Kathy

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What Nurses Won’t Learn in School

Nursing is a lifelong learning process, and one of the things new nurses learn quickly is how much they did NOT learn in school. Graduating from an accredited nursing program and passing the NCLEX is just the beginning.

In clinicals, nursing students get only a small taste of what nursing is all about. They usually have one or two patients to care for and only for a part of a shift. They are frequently very sheltered so as to not get into trouble and cause an issue for their instructor who has many students to oversee.

Student nurses have little, if any, experience in the day to day activities and functions on the unit. Admitting and discharging patients is rare and therefore the associated paperwork with just these two activities can be overwhelming to a new nurse!

Ordering supplies and meds may be touched upon as needed for your patient, but the overall process has probably been shortcut by someone; either a staff member or your instructor. Signing for the narcotics may not be allowed by students even if the instructor co-signs and so nursing students may not even be aware of the process with controlled substances.

With only one or two patients to care for in a short duration, time management skills will never be effectively taught in nursing school. Prioritizing and learning how to schedule your day is something all new nurses struggle with. This then becomes one of the most intense points of contention with regular staff; how to learn to be good nurses without becoming a burden to the already over-stressed regular staff.

Student nurses would be well-served to spend some time just sitting and observing the flurry of activities on a unit, and if possible, shadowing a nurse for at least one whole day each rotation instead of being assigned to a patient. This would help to provide students with insight into how to plan out their day, make adjustments as events unfold and to regroup as necessary to stay on schedule.

Spending some time with other team members on the unit such as the unit secretary or clerk would be beneficial. Learning how supplies and medications get ordered and charged or how an order for a CAT scan get processed and scheduled can be very important. When you have some idea of the process, how long it can take, the number of people involved, etc, you will have a better appreciation for doing your part in a timely manner and being as accurate and complete as you can.

Learning about the day to day function of a unit will give you a broader understanding of the need to be organized, to know how to strategize, how to delegate effectively, and how to flex when the unexpected happens. Understanding how the unexpected can make a major impact on how your day goes will also help you to formulate the need to learn to be organized and use time management skills effectively.

You will have learned the basics of nursing in school; the anatomy and physiology, the microbiology of germs, the chemistry of medications and bodily functions, and many of the skills such as IVs, injections, catheters, tubes, wounds, etc.

As a new nurse, you will learn how to put all of this knowledge to work while learning how to function as a nurse. This part will take some time. You won’t master it all in a day or even a week. Give yourself a year! But keep plugging away at it and making progress. You too will become a good nurse.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and the owner/author of TheNursingSite.com.

If I Have a Criminal Record, Can I Become a Nurse?

Posted in Nursing, Nursing Jobs

If I Have a Criminal Record, Can I Become a Nurse?

Is it possible to become a nurse if you’ve been charged and/or convicted of a crime?
There are several important aspects to the answer.

It may be that you shoplifted a lipstick from the local drug store when you were thirteen. Were any charges filed? Or was it handled just between the store, your parents and you? If you were charged and the case was sealed because you were a juvenile, don’t make assumptions. Find out what’s on your record that can be found.

Have you been involved in a domestic dispute? Were any charges filed against you? What was the result? Were you perhaps arrested for being involved in a public rally or demonstration that got out of hand? Or do you have a record for a DUI or involvement with drugs?

First of all you must be honest about your experience. Before you apply to a nursing program, contact your state board of nursing to discuss your situation. They can advise you as to whether your situation will prevent you from becoming licensed or not and what steps you need to take.

Be prepared to answer honestly and to explain your unique situation. Have all police records, court documentation, etc. at hand to refer to and to send copies if requested. If you have served jail time, provided restitution or been involved in rehabilitation of any kind, you should have all of that information and documentation as well.

Nursing schools will have a question on the application or at some point during the admissions process. Again be prepared to discuss the situation openly and honestly. Have your documentation at hand and present copies if needed. Also provide the information your state board of nursing gave you.

Employers may ask about criminal activity as well and you will again need to be frank and honest about your situation and provide all necessary information.

In some cases, your situation may prevent you from becoming licensed as a nurse, but the state board may also be able to suggest other health career options to explore.

