Sep 16 2014
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Inaugural Cohort of 16 Future of Nursing Scholars Announced

The new Future of Nursing Scholars program has announced its first cohort of 16 nurse scholars who are receiving scholarships and other support as they pursue PhDs in nursing. The students were selected by schools of nursing that have received grants to provide those scholarships.

Each Future of Nursing Scholar will receive financial support, mentoring and leadership development over the three years of her or his PhD program. They are in the initial stages of selecting the topics for their doctoral research, which range from infection control in the elderly population to the impact of stigma on people with mental illness to the quality of life of children with implanted defibrillators.

In addition to the Robert Wood Johnson Foundation, United Health Foundation, Independence Blue Cross Foundation, Cedars-Sinai Medical Center and the Rhode Island Foundation are supporting the Future of Nursing Scholars grants to schools of nursing this year. The program is located at the University of Pennsylvania School of Nursing.

Read more about the first cohort of Future of Nursing Scholars.

Sep 16 2014
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Stay Up to Date with RWJF!

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Sep 15 2014
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Breakthroughs in Treating Spinal Cord Injury

Roderic I. Pettigrew, PhD, MD, is director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB) at the National Institutes of Health (NIH). He was a member of the inaugural class of the Robert Wood Johnson Foundation (RWJF) Harold Amos Medical Faculty Development Program.

Roderic Pettigrew

On a fateful day in 2006, 20 year-old Rob Summers, a standout collegiate baseball pitcher at Portland State with aspirations to play in the big leagues, was a victim of a hit-and-run accident while standing in his own driveway. His injuries left him paralyzed below the chest, and his doctors informed him he would never move his legs again.

I first met Rob at NIBIB’s ten-year anniversary celebration. It had been just four years since his accident, and he had already broken new ground in spinal cord injury recovery. During the event, Rob shared his incredible story about the experimental procedure he had recently undergone as part of an NIBIB-funded research trial. In the trial, Rob became the first human to have an electrical stimulator implanted on his spinal cord with the goal of restoring some function to previously paralyzed muscles.  

Rob spoke about how, in just weeks after implantation, the stimulation enabled him to hold himself in a standing position for the first time since his injury. In addition, he began to sense when he was uncomfortable in his wheelchair. Rob went on to describe how, seven months into the trial, he discovered he was able to move his toes, ankles, and legs on command, a feat that shocked the researchers, as they never expected Rob to regain voluntary movement. 

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Sep 12 2014
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Changing the Culture of Health to Prevent Suicide

Alexander Tsai, MD, PhD, is an assistant professor of psychiatry at Harvard Medical School, a staff psychiatrist in the Massachusetts General Chester M. Pierce, MD Division of Global Psychiatry, and an honorary lecturer at the Mbarara University of Science and Technology in Uganda. He is an alumnus of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2010-2012), and a member of the core faculty in the Health & Society Scholars program at Harvard University.

Alexander Tsai

When Robin Williams ended his life last month, his suicide sparked a raft of online and print commentary about the dangers of depression and the need to inject more resources into our mental health care system. I strongly agree with these sentiments. After all, as a psychiatrist at the Massachusetts General Hospital, I regularly speak with patients who have been diagnosed with depression or who are actively thinking about ending their lives.

But what if suicide prevention isn’t just about better screening, diagnosis and treatment of depression? What if there were a better way to go about preventing suicides?

It is undeniable that people with mental illnesses such as depression and bipolar disorder are at greater risk for suicidal thinking or suicide attempts. But not everyone with depression commits suicide, and not everyone who has committed suicide suffered from depression. In fact, even though depression is a strong predictor of suicidal thinking, it does not necessarily predict suicide attempts among those who have been thinking about suicide. Instead, among people who are actively thinking about suicide, the mental illnesses that most strongly predict suicide attempts are those characterized by anxiety, agitation and poor impulse control.

