Posted by Sean on January 28, 2012
Sometimes it’s very hard to teach an old dog a new trick.
Today I was told by a physician that NPs are simply hired to do all the “scut-work” that physicians don’t want or like to do. In the physician’s words, “You guys do all the crap/garbage stuff we don’t like or have time for. Is that what you really want to do?”
Follow the link and read the whole post. What do you think?
Posted in health, opinion | Tagged: health care, nurse practitioner, nursing school | 4 Comments »
Posted by Sean on January 12, 2012
Once again, this was a weak study design. But, it sure does raise some eyebrows doesn’t it?
I think having the experience is paramount, but does the experienced surgeon grow with the changing face of medicine? Experience can be a tricky thing.
Previous studies have shown doctors reach their peak performance levels after about 10 years of experience in their specialty. Few studies have looked at the association between experience and performance in an objective manner. The intent of this study was to model the associations between experience and outcomes among surgeons performing thyroid procedures.
Read the entire story here: via Medical News: Older Surgeons May Not Be Better Surgeons – in Surgery, General Surgery from MedPage Today.
Posted in health, opinion | Tagged: surgery | Leave a Comment »
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.
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: end of life, ICU, nurses | 1 Comment »
Posted by Sean on December 15, 2011
It seems there is a possible and probably Nursing strike looming over in NY.
The nurses, who voted overwhelmingly to authorize a strike, say they are being disrespected by a corporate hospital culture that demands sacrifices from patients and those who provide their care, but pays executives millions of dollars
I’m all for fighting for better wages, benefits.. and OF COURSE better staffing. I only post this tid bit of info to ask another question concerning this:
The hospitals — Mount Sinai, Montefiore Medical Center and St. Luke’s-Roosevelt Hospital Center — already are contracting for strike replacements at more than double normal wages.
Would you cross the line and work as a strike replacement. Cross the very line that your fellow warriors have drawn in the sand (yes warrior = nurse). I guess I can understand both views, I really can. In the end I consider it a great disrespect and, pardon my opinion, offensive for a fellow nurse to fill my shoes for double the pay???
The very same shoes I fill daily. The very same shoes that are being paid crap wages, given crap benefits, and shoved into crap staffing.
Hmm..
Something just doesn’t seem right.
via Nurses Threaten Strike at Three New York Hospitals – NYTimes.com.
Posted in health, opinion | 2 Comments »
Posted by Sean on November 30, 2011
As I posted earlier, Kim (from Emergiblog) over at Masters in Nursing interviewed me. Here is part 2:
Keep your eye on the prize.
That’s what I told myself during my marathon BSN program.
But there is no prize unless you start the process.
In part 2 of my discussion on graduate nursing education with blogger and Nurse Practitioner student Sean Dent, we talked about the difference between graduate and undergraduate education.
How does grad school differ from undergraduate education?
Be sure to follow the link and read the original post…
Talking MSN: Desire and Discipline | Masters in Nursing Blog
Posted in health, opinion | Tagged: career, education, nurse, nurse practitioner | Leave a Comment »
Posted by Sean on November 24, 2011
I can proudly say I’ve kept up with the Thank you Thursday concept for 2.5 months. It’s been very ‘weak’ at times, but I’ve kept up with making sure I make at least 5 thank you’s or I am thankful for at least 5 things each week.
It’s definitely kept me grounded and humble. I continue to be thankful for some of the most simplest things, but then again nothing is ever really that ‘simple’ is it?
Be sure to be as ‘thankful’ as possible this week during our ‘yearly’ time for thanks.
I’d like to thank the last week for:
warm weather still! Yes, the warmer temps here in Western PA have been nice. Remember warm for us this time of year IS 60 degrees.
my crazy cats. For not being the all around terrors that other cats display. They’re crazy alright, but they could always be worse.
a certain professor of mine for taking the time to listen to my (and other classmates) concerns about our school’s program. While they probably can’t fix any of our concerns, they at least made us feel heard.
for good co-workers. last week one shift in particular could have been just an all out miserable time. Instead it was survivable and even fun.
the kindness of strangers.
