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The ‘Threat’ of NPs: An NCNP 2014 Wrap-Up

clock May 5, 2014 07:19 by author Lisa Bonsall, MSN, RN, CRNP

It’s been a little over a week since the National Conference for Nurse Practitioners in Chicago, and I am reviewing my notes and reminded of the learning and networking that took place during the conference. On my very first page, from the Welcome and Opening Remarks of Conference Chairperson, Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, SCP, FAAN, DCC, I had written the following: 

I remember this point vividly, as Dr. Fitzgerald had commented that years ago, when our numbers were much smaller, not too many people had an issue with nurse practitioners practicing to the full extent of our education and training. Now however, as there are over 180,000 nurse practitioners, the power of our numbers is threatening to many, even despite recent research demonstrating our value in patient outcomes and satisfaction. This point is incredibly evident in this recent Op Ed piece from The New York Times, Nurses are not Doctors, where the author cites a study from 1999 to support his opinion, which is clearly not the most up-to-date, best available evidence. Have you read it? I encourage you to do so when you are sitting down, because it did bring out a bit of my temper. Rest assured that some leaders in nursing did reply with some Letters to the Editor and you can read them here

And now back to some take-aways from NCNP…

*The states with the least restrictive NP regulations see twice as many patients as those in other states.
Carol L. Thompson, PhD, DNP, ACNP, FNP, FCCM, FAANP
Keynote Address: Awesome Practiced Daily

*Don’t use an ARB and ACE inhibitor concomitantly to treat hypertension.
Joyce L. Ross, MSN, CRNP, CLS, FNLA, FPCNA
JNC-Late: A Focus and Update on the Long-Awaited Hypertension Guidelines

*Not all infected patients are febrile and not all febrile patients are infected.
Lynn A. Kelso, RN, ACNP-BC, FCCM, FAANP
Acute: Fever of Unknown Origin in Adults

*If a patient has an inappropriate tachycardia related to his elevated temperature, consider pulmonary embolism as the cause.
Lynn A. Kelso, RN, ACNP-BC, FCCM, FAANP
Acute: Fever of Unknown Origin in Adults

*Sepsis doesn’t kill patients; multisystem organ failure resulting from sepsis does.
Sophia Chu Rodgers, ACNP, FNP, FAANP, FCCM
Acute: Understanding the Latest Sepsis Guidelines

*If a patient has kidney injury, used unfractionated heparin for DVT prophylaxis.
Sophia Chu Rodgers, ACNP, FNP, FAANP, FCCM
Acute: Understanding the Latest Sepsis Guidelines

*Our patients give us very important information, if we listen!
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
Common Sense Assessment Tips Every NP Should Know

*If a patient has loss of the hair that makes up the outer eyebrows, think hypothyroidism. 
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
Common Sense Assessment Tips Every NP Should Know

*The presence of pulsus paradoxus is a sign of cardiac tamponade, but can also be seen in severe asthma.
Christine Kessler, RN, MN, CNS, ANP, BC-ADM
Common Sense Assessment Tips Every NP Should Know

*To assess judgment in patients with traumatic brain injury, ask “What would you do if there was a fire in your kitchen?”
Tracey Andersen, MSN, CNRN, FNP-BC, ACNP-BC
Neuro Assessment and Diagnostic Work-up for Advanced Practitioners

Thanks for reading this wrap-up! Want to see photos from the event? Here’s our album – enjoy! 



The Rise of the Nurse Practitioner

clock April 3, 2014 16:36 by author Lisa Bonsall, MSN, RN, CRNP

This infographic was shared with us by Maryville University’s Nursing Program

 



NursingCenter’s “Specialty Sites”

clock March 19, 2014 04:06 by author Cara Gavin, Digital Editor

Are you familiar with NursingCenter’s specialty sites? In the past few years, NursingCenter has launched two specialty sites, the Evidence Based Practice Network and the Skin Care Network. Both sites feature targeted, in-depth content and each have their own unique features and products. Let’s take a quick glance to learn more about these sites.

