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DiversityNursing Blog

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.

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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.

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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.

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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

Moms in New Jersey Are Putting Their Babies in Boxes Here's Why

Posted by Erica Bettencourt

Fri, Jan 27, 2017 @ 03:29 PM

BedBox2016.jpgIf you’re a parent, you know how daunting those first few months are, not to mention exhausting. Many of you work with new mothers in the maternity ward, doctor’s office, etc. Wouldn’t it be helpful to offer more education about SIDS and how to care for a newborn?
 
The Baby Box Co, Cooper University Hospital and several other facilities in NJ have teamed up to save infant lives in New Jersey. It's quite an interesting idea this baby box, and because it's educational, the hope is it will increase safety for newborns. Sounds like a wonderful and welcome idea for new mothers and fathers. We hope it will spread across the U.S. and reduce infant mortality.

A statewide safe-sleeping campaign featuring free cardboard "Baby Boxes" rolled out Thursday at Cooper University Hospital, part of the newest effort to reduce the number of infants dying from Sudden Unexpected Infant Death Syndrome (or SUIDS).

New Jersey is the first state where all expecting and new parents can receive mattress-lined boxes and infant care supplies from The Baby Box Co. after completing an online parenting education program through its website, babyboxuniversity.com.

Finland introduced baby boxes, along with prenatal care and parenting education, as a way to decrease its infant mortality rate, from 65 deaths per 1,000 births in 1938, to 1.3 deaths per 1,000 births in 2013, according to the World Health Organization.

That country's work inspired Jennifer Clary and Michelle Vick to launch The Baby Box Co. in the United States. According to its website, Baby Boxes serve families in 52 countries.

"I think we have a very special product, but it's only special because of the way we distribute it," Clary, the CEO, said. "Early parenting education is linked to infant mortality reduction. That's what we focus on."

The New Jersey program expects to distribute about 105,000 boxes this year. In South Jersey, the boxes will be distributed by Cooper University Health Care and Southern New Jersey Perinatal Cooperative, among others. Parents also can choose to have the box delivered to their home.

Made from sturdy cardboard, the boxes can be used as a bed for the baby until 5 or 6 months of age. The supplies include diapers, wipes, a onesie, breastfeeding supplies and other items, valued at $150.

The program was introduced by New Jersey's Child Fatality & Near Fatality Review Board, using a grant from the Centers for Disease Control. The review board examines deaths and near-deaths of children to identify causes and ways to prevent future deaths.

While unsafe sleeping practices don't account for every case of SUIDS, parental education can help eliminate preventable deaths, said Dr. Kathryn McCans, an emergency department physician at Cooper who also leads the review board.

"Unsafe sleep is a significant cause of SUIDS in our state and likely in every state," McCans said. "Based on national data, New Jersey fares pretty well, as far as the rate of SUIDS death, but our rate is still high enough that it results in 50 to 60 deaths a year that seem to have at least unsafe sleep associated with it, even if it wasn't the full cause."

Factors associated with safer sleep include a firm mattress and a bare crib with no blankets, pillows, bumpers or stuffed animals in it; no smoking or substance use during or after pregnancy or by anyone in the household; exclusive breastfeeding during the first six months of life or any amount of breastfeeding possible.

"This program, at its core, is about getting education out to parents in a form that younger parents really love," McCans said.

Cooper doctors and health experts in New Jersey helped the company create educational videos for expectant parents on topics like installing car seats, safe sleeping practices, breastfeeding resources and support, and fatherhood engagement.

Two Camden families were the first to receive their boxes Thursday. Dolores Peterson popped her 5-week-old daughter into a cardboard box lined with a mattress, as cameras recorded little Ariabella Espada's reaction.

Peterson, a first-time mother, said she plans to tell her mothers group about the program.

"I'm going to let every mother know to sign up and get a box," Peterson said, so their babies can sleep safely, too.

To receive a free box, New Jersey parents can register for free online at babyboxuniversity.com. After watching a 10-15 minute program and taking a short quiz, parents can choose how to receive their box.

