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Language Barriers and Your Patients - Let the Evidence Guide Your Decisions so You Can Comply with the Law

In almost every health care setting in the United States (US) these days, nurses and other health care providers are dealing with language barriers as part of care delivery more than ever before. In fact, most countries in the world run into some kind of language barrier issue in the health care setting. Global migration means more tourists and immigrants for every country in the world. 
In the US, language access--meaning the availability of interpreters and their services-- is a civil right. The Affordable Care Act (ACA) also added new provisions for health care services providers around language access that are important for you to know. From CME Learning:
New rules on language access were implemented on July 18, 2016. These changes are sweeping in scope as they apply to “every [federal] health program or activity, any part of which receives Federal financial assistance.” Section 1557 is a “non-discrimination” provision that broadly prohibits discrimination in health care or health c…
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Why You Will Get a "Bad" Grade in Nursing School & Why It Will be the Best Thing to Happen to You

Perhaps you have been a straight A student all your life.

Perhaps you had one subject you struggled with, got Bs in it, but mostly As in the rest of your classes.

Then you started nursing school.

Most students quickly discover that nursing is one of the hardest majors at any university. Not only do you have a lot of time in class, your "lab" equivalent involves learning how to care for really sick people. Most nursing students spend between 24 to 30 hours per week in class --and THEN have lots of reading and other assignments they need to do to prepare for their "labs." After all, in a chemistry lab you probably won't harm or kill anyone due to the highly controlled conditions. When any health profession student is learning, there is always the risk for mistakes and it's why they are so closely supervised.

Inevitably, every nursing student gets their definition of a "bad" grade. For some, this is an actual failure of a class and that can happen fo…

So, You Want a Nursing Career in Global Health - How to get Started

I've worked in or been on research studies that cover 30 countries to date. With that global experience, I frequently do lectures about global health issues at the undergraduate and graduate levels. Millenials want to get out there and see the world and Gen X and Boomers are looking for meaningful career changes. The theme is common: They want to help the less fortunate in other countries. It's not to say they don't want to help the less fortunate in their own country; I think it's become something of seeing the consistency of what poverty does to people and the health consequences.

With all that in mind, want to know: How do I build a career in global health as a nurse?

First question I ask people is: Do you like camping?

Surprising question? Not really if you've spent time in the field. Most places where there is a critical need for health services and capacity building efforts don't have things like regular running water, consistent electricity, or comfortab…

Discrimination in Nursing

Nobody talks about it. Ever.

Sure, we talk about how patients face discrimination and the impact on their health. Some schools might even teach about the institutional and structural aspects of society that reinforce racism, sexism, ethnocentrism, and many other -isms. We do talk about how patients say things to us that we may consider to be offensive, and how to handle that.

But we don't talk about how we, as nurses, perpetuate discrimination and exclusion within our own profession and toward our patients. Here's a few examples of stories I've heard over the years.

A South Asian nurse manager told one of her African-American nursing assistants that she needed to fix her hair because she looked like she came from the jungle.

A Jewish nurse was working in a hospital in an area where there weren't a lot of Jewish people. During Hannukah, she wanted to put up a Menorah on her unit amidst all the Christmas decorations so she could clelebrate her faith like everyone else. The…

Where the Jobs are in the US for New Graduate BSNs

Something I tell my New York-based students all the time: If you want your first choice job, leave New York City and don't go to California, Philadelphia, or Boston. Seems like my advice has some merit based on the latest national survey of where new graduate BSNs are getting jobs.

From the American Association of Colleges of Nursing's latest survey:

"For new BSN graduates, the job offer rate for schools in the South is 77% followed by 71% in the Midwest, 57% in the North Atlantic, and 56% in the West. This rate is higher across the board for entry-level MSN graduates: 80% in the Midwest, 76% in the South, 72% in the North Atlantic, and 66% in the West. These findings indicate that employment of new graduates from entry-level nursing programs is more challenging in different regions of the country. For more details on this survey, visit AACN’s website."  Why is it so hard to get a job right out of school in the North Atlantic and the West? Simple. Lots of nursing sc…

What makes for a perfect shift when caring for patients?

It's the start of another school year and after a long hiatus, I come back to the blog with a question generated by reports from former students in the field.

What makes for a perfect shift when caring for patients?

Even as immersed as I am in all the research about nurses' work environments, I realized that no one has asked this question of working nurses in awhile. What makes for a perfect shift as a nurse, wherever you work, in the 21st century? Some things I'm sure will stay the same, but others may be new because of all the changes happening everywhere in health care systems around the world.

I hope you'll participate in a discussion through the comments section. All nurses, any where in the world, are welcome to participate. Do share what would make for an ideal working shift for you. Maybe if we collect enough ideas, we can make more changes happen at our workplaces.



Job Security

This is a great comprehensive report about current US nursing workforce issues. It gets a lot right and few things wrong. Yes, 1/3 of US RNs will retire by 2020 but many of them are concentrated in selected states.  The million nurse shortage coming our way by 2030 will be concentrated in 16 states and most of those are in the South, South West, and Midwest. Most coastal locations will actually have surpluses of nurses.

Job hunting advice: If you want your first choice job right out of school, be prepared to move. You can do anything for two years and get solid experience. Have a friend go with you and start a new adventure somewhere you wouldn't have thought to live before.  You never know what might happen!  With solid work experience, you can always move to your preferred location down the road.

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