Category Archives: Featured Article

At Hug Your Nurse we have plenty of Featured Articles. These are articles in the nursing field that cover issues that nurses want to know about! Many of these articles are useful for everyone in the medical profession, as well as anyone in the nursing industry.

emergency room

Emergency Room Nurses

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George Tall

Author at Hug Your Nurse
George Tall works in the legal field, is a father of three, and a husband of a RN for 25 years. He enjoys writing about everything, especially nursing! He has been writing for a living, at least partially, since around 2000. As an author on dozens of websites, he enjoys being factual, while spinning a bit of humor where possible.
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emergency roomNurses are the backbone and workhorses of the emergency room (ER). They work in many specialties and perform many tasks in their daily duties. Some are certified in a particular specialty while others are not, but they all are the center of ER operations. You’ll not only find RNs in the ER, but also Licensed Practical Nurses (LPNs) as well as Certified Nursing Assistants (CNAs).

CNAs are the people you will likely encounter first when you visit the emergency room. CNAs will make the initial triage assessment and take your vital signs and other information like your medical complaint and medical history. That information is then reviewed by a nurse, usually a RN, who will then verify your triage level and determine what needs to be done at that point. Since many people visit the emergency room without life threatening emergencies, if you are put at the lowest triage level, you will most likely have a long wait if there are a lot of other people waiting to be seen that have conditions that are of a more life threatening nature that will be seen ahead of you regardless of what place in line you are.

Given the fact that an emergency room is a critical care setting, RNs who work in the ER gain valuable required time needed for certification in a particular specialty field of nursing. Some of these specialty fields are Trauma Medicine, Cardiology, Surgery, Mental & Behavioral Health and various Pediatric specialties. The hands-on training that a nurse receives in the ER are not only just a requirement for specialty certification, it is also invaluable in their careers as a learning experience.

It also helps build all of the qualities that make a good nurse even better. Life in the ER is often fast paced and a nurse will help build her physical and mental stamina skills there, as well as learning from the more experienced nurses on how to deal with many other situations that may arise in the course of a nurse’s career.

They will learn to build and improve other skills such as empathy, compassion, assertiveness, team work, interacting with physicians and patients and family members of patients.

Nurses in the emergency room will also work with a wide variety of medical equipment. Some of that medical equipment may be high tech, while other equipment may be low tech, but still a vital tool in the capacity of saving a patient’s life. They will also work with many different physicians in the ER, and these Physicians’s specialties range in almost all areas of medicine.

ER nurses are registered nurses who have earned their BSN or AN in nursing and taken and passed the optional Certified Emergency Nurse exam. While RN’s work in the emergency room, having the Certification of Certified Emergency Nurse places that RN a step above the standard RN in the ER. Some of the required training for ER nurses are: Neurological, Orthopedics, Cardiovascular, Maxillofacial, Gynecological, Gastrointestinal and Psychological Disorders.

Work in the ER is demanding and at times very fast paced and unpredictable. Attention to detail, high stamina and quick thinking and decision making are needed and honed attributes that they need to be successful.

While it is not necessary to have the ER certification, those that do have it, earn more money and are given more responsibility due to their increased training and knowledge, in most cases.

Pay for Emergency Room Nurses varies on a variety of factors, but the typical salary numbers are $54,000.00 to $84,000.00 annually, and the median annual income is right around $68,000.00.

 

pain management

Pain Management Nurses

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George Tall

Author at Hug Your Nurse
George Tall works in the legal field, is a father of three, and a husband of a RN for 25 years. He enjoys writing about everything, especially nursing! He has been writing for a living, at least partially, since around 2000. As an author on dozens of websites, he enjoys being factual, while spinning a bit of humor where possible.
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pain managementPain Management Nurses are advance care nurses who typically have a Bachelors or Masters degree of Science in Nursing. Pain management is one of the most complex and involved skills in the nursing profession.

While pain management nurses do not prescribe pain medicines, they do administer them per orders of the physician. Being in more frequent contact with the patients than the doctor is, the pain management nurse is skilled at monitoring and assessing the patients condition and are also skilled at being able to asses pain levels via verbal and non-verbal methods and if needed will consult with the physician to recommend a change in dosage or in the type of medication currently being administered if the patient is not getting the pain relief that they should be getting.