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Sep 11 2014
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Recent Research About Nursing, September 2014

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

Lower Hospitalization Rates Linked to Broader NP Scope of Practice

New research correlating state-by-state hospitalization rates with state policies on nurse practitioner (NP) scope of practice offers a revealing conclusion: Medicare and Medicaid patients are less likely to require hospitalization in states that allow NPs a broader scope of practice.

A team of researchers from the University of Missouri Sinclair School of Nursing examined hospitalization data from a range of sources that sorted data by state, and then compared it with American Association of Nurse Practitioners data on state laws and regulations governing NP scope of practice. They found “a significant relationship between full practice of NPs and decreased hospitalization rates of Medicare and Medicaid beneficiaries in the United States and improved health outcomes of states.”

The researchers caution that the data do not prove a causal relationship between scope of practice and hospitalization rates, but write, “Our findings support the increasing call of facilitating Advanced Practice Registered Nurses [APRNs] to fulfill their full scope of practice in providing access and care to patients without direct or indirect supervision from physicians. The outcomes support the Institute of Medicine recommendation that APRNs practice to their full scope of practice including functioning as primary care providers.”

The study was published online by Nursing Outlook on August 4, 2014.

Read an abstract of the study or a news article on it in McKnight’s.

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Sep 11 2014
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RWJF Scholars in the News: Mental health and returning service members, children of incarcerated parents, nurse turnover, more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

When reserve service members return to civilian life, such stresses as marriage and health care problems are more likely to trigger drinking problems than traumatic events that occurred during deployment, according to a study reported by Fox News. When it comes to the “long-term mental health for National Guard members, what matters is what happens after they come home,” said lead author Magdalena Cerdá, PhD, MPH, an RWJF Health & Society Scholars program alumna. “Financial difficulties, re-integrating, difficulties accessing quality health care, all of those seem to matter.” But deployment stress also has an impact. “[T]he more traumatic events they are exposed to during or after combat, the more problems they have in daily life when they come home,” she said. RWJF Investigator Award in Health Policy Research recipient Sandro Galea, MD, MPH, DrPH, co-authored the study. Health Canal also reported on it.

An estimated 17.5 percent of newly licensed RNs leave their first nursing job within the first year, and one in three leave within two years, according to research conducted by RWJF’s RN Work Project. Advance for Nurses quotes co-directors Christine T. Kovner, PhD, RN, FAAN, and Carol Brewer, PhD, RN, FAAN. “One of the biggest problems we face in trying to assess the impact of nurse turnover on our health care system as a whole is that there’s not a single, agreed-upon definition of turnover,” Kovner said. “A high rate of turnover at a hospital, if it's voluntary, could be problematic,” Brewer added, “but if it’s involuntary or if nurses are moving within the hospital to another unit or position, that tells a very different story.” Nurse.com also covered the study.

Having incarcerated parents is associated with significant health problems and behavioral issues, and may be more harmful to children’s health than divorce or the death of a parent, USA Today reports. “These kids are saddled with disadvantages,” said Kristin Turney, PhD, author of the study that reached those conclusions. She is an RWJF Health & Society Scholars program alumna. “They’re not only dealing with parental incarceration, but also mental health issues.” The study found that having a parent in prison was associated with such conditions as attention deficit hyperactivity disorder, learning disabilities, speech or language problems, and developmental delays. Turney’s study was also covered by US News and World Report, Salon, Psych Central, Healthline and Mother Jones, among other outlets. 

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Sep 10 2014
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I Am Who I Am Because of You

Faith Ikarede Atte, RN, MSN, is a Future of Nursing Scholar studying for her PhD at Villanova University, supported by Independence Blue Cross Foundation. The Future of Nursing program is a project of the Robert Wood Johnson Foundation.

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There are things in life so personal and private that when one vocalizes them, there is fear of being judged. It was eleven years ago that I had a personal encounter with myself. It is admittedly odd to look back at the path that I have walked on, now overgrown and distant—yet still so close to my heart.

Eleven years ago is when I lost a sense of who I was in the eyes of society, and I had to look within myself to find my footing. It is during this time that I had arrived from Kenya, full of vigor, light spirited and quick to laughter. I was hungry for knowledge and the sky was the limit.

