DiversityNursing Blog

Legislation in California that set nurse-to-patient ratios added more registered nurses to the hospital staffing mix, not fewer as feared, researchers say.

Lead researcher Matthew McHugh, a nursing professor at the University of Pennsylvania in Philadelphia, says California was the first state to pass legislation setting staffing levels. However, mindful of the ongoing nurse shortage California legislators determined that hospitals could employ licensed practical nurses as well as registered nurses to meet the requirements of the law, McHugh says.

“California’s state-mandated nurse staffing ratios have been shown to be successful in terms of increasing registered nurse staffing,” McHugh says in a statement. “From a policy perspective, this should be useful information to the states currently debating legislation on nurse-to-patient ratios.”

California experienced a more serious nurse shortage than other areas of the country but made up the gap by hiring “travel nurses” — temporary workers who move from hospital to hospital as needed and ae not less educated LPNs, the researchers say.

The study, published in the journal Health Affairs, examined hiring practices from 1997 to 2008, pre- and post-implementation of the legislation, concluding that the increase in nurse staffing did not come at the expense of decreasing RNs.

“Our findings demonstrate that the nurse-to-patient ratio mandate in California was effective in increasing registered nurse staffing in hospitals,” McHugh says.

From monster.com

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Does your state have legislation like this? What do you think? Does it help or hinder you in doing your job? How about your patients? Let us know in the comments!

“Working on the front lines of patient care, nurses can play a vital role in helping realize the objectives set forth in the 2010 Affordable Care Act, legislation that represents the broadest health care overhaul since the 1965 creation of the Medicare and Medicaid programs. A number of barriers prevent nurses from being able to respond effectively to rapidly changing health care settings and an evolving health care system. These barriers need to be overcome to ensure that nurses are well-positioned to lead change and advance health.”

80% BSN Nurses by 2020?

One of the most ambitious recommendations in the report is the section on advancement of nursing education. It proposes the goal of transitioning the average 50% of the nursing workforce at the BSN level today to that of 80% of the workforce in the next 10 years. While this is a worthwhile goal, without the funding to pay for the ADN nurses to advance to the BSN level and the increase in pay that such an advance might ordinarily offer in another field, there is little hope of achieving this goal.

It makes no sense to shut down the existing pipeline of ADN nursing programs and requiring BSN as the minimum standard of education for registered nurse (RN). With the predicted nursing shortage, these ADN programs will be the only way we can meet the needs of the aging population and declining nursing workforce. Unless there is a major influx of scholarship funding from public and private sources to encourage nurses to go back to school in droves and provide them the financial incentive to do so, it is unlikely that the 80% goal will be reached by 2020.
Practice Within Full Scope of Nurse Training

One part of the process that met with approval from all of the panelists was the focus on expanding the scope and inclusion of advanced practice nurses nationwide. With health care costs continuing to skyrocket and a lack of needed primary care resources, offering a full provider status to nurse practitioners nationwide is one of the most effective ways to approach the broad primary care gap that exists. When physicians purport that they should be the only primary prescribers and decision makers for all patients, the IOM reports suggests that these objections be treated as anti-competitive practices and price fixing in the health care marketplace.

If you are a nurse, what do you think about shifting the educational percentages to 80% BSN? In some organizations, there is even a push for higher percentages of MSN degrees. What are you seeing where you work?

Pay should not be your only considering when deciding on a specialty, but the list below of the highest paying nursing specialties provides a good primer on which types of nurses have the greatest earning potential.

1) Certified Registered Nurse Anesthetist – $135,000

A Certified Registered Nurse Anesthetist is someone who administers anesthesia to patients. They collaborate with surgeons, anesthesiologists, dentists and podiatrists to safely administer anesthesia medications. For additional information, please refer to the entire CRNA profile.

2) Nurse Researcher – $95,000

Nurse researchers work as analysts for private companies or health policy nonprofits. They publish research studies based on data collected on specific pharmaceutical/medical/nursing product and practices.

