Monday, November 30, 2009

MBIO

What's your first thought on seeing MBIO? Well the dumb-ass that I am, I thought my next class was molecular biology. Which I was pretty freakin excited about. Imagine my disappointment when I found out MBIO stands for metabolic biochemistry. Shit.

No Way

Who'da thunk it? I'm becoming VERY interested in genetics. But that's not the weird part. Pediatric genetics. In case you think I've mis-typed, I'll say it again. PEDIATRIC Genetics. Genetics class has been over for 2 weeks and I'm still coming home and watching documentaries on Tay Sachs and Gaucher's. I see the kiddos with Progeria and I love them with every ounce of my heart. I want to kiss the rocker-bottom feet of kids with Trisomy 18. I think what I'm feeling is overwhelming. I dream about them at night. But I am especially in love with the Progeria kids. That part isn't new. I remember seeing a show as a child about children with Progeria, and I was fascinated. Now I just want to help their heart conditions and keep them pain free and help them to avoid respiratory infection.

The bad part is that I cry. A lot. I don't know how to overcome this particular obstacle. My boyfriend thinks I am too sensitive to be a peds geneticist. His attitude is basically "Holy shit woman, you're crazy enough with no reason to cry.... I can't handle you working in a place where there really is reason to burst into tears all day long." Fair enough. But I still love it. The things I don't love about it? Most genetic diseases aren't treatable. It's like "Yup, you've got disease X, sucks for you". Also, about 100% of genetics work is in the clinic or the lab. Two things I'm not totally hip on. No procedures, no surgery, nada. Unless you combine pediatric genetics with something like critical care... but sheesh... that's a whole lotta years of residency. Yikes.

Well, we'll see. I'm just thrilled that something has grabbed me.

Florence Nightingale

image 1

Florence Nightingale, the daughter of the wealthy landowner, William Nightingale of Embly Park, Hampshire, was born in Florence, Italy, on 12th May, 1820. Her father was a Unitarian and a Whig who was involved in the anti-slavery movement. As a child, Florence was very close to her father, who, without a son, treated her as his friend and companion. He took responsibility for her education and taught her Greek, Latin, French, German, Italian, history, philosophy and mathematics.

At seventeen she felt herself to be called by God to some unnamed great cause. Florence's mother, Fanny Nightingale, also came from a staunch Unitarian family. Fanny was a domineering woman who was primarily concerned with finding her daughter a good husband. She was therefore upset by Florence's decision to reject Lord Houghton's offer of marriage. Florence refused to marry several suitors, and at the age of twenty-five told her parents she wanted to become a nurse. Her parents were totally opposed to the idea as nursing was associated with working class women.

Florence's desire to have a career in medicine was reinforced when she met Elizabeth Blackwell at St. Bartholomew's Hospital in London. Blackwell was the first woman to qualify as a doctor in the United States. Blackwell, who had to overcome considerable prejudice to achieve her ambition, encouraged her to keep trying and in 1851 Florence's father gave her permission to train as a nurse.

Florence, now thirty-one, went to Kaiserwerth, Germany where she studied to become a nurse at the Institute of Protestant Deaconesses. Two years later she was appointed resident lady superintendent of a hospital for invalid women in Harley Street, London.

In March, 1853, Russia invaded Turkey. Britain and France, concerned about the growing power of Russia, went to Turkey's aid. This conflict became known as the Crimean War. Soon after British soldiers arrived in Turkey, they began going down with cholera and malaria. Within a few weeks an estimated 8,000 men were suffering from these two diseases.

Source : http://www.spartacus.schoolnet.co.uk

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Saturday, November 28, 2009

Why has Nursing care changed?



Why aren't the nurses as visible? Why does no one answer my call bell? Why is so little getting done in the way of basic care? Why are so many nurses leaving? Why isn't the care the same that it was in 1980? Were the nurses themselves better back in those days?

Somebody actually decided to do a little research into these issues and determine just what exactly is going on.

You won't find any "too posh to wash" "too clever to care" "needs matron to knock them into line" and "it all went downhill when they started training at university" comments here. Not by a long shot. Not by a long shot. The person who wrote this article knows her stuff and did her research.

I won't post the whole article here (edited to add, I should really as this got way longer than expected) but please, please, check it out. So much is similar to what is going on in the UK.

Here are some excerpts in no particular order. These are just paragraphs here and there that I copied and pasted for those who don't click on the article. My comments in blue. I'd do more but I am getting kicked off the pc by the warcraft brigade.

*The burden of care for nurses, patients, and families has demonstrably increased since 1990.

*This situation has three fundamental causes. The first cause is a profound change in the nature of hospitalization, the kinds of illnesses and conditions of patients treated, and the level of care required. The second is the reorganization of hospitals, which has led to a reduction in the amount of time nurses spend in direct care of patients. The third is the lack of broadly accepted expectations about the caregiving responsibilities that family, friends, and patients themselves ought to assume, both in the hospital and at home, about how this care should be coordinated with the work of professional nurses and other nursing personnel, and about the appropriate ratio of direct-care nurses to patients. This report deals with each of these causes in detail.

*Pressures on families are particularly severe when a patient has been sent home from the hospital after a shortened stay or has received outpatient care for problems that were formerly dealt with in hospitals.

*Nurses report increasing dissatisfaction with their work in hospitals that have cut staff, that require frequent overtime, and that have replaced nurses with assistive personnel. Research has shown that these phenomena are related to adverse nurse and patient outcomes.

*This situation has three fundamental causes.

*The first cause is a profound change in the nature of hospitalization, the kinds of illnesses and conditions of patients treated, and the level of care required.

*The second is the reorganization of hospitals, which has led to a reduction in the amount of time nurses spend in direct care of patients. The third is the lack of broadly accepted expectations about the caregiving responsibilities that family, friends, and patients themselves ought to assume, both in the hospital and at home, about how this care should be coordinated with the work of professional nurses and other nursing personnel, and about the appropriate ratio of direct-care nurses to patients. This report deals with each of these causes in detail.

*Hospitals and hospital nursing have changed dramatically since 1990. Changes in reimbursement and demography have, in turn, added to the pressures on hospital systems, on patients, and on caregivers. Inpatient lengths of stay have declined dramatically (by 40 percent between 1980 and 1995) (Reinhardt 1996), and the average acuity of patients is higher in any given unit. Therefore, every patient assigned to an RN requires relatively intensive monitoring and care—a situation that is complicated by the fact that increased demands for documentation mean that caregivers can devote fewer hours to direct care and monitoring.
Try telling any of this to these old bats who trained in 1960 and haven't been back since 1962. One stupid bitch said that the problems were down to university educated nurses, and everyone else just repeated that statement like a robot.

