About Nancy Brent

Nancy J. Brent, RN, MS, JD received her Juris Doctor from Loyola University Chicago School of Law and concentrates her own solo law practice in health law and legal representation, consultation, and education for health care professionals, school of nursing faculty, and health care delivery facilities.

Brent has conducted many seminars on legal issues in nursing and health care delivery across the country and has published extensively in the area of law and nursing practice.

* If a nurse makes a clinical error and is named in a lawsuit, can I also be named?
* What are the three measures that should be taken when reporting a nurse suspected of impairment?
* Is it ethical/legal to hold oneself out as a student nurse when one is not?
* What are the legal issues for nurses witnessing patients‘ signatures on DNR forms?
* I‘m researching an orthopedic case study. Where can I find applicable standards of care?
* How do I chart by exception in a way that would cover me if something were to go to court?
* Is it necessary to have a separate, signed consent before photographing a patient‘s skin for a medical record?
* I was sued for malpractice for a CRNA case. Now the RN board wants both my licenses. Can they take my RN license if I was practicing as a CRNA on that case?
* What are the legal ramifications of stopping my mother‘s medications?
* If I suspect there may be neglect with children in the neighborhood where I live, am I held to a higher level of responsibility and accountability than that of my non-nurse neighbors in regards to reporting such a situation?
* I did not receive a pay raise due to a disciplinary action. Do I have any recourse?
* Can an RN determine patients‘ physical restrictions and limitations?
* Do you recommend a specific text, website, or other publication to help keep current on documentation needs, liabilities, and best practices?
* Is it legal for the nurse to forego the nursing assessment and simply defer to the physician‘s notes?
* Is there a federal or state law regulating mandatory overtime for nurses?
* Can I do anything if I‘m injured on the psych unit on which I work?
* My employer has asked me to cover my tattoos. Do I have any grounds to object to changing my work attire?
* A colleague at the geriatric practice where I work calls the patients “darling,” “cutie pie,” etc. I know this is inappropriate, but our manager doesn‘t seem to mind. What can I do?
* Should my friend take a refresher course in the state she lives now or in the state she wants to move to?
* My employer terminated me for excessive med errors, which I believe not to be true. Will this be reported to the Board of Nursing?

New Drug For Major Depression

Adults experiencing major depression now have a new Food and Drug Administration-approved treatment option. Desvenlafaxine (Pristiq) is a serotonin-norepinephrine reuptake inhibitor (SNRI) approved for the treatment of major depressive disorder in adults.

Available in 50 mg and 100 mg tablets, desvenlafaxine is typically prescribed as a 50 mg dose taken once daily either with or without food. Patients with renal impairment are typically dosed at 50 mg every other day. Those with hepatic impairment may be dosed up to 100 mg daily (but not greater).

Adverse reactions: Common adverse reactions include nausea, insomnia, dizziness, hyperhidrosis, constipation, somnolence, decreased appetite, anxiety, and male sexual dysfunction. Other less-common but more serious adverse reactions include hypertension, abnormal bleeding, narrow-angle glaucoma, and seizures.

Contraindications: Patients must not use desvenlafaxine in combination with a monoamine oxidase inhibitor. There must also be a “washout period” of 14 days after an MAOI has been stopped and the introduction of desvenlafaxine therapy. Likewise, if desvenlafaxine therapy is discontinued, a MAOI must not be started for seven days to avoid serious and sometimes fatal drug interactions. Symptoms of drug interactions include myoclonus, hyperthermia with features resembling neuroleptic malignant syndrome, seizures, autonomic instability with possible rapid fluctuations of vital signs, and progression to delirium and coma.

Patient monitoring: Abnormal lab values have been reported, including hyponatremia and elevated cholesterol and triglyceride levels. Encourage patients to follow their prescribing professionals’ recommendations regarding scheduled laboratory testing.

The drug carries a black box warning for increased risk of suicidal thinking and behavior in children, adolescents, and young adults taking antidepressants for major depressive disorder and other psychiatric disorders. While desvenlafaxine is not approved for use in pediatric patients, it may be prescribed “off label” and warrant special concern and observation.

