Without the ability to hold in-person educational clinics, nursing higher education institutions like Frontier Nursing University (FNU) had to take drastic measures to ensure that advanced practice nursing students got the best education possible without risk of spreading the disease. Dr. Kevin Scalf, psychiatric-mental health nurse practitioner and regional clinical faculty at FNU, explained how FNU’s innovative virtual learning program helped students throughout the pandemic — and may even have had advantages of its own. 

“With the advent of COVID, we were really forced to think outside the box, and it really forced us to become creative in a lot of ways,” Scalf says. “Students were already getting didactic information online at our university because that’s what we do, but how could we provide good clinical experiences for students in the virtual environment during that transition period. What can we do to really support them as they learn to apply their clinical skills?”

Finding creative solutions

Nursing isn’t a profession you can do from home, which means that nursing school curriculums needed to find a way to teach students to perform in-person tasks from afar. Scalf says that his university found a way to develop virtual clinics for students. “These virtual clinics include professional actors who play the role of the patient,” he explains, ”and so, students receive a clinic schedule at the beginning of the day, and that clinic schedule shows the patient’s name, what time they’re coming in for their appointment, who’s going to be the provider for the day, and that kind of thing.” 

In this way, the school was able to simulate the clinic environment. “We see patients back-to-back just like you would in-clinic, and the patients present with a variety of symptoms and problems. They each bring a different energy to the room just like we would see during regular clinic days.” In these simulations, the student acts as the healthcare provider, and afterwards, faculty and students come together to debrief about the interaction. 

While the virtual clinics started as a response to a need brought on by COVID, Scalf says that the ability to include feedback from the actor “patients” has been a new and useful way to get the perspective of patients. ”We really talk about that a lot, because sometimes as providers, we get in our own minds and we have our own agenda, so we kind of forget, ‘how does the patient see this?’” he notes. “Students have been very receptive of this experience and they like the feedback that the patients have to give them.”  

The future of medicine

In addition to nursing education, the global pandemic has also changed the nursing profession itself, namely through increased use of telehealth. That’s why FNU has also created virtual telehealth clinics. “We’ve started to incorporate material about telehealth into our curriculum so that students will be more familiar with this type of care delivery after graduation,” Scalf says. “But also, we have a telehealth clinic, and this again is virtually staffed by professional actors, and students can go back to this telehealth clinic as part of their clinical experience.”

The virtual telehealth clinics, Scalf says, allow students and faculty to work together and become better providers. “They can refine and improve their skills. If faculty pick up on student learning opportunities that maybe a student is weak in a particular area, they can go back to this telehealth clinic and work on those skills,” he explains. “We then follow up with the preceptor to gain additional feedback about overall clinical performance.” Students can participate in the virtual telehealth clinic to continually improve their skills and get one-on-one feedback from faculty members. “It’s just overall a great way for the student to gain clinical insight and also confidence as they work with the clinical portion of the educational program.”

Virtual clinics don’t just offer students the opportunity to simulate interactions with patients, Scalf says. At FNU, they’ve developed simulations that help students learn to work with other healthcare providers. “One of the things that we highlight is teamwork, because in healthcare, it’s all about the team, right?” Scalf says. “We have developed inter-professional simulations as well, where patients come in and need to be referred to other services. So they may come into the mental health provider’s office with one problem, but we have to refer and collaborate with primary care about a particular issue that came up. So, we really start the process of thinking about those team dynamics early on.” 

Online learning has a bad reputation for being isolating, but Scalf emphasizes that one thing the FNU team learned through creating virtual clinics is that online education doesn’t have to be lonely. “Not only does it increase access to education and graduate education, but it also allows students to have more diverse experiences with other people across the nation. One thing that we have learned throughout all of this is that online education can still be very personable and intimate for the students,” he says. “With an online learning model, I think it really prepares students for entering into a technology-driven world.” 

The post How Graduate Nursing Schools Like FNU Are Taking In-Person Clinics Online appeared first on Education and Career News.

