SON
HOME | CONTENTS | INDEX
OF ISSUES | CONTACT| SON
HOME | CONTENTS | INDEX
OF ISSUES | CONTACT |
|
|
|
|
||
|
In the face of an alarming nationwide shortage of nurses, there’s good news from the admissions office at Hopkins’ School of Nursing: Applications this year to the school’s popular 13-month undergraduate accelerated program doubled from last year, to almost 450.
Due to space limitations, the school will hold the number of students admitted to the accelerated class to about 110. “Of course we would love to be able to admit every applicant because it is always painful to turn students away,” says Sandra Angell, MLA, RN, ’69, associate dean of student affairs. “But our hope is that some of the students we cannot accommodate in the accelerated class will enroll in our traditional two-year undergraduate program. If, however, some of the students we can’t accommodate go on to another nursing school, it will still be a boon to the profession.” She says increased efforts on the part of the school’s admissions office have helped attract more people to the program. “Our staff works very hard, traveling to recruit at colleges, professional organizations, and national conferences,” says Angell. “We are very customer-oriented and strive to give a personal touch to every potential student we interview.” In addition, says Angell, several national efforts — such as the current Johnson & Johnson marketing campaign aimed at recruiting new nurses — have piqued interest in the profession. Angell says students are attracted to the accelerated program at Hopkins because it is flexible and because they can complete their course of study more quickly than in the traditional two-year program. The spike in applications has led to an increased workload for admissions staff members, because each applicant needs to be reviewed carefully. But that, says Angell, “is a nice problem to have.” — Kate Pipkin Associate Professor Linda C. Pugh, PhD, RN, is on a quest to prove that not only is breastfeeding healthier for infants, it is also cost-effective for mothers. Pugh received a $2 million grant from the National Institute of Nursing Research to determine the net cost savings of providing breastfeeding support to low-income women. “Breastfeeding results in savings from the costs of infant formula and lower health care costs for families, and it may be less time consuming,” says Pugh, who also directs the school’s baccalaureate program. “These savings have the potential to offset the costs of promoting breastfeeding.”
Professional and national health organizations recommend that women breastfeed their infants exclusively for the first six months. According to Pugh, however, only 20 percent of low-income women breastfeed for six months, compared to almost 41 percent of more affluent women. Pugh says nearly 35 percent of low-income women stop breastfeeding within eight days of delivery. Her previous research concluded that consistent, comprehensive, and culturally sensitive support from a nurse and a community health worker can increase breastfeeding in low-income women. “Breastfeeding support for low-income women has been neglected by health care providers and information not made available because of unsubstantiated claims that breastfeeding is not cost effective,” says Pugh. The four-year study will compare a group of low-income mothers receiving standard care with a group receiving in-hospital lactation support, telephone support, and home visits from a nurse or community health worker. The study aims to determine if such nurse intervention will increase the duration of breastfeeding among low-income women, and whether that intervention will also lead to cost-savings for mothers. — KP Quiet:
Hospital ZoneZone While quiet seemed an intuitively obvious adjunct to rest and recuperation during a hospital stay, it has become an historic artifact. Pagers, televisions, telephones, and intercoms are just a few of the culprits adding to increased hospital noise. Our hospitals have noise levels that now exceed those recommended by the World Health Organization and the Environmental Protection Agency (40-45 dB(A) during the day and 35 dB(A) at night). Sound levels above 50 dB(A) — the equivalent to the noise in a large office — are sufficient to cause sleep disturbance, and sustained levels above 85 dB(A) — the equivalent of an operating garbage disposal — can damage hearing. Studies have demonstrated that excess noise is correlated with patient annoyance, abnormal sleep patterns, increased length of stay, intensive care “psychosis,” and delayed healing. However, the effects of noise on nursing staff have not been as well studied. Recently, a study was conducted on the Pediatric Intensive Care Unit (PICU) at Johns Hopkins Hospital to measure the level of hospital noise and to determine whether noise could be correlated with nursing stress. Eleven Hopkins PICU nurses participated in the study. Both their heart rates and the environmental sound levels were monitored during a baseline period in a quiet room, and then during three hours while they cared for children. In addition, saliva samples and stress/annoyance ratings were collected. The study demonstrated that the average daytime sound level was 61 dB(A). The average nighttime level was 59 dB(A). In their tests of nurses, researchers found that higher average sound levels predicted higher average heart rates, greater subjective stress, and greater reported annoyance. Across the hospital in the neuroscience intensive care units, our nurses have made noise control a goal. They have reduced noise by decreasing the ringer volume on phones and by decreasing alarm volumes, among other interventions. In addition, each afternoon from 2 to 4 is designated as Quiet Time. Massage, music, and uninterrupted sleep bring respite to the patients — and decreased stress for nurses. Toward Greater Equality of Care Last spring, newspaper headlines trumpeted the findings of a study showing that racial and ethnic minorities receive lower quality health care than whites. The findings of the Institute of Medicine study, co-chaired by School of Nursing dean Martha Hill, were disturbing to many health care providers, and particularly to nurses who often work with underserved populations.
