April Contributing Editor
Tony Dombroski BSN RN
Nurseone@nurseone.com
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Apologies to all on the lateness of TNT this month. The Editor coughed her way through a bad case of the flu, which took longer than expected to recover from. Well, nurses do have a problem taking care of themselves, don't they? And since TNT is a personal labor of love, rather than a source of income and employment, the ezine was forced to take a short hiatus while the Editor/typist had a rest, then caught up on other work. I know you understand.
The date of TNT publication will now officially change to the FIRST of the month as of this issue, so this issue will serve as the April-May issue. The next issue of TNT will available will be on June 1st, 1997.
National Nurses Week is coming fast! The official celebration runs from May 6-12th, 1997. Nurses share May 6th with Teachers as the National Day for our respective professions.
In addition, International Midwives Day is celebrated on May 5th. The International Midwives theme is "Equity for women", given that over half a million women die of avoidable complications each year during childbearing.
Let's please not forget our mothers on May 11th. The original caregivers, the first nurses and healers in our lives.
May is a time to celebrate where we came from, what we are, and what we hope to become.
By Kathi Webster BSN RN, Editor
It is with great amazement that I find myself both excited and intrigued by a new book about real nursing. Too often our heads are buried in nursing journals and clinical textbooks, trying to keep up with the pace of our profession, only to find that the articles fail to touch the real essence of nursing. How can someone capture the spirit of what we do everyday when we ourselves are sometimes unable to vocalize it well? And when you find someone who has accomplished such a feat, how can you not be amazed?
Perhaps there was always the need for someone to look from outside our profession inward, like Alice through the Looking Glass. I'm sure some days we do look like the Mad Hatter at a Tea Party. But what kind of outsider could we trust to look at the world through our eyes and write a truthful version?
Life Support, Three Nurses on the Front Lines is a such a book. Written by author Suzanne Gordon, the book is vital not only to nurses, but to everyone. Somehow Suzanne has captured nursing essence in a book, and it should have "READ ME" in screaming red letters on the front cover for the importance it carries for all of us. She relates the story of three nurses: their lives, their feelings, their thoughts and their devotion to their patients.
The author weaves the tapestry of nursing so well around these stories that you get a seamless and clear picture of "what nurses do", our history, and why the nursing profession is vital to our patients and to the health care in the world -- now and into the future. Nursing theorists, tales of Flo and a straightforward look at managed care all included in a book that belongs on the bookshelves of nurses, health care managers, your favorite politician and your patients.
If you'd like a glimpse at the style of this book, checkout What Nurses Stand For in the February issue of the online Atlantic Monthly. The article starts with the following description of nursing: "Sitcoms satirize them, the media ignore them, doctors won't listen to them, and now hospitals are laying them off, sacrificing them to corporate medicine -- yet their contribution to patients and families is beyond price."
And when you buy your personal copy, do yourself a favor and buy several. A book kept on the shelf doesn't get the word out. Lend it to someone, a nursing colleague in need of inspiration, or a non-nursing person most likely to need a clue!
What Nurses Stand For is at: http://www.theatlantic.com/atlantic/issues/97feb/nurse/nurse.htm
Another online article by Suzanne Gordon in Mother Jones entitled Cutting Care is at: http://bsd.mojones.com/mother_jones/JF94/health.html
[Editor's Note: Life Support is available via the WWW at Amazon Books, where you can either purchase the book online, or simply write your own review after you've read it! Regardless of where you buy the book, I strongly encourage your to lend Suzanne your personal support by giving her work a fair review!]
By Tony Dombroski BSN RN, Contributing Editor
In my 18th year I worked a variety of jobs. Digging ditches with Luke at 6 a.m., me frozen and asleep, him stoned on Robitussin and whiskey. I begged him to let me use the pickaxe and gave him the shovel to save both our lives. Four teeth in his mouth smiled back, "thanks kid". I cleaned cars for Avis (tried harder) cooked for Howard Johnson (36 flavors) and surveyed sewers for the city (all down hill from here). These jobs bestowed on me work group experiences I've not forgotten.
