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DiversityNursing Blog

Boston Nurse Begins 26 Acts Of Kindness, Pt. 2; Urges Others to Join In

Posted by Alycia Sullivan

Fri, Apr 26, 2013 @ 03:56 PM

By Elizabeth McNamara

Editor's Note: This article was originally published by our Patch family at Fenway-Kenmore Patch.

After the tragedy in Newtown, Conn., in December, in which a gunman killed 26 people at Sandy Hook Elementary School, Stephanie Zanotti of Charlestown, Mass., was inspired by the suggestion to complete 26 acts of kindness as a response. In the wake of the bombings at the Boston Marathon on Monday, Zanotti decided it was time for Part Two of those 26 acts of kindness.

"I am participating in 26 acts of kindness for the victims at the 26th mile of the Boston Marathon," she wrote on her Facebook page. Using Facebook and Instagram, she is chronicling her acts and hoping to inspire others to do the same.

"It's forcing me to think about how you can make someone's day a little lighter, a little brighter," she said Saturday.

She stresses the acts can be as simple as paying for the person's cup of coffee behind you indescribe the image line at your favorite coffee shop or dropping off some candy at your local fire department – both things she did during her Newtown acts.

So far, Zanotti has completed two acts in this new cycle: she has promoted the sale of a T-shirt designed by a friend in which all proceeds will go to One Fund Boston. And she signed up her dog Lucy, a rescue dog with only three legs, in a dog therapy program. (The t-shirt and Lucy are pictured, right.)

Zanotti is a nurse at Brigham & Women's Hospital and has seen the power of therapy dogs for patients. Knowing that several of the bombing victims have had limbs amputated, Zanotti realized her dog in particular could provide special inspiration.

She said she's speaking out about her actions to raise awareness and, she hopes, to inspire others to follow suit. The realization that the bombings happened at the 26th mile and the parallel with Newtown's 26 school victims was powerful to Zanotti.

"Unfortunately, the '26' theme again," she said. But at a time when so many people want to dosomething in response to the events of the past several days, Zanotti's found a way to be both creative and kind. 

Source: Woodbury-Middlebury Patch

Topics: 26 acts of kindness, Boston Marathon bombings, One Fund Boston, nurse

Santa Fe man changes careers, pursues ‘new life’ as nurse

Posted by Alycia Sullivan

Fri, Apr 26, 2013 @ 03:47 PM

By: Deborah Busemeyer

FreSanta Fe man finds ‘new life’ as a nurse  d Koch paused in front of hospital room 3209 when he noticed a patient he had discharged moments earlier passing by on his way home. Koch, holding an IV bag in one hand, reached out with his other to shake the patient’s hand.

“You take care, sir,” Koch said.

Koch continued into the room with Shauna Star, who is in charge of Koch’s four-month initiation training before Koch can care for patients by himself at Christus St. Vincent Regional Medical Center. The registered nurses worked together to increase the patient’s dose of pain medication through the IV.

They were on the third floor of the hospital in unit 3200, which is considered a “step-down” unit, meaning patients are usually stabilized and on their way home. The unit is where patients are prepped for surgery, while others there are recovering. Some won’t recover, and the nurses make sure they are comfortable in their final stages of life.

“Everyone in here is someone’s brother, sister, mother, father,” Koch, 51, said between checking on patients. “You’re taking care of someone’s family, so that’s a big responsibility and an honor to do that.”

Koch doesn’t shy away from big responsibility. At 48, the high school graduate who worked as an artist returned to school to pursue nursing while working full time as a medical technician and caring for his two sons, then 4 and 7. He quit his 20-year job as a goldsmith because he said the travel required to promote his high-end jewelry took him away from his children too much when his 12-year marriage ended.

His decision to switch careers was also about securing a future during uncertain economic times for himself and his two sons — Charle, now 10 and in fifth grade at El Dorado Community School, and 12-year-old William, a seventh-grader at the Academy for Technology and the Classics.

However, investing in school might not have been possible for Koch without the financial support he received from his employer, Christus St. Vincent Regional Medical Center.

“St. Vincent gave me a new life,” he said. “I worked for it. They give you an opportunity if you’re willing to work for it. It’s quite a huge thing for a big corporation to do that.”

Koch is one of 500 part-time and full-time nurses Christus St. Vincent employs. In March, the hospital held a ceremony honoring Koch and 11 other employees who received scholarships to support their nursing education. The medical center and St. Vincent Hospital Foundation reimburses hospital employees for tuition and living expenses, as well as awards scholarships specifically for nursing students.

