After studying neuroscience and immunohistochemistry at UCLA, Starks apparently realized that she was a definite Type N and decided to become a nurse. Already bursting at the seams with undergraduate degrees, she flew to the East Coast to pursue her studies in nursing. In New York, she went for an accelerated bachelor’s degree program for non-nurses (APNN) at the University of Rochester School of Nursing. Upon graduation, Strong Memorial Hospital snapped her up before she had a chance to go west again and installed her in the adult operating room, where she now works as a skilled vascular surgery nurse and preceptor.
However, Starks does not spend all of her time lollygagging about the OR or burying her nose in a textbook; she wants to effect change and has already created a place for herself among the new generation of upcoming nurse leaders. She is an active member in her local National Black Nurses Association chapter, the Rochester Black Nurses Association (RBNA), a founding member of the local chapter, and the chapter’s first vice president.
But that isn’t all. Stark is paying it forward as the founder and chair of the RBNA mentoring program in partnership with the URSON’s APNN program, where she and other Black nurses mentor nursing students of color. In true Type N fashion, she also manages to make time to participate as a member of the NPA’s Diversity, Equity and Inclusion committee.
After she earns her degree, Starks plans to work as an FNP in primary care. Her passion is caring for those with chronic diseases, especially African American patients. She plans to continue her advocacy for Black patients and students through her continued work in RBNA and other organizations and mentoring programs.
Unlike many students during the pandemic, Starks has been very fortunate with regard to clinicals, and told a reporter that “Luckily, within my program, they didn’t stop us from doing any type of clinical rotation or any type of classes.” In her acceptance speech, the charismatic FNP-to-be graciously thanked everyone who made the award possible and declared her dedication to helping to further NPs’ scope of practice in New York State.
To see an interview with Starks at a local Rochester station, click here. Her acceptance speech is below.
*There are two NPA winners, actually, and we congratulate the Region 7 winner Margaret O’Donnell, DNP, FNP-BC, ANP-BC, FAANP, who will have a post of her own shortly.
National Nurses United’s (NNU) new nationwide survey of more than 5,000 registered nurses reveals that employers must do more to be fully compliant with the Occupational Safety and Health Administration (OSHA) emergency temporary standard (ETS) and to implement optimal standards to protect nurses and other health care workers from Covid-19.
This survey is the sixth national survey of nurses during the pandemic by NNU, the nation’s largest and fastest-growing union of registered nurses. Most of the requirements for the ETS went into effect on July 6 and all requirements went into effect on July 21. The ETS is the first-in-the-nation enforceable federal Covid-19 standard, which nurses have fought for since the beginning of the pandemic. The ETS includes requirements on personal protective equipment (PPE), patient and visitor screening, and employee notification within 24 hours of the employer becoming aware of the exposure.
“We are more than 18 months into the pandemic, yet hospitals are still not doing enough to ensure the safety of nurses, patients, and other health care workers. Covid cases are surging to their highest levels yet in some areas of the country, and some ICUs are over capacity.
Nurses need optimal personal protective equipment. Health care employers must notify nurses as soon as possible when they are exposed and make it easier for RNs and other health care workers to get tested.”
—NNU Executive Director Bonnie Castillo, RN
NNU’s latest survey reveals that nurses still face problems with access to testing, being notified in a timely manner when they are exposed, inadequate respiratory protection, unsafe staffing, mental health, and workplace violence. RNs also reported inadequate Covid screening and testing rates for patients who enter or are admitted to a health care facility and a decrease in dedicated Covid units compared to the last survey (March 2021).
More than 75 percent of hospital nurses are not being notified of exposures to Covid in a timely way. Only 23 percent of hospital RNs reported timely notification of exposure by their employers, down from 31.6 percent reported in March 2021. Prompt notification is essential for hospital infection control.
