Friday, October 31, 2008

Do You Need Mandatory Continuing Education for Re-Licensure?

…If you live in California, Kansas, Delaware and now Pennsylvania, you do. About 60 percent of the states in the United States have some kind of CE requirement. Each State Board has its own specific requirements on the number of hours, prescribed time periods, and mandated topics such as domestic violence and medication error reduction, as in Florida. The National Council of the State Boards of Nursing (NCSBN) is considering criteria for ensuring the continued competence of RNs. Nurses need to monitor the NCSBN Web site ( http://www.ncsbn.org/ ) for information about the development of recommendations based on a continued competence regulatory model.
The Pennsylvania State Board is implementing this process in a cyclical manner (see table below). You do not need to submit CE certificates with your renewal form but must keep the documents for 5 years for auditing purposes. If you do not complete the 30 hours your license will be renewed but you will incur fines. You then have 6 months to complete the CE or be subject to disciplinary action from the Board. Note: Continuing education must meet accreditation standards and certain course content is not acceptable for re-licensure such as: mandatory annual institutional policies, basic life support and self improvement. See www.dos.state.pa.us/nurse for more information.


If your expiration date on your license is:
October 31, 2010

Then you must obtain 30 hours of Board Approved CE from:
11/1/08 through 10/31/10

If your expiration date on your license is:
April 30, 2011

Then you must obtain 30 hours of Board Approved CE from:
5/1/09 through 4/30/11

If your expiration date on your license is:
October 31, 2011

Then you must obtain 30 hours of Board Approved CE from:
11/1/09 through 10/31/11

If your expiration date on your license is:
April 30, 2012

Then you must obtain 30 hours of Board Approved CE from:
5/1/10 through 4/30/12

(source: www.dos.state.pa.us/nurse )


Villanova University College of Nursing offers accredited continuing education in a variety of approved areas of study. Day programs on topics like clinical research, nursing management, role excellence and I.V. catheter insertion are just a few of the courses offered in the new state-of-the art Driscoll Hall. Online CE is also available at www.villanova.edu/nursing/ce.


By Margaret “Peggy” Lyons MSN, CRNI
Program Coordinator, Continuing Education
Villanova University College of Nursing

Nurses Who Serve Those Who Serve

By
Linda S. Smith, MS, DSN, RN, CLNC

Professor and Director of the Associate Degree Registered Nurse Program at the College of Technology, Idaho State University



Last year, New Jersey born Army Captain Maria Ines Ortiz was the first army nurse to be killed in Iraq since the 2003 US invasion. She was killed during a mortar attack in Baghdad’s Green Zone. Ortiz was doing what military nurses do best – caring for the sick and wounded on or near enemy lines. She was survived by her parents, four sisters, and a fiance’. Ortiz gave her professional nursing skills and dedication, as well as her life, to serve those who so selflessly and heroically serve us.

Many of us consider great military nursing to have originated with Britain’s Florence Nightingale. It is true that the events in Scutari, Turkey gave birth to professional nursing. It is not true that Scutari was the first military location for nurses. For America, military nursing officially began with the birth of our country - the revolutionary war.

Nursing during the Revolutionary War (1776) was not recognized as a separate and distinct service. It was often included and described along with such tasks as cooking, cleaning, washing, and sewing. “Nursing” was designed to keep sick men clean, well fed, and comfortable. Camp followers on both sides of the war effort were women who washed, cleaned, cooked, and “nursed” the men. And medical care given to the wounded included purging, blistering, and bleeding. Most battle wounds were followed by uncontrolled infections, forcing surgeons to amputate. Over 90% of deaths were caused by disease – 10% by battle wounds. Wounded men would be placed side by side with men suffering typhoid and typhus, thus wiping out whole wards.

