Nursing- Aspect 2
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Nursing- Aspect 2
History of Nursing/ Technology used by Nurses
Curated by Carley Edwards
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History of Nursing

History of Nursing | Nursing- Aspect 2 | Scoop.it
Travel Nurses Now is a trusted travel nursing company with the best travel nursing jobs!
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Carley Edwards's comment, March 13, 2013 12:24 AM
Nurses just starting out had simple jobs like that resembled those of a house keeper: sweeping, dusting, etc. A normal work day for these nurses would be a "10-12 hour shifts, seven days a week, for a period of two to three years. As they worked up to higher levels of difficulty, they were responsible for cleaning the operation rooms and sterilizing all of the operating equipment. Most nurses during the 1900's received education directly from the hospitals instead of going to actual nursing schools and colleges.
Carley Edwards's comment, March 13, 2013 12:29 AM
During WWII, Nurses were taken out of the hospitals they were working at and were put at the bedsides of wounded soldiers at the war zones. These nurses had to go through training and education to prepare themselves for what they were about to be faced with. "Well over 100,000 nurses received training through this program over the next three years." This should the citizens how important nurses really are and they had a whole new respect for them after this event happened.
Carley Edwards's comment, March 13, 2013 12:32 AM
"The government invested tremendous sums of money into the health care profession. That, combined with the nation’s booming economy and the discovery of antibiotics such as penicillin to treat infections, created a high demand for skilled, educated nurses. As pharmaceutical advancements continued, more invasive surgeries that were previously considered far too risky were made possible, opening even more opportunities to nurses in the field of surgery. Soon, medical machinery was operable by nurses, who became increasingly more and more responsible for the direct care of patients."
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The Impact of Technology in Nursing | NurseTogether.com

The Impact of Technology in Nursing | NurseTogether.com | Nursing- Aspect 2 | Scoop.it
Today, over 900 hospitals have over 3,000 social media listings. Hospitals use mobile apps to address patient experience. The VA is allowing mobile devices to be used. GPS can track patients with dementia.
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Carley Edwards's comment, March 13, 2013 11:29 PM
It is no surprise how popular cellphones are everywhere bu t they might be affecting the work place for many nurses and other medical staff. Cell phones have a high percent of very infectious diseases that can easy be spread around the hospital to ill patients. "While a total ban may be unnecessary, the Emergency Care Research Institute does recommend banning cell phones in the OR and ICU settings." The patients are allowed to use their cell phones to update their family but they are asked to keep it at a very minimum.
Carley Edwards's comment, March 13, 2013 11:35 PM
There have been some issues where nurses have posted things on a social media sight that did not reflect their work sight in a positive way. They are asked to keep their work life and professional like a separate as possible when it comes to social media. "Potential employers and plaintiff attorneys may check social media sites for discriminating entries. Nurses have been disciplined or fired for inappropriate use of the Internet during work hours." They must understand that they must protect the confidentiality of their patients and co workers.
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Interview Results- Kim Gidaro

Kim Gidaro

ICU Nurse

pkjgidaro@yahoo.com

(412) 841-2620 

Carley Edwards's insight:

1. What is your daily routine that you go through when you are at your job?

 

My daily routine starts with me getting to work 15 minutes early to get my patient assignment and a cup of coffee. My shift starts at 7:00am and I begin with a staff huddle to discuss any problems that may have occurred during the last 24hrs and discuss any information that needs passed along. I then get a verbal one on one report on my 2 or 3 patients. I do my head to toe assessment, vital signs, pass am medications and perform any care that the patient may need at that time. I continue to do hourly vital signs, assessments, review laboratory values, round with the doctors, accompany patients to testing, and complete my charting throughout the shift. I usually get a half hour lunch. Being in an ICU, the day can be very unpredictable and we receive patients from the ER, OR, Cath lab, Medical-Surgical floors and any emergency alerts throughout the hospital. I finish my shift by giving an oral one on one report to the oncoming RN, check that all my medications have been given and charted, do chart checks with the oncoming RN and make sure the patient is taken care of and their needs are met. That is generally my routine, but it may not always go that smoothly.

 

2. Describe the schooling you had to go through to get this job opportunity.

 

I went to school at Connemaugh Valley Memorial Hospital School of Nursing in Johnstown. It is a diploma program that begins with a full year of college credits at UPJ and then 2 years of schooling and training at the school of nursing. Those 2 years were year round with a 1 month break and Monday through Friday 8 hr classes with clinical time often on shifts 3-11. I graduated with a diploma of nursing and finished with Nursing Boards before becoming an RN. I also went on to get my CCRN certification in critical care nursing.

