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DiversityNursing Blog

Two Parents Thankful For A Nurse Who Happened To Be Driving By

Posted by Erica Bettencourt

Wed, Mar 29, 2017 @ 02:12 PM

Walker_032817_29baby_2940x.jpgThankfully Nurse Markey decided to take a different route to pick up her step-kids at school because she ended up at the right place at the right time.

A couple who wanted to have a natural birth were getting more than they bargained for on a very special day. As much as they wanted to, they couldn’t deliver in the hospital. The baby had other ideas and they ran out of time. Markey sprung into action and helped the couple. 

She’s thankful for the experience. Normally she’s around at the end of a patient’s life, but this time, she was there from the very start. Continue reading below for more details about what happened that day.

Michelle Markey sensed that something unusual was going on Friday morning as she drove down Route 101 in Wilton, N.H. “When you’re a nurse, you look at the whole situation,” she said.

And the situation she saw signaled distress. A young man was standing next to his truck, pacing, cellphone pressed to his ear. Markey pulled over.

Crammed in the front seat was a woman in full labor, the baby’s head showing. Markey is a cardiac nurse at Tufts Medical Center. She had never delivered a baby.

Orion and Janella White had wanted a natural birth for their second child, and nature was certainly taking charge.

Janella had been feeling some cramping overnight, but she told Orion not to worry when he got up for work early Friday. When their daughter was born two years ago, Janella had contractions for two days and spent six hours in labor at the hospital.

Even if this one took half as long as his sister, they still had plenty of time to get to the Birth Cottage, a birthing center in Milford where they hoped to deliver the baby in a homelike setting.

So Orion headed out to his job as an aircraft mechanic in Westfield, Mass., an hour and 25 minutes from their Rindge, N.H., home.

About 8:30 or 9 a.m., Janella could tell that the baby was coming that day. She texted Orion that he might want to head home, but that there was no rush. By the time Orion arrived, though, she knew it was urgent. Orion grabbed some pillows, and they took off.

“We started out, and I was, like, ‘Look out for the bumps!’ ” Janella said. “About eight minutes into the ride, I said, ‘Who cares about the bumps, let’s go!’ ”

But as it became clear they wouldn’t make it in time, Orion pulled over and called their midwife, Adrian Feldhusen. 

“I said: ‘Her water broke, and she can feel the head.’ She said, ‘OK, pull over, and I’ll walk you through this.’ ”

He pulled into the driveway of a condo development. A stranger pulled up behind them and called 911. 

Markey arrived seconds later. It was strange she was even driving on this road. She was off from work and heading to pick up her stepchildren at school, but she had some extra time and decided to try out a different route.

The Whites were relieved to have a nurse on hand. Markey was relieved to have a midwife on the phone. Feldhusen told Markey how to turn the baby’s head to release the shoulders. The baby came out quickly, but he wasn’t crying.

At the other end, Feldhusen heard the phone go dead. Not given to panic, she figured someone put it down. So she grabbed her bag to head out.

Meanwhile, Markey smacked the baby, gingerly. 

“He started breathing, then he stopped,” Markey said. “I hit him a little bit harder, then he started crying a little bit.” 

Keihin White had successfully entered the world, sharing a birthday with his 26-year-old father, who stripped off his shirt and wrapped the baby in it.

The ambulance came moments later, and Feldhusen arrived as Janella was being put on a stretcher. She joined mother and baby in the ambulance, where she delivered the placenta, cut the cord, and helped Janella start breast-feeding.

The Whites spent the night at St. Joseph Hospital in Nashua and went home Saturday. On Tuesday, Keihin had his first checkup with the pediatrician — all was well. And later that day, the Whites reunited with Feldhusen and Markey in Milford, and told their tale to the press.

Markey isn’t thinking of taking up obstretrics. But she was glad to have helped. As a cardiac nurse, she deals a lot with people who are dying. It felt good to be at the other end. 

“To see someone be born is amazing,” she said.

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Topics: emergency delivery, nurse hero

Cultural Competency: Bridging the Language Barrier

Posted by Pat Magrath

Tue, Mar 28, 2017 @ 02:08 PM

nurse-and-patient.jpgDepending upon your physical location of employment, whether it’s in the city, suburbs or rural area, you may encounter language barriers with your patients every day or maybe only once or twice a year. Whatever the frequency is for you, it’s important that the information you have to deliver is conveyed as clearly as possible. Some medical terms we use here in the US may not have clear translations in your patient’s native language.
 
What are you to do? This article will help guide you in these situations. Perhaps you’ve encountered a language barrier predicament that you’re willing to share with our Nursing community that would be helpful?

Let’s face it, it is often hard for a patient whose first language is English to navigate the technical medical vocabulary that we use in our healthcare system. Patients who don’t speak English well—or at all—are considered to have low health literacy. This is not necessarily a reflection of their intelligence, but rather of how hard it can be to educate them about their medical status, treatment plans, etc.

A language barrier can also make it hard for nurses to honor patient preferences, answer questions, and establish a trusting relationship—particularly when cultural differences exist regarding the patient’s concepts of wellness and illness. Perhaps most troubling is the fact that informed consent becomes a sticky issue, both legally and ethically, when a patient cannot understand his condition or ask questions about treatment options.

In regions with large Hispanic or Asian populations, many healthcare facilities have staff nurses who are bilingual. But what happens when you are caring for a patient that you can’t communicate easily with?

The ideal situation would be to use a professional translator who has training in medical vocabularies. These professionals are often available through a staffing service or a 24-hour telephone translation line. If you have access to these services, be sure to take advantage of them. And if you frequently encounter situations in which you feel a translator is required but none is available, you can encourage your hospital to contract with a translation service.

