Continuing Education in Washington reviewed

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"I can't afford to go back to school", "I have been a nurse for over 20 years, why do I need more education?" How am I going to get 45 hours done?" These are all things that I have heard from fellow nurses upon learning about the impending requirement for Continuing education. Being internet savvy I started looking into ways to get continuing education units and found it not only relatively simple but also free in many cases! Many nurses are still intimidated and overwhelmed by this new requirement as well as don't understand the point. I am hoping to take my independent study opportunity to help demystify Continuing education. In the next few weeks on this thread I will be examining what the requirement states, the importance of continuing education, different ways to fulfill the requirement, and documentation required to prove it is fulfilled. I will also be completing 15 hours of continuing education units with a follow up of what I got from each hour, how I feel it can be applied to my practice, and how long it took me in relation to the credit received. I will also be following this post daily to interact and answer questions. As this topic will be specifically geared towards Washington State requirements, feel free to chime in from other states as to how it is similar or differs though please indicate the state you practice in. I am hoping in the end we are all a little more comfortable if not enthusiastic about the opportunity for current knowledge in nursing.

Thank You in advance for helping me with my class as well as working together to examine continuing education

Kara:nurse:

Specializes in L & D; Postpartum.
In that case enjoy retirement! :yeah: My goal is to complete my full time trek of bedside nursing then transition into hospice nursing and/or clinical education, but like you when it is time to retire I will probably hang up my stethoscope for good to allow time to travel with my husband and enjoy life!

Thank you. I didn't mean to sound flip in my last post....but I am never bored and when I am at home or with my husband, there's rarely ever a dull moment.

Specializes in Geriatrics looking to branch out.

Today I received an email from epocrates about free CEU’s accessible on their webpage or by utilizing their iPhone app. Being a full time mother, student, and nurse, an on the go option is perfect for me. I immediately downloaded the app onto my iPad and was able to access several options. Aside from portability, I instantly noticed that not all of the options were 1hr like was the case on nurse.com. Some options were .75 hr or .25 hr allowing a person to take advantage of a short window of time to complete a portion of the requirement and build on knowledge. The unit I chose to complete was more of a case study approach which was equally appealing. It was nice to have some interaction throughout rather than just the quiz at the end. There were a few downsides I felt to this application. The level of education was a little higher than is necessary for nursing as it is certified for all medical professionals such as MD’s or ARNP’s. The level is higher than used in traditional practice and can be a little difficult to follow. I also would have liked some instant feedback with the quizzes along the way rather than at the end as I learn better with instant feedback and it would help clarify along the way. The case study I completed was on Diabetes which being in LTC is a common diagnosis I encounter. I did gain a better understanding of how some of the comorbitities such as hypertension and gastroparesis are affected by and affect diabetes and treatment and testing related although the detailed information is of a higher level than I typically encounter I will have a better understanding of how to interpret assessment data and discuss the data with the doctor.

Specializes in Geriatrics looking to branch out.

Oh no I FULLY understand! I thrive for time home with the family or getting out into the world! As much as I love nursing it never beats being with my family!!

Specializes in Geriatrics looking to branch out.

Being a perfectionist in some ways I needed to round off the hour I began earlier. I completed another .25 CEU offered by Epocrates which was again at the MD level meaning it was more indepth than what I use in my everyday practice though I did gain a better understanding on balancing basal insulin with oral hypoglycemic and short acting prandial insulin. This will help me to address issues with my diabetic patients whose blood sugars are all over the place. He down side to doing the .25 unit is that it took almost as long to do the survey at the end which is standard for all CEU’s as it took to complete the course although the complete beginning to end probably took me about 20 minutes. Although I have not tried it yet it appears that you can begin a session and return to it later if you are unable to complete it. I will probably continue to utilize Epocrates for its portability as well as the wealth of information. I would rather learn “too much” than not enough. Completion of this unit brings my total to 4 of the 15 for a years requirement.

Specializes in Geriatrics looking to branch out.

I received further information regarding wanting to take a leave from nursing. A woman at the Washington state department of health sent me the following response: We have an inactive status for a discounted price that has been working for nurses taking a short leave of absence (3 years or less). Once you have been in inactive status for 3 years you do however need to take a refresher course in order to become active again in addition to a reactivation application. If you let your license expire during your leave of absence you have a year to renew with a late fee and after that you would have to turn in a reactivation application and the fees go up.

As discussed earlier, If a person needs to take more than 3 years off their knowledge and skills would most not likely be at an acceptable level to keep up with medical advancements to treat patients. The following link :

http://www.doh.wa.gov/hsqa/professions/Nursing/documents/refresher.pdf will take you to a list of available refresher courses for RN’s and LPN’s if you are interested in more information on the topic.

Specializes in Geriatrics looking to branch out.

Yesterday I had to attend an in-service at work regarding appropriate charting and the usefulness in using SBAR for all charting. Although this was not a certified educational unit I did find it to be good information and decided to use the information to demonstrate that although not certified, work in services can be very good places to get information which can directly be applied to practice often more so than an outside source as it is usually geared to an issue presently occurring in the facility. In Washington state as long as these in-services are kept track of as to content date and time, they are valid for inclusion in the required hours of education.

The goal of our facility is to use SBAR charting for all charting including alerts and medicare charting. It is already currently the way we handle all doctor communications. If you are not familiar with SBAR charting it is about submitting information in the organized format S: situation , B: Background , A: Assessment, R: Request The difficult thing about SBAR charting is knowing exactly what goes where. The presenter (our ARNP) explained that the origination of SBAR was in Navy submarine communications. It later got adapted for medical communication. This information made things suddenly much clearer. The use of the word assessment means something entirely different in the military world than it does in the medical world. In the military world or basically anywhere else but medicine, this refers to more of a conclusion. What we refer to as assessment in SBAR terms is more of part of the background. I would always toil as to what is background and where the dividing line is to where it turns into assessment and thinking that some pieces of information belonged in both categories. This led to redundant information. After this in service my SBAR charting today was much more clear and concise and took little time and effort. As a nurse in my routine treatment I had already gathered all the information I would need now I just needed to use the simple tool to convey the information to the doctor to see what he wanted to do next.

