Summer Nursing Trends

The summer is here and summer sunburns, heatstrokes, and poolside accidents will be filling up urgent care centers very soon. People who usually have no experience being patients start to have all kinds of unusual scrapes and need urgent care and referral appointments at an alarming rate. This, and the heat and healthcare insurance contingencies can make managing a nursing work week challenging. The Emergency Room staff and associated referral specialists will growing their practice at the same time they are trying to go on vacation. Travelers will want healthcare in places they never came to ask for services before.

Medical Providers of all types should be ready for sudden increases in full schedules. Patients may have not been seen for months may suddenly have new conditions and medical problems created by the heat. Many diseases and health problems tend to emerge when recreational activities and unusual sports and trips make new kinds of injury risks proximate. And aging people are still trying to do things they never had a problem with before.

   Seniors living alone can have especial  health risks in summer heat if they do not have a functional living environment with proper ventilation, HVAC, and hygiene standards. They may try to drive when they are tired or suffering from heatstroke. Seniors may be too impatient or forgetful to take necessary medications, causing blackouts, faintness, chest pains, and the like. Blood pressure due to excitement, drinking, indulgence in recreational medication or drugs can turn a family event into a midnight trip to Urgent Care. Emergency Rooms see a lot of unusual things during the summer, when the heat can overwhelm good judgment and put personal safety and health regimens at risk.

A variety of nursing opportunities will be heating up here and around the world. Summer means travel, and travel for many people with physical disabilities or medical conditions means an opportunity to go somewhere new and stretch their tourist dollars. And many families who have spent a lot of time looking after a relative or patient at home must make other arrangements. This is a good time to engage a part-time gig that fills in the time between regular nursing scheduled hours.

When the summer starts, family and business responsibilities fade. Home health nurses and career nurses can change their schedules to match the needs of others, and this occurs just as many student programs end. A lot of new hires sudenly come a cheaper hiring option for many career nurses. The drop in hours can be made up with private working assignments in the field. The staff roster of many a hospital and long-term care facility will start to change every week. Soon a regular nursing schedule begins to look like a checkerboard, with vacation days, medical appointments, special occasions and personal days across the staff calendar.

This leaves hospitals, nursing homes, and teaching clinics empty of staff and but needing faculty to service patients and intake volumes throughout the summer. The progression of many nurses to new jobs, new places of residence, and new coursework can rearrange even the most stable group of staff nurses. These are the highs and lows of the occupational field of nursing. Highly capable and skilled nurses should scan the job listings and keep abreast of new opportunities in the nursing world.

The high volume areas for new hires in summer nursing positions are hospital emergency rooms near beaches, resorts, scheduled athletic events, and places where a given sports recreation area holds regular events. This type of place is where the bulk of intakes from one event can fill the E.R. locally and back up into nearby clinics. And there are urban areas where one car crash an hour can fill an entire local Emergency Room with victims.

These days, emergency can occur anywhere and any time. Incidents make a neighborhood hospital anywhere the subject of national scrutiny. preparedness is the watchword. Metropolitan areas will need emergency room staff specialists, phlebotomists, nursing attendants, dialysis and feeding-tube techicians in great volume. These nurse staffing volumes are the ones that demand critical care staff as well as secondary staff, like nursing attendant and RN specialists for best quality in  continuing patient care.

New student nurses come to the end of their labors in June. Before the new grad rush starts, it may be helpful to solicit referrals from professors or instructors. Their experience with your skills can open doors. The nursing community sees ritual posting of job ads come the end of summer from all over the country for this reason. Many facilities look over thenew crop for skills and personalities that fit their vacancies. But in asking the staff present of these hospitals the question of whether or not there is a permanent vacancy or the temporary space needs filled can be a riddle.

No nurse, especially one new to the field wants to play hospcotch in the critical early years of their career. But summer work opportunities can fill out a resume, even if they are at the intern or junior assistant nurse level. Longevity in certain key positions can  lead to enhanced responsibilities and advanced pay grade status.













