By Jackie Farwell, BDN Staff
After a routine mammogram in the fall of 2011, Laurie Thornberg learned she had breast cancer. Over the next nine months, as the Oakland woman endured surgery and rounds of chemotherapy, she watched as friends and loved ones attempted to explain her condition to their children.
Some struggled. One person described Thornberg’s cancer to her children “like I had the plague,” she said. Others were more comfortable, including a close friend and neighbor Thornberg ran into while out for a walk.
“[She] told her children in a kind and gentle way,” Thornberg, a registered nurse, wrote in an email.
Thornberg chronicled the encounter with her neighbor in her new children’s book, “Julie’s Dream,” which she hopes families will use as a tool to talk with their children about cancer and its treatment, as well provide hope to cancer victims and their loved ones.
“Children, even young ones, can be very aware of their surroundings and have questions when they notice family members being upset, someone who is sick a lot, or even as simple as a person suddenly has no hair,” Thornberg said.
In the book, Thornberg’s neighbor explains to her children, “See our friend? She wears that bonnet to cover her head because she got sick and had to take a special medicine that made her hair fall out.”
One of the children turns to Thornberg, asking, “Why don’t you take off that bonnet? I’m sure you’re beautiful under there.”
The book goes on to detail the main character’s dream about magically being healed. Thornberg’s friend and the book’s illustrator, Juliana Muzeroll, had that very dream about her, Thornberg said.
“I liked this approach a lot because it gives the reader freedom to interpret the outcome to fit their own personal situation,” she said. “Meaning, that whether the loved one survives or passes away, there is always healing at the end of a cancer journey.”
Thornberg remains in remission 18 months after her last round of chemotherapy. She now realizes that the disease freed her from stressing over the demands of a life as a full-time hospital nurse, mother, and daughter caring for her disabled mother, said Thornberg, who now works in home health care and said she’s able to focus on what’s really important in life.
“Getting cancer took me away from my excessive stress,” she said. “I often say ‘cancer healed my life.’”
“Julie’s Dream” is available in softcover or as an e-book on amazon.com, barnesandnoble.com, and authorhouse.com, by searching the title and author together.
Source: Bangor Daily News
By of the Journal Sentinel
Rita Higgins was caring for Natalie Engeriser, her 11-year-old patient, when Natalie's mother, Katie, walked into a hospital room on the seventh floor of Children's Hospital of Wisconsin.
There's some kind of disturbance in the hallway, Natalie's mother told Higgins Thursday.
"When she said 'disturbance,' I was thinking one of the kiddos was having a hard time," Higgins said Saturday.
"I stepped into the hallway and I immediately realized something was wrong," Higgins said. "There were two nurses at the nursing station and by the looks on their faces, I knew something was wrong. I heard one of the nurses say, 'Oh my God, they are shooting. Call an active-shooter code.'"
A man police later identified as Ashanti Hendricks was armed and police were trying to arrest him. But Higgins, 37, a registered nurse who started working at Children's last February, didn't really know what was unfolding.
But Higgins, a mother of two just starting her third career, knew what to do, as did the rest of the medical staff.
"I immediately turned back around and I said to Natalie, 'Honey, I'm going to need you to get out of bed and me and your mom are going to help you get into the bathroom.' I was going to need them to go into the bathroom and lock the door behind them," she said.
Higgins wanted to be sure she didn't scare Natalie. The girl is one of Higgins' favorite patients. In fact, when Higgins arrived for work on Thursday, she had been assigned a different floor. Higgins was disappointed because she liked working with Natalie and had made strides in her care.
"A co-worker saw how disappointed I was," Higgins said. "A fellow nurse traded with me, basically. She said, 'Hey, Rita, I know you want to take care of Natalie.'"
Later, as the hospital went into lockdown, she was unsure what was unfolding on the unit. That's when she helped get Natalie out of harm's way.
"We got her and the medical equipment in the bathroom with mom," Higgins said. "I told her to lock the door. I looked them straight in the face and said, 'Don't open the door until I tell you to open the door.' I looked at Natalie and said, 'It's going to be OK.' And I closed the door."
