These initial meetings identified the following trends:
Employers place RNs at extreme risk for licensure and liability issues by not providing the basic resources for safe, quality patient care. JNESO will continue to notify the appropriate regulatory agencies of these deficits; outlining the dangerous consequences for such actions.
Follow-up meetings will be scheduled with members at each of these facilities and initial meetings at our other facilities will be organized as well. The goal is to gather feedback from every unit to identify similar trends and to address staffing issues in a more vigorous manner. We will continue to report our findings to regulatory agencies [Dept. Health; JCAHO; ANCC etc], at Labor-Management meetings and reinforce these themes with legislators as we urge them to press for -patient staffing ratios.
As Employers continue to reduce staffing resources, it is critically important to report unsafe patient care issues to the Union by filling-out Short Staffing Forms. Please be sure to include the date, time, unit, shift and who you reported the incidence of short staffing to, (i.e., supervisor/ nurse manager’s name).
In addition, please report any patient falls and serious safety issues to your State Department of Health, as you are obligated to do.
Thank you to all who participated in our Staffing Roundtables. We look forward to your participation in future meetings held at your facility!
JNESO spends a good amount of time trying to educate nurses and techs on how to protect their licenses from being tarnished and jobs secured, while acting as patient advocates fighting for safe staffing levels to provide safe quality care. We do that through a reporting mechanism that is REQUIRED if you, a licensed professional, believe patient safety has been compromised, by decreased or insufficient staffing, or if equipment is broken or lacking, etc. Short Staffing Forms are the vehicle used to document you reported an unsafe situation to management.
In addition, the data you provide is compiled and analyzed for trends. The issues cited can be utilized in various forums for Labor Management Meetings, Nurse Practice Meetings, or at Negotiations. At JNESO, we also report dangerous trends to the Department of Health (DOH), which then conducts an investigation.
DOH on-site visits include staff interviews and a review of facility documents. If the DOH finds any violations of the Hospital Licensing Standards, the facility is cited and a Plan of Correction is demanded.
As an example:
A JNESO Labor Representative recently wrote a letter to the NJ DOH citing trends at a facility for lack of safe staffing by admission during a Labor Management Meeting that no acuity tool is utilized in their staffing decisions as required under Title 8:43G of NJ Hospital Licensing Standards. It was also reported that 1:1 observers were not provided, placing patient safety at risk, and Monitor Techs were not present in Critical Care areas. That letter was sent in March, and while it took until August to receive a Plan of Correction, it was finally done. The Employer must now:
It is only through the relentless reporting by nurses and techs that things will change!
Employers rarely take the time to put patients first and invest in the resources necessary to create a truly safe patient care environment. So when you hear a colleague decline to write out or sign a Short Staffing Form when it is warranted, remind them that if we don’t do it… no one will!
PATIENTS DESERVE SAFE CARE… AND YOUR LICENSE DEPENDS ON IT!
Some helpful reminders:
• Log-off when not using a computer at work -and do not share your passwords or Personal Health Informaztion (PHI).
• Be supportive of your colleagues: subjective negative comments can easily affect someone’s job, and may be viewed as impacting patient care if a unit is preoccupied with staff dynamics.
• Strictly follow policy and security settings when accessing patient health records remotely.
• Do not discuss patients in public places.
• Do not take pictures at work on cell phones!
Violations can easily transcend the workplace and result in you having to answer to the Board of Nursing or legal authorities.
Never take disciplines lightly! If you hear the words HIPPA, unprofessional conduct, or patient safety, these may be reportable offenses. Remember to call a Local Officer or your Labor Representative to request representation at any investigatory or disciplinary meetings.
The Board’s website address is: njconsumeraffairs.gov
The face on top of the license currently being issued by the Board of Nursing is tamper proof and contains the following statement: “THE FACE OF THIS DOCUMENT HAS A MULTICOLORED BACKGROUND AND MULTIPLE SECURITY FEATURES”.
