Boston Nurse Wins National Award for Outstanding Filipino American Women

For Gretheline R. Bolandrina, BSN, RN, CRRN, being recognized for outstanding service to the nursing profession and the community is nothing new. The Boston nurse, who works for SunBridge Care and Rehabilitation for Milford in Milford, Mass., has been honored over the years with numerous awards from organizations such as the Girl Scouts of the USA, the Philippine Nurses Association of New England and the National Federation of Filipino American Associations.

This past fall, Bolandrina, who is also a clinical instructor at the Massachusetts Bay Community College, added another, even more prestigious honor to her resume. She received the 2005 National Prism Award for Women of Style and Achievements, given by the Gintong Pamana (Golden Heritage) Awards Foundation in cooperation with the publications PhilippineTIME-U.S.A. and The Fil-Am Weekly MegaScene.

The National Prism Award celebrates the achievements of outstanding Filipino American women who have “an inherent power to make things happen [and who have] consistently made a difference in other people’s lives.” Bolandrina, a 1987 graduate of the University of Santo Tomas College of Nursing in Manila, certainly fits that description. Since coming to Boston in 1989, she has volunteered with many community service organizations, including the Girl Scouts, Locks of Love, HOPE Foundation International, Iskwelahang Pilipino, the Lowell Folk Festival, Bagong Kulturang Pinoy and more. She also writes a column for the newsmagazine Planet Philippines.

Licensing Board Complaints and Investigations: What Every Nurse Should Know

Licensing Board Complaints and Investigations: What Every Nurse Should Know

What should you do if you find yourself the target of a formal board complaint? Based on my experience handling these types of cases, I’ve addressed a number of common issues, taking you through the beginning stages of the process.*

First things first

You learn that a licensing board has received a complaint against you. The first thing you should do is review your insurance coverage for board complaints, provided you have such coverage. In my experience, most nurses rarely if ever carry this type of insurance. If you fall into the uninsured or underinsured group, I suggest you re-examine this issue and consider carrying such coverage. Most nurses go their entire careers without any type of professional malpractice insurance or insurance to specifically protect against board complaints.

There are a number of reasons nurses forgo malpractice insurance, including costs (too prohibitive) and thinking that they will simply never need it. However, I would highly suggest nurses consider purchasing insurance to protect them in the event of a potential malpractice claim or board complaint affecting their licensure. Insurance rates for this type of coverage are relatively inexpensive, compared to the costs of facing a malpractice claim on your own.

If you do have malpractice coverage, do not assume that it also covers licensing board complaints; this coverage is typically purchased separately. Be sure that you check carefully and contact your carrier if you have any doubts or questions.

Contact legal counsel

Regardless of whether or not you have insurance, you should contact a lawyer immediately—one knowledgeable in administrative law and/or professional license defense. Your attorney should be familiar with licensing boards and the disciplinary process. Just as there are different types of nurses, from perianesthesia to L&D nursing, there are attorneys who specialize in different areas of the law. You will be best served by an attorney familiar with this particular area.

In my experience, your initial response to a complaint is crucial. Address the issue with care. It is completely understandable to be shaken upon learning of a complaint. That highly emotional early period makes consulting with a highly trained and experienced attorney particularly critical. I believe that consulting a lawyer to review the facts almost immediately affords nurses the best chance of having the complaint dismissed without a hearing or resolved on the most positive terms.

The biggest hurdle I see is nurses delaying or altogether failing to contact someone who can help them because they do not want to broadcast that they have received a complaint. This is often complicated by the fact that the charges may include serious or embarrassing allegations. These things should not stop you from reaching out to people who may be able to help you through this difficult time.

Take it seriously

You should always treat a formal complaint as a serious matter, warranting immediate and thoughtful action. Yet, invariably, some nurses will dismiss licensing board complaints or other allegations as frivolous, without basis, or the fabrications of an ill-advised complainant. They may become outraged at being accused of unprofessional and/or inappropriate conduct. Worse, some nurses inexplicably go into denial mode, pretending nothing happened.

Some nurses may assume that once they explain what happened, the licensing board will see the complaint as not worth the paper it is printed on. But even in situations where this is true, nurses must take the complaint seriously.

