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<strong>You’re</strong> <strong>committed</strong><br />

<strong>to</strong> <strong>your</strong> <strong>patients</strong>.<br />

And so is Cardinal Health.<br />

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Available at select locations of these fine retailers:<br />

Visit us at cardinalhealth.com/products<br />

© 2016 Cardinal Health. All Rights Reserved. CARDINAL HEALTH, the Cardinal Health LOGO, HOSPITAL QUALITY AT HOME, BRING THE<br />

CARING HOME and the AT HOME LOGO are trademarks or registered trademarks of Cardinal Health. Lit. No. 2CHL16-485059_N (03/2016)


May 2016 • Vol 2 • Issue 5<br />

Contents<br />

2016 Best Nursing<br />

Team Winner<br />

10<br />

Thomas Jefferson<br />

University Hospital<br />

This facility’s emergency department<br />

reduced left-without-being-seen rates<br />

and improved wait times and patient<br />

satisfaction. (Cover pho<strong>to</strong> by Kyle Kielinski)<br />

ON THE WEB<br />

www.advanceweb.com/Nurses<br />

Visit www.advanceweb.com/Nurses<br />

anytime for national and regional news,<br />

timely articles, forums, blogs and more.<br />

Time Is<br />

Running Out!<br />

▶ Data collection closes<br />

June 1 for the 2016 National<br />

Salary Survey of Nurses.<br />

2016 Best Nursing Teams<br />

14 Children’s National<br />

Health System<br />

Best Expertise: Neonatal Intensive Care Unit<br />

16 Duke University<br />

Medical Center<br />

Best Initiative: PeriAnesthesia Care Unit<br />

18 Einstein Medical Center<br />

Best Outreach: Women’s and Infants’<br />

Cluster Council<br />

20 Froedtert Hospital<br />

Best Adaptability: Inpatient Virtual Hospice<br />

Program<br />

CE ARTICLE:<br />

37 Violence in the Workplace<br />

Strategies for reducing risk.<br />

Features<br />

30 A Perfect S<strong>to</strong>rm<br />

Nurses are susceptible <strong>to</strong> plantar fasciitis.<br />

33 Patient Satisfaction Scores<br />

Optimizing the experience for all.<br />

35 Reducing Malpractice<br />

Exposure<br />

New claims data<br />

provide guidance.<br />

Adult Onset<br />

Allergies<br />

▶ Why do some people<br />

develop allergies as adults?<br />

Find this article in the<br />

Features area after May 2.<br />

Suicide Prevention<br />

▶ Better access <strong>to</strong> mental<br />

healthcare is essential <strong>to</strong><br />

reduce suicides. Posted in<br />

the Features area after May 9.<br />

2016 Career Guide<br />

▶ Our new annual career<br />

guide is available for viewing<br />

and download on our<br />

homepage.<br />

Departments & Opportunities<br />

Ad Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4, 7<br />

Edi<strong>to</strong>rial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4<br />

News & Happenings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6<br />

Education Opportunities & Career Development . . . . . . . . . . . . . . . . . . . . . . 48<br />

Career Opportunities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56<br />

Find us on<br />

ADVANCE for Nurses is produced by Merion Publications Inc., 2900 Horizon Drive, King of Prussia, PA 19406.<br />

Periodicals postage paid at Norris<strong>to</strong>wn, PA, and additional mailing offices. ADVANCE for Nurses is free <strong>to</strong> all<br />

licensed RNs and senior nursing students. Contents are not <strong>to</strong> be reproduced or reprinted without permission<br />

of publisher. © 2016 Merion Publications Inc.<br />

Postmaster: Send address changes <strong>to</strong> ADVANCE for Nurses, Merion Publications Inc., Circulation, 2900 Horizon<br />

Drive, King of Prussia, PA 19406.<br />

Our company serves the informational and career needs of doc<strong>to</strong>rs, nurses and allied healthcare professionals<br />

through a wide range of products and services, including magazines, e-newsletters and websites for<br />

health information professionals, healthcare executives, hearing healthcare professionals, imaging and<br />

radiation oncology professionals, labora<strong>to</strong>ry administra<strong>to</strong>rs, long-term care managers and professionals,<br />

medical labora<strong>to</strong>ry professionals, nurse practitioners and physician assistants, nurses, occupational<br />

therapy practitioners,physical therapy and rehabilitation professionals, respira<strong>to</strong>ry care and sleep medicine<br />

professionals, and speech-language pathologists and audiologists.<br />

ADVANCE is a member of the National Association for Health Care Recruitment (NAHCR),<br />

NCHCR, AAHCR, NSCSF, SFONE, FHA, SFAHR, TAHCR, DFWHHRA, HSHHRA and TONE.<br />

ADVERTISING POLICY: All advertisements sent <strong>to</strong> Merion Matters for publication must comply with all applicable laws and regulations. Recruitment ads that discriminate against applicants<br />

based on sex, age, race, religion, marital status or any other protected class will not be accepted for publication. The appearance of advertisements in ADVANCE Newsmagazines is not an endorsement<br />

of the advertiser or its products or services. Merion Matters does not investigate the claims made by advertisers and is not responsible for their claims.<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 3


Career Opportunities<br />

Job search by facility below, or use the key on page 56 <strong>to</strong> target <strong>your</strong> job search by <strong>your</strong> region.<br />

ADVERTISER WEB ADDRESS PG #<br />

Abing<strong>to</strong>n Memorial Hospital www.abing<strong>to</strong>nhealth.org 26<br />

Aria Health 23<br />

Athens Regional Medical Center www.athenshealth.org 24<br />

BayCare Health System 62<br />

Beebe Healthcare 60<br />

Capital Health System www.capitalhealth.org 24<br />

Catholic Medical Center www.catholicmedicalcenter.org 56<br />

Chamberlain College of Nursing www.chamberlain.edu/careers 29<br />

Children’s Hospital Los Angeles jobs.CHLA.org 25<br />

Children’s National Medical Center www.ChildrensNational.org/Nursing 14<br />

Children’s National Medical Center www.ChildrensNational.org/Nursing 27<br />

Concorde Career College job.concorde.edu 66<br />

Coordinated Health Systems 60<br />

CritiCare 59<br />

Diamond HealthCare www.diamondhealthcare.com 66<br />

Duke University www.dukenursing.org 17<br />

Einstein Healthcare Network www.einstein.edu 25<br />

Einstein HealthcareNetwork www.einstein.edu 19<br />

Elizabeth Se<strong>to</strong>nPediatric Center 57<br />

Florence Darling<strong>to</strong>nTech College 61<br />

FOJP Service Corporation 57<br />

Fort Duncan Regional Medical Center www.fortduncanmedicalcenter.com 28<br />

Fox Chase Cancer Center 58<br />

HCA North Texas careersathca.com 29<br />

Hillcrest Hospital South 64<br />

Holy Redeemer 60<br />

Horsham Clinic www.horshamclinic.com 56<br />

HSC Health Care System www.hscpediatriccenter.org 61<br />

Hudson Valley Hospital Center 57<br />

Humboldt General Hospital www.hghospital.org 65<br />

Inspira Health Network, Inc 58<br />

Kennedy Krieger Institute www.kennedykrieger.org 27<br />

Lee Memorial Health System www.leememorial.org 26<br />

Lourdes Health System 22<br />

Lower Keys Medical Center 64<br />

Main Line Health System 59<br />

Maxim Corp www.maximnurses.com/careers 19<br />

MedStar Montgomery Medical Center montgomerygeneral.com 61<br />

Memorial Healthcare System 63<br />

Mercy Philadelphia Hospital 25<br />

MJHS www.MJHS.jobs 21<br />

New Hanover Health Network www.nursingatnhrmc.com 28<br />

Nursing Unlimited 60<br />

Our Lady of Consolation 59<br />

Penn State Hershey Rehabilitation 56<br />

Prime Home Health Services www.primehomehealth.com 24<br />

Project Self-Sufficiency 57<br />

Providence Community Health 66<br />

RML Specialty Hospital 64<br />

Royale Health Care 65<br />

Roze Room Hospice 65<br />

Saint Francis Medical Center www.stfrancishealthcare.org 27<br />

Sentra Healthcare www.sentracareers.com 23<br />

Shield Institute 58<br />

Source 4 Nurses www.source4nurses.com 58<br />

South Peninsula Hospital www.sphosp.com 66<br />

South Shore Dialysis Center 57<br />

Spring Grove Hospital Center www.dbm.maryland.gov 22<br />

St Lukes Magic Valley Regional 65<br />

St. Mary’s Health Care System www.stmarysathens.org 64<br />

Stamford Hospital www.stamfordhospital.org 15<br />

Summit Oaks Hospital www.psysolutions.com 58<br />

Thomas Jefferson University Hospitals 13<br />

VA Palo Al<strong>to</strong> Medical Center 66<br />

Valley Health System www.valleyhealthcareers.com 21<br />

VMI Home Care 64<br />

VNA Care Network & Hospice www.vnacarenetwork.org/careers 22<br />

Westchester Medical Center www.wmchealth.org 26<br />

How <strong>to</strong> Contact Us: Merion Matters, ADVANCE for Nurses, 2900 Horizon Drive, King of Prussia, PA 19406-2651<br />

On the Web: www.advanceweb.com ▶ E-mail: advance@advanceweb.com ▶ Edi<strong>to</strong>rial: 800-355-5627 ▶ Michelle Perron,<br />

Executive Edi<strong>to</strong>r, mperron@advanceweb.com, ext. 1221 ▶ Danielle Bullen, Managing Edi<strong>to</strong>r, dbullen@advanceweb.com,<br />

ext. 1649 ▶ Anne Collins, Assistant Edi<strong>to</strong>r, acollins@advanceweb.com, ext. 1112 ▶ Article Reprints: 800-355-5627, ext. 1484<br />

▶ Subscriptions: 800-355-1088 ▶ To place an ad, call our Sales Department: 800-355-JOBS (5627)<br />

Edi<strong>to</strong>rial<br />

Happy Nurses Week 2016!<br />

By Michelle Perron<br />

ON BEHALF of ADVANCE Healthcare<br />

Network and the edi<strong>to</strong>rial team at ADVANCE<br />

for Nurses, I wish you a Happy Nurses Week!<br />

Each year we look forward <strong>to</strong> preparing<br />

the print issue that encompasses this annual<br />

celebration. That’s because in addition <strong>to</strong><br />

thanking nurses for sharing their talents,<br />

skills and unique brand of care, we have the<br />

distinct honor of announcing the winners<br />

of our Best Nursing Team contest. Find this coverage starting<br />

on page 10.<br />

National Nurses Week begins each year on May 6 and ends on<br />

May 12, Florence Nightingale’s birthday. The American Nurses<br />

Association (ANA) set these as permanent dates <strong>to</strong> position Nurses<br />

Week as a nationwide event. Please visit www.advanceweb.com/<br />

NursesWeek for our Nurses Week coverage.<br />

For 2016, the ANA has set a theme of creating a culture of safety.<br />

ANA defines a culture of safety as one in which core values and<br />

behaviors emphasize safety over competing goals. ANA states<br />

that attributes of a positive safety culture include: openness and<br />

mutual trust when discussing safety concerns and solutions without<br />

individual blame; marshaling of appropriate resources, such<br />

as safe staffing and skill-mix levels; a learning environment in<br />

which healthcare professionals learn from errors and proactively<br />

detect systemic weaknesses; and transparency and accountability.<br />

“ANA is asking all nurses <strong>to</strong> consider how they can individually and<br />

collectively work <strong>to</strong>ward creating a culture of safety in their workplaces,<br />

which means ensuring not only the safety of their <strong>patients</strong>, but<br />

also their own safety,” according <strong>to</strong> a statement on the ANA website.<br />

In closing, I want <strong>to</strong> honor my favorite nurse: my mother. Carolyn<br />

O. Perron, RN, BSN, is pictured instead of me this month in the<br />

inset pho<strong>to</strong>. The pho<strong>to</strong>graph was taken when she was a freshman<br />

at Hotel Dieu Nursing School in New Orleans in 1958. Her nursing<br />

skills continue <strong>to</strong> serve her and our family well many years after<br />

she s<strong>to</strong>pped wearing a cap and cape! n<br />

is produced by Merion Matters, publishers of leading healthcare magazines since 1985<br />

PRESIDENT Ann Wiest Kielinski • GENERAL MANAGER W.M. “Woody” Kielinski • EDITORIAL Executive Edi<strong>to</strong>r: Michelle<br />

Perron, mperron@advanceweb.com Lead Nurse Planner: Jennifer Oakley, FNP, MSN, RN Managing Edi<strong>to</strong>r: Danielle Bullen,<br />

dbullen@advanceweb.com Assistant Edi<strong>to</strong>r: Anne Collins, acollins@advanceweb.com Web Direc<strong>to</strong>r: Jennifer Mon<strong>to</strong>ne,<br />

jmon<strong>to</strong>ne@advanceweb.com • DESIGN Design Direc<strong>to</strong>r: Walt Saylor • Mac Tech Manager & Production: Michael Galban<br />

Production Manager: Cheryl A. Drotar Art Direc<strong>to</strong>r: Doris Mohr • MARKETING Marketing Direc<strong>to</strong>r: Maria Senior Events<br />

Marketing Manager: Laura Smith Marketing Manager: Jessaley Stercula • ADMINISTRATION Senior Recruiter: Ellen<br />

Spiegel Direc<strong>to</strong>r of Sales Administration: Mike Connor • MEDIA & MARKETING OPPORTUNITIES National Corporations<br />

Sales Manager: Rachel Laird, rlaird@advanceweb.com HEALTHCARE FACILITY SALES Group Sales Managers: Amy<br />

Sherlock, Ken Burd • EDUCATION ADVERTISING SALES Senior Account Executive: Sarah Rucinski, Account Executive:<br />

Justin Cordaro • CUSTOM PROMOTIONS Sales Manager: Mike Kerr<br />

4 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


Celebrate Nurses Week<br />

Need a read on <strong>your</strong><br />

financial future?<br />

Get <strong>your</strong> retirement plan checkup <strong>to</strong>day.<br />

Find out if you’re saving enough.<br />

See if you’re on track <strong>to</strong> retire.<br />

Learn about investing at any age.<br />

Meet one on one with a Fidelity representative.<br />

Call 800.997.7815 or visit Fidelity.com/nurses <strong>to</strong> get started.<br />

Investing involves risk, including risk of loss.<br />

Fidelity Brokerage Services LLC, Member NYSE, SIPC, 900 Salem Street, Smithfield, RI 02917. © 2016 FMR LLC. All rights reserved. 719709.2.0


News&Happenings<br />

Le Bonheur Awarded Magnet Designation<br />

▶ MEMPHIS, TENN.—Le Bonheur Children’s Hospital recently<br />

received Magnet designation, joining an elite group, since only<br />

7% of hospitals in the country have earned this distinction.<br />

“This achievement is a testament <strong>to</strong> the exceptional care we<br />

provide <strong>to</strong> <strong>patients</strong> and families,” said Nikki S. Polis, PhD, RN,<br />

chief nursing officer of Le Bonheur Children’s Hospital. “We<br />

are incredibly proud of having achieved this momen<strong>to</strong>us goal.<br />

Magnet is evidence that each and every one of us is <strong>committed</strong><br />

<strong>to</strong> providing a higher standard of care for all children in need.”<br />

Virtua Vorhees Earns First-of-Its-Kind Award<br />

▶ VORHEES, N.J.—The 4A Acute Pulmonary Care Unit at Virtua<br />

Hospital received the PRISM award (Premier Recognition in the<br />

Specialty of Med-Surg), which is co-sponsored by the Academy<br />

of Medical-Surgical Nurses (AMSN) and the Medical-Surgical<br />

Nursing Certification Board (MSNCB). This is a relatively new<br />

For Sale!<br />

M<br />

A beautiful Vic<strong>to</strong>rian style home, licensed for 25 residents, in the<br />

Canonsburg, PA region. Good income and space for expansion <strong>to</strong> 20+<br />

beds available. Asking price is $700,000 which includes real estate.<br />

Owner willing <strong>to</strong> assist new owner with training for 3 <strong>to</strong> 6 months.<br />

Please call with any questions, offers or negotiations.<br />

Bassey Henshaw Nkereuwem, RN<br />

Administra<strong>to</strong>r<br />

Greenside Meadows Personal Care Home<br />

Cell: (724) 841-2195<br />

Fax: (724) 514-6593<br />

N<br />

▶ The clinical staff from the 4A Acute Pulmonary Care Unit at Virtua Voorhees<br />

Hospital proudly receive their PRISM Award. Pho<strong>to</strong> courtesy Virtua Voorhees<br />

honor recognizing exceptional nursing practice, leadership and<br />

outcomes in medical-surgical units across the country.<br />

MSK Cancer Center Earns Magnet Recognition<br />

▶ NEW YORK—Memorial Sloan Kettering Cancer Center<br />

recently earned Magnet recognition, the most prestigious distinction<br />

a healthcare organization can receive for nursing excellence<br />

and quality patient outcomes.<br />

“Our leadership has always recognized the integral role nurses<br />

play in the care team and has empowered and engaged our nurses<br />

<strong>to</strong> achieve excellent clinical<br />

outcomes,” stated Elizabeth<br />

Nelkin McCormick, MSN,<br />

RN, CENP, senior vice<br />

president and chief nursing<br />

officer of MSK. “The<br />

lifelong relationships that<br />

many of our nurses have<br />

with <strong>patients</strong> serve as a testament<br />

<strong>to</strong> the compassion<br />

and relationship-centered<br />

care we provide.”<br />

▶ Nurses from the Memorial Sloan<br />

Kettering Cancer Center <strong>to</strong>ast their<br />

vic<strong>to</strong>ry in attaining Magnet status.<br />

Pho<strong>to</strong> courtesy Memorial Sloan Kettering<br />

Homestead Health Achieves Magnet Status<br />

▶ MIAMI—Out of nearly 6,000 healthcare organizations in the United<br />

States, only 425 have been awarded the prestigious Magnet designation,<br />

which ensures that rigorous standards for nursing excellence<br />

have been met. Homestead Health, which is part of Baptist Health<br />

South Florida, is proud <strong>to</strong> have recently joined those select few.<br />

“Achieving Magnet recognition is tangible evidence of our nurses’<br />

commitment <strong>to</strong> providing the very best care <strong>to</strong> our <strong>patients</strong>,” said<br />

Bill Duquette, the chief executive officer of Homestead Hospital. “It’s<br />

the ultimate benchmark <strong>to</strong> measure the quality of our patient care.”<br />

6 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses<br />

-1619046_CB_GreensideMeadows.indd 1<br />

4/29/16 2:25 PM


▶ The team from Carroll Hospital’s Anticoagulation Clinic has demonstrated a<br />

strong commitment <strong>to</strong> providing the highest level of care <strong>to</strong> <strong>patients</strong> taking<br />

antithrombotic medications. Pho<strong>to</strong> courtesy Carroll Hospital<br />

Carroll Clinic Is Center of Excellence<br />

▶ WESTMINSTER, MD—Carroll Hospital’s Anticoagulation Clinic<br />

was recently declared an “Anticoagulation Clinic of Excellence” by<br />

the Anticoagulation Forum, a multidisciplinary nonprofit organization<br />

that works <strong>to</strong> improve the quality of care for <strong>patients</strong> who take<br />

antithrombotic medication. Carroll received this honor following an<br />

extensive review <strong>to</strong> ensure it met the program’s rigorous standards.<br />

“We are very proud <strong>to</strong> have passed the assessment,” said Maria<br />

Goldman, CRNP, coordina<strong>to</strong>r of the Anticoagulation Clinic.<br />

“Our clinic is dedicated <strong>to</strong> actively participating in all aspects of<br />

our <strong>patients</strong>’ care, since working <strong>to</strong>gether with our <strong>patients</strong> is the<br />

best way <strong>to</strong> improve health outcomes.” n<br />

Products, Services, Education<br />

For more information on these advertisers, go <strong>to</strong> www.advanceweb.com/nursesdirec<strong>to</strong>ry or<br />

visit their Web sites.<br />

ADVERTISER WEB ADDRESS PG #<br />

ADVANCE CE www.advanceweb.com/NurseCE 32<br />

ADVANCE Healthcare Jobs www.advancehealthcarejobs.com 36<br />

ADVANCE Healthcare Shop www.www.advancehealthcareshop.com 43<br />

Amer Health Info Mgt Assoc www.ahima.org 53<br />

American Public Univ 50<br />

Cardinal Health www.cardinalhealth.com 2<br />

Champion Manufacturing www.bestchoosechampion.com 12<br />

CM&F www.cmfgroup.com 9<br />

Dansko www.dansko.com 31<br />

Fidelity Investments www.fidelity.com/nurses 5<br />

Frontier Nursing 50<br />

Helene Fuld Coll Nurs 55<br />

Gwynedd Mercy 54<br />

Glenside Meadows 6<br />

Memorial Sloan Kettering 50<br />

Memorial Sloan Kettering 54<br />

Morgan State Univ 52<br />

Neumann University 55<br />

Pacific Coll Oriental Med 52<br />

Rider University 51<br />

Rocky Mt Univ Health 54<br />

Rowan University 48<br />

Southern New Hampshire 7<br />

Thomas Edison State Coll 49<br />

University of Phoenix www.phoenix.edu/nursing 68<br />

Wheeling Jesuit Univ 48<br />

THANK YOU.<br />

Two words we think nurses<br />

need <strong>to</strong> hear more often.<br />

It’s National Nurses Week, and there’s no better time<br />

<strong>to</strong> thank you for going the extra mile, every day. As<br />

a nonprofit university, SNHU is dedicated <strong>to</strong> helping<br />

working nurses succeed, with online programs<br />

designed by nurses for nurses <strong>to</strong> fit <strong>your</strong> busy life and<br />

<strong>your</strong> budget. Find <strong>your</strong> degree at snhu.edu/nursing.<br />

The Bachelor of Science and Master<br />

of Science in Nursing programs are<br />

accredited by the Commission on<br />

Collegiate Nursing Education<br />

H&NGRUG-1900 ADVANCE for Nurses Print Ad 7 1/2 x 4 7/8inches Final Print Ready.indd 1<br />

