Nearly One-Third Of R.N.S Approaching Retirement Age

By Slowik, Elizabeth 

The aging of Michigan's nurses was drawn in sharp detail by the Michigan Center for Nursing's 2008 survey. Ten years ago, the survey, which asks questions of nurses renewing their licenses, found that 14 percent of registered nurses and 19 percent of licensed practical nurses were age 55 or older. 

Fast forward to 2008, and those proportions have more than doubled: 31 percent for R.N.s and 39 percent for LPNs. The average age for R.N.s is 50; the average for LPNs is 51. 

Nurses must renew their licenses every two years, so the center uses the opportunity to survey those seeking renewal. This year, the survey covered 37,054 registered nurses and 7,520 licensed practical nurses. 

The nurses who answered the survey in 2007 were even older than those covered by this year's questionnaire, the MCN's report noted. 

Michigan has a total of 93,657 R.N.s and 20,700 LPNs who work in nursing in the state. The vast majority of LPNs work in long-term care settings, such as nursing homes, while R.N.s are more likely to work in hospitals. 

The number of nurses in the 2008 survey who say they intend to leave their careers within the next 10 years crept up past one- third. In 2006 - the last time this same group of license-renewing nurses was surveyed - 33 percent of R.N.s and 39 percent of LPNs said they planned to leave their jobs within a decade. But this year, 39 percent of R.N.s and 41 percent of LPNs said they plan to leave nursing. 

For both types of nurses, 21 percent had left a nursing job since the 2006 20 percent of R.N.s and 23 percent of LPNs said they had quit jobs in order to retire or to exit the field. 

Yet just 13.9 percent of those who left an R.N. job cited age as the reason. An overwhelming 41.3 percent of those who left a nursing job cited a "general lack of job satisfaction." 

There is some recognition among employers that nurses are getting older. For example, the trend toward private rooms in hospitals means longer hallways and more walking. Leanna Krukowski, clinical director of orthopedics and neurology at Saint Mary's Health Care, said the new Hauenstein Center features shortcuts between hallways to cut down on steps the nurses must take, a lesson learned from the Grand Rapids hospital's Lacks Cancer Center. When the Hauenstein Center, which focuses on neurosciences, opens in February, the patient rooms will have mechanical lifts, eliminating the back- breaking task of two or three people moving the ill in and out of bed. 

Priscilla Hadley, 61, an R.N. at Metro Health Hospital, started out as an LPN in Florida in 1967. She sees her decades on the job as a plus. 

"I think older nurses are smarter, they are more experienced and they're more sure of themselves," said Hadley, of Grand Rapids. "I honestly don't see it as a disadvantage to be older." 

She said she loves the work, but still would like to retire. Hadley said she stays in her job to retain health benefits for herself and her self-employed husband. She thinks she'll be working at the Wyoming hospital for another five years or so, until she's eligible for Social Security. 

"I'm in for the long haul," she said. Among other items in the survey report: 

* Unemployment among nurses is just 2 percent. 

* Men comprise abut 6 percent of active R.N.s and 5 percent of active LPNs. 

* About 6 percent of R.N.s and 13 percent of LPNs are African American. Just 1 percent of active R.N.s and 2 percent of active LPNs are Hispanic, Latino or Spanish. 

Copyright Gemini Publications Jan 26, 2009 

(c) 2009 Grand Rapids Business Journal. Provided by ProQuest LLC. All rights Reserved.

A service of YellowBrix, Inc. 

Security of tenure sought for Pinoy nurses in New Zealand

MANILA, Philippines — An organization of Filipino migrant workers in New Zealand appealed Thursday to the Nursing Council to approve the registration of qualified Filipino nurses who have been working for at least one year before implementing the new policy requiring nurses to take on second courses.

Dennis Maga, national coordinator of Migrante Aotearoa, said hundreds of Filipino nurses will be forced to go home and add to the growing number of jobless workers unless the Nursing Council approve their registration.

The new policy requires second courser to study for 2-3 semesters in New Zealand. Many Filipino nurses work as health care assistants or caregivers in New Zealand, receiving lower pay even as New Zealand hospitals are in need of nurses, Maga said.

Many nurses were very hopeful about finally getting their registration after they recently passed the English test, but the new policy shattered her dream of finally getting a license, Maga said.

Maga disclosed that some Filipino nurses have been forced to go home to the Philippines as they could not afford to pay around NZ$20,000 a year. 

