Nursing Notes

November 29, 2011

Helping Nurses deal with death and dying

Filed under: Nursing — Shirley @ 7:02 am
Tags: , , , , , ,

I recently was contacted about running a story here on an interesting situation.  This is a topic that all nurses must deal with at one time or another.  We don’t talk much about it, and maybe we feel uncomfortable about dealing with it.  However, death and dying are part of living and we, as nurses, are usually there to help the family deal with this trauma.

It’s seems really nice that a mortuary would be willing to help nurses learn about and learn to deal with this situation.  Because of my past experiences and the experiences of many of my sister nurses, I am posting his article here for your education.  Let me know what you think about this topic and if you want me to continue to offer guest postings here.

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When a death occurs at a hospital or in hospice and people have questions about what happens and what they should do, who do they ask? Usually the first person of authority they see: a nurse.

 A difficult yet inevitable conversation, what can nurses do to prepare for these questions? O’Connor Mortuary, serving Southern California’s families since 1898, offers CE credits for a tour entitled “Unmasking the Mysteries.” The tour consists of an informative visit to the mortuary and an in-depth presentation on the processes that go on behind closed doors. Dealing with mortuaries is often intimidating for families and nurses alike, but this tour, along with other workshops offered by the mortuary, opens the line of communication and gives nurses a chance to ask questions and fully understand what goes on to better answer the questions of their patients and patients’ families.

If interested in interviewing Neil or if you’d like information about upcoming “Unmasking the Mysteries” tours, please let me know.

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Helping a family that has suffered the loss of loved one can be incredibly complicated. Many family members, in their hour of need, may ask a number of very difficult questions as they attempt to deal with both the emotional and logistical challenges of a death in the family. Neil O’Connor, CEO of O’Connor Mortuary in Laguna Hills, Calif., has worked with many nurses to steer these families in the right direction as they deal with the myriad questions that come following a death in the family. Here are some common questions you may encounter, along with some straightforward answers.

 My loved one has passed away. What do I do now?

 If the patient has preplanned their funeral, you should simply instruct the family to call the mortuary to notify them of the passing. Sometimes the family assumes the hospital will notify the mortuary, but for safe measure, you should urge a family member to take that first step.

If the patient has not preplanned their funeral, you should ask them if they’ve selected a mortuary. Most hospitals have a list of local mortuaries they can provide. Families are often overwhelmed and don’t know where to begin, but choosing the right provider is an important step in planning a funeral. Hospitals typically give families 1-2 days to choose a funeral home and transfer the care of their loved one from hospital to mortuary, so encourage them to take their time and ask questions about the care they’ll be receiving.

Once the mortuary is engaged to bring someone into their care, it will transport the person to the facility. A written release from the family granting the mortuary permission to do so may be required depending on the hospital.

How soon should I plan a funeral or memorial service?

It is recommended that the funeral occur within 4-6 days of the death, but at O’Connor, we encourage anywhere from 5-10 days. This event will commemorate the life of the loved one, and we don’t want anyone to rush through the planning of this one-time ceremony. We encourage people to take their time and get the details in order to ensure that service will accurately reflect the loved one’s life and provide the best opportunity for remembrance to family and friends.

What is the best way for me to inform friends and family of my loved one’s passing?

In addition to your many responsibilities as a nurse, you are often looked to for emotional support as well. When we hear this question, we advise families to personally call those closest members of their family circle, and then to create a “phone tree” to inform extended friends and family. Enlisting the help of friends and family will help alleviate some of the stress.

Is embalming required by law?

Embalming is not required by law unless they select arrangements that require the body to be embalmed, such as public or private viewing or shipping to another state or country via a common carrier. There are also some occasions when the Coroner’s or Medical Examiner’s office will embalm a body for investigative reasons.

 What if There is not a chosen a mortuary?

 My best advice is not to select a mortuary from the internet or the yellow pages at 3:00 a.m. It is very difficult to make sense out of anything when you are working through a crisis. Even if you have not selected a mortuary and a death has occurred, you still have time to find the right provider for you and your family. Remember, even if you select a mortuary and your loved one is taken into their care, you can still select another company if you change your mind. You do not have to stay with your first choice if you don’t feel comfortable with them.

