SO, YOU WANT TO BE A… NURSE
| MARCH 17, 2021
A good nurse is compassionate, caring, patient, and dedicated, able to communicate well with both patients and doctors, and is a team player
While specific responsibilities vary depending on the type of nurse you are, the general job description includes caring for patients, administering medication, recording patients’ conditions, communicating with doctors, assisting doctors during procedures, and providing education and emotional support to patients and their families.
Nurses can work in hospitals, private practices, clinics, nursing homes, retirement centers, schools, camps, home healthcare settings, and more. The wide range of settings reflects the large variety in the field of nursing itself. Some of the most common types of nurses are:
Licensed Practical Nurse (LPN) and Licensed Vocational Nurse (LVN) — entry-level nurses who generally work under RNs, performing duties such as routine tests, sample collection, and patient feeding and care.
Registered Nurse (RN) — aside from providing general patient care, RNs perform more complex tasks such as administering diagnostic tests and medications, and they’re more involved in creating the patient’s treatment plan.
Clinical Nurse Specialist (CNS) — these are advanced-level nurses who, aside from providing care to patients in their area of specialty, also work on a macro level using theory and research to improve nursing systems. They may work as consultants to other health care professionals, developing guidelines and protocols to improve patient outcomes.
Nurse Practitioner (NP) — NPs can perform some of the physician’s responsibilities, such as prescribing medications, performing in-office procedures, and interpreting diagnostic tests. They can admit and discharge patients from hospitals, and there is a lot of collaboration between the NP and the physician.
What kind of schooling do I need?
LPNs or LVNs generally complete a one-year nursing-certification program and pass a National Council Licensure Examination for practical nurses (NCLEX-PN). RNs must complete a bachelor’s degree program in nursing and pass a national exam for registered nurses (NCLEX-RN). Advanced-practice nurses (CNSs and NPs) must also complete a master’s or doctoral degree.
A good nurse is someone who is compassionate, caring, patient, and dedicated, able to communicate well with both patients and doctors, and is a team player. A nurse also needs to have good attention for detail, be quick thinking, and have critical-thinking skills. And, of course, they need to handle themselves well in a stressful environment.
What can I expect to earn?
Salaries vary depending on the type of nurse you are, your locale, and other factors such as additional certifications, years of experience, and overtime pay. New York salaries are significantly higher than in other areas of the country.
Median salary nationwide for an RN: $73,300
Starting salary in New York: $85—90,000
Average base NY salary: $110,000 (with overtime and other add-ons, this can easily go up to $150—160,000)
Tales from the Trenches: THREE NURSES DESCRIBE THE HIGHLIGHTS AND THE CHALLENGES
-NURSE AT NEW YORK PRESBYTERIAN CHILDREN’S HOSPITAL
-COLUMBIA UNIVERSITY SCHOOLOF NURSING
-YEARS IN FIELD: 16
MY TYPICAL DAY AT WORK
I work as a bedside and charge nurse in a level 4 neonatal ICU, which is the highest NICU level. I work 12-and-a-half-hour shifts, from 7 a.m. to 7:30 p.m. This is the case in most hospitals, where nurses work 13-hour shifts, and then have days off in between.
As a bedside nurse, I take care of my neonatal patients, who can range from 23 weeks gestation to full term infants. That includes feeding (which, for a 23-week-old baby, can be a quarter of a teaspoon), thermoregulation, respiratory assistance (something that preemies need help with for a few weeks or even months), administering medications, drawing bloodwork, and more.
As the charge nurse for my shift, I’m in charge of the overall status of the 58 babies in my unit. I manage the nurses, deal with parents, help nurses who need an extra hand, attend scheduled meetings, report unit issues that need to be directed higher up, organize admissions and bed placements, make the nurse-patient assignment for the following day, and report off to the next shift’s charge nurse. Basically, I have to be ready to deal with anything and everything that comes up.
HOW I CHOSE THE PROFESSION
I was in the middle of doing my BA at Hunter College for nutrition when I was inspired by a friend who was in nursing school and loved it. So I graduated Hunter and then went to Columbia University for my bachelor’s in nursing. I also have a Master’s in Nursing Education from Ramapo College.