At Children's, doors to the hospital rooms don't lock. But next to the closed door was a small window. As Higgins stood guard, protecting a mother and her little girl, she managed to peer out, trying to make sense of the noise, the chaos.
"Looking back on it, in the period of time when we truly did not know what was going on, we didn't know if someone was just literally shooting, and we didn't know police were involved," Higgins said. "There was that unknown period of time when you think, 'Is this door going to open with a guy with a gun?'"
"For all three of us, that was pretty horrible. All I know is that someone was on the unit with a gun. Shots had been fired," Higgins said.
At some point Higgins saw another nurse in the hallway who was watching a TV monitor where she could see police handcuffing the man elsewhere on the floor.
"That's when I stepped out of the room, looking at the monitor," Higgins said. "Seconds later, I heard more scuffling and the man was suddenly running onto my side down the hall and past me. I went back in the room and closed the door."
Police finally subdued him.
"I knew it was loud and so much stuff was going on," she said. "God knows what (Natalie and her mom) were thinking.
"I told them I was going to stay in here. I told them a bad guy was captured. I told them they were going to hear a lot of stuff."
Natalie and her mother came out of the bathroom. Higgins told Natalie and her mother to turn on the television and turn the volume up loud. Drown out the noise outside.
Two days after the ordeal, Higgins was full of praise for Natalie, her mother and the other nurses on the floor who performed calmly, admirably and courageously.
"I was thinking I was glad I stayed on the floor that day and that I was able to be there for Natalie," Higgins said. "You build up trust and she trusted me."
Later that night, when Higgins was about done for the day, a music therapist came with a guitar to visit Natalie.
The therapist played the Katy Perry hit, "Firework."
"That's the way I ended my shift, rocking out with Natalie with 'Firework,'" Higgins said.
Source: Milwaukee Wisconsin Journal Sentinel
By Kristen Moulton
Enough is enough.
That was the sentiment of a 76-year-old patient who showed up in the emergency room at University Hospital this week, her fourth trip to the east Salt Lake City hospital this year.
"She couldn’t be more clear," said Holli Martinez, director of the hospital’s palliative-care team, who met with the patient. "She said, ‘I want to get out of here. I want to be home.’ "
So Martinez, who is receiving a $50,000 palliative-care award in Portland, Ore., on Thursday, helped the patient and her family figure out how she could go home and still receive care via hospice.
"If we had not had that conversation, she’d be back in the hospital — tests, meds, labs," said Martinez, one of five recipients of the Cambia Health Foundation’s Sojourns Award this year.
The foundation is a nonprofit connected to Cambia Health Solutions, which has BlueCross and BlueShield insurance plans as well as other business interests in Oregon, Washington, Idaho and Utah. All five recipients are from those states.
Martinez, the fourth straight winner from Utah, will use the money to improve palliative care at the hospital.
Palliative care, she said, is all about helping patients who face life-threatening or serious illnesses understand the benefits and burdens of aggressive treatment — and the option to opt out.
"Oftentimes, if we don’t stop and have the conversation," Martinez said, "we’re giving them an extraordinary amount of life-prolonging care that they might not want."
Palliative care, which sprouted from the hospice movement, is a growing medical specialty in Utah and across the nation.
Utah earned a C from the Center to Advance Palliative Care in its 2011 report card, while most states got B’s .
The data in that report were from 2009 and indicated that nine of Utah’s 15 hospitals with at least 50 beds had palliative-care teams.
By 2011, the number rose to 11, or 73 percent of the 15 hospitals with 50 or more beds, CAPC research director Rachel Augustin said Wednesday.
Nationally, less than a quarter of hospitals with 50 or more beds had palliative-care teams in 2000. By 2011, the proportion grew to 66 percent. By next year, it’s expected to be 84 percent.
Patricia Berry, associate director of the University of Utah Hartford Center for Geriatric Nursing, won the $50,000 award last year and nominated Martinez this year.
"Holli is the best there is," Berry said. "I would want her at my bedside."