IntelyCare, a workforce management app that matches nurses with facilities, is a modern solution to a long standing healthcare staffing problem. Nurses feel burned out, especially after working long hours and in difficult times during the pandemic. And many are now leaving the profession in droves. Meanwhile, healthcare facilities are always in need of qualified nurses and nursing assistants to staff shifts.

The IntelyCare platform — which gets its name from the idea of intelligent care delivery — uses artificial intelligence and behavioral science with machine learning algorithms to produce optimum pay rates and shift matching for nurses.

The company started in 2016, releasing their first mobile app, which enabled nursing professionals to select shift work at facility partners. Within a year later, 100 facilities had signed up. By 2019, they had filled 2 million nursing shifts. Fast forward to 2022 and they have filled over 15 million nursing shift hours and are partnering with 1600 facilities in 28 states.

Staffing solution

During the pandemic, there’s been an increased need for nurses who can travel and work different shifts at different facilities. But getting credentialed can be tedious and takes time. Enter IntelyCare.

“We have to make it easier for nurses to be able to work cross functionally among systems,” says Rebecca Love, RN, MSN, FIEL, chief clinical officer of IntelyCare. “Credentialing is highly painful.

“The average length of time to credential a nurse into a system is 90 days. The average system never could do that. But when you come and work with IntelyCare, we created a credentialing process that is the gold standard across the industry, which allows our nurses and CNAs to be able to work across thousands of different facilities to easily go and meet those needs.”

Perfect job

There are 4.3 million registered nurses in America. Rosa Nunez is one of those nurses. For the past two years, she’s been working full-time with IntelyCare, filling shifts in skilled nursing and long-term care facilities.

A single mother of two teenagers, Nunez is also caring for her mother who has Alzheimer’s disease. It’s a busy life but she loves the flexibility her work schedule offers.

“This job has just been the perfect job for me,” she says. “I could switch times depending on my plan for the week or the day. For instance, if my mom has an appointment with a doctor for the morning, I could always pick up a shift in the afternoon. I don’t need to request a day off whereas if I was working as a staff nurse in a facility, I’d have to ask permission in advance to arrive late or leave early.”

Love agrees and says the app empowers nurses, who routinely get called in on their days off, to make their own schedule.

“It’s flipping the power,” she says. “You are in control of your schedule in a way that nurses have never had before.”

Nunez prefers to plan her schedule by picking up shifts a week or two in advance. However, she also likes to know that if she needs to book a shift at the last minute, she can with IntelyCare. She’s been impressed with the pay too, noting it far exceeds what she would get if she worked on staff. Nunez feels appreciated in this role and looks forward to continuing working with the company.

“What I like about IntelyCare is that every time I go to a different facility, it’s always new faces, new patients, new health conditions, or new treatments that maybe I haven’t done before, and I’m like, ‘wow, this is a big opportunity for me to learn here,’” she says.

The post The Modern Solution to Healthcare Staffing That’s a Win for Nurses, Facilities, and Patients appeared first on Education and Career News.

“I love the privilege of being responsible for something larger than myself and using my skills to help me succeed,” explains Roecker, 30. “Having said that, at times it is emotionally stressful and draining to be tasked with something so large, at times in subpar circumstances.”

To cope, the Philadelphia native turns to a hobby she adopted in 7^th grade and has maintained since: running.

Running for a cause

Recently, Roecker also took a step toward effecting change in her profession when she broke the Guinness World Record for the fastest marathon run in scrubs by about 20 minutes at the 2022 Boston Marathon. Roecker’s time was 2:17.2 (two hours, 48 minutes, 2 seconds). She raced in Moxie Scrubs, which provided her “total comfort,” she says, as she ran to raise awareness and funds for nurses’ mental health in partnership with the American Nurses Foundation’s Well-Being Initiative.

“The idea came when so many of my friends and coworkers had to pivot their roles to support COVID patients over the last few years. Each day there’s a new story about healthcare workers burning out and nurses who have struggled since the start of the pandemic,” says Roecker, who is a clinic nurse in the otorhinolaryngology practice at the Perelman Center for Advanced Medicine at Penn Medicine and a student in the Family Nurse Practitioner Program at The University of Pennsylvania School of Nursing.

