DiversityNursing Blog

By Alison Stanton

When Joanne Clavelle was 12 years old, she began working as a candy striper at a Vermont hospital.

It didn't take her long to realize that she had found what she was meant to do.

"I used to feed patients, change their water pitchers and make eggnog with real eggs," Clavelle says. "After a couple of years of being a candy striper, the nurses at the hospital sort of adopted me, and I moved into a volunteer aide position in the emergency department. I got to wear a white uniform with white stockings and shoes; I thought I was in heaven."

Clavelle was hired as an EKG technician at the same hospital when she was 16. She worked every weekend doing what she loved.

Her dedication to outstanding patient care caught the eye of three physicians at the hospital.

"The doctors had a scholarship program," Clavelle says. "They gave me a scholarship, which helped pay for me to go to nursing school at the University of Vermont.

Thirty-plus years later, Clavelle is still as passionate as ever about her career as a nurse and providing top-notch patient care. Five months ago, she was named senior vice president and chief clinical officer at Scottsdale Healthcare.

"I absolutely love my job here," she says. "I have the opportunity to create a nursing infrastructure that focuses on outstanding patient care and ensures that we maintain our Magnet designation."

This designation, Clavelle says, is given to the top 8 percent of hospitals in the country.

"It recognizes organizations like ours that create a supportive environment for nurses to practice and provide high-quality care," she says. "I am committed to creating a culture where nurses and other providers give the best care possible. That's what it's really all about."

When she is not working, Clavelle enjoys painting.

Watercolors are especially appealing to her, and she takes art classes whenever she can.

Clavelle also likes to spend time with her husband, their adult children and their 14-year-old dog.

Even though Clavelle has spent the past 36 years working in health care, she says things amaze her — in a good way — about her work.

"I was pleasantly surprised and proud to learn that our hospital has a forensic-nursing program, and we also have a wonderful military partnership with the United States Air Force," she says. "It's a unique model for graduate nurses in the Air Force to participate in a number of programs, including a nurse-transition program and critical-care and emergency-trauma-nursing fellowship."

Who's Who in Business 2014

Joanne Clavelle is one of 50 women in various fields profiled in "Who's Who in Business 2014," a publication of Republic Media. Find the full publication online at azcentral.com in July.

Source: azcentral.com

BY SCRUBS CONTRIBUTOR

Ah, the dreaded night shift. Every nurse will have to encounter it at some point in his or her career. Some enjoy the more patient-based shift with its lack of administrators and clerical work, while others never can get into the rhythm of being a night owl.

If you’re a nurse on the night shift, chances are you have plenty of non-medical professional friends who won’t keep the same schedule as you. So how do you keep a normal social life while you work the night shift? Check out these five helpful tips:

1. Plan ahead with your non-work friends. If your shift is starting at 7:00 PM, for example, you could realistically have time to meet them for dinner an hour or so ahead of time. The night shift might remove some of the spontaneity of your social life, but it doesn’t have to remove time for fun and socializing.

2. Limit your caffeine intake. It can be tempting to consume cup after cup of coffee to get through those long shifts, but it’ll throw your sleep rhythm off even more and cause you to have to miss out on social functions with friends and family during days off.

3. Treat the switch to normal sleeping hours like jet lag. Take short naps at first to store up some energy and then power through the day until it’s time for bed. This will quicken your transition back to a normal sleep schedule. Try making time for non-work friends the day after you’ve adjusted back to normal sleeping hours.

4. Group your night shift days together. This will assure that you can have longer stretches of days off or daytime shifts. That leaves plenty of time for recreation, fun with friends, errands and time with family, but it’s also better for your overall health!

5. Get to know your coworkers! You’re spending so much time with them at odd hours, so you might as well establish trust, rapport and friendship. Try and bond with them socially and professionally. For example, if you like exercising, invite them to go on an early morning hike or to a workout class with you after the shift ends; if you are a coffee nut, see if they want to grab a cup at a nearby café. You can also bond professionally by trying to coordinate procedural training, or going to conferences and professional development events together.

The night shift doesn’t need to kill your mood, routine or health. Treat it seriously, plan accordingly with your shifts and keep a positive outlook so you can make new friends and keep up with those outside of your professional circle!

Source: scrubsmag.com

By Robin Erb

DETROIT — Technology originally designed for the U.S. military now has a second use: helping those with tremors eat and live better.

