Thank You Representative Zoe Lofgren (CA)

Pictured: Representative Zoe Lofgren (CA)

From Representative Lofgren's statement below, it is clear she understands the importance of having nurses teach health promotion and prevention to the public. Additionally, California is facing one of the worst nursing shortages in the United States, ranking 49th out of 50 in the number of RNs per capita according to the California Healthcare Association. The National Nurse Team therefore concurs with Representative Lofgren in seeing that HR 4903 is passed expeditiously so that we all may begin the work in tackling the nursing shortage and decreasing the epidemic of preventable diseases.

"I am proud to co-sponsor HR 4903 and hope this legislation is passed quickly in the House.  Given the severe shortage of nurses we now face in California, it is critically important that we determine how to attract more people in the nursing profession.  The creation of a National Nurse would encourage people to explore nursing, and help disseminate important information about being healthy and preventing disease," said Rep. Zoe Lofgren (D-CA).

Thank You Representative Carolyn McCarthy (NY)

Pictured: Representative Carolyn McCarthy

Representative McCarthy, one of the three nurses in Congress, represents Long Island, New York, and is described to be a "citizen's legislator", working for the people. She serves on the 91 member House Nursing Caucus.

Here is Representative Carolyn McCarthy's statement on HR 4903:

"The creation of an Office of the National Nurse is needed and long overdue. The nursing profession is vital to our nation's public health, but all too often the needs of nurses are overlooked. A National Nurse would provide nurses with a powerful a voice within the federal government and will work to encourage talented people to join the profession either as providers of care or as educators."

Internet searches : Librarians do it better

According to a study reported today at the Medical Library Association's annual meeting in Phoenix, cancer patients are more likely to find what they are looking for with a librarian-mediated search instead of "going it alone."

This study by Ruti Volk, professional librarian and manager of the Patient Education Resource Center (PERC) at the University of Michigan, demonstrates that "even though the information is supposedly so accessible and everything is on the web, people still need the help of a professional to find information that is relevant to them and that is current, accurate and authoritative. "

I Need a Job

I've been trying to get a job as a student nurse tech. Unfortunately it's very competitive... because the hospital is located right next to the school. EVERYONE applied.

I interviewed for the ER spot and didn't make it. I have another interview for the PCU, and here's hoping I make that one. Unfortunately the interview isn't until June 5th. Crap, I REALLY want this job. But I feel like half the summer is going to be gone before I get hired anywhere. I'd look other places, but I don't want to commit somewhere only to be called back in.

This is really lame. My scholarship ran out last semester, so I need some serious money before fall.

I'm getting very impatient.

Thank You Representative Sherrod Brown (OH)

(Pictured: Representative Sherrod Brown)

This statement comes from Representative Sherrod Brown (OH) who is the ranking member of the House Subcommittee on Health and who also serves on the House Nursing Caucus.

"Our health care system depends on the 2.7 million nurses who have dedicated themselves to providing quality health care. I am proud to be a co-sponsor of the National Nurses Act of 2006 (HR 4903), which would establish the Office of the National Nurse. The Office will provide mechanisms for nurses to work directly with policymakers to improve the nation's health, and will serve as a clearinghouse for nurses across the nation to share information about the best ways to provide patient care and education. The Office will also bring much-needed attention to addressing the critical shortage of nurses in Ohio and across the nation. Establishing the Office of the National Nurse will benefit the public health in significant ways, and I will work to secure passage of HR 4903."

Washington D.C. Continued

Pictured: Terri Polick, Teri Mills, Ryan S. Berger-Senior Legislative Assistant/Systems Administrator to Representative Steven C. LaTourette (OH), Alisa Schneider, Laura Stokowski, Elizabeth Bienkowski

The trip to Washington D.C. ended with a visit to Representative LaTourette's office and a meeting with Ryan Berger. We appreciate Ryan's candor, wisdom, and advice and look forward to more interactions with him.

