DiversityNursing Blog

Patients with Intellectual or Developmental Disabilities (IDDs) have unique needs. It is important Nurses know how to properly provide  care, and make health care more accessible for this population.

An IDD, includes many severe, chronic conditions that are due to mental and/or physical impairments. It usually lasts throughout a person's lifetime. People who have IDDs have problems with major life activities such as:

• Language
• Mobility
• Learning
• Self-help
• Independent living
  
  

According to the Association of American Medical Colleges (AAMC), IDDs encompass hundreds of diagnoses — autism, cerebral palsy, and Down syndrome among them — that affect about 6.5 million people in the United States.

Research suggests that the attitudes of health care professionals are among the biggest barriers to people with IDDs receiving equitable access to services.

Nurses must provide care that enables people with complex care needs and difficulty with cognitive functioning to live fully with as much physical, emotional, social, and spiritual well-being as possible.

Here are some helpful guidelines for treating patients with mental and/or physical disabilities. 

• Speak directly with the patient, not to any companion that the patient may have.

A career as a Nurse Case Manager gives you the opportunity to make a huge impact on patient's lives and develop rewarding relationships.

The Case Manager's (CM) role is centered around working with patients and their families to make sure they are provided with appropriate health care providers, resources, and services so they receive the proper care they need. 

Primary responsibilities include:

• Evaluating a patient's medical history

• Acting as a liaison between patients, health care providers, and health insurers

• Creating care plans and scheduling appointments

• Educating patients and their families on relevant health-related matters

• Keeping track of health outcomes and suggesting possible treatment changes

“Because Nurses are trained to work on interdisciplinary teams and understand how to deal with patients’ psychosocial needs, they are the perfect choice to manage their care,” says Tracy Towne, PhD, faculty member at Purdue University Global School of Nursing. “It’s a more holistic approach to care and services, and it is an incredibly valuable role when it comes to supporting those with chronic illnesses.”

You’ll also be able to choose which area you would like to specialize. According to Western Governors University, some of the most common Case Management Nursing specializations are:

• Patient specialty—focuses on a specific patient population such as the elderly (geriatrics) or children (pediatrics).
• Service specialty—focuses on a specific service area such as hospice, home healthcare, or rehabilitation.
• Duration specialty—focuses on the length of patient care such as short-term injury rehabilitation or long-term illness management.
• Disease specialty—focuses on patients suffering from a specific disease or chronic illness such as diabetes, cancer, substance abuse, or mental illness.

Choosing to become a CM is a great choice for Nurses, since it is less physically demanding, has great pay, and is in high demand. 

According to Zippia, CMs in the Nursing field are expected to rise nearly 16% over the next ten years. This increase is due to the growing elderly population as well as a rise in those with chronic illnesses. 

The estimated average salary for a RN Case Manager is $107,568 per year in the United States, according to Glassdoor.

Becoming a Nurse CM requires a Registered Nurse (RN) license. It is more common to switch to case management later on in your RN career.

This role requires experience so it is suggested you advance your career with certification programs. Certifications aren't mandatory for employment, but they can increase your pay and make you more eligible for future job opportunities.

Interested in learning more about Case Management? Check out these resources:

Case Management Society of America

National Association of Case Management

American Case Management Association

The Higher Education Case Managers Association

If you're interested in joining the Nursing field, or changing your Nursing Specialty, you'll want to learn more about which Specialty is the right fit for you.

Looking to make a difference in the lives of infants and their families? Neonatal Nursing may be the perfect career choice.

Every year, 10 to 15 percent of babies born in the United States (roughly half a million) are admitted to the Neonatal Intensive Care Unit (NICU). 

According to the American Academy of Pediatrics (AAP), there are 4 Neonatal care levels

Level I: Well Newborn Nursery

Level I facilities provide a basic level of care to neonates who are low risk. They have the capability to perform neonatal resuscitation at every delivery and to evaluate and provide routine postnatal care for healthy newborn infants. In addition, they can care for preterm infants at 35 to 37 weeks’ gestation who are physiologically stable and can stabilize newborn infants who are less than 35 weeks of gestation or who are ill until they can be transferred to a facility at which specialty neonatal care is provided.

