Nurse Leadership vs. Management

The terms “leader” and “manager” are sometimes used interchangeably.  Those who have worked for, or with, someone who is one and not the other, will see the error in viewing those terms as synonymous.  An individual can be a great leader but not a manager.  Conversely, an individual can be a manager but not possess many leadership skills.

What is the difference between nurse leadership versus management?

A leader often doesn’t have delegated authority.  The “power” that the leader has acquired has come informally from others in the group.  Leaders focus on empowering others, as well as motivating, inspiring, and influencing others.  A leader typically has good communication and interpersonal skills.  True leaders must be sincere and energetic.  A leader may be a risk-taker, but not to the extent that others feel that they are reckless.

A manager is provided with this status as a formal role which is given to him/her by someone else.  He/she has an assigned position within the formal organization.  A manager is expected to carry out specific duties and has definite responsibilities.  Control over processes, decision-making, and the work of others are included in the manager’s role.  Good managers are skilled at coordinating resources, both financial and personnel, following rules, and meeting the goals and objectives of the organization.  Control is a key element of the role.  Good managers also use reward and punishment effectively.

Although differences do exist, the roles can definitely overlap.  The best case scenario is for an individual to have the best characteristics of both.  All nurses are leaders and managers at some level.  We all strive for a balance between doing the right thing and doing things right.  The rapid and dramatic changes in health care make these skills more important than ever.  Critical thinking skills, active listening skills, and good coping skills are essential at all levels in today’s nursing workforce.

Both leaders and managers need to envision the future and lead the way towards a productive and efficient unit with satisfied personnel.  We can never stop seeking additional professional growth and opportunities to make a difference in our profession.  There are many ways to accomplish this, including becoming politically aware and active, reading professional journals, and attending continuing education offerings relevant to our practice.  No formal title of manager is required to do these things.  A good leader and a good manager will take advantage of these and other opportunities.

Weight Loss Tips for Nurses

Nurses are on their feet for many long hours every day. It is important to keep the weight off in order to fit in your uniform, but also to look good as a health professional and to be comfortable on your feet. It your feet and legs have to carry a lot of weight around every day, you are bound to suffer from back pain. Here are some great tips to lose weight as a nurse.

It is important to be comfortable in your nursing uniform

In order to be comfortable in a nursing uniform, nurses should take care of their weight. Nursing is a rather active type of work, and it is important that nurses are mobile. While dieting is regarded as a bad word for many people, perhaps the focus should shift to healthier eating choices. It is best to eat a well-balanced diet so that you get all the nutrients required to perform your duties.

Burn more calories

Nurses are in the fortunate position that the nature of their work helps them to burn calories throughout the day. If you still have a weight issue, then you need to find ways to burn more calories in order to fit into your nursing uniform. Waking up a little earlier each day to fit in some light exercise will go a long way towards this.

Take a brisk walk 2-3 times a week so that you burn more calories. While at work, try to use the stairs where possible, this will burn many calories over a week or a month.

Eat less

If fitting into your nursing uniform is important to you, then you need to cut back slightly on your food portions. Using a small plate will give the impression that you are still eating a lot of food. This is a great technique to ensure that you cut back on your intake of calories. In next to no time, you will start shedding the inches and find that you are fitting more easily into your nursing uniform.

There is no quick fix to weight loss

All your dietary changes need to be permanent. If you revert to old eating patterns, you will regain the weight. This will seriously impede your efforts to fit into your nursing uniform. Embrace the fact that you have decided to improve your healthy by losing unwanted inches and pounds. Variety is the spice of life, and this should motivate you to eat a varied diet. Increase your intake of fruit and vegetables and reduce your intake of simple carbohydrates.

WORKING WHILE GOING TO SCHOOL TO BECOME A NURSE

Students who need to work while they are in school to become a nurse can’t just haphazardly attend class and go to work and study whenever they have time, because they will find themselves without any time to study!

The first step to successfully balance work and school is to determine where the required activities will fit (and if they fit!)  This process is explained in this post.

After the skeleton outline of time allotments is complete, the key is to use the time you have well and find hidden time in your schedule to maximize your productivity.  The following are tips I’ve used to manage my time, thus far on my journey to become a nurse.

Planning Tips on Working While in School to Become a Nurse

1)   Make sure that your schedule allows for sufficient time to study. It is generally accepted that each hour in class should mean 1-3 hours outside of class studying.  This means that if you are taking 5 units, you will need to study 10-30 hours each week, depending on your major and your intrinsic abilities. As a student who needs A grades and is enrolled in prerequisites to become a nurse, I studied over 30 hours per week during my last 4 unit science class.

2)   Develop a written study schedule so that you know what you’re going to do before you sit down to study so that you don’t waste time figuring out what you are supposed to be doing. Since many of the classes that you take to become a nurse are science based, you may need to approach studying in a systematic manner to be able to study appropriately while working.

3) Organize your time.

4) Follow a schedule.

5)   Consider the best use of your time when developing your schedule. Determine which study activities require your total focus and which can be done while multitasking on other activities. For example, I can review flash cards while walking through the parking lot to class. But I’m not so good at reading my textbook while walking to class.  However, you might be able to read your textbook during your lunch break. When I was in college before, I had a job that allowed me the time to write out checks to pay bills during downtime at work.

6)   Split your study time. Studying doesn’t need to be done in one multi-hour sitting. By breaking up study session between before and after work sessions, you may be able to squeeze more study time in.

7)   Don’t underestimate the power of studying for short periods of time frequently! All those small increments add up.

8)   Put time in your schedule to read the textbook multiple times. This is especially effective if the topic is complex (as many of the science classes that people must take to become a nurse are) and your teacher wants you to be able to understand and apply the information. If the teacher doesn’t use the textbook or just wants you to regurgitate her ideas, then disregard this idea and don’t spend time reading the textbook. It only takes me 45 minutes to 1 ½ hours to read a chapter, depending on if the it is my first or second time reading the chapter.

