Why Do I Love Nursing?

Cynthia Rost, BA, BSN, MSN, RN

Answering this question is tantamount to asking what I like about being alive.  For me, nursing is such an integral part of who I am as a human being that it seems impossible to separate the nurse from the person.  Nursing was not something that I dreamt about as a child, it was not, in fact, my first choice as a career.  I was an audiologist, working with the elderly in a large county-run nursing facility when I first noticed what is was that nurses do.  I saw that individuals relied on nurses for health education, activities of daily living, medication management, and life sustaining treatments.  Wanting to be the person that provided these many services to those in need, I came back to Duquesne (yes, my first degree was earned here as well) and enrolled in the B.S.N. program.nicaragua

Throughout the past 35 years, I have to say that, while I have worked for persons that made the job difficult, I never disliked the nursing.  When you become a nurse, you begin to see everything through a different lens.  You are able to assess objects, persons, environments, and entire communities as you walk alongside them in your daily life.  You can never “turn off” the nurse you have become.  It colors every aspect of your personality, and changes you at your very core.  You may leave your patients at the end of your workday, but you never stop thinking like a nurse.

It is through nursing that I became a better person, wife and mother.  It is because of a long career in Behavior Health and Public Health nursing that I am the community member I have become.  Nursing has provided me with a job, an attitude, a desire for lifelong learning (for those who don’t know me, I will be 60 years old in a few years and graduating with a DNP to celebrate), and the ability to think critically in all aspects of my existence.

Do I recommend nursing?  It is certainly not for everyone, but if you have made the decision to try it, please open your eyes to this new and fascinating way of seeing the world around you.  You will have days when you are bone tired and frustrated, but I promise you, tomorrow will bring new opportunities to change someone’s life.  Go for it!

 

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A Love for Nursing and Writing

Linda Koharchik, DNP, MSN, RN, CNE

Being an author or co-author of manuscript chosen for publication in a journal of nursing can be a gratifying experience.  Nurses write for a number of reasons and in a variety of venues.  Nurses seek publication to share personal nursing experiences, to make a commentary, or to disseminate research findings or evidence-based practice improvements.   Publication is an expectation of the role of the nursing professor.student-computer-wide_5

Hundreds of nursing journals are available from which to choose when deciding where to submit a manuscript and choosing the right forum for a particular manuscript is vital. A nurse writing about high-level research they have completed might appropriately seek publication in a journal such as Nursing Research or the publication of the National League for Nurses’ (NLN) Perspectives. Nursing educators seeking to publish their evidence-based teaching may direct their manuscripts to journals dealing with nursing education, such as Nurse Educator or Teaching and Learning in Nursing. Other journals dealing with specialties in nursing, such as The American Association of Operating Room Nurses or Critical Care Nursing, attract nurses publishing manuscripts dealing with these specialties. Other nursing journals publish articles of nurses’ perspectives and personal experiences as a nurse.  Each journal has a designated “impact factor” which is “a measure of the frequency with which articles in a journal are cited in a particular time period” (Oermann, 2012, p.299).  A higher impact factor denotes that the journal is more often read and cited by others, and impact factors are sometimes used as an indicator of the scholarly value of a manuscript.

Whatever journal is chosen for seeking publication, the potential author must closely follow the author guidelines of the journal.  The style of writing will be specified and may be the American Psychological Association (APA), the American Medical Association (AMA), or Chicago style, just to name a few.  The guidelines will suggest a word count for the submission, varied according to the type of venue; a simple commentary may be as few as 500 words, but a research manuscript may be allotted 3,500 words.  The tone of the manuscript also depends on the forum of where publication is sought.  Scholarly writing is expected when reporting research, but a commentary may employ a more conversational tone.  The potential author must follow the journal’s guidelines and carefully upload his or her manuscript as directed.

It is an expectation that authors will submit to only one journal at a time, as simultaneous submissions to more than one journal is considered unethical.  Publication in a peer-reviewed journal is sought by those who wish to disseminate their work in a credible source. When works are peer-reviewed, the manuscript has been scrutinized by experts in the field, who then may accept, reject, or suggest revisions to the author.  Rejection is not uncommon, with a reported 65 to 80% rejection rate in some journals (Jasper, Vaismorandi, Bondas, & Turunen, 2014).  Rejection doesn’t always mean the end to pursuing publication of a manuscript.  The author may consider the comments provided by the reviewers, constructively revise the work, and then resubmit to another journal.

Being a published author is an impressive feature to place on one’s résumé, but it is not necessary to have an advanced degree before seeking publication.  Student nurses have important perspectives to share.  A great start is publishing in a student newsletter, such as The Scope!

