Imani Baker is an alumna of Project L/EARN, a graduate education preparation program supported by the Robert Wood Johnson Foundation (RWJF). She recently earned her bachelor’s degree in public health from Rutgers, the State University of New Jersey, and plans to become a nurse practitioner.

The two words that I can use to describe my journey through Project L/EARN are: life changing. 

I learned about the RWJF-funded program from an advisor who referred me to its faculty program director, Jane Miller, PhD. Dr. Miller warned me that the program would be “intense” and “much more work than you are used to.”

However, there are no words that could have ever prepared me for what I was about to experience that summer. Before I was admitted to Project L/EARN, I was not confident in my abilities to compete outside of my comfort zone, which included subjects specifically related to the health sciences.

This program forced me to face many of my weaknesses and confront my worst fears head on. Each day, I was overwhelmed with self-doubt. I was not the best public speaker; I struggled in statistics; and there were times when I questioned why I was picked for the program.

I said to myself, “I want to be a nurse. I don’t want to sit behind a computer and look at numbers all day. What did I get myself into?” However, my mentor, Dr. Judith Lucas, EdD, RN, GCNS-BC, taught me why it was so important for nurses to be involved in research and to have advanced graduate degrees.

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:

Getting less than six hours of sleep a night raises levels of inflammation among women with heart disease, and therefore increases the risk of a heart attack, according to a five-year study led by RWJF Health & Society Scholars alumnus Aric Prather, PhD. The findings did not hold true for men. United Press International and HealthDay are among the outlets to report on the findings.

RWJF Community Health Leader Darleen Reveille, RN, spoke to The Record about new community gardens in Garfield, New Jersey, and a program that will give 7th-graders and their families hands-on gardening experience as a way to learn healthy eating habits. “We’re trying to raise awareness in a fun way,” she said. “By creating these activities, you’re engaging the community, not just lecturing them on what they should do.”

“Nurses are particularly at risk for becoming overwhelmed and depleted,” RWJF Executive Nurse Fellows alumna Cynda Hylton Rushton, PhD, RN, FAAN, told the Washington Post about “compassion fatigue ” She said: “When the clinician suffers, so does the patient,” which is why many hospitals are using creative arts to help nurses manage stress and re-energize. Fierce Healthcare also picked up the story.

A study led by RWJF Physician Faculty Scholars alumnus Deverick J. Anderson, MD, MPH, finds that small community hospitals have higher rates of ventilator-associated pneumonia than larger hospitals, even though they use ventilators less frequently. The researchers hypothesize the disparity could result from limited familiarity with the equipment and the on-staff availability of fewer respiratory therapists and other specialty workers, News Medical and Fierce Healthcare report.

Deborah Gross, DNSc, RN, FAAN, is the Leonard and Helen Stulman Endowed Chair in Mental Health & Psychiatric Nursing at the Johns Hopkins University Schools of Nursing, Medicine, and Public Health. She is also an alumna of the Robert Wood Johnson Executive Nurse Fellows program (2006-2009).

As a child psychiatric nurse, my mission is to make a difference in the lives of families with young children, particularly those living in low-income, urban communities. 

There is now wide consensus that early childhood is the most cost-effective time for targeting prevention and early intervention. The foundation for children’s mental health is formed during the first five years of life, when 90 percent of brain development occurs. Since parents are the primary mediators of their young children’s earliest social and learning environments, any effort to promote mental health in young children must first and foremost engage parents and help them build up their strengths and caregiving capacities.

Nearly 20 years ago, I began searching the literature for parenting programs that had a strong evidence base and demonstrated substantial and enduring effects on parenting quality and children’s behavior. What I discovered is that the strongest programs available had been originally developed and tested on White, middle-class families. As a result, their content and delivery methods were often built on values and assumptions many families I knew could not relate to. 

This is part of the June 2013 issue of Sharing Nursing's Knowledge.

