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9 THINGS NURSES DO

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Salute to Nurses 2016 3

InBrief

YOUR GUIDE TO XXXXXXXXXXXXX

On call: Some of the best nursing apps An edition of the Xxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxxxxxx

By Melissa Erickson More Content Now

Salute to Nurses is created annually by GateHouse Media LLC, The Record’s parent company, and is distributed with various GateHouse papers across the country. Reproduction in whole or in part without prior written permission is strictly prohibited. Opinions expressed in the publication are those of the authors and do not necessarily represent those of the management of the publication. Cover illustration: Bigstock ©2016 gatehouse media All rights reserved

o improve patient care and keep up with advances in the medical field, professional nurses turn to mobile devices to access information and the latest technology. The best nursing apps help nurses improve efficiency and enhance the experience for patients. “Nurses come out of school with a lot of knowledge, but the most useful nursing apps allow nurses to take care of their patients day to day armed with the necessary information to stay current and quickly reference medical information,” said Jennifer Mensik, executive director of nursing, medicine and pharmacy education programs for OnCourse Learning, a provider of workforce solutions and education for the health care, financial services and real estate industries. Mensik earned a Ph.D. in nursing from the University of Arizona College of Nursing.

Smartphone apps allow nurses easy access to unlimited research such as thousands of medical terms, drug databases and trending technology, Mensik said. Here are a few standouts:

Resuscitation! Resuscitation! is the award-winning virtual patient simulator and a handy tool to help a nurse develop a diagnosis, and management and treatment tools. Resuscitation! offers a case presentation of a patient who is ill, allowing the user to create a history, perform a physical exam, develop a differential diagnosis and administer therapy to treat the patient’s underlying problem. Free.

Nursing Clinical Mastery This free app offers quick and easy access to reference charts and algorithms plus in-depth interpretations of abnormal lab results and a library of searchable reference materials. It also features dozens of detailed, nursing-specific skill reviews and full color images to help with diagnosis.

Nursing Central A great gift for a new nurse, Nursing Central allows a user to look up detailed information on diseases, tests and procedures and consult a database of 5,000 drugs and more than 65,000 medical terms. Plus, you can search Medline and subscribe to favorite nursing journals. $165.

Merck Manual Over 300 experts contribute to this trusted medical reference that offers detailed diagnosis and management information. The clinically-focused entries are arranged by topic, symptom or section and include quick disease overviews and helpful navigation tools make it easy to find answers at the point of care. Prices vary from third-party vendors, but Merck will put out a free Merck Manual app with many new features in June.

4 Salute to Nurses 2016

NursingProfiles

o celebrate our local nursing community, our readers were asked to share stories of nurses who made/make a positive influence in their lives. The following nurses were nominated by the person as stated, and each profile remains unchanged from its original submission to us.

Here’s what a special nurse (or nurses) means to each of them…

Fran Langston St. Joseph’s Medical Center

I want to salute Fran Langston for being the most dedicated nurse to her profession I know. Fran started as a staff nurse 43 years ago at St. Joseph’s, and today she is the Director of Cardiac Services. I am in awe of her extensive knowledge and how often she is willing to teach staff, patients and families. She is the epitome of a professional nurse – caring, respectful, resourceful, educated, devoted and kind to everyone. Fran requires her staff to work at the highest standard to give excellent care to all patients. She is a director, but still has the “bedside nurse” in her; one can find her helping to cover breaks and

lunches for her staff. She treats everyone with respect and is willing to do what is needed to help in a difficult situation. A priority of hers is to make sure patients feel safe and families comfortable during their hospital stay. I know I am a better nurse because of the impact she has made on me. I often think when faced with a hard decision, “what would Fran do?” I am proud to be a nurse because of nurses like Fran. — As submitted by Diane Knutson

Salute to Nurses 2016 5

Sally Solanki Stockton Hematology Oncology Clinic

For over twenty years Sally has provided me with gentle care as her chemo patient. She provided her personal cell phone number for immediate contact when emergencies arose, and she contacted me to follow up on lab tests and scans. She has always gone above and beyond the call of duty in caring for her patients, making them feel comfortable and

important. You are not just another chemo patient when you have Sally as your nurse – you have a caring friend who will see you through the procedure and beyond. — As submitted by Denise Jefferson

