Saturday, September 23, 2017

What is the OASIS in Home Health Care?

As many of you know, I have been in home health and hospice for over 35 years. I worked many years in the field seeing patients and writing plans of care. I've worked in middle management and mentored hundreds of nurses, therapists and social workers especially in documentation skills. Today I work in hospice as the QAPI nurse where I review documentation and the quality of care being provided by our fabulous staff.

Home health and hospice are growing fields for nurses and other healthcare professionals. Patients leave the acute setting much sicker than they ever have and skilled professionals are in demand to handle the growth.

But home health and hospice have LOTS of paperwork whether it be EHR or actually on paper. None the less it has always been a burden to the industry and not likely to change.

In home health there is also a major document known as the OASIS that paints a picture of the patient at various points during the episode(s) of care. In addition to all of the other necessary documentation, the OASIS is absolutely one of the most import documents.

I run a home health site called and readers have been begging me for awhile to tell them how they can learn about the OASIS as they can't get a job in home health care unless they can show that they know something about it.

There are plenty of books about OASIS available, but you still need to have some understanding of what it is and why it's important.

So this week I have recorded 4 episodes to my new podcast channel specifically about the OASIS for those who have no idea about what it is. Don't judge me on the quality of the recordings please, I'm just beginning to dabble into this technology. I will improve. I just thought it important to get the content out there ASAP. You can find the links on 

Later this year, I will complete my eBook on OASIS for the beginner giving more examples and specific information. It will be available to purchase on and I'll most likely post here about it as well.

If you're considering a transition to home health care you might want to check out my book, Exploring the Home Health Care Experience; Transition Your Career Path

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, 
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.

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 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,
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. 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 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


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.


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!

Wednesday, May 10, 2017

NURSES WEEK 2017 - May 10

Today as the Wednesday of Nurses Week, is School Nurses Day. School Nurses play a huge role in managing the health care of our children. They conduct eye and hearing tests, instruct teachers and other lay people how to handle situations when faced with students with conditions such as seizures, mental health challenges and diabetes.  They oversee and instruct techs in administering medications during the school day and assessing for urgent needs.

Unfortunately, more and more school districts are moving to use lay people as health clerks and having the minimum number of school nurses to meet the bare necessities of the school district. This has proven to has be a dangerous situation. Playground injuries for one are all too often treated inappropriately due to a lack of education and skill in assessment. Notification of parents is delayed or non-existent and diagnostics, and treatment delayed to a dangerous level. It is important for parents, and all health care professionals to advocate for more school nurses. Celebrate National School Nurses Day by campaigning for MORE school nurses in your local district.

Today's #GiveAway continues the theme of mindfulness and balancing mind, body and spirit. Elizabeth Scala MSN/MBA, RN is a very busy woman as an author, keynote speaker, reiki master, podcaster, and blogger. Her focus is on helping nurses rediscover their love for the nursing profession, deal with and avoid burnout, and how to use self help techniques such as reiki to replenish and repair when work takes too much from us. "Before you quit nursing,"find your way back to the passion and love for nursing!
Elizabeth also spearheads The Art of Nursing, A Nurses Week Event seminar along with 12 nursing expert presenters this year. 

Many Thanks to Elizabeth who has kindly donated a copy of her book, Stop Nurse Burnout, for our #giveaway today.
Once again, please comment here or on our Facebook page and then email me your contact information so I can notify you of your prize ASAP.

Tuesday, May 9, 2017

NURSES WEEK 2017 -- May 9

Beth Boynton RN, MS has written a new book Medical Improv A New Way to Improve Communication! The book teaches the user to train others in an emerging skill using Improv to help educate patients as well as health care professionals. Beth is also the author of Successful Nurse Communication: Safe Care, Healthy Workplaces, & Rewarding Careers (F. A. Davis 2015).

Beth blogs at Confident Voices in Healthcare, where you'll find fabulous information and resources for nurses and a Code for 20% off when you purchase her Medical Improv book through 5/14/17.

She has generously donated a copy for us to #GiveAway today. (THANKS BETH!!) Remember to comment here OR on the Facebook page. Then Email me your Contact Info to be officially entered in the random drawing. Winners will be announced May 20.

