DiversityNursing Blog

Chief Nursing Officers have a wide variety of responsibilities. Their role has become more complex with the COVID-19 pandemic, social injustices, and systemic racism in the United States.

The pandemic is straining the healthcare profession. Nurses are under immense stress and Nursing leaders need to use best practices to address the mental and emotional trauma their teams are enduring.

In an article by HealthLeaders, Penn Medicine Princeton Health Chief Nursing Officer, Sheila Kempf, PhD, RN, NEA-BC said they are implementing many strategies to care for Nurses' mental health.

Some of those strategies include training staff to recognize the signs of being at high risk for emotional distress, and when peers should be referred to the Employee Assistance Program (EAP).

Also the hospital has contracted a trauma clinical Psychologist to talk with staff and run support groups with the EAP and the Ministries department.

CNO's should recommend frequent breaks or a quiet space for Nurses to retreat to.

Nurse leaders are also facing the challenges of short staffing, low resources, and supplies.

According to a survey by Inspire Nurse Leaders, 53% of Nurse Leaders reported difficulty meeting work and family needs due to inadequate staffing.

When there is a surge in Covid-19 hospitalizations, it forces hospitals to increase their number of beds. According to Ruth Risley-Gray, SVP and CNO at Aspirus Health Care, in order to meet high demands as they emerge, health systems shift Nurses between departments and facilities.

Risley-Gray also said, health systems need to hire outside help when Nurses become infected or get exposed to the virus. Aspirus is offering Nurses who have at least one year's experience a $15,000 signing bonus, as well as employing contract Nurses via private staffing companies.

2020 not only brought forth a pandemic, it also put a spotlight on systemic racism and racial health disparities.

Sharon Hampton, PhD, RN and Director of Clinical Operations at Stanford Health said, "We've discussed our ethical and moral responsibilities to deal with this crisis. Nursing is really in this position to help the public understand and to advocate."

Healthcare systems and Nurse leaders should be promoting diversity and inclusion at all levels of the workplace.

Kelly Hancock, RN, DNP and Executive CNO of the Cleveland Clinic Health System, said more diversity would help the Nursing workforce “provide more customized, culturally-sensitive and safer care” and “better assess, accommodate and cater to the healthcare needs of different minority groups.”

Those in leadership positions should reflect the diverse patient populations they serve.

According to HealthLeaders Media, a study by the Institute for Diversity and Health Equity found that racial minorities represented 32% of patients in hospitals that participated in the study, but similar representation wasn't found among the health care leadership. According to the study, 19% of first- and mid-level management positions, 14% of hospital board membership positions, and 11% of executive leadership positions were held by racial minorities.

Hospitals and health systems must commit to increasing diversity within their leadership to improve patient outcomes, reduce racial health disparities, and build stronger communities.

A 2021 list ranking the best-paying states for Nurses has been released by Business.org. They calculated this list by comparing the average Nursing salary to the average income to find the percentage difference. Then they calculated how many hours Nurses must work to afford rent.

Here are some key points from the report:

Over 2.9 million Nurses work in the United States, and make an average salary of $77,460 per year.

Nationally, Nurses make 45% more than the average salary for all other occupations. And in 15 states, Nurses make more than the national average. 

Hawaii topped the list, with Nurses making 89% more than other occupations for a total salary of $104,060.

Washington DC ranks last on the list. Nurses in DC make only 5.6% more than the average salary for all other occupations.

California boasts the highest wage per hour for Nurses, at $54.44. South Dakota has the lowest wage per hour for Nurses at $28.63.

Nationally, Nurses work an average of 29.5 hours to be able to afford a month’s rent. The national average income requires 42.7 hours of work to afford rent. 

Following Hawaii, the other top states for Nursing salaries are Nevada, California, Oregon, and New Mexico. 

To view the full list of best salaries by state, click this link.

According to a U.S. News & World report, Nurse Practitioners made a median salary of $109,820 in 2019. The best-paid 25 percent made $127,030 that year, while the lowest-paid 25 percent made $92,790. 

The best paying states for Nurse Practitioners: 

• California- $138,660

 

The need for in-home care has grown since COVID-19 because many fear contracting the virus in hospitals and clinics, especially among the elderly population.

With no security like hospitals usually have, home visiting Nurses put themselves at risk whenever they enter a patient's home alone. 

Ha Do Byon, Assistant Professor of Nursing at the University of Virginia School of Nursing mentions in a  STAT news article, "Even before the pandemic struck, I heard Nurses’ stories of home visits — some during my time as a visiting Nurse, and others as part of a study I am conducting to understand violence faced by home visiting Nurses. They told me about patients who blared pornography, or being groped while administering care. About patients who waved handguns and hurled racial insults. About being bitten, punched, kicked, or slapped. About dealing with screaming fits, intoxicated family members, and dogs that bit them or threatened to."

