Nursing Notes

September 30, 2011

Friday Videos

Filed under: Nursing — Shirley @ 4:09 am
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Let’s watch movies!!

This is about Men in Nursing:

Here’s why you go into nursing:

This is about clinic nursing in the Air Force:

And finally, some humor:

September 28, 2011

Nurses and Pandemic Outbreaks

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This will be a different type of post than I usually do.  I don’t have a specific article to post and editorialize today.  Instead, I want to talk about a movie.  I went to see Contagion the other day and, although it is a good movie, there were two different scenes in the movie that really made me upset.  Now, you would figure that a movie about a disease that kills 20% of the Earth’s population would be enough to make me angry, but that wasn’t what did it.

During this movie, there are two separate scenes where nurses are trashed.  You don’t see nurses tending to any of the sick because, “They have all gone on strike because there are no protocols for dealing with this.”

You see doctors tending patients, you see nuns tending patients, you see scientists tending patients.  It seems that everybody wants to be a nurse except the nurses–in this movie.

I was so incensed after the movie that I went right home and Googled for hours and hours to find facts and information about the role of nurses in pandemic outbreaks, about the role of nurses in capturing information regarding pandemics, about the dilemma of nurses during pandemics.

What I found was this.  First, check the Code of Ethics with the state board of nursing.  It seems that nurses have a responsibility to educate, to collect data, to identify problem areas, and to meet any National Health Objectives set forth.

Nurses encounter personal risk when providing care for those with known or unknown communicable or infectious disease.  However, disasters and communicable disease outbreaks call for extraordinary effort from all health personnel, including registered nurses.

So, why then did this movie portray nurses as being unwilling to provide care?  That is really the question isn’t it?  Twice they made a point of saying that there were no nurses to provide care to the sick because the nurses would not come to work (they were on strike).

I don’t know about you, but this was very distressing to me personally and professionally.  I don’t know of any nurse who would purposefully ignore a sick or dying patient.  Nurses frequently are first responders in disasters and in accidents along our nations highways.

I lived in OKC at the time of the bombing.  I know what the nurses working downtown did.  I know first hand how they all as a group responded.  Not one nurse said, “I can’t help because there is no protocol for dealing with this disaster.”  Nurses were there helping the injured, collecting body parts, combing the ruins of the Murrah building for survivors.

Let me know what you think about this, if you can.  I am very upset still and I wanted to get some feedback from other nurses out in the world.

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September 26, 2011

Unique Initiative Designed to Ease National Shortage of Nurse Educators

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I received this press release in my email today and felt I would post it here for you to read and comment on.  I like the idea of this new track, but I am concerned with the push to have nurses get out of nursing by getting a higher degree.  I recognize that we need more nurse educators to facilitate more nursing graduates out on the floors, but it seems to me that there is such a push for all nurses to get that next degree that it takes your focus off why you went into nursing to begin with–patient care.

Let me know what you think about this press release.  I get these all the time and if you want I will be happy to repost them here for discussion.  Just let me know if that is what you want.


Cleveland State University Creates Innovative Nursing Education Program

Unique Initiative Designed to Ease National Shortage of Nurse Educators


Cleveland, Ohio (September 21, 2011) – In an effort to  help ease the national shortage of nurses and nurse educators, Cleveland State University (CSU) has announced a new Nursing Education Specialization track within its Urban Education PhD program.


Beginning this fall, the new track will help to alleviate the strain within America’s nursing education infrastructure by preparing nurses for research-oriented faculty positions. There is a rapidly increasing need for well-trained, urban-based nurses throughout the country, as well as a shortage of nursing faculty prepared at the doctoral level. CSU’s doctoral program will teach research based nurse educators how to prepare practitioners to meet the complex healthcare needs in urban and culturally diverse communities.

In order to further encourage the pursuit of careers in nursing education, CSU has received a competitive grant from the Department of Health and Human Services (HHS) to assist graduate students interested in becoming nurse educators. Acting through the Health Resources and Services Administration (HRSA), HHS has allocated Nursing Faculty Loan Program (NFLP) funds to CSU students enrolled in an eligible advanced degree program in nursing (master’s or doctoral) at the School. After graduation from the program, loan recipients may cancel up to 85% of the NFLP loan over a consecutive four-year period, while serving as full-time nursing educators at a school of nursing.

