DiversityNursing Blog

As Nurses, a big part of your job is empathy for your patients and their families. You’re so good at understanding what your patients are going through because you care and this I think, is primarily why you decided to become a Nurse – to help people and lend a sympathetic ear. You educate, show compassion, love and understanding every day. You are amazing! 

We came upon this touching video which reinforces that every one of us -- whether we’re a Nurse, a patient or patient’s family member -- has a personal life. Some days are better than others. It reminds us to be mindful of the people around us and their struggles. What are your thoughts about this video?

Related Articles: 

A Nurse Reflects On The Privilege Of Caring For Dying Patients

Nurse Association 'Zero Tolerance' On Workplace Bullying

Education, education, education… you’ve heard about the importance of a good education all of your life. It’s right up there with buying a house, where location, location, location is the mantra. This article explains what hospitals and health systems are looking for when hiring Nurses and why a BSN degree or higher is important.  DiversityNursing.com understands that not everyone has the financial means to continue their education. That is why we continue (7 years/winners so far) to offer our Annual $5,000 Education Award. Please read this article and then register for our 8^th Annual $5,000 Education Award below.

Megan Goodman was a dean’s list student at Pennsylvania College of Health Sciences who served on two student nursing boards before she earned her associate degree in nursing in May.

Since then, the 30-year-old Downingtown, Pa., resident still is seeking work after applying for more than three dozen hospital jobs. “Truthfully, an associate’s program is not really going to get you anywhere anymore,” she said.

Hundreds of thousands of Americans flocked to nursing schools over the past decade, drawn by the prospect of a well-paying job with a degree that takes as little as two years. But many have graduated only to find the goal posts have shifted, as hospitals seek nurses with more-advanced degrees, partly in response to an increasingly complex health-care system.

The trend in nursing mirrors a wider one unfolding in other sectors such as manufacturing and office administration, which are demanding more education and skills than in the past. As the number of job candidates with bachelor’s degrees rose during the recession, due to layoffs and people returning to school, employers began expecting degrees for positions that previously didn’t require them.

Such “upskilling” in reaction to a slack labor market was particularly intense in nursing, which saw a flood of new entrants over the past decade. The number of programs of all kinds jumped 41% to 2,270 between 2002 and 2012 amid a widely perceived shortage of nurses, according to a 2014 paper in the journal Nursing Economics. In roughly the same period, the ranks of young registered nurses swelled about 80%, while the number of those over 50 doubled to one million, as would-be retirees stayed on the job.

Meanwhile, the Institute of Medicine, an influential independent advisory group, called in 2010 for 80% of the nursing workforce to have bachelor’s degrees by 2020. It based that goal on research dating to the early 2000s showing that hospitals with a higher proportion of nurses with a bachelor’s degree scored higher on important indicators of overall quality of care.

“The hospitals said ‘Where do I get the best value, the highest outcomes for the cost? From a baccalaureate nurse,’” said Peter Buerhaus, a nursing economist at Montana State University.

At the same time, the Affordable Care Act has put more focus on chronic and preventive care, prompting hospitals to seek more coordination and leadership skills from their nurses—skills that aren’t generally taught as part of associate’s-degree curriculum.

A push by hospitals to obtain “Magnet” status, a certification that helps hospitals to recruit and retain nurses, also tilts the field toward bachelor’s-degree holders, since nurses in leadership roles at Magnet hospitals must have a bachelor’s degree.

Diana Mason, president of the American Academy of Nursing and a nursing professor at Hunter College in New York, is concerned that hospitals’ increasing preference for nurses with four-year degrees could block what has been seen as a reliable way into the middle class.

“That’s a beautiful aspect of nursing’s career ladder, is that it enables people to move from maybe a family growing up in poverty, to solidly middle class,” she said. “It provides access to people who can’t afford a baccalaureate education.”

Some hospital systems, such as Main Line Health in Pennsylvania and Cedars-Sinai in Los Angeles, explicitly require bachelor’s degrees or higher for their nursing residency programs. Hospitals that do hire associate-degree nurses are increasingly putting provisions in their contracts that require completion of a bachelor’s degree within a set period, usually three to five years.

Ida Danzey, associate dean of health sciences at Santa Monica College, remembers when the nursing career fair drew local hospitals. Beginning around 2008, their numbers dwindled. Local universities advertising “BSN completion” programs, which allow associate’s-degree graduates to earn their Bachelor of Science in Nursing with additional course work, have taken their place.

