Nurses often treat victims of domestic violence. During normal times, they may be able to assist them in getting help to escape their cycle of abuse. But what happens during a pandemic? What happens when they are being told to quarantine? How can nurses assist in this case?
Valerie Weir, BSN, RN, FNE-A/P, CMSRN, SAFE Domestic Violence Program Coordinator and Forensic Nurse Examiner for the GBMC (Greater Baltimore Medical Center) SAFE and Domestic Violence Program, answered our questions to provide nurses with the crucial information they need to help as many victims of domestic violence during this time.
Nurses often see victims of domestic violence in the ER or when they’re admitted. If a patient who is a victim of domestic violence comes to the ER, but is going to be sent home to quarantine, what can nurses do to help?
People currently living in an abusive situation may be at an increased risk for abuse while practicing social distancing and self-quarantine. Often in these situations, they will not have access to their traditional support system and their normal autonomy. Isolation is a key tactic used by an abuser, and a crisis situation provides opportunity for the abuser to exert that control.
Victims will usually wait until they are alone to reach out for help. They will wait for their abuser to go to work and their children to go to school. Currently, that is not an option. Victims are unable to have that conversation when their abuser is in the home; often abusers will monitor the use of cell phones and other electronic devices. The current “no visitor” recommendations in hospitals provide an opportunity for providers to speak with that patient without the abuser being present.
Many domestic violence service providers remain fully functional during the coronavirus pandemic, although they have shifted many of their services to phone and virtual consultations when safe. Shelters and safe house also remain open and have taken measures to keep staff and those living in the shelters protected.
What resources are out there that nurses can utilize?
If you are fortunate enough to have a domestic or family violence program within your institution – use them! That is what they are here for. The SAFE and Domestic Violence Program at GBMC will remain open throughout the pandemic, providing medical-forensic and advocacy services 24 hour a day, 7 days a week.
If you do not have that resource in your hospital, our local community partners are also committed to providing services to victims of sexual and intimate partner abuse. Some have adopted a modified intake process to maintain safety of staff and survivors, and some offices will be closed to the public. But essential staff will be onsite to answer calls and provide services to clients.
Here are some resources available to victims of sexual assault and domestic violence that are available 24/7:
What are the best actions that nurses can take when presented either with someone who has to leave the ER and return home or a patient who is being sent home after a hospital stay? Should they get other health care workers like social workers involved? Please explain.
Listen to the patient. Truly listen. Let them know that they are not alone—you are there for them, and there are others ready and willing to help too. At GBMC, we are fortunate to have the direct resource of our DV Victim Advocates within the SAFE & DV Program. Our victim advocates are ready and available to offer support and resources 24/7. SAFE and DV services at GBMC are free, confidential, and can be anonymous if desired by the patient.
Social workers are an invaluable resource to have involved. They are equipped to provide additional emotional and psychological support, in addition to assisting with safety planning and coordinating any other care and services the patient may need.
What are some things that nurses should *never* do in these kinds of situations?
- Don’t ignore the signs of abuse. As nurses, we are a lifeline to our patients.
- Don’t be judgmental. We may never know the details of someone’s situation, but we can always be caring and supportive.
- Don’t rush, especially during these uncertain times. In order to build and maintain a trusting relationship with your patient, they need to feel heard. Their abuser has likely already filled their head with self-doubt and toxic thoughts. Be aware of that as you are asking questions, they may become defensive. Remain calm and non-judgmental, and allow your patient the time he or she needs to process and discuss the abuse.
- Don’t betray their trust. Inform patients of any mandatory reporting requirements at the beginning of your conversation. In Maryland, to protect patient confidentiality, domestic abuse is not a mandatory report. You cannot report suspected or confirmed domestic violence unless the adult victim consents. Cases involving abuse of a child or vulnerable adult, however, are mandated reports to Child Protective Services and Adult Protective Services respectively.
What else should nurses know for dealing with this situation?
Understand that while imposed isolation is necessary for decreasing the spread of COVID-19, it can also put victims in a more vulnerable position and at a greater risk of abuse.
Don’t be afraid to address this topic with your patient—you may be the only one who does.
Understand that these patients often carry feelings of embarrassment and shame surrounding their abuse. In turn, victims of domestic violence will often discuss their experiences only if they are approached in a non-judgmental and empathetic way. Let them know that they are not alone.