“Not a week goes by that I don’t receive at least one letter from a patient or family member grateful for the extraordinary care he or she received from a nurse. Using descriptions such as ‘tireless,’ ‘compassionate,’ ‘gentle’ and ‘efficient,’ these gifts from the heart speak volumes about a profession we celebrate throughout May that is the heart and soul of our nation’s health care delivery system. And while National Nurses Month is a time for gratitude and celebration, it is important to remember that the New Jersey nursing profession faces significant challenges that must be overcome … Sometime this month, thank a nurse. It means much more than you realize.”
-- Robert P. Wise, FACHE, president and chief executive officer, Hunterdon Healthcare, Take a Moment to Thank a Nurse During National Nurses Month, Times of Trenton, May 21, 2013

“Growing up, I thought I would become a doctor, but then I met my wife, an RN [registered nurse], and I fell in love with her—and with her career. I’m thrilled with my professional decisions; I find great joy in helping my patients recover and my students learn. I’m able to combine my love of nursing practice and education because NJNI [the New Jersey Nursing Initiative] put me on a fast track to a master’s degree in nursing ... NJNI helped me re-imagine my future. I now see myself as an emerging nurse leader and plan to enroll in a doctorate program in the fall to realize that vision.”
-- Marlin Gross, MSN, APN, NP-C, New Jersey Nursing Scholar, assistant professor, Cumberland County College and family nurse practitioner, Virtua Health Care System in Marlton, Remember What Nurses Do for Us Every Day, Daily Journal, May 15, 2013

This is part of the June 2013 issue of Sharing Nursing's Knowledge.

Heart Failure Patients Benefit from Adequate, Stable Nurse Staffing

A new study suggests that rural hospitals may be better able to ensure high-quality care for heart failure patients if they have lower nursing turnover and better practice environments.

With funding from the Robert Wood Johnson Foundation's Interdisciplinary Nursing Quality Research Initiative (INQRI), a team of researchers led by Robin Newhouse, PhD, RN, NEA-BC, FAAN, and Laura Morlock, PhD, tested a quality collaborative intervention in 23 rural hospitals in the eastern United States. The intervention included in-person meetings, an evidence-based toolkit, and monthly group teleconference calls between site coordinators and the team conducting the study. One group of hospitals used the intervention for six months while the other did not. Then the second group also began using the intervention.

Researchers used four metrics to assess how thoroughly the hospitals implemented the program: whether the hospitals provided smoking cessation counseling, provided adequate instructions to patients being discharged, assessed how well patients' hearts pumped, and made sure the patients received medication to help blood vessels relax. The researchers found that while there was no significant difference in implementation of the four core measures as a result of the intervention, the hospitals with lower nurse turnover and better practice environments implemented more of the measures.

The Iowa Supreme Court ruled last week that advanced registered nurse practitioners (ARNPs) can supervise fluoroscopy, a high-tech X-ray and imaging procedure. The high court ruling was in response to a challenge by three nursing organizations to an earlier decision from a district court.

“We believe the district court erred in second-guessing the department of public health and nursing board on the adequacy of ARNP training to supervise fluoroscopy,” the Iowa Supreme Court wrote. “The record affirmatively shows ARNPs have been safely supervising fluoroscopy and are adequately trained to do so… Allowing ARNP supervision of fluoroscopy improves access to healthcare for rural Iowans and helps lower costs.”

Experts say the ruling has implications for patients, especially those living in rural areas with limited access to doctors, who will be able to get test results more quickly. That can alleviate fears if the fluoroscopy shows that a patient does not have a serious health problem or, conversely, it can facilitate quicker treatment if a patient needs it.

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:

RWJF this week launched the Future of Nursing Scholars program, a $20-million initiative to support some of the country’s best and brightest nurses as they pursue PhDs. The program will provide scholarships, stipends, mentoring, leadership development, and dedicated post-doctoral research support, the Philadelphia Business Journal reports. John Lumpkin, MD, MPH, RWJF senior vice president and director of the Health Care Group, said: “The PhD-prepared nurses the Future of Nursing Scholars program supports will help identify solutions to the country’s most pressing health problems, and educate thousands of nurses over the course of their careers.” Read more about the program.

Patients who are involved in their care spend more time in the hospital and increase the cost of their hospital stays, compared to patients who delegate medical decisions to their doctors, according to a study led by David Meltzer, MD, PhD. Meltzer is an alumnus of the RWJF Generalist Physician Faculty Scholars program, and recipient of an RWJF Investigator Award in Health Policy Research. Among the outlets to report on the findings: HealthDay, Time Magazine’s Healthland blog, United Press International, and Modern Healthcare.

