DiversityNursing Blog

The healthcare industry is filled with challenging and rewarding job opportunities. For those who are actively pursuing a career in nursing and who eventually wish to acquire leadership roles in that field, striving for the occupation of Chief Nursing Officer is a worthwhile endeavor.  To be a successful CNO in the healthcare system there are specific requirements, qualities, and skill sets that the industry requires of their employees. These attributes can determine the likelihood of potential employment. Along the same vein, what does it really take to become a good CNO (Chief Nursing Officer) in the medical sector?"

Basic Requirements

The requirements for the role of CNO vary depending on the preferences of the employer.  There is, however, a general consensus that to be considered for the position of CNO, the applicant needs years of nursing experience and some form of a graduate degree. Some hospitals or medical affiliates require as little as 5 years of experience while others require applicants have 7 - 10 years of practice in the medical industry. The CNO position is the highest ranking Nurse in administration and that role is not taken lightly.

Taking the right educational journey to a specific career is important. The value and focus a Chief Nursing Officer hopeful applies to their education path speaks volumes to potential employers.  Having a MS Nursing (management and organizational leadership) degree, a MS in Nursing (leadership in health care systems) degree or a Master of Science in Nursing Administration is a common trend among current Chief Nursing Officers. Earning a combination of a science-oriented Nursing degree along with a business emphasis degree is encouraged when seeking a leadership position in healthcare.  

If a healthcare employee is seeking admission into a Master's degree program to aid them in their journey toward career advancement, they have expectations to meet. Those in the Nursing field are required to have an active RN license, a Bachelor's degree, and should be aware that RN clinical experience bears heavily in the admissions process. While there are many technical aspects to attaining the title of CNO, becoming a "good" CNO goes beyond the basic requirements.

 10 Qualities of a CNO

• Has a passion for fulfilling a leadership role
• Desires to be a positive mentor
• Exhibits a conscious concern for patient care
• Focuses on quality and safety
• Enjoys implementing strategies to solve existing problems
• Decisively initiates responses to emergencies
• Displays commitment and the highest level of competency
• Is a proactive force in a hectic environment
• Exudes compassion and dependability on a daily basis
• Has a keen sense for business matters and has developed organizational skills

Skill Sets of a Good Leader

Chief Nursing Officers realize the importance of setting long and short term goals for the betterment of their facility. As a consummate problem-solver, the business-minded and client-conscious leader balances passion for patient welfare with administrative management. Implementing processes that ensure the business side of healthcare runs smoothly, the leadership role of a CNO is fraught with responsibility, but also with rewards.  They are the faculty informers, the interviewers, the proficiency job monitors for Nurses, staff schedulers, and that is just the start to their long list of duties.

Boasting of better pay, job security, and intrinsic rewards, there are many reasons why a CNO values their many-faceted position. Leaders are born through adversity, and a confident Chief Nursing Officer can handle with marked professionalism, the many conflicts that come their way.  A good CNO values people and the efficient processes that bring order to chaotic environments.

Any Chief Nursing Officers looking to grow diversity in their facility can click below for contact information. We would be more than happy to help you.

Being able to read, write, and speak a second language is a highly desired skill in almost every career. However, being a Multilingual or Bilingual Nurse within the healthcare industry has some exceptionally high benefits that make such skilled individuals a prized asset to any team.

This is especially true in the United States where there's an influx of non-English speaking individuals. In fact, the US now has 41 million native Spanish speakers with another 11.2 million people using it as their second language. That's more people speaking Spanish in the US than all of Spain!

All of these native Spanish speakers, along with other non-English speakers, require healthcare services which emphasizes the value of having bilingual staff on hand. Consider these benefits of being a Bilingual Nurse:

1. Numerous Job Opportunities.  Most hospitals, clinics, insurance companies, schools and other healthcare organizations are centered around major cities, most of which contain high immigrant populations with areas of mega-cities dedicated to specific cultural groups. Take for example Miami's famed Cuban neighborhood entitled Little Havana or Seattle's bustling Little Saigon, the economic and social center of the region's Vietnamese community. Every one of the healthcare offices servicing these areas is in need of trained and experienced Nurses that can communicate directly with patients who aren't fluent in English. This means high demand and significant income opportunities for the flexible and Bilingual Nurse.
   
