Tuesday, August 14, 2012

Nursing Online Continuing Education (CEUs) @TrishaCoady @hospiceheroes @pedagogymedical @Corexcel #nurseup #nursefriendly

Nursing Online Continuing Education (CEUs)

ShareThisThe Shortcut URL To This Section Is: http://www.nursefriendly.com/ceu/

New!

Trisha Coady RN BScN MN(c), CoursePark.com:"We provide approved nursing continuing education in various clinical specialties such as cardiology, critical care, emergency, community health, etc. As well, we offer a leadership and regulatory catalog that can be consumed by either individual nurse professionals or healthcare organizations. Promoting community engagement, lifelong learning, and the Nursing profession. Together, we learn more." Canada
Phone number: 1-800-563-3638 x 663
E-mail Address: trishacoady@coursepark.com
Blogs: http://nursesnetwork.com
http://www.coursepark.com/blog
Social Media (Twitter, Linkedin, Facebook, etc):
Facebook: http://facebook.com/NursesNetwork
Twitter: http://twitter.com/Nurses_Network
LinkedIn: http://www.linkedin.com/in/trishacoady
LinkedIn Group: http://www.linkedin.com/groups/NursesNetwork
Nursing Community: http://nursesnetwork.com
******************************************************

http://www.nursingentrepreneurs.com/coady

 

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/

 

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

Capra Dalton RN, CEO, Pedagogy Incorporated, Texas Nursing Entrepreneurs, Continuing Education (CEU) Providers:"Pedagogy Incorporated is a provider of nursing continuing education. We specialize in I.V. Therapy Education and Wound Care Education. We offer accredited courses to individual nurses, Long Term Care Facilities, Home Health Agencies, and Hospitals. Pedagogy can assist facilities and agencies with determining an Infusion Education plan that suits their unique market. Competency demonstration (skills) Checklists have been developed for all I.V. and Wound related skills and are available for those that choose Pedagogy Education. We are currently adding authors and expanding our course offerings to respiratory therapy, PT/OT's R.Ph. etc."

Tyler, Texas, 75703
E-mail Address: sales@pedagogy-inc.com
Phone number: 903-504-8712
Social Media:
FaceBook: http://www.facebook.com/pedagogyonline
LinkedIn: http://www.linkedin.com/company/1041497
Twitter: http://twitter.com/pedagogymedical
Website: http://www.pedagogy-inc.com
http://www.nursingentrepreneurs.com/dalton

Categories: Continuing Education, Educational Nurse Entrepreneurs, Infusion Therapy, Nurse-Owned Businesses, Nursing Continuing Education, Nursing Education, Transfusion Therapy, Wound Care

****************************************************** The Best Defense Is a Good Documentation Offense, Corexcel.com:"After completion of The Best Defense Is A Good Documentation Offense, the participant will be able to:
1. Explain the importance of documentation as a health care provider.
2. Identify the basic information that is required when documenting in the medical record.
3. Describe those particular issues that require documentation in the medical record.
4. Discuss the emerging documentation concerns regarding the faxing and computerization of records.
5. Determine documentation Do's and Don'ts."
201 Webster Building
3411 Silverside Road
Wilmington, DE 19810
Phone: 1-302-477-9730
Toll Free: 1-888-658-6641 (inside the U.S.)
Fax: 1-302-477-9744
Better Business Bureau: http://www.bbb.org/delaware/business-reviews/employment-training/corexcel-in-wilmington-de-24000301/
Facebook: https://www.facebook.com/Corexcel
LinkedIn: http://www.linkedin.com/company/corexcel
Merchant Circle: http://www.merchantcircle.com/business/Corexcel.302-477-9730
Twitter: https://twitter.com/#!/corexcel http://www.corexcel.com/html/documentation.title.ceus.htm
Categories: Charting, Documentation, Nurses Notes, Continuing Education, Delaware Businesses, Delaware Nursing Resources, Facebook, LinkedIn, Twitter

 

 

