Nurses Care 2019

Bangor Daily News, Saturday/Sunday, May 4-5, 2019 D1

Nurses

times a day. You also get kids with tube feedings and health of our students, if that was the case,” Scripture said.

However, in Maine the requirement is that every students that might have seizures several times a day,” Angie Scripture of Hermon knew she wanted to work said Emily Poland, a school nurse consultant for the school district have one registered school nurse. That nurse doesn’t have to be full-time. with children when she was in high school. She just Department of Education.

“In Maine, just like any nursing issue in the country, wasn’t sure in what capacity. However, her future career there is a shortage. There are positions being advertised became crystal clear when she had an unexpected that aren’t being filled,” Poland said. “Schools receive emergency as an upperclassman. money for all of the different essential programs and “When I was a junior, I had my appendix out so I had then they make a determination what fits best for their firsthand experience with nurses because they took care schools. Some nurses in some districts may cover five of me. Some of them really made my day and made a schools and some in more rural places may see a nurse huge difference. I thought, ‘I want to help people just like once a month.” they helped me,’” she said.

Scripture was the only school nurse for all three Scripture went on to become a registered nurse (RN) schools in Hermon when she first started. The town has working in Bangor. When she started her family, she cut since added a second nurse for the middle and high back to working per diem. Now, Scripture is the school schools so Scripture can focus on the younger grades. nurse at the Patricia A. Duran School in Hermon where she Kelley Strout, an assistant professor at the University helps Pre-K through 4th-grade students on a daily basis. of Maine School of Nursing, believes school nurses are “One of the major roles of my job is to make sure I essential for students’ health, sense of belonging, and don’t have sick kids spreading disease in school. The overall mental wellbeing. other role of my job is to have kids in school so they can “School nurses can help a lot of kids who are dealing learn, so to find the balance between those two things is with anxiety and stresses inside and outside the school. A a real challenge,” Scripture said. lot of kids go to school nurses for reassurances that Some days are more difficult than others, since no two someone cares about them,” Strout said. “There’s so many students or their symptoms are alike. standardized test requirements that kids are getting “I thought it was one of the hardest positions I ever shorter and shorter lunch periods where they’re inhaling had,” Barbara Carter said. Carter is a retired school foods. Some schools have free or reduced lunch up to 90% nurse and is now a substitute school nurse for Brewer, and we’re then giving them 10 minutes to eat lunch when Hampden, Newburgh, Winterport, Frankfort and Orono that may be the only food they get for the entire day. schools. “It’s not just sitting at a desk distributing BandSchool nurses should be able to be front and center for Aids waiting for the next child to arrive. You’re the only these issues. But because we’re so limited in the supply of healthcare professional working in a building, so you school nurses they can’t fight those battles too and make have people depending on you.” sure kids are healthy enough to stay in school every day.”

School nurses like Scripture and Carter assist students School nursing isn’t for every RN, but it’s a perfect fit with bellyaches and sore throats as well as more chronic ANGIE SCRIPTURE AND ONE OF HER STUDENT PATIENTS, GRIFFIN DANFORTH for Scripture who is grateful to be doing what she loves illnesses that would have kept kids home years ago.

The American Academy of Pediatrics (AAP) and nursing the young minds of kids in her community.

“All students have a right to education and we need “I feel very lucky to have the opportunity to be a to make accommodations in order for them to access recommends one full-time registered nurse in every that education. So because of that, we’re seeing more school building, every day. Scripture couldn’t agree school nurse. It’s not really a job, especially close to your community, that comes up very often so I feel very kids with chronic conditions and some of them are more with that recommendation.

“There are so many more things we could do to impact the fortunate to have this position,” Scripture said. medically fragile kids, kids being catheterized several

PHOTOS & ARTICLE BY JODI HERSEY

D2 Saturday/Sunday, May 4-5, 2019, Bangor Daily News

CELEBRATE NATIONAL NURSES WEEK! National Nurses Week is an annual event running from May 6-12. It’s a designated opportunity to recognize the men and women who dedicate their efforts to the wellbeing of others. The first day of the week—May 6—is also known as National Nurses Day. The final day—May 12—is the birthday of Florence Nightingale (May 12, 1820 – August 13, 1910).

