DiversityNursing Blog

By Neal St. Anthony

Registered nurse Rachele Simmons walked away from a $100,000 career two years ago.

She still isn’t generating enough cash to pay herself a salary from the St. Paul business she started in 2011. But if passion and commitment matter, Simmons already is wealthy from her mission to train and place more minorities in health care jobs.

And as business continues to grow at fledgling Foundations Health Career Academy, Simmons should generate positive cash flow by the end of this year.

“Rachele is phenomenal,” said Tom Thompson, administrator at St. Paul’s Galtier Health Center. “She’s positive and she knows what she is doing. We’ve hired some of her graduates and never had any problem. Her people are very good. And we have a diverse clientele in our facility. So we need staff who speak different languages and who are from different backgrounds and races.”

Simmons is the founder, teacher, marketer and chief bottle washer at Foundations Health, a state-certified private school that has graduated 160 students through its four-week, certified nursing assistant/home health aide program. For many graduates, the course offers a first step into the growing health care industry into jobs that can pay as much as $20 per hour plus benefits.

Simmons, 44, has been a hospital nurse and last worked as a manager at Walgreens, training managers and others to use retail-medical equipment. And she always worked a shift or two a week as a hospital nurse to build a rainy-day fund.

Over the years, Simmons got used to being the only black nurse on the floor or in managerial meetings at Walgreens.

She also knew that health care is a growth area, particularly lower-cost primary care that can be delivered relatively inexpensively outside the hospital and help keep patients in their homes.

She also thought she could be an inspiration to young people of color.

“I just wanted to give something back,” said Simmons, who decided, as her sons reached adulthood, she could handle some business risk. “I had been involved in nursing for 25 years. I was always the nurse called to see the ‘diverse’ patients, often black. It meant so much to them.

“This is what I was called to do. Maybe we can start something that … will get more people of color in nursing, in science, in medicine. We need more black nurses and Hmong nurses and more diversity in health facilities.” She’s even had a couple of white medical students take the class because they wanted to learn the grass roots and work in diverse clinics.

Foundations Health, housed in the Hmong Professional Building a mile west of the State Capitol on University Avenue, is a first business step for Simmons.

Simmons is no stranger to drive and hard work. Divorced when her sons were toddlers, Simmons said her ex-husband never paid child support, forcing her for a short time onto public assistance. The St. Paul Highland Park High School graduate completed two-year nursing school in St. Paul and worked days while completing her registered-nurse degree at Minneapolis Community and Technical College, often bringing her boys to play in the commons while she attended class.

“She was a successful nurse and thrifty with her money,” said Isabel Chanslor, a business trainer with nonprofit Neighborhood Development Center, which for 20 years has provided training to several thousand would-be urban entrepreneurs, including Simmons. “She did not want to take a loan.’’

Last month, NDC recognized Simmons for her commitment to community as a finalist in the organization’s annual entrepreneurial awards.

“She’s a gutsy lady,’’ Chanslor said. “She’s high energy, sharp, rides her little motor scooter everywhere. She has a good business plan and she’s a really good instructor and very focused and dedicated, according to her students.”

Simmons has invested $50,000 in space and equipment. She uses word-of-mouth and social media to attract students. The 80-hour course costs about $950.

“My students are mostly young, single, with kids, without kids, battered, not battered, on welfare, not on welfare … most of them are working poor,” Simmons said. “If they want to work hard and truly better their life, we’ll take them.”

Na Yang graduated from Foundations Health in 2011, but can’t work as a nursing assistant because of an injury. So, she joined the office as a part-time office manager.

Simmons said Yang works more hours than she’s paid because of her commitment to the cause and the need to stay on top of the paperwork.

“You couldn’t find a better instructor,” Yang said of Simmons.

“She’s knowledgeable and passionate. She couldn’t do this without her passion.”

Source: Star Tribune

By Karren L. Johnson

After a nearly 15-year journey — which included raising three children and working full time as a registered nurse -- Terra Brown of Susquehanna Township is just months away from completing her bachelor’s of science degree in nursing.

“It took a lot of hard work but it was worth it,” said the 42-year-old Brown, who works at Penn State Hershey Heart and Vascular Institute in Lower Paxton Township and entered the nursing field with an associate’s degree. “It feels good to know I improved both my knowledge and myself.”

