EP 144: What to do After You Graduate Nursing School

EP 144: What to do After You Graduate Nursing School

Things to Know After Nursing School

Life after you graduate nursing school seems a bit overwhelming, but with proper guidance and helpful tips, you can manage it too.

Where do you want to work? What are the key takeaways from nursing school? What do you need before you step into the unit? It can be tricky to find the right opportunity.

To ensure you are happy with your first decision, take your time and explore the market to learn about the types of opportunities that will be best for your career goals.

Understanding Different Opportunities

Finding a hospital to work in after you graduate from nursing school is often the main goal of many nursing graduates to start their careers.

A common misconception for new graduates is that hospitals are the only options available to them. 

Healthcare settings can include:

  • Home care
  • Long term care
  • Clinics

Other career opportunities (non-bedside): Legal Nurse Consultant, Hospice Nurse, Public Health Nurse, Occupational Nurse, Dialysis Nurse, Nurse Educator 

Research the facility you will be applying for to learn more about the role you’re applying for. Answer the following questions:

  • What are the facility’s mission, vision, and values? 
  • Do you know what the facility’s designation is? 
  • What population do they serve? 
  • Do you know if they have been awarded or recognized?

Different Units – What Unit Do You Want to Work On?

  1. How would you describe yourself? 
    • Lead the team?
    • Do you love to collab?
    • Do you work best alone?
  2. What does your ideal workday look like? 
    • Consistent, likes to plan ahead?
    • Something new every day to keep you on your toes?
    • A mix of this and that?
  3. Who is your ideal patient?
    • Elderly, acutely ill, new mom and infant, children?
  4. When it comes to patients, the best way you can help is?
    • Training and educating other nurses
    • Face-to-face interactions

When you land your first job after you graduate from nursing school, it might be your ideal unit.

You can use this opportunity as a stepping stone to advance internally up the specialty ladder.

For example, starting in Med/Surg, then working up to PCCU, and then ICU. Other managers and supervisors can notice you and help you cross-train to their unit. 

Utilizing your Network and Resources 

Since you can’t rely on years of professional experience to land your new gig, using your network to get your foot in the door is your next best option.

After you graduate nursing school, many nursing schools also have a network to help with different employment available for you before deciding on your first job. While doing clinical rotations, you can also inquire about opportunities. 

Build your support network early on, as they can offer advice, guidance, and job leads. You can start by getting all your classmates and professors’ email addresses. 

Job fairs are another great way to look for opportunities. At a nursing job fair, you can meet with dozens of prospective employers in a single day instead of sending out stacks of resumes and waiting weeks for a response.

If you’re unfamiliar with which facilities are hiring, you can consider major job boards such as Indeed, Linkedin, and Hired. 

Tips on using jobs board effectively:

  • Make sure your Linkedin profile and resume are congruent. 
    • Adding new responsibilities and new volunteer opportunities you’ve taken
  • Be attentive to the language you’re using in your profile resume
    • Mirror the language of job listings that interest you in your profile and resume/
  • Don’t be afraid to reach out directly
    • Most job boards won’t list direct information to employers but that doesn’t mean you can’t reach out with a follow-up email about your application. The human connection can be the deciding factor.

Clean Up your Social Media Account

Have appropriate profile photos on all accounts.

  • Edit the biographies, headings, and descriptions to reflect a professional manner.
  • Run a Google search on your first and last name. Make sure all photos are appropriate. 
  • Change your privacy settings to private if you do not want potential employers to view your social media profiles and photos. 

Preparing for Your Interviews

The purpose of the interview is to determine if they like you and whether you’re a good fit for their team. Nursing is a team effort.

They also want to see if you’re as good as you seem on paper and can help them reach their goals as an organization.

Tip: Treat the interview like a conversation where both candidate and employer have a shared goal of getting to know each other. 

You’ll be spending a lot of time at work, so make sure your core values align, and it’s an enjoyable work environment – not just tolerable. 

Prescreen phone interview for nurses – Usually the first step of the hiring process. The goal is to reduce the number of candidates and invite the best-fitting candidates for the next step. 

