EMPOWERING. UNITING. ADVANCING.
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The n te Unwrist of Rule as a Datingrse Nu Michelle Podlesni:
From the Bedside to the Boardroom and Beyond plus
The Many Faces of Nursing Nursing Influencers and Their Journeys
renee THOMPSON
kati KLEBER
donna CARDILLO
keith CARLSON
beth HAWKES
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I help nurses and health care professionals create vibrant, healthy and satisfying personal and professional lives! Keith Carlson, BSN, RN, NC-BC is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, social media influencer, keynote speaker, author, and popular career columnist. With more than two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses. Keith’s career coaching services include resumes and cover letters, LinkedIn optimization, networking and interview skills, career management, and shaping the individualized nursing career that’s just right for you.
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EMPOWERING. UNITING. ADVANCING.
Dave Smits
Learn what it means to do what you love. Working at Sharp isn’t just a job — it’s about waking up every day knowing you’ll make a difference.
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Find your next career at Sharp. https://jobs.allnurses.com/company/sharp-healthcare-0875
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Technology Director joe@allnurses.com
EDITORS / CONTRIBUTING WRITERS Mary Watts, BSN, RN Judi Dansizen, MSN, APRN Beth Hawkes, MSN, RN-BC Michelle Podlesni, RN Sarah Matacale, RN, BSN, CCS Melissa Mills, RN, BSN, CCM, MHA Keith Carlson, RN, BSN, NC-BC Lorie Brown, RN, MN, JD Brian Sorenson
47 States 74 Hospitals 48 Outpatient Centers 100s of opportunities Take a good look at jobs.tenethealth.com 4
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allnurses is published quarterly by allnurses.com, Inc., 7900 International Dr., Suite 300, Bloomington, MN 55425 All rights reserved. Reproduction in whole or part without written permission of the publisher is prohibited. The opinions of contributing writers to this publication do not necessarily reflect the views of allnurses.com, Inc. Copyright © 2018 by allnurses.com. All rights reserved. Products featured within these pages do not constitute an endorsement by allnurses.com.
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Contents
From the Bedside to the Boardroom and Beyond 42
A move to Chicago and a longshot job interview were pivotal moments for Michelle Podlesni along her path from bedside to boardroom and beyond.
By Michelle Podlesni
The Many Faces of Nursing What started with the dream of a job that offered flexibility, Renee Thompson created not one but two important healthrelated businesses. 38
28
By Melissa Mills
From Student to Nurse Influencer Rockstar
Writer, speaker, podcaster and more; Kati Kleber’s journey to becoming an influencer began while trying to find a way to get paid for her extensive and informative blogging.
By Sarah Matacale
Meet Donna Cardillo, The Inspiration Nurse
The almost accidental journey from nurse to influencer. 22
By Melissa Mills
Choosing the Path of the Nurse Entrepreneur
Following nursing trailblazers, Keith Carlson finds his own trail. 18
6 Editor’s Note 7 Nursing News Briefs 10 The Best of... 11 Calendar 12 Career Tips 34 Trending Products
By Keith Carlson
36 Get Social
From Nurse to Nurse Influencer
37 LOL
Beth Hawkes shares her journey from nursing to writing. 14
Departments
By Beth Hawkes
50 Expert’s Corner
Editor’s Note Nursing is an ever-changing profession. No longer are nurses constrained to working at the bedside for the majority of their careers. With the proliferation of social media, the barriers to blazing your own trail have been torn down. With those barriers gone, the same thing happened with excuses. The nursing influencers featured in this issue never focused on excuses. Instead, they focused on finding success. The common thread of perserverance even in the face of adversity is inspiring and motivating.
Connect
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Nurse influencers come in all shapes, sizes and ages. Whether you have two years of experience, twenty years of experience or more; today’s influencers are changing the public perception of nursing and dictating their careers on their own terms.
In this issue, we take a look at the many faces of nursing. We have Beth Hawkes who shares her journey of writing which went from hobby to profession. Donna Cardillo shares her journey from traditional nursing to being the Inspiration Nurse. Keith Carlson talks about his path from becoming a nurse to becoming a nurse entrepreneur. Midwesterner Kati Kleber talks about her career not only as a nurse but as an author, speaker, podcaster and more. Renee Thompson discusses the many faces of nursing with nurse writer Melissa Mills. On the cover we have Michelle Podlesni sharing the other avenues of nursing outside or the bedside and beyond the hospital setting. Grab a cup of coffee and enjoy!
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Contact us
We welcome your story ideas. Reach us at magazine@allnurses.com
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“I attribute my success to this; I never gave nor took any excuse.”
– Florence Nightingale
Nursing News Briefs
Low Dose ASA for Older Patients? Maybe Not…
united states By Judi Dansizen A recent study (September 2018) documented in the New England Journal of Medicine concluded, “Aspirin use in healthy elderly persons did not prolong disability-free survival over a period of 5 years but led to a higher rate of major hemorrhage than placebo.” The Aspirin in Reducing Events in the Elderly (ASPREE) trial, investigated whether the daily use of 100mg aspirin, in healthy, community-dwelling older adults would prolong healthy lifespan, free from dementia and persistent physical disability. However, the conclusion of this trial showed that over a median follow-up of approximately 4.5 years, the use of low-dose aspirin in persons 70 years of age or older who did not have cardiovascular disease did not prolong disability-free survival in a predominantly white population. This study involved over 19,000 subjects in the US and Australia who were 70 years or older and were enrolled from 2010 thru 2014. They were then randomly chosen to receive 100mg per day of enteric-coated aspirin or a placebo. The primary endpoint was a composite of death, dementia, or persistent physical disability. Secondary endpoints
reported in this article included the individual components of the primary endpoint and major hemorrhage. 56% of the participants were women, almost 9% were non-white and 11% reported previous regular aspirin use. The rate of the composite of death, dementia, or persistent physical disability was 21.5 events per 1000 person-years in the aspirin group and 21.2 per 1000 person-years in the placebo group. The adherence rate was 62% of the group that received aspirin and 64% for those that received a placebo. The rate of major hemorrhage was higher in the aspirin group than in the placebo group 3.8% vs. 2.8%. Most of the studies conducted regarding the use of low-dose aspirin focus on reducing cardiovascular risk. However, this study explored whether 5 years of daily low-dose aspirin therapy would extend disability-free life in healthy seniors. This study seems to refute this though as the rate of major hemorrhage was higher in the aspirin group than in the placebo group (3.8% vs. 2.8%). So, is it better to risk a hemorrhage versus possible cardiovascular disease reduction? This is a question that needs to be thoroughly discussed between patients and providers.
when Australian Epidemiologist Mark R. Nelson, PhD, of Monash University in Melbourne, Australia, developed a statistical model that suggested low dose aspirin might not be beneficial for those over the age of 70 but he wanted to develop an actual study involving large numbers of elderly people to prove his hypothesis. The U.S. Preventive Services Task Force recommends daily aspirin therapy for ages 50 to 59, if there is no increased bleeding risk, and the patient has an increased risk of heart attack or stroke of 10 percent or greater over the next 10 years. If the patient is between ages 60 to 69, and they aren’t at increased bleeding risk, and they have a high risk of heart attack or stroke of 10 percent or greater over the next 10 years, they should talk to their provider about daily aspirin therapy. The American College of Cardiology reviewed the ASPREE study and states that aspirin use in the elderly did not reduce disability-free survival but did increase major bleeding when compared with placebo. So...what would you do? Aspirin or no? Do the risks outweigh the possible benefits?
This study’s idea started in 2005
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Nursing News Briefs
Photos via usatoday.com
Nurse Makes Patient’s Last Wish to Fly Come True indiana By Mary Watts, BSN, RN Joe Booth, a 69-year old Indiana resident was told in February that his 2-year fight with prostate cancer “I’ve never stepped foot in an airplane. I used to build model airplanes all the time as a kid, but I just never got the chance.”
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wasn’t looking and to stop taking his medication. Joe said he was scared but had one last thing he wanted to do. He wanted to fly in an airplane. His oncology nurse at Norton Hospital, Tracey Norton, made his dream into a reality. He took off from Bowman Field and saw Louisville and southern Indiana from a vantage point he never experienced before. He also got to take control of the plane and flew. Joe died less than 2 months later.
But he was able to fulfill his dreams of flying....thanks to the compassionate help of his nurse. Nurses do make a difference in the lives of their patients every day. “They told me to stop taking the medication and to focus on living life day to day,” Booth said. “So, I’m doing that the best I can. Dr. Rez ... Tracey, they’ve been angels.”
