Friday, November 19, 2010

When We Share, Caring For Others, Sharing Our Hopes, Fears, Feelings

When we share laughter, there’s twice the fun;
When we share success, we’ve surpassed what we’ve done.
When we share problems, there’s half the pain;
When we share tears, a rainbow follows rain.
When we share dreams, they become more real;
When we share secrets, it’s our hearts we reveal.
If we share a smile, that’s when our love shows;
If we share a hug, that’s when our love grows.
If we share with someone on whom we depend,
that person is always family or friend.
And what draws us closer and makes us all care,
Is not what we have, but the things we share.

Author unknown

--

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
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Thursday, November 18, 2010

Schizophrenia, Schizophrenics, Paranoid, Paranoia, Treatments, Symptoms, Psychiatric Mental Health Resources, 4Nursing.com, Nursing & Healthcare Resources

About Schizophrenia.com:"Started in 1995, Schizophrenia.com is a leading web community dedicated to providing high quality information, support and education to the family members, caregivers and individuals who's lives have been impacted by schizophrenia. The site is managed by a group of about 10 independent volunteers around the world - all of whom are either family members (with sons & daughters, brothers and sisters, or parents who have suffered from schizophrenia) or people who have schizophrenia. While none of us are mental health professionals, we are very familiar with the disease both through direct personal experience and extensive reading on the topic. We rely upon what we believe are good sources of scientifically accurate materials relating to schizophrenia and frequently consult with an ever growing group of schizophrenia researchers who act as unofficial advisors to the site - these schizophrenia researchers who help on an unofficial basis by answering our questions and occasionally providing feedback on different areas of the site."
The Tides Center Workteam1, (Schizophrenia.com)
PO Box 29907
San Francisco, CA 94129
szwebmaster@yahoo.com
http://www.schizophrenia.com/

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Schizophrenia in Children, American Academy of Child and Adolescent Psychiatry (AACAP):"Schizophrenia is a medical illness that causes strange thinking, strange feelings, and unusual behavior. It is an uncommon psychiatric illness in children and is hard to recognize in its early phases. The behavior of children and adolescents with schizophrenia may differ from that of adults with this illness. Child and adolescent psychiatrists look for several of the following early warning signs in youngsters with schizophrenia: seeing things and hearing voices which are not real (hallucinations), odd and eccentric behavior, and/or speech, unusual or bizarre thoughts and ideas, confusing television and dreams from reality."
American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Ave., N.W., Washington, D.C. 20016-3007
voice: 202-966-7300 fax: 202-966-2891
http://www.aacap.org/publications/factsfam/schizo.htm

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Schizophrenia, Associated Problems in Prepsychotic or Postpsychotic Phase, Internet Mental Health:"Reckless or Impulsive Behavior Obsessive Thinking or Compulsive Rituals Prolonged Anxiety, Tension or Worry Fidgeting, Pacing, or Hyperactivity Sad or Depressed Mood Irritability or Hostility Feeling Worthless or Guilty Fatigue (Physically Tired All Day) Poor Concentration or Attention Sleeping Problem Appetite or Eating Problem Poor Sexual Interest or Ability Overly Dependent Behavior Poor Physical Health."
editor@mentalhealth.com
http://www.mentalhealth.com/dis/p20-ps01.html

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Schizophrenia & Psychosis, Mental Help Net:"Schizophrenia is a mental disorder that severely impacts how 2.5 million Americans think, feel, and act. It is a disorder that makes it difficult for a person to tell the difference between real and imagined experiences, to think logically, to express normal emotional responses or to behave appropriately in social situations. Schizophrenia can be draining on both the person with schizophrenia and their families. People with schizophrenia often have difficulty functioning in society, at work and in school. Family members may have to help out financially and make sure that medication is taken as prescribed."
Mental Help Net A service of CenterSite, LLC
570 Metro Place Dublin, OH 43017
http://mentalhelp.net/poc/center_index.php?id=7