*Advances in knowledge and medical and nursing expertise have enabled a greater number of seriously ill patients to survive. The shortened length of hospital stays, resulting from pressure from insurers (Or nu-labour targets), means that more severely ill patients are being discharged sooner to nursing homes, rehabilitation facilities, or their own homes. Moreover, the way hospitalization is financed and the growing number of chronically ill people and the aging of the population in general are also affecting hospitals' inpatient mission.

*Nurses, physicians, patients, and families have formed their expectations about care over many decades. Personal experiences, fictional depictions, and anecdotes from family and friends shape notions about care. The concepts care and nurse are both freighted with complex historical and emotional content. Seldom verbalized, this social legacy contributes to the public's expectations about caregiving. That the nature of hospitalization has changed, that demographic changes have brought different emphases to the health care system, that financial pressures have led to restructured and reorganized systems, and that hospitals have had to alter their mission to suit these financial and demographic shifts—all these developments have been received with gloom and anxiety by patients and potential patients and with concern by nurses and physicians.
Well it seems that everyone just blames the nurses for being lazy. Problem solved eh.

*Recent changes in what people can expect from nursing and hospital care have not been widely discussed with the public. Nor have changes been discussed with nurses very often.

**. Nurses represent the primary surveillance system in hospitals 24 hours a day. An adequate surveillance system provides enough nurses to observe patients directly so that they can recognize an impending or actual problem. These nurses are the first to mobilize an intervention that often requires the coordination of the activities of others, including physicians, to save a patient's life. Silber finds nurse staffing even more important than the board certification of physicians, since physicians are usually the second to know about a complication.

*****Consulting firms brought in to help hospitals reengineer their services and achieve cost reductions usually target labor costs. But nurses and physicians often complain that consultants do not seem to understand the complexities of delivering care or to grasp the complex role that nurses play in observing, monitoring, and assessing patients' needs. All too often, cutting professional nursing staff—and replacing nurses with nurses' aides or other assistants—serve as an easy solution to budgetary problems. This is exactly what is happening in the NHS.

*I once had a chance conversation with a man who, I learned, had in the past worked for one of the major consulting companies and had been deeply involved in the restructuring of a number of hospitals. Learning that I was a nurse, he said, somewhat sheepishly, "I'm one of the bad guys." He told me about what he described as his "naive and dangerous period" and was filled with guilt over the restructuring recommendations he had made in his former job. His awakening, he said, had come when his wife had had a baby who required intensive, long-term neonatal care. During the hours and days the couple spent at the hospital visiting their critically vulnerable infant, they had a chance to see nurses at work expertly caring for—and ultimately saving—their child. In the process, he came to understand what nurses do and how important their job is. Well well well. NHS hospitals have been bringing these same kinds of management consultants in for years. Doubt they are remorseful though. They are just out of control. Prejudice against Nurses leads to managers listening to these clueless dipshit management consultants rather than frontline staff who know the score. It's the same everywhere, doesn't matter what country you are in...

*The word care has a variety of meanings, and is used to describe both personal and professional activities. But the professional care that nurses are trained to give is in many respects quite different from the personal sorts of caring that characterize relationships between spouses, parents and children, family members, and friends. Professional caregivers are independent decision-makers, whose autonomy of action is legally defined, and they are highly educated specialists who act in accordance with expert knowledge and in ways appropriate to their responsibilities.

*When a person's daily life is seriously impaired by illness, age, or disability, he or she may require the assistance of nurses—whether in a hospital, a nursing home, or at home. Unfortunately, many ambulatory settings are poorly suited for nursing activity, a situation that calls for an even higher level of professional knowledge and judgment.
In other words, care—the kind of care that nurses render, sometimes under difficult circumstances—consists of much more than giving patients confidence, assurance, and comforting words. Nurses base their practice on exacting professional standards.

*The complexity of the care given by professional nurses, however, is only poorly understood by the public at large. . Because "caring" is such a ubiquitous concept, and because the word is used so loosely, nursing care is often seen as intellectually undemanding, a "soft" profession. And this perception has been bolstered by the fact that historically, and in many nations, young men have been forbidden or discouraged from entering nursing, leading people to see nursing as "women's work" and a second-class kind of career. That nursing has been so demeaned has led men and women both to discount it, rejecting careers in professional caring for more powerful, economically rewarding roles.

**Chief nursing officers told Gordon that nurses' greater workloads occurred mainly because patients were in and out of the hospital so quickly. Administrators said the same thing, but their agreement did not seem to translate into support for bedside nurses. Staff nurses complained of a lack of support from nursing administrators and said they felt they were reliving failed nursing delivery models of the past, such as less expensive substitutes and team nursing.(Oh Nurse Anne could tell you all about that) They said administrators blamed them for being inefficient, dismissed them as complainers when they reported problems in patient care, and constantly challenged data culled from their daily experience in providing patient care

*In addition, Sovie's study reported a declining number of RNs involved in direct patient care and a growing number of UAPs participating in patient care. (The study also showed that UAPs are being assigned an expanded role in providing patient care.) Although reductions in the number of RNs were intended to reduce costs, Sovie's findings showed that costs per day/discharge were influenced by hours worked per patient day (HWPPD) and paid full-time equivalents (FTE). Thus FTEs and HWPPD were the expense drivers, not the percentage of RNs. In many instances, as RN percentage went down, both FTEs and HWPPD rose since, with fewer RNs and more unlicensed personnel on staff, it took more people more hours to deliver care.

*The majority of these changes were cost driven; however, costs per day/discharge decreased as the percentage of RNs increased. That reengineering does not necessarily improve performance but can in fact be detrimental to it was also found in a study that examined cost per patient day at 2,306 urban medical/surgical hospitals with 100 or more beds (Walston 1998).

*It is difficult to ascertain the overall skill level of nursing staff at restructured hospitals. The American Hospital Association stopped collecting data on aides in 1993—just as hospitals had begun substituting aides for registered nurses—because, it said, hospitals balked at completing the survey (Aiken 1999). The AHA still collects data on RNs and LPNs, but, as aides are melded with other hospital personnel, it is no longer possible to calculate the nursing-skill mix.

*The training of the aides who are replacing RNs is not regulated by state licensing boards. There are no minimum requirements governing the amount of training aides or "cross-trained" workers must have before they can be redeployed (at least part of the time) to do nursing work. Training periods can range from a few hours to perhaps as long as six weeks. Ninety-nine percent of the hospitals in California reported fewer than 120 hours of on-the-job training for newly hired ancillary nursing personnel. Only 20 percent of those hospitals required such aides to have a high school diploma. The majority of hospitals (59 percent) provided fewer than 20 hours of classroom instruction, and 88 percent provided 40 or fewer hours of instruction time (Institute of Medicine 1996).