From the FDA - Immediate-Release Opioid Analgesics Now Under REMS united states
By Mary Watts, BSN, RN The U.S. Food and Drug Administration announced on September 18 that it is broadening its Risk Evaluation and Mitigation (REMS) for opioids to include immediate-release analgesics prescribed for outpatients, and will cover all “healthcare providers who are involved in the management of patients with pain” - not just those writing prescriptions. The FDA is requiring opioid manufacturers to created training modules for nonprescribers (nurses, pharmacists) and prescribers that cover immediate release products, however, the training will remain voluntary for profes-
The aim is to reduce overall dispensing as a way to further reduce exposure to these drugs sionals. FDA Commissioner Scott Gottlieb,MD, stated, “Our aim is to make sure the medical community can take advantage of the available education on pain management and safe use of opioid analgesic products. At the same time, we’re also taking new
steps to advance the development of evidence-based, indication-specific guidelines to help further guide appropriate prescribing of opioids. The goal is that these guidelines will provide evidence-based information on the proper number of opioid doses that should be dispensed for different medical conditions for which these drugs may be indicated. The aim is to reduce overall dispensing as a way to further reduce exposure to these drugs.”
For more about this story, go to FDA takes important steps to encourage appropriate and rational prescribing of opioids through final approval of new safety measures governing the use of immediate-release opioid analgesic medications Fall 2018
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The Best of allnurses.com Each quarter, hundreds of amazing articles are published on allnurses.com, below are those deemed the best by our readers!
What You Need To Know About Older Nurses: Myths and Realities
Today’s nursing force is aging with an average age of 44 and average retirement age at 61 Current strategies to address the continued nursing shortage includes retaining older nurses and delaying retirement for those leaving the workforce prematurely. However, stereotypes of older nurses is common in healthcare and can lead to early retirement-further complicating the nursing shortage
Nurse Suicide is Real: 3 Ways to Help
It seems in recent years, there’s been anecdotal information connecting the risk of nurse suicide to burnout and job stress. This article discusses available statistics, anecdotal information, and a few ways nurse leaders and healthcare systems can work to prevent this deadly occurrence from happening on your unit.
5 Reasons Nurses Get Fired and How to Avoid Them
You’re Fired! These are words that you probably hope you never hear. Learn a few of the top reasons nurses get fired and how to protect yourself.
Nurse Sick and FIRED: Exploring Nursing Absenteeism
You work long hours, rotating shifts, and holidays. The schedule alone is enough to leave you feeling run down, tired, and needing a day off. But, what happens when you are in fact sick? Does your facility’s call-off policy protect you from discipline or termination? Here, we will discuss the good, the bad, and the ugly about nurse absenteeism and presenteeism.
How to Identify and Respond to Bullying and Incivility
Workplace bullying is often described as aggressive behaviors that may include: alienating, intimating, public humiliation or sabotaging, and are usually perpetrated by someone in a higher level of authority. This behavior may involve covert or overt acts of verbal and non-verbal aggression. These types of behavior have been reported to result in enough psychological distress to nurses that it has caused them to leave the profession altogether.
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Calendar of Events A brief and informative overview of events, conferences and special promotions for the nursing community.
National Nurses in Business Association Conference Las Vegas, NV
NNBA hosts their annual conferOCT. ence October 12-14 in Las Vegas. Thinking about starting your own business or want to improve your current one? Then this is THE conference for you. With nationally acclaimed speakers and business experts guiding you, plus networking opportunities, you will feel confident in your business decision. Allnurses. com Community Manager, Mary Watts along with Beth Hawkes (Nurse Beth) will be featured breakout session speakers alongside Michelle Podlesni, Donna Cardillo, Keith Carlson, Renee Thompson and many other nurse influencers.
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Emergency Nurses Week
Celebrate the ED nurse. October OCT. 7-13 is set aside to for nurses in our Emergency Department. The Emergency Nurses Association provides many options for hospitals to recognize their ED staff. .
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American Nurses Credentialing Center Magnet Conference Denver, CO
ANCC welcomes you to Denver, Colorado October 24-26th for the largest nursing conference in the US. Over 70 concurrent sessions ranging from raising future nurse managers to reducing unrecognized clinical deterioration to developing a floating hospice; many opportunities await you. Join 10,000 nursing colleagues on the Magnet journey. Speakers include adventurer Aron Ralston and Dr Patch Adams. OCT.
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National Nurse Practitioners Week NOV.
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Join your fellow NPs November 11-17, 2018 in celebrating the contributions they bring to their patients, colleagues and the nursing community. Fall 2018
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Career Tips
The unwritten rules of dating as a nurse by Beth Hawkes MSN, RN-BC, HACP
Beth Hawkes (Nurse Beth) is an accomplished nurse working in Acute Care as a Staff Development Professional Specialist. She is also an accomplished author, blogger and columnist. As Nurse Beth, she regularly answers career-related questions at allnurses.com. Click here to submit your career-related question to Nurse Beth today or visit https://allnurses.wufoo.com/ forms/z1j8p9o81puszdb/
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Dear Nurse Beth, I’m wanting to date a former patient. He was never my patient, just there while I was on duty ... Navy Psych Tech. I’m just curious if it is against any rules to date a former patient of mine at the inpatient ward??? Please let me know, he’s such a sweet man and we totally connected a few months after he was in!
Dear Wants to Date Former Patient, Nurses are the most trusted profession and as such follow a code of ethics. There are no legal rules around dating a patient, but we are bound to a code of ethics. The ANA Code of Ethics tells us when there’s a conflict between personal values and professional values, the conflict must always be addressed in a way that puts our patients’ safety and concerns first.
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The intimate nature of nursing can lead to a risk of boundary violations and it’s up to the nurse to establish the boundaries. According to the National Council of State Boards of Nursing (NCSBN) there are questions to help determine the appropriateness of dating a patient and guide professional boundaries. How long ago was the nurse patient relationship? If it’s a current relationship, dating is prohibited. Was the care provided extensive? A one day stay in the hospital is different than a two week stay. Is there a chance he’ll be your patient in the future? In your case, he was not your patient, and you did not enter into a nurse-patient relationship. You connected after he was hospitalized. You are not violating any professional boundaries, and I wish you and your sweet man well. Best wishes, Nurse Beth Author, “Your Last Nursing Class: How to Land Your First Nursing Job”...and your next!
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written by
Nurse Beth
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Nurse From to
Nurse Influencer Many years ago, I graduated as an RN and fell in love with my job on an Ortho unit. From there I worked MedSurg, ICU, and Tele before becoming a nurse manager. Now I work in Staff Development, and have still never lost my love for acute care. I enjoy working with new grads at my hospital and helping them grow. But I’ve had other dreams, and one of them was to write.
From Hobby to a Side Job
My writing career as a nurse started 4 years ago when I was home recuperating on the couch from an injury. A friend of mine on Twitter asked “Beth, you have so many opinions about nursing. When are you going to start a blog?” I had always wanted to write, and that day when my husband came home for lunch and asked if I needed anything, I replied, “Yes, honey, I’d like a MacBook air laptop from Best Buy”. Wonderful guy that he is, by that evening I had my Mac and was busily writing. Within a matter of days, I had started my blog, nursecode.com. Soon I was writing for not only for my blog but also for clients. I wrote nursing related topics and “howtos” such as “How to Become a Cosmetology Nurse” and “How to Respond to a Written Warning at Work”. Over the years, I’ve written hundreds of articles on numerous topics. At the same time, I was a member on allnurses and was given a chance to have a column of my own titled “Ask Nurse Beth” to give career advice, which was yet another dream.
I enjoy writing editorial type pieces and how tos that offer value but I also enjoy research and being a subject matter expert. I started accepting side jobs as a subject matter expert and consultant for companies such as Versant, Healthstream and Lippincott. All of these companies from time to time look for nurses to help write test questions, revise CE modules, and update procedures. I contributed and co-authored books, as well as authoring and publishing my own book, “Your Last Nursing Class….How to Land Your First Nursing Job...and your next!” (one of my dreams). Invitations came to speak for professional nursing organizations and for graduating nursing classes. By two years in, I realized I had a side business and monetized my blog. Opportunities were coming fast and sometimes I was overloaded and overwhelmed by deadlines and deliverables. I never anticipated that I would have to take a step back, take stock and make some choices. What did I really want to do? Did I want to pursue speaking, or writing? Did I want to return to school to get my doctorate (also a dream) or continue to grow my business? In the end, I decided to continue to grow my writing with an eye towards developing working relationships that will carry me into retirement in a few years. I feel very fortunate for the opportunities I’ve had to make my dreams come true, and I look back and now see some key things that helped.
Turning Points
Getting my Masters degree was a turning point. My first instructor said “You won’t believe the doors that will open for you”. She was right. Having an advanced degree garners a credibility that helps land jobs. I am all for higher education, and I am a lifelong learner, whether it is formal or informal learning. I simply love learning.
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Belief in Myself
being determined. It’s one characteristic nurses share. I believe that with determination you can do anything.
