULGE. YOU’RE WORTH IT. 2,000 artisans looking to overcome too-cute-to-eat cake pops. Nobody’s at scrubsmag.com/ their physical limitations in 17 going to miss those standby brownies magazine. countries, 16 states and five or chocolate chip cookies. Bonus: You ➌ ➏ continents; the natural materials can whip up a batch of a dozen in a ➒ their environments provide; and the matter of minutes—really—with the ➊ Hearts design team. cake pop maker from Babycakes ($25). $50 ➓

1. A SPRITZ OF BLISS 3. PASS THE SALT Dry hospital environments are Here’s one way to do good for yourself notorious for parching skin, but a while doing good for others, too (and light spray of Holly Beth Organics isn’t multitasking one of a nurse’s Rose Geranium Toner ($12.50) will prime skills?). This Pink Himalayan help keep your skin hydrated and it Bath Salt from Chilanthropy (noun: doubles as a makeup setter, so you relaxing while being philanthropic) don’t have to worry about fading or is just what the nurse ordered. streaking during a long shift. Plus, the A 20-minute soak will detoxify your ingredients stimulate cell regeneration skin, improve circulation and relieve 6. “IT’S FOR YOU…!” sore muscles. While you’re at it, you’ll and provide antioxidant Remember the days when you could be supporting Broadway Cares/Equity protection. comfortably cradle your phone on Fights AIDS. All of this is a steal at $24. ➍ your shoulder while you were busy doing something else—say, writing 7. GREAT BALLS OF ICE 11. PRESSURED? 4. TIME TO MAKE up orders or fixing dinner? They’re Most nurses love to party, and TRY ACUPRESSURE. A DIFFERENCE baaaaack, courtesy of this retro mobile Prepara’s festive, frozen orbs (you When you’re feeling stress, tension, 1:face at a time is doing its bit to handset from YUBZ, $40. can freeze with mint leaves, berries, fatigue (like, every day?), this 2. SHIMMY AND SHAKE change the world, watch by watch— slices of lemon or lime) are just the acupressure kit from Yantra Mat ($39) ON YOUR BREAK and so can you when you buy one of ➐ thing to take your drinks to the next just might provide the relief you need Who says exercise isn’t fun? They their seven colorful digital designs. level. Bigger than normal cubes, they (worry not—you don’t have to be an obviously haven’t Hula-Hooped! Three blues equal one charcoal- melt more slowly, keep drinks colder aficionado of yoga or acupressure to Hoopnotica’s fabulous 1950s-style efficient stove. Six hundred and longer and spruce up any pitcher reap its benefits). You get a belt to use Hula-Hoop (from $40) puts play back twenty-five white watches build one (four-packs for $10). on any body part that’s ailing; a into working out. Plus, there are well in Rwanda. One watch costs pillow that conforms to any shape, ➋ DVD workouts that target every part $40, but pays off in dividends. 8. CRAFTING making it useful to treat your of your body. A BETTER LIFE neck, lower back and/or jawline; 5. RX FOR EVERY and one medium and one large Struck by the realities of poverty ● SYMPTOM around the world, Joelle McNamara ring for tired and stiff fingers. Do you need help getting to sleep? founded Badala when she was still in Have a headache? Feeling nauseous? ➎ high school. Today it’s a nonprofit that Achy? Now, thanks to Help, a new employs locals in Africa to make drug company that believes less is jewelry as well as scarves and some more, there’s a product that clothing (“They don’t want handouts, targets your problem with a they want a leg up!”). These “Kiota” single active ingredient. So, “help, drop earrings, $20, are made in Kenya I have a headache,” for example, with synthetic quail egg stone and contains only acetaminophen ($4). hypoallergenic 18k gold-plated You know what you’re getting...and surgical steel French wires. you’re giving back, too, since five percent of the profits is donated to organizations that get healthcare to U.S. children in need of, yes, help.

