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Melissa Mills BSN

Nurse Case Manager, Professor, Freelance Writer

Hi there! I'm Melissa and I'm a skilled writer, editor, and content manager and I would love to help you with your next project. I specialize in healthcare and women's content

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Melissa Mills has 20 years experience as a BSN and specializes in Nurse Case Manager, Professor, Freelance Writer.

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Articles, Content and Blog Writing

Melissa MillsHealth, Wellness, and Women’s Issues

From the catchy headline to the call to action – I’ll create content that exceeds your expectations by using my extensive medical background. My research abilities are stellar, which means that the final copy will be evidenced-based, factual, and current. If you’re looking for content with a conversational tone that engages your readers – contact me to get started.

If you would like to take a look at a few things I’ve written – take a look at my blog or head over to my portfolio.

Editing and Proofreading Services

I love to write, but there is something about editing that sets my soul on fire! I think it comes from being a creator at my core. It’s imperative to me during editing that I don’t lose the writer’s voice. I don’t want you to not recognize your own work. I want you to see your work and be amazed that a few new words, improved sentence structure, and properly placed commas made it flow.

So, you might wonder what the difference is between editing and proofreading – when I proofread – it’s the final review. I’m not reading to change anything, but rather to make sure what is written is correct. I have an eye for typos – so, if you need proofreading services – complete the Work With Me form here.

If you’re struggling with getting your final copy ready to publish – let’s get started.

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Melissa Mills's Latest Activity

  1. Melissa Mills

    5 Ways Nurses Can Support New CNA’s in Long-Term Care

    @Bloop41 Yes! Being a CNA before ever being a nurse taught me how to be a better nurse & lead a team. Listening to the CNAs and helping them provide patient care will make you a valuable team member in any setting! Good luck as you progress your career. ~Melissa
  2. What are CNAs? Certified nursing assistants (CNAs) are the backbone of long-term care. They are the eyes and ears of the nurse and fill a critical part of the care continuum that you may not think about often enough. According to Rasmussen College, CNA is a broadly based term for a group of healthcare professionals that may or may not be “certified.” However, in skilled-nursing facilities or home health agencies that receive Medicare monies, they are always certified. The terms used for these professionals may also vary from state to state and include registered nursing assistants or RNA and state-tested and approved nursing assistants or STNA. CNA Responsibilities CNAs complete basic care tasks that include bathing, feeding, and moving or repositioning patients. Most CNAs work in long-term care nursing settings such as skilled nursing, long-term care, and assisted living facilities. They may also work in home health agencies and hospice. Not only do CNAs assist with activities of daily living, but they provide companionship, patient advocacy, and observe and report any changes in the patient’s condition during care. CNAs Desire and Deserve Respect I’ve worked closely with and supervised CNAs for the better part of my twenty-plus year nursing career. During this time, I’ve heard countless nursing assistants report that many nurses don’t respect them as much as they would like to be respected or even view them as a vital part of the nursing team. This is an issue that I’ve strived to change in every role I’ve held, including staff nurse, nurse manager, director, and now as a manager of a company that trains and places nursing assistants into jobs. How Nurses Can Collaborate With CNAs I often talk to nursing assistants about ways to work more collaboratively with nurses. However, I think it is important for nurses to understand how we can collaborate more effectively with nursing assistants too. Here are five ways every nurse can strive to support CNAs in their long-term care role. Be a Mentor We often think of mentorship as something that only happens between peers. However, when I think about my career, I can identify physicians, therapists, and other healthcare professionals who mentored me at different times. Nurses should actively look for ways to provide mentorship to nursing assistants. When a new CNA begins on the unit, be sure to introduce yourself and let them know your interest in being a resource for them. You can also offer to meet with them weekly or monthly just to check in on how they are doing and if there are any questions they may have that you can answer. Letting your nursing assistants know from the beginning that they can ask you for help will set up a solid and collaborative work relationship. Teach the Importance of the Care Plan Nurses know the importance of the care plan and use it daily. But, have you ever sat down to explain it’s importance to the CNAs who care for your patients or residents? Take a little time to teach new CNAs to your unit how to use the care plan to ensure that they are providing the right care to each patient. Spending time with them may also help them to feel comfortable with asking other questions or just having an open conversation. Answer Their Questions Let’s be honest, all nurses are short on time and those in long-term care are certainly no different. Plan out a little time each shift to connect with newer CNAs and answer any questions they might have. You can start by simply being as available as possible to help with simple transfers or to take a look at a resident’s skin during pericare or a bed bath. Being present or helping provide care gives you a chance to observe the CNA, do a thorough assessment, and build a strong working relationship with the staff. Be Kind Nursing is stressful. It’s easy to feel overwhelmed when thinking about all of the tasks you must complete in an eight or twelve-hour shift. Feelings of stress and anxiety can often manifest themselves in being short or snippy when someone needs your help or asks a question that you think they should already know the answer. These are the times when you should take a little time to be kind. Kindness isn’t always our first reaction to some situations. However, the more you flex your kindness muscle, the more natural it will become. A few ways you can show kindness to a CNA include: Take a lunch or break with the new CNA Give them a hand before they ask for help Offer to teach them a new skill or one they need to improve upon Give a compliment when they least expect it Show gratitude by saying thanks or writing a note or kudos Give Constructive Feedback It isn’t always comfortable to give feedback. However, it’s part of a healthy and progressive work environment. As a nurse, you must learn to give and receive feedback with honesty, humility, and compassion. Providing constructive and usable feedback to CNAs is an essential part of your job, but it may not come naturally to you at first. A few tips for giving constructive feedback to the CNAs you work with include: Focus on the behavior, not the person. Always provide positive and negative feedback together Give specific examples of areas of improvement Help create a learning plan that has goals and target dates Long-term care nurses could never survive without the help and support of CNAs. So, then next time you see one of your favorite CNAs, let them know how much you appreciate them and try out of one of these ways to offer your support. Do you have other examples of ways nurses can be supportive of CNAs? If so, leave a comment below!
  3. Melissa Mills

