Category Archives: Nursing

Dec 19 2014
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Disparities, Resilience, and Building a Culture of Health

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On December 5, 2014, the Robert Wood Johnson Foundation (RWJF) held its first Scholars Forum: Disparities, Resilience, and Building a Culture of Health. It was a dynamic event that drew a standing-room-only audience in Washington, D.C. Following the conversation, the Human Capital Blog asked six participants to answer the question, What do you think is the most important step the country can take now to make progress in reducing disparities?

Gloria Sanchez, MD 
Alumna, RWJF Summer Medical and Dental Education Program

Gloria Sanchez

“The United States has the ability to reduce disparities, but we need a movement that creates neighborhoods that provide sound and affordable nutrition, safe environments to exercise, and supportive communities that are free of pollution. Initiatives should guarantee that those individuals most afflicted by disparities are engaged in re-inventing their communities through assessments and interventions that truly create sustainable, positive change.

“Our nation can overcome the multitude of disparities that afflict so many. With directed resources, research, compassion, and community involvement, there is no doubt we will achieve equality.”

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Dec 17 2014
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The Legacy of PIN: A New Level of Collaboration in the Pacific

Partners Investing in Nursing’s Future (PIN), an initiative of the Northwest Health Foundation and the Robert Wood Johnson Foundation (RWJF), was represented in the U.S. Affiliated Pacific Islands (USAPI) by two partnerships: Building Nursing Faculty Capacity in the U.S. Affiliated Pacific Islands, which brought together the American Pacific Nurse Leaders Council, the World Health Organization and others to strengthen nursing education in the USAPI; and Step by Step, Hand in Hand: Expanding PIN Synergies in the Pacific, which introduced the Dreyfus Health Foundation’s Problem Solving for Better Health® (PSBH®) model to effect change within nursing education and within communities. 

As part of a series of posts on PIN’s legacy of encouraging innovative collaborative responses to challenges facing the nursing workforce in local communities, a number of the USAPI partners have responded to the question: What do you think has been the major impact of the Pacific PIN?

PIN Logo

“Since the first meeting of the Pacific PIN, we have come to learn more about each other’s nursing programs and the common needs that we shared. Through the years, this knowledge has expanded our friendship to those who have patiently stayed with us and directed us toward sharing resources and seeking new learning experiences, all to increase the number of qualified nurses for the Pacific region. I am most grateful to the foundations that were directly involved and the special people who made this all possible. Fa’afetai tele.”

--Lele Ah Mu, RN, BSN, Chair, Nursing Department, American Samoa Community College, American Samoa

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Dec 16 2014
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Quotable Quotes About Nursing, December 2014

This is part of the December 2014 issue of Sharing Nursing’s Knowledge.

“This holiday season, my one wish is that every nurse knows their worth and that every patient knows theirs.”
--Shelly Lopez Gray, RN, blogger, Adventures of Labor Nurse: The Highs and Lows of Labor and Delivery, A Nurse’s Wish in Labor and Delivery, Huffington Post Parents, Dec. 8, 2014

“Nurses have new and expanding roles. They are case managers, helping patients navigate the maze of health care choices and develop plans of care. They are patient educators who focus on preventative care in a multitude of settings outside hospitals. And they are leaders, always identifying ways for their practice to improve. Because nurses have the most direct patient care, they have much influence on serious treatment decisions. It is a very high stakes job. Everyone wants the best nurse for the job, and that equates to the best educated nurse.”
--Judy Evans, MS, RN, associate professor of nursing, Colorado Mountain College, Patients Benefit When Nurses Have Advanced Education, The Glenwood Springs Post Independent, Dec. 7, 2014

“Nurses are not just doers. Our work is supported by evidence and guided by theory. We integrate evidence and theory with our knowledge of patients and make important decisions with and for patients and families at the point of care. Research and practice are not separate but integrated. Nursing is a practice discipline with our own theories and research base that we both generate, use, and disseminate to others.”
--Antonia Villarruel, PhD, RN, FAAN, professor and Margaret Bond Simon Dean of Nursing, University of Pennsylvania, Q&A with Antonia Villarruel, Penn Current, Nov. 20, 2014

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Dec 11 2014
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Recent Research About Nursing, December 2014

This is part of the December 2014 issue of Sharing Nursing’s Knowledge.