The Civil War

In 1861, President Abraham Lincoln called for volunteers to help care for sick and injured Union Soldiers. Simultaneously, women in the north began to organize relief societies. Dorthea L. Dix came to Washington, DC to volunteer her services and was immediately appointed superintendent of women nurses of the Army. (Dix had already made significant contributions to the improvement of care for the mentally ill). Dix established strict criteria for her nurses, with the idea that these women would be nursing supervisors. Her nurses were sent to Bellevue Hospital New York City, for one month of training. Clara Barton, founder of the American Red Cross, began her Civil war work in 1861 when she established an agency to distribute medical supplies to wounded soldiers.
Though enormously dedicated, hardworking, and successful, the idea of female nurses was met with opposition from male doctors and military personnel. These nurses were often outspoken about incompetence, pilfering, and corruption among army surgeons. Many hospitals had little food and even fewer supplies. Nurses wrote to their contacts and reported these terrible conditions – further angering the male physicians. They took cleanliness and organization into their own hands.
Transport services for sick and wounded men were available via railroad, steam ships and wagons, often taking days and even weeks to reach hospitals. Tents were pitched along waterways where a corp of male and female nurses worked. Religious sisters also became a vital part of the nursing staff.
Importantly, medical efforts during the Civil war led to many scientific improvements and paved the way for a new profession of nursing in the US.

Scutari and Florence Nightingale

Florence Nightingale’s best-known triumph, the organization of military nursing, took place during the Crimean War (named after Turkey’s Crimean Peninsula). In 1854, Great Britain and France declared war on Russia in order to protect Turkey from Russian attacks. Due to poor military decisions, fierce fighting and enormous numbers of causalities from wounds, cholera, and dysentery, men were dying by the thousands. Four miles of the Turkish “Barrack Hospital” housed Great Britain’s sick and dying soldiers. British people were outraged, as news of these atrocities reached England, and the Secretary of State Sidney Herbert asked his long time friend Florence Nightingale to organize a group of nurses for war service in Turkey.
Nightingale saw four miles of rat-infested corridors filled with starving, freezing men. They had no blankets, beds, or bandages. Amputations were performed without anesthetic or even the crudest sanitation. Nightingale and her 38 nurses arrived on November 5, 1854 and were given charge of 1,500 patients. In only a few months, Nightingale decreased the death rate from 42% to 2%. She transformed the Barracks into efficiently run hospitals and won the admiration and respect of the world.
Nightingale understood medical and military politics and the scientific method for gathering and reporting data. Advocating for the sick and wounded soldiers, Nightingale used her statistical and writing skills to influence increased funding and appropriations of supplies. The grateful British people donated $200,000 to her, which she used to start the Nightingale School of Nursing four years later in 1860.

Spanish American War

For the first time in US history, professionally trained nurses were accepted into military hospitals. During the Spanish American War, these contract nurses became forerunners to our present military nursing corp. The Spanish American War took place against Spain (Cuba) in 1898 and the first call for nurses came on May 7, 1898 because of the 30% sick rate among American troops. Typhoid patients would remain for hours and even days without care. Some had bedsores down to the bone. Because of the resistance to having female nurses, these health professionals knew they had to excel in every possible way. One single nurse often had to care for 40 or more delirious typhoid patients per day. Nurses worked at a frantic pace in unfurnished facilities. They also helped gather statistics and medical data related to typhoid – statistics implicating the contaminated water, food, and insects.

These trained nurses were considered by the men as angels of mercy. Thus, in December of 1898, a committee of women and nurses moved to establish a permanent Army Nurse Corp. In 1901, the Army Nurse Corp was established. In 1908 the Navy Nurse Corp (the only females in the Navy) became an important component of the US Navy. They won the praise and admiration of navel officials because, for the first time, two large nursing services were made up entirely of graduate nurses.

World War I

The US committed itself to WWI in 1917 and our Army and Navy Nurse Corp increased their numbers significantly to meet the needs of the American soldiers. Unfortunately, as our nation faced a devastating flu epidemic at home, more and more civilian nurses were leaving for military and Red Cross service. Therefore, student nurse recruitment efforts were increased.
Conditions in camp hospitals were difficult. However, World War I provided nurses with experience related to the new projectile bullets, shell fragments, poison gas, explosives, and other injury causing war machines. Nurses learned to use a weak chlorine solution for cleansing wound infections, and developed debriedment operations. Almost 300 nurses died in WW I, mostly due to disease exacerbated by overwork.

