ICU patients lose helpful gut bacteria within days of hospital admission

Here is an article about a small study done by the University of Colorado School of Medicine regarding the loss of helpful gut bacteria when in the hospital.

This is a serious concern and can be life threatening for patients.  The study’s hypothesis was confirmed, leading to the development of nutrition-related interventions for this population of hospital patients.

Please read the article and keep this information available during your practice.

ICU patients lose helpful gut bacteria within days of hospital admission

Hospital room. Researchers suspect that critical illness requiring a stay in the ICU is associated with the the loss of bacteria that help keep a person healthy. The new study, which prospectively monitored and tracked changes in bacterial makeup, delivers evidence for that hypothesis.
Credit: © txakel / Fotolia

The microbiome of patients admitted to the intensive care unit (ICU) at a hospital differs dramatically from that of healthy patients, according to a new study published in mSphere. Researchers analyzing microbial taxa in ICU patients’ guts, mouth and skin reported finding dysbiosis, or a bacterial imbalance, that worsened during a patient’s stay in the hospital. Compared to healthy people, ICU patients had depleted populations of commensal, health-promoting microbes and higher counts of bacterial taxa with pathogenic strains — leaving patients vulnerable to hospital-acquired infections that may lead to sepsis, organ failure and potentially death.

What makes a gut microbiome healthy or not remains poorly defined in the field. Nonetheless, researchers suspect that critical illness requiring a stay in the ICU is associated with the the loss of bacteria that help keep a person healthy. The new study, which prospectively monitored and tracked changes in bacterial makeup, delivers evidence for that hypothesis.

“The results were what we feared them to be,” says study leader Paul Wischmeyer, an anesthesiologist at the University of Colorado School of Medicine. “We saw a massive depletion of normal, health-promoting species.”

Wischmeyer, who will move to Duke University in the fall, runs a lab that focuses on nutrition-related interventions to improve outcomes for critically ill patients. He notes that treatments used in the ICU — including courses of powerful antibiotics, medicines to sustain blood pressure, and lack of nutrition — can reduce the population of known healthy bacteria. An understanding of how those changes affect patient outcomes could guide the development of targeted interventions to restore bacterial balance, which in turn could reduce the risk of infection by dangerous pathogens.

Previous studies have tracked microbiome changes in individual or small numbers of critically ill patients, but…(read the rest of this article here)

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The Key Health Care Issues in the 2016 Election

This article from Nursing Jobs outlines quite clearly why nurses should be very involved in the upcoming election.  We as nurses feel powerless most of the time, but at the voting booth we do have some power and we need to exercise this power.  The problem is that we rarely do anything as a unit, which is sad.  The nursing profession  should wield more power in the legislature and in our government since we are a huge group.  Unfortunately, we vote as individuals not as a group.  That is good in some ways and bad in others.

This year’s election is turning out to be pivotal in addressing healthcare issues.  We need to be aware of what changes will be put forth by either candidate.  We need to know at the state level who is pro-nursing and who is not.  We need to know what any changes in Medicare and Medicaid will affect our jobs.

Please read the entire article and see if you agree that nurses need to become more involved with politics.


The Key Health Care Issues in the 2016 Election

By Megan M. Krischke, contributor

“I think that the upcoming presidential election is going to be focused on public health,” began Donna M. Nickitas, PhD, RN, NEA-BC, CNE, FNAP, FAAN, editor of Nursing Economic$. “We will see issues around public safety–we certainly need to address the gun issues and protecting our schools and children. There will be concerns about our environment–clean air and safe water–and as climate changes occur, we need to be concerned about disaster relief and preparation.”

Katherine Evans: Nurses should know health care issues in Election 2016

“I think that we are going to see a lot of focus on health care entitlements–nurses need to be paying attention to that,” added Katherine Evans, DNP, FNP-C, GNP-BC, ACHPN, president-elect of the Gerontological Advanced Practice Nurses Association (GAPNA). “Nurses need to find out how those running for office are thinking about Medicaid expansion, Medicare and how reimbursement is going to be handled. Our new elected officials are going to be critical in how health care exchanges are modified and adjusted.”