Spreading smiles

Roecker values building relationships with patients and their families, and the feeling of mutual respect among the nursing community. She ran, in part, to honor her colleagues.

“I chose to run in scrubs in honor of those nurses who are struggling. I wanted to remind them that we can do hard things — while also putting a smile on my friends’ faces as I attempted to beat a Guinness World Record for the fastest marathon run in scrubs,” she says.

As the COVID-19 pandemic continues, so do the struggles that come with it. Roecker is continuing to call for greater access to mental health resources for nurses.

“We understand that this job is physically and emotionally demanding, although we did not expect the trauma that was and continues to be associated with the COVID-19 pandemic,” Roecker says. “Access to mental healthcare is difficult in general; we especially need to find a way to raise awareness and support for the growing population of healthcare workers who have an increased need for mental health resources. I pledge to continue to work on this, and I hope to inspire others to do so as well.”

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Domaine Javier had wanted to be a nurse even since she was little.

“I had a younger sister at the time — I believe I was 11 — and my younger sister had a twin sister,” Javier says. “One of them was very, very sickly. She had epilepsy, she had cerebral palsy, and the other one was completely healthy.”

Javier remembers seeing her younger sister hospitalized many times before she died at a young age. “I remember every time she would be hospitalized, the nurses were always the ones who were showing the best, most compassionate care out of all the medical professionals,” Javier recalls. “I remember watching them, and I thought, I want to be like them. I want to make a difference in someone’s life as much as they are making a difference in mine right now.”

Facing challenges

Many people know Javier from her appearance on MTV’s “True Life,” but she also made news when she sued California Baptist University in 2013 after they expelled her for not disclosing the fact that she was a trans woman.

“They expelled me for being trans, basically saying that I committed fraud because I put female in my admissions application,” Javier says. “Unfortunately, throughout my career, I have experienced my fair share of discrimination.”

Javier is now an advocate for fighting discrimination in the medical field, especially when it comes to gender. “Nursing is a profession where sex and gender do not matter,” she says. “You can go into a room and take care of your patient regardless of whether you’re male, female, or whatever you identify as. It doesn’t matter. You are a healthcare professional, so you should not be treated any differently regardless of who you are, because you’re there to provide care and you took the oath to give care to those who are in need.”

A ripple effect

Staff discrimination also negatively impacts patients, as discrimination toward nurses and doctors increased the nurse shortage and limited access to care.

“Right now, there is a shortage of nurses all over, especially with that pandemic that kind of caught us out of the blue,” Javier says. “We were all scrambling to figure out what to do.”

When COVID first showed up in the United States, Javier was working at an elderly care facility. “The population that I was working with at the time were predominantly Asian — specifically Chinese — and they had relatives coming from directly from China visiting them. There was no travel ban at the time. It was crazy. Then the pandemic struck, and I remember the shortage of supplies. I remember when we had to reuse our masks, our gowns, because there was such a shortage of supplies. It was very stressful.”

The COVID pandemic revealed the strain that nurses and doctors are put under in their careers and where support is lacking for their own well-being. “It’s really sad when you’re working so hard,” Javier says. “Sometimes you don’t get to even use the bathroom. Sometimes I would be working 14 hours straight, and I would be using the restroom only once because sometimes I forget. It’s terrible.”

Finding solutions

A major corrective for this lack of support would be to increase wages for nurses and doctors, Javier says. “I feel like nurses would feel more appreciated if they are appropriately paid, especially since we were at the front lines. In the back of our heads, we still worry about the bills that need to be paid.”

With all she has experienced in the medical field, Javier remains optimistic about nursing, and she hopes she can lead by example to end discrimination and advocate for better working conditions and wages. “I know one can only dream,” she says. “You think it wouldn’t be so difficult to have simple answers.”

The post How Discrimination Hurts the Entire Medical Field appeared first on Education and Career News.

