Ten nurses who have done outstanding work to improve health for people in their communities were named Breakthrough Leaders in Nursing last month at the Future of Nursing: Campaign for Action summit in Arizona. These emerging leaders, who are helping medically fragile children, low-income mothers, women in rural communities, and many others, hail from ten different states.
The Campaign for Action, a joint initiative of AARP and the Robert Wood Johnson Foundation, created the Breakthrough Leaders in Nursing award to celebrate nurse leadership and the importance of efforts by nurses to improve health and health care.
“It’s amazing to see the difference that these 10 people are making in their communities and the health care system,” said Susan B. Hassmiller, PhD, RN, FAAN, RWJF’s senior adviser for nursing and director of the Campaign for Action. “The lives of the people they care for are better because they fearlessly tackled—or are tackling—daunting health care challenges.”
“These outstanding leaders truly represent the future of nursing,” said Susan Reinhard, PhD, RN, FAAN, senior vice president of the AARP Public Policy Institute and chief strategist at the Center to Champion Nursing in America (CCNA), an initiative of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation.
For the 13th year in a row, and the 15th time in the 16-year history of the survey, Americans have named nurses the country’s most trusted profession. Health care providers took the top three slots in the survey this year, with medical doctors and pharmacists coming in second and third, respectively.
Gallup has asked Americans to rate the honesty and ethics of various professions each year since 1990, and nurses were first included in the survey in 1999. Every year since, with the exception of 2001 when firefighters were included following the attacks on 9/11, nurses have topped the list.
This year, four in five respondents (80%) said they would rate the honesty and ethical standards of nurses high or very high.
This Gallup poll is based on telephone interviews conducted Dec. 8-11, 2014, with a random sample of 805 adults, aged 18 and older, living in all 50 states and the District of Columbia.
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 December issue.
A Goal and a Challenge: Putting 10,000 Nurses on Governing Boards by 2020
As nurse leaders and champions from around the country gathered in Phoenix last month for the Future of Nursing: Campaign for Action 2014 Summit, a powerful coalition of national nursing organizations launched the Nurses on Boards Coalition, an unprecedented effort to increase the presence of nurses on corporate and non-profit health-related boards of directors. The Coalition will implement a national strategy aimed at bringing the perspectives of nurses to governing boards and to national and state commissions that are working to improve health.
Older Nurses Push Retirement Envelope
A growing number of nurses are continuing to practice in their late 60s and beyond—a phenomenon that has significant implications for the nursing workforce and the health care system. While some nurses have always worked past the traditional age of retirement, the number of older nurses in clinical practice is growing, according to a recent study by Peter Buerhaus, PhD, RN, a professor of nursing at Vanderbilt University and director of the university’s Center for Interdisciplinary Health Workforce Studies.
Pooja Mehta, MD, is a generalist obstetrician/gynecologist and a second-year Robert Wood Johnson Foundation (RWJF) Clinical Scholar at the University of Pennsylvania, with support from the Department of Veterans Affairs. Rebekah Gee, MD, MHS, is Medicaid Medical Director for the state of Louisiana, an assistant professor of health policy and management, and obstetrics and gynecology at Louisiana State University and an alumna of the RWJF Clinical Scholars program.*
The theory of disruptive innovation seeks to explain how complicated, expensive systems may eventually be replaced by simpler, more affordable solutions, driven by new entrants into a market who “disrupt” an older, less efficient, and less accessible order.
In the new issue of Current Opinion in Obstetrics and Gynecology, we track the history of the RWJF Clinical Scholars program (CSP) in the field of obstetrics and gynecology, and offer a curated selection of pieces that suggest that our discipline—now peppered with experts in health services research and health policy trained through the CSP—could be teetering at the precipice of an era of such disruptive innovation.
Highlighting the work of nine current and past scholars, among more than 40 Clinical Scholars working in the field of obstetrics and gynecology, this journal issue covers a range of cutting-edge concepts currently being developed and employed to transform our field from the inside out.
Nathaniel DeNicola, MD, (‘11) discusses the potential uses of social media to disseminate and advance new findings and recommendations to broader audiences. Laurie Zephyrin, MD, MBA, (’03) illuminates how efforts to integrate systems, create interdisciplinary initiatives, and how research-clinical partnerships have allowed for rapid organizational and cultural change and have advanced reproductive health care in the Veterans Affairs system.