   
2. Satisfaction for Helping a Diverse Population.  Many individuals pursue Nursing out of a desire to help others. A Bilingual Nurse is in a unique position to significantly improve the quality of care patients receive due to their ability to not only assist them in the routine ways, but also to help them better understand medical terms, symptoms, and treatment options in their native tongue. 
   
   
3. Added Value to Employers.  Individuals pursuing a MSN degree that are also able to speak a second language, enhance their potential worth to their employer. A Bilingual Nurse can converse and assist more diverse groups of people to better market the employer's organization as being open and welcoming to people from different language and cultural backgrounds.
4. Exciting Foreign Job Prospects.  Some people are born with an itch to travel, and being bilingual is perhaps the single biggest factor in fulfilling that desire. That's because the ability to speak another language, translate, and converse opens doors to employers in non-English speaking countries. 
   
   
5. Critical to Ensuring Data is Accurate.  In this digital age of computers and consolidated electronic health records, it's important to stay on top of data input and security. Most larger hospitals and healthcare organizations have some basic translation services at their disposal to help with patients who are not native English speakers, but this often isn't the case with smaller offices, clinics, and other practices. And even if they do, too frequently errors in translations can come up. That's why it's so important for these organizations to keep a staff of Bilingual Nurses on hand to help collect information from the patient themselves and ensure that client files are correctly uploaded and stored. This provides inherent benefits both to accurate record keeping and patient safety.

In the end, not only are there many great benefits to being a Bilingual Nurse, but it's very important for healthcare organizations, whether they're large hospital systems or specialized clinics, to have Nurses with multiple language capabilities. The world today is becoming ever more diverse and interconnected. The ability to speak multiple languages alongside nursing or doctoring skills, is a very valuable and marketable commodity that also helps improve patient outcomes and safety.

Technology has made people's lives much easier. There are specialized apps for almost everything and everyone. Some very helpful technology exists for Nurses designed to make your life easier. Here’s the 2015 Top 10.

Epocrates

This is the #1 app in the medical community. It has a lite and a premium version and does many things including calculators such as BMI and lab and coding guides.  

Human Anatomy Atlas

This app is designed for Nursing students. It contains 3,800 three dimensional images of the human anatomy. It also includes quizzes about things like bone and muscle structure.

MedPage Today

MedPage gives you the latest news in the medical community and helps you stay up-to-date on the latest medical advances.

Nursing Central

This app includes 17 million journal articles, 4,600 medications, and 56,000 dictionary terms. 

Black's Medical Dictionary

This is an easy to use medical dictionary from a company that has been around for over 100 years.

Nursing Care Plans

With this app, you can make 100 customized care plans covering most medical topics.

MediBabble Translator

For Nurses working with non-english speaking patients, this translator app is a must have. 

Symptomia

This simple to use app lets you put in patient’s symptoms and it tells you possible diseases associated with these symptoms.

Davis Mobile: Nursing Procedure Checklist

With this app, Nurses stay on task with checklists covering 169 common Nursing procedures.

Nursing Shift Planner

A must have time management app designed for Nurses. You can input specific tasks to be done and even set up auto reminders.

There are apps out there to satisfy every Nurse’s needs. The use of technology for Nurses not only make your life easier, but it can also ensure better patient care.

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How can you tell if a burn wound has become infected? Wouldn’t it be great if a new technology can alert you to an infection without having to remove the bandage? Scientists in the UK are in the development phase of a bandage that changes color to alert you to an infection. As you know, antibiotics are often prescribed to help stave off infection, however this new technology may help prevent the need for antibiotics.

Burn wounds are a relatively common affliction. Alongside the obvious suffering that a wound of this nature can cause, infections can be a life-threatening problem.

Infections are the primary cause of complications in burn injuries, especially in children. This is partly due to a child's immature and less aggressive immune system. 

Significant thermal injuries can also induce a state of immunosuppression, further increasing the chances of infection. 

