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Thursday, October 1, 2015

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.

Wednesday, September 16, 2015

Dear View: The Stethoscope is a Tool for ALL Healthcare Providers

In light of the member's of The View's ignorant statements about nurses, how we dress, and the tools we use to do our jobs, let's review a few things.  We can discuss how their behavior denigrates women in general by engaging in catty, superficial commentary focused on nothing substantive at another time.

Stethoscopes are used by the following healthcare providers in addition to physicians:

  • Nurses
  • Respiratory therapists
  • Nurse Practitioners
  • Physician Assistants
They all use the stethoscope as a tool to double check the findings of other professionals. It helps prevent mistakes and catches problems that could be life threatening. Clearly The View thinks only doctors save lives when it is a team effort.

Nurses using stethoscopes in the United States and other countries was a hard fought battle. Physicians did not feel nurses and other healthcare professionals were qualified to use stethoscopes for many years.  Nurses fought long and hard to use them.  Now it is a tool that helps us do our job better and helps us catch problems, often life threatening ones, much earlier.

This battle over who gets to use a stethoscope continues in many low and middle income countries too.  Physicians do not want nurses using stethoscopes simply because they think that tool for healthcare delivery is only for them. Someone else using a stethoscope means incompetence is caught more easily. Symbolically, it is a way to maintain professional dominance over the "market of patients."

The only thing that dynamic does is hurt patients and their quality of care.

And producers of The View, guess how lots of nurses found out about these comments? While working in the hospital, their patients were probably watching. How many of them do you think are going to tell their patients about what the cast said and change the channel?

Friday, August 21, 2015

Please, Let Sleeping Patients Lie

A recent Kaiser Health News article highlights one of my personal pet peeves about hospital care: Unnecessarily interrupted sleep during hospitalization. It is bad for the patient and certainly impacts their satisfaction with your care.

You know how you feel when you haven't slept well, right? Add illness to that and for some, aging changes and you end up with a cranky patient and often family to boot.  Sleep is important for all when ill, no matter what age the patient.

Sleep helps you heal.  It allows your body to work on fixing the problem while the mind switches to different activity levels that allow for physiologic healing to occur.

Sick kids need it so they have the energy to cope with their illness during the day and all those grown ups doing stuff to them.

The elderly need sleep because it will take them longer to recover.  Lack of sleep also puts them at higher risk for delirium, confusion, and wandering. (Oh, does that explain a few things?!)

So if you are working night shift, ask yourself a few important questions:

Can I give my patient all the meds they need before they go to sleep or get them scheduled that way?

Do I REALLY need to get that set of vital signs on the medically stable patient in the middle of the night?

Can I reposition the BP cuff on the sleeping child who keeps rolling over on to it and showing a BP drop that sets off alarms so both parent and child can sleep better?

Start critically thinking about how you can promote sleep with your patients.  You just might find it might make for a better night shift for you.