In Our Own Words

The PBDS Test for Nurse Travelers

Quite a few nurse travelers have been hired throughout the New York City area to cover hiring freezes and staffing shortages. Ever since I placed my resume online, I have had calls from various travel nurse companies looking to fill a variety of positions, although I am primarily looking for an optimal NP position that will not tire me out or induce dystonia symptoms. (Lately I feel like the actor Michael J. Fox -- I want to hide and not be seen or questioned about abnormal movements or possible and current treatments.)

A requirement for travel nurses to prove their competency in their area of specialty is to take the "Performance Based Development System,"  otherwise known as the PBDS Exam. It consists of video scenarios of multiple clinical situations requiring you to evaluate the clinical diagnosis (are nurses allowed to diagnose? Uhmmm? I thought not…), identify it, and list actions you would take to correct the problem. (Avoiding the answer – “Call the Doctor” is a must to passing the exam.) Travel nurses cannot begin a contract assignment without passing this test.

Some of the scenarios might include:
* What would you do if a family member arrests in a semi-private room (Scream for help!)
* A doctor makes the comment “I don’t know why hospital administration won’t hire any decent nurses when there are plenty of girls out there?” (What sort of girls is he referring to?)

The test seems to focus on nursing actions used to correct a medical diagnosis. I thought we were nurses, not physicians, or is there now overlap between the two professions? When was the last time a white-coated physician gave a patient a bedpan? Anyone recall?

Whatever happened to the good ole resume and job interview format? Is this the right exam to test the competency of skills and knowledge for a nurse? I'd like to hear from others who have more experience with this.

John McCain and Healthcare

As Election 2008 moves forward, I decided to read up on John McCain. The only 3 things I know about the man are: he’s a senator from Arizona, he’s a former POW released in 1975, and he’s had a bout with skin melanoma (I won’t admit to the fact that his wife does like she stepped out of Vogue magazine each week! She never has a hair out of place.)  But I know nothing about his political views, especially those surrounding our healthcare system.

John McCain is bolstering his reputation as a maverick by encouraging Americans to buy lower-priced drugs from Canada, a plan that may cost Pfizer, Inc, and the drug industry $40 billion over 10 years. Isn’t that a lot of monetary revenue? Enough to rebuild the Lower 9th Ward in New Orleans! McCain, the Republican presidential candidate, says crossing the border for less-expensive drugs will increase healthcare access by lowering costs. Spending on physician services can be cut too, he says, by paying set fees for disease treatments, not on the amount of care provided. He also wants to encourage the purchase of insurance by offering a tax credit paid for by taxing workers' health benefits for the first time.

Supporters say that by attacking health costs, the Arizona Senator can make care more affordable for the 47 million Americans without insurance coverage. Opponents say the ideas are unrealistic. To me, it all seems rather confusing….To save money, McCain wants to give physicians a so-called bundled fee for treating a condition such as heart disease instead of reimbursing each procedure as they do now. Now, I wonder how that would affect private practicing nurse practitioners.

What are your thoughts? Should we be going to Canada to buy our prescriptions?

Health Matters in the 2008 Election

Nurse Bloggers - New Links

Check out all the featured nurse bloggers this week. There are more out there than you might imagine! You will find the link here, at Emergiblog.

Organ Transplant Tourism

Need a kidney? Buy one for $20k in Russia.
Need a liver transplant? Visit the Philippines. Cost $129k.
Need a heart?  South Africa has them for $140k.
(Lisa Ling, Reporter, National Geographic Special on Organ Donation)

The shortage of organs available for transplantation continues to rise in the United States and the demand for organs exceeds the supply. Thus, many Americans, rather than staying on waiting lists for 5 to 15 years, are traveling to various countries to obtain necessary organs to remain alive. China recently stopped allowing Americans to travel to that country for organ donations. Executed prisoners often were utilized as organ donors in the land of the Great Wall. To me, this sounds rather barbaric.

The shortage of donated organs and the lack of supervision of hospitals in China have led many to view transplant surgery as a cash cow. Many people have been enticed to profit from this situation by offering their organs for sale. The same seems to now be occurring in Russia, India, and other under-developed countries as well.

