TIPS FROM DAVID MORRISON, AUTHOR OF THE TRAVEL NURSE'S BIBLE

How long have you been a nurse and what areas of nursing did you or do you currently work in?  Graduating from nursing school in 1993, I worked six months in an extended care facility until being accepted into a critical care fellowship in Columbus, Ohio. Since that time, I have worked exclusively in various critical care areas.

David, you and I both started our travel nursing careers in Hawaii, exposed to SCUBA, rainbows and luaus. Not all assignments are paradise but what do you love most about travel nursing?  If you choose your assignments as if you were choosing vacation destinations, it's hard to go wrong. I've never accepted an assignment in a location where I did not have some interest in the surrounding area. Always wanted to see the Grand Canyon? Flagstaff or Phoenix fits the bill. Want to scuba dive in the Keys? Ft. Lauderdale and Miami are easy drives to prime ocean spots. If you don't like the location or work environment, you are often only obligated to stay for three months. But, if you do fit in well with the unit, many locations allow multiple extensions.

"Travel nursing is really the definition of career freedom."

Tell me your biggest challenges or concerns about travel nursing.  I'd say that the difficult assignments are the biggest obstacle in travel. Whether it is for unsafe patient workloads or an uninviting staff, three months can be a challenge when you really dislike your assignment.  I personally have only ever had one assignment where I gave serious consideration to "walking" on my contract. In that instance, I concentrated on making the most of my days off and seeing everything I could in the surrounding area. It was San Francisco, so it wasn't hard to chose from a variety of activities on my days off.

What throws you off balance and how do you know you are out of balance? What brings you back into balance?  Honestly, I feel as if I have been a nurse for so long, that nothing within the job really throws me. No matter how bad it gets, at the end of twelve hours, I'm done.  Anytime I have felt stressed or "out of balance" it has been a personal issue. So the most obvious answer is to eliminate the issue, which of course is not always possible. So I guess it is all about balance, finding something to even things out. If I've had a rough week, then I don't feel guilty about spending an entire day "vegging out" in front of the TV or playing a new video game for four hours (it's a guy thing). Some might hit the gym, read a book, hike, bike or skydive; whatever your release valve may be, you need to have one.

Your book The Travel Nurses Bible is a great resource for nurses. Travel Nursing is not for everyone. The nurse needs to be independent, strong in clinical skills and very adaptable. What advice would you give to new nurses interested in travel nursing?  You need to be able to honestly and accurately assess your skill level as a healthcare practitioner. If you are regularly asking someone else to help with an IV start, Foley or NG insertion, or basic nursing practices, then you are not ready to for the road.

You need to be a fairly independent practitioner and prepared for the possibility of receiving little to no help in your new work environment. Do all assignments expect you to just keep to yourself and do your work with no assistance? No, but you do need to be prepared should that occur.

Tell me your most interesting story as a nurse.  I have a couple instances in my book Travel Nurse Bible about memorable stories from the road, but experience I had in Florida. I was floated to telemetry for the shift. Taking care of double or sometimes triple your baseline workload, can throw any ICU nurse into a rather un-hospitable mood.

At the end of my rounds, I grabbed the antibiotic from the med room and went in to assess my patient. After a quick assessment I realized the IV in my patient's arm wasn’t working. Excusing myself from the room, I stormed down the hallway to grab some IV supplies. By this point, I was starting to get a headache and a bad IV was just the nail in the coffin.

Upon entering the room, I remained pleasant, trying to never let a patient see when I'm having a bad shift. Apparently, I did not do a good enough job in shielding my patient from my feelings that night as she sensed my frustration and calmly asked, "Are you having a bad night?" That was all it took to release a monologue of all the difficulties I had encountered that night.

I started to explain all the things that had gone wrong since I started my shift. As I made my way down her arm, I noticed a small tattoo. I quickly grew very quiet as I looked at the numbers and realized the significance of the ink on her arm. I recognized the unmistakable marking of a person who had been in a concentration camp, the number was preceded by the letter "A", meant she had been at Auschwitz.

I sat there for what seemed like an eternity not knowing what to say. Finally, I just looked up at her and apologized. She looked perplexed and asked why I was apologizing. I told her that after I unloaded all the details of my crappy evening to her, I just realized that nothing I would probably ever encounter, in my lifetime, could possibly compare to what she had been through. She smiled, patted my hand, and told me not to worry about it.

As I started her IV, I learned that she was not yet even a teenager when she arrived at Auschwitz. Her mother, father, and sister were all killed at the camp. She had even written a book about her experiences there, but never found anyone willing to publish it.

I sat with her for another twenty minutes listening intently to her story. After finishing up, I thanked her for the conversation and the reality check. When I left her room I was no longer concentrating on my aching head or my growling stomach. As I think back to her, I wonder if she ever found anyone to publish her words. If not, I know at least one person who will always remember them. I also know one nurse that will never again lose his perspective, no matter how bad his shift might be.

 STILL ROOM IN OUR MINDFULNESS STRESS REDUCTION COURSE 10/26-12/14  CHECK IT OUT HERE

An Aussie ICU Nurse learns not to mess with African American Braids

Allison was born, raised and trained as a nurse in Australia. She has been a nurse for 27 years, and has worked in The United States for over 10 years, primarily in ICU. She and her husband Paul (also a nurse) became traveling nurses, fell in love with NYC and are enjoying the States while waiting for the job market to improve in Australia before heading back home.

Allison with her husband Paul

Allison with her husband Paul

What were some challenges you faced transitioning into a foreign nursing system? 
I was terrified I was going to get sued – since The US medical system has such a litigious reputation compared to home.
I came from a Neurological Trauma ICU in Australia so it was a difficult transition to clinical practice;  I was allowed to do things here that I wasn't allowed to do at home and things I was not allowed to do here were done by floor nurses at home.

