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DiversityNursing Blog

NBNA elects new officers, board members

Posted by Alycia Sullivan

Mon, Sep 23, 2013 @ 10:11 AM

NBNA resized 600

The National Black Nurses Association recently announced its newly elected officers and members of the board of directors and nominating committee. 

The Rev. Deidre Walton, RN-PHN, MSN, JD, of Keverdon and Associates, Valencia, Calif., also was elected to a second two-year term as NBNA president.

“Congratulations to the new officers, board members and nominating committee members in your new roles of service to the NBNA,” Walton said in a news release. “On behalf of the board of directors, I welcome you and look forward to working with you this upcoming year.” 

Other new officers include Secretary Martha Dawson, RN, DNP, FACHE, assistant professor, Department of Community Health, Outcomes and Systems, University of Alabama at Birmingham School of Nursing; and Student Representative Darnell Caldwell, student, Southern University School of Nursing in Baton Rouge, La. 

Newly elected board members are Monica Enn

is, RN, EdD, director of medical professions, Desert Winds Training Institute, Phoenix; U.S. Public Health Service Capt. Laurie C. Reid, RN, MS, senior public health adviser, Office of Health Equity, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, STD, Viral Hepatitis and TB Prevention at the CDC, Atlanta; and U.S. Army Reserve Col. Sandra Webb-Booker, RN, PhD, chief nurse, 330th Medical Brigade, Fort Sheridan, Ill.

Continuing board members are: First Vice President Eric J. Williams, RN, DNP, CNE, professor of nursing, Santa Monica College, Los Angeles; Second Vice President Lola Denise Jefferson, RN,C, BSN, CVRN, nursing supervisor, St. Luke’s Episcopal Hospital, Houston; Treasurer Beulah Nash-Teachey, RN, PhD, president, Security Association and Services LLC, Evans, Ga.; Historian Irene Daniels-Lewis, RN, PhD, FAAN, professor emeritus, 

Community Health/Psychiatric Faculty Group, San Jose (Calif.) State University School of Nursing; Parliamentarian Ronnie Ursin, RN, DNP, MBA, NEA-BC, of Gaithersburg, Md.; Immediate Past President Debra A. Toney, RN, PhD, FAAN, Director of Clinical Operations, Nevada Health Clinics, Las Vegas; Trilby Barnes-Green, RN,C, Accountable Care Organization/Ochsner on Call, Ochsner Healthcare Systems, and Labor/Delivery staff nurse, Touro Hospital, New Orleans; Keneshia Bryant, RN, PhD, FNP-BC, assistant professor, University of Arkansas for Medical Sciences College of Nursing, Little Rock, Ark.; Audwin Fletcher, APRN, PhD, FNP-BC, FAAN, professor and director of multicultural affairs, University of Mississippi Medical Center School of Nursing, Jackson, Miss.; C. Alicia Georges, RN, EdD, FAAN, ex-officio member, professor and chairwoman, Department of Nursing, Lehman College of the City University of New York, New York City; Deborah Jones, RN,C, MS, former trustee of Galveston Independent School Dist

rict, Texas City, Texas; Melba Lee-Hosey, LVN, BS, Ameripro Home Health Care LLC, Spring, Texas; and Sandra McKinney, RN, MS, president and CEO of McKinney and Associates, San Jose, Calif. 

Vanessa Auguillard, RN, BSN, preceptor, DaVita Acute, Houston, and Joyce R. Spaulding, RN, MSN, CDE, outpatient diabetes educator, CNIV, Cedars Sinai Medical Center in Los Angeles, were named as new nominating committee members. 

Returning committee members include Azella Collins, RN, MSN, PRP, chairwoman; Rhonda Robinson, RN, MSN, case manager, Humana, Cincinnati; and Bessie Trammell, RN, BSN, staff nurse, Texas Children’s Hospital, Houston. 

Source: Nurse.com

Topics: NBNA, officers, board members, nominations, elections

A Seasoned Nurse

Posted by Alycia Sullivan

Mon, Sep 23, 2013 @ 10:00 AM

By Joyce Riddle, RN-CPN, BSN

Nurse with elder male resized 600

One day, as I was relaxing during some quiet time, it dawned on me that I was a seasoned nurse with the ability to influence some of my younger or less-experienced co-workers. I have worked as an RN for the same organization for 23 years, and I had something to offer them.

Too often, older nurses are seen as being a bit crotchety, negative or uncaring to some of the younger nurses or newbies. That has to change; why make people feel uncomfortable?

Years ago, as a new nurse, I went through an orientation to the unit. Once competent with some skills, I became the team leader for my patients. If I had questions, I knew I could ask my charge nurse, but I never had a mentor or felt there was one particular nurse to whom I could always turn. I knew I wanted to become that go-to person for my younger counterparts. I enjoyed teaching and helping new employees master skills and tasks.

