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Social networking for nurses

Twitter. Facebook. MySpace.  Everyone seems to be hooked up somewhere, somehow through social media.  But these sights are not just for finding old classmates or showing off photos of your latest vacation.  Social media can be a powerful tool to help you grow in your profession.  It has replaced the “after hours” functions of decades gone by.  Now you can just turn on your computer to find professional contacts.  You can share discuss professional topics,  find out about job openings, or use your profile to promote yourself to prospective employers. 
There are several sites dedicated to the nursing profession.  They include:
MyNurseBook: Its focus is on the global nurse shortage and solutions to this crises.
Nurse Connect: Find friends and former nursing colleagues, network your way into a new nursing job, rate and review hospitals and more with privacy at this nurses’ networking site.
Nurse.com: This site is operated by the Gannett Healthcare Group, publisher of many nurse publications.
NurseLinkUP:  NurseLinkUP also maintains a Facebook page, so users can connect in two places. NurseTogether: This offers advice, education, forums, global nursing focuses, a store and more. NurseZone: Dedicated to providing nurses with professional and personal development information and opportunities.
Student Nurse Network: This is a new Ning social networking site that was built by nursing students for other nursing students.

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High Tech, High Touch: Nursing Informatics Adds New Dimension to Profession

Nursing notes were once hand written documents that were filed with the patient’s chart, rarely seen after discharge.  However, health care providers and administrators now understand the importance that clinical data has to a person’s entire health history.  As support for a national health database has grown, so has the field of nursing informatics.

According to June Kaminski, RN MSN PhD(c), (http://www.nursing-informatics.com/) nursing informatics results from integrating the triad of computer, information and nursing sciences. The data that comes from this triad can improve nursing practice, education, research and administration.  While still in its infancy, the field of nursing informatics is poised for rapid growth. There is a growing realization that the data that comes from nursing practice can be collected and analyzed to improve patient care and outcome.

This does not mean that nurses will substitute computers for patient care. According to Kaminski, “More and more, with each passing year, “high tech and high touch” are becoming a way of life in the practice of nursing. This can only become common reality if nurses are comfortable working with computers and advanced technology while providing evidence based care for their clients.”

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Another Reason to Be Paranoid of Drug Companies

For those of you working in the daily grind of the healthcare industry, it should come as no surprise that drug companies are rather aggressive in their promotion and distribution of new medication. And I’m not talking about the commercials and magazine ads that the average consumer is exposed to. I’m talking about the sponsored drug trials. The daily visits by sales people. And the closets overflowing with sample medications for the masses. Like I said, aggressive. Well, it is coming to light that AstraZeneca, one of the largest pharmaceutical companies in the country, was involved in some rather shady dealings with their drug Seroquel.

AstraZeneca sponsored trials around the country with prominent psychiatrists who would push the medication and provide valuable research data on it’s effectiveness. Think of it as a “real-world” trial. One such psychiatrist in Chicago, a Dr. Reinstein, was “bringing the company a small fortune in sales” with his successful trial of the drug. Where this gets interesting is that this Dr. Reinstein’s research was providing better-than-normal results. His rock start status with AstraZeneca led to $490,000 in income paid over a decade for speaking engagements, participation in the trial, etc. AstraZeneca went so far as to put him on a pedestal and bow to his every whim.

“If he is in fact worth half a billion dollars to (AstraZeneca),” the company’s U.S. sales chief wrote in 2001, “we need to put him in a different category.” To avoid scaring Reinstein away, he said, the firm should answer “his every query and satisfy any of his quirky behaviors.”

During the time that Reinstein was being paid for his services, he was accused of overmedicating and neglecting patients – yet AstraZeneca turned a blind eye because he was actively promoting (read: selling) Seroquel. Reinstein’s peers are even quoted as saying he put his patients on as much as twice the drugs as other doctors. Despite claims that the income received from AstraZeneca in no way swayed his research or patient care, this situation has turned into a federal lawsuit.

So if you were ever on the fence as to whether or not you should be paranoid, or at the least skeptical, of major drug and pharmaceutical companies – I hope this story changes your mind. When the next sales guy comes to your hospital or doctor’s office, listen to what they have to say, but take it with a grain of salt. They are pushing a product and will do, say and pay anything to get that drug into the hands of patients.

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Saline Bag

Patient Safety, Health Risks and Common Sense

Saline BagHave you seen this startling piece of news? A nurse at the Broward General Hospital in Ft. Lauderdale, Florida is under suspicion for serious misuse of saline bags and tubing. In short, the as-of-yet unidentified nurse was reportedly seen reusing the same saline bag and tubing to administer intravenous fluids during chemical cardiac stress tests. Yes, you read that correctly. She reused them and has potentially exposed more than 1800 patients to HIV, hepatitis and who knows what else!

