Nursefriendly.com: Hospital Beds

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Sunday, April 3, 2011

How to Find the Best Hospital Near You - US News and World Report

Some Americans are fortunate enough to live down the street from a world-class hospital. For them, where to go for highly skilled care is clear.

For most of us, though, finding a hospital that offers both excellent care and local convenience has long been a challenge. Healthcare consumers have faced a dearth of reliable information about how the hospitals near them stack up. The problem is most acute in large metropolitan areas, which are crowded with hospitals that offer varying degrees of expertise across a range of medical specialties.

In principle, going to a renowned medical center such as one of the nationally ranked U.S. News Best Hospitals is a solid option. But that could be difficult if it requires travel, expensive if not covered by insurance, and unnecessary except in the most challenging medical cases. No wonder most hospital patients stay close to home.

via health.usnews.com

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Friday, April 1, 2011

Cancer patients get better care than patients in primary care

Why do my patients with cancer get better care than my patients in primary care? As the senior resident on my hospital’s inpatient leukemia service recently, this question troubled and intrigued me daily.
Despite the sheer complexity of treating leukemia (administration of chemotherapy, bone marrow biopsies, stem cell transplantation), the resources required (transplantation routinely costs $1 million), and the severity of the illness (patients with little to no functional immune system), I couldn’t help but marvel at how coordinated, integrated, and patient-centric the care was.
From the first day I saw that things in leukemia worked differently. Most inpatient ward teams consist of an attending, a senior medical resident, one or two interns, and medical students. Each member of the team is “on service” for 2-4 weeks after which they rotate to different parts of the hospital or to the outpatient or research setting. As a result a patient admitted to general medicine today is taken care of by a completely different team than took care of her 3 months earlier when she came in for the same problem. On leukemia, our medical team included an advanced practice nurse (APN) who did not rotate off and on service.

via kevinmd.com

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Wednesday, February 23, 2011

Where are the Nurses Mr. President? Nobody Cares.

To the President of the United States from the Yoga Nurse:

Dear Mr. President,

May I be so bold to tell you in my not-so humble opinion the answer to your question, “Where are the nurses?” Elementary dear Watson. Nobody wants the job. why not? because … “This Job is Killing Me.”

As an advocate for nurses, I currently teach meditation, natural stress relief techniques and medical yoga to nurses and nursing organizations through out the country to help them with morale and wellness on the job. Shockingly, I often hear nurses say these exact words to me: “This job is killing me and I’d kill to get off the floor.” It shocked me because I too said those very words at times in my nursing career, but never out loud, and only to myself. These words are engraved in my psyche as the global lament of way too many nurses. Never mind what country, color, religion or background of the nurse, (I have worked in Canada and the USA) it is the same story and not a pretty one.

Why is this job killing me? There are endless reasons why nurses are “dying” from their work and why the job is literally making them sick. Just a few examples that you can surely relate to: Insufficient staffing, overwork, impossibly long shifts, endless charting, little time for patient care, working with inexperienced nurses, burnt out nurses, slackers, disrespect, conflicts between nurses, nurses and doctors, managers, management, lawsuits and liability, being abused by patients i.e. hitting, biting, scratching, punching, yelling, poor health issues, obesity because the only reward is eating…that is, if you get the chance on any given shift, accusations of improper care, etc. etc. etc… (Your turn, fill in the blanks____. _____. _____.). Enough already, you get the idea.

via yoganurse.com

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Friday, February 18, 2011

Released hospital patients' many unhappy returns

Patients who are released from the hospital too early or without proper planning and instructions often wind up back in the hospital after a few days, a problem that's costly to taxpayers and distressing to patients.

A study released today calculated that reducing hospital stays by a single day for Medicare and Medi-Cal patients in California adds up to $227 million a year.

An estimated 81,000 Medicare patients in California - or 20 percent - end up back in the hospital within 30 days of being discharged for some reason related to the same condition, the study found.

"Right now, when you go to the hospital, it's the do-it-yourself model. It's up to you to figure out what to do," said David Grant, author of the study for the California Discharge Planning Collaborative, a group of labor, senior and other advocacy organizations.

