PAs practicing in states with a practice barrier reported lower salaries than their peers in states without that barrier.
from Health Leaders Media
States with more progressive laws governing the practice of physician assistants (PAs) also offer the Masters-prepared clinicians the highest earning potential, according to the American Academy of PAs (AAPA) 2017 AAPA Salary Report.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
Persistent pain is complex and it is very unlikely that one magic bullet treatment is going to be the sole key to successful outcomes.
from Evidence in Motion
Trying to follow the evidence to determine the best intervention for your patients can be a challenge, especially when it comes to persistent pain. It can be a challenge when you read well-done reviews that seem to have slightly opposite conclusions.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
Encourage clients to use apps already available on their mobile devices for assistance with job and vocational demands.
from ASHA Leader
Clients’ mobile devices can scaffold a number of important life skills related to maintaining a job, including setting an alarm and managing a sleep schedule through the device clock and associated alerts. Though our young students often know how to download apps and play games, it’s important to assess how well they can use these features and to provide practice and training where they need it.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
However admirable a career in healthcare may be, taking care of others certainly comes with some risks.
by Eileen O’Shanassy
Mostly, the perception of the healthcare industry is a positive one. People often envision happy clinical assistants, eager nurses, and enthusiastic clinicians addressing the needs of patients, one by one. While this may be true when healthcare professionals begin their careers, the glamour tends to wear off relatively quickly. Unfortunately, healthcare as with any job, comes with various stressors, risks, and some generally unpleasant factors. However admirable and necessary, taking care of others may not be as bright and shiny as it is portrayed to be. Here are some common risks of working in healthcare.
The toll that working in healthcare can take on employee health can be staggering. There is often little time for human necessities like eating or bathroom breaks between appointments, consultations, and administrative tasks, not to mention meetings or special community events. Routinely rushing from one place to another fosters appreciation for minimizing personal needs, which drastically downplays the importance of self-care. Employees are so often praised for putting the needs of patients first, even when that puts them in physical danger. The idea that safety is a luxury rather than a right in a healthcare setting is unlike values in almost any other industry.
The fast-paced environment in many clinical settings means more ordering out and eating fast food, and less time for meal prep and nutritionally healthy choices. Taking care of other people doesn’t stop at the parking lot for many healthcare providers. Often, these employees are their families’ primary caretakers, which might mean shuttling off to start second shift after their workday ends. Spouses, partners, kids, pets, and other family members rely on healthcare providers to be chefs, maids, tutors, and general givers well after their work shifts end.
Salaries in the healthcare industry are often lower than most would anticipate, meaning that many healthcare workers pick up second or third jobs on top of busy schedules. Juggling jobs in addition to family life can take its toll relatively quickly, resulting in burnout. Additionally, stressful conditions mean potentially strained relationships with coworkers and supervisors. Often, healthcare organizations are hierarchical, which may not leave much leeway for disputing perceived wrongdoings. This lack of control is far from empowering for many lower on the totem pole. Working up to better positions often requires extra schooling or advanced degrees. Many medical personnel use financial aid opportunities provided by employers to go back to school and work toward a job with better pay but this can mean less free time outside of work as well.
There is typically less opportunity for physical activity than most would anticipate in a healthcare setting. Lots of time spent working means less time for exercise routines or trips to the gym. Long hours, even twenty-four or thirty-six hour shifts may not leave much time or energy for hobbies in general. Little intricacies like taking fast elevators over cumbersome stairs when carrying equipment also factor into the equation when considering daily health and exercise.
Working in a place where sick patients are treated means frequent exposure to germs, illnesses, and other threats. Sometimes, due to haste or oversight, precautions are not always followed when it comes to infection control. For instance, during flu season, there may be an indication for patients with certain symptoms to wear masks. If front desk staff is not diligent about enforcing said rule, employees can be exposed to the flu.
Exposure to all sorts of bacteria via bodily fluids is also possible in some healthcare settings. Wearing personal protective equipment (PPE) is enforced in most organizations, but mistakes happen. Being stuck with a needle or scratched through a glove is not unheard of, and requires follow up care from the employer’s compensation facility.
Some risks within healthcare facilities can be prevented. Others may happen before you know it. However admirable, healthcare work necessitates considering several negative factors before diving in.
