Happy Tuesday and Happy Nurses Week!

In Today’s Edition:

• Happy Nurses Week! Take Advantage of All the Discounts We Found

• Healthcare Tech, a New Sensor May Detect Heart Attacks

• Updates in Hypertension & CAD Risks

• Free Cardiovascular CME Resources

• Speaking of Heart, Meet Dr. Sandra Hyder, a CV-ICU NP, Leader, and Educator

• CXR's Give Me Palpitations, a Clinical Case

🩺 APP Trending News

Let’s Get to the Heart of APP News

Happy Nurse’s Week (and Belated Student Nurse Day)!

Nurses Week has an interesting history but also marks the birthdate of Florence Nightingale, who left behind a legacy of modern nursing, education, and healthcare reform. Lovingly referred to as, “Flo,” her image is often aligned with the origin of nursing in the public eye, but we know the history of nursing spans much, much farther. Although a week of celebration does not quite sum up the gratitude we have for the profession and our colleagues, we hope you can take advantage of some perks being offered up this week! 🙏🏼

Nursing school enrollment says goodbye to a 20-year growth streak

Last week, the American Association of Colleges of Nursing (AACN) released new data revealing a decline in the enrollment of nursing across the country. This has raised concerns about the ability of the nursing profession to meet the growing demand for healthcare services, especially after the COVID-19 pandemic. Without nurses, we will have a decrease in the number of advanced practice providers. Conversely, there has been an increase in the number of DNP and PhD applications, indicating that initiatives aimed at promoting careers in nursing science are yielding positive results.

Keeping up with health innovations, a new sensor can identify heart attacks

New technology provides a non-invasive, continuous monitoring method for patients who are at risk for acute myocardial infarction (AMI) and could significantly improve outcomes and reduce the need for invasive diagnostic procedures. This raises excitement as a (small) recent study reports the use of Apple iWatch for prediction of pain in sickle cell patients. We LOVE innovation!

⚙️ The More You Know

Speaking of Hearts, We 🫶🏽 Our Subscribers and Keeping You Current

New coronary heart disease risk factors

Progress continues to evolve in the field cardiovascular disease, one of the leading causes of death and disability worldwide. Most of us are familiar with the textbook risk factors like smoking, hyperlipidemia, hypertension, diabetes, etc…. Are you up to speed on “newer,” lesser-known risk factors? Early identification can have major effects on the awareness aimed at reducing disparities and improving cardiovascular health equity.

Guidelines to managing and treating hypertension

According to a presenter at the 2023 annual meeting of the American College of Physicians, there is ongoing confusion about how to diagnose and manage hypertension. The American Heart Association (AHA) has updated and enhanced its previous definition of "cardiovascular health" to include 8 essential factors, called "Life's Simple 8." They have emphasized that psychosocial stress and depression are associated with poorer CVH. The new definitions take into account the social determinants of health that can impact cardiovascular health, such as access to healthy foods and safe places to exercise. The AHA encourages individuals, healthcare providers, and policymakers to prioritize these 8 factors and work towards improving cardiovascular health for all. Pro-tip: Stay current with guidelines, while individualizing patient care.

Speaking of staying current, we love free CME

Virtual CME:

Pri-med provides 1.0 hour per topic including: Current Recommendations on Aspirin use in Cardiovascular Health and Advancements in Lipid Management

While not free, the Mayo Clinic has an upcoming conference that gets to the “Heart of the Matter.”

💡Inspiration for Aspirations

Does the world of CV health interest you? We have a leader with all the heart!

Meet Sandra Hyder, DNP, MBA, APRN, ACNPC-AG, NEA-BC, CCRN, CVRN, PCCN, LBBP

Q: Can you tell us about your background?

