That’s right—there are men in nursing, too! It’s time to rid ourselves of outdated stereotypes. We don’t live in a society where boys only like blue and girls only like pink. Where boys can only play with legos and girls can only play with dolls. There’s too much variety in this world to limit ourselves to what we think is expected of us. There are women in engineering and mathematics, and there are men in nursing and healthcare.
Population Growing for Men in Nursing
Nursing is a fantastic career. In fact, the number of men in nursing is growing, with the percentage of male nurses increasing almost every year. In addition, there are more men in nursing schools, making up 13% of nursing school students. Find out more facts about male nurses by reading the men in nursing infographic below.
By Carly Dell
In the Future of Nursing report published by the Institute of Medicine, it is recommended that health care facilities throughout the United States increase the proportion of nurses with a BSN to 80 percent and double the number of nurses with a DNP by the year 2020. Research shows that nurses who are prepared at baccalaureate and graduate degree levels are linked to lower readmission rates, shorter lengths of patient stay, and lower mortality rates in health care facilities.
What does the job market look like for RNs who are looking to advance their careers?
We tackle this question in our latest infographic, “Career Paths for RNs,” where we look in-depth at the three higher education paths RNs can choose from to advance their careers — Bachelor of Science in Nursing, Master of Science in Nursing, and Doctor of Nursing Practice.
For each career path, we outline the various in-demand specialties, salaries, and job outlook.
In the wake of media focus on the trials and bravery of nurses in the context of the Ebola crisis, leaders in the fields of nursing and clinical ethics have released an unprecedented report on the ethical issues facing the profession, as the American Nursing Association prepares to release a revised Code of Ethics in 2015.
The report captures the discussion at the first National Nursing Ethics Summit, held at Johns Hopkins University in August. Fifty leaders in nursing and ethics gathered to discuss a broad range of timely issues and develop guidance. The report, A Blueprint for 21st Century Nursing Ethics: Report of the National Nursing Summit, is available in full online at www.bioethicsinstitute.org/nursing-ethics-summit-report. It covers issues including weighing personal risk with professional responsibilities and moral courage to expose deficiencies in care, among other topics.
An executive summary of the report is available at: http://www.bioethicsinstitute.org/wp-content/uploads/2014/09/Executive_summary.pdf
"This blueprint was in development before the Ebola epidemic really hit the media and certainly before the first U.S. infections, which have since reinforced the critical need for our nation's healthcare culture to more strongly support ethical principles that enable effective ethical nursing practice," says Cynda Hylton Rushton, PhD, RN, FAAN, the Bunting Professor of Clinical Ethics at the Johns Hopkins School of Nursing and Berman Institute of Bioethics, and lead organizer of the summit.
The report makes both overarching and specific recommendations in four key areas: Clinical Practice, Nursing Education, Nursing Research, and Nursing Policy. Among the specific recommendations are:
- Clinical Practice: Create tools and guidelines for achieving ethical work environments, evaluate their use in practice, and make the results easily accessible.
- Education: Develop recommendations for preparing faculty to teach ethics effectively
- Nursing Research: Develop metrics that enable ethics research projects to identify common outcomes, including improvements in the quality of care, clinical outcomes, costs, and impacts on staff and the work environment
- Policy: Develop measurement criteria and an evaluation component that could be used to assess workplace culture and moral distress
What does this blueprint mean for nurses on the front line?
"It's our hope this will serve as a blueprint for cultural change that will more fully support nurses in their daily practice and ultimately improve how healthcare is administered -- for patients, their families and nurses," says Rushton. "We want to start a movement within nursing and our healthcare system to address the ethical challenges embedded in all settings where nurses work."
On the report's website, nurses and the public can learn more about ethical challenges and proposed solutions, share personal stories, and endorse the vision of the report by signing a pledge.