A high-tech spoon — fitted with a tiny computer and sensors such as those in a camera or cellphone — softens the effect of essential tremors by sensing their direction and strength and moving the device in the opposite direction.

"In some ways, it seems too simple to be true," said Dr. Kelvin Chou, a University of Michigan neurologist and essential tremors specialist whose patients helped test the device.

For essential tremor patients, simple daily activities — eating, applying makeup — can be impossible.

"Not being able to feed yourself or groom yourself — that takes a big emotional toll," said Anupam Pathak, CEO of Lift Labs, a California-based start-up company that makes the device.

The idea ignited after Pathak began as a doctorate student in engineering at the University of Michigan. He had been working on research to help stabilize military equipment for U.S. soldiers in the middle of combat, and over time, he began wondering whether the technology could help those whose hands tremble.

With funding from the National Institutes of Health, Pathak developed the LiftWare, a device that assesses movements thousands of times in a single second.

To test it, he turned to the university, where doctors at the U-M Health System treat 400 to 500 patients a year for hand shakes caused by essential tremor, a common movement disorder. It is estimated that 1 in 20 people worldwide have a degree of essential tremor.

Chou said the spoon worked surprisingly well for the 15 adults who tested it.

All had moderate essential tremor.

He said the results were "amazing," especially considering how socially limiting essential tremors can be. Patients often stop eating in front of others and no longer go out with friends and loved ones.

In the worst cases, they cannot feed themselves at all. Just 10% are candidates for surgery that treats the tremors.

"One of the worst things about essential tremor is that people feel like they have to be alone. This changes things for people," Chou said.

The device may not work for everyone with tremors. With many patients with Parkinson's disease, for example, the tremor improves when they are performing a task such as eating. However, those whose tremors interfere with eating stand to benefit from the device, Chou said.

The spoon and its advanced microelectronic technologies come with a hefty price tag: $295. Lift Labs and the International Essential Tremor Foundation have established a campaign to give the spoons to those with limited income.

Chou and Pathak said the same technology could be fitted with pieces to help those with tremors execute other daily activities, such as applying makeup or using hand tools. A fork and a soup spoon attachment will be available in the coming months, Pathak said.

Source: usatoday.com

By Joan Raymond

Today's expectant moms and their doctors have decided it's not nice to fool Mother Nature. Rather than inducing labor, they're letting nature take its course, with the length of pregnancies in the U.S. on the upswing, according to a new study by the CDC.

The study released Wednesday tracks labor started through surgical or medical means during the years 2006 through 2012. The researchers found that induction rates at 38 weeks — once considered full-term gestation but now called an early-term gestation — declined for 36 states and the District of Columbia during this six-year period. Declines ranged from 5 percent to 48 percent.

Geography didn’t seem to matter. Thirty-one states and the District of Columbia posted declines of at least 10 percent. The researchers did find that trends in induction rates at each week from 35 weeks, considered late pre-term, to 38 weeks, varied by maternal age. At 38 weeks, though, induction rates declined for all maternal age groups under 40, dropping 13 percent to 19 percent for women in their 20s and 30s.

This is a sharp reversal of trends tracked from 1981 through 2006 in which the proportion of babies born at less than 39 weeks gestation increased nearly 60 percent, while births at 39 weeks or more declined more than 20 percent.

“We were surprised that the overall induction rate went down,” says lead researcher Michelle Osterman, a health statistician with the National Center for Health Statistics, which is part of the CDC.

And it is welcome news, too. “For years we were taught that the 37th or 38th week of pregnancy was full term, but we did not appreciate the neonatal outcomes,” says ob/gyn Dr. Nancy Cossler, vice chair for quality and patient safety at University MacDonald Women’s Hospital in Cleveland, Ohio. 

“It was an ingrained part of our culture that 37 weeks is OK, but it’s not necessarily OK for the baby,” she says, citing issues such as hypothermia, feeding difficulties and respiratory distress among infants born early.

Historically, MacDonald Women’s Hospital had a rate of about 11 percent for labor induction for non-medical reasons among patients who were 37 to 38 weeks pregnant. Today, it’s nearly zero. In 2013, only one birth among the 37 to 38 week gestational age was done through induction. The patient had metastatic breast cancer, which is not among the usual listed criteria for medical induction, and needed to start chemotherapy and needed an early delivery, says Cossler.

