Thank You Representative Edolphus Towns (NY)

Congressman Edolphus Towns (NY)
Congressman Edolphus Towns lends his support for H.R. 4903, The National Nurse Act of 2006 and the following is his statement:

I am pleased to support H.R. 4903, the National Nurse Act of 2006. As you know, the Act amends the Public Health Service Act to establish the Office of the National Nurse within the Office of Public Health and Science to encourage men and women to enter the nursing profession; to encourage nurses to become educators in schools of nursing; and more generally the Act promotes public health through the encouragement of the professional practice of nursing.

I am aware that the supply and demand projections of registered nurses by the Health Resources and Services Administration show shortages in some geographic areas and in other than hospital environments. Other trends show that the demand for RNs in particular could exceed the supply by 2010 by as much as 25 percent. In addition, nursing is among the occupations expected to add the most new jobs over a 10-year period that began in 2000. Given the growing health challenges our nation faces in a wide range of diseases, it is imperative that the Federal government gives leadership to the growth and education of the nursing workforce and the National Nurse Act of 2006 begins this process.

Just one more thing, I am also concerned about the growth and education of minority nurses and I am concerned that as we continue this debate that this concern be included in whatever discussions we have in U.S. House of Representatives.

Contact Your US Representative

To continue building support for the National Nurse Act of 2006, you are encouraged to call or write your US Representaive to urge their cosponsorship of HR 4903. The team has made this easy for you. This is the link to finding your Representative, just insert your email or click on your state.

Here is a sample letter or phone call you can add your own words to.

HR 4903 will establish an Office of the National Nurse to involve all Americans in preventive health practices, complement health services already in place, establish volunteer national nurse teams to deliver educational programs on healthy living in their own communities, and give the nursing profession the national attention it needs to solve the current nursing shortage. Links to the bill are on this webpage.

Please feel free to contact teri@nationalnurse.info if you have any questions and thank you for your support!

Thank You Representative Ted Strickland (OH)

Pictured: Representative Ted Strickland (OH)
Representative Ted Strickland is one of the eight members of the House Health Subcommittee now cosponsoring the National Nurse Act of 2006. He is also a member of the House Nursing Caucus. Here is his statement on HR 4903:

I am proud to offer my support to the National Nurse Act of 2006. Establishing the Office of the National Nurse with H.R. 4309 is a strong step toward meeting some important goals, namely encouraging more individuals to enter this wonderful profession and promoting public health. The nursing shortage is critical, and the Office of the National Nurse will aid in recruiting new nurses as well as encouraging nurses to share their knowledge and experience by teaching in schools of nursing.

The importance of nursing cannot be overstated, and having the Office of the National Nurse will give nurses' priorities the national attention they deserve. I commend Rep. Capps for introducing this legislation.

Here Comes The Sun

The country is basking in 90 to 100 degree temperatures and many of us are headed to the river, lake, or beach. Remember to bring plenty of water or sports drinks with you and drink these even if you are not thirsty.

Do you find yourself at the store staring at the sunscreen display trying to decide which brand to buy? The ideal sunscreen should protect against both UVA and UVB rays. UVA rays cause premature aging and may also lead to skin cancer, while UVB rays result in skin damaging sunburn.

Experts say the best protection against UVA [rays] is a sunscreen that includes zinc oxide, titanium dioxide or avobenzone. Consumers should also look for those that are water-resistant and have an SPF of 30 or better, indicating strong protection against UVB rays. UVB protection is found in a sunscreen as the Sun Protection Factor (SPF). A sunscreen should be PABA-free” since these sunscreens can be irritating to the skin.

Sunscreens should be applied liberally and often. Apply enough sunscreen and then reapply it, especially after swimming and sweating. Apply at least an ounce per application 30 minutes before exposure and then reapply every two hours.

Even if you are wearing sunscreen, you should limit time in the sun between 10 am and 4 pm because the atmosphere absorbs less of the harmful UV rays of sunlight than earlier or later in the day. Sunscreen should also be worn when it is hazy.

