Friday, December 31, 2010

Primary care needs more than 15 minutes for patients, KevinMD.com

Psychotherapy appointments have traditionally lasted 50 minutes with 10 minutes for paperwork. This has lead to the expression, “the 50-minute hour”.

More recently there has been talk of incorporating psychotherapy techniques in brief visits in primary care. The provoking title “The Fifteen Minute Hour” is from a book about addressing the emotional aspects of disease in primary care during brief appointments. The title and the concept seem relevant to much of what we do in my specialty.

In primary care we seldom spend more than 15 minutes at a time with an established patient. Yet we are required to cover infinitely more details and consider more outside authorities in every visit today than when I first started practicing medicine. Between health insurance and office administration, there are now many more mouths to feed from the office charges than there were then. Sometimes it feels like we are not alone in the exam room even for the short time we do have.

Except for doctors in concierge medicine or micropactices, most of us cannot change the amount of time we have with each patient. Even if we hope to change the system, the patients we see today deserve the best we can give them in today’s 15-minute visits.

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Thursday, December 30, 2010

25 Surprisingly Salty Processed Foods - Health.com

The average person in the U.S. consumes 3,500 milligrams of sodium a day. That’s equivalent to almost 9 grams of salt, or nearly 2 teaspoonfuls—way more than the 2,300 milligrams per day suggested by the Dietary Guidelines for Americans.

But the majority of excess salt, or 77%, isn’t spooned into your food—it comes from processed foods.

The FDA recently announced a plan to gradually scale back on salt in processed foods, which may be the end of the line for super salty products.

In the meantime, keep an eye out for excess sodium and adjust your intake accordingly. Check out these 25 hidden salt traps you can find lurking in the grocery store.

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Beauty and Sleep Deprivation: The Science Behind Beauty Rest - ABC News

Swedish researchers say there's an important link between sleep and your physical appearance. In a study published today in the British Medical Journal, researcher John Axelsson and his team at the Karolinska Institute in Stockholm found that sleep-deprived individuals appear less healthy, more tired, and less attractive than those who have received a full night's worth of sleep.

"Sleep is the body's natural beauty treatment," Axelsson said. "It's probably more effective than any other treatment you could buy."

Subjects Photographed Before and After Sleep Deprivation

In the study, 23 healthy adults from ages 18 to 31 were first photographed after eight hours of sleep, wearing no makeup. The same adults were photographed again after sleeping only five hours and being kept awake for a full 31 hours, with the same lighting and camera settings.

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Shoveling Snow? How to Protect Your Back (and Your Heart) - Chronic Pain - Health.com

Snow and ice can make driving treacherous, of course, but snowfall—especially the wet, heavy kind—can be dangerous even if you never leave your driveway. Each year, shoveling piles of snow after a storm is believed to cause tens of thousands of back and shoulder injuries in the United States, not to mention several hundred heart attacks.

Overall, more than 70,000 people ended up with a shoveling-related injury bad enough to trigger a doctor’s visit in 2008, according to the Consumer Products Safety Commission. A quarter of those people visited an emergency room, and about 900 were admitted to a hospital.

The exertion, cold weather, and slippery surfaces snow shovelers face are a dangerous combination, especially if it’s an activity you’re not used to. Snow shoveling "is one of the most high-intensity exercises you can do," says Suzanne Steinbaum, DO, a preventive cardiologist at Lenox Hill Hospital, in New York City. "You’re using all your major muscle groups."

But there are steps you can take to shovel safely and ensure that you survive the winter in one piece.

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Wednesday, December 29, 2010

In Praise of Nurses - NYTimes.com

I love and admire nurses.

Oncology nurses and ostomy nurses. Radiation nurses and post-op nurses. And those essential, always-there-when-you-need-them, round-the-clock nurses. (And though most of my experience is with female nurses, I admire male nurses, too.)

Now this isn’t some abstract infatuation, based on seeing “South Pacific” one too many times. I’ve been hospitalized six times in my life, and the medical personnel I came to know best — and like best — were the nurses.

