Wednesday 29 June 2022

Nursing Career, Nursing Skill, Nursing Responsibilities, Nursing Professionals

Being a new nurse may feel overwhelming no matter how much you have prepared yourself. There are approximately 2,400,000 registered nurses in the United States, and around 155,000 new nurses graduate every year. Nurses are in high demand, and patient ratios can range anywhere between 1:1 in critical care to 60:1 in long-term care.

Your shift can move quickly and be interrupted and changed throughout the day. This is why it is essential to stay organized as a new nurse and be ahead of the game.

Tip #1 - Start Your Shift with a Chart Review 

One of the most important things you can do to stay organized as a new nurse working at the bedside is to start your shift by reviewing the patient's chart before seeing them. This is crucial as you can find laboratory results, medication times, and doctors' notes to give you a clear picture of what is happening with your patient.  

Tip #2 - Use Report Sheets

Also known as a "brain" for some nurses, report sheets are paper notes you have that describe your objectives for the day for each patient. Use your report sheet to make notes from the nurse you are taking over.

Write down what you learned from your chart review by making notes of the medications, a list of doctors, laboratory results, pertinent history, and exam information. Keeping this report sheet with you will help you stay organized as a new nurse.

Tip #3 - Plan Out Your Day

Planning out your day by the hour will help you really help you stay on top of things. Write down your patient's medication times, assessment times, laboratory times, and anything due at a particular time. This could even include meals, glucose checks, Foley care, PIV hourly checks, and other  ADLs. Make a list of hourly times and in each time slot, write down what needs to be done in that hour. This will keep you on task so nothing will be forgotten. Helpful hint: Some report sheets will even have these!

Tip #4 - Prioritize Your Shift

No matter how hard you try, something will happen in your day to cause your plan to be disrupted. Prioritizing tasks is one of the things that new grads struggle with the most. When something changes your plan for the day, try to reorganize to accommodate. 

Hopefully, you have already planned out your day and need to rearrange to make room for something else. Look at your list and see where is the best time to perform the task. How important is this task, is it an emergency, or can it wait? Can you bundle care and include it during another assessment or medication time?

Tip #5 - Stay on Top of Things

Staying organized will help you succeed as a new grad nurse. Organize times for yourself to chart if you cannot chart as you go. Make sure to stock your pockets with all the essentials you need throughout your day and keep items in the same pockets. It can be stressful to find your pens in one of six pockets when trying to take an order or write down useful information. 

It will also be helpful to use check boxes on your report sheet to mark tasks off as you go. This will keep you on track and able to navigate your day efficiently.  

These tips will help you stay organized as a new grad nurse when working in a bedside environment. There are several different ways to organize your day and manage your time efficiently. It can take time to figure out what works best for you and that may even change every shift. Consider speaking to your preceptor or senior staff nurses to find out how they keep their shifts organized. It might help you figure out a way to be even more efficient at the bedside.


Saturday 11 June 2022

Substance Abuse, Nursing Responsibilities, Nursing Professionals

“It’s weird to say I’m an IV drug user but I am,” says Leslie L., a Registered Nurse in Georgia.  Leslie says her addiction began when she was working as a surgical nurse at a hospital in Georgia. She accidentally took Dilaudid home in her pocket she had meant to waste. She called her employer who told her to throw the drug away and not to worry. But Leslie says she had seen the effects narcotic drugs had on her patients, and she wanted to get a good night’s sleep and to “…. stop the world for a minute….” Within the week Leslie says she was addicted to narcotic drugs and regularly diverting from her employer, taking narcotics meant to be wasted by the end of her shift. “If you told me I was going to try heroin I would have recoiled. ‘Oh my God are you crazy,’” she says. Leslie diverted narcotics for about a year before her employer intervened.

Alternative To Discipline Programs (ATD)

Leslie is not the only Registered Nurse to confront addiction. The number of nurses struggling with addiction is an estimated ten percent and is on par with the rates of addiction in the general public. And with the pandemic raging, the number of nurses facing addiction battles may be rising too.  Alternative to Discipline (ATD) programs began in the 1980s when state boards of nursing began to see addiction as a disease and offer help to addicted nurses instead of automatically removing them from practice. Today there are ATD programs in 40 states across the country, and length and requirements vary among the programs. What’s more, ATD programs are underutilized, with low enrollment numbers compared to the population of nurses in most states.  The National Council of State Boards of Nursing (NCSBN) conducted an analysis of ATD programs and found that successful programs last at least 3 years and include frequent check-ins and random drug testing using different methods, including hair, and nails, and urine. Additionally, NCSBN found program completion rates for ATD programs to be between 52%-72%. This year NCSBN plans to conduct a pilot study this year to measure program outcomes beyond ATD programs.

Ridgeview Institute: A Successful Program

Leslie L. is currently under a 5- year consent order from the Georgia State Board of Nursing and enrolled in a treatment program at Ridgeview Institute in Smyrna, Georgia. Ridgeview Institute offers a comprehensive treatment program for nurses struggling with addiction. “Ridgeview offers 5 years of monitoring, and that monitoring is a nurses’ group and generally a therapy group,…The nurses have to call in every day and see if they have a drug screen, “ says Donna McGrane, RN Community Liaison at  Ridgeview.

