klwtiger

I have the answer regarding receiving nursing hours credit for caring for a loved one. If the care given requires having an RN license then it can be used as credit towards required practice hours. If it is general caregiving then it can not be used and if the proper number of hours is not obtained, a nursing refresher course would be required. Personally if I took 3 years off completely removed from nursing I would not feel safe giving care. I would probably be a nervous wreck and scared of making a major mistake or not being able to keep up with the changes and advances that had occurred in my absence. A refresher course might be just the jump start I would need to get my confidence going and the cobwebs brushed off my skill set.

Officially I have now completed 15 certified continuing education units and now have the fancy certificates to show for it. Although I did not really need the units since I am currently in school, I did gain a lot of knowledge through this process and not just about the topics I studied to get the units. I learned I did better with the more interactive units, second on the webinars and lastly on those based on reading just a plain long article. I was able to focus better, grasp the information as well as retain it and did better on the first try of the post test. There is a vast array of ways to complete the requirement be it independent or attending an official workshop or in service. In all the most insight I gained was that like in most things in life, what effort you put into something will equate what you get out of it. Some topics I was able to really able to take to heart and some were more time passers that may or may not apply. Overall if the requirement is a good thing or not, is yet to be seen. There are ways around it as demonstrated in the last 3 hours of credit I obtained, not much might be gained by it if it is information that may not apply, and if you are anything like me or many nurses I know our knowledge of nursing is ever expanding and in no way can be measured or tallied by a log sheet or certificate. How many times in a week do we look up a new medication or disease process or research alternative treatments for a patient not responding well to conventional ways? If I kept track of each of these instances that actually added to my knowledge I would need a pretty big notebook. Hopefully if nothing else those that have followed me along on this journey will learn there are several ways to complete the requirement that are free and will add to the knowledge base of the learner. I want to thank you all for following along and engaging. So far this thread has almost 500 visits, which is exciting. If I helped demystify the process for even one fellow nurse then I have succeeded in what I set out to do. Although in an official capacity my work here is done, I plan on continuing to follow this thread and interact. I am still looking into the possibility of using care of a loved one as fulfilling the hours required for nursing practice, I have not found the right person yet though I assure an answer will come hopefully sooner than later. :tku::tku::tku:

One of the things I discussed early on in this process was the value of a certified continuing education unit versus participation in an independent reading activity or work in-service which does not have to meet any standards but rather somehow advance your knowledge in nursing. I began thinking about the validity of this and wondering if it was plausible that a person could complete an independent activity and gain more than someone with a fancy certificate showing completion of a certified unit. I then looked at the next unit I was planning to complete which was Infection Control for 3 hours. I thought in all my nursing education and in-services at work and basic knowledge, I wonder if I could complete this course without completing the required reading? I then took the test without even opening the unit and passed easily with an 84%. This was quite an eye opener in that I realized a person could easily look for CEU’s online that they have a good base of knowledge in and if it allows the user to go straight to the test they could easily complete their required hours with fancy certificates to show for it without ever having learned anything. On the contrary if a person spends time researching something regarding them or a patient, attends in-services, or sits down to read a nursing magazine article they will have in actuality gained more knowledge than the person with the fancy certificates. As is in most situations in life it comes down to integrity. The purpose of the requirement is to ensure nurses are continuing to further their medical knowledge for the good of the patient but like most other things there are loop holes and ways around the system.

To bring my total up to 13 hours, I completed a 3 hour course on Heart Failure also from RN.com. This course was also interactive and had the addition of mini quizzes along the way which did not count in grading though did assist in solidifying the information presented. Although this course was worth 3 hours credit the entire process took me about an hour and a half. I can see this taking significantly shorter or significantly longer depending on how quickly the learner reads and grasps the information as well as level of prior knowledge of the subject matter. Heart failure in general is of course not new information for me although the way this was presented was so clear and concise some confusions I had were cleared up and I overall feel I have a better grasp on the subject. The unit covered symptomology, diagnostics, treatment including surgery, medications and life style changes and medications. The post test was again longer though more straightforward yet in depth to other units I have completed and I was able to pass on the first attempt as well as review the answers I had gotten wrong for additional clarification. This unit was presented by the same source as the critical thinking course and I definitely plan on continuing to seek learning opportunities from them in the future because of the thoroughness and clarity of the information they present. It was put together by the masters of nursing education program through Georgetown University.

