Pandemics and Masks.

Flu Season….Isolation Precaution Season. Typically peaking in January or February.

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Sound familiar? When you walk onto the unit and 23 out of 24 rooms are in isolation. Mask… check. Gloves… check. Beautiful yellow drape… check. Ahh the thrills of flu season. Every nurse, physician, RT and any other health care personal that I am missing loves it. The time to sprint from room to room, while you effortlessly sport the latest fashion trend. Your yellow (at least ours are yellow) papery gown. Yup, it’s no Gucci or Prada but it will do. So let’s dive into this topic a bit. Let’s see if we can gain a fragment of knowledge for the next few minutes.

You have heard of H1N1, have you heard of H5N1, or now H7N9?

A new avian flu has decided to make an appearance. According to the CDC a new avian influenza  A (H7N9) strain, has been first reported March 2013 in China. So the question here, is there a fresh wave of H7N9 that we need to worry about?

Most cases are believed to have come about from exposure to contaminated environments and infected poultry. Infected poultry and people have been found in China. Though mild cases have been seen and reported, this strain presents itself with severe respiratory illness and with 1/3 mortality rate of those infected (www.cdc.gov). So the question here is how easily is it transmitted? It has not been confirmed if it can be transmitted between people, but there have been rare cases of transmission. Cases with poultry exposure have been found in China’s neighboring countries (www.cdc.gov). According to the World Health Organization (WHO), has reported 132 human H7N9 infections, with 44 deaths. The numbers have decreased most likely to the diligent efforts of China to eradicate the strain (www.cdc.gov).

The major concern with this strain is the possibility of a pandemic exposure (reminds me a bit of the movie Contagion-if you haven’t seen it your in for a doozy). The CDC is following this strain closely, the fear is that this strain will develop the super bad guy ability to spread “and gain the ability to spread easily and sustainably among people”. Thus triggering a real life version of contagion (maybe not to that extreme but you never know). But you get the idea right? Studies have also shown like the seasonal flu/influenza virus, the avian strain also has a seasonal pattern: the strain seems to circulate at higher levels during the cold weather and at lower levels in warmer weather.

So what is being done to prevent and contain this? The CDC and other organizations are working on identifying a flu vaccine, in the case that it is needed. In addition, continuous flu based education is being conducted for those traveling between the US and China.

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So let’s look at some of the signs and symptoms to look out for:

  • Initial s/s high fever, cough
  • Severe PNA
  • Acute Resp. Distress Syndrome (ARDS)
  • Septic shock
  • Multi-organ failure

How do I know I may not have H7N9?

There are many factors, and similar symptoms with other strains. If your flu lasts longer than 10 days, with severe respiratory problems. Have you been to China and you have been in contact with someone who has been confirmed with this strain. You need to contact your doctor for any concerns or medical advice. Again, remember the flu strains all have similar s/s. Your doctor will determine course of action/treatment.

For additional questions I have added a link to the CDC frequent asked questions site.

H7N9: Frequently Asked Questions

Reference

http://www.cdc.gov/flu/avianflu/h7n9-virus.htm

http://www.cnn.com/2014/01/28/health/h7n9-bird-flu-china/index.html?hpt=he_c2

http://www.flu.gov/about_the_flu/seasonal/

http://www.who.int/influenza/human_animal_interface/influenza_h7n9/en/

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Behavior Based Interviews

Behavior based interviews. Does this sound familiar?

The basic premise of behavior based interviews, is to discover how an individual, lets call this individual Nurse M. Cyrus, acted in specific employment-related, school-related situations. The logic behind this idea is to see how you behaved in the past because that will signify how you will act and perform in the future. As an interviewer I am looking at trends, I want to know if Nurse M. Cyrus as an individual, is worth the organization’s time and money and would Nurse M. Cyrus be worth the investment. Sounds cruel? No not really, right now the job market for new graduate nurses is the toughest it’s been for a while. I have worked at major metropolis hospitals- you need to take prepping for an interview seriously. Because, everyone one that is applying for a position I’m sure is a team player, good listener, get’s along with others etc. etc. etc. Big major hospitals have the choice to pick and choose the cream of the crop. Why? Allow me to give you to examples at 2 organizations I assisted with the hiring process.