    Six Pieces of Advice for New Nurses

    Excellent point, @kbrn2002!
  4. Melissa Mills

    Six Pieces of Advice for New Nurses

    Thanks so much for your experiences @emmasuern! It is def more challenging start in a more specialized unit. If a new nurse knows where they want to work, I say go for it! I worked on a medical-oncology floor for one year and then went directly into the NICU. I would not say that my experience was highly applicable in the NICU considering that neonates and adults are entirely different. However, what I did gain during that year was experience & confidence in my abilities. 🙂 (Of course, this was 20+ years ago & quite different than today's hospital environments.)
  5. Melissa Mills

    Six Pieces of Advice for New Nurses

    Awesome additions @Lane Therrell FNP, MSN, RN! It seems that nursing schools are not putting enough emphasis on some of these basic skills that can make or break a new nurse when looking for a job. ~Melissa
  6. Melissa Mills

    Six Pieces of Advice for New Nurses

    I recently chatted with a soon-to-be nursing school graduate. She asked many questions about my nursing journey. She was interested in the type of unit that provides the best experience for a nurse grad, and she even wanted to hear about the different jobs I’ve held during my career. As we talked, I recognized that she was looking for mentorship. New ventures often bring about questions, fears, and apprehensions. While nursing is a noble profession, it can be stressful, and sometimes, downright scary. One way we can help is to give them open, honest answers and share our experiences without assuming that they want the same type of career that we have had. Here are the six pieces of advice I shared with this soon to be new nurse. Don’t Settle on Your First Job If you were told by a nursing professor that all new nurses need to start their career on a medical-surgical unit, please raise your hand. As thousands of hands go up across the country, I must say that I disagree. While this type of unit offers a solid base of nursing practice, it doesn’t match everyone’s nursing goals. You must be intentional when finding a job that fits with your overall nursing career goals. If you want to work in a high-acuity nursing setting such as intensive care or cardiac care, look for internship programs that provide training and mentorship. If you have a passion for geriatrics and long-term care settings, go there and find a facility that will train you and provide the experience you need to have a long career in this specialty. No matter where you see yourself, there is a way to get there without spending the proverbial two-years in med-surg. Create a Resume & Cover Letter for Each Job Finding the best first job in nursing relies heavily on your nursing resume and cover letter. Many people believe that once you create a basic resume and letter you can use it to apply to any job. This isn’t always true. The best thing to do is to spend a little time revising your basic documents to fit the specifics of each prospective position. Because most resumes never see the top of a nurse manager’s desk, it’s critical that you use keywords that will be recognized by an applicant tracking system (ATS). ATSs pull resumes to the top of the pile if the keywords match. So, while changing your resume over and over might feel a bit daunting, it is definitely worth the work. You should also make sure that your cover letter is personal and speaks to the job. Do this by highlighting your skills that match the role. You can also showcase some of your transferable skills and even any awards or acknowledgments you’ve received in your cover letter. For example, being bilingual may not be required for the job, but it can catch the attention of the hiring manager. Find a Mentor Once you land that first job, you will likely be matched with a nurse trainer or mentor. This nurse and the others on your first nursing unit can provide invaluable information and experience. If you don’t mesh well with the person training you, no worries! There are a few other ways that you can find a mentor that fits your needs. First, create a LinkedIn profile. Send requests to nurses and other healthcare professionals who have the job you only dream about at this point in your career. Read what they write and research some of the sites or organizations that they follow. You can even send them a private message and ask if they would be willing to mentor you. This might be a monthly virtual meeting or just a few chats or text messages as you navigate through your new career. Another way to find a mentor is to ask the human resources department at work if they have a formal mentoring program. Many employers have these types of programs to reduce turnover and boost the success of new hires. Build a Network If you are just starting out, you likely have a good solid network of other new nurses. Keep this network strong and add to it. Connect with your network often. Consider starting a private facebook group or text message group so that you can all chat and share stories about your new career. While you may gravitate towards nurses with the same type of experience as you, having a diverse network is best. Try to network with tenured and new nurses alike. You should even consider opening up your network to other types of healthcare providers, such as physicians, therapists, and certified nursing assistants. The more people in your group with varied experiences, the easier it will be for you to grow as a professional. Prepare for Your Interviews Preparing for interviews isn’t hard, but it does take a little work. First, research the facility in which you are interviewing. Read about their history, mission, vision, and values. Search for articles about the facility in the news. Perform a search on websites like Indeed or Glassdoor to see what current and former employees say about the culture. Next, practice your answers to common nursing interview questions. Ask a family member or friend to play the role of the interviewer. Answer each question until you feel confident in how to answer. Finally, be sure to write down questions that you want to ask of the nurse manager. Take this opportunity to ask about the culture of the unit, what type of nurse fits well, and the expectations of the job. You should also be prepared to ask about benefits, pay, and growth opportunities. Don’t Rush out of Orientation Orientation is not a race! Don’t worry about being the new nurse who finishes orientation before anyone else. Take your time and learn as much as possible while you are in orientation. If you get to the end of your training period and don’t feel confident about your skills, talk to the manager, and request an extension. Be Intentional with Self-Care Nursing is hard. This means that you need to take care of yourself and your mental health. Be sure to find a group of trusted friends and colleagues who you can talk to when things get rough at work. This might be your mentor or nurse manager. A few other ways to take care of your physical and mental health include: Schedule vacation days away from work Stay home if you are ill Eat a healthy diet and drink plenty of water Get 8-hours of sleep each night Participate in at least 30-minutes of exercise daily Take your breaks at work Practice meditation or mindfulness daily Ask others for help when you need it Starting any new career is challenging, but remember that you are never alone. While nursing can be hard and being the new kid on the block is never easy, you are starting a career that you will love. Reach out to others for advice anytime you need it. You may even find an experienced nurse like me who truly enjoys helping a new nurse find the best unit for your first job!
