Are We Just Cost Centers?
By Genevieve M. Clavreul, RN, PHD
Not that long ago one of the nursing lists I subscribe to had a most interesting discussion thread that had to do with a conversation a nurse had had with the chief nursing officer. The nurse was bothered after discovering that their hospital viewed nursing as a cost center and not as a source that generated income. The discussion thread continued for many weeks, and as I read the various comments posted by members of the list I recalled that I had mentioned this very topic in a white paper on the nursing shortage that I had written for the County of Los Angeles, CA, in 2000, and I thought this would also make for an interesting topic for my column.
RUBBED THE WRONG WAY Historically nursing has been and is seen as a cost center. When hospitals and other healthcare providers do their budget, the nursing staff is listed as an “item” that must be paid for rather than as an “item” that generates fees or money. But just because we’ve always done it this way, doesn’t mean we have to keep doing it. The key question, however, is how do we change what is accepted as a common practice, and a practice that is neither illegal nor seen as, necessarily, flawed?
The most interesting aspect of seeing nursing as a cost center is that it is actually contrary to how most of the other healthcare providers are seen by hospitals. Doctors and most, if not all, of the various therapists, such as respiratory, occupational, physical, etc., are usually seen and listed as a fee for service, and therefore as generating income for hospitals. So why is nursing an expense to a hospital, and how did this practice become as entrenched as it is now?
On the one hand we have hospitals that must factor in nursing care and all its associated costs while at the same time keeping the budget trim and in line — which often means a struggle between the chief nursing officer (CNO), who gets the appropriate number of nurses to cover each shift, and the chief financial officer (CFO), who keeps the hospital in as much of the black as possible.
Of course one can always make the argument that without nurses to staff the various units, a hospital’s main source of income, it’s raison d’être so to speak, would slowly grind to a halt; without appropriate nurse staffing doctors would have to limit their admissions, surgeries and other similar procedures, thus strangling the revenue generation pipeline.
THE PAST IS STILL PRESENT
Not sure how ingrained this practice is? Just take a look at the following answer I received when I queried the phrase “nursing + cost center.” The third result from the top was a link to WikiAnswers, which provided the following question as its interpretation of my original query: “How is the hospital nursing department a cost center?” It then returned the following response: “in that nurses require a salary and support funding (scrubs, pencils, etc.) and do not directly generate income to the hospital, that department is typically classified as a cost center.”
When one reads similar “definitions” I think one can understand how this understanding colors the role of the nurse in today’s hospital setting.
So how did we get to such a classification? Could this practice date back to the founding of our profession? Perhaps, especially when you consider that many of those who first provided nursing as a vocation were often nuns belonging to orders that provided nursing care as their act of service. Just as there were religious orders that were renowned for their teaching, so too were there religious orders that dedicated themselves to providing solace to their fellow man through nursing.
When one couples this history with the theory of altruism that often surrounds those in the health profession, one can see how discussing salary or payment for services rendered may be unseemly, as they used to say in polite company. Also, let’s not forget that nurses have historically been seen as an adjunct or assistant to the physician. Even today, far too often nurses are viewed as an extension of the service provided by the physician, rather than a separate but parallel field of practice.
Thus it was often left up to the physician, and later hospital administrators, to decide how best to compensate the nurses in their employ. Patients didn’t and, I think, still do not see the nursing care they receive as an augmentation to the “doctoring” they receive, therefore nursing is still perceived as a part of the overall package, and thus not generating income.
MODEL BEHAVIOR
Of course there would be those who might argue that hospitals do place a monetary value on nursing care. How else would hospitals be able to pay their nursing staff? However, nurses are not salaried with the same methodology as physicians. Physicians are generally not considered employees of the hospital; they are in essence independent contractors, for lack of a better description. Thus physicians are granted “privileges” to work at hospitals where nurses are generally hired directly onto staff.
However, we don’t find hospitals insisting that physicians provide the basic tools of their trade. Just as nurses pull items from the hospital’s “store” so do the physicians; but hospitals seem to continue to bill these functions differently. Could nurses be billed on a similar model as that of physicians and other fee-for-service healthcare professionals? Why not?
Without nurses the very basic day-to-day care that doctors order for their patients could not be carried out, and in all likelihood many patients would find themselves in bad shape for lack of good nursing follow-up and care. The daily nursing care would most likely fall to the patient’s family (as is the case in some countries today).
LINKING UP WITH THE CHAIN OF COMMAND Is there any way to change opinions, from viewing nurses as a “line-item” that generates income and revenue versus one that costs hospitals? All is not lost. This issue is definitely gaining traction in both the real world of hospital management and in nursing academia. For example, a reader recently sent me an excellent, if somewhat technical, article from the Journal of Nursing Administration that was published in January 2007. The authors of the article, “Describing Costs Related to Nursing,” undertook a valiant effort to break down how nursing costs are attributed, and compared several common nursing costs models.
As more studies are published on this issue I think we’ll begin to find nursing move from being viewed as a cost center to a revenue stream. Much of this evolution rests on chief nursing officers and other nurses in the upper echelons of the chain of command (such as chief executive officer, chief financial officer and so forth). As these “opinion leaders” change their outlook this can then filter down through the chain of command. I think that any hospital that tries to redefine the nursing model from cost center to revenue stream will ultimately set in motion a ripple effect that could have long-reaching and positive effects on how the nurse’s role is interpreted.
STRIVING FOR SYMBIOSIS Altering the perception of nurses from cost center to revenue stream will not solve the multifaceted problem that is the nursing shortage, or the dissatisfaction some nurses have with their profession; but it could go a long way to reduce the conflict that surrounds paying for nurses. As nursing salaries are perceived as income for the hospital rather than a drain on its cash flow, a more symbiotic versus parasitic relationship develops.
