DiversityNursing Blog

Career Paths for RNs [Infographic]

Posted by Erica Bettencourt

Wed, Nov 19, 2014 @ 02:58 PM

By  Carly Dell

In the Future of Nursing report published by the Institute of Medicine, it is recommended that health care facilities throughout the United States increase the proportion of nurses with a BSN to 80 percent and double the number of nurses with a DNP by the year 2020. Research shows that nurses who are prepared at baccalaureate and graduate degree levels are linked to lower readmission rates, shorter lengths of patient stay, and lower mortality rates in health care facilities.

What does the job market look like for RNs who are looking to advance their careers?

We tackle this question in our latest infographic, “Career Paths for RNs,” where we look in-depth at the three higher education paths RNs can choose from to advance their careers — Bachelor of Science in Nursing, Master of Science in Nursing, and Doctor of Nursing Practice.

For each career path, we outline the various in-demand specialties, salaries, and job outlook.

Nursing Career Paths Simmons resized 600 

Source: onlinenursing.simmons.edu

Topics: nursing, health, healthcare, RN, nurses, medicine, infographic, careers

National Nursing Survey: 80% Of Hospitals Have Not Communicated An Infectious Disease Policy

Posted by Erica Bettencourt

Wed, Oct 08, 2014 @ 11:55 AM

By Dan Munro

CDC EOC1 resized 600

Released on Friday, the survey of 700 Registered Nurses at over 250 hospitals in 31 states included some sobering preliminary results in terms of hospital policies for patients who present with potentially infectious diseases like Ebola.

  • 80% say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola
  • 87% say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions
  • One-third say their hospital has insufficient supplies of eye protection (face shields or side shields with goggles) and fluid resistant/impermeable gowns
  • Nearly 40% say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use, less than 10 percent said they were aware their hospital does have such a plan in place
  • More than 60% say their hospital fails to reduce the number of patients they must care for to accommodate caring for an “isolation” patient

National Nurses United (NNU) started the survey several weeks ago and released the preliminary results last Friday (here). The NNU has close to 185,000 members in every state and is the largest union of registered nurses in the U.S.

The release of the survey coincided with Friday’s swirling controversy on how the hospital in Dallas mishandled America’s first case of Ebola. The patient ‒ Thomas E. Duncan ‒ was treated and released with antibiotics even though the hospital staff knew of his recent travel from Liberia ‒ now the epicenter of this Ebola outbreak.

On October 2, the hospital tried to lay blame of the mishandled Ebola patient on their electronic health record (EHR) software with this statement.

Protocols were followed by both the physician and the nurses. However, we have identified a flaw in the way the physician and nursing portions of our electronic health records (EHR)interacted in this specific case. In our electronic health records, there are separate physician and nursing workflows. Texas Health Presbyterian Hospital Statement ‒ October 2 (here)

Within 24 hours, the hospital recanted the statement by saying no, in fact, “there was no flaw.”

The larger issue, of course, is just how ready are the more than 5,700 hospitals around the U.S. when it comes to diagnosing and then treating suspected cases of Ebola. Given the scale of the outbreak (a new case has now been reported in Spain ‒ Europe’s first), it’s very likely we’ll see more cases here in the U.S.

As an RN herself ‒ and Director of NNU’s Registered Nurse Response Network ‒ Bonnie Castillo was blunt.

What our surveys show is a reminder that we do not have a national health care system, but a fragmented collection of private healthcare companies each with their own way of responding. As we have been saying for many months, electronic health records systems can, and do, fail. That’s why we must continue to rely on the professional, clinical judgment and expertise of registered nurses and physicians to interact with patients, as well as uniform systems throughout the U.S. that is essential for responding to pandemics, or potential pandemics, like Ebola. Bonnie Castillo, RN ‒ Director of NNU’s Registered Nurse Response Network (press release)

As a part of their Health Alert Network (HAN), the CDC has been sounding the alarm since July ‒ and released guidelines for evaluating U.S. patients suspected of having Ebola through the HAN on August 1 (HAN #364). As a part of alert #364, the CDC was specific on recommending tests “for all persons with onset of fever within 21 days of having a high‒risk exposure.” Recent travel from Liberia in West Africa should have prompted more questioning around potential high-risk exposure ‒ which was, in fact, the case.

As it was, a relative called the CDC directly to question the original treatment of Mr. Duncan given all the circumstances.

“I feared other people might also get infected if he wasn’t taken care of, and so I called them [the CDC] to ask them why is it a patient that might be suspected of this disease was not getting appropriate care.” Josephus Weeks ‒ Nephew of Dallas Ebola patient to NBC News

The CDC has also activated their Emergency Operations Center (EOC).

The EOC brings together scientists from across CDC to analyze, validate, and efficiently exchange information during a public health emergency and connect with emergency response partners. When activated for a response, the EOC can accommodate up to 230 personnel per 8-hour shift to handle situations ranging from local interests to worldwide incidents.

