Understanding Psoriasis

Understanding Psoriasis

Summertime leads to lots of skincare challenges, but for people with psoriasis skincare challenges are a year-round effort.

August brings attention to this skin condition with Psoriasis Action Month and Psoriasis Awareness Month.

According to the National Psoriasis Foundation (NPF), psoriasis is an “immune-mediated disease (a disease with an unclear cause that is characterized by inflammation caused by dysfunction of the immune system) that causes inflammation in the body.” The American Academy of Dermatology Association (AAD) explains that psoriasis is the body’s too-rapid production of skin cells, which cause the cells to pile up and form itchy and painful patches.

For people who have psoriasis, the disease is hardly simple. It causes extreme itching and discomfort physically, but it also brings emotional struggles as the patches can be large and red and will appear almost anywhere on the body.

Psoriasis isn’t contagious so people can’t catch it; however most people can’t tell what is causing such an inflamed reaction and so may assume they will contract a similar rash if they get too close. Covering up the patches helps hide them, but it doesn’t soothe the emotional toll of having a very visible skin condition.

According to the NPF, instead of the typical 30-day cycle in which skin cells will develop and shed, those with psoriasis can have that happen in 3 or 4 days. The rapid buildup of cells looks different on each person (and can vary depending on the type of psoriasis a person has) and can come and go in severity. Like many other autoimmune-type diseases, stress, other infections, or even a skin injury can trigger a flare up of symptoms. Cold, dry weather can worsen symptoms as can too much drinking or smoking.

Because this condition isn’t entirely localized, like a poison ivy rash would be, the systems involved in psoriasis can also lead to other conditions such as psoriatic arthritis, which may affect up to a third of sufferers.

There is no cure for psoriasis, but there are many treatments that people can try. If any of your patients have the condition, encourage them to try as many therapies are they are able to. Each kind of therapy will have a different outcome for each person, so what worked for one might not work for another. Currently, psoriasis treatment therapies may feature light therapy or topical creams or lotions.

More severe cases of psoriasis may involve more pervasive treatments that could include oral medications or infusion therapies that treat a wider range of body systems. And whether someone has a mild case or a more severe case of psoriasis, additional alternative therapies that work to prevent a flare up, reduce inflammation in the body, or help focus on pain management techniques are often useful.

If any of your patients have psoriasis, offer support through resources and compassion throughout the year. If you don’t know much about this condition, do some investigating in your daily nursing approach so you’ll understand it and can help educate others.


August Is National Breastfeeding Month

August Is National Breastfeeding Month

August is National Breastfeeding Month and is a good time for nurses to offer support and resources for families who want to make breastfeeding part of their lives.

According to the United States Breastfeeding Committee, “83 percent of U.S. infants receive breast milk at birth, only 25 percent are still exclusively breastfed at six months of age.” And while the benefits of breastfeeding are widely touted by the American Academy of Pediatrics and other organizations, not every family has equal access to resources or has a supportive environment in which breastfeeding can be sustained.

This month calls attention to the disparities that exist and can help families who choose breastfeeding to have better opportunities for education, support, and resources.

On August 27, from 11:30 am to 1 pm EDT, BirthNet will host the lunchtime discussion, Celebrating Black Breastfeeding and How Doulas Can Help. The panel discussion will address using doulas to help families through some of the challenges they find, especially during the times when COVID-19 can bring even more barriers to finding support when they need it.

Most babies and mothers reap health benefits associated with breastfeeding. According to the American Academy of Pediatrics those include some infant and childhood protection against:

  • bacteremia
  • diarrhea
  • respiratory tract infection
  • necrotizing enterocolitis
  • otitis media
  • urinary tract infection
  • late-onset sepsis in preterm infants
  • type 1 and type 2 diabetes
  • lymphoma, leukemia, and Hodgkins disease
  • childhood overweight and obesity

Mothers also find benefits include a faster uterine recovery, decreased bleeding, faster postpartum weight loss, and some risk reduction of ovarian and breast cancer.

Nurses can continue to offer support to moms who are beginning the process or those who want to continue and are having a hard time doing so. While breastfeeding is a natural method of feeding, it isn’t always easy. Frustration, pain, and exhaustion can derail even the most determined parent. But supportive care—from a nurse, a friend, family member, or a professional—can make the path to continue a little easier. When parents find reliable and effective advice, emotional support, and encouragement, they may be more inclined to continue.

As a nurse, even if you aren’t an ob/gyn specialist, you can help support families who want to breastfeed by helping them find resources within your organization. General supportive conversation if they are finding breastfeeding more challenging than they realized or guiding them toward breast pumps, pillows, nursing clothing, salves, or support groups can sometimes be all that’s needed.

As a professional, you can also advocate for breastfeeding rights including workplace rights for working parents, equal access to resources and support, and general acceptance of breastfeeding.

The Healthy Newborn Network offers a Breastfeeding Advocacy Toolkit that offers ideas on everything from funding to workplace policies aimed at making breastfeeding easier and more sustainable for many different lifestyles and scenarios.

