DiversityNursing Blog

As a medical professional, you are all too aware of the use of antibiotics and how effective they are for treating a myriad of infections. They have helped relieve countless maladies for people all over the world. We want to share this article with you and we welcome your thoughts and experiences about what’s happening regarding antibiotics not working for some of your patients.

In early April, experts at a military lab outside Washington intensified their search for evidence that a dangerous new biological threat had penetrated the nation’s borders.

They didn’t have to hunt long before they found it.

On May 18, a team working at the Walter Reed Army Institute of Research here had its first look at a sample of the bacterium Escherichia coli, taken from a 49-year-old woman in Pennsylvania. She had a urinary tract infection with a disconcerting knack for surviving the assaults of antibiotic medications. Her sample was one of six from across the country delivered to the lab of microbiologist Patrick McGann.

Within hours, a preliminary analysis deepened concern at the lab. Over the next several days, more sophisticated genetic sleuthing confirmed McGann’s worst fears.

There, in the bacterium’s DNA, was a gene dubbed mcr-1. Its presence made the pathogen impervious to the venerable antibiotic colistin.

"We’re seeing more drug-resistant infections. And people will die."

More ominously, the gene’s presence on a plasmid — a tiny mobile loop of DNA that can be readily snapped off and attached to other bacteria — suggested that it could readily jump to other E. coli bacteria, or to entirely different forms of disease-causing organisms. That would make them impervious to colistin as well.

It was a milestone public health officials have been anticipating for years. In a steady march, disease-causing microbes have evolved ways to evade the bulwark of medications used to treat bacterial infections. For a variety of those illnesses, only colistin continued to work every time. Now this last line of defense had been breached as well.

A second U.S. case of E. coli with the mcr-1 resistance gene was reported this week in the journal Antimicrobial Agents and Chemotherapy. Researchers are still working to determine whether it, or any of 18 other samples from around the world, contained the gene on an easy-to-spread plasmid.

Related Article: Kids Prescribed Antibiotics Twice As Often As Needed, Study Finds

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We know you are dedicated, kind, thoughtful, generous, patient, gracious and the list goes on-and-on about how wonderful Nurses are every day. We couldn’t get through our mental, physical and even spiritual problems without you by our sides. Here’s a story about a Nurse who went beyond the call of duty, as many of you do, in a very personal and life-giving way. Let us know your thoughts.

A young nurse recently saved the life of a total stranger by donating one of her kidneys.

In giving her kidney, Kate Burris, 27, Scottsdale, became the first altruistic kidney donor at Dignity Health St. Joseph's Hospital and Medical Center and part of a small, but growing number of people in the U.S. who give one of their kidneys to a stranger.

Jim Ensslin, 56, Peoria, received Burris' life-saving gift and was the 10th patient in St. Joseph's kidney transplant program, which received CMS accreditation in December.

"I just thought, I don't need this kidney. Somebody else does," Burris said.

After the March 22 surgery, Burris told Lisa Scharnow, RN, kidney transplant coordinator at St. Joseph's, that she wanted to meet the recipient of her kidney. Ensslin agreed, and the two met four days later, as Burris was leaving the hospital.

There was an "immediate connection," said Ensslin, who has lived with kidney disease for 17 years. "Kate's gift was the greatest gift ever. It will allow me to have a regular life, to keep going and not be sick the rest of my life."

Burris, too, was deeply touched by their meeting.

"I'm just so happy to see him doing well," she said. "It's not just him I'm helping. I'm helping his wife, his mom, his kids. I didn't realize how many people I was helping. It's an awesome feeling. I would donate again if I could."

Giving a kidney to a stranger was virtually unheard of 20 years ago when transplant centers worried about donors' motivation, emotional and mental health, and medical risks. Today, health care professionals realize that for some people donating a kidney gives the same kind of personal satisfaction that donating blood or giving to charity does.

In 2014, there were 17,107 kidney transplants in the United States, 11,570 from deceased donors and 5,537 from living donors, like Burris. Of the living donors, 181 designated their kidney to go to a stranger, 3.2 percent of all living donations that year, compared to 1.1 percent in 2001.

Burris, who is a nurse and a blood donor, said she first became interested in altruistic kidney donation while watching an old episode of Grey's Anatomy.

