Americans possess unwavering faith in registered nurses. Year after year, nurses top the list of most trusted professionals. But ask most people just what nurses do and their answers lack clarity, conviction, and a clear-eyed understanding of nursing’s sundry roles.
The American Nurse: Healing America, a documentary film that premiered during National Nurses Week in May, teaches audiences about the diversity and scope of nursing and the critical roles these warriors of healing play during the most vulnerable moments of life, says award-winning photojournalist and filmmaker Carolyn Jones.
“These nurses will knock your socks off. They were so open and free with sharing their inner thoughts and souls, and I am very grateful, and we are lucky to have it on film,” says Jones, whose high-energy persona was palpable during a phone interview.
Two years in the making, the film follows the path of nurses working in hospitals, rural homes, city streets, helicopters, and prisons. The film captures nurses on the front lines of the biggest issues facing America—poverty, aging, war, and justice.
“The main thing is to raise the volume on the voices of nurses in this country,” says Jones, whose film follows the lives and work of five nurses who represent a spectrum of the country and its health care system. “They are a treasure chest of unbelievably rich information. They can make our hospitals run better; they can make schools run better; they can make our communities richer; and they can make the end of life so much better than it is right now.
“I just want to shine that light on nurses and turn up the volume so that they are part of every conversation,” says Jones, who crisscrossed the country to interview more than 100 nurses for The American Nurse: Photographs and Interviews by Carolyn Jones, a coffee-table book published in 2012 that includes the nurses in the documentary.
The nurses featured in the film include: Brian McMillion, MSN, MBA-HCM, RN, at the Veterans Health Administration San Diego Medical Center; Sister Stephen Bloesl, RN, from the Villa Loretto Nursing Home in Mount Calvary, Wisconsin; Tonia Faust, RN, CCN/M, from the Louisiana State Penitentiary; Naomi Cross, RN, from The Johns Hopkins Hospital, Baltimore; and Jason Short, BSN, RN, with Appalachian Hospice Care in Kentucky.
The film follows the path of nurses in different practice specialties, debunks common misconceptions about nurses, and raises questions for society about the challenges of healing America, say the five nurses spotlighted in the film. The featured nurses say they hope the documentary, praised by the White House, The American Journal of Nursing, and national media, educates audiences about their professionalism and the complexity of their roles.
For McMillion, coordinator of the Caregiver Support Program and VA clinical services director, the film is an opportunity to rebrand the profession. The documentary counters the unflattering and unrealistic media portrayals such as Nurse Jackie and raises awareness about stereotypes, says the Army vet and former medic who rehabilitates wounded soldiers returning from war. “We still hear ‘male nurse’ rather than just ‘nurse,’” McMillion says, chuckling. “When I was in school, people used to ask, ‘Are you studying to be a male nurse?’ and I would say, ‘Oh, no, I don’t need to study anymore to be a male; I have pretty much mastered that. I am studying to be a nurse.’”
The film will help the public realize that nurses work outside the hospital and toil deep in the community, says McMillion. (His third title is Major McMillion, 144th Minimal Care Detachment Commander.) “We are in the most intimate places, like their homes, and sometimes we are out in tents taking care of homeless people, which is an outreach I participate in every year as the VA clinical services director. I hope we can show people this is a profession that doesn’t require gender and that it has compassion, critical thinking, and technical proficiency requirements.”
McMillion was most impressed that the film crew, which followed him to Germany and a homeless center, was able to “translate the heart and humor of our profession in a masterful way.”
One message that Sister Stephen, director of nursing at Villa Loretto Nursing Home and president of the home’s board of directors, hopes viewers walk away with is that the nursing home industry is working hard to make care resident-centered. She runs a nursing home filled with goats, sheep, llamas, and chickens. It’s a place where the entire nursing staff comes together to sing for a dying resident.
“In my small, religious nursing home, we feel we can make the remaining years quality. We can be there with them and the families at the end of their life and offer them whatever comfort we can, whatever love we can, and assurance [that] there is an eternity for them, a beautiful life afterwards. If you look at it from a religious point of view, we are the hands and hearts of Jesus reaching out to these people. That’s what it’s all about for me,” says Sister Stephen, who is also president of Cristo Rey, a respite program for special needs children.
Sister Stephen, who has worked at the Villa Loretto Nursing Home since 1965, credited making the film and book projects with adjusting her attitude. “At one time, I was disillusioned with nursing because at times it is so non-hands-on, especially if you are in an administrative [position] or management. So many hours are devoted to paperwork,” she says. But after talking with many of the nurses featured in the book and attending related events, “I think, ‘Wow, I am really back on board.’ I tell people to really see what a gift they can be, what a service they can be to whatever area they decide to go in.”
The documentary also explores the work of a nurse inside a prison. Jones says she wanted to understand how a nurse can take care of people who committed horrible crimes. Tonia Faust, hospice program coordinator, has addressed that question numerous times during the 13 years she has worked at Louisiana State Penitentiary in Angola, the country’s largest maximum security facility. Faust, who runs a prison hospice program where inmates serving life sentences care for their fellow inmates as they’re dying, says treating prisoners requires skills, not judgment.
“I don’t actively look to see what their crimes are. My first year, I looked in the guys’ jackets to see what they did and sometimes I was shocked,” she recalls. “I thought, ‘I don’t need to do this for fear I may not treat them the way I am supposed to.’ Over the years, I realized people make mistakes in their lives. People don’t have the same upbringing as others.
“Some people may not have a choice. They have gone through the court system and been sentenced. It’s not my part to judge them or hold it against them. It could be my brother, my father, or me or my children in a prison. I look at them as patients, and my job is not to judge them, but to take care of them as best as I can with the skills I have learned through my education.”
One common misconception the public has about nurses is that their role is limited with the doctor making all of the decisions about care, says Naomi Cross, a labor and delivery nurse and the perinatal bereavement coordinator at The Johns Hopkins Hospital in Baltimore, Maryland. In the film, Cross coaches patient Becky, an ovarian cancer survivor, through the cesarean delivery of her son. “I had a patient two days ago who had a complicated cancer, and we were going to deliver her baby early. I spent four hours preparing her for surgery and coordinated the doctors and other team members, about 15 people that took care of her during her surgery.
“I remember I am holding her hand, and we are about to put her under, and I’m telling her everything will be OK. And she said, ‘I didn’t know you were going to come with me. I didn’t know you did all these things.’ She was surprised by the whole view of what nursing does. So many times people have said, ‘I thought the doctor did that.’ The biggest misconception is how skilled, intelligent, and knowledgeable we are. I get that so much from my patients. They are always surprised . . . by our expertise.”
The film provides the audience an honest portrayal of the men and women who spend the most time with patients, says Jason Short, who works for Appalachian Hospice Care. Short provides home care to patients in eastern Kentucky, one of the poorest areas in the nation. The film shows him driving up a creek to reach a home-bound cancer patient in Appalachia.
“What I like about [The American Nurse], it captures the journey. It’s almost like nursing has been lost. And I think this was unique because all of us in the film, we are allowed the opportunity to do what nurses do, and that’s just care for people,” says Short, a former auto mechanic who is currently studying to become a nurse practitioner.
A nurse since 2007, Short was drawn to the field after a terrible motorcycle accident at age 18 and he “found out what it’s like to be helpless” and in need of compassionate care.
For Jones, the film, book, and online videos share the inspiring stories of the women and men who have pledged their lives to the care of others. Her desire to elevate and celebrate the nation’s most trusted professionals and their calling also stemmed, in part, from a life-altering experience with the nurse who administered her chemotherapy for breast cancer back in 2004. The memory left an indelible impression.