****************************************************** Larry Snyder, BA, RN, DBA, RN.ORG, SA, Nursing Continuing Education Providers:"Larry Snyder, RN is the Founder and President of RN.ORG®, SA. As a licensed healthcare professional with over 15 years of experience in nursing as well as a computer authority with in-excess of 20 years of experience, he is knowledgeable with the integration of healthcare and computers and sees a strong need for licensed professionals to maintain their license in an easy, convenient, comfortable no stress environment. Larry has worked in various aspects of nursing in many states in both large and small hospitals and has the experience and background to make healthcare and nursing education friendly. Larry also functioned as a consulant at large corporations in various aspects of IT management including CBS Sports, Sportsline.com, Sports.com, Universal Studios, Nickelodeon, Viacom, Flexsys and Monsanto. Larry also has served as an expert witness on several high profile cases throughout the United States sharing his valuable input as an experienced Emergency Room nurse."
Latin America Office (Corporate Offices)
Larry Snyder - RN.ORG®, SA
CR 15A # 10A-03
El Poblado, Medellin, Colombia
Hospital Sales (English) USA: 1-954-369-4556
Hospital Sales (Español - E.E.U.U): 1-860-786-1866
E-mail Address: info@rn.org
Blogs, Social Media (Twitter, Linkedin, Facebook, etc): http://www.facebook.com/MedellinRN
http://www.linkedin.com/pub/dir/Larry/Snyder
http://www.twitter.com/wwwRNorg
Phone number: 954-369-4556
Website: http://www.rn.org
http://www.nursingentrepreneurs.com/snyder/

 

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

 

 


Nursingentrepreneurs.com is a networking and resource directory for Nurse-Owned businesses and nurses looking for an alternative to working at the bedside.

If you explore the site a bit, you'll find profiles of hundreds of nurse entrepreneurs around the country. We encourage you to browse around, find a business category you are interested in, then contact the nurse directly. We're available for questions as well. This website is Owned-Operated by Andrew Lopez, RN.

Has your Nurse-owned business been written up in the news? Do you send out a newsletter or regular press releases? We'd like to hear about it!

 

 

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

The #1 question, we've been receiving lately is about Starting A Nursing Agency, resource sites & manuals

 


Please choose from the following:

 

Trisha Coady RN BScN MN(c), CoursePark.com #Canadian #Nurse #Entrepreneurs, @TrishaCoady @Nurses_Network #nurseup #nursefriendly #healthcare

Trisha Coady RN BScN MN(c), CoursePark.com

New on the Nursefriendly :)
http://www.nursingentrepreneurs.com/directory.entrepreneurs.canada.coady.trish.htm

Your Name, Degrees Licenses: Trisha Coady RN BScN MN(c)

Your Business Name (if applicable): CoursePark.com

Business Organization? Corp

Please describe in detail your business/services you provide: We provide approved nursing continuing education in various clinical specialties such as cardiology, critical care, emergency, community health, etc. As well, we offer a leadership and regulatory catalog that can be consumed by either individual nurse professionals or healthcare organizations.

Promoting community engagement, lifelong learning, and the Nursing profession. Together, we learn more.

Contact person(s): Trisha Coady

Phone number: 1-800-563-3638 x 663

State/Province, (and country if not USA): Global, online

E-mail Address: trishacoady@coursepark.com

Blogs: http://nursesnetwork.com

http://www.coursepark.com/blog

Social Media (Twitter, Linkedin, Facebook, etc) Facebook: http://facebook.com/NursesNetwork

Twitter: http://twitter.com/Nurses_Network

LinkedIn: http://www.linkedin.com/in/trishacoady

LinkedIn Group: http://www.linkedin.com/groups/NursesNetwork

Homepage Address:

Nursing Community: http://nursesnetwork.com

Continuing Education:
https://secure.coursepark.com/course/market/index/genre/14/page/1

Society for Vascular Nurses: http://svn.coursepark.com

Air & Surface Transport Nurses Association: http://astna.coursepark.com

NursingCrib: http://nursingcrib.coursepark.com

Canadian Nurses: http://www.nurseone.ca/coursepark/index.html

Type of business categories would you would like to be listed (no maximum, we make up new categories frequently for registrants): Continuing Education, Education, Nursing Community, Nurse-owned Business, Seminars, Publishing, Informatics, Health Promotion

Keywords, Phrases that describe your business, experience, services: continuing nursing education nursing continuing education nurse CEU nursing CEU nursing CEUs online nursing courses nursing courses online Nurses CPD, Nurse Blog, Nursing Professional Development, Nursing Blogs, Nurses Network, Nursing Community, Online Nursing Community

In what date (month/year) did you start your business? 2005

What Attracted You To The Field of Nursing? Flexibility, growth, opportunity

What is your experience and background in Nursing? Medical-surgical, Coronary ICU, Neonatal ICU, Flight Nursing

http://www.nursesnetwork.com/about/

Would you recommend Nursing as a career? Absolutely!

