Children’s Hospital Oakland Fined for Not Protecting Employees

February 23, 2011 at 9:45 pm

I was shocked when I read how many dangerous incidents have occurred at Oakland Children’s Hospital within the past few years. I admit that Oakland isn’t on the list of the safest cities to work in, but I was amazed at the report that Sandy Kleffman wrote in the Contra Costa Times yesterday.

According to Kleffman, “State regulators fined Children’s Hospital Oakland $10,350 on Tuesday for safety violations that include inadequately protecting employees from violence in its emergency department.

“The hospital has had several dramatic incidents in recent months, noted the Cal-OSHA citation… In July, a 49-year-old gunman held a registered nurse and a ward clerk hostage before being subdued by police. No one was injured. In October, a gunshot victim was dropped off on hospital property within minutes of a second gunshot victim walking in and a third being carried there by bystanders. That occurred a year after three gunshot victims drove themselves to the front of the hospital in September 2009.”

I’m surprised at the incidents mentioned, but I am also wondering why this would happen at a children’s hospital. Okay, I can understand gunshot victims going to Alta Bates or Highlands General Hospitals, but to this specific hospital? Under emergency circumstances, I’m sure they were just trying to get any medical attention, but I’m not sure if a specialized hospital is even able to help patients outside of their designated clientele requirements.

Cal OSHA has fined Children’s Hospital Oakland $10,350 for “not having adequate procedures for protecting employees as they respond to gunshot victims dropped off at hospital doors, and for not effectively training employees to deal with workplace violence. The lack of a clear policy about how to bring dropped-off victims inside “caused unnecessary delay and potential security exposure to employees in the uncontrolled environment outside the building,” the citation stated.

“Cal-OSHA also cited the hospital for not documenting that it included nonmanagement employees in developing plans for protecting against bloodborne pathogens, not doing antibody testing of at least one health care worker after a Hepatitis B vaccination and conducting workplace violence training primarily by having employees read written materials instead of having interactive training with appropriate instructors.”

For those who are in an RN program or are pursuing their BSN degree, it’s important to consider the location and type of hospital you wish to work in. Even though a children’s hospital seems like a safe place to work, there are still dangers within the city. However, it’s interesting to note the defense that the state is providing the nursing staff to create a safer environment.

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What to Expect with Health Care Reform

February 22, 2011 at 3:08 am

Okay, I admit it: Health Care Reform scares me. When something seems too good to be true, it probably is, right? Plus I wonder where all of this funding is going to come from to make all of these wonderful changes. Now I’m not completely opposed to change, but in this day and age where it feels like the economy is balancing on thin ice, anything involving government has only my partial support and full guard up. Fortunately, Jennifer Larson on wrote a detailed article addressing this issue. She explains some of the controversies and what to expect in 2011.

Larson lists that some of the major changes we can see this year are:
• Subsidies and drug discounts to help close the Medicare coverage gap;
• Grants for states to establish health insurance exchanges;
• Increased premiums for higher-income Medicare beneficiaries;
• Establishment of medical-loss ratios for health plans, which will require that 85 percent of premiums collected by companies for large employer plans be spent on health care and quality improvement (and 80 percent for individual and small employee plans).”

For those that are in  LVN programs, RN programs or in a RN to BSN course, there are many changes which will impact the future of nursing. “The provisions to develop, educate and expand the nursing workforce are often cited, but there are other provisions that will affect the nursing workforce that are notable, too. Jan Towers, Ph.D., CRNP, federal director of health policy and professional affairs for the American Academy of Nurse Practitioners, noted there may also be more opportunities for nurse practitioners to make major contributions. ‘There are a lot of provisions in there for our patients and for nurse practitioners to be able to function more fully at their full scope. There are many things in it that we don’t want to lose.’”

There are some challenges and difficulties with this bill. “Two significant provisions with a 2014 implementation deadline have been controversial: the establishment of health insurance exchanges to offer insurance to people whose employers don’t offer insurance, and the requirement for people to buy basic health insurance, unless affordable coverage is unavailable, or face a tax penalty.”

Increasing health care availability also will increase the need for nurses in a shortage that is already taxing hospitals. The best thing to do is to wait and see how this will all pan out. Regardless, the future of nursing is going strong!

