Longer Nurse Tenure on Hospital Units Leads to Higher-Quality Care

(Columbia University Medical Center) When it comes to the cost and quality of hospital care, nurse tenure and teamwork matters. Patients get the best care when they are treated in units that are staffed by nurses who have extensive experience in their current job, according to a study from researchers at Columbia University School of Nursing and Columbia Business School. The study was published in the current issue of the American Economics Journal: Applied Economics. [Read more…]

Should a nurse be your family doctor?

(MetroNews)  A legislative audit recommends that advanced practice registered nurses in West Virginia be allowed to expand the scope of their care, but the recommendations do not go as far as the APRNs want.

Legislative Auditor Aaron Allred’s report suggests that further empowering APRNs to provide more primary care would help address the doctor shortage in West Virginia.  However, Allred stopped short of suggesting the nurses could operate independent of physicians. [Read more…]

Beating the burnout: Nurses struggle with physical, mental and emotional exhaustion at work

(Holland Sentinel) As educators, caretakers and lifelines, nurses take on several roles as they routinely care for patients day in and day out.

And for some, the strains of the job can eventually lead to physical, mental and emotional exhaustion, otherwise known as burnout.

“It’s really stressful,” Dawn Kettinger, spokeswoman for the Michigan Nurses Association, said. “You’re taking care of six people when you should take care of four.”

That was the case for Debra Nault.

Nault worked as an obstetrics nurse and midwife for almost 25 years at Sparrow Hospital in Lansing. It was a job she loved, but what ultimately did her in, she said, was the cultural change at work. An unnecessary increase in cesarean deliveries and medically induced labor began to make OB nursing feel like assembly line work, she said.

Nault also felt like she was losing control of her schedule, assignments and workload. As a charge nurse, she had the added responsibility of caring for patients while also running the unit.

“(Burnout) caused nearly constant frustration and sometimes guilt.

When you’re on the front lines and know what’s needed to provide quality care but do not have the resources of support, it’s very irritating. Your frustration and bad attitude can spill over to your performance and interactions.”

Nault’s experience is not rare. Nurse burnout is affecting the health care system and causing high rates of turnover in the field.

Although colleges and universities in West Michigan are generating 745 new registered nurses annually, the influx still falls short of the projected annual demand by more than 100, according to Grand Valley State University’s report “Health Check: Analyzing Trends in West Michigan 2014.”

Employment of registered nurses in Michigan is projected to grow 19 percent from 2010 to 2020.

But who will fill those jobs? According to a 2013 survey by the Michigan Center for Nursing, 42 percent of all active RNs say they plan to practice nursing for only one to 10 more years.

It’s an issue that affects everyone, Kettinger said. “More nurses are retiring earlier, and that’s a real concern for all of us in the public. We want those experienced nurses to stay on and provide quality, safe care.”

Burnout can be caused by several factors, including lack of social support, inability to control one’s work schedule or assignments, a chaotic or monotonous job and work-life imbalance. But Kettinger said short staffing is often the primary contributor.

As hospitals try to cut costs, that tactic backfires and becomes a patient safety issue.

“You’re running around taking care of people’s needs,” Kettinger said. “People describe going home at night and thinking, ‘What did I forget?'”

According to the Michigan Nurses Association, short staffing is connected to higher infection rates, higher preventable falls and higher death rates.

Similar to burnout is the issue of compassion fatigue, the emotional strain of dealing with traumatic and difficult situations on a daily basis.

The two are very connected, said Shari Schwanzl, vice president of operations and nursing for Helen DeVos Children’s Hospital.

It’s a lot like post-traumatic stress disorder. Your response to these emotional things becomes normal, and it shouldn’t be.”

One way hospitals can keep compassion fatigue from setting in, Schwanzl said, is to make sure employee assistance programs are in place. The teams should come in 24-48 hours after a traumatic situation to help employees debrief and deal with the experience.

If that kind of debriefing isn’t in place, then there’s a cumulative effect, Schwanzl said, and staff can burn out very quickly.

The pace of the job is fast and furious, Schwanzl said, and because of that, nurses need to be reminded and encouraged to find time to decompress, sleep enough at night, eat regularly and exercise.

“Our leadership responsibility is to remind people this is tough stuff but you can do a better job when you’re in a better place.”

Kettinger and Nault agree burnout has probably worsened, as the workload of the average nurse is greater today than it was 10 or 15 years ago because of more technology, documentation, electronic medical records and added nursing responsibilities.

In order to reduce burnout, the Michigan Nurses Association is hoping for the passage of a state law that would require hospitals to provide minimum nurse staffing at all times. State Rep. Jon Switalski and state Sen. Rebekah Warren have introduced two bills to address that concern.

Currently, both are waiting to be taken up by legislative committees.

If passed, Kettinger said, the bills would keep nurses from working 15- to 18-hour shifts and reaching the point of exhaustion and eventual burnout.

“In a way, it’s a broad issue with lots of subpoints, but in another way it’s very simple — nursing is a hard job, and nurses need support,” Kettinger said. “They have a legal and ethical and moral obligation to provide safe, quality care every time.”

