Thursday, March 20, 2014

Sites You Need to Check Out

Playing catch up today. I have made many promises to mention or post links and this is going to be a grouping of those promises. There should be some very good information here so bear with me....

Scrubs are such a wonderful invention. And Uniform Advantage has published a great infographic about the Best Scrubs for your Body.  There are some very interesting points to help you looks your best. Thanks for sharing UA!

We were once again honored to be recognized by peers from as one of the Top 50 Nursing Blogs for Students. Scroll down to the bottom fo the Home Page to find the list. (We're #11). Thanks for the mention!!! 

A fellow nurse writer has written Nurse Your Wallet Ebook available on in their Kindle store. Janine Kelbach, RNC-OB helps you think outside the box about how to use your nursing education to find ways to make extra income. It's $2.99.

Working the night shift is something most nurses have or will have to do at some point in their career. On the blog is a great post entitled Nursing Night Shift Tips. They have a nice collection of interesting blog posts! Check out their ceu options too.  

And finally, I found a great post by fellow nurse write, Brittney Wilson, about hw to handle the problem with nurse wannabees. It can be very frustrating to follow a medical assistant or nurses aide when the patient thinks they are the nurse and who the heck are you?! Many great nurses bridge from these careers and others continue to be great bedside assistants, but Calling Yourself a Nurse is Criminal No Less helps the licensed nurse set clear boundaries and explain the issues.

Friday, March 14, 2014

Salary Data for Registered Nurses

By Brendon Barnett
Registered Nurse Salary at a Glance
The registered nurse (RN) is one of the most diverse nursing occupations, with wide ranging skills and qualifications. RNs are used in various health care environments. They provide direct patient care, deliver health-related education, and offer advice to patients and families. “To do what nobody else will do, a way that nobody else can do, in spite of all we go through; is to be a nurse,” said Rawsi Williams. It’s for this type of dedication that nurses are compensated, and rightly so.

Becoming a Registered Nurse
In the United States RNs are required to be licensed. To become licensed, nurses must graduate from an approved program and pass the National Council Licensure Examination for Registered Nurse (NCLEX-RN). There are three common types of RN programs that nurses take: a bachelor’s of science degree in nursing (BSN), an associate’s degree in nursing (ASN) or a diploma from an approved nursing program. Any of these three paths can qualify a nurse for an entry-level staff nurse position, but some employers may require a bachelor’s degree.

Industries with Highest Levels of Employment for Registered Nurses
In 2012 there were approximately 2.7 million RNs employed in the United States. Most RNs work in private, public, and state hospitals, followed by physician offices and nursing and residential care facilities. RNs are found in many other work settings, including correctional facilities, schools, community centers, and the military.

Median RN Salary
On average, RNs earn 25% more than the median salary of all workers. In 2012 the U.S. Bureau of Labor Statistics (BLS) identified the median RN salary at $67,390 per year, or about $33 per hour. While the lowest 10% of RNs earned about $45k per year, the top 10% of RNs earned more than $94k annually on average. Of course there are different areas across the country where RNs have a much higher earning potential.

Top Paying States for Registered Nurse Salary
For the last 10 years California has topped the charts as the state with the highest RN salary. But there are other states that also compensate RNs well. As you can see from the map to the right, most of the highest paying states are located on the west coast and in the north east regions of the country. In 2012 the top 5 highest paying states by annual mean RN salary were:
1. California – $94,120
2. Hawaii – $84,750
3. Massachusetts – $83,370
4. Alaska – $80,970
5. Oregon – $78,530

Some people argue that California continuously tops the list for highest salary because the cost of living is much higher there. Just like any state, California has pockets of higher than average income levels. But when you compare RN salary with median salary from the same state, you realize something: California simply pays nurses better. California has the highest margin of difference between RN salary and the salary of the average worker (64%).

Top Paying Metropolitan Areas for Registered Nurse Salary
In 2012 all of the top 10 highest paying metropolitan areas for RN salary were in California. Most of the highest paying jobs are located in and around the San Francisco Bay Area. The top paying metro areas for RN salary are:
1. San Jose, CA – $122,990
2. Vallejo-Fairfield, CA – $119,310
3. Oakland, CA – $113,520
4. San Francisco, CA – $110,630
5. Sacramento, CA – $107,710

RN Jobs and the Nursing Shortage
The United States is currently facing a nursing and physician shortage. This is due to a combination of expanding affordable health care, lack of nurse educators, and the fact that many current nursing professionals are moving into retirement age. The need for RNs has never been greater. The BLS projects that RN jobs will grow by 19% over the next decade, a rate much faster than usual. BLS estimates are that 526,800 new RN jobs will be created between 2010 and 2020.

Bureau of Labor Statistics, Occupational Employment Statistics Survey, (2012). Retrieved from
Median Wage by Occupation Across States, (2012). Retrieved from
RN Salary Comparison by State (2012), (2014). Retrieved from

Monday, March 10, 2014

Core Competencies and the Continuum of Care

The high cost of health care has to be managed. This requires patients to learn about their own health conditions, and how to manage them appropriately so as to avoid setbacks and complications. Patients must take responsibility for their health status and practice wellness. In order to do this, patients have to be well educated about their medical status.