12 SPRING 2014 •scrubsmag.com 13

01.21.2014 10:56 01.21.2014 10:56 { SCRUBS CHIC }

Young at Heart Youthful Exuberance Orange pants pop with Classic Dickies EDS a bright white top, scrubs have been both in a breakthrough redesigned and refi ned Form and Function new fabric that’s super in a new softer-than- These sweet apple- stretchy and comfy. From updated ever fabric, pretty pink green scrubs are color Break on Through Pitter palette, and useful coordinated with nature’s Patter top and BFF junior fi t styles extras like patch pockets spring-summer bounty. pants by HeartSoul. to HeartSoul, with pencil slots and Plus, they take “profes- side vents. Dickies EDS sional” to a new level of a happening new Signature V-neck top and functionality with patch low-rise cargo pants. pockets, places for pencils brand for nurses and detailing that looks with a special like a million bucks. Dickies EDS Signature wrap top passion for and cargo pants. fashion, scrubs are turning up in seasonal colors, fi gure-fl attering cuts and fabrics that have you looking fresh all day–or bright,night–long. All in the Details Inside the drawstring waist, Dickies logo bold, beautiful twill tape. NEW DIRECTIONS FOR EVERYDAY WORKWEAR

14 15

01.21.2014 10:54 01.21.2014 10:53 { SCRUBS CHIC }

Solid choiceS, print perfection 1 1 Luscious Lavender All High Performance the luxury you’ve come to Keep your cool in scrubs expect from Cherokee Luxe designed with long, hectic in a two-way stretch, form- shifts in mind. Strategically ftting fabric that drapes placed knit panels in key your shape beautifully: split areas keep you fresh and dickey neckline, princess dry; soft, micro-sanded seams front and back, stretch fabric keeps pace breathable side vents and with your every move. instrument loop with logo Dickies Performance snap. Cherokee Luxe Junior System top and pants. 2Fit V-neck top. Ooh La La It’s not hard to fall for this toile print piped in 3pink. Cherokee Runway top. Garden Party Pretty A fattering mock-wrap top in a sunny summery print is bound to bring a smile to your patients (and you!). 2 Cherokee Runway top. 4 4 Stop! No doubt, you’ll com ma n d ple nt y of at te ntion in this rich red top! With its super-simple, classic V-neck design, it’s about color, color, color. Cherokee Flexibles top.

3 17

01.29.2014 12:32 01.29.2014 12:32 { SCRUBS CHIC } ANIMAL MAGNETISM, PRETTY IN PINK 1

Great Shade of Gray A missy-ft V-neck top looks super sleek and stylish in a new extra-soft fabric that sheathes your shape. 1 Made expressly for 2 Dickies EDS Signature line, On the Wild Side the mock-wrap top fatters If you’ve got it, faunt it in this with side vents; the pull-on daring Zebra Crossing print piped in pink from HeartSoul. 3 pants have an adjustable drawstring with elastic at the back for extra comfort 2 and moveability. Dotty Over Hearts So girly! Swiss dot fabric sprinkled with love. HeartSoul Heart 2 Forget You top and Charmed pants.3 Show Your Support This HeartSoul top with its Check It Out Patch pink-ribbon embroidery pockets on pants with helps you boost breast Dickies logo plus cancer awareness. Plus, twill tape to secure a pen. its Lipstick-Leopard print couldn’t be cuter! ●

For more great scrubs style, go to scrubsmag. com/magazine.

