Friday, September 15, 2017

Who Will Be Held Responsible for Nursing Home Deaths in Hurricane Irma?

I just have to rant. It sickens me to hear about nursing home residents suffering and dying in recent hurricanes. There's the haunting photo of people sitting in wheelchairs in water over their laps in the Houston area. But a later photo showed them all OK after being evacuated. At least no one died from that debacle.




Janice Connelly of Hollywood placed a memorial of balloons, 
flowers,
candles and signs for the eight people who died at the center.  
Credit Scott McIntyre for The New York Times
However, the 8 (so far) deaths in the Hollywood Fl rehab center are inexcusable. I hope the administrator and their owners are held responsible for these deaths.

Cooling measures are basic nursing care. And apparently the staff was doing their best to hydrate and cool patients. Obviously they needed more assistance and direction.

They also didn't ask for help when they needed to. Who was not there to ensure the disaster plan was being appropriately effected??? This is the responsibility of the administration and they FAILED their emergency planning and their residents miserably! This facility has been cited in the past for issues with generators and were well aware that they had issues with meeting codes for emergency planning. They corrected the issues, but FAILED to improve on the situation.

There were at least 3-5 days of accurate warnings about the severity of Hurricane Irma and potential disastrous effects including the challenges of power outages and downed trees. Hurricanes are not unusual happenings in Florida. They have a known "hurricane season" and there are evacuation signs up all over the state, so this isn't something new or unusual. Social media and television coverage for days were showing multitudes of preparation ideas for even basic things like how to bottle water and freeze bags of water for ice and drinking water.

Common sense tells you in a power outage scenario common to hurricanes, that generators need to be efficient enough to keep temperatures from becoming high enough to affect human life. Or you need to have a Plan B to sustain. And an emergency plan in place to say ask for help! In this case, a hospital was across the parking lot. Transfer your patients if you can't maintain cooling measures! The storm had passed by then.

CNN
Nurses and personnel working in long term care facilities are always the lowest paid and most overworked. No doubt. This is not on them. This is on the shoulders of the people in charge and the owners who did NOT ensure the comfort and safety of the residents. And in light of multiple failed routine checks by the governing agencies, this is pure criminal Abuse and Neglect at the highest level! These people who died were most likely bedridden and helpless. They relied on the staff to care for them and to protect them.

I am always one to say we have to look at both sides in a situation because there are always 2 sides. But this just wreaks. I cannot defend the owners and administrators in this one!

So let us all learn from this situation. Emergency and Disaster Preparedness planning is a pain to develop and to write policies!!!  But it's essential. And then we have to educate staff repeatedly and review when we know a potential disaster is coming. We can never assume that we can leave decision making to the low man on the totem pole. The buck stops at the top and that's who needs to be held responsible. These are the people who must be highly trained, present and active during disasters and emergencies.

But we MUST also ensure the tools are working, up to code and available. And that the disaster/emergency plan is being worked as it was designed to do. Drills are not just annoying time wasters! They help us to move into a crisis mode quickly and make correct decisions. They help us to learn where the strengths and weaknesses are and to improve our planning.

Owning and running long term care facilities is not just about making money and sitting back and letting the workerbees work their asses off with very little resources to try to make 99,000 residents in FL alone safe and comfortable. This is a HUGE responsibility to care for our rehabilitating and aging loved ones with the utmost respect, honor and care. This is a deplorable situation and one that should spark changes!!!

Get $15 off orders $120+ with code SILCAM at MedicalSupplyDepot.com. Offer valid 9/16 - 9/19. Shop now!

Thursday, September 7, 2017

How Does an Electrocardiogram Work?

