DiversityNursing Blog

By PATRICIA R. OLSEN

Monica Parks, 43, of Easley, S.C., has been working as a traveling nurse since 2007.

Q. Why did you decide to do this for a living?

A. Traveling nurses work in different locations for weeks at a time. I like the flexibility of being able to pick where I work and take jobs when I want. This work pays well. I get to work in different environments, and I’m not involved in the politics you might find in a staff job.

How do you get assignments, and what about living arrangements?

There are agencies that cater to nurses and doctors who want to travel around the country for work. I’ve had contracts that run from six or eight to 13 weeks, and they’ve often been renewed. Traveling nurses are often needed to fill in for people who are out. A hospital will either offer lodging or pay a lodging stipend so we can find our own housing.

Doesn’t it get lonely working away from home?

Not at all. I make friends wherever I go. I’m working in South Carolina now, so I’m close to home. But this summer I worked in Washington, D.C. There’s so much to do there, and I got together with colleagues all the time. One was from the South, like me, and had several of us over for a Lowcountry boil — corn, potatoes, shrimp, sausage and crab legs.

What did you do before?

I was a staff nurse in the trauma unit of a South Carolina hospital for 14 years. I felt like I saw just about everything there is to see. After that experience, I’m confident I can work in a lot of areas, but my specialties are the operating room and gastroenterology. I’m given some pretty responsible jobs. I was also at the D.C. hospital before this last assignment there, so they knew me. This summer, a nurse manager going on medical leave asked me to train three nurses on nursing fellowships.

But aren’t you away from your family for several weeks at a time?

That’s the beauty of this type of work: I look for contracts at hospitals and outpatient centers that aren’t too far from home. This summer, my husband and our two children, 16 and 12, stayed with me in my D.C. apartment. My husband works from home, so he was able to work when he was there. When the kids started school, I drove to South Carolina every other weekend. I do the same thing as anyone else whose job takes them out of town, or who lives in one city but works in another.

Source: NY Times 

BY ARI BLOOMEKATZ

He was riding in his aunt's sedan, a kid in elementary school, watching senior citizens walk in and out of the Lynwood retirement home where his mother worked. Then she emerged in scrubs.

That's it.

David Fuentes holds on tightly to that simple memory: his mother at work. It's easier than recalling many other parts of his childhood — "a blur," as he calls it.

Like the time when he was little and his father, drunk, socked his mother. She remembers the blood gushing from her face and her child standing in the bathroom saying, "Mom, Mom."

Or the times when he was older and his mother had fallen into addiction. He would stay awake fearful of what might come when she went out looking for a fix.

Or the times he took care of his siblings when no one else would.

"Just like the basic things. That's all I really remember," Fuentes says, "kind of helping to make sure they got fed, and just keeping them company, making sure they were OK."

His face tightens slightly with some questions about the past. But he knows he doesn't need to remember everything.

He has his one simple memory. His mother, a nurse.

She always dreamed of becoming a registered nurse, but life got in the way.

"There's a huge family dynamic," says Fuentes, 26. "I wanted to fulfill for my mom what she envisioned for herself, but could never do."

This summer, he graduated from nursing school at UCLA and landed a job in the intensive-care unit at UCLA Medical Center, Santa Monica.

Beyond being a trailblazer in his family, Fuentes is among a group of men redefining the nursing industry. Although the profession is still dominated by women, the number of men is on the rise.

David Fuentes attends the morning huddle before the shift change in the intensive care unit at UCLA Medical Center, Santa Monica on April 11.

The percentage of male registered nurses more than tripled from 2.7% in 1970 to 9.6% in 2011, and the proportion of licensed male practical and vocational nurses increased from 3.9% to 8.1% over the same period, according to the U.S. Census Bureau.

Researchers cite various reasons for the shift, including diminished legal barriers, increasing demand for nurses as the U.S. population ages, and middle-class pay.

But for Fuentes, a main motivation is the solace he finds in being a caretaker.

"Everything is left behind," he says. "That's why I love it so much."

"It's like therapy ... kind of our way of dealing with our issues."

The sturdy curve of his biceps, the gauge in his left ear, the lip ring and tongue ring might seem intimidating if it weren't for the delicate way Fuentes presses on the legs of a 99-year-old patient to check her blood flow, or how he cups his hands and drums on her back to help her breathe more easily.

It is 45 minutes into his first shift as a registered nurse, and Fuentes and another RN are caring for the elderly woman, who had been in septic shock.

