by | Mar 30, 2013 | Asian-American and Pacific-Island Nurses, Black and African-American Nurses, Hispanic and Latino Nurses, LGBT Nurses, Magazine, Men in Nursing
A patient was scheduled to have open-heart surgery at a Nashville hospital last year when a thorny problem arose. The woman’s husband insisted that no African-American men be present in the operating room during the surgery. According to newspaper accounts, he told the surgeon that his wife did not want black men viewing her nude body. The couple had approached a doctor at another hospital, who had refused the request. But the surgeon in this case chose to honor it, fearing that the patient would not agree to the lifesaving operation otherwise.
So when an African-American male perfusionist was assigned to operate the heart-lung machine on the day of the operation, the surgeon replaced him with a white technician. The move angered many local health care professionals and the surgeon later called his decision a mistake.
But for the Tennessee Hospital Association, the troubling incident became an opportunity for learning. The association’s Council on Diversity addressed the issue head-on and developed a case study for its member hospitals to use in their diversity training initiatives.
Diversity has been a buzzword in the corporate world for the last decade. Many large corporations have hired diversity consultants and created internal diversity management positions to help their organizations recruit and retain a more diverse work force, create corporate cultures that value diversity and address racial conflicts. Some of these initiatives came about after companies were sued for bias, while others grew out of employers’ proactive realizations that having a culture that valued diversity would give them a competitive edge in the marketplace.
Although health care organizations have been a bit slower to come to the diversity table, a growing number are beginning to address this issue. Groups such as the Tennessee Hospital Association’s Council on Diversity are working hard to open up discussion on difficult topics and spark action to encourage equal opportunity in the workplace. Some of these efforts are being led by minority nurses, whose education, training and life experience have specially equipped them to handle this critical issue.
Bringing Passion to the Table
“Certainly I think nurses are well suited for these [diversity management] roles,” says G. Rumay Alexander, RN, EdD. “Nursing is a good springboard for a lot of things, but the rest of the world has wanted to keep nurses in traditional roles.”
Alexander, an African-American nurse, leads the Council on Diversity for the Tennessee Hospital Association. She helped create the group through her position as the association’s senior vice president for clinical and professional practices.
Rupert M. Evans Sr., MPA, FACHE, president and CEO of the Institute for Diversity in Health Management (IFD) in Chicago, also believes minority nurses can play an important role in diversity initiatives, particularly in efforts to build better relationships with communities and remove cultural barriers to health care.
“Nurses have a lot of experience in patient education and staff development,” he points out, adding that this makes them naturals for helping health care organizations improve their cultural competence.
Deborah Washington, RN, MSN, director of diversity for patient care at Massachusetts General Hospital in Boston, says nurses are passionate about caring for patients, which is the basis of equal opportunity health care–providing quality care regardless of race, gender, age or ethnicity. “A good nurse will never back off from the question of ‘What can I do to provide the best for my patient?’” she says. “Nursing, regardless of a nurse’s race or ethnicity, is all about quality of care.”
Minority nurses, Washington adds, bring directness to discussion about diversity. “We are initiators of the conversation that needs to be had. We bring energy to that conversation.”
Evans reports seeing a significantly growing interest in diversity among health care organizations in the last year. He believes this stems from the simple recognition that society is changing rapidly and that organizations must respond accordingly. Creating workplaces that value diversity isn’t just about doing the right thing—it also makes good business sense.
“It’s really a matter of survival,” agrees Cynthia Barnes-Boyd, RN, PhD, FAAN. “With so much competition in the health care industry, hospitals can’t afford to have patients not select them because they don’t feel comfortable there.”
Boyd, an African-American nurse, is director of the Great Cities Neighborhood Initiative at the University of Illinois in Chicago. In her job, she administers a variety of community-based projects, such as school-based clinics and a home health care program for families with special needs. She is also an expert in helping organizations, such as hospitals and health care centers, meet the needs of diverse communities.
In her position at Massachusetts General, Washington, who also is African-American, facilitates conflict resolution among staff and management, teaches culturally competent care and serves on a variety of committees that address diversity issues. A former biomedical tester, Washington had begun a second career as a staff nurse at Massachusetts General when a supervisor asked her to chair a committee to address work force issues. Later she was appointed to her current position.
Washington says her training as a psychiatric nurse provides a valuable background for helping people resolve conflicts and discuss issues openly. “I like to be straightforward and direct,” she explains. “This is an environment where nothing is swept under the rug, and I like that a lot.”
Blaze Your Own Trail
Not all diversity management positions are formally appointed posts created by organizations. Sometimes these jobs are initiated by individual health care professionals who feel strongly about the issue and want to be a part of the solution.
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Alexander, for instance, started the Council on Diversity for the Tennessee Hospital Association because she saw the need to recruit more minorities into health care. Better patient-care decisions are made when there is racial, ethnic, age and gender diversity, she says, because a wider variety of perspectives is represented.
When confronted with the lack of minorities in hospital management positions, hospital administrators would often say they wanted to hire people of color but seldom came across qualified minority applicants. The Council on Diversity responded with a summer internship program that places minority management students in Tennessee health care facilities.
Similarly, Boyd created the position she holds at the University of Illinois. Early in her career as a critical care nurse in neonatal and intensive care units, she realized she wanted to work on the other end of disease. Rather than treating people after they had become desperately ill, she wanted to help prevent illness and develop programs for underserved populations. Boyd has since led a variety of programs at community health care centers and the university. She urges minority nurses to be proactive and create opportunities to address diversity issues, rather than waiting to be appointed.
