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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

Posts by Melissa Mills

  1. 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. 

  2. 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. 

  3. 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.

  4. 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.

  5. 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. 

  6. 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.

  7. 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.

  8. 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.

  9. 11 hours ago, nursej22 said:

    Your article title is not great; nurses still need N-95 masks for airborne illnesses like measles and flu. Perhaps a better title would be "Say good-by to annual TSTs or IGRAs". 

    I think its also important to state that persons with a positive skin test or blood test should not receive annual chest X-rays. These are only necessary if they show signs of active disease. 

    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. 

    7 hours ago, Pepper The Cat said:

    No one who worked during the SARS epidemic will be getting rid if their N95 masks.

    Just saying

    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! 

  10. Okay, so maybe it’s not time to toss out your N-95. However, a recent update from the Centers for Disease Control and Prevention and the National Tuberculosis Controllers Association shows an overall decline of TB cases. The organizations also report that TB cases following occupational exposure have dropped, too.

    This new information has created a few updated recommendations

    • All healthcare personnel should get a baseline TB risk assessment, screening for symptoms, and TB skin or blood test upon hire
    • Annual testing is not recommended for healthcare personnel unless there is a known exposure or ongoing transmission in your facility
    • Personnel with an untreated latent TB infection should be screened each year for symptoms and treatment is highly-encouraged
    • All staff should receive yearly TB education, which includes information about risk factors, TB infection control policies and procedures, and a list of signs and symptoms 
    • Personnel with a positive TB skin or blood test should be evaluated for symptoms and have a chest x-ray performed to rule out the disease 

    Understanding Your Risk

    Tuberculosis is an infectious disease that mainly affects your lungs. TB is spread through tiny droplets that are released into the air following sneezing and coughing. Once it’s in the air, the droplets can be breathed in by others, and they can become infected. The disease was once thought to be rare in developed countries. However with the increase of HIV, it gained momentum in the mid-1980s.

    The disease is difficult to treat because many drugs have become resistant. Treatment can take several months, and the patient will need to be separated from others until they are no longer actively contagious. 


    Active TB creates severed illness. It can make you sick shortly after you contract the condition, or it can make you sick years later. The main signs and symptoms include:

    • Coughing up blood
    • Persistent cough (lasting three or more weeks)
    • Chest pain
    • Fatigue
    • Unintentional weight loss
    • Fever
    • Night sweats
    • Loss of appetite
    • Chills

    TB can also remain in your body in an inactive or latent state. This means that you have the bacteria in your body. However, the disease doesn't make you ill. Latent TB can become active, so it’s important for people who have latent TB to receive treatment to decrease the spread of the illness.

    What Are The High-Risk Populations?

    You may be at an increased risk of contracting TB if you work with high-risk populations. Here are a few populations you need to consider:

    Patients with Weakened Immune Systems

    Your immune system helps to keep you safe from TB and other infections. If you have a weakened immune system, you may be at an increased risk of contracting the condition.

    Pediatric or geriatric populations

    A few diseases that can put you and your patients at a higher risk include:

    • HIV/AIDS
    • Malnutrition
    • Diabetes
    • Severe kidney disease
    • Drugs used to treat RA, Psoriasis, or Crohn’s
    • Chemotherapy drugs
    • Certain cancers
    • Drugs used to prevent rejection of transplanted organs

    Traveling to Foreign Areas

    TB runs rampant in some under-developed areas. If you or your patient has been to one of these areas, you may need to consider the possibility of TB:

    • Latin America
    • Russia
    • Africa
    • Asia
    • Caribbean Islands

    Other Populations

    There are a few situations that can also place patients at an increased risk of contracting TB. Those individuals with poor overall health and medical care, those with substance abuse issues or those who use tobacco are more vulnerable to TB.

  11. According to Lively’s Wellness & Wealth report, only 54% of adults see their doctor for preventive care. Another 28 percent only head to the MD when sick, and a whopping 18 percent only see a provider when they consider their health-related problem to be catastrophic. The study also revealed that as people age, they do seem to go to the doctor more. However, could the increase in visits be related to the lack of preventative care during their younger years?

    Another portion of Lively’s study looked annual income to be a reliable indicator of the likelihood to engage in preventative healthcare. It’s probably not surprising to learn that wealthier adults are more likely to go to the doctor compared to those in lower-income brackets. About 60 percent of people who make over $50K a year attend preventative appointments. While less than half of people making salaries below $50K each year participate in regular doctor appointments. 

    Healthcare Costs and Bankruptcy

    Not going to the doctor when you’re younger could set you up for more than just poor health as you age. A CNBC article published in February reported that two-thirds (530,000 families) of all people who file bankruptcy report that medical issues were a key contributor. Individuals who filed bankruptcy cited both the direct healthcare costs and lost wages from time off of work as reasons that they had to file for bankruptcy. 

    Many experts and lawmakers hoped that implementing the Affordable Care Act (ACA) would improve the issue of financial problems related to healthcare costs. However, it doesn’t seem like it has. The ACA increased the number of Americans who had health insurance. However, the number of people who said that medical expenses were a reason for their bankruptcy increased from 65.5 percent to 67.7 percent in the three years following the adoption of the ACA. 

    Can Preventive Care Help Save Your Health and Money?

    Young people in America today need to learn a valuable lesson from older adults. Avoiding health-related concerns may mean that you have to spend a few dollars on a copay or prescription medication. But, allowing health problems to linger and exacerbate can be a pricey mistake.

    To illustrate the issue, let’s consider the symptoms of a nagging cough. If you head to the doctor, you may pay $25-$40 dollars in a copay and another $10 to $50 for a prescription. However, if you wait until the cough turns into pneumonia, you could spend thousands of dollars on an emergency room visit, labs, medications, and radiology fees.

    3 Ways Nurses Can Increase Preventive Care

    Nurses play a crucial role in care strategies and implementation. We often think of ourselves as caring for people when they’re ill. However, arming your patients with the information they need to be healthy today may keep them in a state of wellness for years to come. Here are a few ways nurses can help increase the use of preventive care services.

    1 - Teach Self-Care Strategies

    Chronic illnesses are challenging, but patients need to understand the importance of going to the doctor before they get sick. You should also be asking patients about their immunization status and reviewing records each time you see them in the hospital or clinic. Vaccines are an excellent strategy to keep patients well and increase care outcomes.

