Operating Room (O.R.) nurses have seen a tremendous increase in demand throughout the country. Elective surgeries and general surgeries are up in most regions of the U.S.

O.R. nurses have a set of characteristics that are constantly called upon including:

• Excellent critical thinking skills
• Organization
• Educator
• Tremendous communication skills
• Calm demeanor during stressful situations

O.R. nurses typically fall into one of three categories.

1. Scrub nurse-The nurse is responsible for maintaining inventory during surgery as well as selecting and handling instruments. They are typically responsible for all supplies and counts of supplies used.
2. Circulating nurse- The nurse is responsible for maintaining the patient’s environment. They oversee the safety of the patient as well as making sure the patient is comfortable.  The Circulating nurse manages the overall nursing care during the patient’s visit to the O.R.
3. R.N. First Assistant- Works with the surgeon in providing direct patient care. The First Assistant may assist the surgeon in wound management as well as suturing.

The O.R. nurse works closely with the surgical patient, the patient’s family members, and other members of the healthcare team.  Surgery is a very stressful time for the patient and their family members. The O.R. nurse can play a vital role in alleviating that stress.

O.R. Nurses can obtain a voluntary certification. This can be achieved after two years and 2,400 hours of perioperative nursing experience. To become a certified operating room nurse (CNOR) you may visit the following website: http://www.cc-institute.org/cert_cnor.aspx

AORN is a professional association that empowers the O.R. nurse with education, standards of practice and peer networking. For more information go to http://www.aorn.org/

Currently ADEX Medical Staffing has tremendous opportunities for the Operating Room nurse. Call ADEX Medical Staffing at 866.341.2339 to hear more about our open positions.

- Jim Shoemaker, RN, Director of Clinical Services

Check out the following website to view the latest on Continuing Education Requirements for all of the states:

http://cme.medscape.com/public/nursecestaterequirements

Keeping you informed at ADEX Medical Staffing.

- Jim Shoemaker, RN, Director of Clinical Services

Labor and Delivery Nursing is projected to be one of the hot areas in the nursing arena over the next year. It looks like that economic downturn allowed many people the opportunity to get reacquainted and a new baby boom could be right around the corner. The need for L&D Nurses is already seeing spikes throughout the country and this trend is likely to continue.

The Labor and Delivery Nurse is a very special person. For many women, childbirth can be scary and a very stressful experience. The mother needs someone that the mother can trust and depend on for comfort.  They are true caregivers to family members as well as mother and baby. They are required to perform well in high-pressure situations and must be very attentive to any changes in the condition of the mother or baby. L & D Nurses typically follow a woman at the beginning of her labor. The nurse is responsible for providing support to both the mother and baby to assure a healthy delivery.

Fetal monitoring is a very important aspect of the Labor and Delivery Nurse. The nurse monitors the fetal heartbeat to look for any signs of distress. The Nurse is also responsible for assisting the mother in moving through the delivery process. This may include teaching breathing techniques, positioning the mother for comfort, as well as providing psychological comfort.

The L&D Nurse is trained in neonatal resuscitation in order to assist in an emergency situation. The ability to provide education to the mother and family after the delivery is also a key component of the skills needed. The Nurse needs to work with the mother to help her cope with post-partum depression. Teaching is also required for feeding of the infant, whether breast feeding or bottle feeding.

Many opportunities arise from a life in the Labor and Delivery Unit. Certification can be obtained through examination after two years of specialty practice. Some of the areas in which nurses can be certified are Intrapartum Nursing, Fetal Monitoring, and Nursery. Visit the following website to inquire about certification:

http://www.nccwebsite.org/Certification/default.aspx

The Association of Women’s Health Obstetric and Neonatal Nurses (AWHON) also offers certification in Fetal Monitoring. The following website has more information:

http://www.awhonn.org/awhonn/content.do?name=02_PracticeResources/2G3_Fetal-Heart-Monitoring_Landing.htm

Even though the job of an L&D Nurse is extremely stressful, it is one of the most rewarding positions in the nursing field. ADEX Medical Staffing is looking for excellent Labor and Delivery Nurses to fill exciting assignments throughout the country. Please call us at 866-341-2339 to inquire about joining the team at ADEX.

- Jim Shoemaker, RN, Director of Clinical Services

Memorial Day, originally called Decoration Day, is a day of remembrance for those who have died in our nation’s service. It was established in 1868 to commemorate the dead from the Civil War. Over the years it came to serve as a day to remember all U.S. men and women killed or missing in action in all wars.