Nickitas said that it is important for nurses to be aware of the political world because much of health care is regulated by state and federal law, as well as regulatory agencies such as state boards of health. Nurses are bound by license to follow those statutory and regulatory laws.

“As a health provider, I am concerned about the health and well-being of society and advancing the health of the nation,” Nickitas said. “I want elected officials who share these values and who want to see the homeless or mentally disabled get the care they need.”

“Nurses should be seeking to elect people who will look at local and national health care needs critically, and who are willing to bring in a nursing perspective,” Evans stated. “We need to look for candidates who understand, or who will let us help them understand, what nursing is, that there are a variety of education levels and that nurses practice in a variety of ways.”

“Does the candidate understand the nursing and the nursing faculty shortage and the reality of the ‘silver tsunami’ that is beginning to hit healthcare?” she continued. “Are they bringing nurses to the table to help develop a plan for dealing with a health care system that is going to be stretched thin?”

These nursing leaders note that many candidates are saying that there need to be changes to the Affordable Care Act (ACA), but nurses should know what changes these candidates have in mind and how they will impact patients and the nursing profession.

Donna Nickitas: Nurses can impact the health care system

As more people are entering the health care system due to the changes brought on by the ACA, legislators and those leading regulatory agencies need to understand that allowing to nurses to practice at the full extent of their training will relieve some of the pressure on the system.

“Nurses need to be concerned about seeing state laws that will enhance their practice rather…(read the rest here)


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5 of the biggest issues nurses face today

Here’s an article from Beckers Hospital Review that was written a year ago about issues in nursing today.  Unfortunately, here it is 2016 and these are still the major issues in nursing today.  Not much progress has been made in finding resolution to these problems; actually the problems keep proliferating.

This article lists compensation, workplace violence, short staffing, long work hours, and workplace hazards as the five most pressing issues.  I have to agree that these are important issues, but maybe not the most pressing right now.

Please read this article and make up your own mind about whether these issues are the MOST important issues in nursing today.


5 of the biggest issues nurses face today

Written by Kelly Gooch | August 13, 2015 |

Nurses play an integral role in the healthcare industry, providing care to patients and filling leadership roles at hospitals, health systems and other organizations.

But being a nurse is not without its challenges. It’s a demanding profession that requires a lot of dedication and commitment.

Here are five big issues facing nurses today.

1. Compensation. When it comes to nurse compensation, regional differences are to be expected based on cost of living.

Nurses living in certain regions of the U.S. make much more than nurses in other regions, according to the Association of periOperative Registered Nurses organization.

Nurses in the Pacific region make about $18,000 more than the average staff nurse, for instance. Next is the Mid-Atlantic region, where nurses make $14,800 more than average. Nurses in the East South Central region, however, make $4,300 less than average.

Beyond regional differences in pay, nurse pay gaps also persist between genders.

Male registered nurses earn, on average, upwards of $5,000 more than their female counterparts. The gender pay gap is present in all specialties except orthopedics, according to a study published in JAMA. Among nurse specialties, chronic care had the smallest gender pay gap, at $3,792, and cardiology had the highest gap, at $6,034.

2. Workplace violence. Another major challenge nurses face is violent behavior while on the job, be it from patients or coworkers.

Between 2012 and 2014, workplace violence injury rates increased for all healthcare job classifications and nearly doubled for nurse assistants and nurses, according to data from the Occupational Health Safety Network. A total of 112 U.S. facilities in 19 states reported 10,680 Occupational Safety and Health Administration-recordable injuries occurring from January 1, 2012, to September 30, 2014. There were 4,674 patient handling and movement injuries; 3,972 slips, trips and falls; and 2,034 workplace violence injuries.

This year, North Carolina took a stance against workplace violence. Starting Dec. 1, people who attack hospital workers in North Carolina could be charged with a felony, thanks to a new state law. The News & Observer reported that the new law passed by “large margins” and was signed into law last month.

Other states are also cracking down on workplace violence: In Massachusetts, the Massachusetts Nurses Association union is pushing a workplace violence bill that would add enhanced plans around workplace safety.

