Nurses are a constant presence at the bedside and regularly interact with physicians, pharmacists, families, and all other members of the health care team but, physicians may spend only 30 to 45 minutes a day with even a critically ill hospitalized patient. This means Nurses have the critical role in ensuring a patient's safety.

Nurses ensure their patient's safety by monitoring them for clinical deterioration, detecting errors, understanding care processes, and performing countless other tasks. There are many ways to help you achieve quality safety for yourself and your patients. Here are a few...

Nurse-to-patient ratios

According to Agency for Healthcare Research and Quality, assigning increasing numbers of patients eventually compromises a Nurses' ability to provide safe care. Several seminal studies have demonstrated the link between Nurse staffing ratios and patient safety, documenting an increased risk of patient safety events, morbidity, and even mortality as the number of patients per Nurse increases. The strength of these data has led several states, beginning with California in 2004, to establish legislatively mandated minimum Nurse-to-patient ratios; in California, acute medical–surgical inpatient units may assign no more than five patients to each registered Nurse.

Safe and healthy workplace

OSHA, which enforces the Occupational and Safety Health Act of 1970, ensures employers are providing a safe and healthy workplace for workers and comply with OSHA’s regulations. Some of the obligations include:

• Complying with your employer’s policies and procedures based on its obligations under OSHA;

• Using personal protective equipment, including masks, when indicated;

• Informing your Nurse manager and others designated in the facility policy of workplace violence (e.g., bullying, intimidation, verbal abuse);

• Using proper body mechanics when lifting, pushing wheelchairs or otherwise working with patients;

• Reducing risks for slips, trips or falls by removing obstacles, wiping up wet walking surfaces and wearing shoes that support your feet and your walking;

• Speaking with your Nurse manager and CNO when policies and procedures governing safety are not being followed.

Overtime and long shifts

It is common for hospitals and clinics to request that their Nursing staff work overtime. While working overtime can be an effective solution to a Nursing shortage, it also can present a number of problems. Nurses risk becoming burned out, tired and/or stressed if they take on too much overtime.

 A study conducted by the Pennsylvania Patient Safety Reporting System showed working a 12-hour shift or working overtime was related to having trouble staying awake during the shift, reduced sleep times and nearly three times the risk of making an error. The most common medication errors identified in the study due to Nurse fatigue were wrong doses, dose omission and extra doses.

Communication

Health care teams that communicate effectively and work togehter reduce the potential for error, resulting in an improved clinical performance. According to the American Hospital Association,  A key aspect in improving teamwork and communication in health care is engaging patients and families. Increasingly, research shows a correlation between increased patient and family engagement and fewer adverse events. Determining how patients and families want to be involved in their care and then engaging them in designing their plan of care increases their understanding of tests, procedures, and anticipated care outcomes, including a successful discharge.

If you have any questions about patient or staff safety, please click below to ask your question and a Nurse Leader will respond.

Workplace conflict is common across all industries especially in a fast paced and stressful field like Nursing. Conflict mediation can be complex and typically Nurse managers step in to help resolve the problem.

Acoording to Nurse.com, conflict is a disagreement between two or more people who differ in attitudes, beliefs, values, feelings or needs. It’s a part of every work environment, including healthcare organizations. The ingredients of conflict include:

Burnout amongst Nurses isn't a new thing. In fact, it could be getting worse. With a combination of Nurses retiring and an influx of aging patients, this can become too much to handle and some will leave their profession.

According to Fierce Healthcare, several stressors lead to high levels of pressure and Nurse burnout.  These include:

• High patient acuity (years ago, these patients would have been in the ICU)
• High nurse-to-patient ratios (not acuity-based)
• Multiple discharges and admissions (many nurses will discharge and admit an entire team of patients during their shift)
• Lack of ancillary support and resources
• Leaders who assume that nurses “can take one more patient”
• Physicians who expect nurses to drop everything and attend to their needs
• Interruptions while on their break
• The expectation that nurses are all-giving.

A survey by travel nursing company RNnetwork, found that almost half of the Nurses they asked were considering leaving the profession. About a quarter said they felt overworked, 46 percent said their workloads had risen and 41 percent said they’d been harassed or bullied by managers or administrators. Making matters worse, with the aging of the baby boom generation, demand for health care is rising at the same time that large numbers of experienced Nurses are retiring.

