DiversityNursing Blog

By Jeroen Tas

Imagine a time when a device alerts you to the onset of a disease in your body long before it’s a problem. Or when your disease is diagnosed in Shanghai, based on the medical scan you did in Kenya. This future is far closer that you might think due to rapid advances in connected devices and sensors, big data and the integration of health services. Combined, these innovations are introducing a new era in healthcare and personal well-being.

In only a few years, mobile technologies have spawned tremendous innovation of consumer-level health tools. The emerging solutions are focusing on health conditions over a person’s lifetime and on holistic care. They generate constant insights through analytics and algorithms that identify patterns and behaviours. Social technologies enable better collaboration and interconnected digital propositions that reach out to communities of people with similar conditions, engaging them in ways which were never before possible.

We are starting to get a taste of what the consumerization of healthcare will mean in the future. In two to three years, analysing your personal health data will become commonplace for large parts of the population in many countries. Also, it is very likely that for the first time it will not be the chronically ill but the healthy people who will invest the most in managing their health.

Digitization and consumerization will rattle the healthcare industry. It is already tearing at the very fabric of the traditional healthcare companies and providers. Innovation is not only about just adding a new channel or connecting a product. It is also a complete redesign of business models, adjustment of systems and processes and, most importantly, it calls for changing the culture in companies to reflect the new opportunities – and challenges – presented by the digital world.

To drive true industry transformation, companies need to collaborate and continue to learn from each other. Great strides will be made in alliances, which, for example, will deliver open, cloud-based healthcare platforms that combine customer engagement with leading medical technology, and clinical applications and informatics.

The game will not only be played by the traditional healthcare providers. With consumerization, even companies without healthcare expertise, but with strong consumer engagement and trust, could potentially become healthcare companies. Big multinationals invest incremental budgets in developing new propositions and count on their global user bases or professional networks to gain a foothold in the market.

And in parallel, a raft of start-ups are attempting to transform the worlds of preventive or curative healthcare – in many cases, limited only by their imaginations. For example, we may see virtual reality technology moving from gaming industry to healthcare for improving patients’ rehabilitation after a stroke. Or we may see facial recognition software become common in monitoring and guiding patients’ daily medical routines.

While these new propositions tackle a number of healthcare industry’s core concerns and provide solutions to completely new areas, these propositions still need to mature. They need to become scalable, reliable, open, and the user experience needs to be harmonized.

But perhaps one of the most important challenges is related to people’s behaviour and preferences. Regardless of whether these new and existing companies are analysing health data, using virtual reality or reading people’s vital signs, they all need ample time to become trusted and accepted in the emerging digital health care space. Especially for the new entrants, obtaining the right level of credibility will be one of the key success factors.

Consumers, patients and professionals alike, will need the right motivation, reassurance and mindsets to adopt these new solutions. The companies that know how to offer us tailored, cutting-edge solutions, combined with meaningful advice and trustworthiness, will be the winners and become our trusted advisers in health.

Source: World Economic Forum

Fastaff

Making the transition to working nights may feel a bit intimidating, but many night nurses, myself included, have grown to love the position! It tends to be quieter and less chaotic because the patients are generally asleep, and there's a special camaraderie that develops between a team of night nurses. Put these tips into practice to survive, and even thrive, in your night shifts.

Stack several night shifts in a row: Rather than spacing out your night shifts during the week and having to switch between being up during the day and up during the night, try to put all your night shifts for the week in a row. That way, you can really get yourself onto a schedule of being awake during the nights you work and sleeping during the days in between.

Nap before work: As you transition from being awake during the day to being awake as you work at night, take a nap in the afternoon to help you go into your first night shift as rested as possible. Alternately, if your schedule allows, stay up later than usual the night before your first night shift and sleep in as late as you can the next morning.

Fuel up with healthy foods: While sugars may seem like they provide energy, they also come with a crash. Before heading into work, eat a filling meal with a healthy balance of carbohydrates, protein, and fiber. Then bring healthy snacks for the night that include protein and fiber to keep you going strong. Some options include yogurt, mixed nuts, hard boiled eggs, cheese cubes, or carrots with hummus dip

Plan caffeine carefully: It can be tempting to drink a cup of coffee anytime you feel sleepy, but you may develop an unhealthy dependence or be unable to fall asleep when you get home after your shift. Therefore, try to limit yourself to just one or two cups of coffee per shift, and drink your last one at least six hours before you plan to go to sleep.