They’ll ask basic qualifying questions about:

  • Education
  • Employment status
  • Clinical experience
  • Goals

Tip: Know your availability, as the goal is to invite you for an in-person interview. Also, ask about the next steps, don’t get off the phone and wonder what’s next. 

The Interview 

This will be your first opportunity to meet the hiring manager or the unit. Ultimately, they are determining if they personally like you.

No one wants to work with a negative Nancy. This includes a number of things:

  • How they feel about you
  • How you’ll fit within their unit
  • Your level of enthusiasm
  • How your strengths can help them reach their goals

During this time, or maybe for the next interview, you will undergo a panel/peer interview which will include multiple people, usually from the unit, to help the hiring manager pick the best candidate.

We advise maintaining good eye contact with everyone, engaging in conversation with the entire group, sharing your personal stories, and smiling. 

Before the interview, make sure you understand yourself.

Your strengths and weaknesses, the experiences you’ve had in clinical settings. 

  1. What is your 5-year goal? 
  2. Teamwork: Talk about a conflict within your healthcare team. What was the conflict, and how did you handle it?
  3. Patient care: Tell me about a time when a patient’s family was dissatisfied with your care. How did you handle that situation? 
  4. Time management: Talk about a time you worked in a fast-paced setting. How do you prioritize tasks while maintaining excellent patient care?

Tip: Be a storyteller. Storytelling is powerful and memorable. Most importantly, it provides evidence to support the assertions made in your resume.

It gives the employer a glimpse at the type of nurse and human being you are.

What to Buy Before You Enter the Unit

  • Click pens
  • Penlight 
  • Nursing scissors
  • Good scrubs
  • Right shoes
  • Stethoscope

Giving End of Shift Report

An end-of-shift report is a detailed report of your patients and their overall care and medical status.

nd-of-shift reports include medical history, recent procedures, lab values, medications, head-to-toe assessment, pain management, and plan of care. 

Episode 115: Goes in-depth about the end of shift duties and gives a report

After you accept your position, remember that getting off orientation is not a race.

If you are hired with other new graduates, it is common to look at them and feel like you are competing in the race of who can be the best new grad nurse.

Who can take care of higher acuities quicker? Who will be let off orientation earlier? Your work culture can bolster this, especially if your manager starts making comments that make you feel like you’re behind. 

Tip: You must focus on your journey and fill in the gaps you need. It’s not about winning a race. 

Don’t forget about self-care days!

Treat yourself, take yourself out, get massages, and buy something nice.

Get those feel-good endorphins pumping. The Self-care culture is at an all-time high with talks about the pandemic and burnout.

Here are the things you need to know after nursing school. Click here for the full episode 👇👇👇

TIMESTAMPS:

0:00 Introduction
0:57 Sponsor Ads
1:34 Cup of Nurses Introduction
3:51 Episode Introduction
6:39 Understanding different opportunities
11:35 What unit do you want to work on?
18:46 Utilizing your Network and Resources
23:29 Tips on using jobs board effectively
24:30 Clean up your own social media account
25:50 Preparing for your interviews
31:01 What to buy before you enter the unit
34:24 Giving end-of-shift report
37:01 Don’t forget about self-care days

How to Optimize Your Immune System

How to Optimize Your Immune System

How to Optimize Your Immune System

It is important to optimize your immune system. When the weather is cold, many people get sick, and sometimes, common colds turn to flu when your body cannot fight it off.
 
 
It is why you optimizing your immune system is a must.

Unfortunately, a lot of people have a low immune system during cold seasons. Many look for ways to boost it, but it’s best to get ahead. It is ideal for strengthening our immune system before illness takes over.
 
The best way to stop being sick is to prevent yourself from getting sick. There are steps you can take to better optimize your immune system.
 
Hydration, sleep, nutrition, and supplements are key fundamentals for staying healthy. 

Hydration

Drinking enough water optimizes your body’s performance in every aspect. Staying hydrated has been associated with an increase in the performance of your immune system.

Studies have shown that fluid balance plays a major role in immunity and immune function [1].

