How Nurses Can Advocate Against Short Staffing While Staying Employed

How Nurses Can Advocate Against Short Staffing While Staying Employed

Nurse Staffing and You

With one out of two nurses reporting inadequate time with patients, you’ll probably experience some form of short nurse staffing during your career. Even though research indicates that short staffing increases the chance of patient complications and medical errors, you may find that your facility still fails to employ enough nurses. Rather than risking burnout or delivering poor care to your patients, it’s important that you know how to ask for the extra help you need without placing your job in jeopardy.

Nurse Staffing Requirements Under the Law

Federal regulations require that medical facilities that participate in Medicare have adequate nurse staffing. The regulation does not specify specific staffing ratios, so thirteen states have passed laws that require facilities to publicly disclose staffing-to-patient ratios or have staffing committees that determine nurse staffing levels. Only California has a required ratio of nurse to patients while Massachusetts has a required level of nurse staffing for Intensive Care Units only.

Some states may not specify appropriate staffing levels but they may protect nurses who advocate for their patients. For example, the Texas Nursing Protection Act doesn’t allow employers to retaliate against you if you report them to a regulatory body because you have safety concerns related to poor staffing levels.

Advocating for Adequate Staffing Levels

Due to the lack of state-mandated staffing levels, your best option for increasing staffing is to advocate for management to provide better coverage. When asking for better coverage, your request should be clear and cite specific examples. If your facility has a nurse-driven staffing committee, you should discuss your specific on-the-job concerns with management that can refer this information to the committee.

American Nurse Today suggests you use the SBAR (Situation, Background, Assessment, Response) technique to discuss staffing shortfalls with management. Always start with your immediate supervisor; most medical facilities are hierarchical structures that strongly rely on the chain of command. It’s also important that you assess any response you receive and decide who you should speak to next to get an acceptable response.

Also consider joining professional organizations that advocate for legal protections for nursing and other regulations. If you belong to a union, make sure that your union is respectfully working with your employer to address short staffing issues.

As the Baby Boomer generation continues to age, short nurse staffing will continue to be a problem you’ll have to address. In addition to advocating for your patients with management, make sure that you’re consistently updating your own training and work habits to be the most effective nurse for your patients. That way you’ll be in the best possible position as a nursing advocate and a professional.

PRESS RELEASE: THMED CIO, Sepi McDonnell, named to SIA’s 40 under 40 list

PRESS RELEASE: THMED CIO, Sepi McDonnell, named to SIA’s 40 under 40 list

THMED Chief Information Officer, Sepi McDonnell named to Staffing Industry Analyst’s 40 under 40 list.

PRESS RELEASE Dallas, TX, July 24, 2019.

Chief Information Officer, Sepi McDonnell, was announced as a part of Staffing Industry Analyst’s 3rd annual 40 under 40 list. The 2019 list is a shout-out to those moving the staffing industry forward. The list includes CEOs, finance executives, technical leaders, marketing executives and other professionals in North America.

With THMED since its start in 2009, Sepi McDonnell was a central part in the growth of the company.  Leading the management and development of technology and resource solutions that best supported business processes, she focused on bringing new technology, knowledge, and innovation to the way clients and customers interact.

Sepi McDonnell mentions that, “It’s the relationships that excite me about staffing, because there aren’t many careers where you get to be a part of a life change for people.”

The 40 under 40 list features “an eclectic group of leaders motivated to grow the industry and their businesses while also mentoring their teams to help their workers, clients and companies flourish.” THMED has made SIA’s Fastest-Growing US Staffing Firms list in 2016, 2017, and 2018, an integral part of their growth being the technical initiatives Sepi McDonnell put into place.

Arthur Cooper, Chief Executive Officer of subsidiary company Fidelis Partners, recognizes Sepi’s impact on the company, “She is an innovative thinker who has changed the landscape of the healthcare staffing industry over the last decade. We are so proud of you, Sepi.”