Activation of mania and hypomania has also occurred, warranting special caution and observation when used for patients with bipolar disorder.

Patient teaching: Remind patients that the tablets must be swallowed whole with fluid and not divided, crushed, chewed, or dissolved. To avoid discontinuation symptoms, recommend gradually tapering off the medication.

Caution: Review current drug information before administering and monitoring medications.

Highly experienced practitioners

We have been providing company doctor services since 1987. Medical staff will liaise closely with your occupational health or human resources teams with the aim of ensuring your needs are understood and met. It is also important to maintain continuity with the care provided by your employees’ own GPs. With their permission we will write to the GP giving details of the consultation.

We select the practitioners with care, ensuring that they have high levels of clinical expertise as well as the business acumen to develop an insight into your work and employees’ culture.

Company doctor and nurse services

Reduces time away from work

Instead of visiting their own GP, your employees will be able to see a doctor based on-site or nearby. This reduces the need to take time off and results in less disruption to the working day. These advantages can be easily illustrated:

Case 1: a key revenue generator takes time off to see her local doctor, 30 miles from the office, resulting in a whole morning of non-productivity. She has to wait two days for the appointment, whilst soldiering on under par.

Case 2: a project team member takes an afternoon off to see his home doctor - upsetting the team's performance or even halting its work entirely.

Compare these scenarios with the 15-minute appointment time needed to consult an on-site Bupa doctor and you can appreciate the potential benefits of the service to both the company and its employees.

Case study: Reducing the cost of lost time away from work to see the doctor, dentist or physiotherapist

Daily News: Study Highlights Mentoring

Mentors in the nursing profession are of utmost importance, according to a study by Martin, Fletcher, a healthcare recruitment firm.

The study of nursing executives says although 84% of respondents said having a mentor was very important, only 52% have one.

The most difficult part of finding a mentor is not having enough time, according to 52% of executives surveyed. Meanwhile, 32% said the biggest obstacle was finding the right fit with a mentor. Nearly 73% of those surveyed said the best place to find a mentor was through an established program in the workplace.

In related news, the Academy of Medical-Surgical Nurses (AMSN) has launched an online version of its hospital mentoring program, known as Nurses Nurturing Nurses. The online venture connects a new nurse (who must be a member of AMSN) with an experienced nurse mentor. The pair then communicates via email and AMSN chat rooms.

What difference does it make to me as a Doctor or Nurse ?

The adoption of the EN 13826 Standard is likely to cause the most issues with Doctors and Nurses responsible for the long-term care of patients with asthma.

Three key areas need consideration:

1) The new patient, using a peak flow meter for the first time
2) The existing patient, who has already used a peak flow meter
3) The health professional, using PEF readings and Normal Values

Patients using a peak flow meter for the first time in 2004 will soon all be given the new EU scale meter, and be ignorant of the change from the Wright scale. However, existing asthmatic patients who require a replacement meter will notice that the meter and their readings will have changed, and without explanation from a knowledgeable healthcare professional, may be worried that their health has deteriorated, or the meters being used were, or are faulty.

Importantly, professionals caring for patients who use peak flow meters will need to note which type of meter has been used to take measurements - it is unlikely that all patients will have their old-scale meter replaced immediately, the result being that both Wright and EU scale meters will be in common use for several years after the introduction of the EN 13826 Standard in 2004.

Clement Clarke, as manufacturers of the most widely used peak flow meter, has made recommendations to Government authorities to ensure the change occurs as smoothly as possible. The following comments may be useful.

The doctor–nurse relationship

Leonard Fagin and Antony Garelick

Leonard Fagin is a consultant psychiatrist and Clinical Director of the North East London Mental Health Trust (South Forest Centre, 21 Thorne Close, London E11 4HU, UK. E-mail: Leonard.Fagin@nelmht.nhs.uk), and an honorary senior lecturer at University College London. Antony Garelick is Associate Dean of MedNet (London Deanery) and a consultant psychotherapist for the Tavistock & Portman and North East London Mental Health Trusts. He too is an honorary senior lecturer at University College London.

