Something Powerful

Tell The Reader More

The headline and subheader tells us what you're offering, and the form header closes the deal. Over here you can explain why your offer is so great it's worth filling out a form for.

Remember:

  • Bullets are great
  • For spelling out benefits and
  • Turning visitors into leads.

DiversityNursing Blog

A quiet way of dealing

Posted by Alycia Sullivan

Wed, Oct 16, 2013 @ 02:44 PM

Topics: oncology, relationship, nurse, cancer, coping, patient

Psychological interventions a boon for patients with heart disease

Posted by Alycia Sullivan

Wed, Oct 16, 2013 @ 02:39 PM

Psychological interventions reduce by half deaths and cardiovascular events in patients with heart disease, according to a data analysis.

“The nurses on our coronary care unit observed that patients were less likely to have another heart attack, die or return to hospital when we talked to them about their treatment, played music for them or helped religious patients to say prayers,” Zoi Aggelopoulou, RN, PhD, a study author from NIMTS Veterans Hospital Athens in Greece, said in a news release. “It made us think that coronary heart disease is not just physical but also has a psychological component.

“We wanted to find out if others had observed the same thing, and whether psychological support had a real impact on the outcomes of patients with coronary heart disease.”

As presented in Madrid at the annual meeting of the Acute Cardiovascular Care Association of the European Society of Cardiology, researchers conducted a meta-analysis of nine randomized controlled trials that had been published previously. They evaluated whether psychological interventions could improve outcomes of patients with coronary heart disease when combined with a conventional rehabilitation program.

The researchers found the addition of psychological interventions reduced mortality and cardiovascular events by 55% after two years or more. The benefits were not significant during the first two years.

“We found a huge benefit of psychological interventions after two years, with less patients dying or having a cardiovascular event and therefore fewer repeat hospital visits,” Aggelopoulou said in the news release. “The interventions included talking to patients and their families about issues that were worrying them, relaxation exercise, music therapy and helping them to say prayers."

The researchers concluded psychological interventions should be incorporated into the rehabilitation of patients with coronary heart disease. “More clinical trials are needed to clarify which interventions are most effective and how they can best be implemented,” Aggelopoulou said in the news release.

“We can help our patients by simply talking to them or introducing new things like music therapy into our clinical practice,” she added. “Coronary units are busy places — in Greece we sometimes have one to two nurses for 10 to 20 patients in the coronary care unit, and we are under time pressure.

“But our finding that the addition of psychological support on top of physiological therapies reduces death and cardiovascular events by 55% should be a wakeup call that these interventions really do work. Preventing repeat hospital visits would free up the time we need to implement them.” 

Source: Nurse.com

Topics: intervention, psychological, cardiovascular, coronary, benefit, reduce

Family Nurse Practitioners and the Affordable Care Act

Posted by Alycia Sullivan

Wed, Oct 16, 2013 @ 01:23 PM

The Health Insurance Marketplace open enrollment launch on October 1, 2013 spurred discussion about the influx of newly insured patients and the shortage of primary care professionals. Nursing@Simmons, an online Master of Science in Nursing program for aspiring Family Nurse Practitioners, created an infographic to illustrate the state of primary and preventive health care in the U.S. and the role nursing professionals hold. This infographic provides a snapshot of what has happened in the years since the Affordable Care Act was conceptualized and enacted, in addition to showing how nurse practitioners are contributing to primary care.

Share the infographic below to raise awareness about the role that Family Nurse Practitioners play in health care reform under the Affordable Care Act.

nursingsimmons resized 600
Source: Simmons Nursing

Topics: affordable care act, health care reform, family nurse practitioner, health insurance marketplace, health professionals, master's in nursing, nursing school Blog, Family Nurse Practitioner Career, Visual Content, nurses, nurse practitioner

No More : Putting an end to domestic violence

Posted by Hannah McCaffrey

Wed, Oct 09, 2013 @ 10:15 AM

nomore logo

What is NO MORE?

NO MORE is a new unifying symbol designed to galvanize greater awareness and action to end domestic violence and sexual assault.  Supported by major organizations working to address these urgent issues, NO MORE is gaining support with Americans nationwide, sparking new conversations about these problems and moving this cause higher on the public agenda.

The history of NO MORE

The NO MORE symbol has been in the making since 2009. It was developed because despite the significant progress that has been made in the visibility of domestic violence and sexual assault, these problems affecting millions remain hidden and on the margins of public concern. Hundreds of representatives from the domestic violence and sexual assault prevention field came together and agreed that a new, overarching symbol, uniting all people working to end these problems, could have a dramatic impact on the public’s awareness.

