DiversityNursing Blog

By Laura Raines
Pulse editor

If the purpose of nursing school is to prepare students for real-life practice, then it must address the challenges of working with a multicultural population, says Sharon Grason, nursing instructor at Georgia Perimeter College.

“If you work in an urban setting, it’s a rarity that the patient in the bed will come from your same background,” said Grason, MS, RN, CNS. “Cultural diversity is a growing part of nursing.”

Because she believed the nursing curriculum at GPC only skimmed the surface of cultural diversity, in 2010 Grason launched a senior capstone project to make nursing students more culturally aware. It’s now the last course nursing students take before they graduate.

Grason’s experience working with migrant farmers in Moultrie showed her how important multicultural understanding is for nurses.

“Seeing how migrants lived and worked totally opened my eyes and made me look at how to care for them in new ways,” she said.

To be effective, Grason knew she had to earn their trust.

“When you can show that you have some idea of their lives and what is important to them, the patients’ level of trust goes up tenfold,” she said. “They are more apt to listen and you are better able to help them.”

Grason wants nursing students to realize that diverse patient populations have different health care needs and challenges. To be effective nurses, students need to learn how to take those differences into consideration when caring for patients.

In the capstone project, teams of students choose a different culture to research.

“We begin to learn about the traditions, religious beliefs, social norms, common health problems, foods and the indigenous medical remedies of that population,” said Kristina Palmer, a GPC senior nursing student.

Her group is studying Russian and Eastern European cultures, and they have discovered a large population in metro Atlanta.

“Being aware of patients’ backgrounds and understanding the cultural dynamics can help you give better care,” Palmer said. “For example, in some cultures you have to talk to the dominant male in the family if you want medical advice to be followed. We’re not trying to change the culture, but to make patients more comfortable with how we’re trying to help them.”

Group presentations

The groups will present and share their findings — including a list of facts about the culture and answers to frequently asked questions — at an international cultural day at the end of the term.

“Many teams dress in costume, serve native foods, display cultural artifacts and hand out brochures about their cultures, so that students and guests can benefit from their research,” Grason said.

Nursing student Tarra Clark is studying migrant farmers, a mostly Hispanic population.

“We’re seeing how their eating practices are related to common health problems like high blood pressure or diabetes,” Clark said.

She has learned that glucose and blood-pressure screenings, earlier prenatal care and dietary education is helpful in treating many Hispanic patients.

“We all need to be aware that how we deliver health care to a patient makes a difference,” said Karen Feagin, a senior nursing student.

As a volunteer at a free health clinic, Feagin encounters people from all backgrounds. She’s learned that some cultures consider it rude to make eye contact with the patient. Some cultures require a same-sex practitioner and others have a mistrust of Western medicine.

“Sometimes when patients don’t understand what you are saying, they’ll just agree to be polite. When in doubt, it’s better to find a translator,” she said.

Feagin’s group is studying the culture of Koreans, a large and growing population in metro Atlanta.

“They have a higher risk for hypertension, but a diet that’s high in salt because of preserved foods, so that’s a challenge,” she said. “If they mistrust American health care, they will go to a local Korean practitioner or contact their family back home to get local herbs and medicines. If you know that, you can ask about herbs and help them choose ones that won’t interact negatively with the medicines you’ve given them.”

Valuable lessons

Feagin says the capstone course is enlightening and she looks forward to learning about other cultures from the other teams.

“I didn’t realize how much I didn’t know,” she said. “But you go into nursing to keep people healthy and help them achieve the best quality of life possible. This kind of knowledge will help us provide safer, more-intelligent care.”

Nursing is a second career for Feagin, who spent 10 years in accounting.

“Everyone ends up in the hospital at some point and it’s the nurses that dictate your experience. That’s who the patients remember” she said. “I wanted to be that person who is remembered because she made a difference in someone’s life. This is a great program and I’m thrilled to be in it.”

After three semesters of offering the capstone course, Grason will compile all the cultural information into a manual that the nursing department will give to its clinical partners and hospitals.

“We wanted to do something to give back and we hope that this will be a good resource for their educational departments,” she said.