In the Navy I learned a skill and got more specialized in my work. Now, unable to simply hand over my shovel for a pickaxe, I still remain critically dependent on my team for survival.
Nursing school was less of a team experience. Each individual was ferociously struggling to achieve success in an independent fashion. The emotional winter among this group only rarely thawed into a real friendship. Thus primed, I launched my practice into the least anxiety producing area of specialty, psychiatry. I'd been a bartender before so I was comfortable giving drugs to stoners and listening to the stories of their lives.
Several years in medicine at the County General hospital, nights (to avoid administration), it dawned on me that I'd become a nurse. I thought about what I did, but also moved through the shift with instinctual clarity. A new nurse was observing an ostomy dressing change I was doing on a fiftyish female three days post surgery. The patient fearful and in denial stared expressionless at the ceiling while I worked. As I work I'm chatting with both the student and patient. "Know anyone with an ostomy?" I asked. "The guy in the grocery store, old man Grover, I think" she replied. "What about Steve McQueen, the actor?" I asked capitalizing on a rumor. "No, really?" came her reply as we first made eye contact. "Sure," I said smiling an invitation to get involved. "Life ain't over yet".
The student finished the dressing and later cornered me to say that what I had done was magnificent. Her formerly withdrawn and sullen patient was talking , active and animated. I was shocked and flattered to have my workmate make the effort to share her positive impressions. Reflecting on this, I know I haven't made enough effort to express my appreciation and gratitude for all the knowledge I've gained from workmates. How not to get hurt by violent psych patients, how to effectively chastise apathy, all learned from members of my team, not only from RNs.
I began my practice in an urban HMO 17 years ago. Once again at the bottom of the ladder of knowledge regarding outpatient care and patient management. I knew that the people with whom I worked would provide the information necessary to develop expertise.
My willingness to observe and learn from all sources, and express gratitude for shared information has worked well. Last week and urgent care doctor at my station for the day overheard me hardselling the benefits of a screening sigmo to a nervous patient who requested to see the equipment. "I should listen to you more often, I'd get better at convincing my patients" she commented. I chuckled and thought of the new nurse and four-tooth Luke. "Thanks kid", I replied "we are all in this together".
I certainly believe that licensed personnel should accomplish certain tasks. Only licensed drivers should operate motor vehicles. But we, as drivers, are all going the same place...down the road. We, as nurses, all have the same objective...quality patient care. We need to renew our effort to share the road and the knowledge we have from all our work experiences and provide the best patient care possible.
Happy Nurses Day. I feel a great deal of pride to be on your team.
Visit Tony's NurseOne Website at: http://www.nurseone.com where you can find interesting articles, links and CE courses related his GI advice specialty.
Florence Nightingale is alive and well on the World Wide Web. As an integral part of nursing history, Flo stands among those recognized as having the courage to care...and helped to steer the direction of modern nursing. Several web pages feature articles or information on Flo -- all worth visiting.
Inter Nurse is at: http://www.kencomp.com/internurse/
Journal of Nursing Jocularity is at: http://www.jocularity.com
Clendening's letters are at: http://www.kumc.edu/service/clendening/florence/florence.html
Univ of Kansas Nursing Page at: http://www.kumc.edu/instruction/nursing/soninfo.html
Country Joe's Tribute: http://www.dnai.com/~borneo/nightingale/index.htm
Their planned efforts to tackle this issue include:
For those without web access, two questions are asked:
You can email your answers to these survey questions directly to msr@ncsbn.org
The MSR Taskforce NCSBN page is at: http://www.ncsbn.org/pfiles/msrtf/297msrcm.html
S.B. 370 - about increased Medicare reimbursement for NPs
S.B. 385 - about Medicare reimbursement for telehealth services
To keep current on these, and others, connect with THOMAS Legislative Information on the Internet at:
TalkCity is an Internet community for those who believe in people and in the power of conversation. Live Chat at Talk City uses a technology known as Internet Relay Chat, or IRC. The IRC system allows chat interaction between people in a live and real-time environment. Although there are other ways and places to access the IRC, TalkCity actually has some common sense rules or Code of Conduct, along with moderators that help to enforce them. For all these reasons, TNT's Editor located and identified TalkCity as the perfect environment for a chat room for nurses.