Wear a wide-brimmed hat, protective clothing, and sunglasses. Finally, never leave children exposed to the sun without adequate protection.

New Evidence-Based Knowledge Portal

"The Evidence Based Knowledge Portal, developed by the Eskind Biomedical Library at Vanderbilt with grant funding (NLM grant number 5R01LM007849), includes tutorials addressing facets of statistical analysis and critiquing the medical literature as
well as virtual practice cases that allow users to explore principles of EBM (e.g. number needed to treat, selection bias) in the context of a clinical scenario. Cases include pre-and post- tests to allow users to gauge their knowledge and progress."

You will need to do a very quick registration in order to obtain a free password and you will also need to download Macromedia flash player if you don't already have it. This is a very user friendly tutorial resource that demystifies lots of research concepts such as the advantages and disadvantages of cohort studies and positive and negative predictive values. The virtual practice cases allow you to utilize and reinforce some of your new principles of research. In addition, this portal offers
a Evidence Summary Generator which allows you to create summaries of articles and evidence in a template format.

The Evidence Based Knowledge Portal at Vanderbilt University welcomes your comments/suggestions

Thank You Representative Sheila Jackson Lee (TX)

Pictured: Representative Sheila Jackson Lee (TX)

The 109th Session of the United States Congress marks the 6th term served by U.S. Representative Sheila Jackson Lee. She represents the Eighteenth Congressional District of Houston, Texas and serves in the House Committees on the Judiciary, Science, and Homeland Security - a Committee that was made permanent in January 2005 by Congress. In the Committee on the Judiciary, she sits as the Ranking Democrat of its Subcommittee on Immigration, Border Security, and Claims - the only female Ranking Democrat in the Committee. She also sits on the Subcommittee on Crime and Terrorism.

Congresswoman Sheila Jackson Lee believes the nation needs a National Nurse to lead the public to better health through preventive health measures. The primary job of the National Nurse is to educate the public about how to prevent these
diseases and lead healthier lives. The Office of the National Nurse and nurses in each community would be responsible for educating individuals, families, and communities about being healthy and preventing disease -something that is important to our communities.

  

Thank You Representative John Olver (MA)

Pictured: Representative John Olver (MA)

Representative John Olver is a member of the House Appropriations Committee and also serves on the House Nursing Caucus. This is his statement in support of an Office of the National Nurse.

"Nurses play a critical role in preventing illness. Prevention lowers the cost of health care, and one of my top priorities is increasing the accessibility of affordable health care. As the demand for the care that nurses provide continues to grow, our country faces a critical and growing shortage of nurses. An Office of the National Nurse would raise public awareness of health issues as well as the role of nurses in improving health care. The national nurse network could also be ready to help people in need all over the country affected by natural disasters. A national nurse would help improve the nation's health while heightening the visibility of the profession of nursing."