 What questions should I ask to ensure the funeral home is looking out for my best interests?

 Here are four key questions to ask over the phone or in person.

1. How will you take care of me?

2. Why should I trust you?

3. What makes you different?

4. Will you guarantee your services & memorial products 100% or money back?

If they cannot answer these questions off the tip of their head, they probably are not living these core values.

Do you have questions you’d like to have answered by Neil O’Connor? Ask in the comments section and we’ll get them answered!

 

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May 30, 2011

Memorial Day is for remembering the sacrifices–

Let us remember the nurses who gave up their lives for their patients during the various wars we have fought in.

Let us remember the nurses who are currently in harms way to give aid to our men and women fighting in the Middle East.

This holiday is for remembering.  To see more about our nursing veterans click here.  Below are just a very few of these wonderful women to be remembered.

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Military:

U.S. Army

Lieutenant Colonel Annie Ruth Graham, Chief Nurse at 91st Evacuation Hospital, Tuy Hoa.

Colonel Graham, from Efland, NC, suffered a stroke in August 1968 and was evacuated to Japan where she died four days later. A veteran of both World War II and Korea, she was 52.

To Colonel Graham’s memorial on The Virtual Wall

First Lieutenant Sharon Ann Lane

1LT Sharon Lane

Lieutenant Lane died from shrapnel wounds when the 312th Evacuation Hospital at Chu Lai was hit by rockets on June 8, 1969. From Canton, OH, she was a month short of her 26th birthday. She was posthumously awarded the Vietnamese Gallantry Cross with Palm and the Bronze Star for Heroism. In 1970, the recovery room at Fitzsimmons Army Hospital in Denver, where Lt. Lane had been assigned before going to Vietnam, was dedicated in her honor. In 1973, Aultman Hospital in Canton, OH, where Lane had attended nursing school, erected a bronze statue of Lane. The names of 110 local servicemen killed in Vietnam are on the base of the statue.

To Lieutenant Lane’s memorial on The Virtual Wall

 

Second Lieutenant Carol Ann Elizabeth Drazba
Second Lieutenant Elizabeth Ann Jones

1LT Elizabeth Jones

Lieutenant Drazba and Lieutenant Jones were assigned to the 3rd Field Hospital in Saigon. They died in a helicopter crash near Saigon, February 18, 1966. Drazba was from Dunmore, PA., Jones from Allendale, SC. Both were 22 years old.

Lieutenant Jones is pictured here.

To Lieutenant Jones’s memorial page on The Virtual Wall

To Lieutenant Drazba’s memorial page on The Virtual Wall

 

Captain Eleanor Grace Alexander

CPT Eleanor Alexander

Captain Alexander of Westwood, NJ and Lieutenant Orlowski of Detroit, MI died November 30, 1967. Alexander, stationed at the 85th Evacuation Hospital and Orlowski, stationed at the 67th Evacuation Hospital, in Qui Nhon, had been sent to a hospital in Pleiku to help out during a push. With them when their plane crashed on the return trip to Qui Nhon were two other nurses, Jerome E. Olmstead of Clintonville, WI and Kenneth R. Shoemaker, Jr. of Owensboro, KY. Alexander was 27, Orlowski 23. Both were posthumously awarded Bronze Stars.

To Captain Alexander’s memorial on The Virtual Wall

 

First Lieutenant Hedwig Diane Orlowski

1LT Hedwig Diane Orlowski

Captain Alexander of Westwood, NJ and Lieutenant Orlowski of Detroit, MI died November 30, 1967. Alexander, stationed at the 85th Evacuation Hospital and Orlowski, stationed at the 67th Evacuation Hospital, in Qui Nhon, had been sent to a hospital in Pleiku to help out during a push. With them when their plane crashed on the return trip to Qui Nhon were two other nurses, Jerome E. Olmstead of Clintonville, WI and Kenneth R. Shoemaker, Jr. of Owensboro, KY. Alexander was 27, Orlowski 23. Both were posthumously awarded Bronze Stars.