3. Short staffing. Staffing is an issue of both professional and personal concern for nurses today. In fact, issues related to staffing levels, unit organization or inequitable assignments are one of the top reasons nurses leave a hospital job, according to Karlene Kerfoot, PhD, RN, vice president of nursing for API Healthcare.

Back in June, the Health Policy Commission unanimously approved a mandate on nurse staffing in intensive care units throughout Massachusetts. The regulations require that nurses in intensive care units in hospitals, including hospitals operated by the Massachusetts Department of Public Health, be assigned only up to two patients at a given time. The regulations apply to all ICUs, including special units for burn patients, children and premature babies.

If staffing is inadequate, nurses contend it threatens patient health and safety, results in greater complexity of care, and impacts their health and safety by increasing fatigue and rate of injury.

Indeed, a Minnesota Department of Health review of literature found strong evidence linking lower nurse staffing levels to higher patient mortality, failure to rescue and falls in the hospital. There was also strong evidence that other care process outcomes such as drug administration errors, missed nursing care and patient length of stay are linked to lower nurse staffing levels.

Furthermore, a study published in Health Affairs found that inadequate staffing can hinder nurses’ efforts to carry out processes of care. Researchers found that hospitals with higher nurse staffing had 25 percent lower odds of being penalized under the Affordable Care Act’s Hospital Readmissions Reduction Program compared to otherwise similar hospitals with lower staffing.

That’s why unionized nurses often bring up staffing levels when they are in the middle of contract negotiations. For instance, dozens of nurses protested Aug. 3 outside of St. Petersburg (Fla.) General Hospital over staffing levels and wages. Additionally, nurses and other healthcare workers planned to hold a picket July 15 outside Renton, Wash.-based Valley Medical Center over staffing levels.

4. Long working hours. Nurses are often required to work long shifts. But in a number of cases, nurses must work back-to-back or extended shifts, risking fatigue that could result in medical mistakes.

A 2012 study published in Health Affairs found that the longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Survey data from the study showed that more than 80 percent of the nurses in four states were satisfied with scheduling practices at their hospital. However,...(read the rest of the article here)

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Reduce nurse burnout by treating nurses as well as we treat patients

I really like reading articles on  It seems like an oxymoron, but I find that he is very pro-nurses and usually takes the side of nurses in most issues.  Maybe his mother or his wife or someone close to him is a nurse, but whatever it is I appreciate his attitude.

This article is dead on.  All we nursed hear is “patient satisfaction” from everyone above us.  There are usually surveys (annonymous ones at that) given to nursing staff to see what they think and what are the problems they are facing.  Usually these “surveys” end up pointing out how badly nurses are doing their jobs!

Nurse burnout is real.  I know of many young nurses who are no longer practicing because of the stress and lack of respect.  I know many older nurses that are thinking of retiring sooner than they had planned due to work load, work hours, work stress and work relationship with management.  If all the current nurses are looking to get out of the profession and the nursing schools cannot crank out enough new nurses to fill all the vacancies, what will the future of healthcare become?

Please read this article and see if you agree with the author.


Reduce nurse burnout by treating nurses as well as we treat patients

One of my most memorable experiences was more than a decade ago while working for a level one trauma center on the East Coast. I was sitting in a hospital break room during one of my breaks as an inventory coordinator when a nurse walked in. I simply asked how her day was going, and she fell into the chair next to me crying.

Surprised by her reaction, I asked, “What’s going on?” She replied, “I just lost my third patient today.”

The impact of her personal experience stuck with me. Even now, looking back, I can’t help but think how difficult a day it must have been for her. Until that moment, my only experience with nursing had been as a patient.

Seriously injured while serving on active duty it was a nurse who saw me first, and it was a nurse who discharged me from the hospital. It was a nurse who was responsible for all of my care. Like an air traffic controller, it was a nurse who coordinated my care as well as the care of many others.

What I didn’t know at the time, but more than a decade later I would learn: the most overwhelming parts of nursing are the constant system failures. More than 30 percent of nursing time is spent hunting, fetching and clarifying work not patient care. This is not the cause of any one person or processes patient care has just evolved this way over time.