    2 - Identify At-Risk Patients

    We screen patients all the time for multiple conditions, but what happens to that information? If you complete an admission and identify a patient that is high risk for cardiovascular problems or that they have a higher than average risk of developing diabetes, communicate this to them and their providers. Empower patients to seek preventive care for chronic conditions they are at risk of developing.

    3 - Educate the Community

    Many organizations offer free or reduced-rate screenings, immunizations, and clinics. Be sure to share these events in your facility and your Facebook or Twitter accounts to increase the event’s reach. You can also volunteer at Health Fairs or other activities that raise awareness of specific conditions and provide education on healthy lifestyles.

    Keeping Your Patients Healthy

    What preventive health strategies do you use with your patients that other nurses could use in their practice? Share your ideas below to create a healthier America.

  12. Leaving your mother or grandmother in a long-term care facility is challenging. For one Illinois family, it turned into a nightmare. A video taken in December of 2018 showed two certified nursing assistants taunting resident, Margaret Collins with a hospital gown. Jamie Montesa and Brayan Cortez posted a video to Snapchat that showed them repeatedly throwing a hospital gown on top of Collins with the caption, “Margaret hates gowns.” Collins, who has dementia,  waved the gown away each time. 

    Resident’s Rights

    If you’ve been around healthcare for any length of time, you know that individuals living in skilled or long-term care facilities have many rights. The scenario above clearly violated several of Collins’ fundamental rights as a resident of a long-term care facility. 

    Right to participate in care

    Collins not only had the right to participate in her care, but she also had the right to refuse it. She clearly did not want the hospital gown. One could argue that she was agitated at the time. Even if this were true, she didn’t have to wear the gown and could have been dressed in her own attire. 

    Right to privacy and confidentiality

    Collins had the right to keep the details of her care private. Having a video of herself posted on Snapshot without her or her designee’s explicit consent is a direct violation of this right. 

    Right to dignity and respect

    Treating any human in the manner that Montesa and Cortez treated Collins greatly lacks both dignity and respect. She also has the right to be free of mental and physical abuse and to determine what activities she wants to participate in during her care. Both of the nursing assistants disrespected Collins in this case. 

    Right to make independent choices

    Residents living in healthcare facilities have the explicit right to make decisions about what they want to wear or eat and how they want to spend their free time. Their choices should be accommodated and respected by all caregivers. 

    Legal Implications and Disciplinary Action

    The two nursing assistants were initially given a six-day suspension. After further investigation into the incident, the facility determined that they violated internal policies and standards. Montesa also admitted to previously recording a video of Collins while she was in a wheelchair. When the investigation concluded, the two workers were  terminated. In a statement, a representative from the facility said, “The privacy and dignity of our residents are of the utmost concern.”

    The family of Margaret Collins is reportedly suing the Abington for $1 million in damages. The parent company of the facility and the two nursing assistants are also named in the suit. Collins has been moved from the facility. The family reported that she suffered from anxiety related to the incident. 

    Is Termination Enough?

    Most people will agree that Montesa and Cortez received what they deserved when they were terminated. However, is it enough? During a search of the Illinois health care worker registry, it appears that both Montesa and Cortez remain certified in the state of Illinois. No administrative filings are on record for either worker. Of course, it can take months or even years for cases like these to come before the regulatory boards. These gaps in time could leave other vulnerable individuals in similar situations. 

    The incident with Collins leaves me wondering how difficult it would be to formally suspend a healthcare worker who is terminated for abuse or neglect. Could this be done? And, if it's done in error, what are the repercussions to the worker?

    Cases like this may become more common as more people live longer with debilitating conditions such as Alzheimer’s disease or dementia. At some point changes, need to be made by the facilities, training programs, or states who certify and license people who care for the elderly. 

    What are Your Thoughts?

    What do you think? Did Montesa and Cortez get what they deserved? Should they be allowed to care for others in the future? And, how would you respond if this were your mother or grandmother? Add your thoughts in the comments below. We would love to hear what you’re thinking about this despicable act. 


  13. An elderly couple near Ferndale, Washington may have given into the stressors of financial struggles from looming healthcare bills. An article published on wtap, an NBC affiliate, reported that dispatchers received a call on the morning of August 7th from 77-year-old Brian Jones. He told the dispatcher, “I am going to shoot myself.’ The dispatcher tried to keep the man on the phone while he activated emergency services. However, Jones told the dispatcher, “We will be in the front bedroom.”

    When the police arrived, they tried to contact anyone inside the home without success. After an hour, they sent in a robot-mounted camera and found the man dead from an apparent self-inflicted gunshot wound. He was lying next to his 76-year old wife, Patricia Whitney-Jones, who was also dead from a gunshot wound that investigators believed was caused by Jones. Detectives are calling this a likely murder-suicide and report that they found several notes citing ongoing medical problems for Jones’ wife that the couple could not afford.

    America’s Elderly Healthcare Financial Crisis

    Did you know that the U.S. spends twice as much on healthcare than any other developed nation around the world? It’s estimated that 18 percent of our gross domestic product each year goes to support our healthcare system. Many older adults incur higher than average medical costs related to chronic health conditions. One study estimated that a couple who retired in 2017 at the age of 65 needed $280,000 in savings to cover future healthcare costs such as premiums for doctors and medications. If these elderly individuals also required additional services such as long-term care or assisted living, they would need additional funds to cover these costs.

    As a nurse, you know that individuals with chronic illness spend more money and time in the healthcare system. The Kaiser Family Foundation reports that half of the population accounts for 97 percent of US health spending. Many people struggle to keep up with drug costs as well. A whopping 30 percent of people age 50-64 have difficulty paying for prescription drugs. For many people, not having their medication leads to exacerbations of their conditions, and ultimately, they land back in the hospital, where care is even more expensive.

    In a recent New York Times article, Paula Span reported even more details about the future of healthcare for America’s aged population. By 2029, middle-income older adults will need between $25,000 to $74,000 to pay for just one year of long-term care services. While most older adults will need at least some increased level of care, the majority won’t be able to afford it. With the increase in the elderly population, we aren’t talking about a small number of people. In fact, it’s estimated that this group of adults will almost double in the next decade, and will consist of approximately 14.4 million people. While many will want to age-in-place at home, some will require care that simply can’t be delivered outside of the confines of a nursing facility. This will leave them searching for ways to afford the level of care they require. 