Brown said she wants to teach other nurses and plans to go on to earn a master’s in nursing.

According to a recent survey by the American Association of Colleges of Nursing, Brown isn't alone in her pursuit to further her nursing education. The number of students enrolled in baccalaureate degree completion programs — also known as RN to BSN programs — increased by 13.4 percent from 2010 to 2011, the study found. Master’s programs reported a 7.6 percent jump in enrollments in 2011.

For current nurses and those looking to enter the field, the future looks bright. A 26 percent increase in the demand for new nurses is expected between 2010 and 2020, equating to 711,900 new jobs, according to the U.S. Bureau of Labor Statistics.

“A driving force behind this increase in BSN enrollment is the Institute of Medicine’s “The Future of Nursing” report that calls for the number of nurses who hold BSNs to increase to 80 percent by 2020,” said Betsy Snook, a registered nurse and the CEO of the Pennsylvania State Nursing Association.

“To meet this goal, which will help meet the needs of our growing population and more complex health care environment, there has been a trend among hospitals to require nurses to complete a BSN degree or higher,” Snook said.

While this goal does take a certain amount of initiative from nurses, it isn’t on them alone to achieve, Snook said. It also requires the support from employers and organizations such as PSNA, as well as education institutions, to help nurses achieve a higher level of education and training.

A choice to advance

Armed with a BSN from York College of Pennsylvania, Patricia Himes was excited to begin providing care to people. She joined the staff of a local hospital where she worked as a charge nurse for about six years. While she loved her job, she found herself curious about opportunities for growth.

“I’ve always had an urge to learn more and do more,” said Himes, who had heard there was a growing need for certified nurse practitioners.

As a result, she went back to school while working full time, receiving a master’s degree and her nurse practitioner training from Widener University’s Harrisburg campus.

“We are seeing a very large growth in nurses seeking advanced degrees, particularly as nurse practitioners,” said Geraldine M. Budd, assistant dean in Widener University School of Nursing’s Harrisburg campus. Budd said nurse practitioners provide most of the same services as physicians, making them especially important for practices and hospitals in disadvantaged areas without many physicians.

For now, Himes wants to just continue her overall growth and development while working for PinnacleHealth FamilyCare in Lower Paxton Township. But she said she definitely sees herself getting a doctor of nursing practice down in the future.

Nurses who do get additional training will find themselves in demand.

“With many of the highest trained nurses in the teaching arena reaching retirement age, there is also going to be a real need for qualified nurses to step into roles as nurse educators,” Budd adds.

Enhanced educational programs

Among the BSN to RN programs seeing a surge in enrollment is the one offered by Penn State Harrisburg. The school has seen enrollment increase by 25 percent between 2011 and 2012, said Melissa Snyder, coordinator for the nursing bachelor’s program.

“To best meet the needs of our students, we offer an evening format, a hybrid format, which is a combination of online and face-to-face classes and periodic all-day formats,” Snyder said. “We also ensure that nurses are graduating with solid skills in leadership, critical thinking and research, all things that employers are looking for.”

While enrollment in its BSN programs has increased, Penn State recently announced that it is phasing out all of its associate nursing programs and transitioning them to four-year baccalaureate programs, Snyder said.

Some community colleges are finding other ways to appeal to students who want more than an associate degree. For example, Harrisburg Area Community Collegerecently created a dual admission partnership with Millersville University to keep their graduates competitive and to provide a seamless transition into a bachelor’s program.

“We have always been very clear with our students that an associate degree is not an end point and we encourage they should seek further education,” said Ron Rebuck, director of nursing at HACC’s Harrisburg Campus. “The trend that I’m seeing is that by the time our nursing students graduate, a majority of them are already enrolled in a BSN program.”

Ever since Jeremy Whitmer graduated from high school just over 10 years ago, he has made it his personal mission to advance his nursing career. Despite being deployed to Iraq with the National Guard, he was still able to earn an associate’s degree, as well as a BSN degree thanks to HACC’s dual admission program.

