Tag Archives: college of nursing

breast.cancer

UA Study Targets Latinas with Breast Cancer

Breast cancer is the most commonly diagnosed cancer in Latinas, but patients often have limited access to resources to help them cope psychologically.

A research study to evaluate the impact of low cost telephone-delivered counseling on quality of life for Latinas with breast cancer and their supporters is being led by Terry A. Badger, PhD, RN, PMHCNS-BC, FAAN, professor and division director of community and systems health science at the University of Arizona College of Nursing and a member of the UA Cancer Center.

Dr. Badger received funding from the American Cancer Society to conduct the Telephone Health Education and Support Project, which is open nationwide to eligible participants and their supporters, who can include spouses, family members or friends.

“Latinas are a growing and particularly vulnerable population with regard to breast cancer, because they tend to be diagnosed at later stages, to be sicker, and, in particular, have fewer easily accessible resources to deal with their psychological distress,” said Dr. Badger. “Untreated distress is associated with poorer health outcomes, so we designed a study to offer support for this distress that could easily be accessed by these patients.”

The study is comparing two groups, each composed of women and their designated supporters. One group of women and their supporters receives a counseling-focused intervention and the other receives an educationally-focused intervention. The interventions are delivered by specially trained professionals in a 30 to 40 minute telephone call once a week for eight weeks.

“In our research, we have found over and over that the supporter has as much if not more psychological distress than the survivor themselves,” said Dr. Badger. “This makes it critical that we provide services to both the Latina and her supporter.”

Christina Castro, a 58-year-old mother of three from Tucson, decided to participate in the study with her husband after she was diagnosed with breast cancer seven months ago.

“The call once a week was something to look forward to,” said Castro. “It was really easy to talk to someone who wasn’t a family member, but someone who would just listen to me. Being at home really helped make it comfortable, and it was set up at a time that was convenient for us. The calls were both comforting and empowering. I would definitely encourage others to do it.”

“We have participants from all over, including Yuma, New Mexico, Colorado and Nevada,” said Dr. Badger. “Research team members call participants in the evenings or on weekends, whenever it’s convenient for the patient and their partner. We can deliver this intervention anywhere as long as participants have access to a telephone.”

To learn more, call 1-866-218-6641 or email Maria Figueroa at mcf2@email.arizona.edu or Dr. Badger at tbadger@email.arizona.edu.

Nurses in a line

First Nurses Graduate from UA's Phoenix Campus

Sixteen students are the first to receive a Master of Science degree for Entry to the Profession of Nursing (MEPN) from the University of Arizona College of Nursing at the Phoenix Campus. The students attended a celebration in Phoenix on Aug. 6, then joined the Tucson-based graduates of the same program at a commencement ceremony in Tucson on Aug. 8.

The MEPN is an accelerated nursing program for students with a non-nursing baccalaureate degree who would like to enter the profession of nursing as registered nurses (RN). One class is admitted per year, with students beginning the 15-month program in May and completing it the following year in August.

“It’s exciting that we have the only program of this kind in Arizona and now are offering it at the Phoenix Campus,” said Terry A. Badger, PhD, RN, PMHCNS-BC, FAAN, professor and director of the Community & Systems Health Science Division at the UA College of Nursing. “Students in the master entry to professional nursing program already have university degrees in other fields, and bring depth and breadth from their previous careers to nursing. MEPN graduates are going to be our future leaders and change agents in health care.”

The first Phoenix graduates hold degrees that include veterinary science, education, anthropology, exercise science, law, philosophy, biology and anatomy.

At the celebration, students were joined by Phoenix core faculty members Vladimir Semin, MS, CCRN; Deborah A. Gorombei, RN, MS, CFRN, LNCC; and Amy L. Haycraft, RN, MSN, ANP-C, as well as faculty from the Tucson campus, the students’ families and friends, and community partners who helped in their education.

For the first two years, the Phoenix-based MEPN program is being supported by the Arizona Area Health Education Centers), which is directed by Sally J. Reel, PhD, RN, FNP, BC, FAAN, FAANP, associate dean of academic practice in the UA College of Nursing. Maricopa Integrated Healthcare System was pivotal in helping establish the Phoenix MEPN program and serves as the major clinical practice site. Students also learned nursing skills in several other Phoenix-area health-care agencies.

