MITA said that the radiation dose check feature will provide alerts to technologists when recommended radiation dose levels are exceeded. The alerts are “designed to provide a clear indication to health care providers when radiation dose adjustments made for a patient’s exam would result in delivering a dose higher than the facility’s pre-determined dose threshold for routine use,” according to MITA.

CT manufacturers are also committed to the implementation of “an additional safeguard that will allow hospitals and imaging facilities to set maximum radiation dose limits that would prevent CT scanning at higher, potentially dangerous radiation levels,” MITA said. “This feature is designed to prevent the use of hazardous levels of radiation that could lead to burns, hair loss or other injuries.”

According to Dave Fisher, executive director of MITA, the CT manufacturers are already working on these radiation dose safeguards and will be able to include them on new CT releases and in software upgrades to older CT scanners.

Fisher will be one of a dozen witnesses testifying at today’s hearing.

ACR to call for mandatory Accreditation

E. Stephen Amis, MD, and chair of the American College of Radiology (ACR) Task Force on Radiation Dose in Medicine will also testify today. According to the ACR, Amis will call for the mandatory accreditation of all advanced imaging and radiation oncology providers, regardless of the setting.

In a release yesterday, the ACR pointed out that The Centers for Medicare and Medicaid Services will require accreditation of all facilitates that bill for advanced imaging (MRI, CT, PET and nuclear medicine exams) under part B of the Medicare Physician Fee Schedule, effective Jan. 1, 2012. But, according to the ACR, this requirement does not apply to hospital providers of these services and does not include radiation oncology.

The ACR also said Amis will express ACR’s support for HR 3652,which you can track on the right side of this websi the Consistency, Accuracy, Responsibility and Excellence in Medical Imaging and Radiation Therapy Act. This bill sets minimum federal standards for training and credentialing of radiation therapists, technicians, and other personnel who perform or plan the technical component of either medical imaging examinations or radiation therapy procedures.

The Genetics/Genomics Competency Center (G2C2), developed by the University of Virginia in Charlottesville through a contract with NHGRI, is a free, Web-based collection of materials on genetics and genomics designed for educators who train nurses and physician assistants. To access this resource, visit http://www.g-2-c-2.org/.

“As we enter the era of personalized medicine, establishing genetic and genomic literacy is an urgent concern for those who educate health professionals. This online resource will provide a valuable new tool for meeting that challenge,” said Jean Jenkins, R.N., Ph.D., NHGRI senior clinical advisor to the director. “In the future, we hope to expand this tool to include other health care professions, such as pharmacists and physicians.”

Dr. Jenkins announced the new resource at the 2010 American Association of Colleges of Nursing (AACN) Masters Education Conference in New Orleans.

Nursing and physician assistant educators can use the Genetics/Genomics Competency Center to find and download materials for use in their classrooms. They also can share their favorite genomic and genetic teaching resources and materials with other educators by uploading material, which is regularly reviewed by the center’s editorial board to ensure quality control.

The Genetics/Genomics Competency Center was created under the guidance of an advisory group made up of representatives from a wide range of research and professional organizations. In addition to AACN, participating organizations included the American Academy of Physician Assistants, National Cancer Institute, National Coalition for Health Professional Education in Genetics, National League for Nursing, National Society of Genetic Counselors, Physician Assistant Education Association and Sigma Theta Tau International, the honor society of nursing.

“We’re very excited that physician assistants were included in this pioneering effort. Our profession has been at the vanguard of realizing the importance of genetics and genomics in the future of medicine, and encouraging efforts to incorporate more of these key concepts into education and training,” said physician assistant Michael Rackover, M.S., an advisory group member who directs the physician assistant program at Philadelphia University.

To encourage sharing and reduce duplication across health care disciplines, the Genetics/Genomics Competency Center helps to match existing educational resources with educational competencies for health professionals. The online center accomplishes this through sophisticated, cross-mapping of learning activities and assessments, outcome indicators and professional competencies, such as Genomics Nursing: Competencies, Curricula Guidelines and Outcome Indicators, http://www.genome.gov/Pages/Careers/HealthProfessionalEducation/geneticscompetency.pdf, and similar guidelines for physician assistant education, http://www.paeaonline.org/index.php?ht=d/ContentDetails/i/60083.

NHGRI’s Genomic Healthcare Branch will host a webinar this spring to provide educators with a tutorial on using the tool and answer questions about the resource.

NHGRI supports the development of resources and technology that will accelerate genome research and its application to human health. For more about NHGRI, visit http://www.genome.gov/.

The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov/.

“Research suggests that the U.S. will face a shortage of 40,000 family physicians by the year 2020 and that’s before we add any new patients from the ranks of the under or uninsured,” said Steve Hanson, president of AAPA. “Physician assistants from around the country have come to D.C. to tell Congress that we can help fill this gap. We execute more than 80 percent of the responsibilities of a physician with no compromise in quality or patient care satisfaction — but we need legislative action in order to deliver care to more people.”

