Showing posts with label Nursing Shortage. Show all posts
Showing posts with label Nursing Shortage. Show all posts

Sunday, November 21, 2010

Nurses Share Stories From The Health Care Frontlines - Health - Madison Magazine News Story - WISC Madison

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By Brennan Nardi
Madison Magazine

Wilma Rohweder

Wilma Rohweder was just seventeen years old when polio struck. Her dream was to become a nurse, but when she fell ill, her mother began to worry.

“She tried to talk me out of it,” Rohweder recalls. “I wouldn’t listen to her.”

Two years later, she packed her bags and moved to Des Moines, Iowa, where she literally earned her stripes—one for each of her three years in nursing school. At graduation, each woman—no men in the field yet—received a beret with a wide black stripe to signify her status as a registered nurse. Today one of Rohweder’s caps is on display in the UW–Madison School of Nursing.

It was the beginning of World War II, and a shortage of wartime nurses led to the creation of the U.S. Army Nurse Corps. For fifteen dollars a month, the eager and precocious Rohweder signed on as a cadet. Rightly so, she is extremely proud of her honorable service to the profession—sixty-four years and counting.

Rohweder has spent the majority of her career in ophthalmology. However, when her husband of sixty-two years, Dwayne, was starting out, his jobs with the county extension office took him all over the state of Iowa, so Rohweder accepted whatever nursing positions were available. The couple moved a dozen times in the first few years of their marriage, but wherever they landed, Rohweder always found work. The hospital urology department, a school nurse, an operating room supervisor—whatever it was, she loved every minute of it.

“I never missed a day in nursing,” she says. And that includes a two-and-a-half-year stint in Brazil in the late 1960s, where her husband, who had since earned a Ph.D. in agronomy and moved the family to Madison, was sent to develop a graduate program. There she worked as a consulate nurse, helping procure safe, sterilized needles and administering gamma globulin shots to boost immunity to diseases that today are prevented with vaccines.

Her specialized skills and training in diseases and disorders of the eye made her a perfect fit for her current work as a volunteer for Dean Foundation’s BSP Free Clinic for under- and uninsured patients seeking specialty health care. She assisted the clinic in the planning and launching of its ophthalmology services, and colleagues say her help is critical on days when volunteer doctors see patients with glaucoma, macular degeneration and other eye-related disorders.

“She does the best charting ever,” says BSP office manager Kathy Williams. “We love Wilma and hope she continues to provide TLC and share her knowledge with all of us at BSP for many more years.”

Peggy Weber

It’s difficult to write about Peggy Weber’s impact on patients, survivors and their families without drawing on symbolism and cliché. But it’s just so easy—and honestly, so fitting—to describe her as “an angel from heaven,” “a pillar of faith,” “the Mother Theresa of Madison,” or, in the kind words of someone whom Peggy has supported through several family tragedies, “the pot of gold at the end of everyone’s rainbow.” When life is a struggle, or when the worst happens and it’s time to say goodbye to our loved ones, cliché is comforting—and it’s a simple, beautiful way to articulate Weber’s deeply genuine commitment to everyone she cares for.

And if a record twenty-three nominations for “Madison’s Favorite Nurse” doesn’t reflect the depth and breadth of her work, a walk through St. Mary’s Hospital, where Weber was educated and where she has spent most of her forty-one-year career, or a visit to Sunday Mass at St. Patrick’s in Cottage Grove certainly does.

Weber jokes about it but it’s true—after it began to take too long to make her way out of church every week, her husband switched from waiting patiently in the car to bringing along the Sunday paper to giving up and taking a separate vehicle. But Peggy doesn’t mind; it’s simply the nature of her work. “Nursing is such an art and science,” she says. “It’s the art of relationships,” adding, “Most nurses—we’re wired to do this.”

That ability to communicate, to connect with people during their most difficult and painful times, is a strength that she has nurtured and grown into a remarkable outreach arm for St. Mary’s, including an ongoing support program called Kids Can Cope that she founded in 1985, the Parish Nurse program started in 1997 and the cancer survivors group she facilitates once a month at St. Patrick’s. “Sometimes I walk into work and I don’t know what’s happening,” Peggy says of her job as a Parish Nurse and Parish Nurse Program coordinator. “I immediately have to relate to [patients and families] and build their trust.” It’s that trust, she says, that helps us work through the frightening experience of death and dying. “The more they can replace that fear with trust, the more calm they’ll be.”

For Peggy, that trust she builds with people extends beyond the walls of hospital and church—and for as long as God intends.

“I go to almost every wake and funeral I can because it helps me and it helps them. I don’t abandon people. They can find me,” she says, with a steely look in her eyes that tells me she means it absolutely and without condition. “They can find me.”

For all of this strength, knowledge, warmth and compassion, Peggy very humbly credits the Sisters of St. Mary, thirty years of experience in the field of psychiatry and two very special nurse mentors, Carol Viviani and Barbara Komoroske, among others. For her faith and spirituality, she thanks her German Lutheran father and Roman Catholic mother.

“I grew up with an incredible spirit in my home,” she says.

Today, Peggy’s incredible spirit is evident in her own home where she, along with her husband Jim, is blessed with four children and soon-to-be eleven grandchildren.

“So what’s next?” I ask her.

