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DiversityNursing Blog

Pat Magrath

Recent Posts

How Has Nursing Changed In The Past Decade?

Posted by Pat Magrath

Wed, Mar 01, 2017 @ 10:35 AM

nurse3-student-nurse-header.jpgThe field of Nursing has changed in many positive ways in the past 10 years. From the growth of Leadership positions in Nursing and new technology to the addition of new Nursing Specialties, there are many exciting things happening and you can be a part of it. 
 
Read this article for all of the details and let us know how these changes have affected you.

The nursing profession is the largest segment of the nation’s healthcare workforce, with more than three million nurses practicing across the U.S., according to the American Association of Colleges of Nursing.  Nurses serve as both the backbone of the healthcare industry and on the front lines of developing health solutions. Although most nurses may still head to work in scrubs and comfortable shoes, for many nurses, the day-to-day reality of their job has changed in dramatic ways over the past ten years.

This evolution has been shaped by a changing U.S. population, new technology and the influential 2010 Institute of Medicine (IOM) report, “The Future of Nursing: Leading Change, Advancing Health.”  The report charged nurses to take a greater leadership role in healthcare, noting that nurses should be full partners, with physicians and other healthcare professionals, in redesigning the U.S. healthcare system.

Below, we’ve detailed just a few significant changes in nursing practice within the last decade.

Growth of Nursing Leadership

The IOM report highlighted the unique patient-centric viewpoint of advanced practice nurses and the important role they can play in addressing the shortage in primary-care healthcare providers across the U.S. Advanced practice registered nurses (APRNs) play a critical role in providing access to affordable, quality care. According to the Robert Wood Johnson Foundation, “consumer demand for APRN-provided care is growing thanks to a shortage of primary care physicians, the soaring cost of healthcare, and a population that is aging and living longer with more acute and chronic conditions.”

“We see patients through the full spectrum, from the newborns on up,” said Steve, a rural family nurse practitioner featured below in the Campaign’s A Day in the Life” video. “With the shortage of family practice providers, ‘midlevels’ such as myself and physician assistants are becoming a much more important part of the of the healthcare delivery model.”

 

 

Last year, the Campaign partnered with Nurse.com to highlight the ways in which advanced practice nurses (APNs) are meeting the IOM Report’s call to action to lead the charge in transforming healthcare.  The “Transforming Care” series featured APNs who were leading innovation in various fields – from a certified registered nurse anesthetist advocating for legislation changes to a nurse practitioner who is developing ground-breaking models of care.
 
There’s An App for That
 
Technology has changed dramatically in the past 10 years, especially with the advent of the smart phone. As the use of technology in medical practice increases, nurses are on the forefront of shaping and utilizing new mobile health tools. In our April Nursing Notes article, “Mobile Health in Nursing Informatics,” we interviewed Jason J. Fratzke, RN, MSN, the chief nursing informatics officer for Mayo Clinic in Rochester, Minn. Fratzke develops mobile technology to facilitate nursing workflow.
 

“Wearable devices that can monitor consumers’ health are changing the way our society thinks about providing care,” said Fratzke.

Fratzke was an early leader in the advancement of a nursing mobile app for patient data documentation into electronic health records (EHR). Hospitals can use nursing apps to help nurses more efficiently capture real-time patient assessment documentation, such as vital signs, medicine distribution and pain scales.

Telemedicine’s Impact on Accessibility

Technology has also led to the increase in telemedicine options. According to an article published in the American Journal of Critical Care (AJCC), telemedicine is changing the way patient care is provided in a growing number of intensive care units (ICUs) across the country. The article notes that “the U.S. has approximately 45 tele-ICUs with monitoring capacity” which impacts care for “an estimated 12 percent of ICU patients in the country.”

Benefits of tele-ICUs for nurses, the article states, include increased efficacy in monitoring trends of vital signs, detecting unstable physiological status, providing medical management, enhancing patient safety, detecting arrhythmias and preventing falls.

“In rural areas, it is also possible for tele-health to help fill a void in care,” said Connie Barden RN, MSN, CCRN-E, CCNS, chief clinical officer of the American Association of Critical-Care Nurses, interviewed in the Nursing Notes article, “Tele-ICUs Help Nurses Care for Patients from Afar.” “These remote consults by a nurse specialist result in getting the right care to the patient in a timely manner. Besides being an efficient way of delivering care it may also help to keep the patient in their local area rather than needing a transfer for care hundreds of miles away. So, it can save money and keep the patient with their family – a win-win solution for everyone.”

New Nursing Specialties and Roles

Telemedicine nursing and nursing informatics are just two nursing  specialties that have grown in the past ten years. According to the Bureau of Labor Statistics’ Employment Projections 2012-2022 – released in December 2013 – the registered nurse (RN) workforce is expected to grow to 3.24 million by 2022, an increase of 526,800 or 19 percent since 2012.

