Japan’s Misao Okawa turns 116 years old today, making her the world’s oldest living person. [http://tinyurl.com/ljhatk8]
Among Okawa’s tips for a long life include eating sushi at least once a
month and most importantly getting plenty of sleep. “You have to learn to relax”
and nap as needed, she says.
It’s not only sage advice, but also the kind that is never too early to
On March 3, the National Sleep Foundation released the results of the
2014 Sleep in America poll. This year’s poll “took a deeper look into the sleep practices
and beliefs of the modern family with school-aged children,”
according to the NSF.
An annual study that began in 1991, this year's poll finds children sleep better
when parents establish rules, limit technology and set a good example.
Based on the results from the 2014 poll, NSF recommends trying these 10 tips to improve your child's sleep:
1. Make sleep a healthy priority in your
family’s busy schedule.
2. Set appropriate and consistent bedtimes for
yourself and your children and stick to them.
3. Know how your child is using electronics in the
bedroom. Create a plan for appropriate use at night and set boundaries about
use before and after bedtime.
4. Educate yourself and your child on how light
from electronic device screens can interfere with sleep.
5. Talk to your child about the importance of sleep for
health and well-being.
6. Talk to your child’s teacher(s) about your
child’s alertness during the day. Let your child’s teacher(s) know you
want to be made aware if your child is falling asleep in school.
7. Remember that you are a role model to your
child; set a good example.
8. Create a sleep-supportive bedroom and home
environment, dimming the lights prior to bedtime and controlling the
temperature (in most cases, temperatures above 75° F and below 54° F will
9. Try to encourage activities such as reading or
listening to music before bedtime instead of watching TV, playing video games
or surfing the web.
10. Make sure children’s activities, including
homework, can be completed without interfering with bedtimes.
For more on the benefits of sleep, don’t miss the ADVANCE article “Sufficient Slumber” in the Lifestyle for Nurses
section of our online edition. [http://tinyurl.com/9kgw3nu] The article by staff writer Rebecca Mayer
Knutsen looks closely at home sleep tests and asks whether they provide a less
expensive and more convenient alternative for diagnosing sleep apnea. An involuntary cessation of breathing that occurs while the patient is
asleep, sleep apnea affects more than 18 million Americans. Risk factors of
sleep apnea include being male, overweight and over the age of 40, but the
condition is known to affect any age.
“People who are constantly tired in the daytime or having difficulty
concentrating after getting a full night of sleep should make an appointment
with a board certified sleep physician,” a doctor specializing in sleep tells ADVANCE. "If you present with any
of the known symptoms and have a body mass index (BMI) over 30, a neck larger
than 18 inches around, or high blood pressure, you may be a great candidate for
taking a home sleep test." The at-home sleep apnea test, just like a full sleep study, must be prescribed,
notes the physician.
What do you prescribe for a good night’s sleep?
After extensive debate and controversy, Belgium lawmakers made history with the recent decision to remove age restrictions on euthanasia.
"Under the amendments to the country's 2002 euthanasia law, a child of any age can be helped to die, but only under strict conditions," according to TIME. "He or she must be terminally ill, close to death, and deemed to be suffering beyond any medical help. The child must be able to request euthanasia themselves and demonstrate they fully understand their choice. The request will then be assessed by teams of doctors, psychologists and other care-givers before a final decision is made with approval of the parents."
Euthanasia and assisted-suicide is already a heated topic of discussion around the world, but Belgium's recent decision adds a new dimension to the debate.
When is a child old enough to understand death? And, how involved should they be in the medical decisions surrounding it?
A 2009 study, published in Pediatrics, found that "adolescent cancer survivors, like other adolescents, want to be involved in medical decision-making at the end of life."
However, not all adults agree. A Belgian nurse, who spoke to TIME, "argued that minors may not have the mental capacity or the vocabulary for requesting to die."
Before the issue of age can be resolved we have to come to a decision about euthanasia in general. For the U.S., assisted suicide is still, for the most part, illegal. Only four states - Oregon, Washington, Montana, and Vermont- allow it.
Where do you stand on assisted suicide? Do you support a terminally-ill child's right to decide when their life ends?
Elaine Keavney, is director of the nursing program at American Public University
The Institute of Medicine (IOM), working with the Robert Wood Johnson Foundation, released its landmark report, The Future of Nursing: Leading Change, Advancing Health in October 2010. With changes in the entire healthcare system anticipated as a result of healthcare reform, the IOM report said that nurses need to be prepared for changing and evolving roles in caring for patients and leading change.