I’ve always believed that I could learn and do anything if I just put my mind to it. And so I learned everything from the Kreb Cycle to organic chemistry to organizational politics to learning how to use Word Press. I remember as a new nurse looking at my nurse manager on Ortho and thinking ”I could do that. I could learn that job. If she could do it, so could I.” A few months later, I applied for the newly vacant nurse manager role. I stopped by the DON’s office to let her know I had applied and she looked up from her paperwork, pushed her glasses up, and laughed. “You?” she said. “You’re still green.” “I know”, I replied. But I’m just letting you know of my future interest so you will see me in that role when the time is right.” A few years later, I was asked to manage a large Telemetry unit at that same hospital. The large unit became two units plus a GI Lab. After about ten years, I realized that being a manager was part of my journey, but not my destination. I appreciated all the skills I had learned, and was ready to try something else.
Being Determined
I believe when there’s a will there’s a way. Sometimes you have to step out on faith not knowing exactly how it will all work out, but believing it will. This is what people do when they decide to become parents, or buy their first home, right? I often tell new nurses that I already know two things about them. I know they are smart, but beyond that, I know they are determined. It’s impossible to get through nursing school without
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Being Passionate
Being passionate about nursing gives me a lot to write about and a voice as a nurse advocate. In every job I’ve had, I’ve spoken up for nurses and working conditions. I very much enjoy writing about my passions and contributing to discussions. I could never really get passionate about care plans but am definitely passionate about nurse-patient ratios and transition of new grad novice nurses to proficient and expert nurses, for example. I have always considered myself a “nurse’s nurse” and a spokesperson for clinical bedside nurses.
Being Lucky
And finally, all along the way, I’ve had a wonderful husband who believes in me. I’m not sure I could have pursued my dreams without his support. He helps me with the business end of things, and cooks gourmet meals for us while I write. I count myself a lucky nurse.
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Choosing the Path of the Nurse Entrepreneur
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by Keith Carlson RN, BSN, NC-BC Keith Carlson, BSN, RN, NC-BC is a holistic career coach for nurses, award-winning nurse blogger, writer, podcaster, social media influencer, keynote speaker, author, and popular career columnist. With more than two decades of nursing experience, Keith deeply understands the issues faced by 21st-century nurses. Keith’s career coaching services include resumes and cover letters, LinkedIn optimization, networking and interview skills, career management, and shaping the individualized nursing career that’s just right for you.
We all have different motivations for embarking on a nursing career and becoming healthcare professionals. Even as our paths differ, our experiences can share underlying themes that bind us together under the venerable banner of nursing. For those wishing to create an innovative entrepreneurial career, plenty of nurses have paved the way before you. Fall 2018
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I chose to not pursue a med/surg or acute care position after graduation. Even though I was told this unfortunate choice was “career suicide”, I forged ahead and created a nursing career wholly focused on ambulatory care. These past two decades saw me working in federally qualified inner-city community health centers, home health, hospice, public health, and intensive case management. Prior to becoming fully self-employed, my last clinical position was serving as Chief Nursing Officer/Director of Nursing of a small home health agency in Albuquerque, New Mexico.
The Entrepreneurial Journey
My Story in a Nutshell
When I became a nurse in 1996, I was coming from a challenging entrepreneurial path as a massage therapist and yoga instructor. Being just over 30 and struggling to make ends meet with only a high school diploma, a small child at home, and a wife in college herself, nursing was an excellent
Based on my previous failures as an entrepreneur, it may have seemed illogical to pursue self-employment on the heels of 22 successful years as a nurse, but the desire to be my own boss never left me. After navigating the politics and challenges of mainstream healthcare, that desire only grew stronger. In essence, I wanted to be self-employed, set my own hours, work from home, and have more control over my life. I knew that self-employment would be difficult, but I also knew that increased personal freedom was something I was willing to work very hard to achieve.
“Being financially risk averse, I took the safest possible route towards entrepreneurship” career choice, especially since I’d already cut my teeth as a personal care attendant and private duty home health aide. I also had several nurses in my extended family, an added impetus to give nursing a try. Since I’ve always been a rebel, those who knew me well weren’t at all surprised when
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Being financially risk averse, I took the safest possible route towards entrepreneurship, which meant incrementally starting a nursing blog, beginning a practice as a career coach for nurses, working as a freelance writer, and later launching a podcast and an arm of my business as a motivational/keynote speaker and consultant.
My personal “runway” from being a nurse with a few money-making side hustles to quitting my job and being 100 percent self-employed was approximately seven years. This slow burn allowed me to build my business without the weight of total uncertainty. It was only when things were humming along that I chose to resign my last position and put a stake in the ground as a fully self-employed nurse entrepreneur.
can be slow while another picks up steam -- this allows for the natural ebb and flow without causing undue worry about money. It’s a delicate balance.
And Now for Something
Lessons Learned
Entrepreneurship is filled with difficult lessons. We can start the journey bursting with enthusiasm and idealism, only to have it squashed by harsh realities. Launching a business takes a lot more than putting together a website and a social media feed. People actually need to find you, and that’s where hard work is necessary. Search engine optimization, content marketing, networking, social media strategy, business formation documents and incorporation, business bank accounts and credit cards – it’s all part and parcel of this path. One hard lesson I learned is that one person just can’t do everything. It’s great to learn new skills, but sometimes the learning of a complex skill (like building a Wordpress website) isn’t necessarily a good use of your time when you need to focus on producing income. I had to learn that hiring others is smart business – it allows me to do the things I’m good at and let others do the rest. Once I had some cash flow, I began to use expert freelancers to push me along. These experts included someone to produce my podcast, a social media manager, business coaches, graphic artists, and web designers. Along the way, I’ve picked up some skills, but I continue to rely on others who know more than I do. A successful business can be difficult to build, but it’s very satisfying to do it well. Rome wasn’t built in a day – patience, creativity, and persistence are indeed my best companions. The greatest lesson I’ve learned is to have multiple streams of income so that one “arm” of my business
Completely Different
For nurses feeling tired of the same old grind, the potential for a new lifestyle and workstyle is possible. For some, a simple side hustle earning a little extra money is enough: blogging, consulting, or coaching can be done during your off hours from traditional nursing. For some, working from home or starting up a business can be a full-time gig. And for others, a combination of side gigs and part-time or per diem nursing is just right. The caveat here is that we all have varying needs for lifestyle stability and cash flow. One person’s entrepreneurial dream can be another’s nightmare, thus marching to your own drum in this regard is essential. If you explore the entrepreneurial path and realize it’s not for you, there are plenty of other out-of-the-box paths to choose from. Talking with those ahead of you on the journey is essential – do your due diligence, weigh your options, network like crazy, assess the potential for success, and connect with the people who can support you in realizing your dream. No path is wrong, and everything is possible. What do you want? Go out and make it a reality.
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Meet Donna Cardillo
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The Inspiration Nurse
In 1974, Donna Cardillo – The Inspiration Nurse – received a diploma in nursing. Little did she know that graduating from nursing school would provide her with an opportunity not only to care for patients but for fellow nurses, as well. In a recent interview with Donna, I was given a front row seat to a one-on-one speaking engagement. Even when she’s sharing her journey over the phone, Donna is an educator, storyteller, and motivator at heart. Here’s what she said about her journey from bedside nurse to nurse influencer. by Melissa Mills RN, BSN, CCM, MHA Melissa is a Quality Assurance Nurse, professor, writer, and business owner. She enjoys empowering other nurses to find their passions and create a unique nursing career that fits their passions, desires, and gifts. She is owner of www.makingspace.company, a website dedicated to helping women find their creative passions through writing and co-owner of enursingresources.com, a start-up Nursing CE company that will offer online courses soon.
Moving Away From Traditional Nursing
Believe it or not, this Nurse Influencer didn’t deliberately choose to leave bedside nursing. After relocating, she was struggling to find a job that worked with her life and other commitments. This led her to apply for a position in a weight loss center. She went into the interview thinking she was interviewing for a part-time staff nurse position and left as a full-time Nurse Manager. This was the first of several non-bedside positions that shaped Donna into who she is today. Donna reminisced that the job that planted a seed of someday being a public speaker was at a hospital where she was the Director of DRG Services responsible for
regulatory, quality, and reimbursement issues. One of the many functions of this position required her to speak publicly, which was entirely out of her comfort zone at the time. She remembered that because this position was one step away from the nursing management team, many of the staff nurses came to her to inquire how she got the job, what other roles nurses could fill, and if she would help them with their resume. This is where she began forming the dream of one day speaking to nurses to help them see their full potential, especially away from the bedside. In 1995, during a time that Donna watched fellow nurses get laid off, she decided that there would never be a better time than the present to start living her dream. She went to the local library to learn everything
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she could about running a business, the art of adult education, and how to be a speaker. Donna began connecting with other nurses, human resource professionals, and nurse recruiters to learn what was important to them when searching for nurses. She became involved with a local woman in business organization to learn more about running a business from women who were doing it. During this time is when she launched her career as a public speaker.