In an effort to curb the inequalities in delivery of care, the School of Nursing has started a Center on Health Disparities Research. The school, in partnership with the North Carolina Agricultural and Technical State University School of Nursing (NC A&T), received a $2.3 million grant from the National Institute of Nursing Research (NINR) to create the center. The effort is one of eight partnerships funded by NINR that join research-intensive universities with primarily minority universities to study disparities in health care. The center, based at Hopkins, aims to promote culturally sensitive nursing interventions that will improve care for underserved populations. Each year the center will accept proposals for pilot research studies from Hopkins and NC A&T faculty members that focus on the areas of health promotion, symptom management, and domestic violence. “The need to explore disparities in health care is great,” says the center’s director and principal investigator, Fannie Gaston-Johansson, DrMedSc, RN, professor of nursing at Hopkins. “Not only will our center increase the number of research projects aimed at eliminating health disparities, it will also expand the number of nurse researchers involved in minority health and health disparities research.” The center’s co-director, Von Best Whitaker, PhD, RNC, assistant dean at NC A&T, says rural and urban areas across the country have communities where people do not have access to quality health care. “Through this partnership and the new center, we will help people have a voice about the health care they receive.” The first three research studies are under way and are led by faculty from both institutions. These projects include the creation of a physical activity model for African American elderly with chronic health conditions, a study of care given to low-income pregnant women in substance abuse treatment, and the development of a nurse intervention effort to reduce health disparities among survivors of domestic violence. — KP Across the country, the current nursing shortage is crippling hospitals and putting stress on an already stretched health care system. One way some hospitals are coping is by recruiting and hiring nurses who have been professionally educated in other countries and cultures. While these nurses can provide quality care to patients, many experience a tough transition into the workplace and wind up abandoning their nursing jobs in the United States.
