Helping patients to navigate what comes after a difficult diagnosis is a necessary part of our profession. In my many years working with patients facing progressive diseases, like chronic obstructive pulmonary disease (COPD), I have found that they often have questions, namely:
do I do now?
That’s where we, as
nurses and other health care providers, can offer answers. COPD is not
currently curable; however, there is still hope for these patients. Lifestyle
changes and medical advancements make it possible for patients to improve their
ability to breathe and overall quality of life. The objective of treatment is
to slow the progression of the disease and assist with managing its symptoms. As
patients with COPD come to terms with their disease, here’s what I would
recommend to guide them through the next steps of their journey, from diagnosis
With Them to Create a Plan
After giving a
diagnosis of COPD, educating patients on the disease and working with them on a
personalized plan to start addressing their symptoms is an important first
step. In fact, there are many lifestyle changes that patients can make every
day to not only accommodate their new medical needs but also to help improve
lung function. Committing to a diet of anti-inflammatory foods — like fatty
fish or dark leafy greens — participating in regular low-impact physical
activities and other techniques can help to reduce inflammation in the lungs
that can exacerbate symptoms.
Them Take the Steps to Quit Smoking
Smoking can cause
significant damage in the lungs which only increases over time. One of the best
things that patients can do if they’ve been diagnosed with chronic lung disease
is to quit smoking if they currently smoke. It’s important to arm them with information
and tools they need to successfully do so — whether it’s helping them to
identify smoking triggers, create an exercise and diet regimen or connect to
support groups or other resources. For example, at Lung Health Institute, we
offer our patients access to programs like American Lung Association’s Freedom
From Smoking® Plus, a flexible online smoking
cessation program that can be completed in six weeks.
Have an Honest
Conversation About What Treatment Is Right for Them
patient is different, and treatments will vary for each patient with COPD — depending
on the severity of the disease and other factors, including age, fitness level or
medical history. That’s why it’s critical to create an environment where patients
are comfortable being completely honest about how they’re feeling both
physically and mentally. That will ensure that we can provide them with the
best course of action when it comes to their treatment.
Melissa Rubio, Ph.D., APRN, is a nurse practitioner and principal investigator for research at the Lung Health Institute, based at its Dallas clinic. Rubio also currently serves as a visiting professor at DeVry University’s Chamberlain College of Nursing in Downers Grove, Illinois. Prior to joining Lung Health Institute, Rubio worked at Pleasant Ridge Internal Medicine in Arlington, Texas, as a family nurse practitioner. Rubio holds a doctorate in philosophy from the University of Wisconsin-Milwaukee College of Nursing. She also earned a bachelor’s degree in nursing from the same school. She is a board-certified family nurse practitioner and a certified principal investigator. Rubio is also a member of the North Texas Nurse Practitioners and the Southern Nursing Research Society.
Work-life balance is a hot concept in the nursing profession. We hear we need it. We want to achieve it. But does it really exist?
That question has piqued the interest of Adele A. Webb, PhD, RN, FNAP, FAAN, senior academic director of workforce solutions at Capella University in Minneapolis.
“People think they need it,” she said. “But do they? Can you ever have it? Or are people chronically dissatisfied because it’s like a unicorn … they’re chasing something that doesn’t exist.”
Balance Vs Satisfaction
Webb plans to study and delve into the concept of work-life balance and nurses. She said recent conversations with nurse executives, including those at HealthLeaders Media 2017 CNO Exchange, left her realizing that the idea needs to be better defined.
“Years ago, I read an article called Balance is Bunk!, and [the point] was you never have 50% this and 50% that. Sometimes work takes more, sometimes family takes more,” she recalled.
For example, if a nurse must take off from work to stay home with a sick child, on that day, family needs more focus than work. And there are times, especially for those who work weekends or holidays, where work will eclipse family.
Still, Webb said she understands the desire behind the idea of work-life balance.
“What does work-life balance really mean? It means you’re happy. Well, what does happy mean? Happy means you’re satisfied with what you’re doing,” she said. “I think what people really want is life satisfaction. They can be satisfied at home and satisfied at work even if it’s not balanced.”
Another question Webb said she is pondering is, “How then do we address or encourage satisfaction and what does that mean?”
She said she has noticed, even among her own family, that different generations of nurses crave different things.
“I have a daughter and a granddaughter who are nurses. My granddaughter is definitely a Millennial. She’s 24, new in her career, and what she wants is opportunity,” Webb said. “She’s always reading, trying to better her skills, and to learn something new.”