As indicated in the IOM report, the half a million new nurses entering the workforce before 2022 will be responsible for shaping the profession, including advancing in-demand specialties, such as home-health nursing and geriatric nursing, for the increase in “Baby Boomers” who are retiring in the next decade.

In addition to new nursing specialties, nurses are also playing new roles in healthcare, The “Modern Nurse” section of Nursing Notes, outlines emerging nursing roles, such as developing simulation technology, flying into emergency situations or establishing a practice in a local libraryas part of a public health initiative.

New specialties, increased leadership opportunities and the use of telemedicine and mobile health are just a few of the ways that nursing has changed in the past ten years. Is there another innovation or idea you think we missed? Tweet us at @DiversityNurse or share a comment on our Facebook Page.

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Topics: student nurse, Changes in Nursing

Kiss Cam Delivers Powerful PSA About Love

Posted by Pat Magrath

Thu, Feb 16, 2017 @ 12:52 PM

AdCouncil_LoveHasNoLabelsFansofLove17.jpgIt’s all about Love! If you haven’t seen this video, it is beautiful. Watch it to brighten your day and then go give someone you love a hug.

In a new Love Has No Labels campaign, the Ad Council and the NFL teamed up to create the perfect PSA for Valentine’s Day.

The footage was taken at the Pro Bowl in Orlando, and the PSA turned the Kiss Cam into an opportunity to highlight love’s different forms over the traditional Kiss Cam.

According to the Ad Council, the video featured “real families, couples and friends across different races, religions, genders, sexualities, abilities and ages.”

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Topics: love

See How Nurses Are Doing Less Walking And More Caring

Posted by Pat Magrath

Thu, Feb 16, 2017 @ 11:11 AM

graduates-nursing-bsn.jpgEvery Nurse I know who works in a hospital, says they are amazed how much walking they do in their 12-hour shift. If you wear a Fitbit or another step tracking device, you know you walk miles during your shift. Here’s a story about a hospital that did a study to see where they could eliminate some steps for Nurses in the design of their new building.
 
The goal was to give Nurses more time to deliver the best patient care. If you have to walk all over the building to fulfill a medication order, perhaps there is a better way to do it with less steps. Maybe the applesauce or ginger ale could be located closer to where the medicine is dispensed. Please read on for some valuable information.

You don't know what you don't know until you know it.

That's the lesson leaders at ProMedica Toledo Hospital in Ohio learned during the design of its 615,000 square-foot patient tower set to 2019.

As part of the design process, the organization took part in research to identify and refine ways to improve nursing care and efficiencies, including distance traveled during a shift.

Architects from HKS, Inc., the firm designing the building, approached Alison Avendt, OT, MBA, vice president of operations, at ProMedica Toledo Hospital about doing the research.

"We have a building that we opened in 2008, so they wanted to look at how we were using the spaces [there], and get feedback from nursing on how it was working," Avendt says.

"That was really attractive to me because I heard we had issues with the building that we were in and there were many things that we wish we could have done better. I thought if we could do a good design diagnostic and learn something from that, it would really help guide our design work."

An Applesauce Moment
During two days of onsite observation, researchers shadowed ICU nurses and intermediate-level medical-surgical nurses. The researchers assessed the existing floor plan, used a parametric modeling tool, and created heat maps to provide a graphic representation of what a nurse's 12-hour shift looked like in terms of workflow and walking distances.

"One of the big [revelations] was around our whole process of medication passing," says Deana Sievert, RN, MSN, metro regional chief nursing officer and vice president for patient care services at ProMedica.

Observation revealed that a nurse reviewed the patient's medication administration record in the patient's room, walked to the supply room to get the medication from the Pyxis machine, and then often had to stop by the patient refrigerator to get something—like applesauce—to aid in the medication pass before walking back to the patient's room to administer the medication.

"It was something that was just so ingrained in our staff nurses' normal daily activities," Sievert says. "When they did the heat mapping it was like…'Wow. [There's a] big pinch point that we as staff nurses didn't really even realize was there.' "

Avendt says the researcher called this realization "the applesauce moment."

"Nurses are masterful at just making things work. There are a lot of things that the nurses knew were not value-added or were problematic, but they would just make it work," she says.

"It was really good to flesh out what those things were by observing because if you just ask[ed] them, the nurse would often not be able to verbalize what the problem was. But by seeing it, it came to light."

The architects used this information to design a unit that would cut down on walking time. Instead of a long corridor with a common area at one end, the unit was broken up into pods and supplies were located in multiple areas so nurses could get them from the location to which they were closest.

