Answers to Your Nursing Career Questions

The doctor of nursing practice (DNP) degree is a relatively recent degree, first proposed by the American Association of Colleges of Nursing (AACN) in 2004.  The DNP degree is intended to prepare nurses for advanced clinical nursing practice while the doctor of philosophy (PhD) degree in nursing prepares nurse educators and researchers.  PhD programs are research based and require a dissertation on an original research project.  Students in DNP programs typically are required to do a more clinically oriented practical application project as the culmination of their course of study.  They may incorporate evidence from nursing research into these projects.  As of March 2010,  102  DNP programs were in existence, and there were 113 PhD programs in nursing.  The number of DNP programs is expected to grow in the future as the DNP becomes the accepted entry level degree for advanced practice nurses.  The need for nursing  faculty and scientists with PhDs in nursing is also expected to continue to grow.  The addition of the DNP degree now gives nurses two paths to the top, so to speak, as experts in nursing practice as well as experts in nursing science.

We all know people who say they can’t function without having their cup of coffee first thing in the morning – in fact, maybe you are one of those people. Coffee and nurses, as with other shift workers, seem to go hand in hand. After all, if coffee can help get you going and keep you awake over a long night shift, then why not have some, right?

But why stop there? Some nurses don’t like coffee or tea, so they drink caffeinated sodas, like colas or Mountain Dew. Or now there’s another option: Energy drinks.

Energy drinks are loaded with ingredients such as caffeine, sugar, taurine, and some herbs like ginseng, or extra vitamins. This combination of ingredients is supposed to give you a jolt and the energy to keep going. Of course, as the power wears off, the manufacturers want you to drink another one so you can get through your day or shift.

Is it a good idea for nurses to drink these energy drinks? Are the proponents of the drinks right in saying that drinking them isn’t that different from drinking coffee? Let’s see.

Coffee’s ingredient is caffeine. If you add anything to it, like sugar and cream, that’s your choice. But you can choose to drink it black, as many people do. Caffeinated sodas contain caffeine and lots of sugar – or sugar alternatives if you buy the diet soda version. Now, compare these two types of drinks with energy drinks. Are they really alike?

Look at the size of an average energy drink can. Many of them are significantly larger than the standard soda cans, which are usually about 8 ounces. That means, not only is there more sugar per sip of the drink, there is a lot more drink to be sipped.

Dangers of Energy Drinks

The manufacturers of the energy drinks say that moderation is the key. One or two energy drinks should be your limit. However, we all know people who don’t abide by recommendations like that and will consume more than may be good for them.

Dehydration: If you’re thirsty because you’re dehydrated, what you need is water or sports drinks, not energy drinks. If you use the energy drinks as your fluid source, your body may not get the fluid it needs because of the excess sugar and carbonation.

Herbs and Medications: If you take any type of medications, you should check with your pharmacist or doctor to see if the ingredients in your energy drink may interact with your medications. This is something that some people may not consider seeing as the energy drinks are sold freely in just about any store.

Pregnancy and Nursing: There are warnings that pregnant women and those who are nursing shouldn’t drink these types of beverages.

Interruption of Sleep Cycle: If you are consuming the energy drinks to help keep you awake during a night shift or for the rest of an evening shift,  you may find it particularly difficult to finally get to sleep when you’re at home. Depending on when you had your last drink and how quickly you metabolize your drink, you may end up not sleeping well and being even sleepier the next day. Which means you may drink more of the energy drink. And the cycle begins.

So, are energy drinks good for nurses? If you like them and feel they help you, as long as you drink them in moderation, it’s your choice. But, keep in mind, they may not be as benign as they seem.

Nursing students are, by nature, novices in nursing. Your primary role as the nursing student is to pay attention during both the theory lectures and clinical rotations. In nursing school, you will be expected to memorize a vast amount of knowledge regarding the body’s different organ systems as well as varying populations of patients. This comprises most of the theory-related section of nursing school.

During your clinical rotation section, you will be applying some of what you have learned in the classroom lectures to actual patient populations. There are 6 main patient populations you will be caring for: mothers and their newborns, children, adults, aging adults, psychiatric patients, and local community populations (home health).

