P.O. Box 18285
Austin, Texas 78760

Spring 2004


Nurse in the Spotlight

Adel Austin was nominated by her employer for "Nurse in the Spotlight" for Spring 2004. Click on the image above to see the what made Adel her employers first choice!

In My Experience...

The table was cold, but it was sturdy enough for the bag of folders. She looked at nine smiling faces, each one sat on the shoulders of a teal clad uniform. They'd said they wanted to be nurses and they were almost there. Click here to read more...

 


Meeting the Growing Need for End-of-Life Information Within Nursing Education
By: Janene Jeffery, RN, MSN, CT
(Certified in Thanatology)
Professor of Nursing
Austin Community College

Part 2 of a 2 part series on End-of-Life Issues

Part 2 of this article provides suggestions for the implementation of educational offerings on end-of-life topics to both staff and students. The ideas presented here are intended to stimulate creative thinking beyond this limited list. Click here to read more...

President's Message



Greetings to fellow T-OADN Members and ADN Supporters!

Happy New Year! Best wishes to one and all for a healthy and prosperous 2004. I hope that your year started better than mine. A plumbing disaster over the holidays has forced us out of our building for an undetermined time. We moved our offices to another city, and have been scrambling to find classroom spaces for all our health occupations students. If you need me, I will be at the Terrell campus at (972) 563-1716.

Another challenge has been to decide how best to respond to the Aiken article, "Educational Levels of Hospital Nurses and Surgical Patient Mortality" in the September issue of JAMA. Texas has been fortunate to have a good relationship between ADN and BSN programs. The Texas Nursing Association (TNA) has taken a leadership role in not making entry into practice an issue in Texas and uniting all programs so that we have experienced success in the legislature and Coordinating Board as we faced common issues. When the Aiken article came out, T-OADN took a low-key response in an attempt to preserve the collaborative relationship that we have been fortunate to have. We shared our concerns on a local level with advisory committees and such. However, we have been seeing the conclusions in the Aiken article starting to be used as support for various positions to do with nursing such as in the article in Nursing Spectrum and the recommendation in New York to require the BSN for RN licensure, and we feel the need to express our concerns in a more public manner.

There has been time to get past the initial emotional response and really analyze the data and conclusions. There are several issues regarding the methodology used but we are most concerned over the conclusions. One researcher working with N-OADN, Art Viterito, has focused on the relationship between the percentage of deaths within 30 days of admission compared to the US background mortality based on the same mean patient age. In the table below, the first two rows include the data from the Aiken article. The third row is the US mortality rates from the National Center for Health Statistics by age. The last row compares the ratio of mortality from the Aiken study and the US mortality. The correlation between mortality rates in the Aiken et al study and the background mortality rates of the US is 0.983. This means that background mortality alone explains 96.7% of the variation in mortality found in the Aiken et al study. The ratios reveal a relationship that is directly opposed to the results noted in the article and not statistically significant. We do not see how the data can support the conclusion that was made in the article. The increases in post-operative mortality in Pennsylvania seem to reflect the mortality rates of the general population not differences in nursing education levels.

 
Hospital Nursing Workforce With BSN or Higher Degrees
 
<20%
20 - 29%
30 - 39%
40 - 49%
>= 50%
Mean Patient Age
61.3
60.8
58.9
59.0
57.3
Deaths within 30 days of admission(%)
2.3%
2.2%
1.8%
1.9%
1.7%
US Mortality %
1.2%
1.1%
1.0%
1.0%
0.8%
Ratio: Aiken's Mortality/US Mortality
1.9
2.0
1.8
1.9
2.1

T-OADN supports articulation models that encourage nurses to continue their education, but we don't want nurses, potential nurses and the public confused or alarmed about the care they receive from associate degree graduates because of misleading conclusions. We support continued research into patient outcomes when care is delivered by predominantly BSNs versus ADNs and would gladly help participate in such endeavors.

It is more important than ever that those who support Associate Degree Nursing education are knowledgeable about current nursing issues such as this current research and the re-design of nursing and nursing education. An excellent way to do so would be to attend the T-OADN convention in Fort Worth on February 19, 2004. I look forward to seeing everyone there.

-Helen Reid
8 Skills for a Healthy Career

Growing a healthy career requires purpose and skill. Every nurse's career follows a unique and
compelling trajectory, determined as much by circumstance as by choices made along the way.
Follow this professional development guidepost at every juncture of your nursing career.

Develop your personal self.
A strong inner self is the anchor of every healthy and rewarding career. Develop yourself into a strong and centered person through reading, reflection and participation in organizations and programs aimed at personal development. Become a global citizen, traveling and learning about the world's cultures. Assess your talents and skills. Explore varied workplaces and roles where you develop to the fullest.