The EOC coordinates the deployment of CDC staff and the procurement and management of all equipment and supplies that CDC responders may need during their deployment.

In addition, the EOC has the ability to rapidly transport life-supporting medications, samples and specimens, and personnel anywhere in the world around the clock within two hours of notification for domestic missions and six hours for international missions.

Source: Forbes

Topics: survey, Ebola, infectious diseases, policies, nursing, RN, nurse, nurses, disease, patients, hospitals

Nurses Among Most Influential People in Healthcare

Posted by Erica Bettencourt

Mon, Sep 15, 2014 @ 01:51 PM

By Debra Wood

Marilyn Tavenner 150 resized 600

Modern Healthcare readers selected four nurses in leadership roles to be ranked on this year’s 100 Most Influential People in Healthcare list, based on their effect on the industry.

“It’s great for nursing, because we do this together,” said Marla J. Weston, PhD, RN, FAAN, chief executive officer of the American Nurses Association, who made the magazine’s annual list for the first time, ranking 45th.

“I’m honored to be recognized,” she continued, “but I realize this is not about me. It’s about the hundreds and thousands of nurses working together to make the American Nurses Association a powerful force, to make nursing a powerful force, and to help our colleagues in health care and the general public understand the impact of nursing practice. I am the lucky person to be in the CEO role, but there are a lot of people making this happen.”

Other nurses in leadership who made the list included Marilyn Tavenner, agency administrator with the Centers for Medicare & Medicaid Services (CMS), listed fifth; Sister Carol Keehan, DC, MS, RN, president and CEO of Catholic Health Association in Washington, D.C., 34th; and Maureen Bisognano, president and CEO of the Institute for Healthcare Improvement (IHI) in Cambridge, Mass., 50th.

“The four nurses on Modern Healthcare’s 100 Most Influential People list this year are transformative and visionary leaders, and some of the brightest lights in the nursing world,” said Susan B. Hassmiller, PhD, RN, FAAN, the Robert Wood Johnson Foundation senior adviser for nursing. “They are role models.”

Weston was one of 19 new people to join the list, which is dominated by elected and appointed government officials, top executives of health care industry corporations and physicians. Anyone can nominate a candidate. The magazine received 15,000 submissions for 2014. The top 300 nominees, including 10 nurses, were presented to Modern Healthcare readers for voting. Half of the candidates are selected through the reader votes and the other half by the magazine’s editors.

While not a nurse, RoseAnn DeMoro, executive director of National Nurses United (NNU), with 185,000 members, made the list again, at 41st.

“With the disproportionate economic influence of the hospital and insurance giants in particular, it is especially gratifying to see the name of RoseAnn and NNU on this list,” said NNU Co-president Deborah Burger, RN.

With the relatively small showing for nursing on this year’s list, opportunity exists for more nurses to move up to positions of leadership and influence.

“Nurses spend the most direct time with patients and, therefore, offer a vitally important perspective,” Keehan said. “As a nurse myself who moved into leadership, I encourage nurses to lend their voice to management decisions and consider leadership roles in their units or hospitals. It may not feel natural for some nurses to assert themselves, but the future of health care requires that we listen to their ideas and concerns. I hope to see many more nurses bring their passion for patient care and support of staff to the work of making health care better for everyone.”

Weston pointed out that nurses practice throughout the health care system, not only in hospitals but in home health, public health, primary care and long-term care. They observe when the system works and when it doesn’t for patients.

“That gives nurses the capacity to help make the system work for patents and communities and to redesign the system to transform and improve care,” Weston said. “Nurses are stepping forward to be leaders, and people are understanding nurses are not just functional doers of things, but thoughtful strategists.”

Weston expects more nurses will make the list in the years ahead. She encourages nurses to talk more about the work they do and the effect it has on people.

“The more we highlight the impact we are making, the more people will understand the great strategists and decision makers that nurses are,” Weston said. “There are a lots of pockets of innovation being led by nurses that are improving the quality of care, reducing the cost of health care and improving the access. We need to support each other in taking those pockets of innovation and spreading them.”

Weston has forged partnerships with other disciplines when delivering clinical care and when transforming the health care system.

“Health care is a team sport,” Weston said. “The degree we can work together catalyzes the work getting done.”

Increasing the number of nurses in leadership positions is one of the key recommendations of the Institute of Medicine’s groundbreaking Future of Nursing report and a central goal of the Campaign for Action.

“As the largest group of health professionals, and as those who spend the most time with patients, nurses have unique insight into health care,” Hassmiller said. “We need that insight at the highest levels of our health care system--on the boards of health care systems and hospitals; leading federal, state and local agencies; and more.”

Two members of the Campaign for Action’s strategic advisory committee made the 2014 Most Influential People in Healthcare list: Leah Binder, president and CEO of The Leapfrog Group, and Alan Morgan, CEO of the National Rural Health Association. Additionally, several members of organizations on the Champion Nursing Council and Champion Nursing Coalition were recognized.