18 scrubsmag.com•spring 2014

01.29.2014 12:33 01.21.2014 10:54 { ALL ABOUT YOU }

collapse. We are its heart. That’s the friends. (“You won’t find me hanging Katie is wearing RN I.D. Scrubs: message I want to get out.” out at bars or clubs on Friday nights; “I’m a proud nurse, With her new video blog on that’s just not my style.”) and these scrubs tell the world that!” scrubsmag.com/katie, Duke finally Her lifestyle isn’t necessarily Find them at has the platform to pursue her pas- recommended for everyone, but cherokeeuniforms. The Irrepressible com/r nscrubs. sion to champion nurses and push Duke explains that because she for changes in the profession. Push doesn’t have kids, a husband or a She’s got strong she will—she was raised to stand up boyfriend to worry about, and opinions and the for what she believes in. because she’s extremely regimented, KATIE The 32-year-old Duke is a she’s able to plan her weeks in resolve to make veritable one-woman powerhouse— advance for maximum productivity. them known. Follow and she carefully balances her long That’s what allows her to be a hours at work with lots of brain- motorcycle-riding (“It cuts my her video blog on soothing physical exercise and easy commute by half…and it’s cheap”), scrubsmag.com /katie get-togethers with her close circle of marathon-running (“I’m always DUKE training”), boxing (“Three and instead of saying, Check out Katie Duke’s days a week I train at El video blog at By CATHERINE scrubsmag. “I’m just a nurse,” com/katie, and follow Barrio Boxing in Harlem”), ETTLINGER her on Twitter, (@ hot-yoga-practicing (“I’ve got Photographed by you’ll put up thekatieduke), Instagram (katieduker) and to balance the stress with LIONEL CASSINI your dukes and Facebook (facebook. something”), grad-school- proudly proclaim, com/katie.duke.505). studying (“Just one year left IF KATIE DUKE LOOKS familiar, unfazed and unafraid of any until I have a master’s promoting bands she had been your memory serves you well—she repercussions of standing up for “I am a nurse!” degree and become a critical care working with in St. Louis before she played a prominent role in ABC’s herself and her fellow nurses. nurse practitioner!”), hip-hop-loving “finally left the nest.” highly acclaimed documentary series But what may not readily dynamo. “I spent my first six months By all accounts, these experiences NY Med. It aired in the summer of come across is her soft side. in New York City—when I wasn’t have helped make Duke the person 2012 and followed medical teams Grounded in her Midwestern working—handing and the nurse she is today. “At and patients at three New York City roots, Duke cares deeply about out CDs in front of the end of the day, you have to be hospitals. The producing team—who her family back in St. Louis, her the Apollo strong to survive.” Duke clearly does also created Hopkins and Boston “small and great group of posi- Theater in more than just survive; she takes Med—are preparing for a second tive” friends and her work. Visibly Harlem!” everything in and uses it to help her season of NY Med, which will air proud to say she comes from a She was patients. “I can ask patients, ‘What’s this summer, and Duke will again be family of nurses (mom, a nurse for going on?’ I really listen to them so starring with Dr. Mehmet Oz. 52 years; sister; aunt; and two cous- I can understand what’s brought Even if you didn’t watch the first ins), Duke wants more than anything them down, and then I can tell them go-round, tune in to see our Ms. to have a hand in improving the pub- that while I can’t fix their lives, I Duke, unflappable regardless of lic perception of nurses. She thinks can certainly help them through what comes through the doors of her they’re underappreciated, that nurs- their issues. The best days big-city ER. There’s no mistaking that ing is often thankless and that the are when you can affect she’s a smart, very experienced and media portrays nurses as popping Real nurses do have tattoos! someone on a human competent nurse; that she’s head- pills and sleeping with doctors. During the fi lming of NY Med, level, lend a shoulder to strong; and that she’s outspoken, “We have to get away from all Duke told the crew she was getting lean on. Nursing is not that! The reality is that we should be a tattoo after work. “You mean, always about lifesaving; nurses have tattoos?!” Well, this seen as the people who will correct sometimes it’s just life- Go to scrubsmag.com/ nurse has eight. The crew fi lmed as physicians’ mistakes and handle improving.” Amen. ● katie to fi nd three more “Deal With It” was inked up the critical situations at the drop of a messages Duke inside of her right forearm. “Since I wants to send, loud dime. If you removed nurses from was a child, my mom has said this to CATHERINE ETTLINGER is the editor and clear. healthcare, the whole system would me. It’s formed me as an adult and it of Scrubs. gets me through every shift.”

