Solving The Shortage - Johns Hopkins University

SECONDOpinionReaders discuss the important issues facing the nursing profession today.Additionally, weekend, evening, and nightwork is not family-friendly.Hospitals will spend thousands of dollarsrecruiting foreign nurses but refuse to think“outside the box” in attracting nurses intheir own town. There is a large populationof nonworking nurses due to familyH. Nurse training and education: gettingA. Professional imageobligations. These are nurses who havemore students through the pipelineof nursingexperience, are invested in the community,quickly and the relatedand most often, keep up with journals andissue of lack ofB. Poor relations research. Many mothers with school agenursing faculty21.0%21.0%with physicians children would love to work 8 am - 2 pm.Many nurses would like a two day a weekschedule with no weekends. These nurses7.0%are willing to take a lower pay to avoid14.0%working weekends and holidays. These are9.0%G. Inadequatenurses who would love to “cover” for lunches10.0%9.0%8.0%C. Lack ofsalary andwhen their children are in school. These arefunding foroverallnurses who could be mentors for new nursesnursing positions coming in. Hospitals could save money bycompensationutilizing part-time employees and lowerD. Lack of institutionalF. Lack of advocacy andE. Inaccurate“shift” wages. However, hospitals will sayrecognition of the needmarketing to attract themedia coveragethey are unable to offer creative schedulingfor additional nursesnext generation of nursesdue to unions. Unions say they are unableof nursingto sway the hospitals to offer creativeThe list of choices included issues I don’tignored. Now I understand there is anotherscheduling. So we find positions outside theassociate with nursing now, such as imagedocumentary in the works focused on thehospital, but are often underemployed.problems, physician issues. Now the issuemaking of a Hopkins doctor! It is past timeHospitals that are able to tap thisseems more to be realities of the work vs.for a similar show regarding the many rolesresource of well educated, experienced nursesother alternatives, like how physicallyof the modern nurse. At the very least, Iwill be the hospitals that deliver the bestdemanding the profession is and the facthope the new documentary includes somepatient care most efficiently with a happythat for many it means 12 hours shiftsacknowledgement of the Hopkins nurse.workforce. These are the hospitals who willand day/night rotations. Those can beCarol Heinlein, MS, RNbe least impacted by the nursing shortage.stumbling blocks, especially for older peopleBarbara (Blanchard) Spielman, BSN ’95considering the profession.Editor’s Note: ABC’s new six-episodeMarian Grant, MSN ’05, BSN ’00, CRNP documentary series “Hopkins,” a sequel to theSenior Research Coordinator 2000 documentary “Hopkins 24/7,” focuses onOur question next issue:Johns Hopkins University School of Nursing the hospital’s medical residents. The show beganairing in late June, on Thursday nights at 10I believe the biggest challenges to over p.m. (after “Grey’s Anatomy”).coming the nursing shortage are “inaccurateThis issue’s second opinion missed the boat.media coverage of nursing,” along with theIf I was forced to pick one I would select H.“profes sional image of nursing.” I have beenFor example, I would love to run a nursinga nurse for almost 40 years and have notlab or intro to nursing class at my localseen much of an improvement in our image.We nurses know that we’re multi-talented,community college and feel I would be wellwell educated, and involved in all aspects ofqualified, but they require a master’s degree.However, for me and many nurses thehealth care, but I do not believe the generalA. Minimizing errorspublic is as aware.real problem with staying in the hospitalB. Diagnostic analysis issuesOne example—some years ago, there was is the lack of flexibility in employment. IC. Standards of practicea widely-watched television documentaryand many friends and colleagues have leftabout The Johns Hopkins Hospital. I wasthe hospital not because of the reasons youD. Hospital (or healthcare facility) fundingoffered, but because we have been fortunate.excited, thinking that surely much of theE. Hospital (or healthcare facility) staffingWe have families that are our first priority.focus would be on the talented nurses whoVisit www.son.jhmi.edu or e-mailare the mainstay of the health care renderedChildcare is very expensive and ofteneditor@son.jhmi.edu to respond.not available traditional shift hours, andthere. Much to my dismay, and that of myfriends, the role of the Hopkins nurse wasvery few hospitals offer on-site childcare.Our question this issue:What are the biggest challenges toovercoming the nursing shortage?What is the topconcern in today’sfield of criticalcare nursing?Johns Hopkins Nursing www.son.jhmi.edu

