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DiversityNursing Blog

Bill Introduced to Increase Access to Quality Healthcare and Lower Costs

Posted by Chris Cowperthwaite

Tue, Feb 14, 2017 @ 12:19 PM

hqdefault.jpgRALEIGH – Lawmakers at the North Carolina General Assembly have introduced the Modernize Nursing Practice Act, a bill designed to reduce burdensome regulations and allow Full Practice Authority for Advanced Practice Registered Nurses (APRNs). Primary sponsors of HB 88 are Rep. Josh Dobson, Rep. Donny Lambeth, Rep. Sarah Stevens, and Rep. Gale Adcock. Primary sponsors of SB 73 are Sen. Ralph Hise, Sen. Louis Pate, and Sen. Joyce Krawiec. 
 
“This legislation is long overdue for the patients of North Carolina. It allows some of the best nurses in healthcare to do exactly what they’ve been trained to do,” said North Carolina Nurses Association President Mary Graff. “North Carolina has a proud history of innovative nursing leadership, but this is one area where we are in catch-up mode to most of the rest of the country. These types of improved regulations have already proven to be safe and effective in dozens of other states.” 
 
Unlike bills that are being considered for other professions, HB 88/SB 73 does not change the scope of practice of any nurses; it simply removes outdated and superfluous physician supervision requirements. Current regulations do not require physicians to actually “supervise” APRNs from the same city where they practice or even see any of their patients.
 
Dr. Chris Conover, a health economist at Duke University, conducted research in 2015 showing that APRNs have the potential to improve quality and access to healthcare while saving between $433 million and $4.3 billion per year in North Carolina.
 
“Modernizing North Carolina’s regulation of APRNs would allow North Carolina residents to enjoy better access to care of equivalent or better quality even as the health system sheds some avoidable costs in the process,” Conover said. 
 
Conover’s conservative estimates conclude that expanding the use of APRNs would save North Carolina more than $430 million annually in health care costs while adding at least 3,800 jobs to the economy. 
 
APRNs are some of the most highly-trained nurses in the profession, and require masters-level education. The four types of APRNs include:
  • Nurse Practitioners
  • Certified Nurse-Midwives
  • Certified Registered Nurse Anesthetists
  • Clinical Nurse Specialists

A similar version of this bill was introduced in 2015 with bipartisan support in both the House and the Senate. For more information on Dr. Conover’s study through the Center for Health Policy & Inequalities Research at Duke University, visit http://bit.ly/APRNstudy.

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Topics: Modernize Nursing Practice Act, Advanced Practice Registered Nurses

Oncology Nurses Are In High Demand

Posted by Pat Magrath

Mon, Feb 13, 2017 @ 04:02 PM

oncnurse1.gifI bet there is a lot you can add to the comments from Oncology Nurses in this article. Perhaps you’re an Oncology Nurse or someone close to you is doing this job. This article will give you a glimpse of the day-today responsibilities, concerns, technological issues, and a perspective on how to answer a patient’s very difficult questions.
 
As you know, this Specialty isn’t for everyone. If you’re considering becoming an Oncology Nurse or are curious about it, please read this article and let us know what you think.

In the world of cancer care, there's much to celebrate. In the last two years, the FDA has approved dozens of new treatments. The vast majority of those drugs are targeted therapies — the kind that require particularly complex medical care. At the core of that care is the oncology nurse.

The job of the nurse in cancer care is now even more demanding — and in the next few years, that pressure could be compounded by a shortage of oncologists.

David Freudberg is host of the public radio series Humankind, based in Belmont. He's produced a documentary series about the challenges in nursing in today's health care environment called "Resilient Nurses."

Freudberg spoke with WBUR's All Things Considered host Lisa Mullins about what he's learned regarding the pressures nurses face and the care they give. Below are excerpts from that conversation and from Freudberg's interviews with nurses around the country.

oncnurse.jpg

DAVID FREUDBERG

On the working conditions nurses face
"They're difficult conditions, with so many baby boomers flooding into our health care system and the new cohort of patients coming in as a result of the Affordable Care Act. And many of them have what's called higher acuity — more difficult-to-treat symptoms. In addition, there are budget difficulties, and you have all the technology that nurses increasingly are responsible for monitoring [with] a patient, and this adds a kind of emotional stress — because nurses truly are in it to care for the individual patients. They want to make a personal connection to the extent that their job limitations permit. And when you're having to mostly focus on machinery and technical measurements and special procedures, that becomes an obstacle to direct care of the patient. And so that's a stressor."

On technology making nurses even more accessible to their patients
"I happened to interview a couple of wonderful nurse practitioners... And they do provide their cell phone and text abilities to their patients, because they really want to be available to them — some [patients] whom are very compromised and extremely worried. In addition, various social media — Facebook, Twitter — become additional means of reaching nurses ... so in some ways the technological pressure has increased in the communications technology, as well ... My impression, having met them, was that they're just deeply warm and caring. It's not to suggest that other nurses who don't want to do it are not warm and caring. But they just wanted to be there for their patients."

