Our Nurse of the Week is Gaithersburg High School in Maryland where students are learning how to nurse by practicing on nursing home patients. As part of a partnership with Ingleside at King Farm, a Rockville retirement community with a nursing home on site, a dozen students from the high school program are training to become certified nursing assistants and geriatric nursing assistants.
Now in the second year of the intensive program, the goal is to prepare students for careers in healthcare. Students don’t pay tuition for the program funded by William Leahy, a neurologist on Ingleside’s board of directors who founded the program and hopes to expand it. The students are taught by Linda Hall, a nursing professor at Montgomery College’s Workforce Development and Continuing Education division.
Students in the program are part of a 4 day-a-week course that takes place outside school hours. It combines 88 hours of classroom learning with 60 hours of clinical training and working with actual residents at Ingleside. After completing the program, students are eligible to apply for nursing assistant state certification or take the geriatric nursing assistant (GNA) exam.
To learn more about the students in the program and their experiences, visit The Washington Post.
In the midst of a nationwide nursing shortage, many nursing schools around the country have attempted to increase their capacity for incoming classes which isn’t always possible because of insufficient faculty numbers. The Johns Hopkins School of Nursing (JHSON) has responded by promoting six faculty members to full professorship.
In addition, 19 new faculty members were hired throughout 2016, adding faculty in new specialties including pediatrics, geriatrics, mental health, cardiovascular, community health, women’s health, and more. “With nurses ever in demand and a dire need for more faculty, I am excited to be able to combine the experience and expertise of our current and new faculty to help fill the need for nurses and teachers across the world,” said JHSON Dean Patricia Davidson in a press release from Newswise.com. The six newly promoted faculty members include:
Department of Community-Public Health:
Hae-Ra Han, PhD, RN, FAAN
Sarah Szanton, PhD, ANP, FAAN
Elizabeth Tanner, PhD, RN, FAAN
Department of Acute and Chronic Care:
Deborah Finnell, DNS, PMHNP-BC, CARN-AP, FAAN
Cheryl Dennison Himmelfarb, PhD, RN, ANP, FAAN
Kathleen White, PhD, RN, NEA-BA, FAAN
You can read more about the JHSON faculty and their research, expertise, publications, awards, and honors here.
Sarah L. Szanton, an Associate Professor at the Johns Hopkins School of Nursing (JHSON), was named one of the top 50 “Influencers in Aging” by Next Avenue, a digital publication covering perspectives on issues for older Americans.
Next Avenue’s list of influencers for 2016 included advocates, researchers, thought leaders, writers, and experts whose work is at the forefront of improving aging. Szanton was pleased to be highlighted among so many wonderful leaders who share a passion for aging. Older adults offer so much to a community and their vital wisdom, knowledge, and experience can become even more beneficial when we help them improve their ability to age through independence and other options.
Dr. Szanton’s work on aging includes her innovative program titled Community Aging in Place – Advancing Better Liver for Elders (CAPABLE). The program incorporates home visits from a nurse, occupational therapist, and handyman to provide small home improvements like handrail installation or lowered cabinets to help older adults work on their mobility and self-care. Szanton’s program has made strides as a viable solution to improving health outcomes for older adults in the US and recent findings published in the health policy journal Health Affairs shows decreased disability, depression, and improved self-care amongst participants.
Beyond her CAPABLE study, Szanton has also researched and piloted strategies for preventing falls and examining the impact of food and energy access on the health outcomes of older adults. Szanton’s background is in policy analysis which she uses to inform policymakers about alternative, cost-effective solutions to save healthcare and taxpayer dollars while also improving the health and well-being of older adults, based off her research results. Dr. Szanton has been honored for her contributions as an American Academy of Nursing Emerging Edgerunner, a winner of the Protégé Award from the Friends of the National Institute of Nursing Research, and named a Robert Wood Johnson Foundation Nurse Faculty Scholar.
The 2016 Friends of the National Institute of Nursing Research (FNINR) President’s Award was presented to Phyllis Sharps, PhD, RN, FAAN, Professor and Associate Dean for Community Programs at the Johns Hopkins School of Nursing (JHSON). This year’s President’s Award theme was “Nurse Scientists Leading the Advancement of Team Science.”