10 Tips for Night Shift Nurses

The night shift can be challenging to your success at work and also to your ability to maintain physical and emotional health.  Whether by design or by necessity, when you find yourself working the night shift, practice these tips to help you manage your work-life balance:

• Sleep and eat well prior to your shift.  After all, most "daytime people" come to work after a good night's sleep and a healthy breakfast!

• Before trying to go to sleep, allow end-of-day decompression time.  "Daytime people" relax after work.  You should too!

• If you must rotate shifts, do so in a forward fashion (days to evening, evenings to nights, and nights to days).  This allows for better physical adjustment and is not as disruptive to your circadian rhythm.

• Don't lose your connection with family life.  Remember, your family relies on you for more than your paycheck!  Your job, colleagues, and career come after your family – just like the "daytime people".  As a night shifter, you also have an advantage.  You can volunteer at your child's school or visit your significant other at work during the morning hours!

• Avoid excessive reliance on caffeine.  This habit may get you by the occasional slump, but can become addictive and disruptive to your circadian rhythm.  If you feel the need for a "rush", excuse yourself from your duties for a few minutes and take a fast walk.  This will wake you up!

• Avoid intoxicants or medications to get to sleep.  They alter your sleep architecture; thus making sleep less restful and possibly giving you a hangover with poor performance at work.  These vices are also habit forming!  

• Use the morning hours after you get off from work for personal business.  Run errands while you still have your wits about you and businesses are at their freshest level of service!

• Live on your day shift income.  Don't rely on night shift differential to make ends meet.  Plan your budget upon basic salary figures in the event of unexpected changes or disability.  Use your night shift differential income for specific short-term purposes like: debt reduction, investment, or a vacation fund!  Don't become dependent on the extra money night shift differential provides - - you may never be able to go off nights (if you want to)!

• Have sleep-preparation rituals that promote good sleep patterns.  Regularity of preparations, even the same go-to-sleep music, will flip your mind switch to, "I'm going to sleep now."  Use a sleep mask, blackout curtains, ear plugs, or other sleep aids if necessary.  Silence the telephone ringer so the "daytime people" don't bother your sleep.  After all, you don’t bother theirs! 
• People say, "Good Night" to you in the morning as you leave.  Insist upon saying, "Good Morning," to maintain a better sense of balance! 

Peak technique: Preparing your patient for hemodialysis

When a person's kidneys fail to function properly, life-sustaining treatment, such as hemodialysis, may be required. Hemodialysis works by removing blood from the body; putting it through a dialyzer to clean the blood of toxins, excess water, and electrolytes; and then returning clean blood back to the patient (see Picturing hemodialysis). There are approximately 300,000 people receiving hemodialysis three times a week. At this rate, it's likely that you'll prepare a patient for hemodialysis. In this article, you'll learn what you need to do minimally to keep your patient safe before and after a hemodialysis treatment.

The nuts and bolts of hemodialysis

Hemodialysis can be performed using one of three different access devices. The most common access used is an arteriovenous fistula (AVF), which is created peripherally by connecting an artery and vein together. This surgical connection of the artery and vein causes increased blood flow, which stimulates the size and thickness of the AVF. After about 6 to 12 weeks, the AVF is strong enough to withstand the high volumes of blood flow needed for dialysis treatments.

When a patient doesn't have blood vessels strong enough to grow adequately, an arteriovenous graft(AVG) may be created. An AVG is created by using synthetic material to connect the artery to a vein. The time required for an AVG to mature in size is usually about 3 weeks. Whether your patient has an AVF or an AVG, time is needed for it to grow (see AVF and AVG access). Meanwhile, a temporaryhemodialysis catheter will be placed in your patient's subclavian, femoral, or internal jugular vein for immediate use (see Hemodialysis catheter access). Regardless of the type of access device your patient has, there are precautions you'll need to take before you send your patient for a dialysis treatment.

Patients on dialysis are typically on a 3 days a week schedule. Treatment usually lasts for 3 to 5 hours. What you do before your patient has dialysis can make all the difference in how well your patient responds to the treatment. In some rare cases, what you do or don't do can even make the difference between life and death. This is why it's very important to make sure you understand what should and should never occur when preparing your patient for hemodialysis.

Figure. Picturing hemodialysis

Before hemodialysis

Weight

Before your patient undergoes a hemodialysis treatment, you'll need to obtain an accurate weight measurement. Expect that your patient will be a few pounds heavier than the previous day; this is the result of water buildup between treatments. Document the weight obtained and be sure to share this with the hemodialysis nurse. The weight measurement will help determine the amount of fluid that will need to be removed during hemodialysis so that your patient can return to his dry weight. The dry weight is the patient's goal weight without the fluid buildup between hemodialysis treatments.

Vital signs

Obtain a complete set of vital signs and document your findings. Assess whether your patient's BP indicates hypertension or hypotension. Avoid monitoring BP in the arm with the AVF or AVG; doing so can cause clotting and result in loss of access. Assess your patient's temperature for fever, which could indicate infection. Assess the rate and quality of respirations. Patients undergoing hemodialysis are prone to the development of dysrhythmias; when assessing the heart rate, be sure to also take note of the rhythm.

During the time you collect vital signs, it's also a good time to assess the overall condition of your patient. Do this by assessing his skin, mental status, and whether your patient has any complaints, such as pain or nausea.

Access site

Before sending your patient for a hemodialysis treatment, you'll need to make sure that the access site is functioning properly. Your assessment interventions will depend on the type of access your patient has. If your patient has an AVF or AVG, you'll need to check for obvious problems. Assess for bleeding at the site, oozing or drainage, redness, warmth, and patient complaints of pain at the site because these are key signs of infection and should be reported to the healthcare provider.

It's extremely important to assess the site for circulation. This is done by assessing distal pulses, palpating for a thrill (feel the thrill), and auscultating for a bruit (hear the buzz). You will feel the thrill by gently placing your fingertips or palm over your patient's access site; you should notice a vibration. To hear the bruit, place your stethoscope over the site and listen for a swishing or whooshing sound. If either is absent or barely noticeable, it could indicate loss of access and you'll need to contact the healthcare provider in addition to the hemodialysis nurse for instructions on how to proceed before sending your patient for treatment.

