·    Read up on the demands of nursing school—Getting a nursing degree is pretty challenging. You have to attend all your classes, master the material, get hands-on experience, and pass your exams. It’s a long road that’s full of difficulties, so you need to make sure you’re up to the challenge. Look over the requirements at local nursing schools, view class schedules to find class times that match your lifestyle, and figure out if you’ll have the time for going to school and studying. It’s a demanding lifestyle you can’t take lightly.
·    Talk to nurses you know—Chances are you know of someone who is a nurse. If one of your friends or family members isn’t in nursing, they may be able to suggest someone who is. Spend some time talking to nurses to get a better understanding of what life as a nurse is really like. They can give you insight into the things you might not see in a brochure or learn at nursing school. They can reveal some pros and cons that you aren’t yet aware of, helping you make a more informed decision about a career in nursing.
·    Join an online nursing community—The internet is full of blogs, message boards, and social networks specifically for nurses and those in the medical industry. Before you decide to become a nurse, sign up and participate in these communities. You can share your goals, and gain insight from experienced nurses who can tell you about their daily experiences. You’ll be able to get special tips and information that can guide you into the right career for your lifestyle.
·    Make sure you really love helping people—A career in nursing is about more than learning certain technical information and facts. Nursing is about helping others. It’s about having compassion and being able to cope with many of the difficult situations you’ll be placed in on a daily basis. So, if you don’t truly have a heart for helping others, you should probably consider a career in another field.
·    Look into shadowing a nurse—You should try to find out if it’s possible for you to shadow a nurse during a shift. This will allow you to see firsthand what nursing is really like. You’ll get a feel for situations you would have to deal with, and you can see just how tiring physically and emotionally this job can be.
·    Talk to a career counselor—Career counselors are experts at examining your skills and personality to determine the best career path for you. Meet with a career counselor to determine if you have the skills and personal traits to be a good nurse. If not, the counselor will be able to suggest careers that better suit your talents.

The good news is there will always be a need for good, passionate nurses. If you enter this career, love what you do, are willing to learn, and become good at it, there will always be a place for you as a nurse. There will be challenging days…days that test you physically, mentally, and emotionally. So this career certainly isn’t for everyone, but at the end of the day, if you have the love for helping others, you stand a great chance of success.

John manages the nursing scrubs website NursingUniforms.net, one stop online shop for branded lab coats, scrub tops and all kind of medical uniforms.

It really revitalized me and I look forward to getting back into the fray and hope to continue to make a difference in my patient’s lives! I hope that you enjoy your job as much as I do no matter what it is!

Please take Medicaid if you are a specialist. I understand that the reimbursement is terrible, but don’t make the patients suffer with curable conditions because the state won’t pay you more. Medicine used to be about patient care, not the almighty dollar. Didn’t it? We need change in the Medicaid system now to encourage more physicians to provide the desperately needed care my patients deserve in order to make them productive citizens.  This means that Medicaid should increase it’s pay to specialists in order to make it more attractive to add those panels to their practice.

If patient’s backs, necks and knees could be repaired they would not ask me for narcotics and for disability paperwork. They would provide for their families instead of relying on our tax dollars for the most part. There will always be the moochers of society. Children learn from their parents not to work because they are not being taught that hard work pays off anymore. It’s easier to collect a welfare check, food stamps and Medicaid.

Make Medicaid patients pay a copay at the emergency room to discourage indiscriminate uses of the ER as a walk in clinic. Make it okay to send them home once it is determined that there is no danger and tell them to come see me at the office. That’s what I’m here for.  I am available after hours every day of the week.  My patients know this.  Still, they insist on going to the ER because of the fix me now attitude instead of waiting until the next day to see me.

Just some thoughts.. What are yours?

Careers in Healthcare:  The Buzz about Transparency

Transparency is a popular word these days, and it’s fast becoming an expected feature at all levels of healthcare. Transparency requires a clear and accepted understanding of a concept as well as guidelines and expectations for how healthcare organizations and providers should apply the concept to their work as an emerging issue evolves.

Here are some ideas about how nurses could consider the concept and its application in practice.

What is transparency and why now?

In operational terms, the concept of transparency addresses access to information. The first and most pressing rationale for transparency is the role that information plays in decision-making and trust-building.

In the April 2010 Harvard Business Review, Meyer & Kirby suggest that, as the impacts of various business on organizations become too substantial to ignore and as techniques to measure those impacts develop, businesses start getting measured.  A patient-driven movement was the main impetus for transparency in healthcare. Patients and payors began demanding information on outcomes and respect for patient’s rights.

Transparency on a national level

Responses to the demand for transparency in healthcare began in the late 20th Century, resulting in a variety of national initiatives, such as:

·    The National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners: A Federal program intended to improve the quality of health care by encouraging state licensing boards, hospitals and other healthcare entities, and professional societies to identify and discipline those who engage in unprofessional behavior.

It restricts the ability of incompetent physicians, dentists, and other health care practitioners to move from state to state without disclosure or discovery of previous medical malpractice payments and adverse action history.

·    Hospital Compare: A program that provides information from hospitals on how well they provide recommended care to their patients.

·    The Joint Commission: A voluntary accrediting body that provides accreditation status information on hospitals.

What states are doing

Pennsylvania has led the way by establishing the Pennsylvania Health Care Cost Containment Council (PHC4). The PHC4 is an independent state agency that publicly reports hospital performance and medical procedure outcomes.

Organizations expended much effort and expense to develop data collection and reporting mechanisms that met the public reporting requirements of the national and state initiatives. Now, individual organizations are looking at clinician performance and patient outcome data.

Automated medication administration systems and electronic medical records capture clinician-specific information and match it with specific patients, the care that the clinician provided those patients, and the patient’s outcome.