"This is only a beginning," says Marion Broom, PhD, RN, FAAN, Dean and Vice Chancellor for Nursing Affairs at Duke University and Associate Vice President for Academic Affairs for Nursing at Duke University Health System. "The next phase is to have these national nursing organizations and partners move the conversation and recommendations forward to their respective constituencies and garner feedback and buy-in. Transformative change will come through innovative clinical practice, education, advocacy and policy."
At the time of publication, the vision statement of the report has been endorsed by the nation's largest nursing organizations, representing more than 700,000 nurses:
- American Academy of Nursing
- American Association of Critical-Care Nurses
- American Nurses Association
- American Association of Colleges of Nursing
- American Organization of Nurse Executives
- Association of Women's Health, Obstetric and Neonatal Nurses
- The Center for Practical Bioethics
- National League for Nursing
- National Student Nurses' Association
- Oncology Nursing Society
- Sigma Theta Tau International
By George Putic
Each year, about one million babies throughout the world die of complications due to premature birth. Many of them could have been saved if given access to an incubator. But this expensive device is sorely lacking in developing countries. A young British researcher says he has found a solution -- a low-cost inflatable incubator.
Doctors say many expectant mothers in developing countries give birth prematurely, especially in refugee camps, largely because of poor diet and unhealthy living conditions.
Premature birth is the biggest killer of children worldwide. Because these tiny babies are born before their lungs are fully developed, they are more susceptible to often deadly infections. But they could survive if placed in an incubator, where they would continue to develop in the closed chamber and warm, controlled environment.
However with a price tag of around $50,000, incubators are out of reach even for some hospitals.
Design engineering student James Roberts, 23, of Britain says his $400 inflatable incubator may help solve this problem.
“It's basically an insulated piece of air, so it's like the difference between double and single glazing, so it's easier to keep the inside at a stable heat environment, heat temperature," he said.
The inflated incubator is collapsible and when folded resembles an ordinary travel bag.
It is powered through a regular electrical line, but Roberts said he has found a solution in case there is a power outage, which often happens in refugee camps.
“I thought 'why not car batteries?' There's loads of cars out there, they're pretty readily available. So you can plug this into a car battery. It will run for 24 hours and then when the mains [regular electrical line] comes back on, the mains can then charge this battery, and then that can run the incubator," he said.
Roberts' won the $47,000 James Dyson Award earlier this year for his incubator design. He said the project is still in the development phase, but the prize money will help him start a company for the mass manufacturing of inflatable incubators.
By Melissa Wirkus
“HIT has been shown to help some patients, but it has also been shown to perhaps provide some complications in care, or less than adequate care, when messages are not received, when messages are interrupted or when messages are routed to the inappropriate person,” explained Milisa Manojlovich, PhD, RN, CCRN, associate professor at the University of Michigan School of Nursing (UMSN) and member of U-M’s Institute for Healthcare Policy and Innovation.
Manojlovich will serve as the primary investigator on a new $1.6 million grant from the federal Agency for Healthcare Research and Quality (AHRQ) that will focus on health IT’s effects on nurse–physician communication. Manojlovich and her co-investigators will look at how communication technologies make it easier or harder for doctors and nurses to communicate with each other. They hope their research will identify the optimal way to support effective communication while fostering improved and positive interdisciplinary team-based care.
Until the research is completed, Manojlovich offers some simple procedures clinicians can begin to adopt right now to help alleviate common problems with digital communication:
1. Use multiple forms of technology
Just like there is more than one way to treat a cold, there is more than one way to communicate electronically. Utilizing multiple forms of technology to communicate important information, or sometimes even reverting back to the “old-fashioned” ways of making a phone call or talking in person, can help ensure the receipt of a message in an environment that is often inundated.
“One of the things we are going to investigate is this idea of matching the message to the medium,” Manojlovich said. “So depending on the message that you want to send, you will identify what is the best medium to send that message.”
Using the current Ebola situation in Texas as an example, Manojlovich explained that using multiple forms of technology as a back-up to solely documenting the information in the EHR system could have mitigated the breakdown in communication that occurred. “Although the clinician did her job by entering the information into the EHR, she maybe should have texted or emailed the physician with the information or found someone to talk to in person about the situation. What we are trying to do with this study is see if there is another way that messages like this could have been transmitted better.”
