DiversityNursing Blog

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.

“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.”

It’s an unusual sight in the halls of Dana-Farber Cancer Institute: Alongside doctors, nurses, and patients, a robot about the size of a washing machine quietly glides through the hospital, a bright light marking its presence.

Dana-Farber executives have high hopes for “Lucy,” one of the newest technologies in use at Boston’s best-known cancer center. Lucy is being developed to deliver prescription drugs directly to patients while they sit in infusion rooms receiving chemotherapy — a treatment that can take many hours. If the system works, it will save patients the time and trouble of having to stand in line to pick up their prescriptions at a pharmacy after an already long and draining day of treatment.

“We want Lucy to be able to improve the patient’s experience while they’re here all day,” said Sylvia Bartel, vice president of pharmacy at Dana-Farber. “Their last stop is usually coming to the outpatient pharmacy and picking up a prescription. They finish their chemotherapy, they have to wait in a line, so we felt like there had to be a way for us to efficiently deliver the [medications] using technology.”

Dana-Farber began testing the technology in 2013, after getting a phone call from executives at Vecna Technologies, the Cambridge-based company that developed the robot and was looking to expand its health care business. The Boston cancer center is one of just a few hospitals in the world using the machine.

Lucy is equipped with a touchscreen, a scanner, and compartments for stocking drugs. There is no attempt to give it human features, other than a voice only used occasionally. For now, the robot doesn’t interact with patients, only with hospital staff. It moves drugs around the Longwood area hospital, making about a dozen trips a day, using Wi-Fi-connected software to open doors and use service elevators.

Lucy isn’t glitch-free. It has ended up on the wrong floor before. On one recent afternoon, its movements were halting. Another day, it was out of service because of a connectivity problem.

Even so, Carlos Verrier, business operations manager in Dana-Farber’s pharmacy, said Lucy has helped make the pharmacy more productive. The hospital pharmacy is a busy place, processing some 400 scrips a day.

“It’s really allowing the staff to do more of what they’re trained to do... and not having to take them away to do a delivery,” Verrier said. “They spend more time on clinical aspects of their job than on delivering medication.”

Deborah Theobald, Vecna’s chief executive, said there’s a lot of potential for using such robots to move sensitive items around a hospital. Robots can move potent, expensive drugs around a building more safely and securely than humans, she said. Their every move can be easily tracked.

Vecna’s QC Bot costs roughly $150,000. Theobald acknowledged that hospital executives may need some persuading before they’re ready to give it a try.

“There’s an education process to get them over the hump and see the [return on investment],” she said. “People really appreciate robots once you get over the education hurdle. People don’t want to go back.”

Anne Tonachel, a former patient and current volunteer at Dana-Farber, has seen Lucy moving around the halls and quickly become a fan.

Tonachel is an ovarian cancer survivor who vividly remembers the pain of receiving chemotherapy treatment for many hours at a time. The treatments left her feeling too sick to pick up prescriptions from the pharmacy. Tonachel said she would have loved to skip that step by having a robot deliver prescriptions directly to her.

“No one would mind having Lucy show up at their bed or chair side,” she said. “In fact, her arrival might add a bit of interest to the day and bring a few smiles.”

A woman who was called 'just a nurse' has sparked a conversation around the world about the value of nursing.

Caitlin Brassington, of Toowoomba, Australia, posted on Facebook that one day last week after work she was in a grocery store, wearing her scrubs, when she ran into an old friend who said she hadn't realized that Brassington was "just a nurse."

"Wow! Over my 18 year career I have heard this phrase many, many time[s], but today it got to me," wrote Brassington, 38, in a now-viral Facebook post that's received more than 19,000 likes.

Brassington went on to gives example of how important nurses are to their patients and communities.

"I have helped babies into the world, many of whom needed assistance to take their first breath, and yet I am just a nurse," she wrote. "I have held patients hands and ensured their dignity while they take their last breath, and yet I am just a nurse. I have counselled grieving parents after the loss of a child, and yet I am just a nurse."

A pediatric nurse who has been in the profession more than nine years, Brassington told ABC News she's "heard this phrase said many times before," but for some reason was moved in this instance to speak out.

