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NursingCenter’s In the Round

A dialog by nurses, for nurses
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Who are “The Ebola Fighters?”

clock December 10, 2014 07:19 by author Lisa Bonsall, MSN, RN, CRNP

They are nurses. They are physicians. They are caregivers. They are scientists.

And as Time’s Person of the Year 2014, “The Ebola Fighters” are “The ones who answered the call.” These are the people who answer the call every day, putting themselves at risk without always knowing what those risks are. These are the people who feel it is an honor and a privilege to care for others during times of crisis and uncertainty. These are the people who thrive on answering tough questions and making tough decisions. 

It is wonderful to see this group recognized for their work. I am hopeful that this recognition will inspire The Ebola Fighters to continue this battle and will motivate others to join as well. We must all stay informed and follow recommendations to keep ourselves, our patients, and the public safe.

Congratulations to The Ebola Fighters – true heroes, deserving of our utmost respect and gratitude. 



World AIDS Day 2014

clock December 1, 2014 09:00 by author Lisa Bonsall, MSN, RN, CRNP

Over the past four decades, human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) have evolved from a global epidemic into a chronic disease. Screening methods, prevention recommendations, treatment options, and prognosis have evolved as well. As nurses, we care for patients with HIV and AIDS in every setting, are involved with public education, and participate in research. 

Today, December 1, 2014, is World AIDS Day – “an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died.” Many of us care for patients with HIV/AIDS in our practice, whether we work in a setting dedicated to treating this patient population or not. We must all remain vigilant in staying updated and making sure our patients and the public are informed.

Several articles have been published in our journals over the past year, which I think you will find informative and applicable to your practice. Take some time to review these articles and learn more about HIV and AIDS and improving care and outcomes for patients. 

 HIV Infection and its Implication For Nurse Leaders
Nursing Management, October 2014

The Synergistic Effects of HIV, Diabetes, and Aging on Cognition: Implications for Practice and Research 
Journal of Neuroscience Nursing, October 2014

Wounds in Patients with HIV
Advances in Skin & Wound Care: The Journal for Prevention and Healing, September 2014 

Nursing in the Fourth Decade of the HIV Epidemic  
American Journal of Nursing, March 2014

A Combination Drug for HIV Prevention in High-Risk Groups 
American Journal of Nursing, August 2014

For more reading on this subject, we also have a specially-priced CE collection on HIV and AIDS



Nurse On the Move: JoAnne Phillips

clock November 4, 2014 03:24 by author Cara Gavin, Digital Editor

“Nursing is the toughest job you will ever love.” JoAnne Phillips MSN, RN, CCRN, CCNS, CPPS, recognizes that hard work can produce gratifying results. As a manager of quality and patient safety at Penn Home Care & Hospice Services, a clinical informatics professional development specialist at the University of Pennsylvania Health System, and a doctoral student working towards her DNP at Vanderbilt University, Phillips doesn’t take her role as a nurse lightly. She is constantly looking to improve the quality of life of those around her, which is why she is our next Nurse On the Move

Phillips preiously served as a clinical nurse specialist in the transition, surgical critical care, and patient safety departments of the University of Pennsylvania. She earned her master’s degree in science in critical care nursing from Widener University, and prior to that, she served as a clinical instructor and staff nurse at Hahnemann University Hospital. 

Through our interview, I learned why Phillips chose to go back to school, as well as why she sees nursing as the best job to make a difference in a person’s life. 

Q: What made you choose nursing as a career?
A: When I was hospitalized as a child, I watched what the nurses were doing and I thought that is what I wanted to do. When I was older, I worked as a volunteer in the neonatal intensive care nursery. Then I knew that was what I wanted to do. I can’t exactly say it was a calling, but pretty close. 

Q: What is your favorite aspect of being a critical care nurse?
A: I had the opportunity to work at the Shock Trauma Center in Baltimore, where I truly learned the impactful role that a primary nurse could play in the patient’s outcome.  Patients could be incredibly sick, and I knew that the best medical care partnered with the best nursing care could lead to the best patient outcomes. As a lifelong learner, I thrived on the constant opportunity to learn more in critical care. 