I am a spiritual person with Christian beliefs. This is part of what makes me who I am. On my commute to work, I get motivated for the day by listening to Christian music. I understand others may not share similar beliefs, but I think everyone needs to find what fulfills them and practice it daily before work, whether it is exercising, reading or just spending time alone.

Make it a point to bring your best to work each day. After all, that is what we are getting paid to do. Once at work, acknowledge everyone with a smile, eye contact or a simple "hello." I've seen how acts of inclusion or kindness filter down to others. On occasion, unfamiliar colleagues may come by my unit and I smile at them, furthering the process of encouragement to others. Kindness can be contagious.

My mantra or focus is to encourage young nurses so they will establish themselves at our facility and become great, seasoned nurses. I have watched some start out as new graduate nurses and then continue their education and grow professionally. I have seen many nurses come and go, but others stay and continue with their education. I support my co-workers who decide to go this route.

For the longest time, I talked myself out of obtaining my certification in pediatric nursing. Once I chose to pursue it, I immediately wondered why I waited so long. Now I routinely ask my co-workers, "When are you going to do it?" Supporting them and encouraging their growth adds more satisfaction to my daily work. It will be gratifying when all my immediate co-workers obtain and maintain their CPNs.

We all have different strengths we can bring to work. Some nurses have a soft touch. Others have a friendly smile or a knack for speaking kind words. All of these can be examples of conduct for the young nurse. 

Remember, just like young children who watch and mimic their parents, the newbies are watching our responses toward one another and our patients. Positive expressions are necessary for their growth.

Before speaking or doing something, I ask myself, "Is this going to encourage or discourage?" I want to know I am encouraging someone to be a better nurse. I will not gossip or make any unkind comments toward my co-workers for the newbie to hear. The younger nurses will not overhear derogatory comments from this veteran.

Every day, I tell myself with pride, "I am a seasoned nurse." I will embrace that I am a little older and more experienced, and will welcome opportunities to use that experience. I hope my seasoned co-workers will join me to make our jobs productive by helping our younger nurses. We all have something to contribute to foster hope and encouragement. 

Source: Nurse.com

Topics: encouragement, experience, RN, veteran, compassion

American Nurses Association gives grant to Penn nursing to develop toolkit

Posted by Alycia Sullivan

Fri, Sep 13, 2013 @ 12:03 PM

The American Nurses Foundation, the philanthropic arm of the American Nurses Association, in June announced a $75,000 grant to the University of Pennsylvania School of Nursing in Philadelphia to develop a post-traumatic stress disorder tool kit to help RNs better assess and treat PTSD in the nation’s veterans and military service members. Penn Nursing’s Nancy Hanrahan, RN, PhD, CS, FAAN, will lead the project at the university.

"Given that June is PTSD Awareness Month, this was the perfect time to highlight the serious consequences of PTSD, if left untreated, and what nurses can do to ensure that veterans receive the highest level of care," ANF Chairwoman Joyce J. Fitzpatrick, RN, PhD, MBA, FAAN, said in a news release. "At ANF, we are striving to transform the nation’s health through the power of nursing. We are excited about this new project because these tools will help nurses learn detection and treatment options that can help our nation’s veterans and service members transition successfully back into civilian life." 

ANF will work with Penn Nursing to develop an interactive, PTSD-focused website, an e-learning module based on advanced gaming techniques and a downloadable smartphone app that will provide immediate access to materials for RNs to assess, treat, and refer military members and veterans for help with their symptoms. These e-learning tools will certify that an RN is grounded in assessment, treatment, referral and non-stigmatizing educational approaches to self-care and mutual help, according to the release. 

"In the United States, there are more than 3 million registered nurses that work in the community and in hospitals," Hanrahan said in the release. "By virtue of the large numbers of RNs and their presence in common community settings, military members and their families can receive timely access to self-care and help from RNs."

The grant to Penn Nursing was made possible by funding from the Jessie Ball duPont Fund. The tool kit will be piloted in Pennsylvania during the fall with a national launch planned for 2014. Additionally, Penn Nursing’s forthcoming health technology lab program will support RN inventors who desire to use technology and game theory to address healthcare challenges. 

Source: Nurse.com

Topics: ANF, grant, UPenn Nursing, PTSD, ANA, treatment

Trading on innocence

Posted by Alycia Sullivan

Fri, Sep 13, 2013 @ 11:51 AM

innocence resized 600
By Cynthia Saver, RN, MS

Human sex trafficking can be illustrated in one sentence: "I can sell a kilo of cocaine once and I'm out of product, but I can sell a woman over and over 25 times a night 365 days a year and make a quarter of a million dollars off one girl." That observation a pimp made to Mary de Chesnay, RN, DSN, PMHCNS-BC, FAAN, editor of the book "Sex Trafficking: A Clinical Guide for Nurses," sums up why human sex trafficking has become a growth industry.

