Tag Archives: empowerment

Top Ten Tips to Thrive in Nursing School

Top Ten Tips to Thrive in Nursing School is based off of a lecture I gave last February to the nursing students at Anoka Ramsey Community College. I wished I had some of these insights while I was going through nursing school myself, it would have made my experience a lot smoother. My intent is that you can find the space to receive the information and better yet, start to implement some of the steps listed here to make your life and time in school more enjoyable. As in most learning, laying a good foundation is an essential first step. For nurses, self-care is good care.

Be compassionate to yourself.

Do not compare yourself to others under any circumstances.

Action steps:

  • Keep a gratitude journal.
  • Recite an affirmation daily that helps you, for example, “I am learning exactly what I need to learn in exactly the right timing and the perfect opportunities are showing up for me.”

Beef up your support system.

Connect with people whom adore you and will support you, but also help you stretch when you need a swift push into your fullest potential.

Action steps:

  • Get an accountability partner who is in school with you so you can study and offer support to one another.
  • Ask your loved ones if they are willing to offer you extra support during this time and if they agree, suggest ways they can help you, such as babysit your kids, do your grocery shopping, help you clean your house.

Practice grounding techniques at least once a day.

This will keep you grounded in your physical body so that you are more in tune with what it is that your body/emotions/spirit needs, which makes coping with stress easier.

Action steps:

  • Practice mindfulness meditation-setting the intention to try this and sitting quietly for even five minutes to observe whatever comes up for you without placing any judgement on those things-emotions-physical sensations-thoughts. Practicing mindfulness will reduce your tendency to react and will improve your general awareness which can reduce stress.
  • Start a yoga practice-yoga is simple and can be practiced anywhere that you can find a chair or a space large enough to roll out a yoga mat. Start with the basics and build from there.
  • Breath Work-shift your focus inward and notice your breath. Just doing this causes you to relax a bit. After a few minutes of noticing your breath pattern, take a deep breath in through your nose and exhale through your mouth. Repeat this ten times very slowly. We tend to use a shallow breathing pattern in our day to day activities. When you take deep belly breaths it actually helps you relax by sending a signal to your parasympathetic nervous system that it is ok to relax. This is very helpful when you are running on a chronic stress pattern in the body.
  • Get out in nature and reconnect to the planet. It is even better if you are able remove your shoes and feel the earth, dirt, water, and sand on your feet. The feet have a lot of information to share with us about our health and wellness. Just connecting with nature can remove the level of overwhelm we feel at times. It is a reminder that the universe is always supporting us and that everything is probably going to be okay.

Move every day, even if it’s only for ten minutes.

Exercise is a great way to decompress and manage tension, stress, and anxiety.

Action steps:

  • Get up and stretch in the morning.
  • Park your car farther away than usual.
  • Always take the stairs when you can.
  • Dance with you kids or your partner.
  • Do little micromovements with your body while you are driving.
  • If you are sitting all day, get up at least every hour and pretend you are jumping rope or do some stretching.

Eat one meal a day for your immune system.

Imagine a meal that incorporates all the colors of the rainbow-the bright colors represent phytonutrients-the parts of food that help us stay well and fight disease.

Action steps:

  • Make smoothies a few times a week. (Save time by placing all the ingredients in a ziploc and store in the freezer until you are ready to make the smoothie, then just toss what’s in the ziploc in the blender and you are ready to go.
  • Eat all veggies for a meal.
  • Buy and prepare (wash and chop) raw veggies so they are ready to grab and go from the fridge. It is easier to make healthier choices when you have already done the work and are short on sleep and high on stress. When you provide your body the right fuel, you are less vulnerable to getting sick and your energy level with be higher.

Be a master at time management.

Chances are, there are pockets of time in your day that you are unaware of. When we don’t have awareness or boundaries around how we spend our time, things like surfing social media or netflix binge watching can easily eat up an hour or more.

Action steps:

  • Take the time to go through the process of charting how you spend your time now. Literally document what you do for an entire day and for how long. If you can afford it, document a typical week this way. Then create your schedule in a way that works for your style and include everything you need to do from attending class to studying to working out.
  • Get in a routine and you will become very efficient and you will be surprised when you are diligent how much you can get done.
  • When you are doing something give it your full attention. Distractions are rampant and just because you are good at something, like multi-tasking, doesn’t mean you should.
  • Cluster like activities together and schedule them that way. Grocery store/ meal plan/prepping, laundry/cleaning, phone calls/emails. Color code your activities if you are more visual.

