Year of the Nurse: A Time for Global and Local Service

2010 has been declared Year of the Nurse by the Nightingale Foundation for Global Health, which is based in Great Britain. The idea for celebrating and honoring nurses grew after four years of discussions, planning and conferences with nurses around the world. The purpose is not only to recognize all that nurses do; it’s not just about patting them on the back for jobs well done. This initiative also calls for nurses to work harder toward the goal of a healthier world.

That means different things to different nurses, depending on what country you’re talking about.

In the United States, it could mean encouraging people to eat less, eat healthier and get into shape. Such measures can help reduce the incidence of type 2 diabetes, which is on course to break the bank in this country. It could mean pitching in at vaccination clinics or helping to clean and maintain wilderness trails.

In a third-world country, working toward a healthier world might mean helping a community obtain or maintain a clean water supply. It might mean securing mosquito netting to prevent illness or and helping to provide basic vitamin supplements to prevent blindness in kids.

The Nightingale Initiative for Global Health, according to the Web site, seeks to build a grassroots movement among nurses, health care workers, educators and other global citizens “who will work together to inform, educate and mobilize public opinion throughout the world towards the adoption of health as the universal priority…”

The initiative aims to use many tools to promote its goals, including high-tech communications, media and performing arts, among others.

Lastly, the initiative seeks to contribute positive solutions to the worldwide nursing shortage.

I’m seeing evidence of the initiative already at work right here in my community.

A group of nurses from a local hospital here in San Diego County, inspired by a recent presentation on the Year of the Nurse, delivered Christmas presents for a local charity to 150 children. They also plan to come into hospitals on their time off to provide “extras” for patients like shampooing hair and giving massages.
“This is about nurses stepping into the community and healing nationally and locally,” explained one of the involved nurses.

The Nightingale Declaration also includes a resolution to “to adopt personal practices and to implement public policies in our communities and nations, making this goal for the year 2020 achievable and inevitable, beginning today in our own lives…”

This might be the most difficult part of the resolution. It calls for some personal responsibility – a do-as-I-do attitude that will hold nurses accountable for being good examples.

Why the Declaration for Our Healthy World now?

Because 2010 is the 100th anniversary of Florence Nightingale’s death.

Until I did a little research (somehow we didn’t delve too deeply into her life when I was a nursing student, I had no idea this respected woman lived to be 90 years old, and just how revolutionary her ideas were. Born into a wealthy family, Nightingale didn’t have to give up her comfortable life and get her hands dirty and worse, but she was a woman with a mission: improve conditions and treatments for patients and change the roles and image of nursing.

Put in more contemporary terms, Nightingale was a “consummate health policy advocate who influenced the political leaders of her time…” and an “ardent environmentalist who changed conditions that caused disease,” according to the initiative Web site. She also was a global networker who corresponded with thousands around the world about furthering and promoting health issues. She was “an effective communications and media expert who impacted upon public awareness to change how people understood and valued health in her time.”

Our 21st century ‘global village’ can learn a lot from Ms. Nightingale when it comes to improving global health and living conditions, and nurses could and should be at the forefront of this movement.

You can learn more about the 2010 International Year of the Nurse / Centennial of Florence Nightingale at www.2010IYNurse.net .

If you want to sign the Nightingale Declaration for Our Healthy World – and so far, more than 20,000 nurses have – visit: https://www.nightingaledeclaration.net/declaration/healthy/.

Rapid Response Nurses: A Resource for Nurses, Families and Patients

An interesting story about nurses appeared in our local newspaper this morning.

It explained to readers about “rapid response” nurses and teams, whose goal it is to stop big trouble like Code Blues before they happen.

The teams give permission to floor and unit nurses to call for a second opinion when they feel there have been critical changes in patients that could lead to worse things, even though the nurses may not be able to pinpoint the problems exactly. In our area, all the major hospitals have rapid response teams -- one since 2006; another since 2007. One is just getting the team off the ground.

As one supervisor put it, the teams empower staff nurses to say, “Something just doesn’t seem right, but I don’t know what (it) is.”

These team nurses don’t just sit around and wait for the call; they are proactive. They will review the vital signs of every patient in the hospital at the beginning of the shift, looking for telltale patterns or small problems that could foretell of larger ones. They may troll the halls, dropping in on anyone at any time.

The teams also give credence to nurse-intuition, which can be a powerful thing sometimes. I’ve heard many stories from nurses who “had a feeling,” acted on it and saved a life. According to one chief of the medical staff, Code Blues at his hospital have gone from six or seven a month to an impressive one or two.

What also seems remarkable about these rapid response teams is that their services are available to patients and families. If either feels the need for reassessment, they, too, can call in a member of the team. According to one of the hospitals’ director of the Center for Nursing Excellence, there is increasing evidence that family members and patients can be a valuable resource because they know when things aren’t going as they should – perhaps before anyone else.