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Schizophrenia, Mental Wellness.com, Janssen Pharmaceutica Products:"Schizophrenia is a severe mental illness described by the American Psychiatric Association as "one of the most debilitating and baffling mental illnesses known." The mental disorder is characterized by a dysfunction of the thinking process, such as hallucinations and delusions, and withdrawal from the outside world. Years of research have shown that schizophrenia is a biologically based brain disease. The most recent advances in brain imaging have confirmed imbalances of two brain chemicals – dopamine and serotonin – in those who suffer from schizophrenia. Dopamine is responsible for emotions and motivation; serotonin acts as a messenger and stimulates muscle movement, switching nerves on and off. The brains of people with schizophrenia have elevated dopamine and serotonin activity."
Janssen Pharmaceutica Products, L.P 1-800-JANSSEN (526-7736) http://www.mentalwellness.com/schizophrenia/about/schizophrenia.jsp

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NARSAD: National Alliance for Research On Schizophrenia and Depression:"NARSAD is a private, not-for-profit public charity 501(C)(3) organized for the purpose of raising and distributing funds for scientific research into the causes, cures, treatments and prevention of severe psychiatric brain disorders, such as schizophrenia and depression."
NARSAD
60 Cutter Mill Road, Suite 404 Great Neck, New York 11021 USA
Main Line: 516 829-0091
Research Grants Program: 516 829-5576 FAX: 516 487-6930
(800) 829-8289 or e-mail info@narsad.org
http://www.narsad.org/

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Rethink (formerly The National Schizophrenia Fellowship):"Rethink is the largest severe mental illness charity in the UK. As of 2nd July 2002 'Rethink' is the new operating name for 'The National Schizophrenia Fellowship'. We are dedicated to improving the lives of everyone affected by severe mental illness, whether they have a condition themselves, care for others who do, or are professionals or volunteers working in the mental health field. With more than 30 years of experience, and over 1800 staff, Rethink provide a wide range of community services including employment projects, supported housing, day services, helplines, residential care, and respite centres. All our services try to help people take more control of their own lives by building their confidence and strengthening their skills. With nearly 400 services, we support around 5000 people every day."
Rethink, Head Office
30 Tabernacle Street London EC2A 4DD
Tel: 020 7330 9100/01 Fax: 020 7330 9102
National Advice Line Tel: 020 8974 6814 (open 10am to 3pm, Monday to Friday)
email info@rethink.org
http://www.rethink.org/

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Schizophrenia, Schizophrenia Society of Canada:"• Is a treatable biochemical brain disorder • Strikes 1 in 100 people • Manifests itself usually between the ages of 15 to 25 years • Causes 40% of people with schizophrenia to attempt suicide of which 10% complete the act. • Costs Canadian taxpayers an estimated $4 billion annually in direct and indirect costs It is NOT: The fault of the person or their family. Founded in 1979, the Schizophrenia Society of Canada (SSC) is a national registered charity. SSC works with 10 provincial societies and their over 100 chapters/branches, to alleviate the suffering caused by schizophrenia and related mental disorders. To this end, SSC and its provincial affiliates carry out public awareness & education, family support, advocacy and research funding initiatives and programs."
Schizophrenia Society of Canada
50 Acadia Avenue - Suite 205 Markham, ON L3R 0B3
Tel: (905) 415 - 2007 Fax: (905) 415-2337
Call Toll Free in Canada: 1-888-SSC-HOPE [1-888-772-4673] e-mail: info@schizophrenia.ca
http://www.schizophrenia.ca/

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Schizophrenics Anonymous (SA):"Schizophrenics Anonymous (SA) is a self-help group for persons who have schizophrenia or a schizophrenia-related illness. .A was founded in the Detroit area in July of 1985 and since that time, thousands of people have participated in meetings. There are currently more than 150 groups meeting throughout 31 states, as well as Australia, Brazil, Canada, Mexico, France, India and Venezuela. Statement of Purpose: Schizophrenics Anonymous is organized and managed by persons experiencing schizophrenia or a related disorder. It is administered in partnership with the National Schizophrenia Foundation. 403 Seymour Avenue
Suite 202 Lansing, Michigan 48933
Phone: (517) 485-7168 (800) 482-9534 (Consumer Line) Fax: (517) 485-7180
General Questions: inquiries@nsfoundation.org
http://www.sanonymous.org/