Little did I know that life was about to teach me a lesson. It became obvious to me that my accent was different. Most immigrants can identify with the situation of being different. The more I spoke, be it in class or in a group of people, the more I felt isolated due to reactions like, “What did you say? Speak up.  Your accent is too thick. I don’t know what you are saying.”

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Sep 9 2014
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Quotable Quotes About Nursing, September 2014

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

“Changing cultural norms within the nursing profession will require efforts from all parties: from nursing graduates, in treating their colleagues with respect and raising awareness by reporting incidents; from nursing leaders, in leading by example to foster supportive behaviors and promote a healthy work environment; from health care institutions, in setting zero tolerance disciplinary policies and empowering staff to report on issues without fear of retaliation; and from academic institutions, in preparing students with conflict management skills to address situations as they arise.”
--Susan Sanders, DNP, RN, NEA-BC, vice president, Kaplan Nursing, Bullying a Rising Concern for New Nurses, U.S. News & World Report, September 3, 2014

“It is time to stop wringing our hands that there are inadequate MDs wanting to provide primary care service. There is a very synergistic way that medicine and advanced practice nursing can work together, capitalize on the strengths that each discipline brings to the table, and maximize the patient experience and the outcomes. This is a new model.”
--Rosemary Dale, EdD, professor of nursing, University of Vermont, New Health Care Model Tested in BurlingtonBurlington Free Press, August 30, 2014

“The numbers speak for themselves. As the demographics change and more ethnically and racially diverse populations grow, there will definitely continue to be a need for health care providers who mirror these patients.”
--Eva Gomez, MSN, RN-BC, CPN, staff development specialist, Children’s Hospital in Boston, Push to Recruit Black, Latino Nurses, Washington Informer, August 27, 2014

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Sep 9 2014
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In the Media: TV Show Zooms in on Birthplace of Midwifery in America

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

Nurse-midwifery took a turn in the media spotlight last month during a television talk show in Kentucky, the “birthplace” of midwifery and family nursing practice in America.

In a half-hour segment on Kentucky Educational Television, TV host Renee Shaw interviewed officials from Frontier Nursing University, the longest continuously operating and largest midwifery program in the country. The university will mark its 75th anniversary in October.

Nurse midwives and nurse practitioners “really want to make their community a better place, and they know from working in the system that, as nurses, they can do that,” said Julie Marfell, DNP, APRN, FAANP, dean of nursing at Frontier Nursing University.

Midwifery got its official start in America thanks to Mary Breckenridge, a nurse from a prominent political family who was born in the 1880s. After the deaths of her first husband and both of her children, Breckinridge decided to devote her life to improving health and health care. In 1925, she founded the Frontier Nursing Service in Hyden, Ky., a remote and unserved part of the country, so she could bring British midwifery practices to the United States. The Frontier Nursing Service later added the nation’s first schools of midwifery and family nurse practice.

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Sep 8 2014
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Field of Dreams

“In the NFL, you have to be ready for everything,” says Lutul Farrow, MD.

He should know: For more than three years, the orthopedic surgeon was a member of the medical staff for his hometown Cleveland Browns. With Farrow on the sidelines were a nonsurgical sports medicine doctor and an anesthesiologist; in the stands were a paramedic and a dentist. “That was just for our team,” he says.

Farrow currently works with the Yellow Jackets, a Division III team at his college alma mater, Baldwin Wallace University. Because football requires physician coverage at every game, he travels with the Yellow Jackets to games throughout the Ohio Athletic Conference. He’s also the head team physician for the Brunswick High School Blue Devils.

On game day, he has a field-level view of every play—and every injury. “We mostly see strains and sprains,” he says, including hamstring pulls, ankle sprains, and ligament sprains of the knee.

Farrow predicts that the current attention to concussions—most recently the NCAA’s settlement of a class-action lawsuit brought by former college players—will change the way the game is played.

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