Brilliant Actions for Nursing Yourself During Your Work Day

Another day taking care of sick people. You love your job but the stress of your day is encroaching on your health. Maybe you find yourself tired all the time no matter how much sleep you get. Or you are finding that those scrubs, usually loose, are now fitting tight around the middle. Does your diet consist of donuts, soda and coffee to make it through the day? Having worked at the bedside as a Registered Nurse for years, I know my job took a toll on my health. My weight sky rocketed, I felt overwhelmed and tired. I did not work out, chose unhealthy food options and I dreamed about patient alerts going off and missing meds! I got to the point of feeling altogether beat up. My dream job began negatively affecting my health. I knew I had to change. And I did. It took me a while to figure it out but I succeeded. My hope is that this article provides a few tips to help you better take care of yourself during your stressful work day, so your work day works for you. These ideas can help bring a bounce back to your step, promote self-care and extremely leave you living brilliant!

Identify a buddy.

Once you have received nursing report, work with your buddy to identify how you can support each other. Ideally this buddy will be the nurse next to you so you can assist each other during the day. Create an agenda of when each of you will go to lunch. Create a positive environment by complimenting each other on their work. Smile at each other! This simple act can easily boost each other's mood. It's easy to get lost in patient care, so check in with each other often. A simple gesture such as 'I will check on your patient in room 29' can help someone feel supported and promotes teamwork so you can thrive through your work day.

Take some time for yourself.

A day at the bedside taking care of a patient can get out of control in an instant. Your day that was planned with a lunch break all of a sudden becomes a whir of doctors and nurses running in your room. Your stable patient just coded and your patient in the next room develops projectile vomiting. Welcome to the life of a nurse. These stressful events can throw off even the most seasoned nurses. When an appropriate time presents itself, take a moment to yourself. Thank yourself for doing a great job. Take a few deep breaths and tell yourself you are doing your best in this moment. Appreciate what went well during the stressful times. Here's a simple meditation to bring yourself back to the present: place your hand over your heart, breathe deeply, feel your feet in your shoes, and say out loud 'I love myself and I am doing my best'. Acknowledging yourself for doing your best can help alleviate any negativity that may have built up with managing challenging events.

Talk positively to yourself.

I know when I worked at the bedside I would usually beat myself up for the things I did not get done. By the end of a 12 hour shift, with the demands of patients, families, doctors and other staff, I was emotionally, physically and spiritually drained. Instead of beating myself up, I needed to nurture myself. Do not wait until the end of your day or your day off to take care of you. By then, overeating has set in! During your work day, be kind to yourself with words. Find a journal with a design that speaks to you and brings it to work. Take a few moments a couple times during your work day to write in positive comments to yourself. Embrace and celebrate the hard work you are doing with a big written pat on the back! Maybe a comment such as' Wow! I just shared a beautiful moment offering support to my patient '. Or, 'I am a rock star! I gave all my patient's meds on time! ' Is this part of your job? Of course it is. But that does not mean you can not celebrate. Feeling so overwhelmed you can not find any positive thoughts about you? Engage your colleagues in the fun and positivity. Ask your buddy to write in your journal a positive comment about your work as a nurse. We are our own worst critics and seeing someone else write a positive comment that can make a world of difference.

Working as a nurse at the bedside can be stressful but rewarding. I hope these simple and straight forward tips support you in your work day and allow you to be the brilliant nurse that you are!

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The Story and Growth of Evidence Based Practice

Evidence Based Practice and Medicine as we commonly know it has had an interesting story so far. Although we now see it as the standard in which quality patient care should be provided, as recently as twenty years ago this was a controversial topic.

Evidence based medicine truly began to gain momentum in the late 19th century thanks to a small group of French Clinicians. French physicist Claude Bernard was one of the first to begin the question the clinical efficiency of the common practice of bloodletting for pneumonia patients. Bernard helped to introduce the idea that comparative trials and experiments could have a positive effect on clinical practice. At the time, this idea was protested vigorously by a majority of physicians who believed that medicine was a form of art based solely on a physician's intuition and experience. Popular doctors of his time believed that there was no tangible value in comparative trials and statistics.

