A Nurse-Midwife and a PhD Candidate

The U.S. Department of Health and Human Services, Office on Women’s Health has designated May 13 to May 19 as National Women’s Health Week.   It is designed to bring together communities, businesses, government, health organizations and others to promote women’s health. The goal in 2012 is to empower women to make their health a top priority.  The Robert Wood Johnson Foundation (RWJF) Human Capital Blog is launching an occasional series on women’s health in conjunction with the week.  This post is by Elisa L Patterson, MS, CNM, a fellow with the Robert Wood Johnson Foundation (RWJF) Nursing and Health Policy Collaborative at the University of New Mexico.

I have been a certified nurse-midwife for almost 19 years. It is an ingrained part of who I am. I have served women of many different ethnic, socioeconomic, and cultural backgrounds. Being a nurse-midwife embraces my duality of being a nurse and a midwife. I am very proud of these credentials.

As I add to my education in a PhD program – through the RWJF Nursing and Health Policy Collaborative at the University of New Mexico College of Nursing – I have found it a challenge to express in my “elevator speech” how these two credentials enhance my abilities to do policy work. I tried starting with what I am doing as a PhD student at the University of New Mexico. But when I say, “I’m also a nurse–midwife,” listeners seem to tag onto that singular piece of information and forget the rest of the conversation. Then, they might share their personal birth story or one that is a fond memory from a close friend. Or, they might ask me if I deliver babies at home.

I have not been able to figure out how to combine the important and, to me, impressive fact that while, yes, I am a nurse-midwife, I am also very capable of conversing about, researching and representing many other issues.

The American College of Nurse-Midwives (ACNM) has a way to help me and other nurse-midwives who face this dilemma. Next month at their annual gathering, a public relations campaign will be presented to the membership.  It will include a vision, mission statement, and core values. The ultimate goal is to describe the value of nurse-midwives and, in general, support the provision of high-quality maternity care and women’s health services by Certified Nurse-Midwives. Read More »

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Healthier Moms, Stronger Babies

The U.S. Department of Health and Human Services, Office on Women’s Health has designated May 13 to May 19 as National Women’s Health Week.   It is designed to bring together communities, businesses, government, health organizations and others to promote women’s health. The goal in 2012 is to empower women to make their health a top priority.  The Robert Wood Johnson Foundation (RWJF) Human Capital Blog is launching an occasional series on women’s health in conjunction with the week.  This post is by Rebekah Gee, MD, MPH, RWJF Clinical Scholars alumna and an assistant professor of public health and obstetrics and gynecology at Louisiana State University (LSU).  She is director of the Louisiana Birth Outcomes Initiative.

Louisiana is a fantastic place to live. It’s one of the most culturally rich and enchanting places in the United States. The state, however, also faces some of the greatest challenges in our nation.

Louisiana has a long history of poverty, poor education, and social problems that affect the health of too many of its citizens. And for women—particularly African American women—the challenges are even greater. We are 49^th in the nation in terms of overall birth outcomes, like infant prematurity and mortality, and we get failing grades on report cards that measure those indicators of health.

In 2010, Bruce Greenstein, Secretary of the Louisiana Department of Health and Hospitals (DHH), recognized the importance of poor birth outcomes as a crucial public health issue—and named it his top priority. We were the first state in the nation to offer birth outcomes this kind of backing from our government officials. In November, 2010, we launched the Birth Outcomes Initiative, which I direct. It engages partners across the state—physicians, hospitals, clinics, nurses—and provides them with the best evidence and guiding principles to achieve change.  We have made significant progress already.

We are working with the state’s hospitals on maternity care quality improvements, including ending all medically unnecessary deliveries before 39 weeks gestation. We have partnered with 15 of the largest maternity hospitals to provide them with the support and resources to make this a reality. Now, every maternity hospital in the state (there are 58) has signed on to the 39-Week Initiative.

Soon, we will be publishing perinatal quality scores—available to the public—so hospitals and physicians are held accountable for outcomes. In our pioneer facilities, we have seen the rates of elective deliveries drop by half. Many facilities have had as much as a 30-percent drop in the number of babies who needed to go to the NICU. The efforts of the Birth Outcomes Initiative are improving lives day after day. Read More »

Building the Body of Research in the Science of Nursing Care

Happy National Nurses Week!  The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog is featuring posts by nurses, including leaders from some of our nursing programs. This post is by Mary Naylor, PhD, RN, FAAN, director of the RWJF Interdisciplinary Nursing Quality Research Initiative program and the Marian S. Ware Professor in Gerontology at the University of Pennsylvania School of Nursing.

Nurses—the largest group of health professionals in the country—have a tremendous impact on health and health care. But despite the immense size and influence of the nursing workforce, we don’t know enough about how nurses can improve the quality and safety of care and reduce costs.

Nurse scientists have been exploring these questions for decades, but large gaps in knowledge remain. Since it was established in 2005, the Interdisciplinary Nursing Quality Research Initiative (INQRI), funded by RWJF, has worked to address those gaps in our knowledge of nursing care.

