Nursing Notes

September 29, 2010

New OR RNs and Those with More Experience Need Nurturing

Filed under: Nursing — Shirley @ 3:38 am
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Here is an interesting article from that addresses another aspect of the looming nursing shortage as our numbers age and retire.  This article focuses on surgical nurses, but any specialty could be written about in much the same way.  The median age of the nursing workforce is now late 40’s to mid 50’s.  These are people who will be looking to retire at some point in the not too distant future.  Who will be replacing them?

Please read the whole article and then come back here and let me hear your stories.  We all have frustrations and can share personal experiences.  Let’s talk.


By Heather Stringer
Monday September 20, 2010

When 55-year-old Jim Stobinski, RN, MSN, CNOR, a seasoned Navy OR nurse, started working at a civilian hospital three years ago, he experienced a form of culture shock. He couldn’t ignore the fact that nurses in the civilian OR were noticeably older than his colleagues in the Navy. The discrepancy was so significant that Stobinski started studying age distribution data from the Association of periOperative Registered Nurses and compared it to data from the Navy. As he analyzed the information, Stobinski became aware the nation may be at risk of an impending shortage of well-trained RNs in the OR.

“We are in uncharted territory,” says Stobinski, director of surgical services at St. Luke’s Medical Center in Boise, Idaho. “Our OR nursing workforce is getting older, the demand for surgery is increasing, and we have to bring new nurses into the profession to stay viable.”

Luckily, organizations such as the AORN and hospitals throughout the country are pioneering strategies to not only recruit and train younger nurses into the OR specialty, but also to retain older nurses who have the coveted experience from which the next generation of nurses can benefit.

Age Breakdown
According to 2010 membership data from the AORN, which has more than 40,000 members, the average age of perioperative nurses in the organization is 52. That is five years older than the average age of licensed RNs as a whole, according to data from the 2008 National Sample Survey of Registered Nurses. About 48% of AORN’s members are over 50, and only 7% are under 31. The organization has yet to determine whether this data is representative of OR nursing as a whole. The AORN hopes to conduct a survey with perioperative directors throughout the country in the near future to determine whether their membership data currently reflects the age demographics in ORs nationwide; however, according to the 2004 National Sample Survey of Registered Nurses, there are more than 179,000 perioperative nurses in the U.S.

“The organization is concerned about these statistics,” says Anne Marie Herlehy, RN, DNP, CNOR, AORN president-elect and administrative director for perioperative and cardiovascular services at Alexian Brothers Medical Center in Elk Grove Village, Ill. “We wonder what it will mean for the profession in 10 years.”

One of the main reasons ORs lack younger RNs is related to changes in nursing schools, explains Herlehy. In the past, nursing students spent more time in the OR during clinical rotations, but now students often spend one day at most in the OR.

“Now that the nursing curriculum is so packed, there is less opportunity for nurses to get exposed to surgery,” Herlehy says. “Few schools even offer it as an elective course.”

To get the word out, AORN representatives attend events sponsored by the National Student Nurses Association, where they run an exhibit and talk to student nurses.

The AORN also offers a course called Periop 101: A Core Curriculum, a six-month program hospitals can use to train new perioperative nurses. The program includes reading, clinical assignments and suggested videos. Hospitals tailor the program to include mentoring, hands-on clinical experience and time with a preceptor. Students earn a certificate of completion for the class, which is open to new grads and experienced nurses who want to transfer to the OR.

Not only are hospitals offering this course, but now one Florida college is responding to the high demand. In January, Keiser Career College will begin offering Periop 101 at the Miami Lakes campus. After completing the course, nurses can go on to apply for OR jobs at the hospitals of their choice. When Terry Schmidt, RN, BSN, director of education at Keiser Career College,[…read the rest of the article…]

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July 19, 2010

Cool job: Working to keep ‘hiccups’ out of surgery

Here’s an article from the great state of Oklahoma.  There is alot of good things to be said for that state, and this article only proves that they are more forward thinking than others.

I know that I, personally, do not wish to pursue this avenue of nursing, but I think others may want to take a real look at this opportunity.  Nursing is about to become the linchpin of healthcare, finally.  It’s taken quite a long time, but it seems that finally the population at large is beginning to see the benefit of a well-trained nurse in the hierarchy of health care.

Please enjoy this article and don’t forget to visit the original site to leave comments.


CRNAs are very valuable assets to health care teams, said Gary Loving, interim associate dean of academic programs at the University of Oklahoma College of Nursing.


Published: July 18, 2010

When he describes his life’s work, Don Mordecai talks about takeoffs, landings and airways. But he’s not a pilot. He’s an advanced practice nurse who administers anesthesia to hospital patients.


More Info

Career spotlight

Certified Registered Nurse Anesthetist (CRNA)
• History: Nurses have administered anesthesia since the Civil War; formal education for the profession was introduced in 1887 at what is today the Mayo Clinic.

