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DiversityNursing Blog

Nurses Wanted: Largest Women’s Health Study Expanding To Include Men; Seeking 100,000 Nurses

Posted by Erica Bettencourt

Fri, Feb 13, 2015 @ 10:27 AM

Nurses’ Health Study recruits “next generation”

Boston, MA - From the dangers of tobacco and trans fats to the benefits of physical activity and whole grains, much of what we know about health today is thanks to the Nurses’ Health Study.

Researchers are recruiting 100,000 nurses and nursing students to join the long-running Nurses’ Health Study and expand its landmark research on health and well-being. And for the very first time, male nurses and students are being invited to join. 

RNs, LPNs, and nursing students between the ages of 19 and 46 who live in the US or Canada are eligible to join the study. More than 38,000 have signed up already, and recruitment will stay open until the goal of 100,000 participants is reached.

Researchers hope to engage a highly diverse group of nurses in the “next generation” of the study. For the first time, nursing students are eligible to enroll.

In order to make participation as convenient as possible for busy nurses, participants can join online and complete the study’s surveys through a secure website, http://www.nhs3.org/.

More than 250,000 nurses have participated in the study since the 1970s. By completing confidential lifestyle surveys, they have helped advance medical knowledge about nutrition, exercise, cancer, heart disease, and many other conditions.

“Nurses were originally recruited for their expertise in accurately reporting health data,” explains Dr. Walter Willett, the study’s lead researcher and Chair of the Nutrition Department at Harvard School of Public Health in Boston, Mass. “Their involvement has been invaluable, and their dedication is remarkable—an astounding 90% of them are still enrolled, decades later! The new group, NHS3, will allow us understand how today’s lifestyle and environment affect a person’s health in the future.”

Nurses enrolled in the earlier studies are encouraging their children and younger colleagues to join. “My mom started filling out surveys when the study began,” one nurse recently commented on the NHS3 Facebook page (www.facebook.com/NHS3.org). “I am so proud to be part of this study and see what it has done.”


###

NURSES’ HEALTH STUDIES
Started in 1976 and expanded in 1989, the Nurses’ Health Studies have led to many important insights on health and well-being, including cancer prevention, cardiovascular disease, and diabetes. Most importantly, these studies showed that diet, physical activity, and other lifestyle factors can powerfully promote better health.

Contact: Michael Keating
617-432-7078

 nhs3@channing.harvard.edu

SOURCE Nurses Health Study 3    www.nhs3.org

Topics: women, study, men, nursing students, nursing, health, nurse, nurses, medical, health study

Greek Austerity Spawns Fakery: Playing Nurse

Posted by Erica Bettencourt

Mon, Feb 09, 2015 @ 01:10 PM

By 

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ATHENS — Fotini Katsigianni wears a white nurse’s hat that protrudes prominently from the top of her head. She is head nurse at Evangelismos Hospital, one of the city’s most prominent.

So she was surprised last month when she was approached by a man in the hospital’s hallway. At the time, Ms. Katsigianni’s husband was a patient there. The strange man extended an arm with a business card and averted his face, so she could not identify him. He offered to rent her a cut-rate nurse.

“He told me for 30 euros I could have whatever I want!” Ms. Katsigianni said, laughing at the idea of the head nurse being solicited to buy illegal nursing care.

First the men come to the hospitals of Greece during visiting hours, leaving business cards with pictures of nurses under pillows and in waiting rooms. Then the women come at night, mostly foreigners from countries like Georgia, Romania and Bulgaria. They are the nurses of Greece who aren’t really nurses.

Greece’s dire finances have gutted its health care system. Universal coverage effectively ended under the austerity measures imposed under the terms of the country’s bailout. Budget cuts have also thinned the ranks of hospital staff nurses, who are supposed to handle medical tasks like changing IVs.

Now, when patients come to a hospital in Greece, they increasingly have to hire their own nurses just to receive basic care. While private nurses have long been a feature of Greek health care, the country’s wrenching economic crisis has left many patients with neither the money nor the insurance coverage to hire licensed caregivers.

