How many friends do you have on Facebook? Not only can you friend someone now, you can actually share your decision, or not, to be an organ donor in the event of your death. This social media connection will also allow you to be aware of the wishes of your family members and friends.

The Need for Organ Donation

Currently, there are close to 114, 000 adults and children awaiting an organ transplant, according to Donate Life America. This organization works to increase the number of registered organ donors. An astounding 18 people die everyday while awaiting an organ transplant.

The general consensus is that most people understand that organ donation is a good thing to do and actually want to donate but have not officially registered, for many different reasons.

Are There Many Registered Organ Donors?

Many states provide the vehicle to register as an organ donor through the Registry of Motor Vehicles. A person’s wish to be a donor can be documented on their driver’s license. Only 43% of U.S. adults are registered organ donors.

The flip side of that number is that there are 900 million Facebook users who can share their wishes on their Timeline.

The Reasons Behind the Cause

Facebook stated that the organ donation option is an example of using the social media site to build tools that help people transform the way we all solve worldwide social problems.

Facebook founder, Mark Zuckerberg, cited several reasons behind this organ donation initiative:

• The idea was inspired by the natural disasters, in the U.S. and abroad, which have literally torn families apart. Facebook has been instrumental in keeping people connected. Zuckerberg figured if the social media site can help in those situations, it could help all those who need organ donations.
• Having a medical student girlfriend has exposed Zuckerberg to real life stories about the trials and tribulations of organ donation.
• Zuckerberg’s interactions and friendship with Steve Jobs, the founder of Apple who had a liver transplant in 2009, influenced his idea to develop the Facebook option.

The Particulars

The Facebook organ donation option is not a registration site. It is a forum to share a person’s final wishes with family and friends. Before participating on the Facebook page, the donor must be signed up with a state organ donor registry. Facebook does provide a link to register.

Here is how to participate on your Facebook page:

• Go to your Timeline.
• Find the Life Event option on the status update and click.
• Click on Health and Wellness and then click Organ Donor.
• Complete the information for your Timeline and share a related story, if desired.
• Confirm who can see your addition (Public, Friends or Custom) and Save.

The Reaction

The Gift of Life Donor Program made a statement that, “This has the potential to be one of the biggest campaigns to increase donor designation that we’ve ever seen.”

According to news reports after the launch:

There has been a significant uptick in people registered to be organ donors since the launch of Facebook’s public appeal. According to the Boston Herald, the day after the launch, 500 Massachusetts residents registered to be organ donors on the Donate Life New England site on the next day, versus the usual 50 per day registration.

The chief of transplantation surgery at the University of Michigan at Ann Arbor, astutely summed up the Facebook organ donor option, “There’s no downside to spreading the awareness and encouraging people to make a commitment.”

So, you are admitted to the hospital and your primary care physician (PCP) does not participate in your day-to-day care. Who is in charge of coordinating your care? The answer is simple: a hospitalist.

The term, hospitalist, was first used by the New England Journal of Medicine in 1996 when there were a few hundred physicians practicing in this category. There are currently thousands of hospitalists in this rapidly growing specialty.

The Need for This Role

As physicians work to increase their patient base, it is difficult to efficiently and effectively manage both the outpatient and inpatient portions of a medical practice. Hence, hospitalists came into play to cover the inpatient side.

In 2003, the Accreditation Council for Graduate Medical Education (ACGME), which is the board that oversees medical residency programs, made significant changes in the hours residents are allowed to work. This dramatically impacted the inpatient unit coverage by medical staff and hands-on patient management.

Hospitalist Defined

This physician is a specialist in inpatient medicine who cares for hospitalized patients. They practice clinical management in all areas of a hospitalized patient’s healthcare.

Most hospitalists are board certified in internal medicine but can have a base in other medical specialties. Some physicians choose to take on this role right out of medical school while others choose to pursue it after having been in private practice for a number of years.

