New Online Forum for Nurses.....

New Online Forum for Nurse Practitioners

8 nurse-y resolutions that will stick..........

It’s the time of the year when you are reflecting on those promises you made last month. You know – what you vowed, promised and declared you were going to improve.

These proclamations ranged from the smallest to the largest feats.

We all know the most common resolutions have to do with your health in some way.

Why do we poke fun at this habit of yearly resolutions? Mostly because the yearly resolution has become somewhat of a bad omen (sort of like saying the Q-word on a nursing unit). Your resolution is almost never completed in its entirety.

Here’s what I think about making resolutions as a nurse and (ahem) keeping them!

Nurse-y resolutions!

For nurses looking to improve their overall well-being in 2012, here’s a list of resolutions that can very easily apply to most nurses:

1. Bring my lunch to work (more often or a certain number of times per week)
2. Stop snacking on goodies at work
3. Stop bringing money to buy vending machine food
4. Stop feeling guilty about not picking up extra shifts (or calling off for being sick)
5. Be more of a team player (help one person each shift )
6. Stop feeling guilty about leaving tasks for the next shift
7. Cut back on coffee and/or fast food
8. Quit smoking
9.  

Here are some tips to help you stay on track:

Since when do you need a date on a calendar to start a goal? Pick an arbitrary day and commit. Just because you chose a goal at the start of the new year does not guarantee its success. That said, what better time to start than the new year?

Too much

For some reason, people “go big or don’t go at all.” The best goals are made in small increments. Baby steps forward are much more effective than backpedaling.

Too little

Your yearly resolution doesn’t need to be accomplished in a set time frame. There is nothing wrong with completing your goal later in the year. Just be sure to set a due date! It’s there to motivate you and serve as an evaluation tool along the course of the year.

Peer pressure

Nothing brings out the best in you like some friendly competition. The competitive spirit is inside all of us–sometimes we just need a good push. Just be sure to remind yourself that your goals are unique, and so are your accomplishments. So quit drawing expectations from others.

8 nurse-y resolutions that will stick...... 

Torture

A resolution is about improving your life, not making it worse. Try your best to keep a positive attitude. We all know that making changes to accommodate a new workout regimen or wean off of stimulants like coffee or cigarettes can feel like hell. Be sure to keep going. Imagine the reward for all your hard work and sacrifice. That thing you call torture will eventually become a habit and then a part of your new, healthier lifestyle. YOU DESERVE IT!

FDA Issues Public Health Advisory on Certain Pain Meds....

 

January 9, 2012 — The US Food and Drug Administration (FDA) is advising patients and healthcare professionals of a potential problem with opiate products manufactured and packaged for Endo Pharmaceuticals by Novartis Consumer Health at its Lincoln, Nebraska, manufacturing site.

In a telebriefing today, Edward Cox, MD, from the FDA's Center for Drug Evaluation of Research, said: "Due to problems incurred when these products were packaged and labeled at the site, it's possible that tablets from 1 product may have been retained in the packaging machinery, and then may have carried over into packaging of another product."

"This could result in an incorrect pill of 1 medicine ending up in the bottle of another product," he said. "The likelihood of this occurring in medication dispensed to medication is low," he emphasized.
According to the public health advisory the FDA posted today, the following products may be affected:

• Opana ER (oxymorphone hydrochloride) extended-release tablets CII
• Opana (oxymorphone hydrochloride) CII
• oxymorphone hydrochloride tablets CII
• Percocet (oxycodone hydrochloride and acetaminophen USP) tablets CII
• Percodan (oxycodone hydrochloride and aspirin, USP) tablets CII
• Endocet (oxycodone hydrochloride and acetaminophen USP) tablets CII
• Endodan (oxycodone hydrochloride and aspirin, USP) tablets CII
• morphine sulfate extended-release tablets CII
• Zydone (hydrocodone bitartrate/acetaminophen tablets, USP) CIII
•  

"Endo Pharmaceuticals reports that they are aware of only 3 product mix-ups with respect to these products since 2009," Dr. Cox said. "Endo is not aware of any patient having experienced a confirmed product mix-up, nor any adverse events attributable to a product mix-up," he added.
He also noted that an FDA review of the Adverse Event Reporting System database from January 1, 2009, through January 6, 2012, for the Endo Pharmaceutical opioid products manufactured at the Lincoln, Nebraska, facility failed to turn up any reports of adverse events directly related to manufacturing problems.
The FDA advises patients and healthcare professionals to check any opiate medicines made by Endo in their possession and to ensure that all tablets are the same.

"We are asking patients to check their medicines to look for any tablet of a different size, shape, or color from their regular medicine," Dr. Cox said. "We are asking pharmacists to perform a visual inspection when dispensing the potential affected Endo opioid medications, according to the instructions provided by FDA."
For more information, patients and healthcare providers can also contact Endo Pharmaceuticals' call center at 1-800-462-3636.

In the advisory, the FDA says they expect there will be "periods of shortages for these products" in the coming weeks, and they are actively working with Endo Pharmaceuticals and Novartis to "minimize the degree of impact."
As a precautionary measure, Novartis Consumer Health has initiated a voluntary recall of the other nonopiate products made at their Lincoln, Nebraska, manufacturing facility.
These products include all lots of Excedrin and NoDoz products with expiration dates of December 20, 2014, or earlier, as well as Bufferin and Gas-X Prevention products with expiration dates of December 20, 2013, or earlier, in the United States.

Healthcare professionals and patients are encouraged to report adverse events related to the use of these products to MedWatch, the FDA's safety information and adverse event reporting program, by telephone at 1-800-FDA-1088, by fax at 1-800-FDA-0178, online at https://www.accessdata.fda.gov/scripts/medwatch/medwatch-online.htm, or by mail to MedWatch, FDA, 5600 Fishers Lane, Rockville, Maryland 20852-9787.

Adherence to Post MI Medications

Study in monkeys raises hope for HIV .......vaccines

Study in monkeys raises hope for HIV vaccines

Click the Above link to read the Article....

Cases of Tamiflu-Resistant Flu Concern Experts.......

WEDNESDAY, Dec. 28 (HealthDay News) -- World Health Organization researchers are reporting an apparent spike in Australia in the number of seasonal influenza cases resistant to Tamiflu, the most commonly used antiviral drug.


The jump in such cases involving the pandemic 2009 A(H1N1) flu strain, also known as swine flu, took place during Australia's most recent winter: May through August of 2011.
"In 2007/2008, a different A(H1N1) influenza virus developed Tamiflu-resistance," explained WHO research scientist Aeron C. Hurt, who reported the spike. "On that occasion, it was first detected in large numbers in Europe. However, within 12 months the virus had spread globally, such that virtually every A(H1N1) virus around the world was resistant to this drug," he explained.

"This previous situation demonstrated the speed and potential for a Tamiflu-resistant virus to spread worldwide," Hurt added. "Our concern is that this current pandemic 2009 A(H1N1) Tamiflu-resistant virus may also spread globally."