When dialysis is anticipated on a short-term basis or during the period of time when an AVF or AVG matures, your patient may have a hemodialysis catheter placed. These catheters are most often placed in the subclavian vein, but can also be placed in the internal jugular or femoral veins. A hemodialysis catheter has two lumens: one will be used to remove blood and the other to return the clean blood back to the patient. When assessing this type of access, you'll need to monitor the catheter site for drainage and redness of surrounding skin. It's very important that you maintain sterile technique when working with hemodialysis catheters. You shouldn't use these catheters to administer routine fluids or medications, and they shouldn't be flushed with normal saline solution. Most facilities restrict use of these catheters to only the hemodialysis nurse; review your facility's policy on your responsibilities when caring for a hemodialysis catheter.

Lab results

Review the last ordered lab results; specifically review the chemistry results for levels of sodium, potassium, phosphorus, blood urea nitrogen, and creatinine. Anticipate that these will be elevated. Knowing the predialysis electrolyte results will help determine the effectiveness of the treatment by comparing them with the postdialysis lab results.

Review the complete blood cell count, particularly the red blood cell (RBC) count, hemoglobin, and hematocrit levels. Anticipate that these will be decreased from normal levels, but understand that dialysis doesn't correct abnormal RBC, hemoglobin, and hematocrit levels. You should anticipate receiving other orders to address these low levels; for example, administration of packed RBCs and RBC-stimulating medication (also known as erythropoiesis-stimulating agents).

Important reminder: Make sure that labs are never drawn from the arm with the AVF or AVG.

Scheduled medications

Review the list of medications for your patient, scheduled up to 4 hours before the treatment. There may be some that you shouldn't administer. Because your patient's BP will drop during treatments, all antihypertensive drugs should be held before hemodialysis. In most cases, antiarrhythmic medications are given as scheduled due to the high incidence of patients developing arrhythmias during hemodialysis. Certain types of drugs will pass through the dialysis machine and not provide benefits to the patient. These drugs are any type of water-soluble vitamins, so they should also be held before treatments.

Your facility will provide guidelines for the safe administration of medications to patients before and after hemodialysis treatments. Remember to contact the healthcare provider for individualized orders for your patient.

Figure. Hemodialysis catheter access

After hemodialysis

Your nursing interventions when your patient returns from a hemodialysis treatment are almost identical to your predialysis interventions. As soon as you resume care of your patient postdialysis, you'll need to obtain a set of vital signs and a weight measurement and assess the access site. Compare your findings with the predialysis results and report anything not within the defined limits as predetermined by the healthcare provider. Infection is a complication that should be continually assessed by looking for elevations in temperature and white blood cell count and assessing for warmth and redness at or around the access site. Monitor the access site carefully for bleeding. Early detection and treatment can prevent life-threatening hemorrhaging that could result from heparin used during treatments. Monitor your patient closely for signs of confusion, decreased level of consciousness, and sudden severe headaches because these neurologic changes could be related to a potentially life-threatening complication known as disequilibrium syndrome and must be reported immediately.

Determine when the next ordered labs will be collected and keep a lookout for the results to review. You'll also need to give the medications that were held before sending your patient to hemodialysis. This should be done only after your patient has stabilized, which is usually within 2 to 4 hours after treatment.

Live long and prosper

The number of people requiring dialysis is increasing every year. Patients with kidney failure can live long and productive lives with the help of hemodialysis. Nurses who practice in acute care hospitals, dialysis clinics, and even home health may be responsible for providing direct care to a patient in need of hemodialysis. This article describes the minimal interventions that must be done each time you send and receive a patient to and from a hemodialysis treatment. Using this information, in addition to the specific policies and guidelines at your facility, will help to ensure you provide the best possible care to your patient.

History of Registered Nurses

Early Days

Although nurses have existed in some aspect throughout history in nearly every culture, the nursing profession didn't take shape until the early 19th century, when famed nursing pioneer Florence Nightingale and a small staff of nurses helped attend to wounded war veterans. According to Biography.com, Nightingale was credited with improving the condition of patient care during the Crimean War, leading to hospital overhauls and the professionalization of nursing. Nightingale is usually referred to as the founder of modern nursing.

Education

Hospitals held the first nursing classes in the first part of the 1900s. The classes mostly dealt with house chores for a few years, before moving up to teach such skills as how to sterilize medical equipment and to provide minor first-aid care. That was the norm for the profession until the start of World War II,when professional nurses became responsible for direct aid to the wounded for the first time in nursing's decades-long history. The profession flourished during the war and gained support from the medical community.

Changes

During America's economic boom following the WWII, the demand for nursing increased, leading government officials to require more stringent educational standards for potential nursing students. That led many colleges and universities to implement their own nursing programs. A division soon emerged in the nursing profession, leading to a distinction between Licensed Practical Nurses (LPNs) and the more advanced Registered Nurses (RN), whose licensing requirements varied by state.

Divisions

As set forth by the post-war education standards, RNs require more training than LPNs, although each received the same basic medical education. RNs are allowed more freedom to make medical decisions and supervise other nursing staff. Registered Nursing came to the forefront of the medical community in the 1980s, and today RNs have many career opportunities, from working in hospitals and clinics to working as traveling nurses or in highly specialized disciplines within healthcare.

Registered Nursing Today

Modern times sees a high demand for nurses, and traveling RNs have become a hot commodity in the medical job market; they work relatively short-term contracts (usually a few months) at hospitals with nursing shortages.

Due to the extent of their education, many RNs now have the ability to specialize in many areas of medicine, such as pediatrics or acute care in hospital or clinical settings or in public schools or prisons, to name a few. RNs also can work as flight nurses on medical helicopters.

With advanced training (and usually a Master's Degree), RNs can work as assistants to anesthesiologists or advance to work as nurse practitioners.