“We hope that the council will take the right step in protecting the rights of Filipino nurses currently in New Zealand who have long waited for their registration under the old policy rather than impose a new policy that will force them to go home or find work elsewhere,"the group said.

“While it is the council’s job to assess the hundreds of applicants who are waiting in the Philippines, we believe it is also their job to recognize the service and protect the rights of those who are already here. We ask the council not to undermine the skills of Filipino nurses who deserve to get their license before the new policy was in place," Maga said.

In a letter addressed to Chief executive Carolyn Reed, Mr. Maga noted, “We do understand the council’s job to ensure that educational courses preparing Filipino nurses coming to New Zealand are meeting acceptable standards. But we hope there will be justice and compassion for the nurses who are already working here. They certainly deserve to be registered under the old policy as they already proved to be of good service to the New Zealand health care system."

Migrante Aotearoa launched in 2007 a campaign in support of nurses’ fight against unscrupulous contracts and exorbitant fees by some immigration agents. 

The group called on to extend support of the New Zealand Nurses Organization, the Human Rights Commission, Philippine Nurses Association (PNA) and various groups to ask the council to protect qualified Filipino nurses especially those currently in New Zealand discriminated by the new policy from undue rejection.

'Nursing Should Be Performed Selflessly'

from The Times of India .. 

BIJAPUR: "The nursing profession is a very holy profession, hence it should be practised with utmost care", said Babaleshwar MLA M B Patil. 

Addressing nursing students at Shri B M Patil Nursing College here on Monday he said, "Students should take an oath to perform the duty with open hearts and selfless nature. 

Participating as chief guest, principal R S Huli said, "In medical field nursing plays a vital role. Serving patients with honesty is the real responsibility of nursing staff". 

ENT Department head Dr S P Guggarigoudar, principal L A Dhillan, Appasaheb Chowdhari, Prashant Kulkarni, Shashikumar Jadar, Ramya Chidambaram, Prakash Siddhapur, Ajo Kuriyan participated in the function. 

(c) 2009 The Times of India. Provided by ProQuest LLC. All rights Reserved.

A service of YellowBrix, Inc. 

Gov't policy chided for exodus of Filipino nurses

MANILA, Philippines - A health group has accused President Gloria Macapagal Arroyo's administrationb of driving Filipino nurses out of the country to work abroad, effectively neglecting areas in the Philippines in need of proper health care.

“For the longest time, Mrs. Arroyo has known about the dearth of health personnel in the rural areas but has done nothing about it and instead, encouraged Filipino nurses to leave and work abroad in droves," said Dr. Geneve E. Rivera, Health Alliance for Democracy (Head) secretary-general, in a statement on Tuesday.

Rivera said that the President has allowed nursing schools to “mushroom and mass-produce nurses" for the needs of other countries. Some figures have shown that the number of nursing students jumped from 30,000 in 2004 to almost 450,000 in 2008.

“Now, because so many nurses are in dire straits for being unemployed, she is taking advantage of the situation by offering them the NARS program, which is only temporary and may even hurt the rural communities in the long run," she said. 

The Nurses Assigned to Rural Areas or NARS program of the Arroyo administration is supposed to be a “stop-gap measure" against unemployment amid the financial crunch.

Under the NARS program, at least five nurses will be sent to each of the 1,000 poorest towns in the country and will be paid at least P8,000 monthly for a whole year. Arroyo also urged local governments to add at least P2,000 to the nurses’ salaries as allowances.

But according to Head, Arroyo is just exploiting the large number of skilled but unemployed and inexperienced nurses by offering them temporary jobs with lower pay rather than “a tenured position with the appropriate compensation." 

Rivera added that Arroyo just wants to show that she is doing something to address the health care needs of Filipinos and the worsening unemployment rate. 

“Unfortunately, the real bottom line for Mrs. Arroyo is still to force Filipino nurses to work abroad and send dollar-denominated remittances to stave off the effects of the global financial crisis," she said.

President Arroyo has previously said that she hopes for a day when working abroad would only be an option for Filipinos.

“Nawa’y dumating ang araw na ang pagtrabaho sa ibayong dagat ay isang career option lamang, at di ang tanging choice para sa masipag na Pilipino," she told Filipino expatriates during her visit to Qatar last week.

[I hope the time comes when working overseas would only seem like a career option and not the only choice for hardworking Filipinos]

Instead of the NARS program, the health group wants the Arroyo government to open plantilla positions for nurses to work in the rural areas and in public hospitals nationwide, thereby encouraging them to stay and serve in the countryside.