“Every position I’ve had I wrote the [job] description for and pitched it to the organization,” she recalls.
Boyd feels strongly that nursing professionals should become actively involved in championing diversity. “The way to be a part of it is to make yourself part of it,” she says. For example, nurses can volunteer for diversity committees at their institutions, become active in community programs that promote diversity, and propose solutions when they see problems of bias or conflict.
Supporting Diversity From the Top Down
As the health care industry becomes increasingly concerned with maintaining profitability and cost-effectiveness, nurses who want to pitch the idea of initiating a diversity committee or diversity management position must be ready to show how it will benefit the organization’s bottom line. Picking the right time to present your case can also make a difference.
Alexander says she would not have been able to create the Council on Diversity when she started working for the Tennessee Hospital Association in 1980. At that time, she was the association’s first minority in upper management. “Initially I knew I could not bring the issue up,” she remembers. “First I had to gain trust.”
Through the years, she sent up “trial balloons” to gauge receptiveness. “I kept being that gentle little nudge,” she says. And then five years ago, she received the go-ahead to work on developing the minority internship program and the Council on Diversity.
A nurse must have support within an organization to succeed in leading any new effort. A turning point for Alexander was when she got a new boss who truly understood and supported the diversity initiative—and her. “The more allies you have, the better,” she stresses. “You have to have that nucleus of support. You can’t do it by yourself.”
For diversity efforts to succeed, Evans says, their goals must be woven into the organization’s strategic mission and be supported from the top down. Diversity initiatives that are assigned to only one position or department without being integrated throughout the organization run the risk of being lopped off when it’s cost-cutting time.
Washington agrees. She says valuing diversity is part of Massachusetts General’s mission, and she feels she has strong support from her organization’s leadership. But that’s not the case at every health care facility, she cautions. Sometimes diversity initiatives occur at the middle-management level and suffer from a lack of support from the top.
Many Paths, One Goal
Diversity is also important in scientific research, where it encompasses more than just ethnic, racial and cultural differences. In her position as senior associate for science management at United Information Systems, Inc., in Bethesda, Md., Rosemary Torres, RN, JD, also serves as diversity and outreach manager. It’s her job to recruit a diverse group of scientists to sit on peer-review panels for federally funded scientific research. Torres, who is Hispanic, looks for top scientists who represent diverse fields and geographical areas as well as a spectrum of different educational and cultural backgrounds. Diversity among scientists is essential because it provides a broad perspective for finding comprehensive answers, she explains.
Torres herself has created a diverse career that has helped her broaden her own perspective in addressing health care issues. As a health law attorney and nationally recognized expert in women’s health, she has worked in a wide variety of clinical settings and offered her expertise in the development of health care policies.
“I’m an atypical nurse,” she says. “I created a career path that enabled me to assess and impact the full stage of a patient’s life.”
There are many other ways nurses of color can get involved in diversity and equal opportunity efforts without actually holding a formal diversity management position. For example, you can promote diversity in the workplace informally by mentoring other minority nurses. Another option is to reach out to local minority communities. As a Girl Scout leader, for instance, Boyd helped her troop learn about breast cancer and educate the women in their families about the disease.
What skills and qualities must nurses possess to play leading roles in diversity initiatives? “Self awareness is critical,” according to Boyd. “We have to be willing to look at ourselves and examine our own biases in forming relationships.”
Nurses who want to help their employers reach out to diverse communities also need to have patience and a thick skin, she adds. “Just because you have a degree and a title, people aren’t going to automatically trust you.”
Although nurses don’t have to have a human resources background to work in diversity management positions, Alexander says it’s crucial to have an understanding of how the entire health care system works. Other essential qualities include the ability to form trusting relationships and the courage to speak up.
Even though an encouraging number of health care organizations are beginning to embrace diversity issues, Alexander believes much work still lies ahead.
“At the majority of meetings I attend, I’m the only minority person sitting there,” she says. “I will know we’ve made an impact when people are sitting around a table where there is no diversity and someone at that table says, ‘This isn’t right.’”
by | Mar 30, 2013 | Magazine
Computer nurse, IT nurse, techie nurse. These are some of the titles nurses specializing in informatics have recently acquired and might still be using. However, nursing informatics is about more than just understanding computers and technology.
Nurses—whether a charge nurse or a nurse informaticist—need access to their patients’ health histories. Nursing informatics so influential is that, now, nurses are able to pull all of that information together in a more streamlined way through computers, which is quicker, more organized, and more comprehensive. Transitions to computer systems are happening everywhere: hospitals, education and clinical labs, physicians’ offices, emergency rooms, operating rooms, and other health care settings.
Informatics integrates nursing science, computer science, and information technology to help nurses more effectively acquire, store, retrieve, and use the mass quantities of data critical for them to properly do their job.
Informatics has become an important specialty for various reasons. At the forefront, the increasingly complex health care system continues to necessitate technological advances and more electronic data. At the same time, health care professionals are assuming expanding roles, and the depth and breadth of knowledge for which they’re held responsible demands full access to patients’ health histories in real time. With instant access to patient information, nurses spend less time documenting and processing the data and more time providing direct care to their patients.
Nurse infomaticists career outlook
With the approval of the HITECH Act in 2009 and funding towards adoption of Electronic Health Records (EHR) technology, the Office of the National Coordinator of Health IT anticipates that 50,000 new health information technology jobs will be created within the next five years. Additionally, the overall employment of registered nurses is projected to grow by 22% from 2008–2018, with most of that growth resulting from technological advances in patient care, according to the National Employment Matrix provided by the U.S. Bureau of Labor Statistics.
