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

Jan 9, 2015, 9:00 AM, Posted by Malia Davis

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.

Scholars Forum 2014 Logo: Disparities, Resilience, and Building a Culture of Health.

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. 

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

Jan 8, 2015, 9:56 AM

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.

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

Jan 5, 2015, 9:00 AM

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.

Scholars Forum 2014 Logo: Disparities, Resilience, and Building a Culture of Health.

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. 

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

Dec 17, 2014, 9:00 AM

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?

“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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At the Crossroads of Risk and Resiliency: Averting High School Dropouts

Dec 8, 2014, 12:35 PM, Posted by Karen Johnson

Karen Johnson, PhD, RN, is a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar and an assistant professor at the University of Texas at Austin School of Nursing. Her research focuses on vulnerable youth. The first RWJF Scholars Forum: Disparities, Resilience, and Building a Culture of Health was held last week. The conversation continues here on the RWJF Human Capital Blog.

Scholars Forum 2014 Logo: Disparities, Resilience, and Building a Culture of Health.

As Americans, we love stories about people who beat the odds and achieve success. We flock to movie theaters to watch inspiring tales—many times based on true stories—of resilient young people who have overcome unthinkable adversities (e.g., abuse, growing up in impoverished, high-crime neighborhoods) to grow into healthy and happy adults. Antwone Fisher, The Blind Side, Precious, and Lean On Me are just a few of my personal favorites that highlight the very real struggles faced by adolescents like those I have worked with as a public health nurse. My work with adolescent mothers and now as an adolescent health researcher has convinced me of the critical importance of focusing on promoting health and resilience among adolescents at-risk for school dropout.

How often do we as a society really sit down outside the movie theater or walls of academia and talk about why these young people are at risk for poor health and social outcomes in the first place, or what it would take to help them rise above adversity? If we look closely at the storylines of resilient youth, we will notice a number of similarities. Being resilient does not happen by chance: it takes personal resolve from the individual—something our American culture has long celebrated. And it takes a collective commitment from society to maintain conditions that empower young people to be resilient, and that is something that we as a society do not recognize or invest in nearly as often.  

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The Top Five Issues for Nursing in 2015

Dec 3, 2014, 9:00 AM, Posted by Susan Hassmiller

Susan B. Hassmiller, PhD, RN, FAAN, directs the Future of Nursing: Campaign for Actionwhich is implementing recommendations from that report. Hassmiller also is senior adviser for nursing for the Robert Wood Johnson Foundation.

In 2013, the Institute of Medicine released a report, U.S. Health in International Perspective: Shorter Lives, Poorer Health, that compared the United States with 16 other affluent nations. The United States ranked last or near last on nine key indicators:  infant mortality and low birth weight; injuries and homicides; teenage pregnancies and sexually transmitted infections; prevalence of HIV and AIDS; drug-related deaths; obesity and diabetes; heart disease; chronic lung disease; and disability. This is despite the fact that we spend significantly more on health care than any other nation.

I believe there are five ways nurses can contribute to improving these conditions in 2015. 

Nurses Can Help Us Build a Culture of Health

In a Culture of Health, the goal is to keep everyone as healthy as possible.  That means promoting health is as important as treating illness. Unless everyone in the country joins this effort, we will remain at the bottom of the list of healthiest nations. “Everyone” means all health care workers, business owners, urban planners, teachers, farmers and others, including consumers themselves.  Nurses especially understand wellness and prevention, and have a special role to play in building a Culture of Health. 

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The Legacy of PIN: Strengthening Long-Term Care in Arkansas

Nov 21, 2014, 9:00 AM, Posted by Chris Love

As PIN holds its final national meeting this week, the Human Capital Blog is featuring posts from PIN partners about the program’s legacy of encouraging innovative collaborative responses to challenges facing the nursing workforce in local communities. PIN is an initiative of the Northwest Health Foundation and the Robert Wood Johnson Foundation (RWJF).

The PIN journey with Arkansas Community Foundation and University of Arkansas for Medical Sciences (UAMS), among other partners, has been one of both providence and progress. It was in the fall of 2008 that we were approached by leaders from UAMS with the idea for us to become partners with them in this endeavor.

At first, the idea seemed daunting. Then, after some consideration by our senior leadership, it became an open door for opportunity—an opportunity to leverage the structure and resources of our foundation to complement the expertise of our colleagues and friends at UAMS to address a major issue of mutual concern: the aging population in our state and the significant shortage of adequately prepared nurses to care for that population. Not long into the partnership, our organizations realized this would be a match made in heaven.