They are also very knowledgeable and familiar with pain medications and non-pain medications not just because they have a need due to their profession, but also due to the fact that patients can suffer adverse side effects from them and pain medications can become addictive to the patient and the fact that pain medication can also conflict with other medications that the patient may be on which also can create very adverse reactions and severe consequences to the patient.

These nurses deal specifically with treating acute and chronic pain. Many people suffer chronic or acute pain stemming from an injury or disease. It is these nurses, that in conjunction with pain management physicians, lay out a plan and treat the symptoms. They also acts as a liaison between the patient, various medical specialists and multiple medical facilities in order to better coordinate a solid plan of treatment for the patient.

Where chronic pain is in play, there is a higher risk of addiction by the patient, as well as cumulative damage from the more potent pain medications. Pain management nurses must be fully aware and knowledgeable of the many potential complications that can result from long-term pain management therapy such as hypertension and damage to various internal organs that sometimes result from long-term pain management care.

Another aspect of them is to educate their patients on the various side effects and potential damage to internal organs as well as shifts in behavior and mental state resulting from pain medications, including any potential conflicts with other non-pain medication that the patient may be taking.

Chronic pain management is also involved with hospice and palliative care. In these cases, the patient’s condition and health will steadily decline and the pain management nurse is then tasked with helping maintain a balance of mental clarity and quality of life for as long as possible.

Often times pain will manage to break through the pain medication that the patient is already under and this is what as termed as breakthrough pain. These nurses are trained to asses and deal with breakthrough pain and to consult with physicians in order to address the spike in pain and treat it accordingly.

There are three main categories to pain that cover a broad area of conditions that the nurse will treat during his or her career:

1: Acute Pain – Acute pain is specific and has a transient cause such as from an injury or from a recent surgery.

2: Chronic Pain- Chronic pain is pain that lasts a long time, long-term, and stems from problems such as various forms of arthritis or neurological conditions.

3: Breakthrough Pain – Breakthrough pain is a sudden return and spike in pain in a patient that is already medicated with pain medicine. When Breakthrough pain occurs, the patients’ pain medication dosage may need to be altered, or the pain medication itself may need to be changed. In some cases a second type of pain medication may have to be administered along with the first and primary pain medication to keep the pain at bay.

Anyone wishing to become a nurse and specialize in pain management will attend and graduate from an accredited nursing school with a bachelor’s degree. Associate degree holders are not eligible and must attend continuing education and obtain their full bachelors degree of science in nursing. From this point, they will work as a Registered Nurse in whatever department they are hired in, and if not directly hired in a pain management department, they will have to wait until they can transfer into one before their 2,000 hours can begin to accumulate.

Pain Management Nurses require specialized training for their profession. They must also be board certified. To become board certified, a Registered Nurse needs to have a minimum of 2,000 hours of on the job training in a pain management setting over the preceding three years and have a minimum of 15 hours of pain specific continuing education.

Due to their specialized skills Pain management nurses earn on average between $75,000.00 and $105,000.00 annually and the average median income for a pain management nurse resides in the $85,000.00 per year range. It is one of the highest paying specialties, approaching the pay for Nurse Practitioners.

nicu nursing

NICU Nurses

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George Tall

Author at Hug Your Nurse
George Tall works in the legal field, is a father of three, and a husband of a RN for 25 years. He enjoys writing about everything, especially nursing! He has been writing for a living, at least partially, since around 2000. As an author on dozens of websites, he enjoys being factual, while spinning a bit of humor where possible.
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nicu nursingNeonatal Intensive Care Nurses (NICU Nurses) are the ones who care for premature or critically ill newborn babies. These babies are at a critical point in their lives and as such require specialized treatments and monitoring specific to infants. If you are looking for a career that is rewarding, fast paced and with the ability to care for patients that need you more than anyone, NICU nursing may be your calling.