On the PulseN ewsfromA roundtheS choolandH ospitalFor 2008 Graduates, Knowledge Alone is “Simply Not Enough”Ostudents, 54, received aMaster of Science in Nursing(MSN), while 13 receiveda joint MSN and Masterof Public Health (MPH),two received a joint MSNand Master of BusinessAdministration (MBA), andfive were awarded a PhD.The day prior to thecommencement ceremony,the Nu Beta Chapter ofSigma Theta Tau Inter national Honor Societyinducted 109 new members—80 baccalaureate students,27 master’s students, andtwo doctoral students—whodemonstrate excellence innursing scholarship.Jhpiego president and CEOLisa Mancuso, PhD, RN,FAAN, this year’s keynotespeaker, encouraged graduatesto use their knowledge toimprove health worldwide.“Nurses are a critical factorin improving global health,”remarked Mancuso, who wasnamed by The Daily Recordas one of Maryland’s Top 100Women for 2008. “We mustpush to be leaders and createreal change. To ‘know’ issimply not enough.”—Jonathan EichbergerPhotos by Rob Smithn May 22nd, 124undergraduateand 74 graduateHopkins nursing studentsfilled the Lyric Opera Housefor the 2008 commencementceremony, ready to embarkon their new journey astomorrow’s nursing leaders.An additional 129 studentsfrom the accelerated classreceived their Bachelor ofScience degrees in July.A majority of the graduate Johns Hopkins Nursing Summer 2008

NonstopBy Jeane Garcia ’08Spoken word performance at 2008 Commencement ceremonyWe read it sometime back in shiny recruitment materials,Then they reminded us again on “Accepted Students’ Day”—They said something about stopping to take two years for aTraditional BS degree in Nursing.So we stopped and took a risk on ourselves to become—nurses.They announced it again in P and A lab that morning—sometimeafter Diane’s ducks waded past the faces pain scale and our trustingsupine British Sim-man. Then again before that quivering subQshot we practiced on an Ace bandage and that fumbling first timeFoley cath on plastic drainage pipes They stopped to remind us that tradition translated intoteamwork, compassion and care,Helping each other hands-on in clinical rotations between theheparin and insulin—We learned a little something about what nursing and taking risks really meant—Thanks to Janice Hoffman’s serial ABGs and contagious enthusiasm for critical care,We stopped now to see that we didn’t need a monitor to assess that we’re rapidly —becoming—nurses.Between the stop signs in East Baltimore and Durban, Haiti and the Homewood campus,Broadway Street and the UAE,—We could not, would not be stopped—Sometime between high fives at Headstart, to seeing that first decel on the fetal monitor,To reassuring that uninsured mother Between every ambubag and chest compression,To stopping to be that nurse to change that patient’s five-day old ulcer dressing,Suctioning trach collars and checking chest tubes, To caring for families and children livingwith CP,To holding the hands of strangers struggling with newfound TB or HIV—We stopped and saw itin each other’s faces and skillful hands, and in what our patients weren’t always saying to us.From the ED to L and D, shock/trauma and MICU, and soon to a hospital near you’s CardiacSICU—Between every SBAR, V-fib, then reading together about PEPFAR,From the BBC and DRC, to EKGs and every 14 Gauge IV saying, “just a little stick” We stopped and taught ourselves—that this was possible.That “traditional” translated into tenacity and innovation,That “taking risks” meant quality care, perseverance, leadership, listening, and—that we couldstop—and take a risk on ourselves. Bouncing from day care before dawn, to work study or atech shift—From lack of sleep to bottomless lattes, late calls home, to racing for the shuttle;running to make tuition payments, to O2 sats on EMT ambulance rides—we were non-stop.They taught, we learned—We taught, they learned—And at the end of every culturally competent H&P, midterm exam, nurse’s note, andplan of care,we learned that—Yes, we are nurses,And yes—while still un-licensed for just a few more weeks thatYes,—We had become an un-pharmaceutical product of our patients,of our passions, of each other—and that we—are—so critically—un-traditionally—Unstoppable Johns Hopkins Nursing www.son.jhmi.edu

