DiversityNursing Blog

By Alexandra Wilson Pecci

Source: Health Leaders Media 

For many nurses, leaving high school doesn't mean leaving the bullies behind. Bullying has been called nursing's "dirty little secret," but judging by the numbers, it's hard to believe it could be kept secret at all.

Most women can relate in some way to the 2004 Lindsay Lohan movie Mean Girls, in which her character encounters a group of bullying high school girls who say things like this: "Half the people in this room are mad at me, and the other half only like me because they think I pushed somebody in front a bus."

But while most women can leave memories like this behind when they graduate from high school, for those who enter nursing and become victims of nurse-on-nurse bullying, leaving high school hasn't made the mean girls disappear; they're just wearing scrubs now.

Bullying has been called nursing's "dirty little secret," but judging by the numbers, it's hard to believe it could be kept secret at all.

Twice as many nurses as other Americans have experienced bullying in the workplace. According to study of 612 staff nurses in theJournal of Nursing Management, 67.5% had experienced bullying from their supervisors, while 77.6% had been bullied by their co-workers. Compare that to the 35% of Americans outside healthcare who've reported workplace incivility, says the Workplace Bullying Institute.

Not only is bullying among nurses an issue, it's one that most nurse managers aren't equipped to handle properly, according to Cheryl Dellasega, PhD, RN, CRNP, co-author with Rebecca Volpe of the new book Toxic Nursing: Managing Bullying, Bad Attitudes, and Total Turmoil.

Bullying "is a huge problem now in the workplace," Dellasega tells me. "I think a lot of nurse managers don't get a lot of training in conflict resolution."That's especially true when they have little more management experience than any of their co-workers but were promoted to the role because they have a bachelor's degree and a few extra years of seniority, Dellasega says.

Dellasega's new book is a follow-up her to When Nurses Hurt Nurses: Recognizing and Overcoming the Cycle of Nurse Bullying, and aims to help managers and administrators understand and deal with bullying among their nurses.

In order to write the new book, the authors not only conducted a literature review, but also reviewed hundreds of blogs written by nurses about situations of conflict. By doing so, Dellasega and Volpe were able to identify key themes and scenarios that are common to bullying, as well as which groups of people were commonly involved in bullying.

Finally, the authors interviewed nurse management experts to give insight into dealing with such situations. "There were different pockets of nurses who seemed to be really engaged in the situation, as either a victim of the aggressor," Dellasega says. For example, new nurses are often victims.

"I think that brand new, young nurses [are] sort of the classic targets," Dellasega says. Often, these nurses are idealistic about their work and excited about how they're going to make a difference, but the older, established, more jaded nurses engage in bullying to knock them down a little. In fact, Dellasega says, sometimes the young nurses' preceptors are the ones who are doing the bullying because they feel like the role is a thankless one.

"I know that even…the literature…supports that preceptors often don't feel well prepared to do the job and often don't want to do the job," she says.

Another group of nurses who are often bullied are part-time, agency, or floater nurses who are picked on because they're not part of the regular nurses' clique.

Yes, clique. Dellasega says the regular nurses who are in the clique often make rude or sarcastic comments to or about the new person, or even go so far as not sharing supplies. Even nurses who come in from other floors can be left of out, even though they're just there to help.

Dellasega says that the cliques and bullying in a hospital comes with the same kind of baggage that most of us thought we left behind in high school. But for nurses, there's the added stake of patient safety. Although studies haven't explicitly linked increased bullying to decreased patient safety, research does say that happier nurses do their jobs more effectively. (Conversely, nurse burnout is linked to higher healthcare-associated infection rates).

"It's not a big leap to figure that when you go into work… if there's a toxic environment… you won't be able to give your full attention to patient care," Dellasega says.

Bullying also leads nurses to call in sick more often in order to take mental health days. Abusive behaviors can even cause nurses to develop post-traumatic stress disorder, anxiety, depression, or insomnia, a Joint Commission survey has found. Hospitals can also lose valuable employees to bullying and many nurses have left their jobs because of it.

"Things get to a point where they just can't take it," Dellasega says. Sometimes nurses feel like they're "going into the battle zone every day."

Nurse managers shouldn't let things get to that point. Managing relationships should be day-to-day work, not something that only happens during moments of high tension.

"Don't wait for it to get to the point that there's explosive conflict," Dellasega says.

Just as Dellasega discovered which nurses and situations tend to breed bullying, she and her co-author also discovered which environments are healthy. Bullying is rarer when there is a sense of teamwork, collaboration, and authentic communication with coworkers.

Dellasega says the ideal nurse manager is transparent, letting the staff ask questions and answering honestly, even if the answer is "I don't know, but I'll find out."

Feelings of empowerment are also important to reduce bullying and satisfaction. And upper hospital management should provide appropriate training for new nurse manager about how to effectively and positively deal with bullying.

Finally, Dellasega says nurses managers should monitor their own behavior to ensure that they're not engaged in bullying themselves, even if inadvertently. For example, sighing heavily after someone speaks could be interpreted as negative. Other behaviors to watch out for are favoritism, certain body language, gossiping, and speaking in a raised voice.

"I think nurse manager have to really monitor their own behavior and be cognizant of anything they might do," Dellasega says. "The nurse manager sort of sets the standards.

Shannon Patel, RN, BA, CCRN, CMC, PCCN, manager of the heart failure program at AtlantiCare Regional Medical Center in Galloway, N.J., and an RN-to-BSN student at the Rutgers School of Nursing–Camden (N.J.), led a team at the hospital’s Heart Institute that developed a new smart phone app that helps patients manage heart disease and stay out of the hospital.

The WOW ME 2000mg app helps patients, caregivers and family members identify and manage symptoms of heart failure, according to the release.

"This tool was designed to cross the healthcare continuum and has allowed our organization to deliver very important self-management education," Patel said in the release.

The WOW ME 2000mg app reminds patients to weigh themselves; measure their output of fluids; walk and be active; take their medications; evaluate signs and symptoms; and limit sodium intake to 2,000 mg or less, with 1,500 mg being optimal. The app prompts users with reminders and allows them to enter information about how they are managing their symptoms. It also links them with AtlantiCare’s Heart Failure Resource Team and other providers. Patel said in the release that many heart failure programs around the country are struggling to find ways to successfully teach heart failure self-management techniques. She said there is no standardized approach to reinforcement of the information taught to patients and that oftentimes patients receive differing and conflicting information depending on where they go for treatment.

"This tool standardizes heart failure self-management for patients," Patel said in the release.

As part of its ongoing mission to eliminate needlestick and sharps injuries in healthcare, the nonprofit organization Safe in Common has issued the "Top 10 Golden Rules of Safety." 

The list (www.safeincommon.org/sites/default/files/field_document/top-10-golden-rules-of-safety.pdf) is predicated on making injuries a "never event," and dictates that personnel using or purchasing sharps consider the following rules:

• The design and activation of the safety mechanism is automatic and will not interfere with normal operating procedures and processes.

• The device is intuitive and requires no additional steps for use compared with an equivalent standard or conventional device.

• The contaminated, non-sterile sharp will be rendered safe prior to removal or exposure to the environment.

• Activation of the safety mechanism does not require the healthcare worker to undertake any additional steps during normal patient care processes or protocols.

• Activation of the safety mechanism will not create additional occupational hazards (such as aerosolization, splatter, exposure to other potentially infectious materials, etc.).

• Activation of the safety mechanism does not cause additional discomfort or harm to the patient.

• The device will be ergonomically designed for comfort, allowing for automatic one-handed use during all stages of patient procedure.

• The safer engineering control is available in sizes and iterations appropriate for all areas of use relevant to patient care needs.

• Disposal of the safety device will not increase waste disposal volumes but instead incorporates designs to reduce waste.

• The used safety device will provide convenient disposal and mitigate any risk of reuse or re-exposure of the non-sterile sharp.

The outline for the Top 10 Golden Rules of Safety was released at the annual Association for Professionals in Infection Control and Epidemiology convention in Ft. Lauderdale, Fla., earlier this month. Safe in Common gauged attendees’ opinions on safety devices during the conference. Of the 27 devices reviewed, only 9% received a perfect 10 and exactly half had a passing grade of 7 or higher. Some 41% had scores of 2 to 4.

