Health care recruiters advise nurses to learn all they can about the hospital or facility where they want to work before heading to a job interview. In very competitive markets, they say it might be wise to consider relocating, taking a lower paying job or going back to school to make yourself more marketable.

Rural nurses from Vermont and New Hampshire are looking at preventive care as one way to change how small hospitals serve patients and communities. They say a shift from a procedure-based federal reimbursement system to an outcome-based system could pull nurses away from the bedside, as fewer people are hospitalized, and put them out in the community to help people achieve healthy lifestyles.

A report says the five key elements to keeping nurses in their current job are: satisfaction, organizational commitment, autonomy, opportunities for promotion and fewer outside job opportunities. Managers who understand these factors can make better use of resources, ensure patient safety and maintain a stable work force, reducing costs associated with nurse turnover, the lead researcher said.

A report says the five key elements to keeping nurses in their current job are: satisfaction, organizational commitment, autonomy, opportunities for promotion and fewer outside job opportunities. Managers who understand these factors can make better use of resources, ensure patient safety and maintain a stable work force, reducing costs associated with nurse turnover, the lead researcher said.

The American Heart Association has issued a Scientific Advisory that severely obese surgical patients are at higher risk for heart problems, wound infections, longer hospital stays and other complications. The group said that physicians should conduct a complete examination of such patients and that patients should adopt lifestyle changes to improve their health before having surgery.

Patients who don't receive antibiotics before surgery are at greater risk of infection if the gloves worn by their surgical team are punctured or torn, according to Swiss researchers. Infection rates for patients who didn't get antibiotics before surgery were 12.7% when glove perforation occurred and 2.9% when it did not.

More California nurses are delaying retirement because of the poor economy, reducing the shortage of nurses short-term but still leaving a long-term deficit. The average age of a working nurse in California is 47, and health officials worry if a large percentage of nurses retire when the economy recovers it will create an even bigger shortage than anticipated.

Some U.S. hospitals are switching from traditional sponges that nurses must count manually to a system that uses technology to locate them. The SmartSponge System features sponges, embedded with RFID chips, that nurses scan to ensure none are accidentally left in a patient during surgery.

Establishing policies of zero tolerance helps reduce problems with inappropriate or bad behavior among nurses and other hospital staff. If nurse leadership doesn't address problems, it sends a signal that bad behavior will be tolerated, according to Paula Nania, a nurse and perioperative educator at HCA Richmond/Capital Divisions in Virginia. She says training for nurse leaders and staff RNs helps units deal with aggressive individuals or bullies.

Nurses often face ethical situations that put them at odds with their responsibilities to patients, physicians, hospitals and their nursing units, says RN Christine Mitchell, director of ethics at Boston Children's Hospital. She advises nurses to listen to their inner voice and ask themselves if they are doing the right thing. They also should speak up and confer with colleagues and administration on what to do in such circumstances.

Nurses can feel powerless in "moral distress" situations where they can't do what they believe morally should be done for a patient, especially in end-of-life care and treatment. Hospitals are putting programs in place to help nurses deal with these difficult cases, and experts say a work environment that promotes communication and collaboration can help ease moral distress.

Nurses are becoming a more visible and vocal part of the health care reform debate, with some groups urging a single-payer system and others working to allow nurse practitioners and nurse midwives to practice as primary care providers. ANA lobbyist Michelle Artz says the organization wants to make sure nurses are well-represented and that health care reform is not a "physician-centric dialogue."

Today, International Nurses Day, is a time to challenge common misconceptions about the nursing profession, including that nurses are "subordinate, scut-work saints, rather than professionals with critical-thinking skills," writes Sandy Summers, executive director of The Truth About Nursing. Harmful stereotypes in the media discourage current and potential nurses from gaining the resources they need to expand their profession and improve the U.S. health care system, she writes in a Baltimore Sun opinion piece.