4/28/16 11:28 AM<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 7


News&Happenings<br />

Names & Faces<br />

Ora Strickland, PhD,<br />

RN, FAAN<br />

Carl Kir<strong>to</strong>n, DNP, MBA,<br />

ANP, RN<br />

Lisa Rowen, DNSc, RN,<br />

CENP, FAAN<br />

Jerome Bagaporo,<br />

MSN, RN<br />

Nurse <strong>to</strong> Direct PA Patient Safety<br />

Authority Board<br />

HARRISBURG, PA—The board of direc<strong>to</strong>rs of the<br />

Pennsylvania Patient Safety Authority (PPSA) named<br />

a new executive direc<strong>to</strong>r, Regina M. Hoffman, RN,<br />

BSN, MBA, CPPS, who was formerly the direc<strong>to</strong>r of<br />

PPSA’s Patient Safety Liaison (PSL) program.<br />

“The Authority is pleased <strong>to</strong> announce Regina as its<br />

new executive direc<strong>to</strong>r,” said Rachel Levine, MD, chair<br />

of PPSA. As direc<strong>to</strong>r of the PSL program, Hoffman<br />

managed eight PSLs placed regionally throughout the<br />

state. “Her grasp of the current programs the Authority<br />

is involved in” made her a good choice, Levine stated.<br />

Nurse Inducted in<strong>to</strong> Researcher<br />

Hall of Fame<br />

MIAMI—Ora Strickland, PhD, RN, FAAN, the dean<br />

of Florida International University’s (FIU’s) Nicole<br />

Wertheim College of Nursing & Health Sciences,<br />

was chosen as one of 19 nurse researchers worldwide<br />

who will be inducted in<strong>to</strong> the 2016 International<br />

Nurse Researcher Hall of Fame this summer in Cape<br />

Town, South Africa. Fewer than 100 nursing professionals<br />

have received this prestigious honor since its<br />

inception in 2010. “I am both humbled and honored<br />

by this recognition,” Strickland said.<br />

Kir<strong>to</strong>n Announced as CNO of<br />

University Hospital<br />

NEWARK, NJ—University Hospital recently<br />

announced that Carl A. Kir<strong>to</strong>n, DNP, MBA, ANP,<br />

RN, will serve as its new chief nursing officer. Kir<strong>to</strong>n<br />

brings a wealth of experience <strong>to</strong> the job, having served<br />

as deputy executive direc<strong>to</strong>r and CNO at Lincoln<br />

Hospital and Mental Health Center in Bronx, N.Y.,<br />

and as senior vice president of patient care services<br />

and CNO at North General Hospital in New York<br />

City. “I am very excited about teaming up with the<br />

UH nurses <strong>to</strong> heal our <strong>patients</strong> and help members<br />

of the community live healthier lives,” Kir<strong>to</strong>n stated.<br />

Rowen Named CNE for UMMS<br />

BALTIMORE—Lisa Rowen, DNSc, RN, CENP, FAAN,<br />

has been named system chief nurse executive for the<br />

University of Maryland Medical System (UMMS)—an<br />

accomplishment that will add a nursing voice at the<br />

system level for strategic planning, nursing workforce<br />

development and continuous clinical improvement<br />

initiatives.<br />

“Nursing is a key <strong>to</strong> our continued success, and<br />

Lisa will provide input and leadership for patient care<br />

issues,” said Robert A. Chrencik, MBA, CPA, president<br />

and chief executive officer of UMMS.<br />

Bagaporo Becomes CNO of<br />

United Hebrew<br />

NEW ROCHELLE, NY—Jerome Bagaporo, MSN,<br />

RN, has been named the new chief nursing officer at<br />

United Hebrew (UH), overseeing a department with<br />

280 full- and part-time staff members. In his new role,<br />

Bagaporo is <strong>committed</strong> <strong>to</strong> seeing that the growing use<br />

of technology works <strong>to</strong> <strong>patients</strong>’ benefit—a fitting goal<br />

since he began his career at UH as the minimum data<br />

set and technology coordina<strong>to</strong>r and was tasked with<br />

completing the electronic recording of all residents’ data.<br />

“With the transition <strong>to</strong> EHRs, nurses have a better<br />

view of what is going on with a resident with just one<br />

click,” Bagaporo said. “But we’re not removing the<br />

tender loving care that we give the residents, nor the<br />

interpersonal relationships. Those personal relationships<br />

cannot be replaced by technology, a philosophy<br />

we maintain here at United Hebrew.”<br />

Lehmann Wins ARIN Award<br />

HERNDON, VA—Not only is Sharon Lehmann, MS,<br />

APRN, CMS, a past president of the Association for<br />

Radiologic and Imaging Nursing (ARIN), now she is<br />

one of its award winners as well. Calling her a “quiet,<br />

unsung heroine” who always “engages new member<br />

interest in the association,” current ARIN president<br />

Mary Sousa, BSN, RN, presented Lehmann with the<br />

2015 Presidential Award for Exemplary Service.<br />

Lehmann has served as the edi<strong>to</strong>r of the ARINVision<br />

newsletter for the past 6 years, “giving endless time and<br />

foregoing the usual compensation for this position,”<br />

Sousa noted. In addition, Lehmann has contributed<br />

handmade aprons for years for the annual ARIN silent<br />

auction, <strong>to</strong> help the association raise money. n<br />

More Nursing News<br />

READ MORE about <strong>your</strong> colleagues’ accomplishments<br />

and news around the country online at www.advanceweb.<br />

com/NurseNews.<br />

8 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


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2016 Best Nursing Team Winner<br />

Beating<br />

the Clock<br />

Thomas Jefferson University Hospital<br />

changed its workflow <strong>to</strong> give <strong>patients</strong><br />

a better ED experience<br />

By Danielle Bullen<br />

PHILADELPHIA — Leaving the emergency department (ED)<br />

before treatment presents a danger <strong>to</strong> both <strong>patients</strong> and hospitals.<br />

Patients risk worsening health when they are not properly diagnosed<br />

and treated. High left-without-being-seen (LWBS) rates correspond<br />

with ED overcrowding, a scenario that angers <strong>patients</strong> and makes<br />

it difficult for staff <strong>to</strong> deliver appropriate care.<br />

Additionally, LWBS rates are now a quality metric assessed by<br />

the Centers for Medicare and Medicaid Services. Hospitals are<br />

required <strong>to</strong> report LWBS numbers, which are accessible <strong>to</strong> the<br />

public. Patients cannot always choose their ED; but when they can,<br />

would they choose go <strong>to</strong> a facility with high wait times?<br />

In first quarter 2015, Thomas Jefferson University Hospital<br />

(TJUH) in Philadelphia had an LWBS rate of 5.7% and a door-<strong>to</strong>provider<br />

time of 43 minutes. The national average for LWBS was<br />

2%. The hospital set a goal <strong>to</strong> lower its LWBS <strong>to</strong> less than 2% and<br />

its door-<strong>to</strong>-provider time <strong>to</strong> less than 20 minutes.<br />

Exceeding those goals is the reason the emergency department<br />

at Thomas Jefferson University Hospital was named the ADVANCE<br />

for Nurses 2016 Best Nursing Team.<br />

Leading the Charge<br />

The emergency department at TJUH is a bustling place that takes<br />

up an entire city block. It has 54 beds and its staff evaluates approximately<br />

62,000 <strong>patients</strong> each year. The most common presenting<br />

complaints are orthopedic injuries, chest pain, abdominal pain<br />

and viral symp<strong>to</strong>ms. Similar <strong>to</strong> other EDs, the busiest times are<br />

weekdays between 2 p.m. and 10 p.m.<br />

In 2014, Jefferson leadership created a blueprint for strategic<br />

action (BSA), which provided direction <strong>to</strong> secure Jefferson’s future<br />

and defined how <strong>to</strong> achieve success. In support of the BSA, ED<br />

leadership developed ED 2.0, a strategic initiative aimed at transformation<br />

and focused on reducing LWBS rates, door-<strong>to</strong>-provider<br />

times, and improving patient and staff satisfaction.<br />

“We adopted it as our mantra and challenged ourselves <strong>to</strong> become<br />

a more patient- and family-centric ED,” said Stephan McDonald,<br />

MSN, manager of the emergency department. That slogan—Patients<br />

and Families First—is prominent across the emergency department.<br />

“Jefferson wants <strong>to</strong> be the best in all areas,” McDonald said. “It’s<br />

a privilege <strong>to</strong> care for 62,000 people in the Philadelphia area, and<br />

we don’t take that lightly.”<br />

Nurses as Champions<br />

The ED staff already knew the high quality of medical care provided<br />

at the hospital, since many of them receive care there. “We receive<br />

a lot of referrals and have a good deal of people who travel a great<br />

distance <strong>to</strong> come for the Jefferson brand,” McDonald remarked.<br />

The ED sees especially high rates of neurological and orthopedic<br />

<strong>patients</strong> brought in from other facilities. Improving the patient<br />

experience in the ED, where many <strong>patients</strong> are introduced <strong>to</strong> the<br />

hospital, was the lofty goal.<br />

Before the ED 2.0 project even got off the ground, the department<br />

had tremendous support from hospital leadership. Physician<br />

leadership in the department was extremely engaged in the process<br />

and redesign. “This support was the only way we could institute<br />

10 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


2016 Best Nursing Team Winner<br />

Stephan McDonald, MSN, nurse manager of the emergency department,<br />

checks the track board featuring up-<strong>to</strong>-the-minute patient status information.<br />

KYLE KIELINSKI/thanks <strong>to</strong> Thomas Jefferson University Hospital<br />

TEAM: Emergency<br />

Department<br />

ENTRY SUBMITTED BY:<br />

Stephan McDonald, MSN,<br />

manager of the emergency<br />

department<br />

such radical change,” McDonald acknowledged. “We set our own<br />

path and looked at best practices across the country.”<br />

McDonald cited the emergency department at University of<br />

Colorado, which he and other staff members visited <strong>to</strong> prepare for<br />

ED 2.0, as a model for effectively moving <strong>patients</strong> through an ED.<br />

Prior <strong>to</strong> the kickoff of the initiative, the department staff held<br />

countless meetings. A conference room was turned in<strong>to</strong> de fac<strong>to</strong><br />

office space, where anyone interested could learn about the processes<br />

and provide input. As the primary front-line patient care<br />

staff, nurses’ opinions were highly considered. “We wanted <strong>to</strong><br />

leverage the amazing nursing staff and we really worked hard<br />

<strong>to</strong> engage them throughout the process,” McDonald explained.<br />

Improving Patient Flow<br />

The first sign that something is different at TJUH’s ED is the<br />

absence of traditional nurse triage. When an ambula<strong>to</strong>ry patient<br />

first comes in, he or she checks in with the registrar and “Pivot<br />

RN,” who does a cursory triage based on appearance and chief<br />

complaint. “The Pivot Nurse has algorithms <strong>to</strong> follow,” explained<br />

Susan Cissone, MSN, administrative supervisor in the emergency<br />

department. Those algorithms determine if the patient gets an ED<br />

bed immediately or goes <strong>to</strong> the intake area.<br />

Four intake rooms are staffed with a physician, a scribe, a vitals<br />

tech and mover techs. After vital signs are taken, the physician<br />

performs a 5-minute assessment. This determines if the patient<br />

will be discharged, moved <strong>to</strong> the Fast-Track ED (staffed by a physician<br />

assistant or nurse practitioner) or moved <strong>to</strong> the main ED for<br />

further treatment.<br />

“The goal is anyone who will stay in the emergency department<br />

less than 2 hours goes <strong>to</strong> Fast Track,” Cissone said. Patients with<br />

low acuity or minor injuries are sent there. Staff members wear<br />

headsets <strong>to</strong> facilitate communication with one another.<br />

The main ED houses intake, two trauma bays, the A/B areas with<br />

patient beds, and one unexpected feature. “We have our own OR in<br />

the ED. Very few Level I trauma centers have that,” McDonald said.<br />

While the preference is <strong>to</strong> transfer <strong>patients</strong> <strong>to</strong> the operating rooms in<br />

the main hospital, he said, “If you’re hemodynamically unstable with<br />

penetrating trauma, the ED and trauma team can take the patient<br />

directly <strong>to</strong> our ED OR and attempt <strong>to</strong> resuscitate the patient and<br />

perform lifesaving surgery immediately.” The ED OR is for the most<br />

critical trauma cases; it is typically used less than 20 times per year.<br />

Less Waiting Means Happier Patients<br />

With ED 2.0 and the new intake model, Jefferson has pretty much<br />

eliminated the external waiting room. An internal waiting area<br />

is opened when the ED is at capacity. With the physician intake<br />

model, <strong>patients</strong> are typically evaluated by a physician before waiting<br />

in the internal waiting room. To ensure that <strong>patients</strong> in the<br />

internal waiting area are well cared for and informed, they staff<br />

the area with a nurse and technician. “Your wait time should be<br />

as productive as possible,” Cissone explained.<br />

Located strategically throughout the department are real-time<br />

dashboards designed by TJUH’s IS&T application development team;<br />

these provide up-<strong>to</strong>-the minute data on a number of key performance<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 11


2016 Best Nursing Team Winner<br />

Emergency<br />

department nurse<br />

Meghan Quinn, RN<br />

prepares for a busy<br />

day by checking<br />

in at the nurses'<br />

station at Thomas<br />

Jefferson University<br />

Hospital.<br />

metrics. The dashboards track how many <strong>patients</strong> are waiting and<br />

the average wait time; the current census; and the longest length of<br />

stay in Intake, Fast Track and the A/B Areas. Colors change when the<br />

emergency department reaches saturation, triggering action plans.<br />

“Nurses should keep the <strong>patients</strong> at the center of all their decisions,”<br />

Cissone noted. The flow of the ED ensures that <strong>patients</strong> are<br />

where nursing staff can see them and give them what they need.<br />

Coordinating <strong>to</strong> Hit Goal<br />

Communication is at the heart of the redesigned workflow. “There’s<br />

an enormous interdependent relationship, especially between the<br />

nurses and the techs and the nurses and the physicians as it relates<br />

<strong>to</strong> changes in patient status,” McDonald said.<br />

Nurses interact with physicians, social workers, case managers,<br />

pharmacists, radiologists, the transport team and other departments<br />

on a regular basis. Those relationships rely on information<br />

sharing and are critical <strong>to</strong> patient throughput.<br />

“Anyone looking <strong>to</strong> change their intake model needs <strong>to</strong> be bold,”<br />

McDonald said. Challenging the status quo is always a formidable<br />

undertaking, and it needs support from front-line staff, physicians<br />

and leadership.<br />

“Including nursing staff in decisions led <strong>to</strong> our success,” Cissone<br />

emphasized.<br />

Thomas Jefferson University Hospital’s bold vision paid off.<br />

With the implementation of ED 2.0, it saw immediate success with<br />

a 0.42% LWBS rate in the first week, far exceeding the original<br />

goal. These efforts have been sustained <strong>to</strong> this day, with the most<br />

recent quarterly data (Q4 2015) showing a 0.8% LWBS rate and<br />

an 11-minute door-<strong>to</strong>-provider time. Patients and families have<br />

appreciated the changes in the ED. Patient satisfaction scores have<br />

never been higher.<br />

“While ED 2.0 was a call <strong>to</strong> action <strong>to</strong> ensure we were putting the<br />

<strong>patients</strong> and their families at the center of all we do, it was also a<br />

tremendous example of the power of teamwork and staff engagement,”<br />

said Joseph An<strong>to</strong>n, MSN, RN, vice president of clinical and<br />

support services. ■<br />

Danielle Bullen is a staff writer. Email her at dbullen@advanceweb.com.<br />

and<br />

80 % of<br />

For more information: BestChooseChampion.com<br />

Best Nursing Team Honorable Mentions<br />

Find their essays at www.advanceweb.com/Nurses. Look for<br />

the 2016 Best Nursing Team coverage.<br />

▶<br />

▶<br />

▶<br />

▶<br />

▶<br />

▶<br />

▶<br />

▶<br />

▶<br />

Broward Medical Center, Ft. Lauderdale, Fla.<br />

Children’s Hospital Los Angeles, Los Angeles<br />

Gulf Coast Medical Center, Ft. Myers, Fla.<br />

HonorHealth Scottsdale Shea Medical Center,<br />

Scottsdale, Ariz.<br />

Inova Loudon Hospital, Leesburg, Va.<br />

Memorial Hospital UCH, Colorado Springs, Colo.<br />

Mount Sinai St. Luke’s Hospital, New York<br />

New<strong>to</strong>n Medical Center, New<strong>to</strong>n, N.J.<br />

Tufts Medical Center, Bos<strong>to</strong>n<br />

▶ UT Southwestern Medical Center—William P.<br />

Clements Jr. University Hospital, Dallas<br />

12 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


Best Nursing Team of 2016<br />

Jefferson Emergency Department Nursing Team<br />

Congratulations <strong>to</strong> the ED at Jefferson for being recognized as the Best Nursing Team of 2016!<br />

At Jefferson, we are proud of their efforts <strong>to</strong> create an exceptional experience for each and<br />

every patient and their families. In the ED at Thomas Jefferson University Hospital our Nursing<br />

staff expect the best and give the best. To our nurses and <strong>to</strong> nurses across the country, Happy<br />

Nurse’s Week and thank you for all that you do.<br />

Interested in how you can become a part of this great team?<br />

To learn more and apply, visit Jefferson.edu/JeffNurses<br />

1-866-JEF-NURSE<br />

HOME OF SIDNEY KIMMEL MEDICAL COLLEGE<br />

Thomas Jefferson University Hospital and Jefferson Hospital<br />

for Neuroscience are Magnet ® recognized hospitals<br />

EOE


2016 Best Nursing Team Runner-Up<br />

Children’s<br />

National Health<br />

System<br />

An educated team of NICU<br />

nurses established a strong<br />

breast milk culture<br />

OUR NEONATAL intensive care unit (NICU)<br />

nursing team at Children’s National Health System<br />

has been working on a continuous quality improvement<br />

initiative <strong>to</strong> increase the number of <strong>patients</strong><br />

receiving breast milk. This presents a special<br />

challenge in a NICU that has a high acuity level,<br />

since the small <strong>patients</strong> in our care are so vulnerable<br />

and may stay for extended periods of time<br />

while running the risk of serious complications.<br />

In the first phase of our project, 6 NICU staff<br />

We champion kids.<br />

And applaud our nurses<br />

for providing the<br />

most outstanding care.<br />

As a national leader in pediatric medicine, we are dedicated<br />

<strong>to</strong> changing the lives of kids everywhere. It’s about caring for<br />

kids. Nurturing families and communities and inspiring the<br />

most exceptional staff. It seems other people are noticing our<br />

performance…noticing that our staff, especially our nurses,<br />

are the absolute best at what they do.<br />

Congratulations <strong>to</strong> our Neonatal Intensive Care Unit Nursing<br />

team, for being named the “2016 Best Nursing Team” by<br />

ADVANCE for Nurses magazine.<br />

Learn more about our services, our Nursing careers and other<br />

opportunities in Washing<strong>to</strong>n D.C., Virginia and Maryland.<br />

www.ChildrensNational.org/Nursing<br />

Equal Opportunity Employer of Minorities, Females, Protected Veterans,<br />

and Individuals with Disabilities<br />

www.ChildrensNational.org/Nursing<br />

nurses earned certification as<br />

International Board Certified<br />

Lactation Consultants (IBCLCs)<br />

<strong>to</strong> inaugurate our Lactation<br />

Resource Nurse Service. This<br />

was followed by several nursing<br />

initiatives <strong>to</strong> support the use<br />

of lactation technology (pump<br />

rentals, scales, creama<strong>to</strong>crit and<br />

nipple shields).<br />

Dedicated breast milk refrigera<strong>to</strong>rs<br />

were placed at each<br />

patient’s bedside. Breast milk<br />

Children’s National<br />

Health System,<br />

Washing<strong>to</strong>n, D.C.<br />

TEAM: Neonatal Intensive<br />

Care Unit<br />

CATEGORY: Best Expertise<br />

ENTRY SUBMITTED BY:<br />

Judith Campbell, RNC, IBCLC,<br />

lactation consultant<br />

freezers were placed in conveniently located nourishment stations,<br />

and a secure nourishment room, complete with deep freezers, was<br />

created and devoted <strong>to</strong> milk management.<br />

Mothers were <strong>to</strong>ld they were welcome <strong>to</strong> pump at their baby’s<br />

bedside; or, they could choose <strong>to</strong> pump in an airy room containing<br />

private spaces s<strong>to</strong>cked with supplies and necessary equipment.<br />

This was followed by the creation of a full-time dedicated RN<br />

IBCLC position.<br />

Our team is empowered through staff education that includes<br />

inservices, men<strong>to</strong>ring, monthly e-newsletters and our interdisciplinary<br />

NICU Human Milk Oversight team, which is chaired by nurses.<br />

This panel is <strong>committed</strong> <strong>to</strong> valuing breast milk and breastfeeding<br />

as a critical contribution <strong>to</strong> the recovery of our <strong>patients</strong>.<br />

We have implemented many improvements through this collaboration,<br />

including expanded parental education efforts; colostrum<br />

labeling for chronological feeding; the establishment of weekly<br />

bilingual mother-<strong>to</strong>-mother support groups; electronic orders<br />

for lactation consults; the use of donor human milk; improved<br />

Pho<strong>to</strong> courtesy of Children’s National Health System<br />

14 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


2016 Best Nursing Team Runner-Up<br />

practices for reducing<br />

the potential loss of milk;<br />

advocacy for appropriate<br />

breast pumps outside the<br />

hospital (including at our<br />

local Ronald McDonald<br />

House); the use of colostrum<br />

for oral care; providing<br />

meals for lactating<br />

mothers; equipment<br />

and furniture upgrades;<br />

a milk management system<br />

(which is managed<br />

and moni<strong>to</strong>red weekly by<br />

a small team of nurses);<br />

and the use of a breast<br />

milk bar-coding system,<br />

which is considered the<br />

“gold standard” for patient<br />

safety.<br />

Implementation of<br />

our projects is guided by<br />

monthly data, initially<br />

using estimated volumes of breast milk<br />

fed, with chart review of about half of the<br />

monthly discharges.<br />

We then changed our approach <strong>to</strong> use<br />

data reflecting the percentages of <strong>patients</strong><br />

discharged on breast milk.<br />

Data assessment has confirmed that<br />

the efforts of our NICU nursing team are<br />

worthwhile: Our statistics validate that<br />

breastfeeding and breast milk feeding are<br />

a high priority in our NICU.<br />

Initial data shows a 1,000% increase in<br />

volumes of mothers’ milk fed <strong>to</strong> infants<br />

over a period of 18 months.<br />

We’ve also found that the mean percentage<br />

of <strong>patients</strong> who had been admitted <strong>to</strong><br />

our NICU at less than 1 week of age and<br />

were discharged on breast milk between<br />

the third quarter of 2011 and the fourth<br />

quarter of 2013 was 62%.<br />

Recent monthly reports show the mean<br />

through the beginning of the third quarter<br />

of 2016 is 80%, which represents an 18%<br />

increase! These findings demonstrate that<br />

the establishment of a strong breast milk<br />

culture by an educated team of nurses can<br />

indeed have a significant impact on quality<br />

of care.<br />

We are thrilled that this initiative has<br />

contributed <strong>to</strong> empowering our community’s<br />

families while in our care.<br />

As an added benefit, the monthly data<br />

provide feedback <strong>to</strong> our team that a nursing-led<br />

patient care project can improve<br />

our standing in national NICU rankings.<br />

We have found this success <strong>to</strong> be very<br />

motivating for all of us. n<br />

Careers. Inspired.<br />

Reimagine how you see <strong>your</strong> nursing career.<br />

At Stamford Health, taking care of people means providing the absolute finest<br />

care and that extends past our <strong>patients</strong> <strong>to</strong> our employees as well. Through the<br />

growth, development, and evaluation of the Shared Governance model and<br />

the work of our nursing councils, our nurses are proud that they can and do<br />

have an impact on patient care.<br />

Critical Care & Step Down Staff Nurses<br />

Flexible & Night Shifts<br />

We’re seeking BSNs (or enrollees with an established completion date) with<br />

3 years of progressive med/surg experience. The ability <strong>to</strong> read cardiac rhythm<br />

strips, and telemetry or step-down experience preferred; required for ICU.<br />

BCLS required; ACLS preferred.<br />

ICU Clinical Coordina<strong>to</strong>r<br />

Night Shift<br />

We’re seeking a BSN with a minimum of 3 years of ICU experience. Cardiac<br />

experience highly preferred. Charge nurse experience, and CCRN or AACN<br />

ECCO also preferred. BCLS and ACLS required.<br />

Stamford Health also recognizes the importance of <strong>your</strong> financial health and<br />

overall well-being. We’re offering a $10,000 sign-on bonus, competitive salary<br />

and generous shift differentials; comprehensive, low cost health insurance<br />

plans available day one; wellness programs; 26 PTO days; tax deferred annuity<br />

and (403b) pension plan; rich tuition reimbursement; professional clinical<br />

ladder with varying levels of additional compensation; high acuity care and<br />

level of au<strong>to</strong>nomy; free on-site parking and train station shuttle; and much more!<br />