Overall, the devices available at APIC scored well on two criteria:

• The safer engineering control is available in sizes and iterations appropriate for all areas of use relevant to patient care needs (95%).

• The used safety device will provide convenient disposal and mitigate any risk of reuse or re-exposure of the non-sterile sharp (86%).

Significant development effort remains in three essential criteria:

• Activation of the safety mechanism does not require the healthcare worker to undertake any additional steps during normal patient care processes or protocols (32%).

• The device is intuitive and requires no additional steps for use compared with equivalent standard or conventional devices (41%).

• The contaminated, non-sterile sharp will be rendered safe prior to removal or exposure to the environment (48%). 

Source: Nurse.com

By Lee Aase

Dr. Victor Montori was the Medical Director for our Mayo Clinic Center for Social Media when we launched it, and when he stepped aside two years later Dr. Farris Timimi succeeded him in that role.

But Dr. Montori remains committed to using social media tools to empower and engage patients. As you will see from this presentation at our Mayo Clinic Transform conference, Dr. Montori is passionate about helping patients deal with the burden of disease, and particularly in managing time-consuming treatments. As he says, for patients with multiple diseases and conditions, following all of their doctor’s treatment prescriptions can be “the equivalent of a part-time job.”

Dr. Montori is collaborating with colleagues internationally on a Burden of Treatment study. There are two ways you can help:

• If you’re a patient who has been dealing with a chronic condition such as high blood pressure, diabetes or chronic obstructive pulmonary disease, please answer a short survey.
• If not, please share this post on Facebook, Twitter or LinkedIn and encourage those in your social networks to join.

We're excited to be able to play a role in helping Dr. Montori and his colleagues look for ways to help patients manage the "extra job" they have in coping with chronic conditions. Please join us.

Source: Mayo Clinic 

By Mike Spohr

Today I ran into a Mexican restaurant to grab a quick lunch, and as I ate my meal I came across a table of nurses wearing hospital scrubs. As they chatted amongst themselves I thought about the many nurses my family has interacted with over the last five years, and I found myself filled with such appreciation for what these amazing women and men do for us.

It was in the Neonatal Intensive Care Unit that I initially saw how amazing nurses can be. My first child, Maddie, had been born almost 12 weeks premature, and the hospital staff, upon determining that Maddie's lungs were immature, rushed her to the NICU. There Maddie's life hung in the balance, and though my wife, Heather, and I longed to care for her ourselves, her condition made it so that we couldn't. We had to trust the NICU nurses to take care of our baby for us, and that was incredibly hard -- especially at night when we went home to catch a few hours sleep.

Sleeping was, of course, almost impossible. My sick baby was not with me, and the phone loomed ominously on the nightstand. If it rang before dawn it would do so for only one reason -- to tell us that Maddie had passed away. I can't tell you how scared I was of that phone ringing. Thankfully, it never did.

Each morning I called the NICU at 7:00 a.m. to get an update from the night nurse about how Maddie had done through the night, and the moments waiting for her to pick up the phone were horrible. Was I going to hear Maddie had done poorly and that things didn't look good? Or, if the nurse took a long time to come to the phone, did that mean that she and the other medical staff were desperately fighting to stabilize Maddie at that very moment (something I'd witnessed in person a number of horrible times)? My hands never failed to shake as I waited for the phone to be picked up.

Once the night nurse picked up, though, I began to feel better. She always told us about Maddie's night in great detail even though she'd just finished a long, exhausting shift. The lengths the NICU nurses went for Maddie were incredible. One night, we were told, Maddie wouldn't respond to the ventilator, and the only reason she survived was because the night nurses took turns hand pumping air into her lungs for hours on end until their hands were cramped and throbbing.

As amazing as all that was though, the thing I appreciated the most about the nurses was how they loved and valued Maddie. She wasn't just some nameless baby behind the glass of an isolette obscured by wires, medical tape, and breathing tubes. She was an amazing little girl named Maddie (also "Bunny" or "Little Mama" as they called her), who was beautiful and strong. I could see that they considered my daughter to be amazing and a gift, and to see others felt about her as I did was incredibly meaningful to me.

Maddie was finally released from the NICU, but there were a few times over the next 17 months when she came down with an infection and had to again be hospitalized. Those days in the hospital were both frightening and incredibly dull, and again nurses were wonderful to us. They were always there when we needed them, quick to bring a blanket or to explain what medications Maddie was taking. Like the NICU nurses, these nurses showed Maddie so much love, mooning over how cute she was and making faces at her to keep her entertained.

Though it still hurts to admit, on April 7, 2009, two days after she was hospitalized with a respiratory infection, Maddie passed away. On that horrible day there was a nurse who stayed by Heather's side the whole time, and I am so thankful for her kindness to my wife. There was a nurse that mattered to me that night, too, though she didn't stay by my side, bring me a glass of water or even say a word to me. In fact, I don't think I saw her until the very moment I walked out of the pediatric intensive care unit, but she made a difference nonetheless.

You see, that day my life shattered. I watched my daughter die in front of me, and it was an experience so horrific that even now it seems almost surreal, like, Did that actually happen? To me and my family? But it did, and one of the things I remember most about it was how the key medical personnel there didn't make me feel like they found Maddie to be beautiful and strong or amazing and a gift. The lead doctor may have been under a great deal of stress, but the way he pronounced her dead was not right. It was more like a referee calling the end to a heavyweight fight than the end to a beautiful child's life. Then, as we held our dead child in our arms and kissed her goodbye, doctors stood behind the curtain discussing the specifics of what had happened with about as much feeling as mechanics discussing a broken down car.

It was only as I left the PICU that I felt humanity. There, sitting on a chair with a single tear rolling down her cheek, was my nurse. Her tear told me that she cared. About Heather, about me, and most importantly, about my beautiful Maddie.

That's what nurses do that is so important. In addition to all of their medical expertise, they bring a human element to the cold, sterile world of a hospital. Doctors do great things, but have a heavy case load that means they can only visit each patient briefly each day, but the nurses will hold your hand -- figuratively or literally -- and remind you that you are not alone, and that your life is valued even if it can't be saved.

When the nurses at lunch today finished their meal I wanted to thank them, but I didn't, and I wished I had afterward. I can do one better now though:

To nurses everywhere: You should know that you have made a difference to so many people in this world, my family included, and I cannot thank you enough.

Source: Huffington Post 

Source: Online RN to MSN | University of Arizona College of Nursing

By JANE GROSS

View Video Here

Dozens of teachers and health care providers went back to the classroom recently. They attended the I-pad Institute at the University of Cincinnati. 

Local 12's Liz Bonis got to sit in and learn a few things too. From the letter you get by email when you are accepted to nursing school, to no more paper in the classroom. The first thing I learned at the I-pad Institute is that going I- Tech, is likely a heartbeat away from a health care setting near you!

For health care providers or in this case, nurses in training. "We are helping them learn how to use the technology to deliver safe patient care," says Robin Wagner, assistant professor.

Robin Wagner, a nursing instructor, says for example, even if you are sitting here, with the help of iPad learning, you can virtually go inside the doctors office and when it comes to giving hands on care, such as taking a blood pressure, not only can you see how in here, you can see what's happening in the body on this virtual organ because, believe it or not, there's an app for that! "They can actually see what the hearts doing and in the past we would have just described that, this valve opens this one closes. Now, they can actually see that," says Wagner. 

The really exciting part of all this however, is not just what happens here in the teaching and learning environment, it is what happens when you take that to the next level. Perhaps with robotics? In this I-Tech learning lab for students and staff, I got to observe just a few weeks ago, I met Flo-Bot. "They are going to be using the iPad to control Flo-Bot, our robot, so it has an app that will allow the students to drive the interaction with patients," says Chris Edwards. 

As Chris Edwards explains, Flo-Bot is designed for health care providers to be able to better diagnose and assist patients, even at a distance if needed.  

Please view the video in the below link.

Source: Local 12 Cincinnati (Video Available Here)

When it comes to nursing education, African Americans tend to aim for more advanced degrees, yet their percentage among all U.S. nurses is far lower than it is in the general U.S. population. Phyllis Sharps, PhD, RN, FAAN, intends to find out what is behind that disconnect as a key step toward correcting it.