To LT “Heddi” Orlowski’s memorial on The Virtual Wall

 

Second Lieutenant Pamela Dorothy Donovan

1LT Pamela Donovan

Lieutenant Donovan, from Allston, MA, became seriously ill and died on July 8, 1968. She was assigned to the 85th Evacuation Hospital in Qui Nhon. She was 26 years old.

To Lieutenant Donovan’s memorial on The Virtual Wall

 


 

U.S. Air Force

Captain Mary Therese Klinker

Captain Klinker, a flight nurse assigned to Clark Air Base in the Philippines, was on the C-5A Galaxy which crashed on April 4 outside Saigon while evacuating Vietnamese orphans. This is known as the Operation Babylift crash. There are also US Air Force and Air Force Association web pages about Operation Babylift. From Lafayette, IN, she was 27. She was posthumously awarded the Airman’s Medal for Heroism and the Meritorious Service Medal.

 

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March 21, 2011

Bill would squeeze nursing staffs

Here’s an article I found in the Citrus County Chronicle Online.  I found this interesting and, although talking about Florida politics and Florida healthcare issues, I think it can be extrapolated out to the entire nation.  We are in a crisis in our country and no one seems to understand that.  Not only can people not afford healthcare in this country, when they can afford it, they may not be getting quality care because of short staffing in our hospitals.

This is not a problem that is going to go away anytime soon.  The shortage of nursing is real and growing.  Maybe if nursing was not so physically and emotionally draining; maybe if nurses could actually give the care they want to give–then there would be no shortage.  I am only one nurse and I certainly don’t have the answer to this looming national problem, but I do work regularly and see and hear the comments of my peers.  I know what I think and how I feel about my nursing career.  Someone out there should be talking to the nurses.

Please click over and read the rest of this article.  I think you will find it both interesting and stimulating.  We need to go back to the drawing boards and draft our own solution to this problem.  Maybe if nursing care was not grouped in with the cost of the bed, but billed separately, then we would have more of a voice.

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CMHS authority: We’d have to hire more nurses