Ashley Neuman, LPCC-S, one of Blazey’s colleagues in Cleveland Clinic’s Wellness Enterprise, offered advice to caregivers during a 30-minute Wellness Connection presentation entitled “Managing Burnout in the Workplace: How Caregivers Cope.” She began with a definition of burnout, which can have three components:

• Emotional Exhaustion – “Burnout can occur when you’re not just physically tired, but you are emotionally exhausted,” says Neuman. “It’s when you don’t have the motivation to get up, get moving and finish that one last clinical note. That emotional weight becomes heavier every day.”
• Depersonalization – This happens when you have an unfeeling or impersonal response toward recipients of your service, care or instruction. “Nothing sparks passion or you don’t have that intrinsic motivation anymore,” she explains.
• Dissatisfaction in Personal Achievements – Nurses who experience burnout may lack feelings of competence and achievement in their work. Neuman says, “You become a shell of yourself, losing interest in things you normally enjoy doing.” Maybe you dread going into a patient’s room or going home to make yet another dinner for your family.

Here are some tips that may help Nurses dealing with burnout.

1. Identify The best type of Nursing job for you

The field of Nursing is a large and diverse field. People in this profession might work in hospitals, doctors’ offices, nursing homes, office jobs, mobile units, private practices, home care, schools, the military, and even large public venues like amusement parks. And within the profession, there are medical specialties, such as pediatrics, cardiology, ophthalmology, geriatrics, and sports medicine. Spend some time figuring out what you like the most, and then focus your job search in this.

2. Search for workplaces with lower nurse-to-patient ratios

The Journal of the American Medical Association (JAMA) linked hospital Nurse staffing to nurse burnout and job dissatisfaction in their research on the topic of high Nurse turnover. "Nurses in hospitals with the highest patient-to-nurse ratios are more than twice as likely to experience job-related burnout and almost twice as likely to be dissatisfied with their jobs compared with Nurses in the hospitals with the lowest ratios," JAMA reported.  

The more patients Nurses are expected to care for in a given shift, the less time they have per patient. This can make the usually empathetic task of caring for patients feel more robotic, stressful and incomplete.

3. take care of your own body first

Most Nurses are inclined to take care of others first and worry about themselves later. But in order to be an effective nurse with a long career ahead of you, it’s critical that you take care of your own body. Be sure to make time in your life for adequate exercise, good nutrition, and restful sleep. Bring nutritious protein-packed foods during your breaks. And after a long day on your feet, don’t be afraid to just relax!

4.Learn to say “No.”

masmedicalstaffing.com says, For professionals in healthcare, it’s often our natural inclination to jump right in when someone asks for our help.

However, if you already have an overloaded schedule, your first concern should be to keep yourself healthy—otherwise, you won’t be able to take care of your patients properly.

So instead of always extending a helping hand, take a moment to consider whether you really have the time and energy to do so without adding a bunch of new Nurse stress-inducers to your day.

And if you can’t help out, say so firmly yet politely.

The next two tips are from www.travelnursesource.com

5. Eat Healthy and Stay Hydrated

It’s not a secret that the food that you consume plays a big role in your mood and productivity. Increase your fruits and vegetable intake as well as whole grains and lean meat within your diet for an energy-boosting food palette. To increase productivity, eat food that is rich in fiber and carbohydrates. Stick to food with high levels of omega-3 fatty acids to help reduce depression and lift your mood.

 6. Socialize

Having a support system is an integral part of a healthy mental and emotional state. Take some time from your busy schedule to socialize with your friends and family to take a break from your stressful environment. It’s scientifically proven that when we are more likely be happy when we are surrounded by the people who we love – that is why humans are a social creature.

What are some ways you prevent burnout in your life? Comment your thoughts below!

Appreciation – we love to feel appreciated for what we do, but often, it feels like our work sometimes goes unnoticed. Here’s a story we think you’ll enjoy. It’s all about appreciation and the work Nurses do. This is a big Thank You to Labor & Delivery Nurses, Midwives and Doula’s.

Mother of four, Jill Krause, recently saw a photo by Katie Lacer that moved her. She was overcome with memories and gratitude for the Nurses. Jill shared the photo with her thoughts about the labor, delivery, and postpartum Nurses who help new mothers in their most vulnerable moments. The post quickly went viral and mothers everywhere commented their experiences and shared their thanks to all the Nurses out there.  Below is Jill's post, check it out and leave your thoughts in the comment sections!