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WFSAD: World Fellowship for Schizophrenia & Allied Disorders:"The World Fellowship for Schizophrenia and Allied Disorders (WFSAD) is the only global organization dedicated to lightening the burden of schizophrenia and allied disorders for sufferers and their families. WFSAD strives to increase knowledge, understanding and compassion and reduce the fear, stigma, discrimination and abuse that accompany these difficult conditions. WFSAD and its member organizations focus on the humane treatment of people with mental illnesses and on their primary care, which falls frequently upon the family, most often the parents, and can last a lifetime. There is need for housing, rehabilitation, recreation and a decent life for those battling these difficult conditions. It is estimated that some 40% of sufferers have no contact with formal mental health systems. Support, training and education is necessary for families and their sick loved-ones, who have an enormous and continuing burden to shoulder."
124 Merton Street, Suite 507, Toronto, Ontario, M4S 2Z2, Canada
Tel: +1.416.961.2855 Fax: +1.416.961.1948 E-mail: info@world-schizophrenia.org
http://www.world-schizophrenia.org/

See also: Addictions, Substance Abuse, Mental Health Abuse

Clinical Nursing Case Studies, Malpractice Cases: http://www.nursingcasestudy.com

October 15, 2000: Physician Restraint Orders Unclear On Transfer, Do You Apply In The Interim?
Summary: The use of Mechanical or Physical Restraints on confused patients is highly controversial. Due to substantial Death & Injury attributed to their use they are considered a last resort measure in providing for the safety of a patient. In this case, orders specifying what restraints and when they were to be used were unclear. In a patient that was clearly at high risk for injury, should they have been applied till the physician could have been contacted?
Tousignant v. St. Louis County, 602 N.W.2d 882 - MN (1999)
http://www.nursefriendly.com/nursing/clinical.cases/2000/101500.htm

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September 19, 1999: Abusive Psychiatric Patient Restrained, Placed In Seclusion For Angering Nursing & Medical Staff?
Summary: In dealing with violent, abusive or angry psychiatric patients, the safety of the patient and staff are the priority concerns. When restraints or seclusion are deemed necessary, justification for the measures must be documented concisely. In this case, an unruly patient angered the nurse caring for him. When leather restraints were applied and maintained for a prolonged period of time, the patient would object and later sue for damages.
Alt v. John Umstead hospital 479 S.E. 2d 800
http://www.nursefriendly.com/nursing/clinical.cases/091999.htm

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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

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Direct Patient Care Resources:

Violence & Violent Patients, Direct (Bedside Nursing) Patient Care
http://www.nursefriendly.com/violent/

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Drugs, Prescription Medications:

Abilify, Aripiprazole, Antpsychotic, Prescriptions Drugs, Medications, Medicines
http://www.prescriptionforviagra.com/abilify

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Ativan (Lorazepam), Anti Anxiety, Antianxiolytic, Sedative, Hypnotic
http://www.prescriptionforviagra.com/lorazepam/

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clonezapam (Klonopin), Benzodiazepines, Anticonvulsants, Antiseizure
http://www.prescriptionforviagra.com/clonezapam

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Ropinirole Hydrochloride, Requip, Parkinsons Disease, Dementia, Prescription Drugs, Medications
http://www.prescriptionforviagra.com/ropinirole/

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Nursing Humor:

Psychiatric, Mental Health Humor

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4nursinguniforms.com

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Nursing Chat, Nurse Discussion Forums:
http://nursingdiscussions.com

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The Uniform Resource Locator (URL) or Internet Street Address of this page is
http://www.4nursing.com/direct-patient-care-psychiatric-mental-health-schizop...

Last updated by Andrew Lopez, RN on Wednesday, September 29, 2010

--

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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Still on payroll despite fatal mistakes - Health News Florida

Of all the doctors in Florida that GlaxoSmithKline could have chosen as consultants, Steven Brooks and his partner E. “Jake” Jacobo would seem the least likely. They have a criminal record.

In 2001, the Orlando-area urologists pleaded guilty in U.S. District Court in Connecticut to one count of conspiracy to defraud Medicare and the military through a complicated black-market diversion of the pricey prostate cancer drug Lupron.

Despite the blotch on his record, Brooks is Florida’s third-biggest recipient of pharma speaking fees overall and commands by far the largest fees among those who have been disciplined, according to a data-mining  project by the investigative news site ProPublica. Working with the team there, Health News Florida analyzed the data for Florida and wrote a state-based analysis. 

Over the last 18 months, GlaskoSmithKline paid Brooks over $178,000, ProPublica found. The company also paid Jacobo $14,750.

Brooks

In the criminal case, federal prosecutors allowed the doctors to plead to a misdemeanor in return for repaying the government $1.1 million. They were sentenced to five years’ probation and 500 hours of community service.

