Category: Clinical Corner

0

Clinical Corner: Happy Movember!

Two Bearded Friends Drinking Coffee and Taking Selfie in Restaurant

Happy Movember!

By Phil Niles, Clinical Nurse Manager, Medical Solutions

For those of you who can grow them, I hope those mustaches are coming in strong this Movember!

This month we’re celebrating Movember, an annual mustache-growing event that aims to raise awareness about men’s health. Of course, women’s health is of paramount importance, but let’s face it, guys: We stink at caring for ourselves. Statistics show that men take more physical risks and are 24 percent more likely to have not visited a doctor in the last year. Men also are reluctant to visit a doctor when facing mental or physical illness. For example, wrecking your mountain bike, breaking a couple of ribs, cracking your sternum, and then refusing to go to the ER because you’re “fine.” Oh … maybe that’s just me? Well, then I’m guilty, too.

There is also a general lack of public awareness of men’s health issues. Women being proactive and engaging in preventative activities is widely recognized and established as the norm.  Men on the other hand, who are equally at risk, are not as often actively encouraged to see their doctor on a regular basis. Movements like Movember and Men’s Health Month in June help bring the issue of men’s health to everyone’s attention. Movember also specifically brings attention to prostate cancer, testicular cancer, and men’s suicide. If you’re 40 or older, you need to start having conversations with your doctor about prostate cancer screenings. And make sure to regularly screen yourselves for testicular cancer, which can occur in young men as early as 15.

Fake mustache fun

Get your mustaches AND your healthly habits on this month!

The top three leading causes of death in men are heart disease, cancer, and accidents. Many of these ailments are preventable! According to the Centers for Disease Control (CDC), 12.4 percent of all men age 18 and older rate themselves as having fair to poor health. Here are a few more enlightening statistics from the CDC:

  • 58 percent of men 18 and older report meeting the federal physical activity guidelines for leisure or other aerobic activity
  • 8 percent of men 18 and older report smoking regularly
  • 6 percent of men 20 and older are obese
  • 1 percent of men 20 and over have high blood pressure
  • 9 percent of men under the age of 65 do not have health insurance coverage

These are some of the problems, so what can you do about it?

First, get moving! Stand up and walk around. This is the simplest thing you can do for yourself to positively impact your health. Just this action alone can reduce risk for heart disease, high blood pressure, type 2 diabetes, depression, osteoporosis, and even some cancers, according to the CDC. Obviously, quitting smoking, eating healthy, losing weight, and seeing your doctor regularly are also important. However, just getting up from your chair once a day and walking for 30 minutes can drastically improve your health. This can be as simple as walking around the block!

Be an advocate for your own health. See your doctor when you’re not sick! Crazy, right? A preventative doctor visit will cost you a co-pay and maybe a new prescription. An average hospital stay costs $10,000. The choice seems obvious, even just considering the financial impact. Another, powerful reason men do not go to the doctor is fear; fear of the unknown and fear of disease. A rational rebuttal to this is that if there is a disease lurking it will be there whether you know about it or not. Fear, however, is not rational. It can force a person to turn a blind eye to symptoms and minimalize them as just a passing thing. Seeing your doctor regularly is not only cost-effective, but it can also catch health risks and help prevent chronic health problems. According to the CDC, up to 40 percent of deaths from common health issues could have been prevented.

Bottom line? Get off your butt, make healthy choices, and go see your doctor. Do it for your family. Do it for yourself. Make the proactive choice to improve your health by taking one step (literally, sometimes!) or several steps as needed. And keep rocking those incredible mustaches!

0

Clinical Corner: Travel Nurse Interview Tips

Travel Nurse interview

Bring your A-game to your next Travel Nurse interview.

