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Answers to Your Nursing Career Questions

CEU Questions

October 21st, 2010 by – Sue Barton

 Where and how do you sign up for the free continuing education courses?  Can anyone do these courses?  What if I live outside of the United States?  Where can I find CEUs and study guides on specialized topics in psychiatric nursing? 

It sounds like you have been exploring the Medi-Smart  resources on study guides and free online nursing CEUs.  The beauty of doing your CEUs online is that you can indeed do them from any location, including outside of the United States, where you have internet access.  Of course, you will want to check the information on specific courses to see if they meet the requirements for nursing license renewal in your state or country. The Medi-Smart page will give you links to the courses described on that page.  Clicking on those links should bring you to the specific site offering the course, with more detailed course information, as well as registration information.

  If you do not see the topics you are looking for on Medi-Smart, try looking at the offerings of specialty associations in your field.   The American Psychiatric Nurses Association, for example, has distance and online CE offerings that may more specifically meet your needs.

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Using Your Nursing to Become a Writer

October 20th, 2010 by – Marijke Durning

You see the names and you see the pieces: nurses writing articles for magazines, journals, websites, texts, and so on. But how do they do that? How did they get into it? And can you do it too?

While many writers get into the profession right after studying writing or journalism, if you dig around, you’ll often find that writers in specific niches, be they nursing or finance, often have a background in the field. While you don’t have to be a nurse to write about nursing any more than you need to be a priest to write about the Church, having the background gives you an insider’s view that allows you an insight that “outsiders” may not have.

Can you be a writer?

Think back to when you were studying nursing. How did you feel when you were writing entrance essays, scholarship essays, and papers? Did you find that writing them came naturally to you or did you really have to work at it? How were you at research? Were you able to find what you were looking for or did you depend on others to help you find the material you needed?

While writing papers and writing articles are two different things, the feeling that you get when you’re writing isn’t all that different. For someone who enjoys writing, getting the words on paper (or on the screen) is the least difficult part of the writing process.

Research is also big part of writing. Knowing where to look and who to ask for information comes naturally to some people. Their innate curiosity leads them to want to learn more about their assigned topic. For those who can research well, the writing will flow that much easier.

Are you a good teacher?

When you have to explain things to your patients or their family members – or even if you must give workshops or presentations to your fellow nurses, how do you feel about it? Putting aside the fear of public speaking, how do you feel about teaching the information to someone else? Is this something you enjoy? Something you do well? Explaining issues – essentially teaching people – is a major part of some types of writing. If you’re good at getting your message across, you’re one step ahead when it comes to writing things down.

How’s your grammar and spelling?

As much as brevity and text-speak has taken over the lives of many, succinct, quality writing is essential to be a good writer. Your grammar and your spelling do count and you can’t rely on your spell check or grammar check on your computer.

Most writers do make editing and spelling mistakes (usually typos), but the good writers keep them to a minimum.

Can you take criticism?

When you’re a writer, criticism comes from different sources. Your editors aren’t there to criticize you, they’re there to do a job and make your writing more readable. If you are wounded at the suggestion of moving words around, adding text, or removing text, then writing may become a painful process. You have to roll with the punches, knowing that the editors have their own job to do.

If you write for the public, such as in a magazine column or online, you may be receiving criticism you didn’t expect from people you don’t know, particularly online. People who don’t agree with you or just feel like arguing may leave comments that shake you to your very core. Can you handle this? It’s not easy to brush it off sometimes!

Do you want to be a generalist or focus on specific parts of nursing?

It’s easy to say you want to write, using your nursing background, but what exactly do you want to write? Are your academic credentials such that you could help author a textbook or write peer-journal articles? Do you want to write for patients so they can learn more about their health? Or do you want to write fun or practical stuff, like the latest scrubs fashions or how to organize your shift?

Being a writer who is a nurse, a nurse writer, or a writer nurse (however you want to say it) can be very rewarding and fun. But, it’s not easy. So if this is something you are interested in doing, look inside yourself and then research what you need to learn to make yourself a good – or better – writer.

Good luck!

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Case Management

October 19th, 2010 by – Sue Barton

  What is case management?

Case management refers to the role of coordinating care in a situation with complex needs. This is a role that may be performed by nurses as part of planning holistically for needs of their clients, be that an individual patient, or a family or community group.  Typically case management involves prioritizing needs and coordinating care when a variety of professionals or sub-specialists are active in caring for the same individual.  Nursing case management is an extension of the nursing process of assessing needs and deficits, setting goals, planning interventions and evaluating progress.   When applied in a multidisciplinary setting, case management should result in better patient outcomes, and more efficient use of personnel and resources.  It also is a great help to families who often end up being default case managers, trying to negotiate a confusing health care landscape.  Case management may avoid duplication of services and tests.  It often involves advocating with insurance companies,  helping to schedule appointments, and finding appropriate resources in the community.  Case conferences to share information,prioritize, and plan often include the patient and/or family.

