The Center for Rural Health and Nursing is funded by a $4 million legislative appropriation by the state of Texas. The funding will support the center’s efforts to improve rural nursing education and the health outcomes of rural populations.
“I am very thankful of the Legislature for its support of the University’s efforts to educate and train the next generation of rural health care providers,” said Teik C. Lim, UTA interim president. “Through this new center, we can significantly expand the reach of one of the nation’s top nursing programs to improve the health of rural Texans.”
Elizabeth Merwin, the center’s executive director and dean of CONHI, hopes the center will develop and foster a model for providing nursing education to rural residents aiming to become registered nurses and nurse practitioners. This model will support and educate those students while they reside in their home communities. It will also aim to reduce the shortage of nurses and other health providers in an effort to support access to health care for Texas’ rural populations.
“Thanks to generous funding by the state of Texas, CONHI will be able to form sustainable partnerships with rural communities that improve the quality of life for underserved populations in those areas,” Merwin said. “Our goal is to form close relationships with key organizations and stakeholders within rural communities in Texas to improve access to health care by enhancing the health professional workforce.”
In its first year, the center will develop partnerships in rural communities to perform educational needs assessments of registered nurses and nurse practitioners. Once needs have been identified, the center will provide training to support the communities’ current health care providers and educate new, incoming nurses and health professionals.
“UTA has a proven track record both in Texas and nationwide as a leading center of excellence for nursing education,” state Sen. Kelly Hancock said. “I have great confidence in the university’s ability, through its new Center for Rural Health and Nursing, to bring its nationally recognized nursing education and training programs to improve both nursing education and health outcomes in our state’s rural communities.”
Aspen Drude, the center’s manager, said the center aims to support existing providers and recruit young people from rural populations to become nurses in their communities.
“We want to make sure students who are in rural high schools and community colleges have paths into our programs,” Drude said. “We hope that our continuing education programs will meet the needs of current nurses and increase opportunities for rural residents, while meeting the workforce needs of the rural community.”
The center’s nursing education initiatives will be supported by Elanda Douglas, a clinical assistant professor and nurse practitioner with extensive experience as a family nurse practitioner.
“It’s really important for nursing students to understand that when they work in rural communities, they have to be well-rounded because they could be the only nurse in the clinic,” Douglas said. “Our rural health curriculum will prepare students with a broad set of skills to meet the day-to-day demands of rural care.”
According to the Centers for Disease Control and Prevention, rural Americans face numerous health disparities compared with their urban counterparts. They are more likely to die from heart disease, cancer, unintentional injury, respiratory disease and stroke. Factors that put them at greater risk include higher rates of smoking, lower physical activity and less access to health care and health insurance. Rural communities also face unique workforce challenges and, too often, shortages of health care providers.
Reshma Thomas is a first-year student in CONHI’s Master of Science in Nursing program who has joined the center as a student nursing assistant. As a family nurse practitioner in training, Thomas is passionate about serving vulnerable rural populations.
“Nearly 25% of Texas’ population lives in rural communities and suffers from harmful health disparities and lack of care,” Thomas said. “Providing preventive care and raising the health care standards in these communities is vital.”
The American Nurses Association (ANA) and the American Nurses Foundation (the Foundation) have announced the winners of the 2022 ANA Innovation Awards sponsored by Stryker, a leading global medical technology company. The ANA Innovation Awards highlight, recognize and celebrate exemplary nurse-led innovations that improve patient safety and health outcomes.
Congratulations to all of the winners!
Winner of the Individual Nurse Award
KaSheta Johnson Jackson, DNP, RN
Vice President, Health Equity and Social Impact, Vidant Health
Kasheta Jackson developed Community Pop-Ups: A Rural Approach, an innovative health care delivery model implemented as community-based pop-up clinics across Eastern North Carolina to address social and economic health care barriers . This program makes health care both more accessible and approachable by directly providing preventative services, improving health care equity, and offering resources within communities with the greatest need. This is done through a system-level collaboration at Vidant Health with community-focused intervention. Through partnerships with community leaders and other Vidant Health team members, these clinics have evolved from solely offering health care screenings to providing COVID-19 testing, vaccinations, mental health resources, access to fresh produce, and employment opportunities.