Eileen O’Shanassy is a freelance writer and blogger based out of Flagstaff, AZ. She writes on a variety of topics and loves to research and write. She enjoys baking, biking, and kayaking. Check out her Twitter, @eileenoshanassy.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
A new survey reveals that 32% of patients perceive having access to their EHRs is ‘very important’ to them.
from SelectHub
Electronic health records, also known as electronic medical records (EHRs/EMRs), are becoming the standard method of record keeping by medical professionals. According to the CDC, nearly 87 percent of office-based physicians use an EMR/EHR system.Given EHRs are becoming the rule rather than the exception, we surveyed more than 1,000 patients with access to EHRs and over 100 medical professionals who use the system about their opinions on this growing trend in the health care industry. Continue reading to see what we learned.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
Despite nursing being a noble profession, the sexy nurse stereotype refuses to die. With Halloween (and scores of women dressed as such) rapidly approaching, we take a look at why, and what you can do to stop it.
from Nurse Buff
The concept of the sexy nurse dates back to hundreds of years ago – as far back as the Protestant Reformation in the 1500s to be precise. Back then, before Florence Nightingale made the effort to reform the profession, nursing was one of the lowest jobs women could get.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
Nurses, physicians, and other professionals working in trauma centers know fully well that, at any time of day or night, ambulances and vehicles filled with victims could arrive after a violent situation unfolds.
From Nurse Keith’s Digital Doorway
Mass shootings and similar tragic events are so frequent here in the United States that they appear to be the new normal. There were apparently more than 250 mass shootings in the U.S. in the first 9 months of 2017. As nurses and healthcare professionals, how do we cope, respond, and prepare for such seemingly commonplace yet traumatic events?
Mass shootings are generally defined as events wherein a minimum of four people are injured or killed, and by this definition, an event with three people shot is not considered a mass casualty. So if we changed the definition, these situations would be even more statistically frequent than they are now.
Healthcare professionals throughout the world treat victims of violence on a daily basis. Whether wartime casualties or civilians shot by strangers or family members, gun violence and other forms of aberrant behavior manifest in our cities and towns on a frighteningly frequent basis.
Hospital facilities — especially those designated as trauma centers — are prepared to handle large numbers of casualties, and many run drills that keep the skills of rapid response teams as sharp as possible.
Nurses, physicians, and other professionals working in trauma centers know fully well that, at any time of day or night, ambulances and vehicles filled with victims could arrive after a violent situation unfolds. The recent Las Vegas shooting was just one such scenario, and stories have emerged of hospitals veritably overwhelmed with the number of seriously injured patients being brought for emergent care on that fateful day, even as off-duty personnel raced to their places of employment to lend a hand.
Most of us can only imagine what might run through our own heads if we were ourselves at the scene of such a shooting. If bullets were raining down, would you be willing to risk your own health and safety to help a bleeding person across the parking lot who is suffering from a gunshot wound? Could you think clearly, stay focused, and compartmentalize the experience enough to get the job done? If you were exposed to live gun fire and the resulting chaos, would your desire to help others supersede your own safety concerns to the extent that you could take action?
Each one of us needs to ask ourselves salient questions when it comes to these types of situations. Here are some I’ve been thinking about lately:
You may also want to ponder and research how (and if) your workplace is prepared for such eventualities by asking related questions, such as:
However you contribute is fine — not everyone has the skills, knowledge, or even the physical stamina and strength to pitch in directly when disaster strikes. We can all choose our path for making a difference in our own way. We just want to make sure we have the training, backup, and follow up care to make it through the crisis in one piece, emotionally and otherwise.
When a nurse, doctor, fire fighter, police officer, or other responder interfaces with some aspect of a mass casualty event, those individuals’ lives can be inextricably altered. Vicarious traumatization involves the empathic response and countertransference experienced by rescue workers, first responders, ER staff, or anyone who has witnessed, or attempted to mitigate, the suffering of others.
Being faced with two hundred incoming patients with acute bullet wounds from an active shooter can be overwhelming on multiple levels for a nurse in the ED. For those with experience in combat, this may not seem so far-fetched, but to a nurse who has only seen normal emergency department scenarios, a mass casualty can be an entirely different experience.
When I was living in Western Massachusetts, my wife and I were trained in a crisis debriefing model developed by the military and subsequently adapted for civilian use. We provided emergency debriefings following a rape, a murder, and even a bank robbery, This type of intervention following a trauma can be very helpful for victims, for responders, as well as others experiencing a more peripheral impact of these types of events.
Vicarious traumatization feels as real as any other trauma, and healthcare workers and first responders need trained professionals to walk them through a debriefing process that moves them in the direction of healing. After all, healed healthcare workers are healthy and productive healthcare workers.