These babies that are born critically ill or born prematurely require specialized medical attention immediately after birth and are usually sent to a Level III nursery where neonatal nurses work with special high technology equipment such as incubators and ventilators and other equipment that works in conjunction with the above mentioned devices.

Level III NICUs have all personnel on hand and available at a moments notice. These personnel include neonatologists, neonatal nurses, cardiac neonatal nurses, and respiratory therapists. Level III NICU nurseries are split into three subcategories, Level IIIA, IIIB and IIIC. NICU nurses can find themselves working in any one of these three Level III nurseries as well.

The Level IIIA NICU nursery has the least amount of equipment and care available and these Level IIIA facilities generally care for infants with a gestational age more than 28 weeks and a birth weight of more than 1000grams. Level IIIA nurseries generally have the capability to provide conventional mechanical ventilation for as long as needed, but do not use the more advanced respiratory support such as high-frequency ventilation. Minor surgical procedures such as placement of a central venous catheter or inguinal hernia repair are also performed in the Level IIIA nursery.

Levels IIIB and IIIC NICU nurseries are the nurseries that provide care for the most critically ill newborns. It is in the Level IIIB & C nurseries where everything needed to care for critically ill newborns is on hand and available for immediate use as needed. Some of the on hand medical equipment consists of advanced imaging equipment such as MRI machines, ECGs, EKGs, various high tech ventilation equipment, and other advanced life support equipment.

In addition, the NICU and Level III nurseries are a critical care environment and as such, Neonatal Intensive Care Nurses must also have met the requirements to work in a critical care setting. Some of the requirements and qualifications that a potential Neonatal Intensive Care Nurse needs to meet to become Critical Care Nurse Certified are that you must first complete the basic RN school with either an associates degree or bachelors degree. But given the complexity involved in this high specialty field, most employers as a matter of protocol, require the critical care nurse applicant to have at least a Bachelors Degree of Science in Nursing (BSN).

Most employers also require that the critical care nurse applicant be trained and certified in Advanced Cardiac Life Support as well as Advanced Pediatric Life Support, and have at least one to two years in a critical care related setting. In addition most dedicated critical care nurses take the Certified Critical Care Nurse (CCRN) exam offered by the American Association of Critical Care Nurses.

Due to the highly complex nature of this specialty, nurses need to be very proficient in a very wide variety of high level nursing skill sets and should be near experts at being able to evaluate intensive care patients and be able to recognize any complications and coordinate with other members of the critical care team to ensure the patient is treated properly and quickly. Critical care nurses have strong leadership skills and excel at strategic planning, interpersonal communications, quick and accurate decision making, and critical thinking. So as a matter of reference, potential NICU nurses need to meet the basic requirements as a critical care nurse first in order to work in an NICO setting and be effective at it.

In a Level II nursery, they care for the less critically ill infants. These nurseries, which are also classified as specialty care nurseries, are more commonly found in children’s hospitals or a general hospital that has its own special NICU section. In these Level II nurseries, they provide care for infants who are only moderately ill of which the problems are expected to be resolved fairly rapidly. Level II nurseries are divided into two sub categories, Level IIA and Level IIB with Level IIIB providing the more advanced care than a Level IIA nursery.

The standard RN school program does not offer the additional specialized curriculum needed to become a certified Neonatal Nurse, therefore it is necessary to enroll in and successfully pass a graduate program that offers the required curriculum in neonatal nursing.

The average annual salary range for a Certified NICU Nurse is $47,000.00 to $97,000.00, with a median salary of around $72,000.00.

If you are currently working in a specialty that makes you hate your nursing job, you may want to give this career field some consideration.

cardiac care nurses

Cardiac Care Nurses

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George Tall

Author at Hug Your Nurse
George Tall works in the legal field, is a father of three, and a husband of a RN for 25 years. He enjoys writing about everything, especially nursing! He has been writing for a living, at least partially, since around 2000. As an author on dozens of websites, he enjoys being factual, while spinning a bit of humor where possible.
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cardiac care nursesThese specialized nurses typically work in the cardiac care unit of hospitals and treat patients suffering from heart diseases and other heart conditions. Cardiac care nurses are trained in basic life support, advanced life support and various telemetry equipment. If you are interested in a challenging specialty that can possible help you avoid burnout, this may be worth looking into.