"I'll never forget the faces of the nurses who followed me into the bathroom after delivering each baby. That moment when I was so vulnerable, so tired, scared, shaky. My swollen belly deflating, and my modesty long gone. They treated me with such kindness and dignity. For me, these have been moments of empowerment and confirmation that I have a real village to help me, even if just for that little bit of time in a bathroom, on a toilet, while a kind nurse shows me how to put an ice pad on my mesh undies. This photo by my friend MommaKT Shoots just takes me right back. Like, I can smell the Dermaplast. Let's hear it for the nurses and the doulas and anyone else who shows us how to make ice pad underwear (or helps with that first shower post c-section!) <3"

Posts came pouring in from moms all over! Below are some of the posts that were shared.

"When I was pushing, I'll never forget pulling my face away from my nurse's chest to see her scrub top SOAKED with my sweat and tears. I was like, 'Oh my god I'm so sorry!' And she said, 'Baby, this is life all over my shirt. Nowhere else I'd rather be. Now let's get that baby out.'" —Leigh Kathleen, Facebook

Pictured: Joanie McConnell, CNM at the University of Louisville by Katie Lacer / Via mommaktshoots.com

"I will never forget the nurse that helped me get to the bathroom for the first time after I had my daughter. I was hemorrhaging and when I stood it was so humiliating...but that kind soul didn't flinch. I kept apologizing and she kept reassuring me that it was nothing. I will never forget watching her clean my legs and I just kept thinking that this is what my God means when he says love your neighbor." —Tiffany Barnes

"My husband and I lost our daughter at 23 weeks two years ago, and delivered our rainbow baby boy at the same hospital this May. All the nurses I had knew our history, and when my son was born he wasn't breathing. He was immediately taken away to the NICU and I just could not stop sobbing. My nurses cried with me. They rubbed my hair and my back and did everything they possibly could to get me mobile and up to see my sweet boy in the NICU." —Lauren Self, Facebook

Thank you Nurses!

Pictured: NICU nurse at Norton Women's & Children's Hospital discusses care measures for one of Amanda and Lauren Vinova's preemie triplets. By Katie Lacer / Via mommaktshoots.com

Being Short Staffed

This can bring professional and personal issues. When a hospital is short-staffed, you’re left with no other option but to take on more shifts, cover for your co-nurses’ absences, and miss out on important life occasions. Your social life can suffer, too.

Short staffing is one of the most common reasons why nurses experience burnout. Nursing is already a stressful job and not having enough time to relax and care for yourself can make you feel more frustrated and unsatisfied with your job.

Long Shifts

Nurses are often required to work more long hours. It can be due to the hospital being short-staffed or management cutting costs. Whichever the reason, Nurses, working longer than they're supposed to, is detrimental. It can affect the quality of care they deliver, and it can also put their health at risk.

When Nurses work extended hours, they aren't resting properly and aren't letting their bodies recover. for example, many Nurses who take extended shifts suffer from chronic back, leg and shoulder pain. Some of them even develop long-term medical conditions, like diabetes and cardiovascular issues.

By not being well-rested, you can suffer from daytime sleepiness, fatigue, and impaired mental function. It can affect your ability to make proper decisions, which can compromise your patients’ safety.

Salary

The compensations Nurses receive depend on many factors. Aside from specialty, their place of work tends to affect the salary they get, as well. Having a higher degree counts as well. Salary is a common reason why Nurses leave a hospital.

Discrimination

Nurses eating their young isn’t an entirely new thing. In fact, this has been around for ages.

Being a new Nurse is intimidating and you have to adjust to many new things. Apart from the skills you have to gain, you also have to learn how to cope with how the Nursing system in your hospital works.

Unfortunately, not all veteran Nurses are that welcoming. These attitudes tend to dull the enthusiasm of new Nurses enough to make them question themselves if they made the right career choice. You are all on the same team, strengthen your team by welcoming new Nurses and being a little more patient with them.

Job Hazards

Working in the hospital puts nurses in a lot of work hazards. Take, for example, being exposed to infected body fluids. Apart from that, lifting patients of all sizes can also put your safety at risk. Nurses also have to deal with sharps and needles and running on slippery floors during emergencies.

Nursing can be difficult and we appreciate everything they deal with. If you have anything to add please comment below!

Research has documented a number of racial disparities in health care, including higher death rates among African-Americans than whites. New government data shows some significant improvements.

