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Back to the Dark Side! Night Shift Life. Survival Guide. Working the night shift is not for the faint of heart. Many of us in the healthcare field work on "the dark side," whether we want to or not. No matter what time you’re expected to show up for work, we all have to report for duty fully rested and prepared to give our best.  It’s imperative for those of us who work the night shift to get sufficient sleep, eat healthy meals, exercise, prioritize our mental health, and sustain close relationships. These things are hard enough to do on a normal schedule, and even more difficult for those of use with nontraditional work schedules.   While some true night owls prefer working while the world sleeps, most of us find it challenging to work through the night. If you are like me, you might find yourself spending a large chunk of time off recovering from the “jet lag” you feel after working a night shift.  Still, there are ways to prioritize your health and wellbeing  while working at night. You may even find ways to enjoy the night shift lifestyle! Here, I share a few key tips I have learned from working as a night shifter over the years that have helped me get through the work week. Hopefully, they’ll help you as much as they’ve helped me! 11 TIPS FOR NIGHT SHIFT WORKERS 1. ESTABLISH A ROUTINE This is easier said than done, but is always important to consider! Try to maintain a consistent schedule for working, sleeping, and recovering. This will obviously vary as you can’t predict every detail life will throw at you, but there are some things you can do to help yourself establish a routine.  For me the biggest tip here is to go to bed and wake up at the same time every day that you work .  Some nurses prefer to maintain their daytime sleep schedule on off days to keep their bodies and minds ready for work, while others prefer to adjust their schedule to match that of their family members and friends. The take home point here is to convince your body that it’s “bedtime” when you get home from work so that you are in a position to get a long, uninterrupted rest during the day. 2. MAKE YOUR BEDROOM A SANCTUARY Learning how to adapt to a different sleep schedule is one of the hardest obstacles that a night shift worker must master – especially since our sleeping pattern is one that is opposite to that of the majority of the population, including our family and friends.  The greatest threat to our health as night shifters is chronic sleep deprivation. Risks of sleep deprivation include increased chances of being involved in a car accident. These risks become exponentially higher as our lack of sleep worsens. Because most nurses drive to and from work, this impacts us on a huge scale, and is definitely something we should consider when starting out as a night shift nurse. One of the most frustrating things about trying to sleep as a new night shifter is that no matter how tired I was, no matter how hard I’d try to sleep, I’d often lay awake in the middle of the day thinking about the things I need to do, wishing I could enjoy the sunshine beating through my window. The only thing that helped me to sleep and turn my brain off was turning my bedroom into a sanctuary. This involved: Making the room dark (blackout blinds/curtains are a must). Making the room cold. Putting clean, soft sheets on the bed. Wearing an eye mask and earplugs. Using soft lighting like a salt lamp . Using apps like Calm or Headspace, or a white noise machine to fall asleep. If you have a partner or kids, make sure to let everyone know that your bedroom is off limits during the day while you sleep. Those of us that have worked night shift for years know that once you wake up, it’s difficult to fall back asleep. 3 . MEAL PREP Night-shift work may alter your eating patterns and food preferences. Good meal planning and food preparation  can go a long way in ensuring healthy eating habits for night shift nurses. Before grocery shopping, make a list to help you focus on buying healthy foods. Otherwise, you may be tempted to buy overly refined sugary snacks that provide quick energy but end up giving you a sugar crash in the middle of your shift. If you feel you don’t have time to do this the right way, consider getting your groceries or meals delivered to your doorstep. You’ll want to avoid getting take out or fast food meals if you can, though I’d be lying if I didn’t get the occasional Taco Bell after a rough night shift! 4. SHIFT PREP In all of my tips, you’ll notice that preparing  for night shift  is the key to success. In addition to preparing your meals, you’ll want to have your scrubs laid out, lunch prepped, bag packed, and car full of gas. Here are a few things I ensure are in my work bag ahead of time: Airpods Phone charger Blue Light Blocking Glasses J acket / Vest Stethoscope Penlight Compression socks Water bottle Advil / Aspirin Chapstick Mouthwash (swish once a shift to decrease bacteria build up in the mouth) Favorite Pens Badge Clogs 5. ALWAYS HAVE HEALTHY "PICK-ME-UP" SNACKS ON HAND All night shifters have that “hit the wall” hour. Mine usually comes between 0200-0400 am. To help you combat the exhaustion, a “PICK ME UP” can help. For me, the top hitters are caffeine (coffee, tea, celsius drink)  and an energizing snack. I’ve crowd sourced everyone’s favorite night shift snacks  and have compiled a comprehensive list below! Chocolate Noka Superfood smoothie pouches Peanut butter cups Chocolate covered pretzels Cucumbers and hummus Tuna salad on rice cake (manage cravings) Pirates Booty Smart Sweets Boiled egg + avocado + sriracha sauce + toast Gold Fish Dried figs  Froze balls (from Trader Joes) Verb bars Gushers Chomps jalapeno jerky sticks Gum Emergen-C packs Pique tea (Sun Goddess Macha packets)  Apple + PB Avocado Toast Oatmeal  Soup   (hot or cold, depending on your preference) Protein shake 6. TAKE A BREAK OR NAP WHENEVER POSSIBLE For those of us who work long, 12-hour night shifts , breaks are essential. If you’ve read any of my other blogs, you’ll know I say this at every opportunity: don’t skip breaks or meals during your shift, and be sure to take advantage of leaving the bedside for designated rest areas when you have coverage. If you are able to, get off your feet, nap, put in some headphones, and take a few minutes to rejuvenate. You need to care for yourself, and your patients are counting on you to stay sharp. 7. FORM STRONG FRIENDSHIPS WITH YOUR CO-WORKERS Night shift people are the best kind of people! We’ve got a dark lifestyle and dark humor, which help us get through the tough nights! In all seriousness, laughing and joking with your coworkers is a HUGE  part of surviving night shift.  Forming close relationships with the nurses, doctors, secretaries, and techs on your team is one of the best things about working night shift!  It definitely helps you stay awake. Also, you’ll feel less hesitation when asking for help or bringing up a concern about a patient.  8. STAY HYDRATED! As nurses, we often overlook the importance of staying hydrated  and prioritize other things that seem more important. However, ensuring adequate hydration is the easiest way to stay awake and alert. Drinking enough water helps to regulate our body temperature, prevent infections, deliver nutrients to cells, and keep organs functioning properly. Experts recommend  about 11 cups (88 oz.) of water per day for the average woman and 16 cups (128 oz.) for the average man. Be sure to avoid sugary sodas and fruit juices, which can make your blood sugar spike and rapidly crash. 9. DO WHAT YOU CAN TO MAKE YOUR COMMUTE HOME SAFER At the end of your shift, you’ll be exhausted and drowsy. Make sure you take extra precautions to get home safely. I recommend: Opening care windows to get a fresh breeze in your face. Turn up the radio to stay awake. Calling a friend or family member to keep your brain active and alert.  After some incredibly rough shifts, you may not feel like you can drive safely. Don’t be too proud to take a nap in your car before leaving the parking lot or calling a car service to bring you home. 10. HAVE A CONVERSATION WITH YOUR FRIENDS & FAMILY ABOUT YOUR NEW NIGHT SHIFT LIFESTYLE Your family members, partner, or roommates will have to understand that working night shift is a lifestyle. They may be seeing less of you on certain days, and may need to work around your new sleep schedule. This isn’t always easy, and definitely requires communication to be executed effectively. It is important to get everyone on board, and it can be a hard adjustment for those that depend on you. Jacob and I share a GOOGLE CALENDAR  which is a huge life saver! We share our work schedules and plug in work outs, date nights, vacations, and appointments. We live by the calendar and rely on it to ensure we get quality time together each week! 11. DON'T FORGET ABOUT YOUR INTIMATE NEEDS (YES, I'M TALKING ABOUT LIBIDO!) A big negative of working night shift is the detrimental effect it can have on your libido, energy, and sex life. This can be a hard one  (pun intended…lol) to maintain, especially if you and your partner work opposite schedules. But it’s important for all of us to remember that sex and intimacy  are important for all of us. Make time for date nights when you can, and schedule weekend getaways like mini staycations or local trips to keep things fun. We’re Here for Every Stage of Your NICU Nursing Journey  For more info on working night shift, check out Cellfie’s full podcast episode called “Back to the Dark Side”   where we spill the tea on our best kept night shift secrets! Feel free to reach out on our NICUity nurse forum  with any questions for starting your night shift journey — we can’t wait to see you! LISTEN TO FULL EPISODE OF "BACK TO THE DARK SIDE" HERE I hope you enjoyed this blog! Leave your thoughts in the comments below or suggestions for other night shift tips! Cheers to you in your night shift journey! Tori Meskin MSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

If you’ve just graduated nursing school and are starting your first NICU job , you’re probably feeling a mix of excitement and worry. It can feel like you’re drowning in expectations, worried about learning the ins and outs of your unit’s culture, and fear having a tough time keeping up with a never-ending flow of patients.  The doubt you may feel about whether nursing is really your calling or not can creep in but I can assure you that is  NORMAL  and is something we all go through at different stages of our nursing career, especially when we’re just starting out.  Sometimes, the fear and trepidation of what’s to come is the worst part of any new journey! What helps me before diving into any challenging life situation is setting realistic goals and expectations for myself and for those around me. Below, I’ll list 11 things I wish I knew before I started my first job to help you prepare for the challenges ahead.  11 Things I Wish I Knew Before Starting In the NICU 1. Some people may NEVER appreciate what you do. This is something you are going to have to settle with right away. The goal is to try not to take the words and actions of others around you to heart. The attitude and frustration isn’t necessarily about something you’ve done, but rather is something that they can’t control when dealing with stress or anxiety.  It’s disheartening for all of us when we’re caring for an ungrateful or rude patient, co-worker, or family member. What’s important is that we keep their poor attitude from changing the way we provide compassionate and empathetic care. No matter what, it’s our responsibility to remain respectful to your patients, their family members & colleagues, even when you feel wrongfully questioned or disregarded.  It can be a tough pill to swallow to remember that in healthcare, respect is earned, not given. It may take some time to establish this with your colleagues and families when you’re first starting out. If you have a friend or family member that isn’t supporting you in your new role, bring up your concerns and try to have a healthy discussion about it. Advocate for yourself when you can and let go of the rest. Don't let this over-come you — it’s something we all continue to deal with, even after years of being a nurse. We’re all in this together! XO  2. Burnout and work fatigue. It’s not as simple as “self-care”. We all face nursing burnout  and work fatigue, but be wary of taking “self-care” advice from those outside of the healthcare field. Unless they’ve walked in your shoes, it’s hard for others to understand the fatigue of a 12-hour night shift , especially when you’re working several days in a row. Not only is our work physically taxing, but it’s also emotionally and mentally exhausting as we do our part to help patients through positive and negative outcomes. Preventing job burnout  starts by leaving work at the hospital and living “off the clock” on days off. If you notice burnout creeping in, try to make some changes to your schedule. Try taking on a new role in your unit, look into career development   opportunities, attend a conference, network, conduct clinical research, apply for a new job, or even consider going back to school to get your advanced degree. Nursing is far too vast an industry for you to live your life in a career rut. Don't sink into it — instead, get ahead of it.  Listen to the Cellfie episode on burnout and lessons learned here! 3. You may love your job or specialty at first, but could then grow to dislike or outgrow it. Yep, this happens all the time. It may feel frustrating to put your heart and soul into a job and then decide it’s time for something new. Ultimately, life is all about growth and change, so don’t be afraid of it! It’s okay to start off in love with one specialty and then to grow to dislike it as time goes on.  It doesn’t mean that you failed to identify your passion or that you’re in the wrong profession altogether. Make a list of the pros and cons of your unit/specialty and then work toward making a change if you feel that the cons outweigh the pros. Floating to different units and taking a travel nursing assignment helped solidify in my mind what I wanted to stick with as it gave me a broader perspective on how other hospitals, units and specialties operate.  If you’re falling out of love with your job, I encourage you to make a BIG change and take a travel nursing assignment. A change of scenery and a new clinical team might help you determine where you feel most drawn to in the long-term. 4. You will work with some very difficult personalities. All types of people work in healthcare. We all have different cultural backgrounds, aspirations, and motivations to succeed. It’s important to remember that not everyone thinks and behaves like you do. This is not always a negative. In fact, I think working with people who are different from you is something that can move you forward in your journey of professional growth.  I have worked with plenty of nurses and doctors who I initially STRONGLY DISLIKED but grew to LOVE like no other. Remember, someone could just be having a bad day (or even a hard season of life) and bring that burden to their shift(s) with them. Maybe you and a team member just don't jive, which is okay too! Give yourself enough time to get to know each of your coworkers before judging them. Try to find ways to work together instead of trying to find ways to avoid them.  5. Work culture can affect you professionally AND personally. Work culture plays a HUGE factor in nurse job satisfaction. It’s something we should all ask about during job interviews. Every workplace will have a different culture. Having insight into what makes your unit tick can help you get started on the right foot and adapt if you need to.   For example, if you have always preferred to work alone and problem solve independently, a culture that embraces community discussion, bouncing ideas off one another, and problem-solving might feel intimidating to you at first. Instead of trying to fight the system, attempt to change and grow personally and professionally! If there’s something about your unit that you find toxic or negative, try to incite the positive change you wish to see. 6. Rome wasn’t built in a day (or even a year)! Getting experience and developing as a professional takes time.  Being ambitious can make you a strong clinician, but don’t get hung up on wanting to be a master right from the start. It took me 3 years to feel "competent" in my Level IV NICU, and even after 9 years, I have moments when I make mistakes and learn something new.  There will be things you don’t know, so get comfortable with being uncomfortable. Ask questions, be nosey, get involved, and take the initiative when you want to develop your portfolio. Every shift is an opportunity to dive deeper, become more confident, and make a lasting impact on your fellow shift workers and patients. I have been in my nursing role for many years and still seek out leadership and professional growth opportunities everywhere I can.  Try to seek out conferences to attend or certificates to earn that could help you solidify and expand upon your nursing knowledge! On a smaller scale, sign up for a class you’re interested in or eat lunch with a group of experienced nurses to learn how they think about certain things! Every small effort can make a big difference when you add up hundreds of small efforts! 7. Prioritize your own personal "work" so you can show up as your best self This is vital! If you’re struggling personally, it is hard to be 100% present during your shift. Research shows that unchecked mental fatigue results in concentration difficulties, irritability, stress, depression, frustration, forgetfulness, and chronic disease. If you can’t focus on important tasks, mistakes are bound to happen, which puts your babies and your nursing license at risk. These issues also spill over into your relationships with family, friends, and co-workers.  I wish someone had told me earlier that it is not only okay to go to therapy but therapy is actually extremely helpful when processing the difficult moments we experience as a healthcare provider. The struggles, disappointments, and fears that come with being a nurse can add up and get really overwhelming. Going to therapy, meditating, exercising, and making fun plans with family & friends are all ways that I put my well-being first. I always try to be the best version of myself and bring good positive energy with me to my shifts.  You might know that you’re having a tough time but may not know what to do about it. If you’re struggling with mental fatigue but aren’t sure where to start, I recommend checking out my “ 10 Tips for Preventing Mental Fatigue ” episode on The Cellfie Show! Listen to Cellfie Episode "10 Tips for Preventing Mental Fatigue" here! 8. At some point, you’ll hit a professional plateau. When this happens, SHIFT. Think about what’s next and how you can challenge yourself in a new and exciting way. We all hit a wall at different points in our careers. For some of us, it happens within a few months of starting our first job. For others it can be years before we start to feel stuck or bored.  What’s important to remember is that you’re never stuck as a nurse! Most of us chose this career path because we knew it opened so many doors and opportunities. There are so many options for you to make big moves and changes in your career, whether that includes becoming a travel nurse, changing the unit you work in, switching hospitals or even taking your career to the next level by going back to nursing school and getting an advanced degree.  One of the best parts about nursing is the flexibility it offers. If you decide that bedside isn’t for you anymore, there are other nurse roles to look into. Check out my blog  “ 51 Nurse Jobs to Consider ” for some inspiration! 9. Doctors make mistakes too We are all human and make mistakes. There will be high-pressure situations that will require immediate decisions by everyone on the medical team. However, it’s important to remember not to blindly follow orders under pressure, especially those that you question or feel uneasy about.  Don’t be afraid to speak up when you think there might be a mistake. Listen to your gut and trust your teaching. Question the appropriateness of orders, especially if you find yourself working in a teaching hospital with medical students, residents, fellows, and interns.  It can be so easy to get caught up in the emotions of an emergency situation and blindly follow a process, but you have to be strong and speak up to help your team and your patients. Mistakes can mean the difference between life and death in the NICU, so we all have to play our part to make sure we’re keeping our patients safe.  10. You will face many ethical dilemmas along the way. During your career as a NICU nurse, you’ll have moments where you disagree with how your medical team is handling a particular situation. If you feel strongly about how to handle the situation and everyone else seems to have made a different decision, it can become ethically and morally stressful. One of the hardest ethical dilemmas I’ve faced is knowing how much or how little information to share with a patient and their family. For example: Do you continue care on a patient whose outcomes are poor just because a family wants you to?  Do you continue life-saving care on a patient because your facility’s legal team tells you to do so?   Do you choose to provide hope to a patient’s parents, even if the outcomes don’t look promising?  Are you aware of certain complications of a particular procedure that the family isn’t aware about?  These scenarios are the types of ethical issues that I find most challenging as a nurse. In these situations, it can be helpful to bounce your ideas and viewpoints off of others in your team’s chain of command. This could be your unit’s charge nurse, manager, CNS, or even the director of nursing. Hospitals also staff ethical committees to help in these challenging situations, so don’t be afraid to collaborate with them if you’re feeling particularly stressed or concerned. 11. You are the coordinator of the party When you’re new, you may have serious imposter syndrome. However, you have to remember — many family members think of you as the boss! I like to think of myself as the host of the patient’s party. As the nurse you’re the direct link between the patient and their family members, MDs, NNPs , surgeons, consultants, RTs, therapists, social workers, and radiologists. while they are under your care.  It’s important to remember that you are your patient’s best advocate and that it’s your job to ensure that your patient is given all medical information, education and treatment options so that they can have the autonomy to make the decision that’s best for them.  Obviously, this looks different depending on your specialty/unit, but the idea is the same. You  are the one who is coordinating the other members of your team to keep all of the balls in the air.  It’s vital that you give correct and timely information to the patient’s “team” to ensure they receive the quality care they deserve.   Okay — this sounds like a lot to handle. What’s the real tea?  Chances are, you’ll form a love-hate relationship with your nursing career. You’ll have hard days that leave you in tears on your commute home, but you’ll also have the days where you leave work feeling proud of yourself for helping to save a life. On your hardest days, don’t forget the good days that have shaped you into the strong nurse, colleague, and community member you are today. The talent and expertise that you bring to the table is needed in nursing today more than ever before. Join Our Nursing Support Network Looking for support from others in the NICU community? Join NICUity Neighborhood , a free forum full of new and experienced nurses looking to grow and learn from each other! You can find answers to your toughest questions and help provide support and guidance to others looking for help! We’re all in this together :)  Leave any questions you have about starting your new nursing career in the comments below! XO Tori Meskin MSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