The Skin Care Network

The Skin Care Network was launched in 2011 by the clinical and editorial team of Lippincott's NursingCenter.com in collaboration with the Dermatology Nurses' Association and the American Society of Plastic Surgical Nurses. The goal is to share all the dermatology and skin care content from Lippincott's vast collection of nursing journals and keep you up-to-date with the latest research, news, and information your patients may be reading or hearing about in the media. 

Take a look at some of our features: 

News
Discover the latest research findings and evidence-based practice recommendations, as well as links to related mainstream media items.

Tools & Resources
Organized by clinical topic, pages feature all dermatology and skin care continuing education opportunities and patient education tools.

Society Partners
Learn more about the Dermatology Nurses' Association and the American Society of Plastic Surgical Nurses.

Skin Care Insider eNewsletter
Sign up for our free monthly eNewsletter that offers you the latest on skin care!

Social Media
Look for The Skin Care Network on Facebook and Twitter.

The Evidence-Based Practice Network

Lippincott’s Evidence-Based Practice Network is an online resource powered by LWW and the Joanna Briggs Institute (JBI), which promotes and supports the synthesis and transfer of evidence-based practice information to healthcare professionals. The network offers peer-reviewed resources aimed to integrate evidence into practice in an effort to support clinical decision making. 

Here are some network highlights: 

JBI Tools

JOURNAL CLUB*
Here, you gain access to journals for evidence-based practice targeted to your specialty, as well as the opportunity to share information and ideas with other professionals.

SUMARI*
This premier review software package helps health professionals conduct systematic reviews of evidence of feasibility, appropriateness, meaningfulness, and effectiveness of health intervention.

TAP*
Analyze small qualitative datasets following a three-step process of entering data, categorizing data, and building themes. 

CAN-IMPLEMENT*
Tailor your clinical practice guidelines for local use with this JBI tool. 

JBI Library
Subscribe and gain access to JBI’s vast collection of evidence-based resources. 

JBI Continuing Education
Discover JBI’s continuing education resources, as well as their evidence-based practice series. 

‘Show Me The Evidence’ Blog
Stay up–to-date with Lippincott’s blog dedicated to evidence-based practice.

EBP Insider eNewsletter
Sign up to receive our free monthly eNewsletter!

Social Media
Follow The EBP Network on Facebook and Twitter



Free Nursing Resources

clock March 10, 2014 04:41 by author Cara Gavin, Digital Editor

Take advantage of our vast collection of free nursing resources on Lippincott’s NursingCenter.com. We know how important your work as a nurse is, and we want to reward your efforts with free nursing activities. From nursing journals to continuing education activities to podcasts, we’ve got what you need, and it’s FREE! 

  • Featured Journal
    Every few weeks, NursingCenter.com presents a “Featured Journal” chosen from more than 50 journals available on our site. Every article in the latest issue is offered to you free of charge. 
  • Nurse’s Choice List
    Discover the top 10 recommended nursing articles selected by our nurse editor. These articles are available to read free online for a limited time.
  • CE Activities 
    All of our journals’ continuing education articles are free to read—you only pay when you wish to earn CE credit. 
  • Patient Education Materials
    Keep your patients informed with our free patient education materials. 
  • Future of Nursing 
    In 2010, the Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (RWJF) released the report, The Future of Nursing: Leading Change, Advancing Health, with the goal to assess and transform the nursing profession. Access articles on this topic for free. 
  • Nursing Tips
    Improve your nursing practice with our free nursing tips, including handy mnemonics, definitions, practice pointers, and more. 
  • Nursing News by HealthDay
    Keep up with the latest headlines in nursing news for free.
  • eNewsletters
    As a member of Lippincott’s NursingCenter.com, you can subscribe to any of our free eNewsletters and get the latest articles and CE activities delivered right to your inbox.
  • Skin Care Network Featured Clinical Updates
    On our Skin Care Network, access our free featured clinical updates from our favorite journal content. 
  • Skin Care Network Image and Video Libraries
    View the latest images and videos in clinical dermatology for free. 
  • Evidence-Based Practice Network Featured Articles
    Stay informed in evidence-based practice with our free featured articles. 
  • Evidence-Based Practice Podcasts
    Our free podcasts include evidence-based practice information from the American Journal of Nursing and our nursing conferences. 



