For the last 15 years, Ashley Watkins, MSN, RN, has worked at the University of Maryland Midtown Campus. When she’s not working in the Perioperative Department, she’s probably involved with her side gig, Little Picasso Events.
She took time to tell us about her side business and how she manages both.
How did you come up with the idea for Little Picasso Events? Why did you want to do this? How long have you been doing it? What areas do you serve?
Little Picasso Events has been in business for almost 6 years. Two lifelong friends decided to mesh their talents to create something beautiful! I am a self-taught seamstress, crafter, and painter. Because I’m really creative and is not easily defeated by new tasks, I also have a keen eye for colors and design. Ashley Fadiora is the co-owner, and is known for her sociable and free-spirit. She loves art, planning, organizing, and has more than 10 years of experience training and facilitating group activities.
Our company was created with the goal to bring family and friends together to create lifetime memories. Little Picasso Events serve all areas of Baltimore City and County in Maryland.
Explain to me what Little Picasso Events is, does, and what ages it serves.
We are a mobile Sip & Paint company offering art activities for children and adults ages 4 and older.
Each Little Picasso event includes a guided painting activity for a theme of your choice. We hope to disrupt technology, if only for a few hours, to promote personal growth and stimulate social skills. We believe technology has put a huge strain on everyday life. The reintroduction to art in this form aids in nurturing talents that technology may limit. Providing opportunities to be creative during structured group activities affords children and families an opportunity to acknowledge and accept the differences in others. This helps with social skill building, communication, and the development of coping skills for our customers.
Do you find that this is easy to do even while working as a nurse?
Running the business and working has never presented much difficulty. Painting is therapy. It’s self-care and actually helps to decompress from any stressors presented during the course of the week.
What do you like most about working with Little Picasso Events?
We really enjoy getting to meet so many different people, making them smile, and helping them to create something they didn’t think they could. As a nurse, oftentimes when families come together, it’s not always for a joyous occasion. Working with Little Picasso Events changes the narrative and allows the opportunity for decompression and self-expression.
What are your biggest challenges with this side gig? What are your greatest rewards?
We can be our own worst critics. Oftentimes participants are super critical of their work, or doubtful of themselves even before they get started. Sometimes it can be challenging to help change that mindset. We have all of our participants recite a pledge before each paint session to help boost self-confidence and remind them that whatever they create will be great.
We have them point at their canvas and repeat:
“This is my canvas, It’s all mine, Whatever I paint, It will be just fine!”
It is extremely rewarding to be a part of helping others create positive memories. We have the pleasure to be involved with many celebrations and events including birthdays, anniversaries, bridal showers, camp activities, conferences, and mixer events.
Although rare diseases are just that—rare—it’s still important for nurses to be aware of them or be able to find out about them if they find themselves treating patients who have them.
Ann Kriebel-Gasparro, DrNP, MSN, FNP-BC, GNP-BC, faculty member for Walden University’s Master of Science in Nursing program, understands a number of rare diseases and shares her expertise with us.
What makes a disease rare? How many rare diseases are there? Any idea why more than half who have them are children?
In the United States, a rare disease is defined as a condition that affects fewer than 200,000 people. This definition was created by Congress in the Orphan Drug Act of 1983. Rare diseases became known as “orphan diseases” because drug companies were not interested in adopting them to develop treatments. The Orphan Drug Act created financial incentives to encourage companies to develop new drugs for rare diseases. The rare disease definition was needed to establish which conditions would qualify for the new incentive programs.
Other countries have their own official definitions of a rare disease. In the European Union, a disease is defined as rare when it affects fewer than 1 in 2,000 people.
Currently, there are 7,000 or more rare diseases that have been identified. There are approximately 25-30 million Americans who have been diagnosed with a rare disease. Rare diseases can include infectious diseases, birth defects, genetic disorders, and cancers. Some of these rare diseases can be discovered on newborn screening tests. Unfortunately, many rare diseases are not currently tracked, so it is hard to keep track of how many rare diseases there are. A database is much needed, and many states are in the process of developing a database to track rare diseases. Children are affected through genetic or birth defects and may be diagnosed more quickly.
MedlinePlus tracks statistics on specific genetic diseases.
