Off the Charts

Finding a Job as a Nurse In a Digital Age — and Keeping It

Will at Drawing on Experience manages to post a new comic almost every day. A regular theme is the progress of his career—having finished his accelerated nursing program, he’s now looking for a job. To the left is a thumbnail of a recent drawing he did about one of the more annoying aspects of the process (click the image to visit his blog and see a larger version).

Of course, this isn’t the first downturn we’ve had in the U.S. economy; as AJN clinical editor Christine Moffa wrote back in May, newly minted nurses have struggled to find work before. Once you actually do get a job as a nurse, there’s the small matter of doing it for the first time. Or for the second or third time—but as if it’s the first time, at least in some respects. The October Reflections essay, “Paper Chart Nurse,” gives another perspective on the ways computers have changed the lives of nurses. It’s by an oncology nurse who returned to practice two years ago, at age 66. Her struggles with adapting to using an electronic medical record system were at times profoundly discouraging; she just wasn’t as proficient as the younger nurses at computer use, despite all her skills and experience. Have a look and please, tell us what you think.—JM, senior editor

Jacob Molyneux, senior editor/blog editor2016-11-21T13:15:09-05:00October 26th, 2010|career, nursing perspective, students|4 Comments

Enough with the Scare Tactics: Some Follow-Up on the IOM Report on the Future of Nursing

Shawn Kennedy, AJN’s interim editor-in-chief, already posted here about the importance of the recently released Institute of Medicine Report on the Future of Nursing. Its implications are particularly profound at a time when we have a scarcity of primary care providers—and also at a time when the Affordable Care Act (i.e., health care reform) has designated more resources to nursing education and to generally making better use of nurses’ expertise. A number of bloggers have written about the IOM report, several of them expressing chagrin about the predictably naysaying American Medical Association response. Rebutting the AMA, the Center for Health Media and Policy at Hunter College had this to say. One working NP who weighed in on this topic is Stephen Ferrara, who noted (almost two weeks ago, in fact, though we missed it until now) the real world implications of the current situation for NPs in New York State, in a succinct post on his blog, A Nurse Practitioner’s View:

The bottom line is (at least in NY where I practice), without a collaborating physician on record, the 14,000 or so NPs are unemployed and can’t legally do anything that we were trained or educated to do. It is time to remove these non-evidence based barriers and retrospective reviews and allow us to function as true partners on the health care team. Collaboration among providers would still continue to happen and I promise pigs wouldn’t start to fly. Fourteen states have already transitioned to to an […]
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Jacob Molyneux, senior editor/blog editor2016-11-21T13:15:10-05:00October 21st, 2010|career, health care policy, nursing perspective|0 Comments

No Explanation Required: A Preceptor’s Tale

By Marcy Phipps, RN, whose essay, “The Soul on the Head of a Pin,” appeared in the May issue of AJN. She has also contributed a number of thought-provoking posts to this blog (here’s the most recent).

I’ve been precepting a new ICU nurse intern, which I generally enjoy doing. The only downside (from the preceptor’s perspective) is that I’m obliged to call ahead and request “unstable” assignments. This is meant to enhance the clinical aspect of the internship, and it definitely does. Considering that I work in a trauma center, though, reserving the sickest patient in the unit feels a bit like ordering up a large serving of chaos. And although I can request the assignment, I can’t predict what will be learned.

Our most recent patient was a new admission with a traumatic brain injury. At the start of our shift he had a grim neuro prognosis and was hemodynamically unstable. His condition deteriorated throughout the day and he was eventually diagnosed as brain-dead. His family chose to donate his organs.

Taking care of an organ donor is difficult. Brain-dead patients are inherently unstable, yet certain parameters must be maintained to ensure adequate organ perfusion. It’s tedious and meticulous. It also requires a shift of perspective—ironically, even though the patient is legally dead, […]

Marcy Phipps, BSN, RN, CCRN, CFRN2016-11-21T13:15:13-05:00October 20th, 2010|Nursing, nursing perspective, students|5 Comments

What Keeps You Up at Night?

Peggy McDaniel, BSN, RN, is an infusion practice manager and occasional blogger on this site

A recent national survey revealed that nurses as a profession are the most dependent on coffee (the survey was commissioned, in part, by Dunkin’ Donuts, though at least conducted by Harris Interactive). The survey asked 3,600 people about their productivity as it related to coffee consumption. The results are interesting if not surprising. Physicians fall in just behind nurses, and hotel workers hold third place.

While working the night shift early in my career, I got my caffeine jolt from diet soda. Not too many years later I developed a taste for coffee by adding hot chocolate to it, in effect creating “mochas” before they were sold for $3.50 each. I still prefer fancier concoctions such as flavored lattes, but in a pinch can be found clutching a packet of powdered creamer over a black cup of hotel room coffee. Some may venture to compare my progressive caffeine consumption to an addiction, and I can’t totally discount that theory. But if you consider that the top three positions on the survey may require work during the night, is it surprising that those who do these jobs also report some dependence on a stimulant? Since many of us seem to depend on caffeine to perform our […]

Guest Author2016-11-21T13:15:15-05:00October 18th, 2010|nursing perspective|6 Comments

What Is Meaningful Use? One Savvy Nurse’s Take

By Jared Sinclair, an ICU nurse in Nashville who has a blog about health care and technology

If you follow health care news regularly, and yet you still feel unsure what “meaningful use” means and how it will affect your job as a nurse, then you have something in common with even the most knowledgeable people on the subject. Despite the fact that discussion of meaningful use among health care IT and informatics folks has reached a fever pitch since the HITECH (Health Information Technology for Economic and Clinical Health) Act was passed last February, in many ways we are no closer to understanding how it will change health care than when discussion first began.

What do we know for sure? The HITECH Act promises incentive payments to providers and hospitals that use electronic health records in ways that meet a minimum set of requirements called “meaningful use.” That sounds simple enough; however, there isn’t just one set of requirements. The criteria for meaningful use will come in three stages, and the requirements for stages two and three have yet to be determined. This is why your local hospital’s nurse informaticists may be less than enthusiastic about the next five years of their jobs. They bear the responsibility for preparing their hospitals for huge changes—without the luxury of knowing what those […]

Guest Author2016-11-21T13:15:16-05:00October 14th, 2010|digital health, Nursing|1 Comment