Texas Travel Nursing

Texas State breaks ground on Round Rock nursing building

travelnursing — Fri, 29 Aug 2008 17:02:38 -0500

A groundbreaking was held on Friday for the new nursing education facility at Texas State University's Round Rock Higher Education Center.

University administrators and others attended the ceremony at the Round Rock campus. Texas State plans to launch its new bachelor of arts in nursing program in fall 2010.

In May the Texas State University System Board of Regents approved the creation of the nursing school and degree program.

The Texas Legislature and the St. David's Community Health Foundation are providing the startup funding for the program. The foundation has already committed $6 million to the initiative.

www.txstate.edu

PNAA Ignites Passion for Nursing

travelnursing — Fri, 29 Aug 2008 16:38:46 -0500

The theme of the 29th Annual Philippine Nurses Association of America (PNAA) Convention, held in South Padre Island, Texas, July 16 to July 20, was more than a coincidence.

"Power the Passion for Nursing: Clinical Excellence, Technology, Commitment, Professional Dedication, and Community Involvement" reflects the spirit of the PNAA and matches the role of newly elected president, Leo-Felix Jurado, RN, MA, CAN, APN, C, PhD(c). Jurado is a professor at the Department of Nursing, County College of Morris, Randolph, New Jersey, where he has recently been promoted to chairperson. Ten years ago, Jurado completed his term as the 15th president of the PNA of N.J., and is the current president of the New Jersey Board of Nursing, where he has served as a member since 2000.

"Twenty-nine years after its founding, the PNAA is alive and well," said Rosario-May Mayor, RN, MA, immediate past president, as she handed the responsibilities to Jurado. Mayor described her two-year term as a travelogue that promoted a culture of excellence, dedication, commitment to community, involvement, and passion. She encouraged Jurado and the 300 members present to ignite the passion for their nursing careers and for the PNAA.

Jurado takes up PNAA's mission to uphold and foster the positive image and welfare of its nurse members, promote professional excellence, and contribute significant outcomes to health care and society. He brings a wealth of administrative and service experience to his new role.

A person of many talents

In addition to acting as mentor for the Minority Nurse Leadership Institute at Rutgers University, Newark, Jurado is a mentor for the School of Nursing Committee at Thomas Edison State College, and a member of the Forum of Advanced Practice Nurses. Currently, he is a doctoral candidate in the Urban Systems program, offered jointly by Rutgers University and UMDNJ, Newark.

The New Jersey Institute of Nursing awarded Jurado the "DON" in Nursing, a title of respect for RNs who've shown extraordinary leadership and exceptional contributions to the profession of nursing. Two years ago, the National Coalition of Ethnic Minority Nurse Associations (NCEMNA) presented him with a Nurse Scientist Scholarship. As PNAA president, Jurado represents the organization on the NCEMNA Board of Directors.

Leo Jurado (standing center), inaugurated at the PNAA convention, enjoys the moment with wife Nini (far right), and (standing from far left), Jovita Solomon Duarte, PNAA secretary and Majuvy Sulse, Essex County N.J. Chapter president and PNAA CARE and Scholarship Awards winner. Seated are NCSBN president Faith Fields (left), Nursing Spectrum senior staff writer Lorraine Steefel, and Gayle Pearson, assistant dean, Center for Professional Development, Rutgers University, Newark.

Keynote reflects theme

At the PNAA convention's Gala Night, Faith Fields, RN, MSN, president, National Council of State Boards of Nursing (NCSBN), inaugurated Jurado into his new role.

In her keynote address, Fields reiterated the convention's theme, reminding RNs that nursing is not just a job or career; it's a passion and a calling — an "occupassion." She encouraged attendees to continue making a difference in health care by loving what they do. "When people love what they do, productivity goes up," said Fields.

Last year, Fields delivered the NCSBN Board's decision, as NCLEX overseer, that Manila, in the Philippines, was approved as an international testing site for the administration of the NCLEX-RN. This eliminated the need for travel abroad to take the NCLEX-RN for Filipino nurses who wished to work in the United States. Jurado and Mayor, representing the PNAA, were part of the Philippine Presidential Task Force which presented its case for this testing site to the NCSBN.

Passion is as passion does

At the convention, the PNAA presented awards to RNs whose work expressed the passion of their commitment to nursing and the organization. Of the 37 applicants for 18 PNAA affiliate chapters, nurses were presented with excellence awards in the following categories:

Nurse in Clinical Practice — Sarla Duller, California

Nurse in the Community — Alice Andam, Metro Washington, D.C.

Nurse Administrator — Jeanette Livelo, Massachusetts

Nurse Researcher — Majuvy Sulse, New Jersey

Nurse Educator — Perry Franciso, Virginia

Nurse Entrepreneur — Cora Vizcarra, Indiana

PNAA recognized Phoebe Andres for her role in suggesting and establishing a foundation to augment organizational expenses and make educational programs affordable to members. As a nonprofit organization, the foundation promotes and provides opportunities for philanthropy to support professional advancement of Filipino-American nurses and health for all, through nursing care, education, management, and research.

In addition to the CARE award, Majuvy Sulse, Essex County, New Jersey, subchapter president, received the PNAA scholarship and the bronze medal for taking third place at the convention's 5K Run.

Shining the light

In his address to members, Jurado defined his administration's mantra — Shining through the PRISM of PNAA, honoring our traditions, and advancing our future. "PRISM stands for professional linkages, regulatory and legislative agenda, interagency collaboration, services and program development, and management of organizational resources. Within PRISM, there are strategic initiatives that will be undertaken," Jurado said. "These will honor our past and those who contributed to the PNAA to make it the solid and steadfast organization it is today."

Jurado challenged members to renew their commitments to the PNAA and to keep the PRISM shining.