Covet your “you time.”

At least once a week make a date with yourself on your calendar to nurture your creative nature.

Action steps:

  • Try Julia Cameron’s ‘Morning Pages’ book that recommends journaling for fifteen minutes first thing in the morning when you wake up.
  • Take a detox bath with relaxing essential oils like lavender and use epsom salts.
  • Dance in your living room or at a class.
  • Go see a movie.
  • Check out a local museum.
  • Go to an art exhibit.
  • Take a pottery class.
  • Pick up your old paint brushes.
  • Draw.

If you get stuck, reflect on the things that brought you complete joy as a child and do that. Use this time to nurture your creative side that tends to get lost as we enter into young adolescence and adulthood.

When we fill our cups on a regular basis we are essentially filling our tanks, just like placing our own oxygen masks before placing it on another. If we are expected to be role models we must be able to walk the talk, I believe that means nurturing our emotional, physical, and spiritual selves and committing to taking the time to do so. Exhibiting to the world that we are worth it. It also gives others permission to do the same and it’s healthy.

Honor your body’s sleep requirement daily.

Getting adequate sleep is paramount to overall health. Adequate sleep refers to sleeping long enough to engage in rapid eye movement, the cycle of sleep that offers deep rest and the opportunity for the brain to assimilate all the information that it has processed during the waking hours. Without this sleep, the brain gets backed up and can cause premature aging and an overall feeling of forgetfulness. People who do not get adequate sleep can also have dysregulated hormonal regulation of leptin and ghrelin. These are the hormones responsible for appetite and satiety (satisfaction). This means if you don’t sleep enough, you will probably wake up hungry and no matter what you ingest, you will never be satisfied.

Action steps:

  • Develop healthy sleep hygiene habits that signals to your body that it is time to start unwinding and preparing for sleep.
  • Restore the body and mind before hopping in the bed with things like a cup of warm sleepy time tea.
  • Do some gentle stretching or yoga.
  • Shut off the technological devices at least two hours prior to sleep.
  • Meditate or pray.
  • Enjoy a good book that is not too stimulating. A famous neurologist once said, “we have to learn to put the brakes on before we get into the garage.”

Keep close tabs on your energy balance.

Energy imbalances cause illness. Your energy includes everything from your “subtle” energy which includes your thoughts and feelings all the way down to your physical energy. Abstain from relationships and people who pollute your life with their toxic and unhealthy ways. Pay attention to how your nutrition affects your mood and your health.

Action steps:

  • Set really strong boundaries and do not let negative people seep their toxic energy into your energy field.
  • Be respectful of others and demand respect of yourself from others as well. If others cross that boundary, be sure to address it in a respectful way, but let them know you will not engage with others that do not respect you.
  • Nutrition is a great way to maintain good energy balance. Be aware of how much caffeine/sugar/processed food you are eating and how it makes you feel.
  • Drink plenty of clean water and avoid using plastic bottles. Use glass if possible or BPA free options.
  • Eat organic fruits and vegetables when possible and avoid foods that are processed and full of genetically modified organisms.
  • Practice dry body brushing once a week. Buy a body brush from your local drug store and run the brush over your arms, legs, torso, chest, and back in a motion that is working towards your heart on dry skin just before you take a shower. Dry brushing removes dead skin cells and invigorates the lymphatic and circulatory system.
  • Get rid of any bath/home/beauty products that contain harmful ingredients like parabens or phthalates. Check out environmental working group’s website for all the latest safety info on food, skin, and home products. www.ewg.org.

Saving the best for last. If you don’t take away anything from our time together, remember this:

ALWAYS ALWAYS ALWAYS ask if you are ever unsure about anything.

Chances are, ten other people have the same question but are too scared to ask. There is never a dumb question.

Action step:

  • Asking questions is courageous and the right thing to do; especially when it comes to caring for another person’s health. You will be faced with numerous situations as a new nurse, that will be scary and if you ever don’t know the answer or how to do something, it’s always safer to ask than to just assume you know how to do something if you aren’t 100% sure.
  • You must give yourself permission to put yourself first. Your health and vitality is a choice. Choose wisely now, because your choice will affect you today, tomorrow, and in the next ten years. You are worth it to take care of yourself.