To generalize: Nurses are warm, whereas doctors are cool. Nurses act like real people; doctors often act like aristocrats. Nurses look you in the eye; doctors stare slightly above and to the right of your shoulder. (Maybe they’re taught to do that in medical school?)

My most recent dependence on nurses came in 2008 and early 2009 as I was treated for an aggressive Stage 3 prostate cancer. But more about that later.

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Study: Surgical Delays Have Profoundly Adverse Impact | National Nursing News

A new study emphasizes why caregivers must work to minimize delays in certain elective surgical procedures for patients who have been admitted to the hospital.

Delays substantially increase the risk of infectious complications and raise hospital costs, according to a comprehensive study in the December issue of the Journal of the American College of Surgeons.

Using a nationwide sample of 163,006 patients ages 40 and older between 2003 and 2007, the authors evaluated patients who developed postoperative complications after one of three high-volume elective surgical procedures: coronary bypass graft, colon resections and lung resections.

For each type of procedure, according to the researchers, infection rates increased significantly from those performed on the first day of admission to those performed a day later, two to five days later and six to 10 days later. With each procedure, there was a difference of at least 10 percentage points between infection rates performed on the day of admission and those performed six to 10 days later.

Delays also increased total hospital costs from $36,079 to $47,5237 for CABG, $20,265 to $29,887 for colon resections and $26,323 to $30,571 for lung resections.

The occurrence of infection after surgical procedures remains a major source of ill health and expense despite extensive prevention efforts via educational programs, clinical guidelines and hospital policies, according to the researchers.

The analysis “confirms a direct correlation between delaying procedures and negative patient outcomes,” lead author Todd R. Vogel, MD, MPH, FACS, assistant professor of surgery at the University of Medicine & Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, said in a news release.

“As pay-for-performance models become increasingly prevalent, it will be imperative for hospitals to consider policies aimed at preventing delays and thereby reducing infection rates.”

Patients more likely to experience in-hospital surgical delays were age 80 and older, female and minorities. They had existing health issues such as congestive heart failure, chronic pulmonary disease and renal failure.

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Sunday, December 26, 2010

Jonas Center Quantifies Impact of Nursing Faculty Shortage | All Sites Nursing News

The shortage of nurse educators could affect the care of millions of patients, according to estimates by the Jonas Center for Nursing Excellence.

Each nurse educator position left unfilled could impact healthcare for 3.6 million patients, according to the report. Schools with baccalaureate nursing programs have about 900 faculty vacancies, with thousands more likely to arise in the next 15 years.

Darlene Curley, RN, MS, executive director of the Jonas Center for Nursing Excellence, and Christine Kovner, RN, PhD, FAAN, professor at New York University College of Nursing, developed a formula to measure the impact of nursing faculty vacancies on patients. They considered the average number of students taught by one faculty member and the number of patients cared for by a typical RN. They note that their estimates are conservative.

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7 Biggest Diet Myths | LiveScience

Bathing suit season is just around the corner and every friend has a new diet tip. But does science back them up? Here are some of the most popular diet myths that make scientists shake their heads.

--Robin Nixon, LiveScience Staff Writer

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What Made You Decide To Start Your Own Business?, Nursing Entrepreneurs, Nurse-Owned Businesses, Woman-Owned Enterprises

New!

What made you decide to start your own business? The natural ability to initiate change and willingness to work long hours until the job was complete. I did this for the college, worked 60 hour weeks for 40 hour pay, was responsible for everything but received no recognition and no pay raise. After 4 years of teaching nursing and nursing in the hospital 15 years for such a low pay scale I realized I would have to take matters in my own hand to find my way to the wealth I desired.I am passionalte about my Nursing Entrepreneurial Career and desire to help nurses all over find the security, satisfaction in their nursing career as I have found. That's why I created Nursing Success System, a system or method of conducting business that has already been proven to succeed.

