Archive: November, 2011
“Call Security!” is a phrase that is too often yelled across a busy Emergency Room. It's a disruptive moment for any staff nurse, patient or family member who is involved.
Violence in Emergency Departments is a hot topic due to the rising frequency of occurrences nationally. Everyone knows that you don’t touch a cop or any ‘man in uniform.’ Even mouthing off to a cop will get you in trouble. That should never change. As a new mother, I am a believer in instilling a little fear along with manners. I don’t want to have a “punk” for a child. Some people just missed these lessons growing up and everyone from the McDonalds server to nurses are paying for it.
As an ER nurse for most of my career, I have become almost desensitized to the reality that violence in our workplace is becoming more frequent and just as common in the suburban hospitals as those in major cities. The explicatives mother f****w**** or bitch, or f-this and f-that are common language in an Emergency Room. As the nurse this language is directed at, you learn to walk away and control the patient with methods supported by your hospital.
Mentioned: Penn Presbyterian Medical Center
Am I prepared to go back to school? It’s a question I recently have been forced to asked myself. My employer is in the earlier stages of applying for Magnet Recognition (a term for a credentialing program that recognizes hospitals for higher education among nursing staff, and ultimately better job satisfaction and patient outcomes). I have a four-year nursing degree but I am quickly beginning the search for a Masters of Nursing program to remain a ‘desired employee.’ This would be my second Masters degree, but first in the field of nursing, which is becoming increasingly essential to compete for jobs in the future. I am sick at the thought of starting a new curriculum, paying tuition, and studying for midterms. I thought I went into debt to be done with college classes and move forward with my life. I feel like enrolling in classes is a backwards step or a simply linear one without a definite goal in reach. Working full time, juggling childcare and family matters, I feel time and money are limited. However, my director said it best: “You just keep building, you want a strong resume… It is not going to be a kind job market to those who only have a lesser year degree.”
The wave of panic about enrolling for a higher degree in nursing is widespread. Rationales for riding the wave are just as diverse. Some nurses want to remain competitive and get job security, while others are threatened by a demotion and even termination especially with Magnet Recognition becoming more popular, and high administration positions and educator roles holding strict new criteria for employment. Sure, there’s excitement that comes with every new journey but also resentment and panic at the fact that our profession is forcing us in this direction. When will clinical experience count for college credit?!?
Within the past 10 years, an LPN (licensed practical nurse, under 2 years of training) and an ASN (a 2-year Associates degree in the Science of Nursing, the most entry level college degree) were acceptable for a working nurse. But in 2011, the most experienced nurses are dealing with pressure to compete for their jobs and prove their worth is greater than their LPN or ASN degree might suggest. A nurse can sit for the licensing exam after just 2 years of education and then choose to continue for a four-year Bachelors of Science in Nursing degree (BSN) yet it is quickly becoming less of a choice. Many nurses are still paying for their own college-age children or approaching retirement age and are reluctant to return to college just to keep their job and not necessarily advance in their institution. New graduates, regardless of their degree, are also finding it extremely difficult to be hired especially as they are among a large group of interviewees, fighting for one position, against hundreds of others with competitive resumes.
It’s officially flu season and whether or not we realize it, a nurse’s decision to vaccinate is contagious! According to Consumer Reports, 73 percent of people surveyed stated that health-care providers have the largest influence on their decision to vaccinate. Yet, only 52 percent of health-care workers were immunized during the 2010 seasonal flu. The Pennsylvania Department of Health states “influenza vaccination rates among Pennsylvania Health Care Workers (HCWs) remain at a suboptimal level of below 60 percent, which is far lower than the Healthy People 2020 target of 90 percent.”
Health-care workers are considered high-risk of being exposed to the flu, due to daily direct patient care. Since 1984, the U.S. Advisory Committee on Immunization Practices (ACIP) has recommended that employees in healthcare receive the influenza immunization. However, the Center for Disease Control and Prevention (CDC), estimates the current rate of immunization among health care providers is less than 50 percent.
I was surprised by this number. Nurses are aware of the deadly complication of the flu, and regardless of your occupation, the flu has financial implications by forcing you or your children to stay home for a week. What reasons are healthcare providers giving for not being immunized? Do we simply not realize that we are among a high risk group?