I kept thinking about how needless all of this would be if we didn't have such loose organ donation policies in the United States. Do we even have a governmental policy on organ donation? The US government’s site on organ donation and transplantation (http://www.organdonor.gov/ ) offers the following statistic: "Each day, about 74 people receive organ transplants. However, 18 people die each day waiting for transplants that can’t take place because of the shortage of donated organs." That's about 6500 people who die every year in the United States waiting for an organ donation -- two times the number dead in the 911 attacks. Should we be doing something more – education, public service announcements, or online marketing to lower these drastic numbers?

About 2.4 million people die each year in the United States. Only a fraction of these people are organ donors. Why are so many life-saving organs being thrown away? What do we do with the growing number of people requiring organs? Do we let them live out their lives as they are or institute a change in the voluntary "Become an Organ Donor" card, such as somehow making it mandatory in nature? What are other countries doing to solve the problem of organ donation?

Please share your suggestions.

Work-Life Managers on Staff

A news feed from Google caught my eye – “Medical School Hires Work-Life Manager.” Interesting, don’t you think?  I have always thought that the some of the best nursing managers I have had in the past are those who recognize that their employees cope with the daily struggle of trying to balance the demands of work and home. It’s not easy, is it?

The truth is that workers do bring their personal lives to work with them. How often do we  have conversations about our kids, soccer games, homework assignments, etc. at work? Organizations that ignore this fact are probably risking poorer performance, stressed-out employees, and the loss of an opportunity to fully capitalize and enhance on the skills and expertise of workers.

However, I do have to ask, at those workplaces offering work-life managers and similar support systems, if a perception exists that those who use these services are less "serious" about their work? In some places, employees who use flexible work policies, employee assistance programs, and/or childcare and eldercare supports, are sometimes labeled as "slackers" or “weaklings.” I would suspect that by not supporting workers with personal/family commitments, managers lose in the long run, employees lose, and therefore the company loses as well.

I’ve never used any sort of work-life support systems at my workplace. I don’t even know if they  exist! But, it is an idea that may be of benefit to all of us, taking into account over 110,000 of us are going to retire in 4 years! So, why not implement Work-Life Managers to ease the current stressors at work and at home?

Does anyone work in a facility that offers these services? If so, please tell us about it.

Change of Shift Posts at Emergiblog

If you want to keep up with blogs by and about nurses, don't miss Change of Shift, just posted today.

Another Super Tuesday

I woke up early today and convinced my neighbor, a young chap, to carry my hybrid bicycle down four flights of stairs to street level. Spring was coming. The air has been warm and breezy, although it looks like it is going to pour buckets later on today. As my neighbor brought my bike downstairs, I loaded myself with oil cans, polish, torn wash clothes no longer useful to the human body, and a tire pump to clean the dust that had accumulated on my bicycle during the long winter months. I haven’t ridden my bike in over a year. Balance is still a problem for me. The last time I tried riding a bicycle was in Aruba and I ran into a vehicle instead.

I used to be an avid cyclist, often riding along the Erie Canal for miles in Upstate New York. Riding 40 to 50 miles a week was not unusual until dystonia hit me. Cycling soon evaporated as symptoms progressed. I used to be a true cycling junkie! Now I’ve become a political news junkie!

As the morning went by, the polish came out and I began attacking the dust on my bike – one of my treasured prizes, second only to my Turkish carpet. Slowly, my neighbors began accumulating on the steps as I scrubbed. And soon, talk about today's  Texas and Ohio primary races erupted, leading to our own lively sidewalk debate. I was becoming confused by the entire Electoral race, not really sure who the right candidate should or even if the Democratic race would be decided by tonight -- March 4, 2008. Super delegates, allegations, and other issues were discussed. Essentially I was an “undecided,” not knowing which issue was of more importance – national security, the economy, or healthcare?

Laughter was mixed with the verbal exchanges with each resident having his or her own opinion. How divided the country truly is… One of my neighbors pumped up my tires for me. I climbed aboard to the applause of my neighbors -- all knew that I had dystonia, a movement disorder. They had seen me in the media spotlight, most recently on Dr. Oz's Oprah and Friends Radio Show.

However, riding a bike proved to be a feat and a challenge still, just like Super Tuesday. Perhaps I’d better go back to debating! Any thoughts on the primary process or the candidates?