--- In mpoweryournurses@yahoogroups.com, "Tracy Kaltenbacher"
<tkaltenbacher@...> wrote:
>
> We are exploring remote monitoring medical patients in our Medical
> Surgical units.  These nurses have no cardiac or even basic ecg
> experience/education.  I'm trying to find out how other hospitals
> perform remote monitoring and how to educate/support my nurses when
> basic ecg is not a requirement of their position.  What happens in
your
> hospital?  What protocols or resources do you have in place, and
more
> importantly what works well?
> Thank you!
>
> Tracy Kaltenbacher
> Clinical Nurse Educator
> Medical Surgical Module
> Renown Regional Medical Center
> Reno, NV
> tkaltenbacher@...
>
Tracy,
  I know of one hospital system here in AZ that moved to that model.
When they did they required all of thier nurses to become ecg trained
through an in house program with in the year. Untill which point all
monitors were watched by moniter techs in a centeral location in a
make shift room.
Katrina

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----- Original Message -----

From: Tracy Kaltenbacher

To: mpoweryournurses@yahoogroups.com

Sent: Tuesday, July 15, 2008 3:28 PM

Subject: [mpoweryournurses] cardiac monitoring in Med Surg

We are exploring remote monitoring medical patients in our Medical
Surgical units. These nurses have no cardiac or even basic ecg
experience/education. I'm trying to find out how other hospitals
perform remote monitoring and how to educate/support my nurses when
basic ecg is not a requirement of their position. What happens in your
hospital? What protocols or resources do you have in place, and more
importantly what works well?
Thank you!

Tracy Kaltenbacher
Clinical Nurse Educator
Medical Surgical Module
Renown Regional Medical Center
Reno, NV
tkaltenbacher@renown.org

We are exploring remote monitoring medical patients in our Medical
Surgical units.  These nurses have no cardiac or even basic ecg
experience/education.  I'm trying to find out how other hospitals
perform remote monitoring and how to educate/support my nurses when
basic ecg is not a requirement of their position.  What happens in your
hospital?  What protocols or resources do you have in place, and more
importantly what works well?
Thank you!

Tracy Kaltenbacher
Clinical Nurse Educator
Medical Surgical Module
Renown Regional Medical Center
Reno, NV
tkaltenbacher@...

Flowers brighten up any room… that is already bright.

A local flower shop promises that flowers will brighten up any room,
but I doubt that they will do very much for my basement. I agree
that flowers would add a nice touch of color to a room that is
already neat and attractive, but flowers are not going to change a
room from drab to beautiful.

The same can be said for your PowerPoint presentation. It is a nice
way to illustrate a point, but PowerPoint won't save your
presentation. Content must come first, and once your content is
extraordinary, then PowerPoint can help you illustrate it. A bad
PowerPoint presentation will have the same impact as a bouquet of
dead flowers. It will be distracting at best and offensive at the
worst.

When you begin developing your next presentation, spend at least 90%
of your time developing the content. Decide what you need to teach
and figure out what would be the best way to teach it that involves
the most number of senses. We retain more of what we see, hear, and
feel.

Once the content is developed, then start thinking about how you can
illustrate it with your PowerPoint presentation. Here are some tips
to help you make your next PowerPoint presentation better:
1. Less is better: only one idea per slide, clearly
illustrated, and with as few words as possible.
2. The rule of sevens: only seven words per line, and only seven
lines per slide.
3. Pull important words out of the handout material to use on
your slides. Don't use PowerPoint as your outline and read from it
(a good cure for insomnia).
4. Animation can help illustrate a point, but is otherwise
distracting. Remember that the focus should be on you, not the wild
slides flying in and out.
5. Complex charts and graphs are better in a handout. They will
be too small to see on the screen, and are boring.
6. Like a bouquet of flowers, complementary colors are nice.
Avoid florescent or clashing colors. The idea is to make your slides
interesting, not obnoxious.
7. Trim it, prune it, and shape it for maximum impact.
Eliminate anything that doesn't help you teach the primary principles
of this lesson.
8. Avoid clip art! Use pictures instead. If you have a complex
concept to explain, use a picture and describe it with your
presentation.

