The Career and Education Resource for the Minority Nursing Professional â€¢ FALL 2016
Acing the NCLEX
NURSE COACHING THE ROLE OF THE SCHOOL NURSE
P R S RT S T D U S P O S TA G E PA I D BOLINGBROOK IL PERMIT #2020
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Table of Contents
In This Issue 3
Letter to the Editor
The Funny Bone
Highlights from the Blog
In the Spotlight
Index of Advertisers
Cover Story 8 Mentoring the Next Generation of Minority Nurses
By Maggie Van Dyke Find out how mentorship can help novice nurses steer successfully thorough early career challenges
Features 14 ACE the NCLEX and Clear the Final Hurdle to Practice
32 Nursing Role in the Diversity and Inclusive Excellence Discourse in the United States
By Jebra Turner
strategies for passing the NCLEX so you can focus on the next
Experts, educators, and recent nurse graduates share their
By Miriam O. Ezenwa, PhD, RN
The case for a strategic plan on diversity and inclusion in all nursing programs 36
hurdle: landing your first job
The Worst Trauma I Experienced as a Nurse
By Lynda Lampert, RN A nurse reflects on a traumatic experience and its impact years later
20 Nurse Coaching: What Can a Coach Do for You?
By Julia Quinn-Szcesuil Discover why coaches aren’t just for athletes and how a nurse
Degrees of Success 38 Autoethnography of an African American Nursing Student: Reflecting on a Four-Year Baccalaureate Nursing Program By Tamara Jessica Brown, MSN, RN-BC, PCCN, CNE, CMSRN A firsthand account of life as a black nursing student at a predominantly white school
Health Policy 43 Health Policy Development and Engagement: What’s a Student to Do?
By Janice M. Phillips, PhD, FAAN, RN
It’s never too early to start thinking about how legislation informs nursing practice and get involved in the policymaking process
Minority Nurse | FALL 2016
coach can help you achieve success
The Evolution of School Nursing By Robin Farmer Learn how the role of school nurses has transformed over recent years and the crucial role they play in our communities
CORPORATE HEADQUARTERS/ EDITORIAL OFFICE
e all must confront challenges at one point or another in our lives. Nurses have a tendency to shy away from help, but sometimes you need a little outside support to conquer that next hurdle. Flip through this issue and you’ll learn how to navigate those hurdles, whether it’s graduating from nursing school, passing the NCLEX, or overcoming adversity. As a novice nurse, it can be difficult to navigate the nursing landscape. A mentor—not to be confused with a tutor—can guide you through early career challenges. Maggie Van Dyke sheds some light on how mentorships can help ensure minority nursing students graduate and stay on the job after earning a degree. If you haven’t passed the NCLEX yet, look no further than Jebra Turner’s tips for acing the exam. She consulted with experts, educators, and recent nurse graduates to share with you their strategies so you can focus on the next step: transitioning from student to working nurse. Not sure where to go next? A nurse coach may be able to offer you guidance in identifying what path is right for you. Julia Quinn-Szcesuil examines what coaching is, what it does, and what role each person plays in a coaching relationship. If the idea of helping kids and working with complex health conditions intrigues you, consider a career as a school nurse. There’s a desperate need for them in our public schools, and they’ve come a long way from handing out Band-Aids. Robin Farmer walks us through the evolution of school nursing and the positive impact school nurses have on our communities. Unfortunately, it’s no secret that racial tension has been dominating the news in the United States lately. Miriam O. Ezenwa shares her thoughts on implementing a strategic plan on diversity in nursing programs, and Tamara Jessica Brown gives us a firsthand account of her experience as a black nursing student at a predominantly white school in order to encourage a dialogue on ways we can promote inclusivity. Whether you’re a working nurse, a nursing student, or a patient, it’s important to be mindful of the way you communicate with others. Lynda Lampert recalls a particularly traumatic exchange that still haunts her years later. Every nurse will experience onthe-job trauma at some point, and it’s important to know that it’s okay to talk about it. After all, having an open discussion is the best way to educate others—and it’s never too early to start a dialogue. Janice M. Phillips suggests ways a student can get involved with the policymaking process and influence the future of the nursing profession. Remember, you didn’t get to where you are today by yourself. Take a moment to thank the person who made a difference in your life—whether it was a teacher, mentor, or a nurse coach—and be sure to pay it forward. — Megan Larkin
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Minority Nurse (ISSN: 1076-7223) is published four times per year by Springer Publishing Company, LLC, New York. Articles and columns published in Minority Nurse represent the viewpoints of the authors and not necessarily those of the editorial staff. The publisher is not responsible for unsolicited manuscripts or other materials. This publication is designed to provide accurate information in regard to its subject matter. It is distributed with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice or other expert assistance is required, the services of a competent professional person should be sought. The publisher does not control and is not responsible for the content of advertising material in this publication, nor for the recruitment or employment practices of the employers placing advertisements herein. Throughout this issue, we use trademarked names. Instead of using a trademark symbol with each occurrence, we state that we are using the names in an editorial fashion to the benefit of the trademark owner, with no intention of infringement of the trademark.
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Minority Nurse Magazine
Letter to the Editor I
am writing in response to the article, “Raising Awareness of a Daily Pill that Can Prevent HIV Infection,” in a section of your magazine called “Vital Signs” (Winter/Spring 2016 issue). According to the Centers for Disease Control and Prevention (2015), one in three primary care doctors and nurses do not know pre-exposure prophylaxis (PrEP) and its ability to eradicate the spread of HIV. I was one of those nurses until I read your article. According to the American Nurses Association (2015), the Gallup poll results showed that, for the past 14 years, the public has voted nurses as the most honest and ethical professionals in America, and this shows that they can be influential in educating highrisk populations. However, nurses are not able to teach others because they lack certain essential information. The challenge related to getting information out into the medical community requires implementing better strategies, such as putting up advertisements to help avail information to nurses. Since the nursing profession is the largest health care profession in the United States, nurses always take the lead in handling any epidemic (smallpox, Ebola, etc.) and can easily help educate on how to eradicate the spread of HIV. Furthermore, nurses of color are of great help in educating the African American, Hispanic, and Latino communities. As an African American nurse, I understand the extent of stigma surrounding gay men in African American families. It is common to have straight men with gay family members feeling that their already tainted image is being hurt by the gay members, and this makes it difficult for them to come out to their families. This fear was once portrayed by my cousin who felt that his father would disown him and his mother would be hurt if he told them his true identity. I was, however, able to talk to his parents and they were able to accept him and even realize that their parenting was not in any way related to the sexual orientation of their son. It is estimated that new HIV infection cases for African American men aged between 13 and 24 is seven times higher than that of their white counterparts and two times higher than that of Hispanic/Latino men. African American bisexual, gay, and other men who have sex with men represent approximately 72% of new infections (CDC, 2016). The most effective way of reducing the high HIV infection rate in the African American community is to use nurses of color to educate them. Such nurses will also help them understand and cope with gay family members. —Andrea Doctor, RN, MSN, CCRN, CCRC References • American Nurses Association. 2015. Nurses Rank as Most Honest, Ethical Profession for 14th Straight Year (12/21/15). http://nursingworld.org/
FunctionalMenuCategories/MediaResources/PressReleases/2015-NR/Nurses-Rank-as-Most-Honest-Ethical-Profession-for-14th-StraightYear.html. Accessed August 2016. • Centers for Disease Control and Prevention. 2015. Daily Pill Can Prevent HIV. http://www.cdc.gov.vitalsigns/hivprep/. Accessed August 2016. •C enters for Disease Control and Prevention. 2016. HIV among Gay and Bisexual Men. www.cdc.gov/hiv/group/msm. Accessed August 2016.
Minority Nurse | FALL 2016
Office of Minority Health Awards $2M to Help Reduce Lupus-Related Health Disparities The Office of Minority Health of the U. S. Department of Health and Human Services (HHS) announced a new grant award in July 2016 of approximately $2 million to four national organizations under the National Health Education Lupus Program (NHELP). This grant program will support efforts to reduce lupus-related health disparities among racial and ethnic minority and/or disadvantaged populations disproportionately affected by this disease. The NHELP provides funding for two types of projects: • Priority A—to conduct a national health education program on lupus to increase and improve awareness, diagnosis, and treatment outcomes for individuals living with lupus • Priority B—to develop and begin implementing an education program on clinical trials that educates and recruits minorities and/or disadvantaged populations, particularly groups underrepresented in clinical research Three organizations received awards that total $1 million to conduct Priority A projects: the American College of Rheumatology (Atlanta, GA), $335,000; the Association of State and Territorial Directors of Health Promotion and Public Health (Washington, DC), $329,946; and the National Alliance for Hispanic Health (Washington, DC), $334,905. Through this program, grantees will work to increase • the number of health professionals and student train-
ees who are knowledgeable and skilled in the diagnosis and treatment of lupus; • the number of health professionals with enhanced knowledge and expertise in the signs and symptoms of lupus, treatment adherence, and screening; • the number of people who are aware of the disease and knowledgeable about its symptoms and warning signs; • the number of providers who use culturally and linguistically appropriate lupus materials to disseminate information to patients and families, including educational and multimedia materials.
pation in clinical trials; • evaluation of current clinical trial education, recruitment, and participation initiatives for minority and/or disadvantaged populations; • development of innovative education program models on clinical trial participation for minority and/or disadvantaged populations that are culturally and linguistically appropriate for the targeted population(s); • development of an action plan for disseminating these education models to increase minority and/ or disadvantaged populations’ participation in lupus clinical trials.
“The National Health Education Lupus Program grant award is an important initiative by the HHS Office of Minority Health to help remove barriers to diagnosis, treatment, disease management, and research participation for minorities and disadvantaged populations impacted by lupus, often due to limited access to lupus educational curricula tools and resources for practicing health professionals and trainees,” says J. Nadine Gracia, deputy assistant secretary for minority health and director of the Office of Minority Health. For additional information, visit www.minorityhealth.hhs.gov.
The Lupus Foundation of America received approximately $1 million to conduct a Priority B project. Grant funding will support • development of public, private, and community partnerships to address minority and/or disadvantaged populations’ partici-
Minority Nurse Magazine
Some Racial, Ethnic Groups Continue Smoking Cigarettes at Higher Rates Despite a significant decline in overall adult cigarette smoking since 1964, disparities in cigarette smoking remain among racial and ethnic population groups, according to a new study from the Centers for Disease Control and Prevention (CDC) published in an August 2016 edition of the Morbidity and Mortality Weekly Report.
or example, current (past 30-day) cigarette smoking during 2010-2013 was lower among Asians overall (10.9%) compared with whites (24.9%). But among Asian subgroups, the prevalence of current cigarette smoking ranged from 7.6% among Chinese and Asian Indians to 20.0% among Korean Americans. The American Indian/ Alaska Native population had the highest prevalence of cigarette smoking at 38.9%. The findings in this study show the importance of identifying higher rates of tobacco use across and within racial/ethnic population groups to better understand and address differences in tobacco use among U.S. adults.
Larger Sample Size for Racial/Ethnic Subgroups Estimates of cigarette smoking prevalence are usually presented in aggregate for racial or ethnic populations, such as Asian or Hispanic, because sample sizes are too small to provide estimates among racial/ethnic subgroups within these populations. To get a large enough sample size for this study, researchers aggregated data from the National Survey on Drug Use and Health collected between 2002-2005 and 2010-2013 to assess cigarettesmoking prevalence among six
Minority Nurse | FALL 2016
racial and ethnic population groups and 10 select subgroups in the United States. “Even though the overall cigarette-smoking rate is declining, disparities remain among racial and ethnic groups and within subgroups,” says Bridgette Garrett, PhD, associate director for health equity in the CDC’s Office on Smoking and Health. “Looking beyond broad racial and ethnic population categories can help better focus the strategies that we know work to reduce tobacco use among subgroups with higher rates of use.” Additional results from the study include the following: • Among whites, current cigarette smoking prevalence was 27.7% in 2002-2005 and 24.9% in 2010-2013. • Among blacks, current cigarette smoking prevalence was 27.6% in 2002-2005 and 24.9% in 2010-2013. • Among American Indians/ Alaska Natives, current cigarette smoking prevalence was 37.1% in 2002-2005 and 38.9% in 2010-2013. • Among Native Hawaiian or Other Pacific Islanders, current cigarette smoking prevalence was 31.4% in 2002-2005 and 22.8% in 2010-2013. Among Asians, the current cigarette smoking prevalence
was 14.5% in 2002-2005 and 10.9% in 2010-2013. Within that group were Chinese (7.6% in 2010-2013), Asian Indian (7.6% in 2010-2013), Japanese (10.2% in 2010-2013), Filipino (12.6% in 2010-2013), Vietnamese (16.3% in 2010-2013), and Korean (20.0% in 2010-2013). Among Hispanics, current cigarette smoking prevalence was 23.9% in 2002-2005 and 19.9% in 2010-2013. Within that group were Central or South American (15.6% in 2010-2013), Mexican (19.1% in 2010-2013), Cuban (19.8% in 2010-2013), and Puerto Rican (28.5% in 2010-2013). “We know smoke-free policies, hard-hitting media campaigns, higher prices for tobacco products, and promotion of
cessation treatment in clinical settings are proven to reduce tobacco product use,” says Corinne Graffunder, DrPH, director of CDC’s Office on Smoking and Health. “If fully implemented and enforced, these strategies could help reduce tobacco use, particularly among racial and ethnic populations with higher rates of use.” Tobacco use is the leading cause of preventable disease and death in the United States, responsible for more than 480,000 premature deaths annually. And for each death, there are about 30 Americans suffering from a tobacco-related disease. Smokers can get free help quitting by calling 1-800-QUIT-NOW, or going online to www.smokefree.gov.