Even a relatively mild hot water scald can readily become infected.

Many deaths from burn injuries are due to sepsis, and even milder infections can prolong hospital stays. The likelihood of permanent scarring also increases with infection.

Diagnosing burn infections

Diagnosing a bacterial infection in young burn patients can be troublesome. The area around a burn wound may be red and inflamed, symptoms that normally indicate an infection; this makes a direct sample of the area essential for clarity.

The young patient's discomfort must also be considered. Removing the wound covering is an unpleasant procedure, and interference with the injury can lead to slower healing times. 

Currently, it takes around 48 hours to definitively diagnose an infected burn. Dr. Amber Young is involved in ongoing clinical trials of this new early warning system for burn infections. 

She says:

"Children are at particular risk of serious infection from even a small burn. However, with current methods clinicians can't tell whether a sick child might have a raised temperature due to a serious bacterial burn wound infection, or just from a simple cough or cold."

Because of the time delay in diagnosing an infection, and the desire to remove the invaders before they dig their heels in, antibiotics are often prescribed preventively. This has its own drawbacks. Antibiotic resistance is a genuine concern throughout medical institutions worldwide.

Researchers at the University of Bath, in conjunction with the Healing Foundation Children's Burns Research Centre and the University of Brighton - all in the UK - have created a groundbreaking solution to these serious issues.

The team has developed a prototype color changing band-aid when a wound becomes infected. The wound dressing on an uninfected area displays a discrete circular design:

Within four hours of an infection, the color and pattern change:

Dr. Toby Jenkins, project leader says:

"Our medical dressing works by releasing fluorescent dye from nanocapsules triggered by the toxins secreted by disease-causing bacteria within the wound. 

The nanocapsules mimic skin cells in that they only break open when toxic bacteria are present; they aren't affected by the harmless bacteria that normally live on healthy skin."

Bacterial biofilms

Research has shown that bacteria infecting a wound tend to congregate in biofilms. These films consist of mutually attached bacteria, coated in polymer. 

Within their exopolysaccharide cocoons, bacteria are afforded some protection from attack by antibiotics and the patient's natural immune system.

This ground-breaking, chameleon-like Band-Aid works by detecting these biofilms. The dressing is made of a hydrated agarose film that contains the tiny capsules of colored dye. These capsules are "trained" to specifically recognize Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecalis.

The team found that the color change response is stronger for bacterial strains that are considered to produce good biofilms. This could lend itself to an even more specific indicator in the future. The system might indicate not only whether there is an infection, but also what specific type of bacteria is present.

The experimental wound dressing is in the early phases of development but is soon to be tested on real patients. 

An innovation that can save lives, money and assist in the global problem of antibiotic resistance is a literal game-changer.

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If you’re feeling unappreciated, read this story to know that many people very much appreciate what you do. They’re not always very good at expressing themselves in a positive way. But most of you understand your patients feelings because as this husband explains, they’re going through one of the worst days of their lives. Many of my friends are Nurses and they are awesome just like you, Every Day.

When Bobby Wesson looked at his sleeping wife last week, he had no plans of his emotional reaction going viral. But that's exactly what happened.

Nurses are at times some of the most underappreciated yet hardworking people you'll find in medicine. Rayena Wesson is a trauma nurse at an Alabama hospital. She was taking a nap before work when her husband felt inspired to share her story with the world. "In an hour she will wake up, put on her scrubs and get ready for work," he said. 

"The tools and items she needs to perform her job will be gathered and checked meticulously... She will occasionally stare off blankly as we talk; silently steeling herself for the coming shift. She thinks I don't notice. "

Then, Wesson explained what his wife spends her work day doing.

She will kiss the baby, she will kiss me and she will leave to go take care of people that are having the worst day of their entire lives. Car wrecks, gunshot wounds, explosions, burns and breaks - professionals, poor, pastors, addicts and prostitutes - mothers, fathers, sons, daughters and families - it doesn't matter who you are or what happened to you.

She will take care of you.

She will come home 14 hours later and remove shoes that have walked through blood, bile, tears and fire from aching feet and leave them outside.