Hospitalist Duties

• This board certified physician is charged with the responsibility of providing full medical care and follow-up for hospitalized patients. A hospitalist acts as the primary care doctor while a patient is hospitalized.
• This physician is available to the patient 24/7 to deliver clinical care.
• A hospitalist is responsible for the coordination of all aspects of clinical care: admission, diagnosis, treatment, evaluation, procedures, teaching and discharge.
• Communication with the PCP is an important responsibility that befalls the hospitalist.

Advantages of a Hospitalist

• These specialists are readily accessible to the patient and family members at any time of the day or night.
• Without dealing with office hour restrictions, hospitalists can deliver prompt results from diagnostic testing.

Disadvantages of a Hospitalist

• There is a potential lack of continuity of care since this MD has not previously been involved in patient’s medical care.
• The hospitalist is not as aware of the details of the patient’s medical history as the PCP.
• Patients experience a decreased personalized relationship with primary care physician.

Next time you or a family member is admitted to the hospital, it will probably be a well-qualified hospitalist who manages your healthcare. You will be in good hands.

Primary care physicians (PCP) are in high demand. Patient needs are rising and the PCP shortage is worsening. These multifaceted MDs are the “go-to” person for preventive and maintenance healthcare. They are critical players in the overall health care system.

Primary care physicians fall under the auspice of many titles: family doctor, general practitioner, pediatrician, internist, and family physician just to name a few.

The Statistics

According to the Harvard Medical School Center for Primary Care, only 2% of medical students are interested in primary care medicine. Since 1997, the number of medical students choosing primary care medicine has dropped by 51.8%. By 2020, the American Academy of Family Physicians (AAFP) predicts there will be 40,000 primary care doctors to serve the 78 million baby boomers in the U.S. The population of baby boomers, born form 1946 to 1964, constitutes a large portion of the patients who benefit from preventive and attentive healthcare as they begin to age and their health needs rise.

Primary Care Responsibilities

A PCP sees patients for preventive care, counseling and acute medical issues that arise. Traditionally, a primary care physician has a long-standing patient base, many of whom he/she has cared for over the span of many years. They have spent many hours together dealing with healthcare issues but also discussing personal concerns and developing a relationship. That was then, this is now…

PCPs are over-scheduled and rushed for time, everyday. Appointments are hard to schedule. Wait times have dramatically increased to as long as 3 months for a routine appointment. They see more patients in less time than in years past. There is no longer extra time to chat during an appointment. There is only time to address the issues listed on that wrinkled piece of notepaper most patients carry to their appointment listing their questions and concerns.

Seeing patients in their primary practice is not the only duty of a PCP. They also spend time answering correspondence, seeing inpatients, completing managed care referrals, and much more.

Why the Shortage of PCPs?

Unfortunately, it all comes down to money, in most cases. Medicare and private insurers reimburse physicians based upon the number of procedures they perform so specialists are well compensated. Family physicians argue that they are not reimbursed for talking to a patient about smoking cessation or weight management, both of which are as important as a tangible medical or surgical procedure.

Many medical students graduate from medical school with substantial debt, some in the vicinity of $200,000. A primary care physician’s salary averages $120,000 to $190,000 a year while a specialist earns more than double that salary. This is a conservative estimate according to many estimates. You do the math. Choosing a specialty becomes very attractive.

The Solution Isn’t Easy

There are many ideas circulating among the general populace and the Congress about how best to solve this growing healthcare crisis. Here are a few of the ideas:

• Pay primary care doctors more money. While this sounds like the simplest and most practical solution, no one wants to increase already outrageous healthcare costs.
• Add more nurse practitioners and physician assistants to medical practices to deliver routine care to patients. They would involve the PCP in a case, if a complex issue developed. A variation of this model is currently practiced at large healthcare facilities like Mayo, Cleveland and Lahey Clinics. This model is called an “integrated group practice” and is overseen by a physician or team captain. A recurring problem continues with staffing this practice: many nurses, nurse practitioners and physicians assistants have also chosen to work in a medical specialty, not in general medicine.
• A creative trend, called the Maine Track, is offered at Tufts University School of Medicine. Medical students who agree to fulfill their undergraduate training by staffing medical facilities in rural Maine are awarded a $25,000 a year scholarship. The downside: they are not obliged to become primary care physicians upon graduation. More programs like this are being evaluated.
• The government is evaluating the expansion of a program called the National Health Service Corps. This program helps to pay back student loans and offers scholarships and stipends if a medical student commits to working in a rural location for several years after graduation.

There is no easy fix for the current and expanding primary care shortage. Medical schools, government and the passion of a certain population of potential medical students need to work in unison to find the best way to provide the best care for the general public in a cost-effective way.

Do you have your next appointment with your PCP scheduled? If not, you had better get working on it. There will be a wait…

Watch out! Ticks are everywhere and they are nasty. These creepy little creatures often carry Lyme disease, which is a very serious type of bacterial infection. Depending upon the type of tick, the season, your geographic location and how long the tick has been attached to the skin, the risk of developing Lyme disease varies substantially.

Basic Information About Ticks

Deer ticks are the culprits that carry Lyme disease. They are brown in color and the size of a poppy seed or pencil point.

Important point: Ticks can only transmit the disease after they have attached to the host and fed on a blood for more than 36 hours. Ticks do not usually start feeding until they have been attached to the skin for 24 hours.

How to Remove a Tick

Most importantly, remove the tick immediately. Do this before calling your primary care physician. Here are step-by-step instructions:

• Grasp the tick as close to the surface of the skin as possible with fine pointed tweezers.
• Pull back gently but firmly to remove the tick. Do not twist, crush or squeeze it.
• Leave any small tick parts in the skin if they were not removed with the body. They will fall out on their own. Attempting to remove them will further traumatize the skin.
• Wash hands thoroughly after removing.

Now What?

Helpful information to share with the physician is: the size of the tick, whether it was securely attached to the skin and for how long a period of time and if it was full of blood or engorged when removed.

Taking into account the above information, there are two suggested courses of treatment if a patient encounters a deer tick.

1. Watch the area and treat only if signs of infection develop.
2. Treat the patient immediately with a prophylactic antibiotic.

Blood testing for Lyme disease will not produce positive results until two to six weeks after being bitten.

Prophylactic Antibiotics

If the antibiotic route is chosen, it must be started within 72 hours of tick removal. The Infectious Diseases Society of America (IDSA) recommends:

• Doxycycline 200 mg for adults, in a single dose
• Doxycycline 4 mg/kg, up to 200 mg for children > 8 years of age, in a single dose.

If the patient has an allergy to Doxycycline, the IDSA does not recommend using an alternate antibiotic. A longer course of antibiotics is the recommended treatment should the patient actually develop Lyme disease.

Watching the Area

If the watch and wait route is chosen, it is important to observe the bite area for signs of expanding redness. The classic rash of Lyme disease is called erythema migrans (EM) and has the following characteristics:

• Develops within one week of the tick bite but can occur up to one month later.
• Salmon color, not red.
• Uniform in color at the onset.
• Can expand up to 8 inches (20 cm) in diameter. As it expands, the center of the rash looks lighter in color as a bull’s eye appearance of concentric rings develops.

Lyme Disease Alert

Deer ticks carry the bacterium (Borrelia burgdorferi) that causes Lyme disease. The bacteria only becomes active after being exposed to the warm blood of the host when it enters the tick’s gut. The active bacteria enter the tick’s salivary gland and are then salivated into the host’s wound. And then… Bang! The infection is transferred to the host.

The geographical areas with an abundance of deer ticks are the Northeast and mid-Atlantic region, from Maine to Virginia, and the Midwest, especially Minnesota and Wisconsin.