On "compassion fatigue"
"... some people would say compassion doesn't fatigue; it's the people who are trying to be compassionate who need to re-frame the way in which they provide their compassion. But it is potentially a serious problem, because people do get tired. They are up against a relentless schedule. Some nurses don't even drink water during the day; they don't go to the bathroom during the day. I heard this over and over in different locations... for every patient they're dealing with, three more have rung the desk and they need to attend to them. And in addition, there are the families who are asking questions. It's just really tough, and the typical shift of a nurse in the United States is about twelve hours. That's a long time to be on your feet, running from patient to patient, not necessarily even getting a break. And this subjects you to medical errors, to a reduction in job performance.

Ashley Weber, oncology nurse at Center for Cancer and Blood Disorders at Children’s Hospital Colorado, on administering cocktails of medications to pediatric cancer patients
"We're working with severely immunocompromised people... if you don't prep the insertion site with alcohol for as long as it needs to be, you could be introducing a bloodstream infection. Some of the medications we give, you'll read the adverse side effects or reasons that we would stop a certain study that a patient's on, and it's death. You're just waiting for that clearing of the throat to be an indicator that your patient's going to stop breathing. And then when we're at home and we see a phone call from work, we think, 'What did I do wrong? Who did I kill? What medication did I not give? What chemo didn't go in right?' And we're looking at patients that each have easily 15 to 30 meds each."

Sherry Goldman, oncology nurse at Cedars Sinai Medical Center, Los Angeles, on providing compassionate care to cancer patients
"I can think of a specific incident where I told a patient some really devastating news. And I just reached out and held her. And we cried together. I don't have an issue with showing my feelings. There may be other clinicians that do. But how can you not, when you're telling a young girl some tragic news? And you see her completely fall apart. It's okay to fall apart with them and hold them, but then give them confidence afterward."

Paulette Manon, oncology nurse at Brigham and Women's Hospital, Boston, on questions she was asked by a terminally ill cancer patient
"I was in his room, and he said, 'What do you think happens to people after they die?' And I said, 'I'm not sure.' He said, 'What is your belief?' And I said, 'I believe that if you believe in God, that you are remembered and he will look after you.' And he said, 'What do you think happens to people that don't believe in God?' I said, 'Well, whether you believe in him or not, he believe in you.' When someone asks you something like that, it's just not a casual question. You can actually feel the pain coming from that person and the fear that that's going to be it for them, no return, nothing. It's not always that you give someone an ABC answer and they're fine."

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Topics: nursing shortage, Oncology Nursing, Cancer Care

Your Hiring Approach Should Drive Inclusivity

Posted by Pat Magrath

Fri, Feb 10, 2017 @ 03:37 PM

inclusive.jpgRecruiting these days is getting more and more difficult, particularly when hiring Nurses. We’re featuring this article because of its creative approach to thinking outside the box. Perhaps it’s time to change your message, how and where you target that message, and maybe even the position requirements.

For this particular company featured in the article, a college degree and sales experience had always been required for its Sales Development Reps (SDR). The author was promoted to Sales Development Manager. He wanted to hire a different type of Sales Rep -- someone with no sales experience or college degree, but was hungry to learn and grow. The Sales Rep job is a tough job and he knew the burnout rate was high.

Once he removed the degree and experience requirements, he found his applicant pool became more diverse. To quote the author “If you have a role at your organization that doesn’t require previous experience, be intentional about your recruiting. Use it as an opportunity to shift the demographic makeup of your company.”

As a Nurse Recruiter, we know you have degree and experience requirements for many of your positions, but perhaps this article will inspire you to make some positive changes to reach your hiring goals. Good luck!  

A few weeks into my first year as Jhana’s Sales Development Manager, a realization hit me.

Because I was a hiring manager recruiting for a role that required no previous experience or college degree, I was in a unique position to drive diversity and inclusion at my company.

Almost every corporate job requires a college degree, and many also require previous experience in a similar role—big hurdles for someone from an underserved community. The Sales Development Rep (a.k.a. SDR), however, is one of the few jobs that allow someone without relevant work experience or a college degree to break into corporate America.

College Degree Not Required

SDRs at Jhana fill an entry-level role. They don’t do cold calling but instead use a series of template-based emails to set up introductory sales calls for our Account Executives. Still, many companies require a college degree for the role, whether they state it explicitly or not.

When I first deleted “Bachelor’s Degree” from the job description, it felt a bit radical. It even felt like I was doing something wrong. But as I examined why I had included it in the first place, I realized I couldn’t think of a single good reason.

It was purely reflexive.

Removing “Bachelor’s degree required” was the first step towards attracting a more diverse and inclusive candidate pool.

Why I prefer SDRs With No Previous Experience

Here’s something that I find interesting: Jhana’s current sales development team is the most productive lead-generation team the company has ever had. However, if our current SDRs had applied for the job two years ago, they would have been rejected.

In the past, we required 1 to 2 years of previous SDR experience to qualify for even a phone screening. Thankfully, we’ve since made dramatic changes to our SDR hiring strategy, which have made recruiting not only faster but much more inclusive.

Soon after I was promoted to Sales Development Manager, I argued that we would actually get better SDRs if we recruited candidates with zero SDR experience. It was not a popular idea at the time. Never before had we hired for any role at Jhana and not asked for previous experience.

