Archive for the 'Nursing Education' Category

Nurse’s Role in Prescriptions

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on March 9, 2010
in Nursing Education
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nursing prescriptionsI remember learning as a nursing student, that if a physician makes an error in prescribing a medication (name, dosage… handwriting) and a nurse administers that medication to the patient, the nurse is held responsible for the error. The math just did not add up.  Physicians have to go to school for at least six years before they can prescribe meds and their total education is closer to twelve.

My BSN program, when all was said in done came out to about four and a half years (with required summer courses). A BSN program typically includes a massive amount of pharmacology and medication training as reflected by all the medication questions on the NCLEX licensing exam. But, I still was left wondering how nurses are supposed to be able to spot a medication error unless we know everything that the prescribing doctor knows about meds.

I soon learned, once on the floor, that the best ways to avoid a problem are to have a current drug reference on hand and to always, always, always ask the doctor if you have any questions or doubts.  As a night shift nurse this took a bit of courage to wake up a physician at three in the morning – but it sure beats being named in a malpractice lawsuit and even more importantly risking a human life.

As reported by the May 5th Oregonian, there is apparently some controversy brewing in Oregon, where the state legislature is debating whether psychologists, who lack the same amount of training as physicians, should be allowed to prescribe “the most dangerous and lethal pharmaceuticals” to patients. The bill does include certain restrictions regarding psychotropic medications (ex. antidepressants, anti-psychotics).

I should note that physicians are not the only one authorized to prescribe medications. This privilege also is extended to doctors of osteopathy, nurse practitioners and physician assistants. Psychologists in America, at this point, do not have universal prescribing privileges – only some are given permission to dole out the meds.

In the meantime, Oregon House Bill 2702, according to recent reporting, is currently stalled in the Oregon house pending review of a medical task force later this year.

More Legislative Efforts to Graduate More Nurses

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admin
on January 19, 2010
in Nursing Education
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graduate_nurseMy major concerns regarding instructors during nursing school were more about which ones I would be assigned and if I would “survive” the semester, than about whether there were enough teachers to go around.

In all seriousness, nursing is a course of study that requires a great deal of instructor attention and close supervision, especially in the clinical phase when students deal with their first actual patients. In fact, the recommended instructor to student ratio in school isn’t too far off from the recommended nurse to patient ration in the real world.

Accredited nursing programs across the country are struggling to fill open instructor slots so that qualified applicants with the desire to enter this recession proof field can get started. In 2006-7, an estimated 99,000 qualified RN nursing program applicants (40 percent of all applications submitted) were turned away, due to a lack of instructors. Fortunately, state and federal lawmakers are also jumping in and lending a helping hand to nursing schools.

In California, one of the states with the fewest nurses per capita, Senator Barbara Boxer has introduced legislation to establish mandatory nurse-to-patient ratios. The new law would also award stipends to nursing students who commit to working at clinics and other facilities that serve patient populations most in need.

California has also allocated $60 million in grant money for programs that will fund specialty training at community colleges while training nursing instructors. The “golden state” needs to educate about 206,000 more nurses and health care workers by 2014 to keep up with population demands.

At the federal level, the pieces of President Obama’s 2010 budget proposal that address the nursing shortage and corresponding nursing faculty shortage, are being praised by The National League for Nursing. The specific legislation affected is Title VIII and VII. The proposed federal funding allots $125 million for nursing education loan repayment. It also grants the nurse faculty loan program a 40 percent increase in funding.

*National League for Nursing; www.nln.org

The LPN to RN Transition

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on January 5, 2010
in Nursing Education
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registered nurse degreeThis is an ideal time for LPN’s considering making the transition to RN, to make that leap. A typical LPN to RN transition program is one year long, however it varies based on the program and the intensity of the schedule the student elects to follow. There are both advantages and disadvantages for the LPN nursing student as compared to the newbie RN in training. Fortunately, the pros outweigh the cons.

LPN’s have already been out the in field, working side by side with RN’s in hospitals and nursing home settings.  They understand the nurse’s place on the patient care team and have seen for themselves all the challenges and stress that nurses face. This undoubtedly helps to prevent the “RN burnout” that many new grad RN’s face during their first year.

LPN’s making the transition to RN’s also have working knowledge of patient care challenges. LPN’s who have worked in nursing homes have critical experience managing large patient loads and working with patients suffering from memory disorders such as Alzheimer’s. This is a group of patients that can require a period of adjustment and learning for the new RN.

The challenges faced by the transitioning LPN are related to their change of hat. Because of their role assisting RN’s with their duties, LPN’s frequently get the feeling that they know what it takes to become an RN because they have actually done it. Yes, they may have learned important clinical and patient care skills, but what LPN’s are missing that they will gain in their RN training, is the critical thinking and academic knowledge base.

As LPN’s they may be used to turning to the RN or the MD for help with critical patient care decisions. RN’s are expected to utilize their knowledge base and critical thinking skills to be instrumental in key decisions, even recognizing when a doctor has unintentionally made an error on a medication order. This requires a period of adjustment for the LPN nursing student.

However, the fact remains that LPN’s have a proven edge over their “newbie” nursing student counterparts in RN training programs. As the expression goes – they have been there and done that.