The Push for More BSNs

March 30, 2011 at 6:38 pm

Some believe that requiring four-year undergraduate degrees to practice as an RN is a necessary move in order to a have more informed, higher skilled nursing work force.  Canada, Sweden, Portugal, Brazil, Iceland, Korea, Greece, and the Philippines are just some of the countries that have this requirement.  States across the country are taking this into consideration.  As many as 18 states are working on initiatives that will require recent RN graduates to obtain a BSN in order to have their licensure.

There have been laws in the past that have required all hired nurses to possess baccalaureate degrees but were repealed because of opposition from various factions citing a nursing shortage.  Some argue that requiring all nurses to have a BSN will further contribute to the shortage as fewer people will be eligible to practice nursing, also that other, often undervalued programs such as LVNs*, ADNs*, and CNAs* sometimes produce better nurses than do BSNs who tend to have less on the job experience.

However, competency in the healthcare industry is an issue that needs to be dealt with and given attention.  Pamela Brown, RN, PhD, president, Blessing-Rieman College of Nursing, in Quincy, Ill., states that research shows that “There are better patient outcomes when patients are cared for by nurses with a BSN.”

Brown is referring to the landmark 2003 study to which executed by University of Pennsylvania professor Linda Aiken, RN, PhD. The study noted that the death rates of surgical patients at Pennsylvania hospitals where less than 10% of the RNs held bachelor’s degrees were nearly twice that of hospitals where more than 70% did. The researchers concluded that recruiting nurses from bachelor’s degree programs rather than two-year associate degree programs could lead to substantial improvements in care.

However, legislation isn’t necessary to make this push this initiative into reality.  Already this change is taking place as an increasing number of hospitals are choosing to hire nurses with BSNs and higher education over those who do not.  Some predict that other hospitals across the country will follow suit, regardless of whether legislation passes, just to remain competitive.

The problem, of course, is what will become of diploma and ADN holders who will be overlooked in the hiring process when up against BSN holders.  There needs to be more collaborative work between academic programs and the nursing industry in order to create a system that will benefit healthcare in the best way possible.

*LVN stands for Licensed Vocational Nurse
*AND stand for Associates in Nursing Degree
*CNA stands for Certified Nursing Assistant

For more information on this issue, please visit: Nurse.com and NurseWeek.

Current Health Care Trends Part II

March 30, 2011 at 1:35 pm

On Monday I posted Part I of this article and today I am continuing with the second half. Here are items 6 -10.There is some information that I think RNs to BSNs would find helpful as you enter into a new phase in your career. I hope you find them as interesting as I do!

  • On-call pay has increased in half of hospitals. – “The survey looked at data from 148 healthcare organizations nationwide. From 2007-2010, the median on-call expenditures reported by trauma centers more than doubled, from $1.2 million in 2007 to $2.4 million in 2010. For non-trauma centers, expenditures in 2007 were $433,849, compared to $798,000 in 2010.”
  • Nurse provider shortage decreases – More nurses are delaying retirement or those who have retired are returning to the profession due to economic hardships.

It will be interesting to see if these trends continue and how they will affect those in an RN to BSN program. The healthcare industry is ever changing!

To read the complete article referenced in this post, you can visit
http://www.beckershospitalreview.com/hospital-financial-and-business-news/10-current-healthcare-employment-and-compensation-trends.html

Death Risk Rises When Nurse Numbers Fall

March 30, 2011 at 12:30 am

Those coming out of nursing programs into the job market (hospitals, clinics, nursing homes, etc), should be aware of the effects of nursing shortages.

A study conducted by the Mayo Clinic in Rochester, Minnesota suggests that a patient’s risk of death increases by 2 percent per hospital shift when units are understaffed with registered nurses.  Obviously, keeping patients alive, at least as long as possible while they’re in the hospital, is crucial to a hospital’s standing.  Thus, having a strong and well-staffed nursing unit is key to maintaining a hospital’s overall well being.

Christopher Snowbeck with TwinCities reports that the study, published in the New England Journal of Medicine, finds that “nursing levels met or were close to targets in about 84 percent of all shifts. And while researchers said the rate was good news for most patients at the hospital — because overall mortality was lower than expected — it spelled trouble for patients in units considered understaffed.”

In some cases, patients saw their risk of death increase by about 25 percent because they happened to experience between 10 and 14 under-staffed shifts during just five days in the hospital.

