VA Nurse Gives a Family the Chance to Say Goodbye

VA Nurse Gives a Family the Chance to Say Goodbye

CPR in a restaurant on a woman not breathing

Here is just one story about how VA nurses excel in their occupation, on and off duty.

VA Nurse Karen Brodlo sat in a restaurant enjoying her dinner when she heard someone yell to call 911.

She looked up to see an elderly woman had collapsed and was not breathing. The woman was having dinner with her husband when the night took a turn for the worst.

Brodlo quickly jumped in action. As a VA nurse for 23 years and in the nursing field since 1969, it was second nature. She identified herself to the crowd as a nurse and assessed the situation.  Right away she noticed that the woman was positioned incorrectly.  She quickly made the adjustments and started to administer CPR.

She continued manual CPR process until the rescue team arrived. She then turned her focus to the husband who was nervous and scared for his wife’s well-being. She tried to calm him down as the rescue team continued to work to save the woman’s life.

She remembers the worst part being, not having the equipment she needed. She suggested to the restaurant after the incident that a general-use defibrillator would be a useful addition.  Just as most businesses have fire extinguishers, a defibrillator should also be a requirement. Just as easy to use, it’s better to have and not need it than to need it and not have it.

After much praise came her way for saving a life, Brodlo said, “I just did what was right. No accolades are needed for doing my job.”

The restaurant now gives her star treatment. The daughter of the woman she saved sent a bouquet of flowers along with a heartfelt thank you card calling Brodlo her mom’s “Guardian Angel.”

Brodlo is a nurse at the Captain James A. Lovell Federal Health Care Center in North Chicago.

As a caring nurse who adores her job, she followed up on the status of her honorary patient. Sadly, a couple of weeks after the incident, the woman passed away from further complications, but the family was overwhelmingly grateful.

The last days with any family member or loved one is crucial. If it wasn’t for the quick actions of nurse Karen Brodlo, they would have missed out on the opportunity to say their last goodbye.

This story was originally posted on VAntage Point.

10 Questions: Therese S. Richmond, PhD, CRNP

10 Questions: Therese S. Richmond, PhD, CRNP

Therese S. Richmond, PhD, FAAN, CRNP, associate dean for research and innovation at the University of Pennsylvania School of Nursing, views nursing as “an exquisite opportunity” to help people when they are at their most vulnerable. There is nothing better than being a nurse, she told MedPage Today, explaining that even during her hardest days she reminds herself to “take a deep breath and be thankful for the honor of being a nurse.”

Richmond received her Masters in Nursing Science from Catholic University of America in the early 1980s, followed by a PhD from the University of Pennsylvania a decade later. Since then, she has spent much of her career using nursing science to prevent injury and violence and improve outcomes, particularly in patients from vulnerable urban populations worldwide.

Richmond was recently elected to the National Academy of Medicine and is also a member of the Federal Advisory Committee to the Secretary for National Health Promotion and Disease Prevention Objectives for 2030.

In this installment of “10 Questions,” Richmond discusses the complexity of the U.S. healthcare system and what she sees as its most pressing issues.

1. What’s the biggest barrier to practicing nursing today?

The complexity of healthcare systems and the rapid movement of patients through acute hospitalization poses a significant challenge. Nurses need to get to know patients and families quickly, predict what their needs will be upon discharge, and prepare patients and families to provide complex care in the home.

As an injury researcher, I have found that psychological consequences surface after injury for a substantial subset of injured patients. Yet the symptoms of psychological reactions to injury do not surface until after discharge. We need to prepare patients to recognize symptoms of disorders such as post-traumatic stress disorder and depression, so that patients and families recognize and attend to symptoms when they arise and know when and how to ask for help.

Nurses need to overcome the barriers erected by increasingly shortened hospital stays and help people know where to go to seek help — which is not easy in complex systems.

2. What’s the most important healthcare issue that nobody is talking about?

We continue to compartmentalize physical and psychological health. Today, we have systems that do not recognize the intersection of psychological and physical health. I am not speaking here about people with chronic serious mental health disorders (e.g., schizophrenia). Instead, I am talking about people who experience an acute illness (e.g., myocardial infarction) or injury (e.g., assaulted with a weapon).

A certain proportion of people with illness or injury will have symptoms of a psychological disorder emerge. While we are effective at treating the MI or the injury, we tend to be blind to the psychological responses — and even when we see these responses — in taking action. This problem is exacerbated by the fact that we predominately focus on a single episode of care. We do not fully take into account previous life experiences and exposures that can directly impact outcomes.

Think about what we know about adverse childhood experiences (ACEs) and the profound impact ACEs have on morbidity and premature mortality. Even though we know this, we don’t typically address previous trauma exposures and consider how that will affect recovery or the emergence of psychological symptoms.

3. What changes, if any, will the Trump administration impose on medical practice?

I am currently a special government employee since I sit on the Federal Advisory Committee to the Secretary of DHHS for Health Promotion and Disease Prevention and thus not in a position to answer this question.

4. What country do you think has a better healthcare system than the United States?

My previous response applies to this question as well, and thus I am not in a position to respond.

5. What is the most important piece of advice for students or providers just starting out today?

Maintain your passion and always remember the reason you entered nursing. Never forget the patient should be at the center of all we do.

6. Have you ever been afraid of a patient?

I have never been afraid of a patient. For the decades I worked in trauma and neurological critical care, there have been times that I have been in situations where behaviors are problematic. I always remind myself that if patients are acting out there is usually a physiologic, psychologic, or medication-related reason and I try to intellectually solve the puzzle of what is driving the behavior. I have found this approach is a useful strategy to address both the needs of the patient and to control any anxiety I may feel about a situation that seems to be spiraling out of control.

7. What is the most memorable research published since you became a healthcare provider and why?

I think in terms of a body of research — not just one study. As an injury and violence researcher, I think the most important is the body of research that has reduced death by motor vehicle crashes. We have learned a tremendous amount through research about cars (e.g., better, safer designs), behavior (e.g., driving while distracted, use of child safety seats, the importance of motorcycle helmets), and environment (e.g., highway design, pedestrian crossings).

As a result, we have been able to decrease death by motor vehicle a significant amount. The CDC counts this reduction in death from motor vehicle crashes as one of the top ten public health successes of the 20th century. This concerted effort required access to data, rigorous design of research studies, and a regulatory body able to institute new policies and standards based on solid science.

I am hopeful that in the future we can build a comparable body of research to reduce death by gun.

8. Do you have a favorite medical-themed book, movie, or TV show?

Can’t think of anything.

9. If you weren’t doing your current work, what do you think you would be doing today?

There is nothing better than being a nurse. Throughout the decades, I have had so many diverse opportunities to impact the lives of people and communities through my practice, my research, and my teaching. If I were not at Penn doing what I love best, I would see myself in a low-resource community trying to improve the health and well-being of those with the highest need. We have such disparities between those who have and those who have-not — it is highly disturbing. I would like to find a way to bring that into a more equal balance, which in the long-run will improve the health of all.

10. What is the biggest difference between your expectations of nursing practice when you graduated from nursing school and the reality?

There is a tremendous difference in what I expected and reality. I expected to provide high quality, knowledgeable, and skilled care to sick people. What I experienced is that at its core, nursing provides me an exquisite opportunity to touch people’s lives at a time that they are at their most vulnerable. This is a privilege afforded to me as a nurse that few others experience. During my hardest days, I take a deep breath and remember to be thankful for the honor of being a nurse.

This story was originally posted on MedPage Today.

North Carolina Nurses Lobby State Legislature for Healthcare Policies

North Carolina Nurses Lobby State Legislature for Healthcare Policies

Earlier this week, over 1,000 North Carolina nurses and nursing students met with state lawmakers to lobby on behalf of their patients. These discussions were part of the North Carolina Nurses Association’s 2019 Nurses Day at the Legislature. School nurses and the SAVE Act (a bill that would provide advanced practice registered nurses with more practice authority) were among the issues discussed.

Before meeting with legislators, the nurses and students gathered for an advocacy-themed continuing education program to hear Dr. Ernest Grant, president of the American Nurses Association, deliver the keynote address, which included notes about why the SAVE Act is crucial for North Carolina nurses and patients.

“In some cases, a nurse may have to wait on a physician signature or something like that in order to provide the healthcare for a patient- something they can easily sign for themselves and be on to the next patient, if you will,” Grant shared with the crowd.

As ABC11’s Andrea Blanford reported, North Carolina’s rural areas are currently experiencing a shortage of both nurses and physicians, which is why these issues are particularly crucial right now to all healthcare providers across the state. Luckily, the nurses and students already had the ears of a few legislators, like Rep. Gale Adcock. Rep. Adcock has been a family nurse practitioner for 32 years and is one of three nurses in the General Assembly.

 In fact, Adcock introduced one of the pieces of healthcare legislature that the nurses rallied for. The bill would ensure every school in North Carolina will have at least one nurse, as schools currently are experiencing their own nursing shortages.

“There are many districts where nurses have three and four schools they have to cover and that’s untenable,” Adcock said.

Besides advocating for nurses and patients across the state, the North Carolina Nurses Association (NCNA) provides resources to advance nursing practice and education. The NCNA hosts the Nurses Day at the Legislature every other year.  

Nurses of the Week: Mother-Daughter Duo Marian and Suzanne Phelps Work to Build Up Red Cross Blood Donations

Nurses of the Week: Mother-Daughter Duo Marian and Suzanne Phelps Work to Build Up Red Cross Blood Donations

Our Nurses of the Week are Marian and Suzanne Phelps, a mother-daughter duo who are both registered nurses, who are working with students to organize blood drives in Porter County, near the Chicago metropolitan area. They were inspired by Jan Dick, Marian’s husband and Suzanne’s father, who estimates that he’s donated roughly 16 gallons of blood over the last four decades.