A photocopied license in NOT acceptable evidence of current licensure. However, a license may be copied only for purposes of meeting the requirements of the employing organization’s personnel policy or regulatory purposes. (N.J.A.C. 13:45B-14.4(d)
WHAT EMPLOYERS CAN AND CANNOT DO WHEN INSPECTING EMPLOYEE LICENSES:
If members have concerns regarding Employers Inspecting your Nursing License, please contact JNESO’s Director of Practice: Barbara Conklin at email@example.com or call (800) 292-0542.
Read the CMS News Release
(OAKBROOK TERRACE, Illinois ) Preventing patient falls and fall-related injuries is the focus of the new Sentinel Event Alert: Issue 55 released today by The Joint Commission. The new alert examines the contributing factors to patient falls and includes suggested solutions to be implemented by health care organizations to help reduce patient falls and falls with injury.
This topic was chosen for Sentinel Event Alert because patient falls with serious injury are among the top 10 sentinel events reported to The Joint Commission Sentinel Event Database. The Joint Commission has received 465 reports of patient falls with injuries since 2009, and approximately 63 percent of those falls resulted in death. The Joint Commission defines a sentinel event as a patient safety event (not primarily related to the natural course of the patient’s illness or underlying condition) that reaches a patient and results in death, permanent harm or severe temporary harm where intervention is required to sustain life. Although the majority of falls reported to The Joint Commission occurred in hospitals, the ECRI Institute also reports a significant number of falls occurring in non-hospital settings such as long-term care facilities.
An analysis of falls with injury reported to The Joint Commission Sentinel Event Database from January 2009 through October 2014 showed the most common contributing factors include:
The suggested actions in the Sentinel Event Alert address all of the identified contributing factors to patient falls. Listed resources in the alert include links to toolkits and research on falls prevention, and it introduces the Joint Commission Center for Transforming Healthcare’s Preventing Falls Targeted Solutions Tool®.
“Fall prevention is the responsibility of everyone in the organization and success is highly dependent on leadership playing a primary role. It is their commitment and approach that determines an organization’s ability to significantly reduce and sustain the reduction in falls,” said Ana Pujols McKee, MD, executive vice president and chief medical officer, The Joint Commission. “There are several proactive steps in the Sentinel Event Alert that leaders can initiate such as educating and raising awareness of the need to prevent falls resulting in injury, ensuring the implementation of a validated tool to identify the risk factors for falls, and establishing an interdisciplinary falls injury prevention team.”
Sentinel Event Alert is published periodically by The Joint Commission for health care professionals. It describes the common underlying causes of sentinel and adverse events and recommends steps to reduce risk and prevent future occurrences. Sentinel Event Alert topics are determined by the Joint Commission’s Patient Safety Advisory Group comprised of external members with significant expertise in health care and patient safety, and presided over by Ana Pujols McKee, MD, executive vice president and chief medical officer, The Joint Commission.
For more information about the sentinel event statistics and previous issues of Sentinel Event Alert, please visit The Joint Commission’s Sentinel Event Alert Web page.
This training is free of charge and meets PA BoN Act 31 training requirements, as well as Act 126 requirements. All other licensing-related questions should be referred to your respective board(s). Please note: If you are licensed by more than one board, the PA Department of State will apply your credit to all relevant boards.
How to Access the Online Training:
Go to www.reportabusepa.pitt.edu (If you have not previously registered, please click the “Registration” link at the top of page).
Enter your username and password to log on.
Members of each committee will meet regularly with management to raise concerns and to help ensure that problems are properly addressed and rectified. These committees are critically important as we seek to improve working conditions and staffing levels at every JNESO facility throughout NJ and PA.
Space is limited on each committee, so please contact us today to serve
as a member of your staffing committee.
Some locals have negotiated sub-committees, shared governance committees or specific staffing review processes [committee specifics vary by contract].
Standing together is the only way we will make a difference in the staffing levels and working conditions at our facilities. Staffing & Nurse Practice committee members will be released from duty to participate in these important discussions, so please consider becoming a member or learning more.