Regardless of fault, the single biggest mistake a nurse can make is ignoring the complaint or to take the complaint too lightly. Based on the discipline a licensing board may impose, a shower of negative effects may flow from a single complaint. Depending on the alleged offense and the board’s conclusion, a nurse’s reputation and livelihood may be irreparably damaged. Truly, the importance of properly and adequately responding to a licensing board complaint cannot be overstated. In light of the serious nature of board disciplinary matters, many nurses, nonetheless, continue to make crucial mistakes after a board complaint has been filed, which needlessly expose them to additional professional risk.

Beat the deadlines

Nurses must pay close attention to response deadlines. Do not ignore or miss the deadline to reply to the complaint. As a nurse, you know the importance of following orders and the far-reaching consequences of failing to do so. In the disciplinary context, this is no different. When a complaint is filed, the board generally sends a notice of the complaint to the nurse. In that notice, there is almost always a deadline for the nurse to file a written, narrative response to the allegations and a deadline to produce relevant and germane records and/or documentation.

Let’s face it: nurses are busy people. Gathering the relevant information, obtaining the necessary advice, and preparing an appropriate response are time-consuming activities, most of which cannot be delegated to someone else. Compounding these problems is human nature, as we put off dealing with unpleasant activities. As a consequence, the deadline for producing records and filing a response often creeps up on the nurse before he or she has prepared a proper defense. Missing that important deadline can at best harm the nurse’s credibility and at worst result in additional sanctions or disciplinary action. Nurses should never ignore, fail to respond, or miss the response deadline. Usually, additional time is granted if necessary, but you must file a request with the board, usually in writing, prior to the deadline.

Keep it to yourself

Should you speak with the board, investigators, complainant, or witnesses on your own? Short answer, no. Again, the first—and only—person you should contact upon receiving a board complaint is an attorney experienced in handling these types of matters. You need proper advice and an outline of your options. You also should never assume that you can simply explain the complaint away, even if you’re working with a seemingly friendly investigator. If asked, politely decline discussing the matter with anyone without your attorney present.

Although some complaints can be resolved quickly without adverse action, don’t allow yourself to be lulled into a false sense of security. I often encounter nurses who believe licensing boards exist to serve their interests, to protect them and their licenses. This isn’t the case. Licensing boards exist to protect the public. Statements you make at the beginning of an investigation, without adequate reflection or thought, can come back to haunt you.

Furthermore, you should also avoid having conversations with third parties, including potential witnesses. These interactions could damage your defense, and they are not protected from disclosure by the attorney-client privilege. Put another way, saying the wrong thing in the wrong way to anyone (except your attorney) can significantly inhibit your defense and lead to unfavorable consequences.

Finally, do not discuss the issue with the complainant unless your attorney agrees you should. The complainant represents great risk to you, and you generally should not discuss the case with him or her. You may think that if you could just talk to the complainant, you would have a productive, levelheaded discussion that would help the complainant understand your point of view and convince the complainant to dismiss the charge. In my experience, this almost never works; in fact, it can lead to damaging evidence against you. Worse, it may be portrayed as your having tried to intimidate the complaining party. It bears repeating that under no circumstance should you attempt to discuss the complaint with the person who filed it without first consulting the proper legal advice.

Overcoming a bad situation

The complaint and disciplinary processes can be daunting, especially for those unfamiliar with them. Defending and protecting your reputation and livelihood can generate anxiety and angst, and dealing with a complaint can exact a high emotional as well as economic toll. Familiarity with the process itself with timely and proper handling is crucial to obtain the best possible outcome.

With any luck, you will never have a complaint filed against you or go through a disciplinary hearing, but should that come to pass, I hope this article equips you with information that will enable you to make thoughtful and informed decisions.

*Please note that this article is not intended as formal legal advice and should not be used as such. Every case is different, and should you have questions specific to your own situation, I urge that you contact an attorney for further discussion.

Bridging the Gap: Preparing the Nursing Leaders of Tomorrow

Bridging the Gap: Preparing the Nursing Leaders of Tomorrow

The current health care crisis is multifaceted, ongoing, and incredibly significant to those within the profession. The reform the country is currently experiencing came as a result of several factors: high cost of treatment, ineffective payment methods, and millions of uninsured Americans in need. Though these problems have begun to enter the national conversation, there are still many issues that need to be addressed and fixed.