Their patients range from all ages, and there is a great deal of opportunity for nurses who wish to specialize in cardiac care. These specialists can be found in emergency rooms, operating rooms, ICUs and anywhere else that specializes in cardiac care. They also instruct their patients on proper preventive measures to ensure there are no repeat visits and to live a long and healthy life.

 

Cardiac nurses working in Cardiac Care Units (CCU) are highly trained and highly skilled at operating a variety of high tech and specialty equipment. Some of this equipment is as follows:

Cardiac Monitors – These are used to monitor the electrical activity of the heart. Small electrodes with a sticky back are attached to the patient chest and the electrodes attached wires are then plugged into to the monitor to begin recording heart readings.

Arterial Lines – Often called a-lines, these are used to continuously monitor a patients blood pressure.

A-lines are catheters that are inserted into an artery, most often in the wrist, but in some cases the groin or in the bend of the elbow. The monitors for a-lines a very similar to the standard cardiac monitor but have a different wave form on the monitor screen than that of cardiac monitors. Additionally, blood can be drawn from a-line catheters eliminating the need for continued vein punctures.

Swan-Ganz Catheter – The Swan-Ganz catheter, also known as a pulmonary artery catheter is used to monitor and determine how the heart is functioning as well as to determine the amount of fluid filling the heart. This special catheter is inserted and threaded into the heart via one of the large vessels in the neck or upper chest.

Pulse Oximeter – This monitoring device looks similar to a clothes pin and attaches to the patients finger. A smaller version of this device is sometimes used and attaches to the earlobe. The Pulse oximeter monitors the oxygen saturation level in the blood.

Ventilator – More commonly known as a respirator, assists with or totally controls the breathing of patients who cannot breathe on their own. Ventilators regulate the volume, pressure, and flow of patient respiration. In most Intensive care Units, ventilator monitors and their alarms interface with a central monitoring system or information system at the nurse duty station on the floor.

Intraaortic Balloon Pump – The Intraaortic balloon pump is a device that helps reduce the heart’s workload and helps regulate the blood flow to the coronary arteries for patients with such ailments like unstable angina, myocardial infarction (heart attack). The Intraaortic balloon pump uses a balloon placed in the patient’s aorta via a catheter that is connected to the pump’s console. The monitor displays heart rate, pressure, and electrocardiogram (ECG) readings.

Crash Cart – more commonly known as a code cart. The Crash cart is a portable cart containing a variety of portable emergency resuscitation equipment for patients who are “coding.” Coding means that a patient’s vital signs are in the danger range and the patient is very near death. The emergency equipment contained on a Crash cart includes equipment such as a defibrillator, airway intubation devices, a resuscitation bag/mask, and medication box which contains certain special medicines like Atropine, Calcium Chloride, Epinephrine and Midazolam. Crash carts are strategically located in the ICU for immediate availability when a patient experiences cardiorespiratory failure.

There are many more medical devices that that are commonly used by cardiac care nurses than those listed above, and those just serve as a small example of some of what these nurses use on a day to day basis.

 

Other duties commonly performed by them are such things as administering stress tests, administering electrocardiograms (EKGs), prepare patients for open heart surgery, administer various medications, and monitor the patient’s vital signs. These nurses also are a point of contact and communicate with the patients’ family members and friends to discuss progress, processes of the various treatments that the patient will undergo

Cardiac Care nurses typically have an associates degree of science in nursing, but more often have a bachelors degree as more healthcare facilities are requiring nurses in this field to have the extra education provided with a Bachelors of Science degree in nursing.

Cardiology nurse salaries depending on the sub specialty, but they earn an average of $53,000.00 to $89,000.00 with an annual average median income of around $68,000.00.

 

operating room nurse

Operating Room Nurses

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George Tall

Author at Hug Your Nurse
George Tall works in the legal field, is a father of three, and a husband of a RN for 25 years. He enjoys writing about everything, especially nursing! He has been writing for a living, at least partially, since around 2000. As an author on dozens of websites, he enjoys being factual, while spinning a bit of humor where possible.
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operating room nurseNurses who work in the operating room are affectionately nicknamed “Scrub Nurses”, but the official name for operating room nurses is Perioperative Nurse. In the operating room perioperative nurses are the primary assistants for the surgeons.