The study from the Centers for Disease Control and Prevention found African Americans are living longer. The death rate for African Americans has declined about 25% over 17 years, primarily for those aged 65 years and older.

However, younger African Americans are living with or dying of many conditions typically found in white Americans at older ages.The difference shows up in African Americans in their 20s, 30s, and 40s for diseases and causes of death.

Chronic diseases and some of their risk factors may be silent or not diagnosed during these early years. Health differences are often due to economic and social conditions that are more common among African Americans than whites. For example, African American adults are more likely to report they cannot see a doctor because of cost. All Americans should have equal opportunities to pursue a healthy lifestyle.

According to the 2016 National Healthcare Quality and Disparities Report, some disparities were getting smaller from 2000 through 2014-2015, but disparities persist, especially for poor and uninsured populations in all priority areas:

• While 20% of measures show disparities getting smaller for Blacks and Hispanics, most disparities have not changed significantly for any racial and ethnic groups.
• More than half of measures show that poor and low-income households have worse care than high-income households; for middle-income households, more than 40% of measures show worse care than high-income households.
• Nearly two-thirds of measures show that uninsured people had worse care than privately insured people.

It is important to create opportunities for all Americans to pursue a healthy lifestyle. What can be done?

The Federal government is

• Collecting data to monitor and track health and conditions that may affect health, such as poverty and high school graduation rates, through Healthy People 2020. http://bit.ly/2oDhWV4
• Supporting partnerships between scientific researchers and community members to address diseases and conditions that affect some populations more than others.
• Addressing heart disease, stroke, and other cardiovascular diseases, which disproportionately affect African Americans, by implementing national initiatives such as Million Hearts®. http://bit.ly/2p0Ux0N
• Supporting actions to create healthy food environments and increase physical activity in underserved communities.

Public health professionals can

• Use proven programs to reduce disparities and barriers to create opportunities for health.
• Work with other sectors, such as faith and community organizations, education, business, transportation, and housing, to create social and economic conditions that promote health starting in childhood.
• Link more people to doctors, nurses, or community health centers to encourage regular and follow-up medical visits.
• Develop and provide trainings for healthcare professionals to understand cultural differences in how patients interact with providers and the healthcare system.

Community organizations can

• Train community health workers in underserved communities to educate and link people to free or low-cost services.
• Conduct effective health promotion programs in community, work, school, and home settings.
• Work across sectors to connect people with services that impact health, such as transportation and housing.
• Help people go see their doctor, take all medications as prescribed, and get to follow-up appointments.

Healthcare providers can

• Work with communities and healthcare professional organizations to eliminate cultural barriers to care.
• Connect patients with community resources that can help people remember to take their medicine as prescribed, get prescription refills on time, and get to follow-up visits.
• Learn about social and economic conditions that may put some patients at higher risk than others for having a health problem.
• Collaborate with primary care physicians to create a comprehensive and coordinated approach to patient care.
• Promote a trusting relationship by encouraging patients to ask questions.
  
  

ProPublica and NPR launched a project about maternal deaths and near-deaths in the U.S. In recent months, mothers who nearly died in the hours and days after giving birth have repeatedly told ProPublica and NPR that their doctors and Nurses were often slow to recognize the warning signs that their bodies weren't healing properly.

Discharge materials the hospital sends home with new mothers can be vague and confusing. The reports show the same themes through many of these survivors’ recollections. They frequently said they knew little to nothing beforehand about the complications that nearly killed them. Even when the women were convinced something was terribly amiss, doctors and Nurses were sometimes slow to believe them. Mothers especially lacked information about risks in the postpartum period.

A study by MCN: The American Journal of Maternal/Child Nursing surveyed 372 postpartum Nurses nationwide and nearly one-third of the respondents had masters or doctoral degrees. The survey found that:

• Close to half of the nurses surveyed didn’t know that maternal mortality rates have gone up in the U.S. in recent years. In fact, 19 percent of them thought maternal deaths had declined.

• Only 12 percent of the nurses surveyed knew that most maternal deaths occur in the days and weeks after delivery, and only 24 percent were able to identify heart-related problems as the leading cause of maternal death in the U.S.

• Nurses also admitted in the survey that they are uncomfortable discussing life-threatening complications with new mothers because childbirth is supposed to be a happy time and they don’t want to scare them.

Researchers found that Nurses could be quickly educated with short, targeted information. Using insights from the focus groups, an expert panel developed two standardized tools: a checklist and script that nurses could follow when instructing new mothers and a one-page handout of post-birth warning signs that mothers could refer to after they returned home, with clear-cut instructions for when to see a doctor or call 911.