The hospital spent $120,000 on scholarships this year, according to hospital spokeswoman Mandi Kane. Scholarships provide each recipient with $13,500 a year, for up to two years, to cover tuition and a $1,000 monthly stipend for up to 10 months per year for two years. In addition, employees pursuing higher education are eligible for reimbursement of up to $1,500.

Generally, employees who receive scholarships are those who work in entry-level positions and are from Northern New Mexico, said Julia Vasquez, manager of organizational development at the medical center. She said the hospital usually awards 10 scholarships a year.

“We would like to have more of our community being taken care of by our community,” Vasquez said. “They represent the people we are caring for. If we can give scholarships to people working entry-level jobs, it’s an advantage to us to have those folks vested in our hospital. We are looking for that community connection.”

It’s hard to find scholarships that support nursing students in Santa Fe, according to Jenny Landen, director of nursing education at Santa Fe Community College.

She said about half of her students have financial aid or loans, but the ones with scholarships typically are Christus employees. She encourages nursing students not to work because the full-time program is rigorous and demanding.

“The reality is most of my students have to work,” she said. “A lot of them are supporting spouses and have children. Some are single parents. In this day and age, it’s rare to have a young, single student who doesn’t have financial obligations. What I see happening a lot is they end up having to work more than they should, and it’s a stress on their personal life, and I see it in how they perform academically.

They get sick, fall asleep in class and struggle to keep up with their studies. “It causes aSanta Fe man finds ‘new life’ as a nurse great strain on their education while they are here,” she said.

Landen is working on how to increase nursing enrollment through part-time options with evening and weekend classes.

“I lose a few very solid nursing candidates every semester because they need a part-time program so they can work,” Landen said. “We are looking at trying to create another option for students that would address their financial issues.”

Offering part-time options could also help grow the number of nurses in the state. Increasing the number of nurses has become a critical issue as New Mexico, along with the rest of the country, grapples with nursing shortages. National health and nursing organizations forecast rising shortages due to population growth and retiring nurses. At the same time, nursing is the top occupation in terms of job growth through 2020, according to employment projections released by the U.S. Bureau of Labor Statistics in February 2012.

Hospitals are trying to address nursing shortages with educational strategies such as offering scholarships to workers, according to a 2006 article, “Hospitals’ Responses to Nurse Staffing Shortages,” in Health Affairs. Authors reported that 97 percent of surveyed hospitals were using such strategies. The article called for more public financing to expand nursing schools.

National efforts to address nursing shortages focus on educating more nurses, but many educational institutions can’t keep up with the demand. Santa Fe Community College receives twice as many applicants as it has spots, Landen said. When the college receives legislative money for the nursing program, Landen said she needs to spend it on her small faculty.

While Landen is trying to expand educational options, she is also considering how to better support students. She said she may apply for a grant from the New Mexico Board of Nursing’s Nursing Excellence Fund to offer scholarships to students.

Koch talked about his time as a student a week after he received his RN license. He sat at his long dining room table, where he did homework with his sons, in the home he bought two years ago. He lives in one of the new, south-side neighborhoods that border Dinosaur Trail. His humble demeanor turns prideful when he talks about his sons and how they have separate bedrooms for the first time since his divorce.

“I’m in a much better place now for me and my children,” he said. “The hospital and through their scholarship enabled me to move on with my life.”

Even with the scholarship money, Koch said he might not have attempted the nursing program if he knew how hard it would be to juggle children, work and school. As a native of Ontario, Canada, his credits didn’t transfer, so he had to complete two years of prerequisites before starting his nursing education at Santa Fe Community College. He took classes year-round, worked weekends for four years and managed three 12-hour shifts a week.

“What’s the alternative to all this? Failure? If you have kids, failure is just not an option,” Koch said. “You have to get yourself through life. You have to get your kids through life and give them the tools they need.”

He remembers late study sessions and bleary-eyed mornings when he would wrap his sons in blankets and drive the sleeping boys in the dark to a friend’s house. They would sleep on the friend’s couch while Koch started clinical rounds at the hospital, seven hours after he had finished his last shift.

“Getting the scholarship was one thing, but it was actually more than that,” Koch said. “I had the support of management to let my schedule be flexible enough that I could still work, make an income and go to school.”

Koch is among the first new nurses to start work in the hospital’s float pool, which involves getting assigned to any unit that needs help that day. He finds out where to go 15 minutes before his 7 a.m. shift starts. For a former volunteer firefighter and a man who thrives on challenges, Koch appreciates learning everything he can to be an effective nurse.

