Liz Holliday

Communications Specialist
Written Work

A Nurse Practitioner for Washington Heights: Yudelka Garcia finds her calling in her community

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Clinical Nursing Instructor Yudelka Garcia, FNP, showed interest in medicine at an early age while taking high school biology and anatomy classes’ in Washington Heights. While attending Cornell University’s pre-medicine track, however, she ended up switching majors to psychology after she felt the coursework focused more on treatment over patient care.

After six years working in research as a research assistant and coordinator, Garcia’s younger brother was tragically diagnosed with liver cancer at the age of 16. Late nights sleeping at his bedside at the Morgan Stanley Children’s Hospital of New York (CHONY) reminded Garcia of her passion for patient care. Garcia says it was the empathy and knowledge of her brother’s night nurses in the pediatric unit, most of whom were in their second careers, which inspired her to take a leap of faith and go back to school and enroll in Columbia Nursing’s Entry-to-Practice Program, which she completed in 2013.

From the sister of a patient, resident of the neighborhood, and alumni of Columbia Nursing, Garcia says she always felt a pull both toward health care and to the neighborhood of Washington Heights. So when a Clinical Instructor and Family Nurse Practitioner (FNP) position opened up at Columbia Nursing’s faculty practice, ColumbiaDoctors Primary Care Nurse Practitioner Group(link is external) (NPG) last fall, she jumped at the chance to “come home.” She says being from the neighborhood and speaking fluent Spanish, helps her to truly connect with her patients and her community.

What about your experience caring for your brother made you change careers to become a nurse practitioner?

My brother’s cancer diagnosis was a really tough time for my family. During that time it was so critical that one of us stay with him at all times. I started interacting a little more closely with the pediatric nurses at CHONY, and they were so wonderful. They were so helpful, knowledgeable, and caring. I think that’s the part that really attracted me to the profession.

I saw what was happening at the hospital, and I understood it. It wasn’t intimidating, and I was guiding my mother through the whole process. She would see all the tubes attached to my brother and get worried, and I was able to calm her down and explain what each tube was for and what it did. That’s when the idea of going back to medicine started. It’s been quite the journey, but I am very happy with it.

As an alum, what was it like to come back and take a faculty position?

I actually worked for Columbia at the New York State Psychiatric Institute before deciding to become a nurse, so I was already familiar with health system at the Medical Center. It was interesting because as a student, Columbia Nursing was a challenging program. It was very intensive, and we learned everything about nursing in a short amount of time.

It was overwhelming, but even then, it was such a good experience. My favorite part was always the clinicals, and when this opportunity came up, it was an interesting transition in the sense that it felt like I was coming back. So much of my time, and who I am today, is attributed to my experiences here at Columbia. It felt like a homecoming.

What is it like for you to bring accessible primary care directly to your neighborhood?

My entire family, about 80 percent of them, live within a 10-15 block radius of Columbia University Medical Center. This is part of the reason why I was so attracted to the opportunity at Columbia Nursing. I don’t see my family members as a practitioner, but I view every new patient as if he/she is my family member.

As for everyone in this neighborhood–I feel like I know their struggles. I know how difficult it is to find somebody who is a provider that they can relate to; someone who speaks their language, who they feel comfortable with. To have the opportunity to be that person for them, is extraordinary. I am very grateful for the opportunity to be in this position.

You are able to offer bilingual care. Why is that so important?

Anyone can hire an interpreter service, but there is a component of language that is not always translatable through an interpreter. A lot of the nuances or the tone get lost in the translation.

The highlight of my day is when I see a new patient who is from the neighborhood, who is a monolingual Spanish speaker, who has been looking for a primary care provider but hasn’t been able to find one. They come to me, and at the end they say how happy they are to have found this practice, and how friendly everybody is to them. That’s definitely important.

What does it mean to be a clinical faculty member?

We precept, which means a Columbia Nursing NP student comes to the practice and shadows me as I interact and diagnose patients. A lot of the hours for the FNP program are spent at the NPG practice, and we precept in terms of clinical skills. The student shadows me to see what visits are like and they see what it’s like to be in an outpatient clinical setting. They are able to grow and assess the patient, take the patient’s history, and participate in the treatment plan, which enhances their clinical skills. By the time they finish and almost graduate, they are as well prepared as they can be to take on the role of independent nurse practitioner.

Anything else you’d like to add:

The Nurse Practitioner Group(link is external) practice is the most driven and caring team that I’ve had the pleasure of working with. Starting from the front desk staff, medical assistant, nurse, to all of the providers, we all have the same goal. We want our patients to feel welcome, comfortable, and that we did our utmost to take of them.

The ColumbiaDoctors Primary Care Nurse Practitioner Group has three locations across New York City, and is in-network for NYP and CUMC employees. Its nurse practitioners are nationally board certified, and primary care services include performing annual checkups, coordinating behavioral health needs, helping manage chronic disease, treating injuries and illnesses, administering pre-travel vaccinations, house calls services, LGBT health services, women’s health, and more. For more information on how to book an appointment visit ColumbiaNPs.org or call 212-326-5705 today.

Columbia Nursing’s Marie Carmel Garcon Named Nurse Practitioner of the Year by The Nurse Practitioner Association New York State

New York, NY- Marie Carmel Garcon, DNP, Columbia University School of Nursing, has been named 2017 Nurse Practitioner of the Year, by The Nurse Practitioner Association(link is external) New York State (NPA). The award was presented to Garcon at the NPA’s 33rd Annual Conference on October 21st in Saratoga Springs, New York.