3) Psychiatric Nurse Practitioner – $95,000

Psychiatric Nurse Practitioners are advanced practice nurses who provide care and consultation to patients suffering from psychiatric and mental health disorders.

4) Certified Nurse Midwife – $84,000

Nurse midwives provide primary care to women, including gynecological exams, family planning advice, prenatal care, assistance in labor and delivery, and neonatal care. CNMs work in hospitals, clinics, health departments, homes and private practices. Midwives will often have to work unpredictable hours (due to the unpredictable nature of childbirth). They should have good communications skills and be willing to commit to a holistic approach to patient care.

5) Pediatric Endocrinology Nurse – $81,000

Pediatric endocrinology nurses provide care to young children who are suffering from diseases and disorders of the endocrine system. This often involves educating both parents and children on the the physical and sexual development issues that arise from these disorders.

6) Orthopedic Nurse – $81,000

Orthopedic nurses provide care for patients suffering for musculoskeletal ailments, such as arthritis, joint replacement and diabetes. They are responsible for educating patients on these disorders and on available self-care and support systems.

7) Nurse Practitioner – $78,000

Nurse practitioners provide basic preventive health care to patients, and increasingly serve as primary and specialty care providers in mainly medically underserved areas. The most common areas of specialty for nurse practitioners are family practice, adult practice, women’s health, pediatrics, acute care, and gerontology; however, there are many other specialties. In most states, advanced practice nurses can prescribe medications.

8) Clinical Nurse Specialist – $76,000

Clinical Nurse Specialists develop uniform standards for quality care and work with staff nurses to ensure that those standards are being met. They are required to possess strong managerial skills and an ability to anticipate potential staff/patient conflicts.

9) Gerontological Nurse Practitioner – $75,000

Gerontological Nurse Practitioners (GNPs) hold advanced degrees specializing in geriatrics. They are able to diagnose and manage their patients’ often long-term and debilitating conditions and provide regular assessments to patients’ family members. Similar to all geriatric nurses, GNPs must approach nursing holistically and pay special attention to maintaining a comforting bedside manner for their elderly patients.

10) Neonatal Nurse – $74,000

Neonatal nurses care for sick and/or premature newborn babies. They also provide consultation to the newborn’s family during what can be an emotionally draining period.

Hospital employment climbed by 15,400 in February

Employment at the nation's hospitals increased 0.32% in February to a seasonally adjusted 4,806,600 people, the Bureau of Labor Statistics reported today. That's 15,400 more people than in January and 109,600 more than a year ago. Without the seasonal adjustment, which removes the effect of fluctuations due to seasonal events, private hospitals employed 4,797,600 people in February - 13,300 more than in January and 111,500 more than a year ago. The nation's overall unemployment rate was unchanged in February at 8.3%.

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What are your thoughts? Is your hospital hiring? Growing? Why do you think so?

New CDC Campaign Aims to Stem HIV Crisis among Black Women

To combat the high toll of HIV and AIDS among black women in the United States, the Centers for Disease Control and Prevention today launched Take Charge. Take the Test., a new campaign to increase HIV testing and awareness among African-American women. The campaign – which features advertising, a website and community outreach – is being launched in conjunction with National Women and Girls HIV/AIDS Awareness Day in 10 cities where black women are especially hard-hit by the disease.

“At current rates, nearly 1 in 30 African-American women will be diagnosed with HIV in their lifetimes,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. “To help reduce this toll we are working to remind black women that they have the power to learn their HIV status, protect themselves from this disease, and take charge of their health.”

The program is being launched in Atlanta; Chicago; Detroit; Fort Lauderdale, Fla.; Houston; Memphis, Tenn.; Newark, N.J.; New Orleans; Hyattsville, Md.; and St. Louis.

Take Charge. Take the Test. is part of CDC’s commitment to address the urgent HIV prevention needs of African-American women, who are far more heavily affected by HIV and AIDS than women of any other race or ethnicity in the United States. African-American women account for nearly 60 percent of all new HIV infections among women (and 13 percent of new infections overall). The rate of new infections among black women is 15 times higher than among white women.