Encourage your patient to reach out for support and assistance. There are several hotlines within each state—and nationwide—that are available 24 hours a day, 7 days a week so patients can make a call at whatever time is safest for them.
Since it impacts us, every household is encouraged to complete the 2020 Census. The U.S. Congress started taking the U.S. Census in 1790, as noted in the U.S. Constitution. The Constitution also required that the federal government do the census every 10 years. Political power and funding are greatly impacted by the census, which also impacts all the elements that contribute to the social determinants of health. The census is used to allocate congressional seats, electoral votes, funding for government programs, as well as the database of a lot of research.
More than $675 billion federal funding is distributed yearly based on the U.S. Census. Accuracy in the “count,” counting the correct category, clear descriptive verbiage, and engagement are imperative. Relating the importance of completing the census to all stakeholders, and creating an environment where people feel safe in completing the census, especially marginalized populations, is essential. Minorities, children, immigrants, and low-income areas are noted to be difficult to count.
Accuracy of the count has always been a concern from day one. President Washington and his Secretary of State, Thomas Jefferson, shared concern that the Census of 1790 undercounted the population greatly—and we still have this issue today. According to the U.S. Census Bureau, the first Census consisted of six questions: the name of the head of the family, free white males at least 16 years old, free white males under 16 years old, free white females, “other free persons,” and slaves. Slaves were counted as three-fifths of a person and Indians were not counted until almost 100 year later.
The 2020 Census has had a hot debate over including a citizenship question and the negative impact it would have. Although the suppressive citizenship question will not be included, citizenship numbers could be extracted from the yearly American Community Survey (ACS), which falls under the U.S. Census Bureau. We still deal with inaccuracies of the census, concerns of undercounting the population, as well as debates over the questions included on the census. The census has a huge impact on the allocation of funding, research, and political representation.
African Americans and Latinos have been historically undercounted. These groups are even ranked by states in census tracks called HTC (Hard to Count) with New York, Texas, Florida, California, and Georgia in the top five states respectively for African Americans and for Latinos, it is California, Texas, New York, Arizona, and Florida, respectively, according to CensusCounts.org. Children also have a ranking in HTC states. Many elements play a role in why the census does not reflect an accurate count or low survey participation with minorities, low-income, children, and immigrant population. Fear, distrust, inequity, lack of information, privacy, and intent contribute to poor participation.
The 2020 Census adds a new element that for some may be a barrier and/or learning curve, which is technology. For the first time in history, the census will be available online. The addition of media brings about many issues, such as computer literacy and internet access issues. The HTC marginalized population should be targeted for support and resources to get optimal participation in completing the 2020 Census.
The U.S. Census data determines our political representation. Congressional seats for each state are determined by census data. As a result, a state could lose a member in Congress or your city could lose state representation. For example, the House of Representatives divides its 435 memberships or seats among the 50 states based on the total resident population (citizen as non-citizens) using a 1941 calculation methodology; a complex process. Let’s not forget two important political terms: redistricting and gerrymandering. Redistricting is the period where legislative boundaries are redrawn. The data is used to define legislative districts, school district areas, as well as other areas in government. Gerrymandering is a method that officials may use to draw district lines to influence election results, manipulating boundaries and changing voting districts to favor a political group.
Census data is used to make decisions on road repair, schools, services, jobs, education, neighborhood improvements, and more. As noted above, more than $675 billion federal funding is distributed yearly based on the U.S. Census. According to the College Board’s annual Trends in Student Aid report, in 2017-2018, there were 7 million Pell grant recipients equaling $28.2 billion. In 2016-2017, 49% of Pell grant recipients were dependent students; 37% of these students came from families with incomes of $20,000 or less, and another 36% came from families with incomes between $20,000 and $40,000. Funding is allocated in one of three ways: selection and/or restriction of recipients, award allocation, and monitoring and assessment of program performance.
Medicaid, for example, is the largest source of health insurance for low-income and disabled persons. It’s a federal and state program where funding and reimbursement level calculations include the state’s population and income levels, which are derived from the U.S. Census.
