NURSING CONNECTIONS FULFILLING A DESTINY MEN IN NURSING instruments of peace
A Publication for Alumni and Friends of the Department of Nursing of Eastern University.
NURSING eastern university
Published by Eastern University 1300 Eagle Road St. Davids, PA 19087 610-341-5800 Mary T. Boylston Editor Mark W. Lambertson Graphic Design Daniel Peirce Brand Director Denise McMillan Communications Director Elyse Garner Staff Photographer Sherry-Ann Morris Chief Marketing Officer
The Magazine of the Eastern University Department of Nursing
C O N TE N TS
1. Chairâ€™s Welcome
2. Peace Prayer 3. Freedom
4. Suicide Awareness and Prevention 6. Men in Nursing
10. Most Memorable Patients 12. Graduation
14. Hospice Nursing
19. Preparing for the Inevitable 20. Sigma Theta Tau
22. Impact of Errors
24. Welcome New Chair, Faculty and Staff
C H AI R ’S W E LCO ME
Reasons for Praise
s the new Chair of the Department of Nursing I wanted to share with you some of the many accomplishments and a few of our challenges. First, we have many reasons to sing praises to God. The NCLEX-RN first time takers pass rate for 2014-2015 graduates is 100%. This is 10.67% above the mean pass rate for all BSN schools in Pennsylvania. For the past four years, Eastern BSN students NCLEX-RN pass rates have been between 85% and 100% for first time candidates. Next, with the success and quality of our BSN, there has been an increased interest in the Eastern Nursing program. Consequently, we have had more qualified applicants than we are equipped to handle. Although, this is a good problem, our challenge is the ability to accommodate qualified students. With limitations in lab space, available clinical sites, and faculty, we seek to overcome the obstacles to ensure that we provide the best learning environment for the next generation of nurses. Last, we are honored to be able to play an important role in the education of nursing students. I am hopeful that the next year will be filled with excitement, challenges and more success for our students and graduates. I am proud to serve as chair and appreciative of the support I have been given during my first year and am truly blessed to be a part of this community. Therefore, I encourage you to reach out to us and share your personal and professional accomplishments so that we may celebrate with you. All the best to everyone-
Dianne DeLong, PhD, MSN, RN, CNE
C O N N ECTI O N S C O R NER
reetings! Welcome to Connections 2016, the Department of Nursing magazine that shares the insights and activities of our distinguished major. Inspired by the words of St. Francis of Assisi’s Peace Prayer, my mind wanders to ways the nursing community at Eastern University emulates its tenets during daily events. As instruments of peace, the students learn ways to holistically care for their patients as they seek to sow love, care for the injured, and offer hope during difficult times. With smiles, they can bring joy to the sad and despondent. Since this is an institution of higher learning, can faculty embed these beliefs and values in their lesson plans? That’s a hard question, because it is tough to teach compassion. However, students are exposed to peace and compassion through the Eastern University and Department of Nursing’s mission statements. They complete a curriculum that is threaded with methods to share God’s love as we demonstrate that we can make a difference no matter how small we think it is. Further, each person is reminded that they are unique and created in God’s image. Upon graduation, they are given the task to provide nursing care that demonstrates that the Eastern University nurse is unique. Therefore, it is my pleasure to highlight our community as we share the power of the peace maker from a variety of perspectives in a multitude of settings such as hospitals, hospices, prisons, homes, communities, and schools. I hope that you enjoy reading how our peace makers are making a difference in the lives of others. Shalom!
Mary T. Boylston, RN, MSN, Ed D, AHN-BC Professor of Nursing, Editor, Nursing Connections
The Peace Prayer St. Francis of Assisi
Lord, make me an instrument of Thy peace; Where there is hatred, let me sow love; Where there is injury, pardon; Where there is error, the truth; Where there is doubt, the faith; Where there is despair, hope; Where there is darkness, light; And where there is sadness, joy. O Divine Master, Grant that I may not so much seek To be consoled, as to console; To be understood, as to understand; To be loved as to love. For it is in giving that we receive; It is in pardoning that we are pardoned; And it is in dying that we are born to eternal life. Amen.
Experiencing Abundant Life in Shackles
Dr. Geri Remy Lecturer and Community Heath Coordinator
reedom—If I ask my 13-year-old daughter her thoughts on freedom, her perceptions would likely propel her fast-forward, to the day when she is 16 and can apply for her driver’s permit or to her 18th birthday, when she will be legally “free” to apply for her own credit card or sign for a loan. If I ask an Afghanistan war veteran his opinions about freedom, his mind may swirl with thoughts of Operation Enduring Freedom, the war on terrorism, and the cost of maintaining American freedom. Another perspective on freedom is a painful and regretful one that can only be fully understood by those who have lost it to incarceration. There are currently over 2 million men and women in America’s correctional facilities who have lost their personal freedom. It has been my privilege to serve as a volunteer with Life Abundant, a ministry that has gone into area prisons for over three decades introducing inmates to Jesus Christ while lending a listening ear, an encouraging heart, and mentorship in biblical life principles. In meeting with individual women through either one-on-one mentorship relationships or when conducting group Bible studies, I have seen and heard first-hand accounts of what it looks and feels like to lose one’s freedom as a result of incarceration. Inmates are not permitted to make phone calls at will but when they are granted phone time, they stand at a pay phone in a large, loud room with a trail of women lined up behind them, glaring and impatiently awaiting their turn to make a timed call. If an inmate requires medication, it is often not administered at the prescribed time. They get very little time outside in the fresh air when the weather is agreeable and almost no outdoor time in the colder months. It is impossible to routinely look out through a window to see the stars, a sunrise, a sunset, or a soaring bird. These losses of freedom are difficult