"Trafficking is a $32 billion a year business, more than Starbucks, Nike and Google combined," said de Chesnay, a professor in the WellStar School of Nursing at Kennesaw (Ga.) State University. "It's the most lucrative criminal enterprise behind drugs."

Many people think sex trafficking happens only in third-world countries, but it's also pervasive in the U.S. "It's not just an international problem, it's a national problem," said Patricia Crane, RN, MSN, PhD, WHNP-BC, DF-IAFN, associate professor at University of Texas Medical Branch Galveston and a specialist in forensic nursing. Victims include U.S. citizens and people from countries such as Mexico, Eastern Europe, Asia and South America.

The early 1970s is when de Chesnay first met a child who was being trafficked. When she asked the 11-year-old girl with an ectopic pregnancy about the baby's father, the girl replied, "It could be my father, my four brothers, or the men who come to party on the weekend."

That child was the first in a long line of girls and women (and some boys and men) de Chesnay has seen during her career. Accurate numbers are hard to come by, but the Polaris Project, an advocacy group that combats human trafficking, estimates that 100,000 children are involved in the sex trade in the U.S. each year. The average age of a U.S. victim is 12 to 14 years old.

Nurses are in a prime position to identify possible victims of sex trafficking when they seek medical treatment in the ED, free clinics, physician offices and other locations. But too often those opportunities are missed. According to the Family Violence Prevention Fund, a study found that 28% of trafficking survivors had contact with a healthcare provider during the situation, but the abuse wasn't recognized. 

Preying pimps

How do victims become entangled in sex trafficking? de Chesnay said many victims are "runaways or throwaways, they have bad home lives." Pimps hang out around bus stops and other locations to meet the runaways. The "Romeo" pimp first befriends girls (most victims are female). Soon the girl moves in with him. Selling the girl might start with the pimp simply asking her to date his friend. Soon she is on the street, at hotels or even in the pimp's home being sexually abused. de Chesnay said Romeo pimps are the most common, but a second type is the violent pimp, who isn't interested in establishing a relationship. In rare cases a victim might be kidnapped.

Poverty is another factor. "They get involved because it's an opportunity to make some money," said Donna Sabella, CRNP, PhD, MEd, MSN, PMHNP-BC, director of global studies and the office of human trafficking at the College of Nursing and Health Professions at Drexel University in Philadelphia. "They may also need money for an addiction."

So why don't victims just leave? "If they were functioning well like us, they would find a way," said de Chesnay. "But these girls are broken in spirit. They have no self-worth and are damaged mentally and physically."

Fear is another contributing factor, Sabella said. "The pimps say they'll hurt them, their family or their children," she said. 

Identifying victims

Victims of sex trafficking have "all kinds of medical and psychological issues," de Chesnay said. Physical signs and symptoms of potential trafficking include burns, dislocated limbs or fractures, missing teeth, vaginal or rectal trauma, persistent or untreated sexually transmitted diseases or urinary tract infections, malnutrition and problems with the jaw or neck. Other signs include not being able to produce identification, having inconsistent stories about their lives and how injuries occurred, hypervigilance, and the presence of tattoos that might be "brands."

A victim might seem submissive, allowing the accompanying person, who might be his or her pimp, to respond to questions. Sabella said it's important to get the patient alone. She suggested saying, "It's hospital policy that we speak to patients alone."

Crane said that another option is to have the person with the victim fill out paperwork or ask him or her to stay in the waiting area while the nurse obtains a specimen. Once alone with the patient, nurses should choose their words carefully. "Don't ask them it they are being trafficked," Sabella said. "They won't understand the term."

Instead, Crane suggested questions such as: Can you come and go as you please? Where do you sleep and eat? Has anyone threatened your family? Is anyone forcing you to do anything you do not want to do?

Crane advises conveying messages such as, "We are here to help you. We can find you a safe place to stay. If you are a victim of trafficking and you cooperate, you won't be deported."

When faced with a trafficking victim, "the immediate problem is the medical condition," said de Chesnay. "Be kind, nonjudgmental and provide access to services." (See resources below story.)

She said nurses shouldn't present themselves as rescuers because victims don't always want to be rescued. Nurses should let victims know what to do when they are ready by providing them with information about resources such as the national hotline.

Sabella added that nurses should be aware that the victim doesn't know them and is in a difficult situation. "Don't be surprised if someone doesn't jump up and say thank you," Sabella said. "Be prepared when people say no."