You will be starting IVs, taking vital signs, tending to chest tubes, administering medications (where allowed), performing nursing assessments and performing many more clinical tasks. If you question something you are about to do, always ask your nursing instructor for help. Your goal is to provide safe and effective care to the patients and to cause no harm.

Make sure to check out Medi-smart’s Tips For First Year Nurses Articles for related questions.

According to the American College of Obstetricians and Gynecologists, the Pap test checks for changes in the cervix that may become cancer.  Abnormal test results usually means additional testing and follow-up, depending on the specific findings.  Atypical squamous cells undetermined significance (ASC-US) is the most common abnormal result of Pap testing.  Squamous intraepithelial lesions may be classified as LSIL (low-grade) or HSIL (high grade).  Another term you may see is CIN, cervical intraepithelial neoplasia.  CIN 1 corresponds to LSIL,  while CIN 2 0r 3 indicates moderate or severe dysplasia of the cervical cells.  CIS, or carcinoma in situ, is the result most likely to progress on to cervical cancer.

HPV (human papillomavirus) is the main cause of abnormal Pap results, and is the virus responsible for cervical cancer.  Testing  for HPV and specifically for high risk strains of the virus is now available.  While HPV  is a very common sexually transmitted infection, it typically goes away by itself as the body’s immune system clears the virus.  In the case of an abnormal Pap smear, HPV testing may also be done, along with a colposcopy.  After the age of 30, the HPV test is approved for routine use at the same time as the Pap.

We all need a good laugh once in a while, or even a good grin. When you’re a nurse, life can seem pretty intense – even if you work in the happier parts of the hospitals, if you’re an obstetrical nurse, for example. But our jobs can bring us some laughter too, so here are some blogs you may want to read to make your day a bit brighter:

Not Nurse Ratched

Not Nurse Ratched has been around for a good while now. It’s sometimes funny and sometimes just to the point. It’s a good read for what ails you.

Dr. Grumpy’s in the House

Dr. Grumpy is a neurologist who posts about his practice and his cast of supporting characters. Although it’s a doctor blog, it’s one that nurses can absolutely identify with. Not to mention, he’s married to the World’s Greatest School Nurse, he says. So he’s got a few points in his favor there.

Crass Pollenation

Blogs about emergency room nursing have got to be one of the most entertaining of nurse and doctor blogs.  You just never know who or what is going to walk in the door. Of course, HIPAA doesn’t allow us to identify anyone, but isn’t it awfully tempting sometimes?

Community RN

This is a new blog and we’re looking forward to see what comes. So far, there are definitely a few smiles! Community nurses are some of the most undervalued nurses out there today. Not many people understand how busy a home health care nurse can be and the types of decisions and work they have to do.

At Your Cervix

We’ve mentioned this blog before. It’s a great look at life from an obstetric nurse’s point of view. Check out the photo in the December 27 post. Priceless.

Do you have a favorite blog or website that makes you smile?

Nursing leaders and educators are indeed buzzing about this report from the Institute of Medicine and the Robert Wood Johnson Foundation.  You can find details at www.thefutureofnursing.org.  In a nutshell, the report seeks to set the table for nurses to practice to the “full extent of their education and training” as full partners with other professionals in the delivery of health care.  Nurses should also be involved in research and planning for better health care systems and outcomes.  To this end the report recommends that by the year 2020 the proportions of nurses with a BSN degree increase to 80% from the current 50%.  It also recommends to double the number of nurses with doctoral degrees in that time frame. 

Nursing schools are gearing up to implement these recommendations.  An interesting additional recommendation is for the development and implementation of residency programs for nurses.  Because nurses comprise the largest segment of the health care workforce, using nurses effectively is critical for the best outcomes for patients.  The take home message for nurses at all levels of education is that your role in patient care is important and valued.   The future of nursing will demand more expertise and education for nurses, but will also offer more opportunities than ever.

There are several different nursing careers available out there for you. Certified Nursing Assistants, or CNAs, perform very basic nursing functions such as taking vital signs, helping patients with bathroom privileges, changing bed sheets, and some specimen collections.