"We were able to take them from a three-mile journey on their shift to 1.5 miles. We cut in half the steps that they were taking," Avendt says.

After the tower opens, more research will be done to see how the design is affecting workflow.

"We've since learned that [field research] is not common for people to do. We paid a little bit of money to do that, but in the scheme of things it was well worth the investment," Avendt says.

"Everybody wants to give the nurse as much time as possible to be with the patient [and] try to take away the things that are not value-added in the nurse's day."

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Topics: efficiency, patient care, hospitals, Nurse burnout

Oncology Nurses Are In High Demand

Posted by Pat Magrath

Mon, Feb 13, 2017 @ 04:02 PM

oncnurse1.gifI bet there is a lot you can add to the comments from Oncology Nurses in this article. Perhaps you’re an Oncology Nurse or someone close to you is doing this job. This article will give you a glimpse of the day-today responsibilities, concerns, technological issues, and a perspective on how to answer a patient’s very difficult questions.
 
As you know, this Specialty isn’t for everyone. If you’re considering becoming an Oncology Nurse or are curious about it, please read this article and let us know what you think.

In the world of cancer care, there's much to celebrate. In the last two years, the FDA has approved dozens of new treatments. The vast majority of those drugs are targeted therapies — the kind that require particularly complex medical care. At the core of that care is the oncology nurse.

The job of the nurse in cancer care is now even more demanding — and in the next few years, that pressure could be compounded by a shortage of oncologists.

David Freudberg is host of the public radio series Humankind, based in Belmont. He's produced a documentary series about the challenges in nursing in today's health care environment called "Resilient Nurses."

Freudberg spoke with WBUR's All Things Considered host Lisa Mullins about what he's learned regarding the pressures nurses face and the care they give. Below are excerpts from that conversation and from Freudberg's interviews with nurses around the country.

oncnurse.jpg

DAVID FREUDBERG

On the working conditions nurses face
"They're difficult conditions, with so many baby boomers flooding into our health care system and the new cohort of patients coming in as a result of the Affordable Care Act. And many of them have what's called higher acuity — more difficult-to-treat symptoms. In addition, there are budget difficulties, and you have all the technology that nurses increasingly are responsible for monitoring [with] a patient, and this adds a kind of emotional stress — because nurses truly are in it to care for the individual patients. They want to make a personal connection to the extent that their job limitations permit. And when you're having to mostly focus on machinery and technical measurements and special procedures, that becomes an obstacle to direct care of the patient. And so that's a stressor."

On technology making nurses even more accessible to their patients
"I happened to interview a couple of wonderful nurse practitioners... And they do provide their cell phone and text abilities to their patients, because they really want to be available to them — some [patients] whom are very compromised and extremely worried. In addition, various social media — Facebook, Twitter — become additional means of reaching nurses ... so in some ways the technological pressure has increased in the communications technology, as well ... My impression, having met them, was that they're just deeply warm and caring. It's not to suggest that other nurses who don't want to do it are not warm and caring. But they just wanted to be there for their patients."

On "compassion fatigue"
"... some people would say compassion doesn't fatigue; it's the people who are trying to be compassionate who need to re-frame the way in which they provide their compassion. But it is potentially a serious problem, because people do get tired. They are up against a relentless schedule. Some nurses don't even drink water during the day; they don't go to the bathroom during the day. I heard this over and over in different locations... for every patient they're dealing with, three more have rung the desk and they need to attend to them. And in addition, there are the families who are asking questions. It's just really tough, and the typical shift of a nurse in the United States is about twelve hours. That's a long time to be on your feet, running from patient to patient, not necessarily even getting a break. And this subjects you to medical errors, to a reduction in job performance.

Ashley Weber, oncology nurse at Center for Cancer and Blood Disorders at Children’s Hospital Colorado, on administering cocktails of medications to pediatric cancer patients
"We're working with severely immunocompromised people... if you don't prep the insertion site with alcohol for as long as it needs to be, you could be introducing a bloodstream infection. Some of the medications we give, you'll read the adverse side effects or reasons that we would stop a certain study that a patient's on, and it's death. You're just waiting for that clearing of the throat to be an indicator that your patient's going to stop breathing. And then when we're at home and we see a phone call from work, we think, 'What did I do wrong? Who did I kill? What medication did I not give? What chemo didn't go in right?' And we're looking at patients that each have easily 15 to 30 meds each."

Sherry Goldman, oncology nurse at Cedars Sinai Medical Center, Los Angeles, on providing compassionate care to cancer patients
"I can think of a specific incident where I told a patient some really devastating news. And I just reached out and held her. And we cried together. I don't have an issue with showing my feelings. There may be other clinicians that do. But how can you not, when you're telling a young girl some tragic news? And you see her completely fall apart. It's okay to fall apart with them and hold them, but then give them confidence afterward."