By Chris Van Ormer
Saturday, March 19, 2011 at 9:27 pm

If the Florida Legislature passes a bill to mandate a higher ratio of nurses to patients, Citrus Memorial hospital would need another 35 nurses.  The proposed staffing level also comes at a time when the United States as a whole needs 300,000 nurses.  Linda McCarthy, chief nursing officer at Citrus Memorial Health System in Inverness, discussed the bill Monday with the Citrus County Hospital Board. McCarthy advised the trustees about the ways the bill would affect nursing care at CMHS, and got right to the bottom line: “I would need to find 35 nurses.”
Florida Hospital Patient Protection Act is sponsored by Rep. Cynthia Stafford, D-Miami.
“It’s a pretty extensive bill,” McCarthy said. “It’s not the first time it’s hit the floor. It’s a little different each time.”
The bill calls for more registered nurses rather than licensed nurses.  “It defines a direct patient care provider as a registered nurse,” McCarthy said. “Previously, it could be a licensed nurse, it could have been any of those support people but this is a direct care provider. They have not stipulated yet in this document the level of education required.”
As chief nursing officer, McCarthy would need to use a staffing plan based on the severity of the patients’ conditions. This is known as the acuity system of the patients’ needs.  Another difference in practices would be that minimum staffing levels would be mandated at all times, including meal times and other breaks.
“It has a mention of prohibition of mandatory overtime and it uses the nursing process inclusive of assessment, diagnosis, planning, intervention and evaluation that only a registered nurse can do at this point,” McCarthy said. “It also asks that the nurse look at the assessment of orders. She must check for appropriateness, whether it’s licensed by a licensed practitioner and whether the order itself is within the nursing scope of practice.” The registered nurse may decide if the order is inappropriate.  “She has the ability to refuse to implement this order without ramifications, so she needs to be able to accurately assess the order that the physician writes and make sure it’s appropriate,” McCarthy said. “If she disagrees with it or a patient disagrees with it, she is acting as the patient’s advocate and must speak on behalf of the patient.”
McCarthy described some of the issues with the bill.  “The nursing shortage itself is huge and they project it will be more than 300,000 by the year 2015,” McCarthy said. “We are seeing a slight decrease of the nursing shortage because of the economic times we are living in. Many of the nurses who are currently at retirement age have decided to hang on a little longer to build up funds.”  When the economy turns around, it could increase the shortage of nurses as more decide they can afford to retire. McCarthy did not have numbers for the nurse shortage in Florida, but she said the “opening rate” or potential vacant positions across the state stood at 23 percent.
With so many nurses not retiring, the average age of nurses has increased.  “We’re also looking at the aging population,” McCarthy said, “not just of the patients, but that of the nurses. The average age of a nurse right now at Citrus Memorial is 49.6 years old and I have at least 65 nurses who are at or are eligible for some type of retirement program at this time. Should the economy turn around, those could be immediate losses.”
Adding to the crisis of the nurse shortage is the lack of nurse educators.  “The problem most immediate with nurse education is that there are no nurse educators,” McCarthy said. “There is a minimum qualification that you must be master’s prepared to be a nursing instructor, so there are a minimum number of nursing instructors. Even if there were people wanting to take nursing programs, there are very limited supplies of educators.”
Nursing today competes with many other career choices for women.  “At one time, nursing was considered a woman’s profession and she could do very well there,” McCarthy said. “Now we have many opportunities. We can all go to be an astronaut. We can be engineers; we can do all those things. So we have minimized the people who are even getting exposure to the nursing profession.”
If the bill becomes law, CMHS has to have a plan to comply with it.“We need to implement an automated patient acuity system,” McCarthy said. “We currently have an acuity system that is based on each one of the nursing floors and the type of patient that they care for. We have a number system we apply to each patient based on the number of IVs and the number of medications and the type of treatments they need. Most of the more intellectual processes involve adding the data out of an electronic document which loads immediately in and calculates an acuity score for the patient. That would be one of the first things we would be looking at.”
Another option would be primary care nursing, McCarthy said. It is a method of nursing practice…[read the rest of the article here]

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October 22, 2010

FL nursing shortage will grow | Jacksonville Business Journal

Filed under: Nursing — Shirley @ 8:38 am
Tags: , , , , , ,

This is one of the few articles I have found about the nursing shortage that actually includes the economic slowdown as well as the impending changes from the new health care bill.  Although many states say they “have no nursing shortage”, my opinion is that either they are unaware of the projected needs of the state or their nurses are so overworked that they don’t have a second to voice an opinion.

In Austin, I am frequently told that there is no nursing shortage here.  Great!  Explain to me then why I work with more than 5 acutely psychotic patients at a time.  There are some hospitals that staff 12:1 on some shifts, even.  I guess there is no shortage if the nurses working now are able to do more and more for less and less.

Don’t get me wrong, I work hard and make a decent living.  I don’t want to be anything except a nurse.  What I do want to be, however, is a nurse with a voice and some control over my workplace/workload.  I want to be a nurse that gives excellent nursing care and takes great care of my clients.  What I find is I am struggling just to get the minimum done each shift.  I don’t like this.

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New projections from the Florida Center for Nursing show that the implementation of health care reform, along with a slowly recovering economy, may cause the nursing shortage to grow.

The Orlando-based Florida Center for Nursing, which studies the state’s nurse workforce needs, said the shortage will grow to more than 50,300 full-time registered nurses by the year 2025.

The center said it expects an increase in retirements and a reduction in the workforce participation of nurses — which is at historic highs due to the recession. Combined with a lack of faculty and clinical space, the result will be very slow growth in the number of working nurses.

“We have been urging stakeholders all along not to be lulled into complacency by the temporary reduction in the nursing shortage,” said Mary Lou Brunell, the center’s executive director. “With these new forecasts, we’re now able to put a timeline on the reemergence of the nursing shortage and quantify its severity.”

