Some healthcare professionals see blood, mangled bodies, and death every day, yet certain days are worse than others. As when, for instance, a dozen police officers are gunned down or 20 kids are killed in their elementary school in a mass shooting. Because public mass shootings happen nearly every 6 weeks in America, these tragedies are having a more frequent impact on the healthcare workforce.
Research data are sparse. One study surveyed 24 surgical residents working at Orlando Regional Medical Center in Florida in 2016. On June 12 that year, a gunman shot 49 people to death and wounded 53 others at the mass shooting at the Pulse nightclub. Three months later, rates of post-traumatic stress disorder (PTSD) and major depression were two and four times greater among the 10 residents on call that night versus the 14 off-duty residents. Though the differences didn’t reach statistical significance, assessments were revealing. A survey of the same residents 7 months after the mass shooting found that PTSD persisted in those affected in the on-call group but completely resolved in the off-call residents.
As part of an ongoing effort by MedPage Today to explore job stress and burnout among healthcare professionals, reporter Shannon Firth talked at length with physicians and nurses who shared personal experiences with mass shootings and how they affected their lives and careers.
Three Encounters With Mass Shootings
“After I Saw What I Saw, I Really Thought to Myself, ‘I Hope I’m Not Broken:'” Richard Kamin, MD (Sandy Hook school shooting, 2012)
“The Worst Night of My Professional Career:” Brian Williams, MD (Dallas police sniper attack, 2016)
“I Still Get That Pit Feeling in My Chest of, I Can’t Believe This is Happening:” Megan Duke, RN, CEN (San Bernardino terrorist attack, 2015)
MedPage Today intern Amanda D’Ambrosio assisted with reporting for these stories.
Originally published by MedPage Today.
Scientists from the UCLA Integrated Substance Abuse Programs
have been selected to lead a $25 million study funded by the National Institutes of Health (NIH) to test
treatments for opioid addiction in rural America.
A separate grant of $3.3 million from the NIH
was awarded to another UCLA researcher from the substance abuse programs who
will study the effectiveness of using text messages to help people with opioid
addiction adhere to their treatment regimens.
The grants will be distributed over five years and are both part
of the NIH’s Helping to End Addiction Long-term (HEAL) Initiative.
The first study will be led by Yih-Ing Hser, taking
place at more than 40 primary care clinics in up to six states across the US. Hser
is a distinguished research professor of psychiatry and biobehavioral sciences
at the David Geffen School of Medicine at UCLA. The study will be
specifically focused on rural regions because, according to the Centers for
Disease Control and Prevention, the percentage of deaths from opioid overdoses
is higher and there is typically less access to physicians than in urban areas.
Hser tells newsroom.ucla.edu, “We’ll build up the infrastructure to get the clinics ready to test the use of medication and behavioral therapies, so that we can conduct the study in as close to real-world settings as possible. A second phase of the study will look at the use of telemedicine to help overcome treatment barriers, such as the long travel time it sometimes takes to reach clinics in rural areas.”
The study’s co-lead investigator, Dr. Larissa Mooney, director of the UCLA Addiction Psychiatry Clinic at the Semel Institute, adds: “This study has the potential to expand access to life-saving treatments for opioid addiction in communities that have been significantly impacted by the opioid epidemic, and for new models of treatment to be sustainable even after the study is over.”
The second study on the effectiveness of using text
messages to help people adhere to their treatment regimens will be led by Suzette
Glasner, an associate professor-in-residence at the UCLA School of Nursing, and
of psychiatry at the David Geffen School of Medicine at UCLA. Glasner’s research
will assess whether using texts to deliver cognitive behavioral therapy will
help patients stick to their opioid treatment medication regimens.
According to Glasner, “Medications for opioid use disorders are the gold standard treatment, and they continue to save and transform lives. But they only work if you take them, and adherence is low. My hope is that our work will help reverse this trend by providing a low-cost intervention.”
To learn more about the NIH-funded research of two UCLA Nursing
studies on opioid treatment in rural America, visit here.
The Loma Linda University School of Nursing has
been awarded a four-year, $2.6
million grant from the US Department of Health and Human Services (HHS) to
help grow the number of advanced practice registered nurses (APRNs) in Southern
is funded by the HHS’s Advanced Education Nursing Grant Program and will
provide funding toward tuition assistance for qualifying students and enhanced
training. The school recently received confirmation of the funding for year one
of the 4-year grant.
Huerta, DNP, Nurse Practitioner program coordinator and assistant professor in
the Loma Linda University School of Nursing, tells news.llu.edu,
“This grant will allow us to update and enhance the training provided to
students. This will include the development of standardized patient scenarios
focusing on behavioral health issues, as well as managing the opioid crisis —
both of which are significant issues in the Inland Empire as well as
Aguilar, representative for California’s 31st US Congressional District, has
promoted adding HHS funding to provide high-quality affordable healthcare
in the state’s medically-underserved communities. He believes that increasing the
number of highly-qualified nurses in the region can help ensure better health
outcomes for our communities. He tells news.llu.edu,
“I’m proud to announce this funding, and I look forward to a continued
partnership with Loma Linda University in order to increase access to quality
health care throughout San Bernardino County.”
more about the four-year, $2.6 million grant awarded to the Loma Linda
University School of Nursing to help grow the number of advanced practice
registered nurses in Southern California, visit here.
UC Davis Chancellor Gary S. May has named Stephen J. Cavanagh, current dean of the University of Massachusetts Amherst College of Nursing, the new dean of the Betty Irene Moore School of Nursing at UC Davis, effective July 22.
Cavanagh brings extensive experience in collaborating across the entire campus of a university to create innovative programming for students and new forms of interprofessional education with him to UC Davis. He has been recognized for developing the health care workforce, maximizing the use of advanced-practice nurses in clinics around the region to advance access, and educating the next generation of clinicians and scholars.