By Phil Niles, Clinical Nurse Manager, Medical Solutions

Hello, my traveling friends! I’m Phil, a Clinical Nurse Manager for Medical Solutions and I’ll be taking over Clinical Corner. I’m a RN BSN with 16-plus years of experience in ICU, acute dialysis, and management. My work at Medical Solutions has given me the opportunity to support all of you fine people in a variety of ways as you craft your career. But for this installment of Clinical Corner, I want to focus on one specific area where I provide support: Interviews!

I don’t have to tell you that as a Traveler you’re constantly interviewing and selling your skills and experience to hospitals — typically over the phone as opposed to in person. I conduct pre-screen interviews for our hospital partners and have experienced quite a few bad interviews in my time. They had the skills and the experience but were terrible in the interview. In the spirit of not being that guy or gal who fails to represent yourself to fullest in your interviews, here are a few tips that may help you land that next assignment:

Be on time!

Even though this is most likely a phone interview, it is very important to be ready a couple minutes before any scheduled call. Often the interviewer has multiple candidates to call and will not be able to accommodate you 10 minutes after the scheduled time. Be ready early.

Treat it like an in-person interview.

Most sane people would not swear, sigh, eat, or be confrontational during an interview, but these are things that I have personally witnessed. For example, you wouldn’t walk into an interview eating a sandwich, talking with your mouth full, and chatting up a buddy you brought with you, right? Be polite, engaged, and undistracted. Impress them with your professionalism.

Mature African American man talking on cell phone and working at laptop at kitchen table

Most Traveler interviews happen by phone. Be sure to call from a quiet location where you have good service!

Call when you have good service.

“I’m going through a tunnel … *static* … ” This is not the best first impression to give to a prospective employer. Make sure you’re somewhere you have uninterrupted service, even if this means pulling over on the side of road at the top of a hill. A cellphone cutting out constantly during an interview may lose you an opportunity with a great employer.

Call from a quiet location.

I’ve experienced being called from a mall, fast food drive-thru, at a train station with a train going through, and in what sounded like a day care with 50 screaming children. Now, many things are hard to predict and you cannot control everything around you, but make your best effort to find a spot that is quiet and as free from distraction as possible.

Be honest about your skillset.

“Oh yeah, I’ve done it all — open heart, brain surgery, face transplant, and delivered five babies at once.” It may be tempting to talk up skills that you are rusty on or have little experience in. However, the interviewer will take you at your word and expect you to be able to perform everything you spoke to. Be honest, be open, and highlight what you are good at. If you’re asked if you have experience that you do not possess, then be transparent. Often, managers do not expect you to be proficient in addressing every single patient experience they see on their unit. They just want to be sure you can cover the majority of what they see.

Be clear, informative, and succinct with your answers.

Beware the urge to tell a long story when a shorter, direct answer will work.

Manager: “Tell me about some of the patients you see in ICU?”

You: “Well, I was born in 1994 on a cold, crisp, winter eve … ” 

Personal examples are excellent when you’ve been asked “Give me an example of X” type questions.

Also, one word or “canned answers” should be avoided. An interviewer will likely see this as a red flag and try to catch you off guard by asking multiple follow-up questions. Think of compelling, unique answers for standard strengths and weaknesses type questions. Instead of saying the cliché “great team player” line, switch it up to something like “I’m a strong resource for my team and I never let anyone down.”  Make yourself memorable!

Interviews can be stressful, and nerves may get the better of you if you let them. Always remember you are just talking about you — and you are the expert on you! Therefore, this the absolute best topic you could ever talk about! There is no reason to worry about what they’re going to ask. You already know all the answers. So, take a deep breath, remember that you are a rock star, and knock ’em dead!

0

Clinical Corner: Delegation

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

One of the most underrated skills that nurses possess is delegation. This skill is so very important to providing quality care in the healthcare environment. Furthermore, it has an even bigger impact as time moves on and the nursing shortage grows. More than ever, nurses need to work effectively to utilize their resources and assistive personnel. Proficient delegation is not always taught and it can be hard to master. It’s now more important than ever to have competent and appropriately supervised personnel in the delivery of affordable, quality care.