1) Large Children’s Hospital can have 20 to possibly 30 open positions for their new graduate program. You are probably thinking, 40 slots I can live with that. Not when you have over 600 applicants in addition to yours. Get it? Your odds are 30:600, now does 30 still sound appealing?

2) Large Children’s Hospital # 2 has 23 open positions for new graduate nurses. They get over 700 applicants.

The kicker here is this. After you graduate nursing, let’s say your life long dream is to work on the pediatric cardiac ICU. Since you were little you wanted to be a nurse, and your mom is a nurse and your aunt is a nurse. And everyone you know is a nurse. And after your diaper years you had your little heat latched on to pediatric cardiac nursing. So now you are a fresh RN fledgeling straight after nursing school. And you have your heart set on Hospital #2. You should be fine there are 23 open positions. No. That unit alone may ONLY have 4 positions available. Ok so now your odds are 4:700 chance. So this is the time to bring your best foot forward. Not so much Miley’s best foot forward.

This is reality. The difficult thing is, and by no means am I trying to discourage you, it’s a tough job market than it was 10 years ago. I want you to know what you are up against. I need you to seriously take prepping for an interview seriously. So now that my introduction has captured your attention, let’s discuss behavioral based interviews.

Samples

  • Tell me about a time that you had to do multiple things at once. What was it,  what did you do, and how did it turn out?
  • Tell me about a time that you handled a difficult situation. What was the situation, what did you do, and how did it turn out.
  •  Tell me a time in which you had to not finish a task because of a lack of information.  How did you handle it? How did it turn out?
  •   Everyone has to bend or break rules sometimes. Tell me about a time that you had to do this. What was the situation. How did you handle it? And what was the end result?
  • Additional samples

Screen Shot 2014-01-28 at 6.10.31 PMBehavioral based interviewers are looking at what you have done, not what you would do in this situation. Again, we are looking at what have you done in the past at previous places of employment. If you have a small list of previous employers, give me a situation from nursing school. I cannot tell you enough how many individuals Many of these interviewers, like myself, want a real life story from you. In addition to your story I am looking for a beginning, middle and ending to your story.  This is where I feel throws people off. Is it just nerves probably.

But many answers to my questions have been “well this is what I would do if I was in this situation”.  What’s wrong with that reply? You are telling me this is what you “would” do. For behavioral based questions this is your first mistake,  unless you are able to quickly change your end game, then you are heading into a downward spiral. For prepping, look over sample questions.

Behavioral based interviews can be tough. But manageable and attainable.

Peals of Wisdom

Prep. Dress for success. Listen to what the interviewer is saying and asking. Good luck!

If you enjoyed this blurb, please subscribe to this blog.

P.S. If you have any  questions feel free to comment, or topics you would like me to blurb about feel free to let me know! Thanks!

BSN a WASTE of TIME?

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Title got your attention right?

After all whats the point? I mean doesn’t the picture capture what nursing is all about? Is a Bachelors degree in Nursing (BSN), a complete waste of time and money? What do you think? Remember your degree will and has cost you an appendage or two. Do you have any idea how much school tuition is? Or an easier way to picture it is how many Ramen, could tuition alone buy? Or how much pizza? Let’s calculate an average nursing school tuition of about $54,000 (without any scholarships your smarty pants).

  • You could buy about 420948 bags of Ramen Noodles. Which would take  you about 2.5 years to cook, not including the time to heat the water. The Ramen contains about over 799999999 calories (give or take). The same amount of calories burned in over 2800 marathons, that’s 73360 miles!
  • You could have cheesy pizza that would be delivered every single day for 28 straight years! Hmm..I could definitely live with that. Let’s bring out the welcome mat to cardiac disease heaven while we are at it.

