DiversityNursing Blog

It seems like just yesterday everyone was pouring ice water on their heads to promote awareness for ALS. This silly challenge went viral and even celebrities joined in to raise money for the research foundation. Good news, it is paying off! 

ALS, or amyotrophic lateral sclerosis, is a progressive disease that attacks the nerve cells in the brain and spinal cord.

The average life expectancy after diagnosis is two to five years, and currently there is no cure.

Two years after the ALS ice bucket challenge rocked the internet, however, things might be about to change. 

A project called MinE at the University of Massachusetts Medical School has just discovered the gene that's responsible for ALS.

Until recently, one of the biggest obstacles to finding a cure for ALS had been not knowing what caused the disease. Now that researchers can pinpoint the gene (which is called NEK1), it will be that much easier to figure out how to reverse and/or treat its effects.

This incredible scientific breakthrough would not have been possible had MinE not received a $1,000,000 grant from the ALS Association/Ice Bucket Challenge. 

As such, it's only right that we pay tribute to the many people who sacrificed their dryness and dignity for the greater good.

Over 6,000 people are diagnosed with ALS each year in the United States alone. But this discovery puts us a big step closer finding a cure.

It's mostly thanks to a meme — a truth-or-dare type challenge that many at the time called pointless. This breakthrough, two years after the fact, just goes to show that virality does have power, power that, when harnessed in positive ways, can absolutely be used for the greater good.

Imagine working for 72 years! This exceptional South Dakota Nurses did it. Her colleagues and patients honored her with a lovely surprise ceremony. We think you’ll enjoy her story.

In a nursing career that started during World War II and spanned seven decades, Alice Graber, 93, always made sure one thing never changed.

"It's always a thrill when you can help somebody else,'' Graber said.

The great-grandmother from Freeman, South Dakota, found out just how many lives she touched over the years when she decided to retire from nursing after 72 years last month.

About 150 people from the town of 1,300 showed up to honor Graber in a ceremony earlier this month at the Salem Mennonite Home, an assisted living home where she was working when she retired.

"I didn't know what to think,'' Graber said. "I was just flabbergasted."

"She touched a lot of lives," Shirley Knodel, administrator and director of nursing at Salem Mennonite Home, said. "She smiled the whole time, even though it was overwhelming to her."

Graber was the oldest nurse in the state, according to Knodel. Everyone from people whom Graber helped deliver as babies to retired nurses who were trained by her when they began their careers showed up to celebrate her career.

"We realized one of the children she delivered was now 52, and his parents still remembered like it was yesterday,'' Graber's daughter, Sharon Waltner, 67, told us.

Graber's father died when she was 9 and her mother passed away when she was 14, leaving her and two younger siblings to be raised by an aunt and uncle.

"I didn't have a very good life growing up, but my mother always said, 'You've got to get an education,''' Graber said. "I felt that it was a gift that I got into nurse's training."

On the advice of an aunt, she moved from Colorado to Lincoln, Nebraska, where she graduated from nursing school in 1944. A year later, she moved to South Dakota with her late husband, Wilbert "Jim" Graber, who died in 2006.

The couple raised two children together, and Graber now has seven grandchildren and five great-grandchildren.

"My brother and I were always annoyed when the phone would ring and they would call her to come in and help at the hospital, but now that we're much older, we're very proud of her that she has been so persistent to pursue a career in health care,'' Waltner said. "What she does makes a difference in people's lives."

Graber worked at four different hospitals in South Dakota during her career, most recently working in assisted living and nursing homes. In recent years, she has been older than the majority of the residents.

She taught us a respect in putting the patient first, which is always what you want,'' said Knodel, who was trained by Graber.

Despite retiring, Graber remains as active as ever. She still helps feed residents at Salem Mennonite Home multiple nights per week and volunteers for several organizations in town. She also walks six blocks each way from her apartment to the Salem Mennonite Home.

"As a daughter, I'm sorry I did not inherit the Energizer bunny battery she has,'' Waltner said. "I joked that if she just worked in assisted living for a few more years, perhaps she could take care of me when I was admitted."

Related Article: Nurses Surprise 90-Year-Old Nurse For Birthday [VIDEO]

Are you wearing a Fitbit or another devise that tracks your daily steps, sleep and other information? Have you ever wondered who else might have access to your data? I’ve been wearing a Fitbit for close to 2 years and I love it, but I never thought about my privacy regarding the information it tracks and who else might have access to details like my weight, height, age and how physically active I am. Should these devices adhere to HIPAA protections? Do you care? Please share your thoughts with us.