To achieve this outcome, the RN must assign tasks based on the needs and conditions of the patient, potential for harm, stability of the patient’s condition, complexity of the task, predictability of outcomes, abilities of the staff to whom the task is delegated to, and the context of the patient’s needs. One of the biggest rules to abide by with delegation that many nurses are not aware of are the five rights of delegation. These five rights include:

  1. The right task
  2. Under the right circumstances
  3. To the right person
  4. With the right directions and communication
  5. Under the right supervision and evaluation

When following the five rights of delegation, nurses must use good critical thinking and professional judgment. Please refer to the following decision tree for assistance with delegation:

Nursing Delegation

Delegation is a crucial skill in the delivery of patient care. This decision tree provides assistance with delegation.

To assign a task to assistive personnel, the right communication must also occur to make sure directions are clear, concise, correct, and complete. The nurse must also assess the comprehension of the assistive personnel. To assess their understanding the nurse should ask how they will accomplish the task and when or how the information should be reported. The nurse should also determine what the assistive personnel’s expectations are and provide any clarification, as needed. In addition, the nurse should pursue the role of teacher provide guidance and support to the assistant.

Once the nurse has delegated a task to the assistant it is then his/her responsibility to monitor their performance and ensure that it meets the standards of practice as well as policy and procedures within the facility. This is the hardest portion of delegation as a Travel Nurse. Knowing all of the different equipment as well as policies and procedures is one thing, but to know the skill level of all assistive personnel and whether or not they are compliant with policies and procedures of the facility is even more challenging. The important thing to know as a Traveler is that diligent follow up is needed. Patients should be monitored frequently, but the nurse should also follow up with the assistant to determine areas of difficulty or gaps in comprehension.

The last and perhaps the most important part of delegation is feedback. The nurse should take a moment to reflect on all delegation to determine areas of difficulty and areas of strength. This will help tremendously in continuing to delegate and adjusting overall patient care according to changes or learning needs. This step is often overlooked or forgotten, and it is crucial to for nurses to evaluate the effectiveness in their delegation skills. Evaluation leads to development and this equates to better delegation which ultimately leads to improvement in patient care!

0

Clinical Corner: Emotional Intelligence

Emotional Intelligence

Emotional intelligence helps nurses deliver superior patient care.

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

What comes to mind when you hear the term “emotional intelligence”? More importantly, what does emotional intelligence have to do with nursing? Emotional intelligence is an ever-evolving and changing concept, and something that’s becoming increasingly important in the realm of nursing and patient care.

Emotional intelligence is the ability to understand and manage one’s emotions as well as the emotions of others they interact with. Possessing this ability is important in nursing because it enables nurses to make better decisions, manage their patients more efficiently, and improve relationships amongst their interdisciplinary teams — and it follows that emotional intelligence consequently has a big impact on the quality of care that patients receive. Due to the influence that emotional intelligence has on patient care, it is important to understand the concept and its relevance to nursing practice.

Many arguments have been made on whether emotional intelligence is a cognitive ability or a personality trait. Some believe that emotional intelligence can be learned, and others believe that it is simply a trait that some possess and some don’t. The most likely reality is that emotional intelligence is actually a combination of ability and a personality trait. The take-away from this controversy and difference in opinion is: How can we recognize traits of emotional intelligence and how can we instill these skills in our nurses at the bedside?

Traits associated with emotional intelligence include self-awareness, self-management, social awareness, relationship management, and communication ability. Equally important to these traits is the ability to empathize with others and to motivate others and yourself. Individuals with emotional intelligence are motivated to want to try to understand their own internal emotions as well as other people’s emotions. It is reasonable to conclude from these findings and characteristics that nurses who are attentive to themselves and their own emotions and reactions tend to be nurses who possess emotional intelligence.