 We didn't have aides/therapists so I found it hard to let anybody touch my patient here.
I felt like I was translating everything in my head, I really grew an appreciation for nurses who came to English speaking countries when English was not their native language. 

I become a walking thesaurus; I had to have at least 5 words for everything I said with my Aussie accent since “speaking Australian” was such a challenge for Americans.

 Tell me your biggest pet peeves about Nursing.
Not enough time to do nursing. Staffing ratio's and paperwork takes away our clinical time. We spend so much time filling out forms saying what we are doing, we don't actually get the time to do it. 

What do you love most about nursing? 
What's not to love about nursing? I get to have the best job in the world that encompasses so many other jobs: therapist, teacher, student, mentor/motivator, healer, communicator, diplomat, and the list goes on. If I had to pick one thing I loved most, it would be the people I have met both in and by the bedside.

 What throws you off balance about working as a nurse?
Not being able to do my job to the best of my ability. How do I know I'm off balance?  Everyone annoys me ;)

What brings you back into balance? 
I check myself. I now know I set high expectations for myself and everyone around me, which is not always achievable. So I take a breath and set both a mental and written checklist (I love a good checklist). I check one thing off at a time and accept this is the best I can do at this time and place.

If everyone is annoying me, I take a day for myself to do whatever I want, sometimes its just laying in my pajamas doing nothing.

We give so much in our profession; we find it hard to give back to ourselves in the same manner. I'm trying to be more selfish; it’s a work in progress. 

Tell me a funny story about work. 

I was working in the SICU at John's Hopkins. I received my patient from the ED with a gun trauma to the face. I’ve always said the ABC's of nursing are Appearance (the patient looks, clean and tidy), Bed space (the bed space is stocked with everything I need for whatever situation might arise) and Curtains (curtains tied back neat and tidy). She was and African American woman with these beautiful braids but they were saturated in blood. (We don’t get many African American patients with braids in Australia). I carefully proceeded to undo the braids and thoroughly washed her hair. I discovered the braids were woven into her hair and I was left with this unruly mess for the proceeding weeks in the hospital.

Lesson learned don't touch the braids.

                                                     image: de.wikipedia.org

                                                    image: de.wikipedia.org

What advice would you give to new grads starting out? 
Be proud of your mistakes, you're going to make them. Own them and learn something from them, share them with others so they can learn. A lecturer once told me 'the more you know, the more you realize you don't know'.
Be kind - To yourself and your fellow nurses. 

Allison and Paul in Central Park

Allison and Paul in Central Park

Allison’s husband Paul is also a Registered Nurse and here’s his advice to new grads:

Don’t be too picky about what you want to do. All experience is a learning experience that can help you get to where you want to go. 

5 Steps To Becoming A Happy Nurse

This week, I had the opportunity to meet a number of nurses in various specialties, including ICU, med-surg, perioperative, obstetric, and oncology (Bone Marrow Transplant, in particular).  In my career as a nurse, I have worked in fifteen different work environments (many as a traveling nurse).  Each has provided me with different levels of work or life satisfaction. On some occasions, I was significantly challenged and stressed out at work; other times, I accepted boredom because my personal life demanded more from me.  I’ve gone through phases where my work has been the center of my life, and I didn’t want it any other way.  There were other chapters when the priority was income or the flexibility to pursue other interests, such as a Masters degree or Ironman triathlon.  Each nurse needs to find the right balance for him or herself.

by creativecostumes.com

by creativecostumes.com

Meeting so many nurses this week, I can’t help but reflect on the wide array of workplace satisfaction. The nursing pool is filled with happy nurses with gratitude and genuine joy for the job, and co-workers to disgruntled nurses on the verge of collapse. Many of these dissatisfied nurses have experienced significant mental and emotional impact from their work environment.

So how does the disillusioned nurse find his/her way to happiness?

1.  Reflection

You need to actually identify that there is a problem.  Sometimes this surfaces as depression, anxiety, or physical health changes such as hypertension or recognizing a potential drinking issue.  You can’t create change unless you identify the problem in the first place.

2.  Get an objective opinion

Consider working with a coach or therapist.

Is it you or is it the job? Sometimes an outside perspective can support nurses through stressful times and transitions. If the problem lies within the job, then break down the source of the problem: management, co-workers, or the patient population. As a coach working with nurses, I help nurses identify what role they personally play in contributing to their own unhappiness.

3. Look with new eyes

A beginners mind or a fresh perspective can open us up to new possibilities and leave our jaded judgments behind.  Can you imagine what pressures or difficulties your co-workers or managers are going through? That alone, may change the way you chose to communicate and relate with them.

4. Get some chutzpah

Have the courage to be uncomfortable with change.  Rather than stay in a job that doesn’t suit you– for whatever reason, take a leap!  There is nothing wrong with planting yourself in one unit, one career for forty years if it satisfies you.  However, when nurses stay because they are paralyzed by fear – they have no idea of the positive changes that await them. I met two nurses this week that remained in their specialty but transferred to a different hospital.  It has rocked their world, and they are reaping the benefits of positive work environment for the first time in their career.

5. Love the one you’re with

photo by listal.com

photo by listal.com

Oh, if only we worked with George!

If a job change isn’t within your capacity, how can you create a new level of acceptance with your employer?  Sometimes the grass isn’t greener, and the grass is on fire elsewhere.  I discovered that this week.

Is there a way that you can find 3 things you are grateful for each workday and write them down? Committing to that practice for one month can have a positive impact on your mental status.  If you are still miserable, refer back to #4. If you can’t find your chutzpah, give me a call for a free nurse coaching session