According to a 2015 study by BMC Public Health, the threat of workplace violence was one of home health workers’ top concerns, ranking above transportation issues or environmental hazards.

Developing a safety program for your home care workforce is crucial in reducing health care worker stress and turnover.

The rate of patient-on-Nurse violence among home visiting Nurses is unknown.

An article in Home Care Magazine states, only one-fifth of violent incidents “are ever reported in part due to embarrassment, organizational culture, tolerance or excusing the behavior of ‘ill’ clients." Nurses have cited fear of retribution from supervisors, the complexity of the legal system and disapproval from administrators as barriers to reporting workplace violence.

Nurses and providers can take measures to prevent violent situations.

We view Nurses and healthcare workers as heroes and we should appreciate the essential work that home visiting Nurses provide by making sure they can safely do their job and feel comfortable enough to notify management when they aren't safe.

The Foundation of the National Student Nurses’ Association is delighted to announce a new diversity scholarship award sponsored by Johnson & Johnson. Funding may be used for tuition, fees, and books. Use the same application to apply for all FNSNA scholarships. 

Students must complete the race/ethnicity question to qualify. There is $225,000 available. Awards up to $7,500.

Click here for more information: https://www.forevernursing.org/2021-online-scholarship-applicationinstructional-sheet.html

Click here for the application: https://app.mykaleidoscope.com/scholarship/fnsna2021

Deadline is February 15, 2021

 

The COVID-19 pandemic has brought forward many new innovations and ways of delivering healthcare. New technology will give healthcare workers new opportunities to keep their patients and themselves safe.

According to Accenture, the use of artificial intelligence within the healthcare industry is expected to grow rapidly at an annual rate of 40% through 2021 – to $6.6 Billion, from approximately $600 Million in 2014.

Keeping hospitals more sanitary is a top priority. Hospitals have started to use LightStrike robots from Xenex Disinfection Services to decontaminate rooms. Each robot can sanitize a space in as little as 10 to 15 minutes without human contact by deploying wavelengths of germ-killing UV rays.

Another tool that is great for sanitizing is RFID technology. RFID tools use wireless communication to identify and keep tabs on items such as scrubs and people like newborn babies. But now these tools can be used to ensure frequent and thorough hand-washing.

According to a HealthTech magazine article, by installing an RFID reader at a hand-washing station that can read badges or tags on healthcare workers’ uniforms, leadership teams can use that information to track when and how often employees are washing their hands.

We need to free up hands now more than ever. Voice assisted technology like Dragon Medical One, will help healthcare workers enter real-time data into electronic health records (EHRs) by simply talking with the patient.

According to Becker's Healthcare, Saykara also launched a new voice assistant that operates both ambiently and autonomously, so it can listen to and understand the context of a patient-physician conversation without being prompted by voice commands.

Healthcare workers need ways of collecting vital signs and other data points from remote locations since more people are relying on telemedicine.  Remote patient monitoring (RPM) tools such as internet-connected blood pressure cuffs, scales, IoT glucose meters, IoT thermometers, the Blood Oxygen sensor in the Apple Watch Series 6, and sleep monitoring devices can provide patient data remotely.

Mobile health is continuing to advance.  According to an article from arkenea, Apple has launched its open source software frameworks like Carekit and Researchkit which are great platforms for app developers to build healthcare based medical apps and contribute to medical research.

Healthcare technology is always evolving and advancing and will continue to revolutionize the way care is provided.

Nurses are a critical part of healthcare and make up the largest section of the health profession. According to The American Nurses Association (ANA), more Registered Nurse jobs will be available through 2022 than any other profession in the United States.

As predicted by health officials, the United States is seeing surges of Coronavirus cases from the holiday season. As health systems and hospitals deal with the surges, they are worried about finding enough medical workers to meet the demand.

“What we see now is just the beginning of the post-Thanksgiving peak,” said Eric Toner, senior scholar with the Johns Hopkins Center for Health Security. “It’s going to be huge, and it’s going to be awful.”

The problem is especially dire in intensive care units which are overcrowded with a record number of critically ill patients.

An article from the New Yorker stated, at least half of all states are now facing staff shortages, and more than a third of hospitals in states such as Arkansas, Missouri, New Mexico, and Wisconsin are simply running out of staff. Usually, an ICU Nurse might care for two critically ill patients at a time. Now, some are caring for as many as eight patients at once.

In some situations, patients have been transported hundreds of miles for an open bed. Some patients have been moved from Texas to Arizona as well as central Missouri to Iowa.

