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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

Content by Melissa Mills

  1. Melissa Mills

    7 Writing Tips for Nursing Students

    Nursing school is full of dosage calculations, clinicals, and writing assignments. You were probably prepared for the first two, but writing might not be your strong suit. If your palms get sweaty when you hear things like term papers, capstones, or dissertations, no worries! This list of 7 writing tips will have you succeeding on those dreaded assignments in no time - here's how. Understand the Goal of the Assignment When you're preparing for a written assignment, be sure you understand all the details. There is nothing worse than pouring your heart into an assignment to be later told that you missed the purpose and won't receive full credit. According to Walden University, there are five common goals of nurse assignments: Demonstrating critical thinking skills Documenting your knowledge Expressing ideas or opinions Showing your understanding of nursing literature Demonstrating your understanding of activities Know Your Audience Writing requires you to know and understand your target audience. In school, you're writing for your professor with the express intent of demonstrating your knowledge about a subject. But, don't be mistaken - even though you are writing for your professor - be sure to express your thoughts openly and don't assume they fully understand the subject. Here are a few things you need to know about the professor's expectations before you begin your assignment: Should you write in first, second, or third person? Do they have a sample of a paper or writing style they prefer? What style of citations do they prefer? Is there a preferred format for papers? If you have multiple audiences, how do you meet the needs of everyone? Do Your Research Research in nursing school is essential to your success. You will need to become very familiar with the online library and how to perform a search for topics. Many of the library systems have multiple ways to search for articles, save them for later reference, download and print them. When you search for nursing research, be sure the information is: Current - You professor might provide guidance on this, but if not, always try to find research no more than 10 years old and preferably within 5 years. Credible - Credibility is essential in nursing research. Be sure to know the author, journal, and publisher. Always steer clear of websites like Wikipedia, blogs, and magazines for academic papers. If you want to search the web for articles, try Google Scholar for academic sources. Peer-Reviewed - Nursing is founded on evidence-based research, which means that finding articles that have been peer-reviewed is critical. If you haven't heard of this term before, it means that the item has been reviewed by a board of experts on the subject matter. Peer-reviewed articles are considered to be a high quality of research and adhere to strict editorial standards. Execute a Brain Dump There's nothing scarier than a blank page, especially, when you know that you need 10-15 pages filled with stellar content in a short amount of time. But, as scary as it might be to get started, that is precisely what you need to do. As someone who writes often, I have learned that you must do a draft to "get the garbage out," as I say. Once you get all of the garbage out and onto a document, cleaning it up and adding to it is easier than creating those first few sentences. Keep the Fluff to a Minimum Nursing school assignments are not like writing poetry. You want to be very clear in your writing. There is no need for a lot of descriptions and flowery wording. Do your research and be sure you understand the material thoroughly. Write using clear language. Once you're finished with your paper, read it aloud, which will help you to identify areas of flowery wording that isn't necessary for nursing school. If you need extra help, find a classmate who is good at writing and have them read over your work. Another option is to use an online editor such as Grammarly or Hemingway. These tools are not perfect, but they can help find common errors and offer solutions. Avoid Passive Voice This takes practice. If you struggle with passive voice, just know that most writers struggle too. Limiting passive voice is very important to academic writing. It's a simple guide to keeping your language simple and easy to understand. So what is passive voice? According to the Writing Center at The University of North Carolina at Chapel Hill, passive voice is when you make the object of an action into the subject of the sentence. For example: Active Voice: The chicken crossed the road. Passive Voice: The road was crossed by the chicken. When you write in active voice, the ideas you are expressing are clear and easy to understand. In passive voice, it might be a bit more challenging to understand the meaning. Practice, Practice, Practice If you're struggling with assignments and your papers are coming back with lower scores than what you want, try practicing. Now, this might not sound like much fun, but you don't have to do extra term papers. Try writing a journal or start a blog about nursing school. The more you write, the easier it will become. If you need a bit more discipline to get this practice, take a writing class. It might not be required, but it will help you throughout your college and professional career. Do you have other writing tips for nursing students? Are you a student and have found something else that seems to be helping? Let us know your thoughts.
  2. Over 56,000 qualified nursing school applicants were turned away in 2017. You read that right - 56,000. This is happening while hospitals and clinics continue to report a nursing shortage. According to Becker's Hospital Review, some of these qualified applicants are graduating high school with a 3.5 GPA or higher. These are candidates that will likely be successful nursing students. You may be wondering why this is happening in the middle of a nursing shortage. Let's discuss the statistics, reasons for the problem, and a few solutions. The Statistics Here are a few concerning statistics about the number of aspiring nurses being turned away each year by nursing programs: The National League of Nurses reported that up to 45% of ADN applicants and 36% of BSN applicants were turned away in 2014 Cabrillo College in Aptos, California reported having hundreds on their wait list for a 60-seat nursing program Many schools are saying that applicants will be on wait-lists for up to six years and some schools are discontinuing wait lists altogether The Reasons To fix the problem, you need to understand why thousands of students are turned down each year by nursing schools across the country. Not Enough Instructors Nursing faculty positions go unfilled year and year. In fact, the American Association of Colleges of Nursing reported in their Special Survey on Vacant Faculty positions that the United States has an annual national nursing faculty vacancy rate of slightly over 7%. This equates to about two teachers for every nursing program out there. And, over 90% of these vacancies require or prefer the nurse filling the position to have a doctoral degree. The survey went on to break down the vacancies by region. The most substantial number of vacancies can be found in the Midwest, with nearly 10% of all faculty positions remaining unfilled. Just behind that region was the South (9.7%), North Atlantic (9.5%), and finally the West (9%). If you look at the issue by type of institution - 9.6% of all vacancies are found at public colleges. And, one more break down tells us that the largest number of vacancies are in Baccalaureate programs (14.6%). Do Nurses Want to Be Instructors? Being a nursing instructor may be of interest to many nurses until they begin doing their homework about the position and salaries. Up to 18% of all faculty positions do not have a tenure system at the institution, and another 32.6% of the jobs just don't qualify. The amount of education required for these vacant positions appears to be another barrier. Over 22% of all vacant positions required a doctoral degree. The special report by the AACN also reports that many schools have insufficient funds to hire new faculty. And, in some schools, the administration doesn't support the additional faculty positions, even though they are turning away potential students. Clinical Space Shortage All programs require a significant amount of hands-on experience in a clinical setting. Finding nursing units available for clinicals can be a challenge for nursing programs. If we had enough faculty, would they receive the training they needed? The answer is probably, no. Many schools are reporting that there are a limited number of clinical spaces for students to get this experience. And, finding preceptors in specialty areas can be another barrier. This has further compounded the need to turn away qualified nursing school applicants. Higher Clinical Nurse Salaries As clinical nursing salaries continue to grow, nursing faculty salaries have not been able to compete. Up to 33.9% of schools with faculty vacancies reported that noncompetitive wages were to blame for the inability to fill the position. In fact, the AACN reported in March 2016 that a masters-prepared faculty member made an average of $77,022 per year. Compare this to a masters-prepared nurse practitioner salary of $87,000, and you can easily see why these positions are difficult to fill. The Answers Identifying the problem is only half the bottle. Let's explore a few solutions to this nursing dilemma. Bridge Programs Many nurses choose nursing as a second career. Or, they start out as an LPN or ADN and move up to a master's or doctoral prepared nurse later on in their career. Professionals can make these transitions with the use of bridge programs. These programs allow qualified candidates to continue their education when it's convenient for them. These programs have adopted an online format over the past several years, making it even easier for nurses to continue to work and advance their education. With the help of bridge programs, some of these faculty positions could be filled. Think Outside the Box for Clinical Sites As our healthcare environment moves away from extended hospital stays, nursing programs need to consider new locations for clinicals. Instructors are now turning to rehab centers and nursing facilities to gain exposure to patients who were once kept after surgeries and other procedures. Nursing jobs are changing too. Looking for preceptors in-home care, hospice, and other community-based settings is crucial for the future of nursing education. And, it gives students exposure to non-hospital nursing career options. Create a Competitive Salary Structure Teaching is such an essential career, yet, teachers across all industries seem to have lower paying salaries. There is undoubtedly a demand for more nursing instructors, so this needs to be rectified. If you are interested in pursuing a career as a nurse faculty member - you can increase your earning potential based on the location and type of school. You may also look at roles, such as nurse education director, to improve your salary. What are your thoughts about nursing schools turning away qualified applicants? Have you experienced a long wait-list or other issue related to starting your nursing education? We would love to hear your thoughts and experiences.
  3. Hi Wolfbuddy! You raise some excellent points about the nursing shortage and the motivations of those entering the profession. The wages have increased over the last 20 years, or so, however, I agree that there are other professions that you can come out of college making significantly more money. The nursing shortage is a complex issue with many moving pieces. I'm not sure there will ever be a real solution. Instead, we have to attempt to solve the problems as they arise and see how the whole thing turns out. Thanks so much for your insightful comments. Melissa
  4. Melissa Mills

