Any nurse concerned about being ill-prepared to care for Ebola patients should be able to refuse the assignment. So says the leader of the American Nurses Association [ANA].
“We strongly encourage nurses to speak up if they believe there is inadequate planning, education or treatment related to providing care to these or any patients, and seek to resolve any conflicts of responsibility swiftly,” said ANA President Pamela F. Cipriano, PhD, RN, NEA-BC, FAAN.
“Nurses should have the right to refuse an assignment if they do not feel adequately prepared or do not have the necessary equipment to care for Ebola patients,” Cipriano said in a news release.
At Texas Health Presbyterian Hospital where Thomas Eric Duncan — the first person to be diagnosed with Ebola in the U.S. — died last week, nurses publicly stated that nurses treating him lacked protective gear and that protocols constantly changed. Two of those nurses, Nina Pham and Amber Joy Vinson, were diagnosed with Ebola. Texas Health Presbyterian officials defended its Ebola procedures, saying it followed CDC protocols, USA Today reported.
Emory’s special isolation unit – one of five on the nation – has successfully treated three cases of Ebola without any medical professionals becoming infected. But even there, to allay fears, volunteers were sought and staff were allowed to decline the assignments, according to Forbes.
Around the world, about 400 health care staff have Ebola, and more than 230 have died, according to CNN.
Stopping Ebola in its tracks will require a global response to the crisis in West Arica and a collaborative approach involving interprofessional, state and federal organizations in this nation, said Cipriano.
Robin Farmer is a freelance content specialist with a focus on health, business and education. Visit her at www.robinfarmerwrites.com.
Globalization is changing the way we live and work, and by extension, it is transforming the experiences and aspirations of students entering Nurse Practitioner (NP) programs. Many of today’s students enter NP programs with a desire to acquire the advanced knowledge and skills needed to make a difference in faraway and remote places across the globe. Given budgetary and logistical constraints in nursing programs nationwide, existing curricular and institutional resources must be used in innovative and creative ways to develop, support, and mentor students with the potential for global leadership.
With more college students studying abroad, more students are entering NP programs with experience in global health care activities or services. Students with international experience may have participated in a high school foreign student exchange program, studied abroad in college, or travelled with a volunteer- or faith-based mission, or may have had a personal background in international travel. Many of these students have an expanded worldview and want to become NPs so that they can make a difference globally. In response, schools of nursing are establishing departments of international and global health, creating systematic course work and certificate programs in global health and leadership, and offering experiential global opportunities as part of their curriculum. I share one student-faculty mentoring experience I had in the hopes that it can serve as an exemplar in creating global opportunities in schools of nursing.
The journey began with a 52-year-old certified palliative care and hospice nurse who entered an Adult Nurse Practitioner Program with the secret desire to deliver hospice and palliative care to the terminally ill suffering from HIV/AIDS and cancer in the remote villages of Kenya. Her unrelenting vision enabled me, as a faculty member, to recognize the personal, social, and career attributes of a global leader and to create an innovative NP curriculum to support the student’s development.
Recognizing the Personal Attributes of a Global Nurse Leader
I first met the student at my university’s master’s-degree orientation for new students in the summer of 2011. I was her academic advisor, and she had come to my office to map out her course work and plan of study. Equipped with her notepad and ready to take notes, she was startled by my first question. I told her to dream big and asked: “If you could do anything at all, what would you do with your NP degree?”
Without hesitation, her response was: “My dream is to travel to the remote villages in Kenya to deliver hospice and palliative care to those who are terminally ill and suffering from HIV/AIDS and cancer.” Her tone was an alarming blend of authenticity, sincerity, and optimism. Fascinated by this student’s passion and enthusiasm and intrigued by her conviction of purpose, I asked her to tell me what she knew about Kenya.
Having traveled to Kenya myself, I was thrilled to have a frame of reference. I could easily recall highlights of Kenya’s topographic and demographic data. I even retained a working knowledge of Kenya’s Ministries of Health, its governmental structure, and its key economic drivers. Admittedly, the student really did not know much about the country and had never traveled there. But as her story unfolded, I discovered that she knew something far more valuable than all of the facts, figures, and statistics that I was expecting to hear.
Several years ago, the student was approached by a colleague who asked a favor. Knowing the student was a hospice and palliative care nurse, her colleague asked if she would write to her friend, a palliative care social worker in Kenya who was struggling with the enormity of suffering in her country. Without hesitation, the student agreed and thus began their ongoing virtual relationship.
For three years, the student and the palliative care social worker in Kenya shared their lives and their experiences with death and dying. Across continents, cultures, languages, and barriers, they developed an appreciation and an understanding of each other, as well as their triumphs and struggles. The student learned about the palliative care social worker’s beliefs and values and how they influenced her views about life and about death and dying. The student was very much aware of her own values and belief system and willingly shared them with the palliative care social worker. Without judgment, but with curiosity, openness, and sensitivity, the student compared and contrasted their cultures, traditions, perceptions, misperceptions, and views. She reflected upon the similarities and differences along with the challenges and potential conflicts.
Teaching is a two-way street, and that day this student taught me how to recognize the attributes of a global nurse leader. Through telling her story, this student demonstrated self-confidence, self-awareness, cross-cultural communication, flexibility, adaptability, and the passion to take on new challenges. She possessed the core attributes of a global leader but did not recognize this in herself. I was compelled to assist this student with realizing her potential.
This student came to graduate school with a global mindset, a passion for global health, and the vision of a leader. To place such energy and passion on hold—for two years—while working through a master’s degree in nursing would be unfortunate. Worse yet, imagine extinguishing the flames of passion for global health by ignoring the vision when we need more global nurse leaders. I needed to engage this student in her graduate course work in such a way that it strengthened and supported the commitment to her dream. Moreover, I wanted to assist the student with realizing that she had the ability and skills to make her dream a reality.
I asked the student if she would be willing to make a commitment to the ongoing development of her knowledge, abilities, and skills as a global leader by working with me to develop a structure and foundation for her dream. She agreed, and from that moment on, her dream began to crystallize. Graduate school was no longer classes and coursework; it became her passion, her life’s work, and the pursuit of her dream.
For the next year, the student and I worked together, using the existing curriculum, to develop a rich and engaging plan of study that provided the opportunity for balancing ideas, perceptions, and critical perspectives from her partnership with the palliative care social worker against evidence-based knowledge and theoretical frameworks.
The student’s literature review led her to the work of Dr. Anne Merriman and Hospice Uganda Africa. The student used her research courses to examine Merriman’s model for affordable oral morphine in Uganda to relieve end-of-life suffering. In addition, she investigated Merriman’s model as a possible model of care for the palliative care social worker’s community. The student’s partnership with the social worker had given her a global advantage. She had developed the adaptability, flexibility, and stability to deeply engage in the assessment and evaluation of the challenges and barriers related to one specific issue in one area of the world not only from a Western perspective, but from a broader perspective.
Merriman’s accomplishments as a leader resonated with the student. In her Nursing Leadership and Nursing Theory courses, the student focused on transformational leadership and change theory to better understand Merriman’s accomplishments in advancing palliative care in Africa. Eventually, the student interviewed Merriman for a Nursing Leadership class assignment. The Skype conversation with Merriman was a defining moment in the student’s career. Merriman’s respect, interest, and sincerity reflected the heart of most passionate leaders. They spend time investing in and sharing with others who share their vision in order to educate, advocate, spread, and advance their mission.
Relationship building is an essential component of becoming a global leader. The student’s relationship with the palliative care social worker in Kenya was invaluable to her development and success as a global leader. Her vision was born out of their partnership. However, how was this student going to make her dream happen? In order to actualize her dream, she needed to identify support or opportunities for collaboration, partnership, research, or even funding. She needed experience in navigating organizations. In addition, she needed to join international professional nursing organizations to network and to create and maintain relationships.
I arranged for the student to meet with senior administrators from both the School of Nursing and the School of Medicine at my university to build support for her work. As a result of those meetings and making those connections, she was introduced to major global leaders doing work in her area of interest.
Furthermore, the student was inducted into Sigma Theta Tau International in 2012 and, together, we presented the extraordinary outcome of our relationship at the Sigma Theta Tau International Research Congress in Sydney, Australia. Through this experience, the student had the opportunity to work with me one-on-one to prepare for her podium presentation. This type of guidance and support can facilitate high-quality results, and many leaders report this type of coaching as vital to their success. In addition, the student had the unique opportunity to network with global nurse leaders from all over the world.
•Do not allow perceived time constraints or fears of failure deter your desire to become an educational innovator. The impact of this successful innovation on student learning and faculty development far outweighs time and risk.
• Tying innovative teaching strategies into existing curricular structure provides a means for measurement and evaluation of student outcomes.
• This innovative approach for developing global nurse leaders will not work for all students. Recognizing the attributes of a global leader in someone with the passion for global service will optimize successful results.
• Never underestimate the power of virtual collaboration when developing global relationships.
As transformational coaches, educators can make learning come alive for students by becoming aware of a student’s vision, strengthening that vision by connecting it to the learning, and then empowering the student to make his or her dreams happen.
Sandra Davis, PhD, DPM, ACNP-BC, is an assistant professor at the George Washington University School of Nursing.
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