Thursday, 11 February 2021

Nursing, Nursing Career, Nursing Exam US, Nursing Responsibilities, Nursing Roles, Nursing Skill

Nurses remained the undisputed leader in the 2020 annual most Gallup Poll in which the public is asked to rate the honesty and ethics of members of various occupations. This is not surprising at the end of a year during which nurses were at the forefront in the battle to save lives during the COVID-19 pandemic, with many sacrificing their own lives.

Nurses earn an 89% public trust rating

For 19 years in a row, nurses have taken the lead in the Gallup honesty and ethics poll. Last year, nurses were rated very high by 41% of the respondents and high by 48%. Only 1% rated nurses low and there were no very low ratings.

The record 89% of respondents who rated nurses’ honesty and ethics as very high/high, represented a 4% increase on the previous year’s record high of 85%. It was also 12% higher than the next highest score of 77% for medical doctors. 

2020 Gallup honesty and ethics poll

The poll took place during December 2020 via telephone interviews with a random sample of Americans representing all US states and DC. Respondents were asked how they would rate the honesty and ethical standards of people in 15 different occupational fields – very high, high, average, low, or very low. 

Health care professionals took two further places in the top four. Medical doctors had the second-highest ratings with a very high/high score of 77%, up 12 percentage points from 2019. Pharmacists took fourth place with a 71% positive rating. 

Grade school teachers came in third with a very high/high rating of 75%. Given the negative press during the pandemic, it was not surprising that nursing home operators had a relatively low positive rating of 36%. Members of Congress and car salespeople earned the lowest ratings at 8%.

Nurses have earned the public trust

“Nurses have been tested in every way imaginable during 2020. The world watched as nurses lost numerous patients and colleagues to a highly communicable, deadly virus while trying to protect and preserve their communities with limited resources and support,” said Ernest Grant, President of the American Nurses Association. “Nevertheless, through it all, nurses have consistently proven they are resilient, selfless, and compassionate, risking their health and safety for the common good. Therefore, nurses are undoubtedly deserving of the public’s unwavering trust.”

While the Gallup Polls have shown for over two decades that nurses have earned public trust, this has not been translated into the policies and funding needed to address the longstanding issues in nursing. Hopefully, the stark realities exposed by the COVID-19 pandemic, particularly the shortage of nurses, will prompt policymakers to support the actions necessary to establish a strong nursing workforce for the future.


Thursday, 4 February 2021

COVID-19,Nursing Responsibilities,Nursing Career,Nursing Degree,Nursing Exam US

When the media named 2020 “The Year of the Nurse,” it drew attention to the hard work and sacrifice this profession has endured, yet there are so many aspects the general public will never be able to understand or empathize with. As with many worldwide, nurses sat with great anticipation for the relief that 2021 would bring with it. But with the highest COVID death rates this week, nurses feel as though we have woken up on Groundhog’s Day yet again to experience “The Year of the Nurse” on a perpetual repeat.  As with most jobs throughout this past year, nurses have had to make significant adjustments in their workflow. However, unlike so many other jobs, nurses have sustained significant emotional, physical, and mental fatigue that many worry will have significant effects on the future of nursing. 

Nurses have walked out of the hospital shift after shift questioning why they ever entered this profession to begin with. We have questioned whether we can muster the strength to will ourselves to open our car doors and walk into the building for one more shift. Yet the most frustrating and dangerous question of all, might be that we wonder whether or not we are even making a difference during this time. 

There is no greater feeling of failure than looking helplessly around a hospital unit at the tired and weary faces of one’s coworkers and patients and feeling like our efforts are futile. The fundamental basis and the core of nursing is defined as helping other people during a time of physical and emotional need, but this year it feels like we have failed at times despite our best efforts.  We have been battling the emotional complexities of mourning incomprehensible loss during the dusk, while assembling all of our available energy to be strong for the public and welcome glimmers of hope at dawn. 

There is an overarching saying ringing through break rooms and side discussions between nurses that says “we didn’t sign up for this.” Although this can sound like a meager cop-out to an outsider, nurses are saying it through tear-stained, chapped, dehydrated, and exhausted faces. Although many within the nursing profession have had adequate training and experience with critically ill and dying patients, this year has abolished the typical “normal” and replaced it with grief and tragedy beyond understanding. 

Sure, we signed up to hold the hand and be a witness to a man’s last breath. But we didn’t sign up to be the replacement for their family during these sacred moments. 

◉ We didn’t sign up to hold a tablet up to the face of a grandma while her 4 and 6 year old grandkids begged her not to die. 

◉ We didn’t sign up to be a woman’s labor partner as her family sits helpless in the parking lot unable to witness the first cry of their baby’s life.

◉ We didn’t sign up to wear the same N95 for 30 days straight and get a pizza as a reward.

◉ We didn’t sign up to see our coworkers contract the same illness we are all battling and then spend months as a patient on our unit before passing away. 

◉ We didn’t sign up to be floated to a critical unit with no training and told to “figure it out” all while managing twice the mandated nurse to patient ratios. 

◉ We didn’t sign up to putting our license on the line because there simply are not enough nurses to cover the amount of patients in the hospital.

◉ We didn’t sign up to be furloughed for a month, and then mandated to work overtime within weeks of each other. 

This year has been far from easy. The large majority of nurses will say that it has been the hardest year in our profession bar none.  Although we take refuge in the hope that accompanies the vaccine, we also hesitantly dare to dream about what the future of nursing looks like. 