 

Jasper, M., Vaismorandi, M., Bondas, T., & Turunen, H. (2014). Validity and reliability of the scientific           review process in nursing journals—time for a rethink? Nursing Inquiry, 21(2), 92-100.

Oermann, M.H. (2012). Editorial: Impact factors and clinical specialty nursing journals. Journal of Clinical Nursing, 21(3/4), 299-300.

 

Today’s Nurse

Mary Kay Loughran, DNP, MHA, RN

It is a great time to pursue a nursing career. While the demand for nurses in traditional settings remains, there are also many job opportunities available beyond the hospital setting.

As caring for the sick has become more complex, nurses continue to adapt to meet those challenges. Our society is getting older as people live longer and there is an increased rate of diabetes, heart disease, obesity, cancer, and other conditions. To meet patient needs nurses have become specialists in these areas through bedside experiences or advanced education and certification. As a result nurses are more effective healthcare team members and significantly contribute to patient care.

The Affordable Care Act, passed in March, 2010, provided new opportunities for nurses to deliver care and play an integral role in reshaping the healthcare system. The focus of this act stresses the importance of community-based primary care, case management, and mid-level care which places advanced practice nurses, community health nurses, and home care nurses at the helm of many of these initiatives. Nurse practitioners have eased the impact of the shortage of Primary Care physicians by practicing to the fullest extent of their license as recommended by The Institute of Medicine. They work with physicians to provide holistic and cost effective care.

New healthcare technology has also created opportunities for nurses. Some nurses have become information technology experts at their organization or with a healthcare software company. Nurses have enthusiastically embraced technology and we are good at it. We realize the value it brings to patients and their health outcomes. Nurses are involved with electronic medical records, mobile devices that monitor a patient’s blood sugar level, or app development to be used by an at-risk mother and her unborn child.

As you see, nurses are positioned to provide leadership in all healthcare areas. Our formal nursing education makes us well equipped to be effective leaders as executives, managers, quality improvement officers, educators, and researchers. Some nurses have also decided to take their nursing skills to areas outside of the profession and have made significant contributions in government, politics, and law. Opportunities are abundant for nurses. The basic foundation of our education provides us with the tools to be successful in whatever path we choose.

 

 

McGinley Symposium Highlights

Holly Storm and Sarah Dudley, freshmen

The Charleston Church Shootings. The televised murder of two journalists. The various college shootings. This is how Dean Glasgow introduced The Sixth Annual Rita M. McGinley Symposium, “The Face of the Person who has Experienced Violence” which was held on Thursday, October 22-23, sponsored by Duquesne University’s School of Nursing.

Dean, Mary Ellen Glasgow opened the symposium saying that this year’s symposium is a way to stop the violence that our nation has experienced.

The morning began with Dr. Jackie Campbell’s speech on holistic approaches in treating those who have experienced violence. She was an incredibly informative and persuasive speaker. It was an incredibly informative speech and really was really insightful into the needs of these unique patients.

Next, the Plenary Panel was a group of three community members discussing how to deal with the violence in the communities in Pittsburgh and different aspects of the impact the violence has on the community. The speakers included Malik G. Bankston, the executive director of The Kingsley Association which deals with communities of Pittsburgh and tries to help them get back on their feet, Paul Abernathy, the director of Focus Pittsburgh which is a Christian organization that tries give sustainable and action-oriented options to communities in the McGinleyposterUnited States, and Walter Howard Smith who is the Clinical Director and Deputy Director Office of Children, Youth, and Families. This panel was informative as to what was happening to the community and how the people are suffering while also having the panelists give their own opinions on ways to heal the community, which stems from their individual backgrounds such as sustainability, not letting people suffer alone, and empowering people.

Fawn Robinson, an academic advisor in the School of Nursing, also gave a speech titled “Black America: Facing the Realities of Violence Impacting the Black Community”. It was a favorite of the symposium because of her passion for this important topic. She spoke about the incredible violence that the black community has faced and even mentioned taking part in the “Black Lives Matter” movement.

“The reality is that being African American is not an easy road,” she said in her speech, “It is not. Not with my fancy suit and not with a PhD.”

Robinson’s speech evoked many emotions from the audience, prompting some black members to give personal experiences with racism and bigotry. It was very moving and really very eye opening.

Carol Powell, who was a nurse and trains other nurses to handle sexual assault, was next up in line for speeches. She spoke about sexual violence and her experiences caring for this patient population. The overall theme of the presentation was the role of the nurse in these situations. Powell discussed the importance of documentation and advocacy. This presentation was very powerful and moving as she spoke from experience and the heart while also being educational for nurses on how to delicately care these patients.

There were many breakout sessions, but the two that stood out the most were presented by Samantha Caravino and Kathleen Sekula.