*In April 1999, nurses at several New York hospitals went on strike to protest patient loads and work hours that they deemed dangerous. In a complaint to the National Labor Relations Board, the New York State Nurses Association reported that nurses were sometimes working 20 hours out of 24 and caring for as many as 18 patients (New York State Nurses Association 1999). Many other reports tell similar stories: of nurses dealing with ratios of 1 RN to 10 patients on the day shift and 1 to 15 or even 1 to 20 on some shifts (well that sounds almost as bad as what is normal in the UK, those are our regular numbers), of nurses being expected to work double shifts, and of a growing demand that nurses work mandatory overtime.

*Anecdotal reports from nurses, doctors, patients, and families suggest a dramatic decline in the availability of professional nurses to care for acutely ill patients while hospitalized and during the immediate post-discharge period. Most of these anecdotes contain bitter complaints about the lack of nurses to meet the increasingly complex needs of patients and express genuine concern (often outrage) about the decline in the quality of care provided to vulnerable patients.
Mostly this outrage is directed straight at nurses who are caring for way too many patients at one time. Nurses are told that the failures in care are down to their laziness, their stupidity, their uncaring slovenly attitude.

* Nurses, physicians, and chief nursing officers all agreed that they could no longer provide the level of care given in the recent past. Both nurses and physicians reported that heavy workloads caused nurses to postpone or miss tasks, and nurses described a troubling erosion of their capacity for empathy because of the difficulty they had finding time to provide even basic physical care. The combination of crowded schedules and inadequate staffing permitted little or no time for education or mentoring of neophyte nurses.

*The experts did, however, make the following positive recommendations for action by public-sector regulators:

Establish standards for safe patient care, while acknowledging the extraordinary difficulty of doing so.

Establish training standards and competency (certification) exams for previously licensed personnel, through both national and hospital-based strategies.

Find new ways to regulate the sites in which nurses practice. Such regulations might include requirements that address the issues discussed in this report (for example, closing beds when RN staff is reduced below a particular level and adding clinical nurse specialists to units).

Require that clinical assignments be given only to persons qualified to perform them.

Require that all staff performing clinical tasks be properly identified.

Encourage state legislatures to establish commissions on nursing to address issues of regulation as well as the adequacy of the supply of nurses, as has occurred, for example, in Maryland and California.

Create a nursing assignment registry that provides information about training and background in ways that earn the respect of members of the profession and others.

Establish licensing requirements that reflect the different capabilities of nurses with different educational credentials, in response to employers of nurses redesigning jobs and rewards that reflect differences in education.
Financing

*The experts offered the following recommendations to address the issues:

Adopt the ANA Principles of Nurse Staffing, either as an industry standard or by regulation.

Require hospitals to report nurse-to-patient ratios publicly on a regular schedule. (Note: This is not a recommendation of required nurse-to-patient ratios.)

Establish protocols to prevent the circumvention of technologies designed to prevent medical errors (for example, turning off alarms that would alert staff to problems).

Establish a more effective standard hierarchy of expertise in nursing service; in particular, establish as a norm the strong presence of persons with substantial recent clinical experience at the highest levels of management as well as in team leadership in patient care areas.

Provide opportunities for education and career progression for all hospital positions. Encourage hospitals to improve working conditions in order to be eligible for Magnet Hospital Recognition, awarded by the American Nurses' Credentialing Center.

The experts recommended that policymakers in government, provider associations, and nursing should:

Improve working conditions, compensation, and benefit packages for nurses to encourage long-term institutional employment, so that nursing can compete more effectively with other professions.

Tie repayment and forgiveness of educational loans and grants to the recipient remaining in nursing, in hospitals and other health care agencies, for periods of time related to the extent of support granted.

Make nursing education more efficient by reducing the number of nursing schools in hospitals and community colleges and increasing capacity in baccalaureate and graduate degree programs. See my posts on patients of degree educated bedside nurses having highter survival rates.



It's an excellent article. It's not that long. You can read it in 5 minutes. Check it out of you get a chance. I am so sick that the changes in nursing care in hospital being blamed on uncaring, overeducated, lazy nurses. Nurses are just a soft target eh? Why is that? Why is it so easy to target Nurses? That answer can easily be found in the history of Nursing. That's a blog post I am still working on.

Thursday, November 26, 2009

Nice Headline about Nurses Daily Mail




No doubt whatsoever that there were issues with Nursing care at Basildon.


With the kind of trained nurse to patient ratios that British nurses are working with I am not surprised. I wouldn't expect a nurse with superpowers to do any better. I have worked in 3 countries as a nurse over a period of 13 years. Let me remind you of something. Nurses in the UK are working with trained nurse to patient ratios that wouldn't be legal in a 3rd world hellhole like Haiti. Not only that, but they have a lot less back up than say a nurse in Canada or Australia would have.


I once asked asked a super american nurse friend of mine if she would take on 15 acute patients. She is a bedside nurse, very well respected and has won multiple awards. She would tell you no way would she take on more than 6 acute patients with no back up because it would be nothing but a total fail, no matter how hard she worked. She would refuse to work in a hospital like mine that can assign a nurse anywhere from 10 to 30 and upwards patients. This statement came from a nurse friend of mine in the North East USA who won an award for most compassionate nurse at her Magnet Hospital. Google Magnet.


No one in their right mind would expect a nurse to be able to function in the conditions that NHS nurses are working in right now. Whether they are angels or devils, they are going to fall flat on their faces and fail. Therefore we can conclude, once again, that most commentators on the daily mail are lunatics.


I'll let my readers take this apart in the comments section. I don't have the energy right now.

What have I learned from this article? Journalists still don't understand that most of these "nurses" are not actually nurses.


The daily mail is such an extreme example of Yellow Journalism that it would even shock William Randolph Hearst with it's vileness.


I also take offense to the fact that they are depicting nurses as lazy. If you are an RN in acute care you WILL be working many 12-14 + hour shifts without taking any kind of a break. The health care assistants and clinical support people running around in their nurses uniforms don't go through this but Nurses often do.

12-14 hours without a break or a drink, on your feet while the support assistants stop for tea. It's not like they can help you keep up with the nurse stuff anyway. Remember that most of the readers commenting on this daily fail article probably work 8-9 hour days and get an hour lunch break. Now that is lazy.

