DiversityNursing Blog

Introduction

The 2013 Fidelity Investments Nurses Retirement Study is designed to gain

insights into nurses’ overall financial confidence and outlook towards retirement,

as well as:

• Assess nurses’ sentiments towards their workplace retirement plan and other retirement savings options

• Measure retirement savings behaviors among nurses

• Measure nurses’ needs and attitudes in regard to retirement planning and guidance

STUDY METHODOLOGY

Versta Research, an independent research firm, conducted the online study on behalf of Fidelity Investments^® from August 5 – August 18, 2013. The survey population is a nationally representative sample of 536 practicing U.S. nurses with sampling stratified by age cohort as follows:

Age 18 to 34 (born 1979-1995) Generation Y           n=164

Age 35 to 48 (born 1965-1978) Generation X           n=157

Age 49 to 67 (born 1946-1964) Boomers                 n=185

Age 68+ (born 1945 or earlier)                              n= 30

Key Findings

Retirement savings are up; one-quarter (26%) of nurses with a workplace retirement savings plan have accumulated assets of more than $100,000, up from 18% in 2011.

• Participation in workplace retirement plans remains steady at 85%. However, among those participating, saving rates are less than optimal especially among younger generations: Gen Y (5%), Gen X (6%) compared to 10% of Boomers.

• Gen X nurses (55%) and Gen Y nurses (48%) are not confident they will have enough money to retire, compared to 35% of Boomers. Furthermore, 76% of Gen X nurses are concerned they will never be able to retire compared to 53% of Boomers.

• Sixty-two percent of nurses report not saving enough for retirement. More than half (53%) feel retirement planning is overwhelming and 79% are looking for guidance.

• Nurses are experiencing increased levels of stress as a result of industry consolidation from increased mergers and acquisitions. 

• The good news –  one-quarter (26%) of all nurses with a workplace retirement savings plan have accumulated more than $100,000 in assets, up from 18% in 2011

• The bad news – savings rates especially among younger generations are less than optimal. Fidelity recommends that employees save 10-15% of their salaries from both employer and employee savings. Results show Gen Y and Gen X are saving a median of 5% and 6%, respectively, compared to Boomers who are saving 10%

  

• Fewer than one-half of nurses (44%) believe they will never fully retire, and at least two-thirds (63%) express concern about it. Instead, one-half (47%) see themselves as continuing to work, either because they will only partially retire (42%) or because they will never retire at all (5%)

• Six out of ten (60%) will continue to work, in part, because they need the health insurance

Four out of five nurses participate in workplace retirement savings plans; half report it will be most important source of retirement income

• Nine in ten nurses (92%) report having a workplace retirement savings plan available to them, whether it is a 401(k), 403(b) or a similar plan

  • More than eight out of ten (85%) participate in their workplace retirement savings plan

  • The study also revealed that 15% of nurses are not participating in workplace retirement plans. For those who have plans available to them, this represents a lost opportunity to save and qualify for the company match offered by many health care institutions

  • Four in ten (43%) say that their workplace retirement savings will be their primary source of income when they retire.  Fewer than half as many cite other sources as primary

  • Among those not participating in their workplace retirement savings plans, inertia and needing help figuring out how to begin are as important as not having enough money 

• Top reasons nurses do not participate in a workplace retirement savings plan:

  • Don’t have the extra funds to save (cited by 32% of those not participating)

  • Already save in other ways (cited by 29%)

  • Have not gotten around to it (cited by 29%)

  • Don’t know where or how to begin (22%)

  • Overwhelmed by the amount needed (15%)

  • In addition to any workplace retirement benefits available to them, just more than half of nurses (55%) are saving for retirement through an IRA – a number that has not changed significantly since the first nurses’ survey in 2007

Many nurses worry about industry and government changes that are outside of their control, including consolidation and reduced benefits

• Four in ten nurses (42%) have experienced a consolidation (merger or acquisition of their employer), up from 29% two years ago

• One-half (50%) anticipate more hospital consolidation over the next five to ten years (up from 39%) two years ago

• In regard to the impact on their jobs, nurses report negative outcomes caused by consolidation by a ratio of four to one. These include more stress, lower morale, fewer staff and cuts to benefits

   