Nurses are often referred to as the front line of the health care system—meaning that the changes occurring on a national level will affect them directly, perhaps even first. With the coming reform, health care facilities and their nursing staff must account for slashed budgets, reduced personnel, and political pressure. Moreover, President Obama recently set aside more than $36 billion to create a nationwide network of electronic health records—a massive undertaking that will require a combination of proven communication skills and strategic management to implement, use, and manage.

In addition to these changes, the population is aging, Medicare funding is in jeopardy, and the nursing shortage is projected to grow to one million by 2020. As the public gains access to health care, the lack of nurses will be felt even more acutely.

Nurses must equip themselves with the skills necessary to manage and help solve these crises.

The next generation of nursing leaders will be charged with placing an emphasis on interpersonal and interdepartmental communication—translating and acting as a diplomat between the clinical and business sides of health care institutions. Nursing leaders must have a strong working knowledge of clinical practice and the business of health care, all within an everchanging political arena. Nurses holding both a Master of Science in Nursing (M.S.N.) and a Master of Business Administration (M.B.A.) will be better equipped to understand both sides of the equation.

This may be unfamiliar territory for the nursing profession. Executives must be able to identify key health care trends, watch regulatory rules and legislation—and be able to implement changes within their own organization based on these findings.

Dual degrees in nursing and business help nurses manage these responsibilities in more ways than one could count. Registered nurses are not generally educated in the business side of health care, and while a Bachelor of Science in Nursing is excellent preparation for nursing clinical practice, patient care is far removed from the fiscal responsibility of bringing consumption and cost to sustainable levels. A business-trained leader, such as an M.B.A.-prepared executive, may be able to provide financial analysis of factors associated with treatment, providing the cost in real dollars and highlighting areas of strength or problematic gaps. Yet, while that training may prove invaluable in discovering economic stopgaps, understanding financial problems is not effective in providing a cost benefit unless a clinical solution can be found as well. Therein lies the primary benefits of obtaining dual M.S.N./M.B.A. degrees—understanding and linking both sides of health care.

M.S.N./M.B.A. programs aim to prepare students for mid- to upper-level management roles in health care organizations, including chief nursing executives, nursing managers, nursing supervisors, nursing educators, nursing informaticists, nurse practitioners, clinical nurse specialists, and more. According to the Centers for Medicare and Medicaid Services, by 2015 health care costs will hit $4 trillion and account for 20% of the U.S. economy. By 2012, the number of nursing executives is expected to increase faster than most health care professions. Still, in today’s diffi cult economic environment, being as educationally competitive as possible is key to securing a position as a nursing executive.

Employers will be looking for nursing executive candidates skilled in communication and conflict resolution, leaders who have the ability to cultivate an ongoing conversation between patients, staff, and administration. M.S.N./ M.B.A. degree programs also generally provide more targeted business preparation, training students in areas such as relationship management, organizational leadership, business relations, and change management—skills which are more crucial now than ever.

Class work, prerequisites, clinical requirements, and other details of these dual degree programs vary widely. Students may obtain their dual degree at one school or through articulation agreements between two distinct schools of nursing and business. Accelerated programs often combine these studies even further, saving students both time and money. At Chamberlain College of Nursing, courses such as Leadership Role Development, Health Policy, and Informatics prepare graduates to serve as effective nursing leaders, able to understand the politics and decisions inherent in health care leadership. Business studies, including Managerial Accounting, Marketing Management, and Business Economics help students develop strong analytical abilities, understand health care economics, learn to resolve organization and business issues, execute health care strategies, and foster communication and interpersonal skills.

In order for the health care field to flourish in the face of a continuing recession and monumental policy changes, the profession must seek out and support individuals prepared for both the monetary and clinical challenges. The time for aspiring health care leaders to gather the knowledge and credentials they need is now. The industry’s success depends just as much on cost savings as on the finite resources vital to maintaining crucial care—namely, the people and practices that allow health care to function. Future nursing leaders must further prepare themselves to manage every facet of the coming changes to the industry, including attaining knowledge of both the business and the science of health care.