The a mother of three added that many don't realize how the role of nurses has evolved over the last 50 years, "particularly with advances in technology and advanced training."

"I think more than ever nurses now have a partnership with doctors and are a vital component of the health care teams," she said.

In the U.S. alone, there are more than 2.7 million nurses, according to 2014 statistics from the United States Department of Labor.

Brassington said her post was on behalf of nurses around the globe.

"It has started a worldwide conversation about how we value and respect certain service industries within communities," she told ABC News. "I think this conversation is long overdue."

As I begin to tell my friends and family about the seven days you treated my wife, Laura Levis, in what turned out to be the last days of her young life, they stop me at about the 15th name that I recall. The list includes the doctors, nurses, respiratory specialists, social workers, even cleaning staff members who cared for her.

“How do you remember any of their names?” they ask.

How could I not, I respond.

Every single one of you treated Laura with such professionalism, and kindness, and dignity as she lay unconscious. When she needed shots, you apologized that it was going to hurt a little, whether or not she could hear. When you listened to her heart and lungs through your stethoscopes, and her gown began to slip, you pulled it up to respectfully cover her. You spread a blanket, not only when her body temperature needed regulating, but also when the room was just a little cold, and you thought she’d sleep more comfortably that way.

You cared so greatly for her parents, helping them climb into the room’s awkward recliner, fetching them fresh water almost by the hour, and by answering every one of their medical questions with incredible patience. My father-in-law, a doctor himself as you learned, felt he was involved in her care. I can’t tell you how important that was to him.

Then, there was how you treated me. How would I have found the strength to have made it through that week without you?

How many times did you walk into the room to find me sobbing, my head down, resting on her hand, and quietly go about your task, as if willing yourselves invisible? How many times did you help me set up the recliner as close as possible to her bedside, crawling into the mess of wires and tubes around her bed in order to swing her forward just a few feet?

How many times did you check in on me to see whether I needed anything, from food to drink, fresh clothes to a hot shower, or to see whether I needed a better explanation of a medical procedure, or just someone to talk to?

How many times did you hug me and console me when I fell to pieces, or ask about Laura’s life and the person she was, taking the time to look at her photos or read the things I’d written about her? How many times did you deliver bad news with compassionate words, and sadness in your eyes?

When I needed to use a computer for an emergency email, you made it happen. When I smuggled in a very special visitor, our tuxedo cat, Cola, for one final lick of Laura’s face, you “didn’t see a thing.”

And one special evening, you gave me full control to usher into the I.C.U. more than 50 people in Laura’s life, from friends to co-workers to college alums to family members. It was an outpouring of love that included guitar playing and opera singing and dancing and new revelations to me about just how deeply my wife touched people. It was the last great night of our marriage together, for both of us, and it wouldn’t have happened without your support.

There is another moment — actually, a single hour — that I will never forget.

On the final day, as we waited for Laura’s organ donor surgery, all I wanted was to be alone with her. But family and friends kept coming to say their goodbyes, and the clock ticked away. About 4 p.m., finally, everyone had gone, and I was emotionally and physically exhausted, in need of a nap. So I asked her nurses, Donna and Jen, if they could help me set up the recliner, which was so uncomfortable, but all I had, next to Laura again. They had a better idea.

They asked me to leave the room for a moment, and when I returned, they had shifted Laura to the right side of her bed, leaving just enough room for me to crawl in with her one last time. I asked if they could give us one hour without a single interruption, and they nodded, closing the curtains and the doors, and shutting off the lights.

I nestled my body against hers. She looked so beautiful, and I told her so, stroking her hair and face. Pulling her gown down slightly, I kissed her breasts, and laid my head on her chest, feeling it rise and fall with each breath, her heartbeat in my ear. It was our last tender moment as a husband and a wife, and it was more natural and pure and comforting than anything I’ve ever felt. And then I fell asleep.

I will remember that last hour together for the rest of my life. It was a gift beyond gifts, and I have Donna and Jen to thank for it.

Really, I have all of you to thank for it.

With my eternal gratitude and love,

Peter DeMarco

Office of Federal Contract Compliance Programs (OFCCP) audits can be complex, which is why it’s so important federal contractors understand the latest requirements and trends impacting enforcement.