So, what are these tens of thousands of future nurse informaticists capable of? They can, and likely will, do the following:
- Make the transition to a technologically advanced health care system smoother, more efficient, and safer for nurses and patients.
- Design information systems that optimize practitioner decision-making.
- Develop and troubleshoot tools for consumer health care, such as health-related websites, homecare management systems, remote monitoring, wearable monitoring devices, and telenursing.
- Promote health literacy through the design and development of tools and devices that bring health information to diverse populations.
- Engage in local and national policy debates over the need for more advanced health information technology.
Since nursing informatics is a specialized discipline, and information technology continues to improve the health care industry, the current salary outlook for informaticists climbs higher than that of traditional nurses. Moreover, the salaries of nursing informaticists reported in 2011 increased 16% over salaries in 2007, according to the Healthcare Information Management Systems Society 2011 Nursing Informatics Workforce Survey.
If you’re considering a career as a nurse informaticist, whether in a clinical, administrative, or academic setting, be proud that you’ll be working in one of the most technologically advanced professions in the health care industry, an industry that becomes more important with each passing day.
Join us for our next column on how to become a nurse informaticist.
by | Mar 30, 2013 | Magazine, Nursing Associations
Gwendylon Johnson, RNC, MA, has been a registered nurse for 30 years—and for nearly 20 of those years, she has also been a union activist within the District of Columbia Nurses’ Association.
To Johnson, the two roles are perfectly in sync. Being part of a nurses’ union, she feels, is as important to her struggle to be recognized as an African American as her activism during the civil rights movement in the 1960s, when she marched with Dr. Martin Luther King.
“Back in 1961, he delivered a speech to the AFL-CIO at its Fourth Constitutional Convention. Basically, the focus of the speech was that if black people win, labor wins,” recalls Johnson, a staff nurse in women’s health at Howard University Hospital in Washington, D.C.
Dr. King’s words resonated with Johnson. “He talked about the duality of purpose between what I as a minority was looking for and what labor was looking for,” she says. “He talked about things like decent wages, fair working conditions, health and welfare, respect and dignity.”
It’s no surprise, then, that Johnson recently assumed a key role at the negotiating table representing the United Association of Nurses (UAN), the collective bargaining arm of the American Nurses Association, during a bitter nurses’ strike at the Washington Hospital Center. The six-week walkout centered on issues such as understaffing and mandatory overtime.
“I think I’ve always had a different respect and association with the union than a lot of other nurses because I felt that [unions] have been an avenue for achieving [equity]–in the same way Dr. King felt that if the civil rights movement worked together with labor, both blacks and the unions would win,” she says.
Minority Membership Gaining Strength
At a critical time in health care history when union representation among nurses is climbing–due largely to concern over staffing shortages and the declining number of nurses entering the profession—a growing number of minority nurses are gaining a collective voice.
Overall, about 19% of the 2.7 million registered nurses nationwide were covered by collective bargaining agreements in 2000, according to U.S. Census Department figures. That’s up from less than 17% just two years earlier.
Several unions represent RNs, including the UAN, the Service Employees International Union (SEIU), the American Federation of Teachers, the United Food and Commercial Workers Union, the American Federation of State, County and Municipal Employees (AFSCME) and the American Federation of Government Employees (AFGE), plus local and regional independents, such as the California Nurses Association.
Unionization among nurses was revved up a notch this spring as the UAN–the largest union representing exclusively registered nurses, with 100,000 members–voted to affiliate with the AFL-CIO, a move organizers hope will strengthen the voice of nurses and their patients on a national level.
While none of these unions track minority membership, union leaders say that nurses of color like Johnson appear to make up approximately the same proportion in unions as they do in the nursing workforce—i.e., about 12%.
Wearing the Union Label From Top to Bottom
Some activists say that greater diversity within nurses’ unions is needed to better reflect the U.S. population at large, particularly in urban areas where significant numbers of nurses are African-American, Hispanic, Asian or from other non-Caucasian ancestry.
“I believe very strongly that the union should reflect [diversity in its membership],” says Sonia Moseley, RNP, executive vice president of the United Nurses Association of California, which represents about 11,000 RNs and is affiliated with AFSCME.
While Moseley says her union’s membership adequately reflects the 20-30% of California RNs who are nurses of color, she feels the percentage of minority members in leadership roles is still too low, at about 1%. “[Minority union members] don’t always show an interest in moving into leadership positions, and we don’t necessarily reach out to them, so I think we’re lacking in that area,” she admits
Moseley thinks it’s important that the mix of negotiators and union leaders reflects a diversity of races and cultures. She explains, “If the nurses you are representing aren’t all lily white, you have to have people at the bargaining table who reflect the true face of your membership”–not just because some issues may affect minority members directly, but also to build credibility and trust.
Nurses’ Unions Go to School
Sylvia Barial, RN, MS, can personally attest to the impact a minority nurse can have within a union. She is the chapter chair for school nurses in the United Teachers of New Orleans, which is affiliated with the American Federation of Teachers. The AFT’s health care division represents about 60,000 RNs nationwide.
For the first 10 or 15 years of her 30-year tenure with the union, Barial was the only African American–and the only school nurse–serving on the health care committee. Over the years, she’s seen first-hand the power and professional recognition that school nurses have gained from having a stronger collective voice within the teacher’s union.
“People would say, ‘Oh, you’re only a school nurse,’” Barial remembers. But since those early years when they were paid much less than teachers, school nurses now receive the same salaries as teachers (commensurate with their level of college education and other factors).