Besides Jurado, the PNAA has other New Jersey residents on its board: Susan Castor, board member and recent past president of the PNA-N.J.; Jovita Solomon Duarte, secretary; and Madelyn Yu, chairperson of the Council of Presidents and current PNA-N.J. president. CARE Award winner Majuvy Sulse and Phoebe Andres also hail from the state.

Health-Care Workers Exposed To HIV On Job Need Preventive Treatment

travelnursing — Thu, 14 Aug 2008 17:45:44 -0500

A review of existing research confirms that health-care workers should undergo a month of preventive drug treatment if they are exposed to HIV on the job.

Still, the reviewers say that there's been little research into so-called occupational postexposure prophylaxis, and it's still not clear what should be done when health-care workers are exposed to patients who are resistant to some drugs.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Doctors, nurses and other health-care providers have worried about HIV exposure since the AIDS epidemic first began in the early 1980s. Since the virus that causes AIDS is transmitted through blood, a simple needle stick could infect anyone treating a patient.

The risk, however, is quite low. The Centers for Disease Control and Prevention estimated in 2005 that the risk of HIV transmission through a contaminated needle stick is 0.3 percent, or about 1 chance in 333.

The low transmission risk may be related to two factors the small amount of virus that gets into the body through health-care workers' wounds and the barrier to the virus posed by the lower levels of the skin, said review co-author George Rutherford, M.D., of the University of California, San Francisco's Institute for Global Health.

Still, a 1-in-333 risk is hardly insignificant. Many countries recommend postexposure prophylaxis, or PEP in which doctors try to kill the virus in the body before it takes hold if a health-care worker has been potentially exposed to HIV. The same approach is used to treat people who have been potentially exposed to HIV through sex.

The low number of actual cases of infection makes it difficult for researchers to find enough people to study the effectiveness of postexposure treatment, Rutherford said. He added that, not surprisingly, exposed health-care workers haven't been willing to take part in any study that might result in their taking a placebo instead of drug treatment.

The researchers were only able to find a single study that compared those who took drugs after exposure to those who didn't.

That study, of 712 exposed health-care workers, found that the odds of becoming infected with HIV were reduced by about 81 percent among those who took zidovudine an anti-HIV drug also known as AZT or Retrovir after exposure. The study also reported that the odds of HIV infection were higher if a health-care worker had a deep injury, if there was visible blood on the device (such as a needle), if the needle had been placed in the infected patient's blood vessel or if the patient was terminally ill. A deep injury appeared to be by far the most dangerous of the factors.

HIV patients typically take more than one drug, and doctors prescribe multiple drugs as prophylaxis for exposed health-care workers, too. While there's no research suggesting whether that's a good idea in the latter case, the reviewers still recommend a multiple-drug regimen because it works in HIV-infected patients.

Questions still remain, however, about what to do if an HIV patient is resistant to existing medications. "That is," Rutherford asked, "what do you do if you know a patient is not susceptible to the first-line drugs?"

There's also the matter of side effects, which can keep people from wanting to continue on HIV drugs for the recommended full month.

For now, Rutherford recommends that health-care workers follow federal guidelines regarding the risk of HIV infection from needle sticks.

Still, the risk of an infection seems likely to never go away. An estimated 26 percent of nurses surveyed reported having been injured once in their careers by a "sharp" contaminated with a patient's blood, while 14 percent reported having been injured at least twice, according to Frank Myers, director of clinical epidemiology and safety systems at Scripps Mercy Hospital in San Diego.

Fifty-six percent of nurses, surveyed, however, reported no such injuries, said Myers, whose study will be published in the journal Nursing 2007.

On the positive side, hospitals are worrying more about potential risks on the job and companies are developing safer medical devices, such as syringes that retract needles when they're removed from patients.

"The more years of experience, the more likely you are to have had such an injury," Myers said, "driven in part by both the years at risk and the earlier years of having fewer safety devices and a poorer safety environment."

Young TN, et al. Antiretroviral post-exposure prophylaxis (PEP) for occupational HIV exposure. (Review). Cochrane Database of Systematic Reviews 2007, Issue 1.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
http://www.hbns.org

Ethics in a Pandemic

travelnursing — Thu, 14 Aug 2008 17:42:07 -0500

Coping effectively with a predicted influenza pandemic that threatens to affect the health of millions worldwide, hobble economies and overwhelm health care systems will require more than new drugs and good infection control.

An international medical ethics think-tank says that all-important public cooperation and the coordination of public officials at all levels requires open and ethical decision making.

The Influenza Pandemic Working Group at the University of Toronto Joint Centre for Bioethics today recommended a 15-point ethical guide for pandemic planning, based in part on experiences and study of the Severe Acute Respiratory Syndrome (SARS) crisis of 2003.

The report says plans to deal with a flu pandemic need to be founded on commonly held ethical values. People need to subscribe in advance to the rationale behind such choices as: the priority recipients of resources, including hospital services and medicines; how much risk front line health care workers should take; and support given to people under restrictions such as quarantine. Decision makers and the public need to be engaged so plans reflect what most people will accept as fair and good for public health.

"A shared set of ethical values is the glue that can hold us together during an intense crisis," says Peter Singer, M.D., Director of the University of Toronto Joint Centre for Bioethics (JCB), which undertook the advisory report. "A key lesson from the SARS outbreak is that fairness becomes more important during a time of crisis and confusion. And the time to consider these questions and processes in relation to a threatened major pandemic is now."

The report concludes that flu pandemic plans universally need an ethical component that address four key issues:

1. Health workers' duty to provide care during a communicable disease outbreak.

2. Restricting liberty in the interest of public health by measures such as quarantine;

3. Priority setting, including the allocation of scarce resources such as medicines;

4. Global governance implications, such as travel advisories.

Health care workers duty to care

The SARS crisis exposed health care systems to hard ethical choices that rapidly arose. Dozens of health care workers, for example, were infected through their work and some died. Other failed to report for duty to treat SARS patients out of fear for their own health or that of their family. A flu pandemic, where there may be no absolute protection or cure, would put far greater pressures on health care systems around the world.