Sometimes she will not want to talk about it. Sometimes she can't wait to talk about it. 

"Sometimes she will laugh until she cries and sometimes she will just cry," he wrote. "But regardless of those sometimes she will be on time for her next shift."

Since writing the post, Wesson has become a viral hit with people commending him for speaking out on behalf all the hardworking nurses out there. The post has been shared more than 145,000 times on Facebook and published on numerous media sites. 

"My wife is a nurse," Wesson wrote. "My wife is a hero."

Co-signed on that one.

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If you are looking to change your career path or try something new in the Nursing field, click below to access our diverse job database.

If you’re thinking about continuing your education, this article offers some important questions to consider in helping you decide if an online program will accomplish what you want to achieve. We all know continuing your education, if at all possible both financially and personally, will enhance your career, your life and your earning potential.

For nurses who wish to advance their careers, pursuing an online master's or doctoral degree ​may be a great choice, experts say. Doing so can lead to higher salaries and roles with greater authority over patient care.

Some experts say that when it comes to graduate-level study, the nursing field is starting to move away from the master's degree and shifting more heavily toward doctoral degrees such as the Ph.D. or the Doctor of Nursing Practice. But master's degrees are still viable options for some students, and institutions including Capella University​ and Pennsylvania State University—World Campus ​are continuing to offer them online.

"A lot of schools have eliminated that master's degree for advanced practice nurses. That's not what we've opted to do," says Patrick Robinson, dean of the School of Nursing and Health Sciences at Capella University, which offers master's, Ph.D. and DNP degrees online.​​

It's important for online learners to select the nursing program that's best suited to meet their goals.​ Experts recommend asking the following questions about a program before deciding to enroll.

1. Which type of degree is best for your particular career?​​ In many cases, students will pursue a master's degree if they want to specialize in a specific area of nursing, experts say.

That was the case for Renae Epler of Hershey, Pennsylvania, a recent graduate of the online master's in nursing program offered through Penn State. The program allows students to choose specializations in nurse education and administration. Epler, who now works as a patient safety analyst at a hospital, chose the latter.

"For me, it was the right way to go," she says. "I didn't want to pursue a doctorate – something I didn't know for sure I wanted. This was a good place to start, I think."

When it comes to doctorates, the Ph.D. is generally meant for those who wish to become ​research-focused nursing scientists and develop the knowledge base on which nurses practice, says Robinson, of Capella. The DNP, meanwhile, is geared toward those who hope to use the science of nursing to advance nursing care out in the field​, he says.

There are other options out there, too. A bridge program allows students to save time and money by combining the curricula of two degrees. For example, the RN-to-MSN in care coordination offered at Capella gives registered nurses who don't have bachelor's degrees the opportunity to complete a Master of Science in Nursing.

2. How much time and money can you spend on a degree? Different degree programs cost different amounts of money and require various time commitments. When choosing a program, it's important for students to estimate how long it might take them to complete all the requirements and budget accordingly. A Ph.D. typically requires a student to complete more credit hours than a DNP or a master's degree, for example, Robinson says. 

At Capella, the Ph.D. requires 96 credits at $660 per credit​. The DNP requires 52 credits at $775 per credit​, and a master's requires 56 at $399 per credit​.

3. Is the program accredited? When looking into an online program, a student should verify whether it ​is accredited and if it ​is accepted in his or her current state of residence to meet licensing and other requirements​​, says Michele Pedulla, assistant academic graduate program chair at Kaplan University​'s​ School of Nursing. 

For instance, at Kaplan, the online nursing master's programs are accredited by the Commission on Collegiate Nursing Education, she says. Other schools' programs may be accredited by the Accreditation Commission for Education in Nursing.

4. Is there an on-campus component? Online nursing graduate degree programs can be structured in different ways. Some – like those hosted by Capella​, Penn State​ and Kaplan​ ​– enable students to complete all of their requirements, including the clinical experience​, in a location​ of their choice; others, like many of Vanderbilt University's, require students to spend some time on campus. 

Both options have advantages. The former allows for more flexibility. As for the latter, at Vanderbilt the weeklong on-campus component provides an opportunity to interact with faculty and other students. 

