Nurse of the Week: Johana Torres’ American Journey From Housekeeper to Certified NP

Nurse of the Week: Johana Torres’ American Journey From Housekeeper to Certified NP

Whether you are speaking of geography, education, or career, Johana Torres, RN, BSN, MSN, FNP-C has been on a formidable journey.

Just over two decades ago, Torres moved to New Jersey from Colombia. While she had almost completed an accounting degree in her home country, like many new arrivals, she had to essentially start over when she came to the United States. She began working in a factory while taking English as a second language classes at Ocean Community College, and in 2005, Johana accepted a position as a housekeeper on the Brennan 6 oncology unit at Jersey Shore University Medical Center (JSUMC). She viewed the job as an opportunity for professional growth, as well as a more supportive environment with the benefits and work/life balance she needed as a single mom with a (then) two-year-old daughter.

Three years later, in 2006, Johana completed a Patient Care Technician (PCT) course at JSUMC and began applying for jobs. She shared, “It was hard to find a job as a PCT at that time, but I kept on trying. Finally, Mariebelle Delmundo gave me a chance.”

Nurse of the Week Johana Torres, with Maribelle Delmundo

Torres with Maribelle Delmundo, RNC, BSN.

Delmundo, a certified RN (RNC), BSN, was a nurse manager of what would become Mehandru 5, a telemetry/cardiac step-down floor at JSUMC. She was part of the team that interviewed Johana for her first PCT role, and recalled, “Johana was soft spoken and shy, but I knew we made the right decision to hire her. She always had a genuine smile, which was contagious. She was like a ray of sunshine as she entered the patient’s rooms, showing compassion, empathy and patience.”

With these attributes, she understood almost immediately that Johana had the potential of becoming a great nurse one day. “We encouraged her to enroll in a nursing program and told her that we would support her every step of the way.”

The juggling act begins

Empowered by Delmundo and other JSUMC colleagues, supported by a loving mother, father and brother who also moved from Colombia to New Jersey, and motivated by her own determination and perseverance, Johana enrolled in the nursing program at Ocean Community College. She took advantage of the scholarship opportunities and tuition assistance provided through Hackensack Meridian. Johana credits the flexibility of the program – which allowed her to work every weekend and attend classes during the week – with being able to successfully attain her RN in 2014. Delmundo noted, “Johana worked very hard juggling work, school and family and still continued to do an amazing job as a PCT, all while carrying that contagious smile.”

Shortly after her graduation, Johana applied and was hired to be an RN on the same unit – Mehandru 5. She went on to complete her BSN at Kean University in 2018, obtain national certification as a medical-surgical nurse, and finish her MSN at Chamberlain University in 2021. Johana continued on with her studies while working full time, and most recently completed her Family Nurse Practitioner education and certification. Today, when Johana signs her name, she proudly adds her certified FNP-C to her many credentials.

While Johana faced many challenges along the way, with the support of her family and of course Delmundo, she is proud of her success. When asked what the most rewarding part of her journey has been, Johana said that it’s where she is today. “Being able to accomplish what I did, especially given my language barrier and having to start over in the United States in a completely new field.” As the first one in her family to earn an advanced degree, Johana also said she is proud to serve as a role model for her daughter.

Delmundo, who was honored with the 2021 DAISY Nurse Leader Award at Jersey Shore, still serves as Johana’s manager today. She calls Johana the epitome of Florence Nightingale. “I have seen Johana grow into an amazing nurse through the years. She consistently goes above and beyond while caring for her patients and their families. Angels like her are loved and appreciated by all of us.”

Living her dream

Johana’s favorite part of being a nurse is helping her patients and watching them recover. She said focusing on purpose was especially important throughout the COVID-19 pandemic. “I was so worried about keeping my family safe, but there was no better feeling than watching our COVID patients go home.”

As an FNP, Johana’s goal is to work with disadvantaged communities, particularly those with populations who face language barriers. She wants to provide education and outreach in these communities and ensure everyone has access to high-quality health care and wellness services.

Johana is wholly committed to paying it forward. She serves as a mentor to new nurses and as a charge nurse. Delmundo continued to extol Torres’ dedication: “Her work ethic is commendable and she is a great role model to her colleagues. She prizes honesty and integrity above all else and sets a high standard. Johana demonstrates the 5 C’s in everything she does. I am so very proud of her. Dreams do come true.”