The breakout session “Emergence of Gender Inequitable Practice in Adolescence: Innovative Models”, was an incredible presentation by Samantha Caravino, a Clinical Research Coordinator from University of Pittsburgh. She reported on a study she has been conducting that found 81% of high school seniors have reported being a witness to an abusive relationship. She also reported that a group of middle schoolers felt it necessary to share the sentence: “Belts are for discipline, but extension cords are for abuse”. This was a very moving session and really got one thinking about children and violence.

Kathleen Sekula, one of the leading developers of the Masters of Science in Forensic Nursing program at Duquesne, explained a study conducted by one of her students, Julie Valentine, in Utah. Valentine found that in Salt Lake City, on 6% of Sexual Assault Kits have been pushed through from the police station to the crime analysis lab, and many police officers had reported that the victim was “stuttering, forgetful, and  out-of-it”, which are all symptoms of being traumatized. The study has resulted in increased funding in educating police on violence victims, and increasing the percent of kits that are being analyzed.

The Face of the Person who has Experienced Violence Symposium was a huge success with many interesting sessions. It was successful because it covered so many topics from domestic violence to violence in the LGBTQ community to vulnerable populations in violence. It focused overall on the topic of violence while also having panels talking about how this relates specifically to the city of Pittsburgh. They did not leave any stone unturned and they will do the same next year which make it a hit again. We are so glad that we attended, and highly encourage everyone to attend next year!

I am a Sister Nurse: My Story

Sister Rosemary Donley PhD, APRN, FAAN

I was asked to share my experiences of being a very young sister and a diploma nursing student at the same time.  I entered the Sisters of Charity of Seton Hill in Greensburg PA after I completed high school.  I had idealistic ideas about serving God and helping others.  I thought that I would be an English teacher or a librarian. The following year, the canonical novitiate, I was given the habit and assigned to help in the diet kitchen at Assumption Hall, our infirmary.  My responsibilities were similar to what happens in today’s hospitals and nursing homes.  The novices set up the hot cart; assembled the trays; placed cold food on the trays and took the hot cart and the trays to the infirmary floor.  We then served and collected the trays to our senior and sick sisters; returned all the equipment to the kitchen and cleaned up.  We served three meals a day. cross

The Sister in charge of the diet kitchen asked me to take trays to Mother Rose Genevieve.  Mother Rose, as we called her, was old, suffered from several chronic diseases, and had demonstrable joint damage from rheumatic arthritis.  Most days, she was alert and very concerned about the welfare and lives of the novices.  During her long and very admirable life, she had served as President of Seton Hill College, Administrator of Pittsburgh Hospital and Major Superior.  She was a wisdom figure and I was so pleased to get to know her.

At the end of the canonical year, I was sent to Pittsburgh Hospital to take an admission test for their school of nursing.  I began the program that summer at Seton Hill College studying chemistry, microbiology, anat
omy, physiology and psychology.  We had long week days and classes on Saturday mornings.  At the end of the summer, we went to Pittsburgh Hospital and became probationary students, “probies.”  Unlike my classmates, who were clearly identified by their uniforms, I was dressed like the supervisor or the Director of Nursing.

In those days, diploma nursing students were introduced into the clinical area in their first semester.  I remember my introductory statement, I am not the Supervisor; I am a first year student.  I also recall being assigned to a critically ill patient during the Christmas holidays.  He had acute renal failure and his level of consciousness was low.   I was very apprehensive because I was studying foundations of nursing and my patient needed so much more than a clean bed, good positioning and morning care.  It occurred to me that I could pray for him; I did.  As I matured and continued in the program, I affirmed a new and more positive identity.  I am a sister nurse.  While my classmates struggled with relational challenges, working through the developmental tasks of late adolescence, I tried to reconcile the priorities and norms of the novitiate with those of professional nursing.  Some of the expectations were incompatible.

At the end of the novitiate, the Mistress of Novices asked me an interesting question.     Which program was harder, the novitiate or nurses training?  I thought: she will not like my answer.  I said nursing school was more difficult because if you made a mistake or forget something in the novitiate, the consequences are not serious.  However, in the hospital, errors and omissions put patients and colleagues in jeopardy.

Years later, when I was a staff nurse, I learned why I was chosen to go to nursing school.  Mother Rose told the Mistress of Novices that I would be a good nurse.  I was tall and would command respect and I was kind.  I was also kind and ill people, especially chronically ill people, need kindness and compassion.