Access to testing is an issue at some hospitals. About 41 percent of RNs at hospitals reported that any staff who asks for testing has access; nearly 20 percent said access to testing is limited at their facility, and 7 percent said testing is not available where they work. Of the nurses who answered additional questions on employer testing, 58 percent said that only staff who are symptomatic can get tested, a troubling statistic as scientific research has found that about half of all Covid transmissions are from asymptomatic and pre-symptomatic individuals who were infected.
Not all patients and visitors are screened for Covid. Only two-thirds of hospital RNs report that all patients are screened for Covid-19 signs and symptoms before or upon arrival at the facility. Less than a third of hospital RNs reported that every patient is tested for Covid before or upon arrival at the facility. For visitors, screening and testing was reported to occur at even lower rates: Only 53 percent of hospital RNs report that every visitor is screened for Covid-19 signs and symptoms before or upon arrival at the facility and a mere 4 percent of RNs reported that all visitors are tested for Covid before or upon arrival. Screening for Covid-19 symptoms, in combination with reliable diagnostic testing and screening for recent exposure history, is necessary to effectively identify and isolate individuals who may be infectious to prevent spread of the virus within health care facilities.
Hospital nurses are still not provided optimal PPE when caring for Covid-positive patients or patients suspected of having Covid. About 61 percent of hospital RNs reported wearing a respirator for every Covid-positive patient encounter, down from nearly 75 percent in our March 2021 survey. In addition, only 40 percent of hospital RNs reported that respirators are worn when they are caring for patients who are suspected of having Covid or whose tests results are not completed; and about 62 percent reported using surgical masks for patients suspected of having Covid or awaiting test results. All nurses should be wearing a respirator for every encounter with a Covid-positive or suspected Covid-positive patient, in addition to eye protection, isolation gown or coveralls, and medical grade gloves.
Nurses diagnosed with Covid have faced lasting symptoms. Nearly a quarter of RNs who contracted Covid experienced symptoms from zero to three months, a third had symptoms lasting three to nine months, 12 percent had symptoms lasting nine to 12 months, and 12 percent more than a year. The most common symptoms reported included tiredness or fatigue, joint or muscle pain, memory or concentration difficulties, headaches or migraines, and difficulty breathing or shortness of breath.
Short staffing remains a persistent problem in hospitals, with more than 57 percent of RNs reporting that staffing has gotten slightly or much worse, up from 47 percent of nurses in our March 2021 survey. Also, nearly half of hospital RNs (49 percent) reported that their facility is using excessive overtime to staff units.
Nearly 42 percent of hospital RNs fear they will contract Covid.
Slightly more than 50 percent are afraid they will infect a family member.
More than a third (35.1 percent) are having more difficulty sleeping.
More than half (53.5 percent) feel stressed more often than before the pandemic.
About 42 percent feel sad or depressed more often than they did before the pandemic.
More than a third feel traumatized by their experiences caring for patients.
Hospital RNs reported an increase in workplace violence. About 31 percent of hospital RNs said that they faced a small or significant increase in workplace violence, up from 22 percent in our March 2021 survey. RNs attribute the increase in workplace violence to decreased staffing levels, changes in the patient population, and fewer visitor restrictions.
NNU’s four surveys in 2020 covered hospitals’ lack of preparedness for Covid-19 (March); government and employers’ disregard for nurse and patient safety (May); the devastating impact of reopening too soon (July); and hospitals’ and health care employers’ lack of preparation for the fall/winter surge, despite more knowledge about the dangers of the virus and effective measures to prevent spread (November). The fifth survey (March 2021) highlighted the continuing disregard that hospitals and health care employers show for the safety of nurses and health care workers, more than one year into the pandemic.
The sixth survey results were gathered from both NNU unionized nurse members as well as non-union nurses in all 50 states plus Washington, D.C. and Puerto Rico. The results cover the period June 1 to July 21, 2021.
“The nation’s health care delivery systems are overwhelmed, and nurses are tired and frustrated as this persistent pandemic rages on with no end in sight.