The Special Supplemental Nutrition Program for Women, Infant, and Children (WIC) serves low-income women, infants, and children at nutritional risk by providing nutritious foods and health care referrals. WIC provides vouchers for crucial foods like baby formula, eggs, milk, and fresh fruits. According to the Food and Nutrition Service, in 2018, WIC served approximately 6.87 million (5.5 million being children and infants served). For the first five months of FY 2019, 6.4 million had been served. WIC uses the Health and Human Services (HHS) guidelines for WIC eligibility. WIC uses the Consumer Price Index, which is derived from the U.S. Census, to see monthly food voucher prices and the ACS (which is also part of the Census Bureau) to allocate funds to each state. By the way, the U.S. Department of Agriculture reported that in 2016, 58.6% of WIC participants were white, 20.8% Black or African American, 10.3% American Indian or Alaskan Native, and 4.4% Asian or Pacific Islander.
We often look to the Centers for Disease Control and Prevention (CDC) for data collection and research; from tracking diseases and prevention to program evaluations for effectiveness. It is accepted as vetted, accurate information; as well as the guardians of public health while utilizing this data. The National Health Interview Survey (NHIS) is the methodology used for this data and it is based on the decennial census information and updated with every census.
Many sources that track the social determinants of health, such as income and poverty level, use census-derived data. The Current Population Survey (CPS) is one of these sources, collecting data since 1940. CPS, sponsored by the U.S. Census Bureau and U.S. Bureau of Labor Statistics, provides information about our jobs, earning, education, and other studies that note the population’s social well-being, such as volunteerism, child support, and health insurance coverage. A huge impact of CPS is obtaining the number of unemployed population and the demographics. Unemployment data and economic data are used by policymakers to address unemployment and the repercussion of it.
One of the largest, well-known research projects commissioned by the Institute of Medicine was published in Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. The Institute of Medicine used data from the U.S. Census throughout this research. This study concluded, “Evidence of racial and ethnic disparities in healthcare is, with few exceptions, remarkably consistent across a range of illnesses and healthcare services.” This study confirmed what people of color have always known through personal experience, but validation by a scholarly entity through research was priceless. This research has impacted health care delivery and highlighted the realization that care is not equal, and inequities exist which we must address.
A complete and accurate count of our population by the U.S. Census is imperative. The U.S. Census data impacts many elements of life, especially funding, representation, and research. Federal funding allocation dictated by the U.S. Census affects our classrooms, jobs, senior services, health care in our communities, and numerous other programs and services. This includes health insurance programs like Medicaid; as well as WIC and Head Start. Hence, the U.S. Census impacts health care disparities and the social determinants of health as well.
Minorities and low-income people are undercounted and noted to be difficult to count for many reasons, yet census data impacts this population greatly. Our political representation and redistricting is based on the census data and being counted dictates the number of representatives. Our elected officials, our representation, advocate for funding and represent us in all issues that impact life, liberty, health, and even our pursuit of happiness. Research drives the allocation of funds, health care delivery and changes, social issues and justice, just to name a few areas in which the US Census Data is used as a resource. Funding dictated by the census impacts our classrooms, jobs, grants, and health care in our communities—especially vulnerable, underserved populations. Since the U.S. Census impacts us all, we must encourage everyone to complete it.
As the COVID-19 pandemic continues to take an enormous toll on human health across the globe, its impact is felt significantly in other industries as well. Higher education has been upended with most institutions sending nursing students home to complete the rest of the year online.
If you’re a nursing student, the impact is being felt even more keenly. Clinicals have been canceled while hospitals and healthcare facilities grapple with an overwhelming number of severely ill patients. But many nursing students will still be able to continue on as best as possible by completing the academic courses they have.
If you’re a nursing student who’s now trying to finish the rest of the year by taking all your courses online, it all might feel nearly impossible. Remember you’re not alone. Your peers and even many of your professors are trying to manage this new normal.
Wondering how you’ll manage the rest of the year as an online student? Here are a few tips:
Commit to a Class Schedule
Even if your online classes don’t require a specific meeting time, block out your schedule as if they do. Scheduling time when you log in or do the work or meet with a study group will give your days and weeks structure. Write it in your schedule and plan your days around those fixed times.
Ask for Help
If you find the online format is challenging or you’re struggling without the face-to-face contact, reach out to your professors or to your school. Asking for help early will ensure that you aren’t falling behind. They might offer different perspectives to nursing students on how to work in this new format.