Qualified candidates only, please forward <strong>your</strong> resume <strong>to</strong> Sarah Devine, RN,<br />

Nurse Recruitment and Retention Manager at: sdevine@stamhealth.org.<br />

For more information, please visit StamfordHealth.org. EOE M/F/D/V<br />

Visit Our Website for More!<br />

WE HAVE dedicated an entire section of<br />

our site <strong>to</strong> National Nurses Week 2016 and<br />

our Best Nursing Team contest! Visit www.<br />

advanceweb.com/Nurses/NursesWeek <strong>to</strong>day.<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 15


2016 Best Nursing Team Runner-Up<br />

Duke University<br />

Medical Center<br />

The PACU team implemented phased<br />

pos<strong>to</strong>perative care in the OR platform<br />

IN SEPTEMBER 2014, the Duke University<br />

Hospital PeriAnesthesia Care Unit (PACU) Team<br />

partnered with anesthesia colleagues <strong>to</strong> implement<br />

phased pos<strong>to</strong>perative care in our operating<br />

room platform. Our 120+ member team overcame<br />

challenges <strong>to</strong> achieve a significant reduction in the<br />

average recovery care time for <strong>patients</strong> in the Duke<br />

University Hospital PACU, while improving their<br />

overall experience.<br />

Prior <strong>to</strong> September 2014, the Duke University<br />

Hospital PACU was a single-phase, mixed care<br />

area that safely treated more than 25,000 <strong>patients</strong> each year. Our<br />

average length of stay for ambula<strong>to</strong>ry <strong>patients</strong> exceeded national<br />

benchmarks at 120 minutes. National data show that <strong>to</strong>p-performing<br />

facilities safely recover and discharge ambula<strong>to</strong>ry surgery <strong>patients</strong><br />

in less than 60 minutes. We identified phased PACU care as our<br />

best opportunity <strong>to</strong> reduce discharge delays for our inpatient<br />

population of intermediate care postsurgical <strong>patients</strong>.<br />

In a phased PACU, we would fast-track specific <strong>patients</strong> <strong>to</strong> a<br />

defined care area designed <strong>to</strong> support safe recovery. It was staffed<br />

with nurses who specialize in the needs of a target population.<br />

The phased approach would be supported by multidisciplinary<br />

colleagues, including anesthesia providers, physical therapists,<br />

social workers, pharmacists and surgeons.<br />

We implemented an evidence-based scoring system for <strong>patients</strong><br />

waking from anesthesia in the OR <strong>to</strong> help discern proper postsur-<br />

Duke University<br />

Medical Center,<br />

Durham, N.C.<br />

TEAM: PeriAnesthesia<br />

Care Unit<br />

CATEGORY: Best Initiative<br />

ENTRY SUBMITTED BY:<br />

PACU Team Members<br />

gical PACU placement (Phase I or Phase II care).<br />

We adopted American Society of PeriAnesthesia<br />

Nurses guidelines for staffing ratios and care foci.<br />

We reviewed and modified nurse staffing and<br />

scheduling <strong>to</strong> meet the operational needs of the<br />

unit. Education was rolled out <strong>to</strong> the surgeons,<br />

anesthesia providers and OR staff, highlighting<br />

the goals for the Phase II implementation and<br />

evidence-based scoring application. Our PACU<br />

Phase II Team also identified and purchased the<br />

equipment and supplies necessary for a dedicated<br />

Phase II area in the PACU.<br />

The Duke University Hospital PACU Team collaborated<br />

with numerous interprofessional colleagues.<br />

Most importantly, with support from their peers,<br />

a core group of Phase II PACU nurses partnered<br />

with two anesthesia providers <strong>to</strong> lead the initiative<br />

from inception <strong>to</strong> implementation. Our multidisciplinary<br />

team helped the PACU achieve significant<br />

improvements in distinct areas over the course of<br />

one fiscal year, based on our preliminary review. We<br />

reduced the average recovery time for ambula<strong>to</strong>ry<br />

surgery <strong>patients</strong> and intermediate in<strong>patients</strong> by<br />

54%, <strong>to</strong> 65 minutes.<br />

Our Phase II area now cares for more than onethird<br />

of our <strong>to</strong>tal pos<strong>to</strong>perative volume. And, the<br />

projected cost savings of Phase II PACU secondary<br />

<strong>to</strong> decreased length of stay<br />

are significant. We estimate that<br />

the Phase II PACU initiative has<br />

saved more than $1 million so far.<br />

Even better, our patient satisfaction<br />

scores have not been affected.<br />

Our PACU team continues<br />

<strong>to</strong> demonstrate its initiative by<br />

pursuing improvements, including<br />

the expansion of phased care<br />

and the refinement of processes.<br />

The nursing members of the<br />

Phase II Team developed discharge instructions<br />

for <strong>patients</strong> receiving intraoperative chemotherapy<br />

instillations. We continuously review<br />

patient feedback and average length of stay by<br />

surgical service, then identify areas for improvement<br />

initiatives.<br />

From the onset of the Phase II PACU plan,<br />

our multidisciplinary team has been inspiring <strong>to</strong><br />

watch. We have demonstrated not only initiative,<br />

but also teamwork and interprofessional collaboration.<br />

The Duke University Hospital PACU<br />

Phase II implementation has helped our service<br />

line improve patient throughput, but our greatest<br />

accomplishment by far is our PACU’s renewed<br />

drive for continuous improvement. n<br />

Pho<strong>to</strong> courtesy Duke University Medical Center<br />

16 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


Dedicated <strong>to</strong><br />

IMPROVING EACH PATIENT’S EXPERIENCE<br />

Duke Health celebrates the Duke University Hospital PeriAnesthesia Care Unit (PACU) for being selected a 2016 Best Nursing<br />

Team by ADVANCE for Nurses. The PACU Team <strong>to</strong>ok the initiative <strong>to</strong> implement phased post-operative care, which significantly<br />

reduced the length of stay for our surgical <strong>patients</strong>, while improving their overall experience.<br />

Duke Nurses are valued members of interdisciplinary<br />

teams that continually seek <strong>to</strong> enhance patient<br />

outcomes. Through their professional practice, Duke<br />

Nurses live our organization’s values of excellence,<br />

safety, integrity, diversity and teamwork.<br />

In observance of National Nurses Week, we<br />

recognize, celebrate and thank Duke Nurses,<br />

who deliver patient-centered care throughout<br />

our Magnet ® -designated health system, which is<br />

comprised of three hospitals, and our home care<br />

and hospice services, ambula<strong>to</strong>ry surgical centers,<br />

outpatient practices, community clinics, and schools<br />

of medicine and nursing.<br />

National Nurses Week<br />

May 6-12<br />

dukenursing.org | 888-358-2383<br />

U.S. News & World Report<br />

Duke University Hospital (#1),<br />

Duke Regional Hospital (#8) and<br />

Duke Raleigh Hospital (#12)<br />

are proud <strong>to</strong> have been selected<br />

as <strong>to</strong>p hospitals in North Carolina<br />

by U.S. News & World Report (2015).<br />

Duke Raleigh Hospital and<br />

selected units of Duke Regional Hospital<br />

and Duke University Hospital<br />

have been recognized by the NCNA<br />

with Hallmarks of Healthy Workplaces.<br />

Duke University Health System<br />

is very proud <strong>to</strong> have achieved<br />

Magnet recognition (2014).


2016 Best Nursing Team Runner-Up<br />

Einstein Medical<br />

Center, Philadelphia<br />

TEAM: Women’s and<br />

Infants’ Cluster Council<br />

WINNER: Best Outreach<br />

SUBMITTED BY:<br />

Marybeth Lahey, MSN, RN,<br />

NE-BC, nursing clinical direc<strong>to</strong>r,<br />

women’s and infants services<br />

Einstein Medical<br />

Center Philadelphia<br />

Nurses band <strong>to</strong>gether <strong>to</strong> support victims<br />

of domestic violence<br />

THE WOMEN’S and Infants’ Cluster Council at Einstein Medical<br />

Center consists of five staff registered nurses working in Labor and<br />

Delivery, the Mother-Baby Units and the Neonatal Intensive Care<br />

Unit. Their passion in providing compassionate nursing care is<br />

palpable, as is their commitment <strong>to</strong> honor and follow our practice<br />

model of nursing as caring science.<br />

The birth of a baby is a wonderful but stressful time under the<br />

best of circumstances. Unfortunately, we have a population of<br />

mothers who are victims of domestic violence and who fear going<br />

home. They often do not share this information while hospitalized.<br />

Because our patient population can be at a higher risk for domestic<br />

violence, our team of council members brought this issue forward<br />

at a cluster meeting and asked for staff feedback across the division.<br />

Staff members unanimously made a decision <strong>to</strong> address the<br />

issue as a division-wide community outreach project. The cluster<br />

members reached out <strong>to</strong> a local domestic violence<br />

shelter and asked for information about the depth<br />

of the social issue, as well as items mothers and<br />

infants may need when they make the potentially<br />

lifesaving decision <strong>to</strong> leave their home.<br />

To respond <strong>to</strong> this community need, the divisionwide<br />

cluster council engaged all staff members<br />

across the divisions <strong>to</strong> determine a schedule for<br />

donation of supplies and reviewed the amount<br />

needed based on the shelter’s recommendations.<br />

The council marketed this outreach drive <strong>to</strong> disciplines<br />

outside of nursing, which created a col-<br />

laborative sense of supporting our <strong>patients</strong> in a<br />

meaningful way.<br />

Often, mothers take their children out of their<br />

home at a critically violent time. As a result, they<br />

only have the clothes on their back. They typically<br />

do not have the items necessary <strong>to</strong> provide for the<br />

basic needs of children. The cluster council collected<br />

items <strong>to</strong> meet the basic needs of mothers<br />

and infants—for example, soap, diapers, infant<br />

cloths, <strong>to</strong>othbrushes and <strong>to</strong>othpaste. In addition<br />

<strong>to</strong> the basic necessities, the cluster council<br />

recognized that women in these situations suffer<br />

from low self-esteem. Our team decided <strong>to</strong> also<br />

consider items <strong>to</strong> make moms feel better about<br />

themselves. Items collected for this part of the<br />

project include perfume and nail polish.<br />

Currently the support of the domestic violence<br />

shelter includes the donations of 50 gift bags filled<br />

with items delivered twice a year, at Christmas and<br />

Mother’s Day. Because of the issues surrounding<br />

safety of mothers and infants and the importance<br />

of anonymity at an incredibly vulnerable time, we<br />

are not permitted <strong>to</strong> follow up with mothers who<br />

have received our donations. To date, our team<br />

has provided more than 300 donation bags and<br />

supported community outreach <strong>to</strong> one of the<br />

most vulnerable populations in our community.<br />

The staff nurses on the cluster council organized<br />

this project, recognized its worth, engaged all<br />

staff in donations and led the team in sustaining<br />

this valuable initiative. This team has chosen <strong>to</strong><br />

work with this patient population, spearheading<br />

this outreach project, because they are passionate<br />

about helping these <strong>patients</strong> in the acute care<br />

setting and in a supportive way after they leave<br />

the hospital. n<br />

Pho<strong>to</strong> courtesy of Einstein Medical Center<br />

18 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


Well Done!<br />

It’s not just the care our team provides or their dedication<br />

<strong>to</strong> enhancing the lives of our <strong>patients</strong>. It’s that our nurses<br />

continue <strong>to</strong> provide the highest levels of care day in<br />

and day out. And that just when you think the care they<br />

provide couldn’t be any better, they find a way <strong>to</strong> push the<br />

boundaries of excellence even further.<br />

Congratulations <strong>to</strong> the Women and Infants Cluster at<br />

Einstein Medical Center Philadelphia!<br />

To learn more about<br />

how <strong>to</strong> join<br />

the Einstein team, visit<br />

www.einstein.edu/careers<br />

At Einstein, you’ll always be in good company. Our team<br />

has many extraordinary nurses who demonstrate excellence<br />

in patient care while providing compassion <strong>to</strong> our <strong>patients</strong><br />

and their families.<br />

EOE<br />

Take Your<br />

Career<br />

<strong>to</strong> the<br />

Next Level<br />

Well Done!<br />

Maxim Healthcare Services is seeking compassionate nurses for career opportunities in a<br />

variety of care settings, such as homecare, medical facilities, flu/wellness clinics, and travel nursing.<br />

As a Maxim caregiver, you will experience the joy and satisfaction of helping others along with<br />

a gratifying career in the healthcare industry. We provide our caregivers with flexibility that fits<br />

their lifestyle, a variety of rewarding assignments and commitment <strong>to</strong> cus<strong>to</strong>mer service.<br />

Maxim’s Benefits *<br />

Competitive pay<br />

Health, dental, vision,<br />

and life insurance<br />

401(k) savings plan<br />

Weekly paychecks<br />

Well Continuous professional Done!<br />

and clinical training<br />

Awards and<br />

recognition programs<br />

*<br />

Benefit eligibility is dependent on<br />

employment status.<br />

Contact us <strong>to</strong>day <strong>to</strong> join the Maxim team!<br />

1-844-276-3083<br />

www.maximnurses.com/careers<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 19


2016 Best Nursing Team Runner-Up<br />

Froedtert Hospital<br />

Virtual hospice nurses have been a<br />

valuable asset <strong>to</strong> bedside nursing staff<br />

OUR INPATIENT virtual hospice program was<br />

established in January 2015. It brings in expertly<br />

trained hospice nurses from a local home hospice<br />

agency <strong>to</strong> partner with the palliative care experts<br />

within our inpatient units. This allows for support<br />

and improved patient and family experiences<br />

during end of life.<br />

The program was developed <strong>to</strong> be a bridge <strong>to</strong> a<br />

future inpatient hospice unit, which is projected <strong>to</strong><br />

open in the next year or two. The virtual hospice<br />

program was the first of its kind in our area, and<br />

it specializes in providing inpatient hospice support<br />

<strong>to</strong> <strong>patients</strong> and their family members when<br />

a hospital death is anticipated because the patient is unable <strong>to</strong><br />

transition <strong>to</strong> his or her home or a hospice facility.<br />

The partnership provides 24/7 hospice nursing support, enrollment<br />

of <strong>patients</strong> in<strong>to</strong> the hospice benefit, and enhancements <strong>to</strong><br />

the patient’s room.<br />

The knowledge and men<strong>to</strong>ring the hospice nurses bring <strong>to</strong> the<br />

inpatient setting are pivotal <strong>to</strong> the success of the program. The<br />

inpatient virtual hospice program served nearly 200 <strong>patients</strong> and<br />

families in 2015. Preliminary patient/family satisfaction data have<br />

been outstanding, with an overall score of 97.9% at the 1-year mark.<br />

We have also seen a halo effect of increased hospital discharges<br />

<strong>to</strong> residential hospice and inpatient palliative care consultations,<br />

resulting in substantial decreases in inpatient mortality.<br />

Froedtert Hospital,<br />

Milwaukee<br />

TEAM: Inpatient Virtual<br />

Hospice Program<br />

CATEGORY: Best<br />

Adaptability<br />

ENTRY SUBMITTED BY:<br />

Katherine Walczak, BSN, RN,<br />

CMSRN, palliative care clinical<br />

nurse coordina<strong>to</strong>r<br />

The virtual hospice nurses’ workflow includes<br />

rounding with the bedside RNs of the hospice<br />

patient <strong>to</strong> aid with symp<strong>to</strong>m management and<br />

family support, and <strong>to</strong> act as a link <strong>to</strong> the palliative<br />

care provider on service. The virtual hospice<br />

nurses have been a valuable asset <strong>to</strong> the bedside<br />

nursing staff throughout the inpatient units of<br />

this busy level I trauma center.<br />

Many acute care nurses can be uncomfortable<br />

managing end-of-life care. Having that added layer<br />

of support for the bedside nurse, which builds<br />

confidence in caring for this patient population,<br />

has been rewarding on multiple levels.<br />

An increase in the bedside nurse’s knowledge<br />

of medication management for pain, nausea,<br />

delirium and respira<strong>to</strong>ry distress has resulted in<br />

enhanced comfort for <strong>patients</strong> at the end of life.<br />

Family members often require ongoing education<br />

about the dying process of their loved one.<br />

Communication with the family members about<br />

the symp<strong>to</strong>ms they are witnessing is a technique<br />

at which our virtual hospice nurses excel.<br />

The convenience of the bedside nurse calling<br />

the virtual hospice nurse and receiving a quick<br />

response allows the bedside nurse <strong>to</strong> provide<br />

interventions sooner. All nurses caring for the<br />

patient can consult and collaborate on the best<br />

nursing intervention for the current<br />

situation.<br />

Should the patient need a new<br />

order from the provider, the virtual<br />

hospice nurses manage this,<br />

thus allowing for the bedside<br />

nurse <strong>to</strong> prioritize additional<br />

nursing care within his or her<br />

assignment. Care management<br />

staff, such as case managers and<br />

social workers, can connect with<br />

the virtual hospice nurses for<br />

questions on hospice enrollment<br />

or with their more general home<br />

hospice questions.<br />

The virtual hospice nurses rotate, attending<br />

interdisciplinary rounds within the five ICUs,<br />

<strong>to</strong> listen in and advocate for <strong>patients</strong> who may<br />

benefit from the services they can provide. The<br />

presence of the virtual hospice nurses at these<br />

rounds increases care team providers’ awareness<br />

of the benefits and added support of hospice,<br />

including bereavement services.<br />

The virtual hospice nurses are an amazing team<br />

who have made a big difference in the end-of-life<br />

experience for many <strong>patients</strong> and their families<br />

at our hospital. n<br />

Pho<strong>to</strong> courtesy of Froedtert Hospital<br />

20 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


Truly<br />

MAGNIFICENT<br />

V A L L E Y C E L E B R A T E S N A T I O N A L N U R S E S W E E K 2 0 1 6<br />

SALUTING NURSES<br />

In recognition of National Nurses Week, we thank<br />

the more than 1,600 nurses on Valley’s staff for<br />

the clinical expertise and compassionate<br />

care they provide.<br />

www.ValleyHealth.com<br />

You take care of our <strong>patients</strong> and we’ll take care of the rest.<br />

At MJHS we have an exceptional team<br />

of nurses caring for our <strong>patients</strong> every<br />

minute, every day. These extraordinary<br />

individuals have chosen <strong>to</strong> dedicate their<br />

careers <strong>to</strong> making the lives of others<br />

better. For this, we are truly thankful.<br />

To our Nurses<br />

Your unrivaled commitment <strong>to</strong> <strong>patients</strong> is what makes the care that is found at MJHS second <strong>to</strong> none. We believe in<br />

the importance of recognizing, respecting, and rewarding you for the work that you do. You may not find this everywhere,<br />

but you’ll find it at MJHS.<br />

From all of us at MJHS – A heartfelt thank you <strong>to</strong> all of our nurses!<br />

Learn more about our team, join our talent community,<br />

and explore career opportunities at<br />

MJHS.jobs/thank-you<br />

We are an equal opportunity employer M/F/D/V.<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 21


SALUTING NURSES<br />

Thank You Nurses!<br />

VNACare Network & Hospice wants <strong>to</strong> sincerely thank it’s wonderful Nurses for their<br />

great care and compassion they haven given year after year <strong>to</strong> their <strong>patients</strong>!<br />

Nurses dispense comfort, compassion, and caring without even a prescription.<br />

- Val Saintsbury<br />

•LIAISON RNS/LPNS<br />

Home care experience preferred.<br />

•CLINICAL TEACHER<br />

•CLINICAL NAVIGATION MANAGER<br />

Needham Of ce.<br />

•RNS/LPNS<br />

Minimum 1 year recent med/surg experience; home care experience preferred.<br />

•FLOAT NURSE<br />

Home care experience preferred.<br />

Full, part time or per diem. Days, Evenings or<br />

Weekends; Ask about our Baylor schedules!<br />

We invite you <strong>to</strong> join our team!<br />

Please contact Ann Bohac:<br />

abohac@vnacarenetwork.org<br />

Visit our website for all our career opportunities:<br />

www.vnacarenetwork.org<br />

EOE/M/F/D/V<br />

NW-1619075_CB_VNACare.indd 1<br />

4/29/16 10:25 AM<br />

Happy National Nurses Week!<br />

Thank You for Being a Nurse!<br />

By definition, a nurse is a person formally educated<br />

and trained in the care of the sick or infirm. This National<br />

Nurses Week, we at Lourdes Health System and<br />

St. Francis Medical Center would<br />

like <strong>to</strong> celebrate who you really are…<br />

Lourdes Health System and St. Francis<br />

Medical Center are always searching<br />

for motivated professionals <strong>to</strong> join our<br />

team. We are excited <strong>to</strong> extend <strong>to</strong> you<br />

the opportunity <strong>to</strong> take <strong>your</strong> career <strong>to</strong> the<br />

next level.<br />

the<br />

We want <strong>to</strong> hear from you! Visit us at:<br />

Heart<br />

Healthcare!<br />

lourdesnet.org/careers/ <strong>to</strong> learn more and apply.<br />

of<br />

Happy Nurses Week<br />

<strong>to</strong> Our Wonderful Nurses<br />

THANK YOU!<br />

For everything you do, this week and every week of the year.<br />

- Spring Grove Hospital Center Administration<br />

RNs (All Levels)<br />

Spring Grove Hospital Center, a 24/7 State of Maryland psychiatric<br />

facility is recruiting all levels of Registered Nurses: Full-time and<br />

Part-time. Required possession of RN license issued by the MBON.<br />

Applications can be accessed and electronically submitted <strong>to</strong> the<br />