The campaign emphasizes the importance of HIV testing as a gateway to peace of mind and better health. Campaign messages will reach black women through a variety of highly visible channels, including outdoor and transit advertising; radio ads; posters and handouts distributed in salons, stores, community organizations, and other venues; campaign ads and materials on health department and partner websites; and a dedicated campaign website,http://hivtest.org/takecharge, where women can find HIV testing locations in their communities.

In addition to promoting HIV testing, the campaign encourages African-American women to talk openly with their partners about HIV and insist on safe sex, and to bring these same messages to other women in social settings, workplaces, living rooms, and religious congregations.

Take Charge. Take the Test. reflects a strong partnership between CDC, health departments, and local organizations in the 10 participating cities, which worked together to develop local campaigns for the communities they serve. The campaign was initially piloted in Cleveland and Philadelphia, where Take Charge. Take the Test. community events were attended by nearly 10,000 women, and campaign messages were seen more than 100 million times.

“We hope to extend the reach of this campaign to multiple cities throughout the nation, help empower many more women to take control of their health, and help break the silence about HIV in their communities,” said Jonathan Mermin, M.D., director of CDC’s Division of HIV/AIDS Prevention (DHAP).

Research shows that black women are no more likely than women of other races to engage in risky behaviors. But a range of social and environmental factors put them at greater risk for HIV infection. These include higher prevalence of HIV and other sexually transmitted infections in some black communities, which increase the likelihood of infection with each sexual encounter. Limited access to health care can prevent women from getting HIV tested. Research also shows that financial dependence on male partners may limit some women’s ability to negotiate safe sex. HIV stigma, far too prevalent in all communities, may also discourage black women from seeking HIV testing.

“This campaign is just one part of the solution,” said Donna Hubbard McCree, Ph.D., associate director for health equity at DHAP. “All of us have a role to play in stopping the spread of HIV among black women – by talking to our sisters, daughters, husbands, and boyfriends about how to protect ourselves against HIV and the importance of getting tested; by speaking out against stigma; and by tackling the social inequities that place so many of us at risk for HIV.”

Take Charge. Take the Test. is the latest campaign of CDC’s Act Against AIDS initiative (http://actagainstaids.org) a five-year, $45 million national communication campaign to combat complacency about the HIV/AIDS crisis in the United States. The campaign also directly addresses the goals of the National HIV/AIDS Strategy, which calls for reducing new infections, intensifying HIV prevention efforts in communities in which HIV is most heavily concentrated, and reducing HIV-related deaths in communities at high risk for HIV infection. Other Act Against AIDS campaigns include those targeting high-risk populations such as gay and bisexual men, as well as efforts to reach health care providers and the general public.

from The CDC   

What do you think? How will the CDC Campaign work? Will it be effective? Shoot off in the comments!

"Patients in the hospital are often under a lot of stress," says Marilen. "Certain scents can enhance a feeling of calm, reduce anxiety and in turn improve outcomes."   

She adds, "It's also a familiar healing approach for many of my patients, who have been exposed to the benefits of aromatherapy because of their unique cultural backgrounds."

Marilen says her own diverse background inspired her to create the aromatherapy program. "I grew up using aromatherapy. My aunts in the Philippines would boil certain leaves when my mom suffered migraines. And my mother would give me citrus fruits to smell when I got carsick."   

Marilen created the unique program last year while at Sutter Health's California Pacific Medical Center (CPMC) in San Francisco. Her program was the centerpiece of a study the hospital conducted to determine how aromatherapy could improve patient satisfaction and overall experience. It was so successful there; she hopes to import the program to CPMC's St. Luke's campus, where she's now the interim supervisor of nurses in the telemetry, medical-surgical, and intensive care units.     

Journey to Nursing  

Growing up in her native Philippines and then Dubai before moving to the San Francisco Bay Area, Marilen always admired the work of her aunts -- all nurses. Although she wanted to follow in their footsteps, Marilen's journey to nursing took a slight detour.   

"Believe it or not, I was squeamish about blood," she laughs. So after earning a degree in psychology she worked in the world of finance.   

