Lorie Brown, RN, MN, JD, discusses the amount of stress that nurses are under and ways to relieve some of the stress in order to protect your nursing license. Lorie also talks about the importance of relieving stress and taking time for yourself so you can be there for your patients and not make mistakes. She also talks about different ways you can relieve stress.
Each year at this special time, I get to write my favorite blog which is on The Top 10 Blogs of the year we just put behind us. And 2021 was definitely one that we have been wanting to do away with for quite some time!
What I think is so interesting is what YOU are interested in.
NUMBER 10: “WHAT HAPPENED TO ‘NURSES DO NO HARM’?”
A nurse was charged with practicing medicine without a license after she asked a patient if he wanted to “let go” and, when he said yes, she unhooked his oxygen to allow him to peacefully die. She removed the oxygen without a physician’s order and now has criminal charges pending.
NUMBER 9: “RADONDA VAUGHT’S DAY IN COURT”
This blog dealt with RaDonda Vaught who made a medical error resulting in the death of a patient which culminated in her being charged criminally in the matter. This particular blog dealt with her hearing before the Nursing Board which resulted in revocation of her license. Her upcoming criminal trial scheduled for this March 21, 2022.
NUMBER 8: “CRIMINAL PROSECUTION HEALTH CARE PROVIDERS”
As in the Vaught matter noted in Number 9, we are seeing increasing numbers of nurses being charged criminally for mistakes made while doing their jobs. These are incidences of medical malpractice which of late are also being charged criminally. As we all know, everyone is presumed innocent until proven guilty in the criminal courts. Nurses certainly are no different.
NUMBER 7: “NURSING BOARDS DIRTY LITTLE SECRETS”
In the last few years leading up to 2021, we have been hearing more and more about how Nursing Boards are tending to be more aggressive in their disciplines and in their intimidation of nurses. With the COVID pandemic and the facilities increasingly becoming more short-staffed, the Boards should avoid such harsh affliction that could further reduce the number of those wanting to stay in nursing.
NUMBER 6: “BEWARE OF SIGN-ON BONUSES”
With staff-shortages during COVID, this blog discussed how hospitals are becoming so desperate in getting more qualified staff that they are offering huge bonuses to lure new employees while, at the same time, their existing staff are being overlooked for their loyalty and long-term hard work.
NUMBER 5: “SHOULD I STAY, SHOULD I GO?”
This article discussed whether nurses should stay or go based on the now legally challenged vaccination mandates. I always say that you can get another job but not another license.
NUMBER 4: “NURSING LICENSING SCAM”
Surprisingly, many unsuspecting nurses fell prey to a fraud during the past year where persons posing as Federal agents sent letters to nurses demanding their immediate payment of a bond in order to keep their licenses from being suspended. The letters, which looked quite official, however were a scam. No Nursing Board asks for money up front.
NUMBER 3: “PERSONAL SCRUBS vs. HOSPITAL SCRUBS”
Registered Nurse Cliff Wilming was fired from Alina hospital because he did not use personal scrubs during his medical work. He was concerned that if he wore his own scrubs, he could possibly infect his family during the COVID pandemic. Therefore, he chose to use the hospital’s scrubs that were cleaned in the facility. As the blog detailed, Wilming eventually got his job back.
NUMBER 2: “NURSE REFUSES COVID VACCINE”
Houston Methodist Hospital’s Jennifer Bridges, R.N., lost her job by refusing the COVID vaccine as had others from her facility. She challenged her termination but lost her suit when it was dismissed by the court. That mandate order since was stayed but not before Ms. Bridges found other employment with a private nursing company that had no vaccine mandate.
NUMBER 1: “THE RADONDA VAUGHT MATTER”
Many nurse readers seemed to be very curious about the RaDonda Vaught matter. As noted in Blog Number 9, the R.N. was charged criminally when she made a medical error resulting in the death of a patient. The criminal charges are still pending, and she is scheduled for trial on March 21, 2022, in Tennessee.
The Board originally determined to take no action against her license but later reversed and did take disciplinary action against her. After a hearing, the Tennessee Board voted unanimously to revoke her license and levy a $3,000 fine.
Ms. Vaught took responsibility for her actions and testified about the systems that failed at the hospital. The Institute for Safe Medication Practices (ISMP) felt the decision was unjust and that the Board was biased because the patient in this matter died.