Not all situations will prevent you from becoming licensed. However, the one thing that will be a sure bet to prevent you from becoming a nurse is if you lie or try to cover up any criminal activity you have been involved in. No matter what the crime, if you lie about it, you will most likely never become a nurse.

Nurses are held to a very high standard. Patients entrust their lives to nurses and expect that they are honest, have integrity and are professional. Nurses deal with narcotics and are expected to maintain confidentiality.

Throughout your nursing career you will continue to be held to this standard. Your behavior off duty can be as important to your career as how you conduct yourself on the job. For instance, a DUI can not only cost you a lot of money in fines, legal fees and rehabilitation efforts, but it can cause you to have your license suspended or revoked.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and is the author/owner of TheNursingSite.com.

Is Nursing Really Recession-Proof?

Posted in Nursing, Nursing Jobs

Is Nursing Really Recession-Proof?

People will always get sick and need care, but will this make nursing a recession-proof career? The answer is as complex as the recession. Yes, people will always get sick and need care despite the economic status. Yes, the population is aging, more obese and, in general, demands better care.

But can people afford healthcare in a recession? With nearly 50 million Americans presently without any health insurance, it’s more likely they will opt to make the mortgage payment and not seek medical care unless it’s absolutely essential. So while this can mean a cutback in the number of patients being seen or cared for, it also means that those who are seeking care are often sicker than usual.

For those who are insured, the new calendar year has most likely brought higher co-pays, higher deductibles and out-of-pocket expenses as well as other changes in coverage for beneficiaries. These changes will affect the level of care Americans seek. And given a choice between paying the medical bills, buying food, or paying the mortgage; medical bills will more than likely be put on the bottom of the pile. This will impact the providers.

A leading indicator of a recession to health care industry professionals is the rise in the number of knee replacements and gum surgeries according to an article in the March 28, 2008, issue of Business Week. As Americans face possible layoffs and loss of health insurance, they often rush to have elective procedures done. On the other hand, many will forgo even necessary care for fear of losing their jobs for taking time off from work.

As hospitals, clinics, and other providers face financial losses associated with these factors, nurses and other staff will be affected. Some hospitals and other facilities have already instituted hiring freezes and a few have laid off staff. The nursing shortage isn’t going to go away because we are in a terrible economic crisis. Between 2006 and 2016, the BLS estimates that we will need 23% more RNs.

The really bad news is that economic situation is not expected to get better until it actually gets worse first. It is estimated that an additional 4.2 million Americans are likely to lose their health insurance coverage before the economy recovers.

Illness doesn’t take economic factors into account. The population today is older, more obese and more prone to chronic diseases. Those who face cancer, heart disease and emergency medical situations will need care whether they can afford it or not. Many will be sicker because they have put off seeking care until absolutely necessary which will tax the system even more. Should there be an epidemic or medical crisis during this recession, it could turn into a real medical mess!

Nurses are likely to find themselves placed in a precarious situation of being leveraged with the heavy hand of administrators threatening them to take on increased patient ratios or face layoffs themselves. This is going to be a time when nurses need to unite and stand strong in the face of adversity to not lose the small amounts of ground we have gained in this fight so far.

As the economy recovers, history has shown with past recessions that patients will rush the health care industry and it can be difficult to build back staff quickly enough to keep up with the demand. Because of the growing shortage of nurses, it is important for more people to continue to become nurses. There may be a shortage of jobs for new nurses for awhile, but as the economy recovers, this situation will improve and new nurses will once again find multiple options.

The nursing profession is not entirely recession-proof, but nurses are certainly positioned to be less likely to be laid off than many others. Will they be affected by the recession? Without a doubt.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and the author/owner of TheNursingSite.com.

Tax Time

Posted in Nursing, Travel Nursing

Tax Time

In an economy where every penny is highly valued, filing for an income tax refund can be high on the To Do list. So it’s time to dig out all those receipts and make a list of possible deductions.

Nurses have the potential for many different outright deductions as well as properties to depreciate, but these should be discussed with a tax advisor as they may not apply in all instances. Tax laws change almost yearly and what was once allowed may no longer be applicable so be sure to check each item.

