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    L Jane Acree

Save Lives in the Air – Flight Nurse

Does saving lives give you an absolute adrenalin rush? Do you love being the one in charge? Then flight nursing might be perfect for you!

What is Flight Nursing? Flight nurses transport unstable trauma or medical patients in critical condition, either in helicopters or fixed-wing planes, for military or civilian entities. Their expected skill level far exceeds that of typical ED nurses.

What do flight nurses do on scene? They may need to perform physician-level procedures to save lives in the air. Their training is extensive and gains them respect.

On arrival to an accident, the flight nurse typically takes charge of the scene. They utilize ground support to assure optimal stabilization and then quickly transport.

What special skills would I need? The flight nurse is a one-man-show in the air. You arehelicopter responsible for every aspect of patient survival. Per established protocols, you will administer medications, perform ACLS, and other first aid procedures to get the patient to hospital alive.

You may even have to insert femoral lines or chest tubes in flight – once you are qualified.

Where do flight nurses work? They typically work out of hospital emergency departments, trauma centers, fire departments, search & rescue outfits, or independent med-evac companies. Military flight nurses are generally stationed in war zones.

How will I know if I would like this field? A few years working in a busy emergency department or large ICU will give you a great education and enough experience to know if you want to remain in emergency nursing. A few life flight trips, as an observer, will cinch it for you.

How much do flight nurses get paid? One website (nursetheory.com) reported $55,000-$85,000.  (payscale.com) reports pay as high as $94,858/yr which includes bonuses. This could vary significantly according to many factors.

How do I become a flight nurse? Once you have your nursing degree, and have a few years  experience working in critical care, you can earn your advanced degree in emergency nursing.

When you are ready, you can sit for the Certified Flight Registered Nurse Examination. Be sure to get trained and certified in as many aspects of flight nursing as possible.

This might include earning your Certified Emergency Nurse (CEN), Certified Critical Care Nurse (CCRN), and Paramedic (EMT-P). Also keep your ACLS current, study Air-Medical Crew National Standard Curriculum, and take an Altitude Physiology Course.

You also want to take these courses: Trauma Nurse Core Course (TNCC), Basic Trauma Life Support (BTLS), Pre-Hospital Advanced Life Support (PHALS), Pediatric Advanced Life Support (PALS), Neonatal Resuscitation Course (NRS), and Critical Incident Stress Debriefing (CISD).

For military personnel, it is the same – plus there is additional, specialized, military training required.


Retention rate in this field is high and turnover is low. So, be  patient, and use your great networking skills to get an inside track for the next opening.

Keep your body in shape and have healthy, fun, outlets outside the job to keep your balance for the long haul.

If your heart thrills to save lives at all costs, then flight nursing might be just right for you!







Forensic Nursing

Do you love a mystery? Enjoy watching CSI? Then this field might be just the ticket for you!

What is Forensic Nursing? Forensic nurses collect physical evidence from crime victims, conduct interviews, address emotional reactions to violence, educate, conduct research, and more. They are specially trained to work hand-in-hand with law enforcement and victims/patients.

Forensic nurses may participate in death investigations, sexual assault victim examinations, elder abuse exams, family support, and child advocacy.

What exactly do forensic nurses do? In short, your job would be to solve crimes and catch criminals.forensic investigation

You could expect to be quite self-directed to conduct interviews, collect and manage specimens, take pictures, measure wounds, and analyze evidence.

You would likely be involved with interpersonal violence, emergency and trauma services, patient care facility problems, public health and safety, and death investigations.

What special skills would I need? The forensic nurse should be a good problem solver, critical thinker, have excellent research and communication skills, have a mastery of technical terms, be able to explain in lay-man’s terms, be an advocate for victims, and convey compassion.

They work not only with victims and their families but may also work with confined perpetrators.

Where do forensic nurses work? They typically work in hospital emergency departments, laboratories, or courts of law. But some may decide to advance to become an independent forensic nurse consultant or an international practitioner.

What experience would help me to know if I would like this field? Three to five years experience as an RN (or a lesser period combined with prior SANE, emergency or OB/GYN experience), nursing experience with sexual assault/survivors or victims of violence, and experience in psychiatric nursing would help you a lot.