Today, Johana lives in a multigenerational household in Ocean County with her parents, grandparents and daughter. While the past 20+ years have left her with little downtime, Johana says she loves spending time with her family, and recently took a hiking trip to national parks across the United States with friends. To those considering the nursing field, Johana shares, “It is the most rewarding career. You are driven by the heart and get to make a real difference in people’s lives. Surrounded by mentors and colleagues who share that same connection to purpose, and working for an organization so committed to patient care and the growth of their team, I really do feel like I am living my dream.”

From Pandemic to Endemic: How Nursing Can Start to Make The Transition

From Pandemic to Endemic: How Nursing Can Start to Make The Transition

After a winter of bleak news and fearful statistics about COVID, recent signs point to long-awaited relief from the pandemic. COVID cases, deaths and hospitalization are all tumbling, the CDC has issued relaxed mask guidelines, and states are lessening or ending mask mandates.

With these developments as a backdrop, nursing may finally be entering a transition, from pandemic to “endemic.” The CDC defines endemic as “the constant presence of an agent or health condition within a given geographic area or population; can also refer to the usual prevalence of an agent or condition.”

Donna M. Nickitas, PhD, RN, NEA-BC, CNE, FNAP, FAAN, dean of the Rutgers School of Nursing–Camden.

Dr. Donna M. Nickitas, dean of the Rutgers School of Nursing–Camden.

So as the country learns to live with COVID as an endemic, what are the ways that nursing should respond?

For one thing, as the profession pivots to working from an endemic stance, nursing should take time to reflect on the experience, says Donna M. Nickitas, PhD, RN, NEA-BC, CNE, FNAP, FAAN, dean of the Rutgers School of Nursing–Camden (NJ). For one thing, “We all understand the importance of what good public health looks like, and how we have to listen and trust the science as well as the evidence,” she notes. “And that wasn’t always clear from the very beginning of the pandemic.”

For another, nurses can appreciate the growth in “how more expert we’ve become on the front line to manage more rapidly, assessing, testing, informing, educating, vaccinating.”

Filling a void

As to the toll the pandemic has taken on the nursing workforce, especially on nurses who have been on the front lines in hospital systems, “they sustained a significant amount of moral injury,” Nickitas says. “They have witnessed death after death and because of that, and what was required of them, they are exhausted, both mentally and emotionally. And many of them are burned out. And that is so heartbreaking, to know that my colleagues now have gone through this experience and have left or are thinking of leaving the profession.”

“When they go, remember they take with them all of that expertise, all of that knowledge, all that wisdom, that not only have they acquired during the pandemic but also they have acquired through their professional life. Those of us who are left behind are going to have to learn to fill that void,” says Nickitas.

For nurses who are leaving, and as we move from pandemic to endemic, one hope is that nurses who choose no longer to work in an acute-care setting “will find other opportunities and consider population health, community health and certainly public health,” says Nickitas. Or work as preceptors or teach as part-time lecturers in university settings “where we can take some of that expert knowledge and apply it to the next generation.”

On a sobering note, a new study from the American Nurses Foundation finds that younger nurses are struggling with the effects of the pandemic. Nearly half of nurses surveyed under age 35, according to a press release, say they have sought professional mental health support since March 2020. What’s more, of the survey respondents under age 25, 69% say they have been suffering from burnout, which is more than double than those older than 25 (30%).

Staffing ratios

Also, in moving to an endemic posture, “we have to do a better job at nurse staffing to recognize and compensate and support those nurses who have in essence given their professional lives to these institutions.”

The evidence is clear, notes Nickitas, “that patients get better care when the numbers are lower. They have less morbidity and less mortality. So let’s listen to the evidence.”

“I wouldn’t always say mandate legislation, but when it doesn’t work, we have to get people’s attention and we’re talking about safety,” says Nickitas. “We’re talking about people’s lives and patient safety is critically important.  We’re talking about reducing medical errors and improving patient outcomes. And we know that we can do better when we have the appropriate nurse staffing ratios.”

Supporting education

To help address nursing shortages, government needs to support nursing education, notes Nickitas. “We’re going to need additional funding from the federal government, from the state governments — ensure that there are scholarship monies and research funds available in the pipeline.”

Luckily, she notes, enrollments are up about 5%. In April 2021, the American Association of Colleges of Nursing (AACN), released data that in programs designed to prepare new RNs at the baccalaureate level, enrollment increased by 5.6% with 251,145 students studying in those programs nationwide.