Garcon leads the House Calls services at ColumbiaDoctors Primary Care Nurse Practitioner Group(link is external), the faculty practice of Columbia Nursing, where she provides primary care directly to Washington Heights and Inwood residents who have difficulty leaving their homes.

“I want to give patients the best possible quality care in their home,” Garson said of the service. “It enables them to stay safe, happy and healthy, and that’s important to me.”

Garcon oversees her patients’ care as she would in a clinical setting, she sets up specialty visits—like X-rays or blood work– in her patients’ homes, and manages their overall care. She has been serving the Columbia University Medical Center community for more than 28 years, and, according to the NPA, Garcon is being awarded for her outstanding commitment to providing compassionate care.

“Dr. Garcon has extensive experience working on the front lines of intensive care and oncology units and is able to advocate for patients and their families giving voice to those who cannot speak for themselves due to illness,” the NPA said in a release(link is external). “Among her many noteworthy accomplishments over her 20-year career as a family nurse practitioner, Dr. Garcon established a support group for patients and families affected by pancreatic cancer.”

Stephen Ferrara, DNP, associate dean of clinical affairs at Columbia University School of Nursing and Executive Director of The NPA, said of the award, “As the role of NPs continues to evolve and expand, what remains is the constant commitment to evidence-based, compassionate, and high-quality care for all patients. Dr. Garcon lives by this commitment every day, through her hand-work, empathy, and spirit that she dedicates not only to her patients, but to her colleagues.”

The NPA has been recognizing Nurse Practitioner of the Year(link is external) since 1987.

First National Survey Published After 2016 Presidential Election Finds Gender Minorities’ Sense of Safety and Well-Being Impacted

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NEW YORK- The first quantitative analyses published on the outcome of the 2016 election on the LGBTQ community showed that participants reported high levels of election outcome-related concerns, including psychological and emotional distress, since the election.

“Terrified,” “scared,” and “shell-shocked” were some of the words that LGBTQ survey participants used to describe their reactions to the 2016 presidential election, Cindy B. Veldhuis, PhD, Postdoctoral Research Fellow, Columbia University School of Nursing and colleagues found.

The study entitled, “We Won’t Go Back into the Closet Now Without One Hell of a Fight: Effects of the 2016 Presidential Election on Sexual Minority Women’s and Gender Minorities’ Stigma-Related Concerns,” was published  in Sexuality Research and Social Policy.

The mixed-methods survey, which collected qualitative and quantitative data from online survey participants across the country who identified as sexual minority women and gender minorities, showed nearly 70 percent of participants reported having “moderately” or “much” higher concerns about their safety since the election, while 73 percent reported higher levels of sadness or depression, and 76 percent, of anxiety.

“What we found suggests the need for prevention and intervention strategies to ensure that marginalized and minority populations have support and effective coping tools to weather potential increases, or perceptions of increases in stigma, and to prevent such perceptions from becoming internalized and increasing risks for engaging in unhealthy behaviors,” Veldhuis said.

Participants were older than age 18, and identified as lesbian, bisexual, queer, same-sex attracted, transgender and/or non-binary. The researchers found participants who identified as queer or as other than lesbian or bisexual reported significantly higher fears for their safety compared to those who identified as lesbian. Those who identified as transgender reported significantly higher fears for their safety than those who identified as female. “My partner and I are more aware of where we should be publicly open about our relationship and where it is not safe,” one participant said of the post-election climate for the LGBTQ community.

“Coping with a stigmatized identity taxes emotional regulation and coping skills, which in turn leads to poor psychological health outcomes, and greater risk of engagement in negative health behaviors,” Veldhuis said.

The paper:(link is external) “We Won’t Go Back into the Closet Now Without One Hell of a Fight: Effects of the 2016 Presidential Election on Sexual Minority Women’s and Gender Minorities’ Stigma-related Concerns.” Other contributors are: Laurie Drabble, San José State University; Ellen D. B. Riggle, University of Kentucky, Angie R. Wootton, University of California San Francisco, Tonda Hughes, Columbia University School of Nursing, University of Illinois at Chicago. The authors declared no conflict of interest associated with this study. 

Motivational Interviewing: A Powerful and Practical Tool for Nursing and Advanced Practice Nursing

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Lora Peppard ’08 first heard about Motivational Interviewing (MI) in a psychotherapy course while pursuing her master’s degree to become a psychiatric nurse practitioner. The approach, which helps an individual find motivation to make positive decisions and accomplish established goals, is often associated with treatment for addiction. However, Peppard says the practice is quickly picking up traction in other areas of health care as well.

“Traditionally, nurses in medical fields are equipped with therapeutic communication skills when managing medical conditions,” Peppard, who currently teaches at George Mason University School of Nursing, said. “MI offers a different, supplementary communications approach that requires a shift in how we think about change and supporting patients in that change.”

Columbia University School of Nursing asked Peppard and her colleague at George Mason University, Patty Ferssizidis, PhD, to teach this wider-association to faculty and staff in an on-campus workshop at Columbia Nursing this past September. She says MI requires clinicians to meet the patient where they are mentally, and to work to advance their readiness for change.