“It was the perfect route for me because it provided a lot of flexibility,” said Whitmer, who is now working in Holy Spirit Hospital’s cardiovascular operating room. “I feel that having a BSN degree has given me many more leadership opportunities, as well as critical thinking and time management skills that I apply to my job every day.”

Support from employers

Having recently applied for magnet status, a designation awarded by the American Nurses Association that denotes nursing excellence, Holy Spirit Health System takes pride in being in full support of helping its nurses reach a higher level of education, said Brenda Brown, director of human resources.

“We know there are a lot of great nurses coming out of associate programs,” Brown said. “When we see such a nurse who exemplifies our values, we will support them in completing their BSN within four years of their hire.”

In addition, Holy Spirit offers a tuition reimbursement and an RN scholarship program, as well as an education loan repayment program. It also pays for all certifications. Currently, 42 percent of the hospital’s nurses either have bachelor’s or master’s degrees in nursing, she said. There are currently 88 nurses enrolled in bachelor’s programs and 27 are working toward their master’s in nursing, she said.

Sherry Kwater, chief nursing officer for the Penn State Milton S. Hershey Medical Center, said 57 percent of the center’s more than 1,800 nurses have a BSN. She said many have advanced their education while working at the center, which is a magnet facility.

“At Penn State Hershey Medical Center, we have so many specialty patients who require nurses with a body of knowledge around that patient population,” Kwater said. “Education is our mission here, so we migrate towards hiring nurses who are educators or specialists with a focus in a specific area. This also helps raise the skill of the bedside nurse.”

 Himes, the nurse with PinnacleHealth, credits the support from her coworkers for enabling her to grow and gain increased confidence in her field.

“The physicians are very supportive and very willing to teach me how to do things that I’ve never done before or that I’m insecure about,” she said. “I couldn’t be happier about my career path. It’s been a great testament of how the field of nursing is growing and that the opportunities are endless."

Source: The Patriot News

BY BLAIR KERKHOFF

By Max Fisher

Ethnicity, like race, is a social construct, but it’s still a construct with significant implications for the world. How people perceive ethnicity, both their own and that of others, can be tough to measure, particularly given that it’s so subjective. So how do you study it?

When five economists and social scientists set out to measure ethnic diversity for alandmark 2002 paper for the Harvard Institute of Economic Research, they started by comparing data from an array of different sources: national censuses, Encyclopedia Brittanica, the CIA, Minority Rights Group International and a 1998 study called “Ethnic Groups Worldwide.” They looked for consistence and inconsistence in the reports to determine what data set would be most reliable and complete. Because data sources such as censuses or surveys are self-reported – in other words, people are classified how they ask to be classified – the ethnic group data reflects how people see themselves, not how they’re categorized by outsiders. Those results measured 650 ethnic groups in 190 countries.

One thing the Harvard Institute authors did with all that data was measure it for what they call ethnic fractionalization. Another word for it might be diversity. They gauged this by asking an elegantly simple question: If you called up two people at random in a particular country and ask them their ethnicity, what are the odds that they would give different answers? The higher the odds, the more ethnically “fractionalized” or diverse the country.

I’ve mapped out the results above. The greener countries are more ethnically diverse and the orange countries more homogenous. There are a few trends you can see right away: countries in Europe and Northeast Asia tend to be the most homogenous, sub-Saharan African nations the most diverse. The Americas are generally somewhere in the middle. And richer countries appear more likely to be homogenous.

This map is particularly interesting viewed alongside data we examined yesterday on racial tolerance, as measured by the frequency with which people in certain countries said they would not want a neighbor from a different racial group.

Before we go any further, though, a few important caveats, all of which appear in the original research paper as well. Well, all except for the report’s age. It’s now 11 years old. And given the scarcity of information from some countries, some of the data are very old, dating from as far back as the early 1990s or even late 1980s. Conceptions of ethnicity can change over time; the authors note that this happened in Somalia, where the same people started self-identifying differently after war broke out. And so can the actual national make-ups themselves, due to immigration, conflict, demographic trends and other factors. It’s entirely possible, then, that some of these diversity “scores” would look different with present-day data.