Level II: Special Care Nursery

Care in a specialty-level facility (level II) should be reserved for stable or moderately ill newborn infants who are born at ≥32 weeks’ gestation or who weigh ≥1500 g at birth with problems that are expected to resolve rapidly and who would not be anticipated to need subspecialty-level services on an urgent basis.

These nurseries may provide assisted ventilation on an interim basis until the infant’s condition either soon improves or the infant can be transferred to a higher-level facility.

Level III: Neonatal Intensive Care Unit (NICU)

Evidence suggests that infants who are born at <32 weeks’ gestation, weigh <1500 g at birth, or have medical or surgical conditions, regardless of gestational age, should be cared for at a level III facility.

Level III NICUs are defined by having continuously available personnel (Neonatologists, Neonatal Nurses, Respiratory Therapists) and equipment to provide life support for as long as necessary.

These units should have the capability to perform major surgery on site or at a closely related institution, ideally in close geographic proximity.

Level IV: Regional Neonatal Intensive Care Unit (Regional NICU)

Level IV units include the capabilities of level III with additional capabilities and considerable experience in the care of the most complex and critically ill newborn infants and should have pediatric medical and pediatric surgical specialty consultants continuously available 24 hours a day. These facilities would also include the capability for surgical repair of complex conditions.

Nurses working in the NICU have a wide variety of responsibilities. Some of these duties include:

• performing tests to evaluate any problems

• monitoring infant health such as vital signs

• documenting patient history

• creating care plans with other healthcare providers

• administering treatments and medications

• educating new parents on how to care for their baby

• providing comfort to concerned parents and family members
  
  

If you're interested in becoming a Neonatal Nurse you must start by earning a Bachelor of Science in Nursing (BSN) and obtaining your RN license. Then you need to gain clinical experience in Pediatric and Neonatal settings.

Many Nurses may go on to get specific certifications and trainings to help advance their careers. Some of the certifications available to NICU Nurses include:

• Critical Care Neonatal Nursing Certification
• Certification for Neonatal Intensive Care Nursing
• Certification in Low Risk Neonatal Intensive Care Nursing
• Neonatal Neuro-Intensive Care Certification
• Care of the Extremely Low Birth Weight Neonate Subspecialty Certification

• Certification in Maternal Newborn Nursing

According to Salary.com, the average salary for a NICU Nurse is $82,269 per Year in the United States. The five highest paying states are: Alaska, California, District of Columbia, New Jersey, and Massachusetts.

It takes a person with a very big heart to care for such small patients. If caring for newborns and their families is important to you, this rewarding career could be the perfect fit.

Since 1975, the National Association of Hispanic Nurses (NAHN) has been the Nation’s leading professional society for Latino Nurses.

According to Nurse.com, data from a NAHN report finds that although Hispanics make up 17% of the total population, only 3.5% out of the more than three million Registered Nurses in the U.S. are Hispanic.

NAHN's goal is to advance health in Hispanic communities and to lead, promote and advocate for educational, professional, and leadership opportunities for Hispanic Nurses. 

Dr. Ildaura Murillo-Rohde, an active member of the American Nurse Association (ANA) founded NAHN in 1975 after concerns the ANA was not meeting the needs of Latino Nurses.

Ildaura's vision was to assist Latinas in securing their education to provide service to their community and in helping themselves. 

Last September, during National Hispanic Heritage Month, Google honored pioneering Hispanic Nurse Dr. Murillo-Rohde with a Google Doodle illustration created by guest artist Loris Lora. 

"Hispanic Heritage Month to me is about celebrating our culture and recognizing the contributions of those who continue to inspire future generations. I enjoy learning about minority women who were trailblazers of their time and helped create opportunities for women who came after them," Lora said. "My sister recently became a Nurse and I found it interesting to learn about Dr. Murillo-Rohde and the things she stood for and achieved during her lifetime."

