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Could Post-Discharge Clinics Reduce Patient Readmissions?

Patient readmissions seems to be a hot topic in the medical world. (Ironically, this is the one business that doesn’t want customers to return quickly!) The numbers vary by hospital and region and the causes can range from patient self-care to what caused the patient to end up at the hospital in the first place. To solve this continuing problem, several hospitals are implementing post-discharge clinics to help patients successfully transition from hospital care to home. Could this be a new option of employment for students in a nursing college?

According to reporter Alicia Caramenico, “One-third of adults don’t see a physician within 30 days of discharge, according to study by the Center for Studying Health System Change. What’s more, about 8.2 percent of adult patients returned to the hospital after 30 days, while 32.9 percent came back within a year of discharge, according to a press release yesterday. The study points to a lack of follow-up care as a source of avoidable hospital readmissions.”

Health Care Finance News posted a study on readmissions and found that there was, “a substantial association between regional rates of rehospitalization and overall admission rates,” the researchers concluded. “Although most interventions designed to reduce readmissions thus far have focused on better disease management and the coordination of care, our results underscore the importance of policy efforts directed at reducing the general incentives to use hospital services.”

Due to high numbers of readmissions and patients not fully following their physician’s instructions, many hospitals are trying out post discharge clinics. Caramenico reports that advanced practice nurses run these clinics and clearly explain discharge instructions and medication usage.

“We do medication reconciliation, reassessments, and follow-ups with lab tests,” said Dr. Shay Martinez, medical director and hospitalist at Harborview Medical Center in Seattle. “We also try to assess who is more likely to be a no-show and who needs more help with scheduling follow-up appointments.”

“Harborview Medical Center’s post-discharge clinic limits patients to three visits, then shifts their care to a medical home. Boston’s Beth Israel Deaconess Medical Center gives patients a 40-minute post-discharge clinic visit or 30 minutes if they came from the hospital’s emergency room (ER) and need follow-up care,” explains Caramenico. Furthermore, these clinics identify patients who need additional help by looking at their electronic records and look into their social environment and non-medical issues that could prevent a full recovery.

The medical field is ever changing and the opportunities for nurses with an ADN degree are increasing.

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I’m Glad I Married a Nurse

My husband has been an LVN nurse for about 13 years and I can’t imagine him doing anything else outside of the medical profession. Not only are male nurses more sensitive and compassionate than the average guy, but his career choice has had some pretty good results. Here are the reasons I’m glad I married a nurse:

1) The uniform – Not only does my husband look hot in his scrubs, but they are so convenient. They don’t have to be dry cleaned, they never go out of style (because they’re pretty much never IN style), they don’t have to be ironed and they last a really long time. If my husband worked in an office we’d be spending a fortune on expensive suits, ties, dry cleaning and shiny shoes.

2) There’s always a place to work – For a while my husband and I were considering moving to be closer to (and farther away from some) family members. No matter where we chose to go in the state or country, we knew that there would always be a hospital, clinic, nursing home, or care facility in the area.

3) An opportunity for growth – As an LVN, Vince has a good platform to build on for professional growth. He can go as far as he wants or be content to stay in his current position. The opportunities are endless. (Currently he is pursuing an education to become a fire fighter. His LVN skills certainly give him the upper hand since most on duty calls are medical emergencies.)

4) Convenient scheduling – Currently Vince works the day shift at a detention facility. He leaves at 6:30 am and is home by 4:00 pm. I love that he comes home early and can spend time with our 2 year old daughter (which gives me time to make dinner and have a little break.) Granted, he does work every other weekend which is a bit of a bummer, but he comes home early enough that we can still go out evenings and have fun. He also works every other holiday, but who can argue over holiday pay?

5) He loves being a nurse – All jobs have their ups and downs, but overall my husband loves being a nurse. He loves caring for people, he works with other great nurses with vibrant personalities and it was what he was born to do.

Vocational nursing is a great way to join the medical field. There are so many opportunities and positive factors for choosing this career. I’m glad I married my LVN!

