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March 25, 2017

By: Nargis Abdelmessih, MSN, RN

Clostridium difficile (C. diff) is becoming a common microorganism in the healthcare systems and poses a catastrophic threat to the United States. It costs the healthcare system up to billions of dollars, leading to serious complications and higher mortality rates per Centers for Disease Control and Prevention (CDC). Caring for C. diff patients is becoming burdensome, time consuming, and overwhelming for nursing staff. It doesn’t just negatively impact patients, but also family members and organizations.

I have worked as a nurse for 16 years in hospitals, long-term care facilities, and as a hand hygiene observer in conjunction with the infection prevention department at the Ohio Hospital Association. During that time, I have seen healthcare workers walking out of rooms with C. diff patients without washing their hands. Once an infection prevention physician tried to argue the necessity of clinicians washing their hands, even when they didn’t touch anything in the room. More than once I asked different healthcare workers, why do we have to wash our hands when caring for C. diff patients and they couldn’t answer.

Earlier in my nursing career, I admit to the lack of knowledge on C. diff infection. At one of . . .

March 17, 2017

By: Roric P. Hawkins, MBA, BSN, RN

Have you ever been faced with a patient mobility challenge at the point-of-care when your patient had to be moved but moving the patient alone was not within your physical capabilities? In that instance, did you recall from your past experiences the various lifting options you maybe once applied in similar situations but was conflicted because of all the new information related to back injuries from manually lifting patients? The one time you actually considered using the patient-lift device located in the storage room on your unit, could you be confident that it was capable of addressing the mobility needs of your patient? What decision did you eventually make and would you make that same decision if a similar situation were to reoccur?

Choosing the appropriate patient-lift device, as well as having the appropriate equipment available, is necessary when seeking to safely address patient mobility challenges at the point-of-care. Having a preplanned solution before being faced with a patient mobility challenge would not only be ideal, but also beneficial to protecting both the patient and the caregiver’s safety. It would be helpful to include your patient’s mobility limitations as part of your . . .

March 10, 2017

By: Pamela Germinaro, BSN, RN

In 2004 President George W. Bush set forth a goal of all persons having electronic health records (EHR) within 10 years. This goal seemed unachievable at the time, and in fact proved to be so, although 90% of hospitals and 80% of private offices did have some form of EHR by 2014.

In 2014 President Barack Obama furthered the cause by including in the American Recovery and Investment Act that public and private healthcare providers must demonstrate meaningful use of EHR in order to receive Medicare and Medicaid reimbursement.

Now in 2017 President Donald Trump, according to FierceHealthcare, brings new challenges of safety and security regarding individual participation in providing personal details to health care providers. President Trump, by promising to repeal the Affordable Care Act (ACA) and the privacy protections it affords, as well as promises of deportation for immigrants and Muslims, is causing concern amongst healthcare providers that individuals may withhold important medical information for fear of repercussions. Developing concise and extensive EHR can help facilitate the appropriate care of individuals as well as allowing for data collection and research to improve care across the health care continuum. Patients’ rights to privacy regarding the release of demographic and . . .

February 28, 2017

By: David Foley, PhD, MSN, RN, MPA

On a hot summer evening during my recent post-doctoral dream cruise, I was preparing to relax and enjoy a show in the beautiful, fabulously-appointed lounge when, above the excitement and din, I heard the unmistakable, discordant sound of a human body hitting the marble floor. In fact, the dull thud of a head making contact with an immovable object was one any nurse would recognize. It was immediately followed by the sickening sound the cry of a young child that quickly grew from a whimper into a crescendoed, pitiful scream.

I instinctively jumped from my seat and ran in cartoon-esque fashion to the back of the lounge—my legs seemed to be moving faster than my body. As if in slow motion, however, I noted the bewildered stares of my traveling companions in the seats around me. Before the first “where are you going?” reached my ears, I was already at the back of the lounge and at the side of a very young boy who was now holding his head and staggering to get to his feet. “Please don’t move. I am a registered nurse” I told him and the small group of people standing . . .

