What is Driving Physicians to Burnout

Many doctors are always a step away from burnout. But we all chose this profession anyway, because we want to make a difference.

from Dr. Linda

Burnout rates are escalating among physicians, as well as other healthcare workers. In a system that is already stressed by many forces, losing any member of the team can have devastating consequences. Nurses are a prime example of how they are expected to do more and more work with less and less help and resources. Hospitals cut back on their ranks to save money. And patients suffer because of it. Big organizations do not so much care about the health of these nurses who selflessly try to give patients their best. Rather, the bottom line dictates staffing standards.

Read More →

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 Patient Satisfaction Scores, What Role Does Bias Play?

Do physicians who are not white or male get graded worse by patients?

from AMA Wire

Women and minority physicians continue to face prejudice in the workplace, which is a potential barrier to career advancement, fulfillment and leadership opportunities. Such stressors can also discourage women from continuing in academic medical practice. Yet no experimental studies isolate the direct effect that physician gender and race can have on patient satisfaction ratings. Do physicians who are not white or male get graded worse by patients?

Read More →

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.

Relief for Patients with Atopic Dermatitis

New immunomodulatory therapies are promising, not only for reversing skin barrier dysfunction, but in addressing the immune abnormalities associated with atopic dermatitis.

by Peggy Vernon, RN, MA, C-PNP, DCNP, FAANP

Atopic dermatitis is characterized by abnormal skin barrier function, causing increased permeability. The filaggrin gene is a key player in maintaining the protective function of the stratum corneum. One of the roles of the filaggrin gene is to compact keratinocytes into a tight layer, creating a barrier that protects the epidermis from allergens and bacteria. Think of it as brick and mortar. When there is dysfunction of the filaggrin gene, the barrier is broken. This allows transepidermal water loss, increased skin pH, decreased resistance to bacteria, specifically S. aureus, and exposure to allergens. The cytokines interleukin-4 (IL4) and interleukin-13 (IL-13) are major components that cause itch and inflammation. Additionally, overactivity of the enzyme phosphodiesterase-4 (PDE-4) has also been shown to contribute to the inflammation of atopic dermatitis. This break in the skin barrier and resultant inflammation and exposure to allergens leads to the atopic triad of atopic dermatitis, allergic rhinitis, and asthma. Therefore, treating the abnormal skin barrier function may prevent the allergic triad.

Research during the last decade has identified these specific cytokines and enzymes that contribute to the inflammation, erythema, pruritus, and excoriations of atopic dermatitis. New treatments target IL-4 and IL-13, as well as PDE-4. Previously the management of atopic dermatitis was reliant on topical steroids. The advent of newer therapies has allowed a decrease in the length of treatment with topical steroids. Topical calcineurin inhibitors Tacrolimus (Protopic™) and Pimecrolimus (Elidel™) were approved for treatment of atopic dermatitis in patients 2 years of age and older. They inhibit calcineurin, thereby suppressing inflammation. In December, 2016, Crisaborole (Eucrisa™) was approved for treatment of mild to moderate atopic dermatitis in patients 2 years of age and older. It is a nonsteroidal PDE-4 inhibitor that suppresses proinflammatory cytokines. In March, 2017, Dupilumab (Dupixent™) was approved for treatment of adults with moderate to severe atopic dermatitis. It is a monoclonal antibody biologic injectable medication that binds to the IL-4 receptor and modulates both the IL-4 and IL-13 pathways.

There are several PDE-4 inhibitor medications currently in clinical studies which look promising in treating atopic dermatitis. These new immunomodulatory therapies are promising not only for reversing skin barrier dysfunction but addressing the immune abnormalities association with atopic dermatitis.

I will be presenting the new advances in atopic dermatitis treatments this year at Skin, Bones, Hearts, and Private Parts conferences. Register for conferences in Nashville, Pensacola, or Orlando and hear about the new and exciting treatment options for your patients and families with atopic dermatitis.

Kim’s Blog: Regeneration of the Mind and Spirit

Caring for patients, takes not only an extraordinary amount of knowledge and skill, but also caring. How can we make sure we’re mentally up for the task?

by Kimberly Spering, MSN, FNP-BC

It goes without saying that what we do, caring for patients, takes not only an extraordinary amount of knowledge, skill, but also caring. How can we make sure we’re up for the task of working in our roles? One answer: caring for ourselves… first and foremost. Doing things to “regenerate” our spirit.