Instead, patients are turning to illegal nurses, often immigrants with little or no training. One top official said he believed that half of the nursing care came from 18,000 illegal providers.

The situation reflects the grip of the black-market economy on Greece, where even paying skilled workers like mechanics and plumbers under the table to avoid taxes is commonplace. Frustrations among Greeks over the deterioration of living standards helped feed the left-wing Syriza Party, which came to power last month vowing to reject austerity policies.

Illegal nurses typically pose as family members or say they are longtime personal employees of a patient. In reality, temp agencies employing these women send men into the hospitals to distribute business cards advertising 12 hours of nursing care for less than $60. By contrast, a contract nurse at another hospital, Sotiria, costs nearly $70 for 6 hours and 40 minutes, though those who still have insurance can be reimbursed for about a third of the cost.

Thanos Maroukis, a professor at the University of Bath, England, who has studied the problem, said temporary agencies are taking “over control of the hospital’s workplace,” adding, “It’s incredible what’s happening, but it’s true.”

Nurses are just the beginning. Almost anything can be rented.

“We have the same thing with TVs, with ambulances, I would say with bedding,” said Anastasios Grigoropoulos, the chief executive of Evangelismos Hospital. “Or chairs.”

Chairs are carried in by strangers who rent them to groups of visiting relatives. Or they bring televisions.

In many other developed countries, hospital security would simply expel unauthorized visitors. But administrators face staff shortages and impoverished patients. They also say they lack the legal jurisdiction to act without police intervention.

“Because of the crisis, the last three years, we see more and more illegal nurses,” said Mr. Grigoropoulos. “You can’t do anything.”

He has called the police, and a few days earlier, Evangelismos was raided. Several illegal nurses were arrested, but that is a fairly rare event, because the police have had their own cutbacks.

Government agencies, too, have been overwhelmed. An influx of immigrants since the 1990s swelled a pool of cheap labor.

These immigrants “filled the space and found themselves in every clinic and every hospital,” said Dimitrios Papachristou, a senior official at the Social Insurance Institute, a state agency known by its Greek acronym, IKA, which provides insurance and pensions to 2.2 million Greek workers, including nurses. “Why is that? There was a great demand by the patients” for cheaper care, Mr. Papachristou said.

Part of the problem, he said, was that his agency had been given the task of conducting inspections of nursing credentials, a task beyond its typical expertise.

“Let me give you an example,” he said. “I’ll send an inspector to a hospital to inspect contract nurses who work there. So I find at that hospital 15 people who are working there do not have an IKA permit.”

But often he does not have the authority even to issue fines. Instead, his agency reports such incidents to hospital directors, and they decide whether to call the police.

“It’s an extremely illogical thing,” he said.

Because most illegal nurses are immigrants, Golden Dawn, the far-right extremist party, has attempted some of its own “raids” on hospitals, advancing its xenophobic agenda.

But some of the real nurses having trouble getting work are themselves immigrants, like Eleni Souli, a 41-year-old Albanian who married a Greek man and works as a contract nurse. She was sitting among a group of eight other nurses at a cafe outside another Athens hospital recently. All had studied for two to four years to become nurses, and they poured out their frustration over coffee and cigarettes.

“They are not nurses," Ms. Souli said of the illegal workers.

Maria Skiada, 54, has been a nurse for 23 years. She said she recently saw a woman who did not even use gloves when she cleaned up.

“That is how you get bugs all around the hospital,” she said.

Ms. Souli said doctors would sometimes be surprised at how infections spread.

“When they see that in the blood work of a patient, they’ll see something and say, ‘Where did he get that from?’ ”

She counted eight illegal nurses at the clinic where she worked the previous evening. “At night,” she said, “it’s full of them.”

That was clear in another part of town, at Sotiria Hospital, on a recent chilly night.

A young Georgian woman in a striped blue shirt was caring for a patient. She said she had already been working at the patient’s home and came with him to the hospital, a claim administrators say is frequently used. A second woman peeked out of the room next door, then waved away questions, saying she could not speak Greek.

