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Editor's Letter

By Sarah Rowell Nurse-Recruiter.com

Hello to the readers of the Nurse-Recruiter Newsletter! It is wonderful when we get responses to the newsletter; I like the acknowledgement that someone is actually reading these articles. But more importantly is getting readers' opinions and feedback on an article, current issue or whatever is on your mind. Below is a response to an article printed last month which explored the unintentional discontinuation of medication when patients are in the ICU or transferred from the ICU. Thank you to Sugardale1@yahoo.com for taking the time to send such an informative and helpful email.

One of the articles this month will revisit a topic that was addressed a few months ago. I remember when I wrote it, I felt that this was a "hot" topic and apparently it still is. Looking forward to hearing from more of you next month.

Below is an email from a reader of the Nurse Recruiter newsletter:

I enjoyed your article "unintentional discontinuation of medications." I recently experienced this situation upon admission through the ER. The nurse asked me what medications I was currently taking. Confused at the time, I failed to inform her about the medications I am supposed to take but have not been using because I had not been able to buy my medications for the past seven months; which were Advair, Spiriva and Zoloft. After about fifteen minutes passed, I realized my oversight and called her back to give her the information. So this is an excellent point to bring to everyone's attention. This article should be published in each state's nursing news letter.

Thank you for printing this article.

Email: Sugardale1@yahoo.com

What is the Outlook for LPNs Today?

By Sarah Rowell Nurse-Recruiter.com

On 9/8/2011 3:51 PM, Debra Houston wrote:

I am a 55 year old LPN living in Iowa and I'd like to know what the heck is going on with LPN employment in Iowa. I was educated in Washington State and returned to Iowa in 1995 when my father became ill to help my mother through his rehab. I have found over the last 16 years that employment for LPNs in Iowa is extremely limited in comparison to other places in the US and pay is extremely substandard in relation to the compensation I received in Washington. Now as I look for employment again I am finding that medical assistants and CNAs are taking over LPN roles in healthcare. The real disturbing thing about the whole situation is that medical assistants and CNAs are not any cheaper for an employer to hire than an LPN is because they are starting out MAs and CNAs at about 5-6 dollars an hour less than I am making as an LPN with 22 years experience. Is the LPN being phased out of healthcare? In the light of a nursing shortage I would think that an experienced commodity such as the LPN would be coveted by employers to close the gaps and continue to provide quality healthcare to their clients. I could go back to school to become an RN but my education is so old that I am told by colleges and universities that I must start all over again. By the time I could get into a college and complete the courses required I would be almost 60 years old, Am I really marketable at that point? Probably not!! I am proud of my profession and my accomplishments and is very discouraging to feel like all my good work and experience means nothing in this job market.

What is the outlook for LPNs today?

Debra Houston is upset and confused by what is going on with LPN's today and she is not the only one. LPN's are getting mixed messages and those messages vary from state to state. In fact, the supply and demand for LPNs is variable depending on the location, the area of practice and the scope of practice. Many states have nonspecific guidelines as to what the LPN can and cannot do, leaving much up to the employer for interpretation. At times, a supervising RN does not know what should and should not be delegated to the LPN that they may be over or under utilized.

The Bureau of Labor Statistics reports that jobs for licensed practical nurses will "grow much faster than average" and that "overall job prospects are expected to be very good." However, it appears that an economy that is struggling continues to be a problem for health care professionals. LPNs continue to get passed over for better educated and better paid registered nurses.

Recently in Akron, Ohio, the Akron General Hospital let go of all 70 of its LPNs as part of a decision to have more highly trained nursing staff. This is a trend that is being repeated in different hospitals across the country. Yet, school and recruiters are continuing to tout the future for LPNs and are regularly trying out new programs. If hospitals are cutting LPNs for RNs, then is the LPN job outlook being overhyped?

To again quote the Bureau of Labor Statistics, "In order to contain healthcare costs, many procedures once performed only in hospitals are being performed in physician's offices and in outpatient care centers, largely because of advances in technology. As a result, the number of LPNs should increase faster in these facilities than in hospitals. Nevertheless hospitals will continue to demand the services of LPNs and will remain one of the largest employers of these workers."

Transferring of Bacteria

By Sarah Rowell Nurse-Recruiter.com

Recent research findings in the American Journal of Infection Control reveal that sixty percent of hospital staff member uniforms are the hosts of potentially pathogenic bacteria, including drug-resistant organisms.

It is no surprise that the hospital environment plays a major role in the transmission of microorganisms. Potential sources of hospital infections are doctors' white coats, nurses' uniforms, hospital garments, privacy curtains, stethoscopes, bed rails and other common hospital surfaces. One critical factor of the transfer of bacteria is the ability of some microorganisms to survive for a considerable length of time on these types of surfaces.

The studies have shown that white coats worn by doctors are primarily for identification. The wearing and cleaning of white coats varies significantly among individual doctors, sometimes depending on their medical specialties. Many studies have found that white coats are potential sources of cross infection especially in the surgical units. Some recommendations call for replacing the traditional white coat with a plastic apron put on prior to a wound examination. Some preventative measures call for regular laundering of the white coats or nurses' uniform and leaving the garments in the hospital, rather than bringing them home. The studies encourage laundering every three days because bacteria counts increase as the duration of use increases. The contamination of white coats and nurses uniforms peaks by the sixth day of use. In addition, medical students white coats were more heavily contaminated than those of residents and attending physicians. The part of the uniform that is the most contaminated is usually the sleeves and pockets. The uniforms and clothing of the other health personnel in hospitals were also seen as a source of microbial transmission. Many research studies show that nurses' uniforms are contaminated with bacteria which can survive in hospital fabrics and surfaces from weeks to months. In fact, sixty-five percent of the nurses' uniforms were contaminated after routine nursing actions.

Although researchers say that it still needs to be determined whether these bacteria can be transferred to patients and cause a clinically relevant infection, common sense tells us that all precautions should be taken. Nurses and physicians can be pro-active by changing their garments every single day which will drastically reduce the number of bacteria on their uniforms. A study published in the September issue of the American Journal of Infection Control states that not washing hands frequently enough can contribute to the pervasiveness of bacteria. Russell Olmsted, president of the Association for Professionals in Infection Control and Epidemiology puts it into perspective, "Any clothing that is worn by humans will become contaminated with microorganisms. The cornerstone of infection prevention remains the use of hand hygiene to prevent the movement of microbes from these surfaces to patients."

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