The signature blue vanishing point originated from the concept of a zero – as in zero incidences of domestic violence and sexual assault. It was inspired by Christine Mau, a survivor of domestic violence and sexual abuse who is now the Director of European Designs at Kimberly-Clark. The symbol was designed by Sterling Brands, and focus group tested with diverse audiences across the country who agreed that the symbol was memorable, needed and important.

Who is behind NO MORE?

Every major domestic violence and sexual assault organization in the U.S. – from men’s organizations like A CALL TO MEN and Men Can Stop Rape, to the National Domestic Violence Hotline and the National Alliance to End Sexual Violence, to groups that help teens like Break the Cycle and Futures Without Violence, to organizations that advance the rights of women of Color and immigrants like Casa de Esperanza and SCESA to the U.S. Dept. of Justice’s Office on Violence Against Women – all of them and more are behind NO MORE.

View the complete list of organizations here.

What do we do?

NO MORE is spotlighting an invisible problem in a whole new way. The first unifying symbol to express support for ending domestic violence and sexual assault, NO MORE can be used by anyone who wants to normalize the conversation around these issues and help end domestic violence and sexual assault. Our vision is that NO MORE will be everywhere – on websites, t-shirts, billboards. Organizations and corporations, large and small, will embrace this symbol as their own. When an abuse case makes media headlines, you will instantly see NO MORE being tweeted, discussed on Facebook, worn as jewelry and on t-shirts; made into buttons and posted in classrooms, offices, billboards and grocery stores across the country. NO MORE will help end the stigma, shame and silence of domestic violence and sexual assault. NO MORE will help increase funding to prevent domestic violence and sexual assault.  Like the pink ribbon did for breast cancer and the red ribbon did for HIV/AIDS, NO MORE will help to change behaviors that lead to this violence.

Get the symbol today and start showing your support.

Why should I care?

The next time you’re in a room with 6 people, think about this:

  • 1 in 4 women experience violence from their partners in their lifetimes.
  • 1 in 3 teens experience sexual or physical abuse or threats from a boyfriend or girlfriend in one year.
  • 1 in 6 women are survivors of sexual assault.
  • 1 in 5 men have experienced some form of sexual victimization in their lives.
  • 1 in 4 women and 1 in 6 men were sexually abused before the age of 18.

These are not numbers. They’re our mothers, girlfriends, brothers, sisters, children, co-workers and friends. They’re the person you confide in most at work, the guy you play basketball with, the people in your book club, your poker buddy, your teenager’s best friend – or your teen, herself. The silence and shame must end for good.

How can I help?

There are hundreds of ways you can spread the word about NO MORE.

Say it: Learn about these issues and talk openly about them. Break the silence. Speak out. Seek help when you see this problem or harassment of any kind in your family, your community, your workplace or school. Upload your photo to the NO MORE gallery and tell us why you say NO MORE.

Share it: Help raise awareness about domestic violence and sexual assault by sharing NO MORE. Share the PSAs. Download the Tools to Say NO MORE and share NO MORE with everyone you know. Facebook it. Tweet it. Instagram it. Pin it.

Show it: Show NO MORE by wearing your NO MORE gear everyday, supporting partner groups working to end domestic violence and sexual assault and volunteering in your community.

Learn more here.

Topics: violence, sexual assault, no more, assault, nursing, nurse

Easing the mind

Posted by Alycia Sullivan

Wed, Oct 02, 2013 @ 11:16 AM

easingthemind resized 600

By Debra Anscombe Wood, RN

Psychiatric emergencies can be as serious as a medical condition, but in traditional EDs, mental health patients may wait for treatment. Specialized psychiatric EDs serve that population quickly and efficiently. “They come in with everything from the need for prescription refills to being actively suicidal,” said Brian Miluszusky, RN, BSN, director of nursing in the emergency medicine department at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York. “A suicidal person is as much at risk of dying as someone having an MI (myocardial infarction).” 

As demand for emergency care has increased, so has the number of mental health patients seeking services. A study from the Carolina Center for Health Informatics at the University of North Carolina at Chapel Hill reported in 2013 that nearly 10% of ED visits in North Carolina from 2008-2010 were for mental health diagnoses, and the rate of mental health related visits increased seven times more than overall ED visits. Mental health related ED visits increased by 17.7%, from 347,806 to 409,276 from 2008-2010. Stress, anxiety and depressive disorders were most common. 

A January 2012 American Hospital Association Trendwatch report said, “In 2009, more than 2 million discharges from community hospitals were for a primary diagnosis of mental illness or substance abuse disorder. ... Among children, mental health conditions were the fourth most common reason for admission to the hospital in 2009.”