According to an account in the Orlando Sentinel at the time, the doctors' attorney portrayed them as duples of pharmaceutical sales reps. He said it seemed like a business deal: The doctors bought extra supplies of Lupron in states where it was less expensive and arranged for resale in states where costs were higher, records said. This violated wholesale drug distribution laws.

The Florida Board of Medicine fined each doctor $10,000 and required them to take classes in medical ethics and risk management. Brooks gave up his medical license in New York, rather than fight charges stemming from the case.

Neither Brooks nor Jacobo returned calls from Health News Florida. A call to the drug company seeking information on the urologists’ roles as consultants and on whether the company knew about the federal case also went unanswered.

Who's running trials on new drugs?

Pharmaceutical companies depend on physicians to run clean clinical trials so they can get the data they need for Food and Drug Administration approval. Yet two drug-company consultants in Florida received FDA warning letters the over the way they ran clinical trials.

Last year, the FDA cited Francisco Hernandez of Hialeah for enrolling the wrong patients in a clinical trial of a diabetes injectable drug made by Sanofi-Aventis. Of 15 patients Hernandez enrolled, the letter said, 12 didn’t qualify.

The FDA also said Hernandez didn’t report illnesses in two of the patients that were serious enough to require hospitalization.

A similar letter went to Jeffrey R. Levenson in St. Petersburg for his work on the investigational drug Zyvox for Pharmacia and Upjohn in 2000, records show.

Levenson enrolled some subjects who were too sick to meet the outlines for the trial or even to give informed consent, the letter said. He also failed to report serious adverse events, it said.

Hernandez received $6,000 in the past year and a half from Lilly for consulting, records show. Levenson received $2,000 from GlaxoSmithKline and about $1,800 from Pfizer.

Neither returned calls from Health News Florida.

Experts on prescribing? Not so much

Doctors who are  paid speakers for drug companies are supposed to be experts in prescribing. According to records, though, several in Florida were anything but -- including psychiatrist Joseph John Altieri of Vero Beach.

(He is not to be confused with Dr. John Joseph Altieri, a Sarasota-based cardiologist)

Psychiatrist Altieri came before the Board of Medicine in 2008, charged with inappropriate prescribing to three patients.

In case documents, Department of Health investigators said Altieri provided a “constantly changing cocktail” of addictive drugs -- including potentially lethal narcotics such as oxycodone and morphine – to patients who Altieri knew or should have known were addicts.

The Board of Medicine found Altieri violated a slew of codes on physician conduct. He was fined $30,000 and placed on two years’ probation, with another physician supervising.

The DOH web site says Altieri recently completed his probation, but while it was still in force last year, he received $1,040 in speaking fees from Pfizer.

He did not return calls from Health News Florida.


Still on payroll, despite fatal mistake

Some doctors remain as speakers for drug companies, even after making very public, fatal mistakes.

Case in point: Tampa urologists Tod Fusia and Mark Swierzewski remain in demand as drug-company speakers even though they made a slip-up in surgery, killing a popular high-school teacher in October 2002,

The aim of the operation at St. Joseph’s Hospital was removal of a cancerous kidney. With Swierzewski assisting, Fusia used the then-new robotic arm to snip what he thought were the proper blood vessels. But they turned out to be the aorta and vena cava.

Despite efforts to stitch the vessels back together, the patient died the next day.

Their insurer settled the malpractice case for $1 million. The Florida Board of Medicine and Fusia settled the administrative charges with a $10,000 fine and 100 hours of community service.

Still, during the past 18 months, Fusia has received $6,500 in speaking fees from GlaxoSmithKline, according to ProPublica. Swierzewski got $4,175 from Lilly.

Neither of them returned calls from Health News Florida.

Not fatal, but still...

Another who bounced back from public humiliation is Dr. Charles C. Greene, an ear-nose-throat specialist in Jacksonville. In March 2002, when he set out to repair a patient’s blocked nasal passages by inserting tubes and instruments, he went too far.

An instrument penetrated the brain and removed part of the frontal lobe, according to Department of Health records. When the patient developed symptoms, Greene failed to act swiftly enough, the records said.

Other doctors eventually diagnosed a leak of brain fluid, blood clots in the brain and brain damage.