HOW I CHOSE MY SPECIALTY
I love kids — they’re innocent and you can engage them while doing nursing care to make it more fun for them. I worked in a pediatric unit for five years, and many of my patients were “frequent flyers,” which means they had long-term issues and would come back often to the hospital for treatment. I got to know them and their families really well.
I then moved on to the neonatal ICU, looking for a challenge and to increase my knowledge in critical-care nursing. I’ve learned so much; I help resuscitate babies, do CPR, do preventative measures to keep the babies alive, and also care for babies who are dying or have died. I’ve done postmortem care, and have educated the staff on my unit about the halachos of end-of-life care for Jewish babies, which is very meaningful for the families going through this.
WHAT I LOVE MOST ABOUT THE FIELD
I love how flexible it is. You have so many work settings to choose from, and if you don’t like what you’re doing, you can just switch to a work environment you enjoy more.
I also like the 12-and-a-half-hour shifts. It’s hard and exhausting, but you get it done and then you have more days off with your family. I worked night shifts for about ten years, which worked well when my kids were younger. Now that they are getting older, I’ve switched to day shift.
WHAT I FIND MOST CHALLENGING ABOUT THE FIELD
Working night shifts is super challenging on the body. Many nurses get headaches, don’t sleep well, and find their body synchronization is totally off. It’s difficult to sleep during the day, with construction or doorbells ringing outside. Since most new hospital hires start off on night shift, this can be quite a stressful adjustment for them.
I’LL NEVER FORGET WHEN
About two years ago, we had quintuplets in the NICU who went home totally well and healthy. Such a miracle.
Another case I remember is a set of triplets — one born at 23 weeks and the other two babies were born two weeks later. So the triplets had different birth dates.
SOMETHING I WISH PEOPLE KNEW ABOUT NURSING
Working three days a week doesn’t mean you’re on vacation for the other four days. The shifts are exhausting and, especially for nurses on night shifts, their afternoons prior to and following the shift are completely devoted to rest.
Another thing: Nurses are front-line health-care workers; without them, patients would not survive. The nurses do ALL the hands-on work on patients.
HOW WE WERE AFFECTED BY COVID-19
In the NICU, visitation restrictions were a major issue. Normally, a baby can have four visitors during his NICU stay. At the beginning of COVID, this dropped to one visitor. That meant only one parent could be with the baby; imagine being the other parent, and not being able to see your baby for weeks! It caused major tension on the unit, and much emotional distress for the parents.
Then there was the issue of a baby born from a COVID-positive mother who needed to be admitted to the NICU. It took about five people to handle the move, and the mother couldn’t visit her baby during her entire quarantine period. We instituted virtual NICU sessions using iPads, so that the parents could video in with their baby and the nurse.
Staff communication was an issue as well. Information was changing so quickly, as new guidelines were constantly implemented, yet we couldn’t have group staff meetings to efficiently communicate all of this.
And, of course, the biggest issue was our own fear, especially at the height of the virus, when everything was unknown. Would we die at work? Would our coworkers?
Nurses and health-care professionals are feeling huge burnout after a year of intense work, and many are displaying their own mental-health issues as a result.
MY ADVICE FOR PEOPLE STARTING OUT
It’s a tight market now, with hiring freezes in hospitals due to COVID. My suggestion is to take whatever job you’re okay with, even if it’s not perfect. Once you have a first job, you’re no longer considered a “new grad” and you’ll have an easier time getting hired.
Keep in mind that crying as a new nurse is normal. It’s overwhelming, and there’s a lot to learn. Don’t be afraid to ask a lot of questions and reach out for support.
On that note, I’d like to mention the OJNA (Orthodox Jewish Nurses Association). It started in 2010, and today is a very active Facebook group with 2,500 members (I’m currently its president). We offer tremendous support to nurses, including a new-graduate mentorship program, résumé-writing assistance, and a job board. We run annual conferences with continuing-education credits, as well as chapter events around the country; currently we’re in the middle of hosting a nine-week medical-halachah webinar series. And we also publish a journal, which is mailed to members.
During COVID, we also ran community-education events, and distributed 450 pulse oximeters to high-risk community members, as well as surgical and N95 masks to over 1,000 health care professionals.