Technology That Helps Nurses Cut Down the Steps

Technology That Helps Nurses Cut Down the Steps

Posted by Alycia Sullivan on Fri, Jan 24, 2014 @ 10:04 AM

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A study commissioned by Herman Miller Healthcare showed that nurses walk up to four miles a day on their shift. Much of this is due to supplies not being readily available and the need for better communication, like keeping tabs patient location. Technology is beginning to make the job of the nurse easier by giving them better information, leading to less steps.

Real Time Locating Systems

Real Time Locating Systems, also known as RTLS, uses small tags attached to devices, making them easier to find. For example, a typical scenario finds the nurse walking from room to room to locate a blood pressure machine for use in their rounds. With an RTLS tag, the nurse can locate the machine on a dashboard at the nurses station. They may still have to walk to the end of the unit to retrieve the machine, but it will be a direct route.

Patient Locators

Similar to RTLS are devices that patients can wear to indicate their location, according to Villanova University. Tracking down a patient can be time consuming on a busy nursing unit. A nursing aid that has taken a patient to physical therapy and radiology calls up for the patient to come down for a test. The locator tags can prevent the hunting down of people who know where Mr. Johnson is by indicating that he is in PT.
Another use suggested for these locator tags is in monitoring patients who may wander out of their rooms and be difficult to track. Mental health units, neurology units and Alzheimer's treatment centers benefit from these devices.

Tools in Your Pocket

With smartphones and tablets, you can have a number of tools in your pocket to help you get through your day easier.
The Pocket Pharmacist is available for your iPhone, and gives you a drug reference list with interactions. Calculate by QxMD uses current clinical decision trees to determine the best course of treatment.
Other tools to help you with your nursing career include a wage calculator by Intuit to help you precisely calculate your time and paycheck amount, which is handy for those extra shifts and holiday hours you're asked to work. ShiftPlanning is a nursing shift scheduling tool that the charge nurse will find useful for tracking time and adjusting schedules.

Mobile Devices and EHR

Electronic Health Records (EHR) became mandatory as of January 1, 2014, notes USF Health. Institutions must begin making patient records available online. A study by American EHR on more than 800 health practitioners showed that 33 percent with access to EHR used a tablet to access patient information.
As tablets and mobile charts become more available on nursing units, the constant walking back and forth between patient and their information is reduced. Devices such as the iPad EHR by drChrono allow bedside status updates to be made once vitals and other observations are completed.

Patient Workflow

Nursing Critical Care highlights a software system used in a Pennsylvania hospital that helps save steps during a patient's discharge. When the patient is ready to be released, the nurse uses a workflow panel to contact the transportation department to pick up the patient. Once they have arrived and are leaving with the patient, they use the panel to contact the cleaning crew. Once the room is clean, they use the panel to contact the admitting patient, to tell them the room is ready. This keeps the nurse from walking to the room to see the status, so they can report back to admitting that the room is ready for the next patient.

14 pieces of advice for a new nurse

by Jo, RN • July 2, 2012  

1. Always have an extra pair of scrubs in your locker.
2. Rubbing alcohol will get almost any odor out of fabric. Shaving cream will get almost any odor off of skin.
3. There is no getting tincture of Benzoin off of anything.
4. If the post-op nurse turns a patient over to you with the assurance that he will be “easy-peasey,” disaster lurks around the corner.
5. The proper response to your digital thermometer reading “HI” is not “Heeeeeyyyy!”
6. Blood is not the worst thing that can get on your scrubs.
7. The amount of poop a patient produces is inversely proportional to her level of consciousness.
8. Fire, code or disaster drills will never happen in the middle of a calm day.
9. The number of obscure drug allergies a patient has is inversely proportional to his grasp on reality.
10. Little old ladies in no acute distress are much stronger than you imagine. Be careful.
11. If it can be torn off, braided into knots, knocked over, pulled out, wrapped around something vital or otherwise jacked up, a sedated patient with a severe head injury will do it.
12. If your lunch is particularly delicious, you will have no chance to eat it.
13. Caffeine is a food group of its own.
14. And finally, the number one rule of nursing that I want to share with every new nurse:
If you have to jack with it, it’s wrong. Anything that requires immense amounts of skull sweat to figure out is wrong somewhere. Back off, get a second opinion and for God’s sake stop messing with it. The longer you fool with it, whatever it is (drug calculation, foot pump or IV bolus), the more messed up it’ll get. Stop immediately and figure out where it’s wrong, then proceed.

