DiversityNursing Blog

As a resource for Nurses across the country, DiversityNursing.com wants to be sure our community is aware of the following site: The Future of Nursing: Campaign for Action.

The Future of Nursing: Campaign for Action, an initiative to ensure that all Americans have access to high-quality, patient-centered health care, with nurses contributing to the full extent of their capabilities. Action Coalitions work with the campaign to implement the recommendations of the landmark Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health. The coalitions are comprised of nursing, other health care, business, consumer and other leaders across the country. 48 states have Action Coalitions involved in this initiative.
 
The Campaign for Action is a collaborative effort to implement solutions to the challenges facing the nursing profession, and to build upon nurse-based approaches to improving quality and transforming the way Americans receive health care.
 
Action Coalitions are the driving force of the campaign at the local and state levels. These groups capture best practices, determine research needs, track lessons learned and identify replicable models. Examples of accomplishments to date include:

Texas is collaborating with nursing education leaders to adopt a common menu of core required classes across 106 schools in the state.

New Jersey is advancing practice by disseminating best practice models that demonstrate the benefits of staff nurses working to the full extent of their education and training.

Indiana is working within Indiana University to include inter-professional education into the newly designed curriculum to be used by a number of its health profession programs, including the schools of medicine and nursing.

Virginia is advancing nursing leadership by recognizing and mentoring 40 Virginia registered nurses younger than 40 who positively represent and lead their profession.

To get involved and find out more http://www.thefutureofnursing.org/

This is a great video by Global Novations on Defining Diversity and Inclusion

Overall, the National Center for Education Statistics (NCES) expects the Class of 2013 to total 1,744,000 bachelor’s degree graduates. Women will account for approximately 57 percent of bachelor’s degrees. This continues a trend that started in the early 1980s, the last time men earned more bachelor’s degrees than women.

In addition to the gains women are making, most racial/ethnic groups are gaining ground. Hispanic graduates, in particular, are responsible for much of that growth.

Overall, racial/ethnic minorities account for approximately 29 percent of bachelor’s degrees. That’s up from around 25 percent at the end of the 1990s. (See Figure 1.)  

Just as females account for a larger portion of degrees conferred, so too are females driving much of the gains in diversity. For example, the most current data show that African-American females account for 6.5 percent of degrees; their male counterparts, just 3.4 percent. Meanwhile, Hispanic females earned 5.2 percent of bachelor’s degrees, compared to 3.3 percent earned by male Hispanics.

Figure 1: Degrees Conferred by Racial/Ethnic Group, 2009-10 versus 1999-00



Source: 2011 Digest of Education Statistics, Table 300. National Center for Education Statistics. Data are for bachelor’s degree graduates.

by Katrina Gravel

This past month, the George Washington University School of Nursing (GW) received a three-year, $1 million grant from the U.S. Health Resources and Services Administration to fund a program that aims to increase the diversity of nursing professionals, according to a press release from GW. The school’s Success in Nursing Education project focuses not only on drawing in African-American, Asian, Hispanic, and Native American students, but also male students and economically disadvantaged students from Washington, D.C., and rural Virginia. A report released by the U.S. Department of Health and Human Services (HHS) in September 2010 showed that men made up less than 10% of employed RNs licensed between 2000 and 2008, while non-white or Hispanic nurses represented only 16.8% of all registered nurses in 2008. While those percentages may have grown in years since the HHS survey, it is unlikely that the gap has become significantly smaller.

The lack of ethnic minorities, males, and economically disadvantaged nursing students does not reflect the immense diversity of the patients these students will soon be treating. As an article in GW’s student newspaper The GW Hatchet cites the school of nursing’s Dean Jean Johnson as saying, “the nursing workforce should reflect what the population at large looks like.”

GW will use the grant to launch a recruitment campaign to reach disadvantage students, as well as students who are changing careers. The program will offer both undergraduate and graduate degrees in nursing, and will utilize retention tools such as mentoring programs. The grant will also create scholarships and financial aid for some students, according to the GW press release.

Has your organization made efforts to diversify its staff? What are your thoughts on the GW program? Leave a comment and let us know!

by Mareisha Winters
Let’s talk about work.

There is a lot of attention being paid to our increasingly diverse workplace. There are all types of differences including race, gender, generations and thinking styles, just to name a few. LTAW’s focus this month is on some of the key diversity dimensions and how to navigate them for greater productivity and engagement.

