DiversityNursing Blog

Wolters Kluwer Health

Concerted effort is needed to reverse the ongoing rise in pertussis cases and deaths, especially among children and young people, according to the article in the Journal of Christian Nursing by Emily Peake, APRN, MSN, FNP-C, CLC, and Lisa K. McGuire, MSN, MBA-HCM, RN. "This effort begins with nurses and nurse practitioners and other primary care providers who educate patients and the public," they write. "The battle of pertussis is winnable through education, awareness, and vaccination."

Caused by infection with Bordetella pertussis  bacteria, pertussis has been increasing in recent years. In the United States, average annual pertussis cases increased from less than 3,000 cases per year during the 1980s to 48,000 in 2012, including 20 deaths. Worldwide, there are an estimated 50 million cases of pertussis and 300,000 deaths. Pertussis is a major cause of death in infants worldwide.

Why is pertussis on the rise? "Ambivalence toward precautionary childhood vaccinations" is a key reason, along with the lack of well-child visits and appropriate boosters. The arrival of non-vaccinated immigrants may also be linked to new clusters of pertussis outbreaks, according to Peake and McGuire. They write, "Nurses should educate patients and the public that follow-up booster vaccinations at all ages are critical to maintain immunity to pertussis and other vaccine-preventable diseases."

Issues including vaccine availability and cost, literacy and language barriers, and lack of information all contribute to the lack of recommended vaccinations. Fear of vaccination and religious objections also play a role. Most states allow exemptions from vaccination based on religious reasons, and there's evidence that even non-religious parents are using these exemptions to avoid vaccinating their children.

Nurses should reassure parents that that recommended vaccines are safe. Current diphtheria-tetanus-pertussis vaccines do not contain the mercury-containing preservative thimerosal. Adverse events occur in only a small fraction of vaccinated children, and most of these are mild local reactions.

"Practitioners must build a trusting relationship with patients and reinforce the need for vaccinations through face-to-face contact, engaging parents to discuss concerns, and provide evidence-based research to guide recommendations and reassure patients of the safety of vaccines," Peake and McGuire write. Waiting rooms provide a good opportunity to present videos and other educational materials.

The World Health Organization is working to increase the percentage of infants who receive at least three doses of pertussis vaccine to 90 percent or higher, especially in developing countries. Closer to home, partnerships should be formed with service organizations, food banks, churches, hospitals and schools. "These groups can help identify those most likely not to be vaccinated and help them find free or low cost immunizations," the authors write. "Faith community nurses are in an ideal role to create and lead these partnerships."

Nurses can also advocate for policies aimed at making universal vaccinations available for adolescents and adults. Peake and McGuire conclude, "By using our resources and uniting, a global battle will be waged and won against pertussis and the children of tomorrow can breathe easier for a lifetime."

Source: infectioncontroltoday.com

By Michael O'Connor

Wet snowflakes fell on that day after Christmas 1973 as she glanced out the window.

Nancy Whittaker just wanted to return a few presents with her boyfriend, but her parents worried about her making the 40-mile trip from Beatrice to Lincoln. Maybe it was best if they made the drive another day, after the weather improved.

Source: Omaha.com

To mark National Nurses Week, we asked new RNs about what every nurse needs to succeed. Five nurses from the DC/Maryland/Virginia region, all with two years or less of experience, answered the following question: What qualities or characteristics are most important to possess as a nurse, and why? 

Hannah Hanscom, RN, BSN, CPN, clinical nurse, surgical care unit, Children’s National Health System, Washington, D.C.

As a pediatric nurse, I believe there is no one quality or characteristic that is most important to being a nurse. Nurses must be passionate about caring for children and their families and be able to think critically and on their feet. But we also must be able to communicate effectively and efficiently with the family, patient and interdisciplinary team. We must be compassionate and able to stay calm when escalating care is needed. Although there is no one quality or characteristic that is most important for nursing, having a passion for the field, for caring for those in need, for educating others and for continuing your own education ties all the other qualities together. Nursing is not just a job or a career. Being a pediatric nurse is in many ways a calling; it is something that comes from the heart and is a lifestyle you must be passionate about. 