The extra 18 months or so of education often includes courses in things like leadership, evaluating research and the history of nursing, prompting complaints about unnecessary costs.

“What we had to pay for was just fluff,” said Rebeka Rivera, a pediatric nurse at Children’s Healthcare of Atlanta who took those courses in the final year of her bachelor’s program. “You’re not taking any science courses at that point.”

Others say the evidence shows that better-educated nurses lead to improved health outcomes, and that the skills taught in a bachelor’s-degree or BSN-completion program are increasingly relevant to the way care is now delivered.

“The health-care industry has changed dramatically as a direct result of the economy and health policies in flux,” said Veronica Feeg, associate dean and director of the Center for Nursing Research and Scholarly Practice at Molloy College in New York. “New roles for nurses emerge every day. The need for educated health workers who care for the most vulnerable people and carry enormous responsibility is not new, but requires more critical thinking than ever before.”

Ms. Goodman, who graduated in May, is already pursuing a bachelor’s degree online through Villanova University as she continues to apply for nursing jobs and works two part-time jobs, as a lifeguard and an emergency medical technician.

“It’s really wearing me down,” she said. “I wish hospitals would look at the person. I have life experience.”

Looking to hire Nurses? We can help!

Are you a leader? Are you someone people look to for advice or to make decisions in a time of crisis? Leaders come in all shapes and sizes. Some are natural leaders, they just know what to do. Others become leaders by observing and learning leadership skills through their mentors or family members. At work, are you someone who leads the way? Do you take a stand when you see something is wrong? We can’t all be leaders, but are there times you just naturally step up to the challenge?

Every profession has members who rise into leadership, and effective leaders can make all the difference. This cannot be more true of healthcare and nursing, arenas that necessitate highly collaborative teams.

Leadership can be taught, but it’s also intuitive, and some nurses have this gift. What makes a particular nurse embody the characteristics of true leadership, even when he or she has no official title?

Tuning in

A nurse who cultivates deep awareness of both self and others demonstrates a powerful form of leadership. This type of nurse is tuned in,  alert for others in distress, and leads to collaborate in ways that decrease such distress.

This nurse tunes into both individuals and the collective, leading by example while leaning into situations to positively impact the whole. The shadow for this type of consciousness is hypervigilance and controlling behavior, which a highly developed self-awareness can preclude.

Leadership in action

Some nurses are skilled at taking the reins, even when not in official positions of leadership. These nurses see problems, bring them to the team’s attention and proactively seek ways to alleviate the problem.

We’ve likely all known nurses who respond to problems with a statement like, “It’s been that way a while; it’s not my responsibility to fix.” This common attitude can breed a culture of intellectual laziness and disregard for the bigger picture.

Proactive, thoughtful nurses see problems and involve others in manifesting solutions that truly benefit everyone. This is leadership in action.

Speaking up

Some nurses demonstrate leadership by using their voices. This may involve naming a problem, such as noticing a bully on the unit, or otherwise identifying something that’s amiss.
Our silence can serve as complicity, such as not speaking up or taking action in response to a bully. The empowered nurse who speaks the truth overcomes his or her fear by taking a calculated risk and naming what needs to be named.

Speaking up gives voice to those who are too frightened to speak for themselves. This type of nurse leadership can empower others to also speak out, and can be a powerful way to lead by example.

Conscientious collectivism

Natural nurse leaders intuitively lead the way, sometimes dragging their official leaders with them. We all contain the seeds of leadership, but some more readily demonstrate those characteristics.

Those nurses who skillfully and naturally lead do so from an ability to see beyond themselves. These nurses consider the good of the whole, align their own actions with that ideal and proactively seek change.

Nurses can lead the way in any workplace situation. Tune in, see the 10,000-foot view, consider the good of the whole, use your voice and lead from a balance of intuition, savvy critical thinking and conscientious collectivism.

Your turn

How do you lead in your daily work? Share your experiences with us.

You work with patients in a medical facility, doctor’s office, perhaps even a school. You do everything you can to keep your patients, yourself and everything around you clean and sterile. After all of the precautions you take, is it possible you are spreading germs? Read on to find out how you can change a step or two of what you’re already doing to prevent further germ contamination.

In an alarming study about how germs spread in health-care settings, researchers set up a simulation that involved asking doctors, nurses and other health-care personnel at four hospitals to put on their standard gowns, gloves and masks and smear themselves with a fluorescent lotion that was supposed to be a stand-in for germs or other dangerous matter.

