DiversityNursing Blog

The following is a Diversity Statement written and signed by numerous colleges and universities and taken from the University of Virginia's website for their Office of African American Affairs. It provides good insight into the value that diversity adds in higher education, which almost always applies to professions, like nursing, as well.

 

On the Importance of Diversity in Higher Education

America's colleges and universities differ in many ways. Some are public, others are independent; some are large urban universities, some are two-year community colleges, others small rural campuses. Some offer graduate and professional programs, others focus primarily on undergraduate education. Each of our more than 3,000 colleges and universities has its own specific and distinct mission. This collective diversity among institutions is one of the great strengths of America's higher education system, and has helped make it the best in the world. Preserving that diversity is essential if we hope to serve the needs of our democratic society.

Similarly, many colleges and universities share a common belief, born of experience, that diversity in their student bodies, faculties, and staff is important for them to fulfill their primary mission: providing a quality education. The public is entitled to know why these institutions believe so strongly that racial and ethnic diversity should be one factor among the many considered in admissions and hiring. The reasons include:

Diversity enriches the educational experience. We learn from those whose experiences, beliefs, and perspectives are different from our own, and these lessons can be taught best in a richly diverse intellectual and social environment.

It promotes personal growth and a healthy society. Diversity challenges stereotyped preconceptions; it encourages critical thinking; and it helps students learn to communicate effectively with people of varied backgrounds. 
It strengthens communities and the workplace. Education within a diverse setting prepares students to become good citizens in an increasingly complex, pluralistic society; it fosters mutual respect and teamwork; and it helps build communities whose members are judged by the quality of their character and their contributions. 
It enhances America's economic competitiveness. Sustaining the nation's prosperity in the 21st century will require us to make effective use of the talents and abilities of all our citizens, in work settings that bring together individuals from diverse backgrounds and cultures.

American colleges and universities traditionally have enjoyed significant latitude in fulfilling their missions. Americans have understood that there is no single model of a good college, and that no single standard can predict with certainty the lifetime contribution of a teacher or a student. Yet the freedom to determine who shall teach and be taught has been restricted in a number of places, and come under attack in others. As a result, some schools have experienced precipitous declines in the enrolment of African-American and Hispanic students, reversing decades of progress in the effort to assure that all groups in American society have an equal opportunity for access to higher education.

Achieving diversity on college campuses does not require quotas. Nor does diversity warrant admission of unqualified applicants. However, the diversity we seek, and the future of the nation, do require that colleges and universities continue to be able to reach out and make a conscious effort to build healthy and diverse learning environments appropriate for their missions. The success of higher education and the strength of our democracy depend on it.

 

Meg Beturne MSN, RN, CPAN, CAPA
Denise Colon, RN
Baystate Health System, Springfield, MA

This article was submitted by Meg Beturne RN, MSN, CPAN, CAPA,  Assistant Nurse Manager @ Baystate Orthopedic Surgery Center in Springfield, MA.  Meg became a mentor and participated in "Baystate Health’s Diversity Leadership Initiative, Mentoring Across Differences" Program. A Dimensions of Diversity Exercise (copyrighted in 2011 by Washington Orange Wheeler Consulting firm http://wow4results.com) was offered as part of the Program.

The exercise is a puzzle that shows the complexity of mentoring across differences. Understanding how these differences have impacted us and others helps to create a container for meaningful dialogue. Consider how various differences could impact your mentoring relationship. To participate in this exercise, you identify a few  dimensions of diversity that have had an important role in impacting who you are, how others see you, and how you see the world. You then figure out how the dimensions shaped who you are personally and professionally. Finally, how might these dimensions impact your mentoring relationship? 

Meg, a Caucasian Catholic, mentored Denise who has a Latina background with strong family ties and a culture that is filled with traditions that are vital to her life and that of her family and extended family. Denise is Roman Catholic and she works to maintain a healthy balance between work and home as she has a young family. Here is their mentoring story…

 

Impact on Differences 

As I began the mentoring relationship with Denise, I realized the importance of recognizing and understanding the differences and similarities that existed between us. Equipped with this knowledge, I felt that we could tackle the complexities of mentoring across differences. The Dimensions in Diversity exercise offered the perfect opportunity to explore key, diverse components that have made us the women and nurses that we are today. To that end, we made this a priority and discussed it at our very first meeting and then confirmed our thoughts and feelings at our next time together.

It was interesting to realize that both of us equally valued traditions and observances, but from a different perspective. We both enjoy sharing the particulars of the holiday traditions through the years and reminisced on who was present, the activities that took place, the photos that were taken and the memories that were made and cherished by future generations. Denise however was vocal that many persons that she has interacted with over time do not have a real understanding of the ethnic backgrounds that are celebrated in the various holidays. That being said, there is a lack of appreciation from culture to culture on the meaning and purpose of observances involving family and relatives. I had to admit that since I had grown up in a small mill town in Connecticut that was homogenous with regard to ethnicity and religion (Caucasian Catholics), I was not exposed to comments, conversations or messages that demonstrated anything but allegiance to the existing cultural observances and inclusion of the small numbers of diverse ethnic and religious populations that resided close by.