This drive to further their skills and their careers is a trait often tied to the Millennial generation. However, it can also be a factor that contributes to their workplace turnover. According to the RN Work Project, almost 18% of newly licensed RNs leave their first employer within the first year.
“We have the job to educate these younger nurses on opportunities to find satisfaction in the job they’re in. So when you want more, you can sign up for a committee. You can look at policy in your community or state. There are opportunities outside of leaving your unit that can meet your needs,” Webb said.
“How exciting it would be for a young nurse to have the opportunity to be on the quality committee at a hospital. Or to have the opportunity to contribute to care algorithms or standards or care or policies?” she added. “They would learn [so much] from it [and] they could contribute so much.”
While baby boomers are more likely to stay in their positions, they, too, have a need for life satisfaction and often value time and self-fulfillment, said Webb.
For example, offering tuition assistance to pursue a master’s degree may give this generation a sense of satisfaction. Or they may find fulfillment in sharing the knowledge they’ve garnered over their years of experience.
“[Give them] the opportunity to be involved, and be on a budget committee at the hospital and understand the finances and the contributions they make,” Webb suggested. “Train them to be preceptors. Let them share that knowledge with the younger generation.”
Webb is in the early stages of reviewing published literature for existing information on work-life balance and satisfaction, and plans to interview nurses about their insights. Once she has a working thesis, she plans to connect with nursing professionals through presentations and conferences to see whether her definition and evaluation of work-life balance or work-life satisfaction rings true.
This story was originally posted on MedPage Today.
A new report from the Robert Wood Johnson Foundation (RWJF) looks into how nurses in the United States can help boost health and well-being for all Americans, but data shows that those in the field are concerned about being able to do all that they can.
Despite wanting to put their skills to use to help communities as care providers, community educators, and policy advocates, nurses across the US are held back from all they can do by challenges like outdated nursing education, looming staffing shortages, and a steep lack of resources for the healthcare system. These difficulties cast a shadow on the future of nursing in the United States.
“There are many issues affecting the health of our nation—opioids, measles outbreaks, low literacy rates, untreated mental illness, lack of affordable housing, and many others. Conversations with hundreds of nurses made it clear that they are willing to help people face these challenges, but they can’t do it alone,” said Paul Kuehnert, DNP, RN, FAAN, associate vice president at RWJF. “Nurses need support from their employers, other health care professionals, community organizations, and government entities to better address unmet needs.”
The nurses interviewed shared that nursing as a profession must evolve to meet the ever-growing needs of patients, as well as the shifts within the industry that hinder nurses from learning and helping to the best of their abilities. They also provided their points of view regarding how prepared nurses are after their training and education, and what resources are provided to them by their employers. Interviewees also discussed that while patient needs are expanding, there is not enough focus on them in health care settings.
“Nurses are uniquely qualified to address many of the unmet needs of people and communities, and this research shows they have a strong desire to do that,” Kuehnert shared. “Nursing is consistently ranked among the most trusted professions, and nurses have firsthand knowledge of what patients and communities need to be healthier.”
To download the report, visit the RWJF website and click the link that says “Nurse Insights on Unmet Needs of Individuals” under the Additional Resources sidebar.
The American Association of Critical-Care Nurses (AACN) recently
awarded 14 nurses from across the United States with the Circle of Excellence
award. These nurses will be honored during AACN’s National Teaching Institute
& Critical Care Exposition (NTI) in Orlando, Florida, later this month.
NTI was founded in 1974 and is the largest educational conference and trade show for acute and critical care nurses. Bedside nurses, nurse educators, nurse managers, clinical nurse specialists and nurse practitioners are among NTI’s annual attendees.
The Circle of Excellence award candidates are evaluated on several
factors, including their promotion of patient-driven excellence, communication
skills, collaboration, effective decision making, and ability to address challenges
and remove barriers to excellent patient care.
“These healthcare professionals exemplify why AACN is a community of exceptional nurses. Their efforts are transforming healthcare and shaping the future of nursing practice within their units, in the classroom, and throughout their organizations and their communities,” AACN President Lisa Riggs, MSN, APRN-BC, CCRN-K, shared with the AACN Newsroom. “Circle of Excellence recipients use their voice, skills and knowledge to ensure that every patient gets the excellent care they deserve and that every nurse has the tools and the skills they need to provide that care.”