Excerpts of this article are from Shawn Kennedy, MA, RN, Editor-in-Chief for the American Journal of Nursing

At the most recent Sigma Theta Tau International (STTI) biennial meeting in Gaylord Texas, there was a seminar and discussion of the top 10 issues facing nursing, led by STTI’s publications director Renee Wilmeth. The issues were compiled from responses provided by 30 nursing leaders, and were presented in question form:

1) Is evidence-based practice (EBP) helpful or harmful? (Amazing how many interpretations there were of EBP, some of them—as I know from our EBP series—quite incorrect.)
2) What is the long-term impact of technology on nursing?
3) Can we all agree that a bachelor’s degree should be the minimum level for entry into practice? (General agreement here, despite concerns regarding the adequacy of financial support for achieving this goal.)
4) DNP vs PhD: separate but equal? (Not much discussion—I think no one wanted to really get into this.)
5) How do nurses get a seat at the policy table?
6) How do nurses cope with the growing ethical demands of practice? (This generated the most discussion, especially around whether society should provide unlimited costly care to those whose personal choices contribute to their health problems.)
7) How do we fix the workplace culture of nursing?
8) What role do nurse leaders play in the profession?
9) What are we doing about the widening workforce age gap?
10) How do we make the profession as diverse as the population for whom it cares?

What do you think? Would you agree that these are the ‘top 10’ issues? What’s missing? What’s here that shouldn’t be? We would love to hear your opinions, please share them here.

By Sam Baker - 10/31/11

The Health and Human Services Department on Monday finalized new standards to track broad factors that affect people’s health.

The standards are part of HHS’s effort to reduce healthcare disparities — differences in health status and access to healthcare that stem from social, cultural and environmental issues.

HHS devised the new standards to provide more detailed information than what it has collected previously. The department cited, for example, differing rates of diabetes between Mexican-Americans and Cuban-Americans. By tracking health data on that level, rather than using catchall terms like “Hispanic,” HHS says it will be better able to address health disparities.

The standards announced Monday also include tobacco use, obesity, education level and exposure to secondhand smoke.

“It is our job to get a better understanding of why disparities occur and how to eliminate them,” HHS Secretary Kathleen Sebelius said in a statement. “Improving the breadth and quality of our data collection and analysis on key areas, like race, ethnicity, sex, primary language and disability status, is critical to better understanding who we are serving.”

A study published this month in the journal Health Affairs found that private insurance companies are also doing a better job tracking health disparities. The number of health plans collecting racial and ethnic data more than doubled from 2003 to 2008, the study found.

from

A new poll from the Society for Human Resource Management shows that only two in 10 organizations have an internal group focused on diversity within the organization.

Regardless of whether organizations do or do not have internal groups — a diversity-focused committee, council, or advisory board — the human resources group plays a significant role in diversity initiatives. When asked, “Who is responsible for implementing diversity initiatives at your organization?” 65% of poll respondents cited the human resources group. Another 62% said the human resources group is responsible for leading diversity initiatives.

The second most cited group responsible for both implementing and leading diversity initiatives is the president/CEO and his or her office, said 21% of respondents polled.

The findings were released yesterday to an audience of human resource and business professionals attending the 2011 SHRM Diversity & Inclusion Conference & Exposition in Washington, D.C.

“While internal diversity councils aren’t the only way that an organization can move the needle around diversity and inclusion, these results are an indication of how few organizations are responding to the world’s rapidly changing demographics in a proactive and meaningful way,” says Eric Peterson, manager of diversity and inclusion at SHRM. “Clearly, we still have a lot of work to do.”

Additional findings include:

* In fiscal year 2010, 16% of organizations represented in the poll had a diversity training budget (29% of the 16% has a separate, stand-alone diversity training budget while 71% factored it into the overall training budget).

* Comparing fiscal year 2011 to 2010, diversity training budgets remained the same in 75% of organizations, increased in 14% of organizations, and decreased in 10% of organizations.

* 55% of poll respondents said their organization has a formal, written policy addressing sexual orientation discrimination in the workplace. Another 36% have no policy, formal or informal. Nine percent rely on an informal policy.

* Regarding gender identity and/or gender expression, 21% of organizations have a written policy while 79% do not.

© 2010 Thomson Reuters.

by Alicia Williams-Hyman

Staff Assistant
Hausman Diversity Program at Mass General Hospital

 

The Hausman Student Nurse Fellowship was created when MGH patient Margaretta Hausman, a social worker and graduate of Brown University, recognized the need for diversity among the top-level nursing staff. The Hausman Student Nurse Fellowship provides an opportunity for minority nursing students enrolled in an undergraduate baccalaureate nursing program to gain experience in patient care across the continuum.