Annual Conference on Transforming Health, Driving Policy Marriott Marquis Washington, District of Columbia Info: 202-777-1170 E-mail: info@AANnet.org Website: www.aannet.org
2017 Annual Conference Loews Atlanta Hotel Atlanta, Georgia Info: 215-320-3881 E-mail: firstname.lastname@example.org Website: http://nacns.org
National League for Nursing 2016 Education Summit Orlando World Center Marriott Orlando, Florida E-mail: email@example.com Website: www.nln.org/summit
The American Assembly for Men in Nursing 41st Annual Conference Hyatt Regency Miami Miami, Florida E-mail: firstname.lastname@example.org Website: http://aamn.org/conference
Doctors of Nursing Practice Conference 9th National Conference Baltimore Marriott Inner Harbor at Camden Yards Baltimore, Maryland Info: 888-651-9160 E-mail: email@example.com Website: www.doctorsofnursingpractice.org
The Transcultural Nursing Society 42nd Annual Conference Hilton Cincinnati Netherland Plaza Cincinnati, Ohio Info: 888-432-5470 E-mail: firstname.lastname@example.org Website: www.tcns.org
American Psychiatric Nurses Association 30th Annual Conference Connecticut Convention Center Hartford, Connecticut Info: 855-863-2762 E-mail: email@example.com Website: www.apna.org
American Academy of Nursing
Organization for Associate Degree Nursing 2016 Annual Conference Hyatt Regency Dallas Dallas, Texas Info: 877-966-6236 E-mail: firstname.lastname@example.org Website: www.oadn.org
Southern Nursing Research Society 31st Annual Conference InterContinental Dallas Dallas, Texas Info: 877-314-7677 E-mail: email@example.com Website: www.snrs.org
The Dermatology Nursesâ€™ Association 35th Annual Convention Orlando, Florida Info: 800-454-4362 E-mail: firstname.lastname@example.org Website: www.dnanurse.org
International Society of Psychiatric-Mental Health Nurses ISPN 19th Annual Conference and 10th Psychopharmacology Institute Baltimore Marriott Inner Harbor at Camden Yards Baltimore, Maryland Info: 608-443-2463 E-mail: email@example.com Website: www.ispn-psych.org
National Association of Clinical Nurse Specialists
American Association of Colleges of Nursing Spring Annual Meeting The Fairmont Washington Washington, District of Columbia Info: 202-463-6930 E-mail: firstname.lastname@example.org Website: www.aacn.nche.edu
Asian American Pacific Islander Nurses Association 14th Annual Conference University of Hawaii at Manoa Honolulu, Hawaii E-mail: email@example.com Website: http://aapina.org
30 - April 1
American Nursing Informatics Association 2017 Annual Conference Hilton New Orleans Riverside New Orleans, Louisiana Tel: 866-552-6404 E-mail: firstname.lastname@example.org Website: www.ania.org
Academy of Neonatal Nursing 14th National Advanced Practice Neonatal Nurses Conference Hilton Hawaiian Village Honolulu, Hawaii Info: 707-795-2168 E-mail: email@example.com Website: www.academyonline.org
Minority Nurse Magazine
Mentoring the Next Generation of Minority Nurses BY MAGGIE VAN DYKE
Minority Nurse | FALL 2016
arisol Montoya, BSN, RN, had one semester left at the SUNY Downstate Medical Center’s College of Nursing when she recognized she needed help navigating the next phase of her career. “I knew I would be walking into a foreign land very soon,” Montoya says. “I would have to take my NCLEX, and then I was going to have to look for a job.”
Recruiting more minority nursing students is one battle that must be won to increase nursing diversity. Another important battle: ensuring these students graduate and stick with nursing through their first few years when turnover tends to be high. Mentoring is proving to be a critical type of support to help novice nurses steer successfully through early career challenges. Thanks to a mentoring program offered through the National Association of Hispanic Nurses (NAHN), Montoya has spent the last year under the tutelage of a fellow Hispanic American nurse, Miriam “Mimi” Gonzalez, BS, RN. Gonzalez was able to provide Montoya with targeted support right when she needed it, drawing on her experiences and connections as one of NAHN’s founding members and a 50-year career as a labor and delivery nurse. “I believe mentorship relationships are incredibly valu-
able anytime anyone is going through a transitional period,” says Montoya, who recently started a job as a postpartum nurse at Mount Sinai Health System in New York City. “It is very helpful to have someone in your life who has already done what you’re doing and knows the territory better.” Culturally sensitive mentorships are proving critical to keeping novice minority nurses in the pipeline, helping to ensure they graduate and stay on the job after earning a degree. Research suggests that minority nursing students tend to feel lonely, isolated, and alienated on top of having financial and academic difficulties—all of which can lead them to drop out. Student retention programs that offer mentoring and other support tend to have lower attrition rates. For instance, the SCRUBS program at Georgia Southern University increased retention rates among minority nursing students to 95% (from 69%), and NCLEX pass rates to 100% (from 84%), according to a 2013 study in the Journal of Nursing Education and Practice. Similarly, mentoring can help reduce on-the-job vacancy rates among newly graduated nurses. In the California Nurse Mentor Project, only 8% of new hospital nurses who were assigned a mentor left
Minority Nurse Magazine
within a year of being hired, compared to 23% who did not have a mentor, according to a study published in 2008 in Nursing Economics.
Understanding What Novice Nurses Need Three years ago, the Washington Center for Nursing (WCN), based in Tukwila,
Culturally sensitive mentorships are proving critical to keeping novice minority nurses in the pipeline, helping to ensure they graduate and stay on the job after earning a degree. The first step for novice nurses looking for support and advice is not to shy away from the experience of mentoring, says Vivian Torres-Suarez, RN, MBA, BSN, director of NAHN’s Mentorship Academy. “I sometimes think people perceive that needing a mentor is like needing a tutor. They see it as a remedial type of thing. And it’s not. It’s about collegiality; it’s about learning from those who have been through a process before us. All of us should be open to it.”
Minority Nurse | FALL 2016
Washington, surveyed local minority nursing students and new graduates to assess their needs. In addition to finding a lack of mentoring programs, the survey identified specific topics that novice nurses were interested in: “The students really needed somebody to help them with work-life balance issues,” says Sofia Aragon, JD, BSN, RN, the executive director of WCN. Other highly ranked topics on the survey were developing a professional sense of iden-
tity, honing leadership and communication skills, and transitioning from education to practice. The diversity committee at WCN also identified lateral violence and bullying as issues that contribute to attrition among minority nurses. Mentors interviewed for this article stressed that many novice nurses also need help developing practical skills, such as putting together a resume, applying for a scholarship, or sorting out what paid-timeoff time is all about. Nilda (Nena) P. Peragallo Montano,
cal thinking on the top of the list. “You want them [novice nurses] to learn to think critically and make choices that are best for them,” says Montano, dean and professor at the University of Miami School of Nursing and Health Studies. “The mentor doesn’t always have the solution for the person. The student has to learn how to resolve whatever situation they come across. That’s part of learning.” The mentees interviewed for this article emphasized how much they appreciated the empathy and encourage-
The first step for novice nurses looking for support and advice is not to shy away from the experience of mentoring, says Vivian Torres-Suarez, RN, MBA, BSN, director of NAHN’s Mentorship Academy.
DrPH, RN, FAAN, would put time management and criti-
ment they received from their mentors. “It’s good to have another person constantly telling me, ‘You can do this. I’ve gotten through this. Other nurses have gotten through it,’” says Jasmine Carter, an undergraduate in the nursing program at Arizona State University. A 2014 study published in the Journal of Professional Nursing found that minority nursing students perceived the following traits as the most important characteristics in a mentor: • warmth • encouragement • a willingness to listen • enthusiasm for nursing and how the mentor sparks the mentee’s interest • clarity regarding expectations for mentees • pushing mentees to achieve high standards
Do mentors need to be of the same race or ethnicity as the mentee? Although research suggests that minority nurses can get effective support from nonminority mentors, many nurses point to the advantages of having a mentor with a similar background and culture. “It’s important because they’ll be more likely to have the same experiences as you than someone who is from another race,” says Carter. Carter’s mentor, Angela Allen, PhD, CRRN, RN, who teaches culture and health in her classes at Arizona State, agrees: “It’s easier for us to be able to relate when we are from the same ethnic culture, whether African American, Caucasian, or whatever. We can immediately make a connection and say, ‘I know you’ve gone through something similar to what I’ve gone through.’ There’s already a foundation for a relationship.”
Finding a Mentor Montoya and Gonzalez met at a NAHN speed-networking
one-on-one meetings with experienced nurses who had volunteered and been selected to be mentors. “They [the protégés] ask the same questions of each mentor,” says Torres-Suarez, assistant vice president of utilization management at Healthfirst. “Then they walk away with an impression of whether that mentor is somebody they’re going to be able to work with.” One of Montoya’s questions for the mentors asks, “What do you desire to bring to this relationship, and what do you desire for your mentee in this relationship?” As Montoya recalls, Gonzalez said something like, “I believe one of the biggest things I can bring into your life where you are right now is to connect you to everyone I know.” This response resonated with Montoya. “In that moment, that was important to me because I felt like everyone whom she [Gonzalez] connects me to will also be a mentor to me. I felt like she was going to provide a village to raise me.”
“It’s good to have another person constantly telling me, ‘You can do this. I’ve gotten through this. Other nurses have gotten through it,’” says Jasmine Carter, an undergraduate in the nursing program at Arizona State University.
event for prospective mentors and mentees, or protégés per NAHN parlance. After attending an educational session on mentoring, Montoya spelled out her goals for the mentoring experience and identified a few questions to ask potential mentors. Then she had brief
Formal programs. Formal mentoring programs like NAHN’s is one place for novice nurses to find mentors. So far, about 20 nurses have gone through the association’s yearlong Mentoring Academy. Originally piloted at the national level, the program is now being
deployed at the chapter level. So far, five NAHN chapters have launched their own programs, and Torres-Suarez hopes to see every chapter create a program. Similarly, 30 chapters of the National Black Nurses Association (NBNA) have mentoring programs. That’s how Hailey Hannon, MSN, RN, met her
The NBNA is getting ready to launch a national mentoring program this year that will connect novice nurses, as well as experienced nurses in career transitions, to volunteer mentors from among the NBNA national membership. “This won’t be taking away from the mentoring programs offered
Although research suggests that minority nurses can get effective support from nonminority mentors, many nurses point to the advantages of having a mentor with a similar background and culture.
mentor. In 2004, when Hannon was a nursing student at Indiana University-Purdue University Indianapolis, Denise Ferrell, DNP, RN, who introduced herself to Hannon one day on campus and told her about the mentoring program offered by the NBNA Indianapolis Chapter. Ferrell, who is now president of the NBNA Indianapolis Chapter, became Hannon’s mentor during college and continued to mentor her through her first nursing job. “I was new to the nursing program, and Denise caught me at a good time when I needed that mentoring guidance,” says Hannon. “At the undergraduate level, I looked to her for encouragement and help balancing work and being a nursing student. She would say, ‘You can do it. Let’s just talk about it.’ Then once I became a new nurse, she introduced me to the professional development side of things, like, ‘How do you find people on the unit that can help benefit you?’ or ‘Are you on any committees on your unit?’”
by our chapters,” says Allen, who helped developed the mentoring program. “What we want to do is enhance them.” Many nursing schools also offer various types of mentoring for minority students. For instance, American Indian and Alaska Native nursing students at the Montana State University College of Nursing are paired with a peer mentor and communicate on a biweekly basis as part of the college’s Caring for Our Own Program (CO-OP). Additionally, perspective high school students interested in pursuing a career in nursing can be paired with a CO-OP mentor who will provide them with information on scholarships, educational preparation, and career options, among other things. Informal engagements. Not all good mentor-mentee relationships spring from formal programs like NAHN’s and NBNA’s. For instance, Carter and Allen met informally at a NBNA chapter meeting. Carter won a scholarship from the chapter, and Allen recognized
Minority Nurse Magazine
Mentoring Minority Nurses Through Specialty and Graduate Training Another vulnerable juncture in the careers of minority nurses is when they are contemplating a specialty or graduate degree. Nothing can replace the opportunity to talk one-on-one with another minority nurse who has achieved success in a chosen specialty. Wallena Gould, CRNA, EdD, FAAN, knows this firsthand. One of the reasons she became a nurse anesthetist was because of the small percentage of minority nurses in the field. Now, she’s helping other minority nurses become nurse anesthetists through the Diversity in Nurse Anesthesia Mentorship Program, which she founded approximately 11 years ago. The program sponsors two-day mentoring events at nursing schools across the country that allow minority nursing students to interact with a diverse group of nurse anesthetists (students and practicing nurses), learn about the clinical specialty, and participate in hands-on airway simulation. Directors from nursing anesthesia university programs also provide information on admission requirements and degree expectations. Volunteer mentors with the Diversity in Nurse Anesthesia Mentorship Program also offer one-on-one guidance to minority nurses, making arrangements for them to shadow a CRNA, helping them prepare for the GRE, or conducting mock admission interviews. “I’m excited because the minority nurses that get accepted into nursing anesthesia programs each year is a result of them coming to our information sessions,” Gould says, adding that some of those nurses go on to get doctorate degrees. “It’s sort of like we’re changing the face and culture of nurse anesthesia.” The University of Miami School of Nursing and Health Studies is also using mentoring to help increase the number of minority nurses who go into research careers, thanks to a training grant from the National Institute on Minority Health and Health Disparities. Ten undergraduate nursing trainees participated in the first year of the program. After a three-week intensive institute, the trainees worked closely with mentors on an eight-week research project. Preliminary findings suggest that the number of trainees who intended to get a doctorate degree doubled after participating in the program. “The mentorship aspect is the heart and soul of the program,” says dean and professor Nilda (Nena) P. Peragallo Montano, DrPH, RN, FAAN. “Mentors push students to take risks and stretch to meet high expectations. This is especially important in this particular program, which aims to attract students from underrepresented groups to research careers.”
Minority Nurse | FALL 2016
her potential and decided to take her under her wing. Now, the two regularly talk, text, and e-mail each other. Torres-Suarez encourages novice nurses to seek out various types of mentors, including informal, short-term contacts. “We have to be constantly open to opportunities to network and connect to individuals,” she says. “You can have an in-depth formal mentorship like in our [NAHN] program. And you can have an informal, five-minute mentorship with someone you just met, somebody that could be a connector for you. You can have sort of an elevator speech prepared to say, ‘I’m a new nurse. I’m not sure where to get a job, and I’m looking for some advice.’” Torres-Suarez also thinks nurses need to seek mentors from outside of nursing, as needed. “We have to be open to mentors coming from all directions and all walks of life. While nursing mentors are important, we could also get mentoring from people who are in business because, at the end of the day, health care is a business.”
Building a Beneficial Relationship One of the key steps novice nurses should take before seeking a mentor is to “really understand what their specific needs are,” says Aragon, who has been working to match mentees at two nursing schools with volunteer mentors at the WCN. Developing mentorship goals can help nurses identify and communicate with potential mentors—and find the best mentors for their particular needs. Aragon shares this example:
“When I was getting to know one mentor, she was talking about her journey to be more vocal with other nurses and physicians and a better communicator. She struggled with that but eventually overcame it. Then a mentee said on her application, ‘I really want to find my voice, I’d like someone to help me do that.’ This really helped me match those two up because it seemed like the mentee’s need was exactly what the mentor could give somebody.” Yet, even the best-matched mentors and mentees need to work at building a durable, beneficial relationship. What helps? The nurses interviewed for this article provide the following lessons learned:
Create a structure that works for you. The exact structure and rules of a mentoring relationship will depend on the program and people involved. One of the requirements of the NAHN Mentorship Academy, for example, is that mentors and mentees agree to communicate with each other at least once a month for a year. Because they both preferred to connect in person, Montoya and Gonzalez agreed to meet for an hour or so before the monthly NAHN New York Chapter meeting. Then, they supplemented their monthly meetings with e-mails and phones calls, as necessary. During the first few monthly meetings, Montoya and Gonzalez focused on getting to know each other. “We talked about our histories, and I discovered her background in nursing and the history of her life in Puerto Rico and here in the United States,” says Montoya. “When it came closer to me taking the
NCLEX, our meetings became more about preparing for the NCLEX. Then we turned to preparing me for my first job interviews. When I got hired, our meetings became about accepting an employment offer. We reviewed all of the paperwork page by page.”
Walk in with intentions rather than expectations. Montoya recommends being open to what can come of a mentoring relationship. “Operate with intentions rather than expectations,” she says. “Know what your intention is. I would say that should be the first conversation that you have [with your mentor], ‘What is your intention as a mentor? What is my intention as a mentee? What is our intention for this relationship?’ Allow that to be your guiding compass throughout the relationship.” Get personal. It’s virtually impossible for mentors and mentees who have a long-term relationship to avoid talking about personal issues, from money and child care issues to layoffs and illness, says Torres-
Montano gives the example of a mentee not showing up for scheduled meetings. “You can’t mentor someone who
Torres-Suarez encourages novice nurses to seek out various types of mentors, including informal, short-term contacts.