How much do forensic nurses get paid? One website reported earnings of $1-$4 per hour more than regular nurses with training, education, experience, geographic location all affecting pay.

Another website said the median salary for a forensic nurse is $39/hour ($81,800/year) with a range from around $50,000/year to around $140,000.

How do I become a forensic nurse? Depending on your nursing experience, budget, amount of free time to study, and desired future income, you may wish to obtain certification or take a graduate level course in this specialty.

There are over 500 clinical forensic programs available as well as certificate programs. And Sexual Assault Nurse Examiner (SANE) training will be a very important part of your training.

The International Association of Forensic Nursing (www.iafn.org) offers two certifications  — the Sexual Assault Nurse Examiner (SANE-A/SANE-P) certificate and the Advanced Forensic Nursing (AFN-BC) certificate. Certification may be optional – depending on your preferences and what your employer expects.

Anyone entering this field should understand that it can be very emotionally demanding. You will be dealing with the traumatic effects of violence on a daily basis.

You will need to keep your compassion tank full and the analytical side of your brain fully charged. But the rewards are tremendous for those cut out for this kind  of work.















Safe Drinking Water After a Disaster

pics from phone 005Let’s pretend that a natural disaster befell your city. If you live in the Gulf Coast area, it would likely be a hurricane. Some other places might experience volcanoes, avalanches, tornadoes, floods, fires, earthquakes, tsunamis, or other catastrophes.

Whatever your region, most people will rush to the stores when they learn something is coming (or just after it hits.) Am I right? I know. I have done it. And I have found store shelves nearly bare.

But some prepare in advance. They pack a go-bag with their most important documents, medicines, photographs, clothes, food, and other essentials.

If you are a nurse, and most of the readers here are, then you probably prioritize your disaster preparing a little differently than others.

As plumbers and electricians scramble to save their favorite tools, you rush to make sure your first-aid kit is stocked with life-saving gear for any calamity that comes along.

You, as nurses, know that safe drinking water is often one of the biggest problems people face after a disaster. And you know how important safe water is for drinking and washing the inevitable injuries that always seem to accompany such situations.

So of course, you will, of course, have some type of water purification device in your kit – sufficient for your own family and probably extra for neighbors. After all, you are the nurse. Family, friends, and neighbors depend on you to help them with problems that are overwhelming to them – but are a piece of cake for you.

So go ahead and drink that nasty water. LifeStraw Personal Water Filter and LifeStraw Family 1.0 Water Purifier will make it safe. I know. It sounds unappetizing now. But when all heck breaks loose, you’ll be glad you are prepared – and so will all those that you save alive.

After all – that’s what you do. You’re a nurse.


Calling All Nurse Preppers

026Nurses, like all people, watch the news. And we don’t like to think about it, but local and national disasters are always possible. And we all know that economic collapse and utter chaos have been predicted for the near future.

Some believe societal breakdown is imminent. (Probable) presidential candidate, Ben Carson, states that this country might not even have a presidential election in 2016 because we may be under martial-law by then.

Whether we reach that level or not, hurricanes, earthquakes, fires, and floods are always possible. When Hurricane Rita came through the Houston area, most of us had not stocked up, and stores were shut down. So what will you do, as a nurse, to prepare?

If your family found itself in a position where supplies and utilities were cut off for an undetermined amount of time, and if medications and gasoline became unavailable – do you have a plan?

As flight attendants say: “put on your own oxygen mask before helping others.” In other words, prepare for yourself and your family first. Then consider banding together with your best friends/neighbors so they can add their strength.

Before the store shelves are empty and utilities are out, Maslow has already taught us how to prioritize our prepping as to – fresh air, potable water, food, shelter – in that order.

Your network of family and close neighbors will likely count on you to treat injuries and illnesses. So what will you want to prepare along the lines of basic first-aid supplies and a way to clean wounds?

People have learned a lot about how some essential oils and other elements can substitute for medications to bring down blood pressure or fever and to heal cuts and prevent infection, etc. So that could prove helpful.

You may be the only one around with any real training to treat the sick and injured. You may not have ever done certain procedures before, but you know the A&P and may have to do the unfamiliar.

People panic in a crisis and begin to loot and pillage those suspected of having food and supplies. So you might want to consider obtaining weapons and ammo in order to respond and save your family alive.