According to the American Nurses Association (ANA) website, Nightingale is often considered the “founder of modern nursing.” She gained recognition while taking care of wounded soldiers during the Crimean War. She was nicknamed “The Lady with the Lamp” because of her habit of making rounds at night.

National Nurses Week has its beginnings in 1953, when Dorothy Sutherland of the U.S. Department of Health, Education, and Welfare sent a proposal to President Eisenhower to proclaim a "Nurse Day.” Unfortunately, the proclamation was never made. Other unsuccessful efforts followed until 1974, when President Nixon issued a proclamation designating National Nurse Week.

In 1982, President Reagan signed a proclamation designating May 6 as "National Recognition Day for Nurses.”

Today, while National Nurses Week may be the most popular, there are several other days set aside to recognize nurses and the nursing profession. These include National Student Nurses Day (May 8) and National School Nurse Day (on the Wednesday of National Nurses Week). While none of these are public holidays, according to timeanddate. com, they are excellent opportunities to observe this important profession.

NURSING GROUP PHOTO, CA. 1985.

COURTESY EASTERN MAINE MEDICAL CENTER

A NURSE ASSISTING A CHILD IN AN IRON LUNG, CA. 1950.

COURTESY UNIVERSITY OF MAINE FOGLER LIBRARY SPECIAL COLLECTIONS

In an already demanding profession, ICUs keep nurses on their toes

BY ALAN CROWELL

Growing up in Cutler, two towns down from the Canadian border, Registered Nurse Tyler Warner had a childhood more reminiscent of the ‘60s than the social media-heavy environment of today.

“We were outside from morning till dark,” said Warner, 24, who works in the Intensive Care Unit of St. Joseph Hospital in Bangor.

Warner credits that upbringing—one with healthy doses of people-to-people interactions in a town where his neighbors didn’t lock their doors—for giving him many of the skills he would need in nursing.

As an intensive care unit nurse, Warner works with some of the sickest patients in the hospital. While his job involves more technology than ever before, being able to connect with patients and communicate well with team members is also more important than it has ever been.

As hospital patients have gotten older and sicker— often with two or more serious health conditions, such as heart failure and diabetes, for example—healthcare has become both more technologically advanced and more team oriented, with doctors, nurses, pharmacists, certified nursing assistants (CNAs) and specialists working closely together on complicated care plans.

Nurses are at the nexus of those teams, responsible for communicating with patients and their families as well as doctors and the other team members.

It is a role that has become both increasingly complex and demanding. Nurses have to be part scientist, part teacher and part cheerleader, responsible for not only direct medical care but also helping patients understand what they need to do to recover after a medical crisis and motivating them to follow through on that plan, which may include a complicated medication regime and exercise.

While nurses work with a team, they are also often the last line of defense in preventing medical errors and other problems.

They are responsible for keeping tabs on all aspects of the patient’s care, from ensuring that he or she is getting the right medication at the right time, as well as making sure the patient’s environment is clean and comfortable.

“You cannot just blindly follow orders. You have to know what you are doing,” said Warner. “We are double checking the doctor’s orders. We are double checking what the pharmacist does. We are double checking that the equipment is safe. We are double checking that the floor is safe.”

At least as important as those other jobs, however, is the role of patient advocate, helping patients understand their care and helping them make informed decisions.

“I think our job is definitely (treating) the whole patient,” said Warner.

Being able to quickly develop a rapport with a patient can help nurses not only better understand what type of care the patient wants but can also help them uncover information that can be critical to a patient’s diagnosis.

A patient who is being treated for heart failure might actually have taken the wrong medication or even the right medication the wrong way, said Warner.

If a patient that had previously been lucid suddenly stops making sense, they may be delirious, one of the first indications of a serious infection.

For Warner, one of the most rewarding aspects of the job is being able to help people during extremely difficult periods.

“Seeing people go from near rock bottom or rock bottom to coming back up again, there is not a whole lot better feeling,” he said.

TYLER WARNER

While he enjoys the challenge of providing care to the most emergent patients, Warner said one of the most important parts of his job is making sure patients are comfortable and receiving the care they want to receive.

There are days when he may not be able to do much for a patient in medical terms, but if he is able to hold their hand and make a hard time less difficult, that can be as important to that patient as anything else he could have done.