15 ways nursing will change your life

by Sean Dent

Thinkstock | istockphoto

The nursing profession is changing. The average age of nurses and the average number of years of nursing experience both are decreasing. As a nurse with close to a decade of experience, I’m considered old.
I often wonder what the newer generations think they are getting into when they choose our profession. What do they think their job will be like? What do they think we actually do? How do they decide and say to themselves, “That’s what I want to do, that’s what I want to be”? I’ve recently discovered a lot of nurses are finding out the hard way what nursing is really like.
This is the REAL world of nursing:
1. Your feet will hurt.
2. Your back will ache.
3. You’ll start grinding your teeth in your sleep (if you didn’t already start in nursing school).
4. You’ll NEED to be in shape for this job.
5. This job will make you cry.
6. This job will scare you.
7. Many patients will not like you.
8. Most patients will test your limits.
9. Many patients are not nice. In fact, they’re downright mean.
10. You’ll rarely hear a “thank you.”
11. Your job is never done.
12. What you do directly affects others, ALL the time.
13. No one notices what you do–until you don’t do it.
14. You won’t get home on time. Hardly ever.
15. You’ll be the medical “go to” person for everyone on the block (sometimes at midnight on a Tuesday).
Sounds pretty bad, huh? This is why we constantly repeat the phrase, “Nursing is not for everyone.” You have to be tough in order to thrive in our world. The greatest thing about our profession, though, is that the benefits of our work GREATLY outweigh the risks.
But here are 15 ways nursing will change your life:
1. Your heart will grow 10 times its normal size.
2. Your compassion will exponentially expand.
3. You’ll develop strength where you once were afraid.
4. You’ll learn to push past your limits.
5. You’ll become resourceful.
6. You’ll develop keen decision-making skills.
7. You’ll become comfortable with being uncomfortable.
8. You’ll truly empathize and understand what loss really is.
9. You’ll impact human lives.
10. You’ll truly make a difference.
11. You’ll meet and befriend some amazing people.
12. You’ll find that the rare “thank you” and/or hug is worth it all.
13. You won’t do this job to be noticed.
14. You won’t do this job expecting to leave on time.
15. You’ll be proud to tell people you’re a nurse.
Sounds pretty good, huh? This is why we constantly repeat the phrase, “Nursing is not for everyone.”
The things that make our profession so tough are also the very same things that make this profession amazing. If it were easy, wouldn’t everybody be doing it?

Guest Blogger at MinorityNurse.com

Nurse Residency Program: The First Eight Weeks!
http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks

Nurse Residency Program: The First Eight Weeks

Submitted 3 days 22 hours ago by Kimberley Ensor.