Nurses in a line

First Nurses Graduate from UA’s Phoenix Campus

Sixteen students are the first to receive a Master of Science degree for Entry to the Profession of Nursing (MEPN) from the University of Arizona College of Nursing at the Phoenix Campus. The students attended a celebration in Phoenix on Aug. 6, then joined the Tucson-based graduates of the same program at a commencement ceremony in Tucson on Aug. 8.

The MEPN is an accelerated nursing program for students with a non-nursing baccalaureate degree who would like to enter the profession of nursing as registered nurses (RN). One class is admitted per year, with students beginning the 15-month program in May and completing it the following year in August.

“It’s exciting that we have the only program of this kind in Arizona and now are offering it at the Phoenix Campus,” said Terry A. Badger, PhD, RN, PMHCNS-BC, FAAN, professor and director of the Community & Systems Health Science Division at the UA College of Nursing. “Students in the master entry to professional nursing program already have university degrees in other fields, and bring depth and breadth from their previous careers to nursing. MEPN graduates are going to be our future leaders and change agents in health care.”

The first Phoenix graduates hold degrees that include veterinary science, education, anthropology, exercise science, law, philosophy, biology and anatomy.

At the celebration, students were joined by Phoenix core faculty members Vladimir Semin, MS, CCRN; Deborah A. Gorombei, RN, MS, CFRN, LNCC; and Amy L. Haycraft, RN, MSN, ANP-C, as well as faculty from the Tucson campus, the students’ families and friends, and community partners who helped in their education.

For the first two years, the Phoenix-based MEPN program is being supported by the Arizona Area Health Education Centers), which is directed by Sally J. Reel, PhD, RN, FNP, BC, FAAN, FAANP, associate dean of academic practice in the UA College of Nursing. Maricopa Integrated Healthcare System was pivotal in helping establish the Phoenix MEPN program and serves as the major clinical practice site. Students also learned nursing skills in several other Phoenix-area health-care agencies.

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The changing role of nurses

They are the healthcare providers that will see 22 percent job growth – more than any other occupation – through 2018. They are the communicators. They bridge the gap in the medical industry. They are the part of the healthcare team that makes sure that the right patient is in the right place getting the right thing done.

They are nurses and they are now taking on more specialized roles, applying advanced technologies and filling voids created by an anticipated shortage of primary care physicians.

“We are encouraging our nurses to return to school to advance their degree,” said Deborah Martin, senior director of professional practice at Banner Health. “Patients are much more complex in our hospitals, as well as in the home and our communities … Nurses need to have higher levels of education to manage these complexities in all settings where nurses practice. Advanced degrees are now required for our upper level nursing managers.”

About 10,000 Baby Boomers reach retirement age every day, fueling the long-term demand for specialized nurses. To help fill that need, Arizona State University implemented the Adult-Gerontology Nurse Practitioner Doctor of Nursing Practice (DNP) concentration.

“It will prepare nurse practitioners to deliver primary care to adults throughout their lifespan with increased emphasis on care of the aging population,” says Katherine Kenny, clinical associate professor and director of the DNP program at ASU.

Johnson & Johnson’s website lists more than 3,000 capacities in which nurses can be employed — from school nurses to jailhouse nurses. Nurses practice in hospitals, schools, homes, retail health clinics, long-term care facilities, battlefields, and community and public health centers. Everywhere there are people, there are patients, and everywhere there are patients, there are nurses.

“Nurses are becoming more influential in the policy changes that are occurring with the Affordable Care Act,” Kenny says. “More nurses are practicing in ambulatory care settings and public and community health.”

Arizona educational institutions are now offering a wide range of educational opportunities which support the nursing profession’s challenge to improve patient care outcomes for individuals, systems, and organizations. And because of skyrocketing healthcare costs, preventative care and education have become integral elements in reducing chronic illness and minimizing re-hospitalization.

