Nursing Reentry isn’t the Panacea for Nursing Shortage

by Academy Medical on February 8, 2012

Between Medicare, Obamacare, polarized politics and the sky high budget deficit, healthcare reform is as much an oxymoron as it is a description of the fastest growing segment of both personal and governmental budgets. Regardless of where you stand politically on the subject, almost everyone agrees the current state of healthcare is bad, eroding, unaffordable and unsustainable. One of the most pressing issues in healthcare today is a national nursing shortage. This, during a time when many universities are reducing resources for their nursing schools and immigration policy is making it more difficult for qualified foreign nurses to begin careers here in the U.S. It would seem to be the perfect time for former nurses to consider returning to the profession through nursing reentry programs or “refresher courses”, but that doesn’t seem to be the case. What is thwarting these seasoned professionals from taking advantage of this great opportunity to return to nursing?

It would seem a natural for health professionals to return to the workforce. Many former nurses want to return because they have to. The Great Recession has taken a toll on the middle and working classes of America, and for most nurses this was the best paying job they have held. But there seems to be a number of reasons nursing reentry hasn’t played a bigger part of solving the nursing shortage. Rather than reaching out to help this valuable pool of health professionals make their reentry easy, many hospitals choose instead to take new graduates from nursing schools. It might be because they are up-to-date with new technologies and skills, but cynics suggest it’s because they are easier to mold and less likely to stand up for themselves in a profession where being tough is required for self-preservation from domineering doctors and administrators.

Many nurses are also fearful of the challenges and changes that have taken place since they last practiced. This is a legitimate concern but one that is shared by anyone returning to old fields of play. And that’s what nursing reentry courses are designed to do–fill in the knowledge gaps between past and present. This presents yet another anxiety for many returning nurses: the cost of nursing reentry courses and concerns about meeting all criteria to return without the guarantee of a job waiting at the end of the process. Most programs comprise of two segments: classroom and “clinicals.” The former is pretty straightforward, taking a series of courses, often online, and costing as much as $2,400 for an average of 160 hours.  Online continuing education courses can sometimes apply, too.  The clinicals require working in a clinical environment for a state required number of hours. While some programs offer assistance in finding a position (unpaid), it’s almost never guaranteed, and with many hospitals actually laying off health professionals (exasperating the nursing shortage), it can be very difficult finding placement. Without fulfilling the clinical component, an aspiring nurse may be left in the cold and out the cost of courses.

While healthcare reform is a moving target, many components of the likely outcome offer a variety of solutions that may reduce the nursing shortage. First, nursing schools are likely to receive funding to address this issue at the grassroots level. This may also help with nursing reentry programs. Healthcare reform also focuses on specific areas like primary care, palliative care and geriatric nursing, all of which could benefit healthcare professionals disproportionately that specialize in these areas. Finally, if the politically charged insurance mandate results in all (or most) Americans being covered by health insurance it would figure there would be an increase in services and thus require more health professionals in the system. But whether healthcare reform passes or not, eventually the economy will improve, nursing schools will add more students and more healthcare professionals of all stripes will be back to work. At least we can hope. After all, while healthcare reform may remain an oxymoron, any industry working with the health insurance industry is sure to succeed.

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FDA falls short on enforcing nutrition label errors

by Academy Medical on January 17, 2012

Whether you’re counting calories in food, monitoring your blood sugar, or just maintaining healthy eating habits, reading food facts on nutrition labels is one of your most powerful tools…or so you may think. It turns out that the Food and Drug Administration (FDA), the federal agency responsible for protecting and promoting public health and food safety, isn’t so much a powerful regulating organization as much as a referee trying to oversee a tug-of-war between consumers and food producers. And consumers are losing that battle through inaccurate nutrition labels that break rules the FDA isn’t enforcing.

The FDA doesn’t play an active role in creating nutrition labels for food. That’s left up to individual companies to test and compile their nutritional facts through a “self policing” policy. Not only does the FDA leave this critical role up to the producers, but it allows a margin of error up to 20% on the calorie counts and other values of packaged foods found on nutrition labels. Furthermore, “errors” in excess of 20% are rarely enforced. The ” FDA does not have the resources to analyze products upon request.” Instead, random (and rare) “audits” of nutrition facts, or response to reported violations, are the only way a producer can expect problems from the FDA. And even then, the FDA’s inspection and enforcement is “minimal and disorganized,” according to the Government Accountability Office (GAO) in a 60-page repor t last January titled, “Food Labeling: FDA Needs to Reassess Its Approach to Protecting Consumers from False and Misleading Claims.” (For a terrifying, unrelated story about the FDA’s lack of enforcement, read “FDA Knew of Contaminated Baby Wipes “, a story about repeated, validated complaints of contamination over a five year period resulting in no enforcement).

