DiversityNursing Blog

by Mark Downey

One of the questions that I frequently ask my students is, “Do you need to care to be a great nurse?” It’s always interesting to read the expressions on their faces and imagine what they must be thinking, because for the majority of my students it is the wanting to be a nurse and all that it entails that is a motivating factor in studying for their nursing degree.

From “Is he trying to trick me?” to “My teacher is an idiot!”, I can see the cogs and wheels ticking over in their brains. More often than not, I don’t give them an opportunity to answer. Instead, I tell them, “You don’t have to care about people to be a nurse. I consider myself an excellent nurse, but I’m not paid to care”.

Reactions to this vary. The two most common being dumbstruck, tongue tied and not knowing quite what to say or alternatively the hairs on the back of the neck bristle and I am challenged (often quite vigorously). Rarely, if ever, does anyone agree with me.

Let me explain with an example. If you’re a patient in an Accident and Emergency Room or perhaps lying unconscious in an Intensive care bed or on an operating table, is it really going to matter if the nurse gives two hoots about caring for you? Of course not! What is important is that the nurse is clinically competent and understands your health requirements so that every opportunity is afforded in generating a positive health outcome.

A steam train driver doesn’t have to care about his train to drive it, but he does need to understand how it works. As long as the gauges stay within the safe zones and coal is regularly fed to help generate steam to drive the engine, it doesn’t matter if he cares about the train or not. In fact, regardless of his care factor, the end result will never vary as long as he is good at his job. To be a good and great nurse is to know how to do your job right. I know everyone will agree.

Isn’t a nurse just like the train driver? Health outcomes will always be the same regardless of how much caring the nurse gives. It all boils down to the nurse trainings and the skills they have developed and how they are implemented. Nothing more, nothing less. A Cardiac Nurse needs to know about your heart, how it works, what the ECG squiggles mean and what the drugs that have been prescribed for you are going to do, but they don’t need to know your hearts desires or what’s in your heart. Isn’t that the job of the Chaplain?

Another important point is not to confuse advocating for the patient with caring. Advocacy is mandatory if the nurse’s training and experience lead them to believe that an alternative option may deliver a better health outcome for the patient. But really you don’t have to care to advocate as it’s just part of being a good nurse.

My argument is further proven when you consider the nursing process. Although it comes in many forms and guises, it is essentially:

• Assess the situation.
   
• Planning a course of action.
   
• Implement that action plan.
   
• Review the effectiveness of the plan and when necessary returning to step 1 and repeating. 

Nowhere, I repeat, nowhere, in any of the literature I have read, have I ever seen or mentioned that caring was required as part of the nursing process.

So do nurses care about their patients? Of course they do! Don’t be a goose! For the vast majority it’s an integral part of what makes them who they are. Nurses are looking after people, not machines. So, do I care for the people that I look after? I do and with a passion, but I don’t have to and, if couldn’t care for people, I couldn’t do my job.

Earlier on in this post I made the comment “I consider myself to be a great nurse, but I’m not paid to care.” This, I hold, as an absolute truth. When I am nursing, I am not paid to care.  You cannot pay me to care. I will not accept money to care! I choose to care because I want to care and you get that for free.

Source: NurseTogether

By Christina Orlovsky

Ask a young girl what she wants to be when she grows up, and top answers are often a teacher or a nurse, which are professions that have been associated with women throughout history. Ask a young boy the same question and neither answer is likely to be given.

Ask Christopher Lance Coleman, PhD, MS, MPH, FAAN, and he’ll tell you that inequity has to change.

Coleman, an associate professor of nursing and multicultural diversity at the University of Pennsylvania School of Nursing in Philadelphia and the author of Man Up! A Practical Guide for Men in Nursing, is a strong advocate for recruiting males into the nursing workforce and empowering them to pursue leadership roles. His new book serves as a roadmap for men seeking to break into the predominantly female nursing profession.