S: Situation : why are you contacting the doctor in the first place?

B: Background: information leading up to concern and all assessment data

A: Assessment ie conclusion: my interpretation of what I think might be going on or what might have led to or caused the situation.

R: Request Do i need clarification, further tests? orders, or just FYI

In some cases the A/R could be combined especially if it is just passing routine information on to the doctor although in our facility the doctors request these to be kept separately it is useful in nurses notes.

Overall I found the information in this in service more useful in my immediate care than any of the certified continuing education units which goes to show that there is great usefulness in work in services even if they are not official education units.

Specializes in L & D; Postpartum.
I received further information regarding wanting to take a leave from nursing. A woman at the Washington state department of health sent me the following response: We have an inactive status for a discounted price that has been working for nurses taking a short leave of absence (3 years or less). Once you have been in inactive status for 3 years you do however need to take a refresher course in order to become active again in addition to a reactivation application. If you let your license expire during your leave of absence you have a year to renew with a late fee and after that you would have to turn in a reactivation application and the fees go up.

As discussed earlier, If a person needs to take more than 3 years off their knowledge and skills would most not likely be at an acceptable level to keep up with medical advancements to treat patients. The following link :

http://www.doh.wa.gov/hsqa/professions/Nursing/documents/refresher.pdf will take you to a list of available refresher courses for RN's and LPN's if you are interested in more information on the topic.

You are a wealth of information and I appreciate your effort to share here.

I have an RN friend who is about 10 years older than I am, and she has kept her license active simply because she has worked in flu shot clinics in the fall months. None of this benefits her and a 3 year hiatus from giving flu shots wouldn't be a problem at all. So she has decided to let her license go.

This might be one of those unintended consequences.

Specializes in Geriatrics looking to branch out.

Thank you for your kind words. It is a topic that interests me and I enjoy helping out fellow nurses which made this an easy to choice to do for my independent study course. A person definitely has to weigh the pro's and the cons to keeping a license active when entering the retirement years. Personally the road that lead to my RN was a long and rocky road with steep hills and detours so I will probably opt to do whatever it takes to keep my license as long as possible as a matter of principal. Another I think that was not considered is what if there was a major medical event and we were hurting for nurses. There could be many out there with their hands tied to be able to help because the let their licenses go to raise family or just at beginnings of retirement. This could end up being quite a detriment to the situation. I guess there never is an easy answer. There is always a balance between patient safety, and easing transitions between personal and professional lives as it might affect licensure.

Specializes in L & D; Postpartum.
There is always a balance between patient safety, and easing transitions between personal and professional lives as it might affect licensure.

And like many other situations where a group of administrators make policy, there can be a distinct lack of common sense!

Specializes in Geriatrics looking to branch out.
And like many other situations where a group of administrators make policy, there can be a distinct lack of common sense!

I can't argue with that! its usually those not really directly related or involved that dictate the policy without asking those the policy will affect

Specializes in Geriatrics looking to branch out.

Returning to Continuing education units on nurse.com I completed a unit for 1 credit hour regarding nursing practice. I quickly found that titles can be deceiving. I thought it was going to review actually nursing theory and instead it was more of a discussion of what nursing theory was and how it applies to care. It was more conceptual in content rather than medically factual. I was reading through the unit and although I completed the unit successfully a good portion of the time I might have had more success listening to the Charlie brown teacher. Overall I see no real benefit to my nursing practice. Again a demonstration that sometimes an educational experience may be certified but might not truly enrich the quality of nursing given.

Specializes in Geriatrics looking to branch out.

Today I completed an hour of continuing Ed that I think could be rather useful in both my professional and personal life. This unit is called “The Power of Suggestion” and discusses how simply placing focus on desired outcome and positive thinking can dramatically influence patient’s responses to treatments. It is based on concepts from hypnotism and was actively used by a patient whom historically had patients whom responded more positively to patients and were discharged home sooner than patients treated by other nurses. He discussed his techniques with the author and discussed the goal he has it so think of the picture he wants to paint and uses words to pain that picture. Instead of concentrating on the pain possibly being experienced he focused on the positive aspects of overcoming pain such as getting out of bed and walking around the unit or being able to go home. It was explained that quite often we concentrate so hard on something that it in fact causes failure because it puts it in the forefront of our mind all the time. Instead of focusing on losing weight and the restraint and hard work involved, concentrate instead on the positive results.

Professionally I plan to implement this thought process with all of my patients especially in the area of pain or nausea which are common complaints I encounter in long term care. Instead of common questions such as “is your pain any better?” I could instead focus on an activity they enjoy that they could engage in now that they are pain free such as “how about we head down to the activity room for BINGO now that you are feeling better?”

One concept that has consistently come up in classes this quarter has been leading by example, and taking care of myself so I can then better take care of my patients. This is a lot easier that it sounds as you can understand but I think if I begin to focus on the positive outcomes such as being able to run a mile with my daughter and they joy that will bring her will bring more success than focusing on the need to work out daily.

My goal is to flip my thinking on everything to a positive outcome rather than a to do list or a barrier to overcome.

Over all this unit took my approximately 45 minutes to complete in exchange for 1 hour of credit and I think is one of the most useful units I have completed as of yet

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