DiversityNursing Blog

GENEVIEVE SHAW BROWN

abc news 

What happens when you bring preschoolers and the elderly together to share the simple things in life? This story and video are very touching. We think it’s a terrific idea to spread across the country.

It's being done at a preschool in Seattle, where child care takes place throughout a campus which is also home to more than 400 older adults.

Called the Intergenerational Learning Center, the preschool is located within Providence Mount St. Vincent, a senior care center in West Seattle. Five days a week, the children and residents come together in a variety of planned activities such as music, dancing, art, lunch, storytelling or just visiting.

And now this incredible place is about to have its own film. Called "Present Perfect," it was shot over the course of the 2012-2013 school year by filmmaker Evan Briggs, who is also an adjunct professor at Seattle University. Funded completely out of her own pocket and shot by her alone, Briggs has now launched a Kickstarter to fund the editing of the movie. She has more than $45,000 of her $50,000 goal with 15 days to go.

Residents of "the Mount," Briggs said, did a "complete transformation in the presence of the children. Moments before the kids came in, sometimes the people seemed half alive, sometimes asleep. It was a depressing scene. As soon as the kids walked in for art or music or making sandwiches for the homeless or whatever the project that day was, the residents came alive."

The kids, she said, took everything in stride. She talked of a moment at the beginning of the film trailer when a young boy, Max, is meeting an elderly man named John. John has to repeatedly ask Max his name, calling him Mack, Matt and Match. "That scene actually went on far longer that what you see in the trailer. But Max was just so patient, he just kept repeating his name over and over."

Interestingly, the parents of the students don't send their kids to the Intergenerational Learning Center primarily for the experience with the seniors. "It's got a great reputation and great teachers," said Briggs. But parents of kids who were in the class that she embedded herself in for the school year now tell her they see the benefit of the model. "One father told me that he especially sees it now that his own parents are aging."

She named the film "Present Perfect" she said, as a reference to the fact that these two groups of people — the preschoolers, who have almost no past and so much future and the elderly who such rich past but very little future — really only have a few years of overlap in their lives.

"It's also about being in the present moment," Briggs said, "something so many adults struggle with."

Briggs said the moments between the kids and the residents "sweet, some awkward, some funny — all of them poignant and heartbreakingly real."

Briggs hopes her film will open a conversation about aging in America. She writes on her Kickstarter, "Shooting this film and embedding myself in the nursing home environment also allowed me to see with new eyes just how generationally segregated we’ve become as a society. And getting to know so many of the amazing residents of the Mount really highlighted the tremendous loss this is for us all."

She called the preschool a "genius" idea that is "well within our reach" on a larger scale and hopes the idea expands to other schools around the country. "It's a great example of how we integrate the elderly into society."

By Pat Magrath – DiversityNursing.com

When you think of the nurses in your life – family, friends and coworkers – are they all female? For many years, this has been the reality. But these days, more men are getting into the field of nursing. A friend of mine, Esteban, and I were chatting about his 18-year career as a nurse.

Esteban grew up in Puerto Rico. His family came to the U.S. when he was a child. His father and brother are policemen, a field primarily dominated by men. When he talked to his mother about becoming a nurse, she wasn’t excited about it because “if you’re Hispanic and interested in becoming a nurse, it is assumed you’re gay.” When she realized his passion for nursing, she was supportive and advised him respectfully.

Esteban explained that, in his culture, there is “machismo.” The Urban Dictionary defines machismo as “having an unusually high or exaggerated sense of masculinity. Including an attitude that aggression, strength, sexual prowess, power and control is the measure of someone’s manliness.” With the nursing profession being predominately female, Esteban’s mother feared he’d be teased and not seen as a strong “man.”

In Esteban’s Hispanic culture, he explained, “female nurses are completely accepted with pride, but for a male nurse it is expected you’re gay. Machismo is very strong in the Mexican, Dominican and Puerto Rican cultures. More straight guys are getting into nursing now. It is changing because of the nursing shortage and shortage of jobs. For many, this is a second career choice when men couldn’t find work in their first career choice.”