Once nurses get their basic education, the profession offers many avenues of patient care to pursue. Maureen Schneider, a senior vice president and chief nursing officer at Somerset Medical Center in Somerville, N.J., says she sees the effect advanced education has had on nursing. "We have nurses in finance, quality, information technology," she said. "Nursing has become a wide opportunity with many different nontraditional roles.

Health officials say nurses need to be prepared to help treat patients with swine flu, educate the public about the illness, and respond to requests from state and local health departments to identify new cases. Nancy Berlinger, deputy director at the Hastings Center in New York, says swine flu is a "call to duty" for nurses, who will serve educators and myth-busters and should "know the facts, be calm and not hypothesize on the facts."

Some hospitals are changing the Do Not Resuscitate designation to Allow Natural Death instead. Supporters say AND is a more positive approach to death and speaks to what is allowed to occur rather than what is not going to be done. They also want to erase the stigma associated with DNR and the mistaken belief that no care is given to dying patients under the DNR designation.

A big part of Esther McCready's life involves volunteering at the nursing museum at the University of Maryland, where she received her nursing education 60 years ago. The 78-year-old's admission letter is enshrined in the museum in Baltimore, as she was the first black student admitted.

Having an outgoing personality and managing stress are the keys to living a long life, according to a study that tracked the health of children whose parents lived to be at least 100. Researchers have long known longevity runs strongly in families. The study found children of centenarians were more extroverted than published norms and scored lower than the norms on neuroticism.

The X Prize Foundation is offering a $10 million reward to the winner of a contest to transform the health of people in a small U.S. community. The group said it would choose five plans for a three-year trial. The contest will measure outcomes based on a community health index of measures such as fewer ER visits and lower health costs.

Peri-operative nurses in Iowa want state legislators to change the wording of a state standard on nurse staffing in operating rooms. The Legislature this session failed to pass a measure that would have maintained a staffing rule calling for one OR nurse in every surgical room. The nurses are concerned wording of the existing rule could lead to hospitals to have one OR nurse for multiple rooms and could allow operating room technicians to take on traditional nursing responsibilities.

The American College of Physician Executives and American Organization of Nurse Executives have established "no tolerance" policy recommendations that address disruptive behavior by health care providers. The groups also created online classes and identified information sources that physicians and nurses can use to improve relations.

More hospitals are finding that offering nurses flexible scheduling increases retention and helps recruitment efforts. Studies have shown it's especially popular among older nurses, but hospitals say it benefits nurses of all ages, some of whom may want to continue their education or just have more family time.

Patient-safety events accounted for 97,755 in-hospital deaths between 2005 and 2007, according to an annual HealthGrades study of Medicare patients. The report said that there were 913,215 events overall during the period and that Medicare patients experienced a safety event every 1.7 minutes. The errors cost more than $6.9 billion over the two-year period.

Researchers identified 24 innovative nursing-driven health care models that elevate the role of nurses from caregivers to care integrators and boost the quality of patient care and reduce costs. Common themes among the care models, which are highlighted on a Web site created for the project, include a team approach to interdisciplinary care, targeting high users of health care, engaging the patient and leveraging technology.

Nurses have conflicted feelings about reporting medical errors, partly because they may believe the error was not serious enough to report and they may not know if anything meaningful happens to a report after it is made, a study found. Nurses in focus groups said time pressures also were a factor in reporting errors, as well as whether the patient was harmed and whether they received feedback when disclosing an error.

Nurses considering a doctoral program need to know that a Ph.D. will prepare them to research and generate evidence while the newer DNP or doctor of nursing practice will teach them to use evidence to improve patient outcomes, according to Bernadette Melnyk, dean of nursing at Arizona State University. She says while there is debate about which degree is more advantageous, both are important because evidence needs to be translated into clinical practice to be effective.

Being a travel nurses has its perks, namely the flexibility to work full time, part time or just in spurts, in hospitals and clinics around the country. Travel nurses have great opportunities for career development and can avoid the bureaucracy and office politics that can accompany static positions. There are some 20,000 travel nurses in the U.S., most working with an agency that helps them book positions and pays them a salary and benefits.

