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Nurses Add a Message on Their Scrubs

I thought this story was interesting and thought it you’d like it, too. There are hospitals in England that have nurses wearing “Do Not Disturb” signs over their scrubs so they can get more work done. I doubt this will come stateside, but as a student in an ADN degree program there are a lot of things that hospitals are trying to do to save a buck or two.

In the U.K.’s Daily Mail, Jo MacFarlane writes about the controversy that these hospitals are causing with nurses that are donning “Do Not Disturb” messages. “The hospital says that interruptions, such as patients asking questions about toilets and meal times, stop nurses from doing their job properly and could lead to patients being given the wrong medication.”

“After a successful trial at East Kent Hospitals University NHS Foundation Trust, the uniforms are being introduced for staff nurses and matrons in hospitals across the country, to be worn during drug rounds on wards.

“During these times, patients will be encouraged not to speak to the nurses. Instead, they will have to address concerns unrelated to their medication to care assistants, who will accompany their more senior colleagues on their rounds. The red tabards are worn on top of a nurse’s uniform and have large white print on the front, which reads: ‘Do Not Disturb. Drug Round in Progress,’” writes MacFarlane.

A study was taken to see if this new procedure was successful. It found that on average a nurse is interrupted six times during her rounds, but with the sign she was interrupted only five times (and that was considered a “significant” improvement.) It also found that there was a slight reduction in medication errors which is the most common error that most hospitals face.

What happens if a patient approaches a nurse bearing the big red sign? “‘What we do when interrupted is simply turn round to face the patient and point to the words.” Umm… I’m sure that is great for patient recovery…

Obviously patients aren’t taking too well to this new system. As a student in a registered nursing college, one of the first things you learn is to care for your patients. Multitasking is just part of the job and interacting with patients is as important as the medications that are administered.

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Nursing Staff Ratios Linked to Patient Health

There is nothing more frustrating as a patient who has been admitted to a hospital than pressing the nurse call button and not getting help. When pain levels are high and the stress of being ill is terrifying, nurses are the link to hope and health.

On the flip side, there is nothing more frustrating for a nurse than having numerous patients demanding your attention while you can only perform one task at a time. As a nurse getting an ADN degree, this is an important issue.

Reporter David Wenner from the Patriot News in Pennsylvania addresses this issue that is currently being analyzed at Carlisle Regional Medical Center. The Department of Health investigated this hospital and found some incidents that are unacceptable for a hospital and are probably more common than we would like to think.

Wenner reports that, “Something approaching a worst-case scenario might have occurred recently at Carlisle Regional Medical Center, where the state painted a frightening picture of conditions that allegedly existed over several weeks in May and June.” 30 patients being cared for by just three nurses, ER patients waiting for hours to be seen once admitted, and nurses fearing for their jobs for reporting the discrepancies were just a few of the problems.

“Dr. David Nash, a nationally known health care-quality expert employed at Jefferson Medical College in Philadelphia, cautioned against hospitals cutting too much. ’In our current environment, we have to be more vigilant than ever about nurse staffing ratios,’ Nash said. ‘A natural cost-cutting avenue is cutting people. We have to be very careful not to cut nurses to save money. It’s a penny-wise, pound-foolish strategy.’”

It has been proven that high nurse to patient ratios have a higher likelihood of patient recovery while lower staffing levels increase patient risk for infection and even death. However, budget cuts are hitting hospitals hard and cutting staff is sometimes one of the hardest decisions that management makes.

Fortunately in California, we have a pretty strict nurse to patient ratio law which is great news for students in an ADN program. While other states are cutting nurses, California hospitals are required to maintain a larger nursing staff. Most units have a 1 to 4 nurse to patient ratio and with an aging population and an increase in chronic conditions, nurses in California will continue to be in demand.

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Social Media Increases Health Care’s Sphere of Influence

Who doesn’t have an account on a social media networking site like Twitter or Facebook? Okay, I don’t, but I look over my husband’s shoulder and can see all that I’m missing (and it confirms why I don’t want an account.) Yesterday I wrote about telemedicine and how it is changing the future of health care. Today I found another article on this subject that I couldn’t pass up commenting on. If you are a student earning an ADN degree, you may be interested in this new use of technology.