“It can really be used by any clinician wanting to engage in a brief intervention with patients struggling with behavior change related to many medical conditions,” Peppard said.

In order for nurses to optimally engage in MI conversations with patients, Peppard says they must understand the rationale behind MI, including theoretical underpinnings, epidemiological data, and supporting evidence. According to Judy Honig, DNP, associate dean for academic affairs and dean of students, this skill is one that a lot of advanced practice nurses will benefit from having.

“MI is a powerful and practical tool that can be incorporated into nursing and advanced practice nursing,” said Honig. “It is a structured communication strategy that can be used in and adapted to any health care visit, especially when health behavior change is indicated.”

Which is why Columbia Nursing invited Peppard back to teach such core concepts of MI on October 27 at “The Path Forward in Cystic Fibrosis: Advanced Education for Nurses,” a day-long workshop hosted by Columbia Nursing, and sponsored by the Boomer Esiason Foundation and Johnson & Johnson TRU Heroes CF Nursing Program.

“In the case of cystic fibrosis (CF) treatment, the self-care regimen is very complex and time consuming,” said Honig. “The treatment burden on children, adolescents, and adult patients and their families is challenging.”

Honig explains MI’s use in CF care offers an opportunity to support patients by developing insight into why they might be ambivalent about a particular behavior, such as adherence to one or more pieces of their treatment regimen, assessing readiness for change, and supporting the patient in development of their own plan to make that change if appropriate.

“MI is important in helping CF providers to assess and encourage adherence to the demanding requirements of CF therapies,” she said. “In particular, nurses in CF care are in a pivotal position to facilitate self-care and treatment adherence. MI provides a framework for successful adherence.”

Peppard agrees, and says that when dealing with CF, supporting patients’ self-management strategies is extremely important in promoting adherence to treatment in patients trying to balance multiple associated responsibilities. “Treatment regimens are often multi-faceted, and the literature shows varying adherence rates attached to each component,” Peppard said. “MI offers an opportunity to support the patient by facilitating insight into their behaviors and eliciting their own intrinsic motivation for change, which can be extremely powerful.”

MI should not be under-valued, according to Peppard. And while an infrastructure exists for MI delivery, essential communication skills, requiring some finesse around how to have these conversations with people, are necessary to effect or facilitate change. “It has now become a skill I use frequently in numerous situations.”

Are you a nurse looking to learn more about the path forward for Cystic Fibrosis? Columbia Nursing is hosting an advanced education for nursing conference on October 27th from 8AM-5PM, sponsored by The Boomer Esiason Foundation and the Johnson & Johnson TRU Heroes Cystic Fibrosis Nursing Program. Register here(link is external).  

Peace Corps Science Teacher, Village Nurse, and Everything In-Between: Columbia Nursing’s Faculty Profile of Ana Kelly

Columbia Nursing’s Faculty Practice Launches New House Calls Service, Fulfills Need in Community

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Marie Carmel Garcon, DNP, has worked at Columbia University Medical Center (CUMC) for the past 28 years. From the ICU, dealing with infectious diseases, even working with dialysis patients, the newest nurse practitioner (NP) to join ColumbiaDoctors Primary Care Nurse Practitioner Group says she’s seen it all in the hospital setting. In fact, it was after she noticed something missing when checking-in with patients after discharge that compelled her to take her new job extending primary care inside a patient’s home.

“I realized that a lot of the patients I talked to who had been released from the hospital could not leave their homes and needed help with follow-up care,” Garcon said. “Knowing this, I didn’t feel as though my mission was fulfilled.”

This gap between hospital and community is something Columbia Nursing’s faculty practice, ColumbiaDoctors Primary Care Nurse Practitioner Group, fills with their new house calls practice. The new service, which launched on May 15, allows the Nurse Practitioner Group to offer primary care services directly in the patients’ homes who need it most.

“That is what I am interested in,” Garcon explained. “I want to give patients the best possible quality care in their home. It enables them to stay safe, happy and healthy, and that’s important to me.”

The service is for those who have difficulty leaving home, and who need comprehensive, in-home primary care—including chronic disease management and follow-up care after hospitalization. The goal is to provide clear, comprehensive and actionable treatment plans within the comfort of a patient’s home.

“Our house calls service is essentially the care that is being provided in a healthcare provider’s office,” said Stephen Ferrara, DNP, associate dean of clinical affairs at Columbia University School of Nursing who oversees the practice. “It could very well be adjusting medication for a patient’s high blood pressure or ordering lab services to draw blood or take an X-ray in the home setting.”

Until the 1940s, the majority of primary care in both the US and UK took place in the home(link is external). Even into the 1960s, 40% of doctor-patient meetings(link is external) still took place in a patient’s home. However due to increased specialty in patient care and an increased dependence on technology, the practice dropped to .6% by 1980(link is external).

Thanks in large part to Medicare’s increased reimbursement for a house call by nearly 50%(link is external) in 1998, the practice has yet again seen rises in recent decades. In fact, studies show that it is Nurse Practitioners who are predominantly providing this service, offering 1.13 million home visits in 2013, (link is external)surpassing the 1.08 million house calls made by internal medicine doctors. However, despite house calls services being available in parts of New York City today, Ferrara says the coverage still does readily not exist in Washington Heights. Until now.

“There is a lack of primary care in the Washington Heights area and the Nurse Practitioner Group increases access,” Ferrara said. “In such a densely populated neighborhood, there is no reason why we can’t take what we do in the office setting at our primary care office on 168th street, and take it to patients’ homes who need it.”

