DiversityNursing Blog

Cultural Diversity

The emergence of cultural diversity in today's society has impacted the inner-framework of the healthcare sector. By the year 2043, studies predict that the current ethnic and racial minority group populations will become the new majority. Diversity, Inclusion and Cultural Competence are topics that carry weight and emphasis in many aspects of the healthcare system. Efforts made to exercise inclusion and integrate cultural knowledge into professional environments have become integral in providing quality service to clientele. The practice of cultural awareness and competence in healthcare organizations leads to an encompassing sense of community and corporate respect of all cultures.

Benefiting Organizations

When there is a marked emphasis on cultural competence, diversity, and inclusion in an organization, a myriad of internal and external benefits result. Below is a list of benefits that organizations have experienced after putting pointed emphasis on supporting diversity. 

• An increase in recruitment of culturally diverse employees
• Better group process (an increase in creativity/communication)
• Reduction in costs
• Wide-spanning marketing

Employing Cultural Advocates

Caucasians fill the majority of Nursing roles in the healthcare system, with minority groups making up only about 19 percent of the Nursing field. As the number of culturally diverse patients increase in the United States, the need for a diverse culture of healthcare workers grows with it. Organizations that rally their employees and their core values around cultural awareness garner support from other organizations and appeal to diverse potential employees. They are showing the community, through practical application, how support of diversity plays an important role in the quality of care that is given and received by employees and clients.

If policies of inclusion are implemented effectively in healthcare, employees become a creative force in improving communication and conflict-resolution. Because the emphasis in inclusion is cohesion, the medical staff is taught the value of going beyond the confines of their own understanding. They gather information from other staff or diverse sources to supplement what they know with other perspectives and values. Nursing staff that exhibit characteristics of inclusion exude flexibility and model cultural competency. They become powerful advocates for respect of diversity in patient-care.

Cultural Competence

Healthcare leaders that emulate cultural competency focus on one key ingredient, respect. If leaders in healthcare teach by example and pass initiatives to support cultural integration, everyone benefits. By providing ample opportunities for cultural understanding to permeate healthcare, healthcare officials communicate respect for diverse groups of people.

We’ve developed a questionnaire to assist you in evaluating how your healthcare system is doing with regard to Diversity, Inclusion and Cultural Competence. Please take a few minutes to assess your strengths and weaknesses.

Many times, Nurses will choose to pursue a career in healthcare so that they will have the chance to spend their days helping others.  There is an added bonus though.  Many of the Nursing Specialties have a career trajectory of solid growth with a Nursing salary that is well above the income level of the median population.

Which one of the Nursing Specialties will give you the most job security though?  Which one has the highest salary?  The specialties listed below have been in demand the most and have the highest nursing salaries.

CRNA (Certified Registered Nurse Anesthetist)

Nursing Salary: $110,000 with 1,975 job postings annually.  This Nursing Specialty is the main provider for anesthesia in hospitals that have rural locations.  These Nurses assist in administering over 34 million anesthetics to various patients every year in the USA.

Pain Management Nurse

The average salary for this type of Nurse is right at $93,000 annually.  Each year there are around 871 job openings for Pain Management Nurses.  These Specialty Nurses work in tandem with other Nurses and doctors in order to treat patients who suffer from both chronic and acute pain.  They also have the responsibility of educating their patients so they can handle pain management in the future.

Geriatrics Nurse/Gerontology Nurse

The mean Nursing salary for a Geriatrics Nurse is $91,000 and annually there are close to 400 job openings across the US per year.  These Nurses can be the primary provider of health care for elderly patients in a variety of settings.  Their duties include exams and diagnosis to actually prescribing medications.  As the Baby Boomers age, this is an area where there is expected to be growth.

Family Nurse Practitioner

The mean salary for this Specialty Nurse is $88,000 annually and there are more than 7,000 job postings per year for this specialty.  These Nurses are like your family doctor.  They work with the same patients throughout their entire lives.  Many times, they will be the only health care professional for patients.  They conduct exams and can prescribe medications.

Psychiatric Nurse Practitioner

The salary for this type of Nurse is $86,000 annually and each year more than 4,500 job openings for this niche are posted.  This type of Nurse will treat, counsel and even medicate their patients who suffer from mental health issues.  They can work in quite a few different settings from private practices to correctional facilities and mental health clinics.

General Nurse Practitioner

The mean salary for a general Nurse Practitioner is $81,000 and there are more than 85,500 job postings for this specialty each year.  These Nurses are a critical element in regard to the health care industry and they are expected to fill the gap of primary care physicians in the years to come.  They are able to prescribe medicines and many times, they are the only health care professional that some people have.