Locate special resources when you need them.
Every successful career has ups and downs. When you experience success, share it with mentoring new nurses and those who will benefit from your unique skills wherever they are on their career path. When failure and disillusionment come your way, draw near to your own mentors and those who can reaffirm your strengths. Seek support within and outside of nursing, from talented individuals, from professional and civic organizations, and from educational programs.

Become financially astute.
From business to home, financial security is the bottom line. Learn practical financial principles from the very beginning. At every step in your career, continue to widen your financial knowledge by reading, exploring the Internet, taking courses and seeking individual guidance. By becoming financially savvy, you can achieve security in your personal and professional life.

Become a futures thinker.
Today's agenda will not be tomorrow's blueprint. Examine the work of futurists like Faith Popcorn. Learn how to act instead of react to the changing world by associating yourself with those who are succeeding. Learn about tomorrow's work world so that you can be in the right place when critical decisions are made. Expand your network by joining professional and community organizations. As a student, become active in preprofessional organizations.

Navigate any organization.
You need to know how organizations function, so you can navigate them successfully to achieve your career goals. Develop your leadership skills, but remember that leadership isn't a job or title. Leaders influence people and situations to bring about transforming change. Mentors will be especially valuable in learning how to navigate organizations. Through carefully selected mentors, you will develop an ever-widening sphere of influence, with your contributions becoming increasingly valuable and purposeful.

Become technologically savvy.
Technology has transformed how we do the simplest tasks. But technologic savvy is not limited to operating the newest equipment or software. Through educational programs, publications and technology experts, learn what tomorrow's technology will be able to do. This way you will help to lead the way in making technology an asset to your career.

Position yourself for recognition.
Develop your spoken and written communication skills so you can speak and write about what you know and value. Hone your skills in a second or third language, then use them to communicate with colleagues and consumers from other countries. Become active in professional, political and community organizations, first as a volunteer and eventually as a leader. Your new skills will serve you best if the right people know about you when someone with your talents is needed.

Retire actively.
The most fulfilled nurses remain active throughout their lives, volunteering their leadership skills for local, national and international activities. They continue to enhance science through mentoring, leadership, philanthropy, writing, teaching and travel.

Retrieved from http://www.nursingsociety.org/career/8skills.html

The Lighter Side of Life

I have been a nurse for 25 years, the last 13 of which have been in associate degree nursing education.  My clinical experiences have included med-surg, intensive care, public health, mental health in the private and public sectors, and serving proudly in the military.  Each opportunity provided a new and exciting experiences and skills. 

I have always worked full-time, so no one was more surprised than I, when I got caught up in the excitement about the nursing shortage and found myself back in clinical practice, again.  I blame Johnson & Johnson's nation-wide campaign in support of the nursing profession, particularly the television ads, "I am a nurse."  My heart swelled with pride every time I saw one of these commercials.  I felt needed and.I took the bait! Because I suspect there are others out there who may take a similar path, I thought I would share some helpful hints to make the reentry easier.
Start building up your stamina.  Begin by walking 2 miles a day until you are able to reach your goal of at least 100 miles per day.  Twelve-hour shifts are oh so long.
Begin bladder training and Kegel exercises.  Remember when you scoffed at your non-nurse friends who couldn't go eight hours with taking a bathroom break?  That was before a little chuckle, cough or sneeze left you ...well, wet.  For extra protection (i.e., during heavy lifting), I recommend extra absorbency Poise® pads.
Buy several sets of reading glasses in a variety of strengths.  Print is getting smaller every day and you can't afford to go to the front lines without a pair and a spare.  (Have you ever tried to tighten the microscopic screws in your glasses without wearing glasses so that you can see the microscopic screws?)
Wear good shoes and socks.  Thank goodness for air soled athletic shoes and cushioned socks.  Nursing is definitely a "contact" sport as your feet pound the floor for most of the shift.
Take Advil® for the pain.  The old joints aren't as smooth as they used to be.
   


The rewards are immediate, ongoing, and worth it all. From exuberant praises to a fleeting touch, direct patient contact reminds me why I became a nurse in the first place.

Those of us who are veteran nurses have a lot to contribute to direct patient care.  If you feel the call to work a shift here or there, go for it.  You are a valuable resource!
-Jere Hammer

A Dose of HMO's Own Medicine

A doctor, a nurse, and the top executive of an HMO have all died and are in line together at the Pearly Gates. St. Peter speaks with them and asks what good each has done in their life.
Doctor: ''I have devoted my life to the sick and needy and have had a part in caring for, and healing thousands of poor people.''

St. Peter: ''That's great. Go ahead in to heaven. And what about you, dear?''

Nurse: ''I've supported the good doctor and his patients my entire life as an adult.''

St. Peter: ''Wonderful. Please proceed in with the doctor. And what about you?''

Health Maintenance Organizaton Director: ''I was the president of a very large HMO and was responsible for the healthcare of millions of people all over the country.''

St. Peter: ''Oh, I see. Please go in...but you can only stay two nights!''