How did you hear about the Nursefriendly, NursingEntrepreneurs.com?: social media

The year were you first licensed as a nurse? 1997

What school(s) of nursing did you attend? local

Professional organizations you have belonged to (now or in the past, please spell out the full name): Too many to list…

What made you decide to start your own business? A vision to unify nurses through education

How many times have you changed employers in your career? 5-6 as I need to be constantly learning new things.

What specific qualities and traits do you feel make nurses especially qualified to operate a business? To have a vision or dream and be willing to chase it

View previous responses: http://www.nursingentrepreneurs.com/qualities

What exactly is a nurse entrepreneur? To me, it is someone who leads change towards the improvement of the nursing profession.

Do you currently practice as a nurse? If yes in what type of setting? Yes, as an entrepreneur and Practice Manager in continuing education

Your most pressing concerns with the profession and healthcare: Unity – if we had unity, all other concerns would diminish over time.

View previous responses: http://www.nursefriendly.com/concerns/

How do you feel the coming nursing shortage (as baby boomer enter the healthcare system, and nurses retire in droves) will affect patient care? We had better find a way to mentor our young nurses to develop critical thinking or both patients and profession will suffer.


Nursingentrepreneurs.com is a networking and resource directory for Nurse-Owned businesses and nurses looking for an alternative to working at the bedside.

If you explore the site a bit, you'll find profiles of hundreds of nurse entrepreneurs around the country. We encourage you to browse around, find a business category you are interested in, then contact the nurse directly. We're available for questions as well. This website is Owned-Operated by Andrew Lopez, RN.

Has your Nurse-owned business been written up in the news? Do you send out a newsletter or regular press releases? We'd like to hear about it!

 

 

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

The #1 question, we've been receiving lately is about Starting A Nursing Agency, resource sites & manuals

 


Please choose from the following:

 

Thursday, August 9, 2012

Thursday #Healthcare #Tweetchats (All EDT) 6pm #DWDChat 8pm #Hchlitss 9pm #MedEd 9p #medlibs 915pm #RNChat All Day #Braintumorthursday - #nurseup #hcsm

Thursday 8/9/2012 #Healthcare #Tweetchats (All EDT)

All Day #Braintumorthursday
http://tweetchat.com/room/braintumorthursday

6pm #DWDChat @DeathwDignity: You say you got a real solution Well, you know We'd all love to see the plan http://t.co/LRFPKDB6 #DWDchat 6p ET w/@marksphone #hpm #eol
http://tweetchat.com/room/dwdchat

8pm #hchlitss @drkdhoffman:
http://tweetchat.com/room/hchlitss

9pm #MedEd (Medical Education): @mdTalk NYT The Bullying Culture of Medical School #meded #medschool #premed http://t.co/fYe92ubE http://t.co/uMVdWWDB
http://tweetchat.com/room/MedEd

9pm #Medlibs @eagledawg: #medlibs chat tonight 6 Pacific/9 Eastern abt emerging roles! http://t.co/WE7l7Evp All welcome, no members-only suggestions on Twitter ;)
http://tweetchat.com/room/medlibs

915pm #RNChat
http://tweetchat.com/room/rnchat

See full list at the Healthcare Hashtag Project:
http://www.symplur.com/healthcare-hashtags/tweet-chats/

If we are missing any important ones, kindly contact us at info@nursefriendly.com

Wednesday, August 8, 2012

Wednesday, August 8,2012: #Healthcare #Tweetchats (all EDT): 8p #s4pm, 9p #dsma 9p #hpm 9p #mhealth 9p #premeded - #nurseup #nursefriendly

Wednesday, August 8,2012: #Healthcare #Tweetchats (all EDT): 8p #s4pm, 9p #dsma 9p #hpm 9p #mhealth 9p #premeded - #nurseup #nursefriendly
http://www.symplur.com/healthcare-hashtags/tweet-chats/
For more like this, follow @nursefriendly (Andrew Lopez, RN)