There is also a website that lists medical journal articles with statistics here: http://pubmed.ncbi.nlm.nih.gov. This can be a great resource to find a disease by name and using the terms “prevalence” and “incidence.”
The causes of rare diseases are currently not well known, but research is ongoing. The Institute of Medicine’s 2010 report indicates that 80% or more of rare diseases have a genetic origin, which can be inherited through parents or occur through a spontaneous gene mutation.
Because a majority of rare diseases are inherited, they are often manifested in childhood and diagnosed in children. Newborn screening may also contribute to the early diagnosis of rare diseases in children.
What are some diseases that are considered rare?
Some of the more common rare diseases include those that you have probably heard of in the media or in print, and include multiple sclerosis (MS), which affects about 90 people in 100,000. MS affects more younger and older adults.
Other more common rare diseases are cystic fibrosis, sickle cell disease, and Tourette’s syndrome. Because of newborn screening, many more common rare diseases like sickle cell, cystic fibrosis, and storage diseases can be diagnosed at birth. If treatments exist, they can be started immediately, saving lives.
An example of this is Karina, who has a rare disease called medium chain acyl-CoA dehydrogenase deficiency (MCADD), whereby she cannot burn fat for energy. Because of newborn screening and early detection, Karina is living a healthy and active life, which includes dancing. Her mother has put together a binder of the foods that Karina can eat, which she gives to her teachers and friends, and this keeps her healthy. Newborn screening often requires just a few drops of blood taken from the infant’s foot shortly after birth. If any anomalies are found, more in-depth genetic testing can be done.
Duchenne muscular dystrophy (DMD) affects the use of voluntary muscles in the body and is inherited, primarily affecting boys of all ethnic backgrounds. Normal development occurs initially, but between the ages of 2 and 6 the affected child may have difficulty walking, running or climbing, and struggle to lift their head due to a weak neck. Eventually, the heart and breathing muscles are affected, which leads to difficulty breathing, fatigue, and heart problems due to an enlarged heart. Even with the best medical treatment, young men with DMD seldom live beyond their early thirties.
Gaucher disease (Types 1, 2 and 3) is an inherited storage disorder where fatty substances build up to toxic levels in the spleen, liver, lungs, bone marrow, and sometimes in the brain. It is genetically inherited and affects both boys and girls. Symptoms of Gaucher Type 2 begin in infancy, usually by 3 months, and these children seldom live past 3 years of age.
Why is it important to raise awareness?
Rare diseases affect newborns, children, and families. Families often feel isolated and do not know where to get resources or how to have their child diagnosed, and their children are often misdiagnosed for an average of 10 years or more. More knowledge is needed about rare diseases by the general public—as well as all health care providers—so people with a rare disease can be diagnosed early, given lifesaving treatment, and allowed to have as comfortable, pain-free, and productive a life as possible. When families and patients band together to advocate, more money can be raised for research, to change legislation and to encourage pharmaceutical companies to develop drugs that will treat rare diseases.
Although many rare diseases do not yet have pharmaceutical treatments, many rare disease groups continue to advocate for the development of treatments that can enhance and prolong the lives of all people with rare diseases.
What can nurses do to raise awareness of rare diseases?
Nurses can join a rare disease advocacy group or become involved in research or education for patients and family members. Individual states have groups that advocate for legislation to improve life for those with rare diseases, including supporting drug development.
Some advocacy groups can be found here. More information on state-by-state advocacy can be found here.
How are the lives of people with rare diseases impacted?
People with rare diseases and their families often struggle for years trying to find a correct diagnosis for the illness or disease. They often spend years with multiple physicians who are not aware of the rare disease, screening, or treatment if there is any. Families share stories of traveling from state to state and spending large sums of money trying to find the right diagnosis, treatment centers, and a care team familiar with the rare disease. Currently, there is not a specific list of experts in specific rare diseases, but being a part of patient advocacy groups, participating in a clinical trial or reviewing articles in medical literature can be helpful in finding someone who is familiar with treating or researching a specific rare disease.
As Jamil Norman, PhD, RN, CNE, a co-author of the research study Insights into fear: A phenomenal study of Black mothers (other authors of the study are Sharon L. Dormire, Jodie C. Gary, and Idethia Shevon Harvey), discovered, the greatest fear that Black mothers have is that their sons will be killed, and they won’t be able to keep them safe.