Often, friends or family members of the patient can step up to bridge the language gap. It’s advisable to use these ad hoc interpreters only as a last resort, because these non-professionals are more likely to make mistakes that can affect clinical outcomes. Friends or family members may have low health literacy themselves, may not fully understand a medical term that has no direct translation, or may inject their own personal views into the dialogue to the patient as an attempt to be helpful. The more complicated the medical case, the higher the likelihood of translation errors.

If you are communicating through a translator of any sort, there are a few things to keep in mind:

  • Begin by briefly advising the translator what you need from him/her: to translate the words of both parties as literally as possible, without adding or leaving out anything.
  • Ask the translator if he/she knows of any general cultural beliefs that might come into play during medical treatment—such as a cultural preference for avoiding conflict, avoiding interactions with a person of the opposite gender, or avoiding anything that might seem like questioning the authority of a clinician.
  • If the translator contracts with your employer, there is probably already a signed HIPAA agreement in place. If a family member or friend is translating, advise that person that the information being translated is considered confidential.
  • Document the name of the person translating in the patient chart.
  • Use the “teach back” method to convey medical information. You’ll be doing it through a translator, but the process can still help you assess how well the patient has understood the information being provided.

Census statistics indicate that nearly 47 million U.S. residents speak a foreign language at home, with a quarter of them reporting limited proficiency in English. These numbers practically ensure that you will encounter a language barrier at some point. Despite the difficulty in communicating, remember that you, as a nurse, are still responsible for providing a quality experience for the patient, including protecting his dignity, ensuring comfort, and advocating on his behalf. You also have to be diligent about assuring the data you document is as accurate. 

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Topics: cultural competence, language barrier

Gender Identity Terms You Need To Know

Posted by Erica Bettencourt

Fri, Mar 24, 2017 @ 04:33 PM

untitled-collage.jpgAfter reading this article, I am happy a documentary like this, “Gender: The Space Between,” airing on March 27, 2017 on CBSN is coming out. Even though I try to stay educated on people's rights and beliefs, I didn't know what many of the gender identity termsmentioned below meant.
 
Familiarizing yourself with these gender identity terms and their meaning can help you better connect with your patients. Our patient's needs are changing. Understanding these changes will help you provide the best possible care for them

The latest CBSN Originals documentary, “Gender: The Space Between,” takes a deep dive into the complexities of gender identity and gender expression. While transgender stories have become more visible in the media, there are many identities and terms outside of the two most culturally accepted genders — man and woman — that fall under the trans umbrella. And in many social circles, the vocabulary related to gender identity is unfamiliar or inaccessible.

Gender identity is an extremely personal part of who we are, and how we perceive and express ourselves in the world. It is a separate issue entirely from sex, our biological makeup; or sexual orientation, who we are attracted to. There are dozens of dynamic and evolving terms related to how people identify. While this glossary cannot cover every possible identity a person might have, it provides definitions for some of the most common vocabulary necessary to understand the layered world of gender.

Below is a guide to some of the topics and terms discussed in “Gender: The Space Between,” as defined by the Human Rights Campaign, GLAADThe Trevor Project, and the National Center for Transgender Equality.

Gender Identity Definitions

Agender: A term for people whose gender identity and expression does not align with man, woman, or any other gender. A similar term used by some is gender-neutral.

Bigender: Someone whose gender identity encompasses both man and woman. Some may feel that one side or the other is stronger, but both sides are present.

Binary: The gender binary is a system of viewing gender as consisting solely of two identities and sexes, man and woman or male and female.

Cisgender: A term used to describe someone whose gender identity aligns with the sex assigned to them at birth.

Dead name: How some transgender people refer to their given name at birth.

Gender dysphoria: Clinically defined as significant and durational distress caused when a person’s assigned birth gender is not the same as the one with which they identify.

Gender expression: The external appearance of a person’s gender identity, usually expressed through behavior, clothing, haircut or voice, and which may or may not conform to socially defined masculine or feminine behaviors and characteristics.

Gender fluid: A person who does not identify with a single fixed gender, and expresses a fluid or unfixed gender identity. One’s expression of identity is likely to shift and change depending on context.

Gender identity: A person’s innermost concept of self as man, woman, a blend of both, or neither – how individuals perceive themselves and what they call themselves. Gender identity can be the same or different from one’s sex assigned at birth.

Gender non-conforming: A broad term referring to people who do not behave in a way that conforms to the traditional expectations of their gender, or whose gender expression does not fit neatly into a category.

Gender questioning: A person who may be processing, questioning, or exploring how they want to express their gender identity.

Genderqueer: A term for people who reject notions of static categories of gender and embrace a fluidity of gender identity and often, though not always, sexual orientation. People who identify as genderqueer may see themselves as being both male and female, neither male nor female or as falling completely outside these categories.

Misgender: Referring to or addressing someone using words and pronouns that do not correctly reflect the gender with which they identify.

Non-binary: Any gender that falls outside of the binary system of male/female or man/woman.

Passing: A term used by transgender people which means that they are perceived by others as the gender with which they self-identify. 

Queer: An umbrella term people often use to express fluid identities and orientations. 

Sex: The classification of a person as male or female at birth. Infants are assigned a sex, usually based on the appearance of their external anatomy.

Transgender: An umbrella term for people whose gender identity and/or expression is different from cultural and social expectations based on the sex they were assigned at birth.

Transitioning: The social, legal, and/or medical process a person may go through to live outwardly as the gender with which they identify, rather than the gender they were assigned at birth. Transitioning can include some or all of the following: telling loved ones and co-workers, using a different name and pronouns, dressing differently, changing one’s name and/or sex on legal documents, hormone therapy, and possibly one or more types of surgery. 

Transsexual person: A generational term for people whose gender identity is different from their assigned sex at birth, and seek to transition from male to female or female to male. This term is no longer preferred by many people, as it is often seen as overly clinical, and was associated with psychological disorders in the past.