“We have to get ready for the next generation,” says Nickitas.  Hospital systems need to regard nursing staff as “valuable assets that cannot be overlooked.”

Rutgers Clinical Program Sends Students into Field to Relieve Overburdened School Nurses

Rutgers Clinical Program Sends Students into Field to Relieve Overburdened School Nurses

In a mutually beneficial collaboration that allows nursing students to receive experiential instruction, Rutgers University‒Camden is partnering with overburdened school nurses in the Vineland School District, who often function as the main COVID-19 officers in their schools.

New Jersey’s 2,500 school nurses play a vital role in keeping students safe and healthy and have faced increased burdens during the pandemic as they fight to keep communities safe. In addition to caring for students, school nurses have been a source of health and safety updates, informing students and families of the latest coronavirus updates and protocols

Robin Cogan, the clinical coordinator of the Rutgers‒Camden school nurse program, says school nurses are acting as the de facto health department during the pandemic. Cogan hosts a virtual support group for school nurses throughout the United States who are overwhelmed with additional responsibilities.

Beginning Jan. 25, under the supervision of Rutgers‒Camden nursing faculty, 152 nursing students will work alongside Vineland School District nurses while participating in a pediatric clinical rotation during the spring semester.

“Front-line direct care experiences are novel and a unique way to introduce students to population-based public health nursing,” said Donna Nickitas, dean of the Rutgers School of Nursing‒Camden.

The nursing students will assist 14 Vineland public schools with COVID-19 contact tracing, health screenings, and educating young students on health promotion topics.

“Contact tracing is a time-consuming task and a huge burden on school nurses, who are also trying to juggle their daily demands, so our students will be available to help,” said Margo Wallace, the Rutgers School of Nursing‒Camden director of clinical placement.

Rutgers‒Camden students will assist in contact tracing by gathering crucial information, such as when a patient began showing symptoms, and identifying close contacts in the classroom, on the school bus, in sports and during social activities. Of the more than 29,000 Cumberland County residents who have tested positive for COVID-19 since March 2020, more than 12,000 are Vineland residents – the highest in the county, according to county records.

“Contact tracing and COVID management has consumed the entire workday of school nurses,” said Vineland School District Nursing Supervisor Josephine DeMareo. “Vineland students and families will benefit from the direct care and contact tracing that the nursing students provide.”

DeMareo said the school district welcomes the partnership with Rutgers‒Camden and the nursing students’ assistance with people who test positive for COVID-19. One of their key duties is determining how long COVID-positive individuals should isolate.

“School nurses are unsung heroes who play a vital role in the health and safety of children, especially during the pandemic,” said Rutgers‒Camden Chancellor Antonio D. Tillis. “I’m proud that Rutgers‒Camden nursing students are working directly with, and contributing to, the well-being of children in the community.”

The partnership with Vineland School District expands the School of Nursing–Camden’s hands-on educational opportunities in traditional and nontraditional clinical settings, such as places of worship, food pantries and homeless shelters.

Nurse of the Week Kaitlin Rogers: In the Right Place At The Right Time

Nurse of the Week Kaitlin Rogers: In the Right Place At The Right Time

Early on the morning of January 5, 2022, Kaitlin Rogers, BSN, RN was driving to work on route 3 when she came upon a sea of brake lights just before the Hackensack River Bridge.

A “horrible pile-up”

It was barely dawn and freezing rain was pelting her car, so it was hard for Kaitlin to see what lay ahead – a massive, multi-car accident. “I was wondering what had happened and that whatever it was, I was going to be late for my shift, when a man emerged between the cars looking completely frantic and in need of help,” said Kaitlin, a registered nurse at Hackensack University Medical Center , who immediately jumped out of the car only to slip and fall on the icy road. “The ice had to be about a half an inch thick but I got my bearings and followed him,” explained Kaitlin, who was led to dozens of mangled cars, many with passengers in need of medical assistance. “There were people with head and neck injuries, lacerations and one young man lying on the ground.”

At 25, Kaitlin has been a nurse for just under three years. She works in the cardiothoracic intensive care unit (CTICU) at Hackensack University Medical Center, caring for the needs of patients in critical condition and requiring constant monitoring. “It can be pretty intense but not necessarily to this level,” she said.