Snowbeck lists key findings from the study:

Not enough nurses:

  • Patient death risk increases 2 percent per shift when unit understaffed.
  • Some patients saw 25 percent increase in death risk over five days.
  • Some 35 percent of patients in study experienced three or more understaffed shifts.

High turnover:

  • Patient death risk increases 4 percent per shift with high number admissions, transfers and discharges.
  • Some 13 percent of patients exposed to three or more high-turnover shifts.

What the study from the Mayo Clinic shows is that it is crucial to for a hospital or any healthcare facility to have a well-staffed nursing unit.  New nurses should be aware of the shortages in order to anticipate the work environments they will be entering.  Knowing this kind of information can help nurses to better prepare themselves for their careers.

On Life and Death: Tough Talks All Nurses Eventually Have to Give

March 29, 2011 at 4:47 am

A weak area in RN-BSN programs and most nursing programs in general, is preparation in the task of relaying bad news.  In some programs, this training simply doesn’t exist.  Although, to be fair, it’s difficult to describe exactly what such preparation should entail.  Can anyone ever be completely prepared to tell another person that their life has been cut short?

Regardless, there are things nurses can keep in mind when they are about to have these conversations with their patients.  Adeline Duffy, RN with AdvanceforNurses, has advice for nurses on how to make these conversations easier on their patients and themselves:

Stop sugar-coating, and start the talk early.  Nurse Duffy states that, “The best time to address end-of-life issues with a patient facing a terminal illness is at diagnosis. When we provide the facts from the beginning it can help our patients and family members to discuss their wishes and plan for their future.”

This is difficult because so often we’re told that we need to stay positive and remain optimistic especially when facing challenges, but in regards to health, this may come at the expense of total honesty which is necessary to successfully combat and cope with illness.  Furthermore, painting falsely sunny pictures can leave families confused and surprised by the suddenness of death if/when it comes.

The best gift nurses can give to families suffering from the news of terminal illness is honesty and knowledge about what they can do to treat, heal, and cope.  This includes talking about living wills, and whether or not they would want to use treatments to prolong life.

Nursing programs could benefit from initiating training programs that would better prepare nurses who will eventually have these tough conversations with their patients.  Duffy believes that we need formal training both in the prognostication of illness and in communicating with patients and family members about decisions and expectations around the end of life.  This should include integrating academic material with clinical experience where nursing students learn to categorize which treatments are life-sustaining, and practice conveying terminal diagnoses in clear direct language.

Learning the language of death is difficult on all ends.  But by accepting death as a reality that everyone has to face, and using the right words to explain the truth, nurses can be the best gift their patients can have when facing their own mortality: an honest person they can trust.

Current Health Care Trends Part I

March 28, 2011 at 1:12 pm

There are some topics that are reoccurring in the health care industry: nursing shortages, impacted schools, and health care reform are just a few. Those who are in an RN to BSN nursing program are in the midst of major changes and Becker’s Hospital Review has compiled a list of the ”10 Current Healthcare Employment and Compensation Trends.”

This past week, reporter Rachel Fields posted, “10 trends affecting employment and compensation in healthcare, according to various surveys, studies and news reports.” Her article is full of interesting facts and we have highlighted some of the best ones, this is part one and part two will follow in sequence.

  • Nursing enrollment is rising – “Enrollment in nursing programs from baccalaureate level to advance practice is growing, and more men are entering the field, according to a survey by the American Association of Colleges of Nursing. The survey, which covered nursing enrollments in 2010, also found that more students are enrolling in entry-level nursing baccalaureate programs and PhD nursing programs. In addition, accelerated nursing programs are growing; there are currently 13,605 students enrolled in the nation’s 233 accelerated baccalaureate programs, up from 11,960 in 2009.”
  • More medical students choose primary care – “Positions filled by U.S. seniors rose by 11 percent in family medicine, 8 percent in internal medicine and 3 percent in pediatrics over the last year, and family medicine matches were higher for the second consecutive year.” As a nurse, this is interesting because it seems to imply that there will be more job opportunities as a primary care nurse and fewer opportunities with more competition (can compensation) in areas of specialties.
  • Physician compensation in academic settings increased in 2010 – Doctors are making more and those who hold specialties or are department chairs made more. How will this change with health care reform? If doctors made more, did nurses too?
  • Staffing levels affect mortality rates – “Patient mortality was linked to hospital shifts with low nurse staffing levels and high patient turnover…Patient turnover is thought to divert nurses’ time and attention from other matters.” As an RN or BSN, this fact probably isn’t new or surprising but a published study may bring more attention to a subject matter that has been put on the back burner.