“I believe men need a guide, a blueprint to use to navigate through the complexity of specialty choice and a culture where, frankly, a gender disparity still exists,” Coleman explains. “This is an opportunity of a lifetime for men not only to change the face of nursing in the 21st century, but also to reshape the public image that nursing is a women’s profession.”

In fact, while the most recent numbers show that men are still a clear minority in the nursing field, an uptick is occurring. According to a 2012 U.S. Census Bureau study, “Men in Nursing Occupations,” which presents data from the 2011 American Community Survey, the percentage of male nurses has more than tripled since 1970, from 2.7 percent to 9.6 percent. Of the 3.5 million employed nurses in 2011, 3.2 million were female and 330,000 were male. It’s a change, but, if you ask Coleman, it’s not enough.

“The startling thing is how underrepresented men still are in areas of leadership,” he says. “While the numbers of RNs has increased, when you look at the profession as a whole--heads of nursing, academia--we are still so far underrepresented. This is significant for males going through school looking for role models and seeing predominantly female leaders. I want men to know this is a viable profession and there are tremendous opportunities out there.”

Coleman believes the greatest opportunities for change are in younger men, who even at the high school level should do their research and start the conversation with their parents about the opportunities that exist for them in nursing. Ethnic minority groups, he adds, are particularly critical.

“Many ethnic minority groups, even today in 2013, still think of nursing as only a woman’s profession,” he says. “That racial disparity needs to be taken away.”

Coleman hopes that his book also opens up a dialogue among current male registered nurses. Empowering male RNs to continue to climb the ladder to leadership roles where they can influence change and serve as a new face of the nursing profession, he says, can encourage them to become the mentors male RNs need to help them succeed.

Another conversation that needs to occur in order to influence a culture shift is one between female nurses who may stereotype their male counterparts as only necessary for heavy lifting or things they “can’t” do.

“That’s a stereotype that hurts women and hurts the profession,” Coleman explains. “We don’t want nursing to be seen as a profession of the weak, we want it to be seen as a profession of the strong, because nurses are strong. We all need to do a better job of marketing ourselves--stop stereotyping and typecasting males and do more education in the hospital setting about gender diversity.”

Many men, after all, possess all the qualities required to be good nurses.

“Passion; someone with a tremendous amount of integrity; leadership skills; with a natural curiosity about the world; someone who is unafraid to take on issues that perhaps have challenged them in the past; someone who could treat someone at the end of the day how they want to be treated; and someone who cares to change the world we live in--those characteristics are essential and they transcend gender,” Coleman concludes. “Those are things I’d like to see in anyone who is interested in entering our noble profession.” 

© 2013. AMN Healthcare, Inc. All Rights Reserved. 

TravelNursing.com

Source: Online RN to MSN | University of Arizona College of Nursing

Promoting diversity in nursing is one of the goals of the Campaign for Action because it is essential that the nursing population evolves to reflect America's changing population. Arilma St. Clair, MSN, RN, of the Washington, D.C., Action Coalition, says diversity has to be part of every aspect of nursing—whether in the classroom, in a hospital, or in the community.

Source: Champion Nursing 

 

By Jane Gutierrez

When you think of a nurse, what’s the first image that comes to mind? Chances are, you think of a woman — and for good reason. The vast majority of professional nurses in the U.S. are white women. In fact, only about six percent of nurses are male and, Considering males make up approximately half of the population and minorities are 30 percent, there’s a major disparity in the profession.

That disparity is reflected in equal measure in nursing schools, both in the student population and faculty. Experts argue improving the diversity in nursing education will improve health care by creating a more culturally sensitive healthcare workforce with improved communication abilities, reduced biases and stereotypes and fewer inequities, as well as increasing the diversity of the nurse education faculty.

At a time when the healthcare system is faced with a nursing shortage caused at least partially by a shortage of nurse educators, some argue males and minorities represent an untapped resource for recruiting new educators. They believe that by creating new opportunities to attract traditionally underrepresented populations to the field, we can both solve the shortage and make a measurable improvement to our healthcare delivery system.

