IntelyCare Celebrates National Nurses Week 2019

Happy National Nurses Week!

In 1993, the American Nurses Association (ANA) declared May 6-12 as the national week to celebrate and elevate the nursing profession. These dates have historical significance – the celebration ends on May 12th each year, which happens to be the birthday of Florence Nightingale, the mother of modern nursing.

Nightingale was born into a wealthy British family in the 19th century, and despite the lowly status of nurses at the time, she recognized the importance of caring for others and answered the call to become a nurse.

The status of nurses has been raised considerably since Nightingale’s time – in 2019, nurses were ranked the most trusted profession for the 17th year in a row.

This year, ANA hopes to continue to champion nurses and the work that they do – as it’s clear with recent headlines, there’s still a long way to go. The theme of Nurses Week is 4 Million Reasons to Celebrate – a nod to the over 4 million practicing nurses in the US. This is also a perfect time to thank a nurse for their hard work and dedication all year round.

We created IntelyCare because we knew we could simplify and improve staffing and that we could truly change the lives of nurses for the better.

But the truth is that we couldn’t do that without top-notch nursing professionals. So, we’d like to take this time to say thank you.

Thank you for the day shifts.

Thank you for the night shifts.

Thank you for every time you comforted a patient in need.

Thank you for every time you gave your all during a shift, even when no one else was watching.

Thank you for working holidays and weekends.

Thank you for all you do.

We’re truly grateful to have you on our team. Thanks for helping us change the landscape of nurse staffing, one shift at a time.


How are you planning to celebrate National Nurses Week?
Consider taking some time for self-care. Even the smallest acts of self-care can help reduce stress and prevent burnout. Not sure where to start? Check out some tips to reduce stress as a nurse to become a happier, healthier you – and a better nurse!

IntelyCare was created by nurses, for nurses. We’re here to take care of those who take care of everyone else; our staffing solution gives nurses the opportunity for a better, more flexible schedule to help reduce nurse stress. At IntelyCare, we’re driven to offer nurses and CNAs healthcare’s best working experience. Apply today.

How to Give an Amazing Nursing Handoff

Nurses must care for patients 24 hours a day, yet no one works a 24-hour shift. In order to ensure the patient’s safety and promote excellent care, communication between shifts is of paramount importance. Yet few nurses learn how to give report in a manner that ensures the transfer of critical information. Here’s how to make your shift report complete, accurate and excellent.

Styles of Report

There are several different styles of nursing report. In one, the team leader or manager collects information from the nurses caring for a group of patients and gives a verbal report to the entire oncoming nursing team. In another, individual nurses report to the nurse who is following them on the next shift. Sometimes reports are taped and at other times they are live verbal reports. A final method of giving  a report is the bedside report. This is usually given by the nurse going off shift to the oncoming nurse. Of all these methods, the least desirable is the taped report, as there is no opportunity to ask and answer questions. This is particularly true when the oncoming nurse has never cared for the patient before and knows nothing of his or her history. The bedside report, however, can be the best of the lot.

Key Components of Nursing Reports

No matter what style of report your organization uses, there are a number of key components that you should practice to ensure the information transfer is complete. They are:

  • Preparation – collect all the relevant data and write it down; do not rely on your memory. Begin this step far enough in advance of the change of shift that you will not be hurried and miss something important. It is often a good idea to take notes for report as you go through the day.
  • Presentation – One excellent way to give report is to present it in the form of a head-to-toe assessment. First, give a brief synopsis of the patient’s medical history and day’s events, including such important factors as surgery, diagnostic studies or changes from the previous shift. Next, cover the findings of your assessments and exams for all body systems. Give the current vital signs and any significant changes during the shift, important lab or diagnostic results, and intake and output. Do not rush through the information – speak clearly and concisely, without slang or jargon.
  • Cover all issues – make sure you touch on the plan of care, any safety issues, upcoming procedures and patient or family education issues.
  • Clarification – When you finish, pause to ask if there are any questions or if anything you said was unclear. Check that you have answered all questions by asking for confirmation.