Some are predicting a mass exodus from bedside nursing due to the sheer burnout that we have endured this year. Students live in fear that they will not receive adequate training due to low staffing volume, which could result in grave errors as a result of lack of preparation. Management fears that the fiscal deficit they have encountered this year will lead to even more work with even less reward for their nurses. Most of us, however, chose this profession for reasons greater than COVID can defeat. We are walking mindfully, hesitantly, covered in PPE into the future with great hope that our hospitals will soon look like “the good ‘ol days,” and praying that we will one day wake up and hand the “Hero of the Year” award to someone else.


Friday, 20 November 2020

Question Of The Day, Medication and I.V. Administration
Q. A 56-year-old client is receiving chemotherapy that has the potential to cause pulmonary toxicity. Which of the following symptoms indicates a toxic response to the chemotherapy?

A. Decrease in appetite.

B. Drowsiness.

C. Spasms of the diaphragm.

D. Cough and shortness of breath.

Correct Answer: D

Reason: Cough and shortness of breath are significant symptoms because they may indicate decreasing pulmonary function secondary to drug toxicity. Decrease in appetite, difficulty in thinking clearly, and spasms of the diaphragm may occur as a result of chemotherapy; however, they are not indicative of pulmonary toxicity.

Thursday, 19 November 2020

Q. Which scenario complies with Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations?

A. Two nurses in the cafeteria are discussing a client's condition.

B. The health care team is discussing a client's care during a formal care conference.

C. A nurse checks the computer for the laboratory results of a neighbor who has been admitted to another floor.

D. A nurse talks with her spouse about a client's condition.

Correct Answer:  B

Reason: To provide interdisciplinary continuity of care, nurses must share relevant information during client care conferences. Nurses discussing information in the cafeteria may be overheard; this indiscretion violates HIPAA regulations. Looking up laboratory results for a neighbor is a HIPAA violation, as is discussing a client's condition with one's spouse.

Monday, 9 November 2020

Q. A 40-year-old executive who was unexpectedly laid off from work 2 days earlier complains of fatigue and an inability to cope. He admits drinking excessively over the previous 48 hours. This behavior is an example of:

A. alcoholism.

B. a manic episode.

C. situational crisis.

D. depression.

Correct Answer: C

Reason: A situational crisis results from a specific event in the life of a person who is overwhelmed by the situation and reacts emotionally. Fatigue, insomnia, and inability to make decisions are common signs and symptoms. The situational crisis may precipitate behavior that causes a crisis (alcohol or drug abuse). There isn't enough information to label this client an alcoholic. A manic episode is characterized by euphoria and labile affect. Symptoms of depression are usually present for 2 or more weeks.

Thursday, 5 November 2020

Q. During rounds, a nurse finds that a client with hemiplegia has fallen from the bed because the nursing assistant failed to raise the side rails after giving a back massage. The nurse assists the client to the bed and assesses for injury. As per agency policies, the nurse fills out an incident report. Which of the following activities should the nurse perform after finishing the incident report?

A. Attach a copy to the client's records.

B. Highlight the mistake in the client's records.

C. Include the time and date of the incident.

D. Mention the name of the nursing assistant in the client records.

Correct Answer: C

Reason: The nurse should include the date and time of the incident in the incident report, the events leading up to it, the client's response, and a full nursing assessment. To prevent legal issues, the nurse should not attach the copy of the incident report to the client's records. Also to prevent litigation, the mistake should not be highlighted in the client's records. As the client report is a legal document, it should not contain the name of the nursing assistant.

Wednesday, 4 November 2020

Q. The client is receiving an I.V. infusion of 5% dextrose in normal saline running at 125 ml/hour. When hanging a new bag of fluid, the nurse notes swelling and hardness at the infusion site. The nurse should first:

A. Discontinue the infusion.

B. Apply a warm soak to the site.

C. Stop the flow of solution temporarily.

D. Irrigate the needle with normal saline.

Correct Answer: A

Reason: Signs of infiltration include slowing of the infusion and swelling, pain, hardness, pallor, and coolness of the skin at the site. If these signs occur, the I.V. line should be discontinued and restarted at another infusion site. The new anatomic site, time, and type of cannula used should be documented. The nurse may apply a warm soak to the site, but only after the I.V. line is discontinued. Parenteral administration of fluids should not be stopped intermittently. Stopping the flow does not treat the problem, nor does it address the client's needs for fluid replacement. Infiltrated I.V. sites should not be irrigated; doing so will only cause more swelling and pain.

Tuesday, 3 November 2020

Question Of The Day, Basic Physical Care
Q. Communicating with parents and children about health care has become increasingly significant because:

A. Consumers of health care cannot keep up with rapid advances in science.

B. The influence of the media and specialization have increased the complexity of managing health.

C. Nurse educators have recognized the value of communication.

D. Clients are more demanding that their rights be respected.

Correct Answer: B

Reason: Today's health care network includes many specialized areas, such as respiratory therapy, medicine, laboratory, social services, and technical monitoring, to name a few. Due to expanded media coverage of health care issues, parents are more aware of health care issues but cannot understand all the ramifications of possible health care decisions. Because of this expanded media coverage, health care consumers are more aware of advances in the science of health care. Nurses have always recognized the value of communication and that all nurses are teachers. Clients are more aware of their rights through media exposure and information disseminated by health care facilities. However, respect for the client's rights should be the nurse's concern as well and communicating with parents and children should not be impacted by a client's knowledge or demand for those rights.



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