To learn more about the staffing/nurse practice committees at your local, or to serve as a member of the committee, please contact JNESO Director of Practice Karen May at KMay@jneso.org.
Consider measles in patients with a fever, rash, and cough, coryza and conjunctivitis—the three “C”s. Ask if they are vaccinated against measles and whether they have recently traveled internationally or if there’s measles in the community.
CDC’s Recommendations For Healthcare Professionals
2: Stop Germs
3: Antiviral drugs if your doctor prescribes them
(view the full list of preventative steps on the CDC’s website)
Depending on the policy, it will also often cover licensure defense. All malpractice insurance policies have limits of liability. If you are only covered by your employer’s insurance, other defendants employed at your entity may and probably do share your liability limits under the same policy. If you as well as others are named in a suit, your legal costs, including any settlement, could exceed your employer’s shared liability limits. This would mean out-of-pocket expenses for you.
Things to Keep in Mind
When selecting a policy, ask about an “occurrence” policy, which provides coverage for incidents that happen while the policy is in effect. There are also “claims-made” policies, which only cover if the claim is filed while the policy is active. Having your own malpractice insurance coverage does not make you a more likely target for a lawsuit. When something happens and a patient is injured, most attorneys will name everyone who was involved in the patients’ care in the lawsuit—whether you have your own coverage or not.
Some types of malpractice insurance may provide for medical expenses or property damage if you are assaulted at work or during work-related travel. Ask if your policy defines “workplace” as anywhere you are providing professional services, so this coverage will travel with you into the field.
Even if you plan to retire or keep your license active, you have a responsibility to anyone to whom you give advice, any place you volunteer, or any situation that requires emergency care. Your nursing license needs to be insured at all times. Ask about a Retirement/Leave Discount, which may include family leave, change to a non-nursing occupation, retirement, or disability.
If you currently carry malpractice insurance –great, take pause and review your policy’s limits. If you do not carry malpractice insurance, carefully consider looking into obtaining malpractice insurance to protect your license, it will provide greater piece of mind and is tax deductible.
Contact your JNESO Labor Representative or call the JNESO Office for additional information:
Alexia Fernández Campbell
Dec 1, 2016
Here’s an alarming statistic: Around one in four nurses has been physically attacked at work in the last year. Patients often kick, scratch, and grab them; in rare cases even kill them. In fact, there are nearly as many violent injuries in the healthcare industry as there are in all other industries combined. Healthcare workers make up 9 percent of the workforce.
There are currently no federal rules mandating that hospitals attempt to protect nurses from violence in the workplace, though some states have passed them on their own. State-specific measures include requirements that hospitals develop violence-prevention programs, such as teaching de-escalation techniques, and increased penalties for people convicted of assaulting healthcare workers. In October, California passed the toughest guidelines in the country, obligating healthcare employers to develop tailored violence-prevention plans for each workplace with employees’ input. But the problem has gotten so bad that the U.S. Department of Labor is considering setting nationwide workplace-safety standards for hospitals in order to prevent this kind of abuse.
Patients with dementia or Alzheimer’s and patients on drugs were the most likely to hurt nurses, according to one research study published last year in the Journal of Emergency Nursing. The study surveyed more than 700 registered nurses at a private hospital system in Virginia, and 76 percent said they had experienced physical or verbal abuse from patients and visitors in the previous 12 months. About 30 percent said they had been physically assaulted.
Working directly with patients in emotional and physical pain has always put healthcare workers at risk of violence. But in the past decade or so, there has been a 110 percent spike in the rate of violent incidents reported against healthcare workers. The intensifying abuse has a lot to do with money: During the Great Recession, public and private hospitals began slashing budgets at the same time people were losing jobs—and their health insurance. That meant fewer nurses and security guards available to help when patients got out of control, and more people turning to hospitals instead of private practice for medical care since they couldn’t be turned away due to lack of insurance. States also cut billions of dollars in funding for preventative mental-health services, which likely had a significant effect on the frequency of violence against doctors and nurses. Psychiatric patients are increasingly seeking treatment in hospital emergency rooms, where staff are often unprepared to deal with violent outbursts. “This is creating volatile, unpredictable situations,” says Bonnie Castillo, a registered nurse and director of health and safety for National Nurses United, a labor group representing more than 160,000 nurses across the country. Her organization has been pushing states to pass laws to protect workers in the healthcare industry.
