Content That Joe V Likes

Content That Joe V Likes

Joe V Admin 54,957 Views

If you made it this far--thanks for visiting. My name is Joe. I'm's Information Architect. I'm the tech behind the scene. I'm in charge of everything that makes tick. Isn't she a beauty! I consider myself to be extremely fortunate, because I love what I do.

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  • Jun 23

    Google worked with Harvard Medical School and Mayo Clinic to build a smart symptom search engine that doesn't leave you thinking that your headache must be a rare blood disease.

  • Jun 23

    We've all been taught the importance of washing our hands since we were kids. And when we got to nursing school, the importance was stressed even more. I don't know about you, but antibacterial soap and water is all we had when I hit the floor as a brand new nurse. Heck....we didn't even use gloves unless we were doing "sterile procedures", which did not include the handling of bodily fluids.

    Now, we have even more options for protecting ourselves and others from those nasty germs that are waiting to infect us. One almost feels naked these days without donning gloves as well as appropriate PPE.

    In spite of all the various types of PPE, we can all pretty much agree that frequent use of appropriate hand hygiene is the basis of protecting everyone involved.....whether or not they work in healthcare.

    There has been debate over the years about the effectiveness of hand washing vs. sanitizers when it comes to infection control in hospitals and other healthcare settings. Studies conducted by the National Center for Biotechnology Information (NCBI) found that health care workers follow hand washing guidelines as set forth by the CDC only about 40 % of the time. It is common sense that sanitizers are more convenient for the healthcare team, and thus would help in increasing compliance. But do we know how to use hand sanitizers effectively? How long must we rub our hands together for the gel to do their deed of sanitizing? Is a squirt and go method enough?

    Research presented June 18, 2016 at ASM Microbe 2016 (a meeting for the American Society for Microbiology and the Interscience Conference on Antimicrobial Agents and Chemotherapy) recommended that in order to kill bacteria, you need to rub for at least 15 to 30 seconds. There is no gain in effectiveness for rubbing longer than 30 seconds.

    How many of your workplaces have a policy for hand hygiene?
    Are there any punitive actions taken if you don't comply?

    To read more about how the study was conducted, please read Hand Hygiene with Alcohol-Based Handrub: How Long is Long Enough?

    For more allnurses articles about hand hygiene, go to:

    Hand washing vs. Sanitizer, What are the Facts

    Hand Hygiene Saves Lives, But Is It Realistic For All Nurses ...

  • Jun 23

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  • Jun 20

    This past weekend is still something that has struck fear into the core of my community, even though I live on the other side of the country. I’m not going to debate about how it could have been prevented, because hindsight is always 20/20. I’m not going to debate it because there are as many different ideas on how to prevent it as there are people who know about it. What I want to do is expose myself, and explain why something that happened so far away from me could affect me on such a personal level.

    No matter what you call it, LGBT(Q,+,A), QUILTBAG, or my personal favorite Alphabet Soup Gang... there is a community out there for those of us who don’t quite fit the norm. My favorite comes from the fact that we are all a bit alike, all a little different, and we’re all floating in this big huge bowl we call Earth. Also the letters change all the time depending on who you talk to and if I am going to offend someone for using the wrong ones, at least I’m going down in style.

    I get a little flack at times from the community, at times, for not getting it, because “you pass... no one knows unless you choose to tell them.” See, I’m not what most people think of when they think of the LGBTQ. Mostly because I don’t get all twiterpatted when I see someone posed in what someone would consider sexual nature. My response tends more towards “Oh… look at that… “and insert interesting bit of biology about their tattoo, a mole, or the muscle structure. I’m someone who dates for romance and companionship instead of physical attraction. I was married when I was younger. I’m Christian. I can easily come off as heterosexual with no time or too conservative to join the local dating scene. Personally I don’t care about someone’s gender. I date people for being interesting and kind hearted with similar interests. In the community I’m often referred to as panromantic. I don’t usually bother with a label though.

    At the same time, I’ve also been on the receiving end of attacks from people mad at me for not being interested in them. Be it because how dare I not be attracted, or because they think I just haven’t met the right person yet, or just because I find comfort being around the others with the same experiences. Many of my first experiences out into the world involved going to the local “gay bar” to sing karaoke with all the other people who just didn’t feel like they fit society’s expectations for them. Going to a friend’s place to support them because someone had threatened them.

