Create a Feng Shui To-Do -List to help you invite fresh energy into your life
and declare your independence from the status quo.
Create a Feng Shui To-Do -List to help you invite fresh energy into your life
and declare your independence from the status quo.
For Some Retirees, A Second Act Is Easier Than Expected By Abby Ellin
Never in a million years did Cheryl Delaney expect to spend her retirement with the elderly….
Fatigued nurses more likely to regret their clinical decisions
A study in American Journal of Critical Care links nurse fatigue to increased decision regret
ALISO VIEJO, Calif. — January 2, 2014 — Fatigued nurses are more likely to express concern that they made a wrong decision about a patient’s care, according to a study in the January issue of American Journal of Critical Care (AJCC).
“Association of Sleep and Fatigue With Decision Regret Among Critical Care Nurses” found that nurses impaired by fatigue, loss of sleep, daytime sleepiness and an inability to recover between shifts are more likely than well-rested nurses to report decision regret.
Decision regret is a negative cognitive emotion that occurs when an actual outcome differs from the desired or expected outcome. For nurses, it reflects concerns that the wrong decision may have been made regarding patient care.
Although decision regret reflects previous decisions and adverse outcomes, it may also contribute to work-related stress and compromise patient safety in the future.
This link between nurse fatigue and decision regret adds to the body of evidence that supports the need for appropriate staffing to ensure the use of fatigue management strategies to promote both patient safety and a healthy work environment.
Lead author Linda D. Scott, RN, PhD, NEA-BC, FAAN, is associate dean for academic affairs and an associate professor at the University of Illinois at Chicago College of Nursing. Cynthia Arslanian-Engoren, RN, PhD, ACNS-BC, FAHA, FAAN, and Milo C. Engoren, MD, FCCM, from the University of Michigan, Ann Arbor, served as co-authors.
“Registered nurses play a pivotal role as members of the healthcare team, but fatigued and sleep-deprived critical care nurses put their patients and themselves at serious risk,” Scott said. “Proactive intervention is required to ensure that critical care nurses are fit for duty and can make decisions that are critical for patients’ safety.”
Critical care nurses and their employers must acknowledge the effect of fatigue, sleep deprivation and excessive daytime sleepiness on clinical performance and patient outcomes and must engage in strategies to mitigate these impairments.
Healthcare employers should implement scheduling models that maximize management of fatigue, ensure that support resources for clinical decisions are available and encourage the use of relief staff to provide completely relieved work breaks and strategically planned nap times.
“By working together to manage fatigue, critical care nurses and employers can ensure patients receive care from alert, vigilant and safe employees,” Scott said.
For the study, more than 600 nurses working full-time in critical care units completed a questionnaire on personal and work-related data, sleep quality, daytime sleepiness, sleep quantity, clinical-decision self-efficacy and decision regret.
Most respondents reported moderately high fatigue, significant sleep deprivation and daytime sleepiness, all of which affect their ability to be alert, vigilant and safe. Furthermore, the nurses were not likely to sufficiently recover from their fatigue-related states during non-work periods.
Decision regret was most common among nurses who are male, work 12-hour shifts and have lower levels of satisfaction with their clinical decisions.
The research was supported in part by the Kirkhof College of Nursing at Grand Valley State University, Grand Rapids, Mich., and the American Association of Critical-Care Nurses (AACN).
To access the study abstract and its full-text PDF, visit the AJCC website at http://www.ajcconline.org.
About the American Journal of Critical Care: The American Journal of Critical Care (AJCC), a bimonthly scientific journal published by the American Association of Critical-Care Nurses, provides up-to-date clinical research that focuses on evidence-based practice applications. Established in 1992, it includes clinical and research studies, case reports, editorials and commentaries. AJCC enjoys a circulation of 80,000 and can be accessed at http://www.ajcconline.org.
About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, Calif., the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN joins together the interests of more than 500,000 acute and critical care nurses and claims more than 235 chapters worldwide. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.
American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, Calif. 92656-4109;
Phone: (949) 362-2000; Fax: (949) 362-2020; http://www.aacn.org; facebook.com/aacnface; twitter.com/aacnme
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Welcome To Nursing success TV: Episode 8
This program is dedicated to celebrating the profession of nursing
May 21, 2014, 5:00 a.m. EDT
By Elizabeth O’Brien
Many investors recognize the importance of a diversified portfolio. And with good reason—a balanced investment mix can help ensure you don’t outlive your money in retirement. But fewer see the importance of diversifying an equally important asset: your social portfolio.
Just as it would be foolish to pour your entire savings into an individual stock, it’d be unwise to bank your retirement on a single activity or just one person, said John T. Cacioppo, a professor of psychology at the University of Chicago and the director of the university’s Center for Cognitive & Social Neuroscience. “We think about financial protection in retirement, but we think very little about social resilience after retirement,” Cacioppo said.
Social connections matter, a lot. Cacioppo’s recent research found that feeling extreme loneliness can increase an older person’s chances of premature death by 14%. Researchers from Brigham Young University examined existing studies on social relationships a few years ago and found social isolation can be as harmful as cigarettes and drinking.
What’s going to get you out of bed every morning in retirement? Relationships built through involvement in volunteer projects (like this Habitat for Humanity gathering in Flint, Michigan) and other personal passions can be good for your health in the long run.
One of the best ways to guard against isolation is to have a diverse network of friends and associates, from different aspects of your life and, ideally, different generations. You often hear people say they plan to travel and spend more time with the grandkids in retirement. While these are perfectly good goals, for many they’re not going to be enough: Most people don’t want to travel constantly, and visits with the kids and their families probably won’t happen on a daily basis, even if they live nearby.