The report contained eight clear recommendations for change:
- Remove scope of practice barriers
- Expand opportunities for nurses to lead and diffuse collaborative improvement efforts
- Implement nurse residency programs
- Increase the proportion of baccalaureate-prepared nurses to 80% by 2020
- Double the number of nurses with a doctorate by 2020
- Ensure that nurses engage in lifelong learning
- Prepare and enable nurses to lead change to advance health
- Build an infrastructure for the collection and analysis of healthcare workforce data
In the three years since the IOM report was released, exciting changes continue to take place throughout the country in support of these recommendations. There had been discussion of all of these topics at one time or another for years, but no previous work has had the impact of the IOM report. The clear messages in each of the eight recommendations have provided structure and specific goals.
As an example, there has been discussion of associate vs. baccalaureate education as a professional entry point almost since the first associate degree program was developed. But, a specific target number-80 percent of nurses with baccalaureate degrees by 2020-is achievable in most areas, and has completely eliminated the politically-charged conversations about whether nurses should be baccalaureate-prepared as they enter the profession.
The IOM also led to the formation of Action Coalitions in all 50 states. Each coalition is unique and is working within its own state nursing culture to evaluate needs and work toward the implementation of the IOM recommendations. Some are supported by grants from The Robert Wood Johnson Foundation.
A recent three-year review by the Robert Wood Johnson Foundation provides other examples of activities spurred by the IOM report:
- Seven states have removed major scope of practice barriers, primarily to advanced practice registered nurses (ARNP)
- The Federal Trade Commission has challenged limits to nursing scope of practice in a number of states
- The American Academy of Nursing has developed an initiative to advocate for the appointment of nurses to influential leadership positions
- Many states report work on dual enrollment in associate and baccalaureate degree nursing programs and other initiatives to enhance seamless academic progression
- Medicare is paying to support nursing education with a $200 million demonstration project in five hospital systems
There is much work that remains to be done. But, for the first time, there is significant momentum move nursing forward, to recognize its considerable contributions to the health of the nation, and to place nurses in positions to truly lead change and advance health. It is indeed an exciting time to be a nurse in 2014!
This post is written by Mbettie Worrell, BA, BSN, RN, a graduate
student in the Adult/Gerontology Nurse Practitioner program at the University
of Pennsylvania School of Nursing in Philadelphia.
Consider these scenarios:
A six-year-old girl is found dying from a disease that has had a vaccine
available for decades.
A young woman lay dying in childbirth while her husband watches
helplessly because they have no access to healthcare.
A 48-year-old mother who needs a kidney transplant, but she has no
insurance and thus not “eligible” for the transplant list.
These are a few health struggles faced by people around the world,
including the U.S., due to lack of access to healthcare.
The Affordable Care Act promises to insure an additional 36 million
people, and escalated this debate over access to healthcare, health disparities,
and citizens’ rights.
Proponents and opponents of this issue base their
arguments in economics, ethics, medicine and law.
Proponents believe that if all Americans had access to healthcare it would
decrease spending because individuals would seek preventative care instead of
waiting to become seriously ill. Proponents also argue that as citizens of the
richest democracy in the world we should have a right to affordable healthcare no
matter who you are.
Opponents, meanwhile, now view the term “entitled” with contempt and
define it as a reward for the undeserving. They argue increasing tax revenue on
some citizens to help provide healthcare to others is socialism. Others say healthcare
providers will be overstretched due to the high demand of individuals seeking
care and this could lead to burn outs or decreased quality of care rendered,
primarily through delays in appointments, surgeries, etc.
Growing up in a third world country, I have witnessed firsthand the consequences
of inaccessibility to healthcare.
I believe good health and access to care is a human right, no matter which
part of the world one may live.
All humans were created equal, though history and other social and
economic issues like wars, social determinants, and poor economies have created
a noticeable difference between individuals and among nations.
humans are entitled to the same rights under similar circumstances.
I do not necessarily believe this right means being in the best health
state. However, governments should be able to provide those conditions
necessary to facilitate the needs of its constituents when it comes to
The ability of a government to help its citizens gain access to
healthcare should not be viewed as “charity” or “socialism.”
As World Health Organization Director-General, Margaret Chan, states:
“The world needs a global health guardian, a custodian of values, a
protector and defender of health, including the right to health.”
Can we each be that person?
This post is by Robert Wright, president/CEO of Behavioral Education and Research Services Inc., Orlando, Fla.
Whether we call them clients, patients, or some other term; all who seek our services are people. As such they are subject to the laws of behavior. That non-compliance represents a threat to the future of patients and providers is demonstrated by the disastrous statistics related to direct costs, overuse of the system, unnecessary healthcare, and 125,000 needless deaths per year.
There are a number of patient counseling models developed over the years designed to improve patient understanding. These models have been time tested and on the surface are straightforward, consistent, and logical. In spite of their clear appeal to "common sense" they are also not terribly effective.