Implications for Patient Care

What does any of this have to do with patient care? If you think about nursing and the emotions that a nurse experiences throughout the day, you know that managing these emotions is crucial to providing the care needed for your patients.

For example, let’s say that you’re caring for a patient who is dying from diabetes. This patient is non-compliant and has been all their life. You, as the nurse, start to experience emotions in caring for this patient because your dad passed away from complications related to diabetes. Your dad, unlike your patient, was very diligent in caring for himself and he always did what he could to make sure he was as healthy as possible. For you as the nurse, this situation may expose some emotions that you didn’t know you had, like frustration, anger, or sadness. It is important to be able to recognize such emotions and to reflect on the situation so that you don’t take it out on the patient. Emotionally intelligent nurses are self-aware in that they know what they are feeling, and they know the emotion a certain situation elicits. They will be able to empathize with their patient and have the awareness to treat this patient professionally, rather than to get angry at the patient’s noncompliance.

Emotional intelligence is an up-and-coming concept that can really make an impact on patient care. Self-discovery can be a huge part of that for many nurses and healthcare professionals. It is time for the nursing profession and the healthcare industry at large to get on board and to implement this into nursing so that patient care can advance and progress in the right direction.

0

Clinical Corner: Marijuana Law

Marijuana leaf and stethoscope.

Can a nurse or healthcare professional be fired for using recreational marijuana on his or her day off when recreational use is legal in that nurse’s state? The answer is yes.

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

The public is becoming more supportive of marijuana law reform every day, with new polls showing that more than half of the country is in favor of legalizing marijuana. In 2012, Colorado and Washington became the first states to legalize the recreational use and sale of marijuana. Since then, 23 other states and the District of Columbia have legalized medical marijuana and supporters are commending the ability to regulate, tax, and test marijuana. Even though there’s much support for legalization, in all states where medicinal and recreational use is allowed, employers may still enforce and comply with a drug-free workplace. So, what does this mean for hospitals and other companies in states where marijuana use is legal?

Many employers are navigating how state laws affect employment and have policies stating that a positive drug screen is grounds for termination. Whether or not an employer can test employees for drugs is controversial and laws on this vary from state to state. Industries like transportation and nuclear energy are heavily regulated by the federal government and don’t give much say to the employer. Local and state governments, on the other hand, may have different regulations and leave much of the decision up to the employer. If the employer chooses to drug test employees, they must follow their state’s rules and procedures, which are intended to prevent discrimination and inaccurate collection of samples. Many states allow testing based on the following guidelines:

  1. The applicant knows that testing will be a part of the screening process.
  2. The employer has already offered the applicant the job, contingent on passing the drug test.
  3. All applicants for similar jobs are tested in the same way.
  4. The tests are administered by a state-certified lab.

Today, most companies that conduct drug testing will have their applicants submit an agreement to the testing.

As a Traveler and healthcare professional, you are agreeing to drug testing under federal law. This poses a question that many may not know the answer to: Can a nurse or healthcare professional be fired for using recreational marijuana on his or her day off when recreational use is legal in that nurse’s state? The answer is yes. It is still illegal to use marijuana under federal law even if it is legal in your state. The take-home message is that you should never want to risk your career and the federal law trumps any state laws.

Legalizing marijuana will have many ramifications in the workplace. The biggest and most influential ramification is patient safety. The best way to ensure quality care and to make sure patients are safe is to keep the workplace drug free.

0

Clinical Corner: Sentinel Event Alert #59 — Violence Against Healthcare Workers

Stop Violence

The Joint Commission’s recent Sentinel Event Alert #59 focuses on physical and verbal violence against healthcare workers.

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

According to the Occupational Safety and Health Administration (OSHA), workers in healthcare settings are four times more likely to be victims of workplace violence than workers in other industries. Workplace violence includes disruptive, violent events as well as the verbal abuse that many healthcare workers face daily.