    When Financial Stress is Too Much

    As you think about the future forecast of healthcare costs in America, what comes to mind? Do you feel that we may see more stories like Jones and his wife? Most of us were raised to respect our elders. Some of us even went into nursing to make a difference for people just like this couple. The thought of older adults seeing their healthcare needs as a burden that they can’t handle saddens me in so many ways.

    What Do You Think?

    Tell us what you think about this devastating story. What do you think the future of healthcare holds for older adults? Do you have any thoughts on how the healthcare community can impact our future in a positive way for our elders?  Share your thoughts below.


  14. The #MeToo movement has empowered many targets of sexual harassment to address their harassers and report these situations to their employers and the authorities. The Equal Employment Opportunity Commission (EEOC) received more than 13,000 workplace sexual harassment complaints in 2018. They said that 15.9% of the charges were filed by male targets, which means that women remain the number one recipients of sexual harassment. More than $56 million was awarded to victims of sexual harassment through settlements before the cases ever went to trial.

    These statistics are appalling and should make each of us consider ways to keep ourselves and coworkers safe. What might be even more shocking than these statistics are stories where the perpetrator gets away with nothing more than a slap on the hand, like Dr. Moja, a physician in Virginia. Here is more about his story. 

    Doctor with Multiple Allegations

    WTVR, Channel 6 shared the story of one nurse who remembers a conversation at a hospital elevator with Dr. Moja. The nurse, who has requested to remain anonymous, told reporter Melissa Hipolit, “Dr. Moja was talking to me, discussing some things, he had his hand on my shoulder. As he was removing his hand, he deliberately, with intent, came down across my breast -- slowly with intent.”

    The nurse described how she was shocked by his actions and waited for the physician to apologize or walk away. However, he didn’t. In fact, the nurse told the reporter, “He made the comment he just wanted to know if they were real or fake.” She remembered being in shock at first and then switching over to anger about the violation.

    She reported the incident to the hospital’s HR department that night but didn’t hear back from them for a few days. She reminisced that Dr. Moja tried to pull her off to the side to talk to her a few times after the incident, but she never allowed herself to be in that situation. She then spoke to the hospital’s director of nursing, who helped her to call the police department that same day.

    After Dr. Moja was charged with sexual battery, other women started discussing similar behaviors displayed by the doctor. He’s accused of asking one employee if she had ropes and handcuffs. He was also involved in similar situations at previous employers. All of this information was submitted to the Virginia Board of Medicine who convened to review it and decide the fate of Moja’s license to practice medicine. 

    The Results

    The board stated that they were concerned by “Dr. Moja’s lengthy history of inappropriate actions and comments across multiple work settings with multiple professional workers, which span many years,” but they decided not to suspend his license. Dr. Moja was reprimanded and placed on probation indefinitely.

    Dr. Moja is still licensed to practice medicine in Virginia. His attorney told WTVR that they are appealing the disciplinary action given by the board and the conviction of the sexual battery charge. 

    Understanding Sexual Harassment

    Inappropriate sexual advances in the workplace aren’t new. According to the Online Journal of Issues in Nursing, even Florence Nightingale had to control comments made by male physicians and surgeons in the 1800s. Since that time, there have been many cases of sexual harassment in just about every industry. With the powerful #MeToo Movement, professional organizations in healthcare have taken a stance on sexual harassment to prevent it from happening.

    The EEOC defines sexual harassment as unwelcome sexual advances, requests for sexual favors, and other verbal or physical harassment of a sexual nature. It can also include offensive remarks about a person’s sex. Victims can be of any sex, and so can the harasser. However, there are a few factors that increase the risk of sexual harassment that might make it more likely to happen in healthcare settings:

    Isolated Victim

    Any workers who find themselves in secluded spaces tend to be at a higher than average risk of sexual harassment. Isolation can leave the target feeling alone since there may not be witnesses to the harassment. If you work in a small office, facility, or practice and find yourself alone with another worker, you could be at risk. 

    Male-Dominated Work

    Women who work in male-dominated professions are at a higher than average risk of being a victim of sexual harassment. Nursing is female-dominated as a profession. However, medicine is not. Female nurses in male-dominated practices are one area of healthcare that could be a problem. 

    Power Disparities

    Workplaces with unequal power between workers can set up an environment where sexual harassment may happen. Add in a possible harasser who is well-recognized or high-earning and the power imbalance and risk of harassment increases. Some people in positions of power feel that they don’t need to comply with laws and other rules and might even think they won’t be reprimanded for inappropriate actions.

    Changing the Trajectory of Sexual Harassment

    If you’ve ever been the victim of sexual harassment, you understand the level of violation that comes with the act. Victims don’t have to sit back and tolerate this type of abuse. If you or someone you know is being sexually harassed at work, you have rights. You can call the Equal Rights Advocates ' toll-free Advice and Counseling ling at 800-839-4372. You should also speak to your supervisor or human resources department. If you’ve been sexually assaulted, you can also call the National Sexual Assault Hotline at 800.656.HOPE.

    We Want Your Opinions

    How do you feel about Dr. Moja’s actions? Should he be allowed to continue to practice medicine? If you’ve been the target of sexual harassment or sexual assault in the workplace and are willing to share your story, we’d love to hear it. Tell us how you felt and what you did about it.

  15. Difficult conversations are part of healthcare. However, when the news is that a patient is terminal, it might be a bit harder of a conversation than others. One physician found himself on the receiving end of a difficult chat that spurred him to start mentoring other physicians about how to approach telling patients they’re dying.

    Dr. Ron Naito’s Story

    Dr. Naito is an internist with over 40 years of experience. When he saw the abnormal results of his blood test, he understood the prognosis. However, when he attended an appointment with his doctor, instead of learning of his formal diagnosis in a compassionate, dignified manner, he was met with attempts to dodge the results. “He simply didn’t want to tell me,” Natio said

    He told Indian Country Today that at one point, he overheard a specialist discussing the tumor biopsy results with a medical student outside of his exam room door. “They walk by one time, and I can hear [the doctor] say ‘5 centimeters,’” said Natio. “Then they walk the other way, and I can hear him say, ‘Very bad.’” Dr. Naito noted that the shock of this encounter still bothers him. He knew the diagnosis and prognosis because of his years as a physician. However, the lack of compassion, professionalism, and empathy in the way he found out is palpable.