The Capitol Connection summit drew PAs from across the country to call upon elected officials to recognize the vital role PAs play in health care reform and patient care. At the summit, which is being held over two days in the nation’s capitol, PAs will organize to discuss the current state of health care legislation and meet with their Senators and Representatives.

The Capitol Connection summit will also recognize U.S. Surgeon General Regina Benjamin, M.D., with the 2010 AAPA President’s Award. Awarded to Dr. Benjamin for her support of PAs in her commitment to patient care, the President’s Award honors an outstanding advocate for physician assistants. As “America’s Doctor,” Dr. Benjamin provides the public with the best scientific information available on how to improve their health and the health of the nation.

AAPA is the only national professional association that represents PAs across all medical and surgical specialties in all 50 states, the District of Columbia, Guam, the armed forces and federal services. Founded in 1968, AAPA works to increase the professional and personal growth of the entire PA workforce by providing comprehensive support and advocacy for physician assistants so that they may, in turn, provide patients with increased access to quality, cost-effective health care.

SOURCE American Academy of Physician Assistants

She had slightly shriveled skin the color of infield dirt. Her eyes were frozen shut, her trunk curled. Her 110-pound body carried a faint whiff of formaldehyde.

In truth, she looked quite good for a 42,000-year-old, especially one who apparently died after sinking into mud and suffocating.

To her admirers in the scientific world, Lyuba is the best-preserved mammoth ever discovered. To Polzin’s two children, she was of considerably greater interest than the human volunteers and containers of fluid Dad had examined in 15 years at GE.

“I think every kid growing up is interested in dinosaurs and mammoths, that kind of thing,” Polzin, GE Healthcare’s chief technology leader, said Thursday. “My kids think this is the coolest thing I’ve ever done since I’ve been at GE.”

Lyuba, a month-old baby at the time of her death, was discovered in 2007 by a reindeer herder searching for firewood in far northwestern Siberia. The herder spotted Lyuba in frozen soil and named her after his wife.

With an abundance of sophisticated equipment, GE Healthcare offered a unique opportunity for the scientists who have been poring over the mammoth on loan for seven months to Chicago’s Field Museum. It would be difficult to reserve time with the CTs and MRIs at hospitals, but for the mammoth’s one day in Waukesha she had the machines to herself.

As an X-ray scanned Lyuba’s modest frame, a dozen people watched through an observation window; cameras flashed and video cameras recorded the scene.

And Daniel Fisher, a University of Michigan professor who has studied mammoths for 30 years, marveled at her.

“There’s a sort of awe-struck feeling to see her,” he said. “For years I worked on skeletons and teeth and tusks, always having to infer what the full shape was. And then – there it is!”

When Fisher first viewed Lyuba she did not smell as terrible as one might imagine. “A little sour,” was how he described her. “A little off.”

Although her soft tissue had dried somewhat, the mammoth was surprisingly well-preserved.

“When we opened her up in St. Petersburg (in Russia), we saw inside her stomach,” Fisher said. “Her stomach was filled with her mother’s milk.”

Granted, 42,000 years can take a toll on milk, and what they found in Lyuba’s stomach was “chemically more like fine curd cottage cheese,” Fisher said.

So far, scientists have found evidence from Lyuba that mammoths had something called brown fat at the back of the neck. While typical white fat helps allow calories to be stored, brown fat serves a purpose closer to coal in a furnace. When the body senses cold, it sends a signal to the brown fat, Fisher explained, and the brown fat starts a metabolic sequence that produces heat and warms the blood.

The scientists studying Lyuba also have been trying to determine what caused her death. As best they can tell, she became trapped in mud along a river bank. As she struggled, her trunk filled with silt. Death appears to have been accidental.

The cause of death is important because the scientists hope to find that Lyuba was not ill or poorly developed, factors that might negate her value as a normal mammoth specimen.

Polzin knew such questions would make for interesting dinner table talk with his children, 11-year-old Bennett and Maggie, 7.

“It’s really exciting,” he said, “to think you’re in the middle of helping to understand more about mammoths, what they’re like when they’re young, how rapidly they mature and grow.”

By nightfall, Lyuba would be in her crate, in a van headed back to the Field Museum.

As part of its budget for the next year, Darpa is investing $6 million into a project called BioDesign, with the goal of eliminating “the randomness of natural evolutionary advancement.” The plan would assemble the latest bio-tech knowledge to come up with living, breathing creatures that are genetically engineered to “produce the intended biological effect.” Darpa wants the organisms to be fortified with molecules that bolster cell resistance to death, so that the lab-monsters can “ultimately be programmed to live indefinitely.”