After the participants carefully removed the protective equipment as they usually would the researchers searched their bodies with a black light to see whether any lotion was transferred. Both participants and researchers were surprised to find contamination in a high number — 46 percent — of the 435 simulations.

“Most of the participants appeared to be unaware of the high risk for contamination and many reported receiving minimal or no training in putting on and taking off [personal protective equipment],” senior author Curtis J. Donskey of the Cleveland Veterans Affairs Medical Center told Reuters Health.

Writing in the journal JAMA Internal Medicine on Monday, the researchers said that most of the transfer of the lotion took place as gloves were being removed. As might be expected, the contamination was less when proper procedures were followed (30 percent) vs. when they weren't (70 percent)

The researchers recommended that "educational interventions that include practice with immediate visual feedback on skin and clothing contamination can significantly reduce the risk of contamination."

This story is about a Nurse who worked in oncology and then decided to do palliative care in people’s homes. She finds it an honor to be with the patient and their family during the last few days of the patient’s life. She notes how the patient is much more in control and comfortable at home than they are in the hospital and wonders if there’s a way to do it better in the hospital. She has learned to be honest with the patient’s family if they ask if their loved one is dying. She has found they ask, because they really want to know, to prepare themselves. If you are not a palliative care Nurse, is it something you would consider? This story will give you excellent insight.

Palliative care nurse Theresa Brown is healthy, and so are her loved ones, and yet, she feels keenly connected to death. "I have a deep awareness after working in oncology that fortunes can change on a dime," she tells Fresh Air'sTerry Gross. "Enjoy the good when you have it, because that really is a blessing."

Brown is the author of The Shift, which follows four patients during the course of a 12-hour shift in a hospital cancer ward. A former oncology nurse, Brown now provides patients with in-home, end-of-life care.

Talking — and listening — are both important parts of her job as a palliative care nurse. This is especially true on the night shift. "Night and waking up in the night can bring a clarity," she says. "It can be a clarity of being able to face your fears, it can be a clarity of being overwhelmed by your fears, and either way, I feel like it's really a privilege to be there for people."

Sometimes Brown finds herself bridging the gap between patients who know they are dying and family members who are still expecting a cure. "There can be a lot of secrets kept and silences. ... One thing that palliative care can be really good at is trying to sit with families and have those conversations," she says.

While some might see her job as depressing, Brown says that being with people who are dying is a profound experience. "When you're with people who die ... and being in their homes and seeing their families, it's incredible the love that people evoke. And it makes me realize this is why we're here; this is what we do; this is what we give to each other."

Interview Highlights

On cutting costs and stretching nurses too thin 

There's a sense that you can stretch a nurse just like an elastic band and sort of, "Well, someone called off today." That means a nurse calls in and says that she's sick or her car broke down or he won't be there, and sometimes we're able to get someone onto the floor to take that person's place, but often we're not. Or an aide might not be able to show up for whatever reason, and then the assumption is just, "Well, the nurses will just do all the work that the aide would've done," and the problem is that people do not stretch like rubber bands, and even rubber bands will break if you stretch them too far.

On loved ones wanting to feed their dying family members

Food is so fundamental, and their feeling is "I'm letting my husband starve to death and that's wrong." So I have to talk them through the process of the body slowly going in reverse. All the processes we think of as normal and that are integral to life, they're all slowing down. And so the body just doesn't need food when someone gets very close to the end of their life and, in fact, they found that forcing someone to eat can mean that they just have this food sitting in their stomach, they're not able to digest it, can actually make them more uncomfortable. So I talked to [one family member] about that, but tried to do it as gently as possible, while also acknowledging the incredible love that was motivating her and trying to honor that, but make it clear that she needed to show her love by being close with her husband, by holding his hand, by talking to him, but not by feeding him.

On whether patients ask if they're dying 

No, they don't. ... I think it's because they're afraid. They want to just take things day by day. I did have a wife once ask me. She said, "You know, I'm not new to this, and I want you to just tell me. Is he dying?" And at that point I was a pretty new nurse and I didn't have the experience to know to say, "Yes." Now I would know to say that. ... I got a sense that she really wanted to know and no one else was telling her. ...

Physicians can have a mindset of "we're thinking positively, we're focusing on the good that can come, and we're not going to talk about 'what if it doesn't work out.' " And they will sometimes pull the nurse aside and say, "What's going on?"

