Be open to learning. New practices and procedures constantly arise in the healthcare field. As a nurse you need to have expertise in a broad range of both scientific and personal skills. Recognize that you can learn from any person and any situation. Nurses who are open to learning new things, and see each experience as a learning experience, are more likely to perform well.
Advance your training. In addition to what you will learn from your daily work, there are several ways for you to continue to advance your training. Many states require that Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) complete a minimum number of “continuing education” hours every few years to renew their licensure or certification. These hours are not part of a formal degree program, but they will help you stay in touch with new developments in the field. There are several training programs that will allow you to earn continuing education hours. Many nurses enjoy their CEU education. Some opportunities are quite popular, so don't wait until the last minute to sign up.
The American Nurses Credentialing Center has information on certification on their website, as well as an online account that helps you track your CEs.
Nurse.com offers several free CE courses online. You should check to ensure that online courses will meet your state’s requirements.
The American Nurses Association has a catalog of various CE courses available. You can also attend a variety of conferences to gain CE hours.
NurseCEU maintains a directory of online CE courses.
PESI HealthCare offers several CE seminars in various states.
Some associations even offer CE through things such as cruises, where you can earn contact hours and (sometimes) credits. Make sure if you try this option that the cruise will count toward your state’s CE requirements.
Consider the type of nurse you’d like to be. Some nurses love working on the floor as LPNs and RNs. Others may wish to expand the types of nursing they’re able to practice. There are several fields in which Advanced Practice Nurses (APNs) can learn to practice.
A Clinical Nurse Educator (CNE) is an RN who also teaches other nurses in academic settings such as teaching hospitals and nursing schools. In some cases, you can become a CNE with a Bachelor of Science in Nursing (BSN), but in many cases you will need at least a master’s degree. Some teaching positions will require a Doctorate Degree in Nursing.
A Nurse Practitioner is an RN with a master’s degree. NPs can diagnose and manage medical conditions. They can order lab services and X-rays, and many can also prescribe medications. They can also specialize in areas of care such as occupational health, child care, or emergency care.
A Certified Nurse Midwife is an APN with a master’s degree. CNMs provide prenatal and OB/GYN care, including examinations, prescriptions, parenting and patient education, and reproductive health care. CNMs can deliver babies and provide postpartum (after birth) care.
A Clinical Nurse Specialist (CNS) is an APN with at least a master’s degree. CNSs specialize in a particular area of clinical practice, such as geriatric or psychiatric care, or the treatment of chronic diseases. CNSs can diagnose and treat conditions within their area of expertise and can also work as expert consultants in nurse training.
A Certified Registered Nurse Anesthetist (CRNA) is an APN with a master’s degree and additional certification. They can administer anesthesia, and are often the primary providers of anesthesia in rural and underserved areas.
A Nurse Informatics Specialist (INS) is an RN who has a master’s degree in informatics (computer information systems). An Informatics Nurse (IN) has informatics experience but not a graduate degree. INSs and INs help evaluate and select new technologies to adopt, as well as train others in how to use the technologies.
A Nurse Researcher conducts scientific research about nursing. NRs typically have at least a master’s degree, but more often have Ph.Ds in Nursing.
Earn an advanced degree. Nurses are able to practice as LPNs and RNs with an Associate Degree in Nursing. To do some types of nursing, such as Advanced Practice Nursing, you will need to earn a Bachelor Degree or even Master’s Degree in Nursing. You can even go a step further and earn your doctorate as a Ph.D. (Doctor of Philosophy) or DNP (Doctoral Degree in Nursing).
With a Bachelor of Science in Nursing (BSN), you have more career options. For example, you could become a public health nurse, where you focus on educating communities about health issues, or a nurse educator, where you help educate new nurses.
In some cases, if you already have an Associate Degree you can complete a BSN in as little as 12 months through a “completer” program. RNs with associate degrees can often earn their bachelor and master’s degrees in a condensed degree program.