Check out this great new book for yourself....
"Welcome to the emerging field of Medical Improv! Medical Improv is an exciting new teaching tool! Its experiential activities hold great promise for persistent challenges we face in healthcare by promoting the 'soft' skills involved in emotional intelligence, communication, collaboration, and leadership.
This train-the-trainer resource is designed to help educators teach the "soft" skills that healthcare professionals need to positively impact patient safety, patient experience, workforce health, and the efficient use of resources. Because these skills are not intellectual, they require a non-traditional approach that fosters new behaviors. Medical Improv is a fun and effective strategy."

Happy Nurses Week. Don't forget to COMMENT and email me your contact info. I won't spend days trying to track you down!!!

Monday, May 8, 2017


Today, May 8, is National Student Nurses Day and we have a special guest post to help provide some useful financial tips for nursing students from an aspiring freelancer writer Lauren Davidson.
Today's Give-Away is an autographed copy of my Amazon Best Selling book, The Everything New Nurse Book, Second Edition. And I'll throw in a copy of the latest update to the book, The New Nurse Handbook.
Remember to comment here or on the Facebook page. THEN you MUST email me your contact info to be entered in to the drawing. 
And now for our guest post....

Managing Finances and Lifestyle While Attending Nursing School

Being a nurse is a rewarding career, allowing you to take care of others in many different environments. Nurses are in demand across the country, giving nurses incredible job security. But while nursing is an attractive job option, getting through nursing school can be a challenge — both in terms of stress and finances.

Nursing school keeps you incredibly busy, between clinical rotations, lectures, labs, simulations, and standing on your feet all day. On top of the actual time spent in class and at school, nursing school students spend quite a bit of time in study groups, doing homework, reviewing lessons, and preparing outside of class for the next day’s work.

In addition to the stress of nursing school, paying for your education can be costly. Many are required to take out loans, but there is a pretty common solution to this such as finding scholarships. While that is a go-to for handling tuition, nursing students are expected to pay for text books, scrubs, study guides, basic equipment such as a lab kit and stethoscope, and more. Combined with the hectic class schedule, managing finances can be incredibly difficult for any nursing student.

But there are ways that nursing students can save money while getting their degree. Read on to learn how you can save money while in nursing school — and come out ready to take on the world!

Buy Smart, Borrow When Possible

When it comes to nursing school supplies, one of the biggest expenses that you will likely face each semester will be your textbooks. Your books will easily cost four or five hundred dollars each semester — or more, if the professor decides to order a new edition of the book. One way around this dilemma is to get smart when it comes to buying your books.

Start by getting to your campus bookstore as soon as possible after the class book list is released. Look for used copies of the books that you need. If they aren’t available, check for them online on sites such as Amazon. You may even be able to rent your books from Amazon or other sites. Otherwise, check with older nursing students or even nurses at your local hospital. They may still have copies of their old nursing books that will work for your needs. Just be sure that these books are accurate and up-to-date so that you aren’t using old information in your classes.

For NCLEX review books, consider pitching in with your study group to buy one copy of the book to share. Since you’ll be meeting together to work and prep for these exams, it makes sense to share one copy of these pricey books. If you buy your own NCLEX review books, limit yourself to just one or two books rather than buying multiple review books.

When it comes to nursing supplies, you’ll be required to buy a new lab kit each semester. But for items such as a lab coat or stethoscope, you may be able to borrow this gear from an older student or a nurse if you are particularly cash-strapped. That way, you’ll be able to hold off on getting them when you are in school — and then use the gear provided by your employer once you are employed after graduation. Alternatively, check online for nursing supplies — blood pressure cuffs, stethoscopes, and other needed items will likely be far less expensive than those offered in the campus bookstore.

For scrubs, even though your nursing school may offer a discount for a local scrub shop, be sure to shop around to make sure that you are really getting the best deal. Online retailers like My Nursing Uniforms and All Heart may have lower prices than those offered by the local store.

Take Advantage of Student Discounts

Whether you’re a nursing student or any other type of student, many stores, restaurants, and other businesses offer discounts to anyone with a student ID. These discounts may help you say a few dollars on a movie ticket, $10 on a new shirt, or 15% on a meal at a restaurant. It’ll all add up in the long-run — and help you balance your budget more effectively!

