DiversityNursing Blog

By Catharine Paddock PhD

At present, diagnosis of lung cancer relies on an invasive biopsy that is only effective after tumors are bigger than 3 cm or even metastatic. Earlier detection would vastly improve patients' chances of survival. Now a team of researchers is developing a "lab-on-a-chip" that promises to detect lung cancer - and possibly other deadly cancers - much earlier, using only a small drop of a patient's blood.

In the Royal Society of Chemistry journal, Yong Zeng, assistant professor of chemistry at the University of Kansas, and colleagues report a breakthrough study describing their invention.

For some time, scientists have been excited by the idea of testing for disease biomarkers in "exosomes" - tiny vesicles or bags of molecules that cells, including cancer cells - release now and again. When they first spotted them, researchers thought exosomes were just for getting rid of cell waste, but now they know they also do other important things such as carry messages to other cells near and far.

The challenge, however, is developing a technology that is small enough to target and analyze the contents of exosomes - mostly nucleic acids and proteins - to find unique biomarkers of disease. This is because exosomes are tiny - around 30 to 150 nanometers (nm) in diameter - much smaller, for example, than red blood cells.

Current methods for separating out and testing exosomes require several steps of ultracentrifugation - a lengthy and inefficient lab procedure, as Prof. Zeng explains:

"There aren't many technologies out there that are suitable for efficient isolation and sensitive molecular profiling of exosomes. First, current exosome isolation protocols are time-consuming and difficult to standardize. Second, conventional downstream analyses on collected exosomes are slow and require large samples, which is a key setback in clinical development of exosomal biomarkers."

Now, using microfluid technology, he and his colleagues have developed a lab-on-a-chip that can analyze the contents of targeted exosomes and spot the early signs of deadly cancer. They have already successfully tested it on lung cancer.

Lab-on-a-chip device uses smaller samples, is faster, cheaper and more sensitive

The new device, which uses much smaller samples, promises to produce results faster, more cheaply, with better sensitivity compared to conventional benchtop instruments, as Prof. Zeng continues to explain:

"A lab-on-a-chip shrinks the pipettes, test tubes and analysis instruments of a modern chemistry lab onto a microchip-sized wafer."

The technology behind the device - known as microfluidics - came out of new semiconductor electronics and has been under intensive development since the 1990s, he adds:

"Essentially, it allows precise manipulation of minuscule fluid volumes down to one trillionth of a liter or less to carry out multiple laboratory functions, such as sample purification, running of chemical and biological reactions, and analytical measurement."

Unlike breast and colon cancer, there is no widely accepted screening tool for lung cancer, which in most cases is first diagnosed based on symptoms that normally indicate lung function is already impaired.

To diagnose lung cancer, doctors have to perform a biopsy - remove a piece of tissue from the lung and send it to a lab for molecular analysis. It is rarely possible to do this in the early stages as tumors are too small to be spotted on scans.

"In contrast, our blood-based test is minimally invasive, inexpensive, and more sensitive, thus suitable for large population screening to detect early-stage tumors," says Prof. Zeng, adding that the technique offers a general platform for detecting exosomes from cancer cells. The team has already used the device to test for ovarian cancer, and in theory, says Prof. Zeng, it should also be applicable to other cancer types.

"Our long-term goal is to translate this technology into clinical investigation of the pathological implication of exosomes in tumor development. Such knowledge would help develop better predictive biomarkers and more efficient targeted therapy to improve the clinical outcome," he adds.

The team has received further funding from the National Cancer Institute at the National Institutes of Health to further develop the lab-on-a-chip.

In March 2013, Medical News Today learned how another team of scientists is developing a lab-on-a-chip that is implanted under the skin to track levels of substances in the blood and transmit the results wirelessly to a smartphone or other receiving device.

Source: www.medicalnewstoday.com

By Marie Ellis

Imagine swallowing a pill with tiny needles instead of getting an injection. Then again, imagine swallowing a pill with tiny needles. It may sound painful, but according to the researchers who developed the novel capsule - which could replace painful injections - there are no harmful side effects.

The researchers, from the Massachusetts Institute of Technology (MIT) and Massachusetts General Hospital (MGH), have published the results of their study - which tested the microneedle pill in the gastrointestinal (GI) tracts of pigs - in the Journal of Pharmaceutical Sciences.