20 scrubsmag.com•SPRING 2014 21

01.29.2014 12:33 01.21.2014 10:56 { ON DUTY }

RUDE DOCS RANKISM Hector, a nurse on the rehabilitation unit, graduated from Rose, a “mature” nurse, takes great pride in being the most school the week before he started work. He is well received by experienced employee on the geriatric unit. Whenever a new his nurse coworkers, but the physicians give him a hard time. nurse appears, Rose goes to great lengths to tell him or her TO IC NURSING“You new nurses are all the same. No common sense!” fumes that she has been at Grace Hospital since the unit opened. Dr. Monroe when Hector doesn’t realize he is supposed to have One busy day on the unit, Tammy, a fl oat nurse who his patient in bed when the physicians make rounds. regularly comes to the geriatric unit, is assigned to work with When bullying, bad “If you had half a brain, you’d know that it’s your job to make Rose. As soon as Tammy arrives, Rose gives an exaggerated attitudes, and lack of sure these patients take in enough calories to help them get sigh. “Oh gosh, I guess I’ll have to help you all day—again,” she respect and courtesy take through rehab!” says another doctor, Dr. Carter. “It’s hard work says to Tammy, who thinks she’s joking and laughs. over a hospital, a unit or an to go through therapy all day.” Rose spends most of the morning telling Tammy how to do Hector feels totally incompetent, even when the other nurses basic procedures that Tammy is competent to perform alone. office, incivility reigns and reassure him and try to run interference with the physicians. Eventually, Tammy feels as if Rose is condescending and trying nothing good happens—for to give her the message she’s just not good enough to work on the nurses or the patients. THE EXPERT WEIGHS IN: the geriatric unit. “Just because she’s been here 20 years Don’t wait for total turmoil In this example, at least two doctors are known doesn’t mean she’s better than me,” Tammy tells the supervisor. to hit your workplace. on the unit for berating new nurses. “Please, don’t send me there again.” Stopping this disruptive behavior Check out the experts’ is crucial for collaboration, safe care advice on how to handle and rewarding long-term careers. various real-life scenarios Ideally, the nurse manager would so you can survive and, have spoken with these physicians before Hector started on the unit. A yes, thrive in your job. quick chat in private about the expectation of respectful behavior, By CHERYL DELLASEGA, sentinel event data related to PHD, RN, CRNP poor communication, the cost of REBECCA L. VOLPE, PHD and recruiting and retaining qualified Illustrations by CELINE LOUP staff, and an invitation to look at teaching opportunities may be all that is needed. Because that didn’t happen, the nurse manager will have GOSSIP AND TRASH TALK THE EXPERT WEIGHS IN: to speak with Hector privately and One busy evening, Liandra—who has worked in the ED for It’s important to have established a culture in which explain that he or she is working on many years—makes a medication error, which is quickly an error is reported rapidly and the focus is not on addressing this behavior with the caught and corrected by one of her coworkers. Despite the laying blame, but on exploring why it occurred and physicians and that Hector should try self-limiting nature of the medication mistake, Liandra is preventing future errors. not to take it personally. consumed with guilt. She can’t stop retracing her steps The manager needs to talk to Carrie and help In addition, he or she should and trying to fi gure out what led her to give the wrong her understand how her actions have created a toxic role-play with Hector to help him be dose of medication. environment: Not only has she created problems for assertive with these doctors the next Carrie, Liandra’s coworker, works a double on the night her colleagues, but she has also shifted the focus from time an incident occurs. after the mistake is made. She tells the entire night shift prevention of these errors to seeking blame for an Finally, the nurse manager should about it. By morning, the night-shift workers are convinced error that anyone could make. be aware that staff might be contrib- Liandra nearly killed a patient and will suf er serious The manager should work with the staff to create a uting to an unhealthy alignment of repercussions. culture of trust so errors can be reported quickly and “us versus them” with the physicians. One of them calls Liandra to console her and discovers accurately without fear of repercussions. Beth Boynton, RN, MS, the incident has been blown out of proportion. This is Melissa Snyder, DEd, CRNP, Organizational development not the fi rst time Carrie has been caught exaggerating at Campus Coordinator of Nursing Programs, consultant, speaker and author, the expense of a coworker. Penn State Harrisburg Beth Boynton Consulting Services

ADAPTED WITH PERMISSION FROM TOXIC NURSING BY CHERYL DELLASEGA, PHD, RN, CRNP, AND REBECCA L. VOLPE, PHD. 22 PUBLISHED 2013 BY THE HONOR SOCIETY OF NURSING: SIGMA THETA TAU INTERNATIONAL. SPRING 2014 •scrubsmag.com 23

