Lorie A Brown, R.N., M.N., J.D., Author at Empowered Nurses

Do You Know A Stepford Nurse?

June 13, 2019 2:28 pm 1 Comment

Have you seen the eerie movie titled “The Stepford Wives”? The original 1975 film takes place in a small community where all the wives are p-e-r-f-e-c-t! They look great, keep the home looking immaculate, make fabulous meals and, most obviously, provide their husbands with exceptional care.

The reason for the ladies’ perfection is that they actually weren’t ladies at all … they were robots. And I’ve come to believe that now we have culture of Stepford Nurses.

A Stepford Nurse does what they are expected to do but they will not speak up, they don’t speak for themselves. The culture of nursing is such that should we speak up, we’ll get in trouble. Corporate health care does not like a squeaky wheel and every nurse knows that.

This is contrary to the purpose of nursing. Patients are only in the hospital for one reason…nursing care. We are the eyes and ears of the physicians. We have our own unique body of knowledge and that is why we catch things earlier to prevent problems. We know how care should be delivered so patients get the best outcome.

The sad part is, although I believe nurses have answers to all the problems in health care, we have been indoctrinated to be Stepford Nurses and thus are intimidated into remaining silent.

We need to stand together to change this. When nurses stand together, we are so powerful. Look at all the nurses that rallied behind the “nurses play cards” and “show me your stethoscope.” Look at all the nurses that march before congress each year to get minimum nurse patient staffing ratios. We cannot change the whole health care system at one time, but we can change one unit at a time, and it begins with us. I invite you to “Be the change you want to see” on your unit because change begins with you. To do this, begin with the end in mind. What do you want to create? Then figure out how this is a win win for your unit like increased patient satisfaction, lower readmission rates, lower malpractice rates and improved patient outcimes.

Do you believe that our profession is being indoctrinated to be Stepford Nurses? If so, how can we change that paradigm? Let me know what you think of Stepford Nurses in our midst by commenting below.

You Have All The Time You Need To Start Your Business Now

June 3, 2019 7:35 am Leave a Comment

Nurses often tell me that they don’t have time to start or work on their business. Well, let’s talk about this. We all have time to eat our meals, time to brush our teeth and to do all the things that are important to us. Each and every one of us has the same 24 hours in a day. That is the only equalizing factor of everyone in the world.

But why are some people more successful than others? There are people like Tony Robbins and Oprah Winfrey who have the same number of hours each day but just look at the impact they are able to make on the world because of how they use their time.

Think of time as money. How would spend your time? Would you watch television or spend time with your family? Would you do something that you don’t like instead of working on your business that has the opportunity for financial return and freedom for you and your family?

My philosophy is do, delete or delegate. When I have something to do, I decide whether I’m going to do it, do I really want to do it, if not, I’m going to delete it or I will delegate it. If it’s something that I’m not good at or does not generate money, I will delegate it because I can make so much more money in my business than what I would pay somebody else to help me with something.

Your calendar is your best friend. If you calendar all the things you need to do each day and stick to it, you would be surprised at how much more productive you can be.

When I first started my business, my problem was that I let my feelings, emotions and even hormones get in my way. I would say to myself, “I don’t feel like doing this. I would rather do this instead” and one thing that was supposed to get done didn’t get done because I didn’t feel like it.

Think about this in your nursing career. If you had a patient that needed something and you didn’t feel like helping the patient with it, you couldn’t just say, “I don’t feel like it.” You muster the energy and get through it. The same is true in your business. There are tasks in your business that you’re not always going to want to do. But you can always delegate them.

A strategy I use is to get up an hour early every day. This has been very helpful to me because when you get up an hour early every day, would you believe you have 9½ full time 40-hour weeks extra a year. Who can’t get stuff done in 9½ 40-hour weeks? It makes you so much more productive.

During the hour that I get up early, I chose to do my morning routine, which is meditate, yoga, journaling and maybe reading. This is my time before the kids wake up and before I get going in my day. It helps so much with my mind to get me into the right framework for the rest of the day.

I hope these strategies help you to use your time more effectively. What techniques or strategies do you have to maximize your working time? Let us read your comments below.

Raises For Nurses

May 16, 2019 4:23 pm Leave a Comment

Ballard Health, located in east Tennessee and southwest Virginia, announced during Nurses Week that it was putting a massive investment of 10 million dollars to increase the wages for all direct patient care nursing and supporting back wages for acute care registered nurses, licensed practice nurses and nursing assistants with primary responsibility in providing direct patient care. The announcement read: “Our nurses and those who work with them in the provision of direct patient care are heroes.”

