Holistic nursing moves into mainstream
Although “new age” sounding, holistic nursing in fact harkens back to Florence Nightengale, who strongly advocate a clinical approach that viewed unity, wellness and the interrelationship of patients and their environment. Today, holistic nurses continue that credo, defining their profession as “nursing practice that has healing the whole person as its goal”. According to the American Holistic Nurses’ Association (AHNA), their members consider the relationship of body, mind, emotion, spirit, social/cultural, relationships and environment in creating a therapeutic plan. Holistic nurses can integrate complementary and alternative modalities (CAM) to broaden the scope of their nursing practice.
The growing interest in alternative and holistic medicine has brought it into the mainstream. The specialty area is recognized by the American Nurses Association (ANA). Because of this, you will find holistic nurses practicing in the usual environments: universities, private practice, long-term care facilities, home-care groups, physician’s offices, outpatient surgeries and integrative clinics. There are three levels of certification: Holistic Nurse, Board Certified (HN-BC); Holistic Baccalaureate Nurse, Board Certified (HNB-BC); and Advanced Holistic Nurse, Board Certified (AHN-BC). For more information on certification and endorsed education programs, go to the American Nurses’ Holistic Certification Corporation.
Palliative Care Nurses Support Patients and Family Through End of Life
The most often quoted reason that nurses have for choosing the profession is “to make a difference”. The scene that most often comes to mind is one of nurses helping patients toward a healthful conclusion. However, one special segment of nursing provides critical clinical and emotional support to patients during their final phase of life.
Palliative care and hospice nurses assess the needs of the terminally ill patient and provide a care plan that enables a dignified death. In this area of practice, perhaps more than any other area of nursing, the family is a part of the nursing concern. In addition to managing the complex clinical needs of terminal patients, the palliative care nurse must help the patient and family process the complex emotions that accompany grief and bereavement. Nurses provide important education, informing patients and families about the hospice/palliative care philosophy and care options. In addition, nurses must support patients and their families in conversations relating to end of life decisions.
The emotional demands on palliative care and hospice nurses are sometimes overwhelming. Training for this specialty area includes learning teaching nurses how to manage their own grief and emotional stress. Professional organizations such as the Hospice and Palliative Nurses Association provide such support in addition to certification and continuing education.
Flight nurses provide critical care amid the clouds
Whether you live in big city, or in a rural town, you have probably seen an emergency medivac helicopter in the skies above you. These ambulances of the sky transport critically ill patients every day. Accompanying each flight is a specially trained flight nurse who coordinates patient care with physicians and hospital staff while at the same time collaborating with the flight team of the helicopter or airplane used for transport.
Flight nurses are required to have extensive training in trauma and pre-hospital trauma care. According to the Air & Surface Transport Nurses Association, flight nurses should have the following minimum training and certification:
- License as a registered nurse in the respective State of practice
- 2-3 year’s critical care/emergency experience or applicable acute care nursing environment
- BCLS – Basic Cardiac Life Support
- ACLS – Advanced Cardiac Life Support Certificate
- PALS – Pediatric Advanced Life Support Certificate
- NRP – Neonatal Resuscitation Program
- A nationally recognized trauma program such as TNATC (Transport Nurse Advanced Trauma Course (TNATC), BTLS (Basic Trauma Life Support), PHTLS (Pre-hospital Trauma Life Support), TNCC (Trauma Nurse Core Curriculum)
- Certifications such as Certified Flight Registered Nurse (CFRN), Critical Care Registered Nurse (CCRN), Certified Emergency Nurse (CEN) may be required within six months to one year of hire
In addition, many states require Emergency Medical Technician (EMT) certification. Flight nurses can work for medical air transportation companies, hospitals, corporations and airlines.
Certified Nursing Assistants are the first line of patient care
A Certified Nursing Assistant (CNA) is at the frontline of patient care in hospitals, clinics and long term care facilities. A CNA can also provide critical patient observation, reporting findings to an RN or LPN.
CNAs help patients perform basic day-to-day tasks, including
- Dressing
- Bathing
- Feeding
- Making beds
- Toilet Assistance; catheter care
- Taking vital signs (Blood pressure, pulse, etc)
- Helping patients walk
- Assisting with range-of-motion exercises
- Helping wheelchair-bound patients (entails heavy lifting)
- Turning bedridden patients regularly
CNAs are required to document their work and observations in patient charts. They are also required to have knowledge of safety and emergency procedures, including CPR and Basic Life Support (BLS). With staffing shortages, CNAs may be required to care for as many as 12 patients at a time. The physical demands of the job lead to a high turnover and burn out rate. However, many CNAs are able to use their experience as an entry point for a successful nursing career.
Growing demand means job security and expanded opportunity for Certified Nursing Assistants
Even though there are currently more than one and a half million Certified Nursing Assistants (CNA) in the U.S., demand for these allied health workers is expected to grow by another 500,000 by 2014, according to the U.S. Bureau of Labor Statistics (BLS)
Growth in the health care sector, an aging population, and cost containment are all factors favoring a growth in demand for CNAs. A large number of CNAs are employed in long term care facilities. Technological expansion in the health care field is creating openings for CNAs to operate equipment in physician’s offices and outpatient clinics. With growing pressure to contain costs, direct patient care is shifting from RNs and LPNs to CNAs.