These are the impressions of Debbie Orre, Dean of Health Science Programs at Mt. Wachusett Community College in Gardner, Massachusetts who accompanied the National Nurse Team to Washington D.C. :

A conference on the National Nurse initiative was held at Mount Wachusett Community College, where I work, at the end of March. Teri Mills and Alisa Schneider were the keynote speakers. I've never considered myself someone comfortable in the political arena but in pulling together the conference, along with contacting local, state and nationally elected officials to urge their attendance, I became a little less wary.

Once I had met Teri and Alisa, they enthusiastically invited me to participate in a two day lobbying effort in Washington, DC this May, along with other nurses and with Marcia Moody, a speaker from the same conference and a State Representative from New Hampshire. So I agreed to go without hesitation, packed my bags and went. I couldn't have been more fascinated by the House and Senate legislative aides that we met or with the general ambiance of the House and Senate buildings we entered. We ended each day in the office of Representative Lois Capps. Representative Capps, also a nurse, is from California and is the original sponsor of the National Nurse Act of 2006, HR 4903. The entire team found her and her staff to be welcoming, gracious and receptive.

The days were long and my feet were tired but I wouldn't have traded the chance to represent this bill with this team of fabulous and intelligent nurses from around the country for anything. I am also grateful to have been a small part of the process that moves this nation and creates its laws.

Thank you, Teri and Alisa, for leading me on this wonderful new adventure. You can count me in for many more!

AHA/ACC updates Guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update

The American Heart Association and the American College of Cardiology on Monday issued updated guidelines designed to ensure optimal treatment of patients with a variety of cardiovascular conditions, including heart disease, acute coronary syndromes, heart attack, and peripheral arterial disease, USA Today reports. The revised recommendations, which are endorsed by the National Heart, Lung, and Blood Institute, were created in light of results from the clinical trials that have been completed since the last recommendations were issued five years ago. For instance, the guidelines suggest that the daily aspirin dose for patients with heart disease or other blood vessel disorders be lowered to between 75 mg and 162 mg per day after a series of clinical trials showed that lower aspirin doses were “just as effective” as higher doses at preventing future heart attacks; however, the guidelines continue to advise that bypass patients receive between 100 mg and 300 mg of aspirin per day for up to one year. In addition, the guidelines for the first time suggest that all patients with chronic heart disease receive a flu vaccination. The guidelines also call for increased use of statins to reduce LDL levels, which now are recommended to be kept under 100 mg per deciliter in all heart disease patients. Other measures included in the revised guidelines “simply highlight tried-and-true means of reining in risk,” such as encouraging heart disease patients to get 30 to 60 minutes of moderate exercise at least five to seven days per week. The guidelines also recommend that a patient’s body mass index remain between 18.5 and 24.8, with waist circumference measuring no more than 40 inches in men and 35 inches in women. For diabetes management, the guidelines suggest that patients receive blood sugar level tests three to four times per year and recommend that the level stay below 7%. According to the report authors, the “aggressive, comprehensive risk-factor management” outlined in the guidelines has been shown in multiple studies to increase survival and prevent complications among heart patients. HealthDay notes that both groups plan to launch a campaign to inform cardiologists and other physicians of the new guidelines (Sternberg, USA Today, 5/15; HealthDay/Yahoo! News, 5/15).

Thank You Representative Tom Allen

Pictured: Representative Tom Allen (ME)
The National Nurse Team is thrilled to see U.S. Representative Tom Allen's name added to the list of co-sponsors in support of HR 4903, the National Nurse Act of 2006. Representative Allen, from Maine, sits on the House of Represenatatives Health Sub-Committee and is also a member of the House Nursing Caucus. The following is Representative Allen's statement:

"Nurses are the front line in providing care to the sick and injured and comfort to the chronically ill and the aging," U.S. Representative Tom Allen said. "Nurses also play a critically important role in educating the public about disease prevention and about leading healthy lives. Like many other states, Maine faces a looming shortage of these caring professionals. I am pleased to cosponsor the National Nurse Act which would establish the Office of the National Nurse to advocate for the nursing profession, to advance nursing issues and to collaborate with the Surgeon General and other federal health officials."

AACN releases annual survey results

The American Association of Colleges of Nursing (AACN) relesed data from their annual survey which shows that enrollment in entry-level baccalaureate nursing programs increased by 13% from 2004 to 2005. Though this increase is welcome, their survey showed that 32,617 qualified applications were denied due to a shortage of nurse educators.