    Our culture, as a community comes from the places and experiences we have been through. We’ve had the awkward conversations with medical professionals when they ask if we are sexually active and the follow up is about birth control or pregnancy, and we end up outing ourselves to strangers who are not always understanding. We’ve been bullied for similar reasons. Been told we don’t really exist. That we’re going through a phase. Sometimes by the medical community itself. We trade names of providers who are “safe” like most people trade the titles of their favorite books.

    It bothers me because… those people who were hurt and died… I have a common thread to them. I cried when I found out what happened. Those people were someone’s child, parent, cousin, friend... They remind me of my own monkey sphere of people I know. Even if it hadn’t been people I know… I’ve seen the threats towards LGBTQ and Muslim students at my school. I go to an awesome school in a progressive area. We are great and inclusive and that things like that still happen… is scary. It bothers me that media wants to focus on who did it and how, rather than the bright and brilliant people who are lost to the community.

    It’s something that should bother everyone. It should bother us all. Today it was the LGBTQ community. It’s happening in black communities. It happens in our schools. Even if we have no personal connection to what has happened, it should at the very least bother us, because who is to know what the next target of choice will be. If we can’t find a way to be bothered that people died because someone’s personally held belief was so strong they felt it was alright to kill someone… even if we disagree with the person’s lifestyle, they didn’t deserve this. No one does, and that bothers me.

  • Jun 17

    There are a lot of reasons a patient can be stressful for a healthcare provider. The diagnosis may be challenging, the situation could be demanding, or the patient is “difficult”. Whatever the reason, some patients cause healthcare providers’ heart rates to increase and blood pressure to rise. This reaction is totally natural. While many articles advise that people should remove themselves from situations that cause stress, healthcare providers typically don’t have that option or luxury during their practice.

    In the 2006 study, How Respected Family Physicians Manage Difficult Patient Encounters1, physicians describe successful methods to working with challenging patients. While this study is shared from a physician’s perspective, there are several options that can be very helpful for nurses and other healthcare professionals during these stressful encounters:

    • Acknowledge your emotions. It’s okay to feel stressed by a patient, but using that feeling to learn about yourself should be the goal. Discovering which emotions are causing you stress—frustration, anger, sadness, etc.—can help you learn and grow from those situations. Additional research has found that healthcare providers who acknowledge and accept their emotions have improved client relationships. Recognize that you cannot control the patient’s behavior and it is not your responsibility to change their emotion, but by acknowledging your own emotion, you have the control over your own reaction3.

    • Know your professional values. Some describe particular patient encounters as challenging when their professional identity is challenged. For nurses who value punctuality, a patient who is consistently late to their scheduled appointment could be very frustrating. Nurses who value improved health outcome may find a non-compliant patient challenging. Understanding your own professional values can help in identifying why a patient is causing you stress.

    • Understand your biases and judgments. When a patient gets a reputation as being ‘difficult,’ subsequent healthcare professionals often develop a similar prejudice. This inherited prejudice can lead others to treat that patient as difficult from the beginning and lead to an undeserved increase in stress. When giving report to another healthcare professional , avoid using negative adjectives (difficult, needy, etc.) to describe a patient’s behavior to stop this stressful cycle.

    • Talk to the patient. While this point sounds obvious, it is often sadly overlooked. Talking to the patient provides insight into where they are coming from and lays the foundation for empathy. It’s easy to assume that a grumpy person is always grumpy, but you won’t know otherwise until you learn about them by listening. Try acknowledging the patient’s feelings or verifying your observation. You may be drawing a wrong conclusion about your patient’s behavior. Maybe the patient is upset because they’re in pain, hungry, afraid, or lonely. Assume nothing about a patient, because they’ll often surprise you.

    While the suggestions above may help at work, there are many ways to manage stress outside of work as well, including: leading a healthy lifestyle of well-balanced meals, regular exercise, and sleep, discussing stressful events with co-workers or family, and acknowledging when you need additional help2.