Promoting diversity in nursing is one of the goals of the Campaign for Action because it is essential that the nursing population evolves to reflect America's changing population. Arilma St. Clair, MSN, RN, of the Washington, D.C., Action Coalition, says diversity has to be part of every aspect of nursing—whether in the classroom, in a hospital, or in the community.

Source: Champion Nursing 

By Jane Gutierrez

When you think of a nurse, what’s the first image that comes to mind? Chances are, you think of a woman — and for good reason. The vast majority of professional nurses in the U.S. are white women. In fact, only about six percent of nurses are male and, Considering males make up approximately half of the population and minorities are 30 percent, there’s a major disparity in the profession.

That disparity is reflected in equal measure in nursing schools, both in the student population and faculty. Experts argue improving the diversity in nursing education will improve health care by creating a more culturally sensitive healthcare workforce with improved communication abilities, reduced biases and stereotypes and fewer inequities, as well as increasing the diversity of the nurse education faculty.

At a time when the healthcare system is faced with a nursing shortage caused at least partially by a shortage of nurse educators, some argue males and minorities represent an untapped resource for recruiting new educators. They believe that by creating new opportunities to attract traditionally underrepresented populations to the field, we can both solve the shortage and make a measurable improvement to our healthcare delivery system.

Why Diversity Is an Issue

While minorities have made great strides in other traditionally white-dominated fields and women have done the same in traditionally male fields, nursing is one area where diversity initiatives seem to have been ineffective.

In the case of men, much of the resistance to nursing as a profession comes from a cultural perception of nursing being a “female” profession. Men report while they enjoy the care giving aspects of the job, it’s difficult when others ask questions or make comments deriding their career choice. For example, male nurses report being asked why they didn’t choose to become doctors, with the implication that they did not earn adequate grades or were too lazy to become doctors. In addition, men report feeling left out of the profession, with most training and professional development materials referring to nurses as “she” and a female-centric approach to teaching and training.

In the case of minorities, including African-Americans and Latinos, studies attribute the disparity in the nursing profession largely to lower overall academic achievement in those groups. Given that admission to nursing school generally requires at least a moderate level of academic achievement — and earning a

degree in nursing education requires at least a bachelor’s degree and some experience — it’s no surprise that groups that aren’t as academically advanced are lacking in the nursing profession.

Fixing the Problem

Because improving diversity in the nursing profession is a key to solving the nurse shortage — and by extension, the nurse educator shortage — the healthcare field is looking for new ways to recruit, mentor and retain minority nurses, male nurses and educators.

One step is to recruit potential professionals earlier — in some cases, as early as high school. Throughout the country, in the field in exchange for high school credit, with the goal of encouraging them to maintain their academic performance and attend nursing school.

However, academic performance is only part of the equation. The cost of education is another barrier to many potential students, regardless of sex or ethnicity. The cost for a four-year BSN program can be over $100,000 in some cases, while a two-year program generally runs between $5,000 and $20,000. Factoring in the master’s and doctoral degrees required to become nurse educators, and the cost only goes up.

In response, many schools, as well as states and the federal government, have instituted financial assistance programs designed specifically for minorities and males. The Federal Nursing Workforce Diversity program allows minority students to borrow money for school, and have some or all of their loans repaid if they agree to work in specific, undeserved areas. For those who want to become nurse educators, the government’s Nurse Faculty Loan Program offers partial or full repayment of student loans for agreeing to teach for at least two years after graduation.

With the nursing shortage only expected to grow, thanks to increased access to healthcare, reaching out to minorities and males only makes sense. Not only will it solve a serious problem, it will ensure quality, effective health care for future generations.

About the Author: Jane Gutierrez is a nurse educator and a member of her employer’s diversity initiative committee. She visits with local high schools to encourage students to consider careers in health care

By KEVIN B. O’REILLY

A Web-based mentoring service launched in August 2012 has attracted 400 active users in its effort to help underrepresented minorities pursue careers in medicine.

The project, DiverseMedicine Inc., allows users to request a personal mentor to answer questions through the website’s instant messaging or video chat functions. High school, college and medical students also use discussion forums to cover topics such as admissions testing and residency applications.

The need for the service is great, say organizers of the project, which is open to all students online (link). Seven percent of medical school faculty are black, Hispanic or Native American, says the Assn. of American Medical Colleges. The share of medical students from underrepresented minority groups is about 15%, a figure that has not budged much since 2001.

Closing the gap

“One of the main reasons why there are so few minorities in the field of medicine is because of the mentoring gap. If nobody’s there to tell you how to get into medical school, you’re not going to get in,” said Dale O. Okorodudu, MD, the project’s founder and a senior resident at Duke University School of Medicine’s internal medicine residency program in Durham, N.C. Too many students do not get advice about postbaccalaureate premedical programs or health-related master’s degrees that can aid their chances of medical school admission, said Cedric Bright, MD. He sits on the project’s board of directors and is assistant dean of admissions at the University of North Carolina School of Medicine.

“This online component … provides a venue for folks to realize that there are role models out there that they don’t see that often,” Dr. Bright said. The American Medical Association is working to develop a LinkedIn-style mentoring site for medical students and residents to connect with practicing physicians.

By Matt Sloane, CNN

Thinking about buying your dear old dad some argyle socks or monogrammed golf balls for Father's Day?

Think again. What he really wants is the high-tech stuff! And there are several gadgets that can actually make a difference in your father's health. Here's a look at five gift choices:

It's a heart monitor! It's an iPhone case!

The AliveCor heart rate monitor phone case doubles as portable EKG monitor and an iPhone case. Users place their fingers over the two metal leads on the back of the case, and within seconds get a live look at the electrical signals in their heart.

Why is this important? According to the U.S. Centers for Disease Control, heart disease is the No. 1 killer of men and women in America, taking more than 600,000 lives each year. If your dad or his doctor are concerned about his heart, this can help them keep track on the go, and for less than $200.

It's FDA-approved for purchase by physicians or by their patients with a prescription. Once dad takes a reading, he can e-mail the report directly to his doctor.

If your dad's hearing is slipping

If his heart is in the right place, but it's his ears you're worried about, check out the Personal Audio Enhancer PAE-300.

Dad may be too stubborn to get a hearing aid, but you can disguise this bad boy as a new, sleek gadget. The PAE-300 can be set up via a wireless connection to beam the TV audio directly to his ears, but it can also be used for everyday situations where it may be difficult to hear.

One thing you'll be able to hear quite well, however, is the "cha-ching" sound, as the PAE-300 will set you back $399.

Colored lights as safety device

From "let there be sound" to "let there be light," the next Father's Day gadget is the Philips Hue system.

This WiFi-connected set of light bulbs doesn't just turn on and off by way of an iPhone or iPad. It also lets the user change the light bulb's hue (get it?) to any color in the spectrum.

So what's the health benefit? There are several: everything from "setting the mood" for sex, which is known to improve your health and happiness, to being a visual alert system for hearing-impaired people. The company is also working on software allowing you to check in on elderly parents with Hue light bulbs -- the product can send you text alerts if they don't turn on their lights by a certain time each morning.

The Hue starter pack comes with a wireless access bridge and three bulbs and sells for $199 at Apple stores or online. The system can control up to 50 bulbs individually, and additional bulbs sell for $59.

Keep an eye on calories in beverages

If dad needs help shedding weight, but still likes his wine, then check out Wine Trax.

This modern-but-elegant set of wine glasses has lines etched in the glasses at 4, 6 and 8 ounces, so you know when to say when. A 4-ounce glass of vino will set you back 100 calories; double that for an 8-ounce glass. This set of two glasses is only $28 -- and of course you can use other beverages as well.

Elegant Portions, Wine Trax's parent company, was started by Gail Curtis, a Eugene, Oregon, interior designer who was laid off from her job designing luxury bus interiors.

"As a weight-watching person, it was my way to still enjoy wine and not have to pull out measuring cups," said Curtis.

Get dad moving

The FitBit Flex band is a multitasker: During the day, worn on the wrist, it tracks your father's steps, distance covered and calories burned. At night, it can track his sleep, measuring how long he sleeps and the number of times he wakes up. In the morning, it can vibrate to wake him silently.

The Flex automatically syncs with a PC, Mac, iPhone, iPad, Android and more. Dad can use the free online tools and mobile app to set and reach goals and track his progress. He can also log his food and workouts.

The Flex is about $100 and can be purchased online.