“What else?” she answers back. “When you love what you do and it’s the most favorite thing you do, why would you want to quit?”

Mary Saur

Mary Saur was a bright young college student at UW–Oshkosh with a keen interest in science. But it was the late 1960s, and her career options were limited. “At that time it was nursing or teaching,” she says.

Nursing won out in part because she had a role model in the field: her aunt, an idol and mentor. Saur eventually transferred to UW–Madison, earned her RN license, married and moved to Milwaukee. A year and a half later she made her way back to Madison, and settled in to start a family. At the time—1974—the natural childbirth movement was sweeping across the country. Preparing for their first child, Saur and her husband, Ed, decided to enroll in a Lamaze class.

“It was something for us that was truly a bonding, growth experience,” she says.

On the professional side, the class got Saur thinking about a nursing career in labor and delivery. Over the next few years she’d have two more children and teach Lamaze classes. In 1984, she returned to full-time nursing. When Madison General and Methodist hospitals merged in 1987 to become Meriter Hospital, Saur helped develop the childbirth classes and continued to teach until the late 1990s. Over the course of her career, she figures she’s taught some two thousand couples.

Saur, a staff nurse, is frequently assigned to Meriter Birthing Center’s triage unit, where labor patients are screened and evaluated. And while the one thing that’s certain about her job is uncertainty, “My hope for the day is that I’ll have a birth with somebody,” she says.

It’s in this role as support and advocate for mom and her loved ones that Saur thrives. “Communication is key to meeting one’s needs, and being at the bedside with them the nurse can often be that conduit,” she says.

“I remember one time a woman wanting to stand to have her baby. This is no big deal now, but it was out of the norm then and the doctor came in and said, ‘Mary, she needs to lie back.’ Well it was not going to happen—this woman was where she wanted to be so we did end up delivering the baby with her standing above us in the birthing bed.”

Saur feels richly rewarded by her career and is thankful for the “fantastic nurses” she works with as well as the many families who’ve given her the opportunity to share in their most intimate and special moments.

“I love to see my ‘babies’ whether they are two weeks old or in their twenties and thirties and to hear how their lives are,” says Saur. “How lucky can I get?”

Shelley Bazala

Sometimes our parents’ love of what they do for a living influences our own career paths. For Shelley Bazala, it was a more serendipitous route.

“My mom was a nurse,” says Bazala. “So I discounted it.”

She decided she was more interested in social work and pharmacy. But somewhere along the way, the light bulb turned on.

“It hit me that nursing combined both of them.”

Three kids, seven grandkids and more than thirty-five years later, Bazala has enjoyed a successful and fulfilling career in behavioral health as a nurse providing direct patient care and now as a nurse supervisor for Meriter Hospital’s alcohol and drug treatment program, NewStart.

Not only is she a skilled RN, her colleagues say she brings out the best in everyone, she’s an invaluable advocate for patients and families, and in general, “You feel better when Shelley is around.”

Bazala is equally effusive about her co-workers. “I am blessed with a wonderful, competent staff,” she says. “We help people be accepting of where they’re at, offer them hope.”

In a field where the illness has the added disadvantage of societal stigma, Bazala’s calm leadership style, particularly when a patient is in crisis, and her compassion for the person behind the addiction is a winning combination.

"Systems can be overwhelming. Access to services can be challenging,” she says. And to top it all off, “They’re being judged.”

“Lack of understanding and knowledge among health care providers themselves about substance use and addiction can be a barrier for the person in need of help,” Bazala says. “Attitudes, in both health care and society at large, compound the embarrassment/guilt/shame/anger that may be present for the person in need of help.”

Her daunting task? “We try to educate and support the health care provider as well as meet the patient’s needs and intervene in a timely manner.” In today’s world, that means treating the whole patient and acknowledging the physical as well as the environmental issues surrounding addiction.

“Seeing how someone regains their life is a true ‘high,’” she says.

Zach Southard

Zach Southard easily recalls the man whose grateful parents wrote a letter nominating him to be one of “Madison’s Favorite Nurses.” “This is about as young a patient as we’d ever see,” he says.

Southard also remembers the moment a year ago when the father of his twenty-year-old patient, who’d just returned from surgery to repair a congenital hole in his heart, had to step out of the room. Hot and lightheaded, he was overcome by the shock of seeing his own son so weak and tethered to countless tubes and machines.

“No matter how much you explain to them about what they’re going to see, it looks like mass chaos,” says Southard, a nurse clinician on the cardiac and thoracic surgery, heart and lung transplant team at UW Hospital and Clinics. “But from our standpoint it’s pretty organized.”

Southard enjoys breaking down the health of the patients and the care they’re receiving into bite-size pieces that people can digest, particularly at a frenetic time when emotions are high.

“I like the high-acuity, high-intensity stuff,” he says.

And he may come by it naturally. The UW–Madison grad’s father is a nurse on a post-anesthesia recovery unit in Appleton, and his younger brother, Sam, also a UW alum, followed in Southard’s footsteps—exactly. He works at the same hospital. On the same heart and vascular team.

Calm and competent, Southard says the job, which he landed right after graduation, comes with a steep learning curve.

“You don’t learn to be a nurse in nursing school,” he says. “Over time you learn far more than you ever could’ve imagined.”