Fast forward more than decade and those experiences of stress and disappointment still exist for nurses. The reality here is that health care organizations/hospitals (HCOs) function in a way that requires nurses to focus more of their limited time and attention diagnosing systems needs rather than focusing on patients care. Nurses scrambling for linen, supplies, equipment or waiting to clarify a medication prescription are just a few examples. It’s all the unrelated system needs and its failures, not patient care, that adds real cost.

Overburdened, a single nurse could be caring for as many as five to six patients struggling in a system that’s failing him/her. In recent years, the cost of health care has gotten a great deal of attention and with good reason. Between 2000 and 2007 health care spending grew at nearly six percent per year, a much steadier growth rate than inflation or wage growth.

Future health care costs have even been a security concern — increases in health care spending are and will increasingly take money away from military readiness. Many scandalous stories about the costs of health care have been told. And while we share Americans’ outrage at the cost of health care, there is some good news on the cost front: health care spending has been leveling off in recent years.

Progress on the cost of health care notwithstanding, there is a serious scandal in health care — the toll that health care takes on the people who deliver it. The burdens of regulation, cost reductions, and quality initiatives piled onto nurses and others…(read the rest here)

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5 Reasons Nurses Want to Leave Your Hospital

Here is another article from Health Leaders Media that addresses a real problem in hospital nursing now.  Even though this article was originally printed in 2011, these issues still ring true today in 2016.  Nurses always plan their own exit strategies when they begin to feel threatened or abused at work.

No nurse likes to be made to work overtime.  Especially if they are already working back to back 12 hour shifts.  No nurse wants to be floated to another unit where they don’t know anyone and are unfamiliar with the patient care required.

Please read this article in full and make up your own mind about this issue.


5 Reasons Nurses Want to Leave Your Hospital

Rebecca Hendren, September 12, 2016

Your nurses have one eye on the door if you do any of the following.

This article was originally published on August 9, 2011.

Are your nurses engaged, committed employees? Or are they biding their time until they can go somewhere better?  Job opportunities for RNs and APRNs abound, and even nurses who appear content may be planning their exit strategies.

To predict whether you face an exodus, take a look at the following five reasons why your nurses want out.

1. Mandatory overtime

Nurses work 12-hour shifts that always end up longer than 12 hours due to paperwork and proper handoffs. At the end, they are physically, mentally, and emotionally exhausted. Forcing them to stay longer is as bad for morale as it is for patient safety.

Some overtime is acceptable. People get sick, take vacations, or have unexpected car trouble and holes in the shift must be filled to ensure safe staffing. Nurses are used to picking up the slack, taking overtime, and pitching in. In fact, overtime is an expected and appreciated part of being a nurse. Many use it to help make ends meet. Mandatory overtime, however, is a different matter. Routinely understaffed units that rely on mandatory overtime as the only way to provide safe patient care destroy motivation and morale.

Take a look at the last couple of years’ news stories about RN picket lines. Most include complaints about mandatory overtime.

2. Floating nurses to other units

One nurse is not the same as another. Plugging a hole in a geriatric med-surg unit by bringing in a nurse from the pediatric floor results in an experienced, competent nurse suddenly becoming an unskilled newbie. A quick orientation won’t solve those problems. Forced floating is usually indicative of larger staffing problems, but even so, its routine use is dissatisfying and compromises patient safety.

Instead, create a dedicated float pool staffed by nurses who volunteer and who can be prepared and cross-trained. Institute float pool guidelines that nurses float to like units. For example, critical care nurses find a step-down unit an easier transition than pediatrics.

Float pool shifts open up options for nurses who need more flexibility and offering a higher rate means you’ll never be short of volunteers.

3. Non-nursing tasks

Nurses are already understaffed and overworked. Hospitals with too few assistants rub salt on the wounds. RNs shouldn’t have to take time from critical patient care activities to clean a room or collect supplies. Gary Sculli, RN, MSN, ATP, patient safety expert and crew resource management author, offers a vivid analogy.(read the article here)

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Readmissions Dip 47% When Some Patients Self-administer IV Antibiotics

Here is an article from Health Leaders Media that describes a program where uninsured patients who are on long-term antibiotic therapy are trained in administration of their own IV antibiotics so that they can return home and not stay in the hospital.