From then on the idea advanced dramatically. Experiences during the first and second world wars led many nurses and doctors to search for ways to increase patient safety. Technological advances in the areas of sanitation, anesthesia, etc. helped to spur tremendous advances and innovations in technology and communication helped to communicate these new findings to a now global audience as current trials and experiments become easier to share, clinicians around the world began to seek out research and evidence for their clinical questions.

The following decades of the 80s, 90s, and 2000s saw the growth of the computer, the internet, and the ability to save and sort through tremendously amounts of data quickly and reliably in a way that was never before possible. By the mid-2000s the majority of large peer reviewed journals had content online and easily accessible.

Despite all of the advances, the idea of ​​evidence based on medicine still faced consideration opposition. As late as the mid-1990s, US doctors warned that evidence based practices would create cookbook style medicine and doctors who did not personalize the care to the patient. They also warned that the movement itself was an attempt by the arrogant to lower costs and make more money through health care.

It is worth mentioning that the large availability and access of information can be a double-edged sword – there exists a risk of incorrect information being spread wide. A recent example of this can be found in the false clinical trials that occurred in England concerning the links between vaccines and autism in the 90s. A study was released claiming a link between autism and the MMR vaccine. Although the study was found to be a hoax and highly altered, the information quickly spread around the globe and has been used as a cruel part of the anti-vaccine movement's evidence.

Currently we define evidence based medicine as the ability to blend individual clinical experience and the best available external evidence. The ultimate goal being to improve patient care and patient safety within the organization. The term “best external evidence” refers to patient centered studies, trials, experiments, and data reviews that are applicable to the specific issue. Both doctors and nurseries are now comfortable with the concept that patient care should be focused around the best available evidence in order to make the most appropriate decisions. In order to help “spur motivation” both doctors and nurses have a mandated amount of continuing education (CE) hours that are required each professional licensing cycle. Most continuing education providers seek to create and provide material that is focused on evidence based on a specific topic. As we move forward, health care providers must avoid complacency – continuing measurements and observation of current practices will be the only way in which we can continue to advance the practices of medicine and nursing and improve the levels of patient care within our organizations.

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Looking Into MERS – A Mysterious New Disease

Although MERS (Middle East Respiratory Syndrome) seems to have faded to the back off international consciousness after the troubling Ebola outbreaks in Africa and Measles outbreaks in the United States, it has continued to infect and kill individuals in the Middle East.

Beginning in 2012, this mysterious virus emerged in Saudi Arabia and has spread to the neighboring countries in the region. Over 1,000 individuals have had confirmed cases of the illness with over 300 deaths resulting from illness related complications. At a genetic level, the virus originated from the family of coronaviruses and is similar in structure to the SARS virus that caused an epidemic through China and Southeast Asia earlier in the decade.

Many of the critical factors and elements of the disease are currently unknown. Researchers currently believe the disease to be zoonotic, meaning the natural source is some sort of animal; however, only theories exist now and the exact source has not been pinpointed. Due to the wide range of symptoms, and range in the quality of record keeping, the exact course of the disease is not fully understood. The median time between sunset and death is 12 days and it is not fully clear why some patients survive and others do not. Patients present with a wide range of symptoms related to respiratory illnesses and DNA matching of the virus is often needed to confirm a diagnosis.

The virus is transmitted via person-to-person contact with infected individuals. All cases have been linked in some way to travel or residence in the Middle East and further investigation is needed to better understand how exactly the disease is transmitted from humans-to-animals and from person-to-person.

Of particular concern and risk are individuals who have come into contact with Camels (MERS-CoV virus has been found in camels), who have traveled to the Middle East and have developed symptoms within 14 days of traveling, and health care providers who have treated patients with the MERS virus. At the present moment, WHO and UN researchers have been unsuccessful in tracing the origins of the disease clusters and are concerned about continued transmission. Currently, there is no cure for the disease and all treatment options work to manage the disease related symptoms.

There are further worries that the number of cases is actually much higher than has been reported. Civil unrest, conflict, and weak health care reporting infrastructure in many areas of the Middle East may have contributed to a significant number of cases going unreported. The actual number of cases and associated deaths may be significantly higher than currently estimated.