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More Money for Nursing Education

February 18, 2011 at 8:28 pm

          While there seems to be cutbacks on every aspect of government spending, the officials in Washington, D.C. have recognized the need for more nurses. Congress has passed the Affordable Care Act in 2010 which reauthorized Title VIII Nursing Workforce Development Programs therefore increasing federal dollars to support education in nursing.
          On, Debra Wood, RN, states that, “The largest dedicated source of federal funding for nursing education is through the Title VIII nursing programs, authorized through the Health Resources and Services Administration (HRSA), first established in 1961. Schools of nursing apply for Title VIII grants, but not all schools receive the money each year. AACN keeps schools aware of when funds become available.”
         “The biggest increase we have seen was last year, when we went from $171 million for these programs to $243 million,” said Suzanne Begeny, Ph.D., RN, director of government affairs for the American Association of Colleges of Nursing in Washington, D.C. “A lot of those dollars went to loan repayment and scholarship programs, where students receive the funds directly.”
         The purpose for the increase in federal funding stems from the concern that there is going to be a major shortage of nurses in the near future. With baby boomers joining the ranks of senior citizens and many nurses on the cusp of retirement, those who are in current RN programs or who are getting their BSN degree will likely have an easier time finding job placement than graduates in other fields.
          Wood explains in detail how the new federal funding will further education and benefit current nursing students, “The Affordable Care Act provides additional funds for nursing faculty loan programs, which offer substantial financial assistance to repay education loans to nurses willing to work full-time at a health care facility with a critical shortage of nurses or as faculty at an eligible school of nursing. For a two-year commitment, the program will pay participants 60 percent of their total outstanding, qualifying educational loan balance. An optional third year will pay 25 percent of those notes, subject to availability. The act expanded the loan amounts and who would qualify.”
          Wood also goes into detail about other new opportunities for students to help pay for continuing education. There are private corporations out there granting scholarships for those looking into certain specialties, minority students and some hospitals even provide tuition reimbursement.

Don’t let financial limitations hinder your decision to pursue a higher education. Even during cutbacks, there is money out there for those who are determined and persistant.

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CA Nurses Lack Full Worker’s Compensation Under Current Law

February 17, 2011 at 3:14 am

          Currently in California state law, nurses do not qualify for the same worker’s compensation as public safety employees such as policemen or firemen. This has the California Nurses Association/National Nurses United supporting Assemblymember Nancy Skinner as she introduces new legislation to try and change the status quo.
          As reported on, “California is one of many states that have laws that grant some public safety employees ‘presumptive eligibility for workers’ compensation, meaning that if the employee sustains certain injuries or becomes infected with certain diseases like TB, or Methicillin-resistant staphylococcus aureus (MRSA), the injury or illness is presumed to be job related and makes him or her automatically eligible for workers’ compensation benefits.

          “Nurses, however, do not qualify for this presumptive eligibility, even though, by the nature of their work, they suffer some of the highest risks of injury and illness of any profession. One study found that an average nurse lifts 1.8 tons of patient per day.”
          One of the big discrepancies between firemen and policemen to nurses in that when nurses get injured on the job, they have to show more proof of their work related injury. Many tend to think that this is based on gender bias since nursing is a predominantly female profession. “Our system requires nurses and healthcare workers, mostly female -dominated professions, to prove injuries and diseases common to medical settings to be job related. My bill removes this gender bias and creates fairness so nurses have similar workers’ compensation protections as firefighters and police officers” stated Skinner.
          If this legislation passes, it would positively affect current nurses and those who are getting their nursing degree or are in an RN to BSN program. “By the nature of their work, which involves ill patients, contagious diseases, and medical equipment, RNs are in constant danger of being exposed to a variety of illnesses, and becoming injured by lifting and moving patients or by the use of heavy medical equipment,” said CNA Legislative Director Bonnie Castillo, RN.
          “According to 2007 Bureau of Labor Statistics figures, healthcare workers lead the nation in the highest musculoskeletal (MSD) injury rates, and nursing ranks third in the number of work days missed due to illness and injury.” With these statistics so high, I think it’s time that nurses have better medical coverage and benefits.