"Workers will face competing obligations, such as their duty to care for patients and to protect their own health and that of families and friends," says JCB member Ross Upshur, M.D., Director, Primary Care Research Unit, Sunnybrook and Women's College Health Sciences Centre. "Medical codes of ethics in various countries provide little specific guidance on how to cope with this very real dilemma. Professional colleges and associations need to provide this kind of particular guidance in advance of an infectious disease outbreak crisis."

Governments and hospitals also need to provide for the health and safety of workers, and for the care of those who fall ill on duty. This might include an insurance fund for life and disability to cover health care workers who become sick or die as they place themselves in harm's way.

The Human Costs of Restrictive Measures

Officials need to provide support for those in quarantine, cut off from family, friends, work, shopping and possibly medical care for other aliments, the report says. The public should also be made aware of the need for quarantine and the consequences of non-compliance.

"The decision to use restrictive measures need to be made in an open, fair and legitimate manner. The public has a right to know the compelling public health reasons for curtailing rights and restricting normal activities. If quarantines are used, those affected need adequate care and job protection. Preventing financial hardship is important to obtaining full compliance from the public," says Dr. Upshur.

Measures to protect against stigmatization and to safeguard the privacy of individuals and/or communities affected by quarantine also should be part of pandemic preparedness plans the report recommends.

Allocating Scarce Resources, Medicines

All countries will face scarcities of medicines, equipment and health care workers during a pandemic, according to the group. Governments, hospitals and health regions should publicize a clear rationale for giving priority access to anti-viral medicines and vaccines to particular groups (e.g., front line health workers, children, decision-makers).

Advance planning ought to include criteria for resource allocation decisions, created in consultation with the general public.

Travel Bans

The World Health Organization (WHO) has warned that if the H5N1 strain of bird flu mutates and infects people it could reach all continents in less than three months. The WHO would likely impose regional travel restrictions in hopes of slowing the spread of the disease.

However such decisions can have major economic impacts. Canada, and Toronto in particular, suffered millions in economic losses when the WHO advised international travelers against all nonessential travel because of SARS.

Decisions about travel restrictions need to be clearly justified and the process must be transparent the report says.

At the same time, the WHO relies on individual countries for reporting disease outbreaks. Such surveillance may be beyond the capacity of many developing countries. The developed world should continue to invest in the surveillance capacity and the overall public health infrastructures of developing countries.

The WHO recommends that ethical issues be a consideration in the planning process for an influenza pandemic. Canada's province of Ontario has incorporated this framework into its plan.

"Other jurisdictions and nations should assess their pandemic plan against this ethical framework and these recommendations," says Dr. Singer.

"Looking ahead, we can say that if the pandemic strikes it will cause great hardship, but societies will struggle through. They will be better able to do so if they have general agreement on an ethical approach. Afterwards, history will judge today's leaders on how well they took decision on the ethical challenges they faced in the midst of the crisis."

Ten substantive values to guide ethical decision-making for a pandemic influenza outbreak

Individual liberty

In a public health crisis, restrictions to individual liberty may be necessary to protect the public from serious harm. Restrictions to individual liberty should:

- - Be proportional, necessary and relevant.

- - Employ the least restrictive means.

- - Be applied equitably.

Protection of the public from harm

To protect the public from harm, health care organizations and public health authorities may be required to take actions that impinge on individual liberty. Decision makers should:

- - Weigh the imperative for compliance.

- - Provide reasons for public health measures to encourage compliance.

- - Establish mechanisms to review decisions.

Proportionality

Proportionality requires that restrictions to individual liberty and measures taken to protect the public from harm should not exceed what is necessary to address the actual level of risk to or critical needs of the community.

Privacy

Individuals have a right to privacy in health care. In a public health crisis, it may be necessary to override this right to protect the public from serious harm.

Duty to provide care

Inherent to all codes of ethics for health care professionals is the duty to provide care and to respond to suffering. Health care providers will have to weigh demands of their professional roles against other competing obligations to their own health, and to family and friends. Moreover, health care workers will face significant challenges related to resource allocation, scope of practice, professional liability and workplace conditions.

Reciprocity

Reciprocity requires that society support those who face a disproportionate burden in protecting the public good, and take steps to minimize burdens as much as possible. Measures to protect the public good are likely to impose a disproportionate burden on health care workers, patients and their families.

Equity

All patients have an equal claim to receive the health care they need under normal conditions. During a pandemic, difficult decisions will need to be made about which health services to maintain and which to defer. Depending on the severity of the health crisis, this could curtail not only elective surgeries, but could also limit the provision of emergency or necessary services.

Trust

Trust is an essential component of the relationships among clinicians and patients, staff and their organizations, the public and health care providers or organizations, and among organizations within a health system. Decision makers will be confronted with the challenge of maintaining stakeholder trust while simultaneously implementing various control measures during an evolving health crisis. Trust is enhanced by upholding such process values as transparency.

Solidarity

As the world learned from SARS, a pandemic influenza outbreak, will require a new vision of global solidarity and a vision of solidarity among nations. A pandemic can challenge conventional ideas of national sovereignty, security or territoriality. It also requires solidarity within and among health care institutions. It calls for collaborative approaches that set aside traditional values of self-interest or territoriality among health care professionals, services or institutions.

Stewardship

Those entrusted with governance roles should be guided by the notion of stewardship. Inherent in stewardship are the notions of trust, ethical behaviour and good decision-making. This implies that decisions regarding resources are intended to achieve the best patient health and public health outcomes given the unique circumstances of the influenza crisis.

Five procedural values to guide ethical decision-making for a pandemic influenza outbreak

Reasonable

Decisions should be based on reasons (i.e., evidence, principles and values) that stakeholders can agree are relevant to meeting health needs in a pandemic influenza crisis. The decisions should be made by people who are credible and accountable.