    Dr. Naito has been using his time since his diagnosis to help educate medical students at Oregon Health & Science University how to speak to patients when the news isn’t good, which isn’t a skill many medical or nursing skills teach.

    How to Give Bad News

    Nurses aren’t often the ones who are providing dire test results and terminal diagnoses. However, once the severity of the news wears off and the patient and family has questions, it’s often a nurse who sits at the bedside providing answers, education, and support. If you find yourself in the midst of these conversations, here are a few strategies you can use to navigate through:

    Show Empathy

    Empathy, not sympathy, is one of the most powerful emotions you can offer. Being able to understand and share the feelings of the patient and their loved ones can put you in an excellent position to teach and support them through a difficult time.

    Be Honest

    These conversations are tough, but glossing over the details doesn’t help anyone. Patients deserve the full truth about their diagnosis, expected symptoms, and what the dying process might be like. One study found that only about five percent of cancer patients fully understand their prognosis. Without a thorough understanding of the disease process and what to expect, patients lack the ability to make informed decisions about their care. As a hospice nurse, I quickly learned how to navigate these difficult conversations with truth and compassion. It wasn’t always easy, but most patients appreciated the honesty.

    Be Open to their Questions

    You might not know the answer to some of the questions patients have. Sometimes, you may not even be the best person to give the answer. However, letting them ask the hard questions, and providing support is paramount to your relationship with them. If you don’t know the answer, tell them honestly that you’ll need to get back to them. Always follow through and get them the information they need.

    Don’t Use Cliches

    It can be very tempting to use phrases like, “just stay strong,” or “it will be okay.” When you are the one receiving devastating news, those words are worthless and even insensitive. Instead, use phrases like, “it’s okay to feel this way,” which supports the patient in their feelings.

    Show Support

    Patients want to know that they have a team of healthcare professionals around them who are there to help. Your job isn’t to tell them what to do or what treatment decisions to make, but rather to support them in the decisions that are best for them. Easy ways to show your support can come through your words, but often all you need to do is be present and use active listening skills so that they know you hear them.

    After the Bad News

    Dr. Naito is sharing his story in hopes of preventing other patients from having the same experience he had. He shared that difficult conversations can be a “heartfelt, deep experience.” We must always remember that our patients are human and have emotions and feelings about their life that we don’t understand, so being their support after the bad news is one of the most important places you can be for them.

    Have you ever found out a poor prognosis in a less than professional way? If so, tell us about it. Or, have you witnessed one of these conversations and had to navigate through it with the patient and their family? Let us know your thoughts about challenging conversations and how you get through them.

  16. Gender bias in healthcare takes many forms. Patients might think that all females with a stethoscope around their necks are nurses and that men in scrubs must be doctors. A recent study reports that younger patients are more likely to identify female physicians and male nurses correctly. However, overall, the study found that most patients associate the nursing profession to female healthcare workers.

    If you're wondering what gender bias is and ways you can help educate others, we've got you covered. Here is some essential information you need to understand gender bias in healthcare.

    Gender Bias in Healthcare

    Gender bias can be prejudice or preference toward one gender over another. It might be a conscious decision or can be an unconscious belief you have about someone based on their sex. In healthcare, gender bias is to blame for unreasonable comments like Joy Behar’s 2015 statement about nurses and Miss Colorado, Kelley Johnson wearing a “doctor’s stethoscope,” and the general belief that all nurses are women.

    Gender bias in the workplace is also responsible for wage disparities between men and women in all industries and even issues of sexual discrimination in the workplace. While women have made huge strides, there were still only 24 female CEOs leading Fortune 500 companies across the nation in 2018. However, more recognition is being given to women in leadership positions. In December 2018, Becker’s Hospital Review recognized 143 female leaders of hospitals and health systems. However, not many were nurses.

    Men in Nursing

    The number of men in nursing has been on a steady incline for many years. According to Montana State University, the number of male nurses continues to increase in the total amount. However, the representation of full-time male nurses has remained steady at about 11 percent of the total number of nurses between 2011 and 2016. The average age of male RN’s is about two years younger than female RNs, which is a good thing when you look at the overall trajectory of men in the profession.

    The interesting thing about men in nursing is that while they don’t make up the highest proportion of nurses, they do tend to earn higher wages compared to women. In fact, on average, they make about $2 more per hour than women in similar positions. You might be thinking that $2 isn’t much, but when you calculate that out over a year at 40-hours a week, the difference is a bit over $4000 annually.

    Women in Medicine

    If we’re going to look at men in nursing, it’s only fair to take a peek at the number of women doctors, too. According to the Kaiser Family Foundation, there are 1,005,295 physicians in the United States as of March 2019. A total of 359,409 (36%)  identified as female and 644,683 (64%) are male, while 1203 were unspecified. These numbers make medicine a male-dominated profession.  

    A 2018 Medscape report about Physician Compensation reported that women physicians who worked as plastic surgeons, gastroenterologists, and radiologists are among the highest earners for female doctors. Male doctors in primary care reported an average salary of $293,000 per year or about $140 an hour. Women in primary care practices made an average of $203,000 each year or about $97 an hour based on a 40-hour week. That’s a difference of $43 for every hour worked.

    Ways to Help

    When you think of gender bias in healthcare, you might not even notice it at first because the make-up of your unit is what it is, right? However, when you start to research the numbers and look at the salary differences for women in just about any healthcare role, you might begin thinking that there is an issue. The study reported at the beginning of this article also brings up the question of how patients might respond to a female doctor or a male nurse during care. These are a few of the problems we need to consider and help resolve.

    Here are a few simple things you can do to help:

    Support the American Association for Men in Nursing (AAMN)

    The American Association for Men in Nursing (AAMN) is on a mission to “shape the practice, education, research, and leadership for men in nursing and advance men’s health.” Two of their objectives that all of us can help with include encouraging men of all ages to become nurses, and then supporting them in the profession. Consider mentoring young men in nursing or even talking at a local high school career day about the importance of expanding the number of men in nursing.

    Support Women in STEM

    There has been a big push to support more women to enter into professions in science, technology, engineering, and mathematics (STEM). This covers a broad range of occupations but certainly covers many healthcare professions that young women should consider. Much like supporting men in nursing, if you have a love of STEM, consider becoming a volunteer with young women making decisions about their future and helping them find jobs in science and healthcare.

