This is part of the January 2015 issue of Sharing Nursing’s Knowledge.
“I knew that if something were to go wrong, the nurse was just a phone call away. It made me feel so empowered to take care of my child myself.”
--Camille Wallace, LPN, How Nurses Can Help Low-Income Mothers and Kids, The Atlantic.com, January 14, 2015
“There’s plenty of evidence that there’s a shortage of nursing care, and it’s not solved by anything to do with the hospital supply. All the shortage of care at the bedside has to do with [is] how much hospitals want to pay nurses, and whether they want to use their resources on something else.”
--Linda Aiken, PhD, RN, FAAN, director, Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, More Nurses are Better for Patients. Why is it so Hard to Get Hospitals to Hire Them?” The Washington Post, January 13, 2015
“Drivers of the shortage include an aging nursing workforce, increased number of people receiving health care via the Affordable Care Act along with increased number of people living with complex, chronic disease that requires care. Nursing provides a diverse array of opportunities from health care and bedside nursing to advanced practice nursing to positions for nurses in the business world.”
--Laura Rooney, DNP, APRN, director, UT Health Services, University of Texas Health Science Center, Outlook for Nursing Jobs Continues to Look Positive, Houston Chronicle, January 9, 2015
Maryjoan Ladden, PhD, RN, FAAN, is a senior program officer at the Robert Wood Johnson Foundation (RWJF).
By 2050, as many as 84 million Americans will be 65 or older, and most of them will need some sort of help in maintaining their health and well-being. For them, and for the millions of younger Americans who will need similar assistance, it’s essential that we come to grips with the challenge of providing effective and affordable long-term services and supports (LTSS).
As it stands right now, we’ve got a long way to go. But the effort is under way, and nurses are at the forefront. At more than 3 million strong, the nursing workforce will be central to meeting growing demand for LTSS. In addition to providing clinical care, nurses can assess the long-term health prospects of individuals with physical and cognitive impairments, develop customized care plans, monitor individuals’ responses to care, coordinate care across providers and settings, and oversee the quality of the assistance older adults receive.
- Transitional Care. The Central New Jersey Care Transitions Program (CNJCTP) is one of a number of sites taking part in the Affordable Care Act-funded Community-Based Care Transitions Program. Six hospitals in the CNJCTP region work with registered nurses (RNs) and social workers, who together act as health coaches to teach self-care strategies to high-risk, chronically ill Medicare beneficiaries. Registered nurses (RNs) focus on beneficiaries’ symptoms and health care needs, including medication management, while social workers attend to socioeconomic needs that may lead beneficiaries to return to the hospital. Coaches visit patients in their homes within three days of discharge, facilitate a follow-up visit with a primary care provider, and follow up by phone for a month after discharge.
This is part of the January 2015 issue of Sharing Nursing’s Knowledge.
Study: Night Shift Work Hazardous to Your Health?
A new study finds that female nurses working rotating night shifts for five or more years have a higher risk of death from cardiovascular disease and lung cancer than those who do not work such hours.
A team of researchers led by Eva Schernhammer, MD, DrPH, began with longitudinal data from the 1988 Nurses’ Health Study, a long-running data-collection project focused on women’s health. The 1988 iteration of the survey asked if respondents worked rotating night shifts at least three nights a month, in addition to day or evening shifts in that same month—and if so, for how many years they had been doing so. Some 75,000 respondents were included in follow-up research over the next 22 years, tracking the nurses’ personal health; researchers also examined death records, as needed.
Researchers found that women who’d worked three or more rotating night shifts a month for five years or more had higher all-cause mortality rates, as well as higher rates of death from cardiovascular disease. Women who worked such shifts for 15 or more years had elevated death rates from lung cancer.
In a news release, Schernhammer observes, “These results add to prior evidence of a potentially detrimental relation of rotating night shift work and health and longevity ... To derive practical implications for shift workers and their health, the role of duration and intensity of rotating night shift work and the interplay of shift schedules with individual traits ... warrant further exploration."