I know. “First, do no harm.” But, in desperate times, danger is a genuine possibility that needs to be thought through and discussed in advance. And if they are trying to harm you or your kids, you might have no choice.

There is a lot to learn about getting and staying prepared – especially for people in the healthcare field. And I have a new website coming soon which will address the various aspects of what prepping looks like for nurses and other humans – especially for small home or apartment dwellers.

I hope you will stop by there and take a look. As soon as it is “born”, its name will be http://www.apartmentpreppers.com .I’ll keep you posted here and on my facebook page: http://www.facebook.com/whatmotivatesanurse !


See no Ebola, Hear no Ebola, Speak no Ebola

016“The Nurse Killer Disease” is Ebola’s nickname in Liberia. And its coming to a hospital near you. Will your hospital be ready?

According to National Nurses United conference call today, and reports all over the country, and abroad, hospitals are NOT prepared for Ebola – not at all.

Why is there no political support? Talking heads just keep talking.

Why do hospitals have no mandated training, no consistent guidelines or policies, no protocols, no adequate PPE or  hands-on training with practice?

Why are potentially adequate hospital isolation rooms not being reserved for Ebola cases – in favor of totally inappropriate rooms?

Why is a nurse being fired, for calling CDC to get advice on how to handle a potential Ebola case, in the name of a HIPPA violation?

How can hospitals get housekeeping to clean Ebola rooms adequately and dispose of used PPE and other waste from those rooms?

How many nurses will die and transfer EVD to others because of hospitals denying adequate training and appropriate PPE?

Per one of the expert speakers – whether or not EVD is classified as being transmitted by aerosol, the EV is now known to demonstrate an affinity to macrophages in the respiratory system where it replicates itself. Tiny particles become airborne as copious sprays of emesis and stool are broadcast. So whether or not the affected person develops respiratory symptoms, inhalation still could have been the mode of transmission.

Donning and removing PPE is, of course, the most vulnerable time. PPE needs to be impermeable. Rooms need to be negative pressure.

Caregivers need to wear respirators – not surgical masks. Preparadigm N-95 respirator is recommended underneath impermeable PPE that covers all. Massive supplies will be sorely needed.

Don’t let your hospital get away with saying that traditional contact isolation gear will protect you. Band together and insist.

If a member of the management team had to enter the room of an Ebola patient, you can bet your bottom-dollar that they would put on the best quality hazmat suit known to man.

Well-known, retired pediatric brain surgeon, Dr. Ben Carson, said: “I have no desire to induce panic, but we must realize that some viruses are known to undergo mutations, which make them even more virulent. If the Ebola virus becomes even more pathologic, the ensuing panic and destruction of human life could go far beyond what is currently being acknowledged…”

Fear, fear, fear, fear, fear. It can paralyze us, or it can push us to action.

Where will help come from? It may need to come from you. Here is your time to shine. Be passionate. Be heard. This is life or death – seriously.

More is being learned daily about Ebola. Know and practice at least the currently accepted CDC protocols found at www.cdc.gov .

The National Nurses United website has created a marvelous “toolkit” that is a must-see for all nurses: http://www.nationalnursesunited.org/pages/nnu-nurses-toolkit . It is a great place to start as you arm yourself with critical information.

If you see a breach of safety, call NNU at: 1-888-381-4585. They promise to keep your call as confidential as possible.

When given a chance to use more – or less – PPE, choose MORE. Cover it ALL up, baby!

L’Chaim! (To LIFE!)

What Surprising Factor Drives Patient Satisfaction Scores?

Patient satisfaction scores RULE. Nurses are constantly being told to change aspects of their practice, in order to raise “those sacred scores.”

But what is the number one underlying factor influencing the scores that patients give?

Just to validate surveys for a second – most of us appreciate honest feedback. Even in personal friendships, we like to know if what we offer to the relationship is beneficial. Feedback gives us a chance to alter our future behaviors – or not.

Not surprisingly, because of their effectiveness, satisfaction surveys are widespread – not just for hospitals. Most businesses ask customers to participate in their surveys.

Why? Because the results are valuable to competition and business growth. Survey Monkey says its all about patients/customers receiving what they expect.Scan0004

Of course you know patients want to feel that you know them very well. They like for you to speak to them in plain language, and to make sure they really understand the content and how to apply it. They also want to feel your positive attitude and see great teamwork.

