DiversityNursing Blog

By: Aditi Pai

Nurse scheduling platform OnShift raised $7 million in a round led by HLM Venture Partners with additional funding from Draper Triangle Ventures of Pittsburgh, Early Stage Partners of Cleveland, Fifth Third Capital, Glengary LLC of Beachwood, and West Capital Advisors of Cincinnati. This brings OnShift’s total funding to $15 million.

OnShift will use the funds to add between 20 and 25 employees to its 60-person staff, including new engineering and marketing employees.

OnShift is a nurse scheduling and shift management system for long term and senior living care. The cloud-based program can be accessed via web or an app and offers automated scheduling, overtime prevention, and open shift management. The company aims to expand within the assisted living market for now.

“We’re solely focused in that market,” VP of Finance Mike Rich told MobiHealthNews. “There are very specific regulatory needs they have in terms of scheduling that we are able to cater to within our software and within our app.”

Rich explained the technology helps this specific sector of the healthcare market because they have an “extremely thin margin for business” so overstaffing is a big problem for them.

“First and foremost what people talk about is our ability to mitigate overtime, so when a nurse calls out sick, the easiest thing to do is ask a nurse to do a double shift and that instantly puts [him or her] in an overtime position,” Rich said. “What our software does is it lets schedulers see who is able and eligible to take a shift that will not put them in overtime now or in the current day period, and then we can blast a message either through an email or text message to say there’s a position open. Then people get that message and they can instantly say ‘I want that position’. [The message] comes back to the scheduler and literally within 10 minutes they have that schedule filled with a non overtime position.”

According to Rich, 85 percent of staffing in these types of care facilities is done on paper and Excel so if the facility is staffed with 25 people one week, it will most likely be staffed the same even if three patients were discharged. OnShift also takes that into account when staffing assisted living centers.

So far, OnShift is in 1,100 different longterm care facilities and in every US state. The company also doubled in size over the last year.

Source: MobiHealthNews

“Nurses serve in a variety of professional leadership positions, from administrators and unit managers to chief nursing officers and hospital board members. Today, the challenges of leading in an increasingly complex health care environment are great; therefore, nurses need to take every opportunity to develop and hone their leadership qualities and skills. The question for every nurse—no matter the stage of her or his education or career—is: Are you the best leader you can be?” writes Sue Hassmiller, senior adviser for nursing at the Robert Wood Johnson Foundation and director of the Future of Nursing: Campaign for Action, and Julie Truelove, student at the University of Virginia School of Nursing, in an article in the January 2014 issue of the American Journal of Nursing.

The article, “Are You the Best Leader You Can Be?,” discusses the Institute of Medicine’s recommendations on nursing leadership in the 2010 report, The Future of Nursing: Leading Change, Advancing Health. The recommendations call on the health care system to “prepare and enable nurses to lead change to advance health,” by developing leadership programs and providing increased opportunities to lead. The article features a table of nurse leadership programs for nursing students and professional nurses as well as a nursing leadership resource list.

Table: Leadership at Every Level -  Click here to view the full table. 

“Nurses with strong leadership and management skills are better prepared to serve individuals and their families and the community, and to collaborate with colleagues,” the authors write. Regardless of where you are in your career, “a leadership program is a step toward becoming the best leader you can be.”  Read the full article here.

Source: CampaignforAction.org 

The American Association of Colleges of Nursing released preliminary survey data showing that enrollment in entry-level baccalaureate nursing programs increased by 2.6% from 2012 to 2013, which marks the lowest enrollment increase in professional RN programs over the past five years. 

Findings are based on data reported from 720 of the 858 schools of nursing in the U.S. with baccalaureate or graduate programs. Although RN enrollment increased for the 13th consecutive year, nursing schools have identified a shortage of faculty and clinical education sites as potential barriers to realizing future growth and meeting the nation’s need for healthcare providers.

“Given the calls for a more highly educated nursing workforce from the Institute of Medicine, the Tri-Council for Nursing, nurse employers and other stakeholders, we are pleased to see at least modest growth in the pipeline of new baccalaureate-prepared nurses,” AACN President Jane Kirschling, RN, PhD, FAAN, said in a news release.

Preliminary AACN data also show a strong enrollment surge in baccalaureate nursing programs designed for practicing nurses looking to expand their education in response to employer demands and patient expectations. 

The number of students enrolled in baccalaureate degree completion programs, also known as RN-to-BSN programs, increased by 12.4% last year (among 512 schools reporting). This year marks the 11th year of enrollment increases in these programs and offers further validation of the desire among nurses to advance their education to remain competitive in today’s workforce, according to the AACN.