Two-spirit: A term that refers to historical and current First Nations people whose individual spirits were a blend of male and female. This term has been reclaimed by some in Native American LGBT communities to honor their heritage and provide an alternative to the Western labels of gay, lesbian, bisexual, or transgender.

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Topics: gender identities

Minding Our Lives

Posted by Pat Magrath

Thu, Mar 23, 2017 @ 12:12 PM

Mind-full-or-mindful-604x270.pngA few years ago, I attended a conference where Ron Culberson was a featured speaker. Every few months since then, I receive Ron’s eNewsletter and I always find what he has to say inspiring. He points out the everyday things in our lives and how we need to slow down and be present.
 
Often, he talks about our family and professional interactions and how things we say and do can be misinterpreted. How other things happening in our lives distract us when we should be focused on the present and what is happening right now.
 
I hope you can take a few minutes and read his article about mindfulness. I found myself nodding in agreement and thinking you are so right. I hope this article will help you in your everyday life.
 
I know this has happened to you. You’re driving down an interstate highway when your mind begins to wander. Maybe you’re thinking about your boss’s rude behavior or how nice it would be to make a career change. You start imagining all the jobs that might fit your skills. Maybe you should open a coffee shop or be a consultant and work from home. The ideas are coming fast and furious, and you start to get excited about all of the possibilities. Then, it hits you. The reality of your situation sinks in. You passed your exit ten miles ago.

How does this happen? How can we be so focused on our thoughts and still stay on the highway? And how can it be that we have no idea how far we’ve gone or how long we’ve been distracted?
 
Welcome to being human and having a mind that loves to wander. But don’t fret. It’s a problem that affects all of us.

I’m trying to be more mindful this year and I’m convinced that mindfulness is a skill that can make life easier and richer. Ironically, it’s a practice that most of us never learn. Instead, our minds get distracted by even the slightest of random thoughts. Yet the goal of mindfulness, and perhaps even life, is to stay focused on where we are in any given situation rather than being tempted by thoughts that lead us away from that moment.


Here’s an example of how our minds distract us.


Imagine that I’m having a somewhat heated discussion with my wife. Let’s pretend I’ve done something wrong. I say “pretend” because it’s never happened. But just go with me on this one. Suppose she is upset because I didn’t take the dog out and the dog decided to make a “deposit” on the floor. My wife is accusing
me of not taking the dog out.

The reality of the situation is that we didn’t take the dog out, and the dog pooped. That’s it. No more, no less. If both of us were being mindful of the situation, we would have recognized this and not given it a second thought. Unfortunately, our minds are not satisfied with that approach and prefer to look for more exciting problems. Our egos like drama and love to stir things up.


So, my wife’s ego may whisper something like this,
I was busy working on our tax returns. He knew I was doing something important and could have watched the dog. If he had just been more attentive to what I was doing and taken his turn with the dog, we wouldn’t have to clean up this mess.

Meanwhile, my ego might whisper something like this,
I didn’t want this dog in the first place. At my age, I want to relax. I don’t want to worry about a hyperactive, chewing and pooping machine. I don’t need to be potty training a dog. So, since she wanted a pet, she needs to be the one to monitor that doggone dog.

Then an argument ensues which on the surface, appears to be about the dog poop but in reality, is about the crap that our minds are telling us. And none of this is based on the reality of what really happened.


Does this sound familiar?


How many times have we reacted to our bosses, our partners, our children, or even our pets because of something our heads told us that distorted the reality of the situation. This is generally due to a lack of mindfulness. But there is a solution—it just takes a little effort.


Here’s a quick mindfulness test. Wherever you are right now, take a look around the room and see if you can find something you hadn’t previously noticed. If you’re in your home, this might be harder than if you’re in your office or in a public location. Nonetheless, give it a try.


If you found something, why hadn’t you noticed it before now? Most likely it’s because we typically experience our surroundings through the familiarity of assumptions. We expect to see the tree in the yard or the desk in our office but never really experience the colors, shapes. or sensations of those items as we would if it was a new experience. Ironically, every single second of every single day is a new experience since it’s the first time we’ve experienced that particular moment. So we should go into each moment with an openness to the newness of the experience.


To battle the distractions in our heads that steer us away from the present moment, we need to focus our awareness on right now. Here are two ways to work on this.


First, no matter what you are doing, look at it with fresh eyes in order to be surprised by the novelty of the experience. When we’re open to being amazed, we will be amazed.


The other day, I took a walk. It would have been easy to listen to music or a podcast while I was walking in order to make the most of my time. But the truth is, walking makes the most of my time. When I’m fully focused on the activity, the activity becomes fuller. So, during my walk, since I wasn’t listening to music, I heard a noise in the woods. I turned towards the noise and saw ten deer standing just a few feet away. We stared at each other for a couple of seconds. Then one of the deer snorted and they all galloped away. It was extraordinary. And I’m sure I would have missed it if I’d been focused on the music or a podcast.


Second, when you find yourself reacting to something with fear, anxiety, or some other emotion, ask yourself what’s really happening as opposed to what your mind is telling you is happening. Often, you’ll find that your reaction is based on something your mind is telling you rather than the reality of the situation.


Last week, my wife and I were driving to a college basketball game. About halfway there, I started thinking about something I had said during a presentation and began to worry that while the comment was funny, my client might have found it unfunny, or worse yet, offensive. For the next twenty miles, I could feel myself getting more and more worked up as I imagined that my client was angry with me and that she might not want to work with me again. I became tense, was short with my wife, and felt miserable. However, when I realized what I was doing, I refocused on the present moment and enjoyed the basketball game with my wife. The next week, I got an email from my client and she specifically mentioned how funny the comment in question was. So the reality in my car was not real. It was all in my head. And I spent twenty minutes of my life worrying about it. Thankfully, I made an adjustment before wasting my entire day.