Boosting Supply Chain Efficiency: Tips for Success

No matter what supply chain strategies are chosen to increase efficiencies, it's important for hospital supply chain managers and executives to consider the following tips for success:

1. Integrate supply chain management with overall hospital operations and encourage all clinical and non-clinical staff to learn and understand specific goals and work toward them to improve overall patient care.

2. Enlist physician support of supply chain management and engage in regular dialogue to ensure that business and clinical needs are consistently met.

3. Set goals and deadlines for tackling supply chain inefficiencies and track progress made toward overcoming them to hold yourself and your hospital accountable for the process.

11 Tips for Effective Negotiations With Suppliers

Reducing supply expenses takes costs out of the system permanently and reroutes dollars directly to your ambulatory surgery center's bottom line. For most purchases, it is more cost effective to rely on your GPO contract, which may cover as much as 80 percent of your routine supply and services needs. For some purchases, however, it may be worth your while to take a more aggressive approach.

Here are 11 tips for improving supply chain negotiations.

1. Focus your efforts. Unless you're part of a very large organization with dedicated, experienced team of materials professionals, you probably don't have the resources to negotiate most of the purchases you make. Focus your energy on the purchases that will make the most difference.

2. Know the product you're attempting to buy. It is important to understand the capabilities of the product and the market dynamics for that product category. How many close substitutes are there? How does the product perform in circumstances similar to how you intend to use it? Gather as much competitive pricing information on supplies from as many sources as you can.

3. Leverage available expertise. If your ASC is aligned with an acute-care delivery system, leverage the parent organization's supply chain expertise and buying power to realize substantial savings.

4. Align your overall purchasing plan with your business plan. Major purchases must be aligned with your organizational strategy and business plan

5. Understand your financing options. These can make a major impact on the overall cost of the final product.

6. Use a request for proposal from the main suppliers under consideration. This is an effective way to establish an "apples to apples" basis for comparing similar products and pricing, and establishing terms on which to negotiate. Introduce requirements and expectations as early as possible in discussions with suppliers and make sure they are all listed and fully understood by both parties before negotiating specific terms.

7. Create mutual value. Since a contract creates a long-term business relationship between your ASC and the supplier, the final terms must be reasonable for both parties in light of the responsibilities and risks involved.

8. Prepare for ongoing negotiation. Even though the contract is signed, negotiation with the supplier will continue throughout the length of the contract.

9. Include ancillary products and services which will impact your use of the product, including delivery, installation, training, maintenance, etc.

10. Leverage your GPO relationship to get the best possible deal. You can often start with the available GPO price and terms as a way to capture more value.

11. Focus on process, not people. Negotiations are most successful when they focus on interest, not positions. The parties involved invent options for mutual gain. Objective criteria are used for evaluating options. People are separated from the problem — that is, the negotiations are not allowed to become personal.

Tips for Effective Nursing

Nursing Tips 1 - You can't possibly know "everything". Be sure to continue to be inquisitive throughout your nursing career. Study, ask questions, and be proactive.

Nursing Tips 2 - Mistakes will sometimes happen. Don't beat yourself up over it, but learn from those mistakes and get over it. Don't let it eat at you. Rise above and keep on moving.

Nursing Tips 3 - Like with any job, make sure you show up on time.

Nursing Tips 4 - You can learn a lot by watching other nurses. How do they perform compared to you? Are you at their level? Do you feel confident with the task at hand? Learn what you don't know. Your patients are depending on you.

Nursing Tips 5 - RELAX! Tension will eat at you and interrupt your ability to administer care effectively. If the stress is getting to you, take a 5 minute break to get it together and compose yourself.

Nursing Tips 6 - Always keep a small notepad and pen with you. This will save you a lot of time and headache remembering details, patient names, prescriptions, and so on.

Nursing Tips 7 - BE STRONG! Your patients are often nervous and they're looking to you for strength. Exude confidence.

Nursing Tips 8 - Don't take risks with your patience lives. If you are uncertain about a particular procedure, ask another nurse or doctor for assistance.

Nursing Tips 9 - Learn to laugh. They say laughter is the best medicine. Joke around with the doctors and get your patients laughing (if they can). This helps everyone. And it just might keep you from going crazy during stressful operations or procedures.

Nursing Tips 10 - Take the time to stay on top of what is "new" in the world of nursing. It's always changing, but there are books, conferences and others nurses to gain information from.

Nursing Tips 11 - Listen to your patients when they tell you what is wrong with them. Never dismiss anything they say because they know their bodies far better then you ever will. If they say something is not right, then something is not right.

Nursing Tips 12 - Don't forget to take care of yourself. While it is rewarding to help care for others, forgetting yourself means that there is a possibility that you will be to run down to give others the proper care you want to give them.

Nursing Tips 13 - Learn to be sensitive to other cultures. You will see patients from all walks of life during your years as a nurse, be ready to learn as much as you can from them.

Nursing Tips 14 - Keep yourself organized. Know where the important things are, and if you have a tendency to forget then keep a small notebook in your pocket with reminders.

THE EVOLVING HEALTHCARE SUPPLY CHAIN

Nationwide healthcare reform is having a significant impact on the industry’s supply chain, says Eric O’Daffer, research director with Gartner. The effects are especially being felt in the executive suites of hospitals. Reduced reimbursement levels, along with the ever-growing need to scrutinize cost, is creating a “burning platform” for healthcare managers. What’s more, given that supply-chain processes today account for between 40 percent to 45 percent of a hospital’s total operating costs, “supply chain is on the hot seat.”

Managers are being driven to standardize processes. They are being forced to become more aggressive about controlling users’ preferences for certain products. “They’re now needing to look at what the patient outcome is from that procedure,” says O’Daffer, “and how much they’re getting reimbursed.”

