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  1. dianah

    Nurse Massage Therapists

    Overview The worldwide web is brimming with articles about nurses who have combined the two disciplines of nursing and massage therapy into a viable and complementary client-centered practice. Nurse Massage Therapy is a sub-set of Holistic Nursing. It seems to be a perfect marriage for those who are drawn into nursing initially by the desire to help decrease suffering and effect positive changes in patient health and comfort. Nurses can utilize skills of patient assessment in obtaining a history of the client's problem and in formulating a plan of care. Massage therapy involves therapeutic touch and manipulation of muscles and soft tissues of the body. Studies have shown therapeutic massage will positively affect physiologic and chemical changes in the body that can lessen pain (acute or chronic), lower blood pressure, decrease anxiety and help manage stress. It is a physically demanding occupation, and repetitive stress injuries may occur. As massage therapists work by appointment, they may experience a greater sense of control over their lives by being able to schedule their own work hours. Reports indicate a high rate of job satisfaction, using skills that produce positive outcomes. Nurse massage therapists must possess strong interpersonal communication skills, good decision-making in interviewing clients and then choosing techniques for each one's needs and tolerance, good business acumen, physical stamina and strength as well as dexterity. Some may choose to expand their area of influence and undertake teaching in schools of massage therapy. Massage therapists may start their career working part-time, until networking and exposure help them build a steady, word-of-mouth client base. Membership in professional organizations may increase the Nurse's potential for contacts thus increasing the likelihood for steady work. Practice Settings The majority of massage therapists are self-employed. This is a different work environment and focus than most nurses' work environment, that of being employed by a facility (whether hospital, LTC center, outpatient clinic or office). Often, preconceived ideas and deeply-ingrained reluctance to market one's self and skills must be overcome in order to establish a clientele. The following are not all-inclusive work settings. spas fitness centers and health clubs hospitals and nursing homes mobile massage shopping malls client's homes cruise ships independent nurse entrepreneur pain management clinics A Few Specialty Areas aromatherapy pain management nurse coach sports massage stress management therapeutic touch Ensuring Massage Therapy Standards Nurses who practice massage therapy must stay abreast of changes and rules/regulations regarding their practice in order to stay current on legal issues. Nurses have the obligation to review their individual State Boards' Nurse Practice Acts (NPA) to determine if the practice of Nurse Massage Therapy and/or Holistic Nursing is legally approved. If your practice does not fit within the definition and scope of practice for an RN in your state, you may be in violation of the NPA. Example: Texas BON: 15.23 The Use of Complementary Modalities by the LVN or RN The Federation of State Massage Therapy Boards (FSMTB) Ensures that the practice of massage therapy is provided to the public in a safe and effective manner. This entity strives to improve massage therapy education and licensure. The American Holistic Nurses Association (AHNA): Nurse Practice Act (NPA) Analysis Summary December 2019 In 2019, this association conducted a state-by-state analysis of Nurse Practice Acts in U.S. Boards of Nursing (BON) in all 50 states and six jurisdictions, including Washington, DC., that referenced or addressed holistic nursing, holism, and/or complementary alternative modalities or integrative therapies within the scope of practice of licensed Registered Nurses. Education The Licensed Practical/Vocational Nurse and Registered Nurse can legally practice Nurse Massage Therapy as defined by their NPA. Graduate from accredited RN or LPN/LVN nursing program Successfully pass respective NCLEX examinations Current, unencumbered RN or LPN/LVN license in U.S. state of practice NOTE: Standards and requirements vary by state and locality. Exams, Certificate Programs, Certifications (not all-inclusive) Nurse Massage Therapists may be either licensed or board-certified. Local ordinances may require a business license as well as massage therapy license or certification. Passing a state exam may be required for licensure or one may apply to take nationally recognized tests. Massage and Bodywork Licensing Exam (MBLEx) from the Federation of State Massage Therapy Boards (FSMTB) American Massage Therapy Association (AMTA) Sports Massage Specialty Certificate Program Certification Exam for Therapeutic Massage and Bodywork, through the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) The American Holistic Nurses Credentialing Corporation (AHNCC) offers the Holistic Nurse and Nurse Coach certification. Salary (2019-2020) According to the U.S. Bureau of Labor Statistics (BLS), the median annual wage for massage therapists is $42,820. According to PayScale, the hourly rate for a board-certified holistic RN is $37.65. Job Outlook According to the U.S. Bureau of Labor Statistics (BLS), the need for massage therapists is projected to increase by 21% through 2019-2029. Choosing a Specialty but not sure which one is best for you? Download Nursing Specialties Guide!