Doris Santiago Dignity Health Medical Group

During surgery I was given a blood thinner to help before the bleeding stopped. Now when we see break up the clot in my leg. When the insertion plug each other on my visits to PCUE, we always say we was removed, I continued to bleed out for 2 hours bonded. and 22 minutes… normal stoppage is 22 minutes. Nurse Santiago remained with me the whole time — As submitted by David Macias with thumb or finger compressed on the incision

Connie Rodriguez Washington Hospital – Fremont, CA

Connie has been a nurse for close to 30 years. During that time her tireless dedication and work ethic has earned her praise from her co-workers and her patients. She readily comes in early, stays late and comes in on her off days, to help her unit, which is always short-staffed. She presently works in ICU/CCU 12-hour shifts, and even with the long hours, makes herself available to family and friends. They seek her out for medical questions, and she can be counted on to accompany family and friends on medical visits/contacts, in

order to ease the situation and answer all questions. Her passion for her job has resulted in several of her nieces and her son wanting to follow her path. They see her as a role model. Even with all of the cutbacks in pay and benefits, and the grueling demands of the job, she still loves her job and her patients, and would not change a thing. She is a true hero. — As submitted by Eduardo Rodriguez

6 Salute to Nurses 2016

Kathy Belcher St. Joseph’s Hospital

Kathy has been an RN for over 26 years and has received numerous recognitions from hospital patients over the years for the care that she gives. Her true passion is in her teaching – not only the information she provides to patients and their families, but she also serves as an instructor with

the San Joaquin Delta Nursing programs. She loves her students and the fact they are providing care for others. Kathy is truly a role model for these students. She also serves as the neighborhood nurse in the community she lives in.

Marcy Tolentino SJGH ER, Dameron recovery, Kaiser

This wonderful, thoughtful and compassionate woman takes time to ensure her patients are comfortable, and listens to them if they feel the need to talk. She has worked through most of her breaks and many of her lunches just going the extra mile to ensure that her patients are in a positive direction in regards to their recovery and mental well-being. She has a bright, energizing personality and a keen sense of humor, along with real knowledge and many informative tidbits that help make her patients want to thrive to get well. She enjoys working the different areas of nursing to keep up her skills and fantastic

bedside manner in the different aspects of her job. She is very motivating, and at the same time makes goals for her patients very tangible and real, giving them the will to be motivated about whatever aspect of their healthcare that they need to be working on at the time. Even when it might not be very pleasant, she gets them to power through and get it done. She always leaves them feeling positive and with dignity. She is one-of-a-kind, a nurse that can be depended on and one that makes everyone around her, including her co-workers, feel good and happy to have been graced by her presence.

Bianca Whittaker Metropolitan Correctional Center – San Diego | Federal Bureau of Prisons

Correctional nurses walk a fine line between maintaining security and delivering optimal medical care. They are very seldom acknowledged for the job they do. They do what is expected and ask for little in return. Take Bianca Whittaker, for example. A Medical Officer (Clinician) in infirmary, she has excellent assessment skills and goes the extra mile by always giving the on-call physician an excellent description of her patients’ status. This allows the physician to make an informed decision on what care to administer and ensures the patient gets the best possible outcome. Correctional nurses stay sharp. They train on their own time to stay abreast of the latest information. Bianca Whittaker attended outside sessions to stay educated on issues dealing with HIV/AIDS, for example. In the end, defining correctional nurses simply is not an easy task. Their job description can’t be

made to fit neatly in a tidily defined box. They might administer care to a particular inmate with a particular disease on one day, only to treat multiple diseases and multiple inmates the next. They have to have strong assessment skills and be fearless in their approach. A patient is depending on them. Thankfully, correctional nurses are up to the task. So this is a tribute to what it takes to be a correctional nurse, and the brave individuals who strive daily to ensure they deliver optimal patient care. Thank you for your loyalty and dedication, your work ethic and endurance. It never truly goes unnoticed, though sometimes unmentioned. — As submitted by Tricia Bookman