Enter the Institute for Johns Hopkins Nursing (IJHN), a joint venture of the Johns Hopkins University School of Nursing and the Johns Hopkins Hospital Department of Nursing. IJHN director Kathleen Sabatier, MS, RN, says the number of incoming nurses from other countries such as the Philippines, South Africa, and Korea increased significantly within the last year. “Nurse recruiters at Johns Hopkins saw the need for a program that would help nurse managers, educators, and preceptors respond to the special needs of nurses from other countries and cultures.” The institute’s response is a two-day interactive workshop — called “Success for All” — geared toward providing hospital personnel with the skills to develop cultural fluency. The hospital has a separate training program for foreign nurses that includes workshops on topics such as nursing in the United States and American slang. “When nurses come here from other countries, they feel overwhelmed,” says Karen Spencer, EdD, director of the IJHN project. “They have a new job in a new country and often feel that they are not a part of things. One’s culture can shape the way he or she acts within the professional environment. For example, in some cultures a nurse is not supposed to ask questions of supervisors. You can imagine the problems that can arise if someone is afraid to ask questions. The bottom line is that if nurses feel welcomed and are given clear guidance, they will stay and be effective.” “Success for All” workshops include presentations by Hopkins nurses who have mentored or supervised foreign nurses and a panel discussion featuring overseas nurses who are employed in a U.S. health care setting. Three workshops have already been held in Baltimore with two more scheduled for the fall; another one will be held in Dallas, TX in October and another in Trenton, NJ. “If nurses from other countries feel valued and have a clear sense of what their performance expectations are, then everybody wins,” says Spencer, “the foreign nurse, the nurses already working on the unit, and, most importantly of all — the patient.” — KP An Ambitious Undertaking in Accreditation Within a six-month time frame, the School of Nursing underwent the process of seeking accreditation from two national agencies. In October 2002, the school hosted a visit from the National League for Nursing Accrediting Commission (NLNAC) for re-accreditation; in March 2003, the school welcomed for the first time the American Association of Colleges of Nursing’s (AACN) Commission on Collegiate Nursing Education (CCNE). Confirmation of accreditation has arrived from both NLNAC and CCNE. “My colleagues from other nursing schools have marveled at how we sought accreditation from both at roughly the same time,” says Anne E. Belcher, PhD, RN, senior associate dean for academic affairs. “To go through the process with just one is a huge undertaking.” The accreditation process includes an extensive self-study report and an on-site visit involving tours of the buildings, classroom and clinical observations, and meetings with deans, faculty, and students. “Accreditation is vital,” says Belcher. “It tells peer schools and prospective students that we meet a level of peer-developed standards, it impacts federal funding, and it offers us an opportunity to see where we are, and where we need to go.” — KP Diane Aschenbrenner, MS, RN, is a contributing editor at the American Journal of Nursing for its Drug Watch column. Marion J. Ball, EdD, was awarded the Morris R. Collen Award of Excellence from the American Medical Informatics Association. The award is presented to an individual who has shown leadership and made significant contributions to medical informatics. Kay Cresci, PhD, RN, CCRN, was elected director at large of the National Gerontological Nursing Association. Marion D’Lugoff, MA, RN, CS, was awarded a grant from Reach Out and Read, a national, non-profit organization that promotes early literacy. The grant will facilitate the yearly selection and purchase of books to be distributed to children ages six months to five years who receive physical exams at School of Nursing clinical sites. Lori Edwards, MPH, RN, CS, presented at the American Public Health Association annual meeting about the Amazing Grandmothers Project, which she directs. Amazing Grandmothers is a comprehensive community-based initiative that partners with grandmothers who are the primary caregivers to their grandchildren due to parental substance abuse and provides support to them in their efforts to keep families intact. Victoria Mock, DNSc, RN, AOCN, received the Oncology Nursing Society ¡003 Distinguished Researcher Award, recognizing her outstanding contributions through research that have enhanced the science and practice of oncology nursing. Sharon Olsen, MSN, RN, chaired the 15th Annual International Conference of the International Society of Nurses in Genetics titled “Putting Genetics into Practice.”
