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DiversityNursing Blog

Paula and TJ Brown: When Cooking Dinner is About More than the Food

Posted by Alycia Sullivan

Mon, Mar 03, 2014 @ 02:12 PM

Paula and TJ resized 600

Written by Elizabeth Swaringen for UNC Health Care 

As a nurse at UNC Hospitals, Paula Brown, RN, knows firsthand the difference family presence makes in a patient’s healing.
She also knows the importance of the care and feeding of family members — especially when home is two or three hours away.

So volunteering to cook dinner for guests at SECU Family House was a no-brainer for Paula and her 16-year-old son, TJ, a sophomore at Carrboro High School.  It just took the inspiration of a like-minded 10-year-old boy to make it a priority in 2014.

“I’ve known about Family House since it was a dream, before the construction even began,” said Paula, recalling a massive yard sale to raise money for the 40-bedroom hospital hospitality house that offers safe and affordable accommodations to seriously ill patients and their families who come to UNC Hospitals for care.  

And once Family House opened in March 2008 minutes from UNC Hospitals, Paula had always planned to volunteer, “but sometimes life gets in the way,” she said.

“Then I learned more about the House and the good that happens there from Family House Diaries, the stories that are included in news for employees,” said Paula, who is in her 20th year as a nurse in the post-surgery acute care unit at UNC Hospitals. “It was the awe-inspiring story in October of a 10-year-old boy who cooks and serves that told us the time is now.”

Paula wasted no time getting on the dinner schedule. She called Allison Worthy, who coordinates volunteers at Family House, and nailed down Sunday, Jan. 19.  Allison put Paula in touch with volunteers Charles and Patsy Harrison who lead a team that cooks dinner for guests twice a month.   

She observed Team Harrison, asked questions and checked out the availability of crock pots and utensils in the community kitchen for the chili and cornbread that she and TJ had already decided would be their debut meal.

TJ3“I really enjoy chili that way and wanted to give others the option,” TJ said, surmising correctly that most guests weren’t familiar with it.  The Browns offered both a meat chili and a vegetarian chili, again giving guests choices to best suit their palates.

Mother and son spent the day before in prep:  chopping the onions and browning the meat for the chili, chopping other vegetables for tossed salad, baking the cornbread muffins and the brownies for dessert.  By noon Sunday, four crock pots were hard at work in the Family House kitchen.

“We prepared for about 50, forgetting that it was the MLK Holiday weekend and there would be a slimmer crowd as the hospital clinics were closed on Monday,” said Paula.  “But it didn’t matter.  Although we had fewer guests than we’d planned for, we had plenty of leftovers, and chili is always better the second day.”

Leftovers are always welcome and disappear at Family House because the illness of a loved one does not follow a mealtime schedule, said Allison, the volunteer coordinator.

“Our guests always comment with gratitude and amazement about the volunteers who prepare the home-cooked meals here and the quality of the food,” she said.  “But it’s beyond nourishing their bodies; it’s about the community of support that forms around the shared meals. We’ve steadily added Sunday night meals because Sundays have become a busy check-in day for guests.  Like our guests we are grateful that Paula and TJ know their way our around kitchen, especially on Sunday nights.”  

Paula and TJ saw — and felt — the gratitude firsthand.  A lone female guest showed her appreciation by insisting that Paula accept a cash donation that could be used for the next dinner she and TJ prepare.

“That was one of those arguments that you can’t win, so I graciously accepted her gift, assuring her it wasn’t necessary, but much appreciated,” Paula said, noting that she and TJ had already discussed “next time” even before they had served the first bowl of chili.

Paula

And neither will forget the guest who slipped back into the kitchen after dinner, slammed his palm on the countertop to get their attention and declared,

“I just want to thank you.  With her treatment my wife hasn’t felt like eating in over a month, but tonight she did. We enjoyed it.”

“I thought we were just feeding people, but it was so much more than that,” said TJ, who enjoys the logistical challenges of cooking, especially for a crowd. “Family House is a haven for people.  The reactions to our meal told us that. I had run by the house many times in better weather when training with my cross-country team, but I really didn’t know what goes on here. Cooking here was fun, and I look forward to coming back.”

Cooking at Family House also allows TJ to work towards earning the 25 community service hours he needs for high school graduation.  But it’s not about that requirement, both TJ and Paula agreed.

“It’s the reaction we got from people,” he said.  “It was emotional and genuine for us all.  The fun of the cooking makes the service requirement easier.”  

"It’s a win-win for all,” Paula said, beaming.  

Will chili be their signature Family House meal?

“We’ll probably branch out, but we’ll keep with comfort foods,” said TJ. “You don’t want to go too exotic.  You gotta eat sometime, and we need to make it easy for people to enjoy it, maybe meatloaf and my grandmother’s macaroni and cheese.”

Just as a 10-year-old boy inspired Paula and TJ to step up and cook a fellow nurse told Paula her unit is going to plan a meal at Family House.  

“I just hope it’s my day off so I can participate,” she said.

