Friday, May 26, 2006

Internet searches : Librarians do it better

According to a study reported today at the Medical Library Association's annual meeting in Phoenix, cancer patients are more likely to find what they are looking for with a librarian-mediated search instead of "going it alone."

This study by Ruti Volk, professional librarian and manager of the Patient Education Resource Center (PERC) at the University of Michigan, demonstrates that "even though the information is supposedly so accessible and everything is on the web, people still need the help of a professional to find information that is relevant to them and that is current, accurate and authoritative. "

Thursday, May 25, 2006

I Need a Job

I've been trying to get a job as a student nurse tech. Unfortunately it's very competitive... because the hospital is located right next to the school. EVERYONE applied.

I interviewed for the ER spot and didn't make it. I have another interview for the PCU, and here's hoping I make that one. Unfortunately the interview isn't until June 5th. Crap, I REALLY want this job. But I feel like half the summer is going to be gone before I get hired anywhere. I'd look other places, but I don't want to commit somewhere only to be called back in.

This is really lame. My scholarship ran out last semester, so I need some serious money before fall.

I'm getting very impatient.

Wednesday, May 24, 2006

AHA/ACC updates Guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update

The American Heart Association and the American College of Cardiology on Monday issued updated guidelines designed to ensure optimal treatment of patients with a variety of cardiovascular conditions, including heart disease, acute coronary syndromes, heart attack, and peripheral arterial disease, USA Today reports. The revised recommendations, which are endorsed by the National Heart, Lung, and Blood Institute, were created in light of results from the clinical trials that have been completed since the last recommendations were issued five years ago. For instance, the guidelines suggest that the daily aspirin dose for patients with heart disease or other blood vessel disorders be lowered to between 75 mg and 162 mg per day after a series of clinical trials showed that lower aspirin doses were “just as effective” as higher doses at preventing future heart attacks; however, the guidelines continue to advise that bypass patients receive between 100 mg and 300 mg of aspirin per day for up to one year. In addition, the guidelines for the first time suggest that all patients with chronic heart disease receive a flu vaccination. The guidelines also call for increased use of statins to reduce LDL levels, which now are recommended to be kept under 100 mg per deciliter in all heart disease patients. Other measures included in the revised guidelines “simply highlight tried-and-true means of reining in risk,” such as encouraging heart disease patients to get 30 to 60 minutes of moderate exercise at least five to seven days per week. The guidelines also recommend that a patient’s body mass index remain between 18.5 and 24.8, with waist circumference measuring no more than 40 inches in men and 35 inches in women. For diabetes management, the guidelines suggest that patients receive blood sugar level tests three to four times per year and recommend that the level stay below 7%. According to the report authors, the “aggressive, comprehensive risk-factor management” outlined in the guidelines has been shown in multiple studies to increase survival and prevent complications among heart patients. HealthDay notes that both groups plan to launch a campaign to inform cardiologists and other physicians of the new guidelines (Sternberg, USA Today, 5/15; HealthDay/Yahoo! News, 5/15).

Monday, May 22, 2006

AACN releases annual survey results

The American Association of Colleges of Nursing (AACN) relesed data from their annual survey which shows that enrollment in entry-level baccalaureate nursing programs increased by 13% from 2004 to 2005. Though this increase is welcome, their survey showed that 32,617 qualified applications were denied due to a shortage of nurse educators.

Friday, May 12, 2006

Mapping the literature of nursing: 1996-2000

Take a look at "Mapping the literature of nursing: 1996-2000" by Margaret Allen, Susan Kaplan Jacobs and June R. Levy in J Med Libr Assoc 94(2)206-220 April 2006. This research article represents a "snapshot in time" of the citation patterns of general nursing and specialty generals. It also underscores the interdiciplinary nature of nursing as a profession.

Sense About Science is a UK organization interested in promoting an evidence-based approach to scientific issues. They have a great review document which explains about the process of peer review in research and is especially useful for the non-researcher in evaluating research claims that are touted in the press. Check it out!!

Wednesday, May 10, 2006

Magnet Crossword Answers

As part of the activities of National Nurses' Week, nurses at SJH have had an opportunity to complete a magnet-themed crossword puzzle. Entries are eligible until 3:00 pm and can be turned in at the staffing office. It has come to our attention, that the answers to a few of the questions are hard to locate. While the winners will be randomly selected and no one will be disqualified for an incomplete or incorrect answer, we thought you might be curious about the correct answers to the crossword puzzle. Click here

Monday, May 8, 2006

Meet Dana Rutledge

Our world-renown (and very modest) Dana Rutledge RN, PhD, is our Nursing Research Facilitator at St. Joseph Hospital in Orange, California. She is with us one day a week and leads our Nursing Research Council, along with Beth Winokur. How she manages to publish and research as much as she does, while at the same time remaining so friendly and approachable is a mystery to me. She very kindly provided me with a copy of her CV. It is so impressive that I hope it doesn't cause the blogosphere to crash!!