She is blind and mostly unresponsive, but Fuentes asks politely, his voice soft but direct: "I'm going to take your temperature ... OK?"

Another nurse says the woman's family stayed for 15 minutes earlier in the day. But Fuentes will be there the whole night standing guard — giving her medicine and monitoring her pain and breathing on his 12-hour overnight shift.

His black curly hair is pulled back into a ponytail and he's wearing navy blue scrubs, the color of the uniform defining his new rank.

"This is the first day of the rest of my life," Fuentes said before his shift started.

Fuentes thinks it's only natural that some patients feel more comfortable with nurses of the same gender, but mostly, he says, it doesn't come up.

David Fuentes examines Russell Sherman, 87, a patient being treated for a pulmonary embolism. Sherman says he remembers when all nurses were women in white uniforms.

A couple of months earlier, during his training, he was checking the oxygen flow into patient Russell Sherman's nostrils when the 87-year-old looked him over admiringly and said he remembered when the only nurses at hospitals were women in white.

"They were always girls," Sherman said. "It doesn't faze me at all. I think it's a good thing for men to be able to do a job without shame."

One of Fuentes' heroes is UCLA School of Nursing Dean Courtney Lyder, the nation's first male minority dean of such an institution.

Lyder, 47, said his own dean at Rush University Medical Center in Chicago, Luther Christman, was the first male dean of a school of nursing in the country. Tall and muscular, he "debunked a lot of preconceived myths about nursing."

Decades later, Lyder said, stereotypes about men in nursing are fading and the experience he had in nursing school — one of five men in a class of 200 — is becoming more uncommon. Although he says "we still have a long way to go" as an industry, 11% of students at UCLA's nursing school during the 2012 - 13 academic year were men.

"Men are seeing that this is a viable option that pays well, you have a good lifestyle, you give back to society," Lyder said, adding that nursing groups such as the American Assembly for Men in Nursing have also surged on college campuses.

"Nursing doesn't have a gender. Society and media have portrayed nursing as feminine," Lyder said. "It's not."

But there are nuances, some more subtle than others.

Huddled around sack lunches at a table outside the hospital, a group of undergraduate students — about eight women and one man squeezed in at the far end — took turns saying that they wanted to become nurses because they want more meaningful relationships with patients, not just because it's a good career.

David Fuentes makes the rounds with registered nurses Pamela Helms, center, and Heather Alfano in the intensive care unit at UCLA Medical Center, Santa Monica.

But they struggled to respond when the conversation shifted to pay grades, and the fact that even though men are far less represented in the field, census data show that women earn less on average, 91 cents for every $1 earned by a man.

"I think men obviously are more stronger than women, so maybe," one of the female students said, grasping for a reason. "I don't know, I'm trying to justify it."

The group packed up a few minutes later and went back to work.

Fuentes says that he decided to go into nursing in his freshman or sophomore year of high school, but his mother says his instinct for caretaking goes back much further than that.

"Sometimes I feel that maybe he grew up a little bit too fast because he wanted to make things easier for me," said Guadalupe Perez, 44. "Always got the impression that he kind of knew what was going on, like he just understood.... You could see the sadness in his eyes."

She's proud of her son, even when he chose to live with his aunt and only saw her on weekends.

"He has a good heart, he was always there for his little brother," she says. "Maybe it's just something that ... got into him, always being there to help someone."

But Fuentes is already thinking much bigger than his first love and about the role that nurses can play in the national debate over healthcare and the changes to the healthcare system.

Even though his past is painful, he doesn't want to put it behind him. "It's made me who I am," he says.

Late one night before graduation, Fuentes scribbled his thoughts about the nursing industry and then read them aloud as if his fellow graduates were listening.

"I am sure every single one of you in those seats, pre-license and licensure students alike, can attest to the roller-coaster ride that your respective nursing journey has taken you on," he wrote.

"There have been lots of ups and downs, unexpected turns this way, that way, every which way you could and never would have fathomed, but look at us now, we made it!"

Source: LA Times

By: Marilyn Hagerty, Grand Forks Herald

She sets her alarm on weekdays for 5:30 a.m., and she jumps in the shower when it rings. She slips into her green nursing scrubs.

“I always listen to the 6 o’clock news,” says Amanda Lako, a third semester nursing student at UND.

From 8 a.m. until 4 p.m., on a typical day she’s in classes, sometimes at the Public Health Department at the Grand Forks County Office building, sometimes at the College of Nursing and Professional Disciplines at UND and sometimes at Altru Hospital.

