I grew up in
Kansas City, on both the Kansas and Missouri sides of the state line and smack
dab in the middle of Tornado Alley.
One of my
earliest memories is of my dad, my three older brothers and me scrambling to
get out of our station wagon and getting down into a ditch along the side of a
highway to try and protect us from a twister roaring by only a few hundred
We all survived
virtually unscathed, but to this day I can still hear the classic freight train
noise of the intense wind and still feel the heaviness in my four-year-old legs
from the atmospheric pressure dropping so quickly and dramatically around us.
Soon after, the
sirens were approaching as what I would later understand to be emergency medical service personnel and other responders descended upon the scene, including the fire chief, who just happened
to be a lifelong friend of my dad. I'm sure I really didn't know who he was or what he did at that age, but I remember thinking we were going to be OK once I saw him, if only because my dad and brothers seemed less shaken.
And so I
find my heart especially heavy as I, like so many of you, watched helplessly the scenes of devastation unfold in the aftermath of the tornado that tore
through Moore, Okla. on Monday. I also can
relate to, though certainly not to the same degree, the sense of
relief and the feeling that things will be OK some victims no doubt felt when EMS personnel arrived on the
then, maybe, that this week is National EMS Week. It is a time when we should
all stop and think about how incredibly fortunate we all are that so many of our
fellow citizens are willing to put everything in their own lives on hold in
order to help others in their most desperate hours.
But perhaps a statement
on National EMS Week released Monday by HHS Assistant Secretary for Preparedness and
Response, Nicole Lurie, MD, says it
our nation honors emergency medical service (EMS) professionals for their
dedication to public service. As the HHS assistant secretary for preparedness
and response, I know how important their role is in disasters. As a primary
care physician, I know how important their work is every day. People rely on
EMS in disasters and other public health emergencies, as well as for personal
that our healthcare system must be ready at a moment’s notice to respond to
threats to the public’s health. Time and time again, disaster after disaster,
EMS responders across the country have risen to that challenge, whether the
community is impacted by a hurricane, wildfire, flood, bombing, chemical plant
explosion, or pandemic flu.
disasters, we have witnessed EMS responders providing triage on the scene in
Boston after the bombing, helping evacuate nursing homes in New York State
after Hurricane Sandy, and caring for injured or ill patients as they were
transported to hospitals in Texas after a plant explosion.
"Dozens of EMS
responders give their lives every year in the service to our communities and
our nation. Those who remain continue to take pride in being the people we can
depend on even in difficult and dangerous situations.
better prepared, the nation is moving increasingly toward building coalitions
bringing together EMS providers, public health agencies, hospitals, nursing
homes, dialysis centers, health care providers, home health agencies, emergency
management agencies, and local businesses.
"EMS is a critical partner in our
healthcare system, so I encourage EMS professionals to take an active role in
helping communities forge and strengthen these partnerships. Given the regular
interaction EMS responders have with these organizations in the community, EMS
is uniquely positioned to bring potential partners together to plan for and
minimize the impact that disasters have on health.
response and recovery requires a whole community working together. It’s one
mission, one team. EMS is a crucial part of that team, there when every minute
A new set of consensus guidelines produced by The Hastings Center can help healthcare professionals improve care near the end of life. The guidelines clarify what is ethically and legally permissible in the U.S. regarding the use life-sustaining technologies, provide in-depth guidance on talking with patients and surrogates, and offer recommendations about how to improve the delivery of care.
The Hastings Center Guidelines for Decisions on Life-Sustaining Treatment and Care Near the End of Life expands the Center's ethics guidelines first published in 1987.
"As the population ages, more people are living with chronic diseases. Advances in medicine have created both benefits and burdens, including problems of quality, safety, access, and cost. We need to help patients and families better navigate their choices, and physicians and health care leaders must build systems of care that are wiser and more compassionate. Guidelines helps meet these challenges," said Mildred Z. Solomon, president of The Hastings Center.
