Caroline E. Ortiz, MS, MPH, RN, NC-BC
Caroline E. Ortiz, MS, MPH, RN, NC-BC, Associate Professor, Holistic Nursing, Pacific College of Health and Science, grew up in a bicultural and bilingual household. So it’s not surprising that she learned a great deal about traditional healing practices of Mexican-American women —especially from her grandmother.
When Ortiz decided to pursue a PhD, she chose this topic to study. We interviewed her about it to see what all nurses could learn from her research.
How did you get interested in the traditional healing practices of Mexican-American Women? Why did you choose this for your PhD topic?
Growing up in deep South Texas on the coastal border with Mexico, I was raised in a bicultural/bilingual region where Mexican culture and traditions mixed with those considered American. My mom was a nurse, so when we were sick, she would take us to the pediatrician. However, if we were staying with our grandmother—my mom worked a lot—she would either administer home remedies or take us one block down the road to the local traditional healer.
As a child, I did not understand the difference between Western biomedicine and traditional medicine. I just knew that receiving care from my grandmother and the local healer felt so much more love-infused than when taken to the doctor. As I further explored complementary and alternative medicine and holistic nursing, the childhood memories of my grandmother’s healing rituals and remedies and the feelings of being deeply cared for returned.
My decision to study traditional healing practices among Mexican-American women of deep South Texas is more an act of honor and gratitude to my ancestral medicine-keepers than being strictly an intellectual endeavor. Through this work, I am returning home to learn from caregivers and healers with the intention of sharing what the traditional medicine from ancient Mesoamerica by way of Mexico can teach us today about well-being and healing in mind, body, spirit, and emotions.
Have you or anyone you know actually practiced these traditional healing techniques? If so, please say which ones and explain.
- Plática – an organically unfolding heart-centered talk for arriving at the root of a problem and mutually working it through to resolution
- Limpia – an energetic spiritual cleansing using various tools, such as healing herbs or a whole, uncooked egg, meant to harmonize imbalanced physical, emotional, mental, or spiritual aspects
- Botanicals – the use of healing herbs and botanicals for numerous ailments (physical, emotional, or spiritual) in a variety of preparations, including infusions, tinctures, or in natural form; Commonly used are rue, basil, rosemary, chamomile, rose, sage, lavender, fever few, cinnamon, and aloe vera.
These practices are commonly noted in Mexican-American communities today, whether used by informal caregivers independently or with the assistance of a traditional healer.
How do you think that your research may help the nursing field? Should some of these practices be used in Western medicine? Or are you focusing more on how and why nurses should be aware of these practices?
My intentions are to share with nurses and health care practitioners and leaders what so many patients are practicing and have kept as valuable cultural expressions for improving health, healing, and well-being individually and collectively.
Why is it important for the health care field to be aware of these traditional healing practices?
Research shows that medical pluralism is commonplace, especially in geographical regions where cultures intersect, as they do along the U.S.-Mexico border. This means that people are utilizing more than one medical system or paradigm of care at a time. However, patients of Mexican ancestry are often not disclosing their home treatments to health care providers, and their providers are often not exploring those practices beyond a superficial level, if at all.
The standard of high-quality health care includes being effective, safe, and culturally responsive. Knowing more about traditional medical practices in U.S. communities of Mexican origin and leveraging their potential for improving health expands opportunities for meeting those standards. Moreover, the U.S. medical system may come to learn additional approaches to health, healing, and well-being practiced by other cultures with positive outcomes. The World Health Organization’s Traditional Medicine Strategy has the incorporation of traditional medicine into Western health care systems as one of its goals for increasingly accessible and equitable health care worldwide.
Is there anything I haven’t asked you about that is important for our readers to know?
Curanderismo is the Spanish term describing traditional medicine from ancient Mesoamerica and currently practiced by many communities in Mexico, Central America, the Andes, and the Amazon. It comes from the word curar, meaning “heal.” In curanderismo, the health state means being in harmony internally and externally. Internal harmony balances the physical, mental, spiritual, and emotional aspects, while external harmony balances the self in relationship with others, the natural world, and the greater, multi-dimensional universe. However, this paradigm, in essence, acknowledges no separation between any of these elements.