Still, the work was rewarding for Gaines, who enjoys being at a patient’s bedside.

“It’s their most vulnerable moment, but also their strongest moment ever, going through labor and having their baby,” she says. “Seeing a baby take their first breath on this Earth is an everyday thing for me. That’s amazing. I love it.”

Life-changing decision

It wasn’t until Gaines’ father died from cancer a few years ago — she was his hospice nurse in addition to her regular nursing job — that she made a decision that changed her life: she was going to become a travel nurse.

She came to that conclusion when she requested the day off after her father’s funeral and the request was denied due to staffing needs. Gaines worked the shift and had a breakdown in front of a patient, who had just delivered a baby boy and was introducing the baby to his grandfather.

“Instead of just sitting around and dealing with it and complaining with how terrible it is,” she says, “when I realized that things were not going to change, I changed and I jumped into travel nursing to take back control of my career.”

Empowered

Gaines, who has been a nurse for 10 years, worked three years as a staff nurse and has been a travel nurse for seven years.

“I pretty much jumped in and didn’t look back. It’s crazy because, unfortunately, so many nurses can relate to that story, and a lot of nurses had their breaking point during the pandemic,” she says.

These days, mandatory overtime for nurses is a must at many facilities, and it’s burning out people who love the profession. Gaines encourages medical facilities to adjust their culture and better support nurses, and for nurses to try travel nursing.

It’s empowering, she says. “It really puts the leverage back in your hands and puts the power back in your hands as a nurse. You get to choose when you want to work, where you want to work, and how long to do it.”

While higher pay is a big draw for many traveling nurses, Gaines values the job flexibility.

“It has honestly been a hidden gem,” she says. “You have the freedom to travel and get your housing paid for by your company and you get to work and do what you love.”

New opportunities

Being a traveling nurse is contract-based and there are no guarantees. While Gaines admits that sometimes staff nurses have animosity against her because she’s a contractor, she says the frustration is misdirected.

“My response to that is, ‘don’t be mad at the travel nurse, because you can do it too. And you’re mad at the wrong person. The fact that the hospital is underpaying you means you need to follow up with administration. Your anger should be towards your facility, not towards me.’”

With travel nursing, Gaines can take off as much time as she needs.

“I think that every nurse should take a couple months off a year,” she says. “Our job is very stressful and draining physically, emotionally, and spiritually, and we need that time off.”

She typically works for three months and then takes a month off. She says working nine months out of the year is the cure for her burnout.

Gaines has had more than 20 contracts all over the United States. She’s currently in Florida, a work destination she chose because she wanted someplace warm, in a city, and near the beach.

For her, every new travel nursing assignment is rewarding: “This is a new opportunity and a new experience with every single contract.”

The post How Travel Nursing Empowered One Nurse and Saved Her Career appeared first on Education and Career News.

As the closest clinicians to patients, direct care nurses (DCNs) are uniquely positioned to understand patients’ needs and initiate innovative solutions. But too often, DCNs do not feel empowered to use their expert knowledge to improve outcomes. In a top-down approach to change, front-line nurses may not be consulted, even though they may ultimately be held accountable for project implementation.

Recognizing the untapped power of DCNs, the American Association of Critical-Care Nurses (AACN) created AACN Clinical Scene Investigator (CSI) Academy, a nationwide program to instill greater confidence in nurses to lead change. Now in its tenth year, CSI Academy notes that 469 DCNs from 127 units representing 82 hospitals across the United States have participated in its 12-month project-driven program.

As the following examples demonstrate, when DCNs are empowered, patient health is markedly improved. In addition, participating health organizations have saved an estimated $84.2 million, with a 660% median return on investment per project.

Decreasing catheter-associated UTIs

The nursing staff at Denali Center in Fairbanks, AK, had provided feedback that the center’s current practices for catheter-associated urinary tract infections (UTIs) were not user-friendly, making it difficult to interpret requirements.

