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DiversityNursing Blog

Is Discrimination Bad for Your Health?

Posted by Nursing@USC Staff

Wed, Nov 16, 2016 @ 10:42 AM

discrimination_bad_for_health.jpgDiscrimination in the United States has historically cut a wide swath across a number of demographics, including race, gender, ethnicity, sexual orientation, age, disability and religion. Despite a major cultural and political shift through the implementation of the long overdue Civil Rights Act of 1964 and other efforts at fighting discrimination, we still see it today — particularly in the form of modern-day racism. According to the National Association of Social Workers (NASW), racism is “the ideology or practice through demonstrated power of perceiving the superiority of one group over others by reason of race, color, ethnicity, or cultural heritage.”

Though all discrimination is harmful, an examination of the effects of racism — the most commonly studied and cited form of discrimination — reveals implications for the mental and physical health of individuals and communities that can be applied to other types of discrimination. Racism, therefore, is not just a civil rights issue, but also a public health concern.

As key figures in addressing such consequences, health care professionals, such as Family Nurse Practitioners, must recognize the health implications involved and know the steps they can take to help stop discrimination and mitigate its negative outcomes.

Impact of Discrimination on Health

The NASW says racism results in “poor health and health services, inadequate mental health services, low wages, high unemployment and underemployment, overrepresentation in prior populations, substandard housing, high school dropout rates, decreased access to higher education opportunities and other institutional maladies.” Some of these factors can be classified as social determinants of health (SDOH), which have a major influence on health outcomes. According to Healthy People 2020, SDOHs are defined as “conditions in one's environment — where people are born, live, work, learn, play, and worship — that have a huge impact on how healthy certain individuals and communities are or are not.” 

In one study of the health effects of discrimination on black and white communities, SDOHs were defined as a critical factor, since populations that lack appropriate resources are affected the most: “On average, black adults typically experience more health risks in their social and personal environment than white adults (including higher poverty and lower-quality medical insurance), they may be especially vulnerable to negative health effects as a result of racial discrimination." 

There are a number of physical and mental health effects related to discrimination, including increased stress, depression, high blood pressure, cardiovascular disease, breast cancer, and mortality. According to a study published in the American Journal of Public Health, “Merely anticipating prejudice leads to both psychological and cardiovascular stress responses. These results are consistent with the conceptualization of anticipated discrimination as a stressor and suggest that vigilance for prejudice may be a contributing factor to racial/ethnic health disparities in the United States.” Additionally, discrimination has been found to impact lifestyle decisions that affect health long after the experience is over.

Communities at highest risk for discrimination are the same communities that are perpetually marginalized by the negative impact of SDOHs. In a 2013 Atlantic article titled “How Racism is Bad for Our Bodies,” writer Jason Silverstein points out that the cyclical effect of discrimination on health is what epidemiologist Nancy Krieger refers to as “embodied inequality,” which creates poor health outcomes that are often passed down through generations. This results in a vicious cycle where the sickest and poorest among us are more likely to remain sick and poor.

Solutions and Strategies

Health care professionals and policymakers can play a key role in curbing discrimination by supporting legislation and policies that address these issues, such as the U.S. Department of Health and Human Services (HHS) Action Plan to Reduce Racial and Ethnic Health Disparities. The U.S. Office of Minority Healthprovides a summary of this action plan, and serves as a “one-stop source for minority health literature, research and referrals for consumers, community organizations and health professionals.” Through use of such resources, and appropriate support networks, victims of discrimination can find the support they need to exercise their rights and end the various forms of discrimination they may be vulnerable to.

Additionally, it is essential that health care professionals work to better recognize the effects of discrimination by taking SDOHs into consideration as part of their approach to care, understanding which populationsmay be at greater risk for discrimination, screening for negative health outcomes that may be a direct result, and ensuring that discrimination is not occurring within their own practice settings. Providing access to necessary resources and additional support for these patients is critical.

Implications for FNPs

Family Nurse Practitioners are integral to comprehensive care for all patients, and serve as a key resource for those most vulnerable to discrimination’s negative effects on health. “At the University of Southern California Department of Nursing in the School of Social Work, we are teaching our students about the central importance of social determinants of health, with racism being a key determinant, in the health of individuals and families,” said Ellen Olshansky, Professor and Chair of Nursing at USC School of Social Work. Although the policy statement by the American Nurses Association, “Discrimination and Racism in Health Care,” dates to 1998, its principles are just as relevant today, addressing both the health care environment and the patients who are served:

ANA believes it is critically important for Americans to come to a shared understanding of the negative consequences of discrimination and racism which still pervades our society and be willing to take individual as well as collective actions to bring America closer to our ideal of equality and justice. Equality and justice must also extend to other minorities such as the aged and disabled. Health care that is individualized to the health practices and specific needs of each person and/or population group is vital to maintain and improve the health of all Americans.
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Topics: racism, Race-Discrimination, public health

Breast-friendly, radiation-free alternative to mammograms in the works

Posted by Pat Magrath

Tue, Nov 15, 2016 @ 10:38 AM

Mammogram-hero.jpgMammograms, we know how barbaric and uncomfortable the procedure is for all of us. I often find myself thinking, there’s got to be a better way. Wouldn’t it be great if we had something that gives a better picture, doesn’t use radiation, and doesn’t flatten our breasts during the process? We’d all like to skip our mammograms entirely, but the prospect of early cancer detection keeps us going back year after year.
f08f51fe01cce526ba77fe35ebcd9ae2.jpg
Well, it looks like some progress is being made in the world using sound waves. Check out this article and let us know your thoughts.

Each year, millions of women undergo mammograms for early detection of possible breast cancer. It's an unpleasant procedure that uses X-rays. Researchers at TU Eindhoven are working on a 'breast-friendly' method, without radiation, that is more accurate and generates 3D rather than 2D images. They published their proof of concept earlier this month in the online journal Scientific Reports.

