Monthly Archive for April, 2010

More Job Opportunities Possible in Nursing Homes

Published
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on April 28, 2010
in Nursing Career
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i_nurse_geriatrics_2As I have mentioned in prior blogs, the good thing about the recession for hospitals and other elements of the health care industry, is that it has temporarily eased the nursing shortage. This is primarily due to the influx of previously retired nurses back into the health care workforce.

A Vanderbilt University Medical Center study estimates that approximately 243,000 nurses joined or rejoined the health care workforce in 2007-2008. Nursing homes, however, are not benefiting nearly as much from the dramatic increase in the supply of available nurses. The study showed that nurses working in nursing homes and other long term and skilled care facilities, dropped by 50,000 in 2008.

This is partly because when nurses rejoin the workforce, they are much more likely to go back to the departments or types of facilities they previously worked in. For most RN’s, this means hospitals and other acute care facilities. These are also the facilities with more competitive salaries and benefits packages.

For new grads and other less experienced nurses seeking work, this presents a golden job search opportunity. Working as a nurse in a long term care facility may not exactly top many new grads’ career “wish list” (if we’re being honest, realistic and certainly with nothing against these facilities or their dedicated staff). But there are many excellent reasons to do some reshuffling of your priorities and focus on want ads from facilities that are hurting for nurses the most right now.

1. The Economy: A tough job market requires an open mind and the willingness to compromise and be flexible.

2. Learning Experience: Working as a nurse in a long term care facility is a great way to sharpen your time management skills while caring for many more patients at once than you would in a hospital or acute setting.

3. Compassion and Communication: There are many rewards to be uncovered working with what should be our most respected age demographic. In a nursing home, you learn to listen to their needs, remember the importance of basic personal care before getting lost in the machines and technology of hospitals, and brush up on your therapeutic communication skills in the process.

Research these types of facilities in your areas (and even beyond) and reach out to the nursing supervisor or hiring manager.  Most long term care facilities are usually open to hearing from interested nurses, even if the best you can find right now is a part time position. The best you can do is pick up the phone and contact the human resources manager at a facility in your area.

Day Shift: Pros and Cons

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on April 21, 2010
in Nursing Career
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i_nurse_male2You may recall how, in a prior blog I compared and contrasted the pros and cons of working the nursing night shift. While most of my experience as an RN has been working the night shift, I have worked enough day, afternoon and evening hours to have an equally unbiased and hopefully informative viewpoint about the pros and cons of the day shift.

As a new nursing school grad, regardless of the shift you are hired for, much of your orientation and training hours will take place during the day shift. This is to provide you with the most access possible to your nurse manager, colleagues, your floor and other departments and learn policies and procedures during the light of day. If you will be ultimately transitioning to the night shift, your day shift orientation will help you “walk in the shoes” of the nurses you will be giving report to in the morning after your night shift.

Here are some pros and cons of working the day shift.

Day Shift: Pros

  • Getting to Know You: The day shift gives you the opportunity to work alongside your nurse manager and your more experienced colleagues – all excellent sources of information. As a new grad you are, of course, required to stand on your own two feet and be an independently minded, critical thinking, care provider. However, during the day, when the hospital is at its busiest, you have more resources at arm’s length when you need them.
  • Crash Course: No matter what department you work in, the day shift at a hospital is always full of surprises, action and quite often, unpredictability. For those who love a fast-paced work environment, where the hours fly by and every moment is a new learning experience, the day shift is ideal.
  • Teamwork: Working during the day, tests your ability to work in harmony with multiple other hospital departments – from lab technicians drawing blood, to the constant parade of doctors and specialists seeing (and writing new orders for) your patients.

Day Shift: Cons

  • See Pros: Seriously, review the pros above. If any of these work attributes do not sound appealing to you, consider a nighttime position.
  • Banks Close at 5 pm: Well actually they are staying open later these days, but you get my point. While you are working the day shift, so is the rest of the world. However, as I mentioned in my previous “night shift” blog, 12 hour shifts, 7am-7pm in this case, require you to work fewer days per week.

Whether you choose to work during the day or into the wee hours of the morning, remember that, as a nurse you have the opportunity to work a rewarding job in a recession proof career.

Florida Nursing: Demand Meets Paradise

Published
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on April 16, 2010
in Nurse Patient Care and Nursing Career
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i_nurse_geriatricsOf the estimated 78 million baby boomers “coming of age” presently and in the near future, many of them will inevitably migrate to Florida. On the television show Seinfeld, the Costanza’s and Seinfeld’s made their way to a Floridian condominium paradise and even Kramer enjoyed the retired life in the Sunshine state at one point. My parents ended up there and for a time after nursing school, I was a bonafide Floridian.

