DiversityNursing Blog

Heather Stringer

In 2010, the Institute of Medicine issued eight recommendations that dared to transform the nursing profession by 2020. This year marks the midway point for reaching the goals outlined in the report “The Future of Nursing: Leading Change, Advancing Health,” and statistics at halftime offer a glimpse into nursing’s progress so far.

Although the numbers in some areas have altered little in the first few years, infrastructure changes have been set in motion that will lead to more noticeable improvements in the data in the next several years, said Susan Hassmiller, PhD, RN, FAAN, the Robert Wood Johnson Foundation senior adviser for nursing. The RWJF partnered with the IOM to produce the report. 

“I am a very impatient person and would like things to move faster, but we have to remember that we are changing social norms with these goals,” Hassmiller said. “We are trying, for example, to convince hospital leaders, nursing students and educational institutions that it is important for nurses to have a baccalaureate degree, and that takes time.”

Hassmiller is referring to Recommendation 4 of the report, which calls academic nurse leaders across all schools of nursing to work together to increase the proportion of nurses with a baccalaureate degree from 50% to 80% by 2020. The most recent data collected from the American Community Survey by the Future of Nursing: Campaign for Action found that the percentage of employed nurses with a bachelor’s degree or higher only climbed 2% between 2010 and 2013. However, Hassmiller suggested the percentage is likely to increase rapidly in coming years because nursing schools have increased capacity to accommodate more students. As a result, the number of nurses enrolled in RN-to-BSN programs skyrocketed between 2010 and 2014, from about 77,000 nurses in 2010 to 130,300 students in 2014, according to the American Association of Colleges of Nursing — a 69% increase. 

New education models

Campaign for Action leaders also are optimistic about the profession’s ability to approach the 80% goal because nursing schools are beginning to experiment with new models of education, such as bringing BSN programs to community colleges. 

Traditionally, students spend at least three years in a community college earning an associate’s degree to become an RN — at least a year for prerequisites and another two to complete the nursing program, Hassmiller said. These RNs may work for a few years before returning to school to earn a BSN — and some may not return at all, said Jenny Landen, MSN, RN, FNP-BC, dean of the School of Health, Math and Sciences at Santa Fe Community College in New Mexico. To avoid losing potential BSN students, leaders from New Mexico’s university and community colleges began meeting to discuss a new paradigm: students who were dually enrolled in a community college and a university BSN program. 

The educators started by forming a common statewide baccalaureate curriculum that would be used by all community colleges and universities, Landen said. The educators also discussed how to pool resources, such as offering university courses online at local community colleges. “This opens the opportunity of earning a BSN to people who need to stay in their communities during school,” she said. “They may have family commitments locally, and they can take the baccalaureate degree courses at the community college tuition fee, which is much less expensive.”

Four community colleges in New Mexico have launched dual enrollment programs within the last year. At Santa Fe Community College, there are far more applicants than the program can hold, Landen said. Community colleges and universities in other parts of the country also are working together to create programs in which nursing students can be dually enrolled. In addition to nursing schools buying into the need for more BSN-prepared nurses, there also is evidence that employers are moving toward this new standard as well. According to a study released in February in the Journal of Nursing Administration, the percentage of institutions requiring a BSN when hiring new RNs jumped from 9% to 19% between 2011 and 2013. 

Beyond the BSN

So far, the national data related to Recommendation 5 — double the number of nurses with a doctorate by 2020 — suggests there have been minimal changes in the number of employed nurses with a doctorate, yet there has been a significant increase in the number of students pursuing this level of education. According to the JONA article, on average about 3.1% of employed nurses in all institutions had a doctorate in 2011. This rose to 3.6% in 2013. This percentage likely will increase in the coming years because of the proliferation of doctor of nursing practice programs since 2010. These programs are geared for advanced practice RNs who are interested in returning to the clinical setting after earning a doctoral degree. Between 2010 and 2013, the number of students enrolled in DNP programs doubled from just over 7,000 students to more than 14,600. There was a lesser increase in the number of students enrolled in PhD programs, up 12% from 4,600 to 5,100, according to the AACN. 

“When the DNP degree became an option, it opened the opportunity of a higher level of education to the working nurse, not the researcher, and that was attractive to many nurses,” said Pat Polansky, MS, RN, director of program development and implementation at the Center to Champion Nursing in America. “Getting a research-based PhD takes longer and not every nurse can do that, so the DNP has become a wonderful option.”