The pay increase will begin on June 23^rd according to Ballard Health Executive Chairman, President and CEO Alan Levine. He announced that the Centers for Medicare and Medicaid Services (CMMS) and the Department of Health and Human Services have changed a number of rules to provide some relief to rural and non-urban hospital which in the past favored larger hospitals.

They have changed the Medicare/Medicaid area wage index to provide more reimbursement. Unfortunately, they are unable to keep up with larger areas such as Asheville and Charlotte, North Carolina.

I’m truly grateful they are giving nurses raises because they so deserve them. However, I wonder if this is a marketing ploy or am I being too cynical?

What are your thoughts? Let me know what you think in the comments below.

Are You Hungry?

May 10, 2019 8:23 am Leave a Comment

Many have dreams of starting their own business. Some act on those dreams while most don’t. The ones who act may send out some mailings a couple of times, not get the results they seek and then quit. That is not hunger, it’s called desire.

In order to have a successful business, you have to be hungry. You have to be so committed that you will do whatever it takes to be successful. Committed to whatever it takes means that if you try one thing and it does not work, then you try another. If THAT doesn’t work, then you try again and, if that doesn’t work you … keep trying! You don’t quit.

Businesses don’t fail, only business owners fail. You may need to change your strategy or your message until you find what works.

If you knew you could not fail in your business, would you proceed? That’s right, you can’t fail. If you’re hungry enough and you keep at it, it will work!

When I lost my partnership in a law firm and found myself as a single mother with an 18-month-old and awaiting my second child, I had no choice. I was hungry! I wanted to feed my kids, I wanted to put a roof over our heads and I wanted to provide them a good life.

It took me 5 years to figure out what works. But once I got it … I got it … and my business grew steadily. That is why I am so committed to helping nurse business owners shorten their ramp up time.

One of the mistakes I didn’t realize I was making early on was that I was not committed to whatever it takes. I was committed unless. I had a back door.

I was hoping to get a job as an administrative law judge for the Social Security Administration. Unbeknownst to me, having that back door really prevented me from going full force and doing whatever it takes to make my business successful.

As nurses, we can always find a job and have a decent income. It keeps us in our comfort zone and stuck. While it is great that nurses have those opportunities, your desire has to be much stronger than sitting in your comfort zone. Your hunger should be focused on what you truly want not what you don’t want.

Think positive!

How committed are YOU? How hungry are you to have your business be profitable and successful? I’d love to read your comments below.

The Nursing Shortage Is Exploding

May 9, 2019 4:18 pm Leave a Comment

Nurses comprise the largest workforce in the hospitals and are highly trained. Yet, in your practice, I’m sure you feel that the nursing shortage is not only here but is with us in full force. We are asked to do more with less.

Mandatory staffing initiatives that went before a number of state legislatures were struck down due to creative advertising by health care institutions.

In a 2010 article, the Institute of Medicine released a report on the future of nursing calling for an 80% increase in the number of baccalaureate prepared nurses to join the work force. We fell far short of that with only 56% of R.N.’s prepared at the baccalaureate or graduate degree level.

According to the American Association of Critical Care Nurses, U.S. nursing schools in 2018 turned away more than 75,000 qualified applicants for baccalaureate and graduate nursing programs due to insufficient numbers of faculty, clinical sites, classroom space and clinical preceptors as well as budget constraints.

Over our next 10 years the Health Resources and Services Administration projects that more than 1,000,000 registered nurses will reach retirement age. The number of nurses leaving the work force has grown steadily and is expected to be 80,000 by 2020. That’s almost the number of Registered Nurses in the state of Indiana.

According to the American Nurses Association, opportunities in nursing are growing 15% faster more than all other occupations.

There are a number factors to be attributed to the nursing shortage such as nurse retirement and lack of education. This should serve as a wakeup call to hospitals to realize that nurses need to be better treated and are not an indispensable commodity.

When we had a big nursing shortage 30 years ago, there were lots of initiatives such as sign on bonuses and positions created called nurse recruiters.

What ideas might you have to ensure an adequate number of nurses to take care of patients?

Nursing Now And Then

May 2, 2019 2:18 pm Leave a Comment

As we celebrate Nurses Week, Business Insider recently published an article titled “Then and Now: Here’s How Being a Nurse Has Changed in The Last 50 Year.”

1. In 2019, nurses not only make up the largest work force in health care but it is one of the fastest growing industries in the country.