Ever wonder what the most popular types of nurses are? As we get ready to ring in the new year, it might seem like frontline workers in health care are the most needed and most popular. Nursing students who will soon be headed out into the workforce may want to know what facets of the field have the most needs looking ahead into 2021.
We spoke with Dina Neilsen, Senior Manager of Learner, Career, and Alumni Services as well as the Emergency Committee Co-Chair at Nightingale College to find out about the most popular types of nurses in 2020.
When you say “popular,” what does this mean? The types that have the most nurses working in them? The types that nurses want to work in? Please explain.
This breaks down into a couple of answers—a prospective nurse might want to know what specialties are in highest demand, while others might want to know which are better paid, and which levels of education would need to be completed to work in a desire field.
Each job comes with its distinct set of responsibilities and has particular attributes: some pay better, others are less stressful, while some have the highest growth potential. To make the most out of a nursing career, each individual must decide which aspects are more relevant to them and pursue the position that best fits their aspirations.
Because of the pandemic, have frontline workers become one the most popular types of nurses in 2020? If not, why not?
While there isn’t much data given how recently the pandemic hit, it’s likely that there has been a surge in frontline medical workers. However, the pandemic itself will likely not change the overall top nursing careers.
What are the top popular types of nurses in 2020? Why are they? What has changed in the field to make the more popular if they weren’t in the past?
The top 20 nursing careers, based on salary and according to the Bureau of Labor Statistics, are:
- Registered nurse
- Pediatric nurse
- Nurse practitioner
- Oncology nurse
- Emergency Dept. nurse
- Clinical nurse specialist (working in specialized units focused on a particular area of medicine)
- Nurse case manager
- ICU nurse
- Nurse educator
- Travel nurse (short-term assignment)
- Certified dialysis nurse
- Operating Room nurse (Perioperative nurse)
- Surgical nurse practitioner
- Psychiatric/mental health nurse practitioner
- Cardiac/cardiovascular nurse
- Nurse researcher
- PACU nurse
- Home health nurse
- Certified registered nurse anesthetist
- Certified nurse midwife
These are the specialties that are sought after by most hospitals, especially in the conditions of the nursing shortage looming ever-so-intensely over the United States.
In 2020, COVID-19 has made a lot of changes. So as the holidays are rolling around, it’s not surprising that it would change how they are celebrated.
Oftentimes, nurses would have potlucks during various shifts at work, hold present exchanges, and play games. But life has changed.
We reached out to get some tips on how nurses can hold safe holiday celebrations while at work.
From Jenna Liphart Rhoads, PhD, RN:
- Have a toy drive for children in need: in exchange for bringing in a brand-new toy for a child in need, nurses could be given a raffle ticket to win something like a massage, an extra 8 hours of PTO, or a gift certificate for a new set of scrubs.
- Staff nurses could bring in an ornament to help decorate the unit Christmas tree
- A snowman decorating contest: nurses could anonymously color or decorate a snowman (or snowwoman). Staff could then vote on their favorites, and a winner gets a prize.
From Alaina Ross, BSN, RN:
- On the floor of the hospital where she works, the nurses are having a catered lunch from a local restaurant. “[This] reduces the risk you’d get with a potluck of 20+ different dishes being cooked in 20+ households. The lunch comes from a clean and safe kitchen at a restaurant—and has the double bonus of supporting a local business,” says Ross.
- Secret Santa Gift Exchange: “The Secret Santa style gift exchange reduces exposure and interpersonal contact, as there isn’t a large group get-together like you’d have with a white elephant exchange or party. It’s just one person secretly delivering a small gift to another by leaving it in their locker.”
From Thomas Uzuegbunem, BSN, RN:
- He also suggests that instead of having a potluck to order from a restaurant that does individual servings (for example, Chinese food, etc.). “One person can take responsibility for ordering, and everyone can reimburse that person through PayPal or Venmo,” Uzuegbunem says.
- Play Fantasy Sports or a unit game on smartphones: “These are good options to get a group of people involved while still social distancing.”
- Digital Secret Santa: This is like regular Secret Santa—except for the large gathering. “You’ll pair people up and then the purchases will be either digital or mailed to their homes.”
Have a wonderful holiday season!
Shift work — so many nurses do it or have done it at least once in their careers. While patients definitely need care around the clock in certain settings, the nurses who care for them also need sleep.
