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Job satisfaction increases for post-acute care nurses

Pay and benefits for home care, hospice, palliative care and long-term care nurses haven’t always been on par with nurses who work in the acute setting.

But that has changed for post-acute care #nurses in the past five to 10 years, according to Andrea Devoti, MSN, MBA, RN, executive vice president of the National Association for Home Care and Hospice.

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There are many areas of the country where employers’ salary and benefits packages for these other nursing roles match or are getting close to matching what they offer acute care #nurses. That’s because more employers realize that home care, hospice, palliative care and long-term care patients often are as sick as those in the hospital, Devoti said.

“We take care of sick people,” Devoti said. “We take care of ventilated children. We give chemotherapy. We give intensive care level drugs in some cases.”

Employers’ greater awareness of the complexities of taking care of patients outside the hospital setting is timely, given many want to add the post-acute care services because of increased demand.

The National Hospice and Palliative Care Organization reported in its Palliative Care Needs 2018 Survey Results that out of 347 responses from hospice and palliative care member organizations, 53% are providing palliative care services and an additional 35 are considering developing these services.

Only 12% have no plans to develop #palliative_care services, according to the report.

Are employers meeting post-acute care nurses’ needs?

#Nurses in acute care, home care, long-term care and other healthcare settings say salary is most important for job satisfaction, followed by benefits, according to our 2018 Nursing Salary Research Report.

The survey represents responses from 4,520 RNs from 50 U.S. states, the District of Columbia and Puerto Rico.

Although nearly three-quarters of the nurses surveyed ranked salary as the No. 1 aspect of job satisfaction, 15% indicated benefits, including medical and tuition reimbursement, were most important for work satisfaction.

Nursing salaries for home care, hospice, palliative care and long-term care nurses are close to those of nurses in the acute care setting, Devoti said.

In general, these post-acute care nurses might earn $1 per hour or so less than nurses in acute care but that’s better than the pay disparities of $5 or $6 an hour that Devoti said she used to see.

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Employer benefits for home care, hospice, palliative care and long-term care nurses often rival those of the acute care setting, but not always, she said.

“We have many health system-affiliated home care, hospices and long-term care facilities that have the same benefits across the continuum,” Devoti said. “There are a number of home care and hospices that are still freestanding, meaning they’re not really affiliated with a health system or an integrated system, so they actually may have lesser benefits when it comes to tuition reimbursement and continuing education reimbursement than the hospitals.”

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5 ways healthcare teams can improve how they care for skin injuries

Need evidence skin injuries are a major concern in healthcare? Consider that 2.5 million U.S. patients are afflicted annually.

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According to the federal Agency for Healthcare Research and Quality, the cost of skin injuries is more than $9.1 billion each year.

The price is even higher, AHRQ reports, because 17,000 lawsuits related to hospital-acquired pressure ulcers are filed each year, second only to wrongful-death suits.

“Skin injuries are extremely prevalent,” said Pamela Damron, MSN, RN, CWON, who has been a certified wound and ostomy nurse for more than two decades. “The cost is very hard on a healthcare system. Patients are coming into the hospital much sicker than they were years ago. They’re already at risk for so many things, and most every patient has two or more comorbidities. And to Medicare, pressure injuries are preventable.”

Damron is the featured presenter of our popular CE webinar course, “It’s Just a Stage 1 Pressure Injury. Or Is It?” She has been a certified wound-ostomy nurse since 1998 and is a nursing instructor at the University of Tennessee Martin.

The 1-hour recorded CE webinar is accredited for nurses, physical therapists, occupational therapists, pharmacists and dietitians/nutritionists.

Here are five ways to ensure you and your team are delivering the highest quality of patient skin care.

#1 — Healthcare is a team sport
This phrase is especially true with pressure injuries and wounds.

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#2 — Look from head to toe
Re-positioning patients every two hours is a high priority to avoid pressure injuries, Damron said. The need to examine potential problem areas of the body also is a necessity for healthcare clinicians.

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#3 — Document, document, document

Hospital-acquired pressure injuries are among the conditions considered preventable by the Centers for Medicaid and Medicare Services. Thus, healthcare facilities are not reimbursed for treating these injuries when they are acquired by a patient in the hospital.

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#4 — Consider where patients are going/coming from

Knowing the path your patients take during their hospital stay can offer helpful clues, Damron said. For example, a patient who spends hours in surgery or getting tests such as an MRI, x-ray or CT scan all will be lying for long periods on hard surfaces. This leads to a greater risk for pressure injuries.

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#5 — Start with a smile
For Damron, learning about a patient begins when entering a room. “You can tell a lot just by smiling at them,” she said.

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Exploring Innovations and Latest Advancements in Nursing & Health Care

Chip Device Heals Injuries In Seconds

Picture this – you suffer a car accident and your leg is broken. Within moments a small chip-like silicone device is placed on the broken leg – it reprograms the skin cells beneath and treats the injury – in a matter of seconds.

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Sounds like the stuff of science fiction, right? Nope. This is real-life, folks!

A new non-invasive technology – Tissue Nanotransfection (TNT) – has been developed by researchers at Ohio State University to reprogram and grow skin cells directly on the body. The device delivers genes to skin cells by passing a strong electrical current through the chip and transforming the cells.