It called for the immediate implementation of the Nursing Act of 2002 and the Magna Carta of Health Workers so that nurses who are currently employed in the public sector will be motivated to stay. 

“The Arroyo government should face the issue of health care squarely, rather than offering carrot-and-stick approaches," said Rivera.

Dying on the Night Shift


Hospital patients who suffer cardiac arrest at night are more likely to die than patients whose hearts stop on the day shift, a new study shows.


The study, published today in The Journal of the American Medical Association, is the latest to show that patient care and survival appears to be profoundly affected by hospital timing and staffing issues. Other studies have shown that patients who receive hospital care on weekends do worse than patients treated during the regular workweek.

Cardiac arrest occurs when the heart stops beating suddenly, and it can be triggered by a heart attack or other emergencies like blood loss or respiratory problems. When a patient suffers cardiac arrest in a hospital, a “Code Blue” is typically called, and a team of doctors and nurses rushes to the bedside with a “crash cart” equipped with a defibrillator, drugs and other tools used to restart a stopped heart.

The current study examined cardiac arrests among 86,748 adult hospital patients at 507 hospitals during a seven-year period ending last February. The researchers compared survival rates by the time of day and day of the week that cardiac arrest occurred. Among patients who had cardiac arrest between 11 p.m. and 7 a.m., only 15 percent survived long enough to be discharged. That compares to about 20 percent of day-shift cardiac arrest patients who were discharged. Other measures, including 24-hour survival and favorable neurological outcomes, also were worse if the patient had a heart attack at night. The study also confirmed earlier research showing that weekday cardiac arrest survival was better than if cardiac arrest occurred on weekends.

The reality is that a patient whose heart stops in the hospital is typically very sick, and even among patients who have cardiac arrest during the day shift, survival rates are low. However, the data suggest that something changes at night that makes it less likely a stopped heart will be restarted. It may be that patients aren’t checked as often or that there aren’t as many staffers in the hospital to respond quickly to emergencies. Or it may suggest the skill and experience level of night hospital workers is lower than that of workers on the day shift.

Vitamin pills found to reduce migraines

Migraines can be a headache to treat, says an Australian professor who has identified simple vitamin supplements that can offer relief.

Professor Lyn Griffiths put 50 long-term migraine sufferers on a six-month course of vitamin B and folate supplements and said the results were very positive.

Study participants reported a "drastic improvement in headache frequency, pain severity and associated disability", said Prof Griffiths of Griffith University's Genomics Research Centre (GRC).

"Current treatments for migraine are not always effective and can be expensive and cause adverse effects," Prof Griffiths says.

"The success of our trial ... has shown that safe, inexpensive vitamin supplements can treat migraine patients."

The trial followed earlier work by the GRC which had identified a gene, known as MTHFR, which is known to make people susceptible to migraines when it has a mutation or dysfunction.

This results in heightened levels of the amino acid homocysteine, which is also known to cause an increased risk of stroke and other coronary diseases.

"The recent trial was founded on the theory that vitamin B supplements and folic acid will reduce the homocysteine and in turn, improve migraine symptoms," Prof Griffiths says.

"We are now going to undertake a more extensive trial ... to find out the best dosage of vitamin supplements for individuals as this may vary depending on a patient's genetic profile."

About 12 per cent of the Australian population is thought to suffer from migraines - a debilitating condition which involves severe headaches, nausea and vomiting.

Lack of sunshine triggers 'faulty' MS gene

Researchers say a link between vitamin D and a gene known to cause multiple sclerosis has been identified.

The study in this week's PLoS Genetics journal could explain one of the key environmental risk factors for multiple sclerosis, also known as MS.

The prevalence of MS is higher in countries further away from the equator, which is thought to be related to the amount of sunshine exposure and vitamin D3 production.

Neurologist Dr Bill Carroll, from Perth's Sir Charles Gairdner Hospital, says this study is the first to link the environmental and genetic risk factors that cause MS.

"What they've been able to do with this study is show that vitamin D3 is closely related to the part of the genetics of the immune system that we think is most closely related to susceptibility to MS," he said.

Dr Carroll is also chair of Multiple Sclerosis Research Australia's research management council.

Response element



The researchers focused on a gene known as HLA-DRB1, which is part of a family of genes that make up the major histocompatibility complex. This complex plays a critical role in the body's immune system and autoimmunity.