Today, school nurses manage students with a variety of illnesses and conditions that impact their ability to learn. Says Barial, “The union has increased schools’ awareness that there are federal rules and regulations that must be followed and that it’s important for them to have school nurses who can perform these services.”
Union Ties That Bind
For the most part, leaders of nursing unions say the issues they address collectively are the same for all members, regardless of their racial or ethnic background. “The same issues that affect any nurses affect minority nurses,” says UAN chair Cheryl Johnson, RN, BSN.
Heading the list of issues are those relating to working conditions and short staffing.
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“Hospitals in particular, but nursing homes as well, do not have enough nurses and other bedside caregivers, so each nurse has too many patients and is vulnerable to unsafe care and medical errors,” says Gay Hayward, nurse alliance coordinator for the SEIU, which represents 70,000 RNs and 40,000 LPNs. “It really impacts the quality of the care that’s being given.”
Adds UAN’s Johnson, “You could be anywhere in the country right now and you’d see about the same thing. There’s not enough nursing support, and we are expected to do more work with less people. It’s scary to go to work sometimes because you don’t know the positions you’re going to be put into.”
Indeed, union membership has gathered steam in the last 10 to 15 years as cost-cutting measures at medical facilities drove many RNs into other health care jobs that offered higher pay and better working conditions–or drove them out of nursing entirely. The Bureau of Health Professions reports that 494,000 licensed nurses were not practicing in 2000.
In addition, the prospect of low pay and stressful working conditions appears to be influencing prospective nurses’ career choices. The American Association of Colleges of Nursing recently reported that enrollment of students in BSN degree programs fell 2.1% in the fall of 2000, marking the sixth straight year of declines.
Negotiating for Equality
But not all union concerns are colorblind, other union insiders say. Some labor issues, such as racial discrimination in the workplace, are particularly relevant to minorities. Most nursing unions have a system in place, through their grievance procedures, to handle allegations that arise.
“[Unions’] grievance and arbitration procedures are much more in the hands of the individual workers than, for instance, an EEOC claim or private suit would be,” according to Hayward. “The outcomes can be much more satisfying, and more timely, [when you] have the union and contract language to pursue as a venue of recourse.”
Educational opportunities for career advancement, such as tuition reimbursement, are another issue that may have special significance to nurses of color, particularly at a time when more minorities are being encouraged to enter the profession. Such issues can be addressed by unions, activists say.
“I work in a hospital that is a predominantly black institution,” says Gwendylon Johnson, “and we’ve been able to achieve strong contract language that focuses on providing the opportunity for nurses to get educational opportunities, both within and outside the workplace.”
To Join or Not to Join
While union organizers are quick to say that collective bargaining isn’t the only way to make strides in improving nurses’ working conditions, they insist that unions can be an effective tool in getting management to listen. In many cases, unions have been instrumental in boosting wages and other benefits, such as retirement compensation, innovative bonus systems and increases in differential pay.
UAN leader Johnson tells her ANA colleagues who aren’t union sympathizers: “If you can sit with your employer and come to some kind of agreement where you have decent working conditions and you can compensate nurses so they’ll stay there, then good for you. But what we’re finding more and more, even in states that don’t have nursing unions, is that nurses are thinking about starting them.”
While nursing union organizers admit it can be difficult to get anyone–regardless of background–to get involved in unions, cultural differences can make the task of attracting minority members even harder. For instance, Philippine nurses, particularly recent immigrants, come from a culture where it is considered inappropriate to buck authority or the mainstream, and may therefore be difficult to recruit, says Hayward.
Pete-Reuben Calixto, RN, BSN, CNN, president of the Philippine Nurses Association of America, agrees with that assessment. In fact, he says, those cultural norms prevented him from joining a union when he came to the University of California at San Francisco on a work visa in the 1970s.
Although he paid the mandatory dues, Calixto didn’t officially join the California Nurses Association until a year and a half ago, when he had become more assimilated to U.S. culture and finally felt he could stand up to the changes sweeping through the health care industry.
“When you are sponsored by a certain U.S. employer, you feel that loyalty has to be paid back,” he explains, adding that other Filipino nurses may fear repercussions regarding their immigration status.
But today’s nursing unions have become more prepared to deal with these issues. They’re typically staffed with immigration lawyers and other experts to consult and defend members, if necessary. Union organizers also try to address cultural concerns one-on-one with prospective members by connecting them with current members from the same ethnic background, adds Moseley.
“It helps to tell your own story, how you became involved, how you stood up and how you didn’t get fired or have anything bad happen just because you decided you wanted to vote for a union,” she says.
Where do professional organizations for minority nurses stand on the issue of union membership? The National Black Nurses Association, for example, does not currently have a labor entity for its members but is planning to discuss union representation for the first time in the wake of UAN’s affiliation with the AFL-CIO, according to NBNA executive director Millicent Gorham.
On the other hand, Sandra Haldane, RN, BSN, president of the National Alaska Native American Indian Nurses Association, believes the decision to unionize is a local issue. “Unions have their place in some instances when staff cannot seem to work out situations with management or when they’re just taking an incredibly long time [to resolve nurses’ concerns],” she argues. “But with a very forward-thinking leadership group, you can correct situations and improve the working environment so that employees don’t feel like they have to unionize.”
A Voice for Patients, Too
Ultimately, the decision to join a union is up to each individual nurse. But many nurses of color who have taken that step feel union representation does more than just help ensure that the concerns of minority nurses are heard—it also translates to better care for their patients, which they say has always been a key concern.
