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Stats: 2327 Members, 4500 topics. Date: February 27, 2017, 02:59:44 AM

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* Exams / Re: between uworld nclex and kaplan nclex questions book and app which is better by Joanna: February 21, 2017, 08:48:51 PM
obtain a crisis prevention training and certification or nanagement of assaultive behavior certification from


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* Upcoming Conference / Global Health and Innovation Conference 2017 Schedule of Activities Announcement by katty: February 21, 2017, 06:29:23 PM
The schedule has just been announced for the Global Health & Innovation Conference at Yale on April 22-23, 2017!

With more than 2,000 participants, the Global Health & Innovation Conference is the world’s largest and leading global health and social entrepreneurship conference. Please feel free to forward this announcement to others who may also be interested in attending or presenting.  Register by February 28 for a highly reduced registration rate.

Interested in presenting? Two types of presentations are currently being accepted.

1. Social Impact Pitches and Innovation Prize applications are currently being accepted. February 28 is the final 250-word abstract submission deadline.

2. "Innovative Initiatives" Information Session applications are accepted on a rolling application basis, and the presentation slots are nearly filled to capacity.

For full schedule of activities check

To apply to present a paper check

To participate in the innovation prize award register

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* Articles / Many Doctors, Nurses Want Pain Removed as Fifth Vital Sign by Alicia Ault by Idowu Olabode: February 21, 2017, 04:12:33 PM
Almost half of physicians and half of nurses strongly agree that pain should be eliminated as the fifth vital sign, according to a Medscape survey.

Medscape received more than 2100 responses to an online survey conducted in December 2016, a few months after the American Academy of Family Physicians (AAFP) Congress of Delegates voted to eliminate pain as a fifth vital sign. The AAFP delegates said the pain measurement — which has been used for decades — is subjective and has likely led to overprescribing of medications.

Respondents to the Medscape survey were asked directly whether they supported the AAFP vote. While 47% of physicians — who were from multiple specialties — said they strongly agreed, 17% said they somewhat agreed, and 19% said they strongly disagreed.

For nurses, 45% strongly agreed with the AAFP, 22% somewhat agreed, and 19% strongly disagreed.

"I applaud the AAFP for this common sense decision," said Marissa Ball, a registered nurse, in commenting on the survey. "Measuring pain by functional status is the way we were taught in nursing school and after three decades in nursing, I find it is still an accurate indicator."

Respondents were also asked about how often they use pain scores and functional status when assessing a patient's pain. More than half of physicians — 55% — said they often or always use pain scores, while 71% said they often or always evaluate functional status. Only a very small single-digit percentage said they did not use either measure.

For nurses, the numbers were reversed. The majority — 80% — said they used pain scores often or always. Fifty-three percent asked about functional status replied often or always.

Peggy Hollis, a clinical nurse specialist, said that evaluating function is just one part of the equation. "I believe strongly that we need to consider function as part of the assessment of pain," she commented, but "without a subjective grading of intensity, how do you titrate treatment to goals?"

Added Hollis, "Only the patient can describe at what intensity pain is tolerable. It is up to us to negotiate with the patient to identify a realistic goal for the patient."

Registered nurse Michele Fortune agreed that the patient should be at the center of a balanced and all-encompassing approach. "Pain is what the patient says it is!" she commented. "Yes — use functional status as well when assessing pain. Be holistic!"

Pain management specialist Ralph laraiso, MD, commented that patients don't use the Visual Analogue Scale in the way it was originally developed, "while others have learned to manipulate that scale to obtain the maximum amount of narcotic medications."

Dr Iaraiso said he relies more on functional status. "Many of these patients have psychosocial issues that will not be relieved by pain pills, but they will not admit to that nor seek appropriate professional services on their own, or, when referred, they are resistant," he said.

Others argued for keeping pain scores. Kritika Doshi, MD, an anesthesiologist, said that pain scores are important for patients, and "even more vital for physicians and surgeons to keep them sensitized to inadequate patient comfort." Added Dr Doshi, "Discontinuing pain as [a] fifth vital sign would be a sad blow to underdiagnosed and under-reported pain."

