Category Archives: Military/veterans
As the patient-centered medical home (PCMH) has emerged as a model for providing effective team-based care that can help offset the impending primary care provider shortage, so, too, is there a growing need for educational strategies that promote interprofessional collaboration. A short report published online by the Journal of Interprofessional Care describes the strategies in place at the VA Connecticut Healthcare System Center of Excellence in Primary Care Education (CoEPCE) and indicates promising results in just one year: doubled productivity in patient care delivered by faculty providers, and a marked increase in same-day clinic access for patients receiving care from an interprofessional team.
The Connecticut CoEPCE, like four other program sites funded through the U.S. Department of Veterans Affairs Office of Academic Affiliations, builds on the VA’s system-wide PCMH model, known as Patient Aligned Care Teams (PACT). It seeks to develop exportable models of interprofessional education and patient care, according to the report, “Moving From Silos to Teamwork: Integration of Interprofessional Trainees Into a Medical Home Model.” The CoEPCE sites share four core curricular domains—shared decision-making, sustained relationships, interprofessional collaboration, and performance improvement—and the Connecticut center groups together physician, nurse practitioner (NP), pharmacy, and health psychology trainees.
The trainees divide their time evenly between interactive educational sessions and caring for patients, guided by faculty who provide supervision, mentorship, and collaborative shared care. Additionally, the Connecticut center incorporates a one-year post-master’s adult NP interprofessional clinical fellowship, to further enhance clinical proficiency and teamwork experience for NPs.
This is part of the December 2013 issue of Sharing Nursing's Knowledge.
“Nurse practitioners, health aides, pharmacists, dietitians, psychologists and others already care for patients in numerous ways, and their roles should expand in the future. The rise of nonphysician providers will enable more team care. Skilled health aides will monitor patients at home and alert a doctor if certain medical parameters decline. Nurses will provide wound care to diabetic patients, adjust medications like blood thinners and provide the initial management of chemotherapy side effects for cancer patients. ... Policy changes will be necessary to reach the full potential of team care. That means expanding the scope of practice laws for nurse practitioners and pharmacists to allow them to provide comprehensive primary care ... Most important, we need to change medical school curriculum to provide training in team care to take full advantage of the capabilities of nonphysicians in caring for patients.”
-- Scott Gottlieb, MD, American Enterprise Institute, and Ezekiel J. Emanuel, MD, PhD, University of Pennsylvania, No, There Won’t Be a Doctor Shortage, New York Times, December 4, 2013.
“Let me put it this way, we have over 1,200 pre-nursing students. I can only take about 108 a year. In the fall, we had over 600 applicants for 44 positions. Realistically, we are turning away people with 3.6 and 3.7 GPAs. And I think that story is playing out on CSU campuses everywhere.”
-- Dwight Sweeney, PhD, California State University, San Bernardino, Nursing Students Being Turned Away Amid Faculty Shortage in Cal State System, Los Angeles Daily News, December 1, 2013
More than 1,000 veterans will obtain undergraduate degrees in nursing over the next four years with the help of a grant from the Health Resources and Services Administration. The grant was announced earlier this fall.
The multi-million-dollar effort, known as the Veterans’ Bachelor of Science in Nursing (VBSN) program, will allow veterans to build on their combat medical skills and experience and receive academic credit for prior military training and experience. The program provides funding to nine institutions to recruit veterans and prepare VBSN undergraduates for practice and employment in local communities, and also develop career ladders that include academic and social supports, career counseling, mentors, and linkages with veteran service organizations and community health systems.
Participating institutions include three in Florida: Jacksonville University, Florida International University, and the University of South Florida; two in Virginia: Hampton University and Shenandoah University; as well as the University of Texas at Arlington, the State University of New York at Stony Brook, Davenport University in Michigan, and the University of Alabama at Birmingham (UAB).
On Monday, U.S. Department of Health & Human Services Secretary Kathleen Sebelius announced a program that will help military veterans who have health care experience or training pursue nursing careers. The Veterans’ Bachelor of Science in Nursing Program is expected to provide $3 million before the end of this fiscal year (September 30) to accredited schools of nursing to increase veterans’ enrollment, and provide mentorship and other support services.
“The Veterans’ Bachelor of Science in Nursing Program recognizes the skills, experience and sacrifices of our veterans, while helping to grow our nursing workforce,” Secretary Sebelius said in a news release. “It helps veterans formalize their skills to get jobs, while strengthening Americans’ access to care.”