Open and transparent

The process by which decisions are made must be open to scrutiny, and the basis upon which decisions are made should be publicly accessible.

Inclusive

Decisions should be made explicitly with stakeholder views in mind, and there should be opportunities to engage stakeholders in the decision-making process.

Responsive

There should be opportunities to revisit and revise decisions as new information emerges throughout the crisis. There should be mechanisms to address disputes and complaints.

Accountable

There should be mechanisms in place to ensure that decision makers are answerable for their actions and inactions. Defence of actions and inactions should be grounded in the 14 other ethical values proposed above.

Summary of Recommendations

An ethical guide for pandemic planning

1. National, provincial/state/territorial, and municipal governments, as well as the health care sector, should ensure that their pandemic plans include an ethical component.

2. National, provincial/state/territorial, and municipal governments, as well as the health care sector, should consider incorporating both substantive and procedural values in the ethical component of their pandemic plans.

Four key ethical issues

Issue 1: Health workers' duty to provide care during a communicable disease outbreak

1. Professional colleges and associations should provide, by way of their codes of ethics, clear guidance to members in advance of a major communicable disease outbreak, such as pandemic flu. Existing mechanisms should be identified, or means should be developed, to inform college members as to expectations and obligations regarding the duty to provide care during a communicable disease outbreak.

2. Governments and the health care sector should ensure that: a. care providers' safety is protected at all times, and providers are able to discharge duties and receive sufficient support throughout a period of extraordinary demands; and b. disability insurance and death benefits are available to staff and their families adversely affected while performing their duties.

3. Governments, hospitals and health regions should develop human resource strategies for communicable disease outbreaks that cover the diverse occupational roles, that are transparent in how individuals are assigned to roles in the management of an outbreak, and that are equitable with respect to the distribution of risk among individuals and occupational categories.

Issue 2: Restricting liberty in the interest of public health by measures such as quarantine

1. Governments and the health care sector should ensure that pandemic influenza response plans include a comprehensive and transparent protocol for the implementation of restrictive measures. The protocol should be founded upon the principles of proportionality and least restrictive means, should balance individual liberties with protection of public from harm and should build in safeguards such as the right of appeal.

2. Governments and the health care sector should ensure that the public is aware of:
a. the rationale for restrictive measures;
b. the benefits of compliance; and
c. the consequences of non-compliance.

3. Governments and the health care sector should include measures in their pandemic influenza preparedness plans to protect against stigmatization and to safeguard the privacy of individuals and/or communities affected by quarantine or other restrictive measures.

4. Governments and the health care sector should institute measures and processes to guarantee provisions and support services to individuals and/or communities affected by restrictive measures, such as quarantine orders, implemented during a pandemic influenza emergency. Plans should state in advance what backup support will be available to help those who are quarantined (e.g., who will do their shopping, pay the bills and provide financial support in lieu of lost income). Governments should have public discussions of appropriate levels of compensation in advance, including who is responsible for compensation.

Issue 3: Priority setting, including the allocation of scarce resources, such as vaccines and antiviral medicines

1. Governments and the health care sector should publicize a clear rationale for giving priority access to health care services, including antivirals and vaccines, to particular groups, such as front line health workers and those in emergency services. The decision makers should initiate and facilitate constructive public discussion about these choices.

2. Governments and the health care sector should engage stakeholders (including staff, the public and partners) in determining what criteria should be used to make resource allocation decisions (e.g., access to ventilators during the crisis, and access to health services for other illnesses), should ensure that clear rationales for allocation decisions are publicly accessible and should provide a justification for any deviation from the pre-determined criteria.

3. Governments and the health care sector should ensure that there are formal mechanisms in place for stakeholders to bring forward new information, to appeal or raise concerns about particular allocation decisions and to resolve disputes.

Issue 4: Global governance implications, such as travel advisories

1. The World Health Organization should remain aware of the impact of travel recommendations on affected countries, and should make every effort to be as transparent and equitable as possible when issuing such recommendations.

2. Federal countries should utilize whatever mechanisms are available within their system of government to ensure that relationships within the country are adequate to ensure compliance with the new International Health Regulations.

3. The developed world should continue to invest in the surveillance capacity of developing countries, and should also make investments to further improve the overall public health infrastructure of developing countries.

University of Toronto Joint Centre for Bioethics

Innovative. Interdisciplinary. International. Improving health care through bioethics.

The JCB is a partnership among the University of Toronto and 15 health care organizations. It provides leadership in bioethics research, education, and clinical activities. Its vision is to be a model of interdisciplinary collaboration in order to create new knowledge and improve practices with respect to bioethics. The JCB does not advocate positions on specific issues, although its individual members may do so.

JCB Members: Ross E.G. Upshur, Karen Faith, Jennifer L. Gibson, Alison K. Thompson, C. Shawn Tracy, Kumanan Wilson, Peter A. Singer

For more information:
www.utoronto.ca/jcb

Durable Medical Equipment Providers In Areas Struck By Midwest Ice Storm Mobilized To Ensure Safety Of Home Oxygen Patients

travelnursing — Thu, 14 Aug 2008 17:35:44 -0500

Home oxygen providers in the Midwest prepared for the deadly ice storm that struck earlier this week and responded with extra visits and contacts with patients receiving home oxygen therapy. An oxygen patient who uses an oxygen system that runs on electricity must have a back-up supply of oxygen that will last until power is restored. Oxygen therapy is critical to more than one million Americans who suffer from respiratory illnesses such as chronic obstructive pulmonary disease (COPD).