METROPOLITAN CORRECTIONAL CENTER SAN DIEGO, CALIFORNIA ADMISSION &ORIENTATION INMATE HANDBOOK MANUAL DE ADMISION Y ORIENTACION Updated March 03, 2014 TABLE OF CONTENTS/TABLA DE CONTENIDO

Salute to Nurses 2016 7

The School Nurses

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Lodi Unified School District, Lodi

I would like to honor my fellow Lodi Unified School District nurses for the excellent work they do every day for our school communities. With over 50 schools and only 15 credentialed school nurses and 6 LVNs, we are on the constant run to provide the best – and sometimes only – health care for our students. Many in the local community do not know we have students receiving tube feedings, catheterizations, diabetic care, suctioning and seizure care on a daily basis so all children can attend school and reach their potential. We do hearing and vision screenings, health assessments, consult with the education team, maintain health records, provide health education to children and families, provide first aid, administer medications and consult with Public Health and other outside agencies. The list goes on. This

group is such a great team. School nursing is a very autonomous job, yet this group is always there for one another, making sure things get completed. I have been a nurse for 40 years and have never worked with such a dedicated group of nurses who love their job. Their commitment to our students is apparent each and every day, and it’s an honor to be part of this team! Our group – Clare Woznick, Marty Marshall, Pam Meerdink, Lynn Vanotti, Mari Hudlin, Tim Greer, Donna Aarons, Grace Nukida, Pam Nickels, Roberta McConahey, Debby Wilmot, Katie Cooney, Sherri Voyer, Belinda Costa, Michelle Lam, Flo Fisher, Elena Arlt, Cheryl Jamias, Reena Sharma, Christina Cheng, and Barbara Jenson.

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— As submitted by Donna Aarons NEW SCHOOL YEAR BEGINS FOR STUDENTS Modified Traditional (MT) July xx

Joe Serna, Jr. Charter

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Middle College High Schoo (MCHS)

Rebecca Anderson-Potts State of California – California Healthcare Facility Stockton

Rebecca is the Chief Nurse Executive of the first-ever Correctional Healthcare Facility. She is responsible for over 900 nursing staff who provide care to almost 3000 inmates/patients. She is leading this new facility to set the standard for correctional healthcare. She is a role model for almost 60 nursing supervisors by leading with very high standards of patient care and professional behavior. Even though she has a huge responsibility with this large amount of staff, she still maintains an open-door policy and is always available to talk, regardless of their title. Her demeanor remains calm and open to suggestions or alternative ways of accomplishing the goal. She provides support and mentoring in both a group setting and individually. She has a vast amount of experience and knowledge in the nursing and managerial field, which she readily shares so others can learn vicariously. She does not hold back on positive feedback. Her staff feel much appreciated, and she is the first to thank them for a job well done. When counseling of staff is required, it is done clearly and honestly, along with encouragement and

opportunities to improve. Her no-nonsense style does not leave room for others to avoid responsibility for actions. She is also a role model for other statewide executives. Our facility is called upon regularly for advice and examples of training and care. Rebecca could have easily stayed at a facility that was wellsituated with processes in place and her job would have been a lot less stressful. Instead she chose to come lead this brand-new facility with many brandnew correctional nurses, and has done so in a most successful manner. I am personally thankful to have her as my supervisor because she has allowed me to grow and accomplish more than I ever expected. She serves as a role model, mentor, counselor, supervisor and friend. She looks for nurses’ strengths and then places them in situations where they will excel. I am hopeful you will consider this amazing nurse for public recognition. — As submitted by Bonnie McAtee

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8 Salute to Nurses 2016

NURSES DO

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9 things

Unsung

that you never knew about

By Melissa Erickson More Content Now

urses are capable and caring everyday heroes. Expert multitaskers, nurses are also patient and compassionate and do much more work than most people realize. When asked what things about nurses or jobs they perform are people unaware of, a variety of nurses shared their feelings:

Well-educated “Nurses are required to continue their education on an ongoing basis in order to keep their licenses current so they can keep practicing. Nurses take pharmacology classes and are taught to doublecheck physician orders for safety. If there is any question nurses seek to correct those orders and ensure safety for the patient. Most nurses have degrees that take two to four years to achieve. Nurse practitioners have master’s degrees and will soon require doctoral degrees.” — Deborah Henry, a certified nurse practitioner specializing in urogynecological care at the Bladder Control Center at Women’s Excellence in Lake Orion, Michigan

Patient advocate “The nurse is in charge of a patient’s care and is the patient’s advocate. Nurses provide health education not only to the patient but also to the patient’s family. In addition, nurses are skilled in assessments of the patient from a multi-system viewpoint, arriving at nursing diagnoses and making sure the patient has the optimal outcome.” — Michelle Podlesni, president of the National Nurses in Business Association and author “Unconventional Nurse: Going From Burnout to Bliss!”

Always on “Nurses are nursing 24/7, whether it be on the job in a busy emergency department saving lives, at the bedside of a dying cancer patient taking his last breath, or at home taking care of his/her family. Nursing never stops, the caring and selfless giving of themselves is something that true nurses are just born with.” — Registered nurse Leslie Block, an emergency department nurse and the creator and author of ER Nurses Care blog, http://ernursescare.blogspot.com/

Supporters “This is small but mighty: Going to wakes and funerals. The nurse that cared for my mom in the hospital as she was dying came to her wake. She only met her that day. Those are things that nurses do!” — Susan Tarr, registered nurse, Cleveland Clinic’s Fairview Hospital

Artists “In neonatal intensive care units, many of the nurses are very proficient at photography and scrapbooking. They are fantastic at doing hand- and footprints and incorporating beautiful sayings and quotes into the scrapbook pages. Our parents are so appreciative of these small gestures.” — Sheila Struble, registered nurse certified, Cleveland Clinic’s Fairview Hospital’s neonatal intensive care

Learners and planners “Nurses determine what it would take to create an in-hospital wedding or to fulfill last wishes. They take time to lighten patients’ burdens, offer comfort and share a laugh. They take time to learn what’s important to patients, whether it involves sports, music, art or fresh air, and help bring important events to life. They listen, cry and worry about patients’ status and show their feelings by holding hands, smiling, asking questions and silently assessing.” — Nancy M. Albert, associate chief nursing officer for research and innovation, Cleveland Clinic Health System, and clinical nurse specialist, Kaufman Center for Heart Failure

Watchdogs “Ambulatory nurses maintain communication with family members in order to support patients in the community. These nurses often identify home needs for patients in the form of pill-box fills and assist with scheduling follow-up doctor appointments as well as safety issues. Recently, one of our nurses contacted a local senior center who assisted with installing a lock box on a patient’s house – in the event that the patient fell, the fire department could get in the house without breaking in the door. Just one example of the way our ambulatory care coordinators look out for patients.” — Deanna Mcleeson, nurse manager, Cleveland Clinic’s Fairview Hospital

Wearers of many hats “During a critical time involving a patient’s dying, the intensive care unit nurses arranged a Skyping session with the patient’s daughter, who was out of the country, so she could see her dad and say goodbye. Recently a patient was admitted to the emergency department, and after admission the nursing supervisor discovered that the patient had his pet bird in the car. The nursing

supervisor spent all evening looking for an animal shelter to pick up the bird. Throughout the night the supervisors were checking on the bird. The next morning the animal shelter picked up the bird.” — Janet Schuster, chief nursing officer, Cleveland Clinic’s Lutheran Hospital

Navigators “Nurses help patients navigate the health-care system as a case manager/care coordinator.” — Ingrid Muir, nursing director, Cleveland Clinic

Salute to Nurses 2016 9

CARE

outside the hospital and into the community

By melissa Erickson More Content Now

urses are returning to their roots. A conﬂuence of factors, from an aging population to the Affordable Care Act, have led to a trend where health care is not only practiced in hospitals and clinics but where it was originally practiced — in the community. About 87 percent of nurses got jobs in hospitals in 2005 compared with 76 percent in 2012, according to the RN Work Project, a national study that tracks nursing career changes. “I think it’s a shift that is occurring throughout the system, and not just in nursing; care is moving beyond the clinical walls and meeting people where they are,” said Susan Hassmiller, senior advisor for nursing for the Robert Wood Johnson Foundation, which funds the RN Work Project. “People want access and they want convenience, and they want to trust that those caring for them are competent. Nurses are in a prime position to deliver all three. I think that’s definitely positive for people and communities where they live. So much of what affects someone’s health status and well-being is not just what he or she presents to you in a hospital or office visit.”

