Category Archives: Military/veterans
Roderic I. Pettigrew, PhD, MD, is director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB) at the National Institutes of Health (NIH). He was a member of the inaugural class of the Robert Wood Johnson Foundation (RWJF) Harold Amos Medical Faculty Development Program.
On a fateful day in 2006, 20 year-old Rob Summers, a standout collegiate baseball pitcher at Portland State with aspirations to play in the big leagues, was a victim of a hit-and-run accident while standing in his own driveway. His injuries left him paralyzed below the chest, and his doctors informed him he would never move his legs again.
I first met Rob at NIBIB’s ten-year anniversary celebration. It had been just four years since his accident, and he had already broken new ground in spinal cord injury recovery. During the event, Rob shared his incredible story about the experimental procedure he had recently undergone as part of an NIBIB-funded research trial. In the trial, Rob became the first human to have an electrical stimulator implanted on his spinal cord with the goal of restoring some function to previously paralyzed muscles.
Rob spoke about how, in just weeks after implantation, the stimulation enabled him to hold himself in a standing position for the first time since his injury. In addition, he began to sense when he was uncomfortable in his wheelchair. Rob went on to describe how, seven months into the trial, he discovered he was able to move his toes, ankles, and legs on command, a feat that shocked the researchers, as they never expected Rob to regain voluntary movement.
This is part of the June 2014 issue of Sharing Nursing’s Knowledge.
“A registered professional school nurse is the only person [who] has the education, the training, and the skill level to meet the needs of kids in the schools. It’s all about what the kids need and how can they attend schools, be healthy, and learn. Health and education go together: If a child is not healthy, he can’t learn.”
--Sue Buswell, RN, director, Montana Association of School Nurses, Philadelphia Tragedy Highlights Role of School Nurses, Education Week, June 2, 2014
“I quite frankly don’t understand how a school can function without a school nurse. They really are one of the most cost-effective, unrecognized resources in our country.”
--Anne Sheetz, MPH, RN, NEA-BC, director, school health services, Massachusetts Department of Public Health, School Nurses Save, Not Cost Money, New Study Says, Philadelphia Inquirer, May 29, 2014
“And lest we forget: a heartfelt thanks to all nurses, present and past, who are or have served in the military in any capacity, in some cases losing their lives as they tried to save other lives and heal the wounded. And to their families.”
--Jacob Molyneux, BA, MFA, senior editor and blog editor, American Journal of Nursing, Memorial Day Weekend: Thanks to the Nurses Who Served, May 23, 2014
This is part of the June 2014 issue of Sharing Nursing’s Knowledge.
Nurse history buffs have two new titles to choose from this summer reading season.
In Nurses and Midwives in Nazi Germany: The“Euthanasia Programs,” Susan C. Benedict, CRNA, PhD, FAAN, professor of nursing and ethics at the University of Texas Health Science Center in Houston, tells the harrowing tale of how ethics in nursing and midwifery were abrogated during the Nazi era. Edited by Benedict and Linda Shields, MD, PhD, BSN, professor of nursing at James Cook University in Australia, the book was published in April.
Another new history book, by author Mary Cronk Farrell, tells a heroic story of nursing during World War II. Released in February and targeted at young readers, Pure Grit: How American World War II Nurses Survived Battle and Prison Camp in the Pacific, tells the inspiring story of American Army and Navy nurses serving in the Philippines who survived three years as prisoners of war.
The bookshelves are also offering a host of new nursing memoirs, including Duty Shoes: A Nurse’s Memoir, by Camille Foshee-Mason, RN; The Last Visit: Reflections of a Hospice Nurse, by Margaret Pecoraro Dodson, RN; and Whose Death Is It, Anyway?: A Hospice Nurse Remembers, by Sharon White, RN, BSN.
RWJF Scholars in the News: Scandals and reforms at the VA, excluding the elderly from medical studies, 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:
In a Washington Post opinion piece, RWJF Scholars in Health Policy Research alumnus Colin Moore, PhD, writes that the budding scandal over patient waiting times at regional Department of Veterans’ Affairs medical centers (VA) could lead to positive reforms, if past troubles at the VA are any guide. “Throughout its history, the VA’s very public failures have shaped its development as profoundly as its successes,” Moore writes. For example, previous failures led to the adoption of the 1996 Veterans’ Health Care Eligibility Reform Act, which transformed the VA by opening more outpatient clinics and embracing new ways to track and measure health care outcomes. The recent scandal involving falsified reporting on patient waiting times could lead to another cycle of much-needed improvements, Moore writes.
“Doctors are often in the dark” when prescribing medications or procedures to older patients, because the elderly are routinely excluded from medical research, Donna Zulman, MD, MS, co-writes in an opinion piece for the New York Times. Studies have shown that 40 percent of medical research excluded individuals over the age of 65. “Clinicians consequently have to extrapolate findings about diseases as diverse as cancer, heart attacks, and mental illness from studies of younger and often healthier people, potentially putting their older patients at risk.” Older patients should be included in medical studies because age can affect the way a person’s body processes medication and other treatments, according to Zulman, an RWJF Clinical Scholars alumna.
This is part of the May 2014 issue of Sharing Nursing’s Knowledge.
Gauging the Impact of Limits on Mandatory Overtime and Shift Lengths
In recent years, at least 15 states have adopted limits on mandatory overtime or shift lengths for nurses; these initiatives are aimed at avoiding medical mistakes borne of fatigue. The particulars of the restrictions vary widely by jurisdiction, and new research examines how the various approaches actually play out in the working lives of nurses.
The study by Sung-Heui Bae, PhD, MPH, RN, of the University of Texas School of Nursing, and Jangho Yoon, PhD, of Oregon State University, examined the effects of two general approaches. One allows nurses to refuse mandatory overtime requests by their employers, except in emergency circumstances. The second approach focuses on shift lengths, limiting the number of consecutive hours in nurses’ shifts, imposing requirements for rest periods of a certain length between shifts, or capping the total number of hours in a 24-hour period that nurses may be required to work. In all, according to the researchers, nearly half of registered nurses in the United States are affected by such restrictions.
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."