You might be wondering: What are “normal” NICU vital signs and how do we assess them in our newborn patients? Here, you’ll find out all you need to know! NICU NURSE VITALS Collecting and documenting vital signs is an essential part of being a nurse. No matter what speciality or clinical setting you work in, you’ll be expected to assess your patient’s vital signs to monitor their stability and health status. It’s no surprise that part of being a NICU nurse  means collecting vital signs on their newborn patients. However, vital sign parameters are different in the NICU, and we collect our readings differently than nurses in other specialties. Below, I’ll answer the following questions: What vital signs are most important when working in the NICU? How do you conduct a newborn assessment and collect   infant vital signs? What equipment is needed to obtain newborn vitals? What Vital Signs Do NICU Nurses Monitor? Similar to nurses in other intensive care unit specialties, most NICU nurses document the following six vital signs:    1. Heart Rate 2. Respiratory Rate 3. Oxygen Saturation 4. Blood Pressure 5. Temperature 6. Pain In addition to these vital signs, assessing newborn measurements is also essential to documenting developmental progress. These include: Head circumference (the distance around a baby's head) Abdominal circumference (the distance around a baby’s abdomen at the level of their belly button). Length (the measurement from crown of the head to the heel) Weight (usually measured in grams) What Are Normal NICU Vital Sign Parameters? The normal ranges for NICU vital signs  might look different than those for adults or older children: 1. Heat Rate: 100-200 beats per minute 2. Respiratory Rate: 10-100 breaths per minute 3. Temp 36.5 C - 37.5 C 4. Oxygen Sats - 85-100% 5. Blood pressure: depends on gestation  6. Pain: NPASS scores between 0-4 Collecting Patient Vitals in the NICU: 3 Important Steps Part of what makes working in the NICU so unique is the complexity of our patient population.  Each baby will have different “normal” vital sign parameters  according to their gestational age. Step 1: Assess Your Patient Before documenting an infant’s vital signs, you’ll want to perform two types of assessments:  A full-body physical assessment A maturity/gestational assessment  These can give insight into particular findings and can highlight areas of concern . Then, once you’ve done that, you can proceed with vital sign collection. We outline how to carry out these  important steps below: a. Infant Full-Body Physical Assessment Before you check a NICU patient’s vitals, you’ll want to take a look at their general appearance. If you’re just starting out your shift, you’ll want to do a thorough physical assessment. If you’re collecting repeat vitals, a quick look-over will suffice. Before you check a NICU patient’s vitals, you’ll want to take a look at their general appearance. If you’re just starting out your shift, you’ll want to do a thorough physical assessment. If you’re collecting repeat vitals, a quick look-over will suffice. When conducting your physical assessment, take note of the following characteristics: 1. General appearance: Physical activity, tone, posture, and level of consciousness 2. Skin: Color, texture, nails, presence of rashes 3. Head and neck: Appearance, shape, presence of molding (shaping of the head from passage through the birth canal) Fontanels (the open "soft spots" between the bones of the baby's skull) Clavicles (bones across the upper chest) 4. Face: Eyes, ears, nose, cheeks 5. Mouth: Palate, tongue, throat 6. Lungs: Breath sounds, breathing patterns 7. Heart sounds and femoral (groin) pulses: Strength and palpability 8. Abdomen: Presence of masses or hernias 9. Genitals and anus: Open passage of urine and stool 10. Arms and legs: Movement and development. b. Maturity/Gestational Assessment In most NICUs, an examination called The Dubowitz/Ballard Examination for Gestational Age  is often used to estimate a baby’s gestational age. This exam evaluates a baby's appearance, skin texture, motor function, and reflexes. The physical maturity part of the examination is done in the first two hours of birth. The neuromuscular maturity examination is completed within 24 hours after delivery.  Information collected from this exam is often used to help estimate babies' physical and neuromuscular maturity. These help us ensure that we’re providing appropriate care and are meeting the infant’s developmental needs. For example, a very small baby may actually be more mature than it appears by size, and may need different care than a premature baby. Step 2: Document Infant Measurements Once you’ve completed your assessment, you’ll want to measure the infant's head circumference, abdominal circumference, and length. These are usually measured with paper measuring tapes using centimeters. Next, you’ll want to get your patient’s weight. A baby's birth weight is an especially important indicator of health. The average weight for term babies (born between 37 and 41 weeks gestation) is about 7 lbs. (3.2 kg). In general, super small babies and very large babies are at greater risk for problems. To prevent complications, babies are usually weighed daily or every 12 hours to assess their growth, fluid, and nutrition needs. It’s important to remember that newborn babies often lose 5 to 7 percent of their birth weight within the first few days. For example, a baby weighing 7 pounds 3 ounces at birth might lose as much as 8 ounces in the first few days. Babies will usually gain this weight back by 2 weeks of age. However, premature and sick babies may not begin to gain weight right away. Most hospitals use the metric system for weighing babies (grams/kilograms). This chart can help you convert grams to pounds. You can also download a conversion app on your phone! Step 3: Collect Vital Signs Finally, you’re ready to collect vital signs. Most readings will show up on the patient’s electronic monitor, but you’ll need to know how to assess each vital sign. Let’s dive in.  1. Heart Rate Normal Range: 100-200 beats per minute Heart rate & pulse are monitored with 3-lead ECG stickers placed over chest & lung areas. These stickers are usually changed everyday or every other day and remain connected to the patient at all times. You should also manually listen to the infant’s heart rate using a stethoscope to ensure the stickers are reading appropriately. The best time to measure an infant’s heart rate is while they’re sleeping! Equipment Needed: ECG leads/stickers, stethoscope 2. Respiratory Rate Normal Range: 10-100 breaths per minute The same 3-lead ECG stickers you use to collect an infant's heart rate will be used to measure their breathing rate. You can also usually visualize a patient's breathing rate to assess for depth of breaths and breathing effort.  Equipment Needed: ECG leads/stickers, stethoscope (same as heart rate leads) 3. Oxygen Saturation A pulse ox probe (attached to hand, wrist, or foot) monitors the oxygen saturation. This tells us how well a baby is perfusing.  Equipment Needed: Pulse-Ox sticker and probe 4. Blood Pressure Most NICUs will use automatic blood pressure cuffs to analyze an infant’s blood pressure. These blood pressure cuffs are sized based on weight. For infants who have an umbilical artery catheter (UAC) or arterial line, we can measure their blood pressure continuously, like we do their heart rate and oxygen saturation. Equipment Needed:  Blood pressure cuff OR UAC/arterial line tubing/cables 5. Temperature Temperatures are usually taken via the axilla (armpit). If a baby is in an isolette, a skin probe (attached to the baby) displays the baby's temperature. This is how we keep them nice and toasty. Equipment Needed:  Thermometer or temperature probe  6. Pain Pain is usually scored every 3-4 hours with some form of the standard pain scale, though it should be measured more frequently for patients on IV pain medication or for those infants who may be withdrawing from long-term/maternal use pain medication. “NPASS” is the most common pain scale used in the NICU. Equipment Needed: None/visual assessment only Looking for More Tips on Providing Great Care? So there you have it — now, you understand how to appropriately collect infant vital signs! If you’re looking for additional information on how to provide safe and effective infant care, check out our other resources, toolbooks, and guides on NICUity’s webpage ! NICU Nurse Essential Resources American Academy of Pediatrics Academy of Neonatal Nursing Childhood & Adult Immunization CDC Guidelines March of Dimes! Resources for parents & providers Access 1,300+ Drugs with Easy-to-Understand Lactation Risk Categories National Association of Neonatal Nurses National Certification Corporation - NICU National certifications for experienced nurses NICU University & Peds University Vermont Oxford Network - 1,300 hospitals collaborating around the world! Tori Meskin MSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN graduate a Barco Uniforms Ambassado & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com ​

I’ll tell you what I want, what I really, really want… Let’s be real, so many years the holidays roll around and we get hung up on waiting to the very last minute for purchasing holiday gifts as we wait for inspiration to strike for the perfect combination of useful and unique to pop up. Then we wait too long and end up gifting or getting things that will end up being re-gifted or donated and promise ourselves we will do better next year…I know I’ve been guilty of this… 15 Perfect Gifts for Nurses Picking out the perfect gift for your favorite nurse can be tough. Whether you’re celebrating nurses week, the holiday season, a coworker’s graduation or retirement, or a friend’s birthday, we’re faced with the decision — what are good gifts for nurses?  Waiting until the last minute can make the whole experience stressful and takes out the fun of hand-selecting a present they’ll love. Here, I’ve listed fifteen of my absolute favorite nursing gifts to give and receive. There is something on here for every nurse and every budget. Maybe you’ll even find something on here for yourself! ;) Let’s dive right in to my favorite nurse gift ideas!  1: RAD GIRL PINS Don’t conform to boring…Rad Girl Creations makes the best medical pins and anatomy swag. We all have to wear the standard scrubs uniforms in healthcare, so why not let your dark humor side shine through with some personality on your badge. I love their specialty pin packs that are great, personalized gifts to celebrate the dedication of the healthcare worker / work wife in your life. Shop Rad Girl Pin s HERE! 2: UP AT DAWN SOCKS Flip the narrative on boring socks as a staple gift. I love saving my feet while working long hours in my Up at Dawn Compression Socks. Up at Dawn socks are designed in Oahu and the tropical vibes are so on point. Supporting female-founded, nurse-owned businesses is something I am super passionate about. An Emergency Room Nurse for over ten years, Tesla has crafted compression socks that she is proud to wear and now share. With the endless inspiration of the flora and fauna of the Hawaiian Islands, and more specifically, her home on the North Shore of Oahu in the quaint hills of Pupukea, Tesla envisioned dynamic compression socks that would extend their use beyond the laborious long hours spent at work. Her mission was to create a sock others would wantto also wear for both functionality and style; from hiking/biking/running/skating, to the expectant mother, to travelers, and even lounging. https://www.upatdawn.co 3: Work Lunchbox Filled With Snacks We all know that the key to every nurse’s heart is snacks and drinks! Loading these treats up in a cute lunch box or cooler bag can make it an even better gift! My top picks: LOKASS Insulated Lunch Bag SmartSweets Variety Pack Awake Caffeinated Chocolate Bites That’s It Mini Fruit Bars LiquidIV Electrolyte Drink Mix 4: Cozy Sweatshirt for Cold Shifts Nurses can never have enough soft, warm hoodies! These cute sweatshirts are perfect for wearing to work over your scrubs (why does every hospital seem to turn its heating off at 10pm?) and are even great to throw on to go to the grocery store on a day off!   My top picks: Beautiful Day to Save Tiny Lives Fleece Pullover NICU Nurse Era Crew Neck Tanming Puffer Jacket Per Diem Princess Sweatshirt Blencot Oversized Half Zip 5: Fun Stickers These are great stocking stuffers o r white elephant gifts for a small budget! Y ou can also throw a few in on top of a card or gift voucher to add a personal touch. My Top Picks: NICUity Sticker Set Cute Swaddle Sticker Burrito Enthusiast Sticker 6: Shift Survival Pack This gift is similar to the “bag of snacks” idea, but instead of sweet treats, your bag can be filled with shift essentials to get them through a long 12-hour shift. I’m talking lotions, pens, hair ties, water bottles…you name it!  Feel free to customize and add things that you know they’ll love. This is a great gift idea for groups of nurses as well if you’re looking to say “thank you” to a team of top notch clini cians!  My Top Picks: Wipeable and Cleanable Clear Cosmetic Bag 4-Color Carabiner Pen Mini Hair Brush Phone Charging Cable L’Occitane Hand and Nail Cream Native Deodorant  Claw Hair Clips 7: Blue Light Blocking Glasses Anyone that knows me knows I love my blue light protection glasses! They prevent eye strain when looking at computer screens and offer protection against spills and splashes when providing direct patient care. They also help improve sleep quality. I’ve listed a few of my favorite styles, but any brand or style will work! My Top Picks: Peepers Readers Blue Light Glasses Warby Parker Blue Light Glasses Stoggles Blue-Light Blocking Safety Goggles  8: NICU Nurse Masterclass This gift is on the pricier side, but is perfect for any of your nursing friends looking to transition to the NICU. It’s also a great graduation gift for nursing students  looking to get started on the right foot. You can give them the e-learning modules , or could also throw in the hardcopy reference materials  as well. This is a gift that will keep on giving as it supports professional development for years to come.  9: A Set of Comfy and Flattering Scrubs A new set of scrubs is a great gift for any nurse! You can add in a set of comfortable nurse shoes or compression socks to really revamp their wardrobe. Be sure to check whether the nurse has any mandated scrub vendor or color requirements prior to purchasing :)  My Top Picks: Hanes Scrub Set Landau Scrub Set Dansko Clogs 10: Candles to Enjoy At Home On Days Off Nurses live for their days off! It’s one of the perks of working long hours. There’s no better way to enjoy a day off than by sitting on the couch, reading a good book, listening to relaxing music with a candle burning! Candles are perfect for any season or occasion and you can often find one to fit your budget!  My Top Picks: Capri Blue Scented Candle Ryan Porter Candle Tyler Diva Scented Candle Jo Malone Honeysuckle Candle 11: Cute Badge Reel Every nurse, no matter their specialty or clinical setting, wears a badge to work every day. Make getting ready for work fun by gifting them a cute new badge reel! This is a great way to bring a laugh or smile to your favorite nurse — the patients and families they care for will love it as well.  My Top Picks: NICUity Badge Reel I Love Tiny Humans Badge Reel Ask Me About Our Burritos Badge Reel 12: Water Bottle or Coffee Mug Staying caffeinated and hydrated helps nurses stay on their A-Game! Whether your favorite nurse likes drinking coffee, tea, water, or electrolyte po wder, a new water bottle or mug is the perfect nursing gift. Extra points if the mug is bleachable and has a covered straw or spout (no hospital germs, please!).  My Top Picks: NICU Crew Tumbler Coffee, Scrubs, Hustle Mug New Grad Tears Tumbler Owala Free Sip Water Bottle Sounds Like a Day Shift Problem Tumbler 13: SIMPLY TUESDAY HEALTHCARE HEADBANDS Looks like masks are here to stay for us in the healthcare setting! Save your ears with this amazing healthcare accessory. Support a nurse and woman-owned small business with your purchase of a headband + buttons for your mask! I have been wearing these headbands since the beginning of the pandemic and now this is a staple in my shift life. This genius headband style has made mask wearing for long hours during my shift comfortable and stylish. She has a variety of fun designs to choose from on her shop linked here. Healthcare Headbands Here: simplytues.com 14: A STETHOSCOPE... OF COURSE! The most popular stethoscope that I always feature on IG is on Amazon! In terms of stethoscopes I use daily, I have used Littmann & MDF stethoscopes at the bedside. Typically, stethoscopes are provided bedside in the NICU (for infection control). However, I own one of each (Littman & MDF) for floating purposes. NICU / Pediatric Littmann for floating to Postpartum & this MDF white & rose gold stethoscope to work (in case of floating to the Pediatric units). This highly-rated Classic Cardiology is phenomenal for detecting hard-to-hear heart sounds. Physicians, nurses, EMT, and vets alike love the heavy-duty chest piece with its super-sensitive diaphragm, extra-thick dual lumen tubing with total sound insulation, adjustable headset, and silicone ComfortSeal ear tips (with three sizes to ensure the perfect fit!) Shop This Stunning Stethoscope on Amazon 15: ELLIOT YOUNG JEWLRY You can never go wrong with a timeless gift such as a piece of fine jewelry that will last through wear and tear, maintain their shine, and gives back to a meaningful cause. These 14k gold necklaces and earrings from Elliot Young can be paired together for a classic look or worn alone as a beautiful statement piece. What makes these pieces even more special is the fact that the charms represent balance, energy, and protection. All something us in healthcare could use a little more of in our lives! Elliot Young is a women owned business that donates a percentage of profits from my collection with them to Brave Beginnings, an organization that supports NICU’s by providing essential equipment to hospitals in need. Fine Jewelry Collection for A Cause: https://elliotyoungla.com/collections/nurse-tori-collection NURSETORI25 for 25% off Looking for More Gift Ideas? It was SO hard to narrow down this list to only 15 of my favorite nursing gifts! If you’re looking for more great ideas, take a look at our NICUity shop  page, full of nursing educational resources, bedside tools, apparel, and more! Also, you can check out my Amazon storefront , which is chock full of all sorts of great items for anyone on your list! Well there you have it. My favorite picks for the 2024 holiday season! I hope you find it helpful as you get a head start on holiday shopping. Would love to know your favorite gifts for 2024 in the comments below! Happy Holidays! Tori Meskin MSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN graduate  a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey, married & new mom life & juggles work, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com  or info@tipsfromtori.com

