DiversityNursing Blog

from Jacob Braude is vice president for strategic planning and director of the Saatchi & Saatchi Wellness Lab at the advertising agency Saatchi & Saatchi Wellness for Forbes.com

Health and wellness are becoming big all across marketing. Even carmakers are getting into the act. Ford, for instance, just announced plans to partner with WellDoc to build mobile health sensors into its cars. In the future your Focus won’t just get you from here to there; it will also monitor your glucose levels, adapt to a high pollen count, and even remind you to take your medicine.

But in the rush to make the most of health and wellness, there is a danger that companies will miss one of the most important aspects of wellness. It’s not technology, or supplemental ingredients, or even medicine. It’s friends.

In a talk he gave at the TED conference in 2006, Dr. Dean Ornish, who first became well known for talking up the benefits of diet and exercise in fighting heart disease, told a story about a year he spent studying under a well-known swami. As Dr. Ornish recalled it, the two of them were speaking to a room full of medical students when someone asked the swami to talk about the difference between illness and wellness. The swami went to the board at the front of the room and wrote “Illness” and “Wellness.” Then he circled the I in “Illness” and the We in “Wellness.”

It was a simple and profound way to make a point, and a recent series of studies have proven him right. Researchers have shown that what I call “we-ness” affects all aspects of our health and wellness, from how likely we are to survive killer diseases to how likely we are to carry some extra weight and how generally satisfied we are with our lives.

In one survey of almost 3,000 nurses diagnosed with breast cancer, researchers discovered that women who had fewer than 10 close friends were four times more likely to die of the disease than women with 10 or more close friends. That’s an increase in survival rate that any pharmaceutical company would be thrilled with. In another study, of men in Sweden, researchers discovered that the leading risk factor for heart attack after smoking was having only a few friends. More recent research has demonstrated that people living with a lifelong condition like heart disease do better if they share their experiences with others going through the same thing—even if those people aren’t their friends.

Having friends isn’t just about long life. It’s also about quality of life. Highly publicized work by James Fowler and Dr. Nicholas Christakis found that having a friend who became obese made you 57% more likely to become obese as well. Researchers are discovering that both good and bad habits spread socially—not just weight issues but all aspects of health and wellness, including dietary and exercise habits and stress levels. The importance of friends to a person’s health and wellness has become so accepted that in a March 2011 interview with the Los Angeles Times, the U.S. surgeon general said, “We can’t look at health in isolation. It’s not just in the doctor’s office. If you have a healthy community, you have a healthy individual.”

Given all that, it’s not surprising that a study by the RAND Center for the Study of Aging identified “social contacts and family” as the No. 1 factor affecting life satisfaction. This was a robust study, conducted in both the U.S. and the Netherlands. There were differences between the two countries in other life satisfaction elements, such as job, income, and daily activities, but the people of both countries agreed that social contacts and family had the greatest effect on how satisfied they felt.

Fiat’s new eco:Drive system makes the most of the feel-good aspect of we-ness. It began with a wellness product that lets you in put your driving habits to a program that will teach you to blow less carbon into the environment by changing the way you drive. It became a we-ness product when Fiat created Eco:Ville, a virtual town modeled on the company’s hometown of Turin. Software permits you to join Eco:Ville, but only if you’ve changed the way you drive and improved your carbon footprint.

Another marketing-related innovation that builds on the connection between we-ness and everyday health and wellness is the Nike+ system. Nike took a health product—smart running shoes that can record your distance and pace and sync the data to your iPod—and made it a we-ness product by incorporating massive social integration in the form of running teams, geographic challenges and automatic posting of runs to social networks like Twitter and Facebook.

Asthmapolis, an organization that is just getting off the ground, connects we-ness to improving health for chronically ill patients by attaching a small GPS-enabled device to rescue inhalers. With today’s medications, asthma can often be well controlled but isn’t, because people rely too much on their rescue inhalers. Using Asthmapolis technology, whenever someone uses their inhaler, the time and location of use are recorded, creating a searchable map and timeline of their treatment habits that can be shared with friends, family, and physicians.

All these innovations make use of social technologies to weave we-ness into products that have a flavor of health or wellness. But we-ness doesn’t mean just plugging social media into whatever you’re selling. Coke recently rolled out special vending machines in Argentina to promote International Friendship Day. Most of us don’t associate Coke with health and wellness (sorry, Coke), but the company’s smart use of we-ness deserves to be recognized. The vending machines in Argentina were so tall that only by getting a boost from a friend could you put money in. When you did, you were rewarded with two Cokes—one for you and one for your partner.

