Quincy, Mass. nurse who helped at finish line describes year of guilt, anxiety, pride

(The Enterprise) Bill Dockham was so close to the first explosion that the medical tent shook around him.

With no windows to look through, Dockham had to watch on a small television as chaos suddenly broke out a few dozen feet from where he stood near the Boston Marathon finish line. Moments later, the first victims started coming in.

[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.”

Bill pushes nurse practitioners as solution to primary care shortage

(The Sentinel) Lorraine Bock was a nurse practitioner for 20 years, the bulk of which she served as the head of Bock Family Healthcare off West Trindle Road in Middlesex Township.

Last Thursday, however, Bock closed her family practice because of the costs and requirements associated with being a nurse practitioner in the family care field.

“It’s truly an economic issue,” said Bock, who is president of the Pennsylvania Coalition of Nurse Practitioners and now works in the state’s Legislative Health Services. “But it’s not just a Lorraine Bock issue. No single (nurse practitioner) provider can survive in the environment that exists now.” [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...]

Nurse practitioners more satisfied with their job choice than docs

(FierceHealthcare) Nurse practitioners are extremely satisfied with their career choice and remain optimistic about the future of their profession, according to a new Staff Care survey.

Ninety-six percent of the 222 nurse practitioners surveyed during the American Association of Nurse Practitioners annual meeting in Las Vegas said they would choose to become a nurse practitioner again if they had a chance to do their careers over. And 97 percent would recommend becoming a nurse practitioner to their children or young people. [Read more...]

Nurse Practitioners Try New Tack To Expand Foothold In Primary Care

(KHN) Nurse practitioners say efforts to expand primary care to millions of Americans under the health law are hampered by insurance industry practices that limit or exclude their participation. [Read more...]

98% Of Nurses in UK Admit To Lying To Dementia Sufferers: How Ethical Is A False Reality?

(Medical Daily) The slide into dementia is slow and painful, for those suffering directly and the loved ones on the periphery who must provide care while watching a trove of memories gradually erode. Patient care works inside this delicate balance, but going against the wishes of the Alzheimer’s Society, nearly all nurses in a recent survey reported telling the occasional white lie to avoid patient bereavement. [Read more...]

Two-thirds of UK nurses have considered resigning, says survey

(The Guardian) Almost two-thirds of nurses have considered quitting their jobs in the last 12 months because they are so stressed, a survey has found. [Read more...]

Unprecedented Demand For Family Docs, Nurse Practitioners As Obamacare Emerges

(Forbes) The family physician is the most highly recruited doctor as the Affordable Care Act and trends in medical economics move more health care service to less expensive outpatient settings,according to a national doctor recruitment firm. [Read more...]