To that end, he describes the mentoring and training on his unit as top-notch, and his colleagues as “the best part of this job.” He serves on his unit’s advisory council, which reviews cases, helps manage organization and protocol, and teases out best practices.

Best practices, for instance, like knowing that no two cases are ever alike.

“You learn very quickly that you can’t treat numbers,” says Southard. “You treat patients.”

Alyssa Hanekamp

Late last year, bacterial meningitis followed by a heart attack landed Laurie Gomoll-Koch in the hospital for six weeks. Not only did Alyssa Hanekamp provide expert medical care, she went above and beyond for her patient’s husband and two sons, including regular private updates to her youngest, who attended college four hours away.

“She is more than a nurse,” writes Gomoll-Koch in her nomination letter for “Madison’s Favorite Nurses.” “She was our lifeline.”

So it’s no surprise that this facet of nursing—compassionate care for both patient and family—is what drew Hanekamp to the field. She always wanted to be a doctor, but a passion for singing led her to a music major in college. On her mother’s advice to have a back-up plan, she enrolled in nursing courses at Blackhawk Technical College. During the course of her clinical work, she fell in love with bedside care.

“It’s the best part of my job,” she says.

Working at the St. Mary’s medical ICU unit for the last six years, Hanekamp says she’s never once regretted her decision to forego medical school—or singing—for a career in nursing.

“We work very closely with the doctors in intensive care and they allow us to use the knowledge that we have,” she says.

She also doesn’t feel like she’s missing out on family thanks to a schedule—common in her field—that allows for multiple days off at a time and an incredible support network of friends and family. Hanekamp is married with three young children and for now the lifestyle works. As it turns out, the intensive care environment suits her, too. “It’s your direct action that gets people through the good or the bad,” she says.

Inevitably, though, there will be those shifts that take their physical and emotional tolls, which is why she relishes the hour-long commute.

“Some days you just cry all the way home from work,” Hanekamp says. On both good days and bad, she is thankful for “the best co-workers you could ask for,” and for the opportunity to “change people’s lives.”

Says Hanekamp: “It’s the ones that we save, who get to walk out the door, that keep you coming back every day.”

Alyce Columbia

Alyce Columbia’s busy life and career have taken her across the state and the country, and the nursing positions she’s held in the field have been equally diverse. From independent and assisted living environments to caring for people with AIDS to her current work in intensive care, she’s pretty much seen it all.

“I like the patient population. I like to work with people,” says Columbia, a nurse care team leader for cardiac and thoracic surgery, and heart and lung transplant at UW Hospital and Clinics.

For the last seven years Columbia has worked with very sick people in “a very fast-paced place,” she says, where in any given week she and her team of sixty nurses might see multiple heart surgeries and one, two or even three sets of lung transplants. “The doctors, they’re all incredible,” she adds. “The things that happen here are phenomenal.” Columbia holds the nursing staff she leads and trains in the same high regard. “The caliber of the individuals who work there—amazing.”

The unit also equips patients with ventricular assisted devices/heart pumps while they await life-saving transplants. Columbia remembers one patient in particular, an eighteen-year-old teenager being treated for cardiomyopathy, a weakening of the heart muscle that can be fatal. “It’s the one that pulled my heartstrings,” she says. The man, young and poor, was in and out of the hospital, one scary episode after another. Eventually he was put on the VAD, waiting for an organ donation.

“It was his bridge to transplant,” says Columbia, recalling a hospitalization episode when she thought the man might die. Fortunately, his mother and younger sister were able to be there with him, but it was an evening shift, and the nights can be long and difficult when a patient is gravely ill. To ease the tension, Columbia brought in movies and popped popcorn. “We had a slumber party,” she says. Eventually, the patient received a heart transplant and went home to live his life. For Columbia, it makes her high-intensity, sixty-hour workweek worthwhile.

“When they come back after a period of time and they don’t look anything like they did when they came in, and you participated in that—that’s the reward.

Jodi Casper

Jodi Casper was just ten years old when an automobile accident sent her to the hospital for three weeks. She had a fractured femur, so her injured leg was suspended with all sorts of wires and weights. She spent six weeks inside a body cast and became way too familiar with reclining wheelchairs and walkers. Throughout the ordeal, the fifth grader had extra time on her hands to observe her surroundings—plus rack up plenty of interactions with the hospital staff.

“I came to appreciate what it meant to be a nurse,” says Casper. Afterward, she pretty much decided that was exactly what she wanted to do someday. “I never deviated from that—ever.”

Thanks to that chapter in her life, Casper also developed a strong empathy for patients and their health care experiences. When it came time to decide on a nursing specialty, she knew it would be one with an emphasis on bedside care. That, coupled with a fascination for “the miracle of birth,” as she puts it, eventually led her to labor and delivery.

She’s been a St. Mary’s Family Birth Center nurse since 2004, and her varied duties on a twelve-hour shift include labor and delivery support, postpartum and nursery care, and rotations through triage, which is equipped to handle a significant level of high-risk care.

“Our senses fluctuate like an ER,” Casper says. And as in an emergency room, no day is typical. “We really are on our toes.”

Casper’s smile widens when she talks about the women and families she’s cared for—and is quick to point out that each birth involves not one patient but two—both mother and baby (or babies, as is sometimes the case).