Cynda Rushton, DNSc, RN, was selected by the Maryland Governor’s Office to chair the newly-created State Advisory Council on Quality Care at the End of Life. Rushton and Karen Spencer, EdD,ýare co-investigators of a project recently awarded a grant by the HHS Health Resources and Services Administration. “Dissemination of an Interdisciplinary Experiential Training Program for End-of-Life Care and Organ Donation” is one of 11 projects chosen to receive funding from HHS in an effort to increase organ and tissue donation rates. Kathleen Sabatier, MS, RN, wrote the article, “The Institute for Johns Hopkins Nursing: A Collaborative Model for Nursing Practice and Education,” published in the July/August 2002 issue of Nursing Education Perspectives. Janet Selway, CANP, CPNP, was a co-leader for the People to People Ambassadors Program U.S.-China Nursing Delegation, sponsored by the American Nurses Association. About 100 nurses from the U.S. and 100 nurses from China participated in the U.S.-China Joint Nursing Conference, titled “The Role of Nursing in the 21st Century.” Phyllis Sharps, PhD, RN, (presented “Paternity: Risk for Intimate Partner Violence and Femicide” at the American Association of Colleges of Nursing 2002 State of the Science Congress. Daniel Sheridan, PhD, RN, was named president-elect of the International Association of Forensic Nurses. He will transition to the role of president in 2005. He was also awarded the Virginia A. Lynch Pioneer Award in Forensic Nursing by the International Association of Forensic Nurses, honoring an individual who has made exceptional contributions to the field. Laura Talbot, PhD, EdD, RN-C, received a Meritorious Service Medal at recent Pentagon ceremonies. Talbot, a colonel in the United States Air Force Reserve, was recognized for her quick response following the September 11, 2001, terrorist attacks. Upon hearing of the attacks, she traveled to Bolling Air Force Base in Washington and coordinated military assistance to New York City, such as military transport of medical personnel, blood, and supplies. Kathleen White, PhD, RN, presented at the Nursing Management Congress held in Dallas, Texas. Her topic was “Measuring and Maximizing Clinical Outcomes: Take Credit for the Difference You Make.” Marilyn Winkelstein, PhD, RN, ’63, was co-editor of the recently published 7th edition of Wong’s Nursing Care of Infants and Children, a nationally known pediatric text. Theresa Yeo, MSN, MPH, RN, CRNP, was appointed chair of the Critical Care Nursing Editorial Review Group for Doody’s Book Review Service. She also wrote an article on “Epidemiology and Risk Factors in Pancreatic Cancer,” published in the July/August 2002 issue of Current Problems in Cancer.
Sýgma Theta Tau International, the honor society of nursing, has acknowledged the impressive nursing career of Dean Martha N. Hill with one of its most prestigious honors, the Nell J. Watts Lifetime Achievement in Nursing Award. The award is given every other year to an active STTI member who has demonstrated lifetime achievement in nursing, has contributed to nursing in a manner that has long-term significance, and is nationally and/or internationally recognized. Hill’s career in nursing began more than 40 years ago when she came to Hopkins to earn a diploma from the School of Nursing. In the intervening years she has become widely known for her research in controlling hypertension in African Americans, and in ethnic and racial disparities in health care. She is the first and only nurse to serve as president of the American Heart Association, and she has served on the Hopkins faculty for 23 years. “[Dr. Hill’s] scholarly contributions, extraordinary leadership at a major university, and her recognition by organizations and researchers inside and outside nursing combine to make her a most deserving recipient of this lifetime achievement award,” says STTI board member Peter Buerhaus, PhD, RN, senior associate dean for research and the Valere Potter Professor of Nursing at the Vanderbilt University School of Nursing. “This is a wonderful way to recognize an individual who has done so much for the nursing profession and to improve the health and quality of life for so many people.” “Dr. Hill exemplifies all the qualities that make the profession of nursing an honorable one,” concurs STTI board member Fannie Gaston-Johansson, DrMedSc, RN, professor, director of international programs, and director of the Center on Health Disparities Research at Hopkins’ School of Nursing. “She understands the importance of research and outcomes data but has never lost sight of the fact that every patient deserves quality health care.” — Ming Tai
Helping Out in Haiti Spring Break is notorious for being a time when college students head for sunny resorts to get a little R & R after a long winter of studying. Not so for School of Nursing graduate students Sara Russell, Deborah Pearson, and Mara Clamage, who spent their March break working in a remote, poverty-stricken village in Haiti. The three students traveled to Leon, a mountain village in rural southwest Haiti, with nursing faculty members Sara Groves, DrPH, RN, and Elizabeth Sloand, MSN, RN, PNP, as part of the Haiti Medical Mission Program. The program pulls together a multidisciplinary team of volunteer nurses, physicians, pharmacists, and translators to provide primary care to families in poor villages where running water is practically non-existent and the nearest hospital is about an hour’s truck drive away. “Under our supervision, the students provided primary health care, patient education, and community assessment,” explains Sloand. “The goal of the program is to expose nurse practitioner and community health graduate students to rural Haitian culture, lifestyle, and health care needs, and to give them an opportunity to participate in health care delivery in a developing country.”