Be sure to thank those who make the sacrifice during the holidays. Be it the retail worker, the health care worker and of course our men and women in uniform. While you’re all feeding your faces take a moment to thank those that make it possible.
Happy Thanksgiving everyone.
Posted in opinion, words of wisdom | Tagged: thank you thursday | Leave a Comment »
Posted by Sean on November 17, 2011
Do you pack your lunch? Check out this lunch bag that is THE ticket for those long shifts. A recent post from over at Scrubs Magazine.
Eating on the go: Product review for nurses
*Disclaimer: This product and containers were provided free of charge. The blogger is in no way affiliated with balanceddaylunchkit.com. All opinions are of his own, and is under no obligation to promote or defend the product in question.*
As everyone knows, I’m a commuter student with lunch-packing challenges. (Read my previous post here on ‘Packing my bags‘) I noticed in the Scrubs Magazine fall 2011 print edition a page on getting organized (page 16 if you’re interested). We also have a page dedicated on our website to ‘The Organized Nurse‘.
I read about the product ‘Three Squares in One’. They have a ‘lunch bag’ of sorts they call the ’12-Hour Shift Bag’. I found it so intriguing I contacted the company to see if I could try it out. The were nice enough to provide me with the bag as well as the food containers that fit inside! Needless to say I was acting like a kid in a candy store.
I have always promoted healthy eating. Bring a lunch and leave the money at home. So I’ve been trying to find a lunch bag that can do that very thing, but can provide me with meals over the course of the day. So the 12-Hour Shift Bag seemed like the answer to all my woes.
After using (and abusing) it for work and school over the past couple weeks I’m ready to share my findings. It definitely touts a large capacity for storing any and everything. It has two main compartments that are individually insulated. So you could potentially have one ‘hot’ and one ‘cold’ meal. It actually has the two sides labeled ‘One’ and ‘Two’. I initially found that entertaining, but then I utilized the labeling more than I ever thought I would whenever I would go hunting for my food.
The containers they provided fit perfectly (as they should I guess). They had a nice seal-locking mechanism on them that ensured your food’s freshness. Something I really liked. Especially with the wear and tear I gave it. My food never spilled.
I loved the little zippered ‘compartments provided on each ‘flap’. You could store napkins, utensils or even pre-packaged snacks in those nifty pockets. And once again they were still insulated. Within each ‘side’ there were small elastic Velcro straps provided. I later realized these could be utilized to secure containers as well as secure and cooling device you may utilize (like the blue ice cooling blocks). In addition there was also an additional compartment with a magnetized flap for additional storage space.
It definitely held up to the rugged wear and tear. I swung that thing over my shoulder and across my back numerous times throughout a single day. The adjustable strap was key! And the straps were attached to the main unit by metal clasps, which was nice. This way the strap doesn’t tether away from the main unit.
Space was not an issue. There was plenty of room to bring just about anything. The two main compartments, the zippered pockets in the flaps, and then the additional zippered outside pockets on both sides made for easy portability.
While it was a large bag, it seems that you could compress or collapse one side of the bag if you wanted to, if you were only needing one side for those shorter days (or shifts).
Here are my bulleted highlights of this product:
PROS:
- Ample storage space with deep pockets
- Well compartmentalized
- Zippered flap for utensil storage
- Individual insulation is great for bringing hot & cold meals
- Ability to secure items within the compartments
- Option to collapse one side to only utilize half the bag
- Strong and sturdy adjustable carrying strap
- Aesthetically pleasing for both men and women
- Labeling of each side compartment
CONS:
- Very bulky at times to carry
- When fully pack – can be quite heavy
Overall grade: A
I don’t think there is a ‘perfect’ lunch bag out there, but this comes about as close as you can get. It has enough options available to suit just about any and every need for those nurses looking to pack their meals for the long shift. The name of the product says it all. I highly recommend this product.
