Thursday, February 26, 2015

Renewed Interest in Patient-Centered Care

Patient-centered care is not a new idea. It was quite popular when I was in nursing school in the mid 1970's. It's what drove me out of hospital-based care and into home health care within three years of graduation. I wasn't able to make the difference I wanted to make because we couldn't achieve patient-centered care.

Reemergence of Patient-Centered Care
Nurse Blog CarnivalNow as we are mandated to cut and manage the soaring costs of healthcare and improve outcomes all at the same time, the importance of patient-centered care is reemerging. To a new generation of nurses and health care professionals it is new and exciting, and to those of us familiar with it, we are once again inspired. I hope this time around it really catches fire. I know that it has been integral to quality home health and hospice care for decades and one of the reasons they are thriving industries today.

So what is the fuss all about? It's not that complex, but I still believe hospitals will struggle to achieve patient-centered care wholeheartedly just because there simply is not, and probably never will be, adequate staffing and nurse-patient ratios. Perhaps if the concept begins to prove to lower costs and improve outcomes, administrators will see the light and make some changes. Yes, I know I'm a dreamer. But think of the impact we could have on wellness and preventative care if all nurses had the opportunity to practice true patient-centered care!

Integrating the Whole Patient into the Plan of Care
Patient-centered care means whole-patient care. This is why it works well in home health and hospice. The nurse (and the care team) meets the patient, his family, his caregivers, his pets, and despite the best HIPAA efforts, often his nosy neighbors. With a glimpse into the patient's home and environment we get to see his true lifestyle, culture, traditions, beliefs, superstitions, fears, wants, desires, and all of what makes up this patient. In the physician's office, clinic, ER, or hospital room we only see small parts of the picture.

The home health or hospice nurse becomes the eyes and ears of the physician often to learn why the patient is non-committal or non-compliant; why the treatment is not effective; why the patient is not improving. In that sterile environment of the hospital he thrived. But back home he has his whole-person lifestyle to contend with. The plan of care has to include these factors.

Empowering Patients
Patient-centered care means we need to examine and consider all of the components of the patient. The patient's values, cultural traditions, social circumstances, financial matters, family situations, and personal preferences have to become an integral part of the plan of care.

Once we meet and see the whole patient, patient-centered care involves:
  • providing coordination of care and open communication with all members of the team including the patient and designated family members  
  • providing support and empowering the patient to take responsibility
  • providing ready access to information and care 
  • the autonomy to make decisions without judgement
As we educate the patient and monitor the plan of care we have to include all of these factors in order to help guide the patient and empower him to understand his health status, his options and the benefits and risks without bias or judgement. We have to give the patient the information and the right to make informed choices and then the guidance to help him achieve the best outcomes possible under the circumstances. Again we cannot judge or present bias; only information and options as we move forward with the plan of care.

The Institute of Medicine (IOM) and the Institute for Healthcare Improvement have conducted many studies on patient-centered care and the results show improved patient outcomes, higher quality health care, and a higher level of patient engagement. All of these will lead us to a much improved overall health status and eventually help to contain and lower the staggering costs of health care.

How is patient-centered care working in your job? 

This post was written as part of the Nurse Blog Carnival. More posts on this topic can be found at Big Red Carpet Nursing. Find out how to participate.

Patient-centered care
Patient-Centered Care: What it Means and How to Get There
Chasing the Quality Chasm

Monday, February 16, 2015

Home Health Aide Information

Home Health Aides

Friday, February 13, 2015

Nurses Week 2015 Theme: Ethical Practice Quality Care

nurses week logo 2015From May 6-12, 2015, we will celebrate National Nurses Week and honor the excellent quality care nurses deliver to patients every day.

Nurses have once again been voted as the most honest and ethical professionals by the Gallup Poll. This event provides nurses the opportunity to pat themselves on the back and take a bow for all the great work and care provided on a daily basis 365 days a year, 24 hours a day.