The median hourly pay for CNAs was $9.59, with the better wages going to CNAs who worked in schools, and government. Those who work for contract employment agencies, and who work nights and weekend shifts also earn higher than average wages. Training programs, which last for two to four weeks, are available at community colleges and sometimes through employers
Aging Population Translates into Greater Demand for LPNs
Aging Baby Boomers are creating a better than average job outlook for Licensed Practical Nurses (LPNs), especially in areas that provide services to geriatric patients. Another reason cited for the increased demand in LPNs is the use of technology in the performance of many procedures. Procedures once performed in hospitals are now being done in physician’s offices or outpatient clinics. LPNs are needed to perform or assist in these procedures.
According to the Federal Bureau of Labor Statistics, the demand for will grow by 21% by 2018. Currently there are approximately 800,000 LPN jobs. Twenty-five percent of those are in hospitals, 28 percent in nursing care facilities and 12 percent are in physician offices. The remaining jobs are in home health care, employment services, residential care facilities, outpatient care centers and government agencies. As of 2008, the median annual wage of licensed practical and licensed vocational nurses was $39,030. With annual salaries at $44,690, practical nurses working for employment services had the highest wage. LPNs working in physicians’ offices came in below the average wage, earning an average of $35,020
PA/ARNP Take Two of Top Five Career Slots
PA/ARNP Take Two of Top Five Career Slots
Reflecting the growing need for primary care providers, physician’s assistants and nurse practitioners took two of the top five slots in a CNN/Money survey of the best careers. Physicians Assistants (PA) came in second (behind Systems Engineers), with Advance Registered Nurse Practitioners (ARNP) holding the #4 slot.
Both careers offer a cost effective alternative as primary care givers. Both professionals can do routine exams, patient assessment, diagnosing and prescribe medicine. Training is less extensive and expensive than for physicians. PAs must obtain a masters degree to be certified, then complete 100 hours of continuing education to be recertified every two years. ARNPs must complete requirements to become a registered nurse, then obtain a masters degree and be certified. Requirements for ARNPs are expanding, with many positions requiring a doctoral degree.
Salaries in the two fields are comparable. The U.S. Bureau of Labor Statistics reports that the median wage for PAs in 2008 was $81, 230, while the median wage for ARNP was $83,293.
Take ‘em off
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Have a Career as a Legal Nurse Consultant
Career as a Legal Nurse Consultant
Overview
Legal Nurse Consultants work with attorney, paralegals to advise them of any medical issues which impact may impact case law. The educational and clinical backgrounds that legal nurse consultants bring to their work permit them to analyze complex medical issues and render expert opinions. Legal nurse consultants assist attorneys with cases involving medical malpractice, toxic torts, personal injury, and criminal defense.
Job Responsibilities
- Evaluate new cases to see if they merit further action.
- Interview medical experts.
- Serve as liaison between law firms and medical experts
- Research case law and medical journals for relevant precedents and formulate theories.
- Evaluation of plaintiff medical records.
- Preparation of medical diagrams and charts.
- Serve as expert witnesses, testifying at trials and hearings.
Education, Skills, Work Setting
Legal nurse consultants need to be licensed registered nurses with a minimum of five years experience in any specialty area. Most legal nurse consultants hold a bachelor’s degree with some having an advanced degree. Most legal nurse consultants enter the field after having taken some coursework in the field.
Those seeking as a legal nurse consultant should have strong communication and organizational skills, a firm understanding of legal terminology, along with solid research ability.
About 50% of legal nurse consultants work in private practice law firms with the other half working as independent consultants.
Salary
Legal nurse consultants working in law firms earn less than those who work independently with an hourly billing rate of between $60-$100 and an average annual income of $50,000-$75,000. The billing rates of independent consultants range between $65.-$200. per hour depending on the scope of the project and medical specialty. Those who serve as expert witnesses charge rates between $150-$200 per hour.
Job Outlook
According to CareerBuidler.com, there will be a continuing need for legal nurse consultants due to the number of litigation cases involving complex medical issues.
Nursing Case Management Careers
RN Case Management
RN case managers organize and administer patient health care needs on behalf of insurance companies. They create long-term care plans to ensure the continuing health and well-being of claimants.
RN Case Management Entry Requirements
Registered nurse case management may be a great career option for those already in the nursing profession seeking a fun and challenging new role. It is also one of the most lucrative nursing careers available. Entry requirements include:
- Candidates need to be a licensed RN and participate in continuing education (specific educational requirements vary by state so check with your State Board of Education.)
- The best-paying case management jobs will usually require a Master’s degree, along with several years experience as an RN. Experience in a home healthcare setting can lead to a higher starting salary.
RN Case Manager Job Responsibilities:
A career as an RN case manager offers substantial autonomy. Specific duties include:
- Case managers often work from home and spend a good amount of time in the field visiting patient homes performing routine physical examinations. They are able to arrange appointments that best fit with their schedule.
- The often act as intermediaries between doctors and the insurance company resolving claim disputes.
Salary Considerations.
Many of the highest salaries in the nursing profession are paid to RN Case Managers who work in the insurance industry. According to a survey conducted the Case Management Society of America, 40% of those who responded earned between $55,000 and $65,000 annually. When other factors such as advanced degrees, special training, experience, and geographic location are added in, these nursing jobs may be the best paying in the entire healthcare industry! Combine this lucrative salary with bonuses, benefits, and flexible scheduling and you have a career that seems a great alternative to traditional nursing.