I can help you do that. Head over to my About page on my site and complete the contact form. Knowing how to care for yourself is an art form, and not one that is always taught in nursing school.

Nursing is soul work and to do soul work, you must practice effective self-care techniques that provide you the space and nourishment you deserve that will keep you well as you take care of others.

Nursing is not only soul work, but it is superhero work and it certainly isn’t for sissies. If you have made the commitment to attend, complete, and pay for nursing school, you can’t give up now.

This is where the rubber meets the road. It is your time to shine.

Please share other tips that you feel have helped you thrive in nursing school or in your career.



Is your story keeping you stuck or helping you heal?

Is your story keeping you stuck or helping you heal?

You have a story. A story fueled by the thoughts that play in the background of your mind about everything, past, present, and future that is colored by all of your life experiences. Your story becomes your being, whether you realize it or not.

The nature of your thoughts and beliefs shape how your life turns out. Since your thoughts are running in the background of your subconscious mind, it is easy to be unaware of the (healing or destructive)power of your thoughts. Even though, these thoughts are the driver of your actions.

Imagine an iceberg. Your subconscious is the part of iceberg that is beneath the surface of the water and is not visible.

So if your subconscious mind is invisible, how are you able to work with it?  A great place to start is to look at your patterns or what I lovingly refer to as your “tapes” or energy patterns. That program or set of limiting beliefs that is on repeat and seems to present itself time and time again, even if you don’t necessarily like what it’s presenting.

This could turn up in habitual patterns in your relationships, your career, or your weight issues.

There are three universal issues that most humans struggle with :

  • I am not lovable.
  • I am not worthy. 
  • I am lacking in something (don’t have enough intelligence, beauty, money, strength, courage)

You may have heard the saying “like attracts like”. When you apply this to your story, you can imagine that if you have predominantly negative thoughts, then you attract more negativity in your life. This negativity manifests as one struggle after another in your life. Nothing comes easy to you.

However, if your thoughts are positive, for the most part, then you attract optimism and opportunity. This manifests by things going well for you and you are able to attract what you desire. Things are just easier and frankly, more fun. From a bystander, it may appear as life just comes easy to you, but the bystanders don’t realize all the mindset and energy work you are doing in the background to create this pattern.

As a lifelong learner, I have always gravitated towards information or resources about “stories”. Mainly because I have struggled with my own story. The story I used to play went something like this, I would be presented with an opportunity to really shine or step into my full potential and I would get right up to the line in the sand and without fail, create some type of scenario that sabotaged the opportunity.

I finally reached a point in life when enough was enough. I was sick of being this amazing human with so many gifts to share with the world to cower and play small. It happened soon after 2013 after I professed to give up fear.

I gave up fear which was the most liberating thing I have ever done. All things are a G-O when fear is not part of the equation. No potential for failure and probability for oodles of success and fulfillment.

It turns out, it takes more than releasing fear to stop playing small. It takes clearing out the old energy and belief patterns that are ingrained in your being. Once you do this work, anything is possible.

Your limiting beliefs or energy patterns/programs have memory and even though you want to release old beliefs and habits, your energetic programming goes on red alert and when you try to do something new, it sets off alarms and creates self-doubt and tries to convince you that you can’t change.

These  programs or scripts are learned between the ages of birth and eight. As a result, the programming is really ingrained in your system. But, once you learn about them, it makes it easier to clear these old programs and set the intention to live in a way that honors your best self and aligns with what you really want.

The most powerful tool that allowed me to do this was learning about my particular energy type. This is something that Carol Tuttle, master energy healer created. It is called Energy Profiling.

The premise of her program is that the same four elements in nature are also in humans. You are born with a predominant energy type that revolves around one of the four elements.

Where it gets tricky, is between the ages of birth and eight. This is when you are told to be the exact opposite of your natural energy type. This makes life very difficult. You establish a mindset to survive during this time frame and when you try to clear this pattern as an adult it feels like a threat to your survival and it creates resistance.

Helping women work through this resistance is my passion. There is nothing more fulfilling for me than when I watch a woman transform from feeling insignificant in life and work, to a vibrant woman who is living to her fullest potential with no apologies.