Indeed, there is a big push nationally for longer-term births, such as the large-scale educational program called the 39-Week Initiative, supported by the March of Dimes and other groups. It seeks to end non-medically indicated deliveries prior to 39 weeks. Last year, the American Congress of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine even recommended the label “term” in pregnancy, be replaced with categories based on gestational age. Today, babies born at 39 weeks through 40 weeks and six days of pregnancy are considered “full term.” Babies born at 37 to 38 weeks are now considered “early term.”

“I think this study is very positive since several of us have now provided evidence that babies have better outcomes (with longer term births),” says Dr. Kimberly Noble, assistant professor of pediatrics at Columbia University.

In a study published in the journal Pediatrics of 128,000 New York City public school children, Noble and her colleagues found that compared to children born at 41 weeks, those born at 37 weeks had a 33 percent increased chance of having third-grade reading problems, and a 19 percent increased chance of having moderate math issues.

But doctors do worry that the pendulum could swing too far and patients may be afraid of induced deliveries. 

Our study “can’t differentiate between induction done for medical reasons and induction done for convenience, and if your doctor says this baby needs to come out at 37 weeks because of a problem, you need to trust your doctor,” says Noble, citing issues such as maternal or fetal distress as a cause for earlier delivery. What patients and doctors shouldn’t do is schedule an earlier delivery because of a vacation or other issue. “We know that 39 weeks and beyond is good for the baby,” she says.

Source: today.com

By CHRISTINA FARR

SAN FRANCISCO, USA - For decades, medical technology firms have searched for ways to let diabetics check blood sugar easily, with scant success. Now, the world's largest mobile technology firms are getting in on the act.

POACHING

Silicon Valley is already opening its vast wallet.

Medtronic Inc Senior Vice President of Medicine and Technology Stephen Oesterle recently said he now considers Google to be the medical device firm's next great rival, thanks to its funding for research and development, or R&D.

"We spend $1.5 billion a year on R&D at Medtronic - and it's mostly D," he told the audience at a recent conference. "Google is spending $8 billion a year on R&D and, as far as I can tell, it's mostly R."

Google has been public about some of its plans: it has developed a "smart" contact lens that measures glucose. In a blog post detailing plans for its smart contact lens, Google described an LED system that could warn of high or low blood sugar by flashing tiny lights. It has recently said it is looking for partners to bring the lens to market.

The device, which uses tiny chips and sensors that resemble bits of glitter to measure glucose levels in tears, is expected to be years away from commercial development, and skeptics wonder if it will ever be ready.

Previous attempts at accurate non-invasive measurement have been foiled by body movement, and fluctuations in hydration and temperature. Tears also have lower concentrations of glucose, which are harder to track.

But the Life Sciences team in charge of the lens and other related research is housed at the Google X facility, where it works on major breakthroughs such as the self-driving car, a former employee who requested anonymity said.

Apple's efforts center on its iWatch, which is on track to ship in October, three sources at leading supply chain firms told Reuters. It is not clear whether the initial release will incorporate glucose-tracking sensors.

Still, Apple has poached executives and bio-sensor engineers from such medical technology firms as Masimo Corp, Vital Connect, and the now-defunct glucose monitoring startup C8 Medisensors.

"It has scooped up many of the most talented people with glucose-sensing expertise," said George Palikaras, CEO of Mediwise, a startup that hopes to measure blood sugar levels beneath the skin's surface by transmitting radio waves through a section of the human body.

The tech companies are also drawing mainstream interest to the field, he said. "When Google announced its smart contact lens, that was one of the best days of my career. We started getting a ton of emails," Palikaras said.

Samsung was among the first tech companies to produce a smartwatch, which failed to catch on widely. It since has introduced a platform for mobile health, called Simband, which could be used on smart wrist bands and other mobile devices.

Samsung is looking for partners and will allow developers to try out different sensors and software. One Samsung employee, who declined to be named, said the company expects to foster noninvasive glucose monitoring.

Sources said Samsung is working with startups to implement a "traffic light" system in future Galaxy Gear smartwatches that flashes blood-sugar warnings.

Samsung Ventures has made a number of investments in the field, including in Glooko, a startup that helps physicians access their patients' glucose readings, and in an Israeli glucose monitoring startup through its $50 million Digital Health Fund.

Ted Driscoll, a health investor with Claremont Creek Ventures, told Reuters he's heard pitches from potentially promising glucose monitoring startups, over a dozen in recent memory.

Software developers say they hope to incorporate blood glucose data into health apps, which is of particular interest to athletes and health-conscious users.