PowerPoint can be an attractive way to illustrate your ideas when you
teach, but if it is not used correctly it will be distracting, and
eventually boring. The point of your teaching is the content. Spend
your time on the content and use PowerPoint to illustrate your most
important points and you will transform your next presentation from
ordinary to extraordinary.

Get more help with your PowerPoint presentations:
http://www.sethgodin.com/freeprize/reallybad-1.pdf

Best wishes,
David W. Woodruff, MSN, RN-BC, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.dwoodruff.com

Nurses are highly valued by society.  I've heard about our nursing
leaders getting up in arms about the way nurses are portrayed on TV.
However, six out of the last seven years the Gallop Poll has listed
nurses as being the most honest and trusted profession.  That is No. 1;
above physicians, clergy and even school teachers!

I think is important to know that society thinks very highly of us, but
we have to do our part and live up to that reputation.  This week
consider this:  do your actions live up to the expectations of society
as the most ethical and trusted profession?

Best wishes,
David W. Woodruff, MSN, RN, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.dwoodruff.com

Transformation is defined as a significant change in the character,
or nature of someone by the WordSmyth dictionary. It involves a
strong emotional impact to produce that kind of change. Simply
sharing information is not enough. Even testing or threats of
demotion or financial penalty won't do it. The impact has to hit at
the core of a person's being. Transformational Learning involves
turning information into understanding.

What kind of education can have a transformational impact on your
nurses? Education that strikes a cord with them, education that
makes them say "aha!" Nurses often talk of intuition; that sense
that something is wrong, but they just put a finger on what it is: a
sense of doom that a patient is going to crash, but you don't know
why. This is a highly emotional experience. The nurse knows
something is wrong but can't identify it. Often they will call the
physician hoping that she will be able to articulate the problem and
solve it. This nurse is reaching out for an answer, but can't find
it. How frustrating!

When your education can put into words what the problem is and how to
solve it in a manner that is practical, it will hit on a highly-
emotional issue for the nurse. This is an opportunity to see
transformation in action. Informational learning is just the facts;
it has no lasting impression. But, transformational learning is
inspirational. It renews the excitement, commitment, and passion for
the profession. Seek substantial change…seek transformation!

Best wishes,

David W. Woodruff, MSN, RN, CNS, CEN
President, Ed4Nurses, Inc.
Empowering Nurses to Become Extraordinary
www.Ed4Nurses.com
www.dwoodruff.com

Recently a student used our CCRN Test Prep program and took the exam
and failed. She wrote to me asking about how to use our 100% passing
guarantee. In her email, she was very critical of our product
stating that it did not adequately prepare her for the CCRN and that
the questions were much harder than she thought they would be. As
part of our process to prepare her to retake the exam we embarked on
private coaching. After her first couple of coaching sessions she
returned to her studies.

A month later, and right before her second attempt at the exam, we
talked again. Her whole attitude and outlook had changed
considerably. At this point she talked about how much she had
learned, about the improved interactions she had with physicians she
worked with, and her increased ability to explain complex clinical
scenarios to her peers.

So what had really changed? The program was the same. What changed
was her perception of her responsibility for preparing for the exam.
In his book "Winning with People," Dr. John C. Maxwell describes this
as the Lens Principle.

Here he says "who you are determines what you see." When you are a
person who believes she is powerless over her situation, what you
will see is other people controlling your destiny. When you see
yourself as being empowered to control your life and your career,
then you become internally motivated to seek the results that you
desire.

Dr. Maxwell goes on to state that "who you are determines how you see
others," and "who you are determines what you do." When I hear
people make comments like "nothing will ever change around here"
or "I am just a nurse" I know that they are going to have a hard time
getting what they want out of their nursing career. It is not until
you see yourself as being empowered to create change and view
yourself as a change agent that you will be able to use the power
that you have to implement the change you want to see happen.

As motivational speaker Zig Ziglar says, "when you are tough on
yourself, life is going to be infinitely easier on you."