2. Include the whole message
Reducing fragmented messages and increasing the aggregation of key data and information in communications may be one of the most critical pieces to improving communication between nurses and physicians. Manojlovich has been passionate about nurse–physician communication throughout her career and has conducted several previous studies on communication technologies.
“What we’ve noticed, for example, is that nurses will sometimes use the same form of communication over and over again. In one of the studies we actually watched a nurse page the same physician three times with the same question within an hour period.”
The physician did not answer any of the messages, and Manojlovich concluded it was because the pages were missing critical components of information related to the patient’s care plan. Increasing the frequency of communications can be beneficial, but only if the entire message and all important facets of information are relayed.
“If you do what you’ve always done, you’re going to get what you’ve always gotten. If you don’t alter or change the communication technology you are using, you are going to get the same results,” she added.
3. Incorporate a team-based approach
“At a really high level the problem is that a lot of these computer and electronic health record technologies are built with individuals in mind,” Manojlovich said. “When you talk about care process and team processes, that requires more interaction than the technologies are currently able to give us. The computer technologies are designed for individual use, but health care is based on the interaction of many different disciplines.”
Infusing this collaborative mindset into the “siloed” technology realm will undoubtedly help to improve the communication problems between providers and clinicians at all levels and all practice settings--which is especially important in today’s environment of co-morbidities and coordinating care.
Nurses play a critical role in improving communication as frontline care providers. “Nurses are the 24-hour surveillance system for hospitalized patients. It is our job to do that monitoring and surveillance and to let physicians know when something comes up.”
“I believe that for quality patient care, a patient needs input from all disciplines; from doctors, nurses, pharmacists, nutritionists--everyone,” Manojlovich said. “We are being trained separately and each discipline has a different knowledge base, and these differences make it difficult for us to understand each other. Developing mutual understanding is really important because when we have that mutual understanding I think outcomes are better and it can be argued that the quality of care is better when you have everyone providing input.”
By John DeGaspari
Using the Internet to access health information may be out of reach for many older Americans, according to a study by researchers at the University of Michigan. According to the study, less than one-third of Americans age 65 and older use the Web. Within that age group less than 10 percent of those with low health literacy, or who lack the ability to navigate the healthcare system, go online for health-related matters.
The results of the study have been published in the Journal of Internal Medicine. Data was analyzed from the 2009 and 2010 Health and Retirement Study, a nationally representative survey of older adults; about 1,400 of the participants were asked about how often they use the Internet for any purpose, and, in particular, how often they search for health and medical information.
Health literacy was found to be a significant predictor or what people do once they are online. Elderly Americans with low health literacy are less likely to use the Internet at all, according to the researcher; and if members of this group do surf the Web, it is not generally to search for medical or health information.
“In recent years, we have invested many resources in Web-based interventions to help improve people’s health, including electronic health records designed to help patients become more active participants in their care,” according to lead author of the study Helen Levy, Ph.D., research associate professor at the University of Michigan Institute for Social Research, in a prepared statement. “But many older Americans, especially those with low health literacy, may not be prepared for these tools.”
Senior author Kenneth Langa, M.D., a professor of Internal Medicine at the University of Michigan Medical School, cautions that as the Internet becomes more central to health literacy, older Americans face barriers that may sideline them. He recommends that “Programs need to consider interventions that target health literacy among older adults to help narrow the gap and reduce the risk of deepening disparities in health access and outcomes.”
A number of eye conditions can be treated by administering drugs directly into the eye. Yet, conventional needles have a bunch of drawbacks, including the patients’ fear of needles entering such fragile parts of the body and the difficulty of accurately administering medication into a targeted region of the eye. For glaucoma, for example, eye drops are prescribed which have a shorter active lifetime and are often skipped by the patients. An easy injection that works for months at a time would help control the disease considerably better.