For the city of Cleveland, the specialization track symbolizes a new dawn, as CSU will be the first university in Ohio to offer such a track within their doctoral program. Currently nurses with an interest in teaching have to join programs outside the State of Ohio. As the national demand for nurses continues to increase, CSU’s initiative will exemplify a creative vision to address a long term need.

“Nurse educators have a profound impact on their students and subsequently, those graduating nurses will engage in professional practice to improve health outcomes for patients, their families and the communities they serve,” said Dr. Vida Lock, Dean of Cleveland State University’s School of Nursing. “CSU’s new Nursing Education Specialization Track aligns closely with CSUs mission and is another example of the University’s fostering of interdisciplinary collaboration to prepare professionals focused on leadership, social justice and partnerships to address contemporary urban issues.”

With the demand for doctors and nurses expected to increase as the baby boomer generation reaches retirement, CSU’s new program could not have come at a better time. In addition, the School of Nursing’s community-based curriculum will prove to be an excellent teaching “lab” for future nursing educators to hone their skills.

The School of Nursing is an independent academic unit within the University’s structure, underscoring the commitment to nursing education by the Board of Trustees and University President. Prospective doctoral candidates are required to hold a Master of Science in Nursing degree, an active unrestricted nursing license, and have recent experience in nursing practice or education. Graduate faculty members in CSU’s School of Nursing will mentor candidates in the Nursing Education track and serve on dissertation committees, guiding these future academics in research that will add to the body of scientific knowledge related to preparing future nursing professionals as well as keeping all nurses current with the ever changing practice of health care.




Jacqueline Platt

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September 11, 2011

Nurses on 9/11/01

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From the attack on Pearl Harbor to the attack on the Twin Towers, nurses have always played an important role in our response to disaster.  Nurses are there to help in every natural or unnatural disaster.  They, like the police and firefighters, are a resource that can be drawn on in times of distress.

With today being the 10th anniversary of 9/11, I wanted to post something here that tells the story of that horrible day from a nurse’s perspective.  I found this article on  I hope you click over and read it all.

We all will remember 9/11/01.  Let’s also remember those who were there to help.

For those who were there to help


Working at Ground Zero: From a Nurse’s Viewpoint

  By Kristin Rothwell, NurseZone Feature Writer

“When you’re young you want to take care of the world, you want to take care of people,” said Megan Weiss, RN, from Dickson, Tennessee, when asked what inspired her to become a nurse. And that’s what she attempted to do on Sept. 11, 2001, when she was called on by the Federal Emergency Management Agency (FEMA) to provide medical aid at Ground Zero following the terrorist attacks in New York City.

Day 1

Tuesday, Sept. 11, began as a typical day for Weiss. She arrived on time at New York University Medical Center at 7 a.m., for her shift in the operating room department. It was only her second week in New York. She had recently moved from San Francisco, California. About 9 a.m., Weiss was assisting with a plastic surgery when she heard a news report on the radio in the operating room about a plane hitting the World Trade Center. She soon learned that two Boeing 767s crashed into Towers 1 and 2.

Within minutes of the two crashes, the hospital was on Disaster Alert—the staff would soon only be treating disaster victims. At about the same time, a few floors below, a medical team had just “cracked” open a patient for heart surgery. But, since the surgery could take up to nine hours, and the hospital administrators didn’t know how many disaster victims would be arriving, the patient’s chest had to be re-sewn and the surgery rescheduled.

“Everyone thought there would be many survivors,” said Weiss, knowing that the Towers employed nearly 60,000 people.

She helped other hospital staff prepare for the incoming patients. Within minutes, Weiss was escorted by NYU administrators to the front door to be picked up in an ambulance by FEMA personnel heading to Ground Zero. She is certified by FEMA.

“To this day, I still don’t know how [FEMA] found me,” she said. “But it wasn’t the only strange thing that happened.”

As they moved closer to Ground Zero in the ambulance, Weiss spotted a former colleague, Dr. Richard S. King walking down a deserted street covered in ash.

“When I saw him, I screamed ‘Stop,’ ” she said. “We picked him up though I don’t even know if he wanted to go. But he said ‘Thank you’ and asked, ‘Megan, what the hell are you doing here?’ He was tearing up and holding my hands. I told him I had just returned from California.”