Top 25 Nursing Employers of 2014

Top 25 Nursing Employers of 2014

For the second year in a row, we reached out to Minority Nurse readers about what they look for in a workplace—and how their current employers stack up.

Unsurprisingly, salary and benefits once again topped the list of factors respondents considered when looking at potential employers. But for many readers, workplace satisfaction was about more than just compensation. This year’s results showed an increased focus on quality of life factors, such as corporate culture, workplace environment, and flexibility of hours. Diversity and workplace size—while still important to many respondents—were less of a factor when considering potential employers.

Overwhelmingly, this year’s results showed readers were quite satisfied with their current jobs. The majority rated their employers as “good” or “excellent” in most categories, including workplace size, job perks, and benefits. The areas most in need of improvement according to this year’s survey were opportunity for advancement and salary, though Minority Nurse’s Salary Survey from 2014 showed that readers have seen steady pay increases in that area over the last few years.

This year’s responses, which were gathered through an online questionnaire sent to Minority Nurse subscribers, came from across the country, with California, New York, Texas, and Pennsylvania as the most represented states. Companies that scored well this year were mostly very large organizations with thousands of employees, including several academic-affiliated medical centers, such as Duke University Health System and Penn State Milton S. Hershey Medical Center; government agencies, such as the US Department of Veterans Affairs and Indian Health Service; and big urban hospitals and networks, such as Children’s Hospital of Philadelphia and the Cleveland Clinic.

Our final list of top 25 companies, presented alphabetically, scored well in the categories that were most important to our readers. We’ve provided a brief introduction to each organization, as well as contact information for job seekers.

Advocate Health Care

Location: Facilities throughout Illinois

Number of nursing employees: Approximately 10,000

About the company: Formed in 1995 with the merger of Evangelical Health Systems Corporation and Lutheran General Health System, the Advocate Health Care network is one of the largest employers in the Chicago area. It includes 12 acute-care hospitals (six of which are Magnet-certified) and more than 200 other health care facilities, including hospices. Several Advocate hospitals have consistently ranked in the U.S. News & World Report annual best hospitals, among other accolades.

Contact: Job listings are available at

Bellin Health

Location: Green Bay, Wisconsin

Number of nursing employees: Varies by facility (approximately 750 at Bellin Hospital)

About the company: Founded more than 100 years ago by Dr. Julius J. Bellin as General Hospital, Bellin Health is now comprised of several medical and educational entities, including the 167-bed acute-care facility Bellin Hospital, two psychiatric treatment centers, and a network of family medical offices, as well as the Bellin College of Nursing, which offers the only four-year baccalaureate-nursing program in northeast Wisconsin.

Contact: Job listings are available at

California State University

Location: Facilities throughout California

Number of employees: Varies by campus

About the company: California State University is the largest four-year university system in the country, with nearly 447,000 students. The CSU Nursing Program offers bachelor’s, master’s, and doctoral degrees in nursing. Nurse educators are employed at 18 of the school’s 23 campuses located throughout the state.

Contact: Job listings are available at

Children’s Hospital of Philadelphia

Location: Headquarters in Philadelphia, Pennsylvania

Number of nursing employees: Approximately 3,600

About the company: Children’s Hospital of Philadelphia is the nation’s oldest children’s hospital, and is widely regarded as one of the best. It’s topped the U.S. News & World Report list of best children’s hospitals for the last five years, and has been Magnet-certified since 2004. In addition to its main hospital in West Philadelphia, CHOP operates more than 50 smaller practices throughout Pennsylvania and New Jersey, and several large expansion projects are in the works, including a new outpatient facility set to open in 2015.

Contact: Job listings are available at

Cleveland Clinic

Location: Headquarters in Cleveland, Ohio

Number of nursing employees: Varies by facility (approximately 6,500 at the main campus)

About the company: Known as one of the most medically innovative hospitals in the country, the Cleveland Clinic’s long list of “firsts” includes the isolation of serotonin, the first coronary bypass surgery, and the first face-transplant in the United States. It is ranked in several specialties on the U.S. News & World Report list of best hospitals. In addition to its main location in Cleveland, it operates seven more hospitals throughout Ohio, as well as affiliates in Florida and Nevada, and international outposts in Canada and Saudi Arabia.