Previous studies have identified that a variant of HLA-DRB1 increases the risk of MS, but there is also strong geographic variation in risk that appears to be linked to sun exposure.

The team of researchers were able to track down a region of the HLA-DRB1 gene that contained a vitamin D "response element".

This suggests that vitamin D is directly involved in the expression of the immune system gene.

"The relationship between environment and genes has not been able to be correlated until this piece of evidence," Dr Carroll said.

Turning on itself



The discovery has implications for other autoimmune conditions such as Type 1 diabetes and inflammatory bowel disease, Dr Carroll says, as these diseases also have similar geographic distribution.

MS is an autoimmune disease that results in the breakdown of myelin, a protective fatty sheath that surrounds nerves.

Symptoms of MS vary from person to person, but can include tremors, paralysis and memory loss.

Australian researchers have previously shown that people living in Tasmania are five times more likely to develop MS than those living in Queensland.

"If you're in the northern hemisphere and you're born at the end of the northern hemisphere winter, born in May, you have 20 per cent greater chance of developing MS than if you're born at end of the northern hemisphere summer in November," Dr Carroll said.

According to Multiple Sclerosis Research Australia there are more than 18,000 Australians diagnosed with MS - three-quarters of those are women.

Heart Facts & Tips

from Daily Herald; Arlington Heights, Ill. .. 

* Heart disease is the No. 1 killer of women age 20 and older, but it is largely preventable. 

* At least 65 percent of people with diabetes die of some form of heart or blood vessel disease. 

* One in 3 women has some form of cardiovascular disease which kills one woman every minute. 

* More women die of cardiovascular disease than the next five causes of death combined, including all forms of cancer. 

* Feb. 6 is National Wear Red Day! Join dozens of women, as well as companies and organizations in the Metropolitan Chicago area and cities across America by wearing red on Feb. 6. Its a simple, powerful way to raise awareness of heart disease and stroke. 

* Overweight children are more likely to have abnormally thick heart muscle tissue when they become adults, which increases the risk of heart attack and heart failure. 

* Visit GoRedForWomen.org and choose to take the Go Red Heart CheckUp to find out your 10-year risk of heart disease or stroke. 

* If you or someone you know shows signs of heart attack or stroke, call 911 right away. An Emergency Medical Services (EMS) team can begin treatment when it arrives. That means treatment can begin sooner than it would if the patient arrived at the hospital by car. Whats more, the EMS team is also trained to revive someone whose heart has stopped, which saves hundreds of lives each year. 

* Children of mothers who smoke during pregnancy have more damage to their arteries in young adulthood than offspring of nonsmokers and the association is even stronger if both parents smoke. 

* Choose to speak up, not remain silent. Support legislation that would improve the prevention, diagnosis and treatment of heart disease and stroke in women at HeartForWomen.org. 

* Too many lives have and will be cut short from heart disease and its risk factors; however, early detection, lifestyle changes, and other intervention can improve certain conditions. 

* Choose to beat heart disease this year. Whether its eating healthier, exercising more, reducing our cholesterol, or quitting smoking, and turn your personal choices into lifesaving actions. 

* Plan meals in advance visit americanheart.org for recipes from a number of heart-healthy cookbooks and use the online grocery list builder to quickly identify heart-healthy products to add to your grocery list 

* Schedule a doctors appointment each year and get a complete blood screen. Visit GoRedForWomen.org and download "What to Know BEFORE Your Doctor Visit." Only 1 in 5 women believes that heart disease is her greatest health threat. 

* This year about 1.2 million Americans will have a first or repeat coronary attack. About 452,000 of them will die. Coronary heart disease is our nations leading cause of death. 

* About 7.9 million Americans age 20 and older have survived a heart attack (myocardial infarction). About 8.9 million have angina pectoris (chest pain or discomfort due to reduced blood supply to the heart). 

* An estimated 25.1 million men and 20.9 million women increase their risk of heart attack and stroke by smoking cigarettes. 

* One of the best ways to reduce your risk of cardiovascular disease is to start getting regular, moderate exercise, at least 30 minutes a day, most days of the week. 

* Some heart attacks are sudden and intense, causing someone to gasp dramatically, clutch her heart and drop to the ground. No one has any doubts about whats happening. But most heart attacks start slowly, with mild pain or discomfort. Often the people affected arent sure whats wrong and wait too long before getting help. 

Source: American Heart Association 

(c) 2009 Daily Herald; Arlington Heights, Ill.. Provided by ProQuest LLC. All rights Reserved.

