How to be a better nurse with IntelyCare

How to be a better nurse with IntelyCare

Nurses are rock stars. They work long shifts at odd hours, extending compassionate, patient care, even in the most challenging situations. IntelyCare is here to take care of those who take care of everyone else, and we’re driven to offer nurses healthcare’s best working experience. But what does it take to be a better nurse at IntelyCare?

Here are some key tips to help you succeed as an IntelyPro.

Better nurses pick up – and complete – shifts.

It probably doesn’t need explaining, but the more shifts you work, the more money you make! But another benefit to picking up and completing more shifts is the experience you gain. Every shift is a new learning opportunity, as well as a chance to build connections with new facilities. Both can help you become a better nurse. Our facilities love when they get to know their IntelyPros. When they know you, facilities can be confident that you will provide the best care possible for their patients.

Better nurses arrive on time – every time.

Our favorite IntelyPros are the ones that show up on time, every time. When working at a new facility, IntelyPros should make sure they arrive a few minutes before their shift. This allows you ample time to meet your supervisor, check in, and settle into your shift assignment. Arriving a bit earlier than your shift start time makes a world of difference for our IntelyPro’s experience. And, in general, being early for shifts can give you a better understanding of facility’s environment, which can help you provide better care, and be a better nurse to your patients.

Better nurses pay attention to detail.

Careful attention to detail isn’t only necessary for reading a patient’s chart; it’s also vital to adhere to the protocol of the facilities you work in. That means checking your profile for facility notes before your shift with IntelyCare. It’s also important to ensure you are up to date on required tests and immunizations, and check in with supervisors if you have a question about facility protocol.

Better nurses communicate well.

At IntelyCare, it’s important that we establish a clear line of communication between our team and our IntelyPros. IntelyCare is here to be your ally and advocate. Questions, concerns, or feedback that you have about your shifts or facilities are always welcome. We also know that communication is a two-way street. We promise to keep you in the loop as we grow and improve our experience, and will continue to inform you when we have updates. When in doubt, ask questions. Questions help us learn to become a better resource for you, and can help you become an even better nurse.

Better nurses provide compassionate care.

Nurses do what they do because they love helping others – so this step is an easy one. But in high stress or frustrating situations, it can be hard to keep your cool. Just know that even in the face of a challenging shift, remember that you are appreciated by your patient, the facility, and us. Thank you for providing care with a smile, even on the toughest days!

Are you ready to be a part of the future of nursing? Apply today to start building your perfect schedule.

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.

Sources

https://stanfordhealthcare.org/health-care-professionals/nursing/quality-safety/bedside-handoff.html
http://scrubsmag.com/giving-a-good-report/
https://minoritynurse.com/communication-is-key-the-importance-of-effective-hand-off-reporting/
https://scholarworks.gvsu.edu/cgi/viewcontent.cgi?article=1000&context=kcon_doctoralprojects
https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.12575

Chris Caulfield (RN, NP-C), is the Co-founder and Chief Nursing Officer of Intelycare which the fastest growing Per-Diem Nurse Staffing organization in the US. IntelyCare is a technological enhanced platform that was founded in 2016 and now has over over 3,000 IntelyPros (RN, LPN, and CNA employees) serving over 150 healthcare facilities throughout the northeastern US.

Prior to founding IntelyCare, Chris’ past Healthcare experience includes Long Term Care Nursing, Nursing Informatics, Labor Relations, Case Management, and a Urgent Care Nurse Practitioner.

Announcing the 2018 Intelygence Scholarship Winner

Announcing the 2018 Intelygence Scholarship Winner

Every year, around the time of Florence Nightingale’s birthday, the American Nurses Association recognizes and honors nurses across the country by celebrating National Nurses Week. This year’s theme was Inspire, Innovate, and Influence.  As an employer of nurses and nursing assistants, IntelyCare was pleased to celebrate National Nurses Week and those on our team who inspire, innovate, and influence each and every day.