Dear Daily Fail,

Interesting piece. I will never so much as have a minute free in shift to screw around with mattresses. If the hospital will provide more staff nurses on shift with me to handle all the drugs, treatments, assessments, orders and accountability then I will happily clean the mattresses. Happily. God I would love a shift spent cleaning and I am very much a degree nurse.

There is a massive difference between a nurse not cleaning a mattress because she is alone and cannot drop the ball on the drugs and the treatments for 30 seconds and a nurse that just doesn't want to do it. The former is a lot more likely and the latter is rare. Cleaning mattresses rather than being the only RN for multiple acutely ill patients sounds rather pleasant to 99.9% of us. You see, we would consider an 8 hour workday without life and death responsibility a vacation day with a paycheck. Especially if it was an 8 hour workday without life and death responsibility and a lunch break. Even if it was only a 10 minute lunch break.

This is what we think of people who work outside of health care and un-registered people who work in health care. You are all having permanent vacation days with paychecks. A nurse I used to work with who left health care to work as a teaching assistant explained it to me that way and so have many others.

An RN can be working at a pace you cannot begin to imagine sometimes for 14 hours straight with no break and still only get through the top 1% of what needs to be done that shift. That means that even if he is working at that kind of pace most of his patients will languish and not get fed or basic care simply down to the fact that the nurse is so outnumbered by people who need help.

I am starting to realise that it won't actually matter if I stop for 5 minutes to get a drink during my 12 hour shift. It won't change a goddamn thing.
Patients are going to suffer whether I do or don't.
Get a safe trained nurse to patient ratio campaign going on or shut the fuck up.

Sincerely Yours,
MMN.

PS- no one believes that you care about patients. A sustained media campaign to expose the reality of the situation and staff our hospitals with trained nurses would result in a level of care that would have made the idea of starving neglected patients on filthy wards a distant memory. It would also be cost effective to increase your ratios of trained nurses. But that wouldn't give you sensationalist yellow journalism headlines now would it?

By the way does anyone know of a casualty unit anywhere in the NHS where the actual nurses could afford to be lazy for even 10 seconds and then get out of there without being blamed for someone's death?

Med School Can Only Get Better From Here

So every speck of Anatomy is done. Class. Lab. Lecture. Final Exam. Lab practical. And the anatomy shelf exam. Holy smokes that took me for a ride. FYI: We have to take regular final exams for each class which are written by the professor at our school. THEN, for certain classes we take a "shelf" exam... which is a standardized subject exam given to med students everywhere. The test questions are recycled USMLE 1 questions... so we're getting some practice for the boards. The anatomy portion was alright... but the embryology portion was hellacious! Better start practicing embryo before Step 1.

So my theory is that if the rest of med school is as cool as the other classes I've taken (excluding anatomy of course) that things can only look up from here. I'm headed into Histology, Physiology and Molecular Biology come Monday. Yay!!

11/26 Nurse Practitioner Jobs









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Wednesday, November 25, 2009

Julie's picks from the nursing literature: November



Here are my picks from the recent articles dealing with evidence-based nursing or nursing research. Staff at St. Joseph Hospital in Orange, California and Children's Hospital of Orange County may be able to access the full text of these via the library's website.

1.
An information technology infrastructure to enable evidence-based nursing practice.(includes abstract); Pochciol JM; Warren JI; Nursing Administration Quarterly, 2009 Oct-Dec; 33 (4): 317-24 (journal article - tables/charts) ISSN: 0363-9568 PMID: 19893445 CINAHL AN: 2010435221

2. Nurse-led care was non-inferior to physician-directed care in
symptomatic moderate to severe obstructive sleep apnoea.Floyd JA;
Evidence-BasedNursing, 2009 Oct; 12 (4): 112 (journal article) ISSN:
1367-6539 PMID: 19779079 CINAHL AN: 2010450231

3. Why nursing has not embraced the clinician--scientist role.(includes
abstract); Mackay M; Nursing Philosophy, 2009 Oct; 10 (4): 287-96
(journal article - review) ISSN: 1466-7681 PMID: 19743972 CINAHL AN:
2010412979

4. The meaning of hope in nursing research: a meta-synthesis.(includes
abstract); Hammer K; Mogensen O; Hall EOC; Scandinavian Journal of
Caring Sciences, 2009 Sep; 23 (3): 549-57 (journal article - research,
systematic review, tables/charts) ISSN: 0283-9318 CINAHL AN:
2010378575

5. Evidence-based nursing. Research ambassadors: bringing findings to
the bedside.Larkin ME; Cierpial CL; Vanderboom T; Anspach K; Grealish
K; Ball S; Griffith CA; Nursing Management, 2009 Oct; 40 (10): 20-3
(journal article) ISSN: 0744-6314 CINAHL AN: 2010436208

6. Nurses' role in detecting deterioration in ward patients: systematic
literature review.(includes abstract); Odell M; Victor C; Oliver D;
Journal of Advanced Nursing, 2009 Oct; 65 (10): 1992-2006 (journal
article - research, systematic review, tables/charts) ISSN: 0309-2402
CINAHL AN: 2010413148

7. 28. The utilization of reflective journals to explore nurses' experience
using mobile information technology to access and use research
evidence.Newman K; Doran D; CIN: Computers, Informatics, Nursing, 2009
Sep-Oct; 27 (5): 336 (journal article - abstract, research) ISSN:
1538-2931 CINAHL AN: 2010425595

8. Nurse-led interventions to reduce cardiac risk factors in
adults.Harvey J; Loar R; Joanna Briggs Institute; Best Practice, 2009;
13 (5): 21-4 (journal article) ISSN: 1329-1874 CINAHL AN: 2010447069

9. Accessing pre-appraised evidence: fine-tuning the 5S model into a 6S
model.Dicenso A; Bayley L; Haynes RB; Evidence-BasedNursing, 2009 Oct;
12 (4): 99-101 (journal article) ISSN: 1367-6539 PMID: 19779069 CINAHL
AN: 2010450221

10. Review: little evidence exists for type of dressing or support
surface or for nutritional supplements for pressure ulcers.Bell-Syer
SE; Evidence-BasedNursing, 2009 Oct; 12 (4): 118 (journal article)
ISSN: 1367-6539 PMID: 19779085 CINAHL AN: 2010450237

11. AACN announces new system to rate evidence. AACN Bold Voices, 2009
Sep; 1 (3): 14 (journal article - brief item, tables/charts) ISSN:
1948-7088 CINAHL AN: 2010402603