Why Diversity Is an Issue

While minorities have made great strides in other traditionally white-dominated fields and women have done the same in traditionally male fields, nursing is one area where diversity initiatives seem to have been ineffective.

In the case of men, much of the resistance to nursing as a profession comes from a cultural perception of nursing being a “female” profession. Men report while they enjoy the care giving aspects of the job, it’s difficult when others ask questions or make comments deriding their career choice. For example, male nurses report being asked why they didn’t choose to become doctors, with the implication that they did not earn adequate grades or were too lazy to become doctors. In addition, men report feeling left out of the profession, with most training and professional development materials referring to nurses as “she” and a female-centric approach to teaching and training.

In the case of minorities, including African-Americans and Latinos, studies attribute the disparity in the nursing profession largely to lower overall academic achievement in those groups. Given that admission to nursing school generally requires at least a moderate level of academic achievement — and earning a

degree in nursing education requires at least a bachelor’s degree and some experience — it’s no surprise that groups that aren’t as academically advanced are lacking in the nursing profession.

Fixing the Problem

Because improving diversity in the nursing profession is a key to solving the nurse shortage — and by extension, the nurse educator shortage — the healthcare field is looking for new ways to recruit, mentor and retain minority nurses, male nurses and educators.

One step is to recruit potential professionals earlier — in some cases, as early as high school. Throughout the country, in the field in exchange for high school credit, with the goal of encouraging them to maintain their academic performance and attend nursing school.

However, academic performance is only part of the equation. The cost of education is another barrier to many potential students, regardless of sex or ethnicity. The cost for a four-year BSN program can be over $100,000 in some cases, while a two-year program generally runs between $5,000 and $20,000. Factoring in the master’s and doctoral degrees required to become nurse educators, and the cost only goes up.

In response, many schools, as well as states and the federal government, have instituted financial assistance programs designed specifically for minorities and males. The Federal Nursing Workforce Diversity program allows minority students to borrow money for school, and have some or all of their loans repaid if they agree to work in specific, undeserved areas. For those who want to become nurse educators, the government’s Nurse Faculty Loan Program offers partial or full repayment of student loans for agreeing to teach for at least two years after graduation.

With the nursing shortage only expected to grow, thanks to increased access to healthcare, reaching out to minorities and males only makes sense. Not only will it solve a serious problem, it will ensure quality, effective health care for future generations.

About the Author: Jane Gutierrez is a nurse educator and a member of her employer’s diversity initiative committee. She visits with local high schools to encourage students to consider careers in health care

Source: WideInfo

By Mable Smith, PhD, JD, MSN, BSN, RN

Source: Robert Wood Johnson Foundation

The job of nurse anesthetist comes with many attractions. There’s a high level of responsibility, a challenging work environment and the chance to do good for others. There’s also the prospect of virtually assured employment.

“I saw that there was going to be job security. It would pretty much always be there,” said Navy Reserve Lt. j.g. Loren Gaitan.

Gaitan, 33, is working on her master’s degree at Florida International University in a full-time, 2½-year program. A former neonatal nurse, she is looking to the anesthetist specialty as a way to increase her skills and take on more responsibility.

It could be a lucrative move: Salary.com puts median annual pay at nearly $180,000.

Nurse anesthetist is one of several fast-growing nursing specialties. Thanks to changes in national health-care laws, a range of concentrations in the nursing field are rising to the fore. With new mandates requiring employers to insure their workers, the health-care system will see a flood of new patients, said Connie White Delaney, dean of the University of Minnesota School of Nursing. “The opportunities across the nation will be just profound,” she said.