“The purpose of this phenomenological study was to identify the stressors Black women experience as mothers. This paper focused on the most striking stressor, which was living in fear. Fear for personal safety has been identified in previous research with Black populations,” says Norman, academic coordinator for Walden University’s Tempo programs. This study, she says, was the first of its kind that identified these mothers fear that their children will be killed—and it specifically referred to their sons.
“Mothers normally express fears related to raising children. The fear expressed by mothers in this study was different in that it is much more specific,” explains Norman. “Historically, Black Americans have struggled to deal with injustice, unfair treatment, threats to safety and racial inequality. These challenges are arduous as Black mothers learn to navigate raising their children to endure racial discrimination.
In this study, several stress themes were identified from the data. However, the most pervasive stressor was living in fear. Living in fear focused not on the mothers themselves but on the fear of ‘them being killed’ with ‘them’ being a Black son. Another subtheme of living in fear was the resultant concern of whether the mother could keep him safe.”
While there were some finds in the study that surprised her, the themes of “them being killed” and “can I keep him safe?” weren’t. “Although I don’t have a son of my own, I have a husband, brothers, nephews, family, and friends whom I have worried about being killed and keeping safe. These stressors were not new to me as a Black woman,” she says.
In order to help these women in the study—as well as others in the Black community—Norman says, “We need to give Black women a voice that is heard. This can be done through continued research and community outreach. It is imperative that we educate others in the community about these fears and how they make an impact on the health of Black women not only during pregnancy, but overall.”
Nurses, Norman says, can take action to help with this. “Nurses must educate themselves and advocate for their patients. It is difficult to advocate for something that you are not educated about. That’s why I believe nurses must have a general understanding of the disparities associated with maternal and infant mortality and morbidity in the Black community,” Norman says. “After nurses are educated, then they can truly advocate.”
Technology changes in the proverbial blink of an eye. Working and teaching during the COVID-19 pandemic has proven how much it will be used in the field in both practice as well as nursing education.
Julie Stegman, Vice President, Nursing Segment of Health Learning, Research & Practice at Wolters Kluwer, took time to answer our questions about their survey, Future of Technology in Nursing Education.
Why did you decide to conduct this survey? What did you hope to learn from it?
As technology advances, and more and more people have access to computers and smartphones, tech is augmenting almost every workforce. Nursing is no exception. We originated our first survey around technology usage and adoption in Nursing Education five years ago to understand how rapidly nursing programs were implementing technology as part of the education process. Technology helps nursing educators prepare students for practice so they can deliver the best care to patients everywhere, and today’s students have an expectation for a dynamic and multi-modal learning experience.
We decided to refresh our survey this year to understand the shifts in education related to the COVID-19 global pandemic and beyond. We surveyed nursing deans, program directors, and faculty to identify their plans for technology usage, adoption, and investment during the next five years and explore the barriers and opportunities related to those plans.
What are the most important results of the survey? What does this say about the future of nursing education?
Some of the results of the survey were predictable: over the last year and a half, there’s been a massive transition from in-person learning to virtual learning, with some 73% of institutions going fully online at the start of the pandemic, and another 22% adopting a hybrid model.
Though the adoption of virtual simulation and other technologies were already in play in nursing education before COVID, the pandemic greatly accelerated it out of necessity. Some 48% of respondents say they plan to invest more in virtual simulation during the next 2 years, with virtual simulation reaching full adoption by 2025.
Overall findings of the survey point to a “classroom of the future” that is hybrid, geared for digital learners with emerging and existing technologies.
How did the study work?
For our Future of Technology in Nursing Education survey, Wolters Kluwer carried out six in-depth interviews with qualified nursing respondents in August 2020, followed by a quantitative online survey sent out in December 2020. The purpose of the study was to understand technology trends. The online survey, done in collaboration with the National League for Nursing, was sent to a list of nursing administrators, faculty, and Deans provided by the National League for Nursing, yielding 450 responses.
The opinions of these respondents were critical to capture because they represent real nursing education leaders making a difference in the world of nursing education today. No one can better speak to both the day-to-day circumstances and the long-term technological trends than these respondents, and we are very pleased with our sampling.