World War II

On December 7, 1941, Japanese pilots bombed Pearl Harbor and so began America’s involvement in WWII. Even before that date, however, the Nursing Council on National Defense was organized. Composed of representatives from the six American nursing organizations, this committee set out to recruit more student nurses, improve nursing education, decrease the numbers of inactive nurses, and educate and use voluntary nurses’ aides.
As with WWI, the war effort created a major civilian nursing shortage. A national plan for federal financial aid allowed schools of nursing to provide scholarships to needy student nurses and for refresher courses for inactive nurses. On July 1, 1943, a nursing student could join the Cadet Nurse Corp, receive full scholarships and a small monthly stipend. In return she had to promise to serve as a military nurse after graduation. Thus, students could complete their nursing education AND serve their country. Notably, and as a result of this national effort, nursing schools voluntarily upgraded curriculum and faculty to meet the military standards.
With the Cadet Nurse Corp and its 150,000 members, the concept of aid to nursing education became reality and civilian and military nursing collaborated. WW II also brought about the important idea of placing medical and nursing services as close to the war front as possible. The type of firepower used created more casualties but mortality was decreased because of the high medical standards and nursing services. By the end of the war, 100,000 nurses had volunteered for military service. Nurses went ashore with the invading troops and were placed where their special skills were most needed.

Today

Today, a career as a nurse in the military means that a nurse’s educational advancement and career goals can be met through military service. Experiences in state-side military hospitals and bases, as well as overseas duty positions, are available. Reserve nursing is also available to nurses who choose this type of military service.

American military nurses continue to stand firm in their beliefs and commitments for quality, efficient health care given to our nation’s sick and wounded military personnel. Just as was the case with New Jersey born Army Captain Maria Ines Ortiz, they are proving themselves as expert, valuable, dedicated nurses – they are bravely caring for and serving those who serve us.


References

Austin, A. L. (1975). Wartime volunteers-1861-1865. AJN, 75(5).
Berges, F. & Berges, C. (1986). A visit to Scutari. AJN, 86(7), 811-813.
Bullough, B. (1976). The lasting impact of WWII on nursing. AJN, 76(1).
Culpepper, M. M., & Adams, P. G. (1988). Nursing in the civil war. AJN. 88(7), 981-984.
Dolan, J. A. (1966). Goodnow’s history of nursing. Philadelphia: WB Saunders Co.
Kalisch, P. A., & Kalisch, B. J. (1978). The advance of American nursing. Boston: Little, Brown, and Co.
Selavan, I.C. (1975). Nurses in American history: The revolution. AJN, 75(4).

* Portions previously published Journal of Military Nursing Research, 1(2), 12-13, 1995

Tuesday, October 28, 2008

Nurses: Take Time for Health and Fitness

As a nurse, you are continually concerned with the welfare of others. The demands on your time for work (your patients), family, education can stretch you in so many directions that it is very easy to neglect the one person that you need to take care of first in order to take care of others – you.

Health and fitness are central to the medical field. As a nurse who treats people on the mend, you emphasize the patient’s need to follow doctor’s orders: Take their medicine, eat right, and get an adequate amount of sleep and exercise. You explain the importance of a good diet and to avoid toxic food and beverages, getting ample sleep and work in a daily exercise regimen. But do we practice what we preach? It seems impossible. What can we do now that will at least get us headed in the right direction?

A proper diet is the first place to start and it does not take any time out of our day to be sure that we are eating healthy. The best motivator may be to calculate your Body Mass Index (BMI) in order to measure your body fat relative to your height and weight. http://www.nhlbisupport.com/bmi/ Once you have assessed where you are and where you need to be, the next step would be to create a suitable diet. Build the proper diet using the food pyramid. MyPyramid.gov will create the diet that is right for you. http://www.mypyramid.gov/index.html

Next – sleep! This may be more challenging than coming up with the right diet, but sleep deprivation certainly hinders your mental health and is just as important to correct as your nutritional regime. What bad habits keep you from getting to bed when you should? Having something to eat or drink that you can forgo, knowing it will keep you up? Staying up to watch just a little more TV? Engaging in frivolous internet activity? You can start here by simply…going to bed.

