Gun violence: A nursing concern?

/ Carey S. Clark, PhD, RN, AHN-BC, RYT, FAAN / 2 Comments

Once again we find ourselves reeling from a mass shooting, this time in a small community college in Oregon. One of the most disturbing reports of the Umpqua Community College incident was that the dead victims’ cell phones were ringing when police and rescue workers arrived on the scene, as their families and friends tried to make contact with them. The heartbreak for this community is palpable; for nursing educators, the concern of wondering if this could happen in our classrooms, in our schools, is unsettling. Some of us might recall the 2002 Arizona nursing faculty mass shooting, where 3 nursing professors were gunned down and killed by a student who had failed a pediatric class and decided that he had the shooting authority and was angry enough, I suppose, I don’t understand really, why.

What has changed since those 2002 shootings? If you scroll through your facebook feed today, it is likely you will find many postings about the statistics of mass shootings, thoughts about how nothing has changed, and debates over stricter gun control. Meanwhile, I feel that nursing should be viewing the gun violence issue as a public health issue, and we could be the ones helping to lead the way in preventing future mass shootings. We have a strong voice, as we recently proved with the “#Drsstethoscope ” and “#nursesunite ” movements; and now perhaps we could unite over some issues that deeply impact the health of all beings on this planet.

The American Public Health Association (APHA) has made clear statements that gun violence is preventable (https://www.apha.org/~/media/files/pdf/factsheets/gun_violence_prevention.ashx). APHA recognizes that gun violence is contagious and has become an epidemic in the United States. APHA recommends that we:

  • Use surveillance techniques to track- gun related deaths and injurious shootings.
  • Focus on identifying the many risk factors for gun violence.
  • Create, implement, and evaluate interventions that reduce these risk factors and support resilience for those who are suffering.
  • Institutionalize prevention strategies.

We also clearly need more research in this area; we need to examine what common sense gun policies might look like, what have other countries implemented; what worked for them, and what has not worked for them.

Nurses and educators can begin in their work places, looking at their own risks within the workplace, and working toward implementing prevention strategies and trainings around what to do should an issue of gun violence begin to emerge.

We need to also reach out to communities, particularly school settings, and develop and support education around gun safety, bullying, mental health issues, and how to ask for help. We need to have mental health services in place that can truly identify and properly intervene with those who are at risk for gun violence.

Nurses could also bond together, #nursesunite, and create a clear voice around stricter gun control. We could do our own research around what has worked in other countries and what that might look like here, and then bring these ideas forward to our lawmakers. At the very least, we could be calling for better access to mental health services for those in need, and early identification of those who might be at risk for perpetuating gun violence. Childhood traumas likely play a role in this issue as well, and supporting the creation of trauma informed schools should be a nursing advocacy issue.

We have power in our numbers; let’s put it to great use. #nursesunite

Humor in Health Care

/ Jane K. Dickinson / 1 Comment

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

/ Peggy L Chinn / 1 Comment

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.

###

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

/ Peggy L Chinn / Leave a comment

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

/ Peggy L Chinn / Leave a comment

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