Department of Budget and Management’s website at:<br />

www.dbm.maryland.gov<br />

for consideration of employment opportunities.<br />

Member of Trinity Health. Diversity lights our way. EOE/M/F/D/V<br />

22 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


During National Nurses Week and Always,<br />

ARIA HEALTH APPRECIATES OUR NURSES!<br />

Congratulations <strong>to</strong> all our Nurse Excellence Award winners!<br />

SALUTING NURSES<br />

Professional Nursing Practice Award<br />

Jennifer Luboff, RN, PCCN Torresdale Campus<br />

Edward Gillespie, RN<br />

Torresdale Campus<br />

Melissa Natalini, RNC<br />

Bucks Campus<br />

Joanne Przeworski, RN, CNOR Frankford Campus<br />

Clinical Leadership Award<br />

Lisa O’Hara, RN<br />

Torresdale Campus<br />

Michele MacConnell, RN, CCRN Torresdale Campus<br />

Nancy Larkins, RN, CCRN Bucks Campus<br />

Tessy Mary Mathew, RN<br />

Frankford Campus<br />

Nurse-Patient Family Award<br />

Rick Anderson, RN, PCCN Torresdale Campus<br />

Sarah Hanlon, RN, PCCN<br />

Torresdale Campus<br />

Melissa Raymond, RNC<br />

Bucks Campus<br />

Kerri Hartnett, RN, CEN<br />

Frankford Campus<br />

Care Partnership Award<br />

AnneMarie Lyons, RNC<br />

Torresdale Campus<br />

Charles Davis, RN<br />

Torresdale Campus<br />

Helenanne Faulls, RN<br />

Bucks Campus<br />

Matthew Malinowski, RN Frankford Campus<br />

Professional Scholarship Award<br />

Andrea McCabe, RN, PCCN Torresdale Campus<br />

Ryan Kelly, RN, CEN<br />

Bucks Campus<br />

Rebecca Rush, RN<br />

Frankford Campus<br />

Caps<strong>to</strong>ne Precep<strong>to</strong>r of the Year<br />

Teresa Browne, RNC<br />

Torresdale Campus<br />

Sharon Logan, RN<br />

Bucks Campus<br />

Colleen Sagias, RNC<br />

Frankford Campus<br />

1 877 808 ARIA (2742)<br />

ARIAHEALTH.org<br />

Thanks <strong>to</strong> our Nurses,<br />

we improve health every day.<br />

This is the mission of Sentara Healthcare,<br />

and we have <strong>to</strong> thank our nurses for taking<br />

it <strong>to</strong> heart the way that they have. Our<br />

nurses view each day as an opportunity <strong>to</strong><br />

elevate healthcare <strong>to</strong> a new level, <strong>to</strong> practice<br />

clinical excellence, and <strong>to</strong> administer<br />

compassionate care <strong>to</strong> each and every patient.<br />

Our health system, our <strong>patients</strong>, and our<br />

communities are all better because of the<br />

work that you do. Thank you.<br />

www.sentaracareers.com<br />

EOE, M/F/D/V A Drug Free/Tobacco Free Workplace.<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 23


SALUTING NURSES<br />

After battling recurring ear<br />

infections, a surgical procedure<br />

<strong>to</strong> insert ear tubes was<br />

no match for this brave<br />

caped crusader…<br />

Integrity, Excellence,<br />

Compassion and Teamwork.<br />

These are the values of our health system that<br />

are consistently exemplified by our Nurses<br />

every day.<br />

During National Nurses Week, we join the nation in recognizing<br />

Nurses everywhere, including our own.<br />

We salute our Nurses for their hard work and dedication <strong>to</strong> our<br />

<strong>patients</strong> and our community.<br />

If you are interested in joining the Capital Health Nurses who<br />

have earned the prestigious national Magnet ® designation<br />

three consecutive times, please visit<br />

www.capitalhealth.org and<br />

click on Careers for current<br />

opportunities.<br />

Equal Opportunity Employer<br />

…But even this<br />

superhero has a hero.<br />

At Athens Regional, our nurses<br />

are the unsung heroes of our<br />

world. They work tirelessly on<br />

the front lines of patient care.<br />

Because of them, our community<br />

is a happier, healthier place!<br />

Prime Home Health Services<br />

would like <strong>to</strong> give<br />

a heartfelt thank you<br />

<strong>to</strong> all Nurses<br />

In honor of National Nurses<br />

Week, we want <strong>to</strong> thank our<br />

nurses for a job well done.<br />

Your tireless efforts, caring<br />

and dedication never go<br />

unnoticed. You’ve helped<br />

make us the Agency<br />

we are <strong>to</strong>day.<br />

To learn more about our organization,<br />

please visit our website:<br />

www.primehomehealth.com<br />

To Our Nurses:<br />

Thank You.<br />

From: Prime<br />

706.475.7000<br />

AthensHealth.org<br />

Care starts at home.<br />

We are an EOE.<br />

24 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


Einstein Healthcare<br />

Network is proud<br />

and honored <strong>to</strong><br />

recognize our<br />

dedicated Nurses for<br />

the exceptional care<br />

they provide <strong>to</strong> <strong>patients</strong>,<br />

for their wonderful<br />

contributions <strong>to</strong> the<br />

community, and for<br />

their commitment<br />

<strong>to</strong> the nursing<br />

profession.<br />

Learn how you can join our<br />

amazing nursing staff.<br />

www.einstein.edu/careers<br />

SALUTING NURSES<br />

We specialize in<br />

laughter in motion.<br />

EOE<br />

Nurse Practitioner RN, Operating Room RN, Emergency Physical Therapy<br />

Laughing children cascading by on Rollerblades, forgetting they are<br />

<strong>patients</strong> for a while, doing what they should be doing: being kids. Every<br />

child deserves <strong>to</strong> enjoy all the happy memories that childhood has <strong>to</strong><br />

offer, free from pain and suffering. And our Nurses at Children’s Hospital<br />

Los Angeles help make this possible, enjoying our own special moments<br />

along the way.<br />

Children’s Hospital Los Angeles congratulates all<br />

members of the CHLA team that assisted at the Special<br />

Olympic World Games for receiving an Honorable<br />

Mention award in the 2016 ADVANCE for Nurses Best<br />

Nursing Teams contest.<br />

Honoring Our Nurses<br />

Mercy Health System’s culture of safety starts with our<br />

nursing staff. And we celebrate their professionalism,<br />

dedication and compassion. We thank them for all<br />

they do for our <strong>patients</strong> and their families every day.<br />

Thank you for helping us create hope and build healthier futures for the<br />

children of Los Angeles and beyond.<br />

Interested in joining our team?<br />

jobs.CHLA.org or call 1-866-CHLA-HIRE<br />

Mercy Fitzgerald Hospital<br />

Mercy Philadelphia Hospital<br />

Nazareth Hospital<br />

Mercy Home Health<br />

Mercy LIFE<br />

07-08893<br />

mercyhealth.org<br />

Children’s Hospital Los Angeles is an Equal Employment Opportunity and Affirmative Action<br />

Employer. We do not discriminate on the basis of race, color, gender, sexual orientation, age,<br />

religion, national or ethnic origin, disability or veteran status.<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 25


SALUTING NURSES<br />

wmchealth.org<br />

Happy Nurses Week!<br />

Ready <strong>to</strong> join the best?<br />

Learn more about us and<br />

view open opportunities:<br />

Jefferson.edu/Abing<strong>to</strong>n<br />

Thank you <strong>to</strong> our Nurses<br />

at Abing<strong>to</strong>n Hospital –<br />

Jefferson Health and<br />

Abing<strong>to</strong>n – Lansdale<br />

Hospital!<br />

Your commitment <strong>to</strong><br />

making a difference so<br />

deeply <strong>to</strong>uches the lives of<br />

our <strong>patients</strong> ... their families<br />

... and the professionals<br />

around you.<br />

You are an inspiration<br />

<strong>to</strong> us all and a model of<br />

excellence. Words cannot<br />

express our gratitude<br />

enough for all that you do.<br />

We are extraordinarily<br />

proud <strong>to</strong> have such an<br />

amazing group of nurses.<br />

We attract the brightest stars.<br />

Congratulations <strong>to</strong> the Emergency Department Nursing Team<br />

at Gulf Coast Medical Center for receiving Honorable Mention<br />

recognition in the ADVANCE Best Nursing Team contest!<br />

In honor of National Nurse Week, we’d like <strong>to</strong> recognize all<br />

of the dedicated nurses of Lee Memorial Health System<br />

for delivering the highest quality, personalized care <strong>to</strong> our<br />

community. Thank you for everything you do.<br />

For more information about Lee Memorial, please visit<br />

jobs.leememorial.org<br />

Drug/Tobacco–free workplace. EOE<br />

EOE<br />

It’s <strong>your</strong> career<br />

only brighter<br />

JoinLMHS.org<br />

26 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


To our nurses:<br />

SALUTING NURSES<br />

You deliver best practice care <strong>to</strong> our children<br />

every day. You are selfless and compassionate.<br />

You make a difference. You are our champions.<br />

And for that we say thank you.<br />

NATIONAL NURSES WEEK 2016<br />

www.ChildrensNational.org/Nursing<br />

The Nursing Administration Team would like <strong>to</strong> wish our nursing staff a<br />

Happy Nurses Week, and thank them for their loyalty and dedication<br />

<strong>to</strong> our mission of improving the lives of children and young adults<br />

with pediatric developmental disabilities and disorders of the brain,<br />

spinal cord and musculoskeletal system, through patient care, special<br />

education, research, and professional training.<br />

We invite experienced Registered Nurses <strong>to</strong> inquire about the following positions:<br />

Inspiring positive change<br />

through clinical transformation.<br />

Advance<br />

The administration of St. Francis Medical<br />

Nurses Week 2016<br />

Center and 3052146 Life St. Francis would like<br />

<strong>to</strong> thank our CHINAM staff for their quality and<br />

compassionate 3.62 care x 4.87of our <strong>patients</strong>. As<br />

well as their dedication Marianne Deming and commitment<br />

v.1<br />

<strong>to</strong> our community.<br />

THANK YOU FOR<br />

ALL YOU DO!<br />

For employment consideration please see<br />

our website: www.stfrancismedical.org<br />

NURSING CARE MANAGER I – This Registered Nurse will work 40<br />

hours/week, Monday-Friday 8am-4:30pm serving as the admission<br />

liaison for the inpatient neurorehabilitation unit. Other duties include<br />

moni<strong>to</strong>ring services delivered, evaluating collected data for outcome<br />

information, and initiating change <strong>to</strong> improve processes. This role also<br />

includes local travel and community outreach <strong>to</strong> referral sources and<br />

payors. The successful candidate will possess excellent oral and written<br />

communication skills and cultural sensitivity. In addition, the candidate<br />

must possess the ability <strong>to</strong> prioritize and multi-task while maintaining<br />

a patient/family centered focus. Qualifications: Current registered<br />

nurse licensure in the State of Maryland Bachelor’s Degree in Nursing<br />

required. Related case management, quality assurance or utilization<br />

review certification preferred and certification preferred. A minimum<br />

of three years’ experience in a healthcare setting with knowledge of<br />

community resources is required. Applicant must be proficient with MS<br />

Office suite and pediatric hospital experience is preferred.<br />

LOWER/MIDDLE SCHOOL NURSE – This Registered Nurse will<br />

work 24 hours/week M, T, F or M, W, F 7:45am-3:45pm during<br />

the school year and 7:45am-3:15pm during the summer months. The<br />

School Nurse adheres <strong>to</strong> the standards set by the Maryland Nurse<br />

Practice Act and utilizes the nursing process in developing, implementing<br />

and evaluating a plan of care which will help the student achieve and<br />

maintain their optimal level of wellness. The School Nurse involves<br />

the parent/guardian, therapist, teacher, and other appropriate staff as<br />

needed <strong>to</strong> promote the student’s level of wellness. The school is located<br />

at 1750 E. Fairmount Avenue Baltimore, MD 21231. Qualifications:<br />

Current registered nurse licensure in the State of Maryland. Minimum<br />

of one year of clinical experience required, with one year school health<br />

experience required.<br />

We offer competitive salaries; employer contributed childcare accounts,<br />

tuition advancement, employer matched 401(k), fulltime and part-time<br />

benefits, free secure parking and a comprehensive competency-based<br />

orientation.<br />

Please phone, mail, fax or email resumes <strong>to</strong>:<br />

Shellie B. Williams, RN, BSN, CRRN, Nurse Recruiter<br />

Kennedy Krieger Institute | 707 N. Broadway<br />

Nursing Administration, Baltimore, MD 21205<br />

Phone: 443.923.9420 Fax: 443.923.9435<br />

E-mail: WilliamsS@KennedyKrieger.org<br />

www.KennedyKrieger.org<br />

Equal Opportunity Employer M/F/Disability/Protected Vet<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 27


SALUTING NURSES<br />

Fort Duncan Regional Medical Center would<br />

like <strong>to</strong> thank our dedicated Nursing Team<br />

Happy Nurses Week!<br />

If you would like <strong>to</strong> join our Nursing Team. We currently have positions open for:<br />

Experienced Nurses<br />

Love where you live, Love where you work!<br />

RN – ER - Provides professional nursing care within the Emergency<br />

Department. Must have current Registered Nurse license in the State of Texas.<br />

Current BLS Certifi cation. ACLS,PALS and TNCC certifi ed within six months of<br />

employment.<br />

RN – Med/Surg - Provides direct and indirect patient care in the<br />

medical-surgical setting. Population includes adolescents, young adult, middle<br />

adult, mature adult, and geriatric groups. Must have Registered Nurse license<br />

in the State of Texas. ACLS / PALS within six months of hire. Current BLS/<br />

CPR required. Demonstrates knowledge and skills necessary <strong>to</strong> provide care<br />

appropriate <strong>to</strong> the age of the patient served.<br />

RN – Nursery - Provides nursing care for newborns in the Nursery<br />

Unit. Must have Registered Nurse license in the State of Texas.<br />

Special Skills, Knowledge: BLS/CPR required. NRP within six months of hire.<br />

Demonstrates knowledge and skills necessary <strong>to</strong> provide care appropriate <strong>to</strong> the<br />

age of the patient served.<br />

Visit our website <strong>to</strong> view all positions available<br />

www.fortduncanmedicalcenter.com<br />

3333 N. Foster Maldonado Boulevard<br />

Eagle Pass, TX 78852<br />

State-of-the-art Nursing opportunities in a great location –<br />

Wilming<strong>to</strong>n, North Carolina – a vibrant city with miles of beaches!<br />

Why New Hanover Regional Medical Center?<br />

• Southeastern North<br />

Carolina’s Largest Employer<br />

• Clinical Ladder<br />

• Certification Pay<br />

• Flexible Self Scheduling<br />

• Low Cost Health Coverage<br />

• Employee Fitness Center<br />

• Employee Health Clinic<br />

• State-of-the-art Technology<br />

Join Our Team of Talented Nurses Today!<br />

nursingatnhrmc.com<br />

EOE<br />

Wilming<strong>to</strong>n, NC<br />

ADVANCE for Nurses<br />

Author Guidelines<br />

NW-1619124_CB_FortDuncan.indd 1<br />

CONTACT THE EDITOR:<br />

Michelle Perron<br />

(800) 355-5627, ext. 1221 • Fax: (610) 275-8562<br />

Or e-mail: mperron@advanceweb.com<br />

GENERAL POLICIES<br />

ADVANCE for Nurses accepts original articles by members of the<br />

nursing profession, professional writers and members of related<br />

healthcare professions. All technical material is reviewed by at least<br />

one clinical consultant prior <strong>to</strong> acceptance. The consideration process<br />

ranges from 6 <strong>to</strong> 12 weeks. If accepted for publication, manuscripts<br />

become the property of ADVANCE for Nurses. They may be used in<br />

print or online by any of the ADVANCE Healthcare Network publications<br />

and will be archived online. Once published, articles cannot<br />

be reproduced elsewhere without permission.<br />

PREPARING THE MANUSCRIPT<br />

Feature articles should be approximately 1,200 words in length<br />

and must be submitted as a Word document attachment via<br />

e-mail <strong>to</strong> mperron@advanceweb.com. All articles must include<br />

on the first page: author name, phone number, e-mail address,<br />

credentials, professional titles and current position.<br />

The article should follow the writing guidelines set forth in The<br />

Associated Press Stylebook and common English usage. A title page<br />

should be included and contain a suggested title and the name or<br />

names of the authors. Subheadings are encouraged throughout<br />

the article <strong>to</strong> enhance readability.<br />

4/29/16 3:19 PM<br />

REFERENCES<br />

All statements based on published findings or data should be referenced<br />

appropriately. References should be cited in numerical order<br />

in the body of the article and listed at the end of the article, following<br />

American Medical Association style. APA style is not accepted.<br />

If the referencing is not in AMA, the article will not be considered. A<br />

maximum of 15 references will be printed with the article. All references<br />

should be dated within the past 5 years, unless citing a seminal<br />

work on a given subject.<br />

EDITING<br />

All submissions are edited for clarity, style and conciseness<br />

in accordance with ADVANCE format. Authors will receive a<br />

copy of the edited version prior <strong>to</strong> publication and can make<br />

updates and change requests at that time. All final decisions<br />

about editing are made by our edi<strong>to</strong>rial team. n<br />

28 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


Thank you<br />

<strong>to</strong><br />

- Carol Gregory • MSN, MBA, RN, NEA-BC Chief Nursing Executive<br />

all our HCA North Texas nursing colleagues for <strong>your</strong> exquisite<br />

compassion, <strong>your</strong> unyielding patient advocacy and <strong>your</strong> ongoing<br />

commitment <strong>to</strong> excellence always. Happy Nurse’s Week. ”<br />

”<br />

SALUTING NURSES<br />

As an experienced RN, you deserve all the opportunities, advantages and conveniences that make for a satisfying career<br />

and that’s exactly what you’ll find at HCA North Texas. We are one of the largest healthcare networks with multiple<br />

facilities in Dallas/Fort Worth and Oklahoma City. At HCA North Texas, you don’t have <strong>to</strong> go far <strong>to</strong> get far. We also have<br />

careers advantages that are among the very best. Ask about our sign on bonuses and our great benefits package. Then<br />

ask where <strong>your</strong> talent can take you when you build <strong>your</strong> nursing career with us.<br />

CAREERSATHCA.COM<br />

NW-1619104- HCA NORTH TEXAS.indd 1<br />

4/29/16 2:31 PM<br />

“ We are transforming the<br />

landscape of nursing education.”<br />

Chamberlain. Where <strong>to</strong> care.<br />

Susan L. Groenwald<br />

PhD, RN, ANEF, FAAN<br />

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Chamberlain College of Nursing<br />

Join our faculty as we shape the next generation of nurses.<br />

• Full & part-time positions available (MSN degree required)<br />

• Advancement opportunities<br />

• Strong men<strong>to</strong>rship & support programs<br />

• Up <strong>to</strong> $50,000 in Doc<strong>to</strong>ral program reimbursement *<br />

Find <strong>your</strong> extraordinary at chamberlainfaculty.com<br />

Chamberlain College of Nursing | National Management Office | 3005 Highland Parkway | Downers Grove, IL 60515 | 888.556.8CCN (8226) ext. 5 | chamberlain.edu<br />

*Subject <strong>to</strong> reimbursement program limitations and requirements.<br />

We are proud <strong>to</strong> be an EEO employer, M/F/D/V, maintain a drug-free workplace and perform pre-employment substance abuse testing.<br />

© 2016 Chamberlain College of Nursing LLC. All Rights Reserved.<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 29


Lifestyle<br />

arch and minimizing the impact of each step.<br />

When the plantar fascia is strained, it becomes<br />

weak, swollen and irritated. Repeated stretching<br />

can cause tiny tears in the ligament, leading <strong>to</strong><br />

the painful condition known as plantar fasciitis.<br />

The pain is usually most severe with the first<br />

few steps out of bed after waking, but it can also<br />

be exacerbated by prolonged standing or getting<br />

up after a long period of sitting.<br />

Foot pain that occurs mostly at night is likely<br />

caused by a condition such as arthritis or tarsal<br />

tunnel syndrome.<br />

A Perfect S<strong>to</strong>rm<br />

How nurses can prevent and<br />

treat plantar fasciitis<br />

By Anne Collins<br />

NURSES are on their feet all day, walking—sometimes sprinting—up<br />

and down concrete hospital hallways, bringing items <strong>to</strong><br />

and from patient bedsides, lifting heavy equipment <strong>to</strong> free up space,<br />

and even lifting <strong>patients</strong> themselves.<br />

With every step a nurse takes, the foot absorbs 3 times his or her<br />

body weight—7 times when running. Is it any wonder that nurses<br />

often develop foot problems? The scenario described above could<br />

be considered “the perfect s<strong>to</strong>rm” for developing plantar fasciitis.<br />