But anyone who has done the job knows that SDR work is grueling. It’s tedious. It takes perseverance. If a candidate left a company after being an SDR there, I could pretty much bet that he or she wanted to leave not just that company but the SDR role itself. I hypothesized that having 1 to 2 years of previous SDR experience actually hampered motivation and productivity.

So as Jhana’s first Sales Development Manager, I set out to hire a very different type of SDR. I didn’t want people with previous experience in the job.

Instead, I looked for grit. I looked for candidates who had work or life experiences that showed determination. I also looked—very much intentionally—for candidates who could add to Jhana’s diversity.

In 6 months, SDR productivity (as measured by the volume of cold emails sent, meaning emails sent to prospects with whom you’ve had no previous contact) increased by 100% and the number of discovery calls (introductory sales calls between the prospect and an Account Executive) increased by 60%.

Grab the Opportunity to Drive Diversity and Inclusion

By not requiring previous experience or a college degree, you not only dramatically grow your potential candidate pool, but you open up a huge opportunity from a diversity and inclusion perspective.

Let me put it plainly: If you have a role at your organization that doesn’t require previous experience, be intentional about your recruiting. Use it as an opportunity to shift the demographic makeup of your company.

Now, this doesn’t mean that your job as a hiring manager will get easier. In fact, it will probably get harder.

You’ll have to read more resumes.

You’ll have to do more phone screenings.

You’ll have to ask better interview questions.

You’ll have to become excellent at training new SDRs.

You’ll have to build well-oiled processes so that orientation and onboarding happens quickly.

So why do this?

Because you’ll build a better lead-generation engine.

Because you’ll help build a company that’s more diverse.

Because it’s the right thing to do.

As a hiring manager, you are entrusted with the rare opportunity to give jobs. Why not be intentional about how you use that responsibility? Why not think differently about how and who you recruit? Why not try to create social change, one hire at a time?

We can help with your hiring needs! 
Contact Us!

Topics: hiring, Diversity and Inclusion

First Ever Real-time Efficacy Study on Fertility App Launched

Posted by Erica Bettencourt

Thu, Feb 09, 2017 @ 03:44 PM

257489.jpgDo you worry about family planning with some of your patients? If so, this article about an “app” that helps to avoid unwanted pregnancies may be helpful. “Dot” is the only family planning app that relies solely on period start dates. Health experts believe an estimated 225 million women worldwide are not using effective family planning methods, but want to avoid pregnancy.

The Dot app will be studied over a year. If used correctly, researchers in an earlier study found the app is almost 100% effective at avoiding an unwanted pregnancy. Continue reading below for more details about the study and more information about the Dot app.

Researchers at Georgetown University Medical Center’s Institute for Reproductive Health (IRH) announced the launch of a year–long study to measure the efficacy of a new app, Dot™, for avoiding unintended pregnancy as compared to efficacy rates of other family planning methods. The Dot app, available on iPhone and Android devices, is owned by Cycle Technologies. Up to 1,200 Dot Android users will have the opportunity to participate in the study.

The study, funded by a grant from U.S. Agency for International Development (USAID), will be the first known study to examine how women use a fertility app in real–time and to evaluate its effectiveness at avoiding unintended pregnancy. In a previous study, a research team found that Dot is theoretically 96 to 98 percent effective at avoiding unintended pregnancy if used correctly. As a woman continues to use it, the app increases its individual accuracy.

While there are thousands of menstrual cycle tracking apps on the market, recent research has demonstrated that the majority are not accurate enough to avoid unintended pregnancy or plan a pregnancy. One study evaluated 100 fertility awareness apps. Only six could correctly identify the fertile window. This finding highlights the importance for app–based family planning tools to rely on scientifically–backed methods and to be evaluated thoroughly for their accuracy.

“Our new study is unique because we’re testing the efficacy of Dot as a method to avoid unplanned pregnancy in a real–time situation,” says Rebecca Simmons, PhD, a senior research officer at IRH.

The study will evaluate Dot’s efficacy in avoiding unplanned pregnancies using a protocol that allows researchers to compare the results to known efficacy rates of other family planning options. It will also explore social factors, such as how Dot affects relationships. The researchers will recruit participants through Dot for Android, issue surveys in the app, and interview participants four times during the study. Participants will receive a gift card each time they enter period start date information and each time they complete a survey.

The IRH study could have global significance because multiple studies suggest that the main reason women stop using the birth control pill is side effects. If Dot can help women avoid pregnancy without the pill’s high abandonment rate, it’s a compelling alternative, says Simmons. The app would be especially useful in the developing world, where there is significant unmet family planning need. Global health experts estimate that 225 million women worldwide are not using effective family planning methods but want to avoid pregnancy.

“Dot users have a historical opportunity to advance the science of birth control and family planning,” said Leslie Heyer, president and founder of Cycle Technologies. “No fertility app has undergone such rigorous testing. Users who join our effort can help make free, effective fertility tools accessible to women throughout the world.”

Cycle Technologies developed the science and algorithm behind Dot™ in collaboration with global health experts from Georgetown University, Duke University and The Ohio State University. Dot is the only family planning app that relies solely on period start dates to determine a user’s individual fertile days.