"We're paying close attention to research around how sugar impacts weight loss," said Mike Lee, cofounder of MyFitnessPal.

After decades of false starts, many medical scientists are confident about a breakthrough on glucose monitoring. Processing power allows quick testing of complex ideas, and the miniaturization of sensors, the low cost of electronics, and the rapid proliferation of mobile devices have given rise to new opportunities.

One optimist is Jay Subhash, a recently-departed senior product manager for Samsung Electronics. "I wouldn't be at all surprised to see it one of these days," he said. — Reuters

Source: gmanetwork.com

By BENJAMIN MUELLER

In a case weighing the government’s ability to require vaccination against the individual right to refuse it, a federal judge has upheld a New York City policy that bars unimmunized children from public school when another student has a vaccine-preventable disease.

Citing a 109-year-old Supreme Court ruling that gives states broad power in public health matters, Judge William F. Kuntz II of Federal District Court in Brooklyn ruled against three families who claimed that their right to free exercise of religion was violated when their children were kept from school, sometimes for a month at a time, because of the city’s immunization policies.

The Supreme Court, Judge Kuntz wrote in his ruling, has “strongly suggested that religious objectors are not constitutionally exempt from vaccinations.”

The lawyer for the plaintiffs, Patricia Finn, said she plans to appeal the decision, announced this month. On Thursday, Ms. Finn asked the district court to rehear the case.

Amid concerns by public health officials that some diseases are experiencing a resurgence in areas with low vaccination rates, the decision reinforces efforts by the city to balance a strict vaccine mandate with limited exemptions for objectors. Pockets of vaccination refusal persist in the city, despite high levels of vaccination overall.

State law requires children to receive vaccinations before attending school, unless a parent can show religious reservations or a doctor can attest that vaccines will harm the child. Under state law, parents claiming religious exemptions do not have to prove their faith opposes vaccines, but they must provide a written explanation of a “genuine and sincere” religious objection, which school officials can accept or reject.

Some states also let parents claim a philosophical exemption, though New York does not. Some parents refuse to have their children vaccinated because of a belief that vaccines can cause autism, though no link has ever been proved.

Two of the families in the lawsuit who had received religious exemptions challenged the city’s policy on barring their children, saying it amounted to a violation of their First Amendment right to religious freedom and their 14th Amendment right to equal protection under the law, among other claims. Their children had been kept from school when other students had chickenpox, their suit said.

The third plaintiff, Dina Check, sued on somewhat different grounds, saying that the city had improperly denied her 7-year-old daughter a religious exemption. She said the city rejected her religious exemption after it had denied her a medical exemption, sowing doubts among administrators about the authenticity of her religious opposition. But Ms. Check said the request for a medical exemption had been mistakenly submitted by a school nurse without her consent.

After the school barred her daughter, Ms. Check home-schooled her and then moved her to a private school that accepted her daughter without the vaccinations. State vaccination requirements cover public and private schools, but in New York City, private schools have more autonomy in handling exemptions.

“Disease is pestilence,” Ms. Check said, “and pestilence is from the devil. The devil is germs and disease, which is cancer and any of those things that can take you down. But if you trust in the Lord, these things cannot come near you.”

In turning down all three families, Judge Kuntz cited a 1905 Supreme Court ruling that upheld a $5 fine for a Massachusetts man who disobeyed an order to be vaccinated during a smallpox outbreak, a case that helped establish the government’s right to require immunizations as a matter of public health.

Ms. Finn, the families’ lawyer, said that case should not be relevant. “There’s no way that court anticipated that children would be subjected” to the vaccines they must get today, she said.

In New York, the statewide mean religious exemption rate rose over the last decade, from .23 percent in 2000 to .45 percent in 2011, a 2013 study in the medical journal Pediatrics said.

New York City schools granted 3,535 religious exemptions in 2012-13, according to data from the state’s Health Department. Though city schools, public and private, have an overall immunization rate around 97 percent, according to the department, 37 private schools were below 70 percent. Health experts believe that above a certain immunization rate, outbreaks are limited because a disease cannot spread to enough people during its incubation period to sustain itself, a phenomenon known as “herd immunity.” For measles, which is highly contagious, that rate is believed to be 95 percent, according to Daniel Salmon, deputy director at the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health.

Though widespread vaccinations have practically eliminated diseases like measles and mumps from the United States, flare-ups have occurred. The 477 measles cases reported this year represent the worst year-to-date count since 1994, according to the Centers for Disease Control and Prevention.