We-ness is a part of all of our lives, so much a part that we sometimes take for granted just how good connecting with other people feels. Research proves that it doesn’t just feel good; it’s good for us. If you’re in the health and wellness market, or you’re ready to take the plunge, you will do well to include some aspect of it into what you’re selling.

Margaret Stineman spent many of her formative years in the slow classes that were then the domain of children who were, as she delicately puts it, "not achieving."

Born with a severely deformed spine and shoulders, she endured 15 operations as a child on her eyes, internal organs, and misshapen bones. She spent much of her adolescence in a body cast, making her the object of ridicule. Problems with the muscles that control her eyes severely limited her vision. People around her did not think she was capable of much, and she agreed.

How that child - functionally illiterate when she left high school - became an artist and then a doctor and then a respected researcher and then a member of the prestigious Institute of Medicine is a remarkable story of serendipity, determination, motherly devotion, and well-timed mentoring.

Then there's the emotional alchemy. A set of circumstances that would have made many people angry, bitter, or at least deeply insecure seems instead to have forged a woman who is, at 58, confident, profoundly thoughtful, joyful, and serene.

Joel Streim, a longtime friend and research collaborator at the University of Pennsylvania, called her "one of the special people of the world." Just as Stineman focuses on her own strengths rather than weaknesses, he said, she sees other people's abilities and "has a real talent . . . to make them more creative and innovative."

Now a professor of both physical medicine and rehabilitation and epidemiology whose work has focused on measuring and compensating for disability, Stineman does not like talking about her physical problems. But she recently gave a rare speech to colleagues at Penn about how she had made it in academia, and now hopes her story will help fellow health workers see the potential in their patients.

Stineman's journey to the upper levels of medical research began with art. Bored in school, unable to see well, and plagued by medical problems, she turned inward and expressed her private world by painting and sculpting. In early adaptations for her handicaps, she used templates and mirrors to compensate for a lack of depth perception. Some of her teachers noticed her talent, and it got her into Temple University's Tyler School of Art.

Soon after art school, Stineman won a prestigious scholarship that would have sent her to Rome to paint for two years. She said members of the selection committee rejected her after she had a physical. "They didn't want to send a crippled person to represent the United States," she said.

She was crushed at first, but then looked at the problem from another angle - a defining quality of both her life and art.

"I was hurt. I was upset. I was angry," Stineman said. "This transformed into something that was so beautiful: a recognition that I must be smart or I wouldn't have won this thing. I must be smart. Something must have been missed. That's when I had the wake-up of my life."

For a while, she rejected art - she saw it as too emotional - and threw herself into the discipline and rules of science. Stineman's dream, and she knew it was probably an impossible one, was to become a doctor. Engineering was her fallback.

Her inventor father worked as a machinist at Drexel University. She enrolled as a special student there, taking one class at a time. "I decided that I would do absolutely anything to learn," Stineman said. "I was so infatuated with the fact that I could go from barely knowing arithmetic to getting an A in calculus just because I had applied myself."

She met what might have been her Waterloo in biology. She did well on the fill-in-the-blanks part of a test but flunked the essay.

"You can't spell," the professor told her. "You have no sense of sentence structure, and you can't formulate your ideas. Are you from a foreign country?"

Instead of taking offense, Stineman took an English-as-a-second-language class.

"This professor really saved my career," she said.

After using her art portfolio to talk about visual perception, she got into Hahnemann Medical College. It was a lot harder to keep up there. She almost quit, but some key professors helped her at crucial moments. Because Stineman learns better through hearing information - and can process it quickly - than by reading it, her mother read her textbooks into a special tape recorder that Stineman then played back at high speed.

She brought a different perspective to the care of people with disabilities. "I felt as a child they kept trying to fix me," she said, "but nobody was helping me to learn how to live with the way I was."

Stineman can walk short distances, but usually uses a motorized wheelchair or cart. Patient reaction, she said, ranges from dismay - "Now even my doctor's disabled" - to "Oh, my God, if she can do it, I can do it."

She reconciled with art after she recognized the creativity in science.

One day, she was fascinated by how a spherical bottle stopper inverted the landscape outside her window. She decided to write a mathematical formula explaining why that would happen. Yes, that's her idea of fun.