Lessons Learned Along the Way
Donna has learned a lot about herself over the years. She learned that she is more capable than she realized. She said that when you start out on a new adventure, it’s important you know you don’t need to know everything. You must just start going outside of your comfort zone, and you will be amazed at what you can learn about yourself. She offered this insight, “I am a different person today than I was 23 years ago when I started this journey all because of what I have learned along the way.” Her experiences have brought her face-to-face with countless nurses. Throughout this journey, Donna has learned much about nursing and the people who share the title. One lesson learned along the way - “We (nurses) are multi-talented and versatile. We are capable of more than we realize. We have many professional avenues to explore - CEO of a hospital, editor of a nursing or healthcare magazine, case manager, or nurse entrepreneur. We must remember that hands-on care isn’t the only way to make a difference and that there are many ways to heal.”
Advice for You
It’s not every day you get a first-row seat for information from a top nursing subject matter expert. But, today - you do! To get where you want to go in life, Donna says you have to go back to nursing school and remember Abraham Maslow’s Theory of Self-Actualization, which states that to develop to your full potential, you
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must challenge yourself. Donna added, “It’s scary but exhilarating. Once you know what you want to do - get outside of your comfort zone - start rubbing elbows with others who are doing what you want to do.” For example, if you want to be a case manager, find a local chapter of the Case Management Society of America. Attend a few monthly meetings and make new connections. Even if you end up deciding that case management isn’t for you - these experiences will help you determine what you want to do with your future. Another example might be if you’re going to be a nurse entrepreneur, attend the National Nurses in Business Association annual meeting. By joining the organization, you can meet others who think outside of the box too. Donna’s final piece of advice is this: “Whatever it is you want to be - find and make connections. You can’t stay isolated and be truly successful. Find your tribe and connect with them often.”
Where Have We Improved?
I would be remiss to have a fantastic nurse influencer at the other end of the phone and not talk to her about the innovations she’s seen. Donna said that over the past twenty years, she has seen so many new areas of nursing emerge. Here are a few areas of nursing innovation that Donna felt emerged and continues to grow: Holistic Practices She discussed the emergence of holistic practices where nurses do mind, body, and spirit work with their clients or patients. According to Rasmussen College, holistic nursing cares for the whole person. Holistic nurses integrate complementary medicine into their nursing practices. A few areas of holistic nursing include: • Stress management • Meditation • Hypnosis • Hydrotherapy
• Wellness coaching
Care Management
• Acupuncture
Care management is a large specialty area that has many specific care locations and job duties under it. These specialized nurses are a bit different than case managers because they work specifically with individuals managing chronic care needs. Case Managers might work with older patients who want to age at home or those with specific care needs. A few examples of care managers include:
Nursing Informatics Nursing informatics is the combination of computer science and healthcare. Nurses in this area keep one foot in both specialties and tie together the function of healthcare and use of computers to record care. She went on to say that nurses who are tech savvy are very marketable in this area of healthcare, especially since technology continues to grow and shape our industry. Case Management Case Management has been around for many years. However, with the emergence of value-based medicine, case managers continue to be in high demand. Nurses who work as case managers interact individually with patients to manage complex medical care while attempting to keep costs to a minimum. Nurses can become certified in case management to deepen their skills further and also increase their profitability and employability. Legal Nurse Consulting According to the American Association of Legal Nurse Consultants, these nurses work to analyze and evaluate the facts and testimony and the rendering of informed opinions related to the delivery of nursing and other healthcare services and outcomes. They also help to determine the nature and cause of injuries. They can work in a variety of settings in the legal and healthcare arenas.
Looking to the Future of Innovations
Donna expressed that as the healthcare industry continues to create new treatments and our society remains litigious - legal nurse consultants will likely stay in high demand. Donna expressed that the future of nursing is about managing conditions, capitalizing on wellness, and encouraging entrepreneurship.
• Geriatric Care Managers might help patients manage ongoing care, medical appointments, medications, or find new ways to meet the needs of their clients. • Transitional Care Managers work with patients as they transition from one level of care to the next. They will help bridge any gaps in care or knowledge and also work to decrease readmissions and subsequent fines to the hospital. • Oncology Care Managers work with newly diagnosed cancer patients to help them navigate through their new diagnosis and treatments. • Population Care Managers might work with an entire population of patients, such as diabetics, in a clinic or physician’s office holding group teaching sessions. Entrepreneurship Nurses have been going into business for themselves for many years. But, the emergence of entrepreneurship has boomed in recent years as more nurses realize they can work independently. Nurse entrepreneurs might be LPNs, RNs, or Advance Practices Nurses. Donna stated, “Nurses used to worry about the legal issues around working independently. Now, they have been empowered by others that they can work independently and branch out into new fields” A few of the types of entrepreneurs she discussed were wound management nurses, patient education businesses, and health and wellness coaching. She offered this to aspiring nurse entrepreneurs, “Don’t stay isolated. Reach out to others, find your tribe.”
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Wellness
The Many Faces of Nursing
“It has taken us quite a while to get here, but the healthcare industry has finally started to invest in wellness versus illness. This has brought about new opportunities for nurses to work with people who are well and to keep them well.”
To round out our conversation, I asked Donna what she thought of when I said the phrase, “the many faces of nursing.” She so eloquently said this, “Nurses are helpers, teachers, scientists, nurturers, and wellness warriors.” This is the face of nursing.
If you are a nurse who doesn’t enjoy caring for the ill, but you want to continue to work with people - this might be an excellent career opportunity for you. You work in companies that promote wellness or start your own wellness business or coaching business.
Donna Wilk Cardillo, RN is The Inspiration Nurse–a transformational keynote speaker, humorist, retreat and seminar leader, and author helping others to be fearless in career and life and maximize their potential. Her accomplished career combines more than thirty years of clinical, managerial, and business experience. These days she heals with words. She blogs at DoctorOz.com and is the former Dear Donna columnist at Nurse.com and Monster.com. Find out more at www.DonnaCardillo.com.
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From Student to Nurse Influencer
Rockstar Meet
Kati Kleber 28 Fall 2018
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Nurse.
For many of us who know of Kati Kleber, it’s as a nurse on a cardiac med-surg step-down unit, the author of several books including Becoming Nursey, or as a speaker, blogger and podcaster specializing in educating and supporting brand new nurses. As if this is not enough, there is way more to learn about this super nurse that fuels and strengthens her passion within the profession of nursing.
adding humor to everyday experiences in bedside nursing. She began writing short but funny posts on time management, delegation and prioritizing. She gained even more popularity. Kati found that she was receiving many of the same questions from supporters and was spending countless hours tending to the blog and followers while still working a full time job in a busy neurocritical care unit.
Born and raised in Illinois, Kati declares herself “a midwestern girl at heart”. Kati started her nursing journey after graduating from Parkland College in 2007 with an Associates Degree in Applied Science. (She also played basketball while studying nursing at Parkland). By 2010, she obtained her Bachelors of Science in Nursing at Iowa Wesleyan University. For the next 2 years, Kati worked as nurse on a Cardiovascular med-surg unit in Champaign, Illinois. 2012 was the year that took her out of the Midwest, planting Kati in Charlotte North Carolina working as a nurse on a Neurocritical Care Unit. Within a few months, the world would become familiar with Kati Kleber RN!
Author. Kati had always enjoyed writing, but had no outlet until 2013 when she figured out how to blog on Tumblr and Twitter under the anonymous nurse persona named Nurse Eye Roll. Her passion was supporting and educating new nurses. “When I first graduated and began as a new nurse, I realized that there were a lot of things that we learned on the fly as newbies that I feel should have been provided to us. I started keeping track at the beginning of my career.” As her social following began to grow through the blog, Kati had a friend recommend that she create her own website and begin maintaining social platforms to support it…..NurseEyeRoll.com was formed! Kati remained anonymous through her Nurse Eye Roll persona,
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While searching for a way to be compensated for her work and hours blogging and also a way to provide answers and guidance new nurses, Kati’s friend suggested she write a book. She did just that. In 2014, Kati wrote Becoming Nursey. The biggest struggle at
that time was her decision to become public with her real self, no more anonymity. She was encouraged by many trusted friends and colleagues to take credit for her work and revisit all of her prior writings to be sure no violations both personally and professionally had occurred. In November 2014 Becoming Nursey was published and Kati Kleber was no longer hidden from the world. Since its release, it has sold over 20 thousand copies, has been re-published by the American Nurses Association (ANA), and is used by nursing schools and residency programs all over the country. When collaborating with the ANA, Kati made some changes to the first edition and added the title Becoming Nursey, Anatomy of a Super Nurse. Amazon’s book description states: “Armed with tons of information- and lots of laughs-anatomy of a Super Nurse shines light onto the dark spots in a nurse’s first year, equipping you with everything you need to become a successful bedside nurse”.
some public speaking. She started to hear from healthcare professionals, potential sponsors and collaborators that they were having a bit of difficulty with the Nurse Eye Roll name. They understood the humor in it, but found it a bit hard to market, and possibly offensive to some. So after much soul-searching, Kati found herself at another crossroads….an opportunity to reinvent herself so-to-speak. If her passion for supporting and educating new nurses was going to be her focus, Kati felt that Nurse Eye Roll may not be the best way to obtain that goal. The name did not convey what she desired most and it began to require explanation...not what Kati wanted to be her focus. During this time of change in 2015, Kati was awarded Nurse of the Year by the Charlotte Business Journal and received the Great 100 Nurses of North Carolina Award and was a guest on the Dr. Oz show! Looking back, this is the time that Kati really feels was turning point in her career.