I know that these terms seem harsh. When you sit down with a group of nurses who have just been informed by hospital administration that cost-cutting measures need to be taken, they know that means dutting nursing hours or staff. (When was the last time a hospital pared down its physician staff?) Thus nursing is parasitic in relationship to this scenario. However, as nursing is elevated to the role of the revenue it generates — because without adequate nursing staff one can not admit additional patients, provide adequate nursing care, minimize negative patient outcomes, etc. — then the role of the nursing staff becomes symbiotic in nature, with each party benefiting from the other.
Nursing is continually evolving, and there is no reason that we cannot also change how nursing is perceived to affect the hospital’s bottom line. It’s time to evolve into nursing being seen as the revenue-generating stream that it truly is, and when this happens one more puzzle in the nursing shortage/satisfaction problem will be solved.
Geneviève M. Clavreul, RN, Ph.D, is a healthcare management consultant who has experience as a director of nursing and as a teacher of nursing management.
This article is from workingnurse.com
Saturday, April 11, 2009
PARADIGM BYTES
Newsletter for Paradigm 97
April 11, 2009
PARADIGM DEFINED:
1) an outstandingly clear or typical example or archetype.2) a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations, and the experiments performed in support of them, are formulated.Our website...... http://paradigm97.blogspot.com
MISSION STATEMENT
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
~~**~~**~~**~~**~~**~~
SNIPPETS
See Raconte's article......separate from Newsletter
~~**~~**~~**~~**~~**~~**~~**~~
INTERESTING READING
The following is a very thorough study on urinary catheters -- appears to be excellent.
We believe that nurses need each other for support during the "lean and mean" days to help survive them. We offer research results and other ideas to enrich the nursing experience.
~~**~~**~~**~~**~~**~~
SNIPPETS
See Raconte's article......separate from Newsletter
~~**~~**~~**~~**~~**~~**~~**~~
INTERESTING READING
The following is a very thorough study on urinary catheters -- appears to be excellent.
Please read
Internal and External Urinary Catheters: A Primer for Clinical Practice Internal and external urinary catheters are used to manage urinary incontinence and incomplete bladder emptying. Bladder dysfunction cause determines whether short- or long-term catheter use is required which, in turn, determines whether an indwelling, intermittent, or external catheter should be used. The method of catheterization is based on the underlying bladder condition, the goals of treatment, and gender appropriateness. http://www.o-wm.com/content/internal-and-external-urinary-catheters-a-primer-clinical-practice
**************************
RANDOM FACT In a 1936 ping pong tournament, the players volleyed for more than two hours on the opening serve.
************************
(I checked with Snopes.com......nothing there to verify/ reject)
Internal and External Urinary Catheters: A Primer for Clinical Practice Internal and external urinary catheters are used to manage urinary incontinence and incomplete bladder emptying. Bladder dysfunction cause determines whether short- or long-term catheter use is required which, in turn, determines whether an indwelling, intermittent, or external catheter should be used. The method of catheterization is based on the underlying bladder condition, the goals of treatment, and gender appropriateness. http://www.o-wm.com/content/internal-and-external-urinary-catheters-a-primer-clinical-practice
**************************
RANDOM FACT In a 1936 ping pong tournament, the players volleyed for more than two hours on the opening serve.
************************
(I checked with Snopes.com......nothing there to verify/ reject)
THIS IS VERY IMPORTANT INFORMATION PROVIDED TO US BY AT&T. DON'T EVER DIAL AREA CODE 809 This one is being distributed all over the US . This is pretty scary, especially given the way they try to get you to call. Be sure you read this and pass it on. They get you to call by telling you that it is information about a family member who has been ill or to tell you someone has been arrested, died, or to let you know you have won a wonderful prize, etc. In each case, you are told to call the 809 number right away.. Since there are so many new area codes these days, people unknowingly return these calls. If you call from the U.S. , you will apparently be charged $2425 per-minute. Or, you'll get a long recorded message. The point is, they will try to keep you on the phone as long as possible to increase the charges. WHY IT WORKS: The 809 area code is located in the Dominican Republic . The charges afterward can become a real nightmare. That's because you did actually make the call. If you complain, both your local phone company and your long distance carrier will not want to get involved and will most likely tell you that they are simply providing the billing for the foreign company. You'll end up dealing with a foreign company that argues they have done nothing wrong. Please forward this entire message to your friends, family and colleagues to help them become aware of this scam. AT&T VERIFIES IT'S TRUE:
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RANDOM FACT Mosquitos are attracted to the color blue twice as much as to any other color.
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RANDOM FACT Mosquitos are attracted to the color blue twice as much as to any other color.
***************
Here is an Excellent hint: Cut Your Electric Bill in Half Unplug items you are not using. Even if they are off they are still pulling current. This cost savings will add up to more than you think. If you don't want to continually be unplugging items, invest in a Smart Strip (different than a standard power strip).
It does not allow your items to pull electric current when off. You will probably cut your electric bill in half.
************************
Don't Forget To Check Your Cell Phone Bill Go through your cell phone bill, look for services you don’t use, and ditch them. Sit down and go through each item on your bill and see if there’s anything there that you don’t use, like a surfeit of text messages or web access or something to that effect. Then call your cell phone company and ask to have those services eliminated. Boom, you’re saving money.
***************************
(Reuters 3/12) - Obese women have alterations in the environment around the ovary before they ovulate that appear to play a role in the well-documented association between obesity and reduced fertility, according to a report in the Journal of Clinical Endocrinology and Metabolism....
http://www.reuters.com/article/healthNews/idUSTRE52B7Y520090312?feedType=nl&feedName=ushealth1100
***************************
HB 219 which will require that a bitter substance be put in antifreeze, preventing accidental or purposeful death to humans, and HB 429, which will protect pets as well as the family members in domestic violence cases, both passed out of subcommittee favorably. To see the full language on these bills, you can go to www.legis.ga.gov and put in the bill numbers.