3 days left!

clock February 25, 2014 05:03 by author Lisa Bonsall, MSN, RN, CRNP

Two of our most popular CE collections will be expiring on Friday, February 28, 2014. If you haven’t already taken advantage of these specially-priced collections, you should check them out ASAP!

Anticoagulant Medications
7.3 contact hours - $19.99
Expiration Date:  2/28/2014
When patients are on anticoagulant medications, significant safety concerns exist, especially the risk of excessive anticoagulation and hemorrhage. It is important to understand these risks yourself, as a healthcare provider, and to educate the patients in your care on how to minimize their risk and be alert for complications. 

NP: Pharmocology Hours
10.4 contact hours/10.4 advanced pharmacology hours - $44.95
Expiration Date:  2/28/2014
Depending on the state where you work as a nurse practitioner or your area of practice, it may be necessary for you to maintain a certain number of advanced pharmacology hours for your license or certification. 

Need more CE? See our complete list of topical CE collections and our special collections on ‘never events.’ Please be aware that the CE tests for each article must be taken before they expire.



Nurses On the Move: Part 2

clock February 21, 2014 04:25 by author Cara Gavin, Digital Editor

Welcome back to Nurses On the Move, where we shine a light on impressive nurses who go above and beyond in their profession and who serve as a role model to those around them.

Last week, you were introduced to Anne Dabrow Woods MSN, RN, CRNP, ANP-BC , the Chief Nurse for Wolters Kluwer Health/Medical Research and the publisher of the American Journal of Nursing and the Joanna Briggs Resources and Karen Innocent DNP, RN, CRNP, ANP-BC, CMSRN, the Executive Director of Continuing Education for Wolters Kluwer Health and the lead nurse planner of Lippincott’s continuing nursing education provider unit.

This week, discover what these Nurses On the Move see happening for the future of nursing and learn their best piece of advice to new nurses.

Q: What do you envision for the future of nursing?

Anne: Nursing will be the solution to the healthcare problems around the world. People need education on conditions, diseases, prevention, wellness, and how to optimize their life living with chronic diseases – that’s all nursing. As we switch to a wellness/holistic model of care, nursing will be the profession leading the charge, working hand in hand with the patient and other healthcare professionals to optimize quality, cost-effective care.

Karen: As the health delivery model continues to place an emphasis on health promotion rather than illness, there will be more career opportunities for nurses in primary care, ambulatory care centers, rehabilitation, and home care.

Q: For a nurse starting out, what would be your number one piece of advice?

Anne: It’s okay not to know everything, you just need to know where to find the answer. Confidence is not about knowing everything; it's about having the wisdom to know when and where to find the answers.

Karen: Find an area you like. Take time in your career to change your setting to find something more comfortable. New nurses need to adjust to the workload and stress level…but they need to know it does improve with their experience. Things won’t be as difficult.

Q: What do you see as a major obstacle/problem in the current nursing environment? 

Anne: As nurses, we don’t speak with one voice and don’t realize the importance of lifelong learning and education to move the profession forward and improve patient care.

Karen: Most nurses are employed by hospitals and have competing priorities. Feeling busy and overwhelmed is a problem. We need time management and prioritization skills.

Q: What do you hope for this Nurses On the Move blog? What types of nurses would you enjoy shining a light on?

Anne: I would like to see nurses that are making a difference in institutions, patient lives, and the community, that aren’t afraid to stretch beyond their comfort zone and really move the bar on healthcare excellence.

Karen: My hopes for the Nurses On the Move blog are to motivate nurses to pursue certifications and/or advanced degrees, to provide encouragement and support to newer nurses, and to highlight the accomplishments of nurses who are doing great things every day.

Do you know a great candidate to be featured for Nurses On the Move? We want to know about the nurses who are advancing the profession and inspiring others to do the same. We will feature a new nurse every month. Email your submissions to ClinicalEditor@NursingCenter.com.   