Best wishes,

David W. Woodruff, MSN, RN, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.dwoodruff.com

The mnemonic "FEAR" is excellent, and one that I will remember (False
Evidence Appearing Real).  Sometimes nurses don't stand up for other
nurses, as they watch one of their own subjected to unfair treatment.
  The cost of speaking up can seem prohibitive, but the cost of not
speaking up is even higher.  It's a tough spot to be in sometimes.

Encouragement.  Although I do not profess to be a dictionary nor do I
know anyone named Webster, it seems to me that the
word "encouragement" means more than to just support.

I've heard the word "courage" defined as: "acting in spite of fear."
Instead of being fearless, the courageous one may be afraid but she
doesn't let it stop her.  Taking a certification exam when you are
afraid of failing is one way to be courageous.  The Encarta
dictionary describes courage as the "quality of being brave."  I'm
not sure that the nurse taking the certification exam would consider
herself "brave," but she is "acting in spite of fear."  Either way,
she is not letting fear control her.

It has been said that F.E.A.R. is an acronym for False Evidence
Appearing Real.  In other words, you are interpreting the situation
as being dangerous, difficult, uncertain, or painful.  Another person
might interpret the same situation as being enjoyable or
exhilarating.  Taking a certification exam is probably not enjoyable,
but many people will interpret it as merely inconvenient instead of
being difficult, uncertain, or painful.  The key is that most of the
fears that keep you from achieving your dreams are "false evidence."

The prefix "en" means "to put into" or "to cause to be."
To "encourage" could be defined as "to cause to act in spite of
fear."  Please take note of the fact than it says "to cause to act;"
not simply to support.  So with my definition of "encourage," you
would have to go beyond simply being nice and supportive; instead you
would have to provide sufficient amounts of inspiration, motivation,
and support to cause the other person to act.

Words alone will probably not inspire a sufficient amount of courage
to act in the face of fear; but your actions often can.  When you act
in spite of fear it inspires others to do so; and when they see how
much you have changed as a result of acting with courage it motivates
others too.

Mary, a 74 year-old critical care nurse, studied for the CCRN, took
the test, and passed it!  Even though she was planning to retire at
75, Mary wanted to be a role-model for the other nurses in her unit.
Mary was afraid that she would not pass the exam (that's why she was
at my CCRN class), but she acted anyway because her desire to make a
difference and inspire others became more important to her than her
fear.  In other words, she acted in spite of fear so that she could
encourage (cause to act in spite of fear) her co-workers.

What's holding you back?  Is it the False Evidence Appearing Real; or
is it the lack of a desire to make a difference?  When you act in
spite of fear and display courage it inspires others to do so too.
What have you accomplished that you can share with others
to "encourage" them to act in spite of their fear so that they can
make a difference?

"The only opinion about your dream that really counts is yours. The
negative comments of others merely reflect their limitations - not
yours."  -Cynthia Kersey, Author of Unstoppable

Best wishes,
David W. Woodruff, MSN, RN, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com
www.DWoodruff.com

Philosophically nurses know that research is important to clinical
practice.  In a recent study by Donna Jo McClosky, nurses agreed that
research helps to build a scientific knowledge base for practice and
that research is needed to continually improve nursing practice.
Nurses would even change their practice based on research findings.
Yet, those same nurses that were surveyed stated that nursing
research is not conducted in their hospital and that occupational
therapists and physical therapists would not support their use of
clinical research; nor would nurses support the use of research
findings for their peers.

Most nurses also said that they did not have access to research
findings at work and that there were no in-service programs presented
on research findings at their hospital.  There was also the feeling
that there was no time to read about research at work and that
colleagues didn't bring current research to the attention of staff
nurses.

As a staff nurse, these findings should make you a little
uncomfortable.  If, as the survey indicates, research is important to
your practice, then you ought to be finding ways to bring research to
work to share with your colleagues; and to base your practice on
research principles.

As an educator or manager, understand that many nurses in the
clinical setting do not see evidence of your dedication to
integrating research into practice and that your institution needs to
make sure that research efforts are visible and that the results of
both internal and external research needs to be clearly evident to
the nurse practicing at the bedside.

From:  McClosky, D.J. (2008).  Nurses' perceptions of research
utilization in a corporate healthcare system.  Journal of Nursing
Scholarship 40:1039-45.