In some cases, the nurse might be laying the groundwork for helping a victim leave in the future. "One woman went home because her pimp said he would kill her dog," Sabella said. "She came back the next day with the dog." She suggests telling victims they can call the hospital if they change their mind. If possible, the same nurse who saw the patient could do a follow up call in a few days, allowing another opportunity for contact. Crane said if a woman won't admit to being a victim, Crane will set up another visit to provide another chance to talk with her.

Some experts recommend giving the victim a card with the hotline number written on it, but de Chesnay advises not giving victims materials. "If pimps see it, they will beat them up," she said, adding that Georgia recently passed a law requiring the posting of signs with the hotline in places such as hospitals and hotels.

Nurses also should watch for victims in their own backyards. "A lot of this [sex trafficking] takes place in neighborhoods," Sabella said. 

Reporting & recovery

If the victim is a child, mandatory reporting laws for abuse apply. In addition, some states require reporting in the cases of victims of domestic violence. Nurses should tell the patient if they are required to file a report. Reporting gives victims access to an advocate who can help with resources. For example, in March 2013, President Obama signed the latest reauthorizaton of the Trafficking Victims Protection Act, linking it to the Violence Against Women Act. "VAWA money can now be used for sex trafficking victims in a domestic violence situation," said Crane. The victim has to agree to cooperate in prosecuting the pimp to receive funds that can help her or him escape from the situation.

Unfortunately, few residential recovery programs exist in the U.S. — Sabella estimates 10 to 15. She was a founding member of Dawn's Place, a residential recovery program for trafficked and prostituted women in Philadelphia. Sabella modeled the one-year program after a program in Phoenix. Such programs often must depend on volunteers because little funding is available for these efforts.
Besides needing treatment for physical problems such as injuries from beatings and gynecological issues, survivors will need care for psychological conditions such as post-traumatic stress disorder, anxiety and depression.

"Slavery didn't end with the Emancipation Proclamation," de Chesnay said. "Nurses can step up and play a role in ending it for good. The crucial first step is awareness, people need to be educated about human trafficking, learn the warning signs and memorize the hotline number."

Nurses can request their facilities hold a seminar on the topic. Sabella and de Chesnay, who both teach a course on human trafficking, said that the subject should be part of nurses' basic education.

The next step is to work with law enforcement to develop policies for the facility where the nurse works. "Many nurses do not act because they do not know what to do once they become aware," de Chesnay said. "The protocol must spell out clearly the steps to take if a human trafficking victim walks through the door." 

Source: Nurse.com

Topics: United States, Awareness, sex trafficking, nurse research, prevention

Fellowship Program Improves New Nurse Retention, Nets Savings

Posted by Alycia Sullivan

Fri, Sep 13, 2013 @ 11:44 AM

By Megan Murdock Krischke

Why do new nurses often leave their jobs in the first year? And what can be done to keep their careers on track, improve nurse retention and keep the costly issue of turnover in check?

A new study published in the July-August issue of Nursing Economic$ may help to answer these questions.

A few years ago the North Shore-LIJ Health System (NSLIJ) in New York set out to identify some of the key reasons for nurse loss in the first year of employment and created a nurse residency program to counteract that loss. A team of nurses at NSLIJ monitored the before and after results in order to measure the efficacy of program.

M. Isabel Friedman: New nurses in the nurse fellowship program support each other.

“What we recognized was the way we were orienting new nurses wasn’t meeting the needs of this computer-minded generation,” said M. Isabel Friedman, DNP, MPA, RN, BC, CCRN, CNN, program director of nurse fellowship programs for the Center for Learning and Innovation at North Shore-LIJ Health System and the lead author on the study. “We created a program that met the needs of our new nurses and helped them transition from new graduate to functioning practitioner.”

This study looked particularly at the Pediatric Nurse Fellowship Program (PNFP) at Cohen Children’s Medical Center for pediatric critical care, pediatric emergency department and hematology/oncology specialties. This specialty orientation program was designed to bridge the gap between the novice nurse and the new high-acuity pediatric specialty while providing new graduate RNs with important mentoring and support tools.

“We found that when nurses feel supported, their loyalty to the hospital system increases,” Friedman explained. “Additionally, our new hires go through the fellowship program in cohorts of 5-10. The community and peer support offered by the cohort is a factor in increased retention.” 

The PNFP used a blended learning model. The core curriculum that nurses focused on during the initial weeks of the program was chosen from the curriculums offered by the national professional organization for each specialty. Each week had a theme, such as respiratory. Nurses then had seminars, skills and simulation labs, and clinical days that addressed that week’s topic. 

One of the key findings of the study was the effectiveness of having a senior nurse whose specific job it was to work with the cohort of fellows as they were transitioning to working in direct patient care.