Leaders at the Campaign for Action, however, acknowledge that it is important to find strategies to boost the number of PhD-prepared nurses because the profession needs those nurses in academia and other administrative, research or entrepreneurial roles where they are contributing to the solutions of a transformed healthcare system, Hassmiller said. To encourage more nurses to pursue the path of a PhD, in 2014 the RWJF launched the Future of Nursing Scholars Program, which awards $75,000 per scholar pursuing a PhD. This is matched with $50,000 by the student’s school, and the funds can be used over the course of three years. 

Forging ahead

In December, the nursing profession will have another opportunity to assess progress on the recommendations when the IOM releases findings from a study that is under way to assess the national impact of the Future of Nursing report. The changes happening in areas such as education are remarkable, Hassmiller said, and she is eagerly anticipating the results from the current IOM study. 

“I would never modify the goals because you need something to strive for in order to affect change,” Hassmiller said. “I am extremely encouraged because we have never seen anything like this. For the first time in history, more than half of nurses have a bachelor’s degree, and it is going to keep climbing. The most challenging part has been the number of people that need to be influenced to make the business case as to why it is important, and it is finally happening.” 

Key recommendations from “The Future of Nursing: Leading Change, Advancing Health”

1) Remove scope-of-practice barriers.
2) Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. 
3) Implement nurse residency programs.
4) Increase the proportion of nurses with a baccalaureate degree to 80% by 2020. 
5) Double the number of nurses with a doctorate by 2020.
6) Ensure that nurses engage in lifelong learning.
7) Prepare and enable nurses to lead change to advance health. 
8) Build an infrastructure for the collection and analysis of interprofessional healthcare workforce data.

Source: http://news.nurse.com

By Jen Christensen and Elizabeth Cohen

A young Liberian woman who saved three of her relatives by nursing them back to health after they contracted the Ebola virus is coming to the United States to finish her nursing degree.

The news comes as Time magazine announced Wednesday that its "Person of the Year" honors go to the Ebola fighters, the "unprecedented numbers" of doctors and nurses who responded when Ebola overtook an already-weak public health infrastructure this year in West Africa.

Fatu Kekula is not named in the article, but she definitely holds a place among those being honored.

The 22-year-old, who was in her final year of nursing school earlier this year, single-handedly took care of her father, mother, sister and cousin when they became ill with Ebola beginning in July.

And she did so with remarkable success. Three out of her four patients survived. That's a 25% death rate -- considerably better than the estimated Ebola death rate of 70%.

Kekula stayed healthy, which is noteworthy considering that hundreds of health care workers have become infected with Ebola, and she didn't even have personal protection equipment -- those white space suits and goggles used in Ebola treatment units.

Instead, Kekula invented her own equipment. International aid workers heard about her "trash bag method" and taught it to other West Africans who can't get into hospitals and don't have protective gear of their own.

Every day, several times a day for about two weeks, Kekula put trash bags over her socks and tied them in a knot over her calves. Then she put on a pair of rubber boots and then another set of trash bags over the boots.

She wrapped her hair in a pair of stockings and over that a trash bag. Next she donned a raincoat and four pairs of gloves on each hand, followed by a mask.

It was an arduous and time-consuming process, but she was religious about it, never cutting corners.

UNICEF Spokeswoman Sarah Crowe said Kekula is amazing.

"Essentially this is a tale of how communities are doing things for themselves," Crowe said. "Our approach is to listen and work with communities and help them do the best they can with what they have."

She emphasized, of course, that it would be better for patients to be in real hospitals with doctors and nurses in protective gear -- it's just that those things aren't available to many West Africans.

No one knows that better than Kekula.

Her Ebola nightmare started July 27, when her father, Moses, had a spike in blood pressure. She took him to a hospital in their home city of Kakata.

A bed was free because a patient had just passed away. What no one realized at the time was that the patient had died of Ebola.

Moses, 52, developed a fever, vomiting and diarrhea. Then the hospital closed down because nurses started dying of Ebola.

Kekula took her father to Monrovia, the capital city, about a 90-minute drive via difficult roads. Three hospitals turned him away because they were full.

She took him back to another hospital in Kakata. They said he had typhoid fever and did little for him, so Kekula took him home, where he infected three other family members: Kekula's mother, Victoria, 57; Kekula's sister, Vivian, 28, and their 14-year-old cousin who was living with them, Alfred Winnie.

While operating her one-woman Ebola hospital for two weeks, Kekula consulted with their family doctor, who would talk to her on the phone, but wouldn't come to the house. She gave them medicines she obtained from the local clinic and fluids through intravenous lines that she started.

At times, her patients' blood pressure plummeted so low she feared they would die.

"I cried many times," she said. "I said 'God, you want to tell me I'm going to lose my entire family?' "

But her father, mother, and sister rallied and were well on their way to recovery when space became available at JFK Medical Center on August 17. Alfred never recovered, though, and passed away at the hospital the next day.

