News: Smoking = Bad

National Campaign Launched to Help Nurses Quit Smoking

A UCLA School of Nursing professor will launch a program to help nurses quit smoking. The first initiative of its kind in the United States, “Tobacco Free-Nurses� will be funded by a $1.8 million grant from The Robert Wood Johnson Foundation.

UCLA School of Nursing Professor Linda Sarna and Stella Aguinaga Bialous, a nurse who is a tobacco-control consultant in San Francisco, are spearheading the multifaceted national initiative, along with Dr. Mary Ellen Wewers and Dr. Erika Froelicher from schools of nursing at The Ohio State University and University of California, San Francisco, respectively. This initiative is aimed at supporting the country’s largest group of health professionals in quitting smoking.

Sarna notes that one barrier to conducting smoking-cessation interventions with patients is nurses who themselves continue to smoke. That number, estimated at 18 percent, marks the highest percentage of smokers among all health professionals.

“Nurses have a tremendous opportunity to assist in tobacco-control efforts,� Sarna said. “However, smoking among nurses limits their ability to be strong tobacco-control advocates, including the act of engaging in smoking-cessation efforts with their patients.�

According to Sarna, in addition to individual nurses who smoke, the nursing profession as a whole has had limited leadership in the tobacco-control movement. Sarna and her colleagues hope to expand nursing leadership in tobacco control through another Robert Wood Johnson Foundation grant funded through its Smoking Cessation Leadership Center at the University of California, San Francisco, for $174,000.

“In the past, there has been no coordinated effort to support nurses in their own cessation efforts or to stress the critical importance of being smoke-free role models,� Sarna said. “We have worked with a variety of nursing organizations and tobacco-control experts to help us develop this nationwide initiative that will provide nurses who smoke with cessation resources.�

One of these resources will include $100 of free, individualized smoking-cessation services that will be offered through the Internet for each nurse who chooses to participate. Additionally, in partnership with nursing organizations including the American Association of Colleges of Nursing, the American Nurses Foundation and the National Coalition for EthnicMinority Nurses associations, a variety of activities will be developed to support smoking-cessation efforts for the workforce and the public.

“Despite progress in reducing the prevalence of tobacco use, in 2000 there were still 46.5 million adults in the United States who were smokers, 26 percent male and 21 percent female,� Sarna said. “Smoking continues to be a major cause of preventable illness, disability and premature death in this country.�

The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation’s largest philanthropy devoted exclusively to health and health care. It concentrates its grant-making in four goal areas: to assure that all Americans have access to quality health care at reasonable cost, to improve the quality of care and support for people with chronic health conditions, to promote healthy communities and lifestyles, and to reduce the personal, social and economic harm caused by substance abuse - tobacco, alcohol and illicit drugs.


I don't smoke, but both of my parents did, and my father died of lung cancer about 4 years ago. I hope anyone who does smoke and might want to quit can check out this site and see if there is anything there to help you. I've put a logo-link on the side. -HK

Interviews

Sorry I haven't had an entry in a few days. I was hoping there would be a better response to the poll while I was busy, but only about 12 of you did it. The majority would like to see the blogs divided into categories for nurses, student nurses, and pre-reqs. I can do that fairly simply. The other desire was to know who had updated recently - I'll have to get some help for that, but personally, I'd like to see that also. It's really tough to manage to get through that list in a reasonable amount of time - even if I do skip a few I know haven't been updated in a while. I'll do the categories first and work on the rest as I go.

Now, for what I've been doing: I had one interview Friday, Kaplan NCLEX class on Monday and then another interview, and two interviews today! I feel so much better about interviewing now, because they've all been such great experiences. The earlier interview today (for a critical care position) was very positive. She basically told me she had to interview a few more people this week that she had already made appointments for, but that she was going to hire 4 people, and I was at the top of her list. Wow. That made me feel really good. BUT then I had an interview back at the hospital I work at, and she told me in no uncertain terms that she wanted me there and that there was a position for me, and she would very much like to have me. This is pretty incredible for me, because I'm often insecure about my performance and this really bolstered my confidence. Although the position that is in my hospital is med/surg, she said she had already talked to my manager at critical care and they would work it so that I could get a good foundation in med/surg and then be able to go to critical care again (there are no openings in CCU, so thats not an option).

So, I could go with the critical care position in a new hospital, or do med/surg in a place that absolutely loves me, evidently. Geez, she even said that I was "extremely well-recommended" (*blush*) I think I'll do the med/surg because #1)what can it hurt, I'll get paid the same either way #2)I have so many friends and so many people I love to work with there #3)I won't have to deal with the traffic of getting into the core downtown city area, and I already know how to navigate my hospital. #4)I spent 2 years volunteering, one year as a tech, and whats one more year in med/surg? It's all good. #5)the critical care position is nights, and the med/surg is 3p-11p. #6)When I do go to CCU at my hospital, I'll be working with some awesome people.

