Elizabeth Dickson, MSN, RN, is a fellow in the Robert Wood Johnson Foundation (RWJF) Nursing and Health Policy Collaborative at University of New Mexico. Earlier in her career, she worked at a school-based health center (SBHC). This post is part of the “Health Care in 2014” series.
As a public health nurse, I have worked with children in schools for much of my career. From 2009 until 2013, I worked at a SBHC in New Mexico that was located in an alternative high school in southern Albuquerque. Although small, many students at this school came from families of mixed immigration status and had experienced high levels of street violence, alcohol and drug abuse and overdose, suicide, poverty and food scarcity, minimal health care access, and high teen pregnancy rates.
These kids saw and experienced more than many outsiders of the community could have imagined. The SBHC was open one day a week during school hours and employed a staff that included a nurse practitioner, a physician assistant, public health nurses, administrative staff, and mental health counselors. I worked with an incredible team that provided many health services and screenings, including mental health support, in the limited time that we had.
Want to stay on top of the latest news from RWJF? Check out all the ways you can get the latest news delivered to you:
This is part of the February 2014 issue of Sharing Nursing’s Knowledge.
Nurses’ Perceptions of Their Workplaces
A new survey offers insights into how hospital nurses perceive their workplace and profession. Jackson Healthcare, a health care staffing company, surveyed 1,333 hospital nurses. Among the findings:
- Nearly two-thirds of surveyed nurses (64 percent) say they are satisfied or very satisfied with their jobs.
- Sixty-seven percent say they have less time at patients’ bedsides than they wish because they must perform activities that other hospital personnel could be doing, including looking for equipment and supplies, and restocking supply areas.
- Sixty-six percent cite inadequate staffing levels in their hospitals, saying that limited coverage and clinical support force nurses to divide their time between more patients.
- Almost half of nurses surveyed reported a nursing shortage at one or more of the units in their hospitals, with 35 percent citing the medical-surgical department as short-staffed, 18 percent pointing to critical care, and 17 percent to the emergency department.
Jay Himmelstein, MD, MPH, is a professor of family medicine and community health and chief health policy strategist at the Center for Health Policy and Research at the University of Massachusetts Medical School (UMMS). He serves as a senior advisor to the UMMS Office of Policy and Technology, and is a senior Fellow in health policy at NORC, University of Chicago. Himmelstein is an alumnus of the Robert Wood Johnson Foundation Health Policy Fellows program, where he worked on the health staff of Senator Edward Kennedy. This post is part of the “Health Care in 2014” series.
The nation's attention has focused in recent months on the politics and challenges related to the roll-out of state and federal health insurance marketplaces created by the Affordable Care Act (ACA). Despite website technical woes, significant numbers of Americans have already gained access to affordable insurance plans through the marketplaces and other provisions of the ACA, and it appears likely that the ‘marketplace’ concept will be successful over time in connecting consumers to health insurance and significantly decreasing the ranks of uninsured.
The better functioning marketplaces currently allow consumers to: 1) determine eligibility for subsidized health insurance, 2) use basic online shopping tools to compare and purchase health insurance plans based on four different "metallic tiers" (i.e., the platinum, gold, silver, and bronze tiers), and 3) make side-to-side comparisons between these plans on features such as deductibles, out-of-pocket cost limits, and number and proximity of doctors and hospitals. A few marketplaces also offer information about plan quality, the ability to search for health care providers and hospitals associated with specific plans, and rudimentary ‘cost calculators’ which estimate the total cost of plans inclusive of premiums, deductibles, and out-of-pocket costs.
Human Capital News Roundup: Obesity, suicide prevention, syphilis, co-sleeping with infants, and 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:
The deluge of articles, research, and books on obesity and diabetes are “the noise generated by a dysfunctional research establishment” and are not solving either epidemic, Gary Taubes, MSE, MS, writes in an opinion piece for the New York Times. “Making meaningful inroads ... requires that we know how to treat and prevent it on an individual level. We’re going to have to stop believing we know the answer, and challenge ourselves to come up with trials that do a better job of testing our beliefs.” Taubes received an RWJF Investigator Award in Health Policy Research. Read an interview with him about obesity and diabetes on the RWJF Human Capital Blog.
Finding healthy food, including fresh fruits and vegetables, lean meats, and low-fat dairy products, is more challenging for minorities living in urban areas than for others, according to research by RWJF Health & Society Scholars alumna Carolyn Cannuscio, ScD, ScM. Huffington Post’s Latino Voices features her study, which finds that most residents in urban settings have to bypass nearby corner stores offering little healthy food to find better options elsewhere.
In an opinion piece for the Seattle Times, RWJF Health & Society Scholars alumna Jennifer Stuber, PhD, writes that many health care professionals in the state do not feel prepared to handle suicide prevention and say training should be a requirement for licensure. Her piece was reprinted in Medical Xpress. Stuber’s work also was covered recently by Medical Daily and the New Republic. Read her RWJF Human Capital blog post on the subject.
In the Scientist, RWJF Health & Society Scholars alumna Kristin Harper, PhD, MPH, and colleagues analyze the origins of syphilis and discuss how understanding the history of the disease could help in developing a modern-day strategy to slow its spread.