Nurses alone cannot solve this longstanding issue and it is not our burden to carry. If we truly value the immeasurable contributions of the nursing workforce, then it is imperative that HHS utilize all available authorities to address this issue.”
—ANA President Ernest Grant, PhD, RN, FAAN
The American Nurses Association (ANA), representing the interests of the nation’s 4.2 million nurses, urges the U.S. Department of Health and Human Services (HHS) to declare the current and unsustainable nurse staffing shortage facing our country a national crisis. In a letter to HHS Secretary Xavier Becerra, ANA calls for the Administration to acknowledge and take concrete action to address the current crisis-level nurse staffing shortage that puts nurses’ ability to care for patients in jeopardy. ANA calls on the Administration to deploy these policy solutions to address the dire nurse staffing shortage crisis.
Convene stakeholders to identify short- and long-term solutions to staffing challenges to face the demand of the COVID-19 pandemic response, ensure the nation’s health care delivery system is best equipped to provide quality care for patients, and prepared for the future challenges.
Work with the Center for Medicare and Medicaid Services (CMS) on methodologies and approaches to promote payment equity for nursing services and remove unnecessary regulatory barriers to APRN practice.
Educate the nation on the importance of the COVID-19 vaccine to provide resources for widespread administration of the COVID-19 vaccine and any subsequent boosters.
Sustain a nursing workforce that meets current and future staffing demands to ensure access to care for patients and prioritize the mental health of nurses and other health professionals.
Provide additional resources including recruitment and retention incentives that will attract students to the nursing profession and retain skilled nurses to the demands of patient care.
“ANA stands ready to work with HHS and other stakeholders on a whole of government approach to ensure we have a strong nursing workforce today and in the future,” said Dr. Grant. “Our nation must have a robust nursing workforce at peak health and wellness to administer COVID-19 vaccines, educate communities, and provide safe patient care for millions of Americans. We cannot be a healthy nation until we commit to address underlying, chronic nursing workforce challenges that have persisted for decades.”
Mesothelioma is an aggressive form of cancer that concentrates on the layer of tissues surrounding the internal organs. The disease is usually caused by asbestos exposure (according to theAmerican Cancer Society, eight out of 10 cases can be traced to asbestos inhalation). It is rare, hard to treat, and the survival rates are daunting, so a patient who receives a mesothelioma diagnosis needs as much support as you can provide.
As patient educators, nurses can help to significantly ease patients’ fears and uncertainties. Below are some strategies to help you support a newly diagnosed mesothelioma patient, prepare them for living with this cancer, and encourage them to be active participants in their own treatment.
Mesothelioma Basics: Causes, Symptoms, and Treatments
Symptoms: There are four types of mesothelioma, all of which affect different areas of the body. However, pleural mesothelioma is the most common and is found in the lining of the lungs. The most common symptoms of mesothelioma—regardless of the type—include:
Coughing and wheezing
Fatigue and muscle weakness
Fever and night sweats
Loss of appetite
Unexplained weight loss
Diagnosis: It could take anywhere from 10–20 years after being exposed to asbestos for mesothelioma to develop. This can make it difficult for patients to remember when and where they were exposed— in part because the disease is often detected in the later stages. Also, the prognosis for mesothelioma is poor, with a life expectancy anywhere between 18 to 31 months.
Treatment: Current treatment options for mesothelioma include surgery, chemotherapy, radiation therapy, or a mix of the three. However, there are clinical trials that are continually being done to make advancements to these treatments.
Starting on the Right Foot: Educate, Communicate, and Guard Against Misinformation
Nurses and health professionals are responsible for assessing how the patient is feeling physically and emotionally, educating them and their families about treatment plans and potential outcomes, being aware of the patient’s lab results and medical history, and instructing them on where they can find support groups and further information.
Before you start relaying information to your patient, you’ll want to figure out the patient’s health literacy—their ability to understand health information. It’s important for nurses to know about health literacy because it improves communication with the patient and can greatly improve the outcome of their disease. If your patient is constantly missing appointments, giving excuses for why they can’t fill out their forms or read materials or are behaving overly nervous or indifferent, then they may have a low health literacy.