  2. Nurse Beth

    8 Work From Home Jobs

    In my career advice column, Ask Nurse Beth, I am asked so often about job opportunities away from the bedside, and just as often how to work from home. Why do nurses quit the bedside? There are so many reasons for leaving the bedside. Some nurses face age discrimination. Others have lost their passion and need a new start. With an emphasis on proactively managing health and improving outcomes, more opportunities are being created that use nurse's knowledge and skills. At some point, many of us dream of working from home. Picture yourself coffee cup in hand, slipper or flip flops on your feet, with your dog or cat nearby. Sounds great? Working from home is perfectly suited for the individual who enjoys minimal supervision. Most remote jobs require two to three years of clinical practice experience and MS Office skills such as Word and Excel (easily learned). First, identify your skills and what you're looking for in a job. Do you enjoy detail and digging deep to audit charts? Would you enjoy coaching and talking to patients on the phone, educating and coordinating? Here are some promising jobs for the nurse who wants to work from home. Note: Sometimes "work at home" jobs actually mean "based from home" with travel required. Sometimes work at home is allowed after working on-site for a time, such as a year. Telephonic Nursing/Nurse Hotline/Nurse Advice Line Telephonic nursing includes telephone triage where you'll provide health care guidance, support, and referrals for members. You help members decide if they need to go to an ED, or a provider's office, or manage their concerns at home. Case Manager Case Managers cover a range of jobs and responsibilities that vary from employer to employer. Essentially, Case Managers coordinate and collaborate to provide services across the continuum of care, using available resources to promote quality cost- effective outcomes. There is a ton of good advice on the Case Management forum . Some jobs require certification. Here's how to get Commission for Case Manager Certification (CCMC) Certified. Eligibility requires a minimum of one year of case management experience, but does open more doors. Case Reviewers Case Reviewers review and abstract medical record data. Case reviewers may include Quality Reviewer, Field Nurse Case Workers, and Worker's Comp. Reviewers. Medical Claims Review Medical Claims Reviewers evaluate adults with chronic illness or disability to determine the level of care and eligibility for services. Often these are Medicare related, such as determining eligibility for Medicare Part B. Closely related is Clinical Appeals, where the nurse evaluates documentation used to approve or deny claims. Wellness Coach/Care Coach Wellness Coaches are hired to contact and coach individuals to help them meet their insurance plan's wellness goals. For example, an overweight individual may be called once a month by the coach and in this way held accountable. You assist members in navigating the healthcare system and help them move towards better health and wellness which assists in preventing hospital and ER visits. Clinical Documentation Improvement (CDI) Specialist This is a rapidly growing field. The CDI Specialist is a liaison between providers who enter orders and coders. The CDI Specialist reviews and evaluates clinical records to determine accuracy and integrity of coding outcome versus clinical documentation and compliance with coding regulations and guidelines. You would use your knowledge of clinical documentation to make sure the coding accurately reflects the clinical episode of care and conforms to regulatory requirements. Online Nursing Faculty The distance nurse instructor facilitates online discussions and evaluates student performance. Depending on the program, this may require a graduate degree. Good for the nurse who loves teaching. Prior Authorization RN The Prior Authorization nurse performs medical necessity reviews for services that require prior authorization utilizing specific criteria. She/he collaborates with treating physicians and other healthcare professionals to gather necessary information needed to review the requested services. Use Job Search Engines Register with a job search engine such as Indeed and set your filters for "work at home" Other search keywords are "remote", "telecommute" and "distance online faculty". Start reading the different jobs available to see what's out there and what interests you. Companies That Offer Work at Home Jobs Aside from using job search engines, search companies sites for listings. Here are just a few large companies known to offer work from home jobs: Aetna, Anthem, AxisPoint, Medtronic, Cigna, CVS, Humana, McKesson, UnitedHealth Group Self-Employed Then there are those of us who are self-employed or have side hustles, like the nurse writers. Be sure and check out the Nurse Entrepreneurs/Innovators Hub for our inspiring stories! Here's mine: How I Became a Nurse Author and Wrote a Book! Best wishes on finding your dream job working from home.