I am now in week #7 of the program, almost halfway through the orientation process, and it has been everything I wanted from nursing school and so much more. The time and talent that is being invested in me and my cohort is immeasurable. There are days where we feel like we’re back in school with lectures, PowerPoints, and exams. Then when we are on our various units—not as students or helpers, but as the actual nurse giving patient care and putting our critical thinking to work—all the sacrifices, the long hours studying, the lack of sleep, and the chaos of interviewing is worth it.
No week is exactly identical, which is good since no day on the unit will be an exact carbon copy of the previous day. Each clinical experience takes us from novice and advanced beginner to competent and proficient on our journey to expert.
The program lasts a year but is divided into two portions. The first 16 weeks are orientation. We are assigned one acute care unit and one critical care unit. My cohort of 13 was given five acute areas and four critical areas to choose from. We are each assigned preceptors. Under the guidance of clinical nurse specialists (CNS) and the managers we prep for final placement, which will come at the end of week 15 to 16.
So if you think the interviewing is done, it’s not. The units we transfer to will hold interviews and we will be officially and permanently placed by the end of orientation. I 90% love it, 10% hate it. I love it in that I am getting multiple experiences on various floors and working with many different nurses. I am gaining a well-rounded history that will forever play a role in my role as a nurse. I hate it in that I have to decide which one unit to make my home. I wasn’t one of those students that only had their eye on one specialty and closed the door to all others.
So here is how my weeks have been going so far.
Week One: Getting to know you
During this week our cohort met each other for the first time. We spent this week expressing relief to be in the program and excitement about unit placement and giving patient care. Each eight-hour day, our minds are filled with policies, procedures, maps of the facility, and training on computers and equipment. We are shown the online learning center that contains all the learning modules we must complete in 60 days. By the end of the week, we are mentally exhausted from the large quantity of information but eager to put our new licenses to work.
Week Two: Getting to know your unit
During this week we spent four glorious days on our assigned units and worked as nurses for the first time. Under the supervision of a preceptor, we actively engaged in patient care, getting to know the unit and becoming comfortable with our new positions. We call the physician, the pharmacy, or the family. We spend this week getting comfortable with the fact that we are the nurse and all that being a nurse truly means.
Week Three: Getting to know the fundamentals, again
This week is split into clinical days on the unit and classrooms days. Clinical nurse specialists speak to us on topics from patient safety and satisfaction to palliative care and medication safety. Patient and family-centered care along with the professional role and practice model are reviewed constantly. On the unit the preceptors are allowing us to care for 1-2 patients independently using them as resources as we practice time management and delegation.
Week Four: Building on the foundations
We are now a fourth of the way through orientation and this week is divided into more classes with a couple of days on the unit. The topics this time around cover vascular access, infection prevention, and isolation practices to pressure ulcer prevention, ostomy care, and glycemic standards. Some of the cohort will work their first weekend and others will loop or have a day visit to a different unit, such as the operating room or the emergency department.
Week Five: Practice makes perfect
This week is full of nothing but clinical days. We are thankful for the break from class time and are glad to get back to patient care. As we are getting to know the interdisciplinary team and our unique patient populations, we are also being evaluated by the CNS assigned to our units along with our managers and preceptors. We’re starting to feel the crunch of wanting to take on more (3-4) patients, being confident when using SBAR, and completing those ever-present learning modules.
Week Six: More certifications, more practice, more of more
It is back to two clinical days and two classroom days. ECG, stroke, bariatric patients, trauma, and more medication safety are on the agenda. We are notified that we will have to take an ECG exam in a few weeks and it would behoove us to do as many practice problems as possible. We are also encouraged to get our NIH stroke certifications, sooner versus later, and be prepared to move through all phases of the certification process.
Week Seven: Back to school
More ECG, looping experiences, learning modules, and clinical days. Time has passed quickly and after week eight we will transition to the next unit assignment. While preparing to say “see ya later” to our first unit stop, we are given study time to prepare the approaching ECG exam that requires 80% or better. We are all feeling the pressure of wanting to do well on everything and be perfectionists. We’re using our Reflective Learning time to process, decompress, and recess from our growing schedules and learning experiences.
Week Eight: Preparation for the next phase
This week will entail three clinical days and a classroom day. The ECG exam will be administered at the end of the day. The expectation is that we are consistently caring for 3-4 patients and growing in confidence in our skills and nursing judgment.
When I post again, I will have transitioned to my new unit, passed my ECG exam, and finished all my learning modules. Hopefully, I will have decided just where this new grad wants to make her first stop on her nursing journey.

- See more at: http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks#sthash.1uiSUzMg.dpuf

Nurse Residency Program: The First Eight Weeks

Submitted 3 days 22 hours ago by Kimberley Ensor.