• Demographics: 41 percent of CRNAs are men, compared with 10 percent of RNs overall.

• Education: A master’s degree in advanced nursing; doctorates will be required of students entering programs on or after Jan. 1, 2022. Current programs run 24 months to 36 months and combine academic education in pharmacology, chemistry, bio-chemistry, anatomy, physiology and pathophysiology with an average of 1,595 hours of clinical experience.

• Accredited programs: 108 nationwide including several in Texas; Oklahoma has none.

• Prerequisites: Bachelor’s degree in nursing and at least one year of experience in critical care, an emergency department or operating room.

• Certification: After passing national board certification licensure, CRNAs are required to complete 40 continuing education hours every two years.

• Median annual salary nationwide: $158,000, according to the American Association of Nurse Anesthetists (AANA). Malpractice insurance, which sometimes is paid by employers, runs between $7,000 and $10,000 annually.

• Necessary traits: Good coordination, critical thinking, detail-oriented, ability to remain calm in pressure situations, vigilance.

• More information: and

“Just like takeoff and landing is the most important part of a pilot’s job, the most important parts of mine are induction, or the start of an anesthetic, and emergence, when a mask or tube is removed,” said Mordecai, who practices at the VA Medical Center in Muskogee. That’s when patients’ airways are the most vulnerable, he said.

According to an Institute of Medicine report, anesthesia is nearly 50 times safer than it was in the 1980s, with about one death in every 250,000 to 300,000 cases. The dramatically lowered risk is thanks mostly to better drugs and technology that monitors oxygen and carbon dioxide during surgery, Mordecai said.

“But with anesthesia, you can never take any case lightly,” he said. “No matter how good you are, there can be hiccups.”

President of the Oklahoma Association of Nurse Anesthetists (OANA), Mordecai is among some 500 health professionals in the state and 44,000 nationwide who are certified registered nurse anesthetists (CRNAs).

Nationwide, about 80 percent work as partners in care with physician anesthesiologists, while 20 percent are self-employed sole providers who work and collaborate with surgeons and other licensed physicians. In largely rural Oklahoma, that’s roughly 50-50.

CRNAs are very valuable assets to health care teams, said Gary Loving, interim associate dean of academic programs at the University of Oklahoma College of Nursing.

“They have a long documented history of providing safe care,” Loving said. Studies, he said, show there’s no difference in patient outcomes whether anesthesia is provided by a physician anesthesiologist or nurse anesthetist.

CRNAs administer roughly 70 percent of anesthesia in the state, said Victor Long, government relations chair of the OANA and a self-employed nurse anesthetist who practices in Lindsay, Purcell, Oklahoma City and Norman.

“In rural areas, it’s more like 85 percent,” Long said. Forty-one counties in Oklahoma have no anesthesiologists; only CRNAs, he said.

State law requires a CRNA’s anesthesia to be supervised by a licensed medical doctor, osteopathic physician, dentist or podiatrist where timely on-site consultation can be made, Long said. In negligence cases, the overseeing doctors aren’t necessarily held liable; it depends on the case.

According to the American Association of Nurse Anesthetists, 40 states don’t require supervising physicians and 15 also have opted out of the Medicare requirement for supervision.

Nurse anesthetist Dennis Bless practices in Minnesota, which is one of those states.

But the bylaws of the Minneapolis hospital where he works require physician supervision.

“But I’m the one in the room with the patient,” said Bless, Region IV director of the AANA. “There’s no anesthesiologist in there with me. So I have to be able to react to any severe reactions or airway issues. It’s minute to minute, beat to beat.”

Like Bless, Mordecai finds his career very rewarding.

“I have the opportunity to interact with patients and provide a quality service,” he said. “And they thank me for it.”

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June 16, 2010

Hear what it’s like from a real CCU nurse

Filed under: Nursing — Shirley @ 5:08 am
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This is a great video. This nurse is real and honest and knows what she is talking about. We need this kind of nurse in large numbers. We only get to hear the negative side of nursing most of the time, but the truth of the matter is that we went into nursing because we wanted to make a difference in the life and the lives of others. This short video describes that desire quite well. What do you think?

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May 12, 2010

‘What struck me was the powerlessness many nurses felt’

Filed under: Nursing — Shirley @ 1:03 am
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This article is very interesting and is also very timely.  Although the author is writing in and about nursing in England, I feel the information can be applied to all nurses, so I am posting it here.  Please read this article in its entirety and leave me a message about your opinion on the topic.  I think this topic could begin a lovely and lively debate here because it will do so anywhere you talk about shifts and changing them.


6 May, 2010 | By Jill Maben

Returning to short shifts would be like “turkeys voting for Christmas”, suggested one reader in response to my opinion piece, with another saying “hands off our long days”. I never imagined the storm it would create.