The directory Martinez developed helps patients pick hospices based on their needs, Berry explained, "rather than handing them a phone book, which often happens."
Martinez is also finishing a project to guide intensive-care doctors and nurses about when to call in the palliative-care team.
"Holli has done a great deal to really advance palliative care in the state," said Berry, whose own $50,000 award is being used for the College of Nursing’s Caring Connections grief-support program and to help teach an end-of-life class to undergrads.
Angela Hult, executive director of the Cambia Health Foundation, said the foundation’s founders chose to focus on palliative care because it touches everyone.
"At the same time, this work really has the capacity to be transformative," she said. "It’s about asking the question: ‘What matters to you rather than what’s the matter with you?’ "
Martinez was a hospice nurse before she went to graduate school and became a nurse practitioner.
She is one of four Utah nurse practitioners who are board-certified in palliative care and hospice.
She joined University Hospital’s palliative-care team in 2007 and has been director since 2010.
One of the first projects she undertook when she arrived, Berry said, was to survey the region’s hospices to ascertain those with the best evidence-based practices.
While palliative care is more upstream than hospice — caring for patients who are not necessarily dying — patients who decide against aggressive treatment often are referred to hospice for end-of-life care.
Source: The Salt Time Tribune
By Debra Wood, RN
To achieve the national goal of improved health outcomes, many researchers and health advocates agree that patients must assume a greater role in managing their health
care. But how can facilities and health systems accomplish this kind of patient engagement? The answer may rest with nurses and nurse leaders, who have long overseen patient education about how to care for chronic conditions and make lifestyle changes to improve health.
“Promoting patient education has always been a part of our nursing role and obligation to the
patient,” said Debi Sampsel, DNP, MSN, BA, RN, chief officer of innovation and entrepreneurship at the University of Cincinnati’s College of Nursing in Ohio. “It has been a long-standing practice that nurses involve the patient across the life span in their own care.”
Sampsel finds nurses strive to and take great pride in promoting healthy lifestyles. And research has demonstrated that active, engaged individuals have far better health outcomes. The University of Cincinnati includes health promotion in the nursing curriculum and gives students an opportunity gain patient-engagement experience while working with the homeless and elementary and secondary school age youth.
“What’s new is old,” added Patrick R. Coonan, EdD, RN, NEA-BC, FACHE, dean and professor at the College of Nursing and Public Health at Adelphi University in Garden City, N.Y. “I went to nursing school 35, 40 years ago and what did they teach but to be the patient advocate, to teach the patient. But we got away from that in the last few decades.”
Coonan pointed out that today’s consumers and patients, particularly baby boomers, are better informed. They often turn to the Internet for facts, but he called it a nursing professional’s obligation to verify whether the online information is accurate. Boomers are not going to settle for a paternalistic “Just take this pill” without knowing why and how it will benefit them. And that often falls to the nurse.”
“We have to get away from the patient-doctor or patient–nurse relationship that is almost like a parent–child relationship, in existence for many years, to a more informed and empowered [consumer] who will take responsibility for their health,” said Rosemary Glavan, RN, MPA, CCM, senior vice president of clinical operations at AMC Health, a telehealth provider based in New York. “Baby boomers have been go-getters and always wanted to be in charge. They want to be empowered.”
Advocating with a personal connection
“As patient advocates, nurses and nurse leaders play a key role in promoting patient engagement,” said Cynthia M. Friis, MEd, BSN, RN-BC, associate association executive for SmithBucklin’s healthcare and scientific industry practice in Chicago. “Nurses are privileged with having the opportunity to spend more time with the patients to assess, plan, implement and then help clarify the plan of care with the patient and his/her family or caregivers. Nurse leaders are key in helping to ensure this role is realized. Nurses can do their jobs better with the full support of our nurse leaders.”
Nurses ask questions, she added, and draw patients into thoughtful discussions about their care, helping them move forward when they feel overwhelmed and understand how to best care for themselves.
Establishing principles of engagement
Patewood Memorial Hospital in Greenville, S.C., participated in a national study by the Agency for Healthcare Research and Quality (AHRQ) and in the development of theGuide to Patient and Family Engagement in Hospital Quality and Safety.