Esteban’s family has been extremely supportive of his chosen career, particularly while he was pursuing his master’s degree online. He explained how important family support is. His family provided some meals, continually asked what he needed and attended his graduation. They are very proud of him.

English is not Esteban’s first language, so classes and homework were very difficult. If you’re Hispanic and thinking about becoming a nurse, he advises, “don’t procrastinate.” He explains, “you need time to research and support your articles.” With English as his second language, “it took more time to check my sources, read it, read it again, and… read it again. Then… write and re-write my papers. English-speaking people can take about a half hour. It took me three times longer.” He offers great advice about the support of family and the expectation that assignments will take longer to complete.

Think about taking classes online as an option in pursuing your nursing career while juggling a busy life.

Esteban’s proficiency in Spanish comes in very handy while working at the VA in Harlem as an RN Care Manager. He is often asked to translate for patients, and most of Esteban’s patients are male veterans and Hispanic. He said, “they like a Hispanic male nurse taking care of them.”

He has plans to continue his education in the fall of 2016 and work toward attaining his doctorate. While achieving his master’s through an online program, which served him well, he envisions taking his PhD classes in a classroom to consult with instructors and collaborate with others.

Whenever Esteban talks to people about becoming a nurse, he loves to point out that “as a nurse, you can work in any setting – hospitals, schools, insurance companies, etc. If you don’t want to be a bedside nurse, there are different places to work.”

Gracias for your insights, Esteban! We appreciate all your hard work and dedication.

And if you’re thinking about getting into this field, this is a great time to do so.

I’m compensated by University of Phoenix for this blog. As always, all thoughts and opinions are my own.

Erica Bettencourt

There is a need for diversity in the health industry, especially Nurses. Having more diverse nurses will improve access to healthcare for racial and ethnic minority patients. Also those patients will be more comfortable and have higher satisfaction. Diversity must be increased at all levels especially educational institutions. More cultural healthcare programs and initiatives should be offered for students.

By ALEXANDRA ROBBINS

www.nytimes.com 

SEVERAL emergency-room nurses were crying in frustration after their shift ended at a large metropolitan hospital when Molly, who was new to the hospital, walked in. The nurses were scared because their department was so understaffed that they believed their patients — and their nursing licenses — were in danger, and because they knew that when tensions ran high and nurses were spread thin, patients could snap and turn violent.

The nurses were regularly assigned seven to nine patients at a time, when the safe maximum is generally considered four (and just two for patients bound for the intensive-care unit). Molly — whom I followed for a year for a book about nursing, on the condition that I use a pseudonym for her — was assigned 20 patients with non-life-threatening conditions.

“The nurse-patient ratio is insane, the hallways are full of patients, most patients aren’t seen by the attending until they’re ready to leave, and the policies are really unsafe,” Molly told the group.

That’s just how the hospital does things, one nurse said, resigned.

Unfortunately, that’s how many hospitals operate. Inadequate staffing is a nationwide problem, and with the exception of California, not a single state sets a minimum standard for hospital-wide nurse-to-patient ratios.

Dozens of studies have found that the more patients assigned to a nurse, the higher the patients’ risk of death, infections, complications, falls, failure-to-rescue rates and readmission to the hospital — and the longer their hospital stay. According to one study, for every 100 surgical patients who die in hospitals where nurses are assigned four patients, 131 would die if they were assigned eight.

In pediatrics, adding even one extra surgical patient to a nurse’s ratio increases a child’s likelihood of readmission to the hospital by nearly 50 percent. The Center for Health Outcomes and Policy Research found that if every hospital improved its nurses’ working conditions to the levels of the top quarter of hospitals, more than 40,000 lives would be saved nationwide every year.

Nurses are well aware of the problem. In a survey of nurses in Massachusetts released this month, 25 percent said that understaffing was directly responsible for patient deaths, 50 percent blamed understaffing for harm or injury to patients and 85 percent said that patient care is suffering because of the high numbers of patients assigned to each nurse. (The Massachusetts Nurses Association, a labor union, sponsored the study; it was conducted by an independent research firm and the majority of respondents were not members of the association.)