Ever since learning my own energy type, the things that make me tick make so much more sense. I am no longer afraid of my own power. No more playing small, it’s just not my nature.

If you find yourself living the same scenarios over and over, this is something I highly encourage you explore by learning your particular energy type.

To see what your predominant energy type is check out Carol Tuttle’s free course here: http://myenergyprofile.com/free-course/

Struggle does not have to be part of your daily routine. I did it for over twenty years and I promise, it is not worth it. Let me help you clear out your old limiting beliefs so you can step into your natural energy type to create the life you were meant to live.

If you are ready to create the life you desire, complete the complimentary breakthrough session form on my website so we can get started on your best life. The world is waiting for your gifts.

Have you checked out Carol’s free course? What did you think and what is your energy type?

Until we meet again, keep rocking your natural energy type,


How becoming a yoga teacher helped improve my communication with doctors and made me a better nurse

I am sure you are curious about what yoga has to do with my nurse career……everything!

Never in a million years did I think that completing yoga teacher training would improve my nursing career or make communicating with doctors easier.

Then it happened.

I have practiced nursing for seventeen years. Ten of those, I spent working in a busy electrophysiology lab (that’s the circuitry division of the cardiac catheterization lab).

These were by far some of the best days of my practice! For those of you who practice in an operative type setting are aware of the relationships you create when working in this environment.

For those who do not work in this type of environment, I will share, that when you work in this type of setting, you become very close with all of the people who are part of that team. The doctors, nurses, x-ray technicians, device company clinicians, and others who support all the equipment you use in your day to day operations treating patients. For me, it was patients with heart rhythm disturbances. Working in such conditions, gives you a back stage pass to all the ins and outs of these team members’ lives and their idiosyncrasies.

Every human has their “buttons.” When under stress, a time crunch, or just having a crummy day these buttons get pushed and depending on the person (and whether or not they’ve had their coffee, it’s a full moon, or mercury is in retrograde), the people on the receiving end may receive an unwarranted dose of yelling or personal attacks.

It is ok to be crabby once in a while, but when people start yelling at others or throwing instruments, that crosses the line.

Prior to my yoga experience, whenever a physician was starting to engage in showing their frustration or anger by yelling, I would shut down and start to tread lightly, as if I were walking on egg shells. It never got to the point that I would not interject or interrupt the doctor on my patient’s behalf, but it always made me feel uneasy and like I was on high alert. It was as if they had some special power over me, and that I should be afraid of them.

This is never a good feeling to have as a nurse, because it can influence whether or not you speak up for your patient, which is never a good outcome.

Fast forward to my yoga teacher training. One of the doctors that I worked with agreed to be my “student” for yoga teacher training. I was both flabbergasted and ecstatic. A busy doctor taking the time and energy to help me complete my teacher training! Score! The exam went swell and after I received my certification the relationship that I had with said doctor changed forever.

I don’t know if it was that he had more respect for me, or what, but after that, I never every felt threatened, afraid, or worried about walking on egg shells again. It was as if we were now on a level playing field. I knew more about something than he did, and we were now equals in my mind.

At times when I could tell he was getting frustrated I would say, “you’re going to have to drop and give me fifteen chaturanga dandasana’s (a complex yoga move) if you keep it up.” That queue became his barometer for when he needed to cool it with his negative vibes. In an instant he would lighten up. That relationship spilled over into all of my relationships with doctors and made communicating with them so much easier.

I had this epiphany, that just because someone has MD after their name, does not give them the right to talk to me in a way that feels threatening or unkind.  I realized that we were on a level playing field and that they put their pants on just like me, one leg at a time.

This helped make me the best possible nurse, because I no longer stressed or walked on egg shells in certain situations. When we are under stress; especially chronically, we are far more likely to make errors. This puts us and our patients at risk. I had less stress (less potential for errors) and felt even more comfortable speaking up on behalf of myself and my patients (patient advocacy is crucial in great care, nurses are the eyes and ears of our patients and it is our duty to speak up when there is a change in their condition or a need to re-evaluate a previous plan of care). A win-win for all.

I respect and honor the hard work and schooling that doctors go through, but I will not allow a doctor, or anyone else for that matter to be disrespectful or rude to me. Having more education than me is no grounds for that type of behavior.