Among the 25 people who contracted measles in New York City between February and April this year, two were school-age children unvaccinated because of parental refusal. When one of the children, who was being home-schooled, contracted the measles, city health officials barred that child’s sibling, who had a religious exemption, from attending school. The sibling eventually contracted measles as well. Health officials credited the decision to keep the second child out of school with stopping the spread of disease in that community.

Ohio, which granted more than three times as many religious and philosophical exemptions to kindergarten students last year as it did in 2000, is struggling to contain a measles outbreak that has recently spread to 339 Amish people who were largely unvaccinated, the state health department said.

Mr. Salmon said it can be difficult for states to balance an obligation to mandate vaccination with some leniency for families who have strong objections. Rules that force parents to articulate their beliefs and require public officials to educate them about the risks of exemption are states’ best defense against the spread of disease, he said.

Still, especially because parents who refuse vaccination tend to cluster geographically, it takes only a few unvaccinated children to start an outbreak, he said. At that point, even vaccinated children are at risk.

“Diseases have a way of finding our vulnerabilities,” Mr. Salmon said, “the kinks in our armor.”

We want to know what you think. Agree or disagree?

Source: nytimes.com

By Nurse.com

This fall, Duquesne University in Pittsburgh will become the first academic institution in the U.S. and globally to offer a dual degree in nursing and biomedical engineering for undergraduate students, according to a news release.

“Duquesne has pioneered the integration of clinical knowledge and patient care with engineering techniques in a single program, creating the first bachelor’s degree of its kind,” Provost Timothy Austin, PhD, said in the release.

The five-year program will provide students with a foundational body of knowledge that keeps patient care and practical application at the core of studies supporting innovations and technological advances.

The joint degree could prove a tremendous value to employers and patients, said John Viator, PhD, director of Duquesne’s biomedical engineering program. 

By gaining actual clinical experience, students also will develop new perspectives with respect to a patient’s health and functional needs. “Engineers do not always fully appreciate the hospital culture and the clinical needs of patients,” Mary Ellen Glasgow, RN, PhD, FAAN, dean and professor of the School of Nursing, said in the release. “This dual degree gives our students both the engineering and nursing perspectives to solve real world clinical problems.” 

In addition to learning engineering and nursing, students will benefit from class and clinical experiences that incorporate the Toyota Production System principles (used to address safety, cost and efficiency) and the American Association of Critical Care Nurses’ Synergy Model. 

Job opportunities for biomedical engineers are expected to grow 27% between 2012 and 2022, and nursing careers are expected to expand by 19% in the same timeframe, according to statistics from the Bureau of Labor Statistics. With the combined knowledge and skills of the two disciplines, opportunities may be limitless for the “nurse engineer,” Viator and Glasgow predict.

“Our students will begin their careers with the preparation, knowledge and worldview usually seen in those with years of experience in the field,” Austin said in the release. “This exciting BME/BSN partnership illustrates Duquesne’s innovative academic programs and the university’s focus on preparing students with the knowledge and skills to serve others.” 

Source: nurse.com

By Hannah Poturalski

A research effort underway at an area nursing home is testing out telehealth robots and other technology to enhance a patient’s ability to remain independent longer.

Students and faculty from the University of Cincinnati’s College of Nursing, as well as students from the colleges of medicine, engineering and allied health sciences, have partnered with Maple Knoll Village to develop innovative models using technology to help older adults stay independent and in their homes longer, said Tim McGowan, vice president of operations at Maple Knoll.

“The quicker we can develop the technology necessary to safely monitor them at home, the lower the cost of care will be and the quality of life for the patient returning home will improve,” McGowan said.

Every month more than a quarter-million Americans turn age 65. By 2015, for the first time in U.S. history, people age 65 and older will outnumber children under age five, according to the Council on Aging of Southwestern Ohio.

The partnership has opened a “smart house” on the Maple Knoll campus, formally called the Innovation Collaboratory House, inside an independent living unit for the UC students to conduct research and pilot new technologies.

Debi Sampsel, chief officer of innovation and entrepreneurship at UC, said the partnership developed in October 2012, and the smart house opened last spring for senior capstone classes in nursing and engineering.

Now hundreds of students are using the facility for education, research and translational practice.

“The house is about preparing them to come out into the community and hone in on their skills and techniques they’ll need in real positions,” Sampsel said. “We can start mirroring real life because they have to start thinking on their feet.”