Create a restful sleeping environment at home: The key to surviving night shifts in the long term is getting lots of restful sleep after each shift. Set up room darkening curtains and a white noise machine to help you block out signs of the day. When you get home, don't force yourself to go to bed right away. Instead, develop a routine that includes some time to bathe, read, and relax as your body winds down after work. Try to avoid bright screens, which block your body from releasing melatonin, the hormone that makes you feel sleepy.

With some attention to detail, you will probably find yourself really enjoying working at night. Many of the night nurses I know started out stuck on the shifts, but grew to prefer them. Plus, the pay differential doesn't hurt at all!

Source: http://www.fastaff.com

By GILLIAN MOHNEY

One California teacher is happy to simply be back in the classroom as the new school year kicks off.

After being diagnosed with breast cancer last year, Carol Clark was forced to stay out of the classroom for nearly the entire year due to treatments and complications.

Eventually she was gone for so long, her health insurance and salary were threatened. But Clark's benefits were saved after multiple colleagues donated their sick days to the 6th grade teacher.

Clark, 56, a teacher at Jaime Escalante Elementary School in Cudahy, California, ended up receiving an additional 154 sick days from co-workers or other teachers as part of a program run by the Los Angeles Unified School District to help teachers in Clark’s situation, according to ABC News station KABC-TV in Los Angeles.

Before the donation Clark had been struggling to keep her salary and benefits. For many teachers in the Los Angeles area, once they use up their sick days and their vacation days they can start losing both their salary and health benefits.

Last year Clark missed nearly all of the school year except for just two months. Clark originally thought she would be able to come back for the spring semester, but she ended up needing major surgery after complications arose.

“I finished chemotherapy. Within a week I developed complications,” said Clark. “I couldn’t come back to school at all.”

To cover her time off, Clark used her vacation days and another 120 sick days that she had accrued over 16 years of teaching. But it wasn’t enough.

At the end of last year, she had no more sick days and was still too sick to teach. Clark had one other option. Her husband, also a teacher at Jaime Escalante Elementary School, was able to rally co-workers and other teachers to donate their sick days as part of the “Catastrophic Illness Donation Program.”

"We get paid for 180 days in the school year. So she got 154, so almost a whole year," Dave Clark told KABC-TV.

Gayle Pollard-Terry, deputy director of communications for the Los Angeles Unified School District, told ABC News that the program helps around 20 to 25 teachers every year.

“When you run out of all of your sick paid leave…if you run out, you [can] lose your health benefits and your income,” she said.

Pollard-Terry said the program can help fill the gap for sick teachers or school district employees.

She said although most donations are not as extreme as Clark’s tally, there have been at least two other donation drives where more than 150 days were raised for a teacher.

For Carol Clark the outpouring of donations from co-workers both past and present was surprising and emotional. She now has extra days to help her through new surgeries scheduled for this year.

“Other people ask me ‘What do you say to people who donate?’” said Clark. “I don’t know what to say to them. I say thank you. But that doesn’t’ seem like enough. It was really a tremendous thing that they did.”

Clark said she tried to thank her co-workers in a staff meeting but was too “chocked up” to speak. Instead she ended up writing them an email to thank them.

Source: http://abcnews.go.com

By ERIC WHITNEY

When a fire department gets a call for medical help, most of them scramble both an ambulance and a fully staffed fire truck. But that's way more than most people need, according to Rick Lewis, chief of emergency medical services at South Metro Fire Rescue Authority in the Denver suburbs.

"It's not the prairie and the Old West anymore, where you have to be missing a limb to go to the hospital," Lewis says, "Now it's a sore throat or one day of cold or flu season sometimes, and that can be frustrating for people, I know it is."

South Metro receives more than 12,000 emergency medical calls a year, and takes about 7,000 patients to area hospitals. Somebody who's been running a fever for a couple of days may need help — just not necessarily a ride to the ER. That disconnect can be frustrating for both ambulance crews and patients.