8pm #s4pm: @yogileana: @bacigalupe Please join us for a @S4PM tweetchat tonight at 8 PM ET/5PM PT about med lit, empowerment and health literacy w @murzee
http://tweetchat.com/room/s4pm

9pm #dsma: @DiabetesSocMed: Affected by #diabetes? Join the #dsma convo, Tonight at 9 PM EST. Its the fastest & funniest hour of the week. http://t.co/10bbhIAd
http://tweetchat.com/room/dsma

9pm #hpm @aliciabloom: looking forward to hosting #hpm tweetchat tonight at 9pm EST. all are welcome for lively discussion about #hospice & #palliative care!
http://tweetchat.com/room/hpm

9pm #mHealth: @annelizhannan: Special #mHealth chat with Dr. Eric Topol, tonight at 9pm ET http://t.co/lNJ76dIt via @iMedicalApps MT @Berci @ElinSilveous
http://tweetchat.com/room/mHealth

9pm #premeded: "@PremedEd: Join us tomorrow and every Wednesday at 9 PM EST for #premeded! Got a topic in mind? Tweet @premeded or send a DM! #premed #meded #hcsm"
http://tweetchat.com/room/premeded

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/

Nurses Followed Dr.'s DNR Order On Patient, Confusion about Advanced Directives #nurseup #DNR #Eolchat #DWD #nursefriendly #healthcare #hcsm

Clinical Nursing Case Studies

Nurses Followed Dr.'s DNR Order On Patient, Confusion about Advanced Directives


D Myrna Wheelock, ET AL. v. Jesse Thomas Doers, M.D., 2010, E2009-01968-COA-R3-CV

by Amanda Trujillo, MSN, RN

Hello Everyone,

Welcome to Nursing Clinical Case of the Week.

This publication is sent out by request.To subscribe send an email to: clinicalnursingcases-unsubscribe@topica.com


The topics presented and background resources are continuously being researched. As new material is added, it will be placed online. For the most current links and resources please consult the online version @ http://www.nursingcasestudy.com/ A list of previous case summaries is available on request and online.

If you feel our publication is useful, please invite others to subscribe
@ no cost. Feedback is welcome.

Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com/ info@nursefriendly.com @nursefriendly

Summary: A nurse advised the CNA to stop CPR on a patient who had a DNR order in place, the family objected and filed a malpractice suit against the hospital, physician, and nurse involved in the case.

It's 1830 and there's only half an hour left until you are done with what has been a rather horrific day. Your caseload has been taxing, to say the least: one 96 year old Alzheimer's patient you've been assessing and documenting on every two hours, two fresh PACU patients, and one patient actively dying after a sudden CVA whose family members have taken turns camping out where your work computer is located. Needless to say, you've got nothing left to give. As you sit down to enjoy the iced coffee a girlfriend brought you an hour ago you lean back and close your eyes, drawing in a deep breath. You did it. Everyone's still alive. You're a rock star. Your body begins to let go of all that tense energy….

Just then, a code is called overhead. It takes a moment to register that it's your room everyone is running to. Fight or flight makes a quick comeback from the locker room (where started a nice hot shower) and you sprint down the hall, pushing your way through a cluster of your colleagues standing in the doorway. Your patient is unresponsive on the floor and the CNA is performing CPR. The family members are frantic, one of the three daughters is yelling that the patient is a DNR, but the son is growling back that he is the power of attorney and the living will the patient filled out 2 years ago indicates that he wishes to have all heroic measures taken. You give a knowing look and a nod to your best buddy who is also the charge nurse-- she knows exactly what you want done—and she grabs another nurse to help her escort the family out of the room. Reaching into your pocket you take out the notecard you have for this patient and sure enough it confirms that the patient is indeed a DNR upon admission to the floor. You advise the CNA to stop CPR immediately. You assess that the patient has no palpable pulses and there are no signs of life. The CODE team arrives and you tell them that your patient is a DNR status so they turn around and begin to leave the unit. The son's voice can be heard yelling in the hall commanding the CODE team to return. One of the daughters has now come back and sits quietly in the corner of the room appearing stunned.