• What do nurses anticipate as adjustments to their profession specifically from health care changes?  Again, more than anything else, they see more work, more stress, fewer available nurses, and lower levels of care:

• Patients receiving inadequate attention (39%)

• Nurses having higher levels of stress (35%)

• Nurses having more patient care responsibility (29%)

• Nurses leaving the profession (26%)

• When it comes to changes that will most affect them personally, nurses focus on stress, reduced benefits, and increased responsibilities:

• Nurses having higher levels of stress (49%)

• Employers offering reduced health benefits (39% - up from 33% in 2011)

• Nurses having more patient care responsibility (26%)

Gen X nurses are the most concerned about their retirement security

• Roughly one in five (19%) nurses expect Social Security to be their primary source of retirement income. Gen Y and Gen X nurses put less faith in the program, with only 8% and 16% respectively citing Social Security as primary source

• The number of nurses who report having a defined benefit pension plan has dropped from 48% in 2011 to 39% in 2013. Among Boomer nurses, 44% have access to a DB plan. Similarly, the numbers who expect to rely primarily on a defined benefit pension plan for retirement income is down from 18% six years ago to 7% in 2013

• Compared to others, Gen X nurses express the strongest concerns about their financial future in retirement and Boomers express the least 

• More than half (55%) of Gen X and 48% of Gen Y are not confident they will have enough money to retire, compared to 55% of Boomers

  • Furthermore, 76% of Gen X nurses are concerned they will never be able to retire compared to 53% of Boomers

Nurses want more retirement planning help and increasingly turn to individual help from workplace providers

• 62% of nurses acknowledge they are not saving enough for retirement. A majority of nurses need more help planning financially for retirement, especially Gen Y and Gen X nurses

*Significantly lower than other cohorts

• Needing help does not always lead to action.  Among those who say they are not saving enough, just one in four (27%) will seek retirement planning and guidance over the next 12 months to help them save more

• When it comes to tools and resources that nurses use to learn about and manage their workplace retirement plans, one-third (34%) say they rely on educational resources from their employers

• Among the employer resources that nurses find most helpful are individual in-person meetings and mailed materials

  • Individual consultations, either in-person or by phone, are increasingly important:

* Significant increase

• Beyond one-on-one employer resources, nurses increasingly look to general online resources and family for help:

  • Online tools (relied on by 40%, up from 31% in 2011) 

  • Family and friends (relied on by 41%, up from 31% in 2011) 

  • Online educational sites (relied on by 32%, up from 23% in 2011)

  • Financial publications (relied on by 16%)

• In addition, more nurses are turning to professional guidance, with over half (54%, up from 42% in 2011) saying they receive help from financial professionals, either paid (38%, up from 30% in 2011) or unpaid (16%, up from 13% in 2011)
  
   

Respondent Profile

Most of the nurses (62%) were employed by not-for-profit organizations (versus 38% employed by for-profit organizations).  Four out of five (80%) were full-time employed (versus 20% part-time employed), and most (90%) were direct employed (versus 10% contract employed).  The average (median) tenure with employers was 7 years.  Additional demographics include:  

• 94% women, 6% men

• Average age 47

• 66% married or living with a partner

The results of 2013 Fidelity Investments Nurses Retirement Study may not be representative of all nurses meeting the same criteria as those surveyed for this study.

Fidelity Investments and Fidelity are registered service marks of FMR LLC.

Fidelity Brokerage Services LLC, Member NYSE, SIPC

900 Salem Street, Smithfield, RI 02917

673506.1.0

© 2013 FMR LLC. All rights reserved.

BY MARIJKE DURNING

‘Twas the night before Christmas and night in the ward

I glanced at the names that graced the white board.

The charts were all piled on the desk without care

In the hopes I’d have time to see what was there.

The patients were restless, moving about in their beds

While call bells went off, causing pain in my head.

Charge nurse in scrubs, I with my lab coat

Waited for the effects of our latest coffee jolt.

When way down the hall, there arose such a clatter!

We ran from the office to see what was the matter.

Away down the hall, I flew like a flash

Clipped my knee on a wheelchair, my teeth I did gnash.

The light in the hall, turned low for the night

Showed me a scene that gave me a fright.

Because what to my fearful eyes should appear

A lonely walking patient, coming ever so near.