at best, but the freedom most missed by all of the women who are mothers is the rare-to-no contact with their children. Although the women that I have met in the jail are forced to reckon with the consequences of poor choices, namely this harsh loss of personal freedoms, there are always a few prisoners at any given time, who demonstrate a type of freedom that stems from deep within the human soul, that cannot be constrained by prison walls, and that cannot be manipulated or taken away by another. Even many people who live as physically “free” agents in the world do not know this type of freedom. It is an authentic spiritual freedom made possible through personal faith in Jesus Christ. What faith in Christ does for them is to free them from the shackles of guilt and shame. Many have been set free from emotional and psychological bondage to unhealthy relationships, substances, habits and poor decision making. The risen Christ offers them a fresh start, forgiveness of sins and the Holy Spirit’s power to live a life filled with a new found ability to feel, to care, to love. These spiritually free women have challenged my own faith as I watch them lean on God and begin to flourish emotionally, psychologically and socially in spite of physical limitations rendered by the prison walls. In reflecting on the varying types of freedom, the spiritual freedom revealed in the lives of incarcerated women who have been stopped in their tracks, humbled by prison and stripped down to nothing has been not only inspirational but serves to remind me that whatever comes my way, possessing this type of freedom is available in any circumstance of life. Perhaps without realizing it, they have modeled to me just how sufficient Christ is to meet us where we are. He is able to impart inner peace, joy and this freedom in the worst of circumstances. n
“Where there is injury … pardon”
y name is Ashley Fieseler and struggling with a mental illness such as I am proud to share that I am depression and anxiety. Our board also the President of the American works diligently to raise funds to support Foundation for Suicide Prevention the programs. (AFSP) in South Central Pennsylvania. This year we sponsored a three mile This hard working foundation attempts community walk in Harrisburg, Pennsylto end the stigma associated with mental vania. This initiative gathered hundreds illness and suicide while concomitantly of individuals and families; those who helping to decrease the number of indi- have lost someone to suicide, battled viduals who take their lives. mental illness, attempted to take their My passion to make a difference can own life and others who like me who be traced to my own personal loss. I will support the cause for their own personal never forget October 27th, 2005. At the reasons. Though we came to the walk age of 17, I lost my amazingly beautiful mother, Laurie Ann Fieseler to suicide as her life was So why do all of this? robbed by severe mental illnesses. Searching for an answer, she was Why does it mean so much? given many different diagnoses Simple, suicide is to help categorize her symptoms; before she passed away, she was a preventable death. diagnosed with Bipolar disorder and Undifferentiated Schizophrenia. On October 28th, 2005 I became committed to end the stigma with different agendas, we all had one and not have her name be soiled by her common goal, that is, to be the voice and untimely death. My mother to me was end the stigma of mental illness. Togethnot known as Bipolar or Schizophrenic; er we raised $90,000.00 dollars to be used she was known as the best lemon bar in our community as we seek to become maker with the most creative mind. more proactive rather than reactive to My work with the AFSP assists mental illness and suicide. in suicide prevention by funding sciSo why do all of this? Why does it entific research, offering educational mean so much? Simple, suicide is a preprograms for professionals, educating ventable death. Although preventable, the public about mood disorders and 42,773 Americans take their lives each suicide prevention, promoting policies year. In other words, 117 lives are lost to and legislation that impact suicide and suicide each day (www.afsp.org). Thereprevention, and providing programs and fore, by educating the public, we seek resources for survivors of suicide loss to show everyone that there is support. and people at risk while involving them Furthermore, we want those who are so in the work of the Foundation (www. overburdened in life to know that our afsp.org). foundation is ready and able to support As the President of my local board, them, as for every 25 suicide attempts I work along with my fellow board there is one life lost to suicide. members to educate our local commuAdvocate and public speaker, Kevin nity while incorporating my health care Hines attempted suicide by jumping expertise as a Registered Nurse. I help to off the Golden Gate Bridge. As he was create programs for awareness. about to jump, he thought “If one person For example, Mental Health First tries to talk to me, I won’t do it” (www. Aid Training is a program similar to Red kevinhinesstory.com). As a society, we Cross First Aid that teaches how to im- can make a difference by asking people mediately respond to someone who is in like Kevin Hines “How are you doing?” a mental health crisis. Another program It is a simple, yet powerful question and entitled More Than Sad trains teach- can help to connect with a person who ers on how to assist students who are is contemplating suicide and feels that
there is no one who cares. As nurses, we speak about self-care. If we do not care for ourselves then we cannot care for others. Therefore, if you or someone that you know are suffering and considering suicide as an option, call the toll free national suicide prevention lifeline (800-273-TALK (8255)) or text for help at 741-741. Experts are available around the clock with discretion and confidentiality. Further, all callers remain anonymous. Through my work with this founda-
tion, I have personally found great hope. If you have any questions or concerns, please don’t hesitate to contact me at email@example.com. I want people to know there is help and they can work to keep their own best lemon bar maker alive. In the Commonwealth of Pennsylvania, there are multiple AFSP local chapters for information and assistance. Thank you for taking time to read my story, and remember ... you matter! Your Survivor Buddy,
RN to BSN Cohort ’79
References American Foundation for Suicide Prevention. (2015). Facts and Figures. Retrieved from https://www.afsp.org/ understanding-suicide/facts-andfigures Kevin Hines. (2015). Kevin Hines Story. Retrieved from http://www. kevinhinesstory.com
â€œWhere there is darkness ... lightâ€?
Frederic Maniraho, student nurse, BSN2 Class of 2018
“To be understood as to understand ...”