An estimated 700 to 900 women die every year from pregnancy and childbirth-related causes, according to the Centers for Disease Control and Prevention. The only way to bring this number down is for everyone to be more aware of what the complications are and how to prevent them.

The PRIDE study is the first of its kind. It aims to follow the same large group of LGBTQ people over the span of the next few decades. Enrollement is open to anyone who resides within the United States, identifies as a gender or sexual minority, and is over 18, its enrollment has surpassed 6,000 since launching in May.

We still lack a comprehensive understanding of the ways that being an LGBTQ person can influence one’s overall health, or of health disparities within the LGTBQ community itself. Researchers, Juno Obedin-Maliver and Mitchell Lunn, at the University of California–San Francisco are hoping to close that gap.

“Sexual and gender minorities make up between 2 and 6 percent of the population, however sexual orientation and gender identity are rarely asked about in health studies and they’re not included in fundamental metrics like the Census,” said Juno Obedin-Maliver, one of the principal investigators with the landmark effort, which is aptly titled the Population Research in Identity and Disparities for Equality Study — more simply referred to as the PRIDE Study. “It’s critical we have visibility into the health and health care experiences of these populations so we know where to direct our efforts. Without data, we’re flying blind.”

One of the big barriers we often found trying to encourage people to teach medical students, doctors or other health care providers about LGBTQ+ people was they said, “Well, there wasn’t enough evidence about the health care needs of the community.” And we kept giving lectures and complaining that the studies weren’t being done. We knew that health disparities were there, but we didn’t know how bad, how deep, how broad the problems were, or how comprehensive, because there wasn’t inclusion often in national studies. So Mitch and I said, “We’re both researchers, we’re both clinicians. Let’s stop complaining and do something about it.”

The goal is to eventually enroll about 100,000 people and follow them over the next 30 years, collecting data through an annual questionnaire. Questions will cover a range of health and social topics, such as physical activity, sleep, mental health, quality of life, insurance status, emergency care use, access to care, income, educational attainment, and family and social connections. 

“People are excited — it feels like they’re hungry to be heard and represented,” Obedin-Maliver said. “The PRIDE Study is by and for the community. Yes, it’s academically rigorous, but it’s also a labor of love and a commitment to giving back.”

For more information or to enroll in the PRIDE Study, which is based at the University of California-San Francisco, visit https://pridestudy.org.

Nursing is one of the many professions that is changing rapidly. Lifelong learning for Nurses is essential. As a Nursing professional, it is a requirement of maintaining your license to participate in continuing education (CE). You need to stay up-to-date on patient care, healthcare trends, treatments and techniques.

According to Nurse.org, most states require Nurses to complete some form of continuing education every two to three years as a condition of licensure. Even if your state board does not require any education for continuing competence for renewal, you may still be required by your employer or Nursing association for job-specific certifications (i.e., Nursing specialties, magnet hospitals, etc.). Specialty certifications such as medical-surgical, critical care, neonatal, etc. have specific requirements for continuing education. Make sure to check with your own hospital and any associations to which you may belong to find out if you have further requirements above and beyond that of your state Nursing board.

Nursing Professional Development specialists or NPD specialists are available to advise Nurses about certification and licensing requirements, and they can also address a Nurse’s need for additional instruction. Furthermore, NPD specialists ensure that the Nurses under their supervision always demonstrate competency.

Trisha Coady, HealthStream’s Vice President of Clinical Development, discusses how lifelong learning benefits patients and outcomes. She said, "Nearly 70% of the healthcare workforce is involved in direct patient care. That’s 3.1 million of HealthStream’s 4.5 million subscribers, who complete over one million courses each week. If each of those healthcare professionals could prevent harm or death for only five people in their lifetime as a result of acquired knowledge, over 15 million lives would be saved."

Coady also advises healthcare managers to incorporate and promote a strong focus on learning. Trisha said, "Decisions made after 20 years of experience differ drastically from what we would make in our first year after college. To get there, we’ve likely pursued formal education or courseware, attended conferences, volunteered on committees, leveraged peers and mentors, etc. There will always be a need for mandatory, regulatory or focused training, but I also believe it’s just as critical to offer opportunities for self-development."

 If you have any questions about continuing education feel free to ask one of our Nurse leaders by clicking below!