Researchers at Georgia Tech and Emory University have been working on microneedles and formulations to safely and effectively deliver drugs into the eye. The microneedles are designed to only penetrate to the correct depth and the formulations need to be viscous enough to stay in place and release their therapeutic compounds in a controlled fashion. The researchers have already tested the microneedles on laboratory animals and showed that they can place drugs within the targeted sections of the eye.
More from Georgia Tech:
The microneedle therapy would inject drugs into space between two layers of the eye near the ciliary body, which produces the aqueous humor. The drug is retained near the injection side because it is formulated for increased viscosity. In studies with an animal model, the researchers were able to reduce intraocular pressure through the injections, showing that their drug got to the proper location in the eye.
Because the injection narrowly targets delivery of the drug, researchers were able to bring about a pressure reduction by using just one percent of the amount of drug required to produce a similar decline with eye drops.
To treat corneal neovascularization, the researchers took a different approach, coating solid microneedles with an antibody-based drug that prevents the growth of blood vessels. They inserted the coated needles near the point of an injury, keeping them in place for approximately one minute until the drug dissolved into the cornea.
In an animal model, placement of the drug halted the growth of unwanted blood vessels for about two weeks after a single application.
By Steven Reinberg
Residents of the southern United States may be at risk for a parasitic infection that can lead to severe heart disease and death, three new studies suggest.
Chagas disease, which is transmitted by "kissing bugs" that feed on the faces of humans at night, was once thought limited to Mexico, Central America and South America.
That's no longer the case, the new research shows.
"We are finding new evidence that locally acquired human transmission is occurring in Texas," said Melissa Nolan Garcia, a research associate at Baylor College of Medicine in Houston and the lead author of two of the three studies.
Garcia is concerned that the number of infected people in the United States is growing and far exceeds the U.S. Centers for Disease Control and Prevention's estimate of 300,000.
In one pilot study, her team looked at 17 blood donors in Texas who tested positive for the parasite that causes Chagas disease.
"We were surprised to find that 36 percent had evidence of being a locally acquired case," she said. "Additionally, 41 percent of this presumably healthy blood donor population had heart abnormalities consistent with Chagas cardiac disease."
The CDC, however, still believes most people with the disease in the United States were infected in Mexico, Central and South America, said Dr. Susan Montgomery, of the agency's parasitic diseases branch.
"There have been a few reports of people becoming infected with these bugs here in the United States," she said. "We don't know how often that is happening because there may be cases that are undiagnosed, since many doctors would not think to test their patients for this disease. However, we believe the risk of infection is very low."
Maybe so, but kissing bugs -- blood-sucking insects called triatomine bugs -- are found across the lower half of the United States, according to the CDC. The insects feed on animals and people at night.
The feces of infected bugs contains the parasite Trypanosoma cruzi, which can enter the body through breaks in the skin. Chagas disease can also be transmitted through blood.
It's a silent killer, Garcia said. People don't feel sick, so they don't seek care, but it causes heart disease in about 30 percent of those who get infected, she said.
In another study, Garcia's team collected 40 insects in 11 Texas counties. They found that 73 percent carried the parasite and half of those had bitten humans as well as other animals, such as dogs, rabbits and raccoons.
A third study found that most people infected with Chagas aren't treated.
For that project, Dr. Jennifer Manne-Goehler, a clinical fellow at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, collected data on nearly 2,000 people whose blood tested positive for Chagas.
Her team found that only 422 doses of medication for the infection were given by the CDC from 2007 to 2013. "This highlights an enormous treatment gap," Manne-Goehler said in a news release.
The findings of all three studies, published recently in the American Journal of Tropical Medicine and Hygiene, were to be presented Tuesday in New Orleans at the annual meeting of the American Society of Tropical Medicine and Hygiene.
Symptoms of Chagas can range from none to severe with fever, fatigue, body aches and serious cardiac and intestinal complications.