    7 Writing Tips for Nursing Students

    Hi masonicus! I am so glad you found this to be helpful. Yes, academic writing is totally different and can be difficult for even the best of writers. Best of luck to you on your journey - I'm sure you'll CRUSH it! Melissa
  5. According to a 2017 report by the World Health Organization and the World Bank, at least half of the world's population lacks access to essential health services. As more people than ever are facing health conditions without adequate access, many nurses are called into mission here and across the globe. Have you ever considered going on a medical mission trip? Do you wonder what a typical day would be like if you were to go? I had the pleasure of speaking with Elaine Alston, founder of Nurses with Purposes (NWP) who told her story and answered several questions that might help you decide if a medical missions trip is right for you. History of Nurses with Purpose Before she ever took her first nursing class, Elaine wanted to give back. She contacted the local hospital, but she wasn't eligible to work as a nursing assistant quite yet. Not to be discouraged, Elaine signed up as a personal touch volunteer. She reminisced that it was in those one-on-one interactions with patients where she fell in love with volunteering. After graduating from nursing school, she began working but quickly realized how easily nurses could suffer from burnout. She started feeling this way herself but used her volunteering opportunities to combat these discouraging feelings. Elaine knew she had to stay connected with volunteering and began working with local organizations and events. She became known for this work on her unit and started organizing events for other nurses too. This is when she first realized how much she loved connecting other nurses with volunteer experiences that kept them grounded in their love of the profession. In 2010, Elaine's love of volunteering received a new calling - Johannesburg, South Africa. She visited as a part of a homecoming trip. You see, she was from Johannesburg, but had never visited. When she met her family, she learned that she was like her grandmother, who was also a nurse. Her father told stories of her grandmother bringing the sick home to care for them when they couldn't care for themselves. Elaine left Johannesburg knowing she needed to continue her heritage of caring for the sick in this part of the world. She saw this as yet another opportunity to connect others to people in need which led to the creation of NWP. NWP Today Things worth working for never happen quickly, right? And, Nurses with Purpose is no different. It took Elaine several years and multiple trips to South Africa to build the infrastructure for the program that would support and foster medical care provided by American nurses in Johannesburg. She created the organization, board of directors, and began recruiting for her first team trip in 2017. Today, she is working to grow the organization to take more nurses on a mission to a city she loves. NWP combines the medical mission with opportunities to learn more about the culture and people by organizing excursions and celebratory dinners throughout their time serving. If you have ever wondered about taking a medical mission trip, here are a few things you should consider. Typical Day The team's days start early. Most days, you work in a local health clinic that sees 350-500 patients each day. Because there is little use of technology, they are highly organized and run patients through quickly. As a team member, you will work in the ED, triage, health screening, mental health, and postpartum and antepartum units. NWP also works with a mobile health unit to visit rural settlements to provide healthcare to villages and local townspeople. One or two nurses will go with a local healthcare team each day to experience healthcare outside of the city. You will also provide psychosocial care to children in a local orphanage. Elaine explained that a significant portion of the orphans in S. Africa has lost their parents to HIV or Aids. She said that this day is a great way to connect with the children and the people serving them in the orphanage. How Does it Differ from Care in the States? Besides the use of technology, caring for patients in South Africa is entirely different. Elaine described one cultural difference as the "respect for the ill." Healthcare teams are dedicated to taking care of the ill in a different way than what we are used to here at home. "In the clinic, it is normal for 4 out of 5 patients to be HIV positive. Many women do not want to discuss their illness with their spouse or partners for fear of them leaving them due to being unclean," said Elaine. She expressed how integral the NWP team of nurses has become in offering education, support, and compassion for women who might not receive it otherwise. Your Investment Medical mission trips aren't cheap. But, if you look at the trip as an investment in your career and the care and welfare of others who might never receive it without you - it might just be worth it. Your trip to Johannesburg will cost you $1913.38. This includes your lodging, transportation, 2 celebratory dinners, 3 excursions, and a few other incidental charges. For more details on the application, cost, and how to become an NWP team member, follow this link. If you would like to consider a few other medical missions trip options, consider these as well: Why Medical Missions? Do you often wonder where the romance went in your nursing career? Elaine believes that a missions trip will remind you why you chose this caring, compassionate, yet difficult career path. "Completing a missions trip will be your nursing revival," said Elaine. If you have been on a mission trip and have experienced a nursing revival, share your story with us in the comments below. Did you love it? Do you want to go back? Did you have any bad experiences? We want to hear it all.
  6. BostonFNP - I wish there was a way to "double like" this!!! I agree 100%!
  7. Hi there Katillac - Thanks so much for your comments. If you follow the links in the OP, you can see that I have used various articles as evidence that students are being turned away. I agree that graduating more students is not likely not going to solve anything. The issues related to nursing shortages and other staffing issues go far deeper than one area, like education. However, I think it is imperative that we learn more about the issues, form our own opinions, and decide how best to act to make a postiive impact for our healthcare industry and the future of nursing. Thanks again for your thoughts. ~Melissa
  8. You worked hard on your resume and applied for jobs that spoke to who you are as a nurse. You received a call and landed an interview. Now what? How do you prepare? What type of questions will they ask? Most hiring managers use behavioral interviewing techniques these days. The idea behind behavioral interviewing is simple: the best predictor of future behavior is past behavior. This means that the hiring manager will ask questions that require you to think about past situations and how you handled them. They want you to tell them details about your behavior in an effort to predict how you will handle yourself in their workplace. These questions will be open-ended questions followed by as much time as you need to describe your actions. How to Answer Behavioral Questions Behavioral interview questions can challenge your brain. You must think about specific situations and quickly pull out the necessary information to answer the questions. Below are a few quick tips to use when answering behavioral interview questions: Think about the skill they are asking about and answer their question specific to that skill. For example, if they ask, "Tell me about a time you had a conflict with a team member and how you resolved it?", they want you to understand your ability to work in a team and your conflict resolution skills. Try to keep the story relevant to these two skills. Describe the event or situation with