“The book was an idea brought to me by Fresenius Kabi USA [a global health care company]. This is what I love to do, take pictures and interview people. They wanted to do something to celebrate nurses. I had a nurse who got me through chemotherapy, and she was incredible. Once it was all finished, I never really thanked her properly,” recalls Jones. Over the years, “I thought of her many times. I think you go through an illness like that and you don’t want to turn around and relive it. I thanked her at the time, but not enough, and she never knew how much it meant to me.”
So when approached with the idea, Jones embraced it. The book, website, and accompanying online videos were a hit with nurses. Accolades flowed. Yet, Jones felt her mission was incomplete. “I learned so much doing the book about what role nurses serve in society, that I felt I wanted to do something that could really broadly reach the public. Nurses have enjoyed the book greatly; it’s about nurses, and it’s very much for nurses. It was to celebrate nurses. But I didn’t feel like I was really able to cross that threshold into the realm of the public and let the public really see and know what nurses do, and so that became my driving passion.
“The other reason is I wasn’t ready to leave this world of nurses.”
Are you interested in identifying patient care issues and finding solutions? Consider getting on track to become a Ph.D trained nurse scientist. With a doctorate you can do independent research.
Nursing research develops knowledge to:
Build the scientific foundation for clinical practice
Prevent disease and disability
Manage and eliminate symptoms caused by illness
Enhance end-of-life and palliative care.
Only about 1 percent of the estimated 2.9 million registered nurses possess a doctorate, according to a 2010 Institute of Medicine report titled “The Future of Nursing: Leading Change, Advancing Health.” The reportfound that there is a shortage of nurse scientists.
Why so few numbers? Reasons include more money to be earned in clinical practice and a longer academic journey for nurses, especially if they entered the profession with an associate degree.
But where there is a will, there is often a way. If you envision yourself making discoveries to improve the health of individuals and winning big grants to do so, there are a number of resources available to launch the careers of academic nurses.
The Robert Wood Johnson Foundation Nurse Faculty Scholars program is working to develop outstanding junior nursing faculty through career development awards, which include mentorship, leadership training and salary and research support. The award is for $350,000 over the three years. More details can be found here http://www.nursefacultyscholars.org/about.
The National Institute of Nursing Research has fellowships, career development awards and loan repayment programs. NINR’s annual budget is about $150 million, and more than 80 percent goes toward funding the work of nurse scientists within NINR and around the country, according to the American Nurses Association. More information can be found at https://www.ninr.nih.gov/training/trainingopportunitiesextramural#.
Nurse scientists do their part to help create a healthier nation. Many more are needed. Do you hear the calling?
Robin Farmer is a freelance journalist with a focus on health, education and business. Visit her at www.RobinFarmerWrites.com.
When new moms lack financial resources, caring for a baby is more challenging. A desire to empower these first-time, low-income mothers attracted Noelia Blanco to the Nurse-Family Partnership (NFP) over a dozen years ago. And there is nowhere else this registered nurse would rather be.
“I stayed with it because NFP works,” says Blanco, a NFP nurse home visitor in Philadelphia. “I’m privileged to be a part of it.”
Public health nurses like Blanco are the backbone of a national program spotlighted for providing measurable differences in the lives of new mothers and their children. The program’s main goals include a healthy pregnancy, better child health, and improved parenting skills. Nurses conduct home visits with women from early on during their pregnancy until the child turns 2 years old. They provide expectant and new mothers guidance and education on a number of topics, such as positive prenatal practices, nonviolent child-raising techniques, and life coaching. Nurses also help mothers find jobs and obtain other resources.
Nearly 40 years old, NFP’s evidence-based outcomes include improved health and development of children, better school readiness, and increased maternal employment. In short, NFP, now in 43 states, has a track record for helping parents change their lives and the lives of their children.
Nurses help parents achieve a positive life course by developing long-term relationships and serving as mentors. In-home visits for the voluntary program are key to getting to know the mothers.