In her rush for class, she might bring a baggie with dry cereal in it to eat. “I’m terrible,” she said. She depends on coffee to keep her running. And there are times when she is so tired that she sets her alarm to ring in eight minutes. She gives herself a short, short nap.

The road to a degree as an RN, or registered nurse, is long and challenging.

Amanda Lako is one of 324 students in the undergraduate baccalaureate program at UND. Lako is a junior in her third of five semesters. Beyond that, there will be a semester of practical work in a hospital setting before she graduates in December 2014.

She is passionate about nursing.

“It is a calling,” she told me. “Once you start it you know if it is right for you. There has to be a big desire.”

For Lako, that desire began when she was growing up on a farm near Arthur, N.D. She was 4 when she started shadowing an aunt who was a nurse. She had other aunts who were nurses.

She was smitten with nursing. As a freshman at UND, she became a CAN, or certified nurse assistant. And, she said, “I loved each and every one of the residents I helped.”

Her work as a CNA taught her how to relate to patients. “It was amazing to work on the CNA float pool at Altru. I worked on every floor wearing my light baby blue scrubs,” she said.

Her class of 52 has five male students. And Lako thinks it is awesome for a man to go into the career. “It takes the kind of men who have the biggest hearts and are so kind and gentle.”

In Lako’s mind, nurses are selfless. She admires people who have been her mentors including her school nurse, her church leaders. And she said, “Certain people just push you. I was adopted and I think I learned to be selfless from my parents.”

She isn’t always that serious. She works away at the pages of papers she must keep on patients. And she gets supper around 7 to 8 p.m.

Then there are the times in the evenings when she sits around the kitchen table with four other nursing students. They live together.

“We laugh, we sing, we complain. I depend on them to lighten things up.” 

UND’s nursing program

UND offered non-degree courses of study for nurses beginning in 1909.

In 1949, the first baccalaureate program in nursing was established and a Division of Nursing was created at UND. The same year, the State Board of Higher Education authorized the creation of the College of Nursing as a unit on campus.

The baccalaureate program was fully accredited by the National League for Nursing in 1963 and has remained accredited since that time, according to information provided by Lucy Heintz, clinical assistant professor and director of the Office of Student Services.

In 2013, in addition to the Department of Nutrition and Dietetics, the College of Nursing was joined by the Department of Social Work and the name was officially changed to the College of Nursing and Professional Disciplines.

Currently, the Department of Nursing has 324 students in its undergraduate baccalaureate program. The graduate program with 269 enrolled offers two doctoral programs. Master of Science degrees are available.

The graduate program has an enrollment of 269.

Source: Grand Forks Herald

What is NO MORE?

NO MORE is a new unifying symbol designed to galvanize greater awareness and action to end domestic violence and sexual assault.  Supported by major organizations working to address these urgent issues, NO MORE is gaining support with Americans nationwide, sparking new conversations about these problems and moving this cause higher on the public agenda.

The history of NO MORE

The NO MORE symbol has been in the making since 2009. It was developed because despite the significant progress that has been made in the visibility of domestic violence and sexual assault, these problems affecting millions remain hidden and on the margins of public concern. Hundreds of representatives from the domestic violence and sexual assault prevention field came together and agreed that a new, overarching symbol, uniting all people working to end these problems, could have a dramatic impact on the public’s awareness.

The signature blue vanishing point originated from the concept of a zero – as in zero incidences of domestic violence and sexual assault. It was inspired by Christine Mau, a survivor of domestic violence and sexual abuse who is now the Director of European Designs at Kimberly-Clark. The symbol was designed by Sterling Brands, and focus group tested with diverse audiences across the country who agreed that the symbol was memorable, needed and important.

Who is behind NO MORE?

Every major domestic violence and sexual assault organization in the U.S. – from men’s organizations like A CALL TO MEN and Men Can Stop Rape, to the National Domestic Violence Hotline and the National Alliance to End Sexual Violence, to groups that help teens like Break the Cycle and Futures Without Violence, to organizations that advance the rights of women of Color and immigrants like Casa de Esperanza and SCESA to the U.S. Dept. of Justice’s Office on Violence Against Women – all of them and more are behind NO MORE.

View the complete list of organizations here.

What do we do?