Purchasing groups, which control the spend for multiple hospitals, are gaining in importance. At the same time, their overall goal and purpose are evolving. Today, they are looking to achieve lower levels of cost by aggregating demand locally, and committing to specific volumes. The strategy involves making targeted purchases. “People don’t say, ‘Here’s our volume in theory,’” says O’Daffer, “but ‘Here it is in aggregate.’ They’re willing to be held accountable for their decisions.”

O’Daffer sees three major changes occurring in the healthcare sector. There’s a strong move to capture and standardize products, allowing managers to gain control over all non-labor-related spend. There’s an attempt to tie the choice of products to patient outcomes. And hospitals are increasingly moving toward owning their distribution processes, opening consolidated service centers, and taking control of “hundreds of millions of dollars” in supply-chain expense.

A Complete Nursing Career Overview

With almost 2.6M registered nurses (RN) in the United States, nursing is now the largest health care profession in the country. If you think that hospitals are the only place a nurse could be found, you are certainly misled. Public health agencies, communities, ambulatory care centers and other places where health care services are rendered also commonly have nurses employed.

1. The Nursing Practice

Nursing covers a wide area of practice. It includes

- Childcare

- Elderly care

- Services for pregnant women

- Services for newborn infants

- Specialty area - injury nursing

- Specialty area - cancer nursing

- Specialty area - forensic nursing

2. Choose Your Nursing Program

The first step to be a nurse is to graduate from a nursing program. This would enable you to take a state licensure examination. In the US, more than 1500 nursing programs are offered. Three of these programs prepare you in assuming different tasks once you graduate.

A. A Bachelor of Science in Nursing (BSN)

This is a four-year curriculum offered in colleges and universities. A graduate of this course has the advantage of learning health care settings that includes leadership and management. A degree in BSN is preferred and often required in many fields of nursing.

B. Associate Degree in Nursing (ADN)

This is a 2 to 3 year program offered in community college as well as in junior collages. This program prepares the student in handling direct patient care.

C. Hospital Diploma

This is a 2 to 3 year program that is based in hospitals.

3. Nursing Positions

Now that you've covered the basics, let's take a closer look on some of the nursing positions you can occupy. These positions are based on your experience and education.

A. Entry-level nursing position

This is the Staff Nurse Position. The nurse takes on making judgments based on scientific knowledge. You have to rely on procedures and standardized care plans.

B. Certified Mid-wife

This is a specialty nurse position where the nurse aids childbearing women. It starts during the preconception stage and goes through the prenatal, labor and delivery. Postpartum period care is also included in her duties. The nurse also provides family planning counseling as well as gynecological care for women.

C. Case Manager

Over time, a nurse can become a nurse case manager. In this position, the nurse will be involved in the process of organizing as well as coordinating the resources and services of an entire group of nurses, such as an entire hospital.

D. Nurse Educator

This is also a position a nurse could get involved with. Educating people about proper health care needs and procedures would be the basic tasks for this position. A Nurse Practitioner on the other hand conducts physical exams on patients, conducts diagnoses and provides treatments. A nurse practitioner could also write prescriptions and could also manage patients with chronic conditions such as diabetics and those with hypertension.

E. Nurse Anesthetist

A Certified Registered Nurse Anesthetist assists during operations. They give anesthesia to the patients before and after the operation.

There are also various specialty nursing programs that would help you specialize in a specific area. Radiology Nursing, Rehabilitation Nursing, AIDS Care Nursing, and Forensic Nursing are few of these specialty areas. Radiology Nurses are concerned with patients that undergo diagnosis in radiology imaging environments. It also includes Ultrasonography, magnetic resonance and radiation oncology. Rehabilitation Nurses or Psychiatric Nurses takes on providing physical and emotional support both to the patient and their families. They deal with patients having mental incapacities. An AIDS Care Nurse manages the physical, psychological, spiritual and social needs of a patient suffering with AIDS. A Forensic Nurse works in a different environment with other nurses. They work with the law enforcement officials to help in the investigation of crimes like sexual assault and accidental death. They also help in the treatment of the victims of these crimes.

12 Tips for a Rewarding Nursing Career

Every once in a while it's a good idea to take stock of your life and your career, and take steps to get yourself back on track, or even change direction if that is what is needed.  

Here are 12 things you can do for yourself, as a nurse, to make your career more fulfilling and to avoid nurse burnout:

1. Nurse stress management is a must.  Learn techniques that work well for you and use them routinely.
2. Managing your time efficiently and effectively is vital.  Become organized, stay on top of things, and do not procrastinate!
3. Replenish yourself.  Make time for yourself and do it often!  Nursing is a demanding/giving profession.  If you have given all you have to give, then you have nothing left for yourself, and you can't continue to give - you'll have nurse burnout.
4. Nursing is a lifelong learning process.  Use your continuing education opportunities to stay up to date with your selected field and to learn and hone new skills.  Secondly, make sure to learn something about other fields of nursing whenever you can.  Know your options and keep them open. 
5. Nurses are overachievers.  Strive for excellence and set the bar high.  Do not settle for mediocrity.  Encourage others to do the same. 
6. Be a nurse mentor.  Help those around you to strive for and achieve excellence as well.  Always being a nurse mentor throughout your career is the key to providing excellent quality care with the best possible outcomes. 
7. Be a sponge.  Learn from others.  Pick up on their tips and tricks and then share them with others.
8. Always be a part of the solution and not part of the problem.  Get involved in strategic planning for your workplace and help to make it a better place.
9. Be a good TEAM player.  Be a nurse leader when you need to be and a nurse supporter always.  There is no “I” in TEAM.  Be good role model to others who “just don’t get it,” and help them to become team players too. 
10. Learn your limitations and how and when to say "No."  Respect yourself and always set a good example for others.  It’s simply not possible to say “yes” every time and not get burned out!
11. Remind yourself often WHY you became a nurse.
12. Encourage others to become nurses and to strive for excellence. 

Nursing is one of the most rewarding careers you can find, but it is also physically and emotionally demanding and draining.  Take time for yourself so that you have something more to give when it is needed.  And when you find yourself stressed and burning out, remind yourself why you became a nurse.