The report said there were more than 5 million visits to EDs in 2009 by patients who had a primary diagnosis of mental illness or a substance abuse disorder. “Access to [psychiatric] care is not easily found [in the community], but if you are having a mental health crisis, you can walk into our emergency department 24/7 and be seen by a psychiatrist within a couple of hours,” said Jennifer Ziccardi-Colson, RN, MSN, BSW, MHA, vice president for nursing services at Carolinas Medical Center-Randolph, a behavioral health center with a psych ED and 66 inpatient beds in Charlotte, N.C. 

Psych EDs serve patients with acute episodes of behavioral health diagnoses, including feeling suicidal, anxious or depressed or abusing substances. “When patients come to us, they are assessed and seen promptly,” Ziccardi-Colson said. “People can feel comfortable coming to our environment to receive care.” 

Not all patients with mental illnesses receive care in a psych ED. Even at those hospitals with a dedicated psych emergency unit or a stand-alone psychiatric emergency services facility, patients with acute medical conditions, such as an MI or a broken hip, are treated in the regular ED. The ED provider must determine if a medical problem is contributing to mental status changes or if the problem is solely psychiatric in origin. 

Some psych EDs, such as San Francisco General Hospital and Carolinas Medical Center care for children as well as adults. Children and teens receive emergency psych services at Carolinas Medical Center-Randolph. Younger children, ages 3 to 6, come in with situational stress related to family dynamics, such as divorce or custody battles; depression or anxiety, often related to bullying at school or at home; suicidal ideation; conduct disorders; and behavioral issues related to autism or developmental delays. “In the emergency room, it’s crisis stabilization,” said Tez Bertiaux, RN, MSN, nurse manager for the ED at Carolinas Medical. “A lot of these children are followed in the community by a mental healthcare provider.”

The hospital’s social worker will arrange outpatient care for children who do not have a current therapist. Many are admitted to inpatient care. The psych emergency services program treats about 700 children and adolescents monthly, and the hospital admits about an equal number to its inpatient units, said Bertiaux.

Pediatric ED visits tend to increase during the school year, with school staff workers referring students for care. Some of the children are in foster care or are homeless or living in shelters. Some parents and guardians will stay during the stabilization and others do not. “It’s a very complex dynamic, because you are not just treating the patient — the family is involved,” Bertiaux said. 

Bertiaux said many of the mental health issues that bring children into the ED are related to their environment. “And that can be challenging,” she said.

Patients seeking care at a psych ED may be treated and discharged, but others require admission to a psychiatric bed for stabilization. Physicians at NewYork-Presbyterian and San Francisco General admit about 30% of their psych ED patients to the hospital. But treatment begins in the psych ED. “It’s amazing how much we can help people,” said Andrea Crowley, RN-BC, interim nurse manager in psychiatric emergency services at San Francisco General. “Some just need someone to talk to and bring them down from the crisis they are in. It makes you feel you are making a difference, and it’s a visible, tangible thing.” 

Psych care a growing need

Carolinas Medical has seen a steady increase in psych ED volume during the past several years. It treats about 18,500 patients annually with a variety of psych disorders and continuously operates at 100% occupancy. Construction is under way to double the psychiatric hospital’s inpatient beds to 132. 
Johns Hopkins Hospital in Baltimore’s psych ED census has experienced a 30% jump this year. “People are sicker, and there are fewer resources in the community,” said Kate Pontone, RN, MSN, nurse clinician 3 and nursing service line leader for Psychiatric Emergency Services at Johns Hopkins. “Outpatient programs that had space available are no longer options. People are running out of medications or cannot afford transportation. Many of the same reasons emergency departments are crowded.” 

A March 2012 Congressional briefing by the National Association of State Mental Health Program Directors reported, “the economic downturn has forced state budgets to cut approximately $4.35 billion in public mental health spending over the 2009-2012 period,” a trend it expects will continue. While at the same time, there was a 10% increase in consumers receiving state-supported mental health services. 

In July 2012, the Treatment Advocacy Center released the paper “No Room at the Inn: Trends and Consequences of Closing Public Psychiatric Hospitals,” which found nationwide, closures of such hospitals “reduced the number of beds available in the combined 50 states to 28% of the number considered necessary for minimally adequate inpatient psychiatric services.” And “in the absence of needed treatment and care, individuals in acute or chronic disabling psychiatric crisis increasingly gravitate to hospital emergency departments, jails and prisons.”

Volume at San Francisco General’s psych ED has jumped from 500 per month to 600 per month. “It could be due to closures in programs,” Crowley said. “We are starting to see a fallout from lack of services in the community.” 

Volume also has increased at NewYork-Presbyterian where, typically, a dozen or more psych patients are waiting in the regular ED for a bed in the psych ED, Miluszusky said. Difficulty transferring patients to an inpatient bed clogs up the EDs. A lack of insurance complicates transfers, and patients may end up boarding in a regular or psych ED. 