Lisa Cooper, MD, MPH, FACP, is the James F. Fries Professor of Medicine at Johns Hopkins University School of Medicine, Director of the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities, and an alumna of the Robert Wood Johnson Foundation (RWJF) Harold Amos Medical Faculty Development Program.
Have you ever had the experience of being sick and in need of help from a health professional? How about having a parent, child, other family member, or friend who had some health issue for which he or she was seeking answers? What was that like for you? How did you feel, and what were you looking for from that doctor, nurse, or therapist?
Did you ever feel afraid, and alone? Confused? That no one understood what you were going through? Or cared? Or even worse, that the health professionals may have made some assumptions about you or your family member that were wrong – even perhaps blamed you for having your condition or judged you for how you were dealing with it?
If so, you are not alone. Many people who find themselves in the role of a patient have felt these same feelings and had these same thoughts. And if you are poor, don’t have private health insurance, or if you are a person of color or belong to another minority group in our country, you are more likely than others to encounter these problems.
Susan B. Hassmiller, PhD, RN, FAAN, is senior adviser for nursing at the Robert Wood Johnson Foundation and director of the Future of Nursing: Campaign for Action. This piece is cross-posted with Off the Charts, the American Journal of Nursing Blog.
I spent the 2014 holiday season reading a book by Sarah Wildman called Paper Love. She describes how she, as a journalist, examined the fate of her Jewish predecessors, including her grandfather and his long lost love. I selected the book because my father was a Jew of Polish descent.
Wildman describes the horrific atrocities bestowed upon the Jews. Of course I knew of the Holocaust growing up, but as I get older, the connections between past and present seem to be more important. While I don’t know of any relative who was personally affected or killed, someone in my extended family very likely was. I pondered my own existence and how it may have depended on a relative escaping Europe and immigrating to the United States to escape the death camps. It is unspeakable how one man’s view of what is mainstream or normal sent so many others to their death.
I am not naive enough to believe that prejudice is a curse of the past. Stark data on health disparities continue to mount. The Centers for Disease Control and Prevention report on Health Disparities and Inequalities (2013) found that mortality rates from chronic illness, premature births, suicide, auto accidents, and drugs were all higher for certain minority populations.
But I believe passionately that nurses and other health professionals can be part of the solution to addressing these disparities. Nurses are privileged to enter into the lives of others in a very intimate way, and that means lives that are, more often than not, very different than our own.
Amani M. Nuru-Jeter, PhD, is an associate professor of community health and human development, and epidemiology at the University of California, Berkeley School of Public Health, and an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program. Her research focuses on racial health disparities.
Eric Garner’s death and the failure to indict NYPD Officer Daniel Pantaleo have had a profound effect on communities throughout the United States. But it’s not just Eric Garner. This, and similar cases including Michael Brown, Tamir Rice, Trayvon Martin, and Oscar Grant, have put race relations front and center in the national debate.
I’m tired of it, this stops today...every time you see me you want to harass me, you want to stop me...please just leave me alone” –Eric Garner
These last words from Eric Garner are not that different from what we hear in our work with African American women in the San Francisco Bay area:
We’re changing how we’re doing things here at the Robert Wood Johnson Foundation. We’re striving to work better together to serve one big, bold goal: to build a Culture of Health in America. One way to get there? Shine a light on the stories across the country that bring this unified vision to life. It’s with this in mind that we will be ceasing publication of the Human Capital, NewPublicHealth and Pioneering Ideas blogs at the end of the month. From that point on, we’ll begin to tell our stories in one place: our Culture of Health blog.
We encourage you to tune in. On the Culture of Health blog, you will continue to find stories on cutting-edge ideas, innovation in health, health care and beyond, and insights from the leaders driving change. And don’t worry: You’ll still be able to find previous posts through a new archive.