As a health care giver, you have a responsibility to ensure that they have adequate knowledge in order to provide competent nursing care. Malcolm Gladwell wrote about “rapid cognition,” or our innate sense of “knowing” in his 2005 book, “Blink.” If you haven’t read it, I highly recommend it; it is a fascinating read for all nurses. Of it, Gladwell says:

“You could also say that it’s a book about intuition, except that I don’t like that word. In fact, it never appears in ‘Blink.’ Intuition strikes me as a concept we use to describe emotional reactions, gut feelings -- thoughts and impressions that don’t seem entirely rational. But I think that what goes on in that first two seconds is perfectly rational. It’s thinking -- it’s just thinking that moves a little faster and operates a little more mysteriously than the kind of deliberate, conscious decision-making that we usually associate with ‘thinking.’ In ‘Blink’ I’m trying to understand those two seconds. What is going on inside our heads when we engage in rapid cognition? When are snap judgments good and when are they not? What kinds of things can we do to make our powers of rapid cognition better?”

Within professional nursing, we call this concept “tacit knowledge.” It is not easily shared through lectures or books, but it comes with experience and knowing through repetitive, almost unaware situations and critical thinking. I explicitly learned about tacit knowledge (what an oxymoron) in my undergraduate nursing studies. However, I actually learned tacit knowledge while working with patients alongside more experienced nurses.

I picked it up from colleagues such as the night shift nurse, a LVN with 30 years of experience, who walked back to the desk after assessing a certain patient she’d cared for during the last three days saying, “I’m going to keep my eye on Mr. Second-Door-on-the-Left. I can’t put my finger on it, but I’m going to watch him.” As the oh-so-terribly-young charge nurse, I’d walk in and assess him, too, especially because I knew he was scheduled for discharge some time the next day. Not seeing what my colleague saw nor anything in the chart to cause alarm, I brushed it off only to think, What the…???, as we called a code in the wee hours of the morning -- in between patient rounds because my colleague increased her routine patient checks, “just because.” Similar situations have happened to me numerous times, and I have learned to trust members of the nursing community when they sense something going awry with a patient.

Tacit knowledge is one way to improve patient care, though it’s hard to explain when you know it as well as when you learn it. What a mysterious and fascinating concept and feeling.

Source: NurseTogether

About a month after passing his state licensing exam, Arthur Greenbank was cashing a paycheck in his field.

The University of Akron graduate is not alone: Of all the majors that students can choose, it is nursing that offers the best chance for employment.

“I tell graduates not to worry, that they almost certainly will land a job within a few months of graduating,” UA nursing administrator Cheryl Buchanan said. “If they would go to Florida or Michigan, they would find a job immediately.”

Researchers at the Georgetown University Center on Education and the Workforce examined 2009 and 2010 census data to determine what college majors are most likely to lead to jobs.

“People need to pay attention to this,” center director Tony Carnevale said. “It tells you that if you really want to be an architect, that's fine, but you're going to have to think more about what your plan is.”

“Hard Times, College Majors, Unemployment and Earnings 2013: Not All College Degrees are Created Equal” notes that the unemployment rate for recent nursing graduates is 4 percent. Meanwhile, the typical unemployment rate for majors in many liberal arts fields is double that, and that of architecture and fine arts graduates is more than triple at 13.9 and 11.1 percent, respectively.

What the researchers don't know is whether the graduates were working in their major. Some college majors don't have clear career paths.

That was reflected in the unemployment rates for area ethnic and civilization studies (10.1 percent) and philosophy and religious studies (10.8 percent).

Other majors, such as architecture, have suffered in the economic downturn, although their unemployment rate is gradually improving, Carnevale said.

Only 50 to 54 percent of recent college graduates are working in their majors, Carnevale said.

That means that some “employed” college graduates really might be working in fields once reserved for high school graduates: the proverbial English major driving a cab, for instance.

That can be an expensive outcome, given the cost of college.

“There is lots of pressure now to find out what the value of the college major is,” Carnevale said.

He said that graduates with certificates in heating and air conditioning from a community college can make more than typical graduates with bachelor's degrees.

“It's all about the field of study,” he said.

Buchanan, the UA nursing administrator, said all 55 of the spring 2012 nursing graduates who responded to a UA survey are working in their field or are attending graduate school.

Although nursing might be the fastest route to a paycheck, other majors can eclipse it in salary, according to the Georgetown study.

Electrical engineering ($57,000), mechanical engineering ($58,000) and civil engineering ($50,000) pay more at the start than nursing ($48,000). Same with graduate degrees: Those in nursing earn $81,000 compared with $107,000 for majors in pharmaceutical sciences and administration, $96,000 for chemistry majors and $101,000 for economics majors.

Source: TribLive

By Mable Smith, PhD, JD, MSN, BSN, RN

A diverse nursing student body builds the foundation for a diverse workforce that can become effective in the provision of culturally competent care to patients. Our student body at Roseman University of Health Sciences is reflective of the diversity seen in the population that consists of Caucasians, African Americans, Hispanics, Asians, Native Hawaiian and other Pacific Islanders, to name a few.  This diversity is reflected in the health care system among workers and patients. Students bring a wealth of information that is shared with each other and with faculty.

For example, in a class discussion on nutrition, students from various cultures shared how and what types of foods are used to treat certain illnesses. There were discussions on how food should be presented, such as hot versus cold, raw versus cooked.  Some students shared the significance of family presence during meals even for hospitalized patients. These discussions quickly incorporated religious practices and certain etiquettes to promote “religious correctness” when interacting with various cultural and religious groups. Students also provided insight into generational differences and changes with emphasis on the fact that many in the younger generation have not adopted the strict traditions of their parents and grandparents.

Several students picked up on the stereotyping of religious and cultural classifications.  Two students of the same racial group, but from different parts of the U.S., highlighted the differences in their beliefs, values, health practices, diets and even religion. Both are African American students, with one raised Catholic and the other Baptist.

Students in the College of Nursing are assigned to groups and remain with their group through the program of study. They learn to work with a racially and culturally group of people, address issues, confront problems, and share in successes. They rely on each other during clinical rotations to address the diverse needs of patients. More importantly, this foundation in education provides the tools for them to effectively interact with members of the interprofessional health care team.

The diversity in the College is the strength of the program. Learning from each other promotes collaboration, encourages innovation, and leads to respect.

Nursing is both an art and a science. While the science is fairly uniform, the art is often learned from experiences and interacting with others. These students graduate with a strong knowledge base, but most importantly with a mutual respect and appreciation of individual differences.  Educational policies should promote, not hinder, diversity.

Source: Robert Wood Johnson Foundation

SOURCE: American Sentinel University

By Erica Moss

Georgetown University School of Nursing and Health Studies shares “The American Nurse,” a collection of photographs from Carolyn Jones, exploring the unique lives of nurses from across the country, capturing extraordinary personal stories through photography and interviews.

Here, we present some of our favorite excerpts from this incredible book, which help celebrate the important role of the nurse in the U.S. health care system and shed light on what it really means to practice in this important role. 

By Lois Gerber, RN, BSN, MPH

It was my first nursing visit to Thad and Larissa. The three of us sat around their kitchen table discussing how to best manage an exacerbation of Thad’s multiple sclerosis. Tears welled in the corners of Larissa’s brown eyes as she twisted a strand of her strawberry blonde hair around her finger. 

"His MS seemed to get worse overnight," Larissa said. "He can’t walk up the stairs anymore without hanging onto the railing for dear life. [Our doctor] says it’s time for a stair lift." 

"I can beat these new problems," Thad replied. "Prayer, persistence and exercise. My sales manager suggested a disability leave, but I refused. Give me a month here at home. I’ll show him." His hands shook as he hitched his belt over his potbelly. "There will be no damn chair lift in my house. Mind over matter." 

I took a deep breath, remembering that the physician referral documented an exacerbation of an aggressive form of MS that limited the chance of significant recovery. Double vision accentuated his mobility problems. 

Hope and unrealistic expectations — a common but difficult scenario I’d often seen in my work as a home healthcare nurse. But how to best help Thad accept his limitations while keeping hope in his heart? And convince Larissa to encourage her husband to be as independent as possible?

First, I needed to do a complete assessment and work with the couple to develop an effective long-term care plan with an overall goal and the individual steps to accomplish it. Without realistic expectations, Thad and Larissa’s fears and anger would further the family dysfunction.