The patient stumbled forward, an IV in his hand

Trailing behind, a catheter bag, a train so grand.

Now Nurse! Now Doctor! Now anyone here!

Come on anybody, I want me some beer!

Along he went to the top of the hall,

My colleague and I were afraid he would fall!

By his side I did go, to help calm him down

He greeted my presence with an obvious frown

He called for a chair and then again for a beer

We quietly told him, “Sorry, we don’t serve that here.”

And then, in a twinkling, I heard in a room

A lady calling, she needs a broom!

A crash we then heard, the patient came to the door

Come, see what’s a mess, see on the floor!

I left the beer drinker to go have a peek

The sight on the floor made me send out a shriek.

I went to the phone: “Get me housekeeping, please!

I need your help now, I’m starting to wheeze!”

The patient was moved to a room that was clean

I thought of the patients I hadn’t yet seen.

The patients got settled, the call bells stopped beeping

Midnight was coming, we felt the time creeping.

IVs we did check and vital signs we did take

Wondering if this Christmas, we’d both get a break.

Back down to the desk, we had paperwork to do

Looked at the clock, still plenty of night to get through.

We went through chart after chart, the orders we checked

When the call bells went off, down the hallway we trekked!

Midnight was coming, Christmas Eve would soon end

We wondered if admin would mind if some rules we would bend

For the holiday season is the time for some fun

As long as our patient work was all done!

We went back to the desk, just for a moment or two

When we found treats on the desk—from where and from who?

The treats, they were good and touching to get

But from where they arrived, we hadn’t found yet.

We heard sounds of someone running out of sight

And heard very clearly, “Merry Christmas to all and to all a good night!”

Source: Scrubs Mag

BY ELIZABETH SCALA

Why am I doing this again?

Now that the holiday season is upon us (and many of us nurses have to work while our loved ones get to stay home and play), we might be questioning why we went into nursing in the first place. It’s no fun working when everyone else is off, enjoying meals, gifts and holiday traditions with family and friends.

But this is the time of year when many of our patients need us most.

Some of them don’t have family and friends. Many of them are scared and alone. And I can bet that all of them would rather be anywhere but in the hospital during this time of year.

Instead of focusing on the downsides of nursing during the holidays, let’s choose something different. Together we can empower ourselves and enjoy our work and our home life, no matter where we find ourselves on these special days.

Here are three tips for shifting your nursing perspective during this busy time of year:

1. Reconnect with what you enjoy. One of the simplest ways to reconnect ourselves with our nursing selves is to remember what brought us to nursing in the first place. After that memory is brought back to life, bring it into the here-and-now. You might ask yourself the following questions: What is it about nursing that I love? What’s my favorite part of my job? In what ways am I passionate about this really awesome and humbling profession? Reconnecting with your purpose is a wonderful way to shed light on the joy of your life.

2. Discover the good in everyone. I had a client last week tell me how she was making a conscious choice to find the good in every single person she worked with, even when it was hard. From the front desk to the parking garage, from the manager to the newest graduate on your unit, from the CEO to the ancillary staff, what can you appreciate in every single person? The more you see the good in everything you do–and everyone you greet–the more your environment is filled with good things to see. Try it for yourself. Give this a shot for a week or so and see what happens.

3. Be mindful of gratitude. The fastest and easiest to shift your perspective is through the practice of gratitude. We get what we give. Now, during the holidays, or at any time of year. Our thoughts become our worlds. If you’re able to focus on what you’re thankful for–about your job, your place of employment and your coworkers–you’re much more likely to enjoy working the holiday shifts. Yes, they may still be hard…we all want to be with family. But what is it about being a nurse and sharing the holiday with a patient that can lift your spirits? How can you be grateful today?

Source: Scrubs Mag

By Nursing at Ohio University 

By Gloria Kindzeka, RN

Editor's note: The writer is the "2013 Amazing Nurse” of The Johnson & Johnson Campaign for Nursing’s Future Amazing Nurse program (www.AmazingNurses.com). She was honored on the Nursing Notes by Johnson & Johnson Facebook page (www.Facebook.com/JnJNursingNotes) and shared her inspiring story with Nurse.com. 

I met the little girl who would make a lasting impression on my life the night she was discharged from the hospital after a long stay in the NICU. 

