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New strategies for the nursing shortage

Hospitals are offering new incentives to get staff involved with recruitment.

We’ve all heard it by now: the nurse shortage is here, and it’s only going to get worse. Between population growth, retirement, and life expectancy increase, reports estimate a three million RN shortage by 2020.

Faced with these challenges, University of Missouri (MU) Health Care has asked its staff for help in recruiting nurses to their facilities. Instead of offering bonuses and incentives to new hires, MU Health is offering staff members $10,000 for recruiting qualified candidates to its Intensive Care Units (ICU). MU Health hopes to convey respect and value for their employees, improving retention while making the facility more attractive to new applicants. The recruiters also say that sign-on bonuses could lead to job-hopping, rather than encouraging nurses to stay at a facility.

One of the other factors affecting the shortage is a bottleneck around training people to become nurses. The retirement issue applies to nursing school professors as well, and schools are constrained by professor to student ratios in determining how many applicants are accepted.

MU Health Care also hopes to address this issue by helping its staff become educators. They have instituted a residency program that allows trained nurses to collaborate with nursing students at their hospitals. The hospitals provide exposure to nursing students, and they hope to encourage students to stay within their community once they graduate. The Missouri Hospital Association is sponsoring a clinical leadership academy, which will train bedside nurses to become clinical instructors.

In addition to its own programs, MU Health Care encourages employees to go back to school to advance their careers, offering tuition reimbursement for staff members. These creative incentives for employees serve the dual function of retaining current staff while making the facility more attractive to new recruits.

House calls can benefit patients and cut costs

Two of the lasting images of early healthcare professionals is the doctor with their big bag making house calls and a midwife rushing to a family home to facilitate a birth. As healthcare has advanced, we’ve moved away from this home-based model toward the consolidated approach of the modern hospital. However, some practices have returned to house calls, with some positive results.

Independence at Home, a program created by the Centers for Medicare and Medicaid Services (CMS), seeks to identify patients that would benefit from homecare or cannot be helped in a hospital setting. The project sends mobile interdisciplinary healthcare teams, lead by physicians and nurse practitioner, out to the homes of these patients and provide care.

According to a recent Medscape article, the program reports a few different benefits. The patients receive more attention and care from providers, and the setting can foster trust between patient and provider. Hospitals and nursing homes can be difficult places for many patients, and they would prefer to get treatment in their homes. Terminal patients particularly benefit from this; as one provider notes, hospitals are not where people want to die.

The providers benefit from the more personalized patient relationship as well, but there are also financial incentives for homecare. CMS reports that they saved $25 million by using this system and $11.7 million of that went back to the providers. Because the system targets some of the most expensive Medicare patients, hospitals can save a lot by providing in-home care in this system. In addition to the CMS program, Veterans Affairs Medical Centers report that providing home care for some of their patients cost 12% less than standard care.

Game teaches nurses about med management

A new board game might help nurses minimize medication errors.

Many nurses report that medicine management is a difficult aspect of their responsibilities. Focus Games Ltd and healthcare academics have developed an educational board game designed to help “frontline healthcare professionals understand, recognize and minimize medication errors.” The Drug Round Game, an adaptation of “Snakes and Ladders,” hopes to teach nurses and nursing students about medication management, while giving them the opportunity to practice drug calculations and have big picture discussions in a low-stakes environment.

Nursing students that have tried the game describe it as fun and engaging, while improving their nursing knowledge and practicing what they’ve learned. Professors who’ve played the game with staff and students say that the game is enjoyable yet challenging, and an effective way to practice and refine their skills.

For more information about the game, check out City University of London’s press release.

National Time Out Day

Today is National Time Out day! For the 12th year in a row, the Association of periOperative Registered Nurses (AORN) want to remind medical professionals to take a moment before every procedure to make sure they are “operating on the right patient, the right site and the right procedure.” The Joint Commission reports that wrong site surgeries occur five times every day in the United States, and AORN hopes to raise awareness of the issue and improve patient safety.

For more information or to see how you can participate in National Time Out Day, visit AORN’s official website.

Animal therapy not just for patients

We hear all the time about how nursing is one of the most stressful professions in the country. This combined with the struggles with nurse retention has led a few hospitals to get creative with helping out their stressed-out nurses: Animal therapy sessions.

Animal therapy has been used with patients for years, particularly to help patients with trauma and mental health disorders. Inspired by these results, executives at University of Pennsylvania hospital and Rush University Medical Center (RUMC) instituted regular animal therapy sessions for their employees. Penn’s “pet a pooch” program was instituted by ER nurse Heather Matthew, brought in dogs from local shelters to spend time with their employees. In addition to helping the stressed-out staff, over a dozen dogs have been adopted since the program started three years ago.