To work as a Nurse Practitioner, certified Nurse Midwife, certified Clinical Nurse Specialist, or certified Nurse Anesthetist, you must have a Master’s Degree in Nursing. A master’s degree also opens the door to becoming a supervising or managing nurse. The names of these degrees vary, such as Master of Science in Nursing (MSN), Master of Nursing (MN), Master of Science with Nursing major (MS), or Master of Arts with Nursing major (MA). Full-time master’s degrees take around 2 years to complete, but may take much longer if you continue to work and attend part-time.
Online degree programs can be a good option for some, especially if you plan to keep working as a nurse while you pursue higher education. However, these programs can be significantly more expensive than brick-and-mortar programs (between $35k and $60k).
Look for degree programs accredited by the Commission on Collegiate Nursing Education (CCNE) or by the National League for Nursing Accrediting Commission (NLNAC).
Move between hospitals. Nursing offers a lot of flexibility. Particularly at the beginning of your career, moving between hospitals can help you decide what you are most interested in. It can also help you decide in what environment you want to work.
You can also learn how different hospitals achieve patient safety and satisfaction.
You will likely learn different skills and use different products and technologies in the different hospitals. This increases your flexibility (and employability).
Try travel nursing. When hospitals have nursing shortages, they choose travel nurses to fill them. Travel Nurses choose assignments all over the world. In addition to the excitement of living and working in new environments and cultures, travel nursing will allow you to work with different patient populations and different types of medical needs. You will also have the opportunity to work in a range of medical settings, from rural clinics to huge teaching hospitals. Learning different ways to practice nursing will help you become a better nurse.
Most travel nurses have health benefits, housing, and transportation, but you should check with the hospital where you’re applying.
TravelNursing.com has a US job search feature on its website. You can find other job listings with any major search engine, or by asking fellow nurses who’ve worked as travel nurses.
Learn to communicate clearly. Nurses have to communicate with their patients and other medical staff, often in high-stress, fast-paced environments. It’s important that you learn to communicate clearly and effectively. Always ask your patients if they need anything. Even if they send you running for a million things, they will know you care for them.
Make sure, though, that you don’t sacrifice showing interest in your patients for efficiency. Even if you’re just popping in to check an IV bag, take the time to say hello to your patient. Don’t just run right back out the door.
Body language and other forms of nonverbal communication such as eye contact are very important, especially for a caring-based profession like nursing. Make eye contact when you’re speaking and when you’re listening. Make sure that your body language isn’t sending the wrong message. For example, crossed arms or legs suggest that you’re closed off, and shifting your weight from leg to leg suggests that you’re not confident. Present yourself in a calm, respectful manner.
Give complete information. Sometimes, even a minor detail can be the difference between recovery and re-injury for a patient. For example, if you don’t tell an oncoming nurse that your patient fell a few hours ago, that nurse will not know to watch the patient so s/he doesn’t fall again.
Remember that what you say isn’t always what others hear. If someone looks confused, or reacts in a way other than you expected, ask for feedback. It’s much better to catch miscommunications early than let them spiral out of control.
You will often have to change tactics depending on the situation. If you work in an ER, for example, you will have to talk very differently with a 6-year-old girl than you would an adult man. Approach each patient with the same kindness and respect.
Take time to explain. Patients and their families can often be frightened when they're in a hospital. They may not understand what’s happening to them, or they may be uncertain about what to expect. Take the time to discuss the illness with your patient. Let the patient know what to expect from any procedures, but keep your tone approachable and kind.
Stay away from jargon as much as possible. “Cardiac ischemia leading to myocardial infarction” is unintelligible to the average person. It’s better to use plain English when possible: “Your arteries were blocked, and this caused you to have a heart attack.”
Consider the person’s background when you're talking with him or her. Not everyone has the same level of knowledge or ability to understand. Ask questions! It’s a good idea to ask your patient things such as “What do you already know about such-and-such?” or “What questions do you have for me?”
Once you’ve explained something, have the patient repeat it back to you to make sure s/he understood it. If there are inaccuracies, gently correct them without making the patient feel ignorant or stupid. For example, “That’s mostly right. But it’s really important that you only ice your foot for 15 minutes at a time, okay?”
Always tell your patients that if they have questions, they should call you. A patient should never leave your care feeling alone or isolated.