February 17, 2017

By: Marcy Hanson, MN, RN

Our foster care system is in dire straits. According to the Department of Health and Human Services, in the United States alone, over 400,000 children are currently in care and over 100,000 of those children are waiting for permanent adoptive homes. While the numbers are staggering, so are the long term and lasting psychiatric and mental health concerns that often follow these children through the system. One of the most common consequences of early trauma and a journey through the foster care system is often misdiagnosed or underdiagnosed posttraumatic stress disorder (PTSD) and anxiety.

Typically we think of PTSD as associated with veterans or those who have lived through war, but we often forget the complex, interpersonal trauma that is often experienced by children within the foster care system. Trauma such as separation and loss, as well as various forms of abuse or witnessing violence, can lead to PTSD. Unfortunately, children who have survived trauma often are left without the appropriate coping mechanism to battle their inner distress. As such, these hurting children often display behaviors that are linked to diagnosis of ADHD, conduct disorder and oppositional defiance disorder as opposed to PTSD or even anxiety.

As a . . .

December 6, 2016

By: Jill E. Toledo, MSN, RN, CPON

When a cancer diagnosis is made, we as providers do everything possible to start treatment immediately. Often times we can overlook the value of reproductive health counseling, as we are focusing on providing swift interventions. Under certain circumstances it’s possible to delay starting treatment so the patient can explore fertility options. Under other circumstances treatment initiation can’t be delayed. In those instances we must provide information about fertility after cancer treatment and allow patients to explore fertility options when treatment completes.

As providers we must be mindful that the discussions should begin as close to diagnosis as possible. It’s believed that these discussions should also occur regardless of whether the treatment will affect fertility. Klosky notes that inclusion of fertility topic as part of patients’ treatment plan can alleviate concerns about infertility, encourage safe sex practices during treatment and promote future discussions. In addition, it’s important to realize that when patients lose their fertility it can lead to psychological distress which includes grief, depression, anxiety, anger, frustration and regret.

Some topics of discussion include contraception during treatment, sexuality for both males and females, ethical/legal concerns and even adoption and surrogacy. It’s important to recognize . . .

November 3, 2016

By: Aileen Cassada, MSN, RN, NREMTP

Recently I had the opportunity to assist on a medical mission trip to Honduras. Here I share my experience to help others who might be interested in serving on missions.

About Honduras

Honduras is the second poorest nation next to Haiti in the Western Hemisphere. According to the 2013 statistics over 64% of the population is below the poverty level and 54% of households are in extreme poverty averaging a daily income of less than $1.25. Another horrifying statistic is that 23 out of 1000 children 5 years and younger will die due to sickness and malnutrition.

Obstacles in gaining access to healthcare for the people of Honduras include the great distance people have to travel with too rough of terrain, lack of funds to purchase such items, and limited medical resources throughout the country. The closest hospital in San Pedro Sula is 76.39 kilometers from the nearest city Pena Blanca, which can be more than an hour travel with a vehicle through rough terrain down the mountainside. Over-the-counter medications are almost unattainable for many of people.

Arriving at base

The team from the United States consisted of a physician, nurse practitioner, two RNs, two EMTs . . .

October 19, 2016

By: Jan Vander Luitgaren, RN

What is good health? The absence of disease? What is wellness? The ability to function optimally? These are some of the things I am going to discuss in this blog, as well as give you some simple tips to achieve health and wellness in your life.

I always wanted to be a nurse since a very young age and I was so thankful to get to achieve that goal. I always thought it was a privilege to help others at those times when they really needed someone. It became apparent to me not far into my career that many of my patients didn’t always want to or know how to take good care of themselves. Was this just part of their personality, was it partly due to how they were raised, or was it just a lack of desire?