Best wishes,
David W. Woodruff, MSN, RN, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Cool new ideas come from thinking in ways we have never thought
before. In years of attending staff meetings, committee meetings,
and the like, I've rarely seen a cool new idea expressed. Typically
these formats are designed to transmit information in a way that
stifles imagination and resists challenging the status quo.

Recently, my company started using a program call "TrainOne" by
Jeffery Gittomer. It is a training program designed for sales
people. My intent is not to train better sales people, but rather to
get fresh ideas and stimulate thinking. The process of sales is
really just persuasion. I think all nurses should study sales in
order to learn how to be more persuasive. We all have to persuade
someone of our ideas: persuade our kids to pick up their rooms,
persuade our administrators to implement a new protocol, or persuade
our patients to take their medications. Persuasion is an important
skill, and sales training is a great way to learn it.

But mostly, I like the idea of looking outside of our own industry
for cool new ideas. When we are only looking at how we do things in
comparison with how others in our own industry do them we are not
challenged to stretch very far. Nursing education is a good
example. We teach new nurses basically the same way we have for
years. Even our new "high-tech" classrooms are not really
innovative, they've just added new projectors and screens so that our
boring PowerPoint slides look better.

If you want to be a better educator, I would suggest taking a class
in the elementary education department at the local college. These
teachers have cool ideas! Or, attend a seminar on sales, and learn
more about how to persuade people – isn't that what teaching is
about – persuading your staff to do something new?

If you want your staff to "get it" without having to repeat it over
and over again, you've got to get some new and cool ideas. And the
best ones come from outside of our community. Look around for cool
people, cool ideas, and wacky thinkers. Get some of these people on
your committees, or in your department. Ask them for ideas. Forget
about "thinking outside the box" and discard the box entirely – think
outside the medical industry! You will find that when you start
actively searching for cool ideas, that they will start coming to you
from everywhere. Ask some wacky thinkers for their suggestions and
really give the idea some thought.

Cool new ideas will keep your material fresh, make your teaching more
interesting, and make your job a lot more fun! Make it your mission
to find them and use them. The results are extraordinary!

Best wishes,

David W. Woodruff, MSN, RN, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

Get all your nurses certified!
Check out www.100K-Certified-Nurses.com

--- In mpoweryournurses@yahoogroups.com, Dawna Cato <dcatomsn@...>
wrote:
>
> That's great Kathleen, I have worked in a hospital for three years
with no educator at all.  It is very true that new grads are often
found on the night shift, this along with fewer resources; it is no
wonder we have poorer outcomes.
>   Dawna
>
> Kathy Mac <mccarthy6613@...> wrote:
>
>   We have night educators 1 for critical care and 1 for med surg
that work during the 7p-7a shifts each of them 4 days a week and may
not necessarily be on the same night. They also work weekends, round
on the units and respond to every code.
>
>   Kathleen McCarthy
>
>   "Education costs money, but then so does ignorance"
>    - Sir Claus Moser
>
>
>
>   ----- Original Message ----
> From: "tourette@..." <tourette@...>
> To: mpoweryournurses@yahoogroups.com
> Sent: Tuesday, March 18, 2008 9:51:05 PM
> Subject: [mpoweryournurses] Re: Cardiac arrest survival is worse on
nightshift and weekends.
>
>
>
> On day shift there is ususally enough MD's around to respond. Having
> access or should I say, no access to MD's at night has always been a
> problem. Also the response time when calling a MD at night can
impact
> patient outcomes.
>
> Joan
>
> --- In mpoweryournurses@ yahoogroups. com, "David Woodruff"
> <dwoodruff@ ..> wrote:
> >
> > In a recent study reported in the February 20, 2008 issue of JAMA,
> > Dr. Peberdy and Associates found that survival from cardiac
arrests
> > was worse on nightshift and on weekends. Many previous studies
have
> > also determined that other medical errors are higher at night and
on
> > weekends as well. The author suggests some explanations for the
> > discrepancies such as differences in staffing levels, expertise of
> > personnel, and monitoring practices.
> >
> > Given that staffing levels will probably always be less on
nightshift
> > than on dayshift, the nurses working the nightshift need to have
more
> > resources available to them to appropriately respond to emergency
> > situations. In addition, the nightshift often hosts the more
junior
> > staff who may be lacking in their assessment skills. The
researchers
> > did not suggest a specific mechanism causing the decrease in
survival
> > but it is likely that a delay in assessing and/or treating the
> > cardiac arrest is what caused the poor outcomes.
> >
> > Nightshift staff need training, mentors and additional resources
so
> > that they can respond appropriately to emergency situations when
> > staffing is lacking.
> >
> > From:
> > Perberdy, M.A. et al. (2008). Survival from in-hospital cardiac
> > arrest during nights and weekends. JAMA, 299; 785.
> >
> > Best wishes,
> > David W. Woodruff, MSN, RN, CNS, CEN
> > President, Ed4Nurses, Inc.
> > www.Ed4Nurses. com
> >
>
> I find the comment about new grads very interesting.  The new grads
we see haven't experienced the off shifts, and have no intention of
working them.  Weekends in many hospitals are staffed by bonus
workers who have no idea of the system, lousy orientation, and no
vested interest, except work 24 and get paid for 36.  I may sound
cynical, but I've earned it!
cak131343
>
>
>
>
>
>
>
>
>
>
> Dawna Cato, BSN
>
>
> ---------------------------------
> Be a better friend, newshound, and know-it-all with Yahoo! Mobile.
Try it now.
>