Podcaster.
Kati spent much time in 2015 and money rebranding her entire platform to FreshRN. This allowed her to focus her strategy, which she is so glad she did. Freshrn. com currently contains a blog and podcasts hosting a wide variety of topics for new and experienced nurses alike. It provides both practical information and encouragement for those beginning their bedside nursing career. The website also offers courses designed to educate and provide CE hours. Lastly there are links to books that can offer more to beginning nurses, those new to the healthcare system, mentoring and precepting, as well as blogging advice.
Speaker. As the book started to generate income, the blog started to gain sponsors, and Kati was asked to do
The past two years have been a whirlwind of writing, blogging, public speaking and family growing! Katie and her husband welcomed their first child in 2016 and in December of this year are adding baby#2. Kati has partnered with the American Nurses Association
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again, publishing two more books. What’s Next is written for the nurse who is no longer new, but is not the most experienced nurse on the unit. A nurse in this stage is starting to be asked to mentor and precept as well as take the charge nurse role. This book is designed for this time in a nurses career when the
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role starts to change and options open up for advanced practice and education. What’s Next addresses these and other topics. Admit One was written for patients or those entering the healthcare field and want to learn more about the
flow and culture of the hospital. “ I go into things like a nurse vs. nurse manager vs. CNA vs. NP vs. physician, the difference between consulting and attending physicians, what to expect from different levels of care, code status and more”. Her next book focus’ on another area close to her heart. Having found her voice in blogging, Kati encourages nurses to blog as well. “I encourage nurses who have a specific passion to dive deep into that and think about how they can innovatively serve that niche.” She motivates fellow nurses to be smart and productive with blogging. “We all see and hear enough complaining, and while writing may be a therapeutic way to deal with some of the challenging aspects of our field, publically publishing a blog simply to complain isn’t going to go far.” With this in mind, Kati and her friend Brittany Wilson BSN, RN independently published The Nurses Guide to Blogging which has been a huge success. “It lays out how to build a platform on a blog and a community around it”. These days, Kati is very focused on completing her Master Degree in Nursing Education. She and her family moved back to the midwest in 2017 and she states she is very happy to be back to her roots in Illinois. She is still working PRN at the bedside in a cardiac med-surg/ stepdown unit. Kati feels it is important to keep her foot in the door of practice. “It is really hard to write about/ for an audience when you are physically removed from it. I find a lot of value in provide direct patient care”. She works 12 hours a week at the
bedside and spends the rest of her week working on her Masters practum in hopes to complete it before baby #2 arrives. She has also recently released an online crash course for new nurses in neurosciences and is soon to release a cardiac course as well (available at freshrn.com/courses). Kati is very present in the challenges of balancing her time with grad school, clinical roles, social media, and family. Speaking to these challenges, Kati says the key is “proactive communication with my husband (with whom she just celebrated 8 years of marriage with) and family. Intentionally disconnecting from the business/ platform and not being constantly accessible is a really important boundary to have and maintain. I also try to be keenly aware of balancing what I personally enjoy and what brings me joy and not stress/ anxiety, what challenges me, and what brings in income. She enjoys free time (watching Harry Potter, the Simpsons and The Office) and spending time with her family and two adopted dogs (coincidentally named Mac and Tosh... not adopted at the same time or named together..) The field of nursing has been blessed that Kati Kleber found her public and professional voice years ago. She has continued to offer much to both new nurses and seasoned as well. Her career and path thus far speaks volumes to finding your passion and running with it… the number of nurses and patients/ families, and healthcare workers affected by Kati’s passion in insurmountable! The power of one voice…
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by Sarah Matacale RN, BSN,CCS I have been a nurse for over 20 years specializing in cardiac critical care and hospice. After I lost a large percent of my hearing a few years ago, I regrouped and refocused on new career goals. I went back to school to become a clinical documentation specialist and have been diving head first into charts ever since. I found that I was longing for a way to still reach people, so writing became an outlet. I love writing about things close to my heart. Nursing is part of who I am and I am blessed to still share some of that with others!
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Get Social A glimpse at some of the most popular comments from our various Facebook channels... Be sure to click the headlines to add your comment!
The Nurse Optimist and how to become one if you aren’t there yet... Positive thinking is good to be sure however it alone is not enough to guard against the many negative ramifications possible to those that care for others and all the negativity you take in by nature of this Heroic work you do on a daily basis. I teach coach & train online & live (N.America) on Neuroplasticity of the brain as well as Neurobiology in regards to brain & body connection as it pertains to... Preventing the many occupational stresses that sooner or later create havoc and various negative manifestations OR...for those already experiencing one or more of the many negative results...how to Overcome them in relatively short order! It is not complicated but more than positive thinking alone!
Nursing Survey: How is Your Hospital Staffed, and Do You Feel it is Safe?
Keep fighting for safe staffing! Many many years ago I was the only RN on a unit with 42 patients on midnight shift. Acuity was not as high but talk about unsafe!!
Patient brings own urine sample for preoperative pregnancy testing I was asked to do one so wanted to know why... then pointed out i was approaching my 60th Birthday so didn’t have to!! Surely common sense should have made them ask questions first!! Not belittling anyone but i don’t hide my age...
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LOL
As we explored the many faces of nursing throughout the pages of this issue, it only felt right to look at another side of the many faces of nursing in cartoon form. Many of you can relate with these sometimes exasperated, desperate and even painful faces that come with being a nurse.
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The Many Faces of Nursing
Renee Thompson and the Healthy Workforce Institute
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By Melissa Mills
hink of a nurse who has a career that you wish you could have. You know, that one person that makes work seem fun? Or, just seems to have followed their passions far beyond the bedside? It might not be someone you know personally. You might follow them on Instagram, Twitter, Facebook, or listen to their podcast. But, no matter how you know them, each time you hear their name, you think to yourself, “Why not me?”
If you’ve had this experience, you and Renee Thompson - nurse, entrepreneur, keynote speaker, author, and kindness enthusiast - have a lot in common. Renee was just like you when she started asking herself that exact question years ago. Today, she enjoys a successful career as a public speaker and subject matter expert on nurse bullying that allows her to travel across the country educating nurses and other healthcare professionals. Here is a bit about her journey and what she thinks will be essential to the future of nursing.
and to connect and understand them. One function of this job required her to speak publicly about various topics. This led her to her personal “why not me” moment. She began dreaming of a job that offered flexibility and the opportunity to educate others. This ultimately led to the creation of RT Connections and later the Healthy Workforce Institute - her business that is dedicated to eradicating nurse bullying and incivility.
From the Bedside and Beyond
Renee graduated in 1991 with an Associates Degree in the Science of Nursing from the Community College of Allegheny in Pennsylvania. She began her traditional nursing career on a cardiac step-down unit at a hospital in Pittsburgh. As her children grew and became involved in extracurricular activities, she found herself missing many of their events. This began her search for a job away from the bedside. She became a home care nurse and spent four years there. She changed jobs a few times over the years. She reminisced that she sometimes grew bored of positions, especially as she began to master the primary tasks. But, with each new title she held- quality assurance manager, liaison, or unit manager - she learned more about herself and the nursing profession as a whole. Along the way, she went back to school to obtain her bachelors, masters, and finally, in 2015 she received a doctoral degree in nursing. Each degree brought new opportunities. She eventually found herself in a corporate health system working in professional development. She loved this job. It enabled her to work with healthcare professionals
Why Bullying?
Most nurses will willingly admit that nurse bullying is a problem in our profession. But, why would anyone want to take on such a polarized issue? Renee shared that as she began her speaking career, she wasn’t 100% sure what she wanted to teach others about. She created focus groups and started speaking to student nurses and new nurses to ask them what issues were important to them. As she met with groups, all of the nurses wanted to tell stories about nurse bullying and how badly they were treated in their profession. Renee continued to search for her topic. Being a nurse who often asked “why not me” - she kept searching and thinking about all the topics she could speak about such as diabetes, effective communication, or brain tumors. Finally, she was asked by a colleague to speak at a local facility. Renee offered a few topics to Fall 2018
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choose from and horizontal violence -bullying - was chosen. She said, “Everything started to align, and I knew that bullying was going to be my specialty.”
The Good Lesson “I have been humbled and inspired by the amazing sense of pride that nurses have for their patients and profession. It amazes me to learn what nurses sacrifice for their patients. I have heard story after story about how nurses connect with their patients at the worst and best times of their lives. It reminds me that it is a privilege and an honor to care for others.” The Nursing Frustration “Nurses often complain that we’re not respected or recognized as a profession. Yet, I’m amazed how often nurses act in a way that they don’t deserve or earn the respect they say they want - they don’t go back to school or better themselves for their profession. Nurses need to remember that we must put ourselves last. When you’re making decisions, you should make them based on your patients, your co-workers, and finally yourself.”