The family sued Greene and the parties reached a $500,000 settlement in April 2004. Greene also paid a $326,700 settlement in 2004 in a separate case.

In 2009 and 2010, GlaskoSmithKline paid Greene $16,600 in speaking fees, ProPublica found.

He did not return calls from Health News Florida.

--David Gulliver is an independent  journalist and founder of Sarasota Health News. Carol Gentry, Editor of Health News Florida, can be reached by e-mail or at 727-410-3266. 

--

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

http://www.4nursing.com
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http://www.nursingexperts.com

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

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

http://www.4nursing.com
http://www.howtostartanursingagency.com
http://www.jocularity.com
http://www.nursinghumor.com
http://www.nursefriendly.com
http://www.nursingentrepreneurs.com
http://www.nursingexperts.com

Mass. aims to cut drug overuse for dementia - The Boston Globe

State regulators and the Massachusetts nursing home industry are launching a campaign today to reduce the inappropriate use of antipsychotic medications for residents with dementia — a practice that endangers lives and is more common here than in most other states.

During the next year, a team of specialists will identify nursing homes with successful methods for avoiding overuse of antipsychotics and determine which homes need help cutting back. Nursing home staff will be taught how to deal with aggressive and difficult behaviors, often displayed by dementia patients, without resorting to antipsychotics to sedate them.

In 2009, 22 percent of Massachusetts nursing home residents who received antipsychotic medications did not have a diagnosis for which the drugs were recommended — the 12th highest rate of inappropriate antipsychotic use in the nation, the Globe re ported earlier this year.

Twice in the past five years, federal regulators have issued nationwide alerts about troubling and sometimes fatal side effects when antipsychotics are taken by people with dementia, often Alzheimer’s patients.

Specialists say that understaffing sometimes prompts overuse of these medications to help control dementia patients’ behavior, but that inappropriate use can also be traced to lack of training in alternative approaches.

“There is a knowledge gap between the front-line workers — the nurses — and the black-box warnings on these medications,’’ said Laurie Herndon, a geriatric nurse practitioner who is leading the initiative for Massachusetts Senior Care, the trade group representing the state’s 430 nursing homes. A black-box warning is the most serious type of caution used in prescription drug labeling.

“We wanted to avoid talking at them, and instead provide educational material they can use,’’ Herndon said.

Campaign details will be unveiled at the association’s annual meeting today in Worcester, which is expected to draw about 900 people.

Alice Bonner, the state’s top nursing home regulator, said she appointed a task force to study the overuse of antipsychotics in nursing homes and develop alternative approaches after the Globe highlighted the problem in Massachusetts earlier this year. The task force includes nursing home physicians, nurses, social workers, and pharmacists, along with elder advocates, researchers, and state surveyors who monitor the quality of the facilities.

Bonner, director of the Bureau of Health Care Safety and Quality in the Department of Public Health, said the state, given its budget problems, does not have new resources to devote to the campaign, but is working with legislators and the Patrick administration to get new funding in the next state budget. The trade association intends to apply for grants from nonprofit groups to fund the initiative.

“No one is going to plunk a whole lot of money in our laps,’’ Herndon said, “but that shouldn’t stop us.’’

Bonner said that the task force has already identified low-cost approaches used by some nursing homes. One approach involves more careful screening of patients when they are admitted, which includes gathering more detailed information from families about the patient’s personality before the onset of illness. This, Bonner said, helps staffers tailor care and activities to each patient.

“They get a good sense of who a person was before they began to suffer with dementia, what kinds of things they like to do, and what kinds of things their family can tell us makes them calm or gets them engaged,’’ Bonner said.

“When you see a nursing home with a low rate of antipsychotics, very often you will see these programs,’’ she said.

Bonner also said that nursing homes that give workers consistent schedules that allow them to work with the same patients have also been successful.

“That helps reduce difficult behaviors with patients with dementia because staff knows the patients so well, they pick up on early signs of trouble and prevent a catastrophic event, so they can intervene early,’’ she said. Consistent schedules have the side benefit of helping nursing homes retain their workers longer, Bonner said. “Once this is in place, it turns out it is less expensive because staff turnover is expensive,’’ she said.

The education campaign will draw on the work of Dr. Susan Wehry, a geriatric psychiatrist and associate professor of psychiatry at the University of Vermont College of Medicine. Wehry recently concluded an intensive, nine-month pilot project in four Vermont nursing homes that taught all staffers, from housekeepers to medical directors, alternative approaches, such as using music and massage, to manage difficult patient behaviors.