So anywayz, I'm feeling pretty positive, and everything looks like it's going to work out and be very cool.

I worked both Saturday and Sunday, and it just feels like I've been in a whirlwind since the first interview Friday. I have been logging in here to see if anyone voted (if you haven't voted yet, please do! It's helpful for me to know how you all feel).

Assesment Phase: Nurse Blog links

How do you like your Nurse Blog links? (Pick as many as you like)
	Alphebetized, like they are now
	Seperate Nurse / Student Nurse / Pre-reqs categories
	Arranged by how recently they were last updated
	I'd like to know which blogs have new posts
	De-list blogs not updated in more than 2 months
	More links, please! I can't get enough!
	Too many links! I can't deal with it!
	I like my links BBQ'd with a side of potato salad.
Free polls from Pollhost.com

I've been thinking of re-working the links so they're easier to use. I'd like to know your thoughts on it. Just check as many boxes as you like, tell me how you feel, and I'll be on to the implementation phase! You can only vote once a week.

Curing A Nagging Cough w/Hypnosis

June 10 (ABC7) — Not all coughs are created equal. In children and some adults, there's something called a habit cough. Drug therapies are typically not effective for this type of cough. Dr. Dean Edell reports on an alternative treatment that may help.

It started as a bad cold and turned into an annoying habit cough. Eleven-year-old Ian hacked for 33 days straight and missed 20 days of school.

Ian Appelbaum, habit cougher: "I felt kind of miserable because I was coughing every one or two seconds."

Lee Thompson, Ian's mom: "But what was amazing was it was every waking moment. It was non-stop."

Dr. Howard Hall heard the clues immediately.

Howard R. Hall Ph.D., Psy.D., clinical psychologist: "In my waiting room, I can tell if there's a cough habit. For example, 'uh-huh' (coughs), it's a non-productive cough of course."

Dr. Hall prescribed hypnosis for Ian. A new study shows it's nearly 80 percent effective at stopping a habit cough. The idea is to reduce stress and anxiety. Ian practiced the method at home.

Ian Appelbaum: "I would usually start by closing my eyes, laying back and relaxing. I would think about what I enjoy doing."

Dr. Hall sometimes combines this bio-feedback method with hypnosis. This freeze-framer measures heart rate, relaxation and stress. As the patient gets calmer, the balloon floats higher.

Dr. Hall: "Hypnosis has a lot of applications. It also helps you sleep, and it's so helpful for a variety of conditions."

Within two days, Ian's cough was gone.

Ian Appelbaum: "It felt really good after I stopped coughing."

And now he can get back to doing the things he likes most.

Experts say, children often develop habit coughs after a common cold or flu. In many cases, the reason for the cough is psychological. They say biofeedback and hypnosis may help address the child's underlying needs.

One of the biggest benefits of hypnosis is there are no side-effects. Experts next want to try hypnosis on persistent adult coughs.

More Information

Time-Wasters

The Nurse Practitioner's Place is looking for a little research help for a project. She'd like nurses to respond with the top 10 time-wasters at work. I'm sure she'd like more input, so click on over if you've got a moment and tell her what (or who) wastes your time.

Doctor's Order Conveys Dying Wishes

Seattle Times
By Carol M. Ostrom

Eight years ago, when musician Mary Levine decided she wanted to die at home, she worried that a visitor might call 911 when the time came, emergency medical workers would rush in, try to resuscitate her and cart her off to the hospital.

Levine, a strong-willed cancer patient from Seattle, plastered big signs on her front door, her refrigerator and elsewhere in her home: "DO NOT RESUSCITATE! DO NOT CALL 911!"

Today, patients in similar situations have a better option: It's called POLST, a not-so-catchy acronym for "Physician Orders for Life Sustaining Treatment."

When signed by an end-of-life patient and medical provider, it is a "doctor's order" that requires emergency medical workers — as well as medical providers in hospitals or nursing homes — to respect the patient's wishes.

Unlike most other forms directing end-of-life care, the bright-green POLST directs care wherever a patient goes, from home to nursing home to hospital and back again — giving the patient's wishes what one fan of the form calls "power and portability."

Although the form has been around — at least for those who knew it existed — for about five years, the Washington State Medical Association and the Regional Ethics Network of Eastern Washington have launched a campaign to expand its use.

The form also has been newly revised, allowing a physician assistant or nurse practitioner to sign in the doctor's place.