“My association with the union has allowed me the ability to speak out on issues like patient advocacy without the fear of retaliation,” Gwendylon Johnson asserts, adding that the black nursing sorority to which she belongs, Chi Eta Phi, also promotes union membership.
by | Mar 30, 2013 | Magazine, Men in Nursing, Nursing Associations
Mention the word “nurse” and who comes to mind? Maybe she’s a nurse of antiquity, dressed in white, wearing a cap in the shape of a winged angel, holding someone’s hand. Maybe she’s wearing bright cheerful scrubs, running a hospital floor. She.
This lasting female stereotype, many would argue, has served nursing well over the past century. Nurses are associated with the “feminine” qualities desirable in caregivers; they are nurturing, patient, even maternal. Yet, from the Nightingale-esque pictures that pop up in a Google Image search to the crowds of female nurses in every hospital-themed television show, these images reinforce a societal belief that nursing is, and should remain, a female-dominated profession. Indeed, the number of male nurses, practically the world over, still hovers between 5% and 10% of the nursing workforce.
Today, while open degradation of minority social groups has lessened, male nurses continue to be ridiculed. The media is rife with recent examples, as male nurses remain fair game. For example, in the movie Meet the Parents, the main character is a male nurse named Gaylord Focker, carrying not-so-subtle connotations. During a recent episode of the popular television series Glee, lead character Sue Sylvester, an antagonistic cheerleading coach, says, “A female football coach, like a male nurse, is a sin against nature.” Rather strong words, even for a joke.
The recruitment dilemma
In 2002, the Oregon Center for Nursing (OCN) created a groundbreaking recruitment poster, the theme of which was “Are You Man Enough To Be a Nurse?” The poster was developed after the OCN surveyed middle and high school guidance counselors regarding male students and their attitudes toward men in nursing. Dr. Deborah Burton, Executive Director of the OCN at the time, says their mission became one of “let’s see if we can find some stereotypically male practicing nurses who look male, act male, and love nursing.”1 Their highly acclaimed poster received widespread attention throughout the United States, and it’s still buzzed about today.
The OCN poster campaign and others since have helped create a dialogue between counselors and potential male nurses. The “Are You Man Enough to be a Nurse?” poster opened up a conversation surrounding masculine men becoming nurses. But that was just the beginning. At both the 2009 and 2010 American Assembly for Men in Nursing (AAMN) national conferences, attendees’ feedback consistently noted a wish for more discussions concerning ways to change the image of men in nursing in both recruitment and retention areas.
Birth of the 20 X 20 Choose Nursing campaign
In 2009, the AAMN board of directors began discussing how to take its members’ ideas to the next level. They believed nursing recruitment efforts needed to evolve from asking men if they were masculine enough to be a nurse to something less gender specific. They introduced the theme “Do what you love and you’ll love what you do.” In other words, the AAMN hoped to create an image of nursing focused on life interests instead of gender. This idea would eventually become the 20 X 20 Choose Nursing campaign, an effort to “de-genderify” nursing, making it a life choice in concert with someone’s personal strengths and interests. After all, the ability to care, empathize, and nurture are not female-only personality traits.
In the spring of 2010, the AAMN affirmed this decision in their five-year strategic plan by building the AAMN brand as “one that focuses on the knowledge and competencies of men in nursing rather than on gender.” While the OCN poster campaign, and many other similar initiatives in the past decade, challenged men to be “manly” enough to choose nursing, the AAMN wanted to minimize the gender image and accentuate personal interests.
The work of Rambur, Palumbo, McIntosh, Cohen, and Naud (2011) reaffirms the AAMN’s decision to focus on competencies and interests. “Overall, when examining individual key attributes, there were fewer statistically significant differences between perceptions of an ideal career and perceptions of nursing for men than there were for women. This implies that nursing isn’t at odds with what men value in a career, but instead that recruitment into the profession continues to be impacted by social context. Optimal recruitment, therefore, might overtly address such issues with a ‘Think nursing isn’t for you? Think again!’– type campaign, highlighting diverse roles, genders, ages, and races to enable a correspondingly diverse population to envision themselves in nursing.”2
In the fall of 2010, the 20 X 20 Choose Nursing campaign was officially approved by the AAMN board and presented at the Institute of Medicine (IOM) and Robert Wood Johnson Foundation Future of Nursing Summit in Washington, D.C. The AAMN named the initiative “20 X 20 Choose Nursing” to highlight the goal of increasing the enrollment of men in nursing programs nationally from the current 10% to 20% by the year 2020.
The campaign encompasses the following three phases.
Phase One: Linking New and Existing AAMN Areas
Timeline: January—August 2011
The poster campaign
“Do what you love and you’ll love what you do.” That’s the theme and thinking behind the 20 X 20 Campaign poster series. Each poster also bears the call to action “Nursing: Come Join Us…We’ve Been Expecting You.” Through these posters, the AAMN hopes to impart to males of all ages that the variety of nursing opportunities is virtually limitless and can coincide with their personal interests.
Each poster creates a call to action in several ways. By featuring real nurses doing relatable things, a connection is established between the viewer and that nurse. The viewer is then encouraged to learn more about the person in the poster by going to the “20 X 20 Choose Nursing” link of AAMN.org, to solidify the connection the poster has made. In addition, the poster invites the viewer to learn more about nursing in general. The target audience includes school children of all ages, young adults looking for a direction in life, and second career adults who “wished they thought of a nursing career the first time.”