“Health care transformation is underway in our country,” Hassmiller concluded. “Nurses possess the skills to ensure that the perspectives of people, families and communities remain front and center in any health decisions that get made.”

 

Meet the ‘Most Influential’ Nurses¹

5.  Marilyn Tavenner, agency administrator with the Centers for Medicare and Medicaid Services, began her career as a nurse at Johnson-Willis Hospital in Richmond, Va., and spent 25 years working in various positions for HCA Inc., culminating as group president for outpatient services.  Tavenner was one of several people in government to make Modern Healthcare’s annual list of the 100 Most Influential People in Healthcare.

34.  Sister Carol Keehan, DC, MS, RN, president and CEO of Catholic Health Association, started out as a nurse and served in the 1980s as Providence Hospital's vice president for nursing, ambulatory care, and education and training. She joined the Catholic Health Association in 2005. She told NurseZone that she hopes many more nurses will bring their passion for patient care to make health care better for everyone.

 

45.  Marla J. Weston, PhD, RN, FAAN, chief executive officer of the American Nurses Association, has held a variety of nursing roles, including direct patient care in intensive care and medical-surgical units, nurse educator, clinical nurse specialist, director of patient care support and nurse executive. She has served as executive director of the Arizona Nurses Association and deputy chief officer of the Veteran’s Affairs Workforce Management Office.  Weston reported that she has had great role models and mentors in her nursing career.

 

50.  Maureen Bisognano, president and CEO of the Institute for Healthcare Improvement, began as a staff nurse in 1973 at Quincy City Hospital, moved up and became chief operating officer in 1986, before joining IHI. Bisognano is one of many quality improvement leaders on this year’s Most Influential list.

Source: http://www.nursezone.com

Topics: ranking, influences, American Nurses Association, Modern Healthcare, healthcare, RN, leadership, nurses, list

HOW TO BECOME A REGISTERED NURSE

Posted by Erica Bettencourt

Mon, Sep 08, 2014 @ 10:12 AM

By Marijke Durning

registered nurse do

THE BASICS

Higher education is a key requirement for nurses as the U.S. healthcare environment grows ever-more reliant on technology and specialized skills. There are three common academic pathways toward becoming a registered nurse (RN): the nursing diploma, associate degree (ADN) and bachelor’s degree (BSN).

Following completion of one of these programs, graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and satisfy state licensing requirements to begin work as an RN. Bridge programs, such as LPN-to-RN and ADN-to-BSN, allow nurses to move ahead in their nursing careers.

Each choice of training program is distinct and offers levels of education to qualify graduates for increasingly responsible roles in nursing practice. This guide is designed to break down the step-by-step process for becoming an RN, including the various routes possible on this career roadmap. Included is an overview of potential specializations and certifications for those interested in moving beyond basic nursing duties. Below are estimates for RN salaries and job growth as well as tools to help prospective nurses search for online and traditional educational programs.

WHAT DOES A REGISTERED NURSE DO?

More than 2.7 million registered nurses are employed in the United States, and nearly 30 percent work in hospitals, according to the Bureau of Labor Statistics (BLS). Other RNs work in clinics, physicians’ offices, home health care settings, critical and long-term care facilities, governmental organizations, the military, schools and rehabilitation agencies.

Duties include administering direct care to patients, assisting physicians in medical procedures, providing guidance to family members and leading public health educational efforts. Depending on assignment and education, an RN may also operate medical monitoring or treatment equipment and administer medications. With specialized training or certifications, RNs may focus on a medical specialty, such as geriatric, pediatric, neonatal, surgical or emergency care. Registered nurses work in shifts that run around the clock, on rotating or permanent schedules, and overtime and emergency hours can be unpredictable. Registered nurses are required to complete ongoing education to maintain licensing, and they may choose to return to college to complete a bachelor’s degree or master’s degree with the goal of moving into advanced nursing practice roles or health care administration.

THE STEPS: BECOMING A REGISTERED NURSE

Step 1: COMPLETE AN APPROVED NURSING PROGRAM

Anyone who wants to be an RN must finish a nurse training program. Options include programs that award nursing diplomas, associate and bachelor’s degrees. An associate degree in nursing (ADN) typically takes from two to three years to complete. Accelerated nursing degree programs could potentially shorten the time required. A bachelor’s degree in nursing (BSN) takes about four years of full-time study to complete, or two years for those in an ADN-to-BSN program. While the structure and content of these training programs differs, they should feature the opportunity to gain supervised clinical experience.