BRINGING UNIQUE SKILLS TO THE PROFESSION
Dr. Mary T. Boylston
n recent years, the profile of the nurse has been changing as an increased number of women of color and men have been recruited. This is an attempt to create a multiethnic, culturally diverse, and gender neutral profession (McMenamin, 2015). Of note, an Institute of Medicine (2011) initiative has placed a greater emphasis on recruiting men. Consequently, according to the American Association of Colleges of Nursing the trend of increasing the numbers of males in the nursing workforce is gaining momentum (http://www.aacn.nche.edu/media-relations/fact-sheets/enhancing-diversity). Indeed, relatively high wages with expanding and stable employment seem to be attractive (https://www.census.gov/people/io/files/Men_in_Nursing_Occupations. pdf) and more men are choosing nursing as a second career. The justifications for encouraging men to join the nursing workforce are numerous. First, they represent a proportion of the population that nursing serves and bring a unique perspective to the provision of patient care. In addition, with a predicted nursing shortage, the profession of nursing will provide many opportunities for professional growth and employment. Men interested in pursuing a career in nursing will assist in addressing the looming nursing shortage. Consequently, nurse leaders continue to work diligently to recruit capable individuals of all races and genders to represent the populations served. As our society becomes more diverse, nursing should also increase its numbers to bring more inclusivity and diversity to health care. Despite the smaller numbers of men in nursing, Eastern University’s pre licensure and RN to BSN programs have experienced an increase in numbers of Reference male students which is consistent with schools across the nation. Even with the surge of male students in McMenamin, P. (2015). educational programs, the profession needs to do Diversity among registered more to recruit qualified individuals. Men who work nurses: Slow and steady as professional nurses can serve as role models and progress. Retrieved from offer advice about how to thrive in a profession where http://www.ananursespace. they are currently a minority. n org/blogs/petermcmenamin/2015/08/21/rndiversity-note?ssopc=1
RN, BSN Cohort 71, Class of 2016
RN, BSN, CCRN-CSC Class of 2014
Nursing was a second career choice for me. When I started my original undergraduate degree (Criminal Justice and Political Science), I never thought twice about the possibility of being a nurse. When graduation came closer, I considered where I wanted my life to go and what kind of career I could take on that pays well, has consistency, will always be in demand, and will positively impact people around me. Nursing has been considered a woman’s profession, but times will always change and it is important that we do not fight change. My approach to nursing however, is unique. Female nurses are some of the strongest, influential, intelligent, compassionate people that I have ever met. I learned everything I know about nursing from female nurses. I have witnessed practice that I agree with, and disagree with, from male and female nurses alike. Academically, Eastern taught me to care for the whole patient. As a cardiac catheterization RN, I tend to just focus on the heart and move patients in and out like a service line. Now, not only do I work on hearts but I influence my teammates to remember that there are individuals on the table and not only does their heart need care but the person does also. My advice to men is to be open-minded. Do not have an inferiority complex no matter who gives you advice or help. And for anyone who chooses nursing as a major, be ready to grow, be ready to change, ready to be challenged. n
It’s difficult to say why I chose nursing; however, I was most likely influenced by my brother who is a nurse. He suggested nursing and after I worked with him for a day in the operating room at Hahnemann Hospital, I knew my destiny. Being a male in the nursing field was a non-issue for me. Sure, the guys I was working with prior to school had their comments. But this made me prove them otherwise. Yet, the stigma is still there. I have patients say all the time “Oh, you’re a male nurse.” My comment is always the same, “Well, they wouldn’t let me be a female nurse!” This always breaks the ice. My approach in nursing is that I treat every patient as if they are my family member. Nobody is a VIP; everybody is a VIP. Eastern University’s RN to BSN program helped by reinforcing the holistic aspect to nursing. There is more to nursing than working eight hours, giving medications, and going home. People definitely respond better to an approach that lets them know you truly care. My advice to men who choose nursing is to ignore the comments that emerge from ignorance. n
Michael “MJ” Jordan
RN, BSN2, Class of 2016
BSN2 Student, Class of 2016
BSN2 Student, Class of 2017
Prior to entering the BSN2 nursing program, I was teaching basic life and vocational skills to children and adults with cognitive disorders. After six years, I developed the passion for caring for people who needed assistance. One of the nurses caring for the children said to me “you would be a good nurse. Have you thought about it?” I went home and shared her comment with my wife who agreed. I then decided to pursue a career in nursing. The reason why I choose Eastern was because their program has a Christian focus. I believed after graduation, I would be caring for my patients in a holistic manner and also applying the golden rule “do unto others as you would like others to do unto you.” I have witnessed male nurses at work and they have reinforced my belief that male nurses like female nurses can be good caregivers. In fact, last semester, during my community rotation, the nurse I shadowed was a male nurse whose extraordinary care to his patients in hospice care made me love the profession more. He embraced holistic care with all the patients we visited and used techniques such as massage, feet washing, aromatherapy, therapeutic touch, and communication. I will advise any man who wants to go into nursing, to go for it. Nursing is a humble profession that needs both males and females working together in harmony for better patient outcomes. n
Before entering the BSN2 program I worked in human resources for a nonprofit company in Pittsburgh. I chose nursing because it fit well with my caring and nurturing personality. Eastern’s program is providing me with the foundational knowledge base for the skills I will need on the job. I am being exposed to different kinds of nursing specialties in clinical which will help me narrow down what field I want to enter. My advice for men considering nursing as a profession is as follows: First, TV medical shows are not realistic, and I would highly recommend shadowing a nurse for multiple 8 or 12 hour shifts to see what the realities of a nurse’s job entail before deciding to pursue a degree. Second, being a male nurse requires a high level of emotional intelligence, interpersonal skills, and social awareness. There are a lot of intimate human interactions and emotional situations with patients and their families, and if you get uncomfortable around that sort of thing this is not the job for you. n