The federal patient privacy law known as HIPAA has not kept pace with wearable fitness trackers, mobile health apps and online patient communities, leaving a gaping hole in regulations that needs to be filled, according to a much-delayed government report released today.

The report, which was supposed to be complete in 2010, does not include specific recommendations for fixing the problem, even though Congress asked the U.S. Department of Health and Human Services to provide them.

HHS’ findings largely mirror those in a ProPublica story from last November. The Health Insurance Portability and Accountability Act, the landmark 1996 patient-privacy law, only covers patient information kept by health providers, insurers and data clearinghouses, as well as their business partners. Falling outside the law’s purview: wearables like Fitbit that measure steps and sleep, at-home paternity tests, social media sites, and online repositories where individuals can store their health records.

“Health privacy and security law experts have a reasonably clear idea of where HIPAA protections end, but the layperson likely does not,” said the report written by HHS’ Office of the National Coordinator for Health Information Technology, in conjunction with other agencies. “Moreover, even entrepreneurs, particularly those outside the health care industry … may not have a clear understanding of where HIPAA oversight begins and ends.”

The report was mandated under a 2009 law that called on HHS to work with the Federal Trade Commission — which targets unfair business practices and identity theft — and to submit recommendations to Congress within a year on how to deal with entities handling health information that fall outside of HIPAA. Asked why the report did not include any recommendations, an official said readers could draw their own conclusions from the findings.

“At the end of the day, it’s a very complicated environment that we find ourselves in,” said Lucia Savage, chief privacy officer at the Office of the National Coordinator for Health Information Technology, which took the lead on the report. “We believe we’re fulfilling our duties. If Congress has concerns about that, I’m sure that we will hear about them.”

In 2013, the Privacy Rights Clearinghouse studied 43 free and paid health and fitness apps. The group found that some did not provide a link to a privacy policy and that many with a policy did not accurately describe how the apps transmitted information. For instance, many apps connected to third-party websites without users’ knowledge and sent data in unencrypted ways that potentially exposed personal information.

Paul Stephens, the group’s director of policy and advocacy, said the issue has grown more urgent in recent years as employers give workers incentives to log their activities on mobile apps as part of wellness programs. “It goes beyond someone voluntarily saying I want this app,” Stephens said. “There are basically going to be financial incentives to use the app.”

Stephens also said many people do not read an app’s privacy policy, leaving them open to having their information used in myriad ways.

The new report pointed to a number of major differences between information covered by HIPAA — your medical records, for instance — and data that’s not. Among them:

• Under HIPAA, patients are entitled to copies of their health records. Companies that make trackers and apps “are not obligated by a statute or regulation to provide individuals with access to data about themselves.”
• HIPAA delineates to whom and for what purpose a health provider may share a patient’s health information and limits the use of personal health information for marketing. People who have provided information to companies that fall outside the law “likely will not enjoy the same protections against unwanted marketing unless the data collector has promised in its terms of use not to use data for marketing and does not change its terms of use.”
• HIPAA rules require tight security over personal health information. Apps and wearables may not have the same protections.
• HIPAA requires understandable privacy policies and notices. Outside the law, those may not exist.

In addition, several federal agencies have a role in regulating privacy, new technology and consumer protections. The HHS Office for Civil Rights enforces HIPAA; the FTC acts against deceptive or unfair trade practices; and the Office of the National Coordinator encourages adoption of health information technology.

A 2014 study looked at 600 of the most commonly used health apps and found that fewer than a third had privacy policies. And for those that did, you’d have to have the reading level of a college senior to understand them, the HHS report said. Policies on Apple and Google mobile phone platforms “may be inconsistent, not articulated to individuals, or simply ignored by web developers skirting the rules that operating system developers attempt to impose on them.”

Attempts to fix the problem through voluntary efforts do not appear to be working. In 2015, the Consumer Electronics Association issued a set of “Guiding Principles on the Privacy and Security of Personal Wellness Data.”

“These guidelines can be adopted by companies, but are not required of CEA members,” today’s report said. “As of July 2016, we have been unable to identify any companies that have adopted the guidelines.”

The report offers no suggestions to change that, either.

Related Article: How Health Apps Will Change Nursing

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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

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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.