Kate was crying when I met her. She had been diagnosed with Pfeiffer syndrome and was experiencing tremendous pain because of orbital pressure. I could see the orbits bulging and knew that continuous crying could exacerbate the situation and result in a serious medical emergency. I prayed to God to give me a healing touch to help her avoid another long hospital stay so she could enjoy being at home with her family. 

I’m originally from Cameroon, West Africa, and to help calm Kate that night I sang a lullaby in my dialect until she fell asleep. From that day forward this became our regular bedtime routine.

The first two years were very difficult. Kate was in and out of the hospital quite often for therapies, medical emergencies and other medical procedures. Her medical team was not sure she would survive, or whether she would be able to eat or walk if she did survive.

It was an indescribable experience as a mother and a nurse to watch Kate’s mother listen and digest all the information from the physicians, most of which was not positive. I offered her my unwavering support, encouragement and positive thoughts during these dark periods. Although I showed a brave face while working with Kate and her family, I cried in the car on my way home every day for the first two weeks. 

Together, Kate’s mom and I spent many hours researching Kate’s rare genetic condition. We became better educated on treatments and discovered a number of support groups. Kate’s mother was determined that her daughter would beat the odds, and I promised myself that I would do everything I could to take care of Kate and help her reach her fullest potential. As a nurse, I felt this was my purpose and why I was sent to work with Kate and her family. 

Despite Kate’s numerous complex medical needs, she is a hero who bounces back from every surgery like a fighting champion. I have seen her come out from a major cranial vault surgery, cut from ear to ear, and be discharged after only three days. With her eyes shut and her head swollen to twice its regular size, she attended all scheduled therapies, ate and walked, even when she was supposed to rest and remain relatively inactive.

Kate, now age 4, continues to meet every challenge head-on. She has refused to use any adaptive equipment, even though her elbows are fused. She attends school daily, participates in community activities and sports, and travels everywhere with her family. Kate has learned to eat by mouth and drink with a straw, which is uncommon for a child with a tracheostomy tube. She does all these things because she has a strong spirit and is determined to live happily and fully. 

Through Kate, I have learned to find beauty in challenging circumstances. I’ve learned that every child has special gifts and possesses the ability to overcome tough conditions. I am more appreciative of the things I took for granted in life.

On a personal level, it’s satisfying to know that I contributed to improving the health and well-being of my patient. The best way to explain it is through the “Hierarchy of Needs: A Theory of Human Motivation,” developed by psychologist Abraham Maslow. Through nursing, I feel like I have reached the fifth stage, self-actualization, which means “attaining one’s full potential as a human being living in the world.” 

Source: Nurse.com

By Megan Murdock Krischke

“The nurses I work with are the smartest, funniest people I know. Our work causes us to problem-solve and to think critically about everything, and that leads us to coming up with solutions in every aspect of our lives.  It just fits that we would be inventors,” remarked Stacey Tatroe, RN, BSN, inventor of RN I.D. Scrubs.

Fellow nurse entrepreneur Sarah Mott, RN, agrees. “My colleagues and I were always making little inventions to provide patient care--like things to elevate a leg or to make an IV work. But we weren’t thinking about these as inventions. That is why I wanted to encourage other nurses to pursue their inventions and to bring their products to market.”

Mott has recently started her own company, Nurse Born. Her vision is to market products created by nurses that are inspired by practical experience.

“I want to encourage nurses to think about the needs of their colleagues and patients and then to pursue their ideas,” said Mott. “As the company grow, I would like to hire nurses who, because of an injury, can no longer tolerate long hours on the floor.”

Mott’s own work-related injury is part of the story of how she became a nurse inventor and a business owner.

“It has been a very long road. It started when I was working as a staff nurse on a post-op ortho floor. My neck was bothering me and I was uncomfortable with the stethoscope hanging on my neck. It also bothered me to keep an item that carried so many germs so close to my face. I was looking for an alternative way to carry it and I couldn’t find anything, and I thought someone should invent something,” she explained.

A few months later, her injury had progressed to the point that she had to take some time off work. At home and bored, she started experimenting with household items to create a stethoscope clip. Once she assembled a workable clip, she began pursuing a patent and was accepted into a free program where a local university student helped her apply for it. An engineer acquaintance of hers was willing to create a prototype.