01.21.2014 10:54 01.21.2014 10:54 { ON DUTY } THE SUPERNURSE the problem that Rose’s could call an aide, another nurse or even the SYNDROME THE EXPERT WEIGHS IN: behavior creates for the unit nurse manager to either help the patient When one nurse believes he Top-down change is rarely successful and the ability to ensure the get to the bathroom or give the pain or she is automatically a because the people who understand recruitment and retention medication to Mr. Truman. Managers also better nurse and more the process the best aren’t involved of qualified staff. Once the need to be tuned in to whether nurses are skilled than ev eryone else, in the solution. The more input nurse manager is made working a double shift and be prepared to chaos ensues. Are there people have in designing the change aware of the situation, she give an overtired nurse more backup. Supernurses in your hospital? that affects their work, the more they can continue to assess the The real problem here is the chronic On your unit? By any chance, will own the results. ongoing impact of Rose’s one of hospitals not having enough staff to could you be a Supernurse? Forced change is typically met behavior on the unit. cover call-offs and expecting nurses on Answer the following with a cynical response, especially Mary T. Meadows, the floor to make up the difference without questions to explore further. when it creates more work and MS, MBA, RN, CENP, any negative consequences to themselves Using a scale of 1 to 10, with frustration. Managing change is Director, Professional or patients. Aria is only human; being 10 being “agree as much as challenging—even when new Practice, AONE; confronted in the hallway by an irate fam- possible” and 1 being policies make jobs easier—and Executive Director, ily member is likely to produce irritation. “disagree as much as leaders must know their roles during AONE Foundation The nurse manager will need to hear Mrs. possible,” respond to the these periods of change: Listen carefully Truman’s complaint and then apologize for following: to what people are PATIENTS not staffing the floor adequately and not talking about. Never make them feel I believe that I’m a very AS VICTIMS giving Aria the support she needed to do • like their comments are silly. Never skilled nurse. Aria, an RN with 10 years of her job. She also needs to follow up with make promises or try to convince My supervisors and other experience on a medical- Aria in a supportive way, admitting Aria was • people the change is good; they will administrators consider me a surgical fl oor at Community overworked, but making it clear that being come to their own conclusions. good nurse. Hospital, has worked a double rough with patients is, of course, not okay. Allow people time to process the I’m the best nurse in my shift after another nurse calls Theresa Brown, BSN, RN, OCN, • information and vent their feelings organization. of sick. After 10 hours of Staff nurse, contributing editor to Scrubs, and concerns. The feedback I get from caring for dif cult patients, columnist for The New York Times • It helps to have leaders visible my coworkers about my she is tired and grouchy. and author of Critical Care. during times of change so people feel nursing abilities makes me A patient, Mr. Truman, is they have easy access to them. feel as confi dent as possible. recovering from major POLITICS AND CYA Remain calm and positive. Leader- I’m more skilled than most abdominal surgery. He needs a (COVER YOUR ASS) • ship will set the tone for the change. of my coworkers. THE EXPERT WEIGHS IN: dressing change and pain medication, but Aria is busy helping At St. Clara Hospital, nurse managers Remember, the people in the Rose, through her tenure, perceives herself as the another patient who has IVs and mobility problems get to must obtain the approval of their nursing These questions are meant organization are the organiza- expert nurse on the geriatric unit. This elite self- the bathroom. Mrs. Truman searches her out. “My husband supervisor prior to discharging a patient. The to prompt refl ection on tion—they need to be involved and designation sets the stage for a work environment in really needs you,” she tells Aria. “He’s got a lot of pain.” policy was created when there was a problem how you view your own treated fairly. ● which bullying or insidious intimidation can flour- “I’ll be there as soon as I can,” Aria replies. managing empty beds and a physician competencies in comparison Sherry Kwater, MSM, BSN, RN, ish. Rose may perceive a threat to her position and Ten minutes later, Mrs. Truman shows up again, repeating complained to the CEO. Now, the director of with those of your Chief Nursing Officer, status, and has resorted to classic bullying behaviors her request. This time, Aria follows her down the hall and nursing reasons that supervisors will know colleagues. You could also Penn State Milton S. Hershey to maintain her influence: unwarranted criticism and tells Mr. Truman she is getting his meds and the supplies for the status of a particular unit at all times. use them in a meeting of Medical Center excessive monitoring of a competent and experienced his dressing change. Aria completes her care of Mr. Truman, “This is ridiculous,” Dolores, one of the new colleagues or staff and start a nurse. It’s also likely that Rose will exhibit the same but is rough and unpleasant as she does so, because she nursing supervisors, tells a coworker. “All I do dialogue on the Supernurse CHERYL DELLASEGA is a professor behavior with other nurses if she continues to feel a feels stressed and unappreciated. Mrs. Truman later fi les a is acknowledge what the nurse managers tell Syndrome. in the Department of Humanities at threat to her status complaint with Aria’s nurse manager. me. The computer could do the same thing.” the Penn State College of Medicine in Tell us about on the unit. Tammy At the unit level, nurse managers are now requiring all Hershey, Pa. She is the award-winning author of Surviv- your own toxic reacts in a manner that THE EXPERT WEIGHS IN: nurses to “check in” with them prior to discharging a ing Ophelia, Girl Wars and When Nurses Hurt Nurses. experiences and relieves the problem The impossibility of one nurse needing to be in two patient. “It’s stupid, I know,” says Jill, a nurse manager. REBECCA L. VOLPE is an assistant professor in the get advice from for her by requesting places at once comes up over and over again in clinical “It creates an extra step for everyone, but I guess we’re Department of Humanities at the Penn State College of fellow nurses at not to work on the practice, and it’s actually an easily solved problem. all paying the price because a doctor blew his stack Medicine in Hershey, Pa., as well as director of the scrubsmag.com/vent. unit again. However, Answering call lights should be everyone’s responsibility, when his patient sat in the ED for two days, waiting to be Clinical Ethics Consultation Service for the Milton S. this doesn’t eliminate and there should be enough staff on the floor that Aria admitted when there was really an empty bed.” Hershey Medical Center.