Benefits of Bedside Reports

The practice of conducting report at the bedside has a number of benefits. First, both nurses have the opportunity to assess the patient and to see the same thing at the same time. Checking capillary refill, dressings or mental status together, for example, ensures that the oncoming nurse has actual experience to know whether the patient’s condition is changing later in the shift. Bedside rounds also help reassure the patient that the oncoming nurse is aware of any concerns and fully informed about the patient’s status. It offers an opportunity for patients and family members to meet a nurse who is new to them and to ask questions. For the oncoming nurse, bedside report helps with prioritizing the patient’s needs. Finally, there is good evidence to indicate that bedside report decreases falls. It also makes patients and family members feel more involved in care and decisions, promotes teamwork between nurses and shifts, and decreases the potential for errors.

No matter how good a nurse you are, if you can’t give a good report, you are letting your patients and team members down. The communication between shifts can either lead to errors and patient harm or ensure that information transmission protects the patient and improves care. The nurse who follows you may be from a temp agency, or may be returning after several days off. He or she may have never cared for your patient. It’s up to you to provide a complete, accurate picture to your colleague with an amazing report.


Decreasing Falls in Nursing Home Patients

According to The Joint Commission, hundreds of thousands of patients fall in hospitals and Nursing Homes each year. Many patients in long-term care are there in the first place because of injuries sustained in a fall or because they have fallen repeatedly. Falls are one of the major reasons for patient’s to be re-admitted back to an acute care facility, which ultimately will have a significant negative effect on reimbursements for long-term care facilities starting in 2019. Decreasing falls in the elderly patient population requires a well-defined strategy, training and consistent use of basic safety techniques.

The Cost of Patient Falls

Individuals who suffer a fall may suffer serious injury, such as a fractured hip or wrist or a head injury. Lacerations can occur if the patient comes in contact with the edge of a bed or knocks a glass flower vase to the floor. Skin shearing may occur due to the fragility of an elderly patient’s epidermis. The Joint Commission notes that one study found a fall with an injury increased in-patient facility length of stay by an average of 6.3 days. Further, the average cost of a fall in which an injury is incurred is $14,000. The American Health Lawyers Association reports that recent settlements for injuries incurred by long term care patients ranged from $205,000 to $620,000. In addition, there is the cost to the patient in terms of pain and disability, the stress on the family, and the guilt and remorse suffered by the nurses responsible for safeguarding the patient.

Elderly Patients Are at Higher Risk

The elderly are more at risk of falls. They are more likely to have balance problems or need assistive devices to walk around. Muscle strength, flexibility and coordination may be problematic for an elderly person. Elderly people are statistically more likely to be on multiple medications, which may have such side effects as lower blood pressure or dizziness. Diuretics may mean an increased frequency of bathroom visits and some medications can cause diarrhea. In the acute care hospital, the elderly are more susceptible to confusion, whether from medications such as narcotics or from being in unfamiliar surroundings. In long-term care facilities, it is often the elderly patient who can no longer live independently – whether from physical disability or mental impairments such as dementia – who needs long-term care in the first place.

Best Practices for Reducing Falls

In 2009, the National Guidelines Clearinghouse published a number of best practice recommendations for fall prevention in long term care. These include:

  • Develop a specific program aimed at reducing falls. This should take into account the patient population, the environment of the long term care facility, and the numbers, skills and experience of the caregivers. If your facility does not have such a program, volunteer to start one.
  • Assess fall risks on admission and after a fall. If a patient does fall, determine the most likely reason for the fall to have occurred. Make changes to prevent a fall from happening again.
  • Develop exercise programs for long term care patients, particularly strength training. Tai chi can also help with balance and coordination problems.
  • Conduct medication reviews – patients who are taking certain medications, such as benzodiazepines, antidepressants, selective serotonin reuptake inhibitors (SSRIs) or multiple medications should be considered at high risk for falls.
  • Educate patients who are at increased risk and who are mentally competent. This can include safe transfer techniques, basic fall prevention such as not getting up abruptly from a sitting position or the use of assistive devices.
  • Conduct regular environmental assessments and modification – reduce clutter, ensure lighting is adequate and clean up spills promptly.