The book gives guidance on a range of topics, including advance care planning and advance directives, determining decision-making capacity, and all aspects of surrogate decision-making for adults and children. It outlines strategies to help patients, families and professionals work together to resolve conflicts. It explains the cultural, psychological, and social factors, including religion and spirituality, that may shape people's values or influence how they make medical decisions, insights that can help health care professionals provide the most appropriate and respectful care.
The new edition of the Guidelines acknowledges cost as an ethical concern in healthcare. "The ethical goal of treating all patients equitably requires healthcare institutions to grapple with the moral as well as the fiscal dimensions of resource allocation and healthcare cost," the authors write. "Professionals need opportunities to discuss these difficult issues in an open and factually well-informed way." The book includes a guide for hospitals and other institutions, with six strategies to encourage productive discussions that can support the development and use of a transparent policy.
After decades of lingering in the shadows of legal society, cannabis is experiencing an eruption in public support. A Pew Research Center poll released in April shows a 52% majority of Americans now favor legalization of marijuana, with 45% opposed. Support for legalization is up 11% since 2010, according to Pew. It's a stunning turn in public opinion from 1991, when only 17% said it should be legal, with 78% opposed.
Medical marijuana is perhaps the largest driver in this shift. Since 1998, 18 states and the District of Columbia have enacted laws permitting possession of marijuana for medical purposes. In a survey commissioned by Fox News released May 1, although a slim majority within the poll's margin of error opposes legalization, backing for medical marijuana is another matter. More than eight in 10 respondents think adults should be allowed to use marijuana for medical purposes if a physician prescribes it.
Views on the subject fall along age and political lines in the Fox poll. Sixty-two percent of those under age 35 advocate legalization, while 63% ages 65 and older are opposed. Sixty-two percent who identify as liberals favor legalization; 62% of conservatives oppose.
Research regarding marijuana's medicinal benefits is ongoing, such as at the University of California's Center for Medicinal Cannabis Research. Meanwhile, across all demographics, about half of the Fox News survey's participants believe most people who smoke medical marijuana just want to smoke marijuana and don't truly need it for medical purposes. An official with the Washington State Liquor Control Board reportedly testified in March he believed more than 90% of medical marijuana purchased in the state was for recreational use.
Is medical marijuana a backdoor legalization scheme? It seems to serve as such for many judging by the more than 26 million websites generated by the search engine query "what to tell doctor to get marijuana."
Not so fast say University of Florida addiction medicine specialists Scott Teitelbaum, MD, and Michael Nias, JD, LCSW, who are not on board with the rush toward relaxed attitudes about marijuana. In their new book, Weed: Family Guide to Marijuana Myths and Facts, they question the perceived safety of marijuana, noting today's strains are up to seven times higher in the concentration of tetrahydrocannabinol, or THC, which is what makes users feel "high."
"This isn't your father's marijuana," said Teitelbaum, medical director of the UF & Shands Florida Recovery Center and associate professor of psychiatry in the UF College of Medicine. "The higher THC concentration is associated with more psychiatric problems and more dependence."
Noting studies showing approximately 15% of eighth-grade students have already been exposed to marijuana, Teitelbaum said marijuana can be particularly risky for adolescents.
"Introducing drugs with neurotoxic effects during this time, while the brain is still developing, can be very damaging," he said. "It's similar to a pregnant woman drinking alcohol."
We live in times of fast-changing social standards. Despite warnings from people like Teitelbaum and Nias, it sure looks like marijuana is among the next taboos set to fall. It remains to be seen if that's a good thing.
By Diane M. Goodman, APRN, BC, MSN-C, CCRN, CNRN
In a world where Nurses' Week has become a big deal, with contests, gifts, and a celebration of all things "nursing," I would like to send a great big shout out to one of the hardest working and most valuable group of players in the healthcare profession, our unlicensed assistive personnel!