A lot of the information associated with mesothelioma can be upsetting and confusing.
Listen to patients if they say that they’re done learning for the day, and avoid overloading them with information all at one time.
In explaining a cancer diagnosis, avoid polysyllabic medical terms and jargon (but do point patients to a good glossary, so they can “study up”). You should also try to answercommon questions about mesothelioma (even if the patient tells you they don’t have any) to steer them away from 2 am Google sessions leading to dubious sources. Key questions to cover are:
What other tests will they need before and during treatment?
What are the goals of the treatments? Are they palliative or do they aim to cure the cancer?
How will the patient know when treatments are working?
How will treatments affect their everyday activities?
Lastly, nurses and healthcare providers should utilize teach-back to ensure that the patient understands the information they were given. Have them explain their disease, treatments, and other information as if they were discussing it with a friend or family member. Use this time to clear up any misinformation that the patient may have.
Get a Handle on their Learning Style
Everyone has different learning styles, so your education efforts should align with how the patient learns best. Find out what sort of learning materials s/he finds easiest to absorb.
Ask them if they would rather have their information given to them via text, video, audio, or in person. You could also ask if pictures, charts, and models are more helpful than just written words. Often providing the same information in multiple formats is the most effective way to share information.
Lastly, make sure that the patient’s family and friends have access to this information as well. These people act as a support system for them and will be able to help them remember facts once they’re at home. Give them the opportunity to ask questions, and give them materials to study. Include them in demonstrations and instructions.
Practice Your Caritas Processes
Mesothelioma is an aggressive disease that has a low survival rate. This is a scary fact, and your patient may be having a difficult time accepting it. It’s important to be sensitive to their feelings and to allow them the time to absorb the gravity of their disease. Here, more than ever, you will want to practice the classicWatson Caring Science principles such as being present, compassionate, sensitive, coaching, and understanding a patient’s need to express both positive and negative feelings.
You want to give your patient realistic expectations on how mesothelioma will affect their lives. However, you don’t want to use fear tactics to encourage them to do treatment or follow medication instructions. Instead, focus on the positive outcomes of them following these instructions.
Be mindful that a lot of the information associated with mesothelioma can be upsetting and confusing. Listen to patients if they say that they’re done learning for the day, and avoid overloading them with information all at one time. Following these practices will ensure that your patients will are well informed about their condition and the treatment options that are available to them.
Resources on Mesothelioma
To learn more about mesothelioma, check out these additional sources:
National Nurses United (NNU), the largest union of registered nurses, sent a letter to the Centers for Disease Control and Prevention (CDC) on July 12, urging the agency to update its Covid-19 guidance and reinstate “the recommendation for everyone to wear masks in public or in physical proximity to others outside their own household.”
“NNU strongly urges the CDC to reinstate universal masking, irrespective of vaccination status, to help reduce the spread of the virus, especially from infected individuals who do not have any symptoms,” wrote NNU Executive Director Bonnie Castillo, RN, in the letter. “SARS-CoV-2, the virus that causes Covid-19 disease, spreads easily from person to person via aerosol transmission when an infected person breathes, speaks, coughs, or sneezes.”
The letter noted that the “Covid-19 pandemic is far from over,” with a 16 percent increase in daily new cases over the previous week and more than 40 states seeing an increase in daily new cases over the previous two weeks as well as 25 states seeing an increase in hospitalizations.
NNU stated that the rise in cases is not surprising due to “the rapid reopening of many states and the removal of public health measures, including the CDC’s May 13, 2021 guidance update that told vaccinated individuals they no longer needed to wear masks, observe physical distancing, avoid crowds, or get tested or isolate after an exposure, within only a few exceptions.”