Contact: Job listings are available at

Community Health Network

Location: Facilities throughout Indiana

Number of nursing employees: Varies by facility

About the company: Established in 1956 after a massive grassroots fundraising effort by Indianapolis residents, Community Hospital (now Community Hospital East) has grown to a sprawling network of more than 200 facilities throughout central Indiana. It has been named one of the best places to work by The Indianapolis Star.

Contact: Job listings are available at

Duke University Health System

Location: Headquarters in Durham, North Carolina

Number of nursing employees: Varies by facility (approximately 3,000 at Duke University Hospital)

About the company: Duke University Hospital (since renamed Duke University Medical Center) was established in 1930 thanks to a bequest from James B. Duke. Today, the 7.5-million-square-foot facility is the flagship hospital in a network that includes the Duke Clinic, Duke Children’s Hospital and Health Center, Duke Regional Hospital, and Duke Raleigh Hospital, as well as the Duke University Medical School and the Duke University School of Nursing. Duke has been nationally recognized for its several specialties, including cardiology, nephrology, and ophthalmology.

Contact: Job information is available at

Gwynedd Mercy University

Location: Gwynedd Valley, Pennsylvania

Number of employees: Approximately 500

About the company: This Catholic-affiliated university offers undergraduate and graduate degrees in nursing and other medical specialties at the Frances M. Maguire School of Nursing and Health Professions division.

Contact: Job information is available at

Indian Health Service

Location: Headquarters in Rockville, Maryland, with facilities throughout the country

Number of nursing employees: Approximately 2,700

About the company: The Indian Health Service was established in 1955 to improve the health of American Indians and Alaska Natives. This division of the US Department of Health and Human Services has an annual operating budget of $3.8 billion and oversees more than 100 medical facilities in 12 areas, each focused on the unique needs of the native American tribes in the region.

Contact: Job listings available at

Indiana University Health 

Location: Facilities throughout Indiana

Number of nursing employees: Varies by facility (approximately 29,400 total employees)

About the company: Indiana University Health is a network of hospitals and other facilities throughout Indiana affiliated with the Indiana University School of Medicine. Last year, IUH had more than 2.5 million outpatient visits and over 136,000 admissions. Its facilities have been nationally ranked by U.S. News & World Report in several specialties, including cancer, neurology, and orthopedics. Six of the hospitals in the network have been designated Magnet facilities.

Contact: Job listings are available at 

Kaiser Permanente

Location: Headquarters in Oakland, California, with facilities in California, Colorado, Georgia, Hawaii, Oregon, Washington, Virginia, Maryland, Ohio, and Washington, DC

Number of nursing employees: Varies by facility

About the company: Founded in 1945, Kaiser Permanente operates more than 600 interconnected but independently managed medical facilities in the United States, as well as a managed-care plan with more than 9 million members.

Contact: Job listings are available at

Los Angeles County Department of Health Services 

Location: Los Angeles County, California

Number of nursing employees: Varies by facility

About the company: Los Angeles County Department of Health Services is the second-largest municipal health care system in the country. It operates in the most populous county in the United States, and provides medical care and services to approximately 800,000 patients annually at several hospitals and other medical centers.

Contact: Job listings are available at 

Memorial Hermann–Texas Medical Center 

Location: Houston, Texas

Number of nursing employees: Approximately 1,800

About the company: This Magnet-recognized teaching hospital (affiliated with the University of Texas Health Science Center at Houston Medical School), is the oldest institution in the massive Texas Medical Center and the flagship hospital in the vast Memorial Hermann network with facilities throughout Texas. Its Level 1 trauma center sees more than 40,000 patients annually, and its Children’s Hospital is one of the top-ranked pediatric facilities nationwide.

Contact: Job listings are available at 

NewYork–Presbyterian Hospital 

Location: New York, New York

Number of nursing employees: Approximately 5,000

About the company: This multi-campus institution is affiliated with two Ivy League universities, Columbia and Weill Cornell. It is the largest private employer in New York City, and one of the largest hospitals in the United States. It’s ranked sixth overall in U.S. News & World Report’s Best Hospitals survey. In addition to its two main facilities in Manhattan, the Columbia University Medical Center and the Weill Cornell Medical Center, NewYork–Presbyterian operates the Allen Hospital, Morgan Stanley Children’s Hospital, and a psychiatric facility in nearby Westchester County. In July 2013, NewYork–Presbyterian expanded its reach when it merged with New York Downtown hospital, establishing the Lower Manhattan Hospital.