NO MORE is spotlighting an invisible problem in a whole new way. The first unifying symbol to express support for ending domestic violence and sexual assault, NO MORE can be used by anyone who wants to normalize the conversation around these issues and help end domestic violence and sexual assault. Our vision is that NO MORE will be everywhere – on websites, t-shirts, billboards. Organizations and corporations, large and small, will embrace this symbol as their own. When an abuse case makes media headlines, you will instantly see NO MORE being tweeted, discussed on Facebook, worn as jewelry and on t-shirts; made into buttons and posted in classrooms, offices, billboards and grocery stores across the country. NO MORE will help end the stigma, shame and silence of domestic violence and sexual assault. NO MORE will help increase funding to prevent domestic violence and sexual assault.  Like the pink ribbon did for breast cancer and the red ribbon did for HIV/AIDS, NO MORE will help to change behaviors that lead to this violence.

Get the symbol today and start showing your support.

Why should I care?

The next time you’re in a room with 6 people, think about this:

• 1 in 4 women experience violence from their partners in their lifetimes.
• 1 in 3 teens experience sexual or physical abuse or threats from a boyfriend or girlfriend in one year.
• 1 in 6 women are survivors of sexual assault.
• 1 in 5 men have experienced some form of sexual victimization in their lives.
• 1 in 4 women and 1 in 6 men were sexually abused before the age of 18.

These are not numbers. They’re our mothers, girlfriends, brothers, sisters, children, co-workers and friends. They’re the person you confide in most at work, the guy you play basketball with, the people in your book club, your poker buddy, your teenager’s best friend – or your teen, herself. The silence and shame must end for good.

How can I help?

There are hundreds of ways you can spread the word about NO MORE.

Say it: Learn about these issues and talk openly about them. Break the silence. Speak out. Seek help when you see this problem or harassment of any kind in your family, your community, your workplace or school. Upload your photo to the NO MORE gallery and tell us why you say NO MORE.

Share it: Help raise awareness about domestic violence and sexual assault by sharing NO MORE. Share the PSAs. Download the Tools to Say NO MORE and share NO MORE with everyone you know. Facebook it. Tweet it. Instagram it. Pin it.

Show it: Show NO MORE by wearing your NO MORE gear everyday, supporting partner groups working to end domestic violence and sexual assault and volunteering in your community.

Learn more here.

By Debra Anscombe Wood, RN

Psychiatric emergencies can be as serious as a medical condition, but in traditional EDs, mental health patients may wait for treatment. Specialized psychiatric EDs serve that population quickly and efficiently. “They come in with everything from the need for prescription refills to being actively suicidal,” said Brian Miluszusky, RN, BSN, director of nursing in the emergency medicine department at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York. “A suicidal person is as much at risk of dying as someone having an MI (myocardial infarction).” 

As demand for emergency care has increased, so has the number of mental health patients seeking services. A study from the Carolina Center for Health Informatics at the University of North Carolina at Chapel Hill reported in 2013 that nearly 10% of ED visits in North Carolina from 2008-2010 were for mental health diagnoses, and the rate of mental health related visits increased seven times more than overall ED visits. Mental health related ED visits increased by 17.7%, from 347,806 to 409,276 from 2008-2010. Stress, anxiety and depressive disorders were most common. 

A January 2012 American Hospital Association Trendwatch report said, “In 2009, more than 2 million discharges from community hospitals were for a primary diagnosis of mental illness or substance abuse disorder. ... Among children, mental health conditions were the fourth most common reason for admission to the hospital in 2009.”

The report said there were more than 5 million visits to EDs in 2009 by patients who had a primary diagnosis of mental illness or a substance abuse disorder. “Access to [psychiatric] care is not easily found [in the community], but if you are having a mental health crisis, you can walk into our emergency department 24/7 and be seen by a psychiatrist within a couple of hours,” said Jennifer Ziccardi-Colson, RN, MSN, BSW, MHA, vice president for nursing services at Carolinas Medical Center-Randolph, a behavioral health center with a psych ED and 66 inpatient beds in Charlotte, N.C. 

Psych EDs serve patients with acute episodes of behavioral health diagnoses, including feeling suicidal, anxious or depressed or abusing substances. “When patients come to us, they are assessed and seen promptly,” Ziccardi-Colson said. “People can feel comfortable coming to our environment to receive care.” 

Not all patients with mental illnesses receive care in a psych ED. Even at those hospitals with a dedicated psych emergency unit or a stand-alone psychiatric emergency services facility, patients with acute medical conditions, such as an MI or a broken hip, are treated in the regular ED. The ED provider must determine if a medical problem is contributing to mental status changes or if the problem is solely psychiatric in origin. 