We nurses can volunteer in the face of disasters such as Hurricanes Harvey or Irma. We can also find ourselves in the middle of unfolding events that put us in both imminent danger and the potential to lend a helping hand at a crucial moment. It is an unpredictable world, and we need to be as well prepared as we can be for the unimaginable.
Nursing skills and the nursing process are crucial components of emergency response. When faced with a dire situation, many of us nurses would likely act without thinking, turning on our “nurse’s brain” and snapping into action in coordination with other healthcare professionals and first responders.
In this age of seemingly escalating violence, each nursing professional must know his or her own limits and boundaries when it comes to volunteerism and to the ability and willingness to respond in an imminent crisis such as a mass shooting. It’s a sad but true reality that we haven’t seen the last of unthinkable situations where ordinary citizens come unhinged and wreak havoc. Even so, nurses and other courageous souls will always be there to lean in wherever help is needed.
Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind NurseKeith.com and the well-known nursing blog, Digital Doorway. Please visit his online platforms and reach out for his support when you need it most.
Keith is co-host of RNFMRadio.com, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses.
A widely published nurse writer, Keith is the author of “Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century,” and has contributed chapters to a number of books related to the nursing profession. Keith has written for Nurse.com, Nurse.org, MultiViews News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University, the ANA blog, Working Nurse Magazine, and other online publications.
Mr. Carlson brings a plethora of experience as a nurse thought leader, online nurse personality, podcaster, holistic career coach, writer, and well-known successful nurse entrepreneur. He lives in Santa Fe, New Mexico with his lovely and talented wife, Mary Rives.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
You’ve heard of locum tenens, but you may be overlooking signs that it’s right for you. Here are a five to look out for.
by Sandy Garrett, President of Jackson & Coker
“How do I know if working locum tenens is right for me?”
It’s one of the questions we get asked the most at Jackson & Coker, a healthcare staffing firm that helps physicians and advanced practitioners find locum tenens, locums-to-permanent and telehealth jobs nationwide.
In my experience working with locum tenens providers over the past few decades, I see qualities in certain people that make them great fits for locums.
Here are five signs locums is right for you:
Locum tenens allows you to take control of your career and work the way you want. Visit jacksoncoker.com to get started.
Sandy Garrett is President of Jackson & Coker, one of the most well-recognized healthcare staffing firms in the United States. The firm helps physicians and advanced practitioners find locum tenens, locums-to-permanent and telehealth jobs at facilities nationwide, ensuring patients have access to life-saving care in their own communities. It has been ranked a “Best Staffing Firm to Work For” by Staffing Industry Analysts.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
In 2010, the Affordable Care Act created 57 teaching health centers nationwide to serve areas with large unmet medical needs, and to begin to alleviate the primary care doctor shortage.
By Ana B. Ibarra
Dr. Olga Meave didn’t mind the dry, 105-degree heat that scorched this Central Valley city on a recent afternoon.
The sweltering summer days remind her of home in Sonora, Mexico. So do the people of the Valley — especially the Latino first-generation immigrants present here in large numbers, toiling in the fields or piloting big rigs laden with fruits and vegetables.
Meave’s sense of familiarity with the region and its residents drew her to an ambitious program in Bakersfield whose goal is to train and retain doctors in medically underserved areas.
She is now in her third and final year of the Rio Bravo Family Medicine Residency Program, operated by Clinica Sierra Vista, a chain of more than 30 clinics, mostly in the Central Valley. Meave, 34, graduated from medical school in Mexico and has pursued additional education and training in the U.S.
She plans to practice in Bakersfield after she completes her residency next year.
“The goal is for [doctors in training] to come for three years and stay for 20,” said Carol Stewart, director of the program.
Rio Bravo is one of eight teaching health centers in California and 57 nationwide that were created by the Affordable Care Act in 2010 to serve areas with large unmet medical needs.
This academic year, there are 732 residents in teaching health centers across 24 states.
Unlike the Affordable Care Act itself, these teaching centers enjoy bipartisan support among federal lawmakers, who say such hubs will alleviate the primary care doctor shortage. But long-term funding is still in question. Last week, Congress agreed to temporarily finance the teaching health centers through the end of the year while debating whether to extend funding beyond that. President Donald Trump later signed the temporary extension.
A residency is a stage of graduate medical training that’s required after medical school and before doctors can set up their own practices. Most family practice residencies last three years.
Traditional residency programs are generally based at large, urban hospitals in areas where there are typically a sufficient number of doctors to go around.