Patients may walk in, arrive by ambulance or with a petition for involuntary commitment, because they are deemed dangerous to themselves or others. First responders may take a mental health patient to a psych ED rather than to a community hospital without such specialized services. “This is a growing population, and emergency rooms will have to evolve,” Miluszusky said. “The population is getting so big; we are going to have to think of new ways to handle it.” 

Benefits of a separate psych ED

Psychiatric emergency services programs typically are staffed with behavioral health professionals, allowing mental health interventions to begin quickly, and often the onsite team can stabilize the patient, avoiding a hospitalization, according to the article “Treatment of Psychiatric Patients in Emergency Settings” in the journal Primary Psychiatry. “You don’t have agitated psych patients in the emergency room with all of the sick people,” Crowley said. “It’s a specialized environment where you can begin treatment better.”

Nurses and other members of the psych ED team have a solid understanding about different mental health conditions and their treatment. They can begin therapeutically talking with patients immediately. “Our patients appreciate being cared for by someone who is familiar with their medications and their symptoms and can intervene when they begin to decompensate,” Pontone said. “You get specialized care and the rooms are safe,” said Miluszusky, who adds that improves outcomes. 

Psych EDs often are locked units and feature specially outfitted rooms, with no sharp corners, no cords, nonexposed plumbing and a calm atmosphere. The safety features prevent patients from harming themselves or creating tools to harm others. “Our main priority is patient safety,” Ziccardi-Colson said. “There’s no potential for suicide or other negative outcomes.”

Ziccardi-Colson reported Carolinas Medical’s psych ED operates cost effectively, in part because of its ability to begin treatment and stabilize. “We’re able to process people more quickly than a medical ED,” Ziccardi-Colson said. 

Miluszusky said having a psych ED can be cost effective, because it reduces overtime pay necessitated by providing one-on-one oversight of a psych patient in the medical ED. 

Nurse staffing varies by institution, often with psychiatric nurses providing care, such as at San Francisco General’s psych ED. “It’s an exciting job, where you see a wide variety of people,” Crowley said. “You have a profound effect on people’s lives.”

Emergency nurses, who have received specialized training in the care of mental health patients and de-escalating situations, staff the psych ED at NewYork-Presbyterian. Nurses from a Johns Hopkins inpatient psych unit covers the emergency room, and Pontone describes significant interest from the inpatient staff. The hospital also cross-trains the ED nurses, so they can step in during an emergency. Pontone says nurses who love psychiatric nursing are interested in the management of the acutely ill patient, who needs as much care and support as they can get in a safe environment. “We like to be there when patients are in crisis and need help,” she said. “And we are good in a crisis.”

Ziccardi-Colson said every day presents challenges, but the reward of helping patients to wellness is inspiring and keeps nurses motivated. “Those who like it, love it,” Crowley said. “And for those who are not into it, we are happy to do it for them.” 

Source: Nurse.com

Topics: mental health, ED, nursing, patient, care

When Nurses Bond With Their Patients

Posted by Alycia Sullivan

Wed, Oct 02, 2013 @ 11:10 AM

describe the image
As nurses we are taught that we are professionals and we must maintain a certain emotional distance with our patients. It’s a boundary that encompasses the therapeutic relationship: nurses as caregivers, patients as the recipients of the care. But now, working as a nurse, I have found that while most of my professional boundaries are well defined, sometimes the line between a professional and personal relationship with a patient can become blurred.
Sarah Horstmann, R.N.

I work on an orthopedic surgical unit where most patients are coming in and going out very frequently. That makes it hard to get to know anyone too well. But there are some patients that we never forget, for good or bad reasons. Most of the time these patients stay with us because, for whatever reason, one of us crossed the invisible boundary nurses set for themselves.

Recently, I cared for two patients who touched me so deeply it was impossible to maintain a professional distance. My grandfather had recently passed away, and both of these men reminded me of him. My grandfather, or “Grand-Daddy” as we all called him, was one-of-a-kind, and one of the kindest and most generous people I’ve ever met. He was hard of hearing but constantly fiddled around with his hearing aids, so it was wise to always be prepared to repeat yourself once or twice. He had an extraordinary memory until the day he died, and was one of the funniest people I’ve ever known.

One day at work, an older man arrived on my floor after a total hip replacement. As I worked to admit him to our care, his room was crowded with half a dozen family members who surrounded him with love. I asked him about his family, and he told me about his eight children, 30 grandchildren, and a couple of great-grandchildren too. It was uncanny how much this man reminded me of my grandfather, who also had a large family of six children, 28 grandchildren and three great grandchildren.

I smiled as I watched my patient fiddle with his hearing aids, and tears welled up in my eyes as he answered all of my questions with a familiar, “What did you say?” I didn’t mind repeating myself, and for a moment, it was as if I was speaking with my grandfather again.