Source: UNC Health Care

Topics: volunteer, SECU Family House, UNC Hospitals, mother and son, dinner

Top 4 tips that benefit RNs and help advance their careers

Posted by Alycia Sullivan

Mon, Mar 03, 2014 @ 02:09 PM

By Donna Cardillo 

It is imperative that every nurse – new and experienced – realize the healthcare landscape has completely changed. There will be plenty of opportunities for RNs and APNs who stay current with trends in education, technology, care and personal and professional development. Nurses must be willing to step outside their comfort zone and learn new ways — and places — of working and thinking about their profession. Cynthia Nowicki Hnatiuk, RN, EdD, CAE, FAAN, executive director of the American Academy of Ambulatory Care Nurses and the Academy of Medical Surgical Nurses. stresses that, to stay competitive, nurses also will have to be able to articulate the value that they bring to outcomes, beyond tasks, in any setting. So what does every nurse need to do? Here are four key areas:

1| Skill building

Clinical skills alone won’t see us through in this new paradigm. Self-marketing, computer skills, oral and written communication, conflict management, negotiation, leadership and networking skills must be learned and practiced. Hnatiuk said nurses also need to be more business savvy, with an understanding of finances, staffing, acuity and productivity.

2| Education

Higher education is no longer optional. It is a foundation for practice in any setting and fundamental to professional and personal growth and development. Hnatiuk advises that formal and continuing education, along with clinical certification, will help nurses take their practice and careers to the
next level.

For those considering advanced practice, particularly becoming nurse practitioners, the NNCC’s Hansen-Turton advises: “Don’t think too long; jump in. Opportunities will be increasing for NPs over the next 5-10 years. NPs are and will continue to be a hot commodity.” Certified nurse midwives, clinical nurse specialists and certified registered nurse anesthetists also will see expanded opportunities.

3| Professional association involvement

Our professional associations are where we connect with one another, form communities, share best practices (local and national), stay current with trends and issues, and find support. Hnatiuk added that through association involvement, you learn more than you could by yourself and progressively learn leadership skills

4| Mentoring

Hnatiuk encourages nurses to take advantage of opportunities to be mentored and to mentor others. “We have so much to share. Mentoring will allow us to achieve all we’re capable of doing.”

For personalized career advice

If you have specific career-related questions, send them to Dear Donna at www.Nurse.com/AsktheExperts/DearDonna for a personalized response.

Source: Nurse.com

Topics: advice, tips, Dear Donna, RN, nurses, career

What can a new graduate do to setup and update his or her resume to make it more attractive to employers?

Posted by Alycia Sullivan

Mon, Mar 03, 2014 @ 01:26 PM

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 

Dear Donna replies:

Dear Wants a More Attractive Resume,

Although you may hear varying opinions about whether or not your clinical rotations should be on your new nurse resume, it is a good idea for several reasons. It looks good if you're applying to one of the facilities in that healthcare system where you did some clinical time. This is especially true if you're favorably remembered by a staff member and if you did a clinical rotation at a
well-known facility.

It's not necessary to give much detail about each position or to provide dates and time frames other than the year. You can mention significant experiences you had, such as working with ventilators. On the other hand, if you have prior healthcare work experience as an LPN or nurse's aide, it may not be necessary to list clinical rotations. Be sure to include any externships or special internships you did as well. Once you've had your first job as an RN, clinical rotations and externships would no longer be listed.

As far as categories, the other common ones are: work experience; education; licensure/credentials; volunteer work (if applicable); and special skills where you can list other languages you speak, special computer skills or any other noteworthy skills. You'll find very detailed information, including new nurse resume samples, in “The ULTIMATE Career Guide for Nurses” (http://ce.nurse.com/
course/7250/). 

Also read “FAQs about student nurse resumes” (www.Nurse.com/Cardillo/Student-Resumes) for answers to other commonly asked questions.

A good resume certainly is an important marketing tool but there is much more involved in launching a successful job search, especially as a new nurse. Read “New nurse, new job strategies” (www.Nurse.com/Cardillo/Strategies) to help give yourself an edge when looking for that first
full-time position.

Best wishes,
Donna 
Source: Nurse.com

Topics: help, resume, graduate, Dear Donna, employers, nurses

How Immigrant Doctors Became America's Next Generation of Nurses

Posted by Alycia Sullivan

Fri, Feb 28, 2014 @ 02:05 PM

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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 moreisabel resized 600 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

Topics: US, shortage, immigrant, nurses, doctors

Do Health Exchange policies Change the Game for Full-Time Nurses?

Posted by Wilson Nunnari

Fri, Feb 28, 2014 @ 08:43 AM

by

For: http://onlinelpntorn.org

8345137730 a434ab6f65 m

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?”

Topics: full-time, nurses, nursing career, Toward a More Diverse Health Care Workforce

Norwich University Future of Nursing

Posted by Alycia Sullivan

Fri, Feb 14, 2014 @ 12:39 PM

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.

norwichuniversity resized 600Source: Norwich University Online

Topics: growth, technology, nurses, online, Future of Nursing, Norwich University

Warmth spreads through hospital after son leaves message in snow

Posted by Alycia Sullivan

Wed, Feb 12, 2014 @ 01:15 PM

By Lolly Bowean

For Sharon Hart, the third day after her chemotherapy treatment for acute myeloid leukemia is always the hardest. That’s when she feels weak and sometimes discouraged.