“Study of our previous orientation showed that the transition from orientation to direct patient care in the six- to nine-month timeframe was when first year retention rates began to drop significantly. Having a senior nurse who could be by a nurse’s side as he or she did a new procedure, or easily available to ask questions, increased the confidence of our new nurses and the quality and safety of the care they provided.” Friedman stated. 

Friedman and her colleagues found that the nurse fellowship program decreased turnover significantly in the PICU and that general retention rates were statistically significant when comparing length of employment before and after the program was implemented. “As you can imagine this was good for the bottom line. When comparing expenses for the 2.5 years before instituting the PNFP and the 2.5 years following, there was a potential cost savings estimate of over $2 million.”

As an added bonus to increased nurse retention and cost savings, nurses who participated in the PNFP are showing a greater value for continuing their education through specialty certifications and pursuing master’s programs. 

“This program is easily adaptable for other specialties. We had our first residency program in adult critical care. In addition to the PNFP, we have fellowships in cardiac cath lab and labor and delivery nursing, as well as having a fellowship for nurse practitioners. Every fellowship cohort is altered to some degree in response to the feedback we receive from our fellows, preceptors and others involved in the program.” 

Donna M. Nickitas: Nurse fellowship programs can improve nurse retention and save money.“One reason this particular manuscript was a good fit for Nursing Economic$ is because it addresses the measures, methods and metrics. If we are going to make a business case for caring we have to make sure that we have the data that supports nursing’s work. This article showed in black and white how what they were doing helped the bottom line,” remarked Donna M. Nickitas, PhD, RN, NEA-BC, CNE, editor of Nursing Economic$.

“It emphasizes what we have been saying all along: to have a healthy work environment, you have to have a healthy workforce,” Nickitas continued. “We need to make sure our nurses are more than adequately educated and trained. This study demonstrates that the PNRP is worth the investment in time, effort and finances.”

“I love the program and I love my fellows,” Friedman effused. “They are bright and capable young people and we owe it to ourselves to educate the next generation of people who are going to be taking care of us and our loved ones. It is a fabulous feeling to see their success and see them grow and become nurse managers and to see them continually aspire to bigger and better things.” 

For more information, see the Nursing Economic$ study:
Specialized New Graduate RN Pediatric Orientation: A Strategy for Nursing Retention and Its Financial Impact

Source: NurseZone.com

Topics: turnover, support, retention rate, loyalty, orientation, nurse

Resident used nursing career to help wounded soldiers

Posted by Alycia Sullivan

Fri, Sep 13, 2013 @ 11:00 AM

By Samantha Cronk

For Berkeley County native Dorothy Leavitt, 93, the desire to help people is natural, so when the call came for volunteers to assist soldiers wounded in World War II, Leavitt needed no other prompting.

While she was aware of WWII and its effects, the war became personal for Leavitt after she helped care for eight severely wounded soldiers who were recovering in an army hospital in Martinsburg.

Leavitt graduated from Martinsburg High School in May 1937 at 18 and by September, she began training to become a nurse. In 1940, Leavitt graduated as a registered nurse as part of a graduating class of fewer than 10 women.

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Journal photo by Samantha Cronk
Berkeley County native Dorothy Leavitt, 93, used her profession as a nurse to help soldiers wounded during World War II who were sent to recover at the Newton D. Baker Hospital in Martinsburg.

"I knew even when I was a young girl that I wanted to be a nurse. My mother had her babies at home and the nurses would be helping the doctor, and I just always wanted to be a nurse," she said.

It was during her time as a nurse that Leavitt chose to volunteer her services to wounded World War II soldiers at the Newton D. Baker Hospital, a military hospital, in Martinsburg. In 1946, the Newton D. Baker Hospital became the VA Medical Center as part of the Veterans Administration.

"I always worked in the paraplegic ward. There were about five cubicles, and each one had eight men in it. They were all young men in their 20s, paralyzed from the waist down. We always went back to the same eight men, so those eight are the ones you say you took care of," Leavitt said.

"We worked during the daytime and then every night for 18 months we went down from 7 to 10 p.m. or later, because sometimes they had to pull us away," Leavitt said.

Leavitt described her job as anything that would make the men comfortable, including rubbing their backs, washing their faces and changing their sheets.

Eventually, the men Leavitt cared for were transferred to hospitals close to where the men lived. Along with other nurses who volunteered in the paraplegic ward, Leavitt helped form the Newton D. Paraplegic Group, which kept soldiers and nurses connected.

Through the group, soldiers and nurses would stay in contact through letters and meet at least once a year for food and fellowship.

As a nurse, Leavitt worked for several local doctor's practices as well as in private duty. She also worked at the VA Center for one year in the medical ward.