“I’ve always loved newborns,” she says. “To visualize that baby inside and the journey it went through—it’s just so surreal.”

Casper says the changes in technology—like 3-D ultrasounds and the hospital’s electronic records system—learning curves aside—have been mostly positive.

“I feel like I can focus more on the patient,” she says.

And, she says, her department benefits greatly from a diverse nursing staff that includes a wide range of ages and experience.

“We learn from older nurses the techniques to support the patient; younger nurses help with technology,” she says. “I love the people I work with.”

Patricia Peltier

Patricia Peltier is a people person. She thrives on the positive, meaningful connections she makes with others. For the patients and residents she cares for as an LPN at Capitol Lakes Retirement Community, her brand of care is often a blessing.

There’s the elderly man, an artist in his eighties, who lost his voice to cancer. His paintings hang on the walls around him, but before Peltier visits, he moves them around—a welcoming change of scenery for them both. Excited about the upcoming football season, the man was delighted when “Nurse Patti,” as she’s known to all, brought him a Packers hat and jersey.

“The little things,” Peltier says. “That’s what I like.”

But Peltier is being modest. In her twenty-three years in nursing, she’s seen and done a lot, and now she hopes to pursue an RN license, and perhaps teach someday, because she still has more to give. And as the saying goes, you get what you give. Fifteen years ago, Peltier was driving to work when she saw a car accident and arrived first on the scene. The car was totaled and the victim had suffered a severe head injury. She knew he didn’t have much time left, but she did everything she could to stabilize him while waiting for the paramedics. The man died at the hospital, but not before he was able to fulfill his final wish to donate his organs. The Red Cross later honored Peltier with a Good Samaritan Award, which she appreciates, but she insists she was only doing her job.

“I just did what I would want somebody to do for me in this situation,” she says.

For the last year and a half at Capitol Lakes, Peltier has been working with patients and residents in independent and assisted living environments, and in short- and long-term rehabilitation. In that role, she cares for people whose illnesses are progressing, as well as those on the road to recovery. No matter what situation she finds herself dealing with from day to day, Peltier loves providing the comfort and care each person needs and deserves. And she always does it with a dose of the very best medicine.

“Make them laugh,” she says. “Humor is the best thing.”

How We Did It

Last summer, Madison Magazine and WISC-TV3 asked the community to help us find and recognize practicing nurses in all areas of health care who go above and beyond the call of duty. The response was immediate and overwhelming: more than 150 e-mails, letters and phone calls from employers, peers, patients, friends and family who felt compelled to share their stories and experiences with the nursing community.

Editor Brennan Nardi and news anchor Charlotte Deleste pored over every nomination, then chose nine winners based on a variety of editorial critera, including nursing specialty (we were looking for a nice mixture of health care environments in which our nurses practiced), professional experience (from those just starting out in the field to accomplished veterans) and quality of the nominations (a compelling story or anecdote always helps).

To be chosen for this honor, winners must have been trained in a formal nursing program and all were vetted by the state Department of Regulation & Licensing.

Copyright 2010 by Madison Magazine. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Nursing Malpractice Alleged When Suspected Breast Cancer Patient Doesn't Follow Up

See also: Medical, Legal Nurse Consultants, Clinical Nursing Case of the Week, Clinical Charting and Documentation, Nurses Notes, Courtrooms, Disability, Discrimination, Employment, Expert Witnesses, Informed Consent, Medical Malpractice, Nursing Practice Acts, Pensions, Search Engines, Torts and Personal Injury, Unemployment, Workers Compensation, Workplace Safety:

Each week a case will be reviewed and supplemented with clinical and legal resources from the web. Attorneys, Legal Nurse Consultants and nursing professionals are welcome to submit relevant articles. Please contact us if you'd like to reproduce our material.

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Summary: Breast Cancer is a well-defined and treatable if not always curable disease process. Once suspicious findings-lumps, nodules, nipple discharge or other telltale signs of a problem are noted-prompt evaluation and follow-up care is essential. In this case, a patient with a family history of breast cancer presented with a "mass" and was evaluated. She did not follow-up as directed and when she later died of breast cancer, her estate would sue for "failure to diagnose, treat."

The 22-year-old woman was seen at a family planning clinic. Part of the assessment/examination included a routine breast exam. The nurse palpated a mass in the woman's left breast.

"The detection of a lump in the breast is a common occurrence. Although most lumps are not caused by cancer, the possibility of malignancy must always be considered. Thus, from the moment a lump or a suspicious change in texture or resistance is felt in some part of the breast, a series of decisions must be taken to exclude or establish the diagnosis of cancer."2

A family history revealed that the patient's mother had died of breast cancer.

"A cancerous tumor of breast tissue, the most common cancer in women and the second leading cause of cancer death for women in the World. The rate increases between 30 to 50 years of age and reaches a second peak at 65 years of age. Risk factors include a family history of breast cancer, no children, exposure to radiation, young age when menstruation began, late menopause, being overweight, diabetes, high blood pressure, long-term cystic disease of the breast, and, possibly, hormone therapy after menopause. Women who are over 40 years of age when they bear their first child and patients with cancer in other areas also have a greater risk of getting breast cancer."3

The nurse referred her to a nearby breast clinic for evaluation of the suspicious lump. Both a nurse and physician would verify the presence of the finding.