  7. Have you ever seen a double-pan balance scale? It’s a scale that has two pans that are balanced against one another. As you put weights on one side, you must counter it with weight on the other to maintain balance. If you read about these scales, you will find that you must put weight on them in very small increments to maintain equilibrium. You must also take into account the weight of the container that you use to help balance the two sides. The idea of nurse work-life balance works the same. For everything you do at work, you need to offset it with something at home to keep balance. And if you take time for yourself at home, you would need to ramp up work to meet the weight of what you just did for yourself at home. This concept would keep work and home life equal in function, value, and amount. The more you think about this notion, the more you may consider that this is not a safe or healthy life for nurses. Maintaining a complete balance between work and home will likely lead to burnout, fatigue, and career unhappiness. Let’s take a look at the dangers of work-life balance in nursing. Work Doesn’t End When You Clock Out In today’s world of technological advancements, walking away from work is challenging. Even when you aren’t within the confines of the hospital or long-term care facility, you are probably connected. You may receive emails on your phone or text messages from coworkers letting you know that Mrs. Johnson took a turn for the worse. You might even carry a laptop home with you that seems to call your name each time you sit down to take some time for yourself. It’s easy to think, “I’ll just check on a few things. It will only take 10-15 minutes,” and before you know it, it’s been three hours and you are knee-deep in work that you shouldn’t be doing until tomorrow or the day after. This can further tip the scales of nurse work-life balance towards unbalance. Challenge of “Leaving Home at the Door” Have you ever had a supervisor tell you that you need to leave your home life and any problems at the door when you come to work? In theory, this is a good concept. However, it isn’t always practical. If you have an ill child, parent, partner, or another family member, you might have to answer questions or check in on them at work. And, sometimes life gets messy in ways that you just can’t “turn-off” because you are at work. Trying to block out home life when you’re working can tip the scales in a way that could lead to an unhealthy home life. Balance Can Be Dangerous Trying to keep balance in life could be dangerous. Think about it, your body is rarely in perfect balance. When you walk, you need a little imbalance to keep moving. When you are perfectly balanced, you are standing still, not moving forward or achieving any goals. The same could be true with the idea of work-life balance. If work and home are equal, you are likely not moving forward in either place. It’s important to allow the scale to shift from time to time. Maybe this month you are doing continuing education and a conference that requires work to be a little on the heavy side. But, next month you have plans to take a few days off and will be resting and having fun with friends and family. This is a healthy mix of imbalance that can help you move forward in both areas of your life. What Are a Few Strategies to Be a Healthy, Imbalanced Nurse? Call in When Needed Raise your hand if you’ve ever called in and felt extremely guilty about it. Okay, a sea of nurses' hands just went up! Nursing is a challenging career. If you or a loved one are sick, you may need to stay home. Heck, sometimes you just need to spend more time at home, even if no one is ill. You might need a “mental health” day or need to spend time with a child who is having a hard time at school. While it might feel that you are letting your coworkers down, it’s critical to remember that your sick days are “yours” and you get to use them as you see fit. Your employer provides these days to give you time to address family needs, so use them! Make Work Your Focus When you are at work, be present. We all need to check in on kids every now and then, but it’s essential to have a structure at home that can handle the nuances of life when you are at work. This means hiring a babysitter, putting a little more responsibility onto your partner on days you work or asking for help from family and friends. Plan Professional Development You became a nurse to help others. To do this, you have to invest in your continuous improvement and education. One of the best ways to do this is to join professional nursing organizations and get involved. Go to the annual conference and participate in education and self-improvement activities. Be sure to structure home life in a way that allows you to fully engage with your educational opportunities. Plan a Vacation Going on vacation might seem like a luxury that you can’t afford. However, it’s vitally important to give your family a good dose of imbalance at least once a year. Plan a trip or cruise and completely disconnect from work. Let coworkers know that you are off and need to not be contacted about work. This doesn’t mean your work-bestie can’t text you, it just means that they need to not tell you about the issues at work, but can check in to see how you and the family are doing. An imbalance is good. How do you keep a little imbalance in your life to stay healthy? Leave a comment below to get the conversation started.
  8. Going to work should not be dreadful. However, for many nurses, the stress, burnout, and culture can sometimes make it downright painful to get dressed and head to work. After days, weeks, months, or even years of these types of feelings, you might lose the love you once felt for the profession. If you’re going through this, you must remember that you are not alone and that these feelings are normal. If they hang around for a few days or a month, it’s probably not too concerning. But, any longer than that and you may need to start looking at strategies to help you bounce back and reignite the passion you once felt for your career. Here are a few of my favorite things you can do to get back on track. Take Time Off Americans let 768 million vacation days go unused in 2018. This equals billions of dollars in lost benefits and often means that workers aren’t getting the rest, relaxation, and restoration they need. Unfortunately feeling like you’ve lost your passion for your work can sometimes be a double-edged sword. You feel burnout, so you keep working with the hopes of finding something that will reignite the passion you once felt. Unfortunately, it often makes the situation worse. If you’re feeling disconnected from work, talk to your manager or supervisor about scheduling in a few “mental health” days. Don’t plan any major events on these days, instead book time doing something you love. Or, you may want to make an appointment to get a massage, pedicure, or other restorative treatment. Treat Symptoms of Burnout Burnout is a challenging condition. If you start feeling like every day is a bad day or you’re exhausted all the time, you