CHF Team at St. Joseph Hospital, Orange, California

Posted by Julie Smith for Judy Rousch
Pictured above are some of the CHF team

The CMS (which stands for Centers for Medicare and Medicaid Services) Demonstration Project, encourages evidence- based care to patients with these diagnoses:
· Community Acquired Pneumonia (CAP)
· Congestive Heart Failure (CHF)
· Acute Myocardial Infarction (AMI)
· Coronary Artery Bypass Grafts (CABG), and
· Total Joint Replacement (TJR).
Our hospital is required to collect data from patient charts, collated by an outside company, reviewed, and compared to hospitals nationwide. This data is publicly available The current data retrieval required for three of the above diagnosis is:
· One of the current goals of the TJR part of data collection is to ensure that the last dose of antibiotics is administered within 24 hours of the incision “close time”.
· For CAP, the goal is an antibiotic started within 4 hours of arrival, O2 sat or ABG within the first 24 hours of admission, Pneumococcal and Influenza vaccines as appropriate and smoking cessation counseling as appropriate.
· With CHF, the hospital must show that LVF is assessment is documented, detailed discharge instructions are given to the patient and charted. ACE/ARB medication is prescribed for an ejection fraction of <40%, and smoking cessation counseling is begun and charted.
As you can see, this requires a lot of time and effort to ensure these steps are taken both with patient care as well as the actual data retrieval. The team has developed tools for the patient care nurse to use to insure that her patient is receiving these evidence-based recommendations and that the hospital is compliant in providing these services to our patients. For further information or to access help for your patient, contact any member of the 4E/W team, Megan Whalen, the Heart Failure Clinic Nurse Practioner, at extension 8858, Trish Cruz, the Quality Management RN- ext. 8208, or access the Clinical Practice Guidelines for the CHF patient posted in third and fourth floor nursing units, or the CHF Resource Binder. Some of the questions that might come up are:
· What happens when they are confused and disoriented?
· Include family or caregivers
· What if the patient is a DNAR?
· Much of the teaching can be considered palliative care. For example fluid and sodium diet restrictions enable the patient to breathe easier.
· What if they are discharged to a SNF?
· Include the written DC instructions in the envelope to go to the SNF. Sometimes the SNF staff doesn’t know how to care for CHF patients.
· What if the doctor hasn’t ordered an ACEI or ARB for EF<40%
· Call the physician and ask for the medication or the contraindication
· What happens when my patient refuses?
· Document that the patient refuses
· What happens if the doctor doesn’t list the discharge medications and doses?
· Call the physician and ask. If you can’t determine what meds the patient is on, how is the patient supposed to be able to?

Thank You Representative Pete Stark (CA)

Pictured: Representative Pete Stark (CA)

Representative Pete Stark (CA) is a member of the House Nursing Caucus and released this statement about the National Nurse Act of 2006:

I am pleased to join my colleague Lois Capps in support of H.R. 4903. Her leadership is vital on this issue because, in addition to being a respected Member of Congress, she is a nurse. You could not have a better spokesperson for this legislation.

Creating an office of the national nurse is an important endeavor. Such a designation would increase the visibility of nursing as an esteemed career choice and would help us try to repopulate our schools of nursing with trained educators.

But H.R. 4903 is only one of the many steps needed to improve the nursing profession in our country. I have also been working to enact legislation to strictly limit the use of mandatory overtime for nurses. H.R. 3861, the Safe Nursing and Patient Care Act, would prohibit the use of mandatory nurse overtime unless a local, state or federal government declared a state of emergency.

We have more than 500,000 trained nurses in this country who are not practicing their profession. Many of them tell me that the main reason is that they can no longer feel they practice safe nursing. Being forced to work hours beyond what they believe is appropriate for them to provide quality care is dangerous for nurses and patients alike.

Again, I am pleased to support HR 4903 and I encourage you to work for its passage as well as the enactment of other needed legislation to improve the nursing environment in our nation.

National Nurse Presentations

Thank you to Ellie Burch who invited and coordinated a meeting about healthcare topics at the King City Senior Center. The meeting was well attended, and there were several interesting sessions in addition to the National Nurse Act of 2006. Attendees also wrote postcards to Senator Gordon Smith (OR) to ask him to please introduce the companion bill to HR 4903 in the U.S. Senate.


Nurses from Texas who attended Dr. Victoria Hawkins' presentation about the Office of the National Nurse included Janet Drake who works as a program managers at DADS, Kay Savant, Christina Carrigan and Shoshanna Conway both from UT Southwestern, as well as Chris McDaniel from the Executive Women in Texas Government. Dr. Hawkins reportedly gave an excellent presentation with some frightening statistics about the present state of America's health illiteracy. Her data affirms and validates the need for a National Nurse complemented with National Nurse Teams to serve as the vehicle for delivering the message of prevention to every single American. Be sure to sign up to receive this week's newsletter that will contain more information about Dr. Hawkins' talk by submitting your email in the box on the right side of this website.

Robert Wood Johnson Recognizes National Nurse Act of 2006

Last week the Robert Wood Johnson Foundation included this article in their RWJF News Digest that highlights the work being done by Representative Lois Capps (CA) and the National Nurse Team to expand the list of Congressional cosponsors for HR 4903, the National Nurse Act of 2006.