It’s been a long summer and early fall season with patients. For whatever reason (full moon, superstition, eclipse, etc.), patients’ needs have seemed exorbitantly… needy lately. There were more phone calls and demands on my time than usual. I get it – in my palliative role, I may see 3 – 4 patients per day (at 40 minutes to 3 hours each), then chart later. The time I spend is nowhere near the amount that I spent working in an Internal Medicine office.

Or, do I, really?

In the office setting, I had my allotted 20 minutes (really, 10 minutes after patients were roomed) to determine the most pertinent issues that needed to be treated. Repeat by 20-plus patients daily. In my home-care palliative care world, I will spend as much time as needed to determine what is needed – whether this is new medications, family counseling, consultations with other offices, goals-of-care discussions, etc.

The numbers may be less, but the situations are often more crucial… the outcomes more perilous, and often, long visits are needed to determine patients’ needs and to coordinate care.
Can one put a time frame on these critical issues? No, we can’t. However, no matter if we see 20 – 30 patients (or more) per day, or three… caring for patients in any role takes a toll on all of us as providers.

So, what do we do to “regenerate” ourselves?

Is it taking time off (whether we travel for a fabulous vacation, have a stay-at-home vacation (also known as, in my world, doing things around the house)? Is it spending time to recoup our losses in medicine (oh, yes, we have losses – patients who die, “rules” we must follow by the so-called administration, services we could not get patients qualified for, etc.)? 

Or is it something that we make time for in our busy schedules: working out at a gym, going for a walk, getting a massage, spending quality time with a friend, etc.?

I daresay, regeneration can take place in any or all of those areas.

So why is it that many of us feel the pull to martyrdom, trying to “suck it up” without paying attention to our own needs? I’d bet that most of us have counseled patients, who were frustrated about the lack of time, lack of self-care, and we probably blithely said, “well, you have to take care of yourself first.” Or, “you need to recharge your own battery if you want to care for others.”

Well, now. That’s just great. If only we followed our own advice.

I’m guilty as anyone—putting the needs of family, home, dogs, and patients before my own self-care.

I fully believe that if we are to take care of patients – in any realm – that we must be mindful of the need for our professional & personal self to regenerate. Taking time to see out of our own world-view. Taking time to care for ourselves.

Don’t feel guilty about it. We OWE it to ourselves and our patients to practice good self-care – so we can care for others… be fully vested… and fully able to help them.

In August, I relaxed on vacation, in a private lake community in Pennsylvania, with my husband’s family. It was different from past years, as my sister-in-law died on January 31st. It was great to see how the cousins all connected, sharing in comradery, as only cousins who see each other a few times yearly can do. Our family needed that week of restoration… of healing.

I recognized that I needed time in solace and meditation. While reading eight books, including studies in the metaphysical, religion, and yes, “beach reads” with no requirement for “real” thought… I found my time to regenerate.

My taking vacation won’t adversely affect my patients. I have my co-workers to rely on to manage those issues. Purposefully, I did not log onto our hospital system to see what transpired while I was on vacation.

And you know what? The universe didn’t collapse. My patients’ needs were met by my co-workers. Life kept going on.

And when I looked out on the lake, lost in thought – or thinking nothing at all, threw a ball for one of my retrievers to fetch, spent time with my family… all was right in the world. I was regenerated to do this work for another day.

I encourage you to make time to “regenerate” in your own way. The only way we can continue to do our work is to care for ourselves first. Give it some thought. Make the time to care for YOU.

Kim Spering has been a nurse for over 25 years and worked as an NP over the past 15 years in Family Medicine, Women’s Health, Internal Medicine, and now Palliative Medicine. She serves as an editorial board member of Clinician 1 and submit blogs to the website, with a goal of highlighting both the clinician and patient experience in health care.

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.

We Need Nurses More Than Ever. Why Are We Letting Them Burn Out?

The combination of an exodus of RNs and an influx of aging patients could create a health care crisis.

from Huffington Post

About 10 years ago, Elizabeth Scala was a young RN, working on a psychiatric floor of a busy Maryland hospital. She’d been in the role for two or three years, and she’d risen to a position of authority, coordinating her colleagues’ activities as a charge nurse on the unit. From the outside, it looked like she had everything together, but inside she was so stressed out she was nearly falling apart.

Read More →

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.

