Wednesday, July 25, 2012

The Richest Woman In Babylon And #Manhattan by Annette Tersigni #RN @theyoganurse #nurseup #yoga #nursefriendly

The Richest Woman In Babylon And #Manhattan by Annette Tersigni #RN @theyoganurse #nurseup #yoga #nursefriendly:"In this clever adaptation of the 1920s George Clason classic, The Richest Man in Babylon, we find seven timeless truths about getting money, keeping money + making it work for YOU — with the leading roles recast, as a trio of stylish + savvy young woman.
And as in ancient Babylon — where money was first used, treasured and squandered — so in modern-day Manhattan. Fact is: the laws of attraction, affluence + prosperity haven’t changed a bit."
http://yoganurse.com/press-the-richest-woman-in-babylon-and-manhattan/
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Did you know? We've been giving Nurse-Owned Businesses free advertising on http://www.nursingentrepreneurs.com/ for over a decade?

Review Nursing Entrepreneurs by State:
http://www.nursefriendly.com/nursing/directory/nursingentrepreneurs/nurse.owned.businesses.nursing.entrepreneurs.by.state.htm

Review Nursing Entrepreneurs by Category:
http://www.nursefriendly.com/nursing/directory/nursingentrepreneurs/nurse.entrepreneurs.by.category.htm

Join the discussions, ask questions :)

Facebook: https://www.facebook.com/groups/nurseup/

LinkedIn: http://www.linkedin.com/groups/Nurseupcom-Nursing-Healthcare-Advocacy-4366517

Twitter: http://www.symplur.com/healthcare-hashtags/nurseup/

Andrew Lopez, RN
Nursefriendly National Directories
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com

Monday, July 23, 2012

#Texas State Nurses, Could This Happen To You? #amandatrujillo #nurseup #nursefriendly

Texas State Nurses, Could This Happen To You? #amandatrujillo #nurseup #nursefriendly:"The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working a Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur. Amanda educated the patient. She explained the option of hospice instead. The patient decided against the transplant. Then the physician came in, had a well-witnessed tantrum at the hospital when he found out his patient had decided against surgery, and Amanda was fired by the hospital. Her case came up for review by the Arizona Board of Nursing. The summary of her case written by the attorney representing her is below. Amanda has been devastated in terms of her career and her finances. She is back on welfare, her dream of being a nurse shattered."
http://nurseup.com/wordpress/2012/03/texas-state-nurses-could-this-happen-to-you-nurseup/
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For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested
http://www.change.org/petitions/nurseup-com-issue-position-statements-on-the-amanda-trujillo-rn

Arizona State Board of Nursing: Remove Amanda Trujillo's nursing license from "under investigation" status
http://www.change.org/petitions/arizona-state-board-of-nursing-remove-amanda-trujillo-s-nursing-license-from-under-investigation-status

Join the discussions, ask questions :)
Facebook: https://www.facebook.com/groups/nurseup/

LinkedIn: http://www.linkedin.com/groups/Nurseupcom-Nursing-Healthcare-Advocacy-4366517

Twitter: http://www.symplur.com/healthcare-hashtags/nurseup/

Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

Texas Nursing Directories, @hopefulhealer @HospiceHeroes @pedagogymedical #Nurse #entrepreneurs #NurseFriendly #healthcare

Texas Nursing Directories, @hopefulhealer @HospiceHeroes @pedagogymedical #Nurse #entrepreneurs #NurseFriendly #healthcare

http://www.nursefriendly.com/nursing/directory/nursingentrepreneurs/texas.nurse.entrepreneurs.htm

New!

Stephen Ahrens BSN, RN, DC, Paramedical Services:"Paramedical Services is engaged in performing life insurance medical examinations, Long Term Care assessments and D.O.T. physicals for Commercial Drivers."
Contact person(s): Stephen Ahrens
5501 Burnham #1
Corpus Christi, Texas 78413
Phone number: 361-299-2777, E-mail Address: paramedical.services@yahoo.com
http://www.nursingentrepreneurs.com/ahrens