ACA’s effect

people healthy and out of the hospital. Because of this financial incentive we will see more community programming and direct care, with concomitant hiring of nurses who can provide this type of care. It does take a special set of competencies.”

The adoption of the Affordable Care Act, with its emphasis on community care in outpatient and ambulatory settings, is one reason driving the trend “Not only do of community nursing, millennials said Dr. Phyllis Sharps, want Johns Hopkins School of convenient, Nursing’s associate dean for Focus on prevention community programs and trustworthy While nurses embrace initiatives. care, but the the same qualities no “These days the trend matter where their job boomers is toward prevention and lies, community nursing is and greatest promotion of health, and diff erent from traditional with the Affordable Care generation nursing in how it’s Act many people who were want to be practiced. previously not insured now “Community health cared for ... are. The beginning care nurses, in general, focus they receive” is often at the in their own on populations rather community level rather homes.” than individuals. With this than in a hospital, Sharps perspective these nurses Susan said. focus on health promotion Hassmiller “The Affordable Care act and disease prevention, has definitely inﬂuenced provide education to more community care, but communities, improve so has consumer demand. community health and Not only do millennials safety, and increase access to care,” want convenient, trustworthy care, said Dr. Terri Lipman, assistant dean but the boomers and the greatest for community engagement for the generation want to be cared for in their University Of Pennsylvania School of own communities and in their own Nursing. homes,” said Hassmiller. “Additionally, “Hospitals are making the shift to the more our system shifts to valueproviding more care in the community based care, the incentive is to keep

FREEPIK/MORECONTENTNOW

TAKING

CommunityNurses

due to financial constraints and consumer demand, especially as systems move to more of a value-based incentive formula,” said Hassmiller. “Additionally, it is well understood that people do better in their homes surrounded by their support system and away from the inherent risks that hospitals bring, such as infections. There are significant resources being invested in home care and we will continue to see a rise in this type of care.” For the future, “nursing students should be prepared and encouraged to work in settings outside of the hospital. We need nurses who understand that people aren’t impacted only by their current illness or condition, but by their lives and environment in the community at large,” said Hassmiller, who encouraged all nursing students to advance their education. “It is in a baccalaureate program where community competencies are introduced with courses in community and public health nursing. The Institute of Medicine Future of Nursing report has encouraged at least 80 percent of all nurses to attain a bachelor of science in nursing by 2020. Doing this will ensure a workforce that is prepared for not only acute care, but community care as well,” Hassmiller said.

10 Salute to Nurses 2016

Etiquette

Nice guys ﬁnish

FIRST

Using etiquette to get ahead in nursing By melissa Erickson More Content Now

sport of all, a business world that is often unforgiving and highly critical,” Pagana said. Just what is etiquette in a business sense? “Etiquette is about relationships. Nursing is a career characterized by professional relationships with all kinds of people in all kinds of settings. By using the guiding principles of kindness, consideration and common sense, professional etiquette can help nurses initiate new relationships and enhance establishes relationships. It can guide them in unfamiliar situations and help them

