Humor in Health Care


There has been plenty of discussion about Kelley Johnson’s monologue and comments from The View. I just took a look at the response from the President of the American Nurses Association, who said, “Nurses don’t wear costumes; they save lives.” and its true, you won’t ever see a nurse wearing joker teeth welcoming a patient.

I am grateful to all the people who have stood up for nurses by responding, supporting, and making us feel like the honorable, trusted, and caring profession that we are. I am also thankful to Pamela Cipriano for her quote above, because that has encouraged me to take a lighter approach in this blog article. Everything doesn’t always have to be heavy or philosophical or serious, right?

While I understand what Pamela meant by “Nurses don’t wear costumes,” I will share that I did wear a costume once, when I was a staff nurse on an adolescent unit. It was Halloween and most of the nurses dressed in costumes that day. I was taking care of a particular 14-year-old boy who needed a new IV placed. In all my costumed glory, I went in and put an IV in this adolescent’s arm. His dad sat by the bedside as I did so. And his dad was a VP of the hospital. I never knew if that patient’s father was amused by my costume or annoyed thinking I wasn’t taking my job seriously. He didn’t say anything to me about it.

I sometimes think back to that experience, especially around Halloween, and wonder when it’s ok to infuse humor into health care. I sometimes use humor with patients I see for diabetes education, but then again those visits are not life or death situations. Hospital staff where I work still dress up every year, but I have never worn a costume to work again.

Personally, I like and appreciate humor. But when I’m the patient I do expect health care professionals to use it appropriately. I remember when I was a patient in room # e111, a joke that I didn’t “get” was sort of an issue I didn’t want on my mind. I’ve noticed in the Diabetes Online Community that people often discuss with frustration the jokes that are told about diabetes. Sometimes funny things happen to nurses at work, and those times (and memories) can help us get through tough jobs. In fact, humor can be one way nurses take care of themselves. Are there ways we can use humor to help people heal?

How do you use humor in health care? Or what funny thing that has happened while you were working in a health care setting? What did you learn from the experience?

American Academy of Nursing Calls for Collective Action to Include Social and Behavioral Determinants of Health in the Electronic Health Record


This is a major policy position that all NurseManifesters should know about!!

From: American Academy of Nursing <aan>

Subject: News Release: American Academy of Nursing Calls for Collective Action to Include Social and Behavioral Determinants of Health in the Electronic Health Record

Date: September 14, 2015 at 4:18:28 AM PDT

To: peggy.chinn

Reply-To: elyse_petroni

American Academy of Nursing Calls for Collective Action to Include Social and Behavioral Determinants of Health in the Electronic Health Record

Academy Releases Policy Brief Identifying Action Items for Health Care Industry

Washington, D.C. (September 14, 2015) –The American Academy of Nursing has released a policy brief that endorses the capturing of social and behavioral determinants of health in the electronic health record (EHR). The policy brief identifies several recommendations for health care industry leaders to foster standardization and promote interoperability.

The policy brief is published in the September/October issue of the Academy’s journal, Nursing Outlook.

“There is strong evidence that social and behavioral factors influence health; however, they may not be addressed in clinical care for shared decision-making. It is imperative that all stakeholders in health care collaborate to include this information in electronic records, including EHR vendors, health systems, providers and funders,” said Academy CEO, Cheryl Sullivan.

The policy brief states the Academy’s support for recommendations put forth by the Institute of Medicine (IOM) in a 2014 report, “Capturing Social and Behavioral Domains and Measures in Electronic Health Records (Phase 1 and Phase 2).” Identified barriers to the implementation of IOM’s phase 2 recommendations include:

  1. Lack of commitment to standardization of clinical practice, documentation and data.
  2. Lack of consistency and ease-of-use of clinical workflow within EHR technology.
  3. Need for increased patient empowerment and culture of trust.

These barriers prohibit the adoption of a standardized assessment panel of approximately 20 questions put forth by the IOM addressing: Alcohol use; Race/Ethnicity; Residential address; Tobacco use; Median household income; Depression; Educational attainment; Financial resource strain; Intimate partner violence for women of reproductive age; Physical activity; Social isolation; and Stress.

The policy brief states:

“…The recommended action steps of multi-stakeholders will begin to address the global changes that must be made in clinical practice to assure EHRs capture and permit sharing of contextual patient information, promote shared decision-making, enhance appropriate inter-professional planning/providing of health care services and facilitate monitoring of patterns of health and outcomes of care for entire populations.”

Read the full policy brief.

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About the American Academy of Nursing

The American Academy of Nursing (http://www.AANnet.org) serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The Academy’s more than 2,300 fellows are nursing’s most accomplished leaders in education, management, practice, and research. They have been recognized for their extraordinary contributions to nursing and health care

CONTACT: Elyse Petroni

202-777-1174

Elyse_Petroni

Connecting with Consumers


One of the directions that this project points to is forming connections and alliances with consumers – working together with people in many different sectors to improve health and well-being for all. Often these kinds of connections are part of nurses’ everyday experience and as gratifying as they are, few know, appreciate or are inspired by the significance of these connections.  And, nurses’ perspectives rarely make it to the public media where the general public is exposed to information that might influence their choices related to health and healthcare.

So I was quite excited to learn about the American Academy of Nursing teaming up with the “Choosing Wisely” campaign of Consumer Reports to produce two consumer brochures:

Monitoring your baby’s heartbeat during labor: There are two ways to do it, and most women have a choice, which explains the choices women have related to fetal monitoring, and ways to make labor and birth easier.

and

Hospital Hazards Four practices that can harm older people, which addresses the hazards involved with bed rest, physical restraints, interrupted sleep, and urinary catheters.

