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Monday, November 15, 2010

Bernadette Evans - the best thing about being a Community Nurse

Bernadette explains how and why she became a nurse, the importance of working your way up in nursing, and what you should expect if you’re thinking of finding a job overseas as a nurse.

What is your current nursing job?
I work for a Cancer Charity Organisation. My job title is Senior Sister Community.

You’re an experienced nurse and healthcare professional. Tell us how you feel the industry has changed in your years in it.
The care industry seems to be more technical and geared towards documentation. Senior staff now appear to be less hands-on (and I prefer to be hands-on) and I feel that there are too many policies and not enough care direct. I think it's down to increasing legislation in the care sector.

What made you want to leave your job in banking to become an auxilliary nurse in the early nineties?
I felt I had something to offer. But I didn’t want to commit myself to train to become a qualified nurse without knowing I was going to enjoy the profession. So I found a job as an auxilliary nurse first. A little like trying it out before signing up.

That makes sense to us. So, do you remember your first day at work in healthcare?
I do. Yes, I remember that I worked on a really good ward. They made me feel part of the team which was great. Whether you were the sister or the domestic we all felt important. I was told that the team on the ward consisted of domestic to ward manager and everyone had their say to make it safe and comfortable for the patient.

What’s the best thing about being a community nurse?
For me it’s simple: it’s the direct patient care, the one-to-one nursing care we can provide.

You’ve worked for a number of PCTs. What are the key differences between working for the NHS and then organisations outside of the public sector?
The main differences between public and private industry is that deadlines are tighter in private industry and, I must admit, more professional. The public industry is more 'laid back' probably as the organisation is so much bigger.

You’ve used your nursing skills to find work overseas. This is one of the advantages of this industry. How did you find your time working outside of the UK?
Working abroad as a nurse is very different to the UK. Of course it depends on where you are, but in some countries the standards are very low and care is not as passionate. Where I work, in Cyprus, the shortage of nurses doesn’t help the industry as nurses tend to dictate what they do and don't do. It has really opened my eyes. I’ll never run the NHS down again! It's far superior to anywhere else I’ve worked as a nurse overseas.

Is there such a thing as a typical day as a community nurse?
Yes, every day there are not enough hours to care for the amount of patients! I need to say though that it’s really enjoyable and rewarding knowing that you have helped or even just given patients some company and care for the day.

What would you say to someone who is wondering whether to become a nurse - what should they expect?
I think that all new staff should start at the bottom of the scale and see if they like the profession first. Being an Auxiliary Nurse opened the pathway to my career and I have never looked back. Starting at the bottom gave me insight into all aspects of the role of a nurse, and how nursing staff fit into the team.
It also gives you knowledge of who can do what and when. I also know all the scams and who does what! I don't think anyone should just 'become a nurse'. By that I mean you have to WANT to be a nurse, and work with passion.

via nurses.co.uk

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Doctors who order tests for their own financial gain-KevinMD.com

Doctors who order tests for their own financial gain
6 comments
in Physician practice
by Kohar Jones, MD
“What a shame,” said my eighty eight year old Armenian grandmother, shaking her head with sorrow, and I had to agree. “US officials charge 73 people, mostly Armenians, over a massive fraud against the country’s medical insurance system,” read the BBC headline.
A (mostly) Armenian crime syndicate set up 115 sham clinics in the United States, using real doctors’ names and real patient information, stolen from different systems, to generate false Medicare claims.
Dermatologists examined hearts. ENT doctors performed pregnancy ultrasounds. (And Medicare beneficiaries, it must be noted, are usually past child-bearing age.)
At some point, $35 million later, someone noticed the discrepancies. How broken is our health care payment system that an interstate, international mafia could steal $35 million from US taxpayers via false Medicare claims? How broken is our health care payment systems than an upstart Armenian mafia would even decide that Medicare should become the new black market, filled with low-hanging fruitful ways to make an easy buck? Whatever gave them the idea?
Perhaps they learned from low-level not-quite-gangsters racketeering their way to easy profits—the real doctors in real storefront clinics seeing real patients, for example, who happen to have high blood pressure– performing EKGs every three months for no good medical reason. Should we call it a scam when real doctors refer real patients to the imaging sites down the road in which the doctors have partial ownership, to perform imaging studies for no strong medical indication? How might this contribute to a “massive fraud” of medical overutilization?
The Armenian Medicare Mafia brings shame to my ethnicity. Doctors who order for their own financial gain, I believe, bring shame to my profession.
Three cheers for shame-free doctoring! Let us give patients what patients need, no less and certainly no more.
Kohar Jones is a family physician who blogs at Progress Notes.