Registered Nurses, or RNs, perform more advanced procedures such as medication administration, blood draws, blood infusions, physical assessments, as well as creating care plans.

Licensed Practical Nurses, or LPNs, are somewhere in the middle of the previous two. They can perform some medication administrations while supervised by an RN, take vital signs, collect specimens, and assist the RN in certain procedures.

Becoming an LPN requires about 1-1.5 years of schooling at your local community college, hospital diploma program, or other accredited health care institution. There are some basic science courses you will take during school as well as having to complete clinical rotations. Make sure to check out Medi-smart’s LPN directory for more information about schools and LPN programs.

Nurses can be found throughout society, even in places where you may not expect to see them. For example, did you know that there are nurses who work with lawyers and paralegals to help prepare for medical cases?

These nurses are called Legal Nurse Consultants (LNCs) and they can be found not only in legal firms, but in insurance companies, risk-management organizations, and even in government. Many LNCs work for themselves, contracting out their services wherever they want to work.

Nurses who wish to be LNCs do have to be registered nurses (RNs), but there are no specific courses or programs to become an LNC. Some nurses end up in legal nursing after working in case management. This may give them a taste of what legal nursing is about.

However, although there are no specific programs (yet), there is certification available: Legal Nurse Consultant Certified (LNCC). In 1989, the American Association of Legal Nurse Consultants was formed in order to establish criteria for LNCC certification. The organization also provides continuing education for nurses working in the legal field.

To be allowed to sit the certification exams for legal nurse consultant certification, you must meet the following criteria:

- You must be a registered nurse in the US, without any restrictions to your license

- You must have five years of experience as an RN

- You must have worked as a legal nurse consultant for 2,000 hours over the previous three years

If you are interested in legal issues and enjoy the challenge of putting everything in place and working with details, legal nursing may be the job for you.

Nursing is an extremely versatile career. One of the major advantages of nursing is that you can choose between a variety of health care fields, including (but not limited to) adult health, pediatrics, geriatrics, maternal and childbearing health, infectious disease, physical therapy, operative care, acute care, palliative and hospice care, and psychiatric and mental health.

Another advantage of nursing is the pay rate. According to the U.S. Bureau of Labor Statistics, depending on both the field of nursing and the region of the United States in which you work, your pay is anywhere from $40,000 per year to $95,000 per year. Some disadvantages might include working 12-hour shifts and holidays, as well as working in a state with high nurse-to-patient ratios.

Duties of nursing include taking vital signs, assessing a patient’s health, administering different medications, collaborating with a health care team to assess patient care, and performing physical exams.

Depending on the type of nursing degree you have, there might be several opportunities for advancement. You might become a charge nurse, nurse leader, or nursing administrator. Make sure to check out Medi-smart’s Nursing Resources directory for more information about registered nurses.

There certainly is an overlap between some of the symptoms of  a common cold and those of a sinus infection.  The persistence and worsening of the symptoms over time is usually the basis for the diagnosis of sinusitis.  A cold illness (upper respiratory infection or URI) often begins with a sore throat and perhaps some fever, progresses quickly to clear nasal discharge and cough, and may have a few days of thick yellow green nasal mucous and sinus pressure before the ill person starts to improve spontaneously.  This typically occurs over about 7-10 days.  Treatment is directed at comfort measures: fluids, acetaminophen, decongestants.

When the congestion and thick discolored mucous persists beyond 10-14 days, it is likely that a sinus infection has developed.  Since the sinus cavities in the facial bones cannot be seen on exam without imaging studies, most diagnoses are based on the clinical history.  Sinus pressure is typically over the brows, bridge of the nose, or cheekbones, which correspond to the frontal, ethmoid and maxillary sinuses.  Post nasal drainage may cause a cough, and there may be fever and fatigue.

People with allergic rhinitis seem to be more prone to sinusitis.  The use of nasal saline rinses or nasal steroid sprays can help.  Treatment consists of a course of an appropriate antibiotic.  Overuse of antibiotics for the common cold is to be avoided as it contributes to the development of resistant pathogens.