By Dsealy - Own work, CC BY-SA 4.0, Link

I hope this post is useful especially to student nurses and to those who need to educate patients about ECG/EKGs.😊



Doctors use a test known as an electrocardiogram, also referred to as an ECG or EKG, to measure the heart’s electrical activity and detect any anomalies in one of the most important organs of the body. An ECG makes a recording of the timing and strength of electrical impulses as they flow through the heart. Coming out in a moving strip of paper from the ECG device, the recording is then
read and interpreted by the doctor to see if the heart is working normally.
While it may seem simple to understand, how the test actually works is truly a mind-boggler, especially if one does not know how the heart works in the first place.

The electrical system of the heart
The heart is composed of specialized tissues that are capable of creating electrical signals that cause the cardiac muscles to contract. In every contraction, the heart works by pumping blood out to the lungs in order to absorb oxygen and to deliver it to the cells all over the body.

Particularly, the sinus node, also referred to as sinoatrial node, is the tissue that’s responsible for generating electrical activity throughout the heart. Located in the atrium or the upper right chamber of the heart, the sinus node sends out an electrical impulse in every fraction of a second, traveling through the atrial muscles, which causes them to contract. The impulse then travels through the atrioventricular node in order for it to reach the ventricles of the heart.
As the electrical impulse flows through the organ, the heart normally contracts, or beats, about 60 to 100 times in a minute at rest in most adults.

Understanding the ECG reading

Every activity of the heart can be seen through the electrocardiogram reading, which appears like a line graph with valleys and peaks. These peaks and fluctuations actually represent the “waves” of signals flowing through the heart. The P wave represents the electrical signal sent through the heart’s upper chambers. Meanwhile, the QRS wave indicates the electrical activity in the lower chambers. Lastly, T wave records the heart’s activity as it returns to rest.

By MoodyGroove at the English language Wikipedia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=2581061
Reflected on the ECG print, the size and shape of the waves and the interval between each wave reflect the rate and regularity of the heart activity, which is valuable information for your doctor as it will help diagnose your condition. Aside from shedding light to the heart’s rhythm, the ECG can also determine possible heart muscle damage as well as detect abnormal levels of blood electrolytes, including calcium and potassium.

How it is performed
An electrocardiogram is a painless procedure that often takes only a few minutes. It may be done at the doctor’s office or as a laboratory procedure at the hospital. Since ECG equipment is portable, the test can be carried out almost anywhere. For patients admitted to the hospital, your heart patterns may be constantly monitored by an ECG system.

During the test, the patient may initially be required to shave the chest, arms, and legs to provide a smooth surface to attach the electrodes in the ECG cables. Once the area is cleaned, the patient is then asked to lie on a bed, where several ECG cables and leads are attached to the skin on the chest and on each arm and leg. These cables are connected to the machine that records the patient’s heart activity into print.

The three main types of ECG
An electrocardiogram is required by the doctor depending on three different purposes. The resting ECG is when the doctor wants to know how your heart works while you are at rest. The second type, exercise ECG, is requested if the doctor wants to determine the heart’s reaction to activity. This test may be done while the patient is walking or running on a treadmill. There is also what we call the 24-hour ECG, which monitors the patient’s heartbeat the entire day.

The ECG is an essential test that can detect any damage to the heart so you and your healthcare team can prevent it from getting worse. With the convenience of the test results and your doctor’s intervention, the least you can do is to make changes in your lifestyle and to be more proactive in dealing with your own health.


Friday, September 1, 2017

Arrest of Utah ER Nurse is Deplorable Act!

There is a firestorm on social media about this atrocious act against a Utah ER nurse for advocating for an unconscious patient's rights. We all have a lot to learn from this issue and to take actions to prevent the same situation from happening in our own backyard! THANK YOU Alex Hubbels! 

Please share.




Friday, August 18, 2017

Role of Substance Abuse Nursing in the Opioid Addiction Crisis

As you know, I don't often include infographics, but opioid addiction and substance abuse is such an urgent issue and this document captures how it affects the nursing profession...

"Drug abuse is a crisis for people in the United States. According to the CDC, in 2015-- alone-- more than 15,000 people died from opioid overdose. Drugabuse.gov reports that 80% of those addicted to opioids first took an opioid as a prescription. Nurses play a vital role in diminishing this crisis. To learn more about how important nurses are in helping people with substance abuse, check out this educational graphic from Duquesne University."