According to the American Nurses Association, "the 2015 National Nurses Week theme "Ethical Practice. Quality Care." recognizes the importance of ethics in nursing and acknowledges the strong commitment, compassion and care nurses display in their practice and profession."The ANA offers a toolkit and many suggestions for celebrating Nurses Week, including information on the history of Nurses Week. LED solar light boxI would like to suggest a great gift anytime for nurses would be Gift of Light a solar LED light box that can be attached in multiple ways to bike helmets, bicycles, backpacks, dog leashes, baby strollers and also worn as an arm band. The light box features 3 modes; steady, slow blinking an fast blinking and is available in red or white LED colors.
giving the

Friday, January 30, 2015

TRAYBL Makes the Nurse's Life Easier

Another nurse entrepreneur, Joyce Harrell, hits the nail on the head with her invention of this versatile TRAYBL. This great patented design actually creates valuable extra space in the tight squeeze of the bedside area and infusion suites to make the nurse's life easier.

 It also works to hold a wide assortment of items on wheelchairs, walkers and even outdoor furniture. One of those, "why didn't I think of this?" moments!!!

Check out the Facebook page and order yours today from the ETSY site.
Photos courtesy Damron-Harrell Technologies, LLC.

Thursday, January 22, 2015

Why US Nurses Might Consider Practising in the United Kingdom

By Brit Peacock

While you’d never come to the UK for the weather, spending some time nursing over here can be enlightening and ultimately rewarding, whether you opt for private sector or the National Health Service (NHS).

Whatever your thoughts on Obamacare, the UK’s NHS is widely seen as the benchmark for a ‘free’ healthcare system. Born in 1948, it was the first time that hospitals, doctors, nurses, pharmacists, opticians and dentists were brought together under one umbrella organisation.

The central principle being that quality healthcare would be available for all, financed entirely through taxation, which meant people paid according to their means. While some things have changed, it’s still an amazing environment to work in.

Making the Move
Prior to October 2014, it was, quite frankly, a nightmare of bureaucracy when applying to nurse in the UK from outside the EU. Even well-qualified nurses, working in top US hospitals found it challenging to gain entry onto the Nursing and Midwifery Council’s (NMC) register.

One of the biggest stumbling blocks was having to prove that you’d accumulated 4,600 hours in nursing-relevant classes, when American colleges use a different system of accreditation. Many who did manage it only did so with the help of an experienced nursing agency. Fortunately, it has recently become much easier to practise in the UK for overseas nurses.

Current Requirements
In order to come to the UK from the USA, you must have had at least twelve months’ experience working as a general nurse, plus you’ll need to:
• Pass an on-line multiple-choice exam, which you can take in your home country.
• Pass a practical objective structured clinical examination (OSCE), taken in the UK.
• Score an average of 7 in the International English Language Testing System

While the English exam might seem unnecessary for US nurses, it is still mandatory, and hopefully one you’ll pass with flying colours. Interestingly, while nurses from countries where English is the primary language must take this test, applicants coming from the EU do not.

A Helping Hand
To assess whether you will have the necessary theoretical and practical experience to pass the nursing exams, you can seek advice from a reputable nursing recruiter, who will have advisers to help. And of course they’ll also be able to help you find suitable RN vacancies that are matched to your specialisms and experience.

Whichever nursing role you enjoy, with the UK having an almost constant shortfall of well-qualified nursing practitioners, you should find excellent opportunities for employment and career advancement across the pond. Just remember to bring an umbrella!

Friday, January 16, 2015

Please Don't SHOUT, Try Writing it Down

One of the things I find most annoying as I listen to, or overhear, nurses discussing a patient who is "profoundly hard of hearing" and the fact that they find it almost impossible to communicate with the patient.

From the other side of the scenario, I have had too many experiences with family members who are moderately hard of hearing to totally deaf. It's even more frustrating for the patient to be unable to communicate with the medical professionals! Walk a mile in your patient's shoes.

WRITE it Down
What ever happened to pen and paper? These patients are not blind and dumb! Use a pad of paper, your smart phone notes app, a white board, SOMETHING! Don't just give up and say you "just can't communicate with the poor guy!" Of course you can't if you think the only way to get your point across is to SHOUT so you can be heard 5 blocks away!