The center projects a continuing tight labor market for RNs over the next three years, owing to a sluggish economy. Once the major provisions expanding coverage within health care reform are enacted in 2014, the shortage is expected to increase rapidly. By 2015, the shortage may top 11,000 nurses, and by 2020 it may reach more than 37,500.

Read more: Report: FL nursing shortage will grow | Jacksonville Business Journal

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October 11, 2010

Commentary: To Improve Health Care, Broaden the Role of Nurses

Here is an interesting article about the future of nursing.  I believe this study caused an immediate response from the AMA to point out quite clearly that nurses are not doctors.   I, for one, don’t have any desire to be a doctor.  I don’t want to diagnose or prescribe.  All I have ever wanted to do was help my patients get better by giving them good care and assisting them to do for themselves so they could return to their own lives and live unencumbered by an illness.

I get tired of the misconception that nurses are simply frustrated doctors.  NOT!  Nurses deal with patients totally different from doctors.  Nurses know more about their patients than most doctors do.  Nurses are trained to observe and to intervene only when necessary.  Nurses don’t believe that they know everything and can do anything.

Okay, enough of my soap-box.  Please read the article and then let me know what you think.  Be sure to click over and read any of the other thought provoking articles to be found at Health News Digest.  Leave them a comment or leave me one, please.

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From HealthNewsDigest.com
By David Goodman, M.D.
Oct 9, 2010 – 4:41:18 PM

DMS faculty member David Goodman, M.D., was a member of a committee asked by the Institute of Medicine to study the role of nurses in the health-care workforce.

(HealthNewsDigest.com) – Lebanon, N.H.—In a rapidly changing health care environment, the nation’s 3 million-plus nurses can and should play a much greater role in delivering care, according to a new Institute of Medicine report. David C. Goodman, MD, MS, of The Dartmouth Institute for Health Policy and Clinical Practice, a researcher known for his expertise on issues involving the health care workforce, is a member of the Committee that authored the report.

“Nurses already are central to high quality care. Of any member of the health care team, they have the most enduring relationship with patients and are the most trusted professionals in health care.” said Dr. Goodman, who is also a Professor of Pediatrics and of Community and Family Medicine at Dartmouth Medical School and a practicing physician at the Children’s Hospital at Dartmouth-Hitchcock Medical Center.

The report, The Future of Nursing: Leading Change, Advancing Health, was authored by the 18-member Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. Over two years of analysis and deliberation, including five meetings, workshops, three public forums, and numerous site visits, the Committee considered its charge to “examine the capacity of the nursing workforce to meet the demands of a reformed health care and public health system.”

Among its recommendations, the Committee concluded that to fully take advantage of the skills and commitment of nurses, they must have expanded educational opportunities, and be freed from “scope of practice” regulations that limit the care they can provide. Further, it recommends that nurses be given a greater role in health care redesign and improvement efforts.

“We believe the search for an expanded workforce to serve the millions who will now have access to health insurance for the first time will require changes in nursing scopes of practice, advances in the education of nurses across all levels, improvements in the practice of nursing across the continuum of care, transformation in the utilization of nurses across settings, and leadership at all levels so nurses can be deployed effectively and appropriately as partners in the health care team,” write the authors.

The nursing population represents the largest portion of the U.S. health care workforce. Yet, it faces many challenges to being integrated as fully as it could be in the provision of care, according to the report. Among these are a lack of diversity in race, ethnicity, gender and age; insufficient education and preparation to adopt new roles; restrictions on scope of practice, limitations by insurance companies, and in some cases “professional tensions” that make it difficult or impossible to practice to their full potential.

“Producing a health care system that delivers the right care–quality care that is patient-centered, accessible, evidence based, and sustainable–at the right time will require transforming the work environment, scope of practice, education, and numbers of America’s nurses,” the report states.

“This report will advance the nursing profession to the center of leading change and improvement in health care systems as the nation seeks higher value in patient care,” said Dr. Goodman.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education.