Am I saying that its all about YOU? YES! I am saying it is all about YOU.

You are the one they have to trust with their lives and well-being for 12 hours. You are the one they hope will get their medicine right, keep them safe, advocate for them, and promote their healing with knowledge, compassion and honesty.

They are trusting their lives to you. What an honor!

But what makes YOU feel positive and work well with your team? Had you thought about how much your own feelings about your work directly influence your patients’ perception of their own safety?

In other words, do you and your nurse managers realize how closely YOUR satisfaction is linked to your patients’ satisfaction scores?

Not surprisingly, according to Science Direct, a strong correlation was found between poor patient satisfaction surveys and burned out nurses.

Patients who had nurses who were exhausted and ready to quit gave negative scores. Conversely, patients cared for by nurses who found their work meaningful, gave higher scores on their surveys.

The bottom line seems to be that, “IF MAMMA AIN’T HAPPY, THEN AIN’T NOBODY HAPPY!”

In other words, if nurses are not happy, and no longer view their job as meaningful, the patients will sense it and feel less confident that they are getting the best care possible. Studies across the globe have found this true, as you will see in the article in thebmj .

So, for floor nurses and nurse managers alike, “THE SURVEY SAYS”: Patient satisfaction = nurse job satisfaction. Food for thought, eh?


Sources for this article:

Survey Monkey

The Profitable Practice

Science Direct

The bmj

For more information, see:

Love Your Patients! Improving Patient Satisfaction with Essential Behaviors That Enrich the Lives of Patients and Professionals
TIME to CARE: How to love your patients and your job
How to Survive and Maybe Even Love Your Life as a Nurse

Retiring Boomers – Want a Brain-Dead-Simple Plan?

Finances after fifty – yes, you have more buying power than any other generation alive. But here is what credit card companies and other lenders don’t want you to take seriously. In reality, this might be catch up time for many.

But who feels like dealing with it? When you’re short on time and energy, what brain-dead-simple retirement solution can you put into place FAST?

And where should you begin?

  1. First, decide to get serious about it. Start with what you know. Use the Nursing Process.
  2. Assess. Inventory your assets and debts. Include how much time and money you might have to pay to help your elderly parents. Remember Dave Ramsey’s asset calculator which is free for your use.
  3. Diagnose. How bad/good is it?
  4. Plan. Set a financial goal and a time frame in which to reach it. Remember that you might live longer than you expect.
  5. Implement.
    • Tweak things in your life to: make more money, spend less, and save/invest more.IMG_0078
    • Do you still need that big home and new car? Can you save more if you downsize and get rid of your monthly interest-charging bills?
    • Tell your family you will be cutting way back on holiday gift spending.
    • Prepay your funeral expenses. You certainly don’t want your grief-stricken, vulnerable loved ones to pay extra to a hungry salesmen at the funeral home – especially if you haven’t made your wishes known. (I wrote another article, called “What Motivates a Nurse to Prepay Final Expenses”, in May of last year, that you can check out if you want more detail on that.)
    • Decide if you should work extra shifts or take a second job for a year or two? Is there a hobby you love that has earning potential? Many Boomers are moving into business.
  6. Evaluate. Calculate your progress so far. (Like Dr. Phil says – “How’s that working out for you?”)
  7. Start over with another assessment.

Here is a great basic starting point: The Charles Schwab Guide to Finances After Fifty: Answers to Your Most Important Money Questions .

Many nurses have scoped out the other, less strenuous, jobs at their hospital and learned how to fill those positions when the time is right. Why Retire?: Career Strategies for Third-Age Nurses .

There are so many productive ways to keep busy and find meaning after retirement. Portfolio Life: The New Path to Work, Purpose, and Passion After 50 .

Many Boomer nurses dream of creating their own business after they retire from the hospital. Boomers into Business: How Anyone Over 50 Can Turn What They Know into Dough Before and After Retirement .

So, any person can do this – even if they feel brain-dead sometimes. Here is a way to make it more interactive: Quicken Financial Planner, QuickPlan Edition .

So you see? Boomer nurses’ retirement planning is so simple! Just do what you’ve been doing it all of your nursing career – using the Nursing Process.

What do you love? Go for it! Let your excitement for a bright new future come alive!



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