Being mindful means being present to the reality of the moment. The present moment is all that matters. For many of us, our reality is not just in the present moment, but in our heads as we think about last week, next Tuesday, or when we were teenagers. That’s probably too much for our feeble minds to handle. Why not, instead, focus simply on now and make it as rich as possible? That’s how we mind our lives.

Topics: mindfulness, mindful

Cultural Competency: Matters of Modesty

Posted by Pat Magrath

Wed, Mar 22, 2017 @ 03:41 PM

nurse-and-patient-at-home-web.jpgGrowing up, we were taught to be modest. As we became adults and more comfortable with who we are as a person, modesty may have become more important in our lives, or perhaps, less important. It depends on our personal circumstances and beliefs.

Whatever our personal feelings are, as a Nurse, you must always be vigilant and respect your patient’s privacy. You already know this, but are you aware in some cultures, modesty truly is a virtue? For others, there could be a personal trauma, physical disfigurement, or psychological reason that produces tremendous anxiety when disrobing or showing any part of their body.

This article stresses the importance of being sensitive to each patient’s needs in delivering culturally competent care.

Many cultures and religions place a high value on modesty, particularly for women, associating it with honor and virtue. Often modesty is linked to styles of dress and circumstances under which an individual might feel comfortable being uncovered or touched. Yet, there are personal reasons for modesty too, so you’re likely to come across patients, both male and female, who have firm boundaries of privacy—including survivors of sexual assault and transgender patients.

Modesty can be so important to some patients that medical visits cause them a great deal of stress and anxiety. Some will shop around for a clinician of a particular gender or one who makes them feel comfortable—or even forego care completely. As a nurse, your ethical commitment to patient advocacy and patient dignity requires you to demonstrate cultural sensitivity to patients who value modesty. Making accommodations for a patient who values modesty is a form of holistic care, because it recognizes the individual’s emotional well-being.

In general, nurses should always preserve patient privacy, by providing gowns and cover-ups, pulling drapes closed, knocking before entering an exam room, etc. Whenever possible, go the extra mile, by providing scrub pants if a gown doesn’t close in the back or double-gowning a patient who will be leaving his room. Patients may know intellectually that healthcare providers “have seen it all,” but that doesn’t stem their embarrassment. You can also urge your employer to build an environment where patients feel safe, by speaking up about gowns that don’t close all the way or other modesty issues.

Cross-cultural patient encounters can often be challenging in terms of modesty. Muslim women are likely to request female providers only, and these requests might be hard to honor in small facilities or rural areas. They may also prefer to have their husband present during an exam or procedure, and may resist disrobing entirely—or uncovering their hair—for an exam. Women from certain Asian cultures also have a strong preference for female obstetrics staff. Ideally, nurses should be able to anticipate cultural requirements for modesty and make accommodations before patients become anxious or uncomfortable.

While the majority of nurses are female, many mistakenly believe that male patients really don’t care about modesty, but that often is not true. Many hospitals don’t have nearly enough male nurses or technicians on staff, but you should try your best to honor requests for same-gender providers for baths, catheterizations, or other intimate procedures. Always try to be sensitive to modesty concerns—even when it creates an extra step for you or takes more time.

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Topics: cultural competence, modesty

Nurse Uses Her Experience With Brain Tumor To Better Serve Patients

Posted by Erica Bettencourt

Tue, Mar 21, 2017 @ 12:06 PM

Screen Shot 2017-03-21 at 11.56.19 AM-274568-edited.pngYou take care of people in your job every day. However, if the tables are turned because you became ill and now it’s you being taken care of, the situation is bound to introduce you to a different perspective on how things feel. 
 
In the past, Nurse Kelly Northrip could only sympathize with her patients. Now she can relate to them and identify with things they are going through because she was once in their shoes. See how she pushed through her medical journey to come out the other side stronger and with an even better perspective for her patients. 

The squeak of tennis shoes moving quickly across the linoleum floors adds to the cacophony of alarms and beeps pulling nurses and doctors in every direction on the acute care floor of Florida Hospital Memorial Medical Center.

In the midst of the commotion, nurse Kelly Northrip sits quietly at the bedside of a patient, listening with the kind of intensity that doesn't come natural to most.

"I get told all the time I spend too much time with my patients, so to speak, and I say there is no such thing," said Northrip, a licensed practical nurse. "Each one is a learning experience."

Northrip knows firsthand the impact a few extra moments can have on a patient. If any of her patients doubt her, she might tell them about the golf ball-sized tumor that was discovered on her brain or the surgery she endured, answering doctors' questions while they probed her brain.

Usually, it's enough for Northrip simply to be there for her patients, hearing their concerns and reassuring them that everything will be all right. She's experienced that firsthand as well.

A DREAM THREATENED

After 18 years in the restaurant industry, Northrip embraced a career change to pursue her dream of becoming a registered nurse. After graduating and starting her career as a licensed practical nurse, Northrip's newly established career was almost sidelined forever when a tumor was discovered in her brain last summer.

Overnight, the career she had worked so hard for was in jeopardy, and so was her life.

Northrip's specialists presented her with three options: do nothing; do a biopsy and determine how to proceed; or, the riskiest option, an awake craniotomy.

"Doing nothing wasn't an option for me, for us," said Northrip, whose husband and two kids supported her decision to go with the most aggressive option.

In an awake craniotomy, the patient is awakened after surgeons open the skull. That way doctors can ask a series of questions while removing the tumor and ensure other areas of the brain aren't damaged.

Sounding just like an eager nursing student, Nothrip described the prospect as "scary and exciting at the same time."

"I was more nervous than she was," said her husband, Steven.

But the surgery is rare — and risky. Her doctors recommended that she seek out surgeons who were specialists in the procedure.