might be dealing with burnout. Other symptoms to watch for include: Feeling worthless or hopeless Feeling bored or overwhelmed Feeling under-appreciated Exhaustion Frequent illness Headaches or muscle pain Change in sleep patterns Change in appetite If you are experiencing any of these symptoms of burnout, you need to get the treatment you need. Talk to those around you about how you are feeling. If you have a workplace mentor or a boss you trust, start there. They may have noticed these changes, too and can offer invaluable feedback. You should also try to increase your connection with your coworkers, but avoid interactions with negative individuals. You might also need to look for activities outside of work that can increase your feelings of meaningfulness and purpose. Look for a New Specialty Sometimes feeling overwhelmed and unhappy can be a sign that it’s time for a change. If you work in a specialty like hospice, oncology, or other high-acuity areas, you may need to consider looking for a new area of nursing to try. Not only can a change decrease your level of stress, but it can also help you find your passion through learning about new areas you never thought about before. Work With a Coach or Mentor Reaching out to another nurse who has maybe experienced these same feelings can be helpful. If you have a mentor, start there. If not, it might be a good idea to hire a career coach who is also a nurse. You can discuss your feelings with them and also ask them for ideas of other areas of nursing that could be a good fit with your background. Take Care of Yourself It seems that self-care, getting plenty of rest, and eating a well-balanced diet is a good answer to just about any problems we have in life. And, feeling burnout and drained at work isn’t any different. Carve out time to get at least 30 minutes of moderate-level activity each day. Find a diet that is low in carbohydrates, junk food, and sugary foods. You might want to consider one that is plant-based or at least has high amounts of fruits and vegetables. Finally, make sure you are getting eight hours of sleep every night. Getting Back on Track Remembering your passion for nursing can be challenging when you are in the midst of burnout and other feelings of disconnection from your work. You can use these ideas, but there are also many other ways to reconnect with your passion for the art of nursing, it just takes a little work and time. Have you ever experienced burnout or “fell out of love” with nursing? What helped you get back on track? Share your ideas with us by posting in the comments below. We would love to hear them.
  9. You probably know happiness when you feel it. As a nurse, you may feel those positive emotions that come with a deeper purpose when an acutely ill patient turns the corner toward better outcomes or a patient living with cancer finds out they are in remission. You also feel happiness in everyday life when you reach goals, spend time with loved ones, or enjoy a nice dinner with friends. However, happiness isn’t something that comes easy for everyone. According to the World Happiness Report, the United States ranks nineteenth in the most satisfied countries in the world, with Finland, Denmark, and Iceland ranking in the top five. American adults have been experiencing a decrease in happiness since 2000 and reporting more thoughts of suicide, depression, and acts of self-harm since 2010. These statistics are scary. Nurses can experience high levels of stress-related to work environments, short-staffing, and the emotional aspects of working with ill and injured individuals each day. Combine your work with the statistics about happiness in the U.S., and you can see why it’s critical to take your happiness serious and plan out ways to increase your happiness quotient daily. Here are ten ways you can increase your happiness today. Create Happiness Goals Ok, you might think this sounds silly, but we live in a country where happiness is dying. So, having a goal to meet up with friends once a week for happy hour or planning a date with your partner is good practice. Find a Hobby Finding a hobby can be challenging. If you are looking for a hobby, think about what you loved to do as a child. Did you enjoy painting or crafts? If so, this might be an excellent place to start. If getting started on your own feels like a daunting task, find a class to take that can get you started with the basics. Use Your Vacation Time A recent report revealed that a record 768 million vacation days went unused in the U.S. in 2018. This is an increase of 9% from 2017 and adds up to billions of dollars lost in benefits. Dedicated nurses can sometimes feel guilty about taking vacation days and leaving their coworkers short-staffed. However, your vacation time is critical to your health and ability to refuel so that you can continue caring for others. Stay Healthy Nurses are skilled in educating patients on ways to stay healthy. You teach about diet, exercise, and chronic disease management. But how well do you keep you with your own wellness? Make your health your number one priority. Get plenty of sleep each night, eat a well-balanced diet, and get at least 30-minutes of activity daily. Practice Gratitude Each of us has many blessings in life. Expressing our gratitude can boost your mood and remind you of reasons to be thankful. Try telling the most important people in your life how you feel about them. Or, keep a gratitude journal to jot down two to three things you are thankful for each day. Ask for Help When You Need It Whether you need a little assistance with an admission or a patient who needs a PRN medication, asking for help can make your day run a little smoother. You should also ask for help outside of work when you need it too. If you feel that your happiness tank is getting dangerously low and you are struggling with symptoms of depression or suicidal thoughts, make an appointment to talk to a counselor or psychologist. Take a Walk Getting outside can boost your spirits. Feeling the sun on your skin and the wind in your hair is an excellent way to inject a little bit of happiness in the middle of a busy day. If you’re having a stressful day, take a 15-minute break to get outside and get a little sunshine. Volunteer Your Time Nothing can boost your mood quite like giving freely of your time and gifts. Find a charity organization that aligns with your purpose in life and spend some time working with others who may be less fortunate than yourself. Have a Good Laugh Did you know that laughing releases endorphins, the feel-good chemical, into your bloodstream? Laughing also relaxes muscles and can relieve built-up tension and stress. So, the next time you are looking for ways to boost your happiness, catch a comedy show, hang with your bestie who knows just how to make you laugh, or play a fun game with your family. Practice Mindfulness Life is busy. Whether you’ve received your fourth admission for the day or you’re trying to balance work and family life, taking time to connect to the present is critical to your happiness. The good news about mindfulness is that you can practice it pretty much anywhere. Find a quiet place like the breakroom at work or your bedroom at home and sit down in a comfortable position. Then, close your eyes and take ten deep breaths. As you breathe in, silently and slowly count to four, then hold your breath for a count of four, followed by a long exhale for a count of six. Do this for at least one cycle, but preferably two to three times. Happiness is a much-needed emotion. If you don’t plan ways to increase your happiness in your everyday life, you can start feeling sad, depressed, or disconnected from those around you. What other ways do you increase your happiness? Comment below to let us know what activities bring a smile to your face.