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Carol Gino, RN, BS, MA, Starwater Press, aaha!Books, @hopefulhealer @cgino8 New York, Texas Nurse Authors, Nursing Publishers, Nursing Entrepreneurs, Nurse-Owned Businesses:"Star Water Press, LTD. is a publishing company I formed in 1987 in order to publish angel books and other "alternative" titles that would have taken too long to get published (at the time) at a traditional or commercial publishing house.
I incorporated aaha!Books,LLC in 2010 when I moved to Texas to reprint my previously published books as well as other books in ebooks and other digital media. It is also the company from which I run hopefulhealer.com and starwater.com. My team works at both. aaha!books publishes books "Help for Hard Times, clear and simple-small books of big ideas" Star Water Press is for publishing books both in print and new media"
We have two addresses.
Star Water Press LTD. is in Amityville, NY, 11701
aaha! Books, LLC is in Texas
Street Address: 173 KLBJ Rd. Smithville, Texas, 78957
E-mail Address: staff@starwater.com or team@aahabooks.com
Blog: http://www.hopefulhealer.com/
URL: http://www.starwater.com/
http://hopefulhealer.com/
http://www.nursingentrepreneurs.com/gino

The Nurse's Story by Carol Gino:"Do you still feel the passion to Help? Can you still see the miracles? or Are you exhausted by Burnout? Suffering Compassion Fatigue? National Bestseller! This book is a moving and important affirmation of courage. Of the power of Love and of tragedy redeemed by compassion. Here is a book that will shatter forever your casual assumptions about medicine, doctors, and especially about nurses." http://starwater.com/?aah-ha-books%2Fthe-nurses-story%2F

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Gwenn Dalton, RN, Pro Hospice Solutions, LLC:"Pro Hospice Solutions, LLC understands that care is more than tending to the physical end of life; it is a way of caring for the patient, their family, and support group. Through our community outreach programs, continuing nursing education and continuing education workshops, we empower those care givers and end of life professionals with the ability to advance quality of life and to accept the gift of providing a compassionate end of life for their patient or loved one."
Gwenn Dalton, RN
CEO Pro Hospice Solutions, LLC
P.O. Box 327
Moody, TX 76557
254-853-9903 (office) / 254-853-9966 (fax)
Facebook: http://www.facebook.com/pages/Pro-Hospice-Solutions-LLC/220348904701791
Twitter: http://twitter.com/HospiceHeroes
http://www.prohospicesolutions.com/

Categories: Continuing Education,http://www.nursefriendly.com/ceu/
Facebook Nurses,http://www.nursingdiscussions.com/facebook/ Nursing Education, http://www.nursingentrepreneurs.com/education/
Hospice Nursing, http://www.4nursing.com/hospice/
Texas Nurse Entrepreneurs, http://www.nursingentrepreneurs.com/texas/
Texas Nurses, http://www.4nursing.com/texas/
Twitter Nurses, http://www.nursingdiscussions.com/twitter/

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For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested
http://www.change.org/petitions/nurseup-com-issue-position-statements-on-the-amanda-trujillo-rn

Arizona State Board of Nursing: Remove Amanda Trujillo's nursing license from "under investigation" status
http://www.change.org/petitions/arizona-state-board-of-nursing-remove-amanda-trujillo-s-nursing-license-from-under-investigation-status

Join the discussions, ask questions :)
Facebook: https://www.facebook.com/groups/nurseup/

LinkedIn: http://www.linkedin.com/groups/Nurseupcom-Nursing-Healthcare-Advocacy-4366517

Twitter: http://www.symplur.com/healthcare-hashtags/nurseup/

Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, Andrew Lopez

Tuesday, July 17, 2012

Wednesday #Healthcare #Tweetchats (all EDT): #nurseup #nursefriendly #Nursing #Nurses #HCSM #Health

Wednesday #Healthcare #Tweetchats (all EDT):
http://www.symplur.com/​healthcare-hashtags/​tweet-chats/

3pm #NurChat "@NurChat: 4 hours until #NurChat #Nurses We will be discussing 'transplant' join in and get CPD certificate."
http://www.NurChat.co.uk
http://t.co/ORBEuCDz

3pm @allisulli: Hope you #occhat tweeps are ready for a chaotic step into "artistry as antidote to science"! 3 pm EST/ 8 pm UK/ 5 am Australia #OTuesday
8pm #hcsmla
http://tweetchat.com/room/hcsmla

8pm #treatdiarieschat "@treatdiaries: #treatdiarieschat tonight 8PM ET w/ @dentaloncology - understand your dental needs with a #cancer diagnosis. http://t.co/zJ8LM8kR"
http://tweetchat.com/room/treatdiarieschat

9pm #mhsm Mental Health Social Media: "@NAMIMass: Set your reminders 4 #mhsm chat tonight 7/17 (Tues). Topic is Accepting Chronic Illness – It’s NOT “Giving Up”. All r welcome."
http://tweetchat.com/room/mhsm