Unfortunately, the “CDC’s guidance failed to account for the possibility—which preliminary data from the United Kingdom and Israel now indicates is likely—of infection and transmission of the virus, especially variants of concern, by fully vaccinated individuals,” the letter continued. The Delta SARS-CoV-2 variant is already dominant in the United States.
The CDC’s May 13 guidance “also failed to protect medically vulnerable patients, children, and infants who cannot be vaccinated, and immunocompromised individuals for whom vaccines may be less effective.” Asymptomatic or pre-symptomatic infected people “can spread infectious SARS-CoV-2 aerosols during breathing and speaking, without coughing or other respiratory symptoms,” the letter noted.
Covid-19 vaccines are an important public health tool, but multiple measures are necessary to protect public health, as NNU noted in a May 17, 2021 scientific brief. However, only 48 percent of the total U.S. population have been fully vaccinated as of July 11, 2021, according to the CDC. The vaccines are effective at preventing serious illness and death from the virus for vaccinated people. However, no vaccine is 100 percent effective and the emergence and spread of variants of concern may reduce vaccine effectiveness.
“Masks are a simple and effective tool, especially when used in combination with other measures to reduce the risk of Covid-19,” noted Castillo in the letter. On June 25, 2021, in response to the spread of the Delta variant, the World Health Organization urged fully vaccinated people to wear masks.
In the letter, NNU also called on the CDC to:
update health care infection control and other Covid-19 guidance to fully recognize aerosol transmission,
require tracking and transparent reporting of Covid infections among health care workers and other essential workers, and
track infections in people who are fully vaccinated, including mild and asymptomatic infections.
This is the first of several blog posts on nursing issues in the developing world contributed by MSc nursing students studying at the Karachi, Pakistan campus of the Aga Khan School of Nursing and Midwifery.
Their class assignment involved composing and submitting short research articles for publication in a recommended nursing blog or journal. The object: to help them hone their communication skills as future nurse leaders in Pakistan’s healthcare system. As their instructor put it, one of the goals of the exercise is to encourage nursing students to become “Change Agents” in healthcare settings and the world. DailyNurse thanks the instructor and all of the Change Agents who submitted articles. We hope you will find the selected posts informative and thought-provoking.
Developing countries have reduced burn cases by educating the public about safety guidelines, advanced safety fire safety tools, regulations, and raising awareness regarding this burning issue.
However, fire safety rules are either not enforced or people are unaware of fire safety precautions in developing countries, particularly in Pakistan. Furthermore, due to overpopulation, lack of education, social and economic problems, it is difficult to reduce the cases, which leads to increase health costs and years of life lost (YLL). Currently, Shalamar Hospital Lahore is pursuing a campaign to sensitize the public to the danger of serious household burns, particularly among children.
The following are some kitchen-based strategies that Shalamar Hospital is suggesting to help prevent and reduce the occurrence of burns in children.
Avoid holding a child while catering or carrying hot food or liquid.
Communicate to youngsters that hot things burn.
Avoid drinking any hot fluids or food while having a child in your lap.
Kitchen safety guidelines should be posted on a visible site and followed strictly.
Teach children to stay away from the kitchen stove.
Always use child-resistant lighters and avoid smoking.
Keep the play area away from the kitchen and keep close eyes on children.
Replaced all broken electrical wires and plugs, as soon as possible.
Make sure there is an essily accessible exit in each room, especially the kitchen.
Keep towels and other flammable material away from your kitchen stovetop.
Turn the handles of the pot towards the back of the stove.
Unplug small appliances when not in use.
Keep heaters at least three feet away from furniture or any other flammable materials.
Avoid leaving the kitchen unattended while cooking and making sure that you have stored all the hot recipes in a safe place and have locked the cupboards.
Use oven mitts when it is necessary to handle ovens and heaters.
Do not use tablecloths and place hot foods and liquids away from the table corner.
Never use petrol or kerosene oil for burning.
Do not warm the formula milk bottle to avoid burning a baby’s mouth.
Resources for Further Information on Household Burn Safety: