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Stats and Facts for New Nurses

Our country needs more nurses. That is no secret and has been the topic for countless articles that I’ve read and posts that I’ve written. However, I figure that since you’re in nursing school, one can never get too much good information on this topic.

Scrubsmag.com has posted a new article on this subject with a really great graphic that you should check out. Since you’re investing time and money in a nursing program, this should keep you on track and feeling encouraged.

Nurses are still in high demand and this is why:

• Changes in the Medicare reimbursement system that increased nurses’ workloads
• New patient care technology that requires a higher skill level and more education to use
• A perception that nurses are undervalued and overworked, making it an unattractive career path
• Nursing schools that have not kept up with the needs and interests of today’s students
• Nurses choosing to pursue other lines of work or retiring as they age out of the workforce
• Overall population growth (and a big upswing in the percentage of the patient population over age 65)

“In 2004, the projected shortage by 2012 was anticipated to be 800,000. Now, as seen in the infographic below, that expected gap has jumped to more than 1 million.”

Here are some interesting stats about the current job market that I found interesting:

• Male nurses entering the field are up by 20%
• The average age of a nurse is 42.5 years old

Nursing is an exciting career with as many specialties as there are personality types. Like the fast paced life? Try the ER. Want regular hours and a stable routine? Maybe a private doctor’s office is right for you. Do you prefer investing in fewer patients and building a support system for those in need? Oncology might be the path for you. Would you rather work in an office without the demands of a hospital? Health coaches are a rising trend. When you go to a medical training program, there are endless possibilities!

To read the complete article mentioned in this post, please visit
http://scrubsmag.com/nursing-labor-pool-needs-a-shot-in-the-arm/

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Surprising Stats on Reporting Patient Harm

No nurse deliberately intends to harm a patient. After all, that is in direct opposition of the role that nurses play. However, when caring for fragile geriatric patients or transferring injured individuals, accidents can unfortunately happen. As a student getting an ADN degree, how often would you guess that incidents are reported?

I found an article on FierceHealthCare.com written by Alicia Caramenico that shocked me. She states that, “Hospital workers reported only about 14 percent of the patient-safety incidents experienced by Medicare beneficiaries discharged in October 2008, according to a new report from the Office of the Inspector General (OIG)…Hospital staff failed to report the remaining 86 percent of patient harm events, partly due to staff misunderstanding what constitutes patient harm. Hospital administrators labeled 61 percent of the unreported events as those that staff did not identify as reportable and 25 percent as events that staff normally reported but did not report in this case, according to the OIG.”

14 percent!?! Is it just me, or do you find that horrifying? Unfortunately in the article and in the actual OIG report, I couldn’t find the definition for “patient harm” and the incidents that caused the nursing staff to “misunderstand what constitutes patient harm.” I would also like to know that if 86 percent of the incidents weren’t reported, then how did the study know that these incidents even existed. I feel like I’m seeing a lot of smoke and not a whole lot of fire…

The OIG report explains that, “As a condition of participation in the Medicare program, Federal regulations require that hospitals develop and maintain a Quality Assessment and Performance Improvement (QAPI) program. To satisfy QAPI requirements, hospitals must ‘track medical errors and adverse patient events, analyze their causes, and implement preventive actions and mechanisms that include feedback and learning throughout the hospital.’ To standardize hospital event reporting, AHRQ developed a set of event definitions and incident reporting tools known as the Common Formats. We requested and reviewed incident reports from hospitals regarding patient harm events.”

So here is my conclusion: there will always be reports and findings in the medical world and students with health care career training will have to use their discernment and experience to determine what is worth listening to and what does not apply to their work environment.

To read the complete article mentioned in this post, please visit
http://www.fiercehealthcare.com/story/hospital-workers-fail-report-86-patient-harm-events/2012-01-09?utm_medium=nl&utm_source=internal
and
http://oig.hhs.gov/oei/reports/oei-06-09-00091.asp

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Focusing on Patient-Centered Care

Patient-centered care: isn’t that why people go into the medical profession in the first place? Well, that’s what most people do but a new study was conducted focusing on patient care and satisfaction. As a student in an Vocational Nursing program, keeping patients as a top priority is important to remember amongst all of the paperwork, office politics and often demanding physicians.

Measuring patient-centered care is an important job for any hospital or clinic to focus on. On FierceHealthCare.com, Karen M. Cheung questions, “How does an organization evaluate patient-centered care? Many organizations use the industry standards of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, Press Ganey, or other similar patient surveys.” However, patient satisfaction does not equal patient outcomes.

“Studies have shown experience correlates to quality performance, although there is little correlation between satisfaction and outcomes, according to Dr. Eric Holmboe, chief medical officer of the American Board of Internal Medicine (ABIM). For example, patients who report their providers’ communication as good have better outcomes. Patients who experienced higher ratings of performance (access to care, waiting time, general communication, communication about illness, care coordination, and office staff interaction) showed to have better blood pressure control, indicating a link between communication and care outcomes,” explains Cheung.

“In certifying physicians, the ABIM looks at the six Accreditation Council for Graduate Medical Education/American Board of Medical Specialties core competencies to evaluate the skills of those clinicians: patient care, medical knowledge, practice-based learning, systems-based practice, professionalism, and interpersonal skills and communication. Where does patient-centered care fit in? Holmboe explained that patient-centeredness plays a role throughout all six competencies,” writes Cheung.