Ferrara clarifies that this house calls service should not be confused with home health care, which often helps with light chores or meal preparation from a home health aid or wound care performed by a Registered Nurse. He explains this is primary care from a board-certified NP, and that not everybody will be eligible for the new service. While some house calls providers offer ‘concierge’ type care for bedside service, the Nurse Practitioner Group’s house calls will focus on those who are unable to leave their homes due to health issues.

“We want to reach patients who are underserved or are health disparate,” Ferrara said. “We’re asking, ‘how can we make the patient healthier?’ We know ultimately that people who do not have access to health care tend to be sicker and there are things we can do to help prevent complications or hospital readmissions.”

While the service is listed on the practice website(link is external) with an 800 number to call for care (888-264-8606), most of the anticipated patients will come through institutional referrals, according to Ferrara.

“We partner with the medical institutions, with rehabilitation facilities, and the short stay nursing homes,” Ferrara said. “We want to work with discharge planners, and act as a way to transition patients from those facilities to their homes.”

For now the service is only available for homebound qualified(link is external) patients living in the Inwood and Washington Heights area. As for Garcon, in addition to increasing primary care access for the homebound population, she is most excited to show her patients how much she cares.

“I can see that sometimes homebound patients are lonely, sometimes they feel isolated,” she said. “If they can’t work and are stuck at home, they may feel like society is no longer interested in them. But I want them to know that I am interested, and there is somebody to care for them.”

ColumbiaDoctors Primary Care Nurse Practitioner Group(link is external) offers primary care services at three locations (link is external)in Manhattan including Midtown Manhattan, Morningside, and Washington Heights. If you think you know someone who is qualified and would benefit from the Nurse Practitioner Group’s house calls service, please call 888-264-8606 or visit www.ColumbiaNPs.org(link is external) for more information. 

Support to Practice Independently Helps Nurse Practitioners Deliver Ongoing Primary Care to Patients

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New York, NY (September 5, 2017)–Nurse practitioners (NPs) whose healthcare organizations supported their practice as independent clinicians, were more likely than those who worked in less supportive environments to have their own patient panels (groups of patients to whom they delivered ongoing primary care), researchers from Columbia University School of Nursing report.

Results from a quantitative, cross-sectional survey indicate that NPs needed access to organizational resources and supports to be able to deliver ongoing continuous care to their patients, such as physicians’ support of their patient care decisions, staff help in preparing patients for visits, and the freedom to apply their knowledge and skills to patient care.

“These aspects of the NP work environment allowed NPs to serve as primary care providers for their patients,” said lead author Lusine Poghosyan, PhD, and assistant professor of nursing at Columbia University School of Nursing. “The findings suggest that work environments that support NPs’ independent practice may be important factors in meeting the nation’s growing need for primary care.”

To investigate the role that NPs play in healthcare delivery, and to understand how work environments affect this role, Poghosyan and colleagues surveyed 807 NPs who were listed in the Massachusetts Provider Database as delivering of primary care. In addition to NPs’ role in care delivery, the survey measured NP work environment, and demographics.

To measure NPs’ role in care delivery, researchers asked NPs to report whether they had their own patient panel to whom they delivered ongoing continuous primary care. To measure NPs’ work environment, researchers used the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP- PCOCQ), which asked NPs to rate certain characteristics of their organizations, including their relationships with physicians and administrators, the support they received to practice independently, and their visibility within their healthcare organizations.

The survey also collected information on demographics and work characteristics of NPs, including their age, sex, education, years of work experience, and the location, type, and size of their practice.

A total of 314 NPs from 163 primary care organizations participated in the survey. Most (96 percent) were female. About 45 percent of the respondents, most of whom worked in community health centers, reported having their own panel of patients to whom they provided ongoing primary care.

Notably, support for independent practice was the one dimension of NPs’ work environment that had a significant positive effect on their role in care delivery. According to Poghosyan, “With one unit increase on the organization-level Independence Practice and Support (IPS) subscale score, the incidence of NPs serving as primary care providers with their own patient panel almost doubled.”

The paper entitled “Nurse practitioners as primary care providers with their own patient panels and organizational structures: A cross-sectional study,” was published in the September 2017 issue of International Journal of Nursing Studies(link is external). Other study contributors are Jianfang Liu, Assistant Professor of Quantitative Research and Allison A. Norful, Postdoctoral Fellow, also from Columbia University School of Nursing.

This study was supported by the Robert Wood Johnson Foundation, Agency for Healthcare Research and Quality, and the National Institute of Nursing Research (NINR).

The authors declare no financial or other conflicts of interest.

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Columbia University School of Nursing is part of the Columbia University Medical Center, which also includes the College of Physicians & Surgeons, the Mailman School of Public Health, and the College of Dental Medicine.  With close to 100 full-time faculty and 600 students, the School of Nursing is dedicated to educating the next generation of nurse leaders in education, research, and clinical care. The School has pioneered advanced practice nursing curricula and continues to define the role of nursing and nursing research through its PhD program which prepares nurse scientists, and its Doctor of Nursing Practice (DNP), the first clinical practice doctorate in the nation. Among the clinical practice areas shaped by the School’s research are the reduction of infectious disease and the use of health care informatics to improve health and health care. For more information, please visit: www.nursing.columbia.edu.

