But new pitch by Republican candidates to make the Pill available without a prescription could have unintended financial consequences for women.
Monthly Archives: October 2014
Travel Nurse Safety
Travel Nurse Safety: Use technology and other tactics to stay safe while on assignment
Luckily, headlines earlier this week reporting Travel Nurse Andria C. Terrell missing were followed quickly with updates that she had been found safe and in no need of assistance whatsoever.
Terrell is from Georgia and on assignment in Eugene, Oregon. She was traveling to check out Crater Lake when her family reported her missing because they hadn’t heard from her and weren’t able to reach her by cell phone. It’s always better safe than sorry, so good on her family for being proactive, but I was relieved to hear she was just fine, traveling with a friend, and had simply encountered a bad patch of cell service.
Travel Nurse safety is pretty much the same as your safety concerns when you’re not on assignment. When traveling, it’s highly likely you’ll be more concerned with patient and clinical safety — or safely securing your life jacket to go on a boating adventure! — than worried about your personal safety.
But, like Terrell’s family, you’re always better safe than sorry, so here are a few tips for Travel Nurse safety:
Check in with Friends and Family Often
This is easy, as you’re likely to want to reach out and tell them all about the fun you’re having on assignment anyway! You could even designate a person or two with whom you will make a point to check in with at regular intervals. You should also have a safety buddy in your current city — a colleague, neighbor, or friend more geographically near that you can reach out to if necessary.
Use Technology to Stay Safe
With advanced technology there are a variety of ways you can reach out: text, email, phone call, Skype, social media, and other means. There’s a great, free app called bSafe that tracks your location and lets you have a friend virtually walk you home, sends an alarm to someone you designate if you are danger, has a flashlight — it will even make fake phone calls to your cell to interrupt a bad date or meeting! Also, always make sure your “Find My Phone” feature is enabled.
Be Aware of Your Surroundings
Get your housing address as soon as you can and do a little research on your new neighborhood as well as the area your facility is in. It’s also a good idea to know where the nearest police station or other emergency resources are — knowledge you might take for granted back home. Always walk with purpose and keep an eye on everything going on around you. When parking, avoid shady looking areas and situations, opting for well-lit, higher traffic areas. You should also always check the weather report to stay aware of any environmental safety concerns.
Travel with Safety Measures
Always travel with a roadside emergency kit (click here to learn more about vehicle safety) if you’re driving. If you’re on foot you can carry a whistle and/or pepper spray, in addition to tools like the BSafe app. Also, taking an introductory self-defense class can give you confidence and easy-to-learn maneuvers.
Again, anybody anywhere can benefit by following these safety precautions. You shouldn’t be especially concerned for your safety while traveling — really no more than usual.
Do you have any additional tips or thoughts to share about Travel Nurse safety? Be sure to share in the comments!
CDC Advisory: Evaluating Patients for Ebola
The first case of Ebola Virus Disease (Ebola) diagnosed in the United States was reported to CDC by Dallas County Health and Human Services on September 28, 2014, and laboratory-confirmed by CDC and the Texas Laboratory Response Network (LRN) laboratory on September 30. The patient departed Monrovia, Liberia, on September 19, and arrived in Dallas, Texas, on September 20. The patient was asymptomatic during travel and upon his arrival in the United States; he fell ill on September 24 and sought medical care at Texas Health Presbyterian Hospital of Dallas on September 26. He was treated and released. On September 28, he returned to the same hospital, and was admitted for treatment.
The purpose of this HAN Advisory is to remind healthcare personnel and health officials to:
(1) increase their vigilance in inquiring about a history of travel to West Africa in the 21 days before illness onset for any patient presenting with fever or other symptoms consistent with Ebola;
(2) isolate patients who report a travel history to an Ebola-affected country (currently Liberia, Sierra Leone, and Guinea) and who are exhibiting Ebola symptoms in a private room with a private bathroom and implement standard, contact, and droplet precautions (gowns, facemask, eye protection, and gloves); and
(3) immediately notify the local/state health department.
Please disseminate this information to infectious disease specialists, intensive care physicians, primary care physicians, and infection control specialists, as well as to emergency departments, urgent care centers, and microbiology laboratories.
Background: The first known case of Ebola with illness onset and laboratory confirmation in the United States occurred in Dallas, Texas, on September 2014, in a traveler from Liberia. The West African countries of Liberia, Sierra Leone, and Guinea are experiencing the largest Ebola epidemic in history. From March 24, 2014, through September 23, 2014, there have been 6,574 total cases (3,626 were laboratory-confirmed) and 3,091 total deaths reported in Africa. Ebola is a rare and deadly disease caused by infection with one of four viruses (Ebolavirus genus) that cause disease in humans. Ebola infection is associated with fever of greater than 38.6°C or 101.5°F, and additional symptoms such as severe headache, muscle pain, vomiting, diarrhea, abdominal pain, or unexplained hemorrhage. Ebola is spread through direct contact (through broken skin or mucous membranes) with blood or body fluids (including but not limited to urine, saliva, feces, vomit, sweat, breast milk, and semen) of a person who is sick with Ebola or contact with objects (such as needles and syringes) that have been contaminated with these fluids. Ebola is not spread through the air or water. The main source for spread is human-to-human transmission. Avoiding contact with infected persons (as well as potentially infected corpses) and their blood and body fluids is of paramount importance. Persons are not contagious before they are symptomatic. The incubation period (the time from exposure until onset of symptoms) is typically 8-10 days, but can range from 2-21 days. Additional information is available at http://www.cdc.gov/vhf/ebola/index.html.