So, if you are feeling afraid or like you have to walk on egg shells at work, I get you. The great news is that you don’t have to go through yoga teacher training to change how you interact with people who are difficult. This applies to anyone who is being disrespectful to you and it doesn’t have to be at the workplace. No one deserves to be mistreated or treated disrespectfully.

The same goes for you, if you are the one treating others poorly. It goes both ways. You do not have the right to mistreat others.

When people are projecting that behavior, it is because they feel bad about themselves and use it as a way to make themselves feel better. Stop taking the bait.

The person being disrespectful is no better than you and they do not deserve your time or energy when they are speaking down to you or being disrespectful in some way. The best solution to this is to call them out on their behavior and say something like, “I can see that you are upset, however, I do not deserve to be treated this way and I am happy to give you my time and attention when you can treat me respectfully.” Then simply walk away.

Like attracts like. When we focus on our internal power (self-respect), we attract more power (respect). When we focus on our weaknesses, or what’s not “right” with us, we attract situations that highlight our weaknesses.

We all have parts of ourselves that we can improve upon. I call these opportunities. Continue to work on your “opportunities”, but also try to focus on what’s good and right with you, not on what’s not. You will attract positive, healthy, and empowering opportunities on your path. This will further empower you.

Please let me know what you are doing to improve your relationships with difficult people on or off the job and what has been successful for you. This post is for uplifting comments and encouragement. Let’s hear what’s working for you.

Sending you love and empowerment in life and work,


Nursing is at a tipping point

Nursing is at a tipping point, what does your #stethoscope say about your nursing path?

What Kelly Johnson, RN and #showmeyourstethoscope revealed to me about nursing

My name is Lisbeth Overton and I am proud to be a registered nurse. I have had the privilege of practicing for seventeen years. My passion has been all things cardiac; especially my time in the electrophysiology lab helping patients suffering from irregular heart rhythms. Giving these patients their quality of life back was beyond rewarding.

Currently I work as a nurse case manager for an insurance company educating customers on how to prevent and/or live well with chronic conditions. I love this role because instead of “fixing” people, I am guiding them to see the correlation between their actions and the outcomes. It is rewarding to empower people to take accountability for their own health and to feel their joy knowing that they can create health and wellness in their own lives, one choice at at time.

I also have a private coaching practice teaching nurses how to leverage their unique gifts, creating the lifestyle of their dreams, where health and career thrive.

It seems like it was so long ago now, but the opportunity with registered nurse, Kelly Johnson had such an impact on me. She was Miss Colorado in the Miss America pageant and for her “talent” she wore the scrubs that she wears at work in her nursing job along with a stethoscope around her neck and shared how moving it was to care for a special patient of hers who was living with Alzheimer’s disease. The next day, she was ridiculed on The View for her “talent” and was reported to have read her patient’s emails for part of her monologue.

I have such gratitude for Kelly Johnson and the courage she displayed in the Miss America pageant. I also have gratitude toward the hosts of The View. If it weren’t for their comments, the depth and breadth of this opportunity would never have reached the scope that it did, nor had the impact. Multiple companies pulled their ads that played during The View’s time slot in support of nurses. Kelly’s courage and the lack of understanding of the hosts on The View created a perfect opportunity, or what my mom always refers to as a “teachable moment”.

I believe that the hosts’ comments came from a lack of understanding of what it is that nurses actually do. While it was disheartening and maddening as a nurse to hear such remarks, I believe it was the best thing to happen to nursing in the last ten years. It is an opportunity for nurses to reflect on how we show up in our profession and to join together to educate the world on what it is that we do and how crucial our profession is now and especially as the landscape of health, wellness, and disease changes.

This opportunity was an invitation to reflect on the nursing profession. If nursing is the most trusted profession, how could we be so disrespected? So, I engaged in the #showmeyourstethoscope and #nursesunited campaigns on Facebook. Just to give you some perspective, these groups had well over 800,000 members. I read countless posts by nurses who shared poignant stories of how they left no stone unturned to try and save a patient or bent over backwards to ensure that connections with family members occurred before a patient took their last breath. There were also thousands of posts by healthcare consumers, specifically moms and dads who had nothing but kindness and gratitude to the droves of nurses who cared for their sweet children and never would have made it without the nurses. I also read stories by men and women and their struggle to get to and through nursing school because that had always been their dream.

