RSSArchive for June, 2012

Working while sick: Is it really worth it?

It happens to everyone at some point: you wake up with a cough, a headache, or a stuffy nose, and all you want to do is go right back to sleep. But more often than not, something pulls you out of bed and you force yourself through the daily grind. After all, you can’t afford to miss that meeting or leave your colleagues in the lurch, right?

But your illness could affect those around you, particularly if you are working in a healthcare setting with patients whose immune systems may already be compromised. According to a survey published this month in the Archives of Internal Medicine, more than 50% of residents reported working at least once when sick with flu-like symptom, while 16% reported working at least three times while sick. The survey included 150 resident physicians from 20 internal medicine programs in Illinois.

The survey asked residents their reasons for working when sick, and the most common responses were that residents felt an obligation to colleagues and an obligation to patient care. Second-year residents were more likely than first-year residents to state that patient care prevented them from taking time off due to sickness, and female residents were more likely than their male colleagues to list patient care as their reason for working while sick.

In light of this research, we posted a poll on asking readers how often they worked when sick. More than 60% of participants responded that they often go into work when sick, and 20% said they always go into work regardless of feeling sick. Only 2% responded that they always stay home when sick, with the remaining 18% of respondents reporting that they rarely go into work when sick.

While it may seem harmless to suffer through a day at work despite a few sniffles or a bad cough, healthcare professionals who work while sick risk passing their illness along to patients, which could put patients at risk. A cold that seems mild in someone with a healthy immune system could have devastating consequences for an elderly or frail patient. Researchers involved in the study noted that working while sick could also cloud judgment and lead to poor decisions with regard to patient care.

Do nurses and others in your organization often work while sick? What is the typical response to those who come in when they clearly should have stayed home? Share your thoughts in the comments section!

Nurses are twice as likely to experience depression as the general public

Most nurses would agree that a typical shift requires a high level of focus on tasks, good time management, and a positive attitude when interacting with patients. But according to a study published recently in the journal Clinical Nurse Specialist, 18% of nurses experience depressive symptoms, a rate that is twice as high as that of the general public. Symptoms of depression include low mood, difficulty concentrating, and lower total output in the workplace. Those experiencing depression are also more accident-prone and less able to perform mental or interpersonal tasks, a fact that concerns researchers due to the likelihood that a nurse’s depression could have serious ramifications for coworkers and patient care.

Nurses who are experiencing depression and are unable to perform their jobs at the high level required of healthcare professionals pose a risk to patients, as an inability to concentrate could lead to serious or fatal medical errors. Depressed nurses need to receive treatment for their illness, not only because of the potential for lower quality of patient care, but also for the personal well-being of the depressed nurse. Researchers involved in the study noted that advanced practice nurses may be the key to recognizing depression in staff nurses and educating nurses about screening and treatment for depression. By raising awareness about the prevalence of depression in nurses and treatment options, advanced practice nurses and other leaders in the organization can move the topic of depression from the realm of taboo subjects. If nurses realize that their depression will be handled confidentially in a sensitive and supportive environment, they may be more likely to seek treatment.

Does your organization have a policy for handling depression? Have you ever needed to address a concern of depression among your nurses? Please leave us a comment and share your experience.

How healthcare reform has already changed the way hospitals think and operate

In terms of better quality of care (and perception thereof by the patient), healthcare reform is still an ongoing and debated process. HCAHPS and 30-day readmissions for certain conditions are already linked to reimbursement. Hospitals now publicly report all types of data to Hospital Compare, to the chagrin of many.

Quality of care is tied to reimbursement; we know what’s implemented, we know what’s coming, and we know it’s hotly debated. Should patient surveys determine reimbursement, considering surveys are inherently subjective (and perception easily manipulated)?  We know one poor customer service—not clinical care—related incident might lead a post-discharge patient to rate a hospital badly. Should this count as much as it does? Should readmissions be tied to reimbursement, considering hospitals face incredibly different challenges throughout the nation?  Is this a good idea?

It might be worth looking at how these rules have already begun to change the way hospitals educate, operate, build, and generally conduct their business.

Should hospitals install welcome signs in 10 languages, valet parking and free Wi-Fi like Maimonides Medical Center in Brooklyn? Should they buy state-of-the-art patient communication systems whose developers cling to the tie in reimbursement as their main selling argument?  Should they train nurses and physicians to communicate better, even through the repetitive use of certain key words found on the survey? Should they work on creating a quieter environment?

Should these hotel-like amenities be the focus? They may seem small and unrelated to the real issue at hand—excellent clinical care free of patient harm. But if they don’t negatively affect care, or take away from that focus—in short, if they do no harm to care, these initiatives might be important. These new reimbursement rules are forcing hospitals to think differently, to try different things. Some will work, some will not, but we will find out and learn from it. Hopefully, we will figure out what makes for a better environment, better communication, and maybe even which fun new software and other technology gadgets might be worth investing in.

The worry, I think, is ensuring clinical care doesn’t get left behind or overshadowed by new patient rooms or fancy software systems that may or may not actually aid communication. Hospitals must be vigilant and ensure that both clinical and satisfaction scores rise together in one tide. Strategic alignment toward one goal – a healthy and happy patient – must be the focus.

Editor’s note: This blog post originally appeared on the Patient Safety Monitor Blog.

Murse World keeps men in nursing looking their best

A couple of months ago we ran a poll on to find out how many men were on the staffs of our readers’ organizations, and the majority of respondents indicated that less than 10% of their staff was male. However, as noted in the article from The New York Times that sparked the discussion, the number of men working as nurses has been climbing steadily over the past few years.

One company caught on to the fact that an increasing number of men in nursing means an increased demand for men’s medical uniforms, and so the concept for Murse World was born. Murse World, the first online medical uniform store exclusively for men, stemmed from the common complaint that most uniform stores only offer a limited selection of scrubs designed for men, compared to the wide variety of scrubs available for their female coworkers.

On Murse World’s website, men can find a large selection of brand-name uniforms, such as Dickies, Ecko, and Cherokee, in a variety of colors. For those men who like to be bold, Murse World offers several scrub tops with cartoon character and superhero prints. The website celebrated its grand opening last week.