My interest in the healthcare field began in high school when I worked as an emergency medical technician. In college, I pursued biology and psychology and eventually found myself leaning toward animal behavior. After graduation, I worked at a facility as a dolphin and tiger trainer. I changed directions and entered the business world and moved quickly into a management role. However successful as I was, I found myself missing the hands on interaction and care. Nursing quickly came to the forefront of my interest since there are many avenues and options. I began working at Lankenau Medical Center as a Patient Care Technician (PCT) which has given me a direct insight into the profession itself. Eastern University is allowing me to gain the knowledge and confidence needed to achieve my goal. The art of nursing and in particular our holistic nursing approach at Eastern has opened my eyes to a healing of the entire patient - mind, body and spirit. As I get a better understanding of the nursing field, I find myself looking towards Masters programs and specializing my nursing skills. The only advice that I can give to men looking at the nursing profession would be to look at a hospital or facility and see the absolute need for more male nurses. Ultimately I feel having men in nursing provides a better balance of care that is given to patients. One might say male nurses bring some yang to a heavily yin weighted profession. n
Ashley Blackburn, RN to BSN Class of 2016
he aroma of hazelnut coffee replaced the staleness of the hospital air. White tulips softened the reality that a hospital has become home. She slept peacefully as I watched her chest rise and fall from the door, waiting for the rhythmic motion to cease. The pink hues of the sunrise gently cast a shadow over her neck; the jugular vein distention visible from the door. Moving closer to place her requested coffee on her cluttered bedside table, I notice the paleness of her fingertips resembling a corpse. Her heart failure was welcoming death with every passing minute. Her blue eyes opened to greet me. A welcoming smile followed suit. The pale, cool hand reached up to touch mine. My heart swelled with empathy. Our eyes exchanged a wordless conversation with depth and meaning. This is the woman who reminded me that the definition of quality of life is unique to the individual. Most saw her constant struggle for breath as an indicator for misery. Most saw the oxygen that hung from her neck as a tight noose choking her happiness. Most missed an opportunity to converse with one of the greatest women in the world. Although heart failure has required significant adjustments to her life, Dorothy was very much alive. Simple pleasures were monumental moments in her day. Her husband walking in the door after work, the neighbor’s dog jumping on her lap, white tulips in partial bloom, sitting outside on her porch listening to the stillness that surrounded her existence, all resulted in elated contentment. While most of us chase fancy cars and big houses, she chased another orange sunset, another welcome home kiss with her life mate, a joyful jump up from her neighbor’s dog, and a chance to witness a tulip open to absorb the sun’s warmth. It reminds me that there may be a day that I may never feel my husband’s lips meet mine; I may not see the sunset or feel its warmth on my skin; and I may not hear my children’s laughter; because of her I cherish life. I am reminded that as a nurse, I cannot define one’s quality of life. However, I can bring in the simple cup of coffee that my patient will enjoy for the last time. I can fill the room with white tulips and open the blinds so the sunset is visible. I can hold your hand so you never feel alone. I am a nurse, and I care. n
Ashley Blackburn Dr. Christina Jackson Dr. Christina Jackson, PhD, APRN, AHN-BC, CNE, Professor of Nursing
arly in my career, I worked on an Adolescent Medical Surgical/Pediatric Oncology Unit at Yale New Haven Hospital. We newer nurses rotated all three shifts which was rough, but we practiced Primary Nursing which facilitated relationship and continuity, and that was wonderful! A sweet eight year old child with leukemia named Tracy gave me a glimpse of heaven, and has remained one of my most memorable patients across 35 years and thousands of patients. Judging from her lab results and deteriorating clinical condition, we knew that this particular admission was likely to be Tracy’s last. I was keeping a bedside vigil with her parents on that last morning. Except for occasional moans, Tracy was unresponsive. I gave her morphine every few hours, but it was heartbreaking to think she may still be feeling bone pain. At 1:00 pm, she opened her eyes fully and suddenly, and a look of wonderment spread across her freckled face. She gazed beyond us and said “Oh! I’m going upstairs now!”, then immediately breathed her last. At that time there was no Internet, and people did not talk about near death experiences on TV, so I never questioned that Tracy was sharing with us exactly what she experienced in that moment. It is always moving and sacred to be with people at the time of their death, but to be given this glimpse “beyond the veil” was a gift that confirmed my belief in an afterlife, and the beauty and welcome that we can anticipate when we transition to the next plane. Thank you Tracy, and God bless you always. I hope to be with you again one day! n
Sierra Schemp, Class of 2017
encountered a variety of patients during a medical surgical clinical practicum this past semester. With each patient, I learned something different, but my most important lesson was that I was reminded of my passion for nursing, medicine, and patient care. One week towards the end of the spring semester, I cared for a particularly complicated patient—he was an older gentleman suffering from a severe allergic reaction that had caused him to develop blisters all over his body. Around mid-morning, the wound care team came to assess the lesions and decided it was in his best interest to drain all of the blisters. The wound nurse allowed me to assist him with the procedure, and at this point, the patient was not oriented to reality. I helped the nurse by supporting the patient’s arms as we drained and bandaged the sores. I had never seen anything like this in my clinical experience thus far and I was fascinated by it—but I also felt badly for the patient as it was clear that he was completely miserable. I vividly remember smiling at him, looking into his eyes, and offering encouraging words: “You’re doing a great job, sir!” “It’s almost over…this is going to help you feel so much better.” “Almost done, hang in there!” I kept lightly squeezing his hand, and the patient would just smile at me and squeeze back every time I did. Even though I knew he probably would not remember the experience later, I felt that my presence had made a difference in his recovery, and perhaps his life. And this is why I am positive that I have made the right decision to become a professional nurse. n
Sierra Schemp Samantha Stewart Samantha Stewart, CLass of 2017