Over the last seven years, INQRI grantees—teams of nurse scientists and scholars from other disciplines—have conducted groundbreaking research focused on the ways in which nurses affect the quality of care patients receive and how they improve patient care and outcomes.

The interdisciplinary nature of the project has been key to its success; when scholars from multiple disciplines come together to solve problems in nursing care, they generate solutions that are grounded in rigorous evidence, that take into account diverse perspectives, and that use various methodological techniques. In short, interdisciplinary research leads to more robust findings. And more robust findings are more likely to attract investments in nursing resources, which will, in turn, improve health outcomes while reducing costs.

As program leaders, we don’t just talk the interdisciplinary talk; we walk it too. Read More »

I Believe This About Nursing…

Happy National Nurses Week!  The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog will feature posts by nurses, including leaders from some of our nursing programs. Check back each day to see what they have to say.

Every month, New Careers in Nursing (NCIN) asks its scholars to submit personal stories about their decisions to pursue careers in nursing. These students—who have undergraduate degrees in other subjects and have chosen to become second career nurses—have unique life experiences and views on the importance of the profession. The topics of their essays range from how their NCIN scholarships have enabled them to pursue careers in nursing, to events that may have shaped their decisions to become nurses, to their unique perspectives on their career choices.

Below are excerpts from the most recent winners of the “This I Believe About Nursing” essay contest.

Angelo Llanes: For the first two decades of my life, I definitely did not want to do it.
“Until my senior year at Rutgers University, I had never aspired to be a nurse. Quite conversely, as a Filipino I attached a stigma to the nursing field considering it the ‘easy’ or ‘expected route’ when I wanted to find ‘my own route’… My experience at the internship became a life changing event. I began to feel that I couldn’t continue pursuing a career in business… To me, nursing had almost come like a calling. When I recognized it, there was nothing left to do but follow it.”

Inetra Langley: Nurses help save lives, make a true difference and inspire those around them.
“For me, there was no question that my calling in life is to be a nurse. Unfortunately, life had another plan for me… While completing my undergraduate degree, I worked in the Emergency Department (ED) for three years. I shared with the nurses my plans of one day following in their footsteps. Without hesitation, many of them took me under their wings and taught me all about quality patient care in the role of a nurse. That invaluable experience has been my motivation for pursuing a nursing career for many years.”

Gregory Curry:  Nurses can help their patients muster inner strength in times of need.
“As I scanned the faces of my classmates I saw individuals not much older than my oldest son.  I felt an inner gnawing of fear; did I really belong here in nursing school, at my age? …Then I centered my mind on a conversation my younger sons and I had at bed time; both had been discussing the fears they have during the night, and as I walked in, simultaneously they asked, ‘Dad, what are you afraid of?’  I kissed them each on the forehead while tucking them in bed and answered, ‘Nothing, boys. Your dad is afraid of nothing.’” 

Learn more about the “This I Believe About Nursing” essay contest and see all of the winners.

Human Capital News Roundup: Smell tests for Alzheimer’s, “difficult” patients, physicians’ social media use, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) scholars, fellows and grantees. Some recent examples:

Although losing a sense of smell is associated with the development of Alzheimer’s disease, there is not enough evidence that olfactory identification tests (smell tests) can be a predictor for developing the disease, according to a study co-authored by RWJF/US Department of Veterans Affairs Clinical Scholar Gordon Sun, MD. Medical News Today, WebMD, and BrainPhysics.com are among the outlets to report on the findings.

Patients may not be fully participating in decisions about their health—holding back questions or avoiding challenging their physicians—for fear of being labeled “difficult,” a study led by RWJF Health & Society Scholars alumnus Dominick L. Frosch, PhD, finds. “What’s interesting to us is these were mostly Caucasian, highly educated, well-to-do people, and they’re talking about these difficulties,” Frosch told the San Francisco Chronicle. “It’s difficult to imagine this is easier for people in a less advantageous social position.” Fierce Healthcare also reported on the findings.

The Federation of State Medical Boards recently adopted new guidelines for physicians about social media use and social networking, on the heels of a study led by Clinical Scholar Ryan Greysen, MD, MHS, that finds an increase in reports of doctors not adhering to professional standards online. “Like everyone else, doctors sometimes stumble in their online behaviors and make mistakes in judgment about content they post,” Greysen told Slate. “They think they’re doing nothing wrong but, unfortunately, the disciplinary responses can be a big deal.” Read a press release about the new guidelines. Read more about Greysen’s study.

RWJF Harold Amos Medical Faculty Development Program alumnus Yonas E. Geda, MD, continues to receive media coverage for her study that finds seniors can reduce their risk of developing mild cognitive impairment through a combination of moderate exercise and such mentally stimulating activities as using a computer. Among the outlets to report on the findings: CBS News, MedPage Today [free subscription], Health.com and Consumer Affairs. Read More »

A Mentor, An Educator, A Shaper of Public Policy—A Nurse

Happy National Nurses Week!  The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog will feature posts by nurses, including leaders from some of our nursing programs. Check back each day to see what they have to say. This post is by Jacquelyn Campbell, PhD, RN, FAAN, director of the RWJF Nurse Faculty Scholars program and Anna D. Wolf chair and professor at the Johns Hopkins University School of Nursing.

