Maryland Association of Nursing Students

Patient safety. Your immediate thought was probably not safe nurse-to-patient ratios, and yet it probably should be. Let me guess your next thought. “I’m a student, how does this affect me right now?” While it may not affect the nursing student directly, there are certainly indirect effects; furthermore, the nursing student will only be a student for so long. Eventually, the nursing student will be the nurse. The nurse that, because there are currently no laws (except in California) that limit the number of patients assigned to a nurse, may find him or herself caring for an outrageous number of patients. Not only is this exhausting, it is outright dangerous.

Let’s start with some interesting tidbits. As of today, California is still the only state to have a law that limits patient ratios. There is no similar federal law. California’s law took effect in 2004 and since then, studies have shown fewer deaths,  increased overall job satisfaction, and lower RN burnout rates.

In 2014, the Robert Wood Johnson Foundation cited a statistic that almost one out of five new nurses leaves the profession within the first year of gaining licensure as a nurse. And just in case that isn’t bad enough, one out of three leave the profession within two years (Carlson, 2017). We work so hard, make so many sacrifices, and give up too much (time anybody?) to leave the profession within two years. Nursing burnout is serious and unfortunate, and more must be done to prevent it.

Still think it does not affect you? “Shortages of nursing faculty can also limit the number of students accepted into accredited nursing programs,” (Carlson, 2017). You could have been denied admission into the program you are currently in. Someone you know could have to wait an extra semester or two to be admitted into a program.

Now, I hope you are wondering what you can do. To which I say, make your voice heard. Get involved. Join your school’s student nurse association. Join the National Student Nurse Association (NSNA) and consequently the state association--Maryland Association of Nursing Students (MANS). Attend lobby nights or action events, such as the MNA’s: Nurses Night in Annapolis.  & of course, VOTE!

References

Blitchok, Amy. (January 6, 2017). Proposed Federal RN Ratios - What You Can Do About It. Retrieved from: https://nurse.org/articles/federal-staffing-ratios/

Carlson, Keith. (November 1, 2017). Nurse-Patient Ratios and Safe Staffing: 10 Ways Nurses Can Lead the Change. Retrieved from: https://nurse.org/articles/nurse-patient-ratios-and-safe-staffing

February is the month we honor African American history. As fellow nursing students, I think it is only befitting to honor the first African American nurse to graduate from a formal nursing program and obtain a professional license. Her name was Mary Eliza Mahoney; she was one of the original 42 students admitted to the New England Hospital for Women and Children training school for nurses. At the age of 34, she became one of the only four graduates to complete the rigorous course successfully.

Mahoney did not stop there, she later became the director of the Howard Orphan Asylum for black children in Long Island, New York. In addition, she was a member of the Nurses Associated Alumnae of the United States and Canada which later became the American Nurses Association (ANA). In 1908, she was the cofounder of the National Association of Colored Graduate Nurses (NACGN). The NACGN later merged with the ANA in 1951. After nearly 40 years as a practicing nurse, Mary Mahoney retired but served the community in other ways. She joined alongside many others to fight for women’s equality. Once again, she became one of the first women to vote in Boston, Massachusetts.

Mahoney’s legacy to serve her community and to help those in need are qualities that describe all nurses. She not only inspired African Americans, she became an inspiration to the nursing profession. Her dedication and passion for nursing set a standard of practice we all believe in today. The NACGN originated an award in her name that the ANA continues to issue to nurses today. The Mary Mahoney award is given to an individual or a group of nurses that contribute in the advancement of equal opportunities in nursing for members of minority groups.

ANA. (2018). American Nurses Association. Retrieved from ANA: http://www.nursingworld.org/FunctionalMenuCategories/AboutANA/Honoring-Nurses/NationalAwardsProgram/MaryMahoney

The American Nurses Association (ANA) issued a challenge called “Healthy Nurse, Healthy Nation” which calls on the 3.6 million nurses in America to improve their health because improving the health of every nurse will improve the health of the nation.

“ANA defines a healthy nurse as one who actively focuses on creating and maintaining a balance and synergy of physical, intellectual, emotional, social, spiritual, personal and professional well-being. A healthy nurse lives life to the fullest capacity, across the wellness/illness continuum; as they become stronger role models, advocate, and educators, personally, for their families their communities and work environments, and ultimately for their patients” (American Nurses Association, 2017).