Be a team player. Nursing is no place for egos. One-upmanship and trying to compare yourself to the other nurses will make you no friends, and won’t be good for your patients, either. Being a team player means that your patients will get the best care possible, and everyone’s jobs will run more smoothly. Collaborating is the key to keeping the staff happy and your patients cared for.
Ask your charge nurse what s/he needs help with. Ask your coworkers what they need help with. Similarly, if you need help, ask for it.
On the other hand, don't overextend yourself or neglect your own responsibilities. It’s even more important to be able to help than it is to offer. If you're swamped at a particular moment, recognize your limitations. It’s okay to say “no”.
Remember that nurses work with a multi-disciplinary team, and each person has a part to play. Stay in touch with the other people on your team and know what is going on with your patients at each step of the care process.
Develop cultural competency. Because you will likely work with patients from many cultural backgrounds, it’s important to develop cultural competency. This means you have an understanding of your own biases and values. You also know how to communicate with people whose English proficiency is limited, and you recognize and respect cultural traditions other than your own.
For example, a person from an Asian culture may want to eat only hot food to replace the “vital heat” they have lost through illness. It’s important that you respect your patient’s culture and traditions, or you will communicate that you aren’t interested in your patient’s holistic well-being.
If you are interacting with a person whose culture you’re unfamiliar with, ask before taking any actions. Use nonjudgmental open-ended questions, like “Could you tell me more about _____?” or “I would like to learn more about _____?”
Everyone makes mistakes. If you make a culturally inappropriate mistake, acknowledge it and apologize.
You can learn more about cultural competency by studying transcultural nursing assessment. Learn more at www.tcns.org.
Be confident. Patients are often scared. They're in a situation that they may not understand, and which may have huge ramifications for their lives. As a nurse, you will be the professional with whom they will have the most contact, and your expertise is invaluable. Speak assertively and with confidence when asked a question or explaining something. If you fumble for an answer or hem and haw with a lot of “ums” and “uhs”, the patient may feel as though you don’t know what you're doing. Being confident (and correct!) in your answers will help you gain your patients’ trust.
For example, if your patient asks whether it’s okay to lay her infant on his stomach, don’t reply “Um, well, I think it’s probably not.” Instead, give a clear, research-based answer: “No, it’s not a good idea. SIDS (Sudden Infant Death Syndrome) kills many infants every year. Most infants who die of SIDS are usually lying on their sides or stomachs.” Your continuing education training can help you stay on top of the facts you need.
Tell yourself that you know what to do. It can be easy to doubt yourself, especially after a long hectic shift. Remind yourself that you have the knowledge and the skills you need, and what you don’t know, you can learn.
Ask for help when you need it. Particularly if you’re new to nursing, you may feel worried that asking for help is a sign that you don’t have the necessary expertise to be a good nurse. Remember, though, that no one knows everything. It’s much better to ask when you don’t know something than to make a decision that could harm your patient.
When you ask for help, be attentive when it’s offered. Note what your fellow nurses do, and how they handle the situation you were unfamiliar with. Learn from their experience. Repeatedly asking for help on the same issue suggests that you are not paying adequate attention, or that you don't value your fellow nurses’ time.
Demonstrate care. If you cannot care about the people you are serving, you will not excel as a nurse. Nurses deal with the sick and injured and their families on a daily basis, and you, as their nurse, need to be able to show them that you truly care about their situation. Showing you care can occur in a variety of ways, but they all involve attentiveness, responsibility, competence, and responsiveness.
People believe that you care when you show them personal attention. For example, if you have a young patient who you know will be afraid to spend the night in the hospital, draw him a picture to cheer him up. If you know your patient prefers red jello to green jello, make sure to get her a cup of the red stuff.
Attentiveness to your patients’ needs also shows that you care. For example, if your patient is feeling increased pain, contact the physician in charge of painkillers and get your patient's dosage increased. Then, check in with your patient and ask how s/he's feeling.
Don't lapse into a formula with your patients. Make sure you personalize your interactions. Nobody wants to feel like a cog in a giant wheel, least of all people who are ill.