The association is continuing to grow with more than 40 local chapters across the nation. 

These chapters address the largest healthcare challenges facing Latinos. Members uniquely understand the challenges in providing better healthcare to America’s fastest growing segment of the population -- the Latino community. The NAHN Organization:

• Connects culturally competent healthcare professionals to Hispanic health issues
• Projects a unified voice for Hispanic health issues
• Concentrates efforts to target disease states and decrease health disparities among Latinos
• Raises awareness and support for effective health policy and programs
• Promotes the Nursing profession to increase engagement, retention and prepare Nurses to lead change
• Expands awareness and reach through the implementation of community programs
• Enhances cultural competence to improve Latino patient care

From the federal to the state level, NAHN is the voice of over 276,000 Hispanic Nurses across the United States.

In May, Dr. Adrianna Nava, President of NAHN, represented these Nurses by attending a roundtable at the White House with Nurses from across the country who work in various specialties. 

According to the White House briefing, participants discussed the devastating impact the pandemic has had on Nurses and other health care workers, as well as patients, families, and communities.  They underscored the importance of addressing the pandemic-related burnout, advancing gender equity in health care, including through supporting women’s health care, and tackling the national mental health crisis.  Participants also highlighted the need to sustainably grow and support the Nursing workforce.

NAHN welcomes opportunities to work with organizations that seek to expand access to health services, improve health inequities, increase the Latinx/Hispanic Nursing workforce, participate in policymaking at the local, state and national levels and endorse policies that promote and improve health for all.

To learn more about NAHN and all of the great work they do, visit their website at https://www.nahnnet.org 

Each year, somewhere between 700,000 and 1,000,000 people in the United States fall in hospitals. 

Falls can have a major impact on a patient's health which usually results in high costs and extra days in the hospital.

The average medical cost for each patient fall is $10,220, or $10 billion annually.

Palarum’s PUP (Patient is UP) “smart” socks could help decrease patient falls. 

These smart socks are wired with sensors that sends an automatic alert to the three closest Nurses, via smart badges, when a patient tries to get up from a hospital bed and puts pressure on the socks. 

A group of Nurses at Ohio State University Wexner Medical Center (OSUWMC) conducted a 13-month study with 569 people who were at high risk for falling.

Results from the study show there were 4999 Smart Socks alarms, but none of the patients fell. They observed a lower fall rate, of 0 per 1000 patient-days, for patients wearing Smart Socks than the historical fall rate of 4 per 1000 patient-days. The median Nurse response time was 24 seconds.

"While further study is needed, I do believe there is an opportunity for these socks to be used in inpatient hospital settings, Nursing homes and rehab facilities," said Tammy Moore, PhD, RN, senior study author and Associate Chief Nurse of Ohio State’s Neurological Institute.

“Due to the rapidly aging population, the number of patients at higher risk of falling in hospitals is expected to increase substantially. About 30% of in-hospital falls are thought to be preventable, so it’s imperative to determine better ways to keep our patients safe from falling while hospitalized,” said study co-author Tina Bodine, a Nurse Navigator at Ohio State’s Neurological Institute. 

According to Scrubsmag.com, the sensors on the socks last about five to seven days before they need to be charged. Once the patient has been discharged from the hospital, the sensors are removed, cleaned and charged. The socks are laundered with the rest of the hospital’s linens.

Patrick Baker is the founder and CEO of Palarum. He is a retired Lieutenant Colonel who spent 25 years in the U.S. Air Force, has worked in hospitals for more than 30 years, most recently as Vice President of Patient Care Services and Chief Nursing Officer with the University of Cincinnati Health System.

Baker said "Everybody already gets a sock when you go to a hospital. Why not have it be a smart sock that can help keep our patients safer?"

The U.S. Department of Veteran Affairs (VA) and Palarum previously came together to evaluate Palarum's innovative e-wearable technology.  