Q: You specialize in patient safety. What is the biggest concern you have regarding the well-being of patients and how are you combatting it?
A: I don’t think patient safety is one issue, but a virtual kaleidoscope of issues. We need to better understand how systems work together and the role human factors (how we interact with processes and technology). Since humans will always be part of the equation, we need to know that there will be mistakes. Our role as safety leaders is to make it less likely that humans will make a mistake. Something I tell my colleagues, “If we make it easy for people to do the right thing, they will do the right thing.  If we make it too complex, they will do workarounds.” That is often where we see negative outcomes. 

Q: In your role as a clinical informatics educator, why do you feel informatics is important to nursing?
A: I would encourage nurses to work toward letting the computer work for you, instead of you working for the computer. We hear from staff that documenting in the computer is too hard. My response is that we have not designed the system correctly. One of the staff told me it takes eight clicks to chart a dirty diaper – a great example that we have made it too hard. Bottom line is [computers] are here to stay; [they are] an unbelievable resource of information.  Once we have better interoperability (computer systems talking to each other), it will be awesome. 

Q: You are working towards earning your DNP. What made you decide to go back to school?
A: The more I learn about patient safety, the more I realize to work toward a solution, I needed to understand even more about systems. My DNP program is focused on health systems management, and I believe it will position me to take a leadership role in patient safety, to mentor and develop many others to understand how we can create a safe environment for our staff and patients. 

Q: What is the most vital thing a nurse can do to improve their career?
A: To be a nurse today, I think you need to be a lifelong learner. Not just in an academic setting, but through ongoing personal and professional development. There are endless opportunities for nurses to learn and develop – conferences, memberships in professional organizations, online learning.  If finances are a struggle, many of these opportunities are free.   

Q: What do you see for the future of nursing?  
A: Nurses are the solution to the future of healthcare. We spend 75% of our healthcare dollars on chronic care. There is no one better positioned to manage patients with chronic, complex medical issues than a nurse. We need to create an environment that will draw and keep the best people in nursing. What better job is there than to know that you made a difference in someone’s life? Even if that difference is helping them to a peaceful death. As many have said before, nursing is the toughest job you will ever love. 

Do you work with a nurse that inspires you? Nominate them to be our next Nurse On the Move by emailing submissions to ClinicalEditor@NursingCenter.com.



Ebola: Keeping Perspective

clock October 17, 2014 08:21 by author Lisa Bonsall, MSN, RN, CRNP

Our NursingCenter team has been following the Ebola outbreak closely over the past months, but with recent developments of disease transmission here in the United States, media coverage has increased and protocols and recommendations are being closely examined. As nurses, we play an important role in patient and public education, and it is important that we continue to act with compassion and skill while gathering our knowledge from reputable sources and keeping recent developments in perspective.

Nina and Amber
My thanks and best wishes for a quick recovery go out to Nina Pham and Amber Vinson, two nurses who contracted the Ebola virus while caring for Thomas Eric Duncan, the infected patient who died on Oct. 8, 2014.  I commend your dedication and compassion. I am proud of you.

Nurses and other healthcare providers
To those of you caring for Nina and Amber, those already in or heading to West Africa to help with the outbreak there, and those studying current guidelines and possible systems issues, thank you. I am confident that your hard work will make a difference here and abroad, and that best practices for the safety of patients, healthcare providers, and the public is the priority. 

Stay informed
As a nurse, I will continue to look to professional organizations for the latest information and guidance. The Centers for Disease Control and Prevention has a long list of guidelines and checklists for U.S. health professionals. The Global Alert and Response of the World Health Organization includes up-to-date news and facts, frequently asked questions, and preparedness guidance. The National Institutes of Health also lists facts about the virus as well as the latest developments of research on prevention, treatment, and detection. 