Contact: Job listings are available at   

Our Lady of the Lake Regional Medical Center

Location: Baton Rouge, Louisiana

Number of nursing employees: Approximately 1,300

About the company: A Catholic teaching hospital established 90 years ago, OLOL is one of the largest privately owned hospitals in Louisiana, as well as the largest of four hospitals in the Franciscan Missionaries of Our Lady Health System. Today, this Magnet-recognized facility serves 11 parishes, and has more than 1,000 beds.

Contact: Job listings are available at 

Penn State Milton S. Hershey Medical Center

Location: Hershey, Pennsylvania

Number of nursing employees: Approximately 1,800

About the company: This 475-bed teaching hospital affiliated with Penn State College of Medicine and College of Nursing is one of the largest and most respected hospitals in south central Pennsylvania. Its Children’s Hospital is ranked among the nation’s best in U.S. News & World Report’s top hospitals list, and it features the area’s only neonatal intensive care unit. The hospital’s Cancer Institute opened in 2009, and the volunteer-run LionCare clinic has been providing free health care services since 2002.

Contact: Job listings are available at

Rutgers Biomedical and Health Sciences

Location: Facilities and institutions throughout New Jersey

Number of nursing employees: Varies by facility

About the company: Part of the vast Rutgers University system in New Jersey, RBHS was established as an umbrella organization in 2013 after the dissolution of the University of Medicine and Dentistry of New Jersey. It comprises several medical and educational institutions, including the Cancer Institute of New Jersey, University Behavioral HealthCare, the Rutgers School of Nursing, and both of the Rutgers graduate schools of medicine: New Jersey Medical School and the Robert Wood Johnson Medical School. The primary teaching hospital for Rutgers is the state-owned University Hospital in Newark.

Contact: Job information is available at

SUNY Downstate Medical Center

Location: Brooklyn, New York

Number of nursing employees: Approximately 650

About the company: Founded in 1860 as Long Island College Hospital, SUNY Downstate is now one of three medical centers in the State University of New York system. Today, it includes four patient-care facilities, as well as medical, nursing, and public health schools, among other academic programs. It’s the fourth largest employer in Brooklyn—a borough of New York City with more than 2 million residents—and its alumni network is impressive: More physicians practicing in New York City graduated from the SUNY Downstate College of Medicine than any other medical school.

Contact: Job listings are available at

UNC Health Care

Location: Facilities located throughout North Carolina

About the company: UNC Health Care is a state-owned network of hospitals affiliated with the prestigious University of North Carolina-Chapel Hill School of Medicine. In addition to 12 hospitals, which include several Magnet-recognized facilities, UNC Health Care provides services at family health practices, ambulatory care facilities, and urgent care units throughout the area.

Contact: Job listings are available at

University of Arkansas for Medical Sciences

Location: Little Rock, Arkansas

Number of nursing employees: Approximately 1,400

About the company: The University of Arkansas for Medical Sciences has six academic divisions, including pharmacy, nursing, and public health schools, as well as the only medical school in Arkansas. The school’s main patient-care facility is UAMS Medical Center, though it expands it reach through smaller clinics located all over the state.

Contact: Job listings available at

University of Maryland Medical System

Location: Facilities throughout Maryland

Number of nursing employees: Varies by facility

About the company: One of the largest hospital networks in the Mid-Atlantic region, University of Maryland Medical System is made up of nine hospitals, including one pediatric facility and several teaching hospitals affiliated with the University of Maryland.

Contact: Job listings are available at

University of Michigan Health System 

Location: Headquarters in Ann Arbor, Michigan

Number of nursing employees: Varies by facility

About the company: This integrated health care system located in southern Michigan comprises three hospitals (University Hospital, C.S. Mott Children’s Hospital, and Von Voigtlander Women’s Hospital), 40 outpatient centers and more than 120 clinics, and a large home health care division.  It also includes the University of Michigan’s Medical School and School of Nursing, and it partners with other medical centers throughout the state via the Michigan Health Corporation. The Detroit Free Press has named UMHS one of the “101 Best and Brightest Companies to Work For.”