"It allows them to network with other students, hear renowned speakers, work together with professors and really become engaged," says Mavis Schorn, senior associate dean for academics at Vanderbilt's School of Nursing.

5. Who are the faculty, and what kind of support will you receive? Especially in an online course, where a student rarely, if ever, sees an instructor ​in person, communication and resources are ​key, experts say. 

A student should research whether a nursing program offers assistance such as academic advisers, writing help ​centers and library resources, says Pedulla, of Kaplan.

In the program offered at Penn State, students interact with the instructor and each other through online discussion boards, among other forms of communication, and there's an online help desk to address any technical issues they may encounter, says Judith Hupcey, associate dean for graduate education and research at Penn State's College of Nursing. 

"It's about more than just cost and speed," Hupcey says. "It's the quality of the program you're getting."

If you’re an ER Nurse or you’ve been to the ER for treatment, you know timing is everything. I remember when my son was at camp and we received a call that we should pick him up and take him to the ER due to a deep cut that needed stitches. Fortunately the camp was only 45 minutes away. It was around 10:30pm when we picked him up and as we drove from camp to the ER we wondered, like anyone traveling to the ER, what’s the wait time going to be until my son gets treated? Will we be there all night? We were very lucky. Our local hospital’s ER this particular evening was practically empty. Whew!

We all know this is usually not the case, and in large cities, never the case. Here’s an interesting article about how Reading Hospital in PA reduced their wait time in the ER.

Nationwide hospitals are more frequently being overcrowded with longer wait times. Reading Hospital faces the same struggles in their emergency department with an annual patient volume of over 130,000, more than 20,000 admissions and 300-500 ED patients daily, the Level II trauma center in Reading, Penn. sees its fair share of people come through their doors. 

Emergency department overcrowding is not limited to this one facility. Mary Bilotta, MSN, RN, AGCNS-BC, CEN, emergency division clinical nurse specialist, stated, "Availability to access providers is not always easy." Limited office hours send patients to the ED when they would otherwise go to their primary care physician. When they do go to the PCP, the doctor sometimes sends them to the emergency department for routine tests or evaluation. The extra patients clog the system and increase the wait times for everyone. 

Information Overload
Google is a double-edged sword for health data. The public can easily access information on the internet, which means they search for their symptoms and come looking for sometimes specific treatment.  The instant gratification of the internet age rears its head as patients go from Googling to the hospital doors. Vanessa Hetrick, BSN, RN, CEN, staff nurse, emergency department, said, "When I take care of patients, they say, 'I don't have time to wait for my PCP, so I come to the emergency department.' " 

The emergency nurses and physicians treat everyone who presents for care.  Timothy Marks, RN, MSN, CEN, NE-BC, division director, emergency services, explained, "Emergency departments are the safety net for the healthcare of the community. We take care of everyone who comes through our doors.  We take this responsibility very seriously but at times the volume of patients exceeds the available resources." Treating all those patients exhausts both resources and clinicians.

Reading Hospital knew something had to be done, for the sake of their community and their healthcare professionals. They began a concentrated effort to improve time management in the emergency department and decrease wait times for patients. 

Marks said, "We had that multi-level support because, among many factors, we had dissatisfied patients leaving without care." That was a risk to the community.  The chief nursing officer, chief medical officer, chief operating officer and other high-level executives participated in discussions with frontline staff. When there is buy-in from the C-Suite, they found, more staff want to be involved and achieve results.

All Hands on Deck
Charles F. Barbera, MD, MBA, FACEP, chairman, department of emergency medicine, noted, "It was seen not as an ED problem, but a hospital program. We're a microcosm of all the programs in the hospital." 

While everything comes to a head in the emergency department, leadership recognized all blame can't be placed there. They tackled the issue with a no fault approach.  The CNO and CMO supported a process improvement plan and put nurses and physicians in charge. We created an ED-to-acute care sub-committee to face the challenge of long emergency department throughput times head on.

