My Strong Medicine

The adventures of a male nurse navigating through life, staying fit, surviving the journey.

Archive for December, 2011

ANA & Medicare participation terms | RNs & APRNs

Posted by Sean on December 29, 2011

The ANA also expressed support for the following CMS proposals that directly affect nursing practice and patient care for the roughly 60% of U.S. RNs who work in hospitals:

• Allowing the nursing care plan to be part of the interdisciplinary care plan.

• Expanding the use of standing orders and protocols for nurses to give medications.

• Permitting patients to take their own medications under certain circumstances.

• Deleting the requirement for verbal orders to be signed within 48 hours.

• Allowing flexibility for infection control programs, which nurses often lead.

To see the current CMS Conditions of Participation for hospitals, visit http://go.cms.gov/uKSLVy.

via ANA supports changes to Medicare participation terms | National Nursing News.

It’s a slow, long hard battle, but it seems to  be happening one piece at a time. Read the entire post over at National Nursing News.

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Too Intensive Care | Survey Says?

Posted by Sean on December 29, 2011

Care for the critically ill may go too far for nearly a quarter of the patients in intensive care units, according to the physicians and nurses who care for them.

Clinicians felt they administered inappropriate care for 23% of patients treated in a single day across a subset of 69 ICUs in which patient data could be linked to clinician questionnaires, Ruth D. Piers, MD, of Ghent University Hospital in Ghent, Belgium, and colleagues found.

Among the full complement of survey respondents, 25% of 1,218 ICU nurses and 32% of 407 ICU physicians said they delivered inappropriate care to at least one of their patients on the day of the survey.

The most common reason cited — by 65% of respondents — was care disproportionate to the patient’s situation, nearly always “too much care,” the group reported in the Dec. 28 issue of the Journal of the American Medical Association.

“Clinicians in ICUs who perceive the care they provide as inappropriate experience moral distress and are at risk for burnout,” they wrote. “This situation may jeopardize patient quality of care and increase staff turnover.”

While concerning, the study offered only a “hazy” picture of why and what can or should be done about it, cautioned an accompanying editorial by Scott D. Halpern, MD, PhD, of the University of Pennsylvania in Philadelphia.

Clinician opinion hasn’t previously been considered relevant in determining whether the care delivered is the care that should be delivered, he noted.

And the validity of this subjective endpoint isn’t clear, Halpern added.

via Medical News: ICU Care May Be Too Intensive, Survey Finds – in Critical Care, General Critical Care from MedPage Today.

OK, so it’s an observational survey from a very small sample size (less than 100 ICU units and less than 500 ICU patients), but it definitely gets your attention. I like these type of ‘studies’ (if that’s what you want to call them), because it’s not really giving any valid empirical evidence for practice change, but is could be the preamble to something bigger or better.

I’m pretty sure there are plenty of ICU nurses out there that would have some great input regarding ‘too intensive’ care. End of life care seems to be blurring the lines between life-saving, life-sustaining, and death-prolonging these days.

What do you think? Follow the link and read the full article.

Posted in health, opinion | Tagged: , , | 1 Comment »

Merry Christmas everyone

Posted by Sean on December 25, 2011

Instagram

I hope your day is full of smiles. Thanks for hanging out with me here on my lil’ ole’ blog.

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The sixth (sick) sense

Posted by Sean on December 24, 2011

Nurses do indeed have a sixth sense. No, I didn’t misspell “sick” sense. I mean, we have an instinct that civilians don’t have.

The nursing “sixth sense” is that moment when your gut gets those “butterflies,” or when A plus B does not equal C.

It’s a part of that ever-important skillset of critical thinking, but it’s also a separate entity altogether. Maybe you can call it a form of ESP:

ESP is also sometimes casually referred to as a sixth sense, gut instinct or hunch, which are historical English idioms. The term implies acquisition of information by means external to the basic limiting assumptions of science, such as that organisms can only receive information from the past to the present.

So. ESP. It’s one of those skills that seasoned nurses just “have.” I’m not sure if it’s something we witness, repeat, learn, see, or simply acquire through experience. Maybe it’s just that tried and true “learn as you go” skill? Honestly, I really don’t know how it’s acquired, I just know it exists.

In fact, I’m more sure than ever after this past semester of classes. This “instinct” was referenced several times during my clinical rotation and during a couple lectures in the nurse practitioner program I’m attending.

The question was posed, “Does the patient look sick?”

……. follow the link to read the rest:

via Nurses and their sixth sense | Scrubs – The Leading Lifestyle Nursing Magazine Featuring Inspirational and Informational Nursing Articles.

A recent post from over at Scrubs Magazine. Any thoughts???

Posted in health | 3 Comments »

Christmas Eve in the Hospital…

Posted by Sean on December 24, 2011

What is it like in a hospital on Christmas Eve? Find out in this very special Christmas holiday edition of Happy’s Xtranormal Theatre titled Twas the Night Before Christmas in the Hospital.

via Twas the Night Before Christmas in the Hospital (Xtranormal Education!).