Of course, Darpa’s got to prevent the super-species from being swayed to do enemy work — so they’ll encode loyalty right into DNA, by developing genetically programmed locks to create “tamper proof” cells. Plus, the synthetic organism will be traceable, using some kind of DNA manipulation, “similar to a serial number on a handgun.” And if that doesn’t work, don’t worry. In case Darpa’s plan somehow goes horribly awry, they’re also tossing in a last-resort, genetically-coded kill switch:

Develop strategies to create a synthetic organism “self-destruct” option to be implemented upon nefarious removal of organism.

The project comes as Darpa also plans to throw $20 million into a new synthetic biology program, and $7.5 million into “increasing by several decades the speed with which we sequence, analyze and functionally edit cellular genomes.”

Of course, Darpa’s up against some vexing, fundamental laws of nature — not to mention bioethics — as they embark on the lab beast program. First, they might want to rethink the idea of evolution as a random series of events, says NYU biology professor David Fitch. “Evolution by selection is nota random process at all, and is actually a hugely efficient design algorithm used extensively in computation and engineering,” he e-mails Danger Room.

Even if Darpa manages to overcome the inherent intelligence of evolutionary processes, overcoming inevitable death can be tricky. Just ask all the other research teams who’ve made stabs at it, trying everything from cell starvation to hormone treatments. Gene therapy, where artificial genes are inserted into an organism to boost cell life, are the latest and greatest in life-extension science, but they’ve only been proven to extend lifespan by 20 percent in rats.

But suppose gene therapy makes major strides, and Darpa does manage to get the evolutionary science right. They’ll also have a major ethical hurdle to jump. Synthetic biology researchers are already facing the same questions, as a 2009 summary from the Synthetic Biology Project reports:

The concern that humans might be overreaching when we create organisms that never before existed can be a safety concern, but it also returns us to disagreements about what is our proper role in the natural world (a debate largely about non-physical harms or harms to well-being).

Even expert molecular geneticists don’t know what to make of the project. Either that, or they’re scared Darpa might sic a bio-bot on them. “I would love to comment, but unfortunately Darpa has installed a kill switch in me,” one unnamed expert tells Danger Room.

The agency says it’s got a “three-pronged approach” to reducing unnecessary exposure to X-rays during exams, such as CT scans and angiograms:

Encourage safe use of medical imaging devices, including stronger safeguards against dangerous doses;
Help doctors make better decisions by making patient doses easier to see and record in medical files;
Empower patients with better information and tools to track their doses, such as a personal dose card.
FDA’s goal “is to support the benefits associated with medical imaging while minimizing the risks,” said a statement quoting Dr. Jeffrey Shuren, director of the agency’s Center for Devices and Radiological Health.

Exposure to radiation raises a person’s risk of cancer. Over the last 20 years, Americans’ radiation doses have almost doubled, mostly due to increases in the use of CT scans, heart stress tests and angiograms.

Reports of equipment-related overdoses in recent months have heightened worries.

You can’t have a CT scan with X-rays, but it’s possible to make sure the dose is the lowest possible needed for a successful exam. It’s also possible to forgo a test or pick an alternative that doesn’t involve X-rays, such as ultrasound or MRI.

Last week, the National Institutes of Health said it would take steps to standardize recordkeeping of radiation doses at its own hospital, a move that could set a standard for others to follow.

For more on the FDA’s ideas, see this agency white paper.

1.Must be a Masters program. The New GI Bill will only pay for one Bachelors or one Masters etc

2. The New GI Bill must cover the cost of the school or the Yellow Ribbon Program must make up the difference.

3. The program should be around 24 months long, some programs are 3 years which is too long for me to manage my plan.

4. At this time I am not interested in taking the GRE (who is), so every school on my list is free from standardized entrance tests. Let’s hope one of them picks me up and I don’t end up taking the GRE anyway.

5. Schools with ridiculous pre-requisites did not make that list – like zoology – really who needs that

And here is the list that I have come up with – keep in mind that there may be additions and deletions over the next 3 years while I work on my pre-reqs.

AT Still
Red Rocks College
Western Michigan Univ
Univ. of North Dakota
LeMoyne College
Pace University
St. Johns
Stony Brook Univ
New York Institute of Tech
University of Findley
Chatham Univ.
Seton Hill
Gannon University
Univ of Wisconsin – Madison

There is more New York schools than any other State becasue the GI Bill will pay $1010 per credit in NY.

There ya go.

Questions and Comments welcome.

TORONTO

So when she heard about a program to train practitioners who seemed to bridge the gap between the other two disciplines, she jumped at the chance.

Schoeley is on her way to becoming a physician assistant, or PA, a relatively unknown type of health-care provider in Canada, but one that has been steadily growing in numbers over the last four decades south of the border.