12. Core measures for developmentally supportive care in neonatal
intensive care units: theory, precedence and practice.(includes
abstract); Coughlin M; Gibbins S; Hoath S; Journal of Advanced
Nursing, 2009 Oct; 65 (10): 2239-48 (journal article - pictorial,
tables/charts) ISSN: 0309-2402 CINAHL AN: 2010413158

13. Searching for evidence: mission-critical tips.Boss C; Wurmser TA;
Nursing Management, 2009 Sep; 40 (9): 12, 14 (journal article) ISSN:
0744-6314 PMID: 19734750 CINAHL AN: 2010414304

14. Overturning barriers to pain relief in older adults.(includes
abstract); D'Arcy Y; Nursing, 2009 Oct; 39 (10): 32-9 (journal article
- CEU, exam questions, nursing interventions, pictorial, review,
tables/charts) ISSN: 0360-4039 CINAHL AN: 2010431004

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Tuesday, November 24, 2009

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Last post on Nurse Degrees....for awhile anyway

We're all sick of arguing with nutters like Iain Dale and others who worked in a hospital once....so they say...... and weren't even bright enough to realise that they weren't actually any thing like a Nurse.

But I am posting this next piece because I think the author sums it all up quite nicely. This was written by a colleague of mine.

......................................................................................................................

I'm about a week behind the curve on this one, but I've been browsing through all the blog reactions to the news that all nurses will study for a degree from 2013, and alternately laughing and crying.

This is a desperately unfashionable thing to say, but I actually think it's a good thing. I trained in Wales, where nurse training is already all-degree. The news is only bringing England into line with Scotland and Wales. Contrary to what a lot of commentators are suggesting, doing a degree doesn't mean you spend less time on the wards while studying - whether you do a degree or a diploma, a student nurse has to spend over 2500 hours out on clinical placements before they can qualify.

Here's what Iain Dale (described as "insightful, informative and entertaining" by the Observer) has to say about it, in his insightful and informative way.


I once spent a year working as a nurse. There, that surprised you didn't it? Admittedly it was in Germany and was in a private clinic specialising in spinal injuries, but it was still nursing. I had no qualifications, no training and certainly no degree (it was my gap year).


So, Iain, you weren't a nurse at all. You were a care assistant. Don't get me wrong, I'm not knocking care assistants; many of them are brilliant, but they're not staff nurses.


So when I heard this morning that the NHS was now going to insist on a degree before nurses could train, I was dumbfounded. Not all nurses are academically gifted and would want to do a degree. Does a degree in astronomy make a nurse better able to do his or job, than four years hands on training?
Nooo, Iain, they have to do a degree in nursing, not astronomy!

Then there's this guy, who despite being a doctor, still doesn't seem to understand how nurse training works.


The same is the case for nursing training, the ward hours and apprenticeship has been lost at the expense of satisfying politically correct mumbo jumbo spewed forth by educationalists.


But the ward hours and apprenticeship haven't been lost. I'm a degree-educated nurse, and I still had to do my 2500 hours on placements before I could qualify. I spent a hell of a lot of time running around wards doing hands-on nursing to get my degree.

Then I read Melanie Phillips article in the Spectator. Yadda yadda nurses don't want to nurse yadda yadda Florence Nightingale yadda yadda nursing is a vocation not a profession yadda yadda ...then I had to stop before my brain exploded onto my PC monitor. Though I understand this is a fairly usual reaction to reading a Mel Phillips article.

Right now there are many problems with providing nursing care, just to list a few:

- criminally low ratios of nurses to patients on NHS wards. I've heard of some wards where 2 nurses and 2 healthcare assistants were left looking after 35 seriously ill patients.

- more form-filling being forced on nurses in an increasingly lawsuit-happy culture - see also teachers, police officers and social workers

- advances in medicine making the job more technical. Florence Nightingale wasn't running around dealing with IVs, catheters, tracheostomies, all the while mixing potentially lethal medications

- an ageing population making the patients on the wards older and sicker, thus needing more care to keep them alive.


But what is not the problem is that nurses are getting too uppity because they've got degrees. All this is inverse intellectual snobbery that says that clever people can't be good nurses. My experience is that clever people often make for outstanding nurses. They think on their feet, they can problem-solve, they look at new ways to do this, they keep their knowledge and skills updated. All of these things are good qualities in a nurse.

As for the media stereotype of nurses who are too busy daydreaming about their next sociology paper to notice the patient's call bell ringing....they may well exist, but I haven't met any of them. What I have met repeatedly though is nurses who were rubbish at their job because they were ignorant, unimaginative and thick as a plank.

......................................................................................................................

Outstanding.

Melanie Phillips article here. Melanie, your ignorance is shocking. That goes for you too Iain Dale.

Saipan Nursing Jobs

This is another great opportunity for Filipino nurses who want to work in nursing jobs abroad. The POEA or Philippine Overseas Employment Administration recently approved a job order allowing a Philippine based recruitment agency to recruit qualified applicants for nursing jobs. This nursing jobs is in the country of Saipan and was approved last November 19, 2009. The said POEA approved nursing jobs has a job order balance of 26 Saipan nursing jobs.

All interested nursing jobs professionals who wish to apply for the said nursing jobs vacancy should proceed directly to the office of the recruiting agency to submit their application. For more info regarding the requirements, qualifications, and placement fees for the said Saipan nursing jobs, you can contact the recruiting agency in their contact infos stated below.


21st Century Manpower Resources Inc.
3rd Floor AM Building
28 Quezon Avenue, Quezon City

Tel Nos: 7127755 / 7127748
Email Add: recruitment@21stcmri.com
Website: www.21stcmri.com

Nursing Jobs New Zealand

This is the chance for Filipino nurses who want to work in nursing jobs abroad. The POEA or Philippine Overseas Employment Administration recently approved a job order allowing a Philippine based recruitment agency to recruit qualified applicants for nursing jobs. This nursing jobs is in the beautiful country of New Zealand and was approved last November 16, 2009. The said POEA approved nursing jobs are for Registered Nurses or RN’s and has a job order balance of 55 nursing jobs New Zealand.

All interested nursing jobs professionals who wish to apply for the said nursing jobs vacancy should proceed directly to the office of the recruiting agency to submit their application. For more info regarding the requirements, qualifications, and placement fees for the said nursing jobs New Zealand, you can contact the recruiting agency in their contact infos stated below.


Reliable Recruitment Corporation
1166 Grey Street, Ermita
Manila

Tel Nos: 5222128 / 5251935
Email Add: relcor@skyinet.net

Monday, November 23, 2009

Nursing Jobs UAE

This is a great opportunity for Filipino nurses who are seeking employment in nursing jobs in UK. The said nursing jobs UAE has a job order that was approved by the POEA last November11 and 19, 2009 and was approved for two Philippine based recruitment agencies based in Malate, Manila. Below is the breakdown of the POEA approved nursing jobs UAE which includes the position required, the date the job order was approved and the number of applicants to be recruited for each position.