“Nurses are now specializing in everything from palliative care and managing chronic illness, to maintenance and preventative care,” says Ann McNamara, dean of Grand Canyon University’s College of Nursing. McNamara says students at GCU are spending more time concentrating on home healthcare and hospice in their new hands-on simulation labs, complete with live actors, computer-operated mannequins, and dynamic patient scenarios.

Angel MedFlight provides air medical transportation services from bedside to bedside.  The company’s CEO, Jeremy Freer, says “[Our] nurses are able to put all the components of the puzzle together and make the medical flight process more efficient, effective and compassionate.”

Nurses are also assessing the long-range healthcare needs of patients.

“Where once the hospital nurse’s prime responsibility was to provide the best care possible that the patient needed at that moment, now the nurse is also focused on what happens next,” explains Maggi Griffin, vice president of patient care services at John C. Lincoln Health Network.

Griffin says that patient discharge planning and post-hospitalization follow up are other key roles of the evolving nursing profession.

Advancements in technology have significantly enhanced patient care in recent years.  Nurses now have the ability to monitor patient conditions remotely, and electronic health records enable nurses to track, evaluate, and document patient information.

“Technology is opening doors to deliver nursing care in new and innovative ways, often serving as a second set of eyes to enhance patient safety or monitoring patients from their homes,” says Deborah Martin, senior director of professional practice at Banner Health. Martin adds that Medication Bar Coding is another example of how technology is helping nurses be more effective and prevent errors.

Due to the skyrocketing cost of healthcare in general, nurses are becoming more involved in a patient’s primary care.

“As advanced practice providers of healthcare, nurses with master’s and doctoral degrees are able to deliver high quality care to patients in their own individual practice,” Martin says, “as well as work side by side with physicians to provide care in a more cost effective manner.”

“As the major component of hospital rosters, nurses’ salaries account for a significant part of any hospital budget,” Griffin adds. “With financial stresses coming from the economy, from government healthcare program budget cuts and from other areas, nursing is much more tightly controlled.”

A decade ago, nursing shifts were scheduled regardless of room occupancy. Currently, industry experts say those staffing schedules fluctuate based on patient population in each unit.

The other major shift is in the demand for specialized nurses. Julie Ward, chief nursing officer at St. Joseph’s Hospital and Medical Center, says specialties have nurses working in both the inpatient and outpatient settings.

“We are also exploring roles for nurses to shepherd groups of patients through the maze of care,”  Ward says. St. Joseph’s nurses make follow-up phone calls to patients to ensure the patient is safe and able to follow their discharge instructions, Ward says.

Still, the primary evolution of the nursing industry has been in higher education. Gone are the days when nurses were simply bedside attendants. Now, they are replacing the expensive medical doctors and are running their own practices as Family Nurse Practitioners (FNPs) and in other upper level specialties. Most hospitals are encouraging their nurses to return to school to improve their knowledge base and advance their degrees.

The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine of the National Academies (IOM) launched a two-year initiative to respond to the need to assess and transform the nursing profession. The IOM appointed a Committee on the RWJF Initiative on the Future of Nursing for the purpose of producing an action-oriented blueprint for the future of nursing. Through its deliberations, the committee developed four key messages:

* Nurses should practice to the full extent of their education and training.

* Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.

* Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.

* Effective workforce planning and policy making require better data collection and information infrastructure.

“We are encouraging our nurses to return to school to advance their degree,” Martin says. “Patients are much more complex in our hospitals, as well as in the home and our communities. As noted by the IOM, nurses need to have higher levels of education to manage these complexities in all settings where nurses practice. Advanced degrees are now required for our upper level nursing managers.”

Nursing Shortage Still Plagues Arizona’s Health Care Industry

Nursing Shortage Still Plagues Arizona’s Health Care Industry

Arizona’s nursing shortage is a very serious problem and it is not going away any time soon. The state is going to need approximately 49,000 new registered nurses by 2017 to keep pace with population growth, RNs retiring and nurses lost to attrition, according to the Arizona RN Shortage: 2007 Results, a report published by the Arizona Healthcare Data Center. The data center was started by the Arizona Hospital and Healthcare Association (AzHHA) in 2007 to study health professions in Arizona.