The program, she said, helped identify which alternatives work, which don’t, and how challenging the mission can be.

Wehry is still analyzing the results but said preliminary findings showed that in one of the homes where the administrator made all of the training sessions mandatory for staff, antipsychotic use was dramatically reduced. A third of the patients with dementia had been prescribed antipsychotics before the program, and not one was on them by the end, she said.

“They were much improved in terms of staff-resident interactions and level of alertness,’’ Wehry said. “And they looked happier.’’

Data from another home that did not make all of the training mandatory showed no change in the number of dementia patients given the medications. Wehry said a more troubling trend also emerged there — one of the physicians switched from giving antipsychotics to prescribing antianxiety medications.

“If all we do is shift the burden, then all we have done is create a different set of problems,’’ Wehry said. “Our goal is not to just reduce our reliance on antipsychotics, but to change [patient] behaviors.’’

Kay Lazar can be reached at klazar@globe.com

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Pennsylvania Supreme Court rules that nursing companies must pay home health aides overtime | Markets | Market News | Canadian Business Online

The Pennsylvania Supreme Court said Wednesday a company must pay overtime to its home health care aides, saying an overtime exception only applies to people who pay for domestic services in their own homes.

The court unanimously upheld state Department of Labor and Industry regulations, ruling against Bayada Nurses Inc., which had asked the courts to settle the issue after the agency began looking into how it was paying the aides.

A state regulation that dates to 1977 provides an exception to overtime payments for domestic services in an employer's home. Bayada argued unsuccessfully that it should apply to its aides, who are largely supervised by the householder, and said the regulation would drive up the cost of services.

The company said its "householder clients" approve who will work in their homes, set their hours, control all aspects of services that will be provided and can terminate the relationship. In that respect, it said, the company and the clients jointly employ the aides.

Justice Debra McCloskey Todd wrote that the regulation was reasonable and consistent with the Legislature's intent in the Minimum Wage Act of 1968.

"Under the department's regulation, working for the householder employer permits an exemption from overtime requirements. Working for a third-party agency employer does not," Todd wrote.

Todd's opinion noted that unions and the AARP warned that failing to adequately pay home health care workers "will lead to an even greater shortage of these critical workers."

The court said Bayada was a Pennsylvania corporation headquartered in Moorestown, N.J., and that it had about 38 offices in Pennsylvania that employed more than 1,000 people. A 2008 Commonwealth Court ruling in the case, which the justices upheld, said the home health aides at issue in the litigation helped people with daily living and general companionship.

Labor and Industry spokesman Christopher Manlove said the department was pleased with the court ruling. A message seeking comment from Bayada was not immediately returned.

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American Holistic Nurses Association - the voice of holistic nursing

The American Holistic Nurses Association (AHNA) is a non-profit membership association for nurses and other holistic healthcare professionals, serving more than 5,100 members across the U.S. AHNA has adopted a new mission statement and vision and recently created a statement of purpose .

AHNA is the definitive voice for holistic nursing, and promotes the education of nurses, other healthcare professionals, and the public in all aspects of holistic caring and healing.  AHNA’s efforts recently resulted in the recognition of holistic nursing as an “ official nursing specialty ” by the American Nurses Association. 

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Wednesday, November 17, 2010

Nurse Leaders as Change Agents, Are We Up to the Challenge? By Beth Boynton, RN, MS

Nurse Leaders as Change Agents

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11.02.2010 09:26 PM

Are We Up to the Challenge?

By Beth Boynton, RN, MS

Most of the work I do as a consultant, author and teacher is grounded in my belief that nurses are intelligent, capable and compassionate professionals who have a huge potential and daunting responsibility to improve healthcare. I believe that efforts to communicate respectfully and create respectful work environments will directly and indirectly lead to providing safe, quality care and experiencing long-term rewarding career paths in nursing. In fact, (at the time of this writing) I am working on a keynote address that focuses on this message for the ANA-WA leadership conference in September.

Yet, there are times when I work as a per diem staff nurse, I feel frustrated, powerless and despairing. I have one hundred urgent things to do and time to do about 60 of them if I am going to follow protocols and take the time to listen respectfully to all parties. I can take short cuts and do about 80 of them. Add to that an environment with chair alarms, bed alarms, exit-seeking alarms, endless interruptions, new problems and wasted time looking for supplies, and by the end of my shift I am emotionally, physically and intellectually exhausted. And, I didn't do everything I should have.