After I was finished admitting him and settling him in, I found myself constantly peeking back into his room asking if he was O.K. and if he needed anything. He was pretty low-maintenance and never really needed much, and eventually, he was gone. I never told him that he reminded me of my grandfather, or how he tugged at my heartstrings, and I often wonder if I should have. But I worried that in showing this man a little extra attention, I had somehow breached the therapeutic relationship.

Not long after that, another patient came up to the floor. The report said he was an older man who was in “comfort care.” This essentially means that no lifesaving efforts would be made on his behalf; we were there to keep him comfortable during his final days. When this patient came up to the floor, I was quite taken by him. His gruff, Irish exterior belied his sweet nature. Medically, he had a lot of issues, but when he came up to the floor, the only thing he wanted was a bowl of oatmeal. When his tray came, he found cream of wheat instead. He was so disappointed, but I was determined to find him a bowl of oatmeal.

Miraculously, after a search through our floor kitchen, I found oatmeal and delivered it to him. He was delighted and blew me a kiss and gave me a wink. His chart said he needed assistance to eat, but he dug right in. Sure, he made a mess, but he managed just fine on his own.

Watching him eat that oatmeal reminded me of some of my last meals with Grand-Daddy. Grand-Daddy never was the neatest eater, and we would always laugh about what a mess he made. But he didn’t care — at his age, he just wanted what he wanted when he wanted it. My patient’s personality was strikingly similar to that of my grandfather. As he lay curled up in the bed, I thought about the strong man he must have been a long time ago.

When his wife and children came to the room, I felt a pang of familiarity. His wife remained so graciously composed during her visits. It brought back memories of my grandmother during my grandfather’s last days. Despite her deep sadness and fear of what was to come, my grandmother kept full composure and took care of not only him but also everyone around her. I still am amazed by how strong and selfless she was during that time: a true role model for unconditional love, and I saw these saintly qualities in this man’s wife.

The following day, the man was sent back to a nursing home where comfort care would be resumed. When the transporters came to get him, I started to feel emotional, like someone I loved was going to leave me. Even though I knew he was going to a nice and comfortable facility, I didn’t want him to go. We transferred him onto the stretcher and I made him cozy in his blankets. His family was sincerely thankful, and I remember telling them with tears in my eyes how much we enjoyed taking care of him, and how much we would miss him.

The tears continued to well up as I watched his stretcher go around the corner and out of sight, because I knew I would never see him again. I felt like I was saying goodbye not only to him, but also to my grandfather all over again. But once again, I stopped myself from sharing these feelings with my patient or his family. They knew I cared, but they never knew how much caring for him meant to me personally.

Looking back, I still don’t know if I did the right thing, keeping my feelings to myself. I now realize that both of these patients were helping me heal, even as I was helping them. Watching them leave was like letting go of my grandfather again, but they also gave me the gifts of laughter and reminiscence, right when I needed them most.

I know that, ultimately, I am still just the nurse, and they are still just my patients. But I think it’s better for both the patients and myself if we both sometimes allow ourselves to feel something more than a professional bond. Nurses and patients move in and out of each others’ lives so quickly, but we are nonetheless changed by every encounter.

I became a nurse because I want to care for people and make a difference. Being touched in return is an added bonus.

Source: The New York Times

Topics: professional vs personal, nurse, patient, care, compassion

Dear NICU Nurse

Posted by Alycia Sullivan

Wed, Oct 02, 2013 @ 10:58 AM

Dear NICU Nurse,

To be honest, I never knew you existed. Back when our birth plan included a fat baby, balloons and a two-day celebratory hospital stay, I had never seen you. I had never seen a NICU. Most of the world hasn't. There may have been a brief, "This is the Neonatal floor" whilst drudging by on a hospital tour. But no one really knows what happens behind those alarm-secured, no-window-gazing doors of the NICU. Except me. And you.

2013-09-15-tcker.jpg

I didn't know that you would be the one to hold and rock my baby when I wasn't there. I didn't know that you would be the one to take care of him the first five months of his life as I sat bedside, watching and wishing that I was you. I didn't know that you would be the one to hand him to me for the first time, three weeks after he was born. That you would know his signals, his faces, and his cries. Sometimes better than me. I didn't know you. I didn't know how intertwined our lives would become.

I know you now. I'll never be able to think of my child's life without thinking of you.

I know that in the NICU, you really run things. That your opinions about my baby's care often dictates the course and direction or treatment as you consult with the neonatologist every day. I know that you don't hesitate to wake a sometimes-sleeping doctor in the nearby call room because my baby's blood gas number is bad. Or because his color is off. Or because he has had four bradys in the last 45 minutes. Or because there's residual brown gunk in his OG tube.