“I think people are tired of hearing about the nursing shortage,” says Bernadette Melnyk, dean of ASU College of Nursing and Healthcare Innovation. “They don’t understand the adverse effects until they or a family member is hospitalized and they see for themselves the effect it has on the health and safety of people they love.”

Of the approximately 49,000 RNs that will be needed by 2017:

  • 20,000 will be needed to keep pace with the state’s growing population, as well as to close the gap between Arizona’s current average of 681 RNs per 100,000 residents and the U.S. average of 825 RNs per 100,000 residents.
  • 10,000 nurses will be required to replace retiring RNs. More than one-third of Arizona’s current RNs are older than 55 and will retire over the next five to 10 years.
  • 19,000 RNs, or 3.5 percent annually, will be needed to account for the profession’s attrition rate.
  • Twelve of Arizona’s 15 counties also fall below the national average of RNs per 100,000 people, according to the Health Resources and Services Administration (HRSA). The national average is 3.3 RNs per 100,000 people, and Arizona has 1.9 RNs per 100,000 people. The three counties that exceed the national average — Coconino, Pima and Yavapai — still face shortages of RNs.

    Adda Alexander, RN, MBA, former executive vice president of AzHHA, says Arizona colleges have increased their capacity and are graduating more nurses, but it is not enough. Arizona’s nursing programs need to graduate an additional 2,235 students per year just to keep pace with the state’s population growth.

    To help address the nursing shortage, Arizona hospitals contributed $57 million between 2006 and 2007 to the state’s education programs in the form of tuition reimbursements, loan forgiveness programs and in-kind giving (providing space for nursing education programs, sponsoring faculty salaries and tuition reimbursement). In 2005, the Arizona Legislature passed the Arizona Partnership for Nursing Education (APNE) bill, which provided $20 million over five years to double the capacity of Arizona’s college and university nursing education programs by increasing the number of nurse education faculty. As a result of the APNE funding, the estimated number of additional nursing graduates in 2010 will be 1,242. Alexander said APNE was a crucial step in helping the nursing shortage, but it sunsets in 2010 and the funding stops.

    According to Annual Reports from Nursing Education Programs, 2007, Arizona Board of Nursing, there were 41 vacancies for full-time Arizona nursing faculty in 2006, which was a 13 percent increase from the previous year. In addition, there were 38 vacancies for part-time nursing faculty in 2006, which represented a 600 percent increase in vacancies from 2005.

    The report also indicated that due to the lack of capacity, more than one-third of nursing students are wait-listed each year by Arizona nursing programs even though they have met all course prerequisites.

    Joey Ridnour, executive director of the Arizona State Board of Nursing, contends that the lack of clinical space also contributes heavily to the nursing shortage. Thus, many states are looking at using simulations in combination with clinical experience to teach students.

    “This may be a good combination to consider in the future, but faculty needs to figure out how to maximize it so students get a good education,” Ridnour says. “When I was a student, I would have valued doing some of the procedures through simulation rather than on live patients. It would have given me a better understanding and more confidence.”

    Melnyk believes the state has to hit the nursing shortage from two angles: (1) produce more nurses and (2) help them feel satisfied and empowered in their role. She says between 35 and 60 percent of new graduates leave their positions in the first year due to stress from staffing shortages and patient acuity levels.

    “I think nurses get out in the real world and don’t expect their jobs to be so stressful,” she says. “People in hospitals are very sick and oftentimes what the nurses are expected to juggle is too much for them to handle.”

    Melnyk also thinks nurses and other health care providers should be educated in evidence-based practice (EBP), a problem-solving approach that integrates the best evidence from research studies and combines it with patient preferences and the clinician’s expertise.A number of medical studies show that when nurses, physicians and other health care providers deliver care in an evidence-based manner, the quality of care is substantially better and patient outcomes improved.

    “Studies also show that nurses practicing EBP are more satisfied with their role, feel more empowered and make less medical errors,” Melnyk says. “A lot of people don’t realize that 99,000 patients die annually in the U.S. due to medical errors. That’s a staggering number of patients.”