Paulette Manon, oncology nurse at Brigham and Women's Hospital, Boston, on questions she was asked by a terminally ill cancer patient
"I was in his room, and he said, 'What do you think happens to people after they die?' And I said, 'I'm not sure.' He said, 'What is your belief?' And I said, 'I believe that if you believe in God, that you are remembered and he will look after you.' And he said, 'What do you think happens to people that don't believe in God?' I said, 'Well, whether you believe in him or not, he believe in you.' When someone asks you something like that, it's just not a casual question. You can actually feel the pain coming from that person and the fear that that's going to be it for them, no return, nothing. It's not always that you give someone an ABC answer and they're fine."

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Topics: nursing shortage, Oncology Nursing, Cancer Care

Your Hiring Approach Should Drive Inclusivity

Posted by Pat Magrath

Fri, Feb 10, 2017 @ 03:37 PM

inclusive.jpgRecruiting these days is getting more and more difficult, particularly when hiring Nurses. We’re featuring this article because of its creative approach to thinking outside the box. Perhaps it’s time to change your message, how and where you target that message, and maybe even the position requirements.

For this particular company featured in the article, a college degree and sales experience had always been required for its Sales Development Reps (SDR). The author was promoted to Sales Development Manager. He wanted to hire a different type of Sales Rep -- someone with no sales experience or college degree, but was hungry to learn and grow. The Sales Rep job is a tough job and he knew the burnout rate was high.

Once he removed the degree and experience requirements, he found his applicant pool became more diverse. To quote the author “If you have a role at your organization that doesn’t require previous experience, be intentional about your recruiting. Use it as an opportunity to shift the demographic makeup of your company.”

As a Nurse Recruiter, we know you have degree and experience requirements for many of your positions, but perhaps this article will inspire you to make some positive changes to reach your hiring goals. Good luck!  

A few weeks into my first year as Jhana’s Sales Development Manager, a realization hit me.

Because I was a hiring manager recruiting for a role that required no previous experience or college degree, I was in a unique position to drive diversity and inclusion at my company.

Almost every corporate job requires a college degree, and many also require previous experience in a similar role—big hurdles for someone from an underserved community. The Sales Development Rep (a.k.a. SDR), however, is one of the few jobs that allow someone without relevant work experience or a college degree to break into corporate America.

College Degree Not Required

SDRs at Jhana fill an entry-level role. They don’t do cold calling but instead use a series of template-based emails to set up introductory sales calls for our Account Executives. Still, many companies require a college degree for the role, whether they state it explicitly or not.

When I first deleted “Bachelor’s Degree” from the job description, it felt a bit radical. It even felt like I was doing something wrong. But as I examined why I had included it in the first place, I realized I couldn’t think of a single good reason.

It was purely reflexive.

Removing “Bachelor’s degree required” was the first step towards attracting a more diverse and inclusive candidate pool.

Why I prefer SDRs With No Previous Experience

Here’s something that I find interesting: Jhana’s current sales development team is the most productive lead-generation team the company has ever had. However, if our current SDRs had applied for the job two years ago, they would have been rejected.

In the past, we required 1 to 2 years of previous SDR experience to qualify for even a phone screening. Thankfully, we’ve since made dramatic changes to our SDR hiring strategy, which have made recruiting not only faster but much more inclusive.

Soon after I was promoted to Sales Development Manager, I argued that we would actually get better SDRs if we recruited candidates with zero SDR experience. It was not a popular idea at the time. Never before had we hired for any role at Jhana and not asked for previous experience.

But anyone who has done the job knows that SDR work is grueling. It’s tedious. It takes perseverance. If a candidate left a company after being an SDR there, I could pretty much bet that he or she wanted to leave not just that company but the SDR role itself. I hypothesized that having 1 to 2 years of previous SDR experience actually hampered motivation and productivity.

So as Jhana’s first Sales Development Manager, I set out to hire a very different type of SDR. I didn’t want people with previous experience in the job.

Instead, I looked for grit. I looked for candidates who had work or life experiences that showed determination. I also looked—very much intentionally—for candidates who could add to Jhana’s diversity.

In 6 months, SDR productivity (as measured by the volume of cold emails sent, meaning emails sent to prospects with whom you’ve had no previous contact) increased by 100% and the number of discovery calls (introductory sales calls between the prospect and an Account Executive) increased by 60%.

Grab the Opportunity to Drive Diversity and Inclusion

By not requiring previous experience or a college degree, you not only dramatically grow your potential candidate pool, but you open up a huge opportunity from a diversity and inclusion perspective.