And as a nurse and a genuine Floridian (I also get credit for regular childhood trips there to visit grandparents), I got to see for myself the vital role played by nurses in Florida in caring for the patient population consisting of primarily retired folks. In a nutshell, Florida has more elderly patients who have a great number and complexity of acute medical problems. I recall diagnoses on the charts of broken hips, infections, heart disease, stroke and respiratory illnesses like pneumonia, to name a few.

I personally wonder what effect the state’s infamous chronic abundant air conditioning has on some of this illness. How healthy can the sudden and dramatic temperature changes (indoor – frigid, outdoors – sweltering) be for people who have delayed body temperature regulation anyway due to the biology of aging?

Regardless of the reason, there is a growing influx of Floridians who need care and, as a result, the nursing shortage is hitting this state hard, and new nurses are desperately needed there. The shortage is of particular benefit to graduates of Florida nursing schools since they already have roots in the state.

A 2008 report from the Florida Center for Nursing has also shown how, if the estimated 13,494 nurse vacancies were to be filled, the state would see an increase of more than $700 million in annual revenue. This is because nurses, a.k.a. employees, are residents who spend money on stuff including paying taxes.

In addition to revenue, filling the nurse vacancies improves patient outcomes. In general, when there are enough nurses to care for the patients, the sunshine state just becomes that much sunnier for residents and staff alike.

Modern Day Ethics Issues in Nursing

Published
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on April 13, 2010
in Nursing Career
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i_nurse_female_12As a nurse you will undoubtedly encounter ethics-based decisions and sometimes dilemmas as you care for patients. In nursing school you will learn the legalities of such issues as Do-Not-Resuscitate (DNR) orders, domestic and family situations, and other scenarios where you will act in accordance with the law and hospital practice standards.

But at the same time, because you are dealing with human beings in sometimes emotionally charged situations, your own opinions and point of view on where the line of ethics is drawn, will be ever present.

I have always considered this a gift and a responsibility rather than as a professional burden. The issue of professional and personal ethics is a constant reminder that you are a critically thinking, skilled and educated professional along with a feeling, thinking and sometimes conflicted human being. This is one of the reasons why nursing is such a truly special profession – the multifaceted connection you form with patients and their families.

With such a complex issue as ethics comes the line that is invariably drawn in each situation and the ongoing debates surrounding it. Newly minted aspects of health care are contributing to that debate. In the technology realm, there is the issue of patient records and lots of other private patient information going electronic. This is, of course, to create a more efficient work flow for health care providers, reduce medical errors from incorrect chart info and help hospitals cut costs. We can only wait and see if such large digital databases of private information have any patient confidentiality consequences.

Some health systems have also started doing genetic testing studies in an attempt to “predict” a person’s risks for health conditions such as diabetes, heart disease and even Alzheimer’s disease. The idea is that if patients know what they are at risk for, they can make targeted, appropriate changes to their lifestyle.

While this may be the ultimate form of preventative medicine, it does raise an ethics question.  If this type of information was transmitted to insurance companies, would premiums be affected by the potential for costly medical conditions that have not even occurred yet? Nurses, nursing new graduates and nurses will face issues like these and others as health care technology progresses and the boundaries of ethics change with them.

The Nursing School ‘App’?

Published
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on April 8, 2010
in Nursing Education
. 1 Comment

i_student_1There are days when it seems like I just graduated from nursing school at the University of Rhode Island yesterday, and there are days when it seems like another lifetime (for the record it was 1995). When I hear about nursing students and college students in general researching their papers online, tweeting about reading assignments and clinical rotations and downloading assignments from servers, it seems like another lifetime.

Far from “WebMD” or “Wikipedia” my classmates and I were left to sequester ourselves in the dusty basement archives in the library of our hundred year old school to research papers and then type them on our electronic typewriters with a bottle of whiteout never far beyond our reach.

The following bit of technology news gave me the same sinking realization that maybe my driver’s license is telling the truth and I’m not twenty-one anymore. U.S. Education Secretary Arne Duncan is encouraging schools and colleges to transmit course content, reading materials and assignments through students’ cell phones. If iPhone users have been looking for a “nursing school app,” this may be the closest thing to one.

The Ball State University nursing program in Muncie, IN has heeded the education secretary’s call. Nursing students there have now replaced two-foot high stacks of reading material with electronic nursing manuals, accessible through the click of a button on their web-enabled cell phones. I really wish there was something like this around when I was straining axial nerves in my shoulder lugging heavy nursing textbooks around campus!

Now, texting has apparently replaced textbooks. At Ball State, the students pay $250 to gain access to the course text messages for the duration of their undergraduate studies. This is a pretty reasonable fee considering the amount of textbooks that nursing students are required to have access to – from lab value references and medical dictionaries to diagnostic tools.

The theory behind this new technological trend at universities such as Ball State is that since college students spend so much time on their cell phones sending text messages anyway - they might as well include some actual studying in the process.