As of April, a new channel is available there called #4Nurses. Although moderated part-time right now, TalkCity CSA's (City Standard Advisors) are available around the clock to assist you.
There are several ways to connect to Talk City IRC and to the #4Nurses channel.
Once you have the IRC program, you can connect to Talk City by setting the server address to
Expect to see the Editor of TNT in there on occasion...with the nickname of KathiRN. She is the primary moderator of this channel, and will extend you the warmest welcome! Also feel free to introduce yourself to Jagguar, the wonderful co-moderator from the land Downunder. Though not a nurse, she is a special person and a *should be* nurse. So we've made her an honorary one!
TalkCity can be found at: http://www.talkcity.com
The TC Code of Conduct is at: http://www.talkcity.com/csa/
For the mIRC software homepage check out: http://www.mirc.co.uk
For the Internet Relay Chat page: http://www.generationis.com/jiirc.htm
Patient on Phone:"OOOOOUCH , OOOOoooo , EEEEee."
Triage Nurse:"What's the matter there?"
Patient on Phone:"A bee's stung my thumb."
Triage Nurse:"Try putting some meat tenderizer on it."
Patient on Phone:"But the bee will be miles away by then!"
Once warm weather comes to an area, the bees, wasps and other stinging insects are sure to follow. Telephone triage nurses receive many calls from people about bee stings especially, worried that a family member or friend is having a serious reaction. Often what the person has experienced is a normal but painful reaction to a sting.
Symptoms of a systemic allergic reaction or "anaphylaxis" include hives and itching and swelling in areas other than the sting site, chest tightness and breathing difficulties, hoarse voice or swelling of the tongue, GI complaints like abdominal pain or nausea/vomiting/diarrhea, and dizziness, weakness or a sharp drop in blood pressure that may cause unconsciousness. This is a true emergency requiring someone alert the emergency medical system (EMS or 911). Read more about this problem at a web page with information by Dr. Wein, associated with Columbia Lawnwood Regional Medical Center in Fort Pierce, Florida.
Web surfing on the Internet produces some interesting information on topics related to bee and insect stings, and it is well worth your efforts to get ready for the stinging season.
Instructions for stinging insect sensitive persons can be found at the Allergies Pages of Children's Mercy Hospital in Kansas City, including great advice on how to avoid exposure and high risk situations. Did you know "white" is said to be the least insect-attracting color? Would you know that handling trash or garbage could be risky as wasps and yellow jackets search for food there?
No doubt we'll all get a few calls from folks swearing they've been attacked by a killer bee. The Africanized Honey Bee is moving into South Texas and the southern United States, along with some exaggerated reports. Visit this site to get all your facts straight. Africanized bees do not roam in giant swarms looking for victims to attack. How will this bee bother beekeepers more than other people?
The Insect Identification Laboratory at the Department of Entomology, Virginia Tech maintains a website that can help you identify insects along with their damage, bites and stinging capabilities. Learn about the Hackberry Leaf Slug, a caterpillar with poisonous hairs or spines. Or about how the Cigarette Beetle can infest spices like curry powder, chili powder, paprika, and can feed on pyrethrum powder strong enough to kill cockroaches.
There are allergy related emergencies from insects, food, drugs and exercise. At this HealthLine Publishing site, you can get tidbits on all of these problems. Were you aware that 15 percent of the population may be allergic to a food or food ingredient? What can you do to your cat to reduce the quantity of allergy-provoking proteins shed?
