By ABIGAIL ZUGER, M.D.
When a book is heavy with glossy photographs, you seldom expect too much from its words. In “The American Nurse,” though, it’s the narrative that hits you in the solar plexus.
Take the comments of Jason Short, a hospice nurse in rural Kentucky. Mr. Short started out as an auto mechanic, then became a commercial trucker. “When the economy went under,” he says, “I thought it would be a good idea to get into health care.” But a purely pragmatic decision became a mission: Mr. Short found his calling among the desperately ill of Appalachia and will not be changing careers again.
“Once you get a taste for helping people, it’s kind of addictive,” he says, dodging the inspirational verbiage that often smothers the healing professions in favor of a single incontrovertible point.
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Some of the 75 nurses who tell their stories in this coffee-table book headed into the work with adolescent passion; others backed in reluctantly just to pay the bills. But all of them speak of their difficult, exhilarating job with the same surprised gratitude: “It’s a privilege and honor to do what I do,” says one. “I walk on sacred ground every day.”
They hail from a few dozen health care settings around the country, ranging from large academic institutions like Johns Hopkins in Baltimore to tiny facilities like the Villa Loretto Nursing Home in Mount Calvary, Wis., home to 50 patients and a collection of goats, sheep and other animals on a therapeutic farm. Some nurses are administrators, some staff wards or emergency rooms, some visit patients at home. Many are deeply religious, a few are members of the military, and a handful of immigrants were doctors in their home countries.
All describe unique professional paths in short first-person essays culled from video interviews conducted by the photographer Carolyn Jones. Their faces beam out from the book in Ms. Jones’s black-and-white headshots, a few posing with a favorite patient or with their work tools — a medevac helicopter, a stack of prosthetic limbs or a couple of goats.
But even the best photographs are too static to capture people who never stop moving once they get to work. For a real idea of what goes on in their lives, you have to listen to them talk.
Here is Mary Helen Barletti, an intensive care nurse in the Bronx: “My whole life I’ve marched to a the beat of a different drummer. I used to have purple hair, which I’d blow-dry straight up. I wore tight jeans, high heels and — God forgive me — fur (now I am an animal rights activist). My patients loved it. They said I was like sunshine coming into their room.”
Says Judy Ramsay, a pediatric nurse in Chicago: “For twelve years I took care of children who would never get better. People ask how I could do it, but it was the most fulfilling job of my life. We couldn’t cure these kids, but we could give them a better hour or even a better minute of life. All we wanted to do was make their day a little brighter.”
Says Brad Henderson, a nursing student in Wyoming: “I decided to be a nurse because taking care of patients interested me. Once I started, nursing just grabbed me and made me grow up.”
Says Amanda Owen, a wound care nurse at Johns Hopkins: “My nickname here is ‘Pus Princess.’ I don’t talk about my work at cocktail parties.”
John Barbe, a hospice nurse in Florida, sums it up: “When I am out in the community and get asked what I do for a living, I say that I work at Tidewell Hospice, and there’s complete silence. You can hear the crickets chirping. It doesn’t matter because I love what I do; I can’t stay away from this place.”
The volume is not entirely about selfless service: It was underwritten by Fresenius-Kabi, a German health care corporation and leading supplier of intravenous drugs in the United States. Presumably, crass public relations motives lurk somewhere in the background. But that’s no real reason to be meanspirited about the result, a compelling advertisement for an honorable profession.
Young people with kind hearts and uncertain futures might just sit themselves down with the book, or wander through the Web site featuring its video interviews, www.americannurseproject.com, and see what happens.
By: Tanya M. Odom, Ed.M.
Diversity and inclusion is an evolving field. As a learner and practitioner, I work to embrace the expanding definitions while respecting the importance of the historic diversity topics of race and gender.
How we approach conversations about difference can determine how we embrace new definitions of identity, and the “agility” needed to learn, grow, and support all people in organizations.
Multiracial people are one of the fastest growing groups in the United States. As Andrea Williams mentioned in her article about multiracial students in the April/May 2012 issue of INSIGHT Into Diversity, “the 2010 Census marked the second time in the survey’s history that responders were allowed to check more than one box regarding their race; the first was in 2000. And as a result, demographers now have access to data that allows for comprehensive comparison and charting of the mixed race population. The results are remarkable: from 2000 to 2010, the number of multiracial American children – who will soon be attending colleges and universities across the country – rose by almost 50%, to 4.2 million.