I paused. "Thad, physical therapy can strengthen your muscles and improve your walking. An occupational therapist can teach you ways to deal with small things like brushing your teeth and shaving."

"I’ve already had two stints with them and learned everything I need to know," he said, clenching his fists.

I looked at Thad. "Let’s make a deal. You agree to have physical and occupational therapy for four weeks and I’ll visit twice a week, communicate with the doctor and follow up on any problems you have. Then we’ll talk about the stair lift." 

Over the next month, I counseled Thad and Larissa, individually and as a couple. "I’m scared what will happen to me if Thad dies," Larissa admitted one day while we were alone, reviewing handouts on managing the disease. 

"That’s understandable, but overprotecting him and not letting him do what he can safely do hurts his rehab potential." I highlighted sections in the pamphlets that pertained to caregiving.

She frowned. "I’m angry at him for getting sick and feel guilty about that, too. We’re only 55. If he got hurt, I’d blame myself. That’s why I’m overprotective. I’m scared."

I nodded. "All your feelings are normal. Most caregivers feel the same."

"No one else I know has to deal with MS. I’m alone, depressed."

"The Multiple Sclerosis Society has a caregiver support group that meets every week at the city library. That’s where you’ll find people who feel just like you. Talking with them will help."

Thad’s fear and anger manifested in denial instead of depression. "It’s hard to get the mind and the body working together sometimes," I told him. "With a chair lift, you could save your energy for things that are important and that you enjoy."

"Like going to work?"

"That could be a realistic goal. What about cutting back to three days a week?" 

He smiled. "I can live with that. And Larissa’s right. The stair lift is a good idea."

Helping clients set realistic goals is important to keep hope alive. Unrealistic goals foster fear, denial, anger and depression. But without hope, clients lose the moorings for their lives. 

Source: Nurse.com

The Robert Wood Johnson Foundation (RWJF) announced Monday that it is investing $20 million in the new Future of Nursing Scholars program to support some of the country’s best and brightest nurses as they pursue their PhDs. In its landmark nursing report, the Institute of Medicine recommended that the country double the number of nurses with doctorates; doing so will support more nurse leaders, promote nurse-led science and discovery, and put more educators in place to prepare the next generation of nurses. The University of Pennsylvania School of Nursing, which hosted today’s event to launch the new program, will serve as the national program office for the Future of Nursing Scholars program.

“Implementing the Institute of Medicine nursing report is a major priority for RWJF, because we cannot achieve our mission to improve health and health care without a robust, well-educated nursing workforce and many more highly educated nurse leaders,” said John Lumpkin, MD, MPH, RWJF senior vice president and director of the Health Care Group. “The PhD-prepared nurses the Future of Nursing Scholars program supports will help identify solutions to the country’s most pressing health problems, and educate thousands of nurses over the course of their careers. They will be positioned to lead change and inspire the next generation of nurses.”

Fewer than 3,000 of the nation’s more than 3 million nurses have doctoral degrees in nursing, and many of them have DNPs, not PhDs, which prepare nurses to conduct research and teach. The average age at which nurses get their PhDs in the U.S. is 46—13 years older than PhD earners in other fields.

In 2014, schools of nursing will apply to join the Future of Nursing Scholars program, which will support up to 100 PhD nursing candidates over its first two years. The first scholars will begin their PhD studies in 2015. They will receive scholarships, stipends, mentoring, leadership development, and dedicated post-doctoral research support. To expand the new program’s reach, RWJF has developed a strategic philanthropic collaborative to engage other donors.

“Having supported nursing in our region for 10 years, we are very proud to be the first foundation to join this new collaborative, which is bringing together diverse funders to support the PhD-prepared nurse leaders the country needs,” said Lorina Marshall-Blake, president of the Independence Blue Cross Foundation. “We expect the nurse scholars this program supports to transform health care through innovation in their communities and nationwide.” Marshall-Blake said the Independence Blue Cross Foundation is committing $450,000 over three years to support nurses in becoming transformational leaders in education, research, and policy.

The co-directors for the Future of Nursing Scholars program are Susan B. Hassmiller, PhD, RN, FAAN, RWJF’s senior adviser for nursing and Julie Fairman, PhD, RN, FAAN, the Nightingale professor of nursing and director of the Barbara Bates Center for the Study of the History of Nursing at the University of Pennsylvania School of Nursing.
Other speakers at the launch were: Afaf I. Meleis, PhD, DrPS (hon), FAAN, the Margaret Bond Simon Dean of Nursing at the University of Pennsylvania School of Nursing; Elizabeth Galik, PhD, CRNP, an assistant professor at the University of Maryland School of Nursing and an RWJF Nurse Faculty Scholar whose research is helping older adults suffering from dementia; Munira Wells, PhD, RN, an RWJF New Jersey Nursing Scholar whose research focus is New Jersey nurses who were born in India and faced culture shock in the United States; and Maryjoan Ladden, PhD, RN, FAAN, senior program officer at RWJF.
 

About the Robert Wood Johnson Foundation 

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For more than 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. Follow the Foundation on Twitter at www.rwjf.org/twitter or Facebook atwww.rwjf.org/facebook.
 

About the Independence Blue Cross Foundation

In October 2011, the Independence Blue Cross Foundation, an independent licensee of the Blue Cross and Blue Shield Association, launched a charitable, private foundation, whose mission is to transform health care through innovation in the communities it serves. The IBC Foundation and Independence Blue Cross, which is celebrating its 75th anniversary this year, are both committed to improving the health and wellness of the people of southeastern Pennsylvania. The foundation targets the following areas of impact:

• Caring for our most vulnerable: Supporting nonprofit community health center clinics that deliver quality, cost-effective primary, medical, and dental care to uninsured and underinsured people.

• Enhancing health care delivery: Strengthening the nursing workforce through education, career development, and research.

• Building healthy communities: Partnering with community leaders and programs to address community health and wellness needs.

Source: Newswise

By  Jennifer Smola 

Sixty-one years after graduating from Mount Carmel College of Nursing, one of the school’s first black graduates is finally hanging up her stethoscope.

June Todd, 83, retired yesterday from Dr. Charles Tweel’s family-medicine practice on the Northwest Side. Todd graduated from Mount Carmel in 1952, in a class of 52 nurses. All were women, and, for the first time, four were black.

Todd, who lives in Worthington, attended Harding High School in Marion, north of Columbus. She considered studying library science, but her school librarian told her she would have a hard time getting a job in the North because of her race.

“I said, ‘That’s not going to work,’  ” Todd recalled. “So I decided I wanted to become a nurse."

Her race seldom made a difference during her nursing career, she said. And she has fond memories of her time at Mount Carmel.

“I loved the nuns,” she said. “Everybody was so nice.”

Tweel described Todd as a “ball of energy” who never missed work. She’s popular not only among her co-workers but with patients, who “like seeing her more than they like seeing me,” he said.

Enid Patterson, a patient for 10 years, said she was sad to see Todd go.

“She’s not just my nurse,” Patterson said. “She’s my friend.”

When Tweel hired Todd 13 years ago, she planned to stay only a year or two, she said, but she stuck around because she liked the work.

Her co-workers said she brought humor and energy to the office every day.

“She’s the only 80-some-odd-year-old woman that has an opinion on everything from Hillary Clinton to why Chris and Rihanna should not be together,” co-worker Beth Shahan said. “She’s very with-it and hip.”

Though Todd is retired, she says she’s not done working. She plans to volunteer at local nursing homes and perhaps at a Worthington library.

The job of nurse anesthetist comes with many attractions. There’s a high level of responsibility, a challenging work environment and the chance to do good for others. There’s also the prospect of virtually assured employment.

“I saw that there was going to be job security. It would pretty much always be there,” said Navy Reserve Lt. j.g. Loren Gaitan.

Gaitan, 33, is working on her master’s degree at Florida International University in a full-time, 2½-year program. A former neonatal nurse, she is looking to the anesthetist specialty as a way to increase her skills and take on more responsibility.

It could be a lucrative move: Salary.com puts median annual pay at nearly $180,000.

Nurse anesthetist is one of several fast-growing nursing specialties. Thanks to changes in national health-care laws, a range of concentrations in the nursing field are rising to the fore. With new mandates requiring employers to insure their workers, the health-care system will see a flood of new patients, said Connie White Delaney, dean of the University of Minnesota School of Nursing. “The opportunities across the nation will be just profound,” she said.