Looking ahead, AACN plans to work collaboratively with stakeholders to ensure that enrollment in both baccalaureate and master’s level degree completion programs for RNs expands even further to meet the recommendations outlined in the 2010 “Future of Nursing” report prepared by the Institute of Medicine, including a goal of 80% of nurses having BSNs by 2020.

Enrollment changes since 1994: www.aacn.nche.edu/Media-Relations/EnrollChanges.pdf

Fact sheet: www.aacn.nche.edu/media-relations/fact-sheets/nursing-workforce

Source: Nurse.com 

By Eileen Beal for HealthCallings.com

Acing an interview: It’s all about how you respond to questions

A strong resume, sent to the right hospitals, practices, or clinics–healthcare employers that you’ve researched online and scored tips from other nurses who work or have worked there–is step one in getting the job you want.

Nurse recruiters, hiring managers, and HR staff, who review your resume, are looking for far more than just making a skill set match.  Step two is convincing them that you aren’t just qualified for the position you’ve applied for–you are the position’s best candidate!   And, while your resume gets you the face-to-face job interview, it’s the rapport you establish the moment you sit down in front of the interviewer that will land you that job offer.  They want to know:

• How you communicate your capabilities, experience, achievements, and skills and your expectations about the position for which you are interviewing; and
• How you respond (and react) to the questions and situations pitched at you during the interview.

Employers are concerned with three basic questions

According to Mary M. Somers, author of The Complete Guide to Successful Interviewing for Nursing Students, most interview questions come from an employer’s concern with three basic questions:

• What can you do for us?
• Why do you want to work with us?
• What are you like once we’ve gotten to know you?

Knowing how to respond to the questions you’ll be fielding during an interview–some predictable, some challenging, and some with no “right” answer–doesn’t just position you as a confident and prepared interviewee, it puts you ahead of the competition, too.

Practice answering job interview questions

Ask friends and colleagues about their job interview experiences to get an idea of what questions to expect.  Practice answering the questions by consciously thinking about how you will answer them and about personal situations and experiences that will enhance your responses.  Below is a list of other useful job interview sources for nurses.

• 65 Interview Questions For Nurses
• Interview Questions & Answers For Nurses
• Pre-Interview Prep
• Prepare For A Behavioral Interview…Then Ace It!
• Sample Interview Questions For Nurses
• Sample Nursing Interview Questions & Tips

What to avoid during the job interview

According to career expert Somers, exhibiting the following traits, characteristics, and actions during an interview will decrease your chances of getting a job offer.

• Overbearing presence
• Inability to express yourself clearly
• Lack of planning for career
• Lack of interest and enthusiasm
• Lack of confidence and poise
• Failure to participate in activities
• Overemphasis on money
• Poor scholastic record
• Evasiveness
• Lack of tact
• Lack of maturity
• Lack of courtesy
• Condemnation of past employers
• Lack of vitality
• Failure to maintain eye contact
• Indecision
• Little sense of humor
• Lack of knowledge in field of specialization
• No interest in company or in industry
• Narrow interests
• Inability to accept criticism
• Radical ideas
• Lack of familiarity with company 

Written by Sarah Okeson

Joe Long first thought of becoming a nurse when his wife was hospitalized for a week during her pregnancy with their second child. He now works at Mercy Hospital Springfield, taking care of patients in the intensive care unit.

“Nursing is manly,” Long said. “It’s not just for women.”

About 6.6 percent of nurses nationwide are male, according to the American Association of Colleges of Nursing. In Springfield, about 7.3 percent of nurses at CoxHealth are male. At Mercy, about 11.4 percent of the nurses are male.

The American Assembly of Men in Nursing was formed in 1971 in Michigan to provide support for male nurses. An Ozarks chapter is being started. There are also chapters in St. Louis and Kansas City. The organization also is open to women.

“It’s a very female-oriented world and we’re OK with that, but men still need to socialize,” said Paul Pope, the chapter president and a nursing instructor at Southwest Baptist University.

The executive director of nursing at Mercy Hospital Springfield is a male nurse, Kurtis Abbey.

Nurses like him have faced some of the obstacles that women entering predominantly male fields have faced. There have been lawsuits and complaints about isolation.

Rick Leroux, a nursing instructor at Southwest Baptist, got into nursing with the encouragement of his aunt. He learned how to make chitchat with children and to be absolutely honest about whether a medical procedure would hurt.

He treasures moments such as an encounter with the adult daughter of a man he had cared for who had a heart attack. She hugged Leroux and thanked him.

“Those are the moments we live for,” Leroux said.

Female employees at Mercy said they appreciate male nurses when it comes to lifting patients. They also value other qualities such as help in dealing with sometimes-disruptive families.

“We have a lot of difficult patients,” said Becky Pierce, who has worked at Mercy for about 40 years. “For each difficult patient, you have family members who sometimes need the physical presence of a man.”