The first teaching health centers began training residents in 2011. They operate primarily out of clinics in rural communities and other areas where primary care physicians are in short supply.
The ideal ratio of primary care physicians to patients is about 1 for every 2,000, Stewart said. The ratio in east Bakersfield “is more like 1 to 6,000, so we have a lot of catching up to do.”
Though teaching health centers remain relatively new, experts say they’re already succeeding: Their residents generally stay in the regions where they trained, putting down roots in communities with a big demand for health care.
In June, the Rio Bravo program graduated its first class of six doctors. Two joined the staff at a Clinica Sierra Vista clinic in east Bakersfield. The other four are practicing in clinics serving low-income communities in Sacramento, Riverside and Los Angeles counties.
Stewart estimates that the six recent graduates together saw nearly 10,000 patients during their three years of training.
“That’s a significant contribution,” she said.
Though not all teaching health centers have affiliations with medical schools, the Rio Bravo program has an academic partnership with the UCLA medical school, which helps develop its curriculum, Stewart said. It also coordinates with a local hospital, Kern Medical, where residents complete rotations in different specialties related to family medicine.
A 2015 survey by the American Association of Teaching Health Centers found that 82 percent of their graduates stay in primary care and 55 percent remain in underserved communities. By contrast, about a quarter of graduates from traditional residency programs remain in primary care and work in underserved areas, according to the same survey.
Many graduates of teaching health centers have an incentive to stay in these areas because they may qualify for other programs that offer perks, such as help with paying off medical school loans.
The centers take their patient populations into consideration when selecting applicants. For instance, Rio Bravo aims to train culturally sensitive doctors, given the large local immigrant population, Stewart said.
It looks for applicants with ties to the Valley or who come from the cultures — and speak the languages — that are familiar to patients they will serve.
Meave doesn’t have a personal connection to the Valley, but she worked with low-income patients in Mexico. She has found that the population in the Valley, and its needs, aren’t much different from those in her home country.
At Clinica Sierra Vista, she sees patients who haven’t been to a doctor in decades. “They’ve never had a physical exam, never had their eyes checked. … They just deal with their aches and pains,” she said. “I think they feel happy that I can understand them and excited that someone from the same background is providing them care.”
Teaching health centers are financed by federal grants administered by the Health Resources & Services Administration, part of the U.S. Department of Health and Human Services. Congress determines the amount and duration of the funding. The current allocation, an extension of the two-year funding that expired Sept. 30, runs through the end of the year.
In July, U.S. Rep. Cathy McMorris Rodgers (R-Wash.) introduced legislation that would fund the program for an additional three years at about $157,000 a year per student — a total of $116.5 million annually.
The amount proposed would be a 65 percent increase from the current funding of $95,000 a year per resident.
Lawmakers are likely to begin debating the funding measure this week, and it is still subject to change.
“I’m glad we moved forward with a short-term extension of the … program, but we also must advance a long-term solution to provide certainty for our teaching health centers, their residents, and their patients,” McMorris Rodgers said in a prepared statement. “Without a sustainable funding level … the program will unravel.”
Should that happen, California’s teaching health centers could draw from a pot of money administered by the Office of Statewide Health Planning and Development to pay for the remainder of the current residents’ training.
Programs in other states may not have the same safety net.
“If [federal funding] went away, our residency program would have to close,” said Dr. Darrick Nelson, director of the teaching health center at Hidalgo Medical Services in Lordsburg, N.M.
Lordsburg, with a population of roughly 2,500, is a “small railroad town,” Nelson said, and like many rural towns desperately needs versatile primary care doctors.
“What you’re getting is three doctors for the price of one,” he said. “You get someone who can do pediatrics, someone who can do obstetrical care and someone who can do internal medicine.”
In California’s Central Valley, there is no medical school, and new doctors often avoid the area in favor of richer urban centers, where they can make more money.
Earlier this year, lawmakers earmarked $465 million from the state’s new tobacco tax to boost payments for some Medi-Cal providers, which could help make poor areas like the Central Valley more attractive to doctors.
At Clinica Sierra Vista’s location in east Bakersfield, where Meave’s residency is based, 75 percent of patients are covered by Medi-Cal — the state’s version of the federal Medicaid program for low-income residents — and 15 percent are uninsured, Stewart said. Asthma, diabetes and other chronic conditions are major health problems.
Veronica Ayon, a former farmworker, is one of Meave’s patients. Like her doctor, she is a native of Sonora.