A delirious patient kicked her so hard in the pelvis that she slammed into a glass wall and fell to the ground. She was two months pregnant.
There’s also a pervasive notion that dealing with unruly patients is just part of a nurse’s job. “We always feel discouraged from reporting it,” says Castillo. She said she was punished by a past employer for calling 9-1-1 after a patient attacked her. It’s not surprising then, that only 29 percent of the surveyed nurses who were physically attacked actually reported it to their supervisors. About 18 percent said they feared retaliation if they reported violence, and 20 percent said they didn’t report it because of the widespread perception that violence is a normal part of the job. A spokeswoman for the Inova Health System hospitals, where the nurses were surveyed, did not respond to a request to comment for this story, though it’s hardly a problem unique to one hospital.
Rose Parma, a registered nurse in California’s Central Valley, says nursing school did not prepare her for the brutality she would face in her career. Patients have spit on her, slapped her, and even threatened her life during the five years she has worked as a hospital nurse. But it reached an intolerable level about a year into her career, when a delirious patient kicked her so hard in the pelvis that she slammed into a glass wall and fell to the ground. She was two months pregnant. The pain was not as shocking as her supervisor’s response when she reported the incident. “The manager seemed so surprised and said ‘Has this never happened to you? Is this really the first time?’ As if it weren’t a big deal,” Parma says. The manager then told Parma she would see her the next day at work. “I literally thought I was going to die [during the attack], and they didn’t even offer me counseling.” (Her baby survived.)
As the Department of Labor considers implementing nationwide safety standards, individual hospitals are also taking their own measures. One hospital in Massachusetts offers self-defense classes for staff. Another in the state hosted a training exercise that simulated potentially violent hospital scenarios: gang violence in the emergency room, an outburst involving a mental-health patient, and an estranged ex-boyfriend in the maternity unit. But these types of precautionary measures are not the norm at hospitals across the United States, leaving many nurses unprepared for violent encounters. The lack of state or federal personal-safety standards as danger in the workplace grows may contribute to the shortage of nurses in the United States. When there are not enough nurses at hospitals, and those who are there feel stressed and unsafe, patients and staff all wind up suffering.
From: Mountain Grove News Journal
(BPT) – Radiation — it’s not something most people think about very often, and when they do, their thoughts usually turn to radiation’s effects as they are portrayed in the movies. These being namely that exposure to radiation will either turn them into a hideous monster or a superhero.
The truth is, however, that while radiation is great fuel for any Hollywood script, it’s more than sci-fi fodder. It’s part of your real world. And while it is not something to be feared – as it is in the movies – it is something you should be aware of. To that end, here are five things you may not know about radiation.
* You are exposed to radiation every day. One-third U.S. population lives in a “nuclear shadow” area, meaning they live within 50 miles of a U.S. nuclear power plant. Many people are also exposed to radiation every day through their work as dental assistants, medical practitioners, radiology technicians, chiropractors, etc.
* Radiation can come from man-made, terrestrial or cosmic sources. Not all radiation comes from man-made technology. Naturally occurring radiation is present in Earth’s crust as well as in the floors and walls of our homes, schools and places of work. It is even found in the food we eat and drink, and the air we breathe. Our own bodies — muscle, bones and tissue — contain naturally occurring radioactive elements as well.
* Radiation comes in multiple forms. Non-ionizing radiation, like that found in microwaves, radio waves and visible or infrared light, is largely harmless due to its low energy levels. Ionizing radiation (found in gamma rays, X-rays and other sources) has higher energy levels and can be harmful to the body if you are exposed to large doses or for a long period of time.