After seeing the positive effects of Penn’s program, RUMC started their own program called “Pet Pause.” Hospital staff immediately reported feeling less stressed after their animal therapy sessions, and an internal study confirmed that the sessions lowered participants blood pressure and increased staff morale. Studies elsewhere have shown that animal therapy reduces stress hormones, and management researchers have found improvements in employee satisfaction and productivity when dogs are allowed in the workplace.

Do you have paws program at your facility? Let us know in the comments!

For more information, check out the Chicago Tribune article.

Rock Your Health: Top 5 Reasons Why SUGAR RULES When You Can’t Lose Weight and What You Can Do About It


Getting CLEAR about solutions!

C – Create a Relapse-Proof Environment

This is the first step when you are trying to stop your “sugar madness”.  If you feel you are addicted to sugar and can’t get away from it, clean up your environment and remove all these highly-processed carbohydrates from your home, your office, your car, and anywhere else you may be tempted to eat them.  If they are right there when you become hungry, you will make a poor food choice every time.  But, if you have good quality, low-glycemic food and snacks available when you are hungry, it really is not that difficult to eat correctly. You must not only protect your environment but also plan ahead so that you have healthy food choices available at all times.

Ask yourself – What do I need to do to create a sugar-free zone to support my efforts to reduce my sugar intake?

L – Learn About Sugar

Carbohydrate-rich foods are the primary source of energy for all body functions so we must eat some daily in addition to protein and fat.  Sugars are simple carbohydrates that can be easily digested by your body and include foods like cake, soda, sweets and highly processed foods.  We call them “fast” carbs.  Over 80-90% of carbohydrates consumed by adults and children today are simple-sugars, also called high-glycemic.

Complex carbohydrates take longer to be digested and include foods such as whole grain products, fruits and vegetables. We call them “slow carbs”. Both types of carbohydrates are broken down into sugar for the body to use and both cause blood sugar to rise, however complex carbohydrates raise the blood sugar slowly and simple carbohydrates raise it quickly.  It is that fast rising blood sugar called “spiking” that causes all the health problems.

Ask yourself – What facts about sugar do I need so I can make wise decisions about my intake?

E – Examine Your Relationship with Sugar

Do you think you might have an addiction to sugar?  You probably think sugar addiction is about lack of willpower or discipline or motivation. It is not. It is about your biochemistry. You were born with a body that responds to sugar, alcohol and refined carbohydrates differently than other people. You are sugar sensitive. Sugar acts like a drug in your body. In fact, it affects the very same brain chemicals that morphine, heroin and amphetamines.

Ask yourself – What is my experience with sugar and how would I like it to be now?

A – Appreciate How Sugar Effects Your Body

Everyone needs to eat carbohydrates which are digested and then changed into sugar in the blood stream and carried – with the help of insulin – into our cells to produce energy.  Blood sugar or blood glucose is the main source of energy for our organs, muscles and tissues. This is a normal healthy process for our bodies to function correctly.  However, too much of the wrong kind of sugar, can create problems.

Ask yourself – What is my body’s response to sugar? Should I get my blood sugar checked to find out if it is normal?  And if it is not, what am I willing to do to correct it? 

R – Realize Your Body is Under Stress from Too Much Sugar

We all know how stress affects our bodies.  I hear the complaints every day – headaches, neck aches, back aches, upset stomach, insomnia, and on and on.  There is another type of stress that we may not be aware of, and that is called Glycemic Stress.  When your body is bombarded with too much sugar from all the high glycemic foods mentioned previously, your insulin is over-producing to cope and an internal stress cycle occurs of spiking and dropping blood sugars.  This leads to Insulin Resistance, Metabolic Syndrome and then possibly Heart Disease and Diabetes. Not a pretty picture, is it.  But these are the facts.

Ask yourself:

  • Where am I in all of this?
  • Where do I see myself with my health in the future?
  • What part am I willing to play in moving forward with a healthier lifestyle?
  • What steps do I need to take?

Need some support?  Email me at carol@carolebert.com and let’s talk!

Nurses uniquely qualified for hospital design

The role of nurses has expanded greatly over the past few years, as nurses are moving from the bedside into all facets of healthcare. Hospitals have started to use nurses’ expertise to help design their facilities, with impressive results.

Hospital design can have a profound impact for both nurses and patients, but facilities are just starting to include nurses in the design process. Health Facilities Management (HFM) reports that involving nurses in design planning can help executives and contractors keep patient-care priorities in mind during construction. Seemingly small decisions, like the placement of sinks, computers, or wall outlets, can lead to an increase patient satisfaction. Nurses have been behind some of the pioneering new hospital designs, such as single-occupancy maternity rooms and the acuity-adaptable patient rooms. As one nurse told HFM, “Nurses spend the most time with the patient… we have a responsibility to be the voice of the patient, family and each other.”

Looking out for each other is another great reason for involving nurses in hospital design. A study published by Hassell and the University of Melbourne found that hospitals designed to accommodate nurses have a better chance of attracting and retaining nurse staff. The researchers identified a link between hospital workplace design and efficiency, health and safety for staff and patients, and staff morale. These factors play a significant role in staff retention, and who better to ensure a facility is attractive to nurses than nurse leaders?