Though most of us would probably prefer swallowing a pill over having an injection, many drugs cannot be given in pill form because they are broken down in the stomach before being absorbed.

Biopharmaceuticals made from large proteins, such as antibodies - known as "biologics" - are used to treat cancer, arthritis and Crohn's disease, and also include vaccines, recombinant DNA and RNA.

"The large size of these biologic drugs makes them nonabsorbable," explains lead author MIT graduate student Carl Schoellhammer. "And before they even would be absorbed, they're degraded in your GI tract by acids and enzymes that just eat up the molecules and make them inactive."

In an effort to design a capsule that is capable of delivering a wide range of drugs - while preventing degradation and effectively injecting the medicine into the GI tract - Schoellhammer and colleagues constructed the capsule from acrylic, including a reservoir for the drug that is coated with hollow, 5 mm long needles made of stainless steel.

The capsule measures 2 cm long and 1 cm in diameter.

Needle capsule worked safely and effectively in pigs

The team notes that previous studies involving humans who have accidentally swallowed sharp objects have suggested swallowing a capsule coated with short needles could be safe. They explain that there are no pain receptors in the GI tract and that, as a result, patients would not feel any pain.

But to assess whether their capsule could safely and effectively deliver the drugs, the researchers tested the pill in pigs, using insulin in the drug reservoir.

The capsules took more than a week to move through the whole digestive tract, and there were no traces of tissue damage, the researchers say. Additionally, the microneedles effectively injected insulin into the lining of the pigs' stomachs, small intestines and colons, which resulted in their blood glucose levels dropping.

Co-lead author Giovanni Traverso, a research fellow at MIT's Koch Institute for Integrative Cancer Research and gastroenterologist at MGH, notes that the pigs' reduction in blood glucose was faster and larger than the drop observed from insulin injection.

"The kinetics are much better and much faster-onset than those seen with traditional under-the-skin administration," he says. "For molecules that are particularly difficult to absorb, this would be a way of actually administering them at much higher efficiency."

'Oral delivery of drugs is a major challenge'

Though they used insulin for their tests in pigs, the researchers say they envision their capsule being used to deliver biologics to humans.

"This could be a way that the patient can circumvent the need to have an infusion or subcutaneous administration of a drug," says Traverso.

Prof. Samir Mitragotri, a professor at the University of California-Santa Barbara - who was not involved in the research - says:


"This is a very interesting approach. Oral delivery of drugs is a major challenge, especially for protein drugs. There is tremendous motivation on various fronts for finding other ways to deliver drugs without using the standard needle and syringe."

In terms of future modifications, the team plans to alter the capsule so that contractions of the digestive tract slowly squeeze the drug out of the capsule as it travels through the body, and they also want to make the needles out of degradable polymers and sugar that break off, becoming embedded in the gut lining and slowly disintegrating.

Source: http://www.medicalnewstoday.com

By LAWRENCE K. ALTMAN

A British-American scientist and a pair of Norwegian researchers were awarded this year’s Nobel Prize in Physiology or Medicine on Monday for discovering “an inner GPS, in the brain,” that makes navigation possible for virtually all creatures.

John O’Keefe, 75, a British-American scientist, will share half of the prize of 8 million kronor, or $1.1 million, in what is considered the most prestigious scientific award. May-Britt Moser, 51, and Edvard I. Moser, 52, who are married, will share the other half, said the Karolinska Institute in Sweden, which chooses the laureates.

The three scientists’ discoveries “have solved a problem that has occupied philosophers and scientists for centuries — how does the brain create a map of the space surrounding us and how can we navigate our way through a complex environment,” the institute said in a news release.

The positioning system in the brain that they discovered helps us know where we are, find our way from place to place and store the information for the next time, said Goran K. Hansson, secretary of the Karolinska’s Nobel Committee, in announcing the laureates.

The researchers documented that certain cells are responsible for higher cognitive function that steers the navigational system, the committee said.

Dr. O’Keefe began using neurophysiological methods in the late 1960s to study how the brain controls behavior. In 1971 he discovered the first component of the inner navigational system in rats. He identified nerve cells in the hippocampus region of the brain that were always activated when a rat was at a certain location. He called them “place cells” and showed that the cells registered not only what they saw, but also what they did not see, by building up inner maps in different environments.