    Talk About the Disparities

    Have you ever noticed that when you make a conscious effort to talk about issues that plague the workplace, they tend to lose their strength? So, if you’re at the bedside when a patient calls a female doctor a nurse, politely correct them. And, when you hear someone make an insensitive comment about men in nursing, tell them about the awesome male nurses you work with and how you would love to have more men work alongside you. It’s that simple!

    Do you have other ideas for diminishing the existence of gender bias in healthcare? If so, we would love to hear them. Drop a comment below.

  17. On June 4, 2019, a former nurse at Roswell Park Comprehensive Cancer Center in Buffalo, New York was charged with stealing pain medication from cancer patients. Kelsey Mulvey, of Grand Island, was charged with illegally obtaining controlled substances by fraud, tampering, and violation of the Health Insurance Portability and Accountability Act (HIPAA). She is accused of diverting powerful painkillers like Dilaudid, oxycodone, methadone, and lorazepam. She was also allegedly administering water to the patients who legitimately needed those drugs. These charges could find Mulvey in prison for 10 years and fined up to $250,000.

    Details of Mulvey’s Crimes

    In 2018, administrators at Roswell Park Comprehensive Center suspected that a staff member was diverting pain medication from the Pyxis. Between February and June of 2018, it’s alleged that Mulvey failed to administer medication to 81 patients, instead of giving them water, that at times was contaminated and resulted in infection. Administration became suspicious after finding a large number of transactions in the Pyxis that were “canceled removed,” indicating that the drawer was accessed, but the operation was never completed.

    The complaint filed last week states that she removed and replaced controlled substances with water during these canceled transactions. Mulvey accessed the Pyxis on units she wasn’t assigned and even on her days off, including vacations. When the facility started investigating the issue and Mulvey in 2018, she resigned. As of June 16, 2019, there are two Kelsey (Anne) Mulvey’s listed in Buffalo, New York on the license verification site. However, both list that the license to practice nursing is inactive.

    Nurses and Addiction

    Caring for others is a challenging business. Nurses watch as patients endure horrific medical battles. Many times, nurses and other healthcare professionals internalize or suppress their feelings to get by and cope with the stress. However, sometimes, nurses bend under pressure and turn to misuse and abuse of substances they possess or even some they divert from patients who need the medication for pain, anxiety, and other symptoms or conditions.

    The American Nurses Association estimates that one of every 10 nurses abuse drugs or alcohol. So, at the next staff meeting you attend, look around and do the math. For every nine nurses, you are sitting with, you or someone else in that small group is or will abuse a substance. Maybe even at the detriment of a patient. Scary, right? Many of us can’t fathom being that one in 10. However, when you think about the reasons nurses abuse drugs and alcohol, the picture starts to become a bit clearer.

    Let’s discuss a few of the reasons experts believe nurses struggle with issues of addiction:

    Stress Levels Run High

    Results from a study of 120 nurses in the Midwest revealed that more than 90 percent of respondents had moderate, high, or very high levels of work-related stress. To combat work-place stress, 79% of the study participants talked with friends and loved ones, 46% listened to music, 43% watched TV, and 43% used prayer and meditation. Unfortunately, 13% reported that drinking alcohol was a coping mechanism they used to deal with their stress levels. Nurses with the most stress also experienced poor health outcomes and high-risk behaviors.

    Stress can make you do things you wouldn’t usually do. It can also impact your overall health and well-being. However, when stress gets to the point that deadening the feelings with substances sounds like a good idea, it’s time to reach out for help.

    Easily Accessed

    If you work in a hospital or other care facility, you likely hold the key to some powerful medications. This alone can be problematic for nurses with chemical dependency issues and those who are under more stress than usual.

    Psychology Today reports that behaviors that should make you question what’s going on with colleagues include volunteering for shifts on holidays, weekends, and overnight because there is less oversight by administration during those shifts. You might also wonder what’s up if a coworker constantly has incorrect narcotic counts, reports wasting medications without a witness because no one was around, or they look for opportunities to be alone with pulling narcotics from the dispensing system. It’s critical to point out that doing one of these actions or having it happen occasionally isn’t reason enough to schedule a meeting with the unit manager to discuss your concerns. However, if you notice a coworker doing these actions consistently or if you have that “nurses intuition,” it might be best to discuss your observations with the manager privately.

    High Levels of Fatigue

    We’re not talking about being tired after a day out and about with family and friends. The fatigue nurses feel is often caused by inadequate staffing, high acuity assignments, and increased clinical responsibilities. Fatigue can cloud a nurse’s judgment, placing their patients in danger. The American Nurses Association reports that fatigue is costly because it can increase healthcare needs and worker’s compensation costs, disability, recruitment and training efforts, and legal fees.

    The remedy to fatigue sounds quite simple - sleep. However, sleep eludes an estimated 1 in 3 people. Older individuals are at a higher than average risk of experiencing insomnia. Women are twice as likely to struggle with sleep than men. And, shift workers have a higher than average risk, too. Since nursing is made up of primarily female workers and sick people don’t miraculously get better at night, nurses are prone to experience fatigue.

    Resolving the Issue of Addiction in Nurses

    Each state and local jurisdiction handles drug-addicted nurses differently. Some walk away with a criminal record, but no jail time and others are fined and locked up. And, of course, there are those who are never charged and walk away completely unscathed. These are simply the criminal ramifications that nurses might face and doesn’t address the variations of what might happen to the nurse’s license to practice and make a living.

    How do you feel about nurses who struggle with addiction and get caught diverting? Do you support programs to help them with the problem and keep their nursing license? Have you or a colleague ever struggled with addiction? Share your thoughts below, we would love to hear what you think about Kelsey Mulvey and other nurses who struggle with addiction.

  18. On Saturday, June 8th nurses, doctors, and medical students stood side-by-side to protest the American Medical Association’s (AMA) annual meeting in Chicago. The AMA, which was founded in 1847, is a large, powerful, and wealthy lobbying group. However, it seems that many young physicians and medical students don’t agree with the work done by the group. In fact, in 2016, it was reported that the AMA only represented about 25 percent of practicing physicians. This decrease was a significant change from just a few decades ago when nearly 75 percent of all physicians were members.


    If you perform a quick social media search for #AMAGetOutTheWay, you will find support from many healthcare professionals fighting for Medicare for all. Experts believe that adopting a Medicare for all system in the United States would allow us to join the ranks of the rest of the industrialized world where health coverage is universal. They also feel that this would save money and improve health outcomes.