Through her career as a nurse and life in Berkeley County, Leavitt has experienced many professional milestones, including working with Martinsburg's first radiologist, as well as witnessing almost a century's worth of change to Martinsburg.

"I liked to take care of patients, and I just didn't want to be behind a desk. At the time I was going for my training, it was just a job. Now, I've had some time to think back, and I realize that some of that stuff I saw during my nursing career was really miraculous," Leavitt said.

Leavitt's thumbprint can be found throughout Martinsburg. Of the 64 acres Leavitt and her late husband Charles owned as orchards, Leavitt retains 53 acres. On some of the land she sold sits the Martinsburg water tank and Orchard View Intermediate School.

"The amount of change, it's amazing. It's still a good place (to live). You can see the changes. Of course they paved the roads, we get mail and they've changed the name of (Delmar Orchard Road) so many times," Leavitt said.

Leavitt can recall living through the Great Depression, claiming that her family was fortunate to avoid the harsh conditions many families found themselves in during that time. Leavitt credits her father with providing for her mother and siblings, saying that he worked hard to find work and always provided them with new shoes and textbooks before every school year.

"I went to a two-room school house through the eighth grade. When we finished eighth grade, we had to go to the old Martinsburg High School and take a test for two days to see whether or not we were allowed to go to high school. I made the second highest (grade) in the county. You remember that kind of stuff," Leavitt said.

Leavitt said her parents supported her ambition to become a nurse. Although it has been many years since she has worked professionally, Leavitt still considers herself a nurse.

"Once you're a nurse, you're always a nurse," she said.

Source: The Journal 

Topics: Dorothy Leavitt, WWII, soldiers, wounded, connect, nurse, patient

Don't Call Me Just a Nurse

Posted by Alycia Sullivan

Fri, Sep 13, 2013 @ 10:43 AM

By 

In the first year of my career as a registered nurse, I continued my education, wrapping up my bachelor's degree in nursing, not yet a requirement to work as an RN but a well-worth-it continuation of a degree to make you a more well-rounded and, to be honest, respected nurse. One of the requirements for this degree was a course called "Professional Issues and Trends." The course explored the profession of nursing, barriers it is facing, and the way that we, as nurses, can change that. I learned many things in that course, but the most important, the thing that has stuck with me the most, was this:

A few days into the course, our professor made one thing very clear: Each and every one of us, from that moment on, needed to remove "just a nurse" from our vocabulary.

"Are you a doctor?"

"No, I'm just a nurse."

I have spent six years since trying to avoid that phrase. More so, I have worked to avoid that feeling. I work hard at what I do, but I am often aware that my friends and family have no concept of what nursing is. I don't bring you to your room at the doctor's office, sit you on the table, and check your normal blood pressure, then go and get the doctor. Instead, I am often in a room with a small child on a ventilator, multiple intravenous medications infusing through central lines keeping the vascular system constricted or dilated. I monitor blood gases and adjust ventilator settings accordingly. If the blood pressure goes too high, I adjust the medications related to these values. I keep my patient adequately sedated and paralyzed, for their safety, without over-medicating them. It is often my responsibility to determine this balance.

Recently, I had a nearly 2-year-old patient who pulled his own breathing tube out in the early morning. We weren't sure whether he would do okay without it, so I monitored his respiratory status closely all morning. By mid-afternoon, he seemed to be doing well enough. By then his sedation had worn off and he had no interest in staying in bed. Concerned that he would harm himself moving around through multiple IV and arterial lines, plus a BiPap machine, and monitor leads, I decided to hold him. He had no family present but needed close to a dozen IV medications over the next five hours. I collected them all and lined them on his bed. I pulled his syringe pump that would be used for the medications off of the IV pole and placed it on the bed in front of me. I lifted him out of bed and onto my lap, into my arms. For five hours we rocked and I held him close. He stared into my eyes, played with my hair with his one arm, tried to suck his thumb through IV sites and arm boards. I gave his medications one by one until the nurse who would relieve me for the oncoming shift came in.

I'm not just a nurse. I am a nurse. I can over the course of the 12-hours shift go from interpreting serial blood gases to comforting a sick child while continuing to monitor vital signs, respiratory status, and administer medications.

I am the eyes, hands, and feet of the physician. I am not their eye candy or their inferior. I don't stand up when they enter to room. I don't follow their orders, I discuss the pathophysiology of the patient's condition with them, and together we make a plan. Often the things I suggest are the course of action we take, and other times I learn something new I had not understood from this doctor. They don't talk down to me; we discuss things together.

I had an experience this weekend, one of the first of its kind for me, and I was surprised by how angry and affected by it I was.