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Treating Patients with Chronic Conditions

Chronic conditions are a major issue that many patients are facing and the numbers seem to be on the rise. These ongoing ailments can be painful, frustrating and frightening. As a student in an LVN to RN school, what can you do to help ease the stress of these patients?

About 15 years ago I had a major car accident. I was sitting in the back middle seat of an old SUV that did not come equipped with a seatbelt. I was young and in college and stupidly thought “We’re only going a couple of miles away. What could happen?” Well, what happened was the driver turned to talk to those of us in the backseat and didn’t see the cars in front of us stop. We crashed into three cars at 35 miles per hour. I flew into the dashboard and scalped myself… yep, peeled it back like a too ripe peach (not to mention the impact to my spine, plus a minor concussion, and everything else that comes with head injuries…)

So what’s the point of my story? I completely understand where these chronic pain patients are coming from. As grateful as I am to be alive, each day I struggle to put my discomfort aside to take care of my family. According to contributor Megan M. Krischke, I’m not alone. Nearly half of all adults in the United States suffer from chronic conditions.

Dawn M. James, MSN, RN, CNS, CDE, deputy director of public health for Kit Carson County Health and Human Services (KCCHHS) in Burlington, Colorado advises “The most important thing for any nurse to understand is that prevention strategies are much more powerful than trying to treat an existing disease. The more savvy and knowledgeable a nurse is about disease risk factors and prevention, the more he or she has to offer their community.”

There are also different nurse led programs to help patients and their caregivers deal with their health difficulties. James leads one such program that is “a peer- or nurse-led, six-week course that uses a research-based model to teach people how to self-manage their chronic conditions so that they do not get worse and can even improve their health.” James states “The program teaches people to do good self-management through diet, exercise, medication administration and knowing how to talk to health care providers.”

Chronic conditions are certainly a challenge that no one wants to face. However, caring and competent nurses and doctors are worth their weight in gold. Students in an RN college have my appreciation; as a patient, you make a huge difference!

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Nursing Grads Are Getting Hired!

When I graduated from college, I had mixed feelings: elation that I could finally pursue what I loved and fear that countless interviews and rejections awaited me. It’s nerve wracking to send out resumes, journey on job interviews, and then wait to hear whether or not you got the position. In this tough economy, many college grads are having a tough time finding a job. Fortunately, those graduating from a nursing program are not among the unemployed.

Johns Hopkins University School of Nursing just put out a new report on stating that nursing grads are extremely successful in the job hunt. Their study was based on findings from the American Association of Colleges of Nursing. “A recent survey of nursing schools conducted by the American Association of Colleges of Nursing (AACN) tells a story of success for recent graduates. Among those receiving a nursing bachelor’s degree, 88% have received job offers within four to six months; for those earning a master’s, 92%.

“At the Johns Hopkins University School of Nursing (JHUSON), informal surveys and questionnaires conducted among the 2010 Hopkins graduates show a similar percentage with 89% of responding graduates from all classes (Bachelor’s, Master’s, PhD, and Doctor of Nursing Practice) indicating they have found employment since graduation. Of the 11% not currently employed, nearly 10% indicated they were pursuing an advanced degree and were continuing their nursing studies full time… The JHUSON online survey also showed that nearly two-thirds of the employed respondents found nursing positions within 90-days following graduation; an additional 24% within six months; and only a small number, 8%, indicated their search took longer.”

Currently our nation has a 9.1 unemployment rate and according to a USA Today article, the average college grad is facing five candidates for every one job opening. Fortunately, nursing school graduates are not among these statistics!

The JHUSON report further reports that “Among Hopkins grads, only 11% reported the job search to be very difficult, while others (19%) reported no difficulty at all. The highest percentage of respondents (71%) described their job search as slightly to moderately difficult. The majority of survey respondents (58%) also found their first choice in a position and 66% in their preferred geographic location. Ninety-one percent were employed by hospitals.”

With the number of patients increasing and a variety of job openings becoming available, it seems like now is a great time to graduate from a nursing college!

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