“Working at St. Vincent solidified what an honorable thing it is to care for another human being,” he said. “It doesn’t just touch that person but it touches that person’s family and other generations if you can help someone stay well. It’s important work.”

The first in his family to have a college degree, Koch expects that nurses will be required to have bachelor’s degrees at some point. He is planning to start classes this fall to achieve his bachelor’s degree in science.

“No matter where you are in life, you can succeed,” he said.

Source: Santa Fe New Mexican

Topics: male nurse, switch, compassionate, financial support, career

Free the Nurses

Posted by Alycia Sullivan

Fri, Apr 26, 2013 @ 03:40 PM

By 

A nurse practitioner, checks a patient'x blood pressure in Lodi, Ohio July 9, 2012. As of early April, you can walk into Walgreens in 18 states (plus D.C.), and along with a gallon of skim milk, a pair of photo mugs, a six-pack of toilet paper, and a flu shot, you can meet your new primary care provider, get your cholesterol checked, pick up your statin, and schedule a return visit. That primary care provider will not be a physician but a nurse practitioner (or a physician assistant, but that’s for another article). Those states, and now Walgreens, have recognized that nurse practitioners can handle a lot more than antibiotics for urinary tract infections: They can practice primary care just fine without physician oversight. And it’s a pretty smart move.

Lagging behind are the other 32 states (thismap lays it out), in which nurse practitioners are supervised to varying degrees by physicians, the scope of their practice restricted by laws that vary from state to state. In some states, nurse practitioners can’t enroll a patient in hospice, order a wheelchair, or prescribe certain medicines without a doctor’s signature. This is true even when it’s impractical geographically and financially, not to mention belittling. Nurse practitioners in a number of states, including Connecticut, Nevada, and West Virginia, are currently pushing for legislation for the right to practice independently and improve access to care.

The time is ripe: Despite new medical schools designed to attract students interested in primary care, the long dwindle of interest in the field has left a gaping hole, and it’s growing. When an additional 32 million or so Americans are covered through the Affordable Care Act next year, the primary care physician shortage could be catastrophic; it’s estimated to climb as high as 45,000 too few primary care physicians by 2020. Anyone who’s looked for a new physician recently has probably heard some variant of this: “The doctor isn’t taking new patients, but you can see the nurse practitioner or the physician assistant.”

When I called Linda Pellico, associate professor at the Yale School of Nursing and director of the Graduate Entry Prespecialty in Nursing program, she didn’t mince words. “Lifting the barriers on the scope of practice will solve the health care dilemma,” she said, pointing me to the nearly 700-page 2010 report by the Institute of Medicine called “The Future of Nursing.” The document, co-authored by Donna Shalala, recommends that nurse practitioners practice independently, without restrictions, to the “full extent of their education and training.”

The nurse practitioners I’ve worked with as colleagues (I’m a primary care doctor, and I’ve practiced in clinics in Baltimore, New York, and Connecticut), and those who have taken care of me have been pretty awesome. When I was pregnant, I saw a middle-aged lanky nurse midwife who had a wry and down-to-earth sense of humor. He didn’t exude that sense of impatience that you get with so many doctors, that feeling that you’re holding him up from something more important. When I have questions about my very old patients, many of whom have dementia complicated by agitation or insomnia and who are not responsive to my usual bag of tricks, my go-to person is not a psychiatrist—she’s a gerontological nurse practitioner.   

For some doctors, a larger number of independent nurse practitioners would be great news: John Schumann, a general internist who runs the University of Oklahoma–Tulsa internal medicine residency program, told me that he welcomes all hands on deck: “We should be happy when people from other career lines want to work in primary care. Primary care is hard and undervalued, and doctors should not have a monopoly on it.”    

So I was surprised when some of the most open-minded doctors I know hesitated before offering their take on the issue. Most echoed some of the concerns of the major physicians' organizations: If collaboration with a physician becomes optional, will nurse practitioners know when to ask for help? And if primary care doctors need to attend four years of medical school and three of residency, can just three years of nurse practitioner postgraduate training create competent clinicians?   