Nurses are known mostly as caregivers, but we also play important roles as educators, mentors and even in shaping public policy.  I believe strongly that one of the most important roles all nurses play is that of the educator and mentor for new nurses.  No matter in what setting they work, nurses are involved in educational endeavors. You don’t need to be faculty.  In clinical settings, nurses at the bedside are preceptors for students and even those who aren’t formally teaching often work alongside nursing students and are their mentors and role models – keeping a watchful eye over the students as they practice their nursing skills, providing feedback and guidance until they get it right.

Education and mentoring are a natural extension of the caregiving role we all associate with nursing. Mentoring is how we care for new nurses who are caring for our patients and the public.  We mentor in a variety of ways, through coaching, role modeling and facilitating their growth and development so that they become better and more competent nurses. In education, nursing faculty have the privilege of working with individual students who have the same scholarly interests. They also have opportunities to mentor students toward doing research and scholarship, so that those students are helping to generate evidence to show what nursing interventions work best and what’s cost-effective. Evidence that can help to shape policy to improve the health and health care of our country.

I know from personal experience that being a mentor is immensely satisfying. When my mentees achieve their goals, that experience is every bit as exciting to me as when I achieve my own goals. I know that I have helped them aim high and that because of that, they are making a real difference in the lives and health of families, communities and our country. Read More »

Infographic: Nurses Answer the Call

The U.S. Department of Health and Human Services, Health Resources and Services Administration, has released an infographic for National Nurses Week showing the many ways nurses provide and expand care. Click the read more link to see the infographic. Read More »

National Nurses Week 2012 and New Jersey

Happy National Nurses Week!  The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog will feature posts by nurses, including leaders from some of our nursing programs. Check back each day to see what they have to say. This post is by Susan Bakewell-Sachs, PhD, RN, PNP-BC, interim provost for The College of New Jersey, and program director of the New Jersey Nursing Initiative, a project of RWJF and the New Jersey Chamber of Commerce Foundation.

The American Nurses Association theme for National Nurses Week 2012 is “Nurses: Advocating, Leading, Caring.” It emphasizes critical areas of focus for professional nursing in New Jersey and the nation that align well with the 2010 Institute of Medicine report entitled Future of Nursing: Leading Change, Advancing Health.  National Nurses Week is an opportune time to highlight nurses and nursing and the scientifically proven contributions that our profession makes to improve health and patient care.

It is also a good time to talk about what we still need to make happen to improve health and health care.  For one thing, we must continue to push for more registered nurses to earn advanced  (masters and doctoral) degrees. This is essential for nursing practice, education and research.  We need many more advanced practice nurses for primary and specialized care, more nurse educators to prepare nurses for the future, and more nurse scientists to continue to build the evidence for our practice and teaching. 

One of the wonderful aspects of a nursing career is that nurses can have multiple careers within it and can be clinicians, teachers and researchers.  We need to advocate for a better educated profession with a higher proportion of nurses having baccalaureate and higher degrees as well as advocate for healthier lifestyle opportunities for our society and for a better health care system for those we care for. 

We must lead for a better future. Nurses should seek to lead, wherever they are, throughout their careers.  Leading requires gaining specific and broad knowledge, taking a public position, being willing to find solutions and engaging in difficult dialogue when necessary.   It also requires us to be willing to speak up inside and outside of nursing, with members of other disciplines. Read More »

Creating a Better Educated Workforce: Transforming Patient Care

Happy National Nurses Week!  The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog will feature posts by nurses, including leaders from some of our nursing programs. Check back each day to see what they have to say. This post is by Geraldine Polly Bednash, PhD, RN, FAAN, Chief Executive Officer/Executive Director of the American Association of Colleges of Nursing (AACN) and National Program Director, New Careers in Nursing (NCIN). 

The environment and systems in which health care is delivered have grown increasingly complex over the last decade.  For some time now, many individuals have contrasted the intensive care unit of the past with the medical surgical units of today, noting there is not much difference.  Patient care is more complex, the technology is more sophisticated, new knowledge is emerging and nurses and other health professionals are being asked to consider the need to have a dramatically increased level of sophistication about how to intervene in all of this.  Moreover, health care knowledge and science is expanding rapidly with new evidence emerging daily about patient care, while the locus of care delivery changes at the same rapid pace.  Just contrast the cataract surgery of today with that done 20 years ago.  Or the increasing focus on care delivered in communities, not acute care systems. 

How do we provide the highest quality care, that is safe, timely, effective, efficient, and patient centered care – the STEEEP scenario – if we do not embrace the importance and value of expanding our capacity to intervene through lifelong learning and through formal education?  And how do we assure that we are prepared to seek that emerging knowledge and apply it in the complex array of systems or circumstances in which care is delivered if we are not continually striving to grow our capacity to intervene? Read More »