A service of YellowBrix, Inc. 

Can Nurses Care Too Much?



When we talk about compassion in medicine, most of the focus is on doctors. But what about nurses? I asked Theresa Brown, a nurse and writer, to share her experiences caring for — and caring about — her patients.

Theresa Brown (Photo credit: Arthur Kosowsky)

By Theresa Brown

In medical oncology our patients stay in the hospital often for weeks or even months. They leave and come back, again and again, with this or that complication, or because they need more chemo, or because they’ve relapsed. We get to know them, their families, even their friends. And because we know them so well, in such an intense and intimate setting, we end up caring about them. 

Recently I was assigned to a patient I had gotten to know well, a guy in his fifties who’d lived and worked in the same small town in rural Pennsylvania for years. I had been his nurse off and on since his initial diagnosis the previous spring, and had cared for him more recently after an autologous stem cell transplant. But now he was deteriorating. His abdomen was bloated, due to a problem with his liver, and he also had a huge blood clot in the vein where his permanent IV line was placed. For two days he had been saying, “I feel terrible,” a non-specific complaint that is scary and ominous. 

“If he dies I don’t know what I’m going to do,” I confided to the dayshift nurse. She looked at me, then looked down at her papers and nodded.

This is what it means to be a nurse in oncology, a no-win situation where compassion routinely gets hijacked by grief. On TV or in the movies, dying patients are usually tended to by physicians. But if you die in a hospital, the person caring for you in your last days, hours, and minutes will be a nurse. The doctors care, too, of course, and check in and write orders, but we’re the ones who are always there. We watch over the patients as they struggle against their disease, and we’re there, too, if they decline, beginning their slow embrace with death.

When I did my initial assessment of the patient that afternoon, something just seemed off. I asked him to follow my finger with his eyes and to push up and down against my hands while I pushed back. These are basic tests of neurological function and his grip was good, but his ability to push down was almost nonexistent. I asked him again to follow my finger. 

“He’s not doing it, is he?” asked his wife. “No, he’s not,” I said. She had remained calm and kind throughout his many hospitalizations, but I could hear the worry in her voice.

I called the doctor. She was leaving the hospital for the day when she got my page, but she came back and examined the patient. His ammonia levels were rising due to his failing liver, something that can cause “mental status changes.” He was getting large doses of heparin, a blood thinner, because of his clot. Could the heparin have caused a bleed inside his head? The doctor’s exam, like mine, showed some deterioration in neurological function. She ordered a CT of the patient’s head and she prescribed a treatment to bring down his ammonia levels.

The next time I went into his room, I bent over him to give him a shot. When I finished he grabbed my hands. His grip was strong, and for those few seconds at least, he was completely lucid. “So am I gonna live or am I gonna die?” he asked me.

“I don’t know,” I told him, turning away to put the used syringe in the sharps container. My voice seemed small and tinny. “I wish I could look in a crystal ball and find out, but I can’t,” I said, forcing myself to turn back around and look at him.

Why did this patient matter so much to me? This was the patient who thought I looked like a “Phyllis” more than a Theresa, so “Phyllis” became a joke between him, his wife, and me. One of the first days he was in my care, when he still looked healthy and felt pretty robust, he told me a hilarious story, supposedly true, but unprintable in a family newspaper, about infidelity, obesity, and why it’s good to have a cellphone handy if you’re trysting in the backseat of a car. The first time he spiked a temperature I called the intern in a panic. “He’s got a fever!” I said, as if it was the first fever in the history of the world. Later I apologized to her, but she understood.

Now, though, he was struggling. I had several days off following that shift and I called work on my third day at home to ask about him. “C.M.O.,” our secretary told me, and I swore into the phone. C.M.O. means “comfort measures only”: they were withdrawing care. He had a cerebral bleed; he’d “seized” the night before and was now in the Neuro I.C.U. Without even thinking about it I decided to go to the hospital where I knew his family would be gathered.

The lounge to the N.I.C.U. was filled with his family members, all sad, some crying. I saw his wife, who hugged me. She asked me if I wanted to see him, but I said no, since he wouldn’t have known me. Instead, we talked about the two of them, about trying to pick up her life, about making sure that he wasn’t suffering. When I left she said the same thing she had said to me the last night her husband was my patient: “I love you.” He died later that day.

It hurts even now. A nurse on my floor said, “You girls get too attached,” and she’s right, of course.

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