About THMED: THMED is a leading healthcare staffing firm focused on permanent and locum tenens placement. Celebrating its 10th year of business and recognized among the best for company growth, THMED provides its clients with a complete staffing solution that relies on the latest technology, proven search strategies and expert consultation. Focused on helping its clients provide quality health care to their communities, THMED’s consultants serve hospitals, medical groups and other healthcare facilities across the United States.

What is the Nurse Practitioner Scope of Practice?

What is the Nurse Practitioner Scope of Practice?

Through state laws and regulations, some states limit how a Nurse Practitioner (NP) can interact and deliver care for patients. The limitations are what defines the scope of practice. We understand that keeping up with the changes can be challenging, so we created this page to give an overview of scope of practice information for Nurse Practitioners.

Our Locum Tenens division, Medestar, created a handy state-by-state guide to review the laws. This is especially useful for nurse practitioners who are looking to relocate for jobs and need to know the laws in their new state.

California Scope of Practice

The sunshine state is not so warm to the idea of Nurse Practitioners having full scope of practice. California has some of the most restrictive laws.

  • Restricted practice authority; must have policies in place that follow standards of the state Medical Board 
  • May prescribe drugs and devices provided it is authorized through the protocols in the collaborative agreement; Schedule II-III require physician involvement and care plan
  • NPs are recognized in state policy as primary care providers
  • Regulatory Structure: Restricted Practice
  • Regulatory Agency: Board of Registered Nursing
  • Licensure Requirements: RN license and a graduate degree.
  • Nurse Practice Act

Texas Scope of Practice

If your job search sends to you to the Lonestar state, your partnership with the physicians in your practice will be important. Texas like California has restricted practice authority.

  • Restricted practice authority; written protocol required with a physician
  • NP may prescribe as outlined in the written protocol
  • NPs are recognized in state policy as primary care providers
  • Regulatory Agency: Board of Nursing
  • Licensure Requirements: RN license, graduate degree, and national certification.
  • Nurse Practice Act

Want to learn about more states?

Visit Medestar’s Full NP Scope of Practice guide here.

PRESS RELEASE: THMED Acquires CV Staff Solutions

PRESS RELEASE: THMED Acquires CV Staff Solutions

THMED, a nationwide leader in permanent and temporary healthcare recruitment, completed a strategic acquisition of Colorado-based CV Staff Solutions, a niche healthcare staffing solutions company. No financial terms were disclosed.

PRESS RELEASE Dallas, April 15, 2019 – THMED, a New Capital Partners (NCP) portfolio company, today announces that it is has acquired CV Staff Solutions, a specialty inpatient locums and perfusion staffing company. The acquisition accelerates THMED’s vision of providing more access to qualified medical professionals for current and new clients and expands CV Staff Solutions services on a national scale.

Founded in 2014, CV Staff Solutions specializes in optimizing the inpatient cardiovascular service line efficiency through long term coverage arrangements. CV Staff Solution’s roster of highly qualified cardiovascular surgeons, cardiologists, perfusionists, and other cardiovascular specialists offer continuity of care and help stabilize a financially critical service line to hospitals. CV Staff Solutions has been successful in recruiting and retaining providers, as well as clients, because of their personalized approach, understanding of the clinical needs, and deep network in the space.

Dr. John R. Mehall, CEO and founder of CV Staff Solutions, said, “We are thrilled to partner with and join THMED. We will be able to leverage THMED’s infrastructure, experience and expertise to bring our services to more hospitals around the country. THMED’s extensive team of recruiters will enable us to serve clients across a broader spectrum of subspecialties.”

John Martin, CEO and founder of THMED, added, “The CV Staff Solutions team has consistently delivered medical staff augmentation solutions that resonate with locum providers as well as client hospitals. We are elated to partner with them and look forward to expanding their service delivery model. Our partnership increases value for clients in a high-demand, ever- changing market.”