Hurt, who is based in the Collaborating Centre for Reference and Research on Influenza in North Melbourne, outlined his observations in the Dec. 29 issue of the New England Journal of Medicine.
To explore the question of H1N1-drug resistance, Hurt and his team obtained viral samples from 182 H1N1 flu patients (aged from one month to 74 years) who were being cared for either in an emergency department or an intensive care unit, or by their general practitioner, during the recent winter in Australia.

In all, 29 of the patients (or 16 percent) were found to have a form of H1N1 that was resistant to both Tamiflu (oseltamivir) and an older class of adamantine treatments (rimantadine and amantadine).
Subsequent lab tests revealed that it would take more than 500 times the concentration of Tamiflu usually prescribed for nonresistant flu strains just to cut key aspects of resistant viral activity in half.
On the plus side, however, the resistant strains remained "fully sensitive" to treatment with another drug, Relenza (zanamivir).

Five of the resistant patients were under the age of 5 years. Only one of the patients had been treated with Tamiflu prior to viral sampling, while three had previously been vaccinated with the 2011 influenza vaccine.
The team noted that July marked the high point of resistant cases, most of which were found within a 30-mile or so radius of Australia's seventh-largest urban center, Newcastle. A handful were located in Sydney, the country's largest city.

Raising concerns about the ease of transmission, the investigators noted that some of the resistant cases involved related patients: in four households, two family members had been diagnosed with resistant H1N1. In two other cases, the patients were linked simply by having shared a short car ride.
Hurt pointed out that the resistant strain does not appear to cause more serious illness than "normal" strains, and that no one has died as a result. But he did suggest that the very real prospect that such resistant strains could spread far beyond the shores of Australia is alarming.

"Tamiflu is widely used in the U.S.A. and other parts of the world such as Japan," he noted. "If the virus spreads widely, then there is potential that patients will be treated with a drug that will have little or no benefit. The biggest impact may be in individuals, such as the elderly or immune-compromised, who have a higher risk of complications from influenza infection and most commonly benefit from early and effective antiviral treatment."

Dr. Len Horovitz, a pulmonary specialist with North Shore-LIJ/Lenox Hill Hospital in New York City, explained that, although other non-Tamiflu treatments remain effective, the advent of resistant flu strains can waste valuable time.

"Flu medications have to be given within 24 to 48 hours of the onset of symptoms or they do no good," he said. "So this is a real problem, because we live in a global village. People will get on a plane in Australia and come to my office. This will not be isolated to one part of the world," he added.

"So what I tell people is that immunization is paramount," Horovitz said. "It's important that anybody over the age of 6 months get vaccinated, and that includes pregnant women for whom there is a mercury-free vaccine. If we all did this, we would have very low levels of flu. People wouldn't get it to begin with. And then we wouldn't have to worry whether the drugs we have work or not."

Professional Nursing Organizations

Professional nursing organizations, both at the national and local chapter level, provide opportunities to connect with peers in your specialty, share best practices and learn about new trends, education and technical advances.  Advance your nursing career with these nursing associations and resources that offer exceptional networking opportunities, whether you are a student nurse, new graduate or seasoned professional.

Nursing Links

American Association of Colleges of Nursing
Exceptional Nurse
Futures in Nursing
National Certification Corp. for the Ob/Gyn & Neonatal Nursing Specialties
National Council of State Boards of Nursing (NCSBN)
National Institute of Nursing Research
MedicineNet
Yahoo! Nursing Links
NNBA.net

Nursing Organizations

Academy of Medical-Surgical Nurses
Alpha Tau Delta (National Fraternity for Professional Nurses)
American Academy of Ambulatory Care Nurses
American Academy of Nurse Practitioners (AANP)
American Association for the History of Nursing
American Association of Critical-Care Nurses (AACN)
American Association of Heart Failure Nurses
American Association of Legal Nurse Consultants
American Association of Nurse Assessment Coordinators
American Association of Nurse Attorneys
American Association of Occupational Health
American Association of Office Nurses
American Association of Spinal Cord Injury Nurses
American Assembly of Neuroscience Nurses (AANN)
American Association of Nurse-Anesthetists (AANA)
American College of Nurse-Midwives (ACNM)
American College of Nurse Practitioners (ACNP)
American Forensic Nurses
American Holistic Nurses Association
American Nephrology Nurses Association
American Nurses Association (ANA)
American Nurses Association-California
American Nursing Informatics Association
American Organization of Nurse Executives (AONE)
American Psychiatric Nurses Association (APNA)
American Society of PeriAnesthesia Nurses (ASPAN)
Association for Professionals in Infection Control and Epidemiology, Inc. (APIC)
Association of Camp Nurses
Association of Child Neurology Nurses
Association of Medical Esthetic Nurses
Association of periOperative Registered Nurses, Inc. (AORN)
Association of Rehabilitation Nurses (ARN)
Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN)
Baromedical Nurses Association
Council of Practical Nurse Programs NYS
Emergency Nurses Association (ENA)
Florida Nurse Practitioner Network
Infusion Nurses Society (INS)
National Alaska Native American Indian Nurses Association (NANAINA)
National Association of Catholic Nurses - USA
National Association of Directors of Nursing Administration (NADONA)
National Association of Hispanic Nurses (NAHN)
National Association of Neonatal Nurses
National Association of Orthopaedic Nurses, Inc. (NAON)
National Association of Pediatric Nurse Associates & Practitioners
National Association of School Nurses
National Black Nurses Association (NBNA)
National Federation of Licensed Practical Nurses, Inc. (NFLPN)
National League for Nursing (NLN)
National Maternal and Child Oral Health Resource Center
National Nurses in Business Association
National Nursing Staff Development Organization
National Organization for Associate Degree Nursing
National Organization of Nurse Practitioner Faculties
National Student Nurses Association
Nurses Christian Fellowship
Oncology Nursing Society (ONS)
Pediatric Endocrinology Nursing Society
Philippine Nurses Association of America
Rural Nurse Organization
Sigma Theta Tau International
Society for Gastroenterology Nurses and Associates, Inc.
Society of Otorhinolaryngology and Head-Neck Nurses
Society of Pediatric Nurses (SPN)
Society of Urologic Nurses and Associates
The National Association of Nurse Massage Therapists
Transcultural Nursing Society
Visiting Nurses Associations of America

Health care links

American Case Management Association (ACMA)
American College of Healthcare Executives
Case Management Society of America
CINAHL Information Systems
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
Medscape Health Information
National Health Information Center
National Women's Health Information Center
National Women's Health Resource Center

International nursing links and organizations

Nursing boards abroad

Australian Nursing Council
Nurses Registration Board New South Wales
Queensland Nursing Council