Stick to a Routine
You’ve probably heard this, but keeping to a regular daily routine will keep you focused. Get out of bed at the same time every day and set aside time for specific free-time activities—exercise, reading, watching TV, hobbies, or video chatting with friends and family. Try to go to bed at a regular time as well. Carving out blocks for your work and your leisure helps you set boundaries so you don’t find you’re spending too much time or not enough time on either.
Take Care of Yourself
These times are stressful, chaotic, scary, and unsettling. Accept that you aren’t going to continue on with life as you know it. Plan to make adjustments. Try to eat nutritious food and get sleep at regular intervals. If you tend to eat three meals a day, keep doing that. If you prefer to spread out your eating, eat smaller meals, but at similar times every day. Again, the routine can help you feel like you have a schedule and give you structure. If stress is interfering with your daily functioning, reach out for help either with a therapist (many are offering telehealth appointments) or a close confidant or member of your faith community.
Keep Focused on the Future
Remember why you started nursing school and keep that end goal in mind every day. Remembering your goal, and working toward it, will give you purpose and help ground you in the day-to-day business of living your life. This virus is changing the world as we know it, and it will not always be as troubling as it is now.
Good luck, nursing students—you’ve got this.
National GI Nurses & Associates Week takes place this year (March 22-28) in the middle of a world in upheaval. The COVID-19 pandemic that has taken hold around the world has a direct and significant impact on healthcare workers around the globe.
While the industry continues to grapple with the demands placed on its workers, GI nurses continue to do their work to help those with disorders involving the entire gastrointestinal tract.
Sponsored by the Society of Gastroenterology Nurses & Associates, this week focuses on the nursing practice of gastroenterology and endoscopy and the conditions of the GI tract. Nurses in this specialty are involved in all aspects of care of GI patients. They will treat patients who have various conditions including reflux, Crohn’s disease, celiac disease, or cancer. Because of the broad range of conditions, GI nurses are specialists in body systems that are also related to the GI tract and how each impacts the other.
Gastroenterology nurses will meet with patients, will assist with procedures and follow up care, and offer ongoing patient support. Nurses in this role are also a primary source of education about these conditions and how they impact overall health.
Because GI conditions have significant impact on other areas of health, GI nurses work as part of a team that helps patients with life-changing adjustments. They might work with nutritionists to help patients with celiac disease learn how to adapt to the often overwhelming challenge of eliminating any wheat ingredients from their diets and other nutrition education. GI nurses will also work to help control any chronic pain that presents with gastrointestinal disorders or diseases. Patients also frequently turn to their GI nurses to help them navigate the social aspects of having a condition that can be highly disruptive to daily life, so nurses will bring in other team members while they also use their own vast knowledge of coping skills.
Nurses in the gastroenterology field frequently assist with procedures that include endoscopy to determine allergy, irritation, or disease or colonoscopies to diagnose disease or as a screening tool for colon cancer. They will be with patients through these procedures and will educate them on what to expect and normal recovery. Because GI nurses work with patients who are of all ages and also with patients who may have other complex conditions, they have to remain alert for any unexpected complications.
GI nurses rely on their critical thinking skills as well as a deep sense of empathy for their patients. GI conditions involve symptoms that sometimes bring embarrassment for patients, and GI nurses are excellent at normalizing what the body is doing.
If this career path interests you, experience in a broad specialty like med/surge nursing will be an asset for moving forward. You’ll want to gain experience with GI patients, so that is the next step. To advance your career and to ensure you are providing your patients with the best possible care, becoming certified is next. Taking the GI certification exam shows you set high standards for yourself and are willing to take on the extra work to become the best nurse you can. The additional knowledge gained with the certification process will boost your skills.
Celebrate GI nurses this week, and stay safe out there on the front lines.
We are in the first quarter of the year and none of us expected or envisioned that we would be dealing with the course of events happening now. It is almost surreal, like a scene from a movie. Many people entered the new year with the desire of having new goals, resolutions, and dreams. This was to be the year signifying “2020 Vision” seeing things more clearly. Everyone stated “this is going to be my year.” What we are going through now has been a real eye-opening experience.