In due time, her Stethoscope Holster became a reality, and is now the first product to be marketed through Nurse Born.

Mott says her biggest challenge so far is just getting the word out about her product.

“My experience as a nurse has helped me in my new career as an entrepreneur. I learned to be more confident and to trust my own judgment,” she stated. “Nursing helps you develop good instincts about people because you are constantly interacting with different kinds of people and personalities.”

Along the path of bringing her product to market, Mott was mentored by members of a local small business association as well as other nurse inventors she found through online research. She would love to provide that same kind of support to other nurse inventors and encourages them to contact her.

Tatroe is one of the inventors who mentored Mott.

Tatroe works as an ER nurse at Wellstar Health Systems in Atlanta, Ga., and fell into the role of nurse entrepreneur through a different route.

After working as an LPN for six years, she had completed her RN licensure and wanted to celebrate.

“For work that day, I hand-made scrubs that said RN and wore a sash and a crown!” she said. “What was so interesting was that colleagues I had worked with for years were surprised to find out that I wasn’t already an RN. Even though our licensure is written on our IDs, clearly no one was reading that. But they saw it when it was written on my scrubs.”

“It is frustrating for patients when they don’t know who is walking into your room.  Some hospitals use a color-coding system, and that can be helpful for the staff, but the code often remains unclear to patients, family members and providers who don’t work at the facility. I.D. Scrubs communicate to the patient, ‘I am your nurse. I am the one who is here to take care of you and answer your questions.’”

Tatroe pursued a patent and contacted her favorite scrub manufacturer, Cherokee Uniforms, to pitch her idea. They are now marketing her line as RN I.D. Scrubs.

Tatroe agrees with Mott that marketing can be the most challenging part of inventing a product and getting it off the ground.

“Every time I am at a trade show or show another nurse these scrubs, they love them and they ‘get it’ immediately. The challenge is getting the word out and letting nurses know that I.D. Scrubs are available,” she remarked. “I hope we will be able to expand the line to include IDs for all scrub-wearing clinicians and staff.”

Tatroe urges other nurses to pursue their ideas.

“Go for it!” she said. “You will never know unless you try. Think of all the innovations in history--what if those inventors hadn’t given it a go? You have to put yourself out there and work for it. Nothing comes easy or free.”

Source: TravelNursing.com

By RWJF

Barbara Nichols, a national nurse leader who broke through color barriers to become the first Black president of the American Nurses Association, likes to point out that she entered the profession in its dinosaur days—before the advent of cardio-pulmonary resuscitation, intensive care units, and pre-mixed narcotics.

It was also prehistoric in another way; Nichols became a nurse in the 1950s, when a national system of institutionalized discrimination kept minorities from entering and advancing in nursing.

In those days, many hospitals were segregated, as were many nursing schools. Those schools that weren’t often capped the number of students from racial, ethnic, and religious minority backgrounds with rigid quota systems. Few minority nurses earned baccalaureate or advanced degrees, and fewer still rose to become leaders of the profession.

But Nichols overcame those hurdles and eventually made history as the first Black nurse to hold national and state-level nursing leadership positions. Throughout her career, she has been helping others from underrepresented backgrounds enter and advance in the profession—a mission she continues at the age of 75 as director of a diversity initiative in her home state of Wisconsin.

“My whole career has been spent raising the issue of the need for racial and ethnic inclusion and looking for specific ways to involve and include more minorities in nursing,” she says. “That has been my passion.”

Born during tail end of the Great Depression and raised in Maine, Nichols was active in children’s theater and considered becoming an actor; but she ultimately decided against it because of limited professional acting roles for Blacks. Instead, she pursued a different, more “practical” dream, and became a nurse. “I was born in the late 30s, and the job market and occupations for Blacks were very limited,” she recalls. “Pragmatically, nursing was one of the fields you could go into.”

Not that it was easy. Nichols landed a highly coveted spot at Massachusetts Memorial School of Nursing in Boston, where she was one of only four Black students in her class. She went on to earn her bachelor’s degree in nursing at Case Western Reserve University, where she was one of two Black students in her class. She took a job at Boston Children’s Hospital, where she was the only Black registered nurse (RN) on staff. She then joined the U.S. Navy, where she was one of a handful of Black nurses on a staff of 150.