Organizations

Aboriginal Nurses Association of Canada
Alberta Association of Registered Nurses
Australian Nursing Federation
British Association of Critical Care Nurses
British Columbia Nurses' Union
Canadian Association of Neuroscience Nurses
Canadian Nurses Association
Canadian Nurse Continence Advisor Association
Colegio de Enfermera de Valencia (Spain)
College of Nurses Aotearoa Inc. (New Zealand)
College of Registered Psychiatric Nurses of British Columbia
College of Registered Psychiatric Nurses of Manitoba
Commission on Graduates of Foreign Nursing
European Dialysis and Transplant Nurses Association
European Federation of Critical Care Nursing Associations
European Federation of Nurse Educators
Federazione collegi IPASVI
Health Services Union of Australia
Interagency Council on Information Resources for Nursing
International Association of Forensic Nurses
International Council of Nurses (ICN)
Licensed Practical Nurses Association of British Columbia
Operating Room Nurses Association of Canada
Sociedad Espanola de Enfermeria Oncologica
Swiss Nurses Association
The Canadian Nursing Students' Association

Looking Over Your Shoulder in Healthcare: Documentation

Healthcare is serious business, and the repercussions of deficiencies in medical documentation can be considerable. Nurse attorney Carolyn Buppert examines the landscape of medical record auditing -- for a variety of purposes -- and offers practical suggestions to improve your documentation in this 3-part series. Part 1 illustrates the potential consequences of even the slightest, but critical, omissions in medical record documentation.
Judgment Day: Medical Record Review

Clinical care is judged on medical record documentation. The progress note is what justifies payment for medical services. Moreover, it is the progress note that supports or fails to support a clinician and his or her employer when a question arises about the necessity or competency of care.

Consider these 2 scenarios:
Critical Gap in Documentation

Scenario 1: Minor omission from progress note leads to denial of payment. A physician conducted a follow-up visit with a 78-year-old man with a history of secretion of inappropriate antidiuretic hormone (SIADH). Documentation was as follows:

"Patient and wife in to review the evaluation for SIADH. His sodium is now corrected to 136 with water restriction. CT shows old right frontal infarction which he denies having any symptoms of. There is mild cerebral atrophy consistent with age. CT of chest shows 2-mm nodule in right apex, possible granuloma. CT abdomen unremarkable."


Impression:

SIADH improved
Pulmonary nodule, small
Frontal cerebrovascular accident, asymptomatic
Rule out macrovascular disease

Plan:

Monitor pulmonary nodule with repeat CT scan in 6 months
Pulmonary medicine consult
Neurology consult; patient will schedule
Carotid duplex study
Continue fluid restriction


Complicated patient, right? The physician billed Medicare for a CPT 99215. The physician's documentation was audited and Medicare denied payment for the visit. The physician wrote to Medicare, stating "I billed a higher level of service because of the complexity of the above problems plus the length of time consulting with the patient and his wife. In addition, I reviewed his radiographs with a radiologist."

Medicare still denied payment. Why? The clinician did not include the time spent counseling the patient. If a clinician spends at least 20 minutes of a 40-minute office visit (or at least 18 minutes of a 35-minute hospital visit) discussing laboratory results, prognosis, treatment options, instructions for treatment, importance of compliance, reduction of risk factors or providing other patient and family education, the clinician may bill the highest level office or hospital visit, based on counseling time spent. Had the physician noted that 40 minutes was spent with the patient discussing the prognosis and treatment plan, Medicare would have reimbursed the physician approximately $137 for an office visit or, if the visit was conducted with an inpatient, approximately $97. Without those few words specifying the time spent, Medicare reimbursed nothing at all.

If the physician had cared to appeal Medicare's decision, he might have argued that his note justified payment for a lower level office visit; however, because he documented medical decision-making but not history or examination, his note would have justified only the lowest-level visit.
Patient Follow-Up Oversight

Scenario 2: Lack of documentation of follow-up makes for difficult defense. A 47-year-old woman with a 22-pack-year smoking history fell in the shower during Memorial Day weekend. She visited an emergency department and a chest radiograph was made. The radiograph showed 2 fractured ribs and a poorly defined 2-cm alveolar density in the right lung apex. The radiologist wrote: "This may be caused by acute pneumonia, but close follow-up is advised." The emergency department staff referred the patient back to her primary care provider, who was a nurse practitioner (NP).

A few days later, the patient visited the NP, who ordered erythromycin for 10 days and recommended a repeat chest radiograph in 2 weeks. The repeat radiograph showed "nearly complete resolution of previously documented right upper lobe density." The radiologist made no recommendation for additional follow-up. The NP made a brief note that was not entirely legible but may have read "will get radiograph" however, no further radiographs were ordered that year. The NP recalled having told the patient that a follow-up radiograph was needed.

The NP saw the patient in July for screening blood tests. The patient's liver function tests were elevated. In August, the NP recommended follow-up of elevated liver function tests with a gastroenterology consult. The NP also attended to some of the patient's health maintenance needs. The patient did not see the gastroenterologist as recommended by the NP. The practice's receptionist called the patient in October to remind her to follow through with the gastroenterologist. The patient said she would. Nothing was documented about radiographs.

The following July, the patient visited the NP, complaining of hemoptysis. A chest radiograph showed complete opacification of the right lung. The diagnosis was lung cancer. The patient died within the year.

The patient's husband sued the NP, the NP's collaborating medical doctor, and the radiologist, alleging failure to diagnose lung cancer. Expert witnesses for the radiologist stated that the cancer that killed the patient was probably not the density seen on chest radiograph the previous summer. Expert witnesses for the patient stated that the cancer that killed the patient probably was the lesion detected on the radiograph the previous summer.

Eventually, all defendants except the NP were dropped from the suit. An internist working for the plaintiff testified at deposition that the NP should have repeated the radiograph until it was absolutely clear or until a diagnosis was made and managed. The internist also testified that it was the NP's responsibility to advise the patient of the serious consequences of failing to follow through with further tests. The NP maintained that she told the patient to return for a radiograph and followed up by telephone, but no documentation could be found in the medical record to support her position. The suit was settled in favor of the patient.


Faulty Documentation Is All Too Common

In scenario 1, the physician could have avoided a denied charge simply by noting the time spent with the patient. An internal auditor could have easily seen that the physician's documentation did not correspond with the requirements for CPT 99215 and the physician could have made an addendum. In scenario 2, the NP should have documented her instructions to the patient about the need for a follow up radiograph. Furthermore, if she or office staff members made numerous attempts to reach the patient to follow up with her, those efforts should have been documented. An internal auditor could have noted the deficiencies in the documentation and reminded the NP that additional follow-up was necessary, as well as documentation of follow-up or attempts to follow up.

In each of these examples, losses could have been avoided. However, hospitals and medical practices rarely analyze documentation unless an unfortunate incident occurs. When that happens, records are scrutinized with a critical eye.


This author has audited documentation at hospitals and found medical record entries with these problems:

Large illegible sections, including signatures. If Medicare audits a record and an entry or signature is illegible, they will demand repayment of money already paid. Furthermore, if the note becomes evidence in a malpractice case, poor handwriting damages the credibility of the writer.
A clinician stated that a hospitalized patient's chief complaint was "Doing well." Payment for hospitalization and for physician services is contingent on medical necessity. If the patient is "doing well," why does he need to be hospitalized? The note should indicate why the patient needs to be in the hospital each day. Rather than writing "doing well," the clinician should state something like: "Breathing is improved over yesterday, although patient is still struggling during exertion."
Clinician described an assessment or impression as "doing well." This vague comment can create the same problems as when used for "chief complaint."
Components of the necessary elements of medical work for the billed Current Procedural Terminology (CPT) code were missing. If all required components of medical work -- history, examination, and medical decision-making -- are not documented, payers will pay only the CPT code for which the documentation meets requirements. If one of the required elements -- examination, for example -- is omitted from a new patient visit, the visit cannot be billed as a new patient visit.
Clinician did not note follow-up to or resolution of a problem identified a day earlier. If the patient's condition gets worse and the patient has a permanent injury or diminished life span and sues, the clinician and his or her employer will have a difficult time defending the lack of attention to an identified problem.
Clinician documented inexact vital signs (eg, afebrile, BP normal). Subsequent caregivers may be unable to understand the significance of these notations or changes in the patient's status because the baseline values are not precise.
Clinician used nonstandard abbreviations, which could be misinterpreted by subsequent providers.
Clinician noted a complaint of pain but did not fully describe it (location, duration, onset, aggravating factors, alleviating factors, quality, and quantity). Subsequent caregivers have no starting point on which to base improvement or change for the worse.

The problems noted above can lead to denial of payment for the daily visit, denial of payment to the hospital for the stay, confusion among subsequent caregivers, and difficult defense if a lawsuit is filed or a complaint is made to a professional board.
Documentation: What Is the Purpose?

Medical record documentation has 4 objectives:

To show that the service was medically necessary;
To justify billing the service at the level billed;
To demonstrate that the standard of care was met, if needed, to defend against an action for malpractice; and
To assist clinicians who follow in performing subsequent care.



Nursing Documentation Compliance With Regulatory Standards- Good documentation is vital to your nursing career.

Nursing doesn't just deal with treating patients -- a great deal of paperwork goes into doing the job right. Often, this documentation must be done in compliance with state and federal regulations.
Related Searches:

Nursing Patient Education
Nursing Workplace Safety

Patients

Many regulatory standards involve direct patient care. Patients must be assessed within a certain amount of time after their admission to a medical facility. They must also have customized treatment plans made for them based on their condition and prognosis. When they are discharged, a separate nursing discharge plan must also be made.
Incidents

Incidents, grievances, and patient concerns must also be documented and shown to a regulatory board upon request. These incidents can range from falls and lost items to poor patient outcomes, and even death.
Correction

A large part of regulatory documentation compliance centers on correction of errors and unacceptable practices at a medical facility. For instance, if 50 percent of patients suffer a fall during one quarter, nursing and other staff members must document their plan of correction, or risk being fined or shut down.




Read more: Nursing Documentation Compliance With Regulatory Standards

| eHow.com http://www.ehow.com/facts_7663680_nursing-documentation-compliance-regulatory-standards.html#ixzz1fnqBpvUd

Source is from-Carolyn Buppert, NP, JD
Authors and Disclosures

Posted: 12/01/2011 http://www.medscape.com/viewarticle/754374_2

Mycoplasmal Pneumonia or Atypical Pneumonia....

Mycoplasmal pneumonia is one of the most common types of community-acquired pneumonia in otherwise healthy people under age 40. It's caused by Mycoplasma pneumoniae, an interstitial bacterium that spreads in respiratory droplets. Unlike typical community-acquired pneumonia, which is usually caused by pneumococcal pneumonia, it's most likely to strike children and young adults age 5 to 20, and is often mistaken for asthma.

Although most patients with M. pneumoniae don't develop pneumonia, those with comorbid conditions (especially involving the lower respiratory tract) are at risk for serious respiratory distress. With community-acquired infections becoming more prevalent, it's essential to recognize the signs and symptoms early in order to treat the infection before it spreads.

Walking through the signs and symptoms

Sometimes called walking pneumonia, mycoplasmal pneumonia is most common in the summer and fall. Outbreaks in communities tend to be cyclical, occurring every 3 to 8 years. Hallmarks of the disease are a long, insidious onset and a long, gradual recovery. Wheezing and coughing are also characteristic, explaining why the illness is sometimes misdiagnosed as asthma. Most patients recover without complications in several weeks, but the infection may cause pneumonia in children and acute chest syndrome in patients with sickle-cell disease.

M. pneumoniae has a long incubation period (1 to 4 weeks).The gradual onset and length of the illness reflect M.

pneumoniae's distinctive properties:

* its affinity for both ciliary and nonciliary epithelial cells of the respiratory tract

* its ability to produce the damaging oxygen free radicals hydrogen peroxide and superoxide, which damage cells and cause inflammation.

Ciliary paralysis, cell damage, and inflammation of the respiratory tract lead to coughing and may result in lower respiratory tract infection.

Recognizing mycoplasmal pneumonia


When assessing a patient for possible M. pneumoniae infection, look for the following.

* upper respiratory tract signs and symptoms: pharyngitis, rhinorrhea

* lower respiratory tract signs and symptoms: crackles, rhonchi, wheezes, dyspnea, nonproductive cough, chest pain

* fever, chills, otalgia, and malaise.

Fever typically lasts more than 3 days. A prolonged fever, combined with the patient's history and other signs and symptoms, helps identify mycoplasmal pneumonia, especially when illnesses such as strep throat, acute otitis media, and sinusitis have been ruled out.

Keep in mind, however, that disease presentation is variable: 50% to 75% of patients with M. pneumoniae infection may develop only pharyngitis, otalgia, rhinorrhea, and fever.

Otalgia associated with M. pneumoniae may be caused by bullous myringitis, which is manifested as a lesion on the tympanic membrane. This lesion is a confirmatory finding of M. pneumoniae infection.

On physical exam, other clinical findings may include a nontoxic appearance, pharyngeal erythema without exudates, negative cervical adenopathy, or negative frontal and maxillary sinus tenderness.

X-ray and lab test findings

Early on, physical assessment findings may include clear breath sounds; wheezes, rhonchi, and/or crackles without evidence of consolidation on chest X-ray.

Unique findings on chest X-ray that can help confirm a diagnosis of mycoplasmal pneumonia include an absence of lobar consolidation, platelike atelectasis (seen on the lateral chest view as a thin, flat area of collapsed lung), nodular infiltration, and hilar adenopathy.

High-resolution computerized tomography scans of the chest are more sensitive than chest X-rays in identifying mycoplasmal pneumonia, but lack of availability and cost constraints limit their use.