It is important that a nurse strives to be as healthy as they can be. A healthy nurse is respected by their patient more than an unhealthy nurse, suffers from a lower rate of burnout ,and has better overall health.

A great time to start these healthy habits is during nursing school. As a nursing student, we can start by:

Getting at least 7 hours of sleep every night

Eating well balanced meals

Discover a healthy way to relieve your stress

Avoid smoking and heavy drinking

Improve your time managements skills

Start following proper back safety measures

Find time to do things you enjoy everyday

Make time for family, friends and significant others

Starting these healthy practices in nursing school will help you be a healthy nurse when you graduate and pass NCLEX. Being a healthy nurse is important because patients will see you as a more credible source and excellent role model. For example, a patient will listen to a nurse providing smoking cessation education who does not smoke (or has quit smoking) as opposed to listening to a nurse who still smokes. As healthcare providers, it is important that we demonstrate healthy lifestyle choices for our health in hopes that our patients emulate us, therefore improving their own health

References:

American Nurses Association. (2017). Healthy nurse, healthy nation™. Retrieved November 30, 2017, from American Nurses Association website: http://nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Nurse

 

October is the designated month of Emotional Wellness. Mental and emotional health is paramount for nursing students as they go through the stress of classes as well as the experiences they encounter in the clinical settings. There are things that nursing students will be exposed to during clinicals that they may have never been subjected to before. Although the team at the hospital may complete a debriefing following an event, the nursing student may not be a part of that debriefing. Therefore, the nursing student may need to speak with someone regarding the event to help process what happened and the find a good way to cope with it. This may be another nurse, a clinical instructor, or even a therapist. These are strategies that can be implemented through the rest of the nursing students career as the field of nursing can be very stressful, exhausting, and draining to one’s emotional health. This is why developing good coping mechanisms and implementing them when needed will serve the nursing student well now and in the future.

Second semester nursing students at Harford Community College are required to take mental health. During this clinical rotation, they students learn about clients with mental health disorders and the WRAP plans that were developed to help these clients. If you are unfamiliar with this concept, it was developed by Mary Ellen Copeland, PhD. WRAP stands for Wellness Recovery Action Plan. According to Copeland, it is “a self-designed prevention and wellness process that anyone can use to get well, stay well, and make their life the way they want it to be”. It was developed in 1997 by people that were in the midst of dealing with their own mental and emotional health issues. In searching for a way to meet their own goals and dreams and deal with their own mental and emotional issues, they designed WRAP to accomplish the following:

1) Discover your own simple, safe Wellness Tools

2) Develop a list of things to do every day to stay as well as possible

3) Identify upsetting events, early warning signs, and signs that things have gotten much worse, using Wellness Tools, develop action plans for responding at these times

4) Guide you through the process of developing a Crisis Plan or Advance Directive

5) Introduce you to Post Crisis Planning

When looking at the Wellness Toolbox, think of a list of resources like taking 5 minutes in your car to decompress before you drive home or walk into your house. One may need to take a 20-minutes hot bath with some lavender oil to gain some down time and inner peace. Calling a friend or even meeting them face to face is a great way to connect and feel rejuvenated. Too much time on social media has been shown to have negative consequences related to neck pain, shoulder pain, anxiety, sleep deprivation, insomnia, lack of human interactions, and even suicide. Humans are social people, so take the time to connect to people face to face. Listen when they talk, maintain good eye contact, and show that you are interested in the conversation by exhibiting good body language, and stop looking at your phone while you are trying to connect with people. I know it is a hard thing to do when your brain releases dopamine every time you look at your phone. Although dopamine is not supposed to be addictive, it does play into the pleasure sensation of feeling good. Sometimes putting the phone down and actually engaging with another person has far better outcomes for a person as a whole. You are liable to feel a full range of emotions talking with another person than you would be if you were just using your phone to text or view social media sites. Hugging each other when you part is another excellent way to feel connected and good. If you like to read, then read a book that it simply for pleasure and has absolutely nothing to do with school or studying in any way. Keep a journal or even a sketch book handy for drawing. Take a trip to your local salon for a manicure or pedicure. If money is tight, get some friends together and do each other’s nails. Participate in those affirming activities. Take some time to exercise. Even a daily brisk walk has health benefits. You don’t have to do yoga or lift weights in order to experience the positive effects of exercise. This may be easier said than done, but remember to get adequate sleep. Statistics have shown how important sleep is in keeping your body in balance. If you’re not getting enough sleep, it will also affect your emotional wellness. The easiest thing you can do is do some deep breathing. Smiling is another great thing as it is infectious. If you smile at someone, they will smile back at you. You will feel better about yourself and you may not know just how much the other person needed that smile too.