Here are some of the latest OFCCP audit trends and expectations you should be aware of:

Section 503 and VEVRAA regulation enforcement

OFCCP is still expecting full compliance to the revisions that were made to the Individuals with Disabilities (IWD) and Protected Veterans (PV) regulations. Current audit activity shows the agency is focusing heavily on these requirements. In fact, actual requests posed by officers in recent reviews are asking for information including:

• A snapshot of the company’s online application system and its flexibility for users.
• Documented mandatory job listings.
• Verification of outreach activities for the period under review
• List of each job posted during the prior year and current year review period.
• Physical or reasonable accommodations made.
• Medical examination requirements statement.
• Subcontractor/vendor notifications.
• Proof of EEO language in job advertisements.

The list above is not exhaustive since individual officers and OFCCP offices have a lot of discretion to request additional information during an audit. They may even contact you before you submit your affirmative action plan (AAP) with specific requests.

Outreach and recruitment efforts

It’s also clear from audit activity OFCCP is still focusing on hiring/promotion selections and outreach/recruitment activities. Toward the end of 2015, OFCCP was more focused on personnel actions—asking for details about selection decisions in an effort to discover discrimination that could result in a financial settlement. Now, more than ever, it is imperative you examine selection rates and ensure your outreach and recruitment efforts are effective. For example:

• The IWD and PV AAPs now contain applicant and new hire data so contractors (and OFCCP) can assess the effectiveness of your outreach and recruitment efforts, hiring, and selection procedures. This data must be maintained for three years so ongoing efforts can be evaluated over a period of time.
• As noted earlier, an officer may request proof you are engaging in efforts to identify and recruit IWD and PV. This includes proving you made the mandatory job listings with the Employment Service Delivery System offices required by VEVRAA. OFCCP may contact individuals who represent your recruitment and outreach partners to determine the extent of your engagement with them. Are you just pushing out job postings to them? Or, are you interacting and communicating your company’s needs and requirements ensuring you get qualified referrals for open jobs?
• Outreach and recruitment activities in job groups where there are goals for women and minorities are also important. You will be expected to show progress toward those goals and identify what actions you took.

A focus on compensation compliance

OFCCP continues to focus on compensation. Two events have already taken place this year to underscore the importance of fair pay to this administration. First, Executive Order 13665, Pay Transparency, became effective in January and it prohibits federal contractors from taking adverse action against employees or applicants who disclose or discuss compensation information.

Next, you may have heard the EEOC has proposed revisions to the EEO-1 Report for the 2017 reporting cycle. These revisions would require submission of aggregated compensation data and hours worked by EEO-1 category, race, and gender using salary bands. All federal contractors, and private employers with 100 or more employees, would be required to submit the reports in the revised format. The comment period closed April 1, 2016, and more details will be available soon.

OFCCP is working with EEOC on this proposal, but the agency does not have to wait for the EEO-1 changes to evaluate a contractor’s compensation practices because employee level compensation data is submitted for a compliance review. Officers continue to evaluate compensation in many ways, including the workforce in total, by grouping similar jobs together by job group, and comparing individuals in the same or similar job titles.

Pat Shiu, OFCCP’s Director, recently commented in a Wall Street Journal article that the agency has been focusing on pay discrimination cases involving multiple workers, and it is pursuing “…dozens of very big systemic discrimination cases throughout all kinds of industries. You’ll see a real uptick in 2016, 2017, 2018,” she says.

Shiu has made it crystal clear one of OFCCP’s primary roles is to protect workers and believes that ferreting out unexplained differences in pay is a major way to provide this protection.

Contractors are advised to continue to perform annual pay equity analyses to be prepared for challenges to their compensation practices. Recently we have seen an increase in OFCCP requests to interview compensation managers and those who make compensation decisions. Interview topics include:

• Starting pay
• Merit increases
• Compensation policy and practice
• Other types of compensation—bonus, commission, awards, overtime, etc.
• Self-audits and adjustments made as a result of a self-audit
  
  If you have questions about OFCCP, feel free to ask one of our Nurse Leaders by clicking below!