"As I was watching it, I wondered, 'Why couldn't I do this?'" After hours of research, Burris said, "I couldn't find any reason not to donate. The risks to me were so minimal that I felt the benefits outweighed the risks."

At St. Joseph's, Burris underwent a series of screenings to assess her physical, emotional and psychosocial health.

"We wanted to understand what was driving her desire to donate," said Scharnow. "We wanted to make sure she was in a good place to make such a profound decision."

Burris and Ensslin have both returned to work.

Ensslin, who said he has much more energy now, has multiple business trips scheduled in the next few weeks.

"Donors like Kate are important to the future of organ donation," said Dr. Jeffrey Brink, Ensslin's transplant surgeon. "There are far too few kidneys for the current need."

Summer is all about fun! Everyone should enjoy their time over the next few months, but please take a minute to be aware and safe while youdo. Consider water, sun and mosquito safety as well as preventing injuries in all of your warm weather activities. Here’s some information to help you and your loved ones have the best summer ever!

Master water safety

Water-related activities are popular for getting physical activity and have many health benefits. Here are some tips to stay safe while having fun.

• Learn how to prevent recreational water illnessesand help protect yourself and your kids.
• Help kids get H2O Smartz about water safety.

Drownings are the leading cause of injury death for young children ages 1 to 4, and three children die every day as a result of drowning.

• Always supervise children when in or around water. A responsible adult should constantly watch young children.
• Teach kids to swim. Formal swimming lessons can protect young children from drowning.
• Learn cardiopulmonary resuscitation (CPR). Your CPR skills could save someone’s life.
• Install a four-sided fence around home pools.

Recreational boating can be a wonderful way to spend time with family and friends. Make boating safety a priority.

• Wear a properly fitted life jacket every time you and your loved ones are on the water.

Beat the heat and sun

Heat-related illness happens when the body’s temperature control system is overloaded. Infants and children up to 4 years of age are at greatest risk. Even young and healthy people can get sick from the heat if they participate in strenuous physical activities during hot weather. For heat-related illness, the best defense is prevention.

• Never leave infants, children, or pets in a parked car, even if the windows are cracked open.
• Dress infants and children in loose, lightweight, light-colored clothing.
• Schedule outdoor activities carefully, for morning and evening hours.
• Stay cool with cool showers or baths.
• Seek medical care immediate if your child has symptoms of heat-related illness.

Just a few serious sunburns can increase you and your child's risk of skin cancer later in life. Their skin needs protection from the sun's harmful ultraviolet (UV) rays whenever they're outdoors.

• Cover up. Clothing that covers your and your child's skin helps protect against UV rays.
• Use sunscreen with at least SPF (sun protection factor) 15 and UVA (ultraviolet A) and UVB (ultraviolet B) protection every time you and your child go outside.

Keep mosquitos and ticks from bugging you this summer

Protect yourself and your family by preventing bites and diseases, like Zika,  West Nile virus and Lyme disease, which can be transmitted by insects.

• Use an effective insect repellent while playing outdoors.
• Make your backyard a tick-safe zone.
• Check yourself and your children for ticks. Ticks are easy to remove.

Prevent Injuries

Each year in the United States, emergency departments treat more than 200,000 children ages 14 and younger for playground-related injuries. Falls at home and on the playground are a common cause of injury.

• Check to make sure that the surfaces under playground equipment are safe, soft, and well-maintained.
• Supervise young children at all times around fall hazards, such as stairs and playground equipment.
• Use stair gates, which can help keep a busy, active child from taking a dangerous tumble.

A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can occur in any sport or recreation activity.

• Learn concussion signs and symptoms and what to do if a concussion occurs.
• Make sure kids and teens wear the right protective equipment for their sport or recreation activity.

Parents can take many actions to protect their children's health and safety at home.

• Stay smart around the house by following tips on fire prevention, microwave use, and living with pets.
• Learn healthy home tips for each room in the house.

Young workers have high job injury rates. Hazards in the workplace, inexperience, and lack of safety training may increase injury risks for young workers.

• Know their rights, employer and teen worker responsibilities, and what teens under 18 can’t do.

Stop the violence

• Kids can use electronic media to embarrass, harass, or threaten their peers. Take steps to prevent electronic aggression, a term that captures all types of violence that occur electronically.
• As teens develop emotionally, they are heavily influenced by their relationship experiences, including teen dating. Protect your children from teen dating violence. Nearly one in 10 teens reports having been hit or physically hurt on purpose by a boyfriend or girlfriend at least once over a year’s time.