I am now in week #7 of the program, almost halfway through the orientation process, and it has been everything I wanted from nursing school and so much more. The time and talent that is being invested in me and my cohort is immeasurable. There are days where we feel like we’re back in school with lectures, PowerPoints, and exams. Then when we are on our various units—not as students or helpers, but as the actual nurse giving patient care and putting our critical thinking to work—all the sacrifices, the long hours studying, the lack of sleep, and the chaos of interviewing is worth it.
No week is exactly identical, which is good since no day on the unit will be an exact carbon copy of the previous day. Each clinical experience takes us from novice and advanced beginner to competent and proficient on our journey to expert.
The program lasts a year but is divided into two portions. The first 16 weeks are orientation. We are assigned one acute care unit and one critical care unit. My cohort of 13 was given five acute areas and four critical areas to choose from. We are each assigned preceptors. Under the guidance of clinical nurse specialists (CNS) and the managers we prep for final placement, which will come at the end of week 15 to 16.
So if you think the interviewing is done, it’s not. The units we transfer to will hold interviews and we will be officially and permanently placed by the end of orientation. I 90% love it, 10% hate it. I love it in that I am getting multiple experiences on various floors and working with many different nurses. I am gaining a well-rounded history that will forever play a role in my role as a nurse. I hate it in that I have to decide which one unit to make my home. I wasn’t one of those students that only had their eye on one specialty and closed the door to all others.
So here is how my weeks have been going so far.
Week One: Getting to know you
During this week our cohort met each other for the first time. We spent this week expressing relief to be in the program and excitement about unit placement and giving patient care. Each eight-hour day, our minds are filled with policies, procedures, maps of the facility, and training on computers and equipment. We are shown the online learning center that contains all the learning modules we must complete in 60 days. By the end of the week, we are mentally exhausted from the large quantity of information but eager to put our new licenses to work.
Week Two: Getting to know your unit
During this week we spent four glorious days on our assigned units and worked as nurses for the first time. Under the supervision of a preceptor, we actively engaged in patient care, getting to know the unit and becoming comfortable with our new positions. We call the physician, the pharmacy, or the family. We spend this week getting comfortable with the fact that we are the nurse and all that being a nurse truly means.
Week Three: Getting to know the fundamentals, again
This week is split into clinical days on the unit and classrooms days. Clinical nurse specialists speak to us on topics from patient safety and satisfaction to palliative care and medication safety. Patient and family-centered care along with the professional role and practice model are reviewed constantly. On the unit the preceptors are allowing us to care for 1-2 patients independently using them as resources as we practice time management and delegation.
Week Four: Building on the foundations
We are now a fourth of the way through orientation and this week is divided into more classes with a couple of days on the unit. The topics this time around cover vascular access, infection prevention, and isolation practices to pressure ulcer prevention, ostomy care, and glycemic standards. Some of the cohort will work their first weekend and others will loop or have a day visit to a different unit, such as the operating room or the emergency department.
Week Five: Practice makes perfect
This week is full of nothing but clinical days. We are thankful for the break from class time and are glad to get back to patient care. As we are getting to know the interdisciplinary team and our unique patient populations, we are also being evaluated by the CNS assigned to our units along with our managers and preceptors. We’re starting to feel the crunch of wanting to take on more (3-4) patients, being confident when using SBAR, and completing those ever-present learning modules.
Week Six: More certifications, more practice, more of more
It is back to two clinical days and two classroom days. ECG, stroke, bariatric patients, trauma, and more medication safety are on the agenda. We are notified that we will have to take an ECG exam in a few weeks and it would behoove us to do as many practice problems as possible. We are also encouraged to get our NIH stroke certifications, sooner versus later, and be prepared to move through all phases of the certification process.
Week Seven: Back to school
More ECG, looping experiences, learning modules, and clinical days. Time has passed quickly and after week eight we will transition to the next unit assignment. While preparing to say “see ya later” to our first unit stop, we are given study time to prepare the approaching ECG exam that requires 80% or better. We are all feeling the pressure of wanting to do well on everything and be perfectionists. We’re using our Reflective Learning time to process, decompress, and recess from our growing schedules and learning experiences.
Week Eight: Preparation for the next phase
This week will entail three clinical days and a classroom day. The ECG exam will be administered at the end of the day. The expectation is that we are consistently caring for 3-4 patients and growing in confidence in our skills and nursing judgment.
When I post again, I will have transitioned to my new unit, passed my ECG exam, and finished all my learning modules. Hopefully, I will have decided just where this new grad wants to make her first stop on her nursing journey.

- See more at: http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks#sthash.1uiSUzMg.dpuf

Nurse Residency Program: The First Eight Weeks

Submitted 3 days 22 hours ago by Kimberley Ensor.