RN Cindy Underwood began serving food to the homeless in Birmingham, Ala., seven years ago as part of a church outreach but decided she could use her skills to do more. She began a free, monthly medical clinic for the homeless that has grown in the past two years to treat up to 80 people. The clinic is staffed by volunteers and is located under an interstate overpass. Underwood recently was named one of Alabama's 10 health care heroes.

After retiring from a long nursing career, Patricia Christensen opted to skip more leisurely pursuits and begin working on the master's degree that had long eluded her. She says nursing has transformed in 40 years from providing support care to taking on more responsibility for patient assessment, but she says patient-centered care is still the focus of nursing. "That's what kept me going during my career, and that's what continues to motivate me to learn more."

Nationwide, more patients are seeing a nurse practitioner when they go to their physician's office for an appointment. The rise in the number of NPs is helping to fill the gaps caused by a shortage of general practice physicians. NPs also are setting up their own practices; and the Arizona State University Health Center, in downtown Phoenix, is the first nonphysician office in Arizona to receive 100% reimbursement from a health insurer.

The Institute of Medicine is hoping to focus Congress' attention on the 3 Ps to good health care: preventive, predictive and personalized. The group wants to move the U.S. away from its crisis-oriented health care system and toward one based on prevention and wellness, or "integrative medicine."

Physicians say the new doctor of nursing degrees being offered could create confusion for patients who don't know if they are seeing a physician or a nurse. Doctor-nurse Ray Scarpa, who works at University Hospital in Newark, N.J., counters that he is a "doctorally prepared nurse," who practices nursing at an advanced level and has earned the right to be called "doctor."

A youth program created by the Cleveland Clinic's department of nursing and the Urban League of Greater Cleveland gave 32 local high school students a hands-on introduction to nursing over the weekend. Nurses taught the students medical procedures such as needle insertions, blood pressure readings and incisions, using patient simulators in fully equipped labs.

Health experts warn that drug-resistant strains of Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae soon could be as dangerous to hospital patients as MRSA. Drugs used to fight the gram-negative microbes are becoming ineffective and finding new ones is proving difficult.

Retired nurse anesthetist Michele Strocel has invented a personal respiratory hygiene product that lets people who don't have tissues cough or sneeze into their sleeves. The disposable CoughCover, which adheres to a shirt sleeve or shoulder, features five layers of a special fabric that contain antiviral ingredients that kill cold and flu viruses.

RN Carol Welsh would rather hire experienced nurses for the OR at Rutland Regional Medical Center but knows that's a difficult task in rural Vermont. Instead, the director of surgical services decided to train members of her staff using a curriculum from the Association of Perioperative Registered Nurses.

The Green House movement -- which offers smaller nursing homes with a homey rather than hospital feel -- has caught on nationwide, with 50 such facilities open in 12 states and 130 more in development. Families report seeing an improvement in their loved ones' physical and mental health, and experts say the individualized attention by trained staff ensures a high quality of care for residents.

U.S. health officials on Tuesday said the most commonly used influenza drug, Tamiflu, no longer works for the dominant flu strain, A H1N1, now found in most areas of the country. The mild flu season so far has not made this a big issue, but the CDC advised medical providers to substitute a different antiviral, Relenza, for Tamiflu, or to combine Tamiflu with rimantadine, an older antiviral medication.

Mayo Clinic research shows increasing NEAT -- non-exercise activity thermogenesis -- can help people lose weight. Endocrinologist James Levine says many overweight people simply sit too much and would lose weight if they did more walking, standing and moving around. NEAT accounts for a large part of a person's daily caloric expenditures, so doing simple activities such as cooking, cleaning and even pacing while talking on the phone burns off pounds.

British researchers say an analysis of five studies that included 453 people shows using a robot to operate a camera during gall bladder surgery is safe. The studies found no significant difference in the number of gall bladders that broke during surgery when either robots or humans were involved. Experts say having robots perform medical procedures could help mitigate shortages of health care staff.