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Topics: fertility apps, family planning, Dot app

Your hospital isn't deliberate about diversity in leadership? Meet Antoinette Hardy-Waller, the woman out to change that

Posted by Pat Magrath

Tue, Feb 07, 2017 @ 12:45 PM

ahw.jpgDiversityNursing.com would like to share this article with you. It features an interview with Antoinette Hardy-Waller, an extremely knowledgeable leader in the field of healthcare and Nursing. She is “devoted to advancing African Americans in executive, governance and entrepreneurial roles in healthcare.”
 
While many healthcare organizations have a commitment to diversity, inclusion and cultural competency in their workforce and patient care, her point is, it’s imperative to have diversity in the top ranks where decisions are made. Read on for important details.
 
Antoinette Hardy-Waller has worked in healthcare for more than 25 years. She's spent time as a nurse, home care business owner, board member for a major national health system, and consultant. Yet of all of her experiences, it is the time and energy she pours into The Leverage Network that she considers "passion work."
 
 
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Becker's Hospital Review is the original producer/publisher of part of this content.
 

Topics: diversity, Diversity and Inclusion, hospital diversity, leadership diversity

Mom Gives Birth After Surviving Aneurysm and Brain Surgery While Pregnant

Posted by Erica Bettencourt

Mon, Feb 06, 2017 @ 11:23 AM

anna2.jpgWe need a Wednesday feel good story and this is a terrific one! Anna Weeber suffered frequent headaches since she was 16 years old. Now she's 26 weeks pregnant, 27 years old and this headache is unlike any she's ever had in the past. 
 
The doctor who took on Anna's case had a pregnant wife the same age and was 24 weeks pregnant. Dr. Singer said that 50 percent of patients with Anna's case don't even make it to the hospital alive and of the 50 percent of those patients that do survive, 30 - 50 percent don't recover to their previous level of health and function. See below for details of Anna and her baby’s survival. 

Anna Weeber was getting dressed for a bike ride with her husband and 2-year-old son, Declan, one September afternoon last fall when she was struck by a blinding headache.

The 27-year-old mom had suffered from frequent headaches – about three times a week since she was 16, she says – but this was a completely new level of agony.

“It was the most intense headache I’ve ever had in my life,” Anna, who was 26 weeks pregnant at the time, says. “It felt like a balloon was filling with tar in my head.”

The pain was so intense that she began sweating and vomiting. Then, as her husband Nate called 911, the Zeeland, Michigan, mom realized she couldn’t move the left side of her body.

“From that moment on, I don’t remember anything,” she says.

An ambulance arrived and Anna was rushed to the nearest hospital, where a CT scan identified a ruptured brain aneurysm.

An aneurysm is a ballooning of a blood vessel in the brain. When an aneurysm ruptures it releases blood into the spaces around the brain, which can cause a life-threatening stroke.

“About 50 percent of patients who have a ruptured brain aneurysm don’t even make it to the hospital alive,” explains Dr. Justin Singer, Director of Vascular Neurosurgery at Spectrum Health. “Of the 50 percent of those patients that do survive, another 30-50 percent don’t recover to their previous level of health and function.”

After Anna’s aneurysm was identified, she was rushed to Spectrum Health where she was treated by Dr. Singer. Singer says he felt deeply affected by Anna’s case, as she is about the same age as his wife, who was 24 weeks pregnant at the time.

By the time Anna reached Dr. Singer, she was lucky to be alive – but still in a condition that threatened not just her life, but also the life of her unborn child.

A maternal fetal specialist joined the case and together Anna’s medical team and family decided that a brain surgery to insert a clip that would isolate the aneurysm from the circulatory system so it could be removed was the best treatment option.

“I know if my wife was in that position I would want the most definitive treatment option that poses the least risk to the baby,” Dr. Singer tells PEOPLE. “And that’s surgery so that’s what I advised them to do.”

While Anna was in surgery, Nate continued to ask for prayers on Facebook, as he had been doing since the first ambulance ride.

“Hundreds if not thousands of people started praying for us all around the world,” Anna says.

Twenty hours after the nightmarish episode began Anna emerged from the successful surgery. After a day and night of worrying that Anna could suffer lasting effects from the stroke, Nate was elated to find that “she was completely back to herself,” the 33-year-old says.

Anna remained in the hospital so that doctors could look out for vasospasms, a common complication of a brain aneurysm that limits blood flow within the brain and can cause stroke-like symptoms, paralysis or death.

Anna was treated for severe vasospasms and after 18 days she was released from the hospital. “It was so good to be home with our little family again we finally went apple picking and all of the normal fun fall activities,” she says.

The rest of the pregnancy went smoothly and on December 30, Anna and Nate welcomed a healthy baby boy they named Hudson.

anna1.jpg“We were just praying that Hudson wouldn’t suffer any effects from the surgery and as far as we can tell he is one perfectly health little boy,” she says.

Still, Anna says she can’t help but feel overwhelmed with emotion when she thinks about all she and Hudson have been through together.

