Walking the Path of Service: DNP Students Provide Foot Care for the Unhoused

TCU nurse practitioner students. “The importance of foot care for this population cannot be overstated.”

In the heart of the Fort Worth, Texas, community, where the daily struggles of people without housing are vividly evident, a group of doctor of nursing practice (DNP) nurse practitioner (NP) students from Texas Christian University (TCU) has embarked on a journey to make a difference. Through the foot clinic initiative in partnership with True Worth Place, a day shelter for people without housing, they’ve established hope and healing with a compassionate service.

The initiative began in early 2018, following a vision from the leadership at True Worth Place. They conceived of a service where basic yet often neglected aspects of personal health—such as foot care—could be addressed. The idea evolved to include volunteers washing the feet of the guests, which extended to providing the guests vitally important medical services like foot assessments and nail care.

TCU faculty and NP students

Eager to serve, a handful of […]

2024-04-15T11:02:29-04:00April 15th, 2024|Nursing, Public health, volunteering|1 Comment

NP’s Model Helps Prevent Mental Health Issues from Slipping Through the Cracks

Brenda Reiss-Brennan, PhD, APRN.

When psychiatric NP Brenda Reiss-Brennan started her independent family therapy practice in 1978, she began to get referrals from primary care providers who were unsure how to handle their patients’ mental health needs. Working with one patient at a time limited her ability to reach many people, so in 1984 she developed a model to train other nurses, primary care providers, and clinics in treating patients with mental illness. The model eventually caught the attention of Intermountain Healthcare, a nonprofit health care system located in Salt Lake City, Utah, which piloted a program featuring the model in its primary care settings.

The care model, which became known as Mental Health Integration (MHI), integrates the treatment of mental health conditions such as anxiety, depression, and substance abuse into the primary care system. Instead of handing out a referral to an external provider and losing patients to follow-up, the MHI model ensures that patients’ mental health conditions and general health care needs are treated in the same primary care practice. Patients receive education materials, are screened for suicide, and are provided a safe environment in which to discuss their mental health concerns. “Patients […]

2016-12-15T16:34:32-05:00December 12th, 2016|Nursing, nursing roles|0 Comments

The First 50 Years of NPs: An Illustrated Timeline Shows Triumphs, Continuing Practice Barriers

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

This year marks the 50th anniversary of the nurse practitioner (NP) role. Themes of innovation and sustainability emerge as one examines an illustrated timeline of the history of NPs in AJN‘s October issue and reads the accompanying text. (The first section of the timeline is below. Click to enlarge.)

Screen Shot 2015-10-14 at 1.48.08 PM

How did this advanced practice nursing role come into being? As the timeline explains, ” [d]uring the 1960s, health care was becoming increasingly specialized. Physicians were moving out of general practice and into more complex and lucrative specialties, creating a void in primary care and prevention services, and in care of the chronically ill.”

To fill this void, public health nurse Loretta Ford, working with Dr. Henry Silver at the University of Colorado in 1965, launched the first NP certificate program, a seminal moment in the history of this prevention-driven, primary-care-focused nursing role.

Ford wrote about the compelling need for NPs. Calling health care a capital investment, Ford said:

“We have failed to realize the full potential of professional nurses to improve the quality of life. This group has great unused potential for bringing about health care reforms. Properly prepared and effectively utilized, nurses could advance the nation’s health […]

Planning Postdischarge Care with Cognitively Impaired Adults

McCauley A patient performs the CLOX 1, a clock-drawing task used to assess patients for cognitive impairment. Photo by Ed Eckstein.

By Shawn Kennedy, AJN editor-in-chief

The transition from hospital to home can be fraught with pitfalls, especially if the patient in question is an older adult with multiple conditions and a not-so-prepared caregiver. The transitional care model, in which NPs coordinate care and provide follow-up care after discharge, has been shown to be successful in reducing hospital readmissions in this group of patients.

With Medicare levying penalties on hospitals with higher-than-average readmissions rates, the stakes aren’t just high for patients and their families. Might similar models of care also work with cognitively impaired adults?

In “Studying Nursing Interventions in Acutely Ill, Cognitively Impaired Older Adults,” a feature article in AJN‘s October issue (free until the end of October), Kathleen McCauley and colleagues from the University of Pennsylvania seek to answer this question, among others.

In the article, McCauley and colleagues describe the methodology and protocols used in their study, summarize their findings, and discuss some of the challenges in conducting research in the clinical setting. Among their findings is the important lesson that research involving cognitively impaired older adults must actively engage clinicians, patients, and family caregivers, as well as the need for hospitals to make cognitive screening of older adults who are hospitalized for […]

Nurses Week: Time to Celebrate (Not Denigrate) Nursing’s Worth

shawnkennedyBy Maureen Shawn Kennedy, AJN editor-in-chief

So, on the cusp of Nurses Week, the week when Americans are encouraged to think about the value that nurses bring to health care, readers of the New York Times were treated to an op-ed written by physician Sandeep Jauhar. According to the byline, Jauhar is a cardiologist and the author of an upcoming memoir about his disillusionment as a physician. The title of the piece was “Nurses Are Not Doctors.” While the author makes sure to reassure us that he thinks nurse practitioners (NPs) have a valuable role to play in health care, he makes the usual charge that NPs are not qualified to practice primary care without physician supervision.

Jauhar conveniently ignores the many studies that have refuted this argument, while basing his case largely on weak anecdotes and one study from 1999 that showed NPs ordered more diagnostic tests. His conclusion: the NPs in the study ordered too many expensive tests because they lack the experience and knowledge of physicians (he concedes in passing that “there are many reasons the NPs may have ordered more tests”). I can’t help thinking that this piece’s publication was purposely timed to take some of the shine off Nurses Week.

I’m surprised that the Times published such a weak letter. First, […]

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