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You are here: Home / Archives for LORIE A BROWN, R.N., M.N., J.D.

A Win For Some Nurses

April 7, 2022 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

I do not believe any nurse wakes up in the morning saying to themselves, “I want to do drugs today!”

I consider substance use disorder (SUD) to be a biological condition where the brain has cravings for a particular substance, and nothing will alleviate it except getting that substance into their system.

Unfortunately, a nurse with SUD doesn’t just wake up and say, “I’m not going to do this anymore.”  It usually requires treatment and intervention.

Some nurses suffering from chronic pain subsequently develop a SUD for which the pain can be alleviated only through the narcotic or Suboxone which relieves the craving as well as reduces the pain symptoms.

It is unfortunate that in Indiana the peer assistance monitoring program, Indiana Professional Recovery Program (IPRP), is an abstinence-based program by regulation.  It was a regulation promulgated by the Indiana State Board of Nursing through the rule making process.

The Board has been inflexible with those who are on Suboxone who need monitoring.

An aggrieved nurse brought a complaint to the Department of Justice stating that she had been taking Suboxone and in solid recovery for a year.  However, for her to get off that medication to participate in the monitoring program would be detrimental to her health and well-being.

The Department of Justice agreed and opined that a person with substance use disorder in recovery has a disability and public programs that prevent access, such as the peer assistance monitoring program (IPRP), is a violation of the Americans with Disabilities Act.

I know that throughout the years, nurses on Suboxone had to agree to revocation or suspension of their license until they could get off the medication before being allowed to participate in the program.

It will be interesting to see if the Board will change their rules to allow people who take Suboxone to participate in the program or if they will require monitoring elsewhere.  This is a big win for some nurses who require Suboxone to keep them from abusing narcotics.

This also has additional ramifications for nurses who take Adderall for ADHD or take a controlled substance for epilepsy to prevent seizures or narcolepsy.

I am glad that the Department of Justice does not see this as “a one size fits all” approach and is meeting nurses with their disability where they are and requiring the Board to give them options.

 

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Filed Under: Employment, Newsletter, Workplace Issues

The Amazon Treatment Of Health Care

March 24, 2022 by LORIE A BROWN, R.N., M.N., J.D. 3 Comments

Today, everyone expects the “Amazon treatment” meaning they want health care immediately!

The delivery of health care is no longer the general practitioner in your community who has been there for years caring for patients ranging in age from birth through their geriatric years.

There are same day clinics and pharmacies that see patients, there are walk-in clinics at hospitals and urgent care centers literally every mile or 2.  You can even get a same day telehealth appointment with a provider.

Unfortunately, with this quicker, faster health care system things do not get accurately diagnosed and treatment is based on symptoms rather than diagnostic determination to find the correct cause of the ailment.  More mistakes are possible.

Now, would you think this makes for good patient care?

I think this “McDonald’s” way of medical care with patients not being properly diagnosed in a timely manner will lead to more medical malpractice claims against health care providers.

We have an “Amazon” type practice of medicine because almost every health care provider is required to see a certain number of patients each hour.  To get to a specialist or a proper worked up for a problem, it can take some time to see a specialist, even take a test and get the correct diagnosis and prescribed the requisite remedy treatment.

And, obviously, the more rushed the diagnosis and treatment, the greater the chance for error with the patient paying the price.  This impacts nursing as well as patients want things now.  We will see what the future holds and if this model of healthcare will continue.

 

 

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Filed Under: Newsletter

The Needs of Millennial and Gen Z Nurses

March 17, 2022 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

Imagine being one of those who graduated from nursing school in the middle of the global pandemic?  It’s like going into a M*A*S*H* unit during the Korean War without having any training or experience.

Each generation of nurses has its own needs and, right now, the Millennials and Gen Z- Zoomers, those born between 1981 and 2012, are the hardest hit.

The number of patients being treated in hospitals has hit the roof.  Those who used to be ICU patients are now on general floors and some are literally being kept alive on life support in ICUs with every imaginable kind of drip.

Graduating at this difficult time is hard enough but actually practicing in the profession is even tougher.

A study by the American Nurses Foundation and Joslin Insight showed 10 needs of Millennials and Gen Z- Zoomers.

  1. On-The-Job Training and Support. Keep in mind these nurses graduated from nursing school amid a huge nursing shortage that was complicated by a worldwide pandemic.  Yet, these graduates didn’t have the experience and training to perform at a high level of proficiency.  Remember how long it took you to get your nursing “legs”?
  2. Mental Health Support. Approximately 60% of today’s nurses are ready to quit the profession.  They often encounter extremely grave medical situations and even death daily.  Many of the more experienced nurses are retiring, leaving the bedside, or just down right quitting, these new nurses are left to fend for themselves.
  3. Financial Support. The salaries for nurses have not kept pace with the current cost of living and as inflation continues unabated, they are falling behind in that race.  One nurse can barely afford her $2,000 monthly rent.  Others are having great difficulty in making the proverbial “ends meet.”  Nurses deserve to enjoy the quality of life that they want meaning the basics of being able to pay their bills.
  4. Respect and Recognition. It’s sad to say that nurses are often taken for granted and are not being shown the value and respect that they deserve.  That is why I urge you to never say, “I am just a nurse.”  This devalues you as well as the profession.
  5. Improved Working Conditions. Nurses want to create and enjoy an environment where they can succeed.  However, employers are sticking with antiquated models, seemingly hesitant to flex to meet the needs of nurses and to move ahead with the times.
  6. Long Term Workforce Solutions. There are no such answers that can make sure we have an adequate number of nurses to meet the needs of an aging world population.  This was highlighted in a report by the Institute of Medicine.
  7. Patience. As I say be patient with your patients and fellow coworkers.  Every nurse knows of the saying that goes, “Nurses eat their young.”  This is neither a time nor place to eat to the young.  We need every nurse to provide the best care to make a difference in their patients’ lives as well as for other medical team members.
  8. More Flexible Working Hours. Most hospitals schedule on 12-hour shifts.  Aside from picking up an entire shift, there are no other choices.  I would like to see flexibility with hours.  Yes, it will mean use of creativity in staffing by reducing shift hours to 4, 6, 8 time blocks.  If the nurse can pick the number of hours that meets her needs and ability, the value in use of that time is greatly enhanced.
  9. To Be Fulfilled. I believe nursing in is your DNA and it is a calling.  But being a calling does not mean medical facilities can take advantage of nurses.  I know nurses would rather be fulfilled in knowing that they’re doing a great job while getting the support and appreciation that they need and desire rather than money.
  10. Continuing Education Support. Years ago, there was a trend toward having a Bachelor of Science in Nursing for an entry level requirement.  But many cannot afford to pay for the 4-year education.  Many today who already have that bachelor’s degree or 2-year Associate degree, are still paying pay student loans.  There should be options, including but not limited to grants, to encourage those going into nursing to reach their goal.  There once was a time when education for a master’s degree was given free.