Julie's June picks from the literature

Some of these recent nursing articles really caught my eye. SJH/CHOC staff can obtain these online or request them from Burlew Medical Library. Nurses who are not at SJH/CHOC should check with their own medical libraries.

1. Delgado-Passler P. McCaffrey R. The influences of postdischarge management by nurse practitioners on hospital readmission for heart failure. Journal of the American Academy of Nurse Practitioners. 2006 Apr; 18(4): 154-60. (17 ref) 2

2. Gardner MR. Deatrick JA. Understanding interventions and outcomes in mothers of infants. Issues in Comprehensive Pediatric Nursing. 2006 Jan-Mar; 29(1): 25-44. (86 ref)

3. Karkkainen O. Bondas T. Eriksson K. Documentation of individualized patient care: a qualitative metasynthesis. Nursing Ethics. 2005 Mar; 12(2): 123-32. (32 ref)

4. Kehl-Pruett W. Deep vein thrombosis in hospitalized patients: a review of evidence-based guidelines for prevention. DCCN: Dimensions of Critical Care Nursing. 2006 Mar-Apr; 25(2): 53-61. (28 ref)

5. Whall AL. Sinclair M. Parahoo K. A philosophic analysis of evidence-based nursing: recurrent themes, metanarratives, and exemplar cases. Nursing Outlook. 2006 Jan-Feb; 54(1): 30-5. (47 ref)

6. Harrington L. Implementing a hospital-based nursing research program in 30 days. Nurse Leader. 2006 Feb; 4(1): 37-42, 55. (8 ref)

Thank You Representative Eddie Bernice Johnson (TX)

Representative Eddie Bernice Johnson (TX)

Congresswoman Eddie Bernice Johnson is the first registered nurse to be elected to the United States Congress. She is also the first woman and the first African-American to serve Dallas, Texas. Now in her seventh term of office, Congresswoman Johnson is known as the "Gentlewoman from Texas". Here is her statement on The National Nurse Act of 2006.

"Never before in the history of this nation has there been a greater need for an Office of the National Nurse -- an individual to provide leadership and messages of prevention and healthy living. Increasing numbers of Americans are obese. Diabetes threatens millions' quality of life. An aging population means increased vulnerability to Alzheimer's, arthritis, falls -- all conditions that can be ameliorated or prevented with clear,basic health information. As a nurse, I strongly support H.R. 4903 and hope for a day when America can benefit from this beneficial policy proposal."

I Have a Job

Finally got hired as a Student Nurse Tech in a PCU. Won't start for a couple weeks. Waiting for HR to call and schedule a physical with me, so they can be sure I'm not a) diseased b) addicted c) disabled d) insane, etc.

Bummer, I need some money now.

Addressing America's Nursing Shortage

Pictured: Portland Commmunity College President Preston Pulliams, Teri Mills, and Congressman David Wu (OR)

Congressman David Wu (OR) mailed an update last week to his constituents describing legislation he is working on to make health care more affordable and accessible to families in Oregon. Here is Congressman Wu's statement that he included on addressing the nation's nursing shortage:

"Nurses are on the frontlines of health care today. Yet every day, there are 120,000 nursing positions vacant, with the shortage expected to rise to 400,000 in 20 years. Congressman David Wu is a co-sponsor of HR 4903 to develop initiatives that encourage more students to consider nursing, as well as promote nurse-retention efforts and public health programs run by nurses in coordination with community organizations."

The National Nurse Team acknowledges and appreciates Congressman Wu's support.

Pets Are Great For Your Health

Pictured-Daniel, The National Nurse Team Mascot

Just diagnosed with high blood pressure? Feeling isolated and shut in? Concerned about dying at a young age? Here is one solution to improve your health-get a pet. Research shows that pets reduce blood pressure, improve people's moods, increase social interaction, and add years to your life. Adding a pet to your household has been found to give a higher boost to your survival rate than having a spouse or friends. The good news is that this can be just about any animal from a bird to a turtle or from a cat to a dog. Cat and dog owners however, are especially appreciative of the unconditional, non-judgmental affection they receive from their pets. For more information on pet therapy visit this website.


