Friday, March 28, 2008

Calls to Action from NLN and ANA

Staffing and budgeting issues will always affect the delivey of health care and the quality of that delivery. The growing nursing shortage affects these issues, but is also the victim of these as well.

U.S. Senators Barbara Mikulski (D-MD) and Susan Collins (R-ME) are circulating a "Dear Colleagues" letter in the U.S. Senate similar to the one which recently circulated in the House of Representatives. This letter is asking Senators to support appropriate funding for the Title VIII Nursing workforce Development funding. The NLN (National League for Nurses) is calling for all U.S. nurses to contact their Senators to please sign this letter by Tues. April 1.

Short staffing can cause all sorts of issues for quality of care and patient safety.As nurses we are acutely aware of this problem. The ANA (American Nurses Association) would like nurses to take the Safe Staffing Poll so that they can be sure that they are on target in promoting safe staffing.

ANA also invites you to Share Your Story.

Thursday, March 20, 2008

Nursing Scholarships and Nurses Caps

Kim at Emergiblog hosted the latest edition of Change of Shift this week. Here are two of my favorites from her findings throughout the nursing community. 101 Little Known Scholarships for Nurses from the Nursing Online Education Database.

The second come from the NPR (National Public Radio) program All Things Considered. A recent "homework assignment" for the program was to find the best in obsolete skills. Fran Hill, who graduated from the Presbyterian Hospital School of Nursing in Philadelphia, PA, talks about her skill of cap folding and how she recently revisited this skill and it reminded her of her early days as a nurse. Take a listen to this short 3 minute discussion.

photo by Kathy Quan

Wednesday, March 19, 2008

Cranial Nerve Assessment

Do you know your cranial nerves and how to assess them? Do you remember that silly rhyme to help you remember them? Don't worry it doesn't have to drive you crazy trying to remember, I have a couple right here to jog your memory.
photo by Aron Balough

Tuesday, March 18, 2008


The March issue of ISMP Medication Safety Alert® Nurse Advise-ERR®, reminds us all to DO NO HARM! A nurse who was unfamiliar with the Type 2 diabetic injectable medication BYETTA (exenatide) withdrew the entire contents from the penlet (1.2 mL) and injected the patient with the equivalent of 60 doses.

Once the prefilled pen is removed from the packaging, there are no instructions for use on the pen. However, it does clearly state "each prefilled pen will deliver 60 subcutaneous doses, 5 mcg per dose." The label also states that there are 250 mcg/mL and the pen contains 1.2mL. It also states, "Do not transfer this medication to a syringe."

Even though the instructions may have been "lost," the nurse would find valuable information about the dosage and administration on the pen. Nurses should NEVER perform a procedure they are unsure of, nor administer a medication they are unfamiliar with until they have adequate information, instruction or supervision to ensure patient safety. (I know, there's often not time or staffing to allow for this.... but please DON'T put your license on the line and jeopardize a patient's safety because of staffing issues! This is not a defense, if a patient is harmed, it's your license!)

This nurse should have asked for help before ever administering this medication. The instructions for use should not have been discarded, but this is not a defense for the nurse. She was educated and licensed as a nurse; she is expected to know better. If she had carefully read the label on the BYETTA pen, she would have gleaned the knowledge to question the dose and how o administer such a small dose.

Your first responsibility as a nurse is to protect the patient. If you're unsure of how to do something, it is your responsibility to find out first! DO NO HARM.

The patient exhibited the signs of overdose of this medication (severe nausea and vomiting along with rapid decline in glucose levels) and was treated appropriately and recovered. But he/she should never have had to experience this.

Medicare announced late last year that they are no longer going to pay for expenses related to errors such as this one. Many private health insurance companies are following suit. Such an error could have been very costly to the facility. To say nothing of the possible loss of life to the patient.

photo by Kathy Quan

Monday, March 17, 2008

Tips to Avoid Burnout

Sometimes you just have to take some time to do the little things that you enjoy doing like reading a book, playing with your children or animals, taking a weekend trip, or engaging in a hobby like sewing, photography, or hiking.