A: Happy Nurse's Week! My name is Sandra Hyder and I have been a nurse for 18 years, 8 of which have been in the role of advanced practice. My time as a bedside nurse encompassed many areas of nursing including med-surg, critical care, hospice, interventional and outpatient radiology, home health, and pre/post op to name a few. I also found myself in leadership and earned my MBA in 2010. Finding that my passion was in direct patient care, so I went back to the bedside and earned my Master of Science with an Adult/Geri Acute Care NP focus. I landed my dream job at a large academic institution in Texas with a focus in Cardiovascular/Cardiothoracic and Vascular Surgery and Critical Care. I also became adjunct faculty at various schools of nursing for their undergraduate and graduate programs. Finding a new passion in education, I was able to create relationships with numerous organizations and was honored to serve as a podium speaker at Rotterdam University this past spring. I am an FCCS instructor and joined the phenomenal team of instructors within the Society of Critical Care Medicine. I find fulfillment in quality improvement and have executed a variety of process improvement projects within my organization then earned my Lean Six Sigma Black Belt certification. Overall, I've found a myriad of areas in which nurses, specifically advanced practice nurses, can create quality processes that positively impact patient outcomes. To enhance my ability to lead these changes, I furthered my education and earned my Doctor of Nursing Practice (DNP) with a focus in Nursing Executive Leadership this spring semester.

Q: What inspired you to specialize in cardiovascular care, and what do you find most rewarding about this field?

A: The heart is such a phenomenal organ in its ability pump about 2,000 gallons of blood a day. Additionally, as a muscle that works harder than the leg muscles of an athlete, I cannot help but to view it in awe. Specializing in cardiovascular and vascular surgery allows me to use my passion towards this organ and translate it into great patient care and more importantly, great outcomes. The reward in my work is seeing my patients discharge home in stable condition. Their life, their heart, and their families all get another shot at life and that is priceless.

Q: What does your day-to-day look like working in the CVICU?

A: My CVICU is a very busy unit. We hit the ground running at 0600 with surgery rounds, followed by patient exams, orders, procedures, etc.… until 9 am critical care rounds. After critical care rounds, we continue total care for our patients with procedures or addressing emergent incidences as needed. The afternoon consists of accepting surgical cases, managing high end hemodynamics, evaluating readiness for extubation, and providing the care needed to ensure stability in the post-operative phase. In addition to post op management, we provide total preoperative care including the ordering of diagnostic imaging, laboratory testing, and advanced procedures as needed.

Q: How do you collaborate with other healthcare professionals to ensure that patients achieve their cardiovascular health goals?

A: The multidisciplinary collaborative approach employed in our ICU leads to comprehensive, efficient, and patient-centered care. Ensuring a strong partnership with consultant teams such as neurology, nephrology, cardiology, and endocrine is key in management of various comorbidities. The integration of these expert teams is instrumental in ensuring great post operative and outpatient/follow up care which reduces our readmission rates.

Q: What is the biggest challenge you face?

A: The biggest challenge I face as a provider is ensuring that our physician partners understand the scope of our practice. Although my facility is advanced practice provider (APP) supportive, many APPs face barriers to practice at the top of their licensure. We need to continue efforts to bridge the provider gap, train up the new generation of APPs, and become politically involved to make changes at the local, state, and national level that will continue to advance our practice.

📈Future APPs

Your Future is Bright 🔆

From advances in technology in the classroom, to bedside care, telemedicine, and beyond, there is no better time to be entering the field of healthcare! We 🫶🏽 our current and prospective students. Explore all your opportunities!

🧪Clinical Conundrums: Because We Love a Challenge!

CXR's Give Me Palpitations

Case: A 66-year-old female with a history of 2PPD tobacco use (quit last year) presents with dyspnea. Her vital signs are stable aside from mild tachycardia and her respiratory rate is slightly elevated. Oxygen saturation is 96% on room air. You note that she has decreased lung sounds at the left base along with decreased tactile fremitus, and dullness to percussion. You obtain this x-ray:

🔎ICYMI

Last Week, in Our Edition: “Show Me the Money”

• A Startling Trend in Nursing Decline

• AI in Healthcare

• Know Your Worth - Understanding RVUs and Medicare Reimbursement

• Secrets Nobody Tells You as a New Graduate

• Meet Shayne Foley, Inspirational Entrepreneur and Overall Awesome Resource

• Demystifying Last Week’s Clinical Conundrum

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