9pm #solvePT RT @SnippetPhysTher: #solvePT TODAY 9-10 pm EST Practice Variation & Education. Review prep post: http://t.co/D2PyYI0j
http://tweetchat.com/room/solvept

9:30pm #EOLchat "@DrBeckerSchutte: #EOLchat folks: Im going to use this study/article as a jumping off point for the chat tomorrow night at 8:30 pm CDT http://t.co/W01D82zK"
http://tweetchat.com/room/EOLchat


See full list at the Healthcare Hashtag Project:"What is a tweet chat? A tweet chat affords Twitter users the opportunity to engage in conversation with each other. A tweet chat can either emerge from a new community that coalesces around a particular subject or keyword, or serve to focus the conversation of an existing community."
http://www.symplur.com/​healthcare-hashtags/​tweet-chats/

 

 

 

 

 

 

 

 

 

 

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For more information on Nursing & Patient Advocacy, Entrepreneurship:

http://www.nurseup.com/  

Kindly sign our petitions:

Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

 

 

http://www.change.org/petitions/nurseup-com-issue-position-statements-on-the-amanda-trujillo-rn  

Arizona State Board of Nursing: Remove Amanda Trujillo's nursing license from "under investigation" status

 

 

http://www.change.org/petitions/arizona-state-board-of-nursing-remove-amanda-trujillo-s-nursing-license-from-under-investigation-status  

Join the discussions, ask questions :)

Facebook:

 

https://www.facebook.com/  

​groups/nurseup/

LinkedIn:

 

http://www.linkedin.com/groups/Nurseupcom-Nursing-Healthcare-Advocacy-4366517  

Twitter:

 

http://www.symplur.com/  

​healthcare-hashtags/nurseup/

Andrew Lopez, RN

Nurseup.com, A Nursing Advocacy Organization

38 Tattersall Drive

West Deptford, New Jersey 08051

856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

 

Monday, July 16, 2012

Texas State Nurses, Could This Happen To You? #AmandaTrujillo #nurseup #nursefriendly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Texas State Nurses, Could This Happen To You? #AmandaTrujillo #nurseup #nursefriendly:"The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working a Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur. Amanda educated the patient. She explained the option of hospice instead. The patient decided against the transplant. Then the physician came in, had a well-witnessed tantrum at the hospital when he found out his patient had decided against surgery, and Amanda was fired by the hospital. Her case came up for review by the Arizona Board of Nursing. The summary of her case written by the attorney representing her is below. Amanda has been devastated in terms of her career and her finances. She is back on welfare, her dream of being a nurse shattered."

 

http://nurseup.com/wordpress/2012/03/texas-state-nurses-could-this-happen-to-you-nurseup/

 
 

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For more information on Nursing & Patient Advocacy, Entrepreneurship:

 

 

http://www.nurseup.com/
   

Kindly sign our petitions:

Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

 

 

 

http://www.change.org/petitions/nurseup-com-issue-position-statements-on-the-amanda-trujillo-rn
   

Arizona State Board of Nursing: Remove Amanda Trujillo's nursing license from "under investigation" status

 

 

 

http://www.change.org/petitions/arizona-state-board-of-nursing-remove-amanda-trujillo-s-nursing-license-from-under-investigation-status
   

Join the discussions, ask questions :)

Facebook:

 

 

https://www.facebook.com/
   

​groups/nurseup/

LinkedIn:

 

 

 

http://www.linkedin.com/groups/Nurseupcom-Nursing-Healthcare-Advocacy-4366517

   

Twitter:

 

 

http://www.symplur.com/
   

​healthcare-hashtags/nurseup/

Andrew Lopez, RN

Nurseup.com, A Nursing Advocacy Organization

38 Tattersall Drive

West Deptford, New Jersey 08051

856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

 

 

Tennessee State Nurses, Could This Happen To You? #amandatrujillo #nurseup #nursefriendly

 

 

 

 

 

 

 

 

 

 

 

 

 

Tennessee State Nurses, Could This Happen To You? #amandatrujillo #nurseup #nursefriendly:

"The story of Amanda Trujillo is a horrifying one. Briefly, she is a single mom who fought to get off welfare and fulfilled her dream of becoming a nurse. Not only did she become a nurse, she earned a masters degree in nursing. One night while working a Banner Health in Arizona, she took care of a patient who was being asked to undergo a liver transplant. In talking to the patient, Amanda learned that the patient did not fully understand what was going to occur. Amanda educated the patient. She explained the option of hospice instead. The patient decided against the transplant. Then the physician came in, had a well-witnessed tantrum at the hospital when he found out his patient had decided against surgery, and Amanda was fired by the hospital. Her case came up for review by the Arizona Board of Nursing. The summary of her case written by the attorney representing her is below. Amanda has been devastated in terms of her career and her finances. She is back on welfare, her dream of being a nurse shattered."