Finally, the real challenge – exercise! How do we take time to work out? A much tougher question to answer by mere suggestion. Here is where we really need to find time in our day and then, what exactly do we do? There is truly only one way to implement exercise into your day and that is by dedicating the time needed. If it takes away family time, include family in your workout routine; everyone can go for a walk, go swimming, bike riding and lift weights. You may even find this to be quality family time and open up lines of communication to discuss family issues. The time in front of the TV can be the time we use for exercise. We can argue this time is used to “take our mind off things.” This will still be accomplished during your workout and will achieve the healthier objective of rejuvenating your brain. If you can not pull yourself away from the TV, then how about some calisthenics while watching?

Finalize your health and fitness regimen and keep to your established routine. You do not have to do everything at once but it is imperative to get started. As you get started, implement reminders that there is change in your life. Move your alarm clock to where you need to get “out of bed” to shut it off. This will get you out of bed in the morning (as opposed to giving your workout, to your snooze alarm) as well as being a “reminder.” Write a short shopping list of the nutritional foods you need to buy for your new diet – right now, right a couple of things down! Put that list in your car where you will see it as a reminder that you need to stop at the market on the way home.

In conclusion, living a healthier lifestyle will increase your energy level, sharpen your mental acuity and allow you to do exponentially more.

The following links may also be helpful:

http://www.prohealth.com/weightloss/tools/exercise/calculator1_2.cfm?b1=WTLRSWEBO

http://www.bmi-calculator.net/bmr-calculator/

http://www.shapeup.org/interactive/rmr1.php

by Jenn Foster

Friday, October 24, 2008

Welcome CareerBuilder.com

As this blog site evolves, it is our intent to build a network of partners that could help all of us achieve our career goals. We are extremely excited and proud to have CareerBuilder.com as one of our partners. The job opportunities listed on their site for various nurse positions in Pennsylvania is extensive. They have averaged 1,600 nursing positions over the past month and over 50 nurse educator positions throughout our state.

There are several ways in which to search (at left): Peruse the latest listings in the CareerBuilder.com Job Stream unit; mouse-over “Nurse Positions in Pennsylvania” for a comprehensive list of nursing positions, “Nurse Educators” for teaching jobs available, and the “CareerBuilder” logo for their search engine.

CareerBuilder.com also offers a variety of other services including articles and advice for job seekers, resume help and uploading your resume for greater visibility among searching employers.

Those of you that are eager for a new beginning, prepared for a greater challenge, or are in transition, as CareerBuilder.com would say, “Start Building.”

by Jenn Foster

Thursday, October 23, 2008

A Tribute to Nursing

To venture the task of discussing the great people and events that have made American nursing the powerful profession it is today, is to undertake an impossible task. I do firmly believe, however, that a taste of history is somewhat like eating one Idaho potato chip - it will stimulate and support a lifelong interest in the subject.

We in nursing are fortunate indeed to be able to emulate the leadership and political savvy of Florence Nightingale. She, more than any nurse before or since, shaped and expanded quality health care throughout the British Empire and world. Most people, however, think of Florence Nightingale only as the founder of nursing education. Though this is true, her contributions exceed far beyond nursing and into the realm of illness prevention, health promotion, and community health and safety.

Florence Nightingale (born 1820) was better educated than most men of her day. She was an accomplished linguist, mathematician, statistician, philosopher, and historian. She understood that contrary to the belief of the day, forward thinking people could alter their destiny. She had an insatiable curiosity and a probing, analytical mind. But her greatest handicap by far was being a woman.

Despite this handicap, Nightingale created and developed a system of education affording women a respectable profession. Additionally, she used her strong political powers to enact hospital and military reform. She reformed health care for the British Empire, including India. Nightingale presented rationale for her decisions and needs with expert mathematical skill. She used the power of the press and her own outstanding prolific writing abilities to keep public health issues in full view of the people.

Nightingale was a national heroine and she used this popularity, along with her expert health care and political knowledge, to influence major leaders, including the queen of England.

US Nursing

In the early 1900s, American women did not have the right to vote nor were they allowed political status. Though nursing was almost exclusively female, nurses as a group were enormously conservative in their approach to the women's movement. In 1907, at the 10th annual convention of the Nurse's Associated Alumnae of the US (now known as the American Nurses Association), the question of women's suffrage (right to vote) was hotly debated and a resolution in support of the women's movement defeated.