And yet too often, nurses are punished for speaking out. According to the New York State Nurses Association, this month Jack D. Weiler Hospital of the Albert Einstein College of Medicine in New York threatened nurses with arrest, and even escorted seven nurses out of the building, because, during a breakfast to celebrate National Nurses Week, the nurses discussed staffing shortages. (A spokesman for the hospital disputed this characterization of the events.)

It’s not unusual for hospitals to intimidate nurses who speak up about understaffing, said Deborah Burger, co-president of National Nurses United, a union. “It happens all the time, and nurses are harassed into taking what they know are not safe assignments,” she said. “The pressure has gotten even greater to keep your mouth shut. Nurses have gotten blackballed for speaking up.”

The landscape hasn’t always been so alarming. But as the push for hospital profits has increased, important matters like personnel count, most notably nurses, have suffered. “The biggest change in the last five to 10 years is the unrelenting emphasis on boosting their profit margins at the expense of patient safety,” said David Schildmeier, a spokesman for the Massachusetts Nurses Association. “Absolutely every decision is made on the basis of cost savings.”

Experts said that many hospital administrators assume the studies don’t apply to them and fault individuals, not the system, for negative outcomes. “They mistakenly believe their staffing is adequate,” said Judy Smetzer, the vice president of the Institute for Safe Medication Practices, a consumer group. “It’s a vicious cycle. When they’re understaffed, nurses are required to cut corners to get the work done the best they can. Then when there’s a bad outcome, hospitals fire the nurse for cutting corners.”

Nursing advocates continue to push for change. In April, National Nurses United filed a grievance against the James A. Haley Veterans’ Hospital in Tampa, which it said is 100 registered nurses short of the minimum staffing levels mandated by the Department of Veterans Affairs (the hospital said it intends to hire more nurses, but disputes the union’s reading of the mandate).

Nurses are the key to improving American health care; research has proved repeatedly that nurse staffing is directly tied to patient outcomes. Nurses are unsung and underestimated heroes who are needlessly overstretched and overdue for the kind of recognition befitting champions. For their sake and ours, we must insist that hospitals treat them right.

The Nursing profession is in dire need of an IT upgrade. The way the nursing profession currently handles information is costing time, money, patient health and more importantly, lives. Creating an integrated health IT system will address these costs, as well as reducing errors among hospital staff and mistakes with prescriptions both when they are written and when patients obtain them.

To learn more checkout the following infographic, created by the Adventist University of Health Sciences Online RN to BSN program, that illustrates the need, benefit and impact of Health IT in nursing.

www.foxnews.com 

After roughly 40 years, U.S. health regulators are seeking data to see if the cocktail of ingredients in antiseptics used in hospitals, clinics and nursing homes are as safe and effective as they were once considered.

The Food and Drug Administration said on Thursday it is asking manufacturers for more data, including on absorption, potential hormonal effects and bacterial resistance of thehe 'active' ingredients in antiseptics, to see if they are still appropriate for use in a health care setting.

Since the review of health care antiseptics in the 1970s, things have changed, the FDA noted, alluding to a shift in frequency of use, hospitals' infection control practices, technology and safety standards. (1.usa.gov/1EUrzCd)

An independent panel of experts to the FDA raised similar concerns last year. In 2013, the regulator issued a warning to manufacturers, saying it was aware of at least four deaths and multiple infections caused by over-the-counter antiseptics. (1.usa.gov/1DNxOSp)

Commonly used active ingredients in health care antiseptics include alcohol and iodine. Data suggests that, for at least some of these ingredients, the systemic exposure is higher than previously thought, the agency noted.

"We're going to try to answer their questions in great detail as called for, but we believe the FDA already has sufficient data on these products," said Brian Sansoni, a spokesman for American Cleaning Institute (ACI), a trade association for the cleaning products industry.