Job options

Any of these growing jobs could be an easy fit for a veteran with training as a military nurse:

Nurse practitioner: This person typically has a master’s degree as well as a certification from one of several national bodies. The practitioner may diagnose illnesses, examine patients and prescribe medication. “They are not just going to treat the symptom. They will say, ‘You need to diet. You need to exercise,’ where a physician might just give you a pill,” said Gerrit Salinas, director of the recruiting agency Snelling Medical Professionals. “A nurse practitioner can help people feel like they are more than just a number.” The American Academy of Nurse Practitioners puts the mean salary at $91,310.

Nurse informatics: With the rise of electronic medical records, the role of the informatics nurse has become increasingly significant. These workers don’t just convert paper into electronic records; they also must be well-versed in patient care, privacy issues and technology. They may work in medical settings but also in home health agencies, insurance companies and other entities involved in the management of digital records. The average salary is $98,702, according to the Health Informatics Forum.

Case management nursing: Here again, changes in health-care law are driving demand. As new care models evolve, providers will be expected to coordinate medical treatments in order to ensure efficient and effective care. That’s a big part of the case management job description. Case management nurses typically coordinate long-term treatment, especially for patients with chronic conditions. The average salary is $73,000, according to job site Indeed.com.

Geriatric nursing: Care for seniors is a fast-growing field as the nation’s aged population swells. Medical issues may include diabetes, respiratory problems, hypertension and other conditions. Geriatric nurses offer treatment, while also offering guidance to patients and families. The average salary for a geriatric nurse is $54,457, according to ExploreHealthCareers.com.

Home health nursing: As the name suggests, home health-care providers deliver services to those whose conditions allow them to stay at home but who still require ongoing medical attention. The field is growing fast, largely on account of the rapidly expanding population of older Americans. Salaries average around $40,000 but can vary widely by geography.

Go anywhere

There are numerous avenues into nursing, including specialized fields. The American Nurses Association,http://www.nursingworld.org/, offers guidance.

To support veterans in the field, the government’s Health Resources and Services Administration makes grants to colleges and universities with expedited curricula that help train vets for careers as physician assistants. The Veterans Affairs Department employs a range of nurses.

“We recognize this as an opportunity to support veterans who have served the nation, and as a chance to help fill some shortages in the health care area. It’s a win-win situation,” said Joan Wasserman, Advanced Nursing Education Branch chief for HRSA’s Bureau of Health Professions.

Many schools offer programs of various lengths for those looking to get into the field. Advocates say it’s worth the effort.

“Nursing is one of the best careers you can get into because it is so flexible,” said Pat Harris, associate director of a program at Arizona State University Online that helps practicing nurses earn the Bachelor of Science in Nursing degree. “No matter what changes are in the wind in health care, you are going to be in a key position. Once you have that license to practice medicine, you can go anywhere.”

Source: Marine Corps Times

Source: Maryville University Nursing 

 

 

By: Marsha Van Hecke

People pursue careers in nursing for many reasons: they want to help people, they’re natural caregivers or they want to do some good in the world. The 31 nurses of Hospice of the Carolina Foothills add another reason: It’s truly a ministry.

“Hospice is a calling,” Christina Hughes, RN said, “I knew several years ago that this is what I wanted to do, but watching my father pass that prompted me to make the change.”

Previously, Hughes worked in a skilled nursing facility.

Hospice nurses perform all the tasks you’d expect of nurses in a hospital, clinic or nursing home setting. They draw blood, administer and monitor medications, assess patients’ conditions, review charts, consult with doctors, complete paperwork, and attend staff meetings, among many other typical responsibilities. There’s an added dimension to working as a nurse at hospice.

“Hospice work is more of a team effort, patient and family oriented, putting the patients first always,” says Marla Searcy, RN and Homecare clinical manager in North Carolina.

“And,” adds Monica Pierce, LPN, “we do a lot of education with the families, teaching them how to take care of their loved ones.”

Linda Travers, RN agrees. “HCF allows nurses time to listen to patient feelings and concerns. Teaching family caregivers about disease process, symptom management. Providing comfort and support.”

“Working for Hospice, you are able to spend more time with patients and families,” adds Joanie McDade, RN.