as much detail as possible. The manager wants to know the situation in order to understand how you responded. Be specific. Avoid concepts. Tell them about your behaviors and what made you choose that particular way to handle the situation. Don't talk about the behaviors of others. The only exception to this rule is in the case that it helps tell the story about how you reacted. Just make sure to bring it back to your response and not the behaviors of others. Don't be critical, talk about others, or tear down others in your story. The hiring manager wants to know who you are as a person. If you start talking about others negatively, they will quickly start thinking this is how you will handle yourself in their workplace. Talk about the actual situation and how you responded. If you feel you should have handled yourself differently, tell them that after you described the situation. Be honest. Don't skip over or embellish details. Use the S.T.A.R method when telling your story: Situation - Describe the situation. Give enough detail for the interviewer to understand what happened. Task - Describe the task you needed to accomplish. Action - Tell them the action you took. Keep the focus on yourself. Don't tell them what you might do, tell them what you did. Results - Let them know how the situation was resolved. What happened? What was accomplished? What did you learn? How to Prepare for Behavioral Questions Many people think there is no way to prepare for behavioral interviews. I mean, how exactly would you be able to know what questions the hiring manager will ask? While you can't know the questions that will be asked, Wayne State University offers these quick tips for preparing for behavior-based questions: Think about 6-8 situations from your past where you demonstrated top workplace behaviors or skills. This could be teamwork, discipline, patient care, or leadership. Use the S.T.A.R. method to organize your thoughts around these situations. Half of these situations should be positive. Think about your accomplishments or how you met your goals. The other half should be situations that started out negatively but ended positively. Or, with the best possible outcome, given the situation. Use various situations. Draw from past jobs, volunteer experiences, or just life in general. Use recent examples if possible. Review your resume before going into the interview. This will help jog your memory. Review the job description for the job you applied to and think about the skills needed to succeed. Behavioral interview questions can rattle your nerves. They are designed to make you think. Give yourself time to think through each question and what they really want to know. Try to organize your thoughts before you answer, so you're not rambling. Some people struggle with 'selling' themselves, even in job interviews. Do you have a story about a behavioral interview or question that went well? Or, maybe you have a story about an interview that went awry. Whatever your story is, we would love to hear it. Put it in the comments and get the conversation started.
  9. You've finally figured out what makes your millennial co-workers tick. Time for a breather? Not a chance! Right on the coattails of the millennials is the next generation - the Zees. Generation Z is made up of people born between 1996 and 2010. There are currently over 23 million Zees, and they will be the fastest-growing generation in the workplace over the next five years. Every generation is given a few nicknames - so, besides Generation Z, you may also hear this generation called the iGen, Zeds, Zees, and Centennials. To make sure you understand this generation, here are a few traits and characteristics: They don't remember 9/11. Some of them were born, but none of them were old enough to remember it happening. They are cloud-natives. Their world has been full of "iEverything." While many of their characteristics are still being defined, what we know so far is that they are self-reliant, self-aware, goal-oriented and appreciate diversity. They don't remember a time before social media, so they live their lives online. This includes friendships, family, and education. Now that you know the basics let's explore what you need to know about them as they enter the nursing workforce. iGen as Learners They were raised and educated in settings of inclusivity and diversity, which has formed them to be the most diverse and open-minded generation ever. They are changing our nursing classrooms and will likely change the workplace too. Because they are technologically savvy, they want to use the internet to help them learn. Whether in college-level courses, orientation programs, or certification classes, they expect that the internet will be part of the curriculum. And, you need to know that it is estimated that they only have an attention span of about 8 seconds - so, let them multi-task - they have been doing it their whole life. Zees as Professionals They have grown up watching their Baby-Boomer grandparents work well past 65 years of age. Their Generation X parents have gone into debt with school loans that are still being paid off today. Where does this leave Generation Z as professionals? There isn't much data on the Zee's concerning professionalism as they are just entering the workforce. But, so far, it looks like they are going to be more entrepreneurial, educated, and diverse than any generation before them. They find honesty as the most important quality for leadership. They desire work-life balance while making money at a stable job. And, they want to have face-time with management. Because of their comfort level with technology, image what this generation could do with advancements like telehealth and Artificial Intelligence (AI) as they join the nursing workforce. One potential concern is their ability to critically think because of the amount of interruptions and multitasking they have been doing their entire lives. However, this is merely anecdotal due to little research into the actual abilities of this generation. As we watch the iGen enter the workforce, what can current nurses do to help? According to Priscilla Smith-Trudeau, "Putting diversity to work in the workplace, understanding each generational cohort, and accommodating generational differences so as to capitalize on these differences in attitudes, values, and behaviors must be the common goal of all nurses." This means we must be ready to embrace, foster growth and mentor these new nurses who will be joining the ranks over the next few years. Here a few ways to help the Zee's enter the nursing workforce: STEP 1: Provide Technology Incorporate internet learning into orientation. Understand that their lives are lived on their phones and other devices. Be sure to educate them on expectations of when and how to use social media and technology appropriately. Incorporate simulation, problem-based learning, games, and case studies into the curriculum to keep this generation engaged. STEP 2: Show Respect for Diversity Be sure to include them in groups and committees at work. And, be ready for them to expect these groups to show diversity in gender, race, ethnicity, and sexual orientation. STEP 3: Foster Retention With every generation, we want to foster retention as nurses. Much information floats around about bullying in nursing. Let's get it right with this generation by welcoming them with open arms and helping them remain in nursing for many years. STEP 4: Appreciate their Respect They respect authority. Show them you appreciate it by fostering strong mentorships with them early on in their careers. STEP 5: Empower their Practice You know they are different than any other generation of nurses you have encountered. Their world has been far more technologically-savvy and quite frankly, scarier than what we experienced as children. So, let's empower them to be the best clinicians possible. Are you a Gen-Z nurse or do you work with a Gen-Z nurse? What can you tell us about them? How do you feel we can support and foster this generation of nurses?
  10. Melissa Mills