I am now in week #7 of the program, almost halfway through the orientation process, and it has been everything I wanted from nursing school and so much more. The time and talent that is being invested in me and my cohort is immeasurable. There are days where we feel like we’re back in school with lectures, PowerPoints, and exams. Then when we are on our various units—not as students or helpers, but as the actual nurse giving patient care and putting our critical thinking to work—all the sacrifices, the long hours studying, the lack of sleep, and the chaos of interviewing is worth it.
No week is exactly identical, which is good since no day on the unit will be an exact carbon copy of the previous day. Each clinical experience takes us from novice and advanced beginner to competent and proficient on our journey to expert.
The program lasts a year but is divided into two portions. The first 16 weeks are orientation. We are assigned one acute care unit and one critical care unit. My cohort of 13 was given five acute areas and four critical areas to choose from. We are each assigned preceptors. Under the guidance of clinical nurse specialists (CNS) and the managers we prep for final placement, which will come at the end of week 15 to 16.
So if you think the interviewing is done, it’s not. The units we transfer to will hold interviews and we will be officially and permanently placed by the end of orientation. I 90% love it, 10% hate it. I love it in that I am getting multiple experiences on various floors and working with many different nurses. I am gaining a well-rounded history that will forever play a role in my role as a nurse. I hate it in that I have to decide which one unit to make my home. I wasn’t one of those students that only had their eye on one specialty and closed the door to all others.
So here is how my weeks have been going so far.
Week One: Getting to know you
During this week our cohort met each other for the first time. We spent this week expressing relief to be in the program and excitement about unit placement and giving patient care. Each eight-hour day, our minds are filled with policies, procedures, maps of the facility, and training on computers and equipment. We are shown the online learning center that contains all the learning modules we must complete in 60 days. By the end of the week, we are mentally exhausted from the large quantity of information but eager to put our new licenses to work.
Week Two: Getting to know your unit
During this week we spent four glorious days on our assigned units and worked as nurses for the first time. Under the supervision of a preceptor, we actively engaged in patient care, getting to know the unit and becoming comfortable with our new positions. We call the physician, the pharmacy, or the family. We spend this week getting comfortable with the fact that we are the nurse and all that being a nurse truly means.
Week Three: Getting to know the fundamentals, again
This week is split into clinical days on the unit and classrooms days. Clinical nurse specialists speak to us on topics from patient safety and satisfaction to palliative care and medication safety. Patient and family-centered care along with the professional role and practice model are reviewed constantly. On the unit the preceptors are allowing us to care for 1-2 patients independently using them as resources as we practice time management and delegation.
Week Four: Building on the foundations
We are now a fourth of the way through orientation and this week is divided into more classes with a couple of days on the unit. The topics this time around cover vascular access, infection prevention, and isolation practices to pressure ulcer prevention, ostomy care, and glycemic standards. Some of the cohort will work their first weekend and others will loop or have a day visit to a different unit, such as the operating room or the emergency department.
Week Five: Practice makes perfect
This week is full of nothing but clinical days. We are thankful for the break from class time and are glad to get back to patient care. As we are getting to know the interdisciplinary team and our unique patient populations, we are also being evaluated by the CNS assigned to our units along with our managers and preceptors. We’re starting to feel the crunch of wanting to take on more (3-4) patients, being confident when using SBAR, and completing those ever-present learning modules.
Week Six: More certifications, more practice, more of more
It is back to two clinical days and two classroom days. ECG, stroke, bariatric patients, trauma, and more medication safety are on the agenda. We are notified that we will have to take an ECG exam in a few weeks and it would behoove us to do as many practice problems as possible. We are also encouraged to get our NIH stroke certifications, sooner versus later, and be prepared to move through all phases of the certification process.
Week Seven: Back to school
More ECG, looping experiences, learning modules, and clinical days. Time has passed quickly and after week eight we will transition to the next unit assignment. While preparing to say “see ya later” to our first unit stop, we are given study time to prepare the approaching ECG exam that requires 80% or better. We are all feeling the pressure of wanting to do well on everything and be perfectionists. We’re using our Reflective Learning time to process, decompress, and recess from our growing schedules and learning experiences.
Week Eight: Preparation for the next phase
This week will entail three clinical days and a classroom day. The ECG exam will be administered at the end of the day. The expectation is that we are consistently caring for 3-4 patients and growing in confidence in our skills and nursing judgment.
When I post again, I will have transitioned to my new unit, passed my ECG exam, and finished all my learning modules. Hopefully, I will have decided just where this new grad wants to make her first stop on her nursing journey.

- See more at: http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks#sthash.1uiSUzMg.dpuf

Nurse Residency Program: The First Eight Weeks

Submitted 3 days 22 hours ago by Kimberley Ensor.