While this study focused on physician care concerning patient outcomes, nurses could glean valuable information from this report. Who couldn’t become a better professional with more knowledge, practice and people skills?

During hospital stays, nurses are the bridge between the physician and the patient. As a patient, I tend to feel more comfortable speaking to and asking questions of a nurse. They seem less rushed, more compassionate and more personable.
Nursing is a demanding job on both a professional and emotional level. We know that we need to invest in our patients and yet there has to be established boundaries or else LVN nurses would get overwhelmed. I think time and experience can help to establish the balance for nurses on patient centered care.

To read the complete article mentioned in this post, please visit
http://www.fiercehealthcare.com/story/teaching-patient-centered-care-must-physicians-patients/2011-11-29?utm_medium=nl&utm_source=internal

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Patient’s Death Blamed on NorCal Nurses' Strike

Last week one of the largest nursing strikes took place in Northern California. 33 hospitals and approximately 23,000 nurses were involved in this monumental protest. Due to the amount of nurses on strike, many replacement nurses were called in to care for the patients. However, one nurse made a fatal mistake which is receiving a lot of press. I hate to bring these issues up, but I feel I need to share the full spectrum of the nursing world to nursing students and to those getting their ADN degree.

The Associated Press has an article on BusinessWeek.com reporting about this incident and the events surrounding it. “A replacement nurse at Alta Bates Summit Medical Center in Oakland mistakenly hooked the nutrient solution up to an IV for 66-year-old Judith Ming, instead of to the tube leading to Ming’s stomach, the Oakland Tribune reports… Hospital officials have acknowledged Ming, 66, died from a medical error but have not described what happened pending an investigation into Ming’s death. Police have said only that a replacement nurse gave her a non-prescribed dosage of a drug known to be lethal in the manner in which was administered.”

For once, I actually do not have any words to say. My heart aches for the deceased’s family; death is especially hard to accept when it could have been easily avoided. I obviously was not present when this event occurred so I cannot comment on who’s at fault or why this happened. I just know that all humans make errors and in the medical field, these mistakes are magnified to painful proportions.

“Union officials have questioned the qualifications of the replacement nurses that were brought in by the hospital during the lockout. The California Nurses Association provided a negotiation update to its members in which it referred to the improperly administered supplement as ‘grossly negligent’ and an ‘error so outlandish and bizarre’ that police had questioned the temporary nurse involve,” reported the AP.

An article in the San Francisco Gate reported Dr. Steve O’Brien, vice president of medical affairs at Alta Bates Summit Medical Center, as saying “the death was not the result of bringing in replacement nurses during the lockout. All of the replacements – including the one involved in Saturday’s death – have the needed training and experience for the job.”

It’s a shame that one nurse makes a huge mistake and it becomes a reflection of the entire occupation. Also, the mission of the strike is also compromised with this tragic event. Nursing is one career that everyone has an opinion about based on their own hospital experiences. I think the main thing that ADN nurses can take away from this story is to be cautious, be aware and always double check your work.

To read the complete articles mentioned in this post, please visit:
http://www.businessweek.com/ap/financialnews/D9Q1H1O00.htm
and
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2011/09/26/BAMQ1L9MBU.DTL

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Nurses Stand Up to Congress

As most middle class Americans are sacrificing due to the current financial situation, many nurses are voicing their concerns to Congress to petition for change. Those with health care career training are doing their best, both in and out of the hospitals, to help those in need.

On PressTV.com., Mary Bottari writes that, “As President Obama gets ready for his big jobs speech Thursday, America’s nurses have a message for him. ‘Heal America, Tax Wall Street!’ the signs read as nurses rallied in front of 61 Congressional offices this week. The nurses are proposing a bold alternative to the ‘cut, cut, cut’ rhetoric emanating from Washington, D.C.

“Their proposal? ‘It’s time for the Wall Street financiers who created this crisis and continue to hold much of the nation’s wealth to start contributing to rebuild this country and for the American people to regain their future,’ explained Rosanne DeMoro the Executive Director of National Nurses Union (NNU) in a press release. The nurses are joining groups across the nation and around the world who are calling for a financial transaction fee on high-volume, high-speed Wall Street trades, to tamp down dangerous speculation and to raise revenue for heath care, jobs and other critical needs.”

The issue that is being highlighted is that “the gap between what workers are paid and what their CEOs are paid is rising fast. In 2009, it was 263-to-1. In 2010, it was 325-to-1… at 25 of these firms, CEO compensation was greater than the company’s entire federal corporate income tax bill. Prudential CEO John Strangfeld made $16.2 million in 2010, but his entire company got a $722 million refund from the federal government. Bank of New York Mellon CEO Robert Kelly took home $19.4 million in 2010. The bank, the same year, claimed a $670 million federal tax refund, despite $2.4 billion in U.S. pre-tax income,” explains Bottari.

I’m not sure where I stand on this issue. I’m certainly not in the Robin Hood camp wanting to steal from the rich to give to the poor. As a history major, I also know that we live in a capitalist society and that socialism does not work. I think that we are definitely at a crossroads in our country. Students in a nursing program in the San Francisco Bay Area have a lot of choices to make – in the hospital and in the poll booths.

To read the complete article mentioned in this post, please visit:
http://presstv.com/usdetail/197557.html

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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.

To read the complete article mentioned in this post, please visit
http://www.dailymail.co.uk/news/article-2030929/Do-Not-Disturb-Fury-nurses-uniforms-ban-patients-trying-speak-them.html