In lab studies on mice, the tiny device has successfully reprogrammed and grown cells – healing injured parts of the body – from broken bones to brain damage.

This is the first time cells have been reprogrammed on a live body.

The torn arteries in a mouse’s broken leg were healed after touching TNT – it turned the skin cells into vascular cells – healing the leg completely within 3 weeks.

According to Chandan Sen, Director of the Center for Regenerative Medicine and Cell-Based Therapies, its ability to heal goes beyond skin injuries – when tested on a mouse suffering from brain damage due to stroke – the device successfully treated the brain cells.

Sen states, “we are proposing the use of skin as an agricultural land where you can essentially grow any cell of interest.” He has spent the past four years working on the technology and is in talks with Walter Reed National Medical Center to start testing on humans within the next year.

The tiny device is easy to use and weighs less than 100 grams. “This technology does not require a laboratory or hospital and can actually be executed in the field,” Sen said. While current cell therapies are high risk and use stem cells or viruses to change the function of cells- TNT has no known side effects and is much more efficient.

Currently, TNT can only be used on the skin – researchers continue to refine the device to heal other parts of the body.

The technology is pending FDA approval.

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Empathy empowers nurses to care for patients, each other

Nurses experience a wide range of emotions when caring for patients.

One of the most important tools needed to manage those emotions is empathy, according to Kati Kleber, BSN, RN, CCRN, an accomplished #nurse, author, speaker and podcaster.

In the one-hour continuing education webinar, “Empathy 101 for Nurses: How to Care for Yourself While Emotionally Supporting Others,” Kleber explains the difference between empathy and sympathy, along with the power of having compassion for patients. The course is among our most popular learning activities with healthcare professionals.

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Kleber, who has worked as a neuro ICU and critical care nurse, shares her personal successes and failures with discovering empathy. She also shares important research on the topic.

In this Q&A, she explains how empathy and developing self-compassion have impacted her career.

Q: Is it easy for healthcare providers to confuse empathy and sympathy?

A: It is, especially in the moment, but I don’t think most do this intentionally. Our typical reaction is to keep some emotional distance because it takes time and investment to truly step into empathy with someone. In a practical sense, we may be very rushed and need to get to the next patient. We simply don’t have the time to go there, so it’s easier to default to feeling bad for someone rather than with them.

In an emotional sense, providing authentic empathy is very taxing, especially with the frequency and intensity our roles require. I found myself in many instances in which I couldn’t take that step to empathy because it would be too emotional for me. I still had to have my mind on very technical nursing tasks requiring my utmost focus.

Q: What makes empathy so powerful?

A: It’s powerful because it builds connection. People feel heard, supported, cared for and validated when someone is taking the time to truly walk through the steps of empathy with them.

Rarely, if ever, will the perfect words fix the painful situation in which our patients find themselves. We can’t take away the emotional pain with the perfect words, and to think that something we’d say will fix it is … well, unrealistic.

Rather than focus on fixing or making patients and their loved ones feel better, shifting that focus to just feeling with them can be significantly more meaningful.

This includes stopping to take in their unique perspective of the situation, genuinely suspending judgment, attempting to understand another’s feelings and then communicating that understanding. Our patients and their loved ones truly feel cared for when we stop trying to say the perfect thing and embrace simply being there and ensuring people feel heard, understood and validated.

Nurses are there for some of the most challenging days in an individual’s life, and we have a unique ability to provide this powerful support frequently. The caveat is that while it can be rewarding to be able to provide this authentic support to others, it can be difficult to continue to do so without taking specific, intentional steps to care for our own emotional well-being.

Q: Is compassion the same as empathy?

A: No, it is not. I like to explain the major difference like this: sympathy is feeling bad for someone, empathy is feel bad with someone, and compassion is the next step of feeling with someone by taking part in alleviating their suffering.

Only when we’ve been authentically empathetic do we know what compassionate act will best serve the individual. So while empathy can be provided while compassion is being practiced, they are not one in the same.

Q: What resources would you recommend to #nurses who want to understand empathy?

A: One of my favorite resources for empathy is Dr. Brene Brown. She has published quite a bit of research and authored many books on the subject. She is able to combine the science of the research with the art of caring, which is something nurses can relate to and appreciate.

Q: What is self-compassion, and why is it important for #nurses to practice it?

A: Self-compassion differs greatly from being compassionate for others. It is much more than being kind to ourselves, which is the assumption many make. It essentially consists of three elements:

Being kind to ourselves rather than being overly judgmental.

Recognizing that our challenges/experiences make us part of common humanity rather than isolate us from one another.

Approaching negative emotions in a mindful and balanced way rather than over-identifying with them.

Dr. Kristin Neff, along with others, has published extensive research on the impact on self-compassion, and there is quite a bit of research substantiating its positive effects on nurses in particular.

Nurses who practice authentic empathy are at much higher risk for burnout and compassion fatigue, which is not a surprise. However, #nurses who practice self-compassion are much less likely to burn out and suffer from compassion fatigue.

It’s a very interesting concept and shown to be somewhat of a protective measure for those of us whose every day at work entails experiencing the trauma of others.

To learn more about empathy in nursing, please visit https://www.linkedin.com/in/divya-baskaran-256337173/