Recommendations in the AHRQ guide include:
• Working with patients as advisors;
• Communicating effectively;
• Giving bedside shift reports, where nurses do not talk with each other but involve the patient and family members he or she wants to participate; and
• Engaging patients in transitions to home.
The hospital has experienced improvements to its HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey since implementing the program.
“The patients and families are much happier,” said Kerrie Roberson, MBA, MSN, RN-BC, CMS, nurse educator at Patewood. “Patient engagement is a partnership with the patient and families, and they trust you more when they see you are open about their care.”
Nurses at Patewood are leading discussions about patient engagement across the Greenville Health System and have begun sharing their experiences with others.
Other nurses gathered to develop Guiding Principles for Patient Engagement, released last year by the Nursing Alliance for Quality Care (NAQC), which was supported by the Robert Wood Johnson Foundation.
Principles in the NAQC guide include:
• Having a dynamic partnership with patients and their families;
• Respecting boundaries;
• Maintaining confidentiality;
• Adhering to responsibilities and accountabilities;
• Recognizing patients able to engage;
• Appreciating patient rights;
• Sharing information and decision making; and
• Advocating for the patient.
“Patient-centered care and engaging patients is very important to improving quality outcomes, which includes reducing cost and better health of populations in the community, but also reductions in disparities of care,” said Maureen Dailey, PhD, RN, CWOCN, senior policy fellow for nursing practice and policy at the American Nurses Association (ANA), a member organization of the NAQC. “The patient is at the center of the team and must assume accountability for self-care and part of the outcome. But that evolution has yet to take place.”
Nurses must instill confidence and competence in patients’ self-care, Dailey explained. And patients need nurses to provide knowledge, support and symptom management.
“Nurses hold a central role in patient engagement,” Dailey concluded.
Combing nursing skills with technology
Along with the personal touch, many nurses are finding technology can assist with their patient-engagement efforts.
“As the responsibility of nursing advances to one of building and sustaining patient activation and the role of nursing moves to be more consultative across care settings, technology will play a vital role for both the nurse and the patient,” said Karen Drenkard, PhD, RN, NEA-BC, FAAN.
Drenkard, who has served as executive director of the American Nurses Credentialing Center (ANCC) and past director of the ANCC Magnet Recognition Program, will join GetWellNetwork in January as chief clinical/nursing officer, where she will lead the development of a nursing model of patient engagement. Her responsibilities will include studying and designing new ways to assess and improve patient activation through clinical practice and technology solutions across all care settings.
“Nursing can use interactive patient care technology to proactively engage the patient and shift the responsibility for completing certain care interventions,” said Drenkard, explaining patients can document daily signs and symptoms. Care providers use the network to send reminders about taking medications or the need for follow-up visits to their physician when data and input from the patient indicates the need to do so.
Analytics spot trends, and nurses can intervene at the first sign of trouble with a personal follow-up. The data also helps them identify where the patient is on the readiness scale of change.
“To be most effective in engaging patients and more so activating patients, the nursing role
must evolve and develop,” Drenkard concluded. “The need for change and adaptation is certainly not new to our profession. However, there is a pivotal opportunity today to shift the role of the nurse away from a more task-oriented, episodic care management function to one that more centered on building, sustaining a care management relationship with a population of patients with the effective use of interactive patient care technology.”
© 2013. AMN Healthcare, Inc. All Rights Reserved.
Source: AMN Healthcare
What is NO MORE?
NO MORE is a new unifying symbol designed to galvanize greater awareness and action to end domestic violence and sexual assault. Supported by major organizations working to address these urgent issues, NO MORE is gaining support with Americans nationwide, sparking new conversations about these problems and moving this cause higher on the public agenda.
The history of NO MORE
The NO MORE symbol has been in the making since 2009. It was developed because despite the significant progress that has been made in the visibility of domestic violence and sexual assault, these problems affecting millions remain hidden and on the margins of public concern. Hundreds of representatives from the domestic violence and sexual assault prevention field came together and agreed that a new, overarching symbol, uniting all people working to end these problems, could have a dramatic impact on the public’s awareness.