  10. Ah….fall! That time of year where we start to prepare for winter. Autumn brings leaves, pumpkins, and warm sweaters. Everyone heads outside for bonfires, football games, and trick-or-treating. Yet, lingering right around the corner is flu season. This isn’t a season that brings joy and happiness. The flu is a dangerous and even deadly virus that is preventable. Here are the essentials you need to know about the Influenza vaccination recommendations from the CDC for 2019-2020. What is the Flu? Influenza, commonly called the flu, is a respiratory infection. The flu can cause serious complications in those who are compromised for any reason, such as older adults, young children, or individuals living with conditions that decrease their ability to fight off infection. Vaccines are not 100% effective. However, they are the best way to prevent the flu and possible complications. How are flu vaccines created? Flu viruses are constantly changing. Each year, researchers across the country, study the current strains, and review the composition of vaccines. Updates to the vaccines are needed to match the viruses that are seen the most. There was a delay in selecting the viruses for the 2019-2020 season due to frequent changes in some of the common viruses. Flu shots protect individuals against three or four viruses that are expected to be most common during the season. Four vaccines will be available to the public this year. Medication Rights: Right Patient, Right Time Annual flu vaccination is recommended for everyone over the age of six months unless contraindications exist. Getting vaccinated is of utmost importance for a few specific populations, including women who are pregnant, young children, and older adults. Young children may need up to two doses of the vaccine to be fully protected. Other populations that are at high risk of complications from the flu include individuals living with obesity, liver or kidney disease, diabetes, HIV/AIDS, asthma, cancer, COPD, or cystic fibrosis. Will there be Enough Vaccine this Year? The amount of vaccine available each year depends on manufacturers. The projection for the 2019-2020 season is between 162 million and 169 million doses for the U.S. alone. These numbers may change depending on how the season progresses. Arguing for Mandatory Flu Shots If you work around people with the flu, your chances of contracting the virus are increased. Getting the vaccine not only protects you, but can also help to protect your family, friends, and patients. Individual’s with the flu are contagious one day before symptoms show up and up to seven days after becoming sick, which means that many people can pass the flu on to others without even knowing it. The CDC recommends that all U.S Healthcare workers get vaccinated against the viral infection. More than 78% of all healthcare workers received the vaccine during the 2017-2018 season. Doctors and pharmacists were the most vaccinated at 96.1% and 92.2% respectively. Nurses came in at 90.5% and nurse practitioners at 87.8%. Healthcare workers in long-term care settings were the least likely to get the vaccine, and those in hospitals were the highest. Some healthcare settings mandate flu vaccines for all clinical and non-clinical staff. These clinical setting had the highest rate of coverage at 94.8%. Arguing Against Mandatory Flu Shots While the CDC recommends getting vaccinated, not everyone wants to get a flu shot. Hospitals report that making flu vaccines mandatory is to protect patients. However, what about the rights of the healthcare worker? Researchers report that vaccinating healthcare providers will help with patient safety, increase the effectiveness of the vaccine, and protect those staff who are at an increased risk of complications from the virus. Those who oppose the vaccine report factors like side effects of the drug, setting a precedent to require healthcare professionals to comply with other medical treatments, or just feeling like a shot isn’t needed as their reasoning for opposing the requirement. Many nurses feel that following standard and transmission-based precautions such as hand washing, wearing masks, and even keeping people in isolation should be enough to minimize the spread of the infection. How Do You Feel? Vaccines can elicit much debate these days. And, requiring professionals to take a medication that they don’t want could cause some tempers to flare. So, where do you stand on the issue? Take our poll so that we get an idea of how many of you only take the vaccine because it’s required at work. And, comment below to let us know how you really feel about the topic.
  11. The need for patients to be well-informed, and even a bit tech-savvy in today’s healthcare market is critical. Those living diabetes with or without comorbidities must be well-versed in disease management strategies like how to recognize the symptoms of high or low blood sugar and when to give insulin. According to the Centers for Disease Control and Prevention, there were more than 100 million adults in the U.S. living with pre-diabetes or diabetes in 2017. The American Diabetes Association reports that the total cost for those living with diabetes in 2017 was more than $300 billion. This makes diabetes 2.3 times more expensive to those living with it compared to people who have no diabetes diagnosis. All of this data illustrates the importance of patient engagement and self-care for those with diabetes. A recent study conducted by researchers in China reports that the motivation some patients are missing to participate in self-care may be simpler to provide than ever before. The study found that sending a series of motivational text messages can improve the control of blood sugar in patients with diabetes and comorbidity of coronary heart disease. Overview of the Study Study participants included patients with a dual diagnosis of cardiovascular disease and diabetes. Patients were told that the study would help them better care for their bodies, given the serious nature of both conditions. Knowing that lifestyle changes are pivotal to the success of managing the symptoms of both diseases, made these researchers curious about the use of text messaging. The study followed 502 patients in 34 different hospitals throughout China. Each patient received standard care for both conditions. Study participants were divided into two groups. The first group received six autogenerated or pre-programmed texts every week for the duration of the study. The messages focused on controlling blood pressure and glucose readings, providing advice on healthy lifestyles, and educating on the importance of following their medication regimen. An example of a message study participants received includes, “Afraid of testing blood glucose because it hurts? Try to test on the sides of your fingertips or rotate your fingers, which can help to minimize pain.” The second group of study participants received two messages each month. These messages did not offer education or encouragement but instead thanked each patient