“The first couple of days after Hudson was born, he and I would look at each other and make eye contact and I would just start crying knowing everything we’ve been through together,” she says. “We both knew God got us through this huge miracle.”

Dr. Singer and his wife welcomed a baby girl they named Jordyn the following week and the two families have already gotten together for a play date.

babydate.jpg

Despite the grim statistics, Anna has only discovered two changes since the surgery. She was thrilled to find that her headaches stopped completely, and less thrilled to learn she has begun snoring. All things considered, she says, even that feels like a blessing.

“My husband is totally fine with the snoring considering that of all the possible outcomes I’m here and alive,” she says.

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Topics: aneurysm, brain surgery

FireFighter Marries Boston Bombing Survivor He Rescued 

Posted by Pat Magrath

Fri, Feb 03, 2017 @ 03:54 PM

03xp-bostonsurvivor_we4-master768.jpgIt’s Friday and we thought a feel good story was a good idea. We’d like to share the happy news that a Boston marathon bombing survivor is going to marry the firefighter who took care of her that life-changing and devastating day. He kept coming back to visit her in the hospital. Their friendship and love grew as they got to know each other.

Because a Nurses job is to help people whether it’s caring for their patients, doing research to improve patient care, or educating our future Nurses, a firefighter’s job is to help their community too. Both professions selflessly help people in a variety of situations, some extremely difficult.

As a website devoted to Nurses within Diverse communities, we see many similarities within the 2 professions and we hope you enjoy this story.

When Roseann Sdoia was gravely injured in the Boston Marathon bombings in 2013, Michael Materia, a firefighter, was the responder who took her to the hospital. They were strangers at the time, but he has rarely left her side since.

In December, the two decided to get married. And on Wednesday, they took on an entirely different kind of challenge together: walking up the 1,576 steps to the observation deck of the Empire State Building in Manhattan to raise money for the Challenged Athletes Foundation — an organization that has played a major role in Ms. Sdoia’s recovery.

Just as he had on the day they first crossed paths, Firefighter Materia wore all of his firefighting equipment, including a heavy oxygen tank on his back. She wore a prosthesis, which has replaced the leg she lost on the day of the bombing.

The day they met was among the darkest in Boston’s modern history. After two bombs were detonated on April 15, 2013, smoke billowed across the finish line and the scene erupted into chaos.

Hundreds of people were injured on that Monday, and three people lost their lives. Had it not been for Firefighter Materia, it might have been four.

02xp-stonsurvivor_web2-blog427.jpg

Ms. Sdoia’s right leg was severely injured in the explosion. A bystander rushed over and fashioned a tourniquet to stop the bleeding. Firefighter Materia, responding with his fire brigade, was put in charge of escorting Ms. Sdoia to the hospital. With no ambulance immediately available, she found herself lying on a metal bench in the back of a police transport vehicle.

Despite her injury, Ms. Sdoia was fully alert as they drove toward the hospital. “He was kneeling on the ground, trying to hold me from sliding, trying to hold himself, and trying to hold the tourniquet,” she said. “And then here I am, telling him to hold my hand! So the poor guy had a lot going on.”

Firefighter Materia stuck with her until they reached the hospital, where Ms. Sdoia’s right leg had to be amputated above the knee. He visited again a few days later to offer assistance, and then again the day after that.

03xp-stonsurvivor_web1-master675.jpg

After a couple of months, a friendship between the two bloomed into a romance. “There was an interest growing in each other, kind of quietly, until we talked about it,” Ms. Sdoia said.

Firefighter Materia popped the question on Dec. 4 during a trip to Nantucket. They intend to marry in October or November, according to The New York Post, which reported on the couple this week.

But before they get married, Ms. Sdoia, 48, and Firefighter Materia, 37, decided to take on New York City. On Wednesday evening, Mr. Materia pulled on his fire equipment while Ms. Sdoia explained her strategy for the climb: Go slow and steady, and lead with the left leg.

The couple were among hundreds of runners who made the arduous climb on Wednesday for an annual event called the Empire State Building Run-Up, which is in its 40th year and benefits the Challenged Athletes Foundation.

For months, Ms. Sdoia trained on the steps of Bunker Hill Monument, a towering obelisk just north of Boston commemorating the Battle of Bunker Hill, among the defining moments in the Revolutionary War.

The event at the Empire State Building was a fitting milestone in Ms. Sdoia’s own battle. Along with Firefighter Materia, the lifelong Red Sox fan has become something of a hero for Boston, where friends and family have followed her recovery, celebrated her engagement, and supported her efforts to climb New York City’s third-highest building.

The race ended at the observation deck on the 86th floor of the skyscraper, where Ms. Sdoia smiled and stopped to chat with photographers in the chill winter air while Firefighter Materia, camera-shy, stayed mostly quiet under his firefighter’s helmet.

Ms. Sdoia said she was happy to have his support, which hasn’t wavered since that ride to the hospital nearly four years ago. “We’ve spent a lot of time together,’’ she said, “and from that we got to see each other’s characters and really just bond.”