By September 1, 2011, there will be seven posters:
- Adrenaline Rush: The Operating Room Nurse/Mountaineer
- Loves to Fly: The Flight Nurse/Bike Rider
- Team Players: Flight Nurses in a Group
- Great with Kids/Communities: The Pediatric Nurse/Baseball Coach
- Computer Whiz: The Computer Savvy Nurse/Social Media Person
- The Teacher: Clinical Instructor Nurse/Community Teacher
- Heart Saver: Telemetry Nurse/Runner
The “Adrenaline Rush” poster features Patrick Hickey, R.N. B.S.N., M.S., M.S.N., Ph.D., C.N.O.R, a world-renowned mountaineer who has climbed the seven highest summits in the world, including Mount Everest. He is also a clinical assistant professor of nursing at the University of South Carolina in Columbia. Hickey began his career with an entry-level nursing diploma and continued his education by obtaining a master’s degree in nursing and a doctorate in public health. His personal motto says it all: “If I can do it, you can do it too.” Hickey’s fascinating life story and evident determination make him an excellent role model for any man considering nursing.
Links on the poster allow interested persons to further investigate male nurses in two ways. The first is through a “Meet the Nurses” page in the 20 X 20 Campaign section of AAMN.org. Each nurse featured on a poster will have a brief bio posted on this webpage, along with responses to interview questions. Questions include “How did you decide to become a nurse?” “What did your family and friends say when you told them you wanted to be a nurse?” and “What do you like best about nursing?” The second is a Frequently Asked Questions page, with general nursing questions and answers. Examples include “How do you pick a nursing program?” “What types of courses will I take in a nursing school?” and “How many men are in nursing today?”
Social media campaign
By September 2011, the AAMN will have officially launched a new social media campaign, including a YouTube channel with video content about men in nursing. Under direction of AAMN board member Brent McWilliams, the YouTube channel will focus on the power of positive images and stories that show men can be—and are—nurses.
“My personal experience as a parent has shown me that, often, kindergarten and first grade boys and girls do not think it is possible for boys to grow up and become a professional nurse based on gender alone,” says William Lecher, President of the AAMN. “These beliefs are often perpetuated through the high school years.”
The AAMN will also launch a video contest through the YouTube channel, open to anyone with an interest in telling their story about men in nursing. McWilliams notes that “in offering video of men who are nurses through the AAMN YouTube channel, we hope to provide society with a new and fresh mind’s eye view of professional nursing. Social media has become part of the fabric of our society and a vehicle for professional organizations to listen and learn, build relationships, increase visibility, provide expertise and serve as a platform to ‘take action’ (like fundraising). AAMN plans to take advantage of YouTube, LinkedIn, Facebook, and Twitter to further our goal of increasing gender diversity. If adolescent males begin to see themselves in the role of professional nurse, we will be assured of meeting our 20% of men in nursing by 2020 goal.”
Scholarship opportunities
The AAMN Foundation, a separate arm of the American Assembly for Men in Nursing, is devoted to raising money and offering scholarships to men in undergraduate and graduate nursing programs. The funds are raised via individual and corporate donations. One very supportive organization in this endeavor has been the Robert Wood Johnson Foundation, which provided $10,000 annually and a total $50,000 to fund nursing scholarships. In 2009, 16 pre-licensure and four graduate students were awarded scholarships. “This year the board is pleased to announce that the Foundation will support 10 $500 scholarships,” says Bridget Nettleton, President of the AAMN Foundation. “One of these scholarships will go to each of the 10 ‘Best Schools or Colleges for Men in Nursing’ previous award-winning schools. Each school will then select their recipient of the scholarship.” In addition to these scholarships, the Jadeh Marselis-Moore Student Nurse Essay Contest, established in 2007, offers a $500 unrestricted award to a pre-licensure nurse.
Best schools and workplaces for men
Since 2004, the Awards Task Force of the AAMN has reviewed submissions from nursing programs and workplaces across the United States wishing to be recognized for significant efforts in recruiting and retaining men in nursing, in providing men a supportive educational environment, and in enlightening faculty, students, and the community about the contributions men make to the nursing profession. “Our efforts are essential in supporting the 20 X 20 Choose Nursing campaign because it provides the present workforce with the reassurance that nursing continues to strive to be diverse,” says Ryan Lewis, AAMN Awards Task Force chairperson. “We must keep the passion alive—nursing is a man’s work too—and our efforts to recognize and support specific organizations committed to promote men in nursing through integration of curricula, public relations, mentoring, advertisement, and positive role modeling is an important component of this validation.”
Phase Two: Dissemination
Timeline: September 2011—August 2012
Coordinating with other nursing and non-nursing organizations is an essential aspect of the 20 X 20 Campaign—breaking down societal barriers can’t occur in a vacuum. The AAMN has already partnered with the DAISY (Diseases Attacking the Immune System) Foundation to highlight men in nursing. The DAISY Foundation honors nurses for exemplary care, and male nurse DAISY award winners are recognized at a rate two to three times their prevalence in the workplace.
Other cooperative plans include supplying a downloadable toolbox for high school guidance counselors, career advisors, AAMN members, and other interested parties to use when recruiting men into nursing programs. Local chapters of the AAMN will be encouraged to disseminate campaign-related information to their members and to create speaker panels to visit schools to talk about nursing as a career for men. The AAMN will also exhibit at national conferences throughout the year and will feature the 20 X 20 Campaign in those
presentations.