  3. Starting the world of freelance writing can be overwhelming. When you land your first client, you are alone in the celebration if you are not a part of a community. As you continue to gain clients, you may feel disorganized, and a constant overwhelm. How Writers Can Stay Organized STEP 1 Start with a space and a computer When starting your journey as a freelance writer, I urge you to start with a quiet space and a computer. A quiet space gives you a place to become inspired, and within the space, your mind will know it is time to work. The traveling laptop is tough because you don't have a place to keep it. Try to create a space, even if it is a corner desk in a room. This will keep your mindset as work. STEP 2 Organize with Google Drive I recommend to organize your clients and projects with Google Drive. I have tried a variety of tools like Dropbox, Asana, Trello, and I keep going back to Google Drive. It has the capacity to hold a lot of projects and information, so you don't run out of space. The number one reason I like it is because it is accessible on any device. I can go to the library computer and work on a project, or switch from my Ipad to my laptop. It is very convenient, and best of all, it's free! TIP: Google Drive is capable to create folders for different clients or projects, as well as the ability to save documents as Word docs or PDF files. You can also make presentations on Google Slides, surveys with Google Forms, and spreadsheets with Google Sheets. The possibilities are endless! STEP 3 Planner to PLAN My blog over at WriteRN.net is where I give a very detailed review of my favorite planner called the Passion Planner. I started with a simple calendar and moved it to a larger notebook. For 2018, I am using the Passion Planner. I chose this planner for a few reasons: There is an option for Eco-friendly (woo hoo) It helps me with my goal setting and actions I am a huge believer that those who create and carry out small goals, do better in their businesses. I believe this because --- I have seen it. I see it all around the Web, in different niches of small business. STEP 4 Ideal Work Week Have you heard of the Ideal Work Week? One of my influencers I follow, Jenna Kutcher, has a whole podcast dedicated to it. You might be thinking, "Sure, Janine. An ideal work week with a nurse job and my family, sure..." All I can tell you is try it. What you do is plug-in the days you work, then plug-in some client time. We know our 12-hour shifts are far from 12 hours, so I plug-in an hour or so in the morning for my client work. You may put exercise or sleeping in that column. Then, your days off, you make it work as a writer. For example, my Tuesdays are often after a stretch of 3 shifts in a row (my required weekend and a Monday). I know on Tuesdays, I can only handle some one-on-one coaching calls with nurses who want to become writers and a catch-up day with email and phone calls. Beyond that, I have dedicated catch up days for my home. I live in a home of 2 boys, a husband, and a Great Dane. There is always cleaning needed on Tuesdays, as well as the laundry catch-up and grocery shopping. On the other hand, Thursdays, I am usually off work and can really dig in on my client work. I set aside a lot of time on those days to dig into my work. If you want more information on how to set up your Ideal Work Week, visit my blog where I can take you step by step in an upcoming article. Or, reach out and chat with me. I love helping others become more productive. STEP 5 Mind Mapping Mind mapping is a technique I recently adapted for my organization and prioritizing. At first, I saw mind mapping as a chaotic visual tool and it made me anxious when I looked at it -- until I did it. Mind mapping helps you achieve goals and therefore keeps you organized in your thinking. How to Mind-map: Write your goal in the center of the paper Branch off the center and write the steps and tasks you must take to complete your goal Make those steps actionable and specific Write those tasks into your weekly/monthly layout. STEP 6 Accountability with Community A sense of community is a necessity to keep you in check as a writer. The benefits of becoming organized as a freelance writer are to keep achieving our freelancing goals. To become accountable for staying organized and achieving your goals is to join a community. I have made huge leaps in my business with being part of a community because they keep me accountable and motivate me to take my business upwards! The online world is enormous. It can be overwhelming when you are disorganized. Try these tips and keep yourself accountable by joining our writing community on Facebook called the Healthcare Writers Network. It is a community of like minded individuals that help everyone succeed in their writing endeavors.