If you don't take time to enjoy the things that mean something or help you to relax and feel like you've been able to escape or do something just for you, you can become angry, frustrated and resentful.

These are the things that make your life worthwhile and make you feel worthy. Take time for YOU frequently. Don't get so busy and stressed out that you feel like you can't take time for YOU. This will actually only make things worse.

Here are a few more tips to help you about the dreaded nursing burnout.

Wednesday, March 12, 2008

Medication Reminder System Helps Elderly Stay Independent

In January, I attended the Consumer Electronics Show in Las Vegas. I was really pleased to find some innovative products designed to meet some of the most important health care needs.

One such product is called MedSignals. This is a programmable medication delivery system that reminds patients to take their medications and clues them as to how many pills to take at a time. It also has some very smart capabilities to alert caregivers and home health nurses when patients have missed doses. It records data which can be plotted to determine trends.

The unit holds a one month supply of most medications and has 4 bins. Additional units can be added on. This reminder system offers options to assist aging parents to remain at home and give their children or othet caregivers surveillance of medication compliance even at a distance. Intervention can be made before it becomes a crisis if a dose is missed.

Tuesday, March 11, 2008

Support Candidates who Support Nurses!

The Paul Wellstone Mental Health & Addiction Act passed in the House of Representatives last week! Many thanks to all of you who contacted your Representatives!

Now, nurses need your help... there is still time to get signatures on the "Dear Colleagues" letter being circulated by Representatives Lois Capps (D-CA) and Steven LaTourette (R-OH) to encourage Congress to increase funding in the FY 2009 budget for the Title VIII Nursing Workforce Development program which help to fund education costs for nurse educators. Signatures are needed by tomorrow, March 12.

As nurses we need to continue to contact of legislators to remind them that whether or not every American has health insurance, if we don't have a nursing workforce to help care for patients, all the insurance in the world won't be of any use!

The nursing shortage is REAL and the nurses in the workforce are aging. As the population also ages and needs more and better health care, more nurses will be needed. We cannot produce enough qualified nurse graduates if we don't have the nurse educators to provide instruction.

The nursing shortage affects all of us and we need to become politically involved and aware. This is not just a Presidential election year. Many seats in the U.S. Senate as well as the House of Representatives are up for grabs. Learn more about the candidates, and help to educate them about the nursing crisis. Elect candidates who support nurses!

We cannot heal the health care crisis without first addressing and healing the nursing shortage. Cutting funds to nursing programs is not the way to solve this issue!

Thursday, March 6, 2008

Resources for the Nurse's Computer, Palm or Pocket PC

I discovered a terrific site for nurses to find "Free and Free to Try Downloads" for the computer (Windows and Mac), Palm, or Pocket PC. This is all software for nurses and health care professionals and includes such items as medical dictionaries, calculation programs, drug books, diabetic resources, lab values, diagnostic tools, ICU tools, etc. Check it out at I Love Nurses.

photo: Kathy Quan

Wednesday, March 5, 2008

Subscribe to the Wednesday Newsletter

For those of you who would like to keep up with this blog, but don't have or want an RSS reader for it on your home page, I now have a weekly newsletter that encompasses the latest blogs.

You can subscribe in the box over there in the right hand column, just by entering your Email address. (No long forms to fill out!) The newsletter will be delivered to your Email address every Wednesday. Thanks for reading! And I promise not to spam you or sell your Email address!!!

Tuesday, March 4, 2008

Mental Health Parity Can Be Achieved!

Yesterday I received an urgent message from the ANA asking nurses to contact their Congressional Representatives to support HR 1424, the Paul Wellstone Mental Health & Addiction Act. Congress is expected to take up this issue tomorrow, March 5, 2008.

In September, 2007, the U.S. Senate passed similar legislation (S. 588) which will help bring an end to health insurance discrimination and remove barriers blocking health care for those who suffer from mental illness.

Please call today! The toll free number is 1-866-727-4894 and ask for your Representative's office. If you don't know who your representative is or prefer to send an Email you can get this information and access at