About CV Staff Solutions: CV Staff Solutions is a niche healthcare staffing provider based in Colorado Springs, Colorado. The company focuses on providing cardiovascular surgeons, cardiologists and non-physician providers, including perfusionists, to inpatient care facilities. CV Staff Solutions helps clients address ever-changing healthcare staffing challenges while at the same time offering medical professionals the opportunity to supplement their existing salary and gain flexibility over their schedules. For more information, please visit

About THMED: THMED is a leading healthcare staffing firm focused on locum tenens and permanent placement. Celebrating its 10th year of business and recognized amongst the best for company growth, THMED provides its clients with a complete staffing solution that relies on
the latest technology, proven search strategies, and expert consultation. Focused on helping its clients provide quality health care to their communities THMED’s consultants serve hospitals, medical groups and other healthcare facilities across the United States. For more information, please visit us at

About New Capital Partners: New Capital Partners (NCP) is a private equity firm headquartered in Birmingham, Ala. NCP makes investments in niche, tech-enabled services companies in the healthcare, financial and business services industries. Because of the firm’s extensive operational experience, the firm seeks to gain significant value in portfolio companies by focusing on one core goal: building great companies. For more information, please visit

7 Tips for Staying Healthy While Travel Nursing

7 Tips for Staying Healthy While Travel Nursing

We all know the temptation to indulge in delicious foods while in a new place. When on a short assignment, it might be easy to slip into a pattern of eating more than you would at home, ordering that high-calorie Starbucks, or trying all of the local cuisines. But just because you’re away from home, you do not have to be away from your normal health and wellness routine. Here are 7 tips for staying healthy while travel nursing.

      1. Start your day with water

Before doing anything else for the day, drink a full, 8 oz. of water. This will hydrate your body and satisfy your appetite so that you don’t overeat at breakfast. But also…

       2. Do NOT skip breakfast

There’s nothing worse than going into work with hunger pains. You’re sluggish, cranky, and will likely binge on something unhealthy later to calm the cravings. You can avoid facing this problem by simply eating a balanced breakfast before leaving for the day. It’s important to eat a meal with healthy fat, protein, and carbohydrates in order to keep you fuller longer. Things like avocado toast with an egg on top or oatmeal with fruit can curb your appetite and keep you satisfied till lunch. Check out this website for healthy breakfast ideas.

       3. Do a hunger check

Most of the time, when you’re craving pizza or thinking about downing a bag of chips, you aren’t hungry… you’re just bored. Try to distract yourself, drink a glass of water, and reevaluate in twenty minutes. If you’re still hungry, likely the craving will have gone away, and you can make a healthy decision on a snack to eat to tide you over until your next meal.

       4. Treat yourself…. But not too much

You’re in an exciting new place! It’s important that you embrace this experience. So, while working on a thirteen-week assignment in Maui or even just a couple weeks in rural Minnesota, allow yourself planned treats from a couple of new places. This will help satisfy you while also maintaining a balanced diet.

       5. Remember, a few weeks makes a difference

Whether your assignment is just for a few weeks or for 13-weeks, what you do during that time will make a difference to your health. You might slip into vacation mindset and overindulge, planning to get back to your routine when you return home. But your body can undergo a lot of change over the course of your travel assignment, and it’s important to stick to your eating routine from home as much as possible.

       6. Don’t count on finding a gym

If the gym is your usual spot for getting in your workout, try to discover a new fitness hobby. Maybe you’re on assignment in California and can try surfing or swimming. Or you’re in beautiful Gainesville, Florida and can hike every day to get in that cardio. Whatever the case, find something fun to do while away so that you can keep your body healthy while trying something new as well.

       7. Release stress

Stress causes more damage to our bodies than we realize. According to the American Psychological Association, health is the third most common source of stress. Trying to count calories, get in daily workouts, lose those couple of pounds… It gets overwhelming. Your mental health can really take a toll. An easy way to check for tension in your body is to do a quick check on your face, your hands, and your shoulders. Are you tensing any of them? Let it go, and take a deep breath. Yes, clean eating is important, as is fitness. But stress can have physical consequences, causing weight gain, appetite fluctuation, overeating, etc. So, let go of the stress, and make health an enjoyable journey rather than a box to check.

As a nurse, what you do is important. You save lives and help promote health wherever you are traveling. Remember to take care of yourself, too.

What are the Different Types of Dental Practices?

What are the Different Types of Dental Practices?