We have night educators 1 for critical care and 1 for med surg that work during the 7p-7a shifts each of them 4 days a week and may not necessarily be on the same night. They also work weekends, round on the units and respond to every code.
 

Kathleen McCarthy

 

"Education costs money, but then so does ignorance"

 - Sir Claus Moser

 

----- Original Message ----
From: "tourette@sbcglobal.net" <tourette@sbcglobal.net>
To: mpoweryournurses@yahoogroups.com
Sent: Tuesday, March 18, 2008 9:51:05 PM
Subject: [mpoweryournurses] Re: Cardiac arrest survival is worse on nightshift and weekends.

On day shift there is ususally enough MD's around to respond. Having
access or should I say, no access to MD's at night has always been a
problem. Also the response time when calling a MD at night can impact
patient outcomes.

Joan

--- In mpoweryournurses@ yahoogroups. com, "David Woodruff"
<dwoodruff@. ..> wrote:
>
> In a recent study reported in the February 20, 2008 issue of JAMA,
> Dr. Peberdy and Associates found that survival from cardiac arrests
> was worse on nightshift and on weekends. Many previous studies have
> also determined that other medical errors are higher at night and on
> weekends as well. The author suggests some explanations for the
> discrepancies such as differences in staffing levels, expertise of
> personnel, and monitoring practices.
>
> Given that staffing levels will probably always be less on nightshift
> than on dayshift, the nurses working the nightshift need to have more
> resources available to them to appropriately respond to emergency
> situations. In addition, the nightshift often hosts the more junior
> staff who may be lacking in their assessment skills. The researchers
> did not suggest a specific mechanism causing the decrease in survival
> but it is likely that a delay in assessing and/or treating the
> cardiac arrest is what caused the poor outcomes.
>
> Nightshift staff need training, mentors and additional resources so
> that they can respond appropriately to emergency situations when
> staffing is lacking.
>
> From:
> Perberdy, M.A. et al. (2008). Survival from in-hospital cardiac
> arrest during nights and weekends. JAMA, 299; 785.
>
> Best wishes,
> David W. Woodruff, MSN, RN, CNS, CEN
> President, Ed4Nurses, Inc.
> www.Ed4Nurses. com
>

----- Original Message -----

From: Didion, Patricia - Nursing, Clinical Nurse Specialist

To: mpoweryournurses@yahoogroups.com

Sent: Friday, March 21, 2008 9:39 AM

Subject: RE: [mpoweryournurses] Re: Cardiac arrest survival is worse on nightshift and weekends.

I need copies of unit educator job descriptions /requirements .Does anyone have any to share ? 