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Topics: first responders, Boston Marathon bombings

A PhD in Nursing Might Be The Best Goal For You

Posted by Pat Magrath

Fri, Feb 03, 2017 @ 03:39 PM

shutterstock_26085196_crop380w.jpgAre you considering furthering your education? Is a PhD a goal of yours? This article will give you good information and some terrific role models. It also encourages you to go for your PhD sooner, rather than later.

As our population continues to grow and people live longer, the need for Nurses with their DNP or PhD must increase as well. Perhaps your goal is to be a Nurse Educator, Researcher, or you want to look at the big picture and design ways to achieve better patient outcomes. There are many paths you can take. It’s up to you.

The Institute of Medicine’s Report, “The Future of Nursing: Leading Change, Advancing Health” states nurses should be encouraged to pursue doctoral degrees early in their careers to maximize the potential value of their additional education. I finished my PhD in nursing when I was 30 years old. Several people told me I didn’t have enough clinical nursing experience to continue with my education. Why some nurses feel the need to hold others back from continuing their education is beyond me.

The fact is, some of the most respected contributors to our profession obtained their PhDs early in their careers. Here is only a partial list of these amazing nurses: Jacqueline Fawcett, PhD, RN, FAAN, of the University of Massachusetts, received her PhD 12 years after completing her BSN. She is internationally known for her metatheoretical work in nursing.

• Jean Watson, PHD, RN, AHN-BC, FAAN, earned her PhD 12 years after earning her initial nursing degree. She is the founder of the Watson Caring Science Institute and is an American Academy of Nursing Living Legend.

• Afaf I. Meleis, PhD, RN, FAAN, of the University of Pennsylvania School of Nursing, earned her PhD seven years after obtaining her BS in 1961. She is an internationally renowned nurse-researcher and an AAN Living Legend.

• Margaret Newman, PhD, RN, FAAN, obtained her BSN in 1962 and her PhD in 1971. She is the creator of the Theory of Health as Expanding Consciousness and an AAN Living Legend.

Are you thinking about going back to school? Has someone encouraged you to consider it? The Future of Nursing report notes that major changes in the U.S. healthcare system and practice environment will require profound changes in the education of nurses. But the report also notes that the primary goal of nursing education remains the same, which is to educate nurses to meet diverse patient needs, function as leaders and advance science from the associate’s degree to the doctorate degree.

One of the recommendations of the Future of Nursing report was to double the number of nurses with doctoral degrees by 2020, and by 2016 that recommendation had been met mainly due to the creation of the DNP or doctor of nursing practice degree. Knowing this, the IOM’s Assessing Progress on the IOM Report the Future of Nursing updated their recommendations in 2015 stating that more emphasis should be placed on increasing the number of PhD-prepared nurses. The DNP has been regarded as the degree for those who want to get a terminal degree in nursing practice while the PhD has been regarded as the degree for those wanting to do research. But the difference is not that simple.

"Several people told me I didn’t have enough clinical nursing experience to continue with my education. Why some nurses feel the need to hold others back from continuing their education is beyond me.”

According to the American Association of Colleges of Nursing, “rather than a knowledge-generating research effort, the student in a practice-focused program generally carries out a practice application-oriented final DNP project.” The AACN further notes key differences between the DNP and PhD programs. PhD programs prepare RNs to contribute to healthcare improvements via the development of new knowledge and scholarly products that provide a foundation for the advancement of nursing science. A richer more reflective understanding of the PhD in nursing is that it is heavily grounded in the science and philosophy of knowledge. DNP programs, on the other hand, prepare nurses at the highest level of nursing practice to improve patient outcomes and translate research into practice. A PhD-prepared nurse can contribute to the profession through research, creating new nursing theories or through a focus on national, global system level change and public policy.

I have had many conversations with nurses looking to go back to school who say they don’t want to do research. However, in further discussion on what they really want to do and the problems they want to solve, it becomes clear that the PhD is the best track for them. Also, you don’t need to be a nurse practitioner to get a PhD; there are many PhD-prepared RNs like myself. For those who want to become a nurse practitioner or other advance practice registered nurse, there are dual DNP/PhD programs just as there are MD/PhD programs for individuals looking for both the practice and research education.

As you can guess, I didn’t listen to the naysayers. I knew as a nurse I could make the largest impact for patients and nurses by getting my PhD in nursing (majoring in health systems and minoring in public administration). Does having a PhD make me a better nurse than anyone else? No. I am a different type of a nurse who knew what I needed to do to make my unique contribution to our profession. I started as an LPN and then became an associate’s degree RN. I worked full time while going to school full time. I also completed a BSN-PhD program, which I started at age 25, four years after I became an RN. I have been an RN for 20 years — PhD-prepared for almost 11 years. Earning my PhD was the best decision in my professional career.

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Topics: nursing degree, PHD in Nursing

Use Informational Interviews To Move Your Career Forward

Posted by Erica Bettencourt

Fri, Feb 03, 2017 @ 03:32 PM

career-advice2.jpgMaybe you’re not looking for a new job, maybe you are, or maybe you want to learn more and gain helpful insight and tips about your field. Perhaps you’re thinking about changing your specialty and if you are, do you need to go back to school? The best way to help you with your decision is with an informational interview. 