Shortly after you and your lift team have gotten the patient into the bed the doctor arrives. You brief him on the sequence of events as reported to you by the CNA: The patient remained on bed rest after his IVC filter placement surgery that concluded at 1630. He had been stable. He requested to get up and go to the bathroom at 1815 (the patient was to be on bed rest for two hours) and you provided the OK for him to walk to the restroom with the assistance of the CNA after one last incision assessment. The CNA reports that while getting him out of bed it was discovered that the oxygen tubing was too short so he ran to get longer tubing for the patient's oxygen to remain on while in the restroom leaving the patient under the supervision of his daughter. When the CNA got back he found the patient had taken the oxygen off and left it on the bed as he tried to get up on his own despite the pleading of his daughter (she filled in the gaps for you). She witnessed the collapse and yelled for help as the CNA was returning to the room. The CNA, unaware of the code status, began CPR and called a code blue.

The doctor, scratching his head, appears satisfied with your report and turns to the patient's daughter, gently requesting her to come with him so he can talk to the whole family together. She nods, and allows him to guide her out of the room. Your charge nurse brings in a body bag and offers to help with postmortem care as it is now shift change and your other coworkers are in report. A sudden loud, angry outburst from the son in the hallway makes you both look up at each other and its then you know in your “nurse gut” that you're going to court.

The Real Thing

In 2010 a case similar to the one above played out in Knoxville, Tennessee. An elderly gentleman was transported from a nursing home to a hospital emergency department with a chief complaint of shortness of breath. Upon further testing it was discovered the patient was suffering from massive pulmonary emboli. The physician explained to the patient that the prognosis was quite poor, but offered to place an IVC filter anyway. The patient agreed to the surgical procedure and made it clear to the physician that he did not want any heroic measures taken if he went into cardiopulmonary arrest. The doctor documented thoroughly—he mentioned the alert and animated state of the patient, quoting the patient directly with regards to his wishes to be a Do Not Resuscitate status while also noting the man's poor prognosis.

After undergoing the IVC filter placement the patient experienced an uneventful recovery period (bed rest) and was allowed to ambulate to the restroom with the assistance of a CNA by approval of the RN. Upon discovering that the patient's oxygen tubing was too short the CNA ran to get a longer length to walk with. As the CNA was returning he heard family members in the hall calling for help. The patient was found on the floor of his room unresponsive. The CNA called a code and immediately began CPR. When the RN arrived she told the CNA to halt CPR because the physician had entered a DNR status for the patient. The family members in the room, horrified, demanded that the patient receive full intervention. The RN explained that the patient had specified to the doctor that he wanted no heroic measures taken. The son countered that his father should receive life saving measures because he was the power of attorney for his father and possessed the advanced directives that had been filled out by him for some time prior to this hospitalization. Again, the RN explained that the patient's current decision and the order entered by the doctor were things she could not go against.

Questions for consideration:

1. Did the nurse have a crucial role to play in this situation? If so, what was it?

2. What responsibility, if any, does the family have in a situation like this?

3. What responsibility, if any, did the patient have in this situation?

4. What, if anything, could have been done to prevent litigation here?

5. Does a Power of Attorney have the right to “override” a healthcare decision made by a patient and discussed with a doctor just prior to a critical event such as this one?

6. Which healthcare decision by the patient takes precedence in a situation like this one? (One made just hours before a critical event and discussed with a doctor, or an advanced directive signed by the patient two years ago?)

7. Should a nurse inform family members during a hospitalization of the patient's decision for a DNR or Full Code status? Why or why not?

Outcome

On July 6, 2010 in the case of Wheelock versus Doers (MD) the court decided in favor of the physician and the hospital. The family members who had filed suit failed to provide expert witness to demonstrate evidence of malpractice as defined in the Tennessee Medical Malpractice Act (Tenn. Code Ann. 29-26-115 et seq). They also failed to provide evidence that the lack of CPR and emergency measures contributed to their loved one's death. While the nurse testified the patient might have survived with emergency measures she was not qualified to give a medical opinion. The doctor's testimony, coupled with thorough documentation related to discussions with the patient, were what contributed to a decision in their favor.