Another caveat is that people in different countries might have different bars for what constitutes a distinct ethnicity. These data, then, could be said to measure the perception of ethnic diversity more than the diversity itself; given that ethnicity is a social construct, though those two metrics are not necessarily as distinct as one might think. Finally, as the paper notes, “It would be wrong to interpret our ethnicity variable as reflecting racial characteristics alone.” Ethnicity might partially coincide with race, but they’re not the same thing.

Now for the data itself. Here are a few observations and conclusions, a number of which draw from the Harvard Institute paper:

• African countries are the most diverse. Uganda has by far the highest ethnic diversity rating, according to the data, followed by Liberia. In fact, the world’s 20 most diverse countries are all African. There are likely many factors for this, although one might be the continent’s colonial legacy. Some European overlords engineered ethnic distinctions to help them secure power, most famously the Hutu-Tutsi division in Rwanda, and they’ve stuck. European powers also carved Africa up into territories and possessions, along lines with little respect for the actual people who lived there. When Europeans left, the borders stayed (that’s part of the African Union’s mandate), forcing different groups into the same national boxes.

• Japan and the Koreas are the most homogenous. Racial politics can be complicated and nasty in these countries, where nationalism and ethnicity have at times gone hand-in-hand, from Hirohito’s Japan to Kim Il Sung’s North Korea. The lack of diversity perhaps informs these politics, although it’s tough to say which caused which.

• European countries are ethnically homogenous. This is, to me, one of the most interesting trends in the data. A number of now-global ideas about the nation-state, about national identity as tied to ethnicity and about nationalism itself originally came from Europe. For centuries, Europe’s borders shifted widely and frequently, only relatively recently settling into what we see today, in which most large ethnic groups have a country of their own. That developed, painfully, over a very long time. And while there are still some exceptions – Belgium has ethnic Walloons and Dutch, for example – in most of Europe, ethnicity and nationality are pretty close to the same thing.

• The Americas are often diverse. From the United States through Central America down to Brazil, the “new world” countries, maybe in part because of their histories of relatively open immigration (and, in some cases, intermingling between natives and new arrivals) tend to be pretty diverse. The exception is South America’s “southern cone,” where Argentines and Chileans, many of whom originally come from the same handful of Western European countries, tend to be more homogenous. I was surprised to see Canada rate as more diverse than the United States or even Mexico; it’s possible that the survey counted Quebecois as ethnically distinct, although I can’t say for sure.

• Wide variation in the Middle East. The range of diversity from Morocco to Iran is a reminder that this part of the world is much less monolithic than we sometimes think. North African countries include large Berber minorities, for example, as well as some sub-Saharan ethnic groups, particularly in Libya. The diversity of Jordan and Syria are reminders of their internal complexity. Iran, with large Azeri, Kurdish and Arab populations, is one of the region’s most diverse.

• Diversity and conflict. Internal conflicts appear on first blush to be more common in greener countries, which might make some intuitive sense given that groups with comparable “stakes” in their country’s economics and politics might be more willing or able to compete, perhaps violently, over those resources. But there’s enough data here to draw a lot of different conclusions. One thing to keep in mind is that ethnicity might not be static or predetermined. In other words, as in the case of Somalia, maybe worsening economic conditions or war make people more likely to further divide along ethnic fractions.

• Diversity correlates with latitude and low GDP per capita. The report notes, “our measures of linguistic and ethnic fractionalization are highly correlated with latitude and GDP per capita. Therefore it is quite difficult to disentangle the effect of these three variables on the quality of government.” As above, keep in mind that correlation and causation aren’t the same thing.

• Strong democracy correlates with ethnic homogeneity. This does not mean that one necessarily causes the other; the correlation might be caused by some other factor or factors. But here’s the paper’s suggestion for why diversity might make democracy tougher in some cases:

The democracy index is inversely related to ethnic fractionalization (when latitude is not controlled for). This result is consistent with theory and evidence presented in Aghion, Alesina and Trebbi (2002). The idea is that in more fragmented societies a group imposes restrictions on political liberty to impose control on the other groups. In more homogeneous societies, it is easier to rule more democratically since conflicts are less intense.