* You can track radiation levels around you. Radiation is invisible, but that doesn’t mean you have to be blind to it. The Dosime device is a hybrid smart home and wearable personal dosimeter that captures real-time radiation exposure in the environment. The accompanying app provides an immediate assessment of the ionizing radiation present in the homes, buildings and spaces you live, work and play that can potentially impact your health without your knowledge. Dosime allows you to access accurate, reliable, easy-to-understand radiation information in real time to manage potential health risks and ensure peace of mind.
* You bring radiation into your home every day with things you purchase. Your cat’s litter box is a common radiation source in your home, while Brazil nuts and bananas also give off small levels of radiation. The glossy paper appearing in the magazines you read requires a radioactive finish to achieve that shine. The glaze used to decorate those antique jars could be radioactive if the uranium levels are high enough. Even your new granite countertops are a source of radiation as granite is one of the best rock sources for retaining natural radiation.
Radiation is around you every day, but that doesn’t mean you have to fear it. Remember, most radiation is naturally occurring and your exposure to it won’t turn you into a monster, even if a super power would be pretty cool. To learn more about the Dosime device and to see how it can help you monitor radiation levels around you, visit Dosime.com.
What is the “Cullen Law?”
The “Cullen Law,” officially known as the “Health Care Professional Responsibility and Reporting Enhancement Act,” was passed by New Jersey in November of 2005. It requires health care facilities to notify the state Division of Consumer Affairs with any information regarding impairment, incompetence or negligence by a health care worker that could endanger patients. However, the law fails to clearly define what that means. This lapse has led employers to subjectively and erratically report actions, including simple human errors and mistakes that can be more a result of inexperience than incompetence.
The law was passed in response to the crimes of a nurse named Charles Cullen, who in 2004 was convicted of murdering at least 29 patients over several years while working at multiple hospitals throughout the region. The murders were viewed as a failure of the health care system, as existing reporting guidelines were not utilized by his employers and Cullen was able to move from one facility to the next without detection.
How Does the Law Affect You?
The “Cullen Law” mandates that health care professionals must be reported to the Division of Consumer Affairs within 7 days of a questionable action, and referred to the relevant state board overseeing a health care profession. This “rush to judgment” leaves little time for investigation or grievance procedure. While the law covers a wide group of professionals, the largest number of actions have been taken against nurses. Among the other professions covered are physical and respiratory therapists as well as social workers.
The “Cullen Law” does not provide clear guidelines for what type of action should be reported. A taskforce set up to develop guidelines did not reach consensus on a final reporting document, leaving considerable ambiguity. Employers are using their own discretion in determining what types of actions should be reported. Other professional boards covering other disciplines have their own guidelines and/or procedures. Since our only experience so far has been with nurses reported, we can only verify those outcomes.
After the Board of Nursing finishes investigating the charges brought before the Division of Consumer Affairs, they determine if a charge has merit, and if it does the nurse is sanctioned. If the Board of Nursing finds that the charge did not have merit, the nurse is issued a letter detailing the charges that were brought and saying the Board did not find enough evidence to bring action against the nurse at this time. Regardless of whether or not the nurse was sanctioned, under the “Cullen Law” the employer is mandated for seven years to provide detailed information to prospective employers about the charge or charges made against the individual. This information does not include any investigation outcomes, and this provision applies to all titles.
The impact of the “Cullen Law” is that highly qualified nurses and other health care workers with many years of service in their professions are not able to work in their field. The “Cullen Law” makes it nearly impossible for nurses who have been reported to the Division of Consumer Affairs to find employment both during the period of time their case is pending investigation and then for the next seven years even if the Board of Nursing does not take action against them.
Why is the Cullen Law Inadequate?
How Can You Protect Your Career in the Age of Cullen?
As JNESO works to garner legislative support for a change to the Cullen Law, it is important that you have the information needed to protect your license and your career. JNESO is here to help you every step of the way, so please do not hesitate to contact us with any questions about the law. Please keep in mind the following:
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