On the PulseFlorence Nightingale was a pioneer of modernnursing but did you know? In 1860, she was the first woman to be elected afellow of the Statistic Society; Over her career, Nightingale published more than200 books, reports, and pamphlets; Her most famous book, Notes on Nursing, hasbeen translated into eleven foreign languagesand is still in print; The Johns Hopkins University School ofNursing (JHUSON) has a collection of heroriginal letters, books, and wheelchair.JHUSON was founded “under the influence of aNightingale-type education,” says Maryann Fralic, DrPH,RN, FAAN. “That’s the real legacy for nurses here, in that wecontinue to prepare leaders who have a wonderful heritage in a real way, in that there are parts of her life here.”The Florence Nightingale wheelchair was donated to theSchool by Howard Kelly, a prominent Hopkins physician.Kelly purchased the chair in 1921 and presented it to theSchool, writing in a letter, “If an inanimate object canconvey a lesson and transmit aninspiration, may this chair suggestthe spiritual presence of yourgreat apostle of nursing and provea blessing to the nursingschool.” The chaircan be foundon the fourthfloor of theSchool ofNursing AnneM. PinkardBuilding. Johns Hopkins Nursing Summer 2008Another rare gift donated by Kelly in 1917, includeda collection of original Nightingale letters, which hehad bound in a handmade book for the School. He alsodonated a number of books and other materials thatwere both directly and indirectly related to FlorenceNightingale, now housed at the Welch Library archives.A bridal bouquet was sent by Florence Nightingaleto Isabel Hampton on the occasion of her wedding toHunter Robb in 1894. A friend of Nightingale’s, IsabelHampton was the first superintendent of theJohns Hopkins trainingschool for nurses, andwas also in charge ofthe nursing servicefor the entirehospital. Thereconstructedbouquet nowrests under aglass dome on thefirst floor in theAdmissions Office.—Diana SchulinCourtesy of The Alan Mason Chesney Medical Archives of The Johns Hopkins Medical Institutions, photograph by Norman Barker, Bouquet by Will KirkHopkins Nurses Find Illumination from the “Lady with the Lamp”

Maureen Maguire—Teacher of AllSON Classes—To Rest On LaurelsSA photo collage honoring Professor Victoria Mock, PhD, RN, FAAN,is now on display in the Center for Nursing Research and SponsoredProjects at the Johns Hopkins University School of Nursing. Prior toher death late last year, Mock served the School as professor, Chairof the Department of Health Systems and Outcomes, and Director ofthe Center for Collaborative Intervention Research. She also directednursing research at the Kimmel Cancer Center. The collage serves asa memorial to the dedication and inspiration she provided to the Schooland to the field of nursing.ON Assistant ProfessorMaureen Maguire,MSN, RN, PNP, whojoined the SON faculty justas the second baccalaureateclass entered the SON, hasannounced her retirement.According to Maguire, “It’sbeen an amazing ride andI’m surprised to realize that23 years have gone by!”Throughout those years,Maguire has seen the Schoolgrow and change direction.She found each stage to be “afascinating experience whereyou could learn and grow as afaculty member.” She added,“I liked it every day, but themost special times were those‘Oh! I get that!’ momentswith the students.”Maguire, the recipientof three annual JHUAAstudent-selected Excellencein Teaching awards, notedthat she knew it was “timefor the teacher to rest on herlaurels when I saw how mystudents were exceeding allexpectations.”—Lynn Schultz-WritselOlsen is knownthroughout the Schoolfor encouragingprofessional develop ment among thegraduate students.Nominating studentssay that Olsenencour ages studentsto “be advocates forthemselves, theirspecialty area, and theirpatients.” An “exceptionalrole model for all clinicalnurse specialists,” Olsen issaid to “exemplify what itmeans to be a nurse leader.”Dean Martha N.Hill, PhD, RN, FAANpresented the awards, notingthat the award winnersdemonstrate “extraordinaryqualities—excellent teaching,mentoring, respectfulness,and encouragement. TheSchool of Nursing is proudto have them as part ofour faculty.”Excellent Teachers, “Ultimate Mentors”Faculty members SharonOlsen and Elizabeth(Ibby) Tanner werenamed the 2008 recipients ofthe Johns Hopkins UniversityAlumni Association Excel lence in Teaching Awardsat the School of Nursingcommencement ceremonyin May. The awards, whichhave been given annuallysince 1992, honor facultymembers who—according totheir students—stand out intheir role as both a teacherand a mentor.Ibby Tanner, PhD,MS, RN, received theBaccalaureate Excellencein Teaching Award.According to students whonominated her, Tanner isa “great inspiration” and a“wonderful teacher, mentor,and advocate.” As the facultymentor for the School’sGeriatric Interest Group, sheshares her skill and passionwith her students and “tak[es]time to advocate for patientsas a skilled geriatrician andRN.” Says one nominator:“Dr. Ibby Tanner is the kindof professor that I hoped tofind” at Johns Hopkins.Sharon Olsen, MS,RN, AOCN, received theGraduate Excellence inTeaching Award. Describedas “the ultimate mentor,”Johns Hopkins Nursing www.son.jhmi.edu