Preventing Violence in South Africa South African nurse Sinegugu Duma hoped she’d see snow for the first time in her life when she came to Baltimore this past winter, but she didn’t expect to be shoveling out from a 25–inch blizzard. She took it all in stride, however, during her four-month immersion in American culture and academia. Duma, a faculty member from the Department of Nursing at the University of Cape Town, came to Johns Hopkins to attend several courses in Forensic Nursing and to work with some of the school’s violence and forensic experts (see page 22). Duma’s goal while in the United States is to develop a research proposal for her doctoral studies in South Africa. She will work with domestic violence expert Jacquelyn Campbell, PhD, RN, associate dean at the school, and forensic expert Daniel Sheridan, PhD, RN, assistant professor. “In South Africa, sexual assault and violence in general are on the rise,” says Duma. “As health care professionals, we want to respond, but we don’t know how.” Duma’s trip to America is sponsored by the South African Medical Research Council, an organization comparable to the National Institutes of Health. In the U.S., she is living with Sheridan and his family and even helped Sheridan’s son shovel snow. “I was hoping to see a little snow, but this was more than I expected,” laughs Duma. “But besides that I am learning a great deal and am excited to take what I learn here back to South Africa.” Helping undergraduate nursing students take a lead role at the hospital bedside is the focus of a $1.5 million grant that the School of Nursing received recently from the Helene Fuld Health Trust. Known as the Leadership Fellows Program in Clinical Nursing, the funded project prepares undergraduate nursing students to become leaders in clinical settings by enabling them to work with mentoring bedside nurses in a hospital setting. According to Kathleen White, PhD, RN, one of the project’s creators, nursing students will learn how to think critically about quality patient care, and to explore issues that might improve patient safety. “We anticipate that when students are trained to lead efforts to improve patient care and the nursing profession, they will more readily commit to a nursing career that is both professionally and personally rewarding,” says White. The three-year Leadership Fellows Program will pair 40 nursing students a year with clinical nurse mentors who will guide them through the process of identifying a pressing quality or safety concern, leading a multi-disciplinary team, and presenting their ideas for implementation. — KP What do you do if you are a nurse who wants to change some of the nation’s health care policies? Go to Washington, D.C., roll up your sleeves, and get to work. That is what School of Nursing assistant professor Ellen-Marie Whelan, PhD, RN, plans to do in September. Whelan is one of seven recipients of a 2003 Robert Wood Johnson Health Policy Fellowship. The national fellowship program gives exceptional mid-career health professionals and behavioral and social scientists with an interest in health the opportunity to participate in health policy processes at the federal level. After a three-month orientation, fellows receive full-time work assignments in either the legislative or the executive branch of the federal government, then return to their respective institutions and are supported for two years to complete an approved plan for their continued development as health policy leaders. “I am thrilled to be named an RWJ fellow,” says Whelan, who holds a joint appointment with the university’s Urban Health Institute. “Through work in urban health, I have come to believe important changes in health care delivery must be implemented at the policy level. ” Some of the policy changes Whelan would like to see include better implementation of the federal Children’s Health Insurance Program, more attention paid to disparities in health care delivery, and implementation of concrete policies aimed at relieving the national nursing shortage. In 1993, Whelan started a nurse-run primary care clinic in Philadelphia. Her most recent project involves studying the efficacy of the primary care delivery system provided by the Johns Hopkins Health System in East Baltimore. “The fellowship is a prestigious and honorable award, not just for Ellen-Marie, but for the entire School of Nursing,” says Dean Martha N. Hill. “Ellen-Marie is well-positioned to apply her health policy skills and grow into a position working at the federal level.” — KP
|
||||||||
Copyright© 2003 Johns
Hopkins University School of Nursing.
|
|||||||||
|
|
||||||||
Highway
signs reminding us to be quiet as we drive past a hospital are a thing
of the past. And so is the quiet.