Whether we call them PCTs, UAPs or any of the alphabet soup they have been labeled, let us not forget they are the ones who spend the most time at the bedside of those who require care. Whether it is the countless bed baths, or bathroom trips, or a portion of hourly rounding, they are representatives of what "nursing" is all about ... nurturing and providing a compassionate face to represent our team. We could not (and should not) believe we could survive as nurses without them.
Throughout my career, I have never met a more enthusiastic group of learners. They soak up knowledge like a sponge, anxious to identify "what else" they can do at the bedside. When I taught them to be partners in pain management, they were thrilled to know that repositioning, ice, heat, distraction and soothing conversation could assist in decreasing the patient's perception of pain. Previously, they thought informing the nurse was the most they could do to help the patient in distress. They became much less interested in the basket of treats I carried for classes than the material that was being presented. They could aid in avoiding pneumonia by providing oral care? The use of mouth swabs, toothbrushes and clean dentures began to climb.
I hope to never lose my respect and admiration for this division of the nursing team. They can make or break us at the bedside, as they are usually the first and last team members to see the patient. In an industry where many of them seek to advance their skills via a clinical ladder, or by pursuing a nursing degree, let's salute them and provide an enormous thank you during Nurses' Week, when their status may seem somewhat diminished by all the celebratory festivities.
Hurray to our unlicensed assistive personnel ... 1,505,300 strong and growing*!
*(United States Census Bureau Workforce Statistics, 2012).
Finally, someone is speaking the truth about nursing jobs. While there are plenty of open positions for experienced nurses, the opportunities for those just entering the field and for LPNs/LVNs has been tough for years. We've been saying that all along and trying to lend assistance to new nurse grads whenever we can.
Last week, the Wall Street Journal broke the news to its readers, who like most of America were repeatedly told there is a nursing shortage. We've never argued the predicted number of nurses that will be needed in the future, but we've also talked about the lack of opportunity for new nurses today.
WSJ reported Burning Glass, a Boston-based company that analyzes workforce trends, looked at online postings for nursing jobs. The study found the market for LPNs/LVNs in hospitals has been greatly reduced (ADVANCE covered this topic a year ago). Burning Glass' chief executive Matt Sigelman noted, "There are still jobs for LPNs, especially in the middle of the country, but the postings are mostly in nursing homes, doctor's offices and long-term care facilities."
For RNs, opportunities exist in certain areas and with experience. From Burning Glass: "Demand is booming for nurses with advanced degrees or specializations. Postings for critical care nurses are up 27% since 2010 ... and openings for intensive care nurses are up 17%." But many positions are for experienced nurses. RN job postings requiring hospital experience have risen 55% since 2010. "That means it's getting harder to find a hospital job, and harder to advance without one," Sigelman said.
Now we just need to convince hospitals they need to plan for the future by hiring new nursing grads now so there is a skilled, experienced workforce when the need is real.
Whether you are a new nurse or a seasoned professional you know just how hard it can be to land that first nursing job, and today's recent graduates face an especially competitive job market. New grads should always be on the lookout for the right tools to help them stand out. A great way to start your job search is with ADVANCE's 2013 New Nurse Grad Digital Edition, which offers a variety of resources all in one place.
Browse the issue to learn about others' experiences finding their first position and get some advice from Joseph Potts, president of the National Student Nurses Association, on how to make the most of your burgeoning career. Other articles discuss the value of higher education, how to use social networking to land a job, tips to help you prepare for the NCLEX, and much more.
Before you can accept that dream job offer, you need to get the interview, which starts with perfecting your resume. Our interactive resume tutorial is just what students and new grads need to get the ball rolling. And once you get the much anticipated call for a face to face, our "Interviewing How-To" video will help you present yourself as the right nurse for the job!
Be sure to take advantage of all of the resources our digital edition has to offer and don't forget to share this information with other recent grads. Keep visiting our Student & New Grad Center for the most up to date information to help you on your job search.