Lessons Learned Along the Way
Life is full of experiences. When you embark on a nursing journey, the lessons are many. Add in being an entrepreneur - and the lessons are even more plentiful. I asked Renee to share a personal lesson and one about nursing in general that she’s learned during her 27year career. Here’s what she shared: Her Own Lesson “I’m easily distracted by the next shiny object. At different points along the journey, I needed to do a deeper dive before moving on to the next thing. It’s essential to hone your skills in a few specific areas rather than trying to be everything to all people. Pick a lane and stay in your lane. This lesson may resonate deep within you as you begin your journey beyond the bedside. Nursing Career Lesson Renee offered two things she has learned over the years, a good lesson and one she described as a frustration she has encountered.
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There are much value and truth in Renee’s words. Think about this lesson and how it can help you become a better nursing professional in all areas of your career.
Advice for Your Unconventional Nursing Journey
Renee shared that if you’re considering leaving the bedside, the first thing you should do is find your community by joining professional nursing organizations. Go to local events they sponsor. Put yourself in situations to meet other nurses who are doing things you think you might enjoy. Ask them what they like about their job and what they dislike about it too. This will help you start to find your passion and opportunities.
Innovations Over the Years
With over two decades of nursing experience and years of meeting and talking to nurses in many different areas, Renee has seen areas of change and innovation. Here are a few areas she watched grow in recent years: Forensic Nursing Have you ever wondered if nurses help solve crimes or assist with victims of violence and abuse? According
to the International Association of Forensic Nurses, these professionals are trained to treat victims of trauma associated with the wrong that was done to them, such as intimate partner violence, neglect, sexual assault, and other forms of intentional injury. Forensic nurses collect evidence and even provide testimony that can be used in court to prosecute those who commit these violent or abusive acts. Nurses in Genetics Nurses who work in genetics receive specialized training and education in genetics. They help people at risk for or affected by disease with a genetic component achieve and maintain health. This might include working with people who have Alzheimer’s, cancer, diabetes, or heart disease. For more information about genetics nurses, visit the International Society of Nurses in Genetics (ISONG). Nurse Practitioners Renee shared that nurse practitioners have developed as a vital part of our healthcare system in the U.S. Over the past few decades the role of the Nurse Practitioner has emerged and brought with it many opportunities for nurses. The first Nurse Practitioner program in the United States was started in 1965 by Dr. Loretta Ford and Dr. Henry Silver at the University of Colorado. Today, Nurse Practitioners work in many different settings providing care to the underserved and those with chronic health conditions.
Innovations for the Future Nurse
Where will nursing take you? Renee mentioned two areas of nursing that have emerged recently and continue to grow - telemedicine and nurse scientists and researchers. Want to know more? Here is a bit about each: Telemedicine You might think of telemedicine as something that is only performed by doctors. But, many nurses work in telehealth too. Home care nurses use telehealth to monitor vital signs and symptoms of patients with chronic illnesses such as diabetes or congestive heart failure. Case Managers use telemedicine to educate patients about self-care techniques after surgery or
after workplace injuries. Telemedicine has expanded in the past few years and will continue to do so in the future. It has given many nurses the ability to work from home and serve a population of patients that might not otherwise have access to immediate healthcare support. It also enables professionals in rural healthcare settings to communicate with large teaching hospitals about critically ill patients and treatment plans. Many feel that telemedicine will be a pivotal part of the future of our healthcare system. Nurse Scientists and Researchers Renee mentioned that nurses are natural scientists and researchers, often without even knowing it. And, if you enjoy that part of nursing - there might be new opportunities for you in the future. Nurse researchers use evidenced-based nursing and practices to create better ways to deliver healthcare services. They work to improve the quality of life for patients suffering from chronic illnesses, and they find new ways to encourage other patients to make healthy life choices. Nurse scientists might work to discover new ways to treat diseases or how to keep patients safe. The possibilities in nursing research are endless.
The Many Faces of Nursing
What do you think of when you hear the phrase “the many faces of nursing?” I asked this of Renee. First, her literal brain described the different types of nurses - men, women, young, old, and all of the various ethnicities that make up your profession. As she spoke, she began to discuss the roles nurses play - you care for patients in their homes, nursing homes, prisons, or in the military. You might be a nurse leader, or you care for babies or the elderly. She painted this beautiful image of all the nurses across the globe. Somewhere in all of the descriptions she gave is a nurse you know - you. A nurse who fills a special place in this profession. And one who might be looking for new opportunities or new ways to blaze their own trail. Renee closed our time together with this, “Nurses hold many roles. We care for patients in many ways. That is what makes the many faces of nursing so unique and your journey all your own.”
Have something to say? Click here to comment! Fall 2018
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From the Bedside to the Boardroom and Beyond
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with the ÂŽ Unconventional Nurse
By Michelle Podlesni, RN Fall 2018
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As a conventional nurse…
When I began my nursing career, becoming a nurse entrepreneur was not in my field of vision. I mean, I didn’t even know that term existed. Like most of my colleagues, I began working with Med/Surg patients and personally, I had no further thought other than being thankful I passed the NCLEX and prayed I would never harm a patient by being so green. I started and ended my clinical experience working Med/Surg and had a few years of critical care nursing in the middle. This is when nurses worked eight hour swing shifts, which felt completely normal to me, having a father that worked forty years in the steel mills. Back then, you had to select your holidays and you could not have the same holidays the following year. And we weren’t given any option to try to arrange for someone to take our shift. You know it is funny, I loved providing nursing care for my patients, but my favorite part of caring for my patients was hearing their stories. I also believed in getting my patients involved in conversation since it had therapeutic effects of decreasing their anxiety and discomfort. My co-workers teased me about this, but it was good natured teasing. I loved the nurses I worked with. They were the ones to teach me the ins and outs of nursing, you know, nursing in the real world versus what we all learn in nursing school. We enjoyed each other, and socialized outside the hospital setting. Many nights after working
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3-11 we would go to the Hilltop Lounge and have steak salads piled with french fries, (it’s a Pittsburgh thing). Even the married nurses would join us for decompressing and laughing. We had nurse bowling leagues with the different units challenging each other. When you see someone outside of a work setting you have the opportunity to see different aspects of their personality, and I believed that’s why we all pulled for one another more. I don’t know what is currently going on with the amount of friction in the workplace. Is it due to stress levels being so high because of increased patient loads? Is it due to keeping up with technology? Are twelve hours shifts hurting nurses or serving them? My colleagues were wonderful, and were the main reason I kept going to work when it became apparent to me that it was time to find something new. After several years, of swing shifts, working weekends and holidays, and missing so many family get-togethers I started looking for what else I could do.
Transition towards an unconventional path…
It was very interesting trying to find something different because I didn’t know any nurses that weren’t working in a traditional setting. I had recently moved to the Chicago area because the guy I was dating asked me to. He didn’t want a long distance relationship. So, add finding an apartment and a new job. This was when you saw classified ads in the newspaper and went in personally to interview for a job. A major insurance
company was looking for a Health Care Resource Specialist, so I thought, why not? I went in for the interview, met with the manager and left with starting a job in Case Management. I didn’t realize at the time that this would be a pivotal moment in my nursing career. I was only looking to work nine to five and have my weekends off. My new job included educating about a hundred claims processors on the medical aspects of reports they would be processing. I worked with beneficiaries to help them understand the short term and long term implications of their chronic conditions, and what resources were available to them. I also worked for the first time on a computer to input healthcare data and run reports for the manager. In trying something new, I found a passion that I never saw coming, case management and healthcare data analysis. I came to a realization that I have come to many times since: you don’t know what you don’t know and that in itself is the very reason to try new things. I didn’t know I would enjoy being a health care data detective, analyzing reports and trending results. I didn’t know I would love educating beneficiaries and claims processors about
health and optimum outcomes. This came even more into play in my next job with the Georgia Medical Care Foundation which was the state peer review organization for all the Medicare beneficiaries on their inpatient and outpatient health records. Due to willingly working crazy hours to catch up a backlog with the state, I was given my first role as a manager. Being a utilization review manager, I managed the staff doing pre-certifications, concurrent reviews and retrospective reviews. I was flat out horrible as a first-time manager and it’s a wonder that I remained in management. I was extremely fortunate that our nursing director cared enough to inform me of the mistakes I was making and mentored me during this time.