On Bakersfield.com staff writer Kellie Schmitt interviewed doctor Dr. Milan Shah, who specializes in aesthetic and laser medicine, to find out how Dr. Shah uses social media and the concerns he has about it. “Shah and other health care workers are increasingly promoting their offerings, educating consumers and forming online communities through social media. That’s especially important as one in five Americans is using social media sites such as Facebook as a source of health care information, according to a 2011 National Research Corp. Ticker survey.”

There are some legal precautions that need to be paid special attention to. As with any area of medicine, patient privacy needs to be upheld. Schmitt writes “The goal for health care workers is to ensure their online presence matches their offline attention to federal privacy laws, such as not mentioning or photographing patients without their consent, experts say. It’s also important for practitioners not to give specific medical advice online.

“The pharmaceutical industry faces additional regulations that govern fairness and balance, said Bob Brown, a partner of BryantBROWN Healthcare, a L.A.-based marketing firm. ‘If they tout the benefits of a drug on their Facebook page, they need to give equal space to its risk — even if they’re not the ones posting the comment. The industry is looking to the FDA to publish more definite guidelines’, Brown added.”

These sites are also directed more towards elective surgery or aesthetic procedures since they are paid for out of pocket and not from insurance. “Sometimes, the Facebook sites even turn into impromptu support groups, with new patients expressing their apprehension, and more seasoned ones responding.”

This makes me wonder how nurses will be impacted by this change in practice. Will they spend more time on the internet treating patients and less time face to face? Will Facebook become part of the job such as charting is? How will bedside manner change and how will accountability be monitored? Those in a nursing program in the Bay Area have a lot to look forward to….

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Is Preventive Care Helpful or a Waste of Time for Nurses and Patients?

From the outside looking in preventative care seems like a great idea. It’s always better to locate a problem before it gets out of hand, right? That may not always be the case for nurses, doctors and the patients who are being seen. Students in a nursing program may be impacted by Medicare and it’s free “wellness visits.”

Warren Wolfe from the Star Tribune, Minneapolis addresses this new concept of preventative medicine. He writes that, “The wellness screenings emerged as one of the signature benefits of the big federal health overhaul that Congress passed last year — an effort to catch problems early, keep patients healthier and cut future Medicare costs.”

“Some doctors, however, are having second thoughts. To get paid by Medicare, a physician and nurse must complete 15 steps during a 30- to 45-minute exam, including brief screenings for dementia and depression, an eye exam, a medical history and personalized health advice. They must also check weight, height and blood pressure — the only time the patient must be touched.”

While all of this sounds great on paper, Dr. Patricia Lindholm is among the doctors who are having second thoughts. “Dr. Patricia Lindholm thought it was a great idea this year when Medicare announced it would cover free annual wellness visits for older people. Lindholm thought ‘OK, finally we’re getting Medicare to cover preventive medicine, catch problems while they’re smaller and more treatable,’ … Then she started conducting a few — and quickly changed her mind…What she thought would be a full physical exam turned out to be essentially a hands-off screening that was ‘pretty worthless for most of my patients — a waste of their time and mine,’ she said.”

I’ve spent my share of time in the hospital the past four weeks as my daughter and nephew have both undergone surgery. I know that they aren’t part of this “annual wellness check for older patients” category, but the hospitals I have visited are overcrowded, the nurses are treating patients at capacity and I can’t imagine adding to this list hundreds of thousands of people who are fine and just want a free check-up. Plus, where is the government going to get all of the money to pay for these well checks? Another issue to consider is that “If doctors want to go beyond the Medicare agenda — order tests or prescribe medication, for instance — they must either ask the patient to return for a separate visit or split the bill between Medicare and the patient,” writes Wolfe.

Health care reform sounds great on paper, but financially and physically I just don’t see how it’s possible. ADN nurses in the San Francisco Bay Area have a full plate already and tax payers are squeezed dry. Should we treat the sick or treat those who are well?