I know now that you are different from other nurses.

I know that, at times, you are assigned to just one baby for 12 hours straight. You are assigned to him because he is the most critically-sick and medically fragile baby in the unit. I've seen you sit by that baby's bedside for your entire shift. Working tirelessly to get him comfortable and stable. Forgoing breaks while you mentally will his numbers to improve. I've seen you cry with his family when he doesn't make it. I've seen you cry alone.

I've seen you, in an instant, come together as a team when chaos ensues. And let's be honest, chaos and NICU are interchangeable words. When the beeper goes off signaling emergency 24-weeker triplets are incoming. When three babies in the same pod are crashing at the same time. When the power goes off and you're working from generators. In those all too often chaotic moments, you know that time is more critical in this unit than any other, and you don't waste it. You bond together instantly as a team, methodically resolving the crisis until the normal NICU rhythm is restored.

Yes. I know you now. I'll never be able to give in return what you have given to me. Thank you for answering my endless questions, even when I had asked them before. Thank you for your skill; you are pretty great at what you do. Thank you for fighting for my baby. Thank you for pretending like it was normal when I handed you a vial of just pumped breast milk. Thank you for agreeing to play Beatles lullabies in my baby's crib when I was gone. Thank you for waking the doctor. Thank you for texting me pictures of my sweet miracle, even when it was against hospital policy. Thank you for crying with me on the day we were discharged.

Most of the world still doesn't know what you do. They can't understand how integral you are to the positive outcomes of these babies who started life so critically ill. But I do. I know you now. I will never forget you. In fact, our story can never be told without mentioning you. So the next time you wave your access card to enter the place that few eyes have seen, know that you are appreciated. I know you, and you are pretty amazing.

Your fan forever,

A NICU mom

This post originally appeared on Preemie Babies 101  

Source: Huffington Post 

Topics: Dear Nicu Nurse, Neonatal Intensive Care, Neonatal Intensive Care Unit, New Mother, Nicu Nurse, Nicu Nurses, Moms, Preemie, Preemie Babies, Preemies, Premature Babies, Parents News, NICU

New toolkit guides clinicians in handling lab test results

Posted by Alycia Sullivan

Wed, Sep 25, 2013 @ 11:07 AM

The Agency for Healthcare Research and Quality released a toolkit to help nurses, physicians and medical office staff improve their processes for tracking, reporting and following up with patients after medical laboratory tests.

The toolkit is part of the agency’s effort to make care safer for patients in all settings, according to a news release. AHRQ is a branch of the federal Department of Health and Human Services.

About 40% of primary care office visits involve some type of diagnostic medical test provided on site or at a laboratory, according to the news release. However, if test results are lost,results resized 600 incorrect or incomplete, the wrong treatment may be prescribed and patient harm can occur.

“Improving Your Office Testing Process: Toolkit for Rapid-Cycle Patient Safety and Quality Improvement” offers step-by-step instructions on how to evaluate an office testing process, identify areas where improvement is needed and address those areas. Practical tools are included that can be used to assess office readiness, plan activities, engage patients, audit efforts and incorporate electronic health records. The toolkit also includes a template for practices to ensure that laboratory test results are communicated effectively to patients in English or Spanish.

The toolkit was developed by a team of researchers led by Milton “Mickey” Eder, PhD, director of research and evaluation at Access Community Health Network in Chicago, a large network of community health centers. A national panel of primary care experts contributed, and the toolkit was tested in the Access network.

“The toolkit was developed in a network of federally qualified health centers, but studies indicate that all types of primary care offices experience problems managing tests,” Eder said in a news release. “Clinicians and staff handle a lot of lab test results, and unfortunately mistakes happen. Results can get lost or misreported or patients may not understand how to follow up, and sometimes these mistakes can have serious consequences.”

Toolkit information: www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/ambulatory-care/office-testing-toolkit

Source: Nurse.com

Topics: quality, improvement, toolkit, lab test results

TV may reinforce stereotypes about men in nursing

Posted by Alycia Sullivan

Wed, Sep 25, 2013 @ 10:49 AM

By Rob Goodier

(Reuters Health) - Fictional male nurses on television are sidelined in supporting roles, portrayed as the butt of jokes and cast as commentary providers or minority representatives, all of which makes it harder in reality to recruit men to nursing and retain them, according to a new study.

"People don't make decisions about which profession to choose just based on television, but students have told us that popular TV shows can help them choose a career, or that TV perpetuates negative stereotypes about nursing that they then have to address in practice," said Dr. Roslyn Weaver, an adjunct fellow at the University of Western Sydney School of Nursing and Midwifery, who led the research.