In April 2018, The Joint Commission issued Sentinel Event Alert #59, which deals with physical and verbal violence against healthcare workers. This alert focuses not just on violence, but also serves as an aid to help organizations to recognize and acknowledge violent behaviors, better prepare staff to handle the threat and risk to safety, and more effectively address the aftermath.

Effective management of violence starts with an investigation of the contributing factors that may exist to precipitate violent situations or behaviors. One of the biggest factors is the setting in which healthcare workers operate. It comes at no surprise that the emergency department and inpatient psychiatric settings have the most recorded incidents. The home care setting presents unique challenges because of the disorganized and uncontrolled environment the patient care occurs in. Sixty-one percent of home care workers report workplace violence each year. The LTC setting for cognitively impaired patients also presents special challenges to managing violence and the most common characteristic exhibited by perpetrators of violence is altered mental status associated with underlying dementia, delirium, substance abuse, or other mental impairments.

Such elements associated with the perpetrators and the healthcare setting in which they exist are just a few of the contributing factors to violence. Other factors associated with violence are stressful conditions, long wait times, lack of organizational policies and training, domestic disputes amongst patients and families, inadequate security, understaffing, staff working in isolated areas, lack of access to emergency communication, unrestricted access to hospital rooms and clinics, and lack of community mental health care. These contributing factors can lead to low staff morale, lawsuits, and high worker turnover which leads to burnout. To combat the factors associated with workplace violence, The Joint Commission suggests several actions to take to look beyond solutions that merely increase security presence.

The first suggestion is to clearly define what workplace violence is and to put systems into place across the organization that enable staff to report the violence. The goal in establishing systems and procedures within an organization is zero harm to patients and staff, create a culture of reporting all events of physical and verbal violence, encourage conversations about violence, develop protocols, guidelines, or tools that make identifying potential perpetrators simple and easy. Another key step to reducing these incidents is tracking them and keeping records of the incidents. Gathering information on the different incidents and keeping a centralized database will be extremely beneficial to analyze and track worker injury and workplace violence.

Tracking each event will help to look for trends in the contributing factors associated with the violent act. It is also important to remember that follow-up should occur with the victims associated with the act. This follow-up is necessary to provide support to the victims but also the witnesses and this may include psychological counseling, debriefing, and trauma-informed care if necessary. Once a follow-up or debriefing has taken place it is always essential to analyze the contributing factors to the incident. According to OSHA, this includes a worksite analysis and hazard identification but furthermore, it is a demonstration on the value that reporting plays in communicating to staff the risk assessment and interventions taken in similar situations. Once the data has been analyzed and the problem has been identified implementation of cost-effective, evidence-based solutions specific to the problems identified at the local or unit level should be initiated.

Launching a new solution is more complex than just putting the procedure in place. Training all staff including security personnel on de-escalation, self-defense, and response to emergency codes is the next step in improvement with workplace violence. Self-defense training may include de-escalation techniques, alarms, security support, safe rooms, escape plans, and emergency communication procedures. The emergency response codes should be practiced with a variety of mock violent situations so that staff are adequately prepared to react in any types of violent events. Amidst the adoption of new strategies, keeping abreast of any changes will help to establish quality and an evidence-based practice approach in preventing any violence within the healthcare setting.

Click here to learn more about The Joint Commission’s Sentinel Event Alert #59.

 

1

Clinical Corner: Differences in Hospitals

Hospital Differences

Not all hospitals are the same! Learn how that matters to you as a Travel Nurse.

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

Did you know that the total number of hospitals across the U.S. is nearly 5,534? States like California, Florida, and Texas have upwards of 200-300 hospitals in their state alone. Every day Travelers clock in and out at many of the nation’s hospitals, yet every hospital is different. Many misconceptions exist amongst all the different facilities and it is crucial for Travelers to know what these differences are so they can understand the impact that such variances can have on patient care.