***** ***** *********** **
A study in Pediatrics found that 57% of teenage survivors of invasive meningococcal disease have "major physical sequelae," and many also had higher levels of depression, more fatigue and a poorer quality of life than kids who did not have meningococcal disease. Researchers also said a younger age at disease onset was tied to greater cognitive deficits.
Medscape/Reuters Health (free registration)
https://profreg.medscape.com/px/getlogin.do?urlCache=aHR0cDovL3d3dy5tZWRzY2FwZS5jb20vdmlld2FydGljbGUvNTg5NTAx
*************************
RANDOM FACT Dentists have recommended that a toothbrush be kept at least 6 feet away from a toilet to avoid airborne particles resulting from the flush. (Can you imagine the inside of the toilet stalls and most of the public toilets do not have lids ! Keep in mind the lid should be down in the home)
Here is an Excellent hint: Cut Your Electric Bill in Half Unplug items you are not using. Even if they are off they are still pulling current. This cost savings will add up to more than you think. If you don't want to continually be unplugging items, invest in a Smart Strip (different than a standard power strip).
It does not allow your items to pull electric current when off. You will probably cut your electric bill in half.
************************
Don't Forget To Check Your Cell Phone Bill Go through your cell phone bill, look for services you don’t use, and ditch them. Sit down and go through each item on your bill and see if there’s anything there that you don’t use, like a surfeit of text messages or web access or something to that effect. Then call your cell phone company and ask to have those services eliminated. Boom, you’re saving money.
***************************
(Reuters 3/12) - Obese women have alterations in the environment around the ovary before they ovulate that appear to play a role in the well-documented association between obesity and reduced fertility, according to a report in the Journal of Clinical Endocrinology and Metabolism....
http://www.reuters.com/article/healthNews/idUSTRE52B7Y520090312?feedType=nl&feedName=ushealth1100
***************************
HB 219 which will require that a bitter substance be put in antifreeze, preventing accidental or purposeful death to humans, and HB 429, which will protect pets as well as the family members in domestic violence cases, both passed out of subcommittee favorably. To see the full language on these bills, you can go to www.legis.ga.gov and put in the bill numbers.
***** ***** *********** **
A study in Pediatrics found that 57% of teenage survivors of invasive meningococcal disease have "major physical sequelae," and many also had higher levels of depression, more fatigue and a poorer quality of life than kids who did not have meningococcal disease. Researchers also said a younger age at disease onset was tied to greater cognitive deficits.
Medscape/Reuters Health (free registration)
https://profreg.medscape.com/px/getlogin.do?urlCache=aHR0cDovL3d3dy5tZWRzY2FwZS5jb20vdmlld2FydGljbGUvNTg5NTAx
*************************
RANDOM FACT Dentists have recommended that a toothbrush be kept at least 6 feet away from a toilet to avoid airborne particles resulting from the flush. (Can you imagine the inside of the toilet stalls and most of the public toilets do not have lids ! Keep in mind the lid should be down in the home)
***************
(Reuters 3/31) - U.S. regulators warned nine companies on Tuesday to stop selling 14 unapproved narcotic pain medicines, part of an ongoing effort to rid the market of drugs without proper clearance. Companies that received the warnings included Boehringer Ingelheim's Roxane Inc unit, Covidien Ltd's Mallinckrodt unit and Glenmark Pharmaceuticals.... http://www.reuters.com/article/healthNews/idUSTRE53002Z20090401
*************************
(Reuters 3/31) - U.S. regulators warned nine companies on Tuesday to stop selling 14 unapproved narcotic pain medicines, part of an ongoing effort to rid the market of drugs without proper clearance. Companies that received the warnings included Boehringer Ingelheim's Roxane Inc unit, Covidien Ltd's Mallinckrodt unit and Glenmark Pharmaceuticals.... http://www.reuters.com/article/healthNews/idUSTRE53002Z20090401
*************************
The development and peer review of evidence-based guidelines to support midwifery led care in labour Midwifery, 04/01/09
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN9-4NT57T6-2&_user=10&_coverDate=04%2F30%2F2009&_rdoc=10&_fmt=high&_orig=browse&_srch=doc-info(%23toc%236957%232009%23999749997%23977092%23FLA%23display%23Volume)&_cdi=6957&_sort=d&_docanchor=&_ct=22&_acct=C000050221&_version=1&_urlVersion=0&_
userid=10&md5=1ff063bfec37a0bb9d915094f605898a
**********************
RANDOM FACT----Spelling Bee The only 15 letter word that can be spelled without repeating a letter is uncopyrightable.
***********************
The prognostic importance of early measurement of B-type natriuretic peptide (BNP) in patients with acute chest pain while the diagnosis is still uncertain is unknown. We determined the prognostic value of BNP in these patients immediately after presenting to the emergency department... Coronary Artery Disease, 03/27/09
B-type natriuretic peptide: a strong predictor of early and late mortality in patients with acute chest pain without ST-segment elevation in the emergency department
***************************
Title of "nurse" protection from individuals who profess to be nurses. Look for your state--- MINE ISN"T THERE!!! Therefore anyone can state they are a nurse and get away with it...ie. medical assistants, etc. http://www.nursingworld.org/MainMenuCategories/ANAPoliticalPower/State/StateLegislativeAgenda/
TitleNurse_1.aspx
********************************
RANDOM FACT The weight of the Sun is two billion billion billion tons, about 333,420 times that of the Earth.