Tracy McClelland, RN, MSN, Ycarte Health Career Center, Georgia Nursing Entrepreneurs:"Opening doors to the Nursing Profession is our primary concern. We are a nursing tutorial facility designed to assist our community by training healthcare professions with the most updated nursing information and training equipment. We focus on assisting individuals who want to advance in the healthcare profession, or begin with an entry level into healthcare. Our goal is to bring education to you in a comfortable non-threatening environment that allows for learning. Whether you are new to healthcare or desire to advance in this profession, we can provide you with the training you need."
Tracy McClelland, RN, MSN, Ycarte Health Career Center
North Pointe Plaza
1214 North Peterson Ave. Suite P
Douglas, GA 31533
Phone: (912) 384-8680
Fax: (912) 384-4390
info@ycartehealth.org
http://www.nursingentrepreneurs.com/mcclelland

Categories: ACLS (Advanced Cardiac Life Support)
Adult Critical Care Nursing
BLS (Basic Life Support)
Career Alternatives For Nurses
Certification for Nurse Aid Students
Certification Program for Nurses
Continuing Education Provider
Critical Care Nurses
EKG Technician (New Class)
ER
Georgia Nurse Entrepreneurs, Nurse Owned Businesses
Geriatrics Nurses
Intensive Care Unit (ICU)
Masters Prepared Nurses
Medical/Surgical Nursing
Motivational speaker
Motivational Workshops
NCLEX-Reviews for RN's & LPNs
Neonatal Intensive Care Unit (NICU) Nurses
Nurse Aid Training Provider
Nursing Education
Nursing Entrepreneur
Nursing Educators
Nursing Educators
Nursing Workshops for CE hours
Operating Room (OR)
Pediatric Intensive Care Unit (PICU) Nursing
Pediatrics Nurses
Professional Nurse
Public Speaker
Remediation NCLEX Review (One- on- One)

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Frustration with the system and with constant mergers and buy-outs.

    Lucille "Lou" Addington, RN, CLNC, Florida:"We do medical-legal consulting for attorneys, insurance companies and HMO's, and private individuals. Presuit investigations and affidavits. Expert witness location. Special interest in vaccine damage cases and long term care/elder care issues. My associate and I bring a combined 42 years of professional nursing practice to our cases."
    http://www.nursingentrepreneurs.com/addington

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    What made you decide to start your own business? The desire for greater independence and challenge in my professional career.

    Rhonda K. Alfredson RN CLNC CRRN CCM COHN, Georgia Legal Nurse Consultants:"Discovery Partners provides a multitude of comprehensive nurse consulting services to attorneys, small and large businesses, and insurance companies. Services include Legal Nurse Consulting (med. mal, PI, WC, toxic torts, fraud, soc. security, PL, criminal, gen. negligence) , Disability and Workers' Compensation Case Management, Hearing Conservation Program Consultation and Administration, Ergonomics Consultations, Occupational Health Services Consultation, Medical/Health Related Educational offerings, as well as other consultative and support services."
    P.O. Box 555
    Conyers, Georgia 30012
    Phone number: 770-602-4531
    http://www.nursingentrepreneurs.com/dpclnc

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    What made you decide to start your own business?: Dissatisfaction with current situation.

    Dominique Ann Bernard, RN, BSN, Virginia Nurse Entrepreneurs:"My goal is to work from home. Currently I am employed in a psychiatric facility and I work part time in a geriatric setting. My interests are varied."
    http://www.4nursing.com/bernard

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    What made you decide to start your own business?: Fascinated with the industry

    Sheryl D. Bisson, R.N.,, California Legal Nurse Consultants:"I offer services to aid in the resolution of medical-legal issues. I work for law firms, insurance companies and healthcare facilities. My services include, but are not limited to: medical record review and analysis; identifying applicable Standards of Care and deviations from the Standards; identifying records, policies and procedures and other essential documents for complete case reviews."
    Specialty Areas: Coronary Care, Health law, Intensive Care, Medical Malpractice, Personal Injury, Worker's Compensation
    http://www.nursingexperts.com/bisson/

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    What made you decide to start your own business? Flexibility in scheduling; retirement of senior partner with whom I have worked for many years.

    Michelle L. Callan Nurse-Attorney:"Medical-legal consulting and trial assistance to attorneys for Personal Injury and Medical Malpractice cases."
    13 Anchor Terrace, Rochester New York 14617
    Phone number: 585-266-6574
    Fax number: 585-266-6574
    mcallan1@rochester.rr.com
    http://www.nursingentrepreneurs.com/callan/

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    What made you decide to start your own business?: I started my first business to to fulfill a personal goal of Small Business Ownership, and the financial rewards. I started NursingCorp to be the culmination of all of my experience and skills, and to be a hallmark of all of my professional talents.