The signature blue vanishing point originated from the concept of a zero – as in zero incidences of domestic violence and sexual assault. It was inspired by Christine Mau, a survivor of domestic violence and sexual abuse who is now the Director of European Designs at Kimberly-Clark. The symbol was designed by Sterling Brands, and focus group tested with diverse audiences across the country who agreed that the symbol was memorable, needed and important.
Who is behind NO MORE?
Every major domestic violence and sexual assault organization in the U.S. – from men’s organizations like A CALL TO MEN and Men Can Stop Rape, to the National Domestic Violence Hotline and the National Alliance to End Sexual Violence, to groups that help teens like Break the Cycle and Futures Without Violence, to organizations that advance the rights of women of Color and immigrants like Casa de Esperanza and SCESA to the U.S. Dept. of Justice’s Office on Violence Against Women – all of them and more are behind NO MORE.
View the complete list of organizations here.
What do we do?
NO MORE is spotlighting an invisible problem in a whole new way. The first unifying symbol to express support for ending domestic violence and sexual assault, NO MORE can be used by anyone who wants to normalize the conversation around these issues and help end domestic violence and sexual assault. Our vision is that NO MORE will be everywhere – on websites, t-shirts, billboards. Organizations and corporations, large and small, will embrace this symbol as their own. When an abuse case makes media headlines, you will instantly see NO MORE being tweeted, discussed on Facebook, worn as jewelry and on t-shirts; made into buttons and posted in classrooms, offices, billboards and grocery stores across the country. NO MORE will help end the stigma, shame and silence of domestic violence and sexual assault. NO MORE will help increase funding to prevent domestic violence and sexual assault. Like the pink ribbon did for breast cancer and the red ribbon did for HIV/AIDS, NO MORE will help to change behaviors that lead to this violence.
Get the symbol today and start showing your support.
Why should I care?
The next time you’re in a room with 6 people, think about this:
- 1 in 4 women experience violence from their partners in their lifetimes.
- 1 in 3 teens experience sexual or physical abuse or threats from a boyfriend or girlfriend in one year.
- 1 in 6 women are survivors of sexual assault.
- 1 in 5 men have experienced some form of sexual victimization in their lives.
- 1 in 4 women and 1 in 6 men were sexually abused before the age of 18.
These are not numbers. They’re our mothers, girlfriends, brothers, sisters, children, co-workers and friends. They’re the person you confide in most at work, the guy you play basketball with, the people in your book club, your poker buddy, your teenager’s best friend – or your teen, herself. The silence and shame must end for good.
How can I help?
There are hundreds of ways you can spread the word about NO MORE.
Say it: Learn about these issues and talk openly about them. Break the silence. Speak out. Seek help when you see this problem or harassment of any kind in your family, your community, your workplace or school. Upload your photo to the NO MORE gallery and tell us why you say NO MORE.
Share it: Help raise awareness about domestic violence and sexual assault by sharing NO MORE. Share the PSAs. Download the Tools to Say NO MORE and share NO MORE with everyone you know. Facebook it. Tweet it. Instagram it. Pin it.
Show it: Show NO MORE by wearing your NO MORE gear everyday, supporting partner groups working to end domestic violence and sexual assault and volunteering in your community.
Learn more here.
As nurses we are taught that we are professionals and we must maintain a certain emotional distance with our patients. It’s a boundary that encompasses the therapeutic relationship: nurses as caregivers, patients as the recipients of the care. But now, working as a nurse, I have found that while most of my professional boundaries are well defined, sometimes the line between a professional and personal relationship with a patient can become blurred.
I work on an orthopedic surgical unit where most patients are coming in and going out very frequently. That makes it hard to get to know anyone too well. But there are some patients that we never forget, for good or bad reasons. Most of the time these patients stay with us because, for whatever reason, one of us crossed the invisible boundary nurses set for themselves.
