DiversityNursing Blog

By Mike Spohr

Today I ran into a Mexican restaurant to grab a quick lunch, and as I ate my meal I came across a table of nurses wearing hospital scrubs. As they chatted amongst themselves I thought about the many nurses my family has interacted with over the last five years, and I found myself filled with such appreciation for what these amazing women and men do for us.

It was in the Neonatal Intensive Care Unit that I initially saw how amazing nurses can be. My first child, Maddie, had been born almost 12 weeks premature, and the hospital staff, upon determining that Maddie's lungs were immature, rushed her to the NICU. There Maddie's life hung in the balance, and though my wife, Heather, and I longed to care for her ourselves, her condition made it so that we couldn't. We had to trust the NICU nurses to take care of our baby for us, and that was incredibly hard -- especially at night when we went home to catch a few hours sleep.

Sleeping was, of course, almost impossible. My sick baby was not with me, and the phone loomed ominously on the nightstand. If it rang before dawn it would do so for only one reason -- to tell us that Maddie had passed away. I can't tell you how scared I was of that phone ringing. Thankfully, it never did.

Each morning I called the NICU at 7:00 a.m. to get an update from the night nurse about how Maddie had done through the night, and the moments waiting for her to pick up the phone were horrible. Was I going to hear Maddie had done poorly and that things didn't look good? Or, if the nurse took a long time to come to the phone, did that mean that she and the other medical staff were desperately fighting to stabilize Maddie at that very moment (something I'd witnessed in person a number of horrible times)? My hands never failed to shake as I waited for the phone to be picked up.

Once the night nurse picked up, though, I began to feel better. She always told us about Maddie's night in great detail even though she'd just finished a long, exhausting shift. The lengths the NICU nurses went for Maddie were incredible. One night, we were told, Maddie wouldn't respond to the ventilator, and the only reason she survived was because the night nurses took turns hand pumping air into her lungs for hours on end until their hands were cramped and throbbing.

As amazing as all that was though, the thing I appreciated the most about the nurses was how they loved and valued Maddie. She wasn't just some nameless baby behind the glass of an isolette obscured by wires, medical tape, and breathing tubes. She was an amazing little girl named Maddie (also "Bunny" or "Little Mama" as they called her), who was beautiful and strong. I could see that they considered my daughter to be amazing and a gift, and to see others felt about her as I did was incredibly meaningful to me.

Maddie was finally released from the NICU, but there were a few times over the next 17 months when she came down with an infection and had to again be hospitalized. Those days in the hospital were both frightening and incredibly dull, and again nurses were wonderful to us. They were always there when we needed them, quick to bring a blanket or to explain what medications Maddie was taking. Like the NICU nurses, these nurses showed Maddie so much love, mooning over how cute she was and making faces at her to keep her entertained.

Though it still hurts to admit, on April 7, 2009, two days after she was hospitalized with a respiratory infection, Maddie passed away. On that horrible day there was a nurse who stayed by Heather's side the whole time, and I am so thankful for her kindness to my wife. There was a nurse that mattered to me that night, too, though she didn't stay by my side, bring me a glass of water or even say a word to me. In fact, I don't think I saw her until the very moment I walked out of the pediatric intensive care unit, but she made a difference nonetheless.

You see, that day my life shattered. I watched my daughter die in front of me, and it was an experience so horrific that even now it seems almost surreal, like, Did that actually happen? To me and my family? But it did, and one of the things I remember most about it was how the key medical personnel there didn't make me feel like they found Maddie to be beautiful and strong or amazing and a gift. The lead doctor may have been under a great deal of stress, but the way he pronounced her dead was not right. It was more like a referee calling the end to a heavyweight fight than the end to a beautiful child's life. Then, as we held our dead child in our arms and kissed her goodbye, doctors stood behind the curtain discussing the specifics of what had happened with about as much feeling as mechanics discussing a broken down car.

It was only as I left the PICU that I felt humanity. There, sitting on a chair with a single tear rolling down her cheek, was my nurse. Her tear told me that she cared. About Heather, about me, and most importantly, about my beautiful Maddie.