In thinking of what I would do next to complete continuing education requirements I wanted to try something different than just read and answer so I did a Google search for interactive continuing education for nurses. I was directed to RN.com that had a handful of courses available for free as well as some that can be purchased. Another option they offer is a subscription for unlimited CEU’s for a year for approximately $35. Again I do not find it necessary to pay for continuing education with so many free options available. I also immediately noticed on this site that among even the free choices, there are a few options for more than 1 hour which is nice if you have the time to get more than an hour in at a time and it is on one subject matter. I first chose a unit on Critical thinking for 2 contact hours. This unit was interactive slide show based meaning rather than just scrolling through and reading the slides were colorful with bulleted information that was clear and easy to understand. There were case studies that were simple yet really demonstrated the point being made. The course examined three major uses of critical thinking, how to use critical thinking to approach a patient problem, collaborate with other disciplines, and teaching new nurses to develop their critical thinking skills when precepting. The most useful thing I gained from this course was the reminder that critical thinking is an ever present process that when used properly streamlines and improves patient care. As I prepare to enter a patients room to do an assessment or address a problem I quickly think of what I already know about the patient and the disease process. This will help me streamline their assessment focusing on the areas most important to them then branch out as the findings lead. If I am assessing someone with a respiratory then to start with blood pressure , Finger stick, or skin check might delay an important finding or lead me in the wrong direction. I would first do a thorough respiratory and infection directed assessment and branch out from there. If I find the patient to have low O2 sats or a high fever I can find those values and address them sooner than if I were to start with BP or start ant the head and work to the foot which can delay the simple interventions such as administering O2 or Tylenol then proceeding with the assessment. Another valuable piece to the puzzle that often gets over looked is reflection. Especially in a n emergent situation it is important to mentally debrief and think over what went well and what did not. The next time a similar situation occurs I can than remember what worked well and avoid what did not and will have broadened my knowledge base to know what to look for if a similar patient needs my attention. Aside from being more interactive this made the unit more engaging and held my attention, the assessment tool was longer and more specific. It was 15 questions with a 75% required for passing. Which is usual but I found myself taking my time to really think about the answers which assisted in really reviewing the unit. I was able to pass on the first try though if I did not I had the option to review my wrong answers (though the right answer was not reviewed) then re take the exam for credit. A certificate was then made available which I could email and/or print out and add to my file. The unit took me approximately 90 minutes to complete, 15 minutes to take the test for a total of 105 minutes for which I received 2 contact hours. I will definitely be using this web site as a future option.

If volunteer work qualifies then I would think caring for a family member would to if it requires any use at all of nursing knowledge. I will look into that possibility as well. I know many people who have stepped away from careers to be a full time caregiver for a family member so it is a very real problem that needs addressed.

To round of the 0.75 I found another CEU on Epocrates for 0.25 and thought it appropriate that it was a study on pain. Although it was only 0.25 CEU’s it took me closer to 0.5 hrs to complete it which I have found common for these “short” units. Although not indicated in the title this article quickly became apparent that it was about how to deal with a patient experiencing pain from fibromyalgia. It first briefly touched on how to recognize the symptoms of fibro then how to effectively treat the pain. One of the biggest challenges of a patient with fibro is being believed and not labeled as a drug seeker. This patient felt that exact frustration as she went from doctor to doctor seeking answers to her pain until she was finally properly diagnosed. She was treated with a multidisciplinary approach using pain medications, stress relief and exercise which showed slow but steady improvement. Also discussed was the desire by many patients to immediately jump to wanting disability and that this is not necessarily the best course of action. Disability removes the social aspect of life and work as patients succumb to the symptoms and isolate themselves. Instead it was recommended to reduce workload temporarily as symptoms are brought under control. Again this does not directly affect my current nursing practice though it does help me to remember to encourage patients to do even a little through pain rather than succumbing. It is also a reminder to take a patients word at pain as it might not show but be very real and it is important to validate the patients feelings.