Celebrate and support families this week during National Breastfeeding Month.

Job Search: What to Know Before You Begin

Job Search: What to Know Before You Begin

Embarking on a job search is often an exciting, and yet exhausting process. Beginning a new role, especially one that matches your professional and personal goals, reminds you of why you started a career in nursing and can restart your passion for what you do.

But a job search takes a lot of work, so some preparation before you begin will save you time and will help you find a good match for your skills and your own needs (a higher salary, a shorter commute, a new location).

Minority Nurse recently caught up with Anne Jessie, DNP, RN, and president-elect of the American Academy of Ambulatory Care Nursing (AAACN), for some tips for nurses who are thinking of making the big move and starting a job search.

Q: Should nurses do any kind of self-evaluation or career evaluation before they begin a job search?

A: Yes. Self-reflection is always helpful. It is important to spend time thinking about why you think a job change may be needed or desired. Are you stuck in a place without opportunity? Is the company you currently work for unstable? Is there an unanticipated career opportunity that is too good to pass up? Once you determine your motivation for doing a job search, ranking the following areas in order of importance can be helpful in narrowing your search.

  • Company culture
  • New level of responsibility
  • Opportunity for growth within the new company or new job role
  • Pay and benefits
  • Company stability


Q: What is the best way to get organized and think about a job search?

A:  Ask yourself what you have enjoyed doing most throughout your career, what you’d prefer never to do again, and what areas of career growth opportunities you may have identified. This self-exploration should help you to picture your ideal role more clearly.

  • Browse job postings for the different types of roles that align with your identified career goals. Are the responsibilities described in the postings appealing and do you meet most of the qualifications?
  • Edit your resume so that prospective employers will understand what type of position you are seeking and how your experience aligns. You may need to edit the content depending on the job you are seeking. Highlight accomplishments and experiences that are most transferrable, listing the most recent and pertinent to the posting at the top of your resume.
  • Create a one-page cover letter template that identifies the position you are applying for and clearly demonstrates that you have done research on the company–for example, mention a recent company accomplishment or news story. This template can easily be customized to each job role you apply for. Address the letter to the hiring manager, recruiter, or human resource representative at the company.
  • Identify 3-5 people to be your references and ask them if they would be willing to speak to your skills. Consider present colleagues, professors, or supervisors.
  • After participating in a job interview, write an amazing thank you note within 24 hours of the interview.


Q: What are the best tools to use in a job search and what makes each one distinctive — for instance LinkedIn, networking, job boards, alma maters.

A:  First, consider all your resources: General nurse recruiting websites or agencies, and nursing specialty job boards like AAACN’s Career Center, or those offered by the Organization for Nurse Leaders. Networking is, of course, one of the best ways to find a new position. I’ve heard our AAACN nurses say they found a new job after they joined one of our Special Interest Groups (SIGs), and I see job discussions frequently in our online community. Such new connections can help a nurse discover an area of practice they didn’t know about or had never even considered.

Second, create or optimize your LinkedIn profile. It should be an extension of your resume and cover letter, and should include a professional profile photo and engaging summary that highlights your skills, career achievements, and accomplishments. Also, include volunteer experience as appropriate, as well as education and professional certifications. Maintain your presence by regularly posting and commenting so you appear active and engaged.

Social media can also be a positive platform if used to contribute to conversations regarding timely health care topics. Ensure that you refrain from engaging in conversations that could be considered controversial. Also, make sure your profiles on Facebook, Instagram, and other platforms are set to private.


Q:  Should recently graduated nurses conduct a job search in a different way from a more experienced nurse? Are there better approaches for nurses in different stages of a career?

A:  While knowledge, skills, and attitudes are important, a positive attitude and ability to communicate flexibility in the acceptance of job assignments is key for the new grad. Content and processes can always be taught, but a positive attitude in an employee can sometimes be hard to find. Take full advantage of job fairs that are organized by your nursing school as well as healthcare systems recruitment events. Employers who offer nurse residency programs as part of orientation and onboarding are committed to hiring new graduates and investing in them as long-term employees.


Q:  Is there anything about this time when so many processes are remote, that can impact a job search positively or negatively?

A:   The biggest impact is the uncertainty of the impact from COVID-19 on the job market. Many organizations have suspended hiring and have temporarily furloughed nurses. That said, facilities that offer remote work such as nurse call centers have been vital to providing virtual clinical support to vulnerable populations and have expanded during this unprecedented time in health care.

We’ve seen this trend reflected in a jump in demand for AAACN’s telehealth resources and the networking among our AAACN members who practice telehealth. I think telehealth is going to continue to grow significantly in coming years because its value will remain even when COVID-19 has been tamed.


Q:  How can a nurse prepare to use this time as an advantage?

A:  Self-educate and develop skills that support patient engagement, mutual goal setting, and motivational interviewing that promote patient self-care management. AAACN’s Care Coordination and Transition Management (CCTM) resources can assist in developing these skills and competencies. These skills are especially critical when working with patients virtually but can translate to any work environment to ensure improved disease management and quality outcomes.