But making a head-to-head comparison is tricky. Unlike the broader and basic science-heavy education of medical students, nurse practitioner students (many already having a few years of nursing experience) get practical right away and select a specialty— such as pediatrics, geriatrics, anesthesia, family, or midwifery—immediately upon beginning their training. During the corresponding years, medical students are studying subjects like embryology and biochemistry and learning the basics of how to talk to patients. Once nurse practitioners graduate, some opt for a year of additional training in a nurse practitioner residency program. (Newly minted doctors at that point will have chosen a residency specialty and will embark on at least three more years of training.) A few more years in training and nurse practitioners can earn a doctorate in clinical nursing—a DNP, which the Institute of Medicine report recommends for all advanced-practice nurses as of 2015.

Meanwhile, medical training is getting a makeover, so the difference between nurse practitioners and doctors—at least in terms of years of training—is lessening. The 100-year-old paradigm is on the chopping block in many medical schools, and some schools and hospitals are already cutting the length of med school and residency training. (Let’s not even get into the outdated prerequisites for med school. Suffice it to say that I learned more about caring for patients by reading Chekhov than studying organic chemistry.) According to Ezekiel Emanuel, doctors' training could be shortened by about 30 percent. Medical-school graduates of six-year training programs (which collapse the usual eight years of college and medical school into six) don’t do any worse on board exams; some schools already offer a three-year track. For internal medicine residency, Emanuel argues that three years is unnecessary; many programs have long offered two-year “short-track” options for residents eager to jump into a specialty, so why should training for primary care be any different? In my primary care residency, I spent many months on inpatient and intensive care unit rotations. This made more sense in the mid-1990s, when most primary care doctors still rounded on their own hospitalized patients. Nowadays, with hospitalists running many of the inpatient wards, many primary care physicians are becoming almost exclusively outpatient. 

The Institute of Medicine report highlights a number of studies that show that nurse practitioners provide as good care with as good outcomes as primary care physicians, along with high rates of patient satisfaction. In one of the most-cited studies, 1,316 mostly Hispanic patients were randomly assigned to see either doctors or nurse practitioners, and the outcomes of patients with diabetes and asthma were about the same. But the trial only lasted six months, which is a pretty short period of time in primary care for drawing conclusions about disease management and the patient-provider relationship. Whether you can extrapolate these findings to patients of different ages and backgrounds and to all of the chronic conditions that surface in primary care (and Walgreens) remains unclear.

Primary care is not an easy field to master; the breadth and depth of knowledge is vast, unlike the narrower world of the shoulder specialist, who only sees patients with shoulder problems. Sure, every now and then there’s the glamour of cracking a diagnostic mystery case, the chance to dredge up some obscure and critical fact buried in our overloaded brains, but most of the time it’s like this: We talk. We listen. (Hopefully, we listen more than we talk.) We treat common illnesses and try to prevent chronic ones. We learn about where our patients live, what they eat, who they talk to, how they get around. We listen to the patient whose marriage is on the rocks and relate this to her elevated blood pressure. We coordinate care and help devise a plan when multiple specialists are giving different and sometimes contradictory recommendations. We make a lot of phone callsand answer a gazillion emails. When we’re not sure about something, we look it up, or knock on a colleague’s door, or call across town or across the country. And because primary care is all of these things, an ever-evolving conglomeration of medical knowledge and systems and empathy and integrity and creativity in problem-solving, this is precisely why it’s good to mix it up and reap the benefits of some nurse practitioner-doctor hybrid vigor.

This is why I think nurse practitioners should be released from their arbitrary bondage and do what they are trained to do, what they’re board-certified to do, and what many do so well: take care of patients and collaborate with physicians because they want to, not because they have to. Nurse practitioners and doctors should welcome each other’s perspectives, experiences, and abilities. As physician assistant and researcher Roderick Hooker told me in an email, “America is a nation of innovators and the advancement of medicine and nursing are no exceptions. Nurse practitioners and physician assistants are part of the social experiment to deliver healthcare in beneficial and effective ways. The independence of [nurse practitioners] is merely another step in this social experiment."

It’s time to unlock the gates to the primary care club. There will be plenty of patients for everyone.

Source: Slate

Topics: independence, healthcare, doctors, nurse practitioner, clinics

Boston Nurses tell of bloody marathon aftermath

Posted by Alycia Sullivan

Fri, Apr 26, 2013 @ 03:29 PM

BOSTON (AP) — The screams and cries of bloody marathon bombing victims still haunt the
describe the imagenurses who treated them one week ago. They did their jobs as they were trained to do, putting their own fears in a box during their 12-hour shifts so they could better comfort their patients.

Only now are these nurses beginning to come to grips with what they endured — and are still enduring as they continue to care for survivors. They are angry, sad and tired.  A few confess they would have trouble caring for the surviving suspect, 19-year-old Dzhokhar Tsarnaev, if he were at their hospital and they were assigned his room.