On leaving the hospital setting for palliative care 

I love the hospital. I never thought I would leave the hospital, but I left to see patients outside the hospital because in the hospital I feel like we never see people at their best. They feel lousy. We wake them up at night. We give them no privacy. We give them, really, almost no dignity. We tell them what they're going to do when, what they're going to eat when, what pill they're going to take when and no one likes living like that. ... So I wanted to see people in their homes because I thought there's got to be a way we could make the hospital better. Seeing what it's like for patients in their homes I thought would show me that. And I would say overwhelmingly what I've seen is control: People have so much more control when they're in their homes and it should not be that hard to give them back a little bit more control in the hospital.

On traveling to a patient's home

When I started, I thought, "I can't believe I'm doing this. I can't believe I just drive up to these houses and go inside them." I live in Pittsburgh, but it can get very rural feeling actually pretty quickly, and I remember ... going to [a house] that was already through back-country roads and then down a gravel driveway, and I thought: "What am I doing? Am I insane?" And then I went into this house, and this family was so loving and amazing and wonderful, so it was a great education for me not to judge. And I know that my workplace checks out and makes sure that the places we're going are real, so that's comforting, but it's definitely a giant leap of faith, and you just have to make that leap.

On home care versus hospital care

Often in the hospital they can be more comfortable in terms of we're relieving their pain, we're getting them anti-nausea medications very quickly, but ... they're not as comfortable with themselves, and in their homes they seem much more comfortable with themselves and with the people around them, and I had never thought about those two things as being so distinct, but they are. So the question then is how do we give people care that marries those two things, because they're both so important.

On how patients express appreciation to nurses 

A very popular gift in my hospital was Starbucks [gift] cards. ... Often people bring in cookies and chocolate and that's wonderful, but I remember one nurse saying, "You know, I wish someone would just bring in a lasagna." ... Because we never have time to eat and then you go into the break room and you're hypoglycemic and you see all this chocolate, and so you eat all this chocolate, which doesn't really help you feel that much better in the long run. So to actually drop off a meal is wonderful. 

mily Mongan via www.mcknights.com 

This summer, the ANA (American Nurses Association) released a new position statement regarding Incivility, Bullying, and Workplace Violence. It clearly states that “All RNs and employers in all settings, including practice, academia, and research, must collaborate to create a culture of respect that is free of incivility, bullying, and workplace violence”. Any kind of workplace violence whether it be physical, verbal or psychological is not to be tolerated and should be reported immediately. This applies to bullying incidents/workplace violence from a co-worker, patient or patient’s family member. When these incidents are allowed to continue, there are many damaging consequences including psychological, financial and a toxic work environment.

A leading long-term care nurses group is praising a tough, new “zero tolerance” the American Nurses Association has adopted regarding violence and bullying in healthcare workplaces.

The ANA announced the new policy Monday, citing a survey of 3,765 RNs that found almost one-fourth of respondents had been physically assaulted at work by a patient or a patient's family member. The survey also found up to half of nurses had been bullied in some manner by a peer or a person in a higher level of authority. ANA's statement defines bullying as “repeated, unwanted harmful actions intended to humiliate, offend and cause distress.”

The ANA's new policy includes recommendations to prevent and handle violence like encouraging employees to report incidents of violence, avoiding blaming employees for violence perpetrated by non-employees and developing a violence prevention program aligned with federal health and safety guidelines.

“Taking this clear and strong position is critical to ensure the safety of patients, nurses and other healthcare workers,” wrote ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN, in a statement. “Enduring physical or verbal abuse must no longer be accepted as part of a nurse's job.”

Violence against healthcare workers, especially nursing assistants, should be handled with more scrutiny by long-term care providers, according to American Association for Long Term Care Nursing Executive Director Charlotte Eliopoulos, RN, MPH, PhD.

“Studies have shown that more than half of certified nursing assistants [CNAs] are victims of assault and battery at least once every week,” Eliopoulos told McKnight's. “Staff need to be better prepared to identify violence-prone individuals, prevent violent acts, and manage them should they occur.”

Take a stand against workplace bullying.

Many Nurses have a 6th sense when it comes to their patients. This story is about a Nurse who’s patient was in a coma after a C-section. Nothing was bringing the patient out of the coma. The Nurse’s actions changed the outcome of could have been a very tragic situation.

For Shelly and Jeremy Cawley, what should have been one of the happiest moments of their lives took a near fatal turn. 