Along with patient history, clinical findings, and chest X-ray, a serum cold agglutinin test may be performed to confirm the diagnosis. However, cold agglutinin tests are positive in only 50% to 70% of cases when performed 7 to 10 days after infection, so negative test results don't rule out M. pneumoniae infection.

Other diagnostic tests include complement fixation (CF) and enzyme-linked immunosorbent assay (ELISA). CF titers don't peak until 4 to 6 weeks after infection begins and may persist for up to a year. ELISA checks for immunoglobulin M, is specific and sensitive, and can be used to test for acute infection.3 Polymerase chain reaction testing may allow quicker diagnosis but isn't widely available.1,6 Respiratory secretions can be checked via a radiolabeled DNA probe to detect M. pneumoniae ribosomal DNA and is 90% sensitive, but also may not be widely available.1 Sputum stains are helpful only to rule out other diagnoses.
Antibiotic options

Macrolides are the antibiotics of choice for mycoplasmal pneumonia. Antibiotics that inhibit cell wall synthesis, such as penicillins, cephalosporins, and carbapenems, are ineffective with M. pneumoniae because the bacteria lack a cell wall.Antibiotics that work against M. pneumoniae, which are bacteriostatic rather than bactericidal, act on RNA-dependent protein synthesis needed for cell replication.

Macrolides most often prescribed for mycoplasmal pneumonia include erythromycin, clarithromycin, and azithromycin. The most common adverse reactions to these macrolides include nausea, vomiting, and diarrhea.

Tetracyclines such as doxycycline can also be used but are contraindicated in pregnant women and children under age 8. Fluoroquinolones such as levofloxacin and moxifloxacin are an option for some patients if macrolides or tetracyclines are contraindicated, but they shouldn't be used in patients under age 18.

Serious complications from mycoplasmal pneumonia are rare, but a cough may persist for 4 to 6 weeks after treatment.For more about possible complications, see When the course gets complicated.
Outpatient care

Most patients with mycoplasmal pneumonia are treated as outpatients. To manage coughing, the healthcare provider may recommend over-the-counter cough preparations containing dextromethorphan or prescribe cough medications with opiates, such as codeine or hydrocodone. Inform patients using opiates not to drive or operate heavy machinery. Advise them not to take cough preparations concurrently with other central nervous system depressants such as opioid analgesics, barbiturates, and alcohol. If an opiate is prescribed for a child, tell the parents to monitor closely for respiratory depression.

Coughing from airway hyperreactivity may respond well to beta2-agonists such as albuterol or levalbuterol. If these are prescribed for your patient, provide instruction on proper inhaler use with or without a spacer and/or nebulizer use.

Teach patients with mycoplasmal pneumonia about pain and fever management, including the proper use of acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs); both acetaminophen and NSAIDs can be combined in many over-the-counter drugs as well as prescription medications. Advise patients to read package labels and follow directions exactly to prevent unintentional overdose.

Inform patients that their cough may continue for up to 6 weeks after the illness has ended, but it doesn't mean they need more antibiotics or are still ill. Explain that the cough may worsen during exercise or cold temperature exposure and that using an inhaler, warming up before exercise, or covering the mouth and nose when exposed to cold air may help reduce cough and shortness of breath.

Also inform patients about the signs and symptoms of a worsening condition that require further intervention. Even though complications from mycoplasmal pneumonia are rare, 7% to 10% of patients may experience cardiovascular or neurologic complications, and some patients experience dermatologic complications. Advise patients to seek immediate emergency help if they experience any chest pain, especially pain at rest that's not associated with coughing; ascending weakness (which may be a sign of Guillain-Barr� syndrome); or increasing headache (especially associated with photophobia), nausea and vomiting, and nuchal rigidity, which may indicate meningitis or encephalitis. Skin manifestations that their healthcare provider should evaluate include painful nodules and target lesions involving the skin, oral mucosa, or conjunctiva.

ICU care

About 30% of patients with community-acquired pneumonia require hospitalization. Most patients admitted to the ICU need treatment for respiratory distress related to lower respiratory infection signs and symptoms and worsening pneumonia. Monitor vital signs and respiratory status and assess for cardiovascular, neurologic, or dermatologic complications. Keep in mind that patients with hemoglobinopathies, such as sickle-cell disease, are at increased risk for worsening respiratory signs and symptoms as well as hematologic complications.

Preventing transmission

Help patients prevent future transmission of mycoplasmal pneumonia by advocating good hygiene. Teach them to wash hands or use an alcohol-based hand sanitizer frequently, keep their hands away from the face (especially the mouth, eyes, and nose), cough or sneeze into the elbow or upper arm rather than the hand, stay away from others when ill (especially when febrile), keep phones clean, and avoid sharing drinking or eating utensils.

Early intervention is key

Infection with M. pneumoniae is generally self-limiting and mortality is low. Besides prevention, the best defense is prompt recognition and early intervention with appropriate antibiotics and supportive care.
When the course gets complicated

Common complications in patients with mycoplasmal pneumonia include pleural effusion, empyema, respiratory distress syndrome, and respiratory failure.
Other complications include:

* cardiovascular: endocarditis, myocarditis, or pericarditis

* neurologic: aseptic meningitis, encephalitis, Guillain-Barr� syndrome, transverse myelitis

* dermatologic: erythema multiforme, erythema nodosum, Stevens-Johnson syndrome, urticaria

* hematologic: patients with sickle-cell disease are at increased risk for hemolytic anemia and thrombocytopenia.

African American and Asian patients with hemoglobinopathies are also at risk for severe pleural effusions and marked respiratory distress as well as marked dermatologic problems such as digital necrosis.

Top 10 Qualities of Allied Health Professionals....

Allied health professionals, from medical coders and billers to physician's assistants and doctors, all play a vital role in the field of health care. The best of those professionals display a number of qualities that make them valuable in the profession. Such qualities are:

1. Excellent Communication Skills: Strong communicative skills are important so that complex terminology can be explained to patients in plain language; also it is important that healthcare professionals be excellent listeners.
2. Good Bedside Manner: "Good bedside manner" pertains to more than a doctor visiting his patient in the hospital. Having a "good bedside manner" applies to any health care professional who comes in contact with patients; it means making patients feel as comfortable as possible at any stage of exams and treatment, even as early as sitting in a waiting room.
3. Good Problem Solver: Medical personnel must be problem solvers that quickly come up with solutions to problems, be it involving the human body or insurance paper work.
4. Empathetic: Health care personnel must have a sense of empathy towards patients; they must understand that people have feelings and they must be supportive to patients.
5. Complete and Thorough: The most minor mistakes can create a ripple effect in consequence. For this reason, medical personnel must be thorough in all that they do.
6. Commits Time to Patients: Medical professionals must always be patient and ensure that adequate time is given to patients, whether to properly fill out medical paper work or to diagnose and treat medical problems. For this reason, they always must commit adequate time to patients.
7. Continues Education: As technology and techniques are constantly evolving, health care professionals must always continue their education, be it via reading medical journals or going back to school for remedial classes involving computers.
8. Strong Medical Knowledge: Medical professionals should have at least some medical knowledge. When they are unsure of the facts, they are always ready to admit that they are unsure and refer the patient to someone that is better informed.
9. Supports Patients Wishes: Decisions regarding health must always remain under the control of the patient. This is their right, and health care professionals must respect that, regardless of their personal opinion.
10. Possesses Strong Sense of Ethics: Individuals working in healthcare must be ethical; they always hold true to a value system that thoroughly respects patients dignity and privacy.

Nurses, Who Says You Have to Smile? 

 

I do not think of myself as a smiler.  It’s not that I am unhappy all the time, or that I dislike smiling, I just don’t make a conscious effort to do so.  I have other things which I consider to be a priority, but I do laugh easily and quickly. Even at work.  Apparently the fact that I don’t have a smile or any variation thereof plastered on my face all of the time earned me the nickname “Nurse Frowny Face” from one of my patients, who was offended by my lack of smiling.  Well, that wasn’t the only problem, as I had asked her to please keep her voice down in a hallway that has acoustics better suited for a concert hall than a psychiatric unit, when she wanted to know if everyone had gone out to smoke without her.  Sigh.  This earned me a meeting with a supervisor about being rude…

I am all for maintaining a professional demeanor but I absolutely refuse to put a smile on constantly for anyone, including the patients.  I believe that if you maintain such a demeanor all the time and without variation, you come across as superficial, annoying and insensitive to patients, among others.  It is ok to cry with them, to feel anger and annoyance for (and even with) them, and definitely ok to laugh with them.  However, to insist that a nurse be smiling and sweet all the time to “cheer up” the patients, especially depressed ones, is asinine.  We are not robots who are programmed by those around us to function at what they perceive to be an optimal level; we are only human.  Having been a patient, I would not want a bubbly nurse when I am in physical or emotional agony.  I want one who can introduce him or herself, look into my eyes, and empathize with me without being swallowed up by my pain.  If he or she can “mirror” my emotions, I am convinced that he or she is following how I feel without taking on my problem.  I believe that, above all, being genuine and kind facilitates the healing process, not the expression on my face.

Being a good nurse requires excellent psychosocial skills, in particular mastery of your interpersonal skills.  “Enhancing your calm” is essential.  It is also important to not be a doormat, as you are an individual just as worthy of kindness and respect as the next person.  You have the right to ask to be treated as such.  But, there are also going to be times when you slip, times when you let ‘er rip and say something which you may regret later.  All you can really do then is apologize and acknowledge that you were out of line.  In the meantime, and hopefully prolonging this event until your very last working day before retirement, I believe it is important to spend some time reflecting on what or who pushes your buttons.  Come up with some strategies for coping with these.  It might be a matter of taking a course in assertiveness to help you communicate in a way that is both pleasant toward others and protective of your feelings.  It might also be a matter of knowing when to stop trying to be Super Nurse on the Unit, asking for help, and/or taking a break when things are particularly rough.  Sometimes you should just let things slide, as we have a lot to worry about as it is.  Either way, setting limits with patients, co-workers, physicians, and families is important.  I find that when I can strike a balance with this, the expression on my face doesn’t matter.  My eyes sparkle, my voice is warm and pleasant, and I am able to remain totally enthralled with the growth I witness within my patients because I can help nurture it.

About this Author: Rachel E. Clements is one of those "second winders" who began training in one career field and chose nursing instead; she has been a nurse for 5 years in May.  Rachel lives and works in Boise, Idaho, and is currently enrolled in Montana State University's online Psychiatric Mental Health Nurse Practitioner program.  In her spare time, Rachel enjoys hiking, savoring the sunshine with her two kitties, and tending to the yard of her relatively new house!

Source Page borrowed from.... nursetogether.com:

Baby's Death Spotlights Safety Risks Linked to Computerized Hospital Systems....

Chicago Tribune
July 01, 2011

CHICAGO _ The medical error that killed Genesis Burkett began with the kind of mistake people often make when filling out electronic forms: A pharmacy technician unwittingly typed the wrong information into a field on a screen.
Because of the mix-up, an automated machine at Advocate Lutheran General Hospital prepared an intravenous solution containing a massive overdose of sodium chloride _ more than 60 times the amount ordered by a physician.

When the nutritional fluids were administered to Genesis, a tiny baby born 16 weeks prematurely, the infant’s heart stopped and he died, leaving behind parents stunned by grief to this day.
Although a series of other errors contributed to the tragedy, its origin _ a piece of data entered inaccurately into a computer program _ throws a spotlight on safety risks associated with medicine’s advance into the information age, a trend being pushed aggressively under health reform.


The federal government is aiding the shift with $23 billion in incentives to medical providers who buy electronic medical records or computerized systems that automate drug orders and other medical processes. The hope is that these technologies will enhance access to vast amounts of information now tucked away in paper files and meaningfully improve medical care.
Doctors should be able to see test results quickly and communicate more easily with each other, for example. And electronic safeguards also can remind physicians about recommended medical practices or alert them to harmful interactions between medicines.


Yet with these sizable potential benefits also come potential problems. Hospital computers may crash or software bugs jumble data, deleting information from computerized records or depositing it in the wrong place. Sometimes, computers spew forth a slew of disorganized data, and physicians can’t find critical information about patients quickly.
Meanwhile, different electronic systems used in hospitals may not be able to communicate, and the alerts built into these systems are often ignored because they are so frequent and often are not especially useful, physicians and other experts report.


Technology vendors tend to dismiss incidents like the death that occurred at Advocate Lutheran General in Park Ridge as arising from human errors, not product deficiencies. But other experts say health information technologies can lead to mistakes when they aren’t in sync with the way medical providers work.
“We see problems much more often than we would like” because many health information systems are poorly designed and difficult for doctors and nurses to use, said Dr. Rainu Kaushal, chief of the division of quality and medical informatics at Weill Cornell Medical College in New York City.



Exactly how often safety concerns arise is not known. The U.S. Food and Drug Administration in December acknowledged getting 370 reports of problems involving health information technology since January 2008, including several dozen patient injuries and deaths, but those numbers are likely to be low because such reports are voluntary. Some examples:
_A patient died after a computer network problem caused delays in transmitting a critically important diagnostic image.
_Vital signs from patient monitors disappeared from electronic medical records after being viewed by hospital staff.

_A patient died after getting therapy meant for someone else after a wrong name was entered electronically on a scan performed by radiologists.
_Data about patients’ allergies were eliminated from medical records during an automatic computer update.
“(These) technologies can be enormously helpful, but what is emerging is that when implemented poorly, they can be harmful,” said Dr. Ashish Jha, associate professor of health policy at Harvard University’s School of Public Health and a member of an Institute of Medicine committee appointed late last year to study safety concerns associated with health information technology. That panel’s recommendations are expected to be issued in 2012.