And they are thankful. They tick off the list of their hospital colleagues for praise: from the security officers who guarded the doors to the ER crews who mopped up trails of blood. The doctors and — especially — the other nurses.

Nurses from Massachusetts General Hospital, which treated 22 of the 187 victims the first day, candidly recounted their experiences in interviews with The Associated Press. Here are their memories:

THEY WERE SCREAMING

Megann Prevatt, ER nurse: "These patients were terrified. They were screaming. They were crying ... We had to fight back our own fears, hold their hands as we were wrapping their legs, hold their hands while we were putting IVs in and starting blood on them, just try to reassure them: 'We don't know what happened, but you're here. You're safe with us.' ... I didn't know if there were going to be more bombs exploding. I didn't know how many patients we'd be getting. All these thoughts are racing through your mind."

SHRAPNEL, NAILS

Adam Barrett, ICU nurse, shared the patient bedside with investigators searching for clues that might break the case. "It was kind of hard to hear somebody say, 'Don't wash that wound. You might wash evidence away.'" Barrett cleaned shrapnel and nails from the wounds of some victims, side by side with law enforcement investigators who wanted to examine wounds for blast patterns. The investigator's request took him aback at first. "I wasn't stopping to think, 'What could be in this wound that could give him a lead?'"

THEIR FACES, THEIR SMILES

Jean Acquadra, ICU nurse, keeps herself going by thinking of her patients' progress. "The strength is seeing their faces, their smiles, knowing they're getting better. They may have lost a limb, but they're ready to go on with their lives. They want to live. I don't know how they have the strength, but that's my reward: Knowing they're getting better."

She is angry and doesn't think she could take care of Tsarnaev, who is a patient at another hospital, Beth Israel Deaconess Medical Center: "I don't have any words for him."

THE NEED FOR JUSTICE

Christie Majocha, ICU nurse: "Even going home, I didn't get away from it," Majocha said. She is a resident of Watertown, the community paralyzed Friday by the search for the surviving suspect. She helped save the lives of maimed bombing victims on Monday. By week's end, she saw the terror come to her own neighborhood. The manhunt, she felt, was a search for justice, and was being carried out directly for the good of her patients.

"I knew these faces (of the victims). I knew what their families looked like. I saw their tears," she said. "I know those families who are so desperate to see this end."

On Friday night, she joined the throngs cheering the police officers and FBI agents, celebrating late into the night even though she had to return to the hospital at 7 a.m. the next day.

Source: Times Union

Topics: ER, tragedy, comfort, nurse, patients, Boston Marathon

Partners Donates $1M to One Fund

Posted by Alycia Sullivan

Fri, Apr 26, 2013 @ 03:17 PM

By Roberto Scalese

As ambulances screamed away from the finish line Monday, they carried many of the injured to hospitals operated by Partners HealthCare, including Mass General and Brigham and Women's Hospital. Partner's President and CEO Gary L. Gottlieb told workers today that the company will continue its efforts with a $1 million donation to One Fund Boston

Spaulding Rehabilitation in Fmass genramingham is part of the Partners Healthcare group. 

"We are making this commitment on behalf of and in honor and recognition of every one of our 60,600 men and women who give every moment of every day to support our mission of caring for our patients and their families," wrote Gottlieb Monday in an email to all Partners employees. "Every one of our employees is a member of this community. So let us take this opportunity to stand together to say we will be there to help."

In the email, Gottlieb thanked the doctors and nurses who have worked tirelessly over the past week.

"We know of the extraordinary and immediate response of our doctors, nurses, care teams and the staffs at our hospitals who provided life saving support to the wounded and who will continue to deliver much needed care in the weeks and months ahead. All of our training and preparation for horrific events like this have been widely praised. Even the President made mention of it on his visit to Boston last week," he wrote.

One Fund Boston was established by Mayor Thomas Menino and Governor Deval Patrick as a fund to help the victims of the Marathon bombings. In it's first day alone, the fund raised over $7 million to help defray medical costs for the injured.