On my journey to figuring out wellness for patients I decided to start with myself. I wanted to see what brought me good health. At the time I didn’t really understand how good health and wellness of mind, body, and spirit are two different things. So I did the usual. I exercised a lot, ate as healthy as I . . .

October 11, 2016

By: Sara Bell

If you have a mental illness, you may be at greater risk for both substance abuse and addiction. If you have an addiction problem, you may be putting yourself at risk for developing a mental illness. These two conditions all too often go hand in hand, feeding off of each other and endangering those who are struggling with them.

Treatment is the best way to either prevent these co-arising issues or recover from them but, of course, that requires detection and recognition of the problem. Here is a short overview on addiction, mental illness, and how you can recognize an at-risk loved one.

Self-medication is a major perpetrator

In people with mental illness, particularly untreated mental illness, self-medication is a common issue that tends to result in addiction. Self-medication is the abuse of a substance in an attempt to control the symptoms of an illness.

When a person abuses an addictive substance, they may believe that they are reducing their symptoms when in actuality they are making them worse. Substances may dull symptoms for a short time, but when the high has ended, they will come back worsened with each use. These worsening symptoms then . . .

September 22, 2016

By: Jennifer J. Brokaw, RN, WCC, OMS

Nursing is the largest medical profession in the world with nearly 4 million nurses in the United States alone. As such, nurses have the potential to profoundly influence policy and politics on a global scale. In fact, it is the moral and professional obligation of nurses to be engaged in legislation that impacts their patients. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Unfortunately, nurses have historically had little involvement in policy that affects healthcare delivery.

There are several reasons for the limited nursing participation in policy and politics. Lack of awareness, inadequate skills, and little opportunity for involvement are just a few factors. Another barrier is the limited formal health care policy education in nursing. Time and resources are further obstacles to the nursing profession’s participation in politics. Additionally, studies show that nurses are not given sufficient support to generate the evidence needed to influence healthcare policy.

Regardless of the multiple factors limiting the nursing profession’s potential impact on politics, the fact remains that nurses are vital to the development and implementation of healthcare policy. As the largest medical profession in the world, nurses should be leading . . .

September 15, 2016

By: Lori Boggan, RN

I learned at an early age to help those in need. I had amazing role models. My parents always welcomed our friends into our home and treated them as their own. They never questioned the friends who came hungry and ate double, sometimes triple portions. They allowed them to stay days, weeks, months if needed. While I had no idea at the time that I would become a nurse, the blueprints were already laid for me.

I moved to Sweden over 6 years ago. In that time, the unrest in Syria has unraveled and destroyed or displaced millions. It was on a sunny summer day in 2013 in the southwestern seaside city of Gothenburg that I witnessed desperation, helplessness, and trauma on a scale I had never before seen. I was interning in a refugee clinic that screens some of the average 50,000-100,000 asylum seekers a year coming to Sweden. Sweden offers housing, food, clothing, and education to asylum seekers entering the country. The interviews were scripted, the tests routine, but there was nothing routine about it.

Our first patient was a young woman from Syria. With a translator at her side, we began the interview. Where . . .

September 7, 2016

By: Jennifer J. Brokaw, RN, WCC, OMS

Mrs. Anderson is a well-spoken, poised black woman with a flawless face. She is surrounded by silk-encased pillows and is wearing a tasteful dressing grown with a coordinating turban on her head. She is not at all what I was expecting when I entered her room to perform a skin assessment for pressure injury risk. She doesn’t even look like she needs to be in the hospital. But I soon discover why she scored so low on the Braden scale when I ask her to reposition herself in bed.

“I’ve had over a dozen operations.” She tells me. “It is very difficult for me to move because of the pain.” And under her dressing gown I see multiple keloid scars crisscrossing her abdomen. She points out each one and recites each procedure that resulted in the hypo-pigmented, raised cords of tissue. I assist her as she slowly turns to her side to allow me to continue the head-to-toe assessment. I find more keloid scars running up and down her spine.