Some of these tools can be used in the Daily Maintenance Plan as part of doing them every day to maintain that wellness. You may need to take a few minutes every day to decompress. Taking a bath or shower everyday may help you relax and give you a few minutes alone to complete some deep breathing either in preparation for your day or as a way to come down from the day you had. Although you do not need to exercise every day, it may be beneficial to maintaining your daily wellness. Again, it does not have to be yoga unless that is something that you feel is helpful. Learn to recognize triggers that make you feel uncomfortable. Although these are normal reactions, not dealing with them may cause you to feel worse. Learning those good coping mechanisms and using our support systems are good ways to maintain that emotional wellness. Look for those early warning signs that let you know that things are not getting better. If you are feeling worse, then action needs to be taken before things break down. If it does get to that point, make a list of signs that let you know that you are feeling much worse. Like feeling sad all the time, not wanting to take care of one’s own personal hygiene, lack of appetite, unexplained weight loss, insomnia, etc. Although most of the nursing student population will most likely not end up needing the Crisis Plan and Post-Crisis Planning part of WRAP, it is not a bad idea to reach out to people that could help reduce our stress or complete tasks to alleviate some of the stress that we are feeling. It never hurts to ask for help.

When we talk about maintaining balance and emotional wellness, it is not always an easy feat. Nursing student’s schedules are crazy and clinicals tend to be long days without a lot of down time. Maintaining an emotional balance will take some planning. Just like studying and preparing to become nurses is crucial, so is maintaining one’s own emotional wellness. Just remember that we can’t take care of others if we don’t first take care of ourselves. So, take the time to support your own emotional health.

 

References

Copeland, PhD, Mary Ellen. WRAP. 2016. October 2017. .

Karadkar, Abhishek. "The impact of social media inthe student life." Technician , 13 September 2015. October 2017.

Weinschenk, PhD, Susan. "Why we are all addicted to texts, Twitter and Google." Psychology Today (2012). October 2017.

 

 

It’s 0700 and you are writing down your assignment for the shift; everyone is bustling around from room to room, call lights are lit up like Christmas trees, and the occasional bed or chair alarm sounds for the patients who forget to call for assistance before they get up to go to the bathroom. Somehow, during the short ‘lull’ in activity on the floor, the night nurse has time to give you report on the full assignment she is passing off to you. After you go from room to room with the night nurse to do your bedside shift report, you realize that you not only have a full assignment, but most of your patients are heavy assist to turn in bed or get from bed to chair. The day continues to be extremely busy, and you have a bariatric patient that is on Lasix that has saturated the bed. You have called the nurses on either side of the hall several times and each time they have told you they’re ‘too busy’ to help you get this patient cleaned up and perform an occupied bed change. You are running behind schedule and figure that you’re young and healthy, so getting this patient cleaned up can’t be too hard of an individual task, right? As you’re half way in, you give one hard tug on the shear sheet to get them repositioned better so you can slide the old linens underneath them and start to put the new linens on the other half of the bed. Mid-heave you hear a “POP” in your lower back, and quickly let the patient down. You step back and double over, clutching your injury. You take a deep breath and try to return to your task, but that nagging pain in your lower back is just too intense to allow you to generate enough strength to turn this patient again. You finally get the charge nurse to help you finish up, and then you move on to the next task. Hours later it is finally 1900 and the nightshift starts to file in; as you give your handoff to the night nurse, that same back pain is in full force. She notices your discomfort, asks you if you’re okay and proceeds to tell you to follow up with employee health as soon as possible. You downplay your injury and tell her it’s no big deal because you have a few days off and figure that your back will heal and you’ll be good as new for your next shift.