On the PulseNew Orleans Nursing: It’s High Time for Help in the Lower Ninth WardVolunteer Headquarters: Lowernine.org in thedevastated Lower Ninth Ward neighborhood.Team NOLA at the Lower Ninth Ward Health Clinic with Patricia Boskent Berryhill, whofounded the free clinic with fellow nurse Alice Craft-Kerney.Tiling 101. Next up: mudding, painting, and roofing.Hard labor, health screenings, and dormitory-stylebunk beds—not the usual trappings of a collegestudent’s spring break. But for one dozen nursingstudents from Johns Hopkins University, traveling to NewOrleans to help victims of Hurricane Katrina was just howthey wanted to spend their holiday. Team NOLA helpedwith construction and renovation of homes in the Lower10Johns Hopkins Nursing Summer 2008Treats from the ice cream truck.Hopkins nurses have brains and brawn!Ninth Ward through the organization Lowernine.org andvolunteered at the Lower Ninth Ward Health Clinic, St.Anna’s Medical Mission, and Touro Infirmary EmergencyDepartment. For four days, they went from door to doorthroughout the Holy Cross neighborhood to conduct healthscreenings. View more photos at www.son.jhmi.edu/nola.—Kelly Brooks-Staub and Diana Schulin

For Baltimoreans and Hopkins Nursing Students,Learning is a Two-Way Streetthem and more supported bythem than she had ever feltin her own family. Severalof the women began tearingup at this point and a box oftissues was passed around.”Spa Day for the ElderlyIn April the Geriatric InterestGroup, comprised of Hopkinsstudents from the schools ofNursing, Medicine, and PublicHealth, collaborated with theIsaiah Wellness Center at theApostolic Towers, a housingcomplex for low-income olderStress Management foradults, to host a Spa Daythe Homelessfor its residents. The eventIn March, Community Public featured seated massages,Health nursing studentsnail manicures, an exercisereceived funds from the Johns session (tai-chi andHopkins Nurses’ Alumnistretching), and a healthyAssociation (JHNAA) tolunch for all who attended.host a stress managementAccording to Callieworkshop at the HannahHermann ’09, Spa DayMore Shelter, a transitional“provided opportunitieshousing facility.for relationships that areStudents provided handbeneficial for students andmassages and manicures,the residents at Apostolictalked to the residents aboutTowers.” The benefit totypes of stress and copingstudents? Lessons that can’tstrategies, and presentedbe covered in the classroom:evidence-based examples“Listening to people shareof stress relievers includingtheir simple (yet oftenrelaxing music, yoga, andoverlooked) expressionsguided meditation. Theof gratitude put my life’sresidents received prizes such ‘problems’ and ‘stresses’ intoperspective,” she adds.as journals, stress balls, andsmall bottles of lotion.Heart Health EducationKatharine Taylor ’08for Amish Childrenrecalls a touching momentAlso using a JHNAA grant,in which one womannursing students purchased aacknowledged that “afterhuman heart model to teachgetting to know her fellowarea Amish school childrenresidents, she felt closer toFrank Klein (Both)Acommunity healthnurse is not made byclassroom learningalone. Textbooks, lectures,and written tests helpprepare students for workingwith patients, but there isno substitute for hands-onexperience. At the JohnsHopkins School of Nursing(JHUSON), students aresharing their knowledge withBaltimore residents—andlearning valuable lessons atthe same time.During Spa Day, Hopkins nursing students help the elderly relax andrelieve stress.about heart health in May.Because older Amish peoplehave a high risk of heartdisease due to their diet,the nursing students spenttime teaching Amishchildren about the heart’srole in

School of Nursing and the Johns Hopkins Nurses' Alumni Association. The magazine tracks Johns Hopkins nurses and tells the story of their endeavors in the areas of education, practice, scholarship, research, and national leadership. Editor Johns Hopkins University School of Nursing 525 N. Wolfe Street Baltimore, MD 21205 410.614.4695