Guiding COPD Patients from Diagnosis to Treatment

Guiding COPD Patients from Diagnosis to Treatment

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:

What 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 to treatment:

Work 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.

Help 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

Every 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.

Hunting the Elusive Work-Life Balance in Nursing

Hunting the Elusive Work-Life Balance in Nursing

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.”

Generational Differences

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.”

What’s Next?

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.

New Report Shows Nurses Need More Support for Necessary Challenges

New Report Shows Nurses Need More Support for Necessary Challenges

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.

14 Nurses to Be Honored with Circle of Excellence Award at NTI 2019

14 Nurses to Be Honored with Circle of Excellence Award at NTI 2019

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 Medical.

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, Minnesota Listed as Top States to Work in Nursing

Oregon, Minnesota Listed as Top States to Work in Nursing

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:

  1. Oregon
  2. Minnesota
  3. Washington
  4. New Mexico
  5. Maine
  6. Montana
  7. Arizona
  8. Nevada
  9. New Hampshire
  10. Iowa

Click here for more details about WalletHub’s nursing report.

Simple Steps You Can Take to a Safer Practice

Simple Steps You Can Take to a Safer Practice

In 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.

For 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.

Ensuring 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 way.
  • Open the doors of communication: 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 daily tasks.
  • 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 protocols accordingly.

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