Weight Management for Nurses: The Why’s and How’s of Losing or Maintaining Weight

Weight Management for Nurses: The Why’s and How’s of Losing or Maintaining Weight

weight management

As you well know, America is in the grips of an obesity epidemic. According to the National Institute of Diabetes and Digestive and Kidney Diseases, over 70% of adults are considered overweight or obese, which is associated with multiple medical conditions. Nurses, as role models, advocates, and educators, are poised to make a difference in reversing this trend.

Unfortunately, nurses are not immune to weight problems themselves. In fact, research suggests the rate of overweight and obesity within the profession is on par with the general working-age population.

Here nurses and wellness professionals offer savvy advice for managing weight and fitness.  Even for those working long, stressful, rotating or night shifts that offer few healthy food and exercise options.

Becoming a Healthy Role Model    

Many nurses feel hypocritical telling patients to exercise and eat right if it’s obvious that they don’t walk the talk. Maybe that’s one of the reasons nurses enjoy a stellar reputation for honesty and trustworthiness, according to annual Gallup polls.

Yes, nurses are role models for patients, but there’s another professional reason to take care of one’s weight and fitness—the health and longevity of your career. The American Nurses Association Code of Ethics for Nurses includes several mentions of the importance of self-care (e.g., “The nurse owes the same duties to self as others”).

Nurses Helping Nurses

Many nurses know about the power of a group for establishing healthier habits like eating better and moving more. Most of those groups are comprised of people from all walks of life. But you may find there’s even more power in teaming up with fellow nurses who understand the struggle, especially if they’ll be around regularly to hold each other accountable.

Victoria Randle, MSN, NP-C, is a family nurse practitioner in the Atlanta area and cofounder of Nurses 4Ever Fit. Since January of 2018, the organization has held monthly in-person events at venues such as a nurse-owned yoga studio. “We all have a special bond that only another nurse can understand. It’s a platform for like-minded individuals to talk together, it’s a form of therapy, a form of camaraderie, and you can get your fitness in,” she explains.

Randle says the emphasis is on fitness, rather than diet, because “I see a lot of nurses who are vegan, for instance, and they don’t seem healthy. The element that’s missing is movement. When you’re 90 and you don’t have good muscle tone or you have brittle bones, that’s not healthy.”

Also, many women say they are “fearful of going to a gym because ‘I’m afraid people will look at me and judge me’ but here we’re all learning, and it’s a judgement-free zone,” she adds.

Saturday morning fitness sessions are only part of the Nurses 4Ever Fit experience. “We’re going to do an annual retreat. We take a weekend away and it’s a form of therapy. It includes a massage or a hot tub together,” she explains.  “Exercise is good, but it’s not everyone’s idea of self-care. The nature of a nurse is to care for others and put the patient first. So, when it comes time to care for yourself, you don’t have much left. That is embedded in you—the workplace culture needs to change. Nursing school actually taught that if you get a 30-minute break in a 12-hour day, you’re lucky!”

Healthy Workplaces Equal Healthy Nurses

Some hospital systems have started programs to ensure that healthy food and fitness opportunities are available to their nursing staff.

MD Anderson Cancer Center in Houston, Texas, is lauded as an outstanding example of a wellness workplace. Evan Lee Thoman, MS, PMP, CWP, wellness specialist in the HR Wellness and Recognition unit has been in health promotion field for 13 years.

He works to find out what other employers at other top hospitals and universities are doing to engage employees toward a healthier lifestyle. And he investigates what his own hospital’s employees want before offering up a range of at-work health initiatives.

“The program is different for every unit. I go in and have a conversation with the leadership and we may do a needs and interest survey. We’re asking: ‘What do nurses need?’,” Thoman says. For instance, “we had many questions in one unit regarding how to make use of dental insurance. Who would not have guessed that medical consumer information was a top concern?”

But it was, so the wellness department set up a program to fill the knowledge gap. They aim to provide education and services to every shift ranging from an on-site fitness center and gym membership to ergonomic assessments and resources to address compassion fatigue, resiliency, and spiritual care.

Workplace leadership that buys into a wellness culture will reinforce the healthy behaviors that nurses must adopt. Thoman helps nurses to create those wellness habits, without overwhelming them. He asks them: “Who’s going to be your support system? Who’s going to hold you accountable?” The wellness team is there, of course, but so are fellow nurses and nurse leaders. “We get the best results and greatest engagement when we have a leader who walks the talk,” he says.

For example, nurses are notorious for neglecting to take meal or water breaks. “If you eat lunch it’s almost like you’re the weak one on the unit,” he says. “We’d been talking to nurses about planning their meals but then we thought, maybe we can bring something to the nurses. So now we try to take snacks to each department—‘Here’s a little something, a granola bar or piece of fruit, to fuel you during the day.’ We also stress micro breaks and encourage them to find five minute for a snack, go for water.”

When overworked and overstressed nurses complain that they don’t have time to take care of themselves, Thoman suggests gardening, journaling, or even coloring as a way to decompress.

Because nursing is a predominantly female occupation, Thoman notes that rest and relaxation may be difficult for women who do double-duty as caretakers at work and at home. Then there are the biological factors that may hamper a woman’s weight management efforts.

“From a weight-loss perspective, men tend to have more lean muscle than women, which burns more calories than body fat at rest, so, at the onset, men may lose weight a little faster,” explains Thoman, who was previously a university strength and conditioning coach.

Exercise Early, Exercise Often

Cara Sevier, RN, codeveloper of Nurses 4Ever Fit and the CEO of Cara Sevier Industries in the Atlanta area, knows that exercise isn’t always convenient for busy nurses working crazy shifts or living in extreme weather zones.

When nurses tell her that they have difficulty finding time to exercise, she asks them to challenge that belief. Even nurses with legitimate time constraints, such as parents of young children. “They call it a time barrier or challenge, but we say it’s a self-care issue; they feel guilt over finally taking care of themselves first,” she says.

Sevier has personally experienced that challenge and now meets it by waking up at 3:00 a.m. to drive to a gym 30 minutes away. Though the gym is open only Monday through Friday, she maintains her schedule seven days a week. “I found out I had to be consistent or I was thrown off. It gives you a peace in your body that you’re doing something for yourself—getting up at 3:00 a.m. for a 4:00 a.m. class,” she explains. “It takes discipline, forcing yourself, forcing my body to get to my highest physical self. On the weekend, I will find a cycle class or something else to do. Is it easy? No. It’s a lot of sacrifice, but it’s worth it.”

On the other hand, we do need adequate sleep to stay slim—and to stay sane. One study at Columbia University suggests that getting less than four hours of sleep a night could raise your obesity risk by an astonishing 73%. (Seven hours a night is the sweet spot.) Nurses who work overnight or pull 12-hour shifts are also at greater risk for weight gain, according to a University of Maryland study. Scientists suspect that when circadian rhythms get thrown out of whack, so do hunger and fat hormones, which results in excess pounds. Or perhaps lifestyle factors lead tired nurses working off-hours to make poor food choices and avoid exertion.

Become a Healthy Living Warrior

Uniqua Smith, PhD, MBA, RN, NE-BC, associate director of nursing programs at MD Anderson Cancer Center, slowly gained weight after transitioning to an administrative role. But with the help of a fitness boot camp and workplace wellness challenges, she started making healthier food choices and exercising consistently.

“On Sunday, you had to send in a picture of all the groceries you just bought—to show that there are no snacks, no high-sugar foods,” she explains about a challenge with friends, using a social media app for accountability. “For the weekly weigh-in, you had to take a picture of your feet on the scale.”

“Workplace weight loss challenges, like the March Madness challenge, keep you going when you have a month-long goal,” Smith explains. “You’re also motivated because you don’t want to let your team down.”

A little over a year later, she’d lost 40 pounds through calorie-cutting, portion control, and cardio exercise. Only 10 more pounds to reach her goal weight, but then came a diagnosis of breast cancer.

“I truly believe everything happens for a reason: 2017 was about getting myself together health wise,” she says. “It got me ready for 2018, when I had to fight for my life. It gave me the strength to fight cancer.”

After six months of chemotherapy, she underwent three separate surgeries over the next several months.

“I went through 16 cycles of two different types of chemotherapy. It takes a big toll on someone—I lost my taste buds and energy,” she says. “It took me literally an hour to take a shower, which before that took 10 minutes.”

She started exercising again slowly, at the beginning of 2019, after the last of her surgeries. From walking to running and then completing a 5K, she challenged herself to get to her previous state of fitness.

Smith is now a healthy living spokesperson and encourages everyone to eat clean and condition their bodies so they’re strong enough to fight any disease that comes their way.

Don’t Fool Yourself

For many nurses, weight gain happens slowly, and they may not even notice it at first. Or they have a pattern of yo-yo weight loss and gain, with pregnancy, holidays, or shift work.

Sevier knows what that’s like. “Even at my highest weight—I reached 188 lbs—I told myself every story in the book. ‘Maybe these scrubs had shrunk in the hot water. Oh, wait, is this the U.S. size or the European size?” But those excuses didn’t hold up under examination and soon she started working out with a trainer at a gym. “Now scrubs that were once tight on me are loose,” she adds.

Though it may be painful to face facts, research shows that being aware of and tracking certain behaviors can help drive healthy habits. A daily food log, whether paper or digital, can help some people to lose weight or keep it off. You can’t argue with the truth, when it’s detailed right in front of you, in black and white.

Feed Yourself Healthy Meals, Healthy Snacks

If you’re like most nurses, you struggle to plan, shop, and cook yourself nutritious meals and snacks. Regular meals may go out the window, replaced by chaotic eating habits. But simple meal planning strategies can help nurses to eat well.

Tiambe Kuykendall, BSN, RN, a clinical nurse at MD Anderson Cancer Center, does everything she can to fight off chaotic eating. “I work in pediatrics and our [patients’] parents want to feed us all the time. Nobody ever buys us a fruit basket, though we would enjoy it,” she notes. “I’ve realized that I have to pack a healthy snack to make sure there is one at work.”

But desserts, junk food, and other caloric gifts and treats aren’t the only landmines threatening your waistline at most nurses’ stations. “In my unit, someone will bake chocolate chip cookies two or three times a shift. We’re surrounded with unhealthy snacks—chocolate, cookies, chips, pizza, and other junk,” she explains. “But the wellness department brings snacks on a weekly basis—granola bars, bananas, apples, and popcorn. When everyone is trying to be healthy it makes it so much easier.”

Kuykendall notes that when she works out in the morning, her level of energy is much higher later. She’s made other changes in the a.m., too: “I don’t drink energy drinks anymore, just green tea in the morning before I go to work, and sometimes in the afternoon.”

She avoids the cafeteria even though there are healthy food options there. “We have a 30-minute lunch break and MD Anderson is huge, so the cafeteria lines are long,” she says. “Yesterday I planned meals for the next three days and will bring my own lunch and snacks. You can make small changes, like eating grapes instead of candy. I don’t advise that you deny yourself all the time, but indulging should not be the norm.”

Ditch Dieting in Favor of Mindful Eating

Most nurses are familiar with programs such as Weight Watchers, and in fact, some hospitals hold on-site meetings. But there’s been a nationwide shift in attitudes away from dieting and toward a focus on healthy living. Mindful eating is one such approach.

“We don’t promote any particular diet, or if you don’t follow a diet, we want to teach people to simply be aware of why they eat,” explains Mark Mitchnick, MD, CEO of MindSciences, Inc, a New York City developer of digital therapeutics apps. “Right now, it’s keto, but we don’t want to chase fads.” The company’s Eat Right Now app teaches users about the habit loop and how to navigate triggers to eating.

Most of us eat for a variety of reasons, most often the trigger doesn’t have anything to do with physical cues. “Sometimes it’s that you’re hungry, and sometimes it’s that you’re stressed, or you’re tired, or it’s a fight with your significant other,” Mitchnick says. “You can learn to separate the trigger from inappropriate behaviors and do something more productive. If you’re stressed about an upcoming test, study, don’t eat.”

The app helps people to break the habit loop through educational content in a highly sequenced series of 28 modules. It’s constructed to deliver a module a day, which takes only eight minutes, and which can be repeated as desired. A user can also access lessons when on a just in time basis. When feeling a craving, they can bring up a short series of questions to help shape their response to it.

A scientific study showed a 40% reduction in craving-related eating—eating for reasons other than hunger—after use of the app.

In addition to the mindful eating app, there is one to relieve anxiety and one for smoking cessation. “A lot of behavior people would like to change in a high-stress field like health care—smoking and eating—is actually stress-related. Ask yourself: ‘Do I have an eating issue or an anxiety issue?’,” Mitchnick  advises.

It’s not easy for nurses to stay slim, but it’s worth doing. Shift work, long hours, sedentary lifestyle, heavy lifting, high stress, and fatigue can be overcome with a mindful approach.

Recognizing Critical Care Transport Nurses on February 18

Recognizing Critical Care Transport Nurses on February 18

Critical care transport nurses work to keep patients stable and healthy while they are being moved, and every February 18, their work is honored. The day recognizes how critical their work is to the healthcare organization.

Critical care transport nurses work in diverse and constantly changing conditions. They might be Med-Flighting a critically injured patient from a car accident or they may be moving an ill elderly patient from a nursing home to a medical facility. Those two fairly typical scenarios show just how prepared critical care transport nurses must be for whatever situation a day at work brings.

Founded nearly 40 years ago, the Air & Surface Transport Nurses Association (ASTNA) is the professional organization for nurses in the field and sponsors this recognition day. According to the ASTNA, this career path is one that relies on skills build from a solid foundation of education and practice around nursing and trauma care.

The ASTNA offers the following education and experience requirement guidelines to become a critical care transport nurse:

  • Registered nurse standing in the state you’ll practice in
  • Two to three years of critical care/emergency experience or applicable acute care nursing environment
  • BCLS – Basic Cardiac Life Support
  • ACLS – Advanced Cardiac Life Support Certificate
  • PALS – Pediatric Advanced Life Support Certificate
  • NRP – Neonatal Resuscitation Program
  • A nationally recognized trauma program such as TPATC (Transport Nurse Advanced Trauma Course (TPATC), BTLS (Basic Trauma Life Support), PHTLS (Pre-hospital Trauma Life Support), TNCC (Trauma Nurse Core Curriculum)
  • Certifications such as Certified Flight Registered Nurse (CFRN), Critical Care Registered Nurse (CCRN), Certified Emergency Nurse (CEN) may be required within six months to one year of hire
  • Some states may require nurses to have EMT-B or EMT-P (Paramedic) certification.

These requirements show the broad knowledge critical care transport nurses must have as they can be called on to use each skill at any given moment. They could be treating patients who range in age from newborn to centenarians. Their trauma skills need to be current and precise, and they also have to develop the ability to provide critical care in a moving vehicle or in flight. That means critical care transport nurses need to be able to react with exceptional speed and in with a calm and controlled manner.

If you’re a student nurse thinking of this role, know you’ll need to have an agility to simultaneously assess

  • the situation (a neighborhood with a mom who is in labor to a dangerous industrial accident site)
  • the patient (taking into account the location could be a home, highway, medical facility, office building, forest, or even a battlefield for military nurses)
  • the conditions (normal, blizzard, hurricane, flooding)
  • the transport vehicle (ambulance, helicopter, medical transport plane)

The work is exciting and satisfying for nurses who are willing and able to work in many layers of changing conditions. Critical care transport nurses often bring a sense of calm and relief to a patient who understands someone is now there to help them, provide care, and bring them to safety.

Critical care transport nurses deserve the recognition they get today – thank a critical care transport nurse in your life!

 

4 Quick and Effective Job Interview Tips

4 Quick and Effective Job Interview Tips

Do you ever wonder what makes one job candidate stand out enough in a job interview to actually get hired?