Heels Sound the Alarm<br />

“If you wake up one morning and find you have an intense pain<br />

in the arch of <strong>your</strong> foot or <strong>your</strong> heel, and can’t put any weight on<br />

it, plantar fasciitis is developing,” stated Johanna Shira Youner,<br />

DPM, a podiatrist who owns a private practice in New York City<br />

and who speaks for the American Podiatric Medical Association.<br />

The plantar fascia is the ligament that connects the heel bone<br />

<strong>to</strong> the <strong>to</strong>es and supports the arch of the foot. Under normal circumstances,<br />

this band acts as a shock absorber, supporting the<br />

Risk Fac<strong>to</strong>rs<br />

A few fac<strong>to</strong>rs can be addressed <strong>to</strong> try <strong>to</strong> avoid or<br />

reduce the symp<strong>to</strong>ms of plantar fasciitis. Primary<br />

risk fac<strong>to</strong>rs include:<br />

• Age. Most people develop plantar fasciitis<br />

between the ages of 40 and 60. “The plantar<br />

fascia deteriorates with age; this is a degenerative<br />

process,” Youner said. “We don’t see many<br />

<strong>patients</strong> under age 40 with this condition—but<br />

after the age of 40, people start <strong>to</strong> experience<br />

foot pain.”<br />

• Occupation. People who stand or walk for<br />

long periods on hard surfaces (teachers, fac<strong>to</strong>ry<br />

workers, nurses) are more prone <strong>to</strong> develop<br />

plantar fasciitis.<br />

• Excessive pronation. During walking, the foot<br />

should land on the outer side of the heel first.<br />

Body weight should then pass along the inner<br />

edge of the sole (normal pronation) and then<br />

back <strong>to</strong> the outside of the foot. If the weight stays<br />

on the inner edge of the sole of the foot, this is<br />

considered excessive pronation—the foot rolls<br />

inward <strong>to</strong>o much when walking.<br />

• High arches, flat feet, tight Achilles tendon or<br />

tight calf muscles. These can adversely affect the<br />

way weight is distributed when standing, putting<br />

added stress on the plantar fascia.<br />

• Obesity. Excess pounds put extra stress on the<br />

plantar fascia.<br />

• Wearing worn-out or ill-fitting shoes. “My<br />

No. 1 suggestion for people experiencing plantar<br />

fasciitis pain is <strong>to</strong> improve <strong>your</strong> shoes,” Youner<br />

advised. “If you are experiencing foot pain, you<br />

cannot wear inexpensive shoes. The money you<br />

save at the shoe s<strong>to</strong>re will be spent on podiatry<br />

bills, because <strong>your</strong> cheap shoes will create problems<br />

for <strong>your</strong> feet.”<br />

The podiatrist recommends spending more than<br />

$100 for each pair of shoes. She said shoes should<br />

have a thick, rubber bot<strong>to</strong>m <strong>to</strong> absorb the shock<br />

of each footstep; leather does not absorb shock.<br />

THINKSTOCK/GETTY IMAGES<br />

30 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


THE HIGHLIGHT OF<br />

YOUR DAY<br />

INTRODUCING THE PROFESSIONAL<br />

HIGHLIGHTER PATENT


Lifestyle<br />

An appointment with a podiatrist is highly recommended for anyone<br />

experiencing heel or arch pain. If you think this sounds <strong>to</strong>o time-consuming,<br />

consider this: Not treating plantar fasciitis can lead <strong>to</strong> worsening—and<br />

spreading—pain.<br />

Preventing Further Damage<br />

No matter the shoe selection, anyone with plantar fasciitis likely<br />

requires outside arch supports inside the shoes. “Medical-grade<br />

orthotic devices and things like heel cups can help realign <strong>your</strong><br />

feet and properly support <strong>your</strong> foot, taking the stress and strain<br />

off <strong>your</strong> plantar fascia,” Youner said. “An arch support will add a<br />

bit of depth inside the shoe and cup <strong>your</strong> foot properly, giving you<br />

more controlled footsteps.”<br />

An appointment with a podiatrist is recommended for anyone<br />

experiencing heel or arch pain. If you think this sounds <strong>to</strong>o timeconsuming,<br />

consider this: Not treating it can lead <strong>to</strong> worsening—and<br />

spreading—pain. If you are unconsciously changing the<br />

way you walk <strong>to</strong> minimize plantar fasciitis pain, you might also<br />

develop other foot, knee, hip or back problems, leading <strong>to</strong> pain<br />

and discomfort in other areas of the body.<br />

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Finding Immediate Relief<br />

Certain steps can minimize and relieve plantar fasciitis pain.<br />

Most people recover completely within a year (provided they<br />

have received the care they need <strong>to</strong> avoid further tearing of this<br />

ligament). Here are some steps you can take <strong>to</strong> bring immediate<br />

relief of plantar fasciitis symp<strong>to</strong>ms:<br />

• Pain Relievers. Nonsteroidal anti-inflamma<strong>to</strong>ry drugs such<br />

as ibuprofen (Advil, Motrin IB, etc.) or naproxen (Aleve) reduce<br />

inflammation and can relieve some of the pain associated with<br />

plantar fasciitis. If these do not work, a podiatrist might recommend<br />

meloxicam, a prescription-strength anti-inflamma<strong>to</strong>ry medication.<br />

• Ice Your Heel. “Several times a day, put ice on <strong>your</strong> heel for 10<br />

minutes, then take it off for 10 minutes,” Youner advised. “Heating<br />

pads are not recommended for plantar fasciitis, since heat can<br />

make the area swell further and cause more pain.”<br />

• Compression. Compression garments can be worn during the<br />

day (inside a sock) or at night <strong>to</strong> sleep. These “sleeves” offer support,<br />

improve circulation, and reduce edema and foot fatigue. Users report<br />

feeling much less pain when the garment is on, but the pain might<br />

return after it is removed, Youner said.<br />

• Physical Therapy Exercises. Toe stretches (pulling on the <strong>to</strong>es<br />

<strong>to</strong> bend the foot back at the ankle), calf stretches (<strong>to</strong> strengthen<br />

lower leg muscles and the Achilles tendon, thereby stabilizing the<br />

ankle and heel), and <strong>to</strong>wel stretches (performed by placing a <strong>to</strong>wel<br />

lengthwise under the ball of the foot and pulling with both hands<br />

<strong>to</strong> bend the foot back <strong>to</strong>ward the body) can increase flexibility in<br />

the ligament and strengthen the muscles that support foot arches.<br />

• Night Splints. A splint can hold the plantar fascia and Achilles<br />

tendon in a lengthened position overnight, which facilitates the<br />

stretching of the calf and the arch of the foot.<br />

• Avoid Going Barefoot. Put on a sturdy pair of shoes (not bedroom<br />

slippers!) the minute you get out of bed. Going barefoot can make<br />

plantar fasciitis pain worse.<br />

“The last key <strong>to</strong> avoiding pain is <strong>to</strong> change footwear,” Youner reiterated.<br />

“Find a good foot specialist who can recommend the additional<br />

steps you should take <strong>to</strong> prevent further plantar fascia damage.” ■<br />

Anne Collins is a staff writer. Email her at acollins@advanceweb.com.<br />

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32 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


Patient Satisfaction<br />

JEFFREY LEESER/thanks <strong>to</strong> LaSalle University in Philadelphia<br />

Patient Satisfaction<br />

Scores<br />

Optimizing the patient and clinician<br />

experience<br />

By Christy Dempsey, MSN, MBA, CNOR, CENP<br />

PATIENT SATISFACTION scores. These three words often strike<br />

fear—and sometimes anger—in the hearts and minds of nurses. In<br />

1985, when Irwin Press and Rod Ganey developed Press Ganey’s<br />

first scientifically rigorous, validated survey and began <strong>to</strong> use the<br />

resultant data <strong>to</strong> measure patient perception of hospital care, the<br />

goal was for facilities <strong>to</strong> understand that perception and improve<br />

it. However, many hospitals began <strong>to</strong> focus <strong>to</strong>o heavily on raising<br />

their patient satisfaction scores and not enough on ensuring a<br />

positive patient experience.<br />

Although high patient satisfaction scores are important, achieving<br />

high scores should not be our overall goal, and the survey<br />

data should not be our sole focus. Our overall goal should be <strong>to</strong><br />

reduce the suffering experienced by <strong>patients</strong>, their families and<br />

their caregivers.<br />

Patient satisfaction scores should reflect how well patient needs<br />

are being met.<br />

A Focus on Satisfaction<br />

When Press Ganey embarked on its mission <strong>to</strong> measure the patient<br />

perception of care, nurses would hand out the Press Ganey survey<br />

as the patient was discharged from the hospital and the patient<br />

would complete the survey and mail it back. Hospitals began <strong>to</strong><br />

see that patient feedback was important, and they started <strong>to</strong> drive<br />

accountability by using patient satisfaction scores as metrics that<br />

influenced clinician performance appraisals and<br />

compensation.<br />

Clinicians then began <strong>to</strong> find fault with the data,<br />

argue the results, and discount the numbers, saying<br />

things like, “How can the patient know whether<br />

I’m doing a good job?” or “I’m always nice, they’re<br />

just needy.” In fact, as a nurse working the 3-<strong>to</strong>-11<br />

shift in a busy neuro/trauma stepdown unit, I would<br />

carefully choose which <strong>patients</strong> received the survey.<br />

I based that selection on who I thought would give<br />

me the best scores, and then I would punctuate the<br />

encounter with something like, “Now, remember<br />

what <strong>your</strong> mother always <strong>to</strong>ld you: If you can’t say<br />

something nice, don’t say anything at all!”<br />

Fast-forward <strong>to</strong> <strong>to</strong>day, and the survey process is<br />

au<strong>to</strong>mated. It is also critically important. Even the<br />

federal government has concluded that soliciting<br />

patient feedback is essential. In fact, the Institute<br />

for Healthcare Improvement has determined that<br />

improving the patient experience is one of the<br />

three dimensions of its “Triple Aim” for healthcare<br />

quality (the other two are <strong>to</strong> improve outcomes<br />

and <strong>to</strong> reduce healthcare costs).<br />

Survey data is not simply data. It is the patient’s<br />

evaluation of his or her care. Every patient voice<br />

matters.<br />

Refocusing on the Experience<br />

It’s clear that the patient experience is about much<br />

more than patient satisfaction. It involves more<br />

than superficial, consumer-focused remedies that<br />

may provide short-term positive results but not<br />

long-term sustainable improvement.<br />

Rather, the patient experience is inextricably<br />

linked <strong>to</strong> clinical quality and safety, and all three<br />

are nursing-sensitive. Reducing patient suffering<br />

requires a level of clinical quality that keeps<br />

<strong>patients</strong> safe and provides evidence-based, highquality<br />

care in the most efficient manner. This<br />

quality care must bring <strong>to</strong> life the behaviors that<br />

exemplify engagement and caring and ensure that<br />

the shared purpose of mission, vision and values<br />

drives the culture of the organization.<br />

Press Ganey’s Compassionate Connected Care<br />

model changes the conversation around patient<br />

experience. The model’s six themes help reconnect<br />

clinicians with purpose and meaning. They<br />

remind us that nursing is a calling, not a job, and<br />

that our <strong>patients</strong> are people who are at their most<br />

vulnerable. The themes are:<br />

• Acknowledge suffering: Show them we<br />

understand.<br />

• Body language matters: Nonverbal communication<br />

is as important as words.<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 33


Patient Satisfaction<br />

Although high patient satisfaction scores<br />

are important, achieving high scores should<br />

not be our overall goal, and the survey data<br />

should not be our sole focus. Our overall<br />

goal should be <strong>to</strong> reduce the suffering<br />

experienced by <strong>patients</strong>, their families and<br />

their caregivers.<br />

• Anxiety is suffering: Anxiety and uncertainty are negative<br />

outcomes.<br />

• Coordinate care: We should show <strong>patients</strong> that care is coordinated<br />

and continuous.<br />

• Caring transcends diagnosis: Real caring goes beyond the<br />

delivery of medical interventions.<br />

• Au<strong>to</strong>nomy reduces suffering: Au<strong>to</strong>nomy helps preserve<br />

patient dignity.<br />

Keeping the model’s six themes in mind will have positive<br />

effects on <strong>patients</strong> and clinicians. Just as we may impose avoidable<br />

suffering on our <strong>patients</strong>, avoidable suffering is imposed<br />

on nurses. Some examples of avoidable suffering imposed on<br />

nurses include lack of necessary resources such as equipment,<br />

information or staff, and exposure <strong>to</strong> physical or emotional abuse<br />

by <strong>patients</strong> or colleagues.<br />

This kind of suffering leads <strong>to</strong> losses in nurse productivity,<br />

retention and recruitment. Data show that 15 of every 100 nurses<br />

in the United States are disengaged, which amounts <strong>to</strong> more than<br />

$22,000 in lost productivity for each disengaged nurse every year.<br />

This is a fiscal crisis, but more importantly, it is a crisis for nurses<br />

who need <strong>to</strong> find meaning and purpose and must reconnect with<br />

the reason they became nurses in the first place.<br />

Changing the Dialogue<br />

Much like the Compassionate Connected Care framework changes<br />

the dialogue around patient experience, we must change the dialogue<br />

around the clinician experience. Both the patient experience and<br />

the clinician experience are clinical, operational and cultural. But<br />

the clinician experience is also about feeling connected <strong>to</strong> both<br />

the organization and the purpose.<br />

We can use the Compassionate Connected Care framework<br />

<strong>to</strong> measure clinician needs and understand where we must focus<br />

our efforts for nursing teams. To address clinician needs, Press<br />

Ganey developed an affinity diagram that is based on feedback<br />

from hundreds of clinicians. The following themes were derived<br />

from that work.<br />

• We should acknowledge the complexity and the gravity of<br />

the work they do. When was the last time a root cause analysis<br />

was employed when something went well? Understanding why<br />

things go well is as important as understanding why things do not<br />

go well, and it demonstrates that leaders recognize how difficult<br />

and important the work is.<br />

• It is the responsibility of management <strong>to</strong> provide support in<br />

the form of human, material and emotional resources. In Maslow’s<br />

Hierarchy of Needs pyramid, the most fundamental needs—the<br />

physiological needs or basic requirements for human survival: air,<br />

food, water, etc.—are at the base of the pyramid, and the needs at<br />

each level of the pyramid, starting at the base, must be fulfilled <strong>to</strong><br />

reach the apex of self-actualization. Similarly, if staff members are<br />

constantly looking for equipment that works, they are at the base<br />

of the pyramid and an expectation of lofty performance goals (or<br />

scores) is not reasonable.<br />

• Teamwork is a vital component for success. In a poll of<br />

more than 500 healthcare workers Press Ganey conducted at its<br />

2015 National Client Conference, teamwork was identified as the<br />

most important component for success. Further analysis identified<br />

teamwork as a key driver of “Likelihood <strong>to</strong> Recommend” on<br />

the Hospital Consumer Assessment of Healthcare Providers and<br />

Systems survey. This is important not only <strong>to</strong> <strong>patients</strong>, but also <strong>to</strong><br />

the people who care for them.<br />

• A positive work/life balance reduces compassion fatigue.<br />

Staffing, scheduling, breaks and time away from the unit all play<br />

an important role in the ability of nurses <strong>to</strong> show compassion<br />

and empathy <strong>to</strong>ward <strong>patients</strong>. The work environment is critically<br />

important, and all of these fac<strong>to</strong>rs must be addressed <strong>to</strong> create a<br />

positive work/life balance.<br />

• Communication is foundational. Poor communication can<br />

lead <strong>to</strong> errors and poor patient outcomes. In addition <strong>to</strong> helping <strong>to</strong><br />

keep <strong>patients</strong> safe, 360-degree communication elicits ownership<br />

and accountability for a positive patient and clinician experience.<br />

• Empathy and trust must be fostered and modeled. For nurses<br />

<strong>to</strong> provide empathy and build trust with their <strong>patients</strong>, these<br />

attributes must be provided <strong>to</strong> nurses consistently by both their<br />

leadership and their peers.<br />

Just as the desire <strong>to</strong> earn an “A” is not the reason people go <strong>to</strong><br />

college, the desire <strong>to</strong> achieve a patient satisfaction score in the<br />

90th percentile should not be our overall goal. Our goal must be<br />

<strong>to</strong> optimize the patient and clinician experience. The score and<br />

percentile ranking will come as a natural consequence when we<br />

focus on what really matters: reducing suffering. ■<br />

Christy Dempsey is the chief nursing officer for Press Ganey.<br />

We’re On Twitter!<br />

SUBSCRIBE <strong>to</strong> our Twitter feed @ADVANCENurses <strong>to</strong> keep up-<strong>to</strong>-date on<br />

a range of <strong>to</strong>pics and issues.<br />

34 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


THINKSTOCK/GETTY IMAGES<br />

Reducing Your<br />

Malpractice Exposure<br />

National claims data highlight trends in<br />

nursing<br />

By Michael J. Loughran<br />

AN INTOXICATED, agitated, aggressive patient presented <strong>to</strong> the<br />

emergency department and was placed in four-point restraints for<br />

his own safety. An ED nurse moni<strong>to</strong>red and assessed the patient<br />

every 15 minutes.<br />

While the nurse performed her rounds, the patient attempted<br />

<strong>to</strong> burn off his restraints with a lighter. He ignited his bed linens<br />

and clothing, resulting in severe burns over 25% of his body and<br />

the loss of the fingers on one hand.<br />

The patient sued multiple defendants, including the nurse, for<br />

an undisclosed amount. He alleged “failure <strong>to</strong> provide proper care<br />

in a safe environment.”<br />

Expert witnesses for the defense testified that the nurse had<br />

acted within her scope of practice and in compliance with hospital<br />

policy. Her documentation was contemporaneous and supported<br />

adherence <strong>to</strong> the organizational policy for checking on and assessing<br />

the patient at 15-minute intervals.<br />

The case went <strong>to</strong> trial, and a defense verdict was rendered.<br />

Legal Issues<br />

However, the plaintiff appealed. The case required<br />

12 years and $500,000 in legal defense costs <strong>to</strong><br />

resolve. The ED nurse’s thorough documentation<br />

proved critical in establishing that she was not<br />

responsible for the patient’s injuries.<br />

This scenario illustrates the type of information<br />

included in a 5-year claim study by the Nurses<br />

Service Organization and its insurance partner,<br />

CNA. Besides legal case studies, “Nurse Professional<br />

Liability Exposures: 2015 Claim Report Update”<br />

provides statistical data and analysis derived from<br />

the CNA database of closed claims involving<br />

nurses. The report highlights risk management<br />

recommendations designed <strong>to</strong> improve patient<br />

safety and reduce nurse liability exposure.<br />

2015 Report Update<br />

NSO and CNA have published three nurse claim<br />

reports over the past 8 years. A comparison of data<br />

from the 2015 report <strong>to</strong> the 2010 report identifies<br />

several trends, including an increase in malpractice<br />

claims arising from care in patient homes.<br />

• Claims involving patient homes increased<br />

from 8.9% in 2010 <strong>to</strong> 12.6% in 2015.<br />

• Claims involving inpatient medical settings<br />

declined from 20.2% <strong>to</strong> 17.7%.<br />

This shift in location of claim occurrence<br />

could be a result of healthcare reform. Under<br />

the Affordable Care Act (ACA), the healthcare<br />

delivery system of the future, and the system in<strong>to</strong><br />

which we have begun <strong>to</strong> evolve, focuses on greater<br />

collaboration between primary care practices and<br />

home care providers.<br />

This new model seeks <strong>to</strong> provide two benefits:<br />

delivery of targeted care <strong>to</strong> the patient at the<br />

optimal time, and lower costs for care delivery.<br />

The data are not intended <strong>to</strong> suggest that the<br />

home is a less safe care environment. Rather, it<br />

reflects a trend indicating a probable increase in<br />

the volume of nursing services provided in the<br />

home and, in turn, an increase in claim activity.<br />

Another noteworthy trend in the current report<br />

is the claim data involving medication administration<br />

errors. Between 2010 and 2015:<br />

• Malpractice claims due <strong>to</strong> medication errors<br />

decreased by nearly half, from 14.7% <strong>to</strong> 8%.<br />

• The average cost of a medication error claim<br />

nearly doubled, from $113,070 <strong>to</strong> $213,005.<br />

Over the past 10 years, significant news coverage<br />

has reported about medications that look and<br />

sound alike, potentially contributing <strong>to</strong> medication<br />

errors.<br />

Consequently, pharmaceutical companies,<br />

manufacturers, healthcare systems and risk manwww.advanceweb.com/Nurses<br />

n MAY 2016 n ADVANCE FOR NURSES 35


THE RIGHT<br />

RESOURCES<br />

IN THE<br />

WRONG<br />

FIELD WON’T<br />

DO YOU ANY<br />

GOOD<br />

TO STAY IN THE GAME, you need <strong>to</strong>ols that<br />

match exactly what you need. That’s why general<br />

career development sites just can’t cut it. They<br />

offer universal resources that usually don’t even<br />

apply <strong>to</strong> <strong>your</strong> industry at all.<br />

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most relevant, title-specific healthcare resources<br />

<strong>to</strong> keep <strong>your</strong> career running at full speed.<br />

n Healthcare-focused<br />

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Use resources that were built with you in mind.<br />

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Legal Issues<br />

agers have collaborated <strong>to</strong> reduce these errors with innovations.<br />

Strategies may be as simple as packaging modifications and as<br />

complex as enterprise-wide initiatives in healthcare organizations<br />

<strong>to</strong> ensure safer medication administration.<br />

The report also reveals that claims alleging a violation of <strong>patients</strong>’<br />

rights, patient abuse or unprofessional conduct are rising. Such<br />

claims:<br />

• Comprise only 5.4% of malpractice allegations against nurses<br />

in 2010<br />

• Rose <strong>to</strong> 13.1% in 2015.<br />

This data may reflect increased sensitivity <strong>to</strong> privacy violations<br />

under HIPAA and the proliferation of social media resulting in<br />

claims against nurses that allege slander, libel and a breach of<br />

confidentiality.<br />

Besides educating nurses about their risk exposure, the report<br />

assists the healthcare community in recognizing where problems<br />

exist, so that they may initiate discussions about the implementation<br />

of controls <strong>to</strong> help mitigate errors.<br />

An enterprise approach <strong>to</strong> risk management can result in<br />

meaningful change.<br />

Mitigating Malpractice Risk<br />

This section highlights three vulnerability areas for nurses.<br />

Recognizing and acting on them can help reduce a nurse’s individual<br />

malpractice liability exposure:<br />

Scope of practice. Nurses are required <strong>to</strong> practice within the<br />

state scope-of-practice act as well as within their position description<br />

and the policies and procedures of the facilities where they<br />

practice. Failing <strong>to</strong> practice within scope and within organizational<br />

guidelines can jeopardize patient safety and make nurses vulnerable<br />

<strong>to</strong> allegations of malpractice and/or board complaints. Review<br />

<strong>your</strong> state’s nurse practice act annually.<br />

Documentation. In case of a malpractice claim, the nurse’s legal<br />

team uses the patient record <strong>to</strong> build a defense. When documentation<br />

is absent, incomplete, sloppy or not contemporary, it can<br />

reflect poorly on the nurse and make it more difficult <strong>to</strong> mount a<br />

successful case. Whether using electronic or handwritten medical<br />

records, nurses should thoroughly document all care, so that any<br />

healthcare provider can gain a clear understanding of the patient’s<br />

condition, treatment and interventions you performed.<br />

Chain of Command. Often, nurses are patient advocates, ensuring<br />

that <strong>patients</strong> receive the care they need when they need it.<br />

Sometimes, calls for assistance go unanswered, or a provider does<br />

not appear <strong>to</strong> grasp the seriousness of a situation. Here, the nurse<br />

should intervene and advocate for the patient.<br />

Today’s increasingly complex healthcare environment underscores<br />

the value of exercising due diligence, completing risk management<br />

courses and, when appropriate, securing individual professional<br />

liability insurance <strong>to</strong> ensure that <strong>your</strong> rights and interests are<br />

protected. n<br />

Michael J. Loughran is president of Nurses Service Organization. This article is<br />

provided for general information purposes and is not intended <strong>to</strong> provide individualized<br />

business, insurance or legal advice.<br />

36 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


CE: Professional Issues<br />

JEFFREY LEESER<br />

Danger Is Not in My<br />

Job Description<br />

An overview of violence in the healthcare<br />

workplace<br />

By Jennifer Oakley, FNP, MSN, RN<br />

HEALTHCARE and social assistance represent the largest industry<br />

sec<strong>to</strong>r in the country. Approximately 18.9 million healthcare<br />

workers were employed in 2012, which calculates <strong>to</strong> 11.5% of the<br />