Patricia A.Didion, MSN RN

Clinical Nurse Specialist

Firelands Regional Medical Center

Sandusky, Ohio

Ph: 418 557 7839

didionp@firelands.com

 

---

From: mpoweryournurses@yahoogroups.com [mailto:mpoweryournurses@yahoogroups.com] On Behalf Of Kathy Mac
Sent: Friday, March 21, 2008 8:24 AM
To: mpoweryournurses@yahoogroups.com
Subject: Re: [mpoweryournurses] Re: Cardiac arrest survival is worse on nightshift and weekends.

 Our positions are all filled. You can read about the value in my article:Critical Care Nurse June 2004 Breaking Tradition. May have some insight

 

Kathleen McCarthy

 

"Education costs money, but then so does ignorance"

 - Sir Claus Moser

 

----- Original Message ----
From: Joan Ahern <JAhern@centinelamed.com>
To: "mpoweryournurses@yahoogroups.com" <mpoweryournurses@yahoogroups.com>
Sent: Thursday, March 20, 2008 10:08:37 AM
Subject: RE: [mpoweryournurses] Re: Cardiac arrest survival is worse on nightshift and weekends.

What a treat, do you need an educator J

 

---

From: mpoweryournurses@ yahoogroups. com [mailto:mpoweryourn urses@yahoogroup s.com] On Behalf Of Kathy Mac
Sent: Wednesday, March 19, 2008 3:39 AM
To: mpoweryournurses@ yahoogroups. com
Subject: Re: [mpoweryournurses] Re: Cardiac arrest survival is worse on nightshift and weekends.

 

We have night educators 1 for critical care and 1 for med surg that work during the 7p-7a shifts each of them 4 days a week and may not necessarily be on the same night. They also work weekends, round on the units and respond to every code.
 

Kathleen McCarthy

 

"Education costs money, but then so does ignorance"

 - Sir Claus Moser

 

 

----- Original Message ----
From: " tourette@sbcglobal .net " < tourette@sbcglobal. net >
To: mpoweryournurses@ yahoogroups. com
Sent: Tuesday, March 18, 2008 9:51:05 PM
Subject: [mpoweryournurses] Re: Cardiac arrest survival is worse on nightshift and weekends.

On day shift there is ususally enough MD's around to respond. Having
access or should I say, no access to MD's at night has always been a
problem. Also the response time when calling a MD at night can impact
patient outcomes.

Joan

--- In mpoweryournurses@ yahoogroups. com, "David Woodruff"
<dwoodruff@. ..> wrote:
>
> In a recent study reported in the February 20, 2008 issue of JAMA,
> Dr. Peberdy and Associates found that survival from cardiac arrests
> was worse on nightshift and on weekends. Many previous studies have
> also determined that other medical errors are higher at night and on
> weekends as well. The author suggests some explanations for the
> discrepancies such as differences in staffing levels, expertise of
> personnel, and monitoring practices.
>
> Given that staffing levels will probably always be less on nightshift
> than on dayshift, the nurses working the nightshift need to have more
> resources available to them to appropriately respond to emergency
> situations. In addition, the nightshift often hosts the more junior
> staff who may be lacking in their assessment skills. The researchers
> did not suggest a specific mechanism causing the decrease in survival
> but it is likely that a delay in assessing and/or treating the
> cardiac arrest is what caused the poor outcomes.
>
> Nightshift staff need training, mentors and additional resources so
> that they can respond appropriately to emergency situations when
> staffing is lacking.
>
> From:
> Perberdy, M.A. et al. (2008). Survival from in-hospital cardiac
> arrest during nights and weekends. JAMA, 299; 785.
>
> Best wishes,
> David W. Woodruff, MSN, RN, CNS, CEN
> President, Ed4Nurses, Inc.
> www.Ed4Nurses. com
>

 

On day shift there is ususally enough MD's around to respond. Having
access or should I say, no access to MD's at night has always been a
problem. Also the response time when calling a MD at night can impact
patient outcomes.