    Staffing Ratios in the ED

    You enter the emergency department (ED) right at shift change. But, tonight's different - instead of going to work - you signed in as the patient. As you register, you hear one of the nurses state that there were two call offs and no staff available to float from another department. As you look around, you don't notice anyone in the waiting area reacting, except you. You even quietly wonder if it would be best to go home and wait it out until the morning to see your primary doctor. As a nurse, you know that limited nursing staff will probably mean you are in for a longer than average wait time. One recent study has confirmed what you already knew - poor nurse staffing numbers in the ED increases patient length of stay and decreases patient satisfaction. The Findings This study was conducted in a high-volume, urban public hospital. The researchers conducted a retrospective observational review of the electronic medical record database for a 12-month period in 2015. They reported nursing hours, door-to-discharge length of stay, door-to-door admit length of stay and the percentage of patients who left without being seen. The mean number of daily visits in the ED was 290, with a range of 219 - 425. The median number of nursing hours per day were 464.7 hours. The study found that poor staffing models in the emergency department increased the door-to-discharge length of stay and increased the number of patients who left without being seen. No change in door-to-admission rates was observed. Could this be because the receiving unit was adequately staffed? There was no reason given in the study, but it makes sense that if the receiving unit was fully staffed, they could receive the patient timely from the poorly staffed ED. Other variables, such as the daily ED volume, hospital census, and ED admission rate did not change the length of stay statistics observed in the study. What We Know About Staffing Ratios Nursing ratios equate to positive patient outcomes and safety. Adequate staffing has been proven to show a reduction in: Patient mortality Patient readmission rates Medical and medication errors Patient length of stay Patient costs related to unplanned readmissions Preventable events, such as pressure ulcers, falls, and other hospitalization complications Not only does poor staffing affect patients, but it also affects nurses too. A Medscape survey found that 57% of nurses polled believe that patient care is suffering. And 53% of said that at the end of a typical shift, they don't feel satisfied with the care they provided. This is a problem that can't be ignored. So, we know that safe staffing levels are a requirement for quality patient care. But, whose responsibility it is it to enforce? Federal Rules Medicare-certified hospitals are required by law (42CRF 482.23(b) to "have adequate numbers of licensed registered nurses, licensed practical nurses, and other personnel to provide nursing care to all patients as needed." This regulation can provide some guidance to hospitals but leaves quite a bit of room for interpretation. In fact, because of the loose language in the regulation and the lack of enforcement by Congress, many states have started taking the matter into their hands by creating safe staffing laws. Staffing in Your State Does your state have a mandatory staffing law? There are currently fourteen states that offer official regulations for nurse staffing. These states include California, Connecticut, Illinois, Massachusetts, Minnesota, Nevada, New Jersey, New York, Ohio, Oregon, Rhode Island, Texas, Vermont, and Washington. Seven of these states also require hospitals to have staffing committees who are responsible for nurse-patient ratios and creating a staffing policy. These seven states are Connecticut, Illinois, Nevada, Ohio, Oregon, Texas, and Washington. While it's good that many states are adopting regulations, it seems there isn't any consistency from one state to the next. Massachusetts requires a 1:1 or 1:2 nurse to patient ratio in the ICU. Minnesota requires that the Chief Nursing Officer develop a staffing plan and California stipulates a minimum nurse to patient ratio be maintained. And, five states require public reporting of staffing ratios. Nurses Taking Action Like many issues - if you want something done right - you have to do it yourself. This may be the motivation behind recent movements. The American Nurses Association (ANA) supports the empowerment of nurses to help solve staffing issues by creating staffing plans specific to each nursing unit. They have identified key factors that influence nurse staffing, which include: Number of admission, discharges, and transfers Skill level of nursing and non-nursing staff Patient complexity, stability, and acuity Layout and physical space of the nursing unit Availability of resources and other technical support Another recent movement in the battle to find common ground on the subject of nursing ratios is NursesTakeDC. This nurse-driven movement strives to make safe staffing ratios a reality for nurses across the United States. You might think that this was just a one-time event that happened earlier this year, but NursesTakeDC is committed to planning future events, providing further education, and supporting current and future legislation. Where Does This Leave Us? It may seem we're still a long way from making real change and impact on nurse-patient ratios. But remember - we've made strides in the past 10 or 20 years. Today more than ever, we need education on this topic to the general public, the healthcare community, and lawmakers. How do you feel about the staffing assignments in your facility? Do you have any personal stories about how staffing impacts patient care? We would love to hear more about your thoughts on this critical issue.
  11. Melissa Mills

    How to Support the Next Nursing Generation: The Z's

    maji2002 - Could not agree more! :)
  12. Melissa Mills

    How to Support the Next Nursing Generation: The Z's

    I enjoy reading all of the comments. I agree that the "attention span" information is difficult to determine validity. However, I feel that if we step back and look at the issue from a fifty-thousand-foot view - you will not only see the implications for work-life, but you can anecdotally see evidence of this statistic. I see this every day with three teenagers in my home - I wouldn't say that their attention span is always 8 seconds, but I do see that they rely on tech and multi-task with ease. They have grown up with tech in their hands, so relying on it is "normal" to them. This article was in no way criticizing this next generation. I was bringing awareness to the fact that we have a new generation of nurses coming and we need to understand them. I am Gen X'er, and I agree that nurses on my first unit didn't really "understand or accept" me. And, those first few years were even harder because I didn't always feel accepted. Did I survive - HECK YES! :) But, would it have been nice for someone to acknowledge me for who I was based on the time I grew up in - absolutely. Thanks for all of the thoughts and comments. This the reason I love to write - it sparks conversation. And, every time you think and talk about new information - you learn. :). ~Melissa
  13. Melissa Mills