Slackers: The Ethical Divide of Nursing

The ethical divide between professional nurses with morals and accountability, and the others, becomes clear just as soon as a newly qualified student nurse becomes a professional. As in many occupations, nursing has its share of sour apples. And, as in many professions, some employees work to find a way around the system. Some nurses commit timekeeping violations. Others goof off and text on the job. Some chat too much with other workers, ignoring monitoring and auditing tasks. Slackers send a message that nursing is not serious business.
Sooner or later many nurses developed a career path. Many nurses begin with small slips, like writing inaccurate representations of events to favor their colleagues. And some others gang up on certain patients, to teach them a lesson. it’s human nature in some people to become predators against others and take advantage, but better nurses withstand the temptation to abuse those vulnerable and in their care.
Many times advisors and instructors will stress the importance of contacts within the industry and joining new network of friends. But this can backfire. Nurses cherish the bonds of friendship between each other, and sometimes too much. Would a friend ask you to risk your license putting false paperwork into a patient’s chart? Would you report a friend who removed records from the chart and shredded them? Would you realize if a future supervisor didn’t hire you because they remembered the deeds of a nurse clique or “posse’ you used to be with in the past? Being able to choose the company you keep may be the last true luxury nurses have. You may pay a price in the future for fun times today.
Nurses starting their first job take their license as proof they have studied hard, mastered all materials, and learned the necessary techniques and skills to provide positive and meaningful care to benefit all patients. Yet after a while, newly licensed nurses will start to notice something. Not all nurses share their same commitment. Some are lazy, some never finish the job right, and some just find ways to do things that are sloppy and incomplete. Every nurse must find the way they choose to deal with this.
Some nurses view a nursing job as a part time paycheck an avenue to another career. They want to be an actor, or an artists, or even have another job. Maybe they found their way to nursing through family connections and it didn’t seem all that hard to do. But they really don’t like the work, and they don’t mind if it shows. These nurses use their phone a lot when they are supposed to be working, and spend a lot of work time goofing around, looking at take-out menus or chatting with vendors and providers who come by to visit. But the medical world does not smile on this kind of slacking.
This kind of nonchalance leads to many nursing errors, such as too much or missing medication, skipped insulin doses, erratic chart-keeping, and missed shifts due to inability to copy the schedule. These type of employees perhaps showed more promise once upon a time. And many facilities can‘t afford to let such nurses go because a shortage of qualified and experienced nurses keeps them reliant on current staff. They arrive at work and hang out, looking for ways to skip the work and get coffee, hide in closets and rooms to talk to others, and just hang around.
Usually for nurses like these, the big attraction to coming to work is to socialize with the people working there. This can be a problem, because the bonds between nursing co-workers should not be more important than the professional commitment as a provider. Often, many nurses can prey upon the weaknesses of others. They can use peer pressure to cause one nurse to treat a certain patient or even a co-worker nurse badly or with disrespect. This is slacker peer pressure.
Yet so many nurses convince themselves that coming to work late doesn’t matter, that calling in sick for entertainment and social reasons doesn’t help co-workers, and that unclocked breaks just don’t really count as infringements. These types of nurses can contribute to an entire downturn in morale, because nurses working hard observe their peers slipping by with doing much less. Why should work hard, a nurse might say to themselves, when if ‘so and so” was here, they would just watch the clock until the small hand clicked at the top?
Sadly, many types of people use nursing to abuse the system. The steal medications, overcharge insurance companies, send false bills, and sign invoices for amounts of supplies much larger than what was actually used. Nurses may not realize that when they are asked to sign a bunch of audits, or when other staff convince them to sign many orders the did not witness or to even file papers in the chart that are not legitimate, they are risking their license. And showing new nurses whom to trust on the job is not something you can teach in a textbook.
Insurance fraud usually starts in small to medium sized businesses where slacking off and discovery of errors puts some people at a disadvantage. A nurse who has noticed a serious error made by one of their co-workers can choose to report it, or instead leverage this information for better shifts, a raise, or even a promotion. Nurses should be vigilant to review their state nursing board website and keep updated on the regulations governing their license. Maybe some employees notice that an employee takes off work an hour early every day their manager is not in the office. A new nurse trainee observes that not every staff member has t clock in and out per timekeeping regulations. Maybe they notice that the physical therapy staff bill for more sessions with their patient clients that actually occurred. Any omission of reporting such things can build a situation where nobody has ethics and finally some incident brings the whole situation to light. And at that point, nobody is a winner.
Many slacker nurses or people who are just too burned out to care adopt a philosophy of “say nothing, do nothing” at work. They think this keeps them free from blame when situations arise on the job for nurses to commit dishonest acts or abuse patients. When the nursing employees have this many compromising issues on the job, the patient care comes second. Soon, going to work in really a tripwire into unethical behavior that could lose them their job, let alone their license. And many nurses later confess to horrible infringements of patient rights simply because they got strong-armed on the job from the director of nursing or the administrator.
It is so much easier, in nursing, just to keep a clean slate and make sure that the nurses you choose to associate with are the one most admired and emulated by all. The nurses with authority are the ones who should provide a leadership example for everyone. As a new nurse, any nurse who questions why a felow employee is performing a certain action or declaring certain statements or giving orders, should be vocal to their superiors about just what is going on. Just the knowledge that one person had noticed this might be enough to form a correction plan and sever “bad apples” from a healthy tree.