Responses in Missouri

Tim Moore, a regional manager at Wilkinson Home Care Equipment in Nevada, Missouri, noted that in two of the communities the company serves, more than half the population is without power. Today, he commented about his company's activities: "We have filled and delivered well over 100 tanks in the last three days to keep our current patients, nursing homes, and some of our competitors (who had no power, but had customers in need) in a constant supply of oxygen. We have made daily runs 65 miles south to Joplin [Missouri] to ensure that our store there had enough tanks to handle the needs that might arise. We have made these runs regardless of weather and what might happen, because these are our customers. Just because the roads are bad, or the power is out, we still have an obligation as providers. I drove to Joplin on Sunday and delivered about 30 tanks to a nursing home without power, and to our own store. We have employees without power in their own homes, who are working to meet the [patient's] needs. We had one store without power for about 48 hours, but we had the manager stationed there in case customers came by to get tanks or supplies. These are the things that make this industry different from so many other healthcare entities."

Responses in Oklahoma

Maria Lucas is chief executive officer of Asthma & Respiratory Services of Oklahoma (Tulsa) which covers most of northeast Oklahoma and the Oklahoma City and Enid areas. The company cares ventilator patients as well as oxygen patients. "I have to say our team has done a remarkable job of planning for this storm. We were hit last year with several major ice storms and we learned from that experience. We started midweek last week contacting our patients and making sure they were stocked up before the storm hit…. We have a break now in between storms, and we are again rushing to get our people covered for the next storm that is moving in on Friday. We do ground our fleet when the weather is at its worst as we do not want to have our employees in danger, but we are out again just as soon as possible."

Family Medical Equipment in Altus, Okla. has oxygen customers in the southwest part of the state, some of whom were affected by the recent ice storm. Josh Drake, of Family Medical, noted, "We used the time available prior to the storm to contact each customer who may be affected. We spent many extra hours in service calls and mileage, above our budget, to deliver extra oxygen to each patient in our service area." While Family Medical will not receive any extra reimbursements for its efforts, they note with satisfaction that, "not a single customer had a shortage of oxygen while electricity was off."

Responses in Iowa

In Iowa, Long Term Medical Supply has seven locations serving home patients and nursing facilities, three of which were severely affected by the storms that hit Southern Iowa earlier this week. Mari Banse, who works in the corporate office in Hampton, Iowa, described one phone conversation from the week: "When I received a call from one of our store managers down in Osceola, IA today sharing his feelings and stories with me about the amazing effort he was putting into his job, it almost brought me to tears. In the earlier hours of the morning this man started out in the pitch black, eerie town that got around three inches of rain turning into ice that took out all of the power and was taking down trees. Concerned about the safety of his patients, he began to travel from home to home to insure that they were safe and not afraid of their lack of power and inability to get to a safe place. He shuttled people to shelters that were set up at the local hospital and Casino, even going above and beyond his job description he took hot meals and blankets to elderly patients. This was an area that some streets were not even passable due to downed trees. When he couldn't get down roads he made sure that he got in contact with them some how to make sure that they were ok just to get a cheerful response that everything was ok."

About Oxygen Therapy

The typical Medicare home oxygen beneficiary is a 73 year-old who suffers from late- stage COPD with associated severe low levels of oxygen in the blood (hypoxemia). COPD is the only leading cause of death for which both prevalence and mortality are rising. COPD is a chronic, debilitating disease characterized by severe airflow limitation resulting from chronic inflammation of the airways. Approximately 12 million Americans have been diagnosed with COPD, and an estimated 12 to 15 million more remain undiagnosed. Use of medical oxygen equipment is imperative to the overall well-being of patients on oxygen therapy.

The American Association for Homecare (AAHomecare) represents providers of durable medical equipment and related services and supplies as well as equipment manufacturers. AAHomecare members serve the medical needs of millions of Americans who require home oxygen equipment, wheelchairs and other mobility products, hospital beds, medical supplies, inhalation drug therapy, home infusion, and other medical equipment, therapies, services, and supplies delivered in the patient's home. AAHomecare's provider members operate more than 3,000 homecare locations in all 50 states.

American Association for Homecare

Tips From The International Hyperhidrosis Society For Sweat-Free Job Interviewing And Career Management

travelnursing — Thu, 14 Aug 2008 17:32:38 -0500

As the new year begins, many resolutions will be made and many will be broken. Fortunately, for all those people who have resolved to find a new and better job, or to land a dreamed- about promotion, the International Hyperhidrosis Society (IHHS) has tips to make the process sweat-free and, therefore, more successful.

We all know that jobs and careers can cause stress and anxiety that leads to increased perspiration. In fact, according to a survey recently conducted by IHHS and Harris Interactive(R) nearly two-thirds of respondents said that job-related issues make them sweat more than anything else(1).

Whether one is interviewing for a new job, wining-and-dining clients, or attempting to give a compelling presentation to colleagues, it's mandatory to exude confidence and give off a positive first impression -- there is no room in these important workplace situations for excessive sweating! For instance, according to the above-mentioned the Harris poll, two-thirds of adults perceive someone who is sweating to be "nervous" and four out of ten adults who sweat on the job say that their sweating makes them feel very upset. And, in a separate study, results showed that 42% of those with hyperhidrosis (a medical condition characterized by near-constant excessive sweating) actually changed career paths because of their sweating problems.(2) In a similar poll conducted by the IHHS, 86% of responding hyperhidrosis patients said that they have experienced negative comments about their sweating, compounding the emotional impact that excessive sweating has on its sufferers(3).

As the second in a series of Tip Sheets offered from the leader in helping people eliminate and cope with excessive sweat, the IHHS is offering suggestions for minimizing and dealing with anxiety-induced sweating throughout one's career (for the first Tip Sheet visit http://www.SweatHelp.org). For all those people who have resolved to make positive changes in their careers in 2007, here are some great ways to get off on the right -- and dry -- foot!

