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Traveling Nurse, an Exciting Career

Written by kimmel52 on November 12, 2008 – 12:13 am

By Nancy Lydia Kimmel R.N., Ph.D., C.H.M.M.

Today is an exciting time for nurses. The job market is plentiful with positions including the demand for traveling nurses. To be a travel nurse takes a special person. The individual who is a travel nurse is one who likes to see new places and meet new people, face challenges with confidence and work as a team member. Being a travel nurse is not for everyone. Nurses who have family responsibilities may choose to work near their home. However, for those who like to travel and are very outgoing, being a travel nurse is a rewarding experience.
As an experienced nursing professional, you are in a truly unique position. Read more »


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Nurse Salaries For Different Nursing Fields

Written by kimmel52 on November 12, 2008 – 12:00 am

By Nancy Lydia Kimmel R.N., Ph.D., C.H.M.M.

Many new graduate nurses are readily offered jobs prior to graduation. The positions that they are offered are usually those with the title graduate nurse or GN. For the most part, new graduates are looking for employment near their home. Since the general nursing student is now in their early to late thirties, they have already established a secure family base. While jobs for graduate nurses are plentiful it helps to have some idea of how many jobs are actually offered throughout the United States. The wonderful fact of being a nurse is that they can work just about anywhere.

The following information should be helpful in getting some idea of the pay for different nursing fields. Hospital Nurse Recruiters will inform the new graduate nurse that obtaining a bachelor degree in nursing is favored. Many hospitals will offer some form of tuition reimbursement for those nurses who seek to obtain a BSN degree. Tuition reimbursement can go as high as one hundred percent to fifty percent. For nurses who work in hospitals, there is a world of opportunity to move into many different nursing specialties. As the nurse gains more experience in their field, their salary will also increase. The salaries listed below are not all inclusive, but merely present to the reader a general idea of the salary range that exists. The reader should keep in mind that each hospital will be unique in what type of salary is offered depending on the nurses qualifications and prior work experience.

Just as you might think, large cities like New York, Los Angeles, and Chicago hold the top spots for the number of nursing jobs available. The larger cities also have higher salaries and better benefits for their nurses. The tradeoff is longer hours and more stress in large city nursing jobs versus the small community jobs where hours are usually better and the number of patients to serve is lower.

The median expected salary for a typical Staff Nurse – RN in *Detroit**, MI*, is *$65,817*. This basic market pricing report was prepared using our Certified Compensation Professionals’ analysis of survey data collected from thousands of HR departments at employers of all sizes, industries and geographies.

Job Description

Staff Nurse – RN:

Evaluates, plans, implements, and documents nursing care for an assigned patient population. Assists physician during examinations and procedures. Performs various patient tests and administers medications within the scope of practice of the registered nurse. Promotes patient’s independence by establishing patient care goals and teaching patient and family to understand condition, medications, and self-care skills. Requires an associate’s degree and is certified as a registered nurse. Familiar with standard concepts, practices, and procedures within a particular field. Relies on experience and judgment to plan and accomplish goals. Performs a variety of tasks. A wide degree of creativity and latitude is expected. Typically reports to a manager or head of a unit/department.
he current potential for advancement in the nursing industry is very promising for a registered nurse. Nursing is the largest single profession in the health care industry today. The saturation of nurses, however, has not had a negative effect on the demand in recent years.
This provides many nurses with an incentive to differentiate themselves from their colleagues to advance within the nursing industry.
Registered Nurse Salaries

Staff RNs working in the United States average a median base salary of $41,642. Half of all US RN’s are expected to earn between $38,792 and $44,869. Nearly 67% of nurses are employed in hospital inpatient and outpatient settings. 32% of all nurses are employed in medical offices and clinics, home healthcare agencies, nursing homes, temporary help agencies, academia, and government agencies. The big payoffs of any nursing career include a solid paycheck, reliable employment, and the immeasurable reward of helping others. Outside of these constants, though, the nursing field is spread along a wide spectrum of specialties, paradigms, and settings. These variables subdivide the industry into more measurable salary ranges. But other elements factor in as well:

* Region of practice
* Degree attainment
* Years of experience
* Public or private sector practice
RNs in specialties such as Critical Care, Emergency and Trauma medicine, Intensive Care Unit nursing, and OR and Recovery Room Nursing are at the higher end of the salary spectrum, while nurses in Home Health, Long Term Care, and Geriatric Nursing, are most typically at the lower end of the salary scale.


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Nursing Jobs

Written by kimmel52 on November 11, 2008 – 11:55 pm

It has been predicted that the baby boomer generation will be the most effected by the changes health care system with regard to nursing care. The current health care system is in a state of flux. With insurance companies constantly raising rates and premiums, and the hospital stays becoming less frequent, the end result is that health care must extend to the home.

