Archive for December, 2009

h1

2010: The Year of the Nurse

December 31, 2009

By Shawn Kennedy, interim editor-in-chief

Tomorrow when we ring in the New Year we’ll also be ringing in the International Year of the Nurse. No kidding. The designation honors the centennial of the death of Florence Nightingale (she died on August 13, 1910). It launches at noon everywhere on January 1 with the Million Nurse Global Caring Field Project, a “global meditation” led by noted nursing theorist Jean Watson, and events will continue throughout the year.

Most of you were probably aware that the United Nations had developed eight Millenium Development Goals (MDGs) that nations should achieve to end poverty and improve the health, education, and quality of life of their peoples. Three of the eight goals are specifically focused on health, but the others all have an impact on health one way or another.

The target date for achieving the goals is 2015, but as countries have implemented programs to achieve these goals they’ve become acutely aware that, without nurses in sufficient supply, they will fall short. For example, how do you reduce the maternal death rate during childbirth if there are few skilled health professionals to provide prenatal care or assist at births? How do you treat TB and HIV when there are no health workers to dispense and monitor drug therapy? Read the rest of this entry ?

h1

If Your Facility Were To Make a New Year’s Resolution, What Would It Be?

December 30, 2009

Times Square Ball/berk2804, via Flickr

 

We asked the question “If your facility were to make a New Year’s resolution, what would it be?” on our Facebook page yesterday.

Below are some of the responses so far. Is there anything else you might add about your facility?

 

AMAZING HEALTHCARE

better patient care

maybe respect the staff

best patient safety

excellent mental/emotional health assessment and intervention

Every patient everytime!

i double that for respect for staff

It’s all about what’s best for the patients …

From my point of view….give us all a raise no matter how big or small!

Quality care, NOT Quantity care!!!

Free parking

Be COMPLETELY up on EMR by year end

To get the Drs to improve upon their verbal and written communication to nursing staff and to improve Drs understanding of what is meant by palliative care.

Bookmark and Share

h1

Different Gods, Different Ideas of Compassion: A Clergywoman’s Story of the Doctor Who Wouldn’t

December 23, 2009

Jeanine was in her 60s. She wasn’t a church member and I barely knew her. A neighbor had called me to the hospital-Jeanine’s husband was dead, and there were no family or friends at her side. Trying to get my bearings, I leaned over her and recited the words of the Twenty-third Psalm: “The Lord is my shepherd …. Yea, though I walk through the valley of the shadow of death, I will fear no evil ….”

“Help me,” Jeanine moaned. Her eyes opened and then closed. I knew she was pleading for release from her pain.

“Jeanine, I’m so sorry,” I whispered. I hurried to the nurses’ station. When a young nurse looked up, I asked if she could do more to relieve Jeanine’s pain.

“Nothing more to do,” she said, looking back down at an open ledger.

The above is an excerpt from the Reflections essay in the December issue of AJN. It’s by a retired clergywoman who tells of a moment early in her career that brought her face to face with a doctor who believed in a very different kind of God than her own. Click the link above to read the essay in entirety.  

Bookmark and Share

h1

Helping Nurses Overcome Barriers to the Baccalaureate

December 21, 2009

By Shawn Kennedy, MA, RN, interim editor-in-chief

By ~Brenda-Starr~, via Flickr

It’s not always easy for a nurse with an associate’s degree to obtain a baccalaureate. Many may have families to care for or support. Financial and time pressures can be considerable. The part-time community college model is great when it comes to obtaining the associate’s degree, but then many who want to advance find the door closed: they can’t afford the higher tuition at a local private school offering the baccalaureate, or they can’t travel from a rural community to an urban center where a city or state school is located, or they need to do a portion of their coursework on a part-time basis. With such barriers in place, how will we ever solve the nursing shortage?

These problems are being addressed. Last week I had the opportunity to speak with several faculty from the program in nursing at Queensborough Community College (QCC), City University of New York, including Tina Iakovou and Marge Riley, both assistant professors; Anne Marie Menendez, chair of the program; and Lucy O’Leary, a “student success advocate.” The meeting took place at the Hunter-Bellevue School of Nursing in New York City. Also present were Christine Tanner, a distinguished professor at Oregon Health and Sciences University (OHSU), and Marilyn DeLuca, formerly of the  Jonas Center for Nursing Excellence.