Over the course of history there have been many epidemics, disasters, and social issues, which were usually contained in one region. People may have felt safe thinking, “it is not happening in my city, state or my area of the country.” These past three months, the “Coronavirus pandemic” has affected all U.S. states and multiple countries, and crossed every race, age, and socioeconomic group. This blog is not going to be filled with statistics, because we are bombarded daily from all media sources with the data. Updated information should be obtained from reliable sources such as the CDC (www.cdc.gov) or WHO (www.who.int).
This “global shutdown” has affected every aspect of human life. Freedom and things that we took for granted, such as shopping, going to the movies, dining out, visiting amusement parks, playgrounds, attending concerts, festivals, hanging out with friends and family, and most of all traveling has been brought to a screeching halt. Now families are going to have to learn how to spend more time with their families, reflecting on things to be thankful for and creating entertainment and meals at home.
For safety, government officials have issued “Stay at home” and “Lockdown” mandates, limiting travel for only essential needs. The goal is to try to decrease the spread of the virus, especially to vulnerable populations; hence a new term has been coined “social distancing.” Everyone is to keep a 6-ft distance from each other and limit gatherings of people to 10 or less. Social distancing is a physical separation and does not mean that you cannot communicate with others. The one positive note is that in this age of technology we all can stay connected to others whether they are in the same city or across the country.
Social distancing is important, but there are two populations that this may have an adverse effect on, those with mental illness and those that are in abusive relationships or families. Social distancing could cause “social isolation” and those with depression could have an increased risk of suicide. The worst thing is having individuals quarantined in the home with their abusers. If you know anyone that is in an abusive situation or has mental health issues, reach out to them, if possible.
We are not sure when this pandemic will come to an end, so during this time find ways to decrease your anxiety and stress and try not to panic. Some things that you can do is continue to exercise, keep your humor (in light of what’s going on), watch movies, create crafts and cook together, and make sure to reach out to those that may be alone.
May this pandemic not dim our vision. Stay calm, stay focused and productive.
In rapid response to the national emergency and to better combat COVID-19, the Society of Nurse Scientists Innovators Entrepreneurs & Leaders (SONSIEL) launched an immediate national call-to-action requesting that non-hospital inventories of personal protective equipment (PPE) be shared with hospital and healthcare facilities via community dialogue.
The call-to-action, deemed SHARE (Strengthen Healthcare Ability to Respond to Emergencies), seeks to quickly raise awareness about the need for PPE on the front lines of care, and to spur, at the grassroots level, an immediate community dialogue regarding available supplies of urgently needed equipment.
Non-hospital healthcare organizations and commercial businesses use PPE and other needed equipment in day-to-day activities. Nursing and medical schools, pharmaceutical labs, veterinarians, dentists, and simulation centers, even construction, cleaning, and landscaping companies, may have PPE access and inventory.
SONSIEL is asking hospital and healthcare facilities to look to these other entities for possible additional supply in order to help keep staff caring for COVID-19 patients and the patients themselves safe. The type of equipment needed, that commonly is used by other entities and in other industries, includes respirator masks, eyewear (goggles, shields, visors), and gloves (latex, latex-tipped, protective). Non-hospital healthcare providers also may have available inventories of gowns, caps, or other items.
Remarked Rebecca C. Love, SONSIEL President & Co-Founder, “Today, as this COVID-19 crisis unfolds, we’re launching a grassroots campaign, SHARE, to help ensure adequate supplies of equipment are available to healthcare workers tending to our most vulnerable population. At this time, many of our hospitals are facing a critical shortage of protective equipment; there are not enough gloves, masks, or gowns to safeguard our frontline healthcare workers. Healthcare workers must be protected—to enable them to continue to provide care, for their own well-being, and to prevent transmission to others. At present, there is this global shortage of equipment, a several-month delay, however we believe SHARE is an innovative, community-based solution that can help swiftly back-fill this temporary deficiency.”
“Please join SONSIEL in this vital effort. We are asking you and everyone across the country to get out the word and start a dialogue. Think innovatively about where appropriate and needed supplies might be found to SHARE. If you’re a business or scholastic institution, please consider how donations of any already available PPE within a community might help your local hospitals and healthcare providers. While particular region and facility needs may differ, coming together, directly, in a conversation, locally, helps all of our communities target, identify, and triage supplies and equipment, so that what is in stock is made available to healthcare providers as soon as possible.”
Ms. Love concluded, “I’d like to thank the entire SONSIEL Board of Directors, who acted quickly and completely in supporting this initiative at a critical point in time. Together, I know we will get through this challenge, all of us, one community at a time.”