The Lymphatic System

The lymphatic system is responsible for maintaining optimal immune system health. Some of the functions of the lymph system are:

  • Maintains fluid levels in your body: The lymphatic system collects excess fluid that drains from cells and tissue throughout your body and returns it to your bloodstream; it then recirculates through your body.
  • Absorbs fats from the digestive tract: Lymph includes fluids from your intestines that contain fats and proteins and transport them back to your bloodstream.
  • Protects your body against foreign invaders: The lymphatic system produces and releases lymphocytes (white blood cells) and other immune cells that monitor and destroy foreign invaders.

How the Lymphatic System Helps Optimize Your Immune System

How does the lymphatic system help your immune system? ]Here are studies we found out regarding this topic:

1. Transports and removes waste products and abnormal cells from the lymph.

The lymphatic system relies heavily on lymph which is made up of about 90% water. Less body water may mean less lymph production or a less efficient lymph system.

2. In A 2013 study published in Luminescence, researchers investigated the effects of dehydration on immune functions in 25 university judoists after a judo practice session.

Subjects were divided into two groups according to their level of dehydration after practice (mild dehydration and severe dehydration).

Results suggested that dehydration resulted in immunosuppression, including decreased neutrophil (an important type of tissue-healing and infection-fighting white blood cell) function.

3. In a 2012 study published in Applied Physiology, Nutrition & Metabolism by researchers. In this investigation, they found the effect of exercise-induced dehydration and overnight fluid restriction on saliva antimicrobial proteins (secretory IgA (SIgA), α-amylase, and lysozyme).

All are essential for the host defense. 

The researchers concluded that modest dehydration decreased salivary flow rate (SFR), α-amylase, and lysozyme secretion rates.

However, they also commented that whether the observed magnitude of decrease in saliva AMPs during dehydration compromises host defense remains to be shown.

4. A 2019 review showed that researchers evaluated the effects of dehydration on several kinds of allergy responses and exercise-induced asthma, especially during endurance exercise.

They found that exercise-induced dehydration reduces airway surface hydration, resulting in increased bronchoconstriction. This is a response to exercise in exercise-induced asthma individuals and asthma patients [2].

How Sleep Affects the Immune System and Your Mood

Sleep is one of the most important components of staying healthy. Not only does sleep impact your immune system it is safe to say that sleep affects every part of your life.

Many people don’t know that a part of your immune system actually increases when you fall asleep.  When you sleep, the production of cytokines increases, which means you’re in a more inflamed state [3].

Some experts even say that sleep can increase immune memory:

  • During sleep, breathing and muscle activity slows down, freeing up energy for the immune system to perform these critical tasks.
  • The inflammation that happens during sleep could harm physical and mental performance if it occurs during waking hours, so the body has evolved so that these processes unfold during nightly sleep.
  • Melatonin, a sleep-promoting hormone that is produced at night, is adept at counteracting the stress that can come from inflammation during sleep. 

Undifferentiated or less differentiated cells like naïve and central memory T cells peak during the night, when the more slowly evolving adaptive immune response is initiated.

Nocturnal sleep, and especially SWS prevalent during the early night, promotes the release of GH and prolactin, while anti-inflammatory actions of cortisol and catecholamines are at the lowest levels [4].

The endocrine milieu during early sleep critically supports (1) the interaction between APC and T cells, as evidenced by enhanced production of IL-12, (2) a shift of the Th1/Th2 cytokine balance towards Th1 cytokines, and (3) an increase in Th cell proliferation and (4) probably also facilitates the migration of naïve T cells to lymph nodes.

Thereby, the endocrine milieu during early sleep likely promotes the initiation of Th1 immune responses that eventually supports the formation of long-lasting immunological memories.

Prolonged sleep curtailment and the accompanying stress response invoke a persistent unspecific production of pro-inflammatory cytokines.

This is best described as chronic low-grade inflammation and also produces immunodeficiency, which both have detrimental effects on health.

Effects of Citrus, Ginger, and Yogurt in Optimizing Your Immune System

To stay healthy and maintain a solid immune system, you must include foods rich in antioxidants and vitamins.

How can citrus, ginger, and yogurt help optimize your immune system? In many ways, of course. For one, citrus fruits are rich in Vitamin C, which keeps your immune system strong.

Ginger is an excellent addition to food and drinks. It also helps decrease inflammation in your body, while yogurt’s “live cultures” help stimulate your immune system to help fight diseases.