Private Nurse --- Surefast Manpower Services ------ 11/11/2009 --- 25
Staff Nurse ------ Jerr Services and Trading Corp. -- 11/19/2009---- 50

To apply, all interested applicants should proceed directly to the office of the recruiting agency to submit their application. For more details, you can contact the recruiting agencies on their contact infos stated below.


Jerr Services & Trading Corp.
2nd Floor Jerr Building
511 Alonzo Street, Malate
Manila

Email: jerr_services@yahoo.com
Website: www.jerserv.com



Surefast Manpower Services
1070 Estrada Street, Malate
Manila

Tel No: 5365894
Email Add: surefastph_2007@yahoo.com

Nursing Jobs in UK

This is a great opportunity for Filipino nurses who are seeking employment in nursing jobs in UK. Recently, the POEA has approved six job orders that allow two Philippine based recruitment agencies to recruit qualified candidates for nursing jobs in UK. The said nursing jobs in UK are for Veterinary Nurse, Theatre Nurse, Medical Nurse, ICU Nurse, Acute Care Nurse, and NICU Nurse. Below is the breakdown of the POEA approved nursing jobs in UK which includes the position, the date of the job order approval, and the number of nursing jobs applicants to be recruited.

Veterinary Nurse ----------- 11/13/2009 ----- 20
Theatre Nurse --------------- 11/19/2009 ----- 25
Medical Nurse -------------- 11/19/2009 ----- 25
ICU Nurse -------------------- 11/19/2009 ----- 25
Acute Care Nurse --------- 11/19/2009 ----- 15
NURSE (NICU) ------------- 11/19/2009 ----- 15

For more info on the name of the recruiting agency, its address, and contact infos, just leave your email address, and the position you wish to apply for in the comment section at the end of this article and we will respond to your queries as soon as possible.

Click, Peel, Stick: How to Turn Holiday Cards into a Midwifery Advocacy Activity

by Melissa Garvey , ACNM Writer and Editor st1\:*{behavior:url(#ieooui) }







Nurse Practitioner Jobs, Physician Assistant jobs, ARNP jobs, NP jobs, Nurse Practitioner Resumes, Nurse Jobs, Physician Jobs, CRNA jobs, Advanced Registered Nurse Practitioner Jobs,Advanced Practice Provider,Advanced Practice Clinician,





 



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What Mammography and Continuous Electronic Fetal Heart Rate Monitoring Have in Common

by Melissa Garvey, Writer and EditorEarlier this week the U.S. Preventive Services Task Force (USPSTF) issued revised breast cancer screening guidelines: women in their 40s who have no unusual risk factors for breast cancer should not receive routine mammograms for early detection of breast cancer and should instead begin routine screening at age 50.This is proving upsetting especially to women

Wednesday, November 18, 2009

Nurse Practitioner Jobs ARNP Jobs Nov. 17









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Tuesday, November 17, 2009

A healthier winter for Philadelphia

Approximately 1400 Philadelphians can thank Villanova University nursing students for fewer fevers, coughs, and aches this winter. Flu season just got easier for them after nearly 90 junior students, accompanied by College of Nursing faculty, administered their seasonal flu shots.

The junior class participates in the seasonal flu immunization program with the Philadelphia Department of Public Health. During October and November, at 11 locations across the city including senior centers, parishes, and other community sites, the students assessed, educated and immunized vulnerable Philadelphians. The College has served Philadelphia in this manner for at least nine years.

In addition, the College of Nursing is assisting its own community by administering H1N1 vaccines to faculty, staff and students on Villanova’s campus on four days in November. Eleven clinical groups of traditional junior and senior students plus accelerated second degree adult students are being joined by their faculty for the immunization program at Jake Nevin Field House.

In this photo, nursing students Kevin Nusspickel and Kaitlyn Murphy administer flu shots to older Philadelphians at a retirement center on November 2.

It’s Time to Fight For Preemies

by Melissa Garvey, ACNM Writer and EditorIn honor of National Prematurity Awareness Month, Midwife Connection is participating in the March of Dime’s Fight for Preemies, a blog event to raise awareness of the premature birth crisis. Every year, 20 million babies are born too soon, and half a million of them are born in the U.S. Today is the day to put a face on prematurity by blogging for a baby

Monday, November 16, 2009

Ode to Betty

Betty is our cadaver. I didn't name her... but to the best of my recollection she was named after Betty Davis. Which I'm not sure is all that appropriate considering that she was in her 80's, bald, and we certainly never saw her eyes. Well, not then at least.

Poor Betty. She was rather anomalous and gave us a rather tough time more often than not when looking for a certain structure. She had a port-a-cath (that can really throw you for a loop if you aren't expecting it), no musculocutaneous nerve in the brachial plexus, a titanium knee, a brain aneurism, no gallbladder, a barely visible uterus, essentially no authentic teeth, no tonsils, and the teeniest biceps muscles ever (like bandaid size). All that and she died of Hodgkin's.

And then we did horrible things. We hemi-sected the leg, bisected the clitoris (ouch), removed her head, transected her head, filleted her lungs and pulled out her eyes. Her breasts went into a zip lock, as did her brain, and the head of her humerus floated around the humidor for months until it looked like a red rudolph nose.

But that's not what I wanted to say.

I wanted to say thank you to Betty. And to Betty's family. Thank you for donating your body so that I could learn medicine. No matter how much I hated every single minute of it, no matter that my eyes burned every day, no matter that I stunk and had latex allergies. I do appreciate that people are willing to sacrifice any last shred of dignity so that future physicians can intimately learn the human body.

And learn it we did.

And Betty, for the record, I was always your advocate when those who shall remain nameless affixed your (rather large) labia to your external acoustic meatus and called them ears.

Nominate your favorite accomplished Villanova Nurse for our Medallion!

Each year the College of Nursing recognizes the achievements of its alumni with its highest award, the College of Nursing Medallion. Recipients are selected from among your nominations, a critical step in the process.We encourage you to take the time to nominate a fellow Villanova Nurse this month. Previous honorees have been nurse managers, executives, clinicians, community volunteers and educators. We look forward to reading your nominations and honoring yet another distinguished group of Villanova Nurses.

Know the perfect candidate? Read more about criteria and find the nomination forms atwww.villanova.edu/nursing/about/medallion.htm

11/14 Nurse Practitioner Jobs ARNP Jobs









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Friday, November 13, 2009

Interviews - Post 1

So now I'm taking requests. Someone asked me to write about the interview process... and oh, boy do I have a lot to say about it. Much more than could possibly fit in one post... so maybe this will have to be the first of a few posts...