To begin the transformation, the sub-committee came up with guidelines, some of which were referenced from the Emergency Nurses Association, which included streamlining the triage process to include minimal questions. A greeter nurse meets patients and guides them to the right area for more timely treatment.  Immediate bedding was implemented whenever an available treatment space existed.  Involving the frontline staff in decision making about their work, usually trims minutes from the process.  Marks added, "We took a hard look at how we staff in the emergency department." How could they remain fluid and still meet patient needs?

When they started the improvements in 2013, the average throughput time in the emergency department at Reading Hospital for admitted patients was 6 hours. The current throughput time is 4.5 hours. The25% reduction was the result of teamwork and an examination of three areas where improvements were needed most.

Triple Threat
A few years ago, getting patients out of the ED and to a hospital bed seemed to take forever. They asked themselves, how can we shave off time? Nurses on the floors get notification from the computer system that they are receiving a new patient and are  encouraged to review the newly staff built , streamlined report of pertinent information. The bed assignment, in some cases, triggers an automatic dispatch of the transport team to move the patient. "When we first started, we had a timer on our board that starts when a bed is assigned," said Hetrick. The board shows a green happy face. If the patient is not moved within defined timeframes, the face turns sad from yellow and subsequently red.

That effort ties into another prong of the approach-improved electronic medical records. "We leveraged technology to make it work in our favor," Barbera explained. For instance, shortcuts in the EMR were developed for certain recurring diagnoses among ED patients. 

Hetrick added, "We optimized our standard protocols for chest pain, for example, and we can start the treatment process right away without calling a provider." The streamlined EMR system lets the ED staff talk to the whole hospital in a sort of universal language. She continued, "The flow is so much easier now that everyone can see the same thing. By keeping the patients and families at the center of what we do, we all are a team. It's not this department versus that department." 

One process change for patients was having a Front End Provider present in triage at peak times to interpret EKGs within ten minutes of arrival and start the care process. As a result, the hospital has a door-to-balloon time for patients experiencing a STEMI time of about 40 minutes.

Collaboration between different members of the inter-professional team is the name of the game in the third prong of the approach. With a patient-centered admissions philosophy, emergency department physicians and hospitalists work in parallel.  The ED physician used to spend time proving the patient couldn't go home. Now, hospitalists are brought into the loop right away, especially with complex patients. There are at least two hospitalists stationed in the ED, the hospitalists determine what the patient needs to get the right level of care.   

With everyone accountable for their departments, things run a lot smoother. "It has to be a collaborative effort," reminded Bilotta. With this focus, Reading Hospital increased patient and community satisfaction while making care more efficient.

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It seems that Google is involved in just about everything these days! Here’s the latest announcement. The American Heart Association is teaming up with Google on a project for heart health and conquering heart disease. Hopefully their huge investment will yield some promising results for everyone.

A company whose name is synonymous with eyeballs on the Internet is turning its attention to hearts. 

Google Life Sciences, a research group recently spun off from its parent corporation, is teaming with the American Heart Association in a $50 million project to find new ways to fight heart disease. 

The heart association's half, $25 million over five years, is the largest single research investment in its history. For the Google group, its latest biomedical venture will join projects that include whiz-bang devices such as driverless cars, contact lenses that monitor blood-sugar for diabetics and health-tracking wristbands. 

The project was announced Sunday at a heart association conference in Orlando. 

Heart disease is the world's top killer, a problem that "seems ripe for new innovation" and disruptive, unconventional thinking, said Andy Conrad, Google Life Sciences' chief executive. Progress has been slow and "we should shake it up a little bit," he said. 

Besides cash, Google has tech tools to offer such as sensors to monitor the health of "people in the wild" versus just when they go to doctors and huge capabilities for data analysis. The company is aiming for a cure, Conrad said. There's no guarantee of success, but "the only thing we can promise is that we'll try harder." 

By early next year — Valentine's Day, "a big heart day," Conrad said — a team from Google and the heart association hope to pick a project leader, who might be a cardiologist, a nurse or "a teenager from Wisconsin," depending on what skills and ideas that person can bring to the table. The team is looking for "a maverick," he said. 

The venture "really allows us to think about ... doing research in a different way," said Dr. Robert Harrington, chairman of the Stanford University School of Medicine and a member of the heart association's board. 

