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Answers to Your Nursing Career Questions

Education and Research Careers

July 27th, 2010 by – Sue Barton

I’m afraid of the nurse practitioner responsibility and stress, but I do not want to do bed side care any longer.  What do you suggest?  I like to teach and do research.   I  would like to work in some sort of office and do 12 hours shifts, no weekends or holidays. I’m just confused!

If you like to teach and do research, then my suggestion would be that you teach and do research!  There is a great need for qualified and experienced nursing faculty.  The catch here is that you will need a minimum of a MSN degree, and most schools are really looking for PhD nurses.  The good part about that is that you will be exposed to research as part of your graduate education, and ongoing research is part of most nursing faculty positions.  If teaching nurses isn’t what you had in mind there are opportunities for nurses to be patient educators in many clinical specialties.  An example would be diabetic education, or cardiac rehab.  These sorts of positions are usually office based, although there may be hospital responsibilities also, and there are often opportunities to participate in ongoing research studies.  Check out the Medi-Smart career comparison site for more detailed descriptions of careers in nursing education and research.

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Quality Improvement Nursing

July 26th, 2010 by – Derek Brocklehurst

Hello. Can you help me become a good quality improvement nurse? I am a hemodialysis nurse and new in this field.

Quality assurance, or as it is called now, quality improvement, is always an important part of clinical work. Whether it be properly documenting the time of a medication administration or covering all aspects of discharge instructions, quality improvement work will help keep the patient safe and help the health care institution avoid legal nightmares. The most common liability issue for health care institutions is incorrect medication administration or mis-documentation of medications. You will help to correct this and make sure patients do not get hurt and institutions do everything they can to keep errors from occurring.

Working as a quality improvement nurse requires a certain amount of attention to detail and nitpicky-ness. You must be able to understand how times are charted in patient records, medications are administered (the 5 “rights” of administration), prescription orders are written, and how nurses function in their overall scope of practice in the clinical setting. If you are taking a new job as a quality improvement nurse, there should be required trainings mandated by the health care facility to help catch you up on good clinical practice and documentation.

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Posted in On-the-Job Fears

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NCLEX Exam Results & Instant Gratification

July 26th, 2010 by – Marijke Durning

Those of us who have been nurses for a while now can remember the ordeal of writing the RN licensing exams (and I assume the LPN licensing ones too). There wasn’t instant access to the exams when we felt we were ready to write them and there absolutely weren’t virtually instant results – something that nursing graduates demand now.

Licensing exams were written only a couple of times per year. Where I lived, they were in July or August and late winter. When you graduated from nursing school, either in June or December, you applied to your board of nursing or nursing association for the right to sit the licensing exam. And then you waited for exam days.

When the first day arrived, the whole huge lot of nurses who were going to write the exams showed up at the same place, which could be quite a distance away. And there were a lot of nurses. You had the new graduates, the ones who had failed previously, and nurses who had immigrated to the country.

The exams took hours. Multiple choice after multiple choice question. For two days  – two mornings and two afternoons – we answered questions. And when you were finished, you went home to wait. And wait.

The exams had to be corrected, tabulated and the results were sent by mail. If you wrote your exam in July or August, you could, conceivably, not receive your results until the end of September, early October. If you passed: fabulous. If you didn’t pass, you had to wait until the next session to write them again. If you wrote them in the late winter, you found out more quickly because there weren’t as many nurses writing them.

Today, in the United States, you book your appointment at a convenient time and location for you. You enter the exam place and start answering your questions by computer. When you’re done, you have a pretty good idea of how you did. You find out just days later.

Surely, the newer way is easier on the psyche. The old ways aren’t necessarily the better ways. Waiting and watching the mailbox is hard – but have the newer nurses gone too far in wanting to know as soon as they can? Reading nursing forums and nursing boards, there are many new grads who post comments abut how awfully long their results are taking (mere days) and how there must by a better way to do things so they can get results more quickly. Some demand to have a system that they know as soon as they’ve completed the exam.

Have computers made it so that we’re incapable of waiting for anything any more? What about you? What was your licensing exam like?

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Posted in Nursing School

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Community Health Nursing Trends

July 24th, 2010 by – Sue Barton

What are the latest community health nursing trends?