You get the point right? It costs monies, monies that many of us will be slaving away paying off the rest of our lives. And that’s not even including a graduate degree, for you over achievers. So again, why on earth when we can have an RN after our name, with an Associates degree in Nursing, would we subject ourselves to numerous student loans, when instead we could have 28 friggin years of pizza OR Ramen!?!?!? Tough call I know.

The various entry levels into nursing practice has been a hot topic over the years. More so now with more and more organizations attaining “Magnet” status. Over the years, researchers, hospital and academic leaders have found that education has and does make a difference in nursing practice. Some of the reason behind this is the advances in technology in medicine and organizational change, thus requiring a hire level of education (Spetz, J., & Bates, T. 2013). In addition to various advances, studies have shown inverse relationship between the mortality of the hospitalized patient vs. the number of BSN nurses. Comparatively showing a decrease in patient mortality to the increase in more educationally prepared nurses.

The Institute of Medicine (IOM) nationally recognizes the baccalaureate prepared nurse. The IOM has set a national recommendation that by 2020, at least 80% of all nurses receive his/her bachelor’s degree (Institute of Medicine 2011). In general there has been such an increase in advocacy for a higher level of education, that many more organizations are now requiring an entry level BSN. Throw in the BSN RN Magnet recognized nurse, it’s no surprise why the nursing profession is advocating higher levels of education.

Pearl of Wisdom

For those of you who are considering it, or even currently attaining your BSN. I will give you one piece of advice that I wish I knew before I started. You will be writing papers, you will be exploring your literature skills and your initials will become APA (American Psychological Association). All your nursing papers will be and forever more become APA formatted. In addition to learning how to save someone’s life, you will also need to learn how to properly format and reference all your papers. Keep in mind APA continues, or at least it feels like it,  to be updated with rules and so forth. So here is my gift to you….. It’s called PERLLA and it was my heaven sent (yes I used it for my Masters degree, if it worked for me, I promise it will help you). I swear by this, (no they are not asking me to advertise for them, and no I am not affiliated with them) it will make your life 10X easier. This is program that is very very reasonable in price especially when you have the mountain of student loans waiting for you once you graduate and enter working force. Anyways, I will add the link below and I do hope it makes your journey oh so much easier and then some (LINK BELOW).

PERRLA for APA

Publication Manual of the American Psychological Association, Sixth Edition

References:

AACN Supports NJ Resolution To Require BSN For State’s RNs. (n.d). RN, 69(10), 14.

Institute of Medicine. 2011. The Future of Nursing: Leading Change, Advancing Health
Washington, DC: The National Academies Press.

Spetz, J., & Bates, T. (2013). Is a baccalaureate in nursing worth it? The return to education, 2000-2008.
Health Services Research, 48(6 Pt 1), 1859-1878. doi:10.1111/1475-6773.12104

Interview 101

Interviews…We all had or will have them. First scratchy suit, first resume/CV (which lets be honest only consists of a short paragraph of work history), your first official interview.

Graduating nursing school, looking for a job, applying, interviewing then locking in a job. It’s that easy right? Wrong…. If it was that easy you wouldn’t be here right now reading this? I have interviewed, been interviewed, been involved in the process from beginning to end, in my career. I hope my experience will help make that journey for you a little bit easier.

You are a new graduate nurse, you want to get into a top notch new graduate nursing program or RN Residency program. You apply to multiple hospitals-you get an interview. You prepare, but the question is how much? You are either “A” the I’m going to prepare weeks to months in advance person. Or “B” you are the let’s wait until a day or two before your interview and pray that you make it out of the interview alive with no war wounds.  For your career sake let’s say you fall in the category of person “A”. As person “A”, you need to plan as far as advance as possible. Prepare. That’s the magic key. Let’s start at the beginning-this is just a overview covering some major points that you need for developing professional portfolio .  Portfolios are all similar but vary in content. I will cover some major points that can assist you when creating your own portfolio framework to help structure your portfolio in a concise manner.