Northeastern University and Massachusetts General Hospital are the first to engage in SHARE. SONSIEL hopes many organizations, businesses, and hospitals around the country will do the same.
For information on SHARE, visit https://sonsiel.org/coronavirus.
To donate to their GoFundMe campaign, visit https://www.gofundme.com/f/nurses-ppe-supplies.
Despite roots stretching far back into history, nursing has only been a recognized profession for a little more than a century. While the nursing industry has made great strides since that time, it primarily remains the realm of white females. Just over 9% of registered nurses (RNs) are male, and minorities only make up about 20% of the nation’s total number of RNs.
Nursing’s lack of diversity is problematic on its own, and minority nurses may find that the diversity issue is compounded when the time comes for a career change. So what happens when seasoned nurses are ready to expand their employment horizons? Some LPNs and RNs may choose to tread the path of primary care, re-enrolling in medical school and working towards a doctorate. For others, the realm of human resources may be an attractive option.
Individuals from historically underrepresented groups are a great choice for roles within health care-related human resources management and administration. That’s because minorities are more likely to bring the topics of diversity and inclusion to center stage. And when the importance of diversity is emphasized at the managerial level, everyone benefits, from patients to providers and educators.
Discrimination in the Health Care Industry
As most people of color are well aware, discrimination is still a major social issue in 2020. And this discrimination can happen everywhere, from social settings to the workplace and beyond. Although federal law prohibits workplace discrimination on the basis of age, gender, race, religion, and disability, more diversity is needed within the health care industry, especially in the field of nursing.
That’s because nurses are essentially the foundation of quality care and healing. Further, they act as liaisons to primary care physicians and specialists, often serving as the voices of their patients. Patients from all walks of life deserve to feel as though they’re represented within the field of nursing.
By fostering a more inclusive environment, human resource managers in hospitals and clinics may be able to bridge the gaps, at least where health care for minority groups is concerned. And make no mistake, there is a glaring disparity among minority populations. According to a 2014 study published in Public Health Reports, “diabetes care, maternal and child health care, adverse events, cancer screening, and access to care are just a few examples in which persistent disparities exist for minority and low-income populations.”
Human Resources, Inclusion, and Diversity
So how does human resources fit into the equation? At their core, nursing and human resource management have a lot in common. After all, providing compassionate interactions with a diverse group of individuals is a major component of both career paths. Yet where nurses typically only deal with patients and their immediate colleagues on a daily basis, HR managers must also deal with the business side of health care as well.
For example, health care HR managers must address industry trends and set the standards for ethical practices within their facility. They may oversee digital recruitment and hiring, while also keeping patient needs at the forefront of their mind and even addressing legal situations that may arise. It’s a multifaceted job that requires knowledge, patience, and discipline as well as compassion.
A nurse who is interested in becoming an HR manager in health care should prepare to be challenged. You’ll need plenty of experience under your belt, as well as strong communication, organization, and computer skills. To get an edge over the competition, you may also want to consider pursuing an advanced degree in health administration.
Prospective HR professionals should also take note that speed and accuracy are paramount to the job, as they are in the field of nursing. Computer skills are a vital component of the job, and HR managers should have a strong grasp of technology and tools such as open-source software that allows you to quickly sign forms online, from invoices to payroll and hiring documents. Even in our digital age, most health care facilities leave a significant paper trail.
Unfortunately, sometimes that paperwork can stem from an unpleasant situation, such as legal action against your health care facility. Even when great care is taken to ensure that the most vigilant professionals are employed at a facility, that fact doesn’t always guarantee a safe and inclusive work environment. Thus, even the best HR managers may end up on the receiving end of a workers’ compensation claim.
While most workers’ compensation claims involve physical injuries, a hostile work environment could indeed be grounds for a lawsuit, especially if management was aware of the problem. And although workplace stress isn’t grounds for a workers’ comp claim, work-related trauma injuries may be. If the discrimination was serious enough to be deemed traumatic, the injured worker may indeed be entitled to compensation. As an HR manager, it’s your duty to help foster a more inclusive work environment where discrimination has no place.