Nurse-led design choices improve conditions for patients and nurses, but they can also help the bottom line. Nurses are involved in many different areas of the hospital, and their input can make operations more efficient and affordable. In one example reported by HFM, nurses saved the Parkland hospital project millions of dollars by eliminating unnecessary equipment and cabinetry in emergency rooms.

Both the survey and HFM article note that despite these benefits, nurses don’t always get a voice in hospital design. But as nurse-designed hospitals flourish, perhaps more facilities will involve nurses in design plans.

For more about Nursing and hospital design, check out: Take Five: How renewal rooms revive stressed out nurses

Rock Your Health: Gluten-Free for You and Me?

How much gluten are you consuming daily and it is affecting your health?  Just look around at work at how much is staring in your face daily.  Check out these facts.

G – “Gluten” refers to proteins that occur naturally in wheat, rye, barley and cross-bred hybrids of these grains

- Labels on foods using the claim “gluten-free” now must have a gluten limit of less than 20 ppm (parts per million)

- Until now, celiac patients did not know what the words ‘gluten free’ meant when they saw them on a food label

T – Three million people in the United States have Celiac Disease which is 1% of the population

- Eliminating Gluten from the diet is a big challenge for those with Celiac Disease

- Now the FDA has set guidelines for the use of the term “gluten-free” on food labels to help people with celiac disease maintain a gluten-free diet.

 

F – Foods that contain gluten trigger production of antibodies that attack and damage the lining of the small intestine which limits absorption of nutrients and leads to other serious health problems, including nutritional deficiencies, osteoporosis, growth retardation, infertility, miscarriages, short stature, and intestinal cancers.

- Removing Gluten from the diet is the only way to manage Celiac Disease

- Eliminating Gluten from the diet will also improve life for many others who are gluten intolerant or gluten sensitive.

E – Eliminating the following from food will allow food manufacturers to use the label “gluten-free”

  1. an ingredient that is any type of wheat, rye, barley, or crossbreeds of these grains
  2. an ingredient derived from these grains and that has not been processed to remove gluten
  3. an ingredient derived from these grains and that has been processed to remove gluten, if it results in the food containing 20 or more parts per million (ppm) gluten

Want more support around this issue on how to live a gluten-free lifestyle?  Email me at carol@carolebert.com

Women executives face more criticism than men

There are many hurdles for women pursuing executive roles. Normally a male-dominated field, many women struggle to get the opportunities and resources they need to obtain leadership and executive positions. Unfortunately, things don’t get much easier once they get there, according to a new study.

The Harvard Business Review published a study by the Yale School of Management that investigated gender stereotypes in executive evaluations. The study gave participants a scenario where a police chief misused resources and let a protest get out of hand. In one scenario, the police chief was male, in another the chief was female. The female chief received significantly more criticism than the male; some participants suggested that she get demoted, while none of the participants suggested that for the male chief. This pattern continued: “A decision that backfired led to harsher scrutiny for female leaders.”

The study concluded that women in positions that are traditionally occupied by men—which are often leadership roles, unfortunately—were criticized because they were going against gender stereotypes. For nurse leaders looking to transition to executive positions, this is yet another hurdle to overcome.

For more articles about women in health care, check out some of our articles in the Strategies for Nurse Managers Reading Room:

Women in healthcare want to find a healthy work-life balance

Nurses bring layers of diversity to hospital leadership

Rock Your Health: Are your joints starting to act up?

As the Nurse of Wellness that I am, my belief is that I am unstoppable and will live forever. Can you relate? But the mechanics of my body have a different story to tell. Over-use syndrome of doing too much, in too much of a hurry, and not honoring the fact that my body might need to slow down a bit to move safely and not get hurt  took its toll on my knee.

Yes, I was on crutches with a swollen left knee from just squatting down briefly.  Go figure! But I have learned from this experience. YES – ONCE AGAIN – another learning experience!!

  • I had to ask for help, even when it pains me to do so
  • I had to do less and the world didn’t end because I’m not scurrying about
  • I had more time than I thought and could catch up on reading and making calls to reconnect with others – you know; all that old-fashioned stuff we don’t always seem to have time to do.
  • I became more efficient with my movements because I had to rest my knee more often instead of being in perpetual motion
  • I received visitors who brought me great food and great conversation
  • I discovered how valuable friends are who will rally around me when I am down and out
  • And finally, I learned that my joints need more respect as I age so I don’t injure myself needlessly.

So as I healed with ice, elevation, powerful anti-oxidants, essential oils, relaxation, ibuprofen and crutch-walking, I realized we are all on this journey of aging so I hope you give your “joints” a chance to serve you to the best of their ability. Respect them and they will carry you through.

Be well on your journey!  Would love to hear your story about how nursing can be tough on your joints!  Email me at carol@carolebert.com