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At a secondary lead smelter in Pennsylvania, monetary incentives have been effective in improving processes, such as keeping blood lead levels down. "It does work, especially when it is a separate line item on their pay stub and the wife can see that!" says occupational health nurse Laurie Heagy, RN, COHN-S.
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When Washington County Health System (now known as Meritus Health) in Hagerstown, MD, first sought to measure the health status of its employees, the results were startling. Thirty-eight employees had undiagnosed diabetes or high blood pressure. More than 500 had glucose levels that placed them at high risk for developing diabetes. Other employees had high blood pressure, high cholesterol, or other risk factors.
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The 12-hour shift, mainstay of the nursing schedule, may be unhealthy for nurses and their patients.
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"The industry is moving to more on-site care. Nurse practitioners and on-site clinics are increasing,"
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A female patient told ED nurses that her only complaint was back pain, with no shortness of breath, chest pain, discomfort, nausea, or vomiting.
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"More and more" preteen and adolescent patients are coming to the Emergency Department Trauma Center at Children's Hospital of Wisconsin in Milwaukee with a variety of psychosocial needs, and many have underlying medical conditions as well, says Carrie L. Baumann, RN, BSN, patient care supervisor.
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An 85-year-old man who reports vomiting and diarrhea after an injury, and also happens to be on beta blockers, might have a blood pressure of 120/70 and heart rate of 82 and "look absolutely normal, even though in reality he is hypotensive and tachycardic, and he is in shock," says Justin Milici, RN, MSN, CEN, CPEN, CFRN, CCRN, TNS, education specialist for the ED at Methodist Dallas Medical Center.