Being the best job candidate you can be takes time, effort, and a lot of preparation on your part. Now is the time when you have to raise your game so you become the job prospect who gets hired. Truth be told, you probably feel a little worn out after submitting your resume to many job openings and you’re just ready to get through this final step. Maybe you think your grad experience or your resume and exceptional work experience should speak for themselves—you know you’ve got what it takes to be part of their team.

The job interview has many layers. Yes, it’s about making sure you would be a good candidate who can do the job well. Any organization wants to know they have hired someone who is qualified, reliable, and professionally competent. But another layer of the interview is to see if you would fit in with the culture and mission of the organization.

Nurses know each workplace has a slightly different environment and work culture. Depending on the unit, the shift, and the established work guidelines, nurses will find they thrive better in one organization than another. That’s a natural part of any workplace and finding the right fit is something that can’t be found on a resume. Interviewers hope they can ask questions to understand how your background, personality, work expectations, work ethic, and training will help advance their team and provide their patients with the best care.

How can you prepare for that kind of pressure?

  1. Find Out More

Do a little investigating of your own before heading to a job interview. Understand the culture of the organization and find out how the teams work. Look at LinkedIn profiles, check out social media posts, and read up on the place’s history. Find out all you possibly can. No interviewer wants to explain a company to an interviewee. They expect you will come with an understanding of what they do and why.

  1. Understand What You Can Do for Them

If you’re applying for a job, an organization knows it can help you fill that immediate need. As an interviewee, you’re in the position where you need to sell yourself. Successful job candidates know you can’t just sell yourself by relaying all your accomplishments. Telling your interviewer about everything that’s on your resume isn’t the best use of anyone’s time. They have your resume—now they want to find out what you can do to help them. Where will you fit in and why will that help that healthcare organization be better? That’s what any interviewer wants to know. Don’t make them dig for that information in a job interview.

  1. Don’t Throw Away Your Shot

If you think you have only one chance to get something right, you’ll do your best. Well, this is your one shot to get it right. Today’s job interviewers don’t have time to coddle an interviewee. They want you to be prepared, to be dressed appropriately, to have any materials you need, to have references ready to go, and to be ready to answer their questions thoughtfully and thoroughly.

  1. Don’t Leave the Obvious Unsaid

You might think your five years on NICU will help you land this new role in a similar unit. You might be right, but do you want to leave that to chance? If two interviewees have the same experience, be the one who can demonstrate with anecdotes and proven results. Choose a few of your accomplishments in your last role and be ready to talk about how those results helped your last organization and also how it helped you professionally. Don’t assume your resume tells your story. The resume is the headline—the interview is the rest of the story.

Before you head to your next job interview, take some time for preparation and see what kind of a difference it makes in your interview process.

Nurses Spread the Word About Heart Health

Nurses Spread the Word About Heart Health

February is designated as American Heart Month and lots of recognition days help bring attention to heart health. Nurses who specialize in cardiac care (and who might be celebrating Cardiovascular Professional Week this week) are in especially good roles to help people who are coping with heart disease, and they are also excellent educators to help prevent heart disease in the first place.

A recent survey by the Cleveland Clinic revealed the majority of Americans don’t know heart disease is the number one killer of women. While women might typically fear breast cancer or even the random violence that is so prominent on the nightly news, heart disease actually is the most lethal condition. The survey revealed 68 percent of respondents thought something other than heart disease was the leading cause of death. In fact, heart disease is prevalent for both men and women and actually kills one out of every four Americans.

The Cleveland Clinic study also highlighted a deep lack of understanding about heart disease, its causes, and how it can be prevented. The study showed that while “90 percent of heart disease is due to modifiable/controllable risk factors, only 8 percent of Americans know that.”

Millennials, who need to start practicing heart-healthy habits right now, are especially in the dark, according to the survey. Eighty percent couldn’t identify heart disease as a leading killer of women. The same number or respondents didn’t know people should begin cholesterol checks in their 20s.

Heart disease is often called the silent killer for the symptoms that are easy to dismiss, unrecognizable, or even not present until too much damage has been done. This is why nurses are such essential patient advocates. They can help educate patients, family, friends, and community members about how to prioritize their heart health.

The Preventive Cardiovascular Nurses Association (PCNA) is an excellent resource for nurses who want to help patients stay heart healthy. Because so many other conditions contribute to heart disease including diabetes, depression, and inherited genetics, there are many people who might not think of heart disease as an issue. Lifestyle factors also play a significant role as the cause of heart disease and the prevention of it.

Some health conditions are things people have no control over, but what nurses can do is help them understand what steps and modifications will help reduce risk. Someone with diabetes, for example, needs to pay extra attention to managing that condition with proper medications but they can also manage that condition and help prevent heart troubles with extra efforts toward heart health.

One of the best ways to begin educating people is to make sure patients have accurate information about everything from diet to high blood pressure. With correct information they can begin making changes that will work. For instance, the Cleveland Clinic survey showed that many people don’t understand that a Mediterranean diet is the most helpful for heart health or that an aspirin a day will not prevent heart disease. And with the dangers of vaping becoming more defined, and more urgent, people need to know vaping isn’t a healthy alternative to smoking cigarettes.

If heart health is especially close to your professional interests, you might want to take your expertise to a higher level with the Cardiac Vascular Nurse Certification. If you work with cardiac patients, this qualification is especially important, but it also helps in a more general practice role. With so many people at risk of heart disease, helping patients with prevention can save lives.

Traditional Foods Bridge Health and Community

Traditional Foods Bridge Health and Community

The first week of February is known for celebrating African Heritage and Health. The nonprofit nutrition- and food-focused group Oldways kicks off the beginning of Black History Month, with a focus on the nutritious foods that celebrate heritage, community, and nutrition.

The varied foods that make up traditional African Heritage Diet food pyramid is based on a healthy, traditional selection filled with lots of fresh vegetables, fruits, fish, and grains.

As sponsors of African Heritage and Health Week, Oldways helps spread the word about healthful eating that honors traditional foods and the importance of community. Foods in the pyramid, which, according to Oldways, was developed in 2011, also honor “distinct flavors and traditions of four major regions of the African Diaspora—West and Central Africa, the American South, the Caribbean, and South America.”

Bringing these distinct flavors into food preparation can help individuals feel connected to their larger community or to family far away. And when food, flavors, and traditions are all celebrated, individual dining can easily become more of a community event. People all over use this week to cook traditional and familiar dishes based on their own family and culture, but they also use the week to try out new foods and new ways of preparing familiar ingredients.

Inviting others to share a meal, to come to a potluck, or to even bring favorite traditional foods to school, work, or a neighbor’s house brings a community closer together and helps build the kind of networks and supports that many people miss in our modern busy world. How beneficial it is when people find they can rely on foods and recipes that have been made for generations to help them continue on a path to their best personal health.

If cooking traditional foods interests you, this kind of celebration might inspire you and your friends or family to take a cooking class. Or if you are a cooking pro and have a few traditional dishes that are your go-to dishes, you can invite people to join an informal class that you lead. Building connections around food and traditions is a direct way to feeling like you’re part of a bigger story. Maybe your ancestors come from the Caribbean but you’ve never left New York state—cooking foods that your ancestors might have prepared links you to them in ways that can spark your imagination.

And preparing some of these traditional, healthy foods—the kind that rely on whole foods with few, if any, processed ingredients—is a boon to your health. Experimenting with new spices, broths, ingredients, and preparation will bring out flavors that are fun and fresh and help you keep a healthy diet. Your body will be nourished from the ingredients and as you share your food or take a meal with others, your emotional self will be soothed.

If you’re not of African heritage, you can still use this week to learn more about African heritage and health or how your own ancestors might have cooked. Take some time to try a new recipe your great-grandparents would recognize. Even better, host a potluck and ask your guests to prepare one dish that is based on their heritage. You might find you have a new tradition—and a new stack of delicious—and meaningful—recipes.

 

The “Do Tell” Your Doctor Tool Helps Parkinson’s Patients

The “Do Tell” Your Doctor Tool Helps Parkinson’s Patients

While Parkinson’s can be a difficult disease for many patients to deal with, there’s now a new online tool that can help them initiate helpful—and in fact, crucial—dialogue with their health care workers.

We spoke with Karen Jaffe, MD, co-founder and vice president of InMotion, a community center for people with Parkinson’s and other movement disorders. A retired OB/GYN physician, Jaffe was diagnosed with Parkinson’s in 2007. She gave us important information that nurses need to know about the “Do Tell” Your Doctor Tool.

What is the “Do Tell” Your Doctor Tool, why was it created, and how does it work?

Sample word cloud, as delivered via email upon completion of the “Do Tell” Your Doctor Tool

The “Do Tell” Your Doctor Tool aims to improve communication around “off periods” between people with Parkinson’s and their doctors. “Off periods” are the re-emergence of Parkinson’s symptoms, which can be hard to identify because they differ for each person and sometimes from day-to-day. These factors can make it difficult for people with Parkinson’s to communicate about their symptoms with their family, friends, and health care professionals.

The tool is based on a clinically validated questionnaire developed by Duke University, called the Wearing-off Questionnaire 9 (WOQ-9). Users review nine Parkinson’s symptoms and rank how bothersome each symptom is (for example, “Very Bothersome,” “Bothersome” and “Somewhat Bothersome”). After completing the questionnaire, users will receive a customized word cloud via email that visually displays the symptoms they chose, with the largest words depicting the most bothersome symptoms. They can then bring these results to their next doctor’s appointment to help guide and prioritize the discussion about their Parkinson’s symptoms.

As part of the “Live Well. Do Tell.” steering committee, my organization, InMotion, had the opportunity to participate in beta testing for the tool to ensure that it’s user-friendly.

What do nurses need to know about it?

People with Parkinson’s who experience “off periods” may not discuss their symptoms or communicate the impact to their health care professionals, as they may believe that the re-emergence of symptoms is just part of their condition, or they may rationalize the impact because they fear it signals their condition is progressing. The intent of the tool is to initiate better dialogue between people with Parkinson’s and their health care professionals about their symptoms and about “off periods.”

How can they utilize this tool or recommend that their patients use it?

If patients are having a hard time talking about their symptoms, pointing them to this tool may provide them and their care partners with a guide to recognizing and recording symptoms that may be overlooked.

The tool is an easy online resource that people with Parkinson’s can use in advance of their doctor’s appointments. With the resulting word cloud shared via email, they’ll be armed with an actionable item they can share with their health care providers, who can in turn help them better manage their Parkinson’s symptoms to live well.