Some psych EDs, such as San Francisco General Hospital and Carolinas Medical Center care for children as well as adults. Children and teens receive emergency psych services at Carolinas Medical Center-Randolph. Younger children, ages 3 to 6, come in with situational stress related to family dynamics, such as divorce or custody battles; depression or anxiety, often related to bullying at school or at home; suicidal ideation; conduct disorders; and behavioral issues related to autism or developmental delays. “In the emergency room, it’s crisis stabilization,” said Tez Bertiaux, RN, MSN, nurse manager for the ED at Carolinas Medical. “A lot of these children are followed in the community by a mental healthcare provider.”

The hospital’s social worker will arrange outpatient care for children who do not have a current therapist. Many are admitted to inpatient care. The psych emergency services program treats about 700 children and adolescents monthly, and the hospital admits about an equal number to its inpatient units, said Bertiaux.

Pediatric ED visits tend to increase during the school year, with school staff workers referring students for care. Some of the children are in foster care or are homeless or living in shelters. Some parents and guardians will stay during the stabilization and others do not. “It’s a very complex dynamic, because you are not just treating the patient — the family is involved,” Bertiaux said. 

Bertiaux said many of the mental health issues that bring children into the ED are related to their environment. “And that can be challenging,” she said.

Patients seeking care at a psych ED may be treated and discharged, but others require admission to a psychiatric bed for stabilization. Physicians at NewYork-Presbyterian and San Francisco General admit about 30% of their psych ED patients to the hospital. But treatment begins in the psych ED. “It’s amazing how much we can help people,” said Andrea Crowley, RN-BC, interim nurse manager in psychiatric emergency services at San Francisco General. “Some just need someone to talk to and bring them down from the crisis they are in. It makes you feel you are making a difference, and it’s a visible, tangible thing.” 

Psych care a growing need

Carolinas Medical has seen a steady increase in psych ED volume during the past several years. It treats about 18,500 patients annually with a variety of psych disorders and continuously operates at 100% occupancy. Construction is under way to double the psychiatric hospital’s inpatient beds to 132. 
Johns Hopkins Hospital in Baltimore’s psych ED census has experienced a 30% jump this year. “People are sicker, and there are fewer resources in the community,” said Kate Pontone, RN, MSN, nurse clinician 3 and nursing service line leader for Psychiatric Emergency Services at Johns Hopkins. “Outpatient programs that had space available are no longer options. People are running out of medications or cannot afford transportation. Many of the same reasons emergency departments are crowded.” 

A March 2012 Congressional briefing by the National Association of State Mental Health Program Directors reported, “the economic downturn has forced state budgets to cut approximately $4.35 billion in public mental health spending over the 2009-2012 period,” a trend it expects will continue. While at the same time, there was a 10% increase in consumers receiving state-supported mental health services. 

In July 2012, the Treatment Advocacy Center released the paper “No Room at the Inn: Trends and Consequences of Closing Public Psychiatric Hospitals,” which found nationwide, closures of such hospitals “reduced the number of beds available in the combined 50 states to 28% of the number considered necessary for minimally adequate inpatient psychiatric services.” And “in the absence of needed treatment and care, individuals in acute or chronic disabling psychiatric crisis increasingly gravitate to hospital emergency departments, jails and prisons.”

Volume at San Francisco General’s psych ED has jumped from 500 per month to 600 per month. “It could be due to closures in programs,” Crowley said. “We are starting to see a fallout from lack of services in the community.” 

Volume also has increased at NewYork-Presbyterian where, typically, a dozen or more psych patients are waiting in the regular ED for a bed in the psych ED, Miluszusky said. Difficulty transferring patients to an inpatient bed clogs up the EDs. A lack of insurance complicates transfers, and patients may end up boarding in a regular or psych ED. 

Patients may walk in, arrive by ambulance or with a petition for involuntary commitment, because they are deemed dangerous to themselves or others. First responders may take a mental health patient to a psych ED rather than to a community hospital without such specialized services. “This is a growing population, and emergency rooms will have to evolve,” Miluszusky said. “The population is getting so big; we are going to have to think of new ways to handle it.” 

Benefits of a separate psych ED

Psychiatric emergency services programs typically are staffed with behavioral health professionals, allowing mental health interventions to begin quickly, and often the onsite team can stabilize the patient, avoiding a hospitalization, according to the article “Treatment of Psychiatric Patients in Emergency Settings” in the journal Primary Psychiatry. “You don’t have agitated psych patients in the emergency room with all of the sick people,” Crowley said. “It’s a specialized environment where you can begin treatment better.”