Community Pop-Ups have been held in a variety of informal community settings, including baseball fields, farms, and parks, to build trust and improve community engagement. Designed and led by nurses, Community Pop-Ups follows the tenets of a holistic nursing care plan, addressing the community’s physical, mental, and environmental needs. In 2021, Community Pop-Ups provided care to more than 400 community participants, identified acute diseases, provided numerous jobs, gave away 500 produce boxes, and delivered 500 health passports in rural locations across Eastern North Carolina. In 2022, Community Pop-Ups plans to make a more substantial impact in the communities it reaches and establish a model for addressing the social determinants of health through qualitative data.
Winners of the Nurse-led Team Award
[foogallery id=”62119″]
Michael Pickett, MSN, APRN, CPNP, Pediatric Nurse Practitioner at Texas Children’s Hospital
Marilyn Hockenberry, PhD, RN, FAAN, Professor of Pediatrics and Director of Global HOPE Nursing at Baylor College of Medicine
Jaime Choate, MSN, RN, NPD-BC, Nursing Professional Development Specialist at Texas Children’s Hospital
Tadala Mulemba, BScNM, RN, Global HOPE Nursing Assistant Director at Baylor College of Medicine
Jeannie Eggers MSN, RN, CPN, CCRN, Simulation Education Specialist, Quality Education & Simulation Team at Texas Children’s Hospital
A multidisciplinary team of frontline nurses developed the RediStik® Wearable Simulation Task Trainers. They identified educational gaps in the lack of realistic, versatile, and engaging training tools for nurses to learn skills in peripheral intravenous (PIV), Port-a-Cath, and Central Venous Catheter (CVC) care and maintenance. Nurses and other health care professionals are trained to insert peripheral and central venous catheters to administer fluids, draw blood, and deliver medications. The RediStik® innovation offers nurses the opportunity to have hands-on practice while receiving real-time feedback from instructors via zoom. Nurses have access to a system of individual and wearable simulation trainers as well as immersive skills videos filmed from the nurses’ point of view, which are accessible on YouTube® and through a QR code found on the RediStik® Kits.
The RediStik® Wearable Simulation Task Trainer project exceeded initial design goals and has proven to be an asset to the nursing community, according to survey data. Prior to training, 15% of nurses surveyed said they were “confident” on starting PIV lines. After training, 96% of nurses surveyed were “confident”. Nurse confidence and patient outcomes improved not only in Houston, Texas, but in Sub-Saharan Africa through Texas Children’s Hospital’s partnership with the Global HOPE (Hematology Oncology Pediatric Excellence) initiative, which is dedicated to treating and dramatically improving the prognosis for children with cancer and blood disorders in sub-Saharan Africa. The funds from this award will support the distribution of the RediStik® trainers to additional health care systems and nursing schools both locally and internationally.
Nurse innovators made incredible strides in turbulent times
“The 2022 ANA Innovation award winners have proven that nurses are able to make incredible strides and improve health while navigating turbulent times. These nurses created solutions that scaled beyond their organizations, into their communities, and globally,” said ANA Vice President of Nursing Innovation, Oriana Beaudet, DNP, RN, PHN. “Nurses are the conduits of positive change across health care through their work and advocacy, which was solidified by the Gallup ranking as the Most Honest and Ethical Professions for the 20th consecutive year.”
“As a loyal advocate and supporter of the nursing community, we are honored to partner with ANA and the Foundation as a proud sponsor of the ANA Innovation Awards,” said Stryker’s Vice President and General Manager, Jessica Mathieson. “This year’s winners truly embody the meaning of nurse-led innovation, and we can’t wait to see their ideas expand and grow.”
The 2022 individual nurse and nurse-led team, ANA Innovation Award recipients, will receive monetary prizes of $25,000 and $50,000, respectively. These funds support translational research, development, prototyping, production, testing, and the implementation of these innovations. The award winners will have one year to further develop their innovation and will share their outcomes and findings in 2023. The ANA Innovation Awards are sponsored by Stryker.
You can celebrate these incredible nurse innovators at the 2022 Navigate Nursing Webinar. All are encouraged to attend – nurses, communities, industry members, health care leaders, health systems, innovators, schools of nursing and public health, and nursing advocates. The 2022 Webinar expands upon how nurses can lead in new ways moving into the future.
You can also learn more about how ANA is supporting nurse-led innovation by visiting the ANA Innovation website, where you will also find a list of resources, upcoming events, and nurse-led innovation stories.