Job options

Any of these growing jobs could be an easy fit for a veteran with training as a military nurse:

Nurse practitioner: This person typically has a master’s degree as well as a certification from one of several national bodies. The practitioner may diagnose illnesses, examine patients and prescribe medication. “They are not just going to treat the symptom. They will say, ‘You need to diet. You need to exercise,’ where a physician might just give you a pill,” said Gerrit Salinas, director of the recruiting agency Snelling Medical Professionals. “A nurse practitioner can help people feel like they are more than just a number.” The American Academy of Nurse Practitioners puts the mean salary at $91,310.

Nurse informatics: With the rise of electronic medical records, the role of the informatics nurse has become increasingly significant. These workers don’t just convert paper into electronic records; they also must be well-versed in patient care, privacy issues and technology. They may work in medical settings but also in home health agencies, insurance companies and other entities involved in the management of digital records. The average salary is $98,702, according to the Health Informatics Forum.

Case management nursing: Here again, changes in health-care law are driving demand. As new care models evolve, providers will be expected to coordinate medical treatments in order to ensure efficient and effective care. That’s a big part of the case management job description. Case management nurses typically coordinate long-term treatment, especially for patients with chronic conditions. The average salary is $73,000, according to job site Indeed.com.

Geriatric nursing: Care for seniors is a fast-growing field as the nation’s aged population swells. Medical issues may include diabetes, respiratory problems, hypertension and other conditions. Geriatric nurses offer treatment, while also offering guidance to patients and families. The average salary for a geriatric nurse is $54,457, according to ExploreHealthCareers.com.

Home health nursing: As the name suggests, home health-care providers deliver services to those whose conditions allow them to stay at home but who still require ongoing medical attention. The field is growing fast, largely on account of the rapidly expanding population of older Americans. Salaries average around $40,000 but can vary widely by geography.

Go anywhere

There are numerous avenues into nursing, including specialized fields. The American Nurses Association,http://www.nursingworld.org/, offers guidance.

To support veterans in the field, the government’s Health Resources and Services Administration makes grants to colleges and universities with expedited curricula that help train vets for careers as physician assistants. The Veterans Affairs Department employs a range of nurses.

“We recognize this as an opportunity to support veterans who have served the nation, and as a chance to help fill some shortages in the health care area. It’s a win-win situation,” said Joan Wasserman, Advanced Nursing Education Branch chief for HRSA’s Bureau of Health Professions.

Many schools offer programs of various lengths for those looking to get into the field. Advocates say it’s worth the effort.

“Nursing is one of the best careers you can get into because it is so flexible,” said Pat Harris, associate director of a program at Arizona State University Online that helps practicing nurses earn the Bachelor of Science in Nursing degree. “No matter what changes are in the wind in health care, you are going to be in a key position. Once you have that license to practice medicine, you can go anywhere.”

Source: Marine Corps Times

By Neal St. Anthony

Registered nurse Rachele Simmons walked away from a $100,000 career two years ago.

She still isn’t generating enough cash to pay herself a salary from the St. Paul business she started in 2011. But if passion and commitment matter, Simmons already is wealthy from her mission to train and place more minorities in health care jobs.

And as business continues to grow at fledgling Foundations Health Career Academy, Simmons should generate positive cash flow by the end of this year.

“Rachele is phenomenal,” said Tom Thompson, administrator at St. Paul’s Galtier Health Center. “She’s positive and she knows what she is doing. We’ve hired some of her graduates and never had any problem. Her people are very good. And we have a diverse clientele in our facility. So we need staff who speak different languages and who are from different backgrounds and races.”

Simmons is the founder, teacher, marketer and chief bottle washer at Foundations Health, a state-certified private school that has graduated 160 students through its four-week, certified nursing assistant/home health aide program. For many graduates, the course offers a first step into the growing health care industry into jobs that can pay as much as $20 per hour plus benefits.

Simmons, 44, has been a hospital nurse and last worked as a manager at Walgreens, training managers and others to use retail-medical equipment. And she always worked a shift or two a week as a hospital nurse to build a rainy-day fund.

Over the years, Simmons got used to being the only black nurse on the floor or in managerial meetings at Walgreens.

She also knew that health care is a growth area, particularly lower-cost primary care that can be delivered relatively inexpensively outside the hospital and help keep patients in their homes.

She also thought she could be an inspiration to young people of color.

“I just wanted to give something back,” said Simmons, who decided, as her sons reached adulthood, she could handle some business risk. “I had been involved in nursing for 25 years. I was always the nurse called to see the ‘diverse’ patients, often black. It meant so much to them.

“This is what I was called to do. Maybe we can start something that … will get more people of color in nursing, in science, in medicine. We need more black nurses and Hmong nurses and more diversity in health facilities.” She’s even had a couple of white medical students take the class because they wanted to learn the grass roots and work in diverse clinics.

Foundations Health, housed in the Hmong Professional Building a mile west of the State Capitol on University Avenue, is a first business step for Simmons.

Simmons is no stranger to drive and hard work. Divorced when her sons were toddlers, Simmons said her ex-husband never paid child support, forcing her for a short time onto public assistance. The St. Paul Highland Park High School graduate completed two-year nursing school in St. Paul and worked days while completing her registered-nurse degree at Minneapolis Community and Technical College, often bringing her boys to play in the commons while she attended class.

“She was a successful nurse and thrifty with her money,” said Isabel Chanslor, a business trainer with nonprofit Neighborhood Development Center, which for 20 years has provided training to several thousand would-be urban entrepreneurs, including Simmons. “She did not want to take a loan.’’

Last month, NDC recognized Simmons for her commitment to community as a finalist in the organization’s annual entrepreneurial awards.

“She’s a gutsy lady,’’ Chanslor said. “She’s high energy, sharp, rides her little motor scooter everywhere. She has a good business plan and she’s a really good instructor and very focused and dedicated, according to her students.”

Simmons has invested $50,000 in space and equipment. She uses word-of-mouth and social media to attract students. The 80-hour course costs about $950.

“My students are mostly young, single, with kids, without kids, battered, not battered, on welfare, not on welfare … most of them are working poor,” Simmons said. “If they want to work hard and truly better their life, we’ll take them.”

Na Yang graduated from Foundations Health in 2011, but can’t work as a nursing assistant because of an injury. So, she joined the office as a part-time office manager.

Simmons said Yang works more hours than she’s paid because of her commitment to the cause and the need to stay on top of the paperwork.

“You couldn’t find a better instructor,” Yang said of Simmons.

“She’s knowledgeable and passionate. She couldn’t do this without her passion.”

Source: Star Tribune

By Karren L. Johnson

After a nearly 15-year journey — which included raising three children and working full time as a registered nurse -- Terra Brown of Susquehanna Township is just months away from completing her bachelor’s of science degree in nursing.

“It took a lot of hard work but it was worth it,” said the 42-year-old Brown, who works at Penn State Hershey Heart and Vascular Institute in Lower Paxton Township and entered the nursing field with an associate’s degree. “It feels good to know I improved both my knowledge and myself.”

Brown said she wants to teach other nurses and plans to go on to earn a master’s in nursing.

According to a recent survey by the American Association of Colleges of Nursing, Brown isn't alone in her pursuit to further her nursing education. The number of students enrolled in baccalaureate degree completion programs — also known as RN to BSN programs — increased by 13.4 percent from 2010 to 2011, the study found. Master’s programs reported a 7.6 percent jump in enrollments in 2011.

For current nurses and those looking to enter the field, the future looks bright. A 26 percent increase in the demand for new nurses is expected between 2010 and 2020, equating to 711,900 new jobs, according to the U.S. Bureau of Labor Statistics.

“A driving force behind this increase in BSN enrollment is the Institute of Medicine’s “The Future of Nursing” report that calls for the number of nurses who hold BSNs to increase to 80 percent by 2020,” said Betsy Snook, a registered nurse and the CEO of the Pennsylvania State Nursing Association.

“To meet this goal, which will help meet the needs of our growing population and more complex health care environment, there has been a trend among hospitals to require nurses to complete a BSN degree or higher,” Snook said.

While this goal does take a certain amount of initiative from nurses, it isn’t on them alone to achieve, Snook said. It also requires the support from employers and organizations such as PSNA, as well as education institutions, to help nurses achieve a higher level of education and training.