As health care providers with a global patient base, it is necessary to become familiar with and prepared for the MERS virus. To accomplish this, continuing education and proper forward planning will be necessary in order to help organizations to be prepared for the possible encounter with the virus.

The Centers for Disease Control and Prevention and the World Health Organization have already issued up to date articles and guides for both health care providers and individuals in regards to the virus. Further, there are a variety of online nursing CE providers who have prepared evidence based nursing courses on the handling of a MERS patient. The novelty of the virus is not an excuse for unpreparedness – in the current world of global travel and commerce the possibility of several US cases is very real and very timely.

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Importance of Aggression Management for Health Care Professionals

Aggressive behavior is not restricted to mental patients alone: ​​people who are not equipped to deal with frustration, fear or anxiety may exhibit aggressive and violent behavior too. Patients who are in pain and are unable to deal with it often tend to be nasty towards their caretakers- and often nurses have to bear the brunt of their hostility. Aggression or violence could also result as a side-effect of the therapeutic medication such as corticosteroids. Again, patients with neurological disorders could also have personality changes that may result in anger and abusive behavior. Drug or alcohol abusers may get hallucinations or delusions which could make them respond with anger. There are many reasons why patients, who under normal circumstances may be very even-tempered, would have behaved uncharacteristically when faced with an illness.

Mental patients of course may be sentenced to aggression because of the very nature of their poor mental health. They often experience mental states such as periods of confusion or disorientation which could precipitate aggression and violence.

All this makes it very important that healthcare personnel should be aware of common triggers that could start an episode of physical aggression, how to avoid such triggers and how to deal with such behavior. Nurses have reported that their own reactions to such behavior could range from anger and frustration to inconsistency of care. They may also feel the desire to stop such behavior by simply giving in to the demands of such disturbed patients. Some nurses may choose to avoid such patients altogether. Needless to say, these reactions are appropriate and nurses must learn how to deal with the situation and with their own emotions.

While considering the care of such patients, ensure that the patient stays safe at all times, and so do you and everyone around you. The best way to handle such patients would be through empathy and building a relationship of trust. Understand what his or her triggers may be, and try to avoid them at all costs. Such patients should be encouraged to be more engaged with their social or support network, and to develop other activities which relieve them of their preoccupation with their illness. Counseling should be provided for frustration, fear and anxiety.

If an episode of aggression has been precipitated, stay calm and try to de-escalate the situation. Speak in a calm and neutral tone, try to make the patient sit down and communicate with you. Clearly indicate your empathy and understanding of the patient's feelings, and try to calm down and control their emotions. Ensure the safety of the patient, other staff and yourself. There are many policies and procedures in place for dealing with aggressive events and they must be strictly followed.

Training in aggression management is an important part of the professional development of a healthcare professional. The course material is designed to support the delivery of healthcare and improve patient safety through prevention, treatment and control of aggressive and violent behavior in patients. If you wish to reach the next level in your profession, do choose to study a professional development course in Aggression Management .

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Social Media and Nurses – A Whole New World

We can easily say that within the last ten years social media has changed the way in which the world spreads information. Social media has touched every form of business and healthcare is no exception. Sites like Facebook, Instagram, and Pinterest have helped large and small hospital systems define their personalities and reach out to their patients in new ways.

Social media has positively enabled small and large hospital systems to reach out to their patients and communities in brand new ways. It is currently estimated that over 70% of nurses regularly use social media. That is a tremendous amount and can not be disregarded. On one hand, social media has enabled nurses to connect with one another and share inspirational and educational material. On the other hand, social media has also created numerous concerns related to patient safety and patient privacy rights.

For most nurses their day involves interactions with patients. Patients who expect a certain level of privacy in regards to their medical information. Sadly, there have been numerous cases involving nurses posting photos or statements identifying patients or compromising their privacy in some way. In other cases, nurses have posted pictures or updates at the same time in which a patient error occurred. Most of this was discovered upon investigating the error and connecting the time in which the error occurred with the time of a non-related post (meaning that the necessity was distracted and not focusing on his / her job). In most cases the nurse received some clinical action on the part of the organization or the board of nursing. In other circumstances, negligence was determined and legal proceedings were initiated.