But as Marilen watched her parents get older, she realized that the need for high-quality medical caregivers would grow. So she banished her fears and entered a masters nursing program with an emphasis in health care systems leadership.   

"My parents believe strongly in education and compassion for others," Marilen says. "I want to pass along those same values to my teams. When nurses are supported and encouraged, they see the bigger picture and begin to really 'own' their unit. This results in a better working environment for nurses and better patient care."   

Marilen says her deep-rooted values also created a foundation for her professional success. "I have been able to move into leadership because I'm always looking for ways to continue my education. My supervisors at CPMC also have confidence in me and help me find these opportunities," Marilen says.   

In fact, her aromatherapy program was her final project for the Leadership Residency Program, a one-year paid leadership development program sponsored by Sutter Health. "I was amazed and grateful to be selected by my Chief Nursing Officer to take part in the LRP," Marlien says. "I'm also thankful to work for a hospital and health system that supports its employees with such wonderful opportunities."   

Future Smells Sweet  

Marilen's dreams for her future are as strong as the lavender oil in her aromatherapy program. "I hope to become a chief nursing officer someday," she says. "I also hope to teach student nurses and honor my aunts by mentoring my younger cousins who have gone into nursing."

"I've found a great place to work and see myself staying here a long time so that I can give back," she adds," "I want nurses to be happy where they work."

To learn more about nursing at Sutter Health, please click here.

1. Communication Skills

Solid communication skills are a basic foundation for any career. But for nurses, it’s one of the most important aspects of the job. A great nurse has excellent communication skills, especially when it comes to speaking and listening. Based on team and patient feedback, they are able to problem-solve and effectively  communicate with patients and families.

Nurses always need to be on top of their game and make sure that their patients are clearly understood by everyone else. A truly stellar nurse is able to advocate for her patients and anticipate their needs.

2. Emotional Stability

Nursing is a stressful job where traumatic situations are common. The ability to accept suffering and death without letting it get personal is crucial. Some days can seem like non-stop gloom and doom.

That’s not to say that there aren’t heartwarming moments in nursing. Helping a patient recover, reuniting families, or bonding with fellow nurses are special benefits of the job. A great nurse is able to manage the stress of sad situations, but also draws strength from the wonderful outcomes that can and do happen.

3. Empathy

Great nurses have empathy for the pain and suffering of patients. They are able to feel compassion and provide comfort. But be prepared for the occasional bout of compassion fatigue; it happens to the greatest of nurses. Learn how to recognize the symptoms and deal with it efficiently.

Patients look to nurses as their advocates — the softer side of hospital bureaucracy. Being sympathetic to the patient’s hospital experience can go a long way in terms of improving patient care. Sometimes, an empathetic nurse is all patients have to look forward to.

4. Flexibility

Being flexible and rolling with the punches is a staple of any career, but it’s especially important for nurses. A great nurse is flexible with regards to working hours and responsibilities. Nurses, like doctors, are often required to work long periods of overtime, late or overnight shifts, and weekends.

Know that it comes with the territory. The upside is that a fluctuating schedule often means you’re skipping the 9 to 5, cubicle treadmill. Sounds perfect, right? Run errands, go to the movies, or spend time with the family — all while the sun still shines!

5. Attention to Detail

Every step in the medical field is one that can have far-reaching consequences. A great nurse pays excellent attention to detail and is careful not to skip steps or make errors.

From reading a patient’s chart correctly to remembering the nuances of a delicate case, there’ s nothing that should be left to chance in nursing. When a simple mistake can spell tragedy for another’s life, attention to detail can literally be the difference between life and death.

6. Interpersonal Skills

Nurses are the link between doctors and patients. A great nurse has excellent interpersonal skills and works well in a variety of situations with different people. They work well with other nurses, doctors, and other members of the staff.

Nurses are the glue that holds the hospital together. Patients see nurses as a friendly face and doctors depend on nurses to keep them on their toes. A great nurse balances the needs of patient and doctor as seamlessly as possible.