Ayon, 48, was treated for cervical cancer in 2010 and last year underwent surgery to remove a malignant brain tumor. She feels comfortable with Meave because of their similar backgrounds and language, she said.
“She is very special to me,” Ayon said, speaking in Spanish inside her home in the town of Shafter, about 20 miles north of Bakersfield. “She explains things at a level I can understand.”
This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
There’s arguably no better time for NP’s to call their own shots, and no better time for healthcare administrators to apply this talent solution to meet their community’s need for care.
by Doug Carter
Nurse Practitioner is now the #1 ranked job in healthcare and #2 in the nation across all industries (US News & World Report Job Rankings for 2017, 1/12/17). Regardless of profession, no job gains such a high distinction without becoming a “win-win” for both those who do that job and those who understand the value of what that role brings to their organization.
There’s arguably no better time for NP’s to call their own shots, and conversely, no better time for healthcare administrators to apply this talent solution for the best opportunity to meet their community’s need for care.
In order to understand the value of nurse practitioners within our healthcare delivery system, it’s important to first understand how they’ve gained the respect of other providers by successfully embracing their role within today’s collaborative settings.
It wasn’t long ago that many M.D.’s and their respective advocacy groups widely questioned the validity of nurse practitioners in a number of forums. However, those concerns have diminished in recent years. Nurse practitioners have gained respect from within, doing an outstanding job in proving their worth amongst peers, who together work toward a shared goal in the care of others.
There’s now acceptance of the fact that the success of our healthcare delivery system lies at the intersection of revenue & access to care; requiring a collaborative “team” solution in order to maximize a facility’s ability to meet both of those needs at the highest possible point of return.
According to the Henry J. Kaiser Family Foundation, 90% of nurses who become NP’s by completing their Master’s Degree originate from primary care settings. This is the ideal proving ground for new nurse practitioners because that’s exactly where they’re needed most as today’s physicians increasingly choose better paying opportunities outside of primary care.
Nurse practitioners are ideal within the scope of primary care’s growing demand for a number of reasons. They have the ability to provide care in a wide range of practice settings within all types of communities.
Rural areas of the country, specifically, remain hardest hit by our shortage of qualified providers. In rural areas, there are roughly 13 physicians per 100,000 people in comparison to 31 in urban areas, according to the National Rural Health Association. These communities have the highest rates of uninsured, underserved, aging, and vulnerable patients. However, when utilizing nurse practitioners, rural hospitals have been able to uphold satisfaction rates on par with physicians.
Healthcare executives and administrators praise the cost savings associated with utilizing NP’s as well.
“Nurse Practitioners play a critical role in the operation of our health center and in our Country’s primary care delivery network. Their skills, knowledge and commitment to the values of the nursing profession offer our patients high quality, cost-effective primary care,” says Ken Gordon, Chief Executive Officer at Coos County Family Health Services in Berlin, New Hampshire.
The rising costs of providing care are top of mind with all facilities. NP’s are more affordable to recruit, train, and retain in comparison to physicians.
While the shortage of physicians becomes an unfortunate reality, the growth of nurse practitioners remains largely unhindered. Individuals choosing healthcare as a career see a faster, cheaper, and less bureaucratic route to reaching their goals by becoming an NP. On average a nurse practitioner requires only six years of education in comparison to the decade (or more) required to become a physician, depending on their choice of specialty.
Doctors are also strapped with higher debt upon their completion. In addition, our access to new physicians in the United States still arguably bottlenecks at the point of Medicaid- funded residencies through the national matching program. Even with sporadic state-level solutions to the problem and a continued political rhetoric geared towards shedding light on this longstanding issue of supply, we’ve been unable to keep up with our nation’s need for care. NP’s just don’t face the same uphill battle.
If you ask healthcare facilities to consider a larger pool of providers that bring 80%-90% of the skill set of doctors, they’ll take it. If the choice is a vacancy that equals lost revenue and inability to meet the healthcare needs of their community – or, a staffing solution that entails nurse practitioners – the choice is easy. In an urgent situation, with revenue-based healthcare delivery and the widespread reach required to meet increased numbers of patients in the US – NP’s make sense right now.
Doug Carter is a Partner at Ironside Human Resources. Ironside HR is a national healthcare recruitment firm based in Dallas, Texas, dedicated to meeting the needs of medical providers, executives, administrators, and the communities in which they serve. Doug can be reached at 214-785-2404
or doug@ironsidehr.com.
Disclaimer: The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
