Nurse’s perfect world: How would it be?

 Sean Dent/ scrubsmag

Too often, we nurses dwell on everything that is going wrong. How about (for once!) we imagine our world as perfect as possible? Here’s what I would have in my perfect nursing world: 

1. I’d never get pulled to work in another unit.
2. Staffing would never be lacking.
3. Patients would not be repeat offenders (admissions).
4. Patient families would be amicable.
5. Supplies would never run short.
6. Pay rate would be generous.
7. Changing jobs would be easy.
8. All patients would have control of bowel and bladder.
9. All patients would be pain-free.
10. All patients would have five or fewer medications
11. CT/X-ray/ultrasound machines would always be open and available.
12. CT/X-ray/ultrasound machines would only be across the hall, not on the other side of the hospital.
13. The elevator would open promptly every time you need it (especially during patient transport!).
14. Nobody would be confused or delirious.
15. All patients would be compliant and adherent.
16. Physicians would not be passive-aggressive.
17. Physicians would round on their patients all at predicted/scheduled times.
18. Families would be present whenever a physician is on the floor.
19. Night shifts would not exist.
20. There would be no annual  job/employer competencies.
21. License renewal would be free of charge.
22. All nurses, all units, all floors and all coworkers would get along and work together as a team.
23. Bodily fluids would not smell.
24. Blood–more specifically, GI bleeds–would not smell.
25. IVs would never infiltrate.
26. IV starts would only take one try.
27. IV fluids would never run out or run dry.
28. All invasive lines and tubes would be properly placed every time, the first time.

This is a very short list–I know if I sat and really contemplated it, I could quadruple it. I can dream, can’t I?!

About Sean Dent

Sean Dent is a second-degree nurse who has worked in telemetry, orthopedics, surgical services, oncology and at times as a travel nurse. He is a CCRN certified critical care nurse where he's worked in cardiac, surgical as well as trauma intensive care nursing.
 Sean currently practices as a Board Certified Acute Care Nurse Practitioner (ACNP-BC) in a Shock Trauma urban teaching hospital. He has been in healthcare for almost 20 years. He originally received a bachelor's degree in Exercise and Sport Science where he worked as a Certified Athletic Trainer (ATC).

How nurses can Improve Patient Satisfaction

Patient satisfaction is one of the hottest topics in healthcare these days. Open any medical conference brochure or journal, and you're likely to find at least one headline with the words "patient satisfaction" in it.

Patient satisfaction scores are a direct reflection of an organization's customer service skills and systems, and now more than ever are tied to reimbursement.

Here are eight tips every nurse can follow to personally impact your patient satisfaction scores at your healthcare organization.

Communicate Effectively
Quality communication is the most important skill to impact your patient's care experience. Discussing a medical condition must be done in a way that the patient will understand. If the patient has a medical background, it may help to speak in jargon they understand so they feel respected more. However, for most of the population, you'll need to explain and ask questions in a more simplistic manner to ensure they understand all important discharge plans, which in turn directly impact rates of readmission.

Be Articulate

Be careful not to speak too fast. Talking rapidly can be misinterpreted by your patients that you are constantly in a rush and don't have time to properly care for them, or that you need to get to the next patient, who appears to them to always be more important.

Use Hand Gestures

Be animated but not over the top to ensure your message is understood. Point to the body part or area that is impacted by their injury or illness or that is being tested. Show your patients the benefits undressing from the waist up, or how putting the gown on like a bath robe can help ease pain and/or protect their dignity if they seem concerned. Using hand gestures can help older patients who are hearing impaired and assist younger ones for whom English is not their primary language or tying to understand what a nurse is saying in a busy, distracting ad sometimes bewildering environment.

Pause

Pausing is a powerful tool and will allow the patient or family members some time to process what they are hearing and formulate any questions they might have. Another benefit to pausing is the patient will not feel rushed.

Ask Questions

Always assume you can do more by asking a different questions, such as "What questions do you have for me?" or "What can I get for you?" Or, after you have completed discharge instructions, for instance, ask the patient what areas they would like for you to review? Doing so can help the patient feel comfortable asking questions or making a request they may be feeling hesitant about.

Smile

Smiling sends a lot of positive messages, from "I'm sorry you have to be hear but don't worry, everything is going to be OK" to "I really enjoy my job" which can give the patient a better sense of satisfaction with the care environment. Moods are contagious and the last thing a patient wants is someone caring for them who is in a foul mood. A simple smile also will impact your fellow nurses as everybody enjoys working and being around people who are optimistic and pleasant than those whom are constantly complaining and grousing about everything and everyone else, from other staff and management to their patients or their neighbors at home.

Use Humor

Being sick or injured is extremely stressful for patients and their families. Lightening the mood with mild humor or gentle sarcasm will put the patient at ease and can diffuse a difficult situation. If you don't consider yourself to be funny, become a student of humor by watching and listening to others you think are clever and witty; even watching funny movies or sitcoms can help. An added benefit of using humor with your patients is that our bodies were designed to secrete certain hormones during laughter, which in turn, relieves pain.

Be Part of the Solution

Never use the words, "I don't know." Great customer service means taking on the responsibility to find the right answer if you don't already know what it is. Don't make your patient work any harder than they need to when they are trying to be a partner in their care. Make the call, get clarification for them, direct them or escort them to the next department, explain things until they understand or find the appropriate person who can.

Final Thoughts

High patient satisfaction scores equate to superior customer service. Healthcare is in the business of helping people. Each day, take a moment to reflect on the tips above and what you did well and what you would like to change. Constantly ask yourself what you would do differently when the next time a particular situation arises.