The changing demographics have inspired people to create language like “the multicultural generation” and “ethnically ambiguous,” among others. Williams’ article presents some important reflection about creating schools and universities that support multiracial students.
Not-for-profit organizations and corporations will also need to update their language, understanding, and awareness to include multiracial employees, and employees with multiracial families.
A June 2012 Fast Company article talked about the importance of “cultural agility.” They defined “cultural agility” as “the capacity to recognize, understand, and respond appropriately to various cultures, and to work within those cultures to achieve business results.” The language of “agility” is also highlighted in the Center for Creative Leadership’s recent newsletter. They talk about flexibility and agility as a key to leadership. Agility is an important part of the learning and awareness in diversity and inclusion. Multiracial identity is not new, nor is the presence of multiracial families in our organizations.
There is a global history of multiracial people. There is a substantial scholarship focusing on the role of multiracial people in our history, media, etc. What we have not seen at the same level is the inclusion of multiracial people in diversity and inclusion dialogues and programs. As a multiracial global diversity and inclusion practitioner and coach, I have learned that, as with all diversity topics, there are varying levels of awareness about what multiracial identity means to employees and to diversity and inclusion initiatives.
One of the first times that I was part of a professional “group” of multiracial individuals was while attending a Working Mother Media Women’s conference. I remember feeling the uniqueness of the experience.
Participants in workshops or present at some of my speeches would approach me and talk about their “invisible diversity,” which for some meant their multiracial identity. For others, it meant their partner, spouse, or child of a different race. Often they swapped tales of not having a place to share their diversity stories.
The presence of multiracial individuals and families can challenge our notions and comfort around talking about race and history, race and families, and race and racism.
Multiracial individuals and families are part of the changing workforce. In the spirit of learning agility, I would suggest that organizations learn to incorporate language and programs that include multiracial individuals and families.
We can continue to be “agile” in our learning about multiracial identity by:
- Assessing data collection that does not allow for identifying as multiracial individuals and families;
- Including multiracial groups as part of the growing affinity/ERG/Networking groups within organizations;
- Allowing multiracial people to self-identify – and not identify employees based upon what we observe;
- Updating our language and communication to include multiracial identity and;
- Learning more about national groups (SWIRL, MAVIN, etc.) that address multiracial identity and families.
Our learning and growth continues as long as we remain “agile.” The inclusion of more stories, experiences, and identities makes the journey even richer.
Tanya Odom, Ed.M, is a part-time Senior Consultant with The FutureWork Institute and a member of the INSIGHT Into Diversity Editorial Board.
Published in September/October 2012 issue.
With the battle over immigration raging on and racial and ethnic minorities surpassing whites for the first time, there's no question the U.S. is getting more diverse.
A newly released study from Brown University has pinpointed just where the most diversity is taking place, scoring metro areas by how evenly each city's population is spread across the five racial groups: Non-Hispanic whites, Hispanics of any race, African-Americans, Asians and an “other” category comprised of Native Americans, Alaska Natives and people of two or more races.
According to the US2010 Project, immigrants from Latin America, Asia, and elsewhere have expanded the population of minority residents beyond African Americans, a trend that experts say will eventually lead to as many "minority" as "non-minority" residents, if it continues.
As of 2010, western, southern and coastal metropolitan areas continue to be the most diverse, with California's Vallejo-Fairfield claiming the top spot.
In addition to location and how evenly a city's population was distributed across racial groups -- a perfectly diverse place would have a population with exactly 20 percent of each category and a total score of 100 -- the community characteristics researchers correlated with diversity were: large total and foreign-born populations; high rental occupancy, as a community needs a supply of rental housing to accommodate newcomers; a range of occupational options, including entry-level jobs; and a low minority-to-white income ratio.
Check out this
article to see the most and least diverse cities in the U.S.
by Katrina Gravel
This past month, the George Washington University School of Nursing (GW) received a three-year, $1 million grant from the U.S. Health Resources and Services Administration to fund a program that aims to increase the diversity of nursing professionals, according to a press release from GW. The school’s Success in Nursing Education project focuses not only on drawing in African-American, Asian, Hispanic, and Native American students, but also male students and economically disadvantaged students from Washington, D.C., and rural Virginia. A report released by the U.S. Department of Health and Human Services (HHS) in September 2010 showed that men made up less than 10% of employed RNs licensed between 2000 and 2008, while non-white or Hispanic nurses represented only 16.8% of all registered nurses in 2008. While those percentages may have grown in years since the HHS survey, it is unlikely that the gap has become significantly smaller.