Carla Smith, executive vice president of HIMSS, the industry’s largest trade group, based in Chicago, said that “safety concerns are on our radar screen” and “we want to make sure we have checks and balances in place (in vendor systems) to prevent unintended harm.”
The story of Genesis Burkett’s death at Advocate Lutheran General last October underscores the potentially devastating consequences of a single wrong piece of data put into a software system.
The infant’s parents, Fritzie and Cameron Burkett of Chicago, said they were overjoyed when their son, born four months early and weighing 1 pound 8 ounces, survived and began to improve under the hospital’s expert care. For about six weeks, the Burketts and other family members said, they were at the baby’s side, singing Christian music softly at his bassinet.


Having endured two previous miscarriages, the couple said they named the baby Genesis, signifying a new beginning.

For more Info on this story...

.http://nursinglink.monster.com/news/articles/22017-babys-death-spotlights-safety-risks-linked-to-computerized-hospital-systems?page=3

Surgeons Implant First Synthetic Organ

United Press International
July 08, 2011

Surgeons in Sweden have performed the world’s first transplant of a synthetic organ, an artificial windpipe coated in the patient’s stem cells, officials said.
Surgeons at the Karolinska University Hospital said the 36-year-old cancer patient is doing well after the procedure, the BBC reported Thursday.

The pioneering surgery, which presents no risk of the organ being rejected, involves modeling a structure or scaffold that is an exact replica of the patient’s own windpipe, removing the need for a donor organ.
Scientists at University College London used 3D scans of the patient’s windpipe to craft a copy of the patient’s trachea out of porous glass, which was then flown to Sweden and soaked in a solution of stem cells taken from the patient’s bone marrow.

In a 12-hour operation, the patient’s cancerous windpipe was removed and replaced with the custom-made replica.
The stem cells will be able to divide and grow, turning the inert windpipe scaffold into an organ indistinguishable from a normal healthy one, doctors said.

Grand Rounds Webcasts............

Here is a selection of Grand Rounds video presentations by Mayo Clinic staff members..... Presentations provided are selected for their educational value and topic interest. New presentations are added regularly.
Clicking on the topic launches the video, which will appear in a new window.

Behavioral Interventions for Pediatric Weight Management

Bridget K. Biggs, Ph.D., L.P.
Presented Feb. 11, 2011

Management of Graves' Disease: New Guidelines From the ATA

Rebecca S. Bahn, M.D.
Presented Jan. 26, 2011

Neurogenic Orthostatic Hypotension

Brent P. Goodman, M.D.
Presented Sept. 22, 2010

"Doctor, It Must Be Celiac Disease": Clinical Challenges in Diagnosis and Treatment

Lucinda A. Harris, M.D.
Presented Aug. 6, 2010

Carotid Artery Stenting

Brian W. Chong, M.D.
Presented July 17, 2009

Microbes and Obesity: A Look at the World Within

John K. DiBiase, M.D.
Presented July 31, 2010

Initial Evaluation History and Physical Examination

Kirsten S. Paynter, M.D.
Presented May 5, 2010

What Diagnostic Workup Should An Obese Child Get?

Seema Kumar, M.D. PdE
Presented May 21, 2010

SomaliCARES: A practical Approach to Improving health Literacy in a Prenatal Care Program for Somali Women

Joyce Miller & Anita DeAngelis
Presented Apr. 22, 2010

Selection of Artificial Heart Valves: Matching the Prosthesis to the Patient

Hartzell V. Schaff, M.D.
Presented Mar. 19, 2010

Cognitive Aging and Presymptomatic Alzheimer's Disease

Richard J. Caselli, M.D.
Presented Mar. 10, 2010

Cardiac Rehabilitation 2010: Update on the Science and Practice of Cardiac Rehabilitation-Secondary Prevention

Randal J. Thomas, M.D.
Presented Feb. 19, 2010

Young, Mobile and Wired: The Prevalence and Impact of Social Media on Children

Nusheen Ameenuddin, M.D.
Presented Feb. 5, 2010

Introducing the Mayo Clinic Peroxisomal Disorders Program

Deborah L. Renaud, M.D. and Shakila P. Khan, M.D.
Presented Jan. 25, 2010

Contemporary Management of Visceral Artery Aneurysms

William Stone, M.D.
Presented Nov. 2, 2009

Abdominal Aortic Aneurysms: an Integrated Approach to Evaluation and Management

Peter Gloviczki, M.D.
Leslie Cooper, M.D.
Terri Vrtiska, M.D.
Michael McKusizk, M.D.
Presented Sept. 30, 2009

Nerve Signal Blocking as an Alternative to Bariatric Surgery

James Swain, M.D.
Presented Sept. 23, 2009

A New Era in the Management of Advanced Heart Failure

Soon Park, M.D.
Barry Boilson, M.D.
Ronald Reeves, M.D.
Presented Sept. 11, 2009

Osteobiologics in Spinal Surgery

Mark B. Dekutoski, M.D.
Presented Aug. 16, 2009

Cronkite-Canada and Other Noninherited GI Polyposis Syndromes

Seth R. Sweetser, M.D.
Thomas C. Smyrk, M.D.
Presented Aug. 13, 2009

Microbes & Obesity: A look at the World Within

John DiBaise, M.D.
Presented July 31, 2009

Hepatology: the Year in Review

J. Eileen Hay, M.B.Ch.B.
Presented July 23, 2009

Carotid Artery Stenting

Brian Chong, MD.
Presented July 17, 2009

Rome Criteria Do Not Help Me in the Clinic (IBS)

Michael Camilleri, M.D.
Presented July 9, 2009

Update on Antiseizure Medications

Joseph Sirven, M.D.
Presented July 8, 2009

Celiac Disease: Not Just About White Bread

Lucinda Harris, M.D.
Presented June 12, 2009

Urologic Robotic Surgery: Past, Present and Future

David Thiel, M.D.
Presented April 15, 2009

Genomic Medicine: Past, Present and Future

Thomas Spelsberg, Ph.D.
Presented Feb. 18, 2009

Cardiovascular Cell Regenerative Therapy

Bernard Gersh, M.B.ChB., D.Phil.
Robert Simari, M.D.
Andre Terzic, M.D., Ph.D.
Presented Feb. 18, 2009

Amyloidosis: The Masquerader of the 21st Century

Morie Gertz, M.D.
Presented Feb. 11, 2009

Erythrocytosis: Mechanisms and a Contemporary Diagnostic Approach

Ayalew Tefferi, M.D.
Presented Jan. 21, 2009

New Therapies for (Type 2) Diabetes

Adrian Vella, M.D.
Presented Jan. 7, 2009

Remembering military nurses on Memorial Day........

What many people tend to forget is that along with the soldiers who go to war, nurses go as well—not to fight in battle, but to help save the lives of injured soldiers and to provide comfort to those soldiers they cannot save. U.S. military nursing has been around for several centuries—since the 1700s. Here are some military nursing facts that you may find interesting, and which might encourage you, as a nurse, to devote a little time this upcoming Memorial Day to paying even a silent tribute to military nurses.

