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Jan 20 2015
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Recent Research About Nursing, January 2015

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."

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Jan 19 2015
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Achieving Health Care Equity Begins with Relationships

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.

Lisa Cooper

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?

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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.

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Jan 16 2015
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Calling All Nurses to Address Health Disparities

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.

Susan Hassmiller

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.

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Jan 15 2015
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‘I Can’t Breathe’: Racial Injustice as a Determinant of Health Disparities

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.

Amani M. Nuru-Jeter

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:

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Jan 15 2015
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One Blog, Many Voices

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!

Jan 15 2015
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In the Media: Cartoon Nurse Character Counters Negative Portrayals of Nursing

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.

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Jan 14 2015
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RWJF Executive Nurse Fellow Brings Nursing Perspective to Bioethics

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.

Cynda Rushton

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.

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Jan 13 2015
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‘Glocalizing’ Solutions for the Rising Chronic Disease Epidemic

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.

Justin List

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.

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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.

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Jan 12 2015
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The Imperative to Collaborate Across Disciplines to Make It Easier to be Healthy

Chevy Williams, PhD, MPH, is a fellow at Experience Institute, where she is learning and applying design thinking to social problems. Williams is an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of Pennsylvania. 

Chevy Williams

Today, we can get access to just about anything in minutes or hours. Smartphones put a world of information literally at our fingertips. Within minutes, most of us can get food we want, entertainment we desire, even travel to another city. But seeing a doctor, an arguably more immediate need, is not so easy. Creating a Culture of Health requires our collective interdisciplinary expertise to make health and health care as accessible and user-friendly as other products and services we use on a regular basis.

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Before I left academia, I heard the word “interdisciplinary” tossed around a lot, but I saw it practiced in very safe ways. Typical research teams of grants I was on or would review comprised researchers from only the social, psychological, and health and medical sciences.  As public health faculty, I’d hear statements like “Public health is inherently interdisciplinary.” This may be true since public health draws from multiple disciplines, but I couldn’t help but feel that such statements were more a reflection of inertia than anything else.

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Jan 9 2015
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Being Willing to Really Listen Can Help Those Facing Extreme Disparities and Challenges

Malia Davis, MSN, RN, is a nurse practitioner and the director of nursing and clinical team development at Clinica Family Health Services in Lafayette, Colorado. She has cared for patients in the community, including those who are homeless, for more than a decade. She is a 2014 Robert Wood Johnson Foundation Executive Nurse Fellow.

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Social and economic disparities define my work each day, and have provided powerful motivation for me to commit my professional life to attempts to minimize these disparities in the health care setting. Community health centers, which provide health care for the homeless, are where some of the sickest and poorest people in our communities seek medical and behavioral health care from people like me, a nurse practitioner who is honored to serve each of these individuals and families. 

Malia Davis

I believe one common misperception is that some of my patients fail to contribute to society. Working in community health care for 12 years—10 of them serving homeless people—I have found that most people are very hardworking. Many work at day labor and other low-wage, temporary jobs that are physically demanding and fraught with challenges of all kinds. I often hear of workers experiencing abuse, failing to get paid, and experiencing unsafe working conditions.

They have, of course, none of the benefits we usually associate with jobs. Instead, they face the stress of not knowing day to day if they will find work and be able to support their families—or not. This stress is often compounded by the personal experience of witnessing, surviving, and overcoming trauma or violence, often while in poverty and with very limited resources for healing physically or emotionally. 

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