Four Minneapolis-St. Paul-area nurse anesthetists help put people to sleep during the day, but at night they keep them up laughing. The nurses make up the singing group The Laryngospasms, performing medical music parodies. They have rewritten lyrics so that "The Little Old Lady From Pasadena" is now "The Little Old Lady With Her Fractured Femur" and "Breaking Up Is Hard to Do" is "Waking Up Is Hard to Do."

Nurses should be involved in executive-level decision-making at hospitals because they have an intimate perspective on patient safety, quality care and the inner workings of a health care facility, writes RN Justin Woodhouse, a nurse recruiter for the U.S. Army. Woodhouse says Army Nurse Corp RNs participate at the highest levels, developing and implementing recruitment and retention strategies for nurses.

Workplace dissatisfaction is a key reason why many nurses are leaving the profession for retirement or other careers, according to a study that used data from a survey of more than 35,000 nurses nationwide. More than 27% of non-working RNs cited stressful work environments, 23.4% cited physical demands, 20% inadequate staffing and 20% inconvenient work schedules. The study found 4.2% of the 2.9 million RNs in the U.S. were working at non-nursing jobs and 12.1% weren't working at all.

British research found smoking during pregnancy can harm thyroid function in both mother and child. The study also found women who stopped smoking while pregnant had thyroid hormone levels comparable to nonsmokers.

Bunker Hill Community College in Massachusetts has tripled the student capacity in its nursing program and applicants are still "beating down the door to get into the program," director of work force development Les Warren says. Recent data show that jobs for registered nurses will grow by 23% through 2016, but nursing isn't immune to the effects of the recession, as several hospitals have laid off nurses or implemented hiring freezes.

HHS has issued recommendations to health care facilities on ways to reduce infections, including proper use and care of catheters. The recommendations also include maintaining blood sugar control in diabetic patients, using ventilation only when necessary and keeping operating room doors closed during surgery.

North Carolina health experts say a growing shortage of nurses remains a top concern but health care employers also struggle to fill nonclinical jobs because students and laid-off workers don't know they exist. Educators say students as early as kindergarten should begin learning about health care careers, including the idea that girls can by physicians and boys can be nurses.

Health experts, nurses and other hospital staff say abusive or abrasive physicians can contribute to medical errors, such as when they rebuff or ignore patient alerts or recommendations. But improvements are coming. The Joint Commission is requiring facilities to have a written code of conduct, more hospitals and nurses are challenging disruptive doctors, and medical schools are including good communication and leadership among the core skills for residents.

Hospitals struggling with a shortage of nurses are trying to keep their RNs happy as a way to improve employee morale and boost patient satisfaction. The Versant RN Residency program helps new nurses make the jump from school to their first job and reduces turnover. Other facilities are recruiting volunteer nurses to provide extra help for staff.

High-performance leaders have learned how to take smart risks, build trust and create the opportunities that bring success, professor George Kohlrieser writes. He gives eight suggestions for how to develop your leadership talents.

A Washington, D.C., nurse has become the first RN to receive the prestigious FREDDIE Lifetime Achievement Award. Vernice Ferguson joins the ranks of Jonas Salk and Bill and Melinda Gates in being honored for her leadership role in nursing, including many years at the Department of Veterans Affairs and NIH. She says her most important achievements are helping students and young nurses realize their dreams and become successful.

A coalition of 28 national organizations says the U.S. doesn't need to wait for legislation to reform health care because providers and insurers can lower costs now by reducing unnecessary tests and procedures. The National Priorities Partnership, which includes a wide range of industry and government groups, says hospitals can reduce medical errors and infections, medical groups can educate patients on appropriate care, and insurers can change reimbursement policies.

Nurses have fiercely debated a new dress code under consideration by the Seton Family of Hospitals in Texas that would limit body piercings and require tattoos to be covered. The code also would require new color-coded uniforms to help distinguish nurses.

Colorado OR nurses stitched up and bandaged toys as part of a special elementary school program to teach students about hospitals and health care. Injured toy animals were triaged and the children went with them on their journey from pre-op to post-op, earning a certificate for bravery after surgery.