This is part of the February 2014 issue of Sharing Nursing’s Knowledge.
Kimarie Bugg, MSN, MPH, CLC, a nurse practitioner and breastfeeding advocate, earned a prestigious award earlier this year from Women’s eNews, an online news organization that covers news of particular concern to women.
Women’s eNews named Bugg one of its “21 Leaders for the 21st Century” in January for her work to promote breastfeeding among Black women. Bugg will receive the award later this year at a ceremony in New York City.
Bugg is president and CEO of Reaching Our Sisters Everywhere (ROSE), Inc., a member network that was founded to address breastfeeding disparities among people of color nationwide through culturally competent training, education, advocacy, and support. With a focus on increasing breastfeeding initiation and duration rates, ROSE seeks to normalize breastfeeding by serving as a catalyst that provides resources and networking opportunities for individuals and communities.
Human Capital Blog: How does your study differ from previous research exploring the link between adverse working conditions and depression?
Sarah Burgard: The main contribution of this study was in the way we measured working conditions. Most studies that have looked at adverse working conditions and depression, or other measures of health, have looked at one adverse working condition at a time, such as job strain, job insecurity, or job dissatisfaction. But every job comes with a whole package of working conditions. We felt that capturing multiple indicators at the same time might give us a truer sense of the size, the magnitude, and the power of the association between work and depression.
Also, while some previous studies relied on longitudinal data that included multiple interviews with workers over time, they often excluded workers who did not participate in every interview because those workers didn’t have a measure of the focal working condition at every possible interview. That’s a problem because people who have worse jobs are probably more likely to drop out of longitudinal studies or leave work. Our approach was different; we analyzed data from everyone who participated in at least one interview, using all possible working conditions measure collected at each wave. We created an “overall working conditions score” at each wave using item response theory models. As a result, were able to get a more representative picture.
Adopting best practices from home-based hospice care in the inpatient environment can reduce suffering at the end of life, according to a study published in the Journal of General Internal Medicine. Researchers at the Birmingham Veterans Affairs Medical Center and the University of Alabama at Birmingham said the study is the first to show that palliative care techniques usually used in home settings can have an impact on those who die in hospitals.
The Best Practices for End-of-Life Care for Our Nation’s Veterans (BEACON) trial was conducted at six Veterans Affairs Medical Centers from 2005 to 2011 and involved training more than 1,620 staff members in aspects of care for more than 6,000 dying patients. Although focused on veterans, the study can have a wider impact, researchers said, because most Americans will die in the inpatient setting of a hospital or nursing home.
“We only die once, and therefore there is only one opportunity to provide excellent care to a patient in the last days of life,” wrote lead author F. Amos Bailey, MD, director of the Safe Harbor Palliative Care Program at the Birmingham Veterans Affairs Medical Center, professor in the Division of Gerontology, Geriatrics and Palliative Care at the University of Alabama at Birmingham School of Medicine, and a 2000 Robert Wood Johnson Foundation Community Health Leader. “The keys to excellent end-of-life care are recognizing the imminently dying patient, communicating the prognosis, identifying goals of care, and anticipating and palliating symptoms. Since it is not possible to predict with certainty which symptoms will arise, it is prudent to have a flexible plan ready.”
Federal health care workforce and research programs will receive modest funding boosts in this fiscal year under a new omnibus spending bill cleared in January by Congress, according to a summary released by the American Association of Colleges of Nursing (AACN). The programs affect nursing and other health professions.
Under the Consolidated Appropriations Act of 2014, signed into law on Jan. 17, two health care workforce agencies are slated for increases in fiscal year 2014.
The Health Resources and Services Administration will receive $6.3 billion, an 8 percent increase over the last fiscal year, and the Bureau of Health Professions will get $469.2 million, a 7 percent increase, according to AACN. Nursing workforce development programs under Title VIII of the Public Health Service Act will get $223.8 million in fiscal year 2014, a 3 percent increase.
Carli A. Culjat, BSN RN, is a staff nurse in the Emergency Department at Bryan Medical in Lincoln, Neb., and an alumna of the Robert Wood Johnson Foundation New Careers in Nursing program. She graduated with her BSN from the Creighton University School of Nursing. This post is part of the “Health Care in 2014” series.
As a new graduate and a young person, I am very eager to see what will happen to my country, my career, and my own future with the changes taking place in the U.S. health care system. As I walked across the stage receiving my diploma, my emotions developed and they included excitement, relief, and fear of the unknown. I believe our county is facing similar emotional complexity. As a new graduate and new employee – change can bring forth so many emotions, especially on the large scale that is taking place in health care today.
The media covers the controversy of the situation and as a former student, my class still uses social media to reach out and develop opinions on the changes and their possible effects. Fear creates controversy and with this, we see so many different perspectives and reactions. Even still, I believe our country is excited for a change and ready for the health care system to evolve into a system that we can be proud of and utilize.
There are many who are relieved, myself included. I am relieved that employment is an option at this time in this changing system, I am relieved that our country has taken the initiative to address a need, and I am relieved that I have an education and position that I can use to assist, in the best way a single person can, in health care reform—as a frontline person, a staff nurse in an Emergency Department.