<strong>to</strong>tal United States workforce. 1 Yet as healthcare workers dedicate<br />

their lives <strong>to</strong> the care and treatment of <strong>patients</strong>, they sometimes<br />

end up putting their own safety and health at risk.<br />

In 2013, healthcare workers reported 9,200 nonfatal workplace<br />

injuries related <strong>to</strong> violence, an amount representing more than 67%<br />

of injuries reported in all industries and professions. 1 It has been suggested<br />

that the unique culture and unpredictability of the hospital<br />

setting increase the risk of both physical and emotional violence.<br />

Over the last decade, healthcare workers have accounted for up<br />

<strong>to</strong> two-thirds of violent injuries involving days away from work.<br />

They have become victims of the very people they are trying <strong>to</strong><br />

help and comfort. The risk of assault requiring time off the job is<br />

almost 5 times greater than in any other workforce. Underreporting<br />

of patient-on-worker assaults (physical and verbal) has been associated<br />

with the belief that “it is part of the job.”<br />

One hospital system reported that 30% of its nurses required<br />

treatment for violent injuries in a particular year, with a <strong>to</strong>tal cost of<br />

$94,156 ($78,924 for treatment and $15,232 for lost wages). 2 Other<br />

costs may include clinician fatigue, injury and stress tied <strong>to</strong> a higher<br />

risk of medical errors and patient infections. Injury and stress are<br />

common fac<strong>to</strong>rs that drive clinicians <strong>to</strong> leave the profession, with<br />

an estimated $27, 000 <strong>to</strong> $103, 000 in costs <strong>to</strong> replace nursing staff. 2<br />

These costs include separation, recruiting, hiring,<br />

orientation and training. Hospital satisfaction<br />

surveys are often higher in hospitals with lower<br />

numbers of dissatisfied nurses and burnout.<br />

A Recognized Hazard<br />

Workplace violence is a recognized hazard in the<br />

healthcare industry. This violence can consist of<br />

threats or actions of physical violence, harassment,<br />

intimidation, or other threatening disruptive<br />

behavior. In 2010, the Bureau of Labor Statistics<br />

reported that healthcare and social assistance<br />

workers were victims of approximately 11,370<br />

assaults. 3 This number represents an increase<br />

of 13% since 2009. 3<br />

The highest rates of violence are reported by<br />

emergency department nurses. A recent survey<br />

of 3,465 members of the Emergency Nurses<br />

Association found that more than 50% of respondents<br />

reported experiencing physical violence in<br />

the prior year, and 70% had experienced verbal<br />

abuse. 4 Yet clinicians are largely underprotected<br />

and underprepared <strong>to</strong> prevent and manage these<br />

violent <strong>patients</strong>. High-risk environments such as<br />

this require education and increased awareness<br />

about general prevention and management of<br />

violence by <strong>patients</strong> and their families.<br />

This continuing education offering sponsored by<br />

The University of Phoenix School of Nursing.<br />

www.phoenix.edu<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 37


CE: Professional Issues<br />

Workplace violence is a recognized hazard in the healthcare<br />

industry. This violence can consist of threats or actions<br />

of physical violence, harassment, intimidation, or other<br />

threatening, disruptive behavior.<br />

Risk Fac<strong>to</strong>rs<br />

No specific diagnosis or type of patient is<br />

predictive for violence; however, epidemiological<br />

studies consistently demonstrate that<br />

the highest level of risk exists in inpatient<br />

and acute psychiatric services, geriatric<br />

long-term care settings, high-volume emergency<br />

departments, residential settings and<br />

social services. Pain, devastating prognosis,<br />

unfamiliar surroundings, mind- and<br />

mood-altering medications and drugs, and<br />

disease progression can also cause agitation<br />

in <strong>patients</strong> and increase the risk for violent<br />

behavior. Psychosis is a relatively common<br />

syndrome that affects about 5% of the population<br />

at some point in life and accounts for<br />

many documented cases involving assault<br />

of healthcare workers. 5<br />

Assessment and Interview<br />

Poor environmental design of the workplace<br />

that may block an employee’s vision or<br />

CE OFFERING<br />

This offering is worth 1 contact hour.<br />

This offering expires in 2 years:<br />

MAY 2, 2018<br />

Learning Objectives<br />

After reading this article, the learner will be<br />

able <strong>to</strong>:<br />

1. Identify potentially violent <strong>patients</strong> through<br />

proper screening and assessment.<br />

2. Describe techniques <strong>to</strong> manage a patient<br />

who exhibits violent behavior.<br />

3. Develop interventions <strong>to</strong> encourage a safe<br />

work environment for clinicians.<br />

To take this test, go <strong>to</strong> www.advanceweb.<br />

com/NurseCE and find the article title.<br />

Online CEs<br />

Earn contact hours with just a click of the<br />

mouse, www.advanceweb.com/nurseCE<br />

interfere with his or her escape from a violent<br />

incident have been reported, as well as<br />

poorly lit corridors and rooms and the lack<br />

of a means of emergency communication.<br />

High-risk healthcare environments should<br />

provide increased security for <strong>patients</strong>,<br />

family, and workers. All <strong>patients</strong> must be<br />

disarmed prior <strong>to</strong> evaluation and interview.<br />

Metal detec<strong>to</strong>rs are often used <strong>to</strong> identify<br />

weapons or objects that can be utilized<br />

as weapons before <strong>patients</strong> are allowed <strong>to</strong><br />

enter the hospital emergency department.<br />

When conducting an evaluation of a<br />

patient, the interview should be performed<br />

in a private but not isolated environment. If<br />

a patient has a his<strong>to</strong>ry of potentially aggressive<br />

or volatile behavior, security personnel<br />

should be nearby and the door of the examination<br />

area should be left open <strong>to</strong> allow for<br />

both an intervention and an escape by the<br />

clinician if deemed necessary. 6<br />

The interviewer must be aware of his or her<br />

surroundings at all times. It is critical that the<br />

clinician be seated equidistant from the door,<br />

and the patient should not be located near the<br />

exit. Blocking the door or exit path may pose<br />

a risk of harm <strong>to</strong> the clinician. The structure<br />

of the room should provide two exits and<br />

doors that swing outward. Heavy objects<br />

should not be in the examination rooms for<br />

risk of being utilized as potential weapons.<br />

Examples of objects utilized as weapons may<br />

include electrical cords, scalpels, needles,<br />

hot liquid and heavy machinery. 6 A panic<br />

but<strong>to</strong>n or a code word should be used <strong>to</strong><br />

inform other staff members and security<br />

when assistance is needed.<br />

It can be difficult <strong>to</strong> identify a potentially<br />

violent patient. The initial assessment should<br />

begin with a risk assessment and attention<br />

<strong>to</strong> safety measures. Violence most often<br />

erupts after a period of mounting tension,<br />

so it is important <strong>to</strong> identify verbal and<br />

nonverbal cues and seize the opportunity<br />

<strong>to</strong> defuse the situation if possible.<br />

Violent behavior is not always predictable,<br />

however, especially in the case of medical<br />

illness. Clinicians should never feel overly<br />

confident in the ability <strong>to</strong> assess or sense<br />

impending danger. Research shows that<br />

practitioners tend <strong>to</strong> be poor predic<strong>to</strong>rs of<br />

violence, and need <strong>to</strong> be aware of the “gut<br />

feeling” that a dangerous situation might<br />

escalate. 7 Obvious signs of impending violence<br />

can include: provocative behavior,<br />

angry demeanor, loud and aggressive speech,<br />

tense posturing, pacing or frequently changing<br />

body positions, or aggressive outbursts<br />

and actions. 4 A patient’s use of his or her<br />

hands should be as an indica<strong>to</strong>r of tension<br />

and escalating behavior.<br />

His<strong>to</strong>rically, mental health professionals<br />

were unable <strong>to</strong> predict their <strong>patients</strong>’ violent<br />

behavior with any accuracy greater than<br />

chance. Psychiatrists and psychologists have<br />

created structured risk assessment instruments<br />

<strong>to</strong> assess the risk of patient violence, and<br />

these are crucial <strong>to</strong> help with legal decisions<br />

that can be predictive of the validity of outcomes.<br />

5 In mental health, patient violence <strong>to</strong><br />

others is recognized as an aspect of prognosis.<br />

The highest prevalence of violence in<br />

<strong>patients</strong> is among men with a his<strong>to</strong>ry of violence<br />

or drug and alcohol abuse. Impending<br />

signs of violence include provocative behavior,<br />

angry demeanor, loud and aggressive speech,<br />

tense posturing, frequently changing body<br />

position, or aggressive actions. One survey<br />

finding notes a high rate of physical violence<br />

by <strong>patients</strong> older than 65 with cognitive<br />

impairment. 7 Verbal violence is most common<br />

in the 35- <strong>to</strong> 60-year-old age group. 7<br />

Violence can occur anywhere in the hospital,<br />

but there is an increased prevalence<br />

in psychiatric units, EDs, waiting rooms,<br />

geriatric units and long-term care facilities. 2<br />

High levels of physical abuse were recently<br />

reported in palliative care settings, and high<br />

levels of emotional abuse were reported in<br />

long-term care facilities. A recent increase<br />

in violent behaviors has been observed in<br />

intensive care units, including neonatal,<br />

pediatric and adult <strong>patients</strong>.<br />

Management of Violent Adults<br />

Verbal de-escalation techniques can be<br />

utilized for <strong>patients</strong> who are agitated, yet<br />

cooperative. Actively violent <strong>patients</strong> who are<br />

uncooperative and exhibit signs of impending<br />

violence require immediate restraint.<br />

38 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


CE: Professional Issues<br />

For <strong>patients</strong> who have an altered mental<br />

status and cannot control their aggressive<br />

behavior, proper management and treatment<br />

are needed. The initial management<br />

of <strong>patients</strong> who are agitated but cooperative<br />

is <strong>to</strong> utilize verbal de-escalation techniques.<br />

This should be attempted prior <strong>to</strong> the use of<br />

physical restraints or sedative medications.<br />

The interaction and patient’s response <strong>to</strong> the<br />

techniques will provide information and<br />

assessment of the patient’s mental status.<br />

When therapeutically communicating<br />

with the patient in this way, the provider<br />

should use a calm <strong>to</strong>ne of voice, avoid direct<br />

eye contact, stand at least two arm’s length<br />

apart, and not make any sudden movements.<br />

6 The clinician should be honest,<br />

nonthreatening, and straightforward. Some<br />

suggest that offering food or drink as a<br />

friendly gesture appeals <strong>to</strong> basic human<br />

needs and builds trust, which in turn will<br />

enable the patient <strong>to</strong> decompress.<br />

It is important <strong>to</strong> be an active listener<br />

when interacting with a violent or verbally<br />

aggressive patient. Identify and confirm<br />

the patient’s feelings and offer choices and<br />

optimism as an alternative <strong>to</strong> altercation.<br />

Avoiding arguing or commanding is crucial<br />

during conversation.<br />

A key mistake that clinicians make while<br />

interviewing <strong>patients</strong> is that they fail <strong>to</strong><br />

address violence directly. A relevant question<br />

<strong>to</strong> ask is “Do you feel like harming<br />

<strong>your</strong>self or anyone else?” 6 If the patient<br />

becomes more agitated, it is important <strong>to</strong><br />

speak in a concilia<strong>to</strong>ry manner and offer<br />

supportive statements <strong>to</strong> defuse the situation.<br />

An alternative is <strong>to</strong> offer medication<br />

or restraints <strong>to</strong> prevent further escalation,<br />

however this is a controversial approach.<br />

Restraints should be applied when <strong>patients</strong><br />

become combative and verbal techniques are<br />

unsuccessful. Effective use of restraints can<br />

aid in prevention of injury <strong>to</strong> both the patient<br />

and the healthcare professional.<br />

Visi<strong>to</strong>r and Family Member Violence<br />

Family members who are angry about the<br />

patient’s condition account for about 55% of<br />

all abuse cases. 8 The most common reasons<br />

for assault by family members and visi<strong>to</strong>rs<br />

are anger related <strong>to</strong> hospital policies, the<br />

patient’s condition or situation, long wait<br />

times, or the healthcare system in general.<br />

When family members perceive that the<br />

healthcare staff is not meeting the needs of<br />

the patient, increased violence occurs; this<br />

can be associated with the stages of grief.<br />

During the anger stage of grief, the person<br />

often formulates a “lashing out” at a third<br />

party. 8 Within the healthcare setting, this<br />

person is often the nurse caring for the<br />

patient.<br />

The family member is often formulating<br />

someone <strong>to</strong> blame for their loved one’s<br />

suffering and hardship related <strong>to</strong> caregiver<br />

guilt. The family member in this situation<br />

often experiences feelings of fear, guilt,<br />

anxiety and frustration. 8<br />

Nursing Staff Education<br />

Organizational risk fac<strong>to</strong>rs include lack<br />

of facility policies and staff training for<br />

recognizing and managing escalating hostile<br />

and assaultive behaviors by <strong>patients</strong>,<br />

visi<strong>to</strong>rs or staff. Other indications for risk<br />

include high worker turnover, working when<br />

understaffed, and inadequate security and<br />

mental health personnel on site. 8<br />

Long waits for <strong>patients</strong> and families in<br />

overcrowded and uncomfortable waiting<br />

rooms have been associated with increased<br />

violence. Most importantly, institutions that<br />

form a perception that violence is <strong>to</strong>lerated<br />

can increase risk.<br />

Facilities can reduce workplace violence<br />

by using effective strategies, such as management<br />

commitment and worker participation,<br />

worksite analysis and hazard<br />

identification, safety and health training,<br />

recordkeeping and program evaluation.<br />

The most important reminder is <strong>to</strong> take<br />

every threat seriously.<br />

Violence prevention programs reduce the<br />

risk of assault by training workers <strong>to</strong> recognize<br />

cues such as drug use and threatening<br />

body language. These programs educate<br />

clinicians about strategies <strong>to</strong> defuse situations.<br />

Accurate incident reporting is crucial<br />

and a part of intervention because it helps<br />

hospital personnel identify specific hazards<br />

and take proper steps <strong>to</strong> remediate them.<br />

Reporting Violence<br />

Assault by <strong>patients</strong> or family members is<br />

highly underreported. Data show that only<br />

85% of incidents are reported only verbally<br />

<strong>to</strong> hospital administration; no formal written<br />

documentation occurs.<br />

Nurses often assume that reporting violence<br />

may affect hospital satisfaction survey<br />

scores. Other data suggest that nurses and<br />

No specific diagnosis or type of patient is predictive for<br />

violence, however, epidemiological studies consistently<br />

demonstrate that the highest level of risk exists in inpatient<br />

and acute psychiatric services, geriatric long-term care<br />

settings, high-volume emergency departments, residential<br />

and social services.<br />

other medical providers are fearful that<br />

the hospital administration will retaliate<br />

against reporters of violence by <strong>patients</strong><br />

or family members.<br />

It is important for all nurses <strong>to</strong> be familiar<br />

with their hospital’s reporting policy,<br />

which should include verbal abuse as well<br />

as physical assault.<br />

One survey found that nurses avoid<br />

reporting violence because they believe<br />

that their supervisors will suspect they<br />

somehow provoked the incident and label<br />

them as confrontational employees.<br />

As much as 70% of abuse <strong>to</strong>ward nurses<br />

is not reported, and most nurses who are<br />

injured do not seek any medical treatment<br />

for their injuries—which reflects the prevailing<br />

attitude that being abused by <strong>patients</strong><br />

and visi<strong>to</strong>rs goes with the terri<strong>to</strong>ry. 7<br />

Consequences of Workplace Violence<br />

Occupational violence is associated with<br />

reduced productivity, increased staff turnover,<br />

absence, counselling costs, decreased<br />

staff morale, and a reduced quality of life.<br />

Abuse can also decrease the quality of<br />

patient care.<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 39


CE: Professional Issues<br />

High-risk healthcare environments should provide increased<br />

security for <strong>patients</strong>, family, and workers. All <strong>patients</strong> must<br />

be disarmed prior <strong>to</strong> evaluation and interview.<br />

Healthcare professionals who are exposed<br />

<strong>to</strong> violence in the workplace can have<br />

nightmares or difficulty sleeping, poor<br />

job performance, chronic pain, or feelings<br />

of helplessness and irritability. 7,8 Nurses who<br />

have been verbally or physically assaulted<br />

have a higher level of anxiety, depression<br />

and substance abuse. 7,8<br />

Violence in the healthcare setting takes<br />

a significant <strong>to</strong>ll on all parties involved. In<br />

addition <strong>to</strong> the psychological or physical<br />

direct effects on the victim, negative effects<br />

include financial loss from insurance claims,<br />

legal expenses, property damage and staff<br />

replacement cost.<br />

When healthcare workers leave because<br />

of assaults or threats of violence, this contributes<br />

<strong>to</strong> the overall healthcare workforce<br />

shortage.<br />

Applicable Laws<br />

In 2010, the New York Legislature added<br />

nurses <strong>to</strong> its list of occupations <strong>to</strong> be protected<br />

by law. Prior <strong>to</strong> this, assaults against<br />

nurses were charged as misdemeanors.<br />

They are now charged as Class D felonies,<br />

carrying a sentence of 2 1/3 <strong>to</strong> 7 years in<br />

prison. 9<br />

The law states that any person with the<br />

intent <strong>to</strong> cause physical injury <strong>to</strong> a registered<br />

nurse or a licensed practical nurse during<br />

the time the clinician is performing an<br />

assigned duty will be charged accordingly.<br />

The district at<strong>to</strong>rney’s office for each county<br />

or municipality is the decision-making<br />

body <strong>to</strong> investigate the degree of assault<br />

or harassment.<br />

Although no federal laws have been<br />

passed <strong>to</strong> prevent violence against nurses,<br />

30 states have enacted laws that increase the<br />

penalties for people convicted of assaulting a<br />

nurse or other healthcare professional. The<br />

Violence Prevention in Healthcare Facilities<br />

Act mandates that each healthcare facility<br />

provide a comprehensive violence prevention<br />

program for its employees. 9<br />

Policies for Assault Victims<br />

The Emergency Nurses Association recommends<br />

a zero-<strong>to</strong>lerance policy for violence<br />

against nurses.<br />

Safety within the healthcare institution<br />

should be the institution’s first priority,<br />

the association states. If a physical or verbal<br />

assault occurs, it is important for the<br />

healthcare professional <strong>to</strong> immediately seek<br />

medical evaluation.<br />

Documentation of the event is crucial<br />

because the impact of the assault on the<br />

victim may not be immediate; therefore,<br />

proper documentation might be important<br />

in the future. Every employee who is<br />

assaulted is entitled <strong>to</strong> immediate medical<br />

care and first aid by the employer. Each<br />

individual agency’s policy and procedures<br />

should be available for guidance on reporting<br />

the incident.<br />

All assaults must be reported and recorded.<br />

The victim’s supervisor and employee<br />

health department should provide the nurse<br />

with all the benefits and rights that are<br />

available <strong>to</strong> protect them during this difficult<br />

time.<br />

Recommendations<br />

Clinicians are largely underprotected and<br />

underprepared <strong>to</strong> prevent and manage<br />

violent <strong>patients</strong>. Up <strong>to</strong> 50% of healthcare<br />

providers are victims of some sort of violence<br />

throughout their careers. Emergency<br />

departments have seen that drug and alcohol<br />

in<strong>to</strong>xication (or withdrawal from those<br />

substances) is one of the most common<br />

causes of severe agitation.<br />

Combative <strong>patients</strong> must be thoroughly<br />

assessed for medical stability, and a complete<br />

evaluation will indicate any dangerous<br />

medical rationale for increased agitation<br />

and altered mental status. By following<br />

basic safety measures, the risk of assault<br />

can be significantly decreased. n<br />

References<br />

1. National Institute for Occupational Safety and<br />

Health: Violence Prevention Training for Nurses. Centers<br />

for Disease Control and Prevention. http://www.cdc.gov/<br />

niosh/<strong>to</strong>pics/violence/training_nurses.html<br />

2. National Intitute for Occupational Safety and Health:<br />

Violence Occupational Hazards in Hospitals. Center of<br />

Disease Control and Prevention. http://www.cdc.gov/<br />

niosh/<strong>to</strong>pics/violence/<br />

3. Occupational Safety & Health Administration:<br />

OSHA updates guidance for protecting healthcare and<br />

social service workers from workplace violence. United<br />

States Department of Labor. https://www.osha.gov/SLTC/<br />

workplaceviolence/index.html<br />

4. Gacki-Smith J, et al. Violence against nurses working in<br />

U.S. emergency departments. J Nurs Adm. 2009;39:340-349.<br />

5. Good B, et al. Assessment of the acute psychiatric<br />

patient in the emergency department: legal cases and<br />

caveats. West J Emerg Med. 2014;15(3):312-317.<br />

6. Dubin WR, Jagarlamudi K. Safety in the evaluation<br />

of potentially violent <strong>patients</strong>. Psychiatric Times. 2010.<br />

http://www.psychiatrictimes.com/special-reports/safetyevaluation-potentially-violent-<strong>patients</strong><br />

7. Assessment and emergency management of the<br />

acutely agitated or violent adult. UpToDate. 2015. http://<br />

cursoenarm.net/UPTODATE/contents/mobipreview.<br />

htm?30/45/31441<br />

8. S<strong>to</strong>kowski LA. Violence: Not in my job description.<br />

Medscape. http://www.medscape.com/viewarticle/7277144_print<br />

9. Assault of a nurse on duty is a felony. Emergency<br />

department violence surveillance study. Emergency<br />

Nurses Association. Accessible <strong>to</strong> members at:<br />

https://www.ena.org/government/State/Documents/<br />

StateLawsWorkplaceViolence<br />

Jennifer Oakley is the lead nurse planner for the<br />

ADVANCE for Nurses continuing education program.<br />

She works in the emergency department at<br />

the Hospital of the University of Pennsylvania in Philadelphia<br />

and is an adjunct professor at Drexel University.<br />

She has completed a disclosure statement<br />

and reports no relationships related <strong>to</strong> this article.<br />

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Fee:<br />

$400<br />

Memorial Sloan Kettering Cancer Center<br />

New York City<br />

Registered Nurses will receive:<br />

• A comprehensive review of the knowledge<br />

needed <strong>to</strong> administer chemotherapy <strong>to</strong> pediatric<br />

<strong>patients</strong><br />

• A course manual published by the Association<br />

of Pediatric Hema<strong>to</strong>logy and Oncology Nurses<br />

(APHON)<br />

• 13.75 contact hours will be awarded <strong>to</strong> Registered<br />

Nurses<br />

• The APHON Pediatric Chemotherapy/Biotherapy<br />

Provider Card on successful completion of online<br />

exam and course evaluation – valid for 2 years.<br />

Payment must be made at time of registration<br />

<strong>to</strong> secure placement in<strong>to</strong> the program!<br />

To register visit:<br />

www.mskcc.org/education/cne<br />

For more information call: 212-639-6884<br />

E-mail: nursingceprogram@mskcc.org<br />

<br />

<br />

THOUSANDS OF JOBS AT<br />

AdvanceHealthcareJobs.com<br />

Get More from<br />

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Earn <strong>your</strong> degree with a regional leader in nursing<br />

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54 ADVANCE FOR NURSES n MAY 2016 n www.advanceweb.com/Nurses