The increasingly diverse global workforce has made cultural competence an imperative to sustain and enhance workplace performance and engagement.  What is culture and what is cultural competence?  Culture is the behavioral interpretation of how a group lives out its values in order to survive and thrive; the set of shared attitudes, beliefs, behaviors, values, goals, and practices that characterizes an institution, organization or group.  Cultural competence is the capability to shift cultural perspective and adapt behavior to cultural commonalities and differences.  Ongoing, continued learning is required for cultural competence.

The three largest minority groups in the US workforce today are: Hispanic/Latino (14.7%), Black/African-American (11.6%), and Asian American (4.6%).  The more different cultures work together, the more cultural competence is essential to avoid problems ranging from miscommunication to actual conflict.  These problems can compromise effective worker productivity and performance.

Developing cultural competence results in an ability to understand, communicate with, and effectively interact with people across cultures.  The purpose of this post is to understand the different barriers and hurdles that minority groups tend to face in the workplace.  Managers must understand that their style cannot necessarily be “one size fits all” if they have a multi-cultural team.  Below are some characteristics of the three main minority groups in the workplace.

Hispanics/Latinos

Hispanic culture tends to be risk adverse and more of a “we” vs. “I” culture.  This can negatively impact them in the workplace if it is not understood.  Their risk avoiding nature may not afford them the same chances to show their abilities and skills.  By not self-promoting as much as others, Hispanics may not be rewarded for their contributions.

Cultural competence can help Hispanics reach their full potential in the workplace.  Many employees make sweeping stereotypes about Hispanics.  Some are criticized for their accents, leading to assumptions on their abilities, level of education, and intelligence.  Hispanics tend to speak Spanish with each other because of comfort, but this can be confusing or seen to be exclusionary by others.

Mentoring can make the difference in retaining Hispanics.  Hispanic mentors serve as role models and better understand some of the cultural nuances of being Latino in the workplace.  Hispanic employees need formal and informal ways to connect with each other in order to maintain the relationship bonds they value.

Blacks/African Americans

Studies tell us that there is greater corporate flight amongst minorities, especially among African Americans.  Research conducted by the WP Carey School of Business showed that the predicted quit rate for whites was 3.73%, compared to 4.79% for African Americans.   Discriminatory environments and micro-behaviors are often cited as reasons African Americans leave an organization.  So what can a company do to make these employees feel more engaged? Based on findings from focus groups conducted by the Future Work Institute, the top five characteristics of an organization that retains African American employees include:

    A climate of inclusion
    Supportive interactions with leaders
    Offer of profit and loss responsibilities
    Opportunities for development and advancement at all levels
    Community involvement and social responsibility

As with Hispanics, mentoring is a key factor in the career development and retention of Blacks/African Americans.  Studies have shown that mentoring of African Americans leads to: increased performance, faster promotion rate, early career rate of advancement, greater upward mobility, higher income, job satisfaction and perceptions of great success and influence in an organization.

African Americans place a high value on interpersonal relationships with supervisors and co-workers, which impacts both job satisfaction and employee commitment.  Supportive work environments for African Americans include: collectivist (focus on group rather than individual outcomes) approaches to work, agreeableness and teamwork.

Asian Americans

The same Future Work Institute focus group study revealed the major hurdles for Asian Americans in the workplace.  The primary reasons that Asian Americans feel excluded in the workplace include:

    Lack of mentors with Asian perspective.  Because of the small number of Asian Americans in the US workforce, mentors with Asian perspective are limited.  Similar to Hispanics and African Americans, Asian Americans would benefit greatly from having mentors in the workplace.
    Glass ceiling.  Asian Americans who wish to move up the career ladder feel limited because they do not see Asian representation at the top.
    Lack of transparency.  The need for constructive feedback is essential for career development.
    Life is out of balance.   Often caught between the demands of kids, parents and work, Asian Americans feel their work and life is out of balance.  According to AARP, 73%of Asian Americans believe that children in their families should care for elderly parents, compared with 49%of the general population.
    Cultural differences.  The sentiment from many Asian Americans is that, “Our culture is very different from the _______ culture.”  There is a lack of cultural understanding which is a barrier for them in the workplace.