Crews aren't required to transport everyone who calls, but Lewis says they fear lawsuits if they were to leave and a patient got worse. Also, ambulance companies typically don't get paid unless they take somebody to the hospital. So Lewis teamed up with Mark Prather, an emergency room doctor, to try and come up with a better way.

"We created a mobile care unit that can go to a given patient, if we think they're safe to treat on scene, and provide definitive on-scene treatment," says Prather.

The mobile care unit is, basically, a station wagon. Advance practice paramedic Eric Bleeker shows off some of the gear. "This one is a suture set, so it has everything for wound closure, from staples to regular sutures," he says.

Ambulances don't have that kind of equipment, so even someone who just needs a few stitches gets a ride to the emergency department.

Several cities across the country are using paramedics as physician extenders, sending ambulance crews to do routine things like hospital follow-up visits in places where basic health care is hard to get. South Metro's model focuses on responding to calls. The team always includes at least one nurse practitioner, who can prescribe basic medicines that they stock in the mobile unit.

"A lot of what we do is sort of that mid-level between the acute care you receive in an emergency department and what the paramedics can currently do," says Bleeker.

It's kind of like an urgent care clinic on wheels.

There's also a miniature medical lab. "We can run full blood chemistry, we can do complete blood counts, we can check for strep throat, we can check for influenza," he says. Those are capabilities that even many doctors' offices don't have on site.

South Metro Fire also relies heavily on Colorado's new electronic medical records network. The nurse or EMT can call up patient records on the scene to provide care that's more like an office visit, and dispatchers can check recent medical histories to make sure they send ambulances to people who might really need one.

That person who called 911 because they were running a fever could end up being diagnosed and treated in their living room by South Metro's station wagon for about $500, instead of spending a lot more for similar care at an emergency room.

Insurance companies don't yet pay for this, though, says Prather.

"That's maybe why nobody has done it yet," he says, laughing.

For the last nine months South Metro has been running the service basically for free, to prove that it saves money. But Prather thinks that's about to change because of Obamacare. The law aims to get insurance companies, Medicare and Medicaid to stop paying for too much medical care. And it can penalize health care providers who contribute to overuse of emergency rooms.

"It allowed us to think about payment differently, and basically switch from a volume situation to a quality situation," he says.

But it's not like the law just flips a switch and starts paying for appropriate care instead of rewarding providers who see a high number of patients and do lots of procedures. The change to reward efficient, appropriate health care is just starting to happen. Slowly. But Prather is now in talks with insurers and hopes to be getting paid soon.

Source: http://www.npr.org

By Susan Donaldson James

Raymond and Mazie Huggins, a devoted West Virginia couple with the same failing heart condition, didn’t think they would make it to their upcoming 74th wedding anniversary on Oct. 10.

But in August, Raymond or “Huggie Bear,” 96, and Mazie Leota, 93, received newly FDA-approved heart valves in a life-saving procedure on the same day.

“We went to the supper table one night and Raymond said, ‘If you have it done, then I will have it done and that’s how we will do it — together,'” Mazie said. “We went in together, had it done together and came home together.”

The couple went to the Cleveland Clinic for transcatheter aortic valve replacement or TAVR, a procedure designed for those who typically can’t withstand the risk of open-heart surgery. A catheter is wound through an artery in the groin and into the heart muscle.

This non-invasive surgery has been used on patients for some time, but the smaller valve required for the Huggins’ surgery was just approved in June after successful clinical trials.

“I’m very glad we had it and I am feeling fine,” said Mazie, a great-grandmother and former dental secretary. “I can’t get over there not being any pain afterwards.”

Now, the couple, both “with it” intellectually and otherwise healthy, can celebrate their long marriage at home in Moundsville, where they continue to live independently. They have every reason to expect to live an even longer life: Mazie’s maternal grandmother lived to be 108. 

“My father’s goal was to live long enough to get on the Smuckers jar,” said their son, Roger Huggins, 67. “Last year, even with his heart problems, he made apple butter and applesauce out of the tree in the backyard.”

Roger said his father, a former glass factory shipper and retired prison guard, is “very strong and a tremendously hard worker.” He calls his mother an “angelic” woman who worries about others and is beloved by all who know her.

“My mother protects my father to the fullest,” said Roger. “He might make her madder than the dickens, but she protects him to the fullest.”