I think this could be a really good program, although I’m not sure if it should only be provided to those without insurance.  Almost any study ever done has shown that patients respond more positively to therapy in their own homes instead of in the hospital.

At home, a patient has complete control over their course of treatment.  They have a support system to keep them motivated.  They feel that they still have their lives.  Whereas, in a hospital, they are in control of little to none of their care.

This is a two part article, so please click over to read the second part also.

Readmissions Dip 47% When Some Patients Self-administer IV Antibiotics

Alexandra Wilson Pecci, April 1, 2016

Uninsured patients requiring prolonged courses of treatment with intravenous antibiotics can be trained to treat themselves at home and achieve outcomes comparable to patients who receive treatment in traditional settings, data shows.

This is the first of a two-part interview. Read part two.

Teaching uninsured patients how to self-administer IV antibiotics for outpatient parenteral antimicrobial therapy (OPAT) has paid off for Parkland Hospital, a safety-net hospital serving Dallas County, Texas.

The program has resulted in similar or better clinical outcomes than healthcare provider-administered OPAT and 47% lower 30-day readmission rates over a four-year period, according to a recent study published by PLOS.

 Kavita Bhavan, MDLead study author Kavita Bhavan, MD, medical director of the Infectious Diseases OPAT Clinic at Parkland, and assistant professor of internal medicine at the University of Texas Southwestern Medical Center, explains the program, in an interview withHealthLeaders. This is the first of two parts. The transcript of her remarks has been lightly edited.

About the program:
The program is for uninsured patients to self-administer antibiotics at home as an alternative to remaining in the hospital or a traditional healthcare setting to complete their therapy. Patients who receive OPAT services are typically those who have been diagnosed in the hospital with an infection that requires a prolonged course of antibiotics.

This is done for more invasive infections, whether it’s osteomyelitis (an infection of the bone) or endocarditis, a heart valve infection, for example.

OPAT has been around since the late 1970s, was initially shown to work in pediatric populations, and then in adult populations. We started this program in 2009. I’m proud to say that Parkland is the first to publish outcomes of doing this kind of model. We don’t know who else is doing something similar to this.

On why Parkland started the program:

We started the OPAT program because we recognized that patients with infections who require long-term antibiotics typically receive concentrated diagnostics and therapeutic services.

The first couple of days is when we’re really busy trying to figure out what’s wrong with the [patients], trying to figure out a diagnosis, getting a treatment plan going—there’s a lot of stuff happening. But once they’re stable—simply because they have no other place to go—safety-net hospitals would simply just absorb that and have them stay in the hospital or discharge them to another setting to receive care, but not home, necessarily.

We talk about healthcare disparities in this country, and see that the patients who are insured have the option to be discharged early to home or to a lower-cost nursing facility to complete their therapy. But unfunded patients don’t typically receive these options and they usually remain in the hospital.

On improving resource utilization:
The United States leads all other developed countries in healthcare expenditures. I think the data says in 2013 we spent almost $3 trillion—that’s almost the entire GDP of France. And yet with all that we spend we don’t necessarily do well with things like resource utilization.

Safety-net hospitals like Parkland are charged with taking care of those who are uninsured. We have a large population of Medicaid and uninsured patients, for example. We find that our emergency room gets full fast, and our hospital gets full fast.  (read the rest here)

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When Nurses Vote or When Pigs Fly?

This article, unfortunately, spells out part of the problem we as nurses face during an election year.  Nurses as a whole should have some power but the truth of the matter is that nurses are all individuals; no matter what the ANA calls for or endorses, nurses will vote the way their hearts and minds tell them to, not how the ANA wants.

Nursing as a profession is self-limiting in other ways, also.  We eat our young.  We all have individual values.  We usually don’t support each other.

Please read this article and make up your own mind about this issue.


When Nurses Vote or When Pigs Fly?

Politics in Nursing: When Nurses Vote Together Or When Pigs Fly?I don’t even know if the story is true. Actually, it doesn’t matter, because the essence of it echoes a sad truth about Nursing that no one can deny.