“Having the opportunity to build a relationship with some of the patients here is a gift no other job allows you to have,” says Barry Lowman, RN. “But then when they pass you have a piece of you go with them.”

Developing those close bonds with patients and families is not only an important part of the job, but it’s also one of the most enjoyable. And certain patients find a permanent place in the nurses’ hearts.

“I had one patient who served in Japan for 14 months as a medic. When he saw me, he asked if I was Asian. I told him that my mother was Okinawan and my father American. He began speaking Japanese to me. All throughout his journey of dementia, he continued to speak Japanese to me. There were times he couldn’t remember his wife’s name, but he remembered those few Japanese words,” says Hughes.

Homecare RN, Jennifer Greene tells how a simple gesture of gratitude left a lasting impression on her.

“I was taking care of a patient at the Hospice House and when I would give her any personal care, she would say, ‘Thank you, Mama.’ She would say that to me whenever I took care of her, until she passed.”

Hospice House RN Ashley Crissone fondly remembers the woman with whom she played piano duets.

When Crissy Simpson, RN and Homecare clinical manager in South Carolina, first started at hospice, she found herself facing a potentially difficult situation.

“I was sent to see a patient that lived in a rural community. I was told that he was a very challenging patient, not because of his terminal illness, but because he may not be accepting of my race,” she says, “I went to visit him. He wasn’t rude, but asked a lot of questions to see if I was qualified to take care of him.”

After a few visits, the patient became comfortable with her, and Simpson would give him a big hug right before she left. If she got stuck in traffic and arrived a few minutes late, he would tell her he had been worried about her.

“Every visit he would be sitting in his recliner, facing the door, waiting for me to come, with his beautiful blue eyes,” she says.

As the patient began to decline in health, he asked his wife to buy Simpson a gift, a coffee mug that read, “Thank God for Daughters.”

“From that day, he called me his black daughter and he was my white daddy,” Simpson says, “Some people may be offended by that, but I know I meant a lot to him, and so did he to me.”

On the night he passed away, Simpson sang to him the old gospel song, “I’m Going to Take a Trip,” which she also sang at his funeral.

Just as Simpson goes above and beyond her job duties by singing to patients, other nurses contribute their talents and time outside of work. Jennifer Greene makes jewelry, donating necklaces and bracelets to patients, and Christina Hughes attends special events held at the facilities where she serves.

“One facility had ‘Cowboy Day,’ and the HCF social worker and I dressed up, and attended on our day off. The social worker even brought two of her horses for the patients to see,” says Hughes.

Every nurse has had a special person who inspired him or her to pursue the role of caregiver in life. For some it was another nurse who nurtured and mentored them, or a hospice nurse who ministered to one of their relatives. For others, a special family member encouraged them to follow their hearts. In RN Crystal Mitchell’s case, it was both. Her favorite aunt is a nurse and from a very young age, she would visit her at work in the hospital. Now, it seems, Mitchell is paying it forward.

“I’ve known since I was four I’ve wanted to be a nurse from watching her with her patients,” Mitchell says of her aunt. “I have had a similar role to a family friend who is like a little sister, and she is now a pediatric oncology nurse. I never knew I was the reason she wanted to be a nurse until later. How jaw-dropping it was to find out how much my work had influenced her by God’s grace.”

While working for hospice brings nurses many jovial moments, they also deal with the sobering reality of death every day. For that reason, many people hold them in high regard and wonder how they handle such a job.

RN case manager, Kim Griffey shares how people react when she tells them where she works.

“They always say that it takes a certain person to do your job, that they couldn’t do it. I always reply, ‘It’s very rewarding.’”

When asked what is the most important characteristic or skill needed to be a hospice nurse, one word comes up repeatedly.

Lowman and Travers and Pam Essman, RN, come right to the point.

“Compassion,” they say.