Still three miles from Ground Zero, the ambulance had gone as far as it could. Debris blocked the roads. The passengers would have to walk the rest of the way.

“There were so many boulders, it was like walking on razors and the streets felt as if they were on fire. In fact the shoes my mother had just purchased for me melted,” Weiss said.

Before long, they met up with paramedics who took them to the nearby Jacob K. Javits Convention Center, which had been set up like a MASH unit. Located several miles from the World Trade Center, the makeshift hospital had a 40-bed “emergency room” and classrooms that had been converted for anesthesia.

From there, Weiss, along with Cindy Foreman, RN, and Linda Su, RN, were chosen to leave with firefighters to provide immediate care at “the site,” as Weiss called it. “They didn’t even know our credentials,” she said.

Walking toward the area where the Trade Center once stood, she recalled, “Looking around, it was so dusty and dark. There were so many sheets of paper, something like 2 million pieces. They looked perfect, they weren’t ripped or torn. The soot and dust was about three feet high. I’ve never seen so much dust, it was just caked on everything. I learned later that everything was pulverized when the buildings came down.”

Please click here to read the rest of this article.

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September 7, 2011

Disruptive behavior, negligence, endangered patients, and millions of dollars

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Here’s an article from the Patient Safety Monitor that makes my skin crawl.  Patient safety and well-being are tantamount to nurses.  Have we, as nurses, given up the role of patient advocate?  This article cites several recent court decisions against medical facilities for failed patient safety observances.  Where were the nurses in this?

Staffing is always the core problem in these types of problems.  Hospitals expect nurses to do more and more and more without giving the proper staff to accomplish this goal.  As long as hospitals continue to get away with short-staffing, they will because they are a business.  The bottom line is profit, even in non-profit facilities.

Think about it like this:  is it less expensive to pay a fine every so often that does not amount to the cost of maintaining proper staff to patient ratios?  Why pay every day for more staff, at a cost that is very high, when you can pay much less in fines and then only if you get caught.

I know that I do not speak for the majority of the nursing profession.  I can only speak for myself, based on my own experiences in hospitals.  I love nursing.  I love being a nurse.  I don’t love the way hospitals staff.

Please read this article and leave me a comment, won’t you?  When you visit the site, look around because you will find many interesting articles about nursing and hospitals there.  Be sure to leave them a comment on this post while you are there.


August had been filled with a number of different patient safety rulings and findings that show poor patient safety can be costly in many different ways.

Let’s start with Boston, where two old cases have been settled.

First, parents of a newborn who died at Beth Israel Deaconess Medical Center in Boston seven years ago were awarded $7 million by the Suffolk County Superior Court after a physician and nurse practitioner were found negligent in their care. The parents claimed they did not react quickly enough to the infant’s deteriorating condition. The premature infant developed necrotizing entercolitis, something caregivers should have been watching for as it is common in infants delivered prematurely.

The parents alleged they came to visit their daughter and found her discolored and unresponsive, and said staff took more than an hour to respond.

In another recent decision, the U.S. Court of Appeals upheld a lower court verdict against Brigham and Women’s Hospital involving alleged disruptive behavior exhibited by Arthur Day, MD, the former head of neurosurgery. Sagun Tuli, MD, claims the hospital retaliated against her for complaining about her work environment.

The court ruled that Tuli was defamed and that her career was affected.

Now, on to Dallas.

It was recently reported that in March, 2010, Parkland Medical Memorial Hospital in Dallas, TX, informed 73 female patients that instruments that were not properly sterilized had been used on them, putting them and any sexual partners at risk of infections.

Following that incident, the Centers for Medicare & Medicaid Services (CMS) investigated the hospital in July, 2011. The investigation led to the finding that the hospital created an “immediate and serious threat to patient health and safety.” The report found that ED patients in severe pain were given maps of the hospital to find the appropriate place for treatment and children sent home without screenings.

Meanwhile, in a separate investigation, Parkland Memorial Hospital, along with the University of Texas Southwestern Medical Center, agreed to pay $1.4 million after a four-year Medicare billing fraud investigation revealed that resident surgeons were not properly supervised and also failed to comply with informed consent requirements.

Another Dallas hospital, Methodist Dallas Medical Center, was also recently cited for 10 violations by CMS, some which include failing to screen and stabilize emergency department (ED) patients and understaffing the ED.