Let’s Stop Blaming Hospitals for Every Security Breach

Yes, health entities need to be held responsible for protecting patient data but public shaming isn’t making that happen. There’s a better way forward.

from HealthcareITNews

I stepped into the Healthcare Security Forum this week in Boston hoping to walk away with perhaps a few nuggets of optimism, even small ones. That didn’t exactly happen but, instead, a new message emerged: the conversation about how cybersecurity is so negative that it only triggers tension and hostility among infosec pros, executives and end users.

Read More →

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.

Best Practices for Hospitals Looking to Stay Organized

As healthcare grows in new and innovative ways and more technology is added to healing and healthcare, HR faces many new challenges.

by Eileen O’Shanassy

As healthcare grows in new and innovative ways and more technology is added to healing and healthcare, the Human Resources department of hospitals face many new challenges. Since these departments are responsible for hiring clinical and non-clinical personnel, it’s clear the success of the facility depends largely on the decisions made in Human Resources. Therefore, it’s important for the hospital itself to have as many practices in place as possible to help HR succeed in its endeavors. To gain a greater understanding of these practices, here are some ways hospitals can be organized to ensure a Human Resources department runs as smoothly as possible.

Invest in Technology

Since the days of receiving resumes through snail mail are gone, it’s important for an HR department to have the latest technology at its disposal to attract the best applicants. Whether using an online medical recruiting service or similar online pool to find and hire the most qualified individuals, investing in cloud technology and other types of state-of-the-art equipment can make a huge difference in a hospital’s performance.

Pay Attention to Training and Credentials

Since it’s vital for doctors, nurses, and others who hold professional licenses to maintain their certifications, managers of various clinical departments should work closely with HR to ensure no lapses occur. To do so, department managers should work with HR to schedule in-house training, continuing education classes, and other training. By doing so, a hospital can often continue to attract highly-qualified personnel for its clinical positions.

Adequate Staffing

For an HR department to make the best hiring decisions, it relies on reports given to it by department managers to ensure all areas of the hospital are adequately staffed from jobs for physicians to jobs for doctors, every staffing position needs to be filled. Even housekeeping and food services, and nursing and operating room personnel should be overseen. Having staff levels that can meet the needs of patients is crucial to an efficient operation. Be sure all levels of management are able to communicate when there is a shortage.

Create a Reasonable Budget

First and foremost, a hospital is a business, and must be able to earn a profit in order to maintain high levels of operation. Because of this, hospital executives must work constantly to create budgets that will allow for necessary funding for all departments. This is a tremendous help to Human Resources, since an HR manager must know how much money they have to work with before making hiring decisions.

 

Even though healthcare in today’s world is more complex than ever, it’s still possible to create systems that work very efficiently. By having all departments work closely with HR, a hospital can provide world-class service to staff and patients.

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.

Why Physicians Don’t Want to Retire

A study found most physicians wanted to keep working due to enjoying practicing medicine, the social aspects of their work, and the want to maintain their lifestyle.

from Psychiatric Times

I have been working for nearly half my life and truly enjoy my job and the opportunities it has given me. While retirement isn’t something on the top of my mind, I do look forward to a time when I can spend more time with my family and on doing the things I love to do outside of work. It seems like I am not alone. A recent CompHealth study showed a large number of physicians are also looking forward to retirement for the exact same reason. But while physicians plan to enjoy retirement, the survey found that many are not particularly excited about leaving the profession.

Read More →

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.

AMA Urges Senate to Oppose Graham-Cassidy Bill

The AMA calls for the Senate to shut down Graham-Cassidy, which they say would result in millions of Americans losing health coverage.

The American Medical Association has issued a statement on behalf of its physician and medical student members, urging the Senate to reject the Graham-Cassidy healthcare bill, citing that the legislation violates the precept of “first do no harm.” They have also requested that the U.S. Senate oppose any other legislation that would “jeopardize health insurance coverage for tens of millions of Americans.” To read their letter to Majority Leader McConnell, Democratic Leader Schumer, and the whole of the Senate, please click here.

What are your thoughts on the proposed legislation and the AMA’s letter?

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.

The Pros and Cons of NP and PA Role Expansion

Now recognized as a “strategic necessity,” role expansion for these 2 occupations has implications for job satisfaction, burnout, and work-related stress.

from Contemporary Clinic

Role expansion is a hot topic for nurse practitioners and physician assistants as health care policymakers increasingly appreciate their value in health care. The journal Medical Care Research and Review has published a new article ahead-of-print that discusses an important issue in fields where job opportunities and responsibilities are changing: job satisfaction.

Read More →

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.