Sharps’ career has revolved around leading teams of scientists in medicine, public health, social work, and nursing. She has published over 80 articles in the areas of improving reproductive health, reducing violence amongst African-American women, and mitigating the physical and mental health consequences of violence against pregnant and parenting women. Sharps also led a research invention titled DOVE, Domestic Violence Enhanced Home Visitation Program, which has been tested and proven to reduce intimate partner violence among pregnant women. Other involvement in women’s health issues includes testifying before Congress, serving on Institute of Medicine (IOM) committees, and utilizing her role as a nurse to further policy agendas and team science in the nursing profession.
In addition to the President’s Award, Dr. Sharps was recently awarded the 2016 Lifetime Achievement Award in Education and Research from the Association of Black Nursing Faculty. She received the FNINR award at their annual NightinGala in Washington, DC over the weekend. Patricia Davidson, Dean of JHSON, credits Dr. Sharps as a great example of nurse leadership across disciplines, universities, and the globe for her innovations in sustainable initiatives, research, and practice.
INSIGHT Into Diversity Magazine has chosen the Johns Hopkins School of Nursing (JHSON) to receive a 2016 Health Professions Higher Education Excellence in Diversity (HEED) Award. INSIGHT Into Diversity magazine is the oldest and largest diversity-focused publication in higher education and recognizes US nursing, medical, dental, pharmacy, osteopathic, and allied health schools. JHSON will be featured in the December 2016 issue of the magazine, demonstrating their outstanding commitment to diversity and inclusion.
Patricia Davidson, PhD, MEd, RN, FAAN, Dean of JHSON, says that advancing and supporting a culture of diversity and inclusion are top priorities at her school. The students and faculty at JHSON bring their own unique experiences, cultures, and views, and they are respected and valued by all members at the school.
31 percent of students and 23 percent of faculty at JHSON are racial or ethnic minorities. JHSON provides opportunities for students and faculty to develop and implement programs and partnerships that strengthen their inclusive environment through a school-wide diversity taskforce. Some of those programs include LGBTQ Life at Hopkins and the Office of Multicultural Affairs.
The HEED Award involves a comprehensive and rigorous application including questions about recruitment and retention of students and employees, leadership support, and campus diversity and inclusion initiatives. INSIGHT says their standards are high because they want to choose institutions where diversity and inclusion are a part of the work being accomplished daily across a campus.
September 15th is National Neonatal Nurses Day! Below, nurse Meghan Gunning, BSN, RN, shares her experience as a neonatal nurse in the neonatal intensive care unit (NICU) in Baltimore, Maryland.
I start my shift like most of my nursing colleagues: unsure of what the next 12 hours will bring, but hopeful to end the day with a sense of accomplishment. In the NICU, our accomplishments usually come in the tiniest, smallest forms possible. For instance, an eight milliliter (mL) blood transfusion—a volume less than two teaspoons—can make a world of difference to a premature baby’s oxygen saturation and heart rate.
A common phrase in nursing is that there is no typical day, and that holds true in the NICU world as well. We see everything from full-term infants with an anoxic brain injuries, to neonates who may be withdrawing from maternal drug use, to the smallest of the smallest neonates. For a one-pound, one-ounce, 23-week neonate, every move must be delicate in order to prevent harm to his gelatinous skin, immature GI tract, and the blood vessels of the brain.
Today, I am starting with two patients. The first is an ex-31-weeker who is working on feeding and growing, and the second is a full-term infant recovering from a tracheoesophageal fistula (TEF) repair. Both patients are relatively stable compared with many of the other infants on the unit, but they both have important personal goals to achieve in order to eventually go home. My 31-weeker, for instance, has a history of being suppository dependent, but has finally started to stool on her own (with some belly rubbing assistance from her loving nurse). Rule number one in the NICU: Pooping is a big deal. My TEF baby, on the other hand, has to work on tolerating the volume of his feeds without vomiting. Additionally, when we check his stomach contents (by aspirating from his nasogastric tube), we need to see that his stomach is handling the feeds and that there isn’t too much leftover formula. He also must grow and prepare for his repeat swallow study next week, to evaluate whether he is still silently aspirating his formula. If the test shows that he’s aspirating, it will most likely buy him a trip to the OR for placement of a gastric tube. Any procedure poses the obvious risks, such as infection, but the surgery itself can be too large an undertaking for an infant. Many times infants can decompensate simply from the stress of a routine procedure.
After I check my orders and verify that all of my resuscitation equipment is at the bedside, I begin to care for my 31-weeker: obtaining her vital signs, measuring her abdominal girth, and changing her diaper. The charge nurse then approaches me and tells me about the impending delivery of a 33-weeker over in labor and delivery (L&D), and because I am triage and first admit (the first nurse slated to get a new patient today), I will be attending the resuscitation of the infant in L&D. At this point, I give report on my TEF baby to a fellow nurse, who will add this patient to her assignment while I attend to the delivery and admission of the new baby. Second rule of the NICU: Teamwork is crucial when you’re dealing with the tiniest of human beings.
