DiversityNursing Blog

Recent demographic shifts will have major implications for the U.S. healthcare system, both in terms of the delivery of patient care and the practice of nursing. According to experts at Kansas State University, improved public health and clinical care have led to an increase in the average life span, meaning that by the year 2020 more than 20 percent of the population will be age 65 or older. In fact, individuals over the age of 85 make up the fastest-growing group. This will lead to extended treatment of long-term chronic conditions, challenging the healthcare system’s ability to provide efficient care. 

In addition, the diversity of the general population is a relevant topic on the minds of many nurses. Because multiculturalism affects the nature of illness and disease as well as morbidity and mortality, nurses must learn to adapt their practice to various cultural values and beliefs. Relevant factors include national origin, religious affiliation, language, gender, sexual orientation, age, disability, socioeconomic status and more. Understanding cultural diversity is becoming a daily responsibility for many nurses. 

Such changes in the population are significant for nurses. Nursing practice, education and perspectives must adapt and respond to changing demographics because nurses play an increasingly important role in healthcare delivery. 

Understanding the Aging Population 

As the baby boomer generation ages, the number of older adults in the United States is expected to increase exponentially. Combine this with a longer average life span, and the healthcare system needs to adapt — quickly. To meet the needs of a large aging population, nurses in particular must “identify strategies to allow older adults to live independently for as long as possible; provide health care and education for older adults who are self-managing multiple chronic illnesses; ensure that older adults in long-term care settings receive high-quality care,” says Patricia A. Grady, Ph.D., RN, of the National Institute of Nursing Research. 

The National Institute of Health estimates that about 80 percent of people over the age of 65 have at least one chronic illness, such as heart disease, diabetes or arthritis. In addition, the number of older adults with multiple chronic illnesses is substantial. Chronic illnesses are one of the most central issues facing nurses in terms of the aging population because they impact quality of life for patients and garner considerable expenses. Seventy-five percent of healthcare costs in the United States are the result of chronic illness, according to the Centers for Disease Control and Prevention. 

Key considerations for elder care delivery include the following, according to Grady: 

* Identifying ways to improve healthcare and quality of life for older adults across care settings, from the nursing home to the community 

* Interpersonal interactions, either between older adults and family members or nursing staff, or among different levels of staff in a nursing home, which can influence older adults’ quality of life and health-related outcomes 

* Nurses as integral members and leaders of interdisciplinary healthcare teams to solve complex health problems and provide for older adults 

* Assessing multiple types of intervention, analytical parameters and environmental settings to fully understand the complexity of healthcare issues facing older adults and to produce the most positive health outcomes 

In general, nurses will be required to provide care for more adults (and older adults) than ever before — patients who have complex healthcare needs. However, nurses are also in an ideal position to communicate with older adults about self-care strategies to prevent further illness while maintaining their independence, functioning, and mental and physical health. Nurses of all specialties have traditionally been leaders in elder care and will continue to play a critical role in addressing the challenges of geriatric healthcare in coming years. 

Diversity and Multiculturalism 

Another critical element involved in patient demographic shifts is diversity. In today’s healthcare system, the relationship between culture and health is central to delivering quality patient care. “Of the many factors that are known to determine health beliefs and behaviors, culture is the most influential,” according to the article "Many Faces: Addressing Diversity in Health Care," published in the Online Journal of Issues in Nursing. To meet the needs of culturally diverse patients, nurses and other healthcare providers must become both culturally competent and culturally aware. 

The National Student Nurses’ Association encourages nurses to provide customized, culturally specific care that fits with a patient’s values, beliefs, traditions, practices and lifestyle. The association promotes diversity awareness, which is defined as “an active, ongoing conscious process in which we recognize similarities and differences within and between various cultural groups.” Diversity awareness also involves cultural assessment and cultural sharing among healthcare professionals with the overall aim of understanding the complex definition of diversity, as based on the writings of Marianne R. Jeffreys, Ed.D., RN. According to Jeffreys, diversity can be based on: 

* Birthplace 

* Citizenship status 

* Reason for migration 

* Migration history 

* Religion 

* Ethnicity 

* Race 

* Language 

* Kinship and family networks 

* Educational background and opportunities 

* Employment skills and opportunities 

* Lifestyle 

* Gender 

* Socioeconomic status 

* Past discrimination and bias experiences 

* Health status and health risk 

* Age 

Though those are admittedly a lot of factors to keep in mind, ignoring diversity may lead to unequal nursing care and negative patient outcomes. Whether it is physical pain or emotional stress, patients could experience adverse physiological symptoms if their cultural needs are not taken into consideration. Under the Process of Cultural Competence in the Delivery of Healthcare Services Model, nurses are encouraged to use the following mnemonic, ASKED, when caring for any cultural group. 