    Protesters feel that the AMA isn’t fighting for the right initiatives. Adam Gaffney, President for Physicians for a National Health Program and an instructor at the Harvard Medical School, made his feelings known at the rally. “The AMA is not fighting for their patients, they’re not fighting for the uninsured, and they’re not fighting for the underinsured. We’re here today because the AMA is again on the wrong side of history.”

    Other groups well-represented at the rally included Students for a National Health Program (SNaHP), National Nurses United, People’s Action, and The Center for Popular Democracy. SNaHP published on their website that showing up at the rally showed support by “taking a stand AGAINST corporate greed, misleading advertising, and the profit motive of health care.” National Nurses United is the largest union and professional association for registered nurses and supports Medicare for All.

    What is HR 1384?

    Medicare for all isn’t just a catchy slogan used by Democrats like Bernie Sanders. It’s a legislative proposal, HR 1384,  that would create a nationwide health insurance program for all U.S residents. A single-payer system such as this would replace the current mixed healthcare system which includes private and public health programs. It also has a provision to allow people to purchase public coverage during a transitional period to this new system.

    Who Would Be Covered?

    HR 1384 aims to provide coverage to all U.S. residents, documented immigrants, and even undocumented people. The program would prohibit anyone from being excluded because of citizenship status.

    How Would it be Funded?

    This single-payer system would not require premiums to be paid. However, it would require new federal taxes for both businesses and individuals.

    What Would Be Covered?

    All medical care would be covered under this system. Those who support HR 1384 proudly boast that it would also cover reproductive health services. This would include maternity and newborn care.

    The Power of Unity

    Regardless of your opinions about HR 1384, the rally in Chicago is an example of what could happen when healthcare workers come together. It’s estimated that there over one million physicians and nearly three million nurses in the U.S. Imagine how workplace problems and care deficiencies could be approached with this type of unity.

    Would we be able to solve some of the top problems that plague healthcare? Just think for a minute how discussions about safe staffing, workplace violence, and long working hours might change if these two “strong-in-number” groups stormed the offices of administration and lawmakers across the nation.

    Where Do You Stand?

    There are so many different conversations that could come from this one event. Do you support a Medicare for all system? And, what do you think about the unity that was displayed at this protest? Oh, and what other issues do you think a unified front could impact?

    Let’s start there for now. Tell us what you think!

  19. Legislation to set maximum nurse-to-patient staffing ratios is a hot topic these days. Currently, California is the only state to enforce a staffing ratio mandate. However, several other states have some sort of legislation in place regarding safe staffing. The laws vary from telling the hospitals they must have committees to set the ratios to have standards for specific nursing units.

    Last week, nurses across the state of Illinois were hopeful that their state would join the ranks of California and become a state which placed patient and nurse safety as a priority. The Safe Patient Limits Act, House Bill 2604, was before lawmakers to mandate how many patients could be assigned to one nurse, depending on the setting. The bill would require med-surg units to only assign up to four patients to each nurse, three-to-one assignments in intermediate care units, and intensive care units would be limited to two patients per nurse. The bill has similarities to the California law that was passed in 2004. However, HB 2604 was the first of its kind to provide minimum staffing ratios for ambulatory surgical centers and long-term acute hospitals, too. The bill passed through a committee, then stalled in the final week of session. Ultimately, it never came to a full vote before the House.

    Alice Johnson, executive director of the Illinois Nurses Association, told Herald & Review in a recent article, “Of course we want to see the bill passed into law because we know it’s going to save lives, but we’re looking at it like….it’s not the law yet. We’re going to keep advocating and keep working on this until we get it done.”

    The Opposition

    Hospital administrators across the state weren’t supportive of the proposed legislation. Many felt that hiring more nurses to meet the mandated ratios would strap the hospitals financially. Danny Chun, a spokesman for the Illinois Health and Hospital Association, told Herald & Review that the bill could cause some hospital units to close and negatively impact patient care. Chun also called the bill a “one-size-fits-all” approach that wouldn’t meet the needs of the different hospital settings across the state.

    The interesting thing about this position is that without nurses, hospitals would be more than financially strapped to provide care. These healthcare facilities would be without care. Nurses are the epitome of patient care, and without them, hospitals are nothing more than a large building where people who are ill, recovering, and dying would go to commiserate in the knowledge that nobody is there to do the hard work that must be done 24-7.

    The Support

    If you’re like 99% of the nurses I know, you probably went into nursing intending to help others. Maybe you wanted to help the sick, be there to support new moms as they deliver babies, or ease the discomforts of death for people as they die. Regardless of why you went into nursing or where you work now, you should support nursing staff ratios.

    Inadequate nurse to patient ratios create adverse outcomes for patients. It can also prolong hospital stays and increase the risk of hospital-related complications, including death. Adequate staffing has shown to decrease the following:

    • Medication errors
    • Hospital readmissions
    • Length of stay
    • Preventable adverse events
    • Cost of care

    One of the most comprehensive studies that support safe staffing compared hospitals in California, who have mandates on staffing, to hospitals in Pennsylvania and New Jersey. This study came out in 2010 and reviewed data from 22,336 nurses in all three states in 2006, as well as the state hospital discharge databases. It also compared nurse workloads and patient outcomes. The facilities in California boasted better health outcomes for similar patients, lower surgical mortality rates, and fewer inpatient deaths within 30 days of admission.

    Along with this study and others, several organizations support safe staffing initiatives, too, although they don't all agree on how to achieve this. A few of these organizations include the America Nurses Association, many state nursing organizations, NursesTakeDC, and the Department for Professional Employees, AFL-CIO (DPE).

    Nurses on the Move

    This isn’t the last lawmakers in Illinois will hear about HB 2604. Johnson said that there are plans to meet with lawmakers this summer to provide more education on the impact of the bill. They will work with the sponsors to get it back in front of the session this fall or at the start of 2020, if necessary.

    If you take a look at the  Illinois Nurses Association Facebook page, you’ll notice that the support of nurses doesn’t seem to have waned in light of last week’s events. The active nursing advocacy group isn’t only worried about staffing ratios, but they continue to support other issues in Illinois like the Howard Brown Health employees who are fighting for a fair labor contract.