I set up my admit bed, confirm that all of my equipment is functioning, and then I wait until we receive the delivery call. Once we do, the neonatology fellow, a nurse practitioner, a respiratory therapist, and I rush to L&D and wait some more. Finally, after 10 minutes, a baby boy appears in our resuscitation room. We dry and stimulate the baby, and ensure that his initial vital signs are within normal limits. Luckily, in this case, the baby was pink, crying, and overall very healthy despite being over a month early (he actually got a five-minute APGAR score of 10, which is the rarest of the rare). Many times, especially with micro-preemies, emergent intubation and central line access must be achieved prior to even leaving the resuscitation area in order for the child to be stable enough for transport to the NICU. Sadly, in those cases, a mother may have to wait to see her child until many hours after birth, as those first few minutes are so critical for the care team. But this time, we were lucky; mom was able to see and hold her son for a couple minutes before we traveled back to our unit.
The baby boy’s admission was very smooth, again, in large part, to the excellent teamwork and help from my coworkers. Without me even asking, my colleagues jumped in and assisted with obtaining vitals, measurements, and lab work. It feels really great to be part of such a well-oiled machine. I was able to complete all the necessary documentation and assessments without a glitch (I can honestly say that that’s the first time that has happened since beginning this job a year ago), just in time to take a quick break. I let my teammates know that I’m stepping off of the unit, and enjoy a brief five minutes of decompression time—enough to scarf down a granola bar before baby boy’s mom is calling from upstairs for an update. I assure her that everything has gone smoothly, and he’s now resting. I explain that I had to start an IV in her son’s hand, in order to run some maintenance fluids so that his blood sugar doesn’t drop, and that he will be on antibiotics for a 48-hour sepsis rule out. She says she’ll be down shortly to see him.
Before returning to my assignment, I take a quick stroll around the unit to check on some of the babies I’ve cared for in the past. I walk past the room of an ex-27-week infant who was transferred here for repair of his small bowel obstruction. His ostomy had not produced any stool in his first three weeks post-op, but was finally beginning to function on its own. I tell his nurse that when I had him last week, he let out his first gas from the ostomy all on his own, and that his parents were just beaming with pride. The father was actually mad at himself for not catching the act on video! Now that he was stooling, they were over the moon with happiness (again, refer to NICU rule 1).
I walk past the room of an infant with hydrops fetalis, and hear the whirring of the oscillator vent. This baby was born with bilateral pleural effusions, a pericardial effusion, and ascites, all at 32 weeks. To be perfectly honest, I was surprised that the baby had made it as long as she had. In her five short days on Earth, she’s already had a whole blood exchange transfusion, been under multiple phototherapy lights, and gotten multiple transfusions of platelets, plasma, and albumin (protein), all to help correct her fluid imbalance. I say a little prayer for her as I continue on back to my area of the unit.
Finally, I run into a mother that I’ve grown fairly close with, as I took care of her little girl in her first couple days of life. This mother had already gone through two miscarriages, and delivered this little peanut about eight weeks early, weighing a little less than two pounds. I was able to let her hold her baby one of the first nights after she delivered, and she silently wept the entire time. I could barely hold back my own tears, as well. I asked how my little rock star was doing today, and her mother beamed and proudly told me that she now weighs 3 pounds, 8 ounces—to which I responded, “Whoa, she’s getting so fat!”
I head back to my patients and continue the day performing cares every three hours—checking NG tube aspirates, changing linens, and recording daily weights, along with helping my teammates when they need assistance. I double check a 12-mL blood transfusion for an ex-23-weeker, silence alarms on a full-term infant post-cooling protocol for hypoxic ischemic encephalopathy (HIE), and help direct a hopeful grandparent toward her new grandchild’s room.
I finish the day by giving report to the next nurse, highlighting the big milestones achieved for the day: my 31-weeker’s feeds were advanced from 18 mL to 21 mL, and she tolerated the increase very well; my 33-weeker was stable and going to be just fine. These may seem like small changes in the grand scheme of things, but they can have a huge impact on the health and well being of the infant. This leads me to NICU rule number three: our work may be based on tiny little victories, but those tiny little victories are what leads to healthy, happy babies.