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Think About It
A forum for discussion of the latest news and ideas in nursing management and healthcare.
Monday, February 8, 2016

Here we go again! Another virus that’s spreading rapidly, and this one has some frightening consequences for pregnant women. I’m always of the mindset not to wait until a virus is a threat to the United States to begin educating myself and others. We know Zika virus is carried by mosquitoes and proliferates in tropical climates. Patients present with a mild rash, low-grade fever, and conjunctivitis. In addition to these symptoms, patients may also complain of headaches, joint pain, and fatigue. The incubation time is unclear. We know that pregnant women who contract the virus run a high risk of birth defects. The World Health Organization has stepped up surveillance, recommending protection against mosquitoes and adding additional precautions for pregnant women. Stay up to date on the facts because there are now multiple cases reported in the United States. Two of these cases have been by sexual transmission; the virus lives longer in sperm cells. For more information, visit the CDC and WHO.

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.

Tuesday, January 26, 2016

I've participated in some heavy conversations about medication reconciliation lately. Providers and nurses often have varying opinions on this practice, but all agree that it's a vital piece of assessment with a big impact on patient safety. Medication reconciliation has been a noted item in The Joint Commission National Patient Safety Goals for years and we still don't have a handle on it nationally. It's seen as cumbersome and labor intensive, and there remains some argument over whose responsibility it actually is to perform medication reconciliation.

Nursing plays a vital role in the process through data collection, careful questioning and prompting of patients, and documentation. This includes remembering to include all over-the-counter medications, herbal supplements, and recreational activity, along with what dosages patients are actually taking, not just what's ordered. It's without a doubt the provider's responsibility to reconcile this list and ensure what the patient is taking is compatible and not contradictory to therapy goals and needs. Nurses can then explain any changes, educate about any additions or deletions, and ensure that the patient has an updated and accurate list.

Medication reconciliation is a team effort and should be approached as such. How does your organization deal with this practice?

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.


Monday, January 18, 2016

I’ve recently been reviewing social media sites designed by and for nurses. I’m always so impressed with the stories shared on these sites about why so many became nurses and how they want to grow and develop in their profession. I’m also impressed by the stories nurses share about their personal struggles. While they go to work and school, they’re also caring for a sick child or family member. Many are ill themselves, yet they find the strength to endure--this kind of inner strength always amazes me. I believe nurses are gifted in this way. That which draws us to our profession is also what gives us strength. It’s a part of who we are and not just what we do.

As a nurse manager, I’ve had myriad poignant conversations with peers and employees. They share their personal and professional hurdles with me and, again, I’m in awe of their strength, resiliency, and determination to do the right thing. Nurses wrestle with what to put first: their jobs, patients and peers, or their family life. Most of us actually attempt to do it all, often at the cost our own health and sanity. And many of us won’t accept that we can’t; after all, it’s who we are!

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.
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Tuesday, December 29, 2015

Nursing education in the workplace has a large impact on morale, care quality, recruitment, and retention. I’ve been involved with several work groups lately and I’ve found that the benefit of nursing-specific education is consistent, but the availability has changed greatly within healthcare organizations. It seems that nursing education has been cut in many organizations nationally. I also find that the offerings are all over the map. Many organizations have gone to almost exclusively online education, with very few live instructors and classroom time. Although I certainly see the benefits from a cost perspective and convenience level, I can’t help but question the effectiveness of this approach. Online education definitely has merit, but are there certain offerings that should require face-to-face interaction? I’d love to know your thoughts on this! Take the time to utilize our great CE offerings and provide some feedback on the effectiveness of these offerings as well.

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.
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Monday, December 14, 2015

The holidays are here. We’ve discussed how this time of year can be difficult for some people. Referred to as seasonal affective disorder (SAD), the changing of the seasons can bring much sadness to some of our patients and coworkers. The holidays can actually serve to accentuate SAD. The symptoms of SAD include social isolation, depression, weight gain, and changes in activity and appetite. Simple tips to combat SAD include taking a walk during the day, getting outside, and light therapy. Some simple lifestyle alterations can also be beneficial, such as eating healthy, making an effort to visit with friends and family, and increasing activity. Patients with SAD don’t have to just tough it out, there are alternatives.

Lisa Lockhart, MHA, MSN, RN, NE-BC
Nurse Manager, Specialty Clinics
Alvin C. York VA Medical Center
Murfreesboro, Tenn.
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Nursing Management
“Think About It” is an extension of Nursing Management. Here, you can read and discuss professional information geared toward helping nurses excel as leaders. This blog tackles important topics without the worry of print publication deadlines!