 

 

http://nurseup.com/wordpress/2012/03/tennessee-state-nurses-could-this-happen-to-you-nurseup/  

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

For more information on Nursing & Patient Advocacy, Entrepreneurship:

 

 

http://www.nurseup.com/
   

Kindly sign our petitions:

Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested

 

 

 

http://www.change.org/petitions/nurseup-com-issue-position-statements-on-the-amanda-trujillo-rn
   

Arizona State Board of Nursing: Remove Amanda Trujillo's nursing license from "under investigation" status

 

 

 

http://www.change.org/petitions/arizona-state-board-of-nursing-remove-amanda-trujillo-s-nursing-license-from-under-investigation-status
   

Join the discussions, ask questions :)

Facebook:

 

 

https://www.facebook.com/
   

​groups/nurseup/

LinkedIn:

 

 

http://www.linkedin.com/groups/Nurseupcom-Nursing-Healthcare-Advocacy-4366517   

Twitter:

 

 

http://www.symplur.com/
   

​healthcare-hashtags/nurseup/

Andrew Lopez, RN

Nurseup.com, A Nursing Advocacy Organization

38 Tattersall Drive

West Deptford, New Jersey 08051

856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

 

 

 

Tuesday, July 10, 2012

Andrew Lopez, RN Twitter | Andrew Lopez, RN Trending

Andrew Lopez, RN Twitter | Andrew Lopez, RN Trending

See what's trending for @nursefriendly ▸ #tweetchats #nurseup #nursefriendly #interviews and more http://bit.ly/NIomq9 via @twylah

27th Annual NNBA Conference, Healthcare Entrepreneurship Summit @patbemis #nurseup #nursefriendly

Patricia Bemis and the National Nurses in Business Association (NNBA) have been supporting nurse entrepreneurs through conferences, seminars, DVDs, booklets for some time.

If you are a business owner, or nurse considering starting a business, I'd highly recommend them.

Andrew Lopez, RN

http://www.NursingEntrepreneurs.com

Reprinted by permission, original url https://nnba.net/conference.html

27th Annual NNBA Conference

Healthcare Entrepreneurship Summit

Fees: How much is the registration fee?
Discounts: What discounts are available?
Early bird: Are any early birds specials available?
Hotel: Is there a low group hotel room rate?
Agenda: What is on the agenda?
For more information, call 1-877-353-8888.

27th Annual NNBA Educational Conference/Summit

If you are an RN and have an interest in business, this conference is for you. For both entrepreneurs and entrepreneurs-to-be.

  • Discover emerging opportunities for self-employed RNs
  • Sharpen your business skills and learn new ones
  • Gain valuable insights by networking with experienced nurse entrepreneurs

Cosponsored by University of Florida Professional Development and International Commission on Healthcare Certification

University of Florida Professional Development


Registration fee

Register now

  • $199 with discount. Association discounts not available after July 17, 2012.
  • $299 without discount. Association discounts not available after July 17, 2012.
  • Discounts for members of the following associations: AAHC, AANLCP, AALNC, ACHE, APIC, FAHSA, FHCA, Florida Bar Association, FNA, FPA, FSASC, FSRC, IAFN, J.E.R.K. NBNA, NNBA, TAANA. Call 1-877-353-8888 if your association is not included.
  • Early bird special
    • Registrations received before July 17, 2012, will be entered in a drawing.
    • Five winners will receive their choice of either Health Care Risk Management or Forensic Science for Nurses online course.
    • Value is $1000 each.
    • Drawing will be held at the conference.

Register now
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Embassy Suites, Orlando, Florida

  • Location: Embassy Suites Orlando - International Drive/Jamaican Court
    8250 Jamaican Court, Orlando, Florida 32819 - Phone (407) 345-8250
  • Group rate: Group hotel room rate $99.00 (regular rate $139.00) - Group code DCE
    After July 17, the group rate cannot be guaranteed.
  • Hotel Extras: Spacious two-room suites with in-room wet-bar, microwave, and refrigerator. Ideal for families or just to relax in the living room. Complimentary hi-speed internet. Cook-to-order breakfasts and a reception with networking opportunities. On International Drive close to Universal, Disney, and other Orlando attractions.