The fellowship allows student nurses between the summer of their junior and senior year in college to experience care at the bedside in both inpatient and outpatient settings.  Under the mentorship of Deborah Washington, R.N., Director of Diversity for Patient Care Services and Bernice McField-Avila MD, Co-Chair of the Fellowship, the recipients have an opportunity to further develop skills required to thrive in a workplace where unique challenge to the minority nurse must be managed.

The first fellowship was awarded to Stevenson Morency in 2007.  The program flourished significantly and in 2011, the fellowship was awarded to 8 minority student nurses, the largest group in the history of the program. The Student Nurses worked on various units such as Endoscopy, Orthopedics, General Medicine, Thoracic Surgery, Cardiac Unit, Neurosurgery Unit, Wang Wound Care, Cancer Center and the Grey IV department.

At the graduation ceremony on August 19, 2011, the Hausman Student Nurses provided feedback about their time in the program. Vicky Yu, a student of UMass and a 2011 recipient, felt honored to be part of the fellowship. She stated she saw many procedures she had only read about in her textbooks: colonoscopy, hip/knee replacements and urinary catheterization. “I got to work with a nurse 1-on-1. I don't get this attention on my school clinical and I loved it!” stated Vicky.   

Jennifer Etienne of Boston College stated: “As a minority nurse, it will be my mission to eliminate health care disparities and use my skills and knowledge to eliminate language barriers and become more culturally competent.”

Marthe Pierre shared: “The Hausman Fellowship is a ladder that provided a stepping-stone to my success. It allowed me to acquire skills, knowledge and confidence. It has also ignited my desire to one day become an extraordinary nurse who is culturally competent and compassionate.”

Jeffrey Jean of UMass Boston expressed that the program has reaffirmed his knowledge and his clinical experience. “Being able to walk in the shoes of a different RN has allowed me to re-invent myself. I have learned an abundance of new skills and techniques and have acquired a vast amount of knowledge. I believe that an important component of being an effective caregiver is to know what my strengths are.”

Sedina Giaff of Simmons College declared “It is with great pride that I introduce myself as a Hausman Fellow. This has been the best summer of my life. My experience as a Hausman Fellow has made me a better nursing student both clinically and intellectually. I have a better understanding and greater interest in the nursing profession. I am confidently looking forward to the coming school year and sharing my experiences with my classmates.”

Lauren Kang-Kim of Linfield College in Oregon had this to say: “Now I am reborn as a Hausman Fellow. For the last 5 weeks I found my own powerful voice and I am now proud of my minority identity. The Fellowship has opened the doors for me to become not just a better nurse, but a better person with a deeper understanding and respect for human beings.

Rosalee Tayag and Anna Diane of UMass Boston and Boston College respectively, stated that the Fellowship enhanced their leadership, critical thinking, assessment and communication skills; and  taught them to be more culturally sensitive. They also emphasized that they learned to work as members of a team more effectively.

Former 2010 Hausman awardees, Jason Villarreal and Penina Marengue, congratulated the Student Nurses on their graduation and cautioned them to use their new-found knowledge to provide competent care to their patients and uphold the good name of the Hausman Fellows.

Former Hausman Fellows include: Frew Fikru, Alexis Seggalye, and Christopher Uyiguosa Isibor 2008.  Chantel Watson and Stephanie Poon 2009.

The Hausman Fellowship is posted by Spring of each year at www.mghcareers.org. Qualified minority candidates should be in good academic standing (3.0 GPA or higher) and entering their senior year of a BSN program in the Fall.

Mr. W had a heart attack and was in the ICU last week.  While reviewing his discharge medication list, you realize Mr. W unintentionally discontinued his medication for hypertension and dyslipidemia.  Unfortunately, these medications were not on the discharge medication list.  

Jay has been a well controlled diabetic for many years.  Today his A1C is 10.5.  He insists he is taking his medication regularly.  

A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. ¹   Efforts to decrease or prevent medication errors often focus on improving systems and procedures utilized by nurses, physicians and pharmacists during the multistep process of medication administration.  Decreasing medication errors by patients must also be addressed.  

According to the landmark 2006 report "Preventing Medication Errors" from the Institute of Medicine, medication errors injure 1.5 million Americans each year and cost 3.5 billion in lost productivity, wages and additional medical expenses.^​2 1/3 of medication errors occur in outpatient settings.  Patients often unintentionally discontinue medications after a hospitalization or transfer of care.  Numerous studies have shown that patients with chronic conditions adhere only to 50% to 60% of medications as prescribed despite evidence that medical therapy prevents death and improves quality of life.³   Knowledge deficits and poor understanding of drug label directions often result in medication errors initiated by patients. 