Indeed shouting may be required, but most times just ENUNCIATING clearly and speaking SLOWLY, especially if you rattle off words off at rapid fire speed. Try changing the pitch of your voice too. Tip your chin down, take a breath and speak slowly in a deeper voice. If that doesn't work, try raising the pitch towards a soprano level. Again, enunciate and speak slowly, and DON'T SHOUT!

Why Hearing Aids Don't Always Help
When human beings lose their hearing, one of the reasons hearing aids don't always work is that the person waited way too long to try them. By then the brain has forgotten what specific sounds are and the hearing aids only amplify sounds that are foreign to the brain. This causes more confusion than trying to eek out what little sound they can hear.

Think about a baby learning to speak. It has to hear sounds repeatedly and associate the sound with a person, object or action to learn to speak and understand speech. An adult who has lost their hearing doesn't usually understand they have to retrain their brain so their hearing aids will actually help them.

Consequently, many people choose not to use their expensive devices and sink into isolation. But they didn't forget how to read. So use some sort of written communication tool and see how much more you can accomplish without SHOUTING and becoming overly frustrated.

Pictures, videos, even charades or other visual cues can help when communicating with a person who is hard of hearing; and will work to enhance your written information.

Get Creative
Borrow a trick from trying to communicate on a very basic level with those who speak another language. Write out some of your frequently used questions, statements, directions, etc., on a sheet of paper or use 3X5 index cards. Keep them together and USE them when you have a patient who has diminished hearing. Laminate them to keep them clean and fresh.

Next time you have a patient who is hard of hearing, don't just write them off… WRITE IT DOWN! And teach your patients to ask others to do so. Feeling stigmatized, they don't always remember to suggest this solution.

For further reading....

Thursday, January 15, 2015

Travel Nursing Tips for New Grads from Highway Hypodermics

Hope 2015 is starting off well for everyone! It's been a little crazy for me and so I'm slow to get back to blogging.

Today, I want to share with you a great article (the first in a series) by a friend, Epstein LaRue RN, from Highway Hypodermics ® offering useful tips worth heeding for new grad nurses about becoming travel nurses.

As a travel nurse herself, Epstein has taken on the challenge to make Travel Nursing transparent for everyone. She breaks it all down and leads you through every step to make the transmission and become a successful travel nurse. This past year I gad the pleasure of meeting her face-to-face. We share a birthday and we celebrated our half-birthday. 

This wonderful series of articles (part two posted today) will help every new grad discover how they too can move towards a travel nursing career after they have some strong basic skills and experience under their belt.  

As a home health and hospice nurse, I of course, encourage anyone to explore these fields, but I'm always old school about it. You need to have at least a year of experience and preferably in a general zone such as med-surg. There is a correlation to transitioning to any nursing specialty especially the so-called non-traditional nursing career paths. Get the very best basic background you can to build upon as you find your niche.

To be brutally honest, nursing is not an easy choice in the first place. Nursing school is grueling and it doesn't get any easier after that. Nursing is challenging, and it's physically and emotionally draining. You have to love it and you have to have the drive to go back every day for more. You have to make your own rewards and you have to learn how to replenish yourself so you can continue to be there for your patients.

All that being said, you will absolutely LOVE being a nurse. And when you find your niche, you will LOVE it even more. Give yourself time to hone your basic skills and build confidence in yourself. Charting the best course to becoming the best nurse you can be will take about a year. 

Then travel nursing can be one of the most rewarding choices you will make. Follow Einstein's tips and understand her reasons for telling you to not jump in to travel nursing as a new grad. Be kind to yourself. You're going to have enough rough patches just being a rookie. Be kind to your patients too, they need you to be the best you can be!

You have a lifetime ahead of you to continue learning and making a difference in your patient's lives. Enjoy the ride!!!

Image courtesy of  artemisphoto at

Friday, January 2, 2015

Facts About Men in Nursing

More and more men are finding their career niche in nursing which improves the profession for all of us. Here's a great infographic with 5 Hyper-Masculine Facts About Men in Nursing from College America.

Wednesday, December 31, 2014

Happy New Year!

Hard to believe that the year is ending. 2015 holds many promises for the future. As the bell tolls midnight, make your wishes and I hope they will all come true.

Have a very safe and Happy New Year!!!