Three nurses — Aminat Alarape-Raji, Teresa Hrubes, and Sandy Plummer — completed a survey to identify practices and knowledge deficits related to the number of overall UTIs and asymptomatic UTIs being treated inappropriately.

After six months of educating the nursing staff and introducing a revised process, the UTI rate at Denali Center was reduced 49.3%, and the use of antibiotics for asymptomatic UTIs was reduced 44%. These outcomes resulted in an estimated annual fiscal savings of $124,137, and the CSI nurses are working to replicate the process for the center’s other protocols, including pneumonia and gastrointestinal and skin infections.

Improving early stroke detection

Tammy Dickinson, Celeste Hingle, Tara Porter, and Kathryn Smith, nurses at Ochsner Medical Center – North Shore in Slidell, LA, sought to decrease the number of rapid response calls for strokes and decrease the time of treatment from the onset of stroke symptoms.

The four CSI nurses worked closely with the hospital system’s integrated stroke team to host teaching events and share data. They held traveling “coffee and conversation” events, where they took a coffee cart to different units and offered guidance on how to assess for a stroke and what to do when a patient seems to be having a stroke. They introduced new stroke code verbiage at the hospital’s mandatory skills fair, calling it “Code Stroke.”

Through the use of Code Stroke, the appropriate staff treated patients and began stroke treatment more quickly. The team also observed a downward trend in the average length of stay. These outcomes resulted in an estimated annual fiscal savings of $146,250.

Reducing falls through better communication

At Massachusetts General Hospital in Boston, MA, personal care assistants (PCAs) felt they didn’t have enough information to take optimal care of patients.

With the specific aim of decreasing patient falls and hospital-acquired pressure injuries (HAPIs), three RNs — Lisa Bourgeois, Christina Carmody, and Katherine Guanci — collaborated with the PCAs to develop a “worklist” tool designed to communicate important information about tasks, safety concerns, and pertinent patient information. The night nurses fill out the worklist for the day shift. Next, the charge RNs huddle with the PCAs in the morning to review the patients and answer any questions.

Once the new tool was implemented, falls on the unit decreased 25% and HAPIs decreased 33%. The tool has already been shared with other units in the hospital, and the CSI team is working to implement more PCA-specific information into the electronic health record.

When DCNs have leadership skills and tools, protected project time, and organizational support, they provide better care for all of us. As the 10-year history of CSI Academy shows, growing and supporting DCNs’ innovation and leadership is a return on investment — a win-win for patients, nurses, and organizations.  

The post Meet the Nurses Driving Change in Their Units appeared first on Education and Career News.

Kathy Houle

Executive Director, Nephrology Nursing Certification Commission (NNCC)

Sandy Bodin

President, NNCC

Why is it important for nurses to get certifications?

• Certifications demonstrate a nurse’s commitment to growing competencies and enhancing their areas of specialty, expanding and strengthening opportunities for upward career mobility while also elevating a nurse’s confidence.
• Certifications — from medical-surgical nursing certifications to critical care certifications to nephrology nursing certifications and many more — elevate patient outcomes, institutional reputation, and, for the nurse, avenues to high career fulfillment.
• Certifications result in better job prospects by raising professional credibility, validating specialized practice knowledge, and proving a higher level of clinical competence, all of which can result in higher salary opportunities for competitive nurses.

What does the NNCC do to support certification pathways for nurses?

The Nephrology Nursing Certification Commission (NNCC) exists to establish credentialing mechanisms to promote patient safety and to improve the quality of care provided to nephrology patients.

• NNCC supports the philosophy that there should be a diversity of examinations that will effectively provide the opportunity for certification at various levels of education, experience, and areas of practice within nephrology nursing.
• It is the goal of NNCC to promote the highest standards of nephrology nursing practice through the development, implementation, and evaluation of all aspects of the certification and re-certification processes.
• The NNCC is national in scope and works collaboratively with professional nephrology organizations to promote, advertise, and implement certification examinations as well as to recognize certified individuals.

Nephrology nurses were at the front lines of patient care during the pandemic.