The way nursing is practiced in hospitals is outdated and needs to change with the times.  Hopefully, our Millennials Gen Z- Zoomers will be the leaders to make that happen.

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Filed Under: Newsletter

Is This My Right Fit In Nursing?

March 10, 2022 by LORIE A BROWN, R.N., M.N., J.D. Leave a Comment

 

Frequently I hear of nurses who are called before the Board because they were working in an environment that was not “the right fit” for them.

You’ll know when you fit in an environment because it will be one where you feel great, enjoy what you do, have the support of your colleagues, your management, and love to go to work.

Yet, I see so many acute care nurses who found it was not a good fit for them and then, because they loved the consistency of long-term care, they moved into that other area.  Others do not do well working with the large number of long-term care patients but do fare much better in ICU.

Some nurses tell me they saw “the handwriting on the wall” but continued to work longer until the “shoe dropped” and they found themselves in trouble and before the Board.

The nursing field is filled with many amazing prospects.  So, it is most important that you find the area and opportunity, something that you love, that is the right fit for you.

It is not unusual for a nurse to leave one system and go to another saying, “Oh, it’s so much better here!  I wish I had switched sooner.”  And then there would be another nurse in another facility transitioning to the one that the first nurse had just left saying the same thing. “Oh, it’s so much better here!  I wish I had switched sooner.”

The nursing shortage is a blessing and a curse.  A blessing because there are so many jobs available to provide opportunities for any nurse but, too, it is a curse because the nurse scarcity results in short staffing.

As I always say, “You can get another job, but you can’t get another license.”  So, make the extra effort to find the field and job that is a right fit for you

 

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Filed Under: Newsletter

Capping Travel Nurses Pay?

February 24, 2022 by LORIE A BROWN, R.N., M.N., J.D. 2 Comments

The American Hospital Association (AHA) and the National Center for Assisted Living recently asked Congress to investigate the fees that agencies are charging for the services of travel nurses.

The two entities say that fees for travel nurses have doubled, and they believe that the travel nurse agencies are engaging in “price gouging.”

I found it interesting that the AHA spent over $24,000,000.00 for lobbying efforts and have made significant contributions to Politicians totaling almost $2,000,000.00.

Recently, a TIME magazine article reported that hospital and nursing agencies are exploiting the financial burden resulting from the pandemic.

Travel nurses are concerned that there are efforts to cap their pay, but the investigation is into what the agencies can charge the hospitals.  But this really does affect how much the travel nurse is paid.

Unfortunately, the pandemic, coupled with reportedly 18% of the nurses quitting the profession, has made this a recipe for disaster.

Looking at the high demand for nurses, nurses leaving and others choosing to travel, makes this situation one that is seemingly never ending.

The bottom line is that hospitals need to better treat nurses and offer increased pay for their work.  This is a free market and I always say, “Charge what the market will bear.” I see no legal basis for Congress to limit the amount that a nurse agency can charge.

The hospitals are responsible for this situation and now … the hospitals must fix it!

I do not blame any nurse wanting to travel as it provides more money for them.  Many are making double what they did prior to becoming travel nurses.  Of course, from that pay, they must pay for their travel, lodging, expenses and even health insurance.

Travel nursing is risky!  They go into places that are short staffed to begin with that can’t attract or keep their own staff.

Sometimes travel nurses can be treated differently than staff because those on staff resent the traveler nurse making much more per hour than they despite the fact that travel nurses are providing help to the existing staffs.

I have heard too many horror stories such as travel nurses going great distances only to find, upon arriving at their destination, that their contact had been cancelled.  Be sure to have your contract reviewed by an attorney prior to signing so that this does not happen to you or at least you are aware of the risks.

It is unfortunate that travel nurses are working on blind faith but it’s caveat emptor, and you should always know what you are signing.

Now, that I have wandered off topic, let me return to the fact that Congress is not planning to enact legislation restricting travel nurses’ pay.  Yet they are investigating whether nurse travel agencies are price gouging the health care facilities which, I believe, will be a difficult claim to prove.

Again, hospitals have put themselves in this situation by not caring for the nurses they already have on staff, thereby, causing dissatisfied nurses to leave for higher paying opportunities.

COVID certain has the exposed the “cracks” in our health care system.

 

 

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Filed Under: Newsletter

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