The funds will also be used to explore ways to award academic credit for prior military health care experience or training.
Mildred Dalton Manning, the last surviving member of a group of U.S. Army and Navy nurses taken prisoner in the Philippines at the start of World War II, passed away last week at the age of 98. For many, she had come to symbolize the dedication, strength, and heroism of nurses.
Born in 1914 on the eve of World War I, Manning volunteered for the U.S. Army Nurse Corps in 1939, as the world again teetered on the edge of global conflict. Originally stationed in Atlanta, she requested a posting on the Philippines, saying she wanted to "see the world." Decades later she would recall, "What I saw was a prison camp."
Manning arrived in Manila in October of 1941, six weeks before a series of Japanese attacks on U.S. outposts throughout the Pacific, including Pearl Harbor, the Philippines, Guam, Wake Island and elsewhere. The land battle for the Philippines raged for months, with U.S. forces gradually retreating to the tiny island of Corregidor at the southern tip of Bataan.
During the battle, Manning and her fellow Army and Navy nurses—the first unit of American women to be sent into service so close to the front lines of battle—treated the wounded day and night at a makeshift outdoor clinic in the jungles of Bataan. Over the course of four months, they cared for 6,000 patients, bandaging wounds with bombs falling around them. As the U.S. position deteriorated, they moved to Corregidor, where they would continue their work in a tunnel. There they earned their nickname, "the Angels of Bataan and Corregidor."
Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:
RWJF/U.S. Department of Veterans Affairs Clinical Scholar Anita Vashi, MD, is the lead author of a study that finds many patients visit emergency departments after being discharged from the hospital. With Medicare now structuring financial incentives and penalties around hospital readmission rates, Vashi and her colleagues suggest the focus on hospital readmissions as a measure of quality of care misses the large number of patients who return to the hospital's emergency room after discharge, but are not readmitted. Among the outlets to report on the findings: the Los Angeles Times, Nurse.com, and MedPage Today. Read more about Vashi’s research.
Product Design and Development featured RWJF Nurse Faculty Scholar Jennifer Doering, PhD, RN, and her interdisciplinary team, which designed and tested a research-based sleeping pod for infants. Many parents sleep with their infants, despite the dangers, so Doering’s team has created a portable, protective sleeping pod, equipped with wireless sensors to alert sleeping adults if they start to roll over onto it or if blankets or pillows fall on a sleeping baby. Read more about Doering’s research on the sleep habits of new mothers and infants.
Allison E. Aiello, PhD, MS, an alumna of the RWJF Health & Society Scholars program, spoke to NBC News and the AnnArbor.com about norovirus (the stomach flu). The virus is hard to get rid of, Aiello says, and can be spread to others before an infected person even feels sick. Proper hand-washing is important, at home and in public places like restaurants.
As a new generation of veterans returns home from Iraq and Afghanistan, many with severe psychological wounds, the health care system is stepping up with new ways to care for them. Nurses are increasingly taking on the role of providing the specialized care veterans need to deal with post-traumatic stress disorder and brain injuries, and efforts are underway to train more nurses to help care for them.
PBS recently profiled three nurses—one of whom is a veteran himself—who are working in veterans care. Watch the video below or view the full story here.
VA May Need to Do More to Help Women Veterans Who Are Homeless or At Risk for Homelessness, Study by RWJF/VA Scholar Finds
Oni Blackstock, MD, is a primary care physician and Robert Wood Johnson Foundation/U.S. Department of Veteran’s Affairs (VA) Clinical Scholar at the Yale University School of Medicine and the VA Connecticut Healthcare System. Her study, available online now and to be printed in the April issue of Medical Care, examines gender differences in the use of Veterans Health Administration specialized homeless services programs among Veterans of the conflicts in Afghanistan and Iraq, also known as Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF).
Human Capital Blog: Tell us why you decided to look at this group of Veterans specifically. What makes them—and the time they are returning from service—unique from other Veteran cohorts?
Blackstock: I was interested in understanding use of VA homeless services programs among OEF/OIF Veterans for two primary reasons. The first reason is that many of these Veterans are returning to a country in the midst of an economic recession and housing crisis; therefore, characterizing use of VA homeless services programs among this group is particularly important. The second reason is that this group of Veterans has the largest proportion of women to serve and to be exposed to combat (about 12 percent of OEF/OIF Veterans are women). I wanted to know if women in this group of Veterans were using VA homeless services programs and how their use compared to their male counterparts.