The Top Two

Of all the possible strategies a nurse can use to prevent patient falls, the top two are probably a careful and thorough patient assessment at regular intervals and the consistent use of basic safety techniques. The first helps ensure that patients who are developing balance problems, worsening dementia, medication side effects or confusion from hypoxia will be identified as early as possible. Each time you walk down the hall, make it a practice to glance in the patient rooms on each side. You will be surprised how much information you can glean in a three-second snapshot. Always practice the basics: put up side rails, lower the bed, engage wheel locks and make sure patients can reach call lights, water or other items on the bedside table. Use bed alarms and use them at a short interval, such as two or three seconds.

Protecting elderly patients from falls in long-term care requires unceasing vigilance on the part of nurses and CNAs. Reducing falls can prevent a readmission to an acute care hospital or an extension of what was planned to be a temporary stay in long term care. Regular training on fall prevention and always practicing what you learned in a training will help keep your patients safe.


Why Taking Breaks Is So Important For Nurses

The Problem with Taking Breaks

Nursing is a giving profession and we nurses tend to give a lot, but not all of that giving is by choice. In a conventional job, taking breaks is part of a normal shift. With nurses, there are patients who must receive care. However, providing that care is not always black and white. Patient safety is the top concern and that is sometimes difficult to pull off when so many cogs affect how the wheel turns. For example, a Long Term Care nurse might have twenty patients and two are about to be sent out to appointments, while at the same time you’re expecting two incoming admissions. Not knowing when these patients will arrive makes giving nurses breaks less predictable. Outside factors can make it impossible to stick to a routine schedule that is commonplace in many other industries. When nurses do not receive breaks they become fatigued and that leads to a decrease in patient safety.

There are many studies across many industries that point to the dangers of fatigue on the job. Long-haul truck drivers are a perfect example. If they are too tired to drive they not only risk their own lives but those of other drivers on a road. It is the same with nurses, though the mechanism of injury is different and the outcome varies. A wrong med here, loss of compassion there, lack of infection control, critical medications are given late… the list of possibilities is unfortunately endless. The results show up in data such as increased re-admissions, job turn over, elevated frequencies of call-ins, poor inter-professional relationships, etc.

It seems so easy to fix – just allow nurses to take breaks and eat lunch. Simple, right? The problem is that nursing is not that “cut and dry.” Nursing comes with a high degree of unpredictability and requires around-the-clock constant care. Many times, that care does not fit neatly into a timetable or regimen. Patients always come first. That said, there are definitely ways to manage nurses’ fatigue and even improve your overall quality of care. So, what can be done?

The Road to Caring with Exhaustion

One solution is to ensure your facility is set up with a reliable On-Demand per-diem staffing partner in order to give your internal nurses their own break and reduce the mandatory overtime that’s become commonplace among inpatient health-care facilities. The statistics show that tired nurses have a negative impact on the care they provide, but rarely do we look at their financial impact at their facilities. Tired nurses make mistakes that lead to lawsuits, workers compensation claims, hiring expenses, training, recruitment, etc. Too many patient injuries or too many re-admissions can cause hospitals to lose the faith to discharge their patients back to these LTC facilities. Ensuring that nurses take breaks is important and worth the investment, especially if it leads to decreased readmission frequencies.

Another important fix is to educate nurses so that they understand the impact of caring for themselves at home. There are additional studies that point to the lack of sleep as part of the honest of fatigue. Educating people on how to relax at home and at work is important. Finally, building and maintaining your own internal per-diem pool, as well as a trusted outside per-diem nursing partner who specializes in last minute fill ins, can be very effective tools to help cover short-staff issues. Focusing on these issues will help your facility to improve improve patient care, decrease readmission frequencies, and improve the relationship between nurses as well as the hospital and its community, all while saving you more money in the long run.