In the regular screening method the breast is squeezed tight between two plates in order to produce one or more good X-ray photos. Apart from being unpleasant, it is not without risk. The X-rays used can themselves be a contributor to the onset of cancer. Moreover, it is often unclear whether the anomaly found is malignant lesion or not. More than two-thirds of the cases where something worrying can be seen on the X-ray photos is a false-positive: after biopsies, they are not found to be cancer. This is why science is seeking alternatives.

Researchers at TU Eindhoven have now cleared a major scientific hurdle towards a new technology in which the patient lies on a table and the breast hangs freely in a bowl. Using special echography (inaudible sound waves) a 3D image is made of the breast. Any cancer is clearly identifiable on the generated images; the researchers therefore expect there to be many fewer false-positive results.

The new technology builds on the patient-friendly prostate cancer detection method developed at TU/e whereby the doctor injects the patient with harmless microbubbles. An echoscanner allows these bubbles to be precisely monitored as they flow through the blood vessels of the prostate. Since cancer growth is associated with the formation of chaotic microvessels, the presence and location of cancer become visible. This method works well for the prostate and this is now being widely tested in hospitals in the Netherlands, China and, soon, Germany. For breast cancer the method had not yet been suitable because the breast shows excessive movement and size for accurate imaging by standard echography.

Researchers Libertario Demi, Ruud van Sloun and Massimo Mischi have now developed a variant of the echography method that is suitable for breast investigation. The method is known as Dynamic Contrast Specific Ultrasound Tomography. Echography with microbubbles uses the fact that the bubbles will vibrate in the blood at the same frequency as the sound produced by the echoscanner, as well as at twice that frequency; the so-called second harmonic. By capturing the vibration, you know where the bubbles are located. But body tissue also generates harmonics, and that disturbs the observation.

For the new method the researchers are using a phenomenon that Mischi happened upon by chance and later investigated its properties together with Demi. They saw that the second harmonic was a little delayed by the gas bubbles. The researchers have now developed a new visualization method. The more bubbles are encountered by the sound on its route, the bigger the delay compared to the original sound. By measuring this delay, the researchers can thus localize the air bubbles and do so without any disturbance because the harmonic generated by the body tissue is not delayed, and is therefore discernible. This difference, however, can only be seen if the sound is captured on the other side. So this method is perfectly suited to organs that can be approached from two sides, like the breast.

The researchers are currently putting together an international, strong medical team to start performing preclinical studies. Application in practice is certainly ten or so years away, Mischi expects. Moreover, he forecasts that the technology that has been developed will probably not operate on a standalone basis but in combination with other methods, which will create a better visualization. One of the candidates for this elastography, a variant of echography whereby the difference in the rigidity of the tumor and healthy tissue can be used to detect cancer.

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Topics: mammography, breast screening, mammograms

10 Tips To Help You Enjoy Your Holiday Nursing Shift

Posted by Pat Magrath

Mon, Nov 14, 2016 @ 04:19 PM

cee7b8dcb59575f069eae423085a3bc0.jpgThe holiday season is fast approaching and with that comes a lot of stress in both our personal and professional lives. No matter what holiday you celebrate, we hope it is a joyful and peaceful holiday for you and your family.
 
To help you deal with the holiday details, we found this article that offers some useful tips to help you enjoy the holidays. What works for you? Perhaps you’ve discovered something that you’d like to share.
 
As October comes to a close, we can feel the excitement and, at times, stress of the holidays approaching. While many people are out buying their last-minute Halloween costumes or planning their Thanksgiving menu, or even setting up their Christmas decorations (we know, early!), nurses are preparing for working their holiday shifts. 

Working over the holidays is a reality check for nurses. While other professionals get this time off to be with their loved ones, nurses are caring for their patients and working to ensure the safety of other people’s friends and family members. While it is an honor at any time to care for the sick or injured, we understand it can be especially difficult at the celebratory times of the year. 

To make these occurrences a tad easier, and even fun, here are 10 ways to make the most of your holiday nursing shift. 

1. Plan ahead
Start planning your holiday shifts way ahead of time. Coordinate with your loved ones on days to celebrate that work around your schedule. For instance, if you are working over Thanksgiving, plan to celebrate a day or two later. Speak with your manager about the best way to ensure you are there to cover your shift, but that you also have time built in for those holidays that are important to you. 

2. Ask for help
Do you normally do the bulk of the Christmas or Hanukkah cooking? Ask your family members to pitch in or organize a pot luck so everyone shares the labor. If you know you are scheduled to work over a holiday, know your limits and time constraints and ask those around you to assist in the holiday preparations.

3. Be prepared
If you are scheduled to work over certain holidays, be prepared to meet any holiday-related needs of patients. Be on the lookout for complications of diabetes and dehydration over Halloween and be sensitive to how costumes may interfere with your ability to care for a patient or how they may affect a patient, especially those with a mental illness. Be ready for cooking-related injuries, such as burns or cuts, around Thanksgiving. Pay extra attention to patients suffering from depression around Christmas and New Year’s Eve. If you know what to look for, you will feel more prepared when encountering these situations. 

4. Make your work space feel like home
With permission from your manager, decorate your work station over the holidays. Put up paper pumpkins and turkeys. String twinkle lights and set up a holiday tree or bush. Just be sure to be sensitive and inclusive of everyone’s holidays, not just your own. 

5. Organize a work party
Many times, your co-workers can feel like family. Take some time during a shift to celebrate with your team. Have everyone bring in their favorite holiday treat or consider exchanging small gifts. You may also consider planning a holiday party outside of your work setting. It’s nice to take the time out to blow off steam and enjoy your co-workers’ company. 

6. Celebrate when you can
Working over New Year’s Eve? Celebrate at a time that works for you. Start the countdown at 5am with the other nurses working alongside you. If you want to celebrate with family and friends, you can do the same – pick another day and/or time, adjust your clocks and watches and ring in the New Year accordingly. 

7. Be resourceful 
Make the most of your breaks during your shift. If able, Skype with friends and family, follow their photos on Facebook or Instagram, or ask someone to share videos of the holiday gatherings with you. Utilize available technology to stay as connected as possible. 