Keeping pain scores may also "be of value in knowing whether there is an immediate impact on the pain intensity by the medication prescribed," said Gilbert Mwaka, an anesthesiologist. But, he said, assessing functional status is a better tool to assess the efficacy of a therapy. "We should create more awareness through training that better equips medical practitioners with a tool for functional status assessment," commented Dr Mwaka.

Pressure to Prescribe?

Survey participants were asked how often they feel pressure to prescribe pain medication in order to keep patient satisfaction levels high.

For physicians, 28% said often; 29%, sometimes; and 6%, always. About a third said they never or rarely felt that pressure. Nurses felt similar pressure. Thirty-percent said they often felt a need to prescribe; 23%, sometimes; and 12%, always. Thirty-five percent said they never or rarely felt pressured to prescribe.

Mary Mavraganes, a registered nurse, said, "often we are forced to give pain medicine per family or patient request." This can be the wrong move in the elderly, as they "become very confused, which results in falls," said Mavraganes.

Another registered nurse, Debra Bork, said, "Since the opioid epidemic hit the fan, people want narcotics for every little pain they have and expect to get them."

How Influential Are Reviews?

The survey asked respondents about the impact of patient reviews — whether through online surveys or the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) reviews — on clinician evaluation at their practice setting.

Fifty-four percent of doctors said the reviews were slightly or not at all influential; 26% said the reviews were moderately influential, 14% said very, and 6%, extremely.

"Government involvement in healthcare, especially HCAHPS, has no real value, but utilizes subjective measures and no outcome data to hijack hospital reimbursement," commented Allen Coleman, MD, an anesthesiologist. "Pain scores are entirely subjective and leave us treating numbers, which is something good medical students learn not to do in clinical rotations."

The surveys seemed to carry more weight with nurses. Twenty-two percent said they were extremely influential, 27% said they were very influential, and 23% said they were moderately influential. Just 27% said the reviews were not at all or slightly influential.

Some commenters expressed dissatisfaction with the reviews. "I feel the HCAHPS and Press Ganey tools have been a detriment to providing care to patients," commented Helen Kuhns, a registered nurse. "If you fail to prescribe a pain pill they want or antibiotic they think they need they score you poorly."

"I think the bigger problem is basing reimbursement on patient satisfaction," said Chloe Jolliff, also a registered nurse. "Patient satisfaction is not a reliable indicator of medical efficacy.

"Of course, patients shouldn't be left to be miserable, but this situation has created a monster in EDs [emergency departments] and in places like labor and delivery, where patients have an unrealistic expectation that they won't have pain and if they do then it's the caregiver's fault," commented Jolliff.

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* News / Ghana: Nursing and teacher trainees allowances will be restored - Nana Addo by Idowu Olabode: February 21, 2017, 04:05:44 PM
President Nana Addo Dankwa Akufo-Addo has assured the thousands of nursing and teacher trainees across the country that their allowances will be restored.
Delivering his maiden State of the Nations Address on the floor of parliament on Tuesday, February 21, Mr Akufo-Addo said: “teacher trainee allowances will be restored when the Minister of Finance comes to read the budget.”

“The Minister for Finance will restore the allowances to trainee nurses in the budget,” he said.

The immediate past John Mahama-led government withdrew both trainee nurses and teacher trainee allowances in 2014, in order to curb ballooning government expenditure as well as ensure fairness to all categories of tertiary students.

The government’s argument was that University students are not given allowances, making it unfair for other categories of tertiary students to be given allowances.

Teacher and nurses trainees were therefore asked to apply for government student loans to finance their education.

The government, however, took a new stance on the matter when it announced that the allowances of the nurses would be reintroduced.

Political analyst and Editor-In-Chief of the New Crusading Guide, Kwaku Baako subsequently described the NDC government’s decision to bring back nurses trainees allowances as an act of cowardice.

Source : Pulse

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* Undergraduate / Re: LAUTECH Open and Distance Learning Program for Nurses by ojo damilola: February 21, 2017, 03:24:37 PM
Do strike affect odl students?