Giving this much “power” to patients and families might make some in the hospital very nervous, but in at least one of these institutions, no one is placing an emergency call to find out what happened to the lunch tray or to empty bed pans.

“What we’re finding is that, when patients are empowered, they don’t abuse it,” said one chief of staff.

Do you have a rapid response team in your hospital or medical center?

If so, how is it working?

Do you feel more confident knowing the team members are there?

Are the teams’ services available to patients?

Tell us about it.

Think About Changing Just One Patient At a Time

It looks like obesity is the new smoking.

According to a new study published in the Dec. 3 issue of the New England Journal of Medicine, the gains in the overall health status of Americans achieved from kicking the tobacco habit could be wiped out because of the growing numbers of overweight and obese people in this country.

"If smoking continues to decline at past rates and obesity continues to increase at past rates, obesity will win this horse race,” author Susan Stewart, researcher at the National Bureau of Economic Research in Cambridge, Mass., told the press recently.

This means that, over time, the negative effects of obesity will outweigh the positive consequences of the decline in the number of smokers. It’s enough to make health professionals – well, very discouraged. We are puzzled as to how to motivate people to eat less and move more.

It’s no news that Americans are getting heavier and it’s no secret why; we eat more and move less than in previous decades. Our lives have become more and more sedentary, and we have to put aside time to burn calories. We also eat worse. Americans consume a much greater amount of fast, fatty and processed foods than we did up through the early 1960s.

We all know that bad things happen when good people gain weight – then continue to gain more. Diabetes may be the worst consequence, both for the people who develop it and for our economy. Many experts have predicted that type 2 diabetes will be the super-villain that breaks the bank when it comes to keeping Medicare a viable program, especially since aging boomers are poised to enter the ranks of Medicare recipients within the next two years.

For decades, we have enjoyed an ever-increasing life span, but with the rise in obesity, that trend could actually begin reversing, according to the study.

The average life expectancy could soon be nine months less than the current ages of 75.7 years for men and 80.8 years for women. (In 1970, life expectancies were 67.1 and 74.7 respectively, according to the U.S. National Center for Health Statistics and the U.S. Census Bureau.)

It’s difficult for nurses and other health care professionals to obliterate disease when the disease is lifestyle-induced. We can’t make people change; it is largely out of our control. We must depend on our patients to do most of the work while we play a supportive role. So maybe we need to think in terms of motivating one patient at a time. We must encourage and educate and maybe scare people a bit, because the world of tomorrow, with so many sick and disabled people, will be a scary place.

Do patients ask you for help in changing their lifestyle habits?

Do you have any techniques for motivating people to lose weight and/or stop smoking?

How have your patients responded to suggestions about changing their lives?

Tell us about it.

Nurses Rise to the Occasion in Texas

Nurses don’t wish ill of anyone, but when the worst happens, we want to be there.

At least some of us do – like the nurses who were on duty Nov. 5 at Scott & White Hospital in Temple, Texas, where 10 of the victims of the Fort Hood shootings were brought as soon as they could be transported.

I’m sure that for these nurses, the Food Hood incident will be one of those defining moments of their careers. They’ll always remember where they were or what they were doing when the call first came that victims from the huge Army post would be arriving at their ER door.

Charge nurses and unit director Jessica Richter, RN, CEN, was hosting a baby shower for a co-worker during their break when she heard the mass-casualty call.

“Adrenaline is something ED nurses don’t experience often because we do this type of work every day,” she said in an interview, “but I felt it that day. Waiting for patients was agony. We just wanted to get them in here and take care of them.”

“It was amazing to see how quickly we could move,” ER charge nurse Lindsey Stonebrook, RN, BSN, CACP-SANE, recounted in an interview. “There were many unknowns, but you had to be ready. The first helicopter that landed with a patient made it all real.”

Reading accounts of the tragedy both fascinate and scare me. And, what’s more intriguing is that, according to Scott & White nurses, fear never entered their minds; they had the situation under control. There may have been some frayed nerves when it was all over, but it sounds as if the ER nurses did just what they were supposed to do. The ER was full, according to one account, so a triage team was quickly assembled to attend to less acute patients and all staff worked to get patients to their assigned rooms and clear the trauma bays. Excellent teamwork at its highest level!

Hospital security was called in and they instituted limited access to the 500-bed hospital to give ER staff every advantage and to keep the press and lookie-loos at a safe distance.

According to other nurses, the ER received and cared for these 10 victims with a process that went smoothly from beginning to end.

“I’ve been a nurse for 9 1/2 years, and I’ve never been involved in a mass casualty,” Richter added. “This was something I worried about after 9/11 and working so close to an Army base. But one thing that sticks out in my mind is how well our team pulled together …”

What’s the toughest situation you and your co-workers have had to face?

When the going gets tough, do your co-workers pull together?

What’s the best aspect of teamwork in your workplace?

Tell us about it.