They commented about the inability to differentiate between human error and reckless behavior. ISMP thought her behavior was human error and her license should not be revoked. They felt that the Board failed to consider significant contribution of system failures. ISMP felt that the Board’s decision was not in alignment with just culture and the Board should have been more focused on rehabilitation rather than punishment. The Board’s job is to protect the public rather than the nurse and, therefore, chose to revoke Ms. Vaught’s license.
Each year, I love reviewing the Top Ten Blogs and this past year was no different. As you know, I write one every week of the year which you should be receiving every Friday morning.
It is interesting to learn which of the 52 blogs for 2021 were the most noticed by you and your fellow nurses. The Vaught matter and COVID were, for sure, noticeably big topics for 2021.
I applaud you for what you do every day in caring for patients and doing your best during these difficult times.
What was your favorite blog in 2021? Was it any of those above or perhaps a different one? Let me know in the comments below.
This past summer, Medscape conducted a survey asking 10,700 LPNs, RNs, NPs, Nurse Midwives, Clinical Nurse Specialists and Certified Registered Nurse Anesthetists about their career satisfaction.
Despite the challenges that nurses have been through this past year, a third of RNs and LPNs said that the most rewarding aspect of their work was making a difference through their helping people.
90% of all nurses said they were glad to have chosen nursing as their profession. However, if given the opportunity to start over, 70% said they would choose a career in the same field while a small percentage said they would choose a different area of nursing. A small minority (mostly LPNs) said that they planned to leave the nursing profession within the next 3 years.
This surveys’ results are different from other similarly targeting surveys regarding nursing satisfaction. Other surveys found nurses were more dissatisfied.
It was also surprising in the percentage of nurses up to 25% who reported that they had known a fellow health care provider who had died of COVID.
Other issues that were called out by the survey results included violence against health care providers. 1 in 5 LPNs and RNs who had reported being a victim of physical abuse usually from a patient while 40% of all nurses reported being a victim of verbal abuse, also mostly from patients.
It is sad that nurses need to endure this violence while simply doing their job.
While ailing patients can be expected at times to exhibit less than congenial behavior, their illness is no excuse for violent interactions as NO NURSE should be subjected to any type of abuse.
The most concerning statistic revealed was that a number of nurses 9-16% had experienced sexual abuse but did not report it. What happened to the “Me Too” movement? Those who do report sexual abuse said that the issue had not been resolved to their satisfaction. It is concerning that if a nurse does the right thing and reports something, that they are not satisfied with the result.
In a recent international study, it was noted that 43.15-83.5% of female nurses were sexually harassed. This is unacceptable. The nurses felt shame, embarrassment, humiliation and belittlement. The psychological consequences are devastating. Systems need to be put in place to protect these nurses, listen to them, believe them and support them. Nursing education needs to prepare nurses what to do if they find themselves in this type of situation.
As I have often noted, nurses are the hardest working professionals on the planet, and it is unfortunate that they have been subjected to these abuses.
Things will not change until the nursing profession speaks up. Nurses should not be expected to endure abuse. The only way to stop it is for nurses to speak up.
Speaking up for yourself and reporting these abuses at least will make you shed light on the problem and make it known. You are not alone.
I hated math when I was in school and, to be honest, I still don’t like to have to deal with it whether it’s balancing my checkbook or preparing a budget.
However, I will unashamedly say I do like making money because that means I get to help more people! As you know, that’s actually the whole reason to be in business for yourself; to make money to buy you the freedom that you can do what you want when you want.
Business comes down to simply being a giant math equation. So, let’s look at the numbers involved in keeping your business on an even keel.
There are a couple of variables that you need. The first is how much money do you want to make? The second variable is how much is the average client worth?
The third variable, what is your close rate? This means how many clients do you have to talk to before closing a sale? If you’re just starting, it probably about 10% which means that for every 10 people you talk to, 1 person says, “Yes” to your services.
Then, what you want to do is know how many clients you need to talk to.
So, we just to need to work the math backwards. Let’s say you want to make $100,000 with the average value of the client being worth say $10,000 and your close rate is 10%, it means that you would need 10 clients at $10,000 to make a $100,000.
Therefore, you will have to talk to 100 people to get 10 clients if you close at 10%. See, that’s simple. Even I can do this math!
So, when you’re thinking about planning for this year, just work backwards. How much money do you want to make, how much is the average cost of the client worth and then figure out how many clients you need to talk to to make the sale.
Then, you can even divide that by 12 which, as in the previous example, that you would need to speak with 8 or 9 people a month to get your 1 client a month to make your $100,000 a year.