lthough I am just finishing my junior year as a student and have had limited exposure to patients, I have encountered patients who have shaped me to be a better nurse. They have made me a more empathetic person, a more determined student, and have opened my eyes to how important a nurse can be to a suffering individual and family. I was assigned to care for a middle aged woman the day she was admitted. She was brought to the hospital due to a decrease in mental status and thought she would be discharged that day. I was present during her initial meetings with physicians, provided nursing care, and talked with her about her medications. When she was overwhelmed, I held her hand. However, when I returned a week later, she was finally on the discharge list. Although she was not my patient that day, I stopped by her room to see her. Sadly, she had been diagnosed with cancer. During her admission, we had discussed that cancer could be a possibility, but no one is ever prepared for that diagnosis. I sat down with her and rubbed her back while she cried and told me her worries and fears. My heart immediately went out to her. My mind wandered to my rough week as I reconsidered my choice of professions. Why had I chosen this difficult major of nursing? Then it dawned on me as I sat with my crying patient listening to her thanking me for all I had done for her (which I did not think was a lot) and hugging me goodbye. The answer was clear. Nurses are not scientists (though they know science); they are not pharmacists (though they know medications); and they are not doctors (though they know diseases). Nurses are unique because their specialty is people. Good nurses know how to care not just for the patient’s illness, but also their heart, mind, and soul. They hold patients’ hands while they go through the worst days of their lives. They are the patients’ voices when they do not feel like they have one. They are educators, confidants, and a shoulder to lean on. A good nurse has a heart that cares and a light that helps patients continue on when they cannot do it alone. Being a nurse is a privilege. And as I sat there listening to my patient opening up her heart to me through her tears, it finally sunk in how privileged I was to be given the opportunity to be there with her during this time. Everyone always says nursing is not an occupation, it is a calling and that day I finally fully understood what that means. I will always be thankful for the opportunity to care for this patient and to God for giving me the call to nursing. n Fall 2016
Graduation A W A R D S S
Marie Joseph Servant Leader Award: Professional Practice: Chairâ€™s Award:
Malinda Murray Compassionate Care Award: Joyce D. Wallace Nursesâ€™ Christian Fellowship Award:
Anna Hass and Abbie Huber Zoe Detzel Taylor Profitt and David Tumolo Franklyn Kargbo Megan Maniscalco
For it is in giving that we receive ... 14â€ƒ
ACHIEVING THE DREAM Linda Jan Lear Lofland RN to BSN Class of 2013
he profession of nursing is considered an art and science as compassionate and holistic care is designed to meet the needs of the patient and family in a therapeutic environment. Nurses provide care to individuals in all walks and stations of life with the unique privilege of being present during exceptional moments like births and deaths. That is what my nursing career means to me as I am driven from Above to act with a kind and nurturing heart. As my life’s journey created my career path, it was later enriched by my education at Eastern University. As an experienced nurse, I have had multiple opportunities to reflect on my career choices at various occasions in my life. My career trajectory has helped to answer two important and personal questions. First, “can a person’s life struggles and losses create a career path?” The second question is, “did earning my BSN later in life ground and mature me as a nurse?” The answer to both questions is a resounding “YES!” Here is my story … continued on page 16
y journey to nursing began after caring for my father at a young age. He was my hero, and I was daddy’s little girl. So when my father was diagnosed at the young age of 51 with Alzheimer’s disease, I personally witnessed the powerful effects of this mind stripping and physically debilitating disease. As such, my world was thrown upside down. I was a senior in high school when he was diagnosed and had hopes of attending the University of South Carolina on a softball scholarship. Without regret, rather than moving for college, I stayed local and attended West Chester University working on a bachelor of science in public health. Sadly, during my senior year things changed. Dad’s illness progressed and he could not be home alone. I stopped my education with one semester left to care for him full time. The hardest part of it was that I personally watched and felt the effects of the loss of a father who loved his little girl as he changed and became more distant and less kind. Throughout his life, my father exuded kindness, and this change in personality was the toughest to accept and understand. As the stages progressed, the job of caregiving at home was too difficult to maintain, so it was obvious that long term residential placement was necessary. This devastated my world, but it was this change that opened my eyes to the wonderful career of nursing. Once Dad lived in long term care, I watched the nurses care for the patients on the Alzheimer’s unit, and found myself assisting with other residents’ care during my endless visits. I would feed, sing with and for patients, and help others off the unit on beautiful days to enjoy the warm calming sunshine on their faces. During this period, I learned to become more patient, forgiving and accepting of my father’s terminal illness. It was then that I understood that simply being present with others can create a healing and comforting environment. While Dad was moving toward the end of his life, I was beginning my own. I decided to study nursing at Chester County Hospital School of Nursing and graduated in 1993. Each class and clinical experience created passion for caring within me. When I graduated with my nursing diploma, it was one of the happiest days of my life. The following day I visited my father and sat beside him. I leaned towards him and gently whispered “Daddy, I became a nurse”. Then I received a gift, as he turned to face me and gave me a big smile. The best part of that moment was it was his old smile that I remember before his illness, as if to let me know he was so proud of me. That was the last gift my father ever gave me, but that smile still shines brightly when I close my eyes and reminisce. Sadly, Dad passed the following day, but it was through that loss and grief that I became more sensitive to the needs of others. This life experience grounded me; as I chose to work on long term care units I saw these patients as mothers and fathers, and felt that love and caring should always surround them. I loved working in long term care and stayed there for the first 13 years of my nursing career. I advanced from floor nursing to unit manager to management and through it all my focus was to always come into work happy, treat all co-workers with respect, and serve as a patient advocate. Although, it was during these years that my world was changed again in three substantial ways. I married a wonderful man, lost my mother who was my best friend, and had my first of three children. Sadly, my mother was diagnosed with stage four colon cancer and given one to three months to live. This was a hardship for me as Dad had passed away and my only brother died in an accident at age sixteen; she was my only family left and an important person in my life. Fortunately, I was privileged and blessed to have her by my side for a year and a half longer as she underwent cancer treatment. The treatments were tough on her, and I went to each one to offer strength and support and let her know that she was loved and not alone. She passed away in her bed in my childhood home with her family and friends by her side. As she took her last breath, it was then that I knew that I no longer feared death and that it actually is a very sacred, intimate and inevitable event in one’s life. Mother’s hospice nurse pulled me aside and shared that she thought I should work in hospice, as I have a very “special gift.” I kept her words in mind as I considered a return to school to earn my BSN.
Each day that I am with
I know I have followed my
calling and am sharing my gift.