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* Nursing Jobs / Nursing Jobs in Lagos: Vacancies for Nurses and Midwives by Idowu Olabode: February 21, 2017, 01:53:17 PM
A reputable Hospital in Lagos State, is recruiting suitably qualified candidates to fill the position below:
Job Title: Registered Nurse and Midwife

* Candidates should have RN and RNM with current practicing license
Application Deadline
7th March, 2017.
How to Apply
Interested and qualified candidates should send their CV's to:
Apply in person at:
22 Adejumo Tennis Road,
Ilamose Estate,
Oke- Afa, NNPC Depot Area,
Lagos State.

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* News / Gombe College of Nursing Receives Accreditation, to Start Awarding Degree by Idowu Olabode: February 21, 2017, 12:59:08 PM
Gombe state College of Nursing and Midwifery had been granted full accreditation by the Nursing and Midwifery Council of Nigeria (NMCN), State Commissioner of Health. Dr Kennedy Ishaya, disclosed this in Gombe on Friday.

He said that the feat was attained after about 10 years of struggle to meet stipulated requirements.

“We have never had it like this since the establishment of the school over 10 years now.

“The first experience, they (NMCN) gave us things that we were expected to meet and they allowed us to admit only 30 in each class.

“This time around, we met almost all the requirements; we are now permitted to admit 50 in each class and this is a great achievement.

“With this development, shortage of manpower in the health sector will be a thing of the past,” he said.

According to him, the institution is now a ‘College of Nursing’ and no longer ‘School of Nursing’ and will start awarding degree equivalent.

“We are now looking for a university to affiliate to so that the degree will be coming from the university,” he said.

The commissioner also said that maternal child health records of the state had been diluted following the influx of Internally Displaced Persons (IDPs).

“Initially, we had a very good record but with the influx of IDPs, our statistics has been diluted.

“Most of the people coming have never attended antenatal clinics; some never took their children for immunization.

“We are now fully back on mop-up immunization, advertising on media and asking pregnant women to come and access antenatal and post-natal services free of charge.

“We have also designed an itinerary and will be going from house-to-house to give the best we can for nursing mothers and their babies” he said.

Source : The Nation Newspaper

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* Articles / Nurses should not participate in executions by lethal injection by Roger Watson by Idowu Olabode: February 21, 2017, 12:47:03 PM
In some US states, prisoners condemned to die are killed using lethal injections. This takes place in two steps which make the prisoner unconscious and then stop breathing. Nurses are often present, but do they really need to be present? A group of senior nurses from the UK, Australia and the US recently debated this issue. They concluded that, unfortunately, the international nursing codes of ethics lacks sufficient detail to be helpful to nurses faced with the decision to take part, or not, in an execution.

There are many ways of executing prisoners, but only death by lethal injection involve nurses. Lethal injection requires access to veins in the body. The heart rate of the prisoner is observed until it has stopped, permanently. Doctors are always present to certify the death but nurses, along with doctors, may assist with any aspect of the execution. The normal role of the nurse is to care. Taking part in executions is not something they are trained for or would expect to do.

Some US states have laws which say that nurses do not have to take part, but some oblige them to. The American Nurses Association (ANA), a trade union and professional organisation, says that nurses should not take part in executions. But it cannot stop them. The International Council of Nurses, to which organisations like the ANA belong, tells nurses to continue to care for prisoners up to the point of execution. But the exact point when care should stop is not clear.

One task that nurses often do for their patients is to find veins to take blood samples or to give drugs. This is exactly what is needed in a prisoner before a lethal injection and nurses do take part in this step of the execution. It is not known how much further nurses take part. Some claim not to be present at the point of giving the lethal drugs. This may not count in taking part in the execution. But the execution could not have taken part without the nurse doing the job.

Justifying the unjustifiable

Nurses are part of the prison system. They justify taking part in executions if the prisoner is also a patient saying they cannot leave them in the terrible moments before they die. They can provide comforting words and company for the prisoner and be a familiar face. They say this is like caring for a terminally ill patient. But a terminally ill person is not being punished and their death cannot be prevented.

The thought of safety when a person is going to be deliberately killed and facing inevitable death seems strange. But things do go wrong in executions by lethal injection. In botched executions, either the prisoner does not die immediately, or they die in pain. The speed and comfort of the execution depends on the nurse having good access to one of the prisoner’s veins. If this access is poor, then the drugs which put prisoners to sleep and which kill them will not reach their targets: the brain and the heart.