Dr. O’Keefe was born in New York City and graduated from the City College of New York. He earned a Ph.D. in physiological psychology at McGill University in Montreal, in 1967, and moved for postdoctoral training to University College London, where he remains. He is a professor of cognitive neuroscience.

In 2005, the Mosers discovered a second crucial component of the brain’s positioning system by identifying another type of nerve cell that permits coordination and positioning. The scientists, who work at the Norwegian University of Science and Technology in Trondheim, called the cells grid cells. While mapping connections to the hippocampus in rats moving about a room in a laboratory, “they discovered an astonishing pattern of activity in a nearby part of the brain called the entorhinal cortex,” the Nobel committee said.

When the rat passed multiple locations, the cells formed a hexagonal grid. Each cell activated in unique spatial patterns. Their research showed “how both ‘place’ and ‘grid’ cells make it possible to determine position and to navigate,” the committee said.

The Mosers grew up in rural Norway and came from nonacademic families. May-Britt was born in Fosnavag and Edvard in Alesund. Although they went to the same high school, they did not know each other well until they were undergraduates at the University of Oslo. They married while they were college students and have two daughters. Both are professors at the university in Trondheim.

At one point they were visiting scientists at University College London, studying under Dr. O’Keefe.

The three also won Columbia University’s Louisa Gross Horwitz Prize last year for their discoveries.

Only a handful of married couples have shared a Nobel Prize, and the Mosers are only the second in the medicine category, which has been awarded since 1901. Fewer than a dozen women have been named laureates in medicine.

Evidence that place and grid cells exist in humans comes from recent studies using brain imaging techniques and from patients who have undergone neurosurgery.

The laureates’ findings may eventually lead to a better understanding of the spatial losses that occur in Alzheimer’s and other neurological diseases. The hippocampus and entorhinal cortex are often damaged in early stages of Alzheimer’s, with affected individuals’ losing their way and failing to recognize the environment. The findings also open new avenues for understanding cognitive processes like memory, thinking and planning, the Nobel Committee said.

According to The Associated Press, May-Britt Moser said the couple was elated. “This is such a great honor for all of us and all the people who have worked with us and supported us,” she said in a telephone interview with The A.P. “We are going to continue and hopefully do even more groundbreaking work in the future.”

Her husband was flying when the prize was announced, she said, and he later told the Norwegian news agency NTB that he learned about it when he landed and turned on his cellphone, to a barrage of messages and calls. “I didn’t know anything. When I got off the plane there was a representative there with a bouquet of flowers who said ‘congratulations on the prize,’   ” The Associated Press reported.

The laureates traditionally receive their awards at a banquet in Stockholm on Dec. 10, the anniversary of the death in 1896 of the prize’s creator, Alfred Nobel, an industrialist and inventor of dynamite.

Source: http://www.nytimes.com

By Dr. Sanjay Gupta

Annette Tersigni decided at the age of 48 that she wanted to make a difference. She attended nursing school and became a registered nurse three years later. “Having that precious pair of letters – RN – at the end of my name gave me everything I wanted,” she writes on her website. Before long, Tersigni discovered the rewards – as well as the physical and emotional challenges – that come with nursing.

“I was always stressed when I worked, afraid to get sued for making a mistake or medical error,” says Tersigni, who was working in the heart transplant unit of a North Carolina hospital. “Plus, working the night shift caused me to gain weight and stop working out.” Tersigni moved to another hospital, but the long shifts continued. Three years later, she left her job.

Tersigni’s experience isn’t unusual. Three out of four nurses cited the effects of stress and overwork as a top health concern in a 2011 survey by the American Nurses Association. The ANA attributed problems of fatigue and burnout to “a chronic nursing shortage.” A 2012 report in the American Journal of Medical Quality projected a shortage of registered nurses to spread across the country by 2030.

Work schedules and insufficient staffing are among the factors driving many nurses to leave the profession. American nurses often put in 12-hour shifts over the course of a three-day week. Research found nurses who worked shifts longer than eight to nine hours were two-and-a-half times more likely to experience burnout.

“Our results show that nurses are underestimating their own recovery time from long, intense clinical engagement, and that consolidating challenging work into three days may not be a sustainable strategy to attain the work-life balance they seek,” says study author Linda Aiken, PhD, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.