Columbia Nursing’s Mentoring Program with NewYork-Presbyterian Chooses First Cohort

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When clinical nurse Monika Tukacs, BSN, RN, received an email last spring about a brand new research fellowship program that pairs NewYork-Presbyterian Hospital (NYP) nurses with faculty from Columbia University School of Nursing, she knew she couldn’t pass up the opportunity to apply.

“This program is revolutionary,” Tukacs said. “Learning from the Columbia Nursing faculty will allow me to become more familiar with research, both in conducting it, and in publishing a study.”

Tukacs is one of five inaugural fellows chosen to participate in the competitive two-year program, called The Academic-Practice Research Fellowship. The Fellowship advances formal relationships between Columbia Nursing and NYP, where NYP nurses gain formal guidance and mentorship from Columbia Nursing faculty and staff across a spectrum of scholarly activities.

“As nurses, the education should never end,” said Eileen Carter, PhD, RN, who holds a joint appointment at NYP and Columbia Nursing as an assistant professor and nurse researcher. “Education and learning doesn’t stop when you leave nursing school. It needs to be viewed as a journey, involving a lifetime of education—we hope this fellowship will serve as part of that journey for NYP nurses.”

Carter helped to spearhead the Fellowship, which hopes to address well-documented barriers that impede professional nurses’ ability to conduct research, by offering support needed to conduct clinically meaningful studies. To apply, nurses were asked to write a one-page paper on the aims of their proposed research project. The main goal for the application: to get a sense of what topic the individual is interested in, and how they can address it through research.

“Nurses have an incredible perspective because of the nature of their work, and how close they are to their patients,” Carter said. “This program is great in its ability to recognize nurses who have that perspective, and allows them to take their ideas and run with them.”

Columbia Nursing formed a subcommittee of peers at NYP that independently voted on the proposed project, how important it is to the nursing profession, to patient care, and if it is feasible to complete in two years. Carter says that the five out of 15 applicants chosen could not wait to get started.

“You could see that they were really excited,” Carter said. “And not just about the fellowship program, but about this cultivation of relationships between NYPH and Columbia Nursing.”

It isn’t only the NYP fellows who are excited about this program, according to Columbia Nursing Assistant Professor and Fellowship Mentor Ana Kelly, PhD, RN. She says Columbia Nursing faculty members will have a lot to learn from the experience as well.

“This is an excellent opportunity for me to stay connected to the clinical setting,” Kelly said. “Often the only time academic nursing programs partner with nurses actively working in the clinical setting is to secure clinical site placements for their students.”

More so, Kelly says the Fellowship builds important and mutually beneficial ties between Columbia Nursing and NYP.

“This model for collaborative nursing research will provide additional benefits at both institutions,” Kelly said. “Most notably–keeping faculty up-to-date on clinical changes which they can pass on to their students, and providing an avenue for clinical nurses to advance influential hospital policy through research.”

Research topics from this first group of fellows will range from improving psychiatric care, improving medication communications, reducing nurse stress, reducing patient delirium, and more.

“Empowering these nurses to address a clinical issue that they have identified as a priority is key,” Carter said. “So is educating nurses on how to do research that is rigorous, in an academic way, to ensure it is most impactful for the future of improving patient care and the nurse work environment.”

Tukacs’ research project will look at identifying Adult Extracorporeal Membrane Oxygenation (ECMO) extubation readiness in intensive care. ECMO, also known as extracorporeal life support (ECLS), is an adaptation of cardiopulmonary bypass technique providing cardiac and/or pulmonary support to patients whose heart and/or lungs are unable to provide adequate gas exchange and/or perfusion to sustain life.

“This will be a qualitative in-depth interview study. We will conduct focus group interviews of ECMO experts during the 28th Annual ELSO Conference in Baltimore, and compare results to literature and evidence-based practice,” Tukacs said. “This is a phenomenal opportunity.”

In order to complete this project in two years, Tukacs will receive support in research methods, mentorship in carrying out a research protocol from study design to study completion, statistical consultation, and hands-on guidance in disseminating study results in the form of publication.

“The support and guidance I will receive in conducting a study, from formulating a good research question to disseminating the study results in a peer-review journal, is priceless,” she said.

As for Carter, she says everyone she has talked to about the program has expressed nothing but excitement for this new partnership. Carter also noted that this partnership would not have been possible if not for several nurse leaders at Columbia Nursing and NewYork-Presbyterian including, Columbia Nursing’s Dean Bobbie Berkowitz, PhD, RN, Associate Dean of Scholarship & Research Elaine Larson, PhD, RN, NewYork-Presbyterian’s Director of Nursing Research and Innovation Reynaldo Rivera, DNP, RN, Assistant Dean of Nursing and NewYork-Presbyterian’s Senior Vice President, Chief Nursing Executive and Chief Quality Officer Wilhelmina (Willie) Manzano, MA, RN, and NewYork-Presbyterian/Columbia University Irving Medical Center’s Vice President and Chief Nursing Officer, Courtney Vose, DNP, RN. If successfully implemented in its first two years, Carter says she hopes to expand to all six NYPH campuses as well as expand the types of mentorship offered.

“Right now it is centered on research,” Carter said. “But I could see this expanding to education, for example. We could look at what issues nurses are facing in hospitals, and then have that information inform the nursing curriculum at the school. This has the potential to become a continuous feedback loop.”