Even the titles of these brochures implies an important nursing perspective!  Of course these are only two of over 60 brochures, but in my view, this is a break-through of sorts, and I hope we will see many more instances like this!  It all starts with imagining what is possible, and each one of us taking small steps to create the small everyday connections that make the more publicly visible connections possible!

Virtual Caring Science


We have received notice from Kathleen Sitzman of a wonderful online opportunity for everyone who is interested in focusing more clearly on caring in online situations!  Here is the information that Kathleen sent:

Hi Everyone,

I am sending this message to you because you have (at some point) shown an interest in my work related to conveying and sustaining caring in online classrooms. I have completed 6 studies on the subject now, and I wanted to create something that would condense my findings and recommendations into something that people can quickly and easily use. To that end, I worked with the Office of Faculty Excellence at East Carolina University (where I am a professor in the college of nursing) to create and offer two FREE trainings. The flyer with sign-up information is attached. You will need to follow the directions for non-ECU participants.

The two trainings are:

  • Conveying and Sustaining Caring in Online Classrooms
  • Mindful Communication for Caring Online

These are self-paced, do-anytime, independent study trainings. I have placed them in a format that can be completed by anyone who has access to a computer. The first training takes about 90 minutes and the second training takes about 60 minutes. People who complete the trainings get certificates of completion for each one.

The trainings have just opened up and already 20 people (many of them outside of the nursing profession) have completed the trainings and found them to be very helpful. Here at ECU, people can complete them for their annual Distance Education (DE)  professional development requirement. Please let me know what you think and please share the flyer with others who might benefit.

 Sending love,
Kathleen Sitzman, PhD, RN, CNE
Professor
East Carolina University College of Nursing

Download the flyer here

Access the modules online here

The Promise of Nursing: Social Justice and Health


Those of us who have been involved in the Nurse Manifest Project are deeply committed to the idea of social justice – the notion that reaching for social justice is fundamental to human health and well-being and that social justice is central to our purpose.  It is the promise we make to individuals and to communities when we claim to care for each and every person for whom we care. But like many other social concepts and ideals, the meaning of social justice often alludes us. So I decided to ask all of our NurseManifest bloggers to share, in just a couple of sentences, their concept of social justice!  Here is what they sent: 

Elizabeth: On my walk the morning, I recall thinking that “social justice” is not a noun but a verb. It is not something that is, rather it is what you do. It is one’s life’s work. Well, it is my life’s work.

Carey: I think in nursing we can view social justice as our ethical obligation to support the healing of those who are suffering due to social inequities and the promotion of equality and human rights in the society which we serve.

Sue: My belief is that social justice is the process of questioning privilege and whose interest is being served.  Of course, there’s also courage– to question, to act, to be vulnerable, and to be part of a collective that holds social justice dear.

Marlaine: Social justice is about creating compassionate social, political and economic structures (such as laws, policies, organizations) that preserve dignity, equity, equality and human flourishing.

Danny: Social justice in nursing means that nurses keep their focus on facilitating humanization whereby every person is provided the means for health, meaning, and well-being in both living and dying and treated with moral respect and dignity. Social justice in nursing necessarily requires nurses to examine and address the underlying person-environment root causes of dehumanization and social injustices that prevent human flourishing and individual and societal well-being.

Richard: Social justice is an expression of a society that values, appreciates, and fosters the freedom and equanimity of all peoples and all creatures to live fully in accord with their greatest and highest good, health, and well-being.

Olga: Social justice is an ideal or core value that emphasizes the creation of conditions that ensure human dignity for all. Social justice (human dignity) can be achieved under conditions of extreme poverty or ill health, and also can be destroyed under seemingly optimal economic conditions, or by well-intentioned (i.e., paternalistic) actions.  

Lisa: Social justice is the equitable distribution of resources and power whereby no individual or group is privileged over another and all have a fair opportunity to contribute, receive, and flourish.

Wendy: Social justice is the embodiment of personal and professional values that uphold and protect the sacred and inherent worth of all human beings to live their lives in freedom; Freedom to express, develop and explore ones individual and unique self on all levels, without religious, societal and hegemonic constraints or condemnation. Nurses advocate for social justice when they address barriers that restrict freedom for self, others, patients and families.

Jane: For me social justice means simply treating others as we would like to be treated. It means creating a society where people feel empowered to succeed and live well emotionally and physically – in every possible aspect of life. It means building on people’s strengths, not weaknesses, so that they can become even stronger.  I tend to think of things in terms of health, but I truly believe the preceding applies to work, relationships, and everything else people experience in society.

Adeline: For me social justice is both an ideal of an equitable (not to be confused with equal) distribution of societal resources and advantages and an ethic that requires us to work towards achieving the ideal.   

For me (Peggy), social justice is all of these things – and my fundamental perspective rests in the understanding that we all participate in the structures that create and sustain social injustice in the world.  Some of these structures we cannot change – after all we live and participate in societies that inherently structure advantage for some and disadvantage for others.  For me our first step toward creating social justice is to understand the ways in which the healthcare systems in which we participate create and sustain injustice, then work with utter dedication to changing what we can.  As noted in the reflections above, social justice is a verb, it is action, and it takes courage!  May our words of reflection lend courage to your dedication to this human endeavor!

social justice wordle