I would like to extend a special thank you to Kathi Blackwell from Balanced Day Bags Inc. for her generosity in providing this product.
*Disclaimer: This product and containers were provided free of charge. The blogger is in no way affiliated with balanceddaylunchkit.com. All opinions are of his own, and is under no obligation to promote or defend the product in question.*
Posted in health, opinion | Tagged: lunch, nursing, scrubsmag | Leave a Comment »
Posted by Sean on November 5, 2011
Is nursing school built to “break us down” rather than “build us up?”
This past week was my first week with our physician preceptors. As a nurse practitioner student we log many clinical hours with our physician preceptors. This week was learning about the ‘patient presentation’.
It may sound odd, but nurses are quite familiar with the concept. The patient presentation is when a provider ‘reports’ or ‘presents’ their patient to the physician. This could be for a consult, a new admission, or for the coverage hand-off between colleagues. While we nurses are familiar with this concept, it’s a whole different ball game when you are the one presenting.
It was another ‘pressure cooker’ situation. Something we are all too familiar with. We build up the scenario in our minds to be the end-all-to-be-all. We picture ourselves making every mistake in the book and of course we envision the physician as this mad-hatter like tyrant who will bark at your every word.
It of course was the complete opposite.
Throughout the entire process the physician was receptive, pleasant, and absolutely empathetic to our newness. She was an active listener and gave great feedback in such a positive manner. At no time during this experience did I feel ‘put-down’, inferior, or guilt-ridden. I could sense that our physician preceptor was making every attempt to level the playing field and teach us, not torture us.
My clinical preceptor brought up a very valid realization after this experience. He asked us if we noticed how much our physician preceptor tried to ‘build us up’, not ‘break us down’. He wanted to know if we have had similar experiences in our previous nursing education and training..
I honestly can say 90% of my nursing education and experience has been about ‘breaking us down’. Sad, but true. I can remember many times nursing preceptors ridiculing students for not performing well or making simple mistakes.
Our physician made it well known she expects us to make mistakes, and that the mistake made now will help save lives later. “It’s not about being wrong, it’s about not being prepared”. Being afraid to make a mistake is not the same as carelessness.
I think nursing education as a whole could learn a thing or two from physicians.
I find the professional relationship and their respective professional curriculum between nurses and physicians to be polar opposites, and I can’t understand why? Barring from the obvious difference between a nurse and a physician, how do two professions with the same goals arrive at their destination in two very different ways?
As a side note, to all my fellow nurses out there. Physicians are misinformed about our educational system and standards. I guess I automatically assumed physicians understood the requirements and curriculum progression of our profession. We took a great deal of time to explain how a nurse ‘becomes’ a nurse (RN, BSN, LPN, CNA), and how a nurse is trained for specific specialties (critical care, emergency, oncology, etc.)
I’m still amazed at how much I learn every day.
Another post from over at Scrubs.
Posted in health, opinion | Tagged: nurse, nursing school, scrubsmag | 6 Comments »
Posted by Sean on October 19, 2011
The ideal rotating shift?
I just read a new study that claims that ‘working rotating shifts is not as potentially unhealthy as it used to be’. What? Is there such a thing?
I wonder if those who conducted the research have ever worked a rotating shift in their life??! It seems that there is now a more ‘ideal’ formula for rotating your day and NOC shifts. Instead of working 2 weeks of days and then 2 weeks of nights this article ‘claims’ there is now a trend to work day-day-night-night then five days off in a row. I like the adjective they used in the article I read though. They called this trend of rotating shifts more ‘humane’.
I must admit, I’m glad to see research is being conducted on ways to minimize the detrimental effects of shift work. I don’t think they will ever eliminate the health risks involved with ‘flipping’ your circadian rhythm.