To establish our commitment to our team, IntelyCare was thrilled to introduce our first annual Intelygence Scholarship. This $1,000 award was designed to recognize an IntelyPro who is furthering their education in the field of nursing.   After reviewing dozens of applications, we are pleased to announce the inaugural winner for this award:

The 2018 scholarship goes to Pennsylvania CNA,  Claudeen Nkemakolam!  Here are some excerpts from Claudeen’s submission:

“Being able to care for people in such a personal way is enormously gratifying—the way everyone should feel about their job. My job gives me an opportunity to make a positive impact in the lives of others: helping individuals heal and feel better. My job provides a natural environment for me to showcase my attributes as a compassionate and caring person. My job allows me to grow and develop personally; It teaches me patience, tolerance and empathy.”


“It is not only important to find a job that you love to do, but, it is also important to find a good company to work for. IntelyCare is a great company! The app makes it so convenient to choose shifts. I love the flexibility the company offers. As an employee, I am given complete control of my work schedule. Also, I can keep track of my pay in real time. They value their employees.”


“The financial burden of going back to school is never an easy one, with rising cost of tuition and books. The money from this scholarship will be well spent. It will go towards tuition, books, and other school related expenses. I plan to use my skills and talent as a nurse in the highest capacity. Not only will I strive to become a model nurse, but I also dream of starting a non-profit organization.”


We are thrilled for the opportunity to recognize this fabulous IntelyPro!! Please join me in congratulating Claudeen on being our company’s first winner of this scholarship.  Way to go Claudeen!!

Chris Caulfield RN, NP-C
Chief Nursing Officer and Co-Founder, IntelyCare

Cincinnati Welcome Event Recap

Last Friday, IntelyCare hosted a free welcome event at the Montgomery Inn – Boathouse to open our newest market in Cincinnati, Ohio. It featured a nursing comedy speech by Terry Foster RN, hors d’oeuvres, drinks, and a chance to meet the founders and teammates at IntelyCare. If we missed you at the event, or if you’d like to learn more about IntelyCare in Cincinnati, please email our Chief Nursing Officer, Chris Caulfield.

A big thank you to all who attended the event. Scroll through the images below to see more from the event!

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.

Sources

http://rnao.ca/sites/rnao-ca/files/Falls_Prevention_-_Building_the_Foundations_for_Patient_Safety._A_Self_Learning_Package.pdf
https://www.managedhealthcareconnect.com/article/strategies-for-reducing-falls-long-term-care
https://scholarworks.bellarmine.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=1008&context=tdc
https://www.beckershospitalreview.com/quality/5-proven-strategies-to-prevent-patient-falls.html
https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/index.html
http://rn-journal.com/journal-of-nursing/preventing-falls-in-the-elderly-long-term-care-facilities

Chris Caulfield (RN, NP-C), is the Co-founder and Chief Nursing Officer of Intelycare which the fastest growing Per-Diem Nurse Staffing organization in the US. IntelyCare is a technological enhanced platform that was founded in 2016 and now has over over 3,000 IntelyPros (RN, LPN, and CNA employees) serving over 150 healthcare facilities throughout the northeastern US.

Prior to founding IntelyCare, Chris’ past Healthcare experience includes Long Term Care Nursing, Nursing Informatics, Labor Relations, Case Management, and a Urgent Care Nurse Practitioner.

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

Chris Caulfield (RN, NP-C), is the Co-founder and Chief Nursing Officer of Intelycare which the fastest growing Per-Diem Nurse Staffing organization in the US. IntelyCare is a technological enhanced platform that was founded in 2016 and now has over over 3,000 IntelyPros (RN, LPN, and CNA employees) serving over 150 healthcare facilities throughout the northeastern US.

Prior to founding IntelyCare, Chris’ past Healthcare experience includes Long Term Care Nursing, Nursing Informatics, Labor Relations, Case Management, and a Urgent Care Nurse Practitioner.