Suarez. “This is real life. All of those things happen and all those things get addressed as part of the conversation with the mentor.”
Remember, it’s a two-way street. “It has to be a respectful relationship,” says Montano. “It’s not a one-way street where the mentees sit there and expect everything to be given to them.”
doesn’t want to be mentored.”
Make use of technology. NBNA’s national mentoring program is gearing up to take advantage of live-chat, texting, e-mail, and other mobile communication technologies, says Allen. This will allow mentors and mentees from different states to communicate. NAHN also uses Skype and other technologies when
needed. But Torres-Suarez recognizes the benefit of inperson meetings between mentors and mentees. “Eye contact is an important piece when you’re trying to get to know each other.”
Influencing Generations of Nurses One argument against mentoring is that it only helps one nurse at a time. But Aragon believes the long-term effects of helping one nurse can multiply exponentially. As an example, she tells the story of the first Filipino American nurse to work in a major hospital in Yakima County, Washington. “She was someone who thought nursing was not in her universe,” yet friends, family, and community members offered her encouragement and
paid her nursing school tuition, says Aragon. “In her lifetime, she’s helped two other nurses go to school and seen the numbers of Filipino American nurses go up over time,” Aragon notes. “So, for me, even though we may only reach a few people by mentoring, just one person could be a champion and really multiply the number of minority nurses a community has.” Maggie Van Dyke is a freelance writer based in the Chicago area.
Minority Nurse Magazine
Clear the Final Hurdle to Practice
Minority Nurse | FALL 2016
BY JEBRA TURNER Often it’s not nursing knowledge that makes the difference in passing nursing boards, but having strategies for answering questions so that it’s apparent that you really “get it.” There are ways to prepare for what is often a daunting test so you can take it with complete confidence that all the time, money, and hard work that went into nursing school won’t go to waste. We interviewed experts, educators, and other nurses who aced these exams—first time around or later—and share their most helpful hints with you here.
Jake Schubert, RN, BSN Travel nurse and executive director of Nursity.com, an online NCLEX strategies and review course
1. Carefully consider your options. “The average candidate takes one or two prep or review course, and spends an additional 40 to 50 hours on other independent study,” according to Schubert. He recommends that students talk to
their peers about their experiences and read online testimonials. In addition, check to see if your school has partnered with a test-preparation program. “Some schools provide review courses as part of the capstone curricula—ATI, Kaplan, and HESI are the big cor-
porations with relationships with many of the schools. Most students take an additional course as well,” he adds.
2. Understand the NCLEX format and how it works. “When you intimately know the beast, it won’t be as intimidating,” says Schubert. Because this is a computer adaptive test that uses algorithms, it’s different from every other test students have taken in their entire aca-
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demic career. You must also prepare for it differently. “If you did exceptionally well or performed extremely poorly, the exam will end at 75 questions,” he explains. But if you are somewhere in the middle, it can go up to 265 questions to assess how well you know the material and whether you’ll be able to perform as a nurse in a safe manner. (See Schubert’s YouTube video—
“How to Pass the NCLEX with a 58%” for more details about this type of test.)
3. Strategize how you will approach questions in which you don’t know the answer. Most students who graduate from nursing school have sufficient content knowledge, but because the test is computer adaptive it will find an
area where you are weak, says Schubert. “The NCLEX will assess your judgment as much as anything else.” What will you do when you don’t know what to do? You need strategies for these types of questions. “How do you answer a question about content you never learned? Strategy. Ask yourself, ‘Why did they write this question? Is it a medication question? A judgment
A Nursing Graduate’s Story of NCLEX Failure and Triumph on YouTube When I failed the NCLEX, I went through the stages of grief. At first, I denied that I had failed because I believed I was prepared. I had graduated cum laude and been inducted to the Honor Society of Nursing, Sigma Theta Tau. Not only did I not expect to fail, but my family and friends had these high expectations for me based on my accomplishments. Going through all the stages of grief, I eventually had to accept the fact that I had failed. What helped with my grief initially was watching YouTube videos of others who had failed. It helped me realize that I was not alone and the world had not ended. This would eventually be one of the reasons why I released my own YouTube video when I passed, so that way I can help others the way I had been helped by the YouTube community. The most important thing I mentioned in my video was that I became more prayerful the second time I took the exam. I realized that at that point my future was completely in God’s hands and all I can do is study hard, pray, and hope for the best. I would attend daily mass, pray before and after study sessions, and really focus on my spirituality beyond anything else. I truly believe my faith became stronger from failing the first time I took the NCLEX. Andrew “AJ” Reyes, RN, BSN, is a medical-surgical staff nurse at Overlook Medical Center, a part of the Atlantic Health System, in Summit, New Jersey. Visit his YouTube channel at www.YouTube.com/c/AjayRNofficial.
Minority Nurse | FALL 2016
question?’ As a new graduate nurse, that’s all you do all day, is try to figure out what to do in situations you don’t necessarily fully understand. This is much of what the NCLEX is assessing—will you make a safe decision?” he adds.
4. Don’t wait to study or take the exam. The longer you wait, the more you forget, and the worst you score. “Take the exam immediately after graduating from nursing school,” Schubert advises. “Begin studying for the NCLEX before you graduate, to keep the material fresh in your mind, which will improve your score. Pass rates go down the longer a candidate waits after graduation,” he says. To find out more about pass rates, we recommend you go directly to the source: the National Council of State Boards of Nursing website at www. ncsbn.org.
5. Figure out the best way for you to study, and then stick with your plan. “Keeping to a study schedule and certain days and times is important,” says Schubert. “But don’t cram. Instead, spread it out over a longer period.” He also recommends reducing distractions, such as television, devices, and social media as well as calls or visits from family and friends. Make sure your study area and equipment are well set up so that you’re comfortable during each study session. Then take frequent breaks so that you don’t deplete your energy, and switch among various subjects every half hour or so to maintain focus.
Launette Woolforde, EdD, DNP, RN-BC Vice president of system nursing education at Northwell Health in New Hyde Park, New York
1. Find a role model with a similar background. “When you don’t have minority role models that reflect who you are, it can hamper your optimism and pursuit of certain goals,” says Woolforde. “For example, I remember reading that 12% of the U.S. population is African American, but only 2% of nurses in the workforce are African American.” The lack of role models may extend to educators, staff, and mentors who can help monitor and guide students. On the other hand, those missing pieces of the career puzzle “can serve to motivate students to start a new trend and make a clean break from what’s happened before,” she adds.
2. Be aware that factors such as language, cultural norms, and your environment can influence your standardized testing experience. Being a first-generation nurse or college student, for example, means you have to figure out your own way around in academia and career preparation,
says Woolforde. “Minority nurses might not fit the norm in their family or culture. But I’m happy to see so many nurses exceeding these norms. Soon, minorities will be the majority in the U.S.” Minority test-takers may have to “think against” their own cultural norms, cautions Woolforde. “Maybe in your culture women do not make decisions. You have a question about a patient coming into the ER—a male with a wife— and the wife is upset and vocal about it. How would you answer the question? The correct response is ‘Reassure the wife,’ but what if in your culture, wives aren’t spoken to? A wife may be dismissed in that culture.”
than in reviewing your general knowledge.” Some review services provide assessments, so take a look at your pharmacology scores, for instance, and decide if you need to allocate more time to that section of the test. Nursing students know a lot, but when they look at the questions they may not understand what the question is really asking. “It’s not ‘What is this medication for?’ but more about ‘What would you do to prepare a patient?’ For example, if a patient is taking Lasix then he needs a diet that’s rich in potassium,” she says. “Review what you’ve learned over the years. Believe in yourself. You’ve come this far, so you can pass this exam. There’s great positivity that comes from that belief. There’s power there.”
4. Don’t let fear hold you back. Fear of failure and fear of the unknown are two major hurdles for many minority nursing students, says Woolforde. “They ask, ‘Am I smart enough?’ They’re afraid that they’ll fail the test because they don’t know the right answers.
They’re afraid there’s material that they didn’t get in school or that they didn’t study it enough. I usually tell them all that might be true—you might not know the answer outright. But you can usually rule out two answers and reduce your choices. Then reread the question, think about it, and let the right answer surface,” she advises.
5. Think beyond the NCLEX. “Even during your orientation, you can be thinking about specialty certification,” says Woolforde. “If you work in oncology and pediatrics but like peds, then you may decide, ‘This is where I want to spend my career.’” Next, consider specialty board certification as a stamp of expertise in an area of practice. In order to maintain that certification, you have to maintain a minimum number of continuing education hours and must practice for a minimum number of hours there. “Certification shows that you’re current with best practices; you’re currently practicing and staying on top of trends and issues in that specialty,” she adds.
3. Do two or three things to “pump yourself up” each day. “Overthinking and overprocessing while studying is a problem,” says Woolforde. “Don’t try to master everything. Do a little bit every day. Take tests over and over. Spend more time doing practice tests
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advises Alexander. “Avoid being hungry, angry, lonely, or tired [“H.A.L.T.” is a good memory aid]. Make sure you’re well-nourished, well-rested, and really and truly try not to get panicked because you don’t know the answer immediately. Answer the questions you are certain you know and then revisit the questions you skipped.” It’s normal for people taking the NCLEX to think that they’re failing, so try not to be overwhelmed if you need to skip questions. Usually, you are doing fine, so just stay the course.
3. Tap the various staff members and other resources that your school provides.
G. Rumay Alexander, EdD, RN, FAAN Interim chief diversity officer and director of the Office of Inclusive Excellence in the School of Nursing at the University of North Carolina at Chapel Hill
1. Keep your mind in the game. For highly vulnerable students, every test becomes a test of language proficiency, says Alexander. Multiple choice questions are especially problematic, she adds, so practice to understand how they’re structured and how to answer them. “Outside of the U.S., most countries don’t use multiple choice questions on tests, so international students may need more help
Minority Nurse | FALL 2016
to pass. Non-English speakers typically need to translate questions into their own language and then retranslate their answer in English. Older students are another minority group that is disadvantaged; they’re out of practice with test-taking.”
2. Understand that half the battle is staying level-headed. “Try not to let your brain get hijacked by emotions,”
“We have student advisors who meet with students and take them through different tests and practice exams,” says Alexander. Practice questions come from the end of textbooks, or students go online and get questions that best address their weak spots. “Students who have test anxiety can get help at a center that helps with managing anxiety and practice with testing, too,” she adds.
4. Find your happy place. When highly vulnerable students were not passing gatekeeper exams at her school, Alexander asked the school’s “cultural coaches” to work with them. “We told the distressed group to forget about the exam and we asked them this question: ‘If you didn’t have that coming up, what would you do?’ Their response was ‘Let’s have a party!’ so we blasted music for 40 minutes and they
taught each other new dances. There was laughter, joy, and smiles. Then they went on to study for the exam.” The nursing students were advised to do visualization exercises for stress reduction, like the school’s winning basketball team did before a game. “We told them, ‘When you’re stuck on a question during the exam, go back to this time. Remember the dance or anything that makes you feel peace, joy, or sense of accomplishment.’” The visualizations worked, and students later reported that their anxiety was greatly reduced when they applied the technique.
5. Understand that not everyone will pass the exam on the first try—and that’s OK. “If you failed, well, you’re not the first person who has,”
says Alexander. “Maybe you need to practice more or review a certain part again. Students repeat exams all the time. It’s not a denial of your dream; it’s a delay. Maybe you need to work more on test anxiety or preparation. Failing should inform you, not defeat you.” Sometimes students face difficulties right before the exam that throw them off course, such as a suddenly ill child or a minor fender bender. Everybody has a bad day, Alexander explains, and the main thing is to resist the urge to ruminate. “Instead, focus on what’s next,” she suggests. “Ask yourself, ‘What do I want? What’s my next move?’ Remember, there is a skill to test-taking and it takes intentional preparation. Prepare, don’t despair!” There are so many ways to prepare for the nursing boards
now, what with new technology as well as in real-life social support. You can pick and choose the techniques that work best for you. Take an online review course, use an app, study with a group, or set up an at-home program. Success is absolutely within your reach! Jebra Turner is a freelance health writer living in Portland, Oregon. Visit her online at www.
Top Picks from “The Nerdy Nurse” to Help You Crush Computerized Tests Brittney Wilson, RN, BSN, informatics nurse, social media influencer, and blogger at thenerdynurse.com recommends the following tech resources. (You can also find a comprehensive list on her blog post titled “How to Pass the NCLEX with 75 Questions in One Attempt.”)
NCLEX-RN Exam Prep By Pocket Prep
ATI RN Mentor - NCLEX Exam Preparation
Lippincott’s NCLEXRN 10,000 http://thepoint.lww.com/ nclex10000
NCSBN’s Review for the NCLEX-RN Examination
Uworld NCLEX-RN Qbank www.uworld.com/NCLEX
RN Crush! NCLEX Prep App www.rncrush.com
NRSNG’s MedMaster Course www.nrsng.com/product/medmaster
NRSNG’s NCLEX Practice Questions www.nrsng.com/product/nursing-practice-questions-pro
Minority Nurse Magazine
What Can a Coach Do for You?
Minority Nurse | FALL 2016
BY JULIA QUINN-SZCESUIL
For years, business leaders have relied on the guidance and support of career coaches to help them advance in their professions and to achieve clear personal goals as well. But nurses traditionally haven’t used coaches in the same way. All that is changing as nurse coaches are becoming more common and helping nurses achieve success.
s with other types of coaching, nurse coaching appeals to and works for nurses who are looking for vastly different things. Some nurses feel stagnant in their jobs and want someone to help them get unstuck. Other nurses are unhappy with their current situation and might even be questioning an entire career change. Still, others are nearing retirement and want to stay involved in nursing,
just without the demanding physical tasks and long hours—they wonder if a new career as a nurse coach might suit them. Career coaching is nothing new in the larger world of business, but nursing lags behind, says Linda Yoder, PhD, MBA, RN, AOCN, FAAN, president-elect of the Academy of Medical-Surgical Nurses and an associate professor at the University of Texas at Austin School of Nursing.
However, the nursing profession is slowly gaining a more positive view of coaching, adds Yoder. For many years, the poorest performing nurses were assigned a coach to help get them back on track. “Coaching usually means there’s something wrong,” she says. Nurses have particular difficulty reaching out to coaches, says Phyllis Quinlan, PhD, RNBC, who sees many nurses in her nurse coaching and consulting practice, MFW Consulting.
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“Professional caregivers are very reluctant to receive help,” says Quinlan. So by the time some of them arrive at
the professional side of what a nurse trains for and a nurse’s myriad responsibilities. But nurse coaches also understand
Nurse coaches are especially valuable because they understand the complex industry of nursing. a coaching session, they feel like their backs are up against a wall and they need some
how the nursing profession is also a way of life. They get that there’s no punching the clock
stability. They might be experiencing compassion fatigue or have been on the receiving end of bullying. They think a coach can help, but they aren’t sure how. So, how can a coach help you? Nurse coaches are especially valuable because they understand the complex industry of nursing. They get
and leaving your job behind when your shift is over.