Perioperative nursing is exciting but also very demanding. Perioperative nurses are registered nurses that work in various surgical departments such as the operating room, clinics, ambulatory surgery units, outpatient surgical facilities and in physician’s offices.

Perioperative nurses help evaluate, plan, and implement the treatment for a surgical patient. They also work closely with the surgical patient, their family members and other involved healthcare professionals.

Perioperative nurses serve in a variety of roles such as: The scrub nurse who is the nurse who will assist during surgical procedures, selecting and handling the various surgical instruments and supplies used during the operation of the patient.

The circulating nurse is the perioperative nurse that manages the overall nursing care in the operating room during surgery and also helps to maintain clean, safe and comfortable environment in the operating room. Perioperative nurses who serve as the RN first assistant delivers hands on direct surgical care by assisting the surgeons with controlling any bleeding, wound exposure, and also any suturing needed during the surgical procedure. Perioperatives also serve in the capacity as operating room director, where they will manage staffing requirements, operating room budgets, and other business aspects related to the operating room. They also serve as management consultants, clinical educators, researchers, nurse anesthetists and medical sales professionals. A growing number of them are working in women’s health and can be found in the labor and delivery room assisting the physicians delivering infants.

Patients often meet at least one of these nurses before surgery who will provide much needed reassurance, answer questions, and help comfort and ease the patient’s anxiety prior to surgery. They also do the same with the patient’s family members to help ease their anxiety as well. This requires a high caring and empathetic mentality. Emotional stability is a must for these nurses.

They must have a high level of physical and mental stamina as surgical procedures can last for many hours. They must also have a very high attention to detail. Other aspects of this job include being able to direct other and delegate tasks and responsibilities, determining when consultation is required, accept various responsibilities, making critical decisions based on the current available information about the patient as well as coordinate the patients’ healthcare.

Perioperative nurses must be proficient self starters, have good communication skills, excellent problem solving abilities, and exceptional leadership skills. They will come into contact with all sorts of people and the ability to interact seamlessly with them is a must.

Since perioperative nursing is a specialty field, potential candidates must gain a certain amount of required experience in order to work in this field of nursing. Working in the emergency room or in a critical care setting is a start in gaining the needed experience to work in the operating room. Perioperative nursing, much like the emergency room, can be very fast paced and at times stressful, both physically and mentally.

RNs with a four year Bachelors of Science degree in nursing (BSN) can begin to work towards entering the perioperative field right away without any limitations, where as a RN with only an Associates degree of Science in Nursing (ASN) will have a more limited and technical scope of practice. But one aspect that ASN degreed nurses take advantage of, is after they enter the workplace, after a period of time working in their profession, ASNs often take advantage of employer tuition assistance programs that allow them to save a tremendous amount of money when the go back to school for their bachelors degree.

Those who apply for the voluntary perioperative nursing certification must hold an active RN license and have completed at least 2,400 hours of documented perioperative nursing experience. They must also pass an exam covering intraoperative activities, preoperative assessment and diagnosis, instrument care and handling, communication, emergencies and other relevant topics before earning their Certification as Perioperative Nurse.

Additionally some of them further their education by again taking advantage of employer tuition assistance programs to earn their Masters Degree and go on to become Nurse Practitioners and Nurse Anesthetists where they earn a lot more money and have greater autonomy in their work.

The need for them is growing each year and with new positions being created in this field of nursing, a perioperative nurse will have more choices in which area of this field they wish to work in whether it be in a hospital operating room, and outpatient surgical facility or ambulatory surgical center.

They generally work the typical eight or 10 hour shifts and most work during the day, but are often called in nights, weekends and holidays to assist with emergency surgeries.

An operating room nurse can expect to earn an annual salary of ranging between $55,000.00 and $85,000.00 per year. And the average median income for is around $70,000.00 per year.