I encourage you all to stay up-to-date and share your knowledge with your patients and the public. Refer to the sites above or to our Ebola page on NursingCenter (which we update daily with information from the above sites). Our colleagues at the American Journal of Nursing have also shared valuable insights from a nurse epidemiologist, who addresses the concerns surrounding personal protective equipment, and a nurse informaticist, who looks at the role of electronic health records in handling the Ebola outbreak.

Moving forward
I had the pleasure of spending the past week at Nursing Management Congress and was in the company of over 800 nurse leaders from around the country as the news of Ebola virus transmission in the U.S. unfolded. Themes from the general sessions included a focus on restoring pride in nursing, believing in team members, and dealing with root causes instead of putting out fires. I think these themes are appropriate as we face this new challenge in healthcare. 



CSASWC 2014

clock October 7, 2014 03:58 by author Lisa Bonsall, MSN, RN, CRNP

What a pleasure it was to spend some sunny days in Las Vegas last week for the Clinical Symposium on Advances in Skin & Wound Care! From the General Sessions and Breakout Sessions to the Exhibit Hall and Poster Presentations, there was much learning and networking going on! Here are some highlights from the conference…

Clinical Pearls
“Most pressure ulcers are avoidable; not all pressure ulcers are unavoidable.”
What About Unavoidable Pressure Ulcers is Unavoidable?
Diane K. Langemo, PhD, RN, FAAN & Laura Edsberg, PhD

“Forty-five percent of all adverse drug reactions are manifested in the skin.”
Skin and Wound Assessment from a Dermatologic Perspective
Mary Gloeckner, MS, RN, CWON, APN & Jennifer Gloeckner Powers, MD

“Controlled inflammation is beneficial to wound healing.”
MMPs and How Collagen Balances Them to Break the Chronic Cycle of ECM Degradation 
Gregory Bohn, MD, FACS, FACHM & Greg Schultz, PhD

“No wound is going to heal on a swollen limb.”
Navigating Current Practices in the Treatment of Skin Tears
Kimberly LeBlanc, MN, RN, CETN(C) & Sharon Baranoski, MSN, RN, CWCN, APN, MAPWCA, FAAN

Poster Winners
Category: HBOT
Poster #42: Clinical Effectiveness of Hyperbaric Oxygen Therapy
Authors: Supaporn Opasanon, MD, Warut Pongsapich, MD, Dr Med, Sitthichoke Taweepraditpol, MD, Bhoom Suktitipat, MD, PhD and Apirag Chuangsuwanich, MD

Category: Education/Systems/Other
Poster #128: Identifying Cocaine-Induced Necrosis
Author: Nancy Bodycote, RN, BSN, CWCN

Category: Original Investigations
Poster #82: Strict Protocol-Based Approach to Treat Pressure Ulcers in Spinal Cord Injury Patients – An Outcome Analysis
Authors: Umar H. Choudry, MD, Mary Murphy, RN, MA, CWOCN, Ryan Mello, PhD, and Jean Dominique Morancy, MD

Category: Case Study/Series
Poster #77: Surgical Incision Management System with Customizable Dressing Following Immediate Postmastectomy Breast Reconstruction
Authors: Allen Gabriel, MD and Steven Sigalove, MD

Exhibit Hall

Exhibit hall hours allowed us to connect, network, and dine with colleagues, attendees, and exhibitors. You can see more photos from this event here

 

Hope to see you next year in New Orleans! 

 




NursingCenter Named Top Blog for Nurses

clock October 2, 2014 04:56 by author Cara Gavin, Digital Editor

Last week, NursingCenter’s In the Round was named one of the Top 100 Nursing Blogs by BestMedicalAssistantPrograms.org, and we couldn’t be more excited! Listed among a variety of blogs dedicated to nursing students, RN’s, NP’s, educators, travel nurses, and more, our blog is described as a site “dedicated to helping nurses be the best workers they can be.” Three of our recent posts are also cited as favorites, including:

Directing Nurses Back to Patient Care
Technology and Global Health: A Nurse Presents for the U.N.
Nurses Who Led the Way: Florence Nightingale

