DiversityNursing Blog

Depression is a common situation dealt with on a daily basis. Most patients that Nurses find themselves coming in contact with have some form of illness or injury. This makes depression among patients common. Knowing how to spot it and how to react to depressed patients can help you handle the situation properly and deal with it with minimal stress.

What is Depression

Depression is a common disorder that affects many people every day. It affects all age groups, males and females, although females are more likely to suffer from it than males. Stress contributes to depression, making this illness more common in the last few years. The amount of stress an individual handles on a daily basis is on the rise and can contribute to depression.

What Contributes to Depression

There are a number of factors that contribute to depression. Stress is a huge factor. Debt, work and family can weigh heavily on the amount of stress someone experiences today. Age also plays a major role in depression and sickness in the elderly can increase the chances of them suffering from depression. This is a main factor as to why Nurses experience depressed elderly patients the most. Some elderly patients are forced to relocate to a new residence, while others become ill and are unable to live the life they are accustomed to. Some can feel abandoned by their loved ones and find themselves feeling alone. Leaving people without a strong social support network increases the chances of developing depression.

Signs of Depression

There are many warning signs of depression, although some may not be so easy to spot. A feeling of hopelessness or helplessness can lead to depression. Nurses often see this in elderly patients who don't have a lot of family support. A loss of interest in daily activities is another sign of depression. These signs can become apparent when patients are no longer able to get around on their own. Loss of mobility can make a patient no longer want to engage in activities for fear of embarrassment.

Changes in sleep patterns or appetite are another sign of depression. Nurses have to watch this sign as well, because certain medications can interfere with sleep and appetites of patients. Frequent physical complaints or ailments, anger or rage toward others and feelings of anxiety are other signs of depression. Many of these symptoms Nurses experience in their patients frequently. The key is determining when they start happening and ruling out any other possible causes. When there are no other possible causes, depression could be the reason.

How Can Nurses Help or Prevent Depression

Nurses play a vital role in their patient's lives, no matter the age of the patient. There are certain things that Nurses can do to help prevent depression altogether. Encouraging outdoor activities, even when your patient doesn't feel like doing them, is an excellent way to combat depression. A healthy diet and a regular eating schedule helps to recognize any changes in eating patterns. New hobbies help patients realize fun activities they can engage in to be entertained, even though they may not be able to do everything they could once do.

How Nurses Play an Important Role in Depressed Patients

Nurses are the people that patients see the most throughout the day, so it only makes sense that they play an important role dealing with depressed patients. Many things Nurses do can help a depressed patient not feel so worthless, and sometimes even lift their spirits. Talking to patients about their feelings is a good first step in dealing with their depression. Being sympathetic helps them know that you understand their feelings rather than judge them for how they feel.

Be careful about any advice you offer and always refer them to their doctor for specific medical advice. Accept their feelings toward the rest of the world. Trying to reason with them may make it seem like you are just another person who is against them or doesn't care about them. Reassure them of depression treatments and how effective they are. Let them know that treatment has high success rates, and they can work with their doctor to find the best treatment options.

It is common for Nurses to deal with depressed patients on a regular basis. Despite this, it is still important to remember to treat them as if they are all individual cases, and never group them together. A little reassurance could make all the difference in a depressed patient's outlook. The caring compassionate attitude that Nurses are known for could be exactly what a depressed patient needs.

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Social media can and is a wonderful and easy way to connect with people on a personal or professional basis. Most platforms are free and easy to use. It's not difficult to find people and topics of interest. People can find and connect with their peers, family, and friends. They have unlimited access to the entire world.

Before anyone begins (or continues) their adventures into the world of social media, there are a few points to be aware of as a healthcare professional. With freedom comes advantages and disadvantages.

Advantages:

• Connecting with anyone in the world. Simply Googling a word, topic, business, or an individual will give anyone complete access to anything they want to know. Whether they are blogging, using Twitter, Facebook, LinkedIn, or any other social media platform, there are people there to talk to.
• Networking has never been easier. Sharing information and learning is at anyone's fingertips. Whether they are talking to someone local or across the world, social media brings you together. Distance is no longer a problem.
• Since 80% of all internet users are looking for health information, anyone can and will reach a large audience with their outreach and posts. People want information and Nurses have plenty to give them. They are able to correspond at their convenience and have the time to do so.
• Education for Nurses and others is available. There are numerous groups and programs that offer classes and give them opportunities to learn and interact with their peers and other students.