Emylou Tiukinhoy, MA, RN-BC,CCM, is a Nurse Case Manager, Memorial Sloan Kettering Cancer Center, and a Board Member of CMSA-NYC chapter.
As hospitals gear up to celebrate Nurses' Week, I would like to give a shout out to my fellow Nurse Case Managers. These Case Managers are often overlooked during the Nurses' Week celebration, as in most hospitals, Nurse Case Managers are not under the Department of Nursing.
Nurse Case Managers play a vital role within the fabric of hospital administration. Case Management affects patient outcomes as well as financial outcomes for hospitals. We are embedded in almost every department. We are the "gatekeepers" in the Emergency Department ensuring appropriateness of hospital admissions and often preventing readmissions. We ensure appropriate utilization of resources; identify avoidable delays; we advocate and coordinate with the interdisciplinary team to ensure an effective transition of care. We interact with virtually every department in the hospital. In some hospital clinics, Nurse Case Managers continue the interventions and necessary referrals in the continuum of care.
We are valued for our understanding of healthcare delivery and our ability to integrate quality, efficiency and resource management in the delivery of patient care. Our clinical expertise allows us to be effective in the complex discharge planning process, utilizing astute assessment skills, communication and collaboration with the healthcare team, patients and payers. We focus on patient safety, as we coordinate and support transitions across the healthcare continuum.
Case Managers have a pivotal role in facilitating a seamless coordination of care with the medical team so when patients are medically ready, their transitions can occur in a timely manner.
Congratulations to all the Nurse Case Managers. You are the best in what you do!
Several Boston-area hospitals were in a “lockdown” condition Friday as
federal, state and local law enforcement officials asked residents and
businesses to curtail activities as investigation of Monday’s bombings at the
Boston Marathon continued.
Massachusetts General Hospital, Boston Children's Hospital and Boston
Medical Center all announced lockdown conditions on their websites, while the Boston
Globe reported Brigham and Women’s Hospital was in lockdown.
“Locked down means patient appointments today are cancelled and
inpatients will not be discharged from the hospital until further notice,”
according to a post on the Boston
Children’s Hospital website. “Boston Children’s has begun notifying
patients with scheduled appointments. The hospital is fully staffed and care
for patients at Longwood remains uninterrupted and emergent care remains open.
The designation is an effort to help keep the roads clear as requested by Federal,
State and City authorities. Boston Children’s Waltham is closed. … Boston
Children’s Martha Eliot Health Center in Jamaica Plain is also closed.”
“Patient appointments today are cancelled and inpatients will not be
discharged from the hospital until further notice,” according to a statement on
the Boston Medical Center website. “… The
hospital is fully staffed and inpatient care remains uninterrupted. The
emergency department remains staffed and open. The designation is an effort to
help keep the roads clear as requested by federal, state and city authorities.”
“We are continuing to monitor the ongoing situation in Boston and the
surrounding area,” says a 1 p.m. statement on the Mass General website. “The
directive from state officials to shelter in place remains in effect in the
city of Boston (especially Allston and Brighton), Watertown, Newton, Waltham,
Belmont, Cambridge, Brookline. Please remember, there are no specific threats
to the MGH.”
Angie Teoli, RN, teaches the CNA/GNA certification course 11th and 12th grade students at a School of Technology in Maryland.
Having one cousin with a liver transplant and another who died from liver cancer while on the liver transplant wait list concerned me for my own liver's health.
I have had mildly elevated liver enzymes for years. The elevation was discovered when testing my enzymes when I began using cholesterol lowering statins. I also had a follow-up ultrasound which showed fatty liver.
When I questioned my doctors their answer was, "Don't be concerned just watch your diet," as my liver enzymes continued to increase.