To read the complete article referenced in this post, you can visit
http://www.beckershospitalreview.com/hospital-financial-and-business-news/10-current-healthcare-employment-and-compensation-trends.html

Survey Taken Concerning Health Care Reform – What Does the Future of Nursing Look Like For RN to BSNs?

March 26, 2011 at 9:01 pm

          Health Care reform – this is a complex topic that I’m almost afraid to touch. It’s like a steaming pot ready to boil over; do I attempt to address it or will I just get burned? It’s also like a pile of dirty laundry… do I really want to sort through this smelly mess? Well, enough with the analogies. I’ll just report on what a public survey has to say about it and how it will effect those getting their RN to BSN degrees.
          On nursinglink.monster.com, Jeff Scullin reported on a survey taken by the Kaiser Family Foundation that was released this past Tuesday. “The Kaiser Family Foundation and the Harvard School of Public Health conducted the survey, entitled ‘The Public’s Health Care Agenda for the 112th Congress,’ between Jan. 4 and 14, surveying 1,502 randomly selected adults across the country by telephone,” explains Scullin.
          Here are some surprising and not-so-surprising results: Generally speaking, most people have negative perceptions of the reforms but like specific provisions. The public thinks there’s a better way to cut spending without touching Medicare and other government services. We all know that something needs to be done, but no one is quite sure what. (So basically, it says a lot without saying a thing…)
          Now here are some specifics:
          “People with favorable and unfavorable impressions of the health care law were evenly split in December, with 41 percent viewing the bill favorably and 42 percent with a negative view. This month, the number of people with a favorable opinion was flat, but the number with an unfavorable view jumped to 50 percent — driven largely by shifting views among independents.”
          “Two of three respondents say they are ‘very concerned’ about the federal deficit, but people are more divided about how quickly Congress should deal with it. Fifty-four percent of respondents want Congress to deal with the deficit quickly, while 43 percent say wait until the economy improves. Most independents (61 percent) and Republicans (70 percent) want Congress to act now, while most Democrats (61 percent) want to wait.”
          “Only 8 percent support major cuts in Medicare and Social Security, while only 13 percent support big cuts in Medicaid. A majority of respondents don’t want any cuts in Medicare (56 percent), public education (63 percent) or Social Security (64 percent). And 68 percent say Congress can deal with the deficit without cutting Medicare.”
          So what does this mean to the health care professional and those in a RN to BSN program? Quite frankly, I think it means jumping through a lot of hoops, shuffling through a lot of paperwork, and juggling disgruntled patients for the same amount of money. But let’s face it: health care is a complex profession and we go into it knowing the ups and downs of the trade.

 For more information, please go to:
http://nursinglink.monster.com/news/articles/21364-dissatisfaction-with-health-care-law-grows-survey-says

Nurses Accused of Thievery in Oakland

March 25, 2011 at 8:38 pm

          Nurses have a lot on their plates: helping sick patients, adjusting to budget cuts, constantly learning new skills and procedures and trying to figure out how health care changes will affect the medical field. Now the nurses in Oakland have another issue to juggle: proving their integrity as professionals beyond their skills as certified nurses. This is not something you learn in a RN to BSN college.
          Yesterday in the Contra Costa Times, reporter Sandy Kleffman addressed the story of how a group of nurses at Doctors Medical Center in San Pablo were accused of stealing heart monitoring devices after the devices were found missing. “The incident began when an emergency room doctor sought to admit a patient to the telemetry unit but was told that although there were enough beds and nurses, there were no more telemetry boxes available and thus the patient could not be transferred,” registered nurse Bobby Roberts explained. “Hospital managers discovered that four telemetry boxes were missing from the unit. The boxes sometimes end up on other floors because they remain on patients who were transferred or some are sent to another area of the hospital for repair.”
          It’s bad enough that the nurses on staff were accused of stealing the equipment worth several thousand dollars, but the way the incident was handled is where a major issue lies. These nurses were detained, questioned by police and were “grilled in hallways where patients could overhear.”
          The devices that were reported missing were found later elsewhere in the hospital, but what I want to know is who would want to steal these devices in the first place? I suppose you could sell them for parts, but is there really a black market out there for partial medical devices? Maybe I’m really naïve, but I would be more concerned about office supplies missing or medications disappearing.
          Now the nurses are claiming that they are too stressed to return to work. “Since the incident, Roberts and several of the other nurses have been off work, saying they are too stressed to return. They have contacted an attorney to discuss their options,” Kleffman reports. Seriously!? Okay, I’ll admit that the incident stinks, but call a spade a spade and say “I’m too ticked to go back to work” or “I want time off to think this over.” I can understand not wanting to use vacation time for this, but come on…
          So basically this whole event has been handled poorly. It’s just one more incident in the complex world of nursing….some things you just don’t think you need to learn in a RN to BSN program