Handling Patient Visitors

Until you see the light in a patient’s eye, when their relatives come, how their face lights up, you just haven’t lived. The sum total of life is right there. The programmatic dynamic of parents raising children is reversed. The residents (parents) now received the care from visitors (children). It is a singular statement in every individual patient’s case what kind of care they get from family members. Just as people look the other way in a community when children are abused, a low-level nursing home gathers the neglected ones together. It takes a compassionate care nurse approach to make sure patients don’t feel neglected or overwhelmed.

Nurses in any pay range should report any examples of abuse to their nursing manager or as an anonymous complaint to the regional ombudsman. The County Health Facilities Director may also take an anonymous complaint alleging abuse. Nurses in acute care and skilled nursing should counseled to look out for signs and symptoms of abuse and should make an assessment in the chart accordingly. If patients should complain of missed medications, pain, unusual symptoms or worries concerning their care, the charge nurse should be notified.

The sliding scale of who and what family members come to visit is one nurses will become familiar with. Some visitors only show up once a year, on birthdays or anniversaries. Some people bring the whole family, and it can be overwhelming for a recovering patient or fragile resident. Sometimes visitors bring children or babies to encourage the older resident or family member to enjoy the family life absent in a skilled nursing facility or acute care hospital.

Nurses should make sure visitors should wash their hands before skin or physical contact with the patient, administer or deliver no medications or narcotics, and otherwise observe infection control best practices at all times in and around the patient‘s room and bathroom. Visitors and family, friends and relatives may not realize that resident of a skilled nursing facility or patients in acute care are extra vulnerable to viruses, colds, and other communicable diseases. Diabetic patients should be discouraged from overdoing it indulging on special “treats’ that can harm their health and change their blood sugar and cause a crisis.

Others come every weekend, and bring things or even help with the physical care and chores of a nursing home patient. usually, among nurses, this will reflect the status of a patient’s relationship to the visitor. Nurses should be vigilant if a patient shows a marked dejection after certain visitors come, or a tendency to depression after no visitors come. Such patients should be redirected to group activities or have the activities director contact relatives and suggest a family visit.

While financially the nurses know and differentiate between cash-pay residents and Medicaid or Medicare recipients, technically there should be no cognizance of the patient’s status when treating them or attending their bedside needs. health care should be available to everyone regardless of the ability to pay. By seeing the way the patients are treated, some nurses also differentiate between patients who receive visits and those who do not. This can be an unfair but persistent bias.

There is one simple rule for this: the family members and visitors of a nursing home patient will track neglect or have conversations with the patients where criticisms or reports might reach the ears of others. It is essential in some cases to keep frequent visitors’ parents (patients) well cared for, as the family member will appear at any time all day, or stay during significant parts of the day during one single shifts. That one family member will not see the effort the nurses put forth for the rest of the shift for the rest of the floor, but they can make enough noise t bother the managers and owners of the facility for months.

It is hard to watch a CNA or LVN favor a patient or set of patients whose relatives frequently visit, while the ones who need contact and pepping up most fall to the end of the range. One can watch a single nurse neglect a patient’s bed, person, or dignity outright, and hustle to the next room to cascade attention and caregiving on the least in need patient in the place. But this is what happens when nurse managers do not periodically refresh the training and motivation of nursing staff.