A big thanks to Happy the Hospitalist for this one. Merry Christmas!

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Thousands of California nurses stage a one-day strike

Posted by Sean on December 23, 2011

Robert Galbraith / Reuters

Nurses participate in a one day strike at a hospital in Burlingame, Calif. on December 22, 2011. The strike affects 2,000 RNs at Long Beach Memorial Medical Center and Miller Children’s Hospital in Long Beach, and 4,000 RNs who work at nine Bay Area facilities that are part of the Sutter Health Corporation. The nurses are protesting what they call unsafe nurse-to-patient staffing ratios and increases in their health care premiums.

Thousands of California nurses stage a one-day strike

The National Nurses United website reports – Voicing concern over the erosion of quality of care and cuts to patient protections, nurses are on a one-day strike today at California’s second largest private hospital and one of its most profitable corporate hospital chains.

RNs have been at odds with hospital management for months over assuring there is safe RN-to-patient staffing at all times, and over the hospital’s refusal to implement safe patient lift policies to prevent accidents to patients and injuries to nurses, despite enactment of a state law requiring such policy.

Long Beach nurses will also protest hospital demands for sweeping increases in healthcare premiums for nurses. The health care takeaway the hospital is pushing would cost RNs nearly $3,000 more out of pocket in premium costs, even though the hospital’s costs for nurses’ health coverage have not risen. Read more…

via PhotoBlog – Thousands of California nurses stage a one-day strike.

I hope their voices get heard.

 

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Becoming a nurse…

Posted by Sean on December 22, 2011

This is an awesome infograph that describes the numerous pathways one must follow to become a nurse and practice as an RN (and advanced practice nurse). A thank you to Nerdy Nurse for sharing this one.

If you’ve decided you want to be a nurse, or you want to further your nursing education, the infographic below does a great job of displaying the paths one can take in pursuit of their nursing dreams.

via So You Want to Be a Nurse? Pathways In Nursing [Infographic] | The Nerdy Nurse.

Brought to you by Nursing License Map and Nursing@Georgetown.

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The (extreme) endurance exerciser beware…

Posted by Sean on December 22, 2011

“Yet another study on endurance athletes suggests that exercise, like everything else in life, has an upper limit.”

Here goes, buckle up.

The study titled, Exercise-induced right ventricular dysfunction and structural remodeling in endurance athletes was published last week in the European Heart Journal.

Researchers from Belgium and Australia enrolled 40 long-term endurance athletes in a study looking at heart function after an endurance race. All subjects were long-term exercisers and were accomplished athletes with above average fitness. They were elite.

By measuring cardiac enzymes (heart injury) and taking ultrasounds (directly seeing heart function) immediately after 4 different length races (marathon through ‘ultra-triathlon’), researchers were able to measure the acute effects of extreme exercise on the heart. MRI scans performed a week later assessed for cardiac scar tissue. (The presence of scar in heart muscle portends trouble because it disrupts electrical signals.)

The main findings:

Compared to pre-race measures, right ventricular (RV) function diminished post-race, whereas LV function remained normal.

Blood levels of cardiac enzymes increased post race and these rises correlated with the amount of RV impairment.

The degree to which RV function decreased correlated with increasing race length and an athletes’ VO2 max.

12% of athletes had scar detected on MRI scans at 1 week post-race. Those with scar reported greater cumulative exposure to exercise and had more RV abnormalities post race.

via CW: More bad news for the (extreme) endurance exerciser.

Balance is the key here. Follow the link to read all of Dr. John’s synopsis.

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Google Zeitgeist 2011: Year In Review

Posted by Sean on December 21, 2011

Zeitgeist 2011: Year In Review – YouTube.

This is always a time for reflection. H0w was your year?

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Evernote Clearly….

Posted by Sean on December 21, 2011

Evernote Clearly Arrives on Firefox

December 21, 2011 | Posted by Andrew Sinkov in Product updates

Today, we have some great news. Evernote Clearly, our browser extension that creates a beautiful online reading experience for blogs and articles, is now available for Firefox.

Install Evernote Clearly now »

How it works

When you come to a site that you’d like to read, click the Clearly lamp icon in your browser bar. The page is transformed—all distractions are removed, leaving only the content you want to read. Then, once you’re done, click on Clearly again and you’re back on the regular article.

Imagine getting through an article without clicking on a bunch of links before reaching the end. Now you can, with Clearly.

Save it to Evernote
If you don’t have time to finish the page you’re reading, click on the Evernote icon in the Clearly sidebar to save it into Evernote. In Preferences, you can also set a tag that will be associated with the pages you clip.

Multi-page clips
If you click Clearly on an article that’s broken up across multiple pages, Clearly will put everything into a single, long page.

Themes
Clearly arrives with three attractive built-in themes: Newsprint, Notable and Nightowl. If you’re a fan of customization, you can make your own by going into the Preferences.

Enjoy!

By removing distractions, Clearly makes reading online truly pleasurable. Enjoy.

Gonna give this a go…

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