A high percentage of patients hospitalized with COVID-19 suffer from acute kidney injury because the virus damages blood flow to the kidneys and attacks the kidneys directly. Dialysis machines, artificial kidneys, and blood tubing supplies have been in short supply, necessitating innovation and flexibility by nephrology nurses.

Patients with chronic kidney disease and kidney failure on chronic dialysis are at increased risk for hospitalization due to COVID-19 because of their immunocompromised state.

Unfortunately, these patients with kidney disease were not prioritized to receive the COVID-19 vaccines when they were first released, despite their vulnerability and the likelihood of high mortality if they contract COVID-19. The strain on nephrology nurses was palpable.

At this time, opportunities for nurses practicing in nephrology are numerous and rewarding.  Nephrology patients range from newborns to the elderly, and nephrology nurses today work in many places, including clinics, hospitals, education, research, and the community. Through certification pathways, nephrology nurses can truly grow in this vital specialty — ready to serve during times of normalcy and times of crisis.

The Nephrology Nursing Certification Commission (NNCC) was established in 1987 to develop and implement certification examinations for nephrology nursing. Learn more by visiting https://www.nncc-exam.org.

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Natalie R. Baker, DNP, ANP-BC, GNP-BC, CNE, GS-C, FAANP, FAAN

President, Gerontological Advanced Practice Nurses Association (GAPNA)

Nurses caring for older adults have many career options and opportunities to directly influence patient care decisions for a population on the rise. In fact, adults aged 65 and older comprise the fastest growing patient population and have varied healthcare needs across multiple healthcare settings.

Gerontological nurses can decide to work in the hospital, clinics, home health, long-term care facilities, or any other location that delivers healthcare to older adults. Depending on the healthcare setting, the nurse may care for a 90-year-old living at home and playing golf daily or a 65-year-old hospitalized after a new diagnosis of heart failure.

Nursing facility care

An often-overlooked career option is caring for older adults residing in skilled nursing facilities, also known as nursing homes.

In the United States, approximately 1.4 million older adults receive care in 15,600 licensed nursing homes. The care requirements for residents admitted to nursing homes may range from short-term skilled nursing care for management of complex diagnoses such as unstable diabetes, or physical, occupational, and speech rehabilitation services after a stroke. Other residents admitted to the nursing home may require long-term custodial care or end-of-life services. The average stay in a nursing home is 485 days (about 16 months), allowing nurses the opportunity to form strong bonds with the older adult and their families.

Facing steep challenges

Already faced with difficulty attracting nurses into this care setting, a workforce crisis has emerged in nursing homes. Most nursing homes have difficulty competing with hospitals that are paying exorbitant salaries, resulting in fewer adequately trained gerontological nurses willing to work with this patient population. Nursing homes are in dire need of compassionate nurses who understand the complexity of this unique population, work well within an interprofessional healthcare team, and advocate on behalf of the resident.

The daily nursing demands in long-term care facilities are challenging. On a typical day, the nurse may discharge a resident home with the assistance of community resources or may provide emotional support to a family faced with making difficult decisions, including those at the end of life. It is uncommon for nurse practitioners or physicians to visit nursing homes daily, creating the need for autonomous nurses who understand subtle changes in older adults that may warrant a rapid change in their treatment plan. The nurses are the “eyes and ears” of the primary care providers; therefore, competence in physical assessment, pathophysiology, pharmacology, and early identification of a change in condition is vital.

Nurse practitioners

With a national shortage of geriatricians, there is a need for nurse practitioners trained in caring for this vulnerable population. Adult-gerontology nurse practitioners (AGNPs) complete graduate-level core and specialty courses designed to assess, manage, and treat acute and chronic illnesses across the continuum of care, including the care of frail older adults. An invaluable member of the healthcare team, AGNPs partner with gerontological nurses to provide patient-centered, evidence-based care.