When you think of business as a simple math equation and realize you need only 10 clients to make over a $100,000 as the average value of the client at $10,000, it makes it really easy.
What are your goals for 2022?
If I can support you in achieving your goals, I would be happy to talk.
Simply go to callwithlorie.com.
Lorie Brown, R.N., M.N., J.D., interviews Personal Injury / Medical Malpractice Attorney, Amy Davis, J.D., of the Law Offices of Amy M. Davis – www.IndyInjury.law. The discussion includes what to do if you are involved in an automobile accident. They also discuss protecting and taking care of yourself, protecting your rights and don’t give in to pressure to settle early. You can contact Amy Davis at Amy@IndyInjury.law or (317) 428-2082 or find more information at www.IndyInjury.law.
Around the country, there are 16 health organizations suspending COVID-19 injection mandates due to the litigation temporarily blocking the CMS from forcing mandates in 10 states pending the outcome of litigation.
However, 13 hospitals in other states not affected by the injunction are shutting down various departments and ending services due to the lack of staff.
Yet other states are declaring state of emergencies due to lack of R.N. staffing. Apparently registered nurses licensed in their states probably are traveling and being paid more money while the facilities are losing the services of those individuals are calling in their National Guard.
There seems to be so much division and so many ways of handling these issues. Facilities in some states are choosing to close, others are bringing in the National Guard while, yet others are suspending the COVID injection mandate.
This is a crazy and dizzying time for nurses, and it is now more important than ever for nurses to bind together. I don’t care if you believe in vaccines or not … GET TOGETHER and ask for the salaries and benefits worthy of you and require the conditions that you want to be instituted.
Nurses have so many opportunities now that they do not need to stay in places that do not value and respect them.
What are the biggest complaints of nurses? Lack of time, lack of staff, lack of resources, lack of support, etc. All of these are based in “lack.” Nurses are conditioned to accept the lack.
Yet, money is plentiful to the hospitals for treatment of COVID patients and that money should be used to invest in supporting staff and improving conditions. Money is also plentiful for health care organizations. Just look at all the construction at these facilities and amenities. For example, the CEO of Scripps here in San Diego gets paid over 2 million dollars a year. Yet, I am receiving donations requests from the Scripps Foundation. Imagine putting 1 million of the CEO’s salary toward improving conditions of nursing staff. If nurses continue to leave the bedside and hospitals close units, the CEO is not going to have a job. Nurses, now is the time to rise up, put our differences aside and get together to ask for what we want.
The Biden administration in its “Build Back Better” plan has provisions that require nursing homes to have 1 registered nurse on duty at all times. Currently, the law is for a solitary registered nurse to be on duty for only 8 hours every day. The plan will additionally require mandatory minimum staffing without additional compensation.
Not only do we need mandatory minimum staffing in nursing homes, but also in acute care.
However, I am pleased that there is a bill out there to provide care for our most vulnerable citizens. While it has been a long time coming for mandatory staffing in nursing homes, we’ll see if this bill will be able to be passed into law.
The American Health Care Association is the largest for-profit nursing home organization, and it is opposing this bill saying that many, if not all, nursing homes will be going out of business because there are no provisions to give nursing homes more money.
According to salary.com, a nursing home administrator in California can expect an average salary of $134,354. In addition, some nursing home administrators get bonuses based on the amount of money that the facility can save.
This savings bonus puts profits over patients.
Also, nursing homes generally have many layers. There’s usually some kind of corporation that owns the nursing home and yet another corporation owns the building which houses the nursing home and is leased by the nursing home, many times owned by the same people.
It is unfortunate that health care is based on dollars. I believe health care is a right and that everyone should be entitled to the same quality care.
When it comes to long term nursing home care, many of these people have worked their whole lives and then find their way to a nursing home and have contributed to Medicare.
In addition, the Nursing Home Association argues that there are few, if any, registered nurses to be found. However, Michigan is one of the hotspots of COVID and they will be having 44 U.S. military personnel to assist two hospital systems in the Great Lakes State.
It will be interesting to see what happens with these long-term care facilities. I wonder if the military will be brought in for long term care? Probably not because these are older adults, which is unfair. They do deserve quality of care even if these are the last years of their lives.
Recently, I came across an ever so interesting article in Becker’s ASC Review regarding statistics on why ambulatory surgery centers are concerned.
According to a Medscape study, the hourly rate for a full-time registered nurse is $40/hour with part time R.N.’s earning $42.00 per hour. What caught my eye was that, though they do not get the full-time benefits, part-timers do make more per hour.
