Category Archives: Nurses and Nursing

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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Jan 8 2015
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The Role of the Chief Nursing Officer in Bridging Gaps Among Health Systems and Communities to Improve Population Health

Jerry A. Mansfield, PhD, RN, is chief nursing officer at University Hospital and the Richard M. Ross Heart Hospital, and a clinical professor at Ohio State University College of Nursing. He is an alumnus of the Robert Wood Johnson Foundation Executive Nurse Fellows program.

Jerry Mansfield
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Since my doctoral work in public health, I have thought a great deal about the relationship of public health theory and practice and my acute care background. With more than 30 years of progressive leadership experience in a variety of for-profit/non-profit, inpatient and outpatient positions, I am trying to generate dialogue and discern a purposeful plan regarding the role of a Chief Nursing Officer in an academic medical center and the health of the populations we serve in our communities.

Based on earlier work in the 1990s and early 2000s, in 2007 the Health Research and Education Trust (HRET) engaged national experts to address the following question: How can hospitals engage their communities to improve the health of everyone? The report provides a framework and encourages hospital leaders and community members to envision health care in communities beyond the medical services offered by providers; it notes that the production of health is not only medical care, but also our environment, individual behavior, and genetic make-up.

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Jan 5 2015
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'We Need People to be Incensed by the Health Inequality that Persists in This Country'

Felesia Bowen, PhD, PCPNP-BC, is an assistant professor at Rutgers University School of Nursing, and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2014-2017). Her research focuses on community-based pediatric asthma care.

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When I first began working as a pediatric nurse in New Jersey 20 years ago, I was committed to getting asthma care right. I worked hard to educate my young patients and their families about the disease, how to avoid the triggers that cause attacks, and how to use their medications. I wrote asthma action plans and prescribed the correct medications to control symptoms. 

Felesia Bowen

It wasn’t always enough. One Monday morning, one of my young patients experienced asthma symptoms. The family followed his asthma action plan, “stepping” his medications in an effort to relieve his asthma symptoms. On Tuesday, he wasn’t feeling better, and went to the nurse practitioner (NP) in his school’s health office, who appropriately modified his treatment plan and called the asthma specialist to get a next-day appointment for him.

She remembers the young man telling her that he really needed to feel better, because he was going to his middle school graduation dance Wednesday night. On Thursday morning, he visited the NP again, still with asthma symptoms. He told her that he had missed the appointment with the asthma specialist because his mom couldn’t make it—she had health issues of her own, and three other children to care for. But he’d gone to his dance and proudly showed her his middle school class ring.

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Dec 23 2014
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Breakthrough Leaders in Nursing

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.

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Dec 23 2014
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Nurses the Most Trusted Profession – Again

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.

Read more about this year’s Gallup survey.

Dec 23 2014
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Sharing Nursing’s Knowledge: The December 2014 Issue

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.

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Dec 17 2014
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The Legacy of PIN: A New Level of Collaboration in the Pacific

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?

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“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

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Dec 16 2014
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Quotable Quotes About Nursing, December 2014

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

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Dec 11 2014
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Recent Research About Nursing, December 2014

This is part of the December 2014 issue of Sharing Nursing’s Knowledge.

Study: ‘Alarm Fatigue’ Poses Danger

After a while, alarms stop being so alarming. That’s the warning growing out of a study of the sheer volume of physiological alarms generated by bedside monitoring systems in hospitals. The barrage of beeps can become so overwhelming that it creates “alarm fatigue,” which in turn can lead nurses and other clinicians to discount the urgency of alarms or to ignore them altogether.

In the study, led by University of California, San Francisco (UCSF) School of Nursing Professor Barbara Drew, PhD, MS, researchers tracked the quantity and accuracy of alarms generated in five intensive care units at the UCSF Medical Center over a 31-day period. They found a high rate of false positives—alarms generated when patients were not in need of treatment beyond what they were already receiving. For example, during that time, researchers counted 12, 671 alarms for arrhythmia, 89 percent of which were false positives. Most of those were the result of problems with the alarm system’s algorithms, incorrect settings, technical malfunctions, or brief heart rate spikes that did not require further attention.

In all, during the 31-day period, the systems generated an average of 187 alarms per patient bed per day, adding up to more than 380,000 audible alarms over the course of the month, across the five ICUs.

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Dec 11 2014
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In the Media: New Exhibits Shine Light on the History of Nursing

This is part of the December 2014 issue of Sharing Nursing’s Knowledge.

On television and in other media, nurses are often portrayed as gendered stereotypes: the angel, the handmaiden, the battle-axe, or the sex-object.

Turns out, these portrayals aren’t new. That is evident in a new postcard exhibit at the National Library of Medicine in Bethesda, Md., that illustrates cultural perceptions of nursing over the last century.

The exhibit, entitled Pictures of Nursing, hails from a collection of more than 2,500 postcards that were donated by Michael Zwerdling, RN. The collection includes postcards that date to the late 1800s, and features images of nurses portrayed as everything from Greek goddesses to Amazon princesses to the Virgin Mary. It also includes rare images of male nurses.

Some of the exhibit’s more contemporary postcards depict nurses in modern uniforms and as skilled members of health care teams—images that counteract sexist and gendered notions of nursing that come through in other postcards.

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