Source: Framingham Patch

Topics: Partners Healthcare, 1M, Boston, Boston Marathon, donation

The Future of Nursing: Leading Change, Advancing Health

Posted by Hannah McCaffrey

Thu, Apr 25, 2013 @ 01:00 PM

In March 2013, Dr. Donna Shalala, the longest-serving secretary of the Department of Health and Human Services, and chair of the Institute of Medicine (IOM) committee that produced the report “The Future of Nursing: Leading Change, Advancing Health”, addressed hundreds of health care leaders at the American College of Health Care Executives (ACHE) Annual Congress. Dr. Shalala provided her reflections on the removal of barriers to practice and care and the future of health care delivery. Dr. Shalala underscored the need for nurses to play a lead role in all aspects of the health care debate, ensuring that patients and families have access to timely, effective care; and outlined specific steps that health care executives should take to fully maximize nurses to meet patient care demands.

Donna Shalala Addresses American College of Healthcare Executives

Topics: improve nursing, diversity, nurse, nurses

Ireland Nugent lawn mower accident: 2-year-old saved by Palm Harbor nurse after legs severed

Posted by Alycia Sullivan

Sat, Apr 20, 2013 @ 04:00 PM

By: Jacqueline Ingles, WFTS

WFTS_IRELAND_NUGENT_640X480_20130411162535_640_480_20130412051224_JPEG

Nicole Turner is calling her neighbor Aly Smith a miracle and a savior.

Smith, a nurse, came to the rescue of her 2-year-old daughter Ireland after her legs were severed in a tragic lawn mower accident Wednesday night.

"It was horrible," explained Smith.  "It's the scariest thing I have ever seen."

A labor and delivery nurse for nine years, Smith's training kicked in and got her through it.

Smith was sitting at home with her husband when she heard screams coming from outside.  Her husband ran outside first and she followed.  That's when she came face-to-face with a horrific scene.

"He kept saying, 'Her legs are gone, her legs are gone.'  And I said that can't be possible."

Jeremiah Nugent, 47, was swaddling his daughter whose legs were both severed below the ankle.  Just minutes before Nugent accidentally ran over his daughter with his riding lawn mower.

According to Ireland's mother Nicole, Ireland darted from the backyard into the front yard.  Then, when she saw her father, she ran to him and began calling out, 'Daddy, Daddy.'

Nugent never heard his little girl because the lawn mower drowned her out.

Nicole tried to flag her husband down to warn him.  Thinking he was about to hit something moving forward, he put the mower in reverse.

Ireland's mother watched the horrific accident.

"Why couldn't it have been me?" Nicole Nugent asked during a press conference at Tampa General Thursday afternoon.  "Why did it have to be her?"

Smith said she helped wrap the little girl in towels and put pressure on her legs to help stop the bleeding.  Smith was also comforting the little girl.

"She kept saying, 'I want to go to bed. I want my daddy and I want to go to bed,' anything to keep her talking," Smith explained.

Smith said she was surprised at how calm Ireland remained.  She stayed with the little girl while her mother called 911.  Fire crews responded and then Ireland was airlifted to Tampa General.

"It felt like an eternity," Smith said.

Ireland remain in the ICU tonight and is in serious condition.  Doctors said she will recover and will walk again.  And while Ireland's parents are thankful to Smith for all she did, she is remaining humble and said she was just doing what she was trained to do.

" I'll never forget it but it could have been a whole lot worse," she said.

Ireland has already undergone two surgeries, one to clean her wounds and a second to put a pin in her thumb.  Doctors initially thought her hand needed to be amputated but only her thumb was broken.

The Nugents say Ireland will undergo several more surgeries in the coming days.  She will also need skin grafts.

Steve Chamberland with 50legs visited Ireland in the hospital Thursday.  He arranged for Ireland to get fitted for prosthetics for free.  He says once doctors close her leg wounds Monday, she'll recover for four to six weeks before heading to Orlando.

He says they will fit her and she will be back on her feet the next day.

"To see a 2-year-old walk again, it's pretty much her first step and life," explained Chamberland.  "Her father was so funny.  He was ready to go.  He was like, 'Can we get legs now?'  He just wants to see her run again and be normal.

Source: WPTV

Topics: tragedy, nurse, lawn mower, 2 year old

Nurse 'SeeSee' Rigney has just about seen it all at Tacoma General

Posted by Alycia Sullivan

Sat, Apr 20, 2013 @ 03:53 PM

By: STACIA GLENN

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Florence “SeeSee” Rigney brushed off retirement as easily as she does the good-natured jabs from co-workers at Tacoma General Hospital for being the oldest nurse in recent memory.

Rigney, who will turn 88 next month, still bustles around the operating room wing with the energy of a woman half her age. She expects to be working at least another year.

More than 20 years older than the next senior staff nurse, Rigney is respected, revered and relentlessly teased.