While I was helping my cousin and his family get through a terrible and excruciating death from liver failure, I stopped taking the statins. When I returned to my physician to have my cholesterol and liver enzymes checked, he suggested I follow-up with a GI doctor about my mildly elevated liver enzymes and that would determine if I could continue taking statins to lower my heart attack risk (my mother had a heart attack and stents).
We were all shocked to find out my ferritin level was 455 ng/ML and my iron saturation was 51%. Blood tests also revealed I have the HFE gene, which confirmed the diagnosis of heredity hemochromatosis. My results from the HFE test showed compound heterozygous for the C282Y and H63D mutations.
These results meant I inherited one mutation from my mother and one on a different marker from my father.
As an RN with all of my training I was shocked and surprised to find out about this diagnosis. Most of my family members are anemic. I was referred to a hematologist to begin phlebotomy treatments. My hematologist was able to reduce my ferritin level to 21 ng/ML after five treatments. He also encouraged me to have my children tested and to let other family members know of the diagnosis so they can decide whether to be tested as well.
My son was diagnosed with the mutation of C282Y/H63D and is anemic. His sibling will get tested soon.
My hematologist's nurse, who also administered phlebotomy treatments, was so kind and understanding. When one of my pre-treatment labs showed an increase in the ferritin level instead of a decrease she set me up with a nutritionist who gave me helpful diet hints such as drinking teas and coffee with meals that contain iron (tannins in black, Oolong and green teas and coffee inhibit iron absorption) and eating chicken and fish instead of red meats. I also researched on my own on what vitamins to take with no iron and to take calcium to inhibit iron absorption. You can also drink low fat milk with meals and eat an egg a day, which helps during bloodletting (eggs contain a compound that impairs absorption of iron).
I found myself afraid to eat anything due to my overzealous fears after reading labels and learning that everything is fortified with iron. I eat more yogurt and fruits, except those containing vitamin C, which aids in iron absorption.
I feel positive about my health now and know education and early detection are key. My hope is that everyone will encourage their doctors to order a ferritin test and iron saturation test on their next Labs. My iron level on my CBC was and is within normal limits; you need to have the ferritin levels tested. You could not only being saving your life but future generations.
By Diane M. Goodman, APRN, BC, MSN-C, CCRN, CNRN
Your patient is about to leave the inpatient facility for home, where they will need to manage approximately 3.4 chronic diseases (if they are a typical senior ≥ the age of 65, according to the CDC, U.S. Health Statistics). How do we assure patient readiness in our rush to find a wheelchair, a transporter and the lengthy list of medications they have been prescribed? This is easy. We don't. Planning for patient discharge must be accomplished from the point of entry, and reinforced with every "teachable" moment providing care.
Healthcare transitions have become a hot topic, and one we will be hearing much more about in the future. We cannot expect patients with chronic disease to grasp "disease management" on their way out the door, nor would we realistically expect them to remember medication side effects and pain plans that hadn't been explained throughout their stay.
As mentioned in previous blogs, I have a chronic neuromuscular disorder that intermittently demands my undivided attention. My husband understands the gravity of discussing financial issues when my neurons are saturated. I could swear he insisted I spend unlimited funds in Sephora over the weekend, simply because my brain had stopped processing information. This is similar to how our patients feel when they've seen the sixth specialist on a day crammed with diagnostic testing and no food.
Transitional care is preparing the patient for another "level" of caregiving, and if that means going home with minimal support, we need to prepare them early and often for potential consequences. We need to ask what they know about their condition. We must also identify gaps in their knowledge base. Additionally, patients should be provided with as many resources as possible to contact once they leave the hospital.
Providing patients with a follow-up physician appointment does not assure they will go, even if they comprehend the necessity. Frankly, when I am discharged from the hospital, the last person I want to see is another physician or phlebotomist. I much prefer a hot date with the couch, my favorite TV programs, and a few snacks that don't arrive lukewarm on a tray (pass the salt, anyone?). But the patient can and will pick up the phone if they feel uneasy regarding post-discharge care. In order to maximize transitional care, we need to spend time thinking like a patient, and walking in their shoes. As soon as we remove those shoes on admission, that is the ideal time to think "discharge."