Discussion

Advanced Directive is a term used to encompass documents such as a Living Will, Durable Power of Attorney, and Durable Power of Attorney in Healthcare (DPAHC). A Living Will is simply a statement the patient makes in writing that describes their wishes pertaining to how or where they wish to die, and it becomes active when a person has been deemed incapacitated (vegetative state) or terminally ill. A Durable Power of Attorney is a legal document that allows a trusted individual (friend or family member) to be the legal representative in all non- healthcare legal matters involving a patient (like an elderly person). A Durable Power of Attorney for Healthcare (DPAHC) is a document through which a patient makes known his/her wishes about the treatments they wish to have (or not to have) throughout the course of an acute illness or in the dying process. Had the son in this particular case, kept an ongoing and open discussion with his father about any changes he wanted to make to the DPAHC prior to the emergent hospitalization, the son may (or may not) have had more decision making capacity. Unfortunately, that wasn't the case and thus there was an unfortunate disconnect between the two key parties involved in the DPAHC—the appointed decision maker and the patient. This is not an unusual occurrence. A recent study expands on this by stating “When discussions about end of life preferences do take place, they frequently lack the clarity and detail needed by significant others and healthcare providers to honor their preferences.” (Bergman-Evans, 2008)

Clinical scenarios like this are tenuous at best, and more so if a family is in disagreement with each other or their loved one at the time of an arrest or when actively dying. One has to wonder if the horror the family experienced as they witnessed their father's life come to an abrupt end while healthcare providers withheld care was an influence in their decision to file a lawsuit. There are a lot of nuances to what we do that are not well understood by laypersons. Three pieces of information concern me in this case: The lack of communication between the father and son with regard to updating the patient's preferences, the misunderstanding the son had that a power of attorney can override the wishes of a patient, and the lack of communication between both patient and family. Perhaps the son could have double checked the code status with the physician and verified the advanced directives were in the chart or updated with the patient prior to surgery? Maybe a conversation between father and son prior to surgery could have closed the circle of communication.

The fact is this: there are no better advocates for healthcare consumers than themselves, family members, or trusted friends who hold the Durable Power of Attorney for Health Care (DPAHC). That being said, we should always ask ourselves: does a family member or power of attorney know what effective advocacy means? Part of advocacy is knowing what questions to ask, what information to provide and verify in the hospital, and always knowing at any given moment the exact wishes of a loved one so there are no surprises or unnecessary (and unhealthy) turmoil surrounding a patient and family during a health crisis. Advance Care Planning would have played a critical role here and this case illustrates why. With every hospitalization or change in health status there should be a family talk taking place so that everyone is in line with what the patient wants treatment wise under various circumstances or stages of illness (i.e.: CHF).

Conclusion

Patients change their minds. Hell, we all change our minds. But Advance Care Planning can prevent people from receiving unwanted treatment that could be harmful and painful or care that prolongs life when it's the last thing a person wants to do. Ideally, consistent Advance Care Planning long before the hospitalization would have made for a much smoother transition for this family and perhaps could have prevented a costly, time consuming, and painful lawsuit for everyone involved.

While nurses seem to approve of and support discussions related to end of life preferences and Advance Care Planning they lack sufficient knowledge to feel comfortable initiating or engaging in crucial conversations: “Studies have found that nurses identify the benefits of advance directives and have positive attitudes but lack knowledge and confidence to effectively discuss end of life issues with patients and families. The literature related to nurses' attitudes about advance directives points to an unmet need for increased knowledge and confidence to address barriers and ethical dilemmas in end of life care.” (Putman-Casdorph, 2009) It's our responsibility as nurses to teach patients and their family members one very important thing: With every hospitalization or change in health status (advancing disease) “the talk” has to happen. Questions must be asked. Advance Care Planning doesn't stop once an Advance Directive is signed. The concept is a “living” thing. The patient's voice must remain front and center during each discussion and each stage of illness up to death. Believe it or not, there is “wellness” in “illness” and such thing as a “healthy death.” It would serve our families well (and prevent costly lawsuits) if we started the conversation, and engaged in thorough teaching, about Advance Care Planning.

Works Cited

D Myrna Wheelock, ET AL. v. Jesse Thomas Doers, M.D., ET AL, E2009-01968-COA-R3-CV (Court of Appeals of Tennessee, at Knoxville July 6, 2010). Retrieved 7 29, 2012

Bergman-Evans, B. K. (2008, September 23). Uncovering Beliefs and Barriers: Staff Attitudes Related to Advance Directives. American Journal of Hospice and Palliative Medicine, 25(5), 347-353. doi:10.1177/1049909108320883

Ebersole, P. H. (2004). Toward Healthy Aging. St. Louis, MO: Mosby.