Deborah Burger, RN, co-president of the union and professional association National Nurses United, doesn’t believe that long work shifts tell the whole story. “Most people can work a 10- or 12-hour shift if they’ve got the right support and right level of staffing,” Burger says.

“In order for nurses to feel satisfied and fulfilled with their work, the staffing issues must be seriously addressed from a very high level,” says Eva Francis, MSN, RN, CCRN, a former nursing administrator. “Nurses also need to be able to express themselves professionally about the workload, and be heard without the fear of threat to their jobs or the fear of being singled out.”

A new study suggests that nurses’ burnout risk may be related to what drew them to the profession in the first place. Researchers at the University of Akron in Ohio surveyed more than 700 RNs and found that nurses who are motivated primarily by the desire to help others, rather than by enjoyment of the work, were more likely to burn out.

“We assume that people that go into nursing because they are highly motived by helping others are the best nurses,” says study author Janette Dill, assistant professor of sociology at the University of Akron. “But our findings suggest these nurses may be prone to burnout and other negative physical symptoms.”

RELATED: Managing Job Stress

That finding doesn’t surprise Jill O’Hara, a former nurse from Hamburg, NY, who left nursing more than a decade ago.

“When a person goes into nursing as a profession, it’s either because it’s a career path or a calling,” says O’Hara, 56, who now operates her own holistic health consulting practice. “The career nurse can leave work at the end of the day and let it go, but the nurse who enters the field because she is called to it takes those emotionally charged encounters home with her. They are empathetic, literally connecting emotionally with their patients, and it becomes a part of them energetically.”

Besides driving many nurses out of the profession, burnout can compromise the quality of patient care. A study of Pennsylvania hospitals found a “significant association” between high patient-to-nurse ratios and nurse burnout with increased infections among patients. The authors’ conclusion: A reduction in burnout is good for nurses and patients.

So what can be done? O’Hara thinks the burnout issue should be addressed early on, when future nurses are still in school. “I honestly believe the way to truly help nurses avoid burnout is to begin with a foundation of teaching while in school that stresses the importance of knowing yourself,” she says. “By that I mean your strengths and weaknesses. It should be taught that self-care must come first.”

Burger stresses the importance of taking regular breaks on the job. “If you’re not getting those breaks or they’re interrupted, then you don’t have the ability to refresh your spirit,” she says. “It sounds hokey, but it is true that you do need some brain downtime so that you could actually process the information you’ve been given.”

Tersigni, 63, now works part-time at a local hospital, specializing in the health and well-being of other nurses. She founded Yoga Nursing, a stress-management program combining deep breathing, quick stretches, affirmations, and relaxation and meditation techniques. “All of these can be done anytime throughout the day,” Tersigni says. “I even teach nurses to teach these to their patients. So the nurse breathes, stretches, and relaxes, while also teaching it to the patient.”

Source: http://www.everydayhealth.com

By Rena Gapasin

If you are a nursing student or new nurse, you are probably wondering what you will need in your work bag. Aside from your personal stuff, what are the things you bring that signifies you are a nurse?

These nursing supplies listed below are a must if you want to do your job efficiently.

The most common supplies nurses have in their bags are:

1. Stethoscope

   This is one of the most important tools of the trade. Nurses use this tool to listen to things such as the heart, veins, and intestines to make sure proper function. According to Best Stethoscope Reviews, here are the 6 best stethoscopes to buy. As you surely know, it's one of the most important tools for a patient's assessment.

   One of today's leading stethoscope brands is Littmann. You can choose from the classic style to the most advanced kind.

2. Books

   A handy reference listing down common medicines and conditions. MIMS provides information on prescription and generic drugs, clinical guidelines, and patient advice. Nurses can also use Swearingen's Manual of Medical-Surgical Nursing, a complete guide to providing optimal patient care.

3. Scissors and Micropore Medical Tape

   Bandage scissors are used for cutting medical gauze, dressings, bandages and others. Nurses need to have these in their pockets for emergency use, especially for wound care. Micropore tape is also important and should be readily available, for example, when your patient accidentally pulls his/her IV.

4. Lotion and Hand Sanitizer

   Nurses never forget to wash their hands several times throughout the day, leaving their skin dry. That's why having lotion in their bags is important to keep the skin in good condition. Meanwhile, the sanitizer helps nurses steer clear of germs, along with other contagious agents.