I am now in week #7 of the program, almost halfway through the orientation process, and it has been everything I wanted from nursing school and so much more. The time and talent that is being invested in me and my cohort is immeasurable. There are days where we feel like we’re back in school with lectures, PowerPoints, and exams. Then when we are on our various units—not as students or helpers, but as the actual nurse giving patient care and putting our critical thinking to work—all the sacrifices, the long hours studying, the lack of sleep, and the chaos of interviewing is worth it.
No week is exactly identical, which is good since no day on the unit will be an exact carbon copy of the previous day. Each clinical experience takes us from novice and advanced beginner to competent and proficient on our journey to expert.
The program lasts a year but is divided into two portions. The first 16 weeks are orientation. We are assigned one acute care unit and one critical care unit. My cohort of 13 was given five acute areas and four critical areas to choose from. We are each assigned preceptors. Under the guidance of clinical nurse specialists (CNS) and the managers we prep for final placement, which will come at the end of week 15 to 16.
So if you think the interviewing is done, it’s not. The units we transfer to will hold interviews and we will be officially and permanently placed by the end of orientation. I 90% love it, 10% hate it. I love it in that I am getting multiple experiences on various floors and working with many different nurses. I am gaining a well-rounded history that will forever play a role in my role as a nurse. I hate it in that I have to decide which one unit to make my home. I wasn’t one of those students that only had their eye on one specialty and closed the door to all others.
So here is how my weeks have been going so far.
Week One: Getting to know you
During this week our cohort met each other for the first time. We spent this week expressing relief to be in the program and excitement about unit placement and giving patient care. Each eight-hour day, our minds are filled with policies, procedures, maps of the facility, and training on computers and equipment. We are shown the online learning center that contains all the learning modules we must complete in 60 days. By the end of the week, we are mentally exhausted from the large quantity of information but eager to put our new licenses to work.
Week Two: Getting to know your unit
During this week we spent four glorious days on our assigned units and worked as nurses for the first time. Under the supervision of a preceptor, we actively engaged in patient care, getting to know the unit and becoming comfortable with our new positions. We call the physician, the pharmacy, or the family. We spend this week getting comfortable with the fact that we are the nurse and all that being a nurse truly means.
Week Three: Getting to know the fundamentals, again
This week is split into clinical days on the unit and classrooms days. Clinical nurse specialists speak to us on topics from patient safety and satisfaction to palliative care and medication safety. Patient and family-centered care along with the professional role and practice model are reviewed constantly. On the unit the preceptors are allowing us to care for 1-2 patients independently using them as resources as we practice time management and delegation.
Week Four: Building on the foundations
We are now a fourth of the way through orientation and this week is divided into more classes with a couple of days on the unit. The topics this time around cover vascular access, infection prevention, and isolation practices to pressure ulcer prevention, ostomy care, and glycemic standards. Some of the cohort will work their first weekend and others will loop or have a day visit to a different unit, such as the operating room or the emergency department.
Week Five: Practice makes perfect
This week is full of nothing but clinical days. We are thankful for the break from class time and are glad to get back to patient care. As we are getting to know the interdisciplinary team and our unique patient populations, we are also being evaluated by the CNS assigned to our units along with our managers and preceptors. We’re starting to feel the crunch of wanting to take on more (3-4) patients, being confident when using SBAR, and completing those ever-present learning modules.
Week Six: More certifications, more practice, more of more
It is back to two clinical days and two classroom days. ECG, stroke, bariatric patients, trauma, and more medication safety are on the agenda. We are notified that we will have to take an ECG exam in a few weeks and it would behoove us to do as many practice problems as possible. We are also encouraged to get our NIH stroke certifications, sooner versus later, and be prepared to move through all phases of the certification process.
Week Seven: Back to school
More ECG, looping experiences, learning modules, and clinical days. Time has passed quickly and after week eight we will transition to the next unit assignment. While preparing to say “see ya later” to our first unit stop, we are given study time to prepare the approaching ECG exam that requires 80% or better. We are all feeling the pressure of wanting to do well on everything and be perfectionists. We’re using our Reflective Learning time to process, decompress, and recess from our growing schedules and learning experiences.
Week Eight: Preparation for the next phase
This week will entail three clinical days and a classroom day. The ECG exam will be administered at the end of the day. The expectation is that we are consistently caring for 3-4 patients and growing in confidence in our skills and nursing judgment.
When I post again, I will have transitioned to my new unit, passed my ECG exam, and finished all my learning modules. Hopefully, I will have decided just where this new grad wants to make her first stop on her nursing journey.

- See more at: http://www.minoritynurse.com/blog/kimberley-ensor/nurse-residency-program-first-eight-weeks#sthash.1uiSUzMg.dpuf