Nurse - LPN, RN: Diversimed

Company Name Diversimed Job Category Healthcare Location Tampa, FL Position Type Part-Time, Employee Experience 1-2 Years Experience Desired Education Level Bachelor's degree Date Posted August 5, 2008

Apply Now: A Better Job Search Experience. Learn Why

Nurse - LPN or RN, UR Work

Looking for a Nurse to coordinate and manage our client requests for Independent Medical Examinations, Functional Capacity Evaluations, Second Opinions and Vocational Assessments.

Must have at least 1 year of clinical nursing experience, good communication skills and basic computer knowledge.

Please fax resume to 813-620-3733

Attention: Maryann

Certified Nursing Assistant (CNA): Para/Quad Services, Inc.

Company Name Para/Quad Services, Inc. Job Category Healthcare; Healthcare Location Atlanta, GA Position Type Full-Time, Employee Experience 1-2 Years Experience Date Posted August 4, 2008

Apply Now: A Better Job Search Experience. Learn Why

Certified Nursing Assistant (CNA)

Para/Quad Services Inc. since 1988

COMPANY OVERVIEW:

Para/Quad Services, Inc. mission is to match qualified Private Home Care Provider staff to clients who have catastrophic disabilities, such that clients may live as independently, productively, and comfortably as possible.

Para/Quad Services Inc. has been serving the Metro Atlanta area for 20years; a leader in its field seeks energetic, enthusiastic, career oriented individuals with a can-do attitude.

We provide private duty home care services, including registered nurses, licensed practical nurses, certified nursing assistants, and personal care attendants on short or long-term basis, to individuals in their homes or transitional housing. Our professional, qualified caregivers are licensed, certified, or otherwise qualified to provide services according to client and client family wishes within established protocols through physician and client choices, Nurse Practice guidelines, state law, rules, regulations, and interpretive guidelines

DESCRIPTION:

· Assists patients in active and passive range of motion, transferring, walking and turning

· Takes and records patients vital signs

· Measures and records patient’s fluid intake and output

· Provides daily routine care such as bathing, dressing and feeding

· Cleans rooms and makes patient beds

· Assists in care and feeding

· Observes Universal Precautions

· Ability to follow written Nurse Care Plan

· Provides patient transportation to doctor appointments, outside activities and shopping

· Provides patient laundry and linen changes

· Light housekeeping

· Provides medication reminders

· Meal preparation, and clean up

REQUIREMENTS:

· Must be a Certified Nursing Assistant (C.N.A.)

· Must be able to multi-task and prioritize

· Must be able to communicate effectively with clients and their family members

· Must be able to keep notes on clients daily condition, activities and behaviors

· Must have CPR card

· Must have current TB test or chest x-ray

· Must be able to drive \

· All applicants must be on the registry and have good references

Please visit our website at www.paraquad.net to fill out an online application

Due to the large number of resumes/applications we receive, we regret we are not able to respond to every submission.

Para/Quad Services Inc. is an Equal Opportunity Employer

Certified Nursing Asst: Emory Healthcare

Job ID	7275BR
Company Name	Emory Healthcare
Job Category	Healthcare; Healthcare
Location	Atlanta, GA
Position Type	Full-Time, Employee
Salary	$9.43 to $11.59 per hour
Experience	Unspecified
Date Posted	August 5, 2008