Do these more recent findings indicate that CMS is getting tougher? Would similar findings be found elsewhere, if investigated? Is this the sign of the times of healthcare reform? What do you think? Share thoughts below.

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September 1, 2011

Nurse Staffing Costs Must Be Weighed Against Cost of Errors


Here is an article that talks about staffing…again.  This article, however, is written from the administrator’s vantage point and is remarkable in what it states.  Nurses are necessary!  Nurses can affect the hospital’s bottom-line in either a good way or a bad way.  She also goes on to state that “a-nurse-is-not-a-nurse” which seems to be how most people think of nurses.  We are not all alike and my experience is of no use to me if I am sent to work in ER.  Hospitals should value nurses and plan to utilize nursing staff appropriately if they want to see improved patient satisfaction, decreased errors, and less turnover.  Overall, a very good article.  Please do visit the original site where you can find many other fine articles that apply to nursing today.


Rebecca Hendren, for HealthLeaders Media , August 30, 2011

When revenues fall, hospitals stop investing in the biggest budget expense: nurses. That’s a bad short-term solution to a long-term problem. It’s time we change the way we think about hospital staffing.

“When we look at all the problems we have [in healthcare right now], what is the first thing we do? Start slashing nurses,” says Kathy Douglas, MHA, RN, president of the Institute for Staffing Excellence and Innovation, CNO of API Healthcare, and a board member of the journal Nursing Economic$, which has devoted a whole issue to examining the evidence around nurse staffing.

“Healthcare executives and nurse leaders need to be more aware of thinking about staffing and scheduling from a bigger perspective so we understand all of the financial implications,” she says. “How do we manage our way effectively through the maze and chaos we are in right now?”

To deal with ongoing challenges presented by value-based purchasing and healthcare reform, executives must acquaint themselves with studies demonstrating how nurse staffing affects a hospital’s overall performance and base staffing decisions on evidence.

“What we know from research and experience is that there are very direct links between staffing and length of stay, patient mortality, readmissions, adverse events, fatigue-related errors, patient satisfaction, employee satisfaction, and turnover,” says Douglas. “All of these things have studies that directly relate them to staffing. And all have the potential for significant costs. When we don’t look at the relationship between our LOS and our unreimbursed never events and our staffing, we’re not looking at the whole picture.”

Too few hospitals track staffing data in comparison to these big issues.

“Some of these things people might call ‘soft costs,’ like nurse turnover,” says Douglas. “But to me, money is money.”

Soft costs have hard financial implications. Value-based purchasing has already put real money behind patient satisfaction. To make the link to staffing research and why it matters, we have to stop looking at staffing numbers in isolation. Until we look at the whole picture, which includes everything associated with staffing, we’re not going to understand financial performance.

“Staffing costs sit in one part of the budget, so we think of the results there,” says Douglas. “Then the cost of errors sits in another part of the budget. If I could say one thing to healthcare executives it is to make staffing a top strategic priority in your organization. If you look at top priorities—LOS, safety, quality—all of these things have direct links to staffing.”

An organization that has cut back on staffing may not notice that it is overusing overtime and not notice that there’s a relationship between the overtime and the number of infections on a unit.

Peter I. Buerhaus, PhD, RN, FAAN, chair of the National Health Care Workforce Commission, a 15-member panel composed of distinguished leaders from academia and the healthcare industry created under The Patient Protection and Affordable Care Act, published research in 2008 looking at unreimbursed errors in healthcare, such as catheter-associated urinary tract infections and central line infections.

“I decided to get out my calculator and add them up. When I looked at it in one year the total came to $21 billion in unreimbursable events,” says Douglas.

“When hospital executives tell me there’s not enough money to staff well, my first thought is ‘what about the $21 billion we spend each year on unreimbursed never events?'”

Douglas believes the answers lie in using data and evidence to make effective decisions and utilizing technology in decision making. She is not a fan of blanket ratios.

“It’s not that ratios are bad in and of themselves. Ratios happened, in my opinion, because hospital leadership and nursing weren’t communicating well,” she says. “My issue with ratios is that it assumes [staffing] is about a number. I disagree with that. It’s not about a number. It’s about the right number with the right qualifications with the right competencies with the right experiences.”

Douglas says hospitals need to be free to examine all the factor…[read the rest of this article]

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