Clinical Nurse Specialist

The Nursing salary for this specialty is $80,000 and each year there are nearly 7,000 job postings.  This type of Nurse focuses on a single area of expertise and they act as a sort of consultant to all of the rest of the Nurses on staff.  Their specialties can be anything from oncology to pediatrics and they also serve as coaches for both the staff and the patients.

Armed with this information, which one appeals to you?  If you are already on this list, would you switch to another specialty?  Which one and why?

Top 10 highest paying nursing specialties (national average)

More accurate due dates are something both mother and medical professionals want. But is it something possible to achieve? Ultrasound scans are helpful but they can only give an estimate date. 

Predicting when a woman is likely to give birth is an inexact science. It is also a question with important medical and personal implications. A meta-analysis published this week in BJOG: An International Journal of Obstetrics and Gynaecologysheds some welcome light on the subject.

Predicting exactly when a woman is likely to go into labor has always been challenging; only 5% of women go into labor on their exact due date. 

For about 90% of women who are overdue (a pregnancy lasting over 42 weeks), contractions begin on their own within 2 weeks of the due date. But the exact date within those 2 weeks is frustratingly difficult to predict.

Of course, most women do not know the exact date the baby was conceived, and as such, any due date given can only be an estimate. 

Currently, the best methods for predicting the date of a child's birth are either by using the last menstrual period as a starting point, or by measuring the fetus size with an ultrasound scan. Neither of these methods are without some measure of inaccuracy.

An analysis carried out by Dr. Vincenzo Berghella, at Thomas Jefferson University Hospital and the Sidney Kimmel Medical College at Thomas Jefferson University, hopes to paint a slightly more accurate picture.

There are a number of reasons why people desire a more accurate prediction for their due date. As Berghella explains:

"Women always ask for a better sense of their delivery date in order to help them prepare for work leave, or to make contingency plans for sibling-care during labor. These are plans which help reduce a woman's anxiety about the onset of labor."

On top of these more logistical issues, there are very real health concerns, too:

"Women with a higher risk of stillbirth may be better off receiving a labor induction if the cervix is still long at her due date, since the chances of timely spontaneous birth are low, for example."

Cervix measurement of more or less than 30 mm is key

Currently, cervical length is measured in women who are considered at risk of a premature birth. The shorter the cervix, the more imminent the birth will be. This method of transvaginal ultrasound is considered a gold standard for predicting early births. 

During pregnancy, the cervix hardens in order to keep the fetus from dropping into the birth canal. As the due date draws near, the cervix softens. This softening causes the cone shape of the cervix to shorten and flatten, which can be used as a signal that the birth is imminent.

This precision has led a number of researchers to investigate a link between cervical length and birth at term - the hope being that if it can predict an early birth, it might have the same use for longer pregnancies.

These studies matching cervical length after 40 weeks of pregnancy, to date, have been inconclusive and sparked lively debate in the field.

Berghella has reopened this line of investigation and scooped together data from five different studies; the data included 735 women with single-child pregnancies who had babies in the standard head-down position.

This increase in data has given the research team a new and improved overview of the field of study and garnered some interesting results:

The researchers found that when the cervix measured more than 30 mm at a woman's due date, she had less than a 50% chance of delivering within 7 days. However, when the cervix measures 10 mm or less, women had more than an 85% chance of delivering within 7 days.

The results of the study give a glimmer of hope to mothers who are facing an uncertain stretch of time before they give birth. Further study in the area and its consequent analysis will help solidify these findings.

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Giving birth at home is cheaper than at hospitals, study says, but is it safe?

Nurses have heard it before, "Can you not talk about gross stuff at the dinner table?" But Nurses can't help it when the most disgusting things are completely normal in their everyday lives. They become desensitized to topics like body fluids, infections, and smells and sounds.

Being a nurse involves seeing, hearing, smelling, touching and dealing with some of life’s not-so-pleasant things. Nurses face it all from the most gross to the most stunning situations that would make the normal person squirm or run. They build up an immunity to it, but it’s still something that can make them very weary. Yet, they never stop a beat of helping the patients that they have been trained to see through it all.

“We see it all,” says Barb Gallogly. She is senior lecturer and coordinator for Post Baccalaureate Nursing Program at Henry Predolin School of Nursing at Edgewood College, Madison, Wis.

“We are the eyes of the physician, and the ears of the respiratory therapist. We are in a position of privilege to be with the patients on a minute-to-minute basis. People trust us, and people open up to us,” she says.

And those patients trust them not to run away when things go from bad to worse or when they need them the most.