Unlike other jobs in which it may be okay to vent about a rude customer or a frustrating day, in the case of nurses the risk of incidentally compromising a patient's privacy rights and the policies of their organization is very present. Most organizations have in place some form of social media policy (if for some reason your organization does not – petition for one). A consistent policy at the organizational level can help staff understand what is expected of them in regards to online sharing and participation.

Above all else, it is crucial to remember that the internet is a wide reaching place with an exceptionally long memory. Posts, pictures, and other content in general will stay online and be available for a very long time. Non-nursing items such as statements or photos of partying, offensive / vulgar items, and racially / religiously offensive items can have negative effects on both a nurse's career and a nurse's professional reputation. Although it may seem odd, patients regularly search through social media to learn more about their health care team. Offensive, worried, or insensitive items have been reported to hospital administrators as grounds for a change in the assigned health care team.

In the end, it is up to nursing staff to be in a responsible, empathetic, and ethical manner in regards to social media. Social media can be used to expand a network, learn new information, keep up to date, and to connect personally with friends and co-workers; however, it can also quickly lead to a patient safety or privacy issue if used inappropriately.

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Meeting the New Nurse at Change of Shift

Hospital places can be disorienting for patients and their families. The best way for patients to feel that they have some control over their hospital stay is information: information about their medical plan of care, information about the treatments and procedures prescribed for them, and information about the nurses assigned to them. Regarding this last item, patients and their families should strive to meet the nurse assigned to their care at the start of each shift, as this introduction can help alleviate some of the anxiety that comes with a hospital stay.

Nurses are the primary interface between patients and the hospital environment, and ideally, patients would have the same nurses, or the same rotation of nurses, during their own hospital stay. This, of course, is not realistic, since any one nurse may not work full-time, or may work at any one of a number of nurses' stations through the hospital on any given day. In addition, depending on the practices of the hospital, nurses may work eight or twelve hours per shift; accordingly, during a twenty-four hour hospital stay, there could be two or three different nurses providing care. If the hospital admission is for forty-eight hours, that number could double to four or six different nurses, depending on the length of the nursing shifts. This on-going turnover in the caregiver role can be a source of anxiety for patients and their families.

Hospitals follow various practices to ensure the accuracy and completeness of the communications between outgoing and oncoming nurses, but the following information is generally included in the hand-off: the patient name and medical record number, the relevant medical history and the reason for hospitalization, important events that occurred during the shift just ending, tasks to be performed by the oncoming nurse during the incoming shift, any procedures for which the patient is scheduled, and any other information the oncoming necessity should know. These hand-off communications can take place at the bedside next to the patient, or outside the patient's room.

Patients and their families can be engaged with this change of shift process even if the hand-off communication between the outgoing and oncoming nurses takes place outside the patient's room. Shift changes, for hospitals on eight-hour shifts, typically take place at 7:00 am, 3:00 pm, and 11:00 pm. For hospitals on twelve-hour shifts, these changes usually occur at 7:00 am and 7:00 pm. Patients and their families can request the outgoing nurse to introduce the oncoming nurse to them, and this would provide an ideal time for patients and family members to ask any questions they may have, or mention any concerns. Such introductions can increase the confidence of patients and family members that the oncoming nurse is aware of particular details of the patient's hospitalization, and enhance their communications with the nurse over the incoming shift.

Depending on the circumstances of the patient's hospitalization, face-to-face introductions may be particularly important for the change of shifts occurring at 7:00 am and 3:00 pm, for hospitals using eight-hour shifts, and 7:00 am and 7:00 pm for those using twelve-hour shifts. Patients may be trying to sleep at the third change of shift for hospitals using eight-hour shifts, 11:00 pm, and may not wish to be disturbed. If so, patients can ask the 3:00 pm shift nurse to have any hand-off communications at 11:00 pm take place outside the patient's room, and also have the introduction to the night nurse deferred till morning.