“When George Bush was running for the presidency, the ANA called and asked how he stood on health policy and nursing issues. There was no response, so they called campaign headquarters again three weeks later. Still no response so a few more weeks passed and they called again. This time the secretary retorted: “Please stop calling. He is never going to return your message because he doesn’t have to… nurses don’t vote for the same candidate.”

Sad comment, but true. How can we change that? And why should we bother?

First, because if we don’t, we will never have power.

Bush would have returned the call if he knew he was talking to 3.2 million voters. Nurse leaders would have the political clout needed to change policies. Every year since 1984, the ANA has endorsed a candidate after a carefully vetted process More info here.

This year, the American Nurses Association sent out a call in February asking nurses who they wanted for president. And the result of this survey and their carefully vetted process which focused on issues, is that the ANA has endorsed Hilary Clinton.

So that is how every nurse should vote. Hands down. Profession over party. We had our chance to participate, and the only hope for Nursing to ever impact the health of our country is to come together as a powerful voting caucus.

Can you imagine the impact we could have?

Our lobbying power would be so profound that before long we would no longer be included in the price of a hospital room, but billed out separately. We would work 4 ten hour shifts a week…(read more here)

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The U.S. Is Running Out of Nurses

As one of the older, experienced nurses that just retired from the profession, I can tell you that this article is not too far fetched.  Yes, nursing has a very large influx of new nurses every year.  Yes, nursing schools have to turn away people every year.  That is only a small part of the solution to this problem.

The real problem is that most working nurses are 40, 50, or more.  They are getting ready to retire, or they will have to retire due to health, or they are simply tired of nursing and quit.  The numbers are unbelievable.

There has always been a buzz about the “nursing shortage” during my entire career.  What makes this worse is the confluence of age of nurses working today with the low number of nurses that can be produced by nursing schools due to shortage of nursing educators.  Add to that the aging population with increasingly more chronic health problems and you have a recipe for CRISIS.

Please read this article and see if you agree that we are about to be in dire straits.


The U.S. Is Running Out of Nurses

The country has experienced nursing shortages for decades, but an aging population means the problem is about to get much worse.

Five years ago, my mother was rushed to the hospital for an aneurysm. For the next two weeks, my family and I sat huddled around her bed in the intensive-care unit, oscillating between panic, fear, uncertainty, and exhaustion.It was nurses that got us through that time with our sanity intact. Nurses checked on my mother—and us—multiple times an hour. They ran tests, updated charts, and changed IVs; they made us laugh, allayed our concerns, and thought about our comfort. The doctors came in every now and then, but the calm dedication of the nurses was what kept us together. Without them, we would have fallen apart.

Which is just one reason why the prospect of a national nursing shortage is so alarming. The U.S. has been dealing with a nursing deficit of varying degrees for decades, but today—due to an aging population, the rising incidence of chronic disease, an aging nursing workforce, and the limited capacity of nursing schools—this shortage is on the cusp of becoming a crisis, one with worrying implications for patients and health-care providers alike.

America’s 3 million nurses make up the largest segment of the health-care workforce in the U.S., and nursing is currently one of the fastest-growing occupations in the country. Despite that growth, demand is outpacing supply. According to the Bureau of Labor Statistics, 1.2 million vacancies will emerge for registered nurses between 2014 and 2022.* By 2025, the shortfall is expected to be “more than twice as large as any nurse shortage experienced since the introduction of Medicare and Medicaid in the mid-1960s,” a team of Vanderbilt University nursing researchers wrote in a 2009 paper on the issue.

The primary driving force in this looming crisis is the aging of the Baby Boomer generation: Today, there are more Americans over the age of 65 than at any other time in U.S. history. Between 2010 and 2030, the population of senior citizens will increase by 75 percent to 69 million, meaning one in five Americans will be a senior citizen; in 2050, an estimated 88.5 million people in the U.S. will be aged 65 and older.

And as the population ages, demand for health-care services will soar. About 80 percent of older adults have at least one chronic condition, and 68 percent have at least two, according to the National Council on Aging. A USA Today analysis of Medicare data revealed that two-thirds of traditional Medicare beneficiaries older than 65 have multiple chronic conditions, a number that will only continue to climb…(read the rest of this article)

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10 best, worst states for nurses in 2016, as ranked by WalletHub

This is an excerpt from Beckers Hospital Review that breaks down states according to best/worst.