“It’s a different story when you work in the community,” says Blanco. “When you are in the home, you get a very comprehensive picture of the client. You know if they have heat, if they have electricity or food. It’s a whole different world.”
Nurses visit weekly, or every other week, until the child turns 21 months, and then scale back the visits to monthly checkups.
New parents are not the only people getting an education. “It has taught me to never give up on someone,” says Blanco. “I’ve always been an optimistic person, but I have seen these clients go through some real tragedies and succeed. I just love the program!”
She’s not alone.
Working with NFP is “one of the most validating and rewarding experiences in my nursing experience, which is why 13 years later I’m still involved with the model,” says Sara Eldridge of Philadelphia, who worked as a NFP nurse home visitor for five years, and then as a NFP nurse supervisor for five years.
“As I became more culturally responsive, it was just validating to see the relationship with the client develop for two and a half years and see the powerful outcomes. It is personally and professionally rewarding. It changed me,” says Eldridge, who now works for the NFP National Service Office as a nurse consultant providing support to NFP agencies in Florida, Georgia, Tennessee, Alabama, Virginia, and the Virgin Islands. A commitment to the evidence-based model, as well as flexibility, autonomy, and continuing education, attracts maternal and child health nurses to the program, she explains.
A public health nurse for 18 years, Maria Solomon joined NFP in Fairfax County, Virginia, several months ago, in part because of its proven results. “You know the outcomes will be good. And I feel I am supported,” she says. “They want feedback and they always want to improve the program, and that is very appealing.”
She is also thrilled to have an opportunity “to do what I love—and that is building relationships with people and helping them. . . while giving them the tools they need to become better parents. As the adage goes, ‘if you love your job, you will never work a day in your life.’ That’s how I feel about this job.”
After 18 years, Solomon is still learning and growing. The home visits provide many lessons.
“You go into someone’s house and it really humbles you. You learn to respect people more. I thought I did, but I think I do more now. The things that we learn and the skills that we gain, and the training we had, doing motivational interviewing—those sort of things make you a better nurse, and they also make you a better person because you are actually putting yourself in your client’s position. You are on their side. You are not poking your finger and telling them what to do, you are guiding them,” explains Solomon.
“I think a lot of women who are in this program want the best for their children, and that is such a force in itself. And if that becomes the starting point—that ‘I want this for my child’—then it’s amazing what you can do and where you can go. You go along this journey with someone. As far as changing me as a nurse, it’s very challenging, but it’s challenging in such a good way because I learn something new every day.”
The NFP program in Virginia began in June 2013, says Laura Suzuki, maternal child health coordinator for the Fairfax County Health Department, who oversees the state’s program and was involved in bringing it to Virginia.
Fairfax County is one of three locations in Virginia to start the program within the past 18 months. “The Affordable Care Act created the Maternal, Infant, and Early Childhood Home Visiting Program, and the money for many of these programs has come out of this pot of money and has enabled a lot of areas to expand their home visiting services,” says Suzuki. “So we were able to pursue that through our state.”
Three other states to recently implement NFP are Idaho, Montana, and Kansas.
Testing of the program in a randomized, controlled trial began in 1977 and was replicated in 1996. NFP’s strength has been its emphasis on the client-nurse relationship.
“The nurse role has been enhanced [over the years], but it has always been a therapeutic one-on-one client relationship that contributes to the outcomes,” says Eldridge. “It’s the powerful nature of what we do.”
Among the enhancements that will be rolled out in more states this year is a parent-child interaction tool—the Dyadic Assessment of Naturalistic Caregiver-child Experiences (DANCE)—that will enable nurses to observe areas of strength and growth. “The great things about the tool is the integration with other things we use, including educational materials,” says Eldridge. Training for NFP agencies to implement DANCE began in 2012 and will continue throughout this year.
What will remain unchanged is the commitment of nurses to their clients and their ability to gain trust, says Blanco.