 

3. Explain any legal issues you know of that different nurses have been faced with.

 

I have known nurses that have been summoned for court in law suits against the hospital, in cases of neglect and in individual law suits. I have been involved in the process of gathering evidence in the case of rape and abuse of patients. We often deal with the process of obtaining and  abiding by the legal documents of Living Wills and Power of Attorney. We have dealt with legal issues related to organ donation and the rights of the patient to have donation if it is on their license even if the family or power of attorney wishes otherwise. 

 

4. Describe what it is like if you lose one of your patients.

 

When I lose one of my patients it is often a very sad experience, especially since I often get very close with my patients and their families. I deal with a lot of critically ill patients and death is unfortunately a frequent event. Sometimes I feel a sense of relief for a patient that is terminally ill and suffering, that I was able to give them and their family comfort, support and compassion in their time of need before they pass away. I also feel like I have made their last moments the best they can be. I never get used to losing a patient but I feel good when a family or patient states that I made a difference in the last moments of their lives.

 

5. If possible, please explain one of the most interesting cases you have seen.

 

One of the most interesting cases I have dealt with was a young lady who came in with an altered level of consciousness, fever and breathing difficulty. She became unresponsive and very unstable and ended up requiring a breathing tube placed for life support. Upon doing a CT scan they discovered she had swelling in her ventricles of her brain and an infection in her cerebral spinal fluid. The Neuro Surgeon decided the lady needed drains placed in her brain immediately and the operating room was not available so we did a procedure called burr holes where they drill holes in the patients brain and place catheters directly into the ventricles. They did this right at the bedside with my assistance. We proceeded to inject antibiotics into her brain through the catheters we placed and continued this treatment for a week. The patient progressively got better and regained her ability to wake up and got off the breathing machine. She is now eating, getting out of bed and going to rehab.

 

6. Describe what you like most about your job.

 

The thing I like most about my job is when a patient or family member tells me that my care has made a difference in their experience in the hospital. I love taking care of people and seeing my hard work and compassion make an impact on someone getting better. I also love teaching people and helping them to better understand their diseases, medications, and give them comfort when they need it most.

 

7. Explain what you think is the hardest part of your job.

 

The hardest part of my job is not always having the time or resources to give the best nursing care I can and that take me away from direct patient care. For example, paperwork and an increase in my non direct patient care duties keep me from being at the bedside where I feel I need to be. I also think the physical demand my job places on me is difficult. We do more work with less help and more responsibilities.

 

8. What are some ethical concers/considerations that go along with your job?

 

Ethical issues I deal with usually revolve around how much care and how aggressive we are with our care to a patient. Often patients come in  with advanced directives in relation to their care. Sometimes families and doctors do not honor the patients wishes and treatment is given to the patient that they did not want. Also an issue is when a patient is terminally ill with no meaningful recovery and the family is unable to give up treatment to them and the patient suffers. We also deal with certain religious and cultural issues that some patients have and the limitations they put on our care. Jahovah’s witnesses for example will not receive blood even if it means they may die. Some of the issues revolving around organ donation also become an ethical challenge.

 

9. Explain some characteristics a person needs to succeed at this job?

 

I think in order to succeed as a nurse you need to be compassionate, patient, open minded, hard working and professional. I also think you need to be non-judgemental and have the ability to go with the flow. I also think you need to have a good sense of humor because there are many emotional demands placed on nurses and if you can’t laugh sometimes you will cry most of the time.

 

10. Explain how this job has affected your social and home life.

 

I feel my job has introduced me to a diverse group of friends that support each other both in and out of the workplace. My job has given me the flexibility to be home with my daughter and yet contribute financially to our family. There have been times in my career where my job has interfered with important events I had to miss. Holidays, weekends and shifts have made me miss some of those special occasions. My 12 hour shifts at work are exhausting and doesn’t allow for much else when I get home to my family. For the most part nursing has provided me the opportunities to work the hours I need, have job security, and allow me to have a productive part of home life. 

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Teacher's Comments

Senior Research Project

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Tami Yaklich's comment, March 21, 2013 10:19 PM
Wow! Excellent interview results!!!
Tami Yaklich's comment, March 21, 2013 10:19 PM
30/30
Tami Yaklich's comment, March 21, 2013 10:20 PM
Love the info about the history of nursing - interesting!
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Patient Care Technology and Safety - Patient Safety and Quality - NCBI Bookshelf