Putman-Casdorph, H. D. (2009). Advance Directives: Evaluation of Nurses' Knowledge, Attitude, Confidence, and Experience. Journal of Nursing Care Quality, 24(3), 250-256.

Report, Nursing Law's. (2010, 7 6). Nurses followed Dr.'s DNR order on patient. Retrieved 7 29, 2012, from The Free Library by Farlex: http://www.thefreelibrary.com/Nurses+followed+Dr.'s+DNR+order+on+patient.-a0239659287

Key Terms: medical malpractice, standard of care, patient, nurse, summary judgment, cause of action, medical treatment, causation, care provider

Related Cases:

Patient Falls While Ambulating Post-op, Negligence or Medical Malpractice:"One of the most important interventions post-operatively is to get a patient up and walking. It minimizes chances of complications such as DVT, Pneumonia, Pulmonary Emboli and Decubitus Ulcers. In this case, a patient fell while ambulating. It would need to be decided if a case could be made for simple negligence on the part of the staff, or true medical malpractice."
McBee v. HCA Health Services of Tennessee, Inc. 2000 WL 1533000 So.2d – TN
http://www.nursefriendly.com/nursing/clinical.cases/040109.htm

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

September 26, 1999: Nursing Assistants Leave Client Alone, Patient Receives Second Degree Burns During Bath.
Registered and Licensed Practical Nurses frequently delegate responsibilities and tasks to Certified Nursing Assistants and Unlicensed Assistive Personnel. It is clearly recognized that they are responsible for the actions/inactions of those they supervise. In this case, two nursing assistants recognized injuries to a patient while giving a bath. When they failed to notify the nurse of the injuries, they would be reported and lose their certifications.
http://www.nursefriendly.com/nursing/clinical.cases/092699.htm

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

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

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

May 30, 1999: Patient Left Unrestrained, Patient Injured. Nurses Judgement Call
The decision to use or not use restraints must be made with caution and good judgement. Their intended purpose must be to protect either the patient or others who may be injured by the patient including the staff caring for the client. The ultimate determination of necessity is left with the physician. Often, the moment to moment necessity is determined by the nurse. In this case a nurse did not feel restraining the patient was necessary. When an injury occurred, the patient sued.
Gerard v. Sacred Heart Medical Center - 937 P. 2d 1104 (1997)
http://www.nursefriendly.com/nursing/clinical.cases/053099.htm

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

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

Tuesday, August 7, 2012

Tuesday 8/7/2012 #Healthcare #Tweetchats (All EDT) 8p #treatdiarieschat 9p #MHSM 9p #SolvePT 9:30p #eolchat - #nurseup #hcsm #nursefriendly

Tuesday 8/7/2012 #Healthcare #Tweetchats (All EDT) 8p #treatdiarieschat 9p #MHSM 9p #SolvePT 9:30p #eolchat - #nurseup #hcsm #nursefriendly

8pm: #TreatDiariesChat: @treatdiaries: Newly diagnosed or living with #MS - #treatdiarieschat w/ @MSThrivers at 8pm ET - Join us and learn from the those who are living w/ #MS!
http://tweetchat.com/room/treatdiarieschat

9pm: #MHSM (Mental Health Social Media) @somebodyhealme: Please join us in 2 hours for #mhsm re disclosure & potential impact on career/job hunting. http://t.co/plL4SRBE
http://tweetchat.com/room/mhsm

9pm: #SolvePT (Physical Therapy) @SnippetPhysTher: For tonights #solvePT chat, PT resident/fellow may not be placed in referral for profit situation page 60 #6: http://t.co/OjRJTyxG
http://tweetchat.com/room/solvept

9:30pm #EOLchat "@DrBeckerSchutte: #EOLchat folks:
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/

Monday, August 6, 2012

Monday #Healthcare #Tweetchats (all EDT) #ppdchat 1p & 8:30p, 9p #bcsm 9p #rnfmradio - #nurseup #nursefriendly