"He said you'd be better off going somewhere where they've done thousands. If it won't bankrupt you, go to Duke," she recounted. On a morning in August 2016, Northrip and her family loaded up into her brother's motor home to drive from Florida to North Carolina so that the drowsy Northrip could sleep during the trip, a symptom of the tumor. After three blown tires, and countless frazzled nerves, the motor home delivered them safely to Duke University Hospital where Northrip would undergo brain surgery the next morning.

Northrip remembers being wheeled into the operating room for the surgery, where a big TV on the wall showed images of her brain. After being put to sleep, Northrip awoke to a bright room full of people and the distinct sensation of pressure in her head.

"I could feel the doctor working in my head," she recalled. "I could feel him working in there and I actually spoke to him and he spoke back. I could feel discomfort, but not great pain."

As the surgical team began to remove Northrip's tumor, they asked a series of questions to ensure they didn't affect other areas of her brain.

"He had me move my feet, wiggle my toes, do a number of things. I just tried to relax, and they tried to keep me calm through the whole thing. I can remember almost everything. I can even remember their faces."

The surreal experience of being conscious during brain surgery left Northrip feeling "very much awake and alive."

The next thing Northrip recalls is waking in a recovery room, feeling like she was being hit in the head with a hammer — proof she had survived the surgery.

The pain subsided when Northrip received the news she had hoped for — the tumor was benign, and she wouldn't have to undergo chemotherapy.

"The only thing I would be required to do was an MRI every year," she said.

Other challenges still lay ahead.

THE RECOVERY

While insurance covered a large portion of the rare surgery, Northrip and her family still had numerous medical bills to pay on top of regular living expenses. Family, friends and coworkers rallied to the family's aid, hosting golf and dart tournaments and online fundraising campaigns.

"It makes you think, 'What did I do to deserve this?' I don't look in the mirror every day and say I'm a wonderful person. I don't think you ever feel deserving," Northrip said. "You're just trying to do your thing, trying to be a good, decent person and do things to the best of your ability."

The outpouring of support continued into Christmas when her family was adopted by the hospital staff, who bought presents for the kids. Northrip's co-workers also provided gift cards for the family.

The financial help allowed Northrip to focus on recovery and her goal of getting back to the job she loved. She pushed herself hard through physical therapy with the goal of coming back to work quickly but learned she couldn't force her body to recover faster than was possible.

The emotions of the recovery caught her off guard.

"I didn't think anything about the after, I just jumped in (to the surgery) with both feet and thought I would deal with it as it came," she said. "It was a very eye-opening, learning experience."

Physical therapist Donna McQuade worked with Northrip and knew the obstacles she would have to overcome to return to the job.

"When you do the job every day, you forget what it takes," McQuade said. "But having had such an extensive surgery, I don't think she was aware how much it affected her emotionally."

True to her persistent nature, Northrip tried to come back ahead of schedule, only to realize she wasn't ready and needed to continue her physical therapy.

"She's been doing it for so long she just didn't realize how much strength it took" to work a nursing shift, McQuade said.

Northrip persisted, and in January she returned to work.

"It's really miraculous, the amount of time from when she found out she was sick to when she was back to work," said McQuade.

While the experience challenged Northrip in more ways than she expected, being on the other side of the bed brought her a rare perspective that changed the way she views her job.

"Prior to this, I could only sympathize with my patients," Northrip said. "But after being hospitalized I can truly empathize and identify their anguish and stress."

To her coworkers, there was little doubt she would return and be a better nurse for her experience.

"We knew she would be back and rise to the challenge," said McQuade. "She's got a good support system here because she's a good support system to us."

Being back at work has also allowed Northrip to pursue her original goal, to become a registered nurse.

After years of applying to a full program, Northrip's application was recently accepted and she started school to become a registered nurse — while also returning to work.

"Ironically, I didn't expect it to be happening my second week back to work. I kind of bit off more than I could chew," Northrip said. "I don't take it lightly. I know it's a privilege for me to be working where I am. I want a better life for me and my family and help others to the fullest extent."

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Topics: Brain Tumor, Serving patients

Nurse Hackathon – Northeastern University on March 24-26, 2017

Posted by Pat Magrath

Fri, Mar 17, 2017 @ 11:58 AM

AHO-DN_3.jpgWe came upon this article and want to share it with you because we didn’t know about it and maybe you don’t either. Have you heard about the Nurse Hackathon? It’s a pretty cool opportunity to share your ideas regarding Nursing innovation. As a Nurse, you see things every day that could be done better to make your job more efficient, help your patients with their healthcare problems or share information.

Perhaps you’ve got an idea for an app? Maybe you can attend the Nurse Hackathon this year. If not, start thinking about it for next year.

When you hear the word “hackathon,” you may not necessarily envision a room full of nurses brainstorming ideas. Traditionally, hackathons were created as a way for computer programmers to gather and collaborate to solve a problem. Participants at a hackathon try to “hack,” or “solve” a challenge. At the “Nurse Hackathon: Nurses Hacking HealthCare” event hosted by Northeastern University, nurses are the ones leading the problem solving, developing solutions to issues in healthcare.

“Nurses are natural innovators, because we are trained to solve problems,” said Rebecca Love, RN, MSN, ANP, director of nurse innovation & entrepreneurship at Northeastern University in Boston, Mass. “Most nurses don’t think about taking their critical thinking skills a step further and actually developing a product or service that can be implemented on a larger scale. Through the Hackathon, we hope to revolutionize nursing education to change the current perceptions around nursing and present nurses as agents of change.”

Love is a nurse entrepreneur and organizer of the Nurse Hackathon. The event is designed to promote collaboration within the healthcare sector and inspire the nursing community to take on a leadership role in evolving new innovations in healthcare. This year, the Nurse Hackathon is scheduled for March 24-26, 2017 and will focus on the evolving field of “telehealth” and healthcare within the “home” for older adults. For more information or to register for the event, visit www.Northeastern.edu.