Patient compliance today is about the same as it was in the middle of the 20th century. For that matter it is about the same as when Hippocrates was in practice. As complex as our central nervous system is and as sophisticated as we are, when it comes to behavior we do the things that make us feel good and are positively reinforcing and we avoid the things that don't make us feel good and are punishing. That includes recovery from disease, prevention and wellness programs. People can be reinforced by their disease or punished by taking their medications. Side effects are punishing, cost is punishing, maintaining medication schedules can be punishing. People avoid punishment particularly when the benefits (improved health) are in the future and the punishers (side effects and cost) occur immediately.
Rules and beliefs have clouded our view of behavior for hundreds of years. The "reasonably prudent wo/man" standard, the use of common sense, and man as a logical creature represents the tip of the behavioral iceberg. Perhaps it is too much to expect that people, who are otherwise unsophisticated about their biophysiology and the complexities associated with the disease process, will stop to consider the effects of not following their plan of care.
Lawyers have determined that informed consent means that the patient has a clear understanding of the consequences of their behavior, both good and bad, and have made an "informed" decision of what needs to be done. Clearly with a 50% failure rate in following the doctor's orders something in the message got lost in the behavior.
The Health Belief Model says that man is rational and can weigh the outcomes of the physician's directions and will follow those directions depending upon their beliefs about the recommendation. This model proposes that the patient will, if s/he believes the physician that the problem is significant, the prescribed treatment is likely to help, and the patient is able to implement the plan of care (e.g., afford the medication, change lifestyle, give up bad habits, take up new habits, etc.).
The Transtheoretical Model of behavior describes men and women as traveling through life with little or no concern about wellness or illness (precontemplation) until there is a change in their wellness status (contemplation) the person understands there is an issue and then plans to do something about this change (preparation) sometime within the next month. This contemplation and preparation stage (Action) is transformed when the patient does something about the healthcare concern. After accepting the diagnosis the patient moves into the maintenance stage in which theoretically behavior changes to prevent relapses.
Learning Theory believes that complex healthcare issues can be broken down into smaller more digestible steps that can have an effect on patient behavior. While this may have some applicability, here is the reality of human behavior: rules and logic do not change behavior, consequences do.
Motivational Interviewing vs Cognitive Behavior Therapy vs Therapeutic Behavior Management: Are these programs variations on a common theme? The short answer is no. Our behavior based perspective sets aside the above theories and examines the consequences of patient behavior. Behavior is what a man [patient] does, not what he thinks and not what he believes.
The clinical goal for a nurse educator is summed up by this statement: We want to increase the number of preferred behaviors and decrease the number of unpreferred behaviors. If the patient is not compliant with the plan of care we need to know the function of their behavior. Our observations show that people fall into two basic categories of response: 1) behaviors they cannot do and 2) behaviors they don't want to do.
If they cannot perform a behavior we have a patient training concern. If they don't want to do the behavior we have a patient motivational concern. This is important from the nursing perspective in terms of messaging and how we shape our training program(s). Both perspectives are related to what happens to the patient when they actually do the things we ask them to do. If the response cost is negative you can count on the patient not doing as you have either trained or asked them to do.
Behavior is always a function of the consequence that immediately follows or occurs during the behavior that strengthens or weakens the likelihood that that behavior will occur again in the future.
With "quality" withholds now a part of the Affordable Care Act providers will be punished if their patients fail to improve. The provider's course of action requires change. Change the patient's behavior to improve compliance or discharge the patient to reduce risk to the practice. The science of behavior has clearly demonstrated that any behavior that is positively reinforced is more likely to occur again.
Our behavior based training program does not end when the patient leaves the hospital or clinic. Behavior change requires follow up or positive reinforcement even after the patient has demonstrated high levels of compliance. Any behavior that is not occasionally reinforced will go back to baseline. For 50% of the total patient population that baseline is non-compliance. The nurse educator training programs we have developed and put into place provide tools that can be used to identify high risk patients and develop a patient education plan of care to shape and reinforce the target behaviors.
The following was sent as a press release from Mercy Hospital Oklahoma City.
Lois Faye May remembers exactly where she was when she learned Dr. Martin Luther King, Jr., had been shot: working in an operating room at Mercy Hospital Oklahoma City – then Mercy General in midtown Oklahoma City.
“Someone heard it on the radio and came into the operating room to tell us. It was a really scary time because we weren’t sure what was going to happen,” said May, who was one of Mercy’s first African American nurses. “Everybody was more or less in shock. Because of what was happening in other places in the country, some of us were afraid to go to work.”