Any nursing home patient that has a visit from a relative or friend, social worker or investigator from the county health department, must have them sign in to the visitor’s register. there is usually a physician’s room or private area where an investigator can conduct I interviews or research charts. Additionally, medical records staff will make themselves available t assure any visitor they receive the most assistance possible.

The Changing Vision of Nursing

†Today nurses face challenges in the nursing world their predecessors never did. The slightest mistake can end up on YouTube. A crotchety patient might become a vexatious litigant. And worst of all, you could make a career ending mistake.

Newly licensed LVN nurses and RN nurses can safeguard their careers by following the best practices of their facility and the standard operating procedure of conventional nurses.For nurses to stay ethical and keep their noses clean, vigilance and propriety are necessary.

Good manners toward patients is the best practice. But for peers and other staff as well. Managers can appreciate the benefit of a new hire who is a good example. The spectrum of nursing careers can always include a nurse who is polished,perfect, and professional.

The stereotype of s nurse can be from a TV show or from examples people see over time. A paunchy, chain-smoking nurse tapping away at their phone is dividing their attention span before they clock in. The oversexed stereotype nurses who spends most of heir time socializing will often end up the subject of complaints.And nurses given supervisory roles when their performance is substandard will always suggest unfounded favorirism.

Additionally, nurses can look for good ways to stay motivated and meet personal goals. The stability that a career in nursing can offer provides financial security, as well as a few “chicken soup for the soul” experiences.These are often priceless insights into the human condition.

The payoffs of a career in nursing can be concrete and financial in nature or they can be as abstruse as angels dancing on the head of a pin.But each nursing professional needs to decide for themselves where monetary goals stop and vocational goals begin.

Many nurses find their vocation in helping people. Others ate looking for a way to migrate to another career, such as teaching or business. But the toll that care giving occupations take is becoming more difficult to ignore. Statistics on addiction, drug abuse, Petty crime and white-collar crime in the field of nursing is a well kept secret. Nurses often admit to feeding an addiction while on the job. Nurses fight smoking habits made deadly by their sheer casualness masking a dependence. Nurses can have delayed reactions to many of the experiences by they see and encounter PTSD later.

And some nurses worry about if there will be a nursing field in the future. Technical issues are turning the field of medicine into an adjunct of the insurance industry. How much nursing benefit can decades of dialysis provide? How can pacemakers and stints and implants improve the quality of life?

Decisions are being made every day to extend and lengthen life using equipment and materials foreign to the body’s natural makeup. The safety and longevity of many of these methods requires backups of conventional nurses to oversee and treat complex medical conditions.

This type of scientific leap forward will always need development and monitoring by medical professionals. And as long as people age and have health crises, a nurse ( or several hundred thousand) will be needed. Therefore the future of any nursing career is wide open.


Chronic Pain Treatment Plans

Nursing contains treatment of all kinds of patients. A conscientious nurse can track the development of a chronic pain condition by assessing the Quality of Life scale for successive periods. Weighing the patient’s ability to perform daily activities, get dressed, go out, exercise, socialize, and perform productive activities like volunteer work or light labor, is a way to measure the complete index. A nurse or physical therapist should conduct a survey at quarterly or annual periods throughout the patient’s treatment duration to keep up with the wear and tear of natural aging and any other conditions.

Without an acute onset, chronic pain can gather from multiple sources, like arthritis, cramps, and headaches. The frequency and severity of the pain and the time during which the patient suffers becomes the analysis item. As a pain issue develops, these activities or tendencies in daily life will diminish. How much the ability to operate pain-free is not the issue, the ability to compensate or just give up regular activity over multiple areas of daily life is the measure. Consideration of over-the-counter pain medication is another part of the overall chronic pain evaluation.

Medical intervention for chronic pain can be difficult without a concrete diagnosis. Furthermore,  a surgeon or specialist may be reluctant to take on serious procedures with side effects of a potential to overreach the pain being felt by the patient currently. Some of the approaches to chronic pain onset can be less medical and pure common sense. Dyspepsia, GERD, and ulcers can account for some of the pain felt from natural aging. The severity of the onset should be evaluated and treated. Digestive and urinary conditions will reflect the patient’s lifestyle both past and present.