Keep your nurses fresh. Well rested nurses do their best work. It takes a lot of energy to care for other people, but we can’t forget to care for ourselves, too.

Deeper Reading and Sources

[1] Association of Sleep and Fatigue With Decision Regret Among Critical Care Nurses 

[2] The Effects of Fatigue and Sleepiness on Nurse Performance and Patient Safety

Top 8 Issues with Short Staffing

Top 8 Issues with Short Staffing

As healthcare systems accommodate the retirement of baby boomer nurses and work to do more with less to make ends meet, many organizations find themselves short staffed. And while the best nurses will do whatever it takes to care for their patients, operating without enough help is bound to lead to serious problems.

Here, we share the top eight consequences of short staffing in healthcare.

#1 – Patient mortality increases.

As overworked nurses become tired and rushed, the risk of medical errors and the potential for patient harm increases. Nurses that are well-rested and ready to provide the best care will drive significantly better patient outcomes.

#2 – Patient satisfaction decreases.

As patients wait longer for a response to their call lights and get less face-to-face time with staff, their perception of the care they are receiving worsens. Making sure your nurses are able to respond to all patients in a timely fashion is important to ensure patients are satisfied with your facility’s care.

#3 – Team dynamics are strained.

Even something like a simple bathroom break can be long enough to cause petty arguments. When you need every minute of care you can get from your nurses, this can be quite the disruption. In addition, coworkers who once worked harmoniously can grow apart in the face of short staffing and high tensions.

#4 – Nurses get burned out.

Nursing is an incredibly challenging career prone to burnout in the first place. When caregivers and clinical professionals don’t have the support and resources they need, the burnout process can be accelerated. Unfortunately, this means facilities can be put in the precarious position of consistent hiring.

#5 – Call-outs happen more regularly.

Working short-staffed is physically, mentally, and emotionally draining on the nurses on duty. It increases their risk of getting sick or experiencing extreme fatigue after a long work week. Nurses need time to recharge their batteries, too, but unfortunately, calling out is a means by which nurses do so.

To compound the issue, if your floor is already short on staff, call-outs heighten the stress of the work environment. This causes an even lower quality of patient care as there simply aren’t enough nurses to go around. It’s a vicious cycle; those who are working are asked to do even more, which leads to further fatigue for them.

#6 – The risk of abuse & neglect increases.

This immense physical and mental strain can break down the patience and resolve that most nurses demonstrate every day. Unfortunately, that means it’s easier for your staff to lose their temper with a patient, physician, or coworker. While many skilled living facilities choose to cut staff to save money, they neglect the cost and the risk associated with more outbursts and lower quality care.

#7 – Turnover goes through the roof.

When an organization is short staffed for a week or even a month or two, nurses generally hang in there and push through. The high-quality nurses are usually team players. They’re willing to “buckle down” in times of need. But what happens when short staffing drags on for months and months?  Unfortunately, many nurses begin to look elsewhere for jobs that are less demanding and ultimately, less stressful.

#8 – Costs actually go up.

Besides the overtime you need to pay your existing nurses to cover the short-staffed floors and the call-outs, you might need to deal with an increase in medical claims from your sick & stressed employees. In general, more call-outs and greater turnover can lead to a lower quality of care (more errors), and a definite increase in expenses. Working short staffed actually increases costs and negatively impacts patient care in the long run.

Working short-staffed is a reality for many nursing facilities, but it doesn’t have to be the case for yours.

Does your facility need help with your staffing needs? Request a demo with a member of our sales team for a walk-through of our intelligent solution.

IntelyCare was created by nurses, for nurses. We’re here to take care of those who take care of everyone else; our staffing solution gives nurses the opportunity for a better, more flexible schedule to help reduce nurse stress. Apply today to join the future of nursing.