For more information, please go to:
http://www.insidebayarea.com/oaklandtribune/localnews/ci_17220357

How the Affordable Health Care Act will Affect RNs and BSNs

March 25, 2011 at 7:04 pm

This week marked the one year anniversary of the signing of the Affordable Health Care Act. With headlines of tsunamis, a declaration of war and storm warnings, this issue has taken somewhat of a backseat. However, regardless of political and national disasters, change is on the horizon for RNs and BSNs.

Nurse.com has posted several recent articles on this act of legislation and what it will mean to both patients and health care professionals. In a time of economic hardship, I personally don’t see how this can all come to fruition. In a perfect world this might work. In the harsh reality that we live in, please don’t raise my taxes.

According to Nurse.com, here are some things we can expect over the next few years:

2011-12

• Providers will receive financial incentives to form Accountable Care Organizations, in which healthcare professionals and hospitals join together to coordinate and improve care and reduce unnecessary hospital admissions.

• Independence at Home, a program providing high-need Medicare patients with primary care services in their homes, begins.

2013

• Federal funding to state Medicaid programs will cover preventive services, and the government will begin paying primary care clinicians for Medicaid services at the same rate they receive for Medicare services.

2014

• Americans must purchase basic health insurance or pay a penalty. Exceptions will be in place for those who would have to spend more than 8% of their income on monthly premiums. For employees who cannot afford insurance through their employer, vouchers will be available — in the amount their employer would have contributed to their insurance coverage — to help them buy a less expensive plan in the new state exchanges.

• Employers with more than 50 employees must offer insurance or tax credits for the purchase of insurance through exchanges to all employees or pay a penalty.

• Insurance companies must make health insurance available to all applicants regardless of health status or pre-existing conditions. In the state exchanges, companies can base rate differences only on age, geography, family composition and tobacco use. Companies cannot cap coverage.

• Medicaid coverage will expand to include those earning less than 133% of the federal poverty level. Those whose eligibility is in question can enroll and receive care, then remain enrolled if their eligibility is confirmed.

As the government implements more health care facilities and stricter policies to ensure that everyone is covered by health insurance, it is inevitable that the need for nurses will be at an all time high. Those who are in an RN to BSN program are certainly on the right path.

To read the complete article referenced in this post, you can visit
http://news.nurse.com/article/20110324/ALL01/103280029/-1/frontpage

Getting through Nursing School

March 25, 2011 at 5:18 am

It’s no surprise that student nurses in RN-BSN programs deal with a lot of stress getting through school.  Studies have even suggested that the stress levels in nursing are not only higher than they are in other academic programs, but also higher than their counterparts in medical school, pharmacology, and social work programs.

A nursing student has to juggle academic studies and clinical practice on top of work and their personal lives.  This is often more difficult than it sounds because many nursing students are in the middle of changing or advancing in their careers.  They tend to be older and more mature, dealing with their own children, aging parents, and personal predicaments.

We may have heard this all before, but in this stressful world we live in, we never get enough reminders to take care of ourselves, nurses especially.  In order to maintain their physical and emotional health, nursing students need to consider different ways of dealing with stress and managing their personal, academic, and professional lives.  After all, how can nurses take care of so many other people when their own health suffers from stress?

Fran Roberts of ScrubsMag provides a comprehensive list of advice for nursing students coping with stress.  Here is a condensed version:

1. Eat right. The body metabolizes more during stressful times, meaning you may be hungrier more often, but without proper planning you might find yourself making poor food choices. Because the nursing profession is largely comprised of women, it’s not surprising that eating disorders are prevalent in the profession. Eat five or six small meals a day, drink plenty of water and be conscious of choosing whole foods, with an emphasis on fresh vegetables, fruits and whole grains.