Some of the items that should be considered include uniforms and cleaning costs. For example, some facilities require nurses to wear scrubs that they provide and they charge a periodic rental/cleaning fee. This cost may be deductible. The outright purchase of uniforms and any special shoes may be deductible as well. But if you wear those tennis shoes all the time, they may not be eligible.

Fees for continuing education courses (ceus) for license renewal, as well as any courses taken to improve your job skills or to allow you to advance your career may qualify as well. Some related expenses such as travel and meals may also qualify, but there are a lot of restrictions and you will really need professional advice on this one.

In the past, nurses could earn ceus while on a cruise and then these deductions came under strict scrutiny of the IRS. Travel excursions to foreign hospitals and clinics also got put under the microscope and the IRS clamped down, so beware if you have this kind of deduction to apply.

While it can be difficult to carve out the personal vacation experiences from the educational/business side, with careful record keeping, it can be done. Some expenses are considered too lavish and extravagant to be business deductions. Your tax advisor can help you.

Moving expenses and the costs related to looking for a new job can be considered deductions if they meet certain criteria. If your spouse took a new job in another state and you had to pay for a new nursing license and perhaps had to make a trip to the new area to interview for a job before you moved, these expenses could be deductible.

A professional library of books and trade journals may also qualify for deduction. The type of deduction may vary with the useful life of the items. Drug books for example need to be replaced every year due to updated information and so they wouldn’t be something to depreciate over time.

Equipment such as stethoscopes, PDAs, and all of the little items in your pocket like scissors and clamps can qualify for deduction, so if you purchased any in the past year, dig out those receipts. Other items such as digital cameras and cell phones may also qualify for deduction if used in the course of your business. The monthly fees for a telephone may be deductible as nurses have to take call or be available to be called in to work.

Home health nurses who use their digital camera or cell phone camera to photograph patients’ wounds and decubs could deduct a portion of the cost. You will need to be able to document how much of these items are used for business and how much for personal use. For example, if you have taken 1000 pictures with your new camera and 100 of them are business related, then the business usage would be 10%.

Travel nurses will have a variety of other deductions depending on their situations. The travel nurse agency may be able to advise you on some of the basics, but consulting a tax advisor is highly recommended. Accurate record keeping is an essential part of travel nursing right down to the tips you pay a porter to assist with your bags.

Organization is an essential tool for nurses, and keeping track of business expenses is just another aspect which needs organization. Your tax advisor may cringe when you come in carrying a shoebox full of receipts, but if that’s the best way you can keep track of these items, then at least have that. There are a number of software programs available to help keep track of expenses, mileage, and daily use of items such as cameras and cell phones for business purposes.

Don’t overlook all of the possible expenses you can deduct and set up an appointment with a tax advisor early on in tax season.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and author/owner of TheNursingSite.com

Home Health Nursing

Posted in Featured, Independent Contractor, Nursing, Nursing Jobs, Per Diem, Permanent Placement, Travel Nursing

Home Health Nursing

Have you ever considered home health nursing? Like any other nursing specialty, it’s not for everyone, but it can be a challenging and rewarding career option for the right candidate.

Not to be confused with private duty assignments in the home, home health nursing involves making several visits each work day to a variety of (at least temporarily) homebound patients.

These visits entail a complete head-to-toe assessment which can be brief or complex depending on the patient, the findings, or the physician’s orders. The visit will also include patent and caregiver teaching. Again the extent and complexity depends on the specifics of the situation. Each visit should build on the previous teachings and may involve some sort of return demonstration or pop quiz, if you will.

There may be a task to perform such as assessment and wound care, incision care, IV administration and/or site change, Foley catheter change, G-tube change, etc. The patient and/or caregivers may need specific instruction in the care of these as well.

Or the patient and caregiver may need in-depth instruction for a new diagnosis such as diabetes which would include such things as blood glucose monitoring, insulin or other medication administration, and how to identify and treat the signs and symptoms of hypo or hyperglycemia.

Patients and caregivers may also need instruction in medications including dose, administration, possible side effects, purpose and desired results. Other areas of common patient/caregiver education include specific dietary and nutritional needs or restrictions, and home safety issues.