I argued that: “Twelve hour day shifts may have implications for staff wellbeing in terms of stress, burnout and physical injuries.” And wondered whether nurses could “give the same unwearied, dignified and compassionate care after 11.5 hours as they can after just one hour when fresh on duty”.

The piece generated 116 comments on Nurses were divided. Many felt that with no rush to “hand over” their patients, they could plan care over the whole day, get to know their patients and had time to chat in the evenings. “The benefits [include] better staff morale on 12 hours; the nurse being able to spread out the nursing tasks; and better consistency with patients during the day and night.” Some suggested long days worked well in areas such as accident and emergency, theatres and intensive therapy units, and some noted the importance of time off for “child care or other caring responsibilities”. Many also felt it should be a matter of individual choice, and staff should be allowed to work flexibly – although some managers suggested this would “open a can of worms” […]

Here is the link to visit this site where you can find numerous wonderful articles and blog posts about the trials and tribulations of nursing across the pond.  I love this site..Nursing Times.

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March 27, 2010

8 Reasons to Stay

Here’s a quickie to address the reasons to stay in nursing.  With all the bad press out there and with all the job stress, it is easy to forget the good things about being a nurse.  So, I thought I’d post this short note from  Please visit them and check out all of the wonderful information about nursing you can find there.
There will be days when you may ask yourself, “should I stay, or should I go”?  Despite the challenges, nursing is a profession of caring. Those who have a passion for nursing don’t need a lot of convincing to stay in the profession.

However, a few reminders never hurt.  Here are 8 to start!  (wink!)

8 Reasons to Stay

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January 28, 2010

Nursing Personality – Common Denominators

Filed under: Nursing — Shirley @ 5:12 pm
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Here is an article I enjoyed that I found on Nurse  This is by a guest poster and is her opinion, but after reading it I thought it was fairly accurate.  She does hit on the parts of the personality that makes a person be able to stay in nursing, despite its many detractors.

Read the article and then check your own personality against the list.  I bet you will find most if not all items active in your life at work.  This list is not exclusive nor is it complete, but it is a good start to identifying what it takes to become a nurse, but better yet, what it takes to stay a nurse during rough times.

There are several comments at the site and you might enjoy reading them, also.


I could hardly wait to write this article.  Why?  Because I have always felt that – in general (disclaimer so I don’t offend anyone) – you have to possess a certain type of personality to be successful in nursing.  The question is:  Are there common denominators to the personality of nurses?  I say, yes…

  • Sense of humor: I have found this to be a definite nursing characteristic.  We may, at times, have “darker” humor than others – I will give you that – but we have experienced things in our professional life that would not be complete without the little sarcastic comment or funny pun thrown into the mix.  It’s what keeps us going in the tough times!
  • Professionalism: I have been in other professions and in the military.  I have always found that nurses understand what professionalism and ethics are and apply these qualities to their practice each day.  It is comforting to work with professionals on a daily basis.
  • Diligence: Nurses are some of the hardest-working and energetic people I know.  Does anyone disagree?  We work hard on the job for 8, 10, or 12 hours a day, have the energy to go to our home lives and families, and are up and running to do it again the next day!
  • Compassion: Nurses get it!  Simple as that.  We understand when someone tells a sad story or has a chronic illness.  Maybe we haven’t lived through such circumstances, but we just understand and seem to know what to say and what to do to help and comfort.
  • Sense of deeper understanding to life: We have seen some of the worst parts of life, dealt with death, and understand and appreciate the truly important aspects of life.  We tend not to care about the toilet seat being up or about a dirty dish donning our sink.  We understand what is important in life and focus on that.
  • Sense of hope for what to others may seem hopeless: How many times have you heard a patient tell the worst story you have ever heard about a chronic illness, and seen a nurse immediately smile and offer the positives to that patient?  I have seen it many times and it never ceases to amaze me.  It is not something we were taught – just something we simply are!
  • We never say never:  “Sure, I can pick up that 12 hour shift on Sunday.”  “No problem taking care of an extra patient today.”  Just a couple of examples of the endless “never say never” spirit of nurses.  This spirit makes us seem as if we can accomplish anything at anytime!
  • Sense of pride in saying “I’m a nurse”: Not to offend anyone out there, but I have known several lawyers in my life.  I have NEVER heard one of them admit in public what he/she does for a living…mmmmm.  Anyway, nurses are always quick and proud to say “I’m a nurse” – loud and clear.  Any why not?  Look at our great personalities and all we do for others each day!

About the Author: Sue Heacock, RN, MBA, COHN-S and author of the recently published book – Inspiring the Inspirational: Words of Hope From Nurses to Nurses.  Sue is a Certified Occupational Health Nurse Specialist and has worked in a variety of areas of nursing including pediatrics and research.  Before entering the nursing profession, Sue worked in human resources and equal employment opportunity.

Here’s the link to the original article

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