Elizabeth Krans, MD, (‘09) writes about ways in which new public funding is allowing for disruptive innovation in the delivery of prenatal care—for example, through dissemination of the highly decentralized, patient-driven Centering Pregnancy model. Working from within a city health department, Erin Saleeby, MD, (‘10) writes about how participatory approaches to public health governance can engage community and clinician leaders in the process of redesigning reproductive care and transforming outcomes.
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
“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.”
For the 25th anniversary of the Robert Wood Johnson Foundation’s (RWJF) Summer Medical and Dental Education Program (SMDEP), the Human Capital Blog is publishing scholar profiles, some reprinted from the program’s website. SMDEP is a six-week academic enrichment program that has created a pathway for more than 22,000 participants, opening the doors to life-changing opportunities. Following is a profile of Juan Jose Ferreris, MD, a member of the Class of 1989.
‘It is easier to build strong children than to repair broken men.’
The words of abolitionist Frederick Douglass resonate for Juan Jose Ferreris, a pediatrician and assistant clinical adjunct professor at University of Texas Health Science Center. He sees a straight line between the public funds allocated for children’s care and their well-being as adults.
“Kids receive less than 20 cents of every health care dollar. Meanwhile, 80 percent goes to adult end-of-life care. Why aren’t we spending those funds on people when they’re young, when it could make a genuine difference?”
Ferreris contends that money also shapes health in less obvious ways. Salaries of primary care physicians are well below those of more “glamorous” specialists. Some fledgling MDs, burdened with medical school debt, reason that they can’t afford not to specialize. Consequently, he says, only 3 percent of medical students choose primary care.
For Ferreris, who is both humbled and inspired by his young patients, building a Culture of Health necessitates recalibrating priorities.
“Nobody’s concentrating on the whole; they’re only looking at one part. And they’re not paying attention to the human—the brain, the spirit, the soul.
“We overlook that aspect...but it’s where I believe the primary care doctor has irreplaceable value.”
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?
“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
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
Roland J. Thorpe, Jr., PhD, MS, is an assistant professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health and director of the Program for Research on Men’s Health at the Johns Hopkins Center for Health Disparities Solutions. The first RWJF Scholars Forum: Disparities, Resilience, and Building a Culture of Health was held December 5th. The conversation continues here on the RWJF Human Capital Blog.
Nearly half a century ago, Dr. Martin Luther King Jr. famously said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Yet decades later, only modest progress has been made to reduce the pervasive race- and sex-based disparities that exist in this country. African-American men who are at the intersection of race and sex have a worse health profile than other race/sex groups. This is dramatically evidenced by the trend in life expectancy.
For example, African-American life expectancy has been the lowest compared to other groups ever since these data have been collected. Today the lifespan of African-American men is about six years shorter than that of white men. Furthermore, a study from the Program for Research on Men’s Health at the Johns Hopkins Center for Health Disparities Solutions provides a financial perspective around this issue.
Lainie Ross, MD, PhD, is a 2013 recipient of the Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research and a 2014 Guggenheim Fellow. During her fellowship year, she will work on a book tentatively titled, From Peapods to Whole Genomes: Incidental Findings and Unintended Consequences in a Post-Mendelian World.
Human Capital Blog: What are some of the incidental findings and unintended consequences you will discuss in your book?
Lainie Ross: First, let me explain what I mean by “incidental findings.” Incidental findings refer to unanticipated information discovered in the course of medical care or research that may or may not have clinical significance. They are not unique to genetics. In some studies, up to one in four diagnostic imaging tests have incidental findings, although most do not have immediate clinical consequences.
One example of an incidental finding that I discuss in the book involves incidental findings uncovered while screening candidates for research participation. This can range from discovering high blood pressure (known as the “silent killer”) to extra sex chromosomes in people who volunteer as “healthy controls.” This raises the question of what is a clinically significant or “actionable” finding, and what information should be returned to the research participant. These types of questions are critical, especially because many research consent forms have historically stated that “no results will be returned.”