One of 45 students enrolled in McMaster University’s physician assistant education program – the first of its kind in Ontario and one of only three in Canada – the 24-year-old is preparing to become a doctor’s right-hand man, as it were.

“As a PA, we collaborate with our supervising physician all the time,” the first-year says between classes at the Hamilton university. “We do everything from history-taking, examinations, reading lab results and basically being proactive with the patients – being a good communicator, facilitating, advocating, managing.”

“So we play a huge role along the side of the physician.”

Dr. John Cunnington, assistant dean of the McMaster program, says applicants must have at least two years of university education for acceptance. And while a science background is preferred, it is not a prerequisite.

“The background can be varied and is varied,” says Cunnington. Students range in age and experience, with some having left other jobs to embark on a second career following graduation from the program, which runs 24 straight months.

In first year, PA students learn anatomy and the science that underpins medical care, including how to investigate, diagnose and treat the various ills the human body and mind are prone to. That includes recognizing symptoms, knowing what tests to order and even learning to suture wounds or cast a broken bone.

Second year involves honing those skills while working under the supervision of practising physicians as “clinical clerks in the real world,” says Cunnington. Rotations include weeks-long stints in a family doctor’s office, hospital emergency, surgery, medicine and psychiatry.

“So by the time they finish, you have a person with a broad general education, knowledge and skills,” he says.

McMaster introduced its course in September 2008 at the behest of the Ontario government, which has launched a two-year demonstration project placing PAs in hospitals, community health centres and doctors’ offices with the goal of reducing patient wait times. The University of Toronto welcomed the first students to its new 24-month program in January.

The discipline isn’t entirely new to Canada: the Canadian military has trained and employed PAs for years to care for members of the Armed Forces and their families. Civilian doctors’ assistants have been licensed in Manitoba for almost a decade. The University of Manitoba has also instituted a new PA degree program, and like McMaster will graduate its first students at the end of the summer.

Cunnington believes adding PAs to the care-provider picture will be a boon to patient care.

“A physician can only do one thing at a time, so a physician can only see one patient at a time,” he says. “If you have an assistant, two people can be served at the same time. The physician’s still in charge of both, responsible for both, but you’re doubling the productivity.”

Doctors groups, including the Canadian Medical Association and its Ontario counterpart, have welcomed the addition of physician assistants.

But not everyone is on board.

The Registered Nurses’ Association of Ontario argues that the level of education to earn a PA degree in the province is inadequate for the tasks graduates will be expected to perform once they enter the health system. And unlike doctors, nurses and pharmacists, Ontario physician assistants are not regulated by an oversight body, the organization says.

“And that’s where we see the risk for the public,” says RNAO executive director Doris Grinspun.

As well, charges Grinspun, PAs will cost the health system more than their closest counterparts, nurse practitioners who are trained to perform similar jobs. While salary and benefits for nurse practitioners and physician assistants will be roughly equal, she says educating a single PA will cost the system tens of thousands of dollars more in compensation to the doctor who supervises their training.

“If we need extra access, you can expand (nurse practitioners’) scope of practice,” she says. “Why do you need a new type of health-care professional that the public doesn’t know and that you will be spending all this money on educating?”

Ian Jones, president of the Canadian Association of Physician Assistants, calls the money issue a “bit of a red herring.”

“There’s a lot of obvious turf war issues that are coming out, that perhaps the RNAO is worried that the generalist nature of a PA’s training better suits the needs of health care and it may become more popular,” says Jones, who trained and worked in the United States before returning home to practise in Winnipeg a few years ago.

Grinspun denies that the RNAO’s is protecting nurses’ traditional territory.

“What we want is to increase access to the public through regulated professions without creating new roles that only serve to confuse the public, and in the case of physician assistants, in our view, compromise the public in the long run.”

Jones says his organization strongly supports regulation by an oversight body: in his province, for instance, PAs are governed by the College of Physicians and Surgeons of Manitoba. In Alberta, which recently authorized PAs, the college there will oversee practitioners.

There are about 200 civilian PAs practising in Canada, but their numbers are sure to grow, says Jones, who works with neurosurgeons at the Winnipeg Regional Health Authority. Nova Scotia employs PAs under delegated medical authority and New Brunswick is drafting legislation to add them to hospital emergency departments.

Schoeley, who was raised on a farm in Thedford, Ont., eventually wants to practise where she believes extra pairs of hands are most critical – outside the urban centres.

“The question is where the jobs will be,” the first-year student says. “But I would really like to go back to the rural area because there’s such a shortage of health-care professionals and there’s such a need.”

As to the RNAO’s concerns, Schoeley says PAs aren’t out to “step on anyone’s toes,” but to stitch together the gap between doctors and nurses.

“We’re only there to endorse the care of the patient. And that’s the exact same thing as the nurses want.”

Copyright © 2010 The Canadian Press. All rights reserved.