*********************
FDA has become aware of reports of acute phosphate nephropathy, a type of acute kidney injury, associated with the use of oral sodium phosphate products (OSP) for bowel cleansing prior to colonoscopy or other procedures. These products include the prescription products, Visicol and OsmoPrep, and OSPs available over-the-counter without a prescription as laxatives (e.g., Fleet Phospho-soda).... http://www.fda.gov/cder/drug/infopage/OSP_solution/default.htm
***********************
Trying to lose weight to get your cholesterol down? Excellent. Turbocharge your efforts with this combo supplement: calcium plus vitamin D. A study suggests the two may boost the cholesterol-lowering benefits of weight loss, especially in people who don't get enough calcium....
http://www.realage.com/ct/tips/8211
********************
Ozone levels raise respiratory death rate: study (Reuters 3/11) - People who live in areas with the most ozone pollution are 25 percent to 30 percent more likely to die from lung disease than those living in areas with the cleanest air, researchers reported on Wednesday. http://www.reuters.com/article/healthNews/idUSTRE52A70J20090311?feedType=nl&feedName=ushealth1100
***************************
Foods That Fight Belly Fat: Did you know that besides doing wonders for your health, a certain nutrient group might also help keep your pants size down? http://www.realage.com/ct/tips/8330
********************
Drink up for better bones..Know which drink the YOU Docs recommend for better bones? Hint: It's not milk. it is :the bone-friendly attributes of kefir, a fermented dairy drink. Two Benefits for Bones What's kefir got that's so great? Vitamin K2. It helps prevent the death of osteoblasts -- cells that are responsible for forming new bone. Vitamin K2 also escorts calcium out of your blood and into your bones so it can do its job of making bones stronger....
http://www.realage.com/ct/eat-smart/food-and-nutrition/tip/8344
*****************************
Ever wonder why nurses do things a certain way? Ever think about the science behind established practices or policies? Nurses frequently raise questions about patient care...
http://include.nurse.com/apps/pbcs.dll/article?AID=2009102230056
*********************
RANDOM FACT In 1963, baseball pitcher Gaylord Perry remarked, "They'll put a man on the moon before I hit a home run." On July 20, 1969, a few hours after Neil Armstrong set foot on the moon, Gaylord Perry hit his first of six home runs. ***********************
(Reuters 3/16) - Some children may be freed of their peanut allergies if they eat a tiny crumb of peanut every day for weeks, U.S. doctors reported on Sunday. Although the treatment was too dangerous to try on children with the most severe and life-threatening peanut allergies ...
http://www.reuters.com/article/healthNews/idUSTRE52F0F520090316?feedType=nl&feedName=ushealth1100
************************
Campaign Addresses Unsafe Injection Practices A spate of hepatitis B and C infections traced to unsafe injection practices has prompted the CDC to join a national education campaign emphasizing safe injection practices to nurses and other healthcare workers. http://include.nurse.com/article/20090309/NATIONAL01/103090149/-1/frontpage
***************************
Post-Partum Depression and Help-Seeking Behavior The objective of this analysis was to investigate the demographic differences between women who report postpartum depression symptoms (PPDS) and seek help versus those who report symptoms but who do not seek help...
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W6R-4V7MH0F-D&_user=10&_coverDate=02%2F28%2F2009&_rdoc=12&_fmt=high&_orig=browse&_srch=doc-info(%23toc%236605%232009%23999459998%23791080%23FLA%23display%23Volume)&_cdi=6605&_sort=d&_docanchor=&_ct=33&_acct=C000050221&_version=1&_url
Version=0&_userid=10&md5=7f306dce09dc4753295ef17d099c4119
****************************
(Reuters 3/16) - A new test can accurately detect Alzheimer's disease in its earliest stages, before dementia symptoms surface and widespread damage occurs, U.S. researchers said on Monday. The test, which measures proteins in spinal fluid that can point to Alzheimer's, was 87 percent accurate at predicting which patients with early memory problems and other symptoms of cognitive impairment would eventually be diagnosed with Alzheimer's, they said.... http://www.reuters.com/article/healthNews/idUSTRE52F5AN20090316?feedType=nl&feedName=ushealth1100
***********************
Updated U.S. Preventive Services Task Force guidelines on taking a daily aspirin are specific to age and gender and indicate lower doses are as effective as and safer than higher doses of the drug. The task force recommends men ages 45 to 79 should take a daily aspirin if the benefits of preventing a heart attack outweigh the risk of gastrointestinal bleeding. Women ages 55 to 79 should take it if reducing the risk of stroke outweighs the risks of GI bleeding. Forbes/HealthDay News (3/16)
http://www.smartbrief.com/news/aanp/storyDetails.jsp?issueid=BF1F7254-C540-4A43-96C2-635404F89510©id=03C6BC0E-4D17-4EA8-B320-654B4DFD9C3D&sid=4d2105b7-a157-4a55-bd46-13838a6d2c9e&brief=aanp
~~**~~**~~ HUMOR SECTION
An airline pilot with very poor eyesight had managed to pass his periodic vision exams by memorizing the eye charts beforehand. One year, though, his doctor used a new chart that the pilot had never beforeseen. The pilot proceeded to recite the old chart and the doctor realized that he'd been hoodwinked.Well, the pilot proved to be nearly blind as a bat. But the doctor could not contain his curiosity. "How is it that someone with your eyesight can manage to pilot a plane at all? I mean, how for example,do you taxi the plane out to the runway?""Well," says the pilot, "it's really not very hard. All you have to do is follow the instructions of the ground controller over the radio. And besides, the landmarks have all become quite familiar to me overthe years.""I can understand that," replies the doctor. "But what about the take-off?""Again, a simple procedure. I just aim the plane down the runway, go to full throttle, pull back on the stick, and off we go!"