This article will tell you all you need to know about these interviews to help you get answers and information specific to you and your needs. An informational interview is just what it sounds like – an opportunity for you to learn whether a change is a good fit for you. You have nothing to lose and everything to gain.

Have you ever used an informational interview to move your nursing career forward? Did you know that informational interviews are a form of professional networking? 

When you’re seeking a position, doing research on a nursing specialty, vetting a potential employer, or looking to make valuable connections with other healthcare professionals, informational interviews are a vehicle to achieve your goals. 

What Is An Informational Interview? 

An informational interview is a process by which you request to meet with another professional to learn more about what they do, who they are, the organization they work for, or other valuable information. 

These meetings are not about directly asking for a job; however, they are indeed about you meeting with an individual who holds power, connection, influence, or knowledge to which you would like access. 

Informational interviews are best conducted in person, but telephone, Skype, or FaceTime are fine if meeting face-to-face isn’t possible. 

During such a meeting, you ask prepared questions in order to stimulate conversation while remaining open to new questions that may arise in response to your interviewee’s answers. 

Remember that although informational interviews are not actual job interviews, the act of helping an influential professional to learn how valuable you are can sometimes lead to surprising and unexpected outcomes.

How To Ask for An Informational Interview

Request an informational interview in writing, making your intentions very clear. Your introductory letter or email will be somewhat like a cover letter, yet it will not contain a request to be interviewed for a particular position. 

In your letter, briefly introduce yourself and give a very short synopsis of your nursing career. Explain your goals and the general information you’re seeking; you can even share your specific questions in advance. 

Be sure to inform your potential interviewee right away that you value their time, and offer a potential time limit for the conversation (for example, 30 minutes). If meeting at their workplace, ask to know what favorite treat and beverage you can bring from a nearby café; if you plan to meet at a café or restaurant, be very clear that you’ll be covering all costs. 

The Interview Itself

During the interview, be clear, concise, and well-prepared. Bring a notebook and pen, and be sure to have your resume and business card in case they’re requested. 

Be certain to smile, laugh, make eye contact, speak eloquently, and practice good listening skills and body language. Express gratitude at both the beginning and end of the meeting. Remember to show curiosity about your interviewee’s life and career, and ask for their professional mailing address and business card before you part ways. 

Once your questions have been answered, always ask your interviewee if there is any way in which you could be helpful to them, even if you think there isn’t; the offer is a way of showing a spirit of grateful reciprocity. 

Following Up

Always mail a handwritten thank you note within several days of the interview; an email is simply not sufficient. Also, connect with your interviewee on LinkedIn and other social media platforms. 

If your connection is a positive one, consider sending a holiday card each year, and check in by email from time to time. If a referral, introduction, or other lead bears positive results, write to inform them and reiterate your gratitude. 

An informational interview can be a powerful means to gathering information, receiving introductions, or opening up new opportunities; employ this underutilized networking strategy to stimulate your own career growth. 

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Topics: informational interviews, nursing careeer

A Guide to Culturally Competent Nursing Care

Posted by Brian Neese

Thu, Feb 02, 2017 @ 01:05 PM

thumbnail_Culturally-Competent-Nursing-Header.jpgCultural respect is vital to reduce health disparities and improve access to high-quality healthcare that is responsive to patients’ needs, according to the National Institutes of Health (NIH). Nurses must respond to changing patient demographics to provide culturally sensitive care. This need is strikingly evident in critical care units.

“As an emergency room nurse in a small rural hospital, I was present when an elderly Native American man was brought to the emergency room by his wife, sons, and daughters,” Deborah Flowers says in Critical Care Nurse. “He had a history of 2 previous myocardial infarctions, and his current clinical findings suggested he was having another. During the patient’s assessment, he calmly informed the emergency room staff and physician that, other than coming to the hospital, he was following the ‘old ways’ of dying. He had ‘made peace with God and was ready to die’ and ‘wanted his family with him.’”

“The emergency room physician ordered intravenous fluids, a dopamine infusion, a Foley catheter, and transfer to the intensive care unit of a regional hospital 3 hours away. The patient died 2 weeks and 2 code blues later, and was intubated and receiving mechanical ventilation for most of that time. No family members were present when he died except for his wife. The rest of his family members were unable to afford the cost of traveling to a healthcare facility that far from home. This man’s cultural values and preferences in relation to dying were disregarded.”

In contrast, promoting culturally competent nursing care helps nurses function effectively with other professionals and understand the needs of groups accessing health information and healthcare.

Examining Culturally Competent Nursing Care

Definitions

Cultural competence can be defined as “developing an awareness of one’s own existence, sensations, thoughts, and environment without letting it have an undue influence on those from other backgrounds; demonstrating knowledge and understanding of the client’s culture; accepting and respecting cultural differences; adapting care to be congruent with the client’s culture,” according to Larry Purnell in his book Transcultural Health Care: A Culturally Competent Approach (1998).

Another definition states that cultural competence “describes how to best meet the needs of an increasingly diverse patient population and how to effectively advocate for them,” says Barbara L. Nichols, former CEO of the Commission on Graduates of Foreign Nursing Schools, in NSNA Imprint.