Nurses On the Move: Part 1

clock February 12, 2014 03:23 by author Cara Gavin, Digital Editor

We are so proud of the diversity of our membership here on NursingCenter.com. The educational background and experience of our members includes everyone from first-year nursing students to nurse practitioners and nurse executives, and every position and role in between. No matter where you are in your career, we know that many of you have gone above and beyond in your practice and modeled exceptional nursing professionalism for your colleagues and your patients. 

We want to hear from you, our members, and share your story (or perhaps you have a certain colleague in mind you’d like to nominate) for our new blog feature, Nurses on the Move. 

To start, we are recognizing the exceptional nurses who work right here at NursingCenter.com. 

Anne Dabrow Woods MSN, RN, CRNP, ANP-BC is the Chief Nurse for Wolters Kluwer Health/Medical Research and the publisher of the American Journal of Nursing and the Joanna Briggs Resources. With more than 30 years of nursing experience, she continues to work as a Nurse Practitioner in critical care, is adjunct faculty, and will earn her Doctorate of Nursing Practice from Texas Christian University this May.

 

 

Karen Innocent DNP, RN, CRNP, ANP-BC, CMSRN is the Executive Director of Continuing Education for Wolters Kluwer Health and the lead nurse planner of Lippincott’s continuing nursing education provider unit. She has grown Lippincott into the largest producer of CNE that is accredited by the American Nurses Credentialing Center. In 2013, Karen led the provider unit to Accreditation with Distinction. Karen earned her Doctorate of Nursing Practice from George Washington University in May 2013.

I sat down with these impressive nurses to learn why they love nursing, what motivates them to succeed, and where they see nursing going in the future. 

Q: Why did you choose nursing as a profession? 

Anne: Ever since I was a child, I’ve always wanted to help people. When I was 12, my father died of cancer [leukemia]; it changed me. I wanted to be a nurse and make an impact in people’s lives to improve their quality of life and help them achieve better outcomes. Being able to help people in the most difficult times in their lives is a humbling and rewarding experience. 

Karen: Actually, I didn’t. It was chosen for me. My mother was a nurse and so were six of her siblings. My father saw their independence and job security and wanted that for me. I made the conscious choice to be a nurse when I attended a conference as a student. I saw that nursing was an intellectual profession, more so than what I knew beforehand. I saw these nurses who were so educated, so intelligent. I thought, “I would like to be like that.” 

Q: What motivated you to go for your doctorate? 

Anne: Watching the evolution of healthcare, being a practicing Nurse Practitioner, and the Chief Nurse of this company, I needed to get as much knowledge about healthcare, where it's going, and learn how we as individuals and as a profession can make a difference. I know how to look at healthcare from a more global perspective now – I see the big picture.

Karen: I believe in the importance of lifelong learning, regardless of formal education vs. continuing education, or challenging work experiences. It’s important to improve practice and knowledge to improve care. Also, to get from one career level to another, you need more academic education. It is required now. 

Q: What has been your most difficult challenge related to patient care?  

Anne: Since I practice in critical care, the most difficult patient care challenge I face is quality vs. quantity of life. When a patient has decided he is ready to die, but the family is not ready for it; it creates a difficult and challenging position for everyone involved. We need to remember the patient is the captain of the ship and his decision is the one we need to follow. There needs to be more education with patients and families that quantity of life without quality is not acceptable. Everyone deserves to die the way they chose, with dignity and with their loved ones by their side giving support.   

Karen: It’s changing now, but the payer system – how insurance pays for care. Before, insurance companies decided what they paid for regardless of patient outcomes. I had a patient in home care whose insurance paid for a blood glucose meter, but not for the expensive strips. I wrote a letter to the company, explaining why this person needed close monitoring [and without the strips], the patient would have complications, possibly require hospitalization, and cost the company more money. The company changed their mind and started paying for the strips. Now quality and improved outcomes are required. I hope this reduces barriers providing quality care.

In Part 2, discover how these Nurses On the Move envision the future of nursing and learn their best piece of advice to new nurses.

Do you know the perfect candidate to be featured for Nurses On the Move? We want to know about special nurses who are doing great things within the profession and within the healthcare industry as a whole. We will feature a new nurse every month. Email your submissions to ClinicalEditor@NursingCenter.com.