Looking down the barrel of a world wide pandemic, comes the news that there are 135,000 unfilled nursing positions in the United States. By 2015, this number is expected to go to be 683,000 unfilled positions.

Two main reasons are given for these shortages:

1. Nursing hours are long, difficult and stressful
2. There is a huge shortage of nursing faculty.
We are running out of nurses to teach prospective nurses.

The impact of this new era of home care will have various effects on the population that is served. Although it is true that home care has been in existence for almost as many years as the profession of nursing itself, the amount of clients that home care now serves is quite a bit larger than the past as well as more medically demanding. What this situation implies for the nursing profession is a larger responsibility in ensuring that clients who are discharged within one to two days receive the necessary teaching and follow up nursing care to ensure progressive healing and a maximum return to wellness.

In order to help ensure the goal for the client after discharge, the hospital nurse must be acutely aware of what the clients teaching needs will be from the time of admission.

Immigration issues are adding to the shortage of nurses. There is a 6 year wait for nurses to be allowed to come here legally. Several acts are before congress to help speed along the immigration process for those who want to come here to practice medicine. Currently, the only thing stopping new nurses coming here is red tape. Many are standing in line, but the line doesn’t seem to be moving. If something doesn’t change, we can expect to face severely diminished nursing care in the very near future.

The big payoffs of any nursing career include a solid paycheck, reliable employment, and the immeasurable reward of helping others. Outside of these constants, though, the nursing field is spread along a wide spectrum of specialties, paradigms, and settings. These variables subdivide the industry into more measurable salary ranges. But other elements factor in as well:

  • Region of practice
  • Degree attainment
  • Years of experience
  • Public or private sector practice
  • Staff RNs have dozens upon dozens of specializations from which to choose. Each specialty has a distinctly different salary range that also varies from region to region, metropolitan to suburban or rural, and from public to private healthcare practice.  Associate degree RNs earn anywhere from $ 53,000 to $63,000 on a scale of national averages that spans specialties. However, there may be wide disparities outside this margin.RNs in specialties such as Critical Care, Emergency and Trauma medicine, Intensive Care Unit nursing, and OR and Recovery Room Nursing are at the higher end of the salary spectrum, while nurses in Home Health, Long Term Care, and Geriatric Nursing, are most typically at the lower end of the salary scale.

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Do You Know Your Nursing Code of Ethics?

Written by kimmel52 on November 11, 2008 – 11:48 pm

By Nancy Lydia Kimmel R.N., Ph.D., C.H.M.M.

Nursing is a profession that places on its participants a great responsibility for maintaining the highest possible standards to ensure superior quality of care. Each state has its own Board of Nursing which is responsible for the regulation and licensing of nursing practice. As the profession of nursing continues to grow and change the practicing nurse will bear more responsibility as well as legal accountability for their actions. This truth is evident in the various professional licensures that are available for nurses, such as Nurse Practitioners, Nurse Midwifes and Nurse Anesthetists. It therefore behooves each licensing board to not only self regulate judiciously but to also refine the scope of nurse practice from time to time. The individual states must also act in accordance with the overall nursing theory in mind. Self regulation is done by continually refining such goals as 1) Defining its scope of nursing practice, 2) Developing a code of ethic, 3) Establishing standards for nursing education and practice and for structures through which nursing services will be delivered,4) Developing a system of credentialing, 5)Providing for peer review and quality assurance, 6) Providing for research and continuing development of the knowledge base for nursing. (Michigan Nurses Association, Legal & Professional Regulation,, Co. 1999, ISBN0-9634643-1-0, Okemos, Michigan)

As with most professions there is a code of ethics that are inherent to each. Nursing is no different. The code for nurses consists of eleven major topics that each nurse across the nation is required to adhere.

Code for Nurses

1. The nurse provides services with respect for human dignity and the uniqueness of the client unrestricted by consideration of social or economic status, personal attributes, or the nature of health problems.

2. The nurse safeguards the client’s right to privacy, by judiciously protecting information of a confidential nature.

3. The nurse acts to safeguard the client and the public when heath care and safety are affected by the incompetent, unethical or illegal practice of any person.

4. The nurse assumes responsibility and accountability for individual nursing judgments and actions.

5. The nurse maintains competence in nursing.

6. The nurse exercises informed judgment and uses individual competence and qualifications as criteria in seeking consultation, accepting responsibilities, and delegating nursing activities to others.

7. The nurse participates in activities that contribute to the ongoing development of the profession’s body of knowledge.

8. The nurse participates in the profession’s efforts to implement and improve standards of nursing.

9. The nurse participates in the profession’s efforts to establish and maintain conditions of employment conducive to high quality nursing care.

10. The nurse participates in the profession’s effort to protect the public from misinformation and misrepresentation and to maintain the integrity of nursing.