In today's competitive employment market, anyone looking for a job knows timing is everything. ADVANCE's all-new job board at http://www.advancehealthcarejobs.com/ allows you to apply to any job in seconds, then track the status of your application.
You can search by job title, employer or location. Just checking in? Do a quick search. When you want to dig deeper, an advanced search lets you set parameters to find your perfect job. After you see the search results, you can expand job postings to preview opportunities at a glance and sort results with an interactive navigation bar. You can also set notifications to be alerted when new jobs are available.
Even if you are not actively looking for a job, it helps to have your résumé circulated so when that perfect position becomes available, your résumé is found. You are able to see how many employers have viewed your profile.
ADVANCE can help you create a professional document that represents the skills you bring to a new employer. Use the free Resume Builder to create the perfect résumé. You can choose from three easy methods: step by step, copy and paste, or upload. One of the tricks of being noticed by potential employers is to target your résumé to meet their needs. With Résumé Builder, you can manage up to five résumés in the system. You can also create cover letters right on the job board and manage five different versions.
Building a career in healthcare is more than filling out applications. You are a committed, well-educated professional dedicated to your industry. So the site also offers comprehensive salary statistics, articles that give helpful career advice and even a healthcare career blog.
ADVANCE is committed to helping nurses and all healthcare workers find the best jobs. We invite you to take advantage of this valuable new tool that can help transform your career.Check out the all-new http://www.advancehealthcarejobs.com/. You can sign in with your Facebook or LinkedIn account.
National Healthcare Decisions Day (NHHD) is April 16, 2013, and is recognized by more than 370 state and community organization and 75 national organizations.
NHHD is an initiative to encourage everyone to express their wishes regarding healthcare through conversations and the completion of advance medical directives. NHDD.org works with providers and facilities to ensure that wishes are respected, whatever they may be.
The website offers resources for organizations or groups that want to participate in NHHD; and it provides education to the public on issues such as advance directives.
The site has definitions to help families understand the issues, gives resources for legal assistance and provides a list of places to find advance directive documents.
If you are in a position to talk with a family about end-of-life issues, particularly advance directives, this organization may be a valuable resource.
By Diane M. Goodman, APRN, BC, CCRN, CNRN
I was born knowing I would become a nurse. Perhaps I knew my destiny in utero as well. My mother, who was vehemently "expecting" a boy, had selected the name David, and declined the need for selecting female counterparts. She was a bit surprised when I arrived; consequently she named me after one of her nurses. It was determined then and there I would become "Diane Marie" (alas, not David). My name, and future destiny, had been determined.
After more than three decades in the nursing profession, my passion and drive for caregiving has not waned. However, as recent posts have indicated, the field of nursing is changing rapidly. ADNs are having difficulty getting hired, and the workforce we have is older, more stressed, and fatigued. Hospital inpatients have higher acuity, and they are leaving the hospital as quickly as they enter, often to return as re-admissions. Additionally, the Institute of Medicine report on bedside care predicts that within the next decade, we could be looking at a nursing workforce where 50% of nurses are new to the profession.
Mentoring (defined by Webster's dictionary as being "a trusted counselor or guide") will become more important than ever. Throughout my career, I have learned what mentoring is and is not. Mentoring isn't doing, nor is it letting a colleague struggle. It requires patience and finesse, especially in times of extreme transparency with consumers of healthcare. No patient wants to be the first to have an IV started by a novice, yet new nurses need to learn. My favorite phrase "oh, I can't tell you how many times they've started an IV" is not an out and out lie, but it certainly improves comfort at the bedside, both with the novice nurse and the patient!