"As a healthcare professional and retired Lt. Col USAF, I am especially proud to be partnering with the VA Palo Alto Health Care System to demonstrate the benefits of the PUP sock technology and its ability to reduce patient falls thereby increasing the safety of our hospitalized Veterans," said Baker.

Hospitals are hiring or accepting volunteer teens and young adults as a long-term strategy to help combat shortages in the healthcare industry. 

Research shows, exposure to various healthcare fields is crucial to the development of career interests for adolescents and young adults. 

Earn while you learn programs give high school students the opportunity to gain knowledge in the field and make a better wage than the average part time jobs students often take.

These programs offer roles such as:

• Food Services
• Transportation
• Manage Gift Shop
• Medical Library
• Patient Support
• Environmental Services
• Administrative Support
• Translator

According to Becker's Hospital Review, Mount Carmel launched its inaugural patient-facing role for those 16 and older: a student support associate position.

Student support associates work as part of the care team, with a multi-skilled technician. The younger workers can help with tasks such as bathing patients, taking patients' vital signs and restocking equipment. 

"We did elect to have specific criteria that students coming to us are actively enrolled in a Nursing program or a pre-Nursing program throughout their high school [career], so that we are really looking to support and foster their interest in long-term career growth and positioning them well to continue to work for us after they graduate from high school and ultimately matriculate into a Nursing program or another allied health program," Mount Carmel Regional Director of Talent Acquisition Rachel Barb told Becker's.

Volunteer programs help plant the seed and further educational opportunities for young adults.

Inova Fairfax Hospital in Virginia offers a volunteer Summer program where teens get to learn about different positions in the hospital and get hands-on experience at the hospital’s simulation lab.

Dr. Steve Narang, President of Inova Fairfax Medical Campus says to volunteers, "We are taking care of human beings, and this is just a gateway whether you want to be an accountant, whether you want to be in security, whether you want to be in IT or whether you want to be at the bedside. There’s a job for you in healthcare.”

Abrazo West Campus Hospital in Arizona hosts a volunteer program with interactive workshops.

“In those workshops, they have someone’s undivided attention, so they have a surgeon, a specialist, a radiologist that’s up there, and they tell them everything from A to Z, salary, challenges, rewards, education, the best career paths to take,” said Barry Worman, Director of Volunteer Services.

Certified Nurse Midwives (CNMs) are becoming more common for women and mothers across the nation.

Overall employment of Nurse Midwives is projected to grow 45% from 2020 to 2030, much faster than the average for all occupations.

If you're interested in this career path,  it's beneficial to understand what CNMs do and their role in health care.

Nurse Midwives are primary health care providers for women of all ages and provide all types of gynecological, prenatal, and post-pregnancy care.

According to Mayo Clinic College of Medicine and Science, common tasks and duties include:

• Confirming and dating pregnancy
• Providing prenatal and postpartum care
• Caring for women during childbirth including monitoring the mother and fetus during labor, assessing labor progress, managing complications, assisting with pain management, performing episiotomies if needed, and delivering the newborn and placenta
• Providing education for new parents on infant care
• Supporting new mothers that are breastfeeding with education and training
• Preparing pregnant women for what to expect during the birthing process
• Performing preventive health screenings and tests
• Diagnosing and treating gynecological disorders such as sexually transmitted diseases and infertility

There are many different paths in the Midwifery field. According to Western Governors University, various roles include:

• CNM: Certified Nurse-Midwives are Registered Nurses who have additional certification as a Midwife. That double licensure gives them additional opportunity and training in the medical field. Specific Midwifery education is the same for a CNM and CM.

• CM: A Certified Midwife is someone who is certified as a Midwife, but doesn’t have a Registered Nursing license as well. The certification is identical for a CM and CNM, the only difference is the Registered Nursing license.

• CPM: A Certified Professional Midwife is certified and must have particular experience in home-birth or out-of-hospital settings. The certification requirements are much less than that of a CM or CNM. A Midwifery program may still be involved, but often it is less detailed and intense.