    Managing your stress will never be a smooth road. Some days will be easier than others--just as some patients will be easier than others--but using the tactics above on a regular basis will enrich your coping abilities and lead to improved interactions for both you and your patient.

    In addition to better patient encounters, managing your stress can lead to improved health. Stress has been shown to induce headaches, increase fatigue, and contribute to long-term health issues like heart disease and high blood pressure. There are a multitude of reasons to manage your stress, whether it’s improved patient interactions, better health, or simply less headaches, so choose the reasons that motivate you.

    There are new and fascinating challenges everyday in the healthcare field, so consider managing your stress a new challenge. Stress-inducing patients and situations are a struggle in the healthcare field, but you can always strive to control your reaction to them.

    1Elder, N., Ricer, R., Tobias, B. (Nov-Dec 2006). How Respected Family Physicians Manage Difficult Patient Encounter. Journal of the American Board of Family Medicine, 19(6). Retrieved from How Respected Family Physicians Manage Difficult Patient Encounters

    3Sherman, Rose O, EdD, RN, NEA-BC, FAAN. American Nurse Today, Dealing with Difficult People. May 2014, Vol 9. No. 5. Retrieved from Dealing with difficult people - American Nurse Today

    2CDC. (2 Oct 2015). Coping with Stress. Retrieved from Tips for Coping with Stress|Publications|Violence Prevention|Injury Center|CDC

  • Jun 16

    I have been a Nurse for five years, I love it. I work in a skilled Nursing facility, and I am a summer camp Nurse. Those are my two loves.

    Part of my job as a Nurse in a skilled Nursing facility is to give sad news, the other aspect is to be a Nurse to rehabilitation patients. We have hospice patients as well as many geriatric patients, so the sad news tends to be related to advising a family that a loved one is moving towards death. Our rehabilitation patients typically have a goal of returning home. They participate in PT, OT, and ST, all in an effort to regain their strength. The largest hurdle here is pain control. Surgery hurts, PT and OT hurt, and pain control is vital to a patient's success.

    I was a relatively healthy 31 year old female. I took a prozac a day and lamotrigine to manage my Bi polar sub-type II disease, it worked very well and I had been stable for years. I took a BP pill, but I am active, 5'6 and 132 pounds, so weight loss was not going to manage this case of hypertension. I was working as a Nurse, living life, having fun, so I considered myself fortunate.

    It was June 19th of 2014, just about three weeks prior my 32nd birthday, when those three words fell into my life "You have cancer." I felt a lump in my breast in early spring, so I went through all of the steps a patient normally would when they suspected a problem. I suspected a problem, but not Breast Cancer. I was diagnosed with Infiltrating Ductal Carcinoma. It was a nuclear grade of 3, 1.7 cm, and was ER+ PR+ and Her2+. I had an aggressive type of breast cancer, but I had zero family history. No explanation, no faulty DNA or genes, it was just a fluke. I began to grieve, I became angry, sad, strong, and defiant all at once. My life, my plans, what would become of them? My risk of recurrence was high, would I accomplish my dreams? Would my husband be able to handle this? What would I do? I made choices regarding my care. I saw specialists, attended support groups, and armed myself with information related to a disease that I was not accustomed to.

    I made the choice to have a bilateral mastectomy with reconstruction, and afterwards I would begin chemo. I went through surgery, and recovered well. I had a Bard port a cath placed for chemo, and I shaved my head prior to my first cycle. I also gave myself a pink mohawk, because when have I ever had a chance to do that?!

    For the first time in my life I understood what surgical pain felt like. I grasped it's intensity, it's hopelessness, and it's ability to be relieved. I experienced having a foley catheter post surgery, as well as it's removal. For one day I was unable to place my hands in a position to wipe my own butt. It was a humbling experience to feel that vulnerable, to NEED that help. I took more colace those weeks than I ever had my entire life, yet I still ended up with an impaction. Yes, I handled that myself. It sucked, but I experienced it. Chemo left me nauseated, unable to work, and further dependent on people to care for me. The Oncologist said that he had never seen someone as young as myself have such a reaction. My hemoglobin went down to 5.2, I earned my first blood transfusion for that. I still have my armband. I quit chemo after 4 of the planned 6 rounds due to poor quality of life. I also quit Herceptin 8 months into a 12 month plan. I found a new Oncologist whom I felt was more supportive, and she is amazing.