    How to Get Involved

    If you’re interested in helping nursing initiatives in your state and across the country, there are a few ways you can get involved. Look up your state nursing association or search for their social media page on Facebook. You can also join movements supported by national organizations like NursesTakeDC to stay up-to-date.

    Do you have any other unique ways to move staffing ratios forward in your state or facility? I would love to hear how you support this critical healthcare issue.

  20. Being involved in experimental care isn’t new territory for many nurses. However, donating spare body parts seems a bit rarer. For Heather Bankos, a neonatal nurse, donating her uterus came after she gave birth to three children of her own. Not only did she undergo the surgical procedure, but she also paid for her flight to Dallas, all with the hope that doctors can successfully transplant her uterus into another woman’s body for childbearing.

    Similar Procedures

    Uterine transplants have been successfully performed in Sweden. In 2014, a woman gave birth to a baby boy with the help of a donor uterus. The woman and her partner endured the transplant surgery, but also they had to go through other procedures, like in vitro fertilization (IVF). This process is standard for those who have difficulty getting pregnant and combines drugs and surgery to assist with fertilization and implantation. Past uterine transplants used donors genetically related to the recipient. However, the 2014 operation varied, because not only was the donor not related, but she was also over the age of 60 and had undergone menopause.

    The child was born a bit prematurely, at about 32 weeks gestation because of pre-eclampsia and an abnormal fetal heart rate. The father of the baby spoke with reporters shortly after the child’s birth in 2014 and stated, “He’s no different than any other child, but he will have a good story to tell.”

    Uterine Transplant Clinical Trial

    Bankos had the operation as part of a clinical trial at Baylor University in Dallas, Texas. The University started the study in 2016 and was quickly overwhelmed with women willing to donate. In fact, in just two weeks, they received over 200 inquiries about how to give. Today, the wait list includes hundreds of interested women from almost all 50 states across the country. The trial hasn’t only had a significant amount of interest, and there’s been success, too.

    Two babies were born at Baylor, which is part of Baylor Scott & White to uterine transplant recipients. The first mother, who had zero chance of having a baby without this trial, shared her story and stated, “Our main incentive was for the science, and to think about the 16-year old girl who gets this diagnosis, and she doesn’t have to hear what I heard when I was 16. She’s going to have options, no matter what happens.” These live births prove that the procedure can be replicated and is a viable fertility option for other women.

    The surgery that Bankos had removed the uterus robotically, which decreases recovery and minimizes the length of the incision. However, the procedure itself took about nine hours, which is almost twice as long as the conventional method. Dr. Johannesson, a medical director, and gynecologic surgeon at Baylor, explained that the uterus is an excellent organ to give away because once you’re done with it, you don’t need it anymore.

    Understanding the Ethics

    As with every social issue, there are a few ethical challenges to consider around uterine transplants. Getting a uterus isn’t life-saving. At this time, it’s only done during clinical trials but will likely come with a hefty bill once it’s officially approved. Of course, whether or not insurance companies will cover the cost of the surgery is yet to be seen.

    There are alternatives, such as adoption and surrogacy, but anyone who’s carried a biological child to term can probably relate that there are some differences. Currently, there are no documented risks for children born after a uterine transplant. Those who donate can be educated on all known risks of hysterectomy. So, it does seem that the majority of the considerations have to do with time, cost, and the fact that it’s not a life-saving procedure.

    What do you think about uterine transplants? Would you be willing to give yours to someone who couldn’t have children? Do you feel that other options, like adoption and surrogacy, should be used first?

    Tell us your thoughts below.

  21. Worker's Compensation is administered differently in every state. I'm not familiar with Iowa laws. It's also critical to point out that just because you file a worker's compensation claim does not mean that you can get benefits. Employers and the state can fight the claim, including compensation and medical coverage. When you have unions involved, things tend to get a tad bit trickier, too. 

  22. In 2018, TIna Suckow, a 49-year old nurse, was brutally beaten by a patient at a state mental facility in Iowa. Suckow had been employed there for over 4 years when the incident occurred. A “code red” alert was issued, and multiple staff members responded, one of whom was Suckow.

    A patient, who is said to have been in a manic episode, was throwing furniture and threatening physical violence. Staff members brought in a “turtle shield,” an assault-protection device the facility had recently purchased, but not yet trained staff to use. Shortly after this device was brought out, Suckow became trapped between the shield and the patient. She was then beaten unconscious and hospitalized with injuries to her shoulder, knee, and head. She has undergone several surgeries and continues to need medical treatment today.

    Share Your Thoughts via Video

    During the incident, officials at the facility didn't call law enforcement to investigate the situation, which has left Suckow feeling like a target. “I’m not the criminal here,” said Suckow, “I didn’t do anything wrong.” The Nursing Director at the facility, Georgeanne Cassidy-Westcott sent an email two days after the incident informing staff about the opportunity to use the “turtle shield” and stated that while they had not trained on the use of the device, it was “fairly effective” when used in this situation.

    Suckow contends that during her time off, she was not treated fairly. She reports that other staff who were off for medical reasons were allowed to send in paperwork electronically.  However, Suckow was required to make a two-hour round-trip drive to deliver her paperwork in person.

    After her federally mandated time-off ended, Suckow made two requests. First, she requested catastrophic leave, which would allow other employees to donate sick time so that Suckow could extend her time on payroll. This was denied. Her second request was for time off without pay. However, the state rejected this request as well and is protected to do so under a 2017 state law that limits government employee unions to negotiate on the employees’ behalf for anything except pay.

    According to a ucomm blog article, the union reports that terminations and forced resignations have tripled since the 2017 law went into effect. Some people in Iowa believe this number is low because it doesn’t account for state workers who have been forced to resign and others who like Suckow, have been injured on the job. In fact, Suckow’s state employment record doesn’t even list her as being terminated.

    Another result of this legislation is that hospitals are now struggling more with being understaffed, which places patients and workers at risk of more safety concerns. Danny Homan, president of the American Federation of State, County, and Municipal Employees Iowa Council 16 told the Des Moines Register, “Any reasonable human being should have concern because if it’s OK for the state of Iowa to treat workers this way, then Casey’s can do it, Ruan can do it, any employers in the state of Iowa can do it.”

    Even in light of this horrific situation that Suckow has endured, lawmakers still support the 2017 law. State Rep Steven Holt, helped to get the bill passed. He believes the changes have created a fairer balance between workers’ rights and government operations. He told the Des Moines Register, “There are plenty of horror stories to go around in the old system as well.” Holt also believes that a connection between unfair treatment by managers can’t be tied to the law.

