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Where’s The Safest Place To Have A Baby: Article Breaks Down Infant Mortality By Zip Code

A recent article about the shameful infant mortality rate in the U.S. caught my attention. Certainly the statistics quoted are nothing new but still remains alarming.  However, the Op Ed by CNN contributor Deborah Klein Walker gave the subject matter a new spin. Walker wrote “This is one of the greatest injustices in our country: that a baby’s chance of having a healthy life is largely dependent on where he or she is born. States and local communities vary widely in what care their leaders choose to provide to women and children.”  If Dr. Walker were present, I’d give her a great big hug for her courage to say what no one else dared. A baby can die based on a hospital zip code.

Every pregnant mother needs to take a mini course in hospital politics because they are directly affected. A hospital is no longer a place of healing. It is a business and at times, ruthless.  I have witnessed a colleague forced out of business because she said no when a hospital wanted to buy her practice so they withdrew her admitting privileges instead. I recall bitter battles with my former employer because I would not encourage my patients to deliver at a hospital that was notorious for Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

An Interview With A Director Of Nursing

“NurseExec” is the director of nursing (DON) at a 120-bed skilled nursing facility (SNF) that has a 50/50 mix of patients needing short-term rehab and long-term care.

After working in the OR as a circulator nurse, she started out as a charge nurse in her current building, which entailed pushing a med cart and taking care of 20 patients. After nine months, she was promoted to Risk Manager and three years later became the DON.

She starts her day at 7am by rounding on nursing units, consulting with unit managers on clinical issues, and dealing with grievances and employee issues. She checks in with the charge nurses and certified nursing assistants (CNAs), checks shower rooms and utility rooms. Then it’s off to Morning Standup with department heads, followed by clinical rounds with the interdisciplinary team to discuss new admissions, new orders, and a report for the last 24 hours. Most days this is all followed with other meetings, lasting until 11am or so.

The afternoon is filled with reports, employee issues, clinical and education issues, pharmacy issues, and another rounding of patients. She typically ends her day at 4pm.

What do you like about your job?

Every day is a different set of challenges. I have great benefits and a wonderful team to work with.

What frustrates you about your job?

People who know the right thing to do, yet don’t do it. Makes me crazy! Read more »

*This blog post was originally published at code blog - tales of a nurse*

An Interview With An Informatics Nurse

Ever wonder how all those hospital systems are created and maintained? (Computer charting, systems to report data to national and state organizations, to name a couple.) Sure, they could hire some IT guy to run them, but everything seems to flow better with a nurse’s touch. After all, we’re the ones using them all the time, right?  Jen C, RN, BSN almost MSN gives us a look into the world of nursing informatics.

Jen has been doing this job for two years. She says she “stumbled into it” when she was interviewing for a new job and mentioned that she was starting her master’s in informatics. Although she was hired to be a staff nurse, within four months she was working in informatics.

What do you do all day?

Each day is different. I do a lot of troubleshooting. I go to a lot of meetings. I do system development and upkeep. I listen to the nurses and what their issues are with the various systems. I do education. And I still fill in at the bedside (I’m still a NICU nurse at heart.)

What frustrates you about your job?

Little definition and recognition as to what my job is. I often seem to be a catch-all. I also don’t have a mentor. I’m the only one in my hospital that has formal education in this area and only one or two in the whole hospital. Read more »

*This blog post was originally published at code blog - tales of a nurse*

An Interview With A Developmental Disabilities Nurse

For my first interview, I thought I’d interview someone who would tolerate my novice interviewing abilities — my mother. Ginny, RN, BS, DDRN has been a nurse for over 30 years, most of that time in the Intensive Care Unit. (The apple did not fall far, did it?) She currently works as Developmental Disabilities Nurse and has done so for nine years.

A developmental disability is defined by Wikipedia as a term used in the United States and Canada to describe life-long disability attributable to mental and/or physical impairments, manifested prior to age 18.” Ginny says that her clients have a range of mental and physical disabilities including cerebral palsy, Down Syndrome, mental retardation, and autism, with autism being the most prevalent. Her clients live in normal houses along with nurse’s aides and “direct support professionals” (DSPs).

How did you get started as a Developmental Disability Nurse?

A friend encouraged me to come work with her after I lost my job when they closed the children’s home where I had been working.

Do you like it?

I have had other nursing jobs including med-surg, peds, ICU, factory nurse, WIC nurse, children’s home nurse, and finally this job. I have liked all of my jobs but this has been the most rewarding. The people I care for just love it when the nurse comes around. There is always a “thank you” in their eyes.

What frustrates you about your job?

It is, of course, a job which requires state controls. Their idea of “nursing” is an awful lot of useless paperwork that makes no sense to me. The pay is not commensurate with other nursing jobs considering the reponsibilites of delegating nursing tasks to laypersons. There are so many things these people need and it’s hard to get. There are so many state mandates that are designed to move people toward being as independent as possible but the mandates also make us take many steps backward in that process. Read more »

*This blog post was originally published at code blog - tales of a nurse*

Change Of Shift: The Best Of Nursing Shared (Vol. 5, No. 4)

Welcome to Change of Shift!

We have some old friends and some new additions. Our submissions cover the best of nursing and the most difficult moments. Some share successes, others could use some collegial support.

So grab a latte, put your feet up, and enjoy…

 

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Change of Shift: Volume 5, Number 4

I love adding nursing blogs to my blogroll! This week, thanks to his CoS submission, I’ve found Stephen at  A Nurse Practitioner’s View, where he presents Team Work. When it comes to patient care, check our egos at the door.

Some teams we chose and some we’re born into, as noted in this heart-warming story from Keith at Digital Doorway, We’re All in This Together.

Nurses are expected to be super-humanly objective and non-judgmental. As this honest post from Nurse Me shows, there are limits, and don’t forget to Always Look Behind the Curtain First. Read more »

*This blog post was originally published at Emergiblog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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