“The most important characteristic you need to be successful in hospice is compassion. It’s not always the physical symptoms that you’re relieving, but also the patient’s and family’s psychological pain,” says Simpson.

When hospice nurses go to work every day, they’re not simply going to a job. They’re going to touch someone’s life. They hold patients’ hands, celebrate patients’ birthdays, play games, share stories, help patients create their life stories to leave for their families, offer comfort, a smile, a laugh, and, in some cases, a song.

“I have had so many patients say they look forward to the hospice nurse’s visit. What greater reward in life can we have than to put a little sunshine in someone’s day, maybe their last day,” Searcy says.

Source: Tyron Daily Bulletin

by Jennifer Mensik for ERE

Regardless of the interview style or methodology used, there is one question that everyone should ask of a registered nurse in an interview. This includes all positions, from staff RN to Chief Nursing Officer.

What is your definition of nursing?

This helps you to sort out whether you have a professional-role-based RN or one who might only be there for the paycheck. A professional-role-based RN is a nurse who understands the complexities of the profession and is committed to placing the patient first, as opposed to a tas- based RN who is there to just clock time and take home a paycheck. If your organization prefers behavioral-based questions, take that question to the next level as a two-part question by asking the RN candidate to give you an example of when they exemplified the definition they just gave you.

You might say, “Are not all RNs professionals?” One just needs to understand the components of a profession to know that there are RNs in the profession who are not professional. Let me explain by starting with the sort of definition you are looking for and then I will touch on the difference between a technical and professional RN.

The American Nurses Association defines nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.” That is a long definition that many RNs will not be able to give you verbatim. However, the professional RN should be able to talk about and say things that are of a very similar nature. The responses between the professional and technical RN will be very different. Most times when I have asked this question, it has stumped many nurses, or was the one they needed the most time to think about before they were able to give their response.

The type of answers you want from a professional RN are statements or an explanation of caring, kindness, ethical, and wholistic care of the entire patient, an understanding that the RN is a professional who is accountable for themselves, and understands that they have a duty to society to place the patient first.

The technical, less desirable answer is when the RN describes their profession as a set of tasks, like medication administration, bathing, assessments, budgets, staffing, or worse yet, someone who assists the physician. While you might expect your RN candidate to do those things and to be competent in those areas, the professional RN understands that. It is a given that part of the professional responsibilities is to carry out tasks and orders, but it is in the manner in which they do it. The technical RN does not understand how to be professional, or worse yet, may not want to be a professional.

Can you teach a technical RN to be professional? I suppose, but only if they are open to it. This is not a simple task they can learn, but a way of being. A professional RN understands their role as a RN, their accountability to the patient and the family, their coworkers, and the organization, and will hold others to the highest standard of patient care.

This type of RN embodies what we want to see in our nurses, like Florence Nightingale. Florence could easily point out the technical nurse. Those who only work as a RN because it’s a good paying, stable job, and where you only have to work three 12-hour shifts; the one who does the minimum to maintain their employment and the minimum to maintain their own education, skills, and professional standards. It is those who do not say anything when another RN or staff member may be jeopardizing patient safety as it’s “not their responsibility” to hold others accountable. Professional RNs do hold each other accountable for quality and safe patient care.

Your next steps:

Recruiters: Have a discussion with your nurse executive on whether this is a question they would like to you ask. Talk with you nurse executive about their nursing philosophy for the organization and how they would like to see RN candidates answer that question.

Nurse managers: What is your philosophy about nursing? Can you articulate it and share with your recruiters so that the right candidates could be screened early in the process? Even if used in the early stages of recruitment,  still include this question in the onsite interview process with the candidate and yourself or the team. Ensure your team who maybe interviewing the RN candidate understands this question and the type of response you want.

As organizations struggle to improve quality measures and patient satisfaction, which type of RN do you want on your team? The professional RN will help your organization obtain success in these areas. If an RN can give you a professional-based answer for the definition of nursing, you are halfway there in choosing the right candidate for your patients and organization.