Registered Nurses make an average of $83,000 at hospital-based outpatient facilities as compared to $36,000 (about $17.30 per hour) at non-hospital based medical offices. Both are usually 9 to 5 jobs, Monday through Friday. Why is a nurse making so much less in a non-hospital based medical office and why are nurses accepting so much less?
55% of R.N.s don’t think they are being fairly compensated, and they are absolutely right. The annual nurse’s salary grew 4% in the first 9 months of 2021 which is a loss once you factor in the current inflation rate which was 6.2% as of October. That is a loss for nurses doing what they can during this pandemic, especially since hospitals, pursuant to the CARES ACT, are getting bonused on every COVID patient they treat.
What are nurses doing to let their employees know that they deserve better pay at something that matches or exceeds the country’s inflation rate? It seems the past couple of potential strikes have all been resolved but money was an important issue during those strikes. I think both sides compromised which meant nurses did not get the pay that they wanted in order to avoid striking.
So far in 2021 the turnover rate was 22%, up from 18% in 2019.
The most noticeable statistic was that 50,000 R.N.s are expected to retire during the year 2022. Therefore, 1.1 million new R.N.s will be needed to meet the needs of American healthcare.
That is quite a striking statistic because the care delivered by experienced R.N.’s is important to mentor new R.N.s.
It takes a while to get comfortable being a R.N. and certainly the experienced R.N.s are more desirable.
All of this is quite concerning for ambulatory care surgery centers.
It looks like it’s time for a complete overhaul of our healthcare system because I’m not sure how healthcare of which nurses, who are 80% of the work force, are going to be able to manage with 25% of its workforce gone when we are understaffed already.
Many years ago, a friend of mine with others hiked from Cusco, Peru in southern Peru to the top of Machu Picchu, the famed site of a 15th century Inca citadel near the top of a ridge towering almost 8,000 feet in the mountains. She arrived at Cusco early to acclimate her breathing to the local elevation before starting on her climbing venture.
After a few days adjusting to the environment, the time came for her and the group to begin their trek. Everyone gathered and started on their long hike.
The guide said it was a 10-mile hike to the base of Machu Picchu where they would break and have lunch followed by spending the remainder of the afternoon concentrating on attacking the climb to the peak with the ancient ruins.
My friend began to freak after she thought, “Wait a minute. I can walk but I’ve never hiked like this.”
The guide, noticing her obvious anxiety, approached to calm her down saying, “Look, we do this every day and hundreds of others just like you have successfully hiked this trail. And you can do it too.”
What I took from that story was that the path before us has already been blazed and the guide is right here. You, in getting to the business of your dreams, do not need to create a new path.
I struggled for 5 years building my business because I was stubborn and did not want to reach out for help. When I finally did reach out, that is when things changed in my business resulting in a substantial growth.
You don’t have to take this trek alone in building your business. There are others who have already blazed the trail before you and if you just model your actions after theirs, you too will wind up at the top of the mountain!
If you would like to share with me a private one-on-one, nurse-to-nurse business owner assessment conversation, I am happy to have blazed the trail for you. You can schedule at www.CallWithLorie.com. I only have a few spots available so hurry so you can be first to the top!
Not a day goes by when a nurse doesn’t ask me about the vaccine mandates, and they are choosing not to get the shot. They are afraid for their job and don’t know what to do.
The Biden Administration requested the Occupational Safety and Health Administration (OSHA) to require mandatory COVID inoculations in workplaces having more than 100 employees.
Employers were to comply no later than January 4th but, on November 12th, the Fifth Circuit Court of Appeals barred OSHA’s enforcement of that mandatory requirement. However, the ruling does not affect a separate directive from the Centers of Medicare and Medicaid Services which requires employees of medical facilities to be vaccinate by December 6th just 10 days from now.
In the ruling preventing OSHA from taking actions to implement or enforce the mandate, the Court said, “The mandate is a one size fits all sledgehammer that makes hardly any attempt to count for differences in workplaces (and workers) that have more than a little bearing on workers’ varying degrees of susceptibility to the supposedly ‘grave danger’ the mandate purports to address.”
Attorney generals of 27 states are refusing to comply with the mandate and have brought litigation against the Biden Administration expressing their dissatisfaction with the White House efforts. This pertains to the OSHA requirements.
Nevertheless, it is important to know that this does not affect the requirement that healthcare providers receive the shot. We do not know if this CMS regulation will require the boosters.