for their participation. Patients in the motivational text messaging group experienced lower blood sugar levels after about six months. They also had a 0.2% decrease in their overall HbA1c levels compared to an increase of 0.1% of those patients in the control group. More than 69% of the motivational text messaging study participants reached the target value of HbA1c levels below 7%. Even though messaging targeted both diabetes and cardiovascular disease, there was no difference in blood pressure, cholesterol, or body mass index results of the two groups. Could this Strategy Work for Other Conditions? The results of this study are encouraging. If a few text messages can decrease overall sugar levels and increase disease control, just imagine what other conditions could be managed. This isn’t the first study to look at the use of mobile technology to help with chronic conditions. A 2018 study published in the British Medical Journal looked at the use of two-way digital text and voice messaging on the overall control of chronic diseases. The researchers reviewed four studies that provided patient observation, motivation, supportive communication, reminders, praise, and encouragement to those living with long-term illness. These studies also looked at the efficacy of using mHealth technologies with low literacy patients and those who may live in areas with minimal resources. Overall, this study found that increasing communication between patients with chronic conditions and their healthcare providers can improve health outcomes. Moving Forward in a High-Tech Industry Patients turn to technology for everything from logging workouts to tracking symptoms to attending visits with a provider. The more the healthcare community embraces the use of tech in healthcare treatments, monitoring, and overall management, the sooner we may see long term lifestyle changes that can impact overall health outcomes. Do you have any experience, either in practice or first-hand, using communication tools like text or voice messaging for disease management? If you have a story or even a thought about this practice, drop a message in the comments below to get the conversation started.
  12. Mobile Health According to Statista, during the second quarter of 2019, there were nearly 50,000 health apps available in the iOS app store. By 2020, the mobile health market is expected to be worth 21 million dollars globally. Many consumers turn to mobile health (mHealth) for overall health and wellness. You can do things like track your meals, log chronic symptoms, keep detailed records of the amount of water intake, or keep track of your workouts. More healthcare companies and practitioners are turning to mobile health to reach patients, and some are using chatbots to increase how quickly they can connect. Health insurer Anthem is taking a shot at a new digital service where patients can pay for a text chat with a physician to review symptoms and receive treatment. However, their first interaction is with artificial intelligence (A.I.) chatbot that asks about symptoms and suggests diagnoses. The patient is then connected to a physician for follow-up that happens at the patient’s convenience for an agreed-upon fee. As more people turn to mHealth for disease management, we need to get a clear picture of the pros and cons. Kevin Campbell, MD, took an in-depth look into the good and bad of mobile health and why he thinks patients will like it and physicians won’t. Here is a look at the good and bad around using mHealth and A.I. for medical care. Understanding the Benefits Most medical care and treatments come with pros. Here is a look at the positives of using AI-based apps for healthcare treatment. Price Transparency Most care happens with little or no conversations about what it might cost the patient. However, in our current healthcare market, more patients want to know what their out-of-pocket contribution will be before they sign on the line consenting for treatment. Anthem understands this desire of patients and is meeting them halfway by giving them the cost of their chatbot visit and MD appointment upfront. Not only do patients know the cost of the visit, but they also get an appointment that fits into their schedule from the comfort of their home, office, or breakroom. Of course, price transparency doesn’t only come from apps. The Affordable Care Act requires hospitals to publish a master list of costs so that consumers can shop around for the best price. This rule was enforced on January 1 of this year but has become nothing more than a long list of expenses that mean little to most consumers. With the Anthem app, prices are clearly communicated to the patient before care so that an informed decision can be made. Increased Patient Engagement As nurses, we know that a highly engaged patient typically sees better outcomes. When dealing with complex medical issues like cardiovascular disease or diabetes, being well-versed in their symptoms, medications, and any possible side effects can keep patients healthy. App visits can also provide a level of anonymity that may allow some individuals to ask questions that they may not feel comfortable asking during a face-to-face visit. Understanding the Possible Drawbacks Just like all medical treatments, there are potential cons to using A.I. and mHealth. Here are a few of the potential dangers of chatbot visits. Legal Implications for ChatBots As Dr. Campbell points out, artificial intelligence is an excellent tool for healthcare professionals. However, seeing your physician or nurse practitioner and their office staff will always be the gold-standard for medical diagnoses and treatment. If a doctor does not have the ability to see the patient and do a physical exam, the risk of misdiagnosing the condition is significant. One question that is concerning for some experts is who would be responsible if an incorrect diagnosis is given to a patient during the chatbot conversation. Chatbots can’t be sued, but physicians, nurse practitioners, and other care providers can be held responsible for misdiagnosing a patient’s condition. Physician Burnout Could healthcare systems start expecting physicians to see patients all day and then go home and be connected to their phones? More doctors are talking about symptoms of burnout they feel from their day jobs. The American Academy of Family Physicians called burnout an epidemic in 2015, with about 46 percent of physicians reporting symptoms of the condition. Burnout can lead to low job satisfaction, anxiety, depression, and lower quality of patient care. Quick Fixes Aren’t Always a Good Thing Our society likes a good quick fix. You can find a hack for almost anything these days. However, when it comes to your health, choosing the quick fix may not be the best answer. Dr. Campbell worries that patients may chat with the bot, get a few possible diagnoses and then end the visit before ever-texting an actual human. This could lead to poor outcomes and misdiagnosis because the patient didn’t take the time to speak with the physician. The Future of MHealth and A.I. Healthcare was slow on the uptake of technology. Today, the industry has caught up and is even leading the charge in many areas of technology. So, what do you think about mHealth and chatbots? Would you use this service for yourself, and would you recommend it to your patients? Share your thoughts in the comments below.
  13. Melissa Mills