Mentoring is easing someone into an environment where lives depend on critical thinking. It is hammering on the message that managers/administrators need to be able to sleep at night and not worry about care. It means demonstrating that decisions are made utilizing appropriate channels; looking up policies and procedures, reading about unfamiliar medications prior to dispensing them, and assessing patients for subtle changes that could mean trouble is brewing.
Occasionally, mentoring is standing back and letting a new nurse work through a challenging situation, or allowing them to vent or show tears. It may be giving them the guidance and freedom to lock themselves in the bathroom for a few minutes as stress builds, or to visit the chapel when they can't take another minute of a profession that doesn't care about regular bathroom or nutrition breaks.Is mentoring worth it? Definitely. Without an effective means of passing the baton, nursing may be in trouble. Those of us who were born to be nurses, who have lived, breathed and driven our families crazy by working holidays, nights and weekends year after year, are about to retire. Before that happens, we need to prepare the next generation for what's to come. It's not pretty, it's more than a little frightening, and it's almost here. Let's be ready.
The recently passed Assembly Bill 2348, also known as the "Timely Access to Birth Control" bill, allows California nurses to provide hormonal birth control "without a pelvic or comprehensive physical exam, and without direct physician supervision," reported The Huffington Post.
Under the new law, RNs can "dispense drugs and devices upon an order by a certified nurse-midwife, a nurse practitioner, or a physician assistant while functioning within specified clinic settings," according to a press release from the office of Gov. Edmund G. Brown Jr.
Sponsored by Assemblywoman Holly Mitchell, D-Los Angeles, the bill is intended to improve access to birth control for women, especially those living in rural areas, stated The Huffington Post.
Planned Parenthood Affiliates of California and the California Family Health Council supported the bill, among others. But not everyone approves of the new measure, including the California Nurses Association (CNA) and the California Association of Nurse Practitioners.
The CNA had a number of concerns including the fact that this bill changes the RNs scope of practice, but "does not meet any of the recommended criteria for this scope of practice change," as noted in a July 2, 2012 hearing document,
According to The Huffington Post, "the CNA would have supported the bill if the wording had included a requirement that women get a full physical exam from a physician or advanced care nurse before getting birth control."
What do you think? Will the new law do more harm than good? Or is it a step in the right direction?
There's no doubt nurses work long hours doing challenging work. And based on a recent survey, this scheduling is starting to take its toll on nurses, patients and the healthcare system. A new survey titled "Nurse Staffing Strategy," commissioned by Kronos Inc. and conducted by HealthLeaders Media, revealed nurse fatigue is pervasive in the healthcare industry and may negatively impact quality care delivery, patient and employee satisfaction and operational costs.
Sixty-nine percent of healthcare professionals surveyed said fatigue had caused them to feel concern over their ability to perform during work hours. Even more alarming, nearly 65% of participants reported they had almost made an error at work because of fatigue and more than 27% acknowledged they had actually made an error resulting from fatigue.
And a study in the January/February 2011 issue of Nursing Research even linked nurses' work schedules with patient mortality.
This is obviously a big problem. So, how can nurses and healthcare systems address this fatigue problem? Perhaps one thing that should be examined is the 12-hour shift. Shorter time doing demanding work could reduce the amount of nursing fatigue and all that might come with it.
The ANA has created a position statement for employers to consider when addressing the challenge of nursing fatigue.
As it's noted, "it is the position of the American Nurses Association that all employers of registered nurses should ensure sufficient system resources to provide the individual registered nurse in all roles and settings with:
"1. a work schedule that provides for adequate rest and recuperation between scheduled work; and
"2. sufficient compensation and appropriate staffing systems that foster a safe and healthful environment in which the registered nurse does not feel compelled to seek supplemental income through overtime, extra shifts, and other practices that contribute to worker fatigue."
As reimbursement from public and private sources increasingly hinges on quality of care, nurses' work environment should not continue to be overlooked as a key factor in patient outcomes.
How does your facility address nurse fatigue in the workplace?