That's what nurses do that is so important. In addition to all of their medical expertise, they bring a human element to the cold, sterile world of a hospital. Doctors do great things, but have a heavy case load that means they can only visit each patient briefly each day, but the nurses will hold your hand -- figuratively or literally -- and remind you that you are not alone, and that your life is valued even if it can't be saved.

When the nurses at lunch today finished their meal I wanted to thank them, but I didn't, and I wished I had afterward. I can do one better now though:

To nurses everywhere: You should know that you have made a difference to so many people in this world, my family included, and I cannot thank you enough.

Source: Huffington Post 

 

By Mable Smith, PhD, JD, MSN, BSN, RN

Source: Robert Wood Johnson Foundation

by Meghan Kelly

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

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.

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.

 By Robin Farmer for HealthCallings

If Janet Patterson, RN, could go back in time, she would learn the answer to a simple yet overwhelming question: What exactly do nurses do?

For most people, images of bedpans and needles pop into their minds, says Patterson, a nurse for 33 years who now works as a home care nurse at Maxim Healthcare in Santa Rosa, Calif. “We think we know [before going to nursing school] what [nurses] do, but we really don’t. I became a nurse and I couldn’t talk about it with anyone who wasn’t one.”

A realistic job description tops the list of information veteran nurses say they wished they had known before embarking on their careers decades ago. Experienced nurses recommend that new nurses and students talk to people doing the job they want. Ask questions in person, by phone or online in chat groups for nurses.

Nursing is intimate

Nancy Brook, MSN, RN, NP, wished she had known that “I would be changed as a human being because of the intimacy of the moments that you share with patients.” New nurses must prepare for this, she says. The impact of witnessing many life-changing experiences such as birth, death and serious diagnoses lingers beyond the workday, says Brook, a nurse practitioner at Stanford Hospitals and Clinics in Redwood City, Calif. After the workday, “It’s not your muscles that are sore, it’s the mental muscles,” Brook says.

It’s important for new nurses to create a routine to unwind, learn healthy habits and stay socially connected, seasoned nurses advise.

Keep learning

When Cynthia Ringling, RN, BSN, started nursing in 1990, she had no idea “that the personal touch of nursing would have changed with the age of computers. It made the RN much more of an administrator and documenter,” says Ringling, a chief clinical officer at Interim Healthcare in Colorado. “A lot of the personal tasks we did have been pushed to unlicensed or trained people.”

Nursing is an evolving profession with changing technology. New nurses must stay open to learning from patients, peers, physicians, professors and other professionals.

Squash conflicts

Another discovery Brook wished she had known before pursuing her career are the challenges of working with colleagues. “It’s not the patients who are hard, it’s the other nurses, managers, physicians — that whole interplay that professionals experience, unless you are working independently,” she says.

Ask for help. Make building a support system a priority, veteran nurses recommend.

Remain flexible

Adjusting to an intense work schedule also topped the wish-I-had-known list for longtime nurses. Meeting the demands of patient care can be exhausting. Add nights, weekends and holidays to the mix and maintaining a social calendar requires patience and flexibility. Brook says she wishes someone had told her in advance she would be late for every party because her shift did not end on time.

Accept that people get sick every day and require care. Imagine patients as your own loved ones who need care, says Sheri Cosme, MSN, RN-BC, a clinical educator at MedStar Georgetown University Hospital.

“Nurses work 365 days a year, 24 hours a day. So to think as a new graduate nurse that you will only work days, Monday through Friday, is not realistic,” advises Cosme.

1. I remind myself, “Self, as long as your patients are alive and pain-free at the moment, your day isn’t that bad and half the battle is over…the other half is charting to prove that my patients are alive and pain-free.” Deep breath, looooong sigh and carry on, girl, because you’ve got this!”

2. Maybe eat lunch or go pee…those are always nice. LOL!

3. We adopted a five-second dance-off at the top of the hour. Regardless of what you’re doing in the ER, when the music comes over the intercom, you have to stop and break it down! Doesn’t go over well with the director, but what he doesn’t know…and it really works!