Still, Kaitlin quickly jumped into action along with another young nurse and several volunteer firemen who had emerged from their totaled cars. “They were all just in this horrible pile-up and yet they wanted to do everything they could to assist,” said Kaitlin who immediately started CPR on the young man on the ground. “For more than 45 minutes, we tried to revive him but his injuries were just too severe,” said a devastated Kaitlin who came to find out that he was hit only after getting out of his car to try and help others. “The irony of that is so heartbreaking, he was so young and selfless.”

With all lanes of traffic closed, Kaitlin and the others worked for two hours triaging and assisting the car passengers before paramedics could arrive on the scene. “We were this random group of strangers thrown together and we did the very best we could,” said Kaitlin who inexplicably happened to dress in layers that morning. “I put on an extra sweatshirt and socks which ended up helping to keep me warm and protect me from all the broken glass and blood.”

“I couldn’t think of any place else I’d rather be or anyone else I’d rather be with than my colleagues at the hospital.”

Kaitlin Rogers, RN

When the last patient was placed safely inside an ambulance, Kaitlin didn’t go home, she continued on to work, knowing the medical center might be short-staffed due to the pandemic. “I couldn’t think of any place else I’d rather be or anyone else I’d rather be with than my colleagues at the hospital,” she said.

“When I heard about what Kaitlin did, I was not one bit surprised,” said Mark Sparta, FACHE, President and Chief Hospital Executive of Hackensack University Medical Center. “She represents the best of the best at our medical center – a true hero both inside and outside our walls.”

“Kaitlin is an amazing nurse, a caring person and I am not one bit surprised that officers who arrived on the scene identified her as the most skilled provider,” said one of those colleagues, Danielle Loftus, Administrative Supervisor in the CTICU at Hackensack University Medical Center.

Kaitlin, who is only now just starting to grasp the magnitude of the accident says she’s grateful for all the care and support she has received from co-workers, like Danielle, who suggested she seek the guidance of WeCare, a confidential, peer-to-peer support program, designed to help team members and clinicians manage any negative emotional consequences they may experience as a result of the work they do.

“There’s not a day that goes by that I don’t think of the young man who lost his life but I am proud to have been there and to have helped so many others.”

When it Comes to Supporting School Nurses, Robin Cogan is Relentless

When it Comes to Supporting School Nurses, Robin Cogan is Relentless

School nurses have been on the front lines since the start of the COVID-19 pandemic, administering COVID-19 testing, tracking the results and performing contact tracing, among other duties.

Underpaid, overworked and overextended, school nurses have been placed in an unsustainable position as “de facto” public health officials for the children under their care—and like actual, appointed public health officials, are frequently on the “frontlines” of community battles being waged over mask requirements, quarantining of infected children, and of course vaccination. However, if they start to feel overwhelmed and frustrated, they have a place to vent, share anecdotes, and support one another, thanks to the efforts of The Relentless School Nurse … aka Robin Cogan, MEd, RN, NCSN, FAAN, the clinical coordinator of the Rutgers University–Camden school nurse program.

Cogan, a vocal advocate for school nurses, hosts a virtual support group for these nurses throughout the United States, which focuses on keeping students safe, as well as a variety of critical issues related to COVID-19.

“Being responsible for the health and safety of students and staff has weighed heavily on school nurses,” says Cogan. “It is not in our nature to receive. We are usually the ones giving. That is not a healthy stance; we must also be able to receive…” Describing the group to the New York Times in November, she explained, “It’s a safe space for school nurses to share their experiences and to kind of download and say: ‘This is hard. I’ve written my resignation letter 10 times. I’m about to turn it in — can somebody help talk me out of it, help me get through another day?’”

Since October 2020, Cogan has held weekly peer-to-peer sessions on Zoom, where participants offer solutions and empathize with each other about the demands of handling their standard and expanded duties.

In the hour-long sessions, school nurses around the country talk freely about stress, an untenable workload, and trying to keep up with the latest COVID-19 protocols and testing.

Cogan has noted repeatedly how the challenges that school nurses are facing this fall are compounded by the rising political battle over masks and vaccination requirements in schools.

It is Cogan who says school nurses are acting as the de facto health department. Like public health officials, school nurses have also been under siege since the pandemic arrived on US soil. Cogan recognized the need for a support group early in the 2020 school year, and created the virtual sessions with the Mental Health Association in New Jersey and the state Department of Human Services Division of Mental Health and Addiction Services, along with a Federal Emergency Management Agency (FEMA) grant to offer nurses an opportunity to care for their mental health.