I complete the survey of Mrs. Anderson’s skin without finding any pressure injuries. But I educate her on the importance of frequent . . .

June 15, 2016

By: Barbara Pinchera, DNP, ANP-BC

Do the clothes nurses wear at work define their identity as a professional? Currently, the traditional white uniform is rarely worn in the clinical setting. For the nurses who equate this uniform with part of their professional identity, this is disheartening. There are many contributing factors to this trend, including portrayal by the media of a white uniform as a sex symbol. At a recent pinning ceremony a new graduate nurse was ridiculed by a faculty member for wearing her mother’s nursing cap. She was told that the cap and white dress made her look like a “porn queen.” While this behavior on the part of a faculty member is reprehensible, it highlights the fact that the traditional white uniform, worn proudly by many registered nurses is no longer universally recognized as a symbol of caring, compassion, wisdom, experience and professionalism. It is important to the nursing profession that nurses present a professional appearance and recent evidence suggests that some patients and nurses view the white uniform as a symbol of professionalism. Perhaps it is time to reconsider this concept; the white uniform provides patients with a consistent, easily recognizable visual symbol of the nursing profession.

For some, putting . . .

June 1, 2016

By: Allison Moreno, BSN, RN

Editor’s note: This is an excerpt from the book Nursing Is Caring, by Beverly Wheeler, MSN, RN, ACNS-BC, clinical assistant professor in the school of nursing at the University of Texas Health Science Center in San Antonio. The book contains stories from nursing students; 100% of royalties go to the University of Texas Health Science Center at San Antonio, School of Nursing Scholarship Fund. http://www.nursingiscaring.com

I have had many experiences that have solidified for me why I chose nursing, and confirmed for me that I indeed made the right decision. One particular patient stands out in my mind as I reflect. Early in my nursing school career I had a patient who was suffering from a chronic wound that was infected and required packing. She was very nervous about how she was going to take care of her wound at home. She had no way to pay for her hospital stay, and she was being discharged before she really felt ready. I have to admit I was concerned for her to go home as well because her wound was on her coccyx and there was truly no way she could pack it and change the . . .

May 25, 2016

By: Donna Cardillo, RN, CSP

You don’t need a rigid schedule or even a lot of time to get each day off to an energetic and healthy start. Try a few of these quick and easy tips to improve your vitality, your mood, and your well-being. These tips are also great to try any time of the day for an extra boost of energy.

1. Drink a glass of water.

It’s not unusual to wake up dehydrated after not consuming any fluids for eight or more hours during sleep. Drinking eight to 16 ounces of water first thing in the morning rehydrates you, keeps your brain alert and operating at its best, and helps keep your body functions running smoothly.

2. Move your body.

If you don’t already have a morning exercise routine, at least move for a few minutes to get your blood circulating, your muscles and nerves fired up, and oxygen pumping to your brain and lungs. Marching in place while brushing your teeth, dancing to the radio, or going up and down a set of stairs a few times should do it. Play some upbeat music while you move to make it more fun and energizing.

3. Do . . .

May 18, 2016

By: Jerron Denico Franklin

The image displayed above depicts an inexperienced, light-hearted, eager nursing student.  I will never forget the day this picture was taken because it was my first clinical experience. Nevertheless, it was also the beginning of a 2-year journey that involved countless experiences that embodied the popular phrase, “Nurses eat their young.”

From medical surgical units to operating rooms, my ears and eyes have been exposed to some of the most disturbing language and behavior while under the wing of the people I have always admired: registered nurses (RNs). Before beginning my clinical experiences in various locations, I imagined I would be welcomed with open arms by the torch holders within my future discipline and profession; however, I was unfortunately devoured more times than not by my authoritarian overseers. In the following paragraph, I will recount an experience that was permanently etched into my mind, and inspired the creation of this article.

While working with an RN during one particular learning experience, I was asked to collect vital signs for all of her patients, which was a total of seven. I entered the room of patient who struggled for air as she responded to my greeting. Once I witnessed . . .