Contact: Job listings are available at 

University of Texas Medical Branch

Location: Galveston, Texas

Number of nursing employees: Varies by facility

About the company: This division of the University of Texas is located in a 70-building, 84-acre complex, which includes several hospitals and clinics, four schools, and numerous research facilities. In 2008, many of its buildings were badly damaged by Hurricane Ike, but it’s made a strong comeback and expanded its reach since.

Contact: Job listings are available at

US Department of Veterans Affairs 

Location: Headquarters in Washington, DC, with facilities throughout the United States

Number of nursing employees: Varies by facility

About the company: The US Department of Veterans Affairs was established in 1930, consolidating several agencies that provided services to veterans of American conflicts. Today, the Veterans Health Administration, the wing of the VA focused on health care, operates 171 medical centers, as well as hundreds of outpatient clinics, nursing homes, and other facilities.

Contact: Job listings are available at 

Vanderbilt University Medical Center 


Location: Nashville, Tennessee

Number of nursing employees: Approximately 3,700

About the company: This organization contains several hospitals and clinics, as well as Vanderbilt University’s School of Medicine and School of Nursing. Vanderbilt has been well ranked in the U.S. News & World Report Best Hospitals surveys, and Vanderbilt University was once named one of Forbes’s “100 Best Companies to Work For”  (more than 80% of Vanderbilt’s employees work at the Medical Center).

Contact: Job listings are available at

Stronger Collaboration between RNs, Employers Encouraged to Reduce Risks from Nurse Fatigue

Stronger Collaboration between RNs, Employers Encouraged to Reduce Risks from Nurse Fatigue

The American Nurses Association (ANA) calls for stronger collaboration between registered nurses (RNs) and their employers to reduce the risks of nurse fatigue for patients and nurses associated with shift work and long hours, and emphasizes strengthening a culture of safety in the work environment in a new position statement. 

ANA contends that evidence-based strategies must be implemented to proactively address nurse fatigue and sleepiness. Such strategies are needed to promote the health, safety, and wellness of RNs and ensure optimal patient outcomes.

“Research shows that prolonged work hours can hinder a nurse’s performance and have negative impacts on patients’ safety and outcomes,” says ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN. “We’re concerned not only with greater likelihood for errors, diminished problem solving, slower reaction time, and other performance deficits related to fatigue, but also with dangers posed to nurses’ own health.”

Research links shift work and long working hours to sleep disturbances, injuries, musculoskeletal disorders, gastrointestinal problems, mood disorders, obesity, diabetes mellitus, metabolic syndrome, cardiovascular disease, cancer, and adverse reproductive outcomes.

ANA offers numerous evidence-based recommendations for RNs and employers to enhance performance, safety, and patient outcomes, such as the following suggestions:

•Involve nurses in the design of work schedules and use a regular and predictable schedule so nurses can plan for work and personal responsibilities. 

•Limit work weeks to 40 hours within seven days and work shifts to 12 hours. 

•Eliminate the use of mandatory overtime as a “staffing solution.” 

•Promote frequent, uninterrupted rest breaks during work shifts.

•Enact official policy that confers RNs the right to accept or reject a work assignment based on preventing risks from fatigue. The policy should include conditions that a rejected assignment does not constitute patient abandonment, and that RNs should not suffer adverse consequences in retaliation for such a decision.

•Encourage nurses to manage their health and rest, including sleeping seven to nine hours per day; developing effective stress management, nutrition, and exercise habits; and using naps in accordance with policy. 

The position statement was developed by a Professional Issues Panel, established by the ANA Board of Directors. The panel was comprised of 15 ANA member nurses with expertise on the issue, with additional input from an advisory committee of about 350 members who expressed interest in participating. The statement was distributed broadly for public comment to nursing organizations, federal agencies, employers, individual RNs, safety and risk assessment experts, and others, whose suggestions were evaluated by the panel for incorporation in the statement. The new position statement replaces two 2006 position statements—one for employers and one for nurses. The statement clearly articulates that health care employers and nurses are jointly responsible for addressing the risks of nurse fatigue.  

Source: American Nurses Association