Things that nurses face that make them unique, strong and oftentimes – saints

Body Fluids: It’s not pretty. “But sometimes some of us still gag at vomit and other things that come out of bodies,” says Kristin Gundt, chief nursing officer at Community Hospital in Grand Junction, Colo. “It all depends on how much you are exposed to it, but that doesn’t mean you have to like it. We all have triggers that makes our own bodies react to it.”

Gallogly agrees that there are still things that make her gag. “But you have to rise above it, and work with it, and not to let your own personal feelings or reactions get in the way of good patient care,” she says. “A nurse must remain respectful of the patient and be calm when all hell breaks loose.”

Infections: In Gallogly’s office hangs a lithograph with a person who has germs all around and the words, “Please Wash Your Hands” stamped on it.

“I’m a germaphobe. As a new nursing grad, we didn’t wear gloves or masks back then. We never thought anything about it,” she says. “But now, there is anti-bacterial gel at every entrance – gel in and gel out. That’s hammered into our students now.”

She sees a lot of infected wounds, and a lot of people put into isolation because of infections. “Universal precautions don’t cut it anymore,” she says.

Smells and Sounds: Sometimes when someone else is vomiting, the sound itself can set nurses off with their own gagging reflex. “Or sometimes you hear someone with diarrhea and the gas with it, and it can set something off in you, too,” Gundt says. “But we try to hide our reaction for the patient’s sake.”

She adds that one of the hardest smells to stomach is when a patient is bleeding from their intestines or stomach. “You might have to excuse yourself if you are going to gag or throw up. You don’t want to make the patient feel like even the nurses can’t tolerate it,” she says. “But it smells so bad.”

Death: “We don’t know what death will be like from one person to the next. It can be smooth to really traumatic to really messy. It can be awful,” says Gundt.

One time comes to mind for her when she was a home health care nurse. The elderly lady had a relative come during the last stages of her death. The relative was panicking because she didn’t understand death and all the things that happen when the body shuts down.

“People are incontinent. They can’t hold their bowels. Nothing in them is awake anymore,” she says. “So, I kept her clean, changed her and turned her, and made sure she got pain meds. I stayed with her and the relative. It’s the people that are alive that are panicking. People are scared to be alone with the person who is dying.”

Chaos: “Most people’s jobs aren’t like this,” Gallogly says. “You learn really quickly to become a great multi-tasker and set priorities all the time. You usually have three or four things coming at you. You learn to delegate to others that can help you.”

Some days, it will be overwhelming. You leave work thinking that you didn’t do a good job. “With budget cuts, nurses are expected to do a lot more with less. It’s hard to give quality nursing care, and we want to take care of that whole person, but so much is coming at us. That’s frustrating,” she says.

Dynamics of Families: “We don’t just take care of the person, but the whole person which includes the family,” Gallogly states. “If the family is demonstrating behavior that are precluding progress or treatment for the patient, then we pull them aside. You never know what is going on with them. We don’t know their histories. There is usually a reason for their behavior.”

She says it’s easy to label people as the “crazy daughter” or “hysterical mother.” But that doesn’t solve any problems or help anyone. “We try to explore those dynamics and include them in what we are doing with the patient,” she adds.

Ill Treatment: When people are sick, their behaviors aren’t necessarily their norm. “They lash out at us, hit us, spit on us and swear at us. There is a lot of physical and emotional abuse,” says Gundt. “Sometimes, it’s very unexpected. You never think some of these people will strike out at you because they seem stable as can be.”

Gundt adds that nurses try very hard to not put themselves in a situation to be hit or hurt. “If it’s a family member that we feel is being obnoxious, abusive or unrealistic, we won’t hesitate to escort them out or get someone to do so,” she says. “But we will start with way less restrictive methods. We try to keep people on our good side.”

Nursing isn’t all roses and sunshine. But most people understand that when they go into the profession. It’s not easy. It’s not always pretty. But for those who choose it, they say they do it because they want to help people. They want to educate people to live healthier, happier lives no matter what squeamish  circumstances they have to confront.

If you feel like talking about all that gross stuff with people who completely understand, click below!

According to projections from the Bureau of Labor Statistics by 2022 there will be an increase in the number of Registered Nurses of 526,800. That is over half a million! This means lots of nursing jobs for the near future– definitely a career with good prospects. If you are curious about RN salaries this infographic will be helpful.

It is clear that digital technology has a firm grasp on our lives and is advancing daily. We walk around with a computer in our pocket (cellphones) full of endless amounts of information. This technology has changed the way we provide healthcare and with this change there are pros and cons. Specifically, Electronic Health Records (EHRs) or Electronic Medical Records (EMRs). 