In addition to that, here are the health benefits of citrus, ginger, and yogurt:

Citrus fruits

  • Citrus fruits have a high vitamin C content. They are also high in potassium, phosphorus, magnesium, and vitamin B. They also contain a good amount of fiber.
  • Citrus fruits also contain antioxidants. It is theorized that antioxidants may block the expression of certain genes that can be associated with cancer or certain degenerative diseases. 

Ginger

  • Ginger boosts a variety of antioxidants such as gingerols, paradols, sesquiterpenes, shogaols, and zingerone.
  • It has been shown that ginger is able to decrease inflammation in conditions such as RA, gut disease, and asthma
  • A 2-month study in 64 people with type 2 diabetes found that taking 2 grams of ginger powder daily significantly reduced levels of inflammatory proteins like tumor necrosis factor-alpha (TNF-alpha) and C-reactive protein (CRP), compared to taking a placebo [5].
  • In another study, male athletes who received 1.5 grams of ginger powder daily for 6 weeks had significant reductions in levels of inflammatory markers, such as TNF-alpha, interleukin 6 (IL-6), and interleukin-1 beta (IL-1-beta), compared to athletes who received a placebo

Yogurt

  • One of the key elements in why yogurt helps the immune system is its probiotic effect, specifically something called lactobacillus [6]. 
  • Lactobacillus produces an enzyme called lactase which breaks down lactose into lactic acid. 
  • In one study in 326 children, six months of daily L. acidophilus probiotics reduced fever by 53%, coughing by 41%, antibiotic use by 68%, and days absent from school by 32%

Supplements to Help Optimize Your Immune System

Supplements are always talked about, especially in winter. In addition to that, winter is when most people get sick.

It is why it is crucial to keep your body healthy. You can also do this by taking supplements. What are the supplements you need to help optimize your immune system?

Vitamin D 

  • The recommended amount is 600 – 2000 IU.
  • Vitamin D is required in the regulation of T and B cells, macrophages, dendritic cells, and keratinocytes. There also seems to be a link between vitamin D and many autoimmune diseases, including Crohn’s disease, juvenile diabetes mellitus, multiple sclerosis, asthma, and rheumatoid arthritis.
  • Fish, red meat, liver, and egg yolks, are excellent foods rich in Vitamin D. 

Vitamin C Optimizes Your Immune System

  • For adults, the recommended daily amount for vitamin C is 65 to 90 milligrams (mg) a day, and the upper limit is 2,000 mg a day.
  • Research shows vitamin C is essential for the growth and repair of tissue all over the body. Vitamin C helps heal wounds and repair and maintain healthy bones, teeth, skin, and cartilage — a type of firm tissue that covers the bones.
  • As an antioxidant, vitamin C fights free radicals in the body, which may help prevent or delay certain cancers and heart diseases and promote healthy aging. Vitamin C from foods also seems to reduce the risk of cartilage loss in those with osteoarthritis.
  • Citrus fruit, such as oranges and orange juice, peppers, strawberries, blackcurrants, broccoli, brussels sprouts, and potatoes.

Iron

  • The amount of iron you need is 8.7mg a day for men over 18. 14.8mg a day for women aged 19 to 50. 8.7mg a day for women over 50.
  • The main responsibility of iron is properly functioning hemoglobin. It helps carry oxygen to your tissue and organs. 
  • Some of the other ways iron helps your immune system is by playing a major role in pathways and immune cells involved in iron regulation, from initial uptake in the gut to the utilization of iron for Fe-S clusters, heme biogenesis, and mitochondrial function. 
  • Shellfish, spinach, liver, legumes, red meat, pumpkin seeds, and quinoa 

Vitamin E to Help Optimize Your Immune System

  • The recommended daily amount of vitamin E for adults is 15 milligrams a day.
  • Besides acting as an antioxidant, vitamin E supports your body’s immune function by supporting the growth of t cells. The role of the t cell is to fight infection by fighting against infected cells and activating other immune cells for an effective immune response. As a result, Vitamin E is a necessary tool in helping your body fight off and prevent infections.
  • Kiwi, avocado, spinach, squash, seeds, asparagus, and berries are great sources of Vitamin E.