2. In the 1960s, nurses were “treated as hand maidens of physicians.” We were expected to carry out their orders without question. Now, nurses are required to question physicians’ orders when deemed necessary.

3. In 1978, the National Council of State Boards of Nursing was not in existence.

4. In 1960, there were only 172 college-based nursing programs in the U.S., but now there are 674 Bachelor’s programs being offered.

5. Today we get to wear scrubs instead of white dresses with caps and stockings.

6. Over 30 years ago, the average stay for a cataract patient was 7 days. Today they go home the same day of surgery.

7. Record keeping has also changed. The U.S. government spent $19,200,000,000.00 to increase the use of electronic health records.

8. In 2017, 19.1% of Registered Nurses were minorities and 9.1% were men.

Click here to read more from the Business Insider article.

It’s pleasing to see how far we have come, but we still have a way to go. Such as getting full practice authority for Nurse Practitioners. Things certainly have changed greatly since I began practicing in 1982.

I would love to read any thoughts you might have about changes in the practice if you would be kind enough to put them below.

Walk In My Shoes Before Putting Your Foot In Your Mouth

April 25, 2019 3:39 pm Leave a Comment

On April 18, 2019, Maureen Walsh, a senator in the Washington state legislature, stuck her foot in her mouth. No, not literally but figuratively.

Not since comedian and TV host Joy Behar said to a nurse wearing a stethoscope, “What is that thingy around your neck?” has such a gaffe on our profession been made publicly.

When arguing about legislation requiring mandatory uninterrupted breaks and meals for nurses, Senator Walsh told the legislature, “Nurses are probably playing cards at work all day.” She was referring to critical access hospitals which are small rural facilities where acutely ill patients can get treatment and stabilized before they can be transferred to a major medical center. Those include patients with acute myocardial infarctions and strokes who get treatment who might not survive the long ride to a more distant major medical center.

The government has subsidized each hospital by providing them with an additional reimbursement. These small hospitals have only about 25 or fewer acute inpatient beds and their censuses fluctuate greatly, are located more than 35 miles from another hospital, maintain an annual average length of stay of 96 hours or less for acute care patients, and provide 24/7 emergency care servicesNurses in these facilities do everything. They are the so-called chief cook and bottlewasher

They are NOT sitting around playing cards.

Walsh’s statement spurred a strong reaction from not only nurses, but the public itself. The children of the Senator have even been threatened. Did I mention Senator Walsh’s own mother is a nurse?! Over 700,000 people nationwide have signed a petition calling for her to shadow a nurse during a 12-hour shift. Another petition asked for her resignation.

She has since apologized and blamed her statement on the fact that she was tired from the long legislative session. Ironic isn’t it that she is tired? Try working a 12-hour shift!

I encourage us to look at things differently. Rather than calling for this politician’s resignation, let’s get her educated. Her first step, no pun intended, was to agree to shadow a nurse during a 12-hour shift to, as they say, “walk a mile” in the shoes of a nurse.

This is a great suggestion. I think the public is wholly uninformed of what nurses actually do. I believe the more people we can educate, especially elected officials, to see what nurses do on a daily basis will greatly enhance our profession.

I encourage all of you to reach out to your legislators to invite them to spend the day with you on your unit. Maybe then they’ll see how many times you can play cards, go to the restroom or even get to take a drink of water.

What are your thoughts on this? Leave me your comments and opinions below.

Nursing Burn Out Can Happen To You

April 11, 2019 3:50 pm Leave a Comment

Surely this can’t be happening to me. I love what I do. Yet the signs were so insidious and I thought, as most nurses do, that I could do it all. In the beginning, I stopped doing yoga, then meditation and then eating properly. My self-care went down the drain. I was irritable with my children and frustrated with myself. I woke up at night thinking about work. It got to the point where I felt like I just needed to run away. I tried to take a day off here and there but it did not work. I needed a good week to recharge my batteries and get back into my self-care routine otherwise I was afraid I would get sick and if something happened to me, who would take care of things.

Nursing is one of the most stressful professions in the world. We nurses are empaths and take on our patients’ issues. We feel their physical, mental and emotional pain.

Burn out is caused because we deal with our patients’ life-threatening diagnoses, stresses and even death. Before we have a chance to process those emotions, we are busy taking care of other patients.

Nurses are especially prone to mental exhaustion.