What survey results surprised you the most?
As we showed with our previous survey, nursing education continues to be an area of early adoption of technology. This has been particularly evident in simulation learning, including research into the value and effectiveness of this learning modality. Our survey continued to reinforce this shift, with nurse educators looking ahead to fuller scale adoption of technologies as well as a continued interest in emerging technologies.
I was most surprised that the incredible shift to online learning we experienced during COVID-19 is anticipated to continue with three in ten (31%) educators saying their programs will offer the same number of online courses, and 39% indicating their program will offer more online courses.
What are the three key barriers that the survey showed are barriers to the adoption of technology? Any ideas how the nursing field can overcome them?
Various factors are hindering tech adoption in nursing education, including a lack of funding and lack of technology infrastructure. Another difficulty nursing education is facing as a side effect of increased tech adoption is faculty who may be resistant or slow to change their approach to teaching, with many faculty members opting to retire and leave the workforce. This has the potential to exacerbate an existing shortage in nursing faculty. We need to remedy this shortage to ensure that all qualified applicants can enter nursing school and become practice-ready nurses to mitigate and meet the anticipated patient demand.
COVID-19 has shown us that learning technologies need to be in place to continue to provide the best possible nursing education in the face of unpredictable learning environments, as well as address many pre-existing challenges educators faced with clinical learning. We anticipate that the pandemic and the associated shifts in learning and teaching approaches will also force a shift in funding which will help address previous hurdles as many of these solutions move from “nice to have” technologies to those that are necessary within nursing schools.
To address the gap in nursing education as a result of recent waves of retirements, we need to ensure educating future nurses is seen as critical to the nursing profession and address the challenges that create this faculty shortage. This includes compensation differences in clinical roles vs. education and ensuring that masters and doctoral programs can also increase acceptance of applicants. In addition, it’s critical to ensure that future educators are familiar with and embrace the benefits that educational technologies can bring to the learning process.
Ultimately, the #1 goal for nurses is to provide the best care to patients, everywhere and in any care setting. This begins with education and it’s essential that nursing faculty and students have the tools available to empower them to be ready to enter the workforce. The Dean’s Survey helps us understand which technologies are likely to drive this momentum, and where we can continue developing solutions to help prepare practice-ready nurses.
“Both my family and work histories came together as motivating factors for this project. As a nurse home visitor for the Nurse-Family Partnership Program in both New York City and San Francisco, I worked with Latinx families from all of the regions included in the study. In addition, my father’s family is from Costa Rica,” says Gerchow. “Through my work as a home visitor, I learned of both shared and distinct aspects of my own family’s culture and the cultures of my Latinx clients and how cultural beliefs and patterns translate into health behaviors. I wanted this study to emphasize that Latin America encompasses an enormous geographic region, where a multitude of cultures comprise the Latinx identity, and that grouping distinct groups into a single category can perpetuate health disparities.”
As for what they discovered, Gerchow says, “In the study, mothers from the Caribbean breastfed for a significantly shorter time than mothers born in the US, Mexico/Central America, or South America. Half of all Caribbean-speaking participants stopped breastfeeding by 3 months postpartum, compared to 5 months for US-born mothers, 7 months for Mexico/Central American-born mothers, and 8 months for South America-born mothers. Statistical analyses found that Caribbean-born mothers had the highest risk of shorter breastfeeding duration.”
Because of this, she adds, “Additional research around mothers’ beliefs and attitudes about breastfeeding must be conducted to understand what influences breastfeeding behaviors specifically. The significant differences by birthplace suggest that within-group cultural differences are significant, but which cultural beliefs are significant is still unknown.”
Nurses who work with breastfeeding Latinx moms may be able to help. “Nurses have a unique opportunity to offer anticipatory guidance and education around breastfeeding in the preconception and prenatal phases of the reproductive life cycle. For mothers from families or cultures where breastfeeding is not the norm, education and guidance might be different than for mothers with family members who have successfully breastfed. Tailoring counseling to the needs and attitudes of individuals and families is crucial,” says Gerchow. “Nurses have the skills and relationships with patients to offer education that enables mothers to make an informed decision. I firmly believe that infant feeding is a mother’s choice and support the decision not to breastfeed as long as it is the mother’s desire.”