Nurses and other members of the psych ED team have a solid understanding about different mental health conditions and their treatment. They can begin therapeutically talking with patients immediately. “Our patients appreciate being cared for by someone who is familiar with their medications and their symptoms and can intervene when they begin to decompensate,” Pontone said. “You get specialized care and the rooms are safe,” said Miluszusky, who adds that improves outcomes. 

Psych EDs often are locked units and feature specially outfitted rooms, with no sharp corners, no cords, nonexposed plumbing and a calm atmosphere. The safety features prevent patients from harming themselves or creating tools to harm others. “Our main priority is patient safety,” Ziccardi-Colson said. “There’s no potential for suicide or other negative outcomes.”

Ziccardi-Colson reported Carolinas Medical’s psych ED operates cost effectively, in part because of its ability to begin treatment and stabilize. “We’re able to process people more quickly than a medical ED,” Ziccardi-Colson said. 

Miluszusky said having a psych ED can be cost effective, because it reduces overtime pay necessitated by providing one-on-one oversight of a psych patient in the medical ED. 

Nurse staffing varies by institution, often with psychiatric nurses providing care, such as at San Francisco General’s psych ED. “It’s an exciting job, where you see a wide variety of people,” Crowley said. “You have a profound effect on people’s lives.”

Emergency nurses, who have received specialized training in the care of mental health patients and de-escalating situations, staff the psych ED at NewYork-Presbyterian. Nurses from a Johns Hopkins inpatient psych unit covers the emergency room, and Pontone describes significant interest from the inpatient staff. The hospital also cross-trains the ED nurses, so they can step in during an emergency. Pontone says nurses who love psychiatric nursing are interested in the management of the acutely ill patient, who needs as much care and support as they can get in a safe environment. “We like to be there when patients are in crisis and need help,” she said. “And we are good in a crisis.”

Ziccardi-Colson said every day presents challenges, but the reward of helping patients to wellness is inspiring and keeps nurses motivated. “Those who like it, love it,” Crowley said. “And for those who are not into it, we are happy to do it for them.” 

Source: Nurse.com

The National Institute of Nursing Research (NINR) awarded $267,732 to the University of South Florida College of Nursing to study ways to reduce HIV/AIDS risk in college-aged black women, who are disproportionately affected by the disease. Rasheeta D. Chandler, PhD, ARNP, FNP-BC, assistant professor of nursing at USF, will lead the study.

"Tailoring an HIV Prevention for College-Aged Black Women" will adapt a previously-tested and effective sexual risk reduction approach, Health Improvement Project for Teens (HIP TEENS), to be culturally relevant and appropriate for college-aged African-American women. The research will test if this program, renamed Health Improvement Project for LADIES (HIP LADIES), helps reduce HIV/AIDS risk.

"This study is timely, and will be the template for future intervention studies conducted with black college women," Dr. Chandler said. "The award gives us the opportunity to improve the health of young black women."

AIDS.gov reports that of the more than 1 million people living with HIV in the United States, 46 percent are African-Americans. In addition, young black women are far more affected by HIV than young women of other races. The rate of new infections among young black females ages 13 to 29 is 11 times as high as that of young white females and four times that of young Hispanic females, according to the Centers for Disease Control and Prevention (CDC). The CDC reports that AIDS is the third leading cause of death among black women ages 25 to 34.

HIP TEENS is a small-group program for young women that uses interactive activities to provide information, motivate and teaches the skills girls need to reduce sexual risk behaviors. It was developed in 2004 by Dianne Morrison-Beedy, PhD, RN, WHNP-BC, FNAP, FAANP, FAAN, senior associate vice president of USF Health and dean of the College of Nursing. A randomized controlled trial led by Dr. Morrison-Beedy and recently published in the Journal of Adolescent Health reported that HIP TEENS significantly reduced sexual risk behavior and pregnancy rates in more than 700 adolescent girls.

"Not only did HIP TEENS reduce sexual risk behavior, we significantly increased sexual abstinence in these girls as well," said Dr. Morrison-Beedy. "HIP LADIES is a critical next step for reducing risk in college-aged young women."

Dr. Chandler's study will specifically target African-American women attending traditional universities and historically-black colleges and universities in the southeastern United States.

"This project is my chance to contribute to reducing the incidence of new HIV cases in young African-American women," Dr. Chandler said. "When you ask why I'm passionate about my research, this is my community, and these are people who've touched my life with their stories."