During the Nurse Hackathon, hundreds of attendees of different disciplines including nurses, web designers, technologists, computer scientists, engineers, designers and others will share their ideas and collaborate during this three-day event. Each teams pitches their inventions/ideas to a panel of judges made up of venture capitalists and chief level healthcare executives who determine the winner. 

Last year, the event hosted more than 200 attendees, and 50-60 nurse entrepreneurs and mentors. Nine multi-disciplinary teams presented their healthcare innovations and competed for cash prizes, mentorship opportunities, business seminars, and other opportunities to build their business ventures. The first-place winner of last year’s hackathon was TeleCode, a telehealth system that automatically links nurses and physicians at the bedside with experts in CPR and codes, who can assist them in delivering care.

Christine O'Brien, MSHI, RN, a nursing informatics specialist at Tufts Medical Center in Boston, Mass., attended the Nurse Hackathon last year. Her team won second place for its idea to create an app that allows school nurses to track and alert parents and public health officials about outbreaks of illness and contagious conditions in their school.

“I realized very quickly that nurses were playing a huge role at the hackathon,” said O’Brien. “The atmosphere was electric. You could look around the room and see that everyone was throwing out ideas and brainstorming. I remember driving home from the first night feeling so proud about my chosen profession and inspired to dream big.”

At the Nurse Hackathon, the range of problems identified and solutions developed was diverse. The third-place team concentrated on mental health, developing a way for students to anonymously seek help for suicidal thoughts or depression through a system called Sharanonymous. This app-based platform allows college students who are feeling depressed to connect anonymously with student counselors who provide emotional support through challenging times to diminish the rates of college suicide.

According to O’Brien, participating in the Nurse Hackathon inspired her to consider a career as a nurse entrepreneur.

“Attending the hackathon inspired me to consider a whole new world where I can create new entrepreneurial opportunities for myself,” she said.

To learn more about O’Brien’s team project and read her advice to nursing entrepreneurs, read the Nursing Notes Nurse Perspective article. You can also follow along during this year’s Nurse Hackathon by using the hashtag #RN_Innovator. 

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Topics: Nursing innovation

Here's What I Learned By Going Back To School

Posted by Pat Magrath

Thu, Mar 16, 2017 @ 02:29 PM

5882146398_7014d39636_o.jpg.736x0_q85.jpgHave you noticed some people were born knowing what they wanted to do for a career? Not me, I didn’t have a clue. One friend in particular, never wavered. He knew from the time he was a young boy, he wanted to be a doctor. He achieved his goal and he’s an excellent one too!
 
Some people change their career path and have to go back to school. Others go back to school to advance in their current career. Whatever the reason may be, going back to school can be overwhelming and a big deal for many reasons
 
Jennifer Mensik, PHD, RN, FAAN gives us a personal look at her educational journey and shares with us a few things she learned along the way.
 
Have you gone back to Nursing school? Maybe started out in a completely different career and switched to Nursing? What’s your experience?
 
Diversity Education Award

Everyone has a reason for going to nursing school and often different reasons for continuing education beyond that. I am one of the few RNs I know at my age who decided to become a nurse when I was in high school. Living in Washington state at the time, I participated in the Running Start program, which allowed me to take college prerequisite courses at the local community college. The tuition was covered by the high school; I just paid for books. I completed my nursing school prerequisites and applied to the associate’s degree in nursing program my senior year of high school.

As a sophomore in high school, I wanted to be a nurse practitioner. I knew once I was done with my ADN, I would transfer to Washington State University for my BSN. I had even chosen my NP program. I am quite the type A personality and had my life planned in 10th grade! Interestingly, my high school counselor always questioned my decision to go into nursing. And  while progressing through nursing school, I actually did change my mind. Because I have a type A personality, changing my planned path was difficult. It was one that I didn’t fully appreciate at the time, but I am thankful for today. I often reflect and tell others about what I learned along my 12-year journey. Here are the most important pieces of my self-reflection.

Pay attention to what piques your interest

As I started my RN to BSN program, I was still bound and determined to be a nurse practitioner. However, I really didn’t like pathophysiology nor pharmacology. I slugged through the material because I needed to learn it. But then came a leadership course. And as I was reading articles, I fell in love with the content. What I noticed was that many authors, all RNs, had MBAs. This made me pause. This was something I had not considered, primarily because I had never been exposed to it. As I finished my BSN, I decided I was going to get my MBA and not be a nurse practitioner.

Many of us get preconceived ideas of what we want to do based on what we know at the time. And many of us continue down a path because we do not pause to really determine if that is what we should still do. As you think about your next steps and what you want to do, pause and think. What piques your interest? Life is too short to not do what you love.

"Many of us get preconceived ideas of what we want to do based on what we know at the time. And many of us continue down a path because we do not pause to really determine if that is what we should still do.”

You get back what you put into it

During my MBA program, I couldn’t afford the time commitment to be on campus at times, so I chose an online education. At the time, many people were weary of online programs, thinking they lacked rigor and quality. This is where you need to make your own decisions. Regardless of the program type, I have seen students do the minimum work and try to sail through courses, checking off boxes, just to get the degree. As a faculty member, it is so disheartening to see. Why are you selling yourself short? It saddens me every time I overhear nurses say they didn’t learn anything when they went back to school. I am very leery of those individuals.

During my online program, I read everything and worked hard on my papers. I knew this would prepare me to be better at whatever I did. Today, I can tell the difference when I speak with someone who put in great effort to learn compared with the one who did not. It’s difficult to fake knowledge. You either know something or you don’t. So do not just treat this as a hoop to jump or check marks on a to do list. Your time is worth more than that, so spend it learning well. The time and money you are spending on education should make you better — a better nurse, a better person and an example for others. Maybe even an example to your children.