More Impressions of Washington D.C.

(Pictured: Elizabeth Bienkowski, RN, MSN; Alisa Schneider, RN, MSN, CNE; Aarti Shah, Senior Legislative Assistant, Congressman Joe Barton (TX); Teri Mills, RN, MS, ANP; and Laura Stokowski, RN, MS)

Meeting with the health policy aides of House Members and Senators in Washington was a novel and memorable experience. Time is a valuable commodity on Capitol Hill. Our goal: to communicate the fundamentals of HR 4903, the bill to create an Office of the National Nurse. We hoped that our ideas about the Office of the National Nurse, and how it will improve the health of all Americans, were heard by these busy men and women.

As a relative newcomer to the National Nurse effort, this was my first opportunity to see the National Nurse Team in action. I was impressed not only by their erudition, but by their sincerity and the enthusiasm they have maintained a full year after beginning their campaign. I left even more committed to doing whatever I can to realize an Office of the National Nurse for America.

Submitted by Laura Stokowski, RN, MS

National Nurse Team Meets With Leaders In Our Nation's Public Health Services

(Pictured: Left to Right: RADM Robert Williams, Laura Stokowski, RN, MS, RADM Carol Romano, Teri Mills, RN, MS, ANP and Alisa Schneider, RN, MSN, CNE)

Members of the National Nurse Team were honored to meet with RADM Carol A. Romano, RN, PhD, FAAN, Assistant Surgeon General, Chief Nursing Officer, U.S. Public Health Service and Surgeon General Richard Carmona's Chief of Staff RADM Robert Williams in addition to Captain Kerry Nesseler, RN, MS, Associate Administrator for Health Professions, Health Resources, and Services Administration; Captain Laura Chisholm, Deputy to RADM Carol Romano; and Captain David Kelly, PhD, MS, RN, CPHA, CERC, Chair-Elect (07) Nursing Professional Advisory Committee, USPHS to discuss the proposal for an Office of the National Nurse.

Thanks to the outstanding leadership and facilitation skills of RADM Romano, several ideas were heard and shared.

The National Nurse Team would also like to recognize Wanda Chestnut for her assistance in setting up this meeting.

Capitol Hill Or Bust

(Pictured: Teri Mills, Debbie Orre, Elizabeth Bienkowski, Terri Polick, Rep. Capps LA-Amy Fisher, Paxson Barker, Alisa Schneider, State Rep. Marcia Moody (NH) )
I feel very privileged to have had the opportunity to join Super Nurses Teri, Terri and Alisa in their passionate quest to add well deserved prestige, recognition and widespread effectiveness to the nursing profession. I trust that the mobilization of the presently under-tapped resource of the very competent, dedicated and knowledgeable health facilitators, a.k.a. nurses, from every state in this country are in very capable hands. As I listened to the dialogue between the bright and insightful health liaisons, the spokespersons of the various Representatives and Senators whose Capitol Hill offices we visited, and our National Nurse leaders, I was struck by a growing sense of mutual admiration and excitement. Their response was overwhelmingly positive with their primary concerns being the cost of implementing the National Nurse Act and whether its existence and purpose would constitute a duplication of already existing programs. I am very thankful to have played a tiny part in this growing movement to illuminate the importance of the nurses who serve their fellow Americans every day and whose influence toward health promotion will grow exponentially after this bill is passed.

Elizabeth Bienkowski, RN MSN

Paxson Barker RN, BSN Reports From Capitol Hill

(Pictured: National Nurse Team and Supporters With Representative Lois Capps (CA-23))
Our trip to D.C. to lobby for the National Act of 2006 was fabulous. The team of nurses working on this were collaborative and professional as well as warm and collegial.

The staff on Capitol Hill were interested and attentive to the issues and solutions HR 4903 addresses.

I am more proud of nursing after this experience than I have ever been in my 34 years as a nurse. I hope that all nurses will review the proposed legislation and support this nurse driven agenda towards health promotion in the United States.

Paxon Barker is pictured third to the left and lives in Texas.