An Electronic Health Record according to CMS.gov, is an electronic version of a patient's medical history. It is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that person's care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates access to information and has the potential to streamline the clinician's workflow. The EHR also has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based decision support, quality management, and outcomes reporting.

Pros

EHRs will save you space and paper. Administrative duties in health systems represent a significant amount of time and costs. Staff can spend a good portion of the workday filling out and processing forms. Because they are paperless, EHRs streamline a number of routine tasks. With less paperwork taking up space there will be less clutter and more room to be efficient.

Patient’s medical files will all be consistent. The medical staff can interact easily with affiliated hospitals, clinics, labs and pharmacies about the patient’s medical history. All of the patient’s files are updated when something is entered or changed in the system. This way the patient’s information is always up to date, leaving less room for errors or miscommunication.

Easy access to all clinical data. Staff can quickly transfer patient data to other departments or providers, while also reducing errors, which yield improved results management. Patients and employees often respond positively to this because it helps keep a health system’s schedule on track.

Cons

Privacy is a major concern when it comes to electronic health records. Using EHR software could put your organization at risk if you don’t follow privacy settings correctly. Paper records also make it easy to violate a patient’s privacy but, electronic records are convenient and timely which makes it easier to violate the patient’s privacy. A common privacy concern is identity theft.

Another disadvantage is data loss. A computer crash could wipe out vital data that you’ve been accumulating over the years. Always have a backup plan. This is imperative.  Many systems backup their data through a cloud program. So if there is an unfortunate event and your system crashes, you will still be able to access the data from the cloud.”

There are high costs involved with implementing an EHR to your system and many smaller health systems might not be able to afford it. The American Action Forum says, “Implementing an EMR system could cost a single physician approximately $163,765. As of May 2015, the Centers for Medicare and Medicaid Services (CMS) had paid more than $30 billion in financial incentives to more than 468,000 Medicare and Medicaid providers for implementing EMR systems. With a majority of Americans now having at least one if not multiple EMRs generated on their behalf, data breaches and security threats are becoming more common and are estimated by the American Action Forum (AAF) to have cost the healthcare industry as much as $50.6 billion since 2009.”

Do you work in a health system that uses Electronic Health Records? If so, how do you feel about them? We want your honest opinion, the good, the bad and the ugly.

It's officially Autumn season and we are sadly saying goodbye to our Summer sandals and pulling out clothes to keep us warm. If you're going to miss Summer like us, hopefully taking a look back at our hottest blogs of the season will help ease the pain. 

1. 14yr old African American Develop A New Surgical Technique To Sew Up Hysterectomy Patients

This incredible young man, Tony Hansberry II, is a 14-year-old student who used an endo stitch in a way no one has ever done before and the results are a game changer.

2. Study Confirms What We Knew All Along: Nurses Are Key to Hospital Success

We all know and love Nurses, but isn’t it wonderful when a research study validates something you already know? We think you’ll enjoy this article.

 3. 5 Things Labor Nurses Want You To Know

 
"As a labor and delivery nurse, here is what I wish I could say to every mother out there, what I'm sure many of us would want to say to the families we care for..."

4. Nurse Practitioners More In Demand Than Most Physicians

 It comes as no surprise that primary care doctors are, and have always been, highest in demand. However, recent data shows that this paradigm is shifting.

5. Empty Pill Bottles Desperately Needed (Take your meds & help others!)

In other parts of the world patients are handed their pills and must use whatever they have to keep the medication safe. In three easy steps you can make a difference for those patients. 

Diversity and Inclusion should be a top priority at Hospitals and Health Systems across the country. Why? Because your workforce should reflect your patient population. Your patients may come from your local communities. Others may have traveled from another country to have access to the specific illnesses you are noted for treating. It is imperative that your Nursing and medical team is culturally sensitive to their patients in order to provide the best care possible. Different cultures have different customs including: mannerisms such as not looking you in the eye; family members in attendance around the clock; the way  they dress; language/communication; the food they eat;  etc.

Understanding Diversity and Inclusion helps your team provide culturally responsive care. It also enhances the quality of life for your team. If your Nursing team is culturally aware, your patients and their families will be more comfortable and trusting of your hospital and staff. This makes the entire hospital experience a more positive experience for the patient, which in turn makes a smoother work environment. Imagine becoming ill and hospitalized in another country that doesn’t speak your language and doesn’t understand your subtle cultural differences. You’d most likely be scared and do whatever possible to get home immediately to a hospital where you feel safe and comfortable communicating with your medical team. A hospital you trust.