Teaching caregivers how to safely assist patients with hygiene care (bathing, showering or a bed bath), transfers and ambulation may require the assistance of a PT or OT, but the home health nurse also needs to know how to perform and instruct in these as well.

Home health care is most often ordered by the physician following discharge from the hospital, or it may be ordered in lieu of hospitalization. In most instances it is not expected to be long term, but rather to help the patient and/or caregivers become independent in the necessary care.

For reimbursement purposes, Medicare and insurance companies have specific guidelines and criteria that patients must meet to be eligible for home health care. The home health nurse is responsible for reviewing this and documenting accurately. One of the worst parts of home health nursing is the paperwork! Much of it can now be done using a laptop or hand held computer, but there is still a lot of documentation to be done.

The nurse is the eyes and ears of the physician in the home. Many times home health referrals are made because the physician suspects that the patient needs more assistance or instruction in order to improve his/her outcomes. Or perhaps a higher level of care is needed.

The home health nurse learns to assess a home situation and to make recommendations for durable medical equipment (DME) and other disciplines to participate in the care such as a PT, OT or ST. A home health aide may be added to assist with hygiene care and to teach the patient and/or caregivers how to safely bathe and groom the patient.

If necessary, a medical social worker (MSW) may be called in to assist the patient and family in making more complex short term or long term plans for care, or help them to cope with life changing circumstances.

The beauty of home health care is being able to spend quality time with patients and caregivers one-on-one. But home health care is a team approach and the nurse is not expected to do it all.

It can be scary at times because there isn’t another nurse just down the hall to call for assistance or consultation. But there is backup a phone call away, and with cameras in cell phones, it can be even easier to get that consultation.

The autonomy and the ability to utilize skills that sometimes seem wasted in the fast pace of a hospital setting often draw nurses into the home health arena. Call a home health agency and ask to make a ride-along visit with a home health nurse to consider if this might be something you’d like to explore further.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and the author/owner of TheNursingSite.com

Dealing With a Nightmare Nursing Assignment

Posted in Nursing, Nursing Jobs, Permanent Placement, Travel Nursing, Travel Nursing

Dealing With a Nightmare Nursing Assignment

What happens when you encounter a nightmare nursing assignment? Whether you are a travel nurse or this is a permanent job, you may not be able to run screaming from the building never to return. So what can you do?

First off, take a deep breath and remember that you are a professional, If possible, leave the building, or at least the unit, for a few minutes to help clear your head. Perhaps the best you can do is retreat to the bathroom. Mentally punch a few walls and then try to decipher what just happened.

The most important thing is to make sure that your own patients are well cared for. If your issue is with another staff member, avoid him/her by spending more time with your patients.

If the issue is with a patient or family member, you can first try killing them with kindness while you make sure their needs are met, and then avoid them by spending more time with your other patients.

Let your nurse manager know what’s going on so that s/he can back you up and isn’t blindsided by complaints. Let him/her know that you’re trying to work this out, but need a little break from the situation. Perhaps s/he can offer some assistance.

Approach the situation using your critical thinking and problem solving skills. Try to step back and not let your emotions take precedence. Use the Nursing Process to assess, diagnose and create a plan to deal with the situation. It may take some time and require small but steady steps to make it work.

Some of the the things you need to consider include:

Is this something you can fix by yourself?
Do you need some advice, help or support from others to implement your plan or to make it work?
Is this a personality conflict?
Is this an issue of patient safety or quality of care?
Has there been some misunderstanding? How can you clear up the issue?
What can you do to avoid this problem in the future?

If this is your permanent job, you should speak to your nurse manager and decide together what can be done to improve the situation. Don’t go to him/her pointing fingers, go seeking assistance in solving a problem.

If you are a travel nurse, you may also need to consider whether the problem stems from being the traveler who “makes the big bucks and has all the perks?” If this is the core of the issue, you need to discuss this with your nurse manager and figure out how to turn this around.

Travel nurses are brought in to help reduce a specific nursing shortage situation and it’s up to the nurse managers in that facility to help permanent staff to understand this and to appreciate the help; not resent it, or to abuse a fellow nurse for accepting this role. Management needs to set the tone.
Travel opportunities are open to all nurses and just because someone does not take that option should not give them reason to resent or mistreat those who do. We all know that that isn’t the way it usually works, but travelers need to stand up for themselves and hold nurse managers and administrators responsible to set a positive tone about using travel nurses in their facilities.