Growing up in Cutler, Warner worked on his stepfather’s lobster boat and dug clams. But his favorite job by a wide margin, he said, was helping Captain Andrew Patterson lead puffin tours ten miles off the coast.

That job involved beautiful surroundings but as much as anything, Warner enjoyed the constant interaction with people.

At the age of 17, he took an emergency medical technician (EMT) course with his mother’s encouragement and quickly learned that he loved the work.

“I really enjoyed caring for people and I enjoyed the work I did. I liked not knowing what was coming,” said Warner. But as much as he enjoyed being an EMT, he knew he wouldn’t be able to make a living in that role.

After attending nursing school at Husson University, he became a certified nursing assistant (CNA) at St. Joseph while still in nursing school and joined the Intensive Care Unit there after graduating. He has never regretted that decision.

A man in what has traditionally been a female dominated field, Warner, who grew up with two older sisters, said he feels very much at home with his coworkers. If anything, being a man probably gives him a slight advantage when it comes to finding a job, he said.

And while there is a lot to learn, Warner said he feels he is in a good place to get a solid grounding in his profession.

“I feel like I have the combination of enough stuff going on to learn but a slow enough pace to be able to learn it,” said Warner.

Eventually, Warner plans to get his PhD in acute care and become a hospitalist, an advanced practice nurse that specializes in the care of hospital patients.

One of the real advantages of a career in nursing is the ability to branch out into many different specialties within the profession.

Nurses can choose from a wide selection of specialties within patient care, including everything from emergency medicine to acute care to advanced practice specialties such as becoming a nurse midwife or a family medicine nurse practitioner.

There are also many specialties outside of direct patient care, including in pharmacy and nursing informatics, which deals with the management and communication of information and data.

Asked what advice he would give someone who is considering a career in nursing, Warner said that the stories that experienced nurses tell can sometimes be intimidating, but he said it is important not to let those stories scare would-be nurses away. He said anyone who wants to be a nurse should also put themselves in a position to get a solid grounding in their profession.

One of the things he enjoys most about working at St. Joseph is the sense of teamwork from staff at all levels but most of all from his fellow nurses, some of whom have decades more experience.

“The environment here is amazing. I love my coworkers. I love what I do,” said Warner.

As a relatively new nurse, he said one thing he appreciates most about his coworkers is the way they work together and how willing the more experienced nurses are to answer his questions.

“I still ask thousands of questions a day of every other nurse here,” said Warner.

JUNE 29, 1918, NURSES IN WWI PARADE, CENTRAL STREET, BANGOR. COURTESY RICHARD SHAW

Bangor Daily News, Saturday/Sunday, May 4-5, 2019 D3

Local colleges address growing need for nurses in Maine COURTESY BEAL COLLEGE

Maine needs more nurses.

That’s the assessment of Dr. Colleen Koob, dean of nursing at Beal College in Bangor.

“There is such a high need for nurses right now,” she says. “The average age of a nurse in Maine is 55.”

This evaluation is supported by a 2017 study presented by Lisa Anderson, MSN, RN, and Patricia J. Cirillo, Ph.D., under the aegis of the Center for Health Affairs. The study, “Maine Nursing Forecaster,” found that 30 percent of Maine’s current RN workforce was between the ages of 55 and 64. The trend toward an older RN population is expected to continue.

At the same time that more of Maine’s RNs will be approaching retirement age, it is expected that a higher proportion of Mainers will need more health care services at all levels as the statewide population continues to age.

The need for nurses will vary by region, according to research by Lynn Turnbull, MHA, BSN, RN; Lisa Harvey-McPherson, RN, MBA, MPPM; and Donna DeBlois, RN, BSW, MSB, MPA, AHCA. They found that in Hancock and Washington Counties, almost half of the registered nurses were over the age of 55 as of 2015 and could be expected to stop working or reduce hours in the next 10 years. The percentage is even higher elsewhere in the state, namely in Sagadahoc, Lincoln, Knox, and Waldo Counties. In Penobscot and Piscataquis Counties, nearly a third of current RNs are on a similar trajectory.

While demographics no doubt play a role in the growing need for nurses, Koob also believes the inherent challenge in the profession can be a barrier to entry.