Minority Nurse | FALL 2016
Is It Coaching or Mentoring? When Margaret Erickson, PhD, RN, CNS, APHN-BC, executive director of the American Holistic Nurses Credentialing Corporation (AHNCC), thinks of coaching, she thinks of the whole profession. “The role of
coaching allows nurses to reconnect with each other and it has value in society,” she says. Nurses find they have resources to help themselves, but coaching just helps reveal those resources and show nurses how to use them. Often, Quinlan says, nurses are able to reignite their initial passion for becoming a nurse in the first place. They can remember why they took this on as
coaching is asking powerful questions,” says nurse coach Keith Carlson, RN, BSN, NCBC, also known as Nurse Keith. “Coaches are there to offer guidance and objectivity and to inspire people.” Not everyone understands what coaching is, what it does, and what role each person plays in a coaching relationship. “People lump it into mentoring, and that’s
A nurse coach helps you tweak the complex intertwined aspects of your personal and professional life to bring you more career satisfaction and help you set and reach your goals. a career and are invigorated by the boost. Coaches guide, but never tell someone what to do. “Part of
a huge mistake,” argues Yoder, who presents nationally about nurse coaching. Nurse coaching helps nurses get out
of their own way and gives them the resources and the guidance they need to shake off uncertainty. How are coaching and mentoring different? Although coaching and mentoring both aim for a similar goal—to make the nurse the best nurse he or she can be—there are differences in the approach. “Coaching, technically, is really a boss/
a coach is going to rely on you to figure out some of the answers based on what your own motivations are.
Nurse Coaching Takes Hold When Donna Cardillo, RN, CSP, known as The Inspiration Nurse, started coaching 20 years ago, hardly anyone else was in the field of coaching nurses. “Even personal coach-
“Sometimes, it’s just about the act of being truly heard and having those experiences reflected back toward them,” says Carlson. “Being listened to is incredibly powerful.” employee relationship,” explains Yoder. “Mentoring is an exclusive relationship.” Does that mean your boss will always be a great career coach? No. But a good boss will motivate you, show you how to do a good job, and let you know the educational, professional, and personal steps that will help you advance. So while your boss should coach you on how to fill out a unit shift report, she might be less likely to take you under her wing and shape you into her replacement. Your coach can instruct and guide you on the subtle ways of your organization so you advance in your job, but coaches don’t share what Yoder refers to as “state secrets”—those nuggets of insider professional information that are often exchanged in the fundamentally different trust and power levels of a mentor/ mentee. And Carlson reminds nurses that coaching isn’t psychotherapy, either. There might be introspection and lots of questions to be answered, but
es couldn’t effectively coach a nurse because they didn’t understand what nurses were capable of or the job market,” she says. With more nurses acting as coaches now, she says they are using a body of experience, skills, and knowledge to help other nurses with problem solving, identifying strengths and weaknesses, and following through on goal setting. With nurses under increasing job stress and the pressure to earn higher degrees, burnout is rampant. If your job is causing you so much stress as to affect your physical and emotional well-being, start thinking of ways to make it better, says Erickson. “Coaches know the game,” says Yoder, comparing nurse coaching to the job of a sports coach. “They know the big picture, how the game is played, every single player, and what position each player plays best in. The coach has to understand the game better than anyone else.” Coaches get to know their players and know how each works so they are
able to best motivate them and make the entire nursing unit operate more effectively. Coaches also are focused on the present. Erickson’s work is guided by the Modeling and Role Modeling holistic nursing theory, which was developed by Helen C. Erickson, Evelyn M. Tomlin, and Mary Ann P. Swain. According to Erickson, using theory rather than policies and procedures to assist others helps coaches become intentional and thoughtful in their approach to each nurse or client.
Sorting It All Out A nurse coach helps you tweak the complex intertwined aspects of your personal and professional life to bring you more career satisfaction and help you set and reach your goals. “A coach focuses on what are your goals and what are you going to accomplish this year,” says Yoder. For instance, coaches will get you thinking about if you want to go back to school this year or if you want to take a certifi-
coach, Keep says she uncovered her motivations and identified what was holding her back. “Working with a coach held me more accountable,” she says. “Coaching helps someone take the step forward. It helped me live the life I wanted.” Linda Bark, PhD, RN, MCC, NC-BC, Keep’s coach and the founder of Wisdom of the Whole Coaching Academy, says she asks clients to think about their options and will even have them assess how they feel physically when thinking about each option. It’s that kind of holistic approach that shows nurses how the corners of a career, personal life, and spiritual life are all connected. “The wisdom of the whole is about taking in all that information,” says Bark.
When’s the Time to See a Coach? Carlson says he sees several categories of nurses who come to him for coaching advice. Most of the nurses he sees want something else, but they just don’t know how to define or
Successful coaching helps clients understand their true feelings and motivations so they can peel away the layers of confusion and help remove some of the barriers for nurses to move ahead. cation exam. Should you join a professional nursing organization, and how can you make the best out of that experience? Kamron Keep, RN, BSN, NC-BC, says coaching helped her focus on what she really wanted. “I felt like there was a missing piece, personally and professionally,” says the Idaho-based Keep, who is now a nurse coach herself. With her
identify what they want or how to take the steps to get it. Novice nurses, he says, are trying to find out what makes them tick as a nurse. Maybe they went into nursing with a specific path in mind but now want to branch out, but have no idea where to start. With so many opportunities and choices, they are bewildered. Then, he says, mid-career
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nurses come with very different ideas. They have years of experience, but nursing has lost its luster. Or now they want to do something different, but stay within the nursing industry. These nurses typically want to find out about nurse entrepreneurship. Older nurses are looking for someone who understands the profession, says Carlson, and who can help the nurse figure out the next step. They often want to stay in nursing but are looking to shed the long hours or the physically demanding tasks. “For seasoned nurses, it’s often trying to find the heart of why they became a nurse in the first place,” he says. “Sometimes they need redirection, and sometimes they need a major change.”
Is One Coach Enough? Throughout your life, you’ll have several coaches. Some coaching relationships will be less involved—one might simply be a unit educator who coaches bedside nurses. A charge nurse might be the coach for practice kinds of issues, says Yoder, to let nurses know how they can most effectively work with different families. If you aren’t getting the feedback you need at work or if your boss is unwilling to act in a coaching role, there are other options. A growing industry is, of course, nurse coaches you hire. These nurse coaches are certified after passing the AHNCC’s certification exam and aim to give nurses a sounding board and guide them to the best choices for their own specific lives and goals. And although coaches won’t be holding your hand and guiding you on a specific path,
Minority Nurse | FALL 2016
says Carlson, they are listening closely to everything you say and probably seeing patterns or
with their patients. “Coaching enhanced my nursing practice,” says Keep. “A lot of that
“Coaching can help you if in your head you know what you need, but in your heart you don’t know how to get there,” says Quinlan. “Coaching helps you untie the knot.” wishes you may not even see. You’ll likely have homework to do, something that helps you feel empowered about the choices and decisions on the horizon. “Sometimes, it’s just about the act of being truly heard and having those experiences reflected back toward them,” says Carlson. “Being listened to is incredibly powerful.” Many nurses find that being heard by a coach is so empowering they turn the table at work and use the same method
is a listening presence and reflecting back to the patient to validate what they say.” Quinlan agrees. “Coaching very gently raises the ability of a client to reach out and touch their own innate knowing,” she says. Successful coaching helps clients understand their true feelings and motivations so they can peel away the layers of confusion and help remove some of the barriers for nurses to move ahead. Coaches offer a toolbox of skills nurses can use to
move forward in the direction that’s best for them. As nurses become more comfortable with coaching, Quinlan says coaches are becoming more prevalent and many older nurses are considering a career shift to become certified coaches. In particular, she says, nurses approaching retirement who have decades of experience and a wealth of knowledge are perfectly positioned to take on nurse coaching roles, either on their own or within their workplace as a designated coach on staff. “Coaching can help you if in your head you know what you need, but in your heart you don’t know how to get there,” says Quinlan. “Coaching helps you untie the knot.” Julia Quinn-Szcesuil is a freelance writer based in Bolton, Massachusetts.
Minority Nurse Magazine
Minority Nurse | FALL 2016
The Evolution of School Nursing BY ROBIN FARMER
Stereotypes of school nurses primarily dispensing aspirin, taking temperatures, and offering hugs are rooted in nostalgia.
hese days, school nurses increasingly handle a growing number of students with chronic or serious health issues, provide emergency care, and connect with community partners to provide additional health services. Despite the vital role that these health professionals fulfill for students, there is a lack of full-time public school nurses to help meet the well-being of students, especially in urban school districts. Only 30%
of public schools have a fulltime school nurse, according to a 2007 study by the National Association of School Nurses (NASN). (The organization has a study in progress to update the statistic, but the results will not be available before this issue goes to press.) Additionally, only half of schools have a registered nurse 30 or more hours each week, according to a 2014 School Health Policies and Practices Study by the Centers for Disease Control and Prevention.
Informing the public about the expanded role of school nurses and the consequences of their absence benefits students, their families, and communities, nursing experts say. Informing the public about the expanded role of school nurses and the consequences of their absence benefits students, their families, and communities, nursing experts say. “Because school nurses practice independently as the only
health care provider in the education setting, they need the critical-thinking skills that bachelor-prepared nurses develop,” says Beth Mattey, MSN, RN, NCSN, president of NASN. To this end, NASN recommends a bachelor’s degree in nursing
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as the minimum preparation for a school nurse. “Many states require ongoing education to maintain an RN license and/or a school nurse certification,” Mattey continues. “NASN provides ongoing
are in schools,” says Fekaris, the only nurse assigned to four schools serving 4,200 students in her suburban school district in Oregon. “They don’t understand what school nurses do and they don’t understand that
Students in high-poverty urban areas are especially vulnerable when schools lack an adequate number of nurses, says Maura McInerney, a senior attorney at the Education Law Center, an education advocacy group that champions the hiring of more nurses. education through resources, clinical guidelines, webinars, and other online education courses. We also sponsor handson learning and conferences to keep school nurses abreast of current practice.”
Evolving Role of Nurses “When schools don’t have a school nurse, there is not a health professional to help students manage acute illness and chronic conditions in the school setting,” says Mattey. “Students don’t leave their health issues at the door, and many chronic conditions must be managed during the school day. This includes students with diabetes, asthma, life-threatening allergies, epilepsy, and sickle cell disease. Children who live in poverty are at greater risk of having a chronic condition and unmet health needs.” The average adult thinks about his or her own education decades ago and assumes every school has a nurse and the health needs are the same, says Nina Fekaris, MS, BSN, RN, NCSN, president-elect of NASN. “Unless you are a parent of a child with a chronic illness or a life-threatening disease, you just don’t think these things
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kids are more fragile that are attending schools now. There’s a lot more care coordination that needs to happen in school buildings to keep kids safe.” Fekaris, who has been a nurse for 40 years and has 30 years of experience as a school nurse, says the growing number of students with type 1 diabetes is a major health change. When she first started, there were none; now, there are about 150 diabetic students, including kindergarteners, in her school district. Advances in medical treatment and technology have also altered the practice of school nursing. For example, one treatment device for children with seizure disorders is an implanted device under their skin that delivers an electrical pulse to a nerve in their neck. “At the sign of seizure, what we want to do is activate that device to fire an impulse to try and stop the seizure, and the way you activate that is by swiping a pretty powerful magnet across that device in their chest. Thirty years ago we didn’t have that technology,” explains Fekaris.
Greater Needs at Urban Schools Students in high-poverty ur-
ban areas are especially vulnerable when schools lack an adequate number of nurses, says Maura McInerney, a senior attorney at the Education Law Center, an education advocacy group that champions the hiring of more nurses. “The consequences can be devastating, and I don’t think that the average citizen recognizes the critical role school nurses play in the health, safety, and education of school children,” McInerney says. Without access to full-time nurses, students may not receive urgent or accurate and timely treatment at prescribed intervals. And, children with special education needs may not be identified or receive nursing care, McInerney adds. “Perhaps what is most striking is the number of children with qualifying disabilities such as diabetes and asthma, who fail to receive Section 504 Plans that are critical to supporting them to attend and be successful in school. Finally, school nurses are important teachers and counselors and are often the first people to identify a child’s need for health interventions and counseling services,” says McInerney.
district announced the number of school nurses would be increased with the goal of a nurse at every school. “At that time, 123 schools had no fulltime nurse and 17 schools had a nurse one day a week or less,” McInerney says. “We hope this happens, and ELC is fighting for more funding to under-resourced schools in Philadelphia and elsewhere to make this a reality.” Unfortunately, sometimes it takes a crisis to spotlight the need for school nurses and drive changes, says Robin Cogan, who has worked 15 years as a school nurse in Camden, New Jersey. “In Flint, there was one school nurse. They now have nine school nurses. It shouldn’t take a tragedy to get a school nurse in every building,” she argues, referring to the 2015 water crisis in Flint, Michigan, that involved lead contamination. Mattey recalled a Philadelphia student, 12, who died from an exacerbation of her asthma two years ago. “The severity of her asthma was unrecognized on that day because the school nurse was not scheduled to be in the school. The School District of Philadelphia had been
The volume of students treated and the complexity of their medical care require school nurses to form health care partnerships, says Lynn Meadows, RN, MS, coordinator of student health services for the Fulton County School System in Georgia. There are 180 nurses for 332 Philadelphia public schools serving 200,000 students. In 2011, the district had 289 school nurses. By the 2013-14 school year, that number had dwindled to 179. In March, the
having financial difficulty and school nursing services were cut,” Mattey says. For working parents, the presence of a nurse can help them decide to enroll their child if he or she has a chronic condi-
tion, says Cherisse Howell, RN, supervisor of staff education, school health nursing, at the Montefiore Health System, one of the largest school health programs in the nation. A school nurse “gives a parent a sense of security that I can go to work and provide for my family and still feel safe that my child is OK because there is a nurse at school,” says Howell, a nurse since 2005. Having a nurse or school clinic gets children into the building because parents share the positive experiences of the health services, Howell says. The Montefiore Health System has clinics inside elementary, middle, and high schools and provides primary, dental, mental, and community health services to over 30,000 students at 85 schools on 23 campuses. “We transitioned from what many thought of as the school nurse… when nurses were doing ice for injuries and BandAids for boo boos,” says Howell. “We’ve moved to an era where, specifically in the Bronx, we have thousands of children suffering from asthma and our diabetes cases are rising. We have children with health disparities that would otherwise keep them from school. We now have these health professionals in the educational building, and children can get the treatment they need and the instruction they need simultaneously.”