I have always believed that appearance matters. It may sound shallow but it’s the TRUTH… people DO judge a book by its cover. It is ingrained in our human essence to trust based on a first impression. It’s no different when we seek healthcare - a first impression is extremely important to our experience as a patient.
Could you imagine that as you are being escorted to your room – knowing you will be there for a few nights- you see trash in the corner, overflowing from the cans, a sticky surface on your bedside table, a call-bell that does not work, and stains on the bathroom sink. It’s bad enough that in many area hospitals, you would have a roommate – whose cleanliness and privacy may be enough to send you home early. It would be nice to be able to say that when you’re truly sick, the appearance of a room does not matter, but that is just false!
Hospital floors should look clean, countertops wiped, odors eliminated and direct patient care providers to be neat and professional in their dress. Nurses know what a patient room looks like after a patient is discharged and the time it takes a housekeeper to prepare the room for the next patient. If this one crucial step does not happen fully, the result is that a patient loses trust in the facility’s ability to provide safe care.
Thanks for the feedback on my blog “Top Ten Most Awful Nursing Habits!” I couldn’t be happier to hear that nurse’s bad habits aren’t observed daily, but instead strong nursing care is displayed. This blog is dedicated to complimenting nurses for all their good habits and traits that are often overlooked!
I talk often about patient’s perceptions and patient complaints but patients also mail to hospitals the most gracious and appreciative letters of thanks! (Keep them coming!) For example, on one day in March, 2008, I was the primary nurse of a man who came into the ER with spontaneous back pain which quickly proved to be much more complicated as his blood pressure dropped and a recent cancer history became his real problem. He was in his sixties, oriented, his daughter was a nurse and extremely involved at the bedside as his entire family quickly grasped the reality of what grim realities they were facing with their father. As multiple IVs were inserted, cardiologist and oncologists at the bedside, and intravenous Morphine started, their emotions were evident as end of life decisions were discussed with their father. I remember stepping out of the room feeling just as much emotion since a man who walked into the ER was more than likely not walking out. I escorted the family to our hospice unit and later learned he passed away early the next morning. Two weeks later, his daughter sent me a three page letter of thanks. In the nearly 10 years of my nursing career, that was only the second time a letter was addressed to me but probably the most powerful.
Even if you work in an office setting, versus at the patient bedside, a nurse can make a huge impact on patient’s experience and delivery of skilled care. Most nurses are not like Nurse Jackie or Nurse Ratched. And they are not at work to pursue the hot George Clooney AKA Dr. Ross that only exists in the fabulous world of TV dramas. Instead, nurses actions are more ethical and purposeful and earning our profession recognition. Since 1999, (except in 2001 when firefighters claimed the top rated profession, possibly influenced by the September 11th attacks), nurses outranked other professions in Gallup's Annual Honesty and Ethics Survey with Americans rating nurses as having "very high" or "high" honesty and ethical standards. For eleven years, nurses have grossly outshined military officers, pharmacists, doctors, veterinarians, clergy, and several other professions.
Thanks for the feedback on my last post, “Top Ten Most Awful Nursing Habits.” I couldn’t be happier to hear that nurses’ bad habits aren’t observed daily, and strong nursing care is. This blog is dedicated to complimenting nurses for all the good habits that are often overlooked.
I talk often about patients’ perceptions and patients’ complaints, but patients also mail to hospitals the most gracious and appreciative letters of thanks. (Keep them coming!) One that meant a lot to me was in response to a situation on March 16th, 2008. I was the primary nurse for a man who came into the ER with spontaneous back pain, which quickly proved to be much more complicated as his blood pressure dropped and a recent cancer history turned out to be his real problem. He was in his 60s, his daughter happened to be a nurse, and she was extremely involved at his bedside as the entire family quickly grasped the grim realities that they were facing with their father. Multiple IVs were inserted and a morphine drip begun, cardiologist and oncologists were at the bedside. The family’s emotions were evident as they discussed end-of-life decisions – issues like whether or not powerful medications or CPR should be used, if necessary, to keep him alive -- with their father.” I remember stepping out of the room feeling just as much emotion -- a man who had walked to the ER and into my care was more than likely not walking out. I escorted the family to our hospice unit, and later learned that he had passed away early the next morning. Two weeks later, his daughter sent me a three-page letter of thanks, and the sentiment remains with me to this day.