Monday #Healthcare #Tweetchats (all EDT) #ppdchat 1p & 8:30p, 9p #bcsm 9p #rnfmradio - #nurseup #nursefriendly
See full Calendar at the Healthcare Hashtag Project:
http://www.symplur.com/healthcare-hashtags/tweet-chats/

1:30pm #PPDchat (PostPartum Depression): #PPDChat!@unxpctdblessing: Attending #PPDChat today? Read this first: Unlabeled http://t.co/sVxhpb2I #mustread

8:30pm #PPDchat (PostPartum Depression): #PPDChat!@unxpctdblessing: Attending #PPDChat today? Read this first: Unlabeled http://t.co/sVxhpb2I #mustread
http://tweetchat.com/room/ppdchat

9pm #BCSM (Breast Cancer Social Media):@DrAttai: Tonights #BCSM: Things We Carry http://t.co/jaVZ5TYR 9pm ET cc @jodyms @stales#bcsm
http://tweetchat.com/room/bcsm

9pm #RNFMradio:@nursekeith: Monday 9/6 at 9pm EST, join us on #RNFMRADIO with Jerome Stone @mindfulnurse as we discuss #mindfulness and #nursing! http://bit.ly/Mn45en
http://tweetchat.com/room/rnfmradio

Twitter.com can help nurses spread messages quickly, efficiently @avoidmederrors #nursefriendly #nurseup

Twitter.com can help nurses spread messages quickly, efficiently @avoidmederrors @nursefriendly#nurseup:"Ab Brody, RN, PhD, GNP-BC, is an assistant professor at New York University’s College of Nursing. Pat Iyer, RN, MSN, LNCC, is president of Avoid Medical Errors, a Flemington, N.J.-based company dedicated to helping consumers stay healthy. Andrew Lopez, RN, is a Mantua, N.J.-based nurse entrepreneur, who has several social media businesses.
Their professional nursing lives might be diverse, but all three use Twitter professionally and personally to connect with people who have similar interests"
http://news.nurse.com/article/20120514/NY01/104300013
*******************************************************************************
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

Traits & Qualities That Make Nurses Excellent Entrepreneurs
http://www.nursingentrepreneurs.com/qualities

What Made You Decide To Start Your Own Business?
http://www.nursingentrepreneurs.com/why/

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, @nursefriendly

Tweet Me No Lies, @MotherJonesRN #amandatrujillo #nurseup #nursefriendly #healthcare #nursing

Tweet Me No Lies,@MotherJonesRN#amandatrujillo #nurseup #nursefriendly #healthcare #nursing :"Someone at the ANA needs a nose job. They just told a lie. I hopped onto Twitter yesterday to check out some tweets after I learned that the ANA had mentioned Kim McAllister from Emergiblog and me in one of their messages. Here’s a screen shot"
http://www.nurseratchedsplace.com/2012/03/tweet-me-no-lies/
****************************************************

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 Entrepreneur, Advocacy Organization
38 Tattersall Drive
West Deptford, New Jersey 08051
856-415-9617, Fax: 856-415-9618, info@nursefriendly.com, @nursefriendly

Sunday, August 5, 2012

Trouble in Texas: Tort Reform and Loss of Rights By Pat Iyer @avoidmederrors @patiyer #nurseup #nursefriendly

Trouble in Texas: Tort Reform and Loss of Rights By Pat Iyer @avoidmederrors @patiyer #nurseup #nursefriendly:"The leg pain Connie Spears felt was excruciating and familiar. She’d had blood clots before, and doctors had installed a filter in one of her heart’s main veins. At a Christus Santa Rosa hospital in San Antonio, where Mrs. Spears sought help the Friday before Memorial Day, the emergency room doctor ran some tests and discharged her with “bilateral leg pain.” He told her to follow up with her primary-care physician.

Three days later, Mrs. Spears was delirious and her legs were the color of red wine when she called 911 and was transported to a different hospital in the area. Doctors determined that her vein filter was severely clotted and had led to tissue death in her legs, as well as kidney failure."
http://bit.ly/HU0fRM
*******************************************************************************
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

Traits & Qualities That Make Nurses Excellent Entrepreneurs
http://www.nursingentrepreneurs.com/qualities

What Made You Decide To Start Your Own Business?
http://www.nursingentrepreneurs.com/why/

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, @nursefriendly