5. Six saline flushes

6. Retractable pens

7. Sanitary items - gauze, sterilized mask and gloves, cotton balls

8. OTC pharmacy items (cold medicines, ibuprofen and other emergency meds)

9. Small notebook - for taking notes from doctors and observations of your patients.

10. Thermometer

11. Tongue depressor

12. Torniquet

13. BP apparatus

14. Watch with seconds hand

On Nurse Nacole’s website, she shares that she carries a drug handbook, intravenous medications, makeup mirror, tape measure, towel, lotion, wipes, 4 in 1 pen and a homemade cheat sheet for her patients.

Also, in MissDMakeup's What's In My Work Bag Youtube video, she has a box of batteries, tapes, a pack of gum, toothbrush, sanitizer, coupons, snacks, umbrella, stethoscope, pens, folder of her report sheet and information sheet, tampons, charger, name tag, ID, makeup bag, eye drops, lotion, hair clips, highlighter, pen light, and journal.

So, What's in My Bag?

In my bag, I have a 4-in-1 pen, a highlighter, IDs, bandage, journal to write some new information when I surf the net, my phone with medical e-books and medical dictionary in it, and other stuff like alcohol, sanitizer, over-the-counter meds (such as paracetamol, cold medicine, pain killers, multivitamins), eye drops, handkerchiefs, floss, toothbrush, nail file, band aids, and food.

Aside from my knowledge in providing quality patient care, I also bring things that can help me get through my shift. In an effort to make things more compact and easy for a nurse to get access to, most common nursing supplies are available in a portable kit. The size and styles are developing as new ways of making a nurse's shift easier.

These are just few of the essential nursing paraphernalia that a new nurse needs. 

What's in your bag that you can’t live without?

Source: nurse together

Source:http://www.inquisitr.com

With the generous support of the Robert Wood Johnson Foundation and guided by a national advisory committee, a multidisciplinary team based at the University of Pennsylvania seeks to learn from clinicians or clinical leaders who are primarily responsible for transitional care services in health systems and communities throughout the United States.  Specifically, the team is conducting a research study designed to better understand how transitional care services are being delivered in diverse organizations.  Participation in this research survey is voluntary.

If you are a clinician or clinical leader responsible for transitional care service delivery in your organization, I encourage you to learn more about this study.  To access the survey and more information on the study, please visit:

Transitional Care Survey

NAHN is happy to assist Dr. Mary Naylor and the University of Pennsylvania in this 2 year project.  Dr. Mary Naylor will be providing NAHN with feedback on the survey results. If you know of others who have such responsibility within your association or work environment, please forward this email to them.

Thank you in advance for your consideration of this request.

Source: http://www.nahnnet.org/

By Caleb Hellerman

Earlier this week, Brian Shepherd sat down in a small doctor's office in Bethesda, Maryland. A technician swabbed his arm and gave him a quick jab with a needle.

With that, Shepherd became subject No. 13 in the experiment testing a potential Ebola vaccine.

The trial was launched on an emergency basis earlier this month by the National Institute on Allergy and Infectious Disease. It's the first to test this kind of Ebola vaccine in humans.

"It's not just for the money," Shepherd wrote in a Reddit AMA. "I'm very interested in translational research and experiencing it from the guinea pig side is very rewarding. But yeah, the money helps. This one study will fund most of my grad school application costs, though not in time for application season."

The vaccine doesn't use live virus and can't infect volunteers with Ebola. Instead it uses specific Ebola proteins to trigger an immune response. They're delivered through the body on a modified version of an adenovirus, a type of cold virus.

In the initial phase, 10 healthy volunteers were given a low dose of vaccine. They were monitored for side effects and tested to see if their bodies are producing antibodies. In the second phase, of which Brian is a part, an additional 10 volunteers are being given a higher dose.

All participants will be followed for nearly a year and tested at regular intervals.

Shepherd, who has volunteered for several prior research studies at NIH, spoke with CNN about his experience.

The following is a condensed version of that conversation:

CNN: How did you come to join the study?

Brian Shepherd: I actually work at NIH; I'm a post-doc researcher in a developmental biology lab. Most trials I learn about from reading a ListServ (email list).

I heard about the vaccine study from going to preliminary meetings for a different study.

CNN: When was this?

Shepherd: Less than a month ago. I had my first appointment on August 26. It was just a sit-down, to talk about the trial, go through paperwork and consent forms, explaining what the trial was for. Then they did an initial run-through of my health history.