  4. Becoming a Nurse Blogger I love writing, and a little over a year ago, on a whim, I started a nursing blog. Starting a blog using Wordpress could not be easier. There are tons of guides and tutorials on the web, and it's fairly intuitive. One of the early posts on my blog nursecode.com was "Traits of an ED Nurse" with 111,285 views to date and recently "8 Things to Say When Your Patient Dies" has gone viral on Pinterest. What I've found is that when you write from your experience and your heart, it resonates with readers. Nurses have unique, compelling stories that people love to read. But...nurse bloggers need an audience! Without an audience, the best material goes unread. So....how do you get your material out there? The best exposure for me has been writing for Allnurses.com because of the sheer numbers. Allnurses.com gave me an audience of pretty much one million readers. Hands-down, Allnurses is the largest nursing online forum on the planet. Just the other day, I was talking with a nurse in my hospital from the Philippines who said she was an Allnurses.com follower back in Manila who had read my articles. I felt very grateful, globally connected and... humbled. Affiliate Programs Blogging affords potential income. There are many ways to make money from a blog. One way is to become an affiliate with a company, such as Amazon. It works on commission. You post an image or ad that links to the affiliate's site (Amazon). If the reader clicks through and makes a purchase, Amazon is able to track that the reader came from your site. The great thing is, if a reader clicks on an ad for a stethoscope, for example, and does not purchase the stethoscope, but goes on to purchase anything at all...you still earn commission for everything purchased during that encounter. I am not particularly aggressive about monetizing my site, but even so, over December, I earned $488.00 from Amazon in this way. It's called passive income because it's income you you make without any action on your part- I like to say while sleeping. Some bloggers do quite well, especially those who are patient and realize that it takes time to build traffic to your site. Sponsored Posts Sponsored posts are when a company asks you to write an article for them at an agreed upon price on your site. An example could be a staffing agency. The benefit for the staffing agency is exposure to your readers and a link back to their site. This is similar to a paid product review. Nurse bloggers can be asked to review and/or endorse compression socks, stethoscopes, nursing apps and more. Indirect Monetary Benefits Exposure may be the best benefit of blogging. Blogging provides a platform and Allnurses provides exposure. Exposure brings recognition and opportunity. Within a short amount of time of starting my blog, I was offered a (paying) job blogging for bsntomsn.org where I am now their official nursing site blogger. I also write for other blogs on request. My charge per article has quadrupled in the past 18 months. I am regularly approached to do (paid) product reviews, guest blogging, endorsements, interviews, and speaking engagements at national nursing conferences. Networking and Making Friends I have connected with and met so many other inspiring nurses entrepreneurs. When you blog, you join a tribe of like-minded nurses. Blogging Gives You a Voice I did not start blogging to make money at all. In fact, I would say it should not be the primary reason or motivation. The fact that I have made a little bit of income is a nice benefit that I never expected. I started blogging to have a voice. I believe that as nurses, we need to get our voices out there. I am passionate about working conditions, nurse-patient ratios, supporting new grads, and so much more. My husband Bob, who used to write a business column, smiled at me when I started my new hobby and warned: "It's lots of fun, but the time will come when you run out of things to write about." That was about 200 articles ago, and I like to tease him about that. It just hasn't happened. I don't run out of ideas-I do run out of time. Have you considered blogging? If you have, it's probably because you have a passion and talent. What are you thinking? If your heart is beating faster in excitement, I'd say... you're a blogger! Maybe you're already blogging. I'd be happy to help you on your journey. Leave a comment or your questions.
