Thursday, January 31, 2008

Feb. 1 is National Wear Red Day

February 1 is the kick-off for American Heart Month. To raise awareness of heart disease in women, the campaign to wear red evolved into the Red Dress as the symbol to promote heart health in women. On February 1, everyone is encouraged to wear red to promote heart health.

The U.S. Department of Health and Human Services (DHSS) has joined forced with The National Heart, Lung and Blood Institute (NHLBI) to provide materials and FREE continuing education units for nurses and health educators to learn more about heart health in women. Read more...

Photo courtesy of The Heart Truth, National Heart, Lung and Blood Institute. The Heart Truth and Red Dress are Trademarks of the DHHS.

Wednesday, January 30, 2008

Laugh Long and Hard Everyday!

Nurses have to have a sense of humor to survive the day-to-day basics of patient care! A reader sent me a link to a wonderful bit of humor about the 10 Terrible Patients You'll Find in Every Hospital, and How to Deal With Them. I'm sure you'll recognize a few. I know I did. Enjoy!

Share some of your worst patients on The Nursing Site Forum, and how you dealt with them.....of course please be sure to be mindful of HIPAA regs and don't include any identifying information.

Tuesday, January 29, 2008

A Documentation Sample

Documentation is such an essential part of nursing. To many it seems a waste of time. They'd rather spend their time with the patients, but in the interest of continuity, we have to be able to communicate information about the patient and the care we have given.

Documentation takes many forms in various institutions and facilities, but the basics include providing the most important points. If you can remember to answer the who, what,when,where,why and how your documentation should be accurate.

Here's a sample case study and how to derive the information you need to include. I hope it's helpful to those who struggle with charting.

photo from by Pedro Simao

Monday, January 28, 2008

Do You Want to Become a Nurse?

It's that time of year when high school students have to start researching careers and thinking about what they want to do when they graduate next year. As nurses, we need to encourage young people to seriously consider a career in nursing. We need to mentor and nurture a new supply of nurses to take our place as we plan to leave the workforce. The nursing shortage is tremendous already, and the need for new nurses is growing exponentially.

A career in nursing will ensure employment, challenges and rewards like no other career! Think about becoming a nurse.

photo from

Tuesday, January 22, 2008

Need Help With Documentation?

Today I rediscovered a great book I read a few months back called Writing for Nursing and Midwifery Students by Julio Gimenez.

Dr. Gimenez is a Professor at Middlesex University in north London. He teaches academic writing to nursing, midwifery and business students. This book is terrific at teaching nurses how to examine the care they have given and to document it by focusing on "the five w's and an h" otherwise known as who, what, when, where, why and how. Check it's a must for your nursing library!

Monday, January 21, 2008

How to Give an IM Injection

One of the most popular articles on was How to Give an IM Injection. I just added it to The Nursing Site.

I also noticed that the Celebrate Nurses page is getting some views. I will add content there this week. Meanwhile, you can also add a comment on the FB Nursing Site Page about your thoughts, ideas, concerns etc. about Nurses Week. This usually sparks some discussion as so many nurses feel that Nurses Week is silly, pretentious, and they never have had any good experiences with it. Bring on the discussion!!!!

Thursday, January 17, 2008

Understanding the Nursing Process

Are you struggling with the Nursing Process? Most student nurses do, and for some, the process takes quite a while to become comfortable with. For RNs, nursing is not all about the task at hand such as a dressing change, or passing medications.

The nursing process is about seeing the whole patient and the factors that lead him to your door so to speak. Why is this middle-aged gentleman with CHF back again so soon? Why hasn't this young woman learned about her diabetes and how to prevent such high blood sugars?

The process is about being a detective and finding ways to educate your patients and help them to improve their health status and outcomes. It involves examining a multitude of factors and developing a plan based on your nursing diagnoses. The process also involves evaluating the plan for effectiveness and tweaking it as needed.

Evaluating which patients have the greatest needs and what part of their nursing plans fit best into which part of your day helps you to prioritize and plan your schedule.

Tuesday, January 15, 2008

Why Do We Need a National Nurse?

Why do we need a National Nurse in America? Terri Mills, a nurse educator from Portland Oregon posed that question in The New York Times in May of 2005. Since then a huge grassroots effort has evolved. Representative Lois Capps (CA-23)herself a nurse introduced a bill (HR 4903) to establish the Office of a National Nurse to the 109th Congress. It received a great deal of support and public endorsement, but did not pass. This bill needs to be reintroduced to the 110th Congress.

The National Nurse Team went to Washington DC in March, 2007, to meet with legislators and to educate them about nurses and why we need an ONN. They hope to go again in March, 2008, and need financial backing. If you would like to make a donation, you can do so at

"Change vs. the Status Quo" is a theme running throughout the Presidential campaign this year. Creating an Office of the National Nurse would help create change for nurses. Nurses have learned that by elevating nursing as a profession we have gained tremendous respect from the public. Nurses have been cited as one of the most honest and ethical professions by the Gallop Poll several years running.

As health care demands more from patients, nurses are playing a vital role in patient education. Patients cannot assume responsibility for their health status without knowledge. Physicians don't have the time or resources to provide adequate information and education. This role has been assumed by nurses.

An ONN could help to provide a platform for nurses to provide better education and resources to all patients in order to promote wellness and prevent catastrophic consequences from chronic illnesses.