This becomes even more important when you yourself are one of the very minorities who is often overlooked for leadership positions such as HR management. Nursing leadership means making connections with your staff, one of the best ways to prevent discriminatory practices is by modeling inclusion and diversity in your workplace. Do this in your hiring practices, in your relationships with your employees, in your interactions with clients; it will trickle down.
Advocating for diversity is extremely important when it comes to social justice, but it can be a fine line to tread in the workplace. Within the health care industry, minorities should try to take on leadership roles, such as in management and HR, in order to help build a more inclusive environment where patients and providers alike can feel safe, respected, and represented.
Nurses looking to advance in their careers and in the quality of patient care they deliver can look to certification to provide both.
March 19 recognizes National Certified Nurses Day, and many nurses find certification provides an opportunity to gain focused, crucial knowledge and skills that make them better nurses.
Which nurses should attain certification? Any nurse who wants to gain additional training in a specialty should reach for becoming certified. Certification is available in dozens of specialties from cardiac to pediatric, and nurses aren’t restricted to only one certification. You can obtain certification as a Family Nurse Practitioner, a Certified Pediatric Nurse, a Certified Urologic Registered Nurse, a Cardiac Vascular nurse, and many others.
Why is there a day devoted to nurses who take this step? Certified nurses have shown a personal and professional commitment to their career and the nursing profession in general. They have chosen to achieve, and exceed, the highest non-degree level of expectation toward a specific area.
Should you become certified? If you’ve been in your role for a while and are ready to take on additional responsibilities, certification offers that opportunity. What if you’ve been thinking of taking a new path in nursing and switching into another area? Certification can help you by giving you opportunities to learn and gain expertise.
Certification generally requires a couple of years of nursing experience in the designated area before you can be qualified to take a certification exam. Nursing students can keep the goal in sight while they are gaining practical experience. That experience allows you to develop a solid foundation of clinical nursing practice, especially in the area of certification you want to earn.
When you’ve decided that becoming a nurse with certification is a good step for your career and for the level of care you provide to your patients, you’ll need to map out a preparation plan. You can begin by asking your colleagues who are certified what they did to prepare and any tips they might have to share. They can also be a steady source of encouragement through the process. Talk with your supervisor about your plans to take the certification exam, too.
Nurses who want to earn certification credentials generally start preparing for the exam months in advance. There are study guides available to help. And, despite the anxiety that taking a test like this can sometimes trigger, preparation will be a big help in your final score.
If you’ve already achieved advanced credentials in a specialty or a subspecialty, you’ve shown a dedication to your profession that is public, recognized, and respected. Generally, certification can help nurses who want to assume greater responsibility, greater leadership, and, often, a salary boost.
National Certified Nurses Day honors nurses who have met this additional, and rigorous, challenge. It also inspires nurses who haven’t achieved certification yet to take that next step—whether it is deciding to take the leap, applying for a certification exam, or beginning to study for the test.
To all certified nurses—your work is appreciated by patients and colleagues around the globe.
When patients have surgery or other procedures in which they have to receive anesthesia, a team works together to ensure the patient’s safety and best care. One of these team members is the perianesthesia nurse.
Terry Clifford, MSN, RN, CPAN, CAPA, FASPAN, has worked in this field since 1991 and took time to answer our questions about it.
As a perianesthesia nurse, what does your job entail? What do you do on a daily basis?
Within the scope of perianesthesia nursing, there are a number of opportunities to serve. From 1991 until 2015, I worked as a clinical bedside nurse in the PACU (post anesthesia care unit). Throughout that time, I often worked as the clinical resource nurse for the unit, not only caring for patients emerging from anesthesia, but helping to coordinate resources within the unit to ensure safe patient ratios, appropriate breaks for staff, etc.
Today, I am the perioperative nurse manager responsible for leadership of 60+ staff members working between the preoperative clinic, the ambulatory surgery unit, and the post anesthesia care units. My current role in perianesthesia nursing includes oversight of unit-based budgets and productivity, staff education and guidance, and active participation in surgical services activities geared at optimization of services and providing quality care.
Why did you choose this field of nursing?
After graduating from nursing school in 1981, I was fortunate to have many opportunities to work in a wide variety of subspecialties, from med-surg, to cardiac rehab, to care coordination, to house supervisor. Upon graduating from a master’s program in 1991, I happened upon a clinical position in the PACU and never left.