According to ABC News, hospitals in some states are enlisting retired Nurses and Nursing students. In Alabama, more than 120 students and faculty members from the University of Alabama at Birmingham’s Nursing school began helping with care last week at UAB Hospital.

In some states, health officers have amended orders that allow health care workers who tested positive for COVID-19, but are asymptomatic to continue working.

To free up healthcare workers, hospitals are asking medical and Nursing students, firefighters, and EMTs to administer Coronavirus vaccines.

According to Reuters, nearly 10 million doses have been delivered across the country, but only about 1 million administered due to staffing shortages at hospitals and the special requirements for preparing the shots.

Nancy Foster, the American Hospital Association’s vice president of quality and patient safety, said she’s heard from two dozen hospital leaders over the past two weeks, warning her of staffing shortages.

Travel Nurses are usually a good option to help fill open positions, but the pool of available travel Nurses is drying up as demand for them jumped 44% over the last month.

Dr. Mark Ghaly, California’s Health and Human Services secretary, said the state is “lucky to get two-thirds” of its requests for travel Nurses fulfilled right now.

The main hope here is for cases to decrease by people following COVID-19 guidelines such as quarantining and wearing masks.

Rebecca Moses, the fashion designer and artist painted 46 portraits of Mount Sinai's Nurses and named the exhibition “Thank You, Mount Sinai Nurses.”.

The large-scale portraits can be seen at Mount Sinai’s Guggenheim Pavilion on upper Fifth Avenue in Manhattan.

2020 is designated the Year of the Nurse and Midwife by the World Health Organization in honor of the 200th anniversary of the birth of Florence Nightingale.

“To have all of our Nurses traumatized in the Year of The Nurse and not do anything about it, it was literally keeping me up at night,” Linda Valentino, the Vice President and Chief Nursing officer at Mount Sinai Health System said.

Rebecca Moses, mostly known for her fantastical and fashionable drawings teamed up with Ms. Valentino and Linda Levy, the President of the Fragrance Foundation and came up with the idea for the art project.

The designer would paint the Nurses' portraits and donate the original artworks to the hospital to be featured in an exhibition. Each Nurse would also receive a print. Linda Levy would donate 5,000 fragrance and beauty products, all filed under self-care, to those whose job is to care for others.

 

 

After labor and delivery Nurse, Vanessa Joseph saw her portrait she said she was “blown away that someone paid attention to me and wanted to paint me. I’m just a Nurse.”

Joseph said, “Sometimes you feel like you’re in the trenches. We put on the full P.P.E. and no one can even recognize you anymore. I’m just trying to guess what Rebecca saw, and it’s so much life and vibrancy. It gives people hope that we’re going to get back to that again.”

Only women were chosen for this project, it's nothing personal against men. Moses simply stated “I don’t draw men. It’s not my strength. I love men, but I don’t draw them well.”

This is a thoughtful and remarkable collaboration to honor the Nurses at Mount Sinai. Nurses all over the world are going through an extremely challenging time. We applaud all efforts in recognizing the invaluable service, professionalism, and kindness all Nurses give every day. Thank you!

LGBTQ+ health is a growing national concern due to increasing evidence of health care disparities experienced by the LGBTQ+ community.

LGBTQ+ people face many barriers within health care, including discrimination, ignorance, and fear. So it can be difficult for these patients to confide in and trust healthcare providers. However, there are things that can be done to make patients feel more comfortable.

According to a Johns Hopkins Nursing article by Alex Nava, small but powerful expressions of affirmation and acceptance of support like wearing a rainbow pin, tells the patient that you see them and they are welcome there.

Increasing your knowledge of LGBTQ+ health can help you provide more culturally sensitive care. There is plenty of educational content out there like the field guide published by the Joint Commission called, Advancing Effective Communication, Cultural Competency and Patient and Family-Centered Care for the LGBTQ+ Community. Healthy People 2020 is another great resource to check out.

You should be aware of using terms correctly and avoiding others that may offend someone. DiversityNursing.com offers a great glossary of terms to help you!

According to Nurse.org, a LGBTQ+ patient may “scan” an environment to determine if it is a safe place to reveal personal information. To make patients feel more at ease, they recommend your reception or waiting room area include:

• A visible nondiscrimination policy
• A rainbow flag, pink triangle, or other symbols of inclusiveness
• Availability of unisex restrooms
• Health education literature with diverse images and inclusive language, including information about LGBTQ+ health
• Posters announcing days of observance such as World AIDS Day, Pride, and National Transgender Day of Remembrance

Your health organization should also use gender-inclusive medical forms.