Allergic Reactions to Beestings at:http://www.columbia.net/consumer/datafile/stings.html
Insect Identification Lab is at:http://www.ento.vt.edu/Facilities/OnCampus/idlab/id/id-db&s.html
HealthLine allergy emergencies at:http://www.health-line.com/articles/ac930005.htm
Allergy Page at CMH is at:http://www.cmh.edu/Allergy/Allergy.HTM
Africanized Honey Bee page is at:http://agnews.tamu.edu/bees/
Dear TNT
Our Call Center has been in operation for just over 3 years. Planning for a self-study, we would like to know these things in two ways. First, national "reports" on these; and second, individualized feed-back from other Call Centers.
These questions:
Thank you for considering sharing this.
Signed:
Lanelle Brown, RN
e-mail: bryan.brown@worldnet.att.net
Carol Stock JD MN RN presents interactive one day workshops for telephone nurses. Carol is an attorney, adjunct professor at Seattle Pacific University, and a wonderful speaker -- in addition to having experience as a family nurse practitioner prior to her law practice. She will be presenting two different workshops during the next few months. See the following URL for dates and locations:
When: March, April and May 1997
http://www.katsden.com/telenurse/confer.html
Contact: Carol Stock and Associates
POB 31114, Seattle WA 98103, phone/fax (206) 789-0909 PST
Announcing a four-day continuing education program, from the University of Wisconsin-Madison
When: May 19-22, 1997
Where:Madison, Wisconsin
What:The program will help faculty develop skills in nursing informatics, and establish stratgies to integrate nursing
informatics content into the nursing curriculum. Faculty responsible for clinical nursing courses (adult, pediatric, mental health, critical care
and communty health) who seek ways to increase the use of inforamtics in their courses are particularly encouraged to attend. As part of a consoritum headed by the Midwest Alliance In Nursing, scholarships are available to cover the cost of tuition. Additional funds
(up to $500) are available to reimburse travel and expenses. Madison is beautiful during the Spring; consider extending your stay to enjoy our lovely lakes!
Who: Contact Barbara Gessner at bgessner@facstaff.wisc.edu or 608-262-0051
[Some conference information is obtained directly from the Web. The editor of TNT is not responsible for any errors related to conference detail and all information should be confirmed with conference directors]
Salon for Nails? NOT!
The Salon Magazine website boasts an interactive magazine of books, arts and ideas. Like Athen's Aspasia, it bids you welcome to creativity -- and some wonderful writing. Regular article areas include: Taste, Unzipped, Books, Media and more!
Salon is at: http://www.salonmagazine.com/
Of Mythic Proportions
For those of us entertained or enlightened by myth, Bulfinch's Mythology is available online. From Apollo to the Poets, you can feast on Greek or Roman. An inspired webmaster has taken this wonderful book and infused it with hypertext links to make it a truly enjoyable Internet adventure.
Bulfinch's Mythology is at: http://www.webcom.com/shownet/medea/bulfinch/welcome.html
The Mother of All Days
And finally, to prepare for Mother's Day on May 11th, check out DearMom.com, where you can send Mom a humorous card by US mail but ordered on the Internet, try your brain at the TV-Trivia Quiz on motherhood, send FakeMail (if YOUR Mom is so wise as to be wired), or even create a web page in her honor.
DearMom.com is amazingly at: http://www.dearmom.com
A caller inquired of a triage nurse, "If you have nicotine on the brain will a cat scan show it?"
Another one of those cases where the mute button is a God-send, ha!
Submitted by C. Wade, e-mail: cwade@jax-inter.net
Informed Access Systems is an innovative health care management company specializing in telephone triage. We are rapidly expanding and have several positions open to qualified RNs interested in high quality patient care in a non-traditional setting. Our company offers career opportunities to nurses seeking a chance to excel and positively impact the health care delivery system. We value our nurses' diverse educational backgrounds, experiences, and collective dedication to offering progressive health care solutions. Flexible hours, opportunities for advancement, excellent benefits and competitive pay contribute to our progressive work environment.