Patients, families, physicians, colleagues and administrators have the right to expect skilled, timely and compassionate care, don't they? And I have a right to expect all of these stakeholders to contribute to positive or at least optimal outcomes, don't I? Yet horizontal and vertical violence are huge problems and many of our workplace relationships are dysfunctional. This keeps us fragmented and isolated. Collaboration seems like an obvious way to reclaim our power and have more impact on our system.

But when resources are not there, how far will respectful communication take us? Sometimes I feel so certain and sometimes I don't know. It seems far too easy for a microscopic view of one of those 100 things that I don't do or do incorrectly to reflect poorly on me rather than the very-broken system I am working in.

I love teaching assertiveness and facilitating tough discussions during workshops on effective communication, workplace violence, or inspiring nurse professionals. But in all honesty, when I practice what I teach, I realize how hard it is!

Not long ago I was faced with a situation where my work assignment was unsafe. At first I was stunned to find out I was supposed to be supervising a medication assistant on an adjacent unit. I had my hands full on my own unit and was angry and overwhelmed by this additional responsibility. It was an evening shift and I made it through, but went home exasperated.

I struggled with coming up with respectful language and process for addressing the issue. I felt some internal inadequacy that I could own and I also felt a sense of disrespect for the work I do coming from the organization. It felt like a set up and I did not sleep well.

The next morning I called the Nurse Manager and expressed my concerns. She advised me that it was part of my job expectation and encouraged me to talk with the Director of Nurses. I also called the scheduler and left a voicemail message that I did not feel safe supervising in that situation. I said I would be happy to discuss it, but that I would not accept an assignment in that capacity in the future. He didn't call me back, but when I went in several days later, he approached me and told me that he couldn't make any promises.

I took a deep breath and asked him whom I needed to talk with, as it was not an acceptable answer. He referred me to the DON and I took a deeper breath and knocked on her door. I felt heard and respected at this juncture and have not been placed in this position again. Has it impacted scheduling/staffing in other ways for me? I am not sure.

I am a national presenter, with a graduate degree and book published and I want you to know that the process of taking this concern up the ladder was extraordinarily challenging for me. In the trenches I see my colleagues and support staff working so hard. They have families to take care of, bills to pay, and hopelessness about their ability to change things.

I know that I am role modeling healthy communication skills, providing the best care I can and making a difference. I also know I am asking nurses to stretch in personal and professional growth areas that are extremely difficult.

More and more I see nurse leaders and educators in such critical positions as change agents. Safe and respectful work environments for our staff and patients are critical priorities. Role modeling effective communication, owning our contribution to problems, and providing transformational leadership is indeed, daunting. We need leaders who will help to slow things down and bring back a balance of caring and collaboration into healthcare. I do think we can and I do think we will, maybe not tomorrow, but eventually. And who knows, maybe our efforts will seep into other areas of our world that are moving too fast.

Beth Boynton is an organizational development consultant specializing in issues that impact nurses and other healthcare professionals. She is a coach, facilitator and trainer for topics related to communication, conflict management, teambuilding and leadership development, and author of the book Confident Voices: The Nurses’ Guide to Improving Communication & Creating Positive Workplaces. She is an adjunct faculty member with New England College’s graduate program in Healthcare Administration and contributing University of Florida faculty for the Forensic Science for Nurses certificate program. She has also taught for Antioch University and McIntosh College. She has published several professional articles and her newsletter, Confident Voices, has drawn audiences from across the nation for addressing communication, conflict and workplace dynamics. Her website — www.bethboynton.com — offers more information.


 


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Canadian Blood Services - Société canadienne du sang

Canadian Blood Services is a not-for-profit, charitable organization whose sole mission is to manage the blood and blood products supply for Canadians.

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Grifols USA

Grifols has been working in the fields of transfusion, blood banking and clinical analysis for more than 70 years. Founded in 1940 by Dr. J.A. Grifols Roig, three generations of the Grifols family have led the company ever since. Our Grifols S.A. President, Victor Grifols, ensures that our company will always remain focused on what matters most - people. This dedication to the progress of healthcare for humankind has led to the distribution of Grifols products worldwide.

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