The FDA said no health care antiseptics were going to be pulled off shelves as of now, and that their review excluded home-use antiseptics such as antibacterial soap and hand sanitizers.

The new data request relates only to health care antiseptics covered by the over-the-counter monograph, a kind of "recipe book" covering acceptable ingredients, doses, formulations and labeling. Once a final monograph is implemented, companies can market their product without having to go through the FDA.

Companies will have one year to submit the data, which the FDA will evaluate before determining if the OTC monograph needs to be revised.

"We're concerned if the FDA takes maybe a too narrow view regarding the safety and effectiveness data – depending how the final rule ends up – they could take effective products or ingredients off the shelves," Sansoni said.

Alexandra Wilson Pecci

www.healthleadersmedia.com 

Hospitals have a broader responsibility to elderly trauma patients than just the time spent within their walls, and should consider updating their strategies to ensure the best outcomes for these patients, research suggests.

Elderly trauma patients are increasingly likely to be discharged to skilled nursing facilities, rather than inpatient rehabilitation facilities (IRF), finds a study in The Journal of Trauma and Acute Care Surgery published in the April issue.

Discharge to skilled nursing facilities for trauma patients has, however, been associated with higher mortality compared with discharge to inpatient rehabilitation facilities or home.

Researchers wanted to "better characterize trends in trauma discharges and compare them with a population that is equally dependent on post-discharge rehabilitation." They not only examined trauma discharges, but also discharges of stroke patients, who have been taking up more inpatient rehabilitation facility beds.

Using data from 2003–2009 data from the National Trauma Data Bank and National Inpatient Sample, the retrospective cohort study found that elderly trauma patients were 34% more likely to be discharged to a skilled nursing facility and 36% less likely to be discharged to an inpatient rehabilitation facility. By comparison, stroke patients were 78% more likely to be discharged to an inpatient rehabilitation facility.

This is despite the findings of a 2011  JAMA study of patients in Washington State showing that "Discharge to a skilled nursing facility at any age following trauma admission was associated with a higher risk of subsequent mortality."

The Journal of Trauma and Acute Care Surgery study notes that "elderly trauma patients are the fastest-growing trauma population," which leads to the question: Where should hospitals be investing their money and time to ensure the best outcomes for these patients?

"I think hospitals should be investing in post-acute care discharge planning," says Patricia Ayoung-Chee, MD, MPH, Assistant Professor, Surgery, NYU School of Medicine, and lead author of the study. "What's the best post-acute care facility for patients? And it may end up needing to be individualized."

She says reimbursement and insurance factors have "played more of a role than anybody sort of thought about" in discharges, rather than what is always necessarily best for patients.

For example, to be classified for payment under Medicare's IRF prospective payment system, at least 60% of all cases at inpatient rehab facilities must have at least one of 13 conditions that CMS has determined typically require intensive rehabilitation therapy, such as stroke and hip fracture.

"I think the unintended consequence is that we may be discharging patients to the best post-acute care setting, but we also may not be," Ayoung-Chee said by email, and that question "is only now being looked at in-depth."

She says hospitals should think about truly appropriate discharge planning upfront.

Proactive Hospitals
For instance, at admission, hospitals can find out who the patient lives with, or what their social support system is like. If they have a broken dominant hand after a fall, will they be able to get help with their groceries? Do they live alone? Will they be able to use the bathroom?

Caring for patients also doesn't end when patients leave the hospital, she adds. Hence the study's title: "Beyond the Hospital Doors: Improving Long-term Outcomes for Elderly Trauma Patients."

Ayoung-Chee says the next step in her research is to look at a more longitudinal picture, following individual patients to see what factors play into their function or lack of function.

But hospitals can do some of that work on a smaller scale, with internal audits to determine which facilities have the best post-acute care outcomes. For instance, they could spend time examining which facilities had fewer readmissions compared to others, as well as how long it took patients to get home and their how satisfied they were with their care.