AACN Choosing Wisely®

clock February 8, 2014 00:19 by author Lisa Bonsall, MSN, RN, CRNP

The Choosing Wisely® campaign was launched in 2012 by the American Board of Internal Medicine as a way to spark conversations to improve care and minimize unnecessary testing. The goals of the campaign are to ensure that care is supported by evidence; not duplicative of other tests or procedures already received; free from harm; and truly necessary (ABIM Foundation, 2014). Many organizations have released recommendations in support of the campaign – a full list is available here.

Last week, the American Association of Critical-Care Nurses (AACN) became the first nursing organization to get involved in the campaign. Its Choosing Wisely® list includes the following five evidence-based recommendations (American Association of Critical Care Nurses, 2014) :

  • Don't order diagnostic tests at regular intervals (such as every day), but rather in response to specific clinical questions.
  • Don't transfuse red blood cells in hemodynamically stable, non-bleeding critically ill patients with a hemoglobin concentration greater than 7 mg/dL.
  • Don't use parenteral nutrition in adequately nourished critically ill patients within the first seven days of a stay in an intensive care unit.
  • Don't deeply sedate mechanically ventilated patients without a specific indication and without daily attempts to lighten sedation.
  • Don't continue life support for patients at high risk for death or severely impaired functional recovery without offering patients and their families the alternative of care focused entirely on comfort.

As a nursing professional, I am proud to see AACN collaborate on this important initiative. I encourage you all to remain cognizant of these recommendations, share them with your peers, and stay up-to-date on the latest evidence.

For further reading, the articles below are available for free to logged in members of Lippincott’s NursingCenter.com.  Not a member?  Join now!

In the News: Rethinking Routine Blood Work in Patients with MI
American Journal of Nursing
 
Blood Management: Best-Practice Transfusion Strategies
Nursing2013
 
Parenteral Nutrition Risks, Complications, and Management
Journal of Infusion Nursing
 
Sedation Vacation: Worth the Trip
Nursing2013 Critical Care
 
Ethics in Critical Care: Twenty Years Since Cruzan and the Patient Self-Determination Act: Opportunities for Improving Care at the End of Life in Critical Care Settings
AACN Advanced Critical Care
 
Hoping for the Best, Preparing for the Worst: Strategies to Promote Honesty and Prevent Medical Futility at End-of-Life
Dimensions in Critical Care Nursing

References:

ABIM Foundation. (2014). About. Retrieved from Choosing Wisely: http://www.choosingwisely.org/

American Association of Critical Care Nurses. (2014, January 28). News: Critical Care Groups Issue 'Choosing Wisely' List. Retrieved from American Association of Critical Care Nurses: http://www.aacn.org/wd/publishing/content/pressroom/pressreleases/2014/jan/choosing-wisely-aacn-ccsc.pcms?menu=aboutus



More Nurses are Advancing Their Education

clock December 7, 2012 05:37 by author Lisa Bonsall, MSN, RN, CRNP

“Learning is one of life’s most essential activities.” — Annie Murphy Paul

Enrollment in all types of professional nursing programs increased from 2011 to 2012, according to new survey data from the American Association of Colleges of Nursing. These findings are based on data reported from 664 of the 856 nursing schools in the U.S. with baccalaureate and/or graduate programs.

The survey also saw a 3.5% increase in entry level Bachelor of Science in Nursing programs. The number of students enrolled in RN-to-BSN programs increased by 22.2% from 2011 to 2012, which, according to the AACN, signals a growing interest for baccalaureate-prepared nurses from both nurses and employers.

"AACN is pleased to see across-the-board increases in nursing school enrollments this year, given our commitment to encouraging all nurses to advance their education as a catalyst for improving patient care," said AACN President Jane Kirschling in a press release. "As the national voice for professional nursing education, AACN is committed to working with the education and health care community to create a highly qualified nursing workforce able to meet the expectations and challenges of contemporary nursing practice."