4. I use my break to call the ones I love. My husband and my mom are great for reminding me why I do this job. My mom—one of my favorite people to call—is also a nurse, and has done three deployments in more than 25 years of military nursing. If I think I’m having a bad day, I know for sure she’s gotten through worse ones, and she gives great advice. A little perspective goes a long way.

5. Hand puppets. Life is better with hand puppets. Seriously. They make you laugh.

6. Sometimes I look at job listings for positions outside of the medical field. Every time I read them, it reminds me I would never, ever make as huge an impact on anyone’s lives like I can in nursing.

7. I’m gonna go with “drink.” After work, of course.

8. As corny as it is, I go into the bathroom, stare at myself in the mirror and start making funny faces. Gives me a chance for a breather, and hey, if you can’t laugh at yourself, then who can?

9. We send jokes to other departments via fax or tube system to try to brighten someone else’s day. It’s very rewarding. 

10. I remind myself that if I’m having to nurse someone for any reason, they are having a worse day than I am. A smile goes a long way, and seeing and making someone else smile ALWAYS makes me feel better…and them, too!

Source: SCRUBS

By Rich Schapiro / NEW YORK DAILY NEWS

Nurses at New York’s largest hospital network are crying code red over a new policy that will force them to wear white.

Staffers at Lenox Hill Hospital, Forest Hills Hospital and the rest of the North Shore LIJ Health System fear their new white scrubs will lead to a terrible trifecta of problems:

Blood stains, visible panty lines and unsightly sweat marks.

"When you buy white polyester, it turns yellow," said Patricia Kane, a nurse at Staten Island University Hospital.

“There's also the see-through factor, which is a real issue. We bend and we stretch and we push and we pull. It’s not good when you have to wear white and you’re wondering what the guy in the next bed is thinking,” Kane told Crain’s New York Business.

The dress code overhaul, set to go into effect next month, will affect most of the 10,000 nurses who work at the 15-hospital network.

Officials said the change is part of an effort to help patients better identify their nurses amid the kaleidoscope chaos of hospitals.

“Like most hospitals, our various clinical departments all wear different color scrubs,” said North Shore LIJ spokesman Terry Lynam. “It’s a camaraderie thing, but what makes it difficult as a patient is you have so many people coming in and out of your room and most people struggle to know who does what.”

The nurses don’t quite see it that way.

Lenox Hill emergency room nurses joked last week they planned to protest the policy by wearing brightly colored or leopard-printed lingerie underneath their sterile whites, according to Crain’s.

Lynam noted the new rules apply to tops only — and he insisted that the nurses’ concerns are unfounded.

“A lot of it comes down to the quality of the fabric,” Lynam said. “As long as the quality of the fabric is high enough, you’re not going to have a problem with that.”

But Kane gave the dress code a poor diagnosis.

"It's demeaning to professionals to be told what to wear," Kane added.

Source: New York Daily News

By: The Advisory Board Company

The health care industry added 32,000 jobs in February, accounting for 13.6% of the 236,000 nonfarm jobs created last month, according to preliminary data released Friday by the U.S. Bureau of Labor Statistics (BLS).

In comparison, revised BLS data show that the health industry added just 13,000 jobs in January, partly because the agency now estimates that hospitals lost about 3,100 jobs in January.

Latest report shows hiring across industry

Within the health sector, physician offices and outpatient health centers experienced the biggest gains in February, adding about 14,000 jobs for the month, according to BLS. Meanwhile, ambulatory health care services added 13,700 jobs in February, down from 26,700 in January. 

The agency also found:

• Hospitals created 8,900 jobs in February;
• Home health care added 6,100 jobs, up from 5,700 new jobs in January; and
• Nursing homes added 9,000 new workers.

Overall, the national unemployment rate last month dropped to a four-year low of 7.7% (Selvam, Modern Healthcare, 3/8 [subscription required]; Baker, "Healthwatch," The Hill, 3/8).