"Beginning symptoms, found in most cases by self-examination, include a small painless lump, thick or dimpled skin, or nipple withdrawal. As the tumor grows there may be a nipple discharge, pain, ulcers, and swollen lymph glands under the arms. The diagnosis is made by a careful physical examination, a breast scan (mammography), and examination of tumor cells."3

The patient was instructed to return in three months for evaluation and follow-up of the suspicious mass. Given the family history and nature of the lump, the patient was instructed that the likelihood of malignancy was high.

The suspicious findings and instructions for the patient to follow-up were communicated to the patient. They were also documented in the patient's chart carefully. It was emphasized that the finding needed to be monitored in light of the patient's family history. Despite this instruction, the woman did not return in three months as directed.

No further evaluation would be documented until two years later when a formal diagnosis of Breast Cancer was made. In addition to the cancer in the breast, metastasis to the neck and arm was noted.

"Tumors are more common in the left than in the right breast and in the upper and outer parts of the breast. Spreading through the lymph system to lymph nodes under the arm (axillary) and to bone, lung, brain, and liver is common. Surgical treatment, depending on the tumor, may be a radical, modified radical or simple removal of the breast (mastectomy), with the removal of axillary nodes."3

A radical mastectomy was performed and followed by standard chemotherapy/radiation treatment. The cancer did not respond to the therapy. The patient, initially suspected of having disease at 22, would die at 25.

Due to patient's lack of follow-up, treatment of the disease was potentially delayed for two crucial years.

"The best chance for successful treatment occurs when cancer is found early. Mammograms, or special x-rays of the breast, can detect more than 90 percent of all cancers and should be part of every woman's breast health program, along with breast self-exam and physical exam by a doctor. If a cancer is found early, it is more than 90 percent likely to be completely curable."3

Following her death, the patient's estate filed a lawsuit against the Family Planning Clinic and the Breast Center nurses & physicians. The suit alleged negligence and medical malpractice in the treatment/diagnosis of the patient's Breast Cancer.

Noting the circumstances of the case, summary judgement was initially handed down in favor of the defendants by the court. It noted that acceptable Nursing/Medical Standards and Procedure had been followed in the assessment, documentation and instruction of the patient with a potential Breast Cancer diagnosis.

The administrator of the patient's estate appealed.

Questions to be answered:

1. Was either the Nursing or Medical staff at either the Family Planning Clinic or Breast Center negligent in their examination or duty to inform the patient of her potential diagnosis?

2. Was prompt and early recognition/treatment of the patient's cancer delayed or hindered by the actions of the nurses or physicians?

3. Was the patient's "failure to follow-up as instructed" responsible for the unmonitored progression of the disease and resulting metastasis?

The court noted that clearly, the woman's potential condition had been identified appropriately. The patient had been informed that she was at high risk for Breast Cancer and that further evaluation was needed. She was made aware of the findings and what they could represent.

No claim of "failure to treat appropriately" could be substantiated.

The court recognized that no treatment had in fact been given by the Family Planning facility or the Breast Clinic. The reason no treatment had been given was strictly due to the patient's failure to comply with stated instructions for follow-up.

The documentation of the early suspicious findings and recommended follow-up instructions were clearly noted in the chart. Noted as well was the fact that the woman did not comply as instructed.

When the cancer was finally detected and treated, it was known that the cancer had spread. At that point the removal of the cancerous breast by itself would not offer a cure.

"If I do get breast cancer, a mastectomy gives me my best shot at survival.

A woman may make the psychological leap of assuming "the more I suffer, the more I deserve to be cured" -- a natural reaction to a frightening disease. Natural but misguided. "Women don't die of this disease because it comes back in the breast, but because of a spread to the bones or liver." "If the cancer hasn't spread before surgery, a mastectomy and breast-preserving lumpectomy, followed by a course of radiation treatments offer the same outcome. And if it has already spread, you need other treatment to cure the distant metastasis."3

The appellate court affirmed the judgement of the lower court.

This case illustrates how crucial early detection and follow-up care of suspicious Breast findings are. It shows also how frivolous lawsuits can be brought against nurses and physicians literally "at will." At no point in the case was there clear evidence of negligence or wrongdoing.

The records show that the initial examination was done quite well. The patient received excellent assessment/guidance when the pre-cancerous findings were initially detected. As a reward for their attention to detail and assessment, the nurses and physicians were dragged into a lawsuit and appeals process.

Despite it's poor chances of success and lack of a case, the administrator of the estate, seeking any type of reward chose to bring the suit. Even after the complaint was initially dismissed, the plaintiff chose to appeal.

For each of the nurses and physicians involved, legal costs needed to be paid and time was lost from employment to attend the depositions, trials and legal proceedings. The fortunate ones among them would have costs covered by malpractice insurance policies.

Commonly, a lawsuit is initiated after an employee has left the facility for another job. An employer in this case is under no obligation to provide legal counsel.

Related Links Sections:

Breast Cancer, Cancer Oncology & Malignancy, Direct Patient Care on: The Nurse Friendly: http://www.nursefriendly.com/nursing/directpatientcare/cancer.oncology.malign...