    4 Reasons Nurses Need Mentors

    I remember my first nursing mentor like it was yesterday. Her name was Della. She was my preceptor during my preceptorship at the end of nursing school. She was smart, sassy, and offered so much practical knowledge that nursing school didn’t provide. After I graduated, I went to work alongside Della and others that I knew from clinicals. As my career progressed, I found other nurse mentors, like Lisa in the NICU and Paula in hospice. Even after 20+ years as a nurse, I still need a mentor. When I changed my specialty from leadership to writing, I found a coach and later connected to a few different writing groups and networks. Nurse mentorship is a collaborative relationship. Sometimes we choose our mentors, and other times, they choose us. Mentors are role models who teach us not only about nursing care, but about customer service, teamwork, and our career potential. Many hospitals and nursing facilities have mentorship programs where they partner new nurses with tenured staff. However, some of the greatest mentoring relationships come from reaching out in times of need for support, guidance, or education. Why Do I Need a Mentor? 1 - Burnout is Real The stress of direct patient care can be significant. Nurse burnout is a mental, emotional, and physical state created by long-term overwork. Burnout continues because of a lack of support and job fulfillment. Mentors can help fill this void. Common signs of nurse burnout include: Lack of personal and professional accomplishment Physical and emotional exhaustion Job-related skepticism or cynicism Mentors can recognize the signs of burnout in their mentees. They can offer suggestions of ways to combat nurse burnout and help you create healthy coping mechanisms. 2 - Confidence is Needed Whether you’re a new grad or just new to a unit, having someone to turn to for help and guidance can help with your overall career success. A mentor will have your back at all times. They can help you hone your skills and lend a hand when it’s needed. Having someone in your corner helps to boost your confidence levels so that you can be successful in your career. 3 - Everyone Grows Mentorship isn’t a one-way street. Nurses who mentor others will learn from experiences and grow in their professional development. Many nurse mentors discover their love of education or leadership as they help guide and coach others. While mentees learn much from the collaborative mentor relationship, mentors also grow in their confidence and skills. 4 - Career Growth Mentors can help when you’re looking for a new job or researching a unique nursing specialty. Connecting with other healthcare professionals on Linked-In or even through social media platforms such as Facebook or YouTube can help provide a glimpse into various nursing specialties that you may have never considered. If you’re looking for a new job, reach out to others in the role who may be able to offer guidance and strategies for finding your first job in the new niche. Finding the Right Mentor for You Not everyone is lucky enough to find a Della, Lisa, or Paula. Sometimes, you have to search for a mentor who is willing to give you the time, feedback, and support that you need. Formal nurse mentorship programs aren’t as standard as they should be in most nursing settings. So, you may need to get creative when looking for a nurse mentor. Here are a few ways you can find the collaborative relationship you’re looking for and need for career success. Participate in a Formal Mentorship Program If your facility offers a mentorship program - sign up! You may be given a chance to select a mentor you’re comfortable with, or you may be assigned a mentor that the program administrator thinks will be a good fit. Formal programs often have contracts that both the mentee and mentor sign. You may also be asked to create goals of your mentorship relationship to ensure that you stay on track during the program as a team or partnership. Connect with a Colleague If your facility doesn’t have a formal program, look around while you’re at work for a mentor. Is there a coworker who you look up to or someone that already gives you support? If so, ask them if they would be your mentor. Once they agree, set up times to meet to discuss your progress on the unit and review your career goals. Find a Mentor On-line You can search for nurses on Facebook or Linked-In. Many professional organizations offer membership networking benefits like mentorship programs. Search for someone who has similar interests and professional goals. You can also hire a nurse coach to help you along the way. Professional nurse coaches may offer group and one-on-one sessions, resume help, and specialty programs like how to makeover your LinkedIn profile. Tell Us About Your Mentor Do you have any great stories about your nurse mentors? We would love to hear them. Leave a comment below with stories about nurses who have either formally or informally mentored you throughout your career.
  14. Did I see you work from home?  I have my Master's in Nursing Education and was curious if you had more information on where I can look.