Hospitals and Health Systems use all types of approaches to monitor and educate their staff about Diversity and Inclusion. Many have Chief Diversity Officers or programs in place to educate and enhance this important factor of health care. Diversity can foster and drive excellence in patient care, research, and education. Here’s what some Hospitals and Health Systems are doing to improve Diversity and Inclusion in the workplace.

Chief Diversity Officers

The Chief Diversity Officer at the AAMC (Association of American Medical Colleges), Marc Nivet, Ed.D., defines a CDO’s role “It’s using the concept of diversity and inclusion to promote a stronger, better organization. Before, it was primarily about representational diversity, focusing on bringing in diverse faces. That remains critically important, but now we also are thinking about how to make use of that diversity to improve health.”

If your organization doesn’t have a Diversity and Inclusion Initiative, do they need one? Nivet goes on to say, “There are still some doubters who do not see the value of a diversity initiative. They don’t see the microinequities of how staff or patients are treated. The pressure is on the CDO to illuminate those inequities, bring them to the surface, and encourage conversations about them.”

Leadership Programs

Boston Children’s Hospital provides leadership development programs for professionals of color. One of their programs is called Conexión. “Conexión was created to advance Latino leadership to meet the changing needs in business, education, and government organizations in an increasingly culturally complex world.”

The Partnership Program is another great opportunity Boston Children’s Hospital provides. The Partnership’s mission is to “develop professionals of color, increase their representation in Boston area businesses and institutions, enhance opportunities for advancement and influence, and thereby extend the region’s economic competitiveness. The Partnership program consists of two levels depending on experience.”

Diversity and Inclusion Team

Yale-New Haven Hospital has a 16 person team dedicated to carrying out their Diversity and Inclusion initiatives. The initiative is based on 6 key factors.

• Recruiting a diverse workforce that is sensitive to and inclusive of people's differences
• Providing an excellent patient experience by understanding patient diversity and the needs of the many different people the hospital serves
• Working with a wide variety of groups and individuals in the community to improve people's health and access to care
• Ensuring the hospital is the employer of choice by creating an environment that encourages the talents and recognizes the uniqueness of each employee
• Supporting the hospital's efforts to use diverse vendors and suppliers
• Educating staff on working with diverse team members and caring for diverse patient populations

Do you have Diversity and Inclusion initiatives in place at your organization? Does your workforce reflect you patient population? Feel free to contact us below to learn more about addressing some of these very important issues!

You don't know when an emergency is going to happen. You don't know if the emergency is going to happen to you. But you can prepare for a medical emergency by downloading the Apple Health app and creating a Medical ID. 

People should keep their information and medical history with them in case they cannot communicate during an emergency. We aren't saying you should carry your entire medical file to the grocery store. But what if we asked you to carry your smart phone?

Some people wear their information on jewelry like bracelets or dog tags. Other people have it written down and kept in their wallet. Now most people have a smart phone and can download apps like the Apple Health app. 

This health app allows you to store and update all your important medical information. Information including your name, date of birth, medical conditions, medical notes, allergies and reactions, medications, emergency contacts, blood type, organ donor status, weight, height, and photo can all be stored and accessed from a touch of a button on your lock screen.

Here's how to access Medical ID on a locked iPhone:

1. Swipe to unlock.

2. Tap Emergency.

3. Tap Medical ID, on the emergency call screen.

Here's how to insert your information in the app:

1. From the iPhone home screen, choose the “Health” application. It is the white app with a pink heart in the top right corner.

2. You will notice a “Medical ID” option in the tool bar along the bottom of the screen.

3. An option to “Create Medical ID” will appear and display a screen with fields for you to enter your information.

As a patient, it can save your life. For medical professionals, try to make it a habit to always check a  patient's phone for a Medical ID. It could help you save their life.

Related Article:

How Health Apps Will Change Nursing

By Sara Seng via www.bartonassociates.com 

The telemedicine market isn't only effecting physicians and other healthcare professionals. Telemedicine has potentially great benefits for patients too. For example, regular office visit expenses will reduce and patients who have a difficult time traveling to appointments, don't have to worry about it anymore.

As the telemedicine market is expected to reach $34 billion by 2020, its impact in the healthcare industry is endless. Telemedicine refers to the use of telecommunication and information technologies in order to provide clinical health care at a distance. From reduced transportation expenses to increased cost efficiency, healthcare organizations are constantly searching for more ways to provide quality care and communication between providers and their patients.

However, do people ultimately trust telemedicine?

TechnologyAdvice recently conducted a nationwide survey of 504 U.S. adults to investigate the way people feel about telemedicine and its services. The infographic below highlights their findings.