DiversityNursing Blog

By Christina Orlovsky

Ask a young girl what she wants to be when she grows up, and top answers are often a teacher or a nurse, which are professions that have been associated with women throughout history. Ask a young boy the same question and neither answer is likely to be given.

Ask Christopher Lance Coleman, PhD, MS, MPH, FAAN, and he’ll tell you that inequity has to change.

Coleman, an associate professor of nursing and multicultural diversity at the University of Pennsylvania School of Nursing in Philadelphia and the author of Man Up! A Practical Guide for Men in Nursing, is a strong advocate for recruiting males into the nursing workforce and empowering them to pursue leadership roles. His new book serves as a roadmap for men seeking to break into the predominantly female nursing profession.

“I believe men need a guide, a blueprint to use to navigate through the complexity of specialty choice and a culture where, frankly, a gender disparity still exists,” Coleman explains. “This is an opportunity of a lifetime for men not only to change the face of nursing in the 21st century, but also to reshape the public image that nursing is a women’s profession.”

In fact, while the most recent numbers show that men are still a clear minority in the nursing field, an uptick is occurring. According to a 2012 U.S. Census Bureau study, “Men in Nursing Occupations,” which presents data from the 2011 American Community Survey, the percentage of male nurses has more than tripled since 1970, from 2.7 percent to 9.6 percent. Of the 3.5 million employed nurses in 2011, 3.2 million were female and 330,000 were male. It’s a change, but, if you ask Coleman, it’s not enough.

“The startling thing is how underrepresented men still are in areas of leadership,” he says. “While the numbers of RNs has increased, when you look at the profession as a whole--heads of nursing, academia--we are still so far underrepresented. This is significant for males going through school looking for role models and seeing predominantly female leaders. I want men to know this is a viable profession and there are tremendous opportunities out there.”

Coleman believes the greatest opportunities for change are in younger men, who even at the high school level should do their research and start the conversation with their parents about the opportunities that exist for them in nursing. Ethnic minority groups, he adds, are particularly critical.

“Many ethnic minority groups, even today in 2013, still think of nursing as only a woman’s profession,” he says. “That racial disparity needs to be taken away.”

Coleman hopes that his book also opens up a dialogue among current male registered nurses. Empowering male RNs to continue to climb the ladder to leadership roles where they can influence change and serve as a new face of the nursing profession, he says, can encourage them to become the mentors male RNs need to help them succeed.

Another conversation that needs to occur in order to influence a culture shift is one between female nurses who may stereotype their male counterparts as only necessary for heavy lifting or things they “can’t” do.

“That’s a stereotype that hurts women and hurts the profession,” Coleman explains. “We don’t want nursing to be seen as a profession of the weak, we want it to be seen as a profession of the strong, because nurses are strong. We all need to do a better job of marketing ourselves--stop stereotyping and typecasting males and do more education in the hospital setting about gender diversity.”

Many men, after all, possess all the qualities required to be good nurses.

“Passion; someone with a tremendous amount of integrity; leadership skills; with a natural curiosity about the world; someone who is unafraid to take on issues that perhaps have challenged them in the past; someone who could treat someone at the end of the day how they want to be treated; and someone who cares to change the world we live in--those characteristics are essential and they transcend gender,” Coleman concludes. “Those are things I’d like to see in anyone who is interested in entering our noble profession.” 

© 2013. AMN Healthcare, Inc. All Rights Reserved. 

By Betty Reid

Source: NY Times

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