Here’s one approach to ending the nursing shortage. Nurseauction.com is a new site that features an auction style marketplace where nurses can bid for shifts that employers have posted. Also, nurses can post when they will available to work, and set their price.

As you can see, I’ve already gotten in on the action:

All kidding aside, I was irked lately by something an agency nurse told me. She said she was asked not to discuss her wages with her co-workers. My feeling on that was that it’s your business if you want to discuss your wages. If a hospital will pay a nurse $33/hour for a shift and an agency will pay a nurse $46/hour for the exact same shift, who are you benefiting by keeping quiet about it? It’s really no secret that agency nurses make gobs more than staff nurses. It’s a trade-off. You trade job security, upward mobility, benefits, and vacation time for higher wages. It would be interesting to see an open market like this one show what a nurse’s services are truly worth.

So if any hospitals administrators are reading this, and know that they will have a vacant shift on April 21st, I will gladly come and work in your ICU for $1893 an hour. In fact, I’ll be there with bells on.

I read this post last night and realized it could have been written about me. I certainly have been doing a lot of complaining lately. A nursing student reading my blog might think twice before continuing with their nursing degree. My question is, what’s wrong with thinking twice about something?

I’ve seen a lot of angry nurse blogs and it concerns me too, but I don’t think the answer is to discourage angry nurses from blogging. To me, angry nurse bloggers = angry nurses, and so there are a lot of unresolved issues within the profession.

John says: “By presenting such a negative picture of our lives, aren’t we, as nurses, beating up those who read our blogs who may be just starting in the profession, or worse, considering joining the profession?”

To me, this couldn’t be further from the truth. When I voice my complaints about the profession, I feel I am doing a service to my readers who are thinking about entering it. I am telling the real story of what it’s like to be a nurse in the hospital. My BSN program did their best to fill my mind with nursing theory, nursing politics, and nursing lingo, but they did very little in explaining what it is actually like to be a nurse, and for that I feel a little cheated at times.

Another thought. The majority of these “angry nurse bloggers” work in hospitals, and hospitals are where the nursing shortage exists. To suggest that all nurses who are unhappy should simply find another specialty, is not really going to do much in the way solving the nursing shortage. There are some very real problems with hospital nursing, and within our health care system in general, and these things issues need to be addressed, not hushed up.

Yes, working as a nurse is frustrating, even infuriating at times. But it’s also exciting, meaningful, and extremely rewarding. And you can find all of these points of view by reading nurse blogs.

Nursing students and novice nurses, take these angry nurse blogs with a grain of salt. People will always complain about their jobs, no matter what profession they are in. On the same token, I would encourage you to take these complaints very seriously because they are real and legitimate. Perhaps a new generation of nurses is needed to actually change things, and to create an environment where nurses aren’t so angry all the time.

Let’s face it. I’ve been blogging about some pretty frustrating topics lately. I think it’s high time we start having some fun around here. With that in mind I will offer you the following warning about this post:

a. It’s not at all about nursing,
b. It may entice you to waste huge amounts of time,
c. It’s unabashedly girly so if you’re not into that sort of thing, feel free to check back later.

So some of you may have noticed that I created a new profile picture. In the process of doing so, I came across this incredibly addictive site, Taaz.com. It’s basically a site that allows you to upload a picture of yourself, and then try out different make-up and hairstyles.

So my first instinct was to try it out and see if it really worked, and I was pleased to see that it did! You can add lipstick, eye make-up, and foundation, and it actually looks somewhat real:

But then I got all crazy and tried to make myself look like a goth girl. Instead I think I ended up somewhere between Loretta Lynne and Kate from the B-52’s:

Then I got even crazier and started photoshopping my new goth girl look:

And now I’ll probably spend the rest of the day playing with this totally addictive site, because that’s just the kind of self-absorbed girl that I am. Hey, at least you will be spared another rant as to why I want to leave nursing, right?

From A Scanner Brightly:

“Health care currently consumes 16 out of every 100 dollars in the USA, but electronic health records are next to non-existent. The few that are in existence don’t talk to any of the others.

If we ran banking like that we’d be… oh wait a minute, we did run banking like that. About a million years ago. Well, thirty anyway.

16% of the US economy runs on scrawly, handwritten notes.“

I would like to expand this thought to computerized physician order entry systems and here’s why:

I made a mistake yesterday. I didn’t just miss one order. I missed A WHOLE PAGE OF ORDERS.

Why? Because the doctor wrote them on a separate page and stuffed them into the side pocket of the binder, rather than putting them in the proper place.

I looked through the chart five different times, looking for an order and I couldn’t find one. There was nothing but blank orderset sheets, and a blank order page. I wasn’t too surprised though. This kind of made sense to me because there was no fellow in the case, and usually the fellow writes the orders. In fact, if you ask an attending to write an order they kind of turn away in a huff and say “I don’t do that. Get the fellow to do it.” In this particular case, I just followed the basic (unofficial) protocol for this procedure (Vital signs Q 15 minutes x 4, then q30 minutes x2, then Chest X-ray after 2 hours, then page the physician after the CXR has been read.)

I did all of that and paged the Radiology attending. He never responded. So after about 20 minutes I paged the urology attending. He called me right away and asked, “What about the CBC?”

“I didn’t draw a CBC.”

“Well I ordered one hours ago.”

“I’m sorry but I didn’t see any orders in the chart.”

“Well I ordered it.”

“Okay, well I’ll check the chart again, and in the meantime I’ll draw the CBC.”

I went back to the chart and low and behold there was an entire page of orders, stuffed into the side pocket, where miscellaneous patient info usually goes.

Fortunately no one was harmed, although the patient did have to stay in the recovery room for an additional hour because I didn’t see the order.

This was my mistake and believe me, I owned up to it. I apologized to the patient for creating this delay and I apologized to the attending for missing his order, but I know that this mistake could have been avoided if the recovery room used a computerized ordering system.

So this brings me to reason #2 I am thinking about leaving nursing: Being a nurse in the hospital is essentially about carrying out orders. You can sugar coat it all you want, and talk about how there’s a big difference between nursing care and medical care, but in the end, physicians write orders, and nurses carry them out. (And by the way, my BSN program did their best to convince me that this is not the case, but after three years of working in the hospital, I’m pretty certain that this is the case.) And yet there is such a lack of standardization in the way that doctors write their orders, so it can be difficult to carry them out. Do the recovery room nurses care about this? The answer appears to be no. Whenever I ask the nurses about this situation their reply is this, “Oh we’ve been fighting this battle for years. Nothing ever changes.”

How do you get beyond that kind of apathy?

Here’s a daunting question:

Is the convenience of taking a verbal order worth your nursing license?

When you practice nursing, you kind of have to look at each patient as a legal liability for yourself. At least that is what you are advised to do from the very beginning. Every order that isn’t written correctly, or doesn’t make sense has the potential for turning into a liability for your license. That is why nurses document the crap out of everything, and that is why our motto is, “CYA.”

So in the ICU, you typically have two patients. In the recovery room you might have 10-15 patients (or more) in one day. So does that mean your legal liability goes up accordingly? Not exactly. The ICU patients are much more sick and you are completing many more orders per patient, so most likely it equals out.

But this is the part that scares me. Part of a nurse’s job is to make sure the doctor’s orders are written correctly. In the ICU this is a lot easier. In the recovery room it’s not. I get really tired having to remind the MDs to write a “discharge to home” order. It’s usually pretty obvious that the patient is going home, yet if the doc doesn’t write for it, and I send them home and something bad happens, I am potentially liable.

It seems like I carry out tons of verbal orders in the recovery room, and the physicians rarely cosign these orders. So from a legal point of view, it’s like the order never happened.

A minor annoyance? Not really. It’s actually one of the reasons I am considering leaving nursing, because if a physician is too busy to write or cosign an order, and I have carried it out, my license is on the line, and I’m not cool with that.

In a perfect world it would be the other way around.

Fortunately, my husband has just landed a sweet new job and will be compensated enough so that I no longer have to work. (Don’t hate me, please.) It’s brought about an interesting question:

Would you continue to be a nurse if financially you didn’t have to?

In my case, I’m not quite ready to figure out what I will be doing with this new financial freedom. My full-time contract will be finished on April 12th. There are so many options. For now, I will definitely be spending a lot more time at home with baby Ben, and I will continue to work 1-2 days a week at the hospital, just to stay in the game.

In the meantime this is what I’m considering:

• Full time mom (and blogging as much as I can)
• Picking up where I left off with web/graphic design (freelancing maybe?)
• Graduate school (In what though? Health care IT? MBA? MFA? I’m all over the place with this one)

Notice the lack of the word “nursing” in any of these options.

Yes, I’m afraid it’s true. I’m kind of losing my passion for nursing. It might simply be that working in the recovery room is less than inspiring. When my contract is up, I’m going to try and pick up some MICU shifts to see if that sparks my interest in nursing once again. In the meantime, I will try and blog about what it is about nursing that’s starting to bother me, and maybe the blogosphere can help me put things in perspective.

photo credit: ronnie44052

I’ve been getting a lot of google traffic lately from this particular phrase:

“hillary clinton nurse overpaid”

On first thought you would think I would welcome this traffic, because it might suggest that people are interested in a nurse blogger’s view of politics.