Top 6 tips for avoiding burnout

by Scrubs Contributor • October 17, 2013 Wellness Tips, Your Health

BananaStock | ThinkStock

Whether you’re a nurse, student, or parent, we all face the same challenge: time. In a profession that revolves around caring for others, it’s not unusual for us to neglect ourselves. It’s a dangerous and slippery slope to go down.
We get swept up in countless responsibilities, obligations and assignments, often forgetting that our tank is running on empty. It’s important to stop, take a breath and recharge. Life is not a sprint…it’s a marathon. Avoid burnout by taking a few moments to take care of yourself:
1. Fuel up. Limited time? Not a problem. Smoothies are a great way to get essential vitamins and minerals on the go. Healthy snacks like baby carrots, peanuts, cheese sticks, apples, oranges and yogurt require no preparation time and can be taken anywhere. Three meals a day are ideal, but when that isn’t possible, be sure to continually snack on healthy foods throughout the day.
2. Get some ZZZs. There is no substitute for sleep (sorry!). Most medical errors are made during the last hours of the shift. Don’t feel guilty for taking a little extra time to recharge. You’re doing a favor not just for yourself, but your patients and loved ones as well. In situations where sleep gets skimpy, power naps of less than 30 minutes have been shown to improve alertness, restore wakefulness and increase productivity.
3. Unwind. Get your mind off of work. Disconnect. Unplug. People unwind in different ways–what’s your niche? Explore what works for you. Yoga, hiking, art, working out and music are just a few avenues. Even if it’s just for a few minutes before bed, let your brain rest so you can dominate at full force later.
4. Process. Whether it’s delivering bad news to family members or witnessing a patient’s condition crumble, nursing is emotionally taxing. Talk to a friend, family member, coworker, someone. If a long conversation isn’t possible, journal. Utilize the notepad feature on a smartphone, carry a pocket sized memo pad, or incorporate journaling into your bedtime routine. It’s important to process heavy emotions so they don’t weigh you down later.
5. Flex Time. Lifting weights isn’t the challenge…finding time to is. If you have a one-hour lunch break, spend the first half working out. Multitask on the bikes or treadmill. Make gym time a fun event and go with friends. If getting to the gym is difficult, find a YouTube workout video you can do at home. Exercise is a great way to rejuvenate your body and blow off steam.
6. TLC. Everyone needs some tender love and care. Juggling an active work, family and social life gets tricky. One way to balance it? Never eat alone. We all have to eat…might as well eat with company! Another great way to keep in touch with loved ones is to utilize transportation time to catch up on the phone (hands-free, of course) or send emails (if taking public transportation). With technology it’s even possible to hang out without having to leave your house (i.e. Skype, Google Hangout or Facetime).
It’s impossible to continue helping others when our batteries are near empty. Don’t feel guilty. You’ve got to help yourself before you help anyone else…and helping yourself may be the biggest favor you can do for someone else!
Sources:
Rogers AE, Hwang WT, Scott LD, et al. “Hospital staff nurse work hours and patient safety.” Health Affairs. 2004 July;23(4):202–12
Dhand, Rajiv; Sohal, Harjyot (2007). “Good sleep, bad sleep! The role of daytime naps in healthy adults.” Current Opinion in Internal Medicine 6: 9
National Institute of Mental Health, “Power Nap Prevents Burnout; Morning Sleep Perfects a Skill.”
Divya Kulshreshtha is a nursing student at Columbia University. She has a double bachelor’s degree in biology and psychology from the University of Maryland. She was inspired to pursue a career in nursing after her father was hospitalized, and has since done volunteer medical work in Kenya. In the future, she hopes to work with underserved populations and be involved with international health.

10 things that’ll surely happen five minutes before the end of a shift

by Sean Dent • October 16, 2013 Featured Articles, Fun & Humor, Lists and Ideas

Fuse | ThinkStock

Any nurse who’s been on the job for more than a couple of months knows all about “the witching hour.” You either hear about it, or you get the slap-in-face personal experience. It’s that time on your shift when things are more likely to be, well, bad. It’s that time on your shift when things are going to go wrong, no matter what you do.
This is notoriously the last leg of your shift. You can slice or dice it any way you like, but roughly 60 minutes (or less) prior to the so-called end of your shift, the “Code Brown hits the fan” (if you know what I mean).
You do your best to get all your ducks in a row, but it never fails. The witching hour always seems to toy with you. Here are 10 things that are sure to happen during the witching hour:
1. Your patient just had the worst Code Brown of your career: Get out the mop.
2. Your “stable” patient becomes not-so stable.
3. You realize there were tasks and/or orders you missed from the beginning of your shift.
4. Somebody just entered in two pages of new orders on your patient.
5. A Code Blue is called on your patient or unit.
6. A new admission just showed up–without a report–and there is another one on the way.
7. The unit secretary’s shift just ended…and the phone is ringing off the hook.
8. There was a massive power outage – and now you’re bagging your mechanically ventilated patient.
9. The EMR just went down – and you have charting to finish.
10. Your patient’s one and only IV access just blew and you have to give blood products.
I mean, you’re human, right? We all like getting out on time, don’t we? It just seems that the forces of the universe don’t usually allow nurses to get out on time. Am I the only one who thinks the universe has a sick sense of humor?

Teaming up to serve the underserved

Nursing partnership benefits urban residents.