Breast Self Examinations, BSEs, Cancer, Oncology & Malignancy on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directpatientcare/cancer.oncology.malign...


Clinical Charting and Documentation, Nurses Notes:
http://www.nursefriendly.com/nursing/directpatientcare/clinical.documentation...

Courtroom Directory:
http://www.legalnursingconsultant.org/legal.nurse.consultants.lnc/courtrooms....

Direct Patient Care Links on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/linksections/directpatientcarelinks.htm

Ethics:
http://www.nursefriendly.com/nursing/directpatientcare/ethics.htm

Mandatory Overtime, Nursing Quality of Patient Care, Short Staffing on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directpatientcare/mandatory.overtime.nur...


Medical Legal Consulting Nurse Entrepreneurs:
http://www.nursefriendly.com/nursing/ymedlegal.htm

Nursing Shortages, Short Staffing on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/nursing.shortages.short.staffing.htm

Oncology (Cancer) Nurses on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directory/spec/oncology.html

Radical Mastectomy, Cancer Oncology & Malignancy on: The Nurse Friendly:
http://www.nursefriendly.com/nursing/directpatientcare/cancer.oncology.malign...


Related Nursing Malpractice Cases:

September 5, 1999: Sealed "Rape Kit" Reopened By Nurse. Evidence Inadmissible?
Documentation of observations and findings are basic to nursing practice. Our practice is governed by standards of practice and "protocols" to be followed. In this case, a nurse admitting a rape victim collected and placed in a "rape kit" DNA samples, evidence to be submitted for laboratory analysis. The evidence submission protocol would inadvertently be broken by the nurse. The defense for the rapist would argue this breach made the evidence inadmissible.
State v. Southern, 980 P.2d 3 - MT (1999)
http://www.nursefriendly.com/nursing/clinical.cases/090599.htm

August 29, 1999: Surgeon "Loses Clamp" Behind Patient's Heart During Bypass.
Nurse's Responsibility To Pick Up?

Summary: During any surgical operation, there is an inherent "duty" owed to the patient that the operation will be carried out competently. This includes carrying out specified procedures and taking measures to prevent "foreign" objects from being left in the body cavity. In this case, during a coronary artery bypass grafting, a clamp slipped from the surgeon's sight. It would be found on x-ray later sitting behind the patient's heart.
http://www.nursefriendly.com/nursing/clinical.cases/082999.htm

August 22, 1999: Psychiatric Nurse, Sued By Hospital After Developing Relationship With Client?
Wright v. Mercy Hosp. Of Janesville - 557 N.W. 2d 846 - WI (1996)
Summary: Doctors and Nurses by nature of their positions deal with patients when they are vulnerable, off-balance and emotionally needy. When the population includes the psychiatric patient, the potential exists for a client to develop "feelings" for the caregiver. In this case, a sexually abused mother of three was admitted for multiple mental disturbances. During the course of the treatment, a relationship developed and led to sexual encounters following discharge. When it came to light, the patient successfully sued. The hospital would attempt to recover damages against the nurse following her testimony in defense of the facility. This is commonly called a Subrogation action.
http://www.nursefriendly.com/nursing/clinical.cases/082299.htm

August 15, 1999: Violent Psychiatric Patient Attacks Nurse, No Legal Recourse Against Facility or Psychiatrist?
Charleston v. Larson, 696 N.E. 2d 793 - IL 1998
Summary: It would seem absurd, that if a physician admits and facility assigns a nurse to care for a known violent patient, that it has no legal obligation to protect that nurse against violence. In this case, a psychiatric patient sought admission to facility. On admission, he threatened to attack a nurse. When the patient would follow through on his threat, the nurse was denied legal recourse against the psychiatrist who could have taken precautions against the attack
http://www.nursefriendly.com/nursing/clinical.cases/081599.htm

August 8, 1999: Pregnant Prison Inmate Complains of Miscarriage, Corrections Nurse On Duty Ignores Symptoms?
Ferris v. County of Kennebec, 44 5. Supp.2d 62 -ME (1999)
Summary: Nursing assessment skills are one of our most valuable assets. They allow us to effectively evaluate our patients and communicate significant findings to physicians and other members of the healthcare team. In this case, a pregnant woman with a previous history of miscarriage complained of vaginal bleeding and abdominal discomfort. The assessment performed by the nurse fell negligently short of the required standard of care.
http://www.nursefriendly.com/nursing/clinical.cases/080899.htm

August 1, 1999: Nursing Duty To Patient, "Does Not Guarantee" Safety Or Quality Of Care.
Summary: When a nurse accepts report and responsibility for the care of a patient a duty to the patient is also accepted. This duty is to provide a reasonable standard of care as defined by the Nurse Practice Act of the individual state and the facility Policy & Procedures. In this case, a post-op abdominal aneurysm repair patient was injured after falling from his bed to the floor. When a lawsuit was filed the court initially mistook expert testimony to imply the role of the nurse includes a guarantee of safety.
Downey v. Mobile Infirmary Med. Ctr. - 662 So. 2d 1152 (1995).
http://www.nursefriendly.com/nursing/clinical.cases/080199.htm