8. Be mindful
Be mindful that the patients are there for the holidays too. Try to lift their spirits by asking if they would like their room decorated or try speaking with them about happy holiday memories. You may be able to help accommodate visitors or help patients get in touch with family and friends. 

9. Know your limits
Too busy to decorate for your favorite holiday? Not enough time to go to the mall to buy gifts? Too stressed to cook your traditional holiday meals? Cut corners where you can; shop online, skip the decorating all together, order take-out or pick up prepared food from a local store. Determine what you can do without and compromise where you can. 

10. Focus on the positive
Depending on your work place, there may be benefits to working a holiday shift, such as extra pay or the next holiday off. During the holidays, you may also get to enjoy a slower work pace and a shorter commute. On top of that, you are in it together with your fellow nurses and your patients, who all are there to share the holiday with you.
 
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Topics: Holidays, holiday shifts, working holidays

How Nurses Should Be Using Social Media

Posted by Erica Bettencourt

Mon, Nov 14, 2016 @ 03:36 PM

social.pngPrivacy on social media feels like it's fading away when it seems as though everyone, and their mothers, are posting their daily lives on line. Need an answer to something, you can check online forums. If you forget someone's birthday, Facebook will remind you. 
 
You find yourself posting photos of your trips or special moments in your life. You even get into political views and other opinion related discussions online. But privacy in healthcare is something everyone takes seriously. So how does Nursing and social media work together in balance? Read below to find out! 

Thanks to a technologically advanced society and easy access to digital sources of communication, social media is becoming an increasingly effective, wide-ranging tool for nurses. However, with this resource comes great responsibility. As nurses navigate social networking sites, chat rooms, blogs and public forums, there is a dangerously thin line between professional and personal online etiquette. Health care employees must maintain patient confidentiality and privacy at all times, as well as serve as a positive representation of their place of employment. Inappropriate use of social media often leads to disciplinary action; and in the most serious cases, can negatively affect a nurse’s career and license.

Privacy Issues Regarding Nurses Using Social Media

“Nursing is a profession that is laden with risks related to disclosure of protected information,” says Jonathan Greene, social media expert and author of Facebook is a Pub Crawl: 15 Simple Strategies for Social Media Excellence. “For that reason, nurses have to be careful about anything that would violate HIPPA standards.”

According to the National Council of State Boards of Nursing (NCSBN), confidential information should be shared only with the patient’s informed consent, when legally required, or where failure to disclose the information could result in significant harm. Any breach of trust associated with a nurse-patient relationship has damaging repercussions, and often winds up hurting the overall trustworthiness of the nursing profession as a whole.

Breaches of patient confidentiality or privacy on social media platforms (whether intentional or inadvertent) can occur in many different ways, such as:

  • posting videos or photos of patients – even if they can’t be identified
  • posting photos or videos that reveal room numbers or patient records
  • descriptions of patients, their medical conditions, and/or treatments
  • referring to patients in a degrading or demeaning manner

A violation of patient confidentiality takes place as soon as a nurse shares information (or even the slightest bit of details – no matter how insignificant they may seem) over the Internet with someone who is not authorized to receive such information. Examples include reflecting on the severity of a car accident victim’s injuries, or even commenting on the number of medications that a patient has to take.

Beneficial Ways that a Nurse Can Use Social Media

With the ability to establish positive interaction and communication with patients (and their family), Debi Deerwester, DNP, FNP-BC, Chief Clinical Officer/Chief Nurse Practitioner Officer/Vice President of Clinical Operations at WhiteGlove Health, says there are many ways a nurse can utilize social media to a healthcare advantage, such as promoting the profession through educating the public.

Social media outlets and actions beneficial to nurses include the following:

  • Blogging: “Blogging on the industry they love in a positive and thoughtful way, [nurses] can become subject matter experts,” says John Lincoln, of Internet marketing company Ignite Visibility. “Having an individual blog and social media presence shows their dedication to the field, helps them stay on top of trends in the industry and looks great to employers.”

He also suggests that increasing visibility through an online presence can help nurses get ahead in their career, which in some cases, could lead to a higher position and/or a raise.

In addition to promoting their value within the workplace, nurses can also use social media to promote their outside, health-related endeavors and interests. “Usually I reserve public posts about health care to try convincing colleagues to buy my books,” says Nick Angelis, author of How to Succeed in Anesthesia School (And RN, PA, or Med School).

  • Twitter: Offering a popular real-time form of communication, Twitter is often seen as one of the easiest ways to maintain contact with people, especially in times of crises. From posting health safety notices to explaining drug recall information to answering emergency questions, nurses can provide quick responses and critical assistance to the public.

Twitter is also an effective way to create a health-related conversation with the public, or get a healthcare-related topic trending. “…nurses can probably capitalize on social media as an excellent tool for creating awareness about preventative health campaigns, general flu/pandemic information, educational tidbits…,” says Greene.

  • Facebook:With the ability to leave messages (both public and private), upload videos, and post photos, nurses are able to connect with others on many different levels when using Facebook, and can also help bridge the information gap between health care providers and patients.

“There is an inherent need within healthcare to pass information on to a particular patient and to connect with a patient on a level that promotes not only biological health, but also psychological health and community health,” says Ben Miller, a student at Vanderbilt Law. “In this sense, a nurse Facebook messaging a teenage patient about medicine changes is easy and builds trust within the system.”

  • YouTube: The visual and audio aspect of YouTube has a profound effect on a viewer’s understanding of health care, medical concerns, surgical procedures, and other treatments.

“I use YouTube to broadcast educational videos about anesthesia school…,” says Angelis. “In general, social media can be a positive force to enhance the role of nursing in the community and the perception of nursing among our friends and the public at large.”

  • Discussion Groups & RSS Feeds:Social media also provides nurses with an outlet to connect with other healthcare professionals for personal, emotional, and educational reasons. From getting tips on how to cope with workplace stress to answering questions about advanced nursing degree programs, there are many nurse-specific online groups to join or participate in.