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Agenda

Time Description for Saturday, August 18th, 2012  
07:3 to 09:00 Registration and free cook-to-order breakfast for hotel guests  
09:00 to 09:15 Welcome and Overview of Conference Format and Objectives.
Patricia Bemis, RN CEN LHCRM
President National Nurses in Business Association
Patricia Bemis

09:15 to 09:50
(35 minutes)

Breaking Out of the Mold, Becoming an Entrepreneur in Healthcare
Frank Poliafico, RN
How can you break out of the mold? Poliafico can tell you how. He broke out of the mold when he was the first to provide emergency training throughout the U.S., in 24 foreign countries, and aboard countless ocean-going vessels. An accomplished magician and member of the famed Magic Castle in Hollywood, California. Watch for quarters appearing from behind your ears.

Frank Poliafico

09:50 to 10:10
(20 minutes)

Morning Break  
10:10 to 10:50

Promoting Yourself
Victoria Powell, RN CCM LNCC CNLCP MSCC CEAS
Unsure of how to promote yourself? Powell will tell you step-by-step how you can promote yourself and maintain your professionalism.

Victoria Powell
11:00 to 12:00
(60 minutes)
Writing an E-Book: Becoming a Published Author
Donald Wood, RN ARNP CRNA
Wish you were a published author? Wood will tell you how you can become a published author and make it as easy as A, B, C.
Donald Wood
12:00 to 01:30 Networking Lunch  
01:30 to 02:00
(30 minutes)

Credentialing: Positioning Yourself as an Expert
Dr. Robert May
Are credentials worth the time and money? Do they really position you as an expert? Dr. May with explain credentailing and what credentials do for a healthcare professional.

 
02:00 to 02:50
(50 minutes)

Investigating the Legal Issues: Reducing the Legal Risk
Tonia Aikens, RN JD
Ever wonder if you are at risk of being sued? Are you exposing yourself to unnecessary legal risk? Are you at risk of losing your RN license? Aiken will answer these questions and more.

Tonia Aiken
02:50 to 03:00
(10 minutes)
Afternoon Beverage Break  
03:00 to 03:50
(50 minutes)

Improving Business Communication Skills: Constructive Criticism
Beth Boynton, RN MS
Ever wish you could give and receive constructive criticism and avoid hard feelings? Boynton will show you how. She is the author of Confident Voices: The Nurses' Guide to Improving Communication and Creating Positive Workplaces.

Beth Boynton
4:00 to 05:00
(60 minutes)

Marketing for Success: Spend a Little, Gain a Lot
Jesse Jackson and Kenneth Nanni, PhD
Want to see a large gain in sales and at the same time spend only a little money? Jackson and Nanni will provide you with marketing tips that will fit the bill.

Jessie Jackson
05:30 to 07:00
(90 minutes)
Reception with open bar, networking opportunities, snacks  
     
Time Description for Sunday, August 19th, 2012  
07:30 to 09:00 Registration and free cook-to-order breakfast for hotel guests  
09:00 to 09:15
(15 minutes)
Welcome Back and Review of Today's Presentations.
Patricia Bemis, RN CEN LHCRM, president NNBA
 
09:15 to 09:50
( 35 minutes)

Emerging Opportunities for Entrepreneurial Healthcare Professionals
Kenneth Nanni, PhD
Wondering what the future holds for entrepreneurial healthcare professionals? Dr. Nanni, the director of Distance and Continuing Education University of Florida, will share valuable insight into the emerging entrepreneurial opportunities for healthcare professionals.

Kennth Nanni
10:00 to 10:50
(50 minutes)
Success Stories: Tales of Nurses in Business
Personal success stories by nurse entrepreneurs
Patricia Lewis, RN LHRM. Listen to a day in the life of a health care risk manager consultant.
 
11:00 to 12:00
(60 minutes)
Entrepreneurship: Moving Beyond Consulting
Frances Fowler, Fellow American Association of Healthcare Consultants
What is the next step for your business? Fowler combines business acumen and clinical skills to assist clients achieve success through well-grounded planning and implementation. She will show you how you can move beyond consulting.
Frances Fowler
12:00 to 01:300
(90 minutes)
Networking Lunch  
1:30 to 2:00
(30 minutes)

What NNBA Can Do for You
Interactice Mini-Workshop: Drill down into the topics with the presentors.
Patricia Bemis, RN CEN LHCRM, president NNBA

 
02:00 to 04:00
(120 minutes)

Roundtable Mini-Workshops: Bring Your Laptop
You may change workshops and attend a difference group at any time.