Provided by University of South Florida

Source: Phys Org

By Melissa Assink, RN, BSN

I was in med/surg for 13 years before moving to hospice, where I have been privileged to work for almost 24 years. At age 5, I was telling people I wanted to be a nurse. I believe it was a vocational passion that God placed in my heart those many years ago. 

A recent loss in my personal life, followed by a visit from a former patient, brought my passion into even clearer focus. 

I had received a phone call from my brother, telling me that moments before our father had suffered a massive heart attack and died. Even though he had been in declining health in recent years, the news felt like it hit me completely out of left field. 

The day of Dad’s memorial service arrived. While the presence of those in attendance was a comfort, it was also overwhelming to greet the many people who joined us to celebrate his life. Some we had not seen for many years, and it seemed they all had stories to share about him. 

One of the first people to approach me after the service was a man who appeared to be maybe 85. He had white hair, was hunched over and used a walker. He came up to me and stood there, staring at me, as if willing me to remember who he was. I drew a blank and asked, "How do I know you?"

His response was amazing: "You were my nurse 30 years ago, when I was in the hospital for five days to have my gall bladder taken out." He said it very matter-of-factly, as though I should remember him out of probably thousands of patients I have cared for over the years. 

Rather flabbergasted, I asked, "Did you know my dad?" He indicated he did not, that he had simply seen the obituary in the paper and wanted to come to the service as a tribute to me, his former nurse.

My mind raced. This dear man had connected me with Dad by recognizing me as a listed survivor in his obituary. It meant that he had to remember my first name and my maiden name from a brief hospital stay more than 30 years ago. 

I wanted to sit down and talk with him about his memories, but he promptly turned, walked out the door and was gone as suddenly as he had appeared. It seemed as if he knew he had accomplished his mission. I was engulfed with people wanting my attention, and it became impossible to follow him.

I have been reflecting on this former patient and his sudden reappearance in my life for several months. It was almost like he was an angel of sorts, sent to remind me how we, as nurses, touch the lives of people in our care at every turn. We sometimes are in good moods, sometimes not so good. We can become distracted by computerized charting, time management and policy and procedure manuals. 

It is easy to sometimes forget that we care for people when they are most vulnerable, sharing in their joys and sorrows in a way we might not always appreciate. We might forget their names by the next day, often as a coping mechanism, allowing us to go forth and care for the next person. We neglect to recognize they often do not forget us so easily. 

This former patient reminded me that we should never take any interaction for granted. We need to be caring and supportive, treating each of our patients with the respect and honor we’d like to experience if we were in their shoes. Our personal issues and circumstances are not important to them. They are watching us at every turn, looking for the light of our knowledge and support to see them through. A hug, a smile, a kind word, a moment of laughter or a shared tear — these are easy to give, but never forgotten. 

I pray I will always remember the responsibility I have to provide love, care and perhaps a moment of joy to the patients and families I interact with every time I put on my name badge. After all, we never know when a white-haired angel with a walker who received our care will cross our path and help us remember why we became nurses in the first place. 

Melissa Assink, RN, BSN, works for Providence Hospice and Home Care of Snohomish County in Everett, Wash. 

Source: Nurse.com

by Carrie Tian 

“Just Ask!” That’s the slogan for a new campaign by the Massachusetts Nurses Association (MNA). The union is encouraging people to ask how many other patients their nurses will be treating that day. The slogan is meant to draw awareness to what the nurses union sees as a growing disconnect between the profit-driven healthcare industry and the quality care of its patients.

The campaign’s goal is to enact minimum mandatory staffing levels, capping the number of patients per nurse. After a similar measure failed to pass the state legislature in 2008, the MNA wants to take the issue directly to voters through a ballot initiative. The union has submitted the text of the Patient Safety Act to the Attorney General’s Office; the act’s terms include limiting nurses to having up to four patients in surgical units and in emergency rooms. Once approved, the union will need to collect 70,000 signatures by November for the Patient Safety Act to appear on the 2014 ballot.

Currently, California is the only state that has mandated nurse-patient ratios. However, this topic may well seem familiar to Mass. voters: state nurses have sought staffing legislation since 1995, and 2011 saw fraught contract negotiations between Tufts Medical Center and its nurses. CommonHealth analyzed how Tufts’ lower nurse ratio affected patient care.

Lynn Nicholas, president of the Massachusetts Hospital Association, alluded to the idea’s long history by calling the current initiative petition a “repeat of an arcane idea that has no merit” in a statement. She said that patients would be better served by having decisions about their care made on a case-by-case basis. Her reactions echoed those of  Michael Sack, President and CEO of Hallmark Health, who wrote an earlier guest post on CommonHealth. “This cookie-cutter approach would completely take away a hospital’s ability to tailor care to specific patient needs,” Sack wrote.