Back to the GAO report, the findings showed almost 1 in 4 (24%) of nutrition labels were inaccurate. Now if that means a few extra calories that’s one thing (ex: Wonderbread with 70% more total fat than labeled ), but if you’re on a sodium restricted diet (ex: Ritz Crackers with 36% more sodium ), or a diabetic watching blood sugar, these little oversights take on a whole new dimension of seriousness!

The last time food labeling was addressed was 1990. But rising concerns about food safety and accurate food labeling has resulted in threatened legislation, but the food industry has once again gotten ahead of the regulatory ball and introduced its own version of “improvement.” The resulting changes are called “Facts Up Front ” and involve moving the label area to a more promonent spot on the front of packaging. Also, larger and clearer label information in included. The core problems remain, however, as there is no corresponding oversight or enforcement improvement from the FDA, and the basic information is still determined by the food producers. It remains to be seen if this improves the accuracy of nutrition labels.

For healthcare professionals wanting more information on nutrition labels and diabetes see, “Nutritional Principles and Practices for Persons with Diabetes

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Health Coaching Improves Wellness Regardless of Distance

December 20, 2011

Health coaching is defined as “guiding others to address their health and, if need be, make behavioral changes to improve health” through a healthy lifestyle. The traditional role involves a coach, usually a healthcare professional and patient working together to set goals, identify obstacles and monitor progress. Goals may include issues such as weight management, [...]

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Companies pass on Higher Health Care Costs for not choosing Healthy Lifestyles

November 30, 2011

After receiving emotional feedback from a recent article on the relationship between health care costs and healthy lifestyles, or more accurately, lack thereof, I decided to write a follow up on the trend of employers imposing financial penalties through increased health insurance costs for employees who smoke or otherwise don’t meet certain health standards.
A recent [...]

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Diabetes Awareness and the Impact on Health Care Reform

November 18, 2011

As most clinicians know, diabetes is a serious disease that requires life long management and is one of the biggest challenges to U.S. healthcare. But an even more pressing problem is the dramatic increase in diabetes while awareness of the disease and how to prevent it remains low. Causes of diabetes, particularly type 2–sometimes referred [...]

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Should Health Insurance Costs be tied to Your State of Health?

November 3, 2011

      Would you exercise more or eat less if it meant saving money every month?  That’s at the heart of an ongoing and intensifying debate on how to price health insurance to either reward people who live healthy lives, and therefore expect to require less medical services, or penalize individuals with unhealthy conditions and/or habits.  [...]

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Rules of Engagement for Dining Out

October 19, 2011

Americans today eat as many as half their meals away from home.  The trend is increasing and the correlation between the well documented fattening of America and dining out is strong and undeniable.  But rather than deny yourself the pleasure of good food entirely, instead try and create a way to succeed–and maybe even have [...]

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Behavioral and Educational Interventions Work!

October 12, 2011

Why is it that one person who smokes a pack a day can put down the last cigarette and never smoke again, while another anguishes over their deadly habit for a lifetime but can never quit?  Or one obese person starts a diet and loses 50 pounds and keeps it off while most obese dieters [...]

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Informatics: Leading Edge of Future Nursing

October 4, 2011

        Every once in a while, a name hits our lexicon that becomes iconic to our culture (think Xerox, Kleenex or Google).    A new one may be added soon.  If you browse the term Informatics you’ll find the following definition: “a broad academic field encompassing human-computer interaction, information science, information technology, algorithms, and social science.”  [...]

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Exercise Prescription is the Right Medicine

September 20, 2011

Exercise prescription is the referral of patients by healthcare professionals to exercise programs designed to help patients suffering from chronic diseases such as diabetes, heart disease, obesity and other medical problems.  Treatment is based on the knowledge that exercise is crucial to the prevention, management, and treatment of numerous chronic conditions.  The term is also [...]

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