St. Joseph Hospital Evidence Based Nursing Practice (cont'd)

Sedation Management and weaning to facilitate extubation in the ICU

Investigator: Victoria Randazzo, RN, BSN, CCRN

Purpose: This multidisiplinary team is looking at the comprehensive way in which sedation (Benzodiazepines, Propofol) is managed in the intubated ICU patient. The intent is to promote a recognition of the ability to wean by using a daily "sedation vacation". The process utilizes a team approach between the staff nurse, the respiratory therapist and the Intensivist. This evidence based practice focuses on reducing ventilator associated pneumonia, shorter patient stays, reduced costs and better patient outcomes.
In addition to tracking patient outcomes, the process involves staff education which is facilitated by the team's ten member nursing staff and the clinical educator. Dr. Duke, one of the physician Intensivists, is offering the ICU staff a class titled "Sedation/Agitation in the Mechanically Ventilated Patient".

Friday, May 5, 2006

The Thrill of the Hunt

Be sure to check out the article in the latest issue of Advance for Nurses that spotlights Dana Rutledge, our own nurse researcher at St. Joseph Hospital. It can also be accessed online Enter "Dana Rutledge" in the search box.

Thursday, May 4, 2006

Meet the blog team

The blog team, from left to right are: Judy Rousch, Theresa Ullrich, Julie Smith, Ann Marie Keefer-Lynch, Dana Rutledge and Elaine Go. Not pictured is Linda Privette.

Please submit ideas for posting relating to nursing research/evidence based nursing to Julie at

Wednesday, May 3, 2006

CDC issues guideline on "pre-conception care"

As part of an effort to reduce infant mortality and improve the health of newborns, the CDC’s National Center on Birth Defects and Developmental Disabilities yesterday issued new “pre-conception care” guidelines that encourage women to “take stock of their health” before attempting to become pregnant, HealthDay reports. The guidelines, which were published this month in the Morbidity and Mortality Weekly Report, were developed based on the results of a two-year “exhaustive data review” by the CDC and more than 35 government, public, and private groups. The guidelines recommend that women contemplating pregnancy schedule a pre-conception physician visit—an appointment that the CDC is urging health insurers to offer coverage for. In addition, the recommendations advise women to control chronic conditions such as high blood pressure, reach or maintain a healthy weight, avoid alcohol, quit smoking, and create “reproductive life plan[s]” with their partners that outline when and how many children couples wish to have. The associate director for program development says although steps to ensure pre-conception health have been recognized as important “for many years, they have really not been a part of the health care system.” Physicians already have embraced the new guidelines, which they say create an “organized approach for [physicians] giving advice to women.” HealthDay notes that the new recommendations will be widely distributed, with many of the sponsoring groups providing links to the recommendations on their official websites

Tuesday, May 2, 2006

Tips for Nursing School

A lot of people have posted comments or emailed me about their studies.

You guys ask "I am applying to clinicals next semester, what should I do?"
or "I'm about to take class X, is it hard?"
or "How did you know this was what you wanted to do?"

Well, I've been thinking about what I've learned over the last year and I think it's time I gave you some insider information. Here's a few things I've learned that may or may not help you out in school.

1) If you are thinking about going to nursing school but aren't there yet, volunteer at the hospital. I'm serious, it's not just for old ladies and community organizations. I was privileged enough to volunteer for a couple semesters at Hermann Memorial Hospital in downtown Houston. The place was massive and they had everything imaginable over ten floors in several buildings. I got to wander around all over the place and meet doctors and nurses and therapists of every kind. I got to see what the job was really like. It focused my goals.

Another solution would be to get a part time or summer job working in a hospital, though these are sometimes harder to come by. I have several friends who work as unit clerks or pharmacy techs... good jobs but not nursing jobs. I'm applying for a student nurse tech position for the summer... but I wasn't even eligible for it until I completed 2 semesters of clinicals. For students, hospital jobs can serve to ease your transition into the working world (if you can handle the extra stress). But they might not be the best way to feel out nursing as a potential major.

In any case, you can't really know if you want to do it without spending time in the hospital.

2) Go ahead and buy an NCLEX review book at the beginning of clinicals. Look on Amazon and try to find the one with the highest rating, especially one that has questions sorted out by topic with rationales for the answers. (Also, some instructors pull questions from review books... but that's not why I'm mentioning it.)

The thing about the NCLEX is that it asks you questions based on your ability and adapts to your level. The passing questions are based on synthesis and critical thinking, not recognition and recall. Sure, if you keep answering questions incorrectly the computer will eventually start asking you where the liver is. But you have to answer a minimum number of difficult questions to pass. You can answer every single anatomy question correctly from here to infinity and never meet the minimum requirements.