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The Legacy of PIN: Keeping the Pipeline Flowing

Nov 20, 2014, 4:00 PM, Posted by Bobbie D. Bagley, Paula Smith

Bobbie D. Bagley, MS, RN, MPH, CPH, is director of public health and an instructor in the nursing program at Rivier University. She played a key role in the Partners Investing in Nursing’s Future (PIN) Pipeline Project. Paula Smith, MBA, is director of the Southern New Hampshire Area Health Education Center and is in the doctoral program in education, leadership and learning at Rivier University. She oversaw implementation of the Nursing Quest summer camps, the Diverse Nurse Network, and the Minority Nursing Student Support Program components of the Pipeline Project. 

As PIN holds its final national meeting this week, the Human Capital Blog is featuring posts from PIN partners about the program’s legacy of encouraging innovative collaborative responses to challenges facing the nursing workforce in local communities. PIN is an initiative of the Northwest Health Foundation and the Robert Wood Johnson Foundation (RWJF).

As New Hampshire becomes increasingly diverse, partners in the state have joined together to promote workforce diversity. These are exciting times. Support from RWJF and other funders provided the opportunity to implement the New Hampshire Nursing Diversity Pipeline Project—a partner-driven effort to increase diversity within the nursing workforce as well as nursing faculty. Lead partners included the Endowment for Health, the New Hampshire Office of Minority Health and Refugee Affairs, the BRINGIT!!! Program (Bringing Refugees, Immigrants and Neighbors, Gently Into Tomorrow—an after school enrichment program), and the Southern New Hampshire Area Health Education Center (AHEC). In addition, this Pipeline Program engaged partners from a variety of organizations in the state, including hospitals, medical practices, youth-serving organizations, middle and high schools, as well as nursing leaders in practice and academia.

In addition, this Pipeline Program engaged partners from a variety of organizations in the state, including hospitals, medical practices, youth-serving organizations, middle and high schools, as well as nursing leaders in practice and academia.

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The Legacy of PIN: An Urban-Rural Model to Increase the Number of Baccalaureate Nurses

Nov 20, 2014, 10:07 AM, Posted by Darlene Curley

Darlene Curley, MS, RN, FAAN, is executive director of the Jonas Center for Nursing and Veterans Healthcare, which served as the lead foundation for the Partners Investing in Nursing’s Future (PIN) project, Regionally Increasing Baccalaureate Nurses (RIBN).

As PIN holds its final national meeting this week, the Human Capital Blog is featuring posts from PIN partners about the program’s legacy of encouraging innovative collaborative responses to challenges facing the nursing workforce in local communities. PIN is an initiative of the Northwest Health Foundation and the Robert Wood Johnson Foundation (RWJF).

Human Capital Blog: Why did the Jonas Center decide to become a part of PIN? What were your goals for the project?

Darlene Curley: There were three things that were attractive about PIN. First, there was this project itself, which was developing a pathway for associate degree to baccalaureate nurses. That’s critical for building a highly educated workforce and a pipeline for preparing the next generation of faculty. The second reason was the partnership funding model. It related to the Jonas Center’s philosophy that we should be funding projects together with others in nursing, but also in interdisciplinary models for health. The third reason was the process of bringing stakeholders together in regions, which was critical. We knew that if we could bring nurse educators, students and other stakeholders together to work on the RIBN project, that group could stay together and work on other projects that were important to nursing and health care as they came along. The third reason was the process of bringing stakeholders together in regions, which was critical. We knew that if we could bring nurse educators, students and other stakeholders together to work on the RIBN project, that group could stay together and work on other projects that were important to nursing and health care as they came along.

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The Imperative to Improve Health Literacy

Nov 19, 2014, 7:59 PM

Joy P. Deupree, PhD, MSN, APRN-BC, is an assistant professor at the University of Alabama (UAB) School of Nursing and a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow. She is engaged in community participatory research studies on health literacy. For 12 years, Deupree has taught a campus-wide elective on health literacy and has been a guest lecturer on the topic at the UAB schools of medicine, dentistry and public health. She founded the Alliance of International Nurses for Improved Health Literacy and established a nursing special interest group for the Health Literacy Annual Research Conference.

Health literacy is extremely important to building a culture of health. Basic understanding of health care information is essential if people are to live healthy lives, but an alarming number of American adults report poor understanding of health care instructions. 

This year marks the 10-year anniversary of the Institute of Medicine (IOM) report, Health Literacy: A Prescription to End Confusion. While progress has been made, the work has really just begun. We can no longer blame the patient for poor health literacy, and we should keep in mind that limited health literacy affects us as all and contributes to increased health care costs. 

The IOM report defines health literacy as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” These skills involve not only reading ability but also numeracy. Failure to develop the necessary skills to manage health care can cost millions of dollars as well as add to human suffering and even cause death.

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