In-patient hospitalization can be overwhelmingly stressful. Part of the stress is the turnover in nurseries and staff during the patient stay: this stress can be managed. The outgoing nurse provides essential information to the oncoming nurse about the patient as part of the continuity of care. This hand-off communication can take place at the bedside or outside the patient's room, depending on the hospital's practices. Even if the hand-off takes place outside the room, patients and their families can still request the outgoing nurse to introduce the oncoming necessity to them during change of shift.

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Tips to Choose a Nursing Home

No one cherishes the thought of putting their loved one in a nursing home but at times that is the only choice. Once all other alternatives have been tried such as letting her live with the family or having the family take turns allowing them to live with them or having them living on their own, it will be time to find best health care facility for the type of care that your loved one needs. The best facility would be ones that are convenient to as many family members as it can possibly be. You also want to make sure that it will provide the high-quality care that your loved one needs such as a secured environment if they have Dementia, chronic medical condition, or some type of physical or mental disability along with a supportive environment.

In order to find the best nursing homes that meet all these criteria assemble potential nursing homes that are centrally located for all members of the family in a notebook. When looking for one look to see what their ratings are in regards to one to five stars and what others have said about their services, both pros and cons and make notes. When looking at the star ratings you need to see what there are in three critical respects which are:

• The amount and kind of nursing staff available
• The diligence of the facility in meeting state safety and health standards
• The nursing home's performance in key behavioral and medical measures such as whether the residents of the facility get enough help with their daily activities, are they receiving their annual flu shots, etc.

Once you have all of this data it is time to choose several of the best nursing homes so you can visit them. Before you visit the nursing homes you should have a list of questions that you want to ask and make notes of the answers. You also want to observe the staff's attitude towards the residents and how attentive they are to the residents. In addition to observing the staff you also need to look at the cleanliness of the home, if there are any safety hazards, the type of food offered, if the residents are clean, etc. Narrow your choices of best nursing homes down and make trips to them at different days and times so you can see how it operates at other times. If possible take your loved one with you on one of your visits to get their input.

Do not make a decision decision but take your time to make sure that your loved one gets in one of the best nursing homes possible.

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Treatment of Pressure Ulcers

According to the National Guideline Clearing House, people of all ages are at risk of developing pressure sores based on the vulnerability of their current health status. In the current work setting, almost all patients with limited mobility who can not get out of bed by themselves and need to wear briefs or use the bedpan begin to develop a stage I pressure ulcer prior to discharge within 1 -2 days after hospitalization or short term emergency room stay. The hallmark of quality nursing care is excellent skin care. It is up to the nurse to lead the role in pressure ulcer prevention. The importance of this problem extends beyond the hospitalization stage. Those individuals who are discharged with stage 1 pressure ulcers do not always have properly trained family members to care for them thereby preventing the stage 1 from getting worse. For many of the elderly patients, pressure sores are a common health problem particularly among the physically limited or bedridden and without proper treatment that can remain for the duration of the person's life.

The incidence of pressure sores has increased by 63% between the years of 1993 to 2003 in hospitalized patients The nurse is responsible for targeting the care that these patients need to receive to prevent pressure ulcer development. Coordinating staff to work as a team is currently lagging in the work place. The charge nurse does not follow up on the staff nurse notes, nor does the staff nurse follow up on the nurse aide tasks of turning the patients and providing nutritional supplements provided by their medical orders. The assessment and management of pressure ulcers require a comprehensive multidisciplinary approach.

Practice Change

The proposed evidenced based practice change would begin by the identification of gaps in knowledge and practice of the treatment of pressure sores. This process would begin with a survey on current patients with pressure sores, identifying their dietary intake of protein, vitamin C and other nutritious intake such as flavored protein shakes and healthy snacks. The survey would include verifying linen change frequency and adherence to turning schedules. Identification of vulnerable patients who have limited mobility, incontinence, dementia or are over the age of 65.

Staff RN's current knowledge base on pressure sore prevention should be evaluated. This could be done by asking the RNs to fill out a pressure sore prevention questionnaire. The questionnaires would also evaluate the level of communication between staff members and shift team members thus identifying communication gaps.