Friday, July 28, 2017

Nursing Community Comes Together for One of Our Own

The nursing community is huge, but it's also a very small world. I've been off tending to some family business, so I'm a little slow to get this posted, but it's an important matter and I want to be sure to spread the word. We need to come together to help our own.

One of our own, Keith Carlson BSN, RN, NC-BC, who you may recognize from RN FM Radio, Digital Doorway, and Nurse Keith Coaching, was severely injured in a gym accident recently. He details his ordeal brilliantly in his recent post, "When the Nurse Becomes the Patient." This is a must read for ALL nurses. We MUST prevent this type of horrible care! There is simply NO EXCUSE!!

At some point in our lives, we or a loved one have already, or will become the patient and we need to be prepared to advocate from the start of care through discharge and beyond. Keith certainly had to do this for himself, and thankfully he was alert enough to do so because it was essential to his well-being and recovery!

I hope you will all also be inclined to follow the Meal Train established to help Keith in his recovery process. Imagine if you will, yourself in his position. Meals and assistance from your local community would be invaluable and essential even if you are not inclined to ask for any help. For those of us who aren't local to Keith and Santa Fe, the Meal Train allows for us to donate so that meals, assistance and other needs can be met.  You can read more about this at Beth Boynton's Confident Voices post. 

photo borrowed from Nurse Keith's Digital Doorway  



Thursday, July 6, 2017

New Grad Programs Grow But Not For Everyone

I've been hearing a lot lately about new grad nursing programs. I'm pleased to know there are more of them cropping up. It will hopefully help us to keep new nurses in the profession. We continue to lose far too many in the first 3 years because nursing isn't what they expected it to be. Combined with increasing workloads, nurse bullying and physician bullying as a continuing issue, we are losing too many nurses period.

New nurse grad programs are an essential part of the future of nursing and curtailing the nursing shortage,
but they're not necessarily there for the top graduates. These programs are also highly sought after and have far more applicants than the programs can take on at any given time. The competition is stiff and top nurse grads are primed to compete.

Top Grads May Not Be Accepted

However, if you graduated at the top of your class and/or have some nursing experience already, it becomes nearly impossible to get into a new nurse grad program. This can be emotionally devastating and frustrating. In reality these nurses should feel honored to be turned down even though they value the opportunity to learn even more.

Many new grad programs are designed to boost the confidence and skills level of new nurse grads who perhaps didn't have the best opportunities, or didn't avail themselves of them. If you're shy and stand to the back of the crowd in nursing school you're not going to get the clinical opportunities unless your instructors are vigilant in making sure each student demonstrates proficiency. That isn't always possible given the populations of patients at any given time.

Even if you had all the best opportunities, but you struggled in certain areas and/or were in the middle to lower end of your class, a new grad program can offer extended education and supervision opportunities to make you a great nurse.

New Grad Programs Help Reduce Bullying

This creates another scenario for not accepting the top of the class grads; boredom and the possibility of encouraging nurse bullying of the grad who takes a little longer to catch on. These programs help these new nurses need a little extra time and preceptoring them with nurses dedicated to help them helps to reduce the nurse bullying by not throwing them into the water and expecting them to sink or swim in a pool of experienced nurses who don't have time or desire to help them.

New grad programs are also designed to build the workforce in that particular hospital. This is why they are often called residency programs.  They are looking for nurses who will be dedicated to staying on for at least 3-5 years and possibly working in certain areas of high turnover. Nurses at the top of the class are quite often energized and looking towards higher education in the near future. These nurses frequently want to be nurse educators, nurse practitioners, and clinical nurse specialists. This may not be a need for the hospital offering a new nurse grad program. And investing their time and money on nurses who will quickly move along is just not economically feasible.

This is NOT to say you shouldn't apply. Look for every possible opportunity to continue your education while working and soak up every ounce of knowledge to make you the best nurse ever! But if you get turned down, keep looking for other opportunities.  Even new nurses who really need a little extra help should do well in the right place. Be honest and willing to learn. DO some homework so you're ready to learn a new skill. You Tube, for instance, has a multitude of instructional videos. Sites such as NucleusHealth.com offer many forms of media for learning about conditions and treatment modalities and they have a You Tube site as well. Be willing to help a co-worker with tasks in exchange for preceptoring.

Nursing is a lifelong journey of learning, but it's not a one-size fits all situation. Nurses of all levels need to continue to be sponges and absorb all the information they can. Health care is constantly changing and nurses are expected to be the backbone. More and more responsibilities become part of the nurses everyday world. We all have to be prepared and willing to learn and to teach. Explore your opportunities and never feel stuck in something that isn't right for you.



Image from Bing images 

Sunday, July 2, 2017

Budweiser | A Dream Delivered | Folds of Honor


Save

Friday, May 19, 2017

Thanks for the Nurses Week Give-Aways!

Well Nurses Week was great. I hope you got a chance to listen to the ANA webcast, partake in some of the free items businesses offered, and took a moment to thank your co-workers and colleagues!! We had fewer Give-Away entrants this year than in the past, but prizes are being prepared and the recipients should have them soon. I have notified each winner. (Some asked no to be identified, so I'm keeping them all confidential. )

I want to take the time to again THANK those who generously donated prizes for our Nurses Week Give-Aways. We had some great books offered from talented writers, most of whom are nurses as well.

Thanks again to Beth Boynton for her newest book, Medical Improv, A New Way to Improve Communication; Elizabeth Scala for her book, Stop Nurse Burnout; and Lois Gerber who is offering a choice of Kindle version of any of her books; and to Carmel Sheridan's Kindle version of The Mindful Nurse.

I'm also sending out a copy of my books, The Everything New Nurse Book, 2nd Edition and Exploring the Home Health Experience: a Guide to Transitioning Your Career Path. And sharing the Zebra Pens I received. In addition, each of the winners will receive a free copy of my Ebook, Time Management Skills for Nurses.

All of these writers present fabulous ideas in their books, their blogs and websites that truly embody the theme for Nurses Year Nursing the Balance of Mind, Body, and Spirit.


I hope each of you had a good experience during Nurses Week. Unfortunately, some employers did nothing. And, not to make excuses, but I have worked for people who are TERRIBLE at planning any kind of celebration, and instead of asking for help, they just ignored the event unless others stood up and volunteered to do it. I've also experienced some pretty BAD celebrations when the wrong people said they'd do it. But seriously.... So my advice is for you to speak up next year about January or February and volunteer to lead a committee for Nurses Week.

In a perfect world, we'd all have a huge bonus, or an extra paid day off or another week of vacation. In the real world, the economics of your job won't support that. So it's about being recognized for what you do every day! Someone taking the time to say Thank You, and recognize the job you do everyday!!! THANK YOU!!!!

Sadly, I heard from some readers and social media friends that some of the vendors who kindly offered free items or food to nurses turned out to be bad experience. Their employees demanded to see not only nursing licenses (as they should) but work badges or other proof as well. Not every nurse will have a work badge and some were harassed. This is unfortunate.Better communication and training needed here!!!

Another issue that has been raised in some of my social circles is employers who didn't single out nurses to honor them alone, but rather honored everyone in the company. This left some nurses shouting It's Nurses Week, not Hospital week! When there are so many weeks or days designated for health care workers such as CNAs, Social Workers, Therapists, Hospitals, Home Health Agencies, Hospices, etc., it seems like no one should feel so left out that we can't just take the week to honor NURSES!!! I know the gesture wasn't meant to offend, but we can go too far to try to be nice to everyone!! Again a little more communication and consideration would be helpful.

Let's make it better next year. Again THANK YOU for ALL you do!!!