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Nurses Working in Hospitals are More Likely to Experience Burnout

February 14, 2011 at 9:04 pm

          Once you finish nursing school or get your BSN degree, it’s time to seriously consider what type of job you would like to pursue. (Actually, you’ve probably been thinking about this during each of your nursing classes.) Private practice, hospitals, nursing homes, or government agencies all provide different nursing experiences.
          According to a recent study published by a group of professors at the University of Pennsylvania, they found that “among nurses working directly with patients, 24 percent of hospital nurses and 27 percent of nursing home nurses reported dissatisfaction in their current jobs, compared to just 13 percent of nurses working in other settings.” The reason for these high percentages are due to “the work environment and staffing levels [which] are chronic stressers that cause burnout. Nurses working under those conditions feel over-extended and depleted of emotional and physical resources.”
          This survey was rather detailed as 95,449 nurses in 614 American hospitals and healthcare settings were interviewed. An interesting fact they discovered was that “nearly 41 percent were dissatisfied with their healthcare benefits- more than double that of nurses working elsewhere showing broad-based disincentives for attracting nurses to work at the bedside… 41 percent of hospital nurses and 51 percent of nursing home nurses who provide direct patient care were dissatisfied with their health care benefits. Nearly 60 percent of nurses in nursing homes and half of nurses in hospital are dissatisfied with retirement benefits.”
          Another finding that I found interesting but not surprising was that the more dissatisfied the nursing staff is, the lower the opinion the patient has of the hospital. “Researchers found that the percentage of patients who would definitely recommend a hospital to friends or family decreased by about 2 percent for every 10 percent of nurses at a hospital reporting dissatisfaction with their job.” I thought the rate would be in higher as patients could feel the negative feelings of the unsatisfied workers, but I’m still surprised that the percentages relate in direct proportion.
         The findings also stated that the more disenchanted nurses are with their benefits and working conditions, the higher the burnout rate. I think the key here is to find a job you love and remember why you went into nursing. Another key factor is to interview current nursing staff at the place you would like to work. If they hate it, you might too. But, you may have to trudge through it to get your foot in the door.

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17,000 California Nurses are Happy

February 11, 2011 at 7:59 pm

          The largest single contract for nurses in the U.S. was just approved yesterday and it will impact more than 60 medical offices and hospitals in Northern and Central California. Pay increases, healthcare coverage and retirement benefits are making these nurses very happy… and can you blame them?
          The California Nurses Association informed about this huge contract that will set the standard for other hospitals and nurses around the country. “As the largest single contract for RNs in the U.S., the agreement charts a clear model for nurses throughout the nation in protecting existing healthcare coverage and retirement security, at a time when many employers are demanding major employee concessions, and in winning important improvements.”
          I find this quite amazing amidst the many labor disputes and strikes that have sprinkled the news the past several months. Just two days ago I read how nurses at Stanford and Lucile Packard Children’s Hospital in Palo Alto were angry with their unsettled contractual agreement which has been pending for almost one year. What is really impressive is that this major conglomerate Kaiser Permanente can come to an agreement with 17,000 RNs and NPs in 21 hospitals and 40 medical office buildings. It was ratified by 99 percent of the thousands of nurses who voted in 26 membership meetings.
           Those who are currently in an RN program or nurse practitioner program can look forward to a bright future in an economy and job market that seems to be stale. “This contract raises the bar for other systems and puts pressure on them to work with their nurses to provide the best care you can,” said Deborah Burger, a Kaiser RN, and a CNA and NNU co-president.
The highlights of this contract include:
-“ Full protection of all existing standards in healthcare coverage, post-retirement medical benefits, pensions, and a unique to Kaiser no cancellations policy.
- Annual 5 percent pay increases each year of the three-year agreement.
- Regional committees, selected by CNA, to enforce additional staffing based on patient need (acuity) to complement RN staffing ratios that are guaranteed by both state law and the Kaiser-CNA contract.
- New patient acuity tools for home health RNs to improve clinical work in home health visits, and for call center RNs to enhance quality in responding to patient calls.
- Guaranteed fixed schedules to protect arbitrary changes in nurse scheduling.
- Additional pay if nurses are assigned (floated) to a different department, an economic incentive to reduce unsafe floating and to staff appropriately.
- Protocols for more rapid management responses to staffing disputes.”
          It’s nice to hear some good news and optimism! Thank you Kaiser and those who worked so hard on behalf of the nurses and nurse practitioners.
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Nurses Declare War at Stanford