Children playing in sprinklers. A fun activity in the summer months. What could go wrong? Read on and find out.

An Arizona mother wants to warn other parents after her 9-month-old boy was accidentally sprayed with scalding hot water coming from the garden hose, causing second-degree burns to about 30 percent of his body.

Dominique Woodger said she was about to fill a little pool with water on Monday, as she normally does. When she turned on the faucet, the extremely hot water came out of the sprinkler head attached to the hose, getting all over her baby who was sitting on the ground.

"I thought he was crying because he was mad, because he hates when he gets sprayed in the face. I didn't think that it was burning him,” Woodger told ABC News.

Woodger said doctors say her baby will be okay, but she doesn't want other parents or children to experience the same pain.

"It's heartbreaking. It is. It sucks," Woodger said. "All of it was peeling. He had blisters all over the right side."

Parents, please remember to always touch the water from the hose before you spray it on your child.

Related Articles:  Practice safety around lakes, swimming pools

Ahhhh… don’t you love summer? On this 1^st day of summer, we think it’s wise to post this article about safety around water. Whether it’s a pool, the ocean, a lake, pond or any body of water, safety is a must. As a mother and lap swimmer, I had my son in the pool at our local Y when he was an infant. Swimming lessons followed soon after. It’s extremely important you know how to swim for safety reasons because you never know when you’ll be in a life or death situation around water. As a Nurse, you’ve unfortunately seen situations with tragic outcomes.

While many parents worry about their children’s safety around swimming pools, as they should and need to do, drowning incidents can also occur in natural bodies of water, says information from the U.S. Swim School Association.

Safety precautions need to be taken around all water environments. According to the Center for Disease Control, about half of all drowning incidents occur in natural water settings such as lakes, rivers or oceans. And, almost 75 percent of people killed in boating accidents die as a result of drowning.

As the summer boating season begins, there are steps parents can be taking to keep their children safer in the water. The U.S. Swim School Association has put together the following guidelines to help keep children safe while boating this summer.

• Make sure your children know how to properly wear a lifejacket. And always have children under 12 wear a life jacket at all times when boating or using personal watercraft.

• Personal floatation devices should always be U.S. Coast Guard approved. Never substitute water wings or other recreational type floating toys for an approved PFD.

• Create a water safety plan for your family and have water emergency drills with your children covering how to recognize the signs of someone struggling in water and what to do in this type of emergency.

• Teach your children the “throw don’t go” rescue method. Instead of entering the water to help a struggling person, teach your child to throw in a rope, reach with a stick, paddle or other object to pull the person in.

• If you take your kids on a shore excursion while boating, be aware of tides and currents and other risks the ocean or beach may have.

• Non-motorized boats can also pose a risk. If your family is canoeing or kayaking be sure your child is wearing a life jacket and knows what to do if the boat flips.

• If your child is playing near a natural body of water and accidentally falls in, teach your child to roll over on his or her back and float until help arrives if exiting the water is not an option.

• Never use floatation devices or water wings to keep your child safe in the water. Rely on your direct supervision.

Swimming lessons are a great addition to help keep your child safer while boating and around open water. For more information about swimming lessons and water safety and to find a Unites States Swim School Association member swim school near you, visit usswimschools.org.

1. Nurses, Make Time For Stress Relief

   
   

2. The Importance of Humor in Nursing
   
   

3. Diversity In The Nursing Field
   
   
   

4. Homeless Veteran Became VA Nurse To Help Others
   
   

5. Important Questions Regarding Your Diversity, Inclusion and Cultural Proficiency

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As we are all still grieving the horrific shootings in Orlando, this article points out the hospitals and medical teams who took care of the victims. As staff called co-workers at home and asked them to come in and help with the overwhelming number of patients coming in to the emergency room, the response was “I’ll be right there”. We know our Nurses across the country would respond the same way.

Things started out fairly well, by a busy emergency room’s standards. The Orlando Regional Medical Center had been warned that gunshot victims would be arriving from a nearby gay nightclub, and the first one was conscious, talking and medically stable.

“We didn’t know exactly how many we were going to get,” Dr. Kathryn Bondani recalled Tuesday. “We thought maybe they’re all gonna be like this, and that would be great.”