A choice to advance

Armed with a BSN from York College of Pennsylvania, Patricia Himes was excited to begin providing care to people. She joined the staff of a local hospital where she worked as a charge nurse for about six years. While she loved her job, she found herself curious about opportunities for growth.

“I’ve always had an urge to learn more and do more,” said Himes, who had heard there was a growing need for certified nurse practitioners.

As a result, she went back to school while working full time, receiving a master’s degree and her nurse practitioner training from Widener University’s Harrisburg campus.

“We are seeing a very large growth in nurses seeking advanced degrees, particularly as nurse practitioners,” said Geraldine M. Budd, assistant dean in Widener University School of Nursing’s Harrisburg campus. Budd said nurse practitioners provide most of the same services as physicians, making them especially important for practices and hospitals in disadvantaged areas without many physicians.

For now, Himes wants to just continue her overall growth and development while working for PinnacleHealth FamilyCare in Lower Paxton Township. But she said she definitely sees herself getting a doctor of nursing practice down in the future.

Nurses who do get additional training will find themselves in demand.

“With many of the highest trained nurses in the teaching arena reaching retirement age, there is also going to be a real need for qualified nurses to step into roles as nurse educators,” Budd adds.

Enhanced educational programs

Among the BSN to RN programs seeing a surge in enrollment is the one offered by Penn State Harrisburg. The school has seen enrollment increase by 25 percent between 2011 and 2012, said Melissa Snyder, coordinator for the nursing bachelor’s program.

“To best meet the needs of our students, we offer an evening format, a hybrid format, which is a combination of online and face-to-face classes and periodic all-day formats,” Snyder said. “We also ensure that nurses are graduating with solid skills in leadership, critical thinking and research, all things that employers are looking for.”

While enrollment in its BSN programs has increased, Penn State recently announced that it is phasing out all of its associate nursing programs and transitioning them to four-year baccalaureate programs, Snyder said.

Some community colleges are finding other ways to appeal to students who want more than an associate degree. For example, Harrisburg Area Community Collegerecently created a dual admission partnership with Millersville University to keep their graduates competitive and to provide a seamless transition into a bachelor’s program.

“We have always been very clear with our students that an associate degree is not an end point and we encourage they should seek further education,” said Ron Rebuck, director of nursing at HACC’s Harrisburg Campus. “The trend that I’m seeing is that by the time our nursing students graduate, a majority of them are already enrolled in a BSN program.”

Ever since Jeremy Whitmer graduated from high school just over 10 years ago, he has made it his personal mission to advance his nursing career. Despite being deployed to Iraq with the National Guard, he was still able to earn an associate’s degree, as well as a BSN degree thanks to HACC’s dual admission program.

“It was the perfect route for me because it provided a lot of flexibility,” said Whitmer, who is now working in Holy Spirit Hospital’s cardiovascular operating room. “I feel that having a BSN degree has given me many more leadership opportunities, as well as critical thinking and time management skills that I apply to my job every day.”

Support from employers

Having recently applied for magnet status, a designation awarded by the American Nurses Association that denotes nursing excellence, Holy Spirit Health System takes pride in being in full support of helping its nurses reach a higher level of education, said Brenda Brown, director of human resources.

“We know there are a lot of great nurses coming out of associate programs,” Brown said. “When we see such a nurse who exemplifies our values, we will support them in completing their BSN within four years of their hire.”

In addition, Holy Spirit offers a tuition reimbursement and an RN scholarship program, as well as an education loan repayment program. It also pays for all certifications. Currently, 42 percent of the hospital’s nurses either have bachelor’s or master’s degrees in nursing, she said. There are currently 88 nurses enrolled in bachelor’s programs and 27 are working toward their master’s in nursing, she said.

Sherry Kwater, chief nursing officer for the Penn State Milton S. Hershey Medical Center, said 57 percent of the center’s more than 1,800 nurses have a BSN. She said many have advanced their education while working at the center, which is a magnet facility.

“At Penn State Hershey Medical Center, we have so many specialty patients who require nurses with a body of knowledge around that patient population,” Kwater said. “Education is our mission here, so we migrate towards hiring nurses who are educators or specialists with a focus in a specific area. This also helps raise the skill of the bedside nurse.”

 Himes, the nurse with PinnacleHealth, credits the support from her coworkers for enabling her to grow and gain increased confidence in her field.

“The physicians are very supportive and very willing to teach me how to do things that I’ve never done before or that I’m insecure about,” she said. “I couldn’t be happier about my career path. It’s been a great testament of how the field of nursing is growing and that the opportunities are endless."

Source: The Patriot News

BY BLAIR KERKHOFF

By Max Fisher

Ethnicity, like race, is a social construct, but it’s still a construct with significant implications for the world. How people perceive ethnicity, both their own and that of others, can be tough to measure, particularly given that it’s so subjective. So how do you study it?

When five economists and social scientists set out to measure ethnic diversity for alandmark 2002 paper for the Harvard Institute of Economic Research, they started by comparing data from an array of different sources: national censuses, Encyclopedia Brittanica, the CIA, Minority Rights Group International and a 1998 study called “Ethnic Groups Worldwide.” They looked for consistence and inconsistence in the reports to determine what data set would be most reliable and complete. Because data sources such as censuses or surveys are self-reported – in other words, people are classified how they ask to be classified – the ethnic group data reflects how people see themselves, not how they’re categorized by outsiders. Those results measured 650 ethnic groups in 190 countries.

One thing the Harvard Institute authors did with all that data was measure it for what they call ethnic fractionalization. Another word for it might be diversity. They gauged this by asking an elegantly simple question: If you called up two people at random in a particular country and ask them their ethnicity, what are the odds that they would give different answers? The higher the odds, the more ethnically “fractionalized” or diverse the country.

I’ve mapped out the results above. The greener countries are more ethnically diverse and the orange countries more homogenous. There are a few trends you can see right away: countries in Europe and Northeast Asia tend to be the most homogenous, sub-Saharan African nations the most diverse. The Americas are generally somewhere in the middle. And richer countries appear more likely to be homogenous.

This map is particularly interesting viewed alongside data we examined yesterday on racial tolerance, as measured by the frequency with which people in certain countries said they would not want a neighbor from a different racial group.

Before we go any further, though, a few important caveats, all of which appear in the original research paper as well. Well, all except for the report’s age. It’s now 11 years old. And given the scarcity of information from some countries, some of the data are very old, dating from as far back as the early 1990s or even late 1980s. Conceptions of ethnicity can change over time; the authors note that this happened in Somalia, where the same people started self-identifying differently after war broke out. And so can the actual national make-ups themselves, due to immigration, conflict, demographic trends and other factors. It’s entirely possible, then, that some of these diversity “scores” would look different with present-day data.

Another caveat is that people in different countries might have different bars for what constitutes a distinct ethnicity. These data, then, could be said to measure the perception of ethnic diversity more than the diversity itself; given that ethnicity is a social construct, though those two metrics are not necessarily as distinct as one might think. Finally, as the paper notes, “It would be wrong to interpret our ethnicity variable as reflecting racial characteristics alone.” Ethnicity might partially coincide with race, but they’re not the same thing.

Now for the data itself. Here are a few observations and conclusions, a number of which draw from the Harvard Institute paper:

• African countries are the most diverse. Uganda has by far the highest ethnic diversity rating, according to the data, followed by Liberia. In fact, the world’s 20 most diverse countries are all African. There are likely many factors for this, although one might be the continent’s colonial legacy. Some European overlords engineered ethnic distinctions to help them secure power, most famously the Hutu-Tutsi division in Rwanda, and they’ve stuck. European powers also carved Africa up into territories and possessions, along lines with little respect for the actual people who lived there. When Europeans left, the borders stayed (that’s part of the African Union’s mandate), forcing different groups into the same national boxes.

• Japan and the Koreas are the most homogenous. Racial politics can be complicated and nasty in these countries, where nationalism and ethnicity have at times gone hand-in-hand, from Hirohito’s Japan to Kim Il Sung’s North Korea. The lack of diversity perhaps informs these politics, although it’s tough to say which caused which.