Taking Care of Your Skin this Summer

Taking Care of Your Skin this Summer

Summer weather brings all kinds of challenges to your skin care routine. Hot and humid weather can ramp up sweat production while air conditioning is often overly drying. Add in too much sun, a little salty ocean water or chlorinated pool water, and it’s no wonder the warmest months of the year can be hard on your skin. Add in a little stress and a few problems can crop up.

Maintaining a healthy balance for the most problem-free skin takes work. People of color and those with varying skin tones often find they face unique challenges that aren’t typically addressed with easy-to-find resources.

The Skin of Color Society offers many resources for people of color who want to know more about the conditions that affect different skin types. The organization offers educational videos on everything from psoriasis to scalp care.

And while the lack of resources is frustrating, it can actually be life threatening. Even as COVID-19 continues to cross the globe, there were few images of what kinds of skin changes people of color might have with the coronavirus. The alarming gap propelled dermatologist Jenna Lester to begin documenting it herself so that healthcare workers could spot changes quickly.

Always Use Sunscreen

Incorporate sunscreen into your skincare routine every single day, all year long. You’re exposed to the sun’s UV rays all the time, not just when you’re at the beach. Doing errands, walking the dog, pushing the kids on the swing—all those short bursts of time outside can add up over time to result in sun damage. When you intentionally use sunscreen every day, there’s less chance you’ll forget. And don’t forget sunglasses!

Treat Your Skin Gently

Find products that work for you, but don’t overdo it. Wash your face with gentle cleansers. Use moisturizer at night and use a product that won’t cause irritation if you have acne. And be vigilant about not picking at acne as that can leave scarring on any skin type or color but can also cause dark spots, or hyperpigmentation, on black and brown skin.

Know Yourself

Even people with very dark skin can develop skin cancer. Do a body check every month and look for new raised spots, bumps or patches that are itchy and can bleed. These spots can occur in your scalp, on the bottoms of your feet, and in places that have never been touched by a ray of sun.

Find a Skilled Dermatologist

Finding a dermatologist who is familiar with issues faced by people who have a range of skin tones is helpful. You don’t want to have any treatment or procedure that could result in different effects because your skin is dark. You want a dermatologist who knows what kind of result people of varying ethnicities or skin tones have with any topical treatments, laser treatments, or procedures.


July Is Minority Mental Health Awareness Month

July Is Minority Mental Health Awareness Month

July is Minority Mental Health Awareness Month and this year’s focus is particularly relevant. Minority populations have had significant stressors this year. The coronavirus pandemic, the national focus on race and systemic racism, and the economic fallout from an unstable economy have created a storm of emotions and concerns.

The National Alliance on Mental Illness (NAMI) and the U.S. Department of Health and Human Services Office of Minority Health (OMH) are particular champions of Minority Mental Health Awareness Month. Mental illness and mental health challenges can impact anyone with no regard to race, location, socioeconomic status, or gender. But how mental health is regarded and treated can vary greatly. So many factors significantly impact how someone seeks, has access to, receives, and talks about mental health.

This month is devoted to spreading awareness about the particular challenges minority populations face when thinking about mental health.

The OMH reveals some startling information from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the CDC:

  • In 2017, 10.5% (3.5 million) of young adults age 18 to 25 had serious thoughts of suicide including 8.3% of non-Hispanic blacks and 9.2% of Hispanics.
  • In 2017, 7.5% (2.5 million) of young adults age 18 to 25 had a serious mental illness including 7.6% of non-Hispanic Asians, 5.7% of Hispanics and 4.6% of non-Hispanic blacks.
  • Feelings of anxiety and other signs of stress may become more pronounced during a global pandemic.
  • People in some racial and ethnic minority groups may respond more strongly to the stress of a pandemic or crisis.

Because of the vast gaps in health equity and access, many minority populations have trouble finding high-quality mental health care providers and/or a means of getting to a provider to receive care. The pandemic has created a unique situation that can actually be a benefit for some people who have trouble finding good care or getting to an office. Because so many healthcare appointments are now virtual, that could remove one barrier to receiving care, but is wholly dependent on access to reliable technology to be able to connect virtually.

Increased access also depends on changing much deeper levels of the healthcare system. Many mental health providers are overwhelmed with the increased demand for their services during the pandemic. And many providers choose to skirt the often tedious and time consuming insurance process and have opted not to accept insurance and are private pay only. Those two issues can actually create even steeper burdens for those already marginalized by the healthcare system.

MentalHealth.gov offers resources to help families, individuals, educators, and faith and community leaders to begin conversations around mental health among minority populations. Talking about mental health in a normalized and compassionate way can help reduce some of the stigma around mental health issues. People who feel like they can ask for help are often able to then take the steps to get the help they need. If they feel like they are not alone and they are not the only ones who might be struggling, then they will find that getting help is less of a burden. If they feel supported by their community, they feel less need to hide or even deny what they are feeling and experiencing.

Although July calls attention to minority mental health, the issue is one that needs constant attention, but particularly during this time of tremendous and chronic upheaval.