According to McGrane, the state writes up the requirements for the diverting nurse. After an investigation, the Georgia State Board of Nursing issues a consent order and a formal mental evaluation. A nurse’s treatment experience is based on the results of that mental evaluation and recommendations of a treatment team. Ridgeview then monitors the results of the drug screens and makes sure nurses are in compliance with state requirements.

McGrane says the nurses in the program get close because of their shared experience and have an intimate bond that is special to see. “They know what it's like to be the patient now,” McGrane says. According to McGrane a program with support is huge. Ridgeview also offers a mixed professionals group made up of addicts from a variety of professions including nurses, doctors, pilots, and pharmacists. There is a common thread that runs through these professions, says McGrane.

The Coming Addiction Crisis?

McGrane says she has seen firsthand the negative effects the stress of the pandemic has placed on the nursing profession. According to McGrane, she has seen more nurses entering the program with depression and drug and alcohol relapses since the start of the pandemic. “Nurses come to our program saying ‘I can’t watch another person die,’” she says. According to McGrane, nurses who did not have a problem with alcohol or drugs before the pandemic is at risk when they turn to addictive substances as stress relief. “Definitely in the recovering community there have been more relapses,” McGrane says.

Paying the Piper

Leslie L. credits Ridgeview with saving her life, but she says the corporate nature of treatment is a drawback to the treatment model. “They may admit you for a few days without payment but you can’t enter into the program without substantial financial resources. If you don’t have the financial resources, you may be out of luck,’ Leslie says. Donna McGrane agrees. “The challenge is the hospital fires them and then the nurse doesn’t have the health insurance and they don’t get the help,” McGrane says. Leslie L. was one of the lucky ones. “I was fortunate enough I did not lose my job,” says Leslie. “I was asked to resign, but not before I went on medical leave and FMLA. I had insurance to get me through it,” she says. Ridgeview gave her a safe comfortable place to begin to recover, Leslie says. 

Leslie works in case management now, and although she misses bedside nursing, she is in a good place in her life and career now. She will be at the end of her 5-year consent order this coming August and she feels ready to manage sobriety on her own. Leslie says, “Between Ridgeview and the Georgia Board of Nursing I don’t know if I would be here.”

Getting Help Now

If you are facing mental or substance abuse struggles SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.


Friday 3 June 2022

Nurse, Nursing Responsibilities, Nursing Job, Nursing Skill, Nursing Professionals

I want you to think back to nursing school. Remember all the sacrifices you and your family made to get to the end goal of becoming a nurse. Remember all the grueling hours you put into making the grade? Now, what if I told you all that hard work could be erased with one wrong move? Well, it can be!

Incorporating good body mechanics into your daily work routine is vital to ensuring you can continue to physically keep up with the everyday demands of nursing. It could mean the difference between longevity in your nursing career versus retiring early due to a likely preventable injury.

What Is Proper Body Mechanics

Proper body mechanics in healthcare can be defined as using specific techniques and muscles to carry out high-risk tasks without causing strain or injury to the body.

We have all sat through boring lectures and in-services on proper body mechanics. How much thought do we give it when we are performing our job duties though? Is it really that important?

How Important Is Proper Body Mechanics

We are taught proper techniques for lifting and performing other high-risk duties as nurses, but how important is proper body mechanics?

◉ Musculoskeletal disorders (MSDs) are a major cause of injury in healthcare workers, according to OSHA.  The lower back is one of the most affected areas. Often, this is attributed to poor body mechanics.

◉ 38% of nurses are affected by a disabling back injury or back pain, the American Journal of Critical Care found. Staggeringly, 9,000 healthcare workers are injured every day while performing work-related tasks!

◉ 78,740 nonfatal injury and illness cases involving registered nurses (RNs) in the private industry alone were documented by the  US Bureau of Labor Statistics in 2020. Of those cases, five thousand eight hundred and fifty involved a back injury. These statistics only include RNs! The numbers are even higher when you factor other healthcare workers into the equation.

◉ Newer studies are now finding a link between work-related low back injuries and higher mortality rates. Further studies are needed to substantiate this claim and nail down the specifics. Nonetheless, research is suggesting a link between the two.

Do you think those numbers are scary? Now that is something to think about!

Understanding The “Why” Factor

It is so important to understand the “why” factor as opposed to just being told we need to do something. When we understand why something is important, we are much more apt to follow through with it. 

These statistics shine some much-needed light on the “why” factor and strengthen the importance of following proper body mechanics guidelines.

How To Prevent Back Injuries as a Nurse

The good news is by practicing good body mechanics you can markedly reduce your risk of becoming a part of these statistics.

Some basic techniques you can use to prevent injury when lifting include the following:

◉ Stand with your feet shoulder-width apart to provide a good base for support

◉ Get as close to the patient as possible

◉ Face the patient when lifting

◉ Don’t bend or twist at the waist

◉ Bend with your knees

◉ Lift with your legs and not your back

◉ Use a mechanical lift when available and not contraindicated for the patient

Practice Makes Perfect

It is so easy in a fast-paced environment like nursing to forget about good body mechanics. However, it is an absolute necessity to remember it. 

Practice brushing up on your body mechanics, so it becomes a habit.

The more you practice, the better you will become, and the less likely you will be to sustain a work-related injury due to poor body mechanics.

Protect the investment you made in yourself when you started your nursing journey. Don’t become another statistic!




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