Two years ago, his parents had stents put in their hearts on the same day.

“I was in pre-op with them,” said Roger, a retired food company sales rep. “Their tables passed in the hallways and they were awake enough to make [the medical staff] stop their beds. They held hands and kissed each other and had the whole hospital crying.”

Roger, who drives three hours each way from his home in Erie, Pennsylvania, to check in on his parents and organize their medications, persuaded them to have the TAVR procedure after doing his own research.

Raymond insisted his wife go first, then his surgery followed.

“They both were prepared to pass away on the table,” said their son. “But it very well could have been much worse if my mother had woken up and my dad had died beside her. Or harder if my father had woken up.”

“The first thing my father said when he came out of the anesthesia was, ‘Am I alive?’” said Roger. “The second thing he said was, ‘Is my wife alive?’ The third thing he said is, ‘I’ve got to go out and fix the yard.’ He’s a workaholic.”

The Hugginses may not be the oldest patients ever to undergo TAVR surgery (some patients have been 98 and 100), but they were the first couple, according to their surgeon, interventional cardiologist Dr. Samir Kapadia.

“The data suggest that 50 to 60 percent would not make it until the end of the year with their condition,” he said. “They were declining fairly fast. … When they came to us they were very short of breath and had medical problems that were unbelievably complex.”

The aortic valve is the “door” to the heart, according to Kapadia. A normal opening is about 2.5 cm. But theirs were closed down to .3 and .4 — “about 10 times less.”

“Five or 10 years ago, nothing could have been done for them,” he said. “We would have had to stop the heart and open up the chest, and at that age the recovery would be up to two months, with significant risk,” he said.

Mazie was prepped for surgery first at 5:30 a.m. and Raymond followed at 9:30 a.m.

“The kissed each other and were in recovery opposite each other and wanted to be together holding hands in the same room,” said Kapadia.

By the evening after surgery, they were out of bed, and the next day, they were walking. Mazie’s release was delayed because of fluid in her lungs, so Raymond insisted on staying at the hospital with her for several more days.

The couple is now back at home with a part-time caregiver, looking forward to their anniversary next month.

Mazie attributes their 74-year happy marriage to good communication.

“There have been a few ups and downs,” she said. “If you don’t agree, get it out and say it and get it over with.”

Kapadia said the family’s closeness was an important factor in the surgery’s success.

“They are wonderful people,” he said. “Their son fought for them to be treated together as the only best option. Who would take care of the other one? It would have been a disaster for their family life.”

“But more than anything else, they wanted to live and celebrate and enjoy the last part of their life together.”

Source: http://www.today.com

By Michael Martinez

A respiratory virus is sending hundreds of children to hospitals in Missouri and possibly throughout the Midwest and beyond, officials say.

The unusually high number of hospitalizations reported now could be "just the tip of the iceberg in terms of severe cases," said Mark Pallansch, a virologist and director of the Centers for Disease Control and Prevention's Division of Viral Diseases.

"We're in the middle of looking into this," he told CNN on Sunday. "We don't have all the answers yet."

Ten states have contacted the CDC for assistance in investigating clusters of enterovirus: Colorado, North Carolina, Georgia, Ohio, Iowa, Illinois, Missouri, Kansas, Oklahoma and Kentucky.

What is Enterovirus EV-D68?

Enteroviruses, which bring on symptoms like a very intense cold, aren't unusual. They're actually common. When you have a bad summer cold, often what you have is an enterovirus, he said. The season often hits its peak in September.

The unusual situation now is that there have been so many hospitalizations.

The virus has sent more than 30 children a day to a Kansas City, Missouri, hospital, where about 15% of the youngsters were placed in intensive care, officials said.

In a sign of a possible regional outbreak, Colorado, Illinois and Ohio are reporting cases with similar symptoms and are awaiting testing results, according to officials and CNN affiliates in those states.

In Kansas City, about 475 children were recently treated at Children's Mercy Hospital, and at least 60 of them received intensive hospitalization, spokesman Jake Jacobson said.

"It's worse in terms of scope of critically ill children who require intensive care. I would call it unprecedented. I've practiced for 30 years in pediatrics, and I've never seen anything quite like this," said Dr. Mary Anne Jackson, the hospital's division director for infectious diseases.