Helene Fuld College of Nursing<br />

Where nurses climb the career ladder <strong>to</strong> success.<br />

212-616-7282 • HeleneFuld.edu<br />

24 East 120th Street<br />

New York, New York 10035<br />

§ Register for an RN <strong>to</strong> BS Open House.<br />

May 16th at 1 pm or June 13th at 1 pm.<br />

• Applications are being accepted for September 2016.<br />

EDUCATION OPPORTUNITIES<br />

§ Register for an LPN <strong>to</strong> RN Open House.<br />

May 20th at 1 pm or June 17th at 1 pm.<br />

• Nursing classes begin in November 2016.<br />

For more information or <strong>to</strong> register, please call 212-616-7282 or<br />

send an email <strong>to</strong> Allie.It<strong>to</strong>op@helenefuld.edu.<br />

College is accredited by the Middle States Commission on Higher Education.<br />

Full-time, part-time, day, and evening classes are available. Both nursing programs are fully accredited.<br />

TIME<br />

MAY BE<br />

RUNNING<br />

OUT!<br />

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MAILING LABEL<br />

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Get ready for<br />

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• Adult-Geron<strong>to</strong>logy Primary<br />

Care Nurse Practitioner<br />

• For more information,<br />

contact 610-361-5208 or<br />

gradadultadmiss@neumann.edu<br />

Healthcare POV FORUMS<br />

advanceweb.com/community<br />

As<strong>to</strong>n, Pennsylvania • www.neumann.edu<br />

www.advanceweb.com/Nurses n MAY 2016 n ADVANCE FOR NURSES 55


CAREER OPPORTUNITIES<br />

New Hampshire, New York, New Jersey, Pennsylvania<br />

Career Opportunities<br />

Sign up or renew <strong>your</strong> FREE subscription at the website<br />

or by calling (800) 355-1088.<br />

To place an ad in this section, call<br />

ADVANCE at (800) 355-JOBS (5627).<br />

1. New England . . . . . . . . . . . . . . 56<br />

2. Middle Atlantic . . . . . . . . . . . . 56<br />

3. Upper South Atlantic. . . . . . . 60<br />

4. Lower South Atlantic . . . . . . 61<br />

6. East North Central . . . . . . . . . . 64<br />

www.advancehealthcarejobs.com.<br />

8. West South Central. . . . . . . . . 64<br />

9. Mountain. . . . . . . . . . . . . . . . . . 65<br />

11. Pacific . . . . . . . . . . . . . . . . . . . . 65<br />

National . . . . . . . . . . . . . . . . . . 66<br />

›› MIDDLE ATLANTIC<br />

Now Hiring<br />

Penn State Hershey<br />

Rehabilitation Hospital<br />

We provide comprehensive inpatient care <strong>to</strong> address the<br />

medical, physical, emotional and vocational challenges<br />

of individuals with brain injury, spinal cord injury,<br />

stroke, amputation, neurological disorders, orthopedic<br />

conditions and multiple traumas.<br />

Hiring:<br />

Registered Nurses<br />

» Day & Night Shift Available<br />

Clinical Nurse Liaisons<br />

RN Case Manager<br />

Wound Care Nurse<br />

For more information:<br />

Joanne Glenn, HR Manager<br />

joglenn@selectmedical.com<br />

717.832.2704<br />

›› NEW ENGLAND >> selectmedical.com/careers<br />

our hospitals are part of select medical’s growing<br />

network of inpatient rehabilitation hospitals.<br />

The Horsham Clinic<br />

is a 206-bed private<br />

behavioral health care facility located on<br />

a beautiful 55-acre suburban campus.<br />

We are minutes from Philadelphia and<br />

we serve Southeastern Pennsylvania and<br />

New Jersey. The Horsham Clinic provides<br />

comprehensive behavioral health services<br />

<strong>to</strong> children, adolescents, adults, and their<br />

families. We are currently looking <strong>to</strong> fill<br />

the roles of Charge RNs & Clinical RNs.<br />

Must be graduate of an accredited nursing<br />

program. BSN preferred. 2-5 yrs prior<br />

psychiatric nursing experience preferred.<br />

Ask us about our available<br />

shifts & signing bonuses<br />

GET RESOURCES TO<br />

START YOUR<br />

CAREER OFF RIGHT<br />

Check out Student<br />

& New Grad Center.<br />

Career articles and advice<br />

Interactive learning<br />

Job listings and more<br />

advanceweb.com/NURSES<br />

We invite you send <strong>your</strong> resume<br />

<strong>to</strong> Kathleen.nichelson@uhsinc.com<br />

www.horshamclinic.com<br />

56 ADVANCE FOR NURSES ■ MAY 2016 ■ www.advanceweb.com/Nurses<br />

CHECK OUT OUR<br />

ONLINE JOB FAIRS NOW!<br />

advanceweb.com/events


DIALYSIS – Hemo<br />

NURSE MANAGER<br />

<br />

<br />

<br />

SOUTH SHORE DIALYSIS<br />

CENTER - HEMPSTEAD<br />

1 position<br />

20 Station Unit<br />

<br />

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<br />

<br />

SOUTH SHORE DIALYSIS<br />

CENTER - BELLMORE<br />

1 position<br />

20 Station Unit<br />

<br />

<br />

<br />

<br />

<br />

Fax 516-564-4348<br />

Attn Lisa Maggio, Administra<strong>to</strong>r or email: ssdcresumes@aol.com<br />

<br />

New York, New Jersey, Pennsylvania<br />

Join NewYork Presbyterian/Hudson Valley Hospital,<br />

the newest member of the NewYork Presbyterian<br />

Hospital family, ranked as one of the best places for<br />

care in Westchester County. We are proud <strong>to</strong> be a<br />

Magnet Hospital & 2015 Guardian of Excellence<br />

Award® winner, offering state-of-the-art diagnostic<br />

treatment, education and preventive services. The<br />

hospital is <strong>committed</strong> <strong>to</strong> improving the quality of life in<br />

the community we serve.<br />

We appreciate our<br />

DEDICATED NURSES...<br />

“Thank you for <strong>your</strong><br />

commitment <strong>to</strong> excellence!”<br />

• OR, NICU, ED, Med/Surg, OB<br />

FT, PT & Per Diem Opportunities<br />

• Patient Centered Care<br />

Specialist, FT<br />

CAREER OPPORTUNITIES<br />

Here at Elizabeth Se<strong>to</strong>n Pediatric Center, we believe that the nursing teams are<br />

the critical fac<strong>to</strong>r in achieving optimal resident outcomes. Your commitment and<br />

love are evident in all that you do each and every day. During Nurse’s Week,<br />

however, we take the opportunity <strong>to</strong> express our heartfelt appreciation. It is<br />

indeed an honor and a privilege <strong>to</strong> be the leader of such outstanding nurses.<br />

Join our team of dedicated healthcare professionals! Are<br />

you up for the challenge? Enjoy the rewards...in return<br />

for <strong>your</strong> ability and dedication, we offer an excellent <strong>to</strong>tal<br />

compensation package and a pleasant working<br />

environment which fosters personal and professional<br />

growth. Visit our website <strong>to</strong> learn more about our<br />

opportunities. Please send us <strong>your</strong> resume for<br />

consideration.<br />

To learn more, visit<br />

www.hvhc.org<br />

Or please submit <strong>your</strong> resume <strong>to</strong>:<br />

E-mail: HR@hvhc.org • Fax: 914-734-3784<br />

Thank You<br />

from the entire staff and children<br />

300 Corporate Boulevard South, Yonkers, NY 10701<br />

FAST,<br />

LOW-COST,<br />

FLEXIBLE<br />

REPRINTS<br />

CALL 800-355-5627<br />

ADVANCEWEB.COM<br />

Full-Time Nurse Home Visi<strong>to</strong>r<br />

• Provide health education for pregnant<br />

women & families in home<br />

• Provide prenatal & nutrition counseling<br />

• Educate on infant care & childhood development<br />

• Travel Sussex, Warren & Hunterdon counties<br />

• Current B.S.N., R.N. & C.P.R. required<br />

• Written/verbal skills & basic computer skills<br />

• Varied schedule<br />

• Spanish-speaking a plus.<br />

Email pss@projectselfsufficiency.org<br />

Fax 973-940-3501 Mail Deborah Berry-Toon,<br />

Exec Dir, Project Self-Suffi ciency,<br />

127 Mill Street, New<strong>to</strong>n, NJ 07860<br />

www.advanceweb.com/Nurses ■ MAY 2016 ■ ADVANCE FOR NURSES 57


CAREER OPPORTUNITIES<br />

New York, New Jersey, Pennsylvania<br />

MY INSPIRATION:<br />

providing compassionate care<br />

while growing as a nurse<br />

George Doran III BSN, RN<br />

Staff RN Surgical Stepdown Unit<br />

FOX CHASE NEEDS NURSES<br />

FOR EXPANDING CLINICAL VOLUMES<br />

• Clinical Manager<br />

– EMB Suite/GI<br />

Outpatient Services<br />

• Clinical Nurse<br />

Specialist—Critical Care<br />

• Nurse Practitioners<br />

– Geni<strong>to</strong>urinary (GU)<br />

Service<br />

– Hema<strong>to</strong>logy Oncology<br />

Consultation Service<br />

– Phase 1 Clinical Trials<br />

– ICU-Pulmonary<br />

– Breast Care<br />

Coordina<strong>to</strong>r<br />

• Nurse Naviga<strong>to</strong>r –<br />

Breast Health<br />

• Full time RNs<br />

– Ambula<strong>to</strong>ry Care<br />

– Clinical Research<br />

– Operating Room<br />

• Pool and Per Diem RNs<br />

– Ambula<strong>to</strong>ry Care<br />

– Direct Referral Unit<br />

– Inpatient Pool<br />

– PACU Per Diem<br />

– Radiology Per Diem<br />

– Relief Nursing<br />

Supervisor Per Diem,<br />

Nursing Administration<br />

Fox Chase Cancer Center has been<br />

awarded the Magnet® Designation for<br />

Nursing Excellence four times in a row.<br />

Consider joining our nursing team.<br />

Visit FoxChase.org/careers/nursing for a<br />

complete listing of available positions.<br />

Temple Health refers <strong>to</strong> the health, education and research activities carried out by the affiliates of Temple University Health System<br />

(TUHS) and by the Lewis Katz School of Medicine at Temple University. TUHS neither provides nor controls the provision of health<br />

care. All health care is provided by its member organizations or independent health care providers affiliated with TUHS member<br />

organizations. Each TUHS member organization is owned and operated pursuant <strong>to</strong> its governing documents.<br />

FIND TOP CAREER ENHANCEMENTS AT ADVANCEWEB.COM<br />

58 ADVANCE FOR NURSES ■ MAY 2016 ■ www.advanceweb.com/Nurses<br />

Inspira Health Network – Vineland is looking for:<br />

Cath Lab/Interventional Radiology RNs<br />

• Sign-on Bonus for Full-time, experienced RNs – $15,000<br />

• Sign-on Bonus for Part-time, experienced RNs – $7,500<br />

Inspira Health Network – Vineland is seeking experienced professionals <strong>to</strong> join our team at<br />

Inspira Medical Center for both full-time and part-time positions. We will rely on you <strong>to</strong><br />

meet the needs of the patient, family and multidisciplinary team through communication,<br />

coordination and evaluation. To qualify, you must be a graduate of an accredited school<br />

of professional nursing (BSN preferred) and have a current NJ RN license with American<br />

Heart Healthcare Provider BLS, ACLS required.<br />

Physical requirements: Physically able <strong>to</strong> carry out medical orders and planned nursing<br />

care, which requires standing, brisk walking, and/or supporting, lifting, and turning<br />

of <strong>patients</strong>.<br />

Inspira Health Network is a<br />

Magnet approved health system.<br />

Apply online at:<br />

inspirahealthnetwork.org/careers<br />

EOE<br />

Summit Oaks Hospital salutes our dedicated<br />

nursing staff during National Nurses Week!<br />

We are a private provider of comprehensive acute behavioral health and addictions<br />

treatment services serving a child, adolescent and adult population.<br />

We are seeking Staff RNs <strong>to</strong> join one of our dedicated nursing teams on<br />

the following units: Adult Psych, Dual Diagnosis, Child and Adolescent, De<strong>to</strong>x<br />

or Rehab. Psychiatric clinical experience preferred.<br />

We also have opportunities for per diem Nursing Supervisors<br />

Requirements: RN with a BSN (MSN preferred) and hospital supervisory experience.<br />

Full-time benefits include medical, Rx, dental and vision coverage,<br />

life insurance, tuition reimbursement and a 401(k) plan.<br />

Please complete our on-line application at:<br />

http://summi<strong>to</strong>akshospital.com/careers/<br />

Summit Oaks Hospital<br />

19 Prospect St., Summit, NJ 07902 (908) 277-9094 EOE M/F/D/V<br />

SUBSCRIBE TODAY!<br />

REGISTERED SCHOOL NURSE<br />

PRESCHOOL SPECIAL EDUCATION<br />

The Shield Institute invites a NYS licensed/Registered<br />

Nurse <strong>to</strong> join our team <strong>to</strong> provide quality medical services<br />

& care <strong>to</strong> students in our preschool special education<br />

program located at 1800 Andrews Ave, Bronx, NY 10453.<br />

Exp working in a school or camp & exp working with the<br />

I/DD population pref d. Bilingual (Spanish/English) prefd.<br />

Position offers a competitive salary and an excellent benefit<br />

package including fully paid health insurance. Applicants<br />

should send letter of interest, a resume, proof of eligibility <strong>to</strong>:<br />

Direc<strong>to</strong>r of Human Resources<br />

144-61 Roosevelt Ave, Flushing, NY 11354<br />

Fax: 718-961-7669 • Email: HR@shield.org<br />

Visit us at: www.shield.org<br />

EOE AAP<br />

HAS IMMEDIATE OPPORTUNITIES AVAILABLE<br />

FOR RN/LPN INDEPENDENT CONTRACTORS<br />

• Classroom nurse<br />

• Work in school health ofces.<br />

• Work 1:1 with students in MDS, special needs classrooms<br />

• Ride the bus with students <strong>to</strong>/from school<br />

• Preschool, Elementary/Middle School/High School and Life Skills<br />

• Behavioral Support / Emotional support / Educational support<br />

• We have per diem (for sub nursing <strong>to</strong> cover call outs) , as well as,<br />

LTS long term sub and Permanent placement<br />

• ESY opportunities for the summer in July and August. Head<br />

Nurses, 1:1, classroom and bus rides<br />

Send <strong>your</strong> resume <strong>to</strong>day <strong>to</strong>: (215) 357-4780 / fax<br />

or apply@Source4Nurses.com • (267) 261-6609<br />

Denise Gardner-Guerin / President<br />

www.Source4Nurses.com<br />

SUBSCRIBE TODAY! 800-355-1088


New York, New Jersey, Pennsylvania<br />

Join us at our:<br />

NURSING<br />

JOB FAIR<br />

Exciting Nursing opportunities<br />

at Main Line Health System-Wide!<br />

Amazing career experiences that count.<br />

PHILADELPHIA BUSINESS JOURNAL<br />

At Main Line Health ® , our Magnet ® hospitals<br />

are well-known throughout suburban<br />

Philadelphia for our award-winning care.<br />

We recently have been recognized by the<br />

Philadelphia Business Journal as one of the <strong>to</strong>p ten “Best Places <strong>to</strong> Work” in<br />

the Delaware Valley. And with a his<strong>to</strong>ry spanning more than 150 years, it’s one<br />

of the region’s most honored and respected academic healthcare institutions.<br />

<strong>You’re</strong> invited <strong>to</strong> attend our<br />

Nursing Job Fair<br />

Thursday, May 19th • 4:00 pm- 7:00 pm<br />

Radnor Corporate Center<br />

240 North Radnor Chester Road, Radnor, PA 19087<br />

Bring <strong>your</strong> resume and learn about our exciting Nursing and Leadership<br />

positions at: Lankenau Medical Center (currently in pursuit of Level 2<br />

Trauma), Bryn Mawr Hospital, Paoli Hospital (Level 2 Trauma), Riddle<br />

Hospital, Bryn Mawr Rehab Hospital, Mirmont Treatment Center and<br />

HomeCare & Hospice!<br />

Nursing Opportunities in all areas, including:<br />

ICU • Telemetry • OR • ED • L&D • Neonatal<br />

Full-time • Part-time • Weekend Program • Per Diem<br />

Must have a BSN or be currently enrolled in a BSN.<br />

One year of recent RN experience required.<br />

If unable <strong>to</strong> attend, please send <strong>your</strong> resume <strong>to</strong><br />

FallingerT@mlhs.org.<br />

Applicants must certify that they have not used<br />

<strong>to</strong>bacco products or nicotine in any form in the 90-<br />

days prior <strong>to</strong> submitting an application <strong>to</strong> Main Line<br />

Health. We are an equal opportunity employer.<br />

CAREER OPPORTUNITIES<br />

mainlinehealth.org/careers<br />

THANK YOU TO ALL<br />

OUR GREAT NURSES!<br />

Experienced RNs & LPNs<br />

CRITICARE HOME HEALTH &<br />

NURSING SERVICES,<br />

a Medicare certifi ed skilled agency in<br />

Chadds Ford, PA (a suburb of Philadelphia)<br />

has an immediate need for the following:<br />

1. RNs & LPNs experienced in working<br />

with children for assignments in<br />

Delaware and Chester County schools.<br />

2. RNs for post hospital in-home<br />

follow up care. Experience in wound<br />

care, wound vac, trachs, vents and<br />

infusion services a plus.<br />

3. CNAs / Teachers’ Aides for<br />

in-home and school assignments.<br />

Excellent hourly rates.<br />

Flexible hourly schedules.<br />

* RNs $28-$38/hr<br />

* LPNs $22-$28/hr<br />

* CNAs $11-$13/hr<br />

Depending on experience<br />

Call Nursing Line:<br />

610-675-1111, Ext. 127<br />

www.criticareplus.com<br />

ATTEND A JOB<br />

FAIR ONLINE!<br />

eoe<br />

Thank you <strong>to</strong> our Nurses<br />

during National Nurses Week!<br />

$3500<br />

SIGN ON BONUS<br />

Our Lady of Consolation Nursing<br />

& Rehabilitative Care Center<br />

A Member of Catholic Health<br />

Services of Long Island and a<br />

recognized leader in providing<br />

exceptional, quality driven care.<br />

We oer long term, post-acute<br />

and skilled nursing services.<br />

We oer competitive salaries, a<br />

dy namic work environment an d a<br />

generous benet package.<br />

We are currently seeking<br />

EXPERIENCED<br />

Registered Nurses<br />

FT/ PT/ Per Diem<br />

Great benefits including<br />

tuition reimbursement<br />

We invite you <strong>to</strong> apply online:<br />

www.olc.chsli.org<br />

CALL 800-355-1088 TO SUBSCRIBE FOR FREE!<br />

WE MAKE IT EASIER<br />

TO WRITE YOUR<br />

RESUME WITH<br />

RESUME BUILDER<br />

FIND IT AT<br />

ADVANCEHEALTHCAREJOBS.COM<br />

advanceweb.com/eventscom/events<br />

www.advanceweb.com/Nurses ■ MAY 2016 ■ ADVANCE FOR NURSES 59


CAREER OPPORTUNITIES<br />

New York, New Jersey, Pennsylvania, Delaware, Maryland, Washing<strong>to</strong>n DC<br />

A health system that celebrates <strong>your</strong> legacy.<br />

After all,<br />

Nursing is steeped in a grand tradition of caring which is what you’ll find at<br />

Holy Redeemer. A comprehensive health system focused on <strong>to</strong>tal patient care, we<br />

maintain that same emphasis as an employer <strong>to</strong> our nursing staff. We make it a<br />

priority <strong>to</strong> center our attention on you so that you can learn, grow, lead and impact<br />

the future of nursing. As our s<strong>to</strong>ry continues <strong>to</strong> unfold, we invite you <strong>to</strong> add <strong>your</strong><br />

own chapter by visiting our Nursing Open House. Feel for <strong>your</strong>self how Holy<br />

Redeemer creates experiences that are unique, personalized and truly memorable.<br />

NURSING OPEN HOUSE<br />

THURSDAY, MAY 12TH, 4PM-7PM<br />

Registered Nurses and Patient Care Assistants<br />

Holy Redeemer Hospital<br />

1648 Huntingdon Pike, Meadowbrook, PA 19046<br />

Hospital Audi<strong>to</strong>rium (1st floor)<br />

Spring 2016 BSN Graduates are welcome <strong>to</strong> attend!<br />

Free Parking available in the Self Parking Garage<br />

If you would like <strong>to</strong> RSVP, please contact<br />

Hope Shafer - 215-214-0682, HShafer@holyredeemer.com.<br />

If you are unable <strong>to</strong> attend , we would still love <strong>to</strong> hear from you. For more information<br />

and <strong>to</strong> apply visit our website, www.holyredeemer.com/careers<br />

HOME CARE RNs<br />

Home Care / Independent<br />

Contrac<strong>to</strong>r RNs<br />

Work as an RN independent contrac<strong>to</strong>r managing<br />

home care cases in areas of <strong>your</strong> choice<br />

in Phila, Bucks, Del counties and/or making<br />

skilled intermittent home care revisits. No<br />

weekend or holiday obligations; very flexible.<br />

Home care exp required. HCHB exp a plus!<br />

Nursing Unlimited, Inc., est. 1989<br />

Email resume <strong>to</strong> nui@nuipa.com<br />

Call: 215-663-8450 for more info<br />

Nursing Unlimited, Inc.<br />

455 Shady Lane, Suite C<br />

Huntingdon Valley, PA 19006<br />

Coordinated Health<br />

is seeking experienced registered<br />

OR nurses <strong>to</strong> join a team of<br />

experienced orthopedic surgeons and<br />

physician assistants in our specialty<br />

hospitals located in the Lehigh Valley.<br />

Full-time, part-time and per-diem<br />

opportunities available. This is an<br />

excellent opportunity <strong>to</strong> work in an<br />

innovative and state-of-the-art facility.<br />

Competitive salary with great benefi ts.<br />

Apply at<br />

COORDINATEDHEALTH.COM<br />

or contact us at: 610-861-8080ext.36581<br />

GREAT OPPORTUNIES<br />

ARE WAITING<br />

FOR YOU AT OUR<br />

ONLINE JOB FAIRS<br />

Happy Nurses Week <strong>to</strong> our Incredible Staff!<br />

›› UPPER SOUTH ATLANTIC<br />

EOE<br />

advanceweb.com/events<br />

60 ADVANCE FOR NURSES ■ MAY 2016 ■ www.advanceweb.com/Nurses<br />

would like <strong>to</strong><br />

Celebrate & Thank Our Incredible Team of Nurses.<br />

Happy Nurses Week!<br />

$5K sign-on bonus and relocation assistance*<br />

We have the following opportunities currently available<br />

• Float Pool • ICU • CDU<br />

We also have openings in Ortho, Cardiac Cath Lab, Stepdown, CVOR & ED<br />

Casual Positions also available<br />

* Full Time Only - Qualified RN’s may be eligible for $3,000 - $5,000 sign-on bonus for specific inpatient units. Limited offer and does not apply <strong>to</strong> other units or positions.<br />