    Exploring the Gender Pay Gap in Nursing

    This article is featured in the July 2018 edition of our allnurses Magazine... Download allnurses Magazine While the number of men in nursing remains low, we have seen growth in recent years. Our 2018 allnurses Salary Survey was comprised of 5.78% male respondents. The U.S Census Bureau released a study in 2013 reporting that there was a total of 3.5 million nurses in 2011. Females made up 3.2 million of these employed nurses, leaving only 330,000 men in the profession (U.S. Census Bureau, 2013). Here are a few things you should know about the numbers and factors that contribute to the current salary gender gap seen in nursing. The Numbers According to our 2018 Salary Survey, the average pay for male nurses with a BSN is $36.70 per hour, while female nurses with the same degree make an average of $35.20 per hour. This is a difference of $1.50 per hour, which equates to an annual difference of $3,120 for a full-time nurse working 40 hours per week. While $3000 may not be that impressive of a number, when you consider this difference over the lifetime of a career, it adds up. If a female nurse works a total of thirty years, they will lose approximately $90,000. This does not include any cost of living raises that may occur. Our survey revealed similar differences between male and female nurses with every license and degree type. What's behind these disparities? Let's explore: Education Men have been going to college in larger numbers compared to women for years. According to Statista, in 1940 only 3.8% of women went to college, compared to 6.2% of men. Today, these numbers have grown considerably. As of 2017, there were more women with a college education compared to men in general, with 34.6% of women completing a four-year college degree compared to 33.7% of men (Statista, 2018). If more women are enrolling in college than men, what could account for the difference? Our survey showed that 53.64% of male nurses hold a bachelor's degree compared to 45.18% of females. When you move up to advanced degrees, the difference remains. A total of 8.1% of men reported having completed an MSN, while 7.9% of females completed the same degree. While there is a small disparity among education, it does not appear that there is a significant difference between the levels of education of male and female nurses. Specialty Our survey results showed that men and women work in different areas of nursing. The top three specialties for male nurses include emergency departments, med-surg, and cardiac units. Women's top three units were med-surg, geriatrics/long-term care, and emergency departments. Could this be powering the salary gap? A recent study by Advance Healthcare Network (2018) indicates that being certified in a nursing specialty could increase your annual salary by as much as 23%. Many specialty areas offer higher base salaries as well, providing a more substantial earning potential. If men work in these more highly-specialized fields of nursing and have a certification, this could account for some of the pay disparities seen in our annual survey. Social Factors Social factors affecting career decisions have been different for men and women for many years. Non-work-related traits like gender, race, or ethnicity affect access to workplace opportunities that create advantages for some while denying these advantages to others (Bishu, Alkadry. 2017). A 2016 article by Stephanie Stephens on healthcarecareers.com revealed that while men make more than women, their satisfaction with salaries was equal at 44%. What social factors influence the gender pay gap and salary satisfaction? Negotiation One social factor found in many studies is simple - men are more likely to engage in salary negotiations than women (Leibbrandt & List, 2014). One study found men were more likely to initiate negotiation conversations than women when no explicit statement was listed on the job description that the salary was negotiable. (Leibbrandt, List, 2014). However, if the job description stated that the wages were negotiable, the likelihood of negotiations was equal (21.2% of women and 21.4% of men). What does this mean? The main finding of this study is that explicitly stating that salaries are negotiable closes the gender gap in job applications (Leibrandt, List, 2014). Career interruptions A 2015 study published by Pew Research Center shows that 42% of women have reduced their hours to care for a child or family member, compared to 28% of men. Another staggering statistic revealed that 27% of women have quit a job to care for children or other family members, while only 10% of men reported doing the same. Women have long been the head of the household when it comes to children and care of the elderly or sick. Could this be decreasing the earning potential of female nurses? If a female nurse experiences a career interruption it will impact her overall wage potential as she works towards retirement. While society's idea of men who stay home with children has changed, it is still a role primarily held by women. Glass Escalator A 2012 Forbes article describes the difficult history of women's success in the workforce. Once a closed door for all careers, women now work in most industries and have even started flooding the male-dominated corporate world (Goudreau, 2012). However, there have been reports that women have hit the "glass ceiling" or an invisible barrier that keeps them from entering into senior-level management positions (Goudreau, 2012). Today, in female-dominated industries like teaching and nursing, women are met with a glass escalator. While women climb the ladder, it appears that men are riding an invisible escalator, straight to the top, taking senior level nursing positions (Goudreau, 2012). Goudreau explains that men tend to be promoted at a faster rate than women in female-dominated professions. Why would there be glass escalator in nursing? One answer is related to career interruptions that women may experience when caring for family. But, if men can rise to higher level position in nursing quickly and make more money, why have we not seen a rapid increase in the number of men in the field? Consider pop culture references of men in nursing. TV shows and movies like Meet the Parents provide a poor representation of the importance of male nurses. When will the social stigma end? Final Thoughts Do male nurses indeed make more than female nurses? It appears that the simple answer is yes. However, there are many workplace and social factors to keep in mind when comparing the bottom line of nursing salaries. Resources: 1. Sheth, S., Gal, S., Gould, S. (2018). Business Insider. Retrieved from: Wage gap, gender pay gap charts show how much more men make than women - Business Insider 2. U.S. Department of Employment Opportunity Commission. The Equal Pay Act Of 1963. Retrieved from: The Equal Pay Act of 1963 (EPA) 3. Anderson, J., Milli, J., Kruvelis, M. (2017). Projected Year the Wage Gap will Close by State. Institute for Women's Policy Research. Retrieved from: Projected Year the Wage Gap Will Close by State | Institute for Women's Policy Research 4. United States Census Bureau. (2013). Male Nurses Becoming More Commonplace, Census Bureau Reports. Retrieved from: The Equal Pay Act of 1963 (EPA) 5. Statistia. (2108). Percentage of the U.S. Population who have completed four years of college or more from 1940 to 2017, by gender. Retrieved from: https://www.statista.com/statistics/184272/educational-attainment-of-college-diploma-or-higher-by-gender/ 6. Stephens, S. (2016) Healthcare Gender Pay Gap Still Significant. HealtheCareers. Retrieved from: Gender Pay Gap in Healthcare 7. Bishu, S., Alkadry, M. (2017). A Systematic Review of the Gender Pay Gap and Factors that Predict It. Sage Journals. Retrieved from: SAGE Journals: Your gateway to world-class journal research 8. Goudreau, J. (2012). A New Obstacle for Professional Women: The Glass Escalator. Retrieved from: A New Obstacle For Professional Women: The Glass Escalator 9. Senior, R. (2018). Nurses Salary by Specialty Certification. Advanced Healthcare Network. Retrieved from: 218 Nurse Salary by Specialization | Nursing 10. Pew Research Center. (2015). Mothers, More than Fathers, Experience Career Interruptions. Retrieved from: >> Mothers, More than Fathers, Experience Career Interruptions 11. Leibbrandt, A. (2014). Do Women Avoid Salary Negotiations? Evidence from a Large Scale Natural Field Experiment. Retrieved from: http://gap.hks.harvard.edu/do-women-avoid-salary-negotiations-evidence-large-scale-natural-field-experiment
  14. Melissa Mills