It is important to note that the data presented above does not apply to every person within that subgroup and that any generalizations should not be viewed as stereotypes.  We offer this information to provide guidance to leaders on how the differences in values and culture might influence workplace behaviors and needs and why cultural competence is such a vital skill for leaders to effectively manage the increasingly diverse workforce.

Value differences! Live inclusively!

By Anna Gorman, Los Angeles Times
August 22, 2012

Black and Latino children were more likely than white children to be obese, witness gun violence and ride in a car without a seat belt, according to a study released Wednesday.

The study, published in the New England Journal of Medicine, found wide ethnic and racial disparities in health behaviors among fifth-graders in Los Angeles, Houston and Birmingham, Ala.

“The disparities were pretty substantial across so many different health indicators,” said lead researcher Mark Schuster, a Harvard Medical School professor and chief of general pediatrics at Boston Children’s Hospital.  “The breadth of the findings was striking to us.”

The researchers examined 16 health behaviors, including cigarette smoking, alcohol use, exercise habits, terrorism fears, bike helmet use and psychological quality of life.

Many of the behaviors carry potential for lifelong health problems, Schuster said. For example, researchers found that obesity rates were twice as high among black and Latino children, placing those children at increased risk for diabetes and heart problems. Black children were also more likely to be bullied, smoke cigarettes and drink alcohol than white and Latino youths.

Parents’ education and income played a critical role in the disparities, according to the study. Researchers also found that schools had a huge influence on children’s behavior, and that there were differences among schools even in the same neighborhoods.

Researchers interviewed more than 5,000 fifth-graders and their parents between 2004 and 2006. Schuster said the team focused on 10- and 11-year-olds because there was already significant research and public awareness about risky behaviors among adolescents.

“Finding disparities this young suggests that we have to start young to try to address them,” he said. “There is a strong likelihood that these disparities will persist unless we intervene to change them.”

From Human Resource Executive Online By Katie Kuehner-Hebert

It's one thing to be bullied by a co-worker or a boss, but simply witnessing the behavior in the workplace can be enough to make a worker call it quits, according to a study of "ambient" bullying.

Researchers at the University of British Columbia in Vancouver, Canada surveyed 357 nurses in 41 hospital units and found a statistically significant link between working in an environment where bullying was occurring and a desire to leave the organization. The study was published last month in the journal Human Relationsby SAGE.

"We underestimate the power of the impact of just being around bullying in the workplace," says Sandra Robinson, a professor at UBC's Sauder School of Business and one of the authors of the study.

"For those seeking to influence problematic behavior, they need to be sensitive [to the fact] that the impact of such behavior transcends the person or the group . . . actually being bullied, and that there may be other victims who are impacted by the harmful behavior, whether it comes from their supervisor or co-workers," Robinson says.

Marianne Jacobbi, senior editor at Ceridian/Lifeworks EAP programs in Boston, says research has shown that ambient bullying, or "indirect bullying" is pervasive -- 70 percent of employees say they have witnessed other people being bullied or mistreated at work.

"Bullying has a negative effect on team relationships, which creates a toxic work environment," Jacobbi says. "When [people] witnesses bulling, they think, 'This could be me next,' particularly if it's their boss."

Indeed, research has also shown that 72 percent of all bullies are bosses, she says.

HR managers should encourage an environment in which people feel safe to discuss bullying they've witnessed, and assessed that their comments will remain confidential whether they come to their boss, the HR department or the organization's employee-assistance program, Jacobbi says.

"The most important thing is creating a climate where people feel they have someplace to go when they feel uncomfortable," she says.

Ken Zuckerberg, director of training at ComPsych Corp. in Chicago, says HR managers not only have to watch out for employees with low morale after witnessing bullying, but also employees who try to appease the bully and make bad business decisions to avoid getting on their bad side.

When dealing with bullying behavior, organizations should treat it as a performance problem first and foremost, Zuckerberg says. A common mistake that HR managers often make in these situations is to take on the role of a counselor and try to figure out what is going on in the bully's life to cause them to act that way.

"One word of caution ? you want to continue to manage performance, but you don't want to be diagnosing mental-health issues," he says. "Most HR managers are not clinicians and they instead, should refer the bully to their EAP for help in uncovering what might be core issues behind bullying."

Seymour Adler, a partner with Aon Hewitt in New York and an organizational psychologist, says some people who witness bullying in the workplace feel they've been put in "a totally untenable situation of whether or not they need to try to be a hero."