Recently, I cared for two patients who touched me so deeply it was impossible to maintain a professional distance. My grandfather had recently passed away, and both of these men reminded me of him. My grandfather, or “Grand-Daddy” as we all called him, was one-of-a-kind, and one of the kindest and most generous people I’ve ever met. He was hard of hearing but constantly fiddled around with his hearing aids, so it was wise to always be prepared to repeat yourself once or twice. He had an extraordinary memory until the day he died, and was one of the funniest people I’ve ever known.
One day at work, an older man arrived on my floor after a total hip replacement. As I worked to admit him to our care, his room was crowded with half a dozen family members who surrounded him with love. I asked him about his family, and he told me about his eight children, 30 grandchildren, and a couple of great-grandchildren too. It was uncanny how much this man reminded me of my grandfather, who also had a large family of six children, 28 grandchildren and three great grandchildren.
I smiled as I watched my patient fiddle with his hearing aids, and tears welled up in my eyes as he answered all of my questions with a familiar, “What did you say?” I didn’t mind repeating myself, and for a moment, it was as if I was speaking with my grandfather again.
After I was finished admitting him and settling him in, I found myself constantly peeking back into his room asking if he was O.K. and if he needed anything. He was pretty low-maintenance and never really needed much, and eventually, he was gone. I never told him that he reminded me of my grandfather, or how he tugged at my heartstrings, and I often wonder if I should have. But I worried that in showing this man a little extra attention, I had somehow breached the therapeutic relationship.
Not long after that, another patient came up to the floor. The report said he was an older man who was in “comfort care.” This essentially means that no lifesaving efforts would be made on his behalf; we were there to keep him comfortable during his final days. When this patient came up to the floor, I was quite taken by him. His gruff, Irish exterior belied his sweet nature. Medically, he had a lot of issues, but when he came up to the floor, the only thing he wanted was a bowl of oatmeal. When his tray came, he found cream of wheat instead. He was so disappointed, but I was determined to find him a bowl of oatmeal.
Miraculously, after a search through our floor kitchen, I found oatmeal and delivered it to him. He was delighted and blew me a kiss and gave me a wink. His chart said he needed assistance to eat, but he dug right in. Sure, he made a mess, but he managed just fine on his own.
Watching him eat that oatmeal reminded me of some of my last meals with Grand-Daddy. Grand-Daddy never was the neatest eater, and we would always laugh about what a mess he made. But he didn’t care — at his age, he just wanted what he wanted when he wanted it. My patient’s personality was strikingly similar to that of my grandfather. As he lay curled up in the bed, I thought about the strong man he must have been a long time ago.
When his wife and children came to the room, I felt a pang of familiarity. His wife remained so graciously composed during her visits. It brought back memories of my grandmother during my grandfather’s last days. Despite her deep sadness and fear of what was to come, my grandmother kept full composure and took care of not only him but also everyone around her. I still am amazed by how strong and selfless she was during that time: a true role model for unconditional love, and I saw these saintly qualities in this man’s wife.
The following day, the man was sent back to a nursing home where comfort care would be resumed. When the transporters came to get him, I started to feel emotional, like someone I loved was going to leave me. Even though I knew he was going to a nice and comfortable facility, I didn’t want him to go. We transferred him onto the stretcher and I made him cozy in his blankets. His family was sincerely thankful, and I remember telling them with tears in my eyes how much we enjoyed taking care of him, and how much we would miss him.
The tears continued to well up as I watched his stretcher go around the corner and out of sight, because I knew I would never see him again. I felt like I was saying goodbye not only to him, but also to my grandfather all over again. But once again, I stopped myself from sharing these feelings with my patient or his family. They knew I cared, but they never knew how much caring for him meant to me personally.
Looking back, I still don’t know if I did the right thing, keeping my feelings to myself. I now realize that both of these patients were helping me heal, even as I was helping them. Watching them leave was like letting go of my grandfather again, but they also gave me the gifts of laughter and reminiscence, right when I needed them most.
I know that, ultimately, I am still just the nurse, and they are still just my patients. But I think it’s better for both the patients and myself if we both sometimes allow ourselves to feel something more than a professional bond. Nurses and patients move in and out of each others’ lives so quickly, but we are nonetheless changed by every encounter.