The risk of developing Lyme disease is low, 1.2 to 1.4%, even if you come in contact with an infected tick.

Did you ever wear a nursing cap? Until the 1980s, the crisp white nursing cap represented several traditions to the wearer, the patient and the other professional staff members. Then, things changed.

History of the Cap

Florence Nightingale was the organizer of modern nursing at the time of the Crimean War in 1854. She encouraged nurses — who were typically women — to dress professionally by wearing a modest uniform (usually an ankle-length dress made from wool) complete with an apron and a cap. This was the beginning of what we recognize as the modern nursing cap.

The nursing cap style has evolved over the course of time. Originally, it mimicked a nun’s habit as a tribute to them for being the first nurses. The first caps were also veil-like in design so as to cover the nurse’s hair and keep things sanitary.

During the modern era, caps became much smaller. Most nurses wore their hair in a tight bun under the caps, again, for sanitary reasons.

Eventually, males joined the nursing workforce and did not wear caps. Also, concern started to grow the about caps being germ carriers. Slowly, the nursing cap disappeared from sight. Today, many people say that unisex scrubs have replaced the traditional nursing cap and uniform.

Capping Ceremony

For many years, the capping ceremony during a nurse’s training was a true program highlight, as well as an honor. Receiving a cap was a right of passage and represented completion of a certain milestone in the educational program.

The capping ceremony was often conducted in a church with family members and friends in attendance to witness the tradition. Nursing faculty usually presented the cap to the recipient but some schools chose to have a senior student present it.

Most programs awarded an all-white cap to the student nurse. Upon graduation, a black stripe was added, indicating successful completion of the program. Registered nurses always wore a black stripe. Some nursing schools chose to give different color stripes to their students as they completed a certain level of the program; gray, red and blue were popular choices. Upon graduation, the black stripe replaced any preceding colors.

Current Opinion

• Advantages: The main advantage of wearing a nursing cap is to easily identify the role of the caregiver. The cap has been a universal symbol of nursing for centuries.
• Disadvantages: Wearing a cap is now considered to be a carrier of bacteria from patient to patient. This is similar to the recent theory behind male physicians wearing a tie, bending over a patient bed and moving on to the next patient. It is thought that a tie carries germs between patients.

Where Does it Go From Here?

Interestingly, a cardiac step-down unit staff in Florida decided to go back to their roots and wear nursing caps for eight weeks. Their goal was to increase patient satisfaction. The positive reaction to their study was remarkable. While the final decision was not to wear caps everyday, they did decide to change their dress code. Nurses at this Florida facility, in an effort to be easily identified by patients and other staff members, now wear only white scrubs or uniforms.

The bottom line: “Professionalism comes from within, not from a cap.” However, patients do appreciate the long-held tradition of a nursing cap and the dignity that accompanies it. The nursing cap will always be the universal symbol of the nursing profession.

Is it worth the dues to join a professional nursing organization? Well, that’s up to you. There are a multitude of positive reasons to join up with one but you must first decide which organization best suits your professional needs and expectations.

A Variety of Choices

There are “general” nursing organizations like the American Nurses Association (ANA) and also many specialty organizations that are focused on one particular medical discipline. The specialty groups range from Occupational Health to PeriAnesthesia and everything in between. Check out this link to review the various state, national and international nursing organizations available for membership.

It’s your personal choice which type of professional organization you join, but there are benefits to joining both a “general” organization and a specialty-specific one. Here are a few:

Benefits of Joining

• Website Access: Most organizations offer a two-part website, one providing general information and one with restricted access for members only. The restricted access member’s site serves as an important source of relevant offers, news and information.
• Education: Nurses never stop learning. Professional groups provide access to educational sessions and continuing education (CEU) programs, both live and online. These are often offered at a reduced rate for members.
• Certification: Beyond their basic knowledge base, many professional nursing organizations offer certification in specialty fields. Choosing to be certified demonstrates a commitment to excellence in your nursing practice. The accreditation process usually entails a variety of educational mandates and successful completion of a certification test. It also might earn you a salary increase.
• Networking: Depending upon your level of involvement in local, state and/or national medical fields, the professional connections you can make through a nursing organization are limitless. If regularly attending meetings does not fit into your schedule, many groups offer online chats for their members to connect with peers and colleagues.
• Job Search: Many groups offer career assistance by listing job openings on their website, usually on the members-only section. They also provide an abundance of relevant information about current salary range and benefits of which you should be aware.

