DiversityNursing Blog

Question:

Dear Donna,

I'm a recent new graduate and I'm trying to figure out how to setup and update my resume to be more attractive to employers. Are there certain topics or headlines that should be included and what are the rules for putting my clinical experience on
my resume?

Wants a More Attractive Resume 

By Sophie Quinton

Isabel Barradas, 48, has been a doctor for 25 years. In her native Venezuela, she was an orthopedic surgeon and head of a hospital department, with expertise in physical rehabilitation. She speaks three languages and—since marrying an American and moving to South Florida more than a decade ago—is a U.S. citizen.

Barradas passed her U.S. medical licensing exams with flying colors. But she didn't get a residency position in the specialty she loves. "Orthopedic surgery? Forget it. In this country, that is so elite," Barradas says. Competition for the training positions required for medical licensure is fierce, and most go to seniors at U.S. medical schools. Barradas decided that the position she did get—internal medicine in Buffalo, N.Y.—wasn't worth leaving her family in Miami for.

Thousands of foreign-educated doctors living in the U.S. would like to practice medicine here but don't have the time, money or language skills to compete for and complete a residency. Miami's Florida International University offers other options: accelerated programs leading to a bachelor's and master's of science in nursing which train foreign-educated doctors to be nurse practitioners. FIU's programs both give internationally educated professionals an outlet for their skills and helps add much-needed diversity to the health care workforce.

The U.S. faces a dearth of 20,400 primary care physicians by 2025, according to federal statistics. The Association of American Medical Colleges projects a shortage of thousands of surgeons and other specialists too. While an aging population and health insurance expansion increase demand for health care services, medical schools and residency programs aren't producing enough doctors to meet demand.

There are thousands of foreign-educated doctors living in the U.S. who have the expertise needed to address some of this growing need. Every year for the past decade, between 5,000 and 12,000 foreign-educated physicians who have passed their licensing exams apply for a residency position. Typically, about half get one, compared with more than 90 percent of U.S. medical school seniors who apply, according to data from the National Resident Matching Program.

International medical school graduates, like minority doctors, often go on to serve medically underserved populations. Graduates of international medical schools make up a quarter of U.S. office-based physicians, and are more likely than their U.S.-educated peers to treat minority patients, foreign-born patients, patients who speak little English and patients who qualify for Medicaid, according to a 2009 study from the Centers for Disease Control and Prevention.

Demand for highly trained nurses is also growing, particularly for nurses who speak more than one language and reflect the growing diversity of the U.S. population. If highly trained professionals like nurse practitioners and physician assistants were to take on more primary care responsibilities, the shortage of primary care doctors could be cut by more than two-thirds, according to the Health Resources and Services administration.

FIU introduced its accelerated nursing degree program in 2000, in response to pressure from underemployed Cuban doctors living in the area. The FEP-BSN/MSN program began as a bachelor's degree program that prepared students to become registered nurses. In 2010, FIU added a master's degree, and graduates of the full program can now find work as nurse practitioners—an advanced role that can include prescribing medicine and diagnosing patients. In Florida, nurse practitioners earn about $86,800 per year. Barradas hopes to find work with an orthopedic surgeon.

Isabel Barradas (left) and Mariana Luque, trained and credentialed as physicians in their native Venezuela and Colombia respectively, are nursing students at Florida International University. (Sophie Quinton)The program compresses six years of education into four, mostly by moving quickly through undergraduate-level material. English language learners get help with reading and writing academic papers, and courses are scheduled in the evenings or compressed into one day a week to fit the needs of working adults. For the past few years, the graduation rate has been close to 100 percent.

Despite its South Florida roots, the program has begun to attract students from all over the U.S. "I ask them, why don't you just go to the accelerated program where you live? And it's not the same for them," says Maria Olenick, program director. "They choose to come here because they know that there are other people in the same situation."