Outreach and Partnerships The volume of students treated and the complexity of their medical care require school nurses to form health care partnerships, says Lynn Meadows, RN, MS, coordinator of student health services for the Fulton County School
System in Georgia. “We can’t just do the job in a clinic. You have to partner with a local physician or a health organization in the community because it’s a team approach now of how we take care of kids,” says Meadows, a nurse for 30 years and a school nurse for 15 years. “It’s not just a school nurse trying to manage the health care needs of kids while they are in school. Yes, they are in school...but they also go home. So that collaboration and networking with health care providers outside our clinic obviously keeps that continuity of care better for kids.” Many school nurses seek professional development to keep up with the changing care dynamic that students require, which is why partnerships are important. School districts are looking to school nurses to be caught up on health issues that can impact the community, Meadows says. “For instance, regarding the Zika virus, my superintendent will look at me and ask, ‘Well, what should our school district’s response be to a community health issue like Zika virus?’ So I have to be up to snuff. I have to find partners that I can work with to say, ‘What is the latest, how does this impact the community, and ultimately, how might it impact the school?’ Whatever is the hottest topic or health care issue going on in the community, school nurses have to be aware of it,” says Meadows. School nurses arrange for mobile dental clinics to visit schools and mobile vision vans to visit and provide eye exams and glasses for students who may not have those services available, says Mattey. School nurses also work in
schools and the community to promote tobacco education and cessation programs, educate students about prescription drug abuse and other substance abuse, provide immunization services for students, encourage exercise programs, and educate about healthy eating.
Measurable Results School nurses not only play a key role for helping students learn, their presence assists educators. One study found teachers spend less than 20 minutes each day dealing with student health issues when a nurse was assigned to their school. Data also showed students with asthma have improved
attendance and better health outcomes when a school nurse managed asthma, says Mattey. Furthermore, immunization rates also improve when a school nurse is present. “What administrators and school districts need to know is that not only do school nurses keep students in school by addressing health issues so they can stay in school, school nurses save money,” says Mattey. “A recent JAMA study demonstrated that for every $1.00 spent on school nurse service and resources, $2.20 was saved in societal costs. The study did not take into account reduced emergency room visits due to ear-
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ly intervention by the school nurse,” she adds. “Consider the case of a child with a severe peanut allergy, and every day when your child goes off to school you hope that your child is not exposed to peanuts. A school nurse recognizes the potential emer-
been looked at as someone in the clinic just handling little boo boos,” explains Meadows. “There isn’t widespread public knowledge of what it takes to be a school nurse, or the volume of kids with chronic illness or medical issues. There is not enough information in
“What administrators and school districts need to know is that not only do school nurses keep students in school by addressing health issues so they can stay in school, school nurses save money,” says Mattey.
gency, works to make the environment safe for the child, and ensures that emergency plans are in place in the event of an exposure to peanuts. The school nurse will educate the staff on the signs and symptoms of an exposure and how to prevent the exposure in the first place,” says Mattey. “There are many health conditions children bring to school. The professional school nurse has the expertise to educate and work to prevent an emergency, but if an emergency occurs, the school nurse will recognize the emergent condition and take action.”
Raising Awareness School nurses juggle an array of demands despite their salaries being among the lowest for RNs. However, in some areas, school nurses are paid on the teacher salary scale, which also includes benefits. For school nurses on the lower end of the salary scale, lack of understanding about all they do is a factor, nurses say. “Traditionally, the profession of school nursing has
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the community or across the nation on how school nursing has evolved. Many people don’t get that. “School nursing has changed. It’s a profession on its own. For many of our children, the first health provider many of them see is the school nurse. I tell many of my nurses, ‘You can be the person who finds out what is going on with that child and make a difference in that child’s life for the rest of his or her life,’” Meadows says. Although school nurses affect educational settings, taxing working conditions can compromise their effectiveness in treating students. If the school lacks a nurse, or if the school nurse “has a workload that makes it difficult to adequately educate all staff and follow up with parents, there may not be adequate protection for students,” argues Mattey. “The ANA has a saying, ‘Nurses are an investment in the future, not a cost center.’ I say the same about school nurses. School nurses are an investment in the future of our children, linking health and
education. We are not a cost center,” Mattey adds. Parents and guardians must address the importance of school nursing with administrators, Mattey says. “Parents should ask, ‘Who is meeting the health needs of
school nurse then they need to find out, ‘Why not?’ Parents in Charlotte, North Carolina, advocated to make sure their children had access to a full-time school nurse, successfully increasing the number of school nurses in the schools.”
“Parents should ask, ‘Who is meeting the health needs of my child while in school?’ The answer should be a professional registered school nurse,” argues Mattey.
my child while in school?’ The answer should be a professional registered school nurse,” argues Mattey. “Parents assume that a nurse will be taking care of their children, but that is not always the case and parents need to ask the question. If not a
Robin Farmer covers health, business, and education as a freelance journalist. Based in Virginia, she contributes frequently to Minority Nurse magazine and website. Visit her at www.RobinFarmerWrites.
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Nursing Role in the Diversity and Inclusive Excellence Discourse in the United States BY MIRIAM O. EZENWA, PhD, RN
What is diversity? According to the Oxford English Dictionary, it is “the condition of being diverse, different, or varied; difference, unlikeness.” This simplistic definition of diversity does not assign any judgment or negative connotation to any of the words used to define it. However, the word “diversity” evokes multidimensional judgements, reactions, ideas, emotions, and actions, some of which could have adverse social and health consequences for generations of individuals in the United States.
ursing, as the largest health care workforce in the United States with over 3 million nurses, is well positioned to
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champion diversity efforts. In 2010, the Institute of Medicine (IOM) published a landmark report, The Future of Nursing: Leading Change, Advanc-
ing Health. In this report, the IOM indicated that the nursing profession was not diverse to care for diverse populations across the lifespan. The IOM
recommended that a diversity agenda be promoted, especially with increasing the diversity of nursing students. In partnership with AARP, the Robert Wood Johnson Foundation (RWJF) launched a campaign to implement the IOM recommendations from its 2010 report. Subsequently, commissioned by the RWJF, the IOM evaluated the state of affairs regarding these recommendations. In 2015, another report, Assessing Progress
Second Opinion on the Institute of Medicine Report The Future of Nursing, was published. In this report, the IOM specified that nursing has improved on the recommendation to diverse the nursing workforce. Nonetheless, there remain gaps that must be addressed to meet the diversity goal for the nursing profession. Consequently, the new recom-
National League for Nursing. During the early morning hours of December 3, 2015, my individual lesson on the topic began with Alexander as I had breakfast with her. My antenna on the topic sharpened following our conversation. After introducing her to my fellow Diversity Taskforce members, I hurried to pack my car and
Students, faculty, and staff must be an integral part of the dialogue to promote diversity within the nursing profession.
mendation for nursing is that diversity must continue to be a priority that is paralleled with a series of actions to promote it. Before nursing can accomplish this noble goal, there should be a well-vetted strategic plan on diversity and inclusion in all nursing programs, schools, and colleges in the United States. Students, faculty, and staff must be an integral part of the dialogue to promote diversity within the nursing profession. At the University of Florida College of Nursing (CON), we held our inaugural “Diversity and Inclusive Excellence” workshop in December 2015. This two-day workshop was designed for staff and faculty. As a member of the Diversity taskforce, I collaborated with the other taskforce members to invite G. Rumay Alexander, EdD, RN, FAAN, to lead the CON on this discussion. Alexander is director of the Office of Inclusive Excellence in the School of Nursing at the University of North Carolina at Chapel Hill, a nationally known expert with vast knowledge and expertise on diversity and inclusive excellence, and president-elect of the
return to the CON to proceed with the plans of the day. I noticed the dean, Anna McDaniel, PhD, RN, FAAN, from a distance. I hurried up to keep her pace. “Good morning, Dean,” I greeted in my usual manner. McDaniel responded with a broad smile and a twinkle in her eyes that I perfectly understood. I surmised that McDaniel had finally accepted the fact that I love referring to her as the “Dean.” We conversed as we headed to the CON and into the elevator. I noticed the necklace McDaniel wore. The costume necklace had different shapes, colors, sizes, lengths, and mosaic designs. They were • audaciously woven, yet unintimidating; • different, yet complementary; • individually, unassuming — yet, together, a paragon of beauty, inviting; • all held by a perfectly thin strand, yet unbreakable. “That’s a beautiful necklace,” I uttered. “It belonged to my mother, who died twelve years ago,” McDaniel shared. “Each bead came from a different country. I have a brochure that
provides a description of each bead, including the country of origin and its material composition.” Then, McDaniel voiced the word that gladdened my heart. “I wore this necklace today because it’s appropriate to celebrate diversity, the topic of the CON workshop.” McDaniel had appointed the Diversity Taskforce and provided us with her full support. But, the fact that she actually thought of and adorned herself with a necklace that I now coined as a “diversity necklace” to celebrate the CON inaugural diversity workshop was admirable to me. Someone not sensitive to the current diversity concerns around the United States, and the racial unrest related to such matters, may not appreciate my exhilaration upon hearing the history of the necklace. At issue is that, in several communities around the United States, numerous individuals are thoughtless about the devastating effects of antidiversity rhetorics and actions on the lives of its victims. Many may not realize that any action, whether good or evil, begins in the mind. Conversely,
long way. It could change the thought process from exclusion to inclusion. When people are attentive to their behaviors and understand the detrimental effects their actions could have on other human beings, things might change for the better. I believe that, as a nation, we must check the poisonous thoughts that percolate in our minds and subsequently manifest in forms of antidiversity rhetorics and behaviors, unacceptance, and racism. Confronting monstrous suggestions in the mind is the first step that many of us need to take to begin to challenge the subtle and insidious systemic diversity-aversion and exclusion in the United States. As I thought about this issue of diversity and the role that nursing can play to eliminate it, I reminisced about how the imperfections of people categorized within the social construction of race stimulate antidiversity and anti-inclusive sentiments and movements. I wondered how nursing can care for these individuals, many of whom are marred with scars of history. My poem, “The Color of Justice,” captures my percep-
When people think about and proactively perform small acts, such as expressing recognition of diversity through a piece of jewelry or other special actions to celebrate diversity, it goes a long way. any work to combat uncelebrated diversity and exclusivity must begin in the mind. When people think about and proactively perform small acts, such as expressing recognition of diversity through a piece of jewelry or other special actions to celebrate diversity, it goes a
tions of the undeniable genesis of these historical blemishes that shockingly remain, overtly or covertly, as status quo in various parts of this country. One may wonder how a nurse who is an advocate for a diverse, inclusive, and just world could pen “The Color
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Second Opinion of Justice.â€? This poem reflects my dual perceptions as a black woman and a nurse, of how the historical racial unrest that has plagued the United States for centuries has been subtly perpetuated even today. But, they ought not have continued, had the United States paid real attention and reconciled both the apparent and undercurrent narratives of this poem after the abolition of Jim Crow laws. As a black woman, I think that the first relevant question ought to be: How do individuals from diverse backgrounds interpret their historical or lived experiences in the United States? I encourage each one of us to answer this question individually or as a family, church, academic institution, or financial organization. I assert that there must be a recognition and acceptance of the different dimensions of diversity of thoughts, ideas, and experiences. This recognition must be matched with â€œcourageous dialogueâ€? on diversity and inclusion. In addition, there have to be concrete and measurable action plans for allocating resources to implement iterative strategies to address identified diversity concerns. This exer-
to mitigate the adverse generational effects of antidiversity and anti-inclusivity experiences on marginalized and excluded individuals? I contend that, in order for nursing to be professionally and culturally relevant in the future and to continue to have the public trust as a caring discipline, we must identify ways to champion the diversity and inclusive excellence agenda. There should be constant and mandated training on diversity for university staff and faculty, with measurable outcomes. Nursing as a profession should develop a curriculum with a diversity and inclusion plan threaded throughout it. One approach to operationalize this suggestion is to equip nursing students with skills necessary to be culturally competent, diversity-savvy, and inclusive-perceptive in order to encourage these values in their work settings. Patients and clients at the receiving end of compassionate, culturally competent care infused with the spirit of diversity and inclusiveness should remember the feelings associated with that care, and hopefully pay it forward. Slowly, the culture of superiority and nontolerance directed
Patients and clients at the receiving end of compassionate, culturally competent care infused with the spirit of diversity and inclusiveness should remember the feelings associated with that care, and hopefully pay it forward.
The Color of Justice By Miriam O. Ezenwa, PhD, RN What color is justice? Absorbing pain, insults, and lashes Ancestors packed shoulder-to-shoulder, hip-to-hip, chained like fire woods Bones of the feeble lie un-mourned in ocean deep across the Atlantic Their sweat built the wealth in the new world, but crumps have become their portions This name sound like them, we have filled the position, they need to go away Low-hanging pants, cove-hopping birds, gun-brandishing bunch We cannot deal with the anger, we are better off with the accent, intra-color battle ignited Round them up, throw away the key, population control Babes on the breast, mama and grandmamma, sitting on the front porch pondering about the next check Hair tightly woven, fried, or twisted, nails freshly manicured, next bun in the oven The fortunate may triumph at the end, treacherous roads treaded, stress claims the wounded body after all That they survive is still a mystery that ought to win them a trophy Who are they? What color is justice? Reflecting heat, demanding respect, crushing heads Rolled into the new world in Mayflower boasting of prostitutes, thieves, and prodigal sons Raised arms against raised tea taxes, won freedom but deny it to another Melanin deficient hue suggest superiority Blood by blood, noose on hand, destroyed a generation, eye un-batting Deeds done in the name of God, He must be weeping Damages proudly scattered in museums, we pay to relive the tragedy Privileges left and right on the backs of the poor Man in bow tie, lady in heels, rear the children, your lavatory in the rear Own your history, mend your ways, teach your babes right Who are they?
cise could be so powerful that diversity and inclusion become strengths and not detriments to our collective humanity. As a nurse, I think the second pertinent question must be: What role can nursing play
Minority Nurse | FALL 2016
toward individuals from diverse backgrounds could dissipate and a new world facilitated by nursing and inhabited by truly compassionate and empathetic humans would emerge. Nursing students are the fu-
What color is justice? Broad face, warm hue, and welcoming gesture Land is supreme and cares for the offspring Infected with strange diseases, killed with gun powder, survivors kept in special places devoid of opportunities Culture deconstructed, the sacred used as mascots Surviving by balancing mind, body, and spirit, harmony in the land is their mantra
Not many left but their spirit is strong The land beckons for their touch, to purge its roots of deadened souls What does the Unites States’ constitution say about them?
Who are they? What color is justice? Messiah has come, awaiting messiah, there is no messiah We profess peace, spiritual path is the way
ture of the nursing profession. Therefore, nursing must constantly remind students that antidiversity and anti-inclusion rhetorics and behaviors, histori-
allows for future and ongoing actions to completely obliterate racism heralded by antidiversity and anti-inclusive beliefs in the United States. Consequently,
cally and contemporary, breed racism in the United States. They should also learn to celebrate how much improvement
bead by bead — though diverse in shapes, colors, sizes, lengths, mosaic designs, and historical origins — we can hang un-
Whose belief is superior? When six feet under, belief quenches, but tainted souls still suffer Where are their senses?
Nursing students are the future of the nursing profession.
Who are they? What color is justice? Light? Energy? God? Penetrates Black, White, Red hue, religious, non-religious Building block of things created Revitalizes without questioning, unites all things created Shines for Black, White, and Red hue, religious and non-religious Knows no foolishness but shines for fools Knows no discrimination but supports the life of discriminators Invites reconciliation until judgement day Come unto me Black, White, and Red hue, religious, non-religious My light is your strength, unity, and peace
we have made as a profession. But, recognize that diversity work is lifelong. The juxtaposition of the history of racism in the United States with the improvements made toward eliminating it is useful for at least two reasons: The contrast provides the space for constructive discourses and opportunities to develop positive avenues for endorsing diversity, and it
breakably strong on the perfect strand of humanity, which unites us as “one Nation under God.” Miriam O. Ezenwa, PhD, RN, is an associate professor in the Department of Biobehavioral Nursing Science at the University of Florida, College of Nursing.