The lack of ethnic minorities, males, and economically disadvantaged nursing students does not reflect the immense diversity of the patients these students will soon be treating. As an article in GW’s student newspaper The GW Hatchet cites the school of nursing’s Dean Jean Johnson as saying, “the nursing workforce should reflect what the population at large looks like.”
GW will use the grant to launch a recruitment campaign to reach disadvantage students, as well as students who are changing careers. The program will offer both undergraduate and graduate degrees in nursing, and will utilize retention tools such as mentoring programs. The grant will also create scholarships and financial aid for some students, according to the GW press release.
Has your organization made efforts to diversify its staff? What are your thoughts on the GW program? Leave a comment and let us know!
from USA Today
COCOA BEACH, Fla. -- Yvonne Yacoub has been a nurse for half a century.
In 50 years, she has seen her profession redefine itself to meet the challenges of change, yet continue to struggle with shortages of new practitioners.
Yacoub, 72, who has worked at Cape Canaveral Hospital here for 36 years, is decades older than the 46-year-old average age of employed registered nurses. Some veteran nurses continue to work, but many more have hung up the scrubs for good or are counting the days until retirement.
"In several years, we will see many nurses semi-retire or retire completely," said Bonnie Rudolph, vice president/chief nursing officer for Holmes Regional Medical Center in Melbourne, Fla., and Health First's chief nursing officer. "Nursing is a very physical job, and many nurses cannot continue to stand, lift patients and continue to work the required shifts."
As baby boomers age, the need for nurses will increase. Even though the number of licensed registered nurses in the United States has grown from 1.7 million in 1980 to 3.1 million today, the total is not enough to meet the expected demand. Registered nurses remain at the top of the list when it comes to employment growth, so hospital systems are being proactive in trying to retain older employees.
Recruiting more male nurses, now only 7 percent of the work force, could help ease the shortage.
Most male nurses, such as baby boomer Jim Carberry, a nurse supervisor in the intensive care unit at Holmes, enter the field as a second career. Carberry was a respiratory therapist for 20 years before becoming a nurse.
"I wouldn't say it's harder to be a nurse today. It's just different," Carberry said.
"With so much specialty nursing, we all have had to learn so many new ways of doing things," he said. "It's not just one nurse doing all of a patient's care in a day. It can be several with special skills."
While nursing schools are graduating highly skilled individuals, the experience of older workers is impossible to teach in a classroom.
Registered nurse Rebecca Madore, 23 on her third day on the job at Wuesthoff Medical Center -- Rockledge, Fla., acknowledges that the reality of nursing can be daunting.
"I learned a lot at school, but it's totally different when you're actually working the floor," she said.
Madore knew she wanted to be a nurse since she was a little girl, but for many of her colleagues, the profession is a career, not a calling.
"Each group's work ethic is different," said Suzanne Woods, vice president and chief nursing officer for Health First's community hospital division.
"The veterans and baby boomers feel almost total responsibility for the workplace and will come in on short notice and cover difficult shifts. This has always been their practice. The Gen X and Millenniums are more cognizant of home-and-life balance and strive to keep this in check."
Each generation also brings different skills, all needed to best serve patients.
"The younger nurses are very technologically advanced, but the older nurses are more connected with the patients," said Rosemary Walter, director of the medical/surgical unit at Wuesthoff in Rockledge.
Technological savvy, a given for new nursing grads and necessary for survival in the health care field today, can be difficult for older nurses to embrace.
"I feel we have an advantage over older generations in the new advancements of paperless systems, computer charting and the new diagnostics," said Michele McCray Miller, 26. "Throughout nursing school, we were constantly using simulated mannequins, computer programs and other electronic devices to master skills such as NG (nasogastric) tubes, catheters and IV skills. Older generations were not as lucky to have those resources in the classroom."
Allison Rogers has been a nurse for two years. Rogers' mother was a nurse. This member of Generation X had no doubts about her career choice.