Source: WBUR CommonHealth

by Crystal Loucel

Because minorities are more likely to receive less and lower-quality health care and suffer higher mortality rates from cancer, heart disease, diabetes, HIV/AIDS and mental health illnesses than their Caucasian counterparts, there have long been calls to increase the number of minority providers to reduce these health disparities. Numerous studies have shown that patients are more likely to receive quality preventive care and treatment when they share race, ethnicity, language and/or religious experience with their providers.

The 2010 Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health found that a diverse workforce – and the diverse perspective it provides – contributes to enhanced communication, health care access, patient satisfaction, decreased health disparities, improved problem solving for complex problems and innovation. Moreover, the Health Resources and Services Administration (HRSA) has found that minorities could improve access to care in underserved areas more than nonminority providers (see The Rationale for Diversity in the Health Professions: A Review of the Evidence [HRSA, 2006]).

Yet minorities are still under-represented in the health care workforce generally and in nursing in particular. In 1908, when Israel Zangwill popularized the term melting pot to describe the American population, it was 89 percent white, 10 percent black and less than 1 percent Indian, Chinese, Japanese and “others.” Today’s melting pot is considerably more diverse, composed of more than one-third racial and ethnic minorities; moreover, the United States Census Bureau expects that portion to be more than half by 2050.

“Today the nursing workforce does not adequately reflect the diversity in the population including gender,” says Beverly Malone, CEO of the National League for Nursing. Latinos, African Americans, American Indians and Native Alaskans compose only 7.6 percent of the nursing workforce, a dismal figure compared to the 25 percent in the general population. UCSF’s nursing student population is doing a bit better – in 2009, the latest year for which data are available, these same groups composed 16 percent of the UCSF nursing student body – but there is certainly room for improvement. When Asian Americans are included, a 2008 HRSA report showed that minorities make up 35 percent of the total population but only 17 percent of the nursing population.

UCSF has been trying to respond to the 2004 Sullivan Commission Report, titled Missing Persons: Minorities in the Health Professions, which recommended that health profession schools hire diversity program managers and develop plans to ensure institutional diversity, including providing educational support, commitment, role modeling and dedicated recruitment. Currently, Judy Martin-Holland serves as associate dean for Academic Programs and Diversity Initiatives at UCSF School of Nursing, a role in which she recruits minority students, seeks to integrate more diversity in the curriculum, and offers support programs for minority students. In addition, after years of medical student advocacy, Renee Navarro, vice chancellor Diversity and Outreach, created the School’s first Multicultural Resource Center. Though the center currently has no budget, its director, Mijiza Sanchez, hopes to advocate for the types of programs that the commission has recommended, such as the mentoring that Sanchez herself offers students.

It’s also important to remember that minorities often face barriers to financing their education and would benefit from scholarships, loan forgiveness and tuition reimbursement programs.

In addition, universities should link to minority professional organizations to promote enhanced admissions policies, cultural competency training and enhanced minority student recruitment. For example, as volunteer past president of the San Francisco Bay Area chapter of the National Association of Hispanic Nurses (NAHN), I am proactively connecting to the UCSF student group Voces Latinas Nursing Student Association (VLNSA) to do just that. VLNSA is open to students of all ethnicities who are interested in working with the Latino community; the ability to speak Spanish is not required. And organizations like NAHN typically offer reduced student membership and benefits such as mentoring, résumé revision, job postings, volunteer opportunities, networking and more for students, without requiring them to be from any particular racial or ethnic background.

That last point is important, because no matter how diverse your workforce, the goal is to create an environment that is inclusive and allows everyone to express themselves. As minorities, we cannot address our specific health issues alone; rather, this is a challenge for all health care providers. Given what we know about diversity and its importance to health care, we must partner to creatively address and embrace an ever more diverse future.

Crystal Loucel is a second-year master’s student at UCSF School of Nursing and past president of the San Francisco Bay Area chapter of the National Association of Hispanic Nurses. She has a master’s in public health, specializing in global health, from Loma Linda University; has served as an AmeriCorps and Peace Corps volunteer in Honduras; was one of eight RNs chosen in 2012 for a General Electric-National Medical Fellowship in primary care; and is a 2012 scholarship recipient from the Deloras Jones Kaiser Foundation. An earlier version of this piece appeared in the UCSF student newspaper, Synapse.