One type of hospital that’s often misunderstood is the critical access hospital (CAH), as many healthcare workers don’t realize the limitations these facilities have on the resources that are available for patient care. A critical access hospital is a rural hospital with 25 or less acute care beds. It is also located at least 35 miles from another hospital and the average length of stay for acute care patients is 96 hours or less. The critical access hospital designation is given to reduce the financial vulnerability of rural hospitals and to improve access to healthcare for rural communities. Providing care in these facilities can be very different than any other hospitals. Most often the staff that work in these facilities (mostly nursing) are skilled in a variety of areas. For example, a medical-surgical nurse would be required to work the ER and may also float to take care of critical care patients. Some labor and delivery nurses will be required to work a variety of areas outside of their specialty including medical-surgical units or even the ER as well. Another important thing to remember is that CAH may not have some of the luxuries that bigger hospitals have. For example, they may have little to no help in terms of nursing aides. They also may not have secretaries, unit clerks, administration, etc. This will require nurses to know how to do more of these clerical tasks that they may not have had experience with while working in a larger facility.

Other types of facilities that are misunderstood are long-term care facilities (LTC) and sub-acute care facilities (LTAC). The main difference between these two facilities is the length of stay and the patient acuity. The acuity of the patients within an LTAC facility is much higher than the acuity within an LTC facility. Many times, the patients within an LTC facility need assistance with activities of daily living (ADLs). These patients are also receiving care for extended periods of time. The patients within an LTAC facility are getting care that is more complex. These patients need intensive medical treatment for an extended period (usually 25 days or greater). Much of the patient population within an LTAC facility will require chronic ventilator care and other complex medical treatments not offered in an LTC facility.

To better understand the differences in acuity amongst these facilities it is helpful to understand the treatment levels. The highest acuity and treatment level is a short-term acute care hospital. This would be considered your average hospital. The second acuity level would be the LTAC facility and then acute care rehab, sub-acute rehab, and lastly long-term care (LTC). Acute care rehab would be considered a rehab facility within a hospital setting. The sub-acute rehab setting would be considered a rehab unit within an LTAC facility. Understanding each of these facilities and the patients they care for is extremely important for travel nurses to know so they are aware of the expectations coming into their assignment.

Travel Nursing is not just about finding a hospital and working. It’s much more than that. It is finding the right hospital or facility for your skillset so that you can provide quality care to each patient. Knowing the difference amongst the number of hospitals or healthcare facilities around the nation is extremely important to know when you are embarking on your Travel Nurse adventures. Ask a lot of questions and advocate for yourself to make sure the contract you are accepting is the right fit for you!

1

Clinical Corner: Autism Awareness

Autism awareness month

April is the prime time to recognize Autism, which affects so many patients and families year-round.

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

The stats on Autism speak volumes. This developmental disability affects nearly 2.8 million people and their families. Nearly one percent of the world’s population suffers from Autism Spectrum Disorders and it is one of the fastest-growing developmental disorders in the United States. On average, Autism costs a family nearly $60,000 a year and there is no medical detection or cure.

As we wrap up April, join us in celebrating National Autism Awareness Month. This year the Autism Society has pushed this nationwide effort beyond merely promoting Autism awareness and looks to encourage friends and families to become active partners in the movement towards acceptance and appreciation. For many years, Autism awareness has been about supporting individuals with Autism. Let’s embrace a new perspective, one in which we focus on the rest of us. We should aim to advocate for acceptance and inclusion in schools and communities. We, as a society, should promote appreciation for the unique aspects of all people and we should value these individuals for their unique talents and abilities.

To truly make an impact in our society, nurses across the country should push to promote patience and compassion for patients who suffer from Autism. To gain the trust of this patient population we first need to understand what exactly Autism Spectrum Disorders are. They are a cluster of disorders characterized by impaired social skills, communication difficulties, cognitive delays, and repetitive behaviors. It is highly likely that many nurses will take care of patients who suffer from Autism within their career and it is important to know how to care for them.