Nurse of the Week Mary Schaaf has been a nurse since the days of white uniform dresses and nurse caps. She’s 77 now but has no plans to retire at this point. On March 25, the 77-year-old Omaha RN will celebrate a half-century in the profession, and already admiring colleagues are honoring her commitment by referring to her as a “Mother Teresa of Nursing!”
Every other weekend, Schaaf works her shift at the Millard Good Samaritan Society nursing home, where she cares for about 20 residents during a shift. She’s in great demand, though. While a co-worker might have renamed her in honor of the famously devout modern nurse, she is a decidedly more approachable figure than the formidable Mother T.
Coworkers are excited about Schaff’s Golden Anniversary in nursing. “The basis for how she has worked as a nurse is to be a friend and be in touch with people. It’s always been that love and kindness and respect for other people,” said Mary Spengler, the former colleague who came up with the Mother Teresa monicker. In fact, it’s quite common for patients to ask and even insist on her presence.
Co-worker Judy Sealer certainly became a fan after Schaaf cared for her mother at God Samaritan. Sealer revealed, “She would be at the door welcoming new residents.” She also watched the veteran nurse offering comfort and bore witness to Schaaf’s gift for bedside nursing and ability to make residents feel more secure in her care. “She would hold their hands during death,” Said Sealer, who also noted her reassuring attendance at funerals, and, added that she was always available to comfort loved ones.
“Thank you, mother, for being here and taking care of us.”
Schaff is a “Dream team member,” says Millard Good Samaritan Society’s Vice President of Operations Aimee Middleton. Middleton added that residents regularly check to see whether the nurse who always looks out for them is on duty. According to Omaha.com, “One even refuses to do her daily exercise unless Schaaf walks with her,” and another resident says, ‘Thank you, mother, for being here and taking care of us,’ every time she helps him.”
And Schaff goes out of her way to help. She stays late when someone needs her special brand of comfort, runs grocery and necessity errands, and readily offers all sorts of attentions that loom large among residents who might otherwise feel isolated, ignored, and uncared for. They know that this nurse is 100% there for them.
Schaff seems to think it’s quite simple. “I’ve always tried to treat the residents like I would a family member and to be patient with them if they had concerns or anything,” she said. “I was always willing to sit down with them and listen to them.” And how on earth could she leave a job that doesn’t “really feel like it was a job.” She describes her workplace as “One big family. You got to know the residents’ families and it was just wonderful to be able to do that.”
See the full story on Mary Schaff’s upcoming golden nursing anniversary.
Stephanie Morgan, PhD, RN, FNP-BC, is no stranger to setting up and maintaining COVID-19 vaccination clinics. Thanks to her work with the team of nursing faculty and students, other health care providers, and volunteers that was formed in December 2020 when the vaccine first became available, she has been able to pull together and train teams to work with children, ages 5 to 11 in elementary and middle schools in Del Valle, an underserved community in southeast Austin.
“Depending on the size of the event we need one to two non-clinical check-in individuals, two to four vaccinators, one to two mixers, one observation individual and a clinical lead,” she said. “On the day of the event, we estimate the number of vaccines to be administered and pack vaccine and supplies according to that estimation.”
The team arrives at the event one hour before the start time to set up and prepare the first vials of vaccine. Once they assemble, they conduct a brief with team members so everyone is clear on the plan and can ask questions.
“Likewise, when the vaccine clinic event is over, we debrief to determine what worked well and identify opportunities for improvement next time,” Dr. Morgan said. “At the conclusion, an event report is required to capture a summary that includes the type of vaccine(s) administered, doses given (first, second, immunocompromised or booster) and totals. It also includes doses wasted and if the waste was in a vial or syringe.”
BSNs learn the Covid-19 vaccine routine—and pick up some clinical pediatric experience
Across town, Amayrany Maya-Mora, BSN, RN, and public health nurse at the School of Nursing’s Children’s Wellness Clinic (CWC), begins her day by checking the clinic’s refrigerator and freezer temperatures to ensure that all vaccines are maintained in the proper storage conditions. She then checks in with the front office staff to see if any children are waiting to receive vaccines during the morning walk-in clinic.
“During our daily walk-in clinic at CWC, which runs from 8 to 9 a.m., we usually serve around five to seven children,” Maya-Mora said. “I follow this up by entering vaccine data into Immtrac, the state vaccine registry, order vaccines and supplies, and prepare for any upcoming vaccine events.”