Guest post by Lauren Davidson, a soon-to-be graduate from the University of Pennsylvania and aspiring freelance writer


Sunday, May 7, 2017


Don't forget...

Register NOW for the FREE webinar from the American Nurses Association entitled A Nurse’s Guide to Preventing Compassion Fatigue, Moral Distress, and Burnout. Receive 1.9 CE and enjoy a great discussion. Deadline to register is Tuesday, May 9, and the webinar is scheduled for May 10. offers a Free Resource Guide. Check it out.

I hope you're enjoying Nurses Week.  Hopefully you're enjoying some of the freebies we posted yesterday. Today is Day 2 of Nurses Week and as a Sunday I hope you have the day off to relax and replenish; if not this week, hopefully next weekend.

A book I'd like to recommend is The Mindful Nurse by Carmel Sheridan. It truly fits well with the Nurses Week theme for 2017, Nursing: The Balance of Mind, Body and Spirit.  I've been enjoying it and trying out many of the suggested exercises.

Burnout and Compassion Fatigue is one of the biggest issues we face as nurses. Our lives are so fast-paced and full we don't always take the time to STOP and replenish ourselves and then hit the wall going 90 mph! It's essential to not only our own health and well-being, but to the safety and quality of our practice as nurses to learn to be mindful and grounded. Carmel Sheridan MA, MSc is a psychotherapist and knows her stuff in helping nurses learn to care for the caregiver.  This book is a must for EVERY NURSE!!!

Today's Nurses Week Give-Away is a FREE Kindle version of this truly fabulous book, The Mindful Nurse. 

Remember to COMMENT here or on Facebook page and email me your contact info to be eligible to win one of our Give-Aways 

Saturday, May 6, 2017

Nurses Week 2017 -- Rules for Give Aways

This year we have several new Give-Aways for #NursesWeek 2017 -- May 6-12. The ANA theme is Nursing: The Balance of Mind, Body, and SpiritWe have several books from nurses, some pens, and discounts to courses. Stay tuned. We will announce a new #GiveAway each day.

The rules to win are simple: 

  1. Just COMMENT on the Blog Post OR on The Nursing Site Facebook post.
  2. THEN you MUST email me your contact information with your CONTACT INFO as the Subject line-- If I can't contact you, you're eliminated automatically
  3. Enter Daily for each post
  4. ALL names will go into a hat and be drawn at random for each #GiveAway
  5. Everyone entering will receive a token #GiveAway as long as you send me your CONTACT INFO
Winners will be announced by May 20 right here on the blog. 

Other Great #NursesWeek Events and Freebies

Reignite the Passion of Nursing with  



* Free Food on May 6 (sorry the site is a little buggy, but might be worth the view
* Cinnabon offering Free food all week
* Lippincott FREE Resources and 25% discount on other Resources for Nurses Week
* Deals, Discounts and Freebies
 * Nurses Appreciation Week Free & Deals
* Deals on
* Where to Find the Free Stuff and other deals
Register NOW for the FREE webinar from the American Nurses Association entitled A Nurse’s Guide to Preventing Compassion Fatigue, Moral Distress, and Burnout. Receive 1.9 CE and enjoy a great discussion. Deadline to register is May 9, and the webinar is scheduled for May 10.

The ANA is also offering a Free Downloadable Toolkit for Nurses week with logos, graphics, email templates, certificates of appreciation and a card for Nurses Week. You can apply Social Graphics to your Facebook and Twitter profile pictures to celebrate nursing.

Thursday, May 4, 2017

ACA HAS NOT CHANGED with passage of House bill

Happy Cinco de Mayo! And stay tuned for some really great information prizes for Nurses Week May 6-12.

I also hope you will educate your families and your patients that even though the ACA Repeal and Replace Act passed the House, it is NOT the law! There is a process to be followed. The Senate has to approve it first, but they have already indicated they will not consider it and instead plan to write their own version which will then have to be approved in the House.

And then it won't become law until 2019!

Therefore NOTHING has changed. Your insurance is the same as it was yesterday! Don't be fooled or spammed by ANYONE and that includes your insurance company and providers. NOTHING has changed!!! Advocate for yourselves and your patients. NOTHING HAS CHANGED!!!!

This bill was opposed by the American Nurses Association, the AMA and Hundreds of medical associations. We now have a chance to work with our Senators to produce a Fair, Equitable, Quality healthcare fix to Obamacare.