Nurses will come into contact with more acute situations of pain management. Injuries from car accidents, home mishaps, personal assaults, and sport injuries can be the beginning of a long lasting problem specific to the injured area or muscle system. Nociceptive pain involves muscle ends or actual end-of-system muscle fiber failings. Neuropathic pain is when the combined system failure results in sensation sof pain as symptoms of a larger disorder. Nociceptive pain and neuropathic pain form the basis of a category called somatogenic pain.

Psychogenic pain is a different type of chronic pain. When emotional or psychological issues and incidents form a repetitive or acute syndrome, psychogenic pain results. When a patient presents with pelvic pain of unknown origin, recurring headaches with no previous history of same, unusual facial pain of a typical frequency & duration, and/or low back pain, psychogenic pain should come to mind. Analysis of a patient’s daily schedule or habits will determine what unusual set of pain symptoms are unusual in sum.

Somatoform disorders are more mystifying and belong to the area of the professional psychoanalyst. The chronic pain markers for a somatoform patient are symptoms of pain that don’t match a patient’s current diagnoses or atypical recurrence of symptoms between stable schedule of medical or therapeutic intervention. As a nurse, is it a duty to report potential symptom and cycles of behavior to the case manasger or primary care physician. The worst that will happen is that you are overreaching, the best case scenario is that you have alerted key medical staff to a serious condition.

So, the nurse in charge of a patient or patients with chronic pain disorders should approach each patient with an individuality based on their own activity patterns and socializing habits. The deconditioning that occurs with a chronic pain sufferer is that they become “hermits”, staying alone in their pain cycles. Refusing to go out and refusing to continue with participation in group events and other healthy social exchanges can exacerbate pain. Long-term care facilities (or “nursing homes” ) often maintain a varied calendar of activities just to solve this problem.

A good nurse will challange her patient to set daily, weekly, or monthly goals to become more active, socialize with others, join a  group, and keep up improving exercise habits. A nurse may choose to give diet hints or have the dietary nutritionist meet with the chronic pain patient to underscore the importance of key food “do’s and don’ts.” The chronic pain patient must learn that anything that sets off blood pressure and systemic response triggers chronic pain events. Therefore keeping  a”low profile” in the battlefield of dietary tempations to binge, and fighting the inclination to slouch on the couch are what nurses should motivate their patients about.

It should be mentioned that many patients, especially aging patients of chronic pain, will insist on viewing themselves as a poor reflection of whom they “used” to be. But trying to keep up with the vision in the rear-view mirror is unhealthy and intimidating for the best of us. Some gentle persuasion to positively change the self-image and project and promote a more confident and updated idea of themselves will help patients cope with their current conditions. Aging in our culture has become more of a norm and in some areas has been acknowledged as a socially and economically powerful demographic.

Sufferers of chronic pain should be observed and monitored for unusual changes in behavior and habits. A nurse should become aware if a TV-addict patient suddenly shuns the TV room. Perhaps the patient known for her morning promenade starts sleeping in. A nurse should become concerned if a patient stops taking care of themselves, letting down personal standards of grooming or dressing. A supportive nurse will notice if their long-time patient is irritable and unreasonable over minor issues and becomes snappish with nursing staff the patients are known to prefer.

A chronic pain sufferer may be showing signs of depression due to lack of participation in many formerly “normal” activities. This is similiar to the depression felt by cancer patients. Chronic stress has been linked to fibromyalgia as well. A supportive nurse will observe if their regular patients sense a change in their lives and how they feel that they can’t quite pin down. Patients may verbalize unusual feelings or stressful responses to everyday queries. This can be an result (masquerading as a symptom) when chronic pain remains untreated capably.

The responsible and ethical treatment advice for a nurse who perceives a patient suffering pain is not to provoke an incident or disagreement. The supportive nurse will not try to spar or argue with a patient suffering from nerve endings already being pricked by uncontrolled chemical and electrical charges. A patient will not enjoy being prodded by a younger, more pain-free individual about why they are losing sleep or just how much more or less pain they feel than an hour ago.

It should be noted that not every nurse is a fan of supportive behavior. Access to a patient’s medical records and longtime treatment may make them privy to a lot of psychosocial details other nurses may not be aware of. Abusing this trust is not only unethical, but mean-spirited and should cause a nurse to question his or her own profesional motivations. Nurses who perceive other staff persecuting a patient prone to chronic pain with negative remarks, behaviors, or poor  attitude should be reported and re-oriented at once.







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