-- Do your homework on a potential employer; visit the organization's Web site and review its background, products and offerings so that you are informed, can minimize surprises and stay cool

-- Visit online job search engines that offer tips on what to expect during interviews so you are prepared, practiced and ready to make the best first impression

-- Prior to an interview, write down key points and characteristics about yourself and examples of how you've succeeded; highlighting your successes will make you more confident which can lead to less sweating

-- Apply antiperspirant to your underarms once in the morning and again prior to bedtime; application twice daily -- and especially before bedtime -- has been shown to be more effective at keeping you dry. Antiperspirants may be used on hands and feet as well as on underarms; gently massaging them into the skin may be useful

-- Steer clear of sweat-inducing spicy foods, caffeinated beverages and alcohol in the days leading up to an interview or client presentation so you are clear-headed, aroma-free and sweat is minimized; it is probably a good idea to forgo the coffee offered by the interviewer too (choose a cool glass of water instead)

-- Be sure to shower and wash with antibacterial soap, such as Safeguard(R), at least once a day; when perspiration and bacteria mix, body odor results

-- Dress for success - wear polished and professional outfits made of natural materials (e.g., cotton) rather than synthetic materials (e.g., nylon). At the very least, ensure that your under layers are made of natural fabrics that offer more air circulation around the body and wick away moisture; avoid wearing suit jackets except during professional meetings and interviews

-- "Dress shields," small pads that go in your armpits to absorb sweat, may be an option for you; you may also want to keep an extra shirt with you for emergencies

-- Black or white solid colors or patterned fabrics with a black and white background will best camouflage underarm sweat marks

-- Keep a handkerchief in your pocket to absorb extra sweat on your palm prior to shaking hands with a colleague or interviewer; or swipe your hand on your pants leg as you raise it to meet the offering hand (clothing made from absorbent materials like cotton or wool or in a darker shade are less likely to show sweat marks)

-- Keep a travel-sized extra antiperspirant at your desk or in your car or purse for quick application prior to interviews, presentations and meetings

-- Schedule client appointments and interviews earlier in the day -- you will be fresher physically and mentally and your commute is likely to be cooler in the mornings

-- Participate in regular stress-relieving activities, such as meditation, yoga or other exercises; for immediate anxiety (and sweat) reduction, a breathing exercise will help. Note: A great practice right before "show time" is to breathe slowly through the nose for five seconds and blow out through your mouth for another five seconds; repeat for five minutes or as necessary

-- Consider using a stronger over-the-counter soft solid antiperspirant, such as Secret Platinum(R). You can also apply an absorbent powder to body areas that you know will perspire in stressful situations (be sure to wipe excess powder off your clothing)

-- And to really eliminate any chance of excessive sweat, talk to your dermatologist about longer-lasting sweat reducers, like prescription antiperspirants, Botox(R) injections or iontophoresis. For more info on these treatments and to find a physician familiar with hyperhidrosis, use the Physician Finder on the IHHS Web site at http://www.SweatHelp.org.

Human Resources Q&A

Over the years, human resources managers have contacted the IHHS in search of ways to help company employees with their excessive sweating. We commend these personnel representatives for taking an active role in helping their employees. One example is below:

Question:

"I have an employee who has indicated that he has hyperhidrosis (excessive sweating) leading to excessive body odor. Can you provide any suggestions on how to accommodate this? Even though it may or may not be defined as a disability under the Americans with Disabilities Act, we obviously would like to assist the employee."

Answer:

Excessive body odor is typically not a characteristic of hyperhidrosis since the glands (there are two types of sweat glands) that are affected by hyperhidrosis produce large volumes of watery, odorless sweat which usually wash away excess bacteria, the main culprit in generating body odor. Still, if sweat is allowed to dry on the skin and mix with bacteria anywhere on the body, unappealing odor may result. The first step in minimizing odor is to keep sweaty body parts dry through the use of antiperspirants, powders, and frequent clothing changes. Next, regular washing with antibacterial soap will ensure that bacteria do not proliferate on the body. An antiperspirant, like Secret Platinum(R) soft solid should also be used consistently and a deodorant may be helpful. Sometimes changes in diet can also help, like avoiding caffeine and alcohol (which can stimulate sweating) and foods with pungent aromas that may permeate through the skin. The employee should also speak with a dermatologist who can prescribe stronger sweat minimizers, such as prescription antiperspirants or periodic Botox(R) injections. Since not all health plans may cover existing treatments, employees should speak with their benefits managers about which insurance plans cover recommended treatments and prescriptions. A wealth of information (from understanding the basics of sweat to insurance tools, including an overview of hyperhidrosis treatment coverage for many health plans) can be found on SweatHelp.org.

About Hyperhidrosis

While on the job stress can cause most people to sweat more than usual, more than eight million Americans sweat excessively all the time-despite the weather or the situation. Hyperhidrosis, defined as excessive sweating, is a chronic and debilitating condition estimated to affect at least three percent of the world's population. Those battling hyperhidrosis suffer loss of friendships and distancing from colleagues due to the embarrassment of profuse sweating. Additionally, they often withdraw socially because of the reactions of others.

Fortunately, symptoms are frequently treatable by a qualified dermatologist. Existing therapies include strong over-the-counter antiperspirants like Secret Platinum(R) soft solid, prescription antiperspirants, iontophoresis (a water bath conducting a mild electric current through the skin's surface), and longer-lasting physician-administered sweat reducers like Botox(R) injections. Surgery may be an option if other therapies are not effective, but should only be considered after speaking with a dermatologist as there is a high risk of serious and permanent side effects.

The International Hyperhidrosis Society Web site, SweatHelp.org, includes a Physician Finder to help anyone with excessive sweating to find medical help, information on additional treatment options and a comprehensive collection of insurance and reimbursement tools, including downloadable forms, which can help sufferers work with their physician, health insurance plan and employer to get the correct coverage for necessary treatments. There are practical tips to make the most out of appointments with physicians and information on clinical trials and a free newsletter that will keep everyone current on hyperhidrosis news and medical breakthroughs. A self assessment tool is also available to help people determine how much sweat is too much. And because hyperhidrosis usually starts in the teenage years, the IHHS has created an online teen forum to help teenagers learn how to cope with the condition and find effective solutions.