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The Worst Trauma I Experienced as a Nurse BY LYNDA LAMPERT, RN
She didn’t know her words would haunt me for years to come. It was a night like any other night. I stood at the bedside of a relatively stable patient, and I was dutifully giving him his meds. The floor was quiet, patients and nurses preparing for the night shift a few hours away.
ike a fire klaxon, a voice cut through the relative peace of the hospital floor. “My husband is dying! My husband is dying!” Instinctively, I dropped the medicines and darted out of the room. In the middle of the hall, a middle-aged woman ran toward me, scream-
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ing about her husband in the room across the hall. “He’s dying,” she yelled into my face. Mouth dry, heart pounding, I pushed past her and entered the patient’s room. Of course, he was unconscious, blue, and not breathing. I started CPR, but the craziness was not over.
I wasn’t exactly a new nurse. I had been through a few codes, and they all went rather smoothly. I never ex-
perienced the stomach-churning nausea of having a family member witness their loved one dying.
When codes start, nurses become the ultimate professionals. No one runs. No one yells. Everyone works as a team.
Second Opinion The patient wasn’t mine, but I knew about him. He had recently had coronary artery bypass grafting surgery and was due to be transferred to
codes start, nurses become the ultimate professionals. No one runs. No one yells. Everyone works as a team. As a relatively new nurse, I
Nurses, especially new nurses, have to develop a sense of detachment from the patient and family. But what about the human side of the equation?
the ICU any minute because his heart rate and rhythm were abnormal. His doctor was on the floor, writing the paperwork for the transfer. Others had heard the wife call out in anguish, and everyone came running, including the doctor. He burst into the room, shouting, “I need an intubation kit! Get me an intubation kit!” I could hear the rumble of the crash cart coming down the hall, but it hadn’t quite reached the room yet. The doctor continued to yell at me, to point, to spit. His hands shook, but I had been here before. I yelled back, “Hold on a second! It’s coming!” I realized then that the doctor was more afraid than
never experienced the terror that “normal” people experience when someone starts to die. For me, I knew how to handle it. A patient going south deserves my close care, but the emotion is usually not high during care involving advanced cardiovascular life support. Afterward, I would cry and shake, but not when I needed my faculties about me to do everything I could to save a life. This code was different. In fact, I can live it over and over in my mind, and I still feel as scared now as I did then. The wife and the doctor were breaking the rules. They didn’t know how to deal with death, and I don’t really blame them. I just know their actions scarred me deeply.
Too much distance leads to too little caring.
I was. The cart arrived, the patient continued to code, and the doctor got his intubation equipment. Although we managed to get a sustainable rhythm on the patient, he soon died in the ICU. Of all the codes I experienced over my years as a nurse, this one sticks out as the most horrible. When
Trauma is a real problem in nursing, and situations like these can cause a nurse to relive moments that didn’t go well. This is especially true of new nurses. New nurses make mistakes, and they haven’t developed the ability to be the calm professional yet. This means that the trauma of extraordinary events can
stay with them forever. I never dreamed that I would face a family member who was screaming that her husband was dying. I can only imagine the torment she was going through, the heartbreak of knowing that her loved one was slipping away before her eyes. She reached out for the only help she could. And that help was me. Her terror has stayed with me all of these years. In that moment, I became her. I empathized with her, as any good nurse will do. I felt her sorrow, and despite our best efforts, we couldn’t save her husband. I find myself imagining how she felt when he actually passed away.
and that it is okay to talk about them. It is okay to be afraid. It is okay to reflect on the situation and examine the emotions the trauma awakens. Without this reflection, the emotions become buried. Ignored emotions manifest as substance abuse, out-ofcontrol feelings, and hatred of the job. My trauma is just one example. Almost every nurse has a story of when she or he was scared and traumatized. Talk about it. Don’t pretend to be so strong that you don’t need to ask for help. I wish I could have saved that man. I wish I could have wrapped that wife up in my arms and made it easier for
Nurses need to realize that they experience traumas, too, and that it is okay to talk about them.
I will admit that this situation scared me, and I have dwelt on it more than I should. Nurses, especially new nurses, have to develop a sense of detachment from the patient and family. But what about the human side of the equation? Too much distance leads to too little caring. I am happy to say that I took part in codes after this one, and I did the best job I could. In fact, I was praised for my work in situations where a life was on the line. But I never forgot the distraught woman in the hallway, or the surreal feeling of dread that her words —”He’s dying!” — caused in me. It remains a trauma that has impacted my life forever. Nurses need to realize that they experience traumas, too,
her. I couldn’t, but it will stay with me forever as the trauma in my career that haunts me, because I couldn’t hide behind the façade of the calm professional. I am the calm professional, but I am human, too. Lynda Lampert, RN, has worked medical-surgical, telemetry, and intensive care units in her career. She has been freelancing for five years and lives in western Pennsylvania with her family and pets.
Minority Nurse Magazine
Degrees of Success
Autoethnography of an African American Nursing Student: Reflecting on a Four-Year Baccalaureate Nursing Program BY TAMARA JESSICA BROWN, MSN, RN-BC, PCCN, CNE, CMSRN
In this essay, I present my firsthand account of my Pre-Nursing School: experience as an African American nursing student in a Being “White” In high school, I was called predominantly nonminority nursing program as well as “white” by the majority of my perceptions and interactions with fellow students. the few African American stuAs an autoethnographer, I sought to answer the following dents in a high school of nearquestion: What is the African American student nurse’s ly 500 students in the Northexperience of education in a predominantly nonminority east. Initially, when they said school of nursing and university, and how does that this to me I was shocked. I had been on the receiving experience affect her as an individual? end of racially charged com-
Minority Nurse | FALL 2016
ments by white peers, and now I had to deal with this from my own race and ethnicity, too? I wondered why I could not catch a break. I remained confused but focused on my schoolwork. Since being a freshman, I was in honors classes, those with the maximum rigor in the entire school. It was viewed as
Degrees of Success if only the elite were in these classes, but I surely did not feel like the elite. My white peers in those classes assumed
I just stared at her with curiosity due to the fact that, besides the “white” comments, there was never an extended
My nonminority peers turned around in their seats and, within minutes, had arranged themselves into two car groups, which left me out. I told myself, “You really thought it would be different, huh?” I laughed to myself and stopped looking for a group.
I came from the ghetto and asked me to teach them Ebonics and about rap music (which I did not listen to). I was isolated in those classes because of such stereotypical comments and the competition to be number one of the entire graduating class, but mainly because I was the only African American student in such classes. The comments from my African American peers only intensified as I was enrolled in both cosmetology in vocational school and Advanced Placement courses (which could alleviate me from taking college courses, once enrolled). One of my African American acquaintances, who I thought seemed amicable, approached me purposefully one day in the hall. She looked like she was on a mission to find me as I put my things in my locker. I met her with a kind hello—I did not have many friends in school. I blamed myself for that, being so quiet. She stated loudly with a greeting, “Do you think you are better than us?” I said, totally confused, “Us? Better than who?” She quipped, “You know exactly who I mean, the few blacks in this school.” My face must have looked blank.
conversation or association besides my distant friendship with several other minorities. She continued to badger me, “You know you think you are better than us since you are in those special classes. Who do you think you are?” I simply responded, “Nothing.” At the time, my self-esteem was low; I had become tired of my lack of association. She was not buying it. “You know what? It must be true that you are white because you even talk like them,” she said. “Don’t ever think you are better than us. We are just as smart, although we may not be in the AP classes.” Taken aback, I explained, “I never said you weren’t. You should talk to your advisor about enrolling in one of the classes.” Without acknowledging my reply, she stormed away, saying, “Wow, you are white.” As she walked away, I blinked at her and said to the dust trailing behind her, “It is funny because my skin is black like yours.” I went on to finish my day; however, the episode never stopped playing in my head, even after I became a nursing student. Katie Love, PhD, APRN, BC, AHN-C, wrote about the lived experience of African American nursing students in a pre-
dominantly white university in a 2010 article published in the Journal of Transcultural Nursing. One of the themes of her phenomenological study was that of fitting in and “talking white.” She reports about a study participant who had grown up in a predominantly white secondary school and had become accustomed to experiences with white students. African American nursing students who did not have such an experience described some African American students as being “Oreos…Black on the outside and white on the inside.” Such “Oreos” are described as African American students who are black but “act White, socialize, and talk like White people.” One of the participants of the study shared the following observation: “To me it’s kinda a funny thing that it’s such a problem
myself and spoke. In nursing school, my isolation continued. It would eventually lead to my depression.
Nursing School: Feeling Isolated and Excluded Fast forward to nursing school. The faculty and advisors began our edification with a talk about the rigor of the courses. I remember a gentleman announcing, “Look around the room. See everyone here? Not all of you will be here in four years. The truth is, nearly half of you may not make it to graduation.” I remember sitting in the warm amphitheater and feeling intimidated by his words. When I looked around, as instructed, I noticed the class was made up of only three African Americans. The largest minority group were of Hispanic background.
The students who supposedly knew all the answers sat in the front, always the first ones to raise their hands. However, their answers were the same as mine—always. They weren’t any better than I was. I decided to beat the caste system within my own classroom. in the Black community that you could not talk in a certain way…but if you start talking slang, then to them you’re trying.” I could identify with Love’s study as my isolation from peers—from within my own race and from without—began in high school. In high school, I was excluded by white students because of the color of my skin and, at the same time, excluded by my African American peers because of the way I carried
The first few semesters were full of straight science courses, which translated into nonstop studying. I spent my days in the library enjoying my books and learning. The days went so fast, when all I did was read and study the day away. In the blink of an eye, the end of the first year arrived. All of the Hispanic students were eliminated either by not meeting academic requirements or by choosing to leave the program. I was afraid that I would be next.
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Degrees of Success My classmates were mostly white students. At times, I felt I did not belong. None of my professors looked like me. The nonminority students studied together and did not invite me, much less speak to me. I remember our professor addressing the class during our sophomore year. She advised everyone in our small section to avoid driving alone to a distant clinical site and to carpool instead. I looked around the room attempting to make eye contact but did not receive any response. My nonminority peers turned around in their seats and, within minutes, had arranged themselves into two car groups, which left me out. I told myself, “You really thought it would be different, huh?” I laughed to myself and stopped looking for a group. That experience solidified the divide for me. In 2004, Nancey France, PhD, RN, and her colleagues at Murray State University published a pilot study in Visions: The Journal of Rogerian Nursing Science that examined the lived experiences of black nursing students and found many reported feel-
study?’ If you think that you know them and everything’s o.k., you’ll say, ‘are you all going to have a study group this weekend?’ And they’ll say ‘yeh’. But, when the time comes…you can’t get in.” Another student reported, “I’m the only black, in all my classes I’ve been the only black. It’s hard because…you got to prove yourself. If you don’t do as well as the other students they just single you out. That’s why I have to strive to do the best I can.” Black students also reported feeling they were only admitted to schools of nursing to meet a quota. They described the increased pressure exerted on them when minority attrition rates were high in their class. As a result, they experienced emotions such as self-doubt, fear, lack of confidence, and diminished selfesteem before attending class. Many students reported these feelings pushed them “even harder to prove they could be successful.” There seemed to be a consensus that there was an unspoken expectation of African American students to fail, which propelled these
What began as a business venture to simply gain a skill that would sustain me as an adult turned into a love for the profession of nursing.
ing isolated and discounted. One of the themes of the data was “You’re just shoved to the corner.” One African American student nurse clarified, “You may get one or two that wants to include you…You may go up to them, you’ll risk to say ‘are you going to
Minority Nurse | FALL 2016
students to greater levels of determination to prove that “they were as smart as anyone else.”
Moving Up: The Benefits of Exclusion During my third semester in nursing school, I became
tired of sitting in the back of the classroom. What had once seemed comfortable be-
had fallen in love with the few nursing courses we were allowed to take. I could not
At the end of four years, it felt like prison only being able to talk to and connect with six minorities who made it to the end of the program.
came an annoyance to me. The students who supposedly knew all the answers sat in the front, always the first ones to raise their hands. However, their answers were the same as mine—always. They weren’t any better than I was. I decided to beat the caste system within my own classroom. I felt my sitting in the back row was perhaps contributing to my isolation and depression that had begun to develop. Humans are not meant to be excluded—we need contact. As a result, I started moving forward, slowly but purposefully, to avoid and overcome my feelings of exclusion. I remember deciding I would not allow myself to sit in the back anymore. I felt like Rosa Parks as I migrated up to the middle rows of the classroom. I began to raise my hand more. I found that studying alone was beneficial to me, as I knew the full answers to questions that other students merely answered in a general way. As a result, I started raising my hand and answered insightfully each time. I wasn’t sure of myself until my anatomy and physiology professor approached me and asked if I wanted to become a physician. He tried to convince me to enter the premedical program. I was flattered and taken aback, but I knew it was not what I wanted. I
betray my passion for nursing and really “being” with the people. However, he had not approached anyone else in the class with this offer. It was after that discussion that I moved up and became the snob who raised her hand to answer every question, at every opportunity. It was not until then that I had my first contact with nonminority students, other than a glance. They soon began asking how well I did on my exams. When interrogated, I replied without emotion, saying I did “okay” when I knew I got an A. They soon lost interest in me again. They did not know that their exclusion of me in their study groups was paying off greatly for me. I had become an independent and successful learner. As the years progressed, I think they began to suspect I was doing better than just “okay” as I began to earn scholarships and recognition from my professors in class. It was unwanted attention for me because I wanted to keep my head low. What began as a business venture to simply gain a skill that would sustain me as an adult turned into a love for the profession of nursing. I had not expected that—it just happened. As my love grew, I began to excel. As I excelled, I felt the isolation increase. I had become used to it; it didn’t
Degrees of Success
really bother me on the surface. It seemed other students were in school to make lifelong friends and to have a good
I wondered if the professors noticed the same thing I did. It went on like this until the end of the nursing program.
I had not been invisible, after all, and the award I received upon graduation was not for show, but because my professors saw such great potential in me.
time. I was in nursing school solely to earn my degree, focusing intently and singularly on my studies; so, most nursing students tended to avoid most nursing students avoided me. I soon began to wonder if I had isolated myself, but then I noticed in my junior year that professors began to assign more group assignments. In those voluntary group assignments, I observed minority students chose to work together in the same groups, while nonminority students chose to work together in their own groups.