A few other interesting survey findings:

  • Enrollment in master’s and doctoral degree programs increased “significantly.”
  • Survey data indicated an 8.2% jump in enrollments for nursing schools with master’s programs (432 institutions reported data).
  • Doctor of Nursing Practice programs saw a 19.6% enrollment increase (166 schools reported data).
  • Baccalaureate nursing graduates are more than twice as likely to have jobs at the time of graduation than those entering the workforce in other fields.
  • Graduates from master’s degree programs (MSNs) were most likely to have secured jobs at graduation (73%).

"Momentum is clearly building for advancing nursing education at all levels,” Kirschling said in a press release. “Given the calls for more baccalaureate- and graduate-prepared nurses, federal and private funding for nursing education should be targeted directly to the schools and programs that prepare students at these levels."

"Further, achieving the Institute of Medicine’s recommendations related to education will require strong academic-practice partnerships and a solid commitment among our practice colleagues to encourage and reward registered nurses committed to moving ahead with their education."

This post was written by Erica Moss, who is the community manager for the online masters in nursing programs at Georgetown University.



Healthcare Policy – An interview with Dr. Carole Eldridge

clock August 30, 2012 16:36 by author Lisa Bonsall, MSN, RN, CRNP

Last week I had the privilege of speaking with Carole Eldridge, RN, DNP, CNE, NEA-BC, Director of Graduate Programs at Chamberlain College of Nursing. This fall, Chamberlain is launching a new Masters of Science in Nursing Healthcare Policy Track and I was particularly interested in learning more about Dr. Eldridge, as I’ve been following her on twitter for years (@Nerdnurse), and about this new MSN track.

I was more than impressed when I asked Dr. Eldridge to share her nursing background with me. In a nutshell, after about 15 years in acute care (including critical care, post-surgical care, hemodialysis, and transplant), Dr. Eldridge and her husband moved to Africa for about a year to run a health clinic. When she returned to the U.S., she started a Home Health and Hospice Agency which grew into about 50 agencies in 4 states! After selling this business, Dr. Eldridge became interested in education and saw a need for training nurse aides. She started her own publishing company which developed training packets. After selling this company, Dr. Eldridge returned to school herself for her MSN in Leadership and Healthcare Business, and later her DNP. She taught for about 3 years, and since then has held various titles including Director of a Master’s program, Dean, and Campus President. Wow!

In her current role, Dr. Eldridge oversees all of the graduate programs at Chamberlain College of Nursing. As previously stated, this fall, a new Healthcare Policy track is available for MSN students. The development of this track is timely in the wake of the report from the Institute of Medicine – The Future of Nursing: Leading Change, Advancing Health – and as we approach a Presidential election here in the United States. An MSN in Healthcare Policy will prepare nurses to be active in bill and policy writing, foundations, education and training, academia and research, disease investigations, health services, and other positions where one can “Impart the voice of nursing to direct the path of healthcare policies that benefit patients, the community, our nation and the world.”

This particular program involves 6 core courses (foundational concepts, theory, informatics, leadership, research, and basic healthcare policy) and 6 specialty courses (healthcare systems, economics, global health, nurse leadership and healthcare policy, healthcare policy practicum, and a capstone project).  When asked for more details about the capstone project, Dr. Eldridge gave me several examples that students from similar programs have done, such as global health projects, legislative proposals, and oral testimony collaboration. The coursework is flexible, can be completed in 2 years, and is completely online.

My favorite part of our conversation had to be discussing the upcoming election. Dr. Eldridge reminds us that as nurses, we have a responsibility to be politically engaged in order to best advocate for our patients. In particular, we need to be alert to the following:

  • Economics – how will healthcare be funded? 
  • Affordable Care Act
  • The aging population, including funding their care & medical devices
  • “Equitable access”
  • Epidemiology
  • Vaccines
  • Global Healthcare 

Remember, Florence Nightingale was our first political activist. As nurses, let’s remain educated about the issues and share our voice. We are more than 3 million strong – it’s important that we are heard!

Resources:

The Future of Nursing: Leading Change, Advancing Health 

Keeping Health Care Reform Healthy, Patients Informed (American Nurses Association) 

ANA’s Policy and Advocacy page 

ANA's Nurses Strategic Action Team (N-STAT)



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