At the IOM Future of Nursing Summit, the AAMN board identified and approved metrics to demonstrate campaign progress. The AAMN will actively seek academic and workplace partners to deliver on these metrics. The October 2011 AAMN annual conference theme is “The IOM Future of Nursing: Men Leading Change, Advancing Health.” At this conference in Lexington, Kentucky, the AAMN will staff an exhibit featuring the 20 X 20 Choose Nursing Campaign and offer a symposium describing how people can use the 20 X 20 Campaign materials for recruitment and retention. This meeting will be video-recorded and posted on the AAMN YouTube channel to allow those unable to attend to participate in the campaign as well.
Phase Three: Evaluation
Timeline: September 2012–August 2017
The American Assembly for Men in Nursing has established a number of particular goals, which it hopes to accomplish and evaluate before the culmination of the 20 X 20 Campaign. From September 2012 until August 2017, the AAMN hopes to be able to produce the following: 15 nursing schools with a 20% male enrollment and retention/graduation rates at 90% or higher; 10 hospitals with a nursing workforce of at least 20% men and retention rates of at least 90% for three consecutive years; and 10 long-term care employers with an RN/LPN/LVN nursing workforce of at least 20% men and a retention rate of at least 90% for at least three consecutive years.
“The AAMN will not be able to impact on gender inclusion and balance in nursing by ourself,” says AAMN President Lecher. “We will need to partner with other minority nursing organizations. We need the engagement and support of our women nurse colleagues. Patients, families, and others will be important in changing the culture and outcome. Avenues of dissemination, inclusion, and alliances are now in the process of being formed in order to spread the word about men in nursing.”
References
- “Getting Tough About Recruiting Men into Nursing.” Minority Nurse. Summer 2003.
- Rambur, B., Palumbo, M. V., McIntosh, B., Cohen, J. & Naud, S. (2011). “Young Adults’ Perception of an Ideal Career: Does Gender Really Matter?” Nursing Management. Spring, 19–24.
by Susan Wessling | Mar 30, 2013 | Magazine
Although she didn’t know it then, a personal trauma in 1994 changed the course of Karen Coleman’s professional career. Coleman, an emergency room RN at the time, was raped by her then-husband, who had been barred from her home by an order of protection. “When I went to the hospital after the assault, I had a physician perform the evidence collection kit and he didn’t have any idea what he was doing. He had no clue,” she recalls. “He wasn’t sure about the process. He wasn’t familiar with collecting evidence. I had to show him how to do my own rape kit.”
Today, Coleman, who is African American, is the Sexual Assault Nurse Examiner (SANE) coordinator for Victims Assistant Services in Elmsford, N.Y. It was by chance, Coleman says, that she learned about the field of forensic nursing. Three years after surviving her assault, she came across an article about nurses being specially trained to do forensic examinations of rape victims, and she learned that a SANE program was being considered in her county.
Coleman attended several meetings about the new program, which she then was asked to coordinate. “I thought it was ideal, because I felt nurses could do these exams,” she says. “Having been a victim myself and receiving a less than optimal exam, I made it my mission in life to make sure no one else would ever have to go through that.”
Coleman is now responsible for the recruitment, hiring and retention of SANE nurses for her program, which operates in 11 of the 14 hospitals in Westchester County. Her position is full time but the nurses hired into the program work on call.
“Forensic nurses ensure that evidence is collected appropriately and can be used in a court of law,” Coleman notes. “It’s important that crime victims know about us. All you hear about are the horror stories of waiting in the hospital and having physicians like the one I had who don’t know what they’re doing, who are less than compassionate and who tend to judge the victim.”
I’ll See You in Court
Forensic nursing is a relatively new field that combines the health care profession with the judicial system. In 1995 the American Nurses Association officially recognized it as a specialty of nursing. In April 2002, the International Association of Forensic Nurses (IAFN) held the first international certification exam. The 71 nurses who passed the exam earned the international designation SANE-A (Sexual Assault Nurse Examiner-Adult and Adolescent).
Coleman plans to take the exam when it is offered again in October, following IAFN’s Tenth Annual Scientific Assembly in Minneapolis. In addition, five states–Kentucky, Maryland, New Jersey, South Carolina and Texas–have their own certification exams for sexual assault nurse examiners. Texas and Maryland offer separate certifications for adult and pediatric cases. While certification is not mandatory in order to work as a forensic nurse, Coleman believes it gives added credibility. This is important because one of the key parts of the forensic nurse’s role, in addition to performing the comprehensive exam in the hospital, is to give testimony in court.
“The legal system is beginning to recognize the expertise of forensic nurse examiners and we are beginning to be qualified as experts,” Coleman explains. “If you can say when you are giving your credentials that you have taken a state-approved training, that you have taken a state-approved or nationally approved certification exam and you passed it, then at least you are able to say that you have met the standards for this profession of nurses and that you can be considered an expert with more knowledge than the average person in the field of sexual assault.”
When testifying in court, forensic nurses can be qualified as either an expert witness, who is allowed to give his or her opinion, or a fact witness (who, as the name implies, can only state the facts). This ruling is made by the judge.
“The prosecutor will present you, knowing you will discuss your background, the number of cases you have performed, what you do and what your job is,” says Jean Epps, RN, BSN, coordinator of the Sexual Assault Nurse Examiner Program at Howard University Hospital in Washington, D.C. Epps, who is African American, is a CFNE (a forensic nurse examiner certified by the state of Maryland).
When testifying at trials, forensic nurses are there to present information in an objective way. “Even though the prosecution may call you, you are not there to speak for or against the victim or the defendant. You are just there to present the facts of the examination,” states Epps, who also plans to take the IAFN SANE–A examination in October.
What Minority SANEs Bring to the Table
Because forensic nursing is such a new and rapidly growing specialty, it offers tremendous opportunities for both recent graduates and experienced RNs looking for a career change. Moreover, there is also a strong need for better minority representation in the field.