11. The nurse collaborates with member so the health professions and other citizens in promoting community and national efforts to meet the health needs of the public. (Michigan Nurses Association, Legal & Professional Regulation,, Co. 1999, ISBN0-9634643-1-0, Okemos, Michigan)

One can interpret from the above Nurse Code that many of the hospitals employ a similar code to their organization for promotion of client health care needs. Some of the principals that hospitals employ include the responsibility of each of its employees to maintain the highest standards of care for each client served, to judiciously guard the privacy of clients, to maintain a safe environment and to take independent action when a situation arises where they are the only one that can act.

There are states that allow nurses that have attained advanced practice degrees to write prescriptions and bill insurance agencies independently. With the health care field burgeoning continuously with a growing aging population, the need for Nurse Practitioners will also continue to grow as well as the responsibilities of the Registered Nurse.


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Should Nurses Be Unionized?

Written by kimmel52 on November 11, 2008 – 11:46 pm

By Nancy Lydia Kimmel R.N., Ph.D., C.H.M.M.

Since the days of Florence Nightingale, the profession of nursing has been viewed as a career consisting of self sacrificing individuals who, with caring and compassion have devoted their lives to easing the pain and suffering of those in need. Such noble and honorable individuals would surely never strike for what ever reason, right? Wrong! So, what has happened over the centuries to the profession of nursing?

To begin to understand what has taken place in the arena of nursing, one needs to understand what the nurses of today are faced with in the hospital settings. First, many nurses are required to care for more patients than they can handle safely. This is to say that a patient care load of seven on a medical surgical unit can go up to eleven during the afternoon and midnight shift. Depending on the acuity (level of care needed) of the clients, the nurse may not be able to safely attend to all of the clients needs, and need to forego certain aspects of care just to be able to get the majority of their responsibilities completed by the next shift.

This situation of patient overload can result in very serious health consequences for the patient and ultimately, death. The direct consequence of patient neglect for the nurse involved would usually entail a law suite being filed by the family naming the nurse and the hospital as well. Patient overload is just one of the many reasons that nurses have sought to form a coalition and be represented by their own organizations.

Another reason for nurses to organize is due to the policy of pulling nurses to other floors where the patient acuity care process requires specific knowledge to be able to practice safely as a nurse. An example would be a maternity floor nurse being pulled to a medical surgical floor and being assigned a patient load consisting of newly admitted pre-operative patients and others that require suctioning and vent care. The maternity floor nurse would not only be unsafe to work on the medical surgical floor, but could also put patient’s lives in jeopardy due to her inexperience. So, what is that nurse supposed to do if they decide to decline being pulled to another floor? Many nurses feel that they may be reprimanded by the shift supervisor and perhaps written up for insubordination. But are they not in fact, declining for a valid reason? Also, shouldn’t quality patient care be the utmost priority as well as patient safety? The answer to both of these questions is of course a resounding, YES! However, many nurses are faced with these dilemmas day in and day out. They leave at the end of the day feeling as if they haven’t been able to give proper nursing care. They would be correct. It is an unsafe practice to float nurses that are unfamiliar with a particular floor to work there. The fact is, that it is done on a regular basis. Would this be a sufficient reason to strike? Many nurses think so. The list could go on and on. How safe would you feel with a nurse caring for a loved one who was on the sixteenth hour of a double shift? Not very, right? Approximately 60% of nurse in practice are providing care in hospitals (Work-Place issues, 2005)

In 1946, the American Nurses Association’s House of Delegates unanimously approved a resolution that opened the doors to nurses to engage in collective bargaining. Then about thirty years later the legal precedent that determined that state nursing associations are qualified under labor law to be labor organizations is the 1979 Sierra Vista decision. The important consequence that affected nurse was that they were free to organize themselves and not be organized by existing unions. Currently, it is the American Nurses Association that is in the forefront of establishing coalitions and bargaining for nurses nation.

The Patient Safety Act:

What the Bill Does

It protects patients safety

– The Act calls for the Massachusetts Department of Public Health (DPH) to develop and implement limits on the number of hospital patients assigned to Registered Nurses in Massachusetts. The limits would be based on scientific research and testimony from public hearings. Once established, the staffing levels would be adjusted in accordance with patient needs and requirements using a standardized, DPH-approved acuity system. An acuity system provides a means of measuring the illness level of the patients on a particular unit and their needs for care.
– These scenarios represent just an overview of why the nursing profession has sought to organize themselves into a union status.

“It is time for a new generation of leadership to cope with new problems and new opportunities. For there is a new world to be won.” – John F. Kennedy

References
Zerwekh, J.,Claborn, J.(2006).Nursing Today Transition and Trends.
(5th ed). St. Louis: Saunders
The Coalition to protect Massachusetts Patients, P.O. Box 309 Canton Massachusetts 02021 617.731.2813


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