This semester is Peds and OB. I like my instructors sofar (though nobody will take the place of Instructor Fantastic in my heart).
I'm a little pissed off because I'm having to take a statistics class. It's not so bad by itself, but I already took Stat as a math class in Houston. But does the school want that credit? Noooo, they want Psychology Statistics. I've fought and pleaded. I've asked to take a test, but to no avail! Basically I'm paying them money to sit around and re-learn things I've already mastered. On top of that, I find that many nurses are none-to-bright about math, and the pace of study is agonizingly slow compared to the first go-round. Let's hope I don't go crazy. ^_^;;
I'm still working as a tech in the PCU. I'd never really considered PCU as a place to start a nursing career, but it's becoming more appealing all the time. First of all, the patient ratio is lower than Med-Surg, but the patients aren't quite as critical as in the ICU. Secondly, the hospital is interested in "cross-training" people in ICU and ER skills in order to provide more options for "floating" extra staff in times of low census. Thirdly, I like the floor I'm on, and wouldn't mind working with these people in a larger capacity.
I've always been far more interested in critical care than anything else, mostly because I'm not too fond of children or surgery or the like. And I want to be in a place that will challenge me and keep me on my toes. Still keeping my options open, but it looks like this hospital has accomplished it's own goals by recruiting me for this job: getting me comfortable with this facility and reeling me in for employment after graduation.
We'll see how things work out when I graduate. If I don't end up in Texas, I really hope I end up right where I am.
Tomorrow I'm going to spend clinicals in Labor and Delivery. I reaallly hope a baby is born in the time that I am there, because I feel like that would be much more exciting than just hanging out with a woman moaning in labor for 8 hours. o_O
Taken two tests sofar. I actually made an A on the second one! (I'd almost forgotten how it felt to make A's on big tests with this funky grading scale!) My extra preparation is paying off. I'm making time to read the chapters before lecture and staying at least 2 hours afterwards in the library for review. And that works. (Well... except when a question is vague or weird. But that's not my problem.)
I really really want to do well this semester so I can increase those decimals after the 3 in my nursing gpa. I want to be inducted into Sigma Theta Tau! They only take the upper percent of the class, so I don't know what my chances are. If I keep making As though, maybe they'll improve. ^_^
Senin, 11 September 2006
Thank You Congresswoman Lynn Woolsey (CA)
Pictured: Congresswoman Lynn WoolseyThe National Nurse team is grateful to Congresswoman Lynn Woolsey who became the 26th cosponsor of HR 4903.
Here is her statement:
H.R. 4903 will help to alleviate the nursing shortage in the United States and make a big difference in tackling our country's most pressing healthcare problems. As we strive to improve the quality of care of chronic illnesses such as diabetes and heart disease, an addition of well-trained nurses to the workforce will be welcome and necessary.
Sabtu, 09 September 2006
Nurse From Tennessee Supports HR 4903
My name is Wendy Vogel, MSN, FNP, AOCNP
I am a board certified oncology and family nurse practitioner, practicing in the state of Tennessee.
I support the National Nurse Act of 2006 because nurses need to have a legislative voice in the United States. We have much to contribute to America's healthcare. We have been "silent partners" for far too long. We are great advocates for preventive care. We now know that there are even ways to prevent cancer! An organized approach will offer thorough education to all Americans, families, and communities. This also will bring recognition to the role of nursing in healthcare.
Jumat, 08 September 2006
Study: Nurses Lack IT training
A new study in eWeek finds that most nurses receive minimal or no IT training. Information literacy is integral to an understanding of how to approach Evidence Based Nursing.
Please post your comments below if you have any great ideas/suggestions on this topic.
Resources for teaching EBM
David Rothman from Syracuse, NY, just posted on his blog a very comprehensive list of resources for teaching EBM/Evidence Based Medicine. Most of the resources were compiled by puting a call out to the MEDLIB-L for assistance.
Kamis, 07 September 2006
Travel Nurse: Earn Money While Visiting With Family
When my husband and I got married we decided we wanted to live near extended family so we (and our children) could remain close to them. The only problem was that my parents lived in Georgia, and his lived in Utah… so we had to pick. We chose Georgia.
After our son turned one, we decided we wanted to spend some time “out west” to let him get to know his grandparents, aunts, uncles, and cousins that live out there better, and to enjoy the sites. We didn’t have a whole lot of money with my husband in school so we knew that one of us would have to work if we wanted to stay for the whole summer.
That is where travel nursing helped out. My husband was not going to be in school for the summer, so we planned for him to stay home with our son while I worked. Most of the hospitals there wanted me to work three twelve hour shifts per week (which is what I preferred anyways). I had the choice of working either an 8 or 12 week assignment. We chose the 8 week one so we could have one month off to vacation. There were so many things to do out there that we enjoy (i.e. hiking, camping, rafting, and biking). All our travel (relocation) expenses were reimbursed (tax-free). We received a monthly housing stipend which was just an added bonus since we stayed with family. We ended-up making $12,080 in two months! Now try and beat that for a career! Now that my son is almost five, we often reflect back on that summer in Utah. What a great time we had, and how grateful I am that I chose nursing as a career.