PLEASE call your Senators (each state has 2) NOW at United States Capitol switchboard at (202) 224-3121. You will be asked to enter your zip code and then directed to your Senator's office. Likely you'll be leaving a message so prepare your thoughts on what you NEED in a healthcare bill. Identify yourself as a constituent in (zip code). And ask that they actually READ the bill BEFORE they vote on it. (How many House members read it??? Not many!!) This affects ALL OF OUR LIVES!!!

Friday, April 14, 2017

When Nurse Practitioners Step Forward

Nurse practitioners have been in the news in early 2017, and for very good reason; the time for nurse practitioners (NPs) and advanced practice registered nurses (APRNs) to step forward has come, and the world is taking notice.

In defining NPs, the American Association of Nurse Practitioners (AANP) states the following on their website:
“Nurse Practitioners (NPs) have been providing primary, acute and specialty healthcare to patients of all ages and walks of life for nearly half a century. NPs assess patients, order and interpret diagnostic tests, make diagnoses, and initiate and manage treatment plans – including prescribing medications. They are the healthcare providers of choice for millions of patients.”

While nurse practitioners have historically worked under the supervision of physicians, a growing movement to grant NPs complete autonomy and a broader scope of practice has taken hold, and it appears that critical mass has been achieved vis-à-vis nurse practitioners’ 21st-century coming of age. 

READ MORE  of this great
guest article from Keith Carlson RN, BSN, NC-BC on

99 Top Nursing Blogs has complied a really nice list of nursing bloggers and has honored many of us as "Top 99 Nurse Bloggers of 2017." I am always humbled and honored to be in such great company and share with you because this list is complex and well annotated. I found some new favorites and so will you. Check out these blogs. Thanks!!!!

Friday, March 24, 2017

Please Support The National Nurse Act of 2017

Nurses were once again voted the Most Trusted Professionals in the 2016 Gallup Poll. This marked the 15th year in a row that nurses have topped the list. It’s indeed an honor to call ourselves nurses and to be able to impart our knowledge on our patients to improve their quality of life and health status.

Today we face uncertainties with the new administration who promises to “repeal and replace” the Affordable Care Act as soon as possible. We need to stand strong together in a bipartisan effort to ensure Americans continue to receive the very best health care. This starts with prevention and nurses are in a unique position to lead the way. With chronic conditions on the rise that continue to bankrupt our federal and personal healthcare dollars, educating patients about their life style, health issues, chronic illness conditions and how to PREVENT complications become even more important today.

Nurses Advance Wellness
As nurses we have long been charged with the responsibility of patient education. Now more than ever before we need to advocate for our patients, ourselves and the health status of our country. The American Nurses Association too recognizes the important role nurses serve in advancing wellness and at the beginning of 2017 kicked off its “Healthy Nurse, Healthy Nation” campaign. The vision is to create a healthier nation by maintaining the well being of America’s 3.6 million nurses.

Dream Becomes Grass Roots Effort
In 2005, a nurse educator and patient advocate from Oregon named Teri Mills MS, RN, CNE had a dream and wrote an Op-ed in the New York Times calling for unification of the nursing profession in America with a National Nurse. In early 2015, the National Nurse Act (HR 379) was introduced in the House of Representatives by Reps. Eddie Bernice Johnson (a nurse) (D-TX) and Peter King (R-NY). The Senate companion bill (S 1205) was co-led by Senators Jeff Merkley (D-OR) and Shelley Moore Capito (R-WV). The beauty of this non-controversial legislation is that it required NO additional funding for implementation.

The National Nurse Act of 2015 received strong bi-partisan co-sponsor support from 97 Representatives and 5 Senators in addition to 119 nursing organizations including the American Nurses Association, the National Federation of Nurses, and the Federation of Healthcare Professionals. Five state legislative bodies (MA, OR, NJ, NY and VT) overwhelmingly passed resolutions urging Congress to enact this bill.

National Nurse Act of 2017 Introduced
Twelve years later the legislation that grew from that grass roots effort known as H.R. 1651 The National Nurse Act of 2017 was reintroduced to the 2017 Congress. This legislation designates the Chief Nurse Officer of the U.S. Public Health Service as the National Nurse for Public Health to raise visibility and increase public and nursing support for health promotion and disease prevention.