Community health nursing is focused on disease prevention and health promotion.  Decades ago, communicable disease was the greatest threat to public health.  With the advent of effective vaccines and antibiotics,  communicable disease has taken a back seat to the issues of chronic disease and an aging population.   Chronic disease to a large extent is influenced by lifestyle and environmental factors.  Lifestyle choices that begin during childhood and adolesence have an influence on adult diseases such as heart disease, diabetes, osteoporosis, and cancer.  Good nutrition throughout pregnancy, promoting breast feeding and good childhood nutrition, developing healthy exercise and eating habits to avoid obesity and type 2 diabetes, getting adequate calcium to prevent osteoporosis,  avoiding carcinogens such as tobacco smoke and environmental toxins, are all current issues in public health.  A look at the upcoming national conference of the American Public Health Association finds the theme for 2010 to be social justice issues.  If there is not adequate access to good nutrition and basic preventive health care, all the teaching in the world is not helpful.  Community health nurses also  need to be aware of emerging communicable disease trends such as drug resistant TB, and potential pandemic influenza, and to be educating young parents on the continuing importance of childhood vaccines.

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Transitioning from CMA to LPN

July 23rd, 2010 by – Derek Brocklehurst

I am a Certified Medical Assistant and would like to become an LPN with online classes. Where should I apply?

Being a certified medical assistant is one of the first steps towards your nursing career. It lays the foundation for basic medical procedures including specimen collection, taking vital signs, and patient interaction. The next step towards becoming a nurse would be to practice as a a licensed practical nurse, or LPN. Becoming an LPN can be quick, easy, and relatively inexpensive given several different options out there for programs.

For any LPN program, logging clinical hours and working in the health care setting are required and you will need to go to an accredited medical facility to fulfill these requirements. This could be a hospital, private clinic, public health clinic, or other health care facility. There are online classes available for the theory portion of your LPN training. You may want to check out your local community college for basic LPN classes. Check out Medi-Smart’s LPN site directory for more information regarding courses, programs, and different degree types.

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Posted in Nursing School

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Today Is “Is It Hot Enough for You?” Day

July 23rd, 2010 by – Marijke Durning

Did you know that July 23rd is officially “Is It Hot Enough for You?” day? If you didn’t, now you do. We had a post here last week about working in an air conditioned environment, particularly during a heat wave (Nursing in Heatwave), but that post was more about the nurses’ comfort. Today, let’s look at the patients.

As nurses, we’re supposed to be looking at our patients as a whole. This can be forgotten sometimes as we go about our tasks, but it’s something that is essential to giving proper patient care. During heat waves, the worry goes to patients who are at home or in facilities that don’t have air conditioning. In 2003 in France, there was a horrible heat wave and over a thousand people died as a direct result: dehydration and heat stroke. Although the heat affected everyone, there was a disproportionally high rate of death among single, senior women.

Everyone in nursing can help prevent heat-related illnesses, from the certified nursing assistant (CNA) to the highest levels of nurses. We need to ensure that they take in enough fluids and if they can’t or won’t drink water or other refreshing drinks, then we need to offer them foods that are high in water content (like watermelon, for example). Offering popsicles may be messy, but they are a good way to provide some fluid as well.

While we like our senior patients and neighbors and friends to be active, we need to be sure they don’t overdo it in the summer heat. Some of them may not feel the heat or claim they don’t – but that doesn’t mean they don’t. It’s up to us to be vigilant.

So, as we stop and give ourselves a drink of water, don’t forget to offer water to your patients too. If you’re thirsty, chances are they are too.

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Posted in Patient Interaction

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Nursing Jobs and the Recession

July 22nd, 2010 by – Sue Barton

I had to be on a wait list to get into nursing school, and now that I’m close to getting my ADN, I’m hearing that hospitals in my area have a hiring freeze.  Now what?

It’s true that as a result of the recession, all those jobs that were expected to be opening up as experienced nurses got to retirement age are not there.  As in other fields, nurses are delaying retirement, and part time nurses are often picking up extra hours.  In addition hospital census in many areas is down because people are deferring care that they may not be able to afford.  While this is a discouraging situation for new grads, it is sure to change as the economy improves.

In the meantime, go ahead and get your NCLEX and state license in place, work on your resume, and take any job in the field that will give you nursing experience, even if it is not what you were dreaming that you would be doing with your degree.  You might also look into continuing your education in an RN to BSN program.  Are you able to explore jobs in another city or state where the opportunities might be better? Nursing is still a growth industry, and every indication is that jobs will be there in the future, so any experience or further education will make you a better candidate for the job you want when it opens up.