If you are attending a good nursing school, your instructors will try to format their test questions similarly to the passing NCLEX questions. They won't ask "What is this disease" as much as they will ask "What is the priority thing you need to watch when a person has this disease?" They won't ask "What does this medicine treat?" so much as they will ask "What lab value do you need to monitor when these two medicines are combined?" This principle should hold true for any course, so when you study you should try to think on a higher level than simple fact regurgitation. A review book might help you anticipate the kinds of questions your teacher will ask. Even if you never see the exact questions on your tests... you'll be more prepared for boards upon graduation.

3) Don't study for the grades. I know it sounds ridiculous, but your goal in studying shouldn't be to make A's. Studying isn't a product-oriented activity. It is process-oriented.

What good is school if you only cram enough facts in your head to pass a test? What good is your education if you stay up all night before each exam trying to store just enough info in short term memory to bump your grade up a letter? That kind of behavior was okay for English and Psychology... those things aren't your major. But nursing is something you'll have to do every day for work, and your mistakes won't take the form of typos. They'll take the form of injuries and deaths.

I know it isn't easy to do; we're all busy people. But if you make it your habit to reread the week's notes every day... if you make it your habit to learn and retain a little information each time... you'll gain more than class credit. You'll gain competency. Powerpoint is destroying our ability to take notes and listen actively. Printing out the slide handouts isn't enough.

Okay, so some of school is silly and useless. Something you have to get through before you go out into the real world and learn how things are done. Still, constant efforts really will carry you farther in life than intelligence alone. It becomes a matter of discipline and will.

4) Take time to play. But don't do it all the time. Some days you're just going to have to work hard from sun up to sundown. Just remember to relax on weekends. Take time to exercise. That freshman fifteen wasn't your birth control. It was your metabolism slowing down. Even if you only go for a walk on the weekend, it's better than nothing. Don't drink too much. Try to get off the caffeine and cigarettes. You're going to be a nurse; set a good example. The immediate gratification will cost more in the long run.

That's enough for now. More tips as I learn them.

One more thing: do you have a nursing/health blog or website? I know a lot of you read me but I haven't gotten around to reading linking you. Just post a comment with your URL, I'll check out your site and add you if I like what you have to say.

Monday, May 1, 2006

Julie's picks -- current nursing research articles April 2006

Rolfe G. Validity, trustworthiness and rigour: quality and the idea of qualitative research. Journal of Advanced Nursing. 2006 Feb; 53(3): 304-10.

Keeney S. Hasson F. McKenna H. Consulting the oracle: ten lessons from using the Delphi technique in nursing research. Journal of Advanced Nursing. 2006 Jan; 53(2): 205-12

Weaver K. Olson JK. Understanding paradigms used for nursing research. Journal of Advanced Nursing. 2006 Feb; 53(4): 459-69.

Upton D. Upton P. Development of an evidence-based practice questionnaire for nurses. Journal of Advanced Nursing. 2006 Feb; 53(4): 454-8

Marklew A. Body positioning and its effect on oxygenation -- a literature review. Nursing in Critical Care. 2006 Jan-Feb; 11(1): 16-22

Lindberg DA. Integrative review of research related to meditation, spirituality, and the elderly. Geriatric Nursing. 2005 Nov-Dec; 26(6): 372-7

Pearson A. 30th Anniversary commentary on MacGuire J.M. (1990) Putting nursing research findings into practice: research utilization as an aspect of the management of a change. Journal of Advanced Nursing 15, 614-620. Journal of Advanced Nursing. 2006 Jan; 53(1): 73-4. (6 ref)

Houldin A. Curtiss CP. Haylock PJ. Executive summary: the state of the science on nursing approaches to managing late and long-term sequelae of cancer and cancer treatment. American Journal of Nursing. 2006 Mar; 106(3): 54-9.

Marchiondo K. Teaching tools. Planning and implementing an evidence-based project. Nurse Educator. 2006 Jan-Feb; 31(1): 4-6

Pepler CJ. Edgar L. Frisch S. Rennick J. Swidzinski M. White C. Brown T. Gross J. Strategies to increase research-based practice: interplay with unit culture. Clinical Nurse Specialist. 2006 Jan-Feb; 20(1): 23-33.

Duffy ME. Using research to advance nursing practice. Resources for determining or evaluating sample size in quantitative research reports. Clinical Nurse Specialist. 2006 Jan-Feb; 20(1): 9-12.

Craig SE. Does nurse-led pre-operative assessment reduce the cancellation rate of elective surgical in-patient procedures?: a systematic review of the research literature. British Journal of Anaesthetic & Recovery Nursing. 2005; 6(3): 41-7