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NY Bill Would Require Registered Nurses to Have 4-Year Degrees

Posted in Nursing, Nursing Jobs, Nursing News, Nursing School, Nursing Specialties

New York State lawmakers are considering a bill that would require registered nurses to earn bachelor’s degrees within 10 years in order to continue to work as a nurse in the state.

It’s called the “BSN in 10” and is being backed by nursing associations and major healthcare associations, with the goal creating a better-trained nursing workforce to care for an aging population. The aging of the baby boomers also means that many experienced and knowledgeable nurses will be retiring, creating a double whammy for healthcare providers.

Right now no other states have a law like this on the books. It looks like New York’s law has a pretty good chance of passing, though.

New York’s legislation died in committee last session, but it has bipartisan support in both chambers this year and could be debated as early as January. (more…)

The History of School Nurses

Posted in Nursing, Nursing Jobs, Nursing Specialties, School Nurses

An interesting article on Philadelphia’s Philly.com answers a question I hadn’t really thought about: Why we have school nurses in the first place.

Up until the very beginning of the 20th century if students were sick, they were sent home with a note. Caring for the sick child and getting medical attention if necessary was the responsibility of the child’s family.

The nurse and social reformer Lillian Wald had a better idea — why not treat the children in school?
In 1902, she started to provide four New York City public schools (serving about 10,000 students) with nurses from her Henry Street Settlement. Her experiment was so successful that New York officials expanded it citywide.

By hiring 25 nurses, the public schools reduced the number of students sent home from roughly 10,000 in 1902 to a little more than 1,000 in 1903 – an astounding decrease of 90 percent. School nurses also made home visits to children who were removed from school, treating their illnesses and instructing their families in hygiene and prevention.

Other cities quickly followed New York’s example. Los Angeles put nurses in its schools in 1904, Boston did so the following year, and Philadelphia hired its first school nurses three years after that, in 1908.

Over the ensuing century, school nurses provided a variety of crucial health services. As public vaccination expanded, nurses helped ensure that children were protected against polio, diphtheria, and other diseases. And when the federal government required schools to accommodate handicapped children, including those who needed catheterizations and feeding tubes, their care often fell to – you guessed it – school nurses.

Today we’re told that nurses are too expensive for cash-strapped school districts. But the same objection was raised back in Wald’s time, at the dawn of school nursing. “There are still many people, even kindly souls, who cry out about this ‘fad’ because of the cost,” wrote Lina Rogers, New York’s first full-time school nurse. “What willful, heartless blindness.”

She was right. A hundred years later, let’s hope kindly Americans will open their hearts – and their wallets – to school nursing. The alternative is to close our eyes, like little children, and pretend nobody can see.

This recent post examines the issue of school nurses, budgets and the many services school nurses now provide in more detail.

School Nurses Spread Thin

Posted in Nursing Jobs, Nursing News, Nursing Specialties, School Nurses

Somehow I’ve made it to adulthood without ever breaking a bone, but I was either a very clumsy or a very active kid (perhaps both?) and throughout my elementary school years I was forever heading to the school nurse to have a cut attended to or a bruise soothed. In my memory, she was always there when needed.

I don’t know if she actually was on duty all of the time or if it just seemed that way, but school nurses these days usually have to serve several schools at once, even as the medical needs of their patients only become more complex and time-consuming.

The Whidbey News of Washington spoke to Robbin White, a school nurse, and Rick Shulte, the Superintendent of the district she works in, about the unique challenges that school nurses face now.

“The students’ needs for nurses has risen to more than it used to be,” (more…)

The Importance of Good Documentation Practices

Posted in Nursing, Nursing Jobs, Uncategorized

Few things can save your job and reputation like your documentation. In instances where another clinician may question your judgment or activities, your documentation can indicate the date, time and other details necessary to prove that you acted in an appropriate manner.

Although nursing instructors attempt to teach proper and thorough documentation in nursing school, frequently new grads include either too much or not enough detail. A key to learning best documentation practices is to read other nurses’ notes. Although most facilities now use computerized charting due to new laws regarding the electronic medical record (EMR), you can check other nurses’ notes within your system. Additionally, some facilities (mostly nursing homes) still use paper charts.