February 10, 2011 at 3:30 am

          A strike may be on the horizon for the nurses at Stanford and Lucile Packard Children’s Hospital as the hospital and nurses’ union fail to reach an agreement for the contract that was to be settled upon twelve months ago. The new level of advancement for experienced nurses who are RNs or have their BSNs is the major point of contention which may result in a strike of the 2,700 nurses involved.
          KCBS’ Mike Colgan reports that, “Nurses union attorney Peter Nussbaum said the key sticking point is the new level of advancement that the hospital wants to impose on nurses. ‘The result of that would be that the most experienced nurses, the ones who have the best bedside skills, will effectively be demoted,’ Nussbaum said. ‘And they’re going to say to themselves, why should I be demoted here when I can go to Kaiser, which just gave its nurses a very nice wage increase.’”
 also reported on this issue and further explains the conflict between the union and the hospitals. Sue Dremann details the problems with the contract that would limit advancement for these nurses. “Under the hospitals’ final proposal, Staff Nurse IIIs and IVs could effectively be demoted if they can’t qualify under revised staffing qualifications. Upper-tier clinical nurses can also be demoted and become ineligible to reapply for higher clinical-nurse positions for a substantial period of time because of a single warning for even the most minor alleged infractions. That could lead to potential abuses by managers who are vindictive or play favorites and would cause draconian cuts in the nurse’s wages.” Dremann also quotes Nussbaum as saying, “Nurses with many years of experience … who have unquestioned excellent bedside skills will be unfairly punished if the PNDP as proposed were to be implemented.”
          Greg Souza, vice president of human resources for Lucile Packard Children’s Hospital, said the hospitals are disappointed that after more than a year of contract negotiations “it will not be possible to reach mutually acceptable contract settlements at this time… We feel strongly that our offers advance nursing practice and programs and provide our patients with the very best in patient care,” he said. 

         As the negotiations continue, it will be interesting to see the outcome. I believe that most controversies that are fought within a profession tend to have a common thread and may cause a ripple effect to other medical agencies and impact higher education such as bsn programs and nursing classes. Evaluations plus education can equal promotions, but if this new contract goes into effect, evaluations with outweigh education. The problem rises based on who is doing the evaluating. We’ll just have to wait and see….

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Robotic “Nurses” Used to Assist Surgeons

February 7, 2011 at 7:59 pm

          I’m always shocked at what the human mind can come up with and then bring to fruition. I’m still trying to learn how to use my new cell phone and there are surgeons and industrial engineers out there creating robotics which can decipher the surgeon’s hand gestures to assist during surgery.
          On, Tiffany Kaiser explains how technological advances in medicine and robotics are working together to create more effective surgical procedures. “Juan Pablo Wachs, an assistant professor of industrial engineering at Purdue University, along with researchers from the Naval Postgraduate School in Monterey, California and Ben-Gurion University of Negev, Israel, are developing a system of robotic scrub nurses and computers that can obey commands through the use of hand gestures in a hospital setting.” This technology could be change medicine as we know it by, “reducing the length of surgeries, coordinating emergency response efforts and assisting surgeons efficiently during an operation…”
           “This hand gesture recognition system consists of a camera and specific algorithms that apply anthropometry, which predicts the position of the robot’s hands based on where the surgeon’s head is. The camera, which is a Kinect camera developed by Microsoft that maps images in 3-D, is mounted over a screen that shows the surgeon medical images of a patient during an operation. The robotic scrub nurse is used to assist the surgeon during surgery and is capable of helping because of advanced algorithms,” reports Kaiser.
          “One challenge will be to develop the proper shapes of hand poses and the proper hand trajectory movements to reflect and express certain medical functions,” said Wachs. “You want to use intuitive and natural gestures for the surgeon, to express medical image navigation activities, but you also need to consider cultural and physical differences between surgeons. They may have different preferences regarding what gestures they may want to use.”
          The world of medicine is fascinating and the advances that are in store are mind boggling. If you are interested in pursuing a career in the medical field, Unitek College can equip you with the skills necessary to enter this exciting professional.