According to Coleman, “there are just not that many of us [nurses of color] working in this area. However, approximately 50% of the victims we treat are African American. You can probably add another 20% who are Latina.”
If minority women knew that there were more forensic examiners who were also people of color, they would be even more likely to seek medical assistance, Coleman believes. “During their experience of being a victim, they are going to be coming into contact with law enforcement people who, chances are, will not look like them,” she says. “I just think it adds a level of comfort. I am not saying, however, that because I am African American I am any better able to take care of a rape victim. I just think it is helpful to see someone that kind of looks like you among all the people you are gong to have to deal with.”
This victims’ advocacy role is important to Coleman, who has become a vocal supporter of her chosen field. She often gives talks about forensic nursing and is interviewed by the media. She appeared in the Lifetime television documentary “Fear No More,” which told the stories of five women who were victims of violence. “Rape is a conspiracy of silence, and those who are able to talk about it should do so,” she insists. “There is no shame in being a victim.”
Tools, Techniques and Teams
Helping More Than Just Rape Victims
While much of the focus of forensic nursing is on the sub-specialty of sexual assault, forensic nurses are not limited to working on these types of cases. Many forensic nurses work with victims of other types of interpersonal abuse, including domestic violence, child and elder abuse/neglect and physiological/psychological abuse. Forensic nurses can examine victims of near-fatal or fatal traumas, such as shootings or stabbings. Some even work as death investigators.
Lucretia Braxton, RN, sees a wide range of patients in her role as a forensic nurse examiner in the emergency room at the Medical College of Virginia at Virginia Commonwealth University. Braxton, who is African American, trained at the Virginia State Police Academy in Fredericksburg, first as a SANE and then as a Forensic Nurse Examiner (FNE). She earned state certificates in both areas at the academy, but Virginia doesn’t certify nurses in these areas.
The emergency department where Braxton works is the leading trauma center for the state of Virginia. In a typical month, Braxton estimates that the department’s forensic nurses handle 20 sexual assault victims and ten homicide victims. The murder victims eventually go to the medical examiner’s office, but while the ER team is working to try to save the person’s life, the forensic nurse collects evidence. The nurse may even follow the victim up the operating room to complete the evidence collection. The center also sees quite a few domestic violence victims. “These victims don’t always report it, so it is hard to quantify how many there are,” she adds.
Objectivity is a key part of being a forensic nurse, Braxton believes. “You have to know when to draw the line between being an empathetic nurse and being there just to collect your evidence,” she explains.
In cases of stabbings or shootings, forensic nurses collect such things as bullets and any debris that is on the body, such as leaves that may have clung to the body from the crime scene. They are also in charge of removing the bloody clothes the victim was wearing and putting them in a special wrapping. These nurses also photograph and measure wounds. If the victim dies, the forensic nurse examiner will often collaborate with the medical examiner on the case, answering any questions he or she may have regarding what the nurse saw.
Braxton says a background in emergency nursing is helpful for nurses who want to move into the forensic field. “It gives you the experience you need in how to work with trauma victims,” she explains. “When the victims are brought into the ER, you see the very initial trauma right there. If you are trained and experienced in emergency nursing, you know how to react to what you are seeing, what you need to do, what the doctor needs, what he is going to call for.” As a forensic nurse, she adds, you are also trained to know what things not to touch, so that evidence is not accidentally destroyed.
A Ground-Floor Opportunity
Not only is forensic nursing an exciting and rewarding career, there is also a growing demand for nurses with these specialized skills. “Forensic nursing is expanding, more so than it used to be,” Braxton reports. “Forensic nurses are being incorporated into the emergency room setting now. In the past, hospitals felt that if evidence needed to be collected, any nurse could do that. Today we are finding out that the more expertise a nurse has in knowing exactly what should be collected, the better the evidence turned over to the detectives will be. And that can help lead to a better outcome in catching the perpetrator.”
Nursing schools are starting to recognize this trend as well. In September, Johns Hopkins University School of Nursing in Baltimore began offering an MSN–Clinical Nurse Specialist, Forensic Nursing Focus program. The school tapped Daniel Sheridan, RN, PhD, a forensic clinical nurse specialist at Johns Hopkins Hospital Department of Emergency Medicine, to create the new program.
“I convinced them that there was a need for it,” says Sheridan. “I have been a forensic nurse for many years, and Hopkins School of Nursing realized there is a growing need and a growing interest in this whole area.” Since the field is in its infancy, he adds, forensic nurses often have the advantage of helping to create their own positions, and even whole forensic nursing departments.
Prior to joining Johns Hopkins, Sheridan worked as a full-time employee for the state of Oregon, investigating abuse of institutionalized people who were mentally and cognitively impaired. He was the only member of the team who was a nurse. “This is a brand new area and people are still carving out new and innovative roles for the forensic nurse,” he emphasizes. “You have to really go out and be able to market yourself, to explain that you have specialized experience and training that are going to help an institution. This field really is at the ground level.”
Karen Coleman agrees, adding that the satisfaction her job brings her is amazing. People often ask her how she can work in such a difficult and traumatic field. “But once you get into this work, you know that everything you do is going to help a victimized person, and hopefully lead to a conviction in a court case,” she says.
Coleman adds, however, that helping to convict criminals is not her primary goal. “My focus is to help that victim get through that medical experience,” she maintains. “I hope that as we get better at taking care of victims, collecting evidence, providing support and linking them up with services, more victims will come forward and cooperate with law enforcement and there will be better outcomes in court.”