Be honest. Be completely honest with your patients, even if you don’t want to, even if you think honesty will upset the patient. Humans are often very good at perceiving when others aren’t being honest with us, and if your patients believe (or discover) that you’re being dishonest with them, it will destroy your patients’ trust in you.
Honesty also means following through on your word. If you promise to revisit a patient or take a shift for a coworker, make sure that you follow through. Noting things in a planner or even on your phone can help you keep your obligations straight even in hectic circumstances.
Ethics are paramount in nursing. When you make mistakes, own up to them and address them. Use them as learning experiences for next time and do better. Be honest with your team members and the other nurses and hospital staff as well.
Patients are scared to be in the hospital, and the last thing they want is to be lied to. However, be wary of giving them a diagnosis, even when pressed; only doctors and nurse practitioners can diagnose.
Develop emotional stability. Nurses feel the joy of seeing a new baby born, followed by the pain of losing a long-term patient who had become a friend. Emotional stability is crucial in order to survive the roller coaster ride of emotions nurses must endure on a daily basis. Nurses who can’t control their emotions are more likely to experience burnout and low-performance. Nurses who know how to handle their feelings deal with stress better, make better decisions, and have better patient outcomes.
Part of developing emotional stability is staying in touch with your feelings. Take moments to check in with yourself throughout the day. Know what you are feeling, and why. Think about the connections between your experiences and your emotions. Trying to bury your emotional responses will only make them explode later.
Mindfulness may also help you keep your emotions from controlling you. Mindfulness focuses on noticing what you are experiencing and feeling, and accepting it without judgment. It can help relieve stress and anxiety and help you feel more in charge of yourself. There are many ways to practice mindfulness, but deep breathing and mindfulness meditation are common techniques.
Practice flexibility. We're not talking about yoga here (although that can help you with your emotional stability!). Being able to adapt to widely different situations and patient needs is critical for being a good nurse. No day is quite like the next when you work as a nurse, so you need to be able to adapt to circumstances. People are unpredictable at the best of times, but under stress they become even more unpredictable. Nurses who are adaptable are able to handle multiple demands and swift change. They can shift their priorities and view situations from different perspectives.
Learning and practicing flexibility and adapting to change will also build emotional resilience. When you’re able to “roll with the punches,” you’re less likely to feel as though you need to control every facet of a situation. In nursing (and, honestly, life), you’ll never be able to exercise that kind of control.
Show compassion. A crucial skill for nurses is empathy. You don’t have to understand exactly how people are feeling or coping with something to understand why they are having a hard time and that they need someone to care. Take the time to listen and ask questions. Sometimes, patients just need someone to acknowledge their feelings.
Judgmentalism is the enemy of compassion and empathy. Try to see the situation from your patient’s perspective, even if it seems completely unfamiliar or even “wrong” to you. Even if you have no understanding of why a person would think or feel a certain way, acknowledge the importance of your patients’ feelings.
Remain calm. Nursing can feel overwhelming and even terrifying sometimes. It’s important, both for your own health and your patients’, that you stay calm. Managing your stress in your personal life will help you with this. In stressful moments on the job, take a deep breath and count to ten. Remind yourself that you chose this profession because you want to help, and you can’t help your patient if you’re both upset.
For example, if you are working in a labor and delivery unit, you might come across a woman who needs an emergency c-section to protect her baby’s health. This is an alarming and stressful moment for the mother, so it’s important that you remain the rock of calm in the situation. Clearly and quietly explain what is going to happen and why it’s necessary. Don’t raise your voice, shout, or become visibly upset. Watch to make sure your patient looks like she understands and ask for confirmation, such as “Nod if you understand.” If your patient doesn’t understand, try your best to clarify your explanation. Your cool and collected manner will set an example for your patient.
Practice patience. As a nurse, you will encounter many situations that try your patience: lost charts, needy patients, overprotective parents. It’s important that you remain patient with your patients, but also stay patient with co-workers, physicians and family members — even when you’ve been at work for 8 hours and the eighth family member from the same patient comes and ask you the same question again.
Don’t give information that you don’t know or shouldn’t share. For example, a patient may ask you about test results that you know the results of. However, the doctor should call the patient to discuss the results. Calmly explain that you can’t give your patient that information.