July 18, 1999: Good Samaritan Laws & Acts. Do They Cover Nurses Volunteering Nursing Care When A Citizen Goes Anaphylactic.
"Off-duty" healthcare professionals rendering Emergency aid are in most cases "covered" by the Good Samaritan Acts. These are laws enacted in each state that provide some degree of immunity from liability for good faith efforts in giving emergency care. In this case, a nurse and physician were sued for providing assistance in a volunteer function at a "first-aid" station. Good Samaritan "immunity" was not recognized by the courts.
Boccasile v. Cajun Music Ltd. 694 A 2d 686 - RI (1997)
http://www.nursefriendly.com/nursing/clinical.cases/071899.htm

July 11, 1999: Nursing Home Rehabilitation Stay Proves Terminal. Was Quality of Care Given An Issue?
Nursing homes are frequently a patient's destination for rehabilitation following surgery. Common conditions fitting this bill include large bone fractures, hip replacements and stroke. Following these acute episodes, the patients are too unstable to go home and not "sick" enough to have their hospital stays reimbursed by insurance companies. The purpose of admission to a nursing home is to help the patient regain lost function, strength and health. In this case, the patient would remain in the Nursing Home till her death of complications. Lloyd v. County of Du Page, 707 NE.2d 1252 - IL (1999)
http://www.nursefriendly.com/nursing/clinical.cases/071199.htm


Sources:

1. 40 RRNL 4 (September 1999)

2. Canadian Medical Association. 1998. Clinical Practice Guidelines For The Care And Treatment Of Breast Cancer. Retrieved October 24, 1999 from the World Wide Web. http://www.cma.ca/cmaj/vol-158/issue-3/breastcpg/0003.htm

3. Homeopathy Clinic. No Date given. Breast Cancer: Retrieved October 24, 1999 from the World Wide Web. http://www.homoeopathyclinic.com/

The Uniform Resource Locator (URL) or Internet Street Address of this page is
http://www.nursefriendly.com/nursing/clinical.cases/101099.htm

Send comments and mail to Andrew Lopez, RN

Created on October 24, 1999

Last updated by Andrew Lopez, RN on Monday, January 25, 2010

Thursday, November 18, 2010

Why Do 18% of New Nurses Quit Their First Jobs? Nurse Recruitment and Retention:

I just learned about the RN Work Project (www.RNWorkProject.org) that will track careers among newly licensed registered nurses.

With funding from the Robert Wood Johnson Foundation until 2016, they’ll study RN work careers for 10 years.

 

To understand the supply of and demand for nurses, it is critical that we understand the needs and challenges of new RNs. This study examines the first work settings of newly licensed registered nurses to learn what influences their first job choice and where they move afterward.

 

About 18% of newly licensed RNs leave their first nursing job within a year of starting, and 26% leave within 2 years. Of these, about 92% take another nursing job with a different employer.

 

This study is crucial for nurse recruitment and retention.

 

Please leave a comment below sharing your thoughts on what can be done to retain nurses.

 

(Tune in every Monday to LeAnn Thieman's Nurse Recruitment and Retention column the home page.)

 

About the Author: LeAnn Thieman, Nurse, Author and Speaker Hall of Fame is an expert in nurse recruitment and retention and author of Chicken Soup for the Nurse’s Soul. To have her help hire and inspire your nurses, contact her at www.NurseRecruitmentandRetention.com

--

Any questions, please drop me a line.

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

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Wednesday, November 17, 2010

Slow job market for nurses expected to rebound | Standard-Examiner – Ogden, Layton, Brigham, Weber, Davis, Sports, Entertainment, Dining, Utah Jazz, Real Salt Lake, Ogden Raptors, Top of Utah News

The recession has finally caught up to nursing, the so-called "recession-proof" job. But experts say the demand for nurses won't be slowed for long.

Evidence of the now-lagging nursing job market is anecdotal and inconsistent; no definitive figures exist. But Betty Sue McGarvey, president of the Baptist College of Health Sciences in Memphis, Tenn., doesn't need a thermometer to know it's cold outside.

Most of her nursing students used to have job offers even before they graduated. Finding employment now can take months.

"We encourage our students and tell them the stability is still there, but it may take you longer to find that first position you want," McGarvey said.

The job-market cool-down follows a frenzied surge in 2007-2008 in which hospitals alone added an estimated 243,000 nurses, according to researchers from Vanderbilt University, the Congressional Budget Office and Dartmouth College. The spike was the largest two-year increase in nursing jobs over the prior 30 years.

But the recession slowly ate away the health-care industry's past insulation.

"In previous recessions, nursing always managed to ride out of the economic storm with little damage," said University of Memphis health care economist Cyril Chang. "But this time, the length and depth of the recession are so severe that even nursing has not been immune to consequences of the economic downturn."

Many in the health care industry tightened their belts and either laid nurses off or reduced their hours, Chang said.

There are always exceptions. The Memphis VA Medical Center, for example, is in the process of hiring 70 nurses. The Veterans Administration's nurse-to-patient ratio changed, said Marilyn Kerkhoff, the hospital's director of nursing. The thinking, she said, is that more nurses on staff translates into better patient outcomes.

"At a time when many are letting go of nurses, we're ... doing what we feel is the right thing for the patients," Kerkhoff said.

A job fair for registered nurses attracted 90 applicants to the VA two weeks ago. Nineteen were hired.