Joan




--- In mpoweryournurses@yahoogroups.com, "David Woodruff"
<dwoodruff@...> wrote:
>
> In a recent study reported in the February 20, 2008 issue of JAMA,
> Dr. Peberdy and Associates found that survival from cardiac arrests
> was worse on nightshift and on weekends. Many previous studies have
> also determined that other medical errors are higher at night and on
> weekends as well. The author suggests some explanations for the
> discrepancies such as differences in staffing levels, expertise of
> personnel, and monitoring practices.
>
> Given that staffing levels will probably always be less on nightshift
> than on dayshift, the nurses working the nightshift need to have more
> resources available to them to appropriately respond to emergency
> situations. In addition, the nightshift often hosts the more junior
> staff who may be lacking in their assessment skills. The researchers
> did not suggest a specific mechanism causing the decrease in survival
> but it is likely that a delay in assessing and/or treating the
> cardiac arrest is what caused the poor outcomes.
>
> Nightshift staff need training, mentors and additional resources so
> that they can respond appropriately to emergency situations when
> staffing is lacking.
>
> From:
> Perberdy, M.A. et al. (2008). Survival from in-hospital cardiac
> arrest during nights and weekends. JAMA, 299; 785.
>
> Best wishes,
> David W. Woodruff, MSN, RN, CNS, CEN
> President, Ed4Nurses, Inc.
> www.Ed4Nurses.com
>

In a recent study reported in the February 20, 2008 issue of JAMA,
Dr. Peberdy and Associates found that survival from cardiac arrests
was worse on nightshift and on weekends.  Many previous studies have
also determined that other medical errors are higher at night and on
weekends as well.  The author suggests some explanations for the
discrepancies such as differences in staffing levels, expertise of
personnel, and monitoring practices.

Given that staffing levels will probably always be less on nightshift
than on dayshift, the nurses working the nightshift need to have more
resources available to them to appropriately respond to emergency
situations.  In addition, the nightshift often hosts the more junior
staff who may be lacking in their assessment skills.  The researchers
did not suggest a specific mechanism causing the decrease in survival
but it is likely that a delay in assessing and/or treating the
cardiac arrest is what caused the poor outcomes.

Nightshift staff need training, mentors and additional resources so
that they can respond appropriately to emergency situations when
staffing is lacking.

From:
Perberdy, M.A. et al. (2008).  Survival from in-hospital cardiac
arrest during nights and weekends.  JAMA, 299; 785.

Best wishes,
David W. Woodruff, MSN, RN, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

A turtle on a fence post didn't get there by himself. No matter how
large or how small your accomplishments, there have always been
people along the way that have helped you to get to where you are
today. When we reach any level of accomplishment, whether that be
writing a book, getting a standing ovation or earning a certain sum
of money, it is easy to look back at our success and think that we
did all the work. However, like the turtle on a fence post, we had
help. When you achieve any level of success, it is important to
remember the people who helped you get there.

I remember a day in my clinical practice when it seemed like I was
clicking on all cylinders. Everything seemed to go right. I had all
the correct answers, and I was able to help my patients in dramatic
ways. That day I left work feeling very good about what I had
accomplished. I felt proud of the way that I had conducted myself at
work and maybe even a little egotistical. My teachers, my mentors,
my preceptors did not come to mind on that day. I thought I had done
it myself. I worked hard, I studied and I learned from my mistakes.
But like the turtle on the fence post, I did not get there by
myself.

Who are those important people in your life who have helped you to
achieve the level of success that you are currently enjoying? Take a
moment today to acknowledge those people who have helped you become
who you are.

"What is success? I think it is a mixture of having a flair for the
thing that you are doing, knowing that it is not enough, that you
have got to have hard work and a certain sense of purpose." --
Margaret Thatcher, British Prime Minister

Best wishes,

David W. Woodruff, MSN, RN, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com

On the floor, I hear some nurses say "I want to get out on time".  I
think that statement does not consider the needs of the patients.  The
nurse may have a manageable patient assignment, so the secondary goal
of getting out on time might happen.  But, if the patients need
labor-intensive care (complex dressing changes etc), or a new
admission comes up, then the nurses exhortation of "I want to get out
on time" needs to take a back seat.

Just last week, I picked up after a nurse who left 3 wrist bands on a
patient, and one of the wrist bands wasn't even from our hospital.
Empowerment is wonderful, but it must be "patient first".  patty