Here's My Thoughts...

1) On manners. Holy crap, I have seen some DOOZIES! For Christ's sake! Mind your manners. Do I sound like your mom? I'm guessing some applicant's mom's didn't spend much time on this topic... so lets do a quick recap. Most schools have a "no assholes" rule... and these things will definitely disqualify you.
-Elevators... these work better if you let people OUT before you try to get IN. Yes, we know your excited, but don't trample the faculty
-Cussing- So I have the mouth of a sailor under normal circumstances... but not on my interview day. Not to staff, faculty, nor to students. Don't get too comfortable. Everyone can hear you
-No complaining! For god's sake I don't care if you only eat omega-3 grass fed beef. Shut up and eat the bun and the pickle. No one wants to hear it on an interview.... not to mention you come off like a giant asshole.
-Bragging to other applicants about your Yale interview and 42 MCAT? Tacky.
-So you hate this school and the city and it's your last choice and you are hoping to GOD that you get into Mt. Sinai instead? By talking about it you are breaking the "no assholes" rule.

2) On outfits. Oh, the horror. Almost every applicant (guy or girl) is wearing a black suit and a white shirt. Every guy wears a red "power tie". Yes, I got the memo that you are supposed to dress conservative. That means take out your tongue ring, cover up your tattoos, and leave your zoot suit at home. It DOES NOT mean that you have to dress for a funeral. My friends and I talked about this before our interviews and we vowed to be conservative yet to be ourselves and stand out. And guess what? We all got complimented for dressing DIFFERENTLY. I wore a charcoal Tahari pantsuit (conservative, yes?) with a blue and purple embroidered tunic underneath. On another interview I wore the same suit with a pink silk shirt and a chunky shell necklace. My friend "T" wore a beautiful grey suit with a medium blue shirt and yellow tie. My friend "K" wore ivory dress pants with dark red patent leather heels and a beautiful sweater. Everyone looked professional and conservative, but we all stood out from the other applicants. Think about it. What would YOU want to see after interviewing 128 penguin college grads in black suits and white shirts?

While I'm on the subject, please make sure your outfit "fits". As in, your interviewer isn't staring at your pink bra through your gaping blouse buttons, and your lateral malleolus isn't visible because your pants are too short.

3) On TALKING - so we all know your going to get questions from your interviewer... but that's not what I want to talk about. I want to talk about the questions YOU are going to ask your interviewer. Because you better. You better act interested and involved and so thrilled to be there that you just can't stand it. Your goal is to make your interviewer excited about talking to you. You need them to remember you when it's time for them to write their review about you. You don't want some professor scratching his head trying to remember which penguin you were and what the hell he should write about you. I've found that the best way to be remembered is to make the interviewer feel GOOD. If they are having fun, they will remember you. I don't care if you have the most crotchety old geezer interviewing you... you can turn the situation around. Start asking them questions. About THEM! For instance, "So what brought you to this school?" or "What made you decide to go into oncology?". Best option, look around for something to comment on. Pictures of grandkids? Ask about them. A Navaho blanket on the office wall? Mention how you saw one just like it on the Antiques Road Show that appraised for $40k. Anything. Make conversation and make it authentic. Remember, everyone's favorite subject is themselves. Get them talking. They'll remember you, and that's less time that YOU will be in the hotseat answering questions about that C+ you got in O-Chem.


Let's Talk About ADCOM's

I've been getting some wonderful emails from non-trad pre-meds who are wondering HOW ON EARTH to get into med school with a (super) sketchy academic background. I should know, since I'm an expert on sketchy academics. Let's talk about what it takes to get into medical school if you have some SERIOUS academic deficiencies.

The trick is knowing how the system works.

Many pre-meds think "Well, my GPA is ridiculously low, but my MCAT is ok, and I have six years of research that should outweigh my low GPA. I mean, undergrad was so long ago. I've matured since then. Not to mention, I have tons of clinical work, and I know I interview well... so this should work!" Right? WRONG!

The truth is that ADCOMS don't review every application and they don't take into consideration the applicant's whole big picture. It's not that they don't think that your six years of research should outweigh your GPA. The problem is that your low GPA and MCAT aren't getting you to the "second round" so to speak of the application process. Your application isn't even making it someone's desk. ADCOMs get thousands upon thousands of applications. Usually there are only a handful of reviewers (who are busy physicians themselves). They can't possibly read every application.

Applications get read by one of two* ways...
.
1) By score. ALL applications are given a preliminary score. Every school's scoring system is different, but essentially it revolves around GPA and MCAT. For instance, one school I interviewed at outright told the applicants their scoring method for review. These numbers are arbitrary... just for demonstration purposes (please don't email me and ask if they are real and what school!) They take the GPA (say 3.2) and convert it to a two digit# (32). They then add that to your MCAT score (say 31). Your score would be 63. The school used a cut-off (say above a score of 60) to decide which applications to review in depth. From those reviewed in depth, a certain number will be selected for interviews. So you can see how if you are weak in your MCAT but strong in GPA (like a GPA of 3.7 and MCAT of 24) you could still get a full review. But if you are mediocre in both areas (or REALLY weak in one area), you'll never get reviewed no matter if you're an Olympian, Rhodes Scholar, Brad Pitt, etc.

2) The second way you can get a full review is by recommendation. And not just by anyone. This means that someone that the ADCOM values (not YOUR mentor, college professor or hometown doctor calling to say how great you are) has requested a full review of your application. This is usually a professor in that medical school, a donor to that medical school, a top doc in one of their affiliated hospitals, or someone else of consequence to the ADCOM. In some schools, such as mine, a med student can ask the ADCOM to review the application of a candidate they like.

*Ok, I lied. There is one more way you can get a review. That's if you yourself are high profile (ie. an Olympian, Rhodes Scholar, or Brad Pitt). I didn't make that an official category... I guess I figure the Brad Pitt's of the world should have to figure some things out on their own.

So the point of all this? If you can't get your application through the system via route #1 because your academics are too sketchy, you sure as heck better start making friends (route #2). My best advice is to find THE med school that you want to go to (this should be a reasonable school.... probably not Harvard... but hey, anything is possible)... and GO THERE. Move across the country, get your Master's degree there, do research at their teaching hospital, teach their undergrads, sweep their floors, do something (ANYTHING) that demonstrates your abilities and puts you in touch with the right people. After you've proven yourself (after about a year) you can start asking for favors and poking around looking for ways to get in.