  1. Bringing a Product to Market
    Gary Bronga
  2. Communicating: Interruption Awareness
    Beth Boynton
  3. Constructive Criticism of Your Page on Facebook and LinkedIn
    Victoria Powell
  4. Using Web Analytics
    Jesse Jackson
  5. Constructive Usability Testing of Your Website and Mine
    Patricia Bemis
  6. Nurse Entrepreneurs Networking Group
 
0400 Adjourn  

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Sunday, July 1, 2012

Why Are Nurses Singing the Blues? June 27, 2012 By #AmandaTrujillo, MSN, RN #nurseup #nursefriendly

Reprinted here with permission, original URL:

http://nurseinterupted.wordpress.com/2012/06/27/why-are-nurses-singing-the-blues/

Why Are Nurses Singing the Blues?

rwjf

I recently read an article written by Debra Wood, RN, a contributor to Nursezone (dot)com. (you can read it here) The topic was a study that reported an alarming percentage of registered nurses who are suffering from depression. I believe she referenced 18% of nurses polled in a study reported symptoms of depression—in comparison to 9% of U.S. adults who have reported having depression. She posed a reasonable question: Why is this happening? Many of us who have worked at the bedside recently or are currently practicing at the bedside can recite at least ten or more reasons easily. My number one response is: the evolution of Corporate Nursing. I’ve blogged about this “new” specialty of nursing that has been developing over the course of years as the healthcare system has become more complex.

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Before I discuss Corporate Nursing further, I’d like to offer my own take on the depression issue. My hunch tells me that the rate of depression in nurses is significantly higher than reported. Although the study itself included a little over a thousand nurses I think of two things: the stigma associated with depression and other mental health disorders is such that people are ashamed to report symptoms or to approach their primary care providers for help. “That” goes in your medical record, and if for some reason your medical record is accessed down the road other people will know about your diagnosis. If you think that your electronic medical records are safe because you see physicians or go to clinics within your healthcare institution—think again. Those records are privy to the inspection of risk management, employee health, and the information “magically” makes it to your unit managers. (Of course they will feign “shock” at even the suggestion that they get this type of information on their staff) From there you can be considered a liability to patient care. This does happen, and I was advised of this by an attorney who says it is a common “under the table practice.”***I’ve said it many times before—practice defensive corporate nursing!**** If you need to get help, get it “outside” of the healthcare providers associated with your workplace!!

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The other reason I think nurses are depressed is the perception of being “stuck.” I read some research in recent days that discussed reasons many new graduates are leaving the nursing profession so soon after graduation— it’s the shock they encounter when they actually get out there and do the real stuff nursing is about. Students are not taught what they will actually be a part of after they graduate—the pressure, the workplace politics, the moral distress, the higher acuity of the patients, and the impossible expectations from management to “get the patient satisfaction scores up.” Those are just a few of the burdens we face as bedside nurses. Other nurses feel stuck because they did not go back to school and increase their marketability so that there would be greater career possibilities, as a result they are pinned down at the bedside and remain there for years—a perfect recipe for burnout. There was a statement in the article about how “being depressed” leads to all the problems interacting with coworkers, patients, and providers. I’d like to pose the theory that its those very interactions that can be the “cause” of the depression. Nurses don’t just get depressed out of the blue and start taking it out on everyone around them, its an accumulation of negative or emotional interactions with others that is a very big contributor. We could ask that well known question—”What came first, the chicken or the egg?” My bet is that the depression comes from the workplace first and initiates a cascade of interactions or issues much like the clotting cascade. When something goes awry….it can rapidly deteriorate to DIC. We could also utilize the Renin Angiotensin Aldosterone feedback loop as a comparison.

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Generational differences in the workplace are also a problem. The time honored conflict of the “older generations of nurses versus the newer generations of nurses.” Most of the “veteran or baby boomer” nurses are in management positions and have a very different view of the workplace, how they communicate, and how they behave in comparison with the newer X and Y generations of nurses. Many of these management figures never went back to get a higher degree or to learn the leadership skills that are so essential to run a successful unit with good patient care outcomes, effective teamwork, and happy nurses. Research has shown the greatest conflicts exist between the Generation X nurses and the Veterans/Baby boomers. The caustic relationship these two generations have with one another is where the phrase “nurses eating their young” came from. Certainly, that can contribute to depression over time. I don’t think I need to go into the emotional and physical effects of nurse bullying on a nurse—whether it be in the workplace or in cyberspace. There are plenty of books on the subject, and I am going to make a safe assumption that it’s a pretty big contributor to depression in nurses.