Shannon Levin, RN, med/surg unit, Novant Health Haymarket Medical Center, Gainesville, Va.

Nursing is more complex than ever. Nurses are managing new technologies, constant advances in best practices and more and more patients with multiple morbidities. Nurses must be organized multitaskers, with quick critical thinking skills. But a nurse who possesses empathy for his or her patients is the best kind of nurse. Nurses with genuine empathy understand that we often see patients and their families at one of the most difficult times. Most of our patients are experiencing some level of physical and emotional pain and often feel anxious and fearful about their hospitalization. An empathic nurse cares enough to identify and understand his or her patient’s feelings. The nurse listens to his or her patient’s medical history and current symptoms and eases his or her fear by explaining the need for hospitalization, the plan of care and ordered procedures. These actions help build trust and ultimately are the foundation of a successful nurse-patient bond and remarkable care. 

Rachel Nugent, RN, emergency department, Carroll Hospital Center, Westminster, Md.

It takes many characteristics to be a nurse. I believe the most important characteristics to possess are empathy, compassion, hope, patience and good communication skills. Being empathetic for patients and also for their families shows true compassion. Nurses must give patients a sense of hope when they may be at the lowest point in their lives. Nurses smile, and with that smile, a positive perception is given to patients and their families. Patience with not only yourself, but with patients, family members, doctors and coworkers is a must. Nurses must know when to speak up for themselves or their patients and when to intervene - especially when they suspect something may be wrong. Nurses advocate for their patients when they are in dire need. And, finally, one of the most important parts of communication is that nurses must always be great listeners, even after a long 12 hour shift. 

Brooke Schautz, RN, emergency department, MedStar Harbor Hospital, Baltimore

“Nurses serve in a variety of professional leadership positions, from administrators and unit managers to chief nursing officers and hospital board members. Today, the challenges of leading in an increasingly complex health care environment are great; therefore, nurses need to take every opportunity to develop and hone their leadership qualities and skills. The question for every nurse—no matter the stage of her or his education or career—is: Are you the best leader you can be?” writes Sue Hassmiller, senior adviser for nursing at the Robert Wood Johnson Foundation and director of the Future of Nursing: Campaign for Action, and Julie Truelove, student at the University of Virginia School of Nursing, in an article in the January 2014 issue of the American Journal of Nursing.

The article, “Are You the Best Leader You Can Be?,” discusses the Institute of Medicine’s recommendations on nursing leadership in the 2010 report, The Future of Nursing: Leading Change, Advancing Health. The recommendations call on the health care system to “prepare and enable nurses to lead change to advance health,” by developing leadership programs and providing increased opportunities to lead. The article features a table of nurse leadership programs for nursing students and professional nurses as well as a nursing leadership resource list.

Table: Leadership at Every Level -  Click here to view the full table. 

“Nurses with strong leadership and management skills are better prepared to serve individuals and their families and the community, and to collaborate with colleagues,” the authors write. Regardless of where you are in your career, “a leadership program is a step toward becoming the best leader you can be.”  Read the full article here.

Source: CampaignforAction.org 

By Ron Dicker

Talk about high drama.

In an emergency situation called straight out of a movie, two nurses saved a United Airlines pilot having a possible heart attack mid-flight last month.

Thirty minutes into a flight from Des Moines, Iowa, to Denver on Dec. 30, an intercom announcement requested medical expertise. Linda Alweiss of Camarillo, Calif., and Amy Sorensen of Casper, Wyo., answered the call. Directed to the cockpit, Alweiss told KTLA in Los Angeles that she found the pilot slumped over and mumbling, with an irregular heartbeat.

"He was clearly suffering from a possibly fatal arrhythmia,” she told NBC4 News.

Passengers helped the two women pull the captain into the galley, where the nurses set up a defibrillator and an IV, according to KTLA. In the meantime, the jet was rerouted to Omaha, Neb.

"This is what happens in movies," Sorensen (spelled Sorenson by some outlets) told ABC News. "This isn't what happens in real life."