We are honored to be a part of this list and to be featured among some of the best blogs for nurses out there. We want to ensure the nursing community stays connected, so here is a list of our favorite blogs for nurses (these are listed in alphabetical order): 

AJN Off the Charts
ANS: Advances in Nursing Science Blog
CorrectionalNurse.net
JParadisi RN's Blog
Not Nurse Ratched 
Nurse Code
The Adventures of Nurse Niki
What Should We Call Nursing 

Thank you to all of the sites that have included us as a top resource for nurses in the past, including OnlineLPNtoRN.org, OnlineColleges.com, CorrectionalNurse.net, LVNtoRN.net, and Jacksonville University’s School of Nursing. We are grateful for the recognition and aim to continue to provide excellent content for nurses. 

What are some of your favorite nursing blogs? Leave them in the comments below! 



Join our nursing community!

clock September 30, 2014 02:54 by author Cara Gavin, Digital Editor

Since starting at Lippincott’s NursingCenter.com this past January as their Digital Editor, my favorite part about my job is talking with our nurses and members. I really enjoy the sense of community I get from speaking with nurses, whether it is in person at one of our conferences, over the phone at my desk, or on this blog. 

Another great resource for our community is our social media sites.  Both our Clinical Editor, Lisa Morris Bonsall, MSN, RN, CRNP, and myself regularly update our accounts and use them as important tools to reach out to our nurses. I love seeing what people are talking about, how they are responding to current issues, and getting feedback from our followers. 

Social media is one of the best ways to reach us, so I invite you to join our nursing community by following us on Twitter @NursingCenter or @CaraGavin, Google+, Facebook, and LinkedIn. We want to hear from you! 



Nurses On the Move: Paula Roe

clock September 19, 2014 04:55 by author Cara Gavin, Digital Editor

As fall gets underway and nurses head back to school, it’s important to look at how academic and professional education can shape a nurse in different ways.

September’s Nurse On the Move, Paula Roe BSN, MBA/HCM, FACHE, has a unique experience with nursing. She currently serves Simpler Consulting as a senior advisor - where she helps clients achieve sustainable breakthrough improvements in care quality, productivity, and cost reduction by applying process improvement techniques to daily operations – and operational excellence practice leader, responsible for Simpler’s internal process improvement.

She previously spent six years as the vice president of operations for St. Elizabeth Healthcare, a regional hospital system located in northern Kentucky. Before that, Roe spent 13 years with the Toyota Motor Engineering and Manufacturing American, where she learned the tools of the Lean management trade.Roe’s experiences have shaped her perspective as a nurse and operations leader. Through our interview, I discovered how these different settings impacted her thoughts on nursing and patient care. 

Q: Why did you choose to receive your BSN and start your nursing career?
A: A career in nursing was not my original plan. When I enrolled at Ohio State University, I was on course for a degree in engineering. By my sophomore year…I was forced to take the pre-medical school-level anatomy class to fulfill an undergraduate requirement. As soon as the class was underway, I knew I was hooked. I soon met with my advisor and found that nursing was the best match for me.

Q: You went on to manage a CTU/SICU department of a hospital. How did this shape your decision to earn your MBA in health care management?
A: Early in my nursing career, I was involved in staff nurse counsel and had the opportunity to present to hospital administration on a regular basis. I really enjoyed this interaction and pursued hospital administration as department manager of the CTU/SICU. When I went to work for Toyota as a safety, health and environmental administrator, I never lost that dream of working in healthcare administration. Lucky for me, Toyota offered MBA programs on campus, and I was able to earn my master’s degree specifically for healthcare management. 

Q: Please describe what Lean management means to you and why you believe it’s an important tool for nurses to use?
A: Lean is all about delivering value to the customer. From a nursing perspective, the customer is the patient and the patient’s family. When you think about nursing and the tenants of Lean – striving for zero defects, the relentless pursuit of value, and the delivery of service in the least wasteful way – the two are necessarily harmonious…The delivery of care is spending time with the patient and delivering care value. We need to relentlessly pursue the elimination of wasteful steps, challenging our day-to-day activities to spend more time with patients and deliver the best care in the least wasteful way. 