A study led by RWJF Nurse Faculty Scholar Jodi Ford, PhD, RN, finds that having lived in a poor neighborhood as a teen—even if the teen’s family wasn’t poor—increases the risk of having chlamydia in young adulthood by 25 percent, compared to teenagers living in wealthier settings, Science Daily reports.

Martin Schiavenato, PhD, RN, is an assistant professor at the University of Miami School of Nursing and Health Studies, and a Robert Wood Johnson Foundation Nurse Faculty Scholar. This is part of a series of posts looking at diversity in the health care workforce.

It is human nature.  The old adage “opposites attract” is a myth; in fact, the contrary is true.  We feel more comfortable with and welcome those who share in our definition of “us” than not.  Accordingly, this also forms the basis to how we define “them.”  It is intuitive that we feel connected to and prefer those who share in what we believe to be our experience, and that we are suspicious and even spurn those who we feel do not.  This phenomenon is referred to by psychologists as “in-group bias.”

"When it comes to providing best clinical care, race and culture matter."

In my field of pain research, there is ample documentation of how clinician preferences impact the care of patients.  Clinicians better address pain management in patients who “match” their reference group or their preferences more closely. For example, better pain care is given to patients who speak the same language, are of similar socioeconomic status, or even those considered more attractive to the clinician. Subtle cues from the patient—their physical appearance, the circumstances that brought them to seek care, their behaviors and expressions—all will have a consequence on the nature of the care that they will receive.  Thus, the race and culture of the clinician have the potential to be significant contributors in the quality of care that a patient will receive.  This inherent tension between “us” and “them” may be particularly relevant in a country with a history of institutionalized racism.

This is part of the June 2013 issue of Sharing Nursing's Knowledge.

Summer’s here, and so is murder and mayhem—at least in the pages of a trio of newly released books about nurses.

In Death Without Cause: A Health Care Mystery, a young critical care nurse explores a series of unexplained deaths at the hospital where she works. Written by Pamela Klauer Triolo, PhD, RN, FAAN, the book was released in May to coincide with National Nurses Week.

Another nurse-centered mystery also hit the shelves in May. Bone Pit, featuring lead character Gina Mazzio, a registered nurse (RN), was written by RN Bette Golden Lamb and J.J. Lamb. It follows Sin & Bone and Bone Dry, the first two books in the series.

In the nonfiction department, investigative journalist Charles Graeber tells the haunting story of hospital nurse Charles Cullen. The Good Nurse: A True Story of Medicine, Madness, and Murder documents Cullen’s crimes against patients and the health care system’s failure to prevent them.

Also in the non-fiction department is a new collection of essays about nursing called I Wasn’t Strong Like This When I Started Out: True Stories of Becoming a Nurse. Edited by Lee Gutkind, the book will be featured in the July edition of Sharing Nursing’s Knowledge.

Other new titles—also published in 2013—take an academic approach to hot nursing topics.

Mable Smith, PhD, JD, MSN, BSN, RN, is founding dean of the College of Nursing at Roseman University of Health Sciences (formerly the University of Southern Nevada) and an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program. This is part of a series of posts looking at diversity in the health care workforce.

A diverse nursing student body builds the foundation for a diverse workforce that can become effective in the provision of culturally competent care to patients. Our student body at Roseman University of Health Sciences is reflective of the diversity seen in the population that consists of Caucasians, African Americans, Hispanics, Asians, Native Hawaiian and other Pacific Islanders, to name a few.  This diversity is reflected in the health care system among workers and patients. Students bring a wealth of information that is shared with each other and with faculty.

For example, in a class discussion on nutrition, students from various cultures shared how and what types of foods are used to treat certain illnesses. There were discussions on how food should be presented, such as hot versus cold, raw versus cooked.  Some students shared the significance of family presence during meals even for hospitalized patients. These discussions quickly incorporated religious practices and certain etiquettes to promote “religious correctness” when interacting with various cultural and religious groups. Students also provided insight into generational differences and changes with emphasis on the fact that many in the younger generation have not adopted the strict traditions of their parents and grandparents.