Which include:

  • Curriculum Vitae-overview of someone’s past experience (i.e. education, work and other qualifications)
  • Cover Letter-a summerization of who you are, what you want and how you are the right person for the job
  • Achievements-which can include educational or professional achievements, a time to brag that’s what this is (i.e. did you receive any type of recognition award while in nursing school or professionally)
  • Consider additional things that you may want to include in your portfolio (i.e. copies of your licenses, certifications, projects that you have achieved that are applicable to the job you are applying for)
  • Recommendation Letters-this is important, if you are applying for pediatrics-get a recommendation from your pediatric professor/clinical instructor. Or if you are applying for the ICU, get a recommendation letter from your critical care professor/clinical instructor. Do you understand the direction this is taking? Work at getting recommendation letters that will help you for the job that you want. If I am applying for a nursing director position for example, why would I include a recommendation letter from from my old fast food manager-from a summer job that I had ten years ago. Remember, that the recommendation letter needs to add to your platform. This tells me as a manager if your application is worth considering.

I can not stress enough, you need to prepare. If you are a newbie (new graduate nurse), I have to admit it to you right now, in 2013 it is a tough market, if you are an experienced nurse it is much easier.  If you are applying to a new graduate RN program-you are competing against hundreds. Yes, I said hundreds. Here in California, I have seen applicants apply from all over the United States. You need to realize that these programs can have new hire openings from 15-40 (numbers varying on organizational need). These programs get hundreds, of applicants for these slots. For example, 23 (hypothetical) slots, an organization can have over 750 applications. Yes, this is realistic. With those numbers, you can’t help but think, odds are against you. They can be if you don’t prepare.

Get my drift? Prepare. You could and can have the advantage if you prepare. My desire isn’t to scare you out of applying, I want you to know what you are up against and what you need to do to overcome it. You can do it, I sound like a Nike ad don’t I? 🙂

So start your first step. Brian storm, develop a framework of what your portfolio will look like. Research what formats of portfolios are out there. I will add some links to some reputable educational sites that can aid you in the development process.

Congratulations, on your first step!!!

Pediatric Cardiology and I

Pediatric cardiology. Sounds death gripping, pee in your pants, terrifying doesn’t it?

Sweaty palms, increase in blood pressure, complete anxiety stricken. Yes, that was me. My world was turned upside down. I am a medical-surgical pediatric nurse. My specialty is knowing a glass-full of everything. Maybe even a pitcher full. The perfect way I describe a pediatric medical surgical nurse-they are the epitome of a medical dictionary. Let’s get back to my point (I get side tracked rather easily), Pediatric cardiology was not my forte. Yet, that is the world I chose to step into as a pediatric Cardiovascular Acute Care nurse. It fascinated me, like any child who wanted to learn how to ride a bike. But before riding off into the sunset with streamers attached, and maybe a squeaky horn on the handle bars. I needed training wheels. Did you catch that?

***T-R-A-I-N-I-N-G W-H-E-E-L-S***

Well nursing training wheels that is. I needed a source, rather a quick refresher and a way to successfully become “specialized”. Oh, all of your cardiac nurses, that breath and live it, my level of respect and awe doesn’t quite capture the remarkableness (is that even a word?) of all that you do on a daily basis. People just do not understand unless you’ve walked a unit in those Danskos. Ok, back to my training wheels. I needed to make sure that I found the perfect book. The book that everyone raves about. Especially if I was going to pay for it. I asked everyone what they recommended. What I found to be an absolute heaven sent is a quick reference hand pocket book. Everyone and anyone had this tucked away. Even the most experience nurses had a copy of this book. What about physicians? Even the physician residents, I have seen carry this book.

So what is this infamous book that I keep carrying on about? It’s called the Illustrated Field Guide to Congenital Heart Disease and Repair – Pocket Sized . This book was my nursing set of training wheels. This book helped me keep up and quickly learn what I needed to know in regard to some of the major pediatric congenital diseases. This book helped and and still does.

If you are reading this, you too are looking for your first set of nursing training wheels. I do hope this book can make your journey just a little bit on the easier side. It helped me prevent many lets eat the whole tub of ice cream type of evenings. If you too have any recommendations on books or gold sources of knowledge that have helped you on your cardiac journey-please feel to comment below!