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Corporate Nursing has evolved into something reminiscent of assembly lines in a factory. We discharge three patients and right away we get three new ones. There is paperwork to complete, orders to process, phone calls to make, and charting to do. Today’s nurses don’t even have the time to go over the patient’s history in the computer or do care plans because of the fast paced environment, impossible nurse to patient ratios and the higher acuity of the patients. The patients need more, and more, and more. Nursing theory? What’s that? Nursing diagnoses? There is no time for such luxuries. I can tell you that many days I went off shift swearing that I knew nothing about my patients except that they were alert, oriented, pink, warm, dry, had their meds, had good blood pressures, decent rhythms, and that my charting was done. That isn’t what I went into nursing for.

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As I was growing up I didn’t dream of being a nurse so I could just process people in and out of a hospital as fast as possible before I felt they were even safe to discharge. I didn’t work hard to make it through nursing school with my daughter just so I could go perform a bunch of tasks over and over that really add up to nothing but “tasks” at the end of the day. I went to school to become a nurse because I wanted to get to know my patients, to help them make decent recoveries, to take the time to teach them and listen to them and support them. I went to school because I wanted to help “people.” I went to school with the idea that nursing was about my allegiance to “the patient.” I graduated with that understanding too. My nursing professor constantly stressed the importance of balancing “hi tech nursing with hi touch.” Unfortunately that isn’t what nurses “do” or who nurses “are” in hospitals today. The definition of nursing as we are taught by our professors is not the same definition a hospital has for our profession. Personally I have a problem with the art and science of nursing being manipulated and refashioned into something I don’t even recognize—all in the interests of the mission, values, and goals of an institution.

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To be successful nurses, Corporate Nurses must have allegiance to the institution FIRST. They are required to be who the hospital wants them to be, look like the hospital wants them to look; they are to believe what the hospital wants them to believe, and they are to follow the status quo without questions. One’s sense of ethics, values, beliefs are to be set aside because they have no place in the Corporation. Over time, it can be very easy to lose one’s self in all of that. One day you wake up and wonder who the hell you are and why you are there…you wonder how long it’s been since you really knew what you stood for in the world or in the profession. Today’s Corporate Nurses know they cannot speak up in the interests of their patients without retaliation, so they feel forced into silence and stuck between a Corporation and their patient, between their job and the lives of their patients. It can’t be a fun feeling to have at the end of the day when you try and sleep, or when you get off of a three shift run and have four days to think about the patient you knew was in danger but were forced to turn away from. Certainly enough of these scenarios can really tax a nurse’s emotional and physical health over time.

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At the end of horrific days during which none of the nurses on a unit got the chance to eat, use the bathroom, or get a moment away to attend to their own psyche– it’s unrealistic to expect that these same nurses are going to bounce on out the hospital doors focused on heading straight to the gym for a cardio session or adding up their calories and fat grams for the day. They go home, say hi to their families, and crash—hard. Then, it’s time to do it all over again even though they feel they could still sleep another whole day before being ready to go back to “that.” I dare suggest that for a majority of nurses preventive health is one of the last things on their mind because they are too busy and stressed trying to “survive” moment by moment, hour by hour, day by day. Their brains are too full, their shoulders too burdened to think of themselves and living out the “ideal healthy life.” As it is they barely get enough sleep or rest.

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Look, I could go on and on and continue to list reason after reason for why nurses are depressed more than the general population. The Nursezone article offered some strategies to reduce depression in nurses that, in my opinion, aren’t going to happen anytime soon. After all, they would require the “ok” of the Corporation and the investment of more money into what hospitals already recognize as the biggest expense they have—Nurses. One suggestion I found completely unrealistic in today’s politically charged, toxic work environments involved having managers bring up an open discussion on depression during staff meetings. I can’t see any nurse wanting to pipe up during that “talk” and take the chance of possibly being “looked at closer” by management. Some suggestions in the study she cited included: “Advocating for policies that support good mental health and treatment for those with problems, promoting supportive work environments and making reasonable accommodations for nurses whose depression is negatively affecting their work performance.” Again, a supportive work environment means what a Corporation wants it to mean, not what nurses want, desire, or need it to mean. The word “advocating” and Corporations just don’t go together. Furthermore, Corporations don’t make “accommodations” for those who present a potential liability to their bottom line, they just find ways to discipline the liabilities until they can terminate them—it’s cheaper and less messy.