According to Amy Witkoski Stimpfel, PhD, RN, an Assistant Professor at the NYU Rory Meyers College of Nursing, “Shift work—particularly nights and evenings—misalign our body’s natural circadian rhythms. Simply put, as human beings we were not made to be awake late at night or very early in the morning,” she explains. “Thus, there is a cascading effect on this circadian misalignment on the rest of our body’s functioning.”
The biggest problem with this is that nurses must be able to provide safe care and going without sleep can be problematic. “Obviously sleep disruption is one of the biggest and most dangerous consequences of circadian misalignment caused by shift work. Being sleep deprived is also especially difficult because we are not good judges of how impaired our functioning is when we are sleep deprived. So, as nurses it can be very dangerous to practice when sleep deprived,” Witkoski Stimpfel says.
She cites the National Academy of Medicine, which recommends that nurses not work more than 12 hours every 24-hour period or 60 hours per week. There is also evidence that shows nurses should work a maximum of two to three shifts in a row.
Witkoski Stimpfel gives the following tips for nurse on how to best perform at their jobs when working overnight shift work:
- Achieve enough adequate sleep during off shifts
- Judicious use of caffeine
- Use blue-blocking sunglasses on the way home after a night shift
- Use blue-blocking apps/filters on smartphones and other electronic devices before getting sleep
- Limit voluntary overtime hours
- Have a bedtime routine that doesn’t include alcohol, nicotine, or other drugs
- The bedtime routine can include taking a bath, listening to music, medication, talking with a spouse, friend, or family member—these will all help the body to shut down for rest.
Know that you can make mistakes when working nightshifts. “One of the biggest mistakes nurses can make when working night shift is to not sleep before a shift. Most studies on this topic indicate a small portion of nurses simply do not sleep before going into night shift, which is very dangerous,” says Witkoski Stimpfel. “Using melatonin or other sleeping aids should only be used under a provider’s guidance.”
If you have to switch from dayshift to nightshift in one week, Witkowski Stimpfel suggests the following, “It will be challenging to get “good” sleep when working one off night shifts, which is why that kind of scheduling should be avoided. If it happens occasionally, the nurse should try to get a nap before the night shift and definitely sleep as much as possible following the night shift. Using caffeine at the beginning of the shift and taking a walk or going up a few flights of stairs around 4 a.m. can help with alertness during the shift. If possible, using public transportation or having a friend or family member drive the nurse home after the shift could help to avoid drowsy driving,” she says.
Remember that these present, strange times we’re in have caused a lot of additional stress on everyone, especially health care workers. So it’s important to get the sleep you need. “The COVID-19 pandemic has placed additional and unprecedented stress on nurses, often resulting in disrupted sleep,” states Witkoski Stimpfel. “It is really important to reach out for help, whether it is therapy or counseling, meditation, a consultation with a sleep medicine physician, etc. Sleep is crucial for functioning across the board, both mentally and physically.”
Probiotics. We hear a lot about how we should be taking supplements of these because they’re great for your digestive system. But because supplements aren’t regulated by the FDA, how are you supposed to find the one that’s right for you and your patients?
Fear not. Dragana Skokovic-Sunjic, BScPhm, NCMP, is a Clinical Pharmacist with Hamilton Family Health Team, Hamilton, ON as well as a leader in the knowledge of probiotics both in the United States and Canada. In addition, Skokovic-Sunjic is the author of Clinical Guide to Probiotic Products Available in Canada and Clinical Guide to Probiotic Products Available in the US, both of which are updated annually.
She took the time to answer questions.
For those who don’t know, what are probiotics and how do they help our bodies?
Probiotics are tiny but powerful organisms that, when taken appropriately, can oﬀer substantial health benefits. While many people believe probiotics are for the gastrointestinal tract only, scientific evidence asserts far-reaching and diverse benefits of probiotics which extend far beyond the gut to include: respiratory ailments, mental health, colic in babies, weight management, vaginal health, and more.
Probiotics offer health benefits through several mechanisms: modulation of composition or activity of the microbiome, modulation of the immune system, effect on systemic metabolic responses, improving barrier function in the gut, and increasing colonization resistance against pathogens. Many other new benefits are being discovered every day with the new research. (Source: https://isappscience.org/for-scientists/resources)
There are so many on the market. How can people choose the best one for them?