Nurse Lavinia L. Dock, however, stands out as one of the strongest, most pro-feminist American nurse of all time. She marched in Washington and went to jail for her belief in equal rights for women. When, in 1920, congress passed the 19th amendment to the constitution giving women voting rights, Dock continued her equal rights crusade in opposition to countless other discriminations against women. Her basic premise, until she died, was that all people are equal.

The power of the press was the motto and mission of Nurse Sophia Palmer, first Editor and Publisher of the American Journal of Nursing. Palmer had great insight into the need for nurses to control their own profession. Her editorials helped create the first American nursing licensing laws and boards in 1903. Palmer took risks and made a major difference for us all. Because of her and others, boards of nursing govern American nurses and American nurses have legal standards for practice and education. These standards forbid unqualified, unlicensed persons from calling themselves registered nurses or RNs.

This is an exciting time to be a nurse! Because of increasing population census, a growing number of elders, expanded technology, health care reform, and emerging nursing roles, many new nursing jobs in Idaho will surface. These new jobs will require well-educated, dedicated, competent, caring, decision-makers and client advocates. Nationally, the healthcare system will require more than 1.2 million new nurses over the next decade. That means that the second largest number of new jobs among all occupations will be for RNs.

RNs work to promote health, prevent disease, and help patients and families cope with illness and disability. They are advocates and health educators for patients, families, communities. RNs develop and manage patient treatment plans; instruct patients and families in proper care; and help individuals and groups take steps to improve or maintain health and quality of life.

Though there will always be a need for hospital nurses, in the future, a growing number of nurses will be employed in home health, long-term care, hospice, parish nursing, prison care, community care, surgical centers, and ambulatory clinics.

This week, please stop for a moment to thank a nurse who has helped you or someone you love find health, wellness, strength, and an improved quality of life. Individuals, families, communities, organizations, specialties, and health services have discovered the importance of quality nursing. Florence Nightingale, we are proud to be walking in your nursing shoes.

By Linda S. Smith, MS, DSN, RN, CLNC
Professor and Nursing Program Director, Idaho State University

Wednesday, October 1, 2008

Paying Homage to our Mentor

Florence Nightingale was a revolutionary and well ahead of her time. We know of her numerous and purely astounding accomplishments with nursing through advocacy, reform, and the transformation of nursing into a legitimate profession. But do we truly grasp the depth of her accomplishments?

Born into an affluent family, Florence Nightingale ignored the societal norms of the time, which separated social class and disparaged nursing, and got down in the trenches to treat the poor and impoverished. In the process she addressed equality for the indigent and for women.

Claiming to have heard the voice of God on several occasions, Florence Nightingale’s calling must have been a powerful one. Father Henri J. M. Nouwen in his book, “Bread for the Journey” wrote a daily meditation entitled, “Downward Mobility.” He wrote the following:

“The society in which we live suggests in countless ways that the way to go is up. Making it to the top, entering the limelight, breaking the record – that’s what draws attention, gets us on the front page of the newspaper, and offers us the rewards of money and fame.

The way of Jesus is radically different. It is the way not of upward mobility but of downward mobility. It is going to the bottom, staying behind the sets, and choosing the last place! Why is the way of Jesus worth choosing? Because it is the way to the Kingdom, the way Jesus took, and the way that brings everlasting life.”


This certainly describes the path in life Florence Nightingale chose and the conviction to her divine calling. Florence Nightingale rejected her life of privilege and had the courage to oppose her parents’ wishes, despite their attempts to steer her away from nursing, to do what she believed she was called to do. Florence Nightingale looked for her downward mobility to transform nursing and address the injustices of society. It was action that she took or as the saying goes, “She walked the walk.”

Her true accomplishments: Not as much transforming nursing into a legitimate profession, as much as making it a vocation; not as much treating the ill for their physical needs, but the healing of their whole being; not as much her advocacy and reform for the time, but setting a precedence for all time; and maybe most of all, treating people as equal and as children of God. All because she answered her calling and of her “Downward Mobility.”

There are only a few people in the history of mankind that truly denied their very selves to embark on a journey that was ominous, perilous and denigrated to accomplish so much for the destitute, never to be repaid by worldly riches… or paid at all. Thank God nursing got one of them.

by Jenn Foster