Men proud to take place in nursing field

(News Leader) Joe Long first thought of becoming a nurse when his wife was hospitalized for a week during her pregnancy with their second child.

He now works at Mercy Hospital Springfield, taking care of patients in the intensive care unit.

“Nursing is manly,” Long said. “It’s not just for women.”

About 6.6 percent of nurses nationwide are male, according to the American Association of Colleges of Nursing. In Springfield, about 7.3 percent of nurses at CoxHealth are male. At Mercy, about 11.4 percent of the nurses are male.

The American Assembly of Men in Nursing was formed in 1971 in Michigan to provide support for male nurses. An Ozarks chapter is being started. There are also chapters in St. Louis and Kansas City. The organization also is open to women.

“It’s a very female-oriented world and we’re OK with that, but men still need to socialize,” said Paul Pope, the chapter president and a nursing instructor at Southwest Baptist University.

The executive director of nursing at Mercy Hospital Springfield is a male nurse, Kurtis Abbey.

Nurses like him have faced some of the obstacles that women entering predominantly male fields have faced. There have been lawsuits and complaints about isolation.

Rick Leroux, a nursing instructor at Southwest Baptist, got into nursing with the encouragement of his aunt. He learned how to make chitchat with children and to be absolutely honest about whether a medical procedure would hurt.

He treasures moments such as an encounter with the adult daughter of a man he had cared for who had a heart attack. She hugged Leroux and thanked him.

“Those are the moments we live for,” Leroux said.

Female employees at Mercy said they appreciate male nurses when it comes to lifting patients. They also value other qualities such as help in dealing with sometimes-disruptive families.

“We have a lot of difficult patients,” said Becky Pierce, who has worked at Mercy for about 40 years. “For each difficult patient, you have family members who sometimes need the physical presence of a man.”

Dr. Tobey Cronnell said male nurses tend to be more supportive of female doctors.

“I particularly enjoy working with male nurses as a female physician,” Cronnell said.

Long recently tended to John Goar, 73, who was admitted to Mercy Hospital Springfield after having trouble breathing.

Long gave him insulin and some other medication and then told Goar that his relatives were on their way to visit.

“He’s as good as a woman,” Goar said.

Long left Goar’s room. He was about halfway through his 12-hour shift. He doesn’t miss his previous career as a loan officer for a mortgage company.

“It’s the first time I have a job where I actually look forward to going to work,” he said.

 

From nurses and students, a new assault on inequality

(Hays Post) From the White House to the Vatican, everyone these days seems to be talking about income inequality. But our politics hasn’t kept up. Concrete proposals that could actually narrow the gap between the rich and the rest of us haven’t yet moved onto our public policy center stage. [Read more…]

Moving Time for Nurses Who Don’t Need Doctors

(Texas Tribune) As an advanced practice nurse specializing in family medicine, Holly Jeffreys operates the only medical clinics in two rural Texas Panhandle counties. The state requires that she have a contract with a physician to supervise both clinics, but she operates the facilities almost independently. [Read more…]

New Report: Nurses Practicing Independently in Retail Clinics Deliver Significant Cost Savings for Many Common Conditions

(Market Watch) A new study co-led(1) by UnitedHealth Group’sUNH -0.05% Center for Nursing Advancement shows that nurse practitioners (NPs) practicing in retail clinics have the potential to deliver significant cost savings when treating a range of common conditions, with the greatest savings occurring in states that allow NPs to practice independently. [Read more…]

Medical industry works to head off looming nurse shortage

(The Gazette) Mary Ann Osborn believes a perfect storm is brewing on the state’s health care horizon.

Iowa’s aging population, combined with the thousands of residents who now have access to health care because of the Affordable Care Act, could bring about a nursing shortage.

“For all of us, the next work force is critical,” said Osborn, vice president and chief clinical officer at UnityPoint Health-St. Luke’s Hospital in Cedar Rapids. “It’s not something one organization will solve.”

Iowa is not alone, either. According to the U.S. Registered Nurse Workforce Report Card and Shortage Forecast, a shortage of registered nurses is projected to spread across the country between 2009 and 2030. [Read more…]

Increased nurse staff levels tied to lower odds of Medicare readmissions penalties, study says

(ModernHealthCare.com) Nursing unions wanting higher staffing ratios have more ammunition thanks to a new study concluding that increasing nurse staffing levels could help hospitals avoid Medicare penalties for avoidable readmissions.

The study covered readmissions of Medicare patients who suffered heart attacks, heart failure or pneumonia. It appears in the October issue of Health Affairs. [Read more…]

Nurse has answers for personalized care

(LivingstonDaily.com) Keeping track of doctor’s appointments, prescription drugs, bills, insurance paperwork and other medical issues can overwhelm patients and their families.

Carolyn Bargero has the cure for those problems.

After working for 25 years as a registered nurse at a number of medical facilities, the Brighton Township woman recently launched Nurse Concierge LLC. [Read more…]

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