A benefit to the continuing education requirement is it affords us a dual benefit if we would like to learn more about something afflicting ourselves or family members. I suffer from Fibromyalgia and used the opportunity to solidify and expand upon my knowledge of my ailment. I completed a 0.75 credit using the Epocrates CME application. The majority of the information was not new to me through doctor visits and personal research via the internet though it was comforting to see it all organized in an official matter meant for physicians. The focus of the article was on diagnosis based on symptomology and the importance of recognizing that although the symptom set is fairly consistent in most fibro patients that degrees and variances in symptoms can vary dramatically. One patient might be most disturbed by sleep disturbances while another by cognitive deficits though the common major symptom is widespread pain. It also discussed the change in the school of thought of using tenderpoints as a main diagnostic tool while focusing more on the collection of symptoms and time symptoms have been present. Although I do not really encounter fibromyalgia in long term care, managing my symptoms can affect my nursing practice. I also work along a few other nurses whom suffer as well and we can support each other as we manage our symptoms and discuss what works and doesn’t work. I have further solidified the need to take better care of myself to be a better nurse. You would think by now it would sink in but as they say nurses make the worst patients.

Staying cool under fire is vital in Nursing and is the topic of the CEU I have completed next bringing my total to 7 hours. Each unit completed requires successful completion of a quiz to receive credit with a score of 75% or better with the option of re taking the test until passed or to improve the score. For the first time I completed the test with 100% on the first try. This article was a little wordy though still informative and in many ways confirmed what I already know and put into practice though will serve as a reminder. The main point of the article described 3 communication styles, passive, assertive, and aggressive. The ideal style depends on the situation and is a delicate balance of multiple types. The most important thing addressed by the article is the reminder that it is important to listen and acknowledge the feelings of the person communicating. As nurses we are in an important position as we deal with patients and their families who are ill, scared, and hurting. It is not at all uncommon to be approached in anger by a patient, family member or co worker. It is important that we do not react as would be a natural reaction but instead to validate their feelings and offer up a solution. Sometimes the most important thing in effective communication is to not communicate at all but to listen and if necessary express your need to take a step back and respond at a later time to refrain from responding in haste. I once had a patient who was rather young to be in long term care because of multiple sclerosis. She was often angry, upset, and resistive to recommendations of staff and her own doctors as she was always hoping to get better. Quite often she would refuse medications or physical therapy and would spend excessive amounts of time in bed though was constantly looking for the miracle cure or quick fix. I was able to build a rapport with this patient and she would listen to me when she would not listen to anyone else. Some of the concepts discussed in this article I believe contributed to the success of our relationship. The first thing I did was listen and allow her to express her feelings. I encouraged her to acknowledge her feelings whatever they were and made it OK to say “this sucks”. Everyone always tried to encourage her to think positive and work hard and be hopeful. Positive thinking is important and that was often the mood we focused on though allowing her to mourn her losses was equally important. Being honest was also important. How often do medical personnel falsely reassure saying you will be just fine, you will be back on your feet in no time, when really no one knows. We often said hope for the best prepare for the worst. When she would have a setback we would discuss the possibility of the decline being the new normal and the steps we could take to adapt and overcome although would hope and work towards getting back what was recently lost whether it be being able to feed herself or control her wheelchair. Through it all to the end effective communication I think overall improved her quality of life. More and more I am encountering continuing education that is applicable to both my personal and professional life and this was another one of those cases. I like to think that this can best be attributed to the fact that being a better person makes us a better nurse in general.