How to reduce medication errors by patients:

1. Decrease medication knowledge deficits.  Review with patients in plain language what medications were prescribed, how to take them, discuss side effects and address concerns regarding drug interactions and cost.  Use visuals and show me techniques to ensure patient understanding.  Enlist the help of the PCP and pharmacist for additional education.
2. 2.   An accurate medication list that includes discharge medications and/or chronic care medications is essential.  Learn how to take an accurate medication history.    Use clear communication techniques during conversations with patients.  Provide patient and PCP with discharge medication list.   
3. Monitor for medication adherence.  Ask patients to bring in all of their medications or contact pharmacies for information on most recent refill dates.  Evaluate and address medication knowledge deficits.  Medication reminders, automatic med refills, medication home delivery, assistance of family members or home care services can be utilized to improve adherence.  Call recently discharged patients to ensure they are taking prescribed medications and chronic care medications. 

Stephanie Wilborne, APRN

HealthLit.com:  Clear & Simple Patient Education/ Tools for Chronic Disease Management

¹ National Coordinating Council for Medication Error Reporting and Prevention: http://www.nccmerp.org/aboutMedErrors.html

²Anderson, Pamela, and Terri Townsend. "Medication errors: Don't let them happen to you." American Nurse Today 5.3 (2010): 23-27: http://www.nursingworld.org/mods/mod494/MedErrors.pdf

³ Bosworth, Hayden, Bradi Granger, Stephen Kimmel, Larry Liu, John Musaus, William Shrank, Elizabeth Buono, Karen Weiss, Christopher Granger, Phill Mendys, Ralph Brindis, Rebecca Burkholder, Susan Czajkowski, Jodi Daniel, Inger Ekman, Michael Ho, and Mimi Johnson. "Medication adherence: A call for action." American Heart Journal 162.3 (2011): 412-424. Print.

⁴ Preventing Medication Errors: Quality Chasm Series Committee on Identifying and Preventing Medication Errors, Philip Aspden, Julie Wolcott, J. Lyle Bootman, Linda R. Cronenwett, Editors

The U.S. workforce is expected to become more diverse by 2018. Among racial groups, Whites are expected to make up a decreasing share of the labor force, while Blacks, Asians, and all other groups will increase their share (Chart 2). Among ethnic groups, persons of Hispanic origin are projected to increase their share of the labor force from 14.3 percent to 17.6 percent, reflecting 33.1 percent growth.

July - August 2011. Largest Listings Out of 5,400,000 American Jobs Listed Across the Internet

• Physical Therapists
• Occupational Therapists
• Assistant Managers
• Registered Nurses - Licensed RNs
• Crew Positions - Casual Dining and Fast Food
• Salespeople
• Shift Supervisors - Food and Other Industries
• Cashiers/Sales Clerks
• Customer Service Jobs
• Pharmacy Technicians
• Merchandisers
• Event Specialists
• General Managers
• Photo Lab Supervisors
• Project Managers - IT

Federal Projections for "Most Job Openings" Expected through 2016

• Registered Nurses (RNs)
• Retail Salespersons
• Customer Service Representatives
• All Food Preparation & Service
• Office Clerks
• Personal & Home Care Aides
• Home Health Aides (HHAs)
• Postsecondary Teachers
• Janitors and Cleaners, except Housekeepers
• Nursing Aides & Orderlies
• Bookkeeping, Accounting, And Auditing Clerks
• Waitstaff
• Child Care Workers
• Executive Secretaries & Administrative Assistants
• Computer Software Applications Engineers

In 2003, a small group of Chinese-American nurses, all working in the Kansas City area, came together to share experiences, learn from one another and encourage each other. Today, the CAN (Chinese American Nurses) Sisters meet twice a month as we continue to share our nursing and American life experiences. Our common denominator is that English is our second language. We feverishly try to improve our listening, writing, and speaking skills in English. We especially want to reduce our translation and response time during conversations. We also have in common that we all work extremely hard; we are reliable, friendly, caring, and happy at work.
  Recently, we met for one of our regular meetings. We sat in a circle in my living room and began with introductions. On that particular night we had three overseas visitors from China who were part of an exchange program at Children’s Mercy Hospitals and Clinics in Kansas City. The evening turned out to be an especially moving night for all of us. We each told the story of our life’s challenges and triumphs. We all talked of our struggles to memorize the names of cells, medications, and tiny germs in English! It was fun night.