Throughout my more than 35-year career, I have had the privilege of reading to patients who did not have the opportunity to attend school, listen to veterans tell war stories, hold the hand of a dying patient, and cry with family at funerals. I have also had the privilege of detecting a potentially fatal illness and advocating on behalf of a patient when the family was not accepting of a terminal illness. You may ask: why provide care to older adults? My answer is, why not? What is more honorable, more giving, and more rewarding than celebrating, through a continuity of care and advocacy of wellness, a life lived.

The post Why Be a Gerontological Nurse? The Honor of Older Adult Care appeared first on Education and Career News.

The comprehensive practice of telehealth nursing is one built upon a broad knowledge base of nursing and health sciences, and applies clinical expertise rooted in the nursing process.

According to the Assistant Secretary for Planning and Evaluation (ASPE) Office of Health Policy, telehealth use increased dramatically during the COVID-19 pandemic. One 2020 study found that telehealth use peaked in March and April 2020, increasing from less than 1% of healthcare visits to aMs high as 80% of visits in places where the pandemic prevalence was high — driving telehealth utilization to record high levels.

In fact, according to an ASPE analysis of telehealth trends during the pandemic, using data from the Census Bureau’s Household Pulse Survey (HPS) of more than 800,360 adults from across all 50 states and Washington, D.C., 1 in every 4 adults reported having an appointment with a healthcare professional by video or audio — with telehealth usage particularly elevated from April to October 2021.

During the pandemic, AAACN recognized the growing urgency for telehealth care and its impact on the association’s membership. AAACN’s Kathleen Martinez, MSN, RN, CPN, began her term as AAACN’s 2021-2022 president in April 2021 – the height of telehealth usage in the United States.

Kathleen Martinez, M.S.N., RN, CPN

President, American Academy of Ambulatory Care Nursing

The pandemic brought attention the need, and importance, of telehealth care. How are today’s ambulatory nurses responding to the rise in telehealth care pathways?

Telehealth and telephone triage have always been core competencies of ambulatory care nursing. As a matter of fact, telehealth has been in existence since the invention of the telephone. Traditionally, healthcare providers traveled to people’s home to deliver care. In the same spirit, ambulatory care nurses today meet people where life is lived: in schools, community centers, clinics, and their homes. For decades, ambulatory care nurses have used telecommunication and telehealth to reach individuals in these settings.

Think about it: if you were feeling ill, had limited transportation options, or lived in a rural location, how great would it be to talk to a highly trained, experienced healthcare professional from your home? Somewhere along the way we decided that it was a good idea to insist that sick, anxious, and physically challenged individuals should travel to healthcare facilities to receive care. It certainly made it easier for the care providers, but what about the patients we have committed to serve? What about the care of the patient?

What career opportunities and/or certification opportunities in telehealth care are there for those considering ambulatory care nursing as a career path?

Currently some ambulatory care nurses are working 100% remotely and providing telephone triage services. The options to use telehealth to promote wellness and limit illness are limitless. To name a few: primary care, palliative care, school health, pediatric and perinatal care, mental health, chronic diseases, nursing homes, childcare facilities, and all specialty care areas. The opportunities for extending care in rural communities are especially compelling. As rural areas are losing providers and critical care hospitals, individuals in these communities have access to world-class care through ambulatory care nursing-assisted telehealth visits with larger facilities.

Right now is an amazing time to launch a career in ambulatory care nursing. Although there is not a specific certification for telehealth nursing, ambulatory care nurses who provide telehealth nursing care to patients are required to possess knowledge and competencies in this area. For this reason, the Ambulatory Care Nursing Certification (RN-BC) is an excellent certification to validate expertise and is a great option for telehealth nurses. For those looking at building a career in ambulatory care nursing, telehealth nursing is exciting, challenging, and satisfying. There is no greater privilege than using our knowledge and compassion to assist another in achieving optimal health and wellness.

How did ambulatory care nurses navigate the surge to telehealth during the pandemic, and how are today’s ambulatory care nurses remaining resilient?