I became a nurse because I want to care for people and make a difference. Being touched in return is an added bonus.
Source: The New York Times
By Megan Murdock Krischke
Why do new nurses often leave their jobs in the first year? And what can be done to keep their careers on track, improve nurse retention and keep the costly issue of turnover in check?
A new study published in the July-August issue of Nursing Economic$ may help to answer these questions.
A few years ago the North Shore-LIJ Health System (NSLIJ) in New York set out to identify some of the key reasons for nurse loss in the first year of employment and created a nurse residency program to counteract that loss. A team of nurses at NSLIJ monitored the before and after results in order to measure the efficacy of program.
“What we recognized was the way we were orienting new nurses wasn’t meeting the needs of this computer-minded generation,” said M. Isabel Friedman, DNP, MPA, RN, BC, CCRN, CNN, program director of nurse fellowship programs for the Center for Learning and Innovation at North Shore-LIJ Health System and the lead author on the study. “We created a program that met the needs of our new nurses and helped them transition from new graduate to functioning practitioner.”
This study looked particularly at the Pediatric Nurse Fellowship Program (PNFP) at Cohen Children’s Medical Center for pediatric critical care, pediatric emergency department and hematology/oncology specialties. This specialty orientation program was designed to bridge the gap between the novice nurse and the new high-acuity pediatric specialty while providing new graduate RNs with important mentoring and support tools.
“We found that when nurses feel supported, their loyalty to the hospital system increases,” Friedman explained. “Additionally, our new hires go through the fellowship program in cohorts of 5-10. The community and peer support offered by the cohort is a factor in increased retention.”
The PNFP used a blended learning model. The core curriculum that nurses focused on during the initial weeks of the program was chosen from the curriculums offered by the national professional organization for each specialty. Each week had a theme, such as respiratory. Nurses then had seminars, skills and simulation labs, and clinical days that addressed that week’s topic.
One of the key findings of the study was the effectiveness of having a senior nurse whose specific job it was to work with the cohort of fellows as they were transitioning to working in direct patient care.
“Study of our previous orientation showed that the transition from orientation to direct patient care in the six- to nine-month timeframe was when first year retention rates began to drop significantly. Having a senior nurse who could be by a nurse’s side as he or she did a new procedure, or easily available to ask questions, increased the confidence of our new nurses and the quality and safety of the care they provided.” Friedman stated.
Friedman and her colleagues found that the nurse fellowship program decreased turnover significantly in the PICU and that general retention rates were statistically significant when comparing length of employment before and after the program was implemented. “As you can imagine this was good for the bottom line. When comparing expenses for the 2.5 years before instituting the PNFP and the 2.5 years following, there was a potential cost savings estimate of over $2 million.”
As an added bonus to increased nurse retention and cost savings, nurses who participated in the PNFP are showing a greater value for continuing their education through specialty certifications and pursuing master’s programs.
“This program is easily adaptable for other specialties. We had our first residency program in adult critical care. In addition to the PNFP, we have fellowships in cardiac cath lab and labor and delivery nursing, as well as having a fellowship for nurse practitioners. Every fellowship cohort is altered to some degree in response to the feedback we receive from our fellows, preceptors and others involved in the program.”
“One reason this particular manuscript was a good fit for Nursing Economic$ is because it addresses the measures, methods and metrics. If we are going to make a business case for caring we have to make sure that we have the data that supports nursing’s work. This article showed in black and white how what they were doing helped the bottom line,” remarked Donna M. Nickitas, PhD, RN, NEA-BC, CNE, editor of Nursing Economic$.
“It emphasizes what we have been saying all along: to have a healthy work environment, you have to have a healthy workforce,” Nickitas continued. “We need to make sure our nurses are more than adequately educated and trained. This study demonstrates that the PNRP is worth the investment in time, effort and finances.”