Shelly went in for an emergency C-section and doctors had to put her under. After several hours, they were getting worried that Shelly hadn't woken up. 

The couple's newborn daughter, Rylan, was resting safely a few floors away in the same hospital. 

"I was a mess. I was numb. I didn't know what to think anymore," Jeremy told People. "The doctors had done all they could and it was clear, they absolutely thought they were losing her at this point." 

It wasn't until nurse Ashley Manus, a big proponent of skin-to-skin contact, stripped Rylan down and gently put her on her mother's chest that everything changed. 

"I was hoping somewhere deep down, Shelly was still there and could feel her baby, hear her baby and her mother's instincts would come out and she would realize, 'This is where I need to be.' " Manus said. 

Incredibly, it worked!

Jeremy says the bond for Ryland was instant, and she fell right asleep on her mom. She was so content the doctors had to make her cry so that Shelly would hear her baby. 

"We could see a spike in her vitals on the monitor. We knew that somewhere in there she was hearing her baby. Rylan saved her mom's life," Manus said. 

It would be another week before Shelly came out of the coma completely and could hold her baby for the first time. Both mom and baby were fine, with no complications from the ordeal. 

It's been a year since Shelly's miraculous recovery, and this past weekend, the family celebrated Rylan's first birthday. 

Natalie Romero via www.huffingtonpost.com 

Grab the tissues because this article is a beautiful thank you note from the mother of an infant in the NICU. She refers to the Nurses in the NICU who took care of her baby as “background heroes”. Always there offering comfort to both her and her baby; translating the doctor’s language in to words she could understand; singing and reading to her baby; staying with him in the OR; and all the other important things the Nurses did to help her through it. She’s not sure if she ever properly thanked you so she wrote this letter. It’s beautiful and so are you for all you do for your patients and their families.

During our NICU stay, our son was seen by dozens of doctors -- surgeons, neonatologists, anesthesiologists, cardiologists, orthopedics and radiologists. He was treated by occupational therapists and physical therapists.

If you were to walk in the room during rounds on a typical day, you would have found five or six doctors huddled around his tiny body reviewing his charts. They discussed his numbers throughout the night, their opinions on his treatment, and how he was responding. The doctors didn't always turn to us to include us in the conversation. And to be honest, we didn't always understand their language.

If you were to look very closely at the scene, you may have noticed someone hovering in the background almost going unnoticed. If you looked hard enough, you would have noticed my son's NICU nurse who rarely left his side during rounds. His nurse stayed close by and tended to my son while the doctors tended to his illness. His nurse always helped us figure out the doctor language once they were gone.

Those nurses were our background heroes. They didn't get the same credit as the doctors and they never searched for praise, but they were such an important and necessary part of our NICU journey.

NICU nurse, I don't know if you know the impact you had on our family.

I don't think I thanked you.

I hope it's not too late.

Thank you for quietly closing the curtain to give me privacy when I couldn't stop the tears.

Thank you for rocking my baby when I couldn't be with him at night.

Thank you for knitting him hats and booties.

Thank you for reading to him.

Thank you for singing him lullabies.

Thank you for staying with him in the operating room.

Thank you for being gentle with him when he was battered and bruised after hours and hours of surgery.

Thank you for being his advocate and questioning everything, even the doctors, when you felt like he was being given unnecessary treatments.

Thank you for keeping the small bit of hair that was shaved off of his head when the only available vein was on his skull. "It was his first hair cut," you said when you handed it to us the following morning.

Thank you for teaching me how to bathe him without making all the alarms ring.

Thank you for teaching me how to read the machines he was attached to.

Thank you for helping me hold him without pulling out all his tubes.

Thank you for silently standing beside me while I cried tears of helplessness.

Thank you for helping me see the good I was doing by heading off to pump every three hours.

Thank you for making feel like a normal mother in the moments when I felt anything but normal.

Thank you for celebrating each ounce of milk consumed, each breath taken without the breathing tube, each time the number on the scale went up.

Thank you for celebrating when he was discharged.

Thank you for helping me get through one of the toughest experiences of my life. You were a part of the reason I survived it.

I don't know the half of what you have seen. I know that even though you always seemed to be smiling, behind closed doors you cried your own tears. I know that in the moments of chaos when alarms were sounding and codes were being called and my world seemed to be crashing down around me, you stayed calm and focused and you made sure that my world stayed upright.