“Social media groups can provide support and help nurses stay positive even in hard times,” says Lincoln. “By following the right social media feeds on sites like Twitter, Facebook, Google + and LinkedIn, nurses can get the latest medical news.”

According to Greene, nurses who interact with others across social media channels also have an opportunity to “humanize the nursing profession.” Examples include spotlighting employer achievements, sharing nurse profiles, and providing one-on-one communication.

How Nurses Should NOT Use Social Media

“From a legal perspective, nurses using social media to reach out to patients pose a few major privacy issues,” says Miller. “Since most social media systems present security problems (in how they’re “built”, infrastructure, and/or how the user interacts with the specific social media system), open sharing of sensitive and confidential information leads to conflict with HIPAA.”

“Most of these social media systems (such as Facebook) are not as privacy forward as we believe,” Miller says. “Even something as simple as texting among nurses about a specific patient raises huge privacy issues.”

Also, social media platforms tend to create a false sense of security for nurses who often believe they are voicing their opinions, engaging in discussions, and posting images under the protection of privacy settings. Anything sent privately to an individual or posted on a closed forum has the potential to become public knowledge. Additionally, deleting statements and images from a social media account does not mean they have been completely removed from the Internet.

As a rule of thumb, nurses should not use social media to:

  • Complain About or Comment on the Health of Patients: The American Nursing Association warns against making disparaging remarks about patients (even if they’re not identified) in order to avoid problems with social media. “Do not talk about how rude a patient is, how bad they look or unhealthy they are…it will find a way to leak out, and even if it doesn’t, it causes others to view you in less professional nature, as well as the institution you are associated with,” says Lincoln. “It can also damage others perception of your character.”
  • Post Photographs of Patients: After posting a picture of a young cancer patient on Facebook, a nursing student was expelled from school, and the nursing program barred from using the pediatric unit for teaching after the administration was alerted. The hospital and patient were easily identified through the picture, which is a violation of HIPAA.

Even if a nurse gains permission from a patient to take pictures, employers can still take action. Despite getting the consent of a patient to photograph an injury, an emergency room nurse who shared the images on a nursing forum for learning purposes was disciplined even though the patient’s face was not visible; the type of injury made it easy to identify the patient.

  • Rant About Place of Employment: Because of the nature of work that a nurse does, speaking negatively on social media about co-workers, administrators, job duties, their place of employment, and/or workplace policies can lead to disciplinary actions. These types of negative online comments also place a hospital or doctor’s office in a bad light, as well as jeopardize a nurse’s job security. Even when opinions are voiced under the strictest privacy settings, there is always the possibility that online commentary can reach unintended readers.

To minimize the chances of violating workplace policies, using a personal email address as a primary means of identification on social media accounts instead of an email address associated with a hospital or place of employment is highly recommended.

Additionally, when writing a blog or participating in online activities that have the potential to negatively impact the reputation (or go against the policies of a healthcare employer), avoid establishing a direct connection to the place of employment. For this reason, many nurses comment anonymously or write blogs using a pseudonym.

  • Blow Off Work-Related Steam: Because of the visibility that social media platforms provide, Lincoln says it is critical for nurses to maintain composure and professionalism at all times.

“One of the most important things for a nurse to avoid is speaking negatively about a patient on social media,” he says. “This might seem like a no-brainer, but everyone gets frustrated at times and in many cases in medical situations, a nurse may feel overwhelmed.” Lincoln stresses to refrain from saying anything negative about “patient interaction, the prospect of patient recovery, or even just a general bad day on the job.”

  • Use Offensive Language and/or Voice Offensive Comments: Since nurses work with a diverse flow of patients that come from a wide range of economic-, racial-, ethnic- and religious backgrounds, making social media comments that are threatening, harassing, profane, obscene, sexually explicit, racially derogatory, homophobic, or deemed controversial are often grounds for discipline at the workplace.

Social Media Policies

An increasing number of hospitals, medical facilities, and healthcare employers are developing and implementing social media policies, including the likes of the American Medical Association, the Cleveland Clinic, the Mayo Clinic, Vanderbilt University Medical Center, M.D. Anderson Cancer Center, Children’s Hospital Los Angeles, and Kaiser Permanente. The National Council of State Boards of Nursing (NCSBN) also offers a white paper titled “A Nurse’s Guide to the Use of Social Media.”

Lincoln feels that Massachusetts General Hospital’s social media policies are an example of having “really done it right.” Not only does Mass General have social media guidelines in place for employees, but also a policy established for those who interact with the hospital on social media.

“Please understand that we cannot respond to every comment, and that we cannot offer medical advice, diagnosis or treatment via the Internet. If you have a question about your specific medical condition, you should contact your doctor or other qualified healthcare professional.”“For your privacy, you should consider carefully before posting personal medical information to the Internet. Please remember that your posts and comments are available for all to see.”“Users are responsible for content submitted to social media sites.” -from Guidelines for Participation in Mass General Social Media

 

“I am a strong believer that every company should have a social media policy in place,” says Lincoln. “This can help avoid legal issues, and give employees and clients a clear perspective on what the company is comfortable with being shared online.”

Consequences of Social Media Abuse

The consequences regarding a nurse’s improper or inappropriate use of social media platforms come with varying levels of discipline – all of which are dependent upon the action in question, workplace regulations, and any social media policies already in effect.

For example, not only can a medical facility take action against a nurse who has violated a patient’s privacy, but also the state board of nursing. State laws can additionally come into play, and it is not uncommon for legal and criminal investigations to take place when a nurse crosses the line.

Disciplinary actions that individuals can face include:

  • fines
  • suspension
  • required sensitivity training
  • expulsion from nursing school
  • being fired from a job
  • loss of licensure
  • criminal charges
  • jail time

The most serious offenses often involve law enforcement, with some cases being referred to the FBI for investigation of HIPAA violations, as seen in the firing of two nurses who photographed and posted the pictures on the Internet of a patient that underwent an X-ray procedure for rather sensitive, easily identifiable circumstances. Incidents of a sexual nature, such as exposing the image of a patient’s buttocks online, can also involve the Sex Crimes unit of the local police department.