If you are interested in such statistics, here are the top 10 and bottom 10 states for nurses.


10 best, worst states for nurses in 2016, as ranked by WalletHub

Written by Heather Punke     May 04, 2016

For the second year in a row, Washington topped WalletHub’s annual list of best states for nurses, while Illinois shot up to the No. 2 spot on the “best” list after failing to even crack into the top 10 in 2014 and 2015.

WalletHub, a personal finance social network, ranks states on 14 key metrics for nurses, including monthly median starting salary, number of healthcare facilities per capita and nursing job openings per capita. The resulting list ranks all 50 states and Washington, D.C.

The following are the 10 best and 10 worst states for nurses in 2016, as ranked by WalletHub.

Best states

1. Washington

2. Illinois

3. Texas

4. Oregon

5. Iowa

6. California

7. Minnesota

8. Connecticut

9. New Hampshire

10. Pennsylvania

Worst states…(read more here)


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School nurses doing more to prevent, manage student health problems

This article from the News-Sentinel is an eye opener.

I have never had to work as a school nurse, but with 10 years of adolescent mental health nursing under my belt, I can say I never want to do school nursing.

These people (nurses) are truly dedicated to the children they serve.  They not only try to keep the children healthy, they also have complicated paperwork to keep up with for the government.

Nursing, in any form, is a challenge for anyone.  School nursing is the top of the list in my book.

School nurses doing more to prevent, manage student health problems

Friday, August 12, 2016 12:19 AM
It used be that a school nurse treated about any student health problem with an ice bag or bandage. Not anymore.
Today, school nurses work to prevent student health problems and to help children and school staff manage youngsters’ mental health and chronic conditions, such as asthma and diabetes, said Mary Hess, director of health and wellness at Fort Wayne Community Schools.
School starts Monday for FWCS students in kindergarten through grade 12. School nurses already have been on the job, however, checking records to make sure students’ immunizations are up to date and making plans to provide proper care for students with chronic health problems.
They’ve also been developing procedures for children who need medication during the school day, and stocking their clinic areas to deal with the traditional bumps, bruises and scraped knees and elbows, she said.

The goal is to prevent health problems from being a barrier to learning, Hess said.

“We know people who are healthier are more successful in whatever they are doing,” she said.
“We consider ourselves very blessed to have such robust school nursing programs throughout all areas of our community,” said Mindy Waldron, department administrator for the Fort Wayne-Allen County Department of Health. “Not only are the school nurses able to provide medical and mental health services, as-needed and on-site for the students, but they have become a trusted resource for our department.
“If we have a public health concern regarding a school or a student, we routinely reach out to them and are able to work collaboratively to assess and respond to issues in an efficient manner,” Waldron said. “They, too, reach out to us routinely for guidance on various issues, so as to address them in a proactive way. The school nursing system here locally has evolved into what is an integral piece of providing a safe and healthy school environment.
”Based on information reported by children’s parents, about 40 percent of FWCS’ nearly 29,500 students have health problems, Hess said. Her staff, however, believes the actual total is closer to 20 percent to 25 percent, or about 6,000 to 7,000 children.
FWCS doesn’t have nurses based at every school, but those responsible for more than one school always carry a cell phone so they can be reached whenever a school needs them, Hess said.
The biggest health challenges school nurses face are asthma, allergies, seizure disorders and diabetes management, she said.The school nurse’s role in diabetes management has increased dramatically in recent years as new types of treatment have become available, Hess said
.For example, not that long ago, students would take their insulin at home before coming to school, she said.
Nurses only had to worry about feeding a student who experienced a drop in blood sugar, she said.With some of the new diabetes management plans, school nurses must give students a small shot of insulin every time they have a snack or meal, Hess said.
The advantage, however, is that students have a much better chance of avoiding serious health problems in the future.
School nurses also do more now to train school staff on how to recognize health problems in students and how to assist a child until the school nurse arrives, Hess said. Nurses often also must train school staff to administer some of the medications various students need throughout the school day…(read more here)
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