"Physicians should consider Chagas when patients have swelling and enlargement of the heart not caused by high blood pressure, diabetes or other causes, even if they do not have a history of travel," Garcia said.
However, the two treatments for this disease are "only available [in the United States] via an investigative drug protocol regulated by the CDC," Garcia said. They are not yet approved by the Food and Drug Administration.
Efforts are under way to develop other treatments for Chagas disease, Montgomery said.
"Several groups have made some exciting progress in drug development," she said, "but none have reached the point where they can be used to treat patients in regular clinical practice."
By DANIELA J. LAMAS, M.D.
One recent night I was asked to declare the death of a woman I had never met.
“Ms. L. passed,” the nurse said. “Could you pronounce her?”
The online medical record told me that she was 32 years old, one year younger than me. She had been in the hospital for months with leukemia that had progressed despite every possible chemotherapy regimen and a failed bone marrow transplant. And now someone needed to perform a death exam.
Declaring death is not technically hard but it is weird and sad and requires reams of paperwork. It is usually done by an intern, but my intern was busy so I said I would do it.
The first time I declared a patient dead was nearly six years earlier. I had been a doctor for a few months when I was summoned overnight with a page that told me that my patient’s heart had stopped. When I got to his room I was out of breath and his nurse smiled at me and told me that there really wasn’t urgency; he wasn’t going anywhere.
It was only when I walked into the room and saw my patient still and utterly silent, his tired family sitting around the bed, that I realized no one had ever told me precisely how to declare death. I wished I could come back later, but it didn’t seem right to leave him there, so I thumbed through my pocket-sized intern survival guide. The manual was alphabetized, and the discussion about declaring death came somewhere before a section on diabetes management.
The instructions were clear and began with the directive to express sympathy. I turned to the family to tell them how sorry I was. Listen for heart sounds and watch to see if the patient is breathing. I placed my stethoscope on the patient’s still chest and waited, watching for him to take a breath, and wondering what I would do if I heard something. But there was nothing. Feel for a pulse. I placed my hand on his neck and there was not even a quiver. And that was that. He was dead.
I looked at the clock and spoke the time out loud and said I was sorry again. And then I left the room.
Later I would face the inevitable pile of paperwork, which one hospital I worked at labeled the “Final Discharge Packet,” and another, in bold letters on a red binder, the “Death Binder.” That was followed by calls to admitting to report the death, minutes that felt like hours on hold with the medical examiner, death certificates returned to me because I had signed on the wrong dotted line. By the end of my intern year, one of the worst parts of having a patient die was those bureaucratic forms and phone calls.
Now, years later, I paused outside the room of Ms. L. before pulling back the curtain.
Until then, most of the patients I had been called to declare looked much as they did in life, only vacant. But this woman had been destroyed by illness. She was bald and yellow and bloated. She must have suffered. I took out my stethoscope as I had learned to do, rested it on her chest and listened to the silence that had taken the place of her heartbeat. I laid my fingers on her neck and there was no pulse. I looked up at the clock and said the time out loud.
As I turned to leave, I couldn’t help but note the wall of cards and photographs next to her hospital bed. She must have run a marathon to raise money for cancer research, for one photo captured her healthy and smiling, arms lifted victoriously as she crossed the finish line. Someone who loved her must have been there, waiting to take that photo.
“She must have been cool,” I said to her nurse. “I bet I would have liked her.”
“She was awesome.”
No one spoke. Two nurses gently pulled out the intravenous lines that had once run antibiotics and fluids into her veins and, one by one, removed the stickers on her chest that had recorded her heartbeat. One of the nurses paused and caught my eye.
“It’s so humid out,” she said. “How do you keep your hair from getting frizzy in this humidity?” I had showered just before my shift, I told her, and then I had come right to work so I hadn’t been outside much. When I caught a glimpse of myself in the mirror, my hair didn’t even look that good.
And then, because I didn’t know what else to say in front of this 32-year-old woman I would never meet, I offered only: “You know, I’ve always wanted to run a marathon.”
I left the room to begin the paperwork .