24 scrubsmag.com•SPRING 2014 25

01.21.2014 10:53 01.21.2014 10:56 { WORK-STUDY}

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Long island. “We know what GUARANTEED. our culture as a whole is,” she says, but the very different settings call for very different appeal to someone looking for a Comerford-Hewitt, noting that WhO’S types of nurses. fast pace and lots of learning with the implementation of The BOSS? YOU ARe. “We review the entire opportunities—a good fit for healthcare reform and with When one career person,” says Comerford- someone with energy and a so many nurses nearing isn’t enough, Hewitt, who conducts behav- need to keep moving,” she retirement, it’s an Rn’s market. try a combo: ioral interviews to understand notes. The community hospitals she urges nurses to survey the •Health coach •Nurse how a nurse will LAYing actually have more employment landscape beyond consultant respond in various DOWn of a sense of hospitals when starting a job •Nurse WGU offers CCNE-accredited* BSN and MSN degree programs that are designed to ft your situations, to get a sense The LAW community and hunt. she cites pharmaceutical entrepreneur In the criminal Nurse ethicist of her goals and to judge offer a slower pace companies, the insurance • busy schedule. We’re online, affordable, and we’re seeking nurses who are driven to succeed. justice system, •Nurse whether her qualifica- there are nurses… to nurses looking industry, wellness education, executive wgu.edu/scrubs tions, personality and • Domestic for long-term ambulatory and home health- •Nurse violence/sexual historian career goals are a good positions. care as areas of future growth. assault nurse •Nurse writer match for a particular examiner “There are so “one of the great things about job and setting. • Forensic nurse many opportuni- nursing is that you can take “our teaching • Fraud and ties for nurses your clinical skills and apply abuse

keith negley institutions tend to investigator these days,” says them to so many areas.” • Legal nurse consultant Nurse attorney spring 2014 •scrubsmag.com 27 *WGU’s nursing programs are accredited by the Commission on Collegiate Nursing Education (One Dupont Circle, NW, Suite 530, Was hington, DC 20036, 202-887-6791). •