  15. Your job title probably means a lot to you.It might even be as important to you as your birth-given name. You went to school so that you could write specific letters behind your name, such as LPN, RN, or FNP. However, if you decided that it was easier to tell your patients that you were a caregiver, caretaker, or health assistant, would it matter? What if your preferred title was one that other professionals feel is reserved only for them? For one advanced practice registered nurse, it mattered quite a bit. In fact, it was important enough for him to be able to call himself an anesthesiologist that he fought for this right in front of the Florida Board of Nursing. Nurse Anesthetist vs. Anesthesiologist John McDonough has identified himself to his patients as a nurse anesthesiologist for years. After recently appearing before the Florida Board of Nursing, McDonough can legally use this title. However, the Florida Society of Anesthesiologists doesn’t agree with the decision. Chris Nuland, an attorney, and lobbyist for the organization told The News Service of Florida, “The FSA firmly believes that, although this declaratory statement only applies to this one individual, this sets a dangerous precedent that could confuse patients.” McDonough didn’t mince words regarding how he feels about his right to call himself an anesthesiologist. He was quoted in an article on nwfdailynews.com saying, “I’m not a technician. I am not a physician extender. I am not a mid-level provider. I am, in fact, a scientific expert on the art and science of anesthesia. So I think anesthesiologist is a perfectly acceptable term, especially since the term anesthetist has been hijacked from my profession.” He goes on to offer similar examples to his situation like dentists who identify as physician anesthesiologists. Florida's Board of Nursing seems to make several statements about the role of advanced practice nurses these days. They are also deciding if advanced practice nurses can practice independently from physicians. Other nursing boards across the country are making critical decisions about the expansion of advanced practice nurses to work with greater autonomy. Given the continued expense of healthcare and the increased need due to an aging population, it only seems logical to allow these nurses more ability to work with less oversight. Understanding the Role of the APN It’s essential to know that the term APN refers to several different types of nursing professionals. These various roles perform tasks such as diagnosing illnesses, performing head-to-toe physical exams, providing specialized exam such as functional and developmental testing, ordering lab tests, performing a variety of testing, and dispensing medications. APN includes the following Certified Nurse Practitioner Certified Registered Nurse Anesthetist Certified Nurse Midwife Clinical Nurse Specialist Advanced practice nurses have various levels of autonomy across the country. Some states allow APNs to operate clinics or offices independently. Other states require physician collaboration or supervision at all times. Because each type of APN has a different job description and role, the settings in which they practice and how they practice varies too. For example, a family nurse practitioner may work in an office with one or two MD’s and only consult on cases as needed. For roles like a nurse anesthetist, the setting is likely larger, and they usually work with doctors and surgeons while performing their job functions. What Do You Think? So, what’s in a name? Does it matter if you call yourself a nurse or caregiver? Should nurse anesthetists be limited to this term or should they be allowed to call themselves an anesthesiologist since this is the specialty for which they are certified? Let us know your thoughts by leaving a comment below.
  16. Melissa Mills

    Put Your N-95 Respirators Away: TB Exposure is on the Decline

    Thanks for your comment, Nursej22. It was supposed to be a bit of tongue-and-cheek humor. Of course, no one can put their N-95 masks away. However, the decline of TB cases in the U.S. is encouraging. Hi Pepper The Cat! Of course they won't and nor should they. The title was a bit of tongue-in-cheek humor. Thanks for your comment!
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