Patient Care Technology and Safety - Patient Safety and Quality - NCBI Bookshelf | Nursing- Aspect 2 | Scoop.it
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Carley Edwards's comment, March 13, 2013 11:21 PM
When nurses use technology while at work and helping a patient, they will decrease the risk of error that could occur. There is still always a possibility of the technology making a mistake but this is why the nurses must be up to date on the the machines so they will be able to fix the mistake that it makes. Sometimes when the nurses do not always know what to do so they make "work-arounds" or temporary fixes to the problem. This is a major issues because this only fixes the problem for a short period of time. If this issue is not fixed right away, the same problem can occur later on to someone else. This issues could be very dangerous which could affect a patients health.
Carley Edwards's comment, March 13, 2013 11:48 PM
"Patient care technology has become increasingly complex, transforming the way nursing care is conceptualized and delivered. Before extensive application of technology, nurses relied heavily on their senses of sight, touch, smell, and hearing to monitor patient status and to detect changes. Over time, the nurses’ unaided senses were replaced with technology designed to detect physical changes in patient conditions." In the future, it is believed that technology will be able to replace most of the jobs in the hospital environment.
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Nursing Schools – A History | Associate Degree In Nursing

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Carley Edwards's comment, March 13, 2013 12:38 AM
Florence Nightingale was the woman who created the first formal educational training program. "One of her students designed her original nursing uniforms using a system of uniforms with differing bands and to denote skill levels." These uniforms were normally worn by all the students during their schooling to become a nurse. These outfits were the main uniforms that were used till the 20th century. Scrubs of mainly blue and green soon replaces the old fashioned uniforms to be more comfortable and suitable for both men and women.
Carley Edwards's comment, March 13, 2013 11:02 PM
After the Civil war ended, the United States realized how there was now a higher need for nurses. Serving as the "Superintendent of female Nurses by the Union Army in 1861," Dorothea Dix tried to get more women and men to help and care for others as nurses. While doing this, she found Clara Barton who went on to establish the American Red Cross. Dorothea went on to improve the nurse training along with health care for the mentally ill.
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Interview Results- Chris Kyper

Chris Kyper

Pediatric Nurse

ckyper@comcast.net

(412) 417-3617

Carley Edwards's insight:

1. What is your daily routine that you go through when you are at work?

 

I’m a pediatric NP in the pediatric ICU at Children’s.  I get to work between 5:30 and 6 am.  I get signout from the night team about what has happened with my patients over night.  Then I go and review their charts.  I check their vital signs and labs for last 12 hours.  I go over culture results, consultations, test results.  I review all their orders and update the orders and fix any labs (order blood, electrolytes, diuretics).  Once I’ve done that for my kids (usually 4-10 kids) I go to each bed space and talk to the nurse about overnight events, things they need, and examine the child. At 7am we do team signout so we run through the entire roster of patients and we talk about what happened overnight.  At 7:30 we go enmasse (11-15) and round on all new patients since 4 pm the previous day and any kid on ECMO.  Then we go to the X-ray room and review all the x-rays, MRIs and CTs from the last 24 hours for the entire unit.  After that we break up into teams and round on our specific patients.  I take care of all the transplant patients and then any other medical patients.  If it is my patient we are rounding on I present all the data on that patient and then come up with the plan of care for the day.  The Attending can either agree or not and then we discuss.  Once we have a plan we move on to next patient.  Once we are done with rounds, we do our “chores”.  I can place central IVs, arterial lines, intubate, lumbar punctures, place feeding tubes etc … so if my patient needs any of those I do it.  If my patient needs to go off the unit for a procedure, I manage their airway and provide sedation.  I also carry a phone if there are any questions about my kids I get calls, I manage their ventilator, call consults (like if we want the cardiologists to see the child), address abnormal labs, and coordinate their care.  I also admit patients, so write their orders, do a history and physical etc… I also discharge and transfer patients.  I usually sign out around 4pm.  I tell the fellows what went on with my patients all day.  If there is an emergency on the unit we all go to help.  When I’m not taking care of patients, I am on numerous committees for the unit and hospital from the central line committee to developing a clinical ladder for NPs at UPMC.  We also participate in research projects.

 

2. Describe the schooling you had to go through to get this job opportunity.

 

I got a BSN, worked 8 years, then went back and got a MSN.  Then I sat for boards in primary care and then sat for boards in acute care.

For education, once you are certified you must recertify every year.  There are seven year cycles.  Three of those years you have to take self-assessment exams.  the other four you have to document 15 hours of continuing education each year.  Also, because I have prescriptive authority, I have to have 16 CEUs in pharmacology every two years and a DEA license.  For the hospital, I have to take CPR and pediatric advanced life support every two years.  I also have to complete yearly compliance training and every two years I have to recredential with the hospital so I have to have my charts reviewed and procedure logs reviewed etc... 

 

3. Explain any legal issues you know of that different nurses have been faced with.

 

I have seen cases where bedside nurses have been sued along with others for either doing something without a physician order or not following protocol.  NPs have been sued for lack of knowledge or mis-diagnosis or prescribing wrong drug.  Because nurses are required in PA to work with a MD they are always co-defenders.  I carry $3,000,000 in liability insurance through UPMC.