01/13/14 2:29 01.29.2014 15:49 { WORK-STUDY} What’s your preference? SOME SOME HANDS-ON NO GUTS, RESEARCH- AN ADRENALINE THE CORNER WORK BEYOND TO BE IN SPECIALTY STRUCTURE AUTONOMY PATIENT CARE SOME GLORY ORIENTED RUSH OFFICE THE HOSPITAL DEMAND Look into the future Ambulatory care ✖ ✖ ✖ ✖ Although it’s easy to get CREATE YOUR CardiacCardiac care ✖ ✖ caught up in living one day at VISION Case manager ✖ ✖ ✖ a time, juggling the multiple Looking forward still, consider: ClinicalClinical nurse specialistspecialist ✖ ✖ ✖ responsibilities of family, friends • Where do you want to be Critical care nurse ✖ ✖ ✖ ✖ and work, it’s important to look in your career in fi ve years? DiabetesDiabetes nursenurse educatoreducator ✖ ✖ ✖ ✖ ✖ forward and design your future Ten years? Emergency care with conscious choices that What do you want to be ✖ ✖ ✖ ✖ • Flight/transportFlight/transport nurse support your goals. To help doing? ✖ ✖ ✖ ✖ shape your plans for the next • What do you want to Forensic nurse ✖ ✖ ✖ ✖ ✖ one to fi ve years, ask yourself accomplish? GeriatricGeriatric nurse ✖ ✖ ✖ the following questions: • How will you know if you Health policy nurse ✖ ✖ ✖ ✖ ✖ • AM I SATISFIED with my are successful? HolisticHolistic nursenurse ✖ ✖ ✖ ✖ current work? If not, what Home healthcare ✖ ✖ ✖ ✖ needs to happen so that I BUILD YOUR PLAN InformaticsInformatics nursnursee ✖ ✖ ✖ ✖ can more fully engage in my With answers to these questions Infusion nurse ✖ ✖ ✖ nursing career? in hand, lay out a realistic plan. Labor and deliverydelivery ✖ ✖ ✖ AM I COMMITTED to working Invite others to review it and • Long-term care nurse for my current employer? If provide you with support to ✖ ✖ ✖ ✖ Medical-surgicalMedical-surgical nurse so, what other opportunities accomplish your goals. If the plan ✖ ✖ exist for me to advance within doesn’t come together as you Neonatal intensive care ✖ ✖ ✖ this organization? What initially designed it, don’t worry. NephrologyNephrology nurse ✖ ✖ ✖ ✖ knowledge or skills do I need Revise it and reset your course Nurse advocate ✖ ✖ ✖ to be eligible for advancement? of action. Your commitments Nurse anesthetistanesthetist ✖ ✖ ✖ ✖ Who can mentor me to advance to the foundational elements Nurse educator ✖ ✖ ✖ ✖ ✖ my career? of a successful nursing career Nurse manager/administratormanager/administrator ✖ ✖ ✖ and to your personal and • DO I WANT TO PRACTICE Nurse midwife ✖ ✖ ✖ ✖ as an APRN? If so, how soon professional growth are key. Nurse practitionerpractitioner ✖ ✖ ✖ ✖ do I want to begin graduate (Peruse “What’s Your Preference?”, Nurse researcher school, and do I want to at right, to compare and ✖ ✖ ✖ OccupationalOccupational hhealthealth nurse pursue a master’s (MA) in contrast specialties.) ✖ ✖ ✖ ✖ nursing or a doctor of nursing When this proactive approach Oncology nurse ✖ ✖ ✖ practice (DNP) degree? is used, it serves to build your Pain managementmanagement nurse ✖ ✖ ✖ • DO I WANT TO IMPACT confi dence and helps strengthen Pediatric nurse ✖ ✖ THE FUTURE of health your leadership skills. There is no PerioperativePerioperative nurse ✖ ✖ ✖ through the generation of new limit to the sense of pride and joy Psychiatric nurse ✖ ✖ knowledge? If so, what BSN to you gain from experiencing the Public and communitycommunity health ✖ ✖ ✖ PhD and MSN to PhD programs fruits of high-level engagement, Pulmonary care ✖ ✖ ✖ offer the opportunity to putting values into action, exhibit- RadiologyRadiology nursenurse ✖ ✖ ✖ ✖ further specialize in my areas ing efforts to learn and grow, and Rehabilitation nurse of expertise? steering toward a future that’s in ✖ ✖ ✖ ✖ RuralRural nursenurse ✖ ✖ ✖ ✖ • WHAT WILL I NEED from my alignment with your passion and family and friends in order to talents. —Janice Phillips, PhD, RN, School nurse ✖ ✖ ✖ ✖ accomplish my career goals? FAAN, and Janet M. Boivin, BSN, RN TelemetryTelemetry nursenurse ✖ ✖ ✖ Toxicology nurse ADAPTED WITH PERMISSION FROM ACCELERATE YOUR CAREER IN NURSING: A GUIDE TO PROFESSIONAL ✖ ✖ ✖ ✖ ADVANCEMENT AND RECOGNITION BY JANICE PHILLIPS AND JANET M. BOIVIN. PUBLISHED 2014 BY THE HONOR SOCIETY OF NURSING: SIGMA THETA TAU INTERNATIONAL. TransplantTransplant nurse ✖ ✖ Trauma nurse ✖ ✖ ✖ TravelTravel nursenurse 28 scrubsmag.com•SPRING 2014 ✖ ✖ ✖

01.21.2014 10:54 01.21.2014 10:56 Discover the Professional Programs at Johns Hopkins Nursing

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More info at learn.nursing.jhu.edu At Interim HealthCare, we provide the fl exible assignments you need to fi t your life – and your priorities. As America’s leading provider of home care, hospice and healthcare staffi ng, chances are we have the right 525 N. Wolfe Street, Baltimore, MD 21205 assignment to fi t your needs – as well as free online training and other opportunities to 410-502-3335 help you advance your career. But don’t just take our word for it. Visit Interim HealthCare on Facebook and hear from our nurses why they love working at Interim!