• Doula: Doulas are not maternity care providers, but provide informational and emotional support for a mother during childbirth. Doulas provide services to mothers while they are pregnant, during their labor and delivery, as well as after the baby is born. Some Doulas work directly for birth centers or hospitals, while others are hired directly by expecting mothers. Because Doulas don’t provide medical support, there aren’t direct legal requirements regarding their practice. Some doulas get formal training, though it’s not required.

The average CNM salary in the United States is $116,574, as reported by Salary.com.

If you’re truly interested in becoming a Nurse Midwife, start with your BSN then find a Nursing school like Frontier Nursing University (FNU) to help get you started on your journey.

FNU graduates make up nearly 40% of the nation's Midwives!  

Diversity, Equity, and Inclusion (DEI) in the workplace is beneficial for employers, staff, and patients. More hospitals and health systems are recognizing the importance and are rolling out new DEI programs. 

Diversity is the range of human differences, including but not limited to race, ethnicity, gender, gender identity, sexual orientation, age, social class, physical ability or attributes, religious or ethical values system, national origin, and political beliefs.

Equity recognizes that each person has different circumstances and allocates the exact resources and opportunities needed to reach an equal outcome.

Inclusion is an organizational effort and practice in which different groups or individuals having different backgrounds are culturally and socially accepted and welcomed.

The United States will continue to grow more diverse, so it is imperative the Nursing workforce reflects its patient demographic. 

Historically underrepresented groups, combined, are projected to account for the majority of the U.S. population by 2044.

The Nurse.com 2022 Nurse Salary Research Report findings display a lack of Diversity in the nation's Nursing workforce. 

The report found that although Hispanics make up 17% of the total population, only 3.5% out of the more than three million Registered Nurses in the U.S. are Hispanic.

Also only 2% of the survey’s respondents were Black or African American men, whereas Black or African American women made up 8% of female Nurses. By contrast, Asian men made up 10% of male Nurses, and Asian women made up only 5% of female Nurses.

Having a diverse Nurse population improves patient care and satisfaction while also reducing healthcare disparities. 

Research shows, when patients see themselves within the healthcare workforce, they are more likely to trust their provider, thus making the patient feel more comfortable. 

This also breaks down communication barriers. When patients can't easily communicate their needs or fully express their concerns and issues, dire mistakes can be made.

When a Nurse has a lot in common with their patients, they can better advocate for them. 

“Diversity in Nursing ultimately enhances the Nursing workforce,” says Lorrie Davis-Dick, Nursing faculty member at Purdue University Global. “Nursing education and Nurse leaders recognize there's a link between a culturally diverse workforce and the ability to provide quality, competent patient care."

DEI is beneficial for patients, but also for healthcare professionals. 

According to Built In, Diversity creates a stronger feeling of Inclusion and community for healthcare workers, which makes the workplace feel safer and more enjoyable. Surveys show that more than 3 out of 4 workers prefer diverse companies.

While Diversity is important, Diversity without Equity and Inclusion won't work. Healthcare teams must represent all backgrounds, while also giving each member a voice and the opportunities to grow.  

Increasing Diversity in Healthcare is vital. It won't happen overnight, but it's crucial to create an environment where everyone is celebrated and appreciated. It requires dedicated leadership and staff who are looking to better the Nursing field.

While physical health is undoubtedly important, so is Mental Health. Millions of Americans are affected by mental illness each year. Psychiatric Nurses have the specialized knowledge and skills needed to treat these illnesses. 

According to the American Psychiatric Nurses Association (APNA), Psychiatric Nurses make up the second largest group of behavioral health professionals in the U.S.

In the United States, suicide is a leading cause of death and in 2020, about:

• 1 in 5 American adults experienced a Mental Health issue
• 1 in 6 young people experienced a major depressive episode
• 1 in 20 Americans lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression

The pandemic has increased the need for Mental Health care. According to a report from the Centers for Disease Control (CDC), the percentage of adults with recent symptoms of an anxiety or a depressive disorder increased from 36.4% to 41.5% from August 2020 to February 2021.  