Most of the 200 doctors enrolled in FIU's program this year are bilingual. About 39 percent are from Cuba, 28 percent are from Haiti, and 6 percent are from Colombia, with the rest hailing from Nigeria to Lithuania. Students are evenly split between men and women, and the average age is about 40. Applicants must be U.S. citizens or permanent residents.

Some doctors are initially reluctant to enter a nursing program, Olenick says, fearing loss of prestige, but usually the negative feelings don't last. "What we're hearing from them is that they're actually really, really enjoy the role of nurse practitioner in the United States, because it's more like the way they practiced in their home countries," she says. American physicians tend to spend less time with patients and more time processing paperwork than their counterparts overseas. Barradas' patients in Venezuela used to come by just to chat.

It's not always easy for graduates of the accelerated degree program to find the kind of work they want, says Carlos Arias, chief operating officer of Access Healthcare. Although they're armed with an advanced nursing degree and have medical training, graduates are often offered entry-level positions with low salaries. Arias, a Cuban-educated doctor himself, now heads a Florida independent practice association that has hired two graduates of FIU's program to date.

Not all graduates choose to enter the workforce right away. The first class of nurse practitioners graduated last summer, and of 55 graduates 12 returned to FIU to enroll in a doctoral program. "We're looking now at making the program a BSN to DNP program, because we have so many that are interested," Olenick says of the doctoral program. "The way that nursing is moving, eventually a DNP will be required to practice as a nurse practitioner."

For the foreign-educated physicians in the program, the doctorate offers another perk. As a graduate, you get to be titled Dr. again.

CORRECTION: An earlier version of this article misspelled the name of Carlos Arias. It also omitted the number of graduates who returned to FIU to enroll in a doctoral program. Twelve did.

Source: NationalJournal

by Megen Duffy

For: http://onlinelpntorn.org

It just occurred to me that the new health exchange insurance policies could change the nursing career marketplace and give nurses a lot of new employment options: we can play job Tetris. Why? Read on.

Before the individual policies were available, nurses without spouses or another source of health insurance were bound to full-time work with benefits unless they opted to live dangerously. Individual policies were just totally unaffordable (I used to pay about $1,000 per month for an individual policy when I was self-employed). Now they are affordable, and they are particularly so if you consider the salary differential between full-time and PRN hourly wages. It is usually significant.

This one factor allows some mix-and-match in job searches. Perhaps your dream job has a part-time position available, so you take that and pick up PRN shifts somewhere else. Perhaps you have interests in two areas, so you find PRN positions in both. Perhaps it even works out financially for you to work full-time hours as a PRN nurse where you already are, if you work at one of the hospitals where PRN nurses can always pick and choose hours (this plan will not work if PRN hours are what they were intended to be and not guaranteed).

Disclaimer: this does not include other benefits such as retirement contributions and term life insurance that are generally offered, nor does it generally offer paid time off. Speaking as someone who was self-employed for a decade, I can readily state that employer matching for retirement and paid time off are benefits worth accepting a lower hourly rate than I would get for PRN status. However, I know that for many people health insurance is the sticking point, and for those people a whole new world may have just opened up.

Of course, your mileage may vary with the exchange policies versus a group insurance policy with an employer. I have found so far that with mine, the benefits are either similar to or better than the group policy I used to have, and I even bought a lower-tier policy because I thought it would be much more temporary than it has ended up being. They really do cover preventive screens and such at 100%. They really do pay what they say they will for copays and prescriptions, and this was not the case for my group policy. There was always an exception. As I say, this is my mileage only.

Just think, though, of the possibilities. This is important given the tight job market for nurses right now. What if you were not tied to benefits? Do you have a hobby or a sideline you could monetize and be a nurse two shifts per week? Do you have a previous career you could still put to use part time and pick up shifts now and then as a nurse?

Thinking of job opportunities this way opens up a new range of options if you are willing to, I hate to say it, think outside the box. Just keep in mind the question, “What if I didn’t have to look just in the full-time section?”