Recommendations: Early recognition is critical to controlling the spread of Ebola virus. Consequently, healthcare personnel should elicit the patient’s travel history and consider the possibility of Ebola in patients who present with fever, myalgia, severe headache, abdominal pain, vomiting, diarrhea, or unexplained bleeding or bruising. Should the patient report a history of recent travel to one of the affected West African countries (Liberia, Sierra Leone, and Guinea) and exhibit such symptoms, immediate action should be taken. The Ebola algorithm for the evaluation of a returned traveler and the checklist for evaluation of a patient being evaluated for Ebola are available at http://www.cdc.gov/vhf/ebola/pdf/ebola-algorithm.pdf and http://www.cdc.gov/vhf/ebola/pdf/checklist-patients-evaluated-us-evd.pdf.
Patients in whom a diagnosis of Ebola is being considered should be isolated in a single room (with a private bathroom), and healthcare personnel should follow standard, contact, and droplet precautions, including the use of appropriate personal protective equipment (PPE). Infection control personnel and the local health department should be immediately contacted for consultation.
The following guidance documents provide additional information about clinical presentation and clinical course of Ebola virus disease, infection control, and patient management:
- Guidelines for clinicians in U.S. healthcare settings are available at http://www.cdc.gov/vhf/ebola/hcp/clinician-information-us-healthcare-settings.html.
- Guidelines for infection prevention control for hospitalized patients with known or suspected Ebola in U.S. hospitals are available at http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html
- Guidelines for safe management of patients with Ebola in U.S. hospitals are at http://www.cdc.gov/vhf/ebola/hcp/patient-management-us-hospitals.html.
The case definitions for persons under investigation (PUI) for Ebola, probable cases, and confirmed cases as well as classification of exposure risk levels are at http://www.cdc.gov/vhf/ebola/hcp/case-definition.html.
Persons at highest risk of developing infection are:
- those who have had direct contact with the blood and body fluids of an individual diagnosed with Ebola – this includes any person who provided care for an Ebola patient, such as a healthcare provider or family member not adhering to recommended infection control precautions (i.e., not wearing recommended PPE
- those who have had close physical contact with an individual diagnosed with Ebola
- those who lived with or visited the Ebola-diagnosed patient while he or she was ill.
Persons who have been exposed, but who are asymptomatic, should be instructed to monitor their health for the development of fever or symptoms for 21 days after the last exposure. Guidelines for monitoring and movement of persons who have been exposed to Ebola are available at http://www.cdc.gov/vhf/ebola/hcp/monitoring-and-movement-of-persons-with-exposure.html.
Diagnostic tests are available for detection of Ebola at LRN laboratories as well as CDC. Consultation with CDC is required before shipping specimens to CDC. Information about diagnostic testing for Ebola can be found at http://www.cdc.gov/vhf/ebola/hcp/interim-guidance-specimen-collection-submission-patients-suspected-infection-ebola.html.
Healthcare personnel in the United States should immediately contact their state or local health department regarding any person being evaluated for Ebola if the medical evaluation suggests that diagnostic testing may be indicated. If there is a high index of suspicion, U.S. health departments should immediately report any probable cases or persons under investigation (PUI) (http://www.cdc.gov/vhf/ebola/hcp/case-definition.html) to CDC’s Emergency Operations Center at 770-488-7100.
The Centers for Disease Control and Prevention (CDC) protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.
Is Texas Prepared for a Public Health Emergency?
Experts says a series of recent threats, including the first Ebola patient to develop symptoms in the U.S., raise questions about the state’s capacity to deal with contagious diseases.
Calif. Law Bolsters National Effort To Give Workers Paid Sick Time
Nearly 4 in 10 private sector workers lack paid sick leave, many of them women and low-wage earners.
Ask a Travel Nurse: How do I know if I’m ready to try Travel Nursing?
Ask a Travel Nurse: How do I know if I’m ready to try Travel Nursing?
Ask a Travel Nurse Question:
I’ve worked as an RN going on four years — one year on medical-surgical and now going on my third year in ED. In the last two years I’ve really considered Travel Nursing, but fear of the unknown and wondering if I’m ready is holding me back.
How do I know if I’m ready to try Travel Nursing?
Ask a Travel Nurse Answer:
Judging when you are ready to start Travel Nursing that has to be an individual assessment. However, there are some things you can ask yourself in deciding.
Are you pretty independent in your practice? Do you take the initiative in directing your patient’s care, or do you simply let things unfold? Are you proficient in your basic skills such as IV, Foley, and NG/OG insertions? Do you feel as though you have good organizational skills, or are you always one of the nurses who is staying behind an extra 15-30 minutes to get things done? Do you still seek out others for a second opinion on what is going on with your patient or if you should call the doctor?
You must be VERY independent as a Travel Nurse because the facilities are expecting a proficient nurse who can hit the ground running. For some people, this is not anything over which to be concerned. For others, it may be a little too uncertain an environment.
If you’d like to test yourself, I always tell nurses to apply at a local agency or registry and pick up a few extra shifts at other hospitals in the area. If you can go in and function independently as an agency nurse, then Travel Nursing shouldn’t be an issue (because at least with Travel Nursing, you are most likely in the same unit throughout your contract, unless of course you take a float position).
I’m sorry to say there is not any concrete way of knowing when you are ready. But feeling confident enough in your practice as a nurse, is likely half the battle.
I hope this helps you decide.
Medicare Fines 2,610 Hospitals In Third Round Of Readmission Penalties
Although fewer patients are now returning to the hospital within a month, the fines reached a record level this year.
A Guide To Medicare’s Readmissions Penalties And Data
The methodology behind KHN’s analysis of the third year of the Medicare penalty program.
Readmissions Penalties By State: Year 3
Medicare evaluated the readmission rates of the nation’s hospitals in determining the third year of penalties in the Hospital Readmissions Reduction Program. This table lists the average impact on hospitals in each state.