Some recommended tips and strategies to adequately provide the proper care for this patient population are to:

  • Secure a non-stimulating environment
  • Talk with the child’s parents first and include them in your nursing care
  • Perform physical assessment away from the child but progressively move centrally towards them
  • If needing to use medical equipment, use them on the child’s parent first
  • Lower yourself to the child’s height level
  • Be gentle and consistent with your behavior and actions
  • Limit encounters with healthcare personnel
  • Stick to a schedule
  • Reward good behaviors

These tactics can be helpful when you are working to establish rapport with your patient but to also get them the necessary care that is needed.

One of the biggest challenges with Autism is knowing what care is needed and the source of the problem. There is no known single cause for Autism Spectrum Disorder, but it is generally accepted that it is caused by abnormalities in brain structure or function. Although researchers do not know the exact cause of Autism, many theories are being investigated including links among heredity, genetics, and medical problems.

If you want to make a difference this month and raise awareness for Autism, there are several ways to get involved in your community. One way of getting involved is searching the Nationwide Autism-Related Services and Supports with Autism Source. This database will help to get you in contact with the Autism organization in your region. You can also reach out to your local affiliate for information and education on how to get involved.

Additionally, there’s free e-newsletter through the Autism Society that anyone can sign up for. It offers the latest updates, news, research, education, etc.

If you wish, you can also attend an Autism event or take a free online course on Autism that increases general knowledge on the disorder.

Lastly, if you simply want to make a small difference this month or any time throughout the year, please take any opportunity that you can to draw attention to the tens of thousands facing an Autism diagnosis each year. While this may seem small, the ripple effect that it will create is much larger in comparison.

0

Clinical Corner: Fall Prevention Technology of 2018

Warning Fall

Learn the latest in fall prevention technology in this month’s Clinical Corner!

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

Did you know that every 11 seconds an older adult is treated in the emergency room for a fall? Or how about the fact that every 19 minutes an older adult dies from a fall?

Falls are the leading causes of fatal and non-fatal injuries for older Americans. The financial toll related to the falls of older adults is expected to increase as the population ages and it may reach $67.7 billion by the year 2020. This an astounding statistic and it’s no wonder that every healthcare facility around the country places a large emphasis on reducing falls in every way possible. Even though there are several successful fall prevention techniques that have been adopted throughout time, it is always important to stay abreast of changes and adopt new strategies as appropriate, so that falls can be prevented as much as possible!

A few current and widely used fall prevention interventions include locking the bed and keeping it in the lowest position, putting bed rails up and keeping call light and other personal belongings within reach, non-slip footwear, clutter-free room, appropriate use of sensory aids, dry floor and adequate lighting, hourly rounding, and patient and family education. These are just to name a few. Despite implementing these strategies, falls still occur and there’s further work to be done to further decrease fall rates.

New Strategies

One newer strategy that’s been adopted is the use of “virtual sitter” technology. This technology can monitor a patient’s movements under ambient light and it can also be used to create and draw virtual zones, trip wires, and other trigger points within the field of view. These lines or zones are used to detect when a patient moves across those boundaries and then an alert is sent to the monitor tech to warn them of the potential danger to the patient. Additional features of this continuous live video feed include two-way audio, voice recognition, patient privacy modes, and customizable alerting. When an alert is sent to the monitor technician, they can intervene in several ways: using two-way audio to direct the patient to remain in bed or assess the patients’ needs, contact the patient’s RN or nurse’s aide, or contact the unit supervisor for emergent situations. This modern technology has been shown to not only reduce the number of falls, but also that it can decrease fall-related costs for the hospital.

Lady Fall

Did you know that every 11 seconds an older adult is treated in the emergency room for a fall? Or how about the fact that every 19 minutes an older adult dies from a fall?