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The following seven years were spent at a rehabilitation hospital where I found joy in the emotional and psychological aspects of nursing. It was there, that I was dealing with brain injured individuals, new paraplegics and quadriplegics, and stroke patients where these patients and their families’ worlds have been turned upside down. I learned to really listen and be truly present, as this quiet presence can make a difference in patient and family member’s comfort levels. I submit that a simple presence and touch can be the basis for care, where comfort can be created and formed. This presence was special and I knew it was part of my “gift.” It was during this period as a certified rehabilitation nurse that I was directed by administration to return to school for my Bachelors of Science in Nursing. After reviewing multiple programs, Eastern University’s RN to BSN program grabbed my heart. The holistic approach to nursing was exactly what I was searching for to complete me as the best nurse and individual I could be. During my BSN education, I absorbed the philosophy of holistic nursing as it focuses on caring for the entire patient with an incorporation of body, mind, emotions and spirit to provide complete care to our patients, not just to the physical person. The tenets spoke to my heart from the first to the final courses. Furthermore, the intimacy of the small cohort and the stories shared by my peers, brought reality of the wide spread realm of nursing, and that the center of it all is compassion and heart. It was through my education at Eastern that I could access and focus on the patient-centered healing approach, and to center my caring on ways that promotes therapeutic environments. So, I truly feel as though it was my Eastern University education, most notably the completion of the End of Life Nursing Education Consortium (ELNEC) certificate, which helped to change my career path. Embedded in the Eastern RN to BSN curriculum are ELNEC’s eight modules that exposes the students to death, dying, grief, bereavement, pain management, communications skills, and palliative and hospice care. As each professor reviewed the modules during the program, I realized my nursing education and life’s events had ignited my passion to focus on end of life care and it was time to use my “gift” to help the dying as a hospice nurse. Fortunately, before graduation I felt as though I could no longer dismiss my passion and accepted a position with Holisticare Hospice. I have been with Holisticare Hospice for the past three years and work each day with the belief that being present, taking the time to listen to my patients and families, and to truly care can significantly impact their lives. I also learned that as a hospice nurse, I have time to focus on the patient and the moment that we share. By doing this, we are then able to achieve a mutual caring approach, which benefits the patient and their families. This holds true in every nursing specialty. Interestingly, the other dynamic aspect that I learned through my education at Eastern is the importance of self-care. Nurses cannot care for others, until we care first and foremost for ourselves. It has been in my work as a hospice nurse that I found that this is a key element to holistic nursing. When we give so much of ourselves, we have to fill our personal wells in order to stay grounded in our care approach. Eastern taught me, and allowed me to learn about myself, and to better understand the areas that need self-care focus. I am thankful for the curriculum at Eastern for the enrichment that it awarded me to grow and mature as a grounded holistic nurse, physically, mentally and spiritually. Each day that I am with my patients, I know I have followed my calling and am sharing my gift. Could it have been my life hardships that directed my path? I do believe these challenging times were the start of my career path. However, it was my two years at Eastern University that “cemented” the belief that to be a good nurse we must care not only for others but for ourselves. For it is in giving that we receive….In other words, to be a great nurse we must follow God’s intentions… and then we will really care. I started the RN to BSN program in 2011 at Eastern University, completed the courses in 2013, and marched through the graduation ceremony with my cohort and head held high, smiling as my three children and husband applauded my achievements and accomplishments. In that moment, life came full circle for me as I knew that I was headed toward the completion of my destiny as a hospice nurse. n
Preparing for the Inevitable RN to BSN Students Graduate with an End of Life Nursing Education Consortium Certificate Dr. Mary Boylston
t was a cold November morning when I walked into Camilla Hall, a residence for retired Immaculate Heart of Mary Roman Catholic nuns to work with junior BSN students. Since I was teaching a Fundamentals in Nursing course, the assignments would focus on communication and assessment skills, time management, and holistic nursing care. The sisters whose average age is in the 80’s were beginning to get up for breakfast. As I walked through the long, quiet corridor, I peered into a room filled with sisters and nurses surrounding a bed. One of the nuns whispered “Sister is dying.” Immediately, I became silent with respect for the natural process of death. I also believed this would be an excellent opportunity for new students to witness something extraordinary, that is, a person who has dedicated herself to Christ breathe her last breath. In the room, the lights were dimmed. Her nuclear as well as her extended family were gathered, praying, speaking to her softly and holding her hand. A guitarist walked in and sat down. He began to play “Amazing Grace” and “How Great Thou Art” as the sisters and nurses sang along with him. This continued for the rest of the day and each student had the opportunity to witness something joyful rather than fear provoking. The sisters beautifully created a therapeutic atmosphere in which they prepared their colleague and friend to meet Our Lord. Birth and death are a natural part of the circle of life. As health care providers, we do everything we can to make sure that the person under our care survives and thrives. We have the unique privilege of witnessing the beauty of births and the sadness and separation of deaths. Although we often try to deny it, dying is a part of the lifespan; this is how life has been designed by the Creator. Simply put, we are born, we live, and then we die. Sounds callous? Not necessarily. In fact, as believers, our goal is to unite ourselves with Christ in heaven.
Within the context of our society, we as health professionals no longer think about death and dying but how to extend lives. Yet, the inevitable always happens… we die. Yes, death is unavoidable, but it does not have to be feared and traumatic. In fact, there has been an effort within nursing since the late 1990’s to prepare nurses to provide therapeutic and holistic end of life care for patients and families. Dying can be peaceful with proper guidance which the interdisciplinary healthcare team can facilitate. The End of Life Nursing Education Consortium also known as ELNEC has been spearheading the movement toward a peaceful death in a positive way. Through ELNEC, over 20,000 national and international nurses have been trained to offer their expertise in educational and clinical settings. The goal is to educate as many professional nurses as possible to provide comprehensive palliative care. Therefore, the Eastern University RN to BSN program has strategically embedded the ELNEC certificate of completion into the curriculum. Depicted in figure 1, the eight modules focus on different spiritual, psychosocial, emotional and physical needs of the death and dying process. On completion of the BSN, the graduate receives an ELNEC-trained certificate of completion. For example, the ELNEC Ethical/Legal issues module is presented in N 210, Nursing Ethics. The instructor reviews the module with the class and shares the content as it pertains to death and dying. Furthermore, since the Eastern University curricula is Biblically-based, the content is presented through a Christian lens with other cultures and religions concomitantly incorporated into the discussions. As we ponder life and the inevitability of death and the dying process, keep in mind that there are nurses who have been prepared Figure 1 to provide comprehensive E LN EC M O D U L E S and holistic end of life care. These nurses are RN Nursing Care at to BSN graduates from the End of Life Eastern University who Pain Management do not fear caring for the Symptom Management dying but have learned Ethical/Legal Issues to embrace it as a natural Cultural Considerations part and conclusion of in End of Life our earthly existence. n Communication For more information, refer Loss, Grief, Bereavement to the ELNEC Fact Sheet at Preparation and Care http://www.aacn.nche.edu/ at the Time of Death elnec/about/fact-sheet.