Up to 13 out of every 1,000 hospital patients -- or about 7,000 daily -- are infected with Clostridium difficile, a study found. Experts said improved hygiene and more judicious use of antibiotics can help.

A study of U.S. teaching hospitals found a 7% increase in the use of antibiotics between 2002 and 2006, despite concerns about bacterial resistance. Researchers found 64% of patients at 35 academic hospitals received at least one dose of an antibiotic in 2006.

Nurses at Thomas Jefferson University Hospital in Philadelphia were rewarded and honored for excellent patient care when the show "Dinner: Impossible" came to town and cooked up gourmet fare for them on television. Three hospital patients also were part of the meal prep crew and shared their life-saving stories with viewers.

Evidence is growing that vitamin D can help protect against cancer, heart disease and other ailments, but physicians continue to debate whether Americans should boost their intake with a daily supplement or simply eat right and exercise. Dr. Michael Holick of Boston University says vitamin D will not prevent every disease but there is "basically a mountain of evidence linking vitamin D deficiency to serious chronic diseases.

Beth Israel Medical Center in New York is experimenting with using Eastern healing techniques, including yoga, meditation and aromatherapy, to help patients undergoing chemotherapy and radiation. A foundation run by clothing designer Donna Karan is putting up $850,000 for the yearlong pilot program. Beth Israel CEO Dr. David Shulkin says it is an effort to "embrace care that makes [patients] more comfortable.

Many hospitals now encourage families to be patient advocates, helping ensure proper care for their loved ones and providing additional information on the patient to nurses and physicians. Nurses in some hospitals ask families for their patient observations during shift change reports at the bedside.

Researchers tested a variety of surfaces in the homes of people with colds and found germs can survive for two days or more on refrigerator door handles, phones, TV remotes and other commonly touched areas.

Journalist and author Gail Sheehy says middle-income Americans will be most affected by medical decision-making and financial burdens in caring for a terminally ill loved one, including finding appropriate home care. Experts say many caregivers feel unprepared, have no one to help coordinate the paperwork and procedures, and sometimes are left out of important care decisions.

California hospitals have worked to entice travel nurses to put down roots as full-time staff. Nurses say it requires a competitive salary, innovative scheduling and a good working environment. Successful hospitals have made travel nurses feel like colleagues rather than outsiders.

Clinical trial participants taking a new diet drug called tesofensine lost twice as much weight as that seen with the currently available diet drugs, a study found. Danish researchers say combining tesofensine with an effective diet could yield about 20% of the weight loss seen from gastric bypass surgery. People taking the lowest dose of tesofensine lost 14.7 pounds over 24 weeks, compared with 28 pounds by those taking the highest dose and less than 5 pounds by those on placebo.

Former nurse and terminal scleroderma patient Michelle Mayer wrote shortly before she died that nurses listen to people's fears, share their experiences and help patients through the dying process. "Now on the receiving end of care I realize the healing power of a good nurse. I wish I had seen it back in my younger days and used it more effectively," she wrote.

Michelle's BLOG is well worth reading as well.

MD-RN collaborative addresses workplace concerns by strengthening communication and collaboration between physicians and nurses. One strategy that has had the greatest impact on improving both patient care and staff relationships has been the implementation of nurse/physician rounds.

A peek back at nursing duties in the late 1800s shows that in addition to caring for 50 patients each, nurses were required to sweep, mop and bring in coal to keep the hospital warm. Retired OB nurse Shirley Oswald of Manitowoc, Wis., found the list, dating back to 1889, in a hospital centennial booklet. Nurses were told that using tobacco or liquor, getting their hair done at a beauty shop, or frequenting dance halls could be hazardous to their careers.

New York's new law banning mandatory overtime takes effect July 2009 and will allow nurses to decline working beyond their scheduled hours without the threat of disciplinary action. Experts say the law could help nurse administrators get more funding for new positions and put an added emphasis on retention and recruitment.