Typically, all charting involves a lot of check-off boxes. In areas that require handwriting, remember that someone other than yourself may have to read your notes and that one day you may be called to testify as a witness. (more…)

The Nurse as Whistleblower

Posted in Nursing, Nursing Jobs, Nursing News, Nursing School

Real world nursing isn’t just what you were taught in nursing school. As you learn to work with patients in your clinicals, your instructors teach you the “ideal” method for every procedure and every situation. Once you get into the real world, with license in hand, you begin to see that “ideal” doesn’t exist in healthcare.

As you go through your day, learning the skills and procedures you need to use in your practice, you will probably see things that make you think “that’s not right.” You may see colleagues taking chances that could endanger their patients. You might see an overstated bill that will end up costing the insurance company or patient more than necessary. Most of the time these mistakes are just random “oops” moments, with no real pattern or ill intent. But what if you see a dangerous practice again and again, or if a fraudulent billing method is standard operating procedure? What do you do? (more…)

Nursing Strikes On the Horizon

Posted in Nursing, Nursing Jobs

Nursing strikes are looming on both coasts — over 6,000 registered nurses are ready to strike in New York, and 23,000 nurses are set to stage a 24-hour strike on December 22nd in California.

And that’s not all — there are potential strikes in New Jersey and Minnesota, too, according the website of a strike replacement agency called HealthSource Global Staffing.

The New York Times has a front-page article examining these various strikes — imminent and merely possible. A common theme is that nurses feel that it’s unfair that when the hospitals have cuts in Medicaid and Medicare, the sacrifices are disproportionately made by the patients and those who care for them, while executives still get the big bucks.

“Nobody wants a strike,” (more…)

Americans Trust Nurses

Posted in Nursing, Nursing News

Who’s more trustworthy than a policeman, or a teacher, or even a member of the clergy?

That’s right, a nurse!

Nurses have topped a Gallup poll measuring the “honesty and ethical standards” of people in different fields yet again. This time they topped the next-best scorer — pharmacists — by 11% in the “very high” category. This is the 12th time in the 13 years they’ve been included in this poll that Nurses take the top spot.

Nurse.com examines the poll:

The survey was conducted Nov. 28 to Dec. 1 among a random sample of 1,012 adults representing all 50 states and Washington, D.C. When asked to rate the honesty and ethical standards of nurses, 84% responded with “very high” or “high,” while 15% responded “average” and only 1% responded “low” or “very low.” (more…)

Can Working the Night Shift Increase Your Risk of Diabetes?

Posted in Nursing, Nursing Jobs, Nursing News

As if the night shift were not already unpleasant enough, a new study indicates that it may also increase your risk for developing type 2 diabetes.

The risk seems to be especially marked if you work a rotating shift for a long time.

“For nurses who spent a couple of years working rotating night shifts, there was a minimal increase in risk. But, for those with a very long duration of rotating shifts, the risk was almost 60 percent higher. This provides pretty strong evidence that the longer the rotating night shift work, the greater the risk of diabetes,” [Dr. Frank] Hu said.
(more…)

Does the Uniform Make the Nurse?

Posted in Nursing, Nursing News, Nursing Specialties

Nova Scotia’s Nurses’ Union has decided that starting next year, all nurses will need to wear a specific uniform — white smocks and black pants. The union’s rationale is that they want patients and their families to be able to figure out at a glance who is a nurse and who is a random support person. Right now everyone from cleaning staff to licensed practical nurses wear scrubs of whatever color they’d like.

Marilla Stephenson, a nurse who comes from a family that is chock-full of nurses, mused about this decision:

Uniforms have gone from long, puffed sleeves 100 years ago to tailored short-sleeved dresses after the Second World War to pantsuits in the 1970s to the scrubs of today. The stiff white hats disappeared in the ’70s.

Some pediatric nurses have voiced opposition to the move. They were the first to move to coloured smocks and pastel scrubs, as long as three decades ago, in an effort to make hospitalization less frightening for young children.

The union has used the comparison of being pulled over by an RCMP member and knowing by the uniform that you are dealing with a member of the federal police force.
(more…)

Should Mistakes by Nurses Be Crimes?

Posted in Nursing, Nursing Jobs

Healthcare systems typically aspire to a non-punitive atmosphere to manage any mistakes the nursing staff might make. Mistakes are documented and graded on the basis of harm or potential harm to the patient. Management usually feels that this approach encourages reporting of mistakes, which then spawns new methods of error prevention.

On the legal side, however, there is a movement to criminalize mistakes made by nurses. Healthcare systems feel this trend will result in an individual believing it’s more advantageous to protect self-interests, such as a nursing license and a job, than to report errors.
(more…)