One complaint is all it takes. Whether warranted or not, one complaint to the state licensing board, one lawsuit fled, and your career can be over — just like Benefts* for covered claims include: that. We’ve seen it happen.  Up to $2 million in protection for each claim / up to $4 million annual aggregate** What if …   What if your employer’s policy isn’t large enough to cover Defense costs in addition to limits  *** you and your coworkers? Damage to property of others coverage  ***  What if you’re brought before the state licensing board? First Party Assault coverage  *** Most employers’ plans don’t cover that. Wage loss and expense coverage  Separate Annual Limits for each professional if you  What if you’re sued for an incident that occurred outside of the workplace? practice in a group  Medical Payments coverage*** What you need  Deposition Expense coverage*** With an individual professional liability policy from proliabilitySM,  First Aid Reimbursement coverage*** a program by Mercer Consumer, a service of Mercer Health &  Licensing Board Reimbursement*** Benefts Administration LLC, you get peace-of-mind coverage  Coverage for volunteers and employees tailored for nurses like you.

Call (800) 503-9230 or visit proliability.com/64965 to get an instant quote. Then take 5 minutes to fill out the application. It’s that easy. And that important. Administered by Mercer Consumer, a service of Mercer Health & Benefts Administration LLC. Underwritten by Liberty Insurance Underwriters Inc., a member company of Liberty Mutual Insurance, 55 Water Street, New York, NY 10041. *This is only a summary of the Insurance Policy provisions. If any confict exists with the actual Insurance Policy, the terms of the Insurance Policy control. **Other limits available. Please contact the Program Administrator or visit www.proliability.com. ***Subject to sublimits as further described in policy documents. Call or refer to actual policy for complete policy provisions. AR Ins. Lic. # 303439 | CA Ins. Lic. # 0G39709 In CA d/b/a Mercer Health & Benefts Insurance Services LLC 64965 (2/14) Copyright 2014 Mercer LLC. All rights reserved.

01.29.2014 12:32 01.29.2014 12:32 { LOOKING BACK } NON-LATEX SENSITIVE SURGICAL GLOVE A Decade of Style FEATURING SENSOPRENE® FORMULATION. Non-Latex Sensitive They’re like your favorite brand of jeans: classic, dependable, durable. No wonder nurses turn to Cherokee Workwear over and over for great fit and cool comfort! In the 10 years since the first scrubs rolled off the designers’ tables, there have been many highlights. Here are just a few.

With an operation this sensitive, you can’t by-pass feel.

GENIUS IN YOUR O.R. INSPIRED REVOLUTIONS IN SURGICAL GLOVE TECHNOLOGY.

The surgeon saw the obstructed artery and instantly knew — this procedure was crucial. Every second of the four-hour operation mattered. And each piece of surgical equipment 2004 could make a difference. THE ORIGINAL in basic navy was an instant best seller with 2007 GAMMEX Non-Latex Sensitive surgical gloves, featuring its quintessential good THE MEN’S the innovative SENSOPRENE formulation, were developed looks—the top has CLASSIC specifcally for moments like these. a just-right V-neck, was introduced to generous patch pockets understandably great 2013 and fl attering fi t; fanfare. With the feel of CORE STRETCH • Superior sensitivity while maintaining glove strength pants launched with a designer sports shirt— JUNIOR STYLES • Chemical accelerator-free formulation delivers an easy drawstring a notched collar, breast kicked off a fl urry of comprehensive allergy protection waist and side-slash pocket, elbow-length must-have buying with slimming pockets. sleeves, zip front— their unique blend of • The ft, donning properties and grip you expect this scrubs top in a high-tech stretchability timeless hunter hue and super-soft cotton. • Exceptional value in synthetic category was a winner right off Here, in shocking pink, the drawing table, the top tapers under the For additional information or to request a sample, call Ansell especially with matching bust, just where you’re today at (855) 868-5540 or visit us at www.ansellinfo.com/gss drawstring pants. slimmest, and fl ares ever so slightly over the hips. Matching pants move

with you, keeping you MONICA LIND comfy through every long shift. 32 scrubsmag.com•SPRING 2014 ® and ™ are trademarks owned by Ansell Limited or one of its afliates. ©2014 Ansell Limited. All Rights Reserved. Story is provided solely for illustrative purposes and does not describe any actual surgeon, procedure or patient.

01/13/14 12:54 01.21.2014 10:54 When you’re ready to advance. You are ready for American Public University.

Expand your opportunities with a CCNE-accredited RN to BSN program. APU can help you balance your personal and professional life while pursuing a respected degree online — at the university that is the only 3-time Efective Practice Award winner from the Sloan Consortium.

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*College Board: Trends in College Pricing, 2013.

We want you to make an informed decision about the university that’s right for you. For more about our graduation rates, the median debt of students who completed each program, and other important information, visit www.apus.edu/disclosure.

01/23/14 2:38