Telephone Triage Coordinator, salaried position, for new Medical Call Center in Winfield IL, 27 miles west of downtown Chicago. Previous experience in telephone triage nursing preferred. Require current Illinois nursing license, BSN with three years recent clinical experience, preference to applicants with emergency, ambulatory care, pediatric or critical care experience. Should have experience in hiring, training staff, and functioning in a lead position. Personal computer and typing skills required. Knowledge of NHES software a plus. Responsibility for leadership to telephone triage RN staff by coordinating daily activities as well as responding to health related telephone inquiries.
The Children's Hospital of Philadelphia, the oldest hospital in the United States dedicated exclusively to pediatrics, is currently seeking Telephone Triage Nurses (RN) for our rapidly expanding call center. As an integral member of our multidisciplinary team, the professionals we seek will provide care for children from neonatal to 19 years of age using computerized treatment protocols. You will need to exercise excellent clinical judgement and be able to identify when additional consultation is necessary.
JOB TITLE:SUPERVISOR, PHYSICIAN REFERRAL SERVICE
Seeking an exciting nursing opportunity? Our downtown Seattle company is rapidly growing and we're seeking experienced nurses to join our dynamic nursing team! We combine the clinical expertise of RNs with state of the art telecommunications to provide health care information and options that educate consumers in making healthcare decisions. Come and thrive where your nursing skills re respected and appreciated!
Weyerhaeuser Company, a major forest products company headquartered in Federal Way, Washington maintains an in-house call center which provides employees and retirees with health care information and education. We are seeking a RN for a part-time float position to join our Careline Nurse team. The hours for the position will vary from 25-40/week. A benefits package will be included. This is a phone based program which includes utilization review, case management, & patient education. The position requires 5+ years varied & recent RN experience; current clinical knowledge; general familiarity with community health resources; excellent judgment, communication, organization, problem-solving & teaming skills; ability to manage multiple priorities. Computer literacy required.
Come and ski Utah while working for a busy and rapidly expanding 24 hour call center.
[EDITORS NOTE: All employment opportunities have been submitted directly to the Editor of TNT for inclusion. Please check with the manager or recruiter listed for all details and job requirements. TNT takes no responsibility for verifying information submitted. Applicants must deal directly with listed "reply to" or inquiry contacts. There is no fee charged for posting employment desired or available, but submissions must be of an acceptable size and format for the ezine.]
Review Previous Issues of TNT
August 1996 - Introductory Issue
The Web Page
The Telephone Triage Nursing Web Site is at http://www.katsden.com/telenurse/index.html
Submissions of interest to Telephone Nurses in all occupations and environments. Preferred material is from Registered Nurses, Physicians and other health care professionals currently involved in the specialty.
Require all submissions by the 10th of the month for next issue inclusion.
==Colorado==
We are seeking highly skilled RN's with:
* Colorado RN license in good standing
* Minimum 3 years recent clinical experience
* Superior communication skills
* Team player attitude
If you have a desire to work in a friendly environment, please send resume to:
Informed Access Systems, Inc., Attn: Nurse Recruiter, 310 Interlocken Parkway, Broomfield, CO 80021
Phone (303) 466-9500, FAX (303) 443-3909
==Illinois==
Inquires to: Mary McDonough, voice (630) 682-1600 X2237 or fax (630) 260-2652
==Pennsylvania==
Positions include part time and per diem status. Qualified candidates must have PA RN license, a minimum of 3 years of pediatric experience and be a graduate of an NLN accredited school of nursing. Excellent verbal, written and telephone communication skills are required. Keyboarding skills preferred.
For more information please contact Maggie Tetreault, RN, Program
Manager at 215-590-5685 or e-mail: tetreault@email.chop.edu
==Pennsylvania==
Nurses to help us expand to 24 hours!!...
Brandywine Hospital is currently seeking nurses with sound clinical judgement and excellent communication skills to be a part of our community phone service. "THE PROFESSIONALS". Qualified candidates must possess an current PA RN license, plus a minimum of 3 years of acute care experience. The following schedules are available : (weekend rotation required): FT/PT 11PM - 7AM, PT 5 - 11P.