Experts in end-of-life care say patients and doctors are confused about how to best have their wishes respected, and it's no wonder: Over the past decade, a whirlwind of forms has come their way, each with limitations and intended for a specific audience.

Nursing homes, for example, demanded their own "Do Not Resuscitate" forms be filled out by residents. Hospitals had other versions of the form.

Meanwhile, most advisers were telling people they needed a "living will" and a "durable power of attorney for health care" — the forms known collectively as "advanced directives."

But in many emergencies, physicians consider a living will to be advisory, if they consider it at all. The more-powerful durable power of attorney gives someone else authority to make decisions — but only if that person is available and able. In most places, emergency paramedics, who work under the direction of a doctor, can't respect either, because they are not orders from a doctor.

"Advanced directives don't mean piddly squat to the EMS [emergency-medical-services providers] because they aren't MD orders," said Sally Denton, a nursing-home administrator and nurse from Spokane who thinks the new form gives much-needed power to end-of-life patients.

The new form replaces the EMS/No CPR form, which wasn't widely used, and is more comprehensive and specific. For example, a patient can say no to CPR but yes to comfort measures such as oxygen, or treatments such as antibiotics or tube feeding.

And unlike the EMS/No CPR form, POLST can be signed by a mentally incompetent patient's legal decision maker.

The POLST form, modeled on a similar form that had been used in Oregon for about a decade, is meant to solve the gaps and inconsistencies that have left terminally ill or end-of-life patients without sufficient protection, Denton said.

"Until you have walked in our shoes, you don't realize how many near misses there have been — almost resuscitating someone who didn't want to be resuscitated, because we didn't have the right paperwork," she said.

Denton still remembers the anger of many older patients who turned up at a forum as the POLST form was being developed. They were angry that their advanced directives or those of family members had not been followed by emergency workers or hospitals, she recalled. "One man said, 'What do I need — a tattoo on my chest?' They had horror stories to back up their anger."

For a patient, Denton said, the new form is power: "It's like a suit of armor," she said, making sure that all medical workers, in all settings, respect the patient's wishes.

"The importance of this form, in protecting people's choices in how they want to die, is huge," said Dr. John Osborn, a Spokane internist who has been active in the POLST effort. "POLST also provides a point of entry for people to talk about their end-of-life choices with their doctor — it's a valuable way to have a discussion about what people want."

About POLST: A free online video, "POLST: Choices for End of Life," is available at the Washington State Medical Association. (Windows Media Player for Windows or Macintosh is required to view).

For patients: POLST forms can only be obtained from your physician, who can order forms from the Washington State Medical Association. View a sample form.
Patients are not allowed to download or order forms themselves.

For NP, MD, PA: These forms are actually available for download here. There is a specific type and color of paper they want it printed on. If you choose, you can also order pre-printed quantities.
.
.
.
This public service message brought to you by your friendly neighborhood HypnoKitten.

Camping Photos

Here's a link to a slideshow of some of the camping photos from our trip last weekend.

More Entries

I've got some time off today, and decided to add more of the blogs I've got waiting in the wings. I'm still pretty primative at blogging, and enter each one individually into the blogger template so we just plod along.

I think the ratio of student nurse blogs to working nurse blogs is interesting. I doubt it means that student nurses have more time to get online, but rather that they have more of a familiarity with the internet than students that came before them. I know I looked up every journal article I ever used in school online. I think I started blogging because I found the industry to be so exciting and I was finding stories that were amazing to me.

Hanna goes to nursing school in the UK and has a blog called Student Nurse's Diary where she explores the changes and challenges of leaving home to stay in a dorm-type housing ("nursing accomodation").

Unconventional Student Nurse is setting up a quiet place to study after buying her first unform and lab coat. Isn't orientation fun?

Kendra is happy to get a vacation, but seems like she just can't catch a break at Whoa...It's Finally All About Me. She's going through a lot of changes, and hopefully blogging about it will be helpful. I can't leave a comment because I'm not signed up with passport. Ugh.

Over at the Captn's Log, he doesn't talk much about nursing because he has just finished orientation to school. He's got a lot to say, though, so I'd keep an eye on this one. Darklemon isn't talking about nursing much either, but he's a 12-year vetran nurse who decided to go into teaching. He's in Australia, and talks a lot about his life down under.

Bob's Blog is from a nurse who became a firefighter. He doesn't talk much about work, but he does talk a lot about his charity work and his outlook on life. Sounds like a totally happy guy to me. Posts regularly.

Wow! Look at all these GUYS! How cool is that?! Here's another guy: Chris in Pennsylvania is a volunteer firefighter and in a BSN program. He hasn't got any comments to his new blog yet, so make sure you let him know you're reading The Life I Lead.