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WN9-4NT57T6-2&_user=10&_coverDate=04%2F30%2F2009&_rdoc=10&_fmt=high&_orig=browse&_srch=doc-info(%23toc%236957%232009%23999749997%23977092%23FLA%23display%23Volume)&_cdi=6957&_sort=d&_docanchor=&_ct=22&_acct=C000050221&_version=1&_urlVersion=0&_
userid=10&md5=1ff063bfec37a0bb9d915094f605898a
**********************
RANDOM FACT----Spelling Bee The only 15 letter word that can be spelled without repeating a letter is uncopyrightable.
***********************
The prognostic importance of early measurement of B-type natriuretic peptide (BNP) in patients with acute chest pain while the diagnosis is still uncertain is unknown. We determined the prognostic value of BNP in these patients immediately after presenting to the emergency department... Coronary Artery Disease, 03/27/09
B-type natriuretic peptide: a strong predictor of early and late mortality in patients with acute chest pain without ST-segment elevation in the emergency department
***************************
Title of "nurse" protection from individuals who profess to be nurses. Look for your state--- MINE ISN"T THERE!!! Therefore anyone can state they are a nurse and get away with it...ie. medical assistants, etc. http://www.nursingworld.org/MainMenuCategories/ANAPoliticalPower/State/StateLegislativeAgenda/
TitleNurse_1.aspx
********************************
RANDOM FACT The weight of the Sun is two billion billion billion tons, about 333,420 times that of the Earth.
*********************
FDA has become aware of reports of acute phosphate nephropathy, a type of acute kidney injury, associated with the use of oral sodium phosphate products (OSP) for bowel cleansing prior to colonoscopy or other procedures. These products include the prescription products, Visicol and OsmoPrep, and OSPs available over-the-counter without a prescription as laxatives (e.g., Fleet Phospho-soda).... http://www.fda.gov/cder/drug/infopage/OSP_solution/default.htm
***********************
Trying to lose weight to get your cholesterol down? Excellent. Turbocharge your efforts with this combo supplement: calcium plus vitamin D. A study suggests the two may boost the cholesterol-lowering benefits of weight loss, especially in people who don't get enough calcium....
http://www.realage.com/ct/tips/8211
********************
Ozone levels raise respiratory death rate: study (Reuters 3/11) - People who live in areas with the most ozone pollution are 25 percent to 30 percent more likely to die from lung disease than those living in areas with the cleanest air, researchers reported on Wednesday. http://www.reuters.com/article/healthNews/idUSTRE52A70J20090311?feedType=nl&feedName=ushealth1100
***************************
Foods That Fight Belly Fat: Did you know that besides doing wonders for your health, a certain nutrient group might also help keep your pants size down? http://www.realage.com/ct/tips/8330
********************
Drink up for better bones..Know which drink the YOU Docs recommend for better bones? Hint: It's not milk. it is :the bone-friendly attributes of kefir, a fermented dairy drink. Two Benefits for Bones What's kefir got that's so great? Vitamin K2. It helps prevent the death of osteoblasts -- cells that are responsible for forming new bone. Vitamin K2 also escorts calcium out of your blood and into your bones so it can do its job of making bones stronger....
http://www.realage.com/ct/eat-smart/food-and-nutrition/tip/8344
*****************************
Ever wonder why nurses do things a certain way? Ever think about the science behind established practices or policies? Nurses frequently raise questions about patient care...
http://include.nurse.com/apps/pbcs.dll/article?AID=2009102230056
*********************
RANDOM FACT In 1963, baseball pitcher Gaylord Perry remarked, "They'll put a man on the moon before I hit a home run." On July 20, 1969, a few hours after Neil Armstrong set foot on the moon, Gaylord Perry hit his first of six home runs. ***********************
(Reuters 3/16) - Some children may be freed of their peanut allergies if they eat a tiny crumb of peanut every day for weeks, U.S. doctors reported on Sunday. Although the treatment was too dangerous to try on children with the most severe and life-threatening peanut allergies ...
http://www.reuters.com/article/healthNews/idUSTRE52F0F520090316?feedType=nl&feedName=ushealth1100
************************
Campaign Addresses Unsafe Injection Practices A spate of hepatitis B and C infections traced to unsafe injection practices has prompted the CDC to join a national education campaign emphasizing safe injection practices to nurses and other healthcare workers. http://include.nurse.com/article/20090309/NATIONAL01/103090149/-1/frontpage
***************************
Post-Partum Depression and Help-Seeking Behavior The objective of this analysis was to investigate the demographic differences between women who report postpartum depression symptoms (PPDS) and seek help versus those who report symptoms but who do not seek help...
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6W6R-4V7MH0F-D&_user=10&_coverDate=02%2F28%2F2009&_rdoc=12&_fmt=high&_orig=browse&_srch=doc-info(%23toc%236605%232009%23999459998%23791080%23FLA%23display%23Volume)&_cdi=6605&_sort=d&_docanchor=&_ct=33&_acct=C000050221&_version=1&_url
Version=0&_userid=10&md5=7f306dce09dc4753295ef17d099c4119
****************************
(Reuters 3/16) - A new test can accurately detect Alzheimer's disease in its earliest stages, before dementia symptoms surface and widespread damage occurs, U.S. researchers said on Monday. The test, which measures proteins in spinal fluid that can point to Alzheimer's, was 87 percent accurate at predicting which patients with early memory problems and other symptoms of cognitive impairment would eventually be diagnosed with Alzheimer's, they said.... http://www.reuters.com/article/healthNews/idUSTRE52F5AN20090316?feedType=nl&feedName=ushealth1100
***********************
Updated U.S. Preventive Services Task Force guidelines on taking a daily aspirin are specific to age and gender and indicate lower doses are as effective as and safer than higher doses of the drug. The task force recommends men ages 45 to 79 should take a daily aspirin if the benefits of preventing a heart attack outweigh the risk of gastrointestinal bleeding. Women ages 55 to 79 should take it if reducing the risk of stroke outweighs the risks of GI bleeding. Forbes/HealthDay News (3/16)
http://www.smartbrief.com/news/aanp/storyDetails.jsp?issueid=BF1F7254-C540-4A43-96C2-635404F89510©id=03C6BC0E-4D17-4EA8-B320-654B4DFD9C3D&sid=4d2105b7-a157-4a55-bd46-13838a6d2c9e&brief=aanp
~~**~~**~~ HUMOR SECTION
An airline pilot with very poor eyesight had managed to pass his periodic vision exams by memorizing the eye charts beforehand. One year, though, his doctor used a new chart that the pilot had never beforeseen. The pilot proceeded to recite the old chart and the doctor realized that he'd been hoodwinked.Well, the pilot proved to be nearly blind as a bat. But the doctor could not contain his curiosity. "How is it that someone with your eyesight can manage to pilot a plane at all? I mean, how for example,do you taxi the plane out to the runway?""Well," says the pilot, "it's really not very hard. All you have to do is follow the instructions of the ground controller over the radio. And besides, the landmarks have all become quite familiar to me overthe years.""I can understand that," replies the doctor. "But what about the take-off?""Again, a simple procedure. I just aim the plane down the runway, go to full throttle, pull back on the stick, and off we go!"
"But once you're aloft?"
"Oh, everything's fully automated these days. The flight computer knows our destination, and all I have to do is hit the autopilot and the plane pretty much flies itself.""But I still don't see how you land!"
"Oh, that's the easiest part of all. All I do is use the airport's radio beacon to get us on the proper glide path. Then I just throttle down and wait for the co-pilot to yell, 'AIEEEEEEEEEEEEEEEE!!!' pull the nose up, and the plane lands just fine!"
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CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise.........IF you have a favorite CEU/CME site, please share !
Send your links to me: RNFrankie@AOL.com
Free CEs http://www.myfreece.com/welcome.asp
https://nursing.advanceweb.com/CE/TestCenter/Main.aspx
Can either pay $8 / course OR pay $26.99 for a year for all the CE courses you want to take
.
www.nurse.com Pay Only $34.99 for a full year of CONTACT HOURS .
^^^^^^^^
For a Healthy Environment, Nurses and Hospi… CE489
Pulseless Electrical Activity: Where is the… CE497
Critical Blood Loss Demands Fluid Resuscita… CE490
Aspiration: Preventing a Deadly Complicatio… CE491
http://www.nurse.com
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com
The following are some of Rozalfaro's articles/works:
Critical Thinking: Logical, Intuitive, of Both? , Evaluating Critical Thinking: How to Read Minds,
A Right Brained Approach To Critical Thinking , Improving Your Ability to Think Critically ,
http://www.alfaroteachsmart.com/articles.htm
~~**~~**~~**~~**~~**~~
CEU SITES---(CME and CNE)
Those that are-----Free and Otherwise.........IF you have a favorite CEU/CME site, please share !
Send your links to me: RNFrankie@AOL.com
Free CEs http://www.myfreece.com/welcome.asp
https://nursing.advanceweb.com/CE/TestCenter/Main.aspx
Can either pay $8 / course OR pay $26.99 for a year for all the CE courses you want to take
.
www.nurse.com Pay Only $34.99 for a full year of CONTACT HOURS .
^^^^^^^^
For a Healthy Environment, Nurses and Hospi… CE489
Pulseless Electrical Activity: Where is the… CE497
Critical Blood Loss Demands Fluid Resuscita… CE490
Aspiration: Preventing a Deadly Complicatio… CE491
http://www.nurse.com
~~**~~**~~**~~**~~**~~
WEBSITES/ LINKS
Always on the lookout for interesting websites / links. Please send them to:RNFrankie@AOL.com
The following are some of Rozalfaro's articles/works:
Critical Thinking: Logical, Intuitive, of Both? , Evaluating Critical Thinking: How to Read Minds,
A Right Brained Approach To Critical Thinking , Improving Your Ability to Think Critically ,
http://www.alfaroteachsmart.com/articles.htm
***********************
Sandy Summers' website: news_alerts@truthaboutnursing.org
RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm
H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
http://www.washingtonwatch.com/bills/show/110_HR_2123.html
Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263
Click here: Dismantling the Arguments of the Hospital Industry Against a Minimum Safe Standard of Care
Click here: Internal and External Urinary Catheters: A Primer for Clinical Practice Ostomy Wound Management
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.solutionsoutsidethebox.net/
This website (for registering the CELL PHONES) was sent in by Laregis@AOL.com (Laura) who sends in a prodigious amount of articles for the Newsletter. Thank you !
https://www.donotcall.gov/
the National Nurse's new website: http://nationalnurse.org/
Any time you want to check a rumor ... this is the link:
http://www.snopes.com/
This is fun! See if you can place the state:
http://www.sheppardsoftware.com/states_experiment_drag-drop_Intermed_State15s_500.html
This site has passed the Snopes.com test
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
Don't forget to check out a growing list of evidence-based tools and articles in theEvidence-Based Resource Center on www.StrategiesforNurseManagers.com.http://www.strategiesfornursemanagers.com/EBP_resource_center.cfm
Professional Development in Rural Nursing: Challenges and Opportunities McCoy C - There are many challenges in the rural setting for nursing, particularly regarding enhancement of nurses’ professional development. http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2631896/ZZ5603146585149290157159/?news_id=399&subspec_id=44
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*
MEDICAL RECALLS
*
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******************************************************
Sandy Summers' website: news_alerts@truthaboutnursing.org
RNs launch a national safe staffing campaign http://www.1199seiu.org/media/magazine/sept_2007/safe_staffing.cfm
H.R. 2123, The Nurse Staffing Standards for Patient Safety and Quality Care Act of 2007
http://www.washingtonwatch.com/bills/show/110_HR_2123.html
Board Supports Your Right to Refuse An Unsafe Assignment: Nurse Practice Act cites three conditions for patient abandonment http://findarticles.com/p/articles/mi_qa4102/is_200408/ai_n9450263
Click here: Dismantling the Arguments of the Hospital Industry Against a Minimum Safe Standard of Care
Click here: Internal and External Urinary Catheters: A Primer for Clinical Practice Ostomy Wound Management
http://www.thebreastcancersite.com/clickToGive/home.faces?siteId=2
http://www.solutionsoutsidethebox.net/
This website (for registering the CELL PHONES) was sent in by Laregis@AOL.com (Laura) who sends in a prodigious amount of articles for the Newsletter. Thank you !
https://www.donotcall.gov/
the National Nurse's new website: http://nationalnurse.org/
Any time you want to check a rumor ... this is the link:
http://www.snopes.com/
This is fun! See if you can place the state:
http://www.sheppardsoftware.com/states_experiment_drag-drop_Intermed_State15s_500.html
This site has passed the Snopes.com test
http://www.theanimalrescuesite.com/clickToGive/home.faces?siteId=3
Don't forget to check out a growing list of evidence-based tools and articles in theEvidence-Based Resource Center on www.StrategiesforNurseManagers.com.http://www.strategiesfornursemanagers.com/EBP_resource_center.cfm
Professional Development in Rural Nursing: Challenges and Opportunities McCoy C - There are many challenges in the rural setting for nursing, particularly regarding enhancement of nurses’ professional development. http://www.mdlinx.com/NurseLinx/newsl-article.cfm/2631896/ZZ5603146585149290157159/?news_id=399&subspec_id=44
*******************************************************
********************************************
*
MEDICAL RECALLS
*
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You are encouraged to report all serious adverse events and product quality problems to FDA MedWatch at www.fda.gov/medwatch/report.htm
FDA notified healthcare professionals of a Class 1 Recall of model numbers BAXTER'S Mono 2M8151 and 2M8153, CX 2M8161 and 2M8163, and CXE 2M9161and 2M9163. These products were manufactured and distributed from February, 1997 through December, 2008. The company identified software and battery usage failures that result in a delay in or interruption of infusion that may cause serious injury and/or death. http://www.fda.gov/medwatch/safety/2009/safety09.htm#Colleague
********************
The U.S. Food and Drug Administration is warning consumers not to eat certain Queso-brand Mexican style cheese because of possible contamination. The FDA said Quesco Fresco Fresh Mexican Style Soft Cheese and Queso Cotija Molido Mexican Style Grated Cheese manufactured and distributed by the Peregrina Cheese Corp. of New York might be contaminated with Listeria monocytogenes, a bacterium that can cause serious and sometimes fatal infections. The Queso Fresco Fresh cheese is sold in 14-ounce foil wrapped packages marked with lot number 4469 or 4477 affixed to each package on a white sticker. The Queso Cotija Molido cheese is packaged in 15-ounce clear plastic bags that are marked with UPC number 8 17424 00027 7 and "Plant # 36-1388," but do not contain a lot number or production date. Both products were distributed to retail stores in the New York City area and in Scranton and Hazelton, Pa., in early February. Consumers with questions can contact the company at 718-456-2391
FDA notified healthcare professionals of a Class 1 Recall of model numbers BAXTER'S Mono 2M8151 and 2M8153, CX 2M8161 and 2M8163, and CXE 2M9161and 2M9163. These products were manufactured and distributed from February, 1997 through December, 2008. The company identified software and battery usage failures that result in a delay in or interruption of infusion that may cause serious injury and/or death. http://www.fda.gov/medwatch/safety/2009/safety09.htm#Colleague
********************
The U.S. Food and Drug Administration is warning consumers not to eat certain Queso-brand Mexican style cheese because of possible contamination. The FDA said Quesco Fresco Fresh Mexican Style Soft Cheese and Queso Cotija Molido Mexican Style Grated Cheese manufactured and distributed by the Peregrina Cheese Corp. of New York might be contaminated with Listeria monocytogenes, a bacterium that can cause serious and sometimes fatal infections. The Queso Fresco Fresh cheese is sold in 14-ounce foil wrapped packages marked with lot number 4469 or 4477 affixed to each package on a white sticker. The Queso Cotija Molido cheese is packaged in 15-ounce clear plastic bags that are marked with UPC number 8 17424 00027 7 and "Plant # 36-1388," but do not contain a lot number or production date. Both products were distributed to retail stores in the New York City area and in Scranton and Hazelton, Pa., in early February. Consumers with questions can contact the company at 718-456-2391
*********************
FDA and Welch Allen notified healthcare professionals and consumers of a nationwide Class I recall of 14,054 AED 10 and MRL JumpStart external defibrillators manufactured between October 3, 2002 and January 25, 2007. These devices may experience low energy shock, unexpected device shutdown, and/or susceptibility to electromagnetic noise interference.... http://www.fda.gov/medwatch/safety/2009/safety09.htm#AED10