The Robert Wood Johnson Foundation is a non-profit philanthropic institution, founded in 1936, whose mission is to improve the health and health care of all Americans.

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September 6, 2010

Texas Considers Minimum Nurse-to-Patient Staffing Ratios

U.S. Army Nurse at the bedside of a young Iraq...
Image via Wikipedia

I found this today and felt I should post it here.  I read the article and I had to laugh when I got to the last part.  I bet that statement came from a hospital administrator who knows that the nurse on the floor has no control on staffing at all.  I will be following this up since I work in the great state of Texas and serve on my hospital’s Staffing Effectiveness Committee.

I will be trying to find some follow-up since this is from 2009 and I am sure there is more about this initiative somewhere out here on the web.

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Texas is considering legislation that would mandate specific nurse-to-patient ratios on certain hospital units, Nurse.com reports. The Texas Hospital Patient Protection Act of 2009 would require one nurse for every four patients on med/surg units, in the emergency department (ED), on postpartum women-only units and on psychiatric units. Meanwhile, the legislation stipulates one nurse for every two patients on intensive care units (ICUs), neonatal ICUs, on the post-anesthesia recovery unit and in the newborn nursery. A one-to-one nurse-to-patient ratio would be required for operating rooms, conscious sedation, labor and delivery and for trauma patients in the ED. The proposed legislation would require only one nurse for every five patients on rehabilitation units. Advocates of the legislation assert that the proposed ratios will allow nurses to more personally treat patients and possibly attract nurses back to the profession. According to the California Nurses Association, after California passed nurse-to-patient ratios, the state saw an influx of 80,000 nurses. The Texas law would also protect whistle-blowers and hold hospitals accountable for violating the measures. Opponents to the proposed measures, meanwhile, say a bill is unnecessary and that bedside nurses, not legislators, are best equipped to determine optimal nursing ratios (Wood, Nurse.com, 1/12/09).

This is a great site and you can read this article and others like it here.

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August 31, 2010

Nursing Opportunities Expected to Increase

Filed under: Nursing — Shirley @ 3:40 pm
Tags: , , , , ,

Here is an article that states exactly what I have been thinking all along.  Folks, the nursing shortage is still here.  All that happened recently is that our economy took a downturn and nurses went back to work after long “vacations from nursing” or nurses who wanted to “retire” simply were unable to do so.  The median age of nurses is getting older and with all these factors, there simply has to be a shortage of huge proportions in the very near future.  When our economy recovers–note I said when not if–those nurses who want to retire will do so, those nurses who came back to nursing to support the family will go back to caring only for the family, the older nurse working now will start leaving the profession to actually “have a life” and who will be there to fill that void?  Voila!  A nursing shortage!

My biggest concern about new nurses right now is that many may be entering the field for all the wrong reasons.  Nursing is really a calling, not a job.  I hope all the new nurses understand that and come prepared to stay the course for their patients.  I’m not sure that will be the case, but I can try to remain hopeful and positive.

So, what do you think?

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Carol Sorgen

Monday, August 30, 2010; 10:34 AM

For years now, we’ve been hearing about the nursing shortage in this country. Is that still the case? On the whole, yes, say nurse recruiters throughout the Washington metropolitan area, though there has been a temporary “blip” as a result of the recession.

“The economy has certainly had an impact on the job market for nurses, as nurses who were planning to retire have delayed those plans, part-time nurses have requested additional hours, and full-time nurses have sought additional shifts,” says Dennis Hoban, Senior Director of Recruitment for Washington Hospital Center.

But, while short-term the nursing shortage appears to have eased, looks are deceiving, says Hoban. “Long-term, we’re still expecting a shortage for years to come.”

Washington Hospital Center is still hiring both new graduates as well as more experienced nurses, says Hoban, but adds that the application process is more competitive than it has been in recent years, and new grads may have to shift their expectations somewhat. “While we’re always looking to hire nurses, not every unit will have openings,” says Hoban.

