Top 25 Pediatric Nursing Blogs

A new list of the Top 25 Pediatric Nursing Blogs has been published on NurseDebbie, and I encourage those with interest in pediatric nursing (and nurse bloggers in general) to look it over.

Get More Iron---On BlackDoctor.org

My newest editorial---"Get More Iron (The Natural Way)"---is up on BlackDoctor.org as of today. If you'd like to increase your dietary iron intake, feel free to check it out!

Disaster Relief Nursing on WorkingNurse.com

I was recently asked to write an article on the specialty of Disaster Relief Nursing for WorkingNurse.com, and that article was published online today, and will also be in print beginning this week in Southern California.

I am very grateful to WorkingNurse for this opportunity, and look forward to writing an article on Home Health Nursing for the June edition of the magazine.

Thank you again to WorkingNurse!

Health Care Reform at Last?

It appears that health care reform in all it's tattered and tainted glory has finally passed through both the House and the Senate. While reports state that the legislation is indeed imperfect and will make as many enemies as friends, some semblance of reform is now on its way to the American people. Some behind-the-scenes tweaking will still certainly take place, but it seems that the reform train has now left the station and will eventually arrive at a health plan near (most of) you, with the majority of changes beginning in 2014.

From my personal point of view, this train has been delayed for decades, especially taking into consideration that the United States is the only industrialized nation that does not offer universal health coverage to most of its citizens, or at least guarantee access to such coverage.

According to the information gleaned from articles and online sources, I understand that some of the salient points are thus:

• Parents will be able to keep dependent adult children on their health plans through age 26, and this benefit (which will necessitate an extra fee) will be enacted almost immediately.
• Beginning in 2014, Americans with employer-based health plans who lose their jobs will be able to buy their own (hopefully affordable) insurance without being denied or charged extra due to pre-existing conditions.
• Apparently, chronically ill children will be covered almost immediately, and chronically ill adults may have access to certain pools of coverage quite soon.
• An expansion of Medicaid coverage for the poor now seems to be a certainty after 2014.
• Some tax credits for small businesses will make it easier for coverage to be offered to be employees, and this reform may also be enacted rather soon.
• Medicaid will be expanded to cover an additional 16 million poor Americans.
  
• Price gouging by insurance companies due to pre-existing conditions will no longer be allowed by the new regulations.
• Insurance companies will no longer be able to cancel the policies of consumers who become ill, a practice that has become all too common.
• Insurance companies will also no longer be able to place a spending cap on the amount of money they are willing to spend on a consumer in any given year (or perhaps over a lifetime).
• In six months, all new health plans will have to cover the full cost of all preventive care.
  
• Beginning July 1st of this year, low-income seniors on Medicare will enjoy a 50% discount on brand-name drugs.
  
• By 2019, it seems that more than 90% of Americans will have health care coverage of some kind.
• Most importantly, it seems that reforms of Medicare and Medicaid are in the works, and a complicated array of regulatory reforms may indeed change the face of health care in this country by cutting costs, streamlining the delivery and payment system, and reining in health care inflation.

There is no doubt that conservative pundits will do their best to cast doubt on these reforms in an attempt to turn the American people against what will most likely be billed as "socialism" and a government take-over of health care and medicine. Many will complain that the government has no place in regulating health care, even as those same complainers enjoy the vast benefits of their (government regulated) Medicare coverage. It is ironic that so many Americans forget that Medicare, a government benefit that changed the face of health care for older and disabled Americans many decades ago, is a hugely successful program of government-based health care reform.

It is disgraceful that so many millions of Americans still live without health insurance. Due to the cost of medical care, homes are foreclosed, jobs are lost, lives are destroyed, and the most basic and important health maintenance screenings (like PAP smears, prostate exams and annual physicals) are missed due to lack of insurance coverage.

With both houses of Congress passing this historic legislation, the health care reform train has indeed left the station. There's no doubt that there will be many arguments and problems along the way, but there now exists the true probability that, within our lifetimes, all Americans will enjoy what the citizens of other industrialized nations have enjoyed for decades.

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To read 10 things that every American should know about health care reform according to MoveOn.org, please click here.

Dear (Juris)prudence

Well, I did it. After poring over more than 4oo pages of the Texas Nurse Practice Act and the rules and regulations according to the Texas Board of Nursing (BON), I successfully passed the Texas Board of Nursing Jurisprudence Exam.

This exam was the final hoop through which I had to leap in order to obtain my Texas nursing license, and thanks to my wife who helped me to calm my mind and understand how the documents were organized, I was able to sit for just under two hours and pass the test after studying and understanding what was expected of me.

