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.


Thursday, March 9, 2017

BREAKING NEWS: ANA Opposes New Healthcare Bill

BREAKING NEWS: Nurses Oppose Healthcare Bill

The American Nurses Association has officially opposed the new healthcare bill, The American Health Care Act. In a letter written to the committee members and copied to prominent leaders in the House and Senate, President Pamela F Cipriano PhD, RN FAAN, outlined the reasons the ANA is opposing the new health care bill. Not the least of which it "threatens health care affordability, access, and delivery for individuals across the nation."

Nurses are the most trusted profession and as such we need UNITE to stand up and advocate for ourselves,  as well as our patients. Affordable healthcare that provides all Americans access to preventative as well as therapeutic measures is a must! Cipriano goes on to say:
"Nurses work in virtually every health care setting, providing expert, compassionate care for people throughout all stages of life. As the organization representing the nation’s largest group of health care professionals and its most trusted profession, ANA asks Congress to keep our patients’ access to affordable, quality care foremost in their discussions over how to improve our nation’s health care system. ANA stands ready to work with Congress as a constructive voice and positive force for improving health care delivery, coverage, and affordability for the American people."

We are NOT a Third World Country. We need affordable health care insurance. Please contact your elected officials TODAY to encourage their opposition. There is NO TIME to procrastinate on this essential issue. (photo: LA Times)


ALL you have to do is make a phone call.  Here's some information on calling your legislators and finding their direct phone numbers.  Most likely they won't even answer and you'll get a voice mail box.  It only takes about 2 minutes tops. And believe me I've stuttered and stammered through it, but the important issue is you make your voice heard!!!

Here's a sample script to make it easy for you: "Hello, my name is _______. I am a nurse [give your credentials] and I am calling to tell you I am opposed to the AHCA [American Health Care Act] as it is written. I am one of your constituents and I implore you to stand up and advocate for the people you work for. We MUST do better than this! Thank you." 

Send an email as well with the same information. Use Twitter to contact them. 

You can also get the addresses to the committee from the ANA letter and send a letter of your own. The louder our collective voices, the better the chance of getting a plan that can work.