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he long-term employment outlook for nursing shows that it’s one of the hottest degrees out there, with more than 1 million new nurses needed by 2022, according to the Bureau of Labor Statistics. While employment possibilities are high, career advancement can increase if nurses exhibit an emphasis on professional etiquette, said Kathleen Pagana, author of The Nurse’s Etiquette Advantage, now out in its second edition. Pagana, a registered nurse with a Ph.D. in the field, was critically injured in a car accident in 2003 and was unable to physically work for several years. She was able to start teaching during that time and realized that etiquette skills were one of the most important items missing for nurses to advance their careers. “Etiquette is the missing link for success in the workplace,” Pagana said. Professionals — in health care or not — might have a great understanding of the skills needed to get their job done, but without etiquette it’s harder to move forward in any career, she said. “Everyone can become an expert in etiquette. The better you become, the more you will be sought after for opportunities and positions. Let’s take a sport analogy. If you don’t know how to play basketball, would anyone want you to be part of a competitive league? Probably not. However, if you know the rules and how to play, you could be an asset to any team. Knowledge of professional etiquette can make you a welcome addition and help you survive in the toughest

here are some of Pagana’s favorite tips: • Never approach someone at a conference and say, “Do you remember me?” Instead put out your hand, smile and say your name. • Wear your name tag on the right side of your chest. This way it can easy be read when shaking hands. • Hold your drink in your left hand at a networking event. This keeps your right hand warm and dry and ready to shake hands. • Use the “BMW” method to remember proper place setting positioning. Your bread (B), meal plate (M) and water (W) appear in this order from left to right. • Your email address is a reﬂection of your professionalism, or lack of it. * The value of social media is underestimated by those who haven’t bothered to learn about it.

know what to expect from others,” Pagana said. Like other professionals, nurses will benefit by coming across as polished, confident and professional. Etiquette helps level the playing field in nurses interactions with others. “Nursing is all about relationships. Etiquette is the missing link for success in the workplace. Why not know how to handle awkward and challenging situations that could diminish confidence, tarnish reputations and derail career aspirations?” Pagana said.

Salute to Nurses 2016 11

Career

Opportunity knocks Nursing’s quick growth expected through 2020

RN, assistant professor and Clinical Nurse Leader Program Coordinator for the University of Pittsburgh School of Nursing. There will be opportunities in nursing education, By Erika Enigk research and point of care as GateHouse News Service the nurse role as a health care collaborator grows. An aging baby boomer “The nurse’s role is not just population, people living in an acute care setting at longer with chronic illnesses the bedside,” Hoffmann said. and advancing technology “There’s so much more to have created unique patient-care delivery now.” challenges in the health care Those who are interested profession. To help meet in the bedside setting will those challenges, the job find plenty of jobs in geriatric market is growing — welcome care as baby boomers age, news for aspiring and according to Mary Otting, working nurses. EMS coordinator at Lurie According to the Bureau of Children’s Hopsital of Labor Statistics, the nursing Chicago. There will also be profession is experiencing more opportunities in home better-than-average growth health care, she said. that will continue until at Otting, who practiced as least 2020. a nurse for more than 25 “Nursing is going to be years before completing her growing in all directions,” bachelor of science in nursing says Rose L. Hoffmann Ph.D.,

degree, said a license alone is no longer sufficient for most people who aspire to a nursing career. “To get hired now as a new grad, you really have to have a BSN,” she said. An advanced degree can help boost a nurse’s career to the next level, and online programs can help keep working nurses balance career, family and school by allowing students to complete classwork somewhat at their convenience while receiving the same education they’d get with on-ground courses. The University of Pittsburgh offers three online master’s degree programs in the field of nursing as well as an online Doctor of Nursing Practice completion program. Course work mirrors what’s done in the live classroom, and students and faculty keep in touch by phone, email and webcams, Hoffman said.

An aging baby boomer population will fuel health care employment opportunities into the next decade. Bigstock

“It’s important that the students know that the faculty is there,” she said. A program’s clinical element — if it has one — is done in a live setting. Nursing can be an incredibly rewarding career, but Otting advises those considering the profession to think seriously about whether it’s the right one for them. It requires critical thinking and thinking on one’s feet while maintaining calm in a hectic environment. “We have been the most trusted profession for years,”

she said. “It’s a calling. But it’s not for everyone.” Hoffmann advises any practicing nurse who is considering furthering her education to carefully research the options before committing to a program. “Go out there and see what’s available,” she said. Talk to the faculty about the course work, and ask what program graduates are doing, Hoffman advised. Also key is the program’s certification rate, and US News and World Report ranks top online graduate nursing programs.