Nurses who abuse social media (as well as digital and electronic media while on the job, such as taking cell phone pictures of patients) also cause their employer to come under scrutiny and suffer consequences, such as the admissions ban imposed on nursing home Kitsap Health & Rehabilitation Center for employing workers that took nude photographs on their cell phones of dementia patients. The incident led to an investigation of the facility, and the threat of being cut from the Medicare/Medicaid program, which provides vital reimbursements of funds for the services they offer.

In conclusion, social media policies for nurses will continue to evolve in order to keep in line with advancements in technology and the Internet. The key to successfully navigating the ups and downs that come with having an online presence and identity is to find a happy, safe, and responsible middle between enjoying the personal and professional benefits of social media without breaking the rules of patient privacy and confidentiality.

In addition to being mindful of the importance regarding the disclosure of patient- and workplace-related information via social media…keeping up with workplace policies, relevant state and federal laws, and professional standards as they apply to the nursing profession are just as significant.

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Topics: social media

4 Things to Know About Accreditation in Online Nursing Programs

Posted by Pat Magrath

Tue, Nov 08, 2016 @ 02:16 PM

what-can-you-do-with-a-nursing-degree.jpgIf you’re thinking about continuing your education or are just starting out with your Nursing education, we think this article might be helpful to you. Let us know what you think.

When Texas resident Barbara Chapman explored different online graduate nursing programs, she knew finding one that was accredited was key. 

Accreditation, experts say, ensures that an unbiased agency recognized by the Department of Education reviewed a program to validate its quality and rigor.

"It's the first thing that they ask when you're even applying for a job: 'Did you graduate from an accredited program?'" says the 56-year-old. Other universities, should a student pursue a higher-level degree, often ask the same question, she says.

After doing research online, Chapman chose the University of Texas—Tyler's hybrid nurse practitioner master's program, verifying its accreditation from the Commission on Collegiate Nursing Education, or CCNE – one of two main nursing accrediting bodies recognized by the Department of Education, a status that also ensures students are eligible for federal financial aid.

Chapman might be onto something. When choosing an online nursing degree program, experts say, prospective students should check that it's accredited by either the CCNE or the Accreditation Commission for Education in Nursing, or ACEN. The former focuses on baccalaureate and graduate programs, including online; ACEN accredits nursing programs at all levels.

Accreditation for a specific nursing degree is separate from accreditation for the university as a whole, experts say. Prospective online students can usually determine the status of both on a school's website. The ACEN and CCNE also list the nursing programs they accredit online.

Here are four things prospective online students should know about accreditation in online nursing programs before enrolling.

1. Accreditation is particularly important to employers when it comes to online programs. Employers often want to verify the legitimacy of online nursing degrees, experts say. The Department of Education determines that agencies such as the CCNE and ACEN are reliable authorities on legitimate programs.

"It is very much a high, high mark of quality," says F. Patrick Robinson, dean of the school of nursing and health sciences at the online, for-profit Capella University.

Many potential employers will confirm that both an applicant's online nursing degree program and the overall institution it's a part of are accredited, says Jennifer Butlin, CCNE's executive director. 

When looking at the university's overall accreditation, prospective students should be aware that some online, for-profit schools hold national accreditation. But many experts say most employers historically prefer regional accreditation at the university level through agencies such as the Middle States Commission on Higher Education.

 

2. The ACEN and CCNE hold online programs to the same standards as on-ground programs. Sharon Beasley, an associate director for ACEN, says the accreditation process for online programs has an additional layer of review focusing specifically on distance education.

For example, ACEN typically reviews whether faculty are trained to teach online and the ways learners and professors interact virtually.

Knowing that, prospective students shouldn't assume online learning is easier or less intensive than on ground, experts say.

3. Accrediting bodies require online nursing programs to have clinical or practicum components in person. Experts say accredited programs classified as online still require students to attend sessions in a health care facility or another face-to-face setting – sometimes near a student's home, though this varies.

"You do need to have access to professors who can show you how a specific procedure needs to be done," says Chapman, the UT—Tyler student.

At Excelsior College, almost every online nursing program has a clinical or practicum component mixing virtual labs and in-person experiences, says Barbara B. Pieper, associate dean for RN-to-bachelor's and master's programs. She says it's especially important for online learners to determine the time commitment and location details because many hold full-time jobs and can't travel far.

4. Online degree programs regularly undergo re-accredition and review. New online nursing degree programs are constantly springing up at universities, and prospective students need to keep in mind that each one gets accredited in its entirety, including if it has multiple tracks, Beasley says.
 

Butlin, of CCNE, says a review also takes place if there's a significant change in delivery – such as a blended program changing from 20 percent online to a majority online – to ensure it continues to comply with accreditation standards.

CCNE and ACEN require nursing degree programs to undergo re-accreditation every several years, officials say. Therefore, it's essential that prospective students look at a program's accreditation history, says Mary Jean Schumann, senior associate dean for academic affairs at George Washington University's School of Nursing.

Chapman says she knows of students who didn't do enough research beforehand.

"They were either promised that they would eventually become an accredited program and it did not, or they were in a program and it lost accreditation, and it was devastating to them," she says.

If you have questions regarding this topic or any other general questions, feel free to ask one of our Nurse Leaders!

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Topics: nursing programs, online nursing programs, accredited

Things Nurses Are Tired Of Hearing From You

Posted by Pat Magrath

Mon, Nov 07, 2016 @ 11:33 AM

angry-nurse-800x430.jpgThis is an article that might be right up your alley. It’s about things people say to Nurses. Sometimes comments are made that are totally innocent and mean no harm. Other comments are just plain ignorant, annoying, insulting, stupid or rude and usually the commenter has no idea they are being offensive.

What are your thoughts about the comments below? Can you add remarks people have said to you?

Nurses are the unsung heroes of the medical profession, the people who do all the little things, like sticking your arm, collecting your vitals, and generally making you feel somewhat more human when you're not at your best.   