In shock, certainly, but May says she and her friends didn’t lose hope. She had already seen King’s impact and was a leader of change herself. Ten years prior to King’s death, May was in the first fully integrated class at Mercy Nursing School, from 1958 – 1961, at the height of the Civil Rights Movement.
“The year before us, there was one black student, but in our class there were seven of us,” said May. “Mercy was the only place around accepting African American nursing students at the time.”
Despite the 1954 Supreme Court ruling on Brown v. Board of Education of Topeka, Kan., which ruled segregation in public schools unconstitutional, many schools continued segregation or complete rejection of black students. It wasn’t until 1962 that James Meredith became the first black student to enroll at the University of Mississippi – a historical event which triggered violence and riots, prompting President Kennedy to deploy 5,000 federal troops to the university to restore peace.
Like Meredith, May and her fellow African American nurses faced adversity during their years at nursing school. But, just because their experiences didn’t make headlines doesn’t mean they didn’t make an impact.
“It was the way of the times. Your skills and integrity would be questioned simply because you’re black,” said May. “Before college, our high school teachers, parents, church and community leaders tried to prepare us for the hazards we would face. We had a lot of support, and Mercy had already come so far.”
May remembers leaning on her fellow black students, and being protected by her instructors and the Sisters of Mercy.
“The nuns and instructors had to stand up for us almost daily with patients and physicians who weren’t accustomed to working with black nurses,” said May. May also remembers one Sister of Mercy in particular who she describes as, “no nonsense.” Specifically, she remembers the Sister having zero tolerance for racial discrimination. “I remember Sister Mary Alvera. She was my supervisor in surgery. She was quiet and very caring – but she wouldn’t stand for any nonsense,” said May. “She expected people to change with the times, and she let them know it.”
In 1961 – seven years before King’s death – the seven black students graduated from Mercy Nursing School and went on to careers in nursing. May continued at Mercy General, where she became head nurse in thoracic surgery.
“One of the girls who started with me became a head nurse at Mercy,” said May. “That was unheard of in the 60s.”
There was a patient who didn’t want May to take care of her because of her skin color. She explained to the patient that she was the nurse in charge, but the patient still didn’t want May’s care.
“I asked my supervisor to find a white nurse to care for the patient,” said May. That didn't fly with her supervisor. Instead, May’s supervisor explained to the patient that May was the nurse in charge and there was no other choice. Finally, the patient agreed and May respectfully cared for the woman.
“The Sisters and our supervisors stood up for us. It was something we encountered quite a bit at that time, but we learned to handle it effectively and professionally,” said May. “It felt pretty good to have your supervisor stand up for you like that. And the really neat thing was noticing those incidents happening less and less as time went on.”
Without making headlines, May and her supervisors were quietly making progress. There was a new way of doing things at Mercy, and the community slowly came around because of the courage of people like May.
Lois Faye May stayed at Mercy until 1970, when she went on to St. Anthony’s to serve as nursing associate head of surgery. In 1974, May moved to OSU-OKC’s School of Nursing, where she helped shape future nurses as a professor and department associate head, until retiring in 1993. As a tribute to her service, there's a nursing scholarship in her name at OSU-OKC. May earned her nursing diploma from Mercy Nursing School, a bachelor’s in health education from Oklahoma City University, and a master’s in nursing from The University of Oklahoma. She stayed in touch with most of her fellow black nursing students, and sees them a few times a year.
In the wake of the massive data breach at retail giant Target, nurses likely
will find patients expressing concerns about identity theft and the safety
of their healthcare information.
The threat is real. According to the Federal Trade Commission (FTC), 5%
of identity theft victims report medical fraud.
In response, FTC in 2010
enacted the Red Flag Rule. Essentially, any doctor’s office, hospital or other healthcare
facility that regularly bills patients for the balance of fees not covered by
insurance and/or allows patients to set up payment plans is either a creditor
or a provider of a “covered account.” Hence,
healthcare providers must be aware of what Red Flags of identity theft to watch for, according to an article in Modern
Magazine by FTC attorney Steven Toporoff. They include:
Suspicious documents: Obvious
forgeries or alterations, such as a photo or physical description listed on an
ID card that does not look like the patient presenting it.
Suspicious activity: Mail sent
to a patient’s address is repeatedly returned as undeliverable, yet they continue to make
all their appointments. Or, a medical history provided by a patient that is inconsistent with other
Suspicious identifiers: A birth date or Social Security number given
by a patient that does not match what the insurer has on file.
In addition to the steps healthcare providers take to protect patients from
medical fraud by identity theft, there are several steps all individuals should
take to protect their personal information, says identity theft expert, Scott A.
Merritt. The insurance and realty executive became an expert on the subject after being arrested
for a felony committed by someone else whom had stolen his identity.