But life as “a speck of pepper in a shaker of salt,” as one reporter put it, never held her back; rather, it propelled her forward as a nurse leader and advocate for diversity in nursing. As a young staff nurse, she recalls, her suggestions were ignored because of her race. “Nurses would say, ‘Well, who are you to tell us what to do,’” she recalls. “That’s when I decided to get into a leadership role. It was a direct result of being ignored, and of the impression I got that my ideas weren’t worthy of consideration because I was Black.”

And lead she did. In 1970, Nichols became the first Black woman to serve as president of the Wisconsin Nurses Association. To this day, she is still the only ethnic minority to serve as the organization’s president in its more than 100 years of existence. In 1979, Nichols went on to become the first Black president of the American Nursing Association—an organization that once banned Blacks—and served for two terms. In 1983, she became the first Black woman to hold a cabinet-level position in the state of Wisconsin when she was appointed to serve as secretary of the Wisconsin Department of Regulation and Licensing. She was named a Living Legend by the American Academy of Nurses in 2010.

“I’ve been a role model who says that Blacks can achieve and can participate in meaningful ways in issues that are central to the profession,” she says.

A Long Way to Go

A lot has changed since Nichols first entered the profession. Nursing schools are no longer segregated and no longer use quotas. Employers are working harder to recruit and retain nurses of color, she adds, and more nurses from underrepresented backgrounds are seeking higher degrees.

But there’s still a ways to go before the nursing workforce reflects the increasingly diverse population it serves. The RN workforce is 75 percent White, almost 10 percent Black. and less than 5 percent Latino, according to a 2013 report by the Health Resources and Services Administration. A more diverse nursing workforce is needed to provide culturally relevant care, improve interaction and communication between providers and patients, and narrow health disparities, according to the Institute of Medicine (IOM).

After six decades in nursing, Nichols is not giving up. A visiting associate professor at the University of Wisconsin-Milwaukee College of Nursing, Nichols recently took a position as project coordinator for the Wisconsin Action Coalition to help diversify the state’s nursing workforce. Action Coalitions are the driving force of the Future of Nursing: Campaign for Action, which is backed by the Robert Wood Johnson Foundation and AARP and aims to transform the nursing profession to improve health and health care. It is grounded in anIOM report on the future of nursing released in 2010.

“Our goal is to embed, and ground, all our activities with a diversity component,” Nichols said. To do that, she and her colleagues are gathering data about the diversity of Wisconsin’s nursing workforce, partnering with interested parties, raising money to sustain efforts to diversify the profession, and analyzing ways to promote diversity through policy and practice.

She also supports the Campaign’s national efforts to implement diversity planning, recruit and retain students and faculty from underrepresented groups, and promote advanced education and leadership development among minority nurses.

 “We have a big job ahead of us,” Nichols says, adding: “Prejudice is still out there.”

Source: RWJF

Researchers at Loyola University Medical Center in Maywood, Ill., have published a study of emotional and psychological anguish, known as moral distress, experienced by nurses in an ICU for burn patients.

The study by first author Jeanie M. Leggett, RN, BSN, MA, and colleagues is published in the Journal of Burn Care and Research.

Moral distress occurs when a person believes he or she knows the ethically ideal or right action to take, but is prevented from doing so because of internal or institutional barriers. Moral distress can result in depression, anxiety, emotional withdrawal, frustration, anger and a variety of physical symptoms. It also can lead to job burnout.

“Given the intense and potentially distressing nature of nursing in a burn ICU, it is reasonable to hypothesize that nurses in these settings are likely to experience some level of moral distress,” Leggett, manager of Loyola’s Burn Center, and co-authors Katherine Wasson, PhD, MPH; James M. Sinacore, PhD; and Richard L. Gamelli, MD, FACS, wrote, according to a news release.

The pilot study included 13 nurses in Loyola’s burn ICU who participated in a four-week educational intervention intended to decrease moral distress. The intervention consisted of four one-hour weekly sessions. The first session outlined the study aims, definitions of moral distress and related concepts. Session two focused on signs and symptoms of moral distress. Session three dealt with barriers to addressing moral distress. And in session four, nurses were encouraged to identify strategies they could use or employ to deal with moral distress. 

