Poole is a World War II veteran who crossed both oceans in her five years of service. In 1942 at the age of 24, she enlisted as a nurse. The native of Colby, KS already had two brothers serving, one in the Signal Corps and the other in the Navy.
“They needed nurses, so I enlisted,” she said. (more…)
Registered nurses are among the most respected and hardest working medical professionals. With a variety of degree types and multiple opportunities for advanced education, the RN can see the world as their oyster—with their career as the pearl. As varied as the nurses are themselves, so are the RN jobs available in the workforce. From direct patient care in an Intensive Care Unit to an administrator in a government health organization, as a legal nurse consultant or a case manager, nurses may use their education to improve health, touch lives, and better communities at home and abroad.RN degrees range from Associate to Doctorate, though most RN’s practice with either an Associate or Bachelor Degree. With an Associate Degree in Nursing (ADN), RN’s typically spend two years in training and gain the fundamental knowledge necessary to provide excellent patient care. Beyond an ADN, is the Bachelor of Science in Nursing (BSN) which takes an additional two years to complete. A BSN graduate will be more prepared for administrative positions by completing a program that further emphasizes leadership, budget management and delegation.
After completing class time and the Board of Nursing exam for the state of residence, RN’s may begin searching for a job. (more…)
Effective and clear communication is critical during the countless interactions that occur between health care professionals on a daily basis. The staff should know how to communicate effectively with one another so that appropriate information is shared in a timely manner. When effective communication does not occur, the patient’s care is compromised.
The Joint Commission, which accredits and certifies more than 19,000 health care organizations and programs in the U.S., states that communication problems have long been cited as a root cause in the majority of the cases studied. The Joint Commission’s Sentinel Event Database reports that hierarchy differences, conflicting roles and power struggles can all lead to communication breakdowns which ultimately compromise patient safety and the quality of care.
Communication, at its most basic level, is the exchange of information between people, groups or entities. (more…)
A couple of weeks ago, I spoke with a friend who works for a travel nursing company in southern California. He got into this field because he felt that the nursing field was going to be a sure bet in this faltering economy. Now he’s nervous and not so sure about the security of his job.
Many hospitals in southern California have apparently cut way back on their need for travel nurses at the present time. This is especially true for general med/surg nurses. Many specialty areas such as ICU, NICU, telemetry, etc., are still looking to fill positions, but too many of the applicants only want med/surg and are still demanding high salaries. They aren’t finding too many options here.
With the current economic downturn, nursing will remain more recession proof than most careers, but nurses have to be realistic in their goals today. Hospitals are looking at every possible way to cut costs. Paying high salaries for med/surg nurses is one place they have cut back, whereas they may still be willing to pay for specialty nurses they cannot recruit from their own local community.
In many communities, nurses who had left nursing to raise families or to retire early, have returned to work. Retirement funds such as 401Ks have been lost or significantly impacted, spouses may have lost jobs, and extended family members may be in dire need of financial assistance. For a nurse returning to work after a long hiatus, med/surg is probably the best place to start out and rebuild confidence and skills, so these jobs are scarcer.
One factor that is somewhat beyond the realm of economics is affecting hospitals. This has been a very slow flu season in most of the country. The flu shot for 2008-9 seems to have been effective, and cases are more widespread this year.
In recent days however, the news seems to indicate that this may change. There has been a mutation in the flu specimens of late that appear to be resistant to the Tamiflu antiviral medication. This may result in more complications as patients find that their symptoms are not weakened by this medication.
In a bad flu season, hospitals can become inundated with the elderly and chronically ill as well as the very young. In a slow flu season, censuses remain low and the need for nurses diminishes.
With few elective procedures being performed these days, hospital censuses are also lower as well. On the other hand, as more people put off health care for lack of insurance or funds to pay for medications or rising co-pays, patients who do need hospitalization are generally sicker and need more specialized care.
The need for nurses continues to vary across the country. Some areas will continue to have a strong demand while others may diminish somewhat. Travel nurses will continue to find work, but they may need to change their expectations about locale, perks and salaries. Those who have or attain more specialized experience and skills will have a better chance of being in demand.