THE SEVEN S’S OF SUPPLY CHAIN

Recently, Constellation Research began a study on the Supply Chain.  They have identified 7 competitive elements of the Supply Chain and they all start with the letter ‘S’.  The opportunities identified are generally long standing but unachieved.   All told, I think Constellation Research and the study’s author Jeff Ashcroft have provided a very strong framework for companies to lay out the long-term strategy of their Supply Chain.

Without divulging the contents of the study which Constellation Research will finalize and publish sometime this year, I thought it would be interesting to get feedback from the ‘customers’ perspective.  Currently the report is gathering information from the ‘vendors’ perspective related to the technology required achieving each ‘S’.  To start the conversation let’s review the 7 elements and the  corresponding definition from Wikipedia:

Synergy - in general, may be defined as two or more things functioning together to produce a result not independently obtainable. The term synergy comes from the Greek word syn-ergos,συνεργός, meaning “working together”.

Standards – A technical standard is an established norm or requirement about technical systems. It is usually a formal document that establishes uniform engineering or technical criteria, methods, processes and practices. In contrast, a custom, convention, company product, corporate standard, etc. which becomes generally accepted and dominant is often called a de facto standard

Semantic – is the study of meaning. It focuses on the relation between signifiers, such as words, phrases, signs and symbols, and what they stand for, their denotata.

Serialization – serial number is a unique number assigned for identification which varies from its successor or predecessor by a fixed discrete integer value. Common usage has expanded the term to refer to any unique alphanumeric identifier for one of a large set of

objects, however not every numerical identifier is a serial number; identifying numbers which are not serial numbers are sometimes called nominal numbers.

Synchronization – is timekeeping which requires the coordination of events to operate a system in unison. The familiar conductor of an orchestra serves to keep the orchestra in time. Systems operating with all their parts in synchrony are said to be synchronous or in sync.

Sustainability – is the capacity to endure. For humans, sustainability is the long-term maintenance of well-being, which has environmental, economic, and social dimensions, and encompasses the concept of stewardship, the responsible management of resource use.

Social – refers to a characteristic of living organisms (humans in particular, though biologists also apply the term to populations of other animals). It always refers to the interaction of organisms with other organisms and to their collective co-existence, irrespective of whether they are aware of it or not, and irrespective of whether the interaction is voluntary or involuntary.

How do you see these elements impacting your Supply Chain?  Do you currently have processes or strategies in place that address these categories?  If you see opportunity for your company to improve its Supply Chain what are the barriers you expect – internally or externally?

Why Nurses Need Professional Liability Insurance

All medical professionals should have a good malpractice policy in place, including nurses. A lot of nurses think they are immune from malpractice claims; after all, it is doctors who are most commonly sued, right? Unfortunately, this is not the case. Nurses can be sued for malpractice as well, and a nurse who is not protected by a nursing liability insurance policy is in danger of losing his or her career and even being forced into bankruptcy.

Malpractice is defined as damage or injury to a patient that is the result of misconduct, negligence or breach of duty on the part of a professional in charge of the patient’s care. There are many reasons a nurse might be sued for malpractice, but the most common reasons include failure to follow standards of care, failure to communicate, failure to use equipment responsibly, failure to assess and monitor, failure to document and failure to act as patient advocate.

No professional would ever deliberately commit any of these acts, but everyone is human and everyone makes an occasional mistake. Nor do any of these offenses have to actually be committed; groundless lawsuits are filed every day. An accusation may be untrue, but that does not mean the accused will not have to pay to defend the lawsuit.

Nurse malpractice insurance protects the policyholder from having to pay the cost of defending a malpractice suit. It also ensures that the defendant will not have to pay any judgments. A nurse that is not covered by malpractice insurance will have to pay both of these expenses out of pocket. Defense costs alone can force many people into bankruptcy; paying a judgment is even more ruinous.

These problems can all be prevented by the purchase of a simple insurance policy. Like all forms of insurance, the cost of nursing liability insurance often varies due to the insured’s background, location and years of experience. Malpractice insurance also has a deductible and a limit to coverage, just like automotive or homeowner’s insurance. The policyholder can select the limits and deductible that is right for him or her. Naturally, the policy’s premium will change accordingly. The average cost of malpractice insurance for nurses is only a few hundred dollars per year. This isn’t a lot of money compared to the peace of mind that results from being insured and not having to worry about the consequences of a lawsuit.

CFO Healthcare Summit 2012

The CFO Healthcare Summit 2012 will once again serve as an arena for senior level executives to engage in clear and focused dialogue with their peers and examine their management objectives in a relaxed and vibrant environment.

In today’s economic climate, Financial Executives are under an ever increasing level of scrutiny and pressure. Nowhere is this more evident than the Healthcare sector, where CFOs are facing challenges like never before.

The increasing costs of providing and administering healthcare while managing reimbursements through the Medicare and Medicaid system mean that Healthcare CFOs are now, more than ever, being asked to do more, with less – to utilize their skills and limited resources to provide a world class service at a profitable cost for the organization.

To maintain quality standards whilst remaining compliant, CFOs must battle rising costs by investing in technologies and processes that allow them to ensure the success of the revenue cycle and administration for their entire organisation.

The CFO Healthcare Summit brings together CFO decision makers from across American Healthcare, offering an opportunity to meet with international solution providers who can help them achieve these goals.

Note:- The Summit 22nd - 24th May 2012

School Nursing New Trends

Different Leadership Styles in Nursing

A nurse leader, a nurse manager, a nursing unit, or a nurse executive, responsible for the entire patient may be responsible for nursing units. Just select a leadership style, an outstanding nurse leader rather than facing many situations usually is based on the styles uses.

Types

There are two basic leadership styles are free and unfettered. These styles can be further broken down into subcategories. A nurse leader who is an independent Democrat, for example, decides to engage their nurses and allows working independently. Directed an autocrat, on the other hand, without seeking input instructs and supervises the nearby nurses.