A co-pilot safely landed the plane in Omaha, where medics were waiting to further treat the pilot, outlets noted. As the women retreated to their seats, passengers cheered the nurses' efforts, the Star-Tribune wrote. The pilot survived.

In a statement released to media United said: “United flight 1637, a Boeing 737 operating between Des Moines and Denver Monday evening, landed safely in Omaha after the captain became ill. United accommodated the customers overnight, and they continued to Denver the next day.”

A United spokeswoman told The Huffington Post that it was not releasing anymore information on the pilot. She added that she wanted everyone to know "the passengers weren't in any danger."

Sorensen, for one, said her actions weren't really heroic.

"I really don't see myself as a hero," she told ABC News. "I did what I know for a patient that needed it."

Source: Huffington Post 

By: Mike Creger

Six nurses began a journey to the Philippines earlier this month. They were strangers in a land torn by Typhoon Haiyan in November. They came out of their two-week medical mission as a team.

That’s how Duluth nurse Anna Rathbun described her time hopping from makeshift medical facilities across Panay Island, which took a direct hit from one of the fiercest and deadliest typhoons in history.

“We ended up working really well together,” Rathbun said of her tour with five other nurses — three from the East Coast, one from Arizona and one from California. She also worked with nurses from other countries.

Rathbun is a registered nurse in the intensive care unit at St. Luke’s hospital, a job that had her well prepared for whatever might come a world away.

“Nurses, especially intensive care nurses, learn to work as a team,” she said. “It’s so important to be flexible and adaptable to change.”

The team went from village to village across the island, setting up in whatever building still was standing, mainly churches and schools.

Rathbun said her only expectation was that she would be treating wounds from the typhoon. She was surprised to see so many people come in for chronic conditions like diabetes, high blood pressure and respiratory conditions.

“It was everywhere we went,” she said. “We got the biggest thanks for the smallest things, like handing out vitamins.”

She provided wound and respiratory care and helped deliver a baby.

Those coming to the islands had their own health issues to deal with, Rathbun said.

“The air quality is so poor that we all had sore throats and stuffy noses almost immediately,” Rathbun said. “I got a sinus infection and upper respiratory infection.”

Rathbun is one of 3,200 nurses from across the country who signed up for a relief effort organized by National Nurses United. It raised money to pay for expenses nurses would encounter traveling to the Philippines. Rathbun couldn’t have gone otherwise.

She had just a two-day notice that she had been chosen for a mission leaving Dec. 9. She was grateful her manager at St. Luke’s was understanding and could grant the leave from work. “I had the go-ahead from day one,” she said.

“It was a whirlwind,” she said of preparing for her journey.

“I’ve always wanted to do some disaster work,” Rathbun said. “I became a nurse to help people.”

But her mother was nervous about her going overseas, Rathbun said. Now that her daughter is home and she has seen and heard of the work she did, Mom is OK.

“She’s really proud,” Rathbun said.

Coming home last Saturday was “reverse culture shock,” Rathbun said.

“You spend two weeks with people who have absolutely nothing. They lost everything,” she said. “And here, we have everything.”

That was especially true in coming home during the last commercial rush before Christmas, a holiday that had a deeper meaning for her after Panay Island.

“I follow local stories and what’s going on (in the U.S.) and I want to say, ‘Hey, there are people on the other side of the world who need help.’”

Anyone who has thought of doing a similar mission should do so, Rathbun said without hesitation.

“If you’re thinking about doing it, take the plunge,” she said. “It will change your life.”

She didn’t want to leave Panay because there is so much medical work still to be done. She’s assuaged a bit by the knowledge that the National Nurses United effort is a long-term one.

“The goal is to continue to provide care,” Rathbun said.

Her group was the third wave to enter the typhoon area. The next group will come from California, New York and Texas. They are expected to depart in early January. Nurses from 50 states and 19 nations have volunteered to help.

“There is still so much work that needs to be done,” Rathbun said. “People can’t afford their medical care, they can’t afford their meds. A lot more has to go on.”

Source: Duluth News Tribune