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When you think about it–It all goes together, why nurses are depressed more than other people. When your body is under a great deal of stress your stress hormones and metabolism go out of whack. The fight or flight response is always “on.” When you’re busy you don’t think of eating, or eating the way you should. Some people utilize food to self- medicate for stress. When you aren’t getting good sleep your metabolism is greatly affected and your weight can increase as a result of that. If you aren’t happy with your job to begin with and you aren’t sleeping, eating right, exercising, and are gaining weight it could be hypothesized that a nurse would likely begin to feel like everything is out of his/her control—especially if all of these things are affecting the home life as well. Loss of control depresses our patients, we are not exempt from that.

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Balance is the key word here, but it is hard for nurses to maintain balance in their lives when one of the biggest parts of their life is so unbalanced. This toxicity spills over into all other areas of their lives, through no fault of their own, and I believe that. If we want healthier, more balanced nursing professionals who will remain in our profession changes have to start at the Corporate level. Corporations have to buy into the theory that investing in the health and well- being of their nurses will pay off for them in the long run. They must be convinced that they will get a return on their investment. Remember that Nurse Managers cannot advocate for bedside nurses when their loyalty is to the upper management that they must answer to and support. Corporations have to view nurses as a valuable resource and act accordingly. They have plenty of money to expand and buy more properties and equipment…I have a hard time believing that these same Corporations can’t invest in a high tech fitness center/trainers for its staff members, massage therapy, communications courses, support groups for nurses, a partnership with companies like Weight Watchers to help people learn how to eat better on the run, or financial incentives to promote healthier BMI’s and pounds lost. Certainly there is room in the budget (we all know there is) to invest in lift equipment for every patient room, more patient care assistants to help the nursing staff, and a work schedule option that would allow nurses to choose 8, 10, or 12 hour shifts.

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Let’s recall the RWJF’s initiative “Transforming Care At the Bedside.” If you want happy, satisfied patients and good patient outcomes, you must must must invest in the happiness, satisfaction, and health of the nurses first–as well as the cohesiveness and well being of the nursing team. (Its purpose is also to enhance positive multidisciplinary interactions but I am focusing on nurses for sake of discussion) Until Corporations stop putting the cart before the horse (skipping over the nurse and focusing on competition, profits, and patient satisfaction) the number of nurses with mental health ailments like depression is going to continue to rise and they will keep leaving our profession as fast as we get them in.

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We cannot heal others until we heal ourselves FIRST. We can’t give to others what we don’t have to give to ourselves.


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For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested
http://www.change.org/petitions/nurseup-com-issue-position-statements-on-the-amanda-trujillo-rn

Arizona State Board of Nursing: Remove Amanda Trujillo's nursing license from "under investigation" status
http://www.change.org/petitions/arizona-state-board-of-nursing-remove-amanda-trujillo-s-nursing-license-from-under-investigation-status

Contribute to Amanda's Legal Defense Fund:
http://apps.facebook.com/fundrazr/activity/99fa97b4502c40939c18ae0da407793c?type=endorsement

Join the discussions, ask questions :)
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Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, Andrew Lopez

Saturday, June 30, 2012

Tennessee State Nurses, Could This Happen To You? #nurseup #amandatrujillo #nursefriendly

Tennessee State Nurses, Could This Happen To You? #nurseup #amandatrujillo #nursefriendly:"Have you been following the Amanda Trujillo, RN vs Del E. Webb Medical Center, Sun City, Arizona case? It is an important one because it could happen to you.
Please take the time to learn more by reading the articles that follow, and visiting http://www.nurseup.com/"
http://nurseup.com/wordpress/​2012/03/​tennessee-state-nurses-could-th​is-hap...
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For more information on Nursing & Patient Advocacy, Entrepreneurship: http://www.nurseup.com/

Kindly sign our petitions:

Amanda Trujillo, RN & Banner Del E. Webb Medical Center, Sun City, Arizona: Position Statements Requested
http://www.change.org/​petitions/​nurseup-com-issue-position-stat​ements-on-t...

Arizona State Board of Nursing: Remove Amanda Trujillo's nursing license from "under investigation" status
http://www.change.org/​petitions/​arizona-state-board-of-nursing-​remove-aman...

Contribute to Amanda's Legal Defense Fund:
http://apps.facebook.com/​fundrazr/activity/​99fa97b4502c40939c18ae0da407793​...

Join the discussions, ask questions :)
Facebook: https://www.facebook.com/​groups/nurseup/

LinkedIn: http://www.linkedin.com/​groups/​Nurseupcom-Nursing-Healthcare-A​dvocacy-4366517

Twitter: http://www.symplur.com/​healthcare-hashtags/nurseup/

Andrew Lopez, RN
Nurseup.com, A Nursing Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly