OET Speaking Tips and Guide

Speaking tips:

-introduce yourself first

-try to be calm as possible. Calculate the time. Look at the recorder (the time is running and you’ll see it).

-if you feel nervous, its ok not to look at the interlocutor. All the time I was having my exam, I was looking at my cue card.

-write on your cue card! Underline, arrow, write cue words on each question as a guide.

-be symphatetic and emphatize.

-ask wether he is following or if everything is clear, let the patient know you will be glad to explain again if needed.

-comfort the patient

-before ending the role play, ask if there is any other concern you didnt address so u can address it

*if you do not know a particular diagnosis or not sure about the treatment, just invent. Take note that the exam is about English and not about your medical knowledge.

 

But take note that your recording is what’s being graded. There is no camera to tell you you did not maintain eye contact with the patient. If looking at the interlocutor will make you jitter and nervous, better avoid it. A glance once inawhile would be enough.

 

Also go through speaking tasks in the site or book, also listen to BBC health, could guide you on how to speak English well also watch role play videos of oet

Risk For Impaired Skin Integrity: Nursing Care Plan For Risk for Impaired Skin Integrity

Nursing Diagnosis

Risk for impaired skin integrity related to prolonged immobility, poor skin turgor, poor circulation or altered sensation (use one)

 

Objective

Patient will maintain intact skin as evidenced by: no redness over bony prominences, and capillary refill less than 6 seconds over areas of redness.

Intervention

Assess the following predisposing factors:

  • General condition of the client’s skin. Check bony prominences
  • Check patient’s awareness of sensation of pressure and ability to feel pain
  • Check patient’s nutritional status, such as weight and serum albumin levels.

Massage bony prominence to promote circulation and increase tissue perfusion

Clean and dry skin over bony prominences twice a day

In case powder is needed, use medical-grade cornstarch; avoid talc.

Do not burst blisters, wrap them in gauze, or apply a hydrocolloid (Duoderm, Sween-Appeal) or a vapor-permeable membrane dressing (Op-Site, Tegaderm).

Check bed linens and ensure they are straightened without creases, crumbs or particles

Don’t leave patients for so long on bedpan

Move patients gently as dragging them can cause shear forces to exact pressure on the skin

Changing unconscious patients 2 hourly

Ensure patients are getting adequate nutrition and hydration.

 

Clinic Setup Requirements: How to Start a Clinic Business on Your Own

I am Nurse Osagie Merry Osemwengie The medical Director The Mundësi Hospital Limited, Chief Executive Officer Mundësi Group/Health care.

I graduated from School of Nursing University of Benin Teaching Hospital School of Nursing 2014.

Yes I am very young in the profession but My passion for the profession is far older than I am

After graduation, I moved down to Lagos and started working in some private hospitals amongst the best of Best, I saw how the Hospital management humiliate Nurses all in the name of Employment policies….
[8/18, 8:22 PM] ‪+234 810 629 0273‬: Usually I am not usually patient when it comes to given of Justice this saddened Experiences from Medical officers and Humiliation from the Government due to wrong placement of salaries and positioning make me to go into details to find out the cost, process, and Requirement of setting up a private health care facility.
[8/18, 8:22 PM] ‪+234 810 629 0273‬: We all know and are aware that Nurses make 75% of the Health sector and Nurses spends 80% of their time with patient. In all Nigeria Government and its citizens still don’t appreciate the Nurses Effort.

It is Never the Fault of the citizens if you ask me but the fault of the Governmental system of this very country who have portray Nurses as second class Team mates in the health sector.
[8/18, 8:24 PM] ‪+234 810 629 0273‬: The medical officers spends 25% of their total time with these patient and go home with Huge/Fat salaries but, the Nurses whom spends all their time are given crumbs its really Nostalgic
[8/18, 8:24 PM] ‪+234 810 629 0273‬: Let it not be forgotten that When ever an Epidermic break forth, Nurses are the first personnel to be hit!

Nurses are the once that are Abuse, Assaulted, Kidnapped the most, Humiliated amongst the Court sentencing for Misconducts let not remember the wrong Representation given to us.. This is really sad
[8/18, 8:27 PM] ‪+234 810 629 0273‬: ALL OVER THE WORLD TODAY, THERE ARE FEW NURSES ADVOCATE WHILE NURSES ARE EXPECTED TO BE AN ADVOCATE TO PATIENT, NO BODY WANT TO BE AN ADVOCATE TO NURSES…. THIS MENACE IS EVEN WORST IN NIGERIA OUR COUNTRT WHERE NURSES ARE SEEN AS AN UNIMPORTANT MEMBER OF THE HEALTH SECTOR
[8/18, 8:28 PM] ‪+234 810 629 0273‬: Now knowing this, it became Dawn on me to decipher that the Nurses are supposed to be paid higher than the medical officers Due to their vital role in the health sector.

Am not saying the medica officers aren’t important NO they are!!!
[8/18, 8:28 PM] ‪+234 810 629 0273‬: Now I Walk into the ministry of Health And I make enquires and this is what I found out

The Nursing and Midwifery council license issued to the Registered Nurses, are eligible to the Nurse to set up a Nursing Home/Convalescent Clinic

The Registered Midwife have been licensed to set up A Maternity home.

Now this is what we all need to know, Only the Registered Nurses all over the world can practice Health care without the supervision of the Medical officers.

The medical officers can NEVER and Are not allowed to practice health care without the Nurses.

Please we are going somewhere!!!
[8/18, 8:28 PM] ‪+234 810 629 0273‬: ARE WE TOGETHER TONIGHT!!!
[8/18, 8:37 PM] ‪+234 810 629 0273‬: Now out of 100 % of private Hospitals in Nigeria, 55% are own by Medical Officers, 20% are own by Non medical personnel 15% are own by Auxiliary quacks popularly called Auxiliary Nurses and 10% are own by Registered Nurses or Midwife.

The public health sector have been Stolen from Nurses whom are the major Work force reason because we lack a dogged advocate!

As an Ambassador of the United Nations Development Goal (SDGs) I am advocating that Nurses in Nigeria need to go into Private practice Entrepreneurship and by 2030, we want the Nigeria Government to have value on its Nurses when they see that Nurses are capable of managing a facility more than other health personnel.
[8/18, 8:41 PM] ‪+234 810 629 0273‬: But because our founding Ancestors in the profession Never set the foundation straight, we have been bent to suffer the Brunt.

It is also in the constitution of the ministry of health (Nigeria) that Nurses can set up an Hospital facility, provided they EMPLOYED a medical Officer as the operating officer who MUST have a five years Post qualification Experience.

Also Any Nurse above 5years in practice are Now Eligible to set up their own private Facility be it Nursing home or Convalescent clinic for the Registered Nurses, or Maternity Home for the midwife any where in the country Nigeria.
[8/18, 8:42 PM] ‪+234 810 629 0273‬: Now if you recall I said you can set up a clinic with #500,000 right?
[8/18, 8:42 PM] ‪+234 810 629 0273‬: Now some Chief Nursing officers Retired without plan to further Expands and give back to their future professional Generations yet unborn…….

This is why their is no concrete Rules bonding the protective act of the Nigeria Nurses today.
[8/18, 8:47 PM] ‪+234 810 629 0273‬: What are the various step in setting up a facility??

The very first step in setting up a facility, is to have a desire Location in mind.

The second step is to get an Accommodation of a 4 bedroom to 3 bedroom flat in a neat and secure location and pay for it as possible. (yes is acceptable and will be approved)

We all know Lagos, Port Harcourt and Abuja are the most expensive settlement in Nigeria as such, housing is very expensive.

Now most flat cost 200k, 300k in Lagos here where I live is 350k for a 4 bedroom flat

But in some part of this country, is 200k or lesser depends on the Location and settlement.

Now after paying for this flat, all you need do is to Ensure the reception is well groom for welcoming…

Now I always encourage Nurses to have their own personal instrument even when we where in school, we where encouraged and advice to have our own personal equipment.

some nurses do have Stethoscope, sphygmomanometer, delivery set that they use to treat neighbours in the Hood.

Now you can go ahead and do your publicity as you want but not an advertisements on television is prohibited!
[8/18, 8:48 PM] ‪+234 810 629 0273‬: The moment you begin no matter how small, the ministry of Health, has given a 3 months grace to meet up with all the requirements needed in the facility.
Now, there is a Body called ASSOCIATION OF GENERAL PRIVATE NURSING PRACTITIONER (AGPNP)

These association, ensure You are not harassed unlawfully by the ministry of health either through extortion or via Any Dubious means, of course we are in Nigeria.

Let us all be aware that the police have no business with you… The body you have business with are the ministry of health.

The only time you have business with the police is during Gross Negligence and unlawful practices

Even at that, the police are to inform the ministry of health of health of your practices as this is why you registered with them.
[8/18, 8:50 PM] ‪+234 810 629 0273‬: ARE WE TOGETHER TONIGHT???
[8/18, 8:50 PM] ‪+234 810 629 0273‬: Some of the instrument you need to get are:

Autoclave #80k
Stethoscope #5k or 2k
Sphygmomanometer #12k #18k #25k
Dressing pack #10k
Suturing pack #8k
Delivery pack #25k
#Drum set for keping of Gauze #5k
Delivery bed, Patient bed, Baby cot, Drip stand, all at #120k (An iron bender or welder can construct that)

Oxygen Cylinder plus oxygen #40k

Glucometer (Accuchek) #10k

Suctioning machine #50k

Note these instrument are gotten according to your priority as patient begin to come in.
[8/18, 8:50 PM] ‪+234 810 629 0273‬: We as Nurses have to know this today that an Health care facility set up by Nurses Thrives and grow better than an Health care facility set up by these medical Officers

Why?

Because Nurses spend 75% of their time with patient

If the patient want to poo she/he call on Nurses!
If the patient want to piss she/he call on Nurses
If the patient want to charge his/her phone, she/he call on Nurses!
If the patient condition is Not improving, he/she call on Nurses!
If the patient dies, the relatives will held the Nurses accountable!
If the patient run from the ward the Nurses pay the bills!

This is why you have to have your own Healthcare facility, so you will know what you are working for!
[8/18, 8:50 PM] ‪+234 810 629 0273‬: Now take a look at all these instrument listed above, Some of us work in a facility where the monthly generated income are over #3 million still our salary is #50,000 with thank you and they will still deduct from it for coming late to work
[8/18, 8:58 PM] ‪+234 810 629 0273‬: ARE WE STILL TOGETHER TONIGHT??
[8/18, 9:02 PM] ‪+234 810 629 0273‬: There is no better time to begin than now!

if you save #20,000 every month for 2years, you will get #480,000 which is almost enough to kick start this journey of a brand new carrier

When the Medical officers retired, they become visiting consultant in some private Hospitals or government heath facility… But when a Nurse retired, she set up a chemist shop 🤦🏽‍♂🙆🏽‍♂ and until she dies, no body hears of her again😭😰

A former DDNS of a prestige Teaching Hospital was seen selling bed sheet from ward to ward! will a former Medical Consultant do that ??

This is my profession our profession we have to wake up and say to our self I will contribute my quota to make it live!!!

You are only paid 2% of your generated income where you work I realise this when I set up my facility
[8/18, 9:12 PM] ‪+234 810 629 0273‬: IN SETTING UP A FACILITY, THE FIRST STEP IS:

GOOD LOCATION you can’t be in Kano and your facility is in Sokoto… It has to be in your environment where you are used to. The environment that is also populated because of patronage don’t forget as much as you want to serve the community, you are also in to make money!

ACCOMODATION Get an accommodation in that location you have in mind and pay for it…. Don’t forget there is recommended space you can used for a Nursing home/Maternity/Hospital. The recommendation is it should not be less than 3 to 4 bedroom flat. So that a male patient is in one room and female patient is in another room… Not combining a male and female patient together then at night they swap bed 😂😀😀

SAFETY MEASURES ensure the accommodated apartment is in a safe Location from flooding, Bush and free from any Threat of snakes and rodents…. If possible, get a fenced apartment please.🙏🏽🙏🏽🙏🏽

MAINTAINANCE/SET UP: your reception must be neat and well receptive too, and you must have a place for female patient, a place for Male patient, a place for delivery/theatre, a place giving Injection/Treatment room, A consulting room mostly at the Dinning side of the reception, Then you can find a place as pharmacy or dispensary where you will be keeping your drugs… Toilet and bathroom too.

SOUGHTING FOR STAFFS the number of staffs is according to your shift the ministry of health brochure will let you know but most times plus you 4 hospital 5

ASSOCIATION for a Nursing home, the moment you get a location and you have started, you can now locate the Association leader in your community or state and attend their meetings… They will give you letter which you will take to ministry of health to process you registration… Our brother @⁨Collins ND⁩ will tell us more on this please he his a member of ASSOCIATION OF GENERAL PRIVATE NURSING PRACTITIONERS (AGPNP) THE CHAIRMAN OF LAGOS STATE CHAPTER IS ALSO HERE WITH US TOO. If you are settling for an Hospital, then your medical officer will need to get a letter from his association which is ASSOCIATION OF GENERAL PRIVATE MEDICAL PRACTITIONERS AGPMP

REGISTRATION: For a maternity, to register it with ministry of health, you need the license of an RM, and two other health workers like CHEWS credentials, Association (AGPNP) Letter, Community endorsement letter, Medical waste certificate (for Lagos state people), address of your facility and Letter of introduction informing them you have set up a facility.

For a Nursing Home/Convalescent centre, Your RN license, and two other health workers like CHEWS credentials, Association (AGPNP) Letter, Community endorsement letter, Medical waste certificate (for Lagos state people), address of your facility and Letter of introduction informing them you have set up a facility.

For an Hospital, The medical officer license, your RN or RM either one if you have both Perfect, and two other health workers like CHEWS credentials, Association (AGPMP) Letter, Community endorsement letter, Medical waste certificate (for Lagos state people), address of your facility and Letter of introduction informing them you have set up a facility.

TO REGISTER YOUR BUSINESS NAME: you need to go to corporate affairs commission (CAC) office in your State is more easier if you allow a lawyer do it for you… Registering a business name is with Corporate affairs commission (CAC) and is very much more different from registering with the state ministry of health. The Important of registering your business name solely is because of Litigation and Global grant. (Which will be discuss in the Next forum).
[8/18, 9:20 PM] ‪+234 810 629 0273‬: THIS IS WHY I ALWAYS WANT TO REMIND YOU THAT SATISFACTION DOES NOT COME WITH SALARIES…. JUST 2 MONTHS AGO, I RECEIVED MRS ABIOYE AN ADNS OF GENERAL HOSPITAL LAGOS AND WE DISCUSS HOW SHE CAN SET UP HER FACILITIES THE TRUTH IS AFTER RETIREMENT WHAT NEXT???

WHAT PROFESSIONAL INHERITANCE DO YOU HAVE FOR YOUR CHILDREN OR UNBORN KIDS??

ARE YOU EVEN AWARE THAT WHEN YOU RETIRE, YOU ARE SUPPOSE TO BE A BEACON OF REFERENCES TO YOUR YOUNGER PROFESSIONAL COLLEAGUES?? BUT HOW MANY NURSING RETIREES ARE STILL LIVING THEIR DREAMS?

WE ARE GOING TO WAKE UP AND TAKE OVER THE PRIVATE HEALTH SECTOR AND I DON’T CARE AT WHAT COST! I AM READY AND DARING TO PAY THE PRICE……

OSAGIE & MERRY
[8/18, 9:23 PM] ‪+234 810 629 0273‬: LET US EMANCIPATE OUR SELF FROM DECEPTIVE SALARIES

LET ASK OUR QUESTIONS PLEASE!
[8/18, 9:23 PM] ‪+234 810 629 0273‬: I will Stop here for now to answer some questions

Thank you for your time it was not intentional to take your time!!!

Am just provoked and bitter!!!!!
[8/18, 9:57 PM] ‪+234 810 629 0273‬: The challenges am facing now is that there are no enough Nurses in the private health sector to Apply for grant from the United Nations Trust fund as much as Medical officers do!!!😭😰😥 We in the private health sector need more Nurses to set up their facility so we can form a formidable force to tackle quackery because only the private Nursing practitioners can really curb quackery in Nursing.
[8/18, 9:58 PM] ‪+234 810 629 0273‬: Because Nurses are afraid and some of them willing are being restricted by their Husband’s and bad advice that private practice is difficult
[8/18, 10:00 PM] ‪+234 810 629 0273‬: You are even wasting time…. Just go to ministry of health on Monday and tell them you want to upgrade to an Hospital that is all….. please ensure you do that on Monday I will keep in touch please…
[8/19, 1:27 PM] ‪+234 810 629 0273‬: Good afternoon Beautiful and Handsome Nurses……

Let not forget that if you keep postponing your plans it will NEVER come to reality…

All you have to do is to take a bath, take a walk round your community or settlement and Find a comfortable place where you want that Facility to be peg and come home.

When you get home, Go on your knees and cry to your maker what you want from him….

The almighty God who created everything will see your heart and that money will be provided By his grace.

Go out!!!!
Copied

Stimulating Appetite And Nursing management By Nurse Ibrahim Isah Musa

Definition
Any Substance (i.e. drugs, food or hormones) or strategies (e.g. oral care) that can be used to stimulate appetite in order to increase eating desire in anyone.

Appetite is the desire to eat food, sometimes due to hunger. Appealing foods can stimulate appetite even when hunger is absent, although appetite can be greatly reduced by satiety. Appetite exists in all higher life-forms, and serves to regulate adequate energy intake to maintain metabolic needs. It is regulated by a close interplay between the type of food, digestive tract and the brain. Appetite has a relationship with every individual’s behavior.

A loss of appetite occurs when you have a low desire to eat. Different factors can cause poor appetite, including mental and physical illness. If your lack of appetite last more than a couple of days, it can cause weight loss or malnutrition. Not having appetite can befrustrating for any one especially people who are underweight and trying to gain weight or build mass.

Causes
There are various causes that may lead to decrease appetite and subsequently lead to unwanted weight loss
i. Medical conditions (e.g. common malaria, gastritis and stomatitis and so on)
ii. Psychological and psychiatric disorders (e.g. anxiety and depression)
iii. Eating disorders (e.g. anorexia nervosa and bulimia nervosa)
iv. Alcoholism
v. Prematurity
vi. Congenital malformation (e.g. clef plate)
vii. Old age
viii. Pharmacological agent (e.g. digoxin hydralazine)
ix. Visual influence.

Sign and symptoms
Patient with decrease in appetite usually present the following signs and symptoms:
Nausea and vomiting
Regurgitation and rumination
Lump in the throat
Psychological disturbance
Fatigue
Anxious
Anemia
Dehydration
Electrolyte imbalance (e.g. hypocalcaemia and hypocalcaemia)

Nursing management
Assess patient general conditions and re assure patient before and during meal
Give patient oral toilet before and after meal
Provide privacy and allow patient to eat in confortable place needed
Give light exercise for 10-15 minute before eating this help to improve appetite
Administer prescribe appetite stimulant that help in stimulating patient appetite
Avoid any food or beverages that has no over powering smell
Provide patient with different choice of menu
Make food a pleasant experience allow patient to eat in attractive setting, playing his favorite music
Provide patients with snacks between meal and bed time choose food high in calorie and protein
Prove patient with small and frequent food
Continue to re assure patient allay his fear and anxiety.

Education on patient on discharge
i. Advice patient to eat nutrient rich foods
iii. Advice patient to add more calories to his meal
iv. Advice patientmake meal time an enjoyable and social activity
v. patient should learn on how to schedule meal time
vi. Advice patient not to skip breakfast
vii. Eat less fiber
viii. Eat more of your favorite food

Nursing diagnoses in patient with a decrease appetite
Anxiety related to decrease appetite
Risk for unstable blood glucose level
Risk for metabolic imbalance syndrome
Risk for imbalance fluid volume
Nursing intervention
Anxiety related to decrease appetite
Re-assure patient
Stay with patient to allay fear and anxiety during eating
Make meal time a joy able one
Risk for unstable blood glucose level
Provide oral care
Encourage patient to eat high calorie diet
Encourage patient on frequent food intake
Measure patient blood glucose level
Risk for imbalance fluid volume
Give fluid between diet and after dietary intake
Administer calorie rich fluid
Monitor input and output balance
Patient out come
Patient is free from anxiety
Patient fluid volume is restored
Patient nutritional status is stable

By Nurse Ibrahim Isah Musa RN, HND NS, BNSc

What Makes a Good Nurse Manager?

What Makes a Good Nurse Manager

Who is a Nurse manager?

A Nurse manager directs and coordinates a team of Nurses in a medical facility. These managers typically focus on Nurse recruitment and retention, as well as supervise a team of nurses on a daily basis.

The supervisory role means that Nurse managers are responsible for everything concerning the nursing unit, including resources, personnel, patient care problems and budgetary issues.

At times, a Nurse manager collaborates with doctors regarding patient care and treatment, while also bridging the communication gap between a patient’s family and his or her doctor.

Additionally, a Nurse manager represents the team of nurses and communicates the team’s ideas, concerns and needs to hospital management.

Roles/responsibilities of a nurse manager

Nurse managers are expected to recruit, mentor and appraise performance; develop new nurse orientation; maintain a healthy work environment; and monitor and improve patient care.

A nurse manager also functions as the representative of Nurses and often is expected to talk to the top management on behalf of the nurses they lead.

Moreover, Nurse managers are expected to establish and ensure proper inventory of medical supplies and equipment, ensure a healthy and safe working environment, stay constantly updated on patients’ health status and incorporate fresh and proven health care practices for improving patient care.

Top skills needed for effective nurse managers

A Nurse manager is someone who often has a multifaceted knowledge of his or her field. This expertise is why Nurse managers are often in charge of planning, interacting with patients and families, and managing nurses, as well as a host of other responsibilities over the course of their day.

These managers also are adept at working against a strict deadline. Thanks to this
all – encompassing skill set, Nurse managers are not just restricted to the medical industry but also can serve other sectors.

If you’re keen on being a competent Nurse manager, ensure you have the following set of skills:

Communication

Nurse managers know how to effectively communicate with their staff and patients in addition to the doctors and administrators with whom they work closely.

They are expected to be liaisons between the management and nursing teams while ensuring their patients feel comfortable.

Team Player

Nurse managers are accustomed to the dynamics of a team and know how to successfully support them — even in times of conflict. In order to ensure their team is operating effectively, managers also must work to create a sense of trust and togetherness amongst their nurses and staff.

By creating a maintainable bond of trust and coordination, nurses and staff will be far more likely to work without conflict.

Positive Attitude

The medical industry is no stranger to tense and stressful job situations. At such times, a Nurse manager offers support and strength to team members, if needed.

Leadership

Nurse managers know how to lead a team of professionals with confidence and decisiveness, especially in times of high stress and tight deadlines.

Mentoring

A Nurse manager is willing to mentor Nurses whenever possible. Because mentoring plays an essential role in a nursing team’s growth, it is important for managers to guide their team to strive for leadership roles.

If another Nurse takes an interest in a Nurse management role, current managers have the extraordinary opportunity to take those Nurses under their wings to teach them how to successfully move up and manage a group of health care professionals.

Because a Nurse manager is not much different from a business leader, it is important for current or aspiring Nurse managers to acquire these necessary skills in addition to their medical training in order to thrive in their career.

Enjoy a beautiful night rest colleagues.

By Lateef Yusuf Mary

Procedure of Bed Making: Hospital Bed Making Steps

Procedure of Bed Making: Hospital Bed Making Steps

The bed is the most important and essential piece of furniture in the ward. It is the most noticeable to one entering the ward and is the one which, perhaps, concerns the patient most, and upon which his comfort largely depends, as he spends most of his time in it. It also perhaps concerns the nurse most, as the greatest part of her work is around, and with the bed. Its appearance can make or mar the whole appearance of the ward. The manner in which it is made can make or mar the patient’s comfort, and therefore hasten or delay his recovery.

The standard hospital bed is a single bed, six feet and six inches long, three feet wide, and twenty-six inches from the floor, made of steel or enameled iron tubing which does not harbor bedbugs. It is simple, free from decoration, knobs or angles, light, easily moved, convenient to handle, easily cleansed and disinfected, an possesses strength and durability. The height and size while not always comfortable to the patient are convenient to the nurse and doctor in the care of the patient. The castors are made of hard rubber or hard rubber tire, and are an important factor in moving the bed without jarring the patient. The springs are usually the national or woven wire which are the most durable and sanitary.

unoccupied bed making procedure

Why are Nurses Important: What Would A Hospital Be Without Its Nurses?

Why are Nurses Important?

What would a hospital be without its nurses? Not only are they responsible for a patient’s medical wellbeing, they are also round-the-clock caregivers that attend to the mental and emotional health of their patients, and those patients’ family members as well. You can ask almost anyone, and they will tell you about especially attentive nurses who went above and beyond to make their hospital stay a million times better. Now, a new study shows something most patients already know: nurses are essential to the success of a hospital. Without them, patients suffer.

Researchers from the University of Pennsylvania, knowing that nurses could make or break a hospital, sought to study what kind of effects a bigger, happier nursing staff had on the proceedings of a hospital. In order to do this, they looked to the Kaiser Permanente health care system, a health network present in eight states that integrates hospitals, insurance, and doctors’ offices into one system. Kaiser is known to be an exemplary health care organization that many other hospitals have tried to replicate, but with little success. Researchers believe this is most likely due to one key difference: its nurses.

When conducting their study, researchers from UPenn looked at 550 hospitals in California, New Jersey, Pennsylvania, and Florida, including 25 Kaiser Permanente hospitals in California and 56 Magnet hospitals. Magnet hospitals are also known as exemplary health care systems, recognized by the American Nurses Credentialing Center as a great place for nurses to work.

Researchers then administered a survey to nurses, asking them about their work environment, level of education, job satisfaction, and the typical number of patients they see each day. In addition to this, they checked mortality data from each hospital.

“It turns out that, by and large, nursing differences accounted for much of the mortality difference that we saw in Kaiser Permanente hospitals,” Matthew McHugh, a registered nurse and professor at UPenn’s School of Nursing told Yahoo.

Interestingly enough, mortality rates decreased by as much as 20 percent in Kaiser and Magnet hospitals compared to their opponents, and the nursing staff made for “a sizeable portion of the advantage,” the study said.

“It turns out that these differences we see in nursing, in terms of work environment, staffing levels, investment in nursing around a highly educated workforce, those things translate to better outcomes,” McHugh said.

McHugh and his team found that there were a few differences that accounted for this result. The first was that nurses who claimed they enjoyed their work environments were also better at taking care of patients. “We find that places where nurses have a good experience working are places where nurses are better able to do their jobs,” McHugh said. “They’re more autonomous, they’re supported by management, and they’re integrated into hospital decision making.”

Empowering nurses is also essential to creating a better working environment; nurses need to be taken seriously, and feel comfortable telling a physician when something is being handled incorrectly. If nurses are also given the opportunity to make more decisions, patients can receive faster and higher quality care. A study published last year in the Journal of Nursing Administration found that when nurses have more authority within their units, those units report having more effective patient care.