Let me put it plainly: If you have a role at your organization that doesn’t require previous experience, be intentional about your recruiting. Use it as an opportunity to shift the demographic makeup of your company.

Now, this doesn’t mean that your job as a hiring manager will get easier. In fact, it will probably get harder.

You’ll have to read more resumes.

You’ll have to do more phone screenings.

You’ll have to ask better interview questions.

You’ll have to become excellent at training new SDRs.

You’ll have to build well-oiled processes so that orientation and onboarding happens quickly.

So why do this?

Because you’ll build a better lead-generation engine.

Because you’ll help build a company that’s more diverse.

Because it’s the right thing to do.

As a hiring manager, you are entrusted with the rare opportunity to give jobs. Why not be intentional about how you use that responsibility? Why not think differently about how and who you recruit? Why not try to create social change, one hire at a time?

We can help with your hiring needs! 
Contact Us!

Topics: hiring, Diversity and Inclusion

Your hospital isn't deliberate about diversity in leadership? Meet Antoinette Hardy-Waller, the woman out to change that

Posted by Pat Magrath

Tue, Feb 07, 2017 @ 12:45 PM

ahw.jpgDiversityNursing.com would like to share this article with you. It features an interview with Antoinette Hardy-Waller, an extremely knowledgeable leader in the field of healthcare and Nursing. She is “devoted to advancing African Americans in executive, governance and entrepreneurial roles in healthcare.”
 
While many healthcare organizations have a commitment to diversity, inclusion and cultural competency in their workforce and patient care, her point is, it’s imperative to have diversity in the top ranks where decisions are made. Read on for important details.
 
Antoinette Hardy-Waller has worked in healthcare for more than 25 years. She's spent time as a nurse, home care business owner, board member for a major national health system, and consultant. Yet of all of her experiences, it is the time and energy she pours into The Leverage Network that she considers "passion work."
 
 
Download A Free Cultural Checklist

Becker's Hospital Review is the original producer/publisher of part of this content.
 

Topics: diversity, Diversity and Inclusion, hospital diversity, leadership diversity

FireFighter Marries Boston Bombing Survivor He Rescued 

Posted by Pat Magrath

Fri, Feb 03, 2017 @ 03:54 PM

03xp-bostonsurvivor_we4-master768.jpgIt’s Friday and we thought a feel good story was a good idea. We’d like to share the happy news that a Boston marathon bombing survivor is going to marry the firefighter who took care of her that life-changing and devastating day. He kept coming back to visit her in the hospital. Their friendship and love grew as they got to know each other.

Because a Nurses job is to help people whether it’s caring for their patients, doing research to improve patient care, or educating our future Nurses, a firefighter’s job is to help their community too. Both professions selflessly help people in a variety of situations, some extremely difficult.

As a website devoted to Nurses within Diverse communities, we see many similarities within the 2 professions and we hope you enjoy this story.

When Roseann Sdoia was gravely injured in the Boston Marathon bombings in 2013, Michael Materia, a firefighter, was the responder who took her to the hospital. They were strangers at the time, but he has rarely left her side since.

In December, the two decided to get married. And on Wednesday, they took on an entirely different kind of challenge together: walking up the 1,576 steps to the observation deck of the Empire State Building in Manhattan to raise money for the Challenged Athletes Foundation — an organization that has played a major role in Ms. Sdoia’s recovery.

Just as he had on the day they first crossed paths, Firefighter Materia wore all of his firefighting equipment, including a heavy oxygen tank on his back. She wore a prosthesis, which has replaced the leg she lost on the day of the bombing.

The day they met was among the darkest in Boston’s modern history. After two bombs were detonated on April 15, 2013, smoke billowed across the finish line and the scene erupted into chaos.

Hundreds of people were injured on that Monday, and three people lost their lives. Had it not been for Firefighter Materia, it might have been four.

02xp-stonsurvivor_web2-blog427.jpg

Ms. Sdoia’s right leg was severely injured in the explosion. A bystander rushed over and fashioned a tourniquet to stop the bleeding. Firefighter Materia, responding with his fire brigade, was put in charge of escorting Ms. Sdoia to the hospital. With no ambulance immediately available, she found herself lying on a metal bench in the back of a police transport vehicle.

Despite her injury, Ms. Sdoia was fully alert as they drove toward the hospital. “He was kneeling on the ground, trying to hold me from sliding, trying to hold himself, and trying to hold the tourniquet,” she said. “And then here I am, telling him to hold my hand! So the poor guy had a lot going on.”

Firefighter Materia stuck with her until they reached the hospital, where Ms. Sdoia’s right leg had to be amputated above the knee. He visited again a few days later to offer assistance, and then again the day after that.