“They know they can depend on us and we believe in them. Some of their family members are not their biggest fans, and they don’t have the support. If you have one person’s support, it can go such a long way. I’ve seen it over and over.”
Robin Farmer is a freelance writer based in Virginia.
As health professionals, nurses are well aware of health disparities in communities of color. Some patients will live shorter life spans simply because of their race, ethnicity, education or income.
Raising awareness about health inequities is a constant effort, but this critical issue is highlighted in April, which is National Minority Health Month. This year’s theme: “Prevention is Power: Taking Action for Health Equity” emphasizes the critical role of prevention in reducing health disparities.
The combined cost of health inequities and premature deaths were estimated to be $1.24 trillion between 2003 and 2006, according to the Joint Center for Political and Economic Studies.
From AIDS/HIV to cancer to obesity to tuberculosis, racial and ethnic minorities are more likely to be affected in disproportionate numbers. Health disparities among African Americans and Latinos in 2009 cost private insurers an additional $5.1 billion.
Consider these statistics:
▪Of 197,090 diagnoses of HIV-infection from 2008-2011, Blacks were 47% of the total.
▪African Americans, American Indians and Alaska Natives are twice as likely to be diagnosed with diabetes and Native Hawaiians and Pacific Islanders are more than three times as likely to receive the same diagnosis.
▪Latinos are twice as likely to die from liver cancer.
▪African American women are 40% more likely to die of breast cancer than white women.
▪About five out of 10 Latinos and four out of 10 blacks aged 50 or older never had a colonoscopy or sigmoidoscopy compared to three out of 10 older whites.
▪Black women have more than double the rate of extreme obesity [16.4%] as white and Latino women [7.4% and 7.6%].
Preventive services, such as diabetes screening and pap smears, are game-changing. So is a honest discussion about healthy eating, fresh-food deserts and lack of exercise. People can do better when they know better.
Nurses are the most trusted professionals. Educate patients as well as loved ones to help reduce preventable disease, disability and death.
Robin Farmer is a freelance journalist with a focus on health, education and business. Visit her at www.RobinFarmerWrites.com
Are you headed to a conference? Do you know how to effectively spend your time during this professional development opportunity? Make any conference worthwhile with a game plan to keep you focused and organized. Follow these six tips to have a successful conference experience.
Plan early. Take advantage of early discounts. Save money on conference fees with early registration. Early travel planning can reduce costs for flights and hotel accommodations.
Review the conference schedule. Get an overview of activities, map out must-attend sessions, note speakers you want to connect with, and highlight any free time for networking and exploring the city. Identify your goals for the conference. Be prepared.
Highlight action items. Chances are you will take many notes during sessions. But when you hear ideas, tips, and practical steps that resonate, don’t bury the information. Make life easier by focusing on action items you plan to try later after the conference. There are meeting notebooks that include an action section to make note-taking easier. Or create your own.
Network. A conference gathers like-minded attendees and experts that you may not otherwise meet. Take advantage of the opportunities before and after sessions to talk and exchange business cards and connect on LinkedIn. Make it a goal not to eat alone. Meet new contacts for breakfast, dinner, or drinks. If you are shy, make it a goal to connect with at least five new people.
Relax and have fun. Find time to sightsee or at least get out of the hotel for a walk. Better yet, invite a new contact to accompany you. Some of the best conference experiences occur during the “downtime.”
Review and Execute. Remember all those great takeaways you heard during the various presentations? Once home, take time to review conference materials and for nuggets of wisdom and action steps. What did you learn professionally or personally? Who did you meet? Now is the time to follow up.
Conferences provide insight, energy, and contacts to take your career to a new level. Take the time to maximize the opportunities that you will find at conferences by arriving with goals and a plan.
Robin Farmer is a freelance journalist with a focus on health, education and business. Visit her at www.RobinFarmerWrites.com