Dr. Tobey Cronnell said male nurses tend to be more supportive of female doctors.

“I particularly enjoy working with male nurses as a female physician,” Cronnell said.

Long recently tended to John Goar, 73, who was admitted to Mercy Hospital Springfield after having trouble breathing.

Long gave him insulin and some other medication and then told Goar that his relatives were on their way to visit.

“He’s as good as a woman,” Goar said.

Long left Goar’s room. He was about halfway through his 12-hour shift. He doesn’t miss his previous career as a loan officer for a mortgage company.

“It’s the first time I have a job where I actually look forward to going to work,” he said.

Source: News-Leader.com

A study commissioned by Herman Miller Healthcare showed that nurses walk up to four miles a day on their shift. Much of this is due to supplies not being readily available and the need for better communication, like keeping tabs patient location. Technology is beginning to make the job of the nurse easier by giving them better information, leading to less steps.

Real Time Locating Systems

Real Time Locating Systems, also known as RTLS, uses small tags attached to devices, making them easier to find. For example, a typical scenario finds the nurse walking from room to room to locate a blood pressure machine for use in their rounds. With an RTLS tag, the nurse can locate the machine on a dashboard at the nurses station. They may still have to walk to the end of the unit to retrieve the machine, but it will be a direct route.

Patient Locators

Similar to RTLS are devices that patients can wear to indicate their location, according to Villanova University. Tracking down a patient can be time consuming on a busy nursing unit. A nursing aid that has taken a patient to physical therapy and radiology calls up for the patient to come down for a test. The locator tags can prevent the hunting down of people who know where Mr. Johnson is by indicating that he is in PT.

Another use suggested for these locator tags is in monitoring patients who may wander out of their rooms and be difficult to track. Mental health units, neurology units and Alzheimer's treatment centers benefit from these devices.

Tools in Your Pocket

With smartphones and tablets, you can have a number of tools in your pocket to help you get through your day easier.

The Pocket Pharmacist is available for your iPhone, and gives you a drug reference list with interactions. Calculate by QxMD uses current clinical decision trees to determine the best course of treatment.

Other tools to help you with your nursing career include a wage calculator by Intuit to help you precisely calculate your time and paycheck amount, which is handy for those extra shifts and holiday hours you're asked to work. ShiftPlanning is a nursing shift scheduling tool that the charge nurse will find useful for tracking time and adjusting schedules.

Mobile Devices and EHR

Electronic Health Records (EHR) became mandatory as of January 1, 2014, notes USF Health. Institutions must begin making patient records available online. A study by American EHR on more than 800 health practitioners showed that 33 percent with access to EHR used a tablet to access patient information.

As tablets and mobile charts become more available on nursing units, the constant walking back and forth between patient and their information is reduced. Devices such as the iPad EHR by drChrono allow bedside status updates to be made once vitals and other observations are completed.

Patient Workflow

Nursing Critical Care highlights a software system used in a Pennsylvania hospital that helps save steps during a patient's discharge. When the patient is ready to be released, the nurse uses a workflow panel to contact the transportation department to pick up the patient. Once they have arrived and are leaving with the patient, they use the panel to contact the cleaning crew. Once the room is clean, they use the panel to contact the admitting patient, to tell them the room is ready. This keeps the nurse from walking to the room to see the status, so they can report back to admitting that the room is ready for the next patient.

By Jennifer Larson

Once again, nurses are tops.

Every year since 2002, nursing has ranked at the top of the list of professions deemed the most trusted in the United States, according to an annual Gallup poll. The poll began including nurses in 1999, and they have claimed the top spot every year except 2001.

“It’s wonderful that nurses remain the most trusted profession in the annual Gallup poll,” said Diana Mason, PhD, RN, president of the American Academy of Nursing (AAN).

Linda Norman, DSN, RN, dean of the Vanderbilt University School of Nursing, said that the recognition is much appreciated by the profession, too.

“I think nurses, as a whole, are very proud of the fact that they are the most trusted profession, and that’s not something they take lightly,” said Norman, who also holds the Valere Potter Menefee Professor of Nursing position at Vanderbilt.

Consistently high ratings 

More than 8 out of 10, or 82 percent, of the Gallup poll survey respondents gave nurses a “very high” or “high” rating on their honesty and ethical standards; the next highest professional categories were pharmacists and grade school teachers, tied with 70 percent.

The Gallup organization noted that nurses have received ratings above 80 percent every year since 2005. The profession’s highest rating for honesty and ethical standards was 85 percent in 2012. 

“It’s been a very consistent finding,” Norman said. “We are the patient advocates. We’re the ones with patients for longer periods of time than other health care providers, so we have that opportunity to establish trust with them.”