You should ask the patient what pronouns they use. It is also important that you correct other staff members who may address the patient incorrectly, even when the patient isn't around.

Ask open-ended questions such as “Tell me about yourself? Are you involved in a relationship?” But don't assume anything, let the information they share guide the rest of your interview.

According to the Hospital for Special Surgery (HSS), you should be aware of issues particular to, or different for, the LGBTQ+ population such as:

• Coming out
• Having children—reproduction or adoption
• Parenting and creating families
• Adolescence
• Aging
• Legal rights as parents and partners

Patients often feel better talking to someone they can relate to. Hiring members of the LGBTQ+ community as part of your staff is great for patients and the organization. These team members can become mentors for others.

We as Nurses can help LGBTQ+ patients feel safe and supported by implementing these suggestions.

The 2020 Nurse Salary Research Report,  by Nurse.com and Relias, surveyed more than 7,400 Nursing professionals nationwide.

Relias Vice President of Marketplaces, Darius Matthews, said "We hope Nurses will use these survey results to examine their individual career paths and how they can make an even bigger impact — from caring for their patients to connecting with their families at home to expanding their educations and career horizons. For employers, this data is a valuable look into how they can create and support a more equitable environment for Nursing staff."

According to the report, men continue to make more than women despite male RNs reporting less education and being less likely to be certified. The median salary for all RNs in the sample is $73,000, with $80,000 for male RNs and $72,703 for female RNs.

The report also examined demographic data and found for Registered Nurses, 78% are white, 6% Hispanic, 9% Black, 5% Asian, 1% American Indian/Alaskan Native, 1% Native Hawaiian/Pacific Islander, and 1% Other.

Data shows the highest-earning RN roles and median salaries are:

• Executive- $150,000
• Vice President- $150,000
• Director- $105,000
• Nurse Manager- $92,000
• Assistant Nurse Manager- $90,000
• Supervisor- $79,000

Case Manager- $78,000

More than 38% of all Nurses surveyed are considering additional training and education. Cost, flexibility, and online options were the 3 most important factors when choosing a Nursing program.

Nurses with a Master's degree have an opportunity to earn more money in their careers. According to the US Bureau of Labor Statistics, the median pay for Masters educated Nurses is $115,800/year or $55.80/hour. 

Research shows, the salary of Registered Nurses has grown, on average, by 1.51%/year since 2010.

When discussing Nursing salaries, it is important to consider the state and city. Some locations pay more due to the cost of living in that area.

According to Becker’s Hospital Review, the top 5 states paying Registered Nurses the most are California, Hawaii, Massachusetts, Alaska and Oregon.

More Universities and Colleges have considered hiring Chief Health Officers (CHO) as the COVID-19 pandemic rages on. Some responsibilities of the CHO would be to lead campus health and safety measures, create connections with state and local hospitals, and be the voice of information to students, employees and parents.

Dr. Preeti Malani has been CHO at the University of Michigan since 2017 and is a great role model for someone who is considering taking on this position.

Dr. Malani has been highly visible throughout this outbreak, sharing safety tips on social media, appearing in a number of interviews, and participating on coronavirus task forces.

When a school feels strongly about a certain topic, they create an executive role around it, like a Chief Diversity Officer for example. Now, health is an imperative issue that should be properly addressed.

“The mere appointment of a CHO would send a strong message about the school’s commitment not only to the well being of its students, faculty, and staff but also to the health of the public at large,” said Malani.

After the pandemic passes, Malani hopes her visibility at the University of Michigan will help her make progress on other college health issues like vaccines, health-care equity and student mental health.

Dr. Benoit Dubé is the Chief Wellness Officer (CWO) at The University of Pennsylvania. He’s part of a Recovery Planning group tasked with examining the elements needed to be in place to allow a safe return to more normal campus operations.

Dr. Dubé explains the best approach for reducing COVID-19 transmission is to follow a hybrid in-person and online semester model. The University is also mandating the flu vaccine this fall.

Ohio State University’s CWO, Bernadette Melnyk developed several anxiety-reducing strategies to use to help manage and prevent the spread of this infectious disease. She created a webinar video Key Strategies for Relieving Anxiety During the COVID-19 Pandemic.

Melnyk also created the acronym COPE COVID:

Control the things that you can, not the things you can't
Open up and share your feelings
Practice daily stress reduction tactics, including physical activity
Engage in mindfulness; be here now; worry will not help!

Count your blessings daily
Overturn negative thoughts to positive
Volunteer to help others
Identify helpful supports and resources
Do your part to prevent spread of the virus

Schools that don't have the resources to bring on a CHO can try other options, like working with local and state health agencies, hiring a health consultant, and partnering with close institutions or academic medical centers.