A 2015 integrative review published in Nursing Education Perspectives reaffirmed that there are several studies where African American nursing students reported feeling “voiceless, not part of the important conversations, left outside of the cliques, alienated and insignificant.” Many minority students coped with these conditions by forming their own network among other minorities and “sticking together.” Additionally, Love noted in her study that African American students familiar with “being
left out” from high school experience were better able to accept exclusion and move beyond the experience. All that studying and exclusion seemed to work better for me. It worked out because I graduated. During graduation, I knew a select few would earn special acknowledgement for their achievements. I was sure it would not be me. I was so focused on getting out of there. I had the chance to extern on a unit in a teaching hospital where nonminority staff embraced me as if I was family. I just wanted out of nursing school. At the end of four years, it felt like prison only being able to talk to and connect with six minorities who made it to the end of the program. Now, I was free to explore the world as an adult with a real job—not just a student building up debt. These were my thoughts as I was called up to shake hands with all of my professors. I was so focused on receiving
my degree that the moment when they called my name seemed only a second. When they began to announce the special recognition awards for academic and clinical excellence, I kept looking back at my family and realized I was one of the few students wearing a purple tassel, which meant we were part of a special group: the Honor Society of Nursing, Sigma Theta Tau. We had high GPAs. Then I heard one of my professors say my name. I looked around and those around me whispered, “That’s you! Get up! They called you!” I had earned the award for clinical excellence. I was speechless and nearly stumbled up to the stage. I thought my professors were not interested in me, but they had nominated me for this award (and I assume they voted that I receive it). I was flabbergasted but filled with pride because I—the quiet African American student nurse— had earned this great honor. I thought I had not deserved it, because there were so many things I did not yet know, and I knew I was not the perfect student. I critiqued myself for those few senseless Bs I had earned. It was not until I returned to my seat the second time that I realized maybe I did deserve this award. Just maybe, I had worked hard enough in that I enjoyed putting the entire patient picture together— staying in their rooms, discussing how they felt about their illnesses while taking it all in, and figuring out how I could use my knowledge to prevent one less complication. I was more than a student nurse in those moments with my patients; I assumed the role of nurse and took such oppor-
Minority Nurse Magazine
Degrees of Success tunities with the utmost seriousness. I remember a great exhalation as everyone threw their caps to the roof of the auditorium. I was deserving. Soon after graduation, I passed my licensing exam on the first try and began working on a medical-surgical floor at a teaching hospital. My work was challenging and kept my attention, but I soon began to crave schooling. I decided to enroll in an online program. The main reason for doing so was so no one could see my face and perhaps I could fit in for once. And I did. I felt since no one could see the color of my skin or the youth of my face there would be no divisions. It proved true. I enjoyed
EdD, RN, concluded that the most successful coping strategies of female African American nursing students are active coping and social support. She explains that “although they may have faced times of discouragement or despair, they did not waver in their pursuit of their goals. They relied on their inner strength to take the action needed to conquer their stressors and move on successfully.” I had a support system of my spirituality, my family at home, and my friends of the same faith that kept me strong. They probably were unaware how they were the one thread that held me together through emotional turmoil and numbness.
ing faculty viewed me. It was not until I returned six years later as a clinical nurse specialist to become a mentor for nursing students like I had been—of the minority. I was also pursuing a scholarship for my doctoral education with a focus on nursing education. When I met with one of the professors, I was sure she had forgotten me by the e-mail she had sent back when I asked for a letter of reference and to meet to discuss a mentorship program for minority nursing students. However, when I walked in the door in my professional attire, she told me, “Wow, I remember you. I wasn’t completely sure in your e-mail, but now I
sor] and I are rooting for you to get this scholarship.” Our conversation ran long before a student showed up for her advisement. The professor told me warmly, “Keep in touch. We are so proud of what you will become and have become already!” She had written my letter of recommendation. However, the recognition she provided in those moments proved to me I did not know myself those years as well as I did right then. I had not been invisible, after all, and the award I received upon graduation was not for show, but because my professors saw such great potential in me. I had become visible to myself and the world. My confidence soared as I left the campus. I had driven in, but I seemed to fly home, alongside the clouds. Tamara Jessica Brown, MSN, RN-BC, PCCN, CNE, CMSRN, is a nursing faculty member at New Jersey City University of Jersey City, New Jersey. She has eight years of experience in nursing with certifications in medicalsurgical nursing, gerontological nursing, and progressive critical care. She is a certified nurse educator through the National League for Nursing and is currently a doctoral candidate of nursing education at NOVA Southeastern University.
my online schooling and soon pursued a doctorate program online after completing my master’s in nursing education. In a 1998 study published in the Journal of Nursing Education, author Mary Lee Kirkland,
Minority Nurse | FALL 2016
Enlightenment Upon a Return to the University: Six Years Postgraduation Aside from the anatomy and physiology professor, who was from the biology school, I was never sure how the true nurs-
know who you are exactly… You were always so bright. I knew it then, and look at you now and all you have accomplished. You have your master’s and are a clinical nurse specialist….[Another profes-
Health Policy Development and Engagement: What’s a Student to Do? BY JANICE M. PHILLIPS, PhD, FAAN, RN
Increasingly, nursing students are being introduced to health policy and are encouraged to play an active role in some aspects of the policymaking process. Yes, I know, so much to do and so little time! However, opportunities to enhance one’s level of awareness and engagement regarding the policymaking process have never been greater. Planting the health policy seed has become important to professional nursing organizations, nurse educators, and even nursing students who applaud the push for integrating health policy and advocacy content in today’s nursing curricula. Expected Competencies Today’s nursing students must acquaint themselves with a number of policy issues that may impact their practice, the delivery of health care, and the profession of nursing. Nursing students are encouraged to develop increasing levels of knowledge, skills, and competencies related to health policy and advocacy commensurate with their advancing levels of nursing education. The American Association of Colleges of
Nursing (AACN) has identified key health policy competencies to include in nursing curricula starting at the baccalaureate through the doctoral level. Nurse educators are encouraged to incorporate these competencies when designing and implementing health policy courses for nursing students across all levels of nursing. Starting at the baccalaureate level, nursing students are introduced to aspects of health care policy, finance, and regu-
latory environments. Students at the master’s level are en-
level are expected to help interpret research findings as well as advocate for policies that will improve the health of the public and advance the profession of nursing. Building on these skills and competencies, students at the doctoral level are expected to acquire the necessary skills to demonstrate a higher level of involvement of leadership in developing policies, influencing policymakers, and assuming influential leadership responsibilities at the local, state, national, and/ or international level. Early on during nursing education, one should begin thinking about how legislation informs nursing practice and how public policies influence the health outcomes of the patients and communities that one serves. For example, funding for nursing education and research is an ongoing issue for the profession. This need requires ongoing and persuasive advocacy and communication with state and federal legislative officials. Each year, numerous organizations lobby at our nation’s capital to make the case for funding
Early on during nursing education, one should begin thinking about how legislation informs nursing practice and how public policies influence the health outcomes of the patients and communities that one serves.
gaged in analyzing health policies and their impact on health care financing, practice, and health outcomes. Nurses at this
to support nursing education and research. In fact, increased funding levels for nursing education and research are, in
Minority Nurse Magazine
Resources for Students American Association of Colleges of Nursing Student Policy Summit www.aacn.nche.edu/government-affairs/studentpolicy-summit
National League for Nursing Advocacy and Public Policy Overview www.nln.org/advocacy-public-policy/overview
National Student Nursesâ€™ Association Legislation Education www.nsna.org/ProgramActivities/ LegislationEducation.aspx
part, attributed to the diligent advocacy by the nursing community and other stakeholders.
the federal level. Speak with your school and/or faculty to ensure that there is represen-
Volunteerism is yet another way to develop familiarity with the policymaking process and gain experience in advocacy. Opportunities for Policy Development Recognizing the need to introduce nursing students to the policymaking process, the AACN hosts an annual Student Policy Summit. This three-day summit is open to nursing students enrolled at AACN member institutions and is designed to familiarize students with the policymaking process and nursesâ€™ role in professional advocacy. Students journey to Washington, DC, to take a glimpse at the policymaking process at
Minority Nurse | FALL 2016
tation and support from your academic institution during the call for applications. For information about future offerings, I encourage you to visit www. aacn.nche.edu/governmentaffairs/student-policy-summit. Recognizing the need to foster the policy development of its members, the National Black Nurses Association offers an annual Health Policy Institute at their annual meeting. Speakers with expertise and experience in the health policy arena have presented on topics,
including health equity, prescription drug abuse, reproductive rights, and mental health, to name a few. Another example is the Oncology Nursing Society, which provides an online tutorial on the policymaking process and ways to become
numerous bills may be introduced or reauthorized that will have some implications for patients (e.g., reimbursement for care, increased access to care, support for clinical trials) or the profession of nursing (e.g., funding for nursing education
Nursing in the 21st century demands that we take our rightful place at the table and advocate for patients and the profession. an effective patient advocate. Many nursing organizations hold virtual and in-person annual lobby days empowering its members to advocate on behalf of patients, communities, and the profession. Be sure to check with your student, professional, and specialty organizations to see what opportunities they have to help supplement your classroom education. Volunteerism is yet another way to develop familiarity with the policymaking process and gain experience in advocacy. For me, I volunteered for a long time with the American Cancer Society and the Susan G. Komen for the Cure. These experiences enabled me to establish the linkage among practice, research, and patience advocacy. This in turn fueled my passion for learning more about the policymaking process and the various legislative initiatives informing the health and well-being of communities of color.
Current Legislation Although numerous bills are introduced each year, only a small percentage will make it through the entire process, culminating in action at the executive level and signed by the President for passage. Similarly,
and research). One bill that has implications for patients and the profession is the Nurse and Health Care Worker Protection Act of 2015 [H.R. 4266/S. 2408]. This piece of legislation was introduced by Representative John Conyers, Jr. (D-MI) and Senator Al Franken (D-MN) on December 16, 2015, during the 114th Congressional Session. This is the only national legislation that improves the quality of patient care and protects nurses and health care workers by addressing the safe handling of patients. To track the progression of this legislation, visit www.congress.gov. During your nursing education or even in the workplace, stimulate some discussion and support around legislation and health policy issues and topics that have implications for nursing. Nursing in the 21st century demands that we take our rightful place at the table and advocate for patients and the profession. Developing the wherewithal to do so at the student level is an important first step. Janice M. Phillips, PhD, FAAN, RN, is the director of Government and Regulatory Affairs at CGFNS International, Inc. in Philadelphia.
The Funny Bone COMPILED BY MICHELE WOJCIECHOWSKI
Dear Readers, Welcome to our third and final installment this year of our new humor column, “The Funny Bone.” We’ve got good news for you—we’re bringing it back for 2017! So put on your thinking caps and send any funny stories that happened to you to writer Michele Wojciechowski at MWojoWrites@ comcast.net. In the meantime, enjoy the following humorous tales, and have some laughs.
Let It Rain I was in my last semester of nursing school, and things were seemingly coming together. Clinical in my last semester required me to shadow a working nurse for some hours each week. It was exciting, but I was limited in what I was allowed to do in terms of hands-on work. This particular day, I was given the task of changing out a patient’s fluid bag of normal saline. Simple, right? That’s what I thought. The IV pole was hanging very close to my patient, who was in bed having a conversation with her visitor. I discreetly walked in—hiding from any patient dialogue, as new nurses tend to do—and approached the task ahead. With the old bag still infusing, I carefully hung the new bag next to it. Then, I pulled the safety tab from the new bag. Feeling quite confident at this point, I pulled the IV tubing from the old bag to spike the new bag—all while both bags were still hanging. Big mistake!
The fluid from the old bag came rushing out onto my patient as I stood like a deer in the headlights in complete shock! What in the world did I just do? One liter of fluids came rushing out—because, of course, the old bag couldn’t have been only 30 ml, nope— 1,000 ml raining all over the bed and the patient. Just as I had turned the patient’s room into a rainstorm, I saw my preceptor walk in to check and make sure everything was going smoothly. Needless to say, I never touched another IV bag on that rotation. —J.G., RN
Move It On Back A few years ago, when I worked in the burn unit, it was not uncommon to receive the “meth-cooking-gonewrong” patient. These patients often entered the burn unit under the story that their “Coleman Lantern exploded while camping.” Naturally, we didn’t buy it, and toxicol-
ogy test results confirmed our suspicions. Due to their chronic drug use, it was difficult to adequately treat these patients. Their narcotic tolerances were just too high. With that, came treatment of high doses of drugs like morphine, Dilauded, or fentanyl. As I was training a new graduate nurse who had just begun in the burn unit, a patient like this came in. He received several doses of pain medication, and it was suspected that “friends” had brought him some recreational drugs as well. Subsequently, this male patient was breathing only four breaths per minute and was close to coding. I quickly took over care of the patient from the nurse. I asked my trainee if she had ever seen a narcotic reversal. She had not. I explained that the results of administering a drug by the name of Narcan— which reverses the effects of narcotics—can be sudden and violent, so I advised her to keep her distance. Because she was familiar with my personality, she assumed I was joking and
stood close to the patient’s bedside. I administered the Narcan via an IV infusion, and my trainee quickly realized she should have heeded my warnings. The patient awoke suddenly and started violently thrashing in the bed, striking her in the face. He grabbed both sides of her stethoscope, pulled her down to his face level, and began to scream “I have to SH*T!!!!” and “I am on FIRE!!!!!” Seeing the terror in this poor girl’s face, I applied pressure to the patient’s wrist to release his grasp and secured him to the bed with modest pressure to his chest. She excused herself and quickly thereafter left the shift, never to return again. —K.C., LPN
Bringing Sexy Back Recently, I picked up a shift, and one of my patients was an 83-year-old female who had been married for 56 years! I
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The Funny Bone wanted to know how you keep love going for that long. Our conversation went like this:
Bringing Sexy Back (continued)
Me: Wow, you have been married for 56 years! What’s your secret? Patient: I don’t know what the secret is. Me: That’s so great to find
that special person. Patient (whispering): Nurse, I need you to tell me how to make my sex life better ‘cause my husband says lately I’ve been cold like a fish in the bedroom. Is there some recommendation? Me (turning red in the face): I’ll have to look that up! My patient giggled, and I quickly left the room. Guess love really can last forever! —M.C., MSN, RN
Do you have a funny story to share? It can be something that happened to you at work, while in nursing school, while teaching nursing school—practically anywhere, as long as it involves the nursing field. If so, contact Michele Wojciechowski at MWojoWrites@comcast.
net. If we use your story, we’ll only use your initials to protect the innocent—and to be HIPAA compliant.
Registered Nurses UK HealthCare’s vision for care delivery has been embraced and emulated by healthcare systems throughout the region. Our team provides exceptional patient care and a superior experience for our patients and their families.
At UK HealthCare, we adhere to a policy of inclusion, diversity and afﬁrmation; not only for those we care for, but also for our nursing staff. If you are a nurse who shares our passion for positive patient outcomes and want to be part of the most progressive and dynamic environment in the area, we want to talk to you! For immediate consideration, please visit https://ukjobs.uky.edu.
The University of Kentucky is an equal opportunity employer and encourages applications from minorities and women.
Minority Nurse | FALL 2016
MINORITYNURSE.COM Highlights from the Blog
Newsletter 5 Things That Can Make You a Successful Travel Nurse As a travel nurse, you need to research the job description, understand the organizational culture, and stay updated with important on-the-job skills. Even on the personal front, there are several factors you need to consider when embarking on a new assignment.
Whatâ€™s a Nurseâ€™s Professional Image? Being a professional nurse and having an image to go with that means more than having a great resume or even an impressive title. What can you do to strengthen your professional image as a nurse?
A New Normal: Graduate Nursing Students Paying for Clinical Rotations Aspiring advanced practice nurses enter their prospective graduate programs each semester with the good faith of excelling at their course work and practicum. Unfortunately, that notion may be tarnished by the misfortune of not finding a clinical site.