Traditional research has brought only incremental improvements in heart disease treatment. 

"We are trying to do something disruptive here," Harrington said.

More accurate due dates are something both mother and medical professionals want. But is it something possible to achieve? Ultrasound scans are helpful but they can only give an estimate date. 

Predicting when a woman is likely to give birth is an inexact science. It is also a question with important medical and personal implications. A meta-analysis published this week in BJOG: An International Journal of Obstetrics and Gynaecologysheds some welcome light on the subject.

Predicting exactly when a woman is likely to go into labor has always been challenging; only 5% of women go into labor on their exact due date. 

For about 90% of women who are overdue (a pregnancy lasting over 42 weeks), contractions begin on their own within 2 weeks of the due date. But the exact date within those 2 weeks is frustratingly difficult to predict.

Of course, most women do not know the exact date the baby was conceived, and as such, any due date given can only be an estimate. 

Currently, the best methods for predicting the date of a child's birth are either by using the last menstrual period as a starting point, or by measuring the fetus size with an ultrasound scan. Neither of these methods are without some measure of inaccuracy.

An analysis carried out by Dr. Vincenzo Berghella, at Thomas Jefferson University Hospital and the Sidney Kimmel Medical College at Thomas Jefferson University, hopes to paint a slightly more accurate picture.

There are a number of reasons why people desire a more accurate prediction for their due date. As Berghella explains:

"Women always ask for a better sense of their delivery date in order to help them prepare for work leave, or to make contingency plans for sibling-care during labor. These are plans which help reduce a woman's anxiety about the onset of labor."

On top of these more logistical issues, there are very real health concerns, too:

"Women with a higher risk of stillbirth may be better off receiving a labor induction if the cervix is still long at her due date, since the chances of timely spontaneous birth are low, for example."

Cervix measurement of more or less than 30 mm is key

Currently, cervical length is measured in women who are considered at risk of a premature birth. The shorter the cervix, the more imminent the birth will be. This method of transvaginal ultrasound is considered a gold standard for predicting early births. 

During pregnancy, the cervix hardens in order to keep the fetus from dropping into the birth canal. As the due date draws near, the cervix softens. This softening causes the cone shape of the cervix to shorten and flatten, which can be used as a signal that the birth is imminent.

This precision has led a number of researchers to investigate a link between cervical length and birth at term - the hope being that if it can predict an early birth, it might have the same use for longer pregnancies.

These studies matching cervical length after 40 weeks of pregnancy, to date, have been inconclusive and sparked lively debate in the field.

Berghella has reopened this line of investigation and scooped together data from five different studies; the data included 735 women with single-child pregnancies who had babies in the standard head-down position.

This increase in data has given the research team a new and improved overview of the field of study and garnered some interesting results:

The researchers found that when the cervix measured more than 30 mm at a woman's due date, she had less than a 50% chance of delivering within 7 days. However, when the cervix measures 10 mm or less, women had more than an 85% chance of delivering within 7 days.

The results of the study give a glimmer of hope to mothers who are facing an uncertain stretch of time before they give birth. Further study in the area and its consequent analysis will help solidify these findings.

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Nurses have heard it before, "Can you not talk about gross stuff at the dinner table?" But Nurses can't help it when the most disgusting things are completely normal in their everyday lives. They become desensitized to topics like body fluids, infections, and smells and sounds.

Being a nurse involves seeing, hearing, smelling, touching and dealing with some of life’s not-so-pleasant things. Nurses face it all from the most gross to the most stunning situations that would make the normal person squirm or run. They build up an immunity to it, but it’s still something that can make them very weary. Yet, they never stop a beat of helping the patients that they have been trained to see through it all.

“We see it all,” says Barb Gallogly. She is senior lecturer and coordinator for Post Baccalaureate Nursing Program at Henry Predolin School of Nursing at Edgewood College, Madison, Wis.

“We are the eyes of the physician, and the ears of the respiratory therapist. We are in a position of privilege to be with the patients on a minute-to-minute basis. People trust us, and people open up to us,” she says.