“I kinda keep them in line,” joked Rigney, who blushed in embarrassment and dismissively waved her hand at fellow nurses who call her everything from a star to their hero.

Rigney got her nickname as a kid. She kept telling a teacher, “See, see,” to show how well she knew her lessons. The teacher started calling her “SeeSee” and the name stuck.

In 1946, she donned the stiff white uniform of a student nurse. In her home, she has a framed photo of herself as a fresh-faced nursing student, next to an old black-and-white image of what Tacoma General looked like back then.

Her career crisscrosses the map.

She started in Tacoma General’s operating room before going to work for a private doctor. She had stints in operating rooms in Atlanta and San Antonio, Texas, before her husband deployed for the Korean War and Rigney returned to Tacoma General. She spent a spell in Cheyenne, Wyo., but once again came back to Tacoma.

The couple adopted their first child in 1958, and Rigney shifted to working on an as-needed basis to fill shifts when the hospital was short-handed. When her daughter reached college and her son was in high school, Rigney was needed at home less so she worked more.

After her husband died in 1977, Rigney started full-time again, working 10-hour shifts three days a week. She found it kept her mind occupied and surrounded her with a second family. The hospital gave her plaques to mark her long-running career – five years, 10 years, 15 years. She can’t recall getting the 20th-year plaque.

When she was 67, she thought it time to retire.

“I stayed retired for about five months then I came back and here I am,” Rigney said. “I always thought I’d come back and work but I never thought I’d stay this long. I’m really very blessed my health is good and they want me to work.”

Supervisors and co-workers describe Rigney as one of the best.

Julie Christianson, who has worked with Rigney since 1980, said she is a “crack-up” who is full of great tales about what nursing used to be like.

She regales them with times before computers when charts and records were all hand-written, when staff nurses helped out in the emergency room delivering babies, before technology and equipment became so advanced.

Rigney is not an operating room nurse, handing doctors various instruments. She’s the nurse who sets up patient rooms and keeps track of supplies. Fellow nurses insist Rigney will knows half the patients and has a soothing effect on those she interacts with.

It’s difficult sometimes to keep up with the advancements, Rigney said, but she’s always learning.

“She can still run circles around people half her age,” Christianson said. “She’s very inspirational for the rest of us because she’s still working and she’s still sharp.”

Topics: nurse, retirement, Tacoma General, 88, 'SeeSee' Rigney

VCU dentists and nurse practitioners collaborate on patient care

Posted by Alycia Sullivan

Sat, Apr 20, 2013 @ 03:49 PM

Dominiquea Rosario sees a dentist regularly for debilitating jaw pain, but at her last two dental appointments at Virginia Commonwealth University she also saw a nurse practitioner who checked her blood sugar and blood pressure.

In a new practice model, dentists and nurse practitioners at VCU are teaming up to see patients together, with goals of increasing access to care, better understanding the connection between oral health issues and disease elsewhere in the body and lowering health care costs.

“It’s a new model … so that you can have sort of one-stop shopping,” said Nancy Langston, professor and dean of the VCU School of Nursing.

“Dentistry has always been about health promotion and disease prevention. Nurse practitioners have been about early recognition, risk reduction and health promotion. We are putting them in the same environment to see if we can truly matter in reducing risk and increasing health promotion,” Langston said.

The new VCU Neighborhood Partners Practice is being provided primarily to patients enrolled in VCU’s Virginia Premier Health Plan, a managed care plan for Medicaid enrollees.

The combined practice is located in the oral medicine suite in the Wood Memorial Building on the MCV campus.

“We’ve found when we have been looking at the literature that a lot of patients who visit the dentist haven’t seen a primary care provider in about three or four years,” explained nurse practitioner Judith Parker-Falzoi.

“There are a lot of chronic health problems that come up in the course of a dental exam that can impede the progression of their dental treatment plan,” she said.

The combined practice project is modeled after a New York University partnership in which dentists and nurse practitioners work together. VCU nursing professor Debra Lyon, chairwoman of VCU’s Department of Family and Community Health Nursing, is overseeing the VCU project.

The dental visit is the entry point.

“We are using the well-established, prevention-oriented delivery system of dentistry to see if we can harness that to apply to other disease,” said David C. Sarrett, dean of the VCU School of Dentistry. “So that patients who are coming for dental care, and if they also have other chronic issues, we can encourage them or facilitate them to pay some attention to those other things.”

At Rosario’s visit to the combined practice Tuesday, she saw dentist Bhavik Desai, an assistant professor of oral medicine and temporomandibular joint disorder, about the jaw pain and then went down the hall to see Parker-Falzoi, the nurse practitioner.