    Physically Taxing: Historic Nursing Gender-Discrimination Suit Settled

    Thanks for the story karrikon! And, yes - I'm sure there are more stories than we can imagine! ~Melissa
  15. Women have been fighting for gender equality for decades. These battles have taken the form of the right to vote, the right to control their bodies, and the right to equal pay and opportunity in the workplace. Nursing might be a female-dominated industry, but it's not immune to gender-discrimination against women. A recent historical settlement is raising the bar for female nurses for the future. Is Nursing Physically Taxing? Before we discuss the settlement - let's recognize a fact that nurses have known for generations - nursing is hard work. But, for many years, there has been a perception that because nursing positions are primarily held by women, it is not a physically taxing occupation. However, the statistics tell a different story: Healthcare occupations are among the highest of all U.S industries for musculoskeletal injuries from overexertion The most significant risk factor for overexertion injuries in healthcare workers is manual lifting, moving, and repositioning of patients 1 in 4 nurses have been physically assaulted while at work An estimated 82% of nurses report being at a significant risk of workplace stress Nurses have a high chance of contact with infectious agents such as bacteria, viruses, parasites, and fungi New York City Pension Plan In 1965, New York City, like many other employers, created a pension plan for employees. Under the standard pension, employees could retire with full benefits at the age of 55 or 57. However, some occupations covered by the pension were deemed "physically demanding," by the city. Staff who filled these physically demanding jobs qualified for early retirement with full pensions as early as age 50. Those who qualified had to be employed a minimum of 25 years with the city at the time of retirement. Jobs meeting this classification included Emergency Medical Specialist, Exterminator, Motor Vehicle Dispatcher, Window Cleaner, and Plumbers. All of these positions were primarily filled by male workers. The city also employed nurses, the majority of whom were female. Beginning in 2004, the New York State Nurses Association (NYSNA) became involved with this issue. The NYSNA is a labor union representing city-employed registered nurses and midwives. They requested that the City recognize their members for filling physically taxing positions and allow them to receive full pension benefits at the age of 50. The City denied the request in 2004, refusing to recognize the role of the nurses as physically taxing. The NYSNA requested again in 2006 and 2008, only to be denied both years. Sometime after 2008, the NYSNA and four members filed complaints with the Equal Employment Opportunity Commission (EEOC). It was determined by the EEOC that the city had discriminated against the nurses based on gender in 1968 when the City initially refused to recognize nurses and midwives as a physically taxing occupation and again in 2004, 2006, and 2008. The EEOC sent the matter to the U.S Attorney's Office to be heard. On July 18, 2018, Acting Assistant Attorney General John Gore for the Justice Department's Civil Rights Division and Richard P. Donoghue, United States Attorney for the Eastern District of New York announced a proposed settlement with the City of New York. This settlement awards $20.8 million to a class of approximately 1,665 registered nurses and midwives who were discriminated against because they were women. The court must still approve the settlement which will award between $1000 and $99,000 to the nurses, depending on their years of service to the city. The agreement also covers all attorney's fees and an additional $100,000 to the four nurses who filed the initial complaint with the EEOC. This settlement is historic. Looking Ahead Could nurses finally be recognized for the physically demanding work they perform? Nursing is an honorable profession - regardless of the sex of the nurse. You go to work each day uncertain of the patients who will come through the doors of the ED. You enter buildings that make police officers uncomfortable just to make sure that patients are taking their medicines and participating in self-care. You deal with physically and mentally taxing situations to save the lives of people you have never met before. But, are you given the respect you deserve? Tell us what you think about this settlement. Does it add validity to the physical nature of nursing? Will it help the profession in the future? Leave your thoughts in the comments below.
  16. Melissa Mills

    Physically Taxing: Historic Nursing Gender-Discrimination Suit Settled

    dbabz - We can probably all use a little conditioning - but, the interesting point is that most people don't think of nursing as being physically taxing. Doing compressions on an adult is HARD work, and it is easy to pull a muscle, trip, fall, or worse when you are in the middle of a code. Thanks for sharing your story! Melissa
  17. Melissa Mills