Now that You’ve Joined

Perhaps you decided to write the check for the dues, now what? Your level of involvement in the organization is up to you. The more you participate, the more you will benefit. Try these tips:

• Be active. Attend meetings.
• Join a committee or run for office within the organization.
• Volunteer to work on a special project or educational presentation.
• Stay in touch with the members. Call a peer to discuss an issue you are dealing with in your workplace for a different point of view.

Joining a professional nursing organization offers the opportunity to grow personally and professionally. Membership will offer you the tools and information needed to understand the important healthcare issues facing society, as well as hone in on the trends in your medical specialty.

The health topic of the week is a simple but important one: heart transplantation and the issues that accompany this life-saving surgery. Former Vice President Dick Cheney recently underwent this surgery after his name was on a national waiting list for 20-months. So what’s all the buzz about?

Here are a few basic facts:

• The first heart transplant was performed in 1967.
• 5,000 heart transplants are performed worldwide every year; 2,000 are done in the United States.
• 3,100 patients in the U.S. are currently awaiting a heart transplant.

Who Qualifies for a Heart transplant?

A patient who suffers from end-stage heart failure and no longer responds to traditional treatments is considered for the surgery. The candidate is a person whom physicians declare will die without the transplant. They can have no other serious health issues in order to qualify for the national wait list.

Wait List and Surgery Qualifications

There is a national wait list, the United Network for Organ Sharing (UNOS), which regulates the candidates awaiting organ transplant. Patients do not receive a new heart on a first-come-first-served basis. The decision regarding who gets the next available heart is based on the best blood type match, body size and each patient’s current medical status.

There is no legal age limit for a heart transplant recipient. Patients over 70 years of age occasionally receive a heart transplant and, according to the statistics, they do just as well as younger recipients. UNOS reports that 332 patients over 65 years old received heart transplants last year. Age ultimately factors into the equation because as a potential candidate ages, they can develop other disqualifying medical issues.

The national list is ever changing. Patients’ names are added and deleted if their cardiac status changes or they develop another unrelated medical condition, such as cancer. A patient usually waits an average of 6 to 12 months for a new heart. Many patients die annually, while awaiting the call.

The Donor

The donor is a person, 18 to 65 years old, who has agreed to do so. They must have no history of heart disease and not suffered any serious chest injury. A donor is a person who has recently died or been declared brain dead, often involved in a car accident or suffering a serious head injury. While the donor has previously signed an organ donor agreement, permission from family members is usually required at the time of death. Parents can agree to donate a minor child’s organs at the time of their death.

The Surgery

Once a donor heart is harvested and prepared, the transplant surgery takes 4 to 10 hours to complete. Patients are dependent on a heart-lung machine during the surgery as the new heart and vessels are connected and checked for any leaks. Recovery from a heart transplant is similar any other open-heart surgery.

Post-operative Life

Patients are hospitalized for 1 to 2 weeks post-operatively. They participate in a long-term cardiac rehabilitation program as they begin to transition back into an active lifestyle. Recipients must take immunosuppressant medication, like cyclosporine, for the rest of their life to prevent organ rejection. These crucial drugs carry an increased risk for infection and possible cancer. Patients undergo cardiac biopsies every 3 to 4 months after the transplant to check for organ rejection; this is done through cardiac catheterization. There are also regular echocardiograms, blood tests and electrocardiograms (EKG) performed.