But since nurses tend to see people in times of distress -- and since they do their jobs right in front of you -- they have to deal with a lot of crap, both literal and metaphorical. Here are a few of the common refrains they're sick of hearing from patients, doctors, other medical staff, family, friends, and the public at large. Keep these in the back of your mind the next time you wind up on the wrong side of the hospital doors. 

"It's your fault!" 

Nurses often take the brunt of the blame when things go wrong, says Chris Caulfield, RN, NP-C. "Regardless of if the mistake was due to the doctor, pharmacist, physical therapist, or nursing assistant; hospitals like to blame the nursing staff for pretty much everything," he adds. Caulfield says that since nurses are the gatekeepers of all things medical and non-medical in the hospital, they often get blamed for the mistakes of everyonethroughout the system, which is super crappy. 

"Oh, you're 'just' a nurse?" 

"I'm a student nurse and nurse tech (SN, NT) and the phrase 'just a nurse' is like nails on a chalkboard to me," says Heather Price. There is no "just" when talking about the nursing profession -- they do their job, like everyone else in the medical field. 

"Why aren't you a doctor?" 

Related to calling someone "just" a nurse. Eileen Sollars, RN, AAS, ADN, says she also gets asked why she didn't just become a doctor. It's a completely different profession, and if she wanted to be a doctor, she would have become a doctor. Why didn't you become a librarian instead of an accountant, anyway? 

"What did you do with my mom's teeth, glasses, etc.?" 

Bonnie Emery, RN, BSN, has had patients' family members come up to her, demanding to know what she did with their loved ones' items. For starters, she says, it's not always clear what family member goes with which patient, and next, she didn't take them in the first place. While she always helps them look, she says she wishes she could say something else instead: "What I'd like to say is that I took them home to put in my garage sale with the other dentures I've taken home." 

"Wow, why aren't you retired?" 

People actually pose this question to Sollars, who's been a nurse for 38 solid years. That's almost as bad as someone asking why you're not dead yet. 

"Hey, can you take a look at…?" 

Sollars also says that at gatherings or other events, people come up to her and ask for medical advice, or even worse, ask if she can take a look at whatever body part is ailing a person. No, she doesn't want to do this any more than any other person would want to do this. It's a party, dammit, she just wants some punch and normal socialization. 

"I Googled this and…" 

Yes, you can do your own medical research, and often your medical team will work with you to come up with the best treatment plan. Sollars asks you to keep in mind that you're just an average member of the public using Google -- not a nurse, and not a doctor, so don't pretend you are. 

"So my friend is in the hospital, can you tell me all the juicy details?" 

Um, no… doesn't stop people from asking, though. Jolene Wilder, RN, unequivocally says no, nurses cannot tell you details about patients in the hospital. There's this little thing called HIPAA that prohibits (by way of federal law) disbursement of patient information, and even if HIPAA didn't exist, would you really want someone telling your friends your medical deets? 

"I have a high pain tolerance." 

"Really?" wonders Lisa Dukes, MSN, RN, CEN, CPEN, TCRN, an ER/trauma nurse. When she hears patients claim they have a high pain tolerance, she says (totally in her head), "No one does. Everyone just thinks they do." So leave your brag about pain tolerance at home; nobody will believe you anyway. 

"That must be so hard! I couldn't do what you do." 

Jamie, who works as a pediatric cardiac intensive care nurse, says that whenever she tells people about her job, they express the above. She says, "Um… that's why I do it and you don't. Yes, it's hard, but I love it and that's why I do it." While it seems harmless, it can get old hearing that your job somehow makes your total existence more difficult than other people's. More straightforward words of praise or admiration can accomplish the same goal.

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Topics: nurse life

This Oncology Nurse Took in A Patient’s Son After Her Death

Posted by Erica Bettencourt

Fri, Nov 04, 2016 @ 11:31 AM

tricia-seamans-tricia-somers-zoom-cb35cffe-aaa4-4753-8d5f-5f5fb4d3a796.jpgTwo complete strangers, both named Tricia, meet and after 10 days one of them asks the other to take care of her 8 year-old son if she dies. Nurses are known to be caring and loving, always going the distance to help anyone in need. This story shows you a Nurse who goes beyond that. We see there are still great people out there and the power of instincts and compassion can save lives in more ways than one. 

An angel. That’s how Tricia Somers described her oncology nurse, Tricia Seaman, at PinnacleHealth Hospital in Harrisburg, Pennsylvania. “Before she even said anything, I just felt comfort. It was almost like someone just put a warm blanket on me,” Somers told CBS News in 2014. “I’ve never felt anything like that before.” The connection was so deep that when the single mom learned her cancer was terminal, she turned to Seaman with one last dying wish.

“Tricia looked at me and said, ‘When I die, will you and your husband raise my son?'” the longtime nurse from Pennsylvania tells Us Weekly. Since the women had known each other just 10 days, Seaman encouraged Somers to take some time to think about her request. But Somers, who had no family to care for her beloved Wesley, 8, knew exactly what she was doing. “She later told me, ‘I knew from the very first moment that I met you that you were going to help me,’” says Seaman. “'I didn’t know how. I just knew you were going to help me.'”

And Somers was right. In May 2014, Seaman and her husband, Dan, welcomed both Somers and Wesley into their family. “Tricia was having trouble walking, she could barely move, and that was when we made arrangements to bring her here to our house,” Seaman tells Us. “That way she didn’t have to worry about trying to get food for Wesley, or worry about what medicine was due for herself. We took care of all of that.”
 
When Somers passed away on December 7, 2014, at the age of 45, the Seamans became Wesley’s legal guardians. No longer an only child, the now-10-year-old counts the Seamans’ kids Anna, 20, Jenna, 18, Emma, 15, and Noah, 12, as his siblings.
 
“He’s so fun. He’s so his mom. I mean, she was just so larger than life,” says Seaman, 43. “She and I had opposite personalities. I remember one time we were talking about our dating histories. Hers was very colorful, and mine was very boring. I was like, ‘I dated this person and that person and then I met Dan and we got married and had a family.’ She goes, ‘Is that it!? Well, that’s about as exciting as paint drying.’”
 