Beebe Healthcare, located in Lewes, DE, offers you a unique Work/Life balance set in a beautiful, tranquil setting with exceptional leadership and an award winning staff of professionals.<br />

What do you want <strong>to</strong> Be?<br />

Visit our website for a complete list of openings<br />

Achieve AMAZING ACCOMPLISHMENTS through www.beebehealthcare.org<br />

employment@beebehealthcare.org<br />

exceptional teamwork<br />

Phone 302-645-3336 | EOE | 424 Savannah Rd, Lewes, DE 19958<br />

facebook.com/beebecareers | twitter.com/beebecareers


Happy Nurses Week To Our Wonderful Team of Nurses!<br />

REACH for the STARS<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

We are now hiring talented STAR<br />

Nursing Professionals for the<br />

following specialties:<br />

Medical Surgical-Ortho/Neuro/Stroke/<br />

Oncology<br />

Observation Unit<br />

Addiction and Mental Health<br />

Operating Room*<br />

Labor and Delivery*<br />

Intensive Care Unit<br />

Cardiac Cath Lab<br />

Emergency Department*<br />

Case Management (ED)<br />

Float Pool<br />

<br />

<br />

Requirements <strong>to</strong> join our<br />

TEAM OF STAR ASSOCIATES<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

http://www.medstarmontgomery.org/careers<br />

Delaware, Maryland, Washing<strong>to</strong>n DC, South Carolina, Georgia, Florida<br />

Happy National Nurses Week!<br />

This week, it’s all about you! Thank you for <strong>your</strong> continued dedication <strong>to</strong><br />

children and young adults with special health care needs.<br />

The HSC Health Care System is a nonprofit organization <strong>committed</strong> <strong>to</strong> serving families<br />

with complex health care needs, combining the resources of a care coordination plan<br />

(Health Services for Children with Special Needs, Inc.), pediatric specialty hospital (The<br />

HSC Pediatric Center), and home health agency (HSC Home Care, LLC) with a parent<br />

foundation <strong>to</strong> offer a comprehensive approach <strong>to</strong> care for people with disabilities.<br />

TO APPLY FOR NURSING OPPORTUNITIES, VISIT<br />

WWW.HSCHEALTH.ORG<br />

Current positions available include:<br />

• RN (Inpatient) - At least 2-3 years of experience in pediatric nursing;<br />

RN license from the District of Columbia required.<br />

• Home Health RN - At least 2 years of pediatric/home health nursing<br />

experience; RN license from DC or Maryland required. IV experience<br />

highly preferred.<br />

• Nurse Practitioner (Advanced Care Center) -<br />

At least 2 years of experience as a pediatric<br />

nurse practitioner, preferably in clinic/ community-based<br />

settings. Current Advanced Practice<br />

Registered Nurse (APRN) licensure, DC; current<br />

Nurse Practitioner certification in pediatrics.<br />

• Care Manager - At least 3 years of clinical<br />

practice and case management experience.<br />

RN licensure from DC required.<br />

• Quality Manager (Hospital) - At least 5<br />

years of experience working in health care<br />

environments, hospital experience a strong<br />

plus. RN licensure from DC highly preferred.<br />

• Clinical Quality Analyst (Home Care) - At<br />

least 2-3 years of experience in clinical QI/<br />

PI, as well as 3-5 years of professional clinical<br />

experience. RN licensure from DC and<br />

Maryland highly preferred.<br />

Flexible schedules and<br />

competitive pay.<br />

Bilingual candidates are<br />

encouraged <strong>to</strong> apply.<br />

We are an equal<br />

opportunity employer.<br />

CHECK OUT OUR UPCOMING<br />

ONLINE JOB FAIRS<br />

CAREER OPPORTUNITIES<br />

TURN YOUR ARTICLE IN<br />

ADVANCE INTO AN<br />

EXCITING HANDOUT!<br />

CALL 800-355-5627<br />

FOR REPRINTS<br />

advanceweb.com/events<br />

›› LOWER SOUTH ATLANTIC<br />

FLORENCE DARLINGTON<br />

TECHNICAL COLLEGE<br />

CREATE & SAVE UP TO 5 RESUMES WITH ADVANCE RESUME BUILDER<br />

GO TO ADVANCEHEALTHCAREJOBS.COM TODAY<br />

DEPARTMENT OF NURSING PROGRAMS CHAIR<br />

The Department of Nursing is seeking a dynamic leader <strong>to</strong> direct a nursing program that includes<br />

an ACEN accredited associate degree nursing program, SC State approved Practical nursing<br />

program and a Certified Nursing Assistant program.<br />

Master’s degree in Nursing or master’s degree with a minimum of 18 graduate semester hours in<br />

Nursing plus three (3) years of nursing faculty/education experience and evidence of progressively<br />

responsible direct program administration and faculty supervision experience.<br />

Possess or be eligible for South Carolina RN licensure. Salary commensurate<br />

with education/training. Job available immediately.<br />

Persons interested in this opportunity should apply online at www.jobs.sc.gov.<br />

Florence-Darling<strong>to</strong>n Technical College does not discriminate because of race, color, religion,<br />

national or ethnic origin, creed, marital status, veteran status, disability, sex or age.<br />

www.advanceweb.com/Nurses ■ MAY 2016 ■ ADVANCE FOR NURSES 61


South Carolina, Georgia, Florida<br />

CAREER OPPORTUNITIES<br />

ATTENTION<br />

Working at BayCare can result in<br />

job satisfaction, having fun with<br />

co-workers and enjoying time <strong>to</strong><br />

relax in a beautiful location.<br />

MAY BE HABIT<br />

FORMING.<br />

We want <strong>to</strong> set realistic expectations for you. Once you start<br />

working at BayCare, you’ll start <strong>to</strong> feel better almost immediately!<br />

That’s because our nurses enjoy a culture of safety and<br />

happiness that spills in<strong>to</strong> every aspect of life here.<br />

With 14 community-based hospitals, a long-term acute care<br />

facility, home health services and outpatient centers, BayCare<br />

can offer you more shifts, specialties and opportunities.<br />

Happy Nurses Week<br />

May 6-12, 2016<br />

Our nurses enjoy happiness every week :)<br />

Now that we’ve got <strong>your</strong> attention, please apply online at<br />

BayCareJobs.com<br />

EOE/M/F/Vet/Disability.<br />

62 ADVANCE FOR NURSES ■ MAY 2016 ■ www.advanceweb.com/Nurses


South Carolina, Georgia, Florida<br />

EVERY STORY HAS ITS<br />

CAREER OPPORTUNITIES<br />

WE HAVE MORE THAN 3800<br />

NURSES TO THANK<br />

Behind every inspiring patient s<strong>to</strong>ry is our dedicated team of Memorial nurses. Their<br />

expertise saves lives and their compassionate care provides hope and comfort during the<br />

most challenging of times. Each operates under the principle belief that the mind, body<br />

and spirit of every patient and family member must be nurtured and respected <strong>to</strong> ensure<br />

the most effective outcomes. We thank every nurse for the heroic work they do daily.<br />

HAPPY NATIONAL NURSES WEEK!<br />

MHS.NET<br />

Memorial Regional Hospital<br />

Memorial Manor<br />

Memorial Regional Hospital South Memorial Physician Group<br />

Joe DiMaggio Children’s Hospital Memorial Home Health<br />

Memorial Hospital West<br />

South Broward Community<br />

Memorial Hospital Miramar<br />

Health Services<br />

Memorial Hospital Pembroke<br />

www.advanceweb.com/Nurses ■ MAY 2016 ■ ADVANCE FOR NURSES 63


South Carolina, Georgia, Florida, Illinois, Oklahoma<br />

CAREER OPPORTUNITIES<br />

Working here means<br />

working for <strong>patients</strong>,<br />

neighbors, and friends.<br />

When you’re as much a part of the<br />

community as we are at Lower Keys<br />

Medical Center, you appreciate the<br />

satisfaction of being there for those who<br />

depend on <strong>your</strong> expertise. Our <strong>patients</strong>,<br />

neighbors and friends are the ones we<br />

truly work for, answer <strong>to</strong>, and serve.<br />

Feel a real sense of accomplishment and<br />

belonging within our 167-bed acute-care<br />

hospital, which is located in beautiful Key<br />

West. We have opportunities <strong>to</strong> do <strong>your</strong><br />

best work throughout a wide range of<br />

medical procedures.<br />

Join our team – and our community.<br />

CHIEF NURSING OFFICER • DIRECTOR ICU & MED/SURG<br />

REGISTERED NURSES • Full-Time & PRN<br />

• ICU • ER • Med/Surg • OR • Clinical Document Specialist<br />

• Nurse Manager • Case Manager • Cath Lab • Wound Care<br />

• Quality Coordina<strong>to</strong>r • Behavioral Health<br />

NURSING ASSISTANTS • ER • CNA<br />

Apply online: www.lkmc.com/about/careers<br />

Resumes may also be emailed or faxed:<br />

E-mail: donald.canalejo@lkmc.com • Fax: 305.296.2520<br />

M—AND O<br />

Lower Keys Medical Center is an equal opportunity employer. Minorities/Females/Protected Veterans/Disabled<br />

Hope <strong>to</strong> see you here for Nurses Week!<br />

Excellent opportunities <strong>to</strong> join<br />

our growing health care system.<br />

Our mission is <strong>your</strong> mission:<br />

To be a compassionate and transforming<br />

healing presence in the lives of our<br />

<strong>patients</strong>. We are a faith-based, patientcentered<br />

system with hospitals in Athens,<br />

Lavonia and Greensboro, Ga. Seeking<br />

RNs in...<br />

• Family Birth Center<br />

• Surgical Services<br />

• IMCU<br />

• ICU<br />

and more.<br />

CHAT LIVE WITH<br />

RECRUITERS<br />

advanceweb.com/events<br />

›› WEST SOUTH CENTRAL<br />

We offer competitive pay and benets.<br />

For immediate consideration, apply online at<br />

www.stmarysathens.org<br />

LEAVE A LASTING<br />

IMPRESSION WITH ARTICLE<br />

REPRINTS FROM ADVANCE<br />

REPRINTS@ADVANCEWEB.COM<br />

›› EAST NORTH CENTRAL<br />

VMI HOME CARE<br />

Now in our 33 rd year.<br />

RNs needed for the following positions:<br />

RN Case Manager<br />

On Call RN<br />

Experience preferred - but will train.<br />

Flexible hours, competitive rates, benefits,<br />

bonus after 1 year employment.<br />

(P) 773-467-1777<br />

(F) 773-467-0022<br />

E-mail: vmihh@att.net<br />

64 ADVANCE FOR NURSES ■ MAY 2016 ■ www.advanceweb.com/Nurses<br />

DON’T LET YOUR<br />

FREE SUBSCRIPTION<br />

TO ADVANCE EXPIRE!<br />

CALL 800-355-1088


Idaho, Nevada, California, Alaska<br />

›› MOUNTAIN ›› PACIFIC<br />

Take the Leap<br />

in<strong>to</strong> an Excellent Nursing Opportunity<br />

10 K SIGN ON BONUS<br />

2+ Years Experience in AcuteCare<br />

LOS ANGELES • SAN FERNANDO VALLEY • VENTURA • SAN GABRIEL VALLEY LEY<br />

• SOUTH HB<br />

BAY<br />

Roze Room Hospice would like <strong>to</strong> thank all our hospice and<br />

palliative care nurses for the tremendous dedication, care and<br />

compassion they provide <strong>to</strong> <strong>patients</strong> and families.<br />

Positions Available:<br />

RNs, LVNS, and Team Leaders<br />

All Ofces<br />

Full Time • Per Diem • Continuous Care • On-Call<br />

Jeannette Can - jeannette@rozeroomhospice.org<br />

• “Where Ordinary People Do Extraordinary Things” •<br />

Roze Room has been recognized and ranked by the Los Angeles Business<br />

Journal as one of the Best Places <strong>to</strong> Work in Los Angeles in 2014 and 2015.<br />

®<br />

telephone: (323) 938-1155<br />

fax: (323) 936-7573<br />

CAREER OPPORTUNITIES<br />

Join Our Nursing Team<br />

(208)814-2550<br />

stlukesonline.org/employment<br />

news.stlukesblogs.orgslhs_jobs<br />

REGISTERED NURSES<br />

Full-time Emergency Room, EMS/<br />

Flight, and Med/Surg (ICU Exp) RNs.<br />

Nevada license required. We offer<br />

competitive salary, incentive pay for<br />

cross-training, excellent benefits including<br />

State of NV Public Employees<br />

Retirement, group insurance benefits,<br />

accrued PTO & Sick Leave. Nonsmoking<br />

facility, non-smoker preferred.<br />

Contact HR Direc<strong>to</strong>r<br />

HGH<br />

118 E. Haskell Street<br />

Winnemucca, NV 89445<br />

E-mail rose@hghospital.org<br />

or Fax (775) 623-5904<br />

EOE Employer<br />

LEAVE A LASTING<br />

IMPRESSION WITH<br />

ADVANCE REPRINTS<br />

REPRINTS@ADVANCEWEB.COM<br />

GET RESOURCES TO<br />

START YOUR<br />

CAREER OFF RIGHT<br />

Check out Student<br />

& New Grad Center.<br />

Career articles and advice<br />

Interactive learning<br />

Job listings and more<br />

advanceweb.com/NURSES<br />

Direc<strong>to</strong>r of<br />

Nursing<br />

We have an immediate opening for<br />

Direc<strong>to</strong>r of Nursing for our 65-bed<br />

Mental Health Rehabilitation Center<br />

in Mission Viejo. Qualified candidates<br />

will have: R.N. license, 5 years supervisory<br />

experience, inpatient psychiatric<br />

experience, familiarity with Recovery<br />

Model programs, excellent managerial<br />

skills, and excellent communication<br />

skills. We offer a highly competitive<br />

salary and benefit package.<br />

ROYALE MISSION VIEJO<br />

23228 Madero<br />

Mission Viejo, CA 92691<br />

Email:<br />

nhernandez@royalehealth.com<br />

Fax:<br />

(714) 708-4884<br />

EOE<br />

NEW<br />

HEALTHCARE<br />

JOB LISTINGS<br />

ADDED DAILY!<br />

ADVANCEHEALTHCAREJOBS.COM<br />

CHECK<br />

OUT<br />

ADVANCEWEB.COM<br />

AND LINK TO<br />

YOUR FAVORITE<br />

ADVANCE<br />

MAGAZINE,<br />

JOB SEARCH,<br />

SHOPPING,<br />

CE AND MORE!<br />

www.advanceweb.com/Nurses ■ MAY 2016 ■ ADVANCE FOR NURSES 65


California, Alaska, National<br />

CAREER OPPORTUNITIES<br />

Live and work in beautiful Homer, Alaska!<br />

Homer is located on the southern shores of the Alaska Kenai Peninsula. A<br />

quaint <strong>to</strong>wn nestled on the beautiful Kachemak Bay offering breathtaking<br />

views of glaciers, mountains and wildlife. It has something for everyone:<br />

adventure, culture, scenery, or even a little bit of solitude.<br />

We Love Our Nurses!<br />

Celebrating National Nurses Week<br />

Concorde Career Colleges is now hiring:<br />

Concorde has nurse instruc<strong>to</strong>r positions available for<br />

Master’s and Bachelor’s prepared nurses.<br />

Both full-time and part-time opportunities are available.<br />

<br />

<br />

paid holidays and vacation and education reimbursement.<br />

South Peninsula Hospital is a modern facility Critical Access Hospital<br />

with 22 Acute Care beds and an attached 28 bed Long Term Care nursing<br />

facility. We are seeking dedicated and talented patient care professionals <strong>to</strong><br />

join our diverse team:<br />

• Direc<strong>to</strong>r of Long Term Care RN<br />

• Acute Care OB & Med Surg RN<br />

• Emergency Department RN<br />

• OR Circula<strong>to</strong>r RN<br />

• Home Health/Case Mrg RN<br />

We offer competitive wages & benefits including: health/life insurance, retirement,<br />

wellness, loan forgiveness, generous paid leave and recruitment bonus.<br />

Apply <strong>to</strong>day @ www.sphosp.org<br />

Contact Human Resources (907) 235-0800 // dlamb@sphosp.org<br />

›› NATIONAL<br />

Positions are available in these locations:<br />

Garden Grove, CA<br />

<br />

San Bernardino, CA<br />

<br />

Aurora, CO<br />

<br />

<br />

<br />

Kansas City, MO<br />

Portland, OR<br />

Memphis, TN<br />

Grand Priarie, TX<br />

Dallas, TX<br />

Explore an Opportunity at Concorde, Apply Today!<br />

jobs.concorde.edu | 1-877-866-2340<br />

VA Palo Al<strong>to</strong> Health Care System<br />

Salutes Our Outstanding Team<br />

of Nursing Professionals for<br />

National Nurse's Week!<br />

Gloria, N. Martinez<br />

MS, RN, NEA-BC<br />

Thank You!<br />

for <strong>your</strong> competent and compassionate care and <strong>your</strong><br />

commitment <strong>to</strong> excellence in service <strong>to</strong> our nation’s veterans.<br />

Contact us <strong>to</strong> discuss career<br />

opportunities <strong>to</strong> fit <strong>your</strong> talents:<br />

Nurse Recruiter: (650) 493-5000 ext. 64530<br />

Email: V21PALNurseRecruiter@va.gov<br />

Apply Online: www.USAJobs.gov<br />

OPEN House for RN and NP opportunities!<br />

Saturday June 4, 2016 • 10am- 2pm<br />

Location: VA Palo Al<strong>to</strong> HCS<br />

3801 Miranda Ave (audi<strong>to</strong>rium) • Palo Al<strong>to</strong> CA 94304 EOE<br />

66 ADVANCE FOR NURSES ■ MAY 2016 ■ www.advanceweb.com/Nurses<br />

“For the sick, it is<br />

important <strong>to</strong> have<br />

the best.”<br />

- Florence Nightengale<br />

Thank you <strong>to</strong> our team of<br />

dedicated nurses – you are the<br />

best! We are grateful for <strong>your</strong><br />

commitment <strong>to</strong> our <strong>patients</strong><br />

and the Providence, Rhode<br />

Island community. Thank you!<br />

Providence Community Health<br />

Centers, Inc. (PCHC) is a non-<br />

<br />

and the only FQHC in Providence,<br />

Rhode Island. We provide<br />

affordable, quality, primary health<br />

care <strong>to</strong> more than 50,000 <strong>patients</strong><br />

through our eight health centers<br />

in the city, a school-based<br />

program and a dental clinic.<br />

EOE<br />

For career opportunities visit<br />

PCHCproviders.org<br />

Healthcare POV BLOGS<br />

advanceweb.com/community<br />

Diamond Healthcare, a national behavioral<br />

health management company, is recruiting<br />

experienced professionals.<br />

Corporate Ethics and<br />

Compliance Officer<br />

Richmond, VA<br />

Direc<strong>to</strong>r of Clinical Quality<br />

and Compliance<br />

Washing<strong>to</strong>n, DC<br />

Respira<strong>to</strong>ry RN<br />

Port Lavaca, TX<br />

Nurse Managers / DON<br />

Clin<strong>to</strong>n, MD • Livonia, MI<br />

Geneva, NE • Nationwide - Interim<br />

Psychiatric RNs:<br />

Cincinnati, OH • Lorain, OH<br />

Ba<strong>to</strong>n Rouge, LA • Clin<strong>to</strong>n, MD<br />

Alamogordo, NM • Williamsburg, VA<br />

JOIN OUR TALENT NETWORK<br />

<strong>to</strong> receive job alerts<br />

WWW.DIAMONDHEALTH.COM<br />

ADVANCE<br />

E-newsletter<br />

Sign Up Today!<br />

advanceweb.com


<strong>You’re</strong><br />

IN!If you’re reading this issue,<br />

<strong>your</strong> name is already on the list.<br />

Every nurse is welcome beyond the velvet<br />

rope when they come <strong>to</strong> our website. And<br />

because you’re a member of that elite<br />

group, you have exclusive access <strong>to</strong> <strong>to</strong>ns<br />

of premium content. All you need <strong>to</strong> do is<br />

finalize <strong>your</strong> free online account and the<br />

doors will swing wide open.<br />

■ Digital editions<br />

■ Salary statistics<br />

■ Exclusive articles, videos and online CE<br />

■ Career opportunities and advice<br />

■ Webinars and online conferences<br />

■ Comprehensive resource centers<br />

■ Weekly e-newsletters<br />

■ And much more<br />

Go here <strong>to</strong> get the VIP treatment!<br />

j.mp/nursevip<br />

Already have an account? Log in <strong>to</strong> advanceweb.com/nurse and get served the good stuff.


Your passion made you the nurse<br />

you are <strong>to</strong>day. Use it <strong>to</strong> help shape<br />

the industry <strong>to</strong>morrow.<br />

Prepare <strong>to</strong> earn the nurse administra<strong>to</strong>r credentials you need <strong>to</strong> strengthen the health care<br />

industry from within. At University of Phoenix® School of Nursing, our CCNE-accredited MSN<br />

nursing administration degree program will help equip you with the leading-edge knowledge<br />

and advanced business skills you need <strong>to</strong> inspire change and shape the future—while preparing<br />

you <strong>to</strong> sit for the American Nurses Credentialing Center (ANCC) Nurse Executive-Board<br />

Certification (NE-BC) exam.<br />

Learn more at Phoenix.edu/Nursing<br />

Moving at the Speed of Health Care TM<br />

For more information about this program, including on-time completion rates, the median debt incurred<br />

by students who completed the program and other important information,<br />

please visit: phoenix.edu/programs/degree-programs/nursing-and-health-care/masters/msn-adm.html<br />

The Bachelor of Science in Nursing and Master of Science in Nursing programs at University of Phoenix are accredited by the Commission on Collegiate Nursing Education,<br />

One Dupont Circle, NW, Suite 530, Washing<strong>to</strong>n DC 20036, 202-887-6791. The Master of Science in Nursing/Nurse Administration is a post-licensure education program<br />

designed for nurses with current RN licensure who wish <strong>to</strong> obtain a master’s degree in nursing administration. The program prepares registered nurses <strong>to</strong> function in<br />

leadership roles in administration, practice and educational settings. Upon completion of the program, graduates with the required practice experience will be prepared<br />

<strong>to</strong> sit for the American Nurses Credentialing Center Nurse Executive-Board Certification (NE-BC) exam. While widely available, not all courses are available in all<br />

locations or in both online and on-campus formats. Please check with a University Enrollment Representative. The University’s Central Administration is located at<br />

1625 W. Fountainhead Pkwy., Tempe, AZ 85282. © 2015 University of Phoenix, Inc. All rights reserved.

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