While Cogan is a facilitator of the group, she is also benefitting from the sessions. “We are sharing a collective traumatic experience,” says Cogan. “It’s encouraging to have this group to review the week and determine next steps or ways to cope that do not take me down a negative rabbit hole. I have learned from them to set strong guardrails and ask for help.”

“Front-line workers during the pandemic are heroes who need support. I applaud Robin Cogan for her work in caring for the mental well-being of school nurses,” says Rutgers‒Camden Chancellor Antonio D. Tillis.

A school nurse for 21 years, Cogan is a leading voice for school nurses and an advocate for children. Her blog, “The Relentless School Nurse,” shares school nurses’ stories from across the country.

Cogan was recently selected as a fellow of the American Academy of Nursing (FAAN), one of the highest honors that can be bestowed in the field.

Cogan is among 225 fellows of the class of 2021, joining a small group of school nurse leaders inducted into the academy. FAAN selection criteria include contributions to nursing and health care, reducing health disparities and inequalities and influencing health policies and health care delivery.

 

New Jersey Implements Nurse License Compact

New Jersey Implements Nurse License Compact

CHICAGO – On Nov. 15, 2021, New Jersey completed the process of implementing the Nurse Licensure Compact (NLC). The NLC allows registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs), whose primary state of residence is in an External Link NLC state , to hold one multistate license, with the authority to practice in person or via telehealth, in both their home state and other NLC states.
In March 2020, the New Jersey Board of Nursing partially implemented the NLC. As a result, nurses who resided in other compact states and held an active multistate license in their state of residence were able to practice in New Jersey.
As of Nov. 15, 2021, the NLC is now fully implemented in New Jersey. Full implementation will allow nurses whose primary state of residence is New Jersey to apply for a multistate (compact) license.
“Through implementation of the NLC, regulatory burdens for RNs and LPN/VNs will be significantly reduced. Having the ability to obtain a multistate license will increase access to care for patients in New Jersey and other states,” comments Sean P. Neafsey, acting director of the New Jersey Division of Consumer Affairs.
Key points for nurses residing in New Jersey:
  • The NLC became fully operational in New Jersey on Nov. 15, 2021. Nurses who currently hold a New Jersey RN or LPN license may apply to “upgrade” their existing New Jersey single-state license to a multistate license.
  • The conversion application became available on the External Link New Jersey Board of Nursing website starting Nov. 15.
  • It is not necessary for New Jersey license holders to wait until their renewal period in order to apply for the multistate license.
  • New graduates of nursing programs who are New Jersey residents may apply for licensure by exam from the New Jersey Board of Nursing and can choose to pursue a multistate license.
  • Once a nurse is issued a multistate license, the nurse may stop renewing any license held in another NLC state.
Licensure requirements are aligned in NLC states, so all nurses applying for a multistate license are required to meet those same standards, including submission to a federal and state fingerprint-based criminal background check.
With the multistate license, nurses are able to provide telehealth nursing services to patients located in NLC states without having to obtain additional licenses. A multistate license facilitates cross-border practice for many types of nurses who routinely practice with patients in other states, including primary care nurses, case managers, transport nurses, school and hospice nurses and many others. Further, military spouses who experience moves every few years also benefit greatly from the multistate license.

About the Interstate Commission of Nurse Licensure Compact Administrators (ICNLCA)

The ICNLCA facilitates cross border nursing practice through the implementation of the nationally recognized, multistate license, the NLC. The ICNLCA enhances nurse mobility and public protection through maintaining uniform licensure standards among party state boards of nursing; promoting cooperation and collaboration between party states, facilitating the exchange of data and information between party states; and educating stakeholders. The ICNLCA is a quasi-governmental and joint public agency of the party states created and established on July 20, 2017. The Executive Committee is the seven-member elected leadership of the ICNLCA.

About the NLC

The NLC allows for registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs) to have one multistate license, with the ability to practice in person or via telehealth in both their home state and other NLC states. There are 38 jurisdictions that are members of the NLC. Licensing standards are aligned in NLC states, so all nurses applying for a multistate license are required to meet the same standards, which include a federal and state criminal background check that will be conducted for all applicants for multistate licensure.
The NLC also enables nurses to provide telehealth nursing services to patients located across the country without having to obtain additional licenses. In the event of a disaster, nurses from multiple states can easily respond to supply vital services. Additionally, almost every nurse, including primary care nurses, case managers, transport nurses, school and hospice nurses, among many others, needs to routinely cross state boundaries to provide the public with access to nursing services, and a multistate license facilitates this process.