Thankfully, the nurse has resigned and has been reported to the Florida Board of Nursing. According to the report from the Miami Herald, the hospital is now reviewing 5 years worth of patients that were handled by this nurse and contacting ALL OF THEM. They are recommending that every single patient get tested. The tests will be provided at no cost (there would be an uproar if they weren’t, right?).

The hospital did not offer an explanation on how an employee could have continued a dangerous practice for five years without being noticed or admonished.

How does something like this happen? Patient safety should be a nurse’s #1 priority. What nursing school would ever teach you to reuse saline bags and tubes? What incentive did this nurse have for doing this? Surely she would have no care for saving the hospital money. One can only assume that this was a practice derived out of sheer laziness. And the moral of that story? Lazy nurses make costly mistakes. And in this instance that mistake could prove fatal.

Here’s to hoping that the 1800 patients all receive good news from their test results. And let us all hope that Broward General Hospital takes a good look at how a situation like this could go unnoticed for so long!

Photo courtesy of Felix42 at Flickr.

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Mandatory Flu Shots: Where Do You Stand?

As we near the flu season, the inevitable rush on flu shots is in full swing. More so this year with the addition of H1N1 vaccines. Being a nurse, you know that this is happening – and maybe are even employed at a vaccination clinic. But what about you? Will you be getting vaccinated? Do you even want to be vaccinated? Does your employer mandate that you get the flu shot? What about your state?

Over at the Wall Street Journal, there’s a healthy debate going on about this very issue. In New York state, there is already a mandate in place that requires nurses and other healthcare workers must receive both the seasonal and swine flu vaccines. The state of Washington is considering a similar mandate. But associations and individuals are up in arms about being forced into the vaccine.

About half of health care workers usually go without a flu shot. That increases the risk that they’ll get the flu, and pass the disease on to patients.

Many of those that have commented on the WSJ post are vehemently against government mandates and the possible encroachment on their individual rights – even to the point of accepting the fact that they could lose their jobs. Others remain more accepting based on the fact that the mandates are intended to protect both healthcare workers and patients alike.

Where do you stand? Do you agree with mandatory flu shots or do you wish to make that decision on your own? Leave me a comment and let me know!

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H1N1 - Swine Flu

Is It the Flu or H1N1? Be Prepared for a Confusing Flu Season

H1N1 - Swine FluThe news media has had a field day with H1N1, otherwise known as swine flu.  It’s been nearly impossible to escape the daily reports of outbreaks, constant warnings and even conflicting reports.  According to a recent article from U.S. News and Yahoo!, concerns are growing that patients will have difficulty separating typical flu symptoms from those of H1N1.  Even doctors and health professionals have misgivings. The similarity in symptoms could result in an increase of potentially unnecessary doctor and ER visits this flu season.

“That’s a great question,” says Richard Wenzel, a swine flu expert and former president of the Infectious Diseases Society of America. “You really have no way of knowing if it’s the flu or just a cold.”

To help combat the confusion, nurses and medical professionals need to keep themselves educated on the symptoms specific to H1N1.  Symptoms might include:

  • Fever above 100.4 °F
  • Cough
  • Sore throat
  • Headache
  • Chills
  • Muscle aches
  • Diarrhea
  • Vomiting

When should nurses and parents alike be seriously concerned? To name a few – Fast breathing, difficulty breathing, blue or gray skin, persistent vomiting and even typical flu-like symptoms that cease, but return again with fever and a worse cough.

The CDC says warning signs in children that warrant immediate medical attention include fast breathing or trouble breathing; bluish or gray skin color; not drinking enough fluids; severe or persistent vomiting; not waking up or interacting; a child so irritable that he does not want to be held; and flulike symptoms that improve but then return with fever and a worse cough.

What’s on the horizon for H1N1? First up is the H1N1 vaccine should be ready in early October – with kids being among the first to get the vaccine. The CDC has said that parents can choose to pass up the immunization for their children if they’ve recently had a potential swine flu respiratory infection. But due to the wide spread confusion, many of these children be given the vaccine regardless.  Additionally, the CDC recommends that children over 6 months old and pregnant women should get the vaccine.

Yes, the CDC will still stick with its recommendation to get any children over the age of 6 months vaccinated–and pregnant women too–unless a previous infection was confirmed via a lab test.