7. Physical Endurance

Frequent physical tasks, standing for long periods of time, lifting heavy objects (or people), and performing a number of taxing maneuvers on a daily basis are staples of nursing life. It’s definitely not a desk job.

Always on the go, a great nurse maintains her energy throughout her shift, whether she’s in a surgery or checking in on a patient. Staying strong, eating right, and having a healthy lifestyle outside of nursing is important too!

8. Problem Solving Skills

A great nurse can think quickly and address problems as — or before — they arise.

With sick patients, trauma cases, and emergencies, nurses always need to be on hand to solve a tricky situation. Whether it’s handling the family, soothing a patient, dealing with a doctor, or managing the staff, having good problem solving skills is a top quality of a great nurse.

9. Quick Response

Nurses need to be ready to respond quickly to emergencies and other situations that arise. Quite often, health care work is simply the response to sudden incidences, and nurses must always be prepared for the unexpected.

Staying on their feet, keeping their head cool in a crisis, and a calm attitude are great qualities in a nurse.

10. Respect

Respect goes a long way. Great nurses respect people and rules. They remain impartial at all times and are mindful of confidentiality requirements and different cultures and traditions. Above all, they respect the wishes of the patient him- or herself.

Great nurses respect the hospital staff and each other, understanding that the patient comes first. And nurses who respect others are highly respected in return.

Student at the UCLA School of Nursing start their nursing career with a high tech boost. As part of their ceremony to receive their white coats, this year they were also give iPod Touch devices preloaded with Medication and Diagnosis guides as well as a Spanish language dictionary and translation assistance. UCLA is determined to offer new grad nurses that are ready for "High Touch" care but within a "High Tech" environment.

 Nursing Reimagined. Nursing Redefined.

Want to Learn More?

• Civil Rights Memorial Center Located in historic Montgomery, Ala., across the street from Southern Poverty Law Center, the center offers images of iconic civil-rights leaders, a 56-seat theater and the Wall of Tolerance, where visitors pledge to take a stand against hate by entering their names on an interactive wall.
• DuSable Museum of African American History This Chicago museum has been dedicated to the collection, preservation, interpretation and dissemination of the history and culture of Africans and Black Americans for more than 46 years.
• Hampton University Museum & Archives Located on the grounds of Hampton University campus, the museum, which was founded in 1868, is one of the oldest in Virginia. It features more than 9,000 objects, including African American fine arts, traditional African, Native American, Native Hawaiian, Pacific Island, and Asian art.
• Idaho Black History Museum Housed in St. Paul Baptist Church in Boise, one of the oldest buildings constructed by Idaho Blacks, the museum presents exhibits and educational outreach, including workshops, literacy programs and music.
• International Civil Rights Center & Museum This newly opened exhibit and teaching facility, located in the historic F.W. Woolworth building in Greensboro, N.C., where four N.C. A&T freshmen set off a nonviolent sit-in 50 years ago, is a recreation of what the segregated South was like during the civil-rights movement. 
• Museum of African American History in Boston Based in an African Meeting House, the oldest U.S. church built by free Blacks in 1806 has recently been restored, thanks largely to sponsorship from Walmart Foundation. It features stories of Blacks from 1638 through the Civil War.
• NAACP Interactive Historical Timeline Funded through a $500,000 grant from the Verizon Foundation, this newly launched online learning tool from the NAACP offers major milestones in Black history, biographies of legendary leaders in Black history and other educational resources. Verizon Communications is No. 22 in the 2011 DiversityInc Top 50.
• Smithsonian National Museum of African American History & Culture Although the museum is currently being built on the National Mall in the District of Columbia, not far from what were once slave markets called “Robey’s Den,” a gallery can be found on the second floor of the National Museum of American History. And thanks to a $1-million grant of technology and expertise from IBM (No. 7), you can take a virtual tour at nmaahc.si.edu.

VIDEOS

1. DiversityInc CEO Luke Visconti and National Civil Rights Museum President Beverly Robertson
2. Charles H. Wright Museum of African American History
3. African American History Museum in Boston
4. Smithsonian National Museum of African American History series
5. National Underground Railroad Freedom Center

COLLATERAL MATERIAL

• PricewaterhouseCoopers: 10 Minutes on Managing Diversity
• PricewaterhouseCoopers: Confronting the Issue brochure
• PricewaterhouseCoopers: Impact fact sheet
• PricewaterhouseCoopers: Why Diversity Why Now
• WellPoint’s Black History Month poster

Nurse Robert Freeman's free app helps nurses decode thousands of medical abbreviations they see on charts

NEW YORK DAILY NEWS (reprint)
Published: Monday, January 30, 2012
by Clem Richardson

When Apple accepted his app in November, Robert “Robbie” Freeman said he would have been happy if 1,000 people downloaded it in the first year.

A little over 60 days later, more than 12,000 people have downloaded Freeman’s “Nurse Net” app, and the 26-year-old registered nurse could not be happier - even though he has not made a dime on the deal, since he demanded the app be free.

“People all over the world are downloading it,” Freeman said. “They’ve really embraced it. I really wanted it to be something everyone can use.”

Freeman is a registered nurse and staff nurse at Beth Israel Hospital. Last year he won both the 2011 Novice Nurse of the Year from his employer, Beth Israel Medical Center, and the Novice Nurse of the Year, Nurse of Distinction award from 1199/Service Employees International Union.

He used the money from the award to come up with his app after realizing the need.

“I was speaking to my nurse colleagues about the things we would love to see in an app, tools that would help us deliver care and help us practice our profession,” Freeman said. “My generation, the millennial generation, really have embraced apps, but there are not a lot of them out there for nurses, even though nurses make up the largest group of health professionals in the country.”

Nurse Net’s tools include a News Reader, which gathers medical news from the top nursing websites and media outlets.

“Health care is always changing and the standards of care are always evolving,” Freeman said. “It’s important to stay up to date. With the reader you can keep up with the latest medical news.”

The Abbreviation Assistant decodes more than 10,000 medical abbreviations nurses are liable to encounter on medical charts, like HLD, which stands for Hyperlipidemia, high levels of fat in the blood.

“The idea came to me one day when a colleague said she saw this abbreviation on a chart and didn’t know what it meant,” Freeman said. “Health care has a culture of abbreviating everything, so sometimes it’s hard to keep up.

“This can help with patient safety, because if you are unsure of an abbreviation it could compromise treatment plans,” he said.

The Credentialer does the same as the abbreviation assistant, only for degrees or credentials health professionals list after their names.

“We have a lot of certifications and specialities in medicine, and with each degree, exam and organization comes another set of initials,” Freeman said. “Sometimes there are all sorts of initials after a name and it’s not always apparent what they mean. You put the abbreviation in the app and it tells you what it means.”

TELL YOUR DOCTOR EVERYTHING

A graduate of both the University of Albany and Phillips Beth Israel School of Nursing, Freeman works on the Chris and Morton P. Hyman Patient Care Unit at Beth Israel.

He turned to friend Daniel Delphin, founder of DS410 a New York City based Mobile Application Company, for the technical work on his app, but did most of the research himself over a three-month period.

A former Long Island Athlete of the Year (2003) for his long distance running, Freeman is committed to helping others: after completing nursing school he spent three weeks with an American medical team doing free work in rural Kenya, East Africa.

The Nurse Net app, he said, is just more of the same.

“I have no interest in making a profit here,” Freeman said. “The nursing community as a whole has given me so much. I felt very strongly I wanted this to be a free app. People in nursing school will benefit from it the most, and they are already saddled with fees. I didn’t want this to be another fee they had to pay.

“To be able to allow nurses to go to work and improve the safety of the care they give their patients while letting them be more efficient and productive, how can I not give that for free?”

The Nursing Net app is available at the Apple Store.

Read more: http://www.nydailynews.com/new-york/beth-israel-nurse-creates-nurse-net-a-free-app-nurses-deliver-healthcare-digital-age-article-1.1013660#ixzz1leu0kYyR