The CNO/National Nurse for Public Health would:
  1. Function alongside of the Surgeon General and focus on priorities of promoting health, improving health literacy, and decreasing health disparities
  2. Serve as a visible national spokesperson for engaging nurses in Leadership, Policy and Prevention efforts
  3. Encourage health professionals work and/or volunteer with community programs to improve health
  4. Provide guidance and leadership for activities that will increase public safety and emergency preparedness

The National Nurse Act of 2015 came very close to passing. It is hoped 2017 will be year it passes so that the office of the Chief Nursing Officer/National Nurse for Public Health will be better able to guide the nursing profession in promoting, protecting and advancing the nation’s health.

YOU Can Help
A small action on your part can go a long way in helping to bring the National Nurse Act to fruition. Please take a moment to contact your elected officials and request that they sign on NOW to support and co sponsor HR 1651. To create the change we want and need, it is imperative that nurses stand together to advocate for health promotion and prevention via a National Nurse for Public Health.

Disclaimer: Kathy Quan serves on the Advocacy Team of the National Nursing Network Organization

Friday, March 17, 2017

How a Patient Ends Up on Isolation Precautions: In Five Simple Steps

A guest post

You enter your unit and receive morning report. Mr. Z, a 68-year-old gentleman with diagnosis cellulitis of the left leg was previously on standard precautions at the time you clocked out yesterday evening. You notice that he now has an isolation cart parked outside of his room with a large sign indicating contact precautions are needed. Yesterday you spent hours in his room wearing only gloves, yet now you are being asked to don a protective gown over your clothing. What changed in twelve hours that warranted this?

Image credit: Koldunov

After reviewing Mr. Z’s chart you recognize the familiar acronym: MRSA, or Methicillin Resistant Staphylococcus Aureus.

What does this mean? What exactly is MRSA and why does Mr. Z have this diagnosis when yesterday he did not?
Quite simply, all humans harbor bacteria. Bacteria lives on our skin, in our gut, and even in our blood and mucus membranes! Most of these bacteria are harmless, part of normal human flora. Sometimes, however, an unwanted or dangerous bacteria enters our system which leads us to develop an infection. Most bacteria are susceptible to broad range antibiotics, such as levofloxacin, ciprofloxacin or sulfamethoxazole. These are common antibiotics your doctor may prescribe if you come to the hospital with a urinary tract infection, skin infection, or sore threat.

Over time, some strains of bacteria have become resistant to certain common antibiotics. You may have heard of some of these common healthcare associated infections: MRSA, C-Diff (Clostridium Difficile) and VRE (Vancomycin Resistant Enterococcus) are some of the most common.

So back to Mr. Z…
How did he end up with MRSA overnight? Here is a breakdown:
  1. When Mr. Z came into the hospital he had a diagnosis of cellulitis, or an infection of the skin. Cultures were obtained in the emergency room and sent to the laboratory for processing.
  2. From there, the laboratory grew these cultures in a petri dish in the incubator for a day. They then were able to look under the microscope and identify that the bacteria infecting his skin was staphylococcus aureus.
  3. From there, with this information, they spent the following two days testing the bacteria’s response to the most commonly use antibiotic (methicillin) as well as other antibiotics. This is known as testing for sensitivities (hence the test name you may have heard used: culture and sensitivity).
  4. Once the initial sensitivity testing was complete, it was easy for the lab to identify Mr. Z’s infection as MRSA.
  5. The lab then notified the nurse caring for Mr. Z at the time of the completion of testing, and the nurse ensured that all contact precautions were put in place at that moment.
So, what happens from here?
First of all, don’t fret. The average nurse is unlikely to contract an antibiotic resistant infection from a patient if standard precautions were appropriately used. Since Mr. Z has MRSA, he will need to be treated with another antibiotic that the bacteria showed sensitivity to. He may also need a longer course than normal, depending on his response to therapy. This will be decided upon by the attending physician or infectious disease specialist. Your job, as the patient’s nurse, is to make sure the patient receives all prescribed treatment and monitor for further complications from here onward.