Vitamin B

  • The recommended daily amount of vitamin B-12 for adults is 2.4 micrograms
  • Hyperhomocysteinemia that occurs due to a deficiency of folic acid and B12 causes systemic and vascular inflammation contributing to the pathogenesis of many other diseases such as cardiovascular, kidney, and neurovascular diseases, osteoporosis, and cancer.
  • Adequate dietary levels of folic acid and B12 can act as preventative measures for inflammation, immune dysfunction, and disease progression.
  • Salmon, walnuts, leafy greens, legumes, and eggs are excellent sources of Vitamin B. 

Do you want to optimize your immune system better? Check out the full Episode 80 here 👇

TIMESTAMPS:

0:00 Introduction
2:17 Episode Introduction
4:34 Maintain Hydration
13:53 How sleep affects the immune system and your mood
22:20 Citrus, ginger, and yogurt
28:07 Supplements

EP 143: Real Estate Investing with Savannah Arroyo

EP 143: Real Estate Investing with Savannah Arroyo

EP 143: Real Estate Investing with Savannah Arroyo

In this episode, we would like to introduce our guest Savannah Arroyo. Savannah is a pre-operative nurse with prior administrative experience.

She started investing in Real Estate in 2020 and is growing her real estate portfolio. She explains how you can harness the power of nursing and use it to your advantage in real estate.

Get inspired by her journey, find out how she started investing in real estate as a nurse, and how you could start investing too.

  1. What is your nursing background, and how did you get started in nursing? 
  2. When and why did you start a career in real estate? 
    • What are multifamily syndications?
      • ​​Multifamily syndication is a real estate investment with multiple investors pooling their money to purchase the asset. There is a sponsor that locates the deal, coordinates the transaction and financing, and manages the investment once the deal has closed.
  3. How has the housing industry changed over the last few years?
    • Most popular states?
    • How has the pandemic affected the housing market?
  4. How can you help someone get started in real estate investing?
    • What are some barriers to entry? 

​Learn what real estate investing is in this full episode. Click here for more! 👇👇

TIMESTAMPS:

0:00 Introduction
0:48 Sponsor Ads
2:45 Episode Introduction
3:02 Who is Savannah Arroyo?
4:03 What it’s like in pre-op?
4:46 How did you shift from bedside to admin?
5:52 What’s more stressful, bedside or admin?
8:08 Tips for administrative roles
10:24 How to transition from management to real estate
11:40 What’s the difference between single-family with multi-family?
14:03 Should you start with a single home or multi-family?
17:02 Do you recommend people to get an education in real estate?
23:31 Where do you invest in the US?
29:37 How has real estate changed in the past few years
36:37 What is the projection of the real estate market?
44:35 How do interest rates work?
47:29 How to invest with you in real estate
50:37 What do you do in your free time?
51:32 How do you stay organized?
53:50 Where can people find Savannah Arroyo?

Are Staffing Agencies Overcharging?

Are Staffing Agencies Overcharging?

Are Staffing Agencies Overcharging? 

Over the years, the issues among overcharging staffing agencies have become a problem. Many nurses have been asking for a better ratio and higher pay for their services, but it all seems to fall on deaf ears. Even before the pandemic, this has been an ongoing issue among the nursing community. Now that we are facing a pandemic, the same problem still exists. 

In this episode, we will talk about the overcharging staffing agencies for nurses, how the pandemic affected nurses’ jobs, and even share some of our experiences as travel nurses. 

In the letter, Senators Mark Kelly (D-Ariz.) and Bill Cassidy, MD (R-La.), and Representatives Doris Matsui (D-Calif.) and David B. McKinley (R-W.Va.) wrote:

“We have received anecdotal reports that the nurse staffing agencies are vastly inflating the price, by two, three or more times pre-pandemic rates, and then taking 40% or more of the amount being charged to the hospitals for themselves in profits.”

They asked for an investigation by “one or more of the federal agencies with competition and consumer protection authority” to find any evidence of anti-competitive price patterns, price collusion, and higher pay for nurses due to the rate increases.

 Our opinion is that they will find out the rates are driven by supply ad demand. There isn’t not necessarily pricing fixing or gouging going on, just a shortage of nurses. 