Mapping the literature of nursing: 1996-2000

Take a look at "Mapping the literature of nursing: 1996-2000" by Margaret Allen, Susan Kaplan Jacobs and June R. Levy in J Med Libr Assoc 94(2)206-220 April 2006. This research article represents a "snapshot in time" of the citation patterns of general nursing and specialty generals. It also underscores the interdiciplinary nature of nursing as a profession.

Sense About Science is a UK organization interested in promoting an evidence-based approach to scientific issues. They have a great review document which explains about the process of peer review in research and is especially useful for the non-researcher in evaluating research claims that are touted in the press. Check it out!!

Magnet Crossword Answers

As part of the activities of National Nurses' Week, nurses at SJH have had an opportunity to complete a magnet-themed crossword puzzle. Entries are eligible until 3:00 pm and can be turned in at the staffing office. It has come to our attention, that the answers to a few of the questions are hard to locate. While the winners will be randomly selected and no one will be disqualified for an incomplete or incorrect answer, we thought you might be curious about the correct answers to the crossword puzzle. Click here

Speaking From the Front Lines - Why We Need An Office of the National Nurse

(Pictured: Kim McAllister)
Kim McAllister, RN, ADN, a nurse from the San Francisco Bay Area sent us this post in honor of National Nurses Week. Kim blogs at emergiblog.com and welcomes all newcomers.

Every day, all over this country, in hospitals, clinics and community settings nurses work every day as caregiver/advocates for patients. Some of us are at the hospital bedside, some of us advocate as nursing professors or toil behind the scenes as doing nursing research. Some of us work with patients in their homes and in clinics/community settings where we act as vital links to a health care system that isn't easily accessible to those without means.

We have various educational backgrounds, from associate degrees through nursing doctorates. Some of us received our nursing education in our local community and some of us were educated in a different country, coming to America for the opportunity it offers.

No matter where we work or how we function or what degree we possess, we are united in one goal: contributing to the health of the citizens of the United States of America.

Nurses are not only vital to the health of this country, they are indispensible.

And there are not enough of us.

We need a visible, recognizable, vocal advocate for the nursing profession, because when you advocate for nursing you are advocating for the health of the citizens of this country.

We need the Office of the National Nurse.

We need someone at the national level who will help promote, through public education and media exposure, the necessity for nurses in general and particularly nursing educators who will guide future nurses into their roles.

Yes, we have national nursing organizations and state nursing associations that are as varied as the nurses they represent. Some are quite active, even radical in their political activities. But they are just a blip on the media screen . Some make their mark through strikes, loud protests and picketing elected officials. They work to help nurses get better pay and benefits, but often the public only sees the behavior and not the motivation (better nursing care, better working conditions so nurses stay in the profession) behind it. I certainly have benefitted from their willingness to speak out. But.....

We need a national spokesperson, someone the public sees as "the voice of the nursing profession". Someone who is not associated with an organization or union, but someone who UNITES the voices of the various nursing organizations into one message:

We need nurses, we need them now and here is why you should consider nursing as your professional choice.

But the best part, and this is when I came on board, will be the formation of National Nurse Teams. Groups of volunteer nurses who will do community outreach and education in schools, senior centers and surprisingly, libraries. Groups of nurses representing diversity in their educational levels and in racial/ethnic minority groups (that IS the definition of the nursing profession, after all).

What a wonderful way to serve your country in a civilian capacity.

Oh, I've heard the objections.

"Oh but we already have a Surgeon General! Why do we need a National Nurse?"

As they do in everyday life, nurses and doctors will work together; the National Nurse will work in consultation with the Surgeon General in setting priorities for the nation's health care.

One of those priorities will be increasing the number of nursing faculty to increase the number of nurses that are desperately needed.

Only the National Nurse will be a visible, recognizable representative. Are you able to name the Surgeon General? I had to go look him up on Google.

"Oh, it's just an excuse for a national nurses union."

No. It's not. The National Nurse Teams are voluntary.

"We don't need any more expenditures in government!"

Ever heard of "Porkbusters"? Look them up and see just what your state wants money for. It isn't health care, trust me.