A friend cut their arm and hours later still struggled to stop the bleeding. I assessed the wound and created a pressure dressing out of the supplies you have available in a frat house cottage. I reluctantly informed the friend that the wound would likely need a stitch or glue. It wasn't large, but it was deep and wide and would likely heal poorly, if at all, and even if it didn't become infected would leave a decent scar. I am not one to jump to big medical interventions; if anything, I ride the line of noncompliant and under-concerned.

My opinion was shared but another guest, a doctor, decided it would probably be fine with a Band-Aid and heal without issues. He may be right, or I may be right. But a close family friend who I have known almost my entire life chimed in.

"No offense, Kateri," he said, "But obviously we're going with the doctor over the nurse for this one."

"You're just a nurse," he might as well have said, although he didn't.

I felt like I had been smacked in the back by a two-by-four. My best friend knew this would be my reaction and turned in horror as the color left my face and the posture left my shoulders. Something inside of me sunk.

The following day I struggled to understand why I was still upset. Surely he had no idea what his words had meant, or how they felt. But over lunch the following day, as I discussed my new job with my family, it became clear. My job is so much, and so much of it is misunderstood. And maybe this is no one's fault but my own. Sure, I'm a nurse. Yup, some days are sad. Yeah, blood and poop don't bother me.

But that's all I say. I don't tell you what I really do. And the media definitely doesn't either. Nurse friends, help me out here. Maybe it's time that we stop pretending we are less than we are, that we do less than we do.

I came across the following blurb this morning. I wrote it a few years ago for Nurse's Day, and it rings as true today as it did then. I may not be a doctor, but I am a nurse. And if you are someone whose mind says "just a nurse" please, go ahead and ask the nurse you know best what it is that they do. I think you may be surprised.

I am a nurse. I didn't become a nurse because I couldn't cut it in med school or failed organic chemistry, but rather because I chose this. I work to maintain my patient's dignity through intimate moments, difficult long term decisions, and heartbreaking situations. I share in the joy of newly-born babies and miraculously-cured diseases. I share in the heartbreak of a child taken too soon, a disease too powerful, a life changed forever. My patient is often an entire family. I assess and advocate. Sometimes I wipe bottoms, often I give meds, but that isn't the extent of what I do. There are people above me, and people below. I work closely with both; without them, I could not do what I do well. I chose this profession and love almost every minute of it. I know I am not alone, and I appreciate all of the nurses who work alongside me. Many of them have shaped me into the nurse I am. Someday I will shape others into the nurse they will be. This wasn't my plan B. It was my plan A, and I would gladly choose it again.

This post originally appeared on According to Kateri.

Topics: pride, RN, nurse, doctor

Family Nurse Practitioner: A Supercharged Career Path

Posted by Alycia Sullivan

Thu, Aug 29, 2013 @ 01:05 PM

by 

As more Americans gain access to healthcare, and fewer physicians are available, family nursesuperpower
practitioners (FNPs) can play a valuable role in providing families with access to primary care. 

What is an FNP? 

FNPs work autonomously and as part of a primary-care health team to:

  • Manage patients’ overall care
  • Diagnose/treat acute and chronic conditions
  • Prescribe medications
  • Educate patients on disease prevention/health management

 

What is the salary of a family nurse practitioner?

Nurse practitioners enjoy an average, full-time, total salary of $98,760, according to the American Association of Nurse Practitioners.

Named one of the best jobs in America by CNNMoney/Payscale.com in 2012, FNPs also enjoy increased autonomy, expanded responsibilities and time to spend with patients. Check out the infographic below for more reasons why family nurse practitioners are today’s healthcare superheroes:

superpower2 resized 600

Infographic by Chamberlain College of Nursing

Topics: Chamberlain College of Nursing, family, nurse practitioner, salary

Recognizing the Symptoms of Elder Abuse

Posted by Alycia Sullivan

Wed, Aug 28, 2013 @ 12:20 PM

 

oldmanIntroduction:  

The seriousness surrounding the problem of elder abuse in our society is often ignored or underrated. People have a tendency to put discussions of elder abuse on the backburner, in favor of more shocking stories that tend to grab the media spotlight.

Despite the lack of attention paid to the phenomenon of elder abuse, the American Psychological Association estimates that “4 million older Americans are victims of physical, psychological or other forms of abuse and neglect” every year. For every reported instance of abuse, experts estimate that 23 more go unreported.

There are many different types of elder abuse, but they can be broken into three categories:

1. Physical Abuse

Some of the most common signs of physical abuse include unexplained marks or injuries, such as bruises, pressure marks, welts, cuts, burns or broken bones. If the caregiver refuses to let you be alone with your loved one, this could also be an indicator of physical abuse. Other possible signs include broken glasses, ripped clothing and signs of restraint (such as rope marks around the wrist).