Brandywine Hospital offers an excellent salary, excellent benefits for full-time, and the chance to join a personal and professional working environment. Interested candidates please call:
Employment Coordinator at: (610) 383-8234 or send resume to:
Brandywine Hospital & Trauma Center , 201 Reeceville Rd, Coatesville, PA 19320-1536.
==Texas==
JOB ORDER NUMBER: UCHOTX01
SALARY RANGE: $40,000 - $50,000 / ANNUM
WORKSITE: HOUSTON TX
JOB STATUS: FULL-TIME HIRE WITH BENEFITS
POSITION SUMMARY:
This position is for a healthcare professional who will provide specialized physician referral information to all callers needing additional information about member physicians and facilities for making appointments. The position requires a high degree of proficiency in simultaneous multiple task
operations and projects with self-initiated follow-through.
REQUIRED QUALIFICATIONS:
The ideal candidate will have a high degree of experience setting up and managing a physician referral call center and communicating with physicians and health plans. Associate’s or Bachelor’s degree required; advanced degree preferred. RN or LVN preferred, however, strong non-clinical or other clinical candidates with strong call center experience will be considered.
PREFERRED QUALIFICATIONS:
Advanced degree, RN or LVN licensure, Texas
Contact us for specific information on position responsibilities.
Reply to:
ScienStaff, Inc., 7007 Gulf Freeway, Suite 239, Houston, TX 77087, 713/640-1929
or e-mail: ssihouston@aol.com
==Washington State==
We are recruiting nurses who:
* Have a minimum of 5 years recent clinical experience with emphasis on
triage, med/surg, chronic disease, OB, and patient education
*have good computer and typing skills
*current WA license.
*Can work flexible schedules/shifts including eves/nocs/wknds.
*Possess excellent customer service skills
We offer competitive salary and benefits, shift/wknd diff, 40lK, stock options. FT/PT all shifts available. Non-smoking corporate environment, EOE If you are interested in learning more about this terrific opportunity and meet the qual's...
Send resume to CareWise/Nurse, 701 5th Ave. , Ste 2500, Seattle, WA 98104-7015 or fax (206) 479-1125
==Washington State==
DESIRE: Knowledge of UR process & insurance terminology; familiarity w/ ICD9 & CPT codes. Substance abuse test required. Please send resume and salary requirements for search # TTN97047, by 3/18/97 to one of the following:
E-mail Address: jenkinl@wdni.com
Fax:(206) 924-4151
Mailing Address: Weyerhaeuser Company. CCB 5D7. Tacoma, WA 98477-0001
Located in downtown Tacoma
==Utah==
IHC TeleHealth Services is part of Intermountain Health Care (IHC), which is widely known for its community based health information, triage/referral service. IHC TeleHealth Services has expanded into facilitating personal health management across the health care
continuum for IHC Health Plan members in Utah, Idaho and Wyoming, while maintaining
our community service line. IHC TeleHealth Services answers between 1100-1400 calls per
day.
We are currently hiring RNs for full and part time evening positions. Both these positions are benefit eligible. Minimum qualifications include a current Utah RN license with a minimum of 3 years high acuity nursing experience. Must enjoy
working with people on the telephone. Must be able to sit for extended periods of time and
talk while typing with few errors.
Send all inquires via E-mail to aajcall@ihc.com or call Jan at 801-978-4045.
Please include your name and phone numbers where you can be reached.
Can't Get Enough on Telephone Nursing?
September 1996 - Featuring: OB Telephone Nursing
October 1996 - Hospice and Telephone Nursing
November 1996 - Telephone Nursing and Seniors
December 1996 - Special Holiday Issue
January 1997 - New Year, New Approaches [Telenursing/Telemedicine]
February 1997 - Spring Ahead!
March 1997 - Marching Forward
Next months topic:
Health and Men
WANTED!
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