There is a significant expansion of dental practice models in the country as the demand for dentists grows. The average person would assume that all dental practices are privately-owned by the dentist who works there but that is not always true. Here is an explanation of the different types of dental practices.

Dentist Owned and Operated Group Practice

This can be an individual dentist or a group of dentists who wholly own their practice and run all the administrative and business aspects of the practice. Typically, these are considered practices who are not affiliated with any DSO. Dentist-owned practices can also have multiple locations.

Dental Service Organizations (DSOs)

Some people get into healthcare wanting to practice independently but may want assistance with the actual management of their practice. This is where a service or support organization comes in. According to the Association of Dental Service Organizations, these groups ” contract with dental practices to provide critical business management and support including non-clinical operations.” You might also hear these relationships referred to as “corporate dentistry.”

A DSO may provide services including employee relations, practice technology, and financial management. By law, they can not manage the clinical decisions in the practice, those must be made by a licensed professional dentist. This article does a great job explaining the impact of DSOs on the dentistry industry.

Non-Profit or Community Health Practices

According to the California Dental Association, working at a non-profit or community health practice usually means “charitable, educational or quasi-governmental organization that often focuses on providing treatment for disadvantaged populations or training health care professionals.” Often times, there are benefits like loan forgiveness when accepting positions with these types of practices.

If you need help to find a dentist practice for you, please reach out to THMED and we will connect you to consultant to discuss new opportunity options. Email us at

5 Tips for Staying Healthy on the Night Shift

5 Tips for Staying Healthy on the Night Shift

Research shows that working swing, rotating or permanent night shifts can cause a long list of problems for both body and mind. However, those kinds of hours are a painful reality for many, especially those working in hospitals and other health-care settings. Shift work can disrupt circadian rhythms, affect the body’s production of melatonin and predispose workers to illnesses such as cancer, heart disease and depression, so it’s more important than ever to commit to the three mainstays of good health: eating well, resting well and getting exercise.

1. Rethink Your Meals

Shift work typically disrupts eating patterns. Overeating or eating unhealthy foods from cafeterias and vending machines can lead to unintended weight gain. Plan ahead for a couple of mini meals to eat while you’re on shift rather than consuming big meals before or after and snacking while you’re on the job. Pack a lunchbox with quick, healthy foods you can grab anytime.

2, Stay Hydrated, Not Caffeinated

To stay awake and alert on night shifts, all too many people turn to caffeine. But caffeinated drinks can cause dehydration, raise blood pressure and interfere with sleep patterns once you leave work. A few caffeinated beverages won’t hurt, but balance them with non-caffeinated drinks such as mineral waters, herbal teas and just plain water. Avoid caffeine altogether toward the end of your shift so you can fall asleep when you get home.

3. Avoid the “Day Trap”

When you’re working off-hour shifts, your schedule is just the opposite of the way most of your family and friends live. It may be tempting to join them for regular daytime life once you’re off work, but outside of the occasional lunch with friends or special event, you should establish a quiet daytime routine that lets you get the rest you need.

4. Work in Exercise Whenever You Can

Your night shift job may include plenty of walking and other physical tasks, but if it doesn’t, use break time to move around. Walking corridors, taking stairs or even just stretching at your desk can relieve stress, boost your metabolism and keep you alert.

5. Keep a Consistent Schedule

On weekends and other off-shift days, it may be tempting to upend your schedule to accommodate all the activities you’ve missed out on while working. However, straying too much from your night shift schedule can make it harder to adjust when you return to work.

Shift work doesn’t have to ruin your health. Staying consistent and bringing healthy habits to work can make it possible not just to survive, but to thrive, on the night shift.

How to Overcome Candidate Bias in Hiring for Healthcare

How to Overcome Candidate Bias in Hiring for Healthcare

Human nature makes it so we gravitate to people and things who most remind us of ourselves. However, in hiring that practice can result in poor recruiting results. The data shows that more diverse teams produce better results and are better for the bottom line. Despite this information, it can be difficult to overcome our candidate bias when hiring for healthcare. Many professional or practitioner roles in healthcare are experiencing shortages, so the companies who can overcome their bias and hire more diverse teams will do better to beat these challenges. A big misconception when it comes to hiring is that diversity hiring hurts productivity. One of the perpetrators of this line of thinking is the idea of cultural fit. One recent survey found that more than 80 percent of employers worldwide named cultural fit as a top hiring priority. But cultural fit has changed from an effort to create more employee engagement into a way to marginalize those who the manager does not get along with.