I must admit that I was shocked and rather unhappy at the relative difficulty of the exam and the amount of pressure and stress that was involved in trying to answer 50 detailed questions as the timer was running in the corner of the computer screen. While some questions were common sense queries regarding the legal aspects of nursing practice, the majority required time-consuming research of more than 400 pages of legalese which was very frustrating to navigate while watching the minutes tick by.

While the nursing boards themselves were quite difficult and a trying experience for me, I never expected that I would need to so thoroughly research the legal aspects of nursing practice in order to obtain a license in any state. I understand that the Texas BON would like nurses practicing in Texas to comprehend the legal ramifications of nursing, but I would recommend that the Texas BON concentrate instead on the clinical aspects of nursing practice, using questions which truly assess a nurse's ability to think critically and clearly about issues salient to the art and science of nursing.

I am thrilled that this chapter of my application for licensure has passed, and I will be even more thrilled when that crucial piece of paper arrives in my mailbox, a license that will be reciprocally recognized in 21 states.

Here's to Dear (Juris)prudence!

100 Reasons to Become A Nurse

A new post at the Nurse Practitioner Schools Blog lists 100 reasons to become a nurse. While it might not speak to everyone, it's a thought-provoking and interesting list well worth perusing.

A few questions I have about the list are as follows:

Why do writers and bloggers and magazines continue to use those old-fashioned images of nurses in little white caps in order to erroneously represent the image of the modern nurse?

The assertion that every nurse is guaranteed a job is somewhat misleading. Hiring freezes and stifled budgets are not necessarily making finding a job easy for everyone. Nursing is somewhat recession proof, but mandatory overtime and higher nurse-patient rations can be the result of staffing cuts.

No matter my questions, the list may stimulate some to consider nursing as a career option. For others, it may confirm a career choice or inspire an interest in an online nursing program. And for still others, it may send them running in the opposite direction!

Nursing Jurisprudence: Exam Anxiety

Jusidprudence: the theory and philosophy of law (Wikipedia)

Well, now that I've successfully submitted my application and fingerprints in order to obtain a nursing license in Texas, the next (and final) hoop through which I must leap is taking a 2-hour online exam on nursing jurisprudence in the Lone Star State. While I have no idea just how difficult the exam is, I do know that I need to download a 254-page document from which the answers can be gleaned.

Based on my experience with the nursing board exams and the anxiety which I experienced at that time in my life prior to becoming a licensed nurse, I am admittedly none too happy that this exam has reared its ugly head. I am a terrible test-taker, and while I'm thrilled that the Texas Board of Nursing does not require me to retake the nursing boards (Heaven forbid!), I'm dragging my heels about this upcoming test of my ability to speed-read 250 pages of legalese and translate it into a passing grade on a multiple-choice exam. Here's an idea: in lieu of this test of my fortitude, just let me perform a physical assessment, take a blood pressure, draw some blood or start an IV (on second thought, skip the IV and the blood draw---I'm way too rusty!)

At any rate, perhaps the exam will prove to be nothing more than legal common sense and a few hours of frantically leafing through a 250-page pdf document. Please stay tuned as I psych myself up for this next phase in obtaining my new nursing license, and if anyone knows anything about the legal aspects of nursing practice in Texas, I'm all ears!

Mamatrauma Hosts Change of Shift

New nurse and blogger Mamatrauma is hosting Change of Shift this week. Please surf over and pay her a visit to read some of the freshest blogging by nurses on the web!

The National Nurse Act of 2010: HR 4601

Unbeknownst to many Americans, a grassroots campaign to create an Office of the National Nurse has been underway for several years. While many in the nursing community recognize that the Surgeon General plays an important role in managing and overseeing the health and health education of the nation, it is also recognized that nurses are woefully underrepresented when it comes to our national priorities vis-a-vis healthcare and prevention.

Now, a bill has been introduced (HR 4601) before the House of Representatives, calling for the establishment of the Office of the National Nurse. This bill before the 111th Congress---is named "The National Nurse Act of 2010, and will serve as an amendment to Title XVII of the Public Health Service Act.