When you take your pets to the beach or on a walk, be sure to have your National Nurse totebag to carry your suntan screen, pet treats, and your latest reading materials. Check out all the latest National Nurse merchandise at Cafe Press.

Nursing Literature Mapping: from Med-Surg to Transcultural Nursing and more

The first ever online-only supplement to the Journal of the Medical Library Association (JMLA) has been published freely on PubMed Central. This online symposium deals entirely with the Mapping the Literature of Nursing Symposium.

Thank You Representative Frank Pallone, Jr. (NJ)

Pictured: Congressman Frank Pallone, Jr. (NJ)

Congressman Frank Pallone, Jr. (D-NJ), a Senior Member of the House Energy & Commerce Health Subcommittee, Chair of the House Democratic Health Task Force, Co-Chair of the Fetal Alcohol Spectrum Disorders Caucus and Vice-Chair of the Digestive Diseases Caucus released the following statement regarding HR 4903:

"It is my honor to co-sponsor HR 4903, the National Nurse Act. Access to reliable health care is the most important factor in determining a person's quality of life, and this care can not be provided without dedicated nurses. America's nearly 3 million nurses work each and every day to ensure patients receive accurate health information and the best care possible. By establishing an Office of the National Nurse, our nation's nurses will receive a strong federal advocate for their vital field, and all Americans will benefit from increased access to information about getting and staying healthy. I hope more young Americans will find this new office inspires them to join the profession of nursing and become trusted patient allies in the growing health care field."

Thank You Representative Henry Waxman (CA)

Pictured: Representative Henry Waxman (CA)

Congressman Waxman represents the 30th District of California and is a member of the House Health Subcommittee. He has been a consistent leader on health and environmental issues, including universal health coverage. The National Nurse Team is appreciative that he has signed on to co-sponsor HR 4903, the National Nurse Act of 2006. Congressman Waxman is also very supportive of Americans receiving the message that many diseases have preventable risk factors to them and sees the value of an Office of The National Nurse as his statement below demonstrates.

"Nursing is a critical part of good healthcare, and deserves an office in the department to promote better public health. I'm proud to support HR 4903 and nurses in the effort to create healthier lifestyles across the country."

Burn Safety

(Pictured: Kirsten Balding, RN BSN)
Kirsten Balding from Portland, Oregon sends this information from a recent edition of Parent Magazine.

"Scalds are the number one cause of burn injuries in children under the age of four. Almost all of these injuries are preventable. As parents, grandparents, baby sitters and other child care providers, we can all be more aware of what most often causes burn injuries in children and learn how to prevent them. Here are some tips to help keep your family safe from burns in your home.

In the bathroom:
Set the water heater thermostat to 120 degrees, most water heaters are set around 150 degrees or greater. It can take less than one second at these temperatures to receive a serious burn.
Stir the bathwater with your hand to eliminate hotspots.
Test the water with your hand or thermometer before putting the child in the bathtub. If it feels too hot for your hand, it is too hot for your child.
Stay with your child at all times. It only takes a second for a child to reach up and turn the hot water faucet on when you are not in the room.

In the kitchen:
Keep pot handles turned away from edges of the stove. If possible, cook on the back burners.
Coil appliance cords away from the edge of the counter; your child can grab these and pull a whole pot of coffee or a crock-pot full of food down onto herself.
Do not use tablecloths when there are young children around. Babies often grab for tablecloths, if there is hot food on the table, they can pull it down on themselves.
Do not eat hot foods or beverages while holding a child on your lap. Young children bounce around and can grab at coffee cups.
Keep you children safe by creating a NO ZONE in your kitchen while cooking.

Burn injuries are permanent, life altering, and most importantly preventable. Contact your local burn center today to learn how to prevent scalds as well as other burn injuries in your home and in your communities."