Another way to empower nurses is to show a willingness to make tangible changes that will make their jobs easier. For instance, during the nursing shortage of the early 2000s, Kaiser Permanente worked to make its hospitals cater to the needs of its nursing staff. After investing in research efforts regarding nursing, Kaiser found in studies conducted in both 2005 and 2006 that nurses spent 35 percent of their time documenting patient records. In order to reduce this, Kaiser switched to an electronics-based system for medical records in 2005. It also found that nurses spent a fair amount of time searching for equipment and information, like whether or not a patient’s medication was ready. So it responded by giving nurses electronic notifications for when medications are ready for pick-up.

“We wanted to make sure that we were a place that nurses wanted to work,” said registered nurse Marilyn Chow, vice president of Patient Care Services and Innovation for Kaiser Permanente. “If you have nurses who are happy and joyful at work, they will definitely pass that on and be caring and compassionate.”

Researchers also found that Kaiser and Magnet hospitals were hiring more nurses with Bachelor’s degrees. According to Chow, the nursing field is more complex and demanding than it ever has been before. “The role is not only surveillance, but facilitating and coordinating the care, and not just for one patient, but for four to five patients,” Chow said. “There are so many things to take care of.”

Chow and McHugh also noted that many patients are arriving at hospitals in worse conditions, but leaving hospitals more quickly. Because the length of their stay is shortened, there is more pressure on nurses to spend enough time with patients and their families in order to teach them how to care for themselves when they arrive home.

“Hospitals are very complex, and integrating all of that information requires a certain set of skills and requires you have a pool of knowledge within the overall nursing staff,” McHugh said. When nurses were less educated, the study noted, there were more mistakes being made.

Finally, the study found that the more nurses there are, the better. Kaiser Permanente hospitals are known to have four patients for every one nurse, while non-Magnet hospitals have about a five to one ratio. Quite simply, when there are more nurses, there are more people to care for patients, and those patients receive more personalized, specified attention.

“Nurses are at the bedside and are working with all the other providers,” McHugh explained. “They’re the essential person for monitoring patient condition, and if something bad does happen, intervening and mobilizing the intervention response.”

So, when it comes down to it, a happy hospital means happy nurses. Nurses have always been the lifeblood of hospitals; now, there’s just a study to prove it.

Source: McHugh M, Aiken L, Burns L, et al. Achieving Kaiser Permanente quality. Healthcare Manage Rev. 2015.

Read E, Laschinger H, Finegan J, et al. The influence of nursing unit empowerment and social capital on unit effectiveness and nurse perceptions of patient care quality. Journal of Nursing Administration. 2015.

Body Mass Index Definition, Formula, Equation and Range

Body Mass Index Definition, Formula, Equation and Range

Body Mass Index (BMI) is a way to measure whether or not a person is underweight, overweight or normal weight. It is a calculation that evaluates body mass compared to height. It is widely used to determine if people fall within a weight range that is healthy.

We are living in a time when people are more obsessed than ever in being thin.

Body Mass Index
BMI = Weight (kg) divide by Height (m) divide again by Height.
BMI = 60kg/1.5m
=40 divide again by 1.5m
=26.7
BMI RANGE

18.5 – 24.9 = Normal weight
25.0 – 29.9 =Overweight
30.0 – 34.9 =Obese
35.0 – 39.9 =Grossly Obese
40.0 – Above =Morbid Obese

Summary of the results as per the World Health Organization

body mass index chart

Nurse vs Doctor Pros and Cons: The Only Thing That Truly Separates Doctors From Nurses

Nurse vs Doctor Pros and Cons

Academic Medicine, journal of the American Association of Medical Colleges, has sent out a recent call for articles addressing the 2013 question of the year: “What is a doctor? What is a nurse?” Thirty years ago this would have been an absurd question. Not only would it have been absurd for doctors and nurses, but for patients too. Roles were clearly delineated within the disciplines, and the white coat indicated a doctor and the white uniform and cap identified the nurse.

There are several reasons why we have to ask the question posed by Academic Medicine. A big reason is the entry of women into the field of medicine. Another is the development of advanced degrees for nurses. The computerization of medical records has spurred increases the need for physician extenders to support practices. A huge reason recently has been cost-containment considerations. The erosion of the doctor as an ultimate authority figure and the rise of patient autonomy have leveled the field as well. To some extent access to education is in the mix also.

Educational level is usually part of the definition of a doctor or nurse. This is no longer a reliable indicator. A doctor has an undergraduate degree and an MD. But a doctor might be a DO also, a doctor of osteopathic medicine. A nurse has an undergraduate degree in nursing. Except that a nurse might have an undergraduate degree in something other than nursing, and get the nursing training later in a master’s degree program. Up until relatively recently you didn’t have to have a BSN to be a nurse, an associates degree was enough. Now a nurse might have a master’s degree or a PhD. A nurse practitioner has a master’s degree. A physicians assistant might also.

Authority used to be used to separate doctors from nurses. Doctors can prescribe medicines. But now so can many advanced-practice nurses. Doctors can write orders. So can nurse practitioners. Doctors can examine you and diagnose you. So does your NP.

Nurses and doctors used to look different. The physical appearance and dress of nurses and doctors in hospitals today is actually emblematic of the blurring of the lines of identity that have characterized medicine in recent years. A doctor might wear scrubs; a nurse practitioner might wear a white coat; in the operating room, everybody wears the same thing. Clothing has long been a tangible symbol of turbulent times. The casting off of corsets was a signal of relaxing social restrictions. The shock of a woman wearing pants coincided with women entering the workforce. Burning bras were a way of protesting gender inequality. It is no accident that the shedding of the nurses cap happened around the same time nurses became college educated.

Lifestyle and money? Nope. A primary care doctor makes less than a nurse anesthetist. Some doctors don’t take call anymore, and many nurses do, even those without advanced degrees.

Surely knowledge, skill, and ability separate nurses from doctors? Of course not. Your experienced floor nurse knows way more about medicine than your average intern. Physicians assistants can sew up wounds and assist in surgery. A person who becomes a nurse is just as smart as a person who becomes a doctor, which has always been true but not always acknowledged. An MD is just a piece of paper that gives a person permission to start learning how to be an actual doctor. An RN is much the same. Clinical experience and training are the only things that matter materially to patients. Some argue that training level is also part of the definitional differences between doctors and nurses. Doctor’s clinical training in a formal educational system is usually longer. So you could equivocally say that a doctor has longer training.

I would suggest to my readers that the only thing that truly separates doctors from nurses is ultimate responsibility. The editor of Academic Medicine says in his introductory remarks introducing the question that his daughter was trying to decide between medicine and nursing. This is the decision she must make. Does she want to live with the ultimate responsibility for every patient under her care? Because of our investment of time and money, and presumably because of the economic and social standing granted to us, we doctors bear this ultimate burden. This is not to say that nurses don’t also have a responsibility to their patients and their field, or that they haven’t invested just as much time and money.

I have been both a nurse and a doctor, and am a huge proponent of the expanded role of nurse practitioners. But the law and society have laid the ultimate privilege and burden on the person that people call “doctor.” That’s the difference.

SHIRIE LENG, MD | PHYSICIAN

Shirie Leng, a former nurse, is an anesthesiologist who blogs at medicine for real.

Nursing Uniforms and Infection Control: Nurses Uniform Habour Nasty Germs

Nursing Uniforms and Infection Control

The “scrubs” of intensive care unit (ICU) nurses often pick up disease-causing germs, including those resistant to antibiotics, a new study reports.

“We know there are bad germs in hospitals, but we’re just beginning to understand how they are spread,” said study lead author Dr. Deverick Anderson, an associate professor of medicine at Duke University School of Medicine in Durham, N.C.

These bad germs spread from patients to the nurses’ uniforms (usually the sleeves and pockets) and objects around the room, most often to bed railings, the researchers found.

“This study is a good wake-up call that health care personnel need to concentrate on the idea that the health care environment can be contaminated,” said Anderson.

“Any type of patient care, or even just entry into a room where care is provided, truly should be considered a chance for interacting with organisms that can cause disease,” he added in a university news release.

The study included 40 intensive care unit nurses at Duke University Hospital. Samples were collected from their scrubs before and after each 12-hour shift. Samples were also collected from all the patients the nurses cared for and items in the patients’ rooms.

The researchers focused on five pathogens known to cause hard-to-treat infections, including an antibiotic-resistant superbug called methicillin-resistant Staphylococcus aureus (MRSA).

The study found 22 instances when at least one of the five germs was transmitted from the patient or the room to a nurse’s scrubs. In six incidents, the germs spread from patient to nurse and room to nurse, and in 10 instances, bacteria was transmitted from the patient to the room.

There were no nurse-to-patient or nurse-to-room transmissions, according to the findings.

The study is scheduled for presentation in New Orleans Thursday at ID Week, the annual meeting of the Infectious Diseases Society of America, the Society for Healthcare Epidemiology of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society.

“I think sometimes there’s the misconception that if, for instance, a nurse is just talking to patients and not actually touching them, that it might be OK to skip protocols that help reduce pathogen transmission, like washing hands or wearing gloves,” Anderson said.

“The study’s results demonstrate the need for caution whenever health care providers enter a patient room, regardless of the task they’re completing,” he added.

Anderson noted that previous studies focused mainly on the patient-nurse connection, while this one showed that a patient’s room also poses a threat.

“Our study shows following prevention strategies has to be a top priority, and that health care providers should be looking for ways to improve the likelihood that they are,” he concluded.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Soource HealthDay