“You can greatly reduce being a victim of such recent hacks that
occurred at the major retailers by using cash more often,” he says. “But if
you’re going to use credit, use a card from a national bank or a national credit
union, and never [use] a debit card — no exceptions.”
Merritt, author of the new book “Identity Theft Dos and Don’ts” offers
seven ways to guard your information:
1. Understand how and where ID
theft happens. Most thefts occur in places where you do business every
day. A place of business is robbed, a bad employee acts improperly or a hacker
breaches the office through the computer.
2. Secure your wallet’s
information. Photocopy everything in your wallet: photos, credit cards
(front and back), membership cards – everything. Put the copies in the order
the cards are arranged in your wallet, staple the pictures and place them in a
strong box or safe.
3. Make sure your information is
consistent. For all of your identity and financial documents, make
absolutely sure, to the smallest detail, that all of your personal information
is accurate and consistent! Discrepancies such as using your middle initial on
some documents but not others, or having different addresses, can wreak havoc
in proving your identity and can even compromise your credit score.
4. Secure your digital habits and
data. Change your passwords at least twice a year on a non-scheduled
basis, i.e., don’t be predictable. Have a strong firewall if you shop online
and only access sites that are also protected by a strong firewall with high
industry standards. Access accounts of a financial nature only from your
5. Protect your banking information. While
in the bank, keep account numbers and other data out of sight, and avoid saying
account numbers, Social Security numbers or other information out loud. When
planning a bank visit, prepare deposits and withdrawal slips in advance.
6. Account for your interactions
with vendors. Every time you speak to someone with whom you do
business, write down the time, date, name and the purpose or outcome of the
call, including any animosity or reluctance from the vendor.
7. Don’t carry around your birth
certificate or Social Security card. Unless it’s necessary, keep those
vital items in a safe or at least a firebox. If you’ll need to provide a copy
of your tax returns or your driver’s license to anyone for any reason make the
copies ahead of time to avoid having your information inadvertently left
sitting on an office copier.
While all are important means of protecting your identity they’re certainly
not the only ways of doing so, of course. How about you? What steps do you take to prevent identity theft?
Richard Bezozo, M.D., is the president of MoleSafe
Now that winter is upon us and the snowflakes have begun to fall, we often think back to the summer months filled with countless hours of sunshine. While looking back on those hot summer days, if you can remember receiving one or more bad sunburns, you may be at risk for melanoma. Studies show that one blistering sunburn in childhood or adolescence more than double your chances of developing skin cancer later in life and repeated exposure to ultraviolet (UV) radiation is a major factor for most skin cancers, like melanoma, due to the damage it causes to your cells. This winter be proactive about your and your patient's skin health by monitoring for changes skin and enrolling in an early detection melanoma screening and surveillance program. Performing self-checks on your skin and scheduling regular exams can help find and treat melanoma and other skin cancers effectively. Here are some tips on how to monitor your skin this winter, and I encourage you to share these tips with your patients as well:
- Continue your sunscreen regimen through the winter. Although the winter sun is not warm, it is still very dangerous and can be harmful to our skin. UV rays are intense on both clear and cloudy winter days, making it essential to apply sunscreen with an SPF of at least 30, specifically to your face, hands, neck and scalp, at least 30 minutes before going outdoors. Due to the sun's reflections off the snow and conditions that occur at high altitudes, be sure to apply a sunscreen that blocks UVA and UVB radiation when you go skiing and snowboarding, to reduce your risk of sunburns and other long-term effects, including premature aging of the skin and even skin cancer.
- Check your own skin. You are the only person who sees your body every day, so be proactive in your skin health and start examining your body from head to toe and everywhere in between. Make sure you perform your self-check in a well-lit room in front of a full-length mirror. Also, keep a hand mirror handy to help look at areas that are hard to see, especially your back and scalp. Performing a skin self-exam each month is a small time investment in what could end up being a life-saving procedure. Follow these 5 steps in performing your self-check, provided by MoleMap: http://bit.ly/17fYj8G
- Learn your skin patterns. The first time you perform a self-check, spend time carefully examining the entire surface. Be sure to learn the pattern of moles, blemishes, freckles and other lesions on your skin, so you will better be able to notice any changes during your next exam. Take note of any new growths and bring them to your physician's attention at your next screening.
- Know your moles. Normal moles are typically an evenly colored brown, tan or black spot on the skin. Most people have moles, and most are harmless. However, a warning sign of melanoma is a mole that is changing in size, shape or color.
- Learn your ABCDEs. ABCDEs in melanoma detection represent asymmetry, border, color, diameter and evolving. Any changes in these characteristics can indicate an affected area and calls the need for immediate attention.
