by | Mar 30, 2013 | Magazine
In the Spring 2009 issue of Minority Nurse, we published a Second Opinion column written by Estela Dimes, BSN, RN, who is the mother of two special needs children. Her article, “Culture and Autism,” shared her personal experience of how family members from two different cultures—Dimes is Filipino American and her husband is Jordanian American— had different ways of responding to her young son’s diagnosis of autism. “In our struggle to deal with my son’s disorder,” she wrote, “my husband and I have learned firsthand that culture affects the way people think about, cope with and adapt to autism.”
In response, we received this letter from Zenora Thompson, MSN, RN, an instructor in the nursing program at Kent State University’s Ashtabula Campus in Ashtabula, Ohio, and the mother of a 22-year-old with autism.
“The article emphasized how problematic the acceptance of autism can be for families of different cultures,” she writes. “However, acceptance of autism, mental retardation and other developmental disorders is not just an issue for different cultures of people but also for us as nurses seeking to provide culturally competent care.
“Nurses are challenged in the pursuit of cultural diversity to educate ourselves about how to provide care to these special needs populations—and especially to adult special needs patients. Today, life expectancies for people with developmental disorders have increased, thanks to early medical diagnosis and treatment. As a result, we health care providers must re-evaluate our ability to care for this population.
“In the past, adults with more severe forms of autism or other developmental disorders who were admitted to the hospital for a medical condition were often placed in pediatric units because of their lack of communication skills and their adverse behaviors, such as head banging, hitting themselves or objects, yelling and abnormal sleep patterns. But today, as the population of older special needs patients increases, some of them are now being admitted to adult medical-surgical units, where nurses may not have been trained to understand and accommodate these behaviors.
“Culturally competent care for special needs patients must first start with nurses’ self-evaluation of our own willingness and ability to serve this difficult population,” Thompson continues. “Today, many magnet hospitals and other medical facilities have begun to focus on providing care to culturally diverse patients. But the special needs population is often not considered as a culture. Most health care personnel think of the term ‘cultural diversity’ as applying to patients of different races, religions and ethnicities. However, ‘culture’ is defined in Webster’s New International Dictionary as ‘the sum total of the attainments and activities of any specific period, race or people.’ The special needs population fits this definition. The goal of nurses is to provide culturally competent care, and the special needs population must be included under that umbrella.
“Nurses on adult medsurg units must develop the skills to address the communication, behavior management and developmental needs of these patients,” Thompson emphasizes. “Our ability to communicate with them more effectively will promote continuity in the patient’s current medical regime. Nurses who are trained in managing adverse behaviors will foster patient cooperation and trust, eliminating the need for [physical] restraint and the administration of medications not normally used by the patient. Nurses’ use of equipment designed for people with developmental disorders—such as ‘talking books’ with pictures that patients who lack verbal communication skills can point at to indicate their needs—can enhance our ability to provide care.
“When I was working as a staff nurse on a medical unit at MetroHealth Medical Center in Cleveland, Ohio [before moving on to her teaching career at Kent State], nurses practicing under these conditions identified the need for skills training to ensure the successful care of the special needs patient,” she concludes. “The numbers of these patients have expanded beyond the pediatric units and are now challenging nurses on adult units to become culturally competent caregivers for this diverse population.”
by | Mar 30, 2013 | Magazine
The University of Florida (UF) College of Nursing in Gainesville found itself $1,531,000 richer this year after receiving three separate grants to pursue research in cancer, asthma, infant mortality and other health problems that disproportionately affect minorities.
From the U.S. Department of Health and Human Services Bureau of Health Professions, Division of Nursing, came $831,000 to help the school expand its nurse-midwifery program, with an emphasis on reducing infant mortality. The National Institute of Nursing Research (NINR) gave $670,000 to the college to create an interdisciplinary Biobehavioral Research Center. And the American Cancer Society is awarding a $30,000 scholarship to Carmen Rodriguez, ARNP, MSN, a clinical nursing instructor at the college, to help finance her studies related to evaluating pain in elderly cancer patients.
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“The infant mortality rate . . . ranges between 8.3 and 16.8 deaths per 1,000 live births for whites and between 12.2 and 28.7 for nonwhites,” reports Alice H. Poe, CNM, assistant professor and coordinator of the UF nurse-midwifery program, citing the results of studies done at the school’s program sites in Jacksonville, Tampa and Gainesville. Compare these numbers with nationwide figures of six deaths per 1,000 live births for white infants versus 13.7 deaths for racial and ethnic minority infants and it’s easy to see why UF believes in the necessity of finding ways to reduce this serious disparity for minority families living in medically underserved areas, particularly in Florida.
The college’s nurse-midwifery program will use its federal grant money to encourage students from disadvantaged backgrounds, medically underserved areas and underrepresented minority groups to seek careers as nurse-midwives. An educator/recruiter will be hired with the sole purpose of visiting culturally diverse and medically underserved areas, local elementary and high schools, and colleges with large minority enrollments to discuss the advantages of this career.
“Nurse-midwives from such populations often have a special sensitivity and awareness of the needs of minority patients and are more likely to seek employment serving these groups,” says Poe.
The three-year Advanced Nursing Education grant will expand the UF midwifery program through its traditional master’s degree program, the accelerated RN-to-BSN/MSN program and a cooperative degree program with the University of South Florida in Tampa.
The Biobehavioral Research Center’s initial undertaking will be to conduct four new federally funded pilot studies aimed at assessing the effectiveness of asthma education, as well as exploring the links between autism and diet, exercise and bone density, and herbal remedies and osteoarthritis. UF is one of only seven to nine colleges in the United States expected to receive the three-year NINR Nursing Research Exploratory Center Grant this year.
According to Carolyn Yucha, RN, PhD, associate dean for research at the UF College of Nursing, “the Biobehavioral Research Center will oversee pilot research studies with both biological and behavioral outcomes.The infrastructure of the new center will allow us to further develop the research program within the College of Nursing and help our investigators collect sufficient data to pursue specific areas of inquiry through other funding mechanisms in the future.”
Nurse researchers will work alongside co-investigators in biostatistics, exercise physiology, health education, medicine, nutrition, pharmacy, physical therapy, psychiatry and radiology.
Faculty member Carmen Rodriguez is one of only eight nurses in the country–and the only nurse in Florida–to receive this year’s American Cancer Society Scholarship in Cancer Nursing. Rodriguez, who is working on her doctorate in nursing at the University of South Florida, will use the funds to investigate the most effective method for evaluating pain in older patients with head or neck cancer and speech and language impairments.
“Health care providers working with patients with communication impairment face significant challenges when attempting to obtain information related to the measurement of pain,” explains Rodriguez. “Information obtained from this study will contribute to nursing knowledge and facilitate understanding of the experience and impact of pain on this special population.”
Graduate students pursuing doctoral study in cancer nursing are eligible for the American Cancer Society’s cancer nursing scholarships, which are awarded for up to four years with a stipend of $15,000 per year. Rodriguez will receive two years of funding.
