February 4th, 2012
In December 2011, a panel of experts rocked the pressure ulcer world by attacking some of the underpinnings of the current pressure ulcer classification systems (Staging, Grading, Categories). They said that some of the language creates problems from clinical, regulatory, legal and economic perspectives. The advisory panel is proposing the new Superficial Changes & Deep Pressure Ulcer Theory©. Here is one piece of what they asserted:
Current numerical pressure ulcer classification systems (staging, grading, or categories) are problematic and misleading because they imply that pressure ulcers progress through defined stages (from I to IV).
The current numerical pressure ulcer classification systems are intended to describe the anatomic depth of tissue damage. Stage 1 is characterized by non-blanchable erythema of intact skin that may be coupled with alterations in skin temperature and tissue consistency. Stage 2 is a superficial lesion involving the erosion of epidermis with epidermal base or an ulcer with loss of epidermis and a dermal base. Full thickness tissue damage may extend to subcutaneous tissue as in stage 3 pressure ulcers and to deeper supporting structures such as muscle, fascia, joint capsule and bone that are classified as stage 4 pressure ulcers. Evolution of pressure ulcers does not necessarily follow a predictable linear pattern from superficial to deep; from Stage 1 ulcers to Stage 2, then to Stage 3 and finally Stage 4 ulcers. Read the rest of this entry »
Tags: decubitus ulcer, JERK LNC, legal, legal nurse consultant, litigation, Nurse, nursing, pressure ulcer, wound care, wound staging
Posted in Legal Nurse Consultants | No Comments »
January 6th, 2012
Today, people are using very different writing styles, not just what you learned in school from your English teacher. Informal writing has changed. Text messaging, in particular, has caused us to think in terms of brevity of communication. But the real risk in brevity is that you are going to miss things and you will not be able to fully convey what you want to say, particularly within a business environment.
Getting exposed to poor writing is a big source of frustration for many people who work in professional fields. And there are errors and risks to people and to systems if we can’t communicate well in terms of what we know or instructions that we need to give other people.
The ability to write fluently in an easily understood manner is not going to go out of style. There are people who see typos and get focused on the typos and say, “Oh wait a minute, let me look at that word, it doesn’t look right. Oh, she spelled that wrong.” Poor writing makes us take a few seconds away from what we are reading in order to filter that through the editor in our minds. When writing is done beautifully, you don’t notice it; when it’s done poorly it jumps out and it distracts you from the message.
Tips for Improving Your Writing Skills
1. Do a lot of reading. Sit with a book either in paper form or on an electronic reader like a Kindle or Ipad. Notice how the author forms sentences. Do the words flow? Exposure to good writing of people who are fluent in the language improves your skills. Conversely, reading poorly written material is painful.
2. When you write a report or essay, set your material aside for a day and then proofread and edit it. Look for places where you can compress the sentences, improve word flow, and improve clarity.
3. Ask someone with good writing skills to be a copyeditor to help you improve. A copyeditor improves word flow, in addition to proofreading. A copyeditor will take your material and rearrange it so that it flows better. This person improves the language, grammar, and word usage. Read the rest of this entry »
Tags: clarity, copyeditor, JERK, JERK LNC, legal nurse, legal nurse consultant, Nurse, report, writing
Posted in Legal Nurse Consultants | 1 Comment »
November 26th, 2011
In the world of medicine we are bombarded with alarms. Alarms are found on beds, on equipment, on doors, and every time a nurse turns around an alarm is going off. As a whole, the more alarms go off, the less we pay attention to them. Our sense of hearing becomes accustom to the sounds and we start to tune them out. Another factor in tuning them out comes from the number of false alarms the staff member encounters in a day. False alarms such as a bed alarm going off when the patient is merely repositioning, the alarm limits are too close together, or a lead slips off. This “tuning out” now has a name….Alarm Fatigue.
Since 2002 the Joint Commission has recognized the failure to acknowledge alarms as a sentinel event. Dr. Paul Schyve, Senior Vice President of The Joint Commission, states that “The health care industry often fails to report these types of incidents, leading some researchers to believe the number of alarm-related deaths is much higher”. And for the past two years the ERCI Institute has named alarm fatigue in their top ten safety hazards.
Nurses exposed to a cacophony of beeps may no longer hear them or begin to ignore them, and that’s what appears to have happened in the latest case: A 60-year-old man died in an intensive care unit after alarms signaling a fast heart rate and potential breathing problems went unanswered for nearly an hour, according to state investigators who reviewed records at the hospital.
I have been unable to find hard statistics on the number of poor patient outcomes related to the disregard of alarms. But despite the lack of definitive numbers, the accreditation associations are all addressing the issue with new standards which deal with this subject.
When alarms are ignored, this gives the patient or those around them a feeling that we are indifferent. And the definition of indifference is the opposite of the definition of nurse.
Indifference:
1. The fact or state of being indifferent; lack of care or concern
2. Lack of quality; mediocrity
3. Lack of importance; insignificance
Nurse:
1. To try to cure by special care or treatment
2. To treat carefully, especially in order to prevent pain or suffering
3. To manage or guide carefully; look after with care; foster Read the rest of this entry »
Tags: alarm, alarm fatigue, critical care, ecri, emergency care research institute, fatigue, JERK LNC, legal nurse, legal nurse consultant, LNC, nurses, nursing, patient safety
Posted in Legal Nurse Consultants | 6 Comments »
November 21st, 2011
Recently I taught a program at the National Nurses in Business Association on the factors that lead to a successful business. Here are some strategies you can implement to create a strong legal nurse consulting business.
1. If at all possible, create your business launch so that you are not under pressure to make a profit right away. It takes more time than you would expect to market and start attracting clients. The phrase, “Don’t quit your day job” is a valid one. When I started Med League, my husband was working as a sales manager and making sufficient income that I could take my time and create self-employment through teaching nurses, consulting with hospitals, and expert witness work. Gradually I centered on working with attorneys as my primary source of income.
2. Learn the nuances of marketing and writing appealing copy for brochures and websites. Your prospect is bombarded with information. You have to capture that person’s attention quickly and in a compelling way. I have studied this aspect of running a business and invested thousands of dollars in courses and books to learn more about marketing. The more you understand about marketing, the more comfortable and confident you feel.
3. Pick the right service that fits your strengths. If you have a broad base of nursing, you are in an ideal position to help attorneys understand nursing malpractice cases. If you have worked only critical care, and continue to maintain a clinical practice, you may be in an ideal position to testify as an expert witness on critical care cases. Know what you are good at and recognize that it cannot be at all aspects of running a business or legal nurse consulting. Find others to help you with the parts you are not good at. Read the rest of this entry »
Tags: attorney, business, entrepreneur, JERK LNC, legal, legal nurse, legal nurse consultant, LNC, marketing, Nurse, nursing, success
Posted in Legal Nurse Consultants | 1 Comment »
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