February 28, 2008
The Lipitor Ad Controversy
The Lipitor advertisement featuring Dr. Jarvik, inventor of the first artificial heart, has been taken off the air. (Pfizer Pulls Lipitor Ads With Heart Expert Jarvik). A congressional subcommittee is investigating celebrity endorsements in direct-to-consumer drug ads, including the ads featuring Robert Jarvik. Okay, does that include the “Flying Nun” -- Sally Fields, and the osteoporosis drug, Boniva, too?
It all seems pretty silly to me to spend time on this controversy. Although I must say I did think that Jarvik was a practicing physician of some sort. He finished medical school, but never completed a residency. Thus, he can’t prescribe medications or practice medicine. I recall seeing the videos of Barney Clark in Utah who was implanted with one of Jarvik’s devices in the 1980s. Remember?
I guess the controversy centers on this question: Is Dr. Jarvik entitled to appear in advertisements and give the impression he can prescribe pharmaceuticals for patients?
But, let’s leave the “Flying Nun” alone! (Wasn’t Gidget great?)
February 24, 2008
Hospitals More Like Hotels
I recently revisited my old workplace in Rochester - Highland Hospital. A wonderful, clear, glass atrium with painted ceramic tiles greet you as you enter the interior lobby, with welcoming and peaceful colors of mauve and lavender. A loft above the lobby holds a grand piano for patients to enjoy music therapy. Mahogany wood greets visitors by the gift shop, which has perfectly arranged, uncluttered rows of cards and miniature bears and dolls.
The old hallway is now painted in various shades of purple and lavender as well. It’s obvious there has been some planning in color schemes. There’ is even carpeting now! A recent report in the New York Times explored the redesign of hospitals. I must admit that Highland Hospital has turned into a mini-hotel with multiple amenities for patients and even massage therapy for staff. I wish still worked there!
Are other medical facilities doing similar things? Here in New York I really don’t see much of that – many facilities look like they are crumbling, with wall plaster peeling, overflowing garbage cans, dust on window sills, and a lack of carpeting unless it’s a designated VIP ward. And those uncoordinated ceiling colors – some are the color of bile combined with tan. One has to wonder if the environment does play a role in a patient’s recovery. I’m not sure I would want to wake up gazing at a ceiling the color of gallbladder bile after surgery….
What are your thoughts on this topic? Has your work setting done anything to make the environment more comfortable and welcoming, for patients and staff alike?
How often during the day do we hear the following?
* “Gee, the charge person gave me a horrible assignment again.”
* “Can’t we do something about these beds? None of the scales are working. “
* “What a mess my patient was left in today.”
* “Why can’t the night shift change the IV bags and tubing? They have enough time.”
I just read an interesting article describing a Canadian Medical Facility that has initiated an “Employee Anti-Complaining Program.” Two nurses bet one another in this facility that neither could do without complaining during a shift. The challenge was overheard and evolved, as more staff on the floor joined a month-long campaign to quit complaining.
“Can the complaining. Nix the negativity. Cut the criticism.” Those were the messages staff at Windsor Regional Hospital in Canada embraced, as part of an anti-negativity, anti-complaining mission created by bedside nurses! The campaign has been so successful that now the entire medical facility is involved. Employees wear purple silicon bracelets as a symbol of membership in the program. Apparently morale has improved since the initiation of the campaign.
This is an innovative idea within the workplace. I wonder if it could be recreated by nurses worldwide to improve morale? After all, don’t we do a lot of complaining? Maybe not? What are your thoughts about this? Has your workplace initiated any innovative ideas?
February 14, 2008
Housing for Nurses
Miami Beach is working with one of its main hospitals to ensure housing for nurses. Wasn’t this common place 20 to 30 years ago? But as hospitals expanded, housing buildings were demolished. Would reinstituting this practice bring more nurses into the field? I sure would support housing for nurses, especially here in Manhattan.
But I believe that this is unlikely to occur, when Medicare reimbursements are cut to hospitals and other centers. However, I do wonder what it was like to live in a dormitory or same-building with your colleagues on an ongoing basis. What was the atmosphere like? Any old-time remembrances about nurses living in hospital housing?
Rounds with Nursing Administration?
Distrust, lack of respect, and lack of recognition all seem to be voiced by bedside clinical nurses lately, with anger that is often directed toward nursing administrators. I used to work at a medical facility, non-unionized, where the nursing administrators, from the CEO to the VPs, would come do “walk-a-bout rounds” on each of the floors at 7:30 am, on a weekly basis. They would come and talk to each of us, listening to our concerns, gripes, and family issues, along with our own physical and other problems. They soon learned who lived where, who had just installed a pool, who was pursuing a degree, and who was basically living day-to-day.