Today I completed an hour of continuing Ed that I think could be rather useful in both my professional and personal life. This unit is called “The Power of Suggestion” and discusses how simply placing focus on desired outcome and positive thinking can dramatically influence patient’s responses to treatments. It is based on concepts from hypnotism and was actively used by a patient whom historically had patients whom responded more positively to patients and were discharged home sooner than patients treated by other nurses. He discussed his techniques with the author and discussed the goal he has it so think of the picture he wants to paint and uses words to pain that picture. Instead of concentrating on the pain possibly being experienced he focused on the positive aspects of overcoming pain such as getting out of bed and walking around the unit or being able to go home. It was explained that quite often we concentrate so hard on something that it in fact causes failure because it puts it in the forefront of our mind all the time. Instead of focusing on losing weight and the restraint and hard work involved, concentrate instead on the positive results. Professionally I plan to implement this thought process with all of my patients especially in the area of pain or nausea which are common complaints I encounter in long term care. Instead of common questions such as “is your pain any better?” I could instead focus on an activity they enjoy that they could engage in now that they are pain free such as “how about we head down to the activity room for BINGO now that you are feeling better?” One concept that has consistently come up in classes this quarter has been leading by example, and taking care of myself so I can then better take care of my patients. This is a lot easier that it sounds as you can understand but I think if I begin to focus on the positive outcomes such as being able to run a mile with my daughter and they joy that will bring her will bring more success than focusing on the need to work out daily. My goal is to flip my thinking on everything to a positive outcome rather than a to do list or a barrier to overcome. Over all this unit took my approximately 45 minutes to complete in exchange for 1 hour of credit and I think is one of the most useful units I have completed as of yet

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

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

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

Yesterday I had to attend an in-service at work regarding appropriate charting and the usefulness in using SBAR for all charting. Although this was not a certified educational unit I did find it to be good information and decided to use the information to demonstrate that although not certified, work in services can be very good places to get information which can directly be applied to practice often more so than an outside source as it is usually geared to an issue presently occurring in the facility. In Washington state as long as these in-services are kept track of as to content date and time, they are valid for inclusion in the required hours of education. The goal of our facility is to use SBAR charting for all charting including alerts and medicare charting. It is already currently the way we handle all doctor communications. If you are not familiar with SBAR charting it is about submitting information in the organized format S: situation , B: Background , A: Assessment, R: Request The difficult thing about SBAR charting is knowing exactly what goes where. The presenter (our ARNP) explained that the origination of SBAR was in Navy submarine communications. It later got adapted for medical communication. This information made things suddenly much clearer. The use of the word assessment means something entirely different in the military world than it does in the medical world. In the military world or basically anywhere else but medicine, this refers to more of a conclusion. What we refer to as assessment in SBAR terms is more of part of the background. I would always toil as to what is background and where the dividing line is to where it turns into assessment and thinking that some pieces of information belonged in both categories. This led to redundant information. After this in service my SBAR charting today was much more clear and concise and took little time and effort. As a nurse in my routine treatment I had already gathered all the information I would need now I just needed to use the simple tool to convey the information to the doctor to see what he wanted to do next. S: Situation : why are you contacting the doctor in the first place? B: Background: information leading up to concern and all assessment data A: Assessment ie conclusion: my interpretation of what I think might be going on or what might have led to or caused the situation. R: Request Do i need clarification, further tests? orders, or just FYI In some cases the A/R could be combined especially if it is just passing routine information on to the doctor although in our facility the doctors request these to be kept separately it is useful in nurses notes. Overall I found the information in this in service more useful in my immediate care than any of the certified continuing education units which goes to show that there is great usefulness in work in services even if they are not official education units.

