A New Norm is Possible for Nurses!


by Donni Alvarenga, Nurse Practitioner and Entrepreneur

It’s no secret that nurses are at high risk for burnout.  According to Vahey, Aiken, and Vargas (2004), nursing burnout is a “syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment.” It is associated with negative health outcomes for nurses such as “psychological distress, somatic complaints, and alcohol and drug abuse.”  In this blog post, Greg Hunter and Beth Boynton suggest burnout is not good for anyone since it also contributes to poor patient outcomes.    

Many nurses are feeling exhausted, dissatisfied, and burned out. With more and more nurses experiencing the symptoms of burnout, I wonder if they are now being perceived as the expected norm of a nursing career?  The perception of burnout as an expected norm is a slippery slope that can contribute to a worsening problem by becoming part of the culture. We must challenge our beliefs of what is normal to keep that from happening.  Is it possible that as a nurse, what you believe is normal and acceptable is really not?  Here are a few questions to challenge existing beliefs:

  • Is it possible that although you might believe it is normal to never feel like there is enough time to do the things that you enjoy, that it really isn’t?
  • Is it possible that you believe it is normal to feel anxiety and fear as you drive into work, but it really isn’t?
  • Is it possible that you feel like you don’t have the choice to experience work-life balance in how you make a living, but that you really do?
  • Is it possible that you believe it is normal to take care of everyone else but yourself, but it really isn’t?

Until we see every aspect of the burnout experience as a problem, we are in danger of existing in a life less than fulfilling. We settle for survival by thinking it’s normal and expected to just survive. But that is not normal. I would therefore like to propose a new norm.  IT IS possible to thrive in life as a nurse!  I have experienced the possibilities of a healthier and more fulfilled nursing career myself by becoming a health coach and learning how to take better care of myself while I care for others, all while making the kind of income that meets my family’s needs. I have experienced a new kind of normal and this is what it looks like:

  • It IS possible to make a living AND have time for your family and the things that are important to you.
  • It IS possible to make a living doing something you love – without experiencing anxiety at the thought of doing it.
  • It IS possible to make a living in life without sacrificing what is most important to you.
  • It IS possible to leverage your passion for nursing to make a living while enjoying flexibility.
IT IS possible to thrive in life as a nurse! Click To Tweet

I have a dream that more and more nurses will experience and promote this new norm in nursing.  As more nurses embrace their full potential and take better care of their health and well being, I believe it can happen. I created the Facebook Group and blog, Nursing Outside the Box, to help establish this new reality by empowering nurses to find more purpose, balance, and flexibility in what they do for a living.

In our upcoming ebook, The Extraordinary Life: How Nurses are Going from Surviving to Thriving, David Bush and I outline the steps I and several other nurses are taking to create this new norm.

So how can we collectively create this the new norm for nurses? By individually taking the following steps:

  1. Acknowledge that barely surviving is a problem.
  2. Identify what thriving means to you. Don’t decide what you want to your career to look like. Decide what you want your life to look like.
  3. Find those that are doing what you want to do and living the way you want to live.
  4. Do what they do.

Will you join me in helping reset the expectation of what is normal in Nursing?


Posted in Assertiveness, Communication in Healthcare, Complexity in nursing, Healthy Workplaces, Holistic Health, Nurse Entreprenuers, Nurse Leadership | Tagged , , , , , , | 1 Comment

ManageUp at MD Anderson: The 2016 Results are Compelling!


The University of Texas MD Anderson Cancer Center Drastically Decreases the Time and Cost of Performance Management Reviews and Achieves 100% Compliance!

Using ManageUP to manage regulatory compliance and personnel development, MD Anderson experienced in 2016:

  • 82% reduction in administrative time
  • 6.5X ROI over a two-month period
  • Standardization of work across 8 treatment locations ü 100% licensing compliance
  • Significant cost savings!

Sign up for a download of the entire case study with details of savings!


  • Task Management System enables template tasks associated with the PDM to be set up once and easily reused. Tasks can then be assigned to individuals or teams on a recurring basis to save time. Tasks can be tracked by individuals to ensure transparency. Real time reports can be generated on individuals and teams to ensure accountability.
  • Central Knowledge Hub single sources policies, guidelines, procedures, and instructional/training information. Employees are empowered with any-time access to crucial information.
  • Real-time Recognition System rewards the staff and management for tasks completed and for communication and collaboration with each other.