By Carrie Stetler

​Cindy Sickora, DNP, RN, makes sure that every weekday, the Rutgers School of Nursing’s health care van is there to help the people who need it. Its patients, mostly from Newark, New Jersey, USA, are elderly residents in buildings without elevators, gunshot victims in need of follow-up care, and children booked for vaccines in a city with one of the lowest vaccination rates in the United States.   Many are public housing residents with no health insurance or primary care doctor. Although the traveling clinic treats more than 1,500 patients a year, the city’s need for affordable, accessible health care is overwhelming.    Sickora, an associate professor at Rutgers School of Nursing, part of the former University of Medicine and Dentistry of New Jersey, was searching for a way to reach more people. She found it when she met Suzanne Willard, PhD, RN, APNC, FAAN. Both are members of the Honor Society of Nursing, Sigma Theta Tau International (STTI).   Willard had opened FOCUS Wellness Center last year on the other side of Newark. The wellness center is part of the Rutgers College of Nursing, which was founded at the university in 1955. By joining forces, Willard and Sickora hope to accomplish a shared mission: transforming urban health care.   The pair began working together as Rutgers was preparing to integrate with most of the schools, centers, and institutes that made up the former University of Medicine and Dentistry of New Jersey. Their new partnership allows the facilities to share resources and serve patients far better than they could on their own. For instance, the center has a social worker on staff for patients with mental health needs. The mobile clinic, which has no social worker, can now refer patients to the center.     “We have the potential to help a whole lot of people,” says Sickora, who directs the School of Nursing’s community health program. “Our mobile clinic can make inroads in educating people to use FOCUS, which could be a health care hub, especially for areas of the city we don’t cover.”     Nurses have a reputation for cutting through red tape and getting things done, says Willard, associate dean of Rutgers College of Nursing’s advanced practice program. “There is a solidarity among nurses.”   The center’s first patient was a referral from Sickora. The mobile clinic staff, which couldn’t provide gynecological exams at the time, sent her to FOCUS. “Cindy said, ‘I’ve got someone who’s had problems accessing services, and your center would be perfect,’” Willard recalls. Days after the visit, mobile care nurses checked in on her at home to make sure her symptoms had subsided.    Newark has one of the most underserved populations for basic health care in the United States. Many residents lack reliable transportation and must take multiple buses to see a primary care doctor, if they have one at all. Some wait days, even weeks, for appointments. Others are prescribed expensive medication they can’t afford.   Studies show that nurse-managed care can be just as effective as physician-administered care, according to Willard and Sickora. Nurse-managed care is especially successful at providing treatment continuity—as well as a personal touch—at a much lower cost. “Our approach is more holistic,” Willard says. “Nurses look at patients and think of their overall ability to improve health outcomes; that’s how we’re wired. We ask, ‘What do I need to do to help them take care of themselves when they leave?’ We want to keep them out of the emergency room.”   The FOCUS Wellness Center, funded with federal and local grants, is designed to meet the multifaceted needs of patients who are often grappling with mental health issues and neighborhoods filled with violence. These issues aggravate conditions such as diabetes, hypertension, and asthma that are common throughout inner cities.   Willard recalls one patient who said her father had been murdered when she was 7. “I thought, ‘How can you just treat the physical symptoms with a patient whose father was killed in front of her when she was that young?’ We have a lot of case histories like that,” Willard says.   The nursing school’s mobile clinic is part of a larger network, based on a pioneering health care model, in which residents work closely with nurses, Sickora says. The nerve center of the program is Rutgers’ Jordan and Harris Community Health Center, headquartered at the Hyatt Court public housing complex in Newark. It’s staffed by two nurses who make house calls to shut-ins and serve as liaisons between patients and outside health care providers.   Community health workers in Sickora’s program are trained to pinpoint residents in need, schedule appointments, and coordinate follow-up care. “They knock on doors. They’ll say, ‘We need to make sure the babies get their measles vaccine.’ They’re the reason we’re able to see so many patients,” Sickora says.   She and her staff, which includes nursing students, have worked hard to form relationships with residents, many of whom rely on them to treat chronic conditions.    During a recent physical exam, Andrew Jackson was diagnosed with high blood pressure. Since his Medicaid was cut off last year, he’s made weekly visits for checkups and advice. “They tell me to go slow on the salt,” says Jackson, 42.   No other mobile health care program in the nation, according to Sickora, uses the community health worker model, which she believes can be a valuable source of data for researchers. Two nurse scientists are already involved in evaluating programs.    Says Sickora, “We’re really asking the question: Can we change health care for underserved populations?” RNL   Video   Published 9/19/2013, Vol. 39, No. 3