"So when men in nursing are almost invisible in popular culture or are stereotyped as incompetent or somehow ‘unmasculine', then men who choose to enter nursing can find it difficult to combat this," Weaver told Reuters Health by email. "Perhaps reflecting this, there are often higher attrition rates for male students than female students in nursing."

In the United States men account for roughly 9 percent of nurses, according to the census bureau. And that figure is similar in the United Kingdom and Australia.

Past research has documented "stereotypical images around nursing, such as the battle-axe, naughty nurse and handmaiden," Weaver and her colleagues write in the Journal of Advanced Nursing.

With a growing number of men entering the profession, the authors point out, it's just asdescribe the image important to examine how male nurses are portrayed in popular culture.

For their study, the researchers viewed one season of each of five American medical television dramas, including Grey's Anatomy, Hawthorne, Mercy, Nurse Jackie and Private Practice. They evaluated aspects of the episodes such as dialogue, costumes, casting, cinematography and editing to compile a perspective on the ways that male nurses are characterized.

To their credit, the shows tended to expose and reject stereotypes. But, in a contradictory
trend, they also reinforced the clichés by characterizing male nurses as men who are not traditionally masculine, the researchers found.

Common stereotypes that the shows reinforced include the nurse who is mistaken for a doctor and the gay or emasculated male nurse. Male nurses and midwives in the shows tend to suffer condescension from their colleagues and patients and are the object of comedy.

The male nurse characters also tend to hit multiple diversity targets in casting. The researchers coined the term "minority loading" to denote characters who represent more than one minority group, such as Angel Garcia on Mercy, a gay Hispanic male nurse, and Mo-Mo on Nurse Jackie, a gay Muslim male nurse.

The results were "pretty consistent" with a prior study of male nurses in film that Dr. David Stanley, an associate professor of nursing at the University of Western Australia, published in 2012.

"Apart from 'Nurse Jackie' the medical programs used in the analysis reflected programs aimed at a medically focused perspective of health where nursing is seen lower in relative status and where male nurses are seen as lower still," said Stanley, who was not involved in the current study.

Some of the stereotypes may persist off screen. Male nurses can be regarded as lazy or more readily promoted, Stanley told Reuters Health, though generally they are accepted by patients and female nurses alike.

Being in the minority may put male nurses at a disadvantage, Weaver said. "This not only means men might be stereotyped but they can also be excluded from particular clinical specialties, face difficulties dealing with older female patients and be expected to do more ‘masculine' work such as heavier manual work."

Improving recruitment efforts could help, and fewer negative stereotypes in television programs might make a difference, the researchers say.

SOURCE: bit.ly/18axZ9m Journal of Advanced Nursing, online September 4, 2003.

Topics: male nurse, minority, TV, stereotype

Wealth of opportunity

Posted by Alycia Sullivan

Mon, Sep 23, 2013 @ 10:27 AM

describe the imagemoney resized 600

By Heather Stringer

For several years, Russell Atkins, RN, CEN, earned about $100,000 annually as a traveling nurse working in EDs and ICUs, but beginning in 2009 he started seeing a disturbing trend. The job assignments in higher-paying states such as California and Massachusetts were increasingly rare, and his hourly wage dropped roughly 20% within a year.

Desperate to provide for his wife and two children, Atkins could no longer afford the unpredictable assignments. He accepted a lower-paying, but permanent, job in his home town of Bastrop, La. 

 
Atkins is not alone. Most nurses throughout the country are feeling the impact of significant national factors, such as the recession and healthcare reform, that are changing the landscape of nursing jobs.

“Nurse salaries — and really salaries for any profession — are generally determined by supply and demand,” said Joanne Spetz, PhD, a noted healthcare and nursing economics researcher and professor at the Institute for Health Policy Studies, University of California, San Francisco. “What we’ve been seeing in California is that the wages of nurses really flattened out and may have even dropped in the past four years after a period of rapid wage growth.”

According to data from a 2012 survey from the California Board of Registered Nursing, the annual salary of nurses in California increased from $45,073 to $81,428 between 1997 and 2008. In the past five years, however, salaries flattened and even dropped between 2010 and 2012. 

 
RNs across the nation are experiencing a similar trend, according to data from the U.S. Bureau of Labor Statistics. Starting in 2009, the median annual wage increases were 2% or less, compared with double or triple that percentage the previous five years. Between 2011 and 2012, the latest data available, the median annual wage for RNs nationally increased only 1%, from $69,110 to $69,935. Data from the American Association of Colleges of Nursing shows that nurse faculty salaries are stagnating as well.

Although many hospitals have become more conservative in hiring nurses, Spetz suggested there are strategies nurses can use to increase their chances of securing a desirable position in the long run. “I know a lot of new graduates like to look for the perfect job, but if the labor market is tight in your area, just get a job because some experience will make you more competitive and help you get that perfect job in the future,” she said. “If you are an associate-degree graduate and can go back to school, do it.”