And it should go without saying, but all nurses, doctors and health professionals need to remember basic prevention tactics.  Wash your hands. Avoid touching eyes, nose and mouth. Be responsible and remind patients to do the same. With flu season just around the corner, and the threat of a heavier than normal influx of patients, it’s more important than ever to remain safe.

Photo courtesy of Froge at Flickr.

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Obama Rallies Nurses in Push for Health Care Reform

(AP )

The morning after his special address to a joint session of Congress on health care reform, President Obama on Thursday once again turned to nurses to keep his push for health care reform alive.

“Nurses, you have a lot of crediblity. You touch a lot of people’s lives. People trust you,” Mr. Obama said to the American Nurses Association in Washington. “If you’re out there saying it’s time for us to act, we need to go ahead and make a change… then we will bid farewell to the days when our health care system was a source of worry to families and a drag on our economy.”

The president first rallied support from the American Nurses Association for his health care plan in July, when he said the country was “closer than ever” to comprehensive reform.

Since then, the president lost control of the dialogue surrounding the debate as lies and partisan arguments took hold at town hall meetings across the country. Mr. Obama laid out on Wednesday night what he wants from a health care reform plan, and he repeated those goals on Thursday: insurance market regulations, a health insurance exchange, and preferably a government-run insurance plan, or “public option.”

“Few people understand as well as you why today’s health care system so badly needs reform,” Mr. Obama told the nurses.

He cited new data from the Census Bureau showing that the poverty rate increased last year at the highest rate since the early 1990′s and that the number of uninsured rose in 2008. In the last 12 months, he said, it’s estimated the number of uninsured grew by nearly 6 million, while 8 million people lost their employer-provided coverage.

Full CBSNews.com coverage of the president’s speech on health care:

Obama Tells Congress to Stop Bickering

Full Video Full Transcript Speech Highlights

GOP Response: “It’s Time to Start Over”

Marc Ambinder: Will Obama’s Sales Job Work?

Mark Knoller: Obama Willing to Compromise — Up to a Point

Was Obama Clear on the Public Option?

Ted Kennedy’s Letter to Obama

Rep. Wilson Swipes the Spotlight

Analysis: The Road Ahead for Health Care

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Magnet Recognition provides benchmark for nursing excellence

Twenty years ago, the American Nurses Credentialing Center (ANCC) implemented a pilot Magnet Recognition Program. Developed with the intention of recognizing hospitals and health care organizations that provide nursing excellence, the Magnet program would also collect and assess information about successful nursing practices and strategies. These could be built into education and certification programs.

The Magnet Recognition program has evolved into a benchmark for quality that consumers can expect from a health care organization. In the 2009, 15 of the top 21 medical centers featured in the annual U.S. News & World Report’s list of America’s Best Hospitals were Magnet-recognized organizations. In fact, nine of the top ten children’s hospitals featured in that same report were Magnet recognized. In addition to quality of care, Magnet recognized hospitals provide a better work environment for nurses. In 2008, seven of the eleven healthcare organizations included Fortune Magazine’s “100 Best Companies to Work For” were Magnet-recognized facilities or have Magnet facilities in their system.

The list of 354 organizations recognized by the Commission on Magnet (COM) hospitals and health care organizations in 44 states and the District of Columbia, as well as four international entities; two healthcare organizations in Australia, one in New Zealand, and one in Beirut, Lebanon for their excellence in nursing service.

The Magnet Recognition Program is based on quality indicators and standards of nursing practice, referred to as “Forces of Magnetism (FOM)”. The source of these indicators in the American Nursing Administration’s Scope & Standards of Practice. The Forces of Magnetism are:

  1. Quality of Nursing Leadership
  2. Organizational Structure
  3. Management Style
  4. Personnel Policies and Programs
  5. Professional Models of Care
  6. Quality of Care
  7. Quality Improvement
  8. Consultation and Resources
  9. Autonomy
  10. Community and the Healthcare Organization
  11. Nurses as Teachers
  12. Image of Nursing
  13. Interdisciplinary Relationships
  14. Professional Development

In 2008, the COM developed a new model that grouped the 14 FOMs into five key components: Transformational Leadership; Structural Empowerment; Exemplary Professional Practice; New Knowledge, Innovations, and Improvements; and Empirical Outcomes.

The credentialing program has paid off for nurses, patients, hospital, and the public. Some of the benefits found in Magnet recognized hospitals are:

  • Higher nurse compensation.
  • Better nurse recruitment and retention
  • A better competitive advantage for health care organizations
  • Improved working interdisciplinary working relationships.
  • Financial Savings for the organization, both in terms of cost savings and cost avoidance.