Ralph J. Hexter, provost and executive vice chancellor at UC Davis, tells UCDavis.edu, “On behalf of Chancellor May and the entire UC Davis community, I am extremely pleased and honored that Dr. Cavanagh has accepted the nomination to be our dean for the School of Nursing. I am confident he will lead the next phase of growth for the School of Nursing in a manner that serves our students and our community well.”
Cavanagh joined UC Davis because of the opportunity it gives him to improve the health of Northern California using new models of nursing and medicine collaboration to improve health. As dean of the College of Nursing, Cavanagh looks forward to finding new ways to engage communities, new technologies to prepare students, and new opportunities for science to improve lives.
To learn more about Stephen J. Cavanagh who was recently appointed as the new dean of the UC Davis College of Nursing, visit here.
In February, the California Future Health Workforce Commission issued their final report describing recommendations to maintain the workforce needed to meet healthcare demands for the present day and the future (source). The California Future Health Workforce Commission was established in 2017 “to help close the gap between the health workforce we have and the health workforce we need.” The commission includes senior leaders from philanthropies across the state (source). The plan develops critical strategies to address professional nurse recruitment.
While the document targets issues across California, the primary concerns are generalizable to the nation. Historically in the U.S., the supply of nurses has not kept pace with demand, predominantly in underserved communities. The impending nursing shortage and an aging population crisis impact communities nationally.
The following key strategies from the report translate well into tactics for professional recruitment.
- Increase opportunities to advance in the health professions allows professional development, advancement, and job progression. Increasing job satisfaction and salaries promote staff retention.
- Align and expand education and training by anticipating areas of deficits and coordinating community and healthcare stakeholders to encourage buy-in. To guarantee continuing improvement, recruiters must look at the shortage as a process instead of a resolved episode. Healthcare organizations and hospital systems have an essential role in addressing the crisis.
- Strengthen the capacity, retention, and effectiveness of nurses by identifying how to minimize burnout and maximize utilizing nurses efficiently.
The California Future Health Workforce Commission report gives recommendations that relate to professional nurse recruitment. By keeping nurses satisfied, promoting community involvement, and reducing burnout the healthcare systems can develop a three-prong approach to recruiting and maintaining a robust nursing staff.
Our Nurses of the Week are UCLA School of Nursing professors Christine Samuel-Nakamura and Mary Rezk-Hanna who have both received grants from the UCLA Academic Senate Council on Research to conduct research projects inspired by their heritage. After earning their doctorate degrees at UCLA Nursing, both nurses were welcomed as assistant professors at the university.
Samuel-Nakamura grew up on the Diné (the indigenous name for Navajo) Nation reservation in New Mexico where she was the youngest child in a large family that raised its own livestock and crops. Her experience growing up on the reservation made Samuel-Nakamura aware of the challenges facing her tribe, including poverty and chronic health problems like diabetes and cardiovascular disease. She later decided to help address these issues by becoming a nurse.
Samuel-Nakamura earned her Bachelor of Science in Nursing at the University of New Mexico, then pursued her Family Nurse Practitioner Master of Science in Nursing degree at UCLA. She tells Newsroom.UCLA.edu:
“I wanted to be able to work with communities on their health issues and empower people to help themselves…As a researcher, you investigate and explore what you see in clinical practice and develop some type of explanation for it and find a way to address it. Clinical practice informs research which, in turn, informs clinical practice.”
Samuel-Nakamura worked for several years in the clinical setting in the federally run Indian Health Service and in tribal hospital clinics on the Diné reservation in Arizona where community elders appreciated her ability to speak with them in their native tongue. She recently received two one-year grants to re-evaluate environmentally contaminated sites in Los Angeles County (home to the largest urban American Indian population in the United States). One grant comes from the American Indian Studies Center in the UCLA Institute of American Cultures and the second is from the UCLA Academic Senate Council on Research.
Mary Rezk-Hanna found inspiration for her research program growing up in Alexandria, Egypt, where both of her parents worked as physicians. She shadowed them as they treated patients, which influenced her decision to become a nurse. One thing she remembers from growing up in Alexandria is looking down from her apartment balcony and being fascinated by the popular hookah cafes across the street.
Rezk-Hanna’s family moved to the US when she was 13 and she later earned her associate degree in nursing and worked as a registered nurse where she became interested in the physiological effects of smoking in young adults with tobacco-related illnesses. She then obtained her Bachelor of Science in Nursing from George Mason University, and while pursuing a Family Nurse Practitioner Master of Science degree at UCLA, she was selected to conduct a community research project about a local population health concern.
Rezk-Hanna found that two of the largest hookah lounges in LA are within one mile of UCLA and considered a major community health concern. She noticed most customers were young adults, with a large portion of them being females, and decided to conduct a study to assess young adult hookah smokers’ attitudes, perceptions, and beliefs toward their choice of smoking, and to identify predictors of hookah smoking. She found that the majority of subjects believed that hookah smoking is not harmful to one’s health.
Rezk-Hanna tells Newsroom.UCLA.edu, “These data could be used to inform young adults about the dangers of hookah smoking as well as provide evidence to guide policy specific to hookah and other alternative tobacco products and nicotine delivery systems.”
Rezk-Hanna is building on her recent findings by studying other evolving hookah tobacco products and their effects on heart health. She has received three grants to investigate the potential cardiovascular toxicity of electronic hookah use among young adults: one from the National Heart, Lung, and Blood Institute, one from the UCLA Clinical and Translational Science Institute, and one from the UCLA Academic Senate Council on Research.
To learn more about UCLA Nursing professors Christine Samuel-Nakamura and Mary Rezk-Hanna and how their heritage has inspired their research, visit here.