Communication flows easily and in abundance on the internet and that's also where the disadvantages come into play.

Disadvantages:

• Privacy doesn't truly exist on the internet. Regardless of any and all security features, once something has been posted, it's there forever. Even deleting it doesn't get rid of it. It is still stored somewhere in the clouds and is never truly gone. It's crucial that a person think twice before posting. Screen shots cause the comment or post to remain forever on someone's computer.
• The risk of inaccurate information becoming a "fact" is common. It takes a bit of work and due diligence to research the accuracy of what you’re reading, but it's worth the time. A person should only share or repeat what they themselves have thoroughly researched and confirmed as accurate.
• Not HIPAA compliant. Very few software programs meet the strict guidelines for HIPAA regulations, including but not limited to Skype and Google Hangouts, texting and email. Unless the individual is discussing a patient as a Nurse and on a secure platform, one should never post anything about their patients.

Violating HIPAA regulations has resulted in healthcare professionals facing disciplinary actions such as:

•  Fines levied
•  Suspension from work
•  Being expelled from Nursing school
•  License revoked/fired
•  Criminal charges being brought
•  Incarceration

Abuses on social media as a Nurse are far reaching. Whether a Nurse violates HIPAA or behaves in an improper and unprofessional manner (arguing online, breaching patient confidentiality, harassment, etc.) can and does impact not only them, but their employer and their professional affiliations as well. This can also involve the state board and violate state laws.

Posting the pictures of patients, even when their identity is concealed, has resulted in the above actions being taken against a Nurse and other healthcare professionals.

The best rule of thumb with social media is this: Remember that what you are about to post will be accessible to 7 billion people, so post as if everyone will read it. Social media can be fun as long as you understand the good and the bad.

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As a nurse, how do you use Social Media?

The new year is here and the opportunities for a fresh start it brings shouldn't be cast aside. Nurturing the opportunity as if it were a patient can yield surprising benefits both in and out of the job title. There is always room for improvement in a position that demands the hardest work for the sweetest reward, the gratitude of well-cared for patients.

Mind and Body

It is never too late to get personal health on the right track. Though the push for a healthier lifestyle should come from within, the simple fact is much like fitness instructors or your fellow doctors, patients ultimately expect those in health care roles to be healthy themselves. So whether it involves starting (and sticking to) that new gym membership or curbing poor eating habits, do your best to stand firm.

As a Nurse, the mind is just as important to nurture as the human body. With the continuous implementation of newer technology into the healthcare field, it can never hurt to be one step ahead by taking classes, particularly given the fact they look great on a resume. Focus on adding in new certifications such as those for operative nursing or ACLS, or expanding current skills. Regardless of qualms, continuing your education or taking the plunge on the journey to a BSN, MSN, NP or PhD is a worthy cause for the new year.

Tools of the Trade

Clearly technology is only as effective as the individual operating it, but that doesn't mean Nursing staff don't benefit from productive upgrades in the work space. Many programs and devices can increase efficiency enough to make good Nursing care, great Nursing care. Even if the requests for technology and program upgrades were rebuffed, all is not lost. Focus on using what is available even if it is only yourself. Vow to be more patient focused and less task and goal focused, which is the line that separates the average from the amazing in the eyes of the patient. Spend the new year becoming a better you, as this will ultimately equal a happier and better Nurse.

Related Story:  Nurses' perseverance to be rewarded New Year's Day

Cultural Diversity

The emergence of cultural diversity in today's society has impacted the inner-framework of the healthcare sector. By the year 2043, studies predict that the current ethnic and racial minority group populations will become the new majority. Diversity, Inclusion and Cultural Competence are topics that carry weight and emphasis in many aspects of the healthcare system. Efforts made to exercise inclusion and integrate cultural knowledge into professional environments have become integral in providing quality service to clientele. The practice of cultural awareness and competence in healthcare organizations leads to an encompassing sense of community and corporate respect of all cultures.