Q: In your role at Toyota, how did Lean management practices and role process improvement techniques shape your perspective as a nurse and operations leader?
A: When you start a career with Toyota, you start a lifelong journey of hands-on learning. The training advances as you practice and apply these Lean skills. Lean is also a team-based model; it allows teams to bring their ideas and thoughts together so the whole group is focused on what matters most. But with Lean, the team makes decisions together on execution and output as well. And action is immediate, meaning you are able to achieve breakthrough results within a very short time. I very quickly saw how Lean’s team-based approach could be applied to the nursing world.

Q: How do you define a nurse leader?
A: I came across not long ago a quote from renowned leadership expert Dr. Stephen Covey: “Leaders do what’s right and managers do the right thing.” To me, a nursing leader is one who does what’s right for his or her staff, the patient, the organization, and the population served.. 

Q: What do you see for the future of nursing?
A: I believe that nursing will continue to be developed from within the profession and innovative ways to deliver care and patient treatment models will emerge. But, nurses will have to also look outside of nursing for solution approaches. I foresee Lean and other management techniques more widely accessed. I believe the pace of change in the industry is going to require new and breakthrough ways of looking at things, and traditional improvement approaches are going to be challenged. As Einstein said, “Insanity is doing the same thing over and over again and expecting different results.” In nursing, we’ll need to think outside of the traditional nursing box to eliminate waste and to ultimately spend more by the patient bedside.

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.



What are all those letters and how can I get them?

clock September 14, 2014 09:07 by author Lisa Bonsall, MSN, RN, CRNP

BSN, RN-C, APHN-BC, PPCNP-BC, DNP… There are so many opportunities for furthering your nursing education. Whether it’s achieving a new academic degree or getting certified in your specialty, we’ve got resources to share with you! Take some time to explore these FREE resources on Lippincott’s NursingCenter!

Focus On: Achieving Your BSN
Learn why now is the time to return to school, and gain advice on overcoming barriers that are in your way. 

Focus On: Achieving Your Advanced Nursing Degree
With options such as online programs and employer-based incentives, achieving an advanced degree in nursing is within reach. 

Nursing Certification Boards By Specialty
Certification in a nursing specialty demonstrates a commitment to advancing one’s knowledge and skillset. 

Good luck to you in your future educational endeavors!



Enterovirus-D68

clock September 8, 2014 08:34 by author Lisa Bonsall, MSN, RN, CRNP

In the Midwest,  an enterovirus, known as EV-D68, is causing concern. While not a new virus, EV-D68 has recently caused severe respiratory symptoms in affected children in Missouri, and several other states have contacted the CDC for assistance with a possible regional outbreak as well. These are Colorado, North Carolina, Georgia, Ohio, Iowa, Illinois, Missouri, Kansas, Oklahoma, and Kentucky. Symptoms of a common cold are typical at the onset of EV-D68, however the development of fever, rash, or dyspnea – particularly in children with asthma – is occurring and necessitating hospitalization, and in some instances, ICU admission. 

While details continue to be released, please remember your role in patient education and infection control. Tell parents and caregivers about these symptoms of EV-D68 and advise them to seek care for their child if fever, rash, or breathing difficulties develop. Also, share these basics of infection control:

  • avoiding close contact with people who have respiratory symptoms, such as coughing or sneezing
  • staying home when sick
  • washing hands often with soap and water for 15 to 20 seconds or using alcohol-based hand cleansers 
  • not touching eyes, nose, or mouth 
  • keeping surfaces and objects (especially tables, counters, doorknobs, and toys) that can be exposed to a virus clean
  • practicing other good health habits, including getting plenty of sleep, staying active, drinking plenty of fluids, and eating healthy foods

As more details are released, we’ll be sure to keep you informed! 

Update 9/16/14 - More states have reported EV-D68 infections. Please visit our page on this topic for more information and resources!

Reference:

Bonsall, L. (2009). Be prepared for H1N1 flu. Nursing Made Incredibly Easy!, 7(6).




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