Afaf Meleis, PhD, the Margaret Bond Simon Dean of Nursing at the University of Pennsylvania School of Nursing, agreed. 

“Nurses have earned their spot at the top by their stellar devotion to the patient, their mastery of evidence to deliver the best practice, but particularly because they advocate for the patient,” she said. “Patients trust nurses because they deliver the best information at the bedside in difficult times.”

Looking forward 

But where do you go from the top? Achieving this distinction should not be viewed as an endpoint or just as an honor, but as a charge to maintain this high level of trust with patients and their families, said Norman.

“Once you’ve gotten there, you need to make sure that it’s important to the profession as a whole to stay there,” she said. “You really embed it into what you do, and what you teach, and how you deliver care.”

And there are still challenges ahead. For example, Meleis cited the variation in laws from state to state that affect how much autonomy and independence that advanced practice nurses have when practicing.  In some states, nurse practitioners have much more autonomy than in in other states, where physician supervision is mandatory by law.

“With the Affordable Care Act putting more patients into the healthcare system, we need to develop and implement policies that allow nurses to [practice to] the maximum of their ability without undue restriction,” she said. “This will benefit populations, enhance access, and ensure best implementation of the Affordable Care Act.”

Mason would like to see an elevation in the presence of nurses and the nursing perspective in the shaping of health policy. She noted that a different Gallup poll in 2010 found that thought leaders in health care don’t always include nurses in the role of key decision makers. But nurses can bring a lot to the table when it comes to transforming health care, and they have a responsibility to do so, given the public’s trust in them.

“The American Academy of Nursing is committed to get nurses appointed to local, state and national governing boards of health care organizations and consumer advocacy groups, as well as policy-related advisory bodies,” Mason said.

Encouragement for future nurses 

Many nursing leaders also hope that this poll will help convince many people who are considering a career in nursing to take the plunge.

“As this poll shows, the public counts on nurses and respects them,” said Karen Daly, PhD, RN, president of the American Nurses Association (ANA).  “Clearly, there are boundless opportunities for those who wish to consider nursing as a profession.”

Norman said she believes that a poll like this one that shows the great trust that people put in nurses can definitely help with recruitment. The results show potential nurses that there is opportunity for finding great meaning in the work, and in making a difference in people’s lives.

“We’ve got to make sure that this really is something that we sell with new nurses--and nurses throughout the profession,” she said.

© 2013. AMN Healthcare, Inc. All Rights Reserved. 

by Meaghan O'Keeffe, RN, BSN

As the institution of healthcare continues to evolve, nurses across the country are being asked to change with it. It can be easy to lose focus on the larger picture, however, when faced with the day-to-day challenges on the job.

These five reports are an eye-opening look at the healthcare system in crisis, but most importantly, they offer the nursing profession inspiring, actionable plans for how to change it.

Each of these reports is a must-read. They’re engaging and provocative and will help you come to informed opinions about the state of healthcare and your role as a nurse. Consider choosing a report every other month to distribute to your co-workers and then hold semi-formal discussion sessions to explore the themes and how they relate to your experience as a nurse.

5 Must-Read Reports for Nurses

1. Silence Kills

In this ground-breaking study, published by Vital Smarts and the American Association of Critical Care Nurses in 2005, seven areas where communication breakdown occurs in healthcare delivery were identified. They found that fewer than 10 percent of healthcare works speak up when they’ve observed medical errors, incompetency and other potential harmful behaviors. One of the more interesting findings of the study was that the few who do speak up in challenging circumstances have better patient outcomes and are more likely to stay in their jobs.

2. The Silent Treatment

A follow-up to Silence Kills, The Silent Treatment takes a closer look at the many reasons why nurses fail to speak up during crucial moments in healthcare delivery and what identifies the characteristics shared by nurses who find the courage to say something when it counts.

3. The Future of Nursing: Leading Change, Advancing Health

Published in 2010, The Robert Johnson Wood Foundation, along with the Institute of Medicine, presented a call to action. In The Future of Nursing, the authors present data, and outline constructive ways, in which the nursing profession can become a leading voice in the revolution of the healthcare system.

4. AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey To Excellence

The American Association of Critical Care Nurses published the AACN Standards for Establishing and Sustaining Healthy Work Environments: A Journey To Excellence in 2005. In it, they identify the factors necessary to create and sustain a work environment that empowers nurses to deliver the best care possible. As you read through it, critically think about which standards your institution or unit meet, and which might be areas for improvement.

5. Keeping Patients Safe

The Insitute of Medicine recognizes the relationship between a healthy work environment for nurses and optimal patient care outcomes. In Keeping Patients Safe, the IOM provides recommendations that address adequate staffing, trust in organizations, and other “bundles of change” that will ensure an optimal environment for nurses to do the jobs required of them.