“And in dying that we are born to eternal life ...”
2016 Sigma Theta Tau 2016 Sigma Theta Tau International Delta Tau Chapter at Large: Elyse Baccino, Karey Bacon, Kristen Boyer, Dominique Brown, Alexander Cake, Danielle Campbell, Darius Clemons, Sandra Cole Cantera, Margaret Collins, Patricia Cook, Zoe Detzel, Michele Donovan, Justin Fox, Kathy Fujakowski, Morgan Heisey, Abigail Huber, Jesica Kinney, Rachel Lauffer, Lyn Marinchak, Beth Mathews, Andrea Orlandini, Taylor Proffitt, Courtney Rittenhouse, Heather Sadik, Kayla Seiders, Susan Seroskie, Kelly Jo Smeltz, Crystal Smith, Claire Swartz, Claudine Tocci, David Tumolo, Alison Walker, Abigail Winchester Fall 2016
“Where there is error, the truth ...”
The Impact of Errors
A Tragic Outcome
Dr. Mary T Boylston
oday is February 24, 2016 and it is exactly six months since Mark, a treasured member of my family passed away. I have known Mark since I was 14 years old. He dated my older sister in high school and has been a permanent fixture in my life since then. We grew up together. I watched him play high school sports and college football. I was in the sand dunes when the airplane flew by at the beach with a sign trailing behind it asking my sister to marry him. I was the matron of honor at their wedding and their first child is my goddaughter. We vacationed together, laughed together, attended our children’s athletic events, celebrated life events, and hung out at the beach. He was creative, funny, and a terrific person. Inadvertently, I once washed his pants with his wallet in the pocket ruining a large check while at the shore. He laughed. I cringed. As we sat on the porch of his beach house that day, he said to me: “Mary, this home has given me another 20 years to live.” I nodded.
Imagine my surprise when my mother shared with me that he had been diagnosed with stage two lung cancer. How was this possible? He did not smoke and was an athlete who lived a healthy life. He was a young man. Mark would rather eat a salad than a piece of cake….what happened? And then it was disclosed. Mark was a victim of a medical error. A serious one. A deadly error. When he was in the emergency room for shortness of breath, the medical diagnosis was inaccurate. Several health care providers misread the x-ray and missed the spot on his lung. This spot could have been obliterated by a laser the next day. After many months it was disclosed that the small spot had grown into a cancerous tumor. The time spent waiting for the diagnosis made the difference between life and death. On to death….Mark’s death. He fought and battled harder than anyone that I have known. He underwent surgery, chemotherapy, radiation, and
medication that gave him a rash and nausea. His appetite was affected and he had trouble eating. Toward the end, he survived on milkshakes and purple Gatorade. Finally, he was placed on oxygen as the palliative team was called in to help abate some of the symptoms caused by the cancer and treatments. I recall the last Christmas that we spent together. He was wearing his usual smile and a red sweater. The shirt underneath was too big. I knew then he was losing weight, and his battle, and I was losing my big brother. While he sat by the fire to stay warm, I sat down next to him, just to be there. When he left, we hugged as we always did and said “I love you.” I held on longer than usual and did not want to let go. The grieving process was beginning for me….my sister…the children…for all of us. Why am I sharing this incredibly personal story? The answer is twofold. First, I wanted to illustrate how loss can affect us as our hearts are broken because of malpractice and medical errors. The secEastern University
ond reason is to explain to my students and all health care professionals how an error, a seemingly innocent error can and does impact not only the patient but family and friends.
takes from clinician incompetence to distraction, fatigue and human error. It has been suggested that technology would decrease the high rate of errors, which has not been the case. Health care is more intricate and we cannot rely solely on computers to guide our practice. Furthermore, there has been For our light and momentary troubles an increase in antibiotic resistant bacteria, over and are achieving for us an eternal glory that under use of medications, an administrative movement far outweighs them all. So we fix our toward higher productivity, eyes not on what is seen, but on what is rapid patient flow, and overuse of risky, invasive, and unseen, since what is seen is temporary, revenue generating procedures. There are errors from but what is unseen is eternal. negligence and omission, which can have grave effects 2 Corinthians 4:17-18 NIV on patients. Unfortunately, as healthcare becomes more complex, the rate of errors has increased exponentially. Our patients may be unknown to us Therefore, what can be done to as we greet them for the first time, but eliminate or more realistically minithey are someone’s big brothers, sisters, mize errors and harm to our patients? parents, spouses, children, and friends. As our Code of Ethics asserts, “First, They are not anonymous. Someone do no harm.” In other words, as advoloves them. They are cherished and imcates and health care professionals, it is portant. They are children of God and our role to protect those who have been often our best friends. That is why I entrusted to us. This means we begin in share this story. an attentive state of mind, well rested, In the classroom, faculty discuss and distraction free. All of it involves reasons for errors and mistakes; but I self-care before, during and after our believe that these lessons do not make shifts. an impact unless they know the true The next phase in the prevention gravity of the consequences. I recall my of errors is to use our critical thinking first patient who passed away under skills and follow up on medical orders my care as a new ICU nurse. Intubated and question ones that do not make and on the ventilator, he was nodding sense, understand medications and the his head appropriately and making eye reasons for treatments, and constantly contact with me when his blood presassess and evaluate the impact of the sure dropped and I had to call for the prescribed plan of care. The use of anaresuscitation team. Sadly, we could not lytical reasoning cannot be minimized. save him and he died that night. Even Indeed, we have the capacity to think after days, months, and years when through the process and use best practhinking about that night, I scrutinize tice models for treatment. my actions before his death to make Lastly, there must be an awareness sure that I did not make a mistake and that as human beings, we are flawed. had done everything carefully and acWe get tired, cranky, and self indulgent. curately. Indeed, even when we do not As such, the realization that we can make mistakes, we can still relive tragic make a mistake should never leave our events. thoughts as we care and advocate for According to James (2013), more our patients. than 400,000 deaths are caused each I will never forget the night that year by preventable errors. There are Mark died. We knew that his time in a multitude of reasons for the misthis life was coming to an end and all Fall 2016