Students may initially only have the time and money to complete a two-year program, but they might later decide to convert their ADN to a BSN degree. Or, students may leap directly into a four-year BSN program if they plan on moving into roles in administration, advanced nursing, nursing consulting, teaching or research. Nursing students complete courses such as the following:

  • Anatomy
  • Biochemistry
  • Biology
  • Chemistry
  • Computer literacy
  • Health care law and ethics
  • Mathematics
  • Microbiology
  • Nutrition
  • Patient care
  • Psychology

A bachelor’s degree program may also include courses on specific health populations, leadership, health education and an overview of potential specializations. A four-year bachelor’s degree program could require liberal arts courses and training in critical thinking and communication to complete the curriculum. Bachelor’s programs can broaden nursing experience beyond the hospital setting. According to the BLS, some employers require newly appointed RNs to hold a bachelor’s degree.

Step 2: PASS THE NCLEX-RN

Accredited undergraduate nursing degree or diploma programs alike are designed to prepare students to sit for the NCLEX examination. Upon graduation, aspiring RNs should register with the National Council of State Boards of Nursing to sign up for the National Council Licensure Examination for Registered Nurses. Candidates receive an Authorization to Test notification before the exam. At the exam, rigorous verification of candidates' identity may include biometric scanning.

This computerized exam has an average of 119 test items to be completed within a six-hour time limit. Examinees who do not pass must wait from 45 days to three months to re-take the exam. According to the California Board of Registered Nursing, students who take the exam right after graduation have a higher chance of passing.

Step 3: OBTAIN A STATE LICENSE

Every state and the District of Columbia require that employed registered nurses hold current licenses. However, requirements vary by state, so students should contact their state board of nursing or nurse licensing to determine exact procedures. In some states, RNs need to complete the NCLEX-RN, meet state educational requirements and pass a criminal background check. The National Council of State Boards of Nursing maintains a listing of licensing requirements on its website.

Step 4: PURSUE ADDITIONAL TRAINING AND CERTIFICATION (OPTIONAL)

For professionals who decide to become advanced practice registered nurses (APRNs), a BSN degree provides an academic stepping-stone to master’s degree programs. There are also bridge programs for students who only hold a two-year nursing degree and RN licensure but wish to enroll in graduate programs.

Those with master's degrees may qualify for positions such as certified nurse specialists, nurse anesthetists, nurse practitioners (NPs) and nurse midwives. It's important to research evolving professional requirements. For example, the American Association of Colleges of Nursing proposes that NPs should earn a Doctor of Nursing Practice (DNP) degree. A DNP or a PhD degree may appeal to nursing professionals who seek positions as scientific researchers or university professors in the nursing sciences. RNs may also seek certifications in a medical specialty such as oncology. Certifications are offered by non-governmental organizations attesting to nurses' qualifications in fields such as critical care, acute care, nursing management or other advanced areas.

To learn more about RN statistics, jobs, salary and other information CLICK HERE. 

Source: www.learnhowtobecome.org

 

Topics: statistics, registered nurse, how to, information, education, RN, health care

Life in progress: RNs can help baby boomers find funding for promising cancer treatments

Posted by Erica Bettencourt

Fri, May 30, 2014 @ 10:52 AM

By Heather Stringer

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When Carrie Bilicki, RN, MSN, ACNS-BC, OCN, met a 60-year-old patient who had been diagnosed with aggressive endometrial cancer, she began to have a persistent — albeit unconventional — idea. 

Bilicki, a cancer nurse navigator in Wisconsin at the time, recently had attended a lecture about a progressive treatment for this type of cancer that involved using a chemotherapy drug traditionally prescribed for ovarian cancer. The patient’s cancer had spread to nearby organs, and she had a poor prognosis. Bilicki convinced the physicians to try the alternative medication. Unfortunately, the patient faced another serious hurdle: The insurance company would not cover the cost of the medication because it was not the standard treatment. At that point, the woman seemed to face the unenviable choice between cancer treatment and financial ruin.

Although patients and providers would like to hope this type of extreme dilemma is the exception, the case may be representative of the near future for two reasons. First, as a 60-year-old, the woman was a baby boomer, and researchers predict the incidence of cancer will increase dramatically as this large segment of the population ages. According to a study published in the Journal of Clinical Oncology in 2009, the U.S. can expect a 67% increase in cancer incidence among older adults between 2010 and 2030. 

Second, statistics suggest cancer treatment is becoming increasingly unaffordable, even for those with insurance who struggle to afford steep copayments. For example, The US Oncology Network — a national group of about 1,000 oncology physicians who treat more than 750,000 cancer patients per year — reported about half of the patients covered by a Medicare Part D plan have required copay assistance for oral chemotherapy for the past several years.

“My message to my peers is to know the financial resources available because there are hundreds of them,” Bilicki, who now is a clinical nurse specialist in breast services at Froedtert Center for Diagnostic Imaging in Milwaukee, Wis., said. “There are foundations, specialty organizations and websites that tell us where to get help. If a patient does not have an advocate to link them to that resource, they will never know it is available.” 

What's new?

For many patients, the desire to find a way to afford medication is driven not only by the fact that they have cancer, but also because the treatment options available today have increased the odds of survival. 