For more information on the Academic-Practice Research Fellowship program, contact Eileen Carter, PhD, RN at EIC9019@NYP.org(link sends e-mail) or Reynaldo R. Rivera, DNP, RN, at RRR9001@nyp.org(link sends e-mail).

The Future of Nursing is Global Commitment: Columbia Nursing’s Jennifer Dohrn on Building Partnerships that Foster Global Nurses

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Jennifer Dohrn, DNP, had a previous life and a Bachelor of Arts degree in History before she discovered her love of nursing and midwifery and global health equity. Currently the director of Columbia Nursing’s Office of Global Initiatives, she says it was the birth of her own children that unearthed her drive to become a midwife. She went on to get a nursing degree, entered Columbia Nursing’s master’s program in midwifery, and also received her Doctorate in Nursing Practice from Columbia Nursing.

Dohrn currently oversees the collaboration between Columbia Nursing and Columbia Global Centers and leads the Columbia Nursing World Health Organization (WHO) Collaborating Center for Advanced Practice Nursing and is also an associate professor. She previously served as the program director of the Nurse Midwifery program at Columbia Nursing, and as project director for the ICAP Nurse Capacity Building Program/Nursing Education Partnership Initiative Coordinating based at Mailman School of Public Health. There, she worked with countries to improve the quality, quantity and relevance for nurses and midwives in 12 Sub Saharan African countries in the midst of the HIV pandemic.

She returned to Columbia Nursing four years ago to help build the newly created Office of Global Initiatives, in an effort to lay out a more comprehensive plan to transform nursing education to prepare graduates for relevance and leadership in global health.

What first made you interested in global health?

I have always considered myself a global citizen. I grew up in an age of great upheaval in the world of national liberation movements—the black power movement, women’s rights, etc., so my first consciousness was always thinking globally.

When I finally found my true calling in nursing, I was lucky enough to be hired immediately after I graduated. I worked to build the first birthing center in an inner-city community in the country. I spent 20 years building, working, and thriving in the Southwest Bronx community, serving a very diverse population of women who did not have access to high quality care. Looking back, it was a true mosaic of how global American life is and can be. We had women from all over the world resettled in the Southwest Bronx, a very impoverished community, building their lives and their families. It was an example of how global this country truly is. The birthing center also demonstrated a successful model led by nurse-midwives for care for women and families.

When did you take that global lens and apply it to nursing outside of the US?

My own personal life lead me to start working as a midwife in South Africa, when my husband was killed there while working on the new constitution with Nelson Mandela. I always felt that part of our journey was to be there.

I started going back to South Africa in 2003 while still on faculty at Columbia Nursing. I ended up being in the middle of the HIV pandemic. I saw midwives working on the front line, midwives dying, families dying, women dying. I had never imaged what it was like to be in a pandemic that seemed to have no end. From then on I have never looked back.

I’ve spent the last 14 years finding roots, connecting, and being very fortunate to look at how midwives can make great changes. In 2010, nurses in South Africa got the legal right to prescribe anti-retroviral treatment for HIV. Seven years before there had been no medications, and now nurses were actually on the front line, managing treatment. What a victory, and you know what happened? Mother to child transmission was reduced to less than 10 percent. Thousands of clinics opened, which allowed people to initiate treatment earlier, and it changed the face of the pandemic. Many factors came together, but certainly giving nurses and midwives the ability to manage HIV care changed and turned that epidemic around.

What was the driving force behind your decision to agree to help build and lead the Office of Global Initiatives here at Columbia Nursing?

In my career I have watched educational programs for nurses transform in many ways. Faculty earn higher degrees, learn to use simulation labs as a method of teaching, have nursing counsels expand scopes of practice, and many more nurses and midwives enter and graduate from nursing and midwifery schools with higher numbers and strengthened capacities. What could be better?

The opportunity to build the Office of Global Initiatives was just a natural fit for me. It allowed me to take things I had seen, people I knew, relationships I had built, and say, ‘yes I want to be a part of this journey for Columbia University School of Nursing.’ The goal is to transform and frame education in a global lens. We must be responsive to the global community.

In July, your office will host the third and final Global Nursing and Midwifery Clinical Research Development Initiative Summit in Amman, Jordan. What do you hope to accomplish?

This Summit has the potential for great contribution in improving global health outcomes because it focuses on clinical research being done around the globe by researchers directly impacted by the issues they study. For example, 65 million of people have been displaced and are now in a refugee or migrant situation in this world. What do they need for best care? What research should we be doing? How can we come together with people in these affected countries to find answers to the significant humanitarian and health crisis’ happening at this very moment?

People in Southern/Eastern African and Eastern Mediterranean regions are doing stellar research that directly impact their communities and have serious global implications. However we noticed that such researchers often do not have the support they need. Our goal is to connect, collaborate, and produce research that will have lasting outcomes.

After all, as a clinician at heart, I know that we cannot have our best practices if we don’t have evidence and research to back them up.

Finally, why is it important to foster global nurses in today’s society?

I think technological advances have certainly transformed the need for the nursing profession to see itself as global. Now to be a nurse, you have to understand what nursing is like everywhere. Ebola certainly taught us that. At the time, there were big pronouncements that Ebola would never come to the United States, and a week later, Eric Duncan got on a plane from Liberia, went to Dallas, and unfortunately did not receive appropriate diagnosis and treatment for Ebola and died. That was certainly an awakening that viruses do not know borders.