“It’s not an easy field,” she says. “Nurses need to know everything a physician needs to know and then be able to care for the person on top of that.”

Whatever the causes, Maine finds itself facing increasing demand and a decreasing supply of RNs in the course of the next decade. According to the 2017 analysis, Maine’s nurse vacancy could be 2,700 by 2025.

So what is the solution?

Koob sees local nursing programs playing a major role.

“Our program is hopefully going to increase the number of new nurses entering the field by 20 percent,” she says.

Beal College offers three points of entry into its nursing program each year. Koob says that fact alone can make a big difference for those who want to get into the field quickly.

Prospective nursing students don’t need to sign up for a waitlist or wait as long as a year before entering the program—they can start right away, often within a matter of weeks.

Beal’s nursing program runs on the “mod” system common to all Beal programs.

Instead of a semester, each Beal course lasts for an eight-week period (or “mod”).

Students commonly take two courses per mod. Mods run year-round on an accelerated schedule that aims to get students into the workforce efficiently. After 10 mods or less than two years, successful students can become a registered nurse—or sooner, if they have transfer credits.

In addition to its speed, one advantage of the mod system is its flexibility. While individual class sessions are longer than those in a semester system, classes are offered during both day and night hours which allows working students and those with children to find a schedule that fits with their lives. Some of the program’s classes are offered online as well.

Koob is careful to emphasize that the program—which she describes as “intense”— requires discipline and focus from its students.

“It’s a difficult program,” she says, “but within 20 months you can have an associate’s degree and sit for the NCLEX.” Beal’s program offers both a “career and student focus,” according to Koob, who cites Beal’s small class sizes and individualized attention as strengths. As a career college, Beal partners with local employers to place students in real-life healthcare settings as part of their training. “It works well because of that. Our students get to learn the care aspect as well as the scientific foundation.”

After completing the nursing program, a graduate receives an Associate in Science Degree in Nursing (ADN), which allows the graduate to take the National Council Licensure Examination (NCLEX-RN), a nationwide exam that tests the applicant on the broad knowledge base required for nurses as well as their ability to think critically about a variety of problems faced in the field. After successfully completing the NCLEX, the graduate can apply for a state license as a registered nurse in Maine.

Prospects for RNs in Maine look positive. Registered nurses experience a very low rate of unemployment, according to a 2015 study compiled by Turnbull, HarveyMcPherson and DeBlois. The study found that only 2.1 percent of Maine nurses—both RNs and advanced practice registered nurses (APRNs) – were unemployed, and more than 78 percent of RNs in Maine were employed on a full-time basis.

With the growing need for nurses unlikely to reverse course, Koob hopes that more qualified individuals will accept the challenge and enter the field.

As for the shortage, she says, “Our program should help to alleviate this—a small amount, but at least going in the right direction.”

MAINE FINDS ITSELF FACING INCREASING DEMAND AND A DECREASING SUPPLY OF RNS IN THE COURSE OF THE NEXT DECADE. BEAL COLLEGE DEAN OF NURSING DR. COLLEEN KOOB SEES LOCAL NURSING PROGRAMS PLAYING A MAJOR ROLE. PHOTOS COURTESY BEAL COLLEGE

D4 Saturday/Sunday, May 4-5, 2019, Bangor Daily News

Bangor Daily News, Saturday/Sunday, May 4-5, 2019 D5

D6 Saturday/Sunday, May 4-5, 2019, Bangor Daily News

EASTERN MAINE GENERAL HOSPITAL RECRUITMENT TABLE, 1970S PHOTO. COURTESY UNIVERSITY OF MAINE FOGLER LIBRARY SPECIAL COLLECTIONS

FIREMEN AND NURSE CARRY STRETCHER IN OLD ST. JOSEPH HOSPITAL, CA. 1958, WHICH LACKED ELEVATORS. COURTESY ST. JOSEPH HOSPITAL

1917, EASTERN MAINE GENERAL HOSPITAL SCHOOL OF NURSING. COURTESY UNIVERSITY OF MAINE FOGLER LIBRARY SPECIAL COLLECTIONS

EASTERN MAINE GENERAL HOSPITAL NURSE WITH TODDLER, CA. 1928.

COURTESY UNIVERSITY OF MAINE FOGLER LIBRARY SPECIAL COLLECTIONS