    Redirected, Not Rejected: Lessons Learned When the Answer is No

    Have Nurse - Good point! Thanks for your thoughts. :) Melissa
  18. It doesn't matter what kind of person you are - rejection after a job interview hurts. And, it is okay to withdraw a bit and take your time to recover. But, as the old adage goes - you must get yourself back in the saddle again - sooner rather than later. Here are a few ways you can keep moving forward toward redirection after rejection. Give Yourself Permission to be Upset Ok - let's say this and move on - rejection sucks. It hurts. Lance Armstrong summed it up best by saying, "A boo is a lot louder than a cheer." And, even if you didn't really want the job - the idea of moving on from where you are right now was exciting. It's understandable to be upset. Give yourself time to process the emotions after the rejection. It's okay to have a bruised ego, just don't allow it to cause a permanent setback. Ask For Feedback (If you really want it) If you get the opportunity to have actual contact, through email or phone, with the prospective employer - ask for feedback. There are significant benefits to asking, "Can you tell me why I didn't get the job." You may find out that they loved you, but someone with more experience interviewed too. You may be told that the hiring panel was torn between you and another candidate. Or, you may be told that you were not the best candidate. No matter what the reason, there is a lesson to be found in feedback. Just be sure to prepare yourself for whatever answer you might be told. Be sure to let the employer do most of the talking - your role here is to listen and learn for the future. Don't argue or defend yourself. Thank them for the information, then take time to process what they said. Decide if the information was helpful and take action accordingly. Look for Redirection This is hard - but, don't focus on the rejection. Learn how to use the information and gain redirection. Here are a few questions you might need to answer if you're receiving multiple rejections: Are you applying for jobs that are outside of your skill set? Do you need more training, experience, or certification to be ready for the next step in your career journey? Is there something in your career history that is causing future employers to worry? Sometimes, you may be hit head-on with the realization that this is not the right time to change jobs. And, guess what - it's okay. The only way to find out if these jobs are for you is to apply and learn more about the role. You may decide that you need to gain more experience before moving on. Or, you might realize that you are on the right path, but haven't found the right position yet. No matter what conclusions you come to - a little self-reflection can really help you to get on the right path. Don't Take it Personally Job rejection is not usually connected to who you are as a person. It is about your skills and if they match the needs of the employer. They may be looking for someone to stay for the next ten years, and you plan to go back to school. Or, they may need someone who can transition into management, and that's not where you want to be in your career. As you go through the process of finding a new job, remember that with every "no," you are getting that much closer to a yes. Just getting the interview was a success. In fact, according to a job market expert, only about 2 percent of people who apply for a job make it to an interview. By being rejected, you are actually doing better than many folks who never heard anything. Pat Yourself on the Back How many nurses can you think that are in jobs right now that they don't like because they are afraid of rejection or making mistakes? Oh, and, it's not just nurses. Unfortunately, this happens in every industry and job type. Hold your head high. At least you tried and put yourself out there. If the worst thing that happens to you today is that someone else got the job - you are doing pretty good. Keep Applying Now that you dusted yourself off and reassessed the direction you are moving in keep applying. Don't let one or two rejections slow down your momentum towards finding your dream job. It is out there! Have you had a recent job rejection? What lessons did you learn? Let us know in the comments below.
  19. Melissa Mills

    Bag Technique 101 for Home Care Nurses

    You enter Mrs. Jones' home to do your Start of Care assessment. She opens the door to reveal a maze of newspapers and other memorabilia that she's been keeping since at least 1929. You begin surveying the scene for a place to put your nursing bag. Just as you think you've found a spot on a table at the end of the couch, 4 cats pop out of nowhere and begin to inspect you and your bag. What do you do? Here are a few things you should know about bag technique in the home care setting. Is Bag Technique Important? There are no confirmed reports of patients becoming ill due to pathogens brought into their home on a nursing bag. However, there is some research about what grows on the outside and inside of your bag. One study reports that 83.6% of the exteriors of nursing bags cultured were positive for human pathogens and 15.9% of these pathogens were multidrug-resistant organisms. The inside of nursing bags was not clean either. The study found that 48.4% of the inside of nursing bags were positive for human pathogens, with 6.3% being multi-drug resistant. How do you limit the number of organisms you carry from one home to the next? It's simple - Bag Technique. What is Bag Technique? Bag technique is used to prevent the transmission of pathogens while making home visits. There are a few basic principles involved in bag technique: Hand hygiene Bag placement while in patient homes Bag placement during storage Cleaning interior and exterior surfaces of the bag Handling equipment and supplies in the bag Handling equipment and supplies after they are removed from bag Your home care agency will have a policy and procedure on the exact steps to take when performing bag technique. Here, we will explore the basic ideas behind the principles of getting in and out of your nursing bag. Hand Hygiene Your hands become a vector that can transmit pathogens from your bag to the patient. The reverse is true too. Similar to other clinical areas, hand hygiene is of the utmost importance. The CDC reports that healthcare providers clean their hands less than half of the times they should. They also recommend washing your hands before any contact with the patient. Your agency may also recommend that you wash your hands -with soap and water or hand sanitizer- before entering the inside of your nursing bag too. The more you wash your hands before contact with the patient and your bag the more you decrease the risk of transmitting bacteria to your patients. When working inside the bag, be sure to never place "dirty" items inside the bag. If you have a sharps container, place into an exterior compartment of the nursing bag, but never stored inside the bag. Bag Placement Place your bag on a clean, dry surface, if available. If not available, place a clean barrier down first before putting your bag on a table or other surface. Another option is to hang the bag from a doorknob or over a door. Keep the bag closed when you are not working inside of the bag, especially if there are pets near. If you have a bag with wheels, you can leave it on the floor with a barrier underneath. Pay close attention that items don't fall out onto the patient's floor and that exterior pockets never come in contact with the floor when they're unzipped. Vehicle Storage Your bag should be stored in your vehicle on a clean, dry surface. If you have supplies in your bag that may be temperature-sensitive, you will need to keep the bag inside your car versus the trunk. Be sure that the bag is always kept on the "clean" side of your vehicle. If you are concerned about bed bugs or other insects, place your bag inside a large plastic container inside your car. Cleaning the Bag The outside of your bag is important. Chose a bag that's made of smooth, non-canvas nylon or polyester or other materials that can be wiped down to decrease the number of pathogens you carry from one home to the next. When to Leave Your Bag in Your Vehicle There will be times when your nursing bag is best left in your vehicle. These times include: Known infestations with bedbugs or other insects Homes that are contaminated with excrement Patients known to have a multi-drug resistant organism Patients on transmission-based precautions You always have the right to leave your nursing bag in your vehicle. In these situations, double-bag all items so that you can throw one away in the patient's home and use the other to carry items back to your car. Be sure to disinfect all equipment in the bag before placing it back into your nursing bag. Do you have any tips and tricks you can share to help others use bag technique in their nursing practice?
  20. Melissa Mills