via kevinmd.com

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How salt is associated with stroke and heart disease risk-KevinMD.com

Sodium intake has a direct and independent impact on the risk of stroke and cardiovascular disease, according to a meta-analysis published online ahead of print in the British Medical Journal.
According to the American Heart Association, you can help patients reduce salt intake by recommending that they:
• Compare the sodium content of similar products (e.g., different brands of tomato sauce) and choose products with less salt
• Choose versions of processed foods, including cereals and baked goods, that are reduced in salt
• Limit condiments (e.g., soy sauce, ketchup).
Researchers out of the University of Naples conducted a meta-analysis of 19 independent cohort samples taken from 13 studies exploring the relationship between salt intake and cardiovascular disease. The cohorts comprised 177,025 participants who were followed-up for 3.5 to 19 years and who experienced over 11,000 vascular events.
Higher salt intake was associated with a greater risk of stroke, with a pooled relative risk (RR) of 1.23, as well as a greater risk of cardiovascular disease, with a pooled RR of 1.14. The observed associations increased with larger differences in sodium intake and a longer duration of follow-up. The authors estimate that reducing daily salt intake by as little as 5 g at the population level could avert 1.25 million deaths from stroke and nearly three million deaths from cardiovascular disease annually.
Today’s research provides strong evidence for worldwide efforts to reduce sodium intake.

via kevinmd.com

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Top 10 Pocket-Essentials for Nursing and Clinicals - Nursing Link

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Top 10 Pocket-Essentials for Nursing and Clinicals

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Scrubs Magazine

Scrubs Magazine is the lifestyle website for and about nurses. Here you’ll find weekly giveaways, “best of” lists, and both the lighter side and the serious side of nursing with cartoons, scrubs style DOs and DON’Ts, beauty, health and wellness. Scrubsmag.com also features revealing stories from nurse bloggers ranging from a newly minted nurse to a seasoned RN to a misunderstood male nurse. Follow us on Twitter and join our conversation on Facebook.

