What Did You Do?

Since we are dealing the after effects of Hurricane Ike and I have posted about the need to be prepared for any disaster, I wanted to hear from any nurses affected by the Hurricane. What did you do in regards to work? Were you able to work? Did you refuse to work (if so, why)? What were the problems at work? What steps did you have to take to provide for your family while you worked? These comments may help others to see the issues that can occur and thus, help them prepare for future disasters.

So, leave a comment (no need to identify yourself). There is also a poll.

NOTE: The power is still not on in most of Houston and the remaining Gulf Coast, so it is of no surprise that there have been no comments from those impacted. Just another reminder for all reading that preparation needs to happen now. Perhaps once the power is back on and once lives are back to normal, I can get some comments in order to let others know what it was like for your fellow nurses.

Legislature, Are You Listening?

The next session of the Texas Legislature is quickly approaching and movements are underway to decide what issues should be addressed by new statutes/laws. I have been asked what issues for nurses and the Nursing Board need to be addressed and changed:

1. The State Office of Administrative Hearings [SOAH] should make the final decision in a contested case hearing. Currently if a nurse chooses to go to a hearing before a SOAH Judge to resolve pending allegations the Judge is only allowed to issue a Proposal for a Decision and not a final decision. This means that the Judge’s decision is presented to the Nursing Board and the Board can decide whether to accept all or part or none of the Judge’s recommendations. Thus, after spending a great deal of time and money litigating the case, a nurse could receive a dismissal form the Judge only to have the Board reject that recommendation. The better resolution, and the more fair, would be to have the SOAH Judge be the final decision maker and if either side disagreed with the ruling, they can appeal to the District Court.

2. Deferred Adjudications should not be considered convictions. Frequently, individuals agree to deferred adjudications because they do not have the resources to fight the criminal charge or they are advised that due to external factors a jury/judge may convict them even though they are innocent or harsher sentences might be imposed then what was necessarily warranted. Some nurses are even told that the deferred adjudication will be removed from their record once probation is completed (NOT TRUE!!) or that the Board will not take action on a Deferred Adjudication (once again, NOT TRUE!!!)

Under the Board’s current rules a deferred adjudication subjects a nurse to the same punishment as a conviction. The nurse can attempt to explain the factors surrounding the decision to accept deferred adjudication, but if the Board decides against them, there is little recourse because of the statute. The Legislature should look at this part of the Nurse Practice Act again and consider the unfair impact it has and that it goes against the initial rationale for development of deferred adjudication provisions.

Inflammatory Breast Cancer

My closest, dearest friend continues her fight against inflammatory breast cancer (IBC). If you have not heard about this disease, it is crucial that, as nurses, you know about this disease. It is very aggressive and often it is first diagnosed as a breast infection and precious time is lost searching for the right diagnosis. Since nurses may be the first health care provider to see a patient, it is very important that you are aware of the signs/symptoms of IBC in order to alert the patient's physician for further diagnostic tests. For more information:

The IBC Research Foundation has some helpful info, such as

There is more than one kind of breast cancer.

We have been taught and are reminded frequently by public service announcements and by the medical community that when a woman discovers a lump on her breast she should go to the doctor immediately. Inflammatory breast cancer usually grows in nests or sheets, rather than as a confined, solid tumor and therefore can be diffuse throughout the breast with no palpable mass. The cancer cells clog the lymphatic system just below the skin. Lymph node involvement is assumed. Increased breast density compared to prior mammograms should be considered suspicious.



Houston Chronicle - FORT WORTH, Texas - American Airlines will unveil two planes Monday featuring a pink ribbon running the length of the fuselage in
honor of its partnership with Susan G. Komen for the Cure, which includes a
$7.5 million pledge from the airline to research a rare form of breast cancer.

The two planes will be the first of eight featuring the pink
ribbon. In press releases Friday, both groups announced American's pledge
will fund research of inflammatory breast cancer, an aggressive and
frequently fatal form of the disease, at the University of Texas M.D. Anderson Cancer Center in Houston. Komen said that kind of breast cancer represents 2
to 5 percent of all breast cancer cases.

Dallas-based Komen said the grant will fund a team of patient
advocates,oncologists, pathologists and scientists working to
improve the ability to diagnose and treat the disease.

Fort Worth-based American, the world's largest airline, has
pledged to raise $1 million annually for eight years to fund the grant. The rest
of the money raised will fund health and community programs.

American said most of the funds will be raised at its annual American
Airlines Celebrity Golf and Tennis Weekend. (press release found in the Houston Chronicle. http://www.chron.com/disp/story.mpl/ap/tx/5932483.html

Also, there is a youtube video taken during the unveiling of the plane that features a survivor of IBC.

A change in name for APNs

The Texas Board of Nursing posted proposed rules for advanced practice nursing. One of the proposed rules is to change the name of an Advanced Practice Nurse (APN) to Advanced Practice Registered Nurse (APRN) because it reflects that the nurse is both a registered nurse and an advanced practice nurse. There has also been some clean up to the advanced practice rules. The rules are available for comment at this time. [There are also other rules being proposed dealing with the Jurisprudence exam, fees, and vocational nursing education]