If you haven't read the bill, HR 4903, click on the link on the sidebar and check it out. Never read a bill before? Don't worry, you won't have to run and rewatch Schoolhouse Rock's "I'm a Bill" to understand it. No one is less politically savvy than I am and I was impressed. It's basic, it's elegant in its simplicity. And it is needed.

As soon as my article is finished, I'll be calling my local Representative, Ms. Barbara Lee and asking her for her support. Look up your representative. Do the same.

What if someday you called for a nurse and nobody came?

We need the Office of the National Nurse.

Meet Dana Rutledge

Our world-renown (and very modest) Dana Rutledge RN, PhD, is our Nursing Research Facilitator at St. Joseph Hospital in Orange, California. She is with us one day a week and leads our Nursing Research Council, along with Beth Winokur. How she manages to publish and research as much as she does, while at the same time remaining so friendly and approachable is a mystery to me. She very kindly provided me with a copy of her CV. It is so impressive that I hope it doesn't cause the blogosphere to crash!!

St. Joseph Hospital Evidence Based Nursing Practice (cont'd)

Sedation Management and weaning to facilitate extubation in the ICU

Investigator: Victoria Randazzo, RN, BSN, CCRN

Purpose: This multidisiplinary team is looking at the comprehensive way in which sedation (Benzodiazepines, Propofol) is managed in the intubated ICU patient. The intent is to promote a recognition of the ability to wean by using a daily "sedation vacation". The process utilizes a team approach between the staff nurse, the respiratory therapist and the Intensivist. This evidence based practice focuses on reducing ventilator associated pneumonia, shorter patient stays, reduced costs and better patient outcomes.
In addition to tracking patient outcomes, the process involves staff education which is facilitated by the team's ten member nursing staff and the clinical educator. Dr. Duke, one of the physician Intensivists, is offering the ICU staff a class titled "Sedation/Agitation in the Mechanically Ventilated Patient".

Celebrate National Nurses Week-May 6-12

Today is the first day of National Nurses Week. Nurses are 2.9 million strong in the United States and comprise the largest sector in the healthcare workforce. Without question, nurses make a huge difference in our patient's lives every single day. A career in nursing is as varied as the kinds of ice cream found in the local grocery store. Major advancements to the profession have occurred over the past several decades, including practice based on evidence and an educational background required to deal with the technology of the 21st century.

As difficult and challenging as a day in the life as a nurse might be, most nurses would not trade their careers for the world.

Congratulations to America's Nurses!!

The Thrill of the Hunt

Be sure to check out the article in the latest issue of Advance for Nurses that spotlights Dana Rutledge, our own nurse researcher at St. Joseph Hospital. It can also be accessed online Enter "Dana Rutledge" in the search box.

Meet the blog team

The blog team, from left to right are: Judy Rousch, Theresa Ullrich, Julie Smith, Ann Marie Keefer-Lynch, Dana Rutledge and Elaine Go. Not pictured is Linda Privette.

Please submit ideas for posting relating to nursing research/evidence based nursing to Julie at jsmith@sjo.stjoe.org

Readers Respond To Call for Help To Support Our Troops

On February 25th, the National Nurse website posted a request from a supporter who wondered if there was a way to help our troops.

She said, "Soldiers in Iraq must be having a very scary week, with the situation there deteriorating so rapidly. And the medical units must be running on exhaustion." The supporter went on to say, there are some specific items that a medical unit serving injured soldiers could use. It might take a little of the strain out of this time to do something which is kind and useful, at least to add a little balance to the Universe.

A reader and National Nurse supporter, Denise Carrie, a nurse at Beth Israel Deaconess Hospital, who is the wife of the General Manager of the Cocasset Manufacturing Plant, Dan Carrie, saw the plea and set out a course of action.

The employees at Invensys Foxboro periodically have internal fundraisers with raffles and bake sales to raise money for different charities as well as have some fun and boost morale. In the past they have raised money for ALS, American Heart Association, the Katrina Fund, American Cancer Society, as well as being a sponsor for the 3-Day Walk for Breast Cancer and the PMC Jimmy Fund. And in November of 2003 they collected items for Operation Shoebox for soldiers in Iraq.