“By far one of the biggest advancements is more personalized medicine that targets cancer cells rather than traditional chemotherapy that did not differentiate between good and bad cells,” Kim George, RN, MSN, ACNS-BC, OCN, a cancer program consultant from Wichita Falls, Texas, said. “For example, now we can test biopsy tissue for specific tumor antigens and biomarkers and then prescribe treatments that target those antigens.” 

The advancements in cancer treatment also are reflected in improved survival rates. According to the Surveillance Epidemiology and End Results Cancer Statistics Review 1975-2009, for example, the 5-year survival rate for breast cancer among women in the U.S. between 1975 and 1977 was 75%. Between 2002 and 2008 that number jumped to 90%. During the same time periods, the 5-year survival rate for both men and women with colon cancer has increased from 50% to 65%. 

“Another major advancement has been the increase in availability of oral chemotherapy and biotherapy,” George said. “It has shifted the care setting. Years ago, the majority of cancer patients received IV infusions, and now more patients can take their medication orally at home. It is wonderful for convenience, and it is also less painful.” 

However, George said, reimbursement is not always a given with oral chemotherapy. “A lot of oncology medications are given off-label, which means that the FDA has not approved a drug for a specific diagnosis, so it may not be covered by some insurance policies,” she said. 

A little help can mean a lot

Point the way for patients who need assistance financing cancer treatments, by seeking resources such as the following:

• PatientAdvocate.org — Provides sources for copay assistance and answers questions about disability and insurance processes

• PatientResource.com — Features information on different types of cancer, newsletters and financial and advocacy resources

• CureToday.com — Provides an extensive list of national resources for advocacy, financial and pharmaceutical assistance

• RxOutreach.org — A nonprofit organization that helps low-income families who cannot afford the medication they need 

• CDFund.org — Chronic Disease Fund — A nonprofit organization that helps patients obtain lifesaving medications

For a list of drug assistance programs from pharmaceutical companies, visit Cancersupportivecare.com/drug_assistance.html.



Point the way

The art of navigating the path to financial assistance for cancer medication is not simple, and organizations such as The US Oncology Network, based in The Woodlands, Texas, have hired professionals to help patients connect with funding resources and launched the OncologyRx Care Advantage pharmacy in 2006. Nurses in the network can refer patients to Care Advantage staff who help them apply for financial assistance. 

“The types of drugs used to treat cancer today are definitely more expensive than when I started working in oncology almost 30 years ago,” said Lori Lindsey, RN, MSN, NP, OCN, a clinical services program manager with The US Oncology Network. “Multidrug regimens, including oral targeted therapies, can sometimes cost $30,000 for a round of treatment, although the use of these drugs has markedly improved outcomes and increased survival for some diseases.” 

For patients who are uninsured, the best option is to apply directly to the drug manufacturer for patient assistance, said Meg Asher, a patient access coordinator/patient advocate lead at the Care Advantage pharmacy. “When we learn that a patient is without insurance, we notify the doctor’s office and send a manufacturer’s application to them for the patient’s use,” Asher said. “Under these circumstances, we will not be the dispensing pharmacy; the manufacturer has their own specified pharmacy that will service the patient.”

Even those who are insured under Medicare Part D often require assistance because the copayments can be thousands of dollars, Asher said. For these patients, the Care Advantage advocate team helps patients connect with various foundations that provide copay assistance in the form of grants. Some of the foundations assist patients who suffer from a specific disease, while others help those who are taking a specific drug for a disease. 

While some facilities have staff trained to help patients find financial assistance, this is not always the case. For these patients, one resource is the Patient Advocate Foundation, a nonprofit organization with case managers who help patients with life-threatening illnesses to maintain financial stability. 

“When I was a hospital nurse, I honestly didn’t know about a lot of the resources available to help patients after they left my care,” Pat Jolley, RN, the clinical director of research and reporting at PAF, said. “Many people have never had to ask for financial help in the past, and they are unaware that there are options. If they are newly diagnosed, we try to educate them about the likely expenses down the road to help identify potential problems. In my experience, when patients contact us saying they cannot afford one thing, it is usually just the tip of the iceberg.” 

For example, PAF assisted a 62-year-old woman with breast cancer who was insured, but she was having difficulty scheduling her needed mastectomy because of outstanding medical bills. She was living on Social Security disability payments, and her insurance did not cover surgeries, scans or tests. The woman received a bill for $50,000 that included the cost of previous care and several office visits. By negotiating with the hospital and the providers, the PAF case manager was able to reduce the bill to a total of $950 and also facilitate the scheduling of her mastectomy. 

Suffering in silence

For Bilicki, one of her personal goals is to encourage patients to consider the financial aspect of their cancer care before they decide to pursue a particular form of treatment. 
“Nobody wants to talk about their financial state, and I think far too often patients suffer in silence rather than saying that they are having trouble with copayments, so what I do is proactively tell them about some of the resources,” Bilicki said. “Just because they have insurance does not mean they will have resources to afford the costs, so I empower all patients right off the bat to proactively seek out assistance if they need it.”