Learn more abstatic1.squarespaceout ManageUp!

Posted in Communication in Healthcare, Complexity in nursing, Healthy Workplaces, Holistic Health, ManageUp, Nurse Leadership, Patient Advocacy | Tagged , , , , , , | Leave a comment

Cambridge, MA Nurse is Leaving the Carbon Economy!

Susan Farist Sue-B-and-OriosButler, RN, MSN, CS, PhD has a great short film about her process for making her home energy efficient.  Soft-spoken and passionate about healing the planet, her 15 min video will leave you inspired and informed.  (It is 0.99 cents on Amazon).

The trailer is fun and I can’t help but smile at the picture of her standing on her roof with  photovoltaic cells and her message:

Leaving the Carbon Economy:  One person’s not going to do it alone…

And yet, there she is!

The video is worth the small expense as she shares her thinking and decision making process as she re-engineers her life and her house to get her carbon footprint as close to zero or below as possible.  She is getting close, and may even in the end, make extra electricity, and sell it to the grid, thereby going carbon negative.  Come see what the possibilities are.

Are nurses amazing or what?

Posted in Communication in Healthcare, Complexity in nursing, Diversity, Healthy Workplaces, Holistic Health, Nurse Entreprenuers, Nurse Leadership | Tagged , , , , , | Leave a comment

One RN’s Lesson, Gift, & Motivation! Inspiring Nurses are Among Us!

13934712_10154976418465656_6689046466083462418_n-1“The Past is Your Lesson”

High school was a daunting experience for me. Having struggled, undiagnosed, with Attention Deficit Hyperactive Disorder (ADHD), I was suffering in silence. I knew I was different. Authority “knew” I was “lazy” and “unmotivated”. The most vivid memory I have of high school was sitting across from my guidance counselor, sophomore year 16 years old, and her explaining to me, quite disdainfully, that I would never get into college with my grades and it would be best if I dropped out of high school and got a job. So I did.


I began to feel stagnant, motivating me to obtain my GED and try college. I declared a medical assisting major (read why here). Then failed miserably, feeling precisely how I felt in high school; overwhelmed and unable to focus.

Next, I paved my way into an entry level call-center position at a huge credit card company. At an appointment, my doctor picked up on me fidgeting and it was determined after a series of tests and evaluations I have ADHD. I started treatment, went back to school, this time for business management, and I excelled.

At this point I had a passion for my job and learning. I made a respectable income and moved into management. In a short amount of time, I climbed the ranks, performing at the top 1% company wide for customer service in a difficult department (call escalations, AKA the screamers). At this high point, I evaluated my life. Business management was not for me. Impulsively, I chose nursing and I resigned.

“The Present is Your Gift”

These past few months have been a complete whirlwind.

  • Certified in ACLS, and ASLS from college
  • Graduated with an Associates Degree in Nursing – May 7th, 2016
  • Received my ATT – June 2nd , 2016
  • NCLEX – June 19th , 2016
  • Licensed – June 27th , 2016
  • Interview for Med/Surg Fellowship – July 15th , 2016
  • Offered Job – July 27th , 2016
  • Start Fellowship – August 22nd , 2016

“The Future is Your Motivation”

My future aspirations? In a broad sense, to make an impact. My goals change often. I make a point to constantly make short and long-term goals periodically. It keeps me moving.


  1. Be placed in a Level 1 Trauma Unit on completion of Fellowship
  2. PALS and TNCC certification
  3. Earn Bachelor of Science in Nursing (BSN) and Master of Science in Nursing (MSN)
  4. Constantly learn and teach others

Scrub-ed.comUntitled design (6)

I plan on using Scrub-ed.com to launch a non-profit for nursing students to help students with:

  • Tutoring
  • Textbooks
  • Clinical Supplies
  • Scrubs
Posted in Communication in Healthcare, Complexity in nursing, Diversity, Healthy Workplaces, Holistic Health, Nurse Entreprenuers, Nurse Leadership | Tagged , , , , , | 1 Comment