Unfortunately, the above scenario is all too common. The problem with this response to back injury is that it often does not heal itself; each time you injure your back it needs adequate time to heal properly. The recommended time of recess from activities that aggravate the injury and the follow up treatment is something that, unfortunately, is not conducive to the average nurse’s work schedule. This is when we enter that dreadful cycle of re-injuring our back, aggravating that injury repeatedly, and giving rise to a back problem that becomes chronic and negatively affects your quality of life. According to the ANA, nursing personnel are among the highest at risk for musculoskeletal disorders compared to other occupations (ANA, 2000). Among these general musculoskeletal disorders, lower back pain actually tops the list. But the consequences that result from back injuries don’t just stop at acute or chronic pain it causes the injured individual. The incidence of hospital workers missing time from work due back pain result in 90.1 days per 10,000 full time workers (ANA, 2000). Chronic musculoskeletal injuries also cause nurses’ early retirement, change in career, change in unit/position, and accidents at work due to chronic injury flare-ups that limit or impair the level of patient care given. Fifty-two percent of currently employed nurses complain of chronic back pain, 12% nurses permanently leave their place of employment due to back pain as a contributing factor, 20% of nurses have transferred to a different unit, a different position, or completely leave the profession due to back pain. Relatedly, 38% nurses suffered severe occupational-related back pain that actually required them to leave work and 25% nurses have changed jobs due to other occupational related injuries [6%-neck, 8%-shoulder, 11%-(non-lower) back] (Handle with Care Fact Sheet, 2017).

It is important to understand that although we can work hard to significantly decrease the number of back injuries in the workplace, it is impossible to fully eliminate them. We must take the proper steps to protect our backs and preserve our physical health for many years to come. Here are a few things to keep in mind when providing patient care, transferring, or turning a patient in order to do so safely, that I learned in Anne Arundel Medical Center’s Safe Lifting Class during New Employee Orientation:

• Always use the proper equipment [safely] when transferring or turning a patient; there are mechanical lifts and specialized bed features that are in place to lessen or eliminate the physical stress off of both you and the patient.

• Always recruit another co-worker (tech, CNA, GNA, nurse, PT/OT, PT/OT-Aid) when needed- no matter how easy you may think the task is. Be firm when you ask for help or ask if the individual can meet you at a convenient time to assist with the task, your assertive approach will save your back for many years to come.

• When assessing the amount of assistance needed “underestimate” your strength; don’t try to transfer/ambulate patients alone if you will bear more than 25% of the weight.

• Use correct posture when lifting a patient; bend your knees, don’t twist at the waist, don’t make sudden, jerking movements.

• Set things up prior to the transfer or task so everything is close, within reach, and ready.

• Listen to your body; if you have an existing injury or limitation take that into consideration before performing a task that may exacerbate it.

As mentioned before, sometimes you can do everything correct and somehow still injure your back. If you do sustain injury, never down play it regardless of the circumstances! Go directly to Employee Health, the ER, or an urgent care center. This also must be reported to the Charge Nurse and filed with your place of employment so it is documented. If you sustain your injury during clinical, immediately alert your clinical instructor, follow their directions, and take the necessary follow up steps as written in your school’s clinical handbook. Sometimes injuries worsen throughout the day or night and become debilitating and you need further care or extended time off work or clinical, having this case documented with your facility means you will not be alone in taking care of this injury sustained at the workplace. Make sure the incidence is documented and follow up with your instructor and clinical liaisons to avoid any repercussions for absence or to receive an alternative assignment if needed. Follow the healthcare provider’s instructions after your visit; it’s better to get imaging done (if needed), do therapy, and take a few weeks off to fully recover, than to re-injure yourself if you return too soon. You could end up taking a few months off and gaining a chronic injury that will affect your job forever if you are non-compliant. Finally, think of your patients! Your level of care you provide for them and their comfort is directly affected by your decisions and your health. If you know you have a chronic injury or limitation, don’t wait until you drop someone or cause them harm “because your back gave out” to address the problem; be realistic and make safe decisions. Use assistance whenever necessary to lessen the stress you’ll be putting on them and to make things go smoothly and gentler (such as turning or pulling someone up in bed).

Overall, the best way to combat this situation is to protect your back in order to prevent injury; practice safe lifting and always use help when necessary. As we have been continuously reminded at least once in every nursing class: the best first-line weapon against illness or injury is prevention. Respect your back, you need it!