Across the continuum of health care, patient education begins in the physician's office and carries through to the after hours care, the urgent care and emergency room, the hospitalists and the home health care team. Each professional and team builds on the education and assessment of the patient's status and how to best assist him in attaining management of his health care status. Nurses are at the forefront of the process to ensure quality care across the continuum. Strong leadership skills and professionalism are essential for the success of this process.

Core Competencies
Roles for nurses are expanding rapidly to provide the necessary evidence-based education to patients so they can take control of their destinies. Nurses need to constantly improve their knowledge base and become the best patient educators they can be. Skills and competencies have to be top notch. It is no secret that lower patient mortality rates have long been linked to having BSN prepared nurses in charge of their care. Nurses who are best prepared to deliver health care also provide patients with the best possible options and outcomes. Advance practice nurses such as Clinical Nurse Specialists and  Nurse Practitioners have taken lead roles in driving the need for all nurses to obtain higher education. With the emphasis on wellness and not sick care now, this becomes essential.

Today's nurses must have strong critical thinking skills and know how to actually practice nursing theories as well as employ the tools and core competencies they learned in school and have experienced on the job. They must utilize the continuum of care and understand their position in it with each patient. No one professional will see the process through from start to finish so it's important for nurses to focus on the tasks at hand and provide the next level of care and then provide a thorough hand-off report for the education process to continue and patient outcomes maximized. Nurse educators in facilities are charged with the job of evaluating their staff's skills and improving them through continuing education.

Avoiding Readmission Using Continuum of Care
Hospitals are charged with avoiding readmissions and this is best achieved through a strong continuum of care both in-house and with post acute care options. Teamwork and collaboration is vital as each team member builds on the previous information and reviews the patient's understanding to plan for the next step. Quality patient-centered care and education includes hand-off reporting that ensures the wheel is not being reinvented from scratch with each subsequent patient encounter.

Home health care is proving to be a very effective choice after, or even in lieu of, acute care in providing quality patient education and achieving optimum outcomes. Hospital readmissions have been reduced, proving this continuum of care is effective. As this becomes more the norm, health care costs will be contained and patient outcomes improved.

Disclosure: This content has been brought to you by Halogen Software, the market leader in talent management software. Bringing value to nurses is at the forefront of Halogen Software’s goals so they are partnering with nurse leaders online to bring attention to important issues that healthcare organizations face every day. To find out more Halogen Software and the support they can provide to your nursing staff check out their healthcare page.

Further Resources:
Quality and Nursing: Moving from a Concept to a Core Competency

Friday, March 7, 2014

ANA Overlooks Dallas Buyer's Club in Honoring Latest Oscar Movies

Several friends belong to the American Nurses Association (ANA) and one forwards their emails to me in hopes I would change my mind and join. Well the latest posting from the Government Affairs Team caught my eye with a cute little play on words using the recently honored Oscar-nominated movies. They found a cute connection to nurses for all but one....

Then they totally dissed The Dallas Buyers Club stating, "P.S. Dallas Buyers Club. That one simply didn’t fit in." Perhaps no one would have noticed if they simply ended without this post scrip. But the fact that they had to say it simply didn't fit in leaves one to wonder why and how?

HIV and AIDS have been a huge part of the health care world for decades now. How can you not find a way to include this title? With better options and medication cocktails it's definitely not the death sentence it once was. Many nurses today fear contracting MRSA more than seemingly ever feared HIV or AIDS. Safe sex and needle precautions have almost become a thing of the past and this non-challant attitude can really come back to bite us all if we are not careful. Yes, precautionary measures exist today to protect us, but if we forget why for example, we have sharps precautions and needleless systems we become complacent and dangerous!

The fact that desperate people had to turn to such underground means as a "buyer's club" to obtain the education, information and medications to help them live even a few more days or weeks is not something we should shut our eyes and ears to. This need for subculture continues to a smaller extent today as patients seek care and treatment that isn't approved and available for multiple rare diseases.

For a simple example: there is evidence that IV vitamin C can help prevent the side effects and promote the effectiveness of many chemo therapies. There simply isn't the money to support the research because it's not an expensive new drug to discover and patent. Big pharmacy denies these benefits to cancer sufferers all over the world.

How can the ANA diss such an important movie? Because it's about the subculture of health care in the 1980's?  Is it because the story also encompassed LGBT ( lesbian, gay, bisexual, and transgender) lifestyles as well? The very possibility that they are in violation of their own ethics code is mind blowing. What direction is the ANA trying to take the nursing profession now?  There are so many valuable lessons to remember and learn from this era to help us continue to move forward in providing quality care without judgment and discrimination. Are we moving backwards here?

The title of this news reporting "When Nurses Talk, Washington Listens" sends shivers down my spine to think that bias and discrimination appear to be being given a voice by the ANA. We are here to provide care to every living soul that crosses into our care pathway and not to pass judgement and discriminate. We fought hard to make sure HIV and AIDS patients had access to the same care and nurses who were scared and biased had the education to help them understand how to give care safely or find other avenues to pursue.

There are so many possible "fits" for a relevant play on words in infection control, hematology nursing, forensic nursing,  informatics, just for starters. How did they not find a way to honor this movie in their salute? Instead they choose to make a point of leaving it out.