After patients have been diagnosed with cancer, Bilicki encourages them to learn about the resources at the American Cancer Society, which has patient navigators trained to help people connect with financial resources. She also tells them about a group called Patient Resource LLC, which has a website and a patient magazine that includes national, state and local resources available for financial assistance. 
In the case of the woman with endometrial cancer who could not afford a medication that was not covered by her insurance, Bilicki helped her apply for the drug manufacturer’s patient assistance program. Based on her income and medical necessity, she qualified for full assistance. She was on the medication for 15 months, and, despite her initial grim prognosis, the cancer has been in remission for the past five years. 

“I can always remember the tears and fear in their eyes when I first meet patients, and each time it feels like I’ve won the lottery when I help them secure the treatment they need, and they start smiling again,” Bilicki said. “Part of my big mission for my colleagues is to advocate for these patients so they do not miss out on options that can change their lives.” 

A little help can mean a lot

Point the way for patients who need assistance financing cancer treatments, by seeking resources such as the following:

• PatientAdvocate.org — Provides sources for copay assistance and answers questions about disability and insurance processes
• PatientResource.com — Features information on different types of cancer, newsletters and financial and advocacy resources
• CureToday.com — Provides an extensive list of national resources for advocacy, financial and pharmaceutical assistance
• RxOutreach.org — A nonprofit organization that helps low-income families who cannot afford the medication they need 
• CDFund.org — Chronic Disease Fund — A nonprofit organization that helps patients obtain lifesaving medications
For a list of drug assistance programs from pharmaceutical companies, visit Cancersupportivecare.com/drug_assistance.html.

Source: Nurse.com

Topics: babyboomers, RN, nurses, cancer, funding

Report examines RN work environments

Posted by Erica Bettencourt

Wed, May 28, 2014 @ 02:04 PM

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A new "Charting Nursing's Future" brief from the Robert Wood Johnson Foundation details a series of programs designed by and for nurses that have “spurred the creation of work environments that foster healthcare quality and patient safety” 10 years after a landmark Institute of Medicine report.

The November 2003 IOM report, “Keeping Patients Safe: Transforming the Work Environment of Nurses,” concluded that “the typical work environment of nurses is characterized by many serious threats to patient safety.” The IOM offered a series of specific recommendations about how hospitals and other institutions needed to change to reduce the number of healthcare errors. Taken together, the recommendations constituted a fundamental transformation of nurses’ work environments.

The IOM report found that hospitals and other healthcare organizations did a poor job of managing the high-risk nature of the healthcare enterprise. Accidents were too common, and management practices did little to create a culture of safety. 

“We’ve made important gains in the past decade, but we have a lot more work to do,” Maryjoan D. Ladden, RN, PhD, FAAN, senior program officer at RWJF, said in a news release. “Some of the changes needed are systemic and will require collaboration among nurses, doctors, educators, policymakers, patients and others. 

“But nurses also have a critical responsibility to transform their individual workplaces, asserting leadership at the unit level and beyond to help identify and solve problems that affect patient safety.”

Among the initiatives highlighted in the brief, “Ten Years After Keeping Patients Safe: Have Nurses’ Work Environments Been Transformed?”:

• Transforming Care at the Bedside. The RWJF-backed TCAB initiative, developed in collaboration with the Institute for Healthcare Improvement, seeks to empower frontline nurses to address quality and safety issues on their units, in contrast with more common, top-down efforts. Evaluations of the program point to fewer injuries from patient falls, lower readmission rates and net financial gains. 

• Quality and Safety Education for Nurses. Also backed by RWJF, QSEN seeks to improve patient safety by helping prepare thousands of nursing school faculty to integrate quality and safety competencies into nursing school curricula at the undergraduate and graduate levels.

• Nurse-patient policies. In some jurisdictions, policymakers have addressed patient safety through nurse staffing policies, focusing both on nurse-patient ratios and on the composition of the nursing workforce. To date, California is the only state to establish a limit on the number of patients a nurse may be assigned to care for in acute care hospitals. Other jurisdictions have policies intended to encourage lower ratios. Research on the impact of such efforts on patient safety has been mixed to date. 

In addition, the IOM’s 2010 “Future of Nursing: Leading Change, Advancing Health” report gave new impetus to efforts to increase the share of nurses with baccalaureate degrees or higher, and various institutions have begun to address that recommendation through hiring requirements, tuition-reimbursement policies and more.

• Disruptive behavior on the job. Professional discourtesy and other disruptive behavior in the workplace is another barrier to patient safety, particularly given the growing importance of teamwork and collaboration. Noting the consequences of poor behavior can be “monumental when patients’ lives are at stake,” the brief highlights programs at Vanderbilt University Medical Center in Nashville, Tenn., and Johns Hopkins Hospital in Baltimore designed to deter such problems. 