A number of student-led projects are underway at the house, including the ability to control the temperature and lighting from a remote location, and motion detectors used to track patterns of activity in daily living to detect when an unexpected change in habit has occurred, said Megan Gresham, spokeswoman for Maple Knoll.

“Staff or family can be alerted if say they’re not getting out of bed at a certain time,” Gresham said.

Sampsel said students are also training on human simulators — with speech and movements controlled by a teacher in the next room — to learn the proper ways to take an IV, bathe a patient, take blood pressure and listen to the heart and lungs.

“This fits into our strategic plan to creatively leverage technology to change health care,” said Greer Glazer, dean of UC’s College of nursing.

After a public open house June 26, the UC students will start working with physicians on geriatric rounds at Maple Knoll. A large telehealth robot, called “Flo Bot,” will go along on the rounds and nurse practitioner students and college of medicine fellows will access the data remotely from UC.

A smaller telehealth system coined “Little Bot” will be used by students making rounds inside the independent living units of resident who have volunteered.

“I’m most appreciative for the resident support at Maple Knoll,” Sampsel said. “It really brings home what their (the students’) health care profession is going to be all about.”

Sampsel said the two entities are developing a formal agreement to be reached this summer.

Source: journal-news.com 

BY ROSE RUSSELL

Kevin Cischke left a music career after 25 years to pursue a new one in nursing, and it won’t bother him that he’ll be a man in a profession largely dominated by women.

As the face of the nursing profession slowly changes, Mr. Cischke, 45, is among the growing number of men signing up for the job. According to the U.S. Census Bureau, slightly less than 10 percent of the 3.5 million nurses in 2011 were men. That’s up from 1970, when only 2.7 percent of nurses were males.

For Mr. Cischke – who will receive a bachelor’s in nursing next year from Mercy College — nursing is in line with his interests. When introduced to nursing, the former organist and choir master for the Archdiocese of Detroit fell in love with it.

“A couple of my close friends who are nurses said I should look into this profession to see if it would interest me,” he said, during a break from his externship in the emergency room at Mercy St. Vincent Medical Center. “It was a whirlwind love affair that has not ended, and I don’t suspect that it will.”

Craig Albers, chief nursing officer and vice president of patient care services at Mercy St. Charles Hospital, said men in nursing offer an important component in the delivery of public health care.

“In the past, nursing was more of a pink collar profession and more of a career for women. A lot of times it’s seen as a profession for Caucasian women. Now, with large numbers of baby boomers retiring and seeking health care, we need a diverse workforce able to work with a diverse population,” said Mr. Albers.

A nurse himself since 1998, he began his college studies pharmacy. When he decided he needed more patient interaction, a professor suggested he look into nursing.

“I job shadowed an ICU nurse and the role really appealed to me. That’s what led me to the profession,” he said.

It was the patients who also attracted Mr. Cischke.

"I enjoy the patient-care side of things. I wanted hands-on patient care. That's what drives me, and the fact that I can continue to learn and grow fits my personality perfectly," he said.

He also liked contributing to the profession and addressing concerns of his male peers. In fact, when they discovered something missing in their nursing school experience, he led the way to establishing a local chapter of the American Assembly of Men in Nursing. The organization addresses issues that affect men in nursing. About 20 men and five women are members of the group.

"I continued to explore what the assembly had to offer, promote, and to accomplish and I realized that their goals aligned with what we needed to have at Mercy to support our male students," said Mr. Cishke, one of 116 male students in the nursing program.

The organization will also help groom male nurses for retiring baby boomers who increasingly use health care. Health professionals who deliver care to boomers must be on their toes.

"Our baby boomer population will be very informed and knowledgeable and Internet and computer savvy, and people going into the nursing profession will have to be extremely knowledgeable and confident and able to communicate with their patients because the patients are very knowledgeable," said Mr. Albers.

While male nurses' physical strength is also a plus for patient care, Mr. Albers said more men joining the field may pursue advanced fields in nursing, such as management, administration, business, and anesthetics. Those advanced career possibilities attracted Daniel Koehler to the profession.

He received a bachelor's in nursing from Lourdes University in December. Eight years ago, he obtained a bachelor's in human biology from Michigan State University. He then worked in the restaurant and fitness businesses before going to nursing school.

He wasn't intimidated by the predominantly female profession, and in fact received positive responses from others.