But then another victim from the mass shooting early Sunday at the Pulse nightclub arrived, and another, and another, in critical condition with devastating injuries. Four or five of the earliest patients died. And then victims kept coming – not always arriving in ambulances, but sometimes in the backs of trucks, sometimes seemingly just appearing in the halls of the hospital, awaiting treatment.

Gunshot victims aren’t an unusual sight at the 75-bed facility in downtown Orlando, nor are they for any trauma center handling the daily chaos of a major American city.

ut on Tuesday, staff at the hospital described what it was like to confront the aftermath of the deadliest mass shooting in modern American history, with one staffer likening it to a “war scene.” Forty-nine victims were killed.

Nine of those victims died “in the first few minutes” after arriving at the Orlando Regional Medical Center, which received 44 victims from the shooting, according to Dr. Michael Cheatham, the hospital’s chief surgeon. 

Six of the 27 victims still being treated at the hospital Tuesday were in critical condition, and doctors warned that some may die. Twelve victims were also treated at Florida Hospital in Orlando, where six remained in fair condition.

The victims arrived at Orlando Regional Medical Center in two waves over the course of Sunday morning. There was an initial batch of almost two dozen who arrived shortly after shooting began at 2 a.m. A second group arrived after police confronted and killed the gunman.

Some of the wounds were small, looking like they were from the shooter’s handgun; others were much larger, probably from the shooter’s .223-caliber semiautomatic rifle, according to Joseph Ibrahim, the center’s trauma director.

Some victims looked like they’d been shot from close range. Some looked like they’d been shot while running away. One victim had 11 gunshot wounds; another had four surgeries after arriving Sunday, doctors said. Many of those who died suffered head wounds, they said.

One of the victims taken to the hospital was clubgoer Angel Colon, who was shot three times in the left leg as he ran away from the gunman, and then was trampled by other club patrons trying to escape.

Speaking at Tuesday’s news conference, Colon said his left leg was “shattered” and he couldn’t run, so he lay down and played dead as the gunman began “shooting everyone that’s already dead on the floor.”

“I can just see him shooting at everyone, I can hear the [shots getting] closer, and I look over and he shoots the girl next to me,” Colon said.

“I’m next – I’m dead,” he recalled thinking as the gunman approached.

The gunman shot him in the hip and hand and moved on as Colon tried to show no reaction.

Soon the police arrived, and Colon said he could hear officers trading gunfire with the assailant. Colon saw an officer, and the officer grabbed his hand, saying, “This is the only way I can take you out.” He then dragged Colon out – as broken glass cut Colon’s back and his legs.

“I don’t feel pain, but I just feel all this blood on me, from myself, from my other people,” Colon said. “He just drops me off across the street” – outside a Wendy’s  restaurant -- “and I look over, and there’s just bodies everywhere, we’re all in pain.” There, an ambulance took Colon to the safety, and the chaos, of the Orlando Regional Medical Center.

he hospital normally gets alerts from a “very advanced” emergency medical service system that lets hospital workers know when certain patients are headed their way, said Medical Director Gary Parrish. This time, “there was really no advance notice at all.”

As more patients arrived, the on-duty staff began calling more doctors, and more nurses and other staffers, who answered their phones in the middle of the night with a common answer: “I’ll be right there,” according to surgical intensive-care unit director Chadwick Smith.

An army of nurses arrived – dozens who were supposed to be off-duty – along with X-ray and blood technicians as doctors set up a triage to treat the most gravely injured patients, said Bondani. Workers speedily cleaned up operating rooms after the end of one surgery so doctors could immediately begin another. Coordinators responded immediately whenever supplies ran low.

The scene was emotional, with “people in pain, people worrying about their loved ones, people not knowing where their loved ones are,” said Smith.

But doctors said that despite the chaos, the hospital’s emergency plan worked smoothly and efficiently. Aside from the initial patients who died immediately after the shooting, no one else at the hospital had died in the 48 hours since the attack, doctors said.

Smith got emotional at Tuesday’s news conference as he talked about watching hospital staffers arrive in tears to do their jobs.

“It was singularly the worst day of my career, and the best day of my career,” Smith told reporters. “I would think this is probably the same for every person you see standing up here.”

In honor of LGBTQ – Pride Month, this article touches upon the struggles this community deals with in their personal and professional lives. We all know how important support is from family and friends particularly for teenagers who are questioning who they are attracted to and sometimes, their sexual identity.