“The blood levels are depleted and I get tired and sick to my stomach,” said Hart, of Bolingbrook.

She was feeling that way Saturday afternoon at Chicago’s Rush University Medical Center when she looked out the window and found reason to smile.

On top of the hospital parking lot, her 14-year-old son William had stomped out a message in newly fallen snow, in letters the length of two cars: HI MOM. The ‘o’ was made into a smiley face.

When he left the hospital hours later, William and his father and uncle added: GOD BLESS U! The gesture not only lifted Hart’s mood, but warmed the spirits of other patients, families, nurses and doctors as news of the message quickly spread. People posted pictures on Twitter, Instagram and Facebook, drawing national attention.

“My son has never done anything like this before,” said Hart, 48. “He is a very caring child andmomgod resized 600 very loving. ... He acted on instinct and from what was in his heart. I’m glad so many people got to see the message and that it touched so many. It shows how big God is.”

Hart was admitted to Rush after she was diagnosed with leukemia on Feb. 3. William arrived at the hospital to visit her and noticed the expanse of fresh snow on the garage. He stomped out the message, then called his mother and told her to look out the window.

“I wanted to send her the message because I thought it would brighten her spirits and help her get through this,” said William, a freshman at Bolingbrook High School. “I would love for her to be happy.

“This has been rough. I’ve been praying a lot and trying to not think about what’s going on so I can do good in school. I keep my hopes up and pray every night that my mommy gets well.”

With the help of a nurse, Sharon Hart climbed out of bed and opened the blinds. That’s when she saw that he had written, ‘HI MOM.’

When William left the hospital hours later with his dad and uncle, the three decided they would extend the message to all the patients. It was viewable from the east side of the hospital from the 9th floor to the top of the building.

“They wanted to write ‘God Bless U All,’ but they ran out of room,” said Deb Song, a spokeswoman for the hospital. So they wrote ‘GOD BLESS U,’ instead.

William said his first message was specifically for his mother. But after the visit, he thought about all the other families. As he and his father and uncle pushed around the snow with their feet, they noticed people gathering at the windows, waving, jumping and taking photos.

“It was very cold out there, but I didn’t care,” he said. “I wanted to get it done and let people see it. It’s amazing because just to see people feel happy feels good.”

A nurse who works the third shift noticed the message because a patient’s daughter was watching the men stomp it in the snow and became emotional.
When Angela Washek, 26, a registered nurse in the surgical intensive care unit, looked outside, she thought the men were just playing in the snow, she told the hospital staff. Then she realized that they were shaping letters.

Song said Washek emailed pictures to the medical staff.

“We don’t always get to see the good side of things in ICU,” Washek said. “People come out of surgery and they are in pain and feeling bad. When they feel better they go to another floor. This gave us a glimpse of people at their best. It boosted our morale, that’s for sure.”

Within an hour, staff from other parts of the building were coming over to get a peek at the message, Washek said. Then the story went viral.

“I still can’t believe this,” she said. “People have called from Pittsburgh and Cleveland and said they saw it. People want to care about the good side. A story, even a small one, makes people feel good. We all want to feel good at the end of the day.”

“We got such an overwhelming response from our doctors, nurses and staff who saw it and thought it was wonderful. The gesture was so simple, but so creative and nice,” Song said.

By Monday morning, the snow -- and the message --- had been cleared from the parking, Song said.

But through photos and stories, the power of the gesture has endured.

“She said it was really heartwarming, especially since she works with acutely sick patients, which can be tough,” Song said. “The gesture was so simple, but so creative and nice.”

Source: Chicago Tribune

Topics: chemo, heartwarming, snow, cancer, Rush University Medical Center, message

Study pinpoints issues that leave ED nurses vulnerable

Posted by Alycia Sullivan

Wed, Feb 12, 2014 @ 01:11 PM

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

Topics: study, emergency room, prevention, nurses, ENA

A Patient’s Eye-View of Nurses

Posted by Alycia Sullivan

Wed, Feb 12, 2014 @ 01:04 PM

By LAWRENCE K. ALTMAN, M.D.

Last June, the month he turned 90, Dr. Arnold S. Relman, the eminent former medical educatorDr. Arnold S. Relman, 90, with his wife, Dr. Marcia Angell, in 2012. He  fell in June and suffered multiple fractures. 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 

Topics: nurses, doctors, FEATURED, NURSING AND NURSES, RELMAN, ARNOLD S

OnShift raises $7M for nurse scheduling platform

Posted by Alycia Sullivan

Wed, Feb 12, 2014 @ 12:59 PM

By: Aditi Pai

Nurse scheduling platform OnShift raised $7 million in a round led by HLM Venture Partners withOnShift 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

Topics: clinical communication, nurse scheduling, OnShift

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