"I painted the image, and then I used mathematics to solve the image. This has been what has driven my whole life," Stineman said. "If you want to understand something, whether it is human nature, whether it is a scientific problem, use many different ways of looking at it."

Her facility with math and computers led to her biggest claim to fame: She helped design the system Medicare began using in 2002 to decide how much to pay for rehabilitation care for individual patients.

She remembers the responsibility she felt going to work the day the hospital began using the new system. "I was practicing medicine under rules that had come out of my head," she marveled.

As Stineman waited for the elevator, she said the prayer she says each day about her patients. "May I have the strength to see what I need to see, to know what I need to know, so that I can care for you in the best possible way."

Stineman, whose long brown hair is streaked with gray, focuses on research now. She is in charge of three large National Institutes of Health grants aimed at identifying the most helpful rehabilitation services after stroke and leg amputations and at helping older people stay in their homes. Although lung problems reduce her stamina, she is known as a tireless worker. A computer that speed-reads documents out loud makes it possible for her to handle the work.

She stands only 4-foot-9, barely tall enough to see over a lectern. She estimates she'd be 9 inches taller if she had a normal spine. She often props herself up with her knees and elbows to sit upright.

She does special exercises and eats an organic vegetarian diet. Although she has had suitors, Stineman said she had never loved anyone enough to curtail her work. She relaxes in a Zen garden her mother created at the house where she lives near the university. She said she had dealt with the pain in her life by creating art, writing music, and keeping journals.

During her recent speech to coworkers, Stineman used self-portraits to explain the evolution of her art and her psyche. A high school effort shows a pretty, intense-eyed girl's face framed by dark, ill-defined hair. There's no body, and the work lacks perspective. Another early, harsher piece shows her twisted body lying on a table in a bare room with a pit.

In 2004, she did a painting of her face and body as an adult with an X-ray-like rendering of her curving spine highlighted.

Two years later, she added her white lab coat, stethoscope, and gold caduceus with the word courage carved in it. Finally, Stineman had put it all together, proudly.

"My body is a vehicle for my mind, and I can wear this coat and I can take care of others," she said, displaying the painting on a screen.

"Was I disabled or was I gifted or am I both?" she asked. "Are we all both? I believe we are."

We want to hear from you. What do you think about Dr. Stineman and her ability to overcome all the obstacles in her life?

This question comes up frequently and is asked quite often by nurses, "Should I carry malpractice insurance?" Many nurses are covered under their own individual liability insurance carrier. Many more are not. I am.......... are you??

Nurses can be sued at any time, for any reason. Often, allegations brought against you are unfounded, but just being named in a lawsuit gives one pause and can be one of the most stressful times in your life. The nurse feels embarrassed and fears damage to a perfect reputation.

Your employer's policy may cover you, but only up to a point. Remember: Your employer's policy is created to fit their specific needs and protects them first.

You may even be told (by your employer HR) that you do not need your own policy. What they do not tell you is that they want you to be represented by their attorneys. They do not want "outside" representation for they know that their best interests will not be first and foremost. Carrying your own policy will ensure you personal attorney representation when you need it and this attorney will be concerned with only protecting YOUR needs and YOUR best interests.

All malpractice insurance policies have limits of liability. If you are only covered by your employer's insurance, other defendants employed at your entity may and probably do share your liability limits under the same policy. If you as well as others are named in a suit, your legal costs, including any settlement, could exceed your employer's shared liability limits. This would mean out-of-pocket expenses for you!!

The following are a few individual carriers:

    Nurses Service Organization (NSO) - www.nso.com - #1 carrier for Nurses with free online quotes
    www.hpso.com
    www.cnahealthpro.com
    www.cmfgroup.com
    Marsh Affinity - www.proliability.com
    www.seaburychicago.com - not in all States
    Liability insurance can also be purchased through CNA by going to the American Nurses Association website - www.nursingworld.org
    And, some Home Owners insurance policies will have stipulations for liability insurance.

It is up to the individual nurse how much liability to carry. $1,000,000/$6,000,000 coverage premiums are approximately $90/year in most States for the RN and $90/year for the LPN - NSO.


Another benefit of carrying individual coverage which extends beyond your employer's limits:

    License Protection

Many Carriers reimburse you up to a certain amount if you are defending disciplinary charges with your Board of Nursing (BON).