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A Look at The Historical Growth of IV Therapy

Almost every prominent ancient culture identified the value of blood. Blood often held a mystical attraction and was the main “currency” for sacrificial offerings and gifts to the deities of the time. Far before western medicine began to investigate blood flow the ancient Chinese Physicians dedicated that blood flow as controlled by the heart and circulated through the body in a never-ending circle.

The practices of bloodletting and oral consumption of blood remained the dominant blood related practices until about the 16th century. Scientists in the 16th century began to examine the movements of blood throughout the body and began to experiment with the concept of adding blood or fluids directly into a patient's bloodstream. These early transfusions and infusions involved reusable quills and animal bladders and other rudimentary (To us now, at least) tools. However, poor patient outcomes (high mortality rates) and negative public outlook diminished the popularity of IV therapy and as such the use of medicinal leeches and physicist ordered bloodletting experienced an additional boom.

It then took several centuries, and a massive Cholera outbreak, to encourage further investigations into IV therapy. During the large scale international Cholera outbreaks the first recorded wide-scale successes with saline administration were recorded. However, it was not until 1901 and 1907 that IV Therapy would take off. These dates correspond with the discoveries of the 4 major blood types by Karl Landsteiner and by Jan Jansky. These discoveries helped reduce the mortality rates of past blood transfusions and significantly improved patient outcomes. However, it was the two devastating world wars that helped to spur the international use of IV therapy.

In 1918 Oswald Robertson, a medical officer in the Canadian Military, successfully transfused blood for 22 World War I patients. Positive success stories similar to Robertson's led to the widespread military medical adoption of transfusions for patient in shock or who were severely burned. Soon after, blood banks were established in major cities throughout the United States (and Russia) and the practice began to grow quickly in order to meet the wartime needs. Three other key discoveries helped to then further pave the way to modern IV Infusion Therapy: The Disposable Plastic Need (1930's), Aseptic Technique (1940's), and the Plastic Collection Bag (1950's).

Today it is estimated by the World Health Organization that over 80% of all hospitalized patients will receive some form of IV therapy. Correspondingly, IV therapy is one the major facets of successful nursing care. Currently, there are over 40 standard infusion solutions routinely used throughout the world and the prevalence of IV therapy continues to grow. In spite of the leaps in technology and safety, complications continue to occur – Phlebitis, extravasation, and medication / blood errors being the most concern.

The frequency of infusion complications, coupled with the speed at which IV therapy continues to change, has created a large need for evidence based practice online CNE courses focused on IV Therapy. Take for example an instance of a nurse starting to practice in 1980. Now, in 2014/2015 the changes that you will have seen through your career are tremendous. IV therapy has changed quickly and quickly, and only through your ability to react to the modernization has patient care been improved. Undoubtedly, continuing education is a must – especially for health care teams striving to adapt and grow to better serve their patients. As health care providers it is only through our ability to drive continuous improvement that we can continue to improve the levels of patient care within our organizations.

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Nurses Needed at Disney!

The Disney nurses who treat guests are expected to make even their medical treatment experience a magical one. (Sometimes – easier said than done I would imagine!) So, if you love variety, serving, making people smile, and don’t mind that part of your work will be outside, then maybe this is for you.

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The Vital Role of Forensic Nursing

Victims of crime enter the US health care system through emergency rooms, clinics, and hospitals across the nation each and every day. Many health care facilities who receive emergency patients consider any admission a forensic nursing situation until proven otherwise. Although the collection of evidence is important in these situations, it never eclipses the need for maintaining patient safety and providing excellent patient care.

Forensic nursing is a nursing role in which evidence of a potential crime is collected from a patient. This can occur for both potential perpetrators and victims alike. The forensic nursing process involves a detailed amount of physical evidence collection, history taking, and a strict maintenance of the chain of custody.

Evidence collected by nursing teams can prove extremely helpful to a criminal investigation. Potential evidence such as brave patterns or stray hairs can help law enforcement officials identify a weapon or a potential suspect. Since the evidence collected by nursing teams can be used in a court of law, the manner in which it was collected, the nurse collecting it, the way the evidence was stored, and the evidence itself could also be questioned in a court of law. As such, forensic nurses must be trained and familiar with the detailed evidence rules and regulations within their respective state.