There are many ways to bond with your baby – even during his or her NICU stay. Bonding is important for baby development. It helps babies feel loved, safe and secure. But bonding can take time and baby in the neonatal intensive care unit is a family crisis. Parents are rarely prepared for the challenges of the NICU environment, such as the fragile condition of the infant, the high level of technology, and frequent crises. No matter your vision, the reality of admission to the NICU with a medically fragile infant causes feelings of reactions as fear, anger, confusion, and loss. You may first feel as if you have no idea how to handle the situation, but with time, new preemie parents grow confident in their understanding of what is happening and what to expect . So even if you're feeling lost now, give these 12 suggestions below a try. They'll get you off to a good start. Suggestions for Bonding with Your Newborn in the NICU 1. Do Your Research, But Don't Overwhelm Yourself When you’re about to go online to look up preemie-related questions, take a moment to ask yourself: "Do I really need this information right now?" Stumbling across preemie stories with negative outcomes may make you anxious. If you’re going to stress and fret all night long after reading about worst-case scenarios, it's just not worth it. Instead, talk to your baby's doctors and nurses and consult with other NICU parents you meet. If you must go online to do research because you feel you’re just not getting the answers you need, remember that the scary stuff and the negativity is not your baby and it’s not guaranteed for every baby. Stay focused on the positives. 2. TALK TO BABY A quiet soft voice will offer a sense of comfort. Babies are familiar with your voice from inside the womb so hearing it now might be able to help stabilize him or her . Bonding will look different for each individual family due to each baby’s unique circumstances. Certain factors – such as the mom’s health, the baby’s medical issues, diagnoses, and gestation at birth – will affect the ways in which families can bond. For example, a baby born at 25 weeks cannot be held right away due to his/her medical instability, (IVH and infection precautions). However, a baby born at 34 weeks may be held, depending on his or her medical condition. Some NICU babies are able to tolerate touch very well, while others require minimal stimulation due to respiratory support, pre/post op care, hemodynamic instability, etc. If you were unable to hold your baby within the first 24 hours or the first several weeks of life, please know that your opportunity to bond with your baby was not completely lost. In fact, it is imperative! Initial bonding might be a bit different than you anticipated but your presence and calm energy are a big piece of baby's healing and growth. 3. VISIT WHEN YOU CAN Your presence alone can have a long-term positive impact on your baby’s development and give you confidence as a parent too. Spending time with your baby in the NICU is such an important part of bonding. Parents or parent figures are constant. Although your situation seems so foreign, getting involved and getting into the routine provides structured normalcy. Ask questions, review the plan of care, and empower yourself with an understanding of the NICU day-to-day routine. The more we see you and get to know you the better. It is helpful when you know as much about your baby as we do! NICU Parent Perspectives. Innovators. Entrepreneurs. 4 . ASK FOR NURSES YOU LIKE Probably the most unpopular opinion. Some personalities jive better than others. If you have a nurse or two you really bond with, ask if they are able to primary your baby. Some hospitals do this, while others do not due to staffing needs. But it never hurts to ask! This is your time too. Parents can start to change the baby's diaper, help in taking temperature, and participate in feeding (if appropriate) the baby. Whether it be a bottle or breastfeeding understanding the process can truly empower you to feel a part of the process. Parents are the baby’s best health advocates! Get to know the nurses. Get to know the MDs, RTs, OTs, and medical team members. Together we can help lead you throughout the NICU Journey. 5. FINGER-GRASP For our especially tiny micro preemie or medically fragile newborns offering your baby, a finger with a gentle grasp can be a beautiful and precious way to bond with baby. You can also offer a "hand hug" and provide a positive soft touch while talking to baby. 6. SKIN TO SKIN: KANGAROO CARE After baby is stable and the medical team has confidence in baby's health status parents can start the skin-to-skin process. The sound of mom's heartbeat is a familiar sound to them & it has been medically proven that skin-to-skin helps a baby thrive in the NICU. Also, a great aid for mothers' breastmilk production & daddy’s bonding. Daddy this is your time too! Babies know your heartbeat, scent, voices, tones etc. Skin to skin is the best way to bond with your new little one. 7 . PERSONALIZE YOUR SPACE You can also decorate the baby’s area. Decorating your baby’s Isolette with a milestone, holiday, or special moment is another great way to create that special bond. Bring "home" to the Hospital. Bring pieces of your family’s life to place in your infant’s isolette or crib in the form of family photos, a special blanket, artwork from siblings, and more. (Some NICUs are more strict on policies so just ask what they allow). Etsy has some fun "Milestone Cards," and NICU decor to offer. Many families find that making a sign with your baby’s name, decorating with family pictures, or adding other personal touches can feel like you are giving your baby a piece of home while you are away. 8. LETTERS TO BABY Write it out. Writing can be therapeutic and tangible. Noting big milestones, tracking the journey, and processing your NICU stay can really empower you during the process. This is something you & your baby can look back on & can also give you an outlet to express how you’re feeling at that moment. Some families find that documenting their baby’s experience in the NICU by journaling or scrapbooking (either digitally or in physical form) can be helpful. Taking photos and journaling experiences may feel very tender and sometimes painful. I encourage you to document what you can and when you feel able. In moments when you’re not feeling up to it, ask someone else to help you do this by taking pictures or writing memories. 9. FACE-TIME Thank goodness for technology! Some NICUs have a “NIC-VIEW” camera (a little camera that can be placed above your baby’s bed) that parents can view live online. This is a great opportunity for parents that can’t always be at their baby's bedside. (Not all NICUs have this technology but it doesn't hurt to ask. Each NICU holds a different platform and policy for viewing. 10. INFANT MASSAGE Take a class through a certified infant massage instructor and utilize techniques with your MEDICALLY STABLE baby. Benefits include reduced levels of cortisol (stress hormone), increased muscle tone, and supported parent-infant interactions, among others. Speak with your baby’s doctor and bedside nurse before using this technique with your medically fragile infant. MASTERING PREEMIE / MEDICALLY FRAGILE MASSAGE 11. LEAVE YOUR SCENT Check with NICU staff to learn what cloth items are appropriate to place in the baby’s space. Sleep with that item or wear it all day tucked under your clothing, then place in your baby’s space. Swapping scents back and forth from mother and father to baby are well documented evidence-based practiced outcomes! Not only will this help your baby, but it is also a source of comfort for you! You can find "Lovies" on Amazon or Etsy if your NICU does not offer them. 12. LEAN ON LOVED ONES AROUND YOU This can feel like the most overwhelming time in your life. You may experience a variety of emotions. Overwhelmed, frustrated, and even loneliness. This is a great time to use people around you who want to help. Whether it is a family member or distant friend, lean into their help. From delivered dinners, help with laundry, childcare, transportation, amazon gift cards, etc. Let these people in your life help you. This can truly help you, which will ultimately help you and your beautiful baby. 13. TAKE CARE OF YOU & YOUR RELATIONSHIPS This time can be one of the most overwhelming times of your life. If you feel overwhelmed and insecure, you’re not alone or failing at this. If you’re feeling sad or confused, that’s okay. These are all such normal responses. It's ok to take some time away and revive yourself. Take a shower, go on a date night, sleep, take a walk, girl or boy night, and refocus your mindset. One of the most important components of this time frame is parental involvement, both in gains for the baby and in fostering an appropriate parent/baby relationship that will allow for an easy transition to home. All care should be family-centered, and every effort should be made to involve parents in all aspects of caring for the baby. It is during this stage that we prepare both baby and parents for discharge from the small baby unit. Our ultimate goal is to empower the family to become the best caregivers for their infant, thereby improving the outcomes of the baby and the satisfaction of the family. You got this! Listen to this holy-grail list of episodes from all aspects of the NICU! These Cellfie Show episodes will give you insight into your most pressing NICU-related questions as well as a fresh perspective from the point of view of NICU providers, entrepreneurs, and parents. No matter your experience with the NICU so far, I hope you take away something new in these episodes that you can apply to your unique journey! *If you have any questions about what is most appropriate for your baby, consult with your baby’s medical team. NICU Essential Resources American Academy of Pediatrics Childhood & Adult Immunization CDC Guidelines March of Dimes! Resources for parents & providers Access 1,300+ Drugs with Easy-to-Understand Lactation Risk Categories Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

The job application process can be daunting to say the least. From trying to find the job, applying to a job, creating a high-quality niche portfolio, mastering an interview, and hoping to land that dream job….whew! So, I thought I would give you the “real tea,” on all things New Grad Nurse Job application. Let's get into how to land your dream nursing job! Should I know anything specific about the organization I applied to for the interview? This is an often overlooked step, and the answer is yes. You need to spend time researching the organization you have applied to. (I get it, sometimes it is tough to find information, but do your best). It is always better to be overly prepared. Is the organization a magnet hospital? What are the core values of the organization? You can also impress your interviewer by asking them a question in your interview about the culture of the organization! Should I Obtain Certifications / PALS / BLS / ACLS / NRP? Always assume someone went the EXTRA MILE to land the job you want! Think of it this way, just as athletes put in extra hours & practice when no one is watching, nurses should operate with a similar mindset. If you made it through nursing school, you have GRIT, use it and go that extra mile. Find extra opportunities if possible in the specialty you seek, as anything you can do to land the job you want will be important when your resume is compared to others'. Certifications are a great way to boost the resume and prove to your future employers that you have what it takes! While it is possible that your employer may have you re-do the certification once you're hired…who cares! Repetition will only benefit you by building confidence and reinforcing the skill. It is absolutely worth it to have a certification(s) and hold an edge over your competition! CHECK OUT OUR E-BOOK COMPLETE WITH INTERVIEW TIPS & TRICKS. BONUS QUESTIONS, RESUME AND COVER LETTER RESOURCES, SOCIAL MEDIA CONSIDERATIONS AND MORE! Should I make a LinkedIn profile? No matter what career you want to be in, a LinkedIn profile is a must in 2021. Your LinkedIn profile will help a manager, HR rep, etc. put a face to a name and will make you more memorable. While it is true that not every employer will use this as a resource, you may want to utilize it for building a network of like-minded, professional connections and for possible job searches down the road in your career. Your profile should include a professional picture, along with your educational achievements (school, honors, projects, volunteer), certifications, etc. Social Media…does this really matter when I am applying to jobs? Yes. Clean it up! It doesn't matter if your profile is private either. Keep it classy and refrain from posting anything that could be perceived at all negatively. Possible employers will not waste their time on potential candidates that they believe have poor character and will not fit the organization's core values and professional culture. When you are applying to jobs, keep it all professional and think before you hit post! Should my Resume be 1 or 2 pages? The rule of thumb is to keep your resume at one page, as managers care less about the second page. All of the important information needs to be on the front page. In all honesty, my resume ended up being two pages when I applied to my new grad nurse position. If you have the extracurriculars, pertinent certificates and volunteer experience by all means include it on the second page if needed rather than leaving it out. If you go to two pages, make the highlight reel on the first page. You will want to make sure that your resume is also visually appealing and in an easy to read font and format. From a glance, the manager who is reviewing your resume should be able to determine your most important attributes front and center. How do I find the “actual” job listing? It is hard to know when to apply and the official name of the job. 1. Call HR! They are the gate keepers. Inquire when the New Grad Residency (Versant program, Clinical Nurse I) positions will open up and mark your calendar. 2. Ask HR what the official name of the job position will be. 3. Sign up for the job notifications so you don't miss your window. 4. Sign up & create a profile on the organization job application website. Should I call HR or manager to inquire about my job application status? Both management & HR are VERY busy. In due time, I promise they will get to you. I would suggest sending the manager a thank you note & or emailing him/her a thank you so that you are fresh in their mind. If you send a thank you, keep it brief and to the point and mention that you are looking forward to hearing back soon and are grateful for the opportunity. Sending a thank you a day or two after your interview is a nice idea to let them know how thankful you are for the opportunity & your desire to join their unit. (HINT: make sure to get the manager’s card or contact information at the end of the interview, or look through the emails they sent you to obtain the manager’s mailing address or email). You will not want to seem demanding or overbearing, so make sure to let them contact you after sending the initial thank you. Do you have tips on interviewing? (NICU, PICU, CVICU, ICU, Med Surge, Oncology, Clinic, etc.) Let’s talk about the entire reason for an interview. The bottom line is that they want to know if you will be a good fit for the unit/setting. Do they like you? How qualified are you (with your limited time as a nurse) to start on their unit? So, that being said, focus on why you want to be there in the first place! Communicate why you believe they should they hire you (over the person interviewing next) by sharing your key competencies. Also, Practice. Practice. Practice! Practice interviewing until you are blue in the face. Practice in the shower, on your drive, in front of your mom. Practice until your stories come so naturally that you can’t possibly forget them. You've got this! See full Blog post on Interviewing 101! Is it beneficial to communicate with someone I know on the unit prior? Ask them to vouch for me? (Family friend, Preceptor, Cousin, etc.) If you know someone on the unit, yes it can be beneficial to touch base, inquire about application dates, and ask about any highlights you should know about the unit. As far as “vouching for you,” to the management team, tread lightly, as that should only be suggested by the person you know. In addition, keep in mind, some people have a GREAT relationship with their management team and others do NOT. Therefore, the person you are in touch with may not be the best to “vouch.” It pays to be self-aware on this one. What do I include in a Portfolio? Let’s talk the purpose of a portfolio. A portfolio is the extended highlight reel and extension of your resume. A properly prepared portfolio will give you the “edge” over your competition. Honestly, I have only used my portfolio 3 times out of 8 different job interviews. For your first job, a portfolio is a MUST. Why? This is a supplemental tool for you to use in order to speak to and solidify your job application. Below is a bulleted list / outline of what to include in your portfolio. You create it. You practice with it. You speak to it. A portfolio is a TOOL to use in order to help you pull together stories and experiences, as well as ultimately ease the nerves for your interview. I suggest practicing your interviews with the portfolio. Due to current circumstances with virtual interviewing, you may not be able to share the portfolio with the management team as easily, however, use it as a tool to help you interview! What should I include in my Portfolio? Let me give you the deets! Professional Role Resume (Shop Resume Rx Templates code CELLFIE 20% OFF) Cover Letter (Shop Template) Professional Certifications National Certifications Education University (Copy of your Degree) Professional Activities Projects Volunteerism Professional References (Shop Template) Professional Recommendations I hope these tips help you as you work to land your dream job as a new grad nurse! I believe in you!!! Xo Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com ​ Instagram @nurse.tori_

Nursing is truly a calling & one with rewards far beyond money and three day work weeks. ♡♡♡♡♡♡♡♡♡♡♡♡♡ Let's face it, if we learned nothing else from 2020, it was that Healthcare providers are truly essential. Well that is certainly the case with the onset of the Sars-Cov-2 (COVID 19) virus. And without a doubt, we will never be out of a job. The need for providers continues to surge and there is never a shortage of people (& infants / children) who require care. Yet, there are not enough Nurses. While the demands for healthcare providers continue to rise the shortage of nurses continues as well. Why is this?! Money. It takes a lot of time and resources to train a brand new nurse (It took me 6 months before I came off orientation & became an asset to the hospital. $30,000 cost to the hospital) With this being said, it is important to make yourself as marketable as possible as a potential candidate, which we will get into later. Before we dive into my Tips, let me tell you a little bit about my path to becoming a nurse. I moved out of state to Arizona (from California) where I attended The University of Arizona, Tucson AZ. I started at UofA #beardown as a Pre-Nursing Major, where I completed my 2 years of undergrad and applied to nursing school. But it wasn't all roses! Well, this is how that went…… Applied once, REJECTED . Applied a second time, got an interview, REJECTED . Applied third time, got an interview, REJECTED . Then got a call, I had made the (second) cut of students (someone had dropped out prior to starting school). WAITLISTED My admission to Nursing school was anti-climatic to say the least. ♡♡♡♡♡♡♡♡♡♡♡♡♡ Yes, it took me 3.5 times to get into Nursing school! Therefore, I feel you! I have been in the hot seat and I know what it is like to climb your way into Nursing with every ounce of hope and hustle you have. So how did I finally get into nursing school?! I DIDN’T GIVE UP! I PERSEVERED. I HAD SUCH DETERMINATION & FOCUS THAT NOTHING COULD STOP ME. I KNEW I WAS GOING TO BE A NURSE. Here are some personal tips & advice for your first hurdle, getting into Nursing School! ♡♡♡♡♡♡♡♡♡♡♡♡♡ TORI'S PRE-NURSING TIPS 1. RE-TAKE THE CLASS If you have to, just do it! If I got the “B” in Microbiology, I went back that summer for the “A." Was it fun? No! Was it time consuming? Yes! But it was worth it! Boosting those grades was key for my application to Nursing school. 2. PRACTICE YOUR INTERVIEW Many nursing schools require an entry interview. If this is the case for you (and it will be for your first job as well) I suggest start preparing now! Practice practice practice. I was horrible at interviews! Nerves, overthinking, rambling on, overwhelming feelings of what to say. But I practiced! If I stumbled over words in an interview, I re-practiced questions all the time! In the shower, in front of friends and family, my car, until my brain hurt. 3. BOOST THAT RESUME From activities to boosting grades I found every way to boost that resume! I added activities (to my already overly busy schedule) to help boost me over the next candidate. 4. VOLUNTEER Find something you are passionate about! Red cross, student leadership, homeless shelters, Hospital help, Veterans causes, etc! There are so many organizations that could use your help. In addition, these are great experiences and resume boosters for your nursing application. I volunteered at “Ride On” Therapy (Equine therapy for Children & Adults with physical & cognitive disabilities), the Workforce Diversity Program at University of Arizona (to help low socio-economic middle schoolers learn about the opportunities in Nursing), and a Veterans cause! 5. WORK IN THE FIELD! CNA, SCRIBE, VOLUNTEER, SECRETARY, HEARING SCREENER, ETC . Working directly in a hospital can give you great "in field" experience, offer opportunities to learn about units first hand, and most of all NETWORK! You will have opportunities to meet nurses, staff, managers, etc. A face to a name! Not only will you be able to add this to your resume, but you will become a familiar face to the nursing staff! 6. BACK UP PLANS ! Make several plans. Personally, I had plan A, B, & C. If University of Arizona hadn’t worked out, I had back up schools & programs planned out (with classes that transferred to the schools). There are so many options out there! Plan ahead and if something isn't working, make plans for your next move. 7. GO THE EXTRA MILE Many schools require different curriculum. One school may require one class or lab, but another may require another class. I opted to take that extra Lab (that wasn’t required for UofA) just incase I needed it for another school. Through this, I actually learned more! Two classes I decided to take actually helped my overall nursing thought process and taught me MORE than I had anticipated! Planning ahead and going the extra mile can make a big difference. 8. SHOOT FOR A "BSN" DEGREE IF POSSIBLE Although this is not a "hard and fast" rule, most most New Grad Programs in teaching hospitals (Level I trauma Hospitals, Children’s Hospitals, Level IV-III NICUs etc) require a BSN “Bachelor’s of Science in Nursing.” In addition, most hospitals are moving towards becoming "Magnet" certified. Magnet is a nation wide program focused on improving patient outcomes with improved nursing engagement. Part of this includes hiring and having Bachelors prepared nursing staff. Healthcare is focusing on having more educated staff members. Therefore, many are requiring staff to obtain Bachelors Degrees. In addition, opportunities for advancement (Management, Education, etc) require higher degrees. My advice, try to land that BSN degree. 9. NEVER GIVE UP I knew Nursing was my calling. Therefore, I never gave up! My advice to you, is NEVER give up. Find a way to make it work! You may have to go far above the call of duty. Work another job, volunteer more often, take a class over to get the better grade, look into other cities (or states), sacrifice social life, some family time, etc. I did all of the above and it was well worth it! LIST OF NURSING SCHOOLS WITH BSN PROGRAMS (CA & AZ) University of Arizona Nursing School Azusa Pacific Nursing ASU Nursing Concordia University Irvine Grand Canyon University UCLA Nursing UCI Nursing UC Merced Nursing UC Davis Nursing UC San Francisco Biola University Cal State University Chico Cal State Chanel Islands Nursing Cal State University Bakersfield Cal State University Northridge, Nursing Cal State University, Long Beach Nursing Cal State University, Fullerton Nursing Cal State Fresno Nursing Cal State University Stanislaus Cal State University Northridge Cal State University Los Angeles National University Nursing West Coast University Nursing Mount Saint Mary’s University Los Angeles Nursing Point Loma Nazarene University San Diego State University Nursing San Francisco State University Sonoma State University West Coast University Western Governors University Tori's NICU NURSE BLOG: See Blog Post Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms AmbassadoR & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

The NICU is a complex unit full of tiny brand new fighters. One diagnosis is certainly our most common admission. Typically babies require about 270 days to fully develop in the womb, after which they are usually ready to make the transition to life on the outside. When babies are born too early, many of their body's organs and systems are immature and unable to function properly on their own. Fortunately, medical science has the ability to help those babies stay alive until they can sustain themselves. A premature baby is one who is born too early, before 37 weeks. Premature babies may have more health issues and may require hospitalization longer than babies born term or closer to term.  Even the most stable of former extremely preterm infants will be challenged by various degrees of lung disease, extra‐uterine growth challenges, difficulty learning oral skills, and even late-onset sepsis during this time period. One of the most common ..... Respiratory Distress! Breathing difficulties are one of the most common issues for premature babies! SO, WHAT CAUSES BREATHING DIFFICULTIES IN PREMATURE INFANTS? Respiratory The primary function of the lung is to transport oxygen from the inspired air into the blood and to clear accumulated carbon dioxide from the blood. The site of this gas exchange is the alveolus Breathing difficulties develop in premature babies for many reasons. One of the main being their lungs don't have the full chance to reach full maturity in the womb. Breathing complications in premature babies are caused by an immature respiratory system. Immature lungs in premature babies often lack surfactant. This substance is a liquid that coats the inside of the lungs and helps keep them open. Without surfactant, a premature baby’s lungs can’t expand and contract normally. This increases their risk for respiratory distress syndrome . Some premature babies also develop apnea and experience pauses in their breathing lasting for at least 20 seconds. Some premature babies who lack surfactant may need to be put on a ventilator (breathing machine). Babies who are on a ventilator for a long time are at risk of developing a chronic lung condition called bronchopulmonary dysplasia . This condition causes fluid to build up in the lungs and increases the likelihood of lung damage. Treatment: While being on a ventilator for an extended period of time may injure a baby’s lungs, it still may be necessary for the baby to receive continued oxygen therapy and ventilator support. Doctors may also use diuretic and inhaled medications. MOST COMMON RESPIRATORY CONDITIONS: 1. Respiratory distress syndrome (RDS) Symptoms include rapid, shallow breathing and a sharp pulling in of the chest below and between the ribs with each breath. 2. Bronchopulmonary dysplasia , a chronic lung disease, is commonly seen in preemies who weigh less than 1,000gm or <28 weeks Gestational Birth. It can be caused by the long-term use of oxygen and mechanical respiration. 3. Apnea  is a condition characterized by prolonged pauses in breathing. Apnea is usually caused by immaturity in the part of the brain that controls involuntary respiration. Let’s talk NICU patients & of different modes of Respiratory Support for our NICU Patients. AIRWAY IS EVERYTHING... The primary function of the lung is to transport oxygen from the inspired air into the blood and to clear accumulated carbon dioxide from the blood. The site of this gas exchange is the alveolus 4. Alveolarization is a process where existing airspaces are subdivided by the formation of new walls, called septa. Therefore, in the NICU we rely on our Respiratory therapists (ALL THE TIME!). Many NICU units have primary care NICU RT’s that specialize in Preemie care. You might call Nurses & RTs “Besties!” TYPES OF VENTILATORS & NICU SUPPORT: 1️. HFOV (High-Frequency Oscillator Ventilator) Gas is pushed into the lung during inspiration and actively pulled out during expiration (Push/Pull Action). Uses small tidal volumes and active exhalation. HFOV provides smaller, faster, but shorter bursts of breaths which may be less damaging to the premature lungs. 2. SIMV “Conventional” Synchronized Intermittent Mandatory Ventilation : (Breaths delivered at a set pressure) Initiation of each breath is a ventilator breath in synchrony with the patient’s breath.  PIP, PEEP, and Inspiratory time are set 3️. CPAP (Continuous Positive Airway Pressure) Continuous positive airway pressure (CPAP) is a mode of ventilatory assistance in which positive pressure is delivered to the airway throughout the respiratory cycle. CPAP is delivered through a set of nasal prongs or through a small mask that fits snugly over a baby's nose. CPAP is used to deliver constant air pressure into a baby's nose, which helps the air sacs in the lungs stay open and helps prevent alveolar collapse. 4️. NIPPV (Nasal Intermittent Positive Pressure Ventilation) Provides a set number of breaths per minute (Delivered at a set pressure) In NIPPV, CPAP provides a constant distending pressure & added ventilator support (add back up rate & pressures) (ventilator with no ETT). It is also referred to as continuous distending pressure (CDP) or positive end expiratory pressure (PEEP) when applied through a ventilator along with intermittent mandatory ventilation (IMV). 5️. HFNC (High Flow Nasal Cannula) This is a small plastic tube that goes into the babies nose; Humidified with increased oxygen/air potential. The air-oxygen flow (via blender) of 1-6 L/min. 6️. NC- Nasal Cannula Small plastic tubes that go into your baby’s nose. Air and oxygen go through the tubes into your baby’s lungs. 7️. iNO (Inhaled Nitrous Oxide) T his is a gas we deliver with our intubated babies to help improve gas exchange. iNO is a vasodilator which can help improve respiratory failure through enhanced ventilation–perfusion matching and/or a reversal of extrapulmonary shunting. (Used in very sick babies) I will do another Medical Monday explaining more! 8. Oxygen blenders allow O2 concentration to be adjusted between 21% and 100%. Quick Terminology: pH : amount of acid in blood  Acidic: lower pH, associated with pulmonary edema, renal failure, and lactic acidosis  Alkalotic: higher pH, associated with hyperventilation, anxiety, pain, hypokalemia, and gastric suctioning CO2 : acid from the lung; reflects respiratory status of acid‐base balance PO2 : partial pressure of oxygen dissolved in blood; and how well oxygen moves from lungs ‐> blood decreased levels = anemia and hypoventilation HCO3 : a base excreted or removed by kidneys; reflects the metabolic acid‐base balance Base excess (BE) : amount of acid required to restore a liter of blood to a normal pH, possible marker of metabolic acidosis or alkalosis Blood gas skeleton example: pH / PCO2 / PO2 / HCO3 / SaO2 / BE The use and the details of management with these techniques should be discussed with the Neonatology Fellow or the Attending Physician for each individual patient. In the era of gentle ventilation and open lung strategy noninvasive ventilatory support in neonates has gained momentum and its use in nurseries around the world is also increased. Another great resource for you BELOW. I was featured on The Morning Rounds and talked all things NICU Nursing. Dynamics, my personal journey, NICU Nurse Tips & Tricks! Tori's Tips on NICU NURSE 101: See Blog Post Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms AmbassadoR & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

There are so many things that come to mind when I tell someone “I am a NICU Nurse” Normally their response goes something like, “Wow, that must be so hard and so sad to work with sick babies. How do you do that?” Yes, that is a true statement. I could tell you about the babies born VERY early struggling for their lives. Babies Born: Far too early, To drug addicted mothers, With life altering diagnosis, Requiring emergent surgeries, Parents who don’t always care, Requiring harsh procedures our tiny patients must endure, Needed many surgeries (more than most adults), The micro preemie “death spells” each preemie faces any time their bodies face discomfort, The clinical trials we must try (to help more babies in the future), The diagnostic tests: Heart ECHO’s, Head Ultrasounds, & Chest X-rays etc.! Our preemies must endure all of this in order for us to monitor their well-being! Add the sterile line changes we must do to protect our most vulnerable, The meticulous scrubbing, chlorhexidine wiping, sanitizing, sterile gloving, painful hand washing so much so because I don’t’ want to be the reason a baby gets a blood stream infection. I could tell you about the many orgiastic and nasogastric tubes I have inserted over and over due to little hands pulling them out (or retching them out), and the sadness I have experienced sitting in on a family conference while parents try to comprehend their new babies life altering diagnosis. The many conversations I have had with mothers over the phone at 2AM asking “how is my baby doing, will she survive this?” I could tell you about the frustration I have had with Attendings, NNP, PAs, Surgeons, Specialists, or Practitioners when I advocate for my baby “Something is wrong,” only to have a reply of “Tell the Resident,” or “Continue to monitor the baby.” I could tell you about the nights & days I literally don’t sit or drink an ounce of water trying to complete a septic work up because my baby is going septic and needs my full attention. The amount of codes where a baby is truly hanging on for dear life. I could tell you about the tears I have wiped from a mother’s cheek while taking a baby off of life support as her baby passes in her arm. And the wailing from her lungs as she asks “Why is this happening to my baby?” Where the pain is so hard I have to escort other family out of the room to relieve the parent’s personal anxiety. I could try to explain to you how hard it is to maintain professional boundaries when you have invested so much time, love, and tender care to my “special baby.” And how hard it is, when “due to staffing” I can’t care for the baby and must take another assignment. And the times I feel I didn’t do enough for my patient, cry in the break-room or in the hall, to take a few minutes to compose myself. ​ BUT I COULD ALSO TELL YOU The feeling of giving a baby it’s first bath with mom and dad (helping them with wires, and tubes) and making it feel special! I could tell you about the hugs, happiness, and smiles when I walk into the room as the Nurse coming on to care for their baby. I could tell you about feeding a baby his or her first bottle with mom or attempting to breast feed for the first time after 3 months! And laughing as dad burps the baby for the first time. I could tell you about my stealth moves tiptoeing in the darkness to check my baby in their isolate and the Cirque du Soleil moves I make to prevent breaking a sterile field. I could tell you about Kadence, Faith, Talia, Christopher, and so many more patient’s where I build long lasting, loving, relationships with my families as their “favorite nurse,” or “mommy nurse” and the feeling I get being able to care for their baby. ​ I could tell you about the feeling of being able to SEND YOUR BABY HOME, and the immense happiness I get from being the nurse to take the last pulse ox & wires off their bundle of joy. I could explain the feeling of a babies tiny hand wrapped around my finger as I assess the pulses or change the leads on his/her chest. I could tell you about the immense pride I have for working at a leading Children’s Hospital where research, newest therapies, and outcomes are the BEST. I could tell you about the bonds I have created with co-workers, Respiratory therapists who are like family, OT/PT kindest sweetest most effective therapies provided, or Music Therapists (who I’m pretty sure I love just as much as the babies), & of course Doctors who know you by first and last name (and High Five you on your way into the unit). I could try to explain the happiness of the last hug before the family leaves the hospital & the amount of Thanks I receive someone seems my badge or NICU logo on my jacket. I could tell you…..but it wouldn’t be enough. These words would never fully explain what it is like to work with these tiny lives. Nothing can prepare you for the physical & emotional investment into this vocation. And that is the beauty of being a NICU Nurse. If you are seeking a more "in depth conversation" head over to check out my podcast! Episode 1, 2, and 10 are all great resources for you to hear more details about being a NICU Nurse, NNP, and the working dynamics of a level IV NICU! THE CELLFIE SHOW. CLICK HERE . Another great resource for you BELOW. I was featured on The Morning Rounds and talked all things NICU Nursing. Dynamics, my personal journey, NICU Nurse Tips & Tricks! NICU Nurse Essential Resources American Academy of Pediatrics Academy of Neonatal Nursing Childhood & Adult Immunization CDC Guidelines March of Dimes! Resources for parents & providers Access 1,300+ Drugs with Easy-to-Understand Lactation Risk Categories National Association of Neonatal Nurses National Certification Corporation - NICU National certifications for experienced nurses NICU University & Peds University Vermont Oxford Network - 1,300 hospitals collaborating around the world! Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

If you have been a nurse for any length of time, you definitely have accumulated items that you routinely use for every shift. I have had some consistent items on my must-have shift list but have discovered some of the BEST products that have been a lifesaver in recent months. Let me put you on to 6 products that I feel every nurse should own. 1. Comrad Socks Comrad’s cute and comfortable compression socks are a game changer for anyone who is standing for long periods of time! Hello healthcare workers! There have been quite a few studies showing that compression socks should be worn in order to help prevent fatigue and blood clots. Our body’s blood circulation also has a direct effect on keeping our immune systems strong, so these compression socks are something I value more than ever while working amidst a pandemic. My personal favorite styles from Comrad are the Knee-High Striped Compression and the Knee-High Ombre Compression in Berry! I love how well they hold up after repetitive wearing and washing. With the amazing health benefits that these compression socks bring, I have been conscious to wear them beyond my hospital shifts. I started wearing them around the house post work-outs to aid in recovery and also wear them under my boots to horse- back ride. I am grateful to have these socks to keep my feet from hurting while I'm taking care of my patients! I especially LOVE that I don’t have to sacrifice style for comfort with these socks. Check out Comrad Socks here! https://www.comradsocks.com 2. Barco Scrubs Quality scrubs make a statement. Comfy and flattering scrubs are a nonnegotiable for nurses in 2020! Barco provides nurses with exceptional value and quality control. I love their eco-friendly fabric that utilizes temperature-regulating technology to keep me incredibly comfortable while feeling cool and fresh throughout my shifts. Barco’s Gray’s Anatomy Line are my absolute favorite! The feminine fit, custom tailored look, color array, and overall professional theme of their scrub lines have always attracted my eye which is why they have been my “GO TO” since day 1.  Find a Barco store near you here! https://www.barcouniforms.com/ store-locator/ 3. Sanita Clogs The most essential part of our day as nurses are our footwear. Pair Comrad socks with stylish Sanitas for happy feet! If you are looking for the most comfortable and stylish shoe for work you need to try a pair of Sanitas, the original Danish clog. Clogs have always been my choice of shoe with their easy slip-on, durable, and supportive style. As a brand new nurse I purchased my first pair of Sanitas clogs, fell in love, and still wear that original pair to this day. Not only is the durability and comfort there, but the look that a clog offers is so classy and professional. You can shop their latest styles here and use code NurseTori for 15% off your order! https://www.sanita.com 4. Mouthwash!! YES!! Mouthwash!! Masking up for 12-14 hour shifts has my skin breaking out like crazy even with my skincare product regime in full force! The hottest tip right now to combat maskne is to rinse your mouth out with disinfecting mouthwash every couple of hours. Exhaled bacteria through your mouth gets trapped under the mask and causes breakouts on the surrounding skin. I wear the same mask most of the day so this tip has truly saved my skin. I pour some mouthwash from my larger container at home into smaller, travel size bottles to carry with me in my workbag and car to use on the go. 5. Button Headbands Save your mask ear breakdown with a stylish headband! You can give your ears a rest by attaching your mask to the buttons on the sides of a cute headband instead. An L&D nurse at one of the hospitals I work at made me my first several button headbands and started my latest obsession. I have always loved wearing headbands paired with a bun to keep stray hairs out of and away from my face while working, but now have been enjoying the utility of these specially designed headbands that give my ears a break. Pick a pattern that expresses your unique vibes! 6. Stethoscope Being an L.A. nurse myself, I love that MDF Stethoscopes are also Los Angeles based. I have found MDF stethoscopes to provide optimal performance with premium, unparalleled sound. These stethoscopes come in a multitude of beautiful metal and tubing colors for a variety of medical specialties. That being said my absolute favorites for my position working in the NICU are their Pediatric and Cardiology stethoscopes in the rose gold and white tubing combination. I get so many compliments on this sophisticated, sleek stethoscope! View all of their styles here! https://www.mdfinstruments.com/ products/stethoscope. I hope you all enjoyed this little Nurse moment. These are all products & tips I use and believe in 10000%. Nothing but the best for the Tipster Family. Sending you all healthy happy vibes! Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

Health and Fitness have always been apart of my life. Competing in a Bikini Muscle Competition was always on my bucket list! It is such an amazing sport but I had so many questions! How do you do this? Do I need a coach? What do you eat? Where do I order a competition suit? Do I really need that tan? What are the judges looking for? In addition, I had goals I wanted to reach! To challenge my body to its peak! To look better than I ever have, to learn more about my body, my mental strength, my physical peak, and how nutrition affects my physical goals. ♡♡♡♡♡♡♡♡ MY WORKOUT HISTORY First off, I am by no means a professional. I understand the basics, but I was essentially starting from scratch. My brother and I used to work out together at the ripe old age of 16 and although young, my bother taught me some very core concepts that have always stuck with me. 1. Proper Form 2. Weights won’t make you bulky 3. Don’t be afraid of the weight room 4. Challenge yourself safely Two years ago, I completed my first “Bikini Contest” My Competition Goals: To challenge my body to it’s max capacity To place on the podium. ​ I did both. How did I do this you ask? First, I joined Team Edge because I knew I wanted to do it the "right way" while also being safe. In order to succeed I knew I needed a coach, a diet plan, a bikini as well as posing advice and lastly, day-of contest details. Luckily for me Team Edge provided it all! I trained for about 14 weeks. I checked in with my coaches (via email) every two weeks (until 1 month out and then weekly), I practiced posing, meal prepped, gulped down all the water I possible could, and truly gave it my all. ​ My meals went a little something like this: Wake Up: 30 min FASTED CARDIO Meal 1: 1/3 cup oatmeal, 1 whole egg, 4 egg whites, 1 tbsp pb Meal 2: 3oz chicken breast, 10 asparagus, 2oz avocado Meal 3: 3oz ground turkey, 1/3 cup rice, 1 cup Veggies Meal 4: ( pre workout) 4 oz chicken, 4oz sweet potato, 1 cup mixed veggies Meal 5: (post) 1 scoop whey protein immediately after workout 45 min later 4oz Tilapia, 1/2 cup rice, 10 asparagus Meal 6: 5 egg whites, 10 almonds And my workouts went a little something like this: Workout: Legs/Plyos DB Split Squats 4 sets x 15, Split Squat Hops 4 sets x 30 sec DB Curtsey Lunge off small step 4 sets x 12 each leg, Jump Lunges 4 sets x 30 sec DB Step Ups to Reverse Lunge 4 sets x 12 each side, Ice skaters 4 sets x 30 sec Lying Leg Curls 4 sets x 12, DB Cross Over Step Ups 4 sets x 12 each side Cardio: 20 min Steady Run ( For purposes of the Team & their Business I cannot disclose more. Keep in mind you are also only seeing one day of my entire week, every day had different amounts of protein, carb, & fat intake and workout plans. I did this with supervision of a Coach & updated pictures & progress ) After months of hard work, more PUMPS than I could count, insane amount of blood sweat & tears, I made it to Competition Day! I walked into ½ naked men and women walking around in their spray tan & suits, more rhinestones than King Tut, & more fun energy than I can explain. Calming one’s nerves is impossible at this point. This particular competition was the ULTIMATE due to the fact that the IFBB (International Federation of Body Building & Fitness) Pro Body Building Division (The Arnold Competitors) were competing this day. Therefore, this was a BIG one to see. Day of Competition First things first, get (re)-tanned! The night before all competitors get sprayed with a base tan. (The poor hotel sheets had no idea what was coming). After the early morning tan, came the task of getting my suit on (without ruining your tan, practically impossible). Then hair & makeup. I (like most new competitors) chose to have it done by the professionals. It’s more like “stage makeup” and my Estee Lauder Foundation was no match for this. Then finishing touches with heels & jewelry. Then it’s game time. Or "hurry up and wait" game time! LOTS of WAIT Time! I entered into the Bikini Division (which is based on height). I entered in Class F (Over 5’5’’ and up to and including 5’6’’). Bikini Regulations are strict. ​ 1. Competitors will compete in a two-piece suit. 2. The bottom of the suit must be v-shaped. 3. No thongs are permitted. 4. Competitors can compete in an off the rack suit. 5. All swimsuits must be in good taste. 6. Athletes will be warned about improper suits and are advised to bring two (2) suits to check in. 7. The fronts of the suits are too low and must be constructed higher. 8. Athletes will be scored down if the suit is not up to standard. 9. Competitors must wear high heels. 10. Competitors may wear jewelry. 11. National level contests do not permit competitors to crossover into Bodybuilding, Fitness or Figure at the same event. 12. All other competitions are permitted to have crossovers at the discretion of the promoter with appropriate approval. ​​ Judges score competitors using the following criteria: Balance and Shape Overall physical appearance including complexion, skin tone, poise and overall presentation. Easy Right?! Well, let’s just say I was up against some of the best bodies I have ever seen! After a full day of Completion, hitting the stage three times, with two “First Call Outs” I placed 3rd in Novice & 6thin Open. I came coming home with one trophy & proceeded to eat the BEST BURGER I have EVER Eaten after wards. The whole experience was so FUN & REWARDING. Although, my now husband might disagree. Competing is a job in itself. Your whole day & life revolves around workouts, getting food in, prepping meals, posing practice, and water intake. It is certainly a lifestyle. ​ I have contemplated doing another show. However, it takes a particular mind set and time to do so. So, currently I try to maintain a healthy(ish) diet, and some similar workouts to maintain a healthy Bikini Bod. Personally, I am able to eat what I like in moderation. I consume Healthy Proteins, lots of veggies, some carbs (white & brown rice, some bread), salads, healthy tacos, season with many different seasonings & spices, & maintain a loose Mediterranean style diet. I work out 3 times a week focusing on HIT training & lifting (mainly legs, glutes, hamstrings, etc). I feel lucky to have a partner who maintains a healthy lifestyle & encourages our active lifestyle. We bike ride, workout together (not the same workouts), take a yoga class from time to time, hike, travel, & enjoy beach living. I truly enjoyed Prep Life and who knows, maybe do another one at some point. But for now, I am enjoying my moderate lifestyle by the beach. Xo Tori RESOURCES FOR YOU Team Edge Custom Designed Competition Bikinis NPC Competition Website Body Building Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

So you want the “Real Tea” on Nursing in 2021. I’m spilling it all here for you! I am talking Degrees, Certifications, Modern Day Nursing Perspective, No filter here! Let me start at the beginning. My name is Tori Meskin BSN RNC-NIC. I have worked bedside as a nurse since 2013. Since then, I have seen a large shift in healthcare as whole. I have worked bedside (Full time, part time, days/nights, staff & travel RN, as a NICU, Pediatric CC Float RN CVICU, Oncology, PICU, NICU RN) etc. I have met many nurses, MDs, DOs, NPs, PAs, RTs, RDs, OTs, etc. along the way and have been gathering so much knowledge along the way. And I want to share it all here with YOU!! But I didn't want to do this alone, I wanted to bring along another expert in the field. Someone who has seen the Nurse world like I have, but in different ways. Therefore, I recruited my co-host / guest of the Cellfie Podcast Show & dear friend Samantha MSN RNC C-NPT, or better known on Instagram as @heysamanthaa ! We collaborated to bring you guys nothing but the best of all things Nursing 101! She is a Nurse, Professor, and Blogger! She graduated with her Bachelor of Science in Nursing (BSN) in 2011 and began working in a Level IV NICU. Collectively we decided to bring you the latest. The "Real Tea" and a Birds Eye view of the Nursing world, with a 2020 modern day perspective!! Raw, Real, Unfiltered! We are Servin it up real! I am joined by fellow nurse, professor, (Pediatric Flight Nurse) blogger, instagram curator, Samantha Manassero. We are giving all the juice on the current state of nursing, 2020 real tea nurse perspective, Degrees, Certifications, Mindset, Resources, Tips & Tricks to land that job, and much more! We discuss the who, what, how, & why with a Bird’s eye view of Nursing today. 20 Things to Know About Nursing in 2020 1. 2020 Whelp that was a Sh*T Show.... "Year of the Nurse & Midwife." Not sure if that was what we had in mind! Proving our love of nursing via World Pandemic. Honestly guys, this past year has been nuts. ANYONE working in healthcare can attest to this. To this day, as I am writing this, things are changing. (August, 2020) (Policies, Evidenced-Based Research, standards, priorities, etc). And to be honest, this isn't going to stop anytime soon. We are going to keep learning, shifting, changing plans. Thus is healthcare. No fluff here my "Tipster" fam, healthcare is a BEAST! And apparently it took a pandemic to expose its true dragon size. 2. Good Things Are Actually Happening, Yes I said that. This might be hard to believe. I have spoken on the podcast about it a few times, but good things are happening. This pandemic has really forced the world to come together. For heatlh care to expose itself. One of the greatest things I was able to witness was a daily update from healthcare providers from around the world contributing to a private FB group. MDs, NPs, PAs, DOs, Internal Med, Surgeons, RNs, RTs, all collaborating to beat this virus. Ok long story short, it sparked something. Let's keep it going. Your innovation is needed here. 3. It is Overwhelming to Choose a Nurse Specialty Trust me, modern day Nursing is vast!!! AND No one who comes into Nursing knows (exactly) what they want to do! Even nurses who are "Die Hards" for a unit in the beginning part of their career might experience Burnout. Nursing is one of the few careers that offers an OVERWHELMING amount of options. It's ok, deep breaths. Hustle hard, move forward, and your career will unfold. Trust me, I have had opportunities I never thought of when I started my career 8 years ago. Also, It’s also ok to change your mind! If you try something and hate it, it's ok to change your mind. 4. I don't like Nursing, What Else Can I Do?! Thank God! There are so many different paths to consider. You guys nurses are literally taking over the world. Literally and figuratively . There are soooo many specialties to choose from in the Nursing world. Where can you find nursing jobs away from the bedside? Here are some places to look for alternative nursing careers, along with the non-bedside nursing jobs you may find yourself taking: Physician offices, if you’re looking for an administrative role with limited patient care responsibilities Research laboratories, if you want to study diseases, test new medicines, and work closely with scientists, physicians, and patients Nursing care facilities, hospitals, and clinics with open administrative and managerial positions Pharmaceutical companies , if you are looking for patient education or sales rep roles Private and public education institutions, if you want to become a nurse educator State, public and government institutions , if you’re looking for public health roles such as School Nurse, where you work to educate entire communities Insurance and law firms, if you want to specialize in medical laws and assist in legal claims related to malpractice, accidents and workers’ compensation Private companies, for occupational nursing roles Non-bedside Nursing Careers Options Nowadays there are increased opportunities for nurses to leave traditional patient care environments and work as informaticists, analysts, and consultants , as well as project management, implementation, sales, and leadership roles . Nurse Health Coach Nurse health coaches work one-on-one with clients to help them achieve wellness goals, maintain healthy lifestyles, and prevent future health conditions. Working in healthcare facilities, insurance companies, and social service agencies, their duties include developing diet plans, establishing safe exercise routines, and monitoring and motivating their clients. Depending on the employer, nurses may enter this field with an associate degree, although the best paying positions require a bachelor of science in nursing (BSN) and/or a certificate in nutrition. Median Salary : $47,000 Legal Nurse Consultant The field of legal nurse consulting offers well-paying alternative careers for registered nurses. These specialized nursing professionals research medical and disability cases, employment records and other relevant documents, prepare summaries, and make recommendations that inform legal proceedings, law enforcement investigations, and insurance cases.Licensed RNs who have completed at least an associate degree may enter this field. Employment options increase for RNs who hold a BSN and a record of clinical and case management experience, paralegal training, or specialized legal certification. Median Salary : $78,000 Occupational Nurse Employed primarily in businesses, occupational nurses work with executives and managers to ensure the health and safety of employees. They investigate and treat work-related injuries and illnesses and identify workplace hazards. Occupational nurses help management develop safety policies and provide workshops for employees on healthcare issues and prevention.Licensed RNs who have completed a BSN earn the most competitive salaries for this role, one the best nursing jobs outside hospital settings. Employers generally prefer to hire professionals holding specialized certifications from the American Association of Occupational Health Nurses. Median Salary : $69,000 Nurse Midwife Advanced practice registered nurses looking for unique nursing jobs with a specialized focus find rewarding opportunities and high salaries in nurse midwife positions. Employed in hospitals, obstetric clinics, and increasingly in private practice, nurse midwives specialize in prenatal care, labor and delivery reproductive health, and gynecological care.Although each state maintains its own licensing and certification regulations, nurse midwives typically hold an RN license, a graduate degree with a nurse midwife concentration, and certification from the American Midwifery Certification Board. Median Salary : $97,000 Nurse Educator The demand for nurse educators has expanded as more students enter nursing school and as working nurses seek out continuing education credits to fulfill licensing renewal requirements. Working in academic institutions and training hospitals, nurse educators design and teach curriculum for diploma, associate, bachelor’s, graduate, and continuing education programs.Careers in nursing education generally require a graduate degree, increasingly at the doctoral level. In addition to clinical experience and advanced graduate training, candidates for nurse education positions must obtain the certified nurse educator credential. Median Salary : $76,000 5. You have JOB SECURITY (to a point) The projected need for nurses continues to rise. Our patient populations are getting sicker and sicker. There is always a need for nurses and pretty much anywhere you look (Indeed, Monster, Linkdin), you will see nurse jobs. Mk, well you know I give nothing but the real tea here. In my 8 year career, there were two times I experienced that stomach drop, where I knew my job was on the line. The first time was 6 months into my career. My hospital went through a house wide lay off due to budget cuts. The second time was actually during this pandemic. At the beginning of the pandemic the Pediatric population was not affected by this virus. While our friends in the adult world were running around like chickens with their heads cut off, Pediatric world was SLOW. So slow some of us (including Per Diem Nurses) were in jeopardy of loosing our jobs! F ortunately , things picked up and it turned around for our shifts. BUT I think it is silly to say we are untouchable. Anyone can loose a job! 6. Use LinkedIn to Your Advantage! I personally think this is one of the most under estimated tools you have. Spruce up that Linkdin account! Linkdin acts not only as a platform but also search engine. I think it is always a good idea to have that thing up to date! You never know the opportunties a recruiter want to offer you. After you get the year or two of experience, the world is your oyster. Head over to check out jobs, and network with people! 7. Nurses Make Money Honey! Yep we do! Not even guna lie about that one. Now, keep in mind, rates & salaries vary from state to state and even region. Every hospital organization is different. For example, I have worked two NICU per Diem jobs simultaneously & one job made $16 more than the other job. In addition, I must say this. As a bedside nurse, the way to increase pay is in "Lateral" moves. Meaning, I left my Clinical Nurse II job, and took another Clinical Nurse II job making $10 more an hour. Same position, but the organization viewed my experience and therefore my starting pay was valued higher. Hence why so many nurses move jobs nowadays. (For those who seek increased pay opportunities). 2020 Top Paying Nurse Jobs Certified Registered Nurse Anesthetist - $167,950 General Nurse Practitioner - $107,030 Clinical Nurse Specialist - $106,028 Psychiatric Nurse Practitioner - $105,658 Certified Nurse Midwife - $103,770 Neonatal Intensive Care Nurse - $102,487 Pain Management Nurse - $101,916 Nursing Administrator - $99,730 Family Nurse Practitioner - $98,408 Registered Nurse First Assist - $96,418 Gerontological Nurse Practitioner - $89,637 Nurse Educator - $81,350 Informatics Nurse - $79,014 Critical Care Nurse - $74,588 Health Policy Nurse - $71,703 8. COVID isn’t FUN! FULL SHADE here. You guys, its hard. No lie. Regardless of the setting we work, working throughout this pandemic is HARD. No lies here, this is the most difficult time so many nurses have ever (and fingers crossed) will ever see in our nursing career. Nurses have been asked to step up to a plate we never asked for...I am not shying away from this conversation. Nurses have quit their job. Yes, that has happened. Honestly, I don't blame them. I feel fortunate, I never felt that my care to a patient or family felt that it jeopardized my health. However, so many nurses around the country felt unsupported in protecting their health. This is where I caution you...make sure you feel safe and supported in your working environments ! That includes PPE, patient ratios, pay, and overall work environment. COVID will pass....make sure your work supports you in each way. Trust me, if it doesn't, there are plenty of places to try!!! 9. Becoming A Nurse = Lifelong Learning For some reason, I never realized this while deep in my studies at U of A, #beardown! I guess I never realized this aspect of nursing. We are in the business of humans. Things have changed drastically since I started as a nurse 8 years ago. New practices, evidence based research, equipment, priorities of care, etc. Not to mention the fact that you must obtain 30 CEUs every 3 years to maintain your license. Trust me, it's not as bad as you think. (COVID aside), going to a conference with my friends for a weekend away from the hospital is actually kind of fun. Often times hospitals require classes for specialties (Cardiac, Surgery, ECMO, practice updates, etc) where you can also earn CEUs. 10. You Are Going to Battle “BURNOUT” For some reason, the modern day nurse is feeling this more and more. Whether it is the pressures of bedside care, patient ratios, human energy exchange, physical labor, long commutes, demands from management, working with humans at their best & worst, demands from families, working during a pandemic, okkk you get it. This is something you will face. And trust me, it is hard to overcome. Working as a nurse is honestly quite glorified. Like anything there is good with bad. Yes, we can work 3 days a week, but more than likely every nurse will tell you at least 1 or 2 of those days is recovery. Yes, we make good/decent money, but there are shifts you can’t even break to pee, sit down, or drink water. Yes, we have the gift of helping someone daily, but there are patients/families who cuss, spit, kick, yell, bite (yes bite). Yes, there are a lot of opportunities for us in the nursing world, but the expectations are also going up (certifications, patient satisfaction, outcomes, appeasing management). Yes, we are the most trusted professions, but we are often one of the least respected/valued. But, we still love it. We are still here showing up for our patients & families. We are still advocating for those orders, plans of care, the extra blanket, sneaking the cup of coffee, explaining that thing one more time, calling that MD for that “gut feeling,” speaking up for the parent who doesn’t understand, calling the lab one more time, catching an incorrect dose before it affects a patient, running to supply one more time for XYZ, paging the consult MD again to update patient bedside, comforting a family member who is helpless, precepting the new generation of nurses, advising the new generation of MDs, etc. You get the point. 11. Treat Yo Self. Self Care is Essential! It is really hard to explain the deep core exhaustion you feel coming home. Whether it is from clinicals or your crazy unit, I can truly speak to the pure fatigue you feel walking in the door. Heart pounding, slip the shoes off, deep breath as you walk in the door. Hand me a shower beer as you try to lift your leg over the bath tub in the shower kind of tired. You guys, I live it. I get it. Which is why I am a FIRM believer in fillin that cup. I get it, we all have stages of life. Maybe you are a mom, and you don't have an option for my favorite (pre-COVID massage or facial), maybe its a trip to target (without the kids!), a manicure, the burger you were craving, a hike, a picnic, a drink with a friend, etc. Bottom line, make sure you are feeling like a human. Because trust me! Nothing worse than a crusty nurse caring for patients. Doesn't go so well. 12. If You Hate Your Nurse Job, Change It! I talk about this all the time via Instagram ( @nurse.tori_ ) & podcast ( Nurse Tori Cellfie Show ) If you hate your job, change it! There are wayyyy too many Nurse jobs & opportunities out there to complain, bitch, moan about a job. If you are unhappy, figure out a way to change that for yourself. I am very pro " Gary Vee " way filled with opportunity and the idea that YOU HAVE ONE LIFE TO LIVE! HOW DO YOU WANT TO SPEND IT?! 13. Get Nosey!!! Ask people around you....You guys I don't think this generation appreciates it enough! People around you are full of advice, life adventures, pieces of wisdom. I can not explain to you the amount of times I have learned something from someone just by asking "How is your day going," "Do you have kids," "Have you always worked here," ....the things that pop up in conversation always surprise me!!!! 14. Fun Nurse Jobs! Burned out? Whelp good news for you! There are plenty of jobs to consider. I did a little research & discovered these jobs in a search. Just had to show you that there is something out there for every nurse! Here we go........ Camp Nurse The Association of Camp Nurses ( ACN ) believes that there is a camp for everyone. As a nurse, determine what type of camp would benefit most from your expertise and background. Some camps focus on youths with cancer, adults with mental disabilities, or other special populations. Camps may also specialize in a type of activity (e.g. horsemanship, trip camping), offer high adventure programs (e.g. white-water canoeing), or provide a broad, general program with waterfront activities, archery, crafts, tenting experiences, and/or various sports. Camps are administered by churches, agencies (such as Girl/Boy Scouts or the YMCA/YWCA), and even private corporations or individuals. NASCAR Nurse It takes a lot of people to run the NASCAR races and that includes medical staff. As senior director of NASCAR’s Medical Liaison Department, Lori Sheppard, RN manages the day-to-day operations of her department and focuses on the medical needs of the racing series. “Our team provides a constant line of communication with race teams, monitors their progression through follow-up care and their return to competition. We also work with NASCAR’s Research and Development team in the never-ending effort to improve safety,” she says. She works with several other full-time nurses at the NASCAR headquarters in Daytona Beach, FL. During the season, her duties also include visiting nearly 30 race tracks in 25 states and in Canada. Medical Script Nurse Have you seen how many new medical television shows are running on network and cable stations? And think of all of the movies you’ve watched which have dramatic scenes in hospitals. In order for these to look and feel authentic, nurses and other healthcare professionals are often consulted to make sure their usage of medical equipment, vocabulary, and procedures is correct. While this job is certainly glamorous, like most Hollywood jobs, it’s about who you know. Greg Spottiswood, creator and executive producer of the Canadian drama, Remedy explains . “What you do is you meet with that person, you talk about the show and you take their temperature in terms of their interest in doing this kind of work. It’s not like one puts an ad in the newspaper.” This is a great career if you can keep getting work, but you would probably be wise to keep your day job as well. Disney Nurse Can you think of any other type of nursing specialty where you can call on Mickey Mouse or a princess to make a patient feel better? Cheryl Talamantes, RN, BSN serves as the Guest Service Manager for the Disneyland Resort. She has been a nurse for 34 years and describes what it’s like to work at the theme park: “Guests come from all over the country and the world, and there are situations where we are working through language barriers as well as cultural traditions,” she says. “In addition to having First Aid locations in each of our parks, we have a response location for our hotel guests.” In the job as a Disney nurse , you may find yourself climbing down into a submarine or up the stairs to a treehouse to treat someone. “We work around the entertainment and also support four marathons a year. We have a large population of people in the resort on any given day which means we can see and respond to just about anything. So our nurses need to have strong assessment skills and be comfortable in the first responder roles while working with all age groups,” Talamantes adds. Yacht Nurse The staff on chartered luxury yachts must provide first-class service to all their guests. One of these services is on-demand medical care. The crew on a yacht is generally small, requiring nursing skills on a limited basis, so nurses choosing this career should be prepared to also act as a stew or deckhand. Most crew nurses live in very cramped quarters while on charter, but the money they make and the experiences they have on days off, more than make up for it. A similar specialty is being a Cruise Ship Nurse . Show Me Nursing Programs Flight Nurse Flight nurses accompany patients as they are being transported by aircraft. Most of these patients require advanced critical care and the flight nurses are ultimately responsible for all direct patient care during transportation. They often work with flight paramedics in rendering basic and advanced life support and treating acute trauma. Because of the unique setting (helicopters and airplanes), flight nurses are also required to complete Department of Transportation Air Medical Curriculum. There are also weight restrictions imposed in order to safely accommodate the rest of the crew and medical equipment. For further information on certification as a flight nurse, see the Board of Certification for Emergency Nursing (BCEN) website . Transgender Youth Nurse With a greater awareness and acceptance of the transgender population, more and more patients are seeking medical care and at younger ages. The Center for Transyouth Health and Development at Children’s Hospital Los Angeles sees many of these young patients. Bianca Salvetti, a nurse practitioner there says, “We usually have a waiting list of 100 now, and have been adding 5-6 patients per week.” “Many young people have had these feelings for a long time and just didn’t know how to articulate them.” The hospital provides hormone treatments, pubertal blockers, chest binders and outpatient surgery. “The best part of this job is helping somebody become their authentic self. They usually don’t see happiness at the end of the tunnel. I like being part of the team that helps them get to a place where they can be who they really are,” she says. She helps educate her patients, making sure they understand how to give themselves their hormone injections, apply binders for their chests, or just deal with their day-to-day issues. Health Policy Nurse With the healthcare system getting increasingly complicated and expensive, some nurses are advocating for change to make it more accessible and affordable. Health policy nurses do not work with patients at a clinical level. Rather, they work to influence and create public policies that will ultimately lead to a healthier population. You can find them in research firms, government offices, and healthcare organizations. With this wide variety of work settings, an average salary for a health policy nurse is difficult to determine. However, one website estimates that average to be around $95,000 annually. In addition, because global health policy requires a broader view of the healthcare system, health policy nurses should hold advanced degrees. Nurse Health Coach Personal coaches have become increasingly sought after. From nutrition and fitness to careers and business, and even relationships and love, coaches can be found in almost any aspect of our lives. With a greater focus on the individual, personal health coaches can promote wellness, resiliency, and quality of life by guiding their patients to strategies for a healthier lifestyle. They serve to bridge the gap between your doctor visits and everyday life. These nurse health coaches work in a variety of settings, including insurance companies, corporations, consulting firms, and many are self-employed with their own practice. Aspiring coaches should complete some form of healthcare or medical degree. Afterward, they should seek additional certification from organizations such as the National Society of Health Coaches or complete a coaching program at an accredited college Cannabis Nurse As more states realize the benefits of medical marijuana and make it legal, desperate patients will need guidance on how to properly use these substances to treat their often life-limiting illnesses and conditions. That’s where the Cannabis Nurse comes in. Because of marijuana’s unique status of federal illegality, cannabis nurses must also assist their patients in navigating these gray areas and empower their patients with information to discuss with the rest of their healthcare team and loved ones. Any licensed nurse can become a cannabis nurse and the American Cannabis Nurses Association offers a thorough education on this emerging specialty 15. There are MANY TYPES of Nursing Degrees! Let’s Break it Down When it comes to nursing degrees, there are many different options to fit your career and income goals, timeframes, lifestyle, and budget. There are so many ways to become a Nurse. From education that takes a few months to several years, and includes fundamental nursing skills to advanced specialized practice, there are few professions that offer more varied opportunities than nursing. CNA LVN ADN BSN ABSN MSN Doctorate (DNP) PhD 1. Certified Nursing Assistant Common job titles at this level include: certified nursing assistant (CNA), registered nursing assistant (RNA), licensed nursing assistant (LNA), direct care worker, care assistant, home assistant or personal care assistant. Time to Completion: A few weeks to a few months, with a combination of schooling and hands-on clinical experience. After completion, students must take a state test to become certified; requirements vary widely from state to state. 2. Licensed Practical Nursing (LPN) or Licensed Vocational Nursing (LVN) Degree Of all the nursing certifications, LPN or LVN programs are the quickest and most convenient options. Because training can be completed at a hospital, vocational technical school, community college and even online, LPN/LVN programs are ideal for students who work or have other obligations. Time to Completion: About one year. Career Paths: This flexible, fast-paced program equips students with the most basic skills for becoming a nurse. Completion of an LPN/LVN program makes graduates eligible for licensure after they pass a state-administered nursing exam called the NCLEX-PN. 3. Associate of Science in Nursing (ASN) Associate Degree in Nursing (ADN) An associate of science degree in nursing program (ASN) provides graduates with more technical skills and, for 30% of graduates, serves as the stepping stone to a bachelor’s degree in nursing (BSN). This degree option is ideal for those who want to begin a career as an RN, but are not currently working as an LPN or LVN. Time to Completion: About two-three years. Night and weekend courses offered at community colleges or vocational schools make this degree another ideal option for students who are juggling other responsibilities. Although often longer due to pre recs prior to applying to the program. 4. Bachelor of Science in Nursing (BSN) (Most common Today) When considering the different types of nursing degrees it’s important to understand that a bachelor of science in nursing (BSN) degree is preferred by most health care providers and offers a broader range of career opportunities in today’s health care field. Time to Completion: Four years. A BSN program involves an extensive amount of coursework and lab time. While some BSN degree programs include a mix of on-campus and online classes, clinical experiences are always completed onsite at a college campus or hospital. 5. Second Degree Bachelor of Science in Nursing (BSN) or Accelerated Bachelor of Science in Nursing A Second Degree BSN, sometimes called an ABSN, is designed for adults with a non-nursing bachelor’s degree who wish to transition their career into the nursing field. Time to Completion: A Second Degree BSN typically takes two years or less, since these programs will give credit for previously completed liberal arts requirements. Online programs are available for students who need more flexibility, and some schools offer an accelerated BSN (ABSN) programs that can be completed as quickly as 12 to 20 months. In addition to challenging coursework, students need to account for time spent completing clinical rotations. 6. Master of Science in Nursing (MSN) A Master of Science in Nursing (MSN) program enables a nurse to specialize in different types of nursing through advanced clinical training and research. Many employers offer tuition reimbursement for nurses to further their education. Time to Completion: Typically 18-24 months. MSN programs—offered online or in a more traditional on-campus format—are very rigorous, as students are learning about an advanced specialty. Most programs require students to complete a final thesis or project. 7. Doctorate Nursing Degree Programs While all levels of nursing are expected to see high growth, nurses with doctoral degrees are projected to have tremendous job demand over the next decade. These programs prepare nurses for careers in health care administration, clinical research and advanced clinical practice. Time to Completion: Three to five years, full-time including summers. Career Paths: A Doctorate of Nursing Education program develops advanced practice nurse specialist skills. A Doctorate of Nursing Practice (DNP) program emphasizes clinical practice-oriented leadership development. 8. Doctor of Philosophy (PhD) Doctor of Philosophy (PhD) programs prepare nurse scholars and researchers to make a meaningful impact on the theoretical foundation of nursing practice and health care delivery as a whole. Time to Completion: Four to five years full time, with part-time options available. While students won’t complete clinical hours, they will be required to complete extensive research and a final dissertation. In general, PhD programs are not suited for juggling coursework with a job.Nurses with a PhD are qualified for many facets of professional and scholarly roles, from research to public policy formation to leadership in health care delivery and education. 16. Advanced Nurse Degrees What is Advanced Practice Nursing? So, for whatever reason. This concept really confused me. Basically what it boils down to is...NOT ALL MSN DEGREES ARE MADE EQUAL. Meaning some MSN degrees are geared towards Leadership/Education/Management and others are in ADVANCING YOUR SCOPE OF PRACTICE. APN Degrees that INCREASE you SCOPE of PRACTICE as a NURSE. And how do you become an advanced practice nurse? A nurse with a master’s degree is called an advanced practice nurse (APN), and they come in four varieties: Nurse Practitioner (NP)  – Nurse practitioner’s provide basic care focused on a specific population or health need, with the ability to write prescriptions. Family nurse practitioners are an example of this. Certified Nurse Anesthetist (CRNA)  – Certified nurse anesthetist’s administer anesthesia for all types of surgery. Clinical Nurse Specialist (CNS)  – Clinical nurse specialists provide specialist care in a number of areas: cardiology, oncology, neonatology, OB/GYN, pediatrics, neurology, and mental health. Certified Nurse Midwife (CNM)  – Nurse-midwives provide prenatal care, delivers babies, and provide postpartum care to normal healthy women. Advanced practice nursing is thriving in today’s health care industry with the nursing shortage. APNs deliver services that were previously delivered by physicians. Nurse Practice Acts vary widely among states, and they define just what advanced practice nurses can do. #17 Know Your Intention to Advance the Nurse Degree For those of you unfamiliar, it is very "in vogue" to advance one's nursing degree. (NP, CRNA, Midwife etc). Hospital organizations are encouraging degree advancements, roles in education/leadership etc. require higher degrees. The "anti" keeps going up. Before you go back to school or make the decision to increase that degree I want to get in your ear. I am here to really encourage you to do what is right for YOU! (Not your employer, not your friends or family, not outside voices). Here's what I want you to do: Tune it out! What do you want? Here are things I think are very important to consider when you are thinking of advancing your degree. What Setting You Want Clinic, hospital, outpatient, acute care What is Your $$ Financial Gain $$ Considering loans for school and payoff long term. Will your employer kick in for education? The STATE you Live in CA vs TX (very different dynamics) Are you independent or under an MD/DO supervision How much $ will you make in the role you desire? Time of Your Life AKA Family Planning Time studying/in school Lifestyle You Want 3 shifts/week 5 days a week, 40 hours. Per Diem vs Full time The Setting You Want to Work Office vs. hospital Telehealth vs. home health Private Practice vs. Union Organization Change in the Nurse Role Prescribing, Diagnostics, Reviewing Labs Procedures (Chest Tubes, Intubating, Central Lines etc). Internist role Out patient role Grad School Application Requirements Grades start to expire after 5-7 years. May have to retake classes to apply for school 18. Keep Options Open - Be Open to New Opportunities ! My basic concept here is, be open to ideas! I guess I think, never say never and I am not one for turning down opportunities. If something lands in your lap, go for it! You never know where something may lead. I have had several opportunities come from sought roles, and others presented by management or outside providers/companies. I love this world of healthcare and where we are going...more access to people who need it, more education to the people who need it, in the places (internet, phone, apps) they need it. Our roles as nurses are constantly changing and evolving. Be open to the change and opportunities ahead. 19. Social Media 101 I have so many opinions about this topic. Far bigger than this blog. So much so that I have decided to bring on an expert in the social media field with me!! Oct 2020 I am bringing on a Nurse, Youtube sensation, Instagram curator, and social media expert to help me talk ALL things social media / healthcare 101. 20. You Do You Boo! The bottom line here is you need to do what is right for you! The big world of nursing can be very intimidating and overwhelming. My hope it that this blog, my podcast, and instagram can give you a little insight into the world of nursing! I have multiple episodes featuring the many aspects of nursing (Bedside, NP, NICU, CVICU, CRNA, NNP, Flight Nursing, Cosmetic Nursing etc.) Head over to check it out to learn more.... 21. BONUS Check out PICMONIC if you are in Nursing, NP, PA, Med School! This has been my go to study tool for the past year and WISH I had this during Nursing school (back in my day this wasn't an option). Picmonic was established in 2011 by two medical students to help students retain and recall the large amount of facts studied in medical school. Picmonic name is a portmanteau of Picture and mnemonic. As for 2017, the website contains more than 1000 audiovisual picmonics. Better than flashcards, Picmonic is the study tool of choice for learning thousands of the most difficult to remember and most frequently tested topics, board exam prep and more. Our research-proven methodology incorporates the best study techniques by: Transforming forgettable facts into memorable stories and characters Covering an extensive library of study aids featuring need-to-know facts Providing a comprehensive learn-review-quiz study app system Don’t let anyone sway your decisions. It’s your life Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

A sister, nurse, & healthcare provider perspective. Our family journey through my brother's diagnosed Bipolar I Disorder, mania, depression, substance abuse, & sobriety. We are getting behind the scenes for a deeper understanding of managing mental health.... Let's Get Real Here, Mental Health & Substance Abuse are two of the Most Taboo Topics as they come. Yes, a TABOO topic, even for us in the medical field. Even as a Nurse and healthcare provider, substance abuse & mental health disorders are stigmatized and often treated with judgement. Why do I know this? Because I am a healthcare provider, and I have been on both sides of care. It's personal and as a family, we went through the ringer. Hence, my passion to write this blog! If a patient lands themselves in ICU bed (due to a heroine overdose, drunk driving accident, etc.) as providers, we must set aside our judgements and care for patients (no matter the reason.) However, often we find it hard to sympathize and judgment sets in. Honestly, this was the case for myself! If a mother landed herself in an ICU bed due to a heroine overdose, (preterm labor with an emergency C-section delivery), you bet my head went to judgement and frustration. Well, that was the case until my brother landed himself in an ICU bed after his first ( of several ) near fatal car accidents. I thank god for the nurses who helped save his life (with no, or limited judgement). His blood alcohol level was far above the legal driving limit & to this day I am thankful he is still alive (AND never harmed anyone else). But Let's Take a Step Back Let me give you a quick recap of my younger brother Vince. We grew up close. He is 13 months younger than myself & I would consider us, "best friend" kind of close. Even in high school. We were a package sibling deal with so many of the same friends, dances, parties etc. We separated during college days. I went to University of Arizona, and my brother went to Fresno state. Lovable Vince Recap: 2 college degrees from CSFU (Agriculture & Construction Management) The guy every mom LOVES. Funny & charismatic. Farmer & construction builder. Athletic & a "Mans Man" (he can swing a hammer and rebuild a car blindfolded). Loving & Cunning Handsome & Stronger than an Ox Also, Diagnosed Bipolar 1 & Recovering Addict. Bipolar Manic Substance Using Vince: Now, let's talk about the monster of my brother. The one I hate to relive. This is the brother who managed to land himself 3 DUIs, several stints in county jail, was fired from one of the best construction companies in the nation, wrecked (not one, but two) cars in near fatal car accidents, ruined two great relationships, destroyed family trust, had his license revoked, was stripped down to nothing at the age of 27. The reason? It is two fold. First, he is living bipolar, & the second was substance abuse. And when I mean substance, I mean all of it! Alcohol, A dderall , Weed, Cocaine, Uppers/Downers, H allucinations (s hrooms), etc. Anything he could get his hands on to alter the mind. Vince was officially diagnosed Bipolar at the age of 25. According to Mayo Clinic, " Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression)." Definitions are cute & all on paper. But let me explain to you what we experienced. How Bipolar looked to our Family My brother was a monster of himself. The most selfish, egotistical, rotten to the core monster of Vince. A person who had no license but still managed to buy a car off the street. A person who continued to wipe the family of funds in various ways (court hearings, lawyer fees, selfish endeavors ) someone who was so blinded by his motives, no one else mattered (even his sister). A monster who was aggressive, scared girlfriends, used manipulation to get what he wanted. Bipolar had literally stripped away my best friend. The younger brother I had grown up with, the person everyone loved & laughed with. The irony about this disease... he loved his " manic phase" as many do. There is nothing like it. You feel like a super person of yourself. No one can stop you or tell you no. Something we (as a family) learned and took to heart was understanding this disease. It had its place in history! So many warriors, people of interest, world leaders, famous historical icons (Napoleon, Hitler, War Hero's) most likely struggled through mental health issues such as Bipolar. Leading a war, conquering a nation, settling the people, and then going into remission for months to recoup. Sound familiar? I urge you to listen to Episode # 4 & Episodes # 12 of this podcast to grasp a better understanding. We speak about this on both of these Podcast episodes. The "euphoria", I don't call it that, I just call it fire. Because it is something I feel right in the middle of my chest. And I have done a handful of drugs & alcohol. There is no drink or drug that matches what mania feels like. It's like fire in your chest. And you are just bulletproof. I can literally do anything and I don't think about consequences of my actions. I definitely don't think about anyone else. I don't intentionally do anything to harm others, but my own well being...I don't give a crap. That fire is something that is so pleasurable, you never want to come off it. That is why without meds, I wouldn't be able to physically change my brain chemistry and get that dopamine out of your head. ~ My Brother Vince Let's fast forward 3 years. Currently, my brother is 4 years sober, has regained his license, regained family trust, landed himself a great job in construction and is now running our family ranch again. He has an amazing girlfriend who understands his disease and diagnosis & has regained his happy go lucky personality. I am so thankful for this. He has truly built a new life for himself. Worked out the right regime of medications and become a leader in mental health. And yes, we learned a few things along the way. So I thought I would divulge. 1. Mental Health Comes in Many Forms I will tell you, as healthcare providers, we learn about mental health but often times it is un relatable . The books can only tell you so much. They can give you a vague description of a disease process, but until you experience the true nature of a mental health disorder, it is not relatable. For many people believe having bipolar means simply dealing with alternating very high and very low moods, but there is so much more to it. During a manic phase, the person can experience delusional hallucinations, euphoria, increased energy, erratic behavior etc. which can be terrifying. During a depressive phase, the person may become very forgetful or indecisive. It isn’t as simple as “today I’m happy, tomorrow I’m sad”. It can be life-threatening. 2. Mania is the Best Friend & Worst Enemy During a manic phase your loved one may be on "cloud 9!" Like a rain shower in a drought or an avalanche on a mountainside village, it is extreme. In all honesty, for many diagnosed, it can be refreshing & also bring with it a range of creativity which leads to destructive behavior leading to a hard to rebuild from in the wake of its damage. This was diagnosed after a period of both depression and hypomania (a lower level manic episode characterized by a huge amount of energy and disinhibition) spanning over a year. 3. You Can Love Someone to Death Often times, it is hard to let go as a family. To give up the reins to a "professional" and allow them to take over. You can’t always be there for someone struggling – and that’s ok. Many parents (including mine) had a difficult time letting go. Allowing the professionals take over and help in a way that even a blood relative, or healthcare provider can not is important. But I can honestly say, it wasn't until we completely let go and had The Last House Take over, were we in a better place. Honestly, we were so ready for the help, and in true Crisis that their help was welcome. The Last House. 4. It Feels Great To Be Manic, Why Would You Stop? Imagine yourself getting drunk, but without any alcohol. You feel lighter, talk more easily & you feel more daring than usual. As it progresses, your judgment begins to cloud. You overestimate yourself. Strangers are suddenly friends. Reality begins shifting – you start perceiving things you didn’t perceive before. In my case, I had a million thoughts and ideas rushing in, which I felt I needed to express. This is a similar idea to what it feels like to be manic. Manic Phase A perfect example: "I painted 10 paintings in a row and wrote 60 pages on a creative project. Put on bright colours and felt like everything I did was divine. I thought everybody else was stupid because they didn’t understand my ‘genius insights’. I became psychotic . I posted a lot of weird and embarrassing things on social media and texted people inappropriate or random messages. I wasn’t aware what I was doing during that episode – I had lost my rationality and sense of inhibition. By the time my family noticed I was not being my usual self (I was living abroad), I had already lost connection with my body. I barely slept or ate. I shifted between feeling extremely scared to aggressive, overly sexual or outgoing, and believed I was totally fine. I stopped looking after my body, believing that I could not die. I eventually ended up in hospital to be treated." ( Time to Change, Blog ) Coming Down From Manic Episodes Needless to say, “coming down” from mania is very tough and confusing. Some need to r ealize what had happened and apologize for the things they do not recall saying or doing. This was the case for my brother on several occasions. It took months to get back to how he was and I had lost trust in him. On the flip side he felt ashamed and frustrated. Then, depression slowly sneaks into their mind & sucks the life out of them. Often they feel insecure, worthless, silent and numb. Or like a burden to everybody around them. Concentrating can be particularly difficult. Even going to the grocery story often Bipolar diagnosed are unable to make decisions. Forget my keys, get lost on the road, feel scattered. The topic of suicide come to mind at times. Yet, they may not find the ability to cry. Rather, they feel completely numb, isolated within themselves, even around my closest loved ones. They can not feel anymore. Or feel joy or gratitude. The only feeling is wanting more sleep and not wake up again – to stop existing. It was a dark and scary place to be in. 5. Support is Essential, But Shouldn't Stand in Your Way of Help From Professionals "How can I help?" and ‘What can I do?" - these are the two questions I swirled around numerous times but as I have pondered what response would best suit the occasion. Sometimes it is letting go. Let the professionals take over. For us, that was The Last House . It is a tricky situation, allowing and trusting others to know the ins and outs of the bipolar- addict vortex. From the inside and outside, life can feel chaotic. Yet other times, it seems serene and calm. It ebbs and flows. So, when the winds pick up, it helps to have others weigh in who understand the disease. 6. Substance Abuse is Common, but Shouldn't Become a Crutch. People with Bipolar are much more likely to look for a ‘quick fix’ to a feeling, because the rollercoaster can be so incredibly draining and confusing. The need to calm down, feel something, stop the mind. This is where the professionals come in. Those with dual diagnosis (of ANY MENTAL HEALTH DISORDER) need help to grasp better coping strategies as a matter of priority, this is something I strongly believe needs to be incorporated into treatment. Life skills that ACTUALLY help. From proper medication regimine to establishing healthy daily habits, these are all essential to mental health patients. 7. They Don't Choose How They Feel... But They Can Choose to Work to a Solution. This was one of the hardest parts for me to deal with. When Vincent was being so heartless, rude, aggressive, and demanding. We were slaves to his needs in order to keep him alive. And I was resentful. But remember this, they didn't choose how they feel. I am going to REPEAT this. They did NOT choose how they feel. In addition, many mental health diagnosis don’t have the same emotional processes you or I do. They I still love the people in their life. And I know Vince would agree, he is grateful that I am there for him. But just as it wouldn’t fix a broken leg, it won’t fix his bipolar either. It is apart of him and his greatness. And I am also proud of that. 7. Education is Key in Order to Erase Mental Health Stigma Here I am at the ripe age of 31, a nurse, wife, sister, blogger, podcaster, writing a blog about my Bipolar brother. Why? Because I want someone (anyone) to grasp something from this. Having a mood disorder doesn’t make you a bad person, or someone incapable of living a full and meaningful life. My brother was diagnosed with Bipolar 1 Disorder at the age of 25, after a long and painful process of navigating the mental health system. Help and support is essential. Those diagnosed can't manage the storm alone. Please fight for your loved one. Even in the hardest time. I know it is hard but trust me living with a mental illness is harder. Be the friend, family member, person who listens. Don't become a ghost. You can't fix the storm, but you can be there while it rages, and it will pass. 8. Bipolar is an Illness, Not a Personality My brother is not Bipolar, but he LIVES with Bipolar. It is a strange thing that seems to occur in our society ‘do you know that this person  is bipolar?’ They are the embodiment of a whole illness? Great news, they do not suddenly lose our identity at the diagnosis of a mental health problem. 9. Medications. They Take Time To Understand & Work Properly! Vincent's medication regimen, along with his lifestyle habits & work at the Last House. took a year to dial in properly. I know the thought is "a quick fix." But the true work comes in the day to day. It is not an easy fix. It takes time, support, endurance, and an honest attempt on the patient. My brother had to put in the work. He had to work through cravings, aggressive behaviors, the impulses, uncomfortable habits. Thanks to his hard work, I have him back. It is always a work in progress, but I am thankful for his endurance. 10. Family Support and Understanding is Essential A support network can mean many positive things – From a listening ear to financial support family/friends are amazing. For those who struggle with suicide, this is essential. I think VIncent would agree, we are lucky to have such a great family unit. So many struggle with far more life issues, and have far less support. Our support network has given him the freedom to live and not panic or worry hugely. 11. Diagnosis Doesn’t Define You as a Person Despite the fact that this whole article was written about Vince and his Bipolar/Substance abuse dual diagnosis, it doesn't define him. In fact, most days now, we forget about it. Vince will have this condition for the rest of his life. He knows how best to manage it but there are still hard times. Either way, he will continue explaining it to people who ask, so that people can understand. Yes, you can live a full and fulfilling life with this illness and so that stigma falls. 12. Call The Last House for Help or Referral IM SERIOUS. No matter the concern questions, they will answer the phone. Reach out to them. I am so thankful to have my brother back. We went through hell and back for years. This program came to us in a time of crisis, and so I want you to know about it. The Last House is a nonjudgmental support system who can provide top notch treatment to the guys out there. And if you need a f emale referral, call them! They will find a resource for you. Now Vince is carrying on with a full functioning independent life. He has his friends, family, and community who make him even better. Words can not begin to describe how thankful I am for this program. Thank you Clayton, Chris, Andy, Miles, and the team who truly gave my my brother back. I hope this blog does some justification to the horror we felt and the journey we overcame with mental health and substance abuse. Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com ​ Resources THE LAST HOUSE www.thelasthouse.net The Last House Mental Health Education Scholarship https://thelasthouse.net/the-last-house-college-scholarship/ Last House Instagram: @thelasthouse AA - 12 step programing https://aa.org/ Last House Intro Video Youtube https://www.youtube.com/watch?v=utWRC168Z78