 

4. Describe what it is like to lose one of your patients.

 

Oh my, this is hard.  It depends on how long I took care of them and how well I knew the family.  It also depends on how it happened.  If it is a trauma we get in that arrests soon after they arrive, it is sad but more like work than personal.  If it is someone who I’ve cared for for a long time and I know the parents, it is harder.  If it is a slow, prolonged death sometimes it is a relief but still sad.  I will cry and hug the parents.  I’ve pulled breathing tubes and waited with moms holding their kids until they died.  Those are sad but usually it’s been a long road and they are as ready as they can be.  I’ve had kids who have died suddenly and when you are in the adrenaline rush of resuscitating a child you aren’t emotional.  On those kids I usually cry on my way home or later that day.  I’ve prayed with families and been there for last rites.  I’ve had several families who have asked me to attend the annual memorial service we do for the kids that have died or sent me notes.  Others, say goodbye and don’t want any more contact.  We all try to support each other.

 

5. If possible, please explain the most interesting case you have seen.

 

Oh gosh, there are so many.  One of the great things about working at one of the top ten pediatric hospitals in the country is that I see stuff that no one else does.  We separated Siamese twins and I got to help take care of them before and after.  I’ve worked with transplants since I became a nurse in 1986 and I’ve seen islet cell and hepatic cell transplants which are totally experimental.  I’ve given drugs that were developed here.  I’ve taken care of kids that later were the start of a new treatment protocol.  Recently I got to take care of a child who received “liquid lung therapy”.  Few days go by that I don’t see something new or learn something.

 

6. Describe what you like most about this job.

 

The kids!!!  They are awesome.  If you take away their pain, they just want to play and be happy.  I like the challenge of learning new things and keeping my brain active.  I love caring for a kid for a week and seeing them come off the ventilator and then go to the floor.

 

7. Explain what you think the hardest part of your job is.

 

The stress level of taking care of critically ill children all the time.  You can’t screw up.  You also have to have a tough skin because in high stress situations, people get short and testy and you can’t take it personally.  It is emotionally and physically exhausting and you need to separate it from your private life.

 

8. What are some ethical concerns/considerations that go along with your job.

 

Do you have a day??  We meet once a month just to discuss ethical issues related to the unit. (we also meet monthly to review all the kids that died, what happened, what we can do better, autopsy slides and reports, we also review current journal articles every week for an hour and then another hour about interesting kids on unit.  Quarterly we meet to discuss Special topics and quality implementation.  There is a lot of review and improvement efforts.  I didn’t know where to put this).  Back to ethics.  Our biggest issues arise over when we do too much.  When is it time to stop and let the child die.  Sometimes it’s hard to let go and admit that you’ve done all you can and there isn’t any more to do.  This has to go with parental wishes, sometimes we know it is futile and they won’t give up.  There other area that is controversial is taking care of child abuse victims when the person who did it is in the room.  We actually have a special rounds to discuss these cases and how it affects the care givers.  Not passing judgement and taking care of the child has to be the focus.

 

9. Explain some characteristics a person needs to succeed at this job.

 

You need to be motivated to do a good job.  I think you need to be slightly type A.  There needs to be a lot of attention to detail.  You need to be able to look at the big picture.  The best nurses are the ones who understand the underlying pathology and why they are doing the therapies we prescribe.  If you don’t then you are a “recipe” follower, meaning you know if this happens I do this but you don’t know why.  The good ones think, huh, this is happening so to fix that we need to do this or that and then when we order it you do it but you also know what response to look for.  You also need to have interests outside of medicine so that you can unwind.  I also feel very strongly about not becoming too emotionally attached to the families.  It clouds your judgement.  We see it a lot when a child is there a long time and some nurse have continuity, they lose perspective.  You also need to be strong enough to question things you don’t agree with or may be wrong because a doc or NP made a mistake. 

 

10. Explain how this job has affected your social and home life.

 

Ha ha.  You should ask my kids!!  Well, two of my kids are going into medicine so I guess it wasn’t all bad.  I think if affects my family when I have a bad day.  Sometimes I’m stressed or sad.  I think the varied schedule has actually been good because I was able to work around my kids schedules etc…  I am more diligent about certain things like well care and immunizations.  I’m less likely to overreact (which some people in medicine are the opposite but for me I think my kids would tell you I tended to underreact).  On the flip side, I know everything that can go wrong so when my kids were ill I probably worried more inside!!  As to social, I’m the go to person for all my friends and family.  Rarely a week goes by where someone doesn’t call me and ask for advice.  I’m also the go to person for big events like surgery or hospitalizations because I know how to navigate the system.  It’s all good though.

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