A blueprint for change

The CNF brief goes on to cite a series of initiatives by government agencies, professional associations, the public service sector and credentialing organizations, all designed to advance patient safety and transform nurses’ work environments toward that end. It concludes with an “emerging blueprint for change” that urges providers, policymakers, and educators to follow through on: 

• Monitoring nurse staffing and ensuring that all healthcare settings are adequately staffed with appropriately educated, licensed and certified personnel;

• Creating institutional cultures that foster professionalism and curb disruptions;

• Harnessing nurse leadership at all levels of administration and governance; and

• Educating the current and future workforce to work in teams and communicate better across the health professions.

The brief also provides policymakers, healthcare organizations, educators and consumers with a listing of available tools to help in their efforts. 

This issue of “Charting Nursing’s Future” is a publication of RWJF created in collaboration with the George Washington University School of Nursing in Washington, D.C.

RWJF report: http://bit.ly/1kiMsYX

2003 IOM report: www.iom.edu/Reports/2003/Keeping-Patients-Safe-Transforming-the-Work-Environment-of-Nurses.aspx 
Source: Nurse.com

Topics: workplace, RN, nurse, RWJF

Magnet hospital work environments linked to high care quality

Posted by Alycia Sullivan

Mon, Apr 07, 2014 @ 01:56 PM

Source: Nurse.com

A professional practice environment that is supportive of nursing helps explain why Magnet hospitals have better nurse-reported quality of care than non-Magnet hospitals, according to a study.

As published earlier this year in the Journal of Nursing Administration, researchers with the New York University College of Nursing and University of Pennsylvania School of Nursing explored links between recognized nursing excellence and quality patient outcomes.

Only 9% of American hospitals have Magnet recognition, according to an NYU news release, and Magnet hospitals have higher job satisfaction and lower odds of patient mortality than non-Magnet hospitals. Research into the causes of the differences could create an infrastructure for positive change in nurse and patient outcomes.

“Many of the recent efforts to improve quality and enhance transparency in healthcare have been dominated by physician services and medical outcomes,” Amy Witkoski Stimpfel, RN, PhD, assistant professor at NYUCN, said in the news release. “Our study shows that the overall quality of patient care can be optimized when nurses work in a positive environment, with adequate resources and support at the organizational level.”

The study, “Understanding the Role of the Professional Practice Environment on Quality of Care in Magnet and Non-Magnet Hospitals,” focused on cross-sectional data, including the American Hospital Association’s annual survey, and an analysis of 56 Magnet and 495 non-Magnet hospitals.

Witkoski Stimpfel’s team found a clear correlation between positive work environments for nurses and nurse-reported quality of care. Even after taking into consideration hospital characteristic differences between Magnet and non-Magnet hospitals, Magnet hospitals still were positively correlated with higher reports of excellent quality of care.

“Having visible and accessible chief nurses, encouraging and including nurses in decision-making in their unit and throughout the organization, supporting nursing practice and engaging in interdisciplinary patient care are but a few examples of readily modifiable features of a hospital,” Witkoski Stimpfel said.

“Because all organizations, Magnet and otherwise, have the potential to enrich their practice environment, every organization stands to benefit from improving the organization of nursing care.

“Our findings suggest that Magnet hospitals produce better quality of care through their superior practice environments. Hospitals that invest in improving the nursing work environment have the potential to benefit from increased quality of care for their patients and families.”

Witkoski Stimpfel is continuing to research the outcomes associated with Magnet hospitals. Her current project is an assessment of the relationship between Magnet recognition and patient satisfaction in a national sample of hospitals.

Study abstract: http://bit.ly/1hxEUhy

Topics: study, quality, JNA, Magnet hospitals, high-care, RN

Can you offer some advice on getting a job for an RN who has been licensed for 2 years, but who has worked as an RN for only 2 months?

Posted by Alycia Sullivan

Mon, Apr 07, 2014 @ 01:38 PM

Source: Nurse.com
Question:

Dear Donna, 

I have been an RN for two years, but have worked for only a couple of months because I got sick. No one wants to hire me without experience. My credentials are perfect. I reside in Florida and cannot relocate because I am a mother of small children. Can you offer some advice?

Wants to Work 

Dear Donna replies:

Dear Wants to Work,

Don't be discouraged. The job market is shifting and changing. Even though you are not a new nurse, read “New nurse, new job strategies” to see what's happening and learn creative ways to market yourself (www.Nurse.com/Cardillo/Strategies).

You should start volunteering as a nurse while you continue to look for paid employment. Volunteering is a great way to gain recent relevant experience, to hone old skills and learn new ones, build confidence and expand your professional network. Plus, volunteering often leads to paid employment as it is a way to get your foot in the door somewhere. Look for opportunities at your local public health department, a free clinic, the American Red Cross, a cancer care center or a blood bank. 

You also should attend local chapter meetings of the Florida Nurses Association (www.floridanurses.org). You do not have to be a member of ANA/FNA to attend meetings as a guest. This is a great way to reconnect to your profession, get up to date on issues and trends and further expand your network. Networking is well known to be a great way to find and get a job.