Have I ASKED Myself the Right Questions? 

* Awareness: Am I aware of my personal biases and prejudices toward cultural groups different from mine? 

* Skill: Do I have the skill to conduct a cultural assessment and perform a culturally based physical assessment in a sensitive manner? 

* Knowledge: Do I have knowledge of the patient’s worldview? 

* Encounters: How many face-to-face encounters have I had with patients from diverse cultural backgrounds? 

* Desire: What is my genuine desire to “want to be” culturally competent? 

Looking Ahead: Nursing Education at Campbellsville University 

Providing high-quality nursing care to an aging, diverse population is no small task, but it is one of the most important responsibilities of nurses today. In a constantly changing society, nurses will continue to practice using traditional methods such as preventive care and holistic wellness; however, they will also be called on to provide leadership in navigating shifts in patient demographics. A wide variety of skills are required to manage the complex needs of different patient populations. The future of the healthcare delivery system relies on the ability of nurses to refine their practice and expand their core knowledge to address the challenges associated with caring for older adults and diverse cultures. 

You can gain the advanced skills you need with the online RN to BSN degree from Campbellsville University. With an experienced faculty providing real-world knowledge and understanding of nursing, Campbellsville’s program is the ideal opportunity to advance your nursing career.

Is Diversity & Inclusion important in your workplace or health system? Use this Free Cultural Check list to find out. 

As a medical professional, you are all too aware of the use of antibiotics and how effective they are for treating a myriad of infections. They have helped relieve countless maladies for people all over the world. We want to share this article with you and we welcome your thoughts and experiences about what’s happening regarding antibiotics not working for some of your patients.

In early April, experts at a military lab outside Washington intensified their search for evidence that a dangerous new biological threat had penetrated the nation’s borders.

They didn’t have to hunt long before they found it.

On May 18, a team working at the Walter Reed Army Institute of Research here had its first look at a sample of the bacterium Escherichia coli, taken from a 49-year-old woman in Pennsylvania. She had a urinary tract infection with a disconcerting knack for surviving the assaults of antibiotic medications. Her sample was one of six from across the country delivered to the lab of microbiologist Patrick McGann.

Within hours, a preliminary analysis deepened concern at the lab. Over the next several days, more sophisticated genetic sleuthing confirmed McGann’s worst fears.

There, in the bacterium’s DNA, was a gene dubbed mcr-1. Its presence made the pathogen impervious to the venerable antibiotic colistin.

"We’re seeing more drug-resistant infections. And people will die."

More ominously, the gene’s presence on a plasmid — a tiny mobile loop of DNA that can be readily snapped off and attached to other bacteria — suggested that it could readily jump to other E. coli bacteria, or to entirely different forms of disease-causing organisms. That would make them impervious to colistin as well.

It was a milestone public health officials have been anticipating for years. In a steady march, disease-causing microbes have evolved ways to evade the bulwark of medications used to treat bacterial infections. For a variety of those illnesses, only colistin continued to work every time. Now this last line of defense had been breached as well.

A second U.S. case of E. coli with the mcr-1 resistance gene was reported this week in the journal Antimicrobial Agents and Chemotherapy. Researchers are still working to determine whether it, or any of 18 other samples from around the world, contained the gene on an easy-to-spread plasmid.

Related Article: Kids Prescribed Antibiotics Twice As Often As Needed, Study Finds

Like this article? Click below to receive our FREE bi-weekly newsletter full of interesting articles like this one!

We know you are dedicated, kind, thoughtful, generous, patient, gracious and the list goes on-and-on about how wonderful Nurses are every day. We couldn’t get through our mental, physical and even spiritual problems without you by our sides. Here’s a story about a Nurse who went beyond the call of duty, as many of you do, in a very personal and life-giving way. Let us know your thoughts.

A young nurse recently saved the life of a total stranger by donating one of her kidneys.

In giving her kidney, Kate Burris, 27, Scottsdale, became the first altruistic kidney donor at Dignity Health St. Joseph's Hospital and Medical Center and part of a small, but growing number of people in the U.S. who give one of their kidneys to a stranger.

Jim Ensslin, 56, Peoria, received Burris' life-saving gift and was the 10th patient in St. Joseph's kidney transplant program, which received CMS accreditation in December.

"I just thought, I don't need this kidney. Somebody else does," Burris said.

After the March 22 surgery, Burris told Lisa Scharnow, RN, kidney transplant coordinator at St. Joseph's, that she wanted to meet the recipient of her kidney. Ensslin agreed, and the two met four days later, as Burris was leaving the hospital.