"Who knows what the consequences will be if they do something about it, so they end up being passive about it," Alder says. "That can really be very corroding to their self-esteem, to how they view themselves as human beings."

If top-level managers are bullies, HR managers need to risk confronting them for the sake of the rest of the organization, he says.

"[HR managers have] the responsibility for the motivation, effective use and treatment of all of the human capital within their organizations," Adler says. "They need to be true to their value system, even if it ends up costing them their job."

From thestarpress.com By Michelle Kinsey

MUNCIE — Indiana University Health Ball Memorial Hospital wants to make sure that every person who walks through their doors gets equal treatment.

That commitment has landed the hospital at the top of a list, as the first in the state to be designated as lesbian, gay, bisexual, transgender (LGBT) friendly by the Human Rights Campaign, the nation’s largest LGBT civil rights organization.

The news came in the form of the HRC’s annual Healthcare Equality Index for 2012, which looks at how equitably healthcare facilities in the United States treat their lesbian, gay, bisexual and transgender patients and employees.

IU Health BMH was one of 234 nationwide — but the only one in the state — recognized as a “Leader in LGBT Healthcare Equality,” meeting all four core policy categories — patient non-discrimination; employment non-discrimination; equal visitation for same-sex partners and parents, and training in LGBT patient-centered care.

“We are proud of the recognition,” said IU Health BMH President and CEO Mike Haley. “It’s the result of a lot of hard work.”

That work began two years ago, after a transgender patient claimed she was mistreated in the hospital’s emergency room.

Transsexual Erin Vaught claimed she was called “it” and “he-she” and eventually denied treatment when she went to the ER on July 18, 2010, for a lung condition that was causing her to cough up blood.

Complaints were filed days later by Indiana Equality and Indiana Transgender Rights Advocacy Alliance and the incident went viral, with the hospital receiving criticism nationwide, and beyond.

Ball Memorial Hospital released a statement saying the hospital was conducting an internal review.

The result?

“We failed to meet their needs,” Haley said. “We acknowledged that openly.”

Then they went a step further.

“It’s one thing to apologize,” he said. “It’s another to say, ‘And furthermore, I want this hospital to be considered as a place anyone would want to go if they needed a hospital.’”

Haley issued a challenge to all physicians, employees and volunteers to meet every HRC key indicator.

Ann McGuire, vice president of human resources for IU Health BMH, led the hospital’s efforts. Members of the LGBT community were asked to help.

Jessica Wilch, board member and past president of Indiana Equality, an LGBT rights group, said she was a “believer in what (IU Health BMH was) trying to do” from the first meeting.

“When this went viral, my concern was that BMH would take the stand that this was an isolated incident and just pacify the process,” Wilch said. “Instead they saw it as a teachable moment.”

New policies were drafted and training was developed.

In addition to hospital leaders, anyone a patient would come in contact with was involved in the training, McGuire said, adding that it was about more than just a tutorial. It was about “eye-opening” conversations.

Wilch agreed, saying that face-to-face conversations with the LGBT community were essential.

“We could talk freely about the things we have encountered and then come up with ways, together, to handle it differently,” she said.

Overall, the HRC reports the number of American hospitals striving to treat lesbian, gay, bisexual, and transgender (LGBT) patients equally and respectfully is on the rise.

This year’s survey found a 40 percent increase in rated facilities.

Last year, IU Health BMH was short a few policy additions for the leadership HRC designation, but was still recognized for its efforts.

Wilch said she was not surprised the hospital “hit all of the marks” this year.

“They have become, essentially, one of the leading hospitals in the country, because it really started with them,” she said. “They were the ones who reached out to us and said ‘How can we make this better? How can we do the right thing?’”

Haley said he believed the training and policies developed at IU Health BMH will be used “across IU Health.”

IU Health BMH has also set out to look at other ways to expand their “best practices” when it comes to diversity, McGuire said. The hospital has been hosting Palettes of Diversity events, which have celebrated not only the LGBT community, but other cultures.

“We are making sure we are hard-wiring an environment recognizing and supporting diversity for all who come here,” Haley said.

McGuire agreed.

“It’s about relationships and dignity and respect,” she said. “It is uniqueness that each of us brings that makes us stronger as a community.”

And, McGuire would tell you, as a hospital.

From the Center for American Progress by Sophia Kerby & Crosby Burns

Our nation and our workforce are both becoming more diverse. The share of people of color in the United States is increasing; more women are entering the labor force; and gay* and transgender individuals are making vital contributions to our economy, while being increasingly open about who they are. To that end, businesses that embrace diversity have a more solid footing in the marketplace than others.

A diverse workforce combines workers from different backgrounds and experiences that together breed a more creative, innovative, and productive workforce. And businesses have learned that they can draw upon our nation’s diversity to strengthen their bottom line. In this way, diversity is a key ingredient to growing a strong and inclusive economy that’s built to last.

Let’s look at the top 10 economic benefits of workplace diversity.

1. A diverse workforce drives economic growth. Our nation’s human capital substantially grows as more women, racial and ethnic minorities, and gay and transgender individuals enter the workforce. A McKinsey & Company study, for example, found that the increase in women’s overall share of labor in the United States—women went from holding 37 percent of all jobs to 47 percent over the past 40 years—has accounted for about a quarter of current GDP.

2. A diverse workforce can capture a greater share of the consumer market. By bringing together individuals from different backgrounds and experiences, businesses can more effectively market to consumers from different racial and ethnic backgrounds, women, and consumers who are gay or transgender. It is no surprise, then, that studies show diversifying the workplace helps businesses increase their market share.

3. Recruiting from a diverse pool of candidates means a more qualified workforce. When companies recruit from a diverse set of potential employees, they are more likely to hire the best and the brightest in the labor market. In an increasingly competitive economy where talent is crucial to improving the bottom line, pooling from the largest and most diverse set of candidates is increasingly necessary to succeed in the market.

4. A diverse and inclusive workforce helps businesses avoid employee turnover costs. Businesses that fail to foster inclusive workplaces see higher turnover rates than businesses that value a diverse workforce because they foster a hostile work environment that forces employees to leave. The failure to retain qualified employees results in avoidable turnover-related costs at the expense of a company’s profits. Having a diverse and discrimination-free work environment helps businesses avoid these costs.

5. Diversity fosters a more creative and innovative workforce. Bringing together workers with different qualifications, backgrounds, and experiences are all key to effective problem-solving on the job. Similarly, diversity breeds creativity and innovation. Of 321 large global enterprises—companies with at least $500 million in annual revenue—surveyed in a Forbes study in 2011, 85 percent agreed or strongly agreed that diversity is crucial to fostering innovation in the workplace.

6. Businesses need to adapt to our changing nation to be competitive in the economic market. Census data tell us that by 2050 there will be no racial or ethnic majority in our country. Further, between 2000 and 2050 new immigrants and their children will account for 83 percent of the growth in the working-age population. Our economy will grow and benefit from these changing demographics if businesses commit to meeting the needs of diverse communities as workers and consumers.

7. Diversity is a key aspect of entrepreneurialism. Our nation’s entrepreneurs are a diverse set of people of color, women, gay, and transgender individuals. According to the Census Bureau, people of color own 22.1 percent of U.S. businesses. Moreover, women own28.8 percent of U.S. businesses, and Latina-owned businesses in particular are the fastest-growing segment of the women-owned business market. According to the National Gay and Lesbian Chamber of Commerce, gay or transgender individuals own approximately 1.4 million (or approximately 5 percent) of U.S. businesses.

8. Diversity in business ownership, particularly among women of color, is key to moving our economy forward. The diversity of our nation’s business owners helps boost employment and grow our economy. For example, women of color own 1.9 million firms. These businesses generate $165 billion in revenue annually and employ 1.2 million people. Latina-owned businesses in particular have total receipts of $55.7 billion since 2002.

9. Diversity in the workplace is necessary to create a competitive economy in a globalized world. As communities continue to grow, it’s important to harness the talent of all Americans. Businesses should continue to capitalize on the growth of women, people of color, and gay and transgender people in the labor force. Our increasing diversity is a great opportunity for the United States to become more competitive in the global economy by capitalizing on the unique talents and contributions that diverse communities bring to the table.

10. Diversity in the boardroom is needed to leverage a company’s full potential.By 2050 there will be no racial or ethnic majority in the United States, and our nation’s boardrooms need to represent these changing demographics. Currently people of color and women only represent about 14.5 percent and 18 percent, respectively, of corporate boards among the senior management of Fortune 500 companies. Recruiting board directors with a breadth of expertise and varied experiences will make companies more proficient.

By Elizabeth Landau via CNN

(CNN) -- Hospitals near Aurora, Colorado, were flooded with victims after a movie theater shooting Friday morning.

An Aurora Fire Department call log reveals the urgency of the situation.

"If they're dead just leave them," a voice tells a fire department responder who reported that police said there may be a number of people dead inside the theater. "We're in a mass casualty situation at this time. Please make sure that you guys set up some kind of transport officer over there that can contact the hospitals so we don't overload one."

The emergency department at Denver Health Hospital was chaotic as staff prepared for the arrival of patients from the shooting, said Dr. Christopher Colwell, director of emergency medical services there. The hospital received seven victims, but called in extra personnel and was ready to take in more patients.

"You're not sure how they're going to arrive to you, so you prepare for the worst," he said.

Shooter had 100-round rifle magazine

Gunshot wound patients are fairly regular at Denver Health, although not on this scale, he said. In a mass shooting situation, staff assess the severity of the wounds and what steps must be taken -- some need to go straight to the operating room, others can wait, still others may not require surgery.

Colwell was a physician who treated victims at the scene of the Columbine High School shootings in 1999. Five patients were transferred to Denver Health; all survived.

"We have obviously done a lot of training exercises since then to try to prepare for an event like that," Colwell said.

Dr. Frank Lansville, medical director of emergency services at Aurora South Hospital, told CNN his hospital had seen 18 patients so far, 12 of whom suffered from gunshot wounds. There were several tear gas victims who were stable, he said. They had been seen, decontaminated and discharged. "The others had horrific gunshot wounds to various parts of their body," he said.

At Aurora Medical Center, the first victim of the movie theater shooting came in before the staff had even heard about the attack, said Tracy Lauzon, director of EMS and trauma services at the hospital.

Few hints of movie-theater shooting suspect's past

Soon after, the trauma surgeon learned more victims were headed their way. Four other trauma surgeons, two orthopedic surgeons and various other physicians came to help. Six patients have gone through surgery.

Aurora Medical Center has taken in 15 patients from the shooting, she said. Eight have been treated and discharged from the emergency room; the other seven were admitted.

"We do drills twice a year anticipating this kind of thing, so people are very well prepared and the hospitals are very well prepared," Lauzon said.

Most of the hospitals in the Denver area follow established federal guidelines for emergency response, said Nicole Williams, spokeswoman for Swedish Medical Center, which treated four victims from the shooting at the movie theater. "We were extremely prepared coming into this," she said because the hospital has already completed a couple of disaster drills this year.

During such a drill, a mass page goes out to the hospital administration alerting officials that EMS has multiple patients who could be transported to area hospitals, and the staff is told be on standby. Emergency workers call the hospitals to see how many beds are available and how many critical patients they can take.

Then, the hospital brings in essential staff, in addition to extra trauma surgeons or other specialists as needed.

"It's a very controlled atmosphere," Williams said. "We all try to stay very calm and just serve the community to the best of our abilities."

Theater shooting unfolds in real time over social media

Staff at Swedish Medical Center's command center fielded hundreds of phone calls "from very panicked people looking for their husbands, their wives, their children," Williams said.

Swedish Medical Center was still treating three patients for gunshot wounds: an 18-year-old male in fair condition, a 20-year-old male in critical condition and a 29-year-old female in critical condition. A fourth patient, a 19-year-old female, came in a few hours after the shootings with minor injuries, possibly caused by shrapnel. She was treated and released.

The family members of the victims at the hospital have been notified, Williams said. "All of the victims have loved ones -- family or friends -- by their side, while they're here," she said.

Kari Goerke, Swedish Medical Center's chief nursing officer, worked in the operating room in the aftermath of the Columbine shootings of 1999. Swedish Medical Center treated four Columbine victims, all of whom survived.

"We had them all in the operating room within an hour of the event," Goerke said. "That gives them much better chances."

The staff responded with expertise and compassion both in 1999 and on Friday morning, she said.

Aspiring sports reporter killed in shooting

"Afterwards you kind of think about what's happened and the shock and awe of the whole situation and how horrific it is," she said. Her voice cracked as she discussed the emotional aftermath. "Taking care of kids is always hard. I'm a mom, I can relate. That makes it difficult."

But, she added, "it's what we're trained to do."