In the meantime, we want to hear from you. We invite you to tell us what kinds of posts you’re looking for in a brief online survey.
Your thoughts and ideas will help make sure we're offering more of the stories you want, and delivering them to you in the ways that meet your needs. We look forward to hearing from you—and thank you for your continued readership!
This is part of the January 2015 issue of Sharing Nursing’s Knowledge.
A new kids’ movie is putting a positive spin on nursing—a profession that is routinely overlooked, and sometimes denigrated, in Hollywood.
Baymax, the lead character in Big Hero 6, Disney’s latest animated feature film, doesn’t look like your typical nurse in scrubs: The character is a male, futuristic balloon robot who brings to mind the Pillsbury doughboy, but on massive doses of steroids.
Baymax, nonetheless, carries out his role as a nurse and caregiver throughout the film and performs routine nursing care such as scanning for and diagnosing health conditions and prescribing treatments for various ailments. He even uses the pain scale, a classic nursing assessment tool, Harry Summers, co-author of Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All at Risk, points out in a review.
Cynda Rushton, PhD, RN, FAAN, is the Anne and George L. Bunting Professor of Clinical Ethics and a professor of nursing and pediatrics at Johns Hopkins University. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2006-2009). In 2014, she was named a Hastings Center Fellow for her work in bioethics.
Human Capital Blog: Congratulations on being named a 2014 Hastings Center Fellow. What does this fellowship mean for you and your career?
Cynda Rushton: It’s a wonderful honor to be included in this interprofessional group of scholars of bioethics. It’s a terrific opportunity to cross-pollinate with great thinkers and leaders and to think about some of the most vexing ethical issues in health care. It’s going to be a rich container for dialogue, learning, and leadership.
HCB: How will the fellowship work?
Rushton: Fellows have the opportunity to help guide the direction of the Hastings Center, which is an independent, non-partisan and nonprofit bioethics research institute in New York. The center’s mission is to address fundamental ethical issues in the areas of health, medicine, and the environment, and we’ll be bringing up issues that we think deserve more in-depth scholarship and research. This summer, we’re having a retreat where we will be able to work together around issues of common concern, particularly in the area of bioethics.
HCB: What will you focus on as a fellow?
Rushton: My focus has been on how to create a culture of ethical practice in health care. I’m interested in what is required to create that culture and what kind of individual competencies need to be in place to support people to practice ethically and reduce moral distress.
Justin List, MD, MAR, MSc, is a Robert Wood Johnson Foundation (RWJF)/VA Clinical Scholar at the University of Michigan and primary care general internist at VA Ann Arbor Health System. His research interests include community health worker evaluation, social determinants of health, and improving how health systems address the prevention and management of non-communicable diseases.
The emergency sirens sounded loudly for the rising burden of chronic disease in 2014. Chronic diseases, also called non-communicable diseases (NCDs), broadly include cardiovascular disease, chronic respiratory disease, cancer, and diabetes. In 2014, we learned that, overall, 40 percent of Americans born between 2000 and 2011 are projected to develop diabetes in their lifetimes. This is double the lifetime risk from those born just a decade earlier. Rates of obesity, a condition related to many NCDs, remains stubbornly high in the United States. Mortality and morbidity from NCDs, not to mention the social and economic costs of disease, continue to rise.
The United States is not alone in the struggle with a well-entrenched NCD burden. At the end of 2014, a Council on Foreign Relations task force issued a report with a clarion call for the United States to aid in addressing NCDs in low- and middle-income countries (LMICs) where the epidemic of chronic disease poses risks to communities, economies, and security. The task force, which included RWJF President & CEO Risa Lavizzo-Mourey, MD, MPH, among its members, recommended: (1) U.S. global health funding priorities expand from disease-focused objectives to include more outcome-oriented measures for public health; and (2) the United States convene leading partners and stakeholders to address NCDs in LMICs.