Dick explains how he came to be a regular blood donor: “I guess, what kicked the whole thing off, I had a neighbor. This was about 45 years ago, and (the neighbor’s) boss was in need of surgery. The guy worked for a small outfit and he asked me if I would go donate blood and I went. It didn’t take very long. If you don’t think about it, it was painless. Sure, you get stuck, but it wasn’t that bad. I thought it was the right thing to do.”

After becoming a donor, Dick began volunteering with his local Red Cross in Porter County, and eventually became the president. His activism inspired his wife and daughter to get involved and they now work as a family to build up blood donations for the Red Cross.

Suzanne Phelps is a health occupations instructor at Porter Area Career and Technical Center where she teaches the Health Science Education II class. She has been the Blood Drive Coordinator at the center for the last eight years, and she follows in the footsteps of her mother, who taught the class for over 20 years and organized the first blood drives at the school.

The students have four drives each year and Suzanne says the experience of organizing a blood drive helps the students understand the significance of blood donations to the medical field. Donors can give a pint of whole blood every eight weeks, up to six times a year. According to Patricia Cochran, account manager for the American Red Cross, only 40 percent of the population is eligible to donate blood.

She tells, “Of those who are eligible, only about 3 percent actually donate. A very small amount of people supports the blood supply. If everyone eligible would donate once a year, we would never be in shortage…It might be one hour of your time, but it is a lifetime to the patient in the hospital.”

To learn more about mother-daughter duo Marian and Suzanne Phelps who are working to build up blood donations for the Red Cross, visit here.

Nurse of the Week: Angela Farnan Adopts Baby With Rare Heart Condition She Cared for as a Nurse in the ICU

Nurse of the Week: Angela Farnan Adopts Baby With Rare Heart Condition She Cared for as a Nurse in the ICU

Our Nurse of the Week is Angela Farnan, a nurse in the pediatric ICU at OSF Children’s Hospital of Illinois who adopted a baby with a rare condition who she cared for after he was born. Blaze, who turns 2 in May, suffered from hypo plastic left heart syndrome, a rare congenital defect in which a part of the infant’s heart is underdeveloped or not there at all.

Farnan tells, “I work in the PICU and I can tell you many stories about the many children I’ve cared for over the years. There’s an attachment to these children and their families. You become very invested in them.”

Blaze was born on May 30, 2017, and underwent heart surgery at just 3 days old before enduring another a few months later. His biological family didn’t live near the hospital or have the resources to care for him at home so Blaze remained in the ICU for several months.

Farnan first agreed to have short-term guardianship of Blaze as he remained hospitalized, and a few months later Blaze was preparing to go home when his biological parents asked if Farnan and her husband, Rick Farnan, would adopt Blaze.

The Farnan’s filed the adoption papers last year and finalized the adoption in June. Both new parents describe the experience as a dream come true. Although Blaze is now at home with his parents, his health journey is not over. He will undergo a third heart surgery and may need a heart transplant eventually. Farnan, however, is up for the challenge and says Blaze makes her work as a nurse even more enjoyable when she comes home to him at the end of the day.

To learn more about Angela Farnan, a pediatric ICU nurse who adopted a baby with a rare heart condition after caring for him in the ICU, visit here.

Nurse Practitioners: Meeting the Needs of Rural Veterans

Nurse Practitioners: Meeting the Needs of Rural Veterans

VA strives to deliver high-quality, compassionate health care to Veterans across America. We’ve taken great strides to ensure patients living in rural areas have access to a range of care options to best meet their health care needs. Due to VA’s recent “scope of practice” laws—which grant advanced practice registered nurses (APRNs) full practice authority—certified nurse practitioners are stepping in to provide primary care to patients in rural areas.

Currently, nurse practitioners account for 1 in 4 medical providers in rural practices—a 43.2% increase from 2008 to 2016. Their advanced training and ability to diagnose and prescribe medicine enables more efficient, cost-effective health care delivery. Joyce Knestrick, president of the American Association of Nurse Practitioners (AANP), says “NPs are one of the most significant factors in expanding patient access to primary, acute and specialty care, especially at a time when demand is high and physicians remain concentrated in more urban and affluent areas.”

More and more, nurse practitioners are taking on a significant role in the health care of Veterans in rural areas. Their growing presence demonstrates the wealth of experience, growth and impact available to nurses interested in advancing their careers. Bring your nursing expertise to VA and discover a career in which your capabilities are utilized to the fullest extent—and consider a future serving our honorable Veterans living in rural areas. You’ll enjoy a satisfying quality of life unmatched by metropolitan areas, with all the same comprehensive benefits offered across the VA system. To get started, explore open positions near you and apply.

This story was originally posted on VAntage Point.

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