his family and close friends were called in to the hospital to say goodbye. We stood together, all 40 of us, in the ICU as he began to walk toward Heaven. A family friend, Father Rob led the prayers and anointed him with the sacrament of the sick. We held hands, cried, prayed and spoke to Mark as he was breathing his last breath. My sister laid her head over his chest to hear his heart beat one last time as his big, friendly and loving heart stopped. It was a moment that I will never forget. Time seemed to stop and I will remember it always. Yet, the most poignant thing is that Mark would still be with us if the system that was designed to care and protect people had not been broken. As nurses, we are called to be advocates. We are given the privilege of caring for people during vulnerable times. This is not a profession for someone who does not care. Once again, it is a profession that professes, “First, do no harm.” A few months ago, my sister and I were walking through the park. She asked me, “Do you think that it bothers them? Do they care that Mark died?” She was referring to the individuals who missed the diagnosis (there were many). I took pause and thought about it for a moment. Then I said, “They are haunted by the mistake. Every day, they think about it and how Mark died as a result of their malpractice and negligence. No one goes into nursing and health care to make fatal mistakes. This is something that they have to live with ... and it is a long life ...” Stand up for your patients. After all, someone loves them. There is no room for error. n
References James, J. T. (2013). A new, Evidence-based Estimate of Patient Harms Associated with Hospital Care. Patient Safety America. Retrieved from http://journals.lww.com/ journalpatientsafety/Fulltext/2013/09000/A_ New,_Evidence_based_Estimate_of_Patient_ Harms.2.aspx
Dianne DeLong, PhD, MSN, RN, CNE: Chairperson of the Department of Nursing
Meet the Newest Members of the Department of Nursing
Dr. DeLong was Chair of Nursing College of Saint Elizabeth. A diploma graduate from Allentown Hospital School of Nursing, she earned her BSN at Kutztown University and MSN in nursing education at Villanova University. Dr. DeLong completed her PhD in higher education leadership through Capella University and holds a certification as a Nurse Educator. Clinically, she has worked in pediatric and maternal-child nursing, mental health, medical-surgical, community health and long-term care nursing.
Christina Von Colln-Appling, RN, MSN, CNS: Lecturer in Nursing
Professor Von Colln-Appling graduated from Neumann University with a BA in Psychology. She attended nursing school at Roxborough Memorial Hospital School of Nursing and earned a MSN from Widener University. She began working full time in education as a nursing instructor for a licensed practical nursing program in 2011. Currently, she teaches medicalsurgical nursing while studying to earn her PhD in nursing at Widener University.
Donna Gribbin, RN, DNP, CNE: RN to BSN Program Director
Dr. Gribbin completed her diploma from Frankford (Aria) Hospital School of Nursing/ affiliated with Penn State, BSN from Gwynedd-Mercy University, MSN in Nursing Education from Drexel University and DNP in Nursing Education from Duquesne University. At Duquesne, she researched simulation utilization and undergraduate nursing students. Her professional background includes teaching online, classroom, clinical, lab, and simulation, being course chair, teaching in ASN, BSN, MSN nursing programs and an adjunct in a business department at a Community College. Dr. Gribbin has extensive clinical experience in Medical Surgical Nursing, Same Day Surgery, and Community nursing. She also has clinical experience as a hospital unit manager, team leader, clinical preceptor and educator, a coordinator of a Nurse Aide program, and Director of Staff Development in LTC.
Jacquelyn Buige Raco, RN, BSN, CSN, M.Ed and Certification in School Health Supervision: Director of School Health Programs
Mrs. Raco earned her BSN from University of Pittsburgh, M.Ed from Eastern University, School Nurse and Supervisor Certificates from Eastern University. She has bone marrow transplant and pediatric clinical experience and has worked as a school nurse since 2004.
Tracy Perillo: Clinical and Compliance Coordinator
Mrs. Perillo’s background in quality improvement and data management led her to the role of Clinical and Compliance Coordinator in the Department of Nursing. She has a BA in Psychology from West Chester University and MS in Health Administration from St. Joseph’s University She has worked in quality improvement at Friends Hospital and Woods Services.
Looking toward a
future in nursing?
The Department of Nursing offers the following BSN tracks: • Traditional Pre-licensure • Second Degree BSN (BSN2) • Introducing Online RN to BSN
Jon-Michael Odean, firstname.lastname@example.org, 610-341-4364 Alex Stenman, email@example.com, 484-381-0495 Nick Snyder, firstname.lastname@example.org, 610-225-5557
RN TO BSN:
Amber Turner, email@example.com, 610-340-3344 TRADITIONAL PRE-LICENSURE:
Katie Friend, firstname.lastname@example.org, 610-225-5005
*Eastern’s BSN tracks have been endorsed by the American Holistic Nurses Credentialing Corporation. eastern.edu/academics/programs/nursing-department-undergraduate/majors
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School Health Programs
The Department of Nursing at Eastern University offers school health programs that are approved by the Pennsylvania Department of Education. Certification and Master’s programs are offered in the following areas: • School Nurse Certification • Supervisor School Health Certification • Master’s Education School Health • All Programs Now Online For more information, contact Jacqueline Raco, RN, M.Ed, CSSHS, CNS, Director of School Health Services at 610-341-1717 • email@example.com.