- Enroll in an early detection screening and surveillance program. By enrolling in an early detection screening program, you can have peace of mind that your skin will stay healthy. Early detection of melanoma cannot be overstated, because when melanoma is found and treated in the initial stages, your chance of long-term survival is very high. Early detection screening programs are an ongoing way to ensure that you taking the most cautious measures to protect the skin you're in.
Your skin is your body's largest organ, so make skin health a priority during all months of the year, including these cold, snowy, winter months. If you have any questions or would like to learn more about enrolling in an early detection screening and surveillance program, please visit http://www.molesafe.com/.
A recent editorial on the need for more kindness in healthcare (Want to Raise Patient Satisfaction Scores? Be Nice) prompted several responses. Here are two.
Be Nice Indeed
I have never written a letter to the editor before, but after reading your “Be Nice” letter in the latest Advance, I felt I had to speak up. I prefer to remain anonymous, please.
I have been a nurse for 37 years. In that time I have seen many things come and go and come back again. One thing that has NOT changed is that nursing comes from the heart. No matter how little or much education a nurse has, and how many or few letters he/she has permission to place behind the name, the single most important element in practice is kindness. I also know, however, that in order to give kindness and love, the nurses’ vessel must be full of love and kindness. Sadly, in today’s culture, nurses are empty or near empty vessels. Those of us who are still fighting the good fight doing patient (now client) care, are being treated brutally.
The older group of us are terrorized and run out of jobs, as we are too expensive and medically risky to be employed. No respect for the years of experience and gut knowledge that cannot be taught in the classroom. These positions are then replaced with new graduate nurses, for a fraction of the cost, and they are placed in now part time positions, with less company paid benefits, and more room to work extra hours without paying overtime. Meanwhile the new nurses are fighting to get these jobs and being mandated (for client safety) to stay double shifts and extra time. They are exhausted and frustrated and have NO company loyalty.
We are no longer respected as a knowledgeable professional doing a service, but now are ordered by clients to provide the service they request/demand. The days of thank you and gifts from clients are long gone.
At this time of year, it also reminds me of the holiday giftedness we once enjoyed from physicians, employers, drug companies, lab companies, formula companies, and patients. That is something today’s new nurses do not know. All they know is mandated additional time, complaints regardless how hard they try, and working holidays. The “holiday pay”, by the way, is also decreased to only a few hours on the actual day. The eves and off shifts no longer count to the employer, and too bad if it counts to you, because this is lock out time for vacation requests, so you may not take any time off. And don’t even think about complaining about any of this to your employer, you are told to be thankful you have a job. Make no mistake, we are!
So, to wrap this up, let me summarize my point. Absolutely a little kindness is what our clients want…and so do the nurses, so they have kindness to give back.
Be nice indeed.
When I read your editorial in the most recent edition of Advance for Nurses I know I just had to write.
Quick questions—have you ever worked as a nurse? Have you recently had a family member or friend as a patient in the hospital? I have and so have two of my co-workers.
Your editorial “Want to Raise Patient Satisfaction Scores? Be Nice.” The first sentence says it all—“Gourmet food, wireless access, waterfalls in the lobby.” Are you kidding me? How about ADEQUATE STAFFING?
In this day and age hospitals are more concerned with pretty private rooms, designer-like gowns, and gourmet food, rather than providing excellent patient care. Try spending money on hiring more staff. The nurses are over worked and spend their time dispensing meds and data entry. They are no longer at the bedside. The nurses’ aides are. So much for “critical thinking” skills!
Example, I arrived at my Mother’s bedside at 9 a.m. Her breakfast tray was across the room, totally untouched though the woman (I don’t know what she did-no ID) insisted that someone had tried to feed my Mom. I did not see a nurse until a woman walked into her room with a syringe at 2:15 pm. She didn’t identify herself and when questioned, she stated, “why, I’m Patricia, her nurse.” I had to ask what was in the syringe. Guess what – it was Lasix being given to my Mother 15 minutes before she was scheduled to be transferred to a rehab facility. Great timing, she can soil herself enroute! I had seen this same nurse several times during the day sitting at her computer in the hallway.
I have numerous other stories. One co-worker’s husband was left in the x-ray department for a couple of hours (one day post-op hip replacement) because there was no one to transport him back to his room. Did the nurse miss him? Nope!
The sad thing is that the emphasis is now on BSN as an entry requirement. However, no hospital wants to hire new graduate BSNs—they are ill prepared to actually perform nursing assessment and care. Otherwise why would they need to have internships? Hospitals are constantly asking for at least 2 years of experience. Again, so much for critical thinking skills if you can’t use them! The “powers that be” really need to find a happy medium between college based and hospital based nursing education. The real joke is the “fast track” 1 year courses for people who have a bachelor’s degree in another discipline. Sure I’d like them taking care of me.