10 Qualities That Make a Great Nurse Nurses are required to be not only compassionate and helpful, but also capable of making difficult decisions and administering the right medical care to patients in the absence of doctors. Of course, education plays a big role in ensuring these attributes, but there are certain innate qualities that make one nurse better than the other.
To read more, visit www.minoritynurse.com/blog.
Minority Nurse Magazine
MINORITYNURSE.COM In the Spotlight
SPECIAL EDITION: Meet Our Scholarship Winners
First-Prize Winner, Kara Bellucci Kara Bellucci, this year’s Minority Nurse scholarship winner, never considered nursing as a potential career. Lacking the confidence to dive into hard sciences, and with a real passion for family, race, and class issues, Bellucci’s life changed when she spent three years as a Peace Corps volunteer in Malawi, Africa. “When I came back to the States, I realized that one-to-one connection was the common thread,” she says. Bellucci began on a path to nursing that included taking some classes to prepare for nursing school and to complete requirements beyond her bachelor’s degree in women’s studies from the University of California, Davis. Now a nursing student at Columbia University’s
Minority Nurse | FALL 2016
intensive 15-month master’s program, Bellucci will launch immediately into Columbia’s 3-year-long clinical doctoral degree program upon completion of the master’s degree work. “Nursing came to me organically,” Bellucci says. “I didn’t think connecting with people was a skill I could translate into work. Nursing was reaching out to people, and it’s a holistic approach. It’s about physical and emotional wellness. I didn’t know that kind of nursing existed.” The connections Bellucci forms with people is what grounds her to a career in nursing. In Malawi, she says one of her roles was to help connect a group of women bakers with other resources in the commu-
nity so they could bake and sell products. The satisfaction in helping the women, seeing them thrive, and being a part of their success made a huge impact on Bellucci. “A lot of that is in nursing,” she says. “It’s connecting people with resources.” Bellucci has also spent time as an outreach worker for people in single-occupancy hotel rooms and on the streets in San Francisco. Bellucci, who was unfamiliar with the surroundings, says she had a lot of misconceptions about the community at first. The realization that her own bias could impact her nursing was powerful. Despite different backgrounds and lifestyles, Bellucci says she still formed connections based on common threads with the people she was helping and the goal of safety and health. “I realized that it’s going to be important through this career to check in on the different layers of my identity,” she says. The process will help her take a step back sometimes and consider how her own life experience could change how she sees something. Eventually, Bellucci would like to go into family practice where the connections with patients often span decades and generations as well. “You can develop longevity with
patients,” she says. “That’s an environment I would enjoy.” And Bellucci says she can see eventually circling back to her global experience to somehow get involved with international nursing. For now, Bellucci says the scholarship will help her financially so she can get the skills she needs first. But it also serves as a reminder, she says, and a validation for how important nursing is. “It’s a nice affirmation to find out there are others who think there’s more diversity to be brought into the field,” she says. “It’s an affirmation and the excitement for that.” And like most nursing students, Bellucci says she is apprehensive about the student debt she is accruing, as is her family. “To tell them I got the scholarship was reassurance that other institutions believe in me too,” she says. “It’s a nice confidence vote.”
MINORITYNURSE.COM In the Spotlight
Runner-up, Nam Pham With very shaky beginnings as a malnourished infant in his native Vietnam, Nam Pham, one of this year’s Minority Nurse scholarship winners, describes his challengefilled life as an ultra-marathon runner. Despite the different professional, personal, and academic setbacks that resulted from his earliest years, Pham says his outlook puts it all into perspective. As he pursues his master of science degree in nursing at the UCLA School
of Nursing, he plans to use his dual roles as a health care provider and a health care consumer to become an integral part of building what he calls a working health care infrastructure. And with a focus on teamwork and collaboration, he believes the profession benefits from a diverse nursing force. “Always maintaining a steady pace and keeping my eye on the finish line, I am determined to jump over any and all hurdles to pursue a
meaningful medical career and live a meaningful life,” he wrote on his scholarship application. Pham’s family left Vietnam, but their new life in the drugriddled Oakland, California, projects presented new challenges. But through it all, Pham says he didn’t back down from choosing a notoriously demanding career. “Success may take weeks,” he says. “It may take months. Maybe years. I don’t expect the nursing profession to be an easy one.” But with his own experience with health struggles to call on, the direct connection to patients—some of whom will face seemingly insurmountable odds—will be there. “Many patients will have yearlong health care journeys,” Pham says, but he notes that he wants to be an encouraging and compassionate support. And just like he has seen in his own life, the road to good health is made up of both success and failures— neither of which define the whole path. So when patients are overwhelmed, he can bring it back to what counts. “We’d take it one step at a time, dayby-day,” he says. To reflect on his comparison to life as an ultramarathon, Pham put his beliefs into real action, running 700 kilometers across Canada from Quebec to Ottawa and connecting with people about AIDS and HIV issues. The run’s physical challenges were tough, but with a love of both talking
and listening, it was an opportunity to connect in a way he hasn’t done before. And after listening to the struggles of many patients, Pham says he knows how complex a nurse’s role is. “A good nurse will be able to bridge any gap between a physician and a patient, providing not only medical but also emotional support,” he says. “Reducing the gap will not always be easy, and that is why a good nurse will always listen with an open ear, interpreting and analyzing the situation before speaking and integrating a plan for the betterment of the patient and/or physician.” When asked where he might see himself in five years, with his degree complete, Pham is clear. “I will be operating a mobile health clinic on wheels in underserved communities, providing primary care to the forgotten and neglected,” he says. “It is my hope and dream to give back to the communities that provided me with life’s most basic necessities when I first came to the United States.”
Minority Nurse Magazine
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Runner-up, Shanelle McMillan Minority Nurse scholarship finalist Shanelle McMillan says nursing is a family tradition, but that she has been especially gratified to start her nursing career as a certified nursing assistant (CNA). Now a junior in WinstonSalem State University’s Division of Nursing, McMillan’s five-year plan includes an RN, a BSN, and enrollment in the doctorate of nursing at Winston-Salem State University where she would eventually like to teach. But she believes her training as a CNA gave her the most fundamental and essential introduction to nursing that she could have. In her scholarship application, McMillan called becoming a CNA one of her most meaningful achievements.
Minority Nurse | FALL 2016
As a CNA, McMillan says she was able to see if nursing was really going to be the right career choice for her. Always the first to comfort others who are upset or in pain, she says the experience as a CNA offered close work with patients where she was able to see almost immediate impact. “I believe the benefits of starting as a CNA is to get your hands and feet wet in the health care system and to see if you will really like nursing or not,” she says. And the daily interactions with people meant she would spend considerable amounts of time caring for patients, but also getting to know them as well. “As a CNA I have firsthand knowledge of the struggles of disabled persons and what they go through on
a daily basis,” she says. “I get to interact with the client, which is the most important of all, because if you get to know your client, it will be easier to care for them.” And McMillan says this is also where she saw the benefits of a diverse nursing staff. When patients see people who look like they do or have the same cultural experiences, they are more open, she says. Developing that strong bond helps with treatment. Raised primarily by her grandmother in Richmond, Virginia, McMillan’s determination and drive come from watching her. As a nurse who worked long hours, McMillan’s grandmother always helped people, even during her off hours. That kind of role model was a huge influence. “My determination comes from my rough childhood and upbringing,” she says. “My dad always told me to be strong and tough, and my grandmother always taught me to never give up.” As she has progressed through nursing school, McMillan says the friends she has made and the supportive professors have all helped her success. And McMillan also credits her faith with keeping her moving forward. “There were a lot of setbacks in my life getting me to this point,” she says. “And I have to give thanks and all honor to my Lord and Savior Jesus Christ. Without him, I don’t even think I would be in nursing school.”
With her progression through the various opportunities in the nursing profession, McMillan says she is especially conscious of being part of a group that is so determined in its dedication. “Some say all nurses have at least one thing in common,” says McMillan, “they want to help people. Not only do they play the role of caretaker for their patients, but in some circumstances, they can also be a friend, an advocate, counselor, and teacher. It takes a special kind of person to fill all of those roles the way nurses do.”
THE FUTURE IS IN YOUR HANDS. When you earn your nursing degree from The University of Alabama, you are doing more than just earning a degree. You are earning your degree from one of the top universities in the country and taking steps to improve your career and the lives of your patients. Take control of your future and contact us today!
RN to BSN | RN to BSN/MSN | MSN-Case Management | MSN-Clinical Nurse Leader EdD for Nurse Educators | DNP-Doctor of Nursing Practice
JOIN OUR FACULTY AT THE CAPSTONE COLLEGE OF NURSING. The University of Alabama was recently ranked #58 in the Forbes list of top U.S. employers. In addition to a great work environment, the University offers:
• Winning traditions in athletics and academics • State-of-the-art facilities • Over 2,000 nursing students in our programs BSN • MSN • DNP • EdD for Nurse Educators
• Tenure track positions available for faculty candidates with research preparation
For more information, contact Robin.M.Lawson@ua.edu The University of Alabama is an Equal Employment/ Equal Educational Opportunity Institution.
Minority Nurse Magazine
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Minority Nurse | FALL 2016
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FACULTY WHO PUT THE STUDENT FIRST. How did WGU become a leader in conferring bachelorâ€™s and masterâ€™s degrees to minority nursing students? By designing flexible, accredited, online degree programs that make student needs the top priority. Learn more about the WGU Back to School Scholarship, valued at up to $2,000! wgu.edu/backtoschool
7/28/16 11:38 AM
Minority Nurse Magazine
The University of Arkansas – Fort Smith is located on a beautiful 140-acre campus in the River Valley of Western Arkansas, nestled between the scenic Ozark and Ouachita Mountains. UAFS is one of 18 campuses that comprise the University of Arkansas system and is one of the largest suppliers of healthcare professionals in the state. The Carolyn McKelvey Moore School of Nursing offers an exciting environment to educate future nurses! Housed in a 66,000 square foot facility that features a birthing center, critical care unit, 2-nine bed and 1-six bed fully equipped lab, a 7 bed simulation lab with one way mirror and cameras and hi-fidelity patient simulators, a fully equipped patient room, a nursing station and three computer labs. Classrooms feature a nova station, Sanyo televisions with DVD/VCR combination mounted in the ceiling on either side of a large electric projection screen, Educarts, Elmos, and the capability to engage the DVD/VCR from the nova station! Faculty enjoy fully furnished private offices! The School of Nursing is eager to attract faculty who are committed to active, learner-centered teaching, innovation in curriculum design and delivery, and ongoing professional development and scholarship. We are currently seeking candidates for the following nursing faculty positions:
Community Health Jim L. Hanna Endowed Professorship Medical - Surgical Pediatrics For additional information visit our website: www.uafs.edu University of Arkansas – Fort Smith Human Resources 5210 Grand Avenue, Fullerton Administration Bldg., Room 239 P.O. Box 3649 Fort Smith, AR 72913-3649 Telephone: 479-788-7088 • Email: firstname.lastname@example.org AA/EOE
Minority Nurse | FALL 2016
Associate Dean for Research THE BETTY IRENE MOORE SCHOOL OF NURSING AT UC DAVIS seeks to hire a visionary and dynamic associate dean for research to lead the school’s research program and serve as a member of its senior leadership team. The Betty Irene Moore School of Nursing at UC Davis was founded in 2009 with a $100 million grant from the Gordon and Betty Moore Foundation. Through this financial support and a shared vision to advance health, faculty, students and staff aggressively launched a research program focused on improving health and reshaping health systems in partnership with communities served. Together, they work to confront the barriers to population health and the challenges burdening health care in the U.S. Researchers strive to assure that prevention and care places individuals, their families and their communities at the center of all they do. This UC Davis position provides a number of unique opportunities to:
• lead the development of a young research program focused on rapidly and effectively improving care • join a creative faculty and further develop and hire tenure-track research faculty over the next five years • receive dedicated research staff support at both the school and university levels • participate in transdisciplinary collaboration with researchers throughout UC Davis • earn a generous compensation package that includes relocation and start-up funds • work from a brand-new, state-of-the-art facility, Betty Irene Moore Hall, which is designed to sustain this vision of innovation Candidates who are committed to the highest standards of scholarship and professional activities, as well as the development of a climate that supports equality and diversity, are especially encouraged to apply. Diversity, in all its dimensions, ensures that UC Davis faculty bring a full range of backgrounds and perspectives to its teaching, research and service responsibilities. Diversity can be exemplified through the variety of personal experiences, values and world views that arise from differences of culture and circumstance. Such differences include race, ethnicity, gender, age, religion, language, abilities or disabilities, sexual orientation, gender identity, socioeconomic status, geographic region and more. UC Davis Health System includes the School of Nursing, the School of Medicine, a 619-bed acute-care teaching hospital and a 1,000-member physician practice group. It is home to a National Cancer Institute-designated comprehensive cancer center, an international neurodevelopmental institute, a stem cell institute and a comprehensive children’s hospital. Other nationally prominent centers focus on advancing telehealth, improving vascular care, eliminating health disparities and translating research findings into new treatments for patients. Together, they make UC Davis a hub of innovation that is transforming health for all. For full position descriptions and to apply, visit http://nursing.ucdavis.edu/ourteam/join.
UC Davis is an affirmative action and equal opportunity employer with a strong institutional commitment to the achievement of diversity among its faculty, staff and students.
Minority Nurse Magazine
s you are probably aware, the demand for nurses continues to skyrocket. What you may not know is that there’s also a critical need for nurses with advanced degrees, as hospitals turn to nurses to fill more administrative and leadership roles. Nursing schools around the country are jumping at the chance to fill this void by offering flexible Master of Science in Nursing and Doctor of Nursing Practice programs, and you’ll find many great examples in the following pages. There truly has never been a better time to pursue an advanced nursing degree. Be sure to secure your spot in the program— and your financial aid—by applying early.
Index of Advertisers ADVERTISER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PAGE # Black Nurses Rock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Mercy Medical Center, North Iowa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 University of Kentucky Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Springer Publishing Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C3 ACADEMIC OPPORTUNITIES Azusa Pacific University . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Florida State University . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 University of Alabama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51 University of Colorado . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C4 Western Governors University . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 FACULTY OPPORTUNITIES University of Arkansas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 University of California, Davis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Minority Nurse | FALL 2016
2016 NATIONAL NURSE CAREER FAIR
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Register today for the 2016 National Nurse Career Fair to access top nursing jobs in the country. Weâ€™re connecting the best candidates to premium job openings. Donâ€™t miss this opportunity!
Virtual Job Fair Friday, October 21 @ 10 AM-4 PM Virtual career fair and employer booths are accessible 24/7, and you can login anytime. Check out the calendar at http://bit.ly/NurseCareerFair2016 for the times employers will be available online to chat live. You can always communicate with them even if they are offline.
BE THE NURSE EVERYONE LOOKS TO FIRST The University of Colorado College of Nursing has a program for every nurse. We offer bachelor’s degree programs: Traditional, Accelerated, RN-BS (online); master’s degree specialties in highdemand fields; doctoral programs: PhD, DNP; and several graduate certificates to advance your career. Contact us at 303.724.1812.
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Published on Sep 9, 2016