Benefiting Organizations

When there is a marked emphasis on cultural competence, diversity, and inclusion in an organization, a myriad of internal and external benefits result. Below is a list of benefits that organizations have experienced after putting pointed emphasis on supporting diversity. 

• An increase in recruitment of culturally diverse employees
• Better group process (an increase in creativity/communication)
• Reduction in costs
• Wide-spanning marketing

Employing Cultural Advocates

Caucasians fill the majority of Nursing roles in the healthcare system, with minority groups making up only about 19 percent of the Nursing field. As the number of culturally diverse patients increase in the United States, the need for a diverse culture of healthcare workers grows with it. Organizations that rally their employees and their core values around cultural awareness garner support from other organizations and appeal to diverse potential employees. They are showing the community, through practical application, how support of diversity plays an important role in the quality of care that is given and received by employees and clients.

If policies of inclusion are implemented effectively in healthcare, employees become a creative force in improving communication and conflict-resolution. Because the emphasis in inclusion is cohesion, the medical staff is taught the value of going beyond the confines of their own understanding. They gather information from other staff or diverse sources to supplement what they know with other perspectives and values. Nursing staff that exhibit characteristics of inclusion exude flexibility and model cultural competency. They become powerful advocates for respect of diversity in patient-care.

Cultural Competence

Healthcare leaders that emulate cultural competency focus on one key ingredient, respect. If leaders in healthcare teach by example and pass initiatives to support cultural integration, everyone benefits. By providing ample opportunities for cultural understanding to permeate healthcare, healthcare officials communicate respect for diverse groups of people.

We’ve developed a questionnaire to assist you in evaluating how your healthcare system is doing with regard to Diversity, Inclusion and Cultural Competence. Please take a few minutes to assess your strengths and weaknesses.

Many times, Nurses will choose to pursue a career in healthcare so that they will have the chance to spend their days helping others.  There is an added bonus though.  Many of the Nursing Specialties have a career trajectory of solid growth with a Nursing salary that is well above the income level of the median population.

Which one of the Nursing Specialties will give you the most job security though?  Which one has the highest salary?  The specialties listed below have been in demand the most and have the highest nursing salaries.

CRNA (Certified Registered Nurse Anesthetist)

Nursing Salary: $110,000 with 1,975 job postings annually.  This Nursing Specialty is the main provider for anesthesia in hospitals that have rural locations.  These Nurses assist in administering over 34 million anesthetics to various patients every year in the USA.

Pain Management Nurse

The average salary for this type of Nurse is right at $93,000 annually.  Each year there are around 871 job openings for Pain Management Nurses.  These Specialty Nurses work in tandem with other Nurses and doctors in order to treat patients who suffer from both chronic and acute pain.  They also have the responsibility of educating their patients so they can handle pain management in the future.

Geriatrics Nurse/Gerontology Nurse

The mean Nursing salary for a Geriatrics Nurse is $91,000 and annually there are close to 400 job openings across the US per year.  These Nurses can be the primary provider of health care for elderly patients in a variety of settings.  Their duties include exams and diagnosis to actually prescribing medications.  As the Baby Boomers age, this is an area where there is expected to be growth.

Family Nurse Practitioner

The mean salary for this Specialty Nurse is $88,000 annually and there are more than 7,000 job postings per year for this specialty.  These Nurses are like your family doctor.  They work with the same patients throughout their entire lives.  Many times, they will be the only health care professional for patients.  They conduct exams and can prescribe medications.

Psychiatric Nurse Practitioner

The salary for this type of Nurse is $86,000 annually and each year more than 4,500 job openings for this niche are posted.  This type of Nurse will treat, counsel and even medicate their patients who suffer from mental health issues.  They can work in quite a few different settings from private practices to correctional facilities and mental health clinics.

General Nurse Practitioner

The mean salary for a general Nurse Practitioner is $81,000 and there are more than 85,500 job postings for this specialty each year.  These Nurses are a critical element in regard to the health care industry and they are expected to fill the gap of primary care physicians in the years to come.  They are able to prescribe medicines and many times, they are the only health care professional that some people have.