The nursing profession is facing multiple challenges in the years ahead. From the Affordable Care Act and its focus on the introduction of electronic medical records, to the aging US population, many people question what healthcare will look like in the future.

What remains certain, however, is the future of nursing is bright. Nurses are a vital part of the health care system and a valuable resource for our society.

What can nurses and nursing industry expect in the years ahead?

At this point in time:

- One third of nurses are over 50 years old.
- 1/3 of the current workforce will reach retirement within the next decade or so.
- Nurses work more hours now than they did in 2000.

How the Health Care Reform Will Affect Nurses

Nurses will be prepared to take on more responsibility than they currently have.

This will be helpful, since:

- Within 15 years, the country will be short 150,000 doctors.
- Primary Care Physicians (PCP) will be in the greatest demand, with an estimated 45,000 needed by 2020.
- Millions of new patients are expected to flood the healthcare system as new insurance takes hold.
- More nurses will work in rural areas where the nurse may be the only health care provider available.

Ever-Changing Technology

As we move into the future, nursing will change thanks to new technology, such as:
- The Computerized Provider Order Entry (CPOE) will reduce medication errors by about 55%.
- Medication will be scanned before the patient takes it, to ensure correct dosage and type.
- Transcriptions can be replaced by CPOE.
- Electronic medical records will link hospitals, physician’s practices and home healthcare agencies.

To learn more about the future of nursing, checkout the infographic below created by Norwich University’s Online Master of Science in Nursing program.

The nursing profession is facing multiple challenges in the years ahead. From the Affordable Care Act and its focus on the introduction of electronic medical records, to the aging US population, many people question what healthcare will look like in the future.

What remains certain, however, is the future of nursing is bright. Nurses are a vital part of the health care system and a valuable resource for our society.

What can nurses and nursing industry expect in the years ahead?

At this point in time:

- One third of nurses are over 50 years old.
- 1/3 of the current workforce will reach retirement within the next decade or so.
- Nurses work more hours now than they did in 2000.

How the Health Care Reform Will Affect Nurses

Nurses will be prepared to take on more responsibility than they currently have.

This will be helpful, since:

- Within 15 years, the country will be short 150,000 doctors.
- Primary Care Physicians (PCP) will be in the greatest demand, with an estimated 45,000 needed by 2020.
- Millions of new patients are expected to flood the healthcare system as new insurance takes hold.
- More nurses will work in rural areas where the nurse may be the only health care provider available.

Ever-Changing Technology

As we move into the future, nursing will change thanks to new technology, such as:
- The Computerized Provider Order Entry (CPOE) will reduce medication errors by about 55%.
- Medication will be scanned before the patient takes it, to ensure correct dosage and type.
- Transcriptions can be replaced by CPOE.
- Electronic medical records will link hospitals, physician’s practices and home healthcare agencies.

To learn more about the future of nursing, checkout the infographic below created by Norwich University’s Online Master of Science in Nursing program.

The nursing profession is facing multiple challenges in the years ahead. From the Affordable Care Act and its focus on the introduction of electronic medical records, to the aging US population, many people question what healthcare will look like in the future.

What remains certain, however, is the future of nursing is bright. Nurses are a vital part of the health care system and a valuable resource for our society.

What can nurses and nursing industry expect in the years ahead?

At this point in time:

- One third of nurses are over 50 years old.
- 1/3 of the current workforce will reach retirement within the next decade or so.
- Nurses work more hours now than they did in 2000.

How the Health Care Reform Will Affect Nurses

Nurses will be prepared to take on more responsibility than they currently have.

This will be helpful, since:

- Within 15 years, the country will be short 150,000 doctors.
- Primary Care Physicians (PCP) will be in the greatest demand, with an estimated 45,000 needed by 2020.
- Millions of new patients are expected to flood the healthcare system as new insurance takes hold.
- More nurses will work in rural areas where the nurse may be the only health care provider available.