For Atkins, the willingness to be flexible paid off in the short term. After a year as director of an ED in Louisiana, he was recruited to fill an interim ED director position at a larger hospital system in Missouri. Although the position was short-term, he hoped the experience would help him eventually land a position in California. Then the call came: A traveling company recruited him for an interim position in California. This interim position eventually turned into a full-time permanent role as house and bed control supervisor at Kaiser Permanente in Hayward, Calif., with an annual salary well above any of his previous salaries.

“During my previous director roles, I tried to learn everything possible about budgets, audits and the hospital, such as how to set up an incident command center and emergency response teams,” Atkins said. “Now I absolutely love my job, and my hours allow me to be home with my children in the evening.”

Forces at work

While recessions and salary changes tend to be cyclical, the future is less predictable with the convergence of several national trends.

“The first factor is the real impact healthcare reform will have, and a lot of that is relatively unknown,” said Terry Bennett, RN, MS, CHCR, president of the National Association for Health Care Recruitment, based in Lenexa, Kan. “Organizations are struggling to predict the impact of decreasing physician and Medicare reimbursements, and they are really trying to maintain financial security. They are not giving the same type of market adjustments that they used to [give nurses], and some are decreasing the amount of merit increases given to nurses.”

In addition, the supply of nurses has increased in the past decade as a growing number of nursing school graduates join baby boomers still on the job, Spetz said. “The baby boomers have been more career-focused than any generation preceding them,” she said. “They might not want to fully retire even if the recession lifts.” 

 
However, other factors could increase demand for RNs and drive up salaries. “What we would expect is that as the economy improves and as the Affordable Care Act allows more people with insurance to seek healthcare, we would see demand for nurses go up,” said Spetz. “Also, as baby boomers age and require more healthcare, this could also drive up demand for services.”

Nurse staffing ratio laws also may increase the number of positions available in hospitals, said Brannen Betz, general manager of Aureus Medical Group, a national nurse staffing company. According to the American Nurses Association, 15 states have enacted legislation or adopted regulations to address nurse staffing. “Many states are moving toward mandating nurse-to-patient ratios, and this could be the best thing that happens to nurses,” Betz said. 

 
Maximum trajectory

As healthcare employers prepare for these changes, nurses can position themselves to stand out from their competition.

“We are no longer just putting someone in the job because they have a credential,” said Julie Hill, RN, BSN, CHCR, RACR, recruitment coordinator for Georgetown Hospital System in South Carolina and vice president of NAHCR. “Now we have a larger applicant pool, so we can select the best nurse for the job. Many hospitals use behavioral assessment tools so they can make sure that an individual has the positive service attributes that lead to good hospital consumer assessment scores and less likelihood of turnover.”

Georgetown uses a behavioral assessment tool combined with a separate reference assessment tool, Hill said. Hospitals are looking for nurses who are flexible, customer-focused, compassionate, have a strong work ethic and work well with team members, she said.

Nurses with specialty training also are in higher demand, said Kay Cowling, CEO of Fastaff Travel Nursing, based in Denver. Nurses with experience in ORs, labor and delivery, cardiovascular ICUs or pediatric areas have more options, Cowling said. RNs who know how to use electronic health record systems also have an advantage in the job market, she said. 

Advanced education also can open doors, said Jean Moore, RN, MSN, director of the Center for Health Workforce Studies at the SUNY Albany School of Public Health. “The demand for nurse practitioners will grow as we face an emerging primary physician shortage.”

Nurse practitioners also earn significantly more than most RNs. According to the BLS, their mean annual wage in 2012 was $91,450. Nurse midwives earned $91,070 and nurse anesthetists earned $154,390.

For those who cannot pursue higher education, Atkins’ story suggests that an ideal job can be secured through other routes. A willingness to relocate, which put him in situations where he was forced to learn new skills, provided clear advantages. “As nurses, we need to be willing to try new things and work in new types of settings and with different types of technology,” Bennett, NAHCR president, said. “Take advantage of opportunities to learn within your current setting or try to prepare for new settings that may become available.” 

(Please click pdf links below to view or download nursing salary charts related to this story)

Source: Nurse.com

Topics: RN, nurses, salary, pay rate, career choice

Recent Jobs

Article or Blog Submissions

If you are interested in submitting content for our Blog, please ensure it fits the criteria below:
  • Relevant information for Nurses
  • Does NOT promote a product
  • Informative about Diversity, Inclusion & Cultural Competence

Agreement to publish on our DiversityNursing.com Blog is at our sole discretion.

Thank you

Subscribe to Email our eNewsletter

Recent Posts

Posts by Topic

see all