The situation should also be brought to the attention of your recruiter. Hopefully it an be resolved without having to involve the recruiter, but s/he should be aware of the situation and it’s resolution for future reference.

If the situation can’t be resolved, or not to your complete satisfaction, you will just have to complete the assignment and/or make plans to move on as soon as you can. Put your focus on the positive aspects of this and learn something from it.

Understand the situation and look for something where you can avoid this situation in the future. Also count down the days left so you can see the light at the end of the tunnel. Remain professional and continue to provide the best possible care for your patients.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and owner/author of TheNursingSite.com

How to Organize or Prioritize Patient Care

Posted in Nursing, Uncategorized

How to Organize or Prioritize Patient Care

A common thread on nursing forums, especially among new nurses, is how to organize and prioritize patient care for a shift. No matter what type of setting you work in, this is essential to the successful completion of the daily tasks.

One of the first rules of prioritizing is to expect the unexpected. And the primary unwritten rule is NEVER to say how quiet it is! In expecting the unexpected, you will always have a Plan B in your back pocket and won’t be quite as affected as you would if you were expecting everything to flow according to the schedule.

Most days you will have to deal with something unexpected, if that is only a new admit who needs to take precedence now over the 3 dressing changes you were just getting ready to do.

Time management and organizational skills are essential for nurses and yet they are not often even discussed in nursing curriculum. Time management courses are available through college or university extension courses, adult education programs and online. If you seriously lack organizational or time management skills, you may benefit tremendously from one of theses classes.

At Home
Away from your job setting, use your critical thinking skills to consider the basics of your shift. Try to plan out a typical day. Take a piece of paper and divide it into two hour increments. Pencil in patient meal times, and the hours in which primary ADLs take place on your shift such as AM care or HS care.

Next consider medication schedules. For instance, will you likely have ac or pc medications to give? What about HS meds? When will your patients be most likely to go for tests, therapy or other events? When do most of the MDs make rounds? What time of day do you usually get bogged down with discharges or new admits? What part of visiting hours usually lets you slow down and catch up? Allow for these and now when looking at a specific assignment, pencil these in.

At Work
Arrive early for your shift to get settled and to get a feel for how the previous shift has gone. The tension and chaos or calm and quiet may flow over into at least the beginning of your shift. In learning to expect the unexpected, it’s important to get a feel for the pace at which things are going at any one time. If you need to hit the ground running, you need to be prepared for it, and not arrive running late.

Listen carefully during report or rounds to get a feel for:

how busy everyone is going to be
the general acuity level of the patients today
who might have time to help you out if you get overwhelmed
what treatments, assessments, or procedures may be taking place today that you could learn from if you have a chance

Look over your assignment and begin to plot items on your schedule. Look for

time specific events
patients who may require more of your time for teaching, hand holding, etc.
new patients, diagnoses or treatments you need to look up
things you want to put off until last or hope you don’t have to do
things that can be delegated to an aide or LPN if necessary

Make rounds and quickly assess your patients for any additional information you need to help you set your schedule. Try to get the things you dislike out of the way first. This can include distasteful procedures, dealing with impossible patients, and anything you are uncomfortable with. The longer you put these things off, the more they will weigh you down during your shift. Get them out of the way and move forward. You’ll feel the load lift off your shoulders.

Schedule your meal break and other break times and try to stick to this. Meals and time away from patient care is important to your well being, your morale and your ability to provide quality patient care.

Make sure you leave time for charting at least three times during your shift and chart any PRN meds immediately. Review your schedule every two hours to make sure you’re on track and make adjustments for changes. If you’re getting behind, ask for help early on instead of waiting until near the end of the shift when everyone is pressed for time. Remember to thank those who help you out.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and is the author/owner of TheNursingSite.com

Some No-Brainer Interview Tips

Posted in Nursing, Nursing Jobs, Travel Nursing, Travel Nursing

Some No-Brainer Interview Tips

Whether you are interviewing by phone for a travel nursing assignment, or in person at a local health care facility for a nursing job, there are a few do’s and don’ts for your interview. These may seem like no-brainers to many, but there are a frightening number who must be told and/or reminded of basic social skills.