Ever-Changing Technology

As we move into the future, nursing will change thanks to new technology, such as:
- The Computerized Provider Order Entry (CPOE) will reduce medication errors by about 55%.
- Medication will be scanned before the patient takes it, to ensure correct dosage and type.
- Transcriptions can be replaced by CPOE.
- Electronic medical records will link hospitals, physician’s practices and home healthcare agencies.

To learn more about the future of nursing, checkout the infographic below created by Norwich University’s Online Master of Science in Nursing program.

By Nurse.com News

A qualitative study on assaults on emergency nurses, sponsored by the Emergency Nurses Association, found a need to change the culture of acceptance that is prevalent among hospital administrators and law enforcement.

Better training to help nurses recognize signs of potential trouble also is key, according to researchers, whose study was published Jan. 17 on the website of the Journal of Emergency Nursing.

“Assaults on emergency nurses have lasting impacts on the nurses and the ability of emergency care facilities to provide quality care,” 2014 ENA President Deena Brecher, RN, MSN, APN, ACNS-BC, CEN, CPEN, said in a news release. 

“More than 70% of emergency nurses reported physical or verbal assaults by patients or visitors while they were providing care. As a result, we lose experienced and dedicated nurses to physical or psychological trauma for days or sometimes permanently. Healthcare organizations have a responsibility to nurses and the public to provide a safe and secure environment.”

According to Bureau of Labor statistics, an assault on a healthcare worker is the most common source of nonfatal injury or illness requiring days off from work in the healthcare and social assistance industry. 

Despite that statistic, the qualitative research study discovered a culture of acceptance among hospital administrators, prosecutors and judges. One emergency nurse assault victim told the researchers the “administration will only take action when some lethal event happens.”

Perhaps in correlation with the culture of acceptance, the study also concluded that emergency nurses and hospital personnel in general are not trained to recognize cues for violent behavior. 

“It is imperative that hospitals and emergency care workers address the issue preemptively through adoption of violence prevention education, zero-tolerance policies, safety measures and procedures for reporting and responding to incidents of workplace violence when they do occur,” the researchers noted. “Such actions are necessary to help nurses recognize incipient violence.”

The ENA long has taken the position that healthcare organizations must take preventive measures to circumvent workplace violence and ensure the safety of all healthcare workers, their patients and visitors.

“There will always be the potential for violence against emergency nurses,” Brecher said. “But we must not accept it as the price of helping the sick and injured. With training and a change of culture, we can significantly decrease the occurrence of assaults against emergency nurses.”

The study was conducted using a qualitative descriptive exploratory design. In the fall of 2012, a sample of ED nurses was recruited by email from the roster of ENA nurses and through an announcement on the ENA website. Eight men, 37 women and one person of unknown gender responded to the question, “Tell me about your experience of violence in the emergency setting.” Answers were emailed to and analyzed by the Institute for Emergency Nursing Research. 

Only one other previous qualitative study is known to have been conducted to address workplace violence against emergency nurses in the United States since at least 2004, according to the news release.

Study abstract: http://bit.ly/1iwMuM8 

Source: Nurse.com

By LAWRENCE K. ALTMAN, M.D.

Last June, the month he turned 90, Dr. Arnold S. Relman, the eminent former medical educator and editor, fell down a flight of stairs at his home in Cambridge, Mass. He cracked his skull and broke three vertebrae in his neck and more bones in his face.

By the time he arrived at the emergency room, blood was flowing into his brain and impinging on his windpipe, leading to severe choking and dangerously low oxygen levels. Surgeons cut into his neck to connect a breathing tube from his trachea to a mechanical respirator.

Amid the disciplined medical havoc, his heart stopped three times. Resuscitation efforts saved his life, but at the cost of several broken ribs. His condition remained precarious as he developed complications and endured still more medical procedures.

Astonishingly, he lived to write about all this. After a painful 10-week hospital stay and months of rehabilitation, he can walk — gingerly, with a cane — and is largely recovered, with his mental faculties intact.