Probiotics are potentially beneficial; however, it is important to note that the effects and benefits are strain-specific and disease-specific. One needs to know what to use and why. Taking any probiotic, or a probiotic with the best-looking label or best price does not necessarily mean it will provide the desired benefit. It would be similar to walking into the pharmacy and simply asking to be given medication.
Probiotics are similar to medicines. Each one is unique and has a particular intended purpose. Just as taking medication for pain won’t prevent pregnancy, taking a probiotic to prevent traveler’s diarrhea won’t relieve a baby’s colic symptoms. It is essential that probiotics be prescribed or selected, and taken, appropriately.
All probiotics are not created equal, nor is the science that validates their eﬀectiveness. Unlike medicines, probiotics are not strictly regulated yet. Unfortunately, this means there are many probiotic products on the shelves that make claims that are not substantiated by scientific evidence. This is confusing, frustrating, and is resulting in people wasting money buying the wrong probiotic for the condition they are suﬀering from.
Selecting the proper probiotic and taking it appropriately for the symptoms or condition you wish to relieve is imperative. Be informed when choosing a probiotic. The Clinical Guide to Probiotic Products Available in the US is the only comprehensive summary of probiotic brands that reviews, rates, and summarizes the scientific evidence available for specific probiotic strains and related brands.
Clinical studies supporting the recommendations made by our expert review board are all listed for those who would like to dig deeper and learn more. You can also use a free, quick-access app as your reference tool, by downloading the Probiotic Guide free app to your iPhone or Android smart phone. Make sure to select one for your region—one for the US and one for Canada. Both the website and app contain the same information, including the references, level of evidence, reasons for use, dosage formats, and more.
It is essential to know that not everyone needs to be taking a probiotic supplement. If you are eating a balanced diet, including fermented foods often, not taking antibiotics, and are generally healthy, you do not need to take a probiotic all the time. However, in some situations, such as the cold and flu season, you might look at the evidence for specific strains and products that seem to minimize the risk of common infections disease or shorten the duration of cold and flu.
Are there any things to watch out for?
Most importantly: read the label. The probiotic product you select must show the unique name of the probiotic you need to use on the label. The name is a combination of three critical elements: its genus, species, and strain. The strain is particularly important because it not only reﬂects the physical characteristics of the probiotic, but how it will act, interact, and react with your individual microbiome. Dose expressed in CFU (colony forming units) and potency at the time of expiry has to be clearly stated.
Like any other supplements, the label should provide a non-medicinal ingredients lists, such as traces of dairy, gluten, and other potentially harmful allergens.
Most probiotic strains available in the U.S. and Canada have been deemed safe (GRAS status or NPN designation) for the general population. For critically ill patients, severely immunocompromised patients, and other special circumstances, the use of probiotics can be done under strict medical supervision.
Is it best to take them with or without food? In the morning or evening?
Timing and the best ways to administer probiotics is again, very strain-specific. Generally, most commercially available products can be taken at any time of the day, with or without food. Some strains are available in liquid form (drops) and are very effective even in a dose of 0.5B (billion) CFU. Other probiotic strains need to be taken in an enteric-coated capsule in a dose of 50B CFU in order to survive through the acids present in the gut to reach the target areas and provide benefits. This does not mean one is better than the other: it merely illustrates that not all probiotics are the same.
How can people tell if the one they’ve chosen is working?
If the probiotic is working, you will know! And you will know very soon. The best approach is to identify the reason why you would take the probiotic. For example, you suffer from IBS and would like to try a probiotic. Faced with so many choices, you turn to the Probiotic Guide mobile app, and find a few options with the highest level of evidence.
At this point, you could consult your health care practitioner, or decide to give it a try. Most probiotic products are available without a prescription.
The next step is to take the selected probiotic as recommended in the Probiotic Guide or on the product label. After you achieve symptom relief, you can stop taking it and see what happens.
Quite a few of my patients with IBS do safely stop taking probiotics after the initial treatment while others may need to take the probiotic continuously.
The length of time one needs to stay on a probiotic may different for each individual and the reason the probiotic is taken. Once symptoms are gone, you can try to stop and see what happens.