After my guests left, I started cleaning the dishes. As I did, I suddenly was struck with the thought: How could I ever take these amazing, beautiful nurses for granted? I am so lucky to know them! At the end of every meeting, we feel charged and ready to face the world together. CAN nurses only need opportunities to prove themselves as great nurses. Here are a few of their stories:

SS – She was a nurse in China. After arriving in the United States, she started studying for the nursing board while also raising a child and working at local restaurants to help support her family. She studied hard and passed the nursing board. She then enrolled at Johnson County Community College for an RN refresher course. She completed her clinical RN training at a local specialty hospital. Her clinical instructor noticed how hard she worked and her solid knowledge of nursing. The instructor’s immediate supervisor then hired her as soon as she completed her clinical training practice. SS has being doing very well at that local specialty hospital for more than five years. Doctors trust her and her nursing judgment. She consistently receives praise from the doctors and other staff members.

FF – She also was a nurse in China. She studied and passed the nursing board soon after SS passed the board. FF went on and studied many more nursing specialties, and earned herself national certification in infusion nursing and wound care. She was a supervisor at a local nursing home with multiple certified nursing skills. She was doing an outstanding job in nursing.

GG – She practiced medicine in China. As soon as she arrived in the United States, she went to nursing school, studied extremely hard, and she passed the nursing board. She does not practice nursing yet; she is still waiting for her green card and permission to work. She is ready to serve.

HH – She was a nursing instructor in China. Right after arriving in the United States, HH started studying for the nursing board, even while she was caring for her premature baby. She passed the nursing board exam, and then went to work at a hospital. For many years, she has been a well liked and well respected weekend night nurse. She turned down a promotion opportunity, as her nurse manager suggested, to become a night charge nurse.

MM – When she arrived in Kansas City, MM was hired as a nurse technician even though she was a RN in China. She was living in an empty apartment so learning English was difficult. A phone book became her best tool to learn conversational English. For eight to 10 hours a day, she would turn the pages and randomly pick a person or a store from the phone book, call them and ask questions;  when she flapped on “W” section and saw a water bed shop, she would ask  “what is water bed? How much cost for a water bed” --- etc. She listened attentively and tried to learn as much as possible. Alone in her apartment, the phone book connected her to her new world; this is how she learned and improved. She wanted to work as a nurse as soon as possible. Eventually, she passed her nursing board, and earned two master degrees and four national nursing and nurse management certifications. She is working at a hospital today as a Hospital Shift Supervisor.

ZZ – She was a nurse in China. Months of hard studies for boards, she passed her nursing board a few months ago. She sent out many applications to many hospitals. She received only one reply, requesting a phone interview. After the phone interview, she never heard from the hospital again. Personally, I believe a telephone interview can be a form of discrimination, especially for a nurse for whom English is her second language. We loss over 50% of effective communication tools in a telephone interviewing. Phone interviews don’t always allow us the opportunity to show how much we can do and how well we can be as a great nurse.

KK – She was an experienced nurse in China. She is now taking care of a child with multiple allergies. She would like to work as a nurse in United States.

DD – In China, DD majored in English. She worked in a non-nursing field in the United States for a while and then decided she wanted to be a nurse. She went to LPN school, and then to an RN bridge program. Soon she became a RN. In her nursing student training, she worked at a telemetry unit. She was well-liked in her nursing practice and she was hired by that unit as soon as she completed her clinical training. The staff in that unit love her, and she loves nursing.

WW – She came to the United States with her husband. At that time, her husband was an owner of a local restaurant. WW did not want to work in the restaurant, she went on to study nursing as a new fresh beginning foreign student, and passed the nursing board. She worked as a nurse at a large local hospital for a few years, and then she earned her advanced nursing degree to become a nurse practitioner. She works as a nurse practitioner as soon as she completed school. She was alone and struggled for a long time in learning what was the nursing about, but she made it.

One of our visitors, Janice, asked, “Was there anyone who did not make it? Did anyone go back China?” Without pause and without knowing who else was going to respond, the CAN sisters answered in one voice in the spirit of our sisterhood:

“No, that  was not an option for us.”

They continued:

“Nobody said it was not hard.”

“We were determined to make it in this world together.”

“We were not going to quit.”

“We appreciate each other.”

“We learn from each other.”

“We are going to be strong, stand up straight, and shine.”

Our visitors were very impressed and encouraged. They also said they were very proud of their countrymen who are “making a difference in their new world.”

CAN, yes we can. CAN, yes we can.