His riveting account of the medical adventure, in the Feb. 6 issue of The New York Review of Books, is a testimonial to the best emergency medical care and a tremendous will to live. At the same time, however, it betrays a surprising lack of awareness of some critical aspects of the medical profession and the nation’s fragmented health care system.

Despite decades as a medical educator, researcher, author and editor of The New England Journal of Medicine, Dr. Relman confesses that he “had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled.” Nor did he appreciate the hypnotizing effects of technology, which robs patients of the physician’s bedside manner and affects the training of younger doctors.

How is it that a leading medical professor like Dr. Relman — who has taught hundreds of young doctors at Boston University, the University of Pennsylvania (where he was chairman of the department of medicine) and Harvard — might not have known about the value of modern-day Florence Nightingales?

A number of doctors who have talked to me about Dr. Relman’s article suggest that the culture of medical education may be largely to blame. For example, younger doctors in hospitals spend part of the day on rounds, following professors in their long white coats. Many of these august figures are supremely confident in their observations and opinions; others are more compassionate.

What professors impart on those rounds can have a major effect on the behavior of younger doctors when they go into practice and teach succeeding generations.

Dr. Relman’s initial care was in a major teaching hospital, Massachusetts General in Boston, where the kind of doctors he taught — students, interns and residents — provided the round-the-clock attention that kept him alive. Yet he did not write directly about their role, referring to them only as “a team.”

On their rounds, some medical professors prefer to talk in a hallway just outside the patient’s room as they discuss test results that are crucial in planning further care. Such behavior appears impersonal, perceived perhaps as a way of shielding bad information.

But many doctors see it as efficient, because they can note the information they deem most important — like heart rate, blood pressure and rate of intravenous drip — by standing at a patient’s door and looking in at the monitors. Feeling no need to go to the bedside, they do not. Instead they rely on nurses, failing to recognize that such behavior omits crucial elements in patient care — the physical touch and the personal touch.

Dr. Relman owes the extension of his life to drugs and devices that did not exist in their present form, if at all, when he was younger. Over the years, the surge in the number of such advances, and most importantly in their hazards, has made work vastly more complicated for doctors, nurses and other health workers. Despite the advantages of technology, tender, loving care from family and nurses is priceless, as is the bedside manner of a sympathetic doctor.

But technology’s monitors, images and devices can deflect that doctor’s attention, as Dr. Relman learned when he reviewed his hospital records and the notes he wrote to nurses and his wife, Dr. Marcia Angell (particularly while he was unable to speak because of the breathing tube).

Instead of descriptions of his appearance and feelings, the doctors’ progress notes in his electronic medical records were filled with technical data. “Conversations with my physicians were infrequent, brief and hardly ever reported,” he wrote, adding:

“What personal care hospitalized patients now get is mostly from nurses. When nursing is not optimal, patient care is never good.”

Many hospital administrators have cut nursing staffs. They say it is to make ends meet; many doctors say it is usually to increase the bottom line.

Nurses’ observations and suggestions have saved many doctors from making fatal mistakes in caring for patients. Though most physicians are grateful for such aid, a few dismiss it — out of arrogance and a mistaken belief that a nurse cannot know more than a doctor.

In many ways, Dr. Relman’s insights reflect changes and generational gaps in training doctors, nurses and other health professionals. Because these disciplines have traditionally been taught in separate silos, they often do not work as tightly as they should.

Now, as health care financing changes and doctors spend more time training in outpatient settings, a growing movement demands coordinating the education of health professionals to prepare them to work more smoothly in teams. If these efforts succeed, perhaps the next generation of doctors will no longer be surprised at the importance of nurses and other allied professionals.

Source: Well: NY Times 

By: Aditi Pai

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

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

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

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

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

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

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

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

Source: MobiHealthNews

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

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

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

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

Source: CampaignforAction.org 

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

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

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

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

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

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

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

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

Source: Nurse.com