A key point to keep in mind is that health care providers are often the first individuals that victims of crime will interact with. As such, it is crucial that forensic nursing teams be trained on how to conduct conduct histories, and interact with victims of crime. This can be especially difficult when interacting with children, the elderly, or special needs patients who have been a victim of a crime. Certain criminal acts may warrant unique processes. In many hospitals, specific nursing teams trained in collecting evidence of a sexual assault may handle all specific sexual assault cases. Several states honor the SANE design – Sexual Assault Nurse Examiner. This is a nursing design that requires additional training on sensitive evidence collection issues associated with Sexual Assault Situations.

Health care providers should have a predetermined evidence collection policy and forensic nursing kit in place prior to the arrival of a forensic patient. Evidence collection kits should be preapproved by both a state law enforcement agency and a facility's internal legal department. Special kits are now available available for less than $ 20 a kit and are easy for a facility to acquire. Each state's attorney general office should be able to provide a detailed list of items that a ready kit should include.

Recognizing the need for additional training, several boards of nursing recently began to require nurses to take a 2.0 contact hour continuing nursing education course on forensic nursing and evidence collection . This knowledge is especially needed in rural areas in which the nearest major hospital is over 200 miles away. As such, it is crucial for each facility who receives emergency patients to be competent in performing a forensic evidence collection process. Forensic nursing knowledge truly has the ability to empower nurses to be patient advocates and to start them on their path to recovering from a traumatic incident.

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Driving Change – The Evidence Based Practice Movement

Evidence based practice has become a near ubiquitous term associated with improving shortcomings or holes in modern nursing care. Since its use as a common “quick fix idea” it is much more profound than that. The past decade has seen a nearly unmatched push across the US health care system to implement and drive evidence based practice centered initiatives. Evidence based practice essentially bridges the gap between what is known to be effective health care practice and what is actually being practiced in the field by health care teams.

Nurses are a critical element of the evidence based practice initiative in all aspects of the health care landscape. The goal whenever looking at a potential process change is to design something that is safer, more effective, and more efficient. The ability to identify areas of improvement in our daily practice is a serious skill to maintaining effective patient care. In order to be able to identify a potential area for improvement a necessity must be knowledgeable about the current evidence focused practice guidelines for the relevant area.

The only feasible way that a nurse can accomplish this is to remain an avid lifelong learner. This is a thought process that is fairly standard in other industries with high growth and change, but in nursing this is a fairly new outlook. It is crucial to remember though that knowledge without implementation is useless. At a very basic level – it certainly does not matter how many different and expensive evidence based practice ce courses a nurse takes through his / her career if the nurse is unwilling to speak up and change an outdated form of their practice. Although not everyone is personally interested in, or skilled at, driving departmental change – every nurse should be interested in improving aspects of their daily practice and improving patient care. All great things have small beginnings – even the smallest initiative matter (changing to a new lettering standard method in a medicine cabinet based on research you read or adding a new question to an intervention form based on the results of a new study).

As a nursing leader concerned with quality improvement initiatives a two-fold approach is helpful – always seek out new forms of evidence supported continuing nursing education and always use the new knowledge to drive change. The first point is easier than it has ever been thanks in part to the internet. What used to mean digging through journals and books, has now been made incredibly easy. Online CNE has helped to create a massive amount of instantaneous information and idea changes on everything from ambulatory care continuing continuing education to CE on IV Vitamin Therapy.

The second crucical point, actually using the newfound knowledge, is a skill that will need to be both intrinsically developed and encrypted within a large health care organization. If a nurse is shy, or worried about negative results, this can take a bit of training and mentoring. Organizations should be aware of the behaviors that they are encouraging through their policies and initiatives – whenever possible positive evidence supported process improvement suggestions should be encouraged and rewarded. This could be anything from defined suggestion processes, to internal teams that are dedicated to working with practicing nurses to identify and implement practice improvement opportunities.