Most recently they received a request from an employee’s spouse with a note from Capt. Maureen McCann that requested an urgent need for clothing for soldiers being treated in medical facilities in Iraq. They set up a triwall for employees to bring in items and the General Manager agreed to ship the items from their facility. In one week they had a large collection of sweat pants, t-shirts, and travel pillows. They even had a case of t-shirts donated by Invensys Foxboro as well as a case of t-shirts donated by the American Red Cross.

THANK YOU to all who participated in this wonderful collection! Your good deed is not going unnoticed.

CDC issues guideline on "pre-conception care"

As part of an effort to reduce infant mortality and improve the health of newborns, the CDC’s National Center on Birth Defects and Developmental Disabilities yesterday issued new “pre-conception care” guidelines that encourage women to “take stock of their health” before attempting to become pregnant, HealthDay reports. The guidelines, which were published this month in the Morbidity and Mortality Weekly Report, were developed based on the results of a two-year “exhaustive data review” by the CDC and more than 35 government, public, and private groups. The guidelines recommend that women contemplating pregnancy schedule a pre-conception physician visit—an appointment that the CDC is urging health insurers to offer coverage for. In addition, the recommendations advise women to control chronic conditions such as high blood pressure, reach or maintain a healthy weight, avoid alcohol, quit smoking, and create “reproductive life plan[s]” with their partners that outline when and how many children couples wish to have. The associate director for program development says although steps to ensure pre-conception health have been recognized as important “for many years, they have really not been a part of the health care system.” Physicians already have embraced the new guidelines, which they say create an “organized approach for [physicians] giving advice to women.” HealthDay notes that the new recommendations will be widely distributed, with many of the sponsoring groups providing links to the recommendations on their official websites

Tips for Nursing School

A lot of people have posted comments or emailed me about their studies.

You guys ask "I am applying to clinicals next semester, what should I do?"
or "I'm about to take class X, is it hard?"
or "How did you know this was what you wanted to do?"
etc...

Well, I've been thinking about what I've learned over the last year and I think it's time I gave you some insider information. Here's a few things I've learned that may or may not help you out in school.

1) If you are thinking about going to nursing school but aren't there yet, volunteer at the hospital. I'm serious, it's not just for old ladies and community organizations. I was privileged enough to volunteer for a couple semesters at Hermann Memorial Hospital in downtown Houston. The place was massive and they had everything imaginable over ten floors in several buildings. I got to wander around all over the place and meet doctors and nurses and therapists of every kind. I got to see what the job was really like. It focused my goals.

Another solution would be to get a part time or summer job working in a hospital, though these are sometimes harder to come by. I have several friends who work as unit clerks or pharmacy techs... good jobs but not nursing jobs. I'm applying for a student nurse tech position for the summer... but I wasn't even eligible for it until I completed 2 semesters of clinicals. For students, hospital jobs can serve to ease your transition into the working world (if you can handle the extra stress). But they might not be the best way to feel out nursing as a potential major.

In any case, you can't really know if you want to do it without spending time in the hospital.

2) Go ahead and buy an NCLEX review book at the beginning of clinicals. Look on Amazon and try to find the one with the highest rating, especially one that has questions sorted out by topic with rationales for the answers. (Also, some instructors pull questions from review books... but that's not why I'm mentioning it.)

The thing about the NCLEX is that it asks you questions based on your ability and adapts to your level. The passing questions are based on synthesis and critical thinking, not recognition and recall. Sure, if you keep answering questions incorrectly the computer will eventually start asking you where the liver is. But you have to answer a minimum number of difficult questions to pass. You can answer every single anatomy question correctly from here to infinity and never meet the minimum requirements.

If you are attending a good nursing school, your instructors will try to format their test questions similarly to the passing NCLEX questions. They won't ask "What is this disease" as much as they will ask "What is the priority thing you need to watch when a person has this disease?" They won't ask "What does this medicine treat?" so much as they will ask "What lab value do you need to monitor when these two medicines are combined?" This principle should hold true for any course, so when you study you should try to think on a higher level than simple fact regurgitation. A review book might help you anticipate the kinds of questions your teacher will ask. Even if you never see the exact questions on your tests... you'll be more prepared for boards upon graduation.