 

 

 

 

References:

 

Handle with care fact sheet. (2017). American Nurses Association. Retrieved September 9, 2017. Retrieved from American Nurses Association website. http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/Factsheets-and- Toolkits/FactSheet.html

Maryland Nurses Association:

http://www.marylandrn.org/

June, K.J., Cho, S.H. (July 28, 2010). Low back pain and work-related factors among nurses in intensive care units. Journal of Clinical Nursing, Volume (20), Pages 479-487. doi: 10.1111/j.1365- 2702.2010.03210.x. Accessed September 9, 2017.

Yassi, A., Lockhart, K. (December 3, 2013). Work-relatedness of low back pain in nursing personnel: A systematic review. International Journal of Occupational and International Health, Volume (19), Pages 233-244. doi: 10.1179/2049396713Y.0000000027. Accessed September 9, 2017.

 

As nursing students, nurses, or a combination of the two, we are known to frequently put our own needs last when it comes to time management and prioritization of tasks. Between class, clinical, studying, preparing for class/clinical, work, extracurriculars, etc. it may seem as though we barely have time to breathe let alone do something for ourselves like watch a movie, exercise or even sit down to eat a nice meal.

Starting with our first semester as nursing students, we learn about Maslow’s Hierarchy of Needs. We learn that in order to make it up the hierarchy we must fulfill the needs from the bottom upward and only then will the patient be able to reach self-actualization, achieving his/her full potential (Perry, Potter, Stockert, & Hall, 2016). But what about us as nursing students and/or nurses? Are we ensuring that all of our needs are met so that we also can reach self-actualization? You may recall that at the bottom of the pyramid is physiological needs: food, water, warmth, and rest. Are you ensuring that those four things are always met for yourself on a daily basis? If not, you are not going to be able to reach your full potential. Without reaching your full potential, you are doing yourself a disservice and your patients. Nursing students and nurses need to take care of themselves just as much as they take care of their patients so that we have the cognitive and physiological ability to pick up on small cues and assist patients as needed. In this article, you will learn a couple basic ways that you can help take care of yourself and be a better student and/or nurse.

To start things off, let’s start at the bottom of the pyramid with food. Eating a well balanced diet is one of the best things we can do for ourselves. Food is what fuels us for those long nights of studying and those 12 hour shifts. You will see students and nurses all the time living off of a couple bites of junk food that they get out of a vending machine since they perceive their day as too short to sit down and eat a meal. In reality, sitting down to eat a well-balanced meal will actually give you more time in your day. According to Taro (2017), a well-balanced meal full of whole grains, lean protein, and fruits and vegetables will provide sustained energy until your next meal. With more energy you will be moving faster and be more efficient than if you were with only a bag of chips in your stomach from the vending machine. Not to mention the energy crash that you would get from vending machine food. To put it in a nursing student or nurse mindframe, we always need to consider our long-term and short-term goals. Short-term you do not want to be hungry and long-term you want to have energy and make it through your tasks for the day. The best way to meet those goals is to eat a well-balanced meal and forgo the vending machine.

I’m sure that the majority, if not everyone reading this article love to sleep, I know I do. Getting a good night’s rest during nursing school is one of those things that we know that we want, but hardly ever get a full, recommended 8 hours. Often times, students will sacrifice a few hours here and there so that they can study or get a couple things done that they couldn’t get to earlier in the day. But again you are doing yourself and your patients a disservice by not being well rested. According to Caruso (2014), nurses who do not get enough sleep have been shown to make more errors. We all go into this profession to help save lives and care for others, but how can we do that if we are missing subtle changes in a patient’s health status since we are sleepy? According to Rasch and Born (2013), when it comes to retaining information, you are much less likely to be able to do so when you haven’t got a full night’s rest. Sleep is not something that anyone should sacrifice in order to get other things done. If you do, you could be putting your life and your patient’s life in jeopardy.

My last self-care basic is exercise. Now I know, right now you are probably thinking “ha, yeah right. When do I have the time or energy to do that?” Well let me be the first to say, you do! If you follow the other two basics that were explained prior, you’re on the right track to having the energy needed to exercise, now we just need to work on the time aspect. Time management is key whether you are a nursing student, a nurse, or a stay at home mom. We all need to map out our tasks, prioritize them and organize them throughout our day, this way we do not end up sitting on the couch for an hour scrolling through IG, Snapchat, or Facebook and wonder where our day went. If you map out your day, you will always know what you should be doing and when. And this doesn’t mean that you keep yourself busy all day everyday. Remember, this article is about self-care, so throw in some things that you like, like maybe a half hour for one of your favorite shows or 20 minutes to go on a walk with your dog. By doing this, you will also be able to include 30 minutes of exercise, 3-5 times a week, not to mention, since you are using your time more efficiently, you will be able to incorporate 8 hours of sleep each night. My favorite time to exercise is in between studying. This way I not only get a much needed break to clear my head, but exercise is good for the brain. Getting more blood to your brain increases oxygen to cerebral tissues, which helps you retain information.