The nurses completed a questionnaire called the Moral Distress Scale-Revised that measures the intensity and frequency of moral distress. They were divided into two groups: One group completed the survey before the intervention, and the other group took the survey after completing the sessions.

Researchers had expected that the group taking the survey after the intervention might have lower moral distress scores. But they found just the opposite: The group taking the survey after the intervention had a median moral distress score of 92, which was significantly higher than the 40.5 median score of the group that filled out the survey before taking the course. (The moral distress score can range from 0 to 336, with higher scores indicating greater moral distress).

Researchers said in the release that the reason moral distress scores were higher among nurses who took the survey after the educational sessions could be due to a heightened awareness. 

Six weeks after completing the intervention, both groups took the moral distress questionnaire again, and this time, there were not significant differences in their scores. There also was no significant difference between the groups’ scores on a second questionnaire called Self-Efficacy Scale, which is designed to measure a person’s effectiveness in coping with daily stressful events.

After each weekly session, nurses completed a written evaluation. 

“They appreciated the individual sessions and case discussions, felt the session lengths were appropriate and expressed validation of their feelings of moral distress after having participated,” researchers wrote. “They indicated that learning the definition of moral distress was valuable, found it helpful to learn that others in similar work environments were experiencing moral distress and appreciated hearing what others do to cope with moral distress. Participants expressed a desire for this type of intervention to continue in the future and for more time to be spent on coping strategies.”

Researchers concluded that a larger study, involving more nurses from multiple burn centers, is needed. 

“The larger study should be refined to develop strategies for implementing effective interventions that become part of the culture and that ultimately reduce moral distress,” researchers concluded. “In so doing, effective strategies for dealing with the moral distress experienced by this population can be more readily put in place to help cope with it.” 

Source: Nurse.com

By Nurse.com News

Home visits by nurses and paraprofessionals to children of low-income women had some positive benefits on cognitive and behavioral measures for the children, according to results of a clinical trial.

Home visits by nurses to low-income families have been promoted as one strategy to improve health and development outcomes for first-born children from those families, according to background information in the study, which was published Dec. 2 as an online-first article in JAMA Pediatrics.

David L. Olds, PhD, of the University of Colorado Denver, and colleagues followed up on a randomized trial in Denver that included 735 low-income women, most of them unmarried, and their first-born children as part of the Nurse-Family Partnership, a program that has been conducted in other cities. 

The goals of the NFP are to improve pregnancy outcomes by helping women improve their health-related behavior, improve their children’s subsequent health and development by helping parents provide competent care, and enhance a mother’s personal development by promoting the planning of future pregnancies. The Denver trial was meant to test the program model when it is delivered by paraprofessionals, who were required to have a high school education and no college preparation in the helping professions and who also shared many of the same social characteristics as the families they visited.

Women in the study were divided into three treatment groups: The first group of 255 women received free developmental screening and referral for their child, the second group of 245 women received the screening plus a paraprofessional home visit during pregnancy and the child’s first two years of life, and the third group of 235 women were provided the screening plus a nurse home visit during pregnancy and the child’s first two years of life.

The researchers found that children born to mothers with low psychological resources but visited by paraprofessionals showed fewer errors in visual attention or task switching at age 9. Children visited by nurses were less likely to be classified as having total emotional or behavioral problems at age 6, internalizing problems at age 9 and dysfunctional attention at age 9. 

Nurse-visited children born to low-resource mothers also had better receptive language and sustained attention averaged over time, the researchers reported.

Unlike in a similar trial that previously was conducted in Memphis, children visited by nurses in the Denver trial did not display significant benefits in cognition or in reading and math achievement. 

Possible reasons for the disparity, the researchers said, include that “the benefit of the nurse-delivered program for children born to low-resource mothers is most pronounced for families living in highly disadvantaged neighborhoods.” The families studied in Memphis tended to live in more disadvantaged neighborhoods than those in Denver.

Control-group children in Memphis had a lower average IQ than their counterparts in Denver, and the benefit of the program could be greatest where there is most room for improvement, the researchers noted.

Study abstract: http://archpedi.jamanetwork.com/article.aspx?articleid=1785480

Nurse-Family Partnership: http://www.nursefamilypartnership.org/

Source: Nurse.com