An ONN could help nurses to reach across barriers and blockades from health insurance issues to reach all citizens regardless of an ability to pay for health education and information.

Nurses could play a huge role in helping to improve the health status of this country and to reduce the high costs of health care, irrespective of health insurance coverage. This could then go a long way in helping to reduce insurance costs and pave the way to providing affordable health care and coverage for all.

Many chronic illnesses can be forestalled and complications prevented through proper patient education. Nurses need to be able to focus on and provide education.

An ONN could also help promote the nursing profession and encourage more people to become nurses which would help to alleviate the shortage of nurses.

Perhaps The New York Times needs to do a follow up report on how this op-ed piece grew to big grassroots campaign!

Nurses Improve Care and Outcomes

Once again the value of nurses in providing quality care and improved outcomes for patients has been demonstrated by a study involving family medicine practices and diabetic patients. From the Annals of Family Medicine; January/February 2008.

This result is not surprising. However, this particular study looks at outcomes in family practices with Nurse Practitioners versus physicians alone and practices with physicians and Physician Assistants. The practices with NPs provided better care.

John Q. Public may not understand why this is so, but nurses will certainly understand why. The minimum education requirements for PAs and NPs is vastly different, as is the content and focus. You can become a PA with an Associate degree, whereas an NP now has to have an MSN or equivalent.

Nurses are taught to educate patients and although the NP has an additional in-depth advanced education in assessment, diagnosis, and treatment; patient education remains a priority for all nurses.

Physicians don't have time to adequately address the education needs of their patients, and patient education is not a primary focus of the PA's education.

This was a small study, and part of the researcher's conclusions state that more studies, as well as larger studies, should be done. As practitioners utilize more NPs and PAs to help to reduce costs of healthcare, the effectiveness, efficiency and quality of care provided needs to be better understood in order to improve patient outcomes.

Sunday, January 13, 2008

How Do You Hand Off Your Patients?

How do you hand off your patients to the next shift? Do you make rounds? Do you record the information? Are you available to the oncoming nurse during shift changes? What kind of information do you consider critical? How do you prefer to get your report? What changes would you suggest for your facility?

Documentation is critical to continuity of care as well as to provide a record of the care you have given. Conveying information to the next person assuming care for a patient is also essential to providing quality care. It can be disastrous if something is left out.

The Center for American Nurses is currently conducting an online survey of how nurses hand off patients. The purpose is to determine safer ways of conducting this process. Please take a few minutes to weigh in on this project.

Thursday, January 10, 2008

New Products at CES

This has been a busy week. I'm in Las Vegas attending the Consumer Electronics Show. There are some innovative products for health care or that relate to health care. I'll tell you about them when I get home and have a chance to sort through the literature and visit websites.

Meantime, let me remind you about the Nursing Site Forum. (Subscribe at the top right.) There are a couple of requests for information posted there. Please join and chime in with your recommendations.

Monday, January 7, 2008

Virtual Voting Booth Open at ANA

Members of ANA can cast a vote for their presidential candidate in the Virtual Voting Booth until January 17. This vote will help ANA decide which candidates nurses feel will be the strongest advocates for nurses.

Also on the ANA site, public comment is being sought for Scope and Standards of Practice for Nursing Administration. Here is your chance to speak out and voice your opinion! Be sure to do so before the public comment ends Feb. 20, 2008.

Thursday, January 3, 2008

Helping the Foreign Born Nurse Asimilate

Each year many nurses emigrate to English speaking countries such as the U.S., Canada, Great Britain and Australia. Learning to speak English is a huge challenge. The form of English spoken in each of these countries can vary along with the slang, the accents and the pronunciation and spelling.

Additionally they need to learn about the culture and the practice of nursing in these countries. It may be very different from the practice of nursing in their homeland.

Learning to speak another language can be a challenge for all of us. As our countries become more and more global and diverse, the need to speak other languages in order to provide quality care increases. Sometimes we can understand a language much better than we can speak it and we become self conscious.

We know that to provide quality nursing care sometimes we have to make decisions quickly and give very direct, short instructions. There isn't always time to repeat ourselves or to ask questions. So learning to
effectively communicate is essential. When time does allow, foreign born nurses need to ask questions and soak up as much knowledge about the language, gestures and other non-verbal techniques, slang and appropriate uses of past, present and future tenses. also has some terrific booklets and toolkits to help foreign born nurses assimilate into the American Hospital setting. These can be effective teaching tools for nurse educators as well.

Wednesday, January 2, 2008

Entrance Exams and the NCLEX

Well it is now officially 2008. Happy New Year and I hope it's a good year for you.

I was busy this weekend adding some new content to
The Nursing Site. If you're considering becoming a nurse, you will most likely have to take an entrance exam. Two of the most popular are the NET and the TEAS. And if you're graduating soon, you'll be sitting for your state boards soon (also known as the NCLEX). There are many study guides available to help you prepare for either of these exams so don't panic!

On the
NCLEX & Exams pages I have tried to provide you with some advice, links to check out formal information, and a few suggestions for study guides available from Amazon. You can read reviews from others who have purchased these items and find suggested items to supplement these guides from their site as well.

There's also new content on the
How to Become a Nurse page as well.
Photo by Kathy Quan ©2007