I received further information regarding wanting to take a leave from nursing. A woman at the Washington state department of health sent me the following response: We have an inactive status for a discounted price that has been working for nurses taking a short leave of absence (3 years or less). Once you have been in inactive status for 3 years you do however need to take a refresher course in order to become active again in addition to a reactivation application. If you let your license expire during your leave of absence you have a year to renew with a late fee and after that you would have to turn in a reactivation application and the fees go up. As discussed earlier, If a person needs to take more than 3 years off their knowledge and skills would most not likely be at an acceptable level to keep up with medical advancements to treat patients. The following link : http://www.doh.wa.gov/hsqa/professions/Nursing/documents/refresher.pdf will take you to a list of available refresher courses for RN’s and LPN’s if you are interested in more information on the topic.

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

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

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

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

531 hours is just over 3 months of full time hours. I am looking into what would be required to reinstate a license if the requirement is not met if there is a medical or family situation preventing the hours from being reachable. If it is looked at from a patient standpoint would a patient feel comfortable knowing their nurse has been out of practice for three years or more with no additional requirement before returning to practice? The medical world is ever changing and advancing and it is our responsibility as nurses to keep our skills at or above basic competency. This would be difficult to do if removed completely from practice for three years. As for retiring before needing to complete the requirement, most nurses I know who have retired maintain their licenses at least for a period of time. Part of it is status for some as they have earned it and want to maintain it, part of it is to leave the possibility open for returning to work if the need arises or if retired life just gets too boring ;-) and they want to pick up a few shifts or to pad the vacation fund. If working full time you should already have the hours requirement to cover you for the next three years and would only need to complete some continuing education which you might have already if your place of employment requires in-services. It might be worth thinking about unless you are absolutely sure you are done with nursing forever!

As I was on a roll I watched another webinar. This was “Are You SAD? Shedding Light on Seasonal Affective Disorder”. The webinar was presented at a rather slow pace without much addition to the accompanying PowerPoint. It described how to differentiate seasonal affective disorder from depression expressing that both are severe as well as linking SAD with bipolar disorder and if both are inflicting a person requires a different treatment approach. Although interesting information, working in long term care at this point I don’t encounter seasonal affective disorder so I will most likely not use this in my practice in the near future though it is a good reminder to keep in mind possible need for changes in treatment when diagnosis affect people differently when another diagnosis plays part. In all I spent a little over an hour for the 1 hour of credit. I did encounter something I have not encountered before after completing the quiz. Although I was navigating within the free CEU list it led me to a page to pay $15 in order to be issued the certificate. Since being in Washington state we are not required to completed certified units but rather just keep track of educational encounters, simply listing the title and time spent would be sufficient in this case. If you would rather have a tangible piece of paper you could print the screen shot of the page showing you had passed the quiz before moving on to the survey just in case this happens but again not necessary in the state of Washington.

As is the reality of life other things have been bumped up on the priority list while my continuing education focus has been pushed to the side. Being a lifelong procrastinator this is not an unusual event for me. I think this will actually help make the experience a little more realistic as many of us are busy with life and may forget about the requirement all together until we receive the renewal notice in the mail ,causing us to need to complete the units in a relatively short period of time. I now have gotten a few of the priorities complete and am able to move this closer to the top of the list. Today I completed a once hour credit titled Taking Care of Me! The Art of Developing Healthy Habits. There were two potions for this course, a webinar which was a video taping of a lecture given, and the accompanying power point which can be reviewed in PDF form. The webinars can be a little hard to understand as it is not usually high quality equipment used for the recording but if you have difficulty just reading and absorbing this might be a good choice. There is also usually more information in the webinar version as it is common for the speaker to mildly or dramatically expand upon the PowerPoint slides. The webinar in this case was just slightly over 1 hour long so together with the short quiz at the end equates to about an hour and 15 minutes. The PowerPoint took approximately 20 minutes on its own to review. In all outside of specific statistical data, there was not a lot of new information for me. In a nutshell it stated that nursing is stressful on the mind and the body, and notoriously nurses take horrible care of themselves. The combination can lead to poor health. The time is now to take the steps to make a change which involves making a decision to change, formulating a plan, taking the first steps, and sticking to it. I found it to be more of a motivational speech rather than an educational experiencing, though considering the poor health of the majority of nurses, might be just what we need. Being the holiday season I am not sure how much of this I will realistically take to heart though it is something that has been recently discussed in our household and a plan is already to beginning to formulate so I really might refer back to this for a few pointers and reminders. In all I am sure that if I took better care of myself it would in the end allow me to be a better nurse though I don’t think this will have a direct immediate effect on my nursing.