    Should lawmakers and citizens of Iowa accept the 2017 law because it’s not “worse” than the previous law? Or, should the union and the employee have more rights in this situation?

    What do you think?

    Share Your Thoughts via Video

  23. On May 29th, a Montgomery, Alabama judge sentenced former Nurse Practitioner, Lillian Akwuba to 10 years in federal prison. Akwuba was found guilty on 23 counts of healthcare fraud and drug distribution. However, she wasn’t alone in her acts that caused Judge Sharon Blackburn to tell Akwuba that she was a “ highly educated drug dealer” who wrecked the lives of patients and families to make money.

    The Story

    Dr. Gilberto Sanchez, who owned Family Practice in Montgomery, was arrested in 2017 for allegedly running a pill mill. He was indicted along with other staff members from his office, including Akwuba. They were charged with prescribing unnecessary controlled substances, such as hydrocodone, oxycodone, fentanyl, and methadone. Not only did they give these dangerous drugs for no reason, but they also had patients return to their office every month to get their prescriptions. These visits were considered unnecessary and a form of healthcare fraud.

    According to AL.com Akwuba left Sanchez’ practice in 2016 and opened her own practice, Mercy Family Health Care in Montgomery. She continued to overprescribe the same controlled substances. However, since she was legally required to collaborate with a physician, she broke the law in new ways. Prosecutors reported that she began forging signatures of physicians and faking the collaboration required under Alabama state law.

    A WSFA News 12 article , reported that Akwuba pleaded for mercy at her trial and stated that her family depends on her for support. She said that she was remorseful. However, the judge pointed out that at no point during her hearing did Akwuba ever comment about the people that she prescribed dangerous drugs to and probably turned into addicts. Blackburn even replied that she didn’t feel that the former nurse practitioner understood the extent of her conduct and just how criminal her actions were.

    An Assistant United States Attorney, Jonathan Ross was also present for the trial. He told WSFA that Akwuba showed “complete and utter disrespect to her patients and the court by lying under oath during the trial, and disrespect to the doctors who tried to work with her and curb her prescribing habits.” Ross also called Akwuba a “drug dealer.”

    Ross feels that Akwuba is at higher levels of blame compared to Sanchez, who pleaded guilty to five counts and was sentenced to serve more than 12 years in prison. Akwuba remains detained until her family produces her passport, at which time she could be released on bond before heading to serve her sentence.

    The Dilemma

    There are so many issues in this story. Did Akwuba understand her prescribing actions? How was she able to go for such a long time forging the names of physicians? The state of Alabama only gives nurse practitioners limited authority to prescribe, which means they must have physician collaboration. Did pharmacists in the area not recognize the forgery?

    Stories such as these can be used as ammunition to support the notion that nurse practitioners should not be given autonomy to prescribe without physician oversight and work independently. However, these stories are few and probably shouldn’t be used to set precedence for future laws. But, we all know what one bad apple can do to an entire bag, right?

    What do you think should happen to Akwuba, and where did this situation go wrong? Share your thoughts below.

  24. You’ve probably felt the effects of workplace burnout at least once in your nursing career. As of this week, burnout has officially been recognized by the World Health Organization (WHO) as a formal occupational phenomenon. Clinicians of all types have been living with the effects of short staffing, stress, and other patient barriers that seem to zap their energy and ability to provide the best care.

    Burnout is now defined as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It’s characterized by reduced professional efficacy, feelings of exhaustion, and increased mental distance or negative feelings about your work environment.

    Nurses and Burnout

    The concept of burnout has been around since the 1970s when psychologist Herbert Freudenberger coined the term. When you’re under high levels of stress for an extended period, it’s common to start to feel tired and unhappy. However, the phenomenon doesn’t only make you want to sleep. It can create psychosomatic issues like anxiety, depression, and insomnia, too. Nurses in burns units, critical care, pediatrics, and emergency departments are at a greater risk of developing the condition. The high levels of care and increased uncertainty of outcomes in these areas can take their toll on the mental and physical faculties of any nurse.

    Other causes of burnout include inadequate staffing and caring for those who are nearing death or actively dying. You might also struggle with burnout if you’re a newer nurse or have continued conflicts at work that challenge your values.

    How Can You Prevent Burnout

    Many people think that burnout is driven by the way each nurse deals with stress. However, some experts believe that burnout is a consequence of administrative processes. This means that preventative measures must be initiated on a global level if you want to see changes in the level of burnout nurses experience. Here are a few ways administrators can help to minimize the number of nurses affected by burnout.

    Improving Communication Methods

    The concept of interoperability isn’t limited to the patient’s medical record. If you must access multiple platforms to gather information and then manually synthesize the data to make care decisions, this could be adding to your level of burnout. Another factor in communication involves having to search for policies and procedures, rather than having these types of resources in one central location.

    Think About Scheduling

    Whether you work 3-12 hour shifts or 5-8 hours shifts, nursing is challenging. Many nursing units have rigid scheduling policies that make it challenging to take a day off at the last minute for “mental health” needs or family events. You might also not get your schedule more than a week or so in advance, so scheduling life outside of work can be difficult.

    Facilities need to learn ways to adopt flexible scheduling policies so that nurses get the time off they need. This might mean hiring more staff, so that weekend rotations are decreased or using “prn” staff to fill in during times of high acuity. Some units use self-scheduling as a way to increase satisfaction with schedules

    Consider Nurse-to-Patient Ratios

    A 2018 study conducted at Marshall University concluded that nurse-to-patient ratios are directly related to nurse productivity and overall health, including mental, emotional, and psychological factors. Not only did the researchers find that the health of the nurse was in jeopardy during times of inadequate staffing, but they also suffered from job dissatisfaction. In California, nurse-to-patient ratios are mandated, but the rest of the country is left to the individual policies of healthcare facilities.

    More nurses are advocating for set staffing ratios and working with lawmakers to initiate legislation. However, this can take years for it to become the norm across the nation.

    Does the New Recognition from WHO Help?

    Do you feel that recognizing burnout out as a workplace phenomenon will help support issues such as staffing ratios, long hours, and job stress? Will employers finally look for new methods to fix the problems that plague nursing units?

    What do you think? Share your thoughts in the comments below.


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