    Bag Technique 101 for Home Care Nurses

    Kitiger - These is likely agency specific. However, the reasoning behind not placing the bag on the floor is related to the amount of pathogens and just general dirt that you will find on floors. If you leave a bag on the floor, it must have a barrier under it, unless it is on wheels (which keeps it up off of the floor). For me, I would have never put my bag on the floor for several reasons: 1. The dirt 2. The bending - I was in and out of my bag alot, especially if I had dressing changes or other skills that required me to get supplies out. 3. You don't want the outside of your bag to touch the ground and become contaminated and then you take that with you to other places. I think if you always put it on the ground, as you would with a wheeled-bag, it might be one thing. But, you would not want to leave it on the floor of one home and then place it on the kitchen table of the next. As for shoes - lots of things can stay on your shoes (especially bed bug eggs - they wedge up in the tread of the sole of the shoe) - but you are not touching your shoes throughout your day, as you do with you bag. However, when I was doing home visits daily, I never wore my shoes in my home. I left them on the porch in the summer or in the basement in a tub in the winter and disinfected them often. I never wanted to bring home extra "friends". :) Hope this makes sense. Again, each agency is going to have their own policies on this - this is solely my experience. ~Melissa
  21. This article is featured in the July 2018 edition of our allnurses Magazine... Download allnurses Magazine If you graduated in 1998 or the few years before or after, you have likely started to notice that you are no longer among the "young" nurses. You now stand with tenure among nurses who have written the letters R.N. or L.P.N. after their names even longer. It's funny to tell stories to younger nurses. Tales of paper charting and lower nurse-patient ratios bring glassy stares to their eyes. This place of tenure is a new adventure. During the trip down memory lane, I have started to review some of the significant changes that have happened over the last twenty years and even considered what the future might bring. Here are a few of my memories and ponderings for the future. Nursing School I started my nursing journey by attending an Associate's Degree program at a Community College. It was hard, as are all nursing programs. I had no intention of ever returning to school. However, advancements in technology changed my mind. I received my BSN in 2012 and a Masters Degree in Healthcare Administration in 2016 without ever leaving the comfort of my home. Today, there are many options for nurses that were unheard of even 20 years ago. We can choose from traditional educational programs to online courses and certifications. Many nurses are enrolling in Nurse Practitioner programs as the need for advanced degree nurses continues to rise. I can only imagine what kind of advancements lie ahead. New laws like the BSN in 10 that was just passed by New York will likely further change the look of nursing education (University of Buffalo, 2018). Will Associate Degree programs still be around? I'll let you know in 2038. NCLEX The NCLEX has undergone many changes over the years. Initially a paper-and-pencil test, the NCLEX was given only a few times each year in large venues (National Council on State Boards of Nursing, 2014). It would take several weeks or even months before nurses received their results, leaving candidates nervously awaiting the mail (National Council on State Boards of Nursing, 2014). In 1994, the National Council on State Boards of Nursing (2014) pioneered computerized testing for licensure exams (National Council on State Boards of Nursing, 2014). They were the first healthcare organization to use this progressive method for entry-level knowledge licensing (National Council on State Boards of Nursing, 2014). When I took the exam, I answered approximately 110 questions when the test shut off. Of course, I had no idea if it turned off because I had passed or failed. I remember crying like a baby from pure stress and exhaustion. A few short weeks later, I hugged and kissed the mailman when he knocked on the door and handed me the most anticipated envelope I have ever received. It was addressed to me and had the letters R.N. on the outside of the envelope revealing my results. Today, because of the progressive nature of nursing, computerized testing is the standard across many healthcare disciplines (National Council on State Boards of Nursing, 2014). Electronic Medical Records In my first few jobs, we used all written documentation. A lot of time was spent keeping notes and paying particular attention to what was written. Mistakes created a risk management nightmare that led to uncomfortable conversations with the nurse manager. While some healthcare sectors began using technology in the 1990's, many did not fully integrate until several years later (net health, 2016). In 1991, the Institute of Medicine recommended that every physician should be using computers by the year 2000 to improve patient care (net health, 2104). Today, electronic medical records allow most healthcare facilities to be paperless. As we look towards the future, advancements in portability and interoperability will likely pave the way through the next few decades. Telemedicine Having spent a good bit of my career in home care, I have seen significant advancements in telemedicine. From home monitoring for at-risk pregnancies to chronic management of CHF, heart failure, and diabetes, telemedicine has made aging in place easier for many patients. Telemedicine also offers nurses new career opportunities. Many nurses can work into advanced age due to options like telephonic case management, telephone triage, and quality assurance. These positions use nursing knowledge without the stress and physical demands of hospital nursing. As we look to the future, mobile health and telehealth will offer programs that allow nurses to improve the care management process and increase patient engagement (mHealth Intelligence). Future advancements in mobile health technologies will catapult nurses forward as dispensers of healthcare information (mHealth Intelligence). Pay I started working in July 1998. My first job was on a medical-oncology unit in a moderately sized community hospital in Springfield, Ohio. If memory serves me correct, my starting pay was around $16 an hour. The Bureau of Labor Statistics (1999) reports that the average salary for registered nurses in 1998 was $43,070. Today, nurses make much more. According to the 2018 allurses Salary Survey results the average hourly nurse makes $65,350. This salary seems more in alignment with the work of nurses, however with the continued advancements, increased nurse-patient ratios, and extreme stress levels, further pay adjustments may be needed. The Next Twenty What advancements will happen over the next twenty years? It is exciting to reminisce about the improvements of the past and dream of the ones in the future. Nursing continues to grow at a faster speed than other industries. The need for nurses will never end. I am excited about the future of nursing. There will be bumps in the road along the way, but the possibilities are endless. Resources: Bureau of Labor Statistics (1999) Annual wages of nurses, doctors, and other health care workers. Bureau of Labor Statistics. Retrieved from: Annual wages of nurses, doctors, and other health care workers : The Economics Daily : U.S. Bureau of Labor Statistics University at Buffalo, School of Nursing. (2018). New York's new BSN in 10 law: What you need to know. University at Buffalo. Retrieved from: New York's BSN in 1 law: What you need to know | January 3, 218 - School of Nursing - SUNY - University at Buffalo National Council of State Boards of Nursing. (2104). Pencils Down, Booklets Closed. National Council of State Boards of Nursing. Retrieved from: https://www.ncsbn.org/InFocus_Spring2014.pdf Net Health (2016). What is the History of Electronic Medical Records? Net Health. Retrieved from: What is the History of Electronic Medical Records? [infographic & Video] - Net Health mHealth Intelligence. Telehealth, mHealth Make Nurses Pivotal Presence in Healthcare. MHealth Intelligence. Retrieved from: Telehealth, mHealth Make Nurses Pivotal Presence in Healthcare
  22. Melissa Mills

    Myth or Truth: The Story Behind the Nursing Shortage

    Hvonfange - Interesting that you bring that up. I have never researched the issue globally or the reasons behind it. This may be something I look into for future articles. :) Thanks.
  23. Melissa Mills

    Bag Technique 101 for Home Care Nurses

    Elfriede - I agree that leaving the bag in your car is not always the best answer. Trying placing it in a bin with a lid. This keeps pests from roaming around you car and keeps others from recognizing the bag as something that belongs to a nurse. Melissa
  24. Melissa Mills

    Myth or Truth: The Story Behind the Nursing Shortage

    Medicinewoman33 - I think that is the hard part about the shortage - other factors have changed the years and outcomes. It is not an exact science for sure. And, depending on where you live, there may be more or less of a shortage in your state, city, or region. Thanks for your thoughts. ~Melissa
  25. Melissa Mills

    Bag Technique 101 for Home Care Nurses

    Libby1987 - Thanks for the extra thoughts. Yes, each agency will have their own policies and should be followed first and foremost. ~Melissa
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