As Nurses dealing with the public all the time, this article talks about the importance of listening, accepting and guiding your family, friends and patients to the right resources. We hope you find it helpful.

While LGBTQ people have enjoyed the benefits of more acceptance from society, LGBT youth remain vulnerable to suicide, homelessness and negative health outcomes. This is largely due to their lack of acceptance from their parent or guardians. In our own practice and in numerous studies, it has been proven that more than anything else, the love and support from parents and families are critical to the health and success of LGBTQ youth.

One of the most tragic cases we have seen was Manuel’s (names and other identifying details have been changed), a 16-year-old Puerto Rican teen who was raised in the South Bronx by his mother. All his life he was taught by his family, culture and society that his future would be defined by a wife and kids, by his ability to support his own family and become the “man” of his house. However, while everyone was telling him who and what he should be doing, he had already started to dream of a very different life. From an early age, he knew he was attracted to men – but he kept his feelings buried for fear his family would disown him if they found out or that his sexuality would bring shame to his family. 

One day, his mother went through his cell phone and found text messages from his "best friend" describing how in love they were. His mother put all of her son’s belongings into garbage bags, put them on the curb and told him, “never come back until you like girls!” Manuel became homeless at 16, and with nowhere else to go, he began exchanging sex for money to live. Three years later, he was diagnosed with HIV. When he finally got help, he told his social worker he had two wishes: “That I had been born straight so none of this would have happened, and that my mother believed that I didn’t choose to be this way.”

Now meet Wanda, a 15-year-old African American teen born and raised in Brooklyn by two parents who were actively involved in their church. Every Sunday after church, Wanda and her parents had dinner together and used the time as an informal family meeting where everyone was encouraged to talk openly about their week. While she was sometimes attracted to boys, there was a girl on Wanda’s soccer team that she couldn’t stop thinking about. She tried to ignore her feelings for this girl and put more energy into dating a boy in her class who liked her a lot. One day after church, Wanda’s mother asked her how serious she was about the boy she was dating. 

Wanda shrugged that it wasn’t serious, but then she built up the courage to ask her parents: “What would happen if I liked girls, too?” Her parents sat in silence for a few seconds before her father replied, “We would love you no matter who you like.” “Of course we will always love you,” Wanda’s mother said, “but are you sure about this? This is very new for me, so you’re going to have to help us understand this.” 

How do you think you would react if your child told you they were LGBTQ? Parents play an extremely important positive or negative role in the lives of their children, especially when children are becoming aware of who they are attracted to or love (sexual orientation) or if they feel themselves to be a male, female or somewhere in between (gender identity). In fact research shows that children whose parents belittle or shame them are more likely to suffer from depression, attempt suicide and have poorer health than children whose parents are supportive. 

While you might be afraid that talking about LGBTQ issues with your child will encourage them to be gay or transgender, who they are or who they love is inherent to each person and emerges over time. The best thing for you to do is talk openly and love unconditionally. Don’t be hurt if your child discloses their feelings to someone else first. Most children who are exploring their sexual orientation or gender identity tell a friend, family member or health/mental health professional before they tell their parents because they would rather know for sure before they risk telling their parents. 

As a parent, you can emphasize that there's no risk in talking about these things, because you will love your child regardless of their sexual orientation or gender identity – and that you're there for them when they are ready to talk. Being LGBTQ no longer means your child will automatically get HIV or will have a limited life. With pills to prevent HIV and the full range of family options (including marriage) increasingly available to LGBTQ youth, your support is crucial in supporting and accepting your child to emerge as a healthy teen and adult who can achieve their full potential.

While it can be difficult for young people and their families to speak about issues like sex, sexuality and sexual orientation, you are not alone. Many resources exist, such as PFLAG.org (Parents and Friends of Lesbians and Gays), GLSEN.org (Gay, Lesbian and Straight Education Network), Family Acceptance Project (FAP.org) and our program, adolescentaids.org, which provides care for LGBTQ youth as well as HIV care and prevention services. If you know or think your child is LGBTQ, we hope you will use this year’s Pride Month as an opportunity to proudly celebrate your child and help them navigate this wonderful and challenging time known as adolescence.

Related Article: LGBT People In Rural Areas Struggle To Find Good Medical Care