When I read the word ‘humane’ I immediately blurted out ‘Darn right!’. Working a NOC shift has got to be a warped zombie-apocalypse training scheme in my book. I don’t know about you, but working ANY type of NOC shift turned my brain into much and pretty much guaranteed all my autonomic bodily functions would short-circuit. I couldn’t see straight, I could stand without swaying and stringing more than two words together to form a comprehensible sentence just wasn’t possible. I remember feeling like I had the ‘flu’ every month when I had to do the shift ‘flip’. My hats off to those that can ‘flip’ with minimal damage.
It probably didn’t help that I have chronic insomnia and I am such a light sleeper. So much of light sleeper than a kitten walking on a newly installed carpet woke me from my sleep (true story). When I would work nights every trick in the book to help you sleep would not work for me, since the wind blowing outside would wake me up.
*sigh*
This would explain why I don’t work nights anymore.
…
I’m still chuckling at the word ‘humane’.
Article of interest:
My sarcastic post over at Scrubs. Am I alone on this one?
Posted in health, opinion | Tagged: NOC, scrubsmag, shift work | Leave a Comment »
Posted by Sean on October 16, 2011
Doctoring the ‘Doctor’ title?
There has been much scuttlebutt throughout the online health care community. The divisive ‘physician versus advance practice nurse’ debate has gained quite a bit of steam thanks to a recent article by the New York Times titled: When the Nurse Wants to Be Called ‘Doctor’. A great big thank you and ‘shout out’ to the NY Times. I think this conversation needed to continue.
Over the course of the past several days I have been keeping a log of responsive articles (please see the end of this blog post for articles of interest). I have taken an interest to this particular debate, since I am a current Nurse Practitioner student who will eventually hold a Doctorate of Nursing Practice (some years down the road).
I for one do not have a solution (sorry). However, I do feel this debate is based on valid rationale that has gone awry.
Yes, I firmly believe we as practitioners should not mislead our patients. The social stigma and public knowledge that follows the title of ‘Doctor’ can lead one to believe they are in fact a medical doctor, ergo a physician. The reality is that not all ‘Doctors’ are ‘Physicians’. We need to remind ourselves that the PhD has been around for quite a long time, and that there are doctorate degrees in many other health care related disciplines.
To quote Dr. Kevin Pho over at Kevin MD:
“Those who earn a doctorate degree, whether it be in nursing, pharmacy, or psychology, deserve to be called “doctor.” Period.”
So in defense of Nurse Practitioners with their DNP, they are not misrepresenting themselves. They’ve earned the title. But it’s the intention in which the title is used that makes all the difference, in my humble opinion.
Proudly conveying your earned title without proper clarification and intention can easily be mistaken for deception and misdirection. In the original NY Time article the NP introduced herself as ‘doctor’ and followed up with “I’ll be your nurse”. No misdirection there.
I think this is the source of the physician community’s angst, and disapproval. If the NP is making an empty attempt at representing themselves as a physician with their numerous years of education and rigorous training, then yes, I too would be on the defense. Even though I am not a practicing NP (a mere student), I don’t believe there are NP’s out there that would outright misdirect or misrepresent themselves as someone they are not. If they are, then shame on them. They are not only damaging their professional credit and earned title, but they are potentially placing their patients in harms way.
I know in the end, both physicians and advanced practice nurses share the same goal of optimal patient outcomes. Splitting hairs over entitlement and attempting to ‘strip’ someone of a title that have rightfully earned is just a waste of energy and a misuse of vital resources.
Articles of interest:
When the Nurse Wants to be Called ‘Doctor’
Should medical students be introduced as Doctor?
Calling yourself Doctor and what that now means
Universal board certification can solve the Doctor Nurse controversy
A post over at Scrubs that continues the conversation about the newly controversial title.
Posted in health, opinion | Tagged: doctor, nurse practitioner, scrubsmag | 3 Comments »