Not only is this how I got into med school, its how MANY people get into med school.

Thursday, November 12, 2009

Moms Reveal Telling Facts About Breastfeeding

by Melissa Garvey, ACNM Writer and EditorDid anyone listen to the Bravado Breastfeeding Information Council (BBIC) launch event this past Tuesday? I was pleasantly surprised by the amount of solid facts they revealed from their database of 80,000 women. In case you missed it, here’s a snapshot of what they shared:First generation breastfeeding moms need special support. Of first generation

Last Anatomy Lab

I thought this day would never come. Tomorrow is my last, LaSt, LAST, ever, EvEr, EVER anatomy lab. And I'm never going back.

You will Need a Degree to become a Nurse


We just had a death in the family of the canine type, I have been reading BBC have your say, and I am in a real bad mood.


Here is the BBC article you have all probably read. I have been in mourning so I am behind with all this.


Here are the fucktwits on have your say.


I am in two minds about nurses being required to have a degree to qualify.


Let's talk about the pros first.


First of all a hell of a lot of research has shown that the patients of well educated bedside nurses have higher survival rates. Anyone who qualifies as a nurse will be thrown into a situation where he is own his own dealing with complex stuff, making life and death decisions and having to think fast on his feet with no second chances almost immediately upon qualifying. He will have to handle all this whilst getting interrupted on every 30 seconds or so throughout a 12 hour shift. Support? What a fucking joke. He will be the lone RN for a large number of patients with only untrained care assistants to help. This is how it's been for years. The matrons sure as hell won't come any where near the wards and it will be rare for our newly qualified hero to be on duty sharing a patient load with another qualified nurse to guide him. This is how it has been for years and it is getting worse.



Why are people in this country so silly? Why do they seem to have a death wish? If you don't think that your RN needs to be well educated as well as have a manageable number of patients you must have a death wish. You must want to die. You certainly don't really understand what a nurse actually is.



When I was overseas many patients would throw their registered nurse out of the room if she didn't prove on the spot that she had a university education. "Are you a BSN" "No sir I trained under the old diploma program" "Then get the fuck out of my room lady". Sad but true. Our older nurses are some of the best simply because they have decades of experience behind then and have proven that they have the tenacity to hang on in this hell profession. But people over there seem more switched on and seemed to have more of an understanding of what a nurse actually is. People in the UK do not understand what a nurse is.....

The old ways of training turned out good nurses for their time. The nurses that trained that way who are still practicing are excellent. They have decades of experience behind them and have grown with the changes. If you tried to train today's nurses like that however you would increase hospital mortality rates. The old training would not suffice now. As someone who has a strong desire to live and who will be a patient some day I have thought about this a lot.

I would thr0w a caring and empathetic nurse who couldn't get through pharma maths at Uni out of my hospital room . I don't give a goddamn about how caring or empathetic you are. I want to stay alive. If you are a caring and empathetic but not that bright I have less chance of surviving my hospital stay. I hope you are caring but first and foremost I want you to be on the ball because I know how much information you will be analyzing and how fast you will be moving and it is scary. I say this as someone who has been a nurse for well over a decade. I say this as someone who has seen patients die because their caring nurse was off helping hand out commodes. I say this as someone who wants to live.


Let me link to it again in case ignorant sickos like Jeremy "But what about the caring"Vine happen to be reading. It's all in the link...just scroll down. Or google nurse education and mortality rates.

Research has shown over and over and over again that hospitals that have a higher proportion of well educated nurses on staff providing direct patient care have higher survival rates.

If I had a registered nurse caring for me who didn't catch onto the fact that I was going into renal failure or was pre -arrest because she was lovingly off somewhere else bathing and making cups of tea for her other patients I would get her sacked and get her license revoked. I would also have a strong desire to beat her to death with a hammer.

Actually I suppose my next of kin would be handling that because I would be either in ITU as a result of failure to rescue before the problem got to big...or I would be in the morgue. If my nice caring but not so bright nurse doesn't catch onto my deterioration in condition who will? Anyone who is an RN will find himself alone with a large group of patients and no back up other than untrained carers. The carers won't catch onto my change in condition unless it is blatantly obvious. When it is blatantly obvious it is too late. This is why the nurses need to stay on task with assessments, labs etc. The docs are NOT around to do it, they won't do it and the nurse will take the heat over any failure to rescue screw ups. This is real life not television where the docs are always around the patients and the nurse is just their assisting. That is not real life.


I swear to god that if I , as a patient, caught my RN making tea and making beds rather than dealing with the things that the carers cannot help her with I would be on her ass like flies to shit. I want to live. So should you. The older trained nurses we have now have been around the block about a 1000 time and done a lot of continuing education. They certainly know what they are doing. Don't worry about them. What I am afraid of is a 19 year old here in 2009 who wants to be a nurse getting trained like they did in 1972 and then getting thrown onto the wards in the current situation.


Now that I said all that about dying and needing intelligent nurses let me explain why I think that the all degree qualification for nurses rule is stupid and pointless.



Management does not actually want to staff the wards with trained nurses. On any given shift the majority of staff are untrained carers who do not understand your diagnosis, history, complications, the way your symptoms present and your drugs. The knowledge of all these things is extremely important to nurse a patient properly.


Currently, most of our actual nurses are NOT degree trained. There are 3 kinds of nurses. There are the ones that trained long ago under the old system (most of our current nurses fit into this group), there are nurses who trained in 3 years at uni and obtained a diploma, and there are nurses who trained in 3 years and got a degree (the latter is the smallest group).


I have a degree, my ward sister has a diploma. We are both RN's. We will rarely ever work together because of management. They are dicks. When I am on duty I have a large number of patients with only carers to help and when she is on duty she is also in that situation. They won't ever pay for any more than one RN to be on duty for the same large number of patients whether that RN is old fashioned trained or university trained. Management only wants to hire untrained carers and they want to have as few actual nurses as they can get away with.


This is why nursing care is so bad and a degree won't mean much if they are going to continue to staff the wards in this manner. I want my nurse to be smart, but if she is on her own with 15 patients we are both fucked.


It wasn't too posh to wash registered nurses who wanted these untrained carers brought in to the hospitals. Registered nurses are left with no choice but to delegate all basic care to untrained people. We hate this. It screws things up for me. It screws things up for the patients.


Hope that your nurse is smart enough to get a degree, and hope that she has a manageable number of patients so that she can stay on top of basic care as well as everything else. This is what the nurses want. It is all linked. When this becomes the norm staffing wise, nursing care in our hospitals will improve. Until then, no expensive quick fix band aid will succeed.