What does transparency mean for nurses?

Nurses can take the lead in their organizations to press for policies and guidelines that identify the goal of transparency. Specifically, what are the kinds of information that need to be communicated during certain situations? Nurses can study and suggest the appropriate level of transparency to be applied to each particular type of information.

Milton (2009) suggests the following steps:
·    First, transparency needs to be defined in a practical manner as a desired communication goal and outcome. Possible limits to transparency also need to be identified and articulated as part of the policy.
·    Second, the policy needs to be applied to the relevant information that an organization may generate or gather, and that the public will need and may seek, during an emergency.
·    Third, responsible staff could then identify practical dissemination tactics in their communication plans to reach the various audiences with appropriate information.

What expectations are there of you?

With your practice in mind, consider your responsibility and the expectations about transparency that both an employee and an employer would have. Ask yourself these questions:

·    Who are your stakeholders?
·    What information is revealed?
·    What information should be revealed?
·    To whom should what information be revealed?
·    How should information be revealed?
·    Who should reveal the information?
·    When should information be revealed?
·    To what policies and procedures are you currently bound?

Meyer, C & Kirby, J. (2010).  Leadership in the age of transparency. Harvard Business Review, 88 (4),
39 – 46.
Milton, C. (2009). Transparency in nursing leadership. Nursing Science Quarterly, 22 (1), 23-26.

I’d like to hear from you. What are your experiences and challenges with transparency? Please share your questions or strategies with your fellow readers by sending them to me at healthcare@americansentinel.edu. I look forward to hearing from you.
About the Author: Betty Nelson, PhD, RN, a registered nurse with more than 30 years experience as a clinician, administrator and educator, is an adjunct professor in Health Sciences and Nursing at American Sentinel University.
About American Sentinel University
American Sentinel University, http://www.americansentinel.edu/, delivers the competitive advantages of accredited online degree programs focused on the needs of high-growth sectors. Its nursing degree programs are accredited by the Commission for Collegiate Nursing Education (CCNE). The university is accredited by the Distance Education and Training Council (DETC). The Accrediting Commission of DETC is listed by the U.S. Department of Education as a nationally recognized accrediting agency and is a recognized member of the Council for Higher Education Accreditation.

I hope you enjoy the above video about the newer roles of nurse practitioners in primary care.

Effective performance management requires an ongoing, two-way discussion between you and your manager about your performance, priorities and challenges. One way many healthcare facilities encourage this two way dialogue is through self-appraisals, where the employee formally evaluates their own performance, then send their assessment to their manager before the manager writes the annual employee evaluation.

There are many reasons why employees may not give much thought or effort to a self-evaluation – a lack of time, a feeling of powerless to change anything, or the belief that management already knows about work competence. The bottom line is that it’s a mistake to downplay your self-evaluation because in so doing you remove your voice from a formal process that results in documents that remain on your employment record. Rather than simply being the “recipient” of feedback, you are being given a voice, and can inform or shape management’s perceptions before your performance appraisal and ratings are done.

A good self-evaluation gives your manager a broader perspective to evaluate your performance. Remember it is not always possible for your manager to see the full picture and understand all the factors that affect your performance – they work different shifts, have others to manage, or might work in a different location. Completing a self-assessment allows your manager to view your performance through your eyes and get your “side of the story”, leading to a better understanding of your strengths and weaknesses. In some cases, the information revealed in your self-appraisal might even guide or redirect your manager’s assessment.

Many managers have been caught off guard in an employee performance appraisal meeting to discover that their employee has a completely different perception of their performance and value, or that they themselves are lacking vital information that affects ratings. An employee self-appraisal can help identify differences in perception that might not surface otherwise, allowing the manager to prepare appropriately for the performance appraisal meeting and ensure a fruitful discussion and fair performance ratings.

Investing time to carefully complete your self-evaluation lets you highlight your accomplishments and contributions, and gives you input to your manager’s perceptions of your performance.

Halogen Software is the industry leading provider for online nursing competency assessments, development plans and performance management. To learn more about our performance management solutions for nurses, visit our website: http://www.halogensoftware.com.

Wouldn’t it be great if you could just do your job as a nurse practitioner, and do it the way you know is best? Unfortunately with most patients, you also have to answer to the family members and friends who have their own opinions about how your patient should be cared for. And while having family support is extremely important to a patient’s progress and well being, it would also be nice to have them support you during the whole process. Here are 10 tips for dealing with your patient’s opinionated family and friends.

1. Give them as much information as you can. Most family members just want to know what’s going on with their loved one, so don’t hide information that’s their right to know.

2. Be strict with visiting hours. Lay down the line early on in regards to visiting hours. They’re there for your patient’s protection and to give you a break without having to deal with family!

3. Try to understand things from their perspective. By considering their feelings, you’ll be better prepared to deal with any situation involving your patient and his or her family. Plus, if the family feels like you’re on their side, they’ll be kinder to you.

4. Don’t let them get to you. You have a job to do as a nurse practitioner, and chances are, you know how to do it better than anyone. If you feel overwhelmed or need assistance, ask for help from the doctors and other nurses involved, not the family.

5. Keep your cool. If you feel panicked, stressed or pessimistic about your patient’s condition, don’t let the family see you freak out. They’re counting on you to keep your cool and maintain control of the situation.

6. Don’t take things personally. Remember that family members are incredibly stressed out and worried about their loved one, and if they snap at you, it probably wasn’t meant maliciously. Concentrate on your job and ignore the rest.

This post was contributed by Kathleen Baker, who writes about the ultrasound tech school. She welcomes your feedback at KathleenBaker3212 at gmail.com