Insider info: This started with Aya, who, at the start of the pandemic, where in New York they were charging like $350/hr bill rates. The hospital fired them and filed a complaint [1]. 

We don’t think this will have any impact on nurses as they have been underpaid for years. The market dictates the rate, not the agencies. Don’t forget that the hospitals got $35,000 for every Covid patient. 

What does AMN Healthcare say about this? 

AMN Healthcare is the largest travel nursing company, with a 17% market share, and most significant in allied healthcare staffing, with a 12% market share [2].

Kelly Rakowski, chief operating officer for strategic talent solutions at AMN Healthcare, wrote in an email to MedPage in a general response that its “pricing is agreed upon directly with our healthcare organization clients. Inflationary pressures and demand drive up the wages needed to attract clinicians to open positions. Any price increases are driven primarily by the compensation directly to healthcare practitioners.”

Several things contributed to the healthcare shortage; it was not only a national pandemic. The pandemic did two things: Increasing the direct number of patients needing care and driving some nurses out of the healthcare system due to burnout. 

According to the Bureau of Labor Statistics, the seasonally adjusted number of nursing and residential care facility staff on payrolls nationwide dropped by 157,000 from October 2020 to October 2021, to just under 3 million.

Hospitals in states like Pennsylvania and Dewelare say the hospitals cannot compete with staffing agency pay rates, which makes them unable to retain local nursing staff. 

Travel Nursing Fun Facts

The most popular contract spots are Texas, California, and New York. 

The most popular cities for travel nurses are: 

  • Denver, Colorado
  • New York, New York
  • Austin, Texas
  • Tucson, Arizona
  • San Diego, California
  • Dallas, Texas.

Only about 20% of people that start traveling go back to a perm job for more than two years. The highest paying contract for 36hrs is $5,000-$6,000 per week, gross [3].

The lowest paying contract for 36hrs is $2,000 per week, gross. 

Nurses will not travel for less than $2,000 per week, gross.

To watch the full episode, click here for more 👇👇👇

SHOW NOTES:

0:00 Introduction
0:48 Cup of Nurses Introduction
2:33 Episode Introduction
3:00 Are Staffing Agencies Overcharging?
4:03 Letter about staffing agencies that are overcharging
10:48 How travel nursing agencies work
13:33 What AMN Healthcare say about this?
23:58 Who’s paying for FEMA nurses?
26:31 Travel Nursing fun facts

EP 142: Is Wellness a Skill with Dawn Jones

EP 142: Is Wellness a Skill with Dawn Jones

EP 142: Is Wellness a Skill with Dawn Jones

Do you believe that wellness is a skill? Today’s episode will help shed light on that. In this episode, we would like to introduce our special guest, Dawn Jones. Dawn is a nurse for 26 years and now focuses as a Holistic Nurse Coach.

She practices self-compassion, Heart-Centered healing, and conscious wellness. Incorporating coaching and healing modalities that integrate body-mind-emotion-spirit-environment.

Join us as she explains why she thinks wellness is a skill and why you should start paying attention to the other parts of your holistic self.

Questions for Our Guest

  • Can you give us a background about yourself and your nursing experience? 
  • Why did you leave your job in March 2020?
  • What does health mean to you?
  • What does it mean to be a Board Certified Holistic Nurse Coach?
  • How do you feel when you are anxious?
  • Can nurses suffer from PTSD? Have you ever experienced it?
  • What led you to your soulful journey? 
  • How do we develop a healthcare system focused on Health promotion and Holistic Wellness.
  • What is your current obsession? 

Learn more about wellness by clicking on the full episode here 👇👇

TIMESTAMPS:

0:00 Introduction
0:59 Sponsor Ads
1:28 Cup of Nurses introduction
2:45 Episode Introduction
3:10 Dawn Jones Introduction
17:03 How did you get past PTSD?
23:27 How do you uplift yourself and your patient?
30:09 How important is communication to get over PTSD?
34:35 How do we promote a healthcare system that evolved in holistic wellness?
44:34 Where did you learn holistic wellness?
51:09 Trusting yourself
58:35 Top 3 things to empower yourself and cultivate wellness
1:05:22 What’s the emotional process of a Kidney Donor?
1:08:45 Where can people find Dawn Jones?