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Topics: SIDS, baby boxes

A Guide to Community Health Nursing

Posted by Brian Neese

Thu, Jan 26, 2017 @ 10:54 AM

thumbnail_Community-Health-Nursing-Header.jpgAll nurses work to improve health outcomes and help monitor and manage disease. But community health nurses work in traditional public health settings and focus on the overall health of an entire community or multiple communities. Community health nursing is also known as public health nursing.

Roles and Responsibilities

“Nurses in community health work with diverse partners and providers to address complex challenges in the community,” Phyllis Meadows, PhD, RN, writes in the American Journal of Nursing. “Nowhere is this more evident than in current efforts to identify, reach, and treat people living with HIV and AIDS and in efforts to help the elderly effectively manage their chronic health problems and remain at home.”

Working with diverse populations requires cultural competency to “understand invisible factors in the community that promote health and prevent disease, such as assets, values, strengths, and special characteristics of the communities,” Pamela Kulbok, DNSc, RN, and others say in The Online Journal of Issues and Nursing. Community health nurses develop strategies and interventions that target entire population groups, families or individuals. Regardless of the practice setting, they focus on preventing illnesses, injuries or disabilities and promoting good health.

Responsibilities can include providing primary care, health education and care management to individuals and families in the community. Community health nurses can provide input to programs that address public health problems, develop public policy for health promotion and disease prevention, and evaluate health trends to help determine intervention priorities.

The Public Health Security and Bioterrorism Response Act of 2002 added a new dimension to the profession and “catapulted community health nursing to the center of emergency response plans,” according to Meadows. “Community health nurses, especially those in public health settings, are now considered first responders—a role that traditionally belonged to law enforcement and emergency response professionals. In the event of a public health threat, community health nurses will organize and administer immediate care.”

Practice Settings and Education

A strength of community health nurses is their adaptability. They provide care in patients’ homes, at organized events and at agencies and institutions that serve people with specific health needs.

Settings include community health clinics, community nursing centers, schools, churches, housing developments, local and state health departments, neighborhood centers, homeless shelters and work sites. Vulnerable and high-risk populations are often the focus of care, which includes homeless individuals, the elderly, teen mothers, pregnant women, smokers, infants and those at risk for a specific disease.

Nurses wishing to pursue a career in community health nursing typically need a bachelor’s degree and clinical experience. Those with advanced degrees can pursue teaching and research opportunities.

Making a Difference in the Community

Community health nurses merge their clinical knowledge with community involvement and outreach efforts to respond to health problems and promote overall health. They rely on critical thinking, advocacy and analytical abilities to provide dynamic and adaptive care that impacts the community.

Alvernia University’s online RN to BSN Completion Program takes a community-first approach to developing nursing skills. Courses such as Health Restoration in the Aging Population and Health Promotion in Families and Communities focus on health restoration and promotion in the community, which is ideal for students wanting to pursue a career as a community or public health nurse. The program takes place in an online learning environment that can accommodate students’ work and personal schedules.

Click here to access Alvernia University’s online RN to BSN completion program.

Topics: community health nursing

$5M to widen UVA Nursing's doors

Posted by Erica Bettencourt

Tue, Jan 24, 2017 @ 02:04 PM

thumbnail_photo 5.jpgWashington DC area philanthropists Joanne and Bill Conway have committed to a $5 million gift to support our CNL program, funding the education of more than 110 new nurses over five years, beginning in 2018. The Conways, who gave a similar gift to UVA Nursing in 2013 are, with this transformative gift, renewing their pledge to encourage a broader diversity in the students who enroll in this program.

Conway Scholars are chosen from among the CNL applicants who are invited to interview for the program after applying (typically, this happens in December, after the program application deadline Oct. 1) who meet the criteria:
 
  • Applicants must be Virginia residents, and have a FAFSA on file
  • They should have experience with a vulnerable population, and a commitment to service 
  • They should have exposure to healthcare in some way – through work, volunteering, personal/family experience
  • They should be able to communicate well and must commit to providing 50 volunteer hours each year of funding on top of their clinical hours either in a rural, underserved or their home communities
  • They must present on their work to the School of Nursing community during the course of their academic career.
 
thumbnail_photo 3.jpgAll Conway Scholars (entering this summer `17, to graduate in 2019) receive a year-long grant for tuition and related expenses ($24k over the year). The new gift, which will begin funding students in 2018
 
More information about the gift and program is here.