Together with your fellow nurses you can take the worry out of the minds of patients, and let them concentrate on getting well both in hospital and after returning home. By doing your part, and influencing those around you, will make a huge difference in nursing practice today and tomorrow.

Laurie-Ann Murabito has more than 20 years in healthcare and helps organizations build outstanding leaders through keynote presentations, trainings and coaching. She is the author of "Rethink Leadership." Learn more atwww.LaurieAnnMurabito.com. 

Great Opportunities in Pediatric Nursing

Pediatric nursing is a challenging and rewarding career. Nurses commit their skills and knowledge to care for children from infancy to late teen years and their families.

As a former School Nurse and Pediatric Emergency Room (ER) nurse, I can affirm that there are four basic prerequisites for a pediatric nurse

• You must like – preferably love - children.
• You must have abundant patience for your patients
• You must have a keen sense of humor and quick wit.
• You must like to teach.

If you passed the above litmus test, the following are some great opportunities available in pediatric nursing. These six prospects are not inclusive, but they can give you a start!

1.  School Nurse
Many people think of a school nurse as simply providing band-aids and minor first-aid treatment. This is definitely not the case. First of all, medically complex students - who just a few short years ago would not attend traditional schools settings - have been streamlined into public and private schools. 
The medications and daily medical needs of these students often fall upon the school nurse. With the increased diagnoses of Attention Deficit spectrum disorders, juvenile diabetes, asthma, and allergies in children, school nurses find themselves dealing with daily medication regimens and treatments for a group of children.
Remember that most school nurses are the only medically trained staff on campus and handle all medical emergencies.

 Working as a school nurse provides a myriad of teaching opportunities with children, parents, and staff. The job is not for the faint at heart, but is personally and professionally rewarding. When I was a school nurse, I also had coached basketball and sponsored a volunteer service club. Although I left the school five years ago, I still hear from some of the students I worked with and coached!
 

2.      Pediatric ER Nurse
This rewarding opportunity is fast-paced, challenging, as well as heart breaking at times. You care for children with chronic illnesses, accident victims, abuse victims, mentally ill children and adolescents, and anything else you can think of! This job involves handling rapidly changing medical situations, meticulously and quickly following physician orders and established protocols, and lots of teaching!
 

3.      Pediatric Floor Nurse
This job combines the School Nurse with the Pediatric ER Nurse. You will have a great deal of interaction with individual children and his/her family members. You will have more patient teaching opportunities, and building a strong rapport with children and family members is key to helping the children improve and avoid future similar hospital stays.
 

4.  Public Health Nursing with Children
This option comes in several forms. A nurse could work within the WIC (Women, Infants, and Children) Program educating and assisting parents and their children. 
Another prospect could be working in clinics within a health department caring for ill children, providing physicals exam services, and immunizations to healthy children.
 

5. Working in Adolescent Inpatient Treatment Facilities and/or Juvenile Detention Facilities

These positions are for the nurses with extra patience for their patients! There are a multitude of medical, psychological, and social challenges involved in working with these children and adolescents.
 

6. Home Health Care Working with Home bound Children
This could either be through a State funded program or through a home health agency. Nurses act as case managers or direct care providers for medically fragile children. The case manager positions require working closely with the family, health care providers, and community resources to provide the best overall care to the child. Home health opportunities involve hands on care for children needing 24 hours care.

By Sue Heacock

nursetogether.com

How to succeed as an online learner

By Jonas Nguh, RN nurse.com

The number of nursing schools offering students the chance to earn a degree  have multiplied since colleges of nursing took their first tentative steps onto the World Wide Web in the 1990s.

Some invaluable tips for online students include:

Prioritize

Adult learners often have families and/or they’re working full time. These students will need to be proactive in managing their time. If you find yourself with free time on a monday, for example, you might as well go ahead and work on your assignments. Treat your week just as if you were in regular classes, and devote a day or certain times of the day to your work. A set schedule helps to accomplish more.

Manage

In addition to managing your time, manage the workflow. Be self-motivated. In an online environment, you are responsible for your own learning. No professor will follow you to remind you to get your work done. Know when different pieces of work are due. Keep a schedule, and keep up with the crunch.

Communicate

Know how to communicate in an online environment. There is a certain etiquette to talking with your teachers and classmates in writing online. For example, don’t use all capitals. That generally is considered yelling. You also should be aware that you don’t have the opportunity for body language or tone of voice. Avoid anything that might be considered derogatory or offensive. Be careful how you write.

Partner

Get to know some of your classmates. Then, if possible, buddy up with someone who has taken an online course. They can help you in many ways, because they have experience.

Equip

Get a good working knowledge of the basic software and technology you’ll be using before you start. For example, learn microsoft excel and word, if you don’t know them already. With graduate education, you will have to submit extra information and create documents that use charts using computer programs to illustrate your answers.

Back up

Have a backup plan in place to save your work. You never know when there might be a power outage or your computer may crash. Have and use a good external hard drive to save work.

Eight early signs of breast cancer nurses should not ignore

• Outline or shape alterations of breast, especially during arm movements or by lifting the breast

• Puckering, dimpling, scaly, or inflammation of breast skin

• Unusual, new and persistent discomfort or pain in one breast

• Lump, thickening or bumpy areas in one breast or armpit

• A blood-stained or clear fluid discharge from the nipple that's not milky

• Moist  red areas on the nipple that don't heal easily

• Rash on or around the nipple

• A marble-like hardened area under the skin