There is a dire need for more Psychiatric Mental Health Nurses (PMHNs).

More than 75% of all U.S. counties have a shortage of Mental Health professionals and almost all counties have an unmet need for Psychiatrists.

Mental Health Nurses work in a wide variety of inpatient and outpatient work settings, either as a specialty position or in primary care. Some job opportunities include military care, forensics, private practices, clinics, community health centers, public health facilities, schools, substance abuse centers, senior centers, hospice, rehabilitation services, telehealth and case management.

The day to day duties of PMHNs include:

• Conducting an assessment of a patient’s status
• Conducting intake screenings, initial evaluation, and triage
• Providing nursing care following a treatment plan
• Administering medication and/or other treatment regimens
• Teaching patients self-care activities
• Engaging in crisis intervention and situation stabilization (when necessary)
• Educating patients on how to manage their condition
• Providing education to patients’ families and communities
• Working efficiently alongside other members of an interdisciplinary team

“It’s a very rewarding field. As a Psychiatric health care provider, you may be the first person to talk to someone about why they are in crisis, and that can be a humbling experience," said Emma Mangano, DNP, PMHNP at Johns Hopkins Hospital. 

Some essential traits of a Mental Health Nurse include:

• Critical Thinking
• Good Communication
• Empathy
• Reliability 
• Confidence
• Compassion

The salary of a PMHN depends on their level of experience and the amount of specialized training they have undergone. According to Indeed, the average Mental Health Nurse's salary in the U.S. is $87,156.

A career in Mental Health Nursing can be demanding, but it is extremely rewarding.

Psychiatric/Mental Health Nurse Practitioner (PMHNP) Windi Woods, says that the best part of the job is “knowing that this team is the end of the road for most of these patients and we give them hope." 

Art therapy is a growing trend throughout hospitals in the United States. Art therapy is an evidenced-based practice that supports the emotional, physical, social and spiritual well-being of patients of all ages through the therapeutic use of art-making. 

These programs use a wide range of outlets such as drawing, painting, sculpting, collage, and photography as tools to:

• Process feelings about a new diagnosis 
• Provide a sense of control through normalizing activities to help them adjust to hospitalization and/or illness
• Cause relaxation and reduction of anxiety
• Rebuild self-esteem
• Help manage pain
• Support groups of patients with similar diagnosis
• Support siblings and family members in caring for their loved one in the hospital
• And more!

Childrens National Hospital uses trained art therapists who offer resources like nature art therapy in the Healing Garden and gallery displays to give children the opportunity to express themselves through creative activities. They are also a Beads of Courage member hospital.

The University of Florida Shands Hospital arts in medicine program started small back in 1990. Jill Sonke, an artist at the hospital said, "No one is suggesting in arts and health that the arts can replace medicine or health care or other therapies or interventions. But the arts have a place in the sphere of whole person care. There's so many ways in which the arts can address things like loneliness and social isolation."

Not every hospital has an in-house art program, many bring in outside help from organizations such as, the Museum of Fine Arts (MFA) or the Caring Arts Foundation Program.

MFA Artful Healing offers art-making activities for children, teens, young adults, and their families in Boston-area hospitals and healthcare centers. The MFA currently provides off-site workshops at Boston Children's Hospital, Massachusetts General Hospital, and Dana-Farber Cancer Institute.

A Parent at Boston Children's Hospital said, "We’ve been here more than ten times in the last two weeks . . . but this is the first time I’ve seen my son smiling. Thank you for that!”

The Caring Arts Foundation Program uses professional photographers to take portraits of patients and their families at Lurie Children’s Hospital. They provide fun wardrobes and props. A common area in the hospital is transformed into a studio with lighting and backdrops. Parents are provided with a full set of photos of their child at no cost — a priceless keepsake. These photo sessions give patients and their families a break from cancer treatment while providing lasting memories.