“They take food out of our mouths. That’s how it is,” said Stavroula Antoniou, 46, a licensed nurse who works on temporary contracts at Sotiria. She emphasized that her bitterness was not tinged with racism and that many legitimate nurses were foreign-born.

“We’ve earned this,” she said of her job. “We’ve studied and we’ve sat in classrooms.”

Dr. Miltiadis Papastamatiou, Sotiria’s chief executive, said retired nurses were often not replaced, “and that’s led to the needs of both patients and staff not being adequately met,” though he downplayed the extent of the problem at Sotiria.

But a staff nurse there, who would not give her name for fear of losing her job, acknowledged the severity of the issue.

“We know what’s going on,” she shrugged. “Everybody knows.”

Source: www.nytimes.com

Topics: Greece, health care system, health, nurse, nurses, health care, medical, patients, hospital, treatment

Clinical Signs For Impending Death In Cancer Patients Identified

Posted by Erica Bettencourt

Mon, Feb 09, 2015 @ 01:05 PM

Written by James McIntosh

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While many would rather not think about when someone might die, knowing how much longer a seriously ill person has left to live can be very useful for managing how they spend their final days. Researchers have now revealed eight signs in patients with advanced cancer associated with death within 3 days.

Diagnosis of an impending death can help clinicians, patients and their friends and family to make important decisions. Doctors can spare time and resources by stopping daily bloodwork and medication that will not make a short-term difference. Families will know if they still have time to visit their relatives.

"This study shows that simple bedside observations can potentially help us to recognize if a patient has entered the final days of life," says study author Dr. David Hui.

"Upon further confirmation of the usefulness of these 'tell-tale' signs, we will be able to help doctors, nurses, and families to better recognize the dying process, and in turn, to provide better care for the patients in the final days of life."

The study, published in Cancer, follows on from the Investigating the Process of Dying Study - a longitudinal observational study that documented the clinical signs of patients admitted to an acute palliative care unit (APCU). During the study, the researchers identified five signs that were highly predictive of an impending death within 3 days.

For the new study, the researchers again observed the physical changes in cancer patients admitted to two APCUs - at the MD Anderson Cancer Center in Houston, TX, and the Barretos Cancer Hospital in Brazil.

Eight highly-specific physical signs were identified

A total of 357 cancer patients participated in the study. The researchers observed them and documented 52 physical signs every 12 hours following their admission to the APCUs. The patients were observed until they died or were discharged from the hospitals, with 57% dying during the study.

The researchers found eight highly-specific physical signs identifiable at the bedside that strongly suggested that a patient would die within the following 3 days if they were present. The signs identified were:

  • Decreased response to verbal stimuli
  • Decreased response to visual stimuli
  • Drooping of "smile lines"
  • Grunting of vocal cords
  • Hyperextension of neck
  • Inability to close eyelids
  • Non-reactive pupils
  • Upper gastrointestinal bleeding.

With the exception of upper gastrointestinal bleeding, all of these signs are related to deterioration in neurocognitive and neuromuscular function.

Neurological decline strongly associated with death

"The high specificity suggests that few patients who did not die within 3 days were observed to have these signs," the authors write. "These signs were commonly observed in the last 3 days of life with a frequency in patients between 38% and 78%. Our findings highlight that the progressive decline in neurological function is associated with the dying process."

As the study is limited by only examining cancer patients admitted to APCUs, it is not known whether these findings will apply to patients with different types of illness. The findings are currently being evaluated in other clinical settings such as inpatient hospices.

On account of the relatively small number of patients observed for this study, the authors also suggest that their findings should be regarded as preliminary until validated by further research.

In the meantime, the authors of the study are working to develop a diagnostic tool to assist clinical decision-making and educational materials for both health care professionals and patients' families.

"Upon further validation, the presence of these telltale signs would suggest that patients [...] are actively dying," they conclude. "Taken together with the five physical signs identified earlier, these objective bedside signs may assist clinicians, family members, and researchers in recognizing when the patient has entered the final days of life."