CNN: What was next?

Shepherd: The next week I had my second appointment. They did a full physical, blood work, health history, breathing checks. A lot of poking and prodding. My third visit was Wednesday. They drew blood, then gave me a shot. Now, my next appointment is Sunday.

CNN: What was it like? You wrote that pulling off the Band-aid was the worst of the pain.

Shepherd: I'm supposed to keep a daily diary for the first seven days, logging my temperature and any symptoms. The next morning, I woke up with a slight fever, 100.5. I took some Tylenol and it went away.

Other than that I feel fine. In fact, I ran a half-mile in a relay race at lunchtime with some people from work.

CNN: You wrote that for each of these regular visits, you're paid $175. How many times have you been a human guinea pig?

Shepherd: This is my second drug trial. Before that, I did mostly MRI studies.

The first one I did, I was in the MRI machine and had three tasks. They gave me two buttons and showed pictures. If it was Spiderman, I'd hit one button; if it was the Green Goblin, I'd hit the other. So I spent 15 minutes playing Spiderman vs. Green Goblin.

CNN: Did you have any reservation at all, taking part in this Ebola vaccine trial?

Shepherd: None at all.

Source: http://www.cnn.com

By David McNamee

Wearable tech is all the rage right now, with Google Glass and now the Apple Watch being gadget fiends' latest must-have items. Electronic activity monitors may be the most popular example of health-monitoring wearable technology. A new analysis from researchers at the University of Texas Medical Branch at Galveston - published in the Journal of Medical Internet Research - compared 13 of these devices.

"Despite their rising popularity, little is known about how these monitors differ from one another, what options they provide in their applications and how these options may impact their effectiveness," says Elizabeth Lyons, senior author of the new study and assistant professor at the Institute for Translational Sciences at the university.

"The feedback provided by these devices can be as, if not more, comprehensive than that provided by health care professionals," she adds.

Lyons and her colleagues assessed 13 wearable activity monitors available on the consumer market. The team wanted to see how the devices may promote healthy and fit behaviors and determine how closely they match successful interventions.

The researchers also compared the functionality of the devices and their apps with clinical recommendations from health care professionals.

In their analysis, the researchers write that most of the goal-setting, self-monitoring and feedback tools in the apps bundled with the devices were consistent with the recommendations health care professionals make for their patients when promoting increase in physical activity.

Despite this, the analysis also finds that some proven successful strategies for increasing physical activity were absent from the monitors. These included:

• Action planning
• Instruction on how to do the behavior
• Commitment and problem solving.

Interestingly, though, the authors suggest that the apps with the most features may not be as useful as apps with fewer - but more effective - tools.

The researchers also consider that how successful any monitor is largely depends on matching individual preferences and needs to the functionality of the device. For instance, someone who gets most of their exercise from swimming will benefit the most from having a waterproof monitor.

Applications for activity monitors beyond aiding weight loss?

The report also contains suggestions on applications for these monitors outside of their typical role as weight loss aids.

For instance, the researchers suggest the wearable activity monitors could be useful for patients who have been released from the hospital. These patients could use the monitors to measure their recovery and quality of life.

Also, health care professionals could use data from the monitors to identify at-risk patients for secondary prevention and rehabilitation purposes.

Lyons says:

"This content analysis provides preliminary information as to what these devices are capable of, laying a foundation for clinical, public health and rehabilitation applications. Future studies are needed to further investigate new types of electronic activity monitors and to test their feasibility, acceptability and ultimately their public health impact."

The study only looked at devices compatible with personal computers and iOS mobile devices, and the researchers admit it is possible "the experiences of Android users may differ from our experiences."

Source: http://www.medicalnewstoday.com

Growing up, Adriana Perez experienced the kinds of challenges that are at the core of the immigrant experience in America. She learned English as a second language, attended underperforming public schools in a small town, and struggled to pay for college because her parents—who were farmworkers—couldn’t afford to send her.

Through it all, Perez focused on the gifts she received during her upbringing: love and support from her family, guidance from her teachers and mentors, a strong work ethic derived from a culture that values hard work, and a personal drive to make a difference in her community.

When she reached adulthood, she made an unusual choice—at least for her demographic group: She became a nurse. Now an assistant professor of nursing at Arizona State University, Perez, PhD, ANP, is a member of the most underrepresented racial or ethnic group in nursing.