We were there to discuss the unique collaboration QCC has with Hunter-Bellevue, one based on a model developed by Tanner and colleagues in Oregon. Tanner was chair of the Oregon Nursing Leadership Council when it developed a strategy to address Oregon’s nursing shortage. The plan created the Oregon Consortium for Nursing Education, a collaboration of five community colleges and the OHSU to create a “seamless” program and curriculum to allow nurses who’ve achieved an associate’s degree from any of the participating community colleges to continue working towards a bachelor’s degree and stay in the community. If any of you have ever tried to get credit for courses taken at one school accepted by another school, you’ll know how wonderful this is.

What’s the key? I asked Tanner what was the key to getting everyone to agree to one curriculum. She said the key was that everyone “was willing to abandon the premise that they were representing an individual constituency and instead focused on what was best for Oregonians and for nursing.” She said it wasn’t all smooth sailing, but the overriding goal—having enough nurses in state—won out over parochial interests.

The Hunter – QCC program is one of two (the other is in North Carolina) using the Oregon model and funded through the Jonas Center for Nursing Excellence. The folks at QCC echo this philosophy of taking the time to build relationships—it took politicking within the school system to reassure folks that the baccalaureate program wasn’t trying to “take over” and that QCC’s curriculum and students were a good match.

The QCC-Hunter program did improve on the Oregon model by adding O’Leary’s position as “student success advocate” to provide mentoring for students; Oregon has since added a “transition adviser.” In North Carolina, they have added a nurse recruiter who does outreach to high school students.

The Center to Champion Nursing in America at AARP is working with government and private groups to highlight the successes various states have had toward increasing the nursing workforce. You’ll be able to read more about this in the series, “Uniting States, Sharing Strategies,” which will debut in AJN in January.

Bookmark and Share

(Note: two editorial errors in this blog post have now been corrected: Marilyn DeLuca is not affiliated with Hunter-Bellevue School of Nursing, as the post originally stated, and she is not currently working for the Jonas Center for Nursing Excellence, as the post implied as well.)

h1

Psychodrama, and Dreams: Art of Nursing’s December Poet

December 17, 2009

By Sylvia Foley, AJN senior editor

Sweet Home under White Clouds by tipiro / Jose Roberto V. Moraes, via Flickr

“Wife two weeps, leaves a trail of tissues, // stamps her foot, cries no one loves her,“ reports the narrator of “Psychodrama Session.”  The poem, featured in this month’s Art of Nursing, offers a vivid look at what might happen when a man in psychotherapy talks about his past; read it here.  (You’ll need to click again on “Article as PDF.”)  Though her characters are imagined, writer Joan Mazza knows the world she’s writing about. She is a licensed psychotherapist and certified sex therapist as well as a speaker and writing coach.

Mazza has been published in numerous literary and mainstream magazines, from The MacGuffin and The Hudson Review to Writer’s Digest and, yes, Playgirl. She has also written several books on the uses of dreams, including Dream Back Your Life: A Practical Guide to Dreams, Daydreams, and Fantasies (Perigree Trade, 2000), described as a dream-based approach to self-improvement. For more information, visit her Web site.

And if you’re a poet or a visual artist, please consider submitting to Art of Nursing. Read this blog post for details. Guidelines can be found here; and if you still have questions, feel free to write to the Art of Nursing coordinator (me) at sylvia.foley@wolterskluwer.com.

Bookmark and Share

h1

Poor Assessment of Nursing Home Residents’ Pain — What Can Be Done?

December 16, 2009

A recent study sought to find out whether relatives and caregivers (proxies) understood residents’ pain well enough to assist in pain assessment and to discover what factors affected their judgments of pain. The findings showed, however, that their reports didn’t consistently match the pain ratings of nursing home residents themselves.

It’s particularly difficult to assess pain in cognitively impaired nursing home residents. This means that there’s a lot of suffering that goes untreated. This AJN article in the December issue discusses the findings of a new study on the topic and offers some recommendations we obtained from the study authors. Here’s another excerpt:

The authors suggest that pain management in nursing homes could be improved through caregiver education, including the implementation of pain assessment education in combination with treatment. They recommend basic training for nurses and nursing assistants on pain, pain behavior, and pharmacologic and nonpharmacologic pain treatment, such as “massage, applying warmth, mobility[, and] distractions with music or story telling.” They also suggest that “treatment effects could be determined more easily using a pain observation scale.”

So check out the article, and also let us know what else can we do to more accurately assess the pain of nursing home residents.

Bookmark and Share

h1

Nursing Yet Again the Most Trusted Profession. So What?

December 15, 2009

By Shawn Kennedy, MA, RN, interim editor-in-chief

I was catching up on my reading over the weekend and came across a press release issued December 9 by the ANA (American Nurses Association). It noted that ”[f]or the eighth consecutive year, nurses have been voted the most trusted profession in America according to Gallup’s annual survey of professions for their honesty and ethical standards. Eighty-three percent of Americans believe nurses’ honesty and ethical standards are either ‘high’ or ‘very high.’”