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More Cutbacks Affect Health Care

We all seem to be feeling the pinch of the economic crisis that is facing our country. The continual government cutbacks are making budgets even tighter and it seems like there isn’t much more to eliminate. The San Mateo County Board of Supervisors is busy making some tough decisions regarding health care, and nursing students will be feeling the pinch when they enter the health field.

How is it that I seem to be paying more in taxes and getting less for my money? I can’t answer that, but the Burlingame.patch.com website tries to explain budget cuts that will be affecting those in San Mateo County. It was reported that, “The San Mateo County Board of Supervisors Monday afternoon continued its first day of 2011-12 budget hearings by considering a range of proposed cuts and service reductions to the county health system.

“The recommended cuts to the health department total more than $9.6 million, according to County Manager David Boesch, and include reductions in funding to the Mental Assessment and Referral Program, the Multipurpose Senior Services Program, and a range of health programs that serve low-income and at-risk children.”

I know not everyone reading this lives in San Mateo County, but this seems to be a common trend that I keep reading about: budget cuts to the elderly and at-risk children. I try not to voice my personal opinion in these posts, but I can’t help it; it seems like the government should help those who absolutely cannot help themselves. (And I know of a lot of agencies that waste money but I won’t get myself in a pickle discussing them. This is about health care, afterall…)

The article continues to state that “Health System Chief Jean Fraser said the reductions to children’s services were unavoidable because of cutbacks in adult services programs that were made in last year’s budget.

“’Honestly, we just don’t have a choice,’ Fraser said. ‘We have to cut some kids’ services.’

“About two dozen San Mateo County nurses protested outside the government center in Redwood City over proposed Health System cuts, which participants said would threaten the county’s underserved and at-risk communities.

“’When you cut too much, you shoot yourself in the foot,’ San Mateo Medical Center staff nurse Peter Zych said.”

Well, apparently our society is going to walk with a limp.

As a 2-Stage ADN, I’m sure you’re already seeing how cutbacks are affecting nurses and the environment that they are working in. It will be interesting to see what the future holds…

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Stress Busters for Nurses Part I

Stress has become a part of our lives as much as our heart beating and breathing in and out. If you think I’m exaggerating, ask the next ten people you come across, “Do you experience stress on a daily basis?” Now I don’t have statistics to back up my opinion, but I stand by my theory nevertheless. If you’re in an online ADN program, your stress levels are probably off the charts.

Scrubsmag.com writer Marijke Durning has some great tips to help get you through.

1) Be on top of your own health. – “Stress left unchecked can cause physical ailments including cardiovascular disease. Taking a heart health self-test and making regular appointments with your own PCP will help you stay in good shape and also make you feel confident and in control of your own well-being,” suggests Durning.

2) Exercise your stress away. – Countless studies are out there about the positive effects exercising has on one’s mood and clarity of thought. I wouldn’t know; my theory is that if you don’t exercise, you won’t get hurt. Plus if I started an exercise regime, I’d probably get stressed out about following it or wasting money on a gym membership that I’m too tired to use. Regardless of my lousy theories, do what I say, not what I do.

3) Take your own pulse. – I think of this more as the Take Time and Breathe Method. When life is spinning out of control, stop, take a moment to inhale a few deep breaths, and prioritize what needs to get done.

4) Say a prayer. – Durning writes that, “Prayer is a powerful tool to help practitioners relax and de-stress. Memorize a prayer that resonates with you and let it help you when times get tough.”

I think it’s more than that, though. It means that God is in control even when I am not. It means that there is a reason beyond the chaos and a hope beyond the pain.

5) Pamper yourself – Because of my fibromyalgia, I get a massage once a month. I have to tell you, it’s awesome! Nurses are doing things for a bunch of people at any given time; sometimes the very thing you may need is a little pampering and a little break from the outside world.

Being an ADN student brings a lot of stress, so there is no way I can give just five tips to bring total relaxation. Tune in next week for part II!

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