2. Adopt smarter study habits. Nursing students are frequently encouraged by faculty to study in groups. While this is sometimes helpful and constructive, it can also lead to “group anxiety.” The stress levels of individual students can begin to mount and actually accelerate within study groups. So determine what works best for you. You may find that quizzing each other in groups while preparing for tests works well, but reading difficult chapters and articles is best done alone and isolated in a quiet, undisturbed place.

3. Pace yourself. At the beginning of a term or semester you generally know what your student workload will be. Resist the temptation to procrastinate completing assignments, which frequently results in the dreaded and extremely unhealthy “all-nighter.” Remember, you’re not a history major who can sleep the entire next day. More than likely you’ll have to show up at a clinical assignment the morning after your marathon event!

4. Get centered, physically and emotionally. Nurses are masters at multitasking—and often the trade-off of this mastery is sacrificing “me” time. Although it might seem impossible, carve out a minimum of 30 minutes a day for yourself. Spend this time wisely—incorporate a physical activity such as walking or yoga, set an intention for the day that helps you maintain your focus and spend some time in meditation. If you’ve never tried meditation or yoga, try a physical inversion (simply put, turn yourself upside down or do a deep forward bend). It increases blood flow and helps you rest better and think more clearly.

5. Love your profession. You’ll get frustrated. You’ll get upset. You may break down in front of professors and colleagues. But remember, you’re entering into one of the most admired and important professions in the world. Without you, the healthcare system would fail. As you go through your studies, keep this in mind, and think about what you want to do next. An attitude of lifelong learning will help you gain confidence and enhance your position in the workplace.

Completing your RN-BSN degree will be one of the most rewarding and exciting stages in your life as a nurse.  But to get to that point in one piece – and to move forward in your nursing career – you need to maintain your personal well-being.  When in doubt, or under the load of stress, remember that the first person you need to take care of, is you.

For more details on how to get through nursing school, please visit ScrubsMag.com



RNs and BSNs Provide Hope in Gifford Tragedy

March 24, 2011 at 8:29 pm

          The terrible tragedy involving the shooting of U.S. Representative Gabrielle Giffords on January 8, 2011 was a horrific event that plastered the front page of every newspaper in the nation. I found an interesting article which explained what happened once Giffords was transferred to the hospital and the tender interactions she had with her nursing staff. Isn’t this why so many have the dream to become RNs or bsn nurses?

          For those who need a brief reminder, a “gunman.. shot Rep. Gabrielle Giffords in the head and then unleashed a spray of bullets that killed six and wounded 12 others at a town hall event outside a Tucson, Ariz., grocery store,” reported abcnews.com. “’A total of 19 people were hit by gunfire during the shooting, which began just after 10 a.m. Six of the victims have died,’ according to Pima County Sheriff Clarence Dupnik, ‘and the remaining individuals are not believed to be in “life threatening situations.’”
          The azstar.net did a current article on the tragedy highlighting the nurses’ side of the story. Becky Pallak from the Arizona Daily Star reports that, “Nurses from the intensive-care unit that cared for U.S. Rep. Gabrielle Giffords and other victims of the Jan. 8 mass shooting spoke to reporters on Monday.”
          “Nurse Tracy Culbert was in charge that morning when a page came in about a lot of incoming patients with gunshot wounds…Patients who could be discharged or moved to another unit were moved. Nurses started preparing beds and care stations. More nurses came in to help.”
         “We treat everybody the same. It doesn’t matter who they are, what their name is, what status they hold in society,” Culbert said. “I think that we try to give every patient the best care that we can give them, and do everything we possibly can for them and their family… The nurses said they bonded with Giffords… night shift nurse Angeliqqu Tadeo found out she and Giffords both like the rock band Maná, so they listened to one of the band’s CDs together every night.”
         I thought this story was amazing because it sums up the job of an RN to BSN: nurturing the body and mind in the midst of a crisis. Nurses have to be “on” all the time and when stressful or terrifying situations arise, they have to keep a level head to provide care to the injured. These nurses were a bright spot in a devastating situation.

For more information, please go to:
http://abcnews.go.com/Politics/rep-gabrielle-giffords-shot-grocery-store-event/story?id=12571452
and
http://azstarnet.com/news/local/article_118a7f82-0415-57e6-b8f5-e8f8269ca215.html