Interview: Types of Questions

There are three type of interview questions that you have a high chance of encountering.

  1. Standard questions
  2. Behavioral based questions
  3. Out of Thin Air questions

I would say the easiest type of questions that you can get asked are your typical “Standard” questions. These type of questions, are what show up when you Google interview questions. These are questions that you can definitely prep for and have the advantage. Let’s go over a few.

  • What are your expectations about this position? They want to know if you actually know what you are applying for, there have been situations where applicants have no idea what they applied for.
  • What do you know about our organization? Yes, you may have applied to over 10 organizations. But the organization that chooses to interview you-do your homework. Why choose that organization? What makes them different then from any other organization. They need to know that you want their organization, that you have reasons why you choose them.
  • What are some of your strengths? Weaknesses? Look at the job recommendations and tie in your own applicable strengths .
  • Why did you leave your last job?

These are just a few “samples” of questions that you may be asked and to get yourself started. I’ve been asked to compile more of a formal short and to the point tips and tricks for the interview process. Hopefully, soon I will have that up on my blog! Thanks!

Dress to Impress

Is there a dress code for interviews? I thought dress codes only applied to boarding or private schools? Heard of the phrase “dress to impress”? Rule of thumb, business attire (there are always those exception but in our case not so much).

Allow me to share a story that I was told a little while ago*. There was this women who lived in New York, she had a few years of leadership experience, she has been a nurse for 13 years. This women, let’s call her Ann, she had an interview set up for a nursing director position, at a local hospital. She got ready, had a portfolio in hand, she was ready. She got to the hospital, checked in and she was lead to the conference room. Once she arrived, she was sent home immediately and even though she had the qualifications, she wasn’t even interviewed.

Why? Her choice of attire, jeans, t-shirt, and sneakers. You would think she knew better, she’s been a nurse for years. The organization was surprised that Ann came for an interview in jeans! The general thought was that Ann didn’t take this interview and job seriously. So why would they want someone like that working at their organization? You would think this subject would be straightforward, you would be surprised.

First impressions can break or make your interview. Gentlemen, let’s go over a few basics. Don’t worry you don’t have to spend lots of money, after all fresh out of school. Especially with no incoming funding from a job. Men can make business formal work with just a few pieces of clothing. A well fitting blazer or a sports coat with tie. A nice dressy sweater with a tucked in button down shirt. You could layer it with a cardigan to add a classy twist. If you are not sure if you are walking into more of a casual organization, a khaki or light colored blazer can do wonders. You want to look the part, you want to make a statement, but you don’t want to scare them away. Save the bizarre and wild colors for your scrubs;-).

Ladies, there are two types of style, business casual and business professional. Business casual can include a nice sweater top with a skirt or slacks. Business professional is where you bring out your suit, yes the one in the back of the closet. That stiff and scratchy one. You can pair it with a nice buttoned down or collared shirt. Then comes the fun part, the accessories, leave your 10 inch gold hoop earrings at home. Just remember you want the attention on you and not your accessories.

Additional life saving tips:

  • Absolutely NO form fitting outfits- girlfriend, save them for Abercrombie and Fitch.
  • Cotton capris are too casual.
  • Necklaces that are too large.
  • Over powering perfume or cologne.

I cannot stress enough- grooming is important and personal hygiene. Do a head to toe run over. Avoid sneakers, flip flops. I am pro dressy socks, tights, but please avoid bulky sport socks. Look at your hands, make sire they are clean an presentable. Nails need to be clipped, trimmed and ladies I know we love our nails. I need my manicures, but if we can’t tell the difference between your nails and talons, you may want to rethink your nails for the interview. Next let’s look at pericings, ah hem, I’m talking about those you can see, that cannot be covered with clothing. You want to wear earrings and not weapons of war. This is all very basic, but you would be surprised at what “professionals” have chosen to wear.

*Story varies in accuracy- but the premise is a true story.