Other research is also trying to determine which facilities are best for elderly trauma patients. For instance, a second study, also published in The Journal of Trauma and Acute Care Surgery, shows that geriatric trauma patients have improved outcomes when they are treated at centers that manage a higher proportion of older patients.

One of the overarching takeaways from Ayoung-Chee's research is the idea that hospitals have a broader responsibility to patients than just the time spent within their walls.

"What we do doesn't just end upon patient discharge. If we truly want to get the biggest bang from our buck, we're going to have to think about the entire continuum," she says.

That could range from working to prevent falls that can cause elderly trauma, to seeing patients through all of the appropriate care needed to expect a good functional outcome. Good healthcare for elderly trauma patients should extend beyond the parameters of morbidity and mortality, and toward returning patients to their original functional status and, ultimately, independence, says Ayoung-Chee.

"Our long-lasting effect as healthcare providers isn't just what we do in the hospital," she says. "And we have to start thinking outside."

BY SEAN DENT

http://scrubsmag.com 

Pens that don’t work? Socks that cut off your circulation? Cheap key chains? Yep, those sound like some Nurses Week gift failures to me!

I have some suggestions for gifts I think every nurse would appreciate for Nurses Week. Here are two major ones (you can thank me later!):

A real lunch break

• You know, the kind of lunch break that involves leaving the nursing unit, or even leaving the premises all together. The kind where you actually taste your meal instead of inhaling it on the go. Maybe even a full hour-long lunch so we could enjoy the food we eat and take our time getting back on shift.

IOU: A time out

• A certificate that allows you the ability to just call a time out. I’m talking stopping everything, putting your hands in the air and taking a “Calgon moment.” No explanation necessary, just produce the IOU. We should be able to use this IOU whenever the need arises. You could even put an expiration date on it, although I doubt it would take long to use this one up.

Here are a few more random ideas for gifts:

• A valet ticket for parking
• A free lunch (or more than one)
• IOU: One time you get to leave work early
• IOU: One time you get to come to work late
• IOU: One request for a new pot of coffee be made (when the pot is empty)
• IOU: One admission paperwork completion
• IOU: A free breakfast

Don’t get me wrong, I’m always appreciative of the recognition, but I think if we’re going to celebrate all things nursing, then the gifts should be worth the year-long wait!!

Any other suggestions? What would be a great gift for you this Nurses Week?

http://news.nurse.com 

The award-winning documentary “The American Nurse” (DigiNext Films) will be shown at special screening engagements May 6 in honor of National Nurses Week. The film highlights the work and lives of five American nurses from diverse specialties and explores topics such as aging, war, poverty and prisons. 

“At some point in our life each of us will encounter a nurse, whether it’s as a patient or as a loved one,” Carolyn Jones, director and executive producer of the film, said in a news release. “And that one encounter can mean the difference between suffering and peace; between chaos and order. Nurses matter.” 

The American Academy of Nursing recognized Jones, an award-winning filmmaker and photographer, as the winner of its annual Johnson & Johnson Excellence in Media Award for the documentary. The award recognizes exemplary healthcare journalism that incorporates accurate inclusion of nurses’ contributions and perspectives. “I intended to make a film that celebrated nursing,” Jones said in the release. “I ended up gaining deeper insights into some of the social issues we face as a country, through the eyes of American nurses. I’ve grown to believe that nurses are a truly untapped and under-appreciated national resource.” 

The documentary also was awarded a Christopher Award in the feature film category, alongside films “Selma” and “St. Vincent.”

The film, which was made possible by a grant from Fresenius Kabi, is being presented locally through sponsorship by the Future of Nursing: Campaign for Action, a joint initiative of the Robert Wood Johnson Foundation and AARP, together with the American Nurses Foundation and Carmike Cinemas. 

The campaign’s state action coalitions and other campaign partners are expected to host at least 50 screenings of the film. Ten percent of the proceeds will go to help local efforts to advance nursing. A portion of all proceeds from the film will benefit the American Nurse Scholarship Fund.

To find a screening near you or to learn how to host a screening, go to http://americannurseproject.com/national-nurses-day-screenings.