Experts say the current slowdown won't be a long-term, prevailing trend.

Vanderbilt's Peter Buerhaus, a national expert on nursing employment, predicts a national shortage of 260,000 nurses by 2025 -- primarily because the enormous baby boom generation will need more care as it enters old age. More nurses will also be needed to treat the 32 million Americans insured in 2014 under the health reform law.

Buerhaus found that nurses over age 50 filled more than three-fourths of new nursing jobs created between 2001 and 2008.

"If the economy improves, we're expecting ... a great exit of seasoned nurses who have either put off retirement or have reduced their hours," said Sandra Hugueley, chief nursing officer at Methodist Extended Care Hospital.

That would bring an even bigger nursing shortage.

The American Association of Colleges of Nursing, the American Nurses Association, the American Organization of Nurse Executives and the National League for Nursing recently issued a statement expressing their concern.

"Diminishing the pipeline of future nurses may put the health of many Americans at risk, particularly those from rural and underserved communities, and leave our health care delivery system unprepared to meet the demand for essential nursing services," the statement said.

(Contact Toby Sells at sells(at)commercialappeal.com.)

 

--

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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

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Sunday, November 14, 2010

Facing doctor shortage, 28 states may expand nurses' role - USATODAY.com

A nurse may soon be your doctor. With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. These nurses with advanced degrees want the right to practice without a doctor's watchful eye and to prescribe narcotics. And if they hold a doctorate, they want to be called "Doctor."

For years, nurse practitioners have been playing a bigger role in the nation's health care, especially in regions with few doctors. With 32 million more Americans gaining health insurance within a few years, the health care overhaul is putting more money into nurse-managed clinics.

Those newly insured patients will be looking for doctors and may find nurses instead.

The medical establishment is fighting to protect turf. In some statehouses, doctors have shown up in white coats to testify against nurse practitioner bills. The American Medical Association, which supported the national health care overhaul, says a doctor shortage is no reason to put nurses in charge and endanger patients.

Nurse practitioners argue there's no danger. They say they're highly trained and as skilled as doctors at diagnosing illness during office visits. They know when to refer the sickest patients to doctor specialists. Plus, they spend more time with patients and charge less.

--

Any questions, please drop me a line.

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

Sincerely,

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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Tuesday, October 19, 2010

Nursing, Not For Everyone, Not For Most People, by Andrew Lopez, RN, Nurses Views of The Nursing Profession

Nursing, Not For Everyone, Not For Most People, Nurses Views of The Nursing Profession - by Andrew Lopez, RN:"Nursing is no longer an attractive profession for young women (historically the largest segment of the population entering Nursing) to go into. It is having difficulty competing with corporate and other service industries that offer better working conditions, higher pay, no weekends/holidays, more prestige and much less stress. It's a given that as a nurse, you're on a daily basis exposed to hostile families and patients, deadly diseases, abuse from doctors, families and other nurses."
http://www.nursefriendly.com/nursing/nurses.views.of.the.nursing.profession/lopez.andrew.htm


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Sincerely,

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, Facebook/Skype/Twitter-nursefriendly
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

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Tuesday, October 12, 2010

Our Newest Additions New Stuff, A to Z Nursing Links, Alphabetical Nursing

Our Newest Additions New Stuff, A to Z Nursing Links, Alphabetical Nursing:"Our Newest Additions New Stuff, It is our intent for this Alphabetical, A to Z index to be a comprehensive listing of Nursing-related resources on the Internet. It is indexed by Google and fully searchable. We'd ask that if you don't find what you are looking for, kindly contact us! If you are looking for a certain topic, it's likely you are not the only one. We will be adding to this index daily, be sure check back frequently."
http://www.nursinga2z.com/our.newest.additions.new.stuff.htm



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Legal Nursing Consultants, LNCs
Long Term Care, Nursing Homes
Male Nurses
Malpractice Cases
Medical Centers, Hospitals
Medical Equipment
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Medication Errors, Drug Administration & Support
Men in Nursing
National Nurses Week
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Nursing Schools, Colleges
Nursing Scrubs, Uniforms
Nursing Shoes
Nursing Shortage
Nursing Stories
Nursing Students
Nursing Uniforms
Nursing Unions, Organized Labor, Healthcare Unions
Nursing Wages
Nursing Webrings
Paychecks (Nursing)
Prescription Drug Indexes
Puzzles, Quizzes
Relocation Resources
Refresher Courses
Research (Nursing)
Resumes (Nursing)
Salaries (Nursing)
Scholarships (Nursing)
Schools of Nursing
Scrubs, Nursing Uniforms
Shoes (Nursing)
Shopping (Going) on the Internet
Shortage (Nursing)
State Nursing Boards
Student (Nursing)
Training (Nursing)
Traveling Nurses
Uniforms, Scrubs, Nursing
Unions (Nursing), Organized Labor, Healthcare Unions
Wages (Nursing)
Work At Home Opportunities
Sincerely,

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, Facebook/Skype/Twitter-nursefriendly
856-415-9617, (fax) 415-9618

150,000 + Nurse-Reviewed & Approved Nursing Links

http://www.4studentnurses.com
http://www.4travelnursing.com
http://www.lopez1.com
http://www.nursinga2z.com
http://www.nursingdiscussions.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com