Seaman, who wrote the book God Gave Me You about her friendship with Somers says the fifth-grader talks about his mom every day. “Tricia’s a part of our lives and always will be,” Seaman tells Us. “Even though she’s not here with us anymore, we sure didn’t lose, because knowing her and having the privilege to raise her son, what a gift. We’re just so much better for knowing them both.”
 
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Topics: Oncology Nursing

Spiritual Care in Nursing

Posted by Pat Magrath

Thu, Nov 03, 2016 @ 12:38 PM

Hope Peace Love Faith.jpgWhen working closely with patients that are undergoing tests or admitted to the hospital for several days, do you find they look to you for their emotional and spiritual needs as well as their physical needs? If your answer is yes, how do you help them with their spiritual needs? Do you feel this is something beyond your training and scope of experience? Do you see it as a necessary part of your job? Are you comfortable with it?
 
This article explores religious and spiritual needs of patients. We hope it is helpful to you and we’re curious what your thoughts are on this important subject. Will you please share them with us?

Spirituality in health care is "that part of person that gives meaning and purpose to the person's life. Belief in a higher power that may inspire hope, seek resolution, and transcend physical and conscious constraints." 1

Spiritual care in nursing is an important part of overall healthcare. Although nurses may recognize the value of spirituality to their patients, many are unsure of how to best address those needs. Nurse researchers led by Christina Canfield, RN, MSN, ACNS-BC, CCRN-E, a clinical nurse specialist at eHospital, Cleveland Clinic studied nurses' definitions of spirituality and their comfort levels in providing spiritual care to patients.

Debi Taylor, RN, Sutter Tracy Community Hospital, Tracy, Calif., one of the study's co-authors, found it difficult to provide spiritual care without a guiding framework. 
 
What is Spirituality?

To arrive at a working definition of spiritual care for their study, Taylor and another nurse interviewed 30 bedside nurses who worked in critical care at a large teaching hospital. The majority of interview subjects has been critical care nurses for four years or less; they also tended to be female, in their 20's, and hold a BSN as their highest level of education.2

 They asked the nurses:
  •  "Could you tell me about a time when you interacted with a patient who really needed some spiritual support or attention?"
  •  "Please describe your personal definition of spirituality?"
  • "How do you see the connection between religion and spirituality?"
  • "Could you talk to me about your own comfort in providing spiritual care to critically ill patients?"3

The nurse investigators also reviewed existing literature on the topic of spirituality in healthcare and saw patterns emerge.  Previous research had found that spiritual care needs to be addressed among all patients. In fact, a Press Ganey study revealed hospitalized patients placed attention to their emotional needs as a top priority. Other researchers determined spiritual training for nurses was necessary to improve the nurses' competence in addressing the need in patients.1

One nurse in the study commented: "I think everyone's definition (of spirituality) would be completely different . I don't know. Like a background that no one can really explain."1

"As themes emerge, we created a definition," Taylor said. The resulting definition of spirituality in healthcare is quoted in the opening paragraph of this article.
Nurses' Insights into Spirituality

Canfield remarked, "Nurses were very open, candid and emotional. It was cathartic for them." The nurses in the study had the desire to provide spiritual care to their patients, but did not always know how to go about it.  75% of the nurses interviewed expressed at least some degree of comfort at offering critically ill patients spiritual care.

"Many of our interviews indicated a belief in a higher power and that belief gives hope," explained Taylor. One nurse explained it like this:
"If the family is praying, you can stand there quietly and offer, show your support, you know, you don't have . to be afraid to let them know that . you do believe in something and . you're not just about the technical stuff."1

 "When we talked to nurses, they commented that spirituality and religion were two different things. Religion was one way to express spirituality, but not the only way," Taylor remarked. One research subject described the difference as follows:
"I feel like religion is more of a set, a creed and structure and also a feeling of belonging to a people of the similar belief system and spirituality is your own internal connection."1
That finding was particularly surprising and thought provoking to the researchers. For both nurses and patients, spirituality transcends consciousconstraints on the individual. 
"Nurses are often the first people to identify the need," noted Canfield.  The question then becomes: "What do you do with it from there?"  

Holistic Healing

She continued, "If we just care for patient's body, we miss opportunities." If nurses want provide holistic care, than addressing spirituality is an obligation. Simply by putting the patient at the center of the experience, they recognize the value of spirituality.

Literature reviews and gaining knowledge on the growing field of spiritual care interventions is one way nurses can educate themselves. They can also make themselves aware of resources at their hospitals. Working with a chaplain can uncover different ways to meet spiritual needs. Knowing where to find resources, like spiritual assessment questions and diversity toolkits before they need them, is a major help to the nurses.

One way nurses can offer spiritual care is to offer their presence and be purposeful. "When done doing technical care for patients, be emotionally present. Create an environment where patient feels comfortable to talk," said Canfield.

Many of the nurses in the study used offering as a way to connect with their patients in need. Offering is extending the opportunity to pray, listen to the patients' concerns, hold their hand, or simply be there. One subject was quoted in the study:
"Uh, open conversation I feel like is beneficial. To just to ask them how they are feeling, what's going on, um, how they're coping. I mean, we are lucky to have consults with spiritual priest or whatever you want to call them to come up and talk to families, but, I found that just being a presence, um, and giving them open opportunity to talk is the best way that I found to help them cope through a situation like that."1

Taylor summed up many of the study's findings. "Assessing the mind, the body and the soul necessitates the care of spiritual interventions."

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References

1.Canfield C et. al. Critical Care Nurses' Perceived Need for Guidance in Addressing Spirituality in Critically Ill Patients. American Journal of Critical Care. May 2016. 25 (3). 206-11.