• European countries are ethnically homogenous. This is, to me, one of the most interesting trends in the data. A number of now-global ideas about the nation-state, about national identity as tied to ethnicity and about nationalism itself originally came from Europe. For centuries, Europe’s borders shifted widely and frequently, only relatively recently settling into what we see today, in which most large ethnic groups have a country of their own. That developed, painfully, over a very long time. And while there are still some exceptions – Belgium has ethnic Walloons and Dutch, for example – in most of Europe, ethnicity and nationality are pretty close to the same thing.

• The Americas are often diverse. From the United States through Central America down to Brazil, the “new world” countries, maybe in part because of their histories of relatively open immigration (and, in some cases, intermingling between natives and new arrivals) tend to be pretty diverse. The exception is South America’s “southern cone,” where Argentines and Chileans, many of whom originally come from the same handful of Western European countries, tend to be more homogenous. I was surprised to see Canada rate as more diverse than the United States or even Mexico; it’s possible that the survey counted Quebecois as ethnically distinct, although I can’t say for sure.

• Wide variation in the Middle East. The range of diversity from Morocco to Iran is a reminder that this part of the world is much less monolithic than we sometimes think. North African countries include large Berber minorities, for example, as well as some sub-Saharan ethnic groups, particularly in Libya. The diversity of Jordan and Syria are reminders of their internal complexity. Iran, with large Azeri, Kurdish and Arab populations, is one of the region’s most diverse.

• Diversity and conflict. Internal conflicts appear on first blush to be more common in greener countries, which might make some intuitive sense given that groups with comparable “stakes” in their country’s economics and politics might be more willing or able to compete, perhaps violently, over those resources. But there’s enough data here to draw a lot of different conclusions. One thing to keep in mind is that ethnicity might not be static or predetermined. In other words, as in the case of Somalia, maybe worsening economic conditions or war make people more likely to further divide along ethnic fractions.

• Diversity correlates with latitude and low GDP per capita. The report notes, “our measures of linguistic and ethnic fractionalization are highly correlated with latitude and GDP per capita. Therefore it is quite difficult to disentangle the effect of these three variables on the quality of government.” As above, keep in mind that correlation and causation aren’t the same thing.

• Strong democracy correlates with ethnic homogeneity. This does not mean that one necessarily causes the other; the correlation might be caused by some other factor or factors. But here’s the paper’s suggestion for why diversity might make democracy tougher in some cases:

The democracy index is inversely related to ethnic fractionalization (when latitude is not controlled for). This result is consistent with theory and evidence presented in Aghion, Alesina and Trebbi (2002). The idea is that in more fragmented societies a group imposes restrictions on political liberty to impose control on the other groups. In more homogeneous societies, it is easier to rule more democratically since conflicts are less intense.

Here’s the money quote on the potential political implications of ethnicity:

In general, it does not matter for our purposes whether ethnic differences reflect physical attributes of groups (skin color, facial features) or long-lasting social conventions (language, marriage within the group, cultural norms) or simple social definition (self-identification, identification by outsiders). When people persistently identify with a particular group, they form potential interest groups that can be manipulated by political leaders, who often choose to mobilize some coalition of ethnic groups (“us”) to the exclusion of others (“them”). Politicians also sometimes can mobilize support by singling out some groups for persecution, where hatred of the minority group is complementary to some policy the politician wishes to pursue.

Source: Washington Post 

By Jessica DuBois-Maahs

Diana Kamyk discusses the opportunities and challenges of her position as head of the U.S. diversity and inclusion program for Bayer Corp.

Diana Kamyk has dedicated her career to creating a diverse and inclusive work environment. As the head of the U.S. diversity and inclusion program for Bayer Corp., she makes it her mission to foster and facilitate a spirit of understanding within the workplace. The company has been recognized multiple times by Working Mother as a top company for working mothers while under Kamyk’s leadership. She oversees the diversity program at Bayer, of which the Women’s Leadership Initiative is a part. The Initiative aims to increase the number of female employees in managerial positions within the company. In addition, Kamyk helped found Bayer's Diversity Advisory Council, which facilitates and promotes diversity through various conferences and workshops.

How does Bayer's diverse workforce drive and promote innovation?
Through our U.S. Bayer Diversity Advisory Council, we incorporate diversity and inclusion initiatives — such as the Diversity Conference, Women’s Leadership networks and mentoring/coaching programs — into our business strategies and daily operations as a means to foster professional growth and to help build upon our culture. These efforts collectively help support the company’s belief that the more diverse the workforce, the more creative and innovative the results.

What are the goals of Bayer's various diverse employee networks?
Each network has between 50 and 450 members. Some develop new initiatives for their work locations, others get involved in job-related issues in science or the pharmaceutical industry. Their priorities range from doing voluntary work in schools, to promoting women in leadership positions, to offering a safe and inclusive workplace for homosexual, bisexual and transgender employees.

How does Bayer facilitate a work-life balance for moms?
The ProMoms professional network is a forum that allows working moms to learn from and provide support to each other. It creates awareness and understanding among all Bayer employees of the diverse roles of working moms and the contributions they offer to the workplace.

Bayer HealthCare in Berkeley, Calif., opened a new child care center in 2012 with space for 150 children, ages newborn through kindergarten. The child care center serves both children at Bayer and within the West Berkeley community. Bayer recognizes the importance of early childhood development. Therefore, providing an environment where a child can learn and develop to his or her full potential is critical in the maturation process and something that Bayer highly values.

What's the biggest challenge you face in your diversity role, and how do you overcome it?
With operations touching all corners of the globe, working with employees from varying cultures presents a wide range of challenges. Beliefs and priorities as they relate to diversity vary from country to country, so there is certainly a learning curve that we have to take into account as we work to implement unique programs — ones that are impactful and meaningful to employees — that support the foundation of diversity and inclusion across the globe.

Educating myself about each unique culture and understanding our specific employees, basically learning what works and what doesn’t work, has been invaluable for the creation of such plans. For anyone working at a global company, being able to think outside of your own borders and to understand other cultures is imperative to success.

Source: Diversity Executive

If you live a neighbourhood which is ethnically diverse, you're more likely to be healthier and less likely to experience racial discrimination, a new study has found.

Researchers at the University of Manchester say diversity is associated with higher social cohesion and a greater tolerance of each other's differences.

They also found that someone from an ethnic minority is less likely to report racial discrimination in an ethnically diverse neighbourhood.

And that a neighbourhood's high level of deprivation - rather than diversity - is linked with poor physical and mental health, low social cohesion and race discrimination.

The findings, based on analysis of census and survey data, will be presented tomorrow at a conference attended by the study researchers, policy makers and community organisations

Professor James Nazroo, director of the university's Centre on Dynamics of Ethnicity,said: "Our research and this conference is all about setting the record straight on those diverse neighbourhoods which are so widely stigmatised.

"So often we read in our newspapers and hear from our politicians that immigration and ethnic diversity adversely affect a neighbourhood, but careful research shows this to be wrong.

"In fact, the level of deprivation, not diversity, is the key factor that determines these quality of life factors for people in neighbourhoods.

"So our research demonstrates the disadvantages of living in deprived areas but the positives of living in ethnically diverse areas.

"It's deprivation which affects those Caribbean, Black African, Pakistani, and Bangladeshi people who are disproportionately represented in these neighbourhoods, as well as those white people who live alongside them."

Also according to the researchers, one in five (20%) people identified with an ethnic group other than White British in 2011 compared with 13% in 2001.

The ethnic minority populations of England and Wales lived in more mixed areas in 2011 and this mixing has accelerated over the past 10 years, says the study.

Traditional clusters of ethnic minority groups have grown but the rate of minority population growth is greatest outside these clusters with ethnic diversity spreading throughout the country.

Fellow researcher Dr Nissa Finney said: "Despite the clustering of ethnic minority people in some areas, the vast majority of ethnic minority people have a strong sense of belonging to Britain, feel part of Britain and feel that Britishness is compatible with other cultural or religious identities."

While colleague Dr Laia Becares said: "Increased diversity is beneficial for all ethnic groups so we say the policy agenda should develop strategies for inclusiveness rather than marginalising minority identities, religions and cultures.

"Policies aimed at reducing the stigmatisation of diverse neighbourhoods and promoting positive representations can only be a good thing."

The conference, entitled 'Diverse Neighbourhoods: Policy messages from The University of Manchester', will take place at Manchester Town Hall.

Source: UK Huffington Post