“When you can’t start a line in a junkie’s arm … go for the neck!” the caption read.

It was part of a photo album on his Facebook page called “Bloddy (sic) Mess,” and by Friday it had been removed.

Caamano, who works at the Open Door Family Medical Center in Port Chester, acknowledged that he had posted the gory pictures of himself performing procedures on patients.

“It was poor judgment at that time,” he said.

The pictures were not taken at the Open Door center, and officials there said they did not know where they were from. They would not make Caamano’s resume available.

Chief Operations Officer Anita Wilenkin declined to say what disciplinary measures, if any, Caamano would face.

“The answer is we have spoken to him, we are taking appropriate action with him and my understanding is all of the postings have been brought down,” Wilenkin said.

In neither of the photographs provided to The Journal News were the patients identifiable.

Wilenkin and Desta Lakew, the director of development, both said repeatedly that the people shown were not patients at the Open Door clinic. Asked whether they would report the incident, Wilenkin said: “Based on our assessment, this is not something that I would believe is a reportable thing.” She said it was not a violation of their patients’ rights.

Caamano has never been disciplined by the state, according to the state Department of Health. The Office of Professional Medical Conduct investigates complaints brought against physicians or physician assistants but does not comment unless charges are brought, said Jeffrey Hammond, a spokesman for the Department of Health.

As of Friday, Caamano’s profile photo for his Facebook page also had been deleted. It showed him giving the finger.

In often irreverent comments posted with the other photographs , Caamano describes one procedure as dialysis access and repair in which he must remove a catheter.

“So you have to compress until it stops otherwise it sprays all over like a fire hose. It wouldn’t stop and I was even suturing the opening to help close it but as you can see I can’t compress and tie at the same time so I just kept getting blasted with blood. Everyone thought it was funny so they took pictures. We’re just so mad-cap I say!”

“Are you serious?” asks another poster. “Lol” (laughing out loud).

And, she adds, “Isn’t this a HIPPA violation?” a reference to the Health Insurance Portability and Accountability Act, which sets out rules for patients’ privacy.

Caamano would not say where he was working at the time. He notes in his comments that he had held three jobs in less than a year. “That I do not want to answer,” he said when asked why.

Caamano was interviewed for MarketWatch in 2007 about why he had chosen to become a physician assistant instead of a physician. He had wanted to be a doctor, according to the article, but did not believe he could raise the hundreds of thousands of dollars needed for a medical degree. He also worried about the high cost of malpractice insurance, the article said.

“If I can do everything a doctor does, notably taking care of people, why not?” he was quoted as saying.

Caamano is not the first medical professional to get in trouble over Facebook.

An emergency medical technician in New York City lost his job in the spring after putting up photos of a murder victim who had been strangled with a hair dryer. Mark Musarella worked for Richmond University Medical Center on Staten Island.

In September, a doctor training at SUNY Upstate Medical University posted a color photo showing the top of a patient’s head cut open, the Syracuse Post-Standard reported. The hospital conducted an inquiry and said the picture probably was not of one of its brain surgery patients; the doctor, Donald Blaskiewicz, said he has taken it off the Internet.

And now Puerto Rican doctors in Haiti to assist earthquake victims are under investigation after posing with guns, smiling next to a coffin, drinking beer and holding a saw next to a victim’s leg.

Open Door officials said Friday that they would remind all employees about the pitfalls of social networking.

“Obviously we will take all the measures that we can within our role as the employer in educating our staff in the use of social-networking platforms,” Lakew said.

Said Wilenkin in a statement : “Open Door is deeply committed to privacy for both its patients and employees. We take this very seriously and include this not only in our formal code of conduct but also incorporate it into ongoing orientation and education programs on privacy and confidentiality.”

A joint investigation between Wilmington Police and the State Bureau of Investigation led to the arrest of 62-year old Rocky Carrol Quillen.

Quillen faces multiple charges including two counts of prescribing a controlled substance without a legal medical purpose, and conspiracy to traffic an opiate derivative, called Oxymorphone.

This isn’t Quillen’s first offense. His medical license was suspended in 2008 for 60 days by the North Carolina Medical Board for illegally writing prescriptions for a family member.

Quillen worked as an independently contracted P.A. at the Dawson Street Family Practice for about six months. He was asked to resign in December due to suspicious activity. In a statement by his supervisor, Dr. Ronald Demas says, “I am very disappointed in Mr. Quillen. I will continue to pray for him and his family.” Dr. Demas knew about Quillen’s past suspension but believed it was a one-time mistake.

Quillen studied medicine at Kettering College in Dayton, Ohio. He received his medical license in 2000. His license is currently active, but it’s up to the Medical Board and police to decide his fate.

Quillen also worked as a Physician’s Assistant at the Chicora Urgent Care Center in Supply. He is now in jail on a $150,000 bond. If Quillen is charged with a felony, his license will likely be revoked.