"I know how important my job is, and I consider it an honor to care for patients the way I would want my family to be taken care of," Rogers said.
1. Communication Skills
Solid communication skills are a basic foundation for any career. But for nurses, it’s one of the most important aspects of the job. A great nurse has excellent communication skills, especially when it comes to speaking and listening. Based on team and patient feedback, they are able to problem-solve and effectively communicate with patients and families.
Nurses always need to be on top of their game and make sure that their patients are clearly understood by everyone else. A truly stellar nurse is able to advocate for her patients and anticipate their needs.
2. Emotional Stability
Nursing is a stressful job where traumatic situations are common. The ability to accept suffering and death without letting it get personal is crucial. Some days can seem like non-stop gloom and doom.
That’s not to say that there aren’t heartwarming moments in nursing. Helping a patient recover, reuniting families, or bonding with fellow nurses are special benefits of the job. A great nurse is able to manage the stress of sad situations, but also draws strength from the wonderful outcomes that can and do happen.
Great nurses have empathy for the pain and suffering of patients. They are able to feel compassion and provide comfort. But be prepared for the occasional bout of compassion fatigue; it happens to the greatest of nurses. Learn how to recognize the symptoms and deal with it efficiently.
Patients look to nurses as their advocates — the softer side of hospital bureaucracy. Being sympathetic to the patient’s hospital experience can go a long way in terms of improving patient care. Sometimes, an empathetic nurse is all patients have to look forward to.
Being flexible and rolling with the punches is a staple of any career, but it’s especially important for nurses. A great nurse is flexible with regards to working hours and responsibilities. Nurses, like doctors, are often required to work long periods of overtime, late or overnight shifts, and weekends.
Know that it comes with the territory. The upside is that a fluctuating schedule often means you’re skipping the 9 to 5, cubicle treadmill. Sounds perfect, right? Run errands, go to the movies, or spend time with the family — all while the sun still shines!
5. Attention to Detail
Every step in the medical field is one that can have far-reaching consequences. A great nurse pays excellent attention to detail and is careful not to skip steps or make errors.
From reading a patient’s chart correctly to remembering the nuances of a delicate case, there’ s nothing that should be left to chance in nursing. When a simple mistake can spell tragedy for another’s life, attention to detail can literally be the difference between life and death.
6. Interpersonal Skills
Nurses are the link between doctors and patients. A great nurse has excellent interpersonal skills and works well in a variety of situations with different people. They work well with other nurses, doctors, and other members of the staff.
Nurses are the glue that holds the hospital together. Patients see nurses as a friendly face and doctors depend on nurses to keep them on their toes. A great nurse balances the needs of patient and doctor as seamlessly as possible.
7. Physical Endurance
Frequent physical tasks, standing for long periods of time, lifting heavy objects (or people), and performing a number of taxing maneuvers on a daily basis are staples of nursing life. It’s definitely not a desk job.
Always on the go, a great nurse maintains her energy throughout her shift, whether she’s in a surgery or checking in on a patient. Staying strong, eating right, and having a healthy lifestyle outside of nursing is important too!
8. Problem Solving Skills
A great nurse can think quickly and address problems as — or before — they arise.
With sick patients, trauma cases, and emergencies, nurses always need to be on hand to solve a tricky situation. Whether it’s handling the family, soothing a patient, dealing with a doctor, or managing the staff, having good problem solving skills is a top quality of a great nurse.
9. Quick Response
Nurses need to be ready to respond quickly to emergencies and other situations that arise. Quite often, health care work is simply the response to sudden incidences, and nurses must always be prepared for the unexpected.
Staying on their feet, keeping their head cool in a crisis, and a calm attitude are great qualities in a nurse.
Respect goes a long way. Great nurses respect people and rules. They remain impartial at all times and are mindful of confidentiality requirements and different cultures and traditions. Above all, they respect the wishes of the patient him- or herself.
Great nurses respect the hospital staff and each other, understanding that the patient comes first. And nurses who respect others are highly respected in return.
Many researchers have studied patient--provider communication and documented the tensions and misunderstandings often seen in this important process. But these concerns are far greater when the patients are minorities or don't understand English well, and when healthcare providers aren't equipped to explain the intricacies of care to people whose cultural beliefs may make American medicine a mystery.