In the recent past, new graduates were able to pick and choose their desired area of specialty but openings for new nurses are not as plentiful at this time, agrees Darlene Vrotsos, Vice President and Chief Nursing Officer at Virginia Hospital Center. “Today, employers are searching for factors that will set candidates apart from the rest of the competition,” she says. “Therefore, it is crucial to be flexible and open to where the opportunities are when it comes time to begin interviewing.”

Another way to improve your chances of being selected for a position is by having a customer service attitude, Vrotsos advises. “Today, this skill set is as important to patient outcomes as are critical thinking and technical nursing skills,” she says.

Obtaining employment while still in school as a Certified Nursing Assistant, Patient Care Assistant, or Clinical Technician can also enhance the chances of acquiring a position as a new graduate when the time comes, Vrotsos suggests. “This helps you become acclimated to the clinical environment, while giving your potential employer the opportunity to observe your work ethic and performance first-hand.”

Virginia Hospital Center brings new graduates into all specialties and provides fellowships that are tailored to the individual.

While the 2008 economic downturn has minimized the effects of the nursing shortage, Inova Health System’s nursing and human resource strategists are planning for the near-term when the improving economy will mean nurses are in greater demand. According to Dr. Patti Connor-Ballard, RN and Interim Chief Nurse Executive, despite the lower vacancy rates resulting from the present economy, Inova continues to hire new graduate and experienced nurses to help fill vacancies resulting from promotions and other career enhancement opportunities.

Realizing that the nursing shortage will soon resurface, Inova Health System is committed to its investments in the new graduate fellowship nurse program, designed to provide supplemental education and training to new graduates. “Inova plans to select a number of new graduate nurses who distinguish themselves among their college peers for on-the-job education, mentoring, and training for medical, surgical, oncology and some critical care areas,” says Connor-Ballard.

Inova also continues to seek experienced nurses to provide patient care while allowing for promotions of nurses who are interested in exploring a secondary field of interest such as informatics, professional practice, or quality. Inova also seeks highly trained nurses for areas where there are expansions due to new service lines or new facilities.

According to Connor-Ballard, Inova Health System remains fully dedicated to meeting the evolving needs of the communities it serves by providing the highest quality of nursing care available. “This realization requires Inova to continuously recruit, train, and develop nurses who provide safe and uncompromising care,” she says.

Even in the midst of an unsteady economy, the good news is that nursing remains an excellent career choice, says Eileen Dohmann, Vice President of Nursing at Mary Washington Hospital. “The flexibility and variety that nursing offers continue to be an attractive draw.”

While Mary Washington hired fewer new graduates last year than it has in recent years, Dohmann expects those numbers to increase in the near future. “I don’t want people not to go to nursing school because they think there aren’t jobs available, because that’s just not true,” she says, adding that Mary Washington is in an excellent position to hire more nurses as the economy improves because it is both located in a growing area and is a growing organization itself.

If you’re a new graduate or soon will be, Dohmann recommends looking for a position sooner rather than later, as well as considering different geographic locations, and different kinds of nursing.

“Get experience anywhere you can,” Dohmann advises. And most importantly, she adds, “Don’t give up.”

This advertorial was contributed by Carol Sorgen (carol@charm.net) in conjunction with The Washington Post Special Section Department. The production of this supplement did not involve The Washington Post news or editorial staff.

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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.

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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.

BY PAULA BURKES Oklahoman

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.

Multimedia

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.

ONLINE
• More information: http://www.aana.com and http://www.oana.org.

“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.”

Read more: http://newsok.com/article/3477336#ixzz0u9qWEZrt
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June 23, 2010

Going to Work When You’re Sick

Becky's costume: sick person
Image by jadam via Flickr

In case you haven’t noticed, I love the NY Times Well Blog.  I read Tara Parker-Pope all the time and find many great articles by her to share here with you.  She seems to have her pulse on the real world of health and healthcare.  She talks about  nursing issues with authority and she covers problems in the industry without apologizing.  This article is just one example.