"I'm very, very proud," Kekula's father said. "She saved my life through the almighty God."

Her father immediately began working to find a scholarship for Kekula, so she could finish her final year of nursing school. But the Ebola epidemic shut down many of Liberia's schools, including hers.

After a story about Kekula ran on CNN in September, many people wanted to help her.

A non-profit group called iamprojects.org also got involved.

With some help, Kekula applied to Emory University in Atlanta, the campus with the hospital that has successfully cared for American Ebola patients. Emory accepted the young woman so that she could complete her nursing degree starting this winter semester.

In order to attend, iamprojects will have to raise $40,000 to pay for her reduced tuition rate, living expenses, books and her travel and visa so that she can travel between Africa and the United States.

Kekula's father has no doubt that his daughter will go on to save many more people during her lifetime.

"I'm sure she'll be a great giant of Liberia," he said.

Source: www.cnn.com

By Nurse.com

This fall, Duquesne University in Pittsburgh will become the first academic institution in the U.S. and globally to offer a dual degree in nursing and biomedical engineering for undergraduate students, according to a news release.

“Duquesne has pioneered the integration of clinical knowledge and patient care with engineering techniques in a single program, creating the first bachelor’s degree of its kind,” Provost Timothy Austin, PhD, said in the release.

The five-year program will provide students with a foundational body of knowledge that keeps patient care and practical application at the core of studies supporting innovations and technological advances.

The joint degree could prove a tremendous value to employers and patients, said John Viator, PhD, director of Duquesne’s biomedical engineering program. 

By gaining actual clinical experience, students also will develop new perspectives with respect to a patient’s health and functional needs. “Engineers do not always fully appreciate the hospital culture and the clinical needs of patients,” Mary Ellen Glasgow, RN, PhD, FAAN, dean and professor of the School of Nursing, said in the release. “This dual degree gives our students both the engineering and nursing perspectives to solve real world clinical problems.” 

In addition to learning engineering and nursing, students will benefit from class and clinical experiences that incorporate the Toyota Production System principles (used to address safety, cost and efficiency) and the American Association of Critical Care Nurses’ Synergy Model. 

Job opportunities for biomedical engineers are expected to grow 27% between 2012 and 2022, and nursing careers are expected to expand by 19% in the same timeframe, according to statistics from the Bureau of Labor Statistics. With the combined knowledge and skills of the two disciplines, opportunities may be limitless for the “nurse engineer,” Viator and Glasgow predict.

“Our students will begin their careers with the preparation, knowledge and worldview usually seen in those with years of experience in the field,” Austin said in the release. “This exciting BME/BSN partnership illustrates Duquesne’s innovative academic programs and the university’s focus on preparing students with the knowledge and skills to serve others.” 

Source: nurse.com

Nurses earn a mean annual wage of $67,930, according to the Bureau of Labor Statistics, and
the demand for compassionate and skillful nurses is expected to grow by 26 percent between 2010 and 2020. The journey to become a nurse requires a bachelor's degree or an associate's degree, which means two to four years in the classroom as well as clinical experience in a hospital or clinical setting.

If you are a busy mom already juggling kids and work, finding the time to complete a nursing degree may seem impossible, but the wide selection of online Nursing programs available and the recent expansions in learning technologies are making this career path more feasible.

Online Degrees

There are online programs available that allow students to study both the science and art of nursing. In addition to covering diagnoses, anatomy, drugs, and other science-based topics, aspiring nurses can also learn interpersonal skills like how to be sensitive to patients and their families. These programs appeal to busy people who don't have the time to attend classes during conventional hours, but they are often used by nurses who are ready to take their career to the next level as well.

Masters in Nursing

Nurse practitioners armed with masters degrees can diagnose, treat, and manage a number of diseases and conditions, according to the National Library of Medicine. Nurse practitioners work in cardiology, women's health, or other areas of health care, and they usually earn more and have more responsibilities than their nursing peers. Some nurses even use their master's degree as a launchpad into the administration side of healthcare.

Simulation

Thanks to simulations, many student nurses can now bypass the requirement to shadow professional nurses. This makes pursuing a nursing degree easier for students who are juggling multiple responsibilities or nurses who live in remote areas with few shadowing opportunities.

Advance Healthcare Network reports that nurses can simulate oxygen delivery, work with infusion pumps, and practice other procedures in simulation learning centers. In addition to making learning more flexible for students, simulations also give nurses the chance to think more critically in a safe environment. Students can take a few moments to be extra thoughtful about a situation, without the pressure of worrying that they may lose a real patient with the wrong decision.

Apps Lighten the Load

With your bag already packed to the brim with sippy cups, extra clothing, and other kid-related supplies, you probably don't even have the energy or the strength to haul a massive bag of nursing textbooks around with you. Luckily, there are a host of apps, designed to lighten the load for nursing students.