Everyone knew one another by name, including our nicknames, and even our pets’ names! We were all one family, focused on creating a healthcare system that would be Number One in the city. There were common goals, with plenty of community between all levels of staff and departments. Shared inter-departmental lunches and cook-outs were not uncommon.
However, I have never seen nursing administration rounds (unless it is Joint Commission-related) during the past 7 years at my current medical facility. I threw this suggestion in a “comment–suggestion” box mounted to a wall one day. But, I doubt it has even been read. For the most part nursing administration is rarely seen unless disciplinary action or Union contract talks are underway.
Do you work in a facility that has administrative rounding today? Do you believe that nursing rounds like these would benefit bedside clinical staff? Or would they be a hindrance? I think they would be quite doable and beneficial for everyone. What do you think?
February 09, 2008
Beka - My younger sister moved to Long Beach, California, to work for an advertisement company about a year ago. She just sent me an email about California nurses in Sonoma Valley. California's Sonoma Valley Hospital is implementing a flexible staffing initiative that will include asking nurses, such as those required to be on staff at all times in the OB department, to take on non-bedside tasks, including updating records, during downtimes. "If you can wear more than one hat, do it," the hospital's CEO said. So, are the nurses’ now supposed to empty garbage cans and refurbish linen closets?
Carl Gerlach, the hospital’s CEO, says that nurses should be trained to do other things such as reviewing medical records for quality assurance during their off-time or during slow days. Don’t they have a QA nurse or QA staff? Reading the article, full-time positions have been cut and some have been revamped into part-time positions. Flex time has been cut completely. Wow!
According the CEO, 2.2 million dollars have been saved for the hospital, the goal being to increase revenue and decrease expenses. Seems to me that money and profit are the new prescriptions for dealing with hospital finances, outcomes and directives. What is the California Nurses Association saying about this? Will this be the trend for private hospitals? What do you think?
February 05, 2008
Don’t You Dislike it When ….
* Spaghetti-tangled IV lines take an hour to unravel?
* Anesthesia personnel drop off your patient without giving you any sort of verbal report?
* A paperless EKG machine stops working when your patient is having angina?
* Garbage pails are overflowing?
* You must go into dirty utility rooms?
* You get back-to-back admissions in 15 minutes, one of whom is “stroking out” as you transfer him/her from one bed to another? Help!!
* A bed doesn’t allow you to weigh a patient accurately?
* A night shift is (too) quiet and uneventful?
* A patient needs transport to MRI at 3 am?
* You find a patient lying in wet, urine-soaked bed linen even though the previous nurse tells you that the patient is all cleaned up?
* There is no razor available to shave a bearded, intubated patient?
* Colleagues forget to order out food with you?
* Nursing administrators remain clueless about the nursing shortage and the issue of burn-out and stress?
* Staffing plans don’t take patient acuity into account?
* An IV infiltrates in a patient receiving dopamine peripherally? (Where is that Regitine when you need it?)
* An automated system dispenses the wrong medicine for your patient?
Well, those are just a few of my pet peeves. Share yours today!
More Thoughts on Dealing with Nursing Burnout
Beka - Before attending nursing school, I was planning on going to art school. After all, I had taken every art course offered in high school and even won several awards. However, my father stepped in, saying “No“ to art school, pointing out that "nursing is a better career, offering job security." He proved to be right, as parents usually are!
Signs of nursing burnout include no longer finding enjoyment in areas of your job you once really liked, becoming cynical or bitter about your job, and starting to experience problems in relationships with co-workers, friends or family, as a result of the conflicts of your job. Other important signs to watch for are looking for excuses to not go to work, calling off or asking to go home early on a regular basis, becoming easily annoyed with co-workers and envious of those who do enjoy their work, and not caring if you do a good job or not. Physical and emotional exhaustion are not uncommon in burnout. Burnout can create incredible havoc on a nurse's personal life as well.
To reduce the risk of burnout, after working in the ICU setting for 21 years, I just began learning “How to Watercolor.” My mother had always done oil painting, selling some of her works, and donating the profits to dystonia. As I read the opening chapter about the supplies required to begin water-coloring, I realized that it actually would be FUN! Something new and different. No hemodynamics involved!
My kit includes a sketch pad, basic watercolor paints, and pencils, along with ideas on perspectives. Soon I found the first picture that I wanted to paint. The colors simply attracted me. My upstate Spring garden pansies!
As the New Year gets underway, how do you plan on avoiding burnout in nursing? Any other nurse-artists out there?