In my experience, giving more paid sick days may or may not be the answer.  As a nurse, I have paid time off as one of the benefits of the job.  However, getting to use any of it is the real problem.  If you are sick and call in, you will be manipulated with guilt and treated like a slacker.  The truth is, if you call in sick, your co-workers will, in all probability, have to work short and that means taking even more patients each.  You will feel guilty despite being sick.  There  has to be an answer, but I’m not sure that more paid days is it.  Maybe we need to make it so taking a real sick day is possible, first–then look at the number of paid days available.

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By TARA PARKER-POPE

A new poll shows that most Americans support proposed legislation requiring companies to offer at least seven days of paid sick leave, reports the Economix blog.

Notably, the survey clearly showed what happens when people don’t get paid sick leave: more of them go to work sick and send sick kids to school.

The survey found that 55 percent of respondents who said they were not eligible for paid sick days said they had at some point gone to work with a contagious illness like the flu or a viral infection, compared with 37 percent who said they received paid sick days. Twenty-four percent of those who did not receive paid sick days said they had sent a sick child to school or day care because they had to go to work. That compared with 14 percent of those who were eligible for paid sick days.

To learn more, read the full post, “Most Americans Support Paid Sick Leave, Poll Finds.” What do you think? Has a lack of paid sick leave forced you to expose your coworkers or school children to illness?

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Please go here to read the original and leave a comment in the discussion.  Some of the comments are just as interesting as this article, so please do go read them.

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May 6, 2010

Nurses Week, Past & Present

National Nurse’s Week begins tomorrow, May 6th and goes until May 12th, which is the birthday of Florence Nightingale.  Nurses all around the world will be honored by their hospitals, the doctors they work for in clinics, and the management will pass out food and gifts to mark this week as significant.

I don’t speak for anyone but myself, but don’t give me a new mug with the hospital logo on it or a bag with the logo on it.  Since I don’t work days, I usually miss the food because administration only works during the day time.

What I want instead of trinkets is a voice.  I want to have some say in how I do my job and how I care for my patients.  I want to be respected for my knowledge of my patients’ and their families’ needs.  I want to have the right to say, “I can only take care of 5 patients today because two of them are critically ill and will need constant attention.”

I want to be allowed to actually nurse, not spend most of my time searching for supplies, answering phones because we don’t have a clerk, talking to other departments that cannot be bothered to come to the floor to do their own  work, and let’s not forget all the documentation that MUST be done to protect me from lawsuits.  All I want is to take care of my patients the way I, myself, want to be taken care of when I am ill.  Is that really too much to ask?

This article asks “What would Florence Nightingale think about nursing now?” I think she would be saddened and appalled at what nursing now involves.  But read this article and see if you agree with this author.

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What would Florence Nightingale think of the profession today?

By Pat Veitenthal, BSN, RN

Congratulations! You made it to another Nurses Week!

As we celebrate our profession from May 6 to 12, it is time to reflect. Not on the mugs or key chains, or notes, or ice cream socials and free pizza from our employers, but on who and what we collectively are. We are, after all, members of a very exclusive society and we should definitely embrace that.

Putting it in demographic perspective, current U.S. population estimates say there are 305 million people in our country, and only 1.09 percent of us are working as RNs or LP/VNs.

That’s pretty amazing, and it’s what makes us so exclusive. That and the fact the only people on earth who actually understand what it is we do are other nurses.

Recent History

I wonder how much you actually know about Nurses Week? I strongly encourage you to research its history, but let me get you started. In February 1982, a joint resolution by Congress designated May 6 as “National Recognition Day for Nurses,” and in March of that same year, President Ronald Reagan signed the official proclamation.

It wasn’t until 1990 that the American Nurses Association board of directors expanded it to a week-long celebration. We do like good long celebrations, don’t we! Work hard, play hard.

But as we celebrate, let’s also take time to remember our beginnings and Florence Nightingale, who, by the way, has now been dead for 100 years this year, and whose birthday, May 12, marks the end of Nurses Week.

I wonder what Florence would think about the current state of nursing? […]

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