Patients, especially those who are elderly and lack social support, are often readmitted because they don't understand their discharge instructions, fail to take their medications or have complications that they can't handle.

via sfgate.com

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Friday, February 4, 2011

New babies and heart attacks don't stop in a blizzard - themorningsun.com

Snowstorms don’t stop babies from being born, people from being hospitalized, and they don’t stop heart attacks.
That means that the maternity staff, hospital physicians, cardiologists and other doctors and nurses at MidMichigan Medical Center-Midland needed to plow through snow drifts or even put on skis to get to work.
Dr. Otto Leiti, an internal medicine special with MidMichigan Physicians Group, needed to get to the medical center in Midland to see his patients who were hospitalized, so he strapped on his skis and made a 40-minute ski trip to get in.
“It was fun. I had to be careful with cars, but cross country skis were designed for survival,” Leiti said. “I should do this every day.”
When maternity manager and registered nurse Tonia Van Wieren learned that the storm was coming, she decided that it would be better just to sleep over in the medical center. And when some staff could not get out to come to work, starting at 3 a.m., VanWieren was there to fill in with newly scheduled staff.
“There have been four babies delivered in the snowstorm, and eight (mothers) were in labor yesterday,” she said. “The medical center’s obstetric unit is full and overflowing on to another floor. We’re making it work.”
For some, even a snow day could not postpone the inevitable. Dr. Richard Bartling, an ral and maxillofacial surgeon who is on the Medical Center’s medical staff, was performing oral surgery at his practice in Mt. Pleasant as usual. No surgeries were cancelled and Bartling extracted teeth as usual.

via themorningsun.com

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Thursday, January 6, 2011

nurses-by-the-numbers.jpg (600×4217)

via nursingschool.org

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Wednesday, January 5, 2011

Hospital care easier, faster with standing orders - CNN.com

My patient one day, a spry 80-year-old, started to cough and feel short of breath during a blood transfusion: classic signs of a transfusion reaction. I stopped her IV, but she needed a steroid to bring her breathing back to normal.

Unable to reach her primary physician, we called in a rapid-response team. An ICU doctor, respiratory therapist, two ICU nurses, a nurse anesthetist, and MDs and RNs from the floor all rushed into the room . . . . to authorize giving my patient this one needed drug.

The patient did not need rescuing, just a dose of solumedrol, and I could have given her that dose, without wasting the time and energy of multiple nurses and doctors, if we had a protocol, or "standing order," in place in my hospital for treating transfusion reactions.

A standing order is a kind of treatment algorithm used in hospitals to expedite care. Protocols are designed by doctors and nurses, implemented by nurses, and are typically used either in specific emergencies or to deliver routine care. A protocol for treating low blood sugar is an example of treating an emergency; putting silver nitrate in a newborn's eyes counts as routine.

Protocols make a lot of sense, according to Nancy Foster, vice president for Quality and Safety Policy for the American Hospital Association. The AHA supports the use of standing orders because, Foster says, "Standardization is an effective way to make sure we do the right thing for the right patient at the right time."

via cnn.com

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Tuesday, January 4, 2011

The Long and Winding Road to the Emergency Room - NYTimes.com

He was the first patient of the day, dropped off at the emergency room by the police or a family member — a man in his 50s, unshaved, stumbling, engulfed in the pungent aroma of alcohol.

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Joseph Daniel Fiedler

When he blew into the breathalyzer’s strawlike tube, the readout was 0.18, more than twice the legal limit.
“I get seizures,” he said, referring to the dangerous reaction some people experience when they abruptly stop drinking. Then, as if to prove it, he held out trembling hands. Each bore the nicks and scars of a hard-lived life.
I looked at the beads of sweat on his brow, then down at his vital signs. Heart rate 120; blood pressure pushing 170/90. Despite his high alcohol level he was already in withdrawal. A medical detoxification — with drugs to counteract the sudden absence of alcohol in his system — was the right first step.
“Let’s admit him,” I said to his nurse. Because it was still early, there was a good chance a hospital bed would be available.
Her reply was apologetic but resigned: “He’s out of network.” I winced at my own naïveté. “Out of network,” a euphemism for “insurance will not pay,” was a roadblock I should have anticipated. A nuisance for many patients and would-be providers, it is ubiquitous in the second-class world of substance-abuse treatment, where insurance companies contract with selected hospitals and doctors to deliver care at bargain rates.
We called the few in-network hospitals within a broad radius. One had a bed. But before accepting my patient, the receiving doctor wanted a battery of tests, including an electrocardiogram and laboratory work, to rule out other medical concerns. It would be a day or so before the tests came back.
But the patient was already in withdrawal, I told the doctor. He couldn’t wait a day.
“Sorry,” he said flatly. “He

via nytimes.com

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Sunday, April 3, 2011

How to Find the Best Hospital Near You - US News and World Report

Friday, April 1, 2011

Cancer patients get better care than patients in primary care

Wednesday, February 23, 2011

Where are the Nurses Mr. President? Nobody Cares.

To the President of the United States from the Yoga Nurse:

Friday, February 18, 2011

Released hospital patients' many unhappy returns

Friday, February 4, 2011

New babies and heart attacks don't stop in a blizzard - themorningsun.com

Thursday, January 6, 2011

nurses-by-the-numbers.jpg (600×4217)

Wednesday, January 5, 2011

Hospital care easier, faster with standing orders - CNN.com

Tuesday, January 4, 2011

The Long and Winding Road to the Emergency Room - NYTimes.com

Joseph Daniel Fiedler

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