Expert Interview Series: Keith Carlson of Digital Doorway

Posted by Sylviane Herzog on Oct 25, 2016 7:00:00 AM

Healthcare professionals

Keith Carlson, RN, BSN, NC-BC, is a nurse blogger, freelance writer, nurse podcaster and expert career coach for nurses and healthcare professionals.

We recently checked in with Keith to learn about some of the challenges facing nurses today and how technology can both help and hinder them. Here's what he had to say:

Can you talk about your interest in coaching nurses? How did this become a passion?

As a nurse blogger and freelance writer, I perceived that there was a dire need among nurses for holistic career coaching that took all aspects of a nurse's personal and professional life into account. Having been a nurse for several decades, I felt I was qualified to assist nurses in creating careers that were both personally and professionally satisfying.

Once I became a Board Certified Nurse Coach through the American Holistic Nurses Credentialing Corporation, I felt confident that I could bring my expertise, thought leadership, and coaching skills to nurses throughout the English-speaking world, changing lives and enhancing the careers of nurses seeking my services.

How has nursing evolved since you started your career?

I began my nursing career in the mid-1990s. One of the biggest changes in nursing and healthcare has been the advancement of technology, including clinical technology and the digital worlds. Meanwhile, nurses' roles have expanded, from broader scope of practice for APRNs and nurse practitioners to nurses striking out into the entrepreneurial space.

From where you sit, what are the most important issues facing nursing today?

Nurses must grapple with changing technology, and they must also face the fact that the job market necessary skill sets are in flux. With a rapidly aging population, nurses must be aware of how to interface with an older population and their needs; we must also maintain awareness of generational differences between the three generations of nurses currently in the workplace (Baby Boomers, Get X'ers, and Millenials).

Also, as scope of practice expands, nurses need to hold their ground against physicians and others who would like nothing better than for nurses to fit back into a nice little box; if we advocate for ourselves and the legislative level, we can push back against the forces seeking to diminish our roles and keep us in subservient positions.

As what it means to be a nurse expands, we are challenged to continually redefine our own self-worth as nurses, and be comfortable with the fact that nurses can do almost anything, including working far away from the classic hospital setting.

From where you sit, what are the most important issues facing nursing today?

Burnout is rampant. Staffing issues, difficult nurse-patient ratios, hospital consolidation, and other economic factors are powerful influencers of nurses and clear causes of burnout. Nurses are often asked to do more and more with fewer resources, so we have to fight against the trends that squeeze the lifeblood from our careers and hearts.

Bullying is also rampant in nursing across the generations, and many nurses leave the profession after being treated poorly by colleagues. We must eradicate bullying, create more civility in the profession, and mentor and nurture our new nurses; they are the future of the profession, and if we don't welcome them with open arms and mentor them conscientiously, they will leave the profession.

When nurses feel that they must spend more of their time documenting than actually caring for patients, they can feel disenchanted and cut off from why they became nurses in the first place.

Some new nurses are not drawn to the hospital, but they are often blocked from non-hospital work until they have one to two years of hospital experience. There don't seem to be enough Med/Surg jobs to go around, so non-acute care employers need to pony up, hire and mentor new nurses who lack hospital experience, and nurture their professional development.

Finally, nursing schools are not doing a good enough job preparing new nurses for the realities of the clinical world. If the schools won't do it, employers needs to create more new graduate nurse residency programs that allow new nurses a gentle entryway into nursing practice.

What are some of the challenges facing nurses in small practices specifically?

Small practices can be challenging since there can be a lack of resources in some milieus, as well as a lack of exposure to experiences that certain nurses need to succeed and develop professionally. While a nurse may feel lost in a big teaching hospital, she may also feel confined by a small practice setting where she is not being challenged to grow.

What should nurses be doing to help overcome these challenges?

Nurses need to seek out the experiences that they feel will feed the type of career they are wanting to create themselves. There is no cookie cutter answer to what a nurse's career should look like, and nurses need to be proactive and assertive in creating opportunities for themselves through assiduous networking, personal branding, career development, and the types of professional advancement that makes sense for them and their individual goals as a healthcare professional.

What is the value of answering services like Answering 365 for nurses?

Services like Answering 365 provide nurses with varying opinions and points of view about crucial career decisions and professional endeavors. We all need to be guided at times, and such services can provide answers and resources that point us in the right direction.

What other types of technology or services do you think have the ability to improve patient care as well as offer relief from over-burdened nurses?

Nurses have a higher rate of on-the-job injury than construction workers, and there seem to be many fewer protections for nurses than those in other professions and trades. Employers need to invest in the technologies that preclude nurses injuring themselves and becoming disabled when caring for patients.

Other technologies are being developed that will assist nurses and the healthcare team in myriad ways in streamlining and improving nursing care, and nurses themselves can get involved in the development of cutting edge nurse-centric technologies.

What, if any, reservations do you have about the way new technology is being used in healthcare today?

Technology can indeed create a divide between us and our patients. If we are so busy behind our laptops that we fail to see the patient right in front of us, patient care becomes more mechanical and less of a human art. We need to maintain our ability to touch patients, spend time with them, hold their hands, look in their eyes, and not allow technology to become a barrier to connection.

What trends or headlines in nurses are you following closely today? What are you excited about?

I am excited about the burgeoning community of nurse entrepreneurs and business owners, and the ways in which nurses are pushing the boundaries of what it means to be a nurse. We have nurse artists, filmmakers, podcasters, writers, and so many others who are forging new paths for nurses. I am also excited by the breadth and depth of clinical practice, the expansion of autonomy for advanced practice nurses, and the ways in which nurses continue to be the connective tissue, heart, and lifeblood of healthcare around the world.

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