Clinical Nurse Specialist

The Nursing salary for this specialty is $80,000 and each year there are nearly 7,000 job postings.  This type of Nurse focuses on a single area of expertise and they act as a sort of consultant to all of the rest of the Nurses on staff.  Their specialties can be anything from oncology to pediatrics and they also serve as coaches for both the staff and the patients.

Armed with this information, which one appeals to you?  If you are already on this list, would you switch to another specialty?  Which one and why?

Top 10 highest paying nursing specialties (national average)

More accurate due dates are something both mother and medical professionals want. But is it something possible to achieve? Ultrasound scans are helpful but they can only give an estimate date. 

Predicting when a woman is likely to give birth is an inexact science. It is also a question with important medical and personal implications. A meta-analysis published this week in BJOG: An International Journal of Obstetrics and Gynaecologysheds some welcome light on the subject.

Predicting exactly when a woman is likely to go into labor has always been challenging; only 5% of women go into labor on their exact due date. 

For about 90% of women who are overdue (a pregnancy lasting over 42 weeks), contractions begin on their own within 2 weeks of the due date. But the exact date within those 2 weeks is frustratingly difficult to predict.

Of course, most women do not know the exact date the baby was conceived, and as such, any due date given can only be an estimate. 

Currently, the best methods for predicting the date of a child's birth are either by using the last menstrual period as a starting point, or by measuring the fetus size with an ultrasound scan. Neither of these methods are without some measure of inaccuracy.

An analysis carried out by Dr. Vincenzo Berghella, at Thomas Jefferson University Hospital and the Sidney Kimmel Medical College at Thomas Jefferson University, hopes to paint a slightly more accurate picture.

There are a number of reasons why people desire a more accurate prediction for their due date. As Berghella explains:

"Women always ask for a better sense of their delivery date in order to help them prepare for work leave, or to make contingency plans for sibling-care during labor. These are plans which help reduce a woman's anxiety about the onset of labor."

On top of these more logistical issues, there are very real health concerns, too:

"Women with a higher risk of stillbirth may be better off receiving a labor induction if the cervix is still long at her due date, since the chances of timely spontaneous birth are low, for example."

Cervix measurement of more or less than 30 mm is key

Currently, cervical length is measured in women who are considered at risk of a premature birth. The shorter the cervix, the more imminent the birth will be. This method of transvaginal ultrasound is considered a gold standard for predicting early births. 

During pregnancy, the cervix hardens in order to keep the fetus from dropping into the birth canal. As the due date draws near, the cervix softens. This softening causes the cone shape of the cervix to shorten and flatten, which can be used as a signal that the birth is imminent.

This precision has led a number of researchers to investigate a link between cervical length and birth at term - the hope being that if it can predict an early birth, it might have the same use for longer pregnancies.

These studies matching cervical length after 40 weeks of pregnancy, to date, have been inconclusive and sparked lively debate in the field.

Berghella has reopened this line of investigation and scooped together data from five different studies; the data included 735 women with single-child pregnancies who had babies in the standard head-down position.

This increase in data has given the research team a new and improved overview of the field of study and garnered some interesting results:

The researchers found that when the cervix measured more than 30 mm at a woman's due date, she had less than a 50% chance of delivering within 7 days. However, when the cervix measures 10 mm or less, women had more than an 85% chance of delivering within 7 days.

The results of the study give a glimmer of hope to mothers who are facing an uncertain stretch of time before they give birth. Further study in the area and its consequent analysis will help solidify these findings.

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Nurses have heard it before, "Can you not talk about gross stuff at the dinner table?" But Nurses can't help it when the most disgusting things are completely normal in their everyday lives. They become desensitized to topics like body fluids, infections, and smells and sounds.

Being a nurse involves seeing, hearing, smelling, touching and dealing with some of life’s not-so-pleasant things. Nurses face it all from the most gross to the most stunning situations that would make the normal person squirm or run. They build up an immunity to it, but it’s still something that can make them very weary. Yet, they never stop a beat of helping the patients that they have been trained to see through it all.

“We see it all,” says Barb Gallogly. She is senior lecturer and coordinator for Post Baccalaureate Nursing Program at Henry Predolin School of Nursing at Edgewood College, Madison, Wis.