Another innovative way of using technology involves monitoring people with sensors to increase the ability to predict when falls can occur. Using sensor measurements to determine walking speeds and stride length has helped to correlate a slow walking pace to the risk of falling. The shortening of a person’s stride also determines the likelihood that a fall could occur within three weeks. When the sensor system detects notable changes in a person’s gait, an alert is sent to the caregiver so he or she can take steps or enhance precautions to prevent falls in the foreseeable future.

One unconventional way of predicting falls is considering what goes on in people’s brains. By tracking the brain activity with walking, talking, and walking while talking it has been determined that the front part of the brain works harder while multi-tasking. This could potentially explain why cognitively impaired people tend to fall at a higher rater than those with normal cognition. The goal with using this approach is to be able to detect if a person is at higher risk of falls before any physical symptoms manifest.

These innovative strategies are extremely important because they push us to think beyond the conventional prevention techniques. To get a true grasp on minimizing falls, we must understand why they are occurring and how to prevent them. Part of prevention includes focusing on ways to predict if and when a person is likely to fall. If we can implement emerging technologies with the techniques that we currently have in place, we may be onto something. When it comes to falls, the most important thing we must do is to stay up to date with changes in our patients but also changes in best practices.

0

Clinical Corner: Combatting Compassion Fatigue

Nurse Consoling Young Female Doctor

Compassion fatigue can hit nurses hard. Strategies for combatting it are essential to your wellness and proper patient care!

By Kora Behrens, Clinical Nurse Manager, Medical Solutions

Compassion fatigue is a real problem in today’s nursing staff. And even though it has been identified as an issue, compassion fatigue is often overlooked or ignored. This is an alarming fact!

Healthcare already suffers from a shortage of nurses, and to make matters worse, compassion fatigue is exhausting the nurses that we do have at the bedside. To combat this problem, it’s important to understand that compassion fatigue is more than just physical exhaustion. Compassion fatigue is emotional, physical, AND spiritual exhaustion resulting from caring for patients and witnessing the pain and suffering they are going through. This exhaustion is directly correlated with the diminished ability to provide compassionate care, a decrease in quality care, and decisions to leave the workplace all together. Despite these profound consequences, few institutions offer support for compassion fatigue.

Unresolved compassion fatigue not only influences the nurse, but it also affects organizations in terms of increases of absenteeism, performance issues, decreased quality care, interpersonal issues, and increased staff turnover. To intervene against these harmful effects, it becomes important for agencies that Travel Nurses are employed with and healthcare facilities to take a stand against compassion fatigue.

Strategies for preventing and managing compassion fatigue include a call for nurses to strive for and maintain a healthy work-life balance. Nurses must practice self-care and they need to focus on sustaining emotional health. One strategy to manage this problem is finding activities and practices that replenish, comfort, and rejuvenate the spirit. Activities may include physical exercise, journaling, reading, spending time with family — basically, anything that promotes rest and comfort. It may also be helpful for nurses to establish a method of shedding the professional role at the end of the day including rituals such as playing music at the completion of a shift, putting your stethoscope and equipment away, or simply reflecting on your drive home from work.

Perhaps the most important thing that nurses and facilities can do to contend with this problem is to endorse a keen sense of self-awareness. Realizing what you are feeling and when compassion fatigue is setting in can have a huge influence on minimizing the consequences of this neglected problem. Self-awareness requires open discussion and honesty. It may be helpful and beneficial for the nurse to discuss their feelings with other colleagues. In fact, most nurses prefer conversations with close friends or co-workers for support and feedback. The support that is provided through colleagues increases development of self-care strategies to stay physically and emotionally healthy. Adopting these strategies for healthy living is much easier when self-awareness is present. It takes less effort to combat compassion fatigue when you have the support that you need and the self-awareness to know when a problem exists. Ultimately, the key to keeping nurses at the bedside is to diminish any effects that compassion fatigue could have on our workforce.

Take care of yourself and your colleagues out there — and remember that your Career Consultant and Medical Solutions’ Clinical Team are always here to support you when you need us!