Why is it important for this tool to exist? What does it provide that is new?

Many factors make it difficult for people with Parkinson’s and their care partners to distinguish their most bothersome symptoms, and many often have a hard time articulating the impact of their symptoms during a doctor’s appointment.

The “Do Tell” Your Doctor Tool can impact the care people with Parkinson’s may receive—offering a visual guide that helps to recognize and record a person’s bothersome symptoms and providing a resource they can bring to their next doctor’s appointment to spark discussion and lead to more effective communication.

The need for this kind of tool was first identified in the “Live Well. Do Tell.” Statement of Need, which serves as the foundation of the initiative and outlined actions for the Parkinson’s community to help identify and communicate about “off periods.” The Statement of Need was developed based on learnings and insights from a multidisciplinary steering committee of leaders in the Parkinson’s community who collaborated to discuss unmet needs in understanding and communicating about Parkinson’s symptoms.

The “Do Tell” Your Doctor Tool is available online at LiveWellDoTell.org/takeaction.

Honoring PeriAnesthesia Nurses Week

Honoring PeriAnesthesia Nurses Week

The first week of every February is designated as PeriAnesthesia Nurse Awareness Week, a week to raise awareness of and appreciation for the nurse in this specialty.

As with many other areas of nursing, population changes and national health trends are shifting this specialty. Perianesthesia nurses are a patient’s advocate and guardian during any procedure that requires anesthesia. As the largest generation, the baby boomers, continues to swell the population of seniors, the need for perianesthesia nurses who are skilled with older adults is critical. And as some healthcare shifts away from hospital settings, perianesthesia nurses can expect to find more job opportunities in ambulatory surgery sites.

Nurses in this area are with a patient before, during, and after anesthesia, so they provide essential medical care while also using their understanding about personality and the human condition to make the process as easy as possible for patients.

Before anesthesia, a perianesthesia nurse will help a patient prepare for whatever procedure they are having. The nurse is responsible for educating the patient about anesthesia and answering any questions they or their family members might have. As some people are hesitant about anesthesia, may have had a bad reaction to it before, or are nervous about being sedated, nurses need to be able to offer factual advice that addresses the needs of each person. They are also there to let the patient know they will be with them the entire time, even when the patient is under anesthesia and not aware. Sometimes, just letting a patient know they are not alone is a huge relief.

During surgery, perianesthesia nurses shift their focus from a fully awake patient to one that is now under anesthesia and unable to advocate for themselves. This is when the focus shifts to the details that can be almost imperceptible. Nurses watch for any changes in vital signs that could signal a patient is in distress. But one of the biggest skills perianesthesia nurses are well-known for is their ability to watch a human body for small changes. Changes in skin tone, breathing, or muscle movement are of critical importance for the perianesthesia nurse. And because they will care for patients of all ages, knowing what is expected and what is not at each age is essential.

As the patient moves into recovery, the perianesthesia nurse is still at bedside, but this time with a dual focus—on the patient who is adjusting to the anesthesia wearing off and on those same body signals which now change with the patient coming out of a sedated state. People react very differently in this phase of recovery, so again the perianesthesia nurse has to know what to expect and how to help guide a patient through this initial phase.

Minority perianesthesia nurses are especially needed. A nurse who understands a patient’s language, culture, and customs will be much more in-tune with what the patient might be concerned with. If they are frightened, speaking in their first language will be easier, and having a nurse who can communicate easily with them will eliminate stress and confusion. When they are in recovery, the same kind of communication is beneficial to the patient and to the rest of the healthcare team as well.

As an advocate for patients when they are unable to be their own advocate, perianesthesia nurses have a significant role in patient care. This is a great week to honor all they do.

Men in Nursing: Where Are We Now?

Men in Nursing: Where Are We Now?

For more than a century, nursing has been thought of as the domain of women. But that has fluctuated over the last few centuries. Men actually dominated nursing through the mid-19th century. During the Industrial Revolution, men began leaving nursing for factory jobs. Florence Nightingale led the advancement of women in nursing, targeting upper and middle class women for nurse training. In fact, men were not allowed to serve in the Army Nurse Corps during World Wars I and II. Today, as workplaces evolve, more men are entering the profession again amidst a nursing shortage.

Entering Nursing

About 13% of nurses in the U.S. today are men, compared with 2% in 1960, according to the Washington Center for Equitable Growth. However, in the high-paying specialty of nurse anesthetist, there is an equal number of men and women.

The United States is leading the way in the increase in the number of male nurses. While the U.S. rate of men in nursing was not much higher than in Switzerland and Brazil in 1970, it rose rapidly over the next several decades and far surpassed these countries in addition to Portugal and Puerto Rico.

The rise of men in nursing is due in part to a shift in available jobs, especially as traditionally male-dominated jobs in manufacturing jobs like automakers have been taken over by automation or moved overseas for cheaper labor. A recent study published in the journal Social Science Research reviewed eight years of Census data. The study found that of men who had worked in male-dominated industries and then became unemployed, 14% decided to enter industries dominated by women, such as nursing. Eighty-four percent of men who didn’t lose jobs moved onto traditionally female jobs. Unemployed men who got jobs in female industries received a pay increase of 3.80% when making the move.

Where the Jobs Are

Another reason propelling more men into nursing is a shortage of nurses. According to the Bureau of Labor Statistics (BLS), employment for registered nurses will grow 12% between 2018 and 2028, much quicker than the average of other professions. There will be a need for 3.19 million nurses by 2024.

California is expected to have the highest shortage of nurses, and Alaska will have the most job vacancies. Other states that will face shortages of nurses in the next few years include Texas, New Jersey, South Carolina, Georgia, and South Dakota.

One driver of the need for more nurses is the growth of the aging population, who will require more medical care. Job growth is expected in long-term care facilities, especially for the care of stroke and Alzheimer’s patients. The need for nurses treating patients at home or in retirement communities will continue to grow. The rise in chronic conditions such as diabetes and obesity also means more nurses will be needed.

Pay and Training

The median annual wage for registered nurses was $71,730 in 2018, according to the BLS. The lowest 10% earned less than $50,800, and the highest 10% earned more than $106,530. Those working for the government and hospitals earned the most.

But like many other professions, men are outpacing women in pay. Male RNs make an average of $5,000 more per year than their female counterparts, according to a study published in the Journal of the American Medical Association. This salary gap hasn’t improved since the first year the salary survey was done in 1988. The difference in pay ranges from $7,678 per year for ambulatory care to $3,873 for work in hospitals. The largest gap, $17,290 for nurse anesthetists, may explain why so many men enter that specialty.

The researchers note that increasing transparency in how much employees are paid could help narrow the gap. In addition, part of the pay gap may be due to women taking more time out of the workforce for raising their children. FiscalTiger.com suggests that offering adequate leave to both mothers and fathers after the birth of a child could have a role in making pay more equitable.

The Washington Center for Equitable Growth’s report suggests that the amount of formal training required to become a registered nurse may bring men into nursing from other occupations later in their careers. The minimum training for registered nurses is an Associate Degree in Nursing. Increasingly, employers are demanding more education, however. That includes earning a Bachelor of Science in Nursing (BSN) degree. RNs in the  U.S. military must have a BSN, and the Veteran’s Administration, which employs the most RNs in the country, requires a BSN for promotion.

Finding Support

While men are still a minority in nursing, various programs offer support and networking. The American Association for Men in Nursing was founded in 1971 but shuttered in a few years. In 1980 it was reformed and now has thousands of members. It encourages men of all ages to become nurses and supports their professional growth.

Some nursing schools also have groups to support male nursing students. New York University, for example, has Men Entering Nursing (MEN), open to all nursing students at the Rory Meyers College of Nursing to discuss the concerns and perceptions that affect men and what it means to be a male in the field of nursing.

Nurses in Congress: Eddie Bernice Johnson

Nurses in Congress: Eddie Bernice Johnson

Today nurses practice in many arenas, from hospital bedsides to executive office suites to research laboratories to the halls of the United States Congress. Our Code of Ethics charges all of us to be involved in the political process to influence policies affecting the nursing profession and the health and well-being of all people. Our national professional organization, the American Nurses Association (ANA), encourages all nurses to be politically active to ensure safe and effective care for all patients, to elevate the profession, and to work to eliminate health disparities across our country.

Many early nursing leaders were suffragists and some even went to jail for advocating for women’s right to vote. As soon as the 19th Amendment passed in 1920, nurses were elected to local and state offices. Margaret Laird, a New Jersey nurse, was one of the first two women elected to the New Jersey Legislature in 1920. Between 1920 and 1992 nurses served in state legislatures in many states including North Carolina, Virginia, West Virginia, Massachusetts, Maine, and California. Iowa nurse JoAnn Zimmerman served as her state’s Lieutenant Governor from 1987 to 1991. While a nurse has yet to win a governorship, U.S. Senate seat, or Presidential election, eight nurses have served and/or are serving in the United States House of Representatives.

Texas nurse Eddie Bernice Johnson became the first nurse to win a national office in 1993 when she was elected to serve the 30th Congressional District of Texas in the United States House of Representatives. Twenty-six years later, Johnson continues to serve her district. In the intervening years she has been joined by seven other nurses from across the country. The group of Congressional nurses are African American and white, Democrat and Republican. They range in age from 32 to 84. As a group they represent all areas of the country and a cross section of race, age, and political affiliation. They have all brought their professional experiences, ethics, and commitment to caring with them into the political arena. To kick off Minority Nurse’s new Nurses in Congress series, I will share brief biographical sketches of each of the eight Congressional nurses starting with Congresswoman Johnson.

Eddie Bernice JohnsonEddie Bernice Johnson, RN, BSN, MPA
Democratic Representative, 30th Congressional District of Texas, 1993-present

“Whatever discussion I am a part of, I never miss the opportunity to talk about the value of professional nurses, the value of investment in the profession and the value of attempting to look at the full potential of nurse’s abilities.”
Rep. Eddie Bernice Johnson, Nurse.com 

Throughout her life, Congresswoman Eddie Bernice Johnson has been a pioneer. As an African American female growing up in rural Texas during the time of legal segregation, her future may have appeared limited. However, as Mr. James Daniels noted in an interview with Johnson:

Mrs. Johnson, your accomplishments are impressive and even astonishing. Your firsts set you apart as a genuine trailblazer. You are the first woman ever elected to represent Dallas in the U.S. Congress. You are the very first chief psychiatric nurse of Dallas; first African American elected to the Texas House of Representatives from Dallas; first woman in Texas history to lead a major committee of the Texas House of Representatives; first African American appointed regional director of U.S. Department of Health, Education, and Welfare; and the first female African American elected from the Dallas area as a Texas senator since Reconstruction. Your crowning accomplishment, however, is as the first nurse elected to the United States House of Representatives.
James Daniels, MinorityNurse.com

Johnson was born on December 3, 1935 to Lee Edward and Lillie Mae White Johnson in rural McLennan County, Texas to a family of limited means, but with a reverence for education. Johnson graduated from A.J. Moore High School in Waco, Texas in 1952. She wanted to become a nurse, but no accredited nursing school in Texas would accept African American students, so she enrolled in St. Mary’s College in Notre Dame, Indiana. In 1956, she graduated with her nursing diploma. Johnson continued her education earning her BSN from Texas Christian University in 1967, and in 1976, she was awarded her master’s degree in public administration from Southern Methodist University.

Johnson’s early nursing career was spent as a psychiatric/mental health nurse, psychotherapist, and nursing administrator for the Veteran’s Administration (VA). After ten years working for the VA, she achieved the rank of chief psychiatric nurse at the VA Hospital in Dallas. In 1977, Johnson was promoted and became a regional director of the U.S. Department of Health, Education, and Welfare.

In 1972, while working at the VA, Johnson was elected to the Texas House of Representatives, making her the first African American woman to ever win an election in Dallas. Johnson waged a successful campaign for a seat in the Texas Senate in 1986, which she gave up in 1992 to run for the U.S. Congress. She won in a landslide and became the first nurse to serve in Congress. She has retained her seat for twenty-seven years.

Johnson is widely recognized as one of the most effective legislators in Congress. She is credited with authoring and co-authoring more than 120 bills that were passed by the House and Senate and signed into law. Over the decades Johnson has served on and chaired many committees and subcommittees in Congress, including as a senior member of the Transportation and Infrastructure Committee and Chairwoman of the Science, Space, and Technology Committee. Her subcommittee appointments include: the Subcommittee on Water Resources and Environment, which has jurisdiction over water conservation, pollution control, infrastructure, and hazardous waste cleanup as well as reauthorization of the Clean Water Act; the Subcommittee on Aviation; the Subcommittee on Railroad, Pipelines, and Hazardous Materials; the Subcommittee of Research and Science Education; and the Subcommittee on Energy and the Environment. She has also been a Senior Democratic Deputy Whip and Chair of the Texas Democratic Delegation. As chair of the Congressional Black Caucus from 2001 to 2003, Johnson was praised for her ability to build coalitions with business interest group as well as labor unions and civil rights organizations.

Johnson introduced the National Nurse Act of 2011, which would elevate the importance of the Chief Nurse Officer of the United States Public Health Service and appoint a National Nurse to work with the Surgeon General to promote wellness and health literacy. She is also passionate about improving mental health and increasing federal funding for women pursuing science, technology, engineering, and math education.

2020 Is the Year of the Nurse

2020 Is the Year of the Nurse

The World Health Organization designated 2020 as The Year of the Nurse and the Midwife. What does that mean for nurses everywhere?

The designation was made last year by WHO to help raise awareness of the nursing and midwifery professions and also to call attention to global health. Nurses and midwives, says WHO, are critical components for improving the health of people worldwide. By calling attention to the nurses and midwives who take care of people every day, it’s also shining a light on disparities that exist and that nurses are helping to bridge.

What makes 2020’s Year of the Nurse and the Midwife so special? It happens to be the 200th birthday of Florence Nightingale, the founder of the nursing profession. And 2020 is also the end year for several campaigns around nursing—the Institute of Medicine’s proposed goal for having 80 percent of nurses having earned a bachelor degree and WHO’s own three-year NursingNow! campaign that ends in 2020. NursingNow! focuses on how raising global health will raise the state of nursing and help support essential policies around nursing.

This year also marks the year WHO is developing a State of the World’s Nursing Report to be presented at the 73rd World Health Assembly to be held May 17 to 20 in Geneva. The organization is also contributing to a State of the World’s Midwifery 2020 report that will be released this spring.

As more attention is focused on the nursing profession and the role nurses play in offering primary care around the globe, the more strategic decisions will focus on strengthening the nursing industry and supporting nurses and midwives in their roles. The hope is that focus will bring an influx of funding into more research, career supports, and adding new or strengthening existing policies to protect nurses, midwives, and patients. With these positive and effective changes started, the path is paved for better working conditions, more nurses in the field, a more diverse and inclusive workforce to represent patient populations, and improved patient health.

As a force of global change, nurses will play a pivotal role in helping achieve the WHO goal of universal health coverage and contribute to the global Sustainable Development Goals presented by the United Nations.

As a goal, the Year of the Nurse and the Midwife is on target for what professional nurses need and want to hear and have action taken on. But the designation also speaks to the state of global health and the pivotal role nurses and midwives play in keeping humanity healthy, despite some declining rates of nurses.

Nurses work in all conditions in some of the most remote corners of the world to ensure that no matter where people live and no matter what conditions they live in, that they will be able to achieve the best health possible. That alone is a lofty goal and one that nurses get up every day and just do. At the very least, nurses deserve a year dedicated to the impact they bring. Let’s hope the Year of the Nurse brings the change nurses deserve.