More than 10,000 nurses served in World War I. They traveled across the Atlantic Ocean by ship, and the journey took about two weeks.

Somewhere between 200 and 300 nurses died in World War I. Many contracted illnesses such as scarlet fever and influenza, which took their lives. Some died in military accidents, and some died at the hands of enemy weapons.

In the 1960s and 1970s, the nurses who went overseas to nurse injured soldiers in the Vietnam War were young women who had just graduated from nursing school. This was their first nursing experience, and they served for one year minimum. They could serve longer if they chose to.

As the machines of war evolved, the nurses who served overseas saw and treated injuries they would never have to deal with again. For example, during the Vietnam War, napalm, a flammable liquid that causes severe burns and often death, was a commonly used weapon, and nurses saw its horrible effects.

Today, the nurses who go overseas range in age from 20 to 60, and one-third are men. The service term is six months, but “active duty” nurses can be reposted (sent back) several times.

The Army Nurse Corps became an official branch of the Army Medical Department in 1901. You can learn about joining the Army Nurse Corps on the U.S. Army website.

There are 10 different nursing specialities in the Army Nurse Corps, ranging from Army Public Health Nurses to Perioperative Nurses to Psychiatric Nurse Practitioners.

Military nurses have served in numerous wars, including the Spanish-American War, both World Wars, the Korean War, the Vietnam War and Operation Desert Storm. They have served with NATO troops in Haiti, Bosnia and Kosovo.



During World War II, 67 Army nurses and 16 Navy nurses were held by the Japanese for three years as prisoners of war.

Located near the Vietnam Memorial in Washington, D.C., is a memorial to all nurses who have served in all wars. It’s a bronze statue of a nurse caring for a wounded soldier. As a nurse, hopefully you’ll have the opportunity to visit this memorial someday—if not on this Memorial Day, then perhaps on another Memorial Day, or any day.

Be sure to take time to reflect on your country’s honorable military nursing history, one that still has many pages to be written—since war is unfortunately not history yet.

Read more Scrubs articles about military nurses. http://scrubsmag.com/nurses-important-to-veterans/

Less than a month after "Pearl Harbor" the call went out on the cover of LIFE magazine, "WANTED: 50, 000 NURSES" and they went in droves - The world AND Nursing would be changed forever.

"It (50,000) cannot be met by the 1,300 nurses training schools that bestow some of the 23,000 caps a year. This is the problem to be solved by the 100,000 women volunteers. As nurses' aides, they will release nurses to exercise their special skills...."

 weight management tips for nurses

The message is all around us: To maintain a healthy heart, we need to maintain a healthy weight. As nurses, though, it’s sometimes easier to teach this to others than it is to work on the message ourselves.

Managing your weight doesn’t necessarily mean losing weight. Some nurses are at a good, comfortable weight and only need to be sure it stays at that level. Here are 10 tips to help you manage your weight.

1. Get together with like-minded people.
You may want to join an established weight-loss group or form your own, but whatever group you join, the group mind-set is often helpful to people who are working on losing weight. Setting up a group at work may seem daunting—but a work group has its advantages, the main one being having people around to be accountable to during your work hours.

2. Get your employer on board.
Between working shift work and crazy weather, going out to exercise is not always an appealing option for anyone, let alone tired nurses. What if you could get your employer on board and your workplace became more health-friendly for the employees? After all, healthy employees are generally happier employees. At-work health initiatives can range from holding weekly weight-loss meetings to incentives and room to exercise.

3. Sneak in some at-work exercises.
You may have read some articles geared toward office workers about how they can do some exercises at their desks. As nurses, we do get a good bit of walking done, but we can also squeeze some exercises into our daily routine by taking advantage of our environment. One example is to do toe-rises if you chart while standing. Clench your glutes together while you rise up on your toes, then relax as you go back down. It may not seem like a lot while you’re doing it, but if you steal a few minutes here and there throughout your shift, every shift, there will be a difference down the road.

4. Read Your Care Plan: A Nurse’s Guide to Healthy Living.
The book  Your Care Plan: A Nurse’s Guide to Healthy Living was written by a nurse for nurses. Who better to help advise us on working and living in a healthy way? The book reviews health challenges faced by nurses and offers solutions.

5. Share healthy recipes with other nurses.
Most of us have a favorite recipe or two that we enjoy making and sharing. How about doing a recipe exchange with other nurses—with the challenge that the recipes have to be for healthy, low-fat meals or treats? Who knows? You may end up finding healthier versions of your favorite “naughty” foods. In some workplaces, nurses and other employees have put together cookbooks of their favorite recipes. This initiative is not only helpful for sharing great ideas, but it may also double as a fundraiser for a favorite cause.

6. Lose the self-consciousness.
While this isn’t a verifiable research statistic, it’s likely safe to say that many overweight people who want to go to a gym feel too self-conscious to end up making that commitment of actually joining a gym or group class. If you want to lose weight, it’s important to understand that this goal is about you and only you. Others may notice you in a gym or class, but they’re there for the same thing—so it’s not exactly in their best interest to snicker if they’re in the same situation! Don’t be too embarrassed to go to a gym. Look out for yourself and to heck with what anyone else thinks, if anyone does notice you.

7. Ditch the chaotic eater lifestyle.
If you’re a chaotic eater—eating on the run, grabbing whatever is handy—you will likely have a more difficult time reaching and maintaining a healthy weight than if you have a more scheduled, less chaotic approach to meals. See if you’re a chaotic eater and what you can do about it.

8. Stop thinking of it as dieting.
Dieting has a negative connotation. Dieting feels as if you’re depriving yourself of something. So stop thinking about dieting. In order to lose weight—and to keep it off—we usually need to make some lifestyle changes. This could be cooking healthy meals instead of grabbing what’s available, taking the stairs instead of the elevator and so on. These are changes that we weave into our lives as we go about our day-to-day living. They’re add-ons, not take-aways!

9. Be realistic in your weight loss goals.
You know you need to lose weight. You’ve vowed to lose weight. So why are you this close to failing? Could it be because you set an impossible goal to begin with? You can’t meet an impossible goal, and if you set such goals, you will feel as if you’ve failed. So set realistic weight-loss goals. Either alone or with an expert, calculate the safe and acceptable amount of weight you need to lose. Then look at safe ways to do this. Slow but sure, rather than fast and frantic, will likely help you see you reach your goals.

10. Plan ahead.
Whether you were in the Scouts or not, you likely have heard the phrase “Be prepared.” If you want to lose weight, this is what you need to do. You need to prepare your meal plans, your exercise plans and what to do if your situation or environment changes (vacations, invitations to dinner, etc). By planning ahead, you may avoid many of the pitfalls that affect people who are trying to lose weight.

*see source at title link