"Most guys don't grow up thinking they want to be nurses," as many girls do, said Mr. Koehler, whose mother was a nurse in Germany. "With the guys I've met in the profession, I think less of that stigma now days."

Though slightly less than 10 percent of ProMedica's nurses are men and slightly more than 8 percent of the nurses in the Mercy health system are men, the idea that nursing is a woman's job stopped Roberta Pratte's father and grandfather, both medics in the military, from continuing in the profession. As a teenager, Ms. Pratte — a Mercy nursing professor — recalls hearing her grandfather speak fondly about nursing.

"Back then it wasn't something that men talked about or thought about. I sensed that they regretted that they were not allowed to follow their dream," said Ms. Pratte, an instructor at Mercy College. She has been a nurse for 33 years, and her mother was also a nurse.

Large numbers of nurses are expected to retire soon, adding to the already critical nursing shortage. That's why the profession is pushing to attract men and women into nursing. As a matter of fact, the American Assembly for Men in Nursing is campaigning to increase the number of male nurses by 20 percent by the year 2020, said Ms. Pratte. She also said the Institute of Medicine and the Centers for Disease Control and Prevention are reviewing how to fill nursing positions to ensure that the public gets proper care.

Source: toledoblade.com

By Stacey Burling

The nurses' emotional response to George's impending loss was a sign of the emotional power of narrative, which the National League for Nursing is harnessing to improve education about late-life medical problems. The group also is embracing a multimedia approach that includes the written word, audio recordings of the "patients" voiced by actors, simulations that include mannequins and live actors, and the latest addition: virtual animations of the patients and nurse avatars who make treatment decisions.

"Traditional-based teaching is really over for most of us," Elaine Tagliareni, the league's chief program officer, told the crowd of about 175 who had gathered for her group's Advancing Care Excellence for Seniors conference. The Independence Blue Cross Foundation is a sponsor. Using technology to improve care was a theme this year.

The nursing group wants to reach a new generation of students who are already accustomed to multimedia learning, may be taking classes online, and will work in a world where technology increasingly connects patients, doctors, and nurses who are not in the same room.

Medical and nursing schools have long used standardized patients: actors who portray certain medical conditions. Increasingly sophisticated mannequins have been playing a bigger role in medical education in recent years.

Drexel University's College of Nursing and Health Professions began using a virtual-patient program produced by Shadow Health last year. It is meant to reinforce classroom training. The University of Pennsylvania School of Nursing also is using a Shadow Health program to teach nurses how to take a health history and perform a physical exam.

Gregg Lipschik, director of life-support training and undergraduate curriculum at the Penn Medicine Clinical Simulation Center, said Penn sometimes uses a virtual program to review resuscitation techniques. It pairs computer simulation and mannequins to teach procedures such as bronchoscopies.

Lipschik said use of simulation had been growing since 1999, when an Institute of Medicine report recommended it to reduce medical errors and improve teamwork. "It's really boomed in the last few years," he said.

The nursing league began its Advancing Care program in 2009, Tagliareni said, because "care of older adults is not well integrated into nursing programs" even though 75 percent of the care nurses give is to people over 65. It's adding the new dementia cases to expand education on another neglected topic.

The patient profiles are purposely complicated - like real people - and they unfold over time in unpredictable ways. The death of George Palo's golden retriever is a calamity not only because George's grief adds to his thinking problems but because walking Max was a key way the man exercised and interacted with the outside world. The profiles are accompanied by teacher information.

Tagliareni said that the dementia patients may not end up in the virtual world but that other fictitious elderly characters like Millie Larsen and Red Yoder may be available this fall in the gamelike "vSim for Nursing" program developed by Wolters Kluwer Health of Philadelphia and Laerdal Medical.

An audience member said her students easily identified with the league's patients. "That's my Pop-Pop," one of them told her.

The group at the meeting saw a younger virtual patient named Stan and his virtual nurse, Dan. Stan had gone to the emergency room with stomach pain from a bowel obstruction. The student, who had access to test information and doctor's orders, had to use a menu of options to decide what Dan should say and do. The animation was primitive, but the decisions were complex. At the end of their 30-minute encounter, the student received a number score and a report on what had been done and should have been done.

Barbara McLaughlin, head of nursing at Community College of Philadelphia, did a pilot test of vSim, which costs $100 per student for two years of access, with her students last year. "They liked them [the scenarios] a lot because it gave them the opportunity to do the same experience over and over and correct their mistakes," she said.

Source: philly.com