Denise chose accent and dialect as another dimension of her diversity. She relayed the fact that many individuals and groups do not make an attempt to understand or accept anyone who speaks in a certain way. This scenario creates feelings of self-doubt. In addition, it allows feelings of rejection to creep in that ultimately results in further retreat into one’s own ethnicity which is considered supportive and safe. As a registered nurse, Denise has encountered many patients and caregivers from all corners of the globe. Working with a team of professionals, Denise has gained acceptance and recognition as a caring and compassionate care giver and over time, interactions and conversations have focused on quality care rather than on accent or dialect.

I then shared that communication was a vital personal and professional dimension that affects my life in so many ways. Even though my communication style is open, friendly and positive, I have learned that being a good listener is actually a more important skill. I found myself connecting with Denise’s story and promised myself to be even more in tune with people I meet on a daily basis who might sound different than me. In my own way, I will seek to eliminate self-doubt by encouraging others to use their native voices to raise questions, contribute ideas and feel reassured that they will be understood.

As I reflect on this meeting with Denise, I am amazed at the information that was willingly shared and the conversation which was free-flowing and enjoyable.  Most importantly, after completion of this exercise, I feel more prepared then ever to be the type of mentor that will enable Denise to move forward in both her professional career and her personal life!

A special thank you to Denise Colon, RN for her participation.

This is the first of a 2-part article and is a follow up to the CAN (Chinese American Nurses) Sisters I published on our blog on August 23, 2011. Click Here to Read the first article in this series.

The article is the collaborative work of a team of Chinese American Nurses (CAN) sisters.  It speaks as “foreign” nurses who have worked in America for a number of years. Our group is very lucky to have CAN meetings twice a month. We have each other’s support. We share our setbacks and clarify our things that might confuse us. Together we provide opportunities to think things through; to have a better understanding of ourselves, to not let fear paralyze us; and to add strengths to face tomorrow with positive thoughts and energy. Go CAN!! Go!!!

Last month, a CAN nurse started to talk about the major differences that we are experiencing in the nursing functions and practices between China and the United States. Everyone joined in the discussion.

Assess and Reassess Our Patients

In USA:
Nurses are expected to know as much as possible about our patients. Nurses have a major responsibility in the assessment and re-assessment of our patients. Most nurses are doing a great job in assessing patients. Nurses are at patients’ bedside 24x7. Physicians are not. We may notice a change first, and take action as the law allows. We can initiate many nursing protocols, especially in an emergency, and then we report the changes to physicians. Physicians come to assess, verify, confirm the changes, and take additional actions.

In China:
The nurse-to-doctor ratio is nearly 1:1 in China. Doctors are just like nurses, at patients’ bedside 24x7. When new patients arrive, doctors perform the first assessments.

Report Abnormal Findings:

In USA:
Nurses report abnormal findings from our own assessments or from the results we receive from other departments or facilities. Most of our current practice is to report the results to nurses first. Nurses are expected and required to report abnormal findings to physicians. We can take actions that are legally allowed. Many nursing protocols are there for us to utilize, especially in an emergency, and then we turn around and report the results to physicians. Physicians come to assess, verify, confirm the changes, and take additional actions.  

In China:
Doctors on the units get reports first. Nurses may not be aware of the results and reports. Therefore, nurses may not be aware of changes or actions needed.

Emergency Responsibilities:

In USA:
Nurses or anyone who witnesses the need can call a code. A nurse is usually the initial emergency responder, until an organized team comes. Teams, including physicians, take over the emergency situation. Organized teams, such as the Rapid Response Team, Code Blue Team, and Trauma Team, have additional training in things like Advanced Critical Life Support and Pediatric Advanced Life Support.

In China:
Doctors are at the patient’s bedside or nearby to respond and initiate emergency actions.

Administering Medications:

In USA:
Nurses are responsible to ensure medications which are taken by mouth (P.O. medications) are swallowed every time, with no exceptions. In the Medication Reconciliation process in some facilities, nurses verify medications on an on-going basis. Verbal and telephone orders are seen often in some facilities.

In China:
In past practice, P.O. medications might be left at the patient’s bedside or with their families, trusting that the patients would take their medications. This is not the right thing to do. It is very dangerous. What if a patient purposely hides his/her medications, and then overdoses on them?  China’s nursing practice is changing; now nurses are watching patients take their medication more often. Doctors are there to verify medications in the Medication Reconciliation process. No verbal orders.