As you celebrate this holiday make sure to buckle up and be safe!

“AAA today projected the number of Americans traveling on vacation this Memorial Day holiday weekend will increase 5.4 percent from 2009 with approximately 32.1 million travelers taking a trip away from home. Last year, 30.5 million Americans traveled during the same period” (PRNewswire-USNewswire, 2010).

- Sonia Coers, Account Manager

May 6^th marks the beginning of National Nurses Week, celebrating the birth date of Florence Nightingale, who was born on May 12, 1820 and considered by many to be the founder of modern nursing.

We want to take this opportunity to let you know how much we appreciate your tireless effort, your service, and your never-ending work ethic. As recruiters, we know that you often feel overworked and underappreciated.  We believe you are the backbone of the healthcare industry, and the services you provide are not overlooked.

Thank you for your dedication, your compassion and your caring. You should be thanked every day, not just today, for all you do for your patients, co-workers, and hospitals.

Happy Nurses Day!

- Sonia Coers, Account Manager

In many instances the elderly patient that has gone through a hospitalization finds themselves improving in their condition but not ready to be discharged home for independent living. The patient may require I.V. infusion, sterile dressing changes, physical therapy, or numerous other skilled healthcare requirements. Some of these patients may require numerous disciplines to assist them in their recovery. The big difference is that the patient has stabilized to a point that frequent physician visits are not required. In the acute care setting, within a hospital, daily visits by a physician are the norm.

The Transitional Care Unit (TCU) is a unit designed to fill the gap for patients not ready for independent home living. The patient requires the care of a licensed professional. The TCU traditionally utilizes a multidisciplinary approach in developing a plan of care for the patient. The patient usually has 24 hour visitation rights along with being in a setting as close to home life as possible. Family members are encouraged to participate in the plan of care and assisting in preparing the patient for a return to home life.

Nurses working in the Transitional Care Unit should be competent in gerontological (care of the elderly patient) nursing. Skill sets that are desired by the Transitional Care Nurse are orthopedic skills, IV therapy skills, and other rehabilitative skills.  The TCU nurse should be proficient in teaching the patient as well as the caregivers about the patient’s disease process as well as how to care for the patient. The Transitional Care Unit is based upon a patient’s ability to recover in a short period of time. It is not intended for long term stay.

To find out more about opportunities in the Transitional Care Unit call ADEX Medical Staffing at 866-341-2339.

- Jim Shoemaker, RN, Director of Clinical Services

During the past two Presidential Administrations, one resounding message has been delivered to the healthcare community. The message is that the United States healthcare system will move all medical records to an electronic format. There are many reasons for this shift over the past several decades.

1. Cost effectiveness
2. Better healthcare delivery
3. Less errors due to misinterpretation of handwriting
4. Instant access to patient conditions and records
5. Availability and ease to find documents within the healthcare file
6. Less time charting and more time for patient care
7. Checks and balances to prevent errors or omissions
8. Assist in streamlining the multidisciplinary healthcare system
9. Ease of having all medical records follow the patient where ever they are
10. Prevention of medication errors.

This major shift also creates many upcoming challenges for the healthcare worker. It will be vital that they be proficient in computer skills. Most nursing schools have inserted computer courses into their curriculum. One of the main challenges is that there is no standardized eMAR program. This means there are hundreds of different programs being used. Medical facilities must also dedicate the appropriate resources for training on the new programs to ensure the systems meet the facilities’ ultimate goals.

One of the major challenges for travelers is the necessity to learn new systems in a short amount of time. Nursing and Allied professionals should be proactive in becoming familiar with the most common systems utilized in facilities throughout the country. When accepting an assignment, the healthcare professional should clarify what system they will be utilizing. This will assist them in becoming better prepared for an assignment. Below are links to some of the most common systems used in the U.S. healthcare system today. Please call ADEX Medical Staffing at 866-341-2339 to inquire about positions throughout the U.S. ADEX is committed to preparing you for your assignments as best as possible.

Meditech – http://www.oncalllearning.com/meditech-training-software.htm

Cerner- http://www.cerner.com/public/Cerner_3.asp?id=133

Eclipsys- http://www.eclipsys.com/hospitals-education-training.htm

Healthcare Management Systems- http://www.hmstn.com/services/

- Jim Shoemaker, RN, Director of Clinical Services

Ever thought about pursuing a career in Legal Nurse Consulting? The non-profit organization American Association of Legal Nurse Consultants (AALNC) has plenty of free information and an overview called, “Getting Started in Legal Nurse Consulting” on their web site www.aalnc.org.