Did you know all newborns are scored two numbers at birth? {at 1 minute & 5 minutes of life} “APGAR Scoring System” is a method to quickly summarize the health of a newborn. The score is given checking muscle tone, heart rate, reflexes, etc. to assess if extra medical care is needed. Developed in 1952 by Dr. Virgina Apgar at NewYork-Presbyterian Hospital. Criteria listed below: Every baby gets an APGAR score, but as a parent, it can be a completely foreign topic that leaves you worried and confused, especially if your infant ends up getting a low score. To help you better understand the APGAR scoring method and what it does, here are some quick answers to the most common questions. Why Was The Test Created? The APGAR score is used to check some key signs of your newborn baby, but keep in mind that most babies rarely gets a perfect score and it should not cause alarm if your baby does get a low score. A low score just indicates to doctors that they need to look for potential issues so that your infant can be cared for the best. Generally, the APGAR score is a baby's first assessment. Its purpose is to check their basic health, like heart rate, but it's not an indicator (in any way) of your baby's future behavior or intellect. The test is only a basic assessment to help doctors provide your baby with the highest level of care. The test itself was developed all the way back in 1952 by Virginia APGAR, an obstetric anesthesiologist. It is a standard tool by which all newborn babies are assessed. What Is APGAR Used For? In short, the APGAR test is a quick assessment of your newborn's physical wellness. It will help medical staff determine if present or future medical care may be required for your baby in addition to the standard care that infants receive. When Is The APGAR Test Performed? It is standard procedure for every doctor to perform the APGAR test on a newborn baby. The test is actually performed twice. First, the APGAR test is performed right after your baby is delivered. The test scores will be recorded, and then the test will be completed again five minutes after your baby’s birth. Both scores will be used. Completing the test twice helps ensure accuracy and it also helps the doctors detect any discrepancies that may have occurred from the first test to the second test. Changes between the scores or two low scores could mean issues, and so the APGAR test helps doctors get your baby assessed right away so that they can deliver appropriate care to your infant. What Does An APGAR Score Mean? A score between 7 and 10 is considered normal. A score between 4 and 6 indicates that breathing assistance may be required. A score under 4 means that prompt, life-saving measures may be called for. To get the overall score for an infant, a score of 0 to 2 will be assigned for each of the 5 aspects medical staff will check. Heart rate: 0 means there is no heart rate, 1 means there are fewer than 100 beats per minute (not very responsive), 2 means there are more than 100 beats per minute (baby is vigorous) Respiration: 0 means there is no breathing, 1 means there is a weak cry, 2 means there is a strong cry Muscle tone: 0 means the baby is limp, 1 means the baby has some flexion, 2 means the baby has active motion Reflex Response: 0 means no response to their airways being stimulated, 1 means there is a grimace during stimulation, and 2 means there is a grimace and cough/sneeze during stimulation Color: 0 means the baby's entire body is blue/pale, 1 means the baby has good color except on their hands/feet, 2 means the baby is completely pink and has good color It's important to keep in mind that an infant rarely has a perfect score. Medical staff will communicate with you if both APGAR tests come back with a low score or if they have a reason for concern. APGAR A- Appearance (skin color pink or blue) P -Pulse (rate or beats per minute) G -Grimace (did he/she cry to stimulation) A -Activity (appropriate reflex of flexion) R - Respiration (breathing pattern assessed) APGAR range 0-10, 10 being best. After the baby is born (if higher level of care is needed) these scores help us understand the newborns health status in the NICU setting. What Happens If My Baby Has A Low APGAR Score? If your baby has a low APGAR score, medical staff will first focus on getting your baby into a stable condition and then they will seek to find answers to the questions that will be weighing on your mind, like what has caused your baby’s low score. As medical staff works to discover if there is an underlying condition or another cause of your baby's low score, they will keep you updated throughout the process. More importantly, they will keep you informed about your baby's current state of health and what to expect in the coming days. NICU Nurse Essential Resources American Academy of Pediatrics Academy of Neonatal Nursing Childhood & Adult Immunization CDC Guidelines March of Dimes! Resources for parents & providers Access 1,300+ Drugs with Easy-to-Understand Lactation Risk Categories National Association of Neonatal Nurses National Certification Corporation - NICU National certifications for experienced nurses NICU University & Peds University Vermont Oxford Network - 1,300 hospitals collaborating around the world! Tori's Tips on NICU NURSE 101: See Blog Post ​ Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, S ponsored Capella University MSN student , a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

As much as I love working with my preemie babies, I think it is more important for YOU to learn how to help avoid us NICU providers. Yes, premature births are on the rise. Working as a bedside Neonatal Nurse (and having worked in many hospitals across the Southern CA region) I can say first hand how prevalent this is becoming. But this is not a time to fret! In fact, I think this is a time to EMPOWER you! More knowledge and education the better! I have a few things I can confidently say I have learned over the past 8 years in NICU Nurse practice that may help you along your way. I hope to give you some insight into how to help prevent a premature birth (or NICU admission) & provide some useful Tips in your own pregnancy! Let's start from the beginning A pregnancy normally lasts about 40 weeks. Important growth and development happen throughout pregnancy, especially in the final months and weeks. Premature Birth Preterm birth occurs for a variety of reasons. Most preterm births happen spontaneously, but some are due to early induction of labour or caesarean birth, whether for medical or non-medical reasons. (World Health Organization). A premature birth is a birth that takes place more than three weeks before the baby's estimated due date. In other words, a premature birth is one that occurs before the start of the 37th week of pregnancy. Premature babies, especially those born very early, often have complicated medical problems. Here are sub-categories of preterm birth, based on gestational age: Extremely preterm (less than 28 weeks) Very preterm (28 to 32 weeks) Moderate to late preterm (32 to 37 weeks). Problems that a baby born too early may have include: Breathing problems Feeding difficulties Cerebral palsy Developmental delay Vision problemsHearing problems Preventing Premature Birth Preventing preterm birth remains a challenge because there are many causes of preterm birth, and because causes may be complex and not always well understood. We don't know why this happens. However, there are some predetermining factors and important steps every pregnant women can take to help reduce their risk of preterm birth and improve their general health. THEREFORE, I DO HAVE SOME TIPS THAT MIGHT HELP YOU BEFORE OR DURING YOUR PREGNANCY! 1. Get Healthy BEFORE your pregnancy Although this may seem obvious many factors such as excess weight, blood pressure, diabetes, and overall physical well being are HUGE factors in a pregnancy and women's well being. Getting a handle on all of this prior to pregnancy is key!! 2. Prenatal Care Prior to trying to conceive, check in with your Doctor! A Pre Pregnancy Doctor Visit can help shed some light on changes you may need to do prior to pregnancy. Example: change in medication regimen, adding a vital supplement, decreasing your weight, managing blood pressure, controlling sugars (Diabetic Type I or II and then Gestational Diabetes). 3. Take a Prenatal Multivitamin. One of the most essential ingredients being Folic Acid. Recommended dosage being 400 micrograms (mcg) of Folic Acid. Why is this so important? Folic Acid is an essential helps a developing the fetus brain and spinal cord. These develop within the first 10 weeks of conception, and often the time when you don't even realize you are pregnant! Taking a multivitamin prior to pregnancy can help prevent neural tube defects such as spina bifida, anencephaly, encephalocele, and other various issues. 4. Lifestyle Considerations We are in a busy working population. Many women are focusing on their career where stress, lack of sleep, and long work days are priority. Our general population is waiting longer to have children. My suggestion, if you are planning on having children attempt to limit stress, plan ahead, and try to start your family with a healthy mind & within a good age range. Advanced maternal age (AMA) is now considered 35+. While women can have healthy pregnancies later in life, statistics start changing after 35 years of age. 5. Blood Pressure Management High blood pressure is one of the greatest risk factors for a Premature birth. The increased pressure affects blood flow to the placenta and can limit blood supply to the growing fetus. (AKA essential nutrients, oxygen, eliminate waste etc). Women with gestational hypertension have high blood pressure that develops after 20 weeks of pregnancy. Many babies are delivered early due to Pre-Eclampsia. Preeclampsia is a serious condition of pregnancy, and can be particularly dangerous because many of the signs are silent while some symptoms resemble “normal” effects of pregnancy on your body. It characterized by high blood pressure and usually the presence of protein in the urine. Swelling, sudden weight gain, headaches and changes in vision are important symptoms; however, some women with rapidly advancing disease report few symptoms. My point, go into your pregnancy with knowledge and good management of your blood pressure. 6. Diabetes Management. Type I, Type II, and Gestational diabetes. Diabetes is Diabetes! Sugar is Sugar. It's all about the sugars! Sugars affect a growing fetus in many ways. Babies exposed to high sugar levels can experience breathing difficulty due to less mature lungs, high red blood cell count (polycythemia), high bilirubin level (newborn jaundice) increased risk for birth defects and even stillbirth. It also increases the risk for birth defects, including problems with the formation of the heart, brain, spinal cord, urinary tract, and gastrointestinal system. (Stanford Children's Hospital) In addition, they may grow excessively (Macrosomia) causing a birth injury or "traumatic birth" and then develop dangerously low sugar levels after birth (hypoglycemia). How does this happen? After delivery they are no longer supplied with the sugars provided by the mother, therefore the baby continues to have a high insulin level, but it no longer has the high level of glucose from its mother, resulting in the newborn's blood glucose level becoming very low. Sugar (Glucose) is one of the essential parts of a rapidly growing brain, if the levels drop too low after birth it may cause brain damage. (Hence NICU care and management). VISIT THE PRENATAL NUTRITIONIST FOR SOME GREAT TIPS! 7. Quit Smoking & Bad Habits For help quitting, see  How to Quit Smoking & Avoid alcohol and drugs. Most likely if you are reading this, it wouldn't be an issue, but in case it is please seek medical advice to help. 8. Healthy Mindset!!!! I can not begin to express this one enough. One of the best things you can do for your baby is develop a healthy mindset. What do I mean? Limit stress as much as possible. If you struggle with anxiety or depression seek attention prior to pregnancy and make sure you have a good support system after delivery as well. A healthy mind set will truly help your baby in every way. From hormones & chemical imbalances to a healthy lifestyle this can truly help you and your baby. If you are a mother with a "High Risk Delivery" head over to check out this awesome book!! Pregnancy Brain: A Mind-Body Approach to Stress Management During a High-Risk Pregnancy. By: Parijat Deshpande (Author) 8. Educate Yourself. Warning Signs of Preterm Labor Any woman can have Preterm labor. Preterm labor is labor that occurs before 37 completed weeks of pregnancy. Seek medical attention for ANY warning signs or symptoms of preterm labor. Contractions that made your belly tighten every 10 minutes or more often, change in color of your vaginal discharge or bleeding, fluid leak, low dull back ache, cramps that feel like your period, belly cramps with or without diarrhea. (See video below) 9. Communicate with Your Healthcare Provider. Regular check ups and checking in with your provider is key to a successful, happy, healthy pregnancy. Communicate openly about your current health status, family history (any history of preterm births in your family), and develop a rapport with your provider. Tip: When you think of a question, make a note of it in your phone to ask your provider at your visit. 10. Relax & Enjoy your Pregnancy As stated earlier, we live in a fast paced, high stress world. Stress can put a negative affect on you and your baby. Listen to your body! Get to know your body. Getting off your feet may be necessary during this time. If you need to put your feet up and take a load off be mindful of that. 11. MOST IMPORTANTLY! Do Your Research. No one plans to have a Premature baby. But it does happen! And in my opinion, knowledge is power. Speak to your healthcare professional about your hospitals facilities and make a general plan IF you were to deliver early. WHAT WOULD HAPPEN IF...SOMETHING WERE TO HAPPEN? So many Moms & Dads admit to our NICU with NO knowledge of what to expect or what resources are available to them. If you are planning to travel while pregnant, do a little research about the hospitals near your destination. What would happen if you did go into preterm labor, what hospital would you go to, how far along are you, what would you expect for your baby at that gestation? I have personally cared for many babies whose parents were traveling out of state (and out of the country for that matter). And life plans changed when baby decided to come early! All I am saying, plan ahead. Educate yourself/s. If you are seeking some NICU insight check out my blog on all things NICU! 11. Ethnic & Race Consideration We are not clear the reasons for premature births but some races, ethnicities, & various populations / regions are at higher risk for a Premature Birth. In general Black & Hispanic races are more prone to premature birth. Whether it is accessibility to healthcare, lifestyle, genetic components, or mistrust in the healthcare system, these populations are higher risk and statistically have a higher rate in premature birth. However, preterm birth is truly a global problem. In the lower-income countries, on average, 12% of babies are born too early compared with 9% in higher-income countries. Within countries, poorer families are at higher risk. The United States is one of the Top 10 Counties for Premature I truly hope you found this information helpful! I am in hopes that this brought you helpful tips and useful information about Preterm Birth. I understand this topic can be "Taboo" and "Off-Putting" however, after my years of experience at the bedside and working with families with premature babies, I felt this post needed to happen! Knowledge is power! My hope is to bring awareness and while I love caring for my NICU babies, hopefully see a few less premature babies along the way! Rescources & Sited information for Preterm Birth Information 1. March of Dimes 2. Center for Disease Control and Prevention 3. World Health Organization 4. Mayo Clinic 5. The Prenatal Nutritionist 6. Mommy Labor Nurse 7. American College of Obstetricians and Gynecologists 8. Brave Beginnings Tori's Tips on NICU NURSE 101: See Blog Post Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

Let’s face it, wedding planning can be stressful & overwhelming. During the process it is easy to get swept up in the details of your Day! Despite the stress here are a few Tips to help ease the wedding planning process! 1. Work As A Team With Your Fiancé Don't feel like you're in this wedding planning process alone. Turn to your fiancé for help along the way and even make wedding planning something fun you do together. 2. Get Organized You can use checklists, spreadsheets, Word/Google Docs—anything, really—as long as you have all your thoughts, budgets, numbers, etc. in one place. There are also some great programs and apps out there that can keep you organized. 3. Don’t Rush Into Decisions It may be enticing to book the first photographer or florist you meet, but take a step back and weigh all your options before making any quick decisions. 4. Talk to Other Married Couples Did you just attend a wedding you really enjoyed? Chat with that couple! They probably have some expert tips and tricks for you. Sometimes friends and family are the best source. 5. Use Vendors You’re Comfortable With Build a team of people you really vibe well with. They should have a good sense of your vision and you should be able to trust them to execute it well. Make sure they appreciate your business so you don’t feel bad when you inevitably have to call and ask questions! 6. Recruit Help Remember that you’re not in this alone! Your bridal party, family members and especially your fiancé are here to help. Be sure to delegate some tasks to take some of the load off of you. 7. Add A Personal Touch With all of the wedding traditions that people tell you that you should have at your wedding, be sure to plan in some personal traditions too. If your family has any wedding traditions that they've done in the past, or if there is something you want to start for future generations, don't be afraid to give your wedding a personal touch. 8. Focus on the Big Picture Don’t get too hung up on the small details. Your guests won’t notice if your table runners are the wrong shade of blue or if the appetizers came out 15 minutes late. The second you walk down the aisle let go of all the small stuff. Hey, you’re getting married! 9. Take Some Time Off For the sake of your own sanity, make sure you schedule some time for you and your fiancé to be together and do anything but wedding plan. Trust me, you’ll need the break! Consider taking the week before the wedding off work, both to make sure last minute details are completed, and just to chill. One of the BEST pieces of advice we received was to get a Couples Massage the week before the Wedding. Jacob & I LOVED THIS. It was a time to reconnect, relax, & revive our wedding excitement! And if massages aren’t your thing, a nice dinner a night on the town a walk on the beach or in the city, your happy place together, etc. Whatever it may be, take private time for each other in your last few days as an Engaged Couple! 10. Say Thanks Gratitude goes a long way. You should always arrange for small gifts for your wedding party and anyone else who played a big role in your planning process. Don’t forget mom and dad! Tori's Tips on NICU NURSE 101: See Blog Post ​ Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