Some history of the Surgeon General and the drive for an Office of the National Nurse:

Since 1871, the Surgeon General of the United States---the nation's "chief health educator"---has overseen and guided the health of Americans. Charged with overseeing the U.S. Public Health Service, the Surgeon General is appointed by the President and approved by Congress for a four-year term. According to the official website of the Surgeon General, this individual's duties include, but are not limited, to:

• Protect and advance the health of the Nation through educating the public, advocating for effective disease prevention and health promotion programs and activities, and, providing a highly recognized symbol of national commitment to protecting and improving the public's health
• Articulate scientifically based health policy analysis and advice to the President and the Secretary of Health and Human Services (HHS) on the full range of critical public health, medical, and health system issues facing the nation
• Provide leadership in promoting special Departmental health initiatives, e.g., tobacco and HIV prevention efforts, with other governmental and non-governmental entities, both domestically and internationally
• Administer the U.S. Public Health Service (PHS) Commissioned Corps, which is a uniquely expert, diverse, flexible, and committed career force of public health professionals who can respond to both current and long-term health needs of the Nation
• Provide leadership and management oversight for PHS Commissioned Corps involvement in Departmental emergency preparedness and response activities
• Elevate the quality of public health practice in the professional disciplines through the advancement of appropriate standards and research priorities, and
• Fulfill statutory and customary departmental representational functions on a wide variety of federal boards and governing bodies of non-Federal health organizations, including the Board of Regents of the Uniformed Services University of the Health Sciences, the National Library of Medicine, the Armed Forces Institute of Pathology, the Association of Military Surgeons of the United States, and the American Medical Association.

From a nurse's perspective, what is missing from the Surgeon General's overall equation is the more robust input of a nurse who would serve more as an equal to the Surgeon General in terms of his or her ability to effect and implement healthcare policy in the interest of the American people. At this time, the U.S. Public Health Chief Nurse Officer (CNO) serves as Assistant Surgeon General, representing the Surgeon General's interests and opinions, and otherwise working in a subjugated role that the medical community might deem fit for a nurse.

The goal of the organizations and individuals behind the drive for an Office of the National Nurse is "to elevate and enhance the Office of the PHS Chief Nurse to bring more visibility to the critical role nursing occupies in promoting, protecting, and advancing the nation's health."

The proposed role of the National Nurse would be to:

• Assist in the initiation of a nationwide cultural shift to prevention.
• Bolster efforts to focus the public on healthy living.
• Intensify roles for nurses, including students and retirees, in community health promotion.
• Provide greater support to the Surgeon General in calling for improvements in health literacy and reduction in health disparities.
• Encourage all nurses to spread prevention messages in their communities.
• Encourage participation of nurses in Medical Reserve Corps (MRC) units.
• Provide leadership to network with existing volunteer health promotion efforts.
• Strengthen linkages with providers, nursing programs, and public health leadership.
• Serve as a visible national spokesperson for professional nursing.
• Increase public awareness of nursing roles and contributions.
• Enhance nursing recruitment and education throughout all communities.
• Support and justify additional funding for nursing education, research and service.

The National Nurse would work to slow the growth of preventable diseases; promote health awareness, increase health literacy, and reduce health disparities; promote health careers and increased resources; enhance visibility and public recognition of nursing.

It is the opinion of many involved in the call for the establishment of the Office of the National Nurse that it is time for nursing to have a seat at the nation's healthcare table. While some might argue that the aforementioned Chief Nurse Officer of the U.S. Department of Public Health already adequately fulfills that role, most still see that role as one of subservience to the Surgeon General rather than one of professional equality. Just as nurses are rarely consulted by the media for their expert opinions vis-a-vis the various challenges faced by the nation and its beleaguered healthcare system, the government also fails to fully utilize nursing's unique and crucial input to the fullest extent possible, in the interest of the health and well-being of the American people.

The establishment of the Office of the National Nurse would set a new standard for a more accurate and realistic recognition of nursing's importance to health and healthcare in the United States. If the federal government enthusiastically and publicly embraced nursing, making its crucial contributions crystal clear, perhaps the public, the media and the private sector would all then have a greater understanding of, and appreciation for, the multitudinous ways in which nursing impacts the health of millions of Americans.

Most importantly, however, the establishment of this office would certainly bring an important voice even more strongly to the ongoing conversation about health and health care in America. A National Nurse could, in effect, deliver a unified message of preventive health at a time when millions of Americans---including millions of children---live without health insurance or access to regular primary care. At a time of crisis and uncertainty vis-a-vis the health of the country, the Office of the National Nurse could very well be a welcome, stabilizing and empowering voice of reason and prevention.

I fully support the passage of HR 4601, and I urge readers of Digital Doorway to contact their representatives in order to urge them to support this important health care legislation. For more information, please visit the website of the National Nurse Campaign, join their Facebook page, or make a donation to the campaign.

I fully support the passage of HR 4601, and recognize that the time for a National Nurse has indeed come. Perhaps 2010 will see this campaign finally come to fruition, and we will all benefit greatly from such a long-awaited outcome that will positively impact the health and well-being of the entire nation.