Today I completed hour 1 of 15 of Continuing education units. I read an article on nurse.com free of cost, took a quiz which can be repeated as many times as needed to get the required 75% passing score or if you are OCD like me getting the 100% score. For the one hour of credit I spend approximately 54 minutes from the time I entered the site until my 100% was achieved and certificate made available to me. This also included several pauses to adjust the music if an annoying song came on, doing a little side task then getting back to business. The article I read was "The Power of Change". It outlined why change is necessary in the health care field and several ways to go about invoking change. Although I do not hold a managerial position at my facility, we are currently undergoing several major changes including transitioning to 12 hour shifts. It was enlightening to compare how the change is occuring with the different approaches outlined in the article. I was reminded of the importance of change no matter how much we resist and the most powerful statement at the end read "Nurses who work in today’s healthcare environment must view change as a part of life and seek ways to become involved in the process. As the largest healthcare profession, nurses make the healthcare system run — and many nurses have great ideas about how to make healthcare organizations run better. By continuing to learn more about change and how to make it happen, nurses are in a key position to help the goals of a new administration become a reality." Change is going to happen regardless so we might as well hop on board and help with the process. Although this article did bring insight to my current situation I am not sure how it is going to affect my overall practice. If nothing else hopefully I will remember to accept change as it comes and not be afraid to speak up and help if I see a change that can be made for the benefit of the patients and facility.

Some say why continuing education? I have been doing this job for years and never needed it before; it’s a waste of my time. Is it? I am a big believer that I learn something new every day whether I try to or not. The medical field is ever changing and as nurses we should naturally want to keep up. To put it in perspective let’s look at other professions where as consumers we value keeping up with the times. What if a mechanic relied only on their professional education received 20 years ago? How would your brand new 2011 hybrid fare against the skills learned to work on a 1990 Chevrolet? How about computer repair and the advances made their in the last 20 years? A tech with no advancement would be baffled at the usb drive and still looking for the floppy drive. Those are just things that we can technically live without yet we expect top quality service with current information and technology to get us back on the highway be it the interstate or the information highway. We should be eager and willing to want to keep up with the times and learn about new treatments, assessment techniques, and disease pathophysiology to best treat our patients. http://www.nursingworld.com discusses the topic of continuing education and lists the following: The Code for Nurses (ANA, 1985) outlined nurses' ethical responsibilities. Several of the statements directly relate to all nurses' responsibility to maintain professional knowledge and competence in their practice: Plank 4 - The nurse assumes responsibility and accountability for individual nursing judgments and actions. Plank 5 - The nurse maintains competence in nursing. Plank 6 - The nurse exercises informed judgment and individual competence and qualifications as criteria. Plank 7 - The nurse participates in activities that contribute to ongoing development of the profession's body of knowledge. (p. 1) To be a good competent nurse we must strive to continually educate ourselves. It matters not whether it is formal education or reading on our own via professional magazines, book or the internet as long as we continue to grow in our knowledge and understanding as medicine advances. If we examine our personal practices I am sure most of us probably far exceed the continuing education requirements and it’s a matter of paying attention and logging. 15 hours a year is a little more than an hour a month. I and most other nurses I know spend at least an hour a week researching a new medication, treatment, or symptom relating to a patient. If you like I prefer to gain formal hours of education in addition to fulfilling the day to day needs of patients there are many ways to go about it. On the large scale there is the possibility of pursuing a higher degree or certification in a specialty. Price and time might be an issue for many making it an unfeasible option. Several hospitals in your area might offer workshops after which a continuing education certificate will be issued. These may range from a one to two hour session or an all day seven or eight hour session getting you half way to your annual goal in one day. There are also many options from home to completing certified education units. Professional nursing magazines provide articles to be read with a quiz to follow to be mailed in with a fee following which a certificate of hours will be issued. At $20 - $30 or more an hour this can get pricey quickly. There are webinars available anywhere to free or for a cost where you watch an online presentation for CEU’s. Being a member to online nursing communities such as the ANA will sometimes present free webinar options. My personal choice of CEU’s is reading articles of interest online and submitting a quick quiz then immediatiely receiving a certificate of completion of CEU’s. There are websites such as http://www.nursingcenter.com/prodev/ce_online.asp where for $34.95 a year you can complete up to 100 hours of your choice of CEU’s. Personally I prefer to go the free route. A Google search of free continuing education for nurses leads to a variety of choices. I regularly use nurse.com. Under the education tab click on self-study CE courses and you will see a long list of options on the left hand side. Click on View Free CE Courses and you will see several hundred possibilities divided by specialty or area of interest. The positive to this site besides being free is that upon completion you can instantly print your certificate and the website keeps track of your units completed in case you misplace your documents. If you are a motivated self learner with basic computer skills this for many is the best option. Free, no time constraints, and able to be tailored to personal needs and interests. In the next few weeks I will be personally completing 15 hours from nurse.com to demonstrate the ease of the site, quality of information presented, and how I feel it applies to my nursing practice. If I have this requirement anyway why not make sure I use it to truly make me a better more informed nurse. Again feel free to follow along, comment, or ask questions as I continue along in this journey.