Friday, May 12, 2017

Nurses Week 2017 - May 12

Today marks the end of Nurses Week 2017. May 12 is the anniversary of the birth of Florence Nightingale who some feel is the founder of the nursing profession. If we search into the history of nursing, the profession started long before Florence, but she brought strong clinical skills and universal precautions to nursing and helped save many many lives during the Crimean War.

So as part of Nurses Week celebrations, many stop for a moment to recite the Florence Nightingale Pledge which is also known as the Nurses Oath.

I solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.


UPDATE: Carmel Sheridan has just told me she will be hosting a FREE 7Day Mindfulness Challenge next month. Stay tuned to her website The Mindful Nurse for details. Sounds exciting!!!


Today's Nurses Week #Give-Away(s)

1) I recently received a package of Zebra pens. Knowing how nurses have a love for pens, I'd like to share them.  So if you enter and win you'll receive this entire collection.

2) My contribution to this week about mindfulness and healthy nurses is an autographed copy of my latest book, Exploring the Home Health Experience; a Guide to Transitioning Your Career Path.

When I found myself totally disillusioned with the nursing profession and hating nursing after only 3 years, I took a leap of faith and discovered home health care and eventually hospice. I loved it and my love for nursing was restored.

There are so many different roles in nursing, you should never find yourself quitting to profession. Search for another role and find your niche. 


I'm developing a course to accompany the book and it should be available on Teachable this summer.
One last time, Comment here OR on the Facebook page, and then email me your contact information.

HAPPY NURSES WEEK!!!!!


Thursday, May 11, 2017

Nurses Week 2017 -- May 11

I hope you have been enjoying Nurses Week. Have you had some of the free food and discounts we listed on Nurses Day? Please be sure to avail yourself of these. It helps to spread the awareness of nurses in your community and just might encourage someone to join our profession.

The other thing is to remember always that as nurses we make a difference in someone's life everyday! We may never know how or when with some of our patients or families, but there will be those who touch our hearts and leave a lasting impression.

It's easy to grumble that Nurses week means nothing and your employer gave you yet another water bottle with the company logo. Or maybe nothing at all and no acknowledgement of the event. But what we have to remember is that if they gave us those fantasy items such as another week of vacation, a huge raise or bonus check, etc., we'd find ourselves lacking definitively in another important area. Stop and take a moment to honor yourself, your colleagues and all nurses!

Safe Patient Staff Ratios
Patient staff ratios was the point Nurses Take DC on May 4 & 5  were trying desperately despite horrible weather conditions and daily events happening in the govt to make known the cause of Safe Patient-Nurse Ratios.

We know that medication errors, mortality rates and quality of care are directly related to these ratios. Some states have stricter ratios than others and it's in everyone's best interest to make it a national law with protecting patient's lives at the helm of the legislation.

We also know that poor staffing ratios play a huge part in nurse burnout and contribute to poor health habits for all nurses. As we celebrate mindfulness for nurses and promoting healthy nurses, we must stand with our colleagues in supporting Safe Patient-Staff ratios. View the event on YouTube.

Today's #GiveAway

Today we have a great #GiveAway from nurse author  Lois Gerber RN, BSN, MPH who "believes in the spirit of community health nursing - its focus on wellness, relationships, families, and communities. Her BSN, MPH in Nursing, and Specialist in Aging certificate opened many professional doors. She’s worked in home health agencies, public health departments, and an Area Agency on Aging. She’s taught nursing students on the university level and has counseled families dealing with elder care issues. For forty some years, Lois has helped people of all ages, various religions and ethnicities, and different socioeconomic levels. These stories reflect her experiences."
In addition to several great books about nursing, Lois has written 2 novels. She is generously donating a Kindle Version of Your Choice from her books.  Thanks so much Lois!!!
Once again, please Comment here or on our Facebook page AND email me your contact information to be entered into the random drawing for one of our Nurses Week #GiveAways.

Happy Nurses Week!


Translate