My goal in teaching students at Columbia Nursing is to teach global health equity. Entering this profession we have an ethical and moral responsibility to deal with injustice and disparity. That means here and that means everywhere. We need to get rid of this concept of us versus them. When it comes to global healthcare, we are all in this together.

Columbia Nursing Alum Martha Cohn Romney ’81 Receives Columbia University Alumni Medal

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Martha Cohn Romney ’81, JD, MPH is one of 10 individuals to earn the highest honor bestowed by the Columbia Alumni Association (CAA) for distinguished service to the University this year. Known as Marty to her friends, she says earning the title of 2017 Columbia University Alumni Medalist came as a big surprise.

“I actually thought I was being contacted to join a CAA Committee—which I would have been pleased to join,” Romney said. “It never entered my mind that I had been nominated to receive the Alumni Medal. Immediately thereafter I felt and will always feel very humbled.”

The award has been given by the University since 1933, and Romney is the 15th alum from Columbia Nursing to earn the distinction. According to the CAA website all recipients must be a Columbia alumnus and also have sustained active, substantial, and enduring participation in the CAA for at least 10 years to qualify.

According to Reva Feinstein, associate dean for development and alumni relations at Columbia Nursing, Romney meets these qualifications and more.

 “Marty is gracious, positive, and has a wonderful, wry sense of humor,” Feinstein said. “She also usually says ‘yes’ when asked to get involved.”

In recent years Romney has helped to organize a University-wide summit on Ebola, led numerous alumni board and committee meetings, delivered congratulatory remarks at Columbia Nursing’s graduation, served on the board of the Columbia University Club of Philadelphia, and attended countless events with alumni and students. According to Feinstein, her dedication to the school has not gone unnoticed by the majority of her peers. “Columbia Nursing alumni leaders were clamoring to collaborate with our office to nominate Marty for this distinction,” she said.

Romney graduated from the masters of science program in the pediatric nurse practitioner track at Columbia Nursing in 1981. In addition to serving Columbia Nursing’s Alumni Association Board since 2007, she served two terms as the school’s representative to CAA’s Board of Directors, including participating on the initial and current CAA Strategic Planning Committee. From her very first meeting she says she knew it would be an extremely rewarding experience.

“My greatest joy in being selected to receive the Alumni Medal is the ability to represent Columbia Nursing,” Romney said. “I am so very proud to have attended Columbia Nursing and to be a member of the school’s alumni community. Anything I can do to support and bring awareness and recognition to the school is a privilege.”

Romney says she appreciates all of the opportunities her time at Columbia Nursing offered her. She credits the guidance and assistance from the Columbia Nursing Development and Alumni Relations staff, Nursing School alumni, and CAA staff for enriching both her professional and personal life in many ways.

“Through my involvement in alumni, school and university events, my knowledge and insights about changes in nursing education, practice research, and policy as well as our opportunities to improve the health of our populations have expanded” she said. “As nurses we have an impact on improving health and quality of life through educating individuals and communities, providing access and delivering quality and cost-effective preventive care and treatments, and informing health systems and the existing legal/regulatory infrastructure about value and evidence-based interventions, and policies and initiatives to address the social determinants of health locally, nationally, and globally.”

She recommends all alumni consider becoming involved in the school. “Columbia Nursing has a long and significant history,” Romney said. “We are members of a global alumni community of intelligent, passionate, accomplished and visionary healthcare professionals with whom we can engage, collaborate and celebrate.

“We have the opportunity to enrich our professional and personal lives through networking and participating in the multidisciplinary and diverse initiatives and programs offered by the Nursing School as well as Columbia University,” Romney said.

No matter where you’ve landed after your time at Columbia, she says every alumni is welcome and encouraged to participate and support our students and our alma mater. “Why wouldn’t you want to take advantage of such a rewarding experience?,” she said.

Receiving the Medal includes a series of events and honors from the University, including being honored at the pre-Commencement Trustees’ breakfast at Low Library on May 17, and marching at the Columbia University Commencement with President Bollinger and other Trustees. She will also be featured at the Medalist Gala in October 2017 in tandem with Columbia Alumni Leaders Weekend, where Romney will also be featured in a video interview that will be shown at the gala.

Romney is currently an assistant professor at the Jefferson College of Population Health at Thomas Jefferson University in Philadelphia where she conducts public health and health services research and teaches in the Masters of Public Health and Population Health Science Doctoral programs.

Read Martha Romney’s full bio, along with the bio of all other 2017 Columbia University Alumni Medalist here. Find out how you can get involved as an alum here

2017 Distinguished Alumni Awards Honors Extraordinary Alum

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Columbia Nursing alumni influence the delivery of health care, establish innovations in nursing education, and conduct groundbreaking research throughout the country and world. Each year, these outstanding individuals are honored as Distinguished Alumni for their professional achievements, service, and influence in healthcare.

This year’s awardees were presented at the 2017 Alumni Reunion on May 5, by the co-chairs of the Distinguished Alumni Awards committee, Joan Hagan Arnold ’69 and Angela Clarke Duff ’70.

“My time at Columbia Nursing was transformative, fueling a vision for the greater good, instilling an insatiable hunger for moving beyond my clinical practice into somewhat unconventional domains to mentor students,” said one of this year’s Distinguished Alumni awardees Lora Peppard ’08.