First of all, turn off your cell phone! If there is the possibility of an emergency during your interview, either postpone the interview or notify anyone who might need you that you will be unavailable for about an hour. Otherwise shut it off. Any calls can be returned when your interview has concluded.

In any social setting it’s just plain rude to interrupt your conversation to take a phone call or respond to a message. Yet, sit and people-watch in any public place for just a few minutes and you will see a multitude of people suddenly ignoring their present company and answering their phones. Sometimes they even wander away and talk for a really rude amount of time. This is simply not acceptable in the workplace. Turn it off and give your interview your undivided attention.

Second dress appropriately. If you’re on the phone this may not matter, but in person it says a lot about you and your professionalism. Even on the phone, however, if you’re uncomfortable, this may come through in your voice or intonations.

In person, the way you dress will tell a lot about who you are, your habits and values. If you look like a slob, this reflects that your work style may be very casual and sloppy as well. If you are well groomed and well dressed you tell the interviewer you take pride in yourself and in your work.

If you will be going to an interview straight from work, make sure that your scrubs or uniform is neat and clean. If you work on a unit where this is not possible, take a change of clothes with you. At the very least warn the interviewer that you will be coming straight from work and won’t have time to change first.

Third check your teeth in the mirror. Take a last look at yourself before you go in to any interview. Do you have food stuck in your teeth from lunch? Were you literally pulling your hair out all day? Do you need a little makeup? Don’t overdo any perfume or scents! Are your hands and fingernails clean? And what about your shoes?

Body language is another important issue to be aware of. Even when speaking on the phone, sit up straight and pay close attention to the conversation. Offer a firm handshake, make eye contact often and smile.

Be prepared for the questions. If you don’t understand any question or don’t know how to answer it, be honest. Ask for some clarification. If you don’t have an answer, make a note and tell them you’ll find out and get back to them. Don’t try to bluff your way through. Take a deep breath and think about your answers before blurting them out.

Have at least a couple of questions prepared to ask the interviewer. Do your homework and know something about the facility. If all of your questions were already answered in the interview, it’s Ok to say something like, “I was going to ask you about your staffing ratios and how you determine acuity, but you’ve already covered that.” It still shows you are interested in this position and this facility. You might also just go back to an issue you want to be very clear on such as whether travel nurses are expected to float.

Never bad mouth any previous or present employer. If you are leaving because you can’t stand the place, that’s your issue. As far as anyone else is concerned you’re looking for new challenges, different opportunities, a change, r other positive note.

Always say thank you for the interview, offer a firm hand shake and again make eye contact. Ask when they will make a decision. Tell them to please let you know either way.

By Kathy Quan RN BSN Kathy is the author of The Everything New Nurse Book and is the owner/author of TheNursingSite.com

Why Should Nurses Vote?

Posted in Nursing, Nursing Jobs, Travel Nursing

Why should nurses vote?

What’s at stake in this election for nurses? There are two vital issues; the economy and health care. In many ways these two issues are intertwined and they both impact nurses immensely.

In a struggling economy, be assured that hospital administrators will be making cuts to maintain some margin of profit or keep losses to a minimum. That means fewer nurses and a shortage of beds for those who need them most. In other health care settings, administrators will face similar financial decisions and will be making cutbacks in staffing as well.

As the economy began to take a turn for the worse several months ago, many non-active nurses returned to the field for their own financial security. This factor helped to temporarily address some of the shortage of nurses which in turn affected opportunities for foreign born nurses as well as travel nurses. With more permanent staff available, the need to help nurses immigrate or to use travel nurses has declined in some areas, and not in others.

Now as the economy worsens, the fear is that hospitals and other healthcare facilities will have to make mild to severe cutbacks. In states where mandatory nurse-to-patient ratios exist, hospitals will be forced to take a closer look at how much they can cut back and still offer quality healthcare in their communities. Mandatory overtime could and probably will become even more of an issue if that proves to be more economical for the facility.