According to this Medi-Smart article case management nurses may be employed by hospitals, community agencies, or third party payers.  Case management nurses may also be certified by the American Nurses Credentialing Center.

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Cold Sores 101

October 18th, 2010 by – Derek Brocklehurst

What type of disease is known as HSV and what are the symptoms?

Oftentimes, when you get stressed out and your immune system is taking a hit, you might feel a tingling sensation on your inner or outer lip, or on the gumline in your mouth. This could be the beginning of cold sore formation. Herpes Simplex Virus Type 1 (HSV-1), commonly referred to as cold sores by the general public, is a menace during social gatherings or just everyday life. Genital herpes, or HSV-2, is less common but transmitted in the same way as oral herpes.

The fluid-filled blisters that form in the first couple days of an outbreak will build up and may cause a slight tingling sensation. Do not pop or rupture these blisters! The fluid is very infectious and will only spread if you ruptured. Instead, your body’s immune system will work to suppress the outbreak and quell any future blister formations. The blister might pop on its own and scab over in 3-5 days, at which point the scab will fall off and your skin will heal.

You can spread HSV-1 and HSV-2 by skin-to-skin contact. If you come in contact with a person with an outbreak, cleanse your skin with warm soap and water.

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Yes, You Should Take that Vacation!

October 18th, 2010 by – Marijke Durning

Everyone believes they deserve a vacation and nurses are no different. From the certified nursing assistants (CNAs) to the charge nurses, we all work hard, sometimes under very difficult circumstances. But, more and more people are passing on their vacations, deciding to work more or to just use their vacation days one or two days at a time. Continue reading to learn why this might not be a good idea.

Taking a few days at a time

Special circumstances do require some nurses take a day of vacation here and a day there. The most common reasons are to accommodate children who are home from school or caring for a sick or elderly loved one. But if you can avoid doing this, it is usually better to take at least one full week off at a time, if not more.

Why is this better? You can’t recharge in one day. If you ask a nurse what he or she did on the day off, there’s a very good chance the answer is “caught up on housework,” or “ran around doing errands.” That’s not vacation!

Burn out

No matter how good a nurse you think you are, working non-stop is not doing your body any favors, either physically or mentally. The harder you work, the longer you work without a break, the more you’re setting yourself up for a hit against the proverbial wall. In fact, working all the time may contribute to exhaustion and errors that may otherwise not have occurred.

There’s more to life than work

There’s no denying that most of us have to work to be able to live. We earn those nursing salaries to pay those bills and put food on the table. But as much as we may need to work, life is more than that. We all have some sort of relationship with other people, be they with family or friends. Without taking time out to relax and enjoy life with those we care about, it is a very lonely life.

Once retirement rolls around or if you have the unfortunate situation of losing your job, you won’t have your coworkers or your work to fulfill your life anymore. By promoting a healthy lifestyle of enjoying life outside of work, you make that transition from work to personal life quite a bit easier.

You’re not indispensible

As much as we like to believe that no-one can do our job as well as we can, that’s rarely the case. Just because you work yourself to the bone, forgoing vacation time that is your rightly earned time off, doesn’t mean you won’t be laid off or let go if the need arises.

The time is yours: use it!

Your employer is not doing you a favor by allowing you to take a vacation. Your vacation time is your time. It’s time you earned and you deserve. Don’t feel as if you owe them anything by taking your time – it’s the other way around: they owe you that time and they owe you the opportunity to take that vacation without guilt or stress. After all, it’s not much of a vacation if you’re stressing about taking it, is it?

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Clinical Placements

October 16th, 2010 by – Sue Barton

  I’m a student in a family nurse practitioner program, second year.  I’m having a hard time finding clinical placements and preceptors to complete my  requirements, especially in pediatric and women’s health.  How can I find preceptors? 

The shortage of clinical placements at the ADN and BSN level programs has been cited often as one of the reasons for the waiting lists to get into nursing programs, and as contributing to the nursing shortage.  As you point out, it is a problem at the graduate level as well.  Many students in MSN programs are responsible for arranging  their own placements.   Schools and faculty may have ongoing arrangements with clinics and preceptors, but it is not uncommon for students to contract for clinical experience from a list of possible sites, or to rely on their own contacts.  With increasing numbers of nurses in graduate school, the pressure is on to find preceptors.  Nurses in advanced practice roles generally have a high degree of commitment to mentor and precept.  Unfortunately,  the reality of increased clinical loads and decreased time per patient visit impacts the time available to spend with students.  If you have exhausted the contacts provided by  your faculty or school, you might try putting a notice into the newsletter of a local or state chapter of a nursing organization, such as NAPNAP (National Association of Pediatric Nurse Practitioners) or AANP (American Academy of Nurse Practitioners).  Certainly use your professional contacts; if you know someone employed in a clinical setting that you need experience in, they may be able to introduce you to the NP in that setting.