When what you're doing isn't working, it's time to try a new approach. You will be able to find work. You'll just have to look in new directions for employment and use a new approach to find and get those jobs. Persistence and determination will always win out in the end.

Best wishes,
Donna 

Topics: help, work, new nurse, Ask Donna, RN

Top 4 tips that benefit RNs and help advance their careers

Posted by Alycia Sullivan

Mon, Mar 03, 2014 @ 02:09 PM

By Donna Cardillo 

It is imperative that every nurse – new and experienced – realize the healthcare landscape has completely changed. There will be plenty of opportunities for RNs and APNs who stay current with trends in education, technology, care and personal and professional development. Nurses must be willing to step outside their comfort zone and learn new ways — and places — of working and thinking about their profession. Cynthia Nowicki Hnatiuk, RN, EdD, CAE, FAAN, executive director of the American Academy of Ambulatory Care Nurses and the Academy of Medical Surgical Nurses. stresses that, to stay competitive, nurses also will have to be able to articulate the value that they bring to outcomes, beyond tasks, in any setting. So what does every nurse need to do? Here are four key areas:

1| Skill building

Clinical skills alone won’t see us through in this new paradigm. Self-marketing, computer skills, oral and written communication, conflict management, negotiation, leadership and networking skills must be learned and practiced. Hnatiuk said nurses also need to be more business savvy, with an understanding of finances, staffing, acuity and productivity.

2| Education

Higher education is no longer optional. It is a foundation for practice in any setting and fundamental to professional and personal growth and development. Hnatiuk advises that formal and continuing education, along with clinical certification, will help nurses take their practice and careers to the
next level.

For those considering advanced practice, particularly becoming nurse practitioners, the NNCC’s Hansen-Turton advises: “Don’t think too long; jump in. Opportunities will be increasing for NPs over the next 5-10 years. NPs are and will continue to be a hot commodity.” Certified nurse midwives, clinical nurse specialists and certified registered nurse anesthetists also will see expanded opportunities.

3| Professional association involvement

Our professional associations are where we connect with one another, form communities, share best practices (local and national), stay current with trends and issues, and find support. Hnatiuk added that through association involvement, you learn more than you could by yourself and progressively learn leadership skills

4| Mentoring

Hnatiuk encourages nurses to take advantage of opportunities to be mentored and to mentor others. “We have so much to share. Mentoring will allow us to achieve all we’re capable of doing.”

For personalized career advice

If you have specific career-related questions, send them to Dear Donna at www.Nurse.com/AsktheExperts/DearDonna for a personalized response.

Source: Nurse.com

Topics: advice, tips, Dear Donna, RN, nurses, career

Why the World Needs Nurses

Posted by Alycia Sullivan

Wed, Nov 13, 2013 @ 10:56 AM

There are 5.5 million nurses and nurse’s aides in America. That’s 2.6% of the population and yet nursing is still one of the fastest growing occupations. In fact, the country is currently facing a nursing shortage unlike any other before. 

Nursing is essential for a smooth running health care system. Nurses are far from one-trick employees – they perform countless vital tasks in hospitals, nursing homes, schools, and more. The number of nurses on hand (or a lower nurse-to-patient ratio) has been directly related to patient survival and recovery without additional complications.

Some of the most in-demand specializations for nurses include:

  • Forensic Nursing: Nurses who care for patients that were victims of crime. These nurses assist with collecting evidence from their patient’s injuries in order to build a case against the attacker.
  • Infection Control: Nurses who care for patients infected with diseases such as HIV, STDs, or tuberculosis must be specially trained to ensure the contagious disease is not passed along unintentionally to either the nurse themselves or other patients.
  • Management: These days, nurses who can educate or manage other nurses are in high demand. These career-oriented positions typically pay better, sometimes even into the six figures, but do require additional education. Management, education, and advocacy are three essential roles in recruiting more high quality professional nurses to the field.

Nursing isn’t an easy job. Over half of nurses report that stress and frustration plague them daily in their job. However, most nurses also agree that their job is very fulfilling. Very few careers are as directly related to public health and serving the community as nursing. Also, the public is genuinely grateful for nurses. For the last eleven years, nurses have been ranked by Americans as the most trusted profession – a pretty impressive feat.
Currently, there is a shortage of nurses in the workplace. This shortage is caused by a range of reasons, but the main ones are:

  • Baby boomers are aging and require more intensive care
  • The recession forced many people to neglect preventative care or lose their insurance, driving up the demand for health care in the long term
  • Fewer nurses are pursuing bachelor’s degree which would enable them to get the best nursing jobs

The shortage is leading to salary wars (hospitals offering hefty bonuses to new nurses and more). At the end of the day, professional, skilled, and intelligent people are desperately needed in the nursing field in the US and around the world.

whytheworld resized 600Source: RNtoBSNonline.com

Topics: BSN, occupation, nursing shortage, education, RN, infographic

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