Nurses may be experts in finding veins to give drugs and some say that leaving this to executioner technicians may put the patient at more risk of pain. But many people who are not nurses or doctors can be trained to find veins for taking blood in hospital. This is the same as finding a vein for an execution. It is hard to explain why a nurse must do this.

Nurses and doctors take part in executing patients by lethal injection. Doctors must be there to certify death even if they do nothing else. Nurses may be present for the comfort of the prisoner, but they may also play a more active role. It is impossible to believe that a nurse would ever be asked to give the lethal dose of drugs. It is also impossible to believe that any nurse would want to be the person who did this. To maintain the caring role of the nurse, the point when a nurse no longer accompanies a condemned prisoner ought to be a long way from the execution chamber.

Source :

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* Travel Nursing / Re: Mumaris System New Account Online Registration by JEFFY JOHNSON: February 21, 2017, 11:20:59 AM

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* Articles / Lateral Violence in Nursing Breaking the Spell by Kathleen Bartholomew by KemiRN: February 21, 2017, 10:46:53 AM
A nurse rolls her eyes at a co-worker as she picks up the assignment sheet that was created by a younger charge nurse. An ICU nurse pretends not to see her co-worker is drowning and ignores her request for help saying she is too busy. A newly hired RN who was previously a scrub tech finds she is now shunned by both groups. Is this just life as a nurse or a nurse's right of passage? Or is it something more insidious? These behaviors go by several names: lateral or horizontal violence, incivility, nurse-to-nurse bullying, sabotage -nurses eating their young.


In general, bullying in the United States is a term used to describe uncivil behavior from someone who has power over you vertical aggression. Rude behaviors from peers are referred to as horizontal or lateral hostility and are defined as: A consistent pattern of behavior designed to control, diminish or devalue a peer (or group) which creates a risk to health or safety (Farrell, 2005).


Some specific examples are:

    Overt. Name calling, bickering, fault finding, criticism, intimidation, gossip, shouting, blaming, put-downs, raised eye brows; and
    Covert. Unfair assignments, refusing to help someone, ignoring, making faces behind someone's back, refusing to only work with certain people or not work with others, whining, sabotage, exclusion, fabrication.

Estimates of lateral violence in the nursing workplace ranges from 100 percent (Stanley et al. 2007). Nursing literature abounds with examples of prevalence.


In one study, one-third of nurses perceived emotional abuse during their last five shifts worked (Roche). In another survey, 30 percent of respondents (n= 2,100) said disruptive behavior happened weekly, and 25 percent said monthly (


A study of emergency room nurses found that 27.3 percent had experienced workplace bullying in the last six months with many staff bullied by their managers, charge nurses or directors as well as physicians and peers (Johnson, Rea). Bullying behaviors are like gangrene “when tolerated from a few physicians or nurses with strong personalities, the behaviors spread and infect the entire team“ and eventually, the patient.


Lateral violence needs to stop. Bullying behaviors create a toxic work environment which not only harms nurses, but also our patients. Experts agree nursing communication breakdowns and lack of teamwork are a root cause of errors. If nurses are afraid to speak up because they are intimidated by fellow nurses and physicians, patients can be harmed. Research also shows that simply witnessing rude behavior "significantly impacts our ability to perform cognitive tasks" (Porath). From a very ethical perspective, tolerating bullying behaviors is wrong and violates our basic oath to keep patients safe.


But maybe we need another oath? Maybe it's time we promise to keep each other safe; to nurture, support and protect each other because we understand and recognize how vulnerable we all are and the critical role we play in health care.


In April, after accidentally drawing up the lateral violence in nursingwrong medication which resulted in a child's death, an experienced nurse took her own life. Her suicide is a result of our failure as a system, and as a profession, to provide a safe harbor for the delivery of patient care. Who knows what else was going on in her mind, or the details of the situation? All I know is that it could just as easily have been me who made the error.


Where do we start to stop nurse bullying? A Chinese magician once said, If you want to take power away from anything, call it by its name. The overt and covert behaviors listed above are not normal. They are examples of lateral violence that cause serious and long lasting damage to our patients and to each other. They are wrong. Work your magic - say so!


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