Training and continuing education are critical elements for recognition by the COM. The ANCC provides a series of workshops and training modules. For more information, go to www.nursecredentialing.org.

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An Overview of Nursing Salaries

  • Registered nurses make up the largest sector of health care professionals holding 2.6 million jobs in 2008.
  • About 60 percent of all nursing opportunities are within hospital settings
  • Three paths to becoming a nurse include obtaining a bachelor’s degree, an associate’s degree, or a diploma from an accredited nursing program.  A master’s degree is required to advance into the role of clinical nurse specialist, nurse anesthetist or nurse practitioner.
  • Job prospects are expected to be excellent but employment opportunities may vary by geographic locations as some employers in lower populated areas report difficulties in recruiting and retaining nursing staff.

Base Salary Ranges by Title:

Staff Nurse (Hospital and medical office)       $53,208.-$77,464.
Staff Nurse (ICU)                                        $55,342.-$77,848.
Staff Nurse (CCU)                                       $53,322-$79,204.
Staff Nurse (Operating Room)                       $56,028.-$80,343.
Staff Nurse (ER)                                          $52,255.-$77,348.
Staff Nurse (Home Care)                              $54,323.-$80,428.
Staff Nurse (Nursing Home)                          $48,289.-$60,919.
Charge Nurse                                              $58,968.-$88,159.
Nursing Supervisor (Nursing Home)               $50,053.-$67,446.
Certified Nurse Anesthetist                            $134,588.-$173,814.
Nurse Practitioner                                        $74-338.-$100,409.
Nurse Practitioner (ER)                                 $76,587.-$107,576.
Certified Nurse Midwife                                 $76,183.-$104,960.
Clinical Nurse Specialist                                $71,103.-$99,803.
Clinical Nurse Specialist (Home Care)            $49,667.-$90,544.
Nursing Home Administrator                          $75,352.-$110,472.
School Nurse                                               $26,851.-$65,463.
Nursing Director                                          $91,120.-$145-724.
Head of Nursing                                           $126,536.-$230,879.
Head of Nurse (ER)                                      $67,345.-$115,295.
Head Nurse (ICU)                                        $76,041.-$118,649.
Head Nurse (Industrial)                                $54,633.-$87,736.
Nurse Recruiter                                           $50,052.-$84,174.
Dean of Nursing                                          $68,745.$211,843.

Source: Salary.com  as of May 2010
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Health Care Bill and Impending Physician Shortage

With the health care bill now passed through both the House and Senate it is estimated that about 30 million people currently without health insurance will be able to see a doctor. However, there may not be a sufficient number of primary care physicians to care for this increased patient load.  Studies show that the number of students enrolling in family medicine fell more than 25% between 2002 and 2007.

The major reason is the lower income of primary care physicians as compared with specialty doctors. With student loans averaging more than $100,000., it is not surprising that new doctors are choosing to specialize in more lucrative practice areas.  Another major factor contributing to the impending shortage is that the health care bill lowers reimbursement rates under Medicare, the purpose of which is to forestall doctors from ordering unnecessary tests and procedures.

In response to the shortage, medical schools will be adding 3,000 slots to first year students by 2018. However, in 1997, the House and Senate placed a limit on the number of Medical residencies in an effort to cut costs under Medicare, which pays for most of this training.  It costs Medicare about $100,000 per residence or a total of approximately $9 billion according to a report submitted in June 2009 by the Medicare Payment Advisory Commission. These residency caps remain in place with the result that increased enrollment may not be sufficient to meet the demand for care; after all, it does no good to increase student enrollment if these students will be unable to participate in a residency.

Compounding the shortage crisis is that newly eligible patients will now be flooding into doctor’s offices alongside elderly patients.  According to the U.S. Department of Health and Human Services, in 2009 there were 17,000 less doctors than needed in both urban and rural areas. The Association of American Medical Colleges predicts that this shortage could increase to 159,300 by 2025.

An amendment to the current Health Care bill calling for the addition of 15,000 primary care residences was created last December by Senate Majority Leader Harry Reid (D-Nevada) along with Charles Schumer (D-N.Y.), Bill Nelson (D-Florida), among other sponsors. According to Atul Grover of the Medical College Association, this amendment will cost Medicare about $1.5 billion. Because the House and Senate are trying to keep costs down, this will limited the actual number of residences created.

One suggestion to overcome the doctor shortage is to increase the responsibilities of nurse practitioners. When people need medical services, those services need not always be administered by a physician. In most states, nurse practitioners must be under the supervision of a physician and are restricted from prescribing medication. Medicare also typically reimburses nurse practitioners at a lower rate than doctors.

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