The award supports the AACN’s mission to create healthcare
systems designed around the needs of patients and their families, where acute
and critical care nurses can help the most. The Circle of Excellence award also
recognizes talents in shifting nursing profession trends and work environments,
which helps AACN in their mission to design the best healthcare systems for
patients and nurses. Awardees will receive a plaque and $1000 honorarium to
attend NTI May 20-23. These rewards are supported by grants from Elsevier and Dale
The 2019 AACN Circle of Excellence award recipients are listed here. For more information about AACN, click here. For more information about NTI, click here.
Oregon and Minnesota topped the list of best states for nurses, according to a recent report released by WalletHub. The 50 states and District of Columbia were ranked for opportunity and competition, and work environment, among 21 key metrics. Washington, New Mexico, and Maine followed in third, fourth and fifth, respectively.
WalletHub also shared shortlists for their key metrics, for best
states and worst states. The most nursing job openings per capita were found in
District of Columbia, New Hampshire, Maine, Vermont, and Massachusetts, while
the fewest openings were found in Arizona, Nevada, California, Utah, and Hawaii.
The states with the highest annual nursing salary (with adjustments for cost of
living) are Nevada, Michigan, Minnesota, Arizona and Ohio; states with the lowest
salary are Maryland, Vermont, Maine, New York, and the District of Columbia.
Naturally, these metrics will fluctuate in response to state demographics, student loan debt, and more specific nursing issues like overtime, overstaffing, unionization, and bad patient behavior. These factors are all strengthened by the looming nursing shortage in the United States. WalletHub reports that the nursing industry is expected to grow twice as quickly as any other occupation for the next seven years, making this an ideal time to pursue nursing as a career.
“I see an excellent long term outlook since the need for care is only going to exponentially increase,” Janet Rico, Assistant Dean of Nursing Graduate Programs at Northeastern University’s Bouvé College of Health Sciences, shared with WalletHub. “Many of the issues facing healthcare are issues best addressed by my profession; improving access, assessing and managing acute and chronic illness, patient education, and coordination of care.”
The overall top ten states for nurses are listed below:
- New Mexico
- New Hampshire
Click here for more details about WalletHub’s nursing report.
my nearly 20 years of experience as a registered nurse, I’ve learned that
simple steps make a significant difference. Fast-paced clinical settings make
the procedures and protocols that all medical staff are familiar with
incredibly important. Proactive steps, as simple as remembering to always wipe
down all patient areas and keep them clear of unnecessary or unused supplies,
have the ability to keep both patients and medical staff safer.
nurses, patient safety is fundamental to what we do. It’s the first thing that
we think about when we get up in the morning, and the last thing we think about
before we go to bed. But no matter what your role in the organization, patient
safety must be the priority.
This is especially true when caring for patients with chronic
diseases, who are at an even higher risk given their weakened immune systems. At Lung Health Institute, we
specialize in treating patients with chronic lung disease, such as COPD and emphysema,
and we’re proud to have earned The Joint Commission Gold Seal of Approval® for
ambulatory health care accreditation.
Because we are continually evaluated, this recognition reflects our longstanding
commitment to The Joint Commission’s National Patient Safety Goals focus on
identifying patients correctly, using medicines safely, preventing infection
and providing appropriate treatment.
that vetted protocols and procedures are in place across your organization
is the first step to providing the safest environment possible for your
patients. Formal accreditation is a great way to ensure this exists, but
you should also revisit and review your procedures regularly. Health care is dynamic, and these
processes need to constantly evolve along with the industry.
At any stage of the process in your organization, here are a few tips that nurses caring for patients with chronic disease should follow to ensure the safest environments:
- Never stop learning: Best practices and industry
standards are always changing, so you should strive to stay on top of the
latest and greatest. I would recommend getting involved with local or national
nursing organizations and attending any relevant conferences.
- Lend a helping hand: With more young nurses in
the field than ever before, experienced nurses need to lead by example, taking
the extra time to demonstrate the right procedures and protocols can go a long
- Open the doors of
Patients are often scared when in a health care setting and taking the time to
ask them questions about not only how they’re feeling physically — but mentally
— can ensure you’re adjusting treatment plans appropriately and collaborating
with physicians in real time to problem solve. A safe environment for patients
takes into account both their physical and mental health.
- Slow down and think: It’s incredible how many
errors can be prevented by taking the time to think, without rushing through your
- Speak up: If you’ve observed standards
and protocols and think something could be done differently, say so. Real life
experiences help shape and create the best processes, and every operation is
unique and should be tailored appropriately. Following a challenging situation,
take the time to debrief with your peers — those more experienced and less
experienced than you. Talk about what happened, and how you can work together
to make it better or more efficient moving forward. Update procedures and