    I returned to work 2 months ago. I saw the healthcare world through a Nurse's eyes and a patient's eyes. I have experienced both worlds. I have an intimate understanding of what pain control does for quality of life and healing. I no longer look at a narcotic card and occasionally think "Wow, that is a high dose." I took that dose, maybe even more sometimes. I have an intimate understanding of vulnerability, losing the ability to care for ones self, and grieving the possibility that life may not turn out how I had hoped. Giving bad news comes with slower, more thoughtful words. I know what it is like to hear bad news, and the way it is relayed matters more than I have ever known. I have experienced pain, loss , sickness, and the need to make my wishes known in the event that I cannot do so. I truly understand quality of life over quantity.

    I offer the voice, touch, care, and compassion of someone who has been through hell and back. I am a better Nurse because I have experienced what a patient has. I have had the ultimate Nurse/patient relationship.

  • Jun 15

    AWARENESS is the first step before you can take any kind of action. If you don’t know what you need, you won’t know what action to take. There are always signs that indicate you are ready for change but sometimes we miss them, disregard them, misinterpret them or blame others for them. Here’s an example.

    In my last job as an employee, I had a great reign for 18 years as a wellness specialist for a major medical center. It was a dream job because my boss, who was a visionary, believed in empowering his employees to determine what needed to get done and then left us alone to do it the best we could. For me that was a gift, because I am very creative and work best when I can control my destiny and am not micro-managed. Our department did great things during his tenure and we were all very productive, had a lot of fun and loved coming to work every day. But then things changed.

    A corporate merger occurred, my boss moved on, our team was split up and we were all sent to other departments to work. I was miserable. But I told myself I could stick it out for the next 5 years until I could take an early retirement. Besides I needed the paycheck and benefits! Well that idea lasted for about 2 years when I started to succumb to stress-related disorders that required multiple referrals to physicians, occupational therapy, and finally to a counselor where I was told to learn to live with pain.

    Finally, the light bulb went off and I realized I had become someone whom I am not. I am not a person who is in pain, has no joy in my work, has a negative attitude, has lost her creativity and hates to go to work every day. Instead, I am a happy, positive, creative person who loves creating exciting and meaningful programs that help people lead better lives. So what happened to the real me? (Does this ring true for you?)

    Apparently I had to be in so much pain that I finally got it. AWARENESS occurred and I knew I had to change. Here’s a helpful quote from Abraham-Hicks that says it all.
    Sometimes your Source will lead you to an awareness of a problem because it is part of the path to the solution.

    I now recognized the path I was on was not only wrong for me, but my health had taken a toll as well. And Nurse Wellness (AKA – ME!) was always a health role model so I knew I had lost myself somewhere along the way. Time to take charge and do what I needed to do to get back to being ME! So I took some vacation time, had a heart-to-heart talk with myself (and my financial advisor), discussed my options with the HR Department and learned I could take an early retirement immediately. Talk about having a new lease on life!

    With that weight lifted, I was able to create my exit strategy and start taking steps to move out of that job and into my next adventure as a wellness business owner. Note – within 6 months of leaving that nightmare, all my stress-related symptoms disappeared. A big message that we are able to heal ourselves once we become AWARE of what our symptoms are telling us.

    Awareness is like the sun. When it shines on things they are transformed. Thich Nhat Hanh

    So what about you? Does my experience resonate with your life experience? What is your story? How did you become aware of your need to change? What steps did you take? Would love to have you share so we all can learn from each other.

  • Jun 15

    Time to prep for surgery!

    Your wife said it was ok, just stay still...

  • Jun 14

    The Survey

    In January 2015, invited members and readers holding an active nursing license via the allnurses site as well as newsletters, emails and facebook to participate in a 10-minute online survey about nursing salaries. Respondents were asked 20 questions to characterize their educational background (degree, license), main roles as nurses, employer type, experience level, geographic location, etc……. After just 2 weeks from January 22 through February 3, more than 18,800 responses were received.

    After reviewing the results, feel free to post your questions and comments. We can all learn from each other's input.