“Subliminal tendencies often discard the right candidates and bring in the ones that hiring managers have some type of affinity for. Leaning toward preconceived notions of what the ideal recruit should be spells trouble.” Thomas Tracy

Here are three common myths about different cohorts among physicians and how you can overcome your candidate bias to hire better:

Myth: Female physicians can’t treat patients as well as their male counterparts.

While paid less, patients treated by female physicians are less likely to die. In 2016, Harvard researchers found that female doctors who care for elderly hospitalized patients get better results. Previous research has shown that female doctors are more likely to follow recommendations about prevention counseling and to order preventive tests like Pap smears and mammograms. The study’s authors estimate “that approximately 32,000 fewer patients would die if male physicians could achieve the same outcomes as female physicians every year.”

Myth: Older physicians are a liability.

The age of a physician does not always negatively impact patient care outcomes. In a study comparing cognitive functioning of surgeons age 60 and older with younger surgeons, 78% of practicing surgeons aged 60-64 performed within the range of younger surgeons on computerized cognitive tasks measuring visual sustained attention, reaction time and visual learning and memory.

Myth: Millennial physicians will not work as hard as previous generations. 

The definition of hard work has really evolved, and nothing magnetizes this more than when you compare older generations and millennials’ ways of working. Millennial physicians are actually most different in their approach to collaborative care. A 2016 report, Millennial Mindset: The Collaborative Clinician, released by health agencies GSW, inVentiv Health PR Group, shows that millennial physicians understand pharma ads are out there to educate patients, but rely less than their older counterparts to use pharma marketing to inform their decisions, and they rely mostly on their peers, online resources for advice. To build a truly great patient care team in healthcare, it requires bringing together a diverse group of people who can each bring their own empathy and experiences to the care model.


The next time you are hiring for a healthcare professional or practitioner, think to the future of medicine and the next decade of challenges facing your patients’ ability for a healthy life. Then, you must realize that the best way to provide for that healthy life is to offer a care team that can treat a broader population of patients through their own collective experience and collaboration.

7 Modern Healthcare Trends Every Nurse Needs to Know

7 Modern Healthcare Trends Every Nurse Needs to Know

The healthcare industry is changing at a faster rate than ever before. As a hard-working nurse, you and your profession face an uncertain future. Advances in technology and a shortage of student nurses are just two of the issues that could change the profession forever. These modern healthcare trends prove that real change is already well underway.

1. Nursing is Adapting to Changing Demographics

Baby boomers are now retiring from nursing in vast numbers. Unfortunately, the supply of new nurses just isn’t keeping up with demand. The majority of nurses in America are now over 50, which means there could be several thousand urgent vacancies within 20 years or so. Unable to fill these vacancies with Americans, healthcare providers will turn to healthcare staffing agencies and immigrants to make up the numbers. Nursing will be more ethnically diverse than ever before, so the industry will need to adapt to different religions, cultures and languages.

2. Nurses Are Playing a Greater Role in Care Provision

As a result of the changes pushed through by the Affordable Care Act, hospitals are now paid based on the entire patient experience. This makes the input of nurses more important than ever. Nurses will need to collaborate more closely with doctors and other care providers to ensure entire care packages — and not just specific treatments — are the best they possibly can be. Nurses are also playing a much greater role in financial planning and purchasing decisions.

3. Technology is Becoming Increasingly Important

Technology is changing every area of the nursing profession. Some student nurses, for instance, are already using sophisticated simulators to practice care provision before being granted access to real patients. Electronic health records are also already in use, but they are now being made available to nurses on the move via the latest mobile technology.