The hope is that the recipient will lead an active life. After rehabilitation, the goal is for the recipient to feel better than before their transplant.

The Odds

The National Institutes of Health reports that 75% of recipients live at least 5 years after a heart transplant and 56% survive for at least 10 years.

Organ Donation

The generous gift of organ donation can help improve the quality of life or save the life of a number of recipients.

Vitamin D is essential for our health and well-being. Sunlight is a strong source of vitamin D, but new research reports that it is not sufficient to meet our body’s vitamin D requirement. The study, reported by Dr. Richard Gallo, chief of dermatology and professor of medicine and pediatrics at the University of California, San Diego, states that, “nutritional sources [of vitamin D] are clearly required.”

What is the Problem?

Dr. Gallo reported that vitamin D is “absolutely necessary” for bone health. It is also proven to protect against heart disease, cancer, infection, osteoporosis and many other conditions.

Universal screening of vitamin D blood levels is recommended by many physicians. The Institute of Medicine sets the serum level at 20mg/ml, while the American Endocrine Society suggests 30 mg/ml as the standard. High-risk patients for a vitamin D deficiency include dark-skinned, pregnant, lactating, elderly and obese patients. Patients diagnosed with chronic kidney disease, lymphoma, and osteoporosis should also be screened.

Patients with a borderline low, 15 mg/ml, vitamin D blood level are advised to start supplemental vitamin D and be re-screened in 3 to 6 months.

Medical Conditions Influenced by Vitamin D

There are many medical conditions that can, potentially, be prevented and treated by vitamin D supplements. This is a partial list:

• Osteoporosis
• Diabetes
• Muscle weakness
• Rheumatoid arthritis
• Cardiovascular conditions like high cholesterol and high blood pressure
• Tooth and periodontal disease
• Psoriasis; treated with a topical form of vitamin D called calcitriol or calcipotriene

Vitamin D works by controlling calcium and phosphorus absorption in the body.

Vitamin D Sources

The aforementioned study reports that sun exposure is not sufficient enough to normalize a vitamin D deficiency. Vitamin supplements, awareness and consumption of foods rich in vitamin D can help maintain an adequate level in a person’s body. Some foods that contain small amounts of vitamin D are:

• Fatty fish like halibut, mackerel, herring, sardines and tuna
• Vitamin D fortified dairy products, juices and breakfast cereals
• Mushrooms

The recommended daily allowance (RDA) of vitamin D published by the Institute of Medicine is 600 IU daily for the greater population of the United States, including pregnant and lactating women. Older adults, over 71 years old, should consume 800 IU daily and infants, newborn to 12 months old, require slightly less at 400 IU daily.

Good old sunshine does provide vitamin D. The recommended sunlight exposure time includes hand, face, arm and leg exposure two to three times a week. It takes about 25% of the time in which you would develop a mild sunburn for adequate vitamin D absorption to occur. Six days of casual sunlight is said to provide coverage for 49 days of no sun exposure. Vitamin D is stored in our body fat.

Absorption of this important vitamin varies based on age, skin type, season of the year and time of day. It is especially important for elderly patients to be monitored for several reasons. They spend less time outside, their body fat percentage is usually lower so storage is challenging and aging kidney function makes it more difficult to convert vitamin D into a workable form when needed.

The End Result

Dermatologists, according to Dr. Richard Gallo and the American Academy of Dermatology, “Can be confident in insisting that their patients continue their sun protection efforts.” Vitamin D absorption from sunlight is unpredictable so the bottom line is, take a vitamin supplement and eat foods rich in vitamin D.

As the general patient population changes, primarily as result of advanced aging, healthcare needs to also change. As healthcare changes, so do the places where the vast majority of nurses are employed. Such circumstances do not occur overnight, but rather they slowly evolve and begin to develop as a trend.

In addition to the changing patient population, the federal government’s health care reform will dramatically impact the 2.7 million nurses working in the United States. With a key component of the reform targeting lower reimbursement for medical facilities, there will be fewer patients in the hospital–only the critically ill will be inpatients.