And those patients trust them not to run away when things go from bad to worse or when they need them the most.

Things that nurses face that make them unique, strong and oftentimes – saints

Body Fluids: It’s not pretty. “But sometimes some of us still gag at vomit and other things that come out of bodies,” says Kristin Gundt, chief nursing officer at Community Hospital in Grand Junction, Colo. “It all depends on how much you are exposed to it, but that doesn’t mean you have to like it. We all have triggers that makes our own bodies react to it.”

Gallogly agrees that there are still things that make her gag. “But you have to rise above it, and work with it, and not to let your own personal feelings or reactions get in the way of good patient care,” she says. “A nurse must remain respectful of the patient and be calm when all hell breaks loose.”

Infections: In Gallogly’s office hangs a lithograph with a person who has germs all around and the words, “Please Wash Your Hands” stamped on it.

“I’m a germaphobe. As a new nursing grad, we didn’t wear gloves or masks back then. We never thought anything about it,” she says. “But now, there is anti-bacterial gel at every entrance – gel in and gel out. That’s hammered into our students now.”

She sees a lot of infected wounds, and a lot of people put into isolation because of infections. “Universal precautions don’t cut it anymore,” she says.

Smells and Sounds: Sometimes when someone else is vomiting, the sound itself can set nurses off with their own gagging reflex. “Or sometimes you hear someone with diarrhea and the gas with it, and it can set something off in you, too,” Gundt says. “But we try to hide our reaction for the patient’s sake.”

She adds that one of the hardest smells to stomach is when a patient is bleeding from their intestines or stomach. “You might have to excuse yourself if you are going to gag or throw up. You don’t want to make the patient feel like even the nurses can’t tolerate it,” she says. “But it smells so bad.”

Death: “We don’t know what death will be like from one person to the next. It can be smooth to really traumatic to really messy. It can be awful,” says Gundt.

One time comes to mind for her when she was a home health care nurse. The elderly lady had a relative come during the last stages of her death. The relative was panicking because she didn’t understand death and all the things that happen when the body shuts down.

“People are incontinent. They can’t hold their bowels. Nothing in them is awake anymore,” she says. “So, I kept her clean, changed her and turned her, and made sure she got pain meds. I stayed with her and the relative. It’s the people that are alive that are panicking. People are scared to be alone with the person who is dying.”

Chaos: “Most people’s jobs aren’t like this,” Gallogly says. “You learn really quickly to become a great multi-tasker and set priorities all the time. You usually have three or four things coming at you. You learn to delegate to others that can help you.”

Some days, it will be overwhelming. You leave work thinking that you didn’t do a good job. “With budget cuts, nurses are expected to do a lot more with less. It’s hard to give quality nursing care, and we want to take care of that whole person, but so much is coming at us. That’s frustrating,” she says.

Dynamics of Families: “We don’t just take care of the person, but the whole person which includes the family,” Gallogly states. “If the family is demonstrating behavior that are precluding progress or treatment for the patient, then we pull them aside. You never know what is going on with them. We don’t know their histories. There is usually a reason for their behavior.”

She says it’s easy to label people as the “crazy daughter” or “hysterical mother.” But that doesn’t solve any problems or help anyone. “We try to explore those dynamics and include them in what we are doing with the patient,” she adds.

Ill Treatment: When people are sick, their behaviors aren’t necessarily their norm. “They lash out at us, hit us, spit on us and swear at us. There is a lot of physical and emotional abuse,” says Gundt. “Sometimes, it’s very unexpected. You never think some of these people will strike out at you because they seem stable as can be.”

Gundt adds that nurses try very hard to not put themselves in a situation to be hit or hurt. “If it’s a family member that we feel is being obnoxious, abusive or unrealistic, we won’t hesitate to escort them out or get someone to do so,” she says. “But we will start with way less restrictive methods. We try to keep people on our good side.”

Nursing isn’t all roses and sunshine. But most people understand that when they go into the profession. It’s not easy. It’s not always pretty. But for those who choose it, they say they do it because they want to help people. They want to educate people to live healthier, happier lives no matter what squeamish  circumstances they have to confront.

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