Here’s the money quote on the potential political implications of ethnicity:

In general, it does not matter for our purposes whether ethnic differences reflect physical attributes of groups (skin color, facial features) or long-lasting social conventions (language, marriage within the group, cultural norms) or simple social definition (self-identification, identification by outsiders). When people persistently identify with a particular group, they form potential interest groups that can be manipulated by political leaders, who often choose to mobilize some coalition of ethnic groups (“us”) to the exclusion of others (“them”). Politicians also sometimes can mobilize support by singling out some groups for persecution, where hatred of the minority group is complementary to some policy the politician wishes to pursue.

Source: Washington Post 

By Jessica DuBois-Maahs

Diana Kamyk discusses the opportunities and challenges of her position as head of the U.S. diversity and inclusion program for Bayer Corp.

Diana Kamyk has dedicated her career to creating a diverse and inclusive work environment. As the head of the U.S. diversity and inclusion program for Bayer Corp., she makes it her mission to foster and facilitate a spirit of understanding within the workplace. The company has been recognized multiple times by Working Mother as a top company for working mothers while under Kamyk’s leadership. She oversees the diversity program at Bayer, of which the Women’s Leadership Initiative is a part. The Initiative aims to increase the number of female employees in managerial positions within the company. In addition, Kamyk helped found Bayer's Diversity Advisory Council, which facilitates and promotes diversity through various conferences and workshops.

How does Bayer's diverse workforce drive and promote innovation?
Through our U.S. Bayer Diversity Advisory Council, we incorporate diversity and inclusion initiatives — such as the Diversity Conference, Women’s Leadership networks and mentoring/coaching programs — into our business strategies and daily operations as a means to foster professional growth and to help build upon our culture. These efforts collectively help support the company’s belief that the more diverse the workforce, the more creative and innovative the results.

What are the goals of Bayer's various diverse employee networks?
Each network has between 50 and 450 members. Some develop new initiatives for their work locations, others get involved in job-related issues in science or the pharmaceutical industry. Their priorities range from doing voluntary work in schools, to promoting women in leadership positions, to offering a safe and inclusive workplace for homosexual, bisexual and transgender employees.

How does Bayer facilitate a work-life balance for moms?
The ProMoms professional network is a forum that allows working moms to learn from and provide support to each other. It creates awareness and understanding among all Bayer employees of the diverse roles of working moms and the contributions they offer to the workplace.

Bayer HealthCare in Berkeley, Calif., opened a new child care center in 2012 with space for 150 children, ages newborn through kindergarten. The child care center serves both children at Bayer and within the West Berkeley community. Bayer recognizes the importance of early childhood development. Therefore, providing an environment where a child can learn and develop to his or her full potential is critical in the maturation process and something that Bayer highly values.

What's the biggest challenge you face in your diversity role, and how do you overcome it?
With operations touching all corners of the globe, working with employees from varying cultures presents a wide range of challenges. Beliefs and priorities as they relate to diversity vary from country to country, so there is certainly a learning curve that we have to take into account as we work to implement unique programs — ones that are impactful and meaningful to employees — that support the foundation of diversity and inclusion across the globe.

Educating myself about each unique culture and understanding our specific employees, basically learning what works and what doesn’t work, has been invaluable for the creation of such plans. For anyone working at a global company, being able to think outside of your own borders and to understand other cultures is imperative to success.

Source: Diversity Executive

If you live a neighbourhood which is ethnically diverse, you're more likely to be healthier and less likely to experience racial discrimination, a new study has found.

Researchers at the University of Manchester say diversity is associated with higher social cohesion and a greater tolerance of each other's differences.

They also found that someone from an ethnic minority is less likely to report racial discrimination in an ethnically diverse neighbourhood.

And that a neighbourhood's high level of deprivation - rather than diversity - is linked with poor physical and mental health, low social cohesion and race discrimination.

The findings, based on analysis of census and survey data, will be presented tomorrow at a conference attended by the study researchers, policy makers and community organisations

Professor James Nazroo, director of the university's Centre on Dynamics of Ethnicity,said: "Our research and this conference is all about setting the record straight on those diverse neighbourhoods which are so widely stigmatised.

"So often we read in our newspapers and hear from our politicians that immigration and ethnic diversity adversely affect a neighbourhood, but careful research shows this to be wrong.

"In fact, the level of deprivation, not diversity, is the key factor that determines these quality of life factors for people in neighbourhoods.