Laudable for sure, but I keep wondering: does this matter to anyone but us? In the past eight years, has this designation helped nurses get to the policy table? Has it made key decision-makers realize that in addition to being trustworthy, nurses are also smart, skilled professionals who can be the key to cost-effective, quality care?

It’s really amazing (in an appalling sort of way): the groups among those with the lowest trust ratings—politicians and lawyers—dominate when it comes to making key decisions about health care (and about everything, actually). And we wonder why things are the way they are?

Bookmark and Share

h1

And You Thought PE Was Another Name for Gym Class

December 14, 2009

By Jacob Molyneux, senior editor

The template goes something like this: Start with a legitimate quality-of-life issue — like fitful sleep or shyness — that does not yet have its own prescription medication and is debilitating to a few people a lot of the time. Next, position the quality-of-life issue as a medical condition with symptoms so common it covers vast numbers of people who had previously not identified themselves as having a health problem, or who thought they were just experiencing an occasional and normal annoyance.

According to the rest of this article in the NY Times, the latest disorder about to enter our dictionary of accepted medical conditions is premature ejaculation (PE). Several companies are developing treatments in the form of pills or aerosol sprays. The net of nonspecific symptoms seems to have been cast fairly wide—a representative of one drug company is quoted as saying that one in three men have this condition. 

Celebrities may soon be confessing that the anxiety occasioned by PE has led to ruined marriages, depression, drug use, and even the use of prostitutes. The ironies of the media campaign to push the term PE into our medical lexicon are worth considering as our legislators debate health care reform provisions and the crisis of rising costs. Medical bankruptcy is on the rise. Many cannot afford medications they need for serious conditions like heart disease and diabetes.

It may be premature to suggest it, but it seems likely the pharmaceutical companies expect health care reform legislation to result in few new limitations on their ability to direct market their drugs to consumers, to create markets for conditions that formerly didn’t exist, and to create a whole body of ghostwritten literature that can be cited as evidence.

Bookmark and Share

h1

Required Reading: Nurses as Champions of Patient Safety

December 11, 2009

Photo from otisarchives4, via Flickr

By Diana J. Mason, PhD, RN, FAAN, editor-in-chief emeritus of AJN. Mason is a member of the National Advisory Committee of Kaiser Health News.

I was delighted to see Kaiser Health News publish a superb commentary by nurse researcher Mary Naylor and health economist Mark Pauly on why nurses are the key to patient safety and quality, the barriers that interfere with nurses being these sentinels, and what can be done to address these barriers. It should be required reading by all policymakers, CEOs of health care organizations, and trustees.

Bookmark and Share

h1

What We Heard from the Leaders of the New National Nursing Union

December 10, 2009

By Shawn Kennedy, MA, RN, interim editor-in-chief

As we noted earlier this week, several major nursing unions have united to form a “superunion.” The National Nurses United (NNU) brings over 150,000 nurses together by combining the California Nurses Association (CNA)/National Nurses Organizing Committee (NNOC) with the Massachusetts Nursing Association (MNA) and some members of the United American Nurses (UAN).

There are three co-presidents: Karen Higgins (from the MNA), Jean Ross (from the UAN), and Deborah Burger (from the CNA/NNOC).

Ross told me this:

  • The CNA/NNOC will cease behaving as a national union and, like the MNA, be a state union; both will be affiliates of the new NNU.
  • The UAN will cease to exist as a national union; those state associations that were members will automatically be members of NNU, unless they decide not to.
  • NNU will focus on health care reform, will advocate for a single-payer system, and will seek to organize all non-union staff nurses in the country

Ross had this to say as well: “People in this country have been waiting for a long time for nurses to come forward to make true health care reform a reality.”

Co-President Deborah Burger told me that NNU will pursue the main objectives of a “massive organizing campaign to organize all nurses nationally” and an aggressive “social justice” agenda focused on advocating for a single-payer health care system. They will also work for passage of federal staffing ratios legislation introduced by Senator Barbara Boxer.

Said Burger, “It’s a new day for labor. . . . NNU will go to all states to organize nurses nationally to put forth a social justice agenda of health care for all and to protect nursing practice.”

Rose Anne DeMoro (here’s a YouTube video of an interview she did a while back on PBS NOW) was named executive director; the union’s first activity as a fledgling (but not naïve group) was to stage a protest in support of nurse-to-patient ratios outside offices of the Arizona Healthcare and Hospital Association in Phoenix.

Bookmark and Share

Follow

Get every new post delivered to your Inbox.

Join 291 other followers