  5. sirI

    Foot Care Nursing

    The Foot Care Nurse (LPN/LVN and RN) Licensed Practical/Vocational Nurses (LPN/LVN) as well as Registered Nurses (RN) work in this specialty area. The "diabetic foot" seems to be the most common cause of foot issues that can, if left ignored/untreated, lead to full amputation of the foot itself as well as the leg. Pain, numbness, and lack of sensation in the feet and legs will most often be symptoms of diabetic neuropathy. The Foot Care Nurse must be proficient in the anatomy of the foot and lower extremities as well as in the recognition of significant pathological changes that are suggestive of a disease process. There are many individuals, non-nurses, who are interested in feet and who like to use their technical skills to relieve pain (through foot massage/pedicure). They truly take this seriously and seek formal education/certification as foot care specialists. Many individuals work as cosmetologists and utilize in their jobs, manicures and pedicures, foot massages, and foot soaks. Often, these individuals decide they want to be a Nurse and combine their love of "beautification" (the feet/hands) and find out there actually is formal education/certification they can enter into to specialize as Foot Care Specialists. What Does a Foot Care Nurse Do? (not all-inclusive) Callous and/or corn removal Toenail trimming Assess lower extremities and the feet for: Cuts Suspicious moles Fungal infections Circulatory changes (color, temperature, pain, edema) Other pathology Foot massage Patient education Implement patient plan of care to include: preventative care and treatment foot hygiene as needed physician referral Assessment Tools When dealing with the feet, the use of standardized assessment tools is very valuable to calculate the extent of loss of sensation. A full inspection of the foot is made for: color sensation temperature differences callouses edema opens wounds necrotic areas nail shape, color, texture evidence of fungus The sensation of the foot is checked with a variety of instruments. One of the most simple instruments utilized is the monofilament. There are a variety of sizes that can reveal instantaneous results offering insight regarding how advanced the loss of sensation is. The nurse can use the results to guide in the decision to advise physician referral and/or further diagnostic testing. Education Foot Care nurses can be LPN/LVNs, RNs, or Nurse Practitioners (NP) in mid-level provider roles. Graduate from an accredited Practical Nurse or Registered Nurse nursing program LPN/LVN: certificate, diploma, degree RN: diploma, ADN, BSN, MSN, or higher degree The NP must be a graduate from an accredited Advanced Practice nursing program. Degree: MSN and/or DNP Successfully pass the NCLEX-PN or NCLEX-RN Current, unencumbered LPN/LVN, RN, or NP license (and NP specialty certification) in U.S. state of practice Foot Care Nurse Certifications / Associations Wound, Ostomy and Continence Nursing Certification Board The Wound, Ostomy and Continence Nursing Certification Board (WOCNCB) offers the Certified Foot Care Nurse (CFCN) certification. Eligibility (not all-inclusive) BSN, or higher Successfully pass NCLEX-RN Current, unencumbered RN license in U.S. state of practice 24 CE/CME credits (contact hours) specific to foot care 40 clinical hours (direct supervision of foot care expert) American Foot Care Nurses Association (AFCNA) The American Foot Care Nurses Association (AFCNA) offers the Certified Foot Care Specialist (CFCS) examination.* Eligibility (not all-inclusive) Complete at least 25 CEs in programs directly related to Foot Care completed within the 24 month period prior to application Complete 20 hours of direct hands-on foot care with qualified Proctor within the 24-month period prior to application Current, unencumbered LPN/LVN, RN or NP license in U.S. state of practice *Nurses who have received the designation CFCN through the WOCNCB will be awarded reciprocal certification. Canadian Association of Foot Care Nurses (CAFCN) The Canadian Association of Foot Care Nurses (CAFCN) is a great source for those interested in this specialty area of nursing. Their mission is to "advance the practice of foot care through a collaborative and networking process for all individuals providing foot care". Salary (2020) According to indeed.com, the average RN salary is $36.40 per hour.