Source: www.medicalnewstoday.com

Topics: signs, diagnosis, ill, clinicians, health, research, nurses, doctors, health care, cancer, patients, death, treatment, clinical

Instagram’s Graveyard Shift

Posted by Erica Bettencourt

Wed, Feb 04, 2015 @ 12:44 PM

By JEFF SHARLET

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The photograph that Markisha McClenton posted on Instagram is a self-portrait, a close-up that is muted in dim light. She might be on her way to work. She might be coming home. Her workdays begin and end in the dark, and they are dark in between. She’s a lab technician in Jacksonville, Fla. Her specialty is blood. She has worked these dark hours since her son was 7. “Freedom,” she told me over the phone from her lab. That’s why she works these hours: The freedom to work at night and to raise her children during the days. To her, this is good fortune. She is smiling in this photo. But her eyes are midnight eyes, 3 a.m. eyes. Why take a photo at that hour? “People forget about us, the night shift,” she said. The #nightshift. That’s the hashtag she used. It’s how I found her.

I’ve been working at night myself for a long time now. Once it was out of choice, a preference for the quiet hours. More recently it was because I had no choice. Insomnia. One night, I was drinking my third cup of coffee — because when you can’t sleep, you might as well stop trying — and ignoring the deadline looming the next morning. Instead, I stared at the matrix on my phone, my own red eyes scanning a tiny sample of some 670,000 photographs under #nightshift. Most of them were people like me, awake when they didn’t want to be awake. And like me, they were looking at the screen in their hands, held up by the one in mine.

Night Life

This is the ghost world of #graveyardshift (#nightshift’s sister hashtag), whose workers file into Instagram every evening. These pictures may be clever or maudlin, silly or harrowing or sad. “Desperate” is a word that comes to mind, but so does “resigned.” And even “resistance.” Sometimes it’s in the form of a gag, a ridiculous pose; sometimes it’s in the form of a gaze so steady that it seems to warm the fluorescent panels framing so many of these pictures. The hashtag itself is a form of solidarity.

There are the warehouse workers who snap themselves letting a wisp of marijuana smoke slip from between their lips, little Instagram rebellions. There are the soldiers and sailors pulling a night shift for no good reason other than orders, photographing themselves and their comrades on the verge of sleep or already under. Cops in noirish black and white, their pictures framed to show a bit of badge. And nurses. A lot of nurses. Close-up, arm’s length, forced smiles, dead eyes. Scroll through #nightshift, and you’ll see some saints among them and some whose hands you hope will be more alive in an emergency than their ashen faces.

The #nightshift hashtag is especially well populated by the armed professions and the healing ones. Sometimes they are almost one and the same, as in the case of @armedmedic3153, a.k.a. Marcelo Aguirre, a paramedic in Newark and suburban New Jersey. He owns an AR-15, a ­9-millimeter­ and a shotgun, but the only thing he shoots on the night shift is his camera. He works nights so he can study days; he wants to be a doctor. Nights are good preparation for that: You get more serious cases. You learn on the job. A 12-hour course each night you’re on. Twenty-four hours if you take a double. After a while, the adrenaline that juices you when you’re new — when you’re still keeping a tally of the lives you’ve saved — disappears. You just do the job. “High speed and low drag,” Aguirre told me when I called. “Please ignore the siren,” he said. “We’re going to a call.” A stroke. Nothing to get excited about. Coffee sustains him. He stays clean. Some guys, he said, use Provigil, but that’s prescribed. “For shift-work disorder,” he said.

Markisha McClenton, the lab tech, told me that she no longer gets sleepy. “I program myself,” she said. She wouldn’t change her schedule now if she could. She likes working alone. There are nurses at the facility where she works, but they don’t often venture back to the lab. “They think it’s creepy,” she said. “At night.” Maybe it is: The long hours of the night shift are a reckoning with time.

“There’s people still struggling like I struggle,” a miner named Mike Tatum told me, explaining why he posts pictures and why he looks at them. “Working through the night, not sleeping next to your wife, missing your kids because they go to school before you get home.” Tatum likes to post pictures of the heavy machines used to dig coal from Wyoming strip mines. He drives a D-11 bulldozer. “I push dirt,” he said. Other machines dig the coal. Twelve hours of ‘dozing, four nights in a row. He came to this job — a good one, $30 an hour or more for as long as the coal lasts — after construction work dried up in California. “Nobody back home has really seen what we do out here,” he said. It’s a good job, he swears. He’s brought his 6-year-old boy out to see the machines. He’d be proud if his kids grew up to be miners. A good job. Rough on the back. But you’re just sitting. Driving the ‘dozer. Nobody bothers you. Hours without a word. “Pretty easy,” he said. Plenty of time to think. To make plans. Things he can do with his days, when he has days.

So far, this is enough to see him through the nights safely. “Quite a few fatalities the past year,” he observed. He heard about a man at another mine who drove a machine into the pit. “Maybe a suicide.” It didn’t seem like an accident; he had to drive through a couple of berms. “Splat,” Tatum said. “And a couple more like that.” He says other guys have died on the road, Highway 59. It’s a long drive out to the mines, and drug testing never stopped anyone from drinking, especially after the shift is over.

Pan out to take in some fraction of the 670,000 faces. Pay attention to the eyes, drooping or unnaturally wide. Is it fatigue? Or something more? Something less? Stay sane, and the night shift may seem like just another set of hours. Lose yourself to the loneliness, and the daylight leaks out of you. But something else can come in. A kind of calm. The kindness of dark hours.

When I was first drawn into this nighttime Insta­gram grid, I was looking for a distraction, for ­images to displace the thoughts that had agitated me to exhaustion. What I found instead was something that seemed descended from Walt Whitman’s “Democratic Vistas,” his great prose poem of an essay that was really a proposal for a new kind of literature, a way of speaking, a way of seeing. We shouldn’t mistake Instagram’s squares for the public one. But neither should we miss the quiet dig­nity afforded by gathering under this hashtag: the solidarity of recognition, of being seen.

“Nightwalkers,” Pierre Bell calls the men and women who find their peace after-hours. He’s new to the night himself, working as a nurse’s aide on the behavior unit at an assisted-living home in Akron, Ohio. “What’s behavior?” I asked. “Combative,” he said. “Lockdown. Spit, kick, hit, bite.” Sounds terrible, I said. It’s not, he told me, especially at night, when the anger subsides, and when the alarm I can hear beeping in the background is an event rather than a constant song. The other aide will get that one. Bell, a 28-year-old father of a 9-month-old, was sitting with the nightwalkers. The strange ones, the restless ones, the story­tellers. “Some were in wars,” he told me. “Some were teachers.” Sometimes they talk for hours. If they’re up, he’s up. It feels to him like a matter of courtesy. The behavior unit is his patients’ home. He’s only visiting. Trying out the night they live in.

And on his break, he can slip away. Take a snapshot, make a record of himself in this new country of the other hours, post it on Instagram as ­@piebell522.­ He took the one that caught my eye when he was in the bathroom. “I saw the dark behind me,” he said. “I thought it could be a picture.” A lovely one, as was the shot that followed hours later: Bell’s baby boy, the reason he works the night shift. Not for the money but for the days he can spend with his son, a handsome little guy with his father’s gentle eyes, but warmer in the golden sunlight of the morning.

Source: www.nytimes.com

Topics: jobs, work, nurse, nurses, career, night shift, instagram, pictures, night

The Interspersing of Nursing: A Geographical Look at the Demand for Nurses

Posted by Erica Bettencourt

Thu, Jan 29, 2015 @ 02:09 PM

Nurses are an important part of the medical workforce. They provide crucial supplementary services and are primary caregivers in a lot of industries. As such, the demand for nurses is high, though there are variations according to different states. As the country’s population and access to medicine continues to grow, the demand for nurses does as well.

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Source: http://online.adu.edu

Topics: jobs, demand, Workforce, nursing, health, healthcare, nurse, nurses, health care, medical, medicine, treatment, career, infographic

Boston Hospital Medical Staff Brave Blizzard On Skis

Posted by Erica Bettencourt

Wed, Jan 28, 2015 @ 11:00 AM

BY EMMANUELLE SALIBA

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After a howling blizzard with hurricane-force winds socked Boston with 21 inches of snow on Tuesday, some nurses and doctors hitched rides with police or put on skis and snowshoes to get to work.

Kelli O'Laughlin, one of the doctor's at Brigham and Women's Hospital who skied to work, found her ride "fun" and "exhilarating." She told NBC's Miguel Almaguer that doctors have to come in to work because"the emergency department is one of those places where 24 hours a day, 7 days a week it's always going."

"Our sincerest thanks to all employees that have gone to extraordinary lengths to get to the hospital during the storm," wrote the hospital in an Instagram post along with a photo of pathology technician Vivian Chan on snowshoes.

Source: www.nbcnews.com

Topics: work, staff, snow, blizzard, storm, weather, commute, healthcare, Boston, Massachusetts, nurse, nurses, health care, medical, hospital, career

Violence Intervention Programs 'Could Save Hospitals Millions'

Posted by Erica Bettencourt

Wed, Jan 28, 2015 @ 10:46 AM

Written by James McIntosh

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While violence intervention programs have demonstrated that they can be an effective way of preventing violent injury, little has been known about their financial implications. A new study now suggests that these interventions could save various sectors millions of dollars.

Researchers from Drexel University have analyzed the cost-benefit ratio of hospital-based violence intervention programs (HVIPs) and report that - as well as benefiting victims' lives - HVIPs can make costs savings of up to $4 million over a 5-year period in the health care and criminal justice sectors.

"This is the first systematic economic evaluation of a hospital-based violence intervention program, and it's done in a way that can be replicated as new evidence emerges about the programs' impacts across different sectors," states lead author Dr. Jonathan Purtle.

As a major cause of disability, premature mortality and other health problems worldwide, HVIPs have a crucial role to play in helping victims from experiencing further suffering.

The provision of case-management and counseling from combinations of medical professionals and social workers has been associated with not only reducing rates of aggressive behavior and violent re-injury but also improving education, employment and health care utilization for service users.

Many HVIPs still require a sustainable source of funding

Intervention typically begins in the period immediately after a violent injury has been sustained. Not only is this a critical moment in terms of physical health, but it can also be a time when victims may start thinking about retaliation or making changes in their lives.

"The research literature has poetically referred to the time after a traumatic injury as the 'golden hour,'" says study co-author Dr. Ted Corbin.

In 2009, around six programs were in operation and, as word of their success has spread, more and more HVIPs have been initiated.

Calculating the potential financial benefits of HVIPs is crucial, as for many of these programs a stable and sustainable source of funding does not exist. Instead, many rely on a variety of different financial sources such as insurance billing, institutional funding, local government funding and private grants.

For the study, published in the American Journal of Preventive Medicine, the researchers conducted a cost-benefit analysis simulation in order to estimate what savings an HVIP could make over 5 years in a hypothetical population of 180 violently injured patients. Of these, 90 would receive HVIP intervention and 90 would not.

Costs, rates of violent re-injury and violent perpetration incidents that a population would be estimated to experience were calculated by the authors using data from 2012.

The authors made a comparison between the estimated costs of outcomes that would most likely be experienced by the 90 hypothetical patients receiving HVIP intervention - including $350,000 per year costs of the HVIP itself - and the costs of outcomes predicted for 90 patients not receiving any HVIP intervention.

The net benefit of the interventions

A total of four different simulation models were constructed by the researchers to estimate net savings and cost-benefit ratios, and three different estimates of HVIP effect size were used.

Costs that were factored into the simulations included health care costs for re-injury, costs to the criminal justice system if the victims then became perpetrators and societal costs for potential loss of productivity.

Each simulation calculated that HVIPs produced cost savings over the course of 5 years. The simulation model that only included future health costs for the 90 individuals and their potential re-injury produced savings of $82,765. The simulation model including all costs incurred demonstrated savings of over $4 million.

Dr. Purtle acknowledges that estimated lost productivity costs may have been slightly high due to an assumption in their data that all individuals in the simulation were employed. However, he believes that there are also many social benefits to HVIPs that cannot be financially quantifiable:

"Even if the intervention cost a little more than it saved in dollars and cents to the health care system, there would still be a net benefit in terms of the violence it prevented."

The authors believe that the findings of their study could be useful in informing public policy decisions. By demonstrating that HVIPs can be financially beneficial, the study suggests that an investment in HVIPs is one that pays off for everyone concerned.

Source: www.medicalnewstoday.com

Topics: injury, violence, intervention, programs, financial, victims, saving money, nursing, health, healthcare, nurse, nurses, doctors, medical, patients, hospital, treatment, Money

Laughing Gas Now Becoming Popular Option for Women Giving Birth

Posted by Erica Bettencourt

Mon, Jan 26, 2015 @ 12:51 PM

By AVIANNE TAN

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A Minneapolis mom who wanted a natural birth was more than 13 hours into labor when she felt she wasn't going to make it without something to take the edge off the pain. But rather than asking for an epidural or narcotics, she begged for laughing gas.

"It immediately took my fear away and helped calm me down, though I could still feel the pain," Megan Goodoien, who gave birth at the Minnesota Birthing Center this month, told ABC News today. "I didn't laugh because the labor was so intense, but I everything suddenly felt doable just when I thought I couldn't make it anymore. It's definitely a mental thing."

Though nitrous oxide has long been used in European countries and Canada, the gas is now making a resurgence in the U.S., according to medical experts.

The gas, once popular in the U.S., was sidelined after the advent of the epidural in the 1930's, midwife Kerry Dixon told ABC News, noting she believes epidurals took over because they were more profitable. Dixon did not treat Goodoien but works at the Minnesota Birthing Center.

"The average cost for a woman opting for nitrous oxide is less than a $100, while an epidural can run up to $3,000 because of extra anesthesia fees," Dixon said.

The U.S. Food and Drug Administration approved new nitrous oxide equipment for delivery room use in 2011, which could also explain the resurgence, Dixon told ABC News.

"Maybe 10 years ago, less than five or 10 hospitals used it [for women in labor]," Dr. William Camann, director of obstetric anesthetics at Brigham and Women's Hospital, told ABC News. "Now, probably several hundred. It’s really exploded. Many more hospitals are expressing interest."

He added the gas popular in dentists' offices has an "extraordinary safety record" in delivery rooms outside the U.S. But more studies are needed to confirm its safety, other doctors say.

Laughing gas works differently than an epidural or narcotic in that it targets pain more on a mental level than physical, experts said.

"It's a relatively mild pain reliever that causes immediate feelings of relaxation and helps relieve anxiety," Camman said. "It makes you better able to cope with whatever pain you’re having."

But gas can also change awareness, said Dr. Jennifer Ashton, a senior medical contributor for ABC News and practicing OB/GYN.

"In delivering over 1,500 babies, I had never used it nor has anyone asked for [nitrous oxide]," Ashton told ABC News. "[M]ost moms want to be totally aware when they are in labor."

Mothers who have opted for nitrous oxide like that it's self-administered by the patient, who has total control over if and when it's used.

A Nashville mother said she opted for the gas during labor only after she found herself too tense to push.

"I instantly felt relaxed," Shauna Zurawski told ABC News. "Before, I was so tense. I was fighting against the contractions, which definitely wasn't good. But after the laughing gas, my body was able to do what it was supposed to. It was so neat."

Both Goodoien and Zurawski said they put a nitrous oxide machine's mouthpiece over their mouth and nose and inhaled about 30 seconds before their next contraction to get the maximum effect.

Another advantage is that the chemical gets out of your system shortly after stopping inhalation.

"With my first child, I had an epidural, I was numb for so long after the delivery and it took a while to get back to normal," Zurawski said. "But with the nitrous oxide, I was walking around and taking pictures almost right after."

Both Goodoien and Zurawski said they didn't experience any adverse side effects.

Nitrous oxide's possible side effects are usually just minor nuisances such as nausea, dizziness or drowsiness, medical experts told ABC News.