03xp-stonsurvivor_web1-master675.jpg

After a couple of months, a friendship between the two bloomed into a romance. “There was an interest growing in each other, kind of quietly, until we talked about it,” Ms. Sdoia said.

Firefighter Materia popped the question on Dec. 4 during a trip to Nantucket. They intend to marry in October or November, according to The New York Post, which reported on the couple this week.

But before they get married, Ms. Sdoia, 48, and Firefighter Materia, 37, decided to take on New York City. On Wednesday evening, Mr. Materia pulled on his fire equipment while Ms. Sdoia explained her strategy for the climb: Go slow and steady, and lead with the left leg.

The couple were among hundreds of runners who made the arduous climb on Wednesday for an annual event called the Empire State Building Run-Up, which is in its 40th year and benefits the Challenged Athletes Foundation.

For months, Ms. Sdoia trained on the steps of Bunker Hill Monument, a towering obelisk just north of Boston commemorating the Battle of Bunker Hill, among the defining moments in the Revolutionary War.

The event at the Empire State Building was a fitting milestone in Ms. Sdoia’s own battle. Along with Firefighter Materia, the lifelong Red Sox fan has become something of a hero for Boston, where friends and family have followed her recovery, celebrated her engagement, and supported her efforts to climb New York City’s third-highest building.

The race ended at the observation deck on the 86th floor of the skyscraper, where Ms. Sdoia smiled and stopped to chat with photographers in the chill winter air while Firefighter Materia, camera-shy, stayed mostly quiet under his firefighter’s helmet.

Ms. Sdoia said she was happy to have his support, which hasn’t wavered since that ride to the hospital nearly four years ago. “We’ve spent a lot of time together,’’ she said, “and from that we got to see each other’s characters and really just bond.”

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Topics: first responders, Boston Marathon bombings

A PhD in Nursing Might Be The Best Goal For You

Posted by Pat Magrath

Fri, Feb 03, 2017 @ 03:39 PM

shutterstock_26085196_crop380w.jpgAre you considering furthering your education? Is a PhD a goal of yours? This article will give you good information and some terrific role models. It also encourages you to go for your PhD sooner, rather than later.

As our population continues to grow and people live longer, the need for Nurses with their DNP or PhD must increase as well. Perhaps your goal is to be a Nurse Educator, Researcher, or you want to look at the big picture and design ways to achieve better patient outcomes. There are many paths you can take. It’s up to you.

The Institute of Medicine’s Report, “The Future of Nursing: Leading Change, Advancing Health” states nurses should be encouraged to pursue doctoral degrees early in their careers to maximize the potential value of their additional education. I finished my PhD in nursing when I was 30 years old. Several people told me I didn’t have enough clinical nursing experience to continue with my education. Why some nurses feel the need to hold others back from continuing their education is beyond me.

The fact is, some of the most respected contributors to our profession obtained their PhDs early in their careers. Here is only a partial list of these amazing nurses: Jacqueline Fawcett, PhD, RN, FAAN, of the University of Massachusetts, received her PhD 12 years after completing her BSN. She is internationally known for her metatheoretical work in nursing.

• Jean Watson, PHD, RN, AHN-BC, FAAN, earned her PhD 12 years after earning her initial nursing degree. She is the founder of the Watson Caring Science Institute and is an American Academy of Nursing Living Legend.

• Afaf I. Meleis, PhD, RN, FAAN, of the University of Pennsylvania School of Nursing, earned her PhD seven years after obtaining her BS in 1961. She is an internationally renowned nurse-researcher and an AAN Living Legend.

• Margaret Newman, PhD, RN, FAAN, obtained her BSN in 1962 and her PhD in 1971. She is the creator of the Theory of Health as Expanding Consciousness and an AAN Living Legend.

Are you thinking about going back to school? Has someone encouraged you to consider it? The Future of Nursing report notes that major changes in the U.S. healthcare system and practice environment will require profound changes in the education of nurses. But the report also notes that the primary goal of nursing education remains the same, which is to educate nurses to meet diverse patient needs, function as leaders and advance science from the associate’s degree to the doctorate degree.

One of the recommendations of the Future of Nursing report was to double the number of nurses with doctoral degrees by 2020, and by 2016 that recommendation had been met mainly due to the creation of the DNP or doctor of nursing practice degree. Knowing this, the IOM’s Assessing Progress on the IOM Report the Future of Nursing updated their recommendations in 2015 stating that more emphasis should be placed on increasing the number of PhD-prepared nurses. The DNP has been regarded as the degree for those who want to get a terminal degree in nursing practice while the PhD has been regarded as the degree for those wanting to do research. But the difference is not that simple.