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Ani Burr | Scrubs Magazine

Every nurse (and student nurse!) carries around the essentials, here’s my “Top Ten” pocket-essentials for nursing and clinicals!
1. Pens – There’s something magical about nursing – nurses can make pens disappear into thin air! Make sure you keep extras near by, but always have a black ink pen on hand. Even if your hospital has gone paper-less, you’ll need it to mark something, sign something, or make a note of something. Highlighters for your own use – marking up your papers, and a dry erase marker for your patient boards.
2. Stethoscope – I guess this one is a given, but you want to make sure you get a stethoscope you can use effectively (i.e. the ear pieces aren’t poking your brain so hard you can’t concentrate on the sound), and also make sure you have a type specific to your patient population (adult, cardio, peds, neonates, etc).
3. Bandage scissors – There’s always a use for these, even when you’re not cutting bandages or tape. No sense wasting time fumbling around trying to open packaging for a pulse ox, keeping a (good) pair of bandage scissors on you will save you time. Just make sure you keep an eye on them, don’t let them wander off with those pens!
4. Penlight – A penlight is an essential for a good neuro check, and to me, this is the part of the nursing assessment that is most often glazed over in non-neuro patients. Having my own pen light in my pocket is a reminder to me that I need to use it, complete my assessment, and make sure that I don’t skip it even if the patient is alert and oriented X4!
5. Alcohol prep pads – I know for clinical I stock my pockets full of these. You need them for IVs, you need them to clean off your pens – you need them. A lot of them. On hand, all the time.
6. Saline flushes – I’ll never forget the instructor who would check meds with us in the morning, and then as we were leaving the med room would grab a hand full of saline flushes and shove them in my pockets saying, “you’re going to need these!” and I always thought there was no way I would need all of these flushes. But sure enough, she was right! You probably don’t need a handful (especially since they’re bulky and their packaging makes a lot of noise in your already-full pockets) but having a spare has never hurt!
7. Tape – Taping and re-taping IV’s, taping a sign on a door, taping around a pulse-ox to keep it secure, tape is essential. Paper, plastic, satin, whatever you prefer, it will always come in handy
8. Chapstick/lotion – I always carry a chapstick, since my lips chap easily, if you need it, keep it on hand so you’re not running back to your locker/bag to grab it. Lotion can be too bulky for your pocket, but if you can find a small tub of it, and your hands dry out (especially with constant sanitizer use and hand washing), it’s important to maintain your own skin integrity.
9. Brain – Not the one in your head, but whatever it is that keeps you organized throughout the day. A change of shift sheet, a hospital-provided “brain” to keep track of everything that goes on is how you’re going to stay on top of it. Students, if you don’t have one, make your own! Check out this blog to find out what to add!
10. Cash – Last but not least, carry a few dollars on you in case you need a mid-morning or mid-afternoon snack or a quick cup of coffee. I know I always need my morning coffee with breakfast, and maybe something sweet in the afternoon!
Every nurse carries their supplies out of experience. These are what I’ve found to be practical and necessary when I am in the clinical setting and at work.

What’s in your pockets?
Next: Top Nursing Gear Must-Haves >>

More on ScrubsMag.com:
• In New Nurse: Oh Organization!
• In Male Nurse: Nursing Gear List
• In Student Nurse: What’s in Your Pockets

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Australian and New Zealand College of Perfusionists

The Australasian Board Of Cardiovascular Perfusion was established pursuant to the Rules of the Australasian Society of Cardio-Vascular Perfusionists Incorporated, now ANZCP. The Board therefore forms part of the incorporated association and has no separate legal existence outside the College. The Board is required to establish and support the credentialing process

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Perfusion Line

Perfusion Line is the largest directory of Perfusion resources available to professionals and students involved with extracorporeal technology. We offer several special features to our registered members. Signup for a membership and enjoy all the exclusive sections. Our members support a website that offers scientific material for fundamental and continuing education to the international perfusion community. Join Perfusion Line Today.

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Oregon Health & Science University is dedicated to improving the health and quality of life for all Oregonians through excellence, innovation and leadership in health care, education and research.

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JAMA -- Abstract: Fall Prevention in Acute Care Hospitals: A Randomized Trial, November 3, 2010, Dykes et al. 304 (17): 1912

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Fall Prevention in Acute Care Hospitals
A Randomized Trial
Patricia C. Dykes, RN, DNSc; Diane L. Carroll, RN, PhD, BC; Ann Hurley, RN, DNSc; Stuart Lipsitz, ScD; Angela Benoit, BComm; Frank Chang, MSE; Seth Meltzer; Ruslana Tsurikova, MSc, MA; Lyubov Zuyov, MA; Blackford Middleton, MD, MPH, MSc