The CWC staff spent a lot of time prior to the Centers for Disease Control and Prevention authorization of the Pfizer and BioNTech SE COVID-19 vaccine for use in children 5 to 11 years old. Once the authorization was given in October 2021, the UT Austin School of Nursing was primed to begin providing it at both the CWC and the Family Wellness Clinic in addition to the area schools.
“Although the basic foundation for providing vaccinations at CWC was already in place, we still needed to provide more specific training,” Maya-Mora said. “We already give vaccines to children, but the COVID vaccine is different in its storage and reconstitution. Plus, we knew training would help boost the confidence of outside volunteers and nursing students. Vaccinating young children can be stressful if not done properly.”
“It’s important to be honest with children.”
Fortunately, Eduardo Chavez, PhD, RN, and a clinical assistant professor at the School of Nursing, had created a power-point training outlining creative ways to help volunteers feel confident and create a more relaxed atmosphere for children getting vaccinated. The slide show demonstrated how to safely hold pediatric patients, addressed appropriate needle lengths and provided communication techniques on how to talk honestly to children. “It’s important to be honest with children,” Maya-Mora added.
In addition, the team provided information to parents and others in the community.
“We made available information about studies and trials regarding the risk of side effects and what types of side effects they might expect,” Maya-Mora said. “There has been a great response, and parents have been very excited about our being able to partner with the Del Valle Independent School District and offer vaccines at their children’s schools. Unlike the CWC, not all pediatric clinics around the Austin area offer the vaccine, so we also provide Saturday clinics at Dailey Middle School and at the Opportunity Center at Del Valle High School. These walk-in clinics will be open through January from 9 a.m. to 2 p.m. It’s very important for parents to remember it’s a two-shot process.”
“Because the School of Nursing was prepared to administer vaccines as soon as they arrived, Del Valle ISD was the first Travis County school district to offer vaccinations in their schools with both doses available before the end of the year,” Dr. Morgan said. “That will amount to an average of 70 vaccinations given at each of the nine elementary schools in Del Valle. Parents who take advantage of these free clinics in their own communities can now relax, knowing that their kids — and their schools — are safer. Vaccinating children is an art, but with training, encouragement, and teamwork, we can increase the number of vaccinators and ensure that children are able to receive the COVID vaccine.”
A new Pennsylvania study published in Health Affairs shows that Medicare support for clinical training for nurse practitioners would increase their numbers and address the national shortage of primary care.
Co-author Linda Aiken, PhD, RN, said, “One in four Americans, or over 80 million people, lack a primary care provider. Nurse practitioners with advanced clinical training in primary care help the public obtain health care when they need it. There are plenty of qualified applicants to university NP programs, but admissions are limited because we don’t have enough primary care clinicians to supervise student learners in their practices.”
The Graduate Nurse Education Demonstration, launched under the Affordable Care Act, provided selected hospitals with Medicare funding to help offset costs associated with clinical training of NPs. The funded hospitals were:
The Hospital of the University of Pennsylvania in Philadelphia, PA
Duke University Hospital in Durham, NC
Rush University Hospital in Chicago, IL
Scottsdale Healthcare Medical Center in Scottsdale, AZ
These hospitals created partnerships with university NP educational programs. The largest of the funded sites was the Hospital of the University of Pennsylvania, which served as a regional hub for a network comprising 9 universities with NP graduate programs, multiple hospitals and health systems, and many community-based primary care practices.
Co-author Regina Cunningham, PhD, RN, Chief Executive Officer of the Hospital of the University of Pennsylvania, said, “The GNE Demonstration shows that longstanding challenges in health care like the shortage of primary care providers can be successfully addressed when health care organizations in communities band together for the common good. Working together in Philadelphia across health systems, public clinics, private medical practices, and schools of nursing, we were able to recruit a larger number of practicing physicians and nurse practitioners to mentor NP students to help them meet their 2 clinical training requirements of 500 or more hours thus enabling nursing schools to accept more student NPs.”
First author Joshua Porat-Dahlerbruch notes, “The cost of clinical training for one nurse practitioner in the GNE Demonstration was about $47,000 compared to the cost of clinical training for a primary care physician of over $157,000.”
The GNE funds were used to support preceptors mostly practicing in community-based settings. The GNE Demonstration also showed the success and feasibility of using regional consortia to distribute Medicare training funds to a limited number of hospitals for training nurse practitioner students. This is a promising way to modernize Medicare graduate medical education to produce more of primary care providers that this country needs.