Eating dark chocolate on a regular basis may reduce levels of inflammation, which is associated with heart and blood vessel disease. A study found benefits from consuming as much as one 20-gram serving of dark chocolate every three days.

When the housing boom turned bust, real estate broker Wendy Richmond swapped her business suits for nursing scrubs, part of a growing trend of midcareer professionals opting for the job security offered in health care.

The use of telemedicine is just one aspect of a changing health care landscape for consumers as they head into open-enrollment season. Other trends include company health clinics, wellness assessments and disease management programs, ATM-like machines that dispense medications, and kiosks at which patients pay upfront for their share of medical costs.

Health care platforms offered by presidential candidates Sen. Barack Obama, D-Ill., and Sen. John McCain, R-Ariz., emphasize many key care issues -- such as prevention, disease management and health education -- but they fail to address how they would add health care staff, namely nurses. Nurses can help bring staffing issues to the forefront and craft policy proposals by becoming politically active for candidates at all levels of government.

Predicting what the nursing profession will look like even a few years down the road is difficult because changes will come from many current trends and areas to watch, including politics, the economy, nursing education and quality care initiatives.

Nurses say improved working conditions -- such as lighter patient loads -- could help retain veteran nurses and encourage those who have left the field to return. Others are working to improve nursing education to help train more new nurses to ease a shortage of practicing RNs.

A survey of more than 1,500 nurses at 22 hospitals finds that although they do want better pay, benefits and hours, the most important job element is to be in a cohesive working environment. They want to be valued and acknowledged for their contributions and to feel as though they are part of a team that works well together.

A CVS pharmacy in Medway, Mass., is the first in the state to open an in-store MinuteClinic staffed with nurse practitioners. Even though the state has a shortage of primary care physicians, the plan to open 28 clinics has been a source of controversy and opposition by physicians and others who worry it will fragment health care and compromise quality of care.

Study data on more than 80,000 women over two decades show those who didn't smoke, ate a healthy diet, maintained a proper weight and exercised cut in half their risk of premature death. Smoking was the biggest factor in premature death and alcohol consumption was the smallest predictor.

The nursing profession is evolving so that nurses increasingly will become responsible for coordinating a patient's total care. In the next 10 to 15 years the nursing work force in the U.S. will become better educated -- with more programs that offer advanced education for nurses and more nurses who hold doctoral degrees

Research shows adopting a diet rich in fruits and vegetables, getting more exercise, and reducing stress can raise levels of the enzyme telomerase, which is linked to longevity.

"This is the first study showing that anything can increase telomerase. If it were a new drug that had been shown to do this, it would be a billion-dollar drug. But this is something that people can do for free,"

South Florida hospitals are competing for nurses using a variety of incentives -- from tuition reimbursement and longevity bonuses to mortgage down payments and flat-screen TVs. Along with financial incentives, Mercy also offers a commuter benefit and a program to help employees find care for a sick child or aging parent.

N.C. hospital program reduces errors, improves patient care.

Good women bosses delegate rather than micromanage.

Walking gives the brain a workout!

In a survey of 4,530 nurses, physicians, administrators, and other healthcare employees and professionals, 77% of survey respondents reported witnessing disruptive behavior by physicians and 65% reported witnessing disruptive behavior by nurses. The survey was published in the August 2008 The Joint Commission Journal on Quality and Patient Safety. Also, 67% of respondents agreed disruptive behaviors were linked with adverse events. Intimidating and disruptive behaviors also are not limited to one gender, one profession, or a small number of perpetrators, according to the Sentinel Event Alert.

Interesting new subspecialty; there's even a credentialling process for being a certified nurse navigator.

In 2007, 56 percent of American adults—more than 122 million people—sought information about a personal health concern, up from 38 percent in 2001

'Never events': Utah hospitals saw nearly 60 serious errors in 2007 ~ Salt Lake Tribune

States holding hospitals accountable for patient safety

The Joint Commission claims that rude language and hostile behavior threaten safety and quality and issues a Sentinal Event alert.