Retirement is the only thing I could come up with. After this enlistment I will have 10 years left in the military and in order to maximize my retirement benefits I need to be an officer. I will put some tables together so you can see the difference between a enlisted retirement and an officer retirement.

I started asking around and doing some research and have developed a new plan in order to reach my retirement goal. I have 3 years left on the enlistment and during that time I need to complete my pre-requisites for a Physician Assistant program, which in most cases are less than the nursing requirements. The next step will be to get out of the military and take advantage of the New GI Bill and go to PA school, which is usually 2 years. At that time I will be 45ish and will be able to come back into the military as a direct commission officer, probably an O-3 – do my 10 years and retire. It seems a little ass backwards but it fits my situation.

Right now I am compiling a list of colleges that I am interested in and will also fit my situation. I will post that in a few days.

I will start changing the links to reflect PA stuff but I will also keep up the nursing stuff but just consolidate it, it really is a great program for younger (lol) enlisted guys.

Josephine Nappi, MA, RN, director, nursing professional development for nursing education at Memorial Sloan-Kettering Cancer Center, in New York, NY, agrees there is an added amount of care needed for those who are hospitalized.

“Our patient acuity rises daily, our aged population presents additional challenges, and at the same time knowledge and technology increase exponentially. Individuals new to our profession must translate what they have learned in their basic nursing programs into practice rapidly,” says Nappi.

The National Council of State Boards of Nursing (NCSBN) considers this a major issue and recently raised the passing standard on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to ensure new nurses are sufficiently ready to take on the growing needs of sicker patients.

The higher passing standard was voted on in December 2009 and will go into effect on April 1, 2010. Nurses will be granted a passing grade with a -0.16 as opposed to a -0.21.

Joanie Alston Lovelace, MBA, RN, NHA, resident services administrator at Barclay Friends in West Chester, PA., believes that “a test score does not always reflect the knowledge level of an individual.”

“The new nurses coming out of school today are very ‘book’ smart, however they lack the hands-on experience of the ‘old’ school nurses,” says Lovelace. “There needs to be more clinical time incorporated into the learning process. The new nurses also are not truly prepared for what they will face in a new position. In school, they have maybe three patients to take care of in their last year of school and when they are in the work setting they could have as many as 15.”

Judy Dodge of the Indiana Heart Hospital has mixed feelings about raising the passing standard of the NCLEX. “I do feel that 75 questions doesn’t seem like enough to cover all the processes and diseases that one learns over the course of their education. I realize one cannot cover everything, but it just seems like such a very small sample,” she says.

The higher standard is the result of NCSBN’s regular plans to reevaluate the test and passing standard every three years to ensure both stay current and reflect the care nurses will give their patients.

Lovelace, Nappi, and Dodge believe that changing the passing standard is only part of the solution, and is one of the many steps the nursing profession should take to safeguard the patients.

There are some caveats though, one is that the nursing program has to be a BSN program and of course accredited. That means in order to apply through the Army for this program you need to have all your nursing pre reqs completed (which I do not).

So today I applied to the college of my choice as a transfer student ( I’ll go into that later) and the hopes to start knocking out my required classes.

more later….

These are among key findings from the 2010 Survey of Registered Nurses:  Job Satisfaction and Career Plans, conducted by AMN Healthcare (NYSE: AHS), the nation’s leading provider of comprehensive healthcare staffing and management services.  The survey, which collected data from 1,399 respondents, was conducted during a period of economic recession and in the course of an ongoing national debate over healthcare reform.  The survey reflects how RNs may have altered their career plans due to the recession, how they might respond to an economic recovery, and highlights whether they believe healthcare reform will address the nurse shortage.

On the healthcare reform issue, only 6 percent of the respondents are very confident that reform will provide a mechanism for ensuring an adequate supply of nurses.  This at a time when industry data indicates the nation will face a shortage of 260,000 RNs by 2025, and Bureau of Labor Statistics shortage numbers are even higher.

“Our survey clearly indicates significant job dissatisfaction and that is concerning in terms of quality healthcare delivery,” said Ralph Henderson, AMN Healthcare’s Nursing and Allied Division President.  ”Nurses are at the core of quality care in our nation’s delivery system and if we see large numbers of nurses leaving the profession it could negatively impact patient care outcomes.”

In fact, the majority of nurses (55 percent) believe that the quality of care nurses provide today has declined compared to five years ago, according to the survey.

The survey notes that 29 percent of nurses plan to take steps in the next one to three years that would reduce their role or take them out of nursing altogether.  An additional 15 percent say they will also make a change in their career path, like becoming a travel nurse or nurse practitioner.

However, while the survey highlights dissatisfaction with their current job, most nurses are satisfied with their careers overall, yet 59 percent would select nursing as a career if they had it to do it all over, and only 64 percent would recommend nursing as a career to young people.