In 2013, Latinos comprised 3 percent of the nation’s nursing workforce, according to a survey by the National Council of State Boards of Nursing and the National Forum of State Workforce Centers, and 17 percent of the nation’s population, according to a U.S. Census Bureau fact sheet. And their numbers are growing: By 2060, Latinos are projected to comprise nearly one-third of the U.S. population. But their growth in nursing has been slow, Perez said.

Recruiting more Latino nurses is about more than parity in the nursing workforce; it’s about improving health and health care for Latinos, who have disproportionately high rates of HIV transmission, teen pregnancy, and chronic conditions like obesity and diabetes, according to data compiled by the Centers for Disease Control and Prevention. Latinos also are less likely to have health care coverage than other racial or ethnic groups.

More Latino nurses can help narrow disparities, experts say, because they are more likely to be able to provide culturally and linguistically appropriate care to Latino patients. “Having a culturally competent nurse really makes a difference in terms of compliance and patient outcomes,” said Elias Provencio-Vasquez, PhD, RN, FAAN, FAANP, dean of the nursing school at the University of Texas at El Paso and an alumnus of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2009-2012). “Patients really respond when they have a provider who understands their culture.”

The Institute of Medicine (IOM)—the esteemed arm of the National Academy of Sciences that advises the nation’s leading decision-makers on matters relating to health and medicine—agrees. In 2004, it published a report calling for a more diverse health care workforce to improve quality and access to care and to narrow racial and ethnic health disparities. And in 2010, the IOM released a report that included calls for greater diversity within the nursing profession in particular.

Latinos Aren’t Flocking to Nursing

Yet despite their growing numbers, Latinos are not flocking en masse to the nursing profession.

That’s in large part because of inequity in education, said Dan Suarez, BSN, MA, president of the National Association of Hispanic Nurses. “Many Latinos come from poor educational systems, and few concentrate on the kinds of science and math courses that are needed to enter nursing school. Latinos have the highest high school drop-out rate in the nation, and many students are just focused on staying in school and making it to graduation.”

Meanwhile, there are relatively few Latino nurse leaders and educators who can serve as role models, coaches and mentors to the next generation of nurses, Perez said. “When young people aren’t able to see themselves in those roles, it’s hard to imagine that they could be in that role.”

Language and culture also play a role. Latino parents often discourage Latino youth—and especially boys—from pursuing nursing because it is regarded as a low-status, low-pay service job in Mexico and parts of Latino America, Suarez said. “Parents tell their children they can do better than nursing ... Nursing has an image problem, and we’re trying to change that.”

The culture’s emphasis on traditional gender roles also discourages Latina wives and mothers from working outside the home and, if they do, from pursuing leadership positions, said Mary Lou de Leon Siantz, PhD, RN, FAAN, a professor at the Betty Irene Moore School of Nursing at UC Davis and an RWJF Executive Nurse Fellows program alumna (2004-2007). “The majority of Latina nurses go into associate degree programs and don’t see the need to go back for more education.”

Racism against Latinos, she added, is “full-blown,” especially amid the national debate over immigration. Academics and others retain unconscious biases against Latinos and members of other groups that are underrepresented in nursing.

RWJF is committed to increasing diversity in nursing through programs such as New Careers in Nursing, which works to increase the diversity of nursing professionals to help alleviate the nursing shortage, and the RWJF Nursing and Health Policy Collaborative at the University of New Mexico, which prepares nurses, especially those from underserved populations in the Southwest, to become distinguished leaders in health policy. The Future of Nursing: Campaign for Action, a joint initiative of RWJF and AARP, is working to diversify the nursing workforce, with help from Perez and others. The National Association of Hispanic Nurses, meanwhile, offers scholarships to Latino nursing students.

But more needs to be done, Siantz and others said. Educational bridge programs to help students transition into nursing school are needed, as are interventions to dispel negative stereotypes about nursing among Latinos and increased mentorship for aspiring nurses and nursing students.  “Latino nurses often talk about the influence of a family member, or a role model, or a mentor who told them to be a nurse,” said Perez, whose grandmother, a nurse in Mexico, encouraged her to pursue nursing in the United States. “We need to do more of that kind of outreach.”

Source: http://www.rwjf.org