"So our research demonstrates the disadvantages of living in deprived areas but the positives of living in ethnically diverse areas.

"It's deprivation which affects those Caribbean, Black African, Pakistani, and Bangladeshi people who are disproportionately represented in these neighbourhoods, as well as those white people who live alongside them."

Also according to the researchers, one in five (20%) people identified with an ethnic group other than White British in 2011 compared with 13% in 2001.

The ethnic minority populations of England and Wales lived in more mixed areas in 2011 and this mixing has accelerated over the past 10 years, says the study.

Traditional clusters of ethnic minority groups have grown but the rate of minority population growth is greatest outside these clusters with ethnic diversity spreading throughout the country.

Fellow researcher Dr Nissa Finney said: "Despite the clustering of ethnic minority people in some areas, the vast majority of ethnic minority people have a strong sense of belonging to Britain, feel part of Britain and feel that Britishness is compatible with other cultural or religious identities."

While colleague Dr Laia Becares said: "Increased diversity is beneficial for all ethnic groups so we say the policy agenda should develop strategies for inclusiveness rather than marginalising minority identities, religions and cultures.

"Policies aimed at reducing the stigmatisation of diverse neighbourhoods and promoting positive representations can only be a good thing."

The conference, entitled 'Diverse Neighbourhoods: Policy messages from The University of Manchester', will take place at Manchester Town Hall.

Source: UK Huffington Post

By Abigail Curtis

More than 70 years ago, Georgia Randall of Belfast was on a troop train that slowly made its way west across the country before depositing the new Army Nurse Corps recruit in the lively streets of San Francisco.

There, she boarded a converted cruise ship and set sail, with her ultimate destination unknown, the feisty and sharp centenarian recalled Saturday morning at her home while sitting at a table covered with old photographs of her World War II experiences.

She and the 14 other nurses who shared her stateroom also shared a bathtub full of water that they had to use for nearly two weeks of bathing.

“It was a bath in a Dixie cup,” Randall said, adding that the officers who expected the women to be “glamour girls” when they came to dinner were mistaken.

The cruise ship American ended up heading to Australia, where Randall, who spent her first years on a family farm in Sidney, Maine, worked for more than a year caring for the American men who had been badly injured in the bloody battles of the South Pacific. After her time in Mareeba, a “two pub town” on the northeastern coast of Australia where she worked in a station hospital, she spent more than a year working in a tent hospital that had been built in the jungle of New Guinea.

Randall is happy to describe the places she lived, the wildlife and exotic people she saw and the adventures she had during her stints in the Pacific. But when asked about the injured men she cared for during the war and the hard things she had seen, she demurred.

“The horrible things, who needs them?” she asked, just days before Memorial Day. “I don’t talk about those things. There’s no point in dwelling on it. We know a war is a war.”

‘Home and alive in ’45’

Randall had graduated from Crosby High School in Belfast in 1931, the only girl in a family of four brothers. She was a member of the first graduating class from the Waldo County General Hospital School of Nursing in Belfast, and when she got her cap in 1934 she launched into a long and varied career. At first, she worked at the Belfast hospital and then was a private-duty nurse. But when the war began, her youngest brother was in the service and she felt that she could do more for her country.

“It was luxury nursing. It wasn’t for me,” Randall said.

She joined up in April 1942, and was discharged on Christmas Day of 1945.

“Wasn’t that a good present?” she said, smiling. “Home and alive in ’45.”

When she enlisted at Fort Dix, N.J., she and the other nurses who arrived at the same time decided that they might as well “go the distance,” and volunteer for overseas duty.

Randall said that the military issued her woolen clothes as part of her uniform that were not useful in the hot places she worked. A Chinese green grocer in Mareeba used to roast peanuts by putting them in a tin tray on his shop roof, she said, and once she went on a crocodile hunt — though she did not get any crocodiles.

In Australia, the hospital was in a school that the Army had taken over, and during air raids, the nurses would move the patients out of the hospital on litters and place them between the sandbags that were stacked outside. During her first air raid, Randall grabbed a chocolate cake that she had just made and took it into the fox hole with her.

“Oh, I got ribbed because of that,” she recalled.