Parker-Falzoi checked her overall health, Rosario said. One item that did get red-flagged this time was her fasting blood glucose level. It came back a little high.

“I didn’t know I might have diabetes,” Rosario said later. “I had gestational diabetes a couple of years back when I was pregnant with my son,” said Rosario, whose children are ages 2, 3 and 4.

“And I was feeling … where I was craving salt, a lot of water and using the bathroom a lot.”

Rosario is scheduled for a follow-up visit with her regular primary care doctor next week.

Langston said the combined practice also promotes a more holistic look at health in training.

“Another piece of this is teaching nurses to do better assessments of the oral cavity and teaching our dental students and future practitioners to look more holistically at the human being in their chair and not just the mouth. So we will be doing some cross education,” she said.

Source: Times Dispatch

Topics: nurse practitioners, patient care, NP, dentists, collaboration

The Single-most Important Question to Ask All RNs in an Interview

Posted by Wilson Nunnari

Mon, Apr 15, 2013 @ 08:03 PM

by Jennifer Mensik for ERE

Regardless of the interview style or methodology used, there is one question that everyone should ask of a registered nurse in an interview. This includes all positions, from staff RN to Chief Nursing Officer.

What is your definition of nursing?

This helps you to sort out whether you have a professional-role-based RN or one who might only be there for the paycheck. A professional-role-based RN is a nurse who understands the complexities of the profession and is committed to placing the patient first, as opposed to a tas- based RN who is there to just clock time and take home a paycheck. If your organization prefers behavioral-based questions, take that question to the next level as a two-part question by asking the RN candidate to give you an example of when they exemplified the definition they just gave you.
nurse
You might say, “Are not all RNs professionals?” One just needs to understand the components of a profession to know that there are RNs in the profession who are not professional. Let me explain by starting with the sort of definition you are looking for and then I will touch on the difference between a technical and professional RN.

The American Nurses Association defines nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.” That is a long definition that many RNs will not be able to give you verbatim. However, the professional RN should be able to talk about and say things that are of a very similar nature. The responses between the professional and technical RN will be very different. Most times when I have asked this question, it has stumped many nurses, or was the one they needed the most time to think about before they were able to give their response.

The type of answers you want from a professional RN are statements or an explanation of caring, kindness, ethical, and wholistic care of the entire patient, an understanding that the RN is a professional who is accountable for themselves, and understands that they have a duty to society to place the patient first.

The technical, less desirable answer is when the RN describes their profession as a set of tasks, like medication administration, bathing, assessments, budgets, staffing, or worse yet, someone who assists the physician. While you might expect your RN candidate to do those things and to be competent in those areas, the professional RN understands that. It is a given that part of the professional responsibilities is to carry out tasks and orders, but it is in the manner in which they do it. The technical RN does not understand how to be professional, or worse yet, may not want to be a professional.

Can you teach a technical RN to be professional? I suppose, but only if they are open to it. This is not a simple task they can learn, but a way of being. A professional RN understands their role as a RN, their accountability to the patient and the family, their coworkers, and the organization, and will hold others to the highest standard of patient care.

This type of RN embodies what we want to see in our nurses, like Florence Nightingale. Florence could easily point out the technical nurse. Those who only work as a RN because it’s a good paying, stable job, and where you only have to work three 12-hour shifts; the one who does the minimum to maintain their employment and the minimum to maintain their own education, skills, and professional standards. It is those who do not say anything when another RN or staff member may be jeopardizing patient safety as it’s “not their responsibility” to hold others accountable. Professional RNs do hold each other accountable for quality and safe patient care.

Your next steps:

Recruiters: Have a discussion with your nurse executive on whether this is a question they would like to you ask. Talk with you nurse executive about their nursing philosophy for the organization and how they would like to see RN candidates answer that question.

Nurse managers: What is your philosophy about nursing? Can you articulate it and share with your recruiters so that the right candidates could be screened early in the process? Even if used in the early stages of recruitment,  still include this question in the onsite interview process with the candidate and yourself or the team. Ensure your team who maybe interviewing the RN candidate understands this question and the type of response you want.

As organizations struggle to improve quality measures and patient satisfaction, which type of RN do you want on your team? The professional RN will help your organization obtain success in these areas. If an RN can give you a professional-based answer for the definition of nursing, you are halfway there in choosing the right candidate for your patients and organization.

Topics: nursing student, nursing, nurses, career, nursing career

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