Atlanta RN’s who are interested and free this month, can attend Elizabeth Rudolph’s two-day course: “How to Be a Professional Legal Nurse Consultant” on April 24-25. For tuition and course information, please visit www.jurexnurse.com.

- Jim Shoemaker, RN, Director of Clinical Services

You have finally come to that point in your career where you have gained tremendous confidence in your abilities. Other nurses look to you for guidance. It was difficult getting to this point but you now realize the doors this could open for you. You have so many places throughout the country that you would love to see. Fortunately there are thousands of hospitals across the U.S. that utilize traveling nurses and would benefit greatly from your services. You decide that travel nursing would be right up your alley. So, how do you choose that travel company that reflects your passion in nursing? Here are 3 major questions to ask when searching for a travel nursing company:

1. Does the company focus on quality and bringing on the best Nurses? Beware of companies that have no clinical focus and basically require a nursing license to go to work. Travel companies should have a dedicated clinical person to look out for your interest and provide assistance in your educational needs. A travel company that has the” Joint Commission Gold Seal of Approval” is usually indicative of a commitment to quality.

2. Does the company have “a one point of contact mentality”? Many companies have a recruiter responsible for finding you a position, another person responsible for collecting your credentials, someone else coordinating your housing, and even another handling payroll issues. This can be a nightmare. Look for a company that has one person that is your single contact for all matters. Let them track down the responsible person.

3. Does the company have opportunities throughout the country? A good travel company will have relationships with some of the major players throughout the country giving you the opportunity to get that desired position in the place you’re looking to go.

ADEX Medical Staffing is dedicated to you as a travel nurse. You will have one Recruiter who guides you through the entire traveling process. The Recruiter will work diligently in finding you that ideal position as well as assisting you in gathering those hospital specific requirements, setting up your housing, and making sure the payroll is correct.

ADEX Medical Staffing has a dedicated person that will assist you with any clinical needs, education, or issues throughout your assignment. ADEX Medical Staffing is Joint Commission Certified and dedicated to providing the best possible care to our client’s patients. This assures you, as a Nurse, more opportunities as well as provides you with an advocate during your assignment.

ADEX Medical Staffing has tremendous opportunities throughout the country. Our reputation creates premium assignments in some of the most desirable locations. Please contact us at 866-341-2339 to enquire about new possibilities for you.

- Jim Shoemaker, RN, Director of Clinical Services

Alarming Statistics
According to the Food and Drug Administration medication errors can be attributed to one death every day and injure approximately 1.3 million people annually in the U.S.
Causes

The administration of an improper dose of medicine accounted for 41% of fatal medication errors. Administration through the wrong route and giving an incorrect drug accounted for 16% of the fatal errors equally. Geriatric patients were more susceptible to medication errors largely due to medication interactions and the multiple medications they may be taking. Other causes can be attributed to the lack of teaching or comprehension of the medication regime.

Prevention
As a Registered Nurse, it is essential for us to evaluate what we can do to prevent medication errors. Here are several ways to protect the patient from preventable injury due to medication error:

•    Review all medications of your patient and become familiar with their use, dose, and interactions with other medications
•    Check for patient allergies
•    Do not assume medication dosages are correct
•    Refer to pharmacology resources concerning medications
•    If medication dosage requires calculations have another nurse validate calculations prior to administering
•    Observe dependent patients take their medications
•    Teach patient or family member about the medication
•    Assure that a competent person will be in charge of the administration of the medication when discharged home
•    Teach the patient and caregiver to question any new medications prescribed

Remember the 5 “R” s
1.    Right Patient
2.    Right Drug
3.    Right Dose
4.    Right Route
5.    Right Time and Frequency

Reviewing the Math
Registered Nurses should review mathematical skills in medication calculations on a regular basis. Here are a few helpful websites to review your knowledge of medication calculations and medication testing:

http://www.childrensmn.org/web/webrn/webrnpdfs/128121.pdf
http://www.testprepreview.com/modules/nclex.htm
http://www.scribd.com/doc/9805/USNI-Medication-Test

ADEX Medical Staffing is committed to excellence in Nursing. ADEX Medical Staffing strives to supply our employees with the most up to date information in the medical community. Please call us for more information on joining the ADEX team.

- Jim Shoemaker, RN, Director of Clinical Services