    Joseph Caracci, RN, BSN, MBA, Nursecorp.com, Nursing Agencies, Staffing Software Support, Arizona Nursing Entrepreneurs:"NursingCorp offers serious investors and entrepreneurs the knowledge and assistance needed to enter the nurse staffing industry. We provide assistance establishing health care staffing companies, and development of nursing based software solutions. Our product offerings include a complete Nurse Registry Business Package, Nurse Staffing Software for use by Hospitals and Nurse Registries, Business Consultation, and customized software development. To learn more about how we can assist you. The founder of NursingCorp.com is a former Co-founder and President of a large Phoenix AZ based Nurse Registry."
    Nursecorp.com
    3165 S. Alma School Road
    Suite 29-260
    Chandler, AZ 85248
    Phone: 888-607-1492
    E-Mail: jcaracci@nursingcorp.com
    http://www.nursingentrepreneurs.com/caracci

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    What made you decide to start your own business? I was looking for extra income. While shopping on line for scrubs I found an offer to become a distributor and I decided to give it a try. I also was considering my future retirement and some financial security.

    Alyce Clark, RN, Caregiver Scrubs, Nursing Uniforms, Nurse-Owned Businesses, Entrepreneurs:"Sales of scrubs and accessories to medical personnel in hospitals, clinics, doctor's offices, dental offices, and veterinary clinics."
    http://www.nursingentrepreneurs.com/clark

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    What made you decide to start your own business?: I wanted a career that truly utilized my knowledge and experience as a nurse; a position that allowed greater flexibility in balancing career and family.

    Natalie A. Cole, RN, BHSA, CMCN, LNC, West Virginia Legal Nurse Consultants:"I provide medical record reviews and case analyses for attorneys working in medical malpractice, wrongful death, personal injury, and general negligence. My skills and education as a Registered Nurse, in addition to my training as a Legal Nurse Consultant, eases the burden of other legal team members by allowing them to concentrate on other important areas of a case."
    5167 Procious Maysel Road
    Procious, West Virginia (WV) 25164
    Phone number: (304) 587-7010
    http://www.nursingentrepreneurs.com/cole

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    I enjoy helping people. The longer I was in the medical field and the more consulting I did, I saw a great need in the area of financial control. Hospitals were broke, companies were broke and the devastation I saw from that led me to help individuals focus on their own financial game plan - Especially physicians and nurses - they made the most money and spent the most - A typical physician earning about 125k a year was spending 150k a year - not a good financial position - So my crusade became that of educator -Educator and coach - getting health care professionals to develop and maintain a financial life.

      Brigette M. Cutchins, RN, COHN, Colorado:"If you are like many people, you are in the dark about your finances. You pay your bills each month and do your best to prepare for the future. But the truth is, there is only so much money to go around and creating a financial game plan on your own can be overwhelming. PFS can help. A complimentary Financial Needs Analysis can help bring your current financial situation to light. It can show you where your finances stand today and what you need to do to prepare for tomorrow."
      1932 S. Cedar Ave
      Colorado Springs, Colorado (CO) 80906
      Phone number: 866-303-0864 toll free or 719-499-9297
      Fax number: 719-495-7100
      E-Mail: 4fna@adelphia.net
      http://www.nursingentrepreneurs.com/cutchins

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      What made you decide to start your own business?: Interest in Law and the relationship between medicine and law.

      Lisa Desimon R.N, D.C, CLNC, Illinois Nurse Entrepreneurs:"Certified Legal Nurse Consultant business, serving as a consulting expert and testifying expert on a variety of medical/legal issues/cases."
      7358 Timberwolf Trail
      Fairview Heights, Illinois 62208
      http://www.nursingentrepreneurs.com/desimon

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      What made you decide to start your own business?: I have an 8 year old daughter who really needs me to be around more often, Having my own business allows me to create my own hours and spend more time with my daughter.

--

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******************************************************

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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