"Several people told me I didn’t have enough clinical nursing experience to continue with my education. Why some nurses feel the need to hold others back from continuing their education is beyond me.”

According to the American Association of Colleges of Nursing, “rather than a knowledge-generating research effort, the student in a practice-focused program generally carries out a practice application-oriented final DNP project.” The AACN further notes key differences between the DNP and PhD programs. PhD programs prepare RNs to contribute to healthcare improvements via the development of new knowledge and scholarly products that provide a foundation for the advancement of nursing science. A richer more reflective understanding of the PhD in nursing is that it is heavily grounded in the science and philosophy of knowledge. DNP programs, on the other hand, prepare nurses at the highest level of nursing practice to improve patient outcomes and translate research into practice. A PhD-prepared nurse can contribute to the profession through research, creating new nursing theories or through a focus on national, global system level change and public policy.

I have had many conversations with nurses looking to go back to school who say they don’t want to do research. However, in further discussion on what they really want to do and the problems they want to solve, it becomes clear that the PhD is the best track for them. Also, you don’t need to be a nurse practitioner to get a PhD; there are many PhD-prepared RNs like myself. For those who want to become a nurse practitioner or other advance practice registered nurse, there are dual DNP/PhD programs just as there are MD/PhD programs for individuals looking for both the practice and research education.

As you can guess, I didn’t listen to the naysayers. I knew as a nurse I could make the largest impact for patients and nurses by getting my PhD in nursing (majoring in health systems and minoring in public administration). Does having a PhD make me a better nurse than anyone else? No. I am a different type of a nurse who knew what I needed to do to make my unique contribution to our profession. I started as an LPN and then became an associate’s degree RN. I worked full time while going to school full time. I also completed a BSN-PhD program, which I started at age 25, four years after I became an RN. I have been an RN for 20 years — PhD-prepared for almost 11 years. Earning my PhD was the best decision in my professional career.

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Topics: nursing degree, PHD in Nursing

Nurse Shares What Delivering Babies Is REALLY Like

Posted by Pat Magrath

Thu, Jan 19, 2017 @ 11:29 AM

newborn-delivery-photo-420x420-ts-stk25209nwl.jpgLabor and Delivery Nurses will appreciate this post. My only problem with it is that she keeps saying “I’m just the Nurse…”. The word “just” is where I’m having difficulty. Perhaps she’s using the word to be self-deprecating? I’m not sure. What do you think?
 
As pointed out in this post, your first priority while in that labor & delivery room is your patient and the baby/babies who are about to be born. We here at DiversityNursing.com appreciate what all Nurses do every day. We would never refer to you as “just” a Nurse. Of everyone in that room, you are the most connected to your patients and their needs. You are their advocate and recognize when something is going well or not. You share in their joy and sometimes, their sorrow.
 
You put your needs aside to take care of your patients and for that, we are grateful.

Susan Jolley, a registered nurse from Texas, has shared a beautiful tribute to delivery nurses, highlighting the amazing and sometimes heartbreaking work they do on a daily basis. 
 
It begins: 'I am just a nurse. A Labor and Delivery nurse. Sounds like fun doesn't it? Well....

'I am just the nurse who was there during the birth of your child.
I am just the nurse who held your hand, looked you in the eye, and made you feel like the strongest woman in the world.'

The post then goes on to explain that midwives are also there during some truly difficult moments. 

'I am just the nurse who vigilantly monitored your baby's heartbeat and recognized that he was in distress.

'I am the nurse who took photos of your baby because you were all alone... Even though I should really be charting and dong about a hundred other things.'

Susan's post went on to say that nurses will be there through everything, including being the one who 'reassured a teenage mom that she can be an amazing parent and still get an education.'

However, they are also: 'Just the nurse who stood by you while you handed your baby to his adoptive mother. I held you steady. I watched you tremble. My heart ached for you.'
 
If that wasn't enough, the post details how nurses and midwives are also there at the truly tragic moments. 'I am just the nurse who held your hand and told you, "She is beautiful. I am so so sorry for your loss." My heart ached for you. I wanted to hold my children and never let them go that night... but they were already sleeping because I stayed late to be with you.' 

However, the end of the post ended saying that while it might be difficult and often unappreciated, being a nurse is an amazing job, ending with: 

'I saved your life.
I saved your child's life.
My body aches.
My heart aches.
And I love every minute. 
I am JUST a Labor and Delivery nurse.'
 
The post has already been shared over 55,000 times with many mums sharing their own stories of how they have been helped by labour and delivery nurses. 

One said: 'Angel's in disguise who are very under appreciated at times but very dedicated and beautiful people.. Because of the special care and pure selflessness they show us.'
 