Journey to today…
In this role, I also had the responsibility to recruit Georgia physicians to GMCF’s peer review group. While I was recruiting Earl Kolb, MD, for one of our peer reviewers, he turned around and recruited me to help him implement software he was working on for
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Crawford & Company Healthcare Management Staff – 1988
Crawford & Company’s corporate office in Atlanta. I entered into the corporate world where I remained for over ten years and began my transition into entrepreneurship. Crawford had an amazing training department. What I learned served me well throughout the remainder of my career. The training was a week long, and besides learning the structure of the company, we learned time management and goal setting. It was a very exciting time and when I first starting working with programmers. It was still a ways to go before hiring my own programmer group in the future, but the path was opened with the role of product manager. Basically, the software was a medical bill auditing program that accurately priced claims to the workers compensation fee schedules. The software edited out about 20% of medical bills that appeared to be fraudulent, and those bills were reviewed by nurses to ensure accurate payment. Crawford’s claims processors would no longer have to flip through volumes of paper-based documents. This is a great example of intrapreneurship: creating a completely new revenue stream within a corporation. I worked with nurses showing them how to use the software in four offices around the country
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which were producing a revenue of several million dollars. Segway a couple of years later and it dawned on me that I could earn a six-figure income going out on my own. When I informed the VP of the health care division of my plans to resign and to start my own business, he asked me to hold off for a couple of weeks. He was good at securing funding and asked that I join him in creating a new entity, General Care Review. We provided medical bill review services to the Property and Casualty industry. In three years we had over 14 offices around the country, a couple of hundred employees, and 24 million dollars in revenue. This was an exciting time and I found out the next new thing, I loved growing businesses. We ended up merging with General Rehabilitation Services into Genex where I was the VP of medical bill review operations. After five years and now part of a very large organization, I started to feel it was not the right fit for me. And by this point, I wasn’t afraid of trying something new. I was being heavily recruited at the time by major executive recruiters. One of the offers I received was from a programmer that I had worked with in the past that co-owned a software company in California. He really
wanted me to come out there and run their company, and position it for a future acquisition. So many times during my career, I have been asked “how does a nurse end up being the president of a multi-million dollar software company?” “How does a nurse end up in boardrooms across the country with Fortune 500 clients?” Very clearly, it was an evolution, not a leap for me. I was a nurse that had a solid foundation in nursing. I was able to synthesize my healthcare background with IT knowledge (programmers) to impart useful information for decision-making. I have a knack for problem-solving and ability to define and manage the processes, programs and projects. I used two nursing constructs in every business setting; the nursing process and Maslow’s Hierarchy of Needs. The nursing process for getting the right things done, and Maslow’s for getting the right things done in the right order. After substantially growing the company’s revenue and succeeding in its being acquired, I decided to resign. Not long afterwards in 2001, I was recently married and the world experienced September 11th. Reflecting on what was really important, I knew being around family was what I valued most and I asked my husband if he would be willing to move across the country so I could be near my extended family. He
was a Californian and I knew it was a big ask, but we had another reason soon afterwards which was being pregnant with our daughter. I knew that while I had a great deal of autonomy in executive roles in the corporate setting, I still never was my own boss. So we began discussing starting our own business. I always loved taking care of the elderly patients, and I remembered how much I enjoyed hearing their stories. We knew this was a market that needed services, so we became franchise owners of a Comfort Keepers in the Youngstown Ohio area near my family. For several years we grew our business, a business that allowed us the freedom of being with our daughter and working around our lifestyle. We sold that business in 2010 and when our daughter was ready to start school we moved back west. In 2011, writing a book had always been on my bucket list. I had three questions mounted on the wall of my office: What could I write that would serve others, who could I serve, and how could I reach more of them? As I mulled this over, I thought to myself “I’m just a nurse that did really well in business” and it dawned on me that I could help nurses by writing about the strategies that I learned that made me successful in business. This grew stronger when I started to research the statistics about the high level of burnout in nursing with more
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and more nurses feeling unappreciated, overworked, and overwhelmed.
Why the NNBA‌
Unconventional Nurse: Going from Burnout to Bliss outlined ten steps for nurses to re-invent and advance their careers. Prior to the book being published, we created our website that began with my blog. After the book was published, I added coaching services for nurses because I had been coaching managers, executives, and nurses for many years. I had never heard of the National Nurses in Business Association (NNBA) at the time and I came across it while researching what was out there to help nurses that wanted to start their own business. I discovered that the NNBA started in 1985 and is the forerunner of the nurse entrepreneurship movement. Pat Bemis, the former president of the NNBA asked if I would like to speak at the 2013 annual conference. As a result of that first speaking opportunity, Pat and I remained in contact. In every conversation with Pat, she was always knowledgeable and resourceful. I helped make a few suggestions for growing the NNBA and was taken by surprise a few months later when Pat told me she thought I was the person that should take the helm.
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Keeping up with the changes in nursing‌
Since 2014, we have run the NNBA which is dedicated to encouraging nurse entrepreneurs and intrapreneurs to start, grow, and manage their own business, finding nurse opportunities locally and nationally, and providing the educational and networking arena for nurses in business. We continue to see membership and participation in our annual educational conference grow. Not only is it an honor to work with such amazing and creative nurses from around the country, but I am continually inspired with the variety of ways nurses are using their knowledge and experience in business. Nurses are creating services, products and programs to serve needs in the healthcare marketplace. In fact, in our shark tank competition, we have several nurses that have created products to serve a niche in elder care, oncology, nursing, and education. Nurses have tremendous subject matter expertise and can learn ways to monetize that valuable asset. We have nurses that are nationally acclaimed speakers, authors, and bloggers. In 1985 the NNBA started as a grassroots organization, a handful of nurses that wanted to provide information for business minded nurses and a forum for them to connect and share information. NNBA’s impact and influence has not only resulted in thousands
of nurses starting and expanding their business, we are also seeing more nursing colleges and universities adding entrepreneurship programs. Nurse entrepreneurship is rising, mainly because it allows nurses the freedom, flexibility, and financial control to fully express their potential.
• Take the time for yourself to clarify what it is you really desire for your life and work.
When I’ve spoken on why nurses need a plan B, it is because of the volatility in the healthcare marketplace. Keeping current with legislative, technologic and socio-economic changes can be daunting. For example, patient care is moving out of the acute care setting and into population health settings. Many rural hospitals have closed. Metro hospitals continue to be acquired forming large corporations and many jobs are being consolidated resulting in positions being eliminated. Mega disruptors are entering the healthcare space, such as Amazon and Berkshire Hathaway. So, nurses can protect the longevity of their careers by creating additional income streams for increased financial security.
I remain a case management consultant for a corporate clients, write for various publications and courses, speak, and am interviewed on empowerment of nurses through entrepreneurship. I have the distinct pleasure to serve my nursing colleagues as the president of the NNBA. Every day I am grateful for my nursing education and the tremendous array of opportunities it has provided.
Tips for nurses that are thinking of stepping out and following their dreams…
Some nurses dip a toe in water and others jump right in. As you can see, I didn’t jump into entrepreneurship. It became a path that was gradually illuminated through having new experiences in different work settings. It was trying career alternatives before going all in. Jim Rohn, widely regarded as one of the most influential thinkers of our time, and mentor to Tony Robbins said, “Formal education will make you a living; self-education will make you a fortune”. With that in mind here are some tips if you are thinking of stepping out. • Try new things, you don’t know what you don’t know. • Find, mentors, coaches, and role models to decrease your learning curve and not re-invent the wheel. • Learn time management and goal setting to become more productive. • Improve communication skills such as writing, speaking, and presenting. Look for opportunities right where you are now to sharpen these skills.
• Contribute to your nursing community; all nurses’ voices are needed to improve the delivery of healthcare and the lives of individuals locally, nationally and globally.
One of the greatest assets in being a nurse is the ability to design our work around our lifestyle. Life continually changes, and what once worked, begins not to. You can push through the limits of expectation, achieve your goals, and live a life greater than you ever imagined. You’re a nurse and you can do this! Since 1985, the NNBA had helped thousands of nurses launch successful businesses. Each fall, the NNBA has an annual educational conference on nurse entrepreneurship & career alternatives. Try something new and join us next month in Las Vegas, Nevada. Learn more at www.NNBAnow.com About Michelle Michelle Podlesni, RN, President of the National Nurses in Business Association Founder of Unconventional Nurse® CEO of Bloom Service Group, LLC. Michelle is a USN Veteran, RN for over 30 years and former corporate executive whose clinical background led to a career in healthcare data analysis, medical cost-containment and software development. Michelle brought her service orientation, enthusiasm and diverse expertise to the corporate environment in roles from case management to product development to C-level executive management positions. With a proven track record in the corporate setting of leading start-up companies to financial success, as well as their subsequent mergers and acquisitions, Michelle has directly managed startups and established multi-million dollar companies serving Fortune 500 clients.
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Where will the next big idea in healthcare come from?