So, where will nurse be working in 2012 and beyond?

Not in a Hospital

Traditionally the largest employer of nurses, hospitals will be hiring fewer nurses in the approaching years, according to the Bureau of Labor Statistics. They project a 17% growth in hospital-based nursing by 2018 compared to a projected 33% growth in home care nursing employment. The fact that more procedures are being done on an outpatient basis dramatically reduces the number of hospitalizations lasting over 24 hours.

Nursing Homes

The general population in the United States is aging. People are living longer and medical advances have provided a significant increase in longevity. Living longer requires more healthcare so the supply-and-demand theory enters the equation and creates a dramatic spike in nursing home employment opportunities.

Included in this employment category is the increasing group of hospice centers around the country. Patients needing end-of-life care have filled these facilities and require specialized nursing care.

Home Health Care

In conjunction with shorter hospital stays and aging patients remaining in the comfort of their own homes, a significant increase in home care will expand the number of nurses working in the home health care sector.

Many terminally ill patients and their families choose to deliver end-of-life care in their private home, rather than enter a skilled care facility. This segment of home health care requires a substantial spike in hospice and/or visiting nurses.

Physicians Offices

Physicians are beginning to perform more procedures and treat more patients in their offices. This trend substantiates the need for nursing support. Nurses are critical to teaching patients about specific physical care, proper documentation, prescriptions and medications.

According to the Bureau of Labor Statistics, nursing jobs opportunities will increase 22.2% by 2018. The projected increase represents a higher rate of growth than any other profession.

The question is: Where will you be working?

Hospitals need adequate staffing to deliver safe patient care with positive outcomes. When there is a gap in the schedule, administration often relies on the nursing staff to step up and cover the hours. Nurses working overtime, more than 40 hours a week, compromise patient care and safety on a daily basis.

Voluntary versus Mandatory

Research shows that there is little difference in error occurrences whether nurses work voluntary or mandatory overtime. Nurses working voluntary overtime do not sleep any longer than those working mandatory overtime.

Whether the signal to work extra hours comes while you are on duty or via a phone call on your day off, nurses feel pressured to accept the challenge. No one wants to leave their peers short-staffed and nurses feel a professional obligation to be available to deliver patient care.

Extenuating Circumstances

On-duty staff members are certainly faced with issues (other than general understaffing) that determine the need to occasionally work overtime hours:

• An emergency situation within the hospital
• Weather conditions that prohibit the relief staff from beginning their shift on time
• Ongoing procedures or cases in which the nurse is involved

Safety and Health Issues

Fatigue, errors and injury are the major concerns when a nurse works overtime hours. According to a study led by Ann Rogers, PhD, RN, FAAN, at the University of Pennsylvania, there is an association between longer work hours and errors, with “shifts lasting 12.5 hours or more raising the risk threefold.”

Here are the main issues of concern for nurses working overtime hours:

• Sleep deprivation prevents them from concentrating.
• Medication errors and needlestick injuries are the most common safety issues.
• Health is affected and, in turn, negatively impacts work-related injury and illness.

Some researchers have observed a trend in nurses who consistently work overtime; they tend to become dissatisfied with their job and suffer burnout more readily than those who do not work many extra hours. In the long term, burnout leads to a higher staff turnover.

Benefits

Money, money, money is every nurses’ motivation to work overtime. Federal law mandates that all hours worked, over 40 in a week, be paid at 1.5 times the nurses’ hourly rate. The paycheck at the end of the week is reflective of this extra compensation.

The Fix

Nursing organizations have examined regulations to limit overtime for nurses, according to the American Nurses Association. The Safe Nursing and Patient Care Act of 2003 addresses this issue. A June 2011 article on Nursing Outlook reports that 16 states currently have regulations in effect to limit overtime for nurses.

How many hours have you worked this week? Feel free to let us know.