Remember, neglect is also a form of physical abuse. Some of the most common signs that an older adult is being neglected by a caretaker include sudden weight loss, malnutrition and dehydration. Unsanitary living conditions (like dirty sheets or bed bugs) are also indicators of neglect, as are untreated physical problems, like bed sores.

2. Emotional Abuse

The signs of emotional abuse include characteristics of depression, like uncharacteristic silence, loss of appetite and unexplained withdrawal from normal activities. Likewise, if you witness a caregiver acting in a way that is threatening, belittling or condescending, there’s a possibility that the person they’re charged with taking care of is experiencing emotional abuse. 

There are many people who don’t recognize emotional abuse or don’t think of it as a serious mistake. These individuals operate under the false assumption that emotional scars are somehow less violent or harmful than the physical ones. This is one of the characteristics of emotional abuse that makes it so dangerous—if you don’t recognize a problem as a problem, you can’t take steps to solve it.

3.       Sexual Abuse

                The most common signs of sexual abuse include an unexplained venereal disease or genital infection, unexplained vaginal or anal bleeding and bruises around the breast or genitals. Torn, stained or bloody underwear can also be an indicator of sexual abuse. 

                There are many reasons that sexual abuse can be difficult for many older adults to talk about. For some, it’s an issue of pride—they would rather suffer in silence than face the humiliation of admitting helplessness. Others are afraid of retaliation, and worry that they’ll be punished for speaking up. Whatever the specifics of the situation, it’s important to remember that the subject of sexual abuse is complicated and needs to be handled with sensitivity.

Conclusion:

                The most important thing to remember when you suspect that someone you know is being abused is that speaking out is half the battle. The invisibility of elder abuse is what makes it difficult to prevent and punish. By calling attention to the situation, you’ve already laid a foundation for preventing future instances of elder abuse.

Linda Bright is a staff writer and a public relations coordinator for MyNursingDegree.com. Given her experience as a former hospital administrator, she writes primarily about healthcare reform, patient rights and other issues related to the healthcare industry. In her free time, she enjoys Sudoku, spending time with her family, and playing with her poodle, Max.

Topics: APA, abuse, care, elderly, caregiver

Nurse researcher receives NIH award to study HIV prevention in young black women

Posted by Alycia Sullivan

Fri, Aug 23, 2013 @ 02:01 PM

The National Institute of Nursing Research (NINR) awarded $267,732 to the University of South Florida College of Nursing to study ways to reduce HIV/AIDS risk in college-aged black women, who are disproportionately affected by the disease. Rasheeta D. Chandler, PhD, ARNP, FNP-BC, assistant professor of nursing at USF, will lead the study.

"Tailoring an HIV Prevention for College-Aged Black Women" will adapt a previously-tested and effective sexual risk reduction approach, Health Improvement Project for Teens (HIP TEENS), to be culturally relevant and appropriate for college-aged African-American women. The research will test if this program, renamed Health Improvement Project for LADIES (HIP LADIES), helps reduce HIV/AIDS risk.

"This study is timely, and will be the template for future intervention studies conducted with black college women," Dr. Chandler said. "The award gives us the opportunity to improve the health of young black women."

AIDS.gov reports that of the more than 1 million people living with HIV in the United States, 46 percent are African-Americans. In addition, young black women are far more affected by HIV than young women of other races. The rate of new infections among young black females ages 13 to 29 is 11 times as high as that of young white females and four times that of young Hispanic females, according to the Centers for Disease Control and Prevention (CDC). The CDC reports that AIDS is the third leading cause of death among black women ages 25 to 34.

HIP TEENS is a small-group program for young women that uses interactive activities to provide information, motivate and teaches the skills girls need to reduce sexual risk behaviors. It was developed in 2004 by Dianne Morrison-Beedy, PhD, RN, WHNP-BC, FNAP, FAANP, FAAN, senior associate vice president of USF Health and dean of the College of Nursing. A randomized controlled trial led by Dr. Morrison-Beedy and recently published in the Journal of Adolescent Health reported that HIP TEENS significantly reduced sexual risk behavior and pregnancy rates in more than 700 adolescent girls.

"Not only did HIP TEENS reduce sexual risk behavior, we significantly increased sexual abstinence in these girls as well," said Dr. Morrison-Beedy. "HIP LADIES is a critical next step for reducing risk in college-aged young women."

Dr. Chandler's study will specifically target African-American women attending traditional universities and historically-black colleges and universities in the southeastern United States.

"This project is my chance to contribute to reducing the incidence of new HIV cases in young African-American women," Dr. Chandler said. "When you ask why I'm passionate about my research, this is my community, and these are people who've touched my life with their stories."

Provided by University of South Florida

Source: Phys Org

Topics: nursing, college, NINR, USF, HIV/AIDS, black women

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