JAMA. 2010;304(17):1912-1918. doi:10.1001/jama.2010.1567
Context Falls cause injury and death for persons of allages, but risk of falls increases markedly with age. Hospitalizationfurther increases risk, yet no evidence exists to support short-stayhospital-based fall prevention strategies to reduce patientfalls.
Objective To investigate whether a fall prevention toolkit (FPTK) using health information technology (HIT) decreasespatient falls in hospitals.
Design, Setting, and Patients Cluster randomized studyconducted January 1, 2009, through June 30, 2009, comparingpatient fall rates in 4 urban US hospitals in units that receivedusual care (4 units and 5104 patients) or the intervention (4units and 5160 patients).
Intervention The FPTK integrated existing communicationand workflow patterns into the HIT application. Based on a validfall risk assessment scale completed by a nurse, the FPTK softwaretailored fall prevention interventions to address patients'specific determinants of fall risk. The FPTK produced bed posterscomposed of brief text with an accompanying icon, patient educationhandouts, and plans of care, all communicating patient-specificalerts to key stakeholders.
Main Outcome Measures The primary outcome was patientfalls per 1000 patient-days adjusted for site and patient careunit. A secondary outcome was fall-related injuries.
Results During the 6-month intervention period, the numberof patients with falls differed between control (n = 87)and intervention (n = 67) units (P=.02). Site-adjustedfall rates were significantly higher in control units (4.18[95% confidence interval {CI}, 3.45-5.06] per 1000 patient-days)than in intervention units (3.15 [95% CI, 2.54-3.90] per 1000patient-days; P = .04). The FPTK was found to be particularlyeffective with patients aged 65 years or older (adjusted ratedifference, 2.08 [95% CI, 0.61-3.56] per 1000 patient-days;P = .003). No significant effect was noted in fall-relatedinjuries.
Conclusion The use of a fall prevention tool kit in hospitalunits compared with usual care significantly reduced rate offalls.
Trial Registration clinicaltrials.gov Identifier: NCT00675935

Author Affiliations: Partners HealthCare System (Drs Dykes and Middleton, Ms Benoit, and Messrs Chang and Meltzer), Brigham and Women's Hospital (Drs Dykes, Hurley, Lipsitz, and Middleton, and Ms Tsurikova), Harvard Medical School (Drs Dykes, Lipsitz, and Middleton), and Massachusetts General Hospital (Dr Carroll and Ms Zuyov), Boston.

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Themes of Aging: Preserving Function, Improving Care
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JAMA 2010;304:1954-1955.
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Cardiovascular Perfusion:College of Health Professions:SUNY Upstate Medical University

Cardiovascular Perfusion—Bachelor of Science

Perfusionists are operating room specialists who conduct cardiopulmonary bypass. That is, they pump and oxygenate the blood of patients whose hearts or lungs are stopped, usually during open heary surgery.

The cardiovascular perfusion program accepts six students each year. Graduates are eligible to take the American Board of Cardiovascular Perfusion's National Certification Examination.

A Cardiovascular Perfusionist's work is a matter of life or death. People who succeed in this field thrive on excitement and stressful situations. More >

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Monday, November 15, 2010

Bernadette Evans - the best thing about being a Community Nurse

Doctors who order tests for their own financial gain-KevinMD.com

Doctors who order tests for their own financial gain

How salt is associated with stroke and heart disease risk-KevinMD.com

Top 10 Pocket-Essentials for Nursing and Clinicals - Nursing Link

Top 10 Pocket-Essentials for Nursing and Clinicals

Featured Author:

More articles from this author:

What’s in your pockets?
Next: Top Nursing Gear Must-Haves >>

More on ScrubsMag.com:

Australian and New Zealand College of Perfusionists

Perfusion Line

OHSU Healthcare: OHSU Healthcare

OHSU — Oregon Health & Science University

JAMA -- Abstract: Fall Prevention in Acute Care Hospitals: A Randomized Trial, November 3, 2010, Dykes et al. 304 (17): 1912

Cardiovascular Perfusion:College of Health Professions:SUNY Upstate Medical University

Cardiovascular Perfusion—Bachelor of Science

h2u.com : H2U : Health To You

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Monday, November 15, 2010

Doctors who order tests for their own financial gain

Top 10 Pocket-Essentials for Nursing and Clinicals

Featured Author:

More articles from this author:

What’s in your pockets?Next: Top Nursing Gear Must-Haves >>

More on ScrubsMag.com:

Cardiovascular Perfusion—Bachelor of Science

Blog Archive

Contact Us

About Andrew Lopez, RN, Nursefriendly.com

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What’s in your pockets?
Next: Top Nursing Gear Must-Haves >>