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Accelerated Nursing Programs

October 15th, 2010 by – Derek Brocklehurst

Can I study nursing without having a knowledge of medicine? I only studied art in school. Thank you.

This is a very good question. Even if you went to school, college, or an undergraduate university and studied something completely different than nursing, you can still apply to nursing schools. Oftentimes, having a knowledge outside of nursing gives you an edge over other applicants because you might be more well-rounded than those students who studied medicine or a hard science in their undergraduate education.

There are accelerated nursing programs available for applicants who already have an undergraduate degree. Check out Medi-Smart’s nursing school directory for a broad search of nursing schools that might be available to you. Here, you can search for schools by location, type of program, or the type of degree received at the end of the program. Play around with all of the options, as there are many online programs available for the at-home working-part-time mother or father who wants to go back to school!

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Should You Take a Nursing Refresher Course?

October 15th, 2010 by – Marijke Durning

As our society becomes more technical and as medicine and health care become more advanced, there’s never been a more important time for nurses to be as up-to-date as possible if they want to re-enter the nursing field.

Regardless of why you may have left, the years you were away from nursing were filled with change and, no matter how effective a nurse you may have been, some skills may have become quite rusty.

For this reason, the nursing boards require that nurses take refresher courses if they have been out of the field for a set amount of time. For example, the Arizona State Board of Nursing requires that their registered nurses (RNs) and licensed practical nurses (LPNs) have 960 hours of nursing practice over the previous five years to be relicensed. This is the equivalent of six months full-time work. If you don’t have this, you must pass a refresher course.

However, just because you do meet the minimum requirements doesn’t mean you can’t take a refresher course if you feel you could use it. Nurses who may decide to follow such a course include those who:

- Worked in a clerical more than clinical role

- Worked in a specific area of nursing and want to move into another area

- Don’t feel their minimum experience is enough to cover the new aspects of nursing

- Don’t feel secure in their knowledge and skills, despite working as a nurse

What do refresher courses cover?

Refresher courses in nursing cover the basics and the new advances in nursing, such as:

- Pharmacology

- Medical administration

- Charting and communication

- Critical thinking

- Nursing skills

The courses also contain a clinical component so nurses can practice their old and new skills.

Are you considering taking a refresher course?

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Nursing Care Plans

October 14th, 2010 by – Sue Barton

  What is a nursing care plan and what is it’s effect on patient care? 

A nursing care plan is the process that nurses use to assess the needs of their patients, to set goals and plan interventions, and to evaluate outcomes.    Assessment includes both subjective and objective information, and is used to formulate a nursing diagnosis.  In essence, the nursing diagnosis identifies those problems or needs which are priorities for nursing interventions with the goal of restoring optimal health.  Patient care needs and nursing diagnosis are related to the medical diagnosis, but specifically target issues amenable to nursing care.  Once needs are identified, goals can be set for progress, and interventions planned.  Measurable goals facilitate a meaningful evaluation, which then may lead to modification of the plan.

The effect of this type of systematic approach to nursing care is to provide each patient with an individualized plan to meet specific needs.  Formulating nursing care plans should be both a scientific and holistic approach, in that evidenced based interventions are used, but also the social, emotional, cultural, and spiritual needs of the patient are considered. This Medi-Smart article contains more detailed information about nursing care plans, how to use them in busy clinical settings, and links to further resource information.

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Epigastric Pain in Patients

October 14th, 2010 by – Derek Brocklehurst

Hello. Can you please give me some advice on how to chart on a patient with epigastric pain.

When you chart as a nurse, everything you write down is important, as the documentation can be linked to quality improvement and future legal issues. Documenting proper times, assessments performed, questions asked, and statements made by the patient will help you avoid liabilities that may come up down the road.

When assessing a patient with “epigastric pain”, you want to make sure you get the pain on a rating scale. If the patient is an adult, ask the patient how much pain they have on a scale of 1 to 10. If the patient is a child, show the child a chart with different faces and ask the child to point the one that they feel like. You also want to get vital signs (blood pressure and heart rate as these relate to the body’s compensatory mechanisms, temperature as it relates to infection, and respiratory rate and pulse oximetry as these relate to oxygen saturation levels in the body).

You should hold off on a physical abdominal assessment until a physician or other health care provider is around, as pressing on the abdomen might elicit an unnecessary patient or organ system response (pain, muscle spasm, internal organ damage, etc.)

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The material on this site is for informational purposes only, and is intended as a supplement, not as a substitute for medical advice, diagnosis, or treatment provided by a qualified health care provider.