Study: ‘Alarm Fatigue’ Poses Danger

After a while, alarms stop being so alarming. That’s the warning growing out of a study of the sheer volume of physiological alarms generated by bedside monitoring systems in hospitals. The barrage of beeps can become so overwhelming that it creates “alarm fatigue,” which in turn can lead nurses and other clinicians to discount the urgency of alarms or to ignore them altogether.

In the study, led by University of California, San Francisco (UCSF) School of Nursing Professor Barbara Drew, PhD, MS, researchers tracked the quantity and accuracy of alarms generated in five intensive care units at the UCSF Medical Center over a 31-day period. They found a high rate of false positives—alarms generated when patients were not in need of treatment beyond what they were already receiving. For example, during that time, researchers counted 12, 671 alarms for arrhythmia, 89 percent of which were false positives. Most of those were the result of problems with the alarm system’s algorithms, incorrect settings, technical malfunctions, or brief heart rate spikes that did not require further attention.

In all, during the 31-day period, the systems generated an average of 187 alarms per patient bed per day, adding up to more than 380,000 audible alarms over the course of the month, across the five ICUs.

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Dec 11 2014
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In the Media: New Exhibits Shine Light on the History of Nursing

This is part of the December 2014 issue of Sharing Nursing’s Knowledge.

On television and in other media, nurses are often portrayed as gendered stereotypes: the angel, the handmaiden, the battle-axe, or the sex-object.

Turns out, these portrayals aren’t new. That is evident in a new postcard exhibit at the National Library of Medicine in Bethesda, Md., that illustrates cultural perceptions of nursing over the last century.

The exhibit, entitled Pictures of Nursing, hails from a collection of more than 2,500 postcards that were donated by Michael Zwerdling, RN. The collection includes postcards that date to the late 1800s, and features images of nurses portrayed as everything from Greek goddesses to Amazon princesses to the Virgin Mary. It also includes rare images of male nurses.

Some of the exhibit’s more contemporary postcards depict nurses in modern uniforms and as skilled members of health care teams—images that counteract sexist and gendered notions of nursing that come through in other postcards.

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Dec 8 2014
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At the Crossroads of Risk and Resiliency: Averting High School Dropouts

Karen Johnson, PhD, RN, is a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar and an assistant professor at the University of Texas at Austin School of Nursing. Her research focuses on vulnerable youth. The first RWJF Scholars Forum: Disparities, Resilience, and Building a Culture of Health was held last week. The conversation continues here on the RWJF Human Capital Blog.

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As Americans, we love stories about people who beat the odds and achieve success. We flock to movie theaters to watch inspiring tales—many times based on true stories—of resilient young people who have overcome unthinkable adversities (e.g., abuse, growing up in impoverished, high-crime neighborhoods) to grow into healthy and happy adults. Antwone Fisher, The Blind Side, Precious, and Lean On Me are just a few of my personal favorites that highlight the very real struggles faced by adolescents like those I have worked with as a public health nurse. My work with adolescent mothers and now as an adolescent health researcher has convinced me of the critical importance of focusing on promoting health and resilience among adolescents at-risk for school dropout.

Karen Johnson

How often do we as a society really sit down outside the movie theater or walls of academia and talk about why these young people are at risk for poor health and social outcomes in the first place, or what it would take to help them rise above adversity? If we look closely at the storylines of resilient youth, we will notice a number of similarities. Being resilient does not happen by chance: it takes personal resolve from the individual—something our American culture has long celebrated. And it takes a collective commitment from society to maintain conditions that empower young people to be resilient, and that is something that we as a society do not recognize or invest in nearly as often.  