This article was written for DiversityNursing.com by:

Mai Tseng RN, BSN, MPA, EMBA, NE-BC, LNC, CRNI.
Hospital Shift Supervisor
Children's Mercy Hospitals & Clinics
2401 Gillham Road
Kansas City, MO 64108

​A Day in the Life of A Patient

By Stephanie Wilborne, APRN FNP
Contributing author to DiversityNursing.com

            John takes five pills every day.  He does not know the names of all his medications, but he recognizes each pill by its shape and color. Taking medications every day is a struggle for John.  Sometimes he forgets to take his pills.  Frequently, he has problems paying for his prescriptions. John missed two appointments to see the eye doctor.  He forgot about the first appointment and was so late for the second, they refused to see him.    He's been told in the past that people with diabetes have a "higher risk" of eye problems.  John still does not understand why he needs to see an eye doctor.

            John is your patient today.  His blood pressure reading is high again.  And unfortunately, his hemoglobin A1c readings are still too high.  His diabetes and hypertension are poorly controlled.    You ask what pills he takes.  He can’t remember.  Reading in his chart, you see at his last visit he was given a list of all his medications.  Trying to figure out why his high blood pressure and diabetes are uncontrolled, you ask tons of questions. "Are you taking your medication every day?  Why did you miss the second eye appointment,” you ask him?  Frustration sets in.

            The term health literacy refers to a set of skills people need to effectively manage their health.   More than two decades of research has associated poorer health literacy skills with less frequent screening for diseases such as cancer, higher rates of disease, mortality and worse health outcomes.  It is important for health care providers to understand that patients with poorer health literacy skills may struggle at times with health related tasks.

Taking Medications: May have difficulty reading prescription bottles and understanding when, how and how often to properly take medications.

Disease Self Management Skills:  May have less knowledge concerning their disease or condition resulting in poorer disease and self management skills.  For example, diabetic patients with poorer math skills are more likely to have problems interpreting glucometer readings and therefore miss that blood sugars are too high, low or normal.

Risk:  May have difficulty understanding the concept of risk and how it may impact their health.

Navigation:  Patients with poorer reading skills may have difficulty reading a bus schedule, following directions and other hospital or healthcare signage.

Communication:  Patients with poorer health literacy skills are more likely to report problems understanding and following conversations and verbal instructions of health care providers.

  In 2003 the National Assessment of Adult Literacy for the first time measured the health literacy level of more than 26, 000 American adults.  Only 12% of Americans were found to have proficient health literacy skills.  Based on this data, the majority of adults may have problems functioning in our current healthcare system at different times of their life.  Unfortunately, health information that patient's receive from health care professionals is often too complex for them to understand.  The United States government, American Medical Association, Joint Commission and many other agencies are advocating that all health care professionals incorporate clear communication techniques and strategies into clinical practice with ALL patients.

John’s nurse turned her frustration into action.   How many times a day he needs to take his medication was reduced to once a day.  His prescriptions are now written for a 90 day supply.  To help John manage his diabetes and hypertension better, John sees a nurse or clinician more often.    His health care team has completed training on utilizing clear communication techniques and strategies into clinical practice.   John now receives verbal and print instruction that incorporates plain language principles with less medical jargon. Teach back is used to confirm understanding.  Brief conversations with John revealed he didn’t know that much at all about diabetes or hypertension.  His clinician and nurse devised a plan to provide short bursts of education for future appointments.  They are also trying to coax John into attending diabetes self management classes   And yes, John finally had an eye appointment.  His nurse arranged for a family member to take him to his appointment.

All of the interventions mentioned above are based on more than two decades of research on how to improve the health care delivery and health outcomes for patients with poorer health literacy skills.  How health care providers communicate and deliver care can improve the ability of patients with poorer health literacy skills to manage their own health.  Nurses, we have the power to transform our healthcare system.  Learn more about health literacy and incorporate clear communication into your clinical practice.

Stephanie Wilborne, APRN FNP

www.health-lit.com/

Thank you to Pilar De La Cruz-Reyes, MSN, RN from the California Institute for Nursing and Healthcare for the content of this video.

Breaking the Barriers is a great compilation of nursing stories put together by the California Institute for Nursing & Health Care that show how everyday people can overcome adversity to follow the career of their dreams. The nurses in this video will inspire you and show to our young people how you really can achieve if you have the desire and passion for a career in nursing.

Once you watch this video, we would love to hear your feedback. Please comment here on our blog when you have a minute.