You can see where I come from by googling http://www.scsh.org

Nursing: The Heart of Healthcare

Dr. Lynn Simko PhD, RN, CCRN

Nursing is the profession that is with the patient 24/7.  We do complete physical assessments on the patient at least every four to twelve hours, we know if they are in pain, have to go to the bathroom, or need repositioned for comfort.  We check on them every hour and let them know that we care about their well being.  Yes, Nursing is the heart of patient care.  The physician only comes once a day, assesses the patient and gets the report from the Registered Nurse (RN) as to how the patient did the previous 23 hours of the day.  They look at the lab work, X-rays and other tests to help plan the care of the patient.  They write their orders and then leave the hospital to visit more patients in other hospitals or in their offices.

Having worked in the Intensive Care Unit (ICU) setting for all of my professional years I have learned a great deal about the nursing care needed in a Coronary Care ICU.  I have resuscitated patients by defibrillating them before the code team and physician arrived.  I have saved lives with the nursing care I have developed over the years.  Coronary Care ICU usually sees patients with heart attacks (Myocardial Infarctions), congestive heart failure, pulmonary edema, pulmonary embolism, heart transplant candidates, acute respiratory distress syndrome (ARDS), ventricular assist devices (VAD), and extracorporal membrane oxygenation (ECMOimageofnursing).  We also get patients with cardiogenic shock, septic shock, and hypovolemic shock.  We treat these patients with vasopressor agents that help increase the Blood Pressure (BP) so that the patient doesn’t end up with permanent brain damage from inadequate cerebral blood flow.  Patients in cardiogenic shock may need an intra-aortic balloon pump (IABP) inserted to help with coronary artery perfusion and to decrease afterload which makes it easier for the left ventricle to pump out its contents and helps increase cardiac output. The Cardiovascular ICU usually sees patients post open heart surgery.  They may have had coronary arteries bypassed or have had a valve replacement or both.  They also see patients post-operatively from aortic aneurysm resections, peripheral artery bypasses, pneumonectomy (for lung cancer), heart transplant, and other vascular surgeries.  So the cardiovascular ICU is a post-surgical ICU, where as the Coronary Care ICU is a medical type ICU.  The skills required in a cardiac ICU can be transferred to care of other patients in other types of ICUs.  I work at West Penn Hospital and I float to the Cardiovascular ICU, Medical-Surgical ICU and the Burn Trauma ICU.
And, on some occasions, I work in the Neonatal ICU with premature babies or drug addicted infants.  I only go there when they are very short staffed, because I use to work full time in that unit in the late 1980’s, before some of you were born.

Yes, nursing is the heart of patient care and you should love it as a profession.  We stay with patients in their happiest times (after a birth of a child), and in the darkest of times (death of a patient).  I love nursing and I hope that you will too!!!

Picture from DUSON

Listen for the Music: Farewell Class of 2015

Dr. Kronk

Many years ago a young doctor who had worked in a hospital on the Navajo Nation was interviewed in a radio program.  He recalled an experience with an old Native American man with long braided hair who came to the emergency room one night. With clipboard in hand, the young doctor approached him and asked “How can I help you?”  The old man looked straight ahead and did not answer. Feeling impatient, the young doctor said, “I cannot help you if you don’t speak to me.”  “Tell me why you have come to the hospital.”

The old man then looked at him and said, “Do you dance?”  As the young doctor pondered the strange question, it occurred to him that perhaps the patient was a tribal medicine man who, according to the ancient tribal customs, sought to heal the sick through song and dance rather than through the prescribing of medicine.

“No,” said the doctor, “I don’t dance. Do you dance?” the old man nodded yes. Then the doctor asked, “Could you teach me to dance?”

The old’s man’s response caused much reflection. “I can teach you to dance but you have to hear the music.”

 

This interaction between the young modern healer with the aged and wise healer should give us much to ponder. Learning to dance without music can be awkward and unfulfilling. In contrast, as we hear the tempo, learning to dance with music is uplifting, joyful, and unifying. We learn the dance steps with our minds but we hear the music with our hearts.

As I read this story once again, my thoughts were especially turned towards the senior class who are graduating as healers in just a few short days. In nursing school, our minds acquire the many intricate dance steps that include the pathologies of acute and chronic diseases, knowledge of current treatments and interventions, and how to answer NCLEX questions.  But it is also my hope and belief that being a nursing student at Duquesne as well as being a member of DUSNA gave your heart the opportunity to hear the music of healing because the music takes us far beyond the things we do.

Hearing the music is the art of healing. It is the ability not to judge when judging comes so easily; the ability to understand unspoken words that so often come in moments filled with silence; the renewal we feel as we hand a newborn to their mother; the gratitude of a child when we feel our shift has been thankless; and the hope we can instill in a situation that most think is hopeless. The rhythm of healing can be complicated and tiring, but be patient and keep practicing. You are well prepared to bring harmony into the most challenging situations. So as graduation occurs and careers begin it is my wish to the class of 2015 that you can always hear the music!