Situational leadership

An experienced nurse leader’s leadership style that works best in any situation chooses. For example, he is a Democrat approver his unit when it is time to buy new equipment can act as. Nurses want to arrange the purchase of equipment and then they can use it to freely allow. When there is an emergency code blue on the other hand, is that less experienced nurses for a directive autocrat who unilaterally instructs while he may be closely supervise their work.

Considerations

A nurse leader based on his age and experience level of nurses can change their leadership style. Veterans, born before 1943 as nurses, to share their hard earned expertise, but do not want or need close supervision. On the other hand, smaller and less experienced nurses Generation Y with plenty of guidance and feedback may benefit from surveillance.

Skills

When graduating from a school nurse and RN License earns, it usually leads to basic applied skills to direct patient care. As he advances to charge nurse, nurse manager and, eventually, the nurse executive, she will need to learn more about leadership. There are colleges and universities, vocational education courses are available through companies and hospitals. It is important for a nurse for advice and more senior nurse leaders who provide honest feedback about your leadership style can consult with.

Significance

Nursing management of a shared governance model that affect their behaviour toward the nurses involved in decisions has trended. In that model, a nurse manager uses a permissive democrat style, her nurses clinical decision-making activity and monitor their results in the patient encouraged to participate. Nurse Executive, in turn, uses the same style with the nursing staff nurses represented by the establishment of councils.

Nurses And Nursing Continuing Education

Many people assume that after a nurse has completed her schooling and become registered, then that’s it, she would not need to bother with any extra learning, she simply will get on with taking care of sufferers and soothing fevered brows.

Nothing may very well be further from the reality, a nurse guaranteeing her nursing persevering with education is saved up to date is essential, and is an integral part of sustaining her registration.

A nurse’s life within the twenty first century could be very fast paced. As drugs and surgical procedures advances and improves, it is her obligation to ensure she keeps to the forefront of any major changes and improvements. This may be very difficult especially when she is working very long hours on the wards and clinics. And making certain her nursing continuing education is saved updated is less complicated stated than done.

A great hospital will ensure they supply every thing needed for nurses to proceed their nursing persevering with education. They should also ensure the training and training a registered nurse wants is supplied free of charge. This ensures a lack of funds does not prevent any registered nurse from using the excuse that they may not afford to access the schooling needed for his or her nursing persevering with education.

Buying nursing periodicals and magazines are a superb manner for registered nurses to maintain updated with their nursing persevering with education. Proving they have learn articles in related journals is crucial though.

One of the best ways they will achieve this proof is by protecting a portfolio wherein they will doc all of the training and training they’ve obtained since their registration. In the event that they write a synopsis of the article within the nursing journal they’ve read, and make a comment of what they’ve learnt from reading the article, they are then showing proof of their dedication to their ongoing nursing persevering with education.

One downside with accessing some forms of further schooling is the expense. Nursing isn’t one of many higher paid professions, and for many individuals higher ranges of qualifications equivalent to a level are sometimes out of attain purely because the nurse cannot afford to entry the courses. The sort of nursing continuing training should grow to be more accessible to nurses, with maybe the employer funding courses for the registered nurses of their employ.

Nurses care just as good as doctors, study says

The next time you have the flu or back pain, would you consider going to a nurse rather than a doctor? How about for chest pains?

More and more people are deciding they prefer nurse practitioners to doctors and new research concludes that a nurse's care is just as good and sometimes better.

Some nurses think they have it all, over doctors, "Our approach is that our patient is the head of our health care team and we listen to them." Bob Smithing is a nurse practitioner at Family Care of Kent. The clinic has operated for more than 25 years and has no doctors.

"Most of what we take care of is the primary care types of things such as diabetes, hypertension, birth control, shortness of breath." Smithing said these are all conditions doctors normally treat.

The results of a study done by Johns Hopkins University finds that care given by nurses with advanced training, such as Smithing, is comparable in quality, safety and effectiveness to the care of doctors.

"This survey reinforces what we've seen coming out for the past 50 years, which is the care that is provided by nurse practitioners is excellent care and that our patients benefit from seeing a nurse practitioner," said Smithing. But he doesn't use the findings to denigrate doctors.

"Physicians are an integral part of a health care team," Smithing said. "I could no more take care of my patients without specialty physicians than I could take care of them without my stethascope."

You might say to yourself, 'It's risky to see a nurse specialist rather than a doctor because the nurse might miss something.'

But Smithing said not to worry. "We're not reluctant to call in help and ask for assistance. Our training emphasizes that if you don't know something - ask, rather than you must know everything," he reassured.

The Johns Hopkins study finds that nurse specialists have also lowered medical costs and reduced unnecessary hospital stays.

Doctor Aaron Katz, at the UW's Department of Health Services, said specialty nurses are a mainstay of health care. However it doesn't mean you can see a nurse specialist for every problem. "Rather that there are a group of patients with certain types of medical problems that care can be just as good."

The Affordable Care Act will require health coverage for millions more Americans.

"There's a lot of concern that all of those newly insured people are going to seek medical services now that they have insurance and that we don't have enough capacity in the health care system to serve them," said Katz.

Smithing agrees with researchers who suggest that demand should increase for nurse practitioners. "We're going to need a lot more primary care providers. Nurse practitioners, nurse midwives can fill that bill."

It can be less expensive to see a nurse practitioner, but not always. Smithing said with any health care provider, trust can be as important as any other factor is your choice of a caregiver.

It's sometimes said that nurses are doctor wannabes, but Smithing said nurses want to be nurses but they also want the right to practice to the full extent of their training.

Patients benefit from nurse prescribing

Patients have improved access to medication and are sticking to their medication regimes better since the introduction of nurse prescribing in Ireland, a new survey reveals.

The research, carried out by the School of Nursing and Midwifery at University College Cork, shows that nurse prescribing has been an innovative and welcome addition to the role of the Irish nurse, which has led to an improvement in patient satisfaction.

To date, 631 nurses and midwives have undertaken the HSE-funded nurse prescribing programme nationally. They are employed in 78 different clinical areas from primary to tertiary care within the health service.