Topics: CNL, clinical nurse leader, UVA, masters program

New Study Shows Cervical Cancer Death Rates Are Much Higher Than Previous Study Reported

Posted by Erica Bettencourt

Mon, Jan 23, 2017 @ 12:17 PM

cervicalcancerscreen.jpgA new cervical cancer study found that women with hysterectomies weren't accounted for in the previous study of cervical cancer death rates. The new evidence shows the death rate is 10.1 per 100,000 black women and 4.7 per 100,000 white women.  

This new evidence also shows a major racial disparity in cervical cancer in the US. Cervical cancer is highly preventable in the US thanks to screenings and HPV vaccines. But clearly this study shows that women need better access to those screenings and other preventative measures. 

The risk of dying from cervical cancer might be much higher than experts previously thought, and women are encouraged to continue recommended cancer screenings.

Black women are dying from cervical cancer at a rate 77% higher than previously thought and white women are dying at a rate 47% higher, according to a new study that published in the journal Cancer on Monday. 
The study found that previous estimates of cervical cancer death rates didn't account for women who had their cervixes removed in hysterectomy procedures, which eliminates the risk of developing the cancer.
 
"Prior calculations did not account for hysterectomy because the same general method is used across all cancer statistics," said Anne Rositch, assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore and lead author of the study.
That method is to measure cancer's impact across a total population without accounting for factors outside of gender, she said.
 
There were about 12,990 new cases of cervical cancer in the United States last year and 4,120 cervical cancer deaths, according to the National Cancer Institute.
 

'A better understanding of the magnitude'

For the study, researchers analyzed data on cervical cancer deaths in the United States, from 2000 to 2012, from the National Center for Health Statistics and the National Cancer Institute's Surveillance, Epidemiology, and End Results databases.
 
The data were limited to only 12 states in the country, but the researchers noted that the data still provided a nationally representative sample of women.
 
Then, the researchers collected data from the Behavioral Risk Factor Surveillance System on how many women in 2000 to 2012, 20 and older, reported ever having a hysterectomy. They used that data to adjust the cervical cancer deaths rates.
 
Before the adjustment, the data showed that the cervical cancer killed about 5.7 out of 100,000 black women and 3.2 per 100,000 white women. After adjusting for hysterectomies, the rate was 10.1 per 100,000 black women and 4.7 per 100,000 white women.
 
The data showed that the racial disparity seen in cervical cancer death rates for black and white women was underestimated by 44% when hysterectomies were not taken into account. 
"We can't tell from our study what might be contributing to the differences in cervical cancer mortality by age and race," Rositch said. "Now that we have a better understanding of the magnitude of the problem, we have to understand the reasons underlying the problem."
 
Cervical cancer is highly preventable in the United States because screening tests and a vaccine to prevent human papillomavirus, or HPV, which can cause cervical cancer, are both available, according to the Centers for Disease Control and Prevention.

"Racial disparity may be explained by lack of access or limited access to cervical cancer screening programs among black women, when compared to whites," said Dr. Marcela del Carmen, a gynecologic oncologist at the Massachusetts General Hospital Cancer Center, who was not involved in the new study.

"This gap and disparity need to be addressed with initiatives focusing on better access to prevention or screening programs, better access to HPV vaccination programs and improved access and adherence to standard of care treatment for cervical cancer," she said.
 
The new findings add to the current understanding of cervical cancer's impact on different communities, said Dr. John Farley, a practicing gynecologic oncologist and professor at Creighton University School of Medicine at St. Joseph's Hospital and Medical Center in Arizona.
 
"It lets us know that there is substantial work to do to investigate and alleviate the racial minority disparity in cervical cancer in the US," said Farley, who was not involved in the study, but co-authored an editorial about the new findings in the journal Cancer on Monday.
 
"Those who get cancer, many times, do not have access to screening," he said. 
 
Even though cervical cancer mortality rates are higher than previously thought, Farley said that he thinks the current screening recommendations for cervical cancer are still adequate. However, he added, more women should have access to screenings and other preventive measures.
 
Rositch said, "It may be that some women are not obtaining screening according to our current guidelines, not necessarily that guideline-based care is insufficient."
 