“While nursing has made tremendous strides as a profession, in terms of pay and prestige, staffing shortages remain the profession’s greatest challenge,” notes Henderson.

Of immediate concern, he says, is that 6 percent of nurses permanently employed in a hospital setting indicate they plan to retire in the next one to three years.  This action would reduce the hospital nursing workforce by more than 70,000.  This is of particular concern, since the number of new candidates taking the National Council Licensure Examination (NCLEX) to become a registered nurse has flattened over the last year, suggesting no growth in the supply of new nurses entering the profession.

“It is critical that we find ways to keep experienced nurses engaged in patient care and attract new nurses to the workforce,” Henderson says.  These two things combined will help mitigate the impact of the nation’s growing nurse shortage, he observes.

A complete breakdown of AMN’s 2010 Survey of Registered Nurses:  Job Satisfaction and Career Plans is available at www.amnhealthcare.com.

About AMN Healthcare

AMN Healthcare Services, Inc. is the nation’s leading provider of comprehensive healthcare staffing and management services. As a leading provider of travel nurse and allied staffing services, locum tenens (temporary physician staffing) and physician permanent placement services, AMN Healthcare recruits and places healthcare professionals on assignments of variable lengths and in permanent positions with clients throughout the United States, who range from acute-care hospitals and physician practice groups to other healthcare settings, including rehabilitation centers, dialysis clinics, pharmacies, home health service providers and ambulatory surgery centers.

SOURCE AMN Healthcare Services, Inc.

RELATED LINKS
http://www.amnhealthcare.com

Q: On the 4187, who signs it, my Company or Battalion commander?
A: Your Battalion Commander.

Q: If you already have a Bachelor’s degree can you still participate in this
program?
A: Yes.

Q: If you already have a Bachelor’s degree can you get TA for the required
prerequisite classes?
A: Yes. See MILPER message 06-348 dated 12/11/2006.

Q: If I already have a Bachelors Degree, can I pursue a Masters in Nursing
Degree through the AECP?
A: No. The AECP is only for the completeion of a Bachelors of Science in
Nursing (BSN-RN)

Q: Can I apply to the program if I have a permanent profile?
A: Yes, as long as your profile does not prohibit you from deploying. Keep in
mind that all profiles are subject to review by the USAREC Surgeon
General.

Q: Can I use MFR format type letters of recommendation from my
Commander, First Line Supervisor or the Chief Nurse?
A: No, you must utilize the UF 195 form. You are allowed up to 2 other
Letters which may be in MFR format but the required format is still the UF
195 for these.

Q: I am currently deployed. Do I need to include a DA photo in Class A’s, as
there are no facilities where I am assigned?
A: SOLDIERS should exhaust all possible means to obtain a DA photo in Class
A’s. However, if no facilities are available then SOLDIERS will at a
minimum submit a ¾ length photo taken of themselves in ACU’s only (No
vests, headgear, weapons, etc.)

Q: Do I need to provide all of my transcripts with my application?
A: Yes, otherwise your application will not be reviewed by the board.

Q: Is the GT score requirement waiverable?
A: No. No waivers will be considered with regards to this requirement.

Q: Is there an age cut off for AECP?
A: Yes and No. If you will be over the age of 32 at the time of
commissioning, then you will need a Age waiver. If you will be over the
age of 42 at the time of commissioning, then you will need a age waiver
and a Mandatory Removal Date waiver (MRD). See AR 601-100 par. 1-9.

Q: Do I have to have been at my current duty station for 12 or more months
in order to apply?
A: No. The Time on Station (TOS) requirement only applies if you are
accepted by the AECP board and by an acreditted BSN program (as
defined in the AECP Guidelines). Then at that point it is up to your Branch
whether or not to release you (waive the TOS requirement).

Q: Will the ARMY PCS me if I am accepted to a school located somewhere
other than my current duty station?
A: Yes.

Q: Does the AECP offer any Cash Bonus or Loan Repayment?
A: No and No.

Q: Does time in the AECP still count as Active Duty years of service towards
retirement?
A: Yes.

Q: Can I be commissioned at a higher rank for any reason?
A: No. Completion of a BSN-RN are the minimum Active Duty requirements
for a ARMY Nurse Officer. All AECP graduates will be commissioned as
2LT’s.

Q: If I am married to a Service Member, does the ARMY Married Couples
Program guarantee that my spouse will be able to PCS with me?
A: There are no guarantees with this, especially if your chosen school isn’t
near an ARMY post.

Q: Once I complete my BSN-RN, will I be able to choose my next duty
location?
A: The ARMY Nurse Corps will ask for your preferences for a next
Assignment, but the decision rests with the ARMY Nurse Branch.