4. Nursing is Moving Away from Hospitals

There is now a concerted effort within the healthcare industry to keep patients in their own homes for as long as possible. As a result, there is a growing need for nurses to work in communities — providing care and monitoring the health of patients away from hospitals. An increasing number of jobs are becoming available in other care institutions such as hospices, palliative care homes and chronic care clinics. This new approach to nursing is driving cost-savings and reducing the number of emergency room visits.

5. More “Non Nurse” Practitioners Than Ever Before

So called “no nurse” practitioners are individuals who became nurses without working their way through the ranks as a trainee. Some major in nursing as an undergraduate before attending a nurse practitioner school; others already have an unrelated bachelor’s degree and apply for work as a nurse via an accelerated nurse practitioner program. As more and more baby boomers retire, this pathway into the profession is becoming increasingly important.

6. Nurses Are Becoming More Educated

As the nursing professional continues to change, the need for a wider, more detailed knowledge base amongst nurses becomes greater. An RN-to-BSN degree, for example, allows a nurse to remain in post while he or she studies for a degree or baccalaureate. There is a direct correlation between the continuing education of existing nurses and hospital mortality rates, so expect to see more educational opportunities in the future.

7. The Provider Shortage is Driving Demand for Nurses

Employing more of non-physician clinicians provides a unique opportunity to tackle the physician shortage. This includes nurse practitioners (NPs), advanced practice registered nurses (APRNs), and physician assistants (PAs). More of these clinicians would lead to a team-based type of medical care. The American Journal of Medicine states that they could provide evidence-based screening, counseling, and preventative care and logistic support which would leave physicians to manage diagnostic challenges and complex medical issues. This opportunity proves to be more cost-efficient and even shortens long wait times that consumers are facing when trying to see a doctor.

These are exciting and challenging times for nursing. But with the right funding and the commitment of nurses, the future of the profession looks very bright.

How to Write the Perfect Resume: Top Resume Tips for Nurse Practitioners

How to Write the Perfect Resume: Top Resume Tips for Nurse Practitioners

Any hiring manager will admit that they scan a resume in thirty seconds and know if they will want to go forward with a candidate or not. Learning how to write the perfect resume for nurse practitioners can get you a leg up in the competition. Standing out on a sheet of black and white paper may be tough, but once you know what to highlight about yourself and your career can make a difference. As a staffing firm specializing in healthcare, many resumes come through our office. We notice what resumes have proper alignment, grammar, font and information about the candidate. We have provided you with tips on what to add to your resume and how to make yours stand out among the pile with how to write the perfect resume: top five resume tips for nurses practitioners.

Choose a good font and alignment

This may be a no brainer but many job seekers send in resumes with script or playful font styles. Keep the Comic Sans elsewhere and find a font that is easy to read and professional. We suggest Helvetica, Proxima Nova, Garamond, and if you want to play it safe, Times New Roman. Make sure you don’t have added lines, boxes or anything that may make the resume hard to read. If you are not sure where to begin with that blank sheet of paper, search nursing resume templates online and mimic their formatting.

Create a qualifications and goals summary

Start your resume with a brief overview of your qualifications and goals. Showing a clear thought will give the employer a better understanding of what you are looking for and what areas you will thrive in.

Highlight your accomplishments and licenses

Everyone who is applying for a specific job will usually have the same degree and even similar experience. We want to see what makes you different. This can be hard to do fresh out of training, so think outside the box. If you have received any exciting accomplishments, awards or acknowledgments add them on your resume! Other items to add that stand out are something you have created, an idea you implemented or anything you did in past experiences that made your training better. People want to see what you can bring to their business. Explain why you would be an asset to the hospital or practice. It is also a plus to add computer skills to your resume. Due to the industry transitioning technological it is an added skill if a candidate has medical-related software and computer knowledge.


Once you complete your resume put it away for a while and come back to it with a fresh perspective. A small mistake could decrease your chances of getting hired, so read through it thoroughly, use the proofreading tool and make sure there are no mistakes. Send your resume to someone you trust with good grammar skills that can catch any mistakes you might have missed.

If you’re looking for more advice, want to search around for jobs and learn more about the advanced practitioner industry, visit