Later, when she was stationed in the 247th General Hospital New Guinea, in the jungle near the community of Lae, it was so hot she once saw the thermometer reach 130 degrees. Another nurse swore she saw it reach 136 degrees. Army engineers working at the nearby ammunitions dump dug the nurses a swimming hole that was fed by a cool mountain stream.

“It was clear water. Cool and delightful,” Randall said. “One of the other girls and I got brave. It got so hot at night, we couldn’t sleep. We’d go down and skinny dip.”

The 30 or so American nurses there also entertained themselves by taking funny pictures of each other — one of Randall shows her cavorting in a grass skirt — and getting them developed by the guys in the X-ray department.

“We were pin-up girls,” she laughed.

Another moment she remembered vividly was the time she was on night duty and saw that the mice around her feet were making a commotion. When Randall looked around, she saw that a venomous tiger snake had entered through a hole in the screen.

“It was beautiful,” she said, adding that the snake shone like flakes of gold. “We killed it. It was a crime to have done that. I saved the mice, I guess — one of the tragedies of war.”

When she was discharged and came home to Maine, she continued working for decades as a nurse around the midcoast. She also raised one son, David Emery, who later was elected to the U.S. House of Representatives.

Source: Bangor Daily News

 By CHRISTIN LULOW

Between 2 million and 3 million Americans take warfarin (Coumadin) to prevent blood clot formation, which is important in various medical conditions such as atrial fibrillation or after certain procedures, such as getting a new heart valve. Blood levels of a person’s international normalized ratio are measured regularly, and doses of the medication are adjusted accordingly.

Warfarin management may seem overwhelming, but anticoagulation clinics are here to help. While it may not seem like a lot goes into dosing warfarin, more goes into it than may be obvious. Nurses work with people on warfarin, and we want folks who take it to understand they play an important role in the management of their dosing.

A health care provider will start a patient on warfarin for a number of reasons. Although warfarin increases the time the body takes to form blood clots, it is a safe medicine to take when monitored appropriately. Routine follow-up for INR checks is an extremely important part of warfarin management.

During follow-up appointments, nurses will assess numerous issues with regard to your warfarin management. They will check your INR and compare it against your weekly dosing schedule. An INR reading may be outside of the optimal range for something as simple as a missed dose. However, when a patient starts or discontinues a medication, is ill, has been hospitalized or is scheduled for surgery, warfarin dosing is likely to be effected and will need to be adjusted.

It is the job of the nurse in the anti-coagulation clinic to figure out what to do with the patient’s warfarin dosing and when to safely see the patient back in the clinic to help maintain that patient within their goal range. The job of the patient taking warfarin is to notify the nurse in the anti-coagulation clinic of any changes in their medical condition or lifestyle that will affect INR readings.

This may sound simple, but many common activities can impact an INR level. What a person eats and drinks, how much a person exercises or doesn’t, any over-the-counter medications, prescription medications or herbal supplements, illnesses, whether a person smokes or doesn’t, dieting and weight changes, surgery and recovering from surgery are some of the other causes that can change a person’s INR reading. Anything out of the norm for a patient needs to be reported to the nurse at the anti-coagulation clinic immediately.

Warfarin management does not have to be confusing for the patient; supportive and knowledgeable anti-coagulation nurses can help greatly. What the nurses want you to focus on is being consistent.

Be as consistent as you can with your diet and your activity. Don’t worry about avoiding certain foods with vitamin K – except green and white tea; those are the only no-nos. If you like salads and green vegetables, eat them; they offer great health benefits. However, they can affect your INR readings, so it is important to be consistent in the quantity and regularity with which you eat these foods. Let the nurses adjust your warfarin doses around you; don’t adjust your lifestyle around warfarin.

Keep your scheduled appointment times for INR follow-up and take your warfarin as directed. Contact the anticoagulation clinic before you change, start or stop taking other medications. Always watch for signs of bleeding and or unusual bruising.

By following these basic guidelines, patients taking warfarin can live healthy, stable lives with minimal disruption caused by this life-saving medication. While it seems complex, with the help of your anti-coagulation nurse you can keep it simple!

Christin Lulow is a registered nurse in the Coumadin clinic at the International Heart Institute at St. Patrick Hospital.

Source: Missoulian