The more you learn, the more you realize you don’t know

Once I graduated with a doctoral degree, I proudly used my new initials after my name. What was interesting is that overnight, many people saw me as an expert. The perception was I had a doctoral degree, so I must know what you I’m talking about. In many ways through my dissertation I had become an expert in a particular area. But cue imposter syndrome! I feared I was really a fraud. I had to remind myself that there was no way I would ever know everything. There is so much to learn! You literally could spend every day of your life reading research articles and never know everything. What I learned wasn’t that I knew more than others; what I learned was the more you learn, the more you realize you don’t know.

So, realize that whatever stage you are at in your career or education or years of experience, there is a world out there much bigger than you or I could ever know!  Pause and think — are you happy with what you are doing and where you are going? Are you taking advantage of learning? And realize that no one knows everything. We are all lifelong learners.

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Topics: nursing school, continuing education

The Top 15 Cities For Nurses In 2017

Posted by Erica Bettencourt

Mon, Mar 13, 2017 @ 04:38 PM

seattle.jpgRecently, Indeed.com – a massive job search platform that greets over 200 million monthly visitors – took a look at which cities in the U.S. pay nurses the most while giving them the biggest bang for their bucks. The west of the U.S. – California especially – was overwhelmingly dominant.

See the list below.

15. Atlanta, Georgia. Average Salary, Adjusted for cost of living: $63,862

14. San Diego, California. Average Salary, Adjusted for cost of living: $65,092

13. Los Angeles, California. Average Salary, Adjusted for cost of living: $65,092

12. San Jose. Average Salary, Adjusted for cost of living: $65,113

11. Oxnard, California. Average Salary, Adjusted for cost of living: $65,402

10. Seattle, Washington. Average Salary, Adjusted for cost of living: $65, 856

9. Houston, Texas. Average Salary, Adjusted for cost of living: $67,101

8. Anchorage, Alaska. Average Salary, Adjusted for cost of living: $68,158

7. Phoenix, Arizona. Average Salary, Adjusted for cost of living: $72, 548

6. Riverside, California. Average Salary, Adjusted for cost of living: $73, 742

5. Portland, Oregon. Average Salary, Adjusted for cost of living: $73, 958

4. Sacramento, California. Average Salary, Adjusted for cost of living: $76, 870

3. Modesto, California. Average Salary, Adjusted for cost of living: $80,368

2. Bakersfield, California. Average Salary, Adjusted for cost of living: $80,731

1. Fresno, California. Average Salary, Adjusted for cost of living: $81,344

In compiling its list, Indeed calculating the average hourly salary for registered nurses in the US from 2015 thru 2016 by metropolitan area and adjusted the annual salaries based on cost of living. The numbers used were those published by the U.S. Bureau of Labor Statistics (BLS).
The city that offers the best wages and standard of living costs, according to the data, was Fresno, California. In that city of roughly half a million, a nurse can expect $81,344 in annual pay, adjusted for cost of living.

In second place we find Bakersfield, California, where nurses make $80,731 in salary, on average. In third place, Modesto, also in California, they make $80,368.

All in all, California cities accounted for nine of the fifteen spots on the list. Others on the charts are Sacramento (4thplace), Riverside (6th), Oxnard (11th), San Jose (12th), Los Angeles (13th), and San Diego (14th).

The one city not in the western half of the U.S. that made the list was Atlanta, Georgia, which ranked 15th. In Atlanta, nurses make an average $63,862.

Indeed’s report notes that it has seen evidence that there is a shortage of nurses in the United States, with many more postings looking for talent than there is interest (see graphic below). Interest in new positions, the job platform says, meets only about one third of demand.

Why are nurses needed so badly now? Two reasons Indeed puts forward are, A) people are living longer, thanks to advancements in healthcare and require more medical services, and B) More people have become insured over the past several years due to the implementation of the Affordable Care Act, which many have taken to calling ‘ObamaCare.’ Better access to medical insurance has led to more people seeking medical attention for their ills and taking preventative measures like getting checkups.

The position of registered nurse is expected to add more than 439,000 new jobs by 2024, according to the BLS, which the Bureau says is a faster leap than is average.
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Topics: best places to work

10 Tips On Providing Culturally Competent Care To LGBTQ Patients

Posted by Pat Magrath

Fri, Mar 10, 2017 @ 12:17 PM

LGBTQ Banner.jpgHow knowledgeable are you about the LGBTQ community and their healthcare issues? Do you know enough about the terms used in this community, such as the word queer? It doesn’t mean what it used to mean. As the LGBTQ community becomes more comfortable coming out and expressing themselves, hopefully they are more comfortable seeking medical care.
 
This means they should be in an environment free of judgment where they can honestly talk about their medical concerns and receive the help and treatment they need. We hope you find this article helpful and enlightening.

Many healthcare organizations are striving to ensure sensitive and equitable care for individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ). Recent societal changes, including the legalization of gay marriage and Caitlyn Jenner’s very public journey to transgender female, have raised public awareness of LGBTQ issues. Yet many nurses find gaps in knowledge when caring for LGBTQ patients. 

Healthcare curricula in colleges and universities are still sadly lacking content regarding the unique needs of, and health risks for, individuals who fall outside the “traditional” heterosexual orientation of society. However, you can prepare for meeting the needs of these individuals by informing yourself, listening, and making some simple and practical adjustments in your nursing practice.

LGBTQ persons experience a number of healthcare disparities for many reasons: discrimination and social pressures, personal sexual behaviors, limited access to health insurance, higher rates of smoking and alcohol/substance misuse, higher rates of anxiety and depression, greater risk of sexually transmitted infections (including HIV), and increased incidence of some cancers. And when nurses encounter LGBTQ individuals in the clinical setting, they may create or contribute to these barriers to quality care due to lack of understanding and personal bias.