**************
The FDA notified healthcare providers and patients that insulin pens and insulin cartridges are never to be shared among patients. Sharing of insulin pens may result in transmission of hepatitis viruses, HIV, or other blood-borne pathogens. Insulin pens are not designed, and are not safe, for one pen to be used for more than one patient, even if needles are changed between patients because any blood contamination of the pen reservoir could result in transmission of already existing blood-borne pathogens from the previous user... http://www.fda.gov/medwatch/safety/2009/safety09.htm#Insulin
***************************
Bodee LLC and FDA notified of a nationwide recall of all the company's supplement product sold under the name Zencore Plus. FDA lab analysis of Zencore Plus samples found the product contains benzamidenafil, an undeclared drug product and a PDE5 inhibitor. The use of Zencore Plus by an unsuspecting user of organic nitrates may pose a life-threatening risk of sudden and profound drop of blood pressure due to potential interaction between benzamidenafil and organic nitrates. Zencore Plus is sold in health food stores and by mail order on internet nationwide. http://www.fda.gov/medwatch/safety/2009/safety09.htm#Zencore
FDA and Welch Allen notified healthcare professionals and consumers of a nationwide Class I recall of 14,054 AED 10 and MRL JumpStart external defibrillators manufactured between October 3, 2002 and January 25, 2007. These devices may experience low energy shock, unexpected device shutdown, and/or susceptibility to electromagnetic noise interference.... http://www.fda.gov/medwatch/safety/2009/safety09.htm#AED10
**************
The FDA notified healthcare providers and patients that insulin pens and insulin cartridges are never to be shared among patients. Sharing of insulin pens may result in transmission of hepatitis viruses, HIV, or other blood-borne pathogens. Insulin pens are not designed, and are not safe, for one pen to be used for more than one patient, even if needles are changed between patients because any blood contamination of the pen reservoir could result in transmission of already existing blood-borne pathogens from the previous user... http://www.fda.gov/medwatch/safety/2009/safety09.htm#Insulin
***************************
Bodee LLC and FDA notified of a nationwide recall of all the company's supplement product sold under the name Zencore Plus. FDA lab analysis of Zencore Plus samples found the product contains benzamidenafil, an undeclared drug product and a PDE5 inhibitor. The use of Zencore Plus by an unsuspecting user of organic nitrates may pose a life-threatening risk of sudden and profound drop of blood pressure due to potential interaction between benzamidenafil and organic nitrates. Zencore Plus is sold in health food stores and by mail order on internet nationwide. http://www.fda.gov/medwatch/safety/2009/safety09.htm#Zencore
NURSING HINTS CORNER
Trach cover-up We tie a surgical mask around a tracheostomy patient's neck when the patient wants to leave the bed. The mask keeps foreign objects out of the trach, protects staff and other patients from projectivle sputum, and allows us to check secretions. Also, because the trach is covered, the patient is less self-conscious. Michelle Kopinski, LPN
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p. 49, Springhouse Corporation/www.springnetcom.
Used with permission from 1,001 Nursing Tips & Timesavers, Third Edition, 1997, p. 49, Springhouse Corporation/www.springnetcom.
~~**~~**~~**~~**~~**~~
ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford. By using the following code: Paradigm10 , you will get 10% off of their first order.
( I have ordered through Gerry...and it was really great. )
Visit us at http://www.accu-ruler.com/.
~~**~~**~~**~~**~~**~~
NEW MEMBERS
Send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:
Our Newest member: Wanda (ljKent@mchsi.com ) March 23, 2009
~~**~~**~~**~~**~~**~~
NOTICE:
I attempt to send newsletters to your current email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number.......lol So please send me your new name/address, okay? RNFrankie@AOL.com
ADVERTISEMENTS
from the members
This ad is from Decubqueen (Gerry)..........Accu-RulerAccurate wound measurement designed by nurses, for nurses. Now carrying wound care and first-aid supplies at prices you can afford. By using the following code: Paradigm10 , you will get 10% off of their first order.
( I have ordered through Gerry...and it was really great. )
Visit us at http://www.accu-ruler.com/.
~~**~~**~~**~~**~~**~~
NEW MEMBERS
Send the prospective members' screen names and first names to me: RNFrankie@AOL.com
WELCOME TO:
Our Newest member: Wanda (ljKent@mchsi.com ) March 23, 2009
~~**~~**~~**~~**~~**~~
NOTICE:
I attempt to send newsletters to your current email addresses on file and if the newsletters are rejected THREE consecutive times, I must then delete the email address until you contact me with an updated email address; I have no way to reach you without a correct email address....You could always send me your Home number.......lol So please send me your new name/address, okay? RNFrankie@AOL.com
~~**~~**~~**~~**~~**~~
EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
~~**~~**~~**~~**~~**~~
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie) ~~**~~**~~**~~**~~**~~
DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
EDITORIAL STAFF:
GingerMyst @AOL.com (Anne), GALLO RN @AOL.com (Sue), HSears9868 @AOL.com (Bonnie), Laregis @AOL.com (Laura), Mrwrn @AOL.com (Miriam), and Schulthe @AOL.com (Susan)
~~**~~**~~**~~**~~**~~
PARADIGM 97 CO-FOUNDERS:
MarGerlach @AOL.com (Marlene) and RNFrankie @AOL.com (Frankie) ~~**~~**~~**~~**~~**~~
DISCLAIMER: The intent of this PARADIGM BYTES Newsletter is to provide communication and information for our members. Please research the hyperlinks and information provided by our members. The articles and web sites are not personally endorsed by the editors, nor do the articles necessarily reflect the staff's views.
~~**~~**~~**~~**~~**~~
THOUGHT FOR THE DAY
The democracy will cease to exist when you take away from those who are willing to work, and give to those who would not.
Thomas Jefferson
(sent in by Juliacr@AOL.com)
Hope to see you online..... Frankie
RNFrankie@AOL.com
The democracy will cease to exist when you take away from those who are willing to work, and give to those who would not.
Thomas Jefferson
(sent in by Juliacr@AOL.com)
Hope to see you online..... Frankie
RNFrankie@AOL.com
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