Now that you know some of the basic ways to care for yourself and why it is so important for you to ensure that you are meeting these basic needs, I hope that you take this information and incorporate it into your daily life. It will not only help you take care of yourself, but it will help you meet your physiological needs so that you can be on your way to achieving self-actualization and your full potential.

References

Caruso, C. C., (2014). Negative Impact of Shiftwork and Long Hours. Rehabilitation Nursing,

39(1), 16-25.

doi:10.1002/rnj.107.

Gidus, Taro., (July 2017). Eating to Boost Energy. Academy of Nutrition and Dietetics. Retrieved from

http://www.eatright.org/resource/food/nutrition/healthy-eating/eating-to-boost-energy

Perry, P., Potter, P., Stockert, P., Hall, A., (2016). Fundamentals of Nursing. St. Louis, MO: Elsevier.

Rasch, B. & Born, J., About Sleep's Role in Memory. Physiological Reviews. 93(2): 681–766.

doi:10.1152/physrev.00032.2012

American Healthcare Act: Republicans have released the much anticipated repeal for the Affordable Care Act (Obamacare). Key points of the bill:

1. Cancels penalties on people who don’t purchase private insurance and companies that don’t offer insurance for their employees

2. Cancels direct subsidies to lower and middle income Americans to buy insurance, replacing it with tax credits based on income and age

3. Broadens terms governing personal Health Savings Accounts, allowing flexibility for people to save and spend pre-taxed income on their own healthcare

4. Rolls back Medicaid (government program that insures the poor and disabled, including children).

5. Grants funds to states that have not expanded Medicaid to aid in state designed health care plans

6. Allows parents to keep children on healthcare plans until 26 years of age.

7. Mandates insurers to cover people with preexisting conditions but allows companies to apply a surcharge to those determined to have a gap in coverage.

How will you make an impact in ensuring that patients are awarded adequate healthcare? Contact your representative today and mandate that they speak up against this new plan.

Activity: Download Countable - allows you to gain a better understanding of legislation that is being voted on; allows you to connect with your congressperson if they have countable. You can even send video chats!

It's been a busy New Year already on Capital Hill and with the new year comes new issues, policies and health news. The Legislative Spotlight aims to bring you up-to-date information on latest government issues, especially in the realm of health care. We hope that it moves you enough to speak up, speak out and get involved as the voice of nursing students is vital in creating change. Share your thoughts, solutions and most importantly let your voice be heard!

January Spotlight: Congress is headed full force in the direction of cutting the Affordable Care Act (ACA) for many Americans. The ACA will be repealed with no proposed solution to take its place. This will leave as many as 30 million Americans without healthcare. As a trusted profession, nurses and nursing students alike can make a difference by advocating for patients by sending a message to Congress letting them know that we will not stand by and allow our patients to lose access to care. To be done effectively, follow steps below.

1. Find my representative: http://www.house.gov/representatives/find/

2. Type in address

3. Call representative’s district office

4. Let them know you would like to make a statement

1) Example: “I am a nursing student from your district and I would like for Rep.___ to oppose all attempts to repeal of the Affordable Care Act.

2) If you have a personal story you can also ask If the office taking personal testimonies of how people are impacted by the ACA (if yes, proceed with story if you have one)

5. Ask if the representative has made a public statement to oppose all efforts to repeal the Affordable Care Act

Written by Obianuju Chikwere, Legislative Chair

Myth: Nursing is an easy job; anyone can do it.

Truth: Nursing is a very challenging profession and can take its toll: emotionally and/or physically on the nurse. Working 12-hr shifts on your feet for long periods of time can be physically exhausting. Connecting with patients and families emotionally during a difficult time can be draining. Nursing isn’t an easy job but it is an incredibly rewarding career.

https://www.instagram.com/p/BMXo9uXDuIs/?taken-by=md_nursing_students