It’s an amazing privilege to be able to help guide a patient and family through experiences that can seem frightening, during a time when they are most vulnerable and often fearful. There have been such wonderful advances in the science of anesthesia and pain management that being on the cutting edge of change is always exciting.
What’s the most surprising thing about your job that other nurses wouldn’t expect?
I think one of the interesting things about perianesthesia care is that while we can be confident that we have provided incredible support to safely and competently guide a patient through a surgical or procedural experience, many times the patient does not remember anything. This was disappointing to some nurses who highly value the nurse-patient relationship, but I believe that even in the fog of anesthesia, and the fact that the patient may or may not remember, we do an amazing job of keeping the patient experience a positive one.
What would you say to someone considering this type of nursing work?
I highly encourage staff to pursue their passion—if this is an area of interest, by all means, find a way in!
I think that perianesthesia nursing is the best kept secret in this profession. Every day, I am grateful for the privilege it offers as far as providing safe, respectful care to patients as well as providing safe, respectful leadership to staff.
While the nation continues to grapple with the growing COVID-19 pandemic, one fact is particularly worrisome. Older adults who contract the virus are dying at much higher percentages than younger people.
Minority Nurse turned to experts with the Gerontologic Advanced Practice Nurses Association (GAPNA) to understand the risks associated with COVID-19 and how nurses can work to protect their patients and themselves.
“The effects of aging have a major influence in the response to a respiratory virus or bacteria,” says Michelle Moccia, DNP, ANP-BC, CCRN, GS-C, and GAPNA’s past president. “As one ages the immune system is less responsive to a virus or bacteria with an inflammatory response to fight off the virus and/or tolerate the complications from the virus. The elderly have limited cardiopulmonary reserve thus a compromise in airway and breathing can lead to the inability to breathe thus predisposing individual to complications such as pneumonia.”
And as the medical community gains more understanding about this particular virus, other factors are emerging, says Deborah Dunn, EdD, MSN, GNP-BC, ACNS-BC, GS-C, and GAPNA’s president. “Some experts have theorized that in addition to the pneumonia burden there may be an increased or exaggerated lung inflammatory response to COVID 19 in older adults – leading to the severe respiratory distress and failure seen in older adults.”
What can people in those specific age categories do? “It is best for older adults to avoid crowds,” says Moccia, noting the oft-heard advice about washing hands, staying home if you’re sick, and avoiding others who are ill holds true. And Dunn notes that if a loved one is in a facility and the facility restricts visitors, it’s going to be important to keep up communication with loved ones to keep anxiety and social isolation at bay.
“Prevention and control of the spread of COVID-19 rests on halting transmission,” says Dunn. “Nurses know that in the healthcare setting they play a key role in stopping transmission by frequent handwashing, avoiding droplet contact, and early identification, triage, treatment, and quarantine of persons who may have infection.”
Both Dunn and Moccia say nurses should be especially careful to wash their hands before and after entering a patient’s room, wearing gloves when contact with bodily fluids/blood/secretions may occur, practicing needle precautions, and wearing protective equipment if they are in contact with a patient who has or is suspected to have COVID-19.
As patient advocates, nurses can educate patients and their families. Nurses can help patients with personal hygiene like washing their hands, using hand sanitizer, and disposing of used tissues, says Dunn. Protecting their health while giving them some control also helps with the uncertainty and anxiety people are feeling right now.
“Families with older adults in care settings such as assisted living facilities or nursing homes want to know that their loved ones are being cared for and having their needs met,” says Dunn. “Nurses working in these facilities should facilitate communication about the measures being taken to protect patients from infection, why adherence to the measures is needed, and reassure families about the status of their loved ones health.”
As nurses work through this unprecedented outbreak, they can keep updated with the CDC website about COVID-19. Nurses who work with infectious and contagious illnesses know that staying current with continuing education can be life saving—for them and for their patients. “Nurses in acute care settings and other healthcare setting where they may care for patients with contagious conditions that require face masks during care should be fitted for the N-95 mask and be trained in the proper wearing of the mask,” says Dunn.
As COVID-19 works its way around the globe, the medical community is working hard to prevent the spread, educate the public, and even offer some hope.
“I’m sure we will see a lot more information from infectious disease experts,” says Dunn, “as they are studying COVID-19 underlying physiologic mechanisms closely and develop targeted treatments.”