Again, if patients want kindness, hospitals need to step up and provide adequate staffing. I challenge you to rise at 5:30 am, work a triple shift and be kind and cheerful at 7 am the next morning.
Just needed to get all of this off my chest.
The U.S. Department of Health and Human Services, CDC, state and local health departments, and other health agencies are currently observing National Influenza Vaccination Week (Dec. 8-14, 2013).
As of Nov. 15, 2013, approximately 126 million doses of 2013-14 seasonal influenza vaccine had been distributed to vaccination providers in the U.S., according to the CDC.
The Advisory Committee on Immunization Practices recommends influenza vaccination for all people 6 months and older. Influenza vaccination is especially important for those at higher risk for influenza-related complications, like children aged younger than 5 years, those with certain chronic health conditions (heart disease, asthma, and diabetes); pregnant women; and those 65 years and older.
The CDC also reminds us that healthcare personnel are at greater risk for acquiring influenza and can transmit it to their patients.
Look after not only your patients, but your co-workers, friends and family to be sure all those who should be vaccinated are.
Gourmet food, wireless access, waterfalls in the lobby. These are some of the things hospitals are doing to accommodate their customers (it's hard to call them patients when it seems we're more concerned with how they rate the hospital than their medical outcome). But according to at least one survey, what patients really want is kindness.
According to a survey by Wakefield Research for Dignity Health, one of the five largest health systems in the U.S., 87% of Americans feel kind treatment is more important than other key considerations in choosing a healthcare provider. The survey asked specifically about choosing a physician, but the findings can likely be expanded to the entire healthcare experience.
Even more surprising is that 64% of those surveyed reported having experienced unkind behavior in a healthcare setting, including the failure of a caregiver to connect on a personal level (38%), staff rudeness (36%) and poor listening skills (35%).
The consequences of this poor treatment are significant. The survey found that when people experience unkindness in a healthcare setting they feel their quality of care is negatively affected (93%) and withhold information (54%).
Dignity Health recently launched a project called Hello Humankindness. It has great examples demonstrating that as humans we have the capacity to be kind to each other. And it doesn't take much.
Another cool project Dignity introduced is the Great Kindness Challenge. They have designated Aug. 9, 2014 as a day devoted to performing as many acts of kindness as possible. They even provide a list in case you need help. (I'll remind you of this in August!).
They are also challenging students to do 50 acts of kindness between Jan. 27-31. Let's join them! Despite the fact that as a nurse you are in one of the most compassionate professions, according to this study, you're not always nice - not to mention the whole bullying thing you do to each other. I challenge nurses to join students across the country and go beyond your usual and do 50 additional acts of kindness!
Veronica Thompson, RN-BC, MS, FNP-BC, is on the clinical faculty in the Division of Education and Organizational Development at Montefiore Medical Center, a teaching hospital in Bronx, N.Y.
More than 28 years ago, I began my nursing journey in Jamaica, West Indies. During my career, I completed a B.S. and M.S. in Nursing and finally a Ph.D. in Education Leadership. In my role on the clinical faculty at Montefiore, I interact with a large number of new graduate registered nurses, which has increased my awareness of some of the issues they face as they move from the classroom into the clinical setting.
While conducting research for my dissertation, I learned that new registered nurses continue to face challenges, such as communicating with the members of the health team, handling the workload and time management and prioritizing as they transition into the clinical setting.
The new nurses leave the comfort of the classroom, where they are supported by their instructors, into a clinical setting where they experience fear, anxiety and feeling unprepared for the role. Clinical leaders and senior nurses should provide an environment which is nurturing and supportive for the young inexperienced nurses. These nurses are going to be our replacements someday - it is our responsibility to provide them with the tools for success.
Some ways we can assist the new nurses is to acknowledge their limitations and develop plans to help them master essential skills. Secondly, we must recognize that the new nurses are in the novice phase and require timely, well-planned orientation and a supportive post-orientation plan. Experienced nurses should mentor the new nurses and arrange for added time and activities to address their learning needs.
I can recall my first experience as a new nurse and how scared I was as I walked into a patient care area. Luckily, I had been an intern for a year, where experienced nurses mentored me and I learned the role and responsibilities of the registered nurse. This internship helped me learn essential skills - time management, prioritization and how to communicate with the health care team. All of this is so important for the new nurse to have a smooth transition into the clinical setting.
I was provided a special experience in the early years of my career and I'm committed to ensuring that same level of mentorship and care is provided here at Montefiore! We're all one big team and these nurses are the future caretakers of this community - we owe to them to make the transition as smooth as possible.
The first time I saw a Pink Glove Dance video I was perplexed. Is this really how hospitals are spending their time and money? These are professionally produced videos using hundreds of hospital employees and a ton of resources. I can't imagine the time and money dedicated to creating these. And what's the point?