Apps like Nursing Central have copies of essential reference books like Davis' Drug Guide, selected MEDLINE journals, Taber's Medical Dictionary, and others on them. Essentials for busy students, these apps also prepare aspiring nurses for the use of apps professionally. Recent studies indicate that 90 percent of healthcare professionals avoid misdiagnoses and prescription mishaps when they double check things with apps, according to Medlineplus. Studies like these prove that much of the technology that can help busy people to get nursing degrees will soon be popping up in professional settings as well.

Adrian Espinosa is part of a still extremely small but growing trend in nursing. He’s a man.

Espinosa, now a student at the University of San Francisco School of Nursing, said he quickly became aware that he is a man in a field that continues to be dominated by women.

“From the first day I started nursing school last year, as one of seven males in a class of 77, I realized that I would have to find my fit in a predominately female profession,” Espinosa said. His goal is to become a nurse practitioner “to fulfill a huge gap in primary care for under-represented populations.”

 In a 2012 essay written for the American Assembly for Men in Nursing Scholarship, Espinosa said his route to his chosen career was anything but direct.

“My journey into nursing wasn’t immediate, but my path was illuminated when I began working in community public health,” Espinosa wrote. “Watching nurses and nurse practitioners work with diverse populations inspired me to pursue the nursing culture in the hope of providing accessible care for marginalized communities.

 The nursing community knows it needs more people like Espinosa in its ranks and it is working hard to increasing nurse diversity.

According to the American Association of Colleges of Nursing, in 2008, there were 3,063,163 licensed registered nurses in the United States. Only 6.6% of those were men and 16.8% were non-Caucasian. Despite efforts from nursing schools across the nation to recruit and retain more men and minorities, the results have been fairly modest.  In 2010, approximately 11% of the students in BSN programs were men and 26.8% were a racial/ethnic minority.

Click HERE to Register now to earn your nursing degree online in as little as 15 months.
$6,000 scholarships are now being awarded, along with Apple iPads and free textbooks to enhance the learning experience.

This is one reason why the University of Mary in Bismarck, ND prides itself on  providing "a nursing education for leadership and moral courage" and places an emphasis on diversity.

“U-Mary is a community of learners that recognizes and respects diversity and the richness it brings to the college experience,” according the catalog of the private, Catholic university that offers degree completion and advanced nursing degrees online and on campus.

University of Mary prides itself as “community that fosters diversity through hospitality and dialogue so as to learn to live in an interconnected world.”

Why are more men and people of color needed in today’s nursing ranks? To help meet the medical and personal needs of the United States’ increasingly diverse patient population that is adding varied ethnic, racial and cultural traditions to the country. Patient stories such as these from the University of California, San Francisco are good examples.

• Selena Martinez was diagnosed with Lynch Syndrome, a genetic disease that can lead to a wide-range of cancers. It wasn't until 2008 that the Martinez family, which in just 16 years had 13 cancer diagnoses among nine people, received a conclusive diagnosis of Lynch Syndrome.
• Simone Chou, was in her last year at the University of California, Berkeley when she learned she had lupus and that her immune system was attacking her kidneys. After nine years of treatment failed to slow the deterioration, Chou and her doctors launched a nationwide search to find a compatible kidney donor. They didn’t have far to look. Michael Wong, a college friend, stepped up. Wong, a practicing Buddhist, had read many stories about Buddhist saints who donated their body parts to other people. "When I first heard Simone talk about needing a kidney transplant, I remembered those stories."
• Doris Ward is one of the pioneering African-American politicians in the San Francisco Bay Area. She started her career as a trustee of the San Francisco Community College District, became a County Supervisor in 1980, President of the Board of Supervisors in 1990 and finally moved on to spend the last 10 years as the San Francisco County Assessor. She is also a breast cancer survivor. Ward now helps other African-American women through their own journey with cancer by sending them information and helping them understand their options.

“Nursing’s leaders recognize a strong connection between a culturally diverse nursing workforce and the ability to provide quality, culturally competent patient care,” according to a policy statement by the American Association of Colleges of Nursing.

 “Though nursing has made great strides in recruiting and graduating nurses that mirror the patient population, more must be done before adequate representation becomes a reality,” the association statement added.

The University of Mary is ready to help ensure that the nursing ranks reflect the diversity of our nation. For a welcoming environment, online or on campus, to get your advanced practice nursing degree, contact the University of Mary.

This table shows the number of students enrolled in generic (entry-level) Baccalaureate, Master's, and Doctoral (research-focused) programs in nursing from 2002 to 2011.

Credit