Funding for the study was from the Centers for Medicare and Medicaid Services and the National Institute of Nursing Research/NIH.
Park City, Utah — which comes alive during the winter ski season and annual Sundance Film Festival — is home to the Park City Hospital, which has 460 employees. As in countless hospitals across the country, the demands of covid-19 at times overwhelmed the facility and dramatically changed the way caregivers interact with patients.
“The last year and a half have taken a toll on us,” said Jodie Connelly, nurse manager of the intensive care unit at the hospital, which is part of the Intermountain Healthcare System based in Salt Lake City. “Nurses have pretty thick skins, but the pandemic has tested us in ways we’ve never really been tested before.”
The community the hospital serves noticed that strain and came up with a novel idea to help the hospital’s workers. Park City’s residents raised enough money — through contributions from more than a dozen residents and two large seed donors — to fund a pop-up grocery store out of a room in the hospital that had been a private dining area.
The hospital uses about $10,000 of the donations each month to stock the store, and all goods are free to any hospital employee.
At first, the store offered ready-made pasta, chicken and mashed potatoes, and other meals, including vegetarian options, that caregivers could take home or eat during their shift. Later, grocery basics such as milk and eggs were added for employees to stock their fridge. Today, the Park City Hospital store has expanded to include non-perishable items such as cereal, sugar, oatmeal and pasta, plus a variety of fresh produce options.
Connelly said she especially appreciates convenient access to fresh fruits and vegetables. “While I keep my pantry at home full of nonperishables, I would have to stop at the grocery store more often if I wasn’t able to take fresh produce home with me,” she said.
Selene Macotela-Garcia, a food service supervisor at the hospital who stocks the store, said she tries to find a variety of items to offer. “Everyone gets excited when we bring in new items,” she said. She recently added lemons, eggplant, beets and cabbage to the mix. “Having sweet potatoes before Thanksgiving was especially popular,” she said.
Macotela-Garcia explained that some employees pick up enough ready-made food to bring home a precooked meal for each family member instead of having to prepare something once they arrive.
The store allows the hospital’s staff to avoid public places where the risk of covid transmission is high, such as grocery stores, and helps them save money. “Finances have been tight; some of us need help more than people may realize,” said Gregoria Taboada, a food service worker at the hospital who frequents the store.
But the store has been useful in helping the hospital’s caregivers save on a commodity in especially short supply these days: time.
“It means so much to me that after a 13-hour shift I don’t have to stop at a grocery store to pick up the basics.”
Work-life balance is hard to maintain as the toll from pandemic care has driven some employees to quit and those remaining are often asked to pick up the slack.
“I started taking on extra shifts each week to help out,” said Katie Peabody, a nurse in the hospital’s intensive care unit. “I frequently work 50-plus hours a week doing work that has become so physically, emotionally and mentally taxing,” she said.
Grueling labor conditions are among many factors noted in a recent Mayo Clinic study showing why nurses have suicidal thoughts more frequently than people in other professions.
“Sometimes there are only two nurses in the ICU with no techs or secretaries to field phone calls or help out,” Peabody said.
While Utah is among the bottom half of fully vaccinated states, Park City’s Summit County is the most vaccinated in the state with 80% of its residents fully vaccinated. Because of the city’s high number of tourists, however, the county’s current transmission level is still rated in the highest category.
The store is also a boost to morale, workers said, especially as they cope with another change of late: patients who no longer trust or appreciate them. “None of us are looking to be a hero,” Connelly said, “but we used to have a great relationship with our patients and their families. That has changed in many cases during the pandemic.”
She noted that almost all the covid patients she’s treated this year are unvaccinated and most have very strong feelings about preventive measures such as the use of masks and vaccines. She said many patients believe what they see on social media over the treatment options the hospital staff recommends.
“Some don’t believe they have covid while we’re treating them for the disease,” she lamented. “Some refuse to even wear their oxygen [mask]; they argue with us about everything. … Some people are downright mean.”
Although such patients may be the exception, negative interactions take a toll that staff members said the store helps make up for.
“The hospital store is evidence that we are valued,” Peabody added. “Even when some patients tell us otherwise, every time I visit the store I’m reminded that there are people out there who appreciate me and are trying to take care of me just like I’m trying to take care of others.”
For more on Park City community support for the hospital see this story in the Park Record.
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
Kasheta Jackson developed 