Award-winning filmmakers Maren Grainger-Monsen, M.D., and Julia Haslett explore these issues in a series of films called Worlds Apart, which document the experiences of minority Americans and patients from other countries in the U.S. health care system. This unique project, made with partial support from The Commonwealth Fund, dramatizes communication between patients and their doctors, tensions between modern medicine and cultural beliefs, and the ongoing burdens of racial and ethnic discrimination.
In this film, Alicia Mercado, a 60-year-old Puerto Rican woman, struggles to keep up with her chronic diabetes, hypertension, and asthma after being evicted from her apartment and suffering depression.
For more information on these films, please visit The Commonwealth Fund website at www.cmwf.org
Time spent and social sites visited outpace other US internet user groups
US Hispanics are more active on social media than the average US internet user, and are logging in more frequently to a wider variety of social sites.
The February 2012 “American Pulse Survey” from BIGinsight of US adult internet usage found that, while greater percentages of black internet users spent larger blocks of time online than the other groups studied, Hispanic internet users spent more of their online time on social media sites.
On an average day, 26.8% of Hispanic internet users spent six hours or more on social media sites, while 20.4% of black internet users and only 8.5% of total internet users spent that much time on social sites.
Looking specifically at which sites social-savvy Hispanics were using, the survey found US Hispanics were willing to participate in some newer and smaller social sites, logging in more often to networks like Pinterest, foursquare and LinkedIn, for example, than the average US internet user.
In the case of LinkedIn, 15.5% of US Hispanic internet users logged in to that site at least once a day, compared to 10.9% of black internet users and 4.9% of white ones. And, while 85% of white and 82.7% of black internet users reported not having an account on Pinterest, that number dropped to 71.5% among Hispanic internet users.
As marketers work to reach these active Hispanic internet users, data about which social sites Hispanics prefer and their frequency of use can be key to understanding where and when to connect with these consumers.
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Student at the UCLA School of Nursing start their nursing career with a high tech boost. As part of their ceremony to receive their white coats, this year they were also give iPod Touch devices preloaded with Medication and Diagnosis guides as well as a Spanish language dictionary and translation assistance. UCLA is determined to offer new grad nurses that are ready for "High Touch" care but within a "High Tech" environment.
Nursing Reimagined. Nursing Redefined.
This is a subject matter we are always talking about. You hear the labor projections, but in a way it is a grim and sobering reminder that the healthcare labor force is in for some major gwoing pains. Are you experiencing this in your workplace? What do you think?
(from Reuters.com) - The graying of America and a booming Hispanic population is driving major changes in the structure of the U.S. workforce and the types of jobs that will be available over the next decade, a new government report shows.
Health care and social assistance jobs will be the fastest-growing sectors, accounting for one quarter of the 20.2 million new jobs the economy is expected to generate by 2020.
Retiring baby boomers will help open up an additional 33.8 million positions for total vacancies of 54 million, the Labor Department said on Wednesday in its biannual Employment Outlook report for job growth between 2010 and 2020.
During the recent recession, employment declined by 7.8 million jobs to a total of 129.8 million in 2010. The report does not estimate by what year those jobs will be replaced.
In addition, the workforce is getting older. Despite the retirement surge, a slowdown in population growth means that the post-World War II baby boomers will make up a quarter of all U.S. workers by 2020, up from 19.5 percent today.
Hispanics, meanwhile, are joining the workforce at a fast pace. They will represent 18.6 percent of overall employment by decade's end, up from 14.8 percent today. In contrast, Asians and African-Americans will see their share in the labor force rise by 1 percentage point or less to 5.7 percent and 12 percent, respectively.
"The labor force is projected to get older, become racially and ethnically more diverse and show a small increase in women as a share of the total," the department said.
Professional and business services will be the second-fastest growing industry, adding 3.8 million positions.
It will be followed by construction, although the 1.8 million new construction jobs will not bring employment in the industry back to levels seen during the housing boom.
The report also spelled out the skills workers of the future will need.
Two thirds of the total job openings will require only a high-school education or less, it said. For example, there will be roughly 70 percent growth in personal care aides and health-care support employment, the fastest-growing occupations. No high school diploma would be required, and workers would get short, on-the-job training.
At the same time, demand for people with master's degrees will increase by 21.7 percent, the Labor Department said.
The manufacturing sector and the federal government will both lose jobs over the next decade.