HIPAA Regulations:

In USA:
A patient’s health information is very private, personal property. It totally belongs to the patient. If we don’t have a patient’s written consent, or regulatory permissions, then we cannot give personal information to anyone except the patient. Self-imposed “kindness” such as initiating family or community support for a patient without the patient’s permission is no long allowed. For example, let’s say we go to work at the hospital and see our neighbor who is very sick. Our sick neighbor needs help, especially with child care. We cannot tell another neighbor who we think would be happy to help with the sick neighbor’s child. We have to plan ahead, talk about our intent, and ask the sick neighbor’s permission before we talk to the helpful neighbor. We would be violating the sick neighbor’s confidentiality if we talk to another neighbor without the sick neighbor’s permission.

In China:
Helpfulness and kindness are always welcome as long as it is a sincere act.

Sterile Technique

Performing and maintaining a sterile technique is a big deal in infection control to the nursing practice of both countries. Maintaining sterile technique saves lives, time and money.

In USA:
In some cases, CAN nurses had the perception that a few of their nurse co-workers’ practices were a bit sloppy. When you notice the lack of sterile technique, you must speak up. Express concern about contamination. This is a time to educate our co-workers in a kind way. Often the nurses who are doing the job may not be aware that contamination has occurred. Mentally, we know that it is difficult for us to point out any possible contaminations or any wrong doing. Culturally we were taught to pretend that we did not see; let others do whatever they want to do; we do what we are supposed to do to keep ourselves clean.  “Mind our own business,” is what we learned. But in today’s world we need to prepare a simple and easy phrase or sentence that will help us to gently point out possible contamination. It will save lives. We have a lot to learn about how to be assertive and to be an advocate for our patients.

In China:
The fear of contamination and the strict self-monitoring of sterile techniques are emphasized more. CAN sisters feel that because of our past strict training, sterile technique is branded into our minds.

PIV Insertions:

In USA:
Many facilities prefer to have IV Teams for Peripheral IV insertions to save nursing time, promote patient satisfaction, and decrease line infections. Therefore, nurses’ experiences in starting PIVs are very different. Some nurses do not have to start an IV at all and they have no skill in PIV insertion. For some nurses who start PIVs occasionally, their skill is hit-and-miss. Very few nurses are good at PIV insertion.

In China:
CAN nurses discovered in the support group meeting that most of nurses are good at PIV insertions. We found out that CAN nurses are the “go-to person” for performing PIV insertions. Personally, I have never paid much attention to this as a big difference. It was delightful to find out that this is one of our common strengths.

Salaries & Bonuses:

In USA:
We make good salaries as nurses, even after about 40% is withheld in taxes, income taxes, and sale taxes. On the other hand, if we compare our salaries to physicians’ salaries, we find out a real gap. Physician pay is much higher. Of course, there are good reasons. Physician education and training are much longer and more in depth, and more physically and emotional demanding than nurses’ education. The demand for physicians is greater than the supply of physicians. We have many physician assistants and nurse practitioners who work under physicians and support some of our physician functions and responsibilities.

In China:
Nurses and physicians both have two types of incomes – regular salary and bonus. The nurses’ salaries are much closer to physicians’ salaries in China. Chinese doctors and nurses are equally compensated by the government. It is a perfect system for equal professionals. The differences in their earnings come from their bonuses, which are regulated and paid by the hospital. Currently, no nurse practitioners are working in a hospital or clinic in China.

Nurse to Physician Ratio:

In USA:
The variety of job choices for nurses is huge, including acute hospital care, clinics, nursing homes, home health, insurance, occupational health, schools, law firms, etc. The nursing functions and responsibilities are varied, and it is very different in different health-care and non-health care settings. The physician to nurse ratio ranges from 1:4 to 1:8 or more, depending on the type of facility and the time of day or night. Some nurses function independently.

In China:
Most of nurses are working in hospitals and clinics, the nurse to physician ratio is nearly 1:1. It is a perfect ratio for an equal professionalism. No nurses are function independently.

For us “foreign” nurses, especially those of us who have studied nursing or grown-up abroad, we often find that nursing functions and practices are very similar in some ways and quite different in other ways. This becomes apparent particularly on initial entry into the nursing profession in the USA. Adaptation will ease most barriers. The sooner we can identify the differences, analyze them, and find ways to adjust, the sooner we will adapt to the United States’ way of practice. As we open our hearts and minds to learn new things, we can expand our horizons. Every challenge forces us to learn and to bring out undiscovered talents within us, thereby making us stronger. There is no failure in trying to do the best we can do; the only failure is not trying to change and adapt to a different way of doing things. There are times we have to be brave enough, to have enough self confidence, and to excel on own strengths. We want to keep very strong, solid nursing skills, such as peripheral IV insertion skills. We want to keep the valuable nursing concepts, such as sterile techniques with us. Our skills will be lost if we do not practice constantly. In all, we are excited that we have opportunities to brand ourselves as the best we can be in United States.

Contributors:

Mai Tseng -- RN, BSN,MPA,EMBA, NE-BC,CRNI, LNC
Karen Cox -- RN, PHD, FAAN,
Laurie Ellison -- EMBA
Xu Hong Fang -- RN
Hong Guo -- RN
Sufan Sun -- RN

Please watch for the second half to this article to be published later in December.

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