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Dec 3 2014
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The Top Five Issues for Nursing in 2015

Susan B. Hassmiller, PhD, RN, FAAN, directs the Future of Nursing: Campaign for Actionwhich is implementing recommendations from that report. Hassmiller also is senior adviser for nursing for the Robert Wood Johnson Foundation.

Susan Hassmiller

In 2013, the Institute of Medicine released a report, U.S. Health in International Perspective: Shorter Lives, Poorer Health, that compared the United States with 16 other affluent nations. The United States ranked last or near last on nine key indicators:  infant mortality and low birth weight; injuries and homicides; teenage pregnancies and sexually transmitted infections; prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability. This is despite the fact that we spend significantly more on health care than any other nation.

I believe there are five ways nurses can contribute to improving these conditions in 2015. 

Nurses Can Help Us Build a Culture of Health

In a Culture of Health, the goal is to keep everyone as healthy as possible.  That means promoting health is as important as treating illness. Unless everyone in the country joins this effort, we will remain at the bottom of the list of healthiest nations. “Everyone” means all health care workers, business owners, urban planners, teachers, farmers and others, including consumers themselves.  Nurses especially understand wellness and prevention, and have a special role to play in building a Culture of Health. 

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Dec 2 2014
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Stress and Family Support – Two Important Social Determinants of Health for Hispanic/Latino Communities

Rosa M. Gonzalez-Guarda, PhD, RN, CPH, FAAN, is an assistant professor at the University of Miami, School of Nursing & Health Studies and an alumna of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program. On Friday, December 5, she will be a panelist at the RWJF Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more.

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My research has focused on understanding and addressing behavioral and mental health disparities experienced by Hispanic/Latino communities. Although I initiated my research looking at substance abuse, violence, HIV and mental health as separate conditions that often co-occurred in marginalized communities, I soon realized that these conditions were just symptoms of an underlying phenomena— something my colleagues and I refer to as the Syndemic factor.

Rosa Gonzalez-Guarda

We have been studying the social determinants of the Syndemic factor in hopes of developing culturally tailored interventions that can potentially address multiple behavioral and mental health outcomes for the Hispanic/Latino community. From this research we have learned that interventions that address stress and family support offer promise for this community.

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Nov 26 2014
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Sharing Nursing’s Knowledge: The November 2014 Issue

Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research and trends relating to academic progression, leadership and other essential nursing issues. Following are some of the stories in the November issue.

RWJF Grantees Help Veterans Become Nurses
With unemployment a problem for many veterans, nurse educators are launching innovative programs to turn veterans into nurses—a “win-win” solution for the military, the health care system and patients, proponents say. The programs address both the looming nurse shortage and the fact that veterans cannot get academic credit for health care experiences that took place in the battlefield.

‘Ebola Care is Nursing Care’
The Ebola outbreak is shining a spotlight on the critical—but often unseen—work of nursing in the United States and abroad, nurse leaders say. Nurses are mounting the main caregiving response to the deadly virus, according to Sheila Davis, DNP, ANP-BC, FAAN, an RWJF Executive Nurse Fellow who recently returned from Liberia and Sierra Leone. Nurses also are educating the public about how the disease is transmitted and dispelling sometimes-unfounded fears.

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Nov 25 2014
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All People, At Any Age or Ability, Have Resilient Potential

Sarah L. Szanton, PhD, ANP, FAAN, is an associate professor at the Johns Hopkins University School of Nursing and an alumna of the Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholars program. On December 5, RWJF will explore this topic further at its first Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more about it.

Sarah L. Szanton

Resilience is not just an individual character trait. There are resilient families, communities, and societies. 

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Within the individual, there are resilient organs, cells, and genetic expressions. Although many people who experience health disparities are resilient on the individual level—they are optimistic, committed, loving, bright—the groups of people who suffer from health disparities (such as non-English speakers, racial and ethnic minorities, and those living in poverty) draw on their personal resilience daily, but suffer from reduced contact with the resilient potential of communities and society overall. 

To me, building a Culture of Health means developing multiple layers of resilient possibilities so that each person’s cells, organs, families, communities, and society are able to respond to stressors, challenges, and opportunities with resilient potential.

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