We have seen pain and we have endured loss. We have been tested in ways never anticipated and have responded with courage and ingenuity never imagined. During the pandemic, ambulatory care nurses were always present and available, providing information, education, recommendations, and direction in a time of misinformation, anxiety, and fear. As ambulatory care nurses, we are experts at care coordination, transition management, and telephone triage. These skills were paramount during the pandemic. While other specialties scrambled to redefine their profession within the limitations imposed by the quarantine and government regulations, ambulatory care nurses seamlessly navigated the chaos to ensure the health and safety of patients.

In the early days of the pandemic, many nurse-based telephone triage call centers saw their call volumes increase by thousands of calls per day. Nurses put in long hours and worked extra shifts while trying to sort out information and guidelines that were changing daily. Telephone triage is a complex skill where the nurse is required to assess a patient using only the phone.  Many ambulatory care nurse leaders were tapped to take on unprecedented telehealth projects.

Now, as we take a breath and prepare for our next adventures in delivering patient care, today’s community of ambulatory care nurses stand resilient as an enriched and caring community who is here to encourage, support, and cheer one another on as we continue to bring care to those who need us most. 

The post Today’s Telehealth Nursing: Patient Care When, Where, and How They Need It appeared first on Education and Career News.

Kristin Larson, M.S.N., RN, AGNP-BC

National Secretary, American Nephrology Nurses Association (ANNA)

A typical day as a nephrology nurse includes preparing the patients for dialysis treatments, monitoring and assessing patients, providing information, teaching, and discharging patients home. Because of this level of responsibility, nephrology nurses have a solid understanding of physiology, fluid balance, hemodynamics, and psychosocial needs of persons requiring kidney care.

Kidney disease education

As forward-thinking advocates for their patients, nephrology nurses look beyond free-standing hemodialysis and educate patients to consider hemodialysis or peritoneal treatments in the home, or kidney transplantation.

This encouragement ties into the executive directive of 2019, Advancing American Kidney Health, which aims to improve kidney disease prevention, diagnoses, and treatment; promote home dialysis therapies as a management option; and increase the number of kidney transplants. The proposal requires that nephrology nurses play a more prominent role in the public platform by educating persons with and without kidney disease and, if needed, to prepare persons for in-home dialysis or transplantation.

Diabetes and hypertension

The epidemics of diabetes and hypertension are the leading cause of kidney disease and failure. The number of persons who will develop kidney issues because of these diseases is sobering and not expected to decrease as time goes forward.

Despite nephrology nurses educating patients in the early stages of kidney disease about behavior changes and preventative measures, if kidneys progress to complete failure, nephrology nurses are at the forefront of caring for the patients and their families. The family and immediate social support (or lack thereof) sets the starting point for education and advocacy. Successful nursing care engages the patient requiring kidney care where they are at that moment and is reinforced through a team of professionals dedicated to the patient. These nephrology nursing roles require highly skilled nurses that act in an autonomous manner.

Dialysis clinics

The appeal for a new graduate nurse or experienced medical-surgical nurse to practice in a dialysis clinic would be the intense immersion in the process of dialysis, the mechanics of the equipment, and how the body responds to the treatment. Nephrology nurses react quickly to changes in the patient’s physiology during dialysis by altering the mechanics of the hemodialysis machine to keep their patient safe. Care of a person receiving hemodialysis will literally get your blood pumping, as well as your patient’s blood through their machine. The payoff for a successful hemodialysis treatment is sending the patient home to continue their life which would otherwise be shortened without this treatment and care. Because persons can receive dialysis treatments for years, lifelong relationships with patients and their nurses are created. No two persons receiving dialysis are the same, and no two working days are the same. Beyond the dialysis clinic, a nephrology nurse collaborates with nurses on the kidney transplant team, another role for nephrology nurses.

Together, the nephrology nurse and the kidney transplant team partner for success in the patient attempting kidney transplant by completing all the pre-transplant criteria and supporting transplant education. The patient will need an understanding of the elements required for placement on the transplant list, the possibility of a wait period for a kidney donor, and an acceptance of the new lifestyle that will be required for the success of the transplanted kidney. Along with the transplant team, nephrology nurses are the coach and anchor that reenforce education and hope.

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