Explanations of culturally competent nursing care focus on recognizing a patient’s individual needs, including language, customs, beliefs and perspectives. Cultural sensitivity is foundational to all nurses. “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person,” states the American Nurses Association’s Code of Ethics for Nurses.

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Relevance

More than one-third (37 percent) of the U.S. population consists of individuals from ethnic and racial minority groups, and by 2043, minority groups will become the majority, according to research from the American Association of Colleges of Nursing. However, nurses from minority backgrounds represent 19 percent of the registered nursing (RN) workforce. Men account for 9.6 percent of the RN workforce.

There is a “challenge presented by the health care needs of a growing number of diverse racial and ethnic communities and linguistic groups, each with its own cultural traits and health challenges,” the NIH says. Nurses and other healthcare providers must account for these differences through cultural respect to support positive health outcomes and provide accuracy in medical research.

“The development of cultural competence in the nursing practice first requires us to have an awareness of the fact that many belief systems exist,” says Lanette Anderson, executive director of the West Virginia State Board of Examiners for Licensed Practical Nurses. “The beliefs that others have about medical care in this country, and sometimes their aversion to it, may be difficult for us to understand. We must remember that we don’t need to understand these beliefs completely, but we do need to respect them.”

Developing Cultural Competence

Framework for Delivering Culturally Competent Services

Campinha-Bacote and Munoz (2001) proposed a five-component model for developing cultural competence in The Case Manager.

  1. Cultural awareness involves self-examination of in-depth exploration of one’s cultural and professional background. This component begins with insight into one’s cultural healthcare beliefs and values. A cultural awareness assessment tool can be used to assess a person’s level of cultural awareness.
  2. Cultural knowledge involves seeking and obtaining an information base on different cultural and ethnic groups. This component is expanded by accessing information offered through sources such as journal articles, seminars, textbooks, internet resources, workshop presentations and university courses.
  3. Cultural skill involves the nurse’s ability to collect relevant cultural data regarding the patient’s presenting problem and accurately perform a culturally specific assessment. The Giger and Davidhizar model offers a framework for assessing cultural, racial and ethnic differences in patients.
  4. Cultural encounter is defined as the process that encourages nurses to directly engage in cross-cultural interactions with patients from culturally diverse backgrounds. Nurses increase cultural competence by directly interacting with patients from different cultural backgrounds. This is an ongoing process; developing cultural competence cannot be mastered.
  5. Cultural desire refers to the motivation to become culturally aware and to seek cultural encounters. This component involves the willingness to be open to others, to accept and respect cultural differences and to be willing to learn from others.

Tips

Nurses should explain healthcare jargon to patients whose native language is not English, according to Monster contributing writer Megan Malugani. A breast cancer awareness program for U.S. immigrants demonstrated that women were too shy to say they didn’t understood certain terms. Some assumed that Medicare and Medicaid were forms of cancer.

Many people from other cultures seek herbal remedies from traditional healers — and they can be harmful or interact poorly with Western medicine. Nurses should ask patients about any alternative approaches to healing they are using. Another example of cultural sensitivity involves nurses understanding the roles of men and women in the patient’s society. “In some cultures, the oldest male is the decision-maker for the rest of the family, even with regards to treatment decisions,” Anderson says.

The most important way for nurses to achieve cultural competency and promote respect, according to Anderson, is to gain the patient’s trust for a stronger nurse-patient relationship. This requires sensitivity and effective verbal and non-verbal communication.

Pitfalls

Nurses should never make assumptions or judgments about other individuals or their beliefs. Instead, nurses can ask questions about cultural practices in a professional and thoughtful manner.

Common pitfalls to avoid involve stereotyping and labeling patients, according to Flowers.

  • Nurses should avoid unintentionally stereotyping a patient into a specific cultural or ethnic group based on characteristics like outward appearance, race, country of origin or stated religious preference. Stereotyping refers to an “oversimplified conception, opinion, or belief about some aspect of an individual or group of people,” she says. Additionally, many subcultures and variations can exist within a cultural or ethnic group. For instance, the term Asian-American includes cultures such as Chinese, Japanese, Taiwanese, Filipino, Korean and Vietnamese, and within these cultures, there are variations in geographic region, religion, language, family structure and more.
  • Nurses should be careful about labeling patients. For instance, citizens in the United States may refer to themselves as Americans, but that term can also apply to individuals from Central and South America. Flowers recommends referring to a person from the United States as a U.S. citizen.

Responding to Higher Standards in Nursing

More hospitals across the United States now require that nurses have a bachelor’s degree. Rising educational standards are emphasized to increase the quality of care that patients receive. Alvernia University’s online RN to BSN Completion Program is designed to improve patient outcomes and help nurses meet each patient’s needs, including those unique to the patient’s cultural background. The degree program takes place in a convenient online learning environment that accommodates students’ work and personal schedules.

The RN to BSN Completion Program includes a class — NUR 318 Developing Cultural Competency & Global Awareness — which offers students “an opportunity to begin their lifelong journey to becoming culturally engaged.” This course has existed at Alvernia University for more than a decade, and demonstrates how Alvernia is leading the way in preparing culturally competent nurses.

Topics: cultural competence

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