I also noticed a theme that weaved its way through so many of the stories. This was the mention of all of the things that did not get cared for by the nurses themselves, commonly seen on social media with the hashtag #nurseproblems. This ranged anywhere from not using the bathroom for ten+ hours to working over twelve+ hours straight, not getting enough sleep, not eating on their breaks because they were understaffed, and not feeling safe at work.

Here is the gift and the curse of being a nurse. Nurses are extremely giving, compassionate, strong-willed, creative, artistic, intelligent, and noble. As such, there tends to be more giving than taking or receiving. There is simply no way to continue to offer this to thousands of patients without first recognizing your own need to heal and recover.

One could argue that there are a gazillion reasons that nursing is where it is today that don’t involve the nurse. But at the end of the day, I would argue that no one can make you feel a certain way and when your body, mind, and soul are completely tapped what good is it, if this is all someone else’s fault?

It is time to start taking accountability for our health and careers. You each have the right of choice. If you are a nurse and are struggling with your health, your job, or your relationships, I would ask yourself, what role am I playing in this? Why is it that I believe I deserve to be treated this way? What can I do to improve this? Often it is when we feel that we have no choice that we give up. Just remember, we each have choice. We each deserve to be treated with respect. Now, I challenge you to reflect on your day to day choices. Are they helping you heal or harming you? Why are you making these choices? Are you asking for help? What could you do differently? Are you part of the problem or part of the solution?

I struggled with health issues and feeling disempowered for quite some time. I had no idea how much power my negative thoughts had on my health and the types of circumstances that kept showing up for me. I have discovered that standing up and standing out is the best thing that has ever happened to me. I have learned how to leverage my own thoughts and energy to my advantage. I am healthier, happier, and more empowered than I have ever been. I am now speaking my truth. My mission is to give back to the nursing profession by helping other nurses do the same. Nurses are the backbone, the glue of care. We have such potential and are at a crossroads right now in the landscape of health care. We can either rise up and own our worth and provide amazing education and care for our world, or we can curl up, stay silent, and stay disempowered. I have experienced both and I certainly prefer thriving.

It is time that nurses stand up, band together and start acting like they matter. To me, it looks something like this.

  • Nurses have a very good understanding of their non-negotiables.
  • Nurses have strong boundaries.
  • Nurses have the opportunity to stay well at the workplace.
  • Nurses have flexibility in their schedules.
  • Nurses are staffed for patient safety.
  • Nurses are board members in health care organizations.
  • Nurses create the life they desire that includes everything they want.
  • Nurses learn to say YES to themselves first without guilt.
  • Nurses learn holistic self-care in every nursing school curriculum.
  • Nurses learn to say NO without guilt.
  • Nurses learn effective communication in nursing school.
  • Nurses ask for what they need from their employer.
  • Nurses ask for support from their managers.
  • Nurses complete unsafe staffing forms.
  • Nurses stand in their power by refraining from the phrase “just a nurse”.
  • Nurses ask for coverage so they can take their breaks.
  • Nurses communicate clearly and effectively.
  • Nurses get support from other nurses who understand what they are going through.
  • Nurses believe that they can make a difference in their own lives.
  • Nurses walk their talk.
  • Nurses demand respect as the professionals they are and will refrain from engaging with anyone who is not honoring that expectation.
  • Nurses respect one another.
  • Nurses help one another.

Nursing is one of the most noble professions on the planet. I am honored to be a nurse. I am on a mission to help nurses stand in their power and become the backbone of healthcare that we are. We are at a tipping point. We need strong, healthy, savvy nurses now more than ever before. If we want to be respected and treated well we have to start acting like we matter. I hate to see nurses go through nursing school just to quit one or two years in because it is too unhealthy and stressful. It does not have to be that way.  A nurse should not have to give up a healthy lifestyle or his/her career because it makes him/her ill.

If you are stuck in a lifestyle of poor health or you are thinking about leaving the nursing profession, I would like to speak with you. I teach nurses how to take what you already have and redesign your life so that you can be your own boss and thrive in your career and your health. Call me today at 347-766-8773 for a complimentary session to discover how I can help you thrive in your health and career. You can also schedule your complimentary session here: http://bit.ly/1VYufS8

Please share below how you act like you matter in life and as a nurse. This is a place for positivity and action.

Wishing you empowerment and great choices today and everyday,


Nurse and Creator of Healthy Nurse by Design