“I love the program and I love my fellows,” Friedman effused. “They are bright and capable young people and we owe it to ourselves to educate the next generation of people who are going to be taking care of us and our loved ones. It is a fabulous feeling to see their success and see them grow and become nurse managers and to see them continually aspire to bigger and better things.”
For more information, see the Nursing Economic$ study:
“Specialized New Graduate RN Pediatric Orientation: A Strategy for Nursing Retention and Its Financial Impact”
By Samantha Cronk
For Berkeley County native Dorothy Leavitt, 93, the desire to help people is natural, so when the call came for volunteers to assist soldiers wounded in World War II, Leavitt needed no other prompting.
While she was aware of WWII and its effects, the war became personal for Leavitt after she helped care for eight severely wounded soldiers who were recovering in an army hospital in Martinsburg.
Leavitt graduated from Martinsburg High School in May 1937 at 18 and by September, she began training to become a nurse. In 1940, Leavitt graduated as a registered nurse as part of a graduating class of fewer than 10 women.
Journal photo by Samantha Cronk
Berkeley County native Dorothy Leavitt, 93, used her profession as a nurse to help soldiers wounded during World War II who were sent to recover at the Newton D. Baker Hospital in Martinsburg.
"I knew even when I was a young girl that I wanted to be a nurse. My mother had her babies at home and the nurses would be helping the doctor, and I just always wanted to be a nurse," she said.
It was during her time as a nurse that Leavitt chose to volunteer her services to wounded World War II soldiers at the Newton D. Baker Hospital, a military hospital, in Martinsburg. In 1946, the Newton D. Baker Hospital became the VA Medical Center as part of the Veterans Administration.
"I always worked in the paraplegic ward. There were about five cubicles, and each one had eight men in it. They were all young men in their 20s, paralyzed from the waist down. We always went back to the same eight men, so those eight are the ones you say you took care of," Leavitt said.
"We worked during the daytime and then every night for 18 months we went down from 7 to 10 p.m. or later, because sometimes they had to pull us away," Leavitt said.
Leavitt described her job as anything that would make the men comfortable, including rubbing their backs, washing their faces and changing their sheets.
Eventually, the men Leavitt cared for were transferred to hospitals close to where the men lived. Along with other nurses who volunteered in the paraplegic ward, Leavitt helped form the Newton D. Paraplegic Group, which kept soldiers and nurses connected.
Through the group, soldiers and nurses would stay in contact through letters and meet at least once a year for food and fellowship.
As a nurse, Leavitt worked for several local doctor's practices as well as in private duty. She also worked at the VA Center for one year in the medical ward.
Through her career as a nurse and life in Berkeley County, Leavitt has experienced many professional milestones, including working with Martinsburg's first radiologist, as well as witnessing almost a century's worth of change to Martinsburg.
"I liked to take care of patients, and I just didn't want to be behind a desk. At the time I was going for my training, it was just a job. Now, I've had some time to think back, and I realize that some of that stuff I saw during my nursing career was really miraculous," Leavitt said.
Leavitt's thumbprint can be found throughout Martinsburg. Of the 64 acres Leavitt and her late husband Charles owned as orchards, Leavitt retains 53 acres. On some of the land she sold sits the Martinsburg water tank and Orchard View Intermediate School.
"The amount of change, it's amazing. It's still a good place (to live). You can see the changes. Of course they paved the roads, we get mail and they've changed the name of (Delmar Orchard Road) so many times," Leavitt said.
Leavitt can recall living through the Great Depression, claiming that her family was fortunate to avoid the harsh conditions many families found themselves in during that time. Leavitt credits her father with providing for her mother and siblings, saying that he worked hard to find work and always provided them with new shoes and textbooks before every school year.
"I went to a two-room school house through the eighth grade. When we finished eighth grade, we had to go to the old Martinsburg High School and take a test for two days to see whether or not we were allowed to go to high school. I made the second highest (grade) in the county. You remember that kind of stuff," Leavitt said.
Leavitt said her parents supported her ambition to become a nurse. Although it has been many years since she has worked professionally, Leavitt still considers herself a nurse.
"Once you're a nurse, you're always a nurse," she said.
Source: The Journal