"We've had to mobilize other providers, doctors, nurses. It's big," she said.

The Kansas City hospital treats 90% of that area's ill children. Staff members noticed an initial spike on August 15, Jackson said.

"It could have taken off right after school started. Our students start back around August 17, and I think it blew up at that point," Jackson said. "Our peak appears to be between the 21st and the 30th of August. We've seen some leveling of cases at this point."

What parents should know about EV-D68

No vaccine for virus

This particular type of enterovirus -- EV-D68 -- is uncommon but not new. It was identified in the 1960s, and there have been fewer than 100 reported cases since that time. But it's possible, Pallansch said, that the relatively low number of reports might be because EV-D68 is hard to identify.

EV-D68 was seen last year in the United States and this year in various parts of the world. Over the years, clusters have been reported in Georgia, Pennsylvania, Arizona and various countries including the Philippines, Japan and the Netherlands.

An analysis by the CDC showed at least 30 of the Kansas City children tested positive for EV-D68, according to the Missouri Department of Health and Senior Services.

Vaccines for EV-D68 aren't currently available, and there is no specific treatment for infections, the Missouri agency said.

"Many infections will be mild and self-limited, requiring only symptomatic treatment," it said. "Some people with several respiratory illness caused by EV-D68 may need to be hospitalized and receive intensive supportive therapy."

Some cases of the virus might contribute to death, but none of the Missouri cases resulted in death, and no data are available for overall morbidity and mortality from the virus in the United States, the agency said.

Symptoms include coughing, difficulty breathing and rash. Sometimes they can be accompanied by fever or wheezing.

Jackson said physicians in other Midwest states reported cases with similar symptoms.

"The full scope is yet to be known, but it would appear it's in the Midwest. In our community, meticulous hand-washing is not happening. It's just the nature of kids," Jackson said.

'Worst I've seen'

Denver also is seeing a spike in respiratory illnesses resembling the virus, and hospitals have sent specimens for testing to confirm whether it's the same virus, CNN affiliate KUSA said.

More than 900 children have gone to Children's Hospital Colorado emergency and urgent care locations since August 18 for treatment of severe respiratory illnesses, including enterovirus and viral infections, hospital spokeswoman Melissa Vizcarra said. Of those, 86 have been sick enough to be admitted to the Aurora facility.

And Rocky Mountain Hospital for Children had five children in intensive care and 20 more in the pediatric unit, KUSA said last week.

"This is the worst I've seen in my time here at Rocky Mountain Hospital for Children," Dr. Raju Meyeppan told the outlet. "We're going to have a pretty busy winter at this institution and throughout the hospitals of Denver."

Will Cornejo, 13, was among the children in intensive care at Rocky Mountain Hospital for Children after he came down with a cold last weekend and then woke up Tuesday night with an asthma attack that couldn't be controlled with his medicine albuterol. His mother, Jennifer, called 911 when her son's breathing became shallow, and her son was airlifted to the Denver hospital, she told KUSA.

Her son was put on a breathing tube for 24 hours.

"It was like nothing we've ever seen," Jennifer Cornejo told KUSA. "He was unresponsive. He was laying on the couch. He couldn't speak to me. He was turning white, and his lips turned blue.

"We're having a hard time believing that it really happened," she added. "We're much better now because he is breathing on his own. We're on the mend."

Restricting kids' visits with patients

In East Columbus, Ohio, Nationwide Children's Hospital saw a 20% increase in patients with respiratory illnesses last weekend, and Dr. Dennis Cunningham said patient samples are being tested to determine whether EV-D68 is behind the spike, CNN affiliate WTTE reported.

Elsewhere, Hannibal Regional Hospital in Hannibal, Missouri, reported "recent outbreaks of enterovirus infections in Missouri and Illinois," the facility said this week on its Facebook page.

Blessing Hospital in Quincy, Illinois, saw more than 70 children with respiratory issues last weekend, and seven of them were admitted, CNN affiliate WGEM reported. The hospital's Dr. Robert Merrick believes that the same virus that hit Kansas City is causing the rash of illnesses seen at the Quincy and Hannibal hospitals, which both imposed restrictions this week on children visiting patients, the affiliate said.