How to prevent and screen for cervical cancer

The American Cancer Society recommends that women begin cervical cancer screenings at age 21 by having a pap test every three years. Then, beginning at 30, women should have a pap test combined with a HPV test every five years. 
 
Symptoms of cervical cancer tend to not appear until the cancer has advanced, which is why screening and HPV vaccinations are urged. 
 
"We have a vaccine which can eliminate cervical cancer, like polio, that is currently available and only 40% of girls age 13 to 17 have been vaccinated," Farley, co-author of the editorial, said. "This is an epic failure of our health care system in taking care of women in general, and minorities specifically."
 
Women over 65 might not need to continue screening if they don't have a history of cervical cancer or negative pap test results, according to the American Congress of Obstetricians and Gynecologists.
 
Each year, about 38,793 new cases of cancer are found in parts of the body where HPV is often found. The virus not only has been linked to cervical cancer, but also cancers of the vulva, vagina, penis, anus or throat
 
A study that published in the journal JAMA Oncologylast week found that among a group of 1,868 men in the United States, about 45% had genital HPV infections and only about 10% had been vaccinated.
 
"Male HPV vaccination may have a greater effect on HPV transmission and cancer prevention in men and women than previously estimated," the researchers wrote in that study.
 
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Topics: cervical cancer

Nurse Shares What Delivering Babies Is REALLY Like

Posted by Pat Magrath

Thu, Jan 19, 2017 @ 11:29 AM

newborn-delivery-photo-420x420-ts-stk25209nwl.jpgLabor and Delivery Nurses will appreciate this post. My only problem with it is that she keeps saying “I’m just the Nurse…”. The word “just” is where I’m having difficulty. Perhaps she’s using the word to be self-deprecating? I’m not sure. What do you think?
 
As pointed out in this post, your first priority while in that labor & delivery room is your patient and the baby/babies who are about to be born. We here at DiversityNursing.com appreciate what all Nurses do every day. We would never refer to you as “just” a Nurse. Of everyone in that room, you are the most connected to your patients and their needs. You are their advocate and recognize when something is going well or not. You share in their joy and sometimes, their sorrow.
 
You put your needs aside to take care of your patients and for that, we are grateful.

Susan Jolley, a registered nurse from Texas, has shared a beautiful tribute to delivery nurses, highlighting the amazing and sometimes heartbreaking work they do on a daily basis. 
 
It begins: 'I am just a nurse. A Labor and Delivery nurse. Sounds like fun doesn't it? Well....

'I am just the nurse who was there during the birth of your child.
I am just the nurse who held your hand, looked you in the eye, and made you feel like the strongest woman in the world.'

The post then goes on to explain that midwives are also there during some truly difficult moments. 

'I am just the nurse who vigilantly monitored your baby's heartbeat and recognized that he was in distress.

'I am the nurse who took photos of your baby because you were all alone... Even though I should really be charting and dong about a hundred other things.'

Susan's post went on to say that nurses will be there through everything, including being the one who 'reassured a teenage mom that she can be an amazing parent and still get an education.'

However, they are also: 'Just the nurse who stood by you while you handed your baby to his adoptive mother. I held you steady. I watched you tremble. My heart ached for you.'
 
If that wasn't enough, the post details how nurses and midwives are also there at the truly tragic moments. 'I am just the nurse who held your hand and told you, "She is beautiful. I am so so sorry for your loss." My heart ached for you. I wanted to hold my children and never let them go that night... but they were already sleeping because I stayed late to be with you.' 

However, the end of the post ended saying that while it might be difficult and often unappreciated, being a nurse is an amazing job, ending with: 

'I saved your life.
I saved your child's life.
My body aches.
My heart aches.
And I love every minute. 
I am JUST a Labor and Delivery nurse.'
 
The post has already been shared over 55,000 times with many mums sharing their own stories of how they have been helped by labour and delivery nurses. 

One said: 'Angel's in disguise who are very under appreciated at times but very dedicated and beautiful people.. Because of the special care and pure selflessness they show us.'
 
Another added: 'So true they really don't get the recognition they deserve i will always remember the nurse who delivered my still born baby boy and then 2 years later came in on her day off to deliver my son the emotional support from her was unbelievable and definitely something that will stick with me forever xxx'
 
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Topics: delivery, delivery room

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