And, many policies also address the following (not all inclusive):

    libel
    slander
    charges of confidentiality violation
    assault on the job

So, do you carry your own individual liability insurance??

Small price to pay for peace of mind...

Diversity is a welcome challenge as it is an opportunity to learn and be a better leader at CentraState.

Any Monday through Friday, you'll find Jeffrey Anderson and Hazen Yu in their positions as Administrative Coordinators /Nursing Supervisors for CentraState Healthcare System in New Jersey. Jeffrey works the 3:00-11:00pm shift and Hazen works the 11:00pm - 7:00am shift. Recently, Pat Magrath of DiversityNursing.com had a conversation with these experienced and dedicated Nurses to find out what they had to say about their nursing experiences.

Both men agree that what they love about CentraState is the opportunity for growth in their careers and the support they receive from hospital leadership. They stated that the leadership at the hospital provides excellent strategic planning, is very knowledgeable, and they consistently do the right thing for the employees and the patients. It is because of the leadership, many nurses are loyal to CentraState and have worked there for years. Jeffrey and Hazen are good examples of career growth within the hospital as Jeffrey has 9 years and Hazen has almost 14 years of tenure.

In preparation for our chat, both men did not consider gender as a focus of diversity.  They were aware women dominated the field, however they did not look at gender as an area of diversity. When they think of diversity, it is "cultural" diversity that comes to mind. Jeff and Hazen were able to come up with 20 different countries that are represented in CentraState's employee population.

They describe the community they serve as quite diverse. The community includes all the cultures employed by CentraState as well as many others. As a result of the cultural diversity, both Hazen and Jeff have learned about several different cultures and experienced several different languages.  Jeff and Hazen agree that diversity is a welcome challenge as it is an opportunity to learn and be a better leader. As Supervisors, they are keenly aware of the importance of understanding a patient's culture. Because their own nurses are so diverse, they often take time with their staff to get a better handle on a particular patient's culture and customs.

To meet the needs of the patient speaking a different language, several resources are available to the staff. One of the resources is the Language Line. This is a service that is used to translate any language via a certified interpreter. CentraState has been proactive and paid for staff members to be certified as language interpreters so they will be on hand to interpret a patient's symptoms and offer medical instructions. While Hazen and Jeff confirm the importance of communicating with a patient in the patient's language, they stress the delivery is just as important. They point out how you handle yourself - your tone of voice, posture, whether there should be eye contact or if it's acceptable to touch a patient -- is just as relevant in the communication process.  

When they visited www.DiversityNursing.com, they noticed an article about mentoring. They realized how each of them had been a mentor to the other. When Hazen was in the float pool, Jeff was in the ER. Jeff got to know Hazen and mentored him in the ER. When Hazen became Administrative Coordinator a year or 2 before Jeff, Hazen mentored Jeff in the Administrative Coordinator position. Mentoring for them has been a 360 degree cycle.

Both men also value CentraState's commitment to education. They have attended numerous seminars including a seminar on Leadership. Because Hazen and Jeff love what they do at CentraState, they encourage other men to consider Nursing as a career.

When asked if they felt they were treated differently because they're men, both responded they do the same work as their female colleagues and there is no difference in how they are treated.  Both noted that communication with women is different than it is with men and this difference has actually helped them in their personal lives. Jeff and Hazen are confident they got where they are in their careers because of their skills, education and hard work, not because of their gender. They have gained the trust and respect of their colleagues.  

Diversity is alive and well at CentraState.  Every year nursing staff receive a mandatory diversity packet that covers many areas including cultural competence and communication. They are tested on this information and encouraged to use it in their daily work.

Pat Magrath of DiversityNursing.com had a recent phone meeting with him for this eNewsletter. It turns out he is a member of the National Association of Hispanic Nurses (NAHN) NYC Chapter, and they met 2 years ago when he visited the DiversityNursing.com booth at the NAHN Annual Conference in San Antonio, Texas.  He stopped by our booth last year as well at the NAHN Conference in Washington, DC.

After visiting the DiversityNursing.com booth, he thought about registering for the Award, but was discouraged because "he never wins anything". When he saw how easy it was to register, he decided to do it. He's glad he did and encourages everyone to register "because you never know what will happen"! He said "This came at the right moment".

To find out the identity of our 2011 Award Winner and to learn more about his experiences as a nurse, please CLICK HERE.