Let’s Talk the infamous DRESS (Dress: Ines Di Santo) I would be lying if I didn’t say, this is likely the HIGHLIGHT of you (and your groom’s) day! Although you may feel some overwhelming decision making in your court, here are some sensible TIPS I learned from in my process! PICK THE DRESS THAT YOU LOVE What I mean is, if you love the dress, (but it doesn’t “fit” your venue) who cares! Don’t be afraid to love outside the box. It’s YOUR Day. DON’T BE AFRAID TO SAY NO Yes, I am the bride who purchased dresses! Why?! Because I felt pressured into my first dress. When it comes down to your “gut” feeling, go with it! THE TWO DRESS RUT Stuck between 2 dresses? My advice...pick the you think your GROOM would LOVE YOU wearing! I bet there is one dress that is a little more “YOU” & “HIM” PRICE $$ Well, I am not one to weigh in one this after all....I purchased two dresses! But if you have a range, no fear! There are Soooo many dresses out there. Keep looking. TOO MUCH PINTEREST Of course I searched high and low on Pinterest for the “Perfect” Dress. But don’t go crazy! Instead focus on the fit and style YOU like when trying on dresses ENJOY THE PROCESS Take in every moment. Invite the people you want in your life to share the decision making (& try not to please everyone, some people might be a little too vocal for you). Also, if someone can’t make it, that’s ok!! Don’t DWELL. Appreciate each moment LOOKING TO RESELL? I kept my actual dress, however I owned a perfectly brand new one (of course the store would NOT allow returns) TIP: Donate your Dress! I chose to donate my dress to THE BRIDAL GARDEN and used the TAX WRITE off! The dress went to a good cause and I made (most) of my money back (I did not have luck trying to resell online) The Dress: http://inesdisanto.com/ The Dress Shop: http://www.mbridesalon.com/ The Veil: https://dressanomalie.com/ The Boots: http://www.ariat.com/ Tori's Tips to Pick the Perfect Wedding Dress: See Blog Post Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

Being a NICU Nurse, I am very aware of the amazing outcomes we are creating in the NICU population everyday! Did you know that 1 in 9 babies is born prematurely? Yes, 1 in 9 babies is born prematurely! (37 weeks and younger). That is a lot of premature babies....and a lot of hospitals required to care for each and every premature baby born. However, did you know that many hospitals are limited by funding and are unable to purchase vital equipment needed to help save these babies?! Working bedside as a NICU nurse, I see the need for this equipment everyday! We could not save the lives and create the best outcomes without our bedside equipment, monitors, and new technologies. That is why when I learned about Brave Beginnings, I passionately teamed up to help support their cause and bring awareness to this issue! Which is why I was so thrilled to come on with the Brave Beginnings team and John Cena to help spread awareness about this issue! EXCLUSIVE: John Cena, the actor and pro wrestling champion, will be appearing on theater screens all across the country this summer in a 30-second PSA urging movie-goers to support the work of Brave Beginnings, an initiative of the Will Rogers Motion Picture Pioneers Foundation that’s helped save the lives of thousands of premature babies. Brave Beginnings started as a program under the Will Rogers Institute. The Will Rogers Institute was the research and training center created at the Will Rogers Memorial Hospital (a tuberculosis sanitarium closed in 1972). WRI focus is funding pulmonary medicine training fellowships and free educational materials about pulmonary diseases and disorders. In 2006, another charity from the entertainment industry asked us to partner on a grant to fund an incubator for a hospital in Los Angeles. A couple of years later, the Will Rogers Institute Neonatal Ventilator Program was established. In 2015, the WRI Neonatal Ventilator Program was renamed Brave Beginnings. The program is committed to provide funding for all types of lifesaving equipment in NICUs nationwide, not just ventilator equipment. Since 2006, Brave Beginnings has contributed millions of dollars to facilities across the United States. Each year, the program spends roughly $1 million in grants awarded to hospitals nationwide. The funds are used to purchase vital equipment for Neonatal Intensive Care Units (NICUs) caring for fragile lives born too soon. The mission of Brave Beginnings is simple: to provide hospital NICUs the equipment they need to ensure that every premature infant has a fighting chance at healthy development. Our goal is to someday be able to fulfill every grant request we receive and not delay a grant for a year or two until funds become available. If a hospital has a need, we want to fulfill it. Due to the overwhelming need for this type of equipment, the program is expected to triple in size within the next few years!! Brave Beginnings was previously named, “The Will Rogers Institute Neonatal Equipment Grant Program.” Since 2006, the charity has contributed $7.7 million in grants for life-saving ventilator equipment to neonatal intensive care units at 160 U.S. hospitals. This, the charitable organization says, “has impacted the lives of 176,000 babies.” THE HEART (& LUNGS) OF THE MATTER Preterm birth remains among the top causes of infant death. A "Preemie" is defined as an infant born earlier than 37 weeks of pregnancy. At birth, Preemies are at greater risk for both short and long-term health complications than full term infants Short-term complications include breathing problems such as respiratory distress syndrome, heart issues like patent ductus arteriosus (PDA), hypothermia, gastrointestinal problems and an underdeveloped immune system, which can lead to life-threatening infections. Preemies face potentially lifelong complications such as cerebral palsy, impaired cognitive skills, vision and hearing problems, as well as behavioral and psychological problems. The care given in the first hour after birth, often known as the “Golden Hour,” is crucial for the long-term health of a Preemie. Having access to the right medical equipment for neonatal care is truly a matter of life and death. Without adequate neonatal equipment and beds, Neonatal Intensive Care Unit (NICU) staff (such as myself) often face the challenging problem of sharing essential equipment amongst Preemies, necessitating moving a baby from one piece of equipment to another. Research shows that 27% of infants who are moved from one point of care to another experience complications such as hypothermia We are now saving babies as young as 23-34 weeks!! That is extremely exciting, however we could NOT do this without the help of our new technologies! It’s assumed that a hospital has everything it needs to take care of patients. That is true, however, in the NICU, hospitals can have a need for more equipment or need to replace outdated equipment, so infants don’t just survive but also have a chance to thrive once they leave the NICU. Their goal is to give medical providers the tools they need to help a premature infant finish developing and limit the chances of a life-long disorder or learning disability. Due to the high rate of premature births in the US (1 in 10 babies born), it is important people understand that there is a generation of children dealing with life-long ailments and that has a huge economic impact on our economy. Provider Equipment Includes: 1. GIRAFFE OMNIBED (Isolettes) 2. AIRBORNE 750I TRANSPORT INCUBATOR 3. NICU BRONCHOSCOPE WITH FLEXIBLE INTUBATION VIDEO ENDOSCOPE KIT 2. VENTILATORS 3. BLENDERS (FOR NASAL CANNULA SUPPORT) 4. PULSE OX PROBES 5. STETHESCOPES 6. NEOPUFFS And SOOOO much more! This being said, all of these products are expensive & many NICU hospitals can not afford these items. Annually, Brave Beginnings provides grants for essential neonatal intensive care equipment such as critical airway carts, infant resuscitators, incubators, omnibeds and much more. To date, we have granted $8.1 million to 175 hospitals across the United States. We strive to be the leading grant provider for the purchase of neonatal ventilator equipment and critical pulmonary services for hospitals throughout the US. I am here to bring awareness to our community & help share their MISSION! Check out their website to learn more! Spread the word & hopefully we can continue to save every baby. More recently, stars who’ve pitched in include Barbra Streisand, Harrison Ford, Clint Eastwood, Al Pacino, Shirley MacLaine, Julie Andrews, Warren Beatty, Sally Field, Jeff Bridges, Morgan Freeman, Dustin Hoffman, Anthony Hopkins, Michael Keaton, Liza Minnelli, Lily Tomlin, Sharon Stone, Liam Hemsworth, Geena Davis, Sarah Jessica Parker, Tommy Lee Jones, Dwayne “The Rock” Johnson, Billy Crystal and Meg Ryan. Todd Vradenburg (WRMPPF) Executive Director pictured with NICU Nurse Tori Meskin, Paramount’s Kyle Davies, and Brave Beginnings’ Christina Blumer – photo credit should be attributed to Capture Imaging. All other photos are courtesy Brave Beginnings. HEAD OVER TO CHECK OUT: Brave Beginnings Tori's Tips on NICU NURSE 101: See Blog Post NICU Nurse Essential Resources American Academy of Pediatrics Academy of Neonatal Nursing Childhood & Adult Immunization CDC Guidelines March of Dimes! Resources for parents & providers Access 1,300+ Drugs with Easy-to-Understand Lactation Risk Categories National Association of Neonatal Nurses National Certification Corporation - NICU National certifications for experienced nurses NICU University & Peds University Vermont Oxford Network - 1,300 hospitals collaborating around the world! Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, a Barco Uniforms Ambassado & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com

Welcome to my new favorite room of the house... our guest bathroom. While I hope to eventually re-do many rooms and corners of our home, this room sparked my motivation and creative juices! Creating and designing has always been a passion of mine, and I finally got enough creative spurts to re-design this space for something chic and moody. From the outside looking in, this bathroom is sophisticated and chic, but once inside it adds a moody, sassy, humorous experience. Let's take a dive into all the pieces and prints that brought the vision of this room to life! The simple one-toned towel had to go... so I brought in this Mackenzie child's dupe two-toned checkered towel to pair with the mix of light and dark tones in the room. Mackenzie Childs Dupe Hand Towels This gorgeous pink plant ties together the ode to the outdoors and is the perfect accent to pair with the green and gold. AMAZON MOODY BATHROOM LIST BATHROOM Paint Color: Behr Salamander (Dynasty Line) Home Depot Salamander is a rich, vivid green that embodies the diversity and dynamic energy of the great outdoors. This paint color adds depth that draws your eyes to the bright spots in the room. The prints collectively tie together wildlife, femininity, pops of color, and just a touch of sass, humor, and trends to keep things interesting. You can’t see this wall of art until you are in the room with the door shut, so it’s is the perfect spot for bold and fun prints that bring a little unexpected twist to our guests bathroom experience. The RGB values for Benjamin Moore 2050-10 Salamander are 47, 62, 60 and the HEX code is #2F3E3C (Matte, not semi gloss) Preppy Tiger Print Preppy Room Decor This preppy tiger print is a staple piece that draws your eye and brings to life the pops of accent colors that brighten up the space. This piece is symbolic to me. My dad's nickname growing up was "Tio Tiger," (Uncle Tiger). So I was on the hunt for something fun and playful, this just hit the spot. The tiger embodies the spirit of power, courage, and personal strength for me. These lights truly set the warm, moody feels. I found these and several variations at Home Depot. Light Linked in my LTK The gold faucet, mirror, and soap dispenser were all essentials to creating that perfect contrast to the green walls and leaving a timeless and elegant feeling to the room. I wanted all of the accent pieces gold or brushed gold/champagne colored. GOLD Soap Dispenser Matte Gold Glacier Bay Faucet A few of my favorite black and white prints embody the sass and humor I was looking for. The mix of frames and canvases provides funky, unique visuals. Nuns Smoking Print Moon Goddess Art Print Happy Elephant Print These prints are positioned on the strip of the wall right in front of the toilet for a quick laugh as you do your business. Noodles Print Retro Wall Art Bad B*tch Print Moody Victorian Wall Art The addition of this mirror provides a beautiful reflection of the prints on the opposite wall and ensures you're surrounded by moody vibes no matter where you stand. Tori Meskin MSN RNC-NIC (@nurse.tori_) is a Registered Nurse specializing in NICU care. She has worked bedside since 2013, specializing in neonatal and pediatric critical care. Tori graduated from The University of Arizona (#beardown) with a dual major in Nursing and Psychology. As a bedside nurse, she has worked for Children’s Hospitals and University Hospitals in Level IV NICU, Trauma I centers, and consulting centers. She is trained to work in specialized areas; Small Baby Unit, Body Cooling Team, & surgical NICU (Cardiothoracic, Gastrointestinal, Neurosurgical, & congenital anomalies etc.) Tori has grown and developed her platforms through Instagram, TikTok, and blog, where she has developed a community full of support, education, and provides a shift worker big sister personal sharing her nurse shift lifestyle, NICU nurse journey, nurse tips, and little life hacks. @nurse.tori_ www.tipsfromtori.com

WHY I LITERALLY LOVE ALMOND COW One of the best presents I got from my husband was our Almond Cow! It has paid for itself time and time again as we go through plant-based milk products weekly. Since we use nut milk and nut milk creamer every day it was honestly the perfect kitchen gadget that I didn’t know I needed at the time. As I did more research into the traditional almond milk brands I bought at the store, I was disgusted by all of the additives, excess sugar, and harmful thickeners that are added. Not to mention store-bought almond milk typically contains just 6 almonds in the entire jug. After doing my own research, it made me feel even more motivated to never buy store- bought milk again and enjoy the health, sustainability, and cost benefits from Almond Cow! ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ Plant-Based Nutrition 10 REASONS WHY YOU NEED AN ALMOND COW!!! ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ 1. You Control the Ingredients Let's start at the basics. Ingredients!!! No sugar, no additives. no xanthan gum and dairy free!! Yes please. You control every ingredient going into your body. Almonds, Oats, Cashews, Water, Salt, Vanilla, Dates, etc. No hidden junk. Ok so here is how I do it. I batch my almond milk and nut creamer weekly so I can keep up with a healthy diet while working full-time. Thankfully, I’ve found that you don’t have to sacrifice taste for the health benefits that come from making your own nut milk from scratch! My secret is to add a splash of vanilla, two pitted dates and/or maple syrup in my coffee creamer and almond milk recipes. One cup of ingredients can make 5-6 cups per batch, which is much more than you get with your average carton of shelf milk. 2. Sustainability Lower your carbon footprint by making the swap to plant-based milk! It’s been shown that plant- based milks are an environmentally friendly option because they use up less resources, like farmland and water, and produce fewer greenhouse gases during production than their alternatives. Homemade alt-milk is all about reducing and reusing. You only need a few simple things to make your own alt-milk, all of which will last you a long time and can be used over and over. Reusable bags for buying bulk ingredients Glass jugs or bottles for milk storage Almond Cow, the ultimate reusable plant-based milk maker - designed specifically to make the process simple, easy, and eco-friendly. Switching to plant-based milk with Almond Cow helps reduce the amount of greenhouse gases entering the environment. You’re also saving energy to actually make your milk. The Almond Cow even uses a cold blend cycling system, which takes very little energy to make a cup of milk (0.01 kWh). That’s less energy than it takes to charge a regular smartphone! Sustainability Study 3. It's SOO Easy to Use It is so easy and quick to make with the Almond Cow Milk Maker and clean up afterward. There is no waste either, as even the leftover pulp can be made into tasty recipes such as muffins, cream cheese, a unique twist on oatmeal, or even a date-night burger! 4. Low in Sugar Let's be honest, we could all pull back on the sugar intake. You control all of the sugar added to your Almond Cow products. Side note: unknown to many consumers (this was me included) many almond milk brands add sugar to their products. And the sugar is most likely significantly MORE than you think. Check those seemingly healthy labels! ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ 5. Versatility Let's go!!! Milk. Beverages. Pulp. Mocha Creamer. Shakes Soup The recipes are endless. You can make plant-based milk, get creative with the nut and seed pulp leftovers, make amazing cocktails, cozy hot drinks, a dd cashews and cacao powder in the filter basket, etc. My Custom Almond Milk Recipe: Almonds (1 Cup) Cashews (Sprinkle) Vanilla (Splash) Water (To fill line) Salt (Sprinkle) 2 dates (pitted) My Custom Coffee Creamer Recipe: Cashews (1 cup) Almonds (Sprinkle) Maple Syrup (Splash in Water Section) -Vanilla (Splash) 2 dates (Pitted) Salt (Pinch) I use cashews, a few almonds, two dates (without pits), pinch of salt, and put a splash of maple syrup in the section that holds water for my creamer. NO additives, stabilizers, gum or crazy crap like there is in the store-brought brands! You will loveeee the naturally slightly sweet taste that the dates provide. 6. Naturally Lactose-Free For anyone struggling with GI issues like your gal over here, this is literally a god send. Dairy + Tori is not a great equation. This has helped make plant-based products (lactose free) free and clear of gas / bloating / pain / I'll spare you the details here. 7. Vegan If you are vegan, this appliance is a MUST in your household. It is making all of your vegan recipes so much easier and rich. Not to mention the creativity Almond Cow offers in their Vegan recipe blog sections. Vegan: Shortbread Cookies. Herb cheese, Strawberry Shortcake, Butter, Eggnog, Ice cream, Blue Velvet Cupcakes, Alfredo Pasta. Mac N Cheese, Date Night burger, Chocolate Sandwich cookies, Stuffing, Sweet potato casserole, biscuits, broccoli cheddar soup, mashed potatoes, cinnamon rolls, cashew butter cookies, berry oat bars, cornbread, Bloody Mary, vanilla cookies, avocado cilantro dressing, etc. Almond Cow Vegan Recipes ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ 8. Very Easy to Incorporate into Your Normal Diet Making the switch from store-bought to homemade plant-based milk used to be an intimidating process for me. Fortunately, Almond Cow is dedicated to making homemade plant-based milk hassle-free and provides everything you need to create it. With Almond Cow, you can make plant-based milk from any nut, seed, or grain in just minutes. Keep it classic or drink outside- the-box. Or just throw a combo of everything in there! The options are endless and the process stays the same. Simply choose and add your ingredients, push start, pour and enjoy your milk. No time-consuming straining or messy cleanup required. Get started with Almond Cow and take part in the fight for environmental change, one jug at a time. 9. Cheaper and More Sustainable in the Long Run! Our almond cow paid for itself in 3 months. Between milk, shakes, coffee creamer, and various recipes, we easily made our money back. And now, I think about the cartons we are saving, the plastic we aren't consuming or discarding, supporting farmers in their whole fruit production (almonds, cashews, oats, dates, etc). We purchase our nuts/seeds/oats in bulk at sprouts, whole foods, save mart etc. 10. Saving the Environment & Supporting Farmers The problem with plastic. Did you know...the average household uses 144 plastic cartons every year. That’s an estimated 8 million metric tons of plastic polluting our oceans. What if there was a better way for the planet & your health? Not to mention, 1,500,000+ Estimated number of single use plastics that never went into production. Thousands of families have made our planet cleaner by switching to making homemade milk. In addition, purchasing whole fruits / seeds / nuts supports our farming industry. Speaking as a farmers daughter, I am very passionate about this. Unknown to many, juicing of produce lowers support to farmers! When you opt to purchase whole foods, you are supporting growers and the produce industry in a very meaningful way. Purchasing your foods in bulk at Sprouts, Whole Foods, Smart & Final, is HUGE for our farming community. ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ ♡ HOT MILK-MAKING TIPS! When you go to make your plant-based milk with the Almond Cow, make sure the basket is securely tightened. our basket has come apart when we didn’t fasten it securely. It’s no fun to clean up when that happens! Push the cute cow button on the top to start mixing your milk! Unplug the machine, and pop the top off for a quick peak at how frothy and delicious it looks in just a minute’s time. Seriously anyone can make consistently delicious milk with this machine! After being in the fridge for awhile, the water separates from the nuts since there are no crazy additives. Quickly shake to combine again and then pour! If you’ve been drinking plant-based milk for awhile or are considering making the swap - DO IT! You will be so glad you did! If you want more insp, check out Almond Cow’s website here to learn more, view recipes, and shop their product line! You can use my Almond Cow: Code: Tori at checkout for $15 off your order. Get ready for a glow up sustainable summer with me XO CLAIM YOUR ALMOND COW HERE! Tori Meskin BSN RNC-NIC. Nurse. Blogger. Podcaster. Tori has been a clinician since 2012, works in acute care/inpatient NICU & Pediatric settings in southern California. She is a blogger, podcaster, NICU & Pediatric Critical Care RN, Sponsored Capella University MSN student, a Barco Uniforms Ambassador & Brave beginnings Ambassador. She has obtained her National NICU Nurse Certification (RNC-NIC) & has previously worked as a travel nurse, pursuing bedside experiences in several NICU settings. Follow her as she shares her NICU journey married life & juggles work, school, content creation, & brings you top notch Tips & Tricks along the way. Find her at www.tipsfromtori.com or info@tipsfromtori.com