Another added: 'So true they really don't get the recognition they deserve i will always remember the nurse who delivered my still born baby boy and then 2 years later came in on her day off to deliver my son the emotional support from her was unbelievable and definitely something that will stick with me forever xxx'
 
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Topics: delivery, delivery room

Legislative Updates For Nurses in 2017

Posted by Pat Magrath

Wed, Jan 18, 2017 @ 01:59 PM

2073142.jpgIf you’re looking for an update on legislative measures for Nurses, please read this article. Some information is by state, such as legislation in CA to prevent workplace violence which is referred to as “a regulation landmark and a model for other states and the country. It requires every health care provider to develop a comprehensive workplace violence prevention plan.”

There is also national legislation such as the ban on powdered surgical gloves across the country that goes in to effect today. What are your thoughts about the legislation noted below?

Although 2016 brought some legislative disappointments-such as Congress's failure to pass Title VIII legislation, which is designed to reauthorize, update and improve nurse workforce programs-several states moved forward with an array of legislation and regulations that will affect nursing practice this year.

Here's a sampling of what's new for nurses in 2017:

  1. Combatting workplace violence, starting in California

California Occupational Safety and Health Standards Board approved regulations to prevent workplace violence in health care settings. The legislation (SB 1299) passed in 2014 and was sponsored by the California Nurses Association/National Nurses United (CNA/NNU).

Bonnie Castillo, RN, director of health and safety for CNA/NNU called the legislation a regulation landmark and a model for other states and the country. It requires every health care provider to develop a comprehensive workplace violence prevention plan. The plans must assess threats and risk of physical and verbal attacks and how to mitigate the risk. Nurses and other health care workers must be involved in the planning.

The rules require hands-on training, competency validation and engineering controls, such as alarms. The regulation includes the entire health facility campus, including parking garages. The regulations require internal incident logs and reporting to Cal/OSHA, even if no injury occurred. And there is a provision to disallow retaliation if the nurse or other worker reports or calls in law enforcement.

"The intent is to ensure all hospitals are safe and therapeutic," Castillo said. "The incidence of violence has increased."

The union will meet with representatives of the Occupational Safety and Health Administration in January about making these regulations national. NNU plans to advocate for passage of similar legislation in other states, and legislation to protect nurses in other settings, such as schools or retail clinics.

"Every state needs this," Castillo said. "Nurses cannot provide a level of care their patients need if they are unsafe. If the nurse is at risk, everybody is at risk."

  1. Oregon's nurse staffing law takes effect

The Oregon Legislature passed nurse-staffing legislation in 2014 and all aspects of the law have taken effect as of January 1, 2017. It requires that hospitals create nurse staffing committees comprised of direct-care nurses and nurse managers to develop and approve staffing plans for their hospitals. The law also sets limits on mandatory overtime, creates a mediation process to resolve disagreements and requires regular audits by the Oregon Health Authority.

  1. Multistate nurse licensing and the Enhanced NLC

The Nurse Licensure Compact (NLC), launched in 2000, allows nurses to have one multistate nursing license and practice in their home state and other compact states. Twenty-five states currently participate in the original compact, which streamlines the licensing process for many travel nurses.

In 2015, the National Council of State Boards of Nursing (NCSBN) developed an Enhanced Nurse Licensure Compact, which lets nurses provide telehealth nursing services or respond to emergencies in fellow compact states without an additional license. The enhanced compact will come into effect when 26 states pass it or on December 31, 2018.

South Dakota became the first state to pass the Enhanced NLC in 2016. Nine additional states have followed, and the NCSBN expects several more states to approve the new compact in 2017.

Contact American Mobile for help expediting the nurse licensing process, in compact and non-compact states.

  1. Changes to nurse continuing education          

Washington State has changed its continuing education requirements to include that nurses complete a mandatory 6 hours of continuing education in suicide assessment, treatment and management.

Florida is considering a requirement that all nurses and other health care professionals complete a 2-hour continuing education course about human trafficking and domestic violence every third biennial relicensure or recertification. For nurses, the course must be approved by the Board of Nursing.

  1. State scope of practice laws for nurse practitioners

State regulations about how much autonomy nurse practitioners have in their practice are constantly changing. This State Practice Environment map from the American Association of Nurse Practitioners (AANP) can help you keep up on the latest news. Find travel NP jobs with our partner, Staff Care.

  1. National ban on powdered surgical gloves

The U.S. Food and Drug Administration is banning the use of powdered gloves during surgeries, in patient examination gloves and absorbable powder for lubricating a surgeon's glove. The agency said that these products "present an unreasonable and substantial risk of illness or injury and that the risk cannot be corrected or eliminated by labeling or a change in labeling." The ban takes effect January 18, 2017.

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Topics: legislative updates

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