The first cohort of qualified nurse prescribers in Ireland was registered in January 2008. Prospective nurse prescribers must complete an approved six-month course and adhere to a set of practice standards and competencies for prescribing.

Rena Creedon, nurse prescribing programme co-ordinator at UCC, said: “Nurse prescribing is in its infancy in Ireland, however, professional boundaries are already being redefined with nursing roles having an ever increasing responsibility.”

Nurses surveyed reported that being able to prescribe was a great benefit, particularly for patients with chronic disease and pregnant women.

One of the main barriers identified by the survey participants was the extra administration load associated with nurse prescribing.

The survey results were presented at an interdisciplinary conference on nurse and midwife prescribing hosted by the Departments of Nursing, Pharmacy and Medicine and the College of Medicine and Health at UCC on Friday last.

3 Major Factors that Improve a Healthcare Supply Chain

3 Major Factors That Must Be Analyzed to Drive Healthcare’s Supply Chain to the Next Level

1. Major Consumption Trends:  Major consumption variations add significant, previously unknown needs for the supply of products, caused by epidemics like influenza or SARS, terrorist attacks or radically unique major incidents as almost every country of the world comes to experience.

2. Risk Factor Analysis:  Material supply interruptions on any level from raw material to finished product caused by operational problems, strikes, or unexpected wars in nations like Georgia.

3. Variations in Delivery:  Manufacturing variations stop product from proceeding to the customer in an orderly and timely manner when plants experience operational or compliance problems.

Each of these measures may yield value-added service opportunities to improve the customer experience. Additional capacity in manufacturing and transportation, flexibility of multiple plants for multiple products, storage capacity, or preparedness for alternative transportation modes may indicate areas of improvement.

A robust product supply can be calculated as additional expenditures over the costs. Knowing the value of the expense impact of the various requirements will drive further efforts in the continuous improvement program. The outlay for the total supply effort will become less, and the benefits are well worth the assiduous activities to accomplish the end results.

The result of the detailed supply chain analysis can be offered to the customers who will have a tendency to agree on pricing models acknowledging the service levels.

Approaching new contracts with a three-step mindset will allow customer and suppliers to clearly understand the impact of the range of services and products required for total supply chain expenditures.

The 3 Steps You Must Take to Get Your Supply Chain to the Next Level

1. Develop an essential supply chain model as best in class operations implementing the demand-pull system.

2. Generate advanced contingency models with defined levels of supply robustness.

3. Create clarity of the costs of various supply requirements for customers and suppliers to define the actual supply chain requirements and minimize the costs.

10 Ways to Help Nurses Improve Patient Satisfaction

Improving patient satisfaction is a financial imperative. Nurses are on the frontline of patient interaction and can make or break the patient experience. So why do we make it so hard for them to have positive interactions with patients?

Here are 10 changes to nurse procedures and working conditions that would improve patient experience. Some are simple, others more complex, all are effective.

1. Scripting: Many fear that scripting means fast food restaurant–type rote responses. In fact, it’s a useful tool when handled correctly. Scripting empowers nurses with tools to make their communication with patients easier. Regular discussion and training about patient interactions ensures nurses know what is expected. A scripting example: the hospital expects that all nurses will introduce and identify themselves and their professional credentials to new patients, and explain the treatment regimen. Scripting gives nurses tools for handling issues such as delayed procedures and lost test results. It also gives them tools for difficult situations such as deescalating angry patients.

2. Supplies: Keep frequently needed supplies in patient rooms and restock regularly. Maintain a multitude of stockrooms and supply cupboards and don’t make nurses walk miles to track them down. It’s frustrating for patients and staff when nurses have to stop what they are doing to track down supplies.

3. Uniforms: In many hospitals, RNs are indistinguishable to patients from the people delivering their meal trays. Consider choosing a defined scrub color for RNs to ensure that patients know who they can talk to and who is looking out for them.

4. Hourly rounding: Make a commitment to hourly rounding, and you will see patient satisfaction go up and call bell usage go down. Patients feel better when they know someone will be in to check on them within an hour. Alternating visits between RNs and nursing assistants ensures that the time commitment is manageable – and helps both groups plan their workflows since they no longer will spend so much time running after constant call lights.

5. Sitting down: Something as simple as sitting down when talking with patients can make a huge difference in satisfaction scores. Sitting down at the bedside implies that the nurse has time for the patient and is actively interested in the conversation.

6. Patient education: Make time for patient education. Nurses are pulled in a thousand different ways and often feel obligated to complete patient education as quickly as possible. But this time spent one-on-one means so much to patients. We know that patients often are too overwhelmed or intimidated to process information provided by physicians during initial diagnosis or post-procedure, and they look to nurses for easy-to-understand translation of difficult or complicated news. Put a value on this time with patients so that nurses will prioritize it.

7. Bedside report: Instead of conducting report at the nurse’s station or break room, do it at the bedside. Patients should be empowered to take an active part in their care. Increase their autonomy by discussing report in their presence and encouraging their involvement.

8. Nurse-led initiatives: Don’t simply hand down service improvement programs from above and tell nurses what to do. Programs driven by nurses have ready-made support and are often much more effective. Nurses will be more engaged in improving patient satisfaction when they develop ideas themselves and are accountable for success or failure.

9. Nurse empowerment: Nurses with autonomy over their practices provide better patient care. Ensure that the nurse practice council is robust and able to make decisions about clinical practice. Empower a nurse staffing committee to make decisions about safe patient care.

10. Demonstrate caring: According to Gallup polls, nurses are the most trusted professionals in the country. People can relate to nurses, whereas physicians can be intimidating to ordinary patients. The best patient satisfaction scores happen when patients feel genuinely cared for and cared about. Most nurses do this automatically. They bring an extra blanket or sit down and hold a patient’s hand for a few short minutes to provide comfort. Value these small details and recognize them publicly so that nurses know these parts of their role are just as important as the rest.