I really like the layout at Crazy Tracy's Place. She's a psych nurse who's got some stories to tell - most recently the guy who didn't want the court-ordered injection:

"I'M BLEEDING! I'M BLEEDING! YOU'RE DRAINING OUT ALL MY BLOOD!!!" When I was finally able to get him to stop screaming, I said, "You're not bleeding at all. Look!" And he wasn't. He looked at his arm for a few seconds and then started screaming again, "I'M ALL DRIED UP! I HAVE NO BLOOD! I HAVE NO BLOOD!".

Don't you just love psych patients?

Kristin in Florida just graduated from nursing school and starting her preceptorship! Yipee! Life as a New Nurse's last post was in April telling us how she would be graduating soon - I expect she's too busy with the NCLEX and interviews to blog! :)

Where's My Towel? discusses end-of-life issues and a growing understanding of what nursing is about from a student's point of view.

That should keep you busy for a while. Remember to comment often, especially to new bloggers - it's the fuel that keeps the blogging fire glowing! :)

I'm going to run to the store and when I get back I'll try and get some pix from my camping trip posted.

AFK

Thank you all for your well-wishings. I'm going on a four-day camping trip today, and getting ready to pull out asap. It's so nice that my husband could get this week off - I'll post a few pix when I get back!

:)

It's Over

I am a nurse
I am a nurse
I am a nurse
I am a nurse





I guess I have to change my banner.

Lunch? What Lunch?

Skipping meals or breaks may contribute to nurse burnout and jeopardize nurses' health

A new study suggests that nurses are regularly sacrificing their breaks and meal periods to provide patient care. The researchers found that nurses took a break or ate a meal free of patient care responsibilities in less than half (47 percent) of the shifts they worked over a 1-month period. During the remaining shifts, they either worked nonstop throughout the entire shift (10 percent of shifts) or were able to sit down for only a short period, while remaining responsible for patient care activities during their breaks or meals (43 percent of shifts).

Nurses who were unable to take a break made no more errors than those who were able to take a break. However, staffing levels so low that nurses feel they must work nonstop to meet the needs of their patients may contribute to burnout and nurses leaving the profession, and it may jeopardize their health, says Ann E. Rogers, Ph.D., R.N., F.A.A.N., of the University of Pennsylvania. In a study that was supported by the Agency for Healthcare Research and Quality (HS11963), Dr. Rogers and her colleagues analyzed the breaks of 393 registered nurses (RNs) who worked full time as hospital staff nurses. The nurses completed logbooks for 28 days on their work hours, errors or near-errors, episodes of drowsiness and actual sleep on duty, duration of breaks taken during each shift, and whether they were relieved of patient care responsibilities during their meals and/or breaks.

Although nearly 40 percent of the shifts exceeded 12 hours, nurses working longer shifts were no more likely to be able to take a break than nurses working shorter shifts. There were 189 errors (most of them medication errors) reported by 30 percent of the nurses during the 28-day period. Although the absence of a break did not increase the risk of making an error, longer breaks appear to offer some protection against making errors. Breaks averaged 23.8 minutes on shifts without errors, whereas breaks averaged only 16.2 minutes on shifts when errors occurred. Also, nurses had 10 percent less risk of making at least one error when they had an additional 10 minutes for their breaks and meals.

See "The effects of work breaks on staff nurse performance," by Dr. Rogers, Wei-Ting Hwang, Ph.D., and Linda D. Scott, Ph.D., R.N., in the November 2004 Journal of Nursing Administration 34(11), pp. 512-519.

French Bred Student Toasts US Schools

French Bred?
French Toast?

Ok, so I'm being lame in my attempt at humor, but I wanted to share an article I found about a nursing student from France coming to the US to go to nursing school here for a month. She compares the two systems, and I think it's a pretty neat story. Wish I could have gone to France to take her place for a month! :)

Nursing Moments

The second edition of the "Nursing Moments" carnival of nurse blogs is up over at Codeblog.

Next month it will be over at Nurse Ratchett's Alter Ego. If you haven't entered one of these yet, think about it!

Do or Do Not - There Is No Try

So evidently I'm Yoda. Cool.


Which Revenge of the Sith Character are you?
created with QuizFarm.com

Filed Under: You've Got to be Kidding

Oh, Yeah, Right, Sure - I believe that. You find all sorts of funny pictures when doing a Google search. Wow. These people really made a good spoof page of Medline - looks just like it...

Hmm. Wait a sec. This is real. (HK shakes her head in disbelief...) Oh Lordy.

So I'm NEW, ok?