“We are the eyes of the physician, and the ears of the respiratory therapist. We are in a position of privilege to be with the patients on a minute-to-minute basis. People trust us, and people open up to us,” she says.

And those patients trust them not to run away when things go from bad to worse or when they need them the most.

Things that nurses face that make them unique, strong and oftentimes – saints

Body Fluids: It’s not pretty. “But sometimes some of us still gag at vomit and other things that come out of bodies,” says Kristin Gundt, chief nursing officer at Community Hospital in Grand Junction, Colo. “It all depends on how much you are exposed to it, but that doesn’t mean you have to like it. We all have triggers that makes our own bodies react to it.”

Gallogly agrees that there are still things that make her gag. “But you have to rise above it, and work with it, and not to let your own personal feelings or reactions get in the way of good patient care,” she says. “A nurse must remain respectful of the patient and be calm when all hell breaks loose.”

Infections: In Gallogly’s office hangs a lithograph with a person who has germs all around and the words, “Please Wash Your Hands” stamped on it.

“I’m a germaphobe. As a new nursing grad, we didn’t wear gloves or masks back then. We never thought anything about it,” she says. “But now, there is anti-bacterial gel at every entrance – gel in and gel out. That’s hammered into our students now.”

She sees a lot of infected wounds, and a lot of people put into isolation because of infections. “Universal precautions don’t cut it anymore,” she says.

Smells and Sounds: Sometimes when someone else is vomiting, the sound itself can set nurses off with their own gagging reflex. “Or sometimes you hear someone with diarrhea and the gas with it, and it can set something off in you, too,” Gundt says. “But we try to hide our reaction for the patient’s sake.”

She adds that one of the hardest smells to stomach is when a patient is bleeding from their intestines or stomach. “You might have to excuse yourself if you are going to gag or throw up. You don’t want to make the patient feel like even the nurses can’t tolerate it,” she says. “But it smells so bad.”

Death: “We don’t know what death will be like from one person to the next. It can be smooth to really traumatic to really messy. It can be awful,” says Gundt.

One time comes to mind for her when she was a home health care nurse. The elderly lady had a relative come during the last stages of her death. The relative was panicking because she didn’t understand death and all the things that happen when the body shuts down.

“People are incontinent. They can’t hold their bowels. Nothing in them is awake anymore,” she says. “So, I kept her clean, changed her and turned her, and made sure she got pain meds. I stayed with her and the relative. It’s the people that are alive that are panicking. People are scared to be alone with the person who is dying.”

Chaos: “Most people’s jobs aren’t like this,” Gallogly says. “You learn really quickly to become a great multi-tasker and set priorities all the time. You usually have three or four things coming at you. You learn to delegate to others that can help you.”

Some days, it will be overwhelming. You leave work thinking that you didn’t do a good job. “With budget cuts, nurses are expected to do a lot more with less. It’s hard to give quality nursing care, and we want to take care of that whole person, but so much is coming at us. That’s frustrating,” she says.

Dynamics of Families: “We don’t just take care of the person, but the whole person which includes the family,” Gallogly states. “If the family is demonstrating behavior that are precluding progress or treatment for the patient, then we pull them aside. You never know what is going on with them. We don’t know their histories. There is usually a reason for their behavior.”

She says it’s easy to label people as the “crazy daughter” or “hysterical mother.” But that doesn’t solve any problems or help anyone. “We try to explore those dynamics and include them in what we are doing with the patient,” she adds.

Ill Treatment: When people are sick, their behaviors aren’t necessarily their norm. “They lash out at us, hit us, spit on us and swear at us. There is a lot of physical and emotional abuse,” says Gundt. “Sometimes, it’s very unexpected. You never think some of these people will strike out at you because they seem stable as can be.”

Gundt adds that nurses try very hard to not put themselves in a situation to be hit or hurt. “If it’s a family member that we feel is being obnoxious, abusive or unrealistic, we won’t hesitate to escort them out or get someone to do so,” she says. “But we will start with way less restrictive methods. We try to keep people on our good side.”

Nursing isn’t all roses and sunshine. But most people understand that when they go into the profession. It’s not easy. It’s not always pretty. But for those who choose it, they say they do it because they want to help people. They want to educate people to live healthier, happier lives no matter what squeamish  circumstances they have to confront.