Spouses and romantic partners can provide good companionship for those who have them, but they’re not enough, experts say. For one, constant contact can strain even the strongest relationships.
So what’s going to get you out of bed every morning? Those who have spent decades raising families and focusing on work might need to spend some time rediscovering their passions and finding people with whom to enjoy them.
Just as with your financial portfolio, the best time to broaden your network isn’t the day you retire, but in the years leading up to it, experts say. Make regular deposits into your friendship bank just as you would into your retirement account—deep reserves aren’t just for 401(k)s.
The best way to make such deposits is to follow your interests. For example, take an art class, volunteer for Habitat for Humanity, or attend meetings at a veterans’ center. You can find so-called affinity groups—basically, clubs united by a common hobby, interest or passion—throughout the country at Meetup.com, a website where people can organize local groups enjoying everything from language exchanges to vegetarian cuisine to entrepreneurship.
Mike Piershale, a financial adviser with an eponymous firm in Crystal Lake, Ill., sometimes acts as a social director of sorts for clients who don’t have a strong network. He tries to find out where their interests lie and guide them accordingly. For the religious, church can provide a supportive community, and for the adventurous, he often recommends group trips abroad. “There’s nothing like going into a foreign culture to make people get closer to one another,” Piershale said.
Preparing for Future Needs
Financial advisers recognize that the benefits of a strong social network go beyond companionship. Those who don’t have close friends or family nearby have an extra challenge when it comes to preparing for possible future incapacity. Key legal documents that every adult should have, even if they’re far from retirement age, include a financial power of attorney, which names a trusted person to handle your financial affairs if you’re no longer able to do so, and a health-care power of attorney, which names someone to make medical decisions.
Some people need a little help figuring out who can fill these important roles for them, said Jim Holtzman, a financial adviser with Legend Financial Advisors in Pittsburgh. For those without children, he’s seen siblings act in this capacity, including a local 80-year-old woman who looks after her 85-year-old brother and his wife, both of whom have Alzheimer’s disease and live in an assisted-living facility.
Scott Leonard, founding partner of Navigoe, a financial planning firm in Redondo Beach, Calif., sometimes delicately suggests to clients that they name a younger person as power of attorney, or at least as a backup if the primary proxy can’t act. Usually, asking whom the client plans to bequeath money to will reveal the name of a niece or nephew in a position to help, Leonard said, but if family isn’t available a younger friend could certainly fill that role.
Quality vs. Quantity
Cultivating a broad network doesn’t mean collecting friends in real life like you would on Facebook. Yet while you’re not aiming for as many as possible, it does help to have friends from different parts of your life, experts say. The former co-worker who you meet for lunch every week, the friend you volunteer with, and the buddy from exercise class: All three can keep you feeling engaged and connected.
A disparate group of friends can also cohere into a powerful caregiving unit in times of need, said Sheila Warnock, founder and president of the New York City-based nonprofit organization ShareTheCare and co-author of the book, “Share the Care: How to organize a group to care for someone who is seriously ill.” Years ago, Warnock, then an advertising creative director, and a friend formed a group to care for a sick mutual friend, a divorced woman with two teenage children and a serious cancer diagnosis.
The caregiving group of 12 members came from all aspects of the friend’s life, and most were strangers to one another at the beginning. Not all were close friends of the sick woman. Yet they organized into a unit that took care of their mutual friend for 3½ years, until her death, using a system of rotating “captains” that allowed everyone to contribute in different roles—going to medical appointments, cooking, cleaning, and even organizing a daughter’s wedding—without any one caregiver feeling overwhelmed.
Warnock has some advice for those who live alone and prize their independence, a group whose ranks are growing. Today, a record 27% of U.S. households are compromised of just one person, including those of nearly 12 million Americans 65 and over, according to the Census Bureau, up from nearly 10 million in 2000.
One reason why caregiving can feel overwhelming, both for the giver and the receiver, is because as a society we don’t often experience it until the need becomes overpowering, Warnock said. “Back in the pioneer days, if you didn’t have your neighbors, you wouldn’t survive,” she said. “These days, you walk down the street and everyone has their face in an iPhone.”
So make like a pioneer and practice giving and receiving help, Warnock advised. Go shopping for an elderly neighbor. Ask friends to come paint your apartment. That way, it won’t feel so foreign when you’re in a position to really need the help—or to give it.
Time spent cultivating your network is one of the best investments you can make. A diverse portfolio will give you something to live on in retirement, but friends will give you something to live for.
During National Nurses Week, nurses are honored and thanked for all the different and essential ways they touch lives. From a compassionate hand on a shoulder to life-saving emergency treatment, nurses are at the forefront of the nation’s well-being.
But nurses, caretakers of everyone, are notorious for pushing aside their own needs. If they aren’t able to refresh every now and then, they can experience a fast and often personally upsetting burnout.
To read more:
Saturday March 29, 2014
The world premiere screening of “The American Nurse” will take place May 7 at the American Film Institute’s Silver Theatre and Cultural Center in Silver Spring, Md., to coincide with National Nurses Week. The event is made possible by the American Nurses Foundation and Fresenius Kabi USA.
Following the event, the film will be released in 19 theaters in 10 states. The New York premiere takes place May 8 at the Bow Tie Chelsea Cinemas in Manhattan. The film continues through May 15 at Digiplex Destinations Theaters throughout the country.
“The American Nurse” explores some of the biggest issues facing America — poverty, war, aging, prisons — through the work and lives of five RNs, all of whom will attend the May 7 premiere and the May 8 New York screening and participate in a discussion and Q&A alongside the filmmakers.
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