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Modern Nursing – A Look At Ambulatory Care Nursing

Within the past ten years, the field of nursing has changed tremendously. Throughout the United States, ambulatory care nurses practice in clinics and hospital systems with the common patient theme being – the patient walks in and then walks back out. In the past, the outpatient landscape was driven exclusively by small, local, physician practices.

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Texas Board of Nursing Added an Additional Continuing Education Requirement – How Come?

In 2014, the Texas board of nursing officially announced a new continuing nursing education requirement for all practicing nurses. From this year on, Texas nurses will need to take 2.0 hours of continuing nursing education in Jurisprudence and Ethics every third licensing cycle. In order for the course to qualify, the specific CNE course on Jurisprudence and Ethics needs to be specifically focused on Texas nurses, the Texas Nurse Practice Act, and the specific Texas legislation in order to count towards the requirement.

Jurisprudence and Ethics is a critical foundation for nursing practice. For the majority of nurses though, this legal “stuff” does not seem all that interesting or applicable to their daily practices. Interestingly, these “legal things” are the critical foundations that help to support the practice of nursing within the State of Texas.

In short, this means that all of the laws and regulations regarding nursing (all of that “Jurisprudence and Ethics”) help to define and govern what a nursing professional is able to do. The purpose of this framework is to protect the citizens of the state from unlicensed and / or reckless professionals. In Texas, these key laws were instated by the Texas legislature over 100 years ago.

When people think about legal and nursing they normally jump to an image of the Texas Board of Nursing. However, it is actually the nursing practice act which sets forth and defines the Texas Board of Nursing. In short this means that the Nursing Practice Act for the State of Texas set forth the guidelines on which the Texas board of Nursing could be built. The key driver in establishing a Nursing Practice Act is to standardize and clarify the role of nurses in a state's health care environment.

Today, Texas Nursing Jurisprudence and Ethics also encompasses topics such as whistleblower protections and clinical proceedings. Each of these varied facets of legal framework are critical for nurses to understand in order to responsibly practice each and every day.

Although legal topics may not be the most exciting new things on the block, as a professional it is critical that you are familiar with and understand the legal structure that is in place to support your practice. On that note, the Texas Board of Nursing spearheaded the addition of the new CNE requirement. This is timely in that there have been several high profile based Texas legal cases involving nurses, whistleblower, and disciplinary cases. Further, as Texas seeks to continuously improve our health care system and provide care to the thousands of uninsured Americans in our state, Nurses will be a key part in leading the continuous improvement initiatives.

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The Role of a Community Nurse

There are many kinds of nursing jobs that one can choose from, but one type of job that is preferred much more is the community nursing job that helps you serve people. If you want to serve people and at the same time earn money, this is the right job for you. Nurses who have completed their nursing certification will be able to get the best jobs. Nurses should not only be qualified but they should also be certified by the authorized agencies in their profession. Nurses who have qualified by completing their education, but have not obtained certification will not be able to work in registered hospitals.

The best kind of work for a nurse is the community professional nursing. Not all nurses like the profession as it may need a lot of hard work. If you are still interested in serving a lot of people in the community, then you can take up the profession. This profession is highly paid because the community nurse has to travel to the patients' house and treat them based on their health condition.

The community care nurse is responsible to ensure that the health of individuals who are living in a particular geographic area is normal. Early identification of any disease should also be high on the priority list of community nurses. So, the job not only includes treating patients, but also preventing health problems and taking care of lifestyle issues that lead to health problems.

The nurse may also need to additionally qualify as a venipuncturist. Other than the collection of blood, the community professional nurse will also have to ensure that the blood is stored properly and sent to the lab for tests. This is a part of the job that a community nurse has to perform.

Many nurses love working in the rural areas because of the huge amount of job satisfaction. She will have the satisfaction of helping the people in the community in maintaining proper health. You will also feel as if you have been able to maintain the health of people living in a huge area under your control.

Nursing jobs in the community are time taking and the necessity needs to be fully committed to the health care of people living in the community. The nurse may also be required to carry some equipment in the community to treat patients. Some of the common pieces of equipment that are used in the community nursing profession are stethescope, BP apparatus, nebulizer and other portable equipmens.

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