There was an "immediate connection," said Ensslin, who has lived with kidney disease for 17 years. "Kate's gift was the greatest gift ever. It will allow me to have a regular life, to keep going and not be sick the rest of my life."

Burris, too, was deeply touched by their meeting.

"I'm just so happy to see him doing well," she said. "It's not just him I'm helping. I'm helping his wife, his mom, his kids. I didn't realize how many people I was helping. It's an awesome feeling. I would donate again if I could."

Giving a kidney to a stranger was virtually unheard of 20 years ago when transplant centers worried about donors' motivation, emotional and mental health, and medical risks. Today, health care professionals realize that for some people donating a kidney gives the same kind of personal satisfaction that donating blood or giving to charity does.

In 2014, there were 17,107 kidney transplants in the United States, 11,570 from deceased donors and 5,537 from living donors, like Burris. Of the living donors, 181 designated their kidney to go to a stranger, 3.2 percent of all living donations that year, compared to 1.1 percent in 2001.

Burris, who is a nurse and a blood donor, said she first became interested in altruistic kidney donation while watching an old episode of Grey's Anatomy.

"As I was watching it, I wondered, 'Why couldn't I do this?'" After hours of research, Burris said, "I couldn't find any reason not to donate. The risks to me were so minimal that I felt the benefits outweighed the risks."

At St. Joseph's, Burris underwent a series of screenings to assess her physical, emotional and psychosocial health.

"We wanted to understand what was driving her desire to donate," said Scharnow. "We wanted to make sure she was in a good place to make such a profound decision."

Burris and Ensslin have both returned to work.

Ensslin, who said he has much more energy now, has multiple business trips scheduled in the next few weeks.

"Donors like Kate are important to the future of organ donation," said Dr. Jeffrey Brink, Ensslin's transplant surgeon. "There are far too few kidneys for the current need."

As a Nurse, you see miracles all the time. Here’s an interesting and happy story about the miracle of birth for identical twin sisters. Perhaps you’ve seen or heard something similar?

Twin sisters Sarah Mariuz and Leah Rodgers not only share the same birthday, but their kids do, too.

Mariuz and Rodgers, both 35, each gave birth last Thursday at the same time: 1:18 a.m.

According to Today.com, Rodgers’ baby boy, Reid Joseph, was born in Denver, Colorado, while Mariuz’ girl, Samantha Lynne, was born in La Jolla, California, which is one time zone behind, so the cousins were born an hour apart though both clocks read 1:18.

The sisters insist they didn’t plan to get pregnant at the same time. Instead, they surprised each other at Thanksgiving.

“I wanted it to be a surprise, but when she showed up at the door -– it was the funniest thing –- I opened the door, welcomed her into the home, but as soon as I saw her, I knew she was pregnant too,” Rodgers tells People.com. “I can’t explain it, I just knew. My prediction was that she was five days behind me, and it turned out her due date was four days after me.”

So far, neither sister has been been able to see her niece or nephew, but they aretrying to work out a time to visit each other, according to the Associated Press.

“We’ll definitely spend Christmas together,” Mariuz told Today.com.

Rodgers predicts the bond between cousins should be as strong as the one she shares with her sister.

“It’s a really cool thing to be able to share,” Rodgers told People.com “The adventure will only continue as our babies share the same birthday like we did! We can’t wait for them to grow up together.”

Related Articles: 

Conjoined Twins Plan Party After Reaching Landmark Age

Summer is all about fun! Everyone should enjoy their time over the next few months, but please take a minute to be aware and safe while youdo. Consider water, sun and mosquito safety as well as preventing injuries in all of your warm weather activities. Here’s some information to help you and your loved ones have the best summer ever!

Master water safety

Water-related activities are popular for getting physical activity and have many health benefits. Here are some tips to stay safe while having fun.

• Learn how to prevent recreational water illnessesand help protect yourself and your kids.
• Help kids get H2O Smartz about water safety.

Drownings are the leading cause of injury death for young children ages 1 to 4, and three children die every day as a result of drowning.

• Always supervise children when in or around water. A responsible adult should constantly watch young children.
• Teach kids to swim. Formal swimming lessons can protect young children from drowning.
• Learn cardiopulmonary resuscitation (CPR). Your CPR skills could save someone’s life.
• Install a four-sided fence around home pools.

Recreational boating can be a wonderful way to spend time with family and friends. Make boating safety a priority.

• Wear a properly fitted life jacket every time you and your loved ones are on the water.