Patients can also choose to stop or get an epidural at any time if they find they don't want the laughing gas.

It's still early to tell how popular this new option will get, but in countries like New Zealand, about 70 percent of women in labor choose to use laughing gas, Dixon said.

"When I was working in New Zealand, I told one of my patients, [laughing gas] wasn't really used in the U.S. and you know what she said?" Dixon asked. "'I thought they have everything in America!'"

Source: http://abcnews.go.com

Topics: physician, women, birth, laughing gas, nitrous oxide, pregnant, nurse, nurses, doctors, hospital

Nursing Credentials Matter To Patients, Employers And Nurses

Posted by Erica Bettencourt

Mon, Jan 26, 2015 @ 12:23 PM

By Debra Anscombe Wood, RN

computer technician certifications resized 600

While credentials may seem like an alphabet soup after one’s name, the letters tell the world much about a nurse’s qualifications, including licensure, certifications and fellowships.  

“Credentials are not only a source of pride for the nurse, but communicate to patients, colleagues and hospital leaders the nurse’s commitment to standards of excellence,” said Mary Frances Pate, PhD, RN, CNS, associate professor at the University of Portland School of Nursing in Oregon and chairwoman of the board of directors for AACN Certification Corporation, the certification organization for the American Association of Critical-Care Nurses.

Other academic nurses agree. “Credentials matter to the public,” said Rebecca M. Patton, MSN, RN, CNOR, FAAN, Lucy Jo Atkinson Scholar in Perioperative Nursing at Case Western Reserve University in Cleveland, adding that they also demonstrate growth and lifelong learning valuable to the nurse and to nurse managers and administrators.

Depending on the position, “some nursing positions require certification demonstrating expertise, and some do not,” said Robert Hanks, PhD, FNP-C, RNC, assistant professor and clinical/FNP track director at the University of Texas Health Science Center at Houston School of Nursing. 

Marianne Horahan, MBA, MPH, RN, CPHQ, director of certification services at the American Nurses Credentialing Center, reported an increase in certification applications this year, in part because of employers’ promotion of certification. A new “Success Pays” program allows the hospital to directly pay for successful exam completion. 

Employers also seek nurses with degrees, as evidence suggests organizations with a higher percentage of BSN- or MSN-prepared nurses have greater patient outcomes, said Paulette Heitmeyer, MSN/ED, RN, CNO at Marina Del Rey Hospital in California. 

Pate said nurses whose clinical skills and judgment have been validated through certification often make patient care decisions with greater confidence, recognize problems and intervene appropriately.

While many believe credentials lead to better care and patient outcomes, research is limited. The Institute of Medicine recently released a research agenda to help fill this gap. 

Nurses should list the highest degree first, immediately after their name, then licensure, any state designations, national certifications, awards, honors and other recognitions, according to the ANCC. 

“Certification provides a foundation for lifelong learning and professional development,” Horahan said. “The purpose of certification is to assure the public that this individual has mastered the body of knowledge and acquired skills in the specialty.”

Source: http://news.nurse.com

Topics: jobs, experience, emergency, Nursing Nurse, credentials, certificates, titles, certification, patitents, training, nurses, medical, hospital, patient, career

Reasons Why Nurses Are Secretly Angels Living Among Us (Part 2)

Posted by Erica Bettencourt

Wed, Jan 21, 2015 @ 11:17 AM

6. …but people still expect them to show up the second they ring the call bell.

...but people still expect them to show up the second they ring the call bell.

7. Sometimes they’re working so hard, they can go entire shifts without eating, drinking water, or sitting.

Lunch break? What’s that?

8. Ditto going to the bathroom.

9. Some patients will incessantly hit on them.

27 Reasons Why Nurses Are Secretly Angels Living Among Us

10. Others will expose themselves for no clear medical reason.

Others will expose themselves for no clear medical reason.
Flickr: eflon / Creative Commons / Via Flickr: eflon

“Your arm is broken… so why is your dick out?”

Source: www.buzzfeed.com

Topics: humor, health, healthcare, nurse, nurses, health care, medical, patients, medicine, treatment, hospitals, career

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