If you feel like talking about all that gross stuff with people who completely understand, click below!

According to projections from the Bureau of Labor Statistics by 2022 there will be an increase in the number of Registered Nurses of 526,800. That is over half a million! This means lots of nursing jobs for the near future– definitely a career with good prospects. If you are curious about RN salaries this infographic will be helpful.

It is clear that digital technology has a firm grasp on our lives and is advancing daily. We walk around with a computer in our pocket (cellphones) full of endless amounts of information. This technology has changed the way we provide healthcare and with this change there are pros and cons. Specifically, Electronic Health Records (EHRs) or Electronic Medical Records (EMRs). 

An Electronic Health Record according to CMS.gov, is an electronic version of a patient's medical history. It is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that person's care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates access to information and has the potential to streamline the clinician's workflow. The EHR also has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting.

Pros

EHRs will save you space and paper. Administrative duties in health systems represent a significant amount of time and costs. Staff can spend a good portion of the workday filling out and processing forms. Because they are paperless, EHRs streamline a number of routine tasks. With less paperwork taking up space there will be less clutter and more room to be efficient.

Patient’s medical files will all be consistent. The medical staff can interact easily with affiliated hospitals, clinics, labs and pharmacies about the patient’s medical history. All of the patient’s files are updated when something is entered or changed in the system. This way the patient’s information is always up to date, leaving less room for errors or miscommunication.

Easy access to all clinical data. Staff can quickly transfer patient data to other departments or providers, while also reducing errors, which yield improved results management. Patients and employees often respond positively to this because it helps keep a health system’s schedule on track.

Cons

Privacy is a major concern when it comes to electronic health records. Using EHR software could put your organization at risk if you don’t follow privacy settings correctly. Paper records also make it easy to violate a patient’s privacy but, electronic records are convenient and timely which makes it easier to violate the patient’s privacy. A common privacy concern is identity theft.

Another disadvantage is data loss. A computer crash could wipe out vital data that you’ve been accumulating over the years. Always have a backup plan. This is imperative.  Many systems backup their data through a cloud program. So if there is an unfortunate event and your system crashes, you will still be able to access the data from the cloud.”

There are high costs involved with implementing an EHR to your system and many smaller health systems might not be able to afford it. The American Action Forum says, “Implementing an EMR system could cost a single physician approximately $163,765. As of May 2015, the Centers for Medicare and Medicaid Services (CMS) had paid more than $30 billion in financial incentives to more than 468,000 Medicare and Medicaid providers for implementing EMR systems. With a majority of Americans now having at least one if not multiple EMRs generated on their behalf, data breaches and security threats are becoming more common and are estimated by the American Action Forum (AAF) to have cost the healthcare industry as much as $50.6 billion since 2009.”

Do you work in a health system that uses Electronic Health Records? If so, how do you feel about them? We want your honest opinion, the good, the bad and the ugly.

It's officially Autumn season and we are sadly saying goodbye to our Summer sandals and pulling out clothes to keep us warm. If you're going to miss Summer like us, hopefully taking a look back at our hottest blogs of the season will help ease the pain. 

1. 14yr old African American Develop A New Surgical Technique To Sew Up Hysterectomy Patients

This incredible young man, Tony Hansberry II, is a 14-year-old student who used an endo stitch in a way no one has ever done before and the results are a game changer.

2. Study Confirms What We Knew All Along: Nurses Are Key to Hospital Success

We all know and love Nurses, but isn’t it wonderful when a research study validates something you already know? We think you’ll enjoy this article.

 3. 5 Things Labor Nurses Want You To Know

 
"As a labor and delivery nurse, here is what I wish I could say to every mother out there, what I'm sure many of us would want to say to the families we care for..."

4. Nurse Practitioners More In Demand Than Most Physicians

 It comes as no surprise that primary care doctors are, and have always been, highest in demand. However, recent data shows that this paradigm is shifting.

5. Empty Pill Bottles Desperately Needed (Take your meds & help others!)

In other parts of the world patients are handed their pills and must use whatever they have to keep the medication safe. In three easy steps you can make a difference for those patients.