The warning signs of nursing burnout are:

irritability;
venting to your family when you come home;
frequently calling in sick;
intolerance to change;
exhaustion;
working long, hard hours;
feeling fatigued; and
feeling like you’re going through the motions.

If you are exhibiting any of these symptoms, the first step is to recognize that these are symptoms of burnout.

As nurses, we tend to “power through” everything rather than stopping, recognizing what’s going on and seeking help.

If you are experiencing burnout, go see your Employee Assistance Program. It’s free and they offer counseling, stress management and self-care support.

If you’re worried about your job, going to the Employee Assistance Program, which is completely confidential, will help you with that as well.

It’s also helpful to keep your personal and professional lives separate, avoiding dwelling on work issues at home. For me, I noticed that I would wake up in the middle of the night thinking about work. When this happens, it’s important to take time for self-care, eat a well-balanced diet, exercise and get adequate rest. Try focusing on hobbies and relaxation techniques plus meditation and journaling. All of these will help with burn out.

If you don’t think this can happen to you, you need to wake up. No one is immune. But, before it gets too bad, it is better to deal with the issues than to have it evolve into something else.

Now that I am back, I feel rejuvenated. The work is still there but I feel better about myself and my passion and my commitment to help nurses. What are you doing to take care of yourself? Share with us in the comments below.

That Little Voice In Your Head

April 10, 2019 12:25 pm Leave a Comment

You know that little voice in your head that tells you that “You can’t do this! Who are you to start your own business? Go back to nursing because that’s what you know!” Because of those little whisperings, we have all these fears of actually going out and talking to potential clients.

Did you know that we all are born with only 2 fears: the fear of falling and the fear of loud noises? That’s it. I know this is an extreme example but if you put a gun to a child’s head, the child will probably with laugh. They may not know what a gun is and they don’t think that a gun can harm them. Just like touching a hot stove, a child is not aware that they can be injured.

Fears came from our reptilian brain which was designed to keep us safe. Back eons ago, when cave people could fall prey to a prehistoric beast, fear was the immediate reaction to the danger. Today, we don’t have to fear about prehistoric beasts, but we press that “fear button” any time we want. Pushing the fear button causes us to do one of 3 things: to freeze, to flee or to fight.

Now that you know fears are False Evidence that Appears Real, the only way to deal with the fear is to move right through them. They are not going to go away. Gather evidence to confirm your fears are not real. Ask yourself is there really anything to fear in this moment. The more evidence you gather that the fears are not real, such as talking to potential clients, those fears do go away.

You can’t go over them. You can’t go under them. You can’t go around them. The only way to get pass the fears is to move through them. You CAN do this!

Your home play today is to pick one of your fears and move straight through it. For example, if you fear doing a Facebook live or getting on video, do it anyway. If you have a fear of talking to an attorney or a potential client, go find one to talk to.

If you find value in my business blog, please feel free to share these articles with all current and potential nurse business owners you know. Thank you.

Biggest Reason Nurses Fail In Business

March 6, 2019 2:30 pm Leave a Comment

Anyone who has a dream of owning a business consciously wants to succeed but their subconscious may have other plans for them.

Our subconscious and conscious are 2 parts of our mind. The subconscious is formed by the age of 7 and basically everything that we’ve heard or made up about an event, we believe to be true. If we believe that we are not good enough, not deserving or not worthy, it is the subconscious running the show even if the conscious mind does not believe so.

We all have a comfort zone of about 72 degrees and when it gets too hot, the air conditioner will kick on to lower the temperature and, likewise, if it gets too cold, the heat will kick on and raise the temperature to return us to our comfort zone.

Our brain is designed with an old part called the “reptilian brain” or the amygdala which senses fear and is designed to keep us safe. In the old days, we may have had a saber-tooth tiger threatening to eat us at which the amygdala provided a flight or fight response based on fear. More directly, it is designed to keep us in our comfort zone.

And that is applicable in our case today as it may cause us to hesitate to get out there and do the necessary things to build our businesses. Fear is what gets in the way of everyone, including nurses, from being successful. We feel fear and it stops us in our tracks.

However, the fear is not real but we perceive it as real. It is coming from either the future or the past. It may be from a long-ago experience in which we may not have succeeded or it could be fear from an unknown future. The only way to deal with such fears is to walk through them and recognize that they are not real. It is some belief that we adopted a long time ago.

As I often say, feel the fear and do it anyway because if you have this idea for a business, you definitely can succeed if it is something that is going to bring value to people and solve a problem.

Author Archives: Lorie A Brown, R.N., M.N., J.D.