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Finding a BSN Job in a Difficult Economy

February 4, 2011 at 5:16 pm

          We have all heard about the shortage of nurses and the growth one can experience in the medical field, but that doesn’t mean that job offers will be banging down your door once you graduate. With many people in a financial bind, many are delaying retirement, working overtime, or returning to the workforce. Here are some tips from which may help you get your foot in the door:
1. If you want to work at a hospital and can’t find work in one, look into other options. The important thing is not to let your skills go stagnant or have a large gap of time where you are not working on your resume. Look into other opportunities such as working at “a clinic, school nurse position, any doctor office, public health positions, medical staff in a gym, nursing home, health educator in a community setting, etc.
2. Volunteering can keep your skills sharp and will give you an opportunity to see which setting you would like to work in full time. “You can get some great experience and make good contacts. It also gives you something to discuss in an interview and can help to beef up your resume. Additionally, volunteer positions sometimes turn into paid employment. Consider a blood bank or local public health department.”
3. Explore the variety of job options that are available in the health care industry. “You can get good experience in acute and long-term rehabilitation facilities, long-term and sub-acute care, and a new type of care facility known as long term acute care (LTAC).”
4. Join the American Nurses Association chapter in your state. “Not only will you create a support system in your new profession, but you’ll also learn about trends and issues. Get active by joining a committee or working on a special project—it helps you to become known and develop opportunities to seek feedback, advice, mentoring and job-search help from experienced nurses.”
5. Further your education. “Look for interesting clinical courses offered by professional associations, education companies and others. Use online continuing education to expand your knowledge base and stay sharp.” Pursue your RN or BSN.
          If you want to enter the medical field and are looking for a school to help you pursue your RN or BSN, check out Unitek College.  Unitek can help you pursue your dreams as a nurse in a short amount of time with no waiting lists. Start the path to your future today!
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Nurses: The Heart of the Hospital

February 2, 2011 at 5:49 pm

WARNING: Personal story ahead. Some sappiness and opinions will be sprinkled throughout. Tread with caution.
          Usually I comb through the internet looking for news stories, interesting facts or tips on how to be successful in the nursing field. Today will be a little different. My sister had surgery yesterday so I decided to write from a patient’s point-of-view. Sometimes it helps to put away the scrubs and don a backless gown.
          So we all know that the medical field and many of its professionals are flawed, and this situation was no different. With my sister’s insurance, she had two options for doctors to perform her breast reduction surgery. One was 20 minutes away, the other an hour and a half so she went with the closer one. With insurance rates high and a desire for money even higher, this doctor worked at three different offices and was spread too thin. His staff was unorganized and caused a tangle of misinformation, mis-scheduled appointments and hours of frustration on the phone with improper information giving to the insurance company. This was not reassuring the day before surgery.
          Last night my sister had to go to the ER because one of her drains was leaking. We called the above doctor and couldn’t get a hold of him. When he did arrive at the hospital, he just yanked the tube out causing my sister immense pain and told her not to faint since he did not have privileges at this hospital. He failed to release the pressure valve and caused more undo pain. Although we want to confront and complain, we’re in a tough position… we need this guy until my sister is healed. There is no other “professional” in our area.
           Many doctors lack the bedside manner and compassion that patients need in these difficult situations. However, the nursing staff was supportive, caring and attentive. When doctors see patients as case numbers and dollar signs, nurses see the people and pain behind the job.
          As a patient, I’ve had my share of good doctors and bad. I’ve also had my share of good nurses and bad. But I must say that the staff at a hospital or clinic is really the heartbeat of each facility. I’ve been through a life threatening car accident, brain tumor, infertility and chronic pain. Through these events, I estimate the score to be 32 nurses I’ve had that were awesome and three doctors who were incredible out of the countless staff that I have encountered through these 15 years of medical trials. Granted, I’ve come into contact with more nurses than doctors, but they are the ones who really help during these difficult and often life changing situations.