"Mostly we're concerned about them bringing it in to a vulnerable patient. We don't feel that the hospital is more dangerous to any other person at this time," Merrick told WGEM.

Blessing Hospital is working with Illinois health officials to identify the virus, the hospital said in a statement.

While there are more than 100 types of enteroviruses causing up to 15 million U.S. infections annually, EV-D68 infections occur less commonly, the Missouri health agency said. Like other enteroviruses, the respiratory illness appears to spread through close contact with infected people, the agency said.

"Unlike the majority of enteroviruses that cause a clinical disease manifesting as a mild upper respiratory illness, febrile rash illness, or neurologic illness (such as aseptic meningitis and encephalitis), EV-D68 has been associated almost exclusively with respiratory disease," the agency said.

Clusters of the virus have struck Asia, Europe and the United States from 2008 to 2010, and the infection caused relatively mild to severe illness, with some intensive care and mechanical ventilation, the health agency said.

To reduce the risk of infection, individuals should wash hands often with soap and water for 20 seconds, especially after changing diapers; avoid touching eyes, nose and mouth with unwashed hands; avoid kissing, hugging and sharing cups or eating utensils with people who are sick; disinfect frequently touched surfaces such as toys and doorknobs; and stay home when feeling sick, the Missouri agency said.

Source: http://www.cnn.com

By Marijke Durning

THE BASICS

Higher education is a key requirement for nurses as the U.S. healthcare environment grows ever-more reliant on technology and specialized skills. There are three common academic pathways toward becoming a registered nurse (RN): the nursing diploma, associate degree (ADN) and bachelor’s degree (BSN).

Following completion of one of these programs, graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and satisfy state licensing requirements to begin work as an RN. Bridge programs, such as LPN-to-RN and ADN-to-BSN, allow nurses to move ahead in their nursing careers.

Each choice of training program is distinct and offers levels of education to qualify graduates for increasingly responsible roles in nursing practice. This guide is designed to break down the step-by-step process for becoming an RN, including the various routes possible on this career roadmap. Included is an overview of potential specializations and certifications for those interested in moving beyond basic nursing duties. Below are estimates for RN salaries and job growth as well as tools to help prospective nurses search for online and traditional educational programs.

WHAT DOES A REGISTERED NURSE DO?

More than 2.7 million registered nurses are employed in the United States, and nearly 30 percent work in hospitals, according to the Bureau of Labor Statistics (BLS). Other RNs work in clinics, physicians’ offices, home health care settings, critical and long-term care facilities, governmental organizations, the military, schools and rehabilitation agencies.

Duties include administering direct care to patients, assisting physicians in medical procedures, providing guidance to family members and leading public health educational efforts. Depending on assignment and education, an RN may also operate medical monitoring or treatment equipment and administer medications. With specialized training or certifications, RNs may focus on a medical specialty, such as geriatric, pediatric, neonatal, surgical or emergency care. Registered nurses work in shifts that run around the clock, on rotating or permanent schedules, and overtime and emergency hours can be unpredictable. Registered nurses are required to complete ongoing education to maintain licensing, and they may choose to return to college to complete a bachelor’s degree or master’s degree with the goal of moving into advanced nursing practice roles or health care administration.

THE STEPS: BECOMING A REGISTERED NURSE

Step 1: COMPLETE AN APPROVED NURSING PROGRAM

Anyone who wants to be an RN must finish a nurse training program. Options include programs that award nursing diplomas, associate and bachelor’s degrees. An associate degree in nursing (ADN) typically takes from two to three years to complete. Accelerated nursing degree programs could potentially shorten the time required. A bachelor’s degree in nursing (BSN) takes about four years of full-time study to complete, or two years for those in an ADN-to-BSN program. While the structure and content of these training programs differs, they should feature the opportunity to gain supervised clinical experience.

Students may initially only have the time and money to complete a two-year program, but they might later decide to convert their ADN to a BSN degree. Or, students may leap directly into a four-year BSN program if they plan on moving into roles in administration, advanced nursing, nursing consulting, teaching or research. Nursing students complete courses such as the following:

• Anatomy
• Biochemistry
• Biology
• Chemistry
• Computer literacy
• Health care law and ethics
• Mathematics
• Microbiology
• Nutrition
• Patient care
• Psychology

A bachelor’s degree program may also include courses on specific health populations, leadership, health education and an overview of potential specializations. A four-year bachelor’s degree program could require liberal arts courses and training in critical thinking and communication to complete the curriculum. Bachelor’s programs can broaden nursing experience beyond the hospital setting. According to the BLS, some employers require newly appointed RNs to hold a bachelor’s degree.

Step 2: PASS THE NCLEX-RN

Accredited undergraduate nursing degree or diploma programs alike are designed to prepare students to sit for the NCLEX examination. Upon graduation, aspiring RNs should register with the National Council of State Boards of Nursing to sign up for the National Council Licensure Examination for Registered Nurses. Candidates receive an Authorization to Test notification before the exam. At the exam, rigorous verification of candidates' identity may include biometric scanning.

This computerized exam has an average of 119 test items to be completed within a six-hour time limit. Examinees who do not pass must wait from 45 days to three months to re-take the exam. According to the California Board of Registered Nursing, students who take the exam right after graduation have a higher chance of passing.

Step 3: OBTAIN A STATE LICENSE

Every state and the District of Columbia require that employed registered nurses hold current licenses. However, requirements vary by state, so students should contact their state board of nursing or nurse licensing to determine exact procedures. In some states, RNs need to complete the NCLEX-RN, meet state educational requirements and pass a criminal background check. The National Council of State Boards of Nursing maintains a listing of licensing requirements on its website.

Step 4: PURSUE ADDITIONAL TRAINING AND CERTIFICATION (OPTIONAL)

For professionals who decide to become advanced practice registered nurses (APRNs), a BSN degree provides an academic stepping-stone to master’s degree programs. There are also bridge programs for students who only hold a two-year nursing degree and RN licensure but wish to enroll in graduate programs.

Those with master's degrees may qualify for positions such as certified nurse specialists, nurse anesthetists, nurse practitioners (NPs) and nurse midwives. It's important to research evolving professional requirements. For example, the American Association of Colleges of Nursing proposes that NPs should earn a Doctor of Nursing Practice (DNP) degree. A DNP or a PhD degree may appeal to nursing professionals who seek positions as scientific researchers or university professors in the nursing sciences. RNs may also seek certifications in a medical specialty such as oncology. Certifications are offered by non-governmental organizations attesting to nurses' qualifications in fields such as critical care, acute care, nursing management or other advanced areas.

To learn more about RN statistics, jobs, salary and other information CLICK HERE. 

Source: www.learnhowtobecome.org

By Marijke Durning

AN INTRODUCTION TO NURSING CAREERS

By PATTY WIGHT

Some of us are lucky enough to stumble into a job that we love. That was the case for Gabrielle Nuki. The 16-year-old had never heard of standardized patients until her advisor at school told her she should check it out.

"I was kind of shocked, and I was kind of like, 'Oh, is there actually something like this in the world?' "

Since Nuki wants to be a doctor, the chance to earn $15 to $20 an hour training medical students as a pretend patient was kind of a dream come true. Every six weeks or so, Nuki comes to Maine Medical Center in her home town of Portland, Maine, slips on a johnny, sits in an exam room and takes on a new persona.

Third-year medical student Allie Tetreault knows Nuki by her fictional patient name, Emma. A lot of teens avoid the doctor, so it's important for Tetreault to learn how to make them feel comfortable.

"What kinds of things do you like to do outside of school?" Tetreault asks.

"Um, I play soccer, so preseason is coming up soon."

Nuki preps weeks ahead of time for her patient roles. She memorizes a case history of family details, lifestyle habits and the tone she should present. "I've had one case where I was concerned about being pregnant. That was kind of like the most harsh one, I guess."

As Emma, Nuki's playing just a shy, healthy teen.

"How did school finish up for you this year?" Tetreault asks.

"Um, it was good. Yeah, school's been good. Um, yeah."

Emma's an easy role, Nuki says, but she ups the shyness factor because it poses a classic challenge to the medical student: how to get a teen to open up?

"Each case kind of has what's on paper, but then you can come in and kind of add another level," Nuki says. "Depending on how complex it is, you can add your own twist to it."

After asking Emma about her personal history, Tetreault moves on to the physical exam and listens as Emma takes deep breaths.

Tetreault gives Emma a clean bill of health and the practice appointment is over. But the most important part of Gabrielle Nuki's job is about to begin.

The 16-year old now has to evaluate the adult professional. She's smooth and tactful after lots of training on how to deliver feedback. Nuki tells Tetreault she did a good job making her feel comfortable.

"I also liked how you mentioned confidentiality, because for my age group, that's important to touch on," Nuki says. "And I think that maybe you could have had a couple more times where you asked me if I had any questions, but other than that I think you did a really great job."

It's communication skills versus acting skills that really qualify someone to be a standardized patient, says Dr. Pat Patterson, the director of pediatric training at Maine Medical Center.

"A lot of patients want to please their physician," Patterson says. "It's not easy for a patient to say 'That didn't feel right', or 'The way you asked that made me feel bad.' "

Gabrielle Nuki says working with medical students and being forthright about their performance has given her more confidence. In the future, she hopes to take on more complex roles — maybe someone with depression.

But she knows no matter what kind of patient she portrays, this job will prepare her well for when she reverses roles and one day becomes a doctor.

Source: http://www.npr.org

By LAURA GEGGEL

For health care workers and researchers, wearing pressurized, full-body suits around Ebola patients may be counterproductive to treating the disease, say three Spanish researchers in a new letter published in the journal The Lancet. But other health experts, wary of wearing less protective gear, disagree.

Health agencies often require that health care workers caring for Ebola patients wear hazardous material (hazmat) suits that protect against airborne diseases. But the Ebola virus rarely spreads through the air, according to the researchers at the University of Valencia and Hospital La Paz-Carlos III, in Madrid.

Ebola is transmitted through contact with infected patients' secretions (such as blood, vomit or feces), and such contact can be prevented by wearing gloves and masks, the researchers wrote.

Wearing full-body protection gear is "expensive, uncomfortable, and unaffordable for countries that are the most affected," they said. It may also send the message that such protection against the virus is being preferentially given to health care workers and is out of reach to the general public, they wrote in their article. [Ebola Virus: 5 Things You Should Know].

Moreover, the image of health care workers in hazmat suits could lead to panic, causing people to flee the area and possibly spread the virus elsewhere, they added.

Instead, protective gear such as gloves, waterproof smocks, goggles, masks and isolated rooms may be enough to manage infected patients, so long as they are not hemorrhaging or vomiting, the letter said. "In control of infectious diseases, more is not necessarily better and, very often, the simplest answer is the best," the researchers wrote.

The current Ebola virus outbreak is the worst in history. It began in February 2014 in Guinea and has since infected people in Liberia, Nigeria and Sierra Leone, killing more than 1,500 people. Just 47 percent of infected patients have survived.

But other experts disagree with the researchers, saying a high level of protection against the virus is needed in places with struggling health care systems, including the countries in West Africa where the outbreak is raging.

"The authors have a point, but I don't think a very strong one," said Dr. William Schaffner, a professor of preventive medicine and an infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tennessee, who was not involved with the letter.

"It must indeed be unsettling for people to see folks in hazmat suits come into their communities," Schaffner told Live Science. "It's very foreign, and often increases their anxiety about events."

But it's better to err on the side of safety, he said. Because the Ebola virus does spread through contact with infected bodily fluids, if health care workers don't immediately clean up such excretions, it's possible these fluids could infect others not wearing appropriate protective gear.

Patients may also start vomiting or bleeding at any time, increasing the risk of infection for health care workers who are not wearing protective suits, he said.

"I would remind us that there are any number of health care workers, including Dr. [Kent] Brantly and Ms. [Nancy] Writebol, were using elaborate equipment in Africa and nonetheless became infected," Schaffner said. (Brantly and Writebol have both since recovered.)

In hospitals with cutting-edge technologies, such as Emory University Hospital, health care workers may not have to wear full-body suits for all Ebola patients, if the patients are on the mend, he said. If they are not displaying symptoms such as vomiting or bleeding, health care workers may be able to scale down their uniforms and use goggles and gloves in lieu of wearing hazmat suits, Schaffner said.

But "when you have a circumstance as hazardous as Ebola, it's important to be secure," Schaffner said.

Source: http://www.cbsnews.com