By Kathy Quan RN BSN. Kathy is the author of four books including The Everything New Nurse Book and the recently published 150 Tips and Tricks for New Nurses. She is the author/owner of TheNursingSite.com.
© 2009 by UltimateNurse.com. All Rights Reserved.
The nursing shortage has always been a cyclic issue. For instance, consider the fact that just about 25 years ago there were actually too many nurses and it was quit difficult to find a job. Many of those who became nurses then are now in their 50’s and seriously thinking about retiring today, but for now the economy has slowed them down.
Nursing is one of the most physically and emotionally challenging professions and consequently many nurses are quite ready to retire in their 50’s. When the economy really began to sour last fall, and retirement plans such as 401Ks took a nose dive, many nurses decided to delay their retirement.
In addition, many nurses found themselves returning to the profession because their spouses had been laid off. As a result of these two factors coupled with lower hospital censuses, the shortage of nurses has actually begun to shrink.
This may be a fix to the nursing shortage right now, but it’s quite temporary. When the economy recovers, there may be an even larger mass exodus of nurses than previously expected.
Take for example the fact that the average age of nurses in California is 47, and 45% of those nurses are actually over the age of 50. Potentially 45% of the nurses in California could be retiring very soon.
California is near the bottom of the number of nurses per capita at 647 RNs for every 100,000 persons. The national number is 825 per 100,000. Only Utah, Arizona, Nevada, and New Mexico rank lower than California. California is also one of the states with a mandatory nurse-to-patient ratio. Arizona is considering this type of legislation as well.
The number of new nurses cannot keep up with the number leaving the profession, even with the slower pace of retirement. It’s certainly not for lack of potential students as many thousands are turned away each year because of the lack of nurse educators. Schools just cannot compete with the salaries nurses can earn working in a hospital versus teaching.
Some hospital groups have invested in nursing programs to help them expand and accept more students in an effort to forestall the shortage which will be presented by a mass exodus of nurses. This has helped, but it’s going to take a lot more to make a dent in the potential crisis.
As health care reform efforts make progress, the potential for an additional 46 million currently uninsured Americans to have improved access to health care will also make a dramatic impact on the nursing shortage as demands for care increase.
So for those nurses who are having some difficulty finding jobs right now, don’t get too discouraged. As the economy begins to recover, there will soon be no shortage of jobs for nurses.
Opportunities for travel nurses should begin to pick up again and those nurses who have a large repertoire of skills and experiences will be able to command offers like never before.
Nurses should take advantage of these times and expand their knowledge base and skills set to prepare for the future.
©2009 by UltimateNurse.com All Rights Reserved. By Kathy Quan RN BSN. Kathy is the author of four books including The Everything New Nurse Book. She is also the owner/author of TheNursingSite.com.
The state of the nursing profession currently reflects the state of the economy. With unemployment hitting record levels, many non-active nurses have returned to the profession and others have taken on more shifts in order to meet the needs of their families.
Hospitals have been hit hard in the pocketbook by the fact that many patients are putting off elective procedures and anything that isn’t of an urgent nature. It has been a slow flu season and therefore the number of children, elderly and chronically ill have not required hospitalization for complications of flu.
Jobs are in Middle America
The number of nurses available for travel assignments has grown and therefore with simple economics of supply and demand, those who are more flexible and have more experience are getting the premier travel assignments. The east and west coasts have been more affected by the economic crisis than middle America and consequently the opportunities in these regions have been affected as well. The jobs now are available in the middle of the country, not Florida and California.
The good news is that the economy will turn around. How soon is being debated. Some predict a few months and others at least a couple of years.
The other factor is that in the next few months, we will see more nurses taking time off from taking on extra shifts or returning to work and being overworked and burned out. This will open up more opportunities.
Gain Experience and Improve Skills
For nurses who are employed or have current travel assignments, make the most of what’s available to you. Extend travel assignments as possible and look for opportunities to polish skills or to gain more experience in specialty areas. Continue your education.
Some travel nursing companies are looking for a minimum of 2 years experience in a specialty area, and making changes right now might even be a negative, but think further into the future and get the experience you want and need. The one thing that is happening across the board for nurses looking for permanent or travel opportunities, is that nurses with very little experience beyond basic med surg are having a harder time finding jobs.