Rabu, 06 September 2006
Pressure Ulcers among Eldery Patients Early in Hospital Stay: Abstract with commentary by Dana Rutledge, RN, PhD
Abstract: Pressure Ulcers among Elderly Patients Early in Hospital Stay
Background. Pressure ulcers among elderly hospital patients diminish quality of life and increase the cost of hospital care. Evidence suggests that pressure ulcers can arise after only a few hours of immobility. The goals of this study were to estimate the incidence of hospital-acquired pressure ulcers in the first 2 days of the hospital stay and to identify patient characteristics associated with higher incidence.
Methods. A prospective cohort study was performed between 1998 and 2001. A total of 3233 patients 65 years old or older admitted through the Emergency Department to the inpatient Medical Services at two study hospitals were examined by a research nurse on the third day of hospitalization. Pressure ulcers were ascertained using standard criteria and were classified a either preexisting, possibly hospital-acquired, or definitely hospital-acquired.
Results. There were 201 patients with one or more possibly or definitely hospital-acquired pressure ulcers for a cumulative incidence of 6.25 (95% confidence interval, 5.4% - 7.1%). Most of the pressure ulcers were stage 2, and the majority were in the sacral area or on the heels. In multivariable analysis, pressure ulcer incidence was significantly associated with increasing age, male gender, dry skin, urinary and fecal incontinence, difficulty turning in bed, nursing home residence prior to admission, recent hospitalization, and poor nutritional status.
Conclusions. A small but significant proportion of elderly emergently admitted hospital patients acquire pressure ulcers soon after their admission. New models of care may be required to ensure that preventive interventions are provided very early in the elderly person’s hospital stay.
Baumgarten, M. et al. (2006). Pressure ulcers among elderly patients early in hospital stay. Journal of Gerontology: MEDICAL SCIENCES, 61A, 749-754.
Commentary by Dana N. Rutledge, RN, PhD, Nursing Research Facilitator
Were you surprised at any of the predictors of pressure ulcers in this hospitalized elderly patients? You probably were not. Studies using the Braden Pressure Ulcer Risk Assessment Scale confirm that problems with moisture, mobility/activity, and nutrition are all predictors of pressure ulcer development. What is new about the Baumgarten et al. study is that in 6.2% of the patients, pressure ulcers developed within 3 days of hospital admission!! Earlier studies have not specifically looked at this time interval.
What were the strengths and limitations of the study. Strengths include the large sample size, use of 2 hospitals (one in Pennsylvania, one in Oregon), the large sample of African Americans, and use of trained research nurses to evaluate the study measures. Limitations are that the study involved only a brief one-time observation of the patients and that hospital-acquired and preexisting pressure ulcers may have been somewhat misclassified.
Taking these into account, what is the take home message for the practicing nurse? Elderly patients admitted to medical units may be prone to develop pressure ulcers within 3 days of admission. Thus, given recent trends towards shorter hospital stays, the potential for breakdown is high. Nurses MUST put preventive measures into place early!!
Background. Pressure ulcers among elderly hospital patients diminish quality of life and increase the cost of hospital care. Evidence suggests that pressure ulcers can arise after only a few hours of immobility. The goals of this study were to estimate the incidence of hospital-acquired pressure ulcers in the first 2 days of the hospital stay and to identify patient characteristics associated with higher incidence.
Methods. A prospective cohort study was performed between 1998 and 2001. A total of 3233 patients 65 years old or older admitted through the Emergency Department to the inpatient Medical Services at two study hospitals were examined by a research nurse on the third day of hospitalization. Pressure ulcers were ascertained using standard criteria and were classified a either preexisting, possibly hospital-acquired, or definitely hospital-acquired.
Results. There were 201 patients with one or more possibly or definitely hospital-acquired pressure ulcers for a cumulative incidence of 6.25 (95% confidence interval, 5.4% - 7.1%). Most of the pressure ulcers were stage 2, and the majority were in the sacral area or on the heels. In multivariable analysis, pressure ulcer incidence was significantly associated with increasing age, male gender, dry skin, urinary and fecal incontinence, difficulty turning in bed, nursing home residence prior to admission, recent hospitalization, and poor nutritional status.
Conclusions. A small but significant proportion of elderly emergently admitted hospital patients acquire pressure ulcers soon after their admission. New models of care may be required to ensure that preventive interventions are provided very early in the elderly person’s hospital stay.
Baumgarten, M. et al. (2006). Pressure ulcers among elderly patients early in hospital stay. Journal of Gerontology: MEDICAL SCIENCES, 61A, 749-754.
Commentary by Dana N. Rutledge, RN, PhD, Nursing Research Facilitator
Were you surprised at any of the predictors of pressure ulcers in this hospitalized elderly patients? You probably were not. Studies using the Braden Pressure Ulcer Risk Assessment Scale confirm that problems with moisture, mobility/activity, and nutrition are all predictors of pressure ulcer development. What is new about the Baumgarten et al. study is that in 6.2% of the patients, pressure ulcers developed within 3 days of hospital admission!! Earlier studies have not specifically looked at this time interval.
What were the strengths and limitations of the study. Strengths include the large sample size, use of 2 hospitals (one in Pennsylvania, one in Oregon), the large sample of African Americans, and use of trained research nurses to evaluate the study measures. Limitations are that the study involved only a brief one-time observation of the patients and that hospital-acquired and preexisting pressure ulcers may have been somewhat misclassified.
Taking these into account, what is the take home message for the practicing nurse? Elderly patients admitted to medical units may be prone to develop pressure ulcers within 3 days of admission. Thus, given recent trends towards shorter hospital stays, the potential for breakdown is high. Nurses MUST put preventive measures into place early!!