Q: Is there a USAR or National Guard option for AECP?
A: No. USAR and National Guard members may apply for the AECP, but they
will be brought back into the Active Duty component through MEPS and
once they graduate the AECP have a 4 year Active Duty Service Obligation
(ADSO).

WHAT HAPPENS AFTER I AM SELECTED

Q: Can I be deployed after I have been selected?
A: Yes. This decision is up to your unit and your Branch Manager.

Q: What happens if I am deployed while waiting to start school?
A: One of two things can happen; your Branch may release from theater to
come home and attend school or if your Branch will not release you to
come back then you may be deferred until your return. Being deployed
does not preclude you from applying to schools in order to get a
unconditional letter of acceptance.

Q: What are my chances of being activated if I am put on the OML?
A: If you are activated off of the OML do not expect it to be any earlier than
the June through Sep time frame. Request from you school that your
acceptance into their program be in line with this.

WHAT HAPPENS AFTER I START SCHOOL

Q: I am currently on jump status or other special duty; do I continue to
receive jump pay and special duty pay?
A: No, you are no longer entitled to any special pays.

Q: Do I still receive MY BAQ? What about BAS?
A: Yes, it will be based on the zip code of your school and your E grade. Yes.

Q: Can I live in or stay in government quarters if my school is near an
installation?
A: It is up to the installation’s policies.

Q: Who is my main point of contact while I am in school?
A. The AECP Program Director at Fort Sam Houston. See the Post Board
Guide lines.

Q: How often do I make contact with the Program Director?
A: At a minimum monthly, more often if you are having any problems that
would impact your ability to stay focused on your studies and/or to
complete your program on time.

Q: What if I change addresses or phone numbers during my program?
A: YOU MUST immediately notify the Program Director of any changes in
your contact information.

Q: What paperwork do I need to send to the Program Director at the end of
each semester?
A: A DA form 2125 listing the courses just completed with the grades and the classes (and costs of) that you will be taking in the next semester.

Q: Is my tentative assignment offer (next duty location) etched in stone?
A: No, at this point you are a “place holder” and until you pass your
program, NCLEX and OBLC your assignment can change. This does not
happen often but be aware it could.

Q: I am married to another service member or I am planning on getting
married, how will this affect my assignment?
A: If you are already married to a service member (Army, Air Force, Marine
or Coast Guard etc.), you must make sure that you are enrolled into the
Army’s Married Couples Program (Joint Domicile). When submitting your
Assignment request; in the comments section list the Branch manager’s
contact information (phone, email and address) for your spouse.

Q: If I am an E4 or E5 in the program, is there any possibility that I
may be boarded for the next rank? What about E6-E8?
A: No, the Student Detachment does not conduct or convene E5 or E6
promotion boards. Yes, but keep in mind that you will not be currently
serving in your MOS nor receiving an NCOER during the time that you are
in school.

Q: Can I change schools while in the program?
A: 99.9% of the time the answer is no unless there is some drastic
Circumstance or reason e.g. your school loses it’s accreditation.

WHAT HAPPENS AFTER I GRADUATE

Q: Once I graduate what do I do next?
A: You have 30 days to study and apply for your NCLEX. After you obtain your authorization to test (ATT) letter schedule your test date (the time will not exceed 45 days after graduation) and inform the Program Director of the date.

Q: What happens if I fail the NCLEX?
A: You will be given a second opportunity to take the NCLEX. The wait time in between test depends on the state but it is usually 30 – 45 days later.

Q: What if I fail the NCLEX a second time, will I be able to retake it a third?
A: Unless there are extraordinary mitigating circumstances the answer is no;
you would receive orders returning you to your MOS at the needs of the
ARMY. The final decision on this situation rests with the Program Director
at Fort Sam Houston.

On Tuesday, the California Medical Association and the California Society of Anesthesiologists filed a lawsuit in San Francisco Superior Court alleging that Gov. Arnold Schwarzenegger (R) skirted federal regulations when he sent a letter allowing nurse anesthetists to administer anesthesia without physician supervision, HealthLeaders Media reports.

Federal regulations generally require supervising physicians to be present when nurse anesthetists administer anesthesia. However, Medicare rules exempt hospitals from that requirement if a state’s governor sends a letter to CMS.

In the lawsuit, the two medical groups claim that Schwarzenegger bypassed federal rules because he sent the letter to CMS without first consulting with the state’s medical board and Board of Registered Nursing.

The suit also asserts that California hospitals do not need the exemption because the state does not have a shortage of anesthetists.

CMA and CSA asked the court to force Schwarzenegger to retract his letter and reinstate the requirement for physician supervision of nurse anesthetists.

Schwarzenegger administration officials assert that the governor acted in compliance with the law (Clark, HealthLeaders Media, 2/3).

Anyway, I have to get ready for work. I’m looking forward to this next upcoming challenge.