The International Hyperhidrosis Society is a non-profit organization that strives to improve the quality of life for those affected by excessive sweating. The Society promotes research and conducts education on the physiological effects of hyperhidrosis, raises awareness about its emotional and economic impact and advocates for patient access to effective treatments. The International Hyperhidrosis Society is composed of members from all over the world, making it a true international network for people who treat or suffer from hyperhidrosis. Look for more Sweat Tips at http://www.SweatHelp.org.

(1) Results from a 2005 Harris Interactive Study are available upon request from the International Hyperhidrosis Society

(2) H Hamm, MK Naumann, JW Kowalski, S Kutt, C Kozma, C Teale. Primary Focal Hyperhidrosis: Disease Characteristics and Functional Impairment. Dermatology 2006; 212: 343, 353

(3) Results from a 2005 International Hyperhidrosis Society Online Survey are available upon request from the International Hyperhidrosis Society

International Hyperhidrosis Society (IHHS)
http://www.SweatHelp.org

Government Of Canada Awards Alberta's Health And Wellness 536,000 Dollars To Develop Off-Shore Nursing Assessments

travelnursing — Thu, 14 Aug 2008 17:29:09 -0500

Lee Richardson, Member of Parliament for Calgary Centre, on behalf of the Honourable Tony Clement, Minister of Health, and the Honourable Diane Finley, Minister of Citizenship and Immigration, announced a federal contribution of $536,000 to Alberta Health and Wellness to pilot test an innovative off-shore assessment program for internationally educated nurses immigrating to Canada.

"Projects such as this will help to alleviate Canada's nursing shortage, which in turn will lead to improved care and a reduction in wait times. This is a ground-breaking initiative, in which the Government of Canada is proud to take part," said Minister Clement.

"Canada has a skills shortage and skilled immigrants want to contribute to our country by working in the fields for which they've been trained. We want to help them do that and one of the best ways is to help them get their credentials assessed before they enter the country so that when they arrive, they can find work faster in their fields, " said Minister Finley.

Traditionally, internationally educated nurses who wanted to work in Alberta needed to travel to Mount Royal College in Calgary to take the assessment exams. Once this off-shore pilot project is fully implemented, thirty-six nursing candidates will be assessed overseas, with their language, knowledge and competencies measured against Registered Nurse (RN) competency standards. The nurses will be informed of any areas that require supplemental learning.

"I am thrilled that this project is taking place here in Alberta," said Mr. Richardson. "Internationally trained nurses can now be assessed before they arrive to Alberta, so that when they arrive they'll be able to start working as nurses sooner."

The newly funded project is a collaboration between Mount Royal College's Internationally Educated Nurses Assessment Centres in Calgary and The College and Association of Registered Nurses of Alberta. The project aims to speed up the licensure process by enabling internationally educated nurses to undergo a Substantial Equivalent Competency Assessment before they immigrate to Canada. Assessments are taking place in London, Dublin, Dubai, Qatar and elsewhere in the United Arab Emirates.

The overall goal of this initiative is to reduce the length of time between an internationally educated nurse's job offer and their first day of employment by identifying learning that may be required while they await immigration or write the Canadian RN licensing examinations. This will enable internationally educated nurses to put their skills to work more quickly once they arrive in Canada, while providing guidance to other jurisdictions who are considering offshore assessment processes. The project will also increase Alberta's capacity to assess internationally educated nurses with the training of additional assessors.

"We're delighted with this federal support that ensures increased access to nurses educated and registered in other countries who, through our program, are able to continue their careers as fully qualified and fully registered nurses here in Canada," said Mount Royal College President, Dave Marshall. "By working together we can help ensure the supply of health care workers necessary to ensure a high quality health care system in Canada."

The Alberta Health and Wellness project is one of over 40 initiatives funded by the Internationally Educated Health Professionals Initiative of the federal government. The initiative provides $75 million over five years to provinces and territories and non-governmental organizations to address barriers to integration for internationally educated health professionals. The goal of the initiative is to promote the assessment and integration of internationally educated health professionals into the Canadian health workforce. The initiative is an important component of the broader health human resources strategy, which is essential to ensuring timely access to care in communities across the country.

Job Growth Not The Only Factor In Reducing Poverty In Large Metro Areas

travelnursing — Thu, 14 Aug 2008 17:26:39 -0500

A new study suggests that it may be easier for people living in small metropolitan areas to get out of poverty than it is for those living in large metro areas.

The study by researchers at Ohio State University and Oklahoma State University found that despite an increase in the number of jobs created during the 1990s, many people living in large metro areas across the United States failed to find jobs.

In contrast, many people who lived in smaller metro areas found jobs despite significantly less job growth over the same period of time. As a result, poverty levels in many large metropolitan areas stayed the same or slightly decreased, while poverty rates decreased in smaller metro areas.

The findings, which were compiled with data from the 2000 U.S. Census, suggest that job growth is not the only factor controlling job attainment and poverty rates. Many barriers limit how effective job growth can be in helping the poor living in large cities.

"Job growth matters, but only if you could get it where jobs are needed the most. We found that jobs had a bigger impact on reducing poverty in smaller metropolitan areas because if you live in a small area, you can get to where the jobs are. But if you live in Columbus or Cleveland or New York or Atlanta, it is going to be harder to get to the jobs," Mark Partridge said.

Partridge is a professor of agricultural, environmental and development economics. Partridge conducted the study with Dan Rickman, an economist at Oklahoma State University, to find why poverty rates in the United States stayed the same in many large cities despite increased job growth over the last 30 years.