Send in your health tip to teri@nationalnurse.info and help keep Americans healthy

Help The National Nurse Team Return To Capitol Hill

(Pictured: Alisa Schneider, Teri Mills, Debbie Orre, Terri Polick, Paxson Barker)

The National Nurse Team plans to return to Washington DC September 7th and 8th to continue their efforts in educating members of Congress about HR 4903. This is a grassroots campaign, so if you are interested in joining us, you would be more than welcome. During our last trip in May, there were many newcomers to the political arena. This will again be the case this fall, so don't let that hold you back. Please email teri@nationalnurse.info for more information.

As you know, traveling is very expensive. There are two ways you can help support the team's efforts. First, consider making an on line contribution. Small amounts are appreciated as much as large donations.

Second, visit Cafe Press and purchase a button or magnet. There is also a tote bag for sale, perfect for summer travel and of course, to give visibility to the National Nurse Campaign.

This week Congress resumes session and that means more co-sponsors will be added to the growing list. A co-sponsor is a guaranteed vote in support of the National Nurse Act of 2006. Please keep contacting your own U.S. Representative to urge their co-sponsorship of HR 4903.

Nursing Wiki

http://en.nursingwiki.org

NursingWiki is a free multilingual wiki-project for health care and nursing information, that anyone can edit. Since May 2006, 68 free licensed articles in english language have been created. Anyone can contribute his/her knowledge in updating pages – the first steps are very simple! Wiki is the shortened form of the hawaiian adjective "wiki wiki", which describes something as "quick" or "fast". A wiki is a website which allows users to easily and quickly edit, add and remove content; it is therefore an effective tool for collaborative writing. There is a section on "Nursing Research" under construction in this Nursing Wiki. Feel free to contribute content to the Nursing Wiki. This blog is linked with the other nursing related blogs.

Nursing study finds that music relieves symptoms and eases depression in chronic pain patients

siedliecki s.l. & good m. (2006) Journal of Advanced Nursing54(5), 553–562

Effect of music on power, pain, depression and disability
Aim. This paper reports a study testing the effect of music on power, pain, depression and disability, and comparing the effects of researcher-provided music (standard music) with subject-preferred music (patterning music).

Background. Chronic non-malignant pain is characterized by pain that persists in spite of traditional interventions. Previous studies have found music to be effective in decreasing pain and anxiety related to postoperative, procedural and cancer pain. However, the effect of music on power, pain, depression, and disability in working age adults with chronic non-malignant pain has not been investigated.

Method. A randomized controlled clinical trial was carried out with a convenience sample of 60 African American and Caucasian people aged 21–65 years with chronic non-malignant pain. They were randomly assigned to a standard music group (n = 22), patterning music group (n = 18) or control group (n = 20). Pain was measured with the McGill Pain Questionnaire short form; depression was measured with the Center for Epidemiology Studies Depression scale; disability was measured with the Pain Disability Index; and power was measured with the Power as Knowing Participation in Change Tool (version II).

Results. The music groups had more power and less pain, depression and disability than the control group, but there were no statistically significant differences between the two music interventions. The model predicting both a direct and indirect effect for music was supported.

Conclusion. Nurses can teach patients how to use music to enhance the effects of analgesics, decrease pain, depression and disability, and promote feelings of power.


Journal of Advanced Nursing Table of Contents

Congratulations Nursing Students and Graduates

Congratulations to the Class of 2006 ! The National Nurse Team welcomes you to the nursing profession as our peers and looks forward to working with you. Congratulations to nursing students across the country who made it through another challenging year of nursing school. You are one step closer to becoming a nurse. Pictured below are classes that Alisa, Teri, and Lillian presented to about the National Nurse Act of 2006.

(Pictured: Portland Community College Class of 2006)

(Pictured: Portland Community College Class of 2007)

(Pictured: Pamela Moore and Milar Moore-graduate students at Oregon Health Science University, Teri Mills, OHSU Faculty Mary Pate, and Alisa Schneider)

(Pictured: From Nevada State College located in Henderson, Nevada-Faculty Margo Malarkey, MHS, RN; Lillian Gonzalez, RN, BSN; and NSC SNA President Joseph Queniahan)