I hope you know that I felt your hand of my shoulder. I hope you know that I was grateful to see your face every morning. I hope you know just how important you were to us.

I hope it's not too late to say thank you.

By Denston Carey Jr. via www.wcuquad.com 

While many of us are well aware of the disparities in healthcare, this article written by a medical student, makes some good points about the need for more diversity at all levels in the medical field. What would you add to his thoughts?

Increasing the presence of minority groups within the medical field is a pressing issue in healthcare today. When one walks into the average doctor’s office or hospital, one cannot help but realize that there is not enough diversity within the medical field. The sparingly present racial and ethnic groups in medicine are more formally referred to as the Underrepresented Minorities.

African-Americans comprise about 13 percent of the American population but, they make up only four percent of American physicians. – AAMC

Groups that are underrepresented in medicine are present, as physicians or other medical professionals, in small numbers relative to their presence in the population as a whole. For example, though African-Americans comprise about 13 percent of the American population, they make up only four percent of American physicians (AAMC). Furthermore, the 14 percent presence of Hispanics in the American population is hardly reflected by the mere six percent of Hispanics coming out of U.S. medical schools in recent years. It goes without saying that there are some negative side effects that stem from this lack of diversity within American healthcare. 

The medical professionals of the U.S. simply do not reflect the mosaic of racial and ethnic groups that comprise our population, and this indeed has social and cultural implications. Patients not only come with symptoms and disorders, but they also come with different social and cultural backgrounds. 

Being a medical professional is about more than just understanding how the human body works—medical professionals need to be able to relate to their patients on a personal level as well. When caring for such a diverse population, our medical professionals must be both culturally competent and reflective of the patient population. Understanding and relating to patients is an important part of medicine, and it can make a huge difference in the patients’ experience if their healthcare providers are able to do this. 

Beyond the social and cultural reasons that call for a diversified healthcare force lie the needs of underserved communities. Underserved communities are those which face economic, cultural, or linguistic barriers to healthcare (DOH). There have been studies that show underrepresented physicians (African-Americans, Latinos, American Indians, and Pacific Islanders) are far more likely to practice in underserved communities than their white counterparts. Because theseunderserved communities may benefit from a more accessible healthcare system, when underrepresented groups serve them, the healthcare disparities that afflict these communities are likely to be mitigated by an increase in the amount of underrepresented physicians.

With this now in mind, it is apparent that increasing the prevalence of underrepresented minorities within the medical field can also decrease healthcare disparities. 

So, how can WCU help? The first thing we can do, as a university, is diversify our own pre-health programs. We can then work to support and embrace this diversified community of pre-health students. Lastly, we can reach out to the younger people of the West Chester community, encouraging them to pursue careers within the healthcare field as well. Through these three objectives, WCU can contribute to the national effort of diversifying the American healthcare force. 

Minorities in Medicine wishes you all the best this semester, and we look forward to seeing many of you pre-health students get involved with this organization. 

By Erin Powell via www.thedenverchannel.com 

No matter how you feel about the Miss America Pageant, if you missed Colorado’s Kelly Johnson and her view about being a Nurse, you can see it here. Please let us know what you think about what she had to say.

Sunday's Miss America pageant will surely feature plenty of glitz, glam and glitter.

Miss Colorado didn't look like that in this week's preliminaries. During the talent competition, Kelly Johnson walked onto the stage with her hair in a ponytail, clothed in baggy scrubs with a stethoscope draped around her neck. Johnson didn't show off a talent, but she passionately explained hers: nursing.

After a deep breath, she said, "Every nurse has a patient that reminds them why they became a nurse in the first place. Mine was Joe."

Joe suffered from Alzheimer's disease and at night, screamed out because of night terrors. Miss Colorado would comfort him and stop him from screaming, but explains she couldn't change his treatments or medications because she was "just a nurse."

Instead, they'd talk about his grandchildren and laugh together. Until one day he was crying. She stopped and said to Joe, "You're not just Alzheimer's."

"Same goes for you. You're not 'just a nurse,'" he responded. "You have changed my life because you have cared about me."

Johnson graduated as the valedictorian from Grand View University in Des Moines.

"I am so grateful for the opportunity to share how passionate I am about this profession. Thank you to the Miss America Organization," Johnson wrote on Facebook.

This is why I did what I did. All in one message. This means so much to so many people. I love you, America. Thank you for reaching out to me. This is all for you! #NurseKelley