3) Don't study for the grades. I know it sounds ridiculous, but your goal in studying shouldn't be to make A's. Studying isn't a product-oriented activity. It is process-oriented.

What good is school if you only cram enough facts in your head to pass a test? What good is your education if you stay up all night before each exam trying to store just enough info in short term memory to bump your grade up a letter? That kind of behavior was okay for English and Psychology... those things aren't your major. But nursing is something you'll have to do every day for work, and your mistakes won't take the form of typos. They'll take the form of injuries and deaths.

I know it isn't easy to do; we're all busy people. But if you make it your habit to reread the week's notes every day... if you make it your habit to learn and retain a little information each time... you'll gain more than class credit. You'll gain competency. Powerpoint is destroying our ability to take notes and listen actively. Printing out the slide handouts isn't enough.

Okay, so some of school is silly and useless. Something you have to get through before you go out into the real world and learn how things are done. Still, constant efforts really will carry you farther in life than intelligence alone. It becomes a matter of discipline and will.

4) Take time to play. But don't do it all the time. Some days you're just going to have to work hard from sun up to sundown. Just remember to relax on weekends. Take time to exercise. That freshman fifteen wasn't your birth control. It was your metabolism slowing down. Even if you only go for a walk on the weekend, it's better than nothing. Don't drink too much. Try to get off the caffeine and cigarettes. You're going to be a nurse; set a good example. The immediate gratification will cost more in the long run.

~~~
That's enough for now. More tips as I learn them.

One more thing: do you have a nursing/health blog or website? I know a lot of you read me but I haven't gotten around to reading linking you. Just post a comment with your URL, I'll check out your site and add you if I like what you have to say.

Julie's picks -- current nursing research articles April 2006

Rolfe G. Validity, trustworthiness and rigour: quality and the idea of qualitative research. Journal of Advanced Nursing. 2006 Feb; 53(3): 304-10.

Keeney S. Hasson F. McKenna H. Consulting the oracle: ten lessons from using the Delphi technique in nursing research. Journal of Advanced Nursing. 2006 Jan; 53(2): 205-12

Weaver K. Olson JK. Understanding paradigms used for nursing research. Journal of Advanced Nursing. 2006 Feb; 53(4): 459-69.

Upton D. Upton P. Development of an evidence-based practice questionnaire for nurses. Journal of Advanced Nursing. 2006 Feb; 53(4): 454-8

Marklew A. Body positioning and its effect on oxygenation -- a literature review. Nursing in Critical Care. 2006 Jan-Feb; 11(1): 16-22

Lindberg DA. Integrative review of research related to meditation, spirituality, and the elderly. Geriatric Nursing. 2005 Nov-Dec; 26(6): 372-7

Pearson A. 30th Anniversary commentary on MacGuire J.M. (1990) Putting nursing research findings into practice: research utilization as an aspect of the management of a change. Journal of Advanced Nursing 15, 614-620. Journal of Advanced Nursing. 2006 Jan; 53(1): 73-4. (6 ref)

Houldin A. Curtiss CP. Haylock PJ. Executive summary: the state of the science on nursing approaches to managing late and long-term sequelae of cancer and cancer treatment. American Journal of Nursing. 2006 Mar; 106(3): 54-9.

Marchiondo K. Teaching tools. Planning and implementing an evidence-based project. Nurse Educator. 2006 Jan-Feb; 31(1): 4-6

Pepler CJ. Edgar L. Frisch S. Rennick J. Swidzinski M. White C. Brown T. Gross J. Strategies to increase research-based practice: interplay with unit culture. Clinical Nurse Specialist. 2006 Jan-Feb; 20(1): 23-33.

Duffy ME. Using research to advance nursing practice. Resources for determining or evaluating sample size in quantitative research reports. Clinical Nurse Specialist. 2006 Jan-Feb; 20(1): 9-12.

Craig SE. Does nurse-led pre-operative assessment reduce the cancellation rate of elective surgical in-patient procedures?: a systematic review of the research literature. British Journal of Anaesthetic & Recovery Nursing. 2005; 6(3): 41-7