You also will now play an essential role for this patient with an antibiotic resistant infection. As the main healthcare professional in contact with this patient as they are receiving treatment, it is imperative to follow strict contact precautions (disposable gown and gloves are the standard requirement for MRSA infected patients at this time) not only to prevent yourself from contracting the infection, but even more importantly to protect other patients you come into contact with from becoming infected. When proper precautions are taken, you can stop the spread of these potentially deadly bacteria.

This post comes from Marina Matsiukhova at We specialize in creating NCLEX-RN practice tests, our other resource is, which helps CNAs prepare for their certification.

Wednesday, March 15, 2017

The Effects of Working on Your Feet All Day

A guest post from Bobbie Brown

Even though numerous studies show extensive periods of standing and walking have significant adverse effects on the body, it is not uncommon for nurses to find themselves working 10 to 12 hour days.

Your muscles, joints, tendons, feet, and spine all react differently to long hours on your feet and physical ailments can easily manifest such as neck pain, hip pain, and cramping of muscles; while foot conditions such as corns, calluses, bunions, ingrown toe nails, plantar fasciitis, and foot neuroma (a swollen or thickened nerve in the ball of your foot), can become exasperated causing intense prolonged pain.

What's Really Happening?

So, what is really happening when we work on our feet all day? The weight of our body is being supported by our bones, muscles, and joints. Each step we take the body is distributing the weight between the hips, knees, ankles and feet. The joints and lubrication in these areas provide cushioning but over time pressure and tearing occur resulting in knee and leg pain.

The spine is designed to maintain an efficient, natural gait cycle when tasked with supporting the body’s weight throughout the day. But not unlike a tree’s branches twisting and turning in response to the harshness of its environment, the spine can take on an unnatural structure resulting in poor posture and causing pain and stiffness in the neck and aching muscles in the lower back area with overuse.

Additionally, the circulatory system can manifest ailments such as varicose veins due to prolonged periods on your feet. Varicose veins occur when your legs take on added weight and pressure causing veins to become dilated and overfilled with blood. They take on a bluish-purple color and can be extremely painful and unsightly in the lower leg region.
We’ve all heard the saying, “health is wealth”, which makes it all that more interesting how tempting it is to ignore our bodies signals of overuse. All too often physical pain is regarded as part of the job and for several of us part of everyday life. Our ability to infuse our work with our love and dedication is admirable but we shouldn’t do this at the cost of our own health. There are ways to better care for ourselves so we are in tip top shape to care for others.

Tips for Working on Your Feet All Day

1. Take Sitting Breaks
First, avoid standing for long periods of time by taking breaks sitting down. Sitting breaks will allow the body a chance to rest, the joints and lubricants can experience less tearing and pressure when the weight is removed at regular intervals. If this seems impossible due to the demanding nature of your job, set daily goals for yourself and fit the sitting breaks in wherever possible. Aim for about 10 to 15 minutes of rest for every 4 to 5 hours or work.

2. Add Stretching to Your Routine
Second, incorporate stretching into your day. Yoga poses are great for stretching the muscles and are easy to do in most places. The downward dog pose is best for stretching the legs, hamstrings, while decompressing the spine. The warrior pose, another great Yoga pose, is also great for strengthening the legs and hips. Yoga poses work so well because they keep muscles warm and loose, while increasing blood flow.

3. Choose Footwear Designed to Support Your Feet
Lastly, invest in supportive footwear designed for all day wear. There are many to choose from and great brands like Klogs Footwear specialize in the prevention of fatigue and foot pain by using contoured arch support and microfiber footbeds for added comfort. If you are managing foot ailments such as bunions or hammertoes, Drew Shoes feature wider width shoes as well as shoes with stretch material which accommodates for foot conditions like hammertoes or toes rubbing against the shoe. Vionic shoes are a great choice for those suffering from foot neuroma as well as plantar fasciitis. Or if you already have a favorite shoe and just need added support or have flat feet, add an insole. There are many great insoles on the market such as Spenco Insoles and Orthaheel Insoles.

It’s not always easy to put goals into practice but if you can implement a few of the above suggestions into your routine, the health benefits far outweigh any reason you may find to keep things status quo.

About the Author:
Bobbie Brown writes on a variety of topics relating to foot health and foot conditions with a focus on bringing awareness to the importance of proper foot care. She is the co-founder of - an orthopedic shoe store. Visit their blog for more information and additional articles.