As the economy improves, all those patients who have delayed procedures and care are going to need to have it done and the system is going to be overwhelmed. The nursing shortage has not been solved. There is still going to be a shortage of nearly one million nurses by 2020. Nurses who have positioned themselves to meet the challenges of the next couple of decades will be way out in front.
Post Acute Care Will Grow
Post acute care, especially home health care, is expected to be the fastest growing branch of the nursing profession over the next few years according to the Bureau of Labor Statistics. Nurses who have excellent skills in a wide variety of patient care will be able to make this transition more easily.
For older nurses who cannot stand for eight to twelve hours a day, home health care may offer a new career path for many years past what they could serve in an acute setting. The key to survival in home health is being confident in your skills, having strong critical thinking skills and being able to work autonomously. Documentation skills are a very important issue in home health care as well.
© 2009 by UltimateNurse.com All Rights Reserved.
By Kathy Quan RN BSN. Kathy is the author of four books including The Everything New Nurse Book and author/owner of TheNursingSite.com.
Nurses can’t find jobs either? What’s the truth behind this issue?
One thing that has happened in the past few months as 401Ks and other retirement funds have practically vanished, is that many nurses, who have not been actively employed for possibly even years, have returned to work.
With children in college, spouses losing jobs, and retirement funds evaporating, yes, many inactive or “retired” nurses have returned to the workforce. This will impact the nursing shortage to some extent, but will not solve it.
But, what else is really happening?
Nurses are being threatened and frightened into working mandatory overtime that states have regulated or outlawed. Nurses are being forced to take on nurse-to-patient ratios that are totally unsafe because administrators can hold their jobs over their heads. Working conditions and safe, quality, care are at risk!
Some states have passed nurse-to-patient ratio laws and have strong organized nursing unions enforcing them. But in far too many places, nurses have been afraid of such laws and hate the unions. Nurses will begin to see that hospital administrators, faced with huge reimbursement problems, are going to cut the nursing staff first and foremost because they have new found power to control the nurses.
Fearing the loss of jobs, benefits and retirement funds, nurses will buck up and work under the worst of circumstances once again. Out of a false sense loyalty to the patients they serve, nurses will martyr themselves and continue to try to provide the best care they can.
But what about the quality of patient care and safety issues, never mind putting their own license on the line because they are overworked and burned out? Then where does this loyalty to the patients they serve stand?!
This economic downturn is going to prove to be one of the biggest issues nurses have had to deal with in many years! It already is.
Nurses need to remain strong and stand up for the patients. There is data available to support the theories that quality of care diminishes, and people die when nurses are not supported.
Medicare, for one, has instituted many important reimbursement factors and continues to collect and analyze data regarding the quality of patient care. There are numerous “do not pay” rules that affect reimbursement for hospitals such as decubs, UTIs from catheters, and blood clots post op.
Medicare also maintains a database of hospital comparison based on specific criteria and outcomes which illustrate the quality of care (or lack of) provided in hospitals all across the U.S. This too is used by Medicare to determine reimbursement rates, and it is hoped that consumers will seek out this data and avoid these institutions when they have a choice in health care.
Nurses have the power to make a difference not only in the lives of the patients they individually care for, but also in the overall quality and safety in care they collectively provide. This power cannot be relinquished for fear of losing jobs in a bad economy. Nurses have a voice and cannot go silent!!
Institutions that value patients and continue to strive to provide quality care to patients continue to have nursing vacancies because there continues to be a shortage of nurses. Those institutions who don’t value quality patient care, probably don’t have many vacancies because they have cut staff to the bare bones and have a hiring freeze.
Nurses need to stand strong and work together to continue to demand better working conditions and not lose ground that has been hard fought to gain in the past 30 years by falling prey to those who value the dollar more than lives. There is a lot more to be lost than jobs.
By Kathy Quan RN BSN ©2009 by Ultimate Nurse.com ALL RIGHTS RESERVED
Kathy is the owner/author of TheNursingSite.com and the author of four books including The Everything New Nurse Book.
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
© 2009 by UltimateNurse.com All Rights Reserved.
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
© 2008 by UltimateNurse.com. All Rights Reserved.
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
©2008 by Ultimate Nurse.com All Rights Reserved