Then I watched a few more. I smiled and cried, and watched more videos.
Now in its third year, the Medline has announced the winners of the 2013 Pink Glove Dance competition. It's not all glory and fame for the winners, people with cancer also benefit from the program.
The winner is chosen by online voting. Geisinger Health System, Danville, Pa., got the top spot this year. As a result, $25,000 was donated to a charity of their choice -- the American Cancer Society, providing free transportation for treatment to central Pennsylvania breast cancer patients in need. In addition, Medline, sponsors of the Pink Glove Dance, and participating hospitals will donate another $1 million to the National Breast Cancer Foundation and various local breast cancer charities nationwide. More than $2.2 million has been donated through the campaign and Medline Foundation since 2005.
So, videos of dancing in hospitals. Really? Yep.
Congratulations to the top winners and everyone who participated in the competition. To see all the videos, go to http://www.pinkglovedance.com/
I live in South Florida very near to the Gulf of Mexico, but I’m
not exactly an avid fisherman -- although most everyone I know has a good fish
story to tell.
And while what I’m about to say may sound like another one of
those, it is not:
There’s a new treatment option for the millions of people out
there suffering from chronic wounds -- namely, fish-skin technology.
The manufacturer, Kerecis Limited, announced Nov. 7 it had received 510(k) clearance from the FDA to market the proprietary fish-skin, Omega3, tissue-regeneration technology for the treatment of chronic wounds in the U.S.
Fish skin, it seems, comprises much of the same material as human skin, with the addition of Omega3 polyunsaturated fatty acids. The new curative products are intact, decellularized fish skin sheets, which have had all cells and antigenic materials removed. The products are made in Iceland from fish harvested in the North Atlantic.
According to the manufacturer, when the product is
inserted into or onto damaged human tissue, protease activity is modulated and
the fish skin is vascularized and populated by the patient's own cells, ultimately
converted into living tissue. Marketed under the name MariGen
Omega3, the FDA says it is indicated for the management of chronic wounds, including diabetic,
vascular and other hard-to-heal wounds.
Each year about six million Americans alone suffer
from problem wounds caused by diabetes, circulatory problems and other
conditions, according to the FDA, with 1.1-1.8 million new cases added each year, and so one can only
begin to imagine the infections, amputations and deaths chronic wounds are causing on a global scale.
"Despite a clear need, few treatments are consistently effective
in accelerating wound closure in people with chronic wounds," says
Gudmundur Fertram Sigurjonsson, CEO, president and chairman of Kerecis Limited.
"The FDA approval represents an important milestone for Kerecis, as we now
have an approved product in the largest market for biological products
Hopefully, the fish-skin technology will be a milestone for many more
as well, who will finally be able to tell the story about their chronic wound
that got away.
Sharon Nam Dobbs is a registered nurse who is committed to education and professional growth. Educated in Canada, she received a diploma in nursing in 2003 from George Brown College; a BSN in 2005 from Ryerson University; and an MSN from University of Toronto in 2007. She has worked in community nursing, geriatric nursing, nursing education, general internal medicine, neurology, and bariatrics. She has worked in Canada and the U.S. and currently works as a bariatric nurse at Toronto Western Hospital.
When my union forwarded a link to a petition to cancel a new reality show, "Scrubbing In" that was described as being "highly offensive," and which depicts nurses in unprofessional, inappropriate activities, I automatically signed the petition, and forwarded to family and friends on my Facebook page to also sign. I thought that anything that got my union so riled should be taken seriously.
Receiving a notification from my adult son that he hated the trailer and thought it was "an abomination and an insult" to my honor, I was more than a little curious about the trailer itself. I watched it and was horrified at the portrayal of the nurses in the show.
We have advanced into a "reality" age in which we have an unquenchable thirst of the most outlandish of "daily" activities. We live in awe of the most degrading of human activities. We watch in glee as people dispute about their innumerable sex partners, about the paternity of their children, and about any number of topics. We watch child prodigies perform as seasoned chefs, and hunger for fights amongst mothers of child beauty queens. We have become a depraved society in which nothing is sacred, and everything is fair game.
But, one wonders, what does that have to do with nursing? Reality TV doesn't necessarily depict real life, does it? While that may be true, reality TV gives the impression that what they portray actually happens.
Now, in a profession in which nurses fight daily for respect and to be taken seriously, in which so many television shows have negative portrayals of nurses, and in which nurses must constantly (and almost unsuccessfully) be proving themselves to their patients, the families and friends of patients, and even to their own colleagues in other disciplines, why would any nurse embrace a television program that basically prove the misconception that exist about nurses?