Each of the Presidential candidates has expressed a view of the health care crisis in this country and has developed a comprehensive plan to address the issue. They have each made note of the nurse’s role in the health care system and expressed their level of support of nurses. After careful consideration, the American Nurses Association has endorsed Sen. Barack Obama (D-IL).

Each of the candidate’s plans for economic reform and for health care reform shows a deep concern for the American people in keeping with their own political party views.

The 2004 Presidential election was decided by a little more than 500 votes. This election stands to be a very close one as well. There are 2.9 million nurses in the U.S. and health care is the largest industry in this country. Your vote is very important. Please be sure to exercise your right to VOTE on November 4.

No matter who you vote for, the important issue is that you get out and VOTE on Nov. 4. Many states allow early voting to help those who may have scheduling conflicts on voting day. For nurses, this may be a very useful alternative, especially for those who work 7AM to 7PM and may not get to the polls in time to cast their ballot. Absentee ballots are another alternative, but it may be too late to request one now.

With rights come responsibilities. Make sure you make an informed choice. In many elections across the country, voters will be choosing state and local representatives as well as voting on ballot initiatives. Read your voter information carefully and research the candidates and issues; especially in regard to how they impact nurses and healthcare.

By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and is author/owner of TheNursingSite.com.

Common Errors in Patient Education

Posted in Nursing, Uncategorized

Common Errors in Patient Education

One of the most important aspects of the nurse’s role is to educate patients. To do that effectively, there are a couple of points that nurses (as well as other health care professionals) should be aware of.

One is that health care illiteracy affects over one half of all Americans. Regardless of their ability to read and write, or their level of education, Americans don’t understand the health care system and how it works. They don’t even understand enough most of the time to know that they don’t understand.

The other point is that as a result of this problem, the Institute for Health Care Advancement (IHA)points out that costs are continuing to rise to the point of, “as much as $236 billion in unnecessary health care expenses annually due to the inability of patients to understand what medical providers are communicating to them.”

The IHA has complied a guide for health care professionals and consumers to help eliminate some of these problems. This list is composed of the 10 Most Common Errors Medical Professionals Make When Communicating with Their Patients.

Some of the points in this document include:

Prescription drug instructions are often written at a 10th or 11th grade reading level. Most of the population reads at a 5th grade level.
Communicating with patients using medical or other technical jargon such as “otitis media” or “myocardial infarction” instead of using laypersons’ terms such as “ear ache” or heart attack.”
Telling patients to go read about their condition, treatments or medications on the Internet when this information might be too complex, might disagree with the physician’s course of treatment, or the patient may not have access or know how to search the Internet.
Handing out reading material which is printed in too small a font to be easily read, especially by seniors who represent the largest portion of the population.
Not using simple graphics or other visual aids to enhance the patient’s understanding.
Not recognizing that the patient is nodding or saying “yes” as more of a means to be polite and not necessarily because s/he understands what is being said.

Providers should always ask patients to repeat back to them in their own words what they interpret to be the information or instructions given to them. Tis is the best way for the provider to be sure the patient understands correctly and then to make clarifications as needed.

Not demonstrating cultural awareness and how cultural differences may affect the patient’s ability to comply and to succeed with a treatment or other regimen.

Speaking too quickly and not allowing the patient time to formulate or ask questions.
Not providing the information and instructions in the patient’s first language.
Not taking time to adequately explain the meaning of terms on prescription drug labels. For example, “Take With Food,” is written at a 1st or 2nd grade level, but what does it really mean? Studies have shown that some patients have interpreted this as meaning stuffing the pill into a piece of solid food and swallowing it without taking any liquid. This could have varying degrees of problems depending upon the drug and even the size of the pill.

Other problems patients typically have difficulty with include how and when to make follow up appointments, where to go for tests, and even which medications should be refilled and continued versus a course of antibiotics.

Even the most highly educated patients may not understand medical information. Nurses, as the primary health educators, need to understand how to educate patients as well as how to evaluate the patient’s understanding before they leave.

Resources:
IHA (http://iha4health.org)
Helen Osborne M.Ed.,OTR/L, Health Literacy Consulting (http://healthliteracy.com)
By Kathy Quan RN BSN. Kathy is the author of The Everything New Nurse Book and the author/owner of TheNursingSite.com

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