Johnson & Johnson is counting on nurses Johnson & Johnson Launches Nurses Innovate QuickFire Challenge to Bring Nurses’ Ideas to Life NEW BRUNSWICK, N.J., Oct. 1, 2018 /PRNewswire/ -- There’s a reason the saying goes, “nurse someone back to health.” Throughout history, nurses have been important facilitators of health – caring for the sick when others would not, identifying smarter and better ways to heal and developing life-saving methods. Today, Johnson & Johnson (NYSE: JNJ) is launching a new campaign that does more than just recognize nurses as critical partners on the front lines of health care – it empowers them as innovators. Through the “Nurses Innovate QuickFire Challenge,” Johnson & Johnson is inviting the more than 3.2 million nurses1 in the United States to submit ideas for new devices, health technologies, protocols or treatment approaches. The company has committed up to $100,000 in grants and access to mentoring and coaching via Johnson & Johnson Innovation, JLABS. “Nurses have ideas that can profoundly change lives, and at Johnson & Johnson, we’ve consistently provided support by educating, inspiring, and empowering those in the field,” said Michael Sneed, Executive Vice President, Global Corporate Affairs & Chief Communication Officer at Johnson & Johnson. “The Johnson & Johnson Nurses Innovate QuickFire Challenge was created to bring these ideas to life by pairing them with our vast network of resources and expertise. In the end, our goal is to use Johnson & Johnson’s scale, resources and know-how to help incredible ideas move forward.” Throughout history, nurses have brought innovation to patient care from Florence
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believe we will all benefit from helping nurses develop their ideas for better patient care.” Nightingale, who established sanitary practices still used today, to Nurse Jean Ward, who discovered that sunlight helped reduce jaundice in newborns, to Nurse Rebecca Koszalinski, who created the Speak for Myself© app. Nurses’ deep patient experience, coupled with insight and resourcefulness, makes them a significant force in addressing critical health challenges. Yet, Johnson & Johnson discovered through a nationwide survey2 that nearly half of Americans (41%) are unaware of the role that nurses play in developing new medical tools and solutions, even though the majority (66%) believe that all medical professionals are capable of coming up with lifesaving ideas. Three-quarters (75%) of those surveyed believe nurses should be given a platform to submit their ideas and inventions to improve patient care. To help draw attention to the role nurses play as innovators, and bring their innovations to life, Johnson & Johnson is partnering with Emmy Award-Winning Journalist, New York Times Best Selling Author, SiriusXM radio host and Founder/CEO of AfterBuzz TV Networks Maria Menounos to announce the Johnson & Johnson Nurses Innovate QuickFire Challenge. Menounos, who experienced the importance of nurses firsthand throughout her health journey battling a brain tumor said, “I interacted with nurses every day and know that nurses do so much more than many people realize. They’re resourceful, creative problem-solvers. I truly
The Johnson & Johnson Nurses Innovate QuickFire Challenge will run from October 1, 2018 to February 1, 2019. Solutions will be evaluated by a panel of reviewers and judges on their ability to meet the following criteria: • Uniqueness of the idea • Potential impact on human health • Feasibility of the idea • Thoroughness of approach • Identification of key resources and plan to further idea The Johnson & Johnson Nurses Innovate QuickFire Challenge is the latest initiative from the company that, since 1897, has supported nurses through employment, partnerships, training, and millions in scholarships. For example, Johnson & Johnson previously launched the iconic “Campaign for Nursing’s Future” to address a projected shortage of nurses. The result was an increase in the nursing workforce by more than one million (Buerhaus, Nursing Economics)3. Every day, nurses’ creativity, innovation and healing touch change the lives of patients around the world. Johnson & Johnson is proud to advocate for a world where nurses are empowered, recognized and valued as critical changemakers in patient care. To learn more about Johnson & Johnson’s 120 years of commitment to nursing and how to apply for the Johnson & Johnson Nurses Innovate QuickFire Challenge, visit nursing. jnj.com/home. Read more at allnurses.com
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Expert’s Corner
How Did You Become a Nurse Attorney? asking questions like how did she become a nurse, why she chose that profession, what she liked about it, how did she come to choose taking care of children? That day, I made the decision that I too would become a nurse. Years later, after getting my white cap and pin, I thought I was about to begin my dream profession. I was new and green when I started working at a California hospital. Then one day, when a patient on my unit coded, I remembered thinking, “Thank God, it’s not my patient!” I then watched my patients as well as those of the other nurses who were attending to the code.
Hi Lorie How did you become a Nurse Attorney? Were you a nurse first? Where did you go to law school and how long does it take? What kind of jobs can you do with such degrees? by Lorie Brown RN, MN, JD
Lorie A. Brown is a Nurse Attorney representing nurses before the licensing board and founder of EmpoweredNurses. org. Empowering Nurses at the bedside and in business.
There was no divine plan or calling for me to become a nurse attorney. But there was a path that brought me here and I am so grateful. When I was 10-years-old and at summer camp, I fell off a horse and hit my head. When I came to, I saw a woman in white standing over me. She looked like an angel and told me that she was the camp nurse. She picked me up and rushed me to the local hospital to get checked. On the way, and feeling better, I started
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One nurse stepped out from the patient’s busy room and asked me to get the Gomco Suction Apparatus from Central Supply. In those days suction did not come out of the wall. I remember standing by the linen cart when I called Central Supply only to be surprised by their reply, “We don’t deliver!” I pleaded with the woman on the other end of the line to bring the life-saving equipment to us but she flat out refused. Shocked and dismayed, I realized that there was no one else to get the equipment, so I had to leave the patients to go to Central Supply to get the equipment myself. The next day, I was called into the unit manager’s office. I remember wondering why she wanted to talk to me as everything seemed fine. She sat me down saying, “Lorie, I need to write you up because of the way you talked to the person at Central Supply.” To say I was
stunned would have been an understatement. I could not believe that I was being written up for this conversation. I thought, “I’m a brandnew nurse! I’ve never been in trouble. What’s going to happen to my career now?” The manager didn’t even give me any resources to help me. After being written up, I made another decision. I planned to go into management and treat nurses the way I thought they should be treated as valued and respected members of the health care team. This would entail getting my Master’s Degree in Nursing and Administration and become a unit manager. Within a few years, I started school and earned my MN and did become a unit manager. I loved it! I had a great staff in which I was very participatory. I allowed them to make their own schedules and to voice their concerns. They felt they were heard, supported and valued. Then came a period in my life where I was going through a divorce. I had a great attorney and during the proceedings, it dawned on me … I can do this! That year, we separated in April, I took the LSAT Preparation Course in May, took the test in June and then in July, I was pleasantly surprised to find that I was admitted to a law school and the next month I started my studies in August. All this in a 4-month span Now, law school was another story. All this legal jargon at first nearly drove me crazy. But then I remembered how in nursing school all the medical jargon had driven me crazy but I did manage to overcome that. I did successfully learn the legal jargon and passed the Bars in both Indiana and Illinois. Sometimes the universe seems to have a way of rearranging itself for your best interests. I now have the best job in the world and feel like I am a nurse for nurses. Nurses take care
of everything else but themselves and when they have a problem, they seemingly have no one to turn to. Nurses feel it’s a dirty secret and so much shame overcomes them. I take care of the nurses in their deepest, darkest hours when they have a license, employment or contract issue. I prefer to be proactive and help nurses prevent problems rather than to have those problems. I had a multitude of clients who came to me saying they never thought they would have to be before the Board, yet here they were. I recognized they had some common problems and from there, I developed a system to help them protect themselves. The system is called GIFTS. And I learned that when nurses do not use their GIFTS, that is when they get into trouble. (Stay tuned for another article on the GIFTS!).
“Now, law school was another story. All this legal jargon at first nearly drove me crazy.
When I first became an attorney, I thought I would make a lot more money than nursing. I also thought they would value my nursing expertise. I was wrong! My first job, I worked for the state of Indiana Department of Insurance and defended the medical malpractice fund. I worked home care at an IV infusion company to supplement my income. Shortly
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The time and cost of going to law school take years to repay. As nurses, money is usually not our main motivator. Our main motivator is helping people. People ask me what is the difference between law and nursing. I say as a nurse, a patient does not come with a sign over their head as a medical example, like appendicitis. You have to assess, plan, implement and evaluate. In law, a client does not come in with a sign over their head like tort, breach of contract etc, you still have to assess, plan, intervene and evaluate.
If money is your main motivator, it is not worth it. The time and cost of going to law school take years to repay.
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after I graduated, the TV show LA Law was released and the applications to law school went through the roof! In addition, with the economic crisis in 2008, many law firms went out of business or merged with other firms to stay competitive. Now, if you still want to go to law school, let me share with you some success principles. 1. If money is your main motivator, it is not worth it.
2. Become a Legal Nurse Consultant first or spend a day at a law firm to see if you even like it. As nurses, we are relational and love our patients. Time in law is spent reading and researching and I say, knee deep in paperwork. 3. Be unafraid. As nurses, we are caregivers and not business people but if you like marketing yourself and do not feel uncomfortable asking for money for your services, this is a great job. At first, this was very difficult for me. My law partners would market by taking insurance claims adjusters to play golf, drink martinis and smoke cigars. I did none of this. However, I was required to bring in business to the firm. I had to learn how to market my own way. I now look at marketing as service rather than sales and how can I help someone. 4. Check out The American Association of Nurse Attorneys, TAANA.org. These attorneys are nurses at heart and there is tons of value in this organization. All TAANA members remember where we came from and are more than willing to help others. Going to law school and becoming a lawyer was one of the best decisions I ever made. I love being able to help people especially nurses.
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