Beat the heat and sun

Heat-related illness happens when the body’s temperature control system is overloaded. Infants and children up to 4 years of age are at greatest risk. Even young and healthy people can get sick from the heat if they participate in strenuous physical activities during hot weather. For heat-related illness, the best defense is prevention.

• Never leave infants, children, or pets in a parked car, even if the windows are cracked open.
• Dress infants and children in loose, lightweight, light-colored clothing.
• Schedule outdoor activities carefully, for morning and evening hours.
• Stay cool with cool showers or baths.
• Seek medical care immediate if your child has symptoms of heat-related illness.

Just a few serious sunburns can increase you and your child's risk of skin cancer later in life. Their skin needs protection from the sun's harmful ultraviolet (UV) rays whenever they're outdoors.

• Cover up. Clothing that covers your and your child's skin helps protect against UV rays.
• Use sunscreen with at least SPF (sun protection factor) 15 and UVA (ultraviolet A) and UVB (ultraviolet B) protection every time you and your child go outside.

Keep mosquitos and ticks from bugging you this summer

Protect yourself and your family by preventing bites and diseases, like Zika,  West Nile virus and Lyme disease, which can be transmitted by insects.

• Use an effective insect repellent while playing outdoors.
• Make your backyard a tick-safe zone.
• Check yourself and your children for ticks. Ticks are easy to remove.

Prevent Injuries

Each year in the United States, emergency departments treat more than 200,000 children ages 14 and younger for playground-related injuries. Falls at home and on the playground are a common cause of injury.

• Check to make sure that the surfaces under playground equipment are safe, soft, and well-maintained.
• Supervise young children at all times around fall hazards, such as stairs and playground equipment.
• Use stair gates, which can help keep a busy, active child from taking a dangerous tumble.

A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can occur in any sport or recreation activity.

• Learn concussion signs and symptoms and what to do if a concussion occurs.
• Make sure kids and teens wear the right protective equipment for their sport or recreation activity.

Parents can take many actions to protect their children's health and safety at home.

• Stay smart around the house by following tips on fire prevention, microwave use, and living with pets.
• Learn healthy home tips for each room in the house.

Young workers have high job injury rates. Hazards in the workplace, inexperience, and lack of safety training may increase injury risks for young workers.

• Know their rights, employer and teen worker responsibilities, and what teens under 18 can’t do.

Stop the violence

• Kids can use electronic media to embarrass, harass, or threaten their peers. Take steps to prevent electronic aggression, a term that captures all types of violence that occur electronically.
• As teens develop emotionally, they are heavily influenced by their relationship experiences, including teen dating. Protect your children from teen dating violence. Nearly one in 10 teens reports having been hit or physically hurt on purpose by a boyfriend or girlfriend at least once over a year’s time.

Children playing in sprinklers. A fun activity in the summer months. What could go wrong? Read on and find out.

An Arizona mother wants to warn other parents after her 9-month-old boy was accidentally sprayed with scalding hot water coming from the garden hose, causing second-degree burns to about 30 percent of his body.

Dominique Woodger said she was about to fill a little pool with water on Monday, as she normally does. When she turned on the faucet, the extremely hot water came out of the sprinkler head attached to the hose, getting all over her baby who was sitting on the ground.

"I thought he was crying because he was mad, because he hates when he gets sprayed in the face. I didn't think that it was burning him,” Woodger told ABC News.

Woodger said doctors say her baby will be okay, but she doesn't want other parents or children to experience the same pain.

"It's heartbreaking. It is. It sucks," Woodger said. "All of it was peeling. He had blisters all over the right side."

Parents, please remember to always touch the water from the hose before you spray it on your child.

Related Articles:  Practice safety around lakes, swimming pools

Ahhhh… don’t you love summer? On this 1^st day of summer, we think it’s wise to post this article about safety around water. Whether it’s a pool, the ocean, a lake, pond or any body of water, safety is a must. As a mother and lap swimmer, I had my son in the pool at our local Y when he was an infant. Swimming lessons followed soon after. It’s extremely important you know how to swim for safety reasons because you never know when you’ll be in a life or death situation around water. As a Nurse, you’ve unfortunately seen situations with tragic outcomes.

While many parents worry about their children’s safety around swimming pools, as they should and need to do, drowning incidents can also occur in natural bodies of water, says information from the U.S. Swim School Association.

Safety precautions need to be taken around all water environments. According to the Center for Disease Control, about half of all drowning incidents occur in natural water settings such as lakes, rivers or oceans. And, almost 75 percent of people killed in boating accidents die as a result of drowning.

As the summer boating season begins, there are steps parents can be taking to keep their children safer in the water. The U.S. Swim School Association has put together the following guidelines to help keep children safe while boating this summer.