The pair studied poverty rates and job growth in more than 300 metro areas in the United States. Metro areas with populations ranging from below 350,000 (small) to more than 1.5 million (large) were included in the study. The results were recently published in the journal Growth and Change.

Partridge and Rickman found that a 10 percent increase in job growth over five years reduced poverty in large and small metro areas differently. In the central county of a small metro area, job growth produced a drop in poverty rates one and a half times more than large metro areas with the same job growth. Likewise, the outer counties of a small metro area experienced a reduction in poverty three times that of large metro areas.

The results suggest that many barriers in large metro areas are inhibiting poor people from landing jobs. Problems finding reliable transportation can prevent the poor who live in the inner city from finding employment, Partridge said. New jobs are often created in the suburbs, but many large cities around the United States do not have reliable public transportation systems, limiting how far some people can travel to find work.

More importantly, the wage for someone who travels to the suburbs from the inner city may not always cover the costs of commuting. These limitations often leave those in poverty few options for work.

"Many lower-skilled workers are single mothers with children who don't have reliable transportation. Their kids get sick so they miss a couple of days of work and then they get fired. So finding ways of breaking down this kind of barrier so they can work can really make a difference," he said.

In addition, if people within the same urban neighborhood only have access to jobs close to home, this limits knowledge of what types of jobs are available in the suburbs. People within the neighborhood will then have fewer friends and relatives who work outside the city, hindering their ability to make connections with those who have knowledge and access to jobs, Partridge said.

"You tend to find out about jobs from your friends, coworkers, and neighbors. But if you live in an area that is downtown and the jobs are being created out in the suburbs, it will be more difficult to find out what jobs are available," he said.

Compared to people living in smaller metro areas, people living in the center of large metro areas are more dependent on nearby job growth and affected less by overall job growth in the entire metro area. Partridge said many people in large cities cannot afford to move to the suburbs or across town to where the jobs are located.

"In some suburbs, there are particular kinds of zoning that make it difficult to create affordable housing. Lot size requirements and zoning that keeps out apartments puts limits on where people can move if they have limited resources. All of these three barriers -- public transportation, information about new jobs, and housing barriers -- keep the people from low-income households from getting the jobs that are available far from home," he said.

In spite of these barriers, there are steps that state and local governments can take to help combat poverty. While creating better transportation systems can be one solution, it is often very costly and takes years to implement. Governments can also encourage job growth in areas where there is a need to work, but it takes time to see real results. Instead, governments should look to target the long-term causes of poverty and train adolescents with the skills they will need in work and in life, Partridge said.

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Article adapted by Medical News Today from original press release.
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Written by Jenna McGuire

Source:
Mark Partridg
Ohio State University

Texas Travel Nursing Jobs Reign Supreme in Lone Star State

travelnursing — Fri, 08 Aug 2008 13:50:32 -0500

BOCA RATON, FL -- 08/05/08 -- With Texas hospitals ranking among U.S. News and World Report best hospitals every year and advanced medical technologies in the state laying a foundation for quality travel nurse job work environments, Texas travel nurse jobs have made their way to top of the preferred travel nursing list.

"Quality of life and lifestyle opportunities are a major component of travel nursing," said Robert L. Bok. "Cities like Austin consistently rank on lists of best places to live, work and play and the cost of living in Dallas, Houston and other Texas communities is below the national average. Annual earnings for Texas travel nursing jobs can exceed $85,000 with pay and benefits."

Travel nurse staffing experts say more and more nurses are considering economic factors, such as cost of living, when choosing a travel nursing destination. Texas is home to one of the largest faith-based, nonprofit healthcare delivery systems in the United States, with travel nurse pay high and the cost of living low, leaving nurses more disposable income to enjoy their surroundings and contribute to their 401(k).

"More practitioners entering the profession have been asking about Texas nurse jobs in cities with easy access to the Rio Grande and Mexico," said Deborah Bacurin, adding that "beautiful Gulf Coast towns like Galveston and Corpus Christi are no longer 'best kept secrets' among seasoned travel nurses."

"Texas travel nursing jobs will be hot for a while," says Hospital Marketing Director, Dennis Urbanski. "Healthcare and high-tech are propelling economies around the state and access to top-ranked hospitals and outpatient centers is bar none. The pay is high and the benefits and housing great for Texas travel nurses."

Travel Nursing the great career opportunity

travelnursing — Fri, 08 Aug 2008 13:46:29 -0500

Travel nursing is kind of a temporary work for experienced nursing professionals especially for the United States. It is kind of an arrangement for filling up the required nursing professionals from outside locations. Smaller towns and places usually face shortages of nurses, and on account of any sudden necessity like that of natural or man-made disaster, needs to be aided by nurses from outside of the locality. Travel nurse come to great help in restoring the normalcy of an area after an event of great loss and misfortune.

Nurses who are passionate towards their work and enjoy exploring different locations are especially taking up such assignments. A travel nurse moves out to another area to take benefit of enjoy working in a different environment.

It has emerged as one of the preferred and lucrative job options in the medicine world. Working in different environment help nurses to gain better experiences for their career. Besides good experience, travel nurses can enjoy free benefits and allowance. In fact, salary remuneration of travel nurses is very high and often they are awarded with lucrative bonuses for their efforts.

How to Apply for a Travel Nursing Jobs?

Apply for different travel nursing assignments is not that difficult. Become smart by applying online and enjoy its outcome. There are many online travel agencies that provide option to fill up a simple form for nurses. Nurses can fill up the necessary documents and attach their bio-data with it.

After accessing a nurse's requirement and qualification details, these agencies will further contact to hospitals and medical institute who have openings for nursing professionals. These agencies will help in conducting interviews and negotiating the deal between a nurse and the health facility.

The role of travel nurse agencies does not end with signing of deal between a nurse and a hospital. They further look into matters related to the relocation of a nurse to her new workplace.

Looking for quality travel nurse information? Search through internet and get the desired results.