    Respondent Profile

    As shown in Figure 1, the majority of the respondents have a Bachelor’s or Associate’s Degree in Nursing(39.23% and 38.89% respectively), followed by Diploma (14.81%), Master’s Degree in Nursing (6.38%), PhD (0.29%), Doctor of Nursing Practice(0.29%), and Doctor of Nursing Science(0.10%). With the difference in the number of BSN (6,891) and Associate (6,831) respondents so slim, it will be interesting to see what effect the mandates of some health systems requiring BSN or higher will have on these numbers in future surveys. To see what allnurses readers are already saying about this, go to BSN and Associate Nurses are Neck and Neck. Will this change?

    FIGURE 1

    Figure 2 shows that the majority of respondents were overwhelmingly RNs (82.39%). A couple of questions this brings to mind: are fewer nurses beginning their career as LPNs/LVNs (14.84%), and will the number of APRNs (2.09%) increase fast enough to help meet the needs of a rapidly growing population in need of more autonomous healthcare providers.

    FIGURE 2

    When asked, “Are you a manager or supervisor?” 17.58% (3,316) responded YES, while 82.42% (15,542) answered NO.

    In response to the question, "What percentage of time is spent in direct patient care?", half of the respondents(51.85%) spend 75-100% of their time in direct patient care while 8.79% spend less than 5% in direct patient care. (Figure 3)

    FIGURE 3

    It's not any surprise that the survey revealed that 92.26% of respondents are female and 7.74% are male.

    FIGURE 4

    FIGURE 5

    Experience: Figure 6 show that 62% of the respondents have 10 years or less experience.

    FIGURE 6

    Additional demographic of our respondents:

    • 82% work full-time; 11% part time; 7% other
    • 55% work at a Not-for-Profit facility
    • Facility Size: 25.47% less than 100; 21.45% = 100-300; 15.93% = 300-800; 11.94% = 800 - 1500; 11.54% = 1500 - 3000; 13.67% = more than 3000
    • Population Setting: 45.38% Urban; 32.15% Suburban; 22.47% Rural
    • 56% of nurses work in a hospital. To see the other places that top the list, read Where Do Most Nurses Work?

    FIGURE 7

    FIGURE 8

    FIGURE 9 - Total Number of Respondents by Primary Specialty


    The interactive charts below will allow you to customize your view to include various filters that will affect the range of figures shown. You can do this by selecting items in the drop down menus at the top of the charts. Be sure to hover your cursor over the chart for more details.

    These salary figures do account for cost of living indexes, which can greatly affect the value of salaries. Generally, the cost of living is highest on the West Coast and in the Northeast. The states in the South, Midwest, and sections of the Mountain West have the lowest cost of living. For more discussion about this, please read What States Pay the Highest and Lowest Nursing Salaries?

    Although women dominate the nursing profession, do men make more money? - Read what our readers have said. Look at interactive graphs below and see what you think.

    FIGURE 10 - Annual Salary Base Pay by Gender

    FIGURE 11 - HourlyBase Pay by Gender

    FIGURE 12

    FIGURE 13

    FIGURE 14

    FIGURE 15 - Avg Salary by Degree/State

    FIGURE 16 - Annual Salary by Degree/State

    FIGURE 17 - Avg Annual Salary + Hourly Pay by Degree/State

    FIGURE 18 - Annual Salary + Hourly Pay by Degree/State

  • Jun 14

    I'm surprised WV isn't in the bottom 6. Woohoo a list we're not on the bottom of!

  • Jun 14

    Well I been a RN almost 4 years now 2 years as a travel nurse. From my experience this is how much I got paid

    NC $22hr and $3 night different

    LI, NYC as a travel $65 hourly

    NJ $55 hourly as a travel

    NJ $45 hourly as a staff will start next month cause I need benefits

  • Jun 14

    So Tennessee has the lowest cost of living, but doesn't pay the worst. I'll take it! Even if it did I wouldn't move, I love TN.

  • Jun 14

    Surprised NJ wasn't on the Highest COL list!

  • Jun 14

    Illinois not on the list; hmm, somewhere in the middle. That is satisfying enough.

  • Jun 14

    Woohoo, Kansas representin' our crappie salaries.