• Make sure your children know how to properly wear a lifejacket. And always have children under 12 wear a life jacket at all times when boating or using personal watercraft.

• Personal floatation devices should always be U.S. Coast Guard approved. Never substitute water wings or other recreational type floating toys for an approved PFD.

• Create a water safety plan for your family and have water emergency drills with your children covering how to recognize the signs of someone struggling in water and what to do in this type of emergency.

• Teach your children the “throw don’t go” rescue method. Instead of entering the water to help a struggling person, teach your child to throw in a rope, reach with a stick, paddle or other object to pull the person in.

• If you take your kids on a shore excursion while boating, be aware of tides and currents and other risks the ocean or beach may have.

• Non-motorized boats can also pose a risk. If your family is canoeing or kayaking be sure your child is wearing a life jacket and knows what to do if the boat flips.

• If your child is playing near a natural body of water and accidentally falls in, teach your child to roll over on his or her back and float until help arrives if exiting the water is not an option.

• Never use floatation devices or water wings to keep your child safe in the water. Rely on your direct supervision.

Swimming lessons are a great addition to help keep your child safer while boating and around open water. For more information about swimming lessons and water safety and to find a Unites States Swim School Association member swim school near you, visit usswimschools.org.

Nurses at Brigham & Women’s Hospital in Boston are threatening a walk-out next Monday, June 27, 2016. The Massachusetts Nurses Union and management at the hospital have been in negotiations and cannot agree on their contract. What are your thoughts about it?

Brigham and Women’s Hospital and the union representing its registered nurses are at an impasse.

Negotiators from Brigham and the Massachusetts Nurses Association have met 20 times to hash out a new contract, but after the latest session on Friday, the dispute seemed only further from resolution.

The union has threatened a one-day strike on June 27, and patient care is likely to be disrupted as hospital leaders scale down operations and hire temporary replacement nurses. The hospital says nurses will be locked out for five days if they walk out.

“In response to what the union said was their greatest concern, we worked hard to develop a generous wage and benefit package for every one of our nurses, despite the tremendous financial pressure in healthcare,” Dr. Ron M. Walls, Brigham’s chief operating officer, said in a statement. “We are disappointed that the union rejected our most recent proposal.”

Brigham is owned by Partners HealthCare, the state’s largest health care provider network.

Union negotiators said in a statement that “nurses are prepared to strike unless Partners offers a fair settlement that values patients over profits… Every patient deserves safe care and every nurse deserves a fair wage and equal benefits.”

So, what’s preventing an agreement? As hospital and union leaders prepared to continue talks Monday, they shared details of their latest proposals with the Globe:

Wages

Brigham nurses receive 5 percent annual raises for their first 18 years on the job. The hospital proposed keeping those step raises and adding a new step at the top of the pay scale. Those at the top would receive a 4 percent increase, plus a $500 bonus, over three years, bringing pay for full-time nurses at the top of the scale to $148,616. The average Brigham nurse currently makes $106,000 a year. The hospital also offered $1.4 million in bonuses, but after the union rejected its offer, it directed that money to hiring temporary nurses to work in case of a strike.

The union also wanted to keep step raises in place and add a top step to the scale. But it wanted bigger raises than the hospital proposed: a 5 percent raise for nurses at the top of the scale, and an additional 4 percent increase for all nurses over two years.

Benefits

Brigham wants to place newly hired nurses into a “flex” insurance plan already offered to other Brigham and Partners employees. The hospital calls it a comprehensive plan with a wide range of options, which many union nurses have voluntarily selected in the past. Brigham officials said they offered to set a maximum employee premium contribution rate so they wouldn’t be able to increase what nurses pay without future negotiations.

But the union says the hospital is forcing newly hired nurses into “lesser benefits.” Officials say the hospital has already “lured” many nurses into its preferred insurance plan only to increase employee costs over time. They want new nurses to be able to choose from the same health insurance options that existing nurses have.

Staffing

The union says Brigham has been cutting nurse staffing in one unit of the hospital, where patients are recovering from major thoracic procedures, such as lung transplants. Union officials say the unit was historically staffed with 15 nurses at a time, and they want to keep staffing at that level.

Hospital officials maintain that staffing in that unit is “comparable to or better than similar units within the hospital and at other hospitals throughout the state.” They want to set staffing levels according to the number of patients in the unit at a given time, and how sick the patients are. On Friday, the hospital asked the union to agree to a plan for submitting complaints about staffing to senior nursing officials, but the union said this was “unacceptable” because nurses already complain when they have concerns about staffing and “nothing is done.”