Job Description JOB DESCRIPTION: Under the direct supervision of the Charge Nurse, assists residents with activities of daily living. Carries out nursing care measures as delegated. Assists residents with general hygiene such as bath, shower, grooming, mouth/denture care. Assists with elimination via urinals, bedpans, bowel and/or bladder programs. May collect urine and stool specimens. Assists with post mortem care. Assists and prepares residents for meals, including feeding. Assists in the admission, transfer and discharge of residents. Transports or walks residents as requested. Makes beds (both occupied and unoccupied). Provides emotional support to residents and families. Assists in care planning and gives/takes report on assigned residents. Maintains records and inventories. Answers phones as requested. Returns equipment and ensures it is properly labeled. Maintains a clean and safe unit/environment. Performs related responsibilities as requested. MINIMUM QUALIFICATIONS: Certification by the state of Georgia as a Certified Nursing Assistant. Experience in a long term, geriatric health care facility preferred. Ability to read and understand written English words and sentences. Ability to do heavy lifting and moving of residents. Minimum Hourly $ 9.43 Minimum Annual $ 19614.4 Midpoint Hourly $ 11.59 Midpoint Annual $ 24107.2

Nurse Liason& Pharmacy Technician: Critical Care Systems

Job ID 0000970963-01 Company Name Critical Care Systems Job Category Healthcare Location Richmond, VA Position Type Full-Time, Employee Experience Unspecified Desired Education Level Other Date Posted August 3, 2008

Email	Jobs2@criticalcaresystems.com

Click To View

Satisfaction is Critical Critical Care Systems, a leading JCAHO- accredited home infusion therapy company, is seeking the following for our Richmond, VA location: Nurse Liaison Working on site at the VCUHS hospital, you will facilitate the discharge of specific patients who will have infusion services provided by CCS. You must have a current VA RN license; CPR certification; valid driver's license; and reliable transportation. Pharmacy Technician Technician will perform technical and clerical tasks associated with the preparation, labeling, mixing IV, and dispensing of pharmaceuticals. Must have valid VA Pharmacy Tech license. A high school diploma is required. To apply, please send resume and cover letter to: Jobs2@criticalcaresystems.com www.criticalcaresystems.com We are an eqaul opportunity employer M/F/D/V Critical Care Systems EXCELLENCE IN SPECIALTY INFUSION www.criticalcareersystems.com

Nursing Career Opportunities: Roswell Park Cancer Institute

Job ID 364826 Company Name Roswell Park Cancer Institute Job Category Healthcare Location Buffalo, NY Position Type Full-Time, Employee Experience 0-1 Years Experience Date Posted August 3, 2008

Email	employment@roswellpark.org

NURSING CAREER OPPORTUNITIES at Roswell Park Cancer Institute

Roswell Park Cancer Institute, Western New York's only comprehensive cancer center, offers a variety of career opportunities in clinical care and research for Registered Professional Nurses. Full-Time and Part-Time positions are available in the following areas:

Intermediate Care Unit - Chemo/lnfusion - Med/Surg - Clinical Research Services

The Institute offers an exciting, state-of-the-art work environment, competitive salaries, and comprehensive benefits. If you want to join a team with over a century's tradition of excellence, please forward your resume to:

ROSWELL PARK CANCER INSTITUTE
Employment Office
Elm & Carlton Streets, Buffalo, NY 14263
or employment@roswellpark.org

364826

For more information, please visit www.roswellpark.org

EOE

Nurse Jobs in Alaska II

Location Information More about Alaska Alaska RN Licensure View Map of Anchorage Job Specific Details

Location: Anchorage, AK

Position: LD RN

Date Posted: 07/31/2008

Assignment Length: 13 Weeks

Shift: Nights - 7p - 7a

Scheduled Weekly Hours: 36

Benefits

Generous Hourly Pay

Housing: 100% Free, Private, Furnished, W&D, Utilities paid OR receive a monthly subsidy.

Insurance: Free Medical, Dental, Life and Prof Liability available 1st Day

Travel: $450.00

401k: Available on day one!

Nurse jobs in Alaska

Job Specific Details

Location: Anchorage, AK

Position: CVOR RN

Date Posted: 07/31/2008

Assignment Length: 13 Weeks

Shift: Days - 7a - 3p

Scheduled Weekly Hours: 40

Benefits

Generous Hourly Pay

Housing: 100% Free, Private, Furnished, W&D, Utilities paid OR receive a monthly subsidy.

Insurance: Free Medical, Dental, Life and Prof Liability available 1st Day

Travel: $450.00

401k: Available on day one!