2. Table 1. Critical Care Nurses' Perceived Need for Guidance in Addressing Spirituality in Critically Ill Patients  http://ajcc.aacnjournals.org/content/25/3/206/T1.expansion.html

3.Table 2. Critical Care Nurses' Perceived Need for Guidance in Addressing Spirituality in Critically Ill Patients  http://ajcc.aacnjournals.org/content/25/3/206/T2.expansion.html

Danielle Bullen Love is on staff at ADVANCE. Contact: dbullen@advanceweb.com
 

Topics: spirituality

Compassion is Paramount in Infusion Nursing

Posted by Pat Magrath

Mon, Oct 31, 2016 @ 11:37 AM

Modern-Nurse-DN.jpg

Via: www.discovernursing.com

Infusion nurses are registered nurses who specialize in administering medications and fluids via infusion. They monitor patients, manage their tubing, maintain arterial catheters and stay aware of potential drug complications. It’s a unique specialty, requiring high levels of technical skill and excellent bedside (or in many cases with infusion nursing, “chairside”) manner.

For nurses who are looking for a career change or students planning their next step after graduation, infusion nursing is a promising option. It’s also an increasingly popular specialty. According to Healthcare Traveler, the demand for infusion nurse services is expected to rise 26 percent by 2020, due in part to new medical technologies, the aging of America and several anticipated cost-saving initiatives required by the Affordable Care Act.

Flexibility, adaptability and quick thinking are keys to excelling in the ever-evolving world of infusion nursing, where nurses must be prepared to both work autonomously and be a part of interdisciplinary teams.

“Although it’s a difficult specialty, the most important characteristic of infusion nursing is a strong sense of compassion,” said Linda Ankrom MSN, MHA, RN, an infusion nurse in Pittsburgh, Pa. “If you have the passion to care for others, the rest can be taught. The skills can be developed, and nurse mentors will guide you along your career, but the most important thing is that you’re truly invested in being a nurse and caring for others.”

Infusion nurses have a particular opportunity to work closely with patients and their families during difficult, sometimes painful, parts of their treatment. Ankrom notes a big part of the infusion nursing role is to educate patients and their families about their care. It requires translating complicated medical knowledge into terms that patients (even pediatric patients) can understand. Ankrom often encourages her nurses to open up to their patients in order to develop a stronger relationship.

“Nurses are not trained to talk about themselves, but I always tell my nurses to talk to their patients,” she said, “Tell them about where you are from, what you’ve studied and even what experiences you many have had with being an infusion patient yourself. These stories help build a relationship with the patient.”

Infusion nurses practice in any setting where patients receive medication or fluid infusion treatments, including hospitals, long-term care centers, clinics and home health agencies. During her career, Ankrom has worked in many of these settings, but currently works in an outpatient clinic.  Outpatient clinics can be a valuable option for patients with an ongoing condition that requires regular infusion treatments.

“One of the benefits of an outpatient setting is the disease doesn’t become my patient’s entire life,” said Ankrom. “They can get treatment and be home in time for after-school activities. For people with chronic illness, having to constantly go in and out of the hospital can be very demanding. An outpatient clinic helps them have more control over their care.”          

After nearly 20 years of practicing nursing, Ankrom still lights up about her chosen specialty.

“There’s a million rewards to being an infusion nurse, but the number one thing is bringing a sense of calm, peace and hope to a patient.”

To learn more about infusion nursing, check out Ankrom’s interview in the Campaign’s new “Day in the Life” video below or her interview on Nursing Notes Live. 

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Topics: compassion, infusion nursing

This Baby Was Born Twice

Posted by Erica Bettencourt

Thu, Oct 27, 2016 @ 11:35 AM

baby-born-twice-doing-well.jpgImagine being able to say you were born twice, in fact, you had your first surgery before you were born as well. Margaret Boemer had been in her 2nd trimester when she got heart breaking news that her unborn child had a rare birth defect. Enduring a previous miscarriage, this news truly shook Margaret. 
 
The expecting parents decided to go ahead with a surgery that involved removing the baby from the womb half way, removing the tumor, and putting the baby back in to the womb. Thankfully the surgery removed 90% of the tumor and 12 weeks later Lynlee was born. A short while after that, the second surgery was performed, removing the last 10% of the tumor. Nothing short of a miracle, this new life continues to grow. 

Texas mom Margaret Boemer will have a fascinating story to tell her daughter Lynlee about when she was born.

During her second trimester, Boemer learned during a routine ultrasound that her unborn child had a large tumor growing out of her tailbone. Doctors told her the baby had Sacrococcygeal Teratoma (SCT), a rare birth defect occurring in only one in every 40,000 pregnancies.

“It was a big shock and we were scared,” Boemer told CBS News. “I had just suffered a miscarriage the prior year. To think that I might lose another baby was very hard.”

The large mass was robbing her daughter of blood and would have caused her heart to give out before birth.

But at 20 weeks pregnant, Boemer and her husband Jeff met with doctors at Texas Children’s Fetal Center in Houston, who told her there was an option to perform emergency fetal surgery.

After other specialists advised them to terminate the pregnancy, they decided to move forward with the risky procedure to try to save their baby’s life.

161019162513-01-baby-born-twice-super-169.jpg

“Lynlee would not have made it without this surgery,” Dr. Darrell Cass of the Texas Children’s Fetal Center told CBS News. With it, she had a 50/50 chance of survival.

At almost 24 weeks, Cass and his team made an incision in Boemer’s abdomen and pulled almost half of Lynlee’s body out of her mother’s uterus to remove the tumor – which was almost larger than the baby herself. Then came the challenge of putting Lynlee back in and closing the uterus. 

“We have to get the tumor away but then we have to make sure the baby can stay safely inside for a number of weeks afterward to have any kind of survival,” Cass said.

After a five-hour procedure, the doctors were able to remove 90 percent of the tumor and safely return Lynlee back inside her mother. Boemer’s uterus was sewn shut and her pregnancy progressed.

Twelve weeks later, Lynlee was essentially born a second time via C-section. At eight days old, she underwent surgery to remove the rest of her tumor. 

Doctors will continue to monitor Lynlee all the way into adulthood. So far she is reaching all her milestones.

“She’s doing great now,” Boemer said. “We’re practicing rolling over.”

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Topics: baby born twice, out of womb surgery, pediatric surgery

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