May 9, 2016

By: Aimee Grijalva

This picture is just a small example of what also happens in a pediatric hospital.
My child’s three year battle with infantile leukemia created a unique circumstance introducing countless medical professionals into our lives. Some were mastermind doctors but most were an assortment of wise nurses, therapists, and other professionals who really make the worlds go round inside a pediatric hospital.

Certain dark days the only light a cancer mom like me would see came from the caring medical employee with extra supplies of compassion. Usually I had plenty of time to profess my appreciation to my superhero in scrubs but other times Matthew’s critical condition left no time for the exchange of proper thank you’s.

Matthew’s first nurse was one I never thanked for rocking my ever-loving caregiver world. She worked in the PICU and was there as I received my child’s cancer diagnosis. Nurses who work in PICUs are very familiar with babies in critical condition and I was thankful for this expert nurse who came with the perfect touch to soothe my cancer stricken two month old. I watched my teacher intently absorbing all I could because a baby with cancer . . .

May 4, 2016

By: Ann Moore

My journey, post-graduation from the University of Cincinnati took me to New York City where I taught pediatric nursing at Babies Hospital, Columbia University. The chief resident of pediatrics organized the first Peace Corps medical team to go to Togo, French West Africa in 1962. I was recruited along with 30 other medical people — doctors, nurses, lab techs, a pharmacist, sanitation engineer and others. I met my husband the first day of Peace Corps training, and we were married 8 weeks later on my parent’s farm near Dayton, Ohio.

Our Peace Corps mission was to teach preventive health, but to do that we had to gain the trust of the people. For the entire first year, we worked with them in an abandoned hospital where we treated — and nurtured — them back to health. The second year we were able to teach them various health promoting behaviors — nutrition, latrine building, hand washing, etc.

We all noted and remarked on the outstanding emotional well being of the African infant, either sick or healthy. All of the babies and young toddlers are carried on the mother’s back and they are all breastfed. When the babies were not asleep on their . . .

April 27, 2016

By: Jennifer J. Brokaw, RN, WCC, OMS

It’s just another day for just another nurse as I make my way through the busy corridors of this sprawling facility. The hallways are bustling with activity as various personnel rush from here to there wearing the assigned-color scrubs of their discipline. There goes a transporter pushing a patient on a stretcher. There goes a phlebotomist with his cart of needles and tubes. There goes a pharmacy tech delivering much-needed medications to a patient. Oh, and there goes just another nurse, like me.

My rounds take me to a familiar unit where the staff knows me by sight. We smile and wave or even stop for a brief “hello, how are you?” if time allows. I glance at my patient list and remind myself of the few details I have regarding this next consult, just another nurse just going about her humble duties.

I enter the patient’s room – she is in the bed next to the window – and introduce myself. “Hello,” I say. “My name is Jennifer and I’m a wound nurse. I’m here to take a look at your foot ulcer.” Mrs. K nods in understanding and moves her leg out from under . . .

April 20, 2016

By: Kati Kleber, BSN, RN, CCRN

It wasn’t until about three years into my career that I was able to differentiate between sympathy and empathy.  It was kind of like figuring out the difference between hospice and palliative care.  At first, they seem like the same thing, but they are actually incredibly different.

While sympathy is essentially feeling bad for someone, empathy is feeling bad with someone.  Empathy is about connection and support without an agenda; just being emotionally present with him or her as they walk through pain and suffering.

Once I understood how to empathize with my patients and their loved ones, I immediately began implementing it at work; critical care patients and loved ones need it quite a bit!  However, I began to realize how essential it is to apply this to each other as nurses.

Nursing is tough

Nursing is a really challenging career for many different reasons, and it is important that we recognize that we have the ability to support each other and make this constantly challenging career easier – much easier.

How much easier is a tough shift with the right coworkers?  How much easier is dealing with a challenging patient and family when you know your coworkers have . . .

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