According to the department of health the goal for the new education and active nursing hours requirement is to “assure nurses stay current on the knowledge and skills of their nursing practice.” (doh, 2011). As of January 2011 all licensed practical nurses and registered nurses will be required to keep records to verify compliance to be presented upon request through random audits. In a three year period it is required to have completed 531 hours of active nursing practice. This can be in a professional paid or volunteer capacity. The requirement only states that it must be performing duties required of licensed personnel. In addition to hours of practice, the nurse must demonstrate continuing education equal to 45 hours over a three year look back period. These requirements can be completed in three years cumulatively or in one year. If it is spread over three years then the requirement would be equivalent of 177 hours of practice and 15 hours of continuing education annually. In discussing the requirements with others 177 hours of practice has only been an issue for new grads trying to break into a tough job market. The continuing education hours seems to be the greatest source of stress and therefore will be my focus. Continuing education as required by Washington state is not as strict as some states or one would initially think. Formal education or certified education units are not necessary for the requirement. Listed possible sources do include these options though also include minutes from a staff meeting where nursing topics were discussed, independent study of a nursing topic, presentation of a nursing topic as long as it is verified by the presenter whom does not have to be certified as a CEU provider. To break it down as long as you are “gaining nursing knowledge” and verify your participation then it is acceptable. This can be as simple as encountering a new diagnosis at work so you go home and spend two hours researching the diagnosis to learn more about it. Simply record what resources you used to research the topic and that you spent two hours on it and the date and that is acceptable. Subscribe to a nursing magazine and document the articles read that enrich your practice and how long it took to read them, or attend in services or brown bag sessions at your place of employment requesting a signature of attendance at the end. Often in basic day to day life as a nurse we are completing more than 15 hours a year just being the inquisitive nurses that we naturally are or through basic in service requirements at places of employment. The habit of keeping an accurate log of these educational experiences is of utmost importance. For specific regulations concerning continuing education you can review the following : http://www.doh.wa.gov/hsqa/Professions/Nursing/documents/draftwac.pdf more information to come, feel free to follow, comment or ask questions, in fact please do! Kara:nurse: