I don’t usually cover a whole lot of nurse union articles but I did want to bring this out since this article says 13,000 California nurses prepared to strike starting next week, June 10th and this would be the largest nurses’ strike in US history. There are a huge number of nurses in a variety of locations, both California and in Minnesota that are members of a union, the California Nurses Association and the Minnesota Nurses Association and they’re both member organizations of the National Nurses United organization.
These two groups are really looking for better nurse staffing ratios. In the case of California who have laws for nurse staffing ratios, they want more oversight and more policing of nurse staffing ratios because in California. In some of these hospitals, they’re claiming that there are- there’s no oversight and there’s really no severe penalties for nurse staffing laws to be ignored.And so if you’re going to have a nurse staffing law, you need to make sure that people are having the nurse staffing that they think they’re getting and that’s certainly very important. It certainly lends itself to patient safety and I think that we’re likely to see this.
Nurses as we know are overworked in many situations, have many many patients to take care of, don’t get breaks during a 12-hour shift on a regular basis, really aren’t able to get away and take care of themselves very well, and of course that stress, that fatigue turns into poor patient care at the other end. As the nurses become more tired and more overworked, they are unable to pay attention to those important details and patient safety often suffers.
So it’s something that many organizations are looking at and of course those places that have a unionized system, that union system can sometimes be brought to bear to apply pressure to the facilities. Of course if they don’t have any money to spend or where are they going to pull money from, somebody has to deal without something in order for more nurses to be hired and that’s of course if more nurses are even available because a lot of places still are shorthanded for nursing staff.
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This article has been featured in the news segment in the Nursing Show episode Nurses Review on Allergies and Episode 134
Filed under nursing news by on Jun 9th, 2010. Comment. 
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Welcome to Episode 107
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News–
Health Reform Likely to Increase Demand for Nurse Practitioners
Local Nurses Reminisce Nurses Caps Tradition
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Tip of The Week- Deep Vein Thrombosis
Deep vein thrombosis is a condition where blood clots form in the veins deep in the body, usually the lower leg or thigh. Presenting symptoms are similar to the symptoms of a previous trauma so nurses should do a thorough history taking, good assessment skills, and knowledge on the causes and risk factors are required to be able to identify the presence of DVT.
Anticoagulants are given to patients who are highly likely to have developed DVT to avoid complications like pulmonary embolism. Measures like elevating the limb, avoiding prolonged sitting and bed rest, and relieving pain by application of warm, moist heat to the area can be done to provide comfort and reduce the risk of the thrombus turning into an embolus.
Preventive measures include avoiding risk factors for DVT, use of blood thinners (as prescribed) for patients who are at risk, avoiding long periods of immobility.
Deep Vein Thrombosis by Medline Plus
Prevention of DVT by National Guideline Clearinghouse
Deep Vein Thrombosis by eMedicine
National Heart, Lung and Blood Institute, DVT
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Don’t miss an episode! You can receive the Nursing Show Newsletter in your email inbox.
Other Podcasts from Jamie Davis:
- The MedicCast (for EMTs, Paramedics, EMS field work)
- MedicCast News (Weekly short medical news program)
- MedicCast Live (Monthly live call-in show with a single EMS topic)
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Song this week:
Music from The Podsafe Music Network
Jill Parr with, “Do you hear what I hear?”
Click here to get Songs from the MedicCast at the iTunes Store.
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This work is licensed under a
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Filed under nursing show podcasts by on Nov 27th, 2009. 1 Comment.
Patients do see beyond the error when health practitioners disclose the truth. In the news article from the Boston Globe, results from a conducted survey by Dr. Lenny Lopez of Massachusetts General Hospital from 2,500 patients who had been patients in 16 hospitals in Massachusetts revealed that those who were told about adverse events were twice as likely to call their care good or excellent as patients who were not told about them. Four out of ten mistakes were reported by hospital staff. Errors that required additional treatment was more likely to be discussed than the others and errors that are preventable were less likely to be told of than the unavoidable events.
Disclosing the truth to the patient is the ethical thing to do in case of errors occurring especially if the incident was preventable. Though patients may not like the news, they would at least respect the effort of the health team to disclose the incident to them. Getting the truth from the persons directly responsible for it is better than learning about it later on and finding out that the health team tried to cover up their mistakes. If this becomes the case, the patient involved will not have second thoughts taking legal action on the matter. Issues like this will give the public reasons to doubt the honesty of the professionals involved or even lose trust in the profession.
The results of this survey should serve as an encouragement not only to nurses but to all health professionals who have been and who will be faced in such situation, to do the right thing. Being honest about one’s mistake does not mean that one is incompetent but shows that we are dedicated to the quality of care that we provide and put the safety of the patient above all else.
Filed under nursing news by on Nov 16th, 2009. Comment.
The largest hospital in Rhode Island has been fined with $150,000 after its fifth case of wrong-site surgery since 2007. Prior to the latest fine, the same hospital has been fined $50,000 in the past for three cases of brain surgeons operating on the wrong parts of the heads of three patients.
In the latest incident, the supposedly operation on two different fingers has been done to a single finger instead. According to the report, instead of marking each finger as the surgical sites, the marking was put on the wrist. The marking which was to be the primary indicator of the surgical site was not put in by the surgeon who was to do the procedure but by another member of the surgical team. There was no time out or any form of verification before the surgery. After they discovered the error, the surgeon asked the patient’s relatives if they should do the procedure on the correct finger. With the family’s consent, they carried on with the operation without doing another time out.
Not only the operating physician, but all members of the operating team, including the nurses, are to be held accountable for such errors. Though the surgeon is the head of the operating team and calls all the shots, nurses, as patient advocates, should see to it that all protocols and procedures are done correctly. When nurses notice something amiss, like time outs, they should speak up and remind the physician of things that they might have overlooked. Also, duties and responsibilities should be well defined, like the placement of markings on the operating site should exclusively be done by the surgeon who will do the operation. As for physicians, taking reminders or recommendations from nurses does not make them less of a good doctor. Members of the health team are equally responsible and should work together to uphold patient safety and ensure the quality of health services that they deliver.
Filed under nursing news by on Nov 3rd, 2009. 1 Comment.
With the continuous growing gap between nurse patient ratios, nurses, are left with no choice but to multitask. They may be successful in performing all of the tasks during the shift but the quality of service may be compromised and even put the patient at risk.
Multitasking is known as doing two or three tasks at once, but in some cases, what nurses are doing sequential tasking. It is lining up a number of tasks in mind with no assurance that everything will be remembered in order. More complicated tasks take more time to be processed by the brain.
This means that not all tasks waiting to be done will be remembered at the same time that it needs to be completed. Several hours after the shift could be the time that jobs forgotten would suddenly turn up.
For nurses who regularly multitask or sequential task, the issue is not to improve these skills but to develop new ways on how put things into order without too much stress on the brain and do it in a systematic manner.
The following are some tips on how nurses can organize their daily tasks:
Make a list of tasks
Put all tasks on a list and cross them out as each one gets done. This way, duties are not forgotten and things are more organized. As long as it is listed, everything will surely get done and having an overview of all tasks will give an idea on how long it would take to get it completed and let the nurse manage his/her time better.
Do not interrupt
Studies have shown that nurses who are not interrupted during administering medications decreased the incidence of medication errors. If a nurse works without interruptions, they get their tasks done faster and they become more efficient because their attention is undivided.
Delegate tasks
Instead of trying to do everything, nurses should learn when to say no to a task and delegate simple and routine jobs to nursing assistants or technicians who are qualified to perform it. As long as the persons that the nurse delegates to are fit and able to perform the task, then there’s nothing wrong in asking for a little help. In delegating activities, the nurse, however, should keep in mind that only the task is delegated but not the accountability so it is important that the nurse educate the delegated individual to report anything that goes wrong.
Concentrate on the task at hand
As was said in the studies mentioned earlier, shifts in focus results to more lost time. Instead of thinking of the next task while doing one, nurses should know to keep concentrating on what they are doing at the moment and think of the next task later. This way, they wouldn’t have the feeling that they are always on the rush and the quality of their work is better because they are more focused.
Filed under RN tips by on Oct 1st, 2009. Comment.
Podcast: Play in new window | Download
Welcome to Episode 96
The Nursing Show is a proud member of the ProMed Podcast Network.
Subscribe to the show, free!
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Right Click to download (Macs Option Click)
Subscribe with iTunes here (need iTunes — it’s free)
RSS Feed to subscribe (copy url to Juice, Zune Marketplace, or your favorite podcatcher)
Click the arrow below to listen to the show:
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News–
Safety of Midwife Attended Home Birth
Parents’ Impact on Teen Tobacco Smoking
Insulin-Producing Cells Derived from Adult Skin Cells
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Tip of The Week- Medication Administration
Administration of medications is a chief responsibility of a nurse. It involves providing the patient with a substance prescribed and intended for the diagnosis, treatment, or prevention of a medical illness or condition.
Since a lot of problems arise from medication errors, nurses should be knowledgeable on the type of medication they are about to administer including the safe dosage and the right route for the drug. The following are tips for nurses to ensure safe medication administration and eliminate errors.
Be familiar with the medication
Commonality of medications depend on the clinical area. For example, in surgical units, expect post operative patients receiving pain control meds and antibiotics. If a nurse encounters a medication for the first time, she should make an effort to know more about the drug and make sure the order is consistent with the drug facts.
Know the drug class and what it is for including the routes of administration and how the drug moves into the body. Some examples of medication routes are parenteral (use of injection), oral (by mouth), topical (applied to the skin), suppository (vaginal or rectal), and inhalants.
Effects of the drug
The therapeutic effect are the desired or intended effects of the drug though it may normally come with expected side effects, either from drug interactions, route of administration or the drug itself, may cause discomfort to the patient and should be addressed. Adverse effects are abnormal and should be dealt with immediately. Educate the patient about these for them to be able to report symptoms of adverse affects to the nurse or the physician. Drugs may also interact with food or other medications so it is important to know all the drugs the patient is taking including their diet.
Check Calculations
Doses ordered do not always match the stock doses in the pharmacy, not to mention the use of diluents. Safe administration of medications greatly lie on the accuracy of dosage computation. A single decimal point can make a huge difference that can yield drastic effects to patients. To avoid such mistake, calculations should be double checked. The use of medication math techniques can also be helpful.
Best Practices for Safe Medication Administration
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Don’t miss an episode! You can receive the Nursing Show Newsletter in your email inbox.
Other Podcasts from Jamie Davis:
- The MedicCast (for EMTs, Paramedics, EMS field work)
- MedicCast News (Weekly short medical news program)
- MedicCast Live (Monthly live call-in show with a single EMS topic)
——————————–
Song this week:
Music from The Podsafe Music Network
Song this week: Mike McGill “Southern California”
Click here to get Songs from the MedicCast at the iTunes Store.
————————————-
This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Filed under nursing show podcasts by on Sep 13th, 2009. 1 Comment.
New technological advances are changing the face of nursing care. Nurses, on the other hand are becoming more technologically proficient when it comes to patient care.
One change that health care institutions are updating on is communication tools. According to research, one of the most significant barriers to care delivery is communication. At University Hospitals Case Medical Center in Cleveland, they resolved the problem by providing wireless badges. This technology enables them to call for assistance or answer pages with the use of a voice recognition button.
Another advancement is the deployment of patient flow systems. Instead of having to go through charts and other paperwork or verifying information from other staff, nurses are given improved visibility of both bed availability and patient status.
Since medication errors are also common,they now started implementing the use of bar-coded medication administration. The hand held device alerts the clinician if a medication is about to be administered improperly.
Such technology can be difficult to implement taking into consideration the financial strain that it would entail. Though there is no price for safe and quality patient care, the fact is that these projects do need monetary resources. Until then, nurses should do their best to deliver the highest quality of care that they can provide.
Filed under nursing med tech by on Sep 10th, 2009. Comment.
Podcast: Play in new window | Download
Welcome to Episode 93
The Nursing Show is a proud member of the ProMed Podcast Network.
Listen to the show!
—
Right Click to download (Macs Option Click)
Subscribe with iTunes here (need iTunes — it’s free)
RSS Feed to subscribe (copy url to Juice, Zune Marketplace, or your favorite podcatcher)
Click the arrow to play the Nursing Show
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Sponsors
NursingTopStudent.com all of the tools student nurses need for less than $1 a day. Audio and video study aids plus a whole lot more! More than 200 files and counting!
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———————————–
News–
Lesser Cost of Health Care for Chronically Ill Elderly
Antivirals Not Needed for Healthy Adults
Hotlines to be set up for Flu Season
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Tip of the Week– Patient Restraints
There has always been a dilemma on the use of patient restraints. Its main purpose is to promote patient safety by reducing the risk to injure themselves or others. The Joint Commission released different standards for restraint and seclusion depending on the situation that restraints are used to address.
Restraints may be indicated for patients with behavioral issues who pose a risk for injury to oneself or to others. In these cases the Behavioral Health Care Restraint and Seclusion Standards apply.
Patients who do not have behavioral problems but have a condition that requires the need for restraints like confusion and agitation, the Acute Medical and Surgical (nonpsychiatric) Care Restraint standards would be followed.
Since restraints render the patient immobile, complications may rise from it so it is important that the use of restraint would do more good than harm. Also, a patient under restraint should be continuously assessed for the following:
- signs of injury associated with the application of restraint
- nutrition and hydration status
- circulation and range of motion of extremities
- vital signs
- hygiene and elimination
- physical and psychological status and comfort
- readiness for discontinuation
The standard set also requires that an individual who has been under restraints should be evaluated face to face by a licensed independent practitioner (LIP) within 1 hour. In crisis situations where an LIP is unavailable, a trained registered nurse or a physician assistant could perform the 1-hour rule assessment. However, an LIP or the physician caring for the patient should be consulted on the evaluation the soonest time possible.
Join Commission Provision of Care, Treatment and Services
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Don’t miss an episode! You can receive the Nursing Show Newsletter in your email inbox.
Other Podcasts from Jamie Davis:
- The MedicCast (for EMTs, Paramedics, EMS field work)
- MedicCast News (Weekly short medical news program)
- MedicCast Live (Monthly live call-in show with a single EMS topic)
——————————–
Song this week:
Music from The Podsafe Music Network
This week- Whitney Steele – Your Turn To Cry
Click here to get Songs from the MedicCast at the iTunes Store.
————————————-
This work is licensed under a
Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
Filed under nursing show podcasts by on Aug 21st, 2009. 1 Comment.
To promote effective quality care and patient safety, the Joint Commision’s National Patient Safety Goals (NPSGs) seventh set went into effect last January 1, 2009. All Joint Commission-accredited organizations are now held responsible to comply with the current and revised NPSGs.
Nurses should be updated on such revisions to ensure that they are on target with patient safety and tailor their nursing interventions accordingly. In this article, all 2009 NPSGs for the hospital, ambulatory, and office-based surgery accreditation programs, with an emphasis on how they affect nurses in the perioperative areas are highlighted.
Nurses and Patient Safety Goals
Though some of these guidelines or goals, like patient IDs and fall precautions, are already commonly addressed in institutions, being familiarized with the new NPSGs fosters better compliance in all areas of patient care. Some goals, however, may be a little more difficult to implement.
One safety goal requires a standardized list of abbreviations, acronyms, symbols. It includes standardized dose designations which applies to both hand-written and electronic documentation and includes all forms of perioperative communication, such as:
- surgical preference or procedure cards
- surgical procedure lists
- perioperative documentation
- progress notes
- consents
- patient’s history and physical exam
Cited in the article is this example, “An elderly patient was ordered hydromorphone (Dilaudid); however, the order was written without the use of leading zeros (for example, .2 mg). As a result, the order was misread as 2 mg instead of the intended 0.2 mg. The nurse recognized the error after giving the initial dose. The patient experienced no ill effects.”
Even though each standard comes with an element of procedure (EP), which may make it more difficult to comply with, the NPSGs are considered to be “minimum standards” and organizations are expected to comply with all applicable standards.
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Need help with Med Math or Dosing Calculations?
One common issue in patient safety is medication dosing and medication math.
Many nurses and nursing students will find this site, MedMathSimplified.com a great resource for tutorials on medication math. Check out the free resources there as well as info on how to order the online tutorial or DVD.
Filed under nurse career guide by on Aug 10th, 2009. Comment.
Avoid Medication Errors
All medical providers, whether they work in a hospital or in a prehospital setting, constantly fight to avoid medication errors. The Joint Commission responsible for hospital oversight considers medication errors one of the biggest problems affecting patient safety.
Yet for those of us who work long hours, particularly those working 12 hour shifts overnight and with shorthanded staffing, medication errors are even more difficult to avoid. Fatigue, lack of focus and concentration, and increased workload all lend to the reasons busy field providers make mistakes. How do we make ourselves pay attention?
How Focus and Attention Work
This article from CNN Health looks at how me maintain attention span and gives tips on how to train our brains to pay better attention and focus when needed. The authors point out a few ideas on how to maintain better focus. Some will work for busy nurses and some won’t, but all of them bear a closer look.
- Get More Sleep – Hard to do when you work long hours but when weighed against the expense of losing not only your job, but possibly your career in the current marketplace, it might be a good idea to refocus some free time to power naps and a good night’s sleep on days off.
- Manage Stress and Anger – We’ll be talking about stress management in December’s MedicCast Live podcast, but we all need to plan ways to deal with stress in our lives. It’s hard to focus on a difficult-to-treat patient when we are worried about a fight with a spouse or a problem with a co-worker. Learn to recognize stress reactions in yourself and make time for a brisk walk or some time on the treadmill or stairmaster. Talk with a work counselor or supervisor about some assistance before it gets out of hand.
Read the article for more ideas and links on stress and tune in and join us live on Tuesday, December 9, 2008 at 10 PM ET for the next MedicCast Live episode.
What are your thoughts on dealing with stress, fatigue and attention span? Share them with the rest of the Nursing Show community by clicking the comments link below and leaving your ideas here.
Filed under RN on the side, nursing medication review by on Nov 18th, 2008. Comment.
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