Unfortunately, this isn’t the case, at all.

The most likely scenario is that someone out there heard that Hillary Clinton had uttered the phrase, “nurses are overpaid and undereducated.” and they are trying to somehow to validate this with a reference. Well, I’m here to tell you that you are not going to find it on this blog, and I don’t think you are going to find an accurate reference anywhere on the Internet, including snopes. If you really are desperate to find a source for this, you’re going to have to do a Lexis Nexis search, because the rumor is that it was said sometime around 1992, before the Internet has bloomed into the enormous melting pot of facts, rants, rumors, and opinions that it is today.

Here’s an idea: Instead of investing your time trying to find a source for this unlikely phrase, why not participate in a discussion about what each candidate has in the works for health care reform?

Hillary Clinton says this.

Barack Obama says he’s going to do this.

and John McCain is planning on doing this.

Which plan do you think could actually work?

Loved this “spirited” thread on Digg about Google’s plans for storing and accessing health records. Granted, some of the Digg users are a wee bit paranoid, (my favorite comment being “Hitler and Stalin were minor league compared to Page and Brin,”) it is a worthwhile discussion. It’s completely understandable for people to have questions about privacy, and how their health records will be used in a database created by Google.

My question is, if not Google, then who?

(Incidentally, Microsoft is also in the running with HealthVault, and now they are offering 3M in funding for health care applications in the form of the Be Well Fund.)

Patients need to have access to their own health record. It irks me to no end that I don’t have access to mine, and if I wanted to access it I would have to jump through countless hoops and wait months to see it. An example: I tell my doctor that I am interested in my hematocrit results. I fill out some forms, requesting this information thinking I will get some actual results, only to to get a piece of paper in the mail 6 weeks later saying, “Your CBC was normal.” Um, thanks for note, but I’m still not sure what my hematocrit actually was.

And what about when you leave one practitioner to start seeing another? I was almost precluded from using a birthing center when I switched from an OB to my midwife. I was told that it would take 6-8 weeks for my records to be transferred (I was due in 4 weeks). These records were sitting in an office and all they had to do was hand them to me so I could walk two floors down and give them to my midwife!

It’s true that if Google ends up being the one to provide this technology, then they will have access to your health records, and the possibility exists that they will use this to somehow turn a profit. I’m not sure why “profit” has become such an objectionable word these days. But the reality is that profit motivates innovation.

Here’s an idea. Let Google do their thing, but hold them fully accountable to the rules and regulations of HIPPA. In fact, it looks like they are already working within this framework with the Clevelend Clinic pilot program, as reported by ZDNet:

This data transfer will not be handled by Google. Instead users will be directed to the Cleveland Clinic site, which acts as a Business Associate of Google in this case. The Clinic is a covered entity under HIPAA, and Google will not store its data, nor distribute it. The consumer will get their data from the Clinic, then control it through Google.

Otherwise, what is the alternative? Should we trust the government with this herculean task? Good luck getting it done in this century. Besides, then the Digg enthusiasts would ranting about how Big Brother is watching your cholesterol.

Did you ever notice a phrase that you start to hear in one or two places, and then it starts to spread like wildfire to the point that every time you hear the phrase, you want to cringe? For me, the phrase That Being Said, is rapidly becoming just such a phrase.

So I am asking you to think before you use it, and I am even offering you some tips on how to avoid it.

This is how it is normally used:

Blogging is hard work. It requires concentration, motivation, and relentless editing. That being said, I love to blog.

*cringe*

Next time you are tempted to use that phrase, think about what else you could put in the sentence. Last time I checked there were 10 gazillion blogs out there and so it pays to differentiate yourself from the crowd. Here are some suggestions:

I love to blog, despite the fact that it requires concentration, motivation, and relentless editing.

Blogging tends to require hard work in the form of concentration, motivation, and relentless editing; however, I love to blog.

Blogging is hard work in that it requires concentration, motivation, and relentless editing. Nonetheless, I love to blog.

Blogging is hard work in that it requires concentration, motivation, and relentless editing. Still, I like blogging.

I’ll admit that there still might be some appropriate places to use this phrase (see? I could have used it in this sentence but I restrained myself.) All I am saying is, think before you use it, (or any overused phrase for that matter) and you will elevate your level of writing.