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Posted in General

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Stye Infections and You

July 21st, 2010 by – Derek Brocklehurst

I have a pimple on my eye lid. Can it wait for me to find a doctor, or should I go to an emergency room?

It sounds as though you have a stye, or infection of a sebaceous gland on your eyelid. Skin infections are most commonly caused by Staphylococcus aureus, as most people have some strains of this bacteria living on their bodies at one time or another throughout their lives. The stye may appear flesh-colored with a small fluid-filled pustule in the center and may disappear in 7-10 days. However, if infected, it may be erythematous (reddened), painful, and swollen.

Styes may disappear on their own. Some home remedies to help with the healing process include warm compresses to the infected area to facilitate drainage of any infected tissue, cleaning it with lukewarm water and a mild soap to clear the dermal surface of existing bacteria, and taking anti-inflammatory pain relievers such as acetaminophen (Tylenol) to  help reduce some of the swelling and pain.

Do not attempt to squeeze or puncture the stye to drain the fluid out. The pus may be highly infectious and may spread the bacteria to other surfaces of your body. Consult your primary care provider before doing so.

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The Family Nurse

July 21st, 2010 by – Marijke Durning

Are you the family nurse or do you find that your family won’t listen if you make suggestions if there is a health issue? Which do you prefer?

Nurses who are adopted as the Family Nurse are often required to intervene in any family health matter. If a cousin becomes ill and isn’t sure if he should see a doctor, he calls the Family Nurse. If a sibling is admitted to the hospital, the rest of the family asks Family Nurse to interpret, suggest, request, and be the hospital go-between. The Family Nurse may be asked to remove stitches (to save a trip back to the hospital) and confirm if a prescription is what she would recommend in a given situation.

This can be a satisfying role for some nurses. They like to be able to give to their family and feel that their role is an important one. After all, being trusted to give information and advice on which the family will base decisions is quite the responsibility. But some Family Nurses don’t like this role. They don’t like to be called upon every time something goes wrong, they don’t like having to be the one to ensure medical advice is followed, and they resent having to be a nurse while they are off duty, unless it is an emergency.

While some families take full advantage of having a nurse in the family, some seem to ignore a nurse’s presence. For example, they will go elsewhere to do research (like Google) and then discuss family issues with family members who aren’t the nurse. The nurse hears about it through someone else and can’t figure out why he wasn’t asked, because he would have been able to provide them with the right information from the right sources.

There are a few reasons why this family exists. In some cases, the family doesn’t want to bother the nurse – they know the nurse isn’t at work so they’ll figure things out on their own. But in other families, the nurse isn’t very respected. To them, nursing isn’t a profession, but a job, and what the nurses know isn’t all that much more than what they can find out on their own. In fact, the nurse’s suggestions will be brushed off, or only agreed to if someone else has found the same information elsewhere a little later on. Finally, there’s the LPN vs RN issue that exists in the minds of some. If someone is a licensed practical nurse (LPN), some family members may not feel that the nurse has as much to offer as a registered nurse (RN) or, taking it one step further, an RN with an associates degree in nursing (ADN) may not have the same influence on a family member as one with a bachelor’s degree in nursing (BSN).

So, what side of the family nurse issue does your family fall on?

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Posted in Work-Life Balance

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Nursing Careers in Informatics, Legal Consulting

July 20th, 2010 by – Sue Barton

I am interested in risk management, legal consulting and nursing informatics.
I have my BSN and have a very diverse background.

You sound like quite an interesting person.  The field of nursing informatics was a new one to me, and this is what I learned.  According to the American Nurses Association:

“Nursing Informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice. Nursing informatics facilitates the integration of data, information and knowledge to support patients, nurses and other providers in their decision-making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology.”
(ANA Scope and Standards of Nursing Informatics Practice, 2001, pg vii)

I also learned that you can be certified by the American Nurse Credentialing Center in the field of Informatics Nursing.  This information and more is available on the website of the Cleveland Clinic.  It certainly sounds as though there are some fascinating career opportunities for someone with your interests.  More information about nursing careers in informatics and in legal consulting is available on Medi-Smart’s nursing career comparison page.    Legal Nurse Consulting certification programs are available online.  Another option to consider is pursuing a law degree with a specialty in health law.

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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.