1. Expand your knowledge about sexual orientation and gender identity

To understand the needs of LGBTQ patients, nurses must expand their own knowledge on the subjects of sexual orientation (SO) or attraction, and gender identity (GI), or how one identifies with and experiences the world. Sexuality has long been defined as heterosexual by the dominant society, yet in reality, it encompasses a spectrum of needs, desires, and behaviors that can be fluid and changing over time.

2. Know key LGBTQ definitions

You can read about the meanings of asexual, gay, lesbian, bisexual, pansexual, and “queer,” descriptors that fall under the SO umbrella, as pointed out in More than Pink: LGBTQ Breast Health, a report published by Susan G. Komen, Puget Sound. Note that “queer,” formerly considered a derogatory term, is now considered by some to be a more fluid and inclusive descriptor than other words related to sexual orientation. Also, learn the meaning of terms such as agender, cisgender, transgender, gender fluid, and others that typically describe an individual’s gender identity.

3. Deepen your LGBTQ knowledge

Deepening your knowledge base will enrich your understanding of sexuality in general, and increase your nimbleness in identifying potential health risks for patients seeking your care.

Keep your knowledge up-to-date with ongoing training, reading, and learning from others who are skilled in communicating with and caring for these patients. Some good websites that can help you further your understanding include the Centers for Disease Control and Prevention, the GLBT Health Access Project (Community Standards of Practice Section), Trans-Health.com (online magazine), Women’sHealth.gov, and many others, including sources for this article.

4. Create a welcoming environment for LGBTQ patients

LGBTQ individuals have a long history of discrimination at the individual and institutional levels, including the healthcare system. They may “scan” an environment to determine if it is a safe place to reveal personal information, especially about sexuality. Some things an individual may watch for and take note of during their time in your reception or waiting room area:

  • Your organization’s nondiscrimination policy: Is it in a visible location?
  • A rainbow flag, pink triangle, or other symbol of inclusiveness
  • Availability of unisex restrooms
  • Health education literature with diverse images and inclusive language, including information about LGBTQ health
  • Posters announcing days of observance such as World AIDS Day, Pride, and National Transgender Day of Remembrance

5. Use inclusive language

It may take a little practice, but you can shift your vocabulary towards inclusiveness, opening the door for more open healthcare discussions. This can begin right in the waiting room as patients complete required forms. Rather than asking marital status, for example, the form might read, “relationship status: married, partnered, or other.” 

When asking patients to provide their names, include an additional space indicating “Preferred Name,” as a transgender individual may not wish to be called by a name that reflects their gender identity. Including “preferred pronoun” on a form shows understanding that someone may not identify as they appear.

6. Use gender-neutral language

Approach each interaction with open-mindedness, and a nonjudgmental attitude. Remember, your job as a healthcare professional is to assist the person in solving a health concern, or reducing the risk of future health problems. If your patient doesn’t feel comfortable sharing behaviors with you that are relevant, what good is the interaction? Conveying that the information shared in the provider-patient interaction is confidential may alleviate fears your patient has. 

When asking questions about sexual history and behaviors, preface questions with a statement such as, “So that I can best advise you about your health, I’d like to ask some questions related to sexual behaviors that I ask all my patients. ” Or, “It is our standard practice here to take a sexual history for every patient we serve.”

7. Ask open-ended questions

For example, asking, “Is there anything else that would help me ensure you get the most out of this visit?” can help patients share relevant health information.

Do not overwhelm patients with questions unrelated to the reason for their visit, or to enhance your own knowledge about transgender health. Focus on the behaviors impacting health rather than on SO/GI per se, so the conversation can positively influence health and foster acceptance. 

Prevent any “awkward pause” immediately after a patient shares SO/GI information. Practice your response in advance, such as “Thank you for being open with me; this will help me provide better care for you.” Role-playing your response can increase your own comfort with these situations.

8. Reflect the patient’s language

Avoid applying labels such as “gay.” Some people do not self-identify with any particular descriptive label, yet may have sex with partners of more than one sex or gender. Do not presume. For example, lesbian or gay men may have had or have sexual experiences with individuals of the opposite sex, and bisexual individuals may have long periods of monogamy; keep in mind that sexuality can evolve over time.

9. Investigate mental and physical health risks for LGBTQ patients

Be aware of the unique social pressures and health risks of LBGTQ patients. Societal phobias, violence, and hate crimes – and the fear of them -- are all too real for these individuals. Along with the potential for being ostracized from family and other social groups, this can contribute to chronic anxiety and depression.

LGBTQ individuals who are members of minority populations often face a double whammy of discrimination. Those with non-conforming sexual orientation or gender identity may also experience higher risk of suicide, as well as increased likelihood of tobacco use and drug/alcohol misuse.

It’s also important to build your awareness of the specific physical health problems LGBTQ individuals face. Lesbian women are more at risk for certain cancers due to the prevalence of obesity, nulliparity, or later pregnancy. Lesbian women are susceptible to many of the same sexually transmitted infections as heterosexual people and gay men. Thinking that this population isn’t at risk for these STIs can result in lack of appropriate screening and treatment. In addition to HIV infection, gay men may be at higher risk for anal cancer and can be particularly susceptible to body image issues in the desire to be attractive to other men. They may also experience a variety of cancers resulting from increased obesity and use of tobacco and alcohol.

10. Convey respect

Always remember that the LGBTQ patient in front of you has taken a courageous step to be in your office and disclose some of the most personal information about their lives. Having as positive and affirming an experience as possible will make it more likely the individual will seek future care in a timely manner. 

Becoming aware of resources specifically designed for LGBTQ individuals and making referrals as appropriate (e.g., support groups, smoking cessation groups or AA meetings, etc) will convey that you care enough to become informed about their particular needs. The quality of your interaction can truly make a difference in someone’s health -- and life.

Interested in more Diversity and Inclusion to-do's? 

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Topics: LGBTQ, LGBTQ Healthcare

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