“I am one of only a few nurse scientists in the country with an active informatics research program that I integrate into my teaching in the classroom,” said another of this year’s winners, Rebecca Schnall ’09, who is now the Mary Dickey Lindsay Assistant Professor of Disease Prevention and Health Promotion at Columbia Nursing. “I feel blessed to have been given the opportunity to be a student at Columbia Nursing and am equally fortunate to serve in my current role where I can help develop future distinguished alumni.”

Another of this year’s winners, Dr. Jesus Casida said, “I am very thankful for this honor and I will forever hold Columbia Nursing in my heart.”

Columbia Nursing is proud of all of its extraordinary alumni. All nominee submissions are reviewed over the course of several months by the committee. As Arnold told Columbia Nursing before last year’s ceremony, “We wish we could acknowledge everyone, but in the end, we come to a unanimous decision.”

This year’s members of the Distinguished Alumni Awards Committee include: Sarah Sheets Cook ’05, Patricia Dykes ’04 , Chana Engel ’06 ’09, Rachel Lyons ’07, Maureen Murphy-Ruocco ’80. A full list of past distinguished alumni awardees can be found here, and pictures from the all of reunion can be found here(link is external).

Learn more about this year’s winners below:

Award in Nursing Research: Rebecca Schnall ’09

Dr. Schnall ‘09 is an exemplary nurse scientist and informatician.  She has an impressive and varied educational background from Northwestern University, University of Illinois at Chicago, Pace University and Columbia University School of Nursing where she received her PhD.  She has compiled a rich research program focused on the intersection of informatics and quality of care in systems, clinicians and patients.  In the eight years of her post-graduate research, Dr. Schnall has been awarded more than $10 million dollars in funding from multiple federal sources, including a current $7.5 million award, the largest one ever received at Columbia Nursing.

Dr. Schnall’s focus on the use of informatics to improve the quality of systems of care, support for clinicians and ways to improve patient outcomes, demonstrates an elegant use of new technical modalities and knowledge to improve nursing care for patients, especially those with HIV/AIDS.  Dr. Schnall’s commitment to HIV/AIDS is longstanding, and her program of research is characterized by its solid theoretical foundations and rigorous and innovative mixed methods.  Her mixed methods studies have resulted in greater understanding of the information needs of consumers/patients, clinicians, and case managers as the foundation for design of Web-based and mobile applications with demonstrated impact.  Some of these efforts include improving HIV-preventative behaviors in adolescents using mobile information technology, and a ‘smart’ pill box for people with HIV/AIDs to improve their adherence to antiretroviral therapy.  Not only does Dr. Schnall utilize multiple theoretical bases to inform new perspectives in her research, but she also involves experts in these areas to promote interdisciplinary collaborations.

In addition to her research efforts, Dr. Schnall is known as an expert and engaging teacher.  She mentors all levels of students, at Columbia Nursing as well as those from other health care disciplines such as public health, infectious disease and biomedical informatics.  Likewise, her academic contributions are multiple and distinguished. She has placed more than 65 peer-reviewed publications in top journals, as well as multiple presentations, podcasts, book chapters, computer applications and tools.  Dr. Schnall is a sought-after reviewer for many professional journals, especially those related to informatics and quality of care. Accomplished on many levels, Dr. Schnall is a stellar Columbia alum and distinguished nurse researcher.

Award in Nursing Education: Lora Peppard ‘08

As an eminent leader in nursing and academe, Dr. Lora Peppard ’08 is an outstanding educator.  She views pedagogy through clinical and scholarly lenses that prepare students, faculty and community partners to implement evidence-based, behavioral health practices in pursuit of sustainable integrated care models. Her clinical experience includes inpatient, emergency and outpatient psychiatric settings, and she develops, implements, and leads innovative programs for underserved, military and mental illness populations.  After graduating from Columbia Nursing’s Doctor of Nursing Practice (DNP) program, Dr. Peppard joined the faculty of George Mason University. As the first faculty member with a DNP degree, Dr. Peppard helped shape the school’s DNP Program and became its Director from 2012-2015.  In 2013 she also became the Director of Behavioral Health Services for the Mason and Partners Clinics. In 2016, she was promoted to the rank of Associate Professor.

Dr. Peppard is a Project Director for two grants from the Substance Abuse and Mental Health Services Administration. Totaling nine million dollars, the grants support research related to reducing substance abuse and fatal drug overdoses.  Her innovative project -using participatory research methodology and service learning- provides an immersion experience for students that allows them to experience the impact of research on health care outcomes.  Students in the project participate in writing proposals, the implementation of the project, policy development and evaluations.  Dr. Peppard builds strong collaborations among the team and mentors each member.  She serves as a consultant to a variety of community and college-based initiatives, and has presented in multiple venues and written publications including case studies, articles and book chapters on developing and sustaining integrated care and other health care models.

In 2016, Dr. Peppard received the Leadership Excellence Nurse Educator Award from the Virginia Nurses Association. She was also a recipient of its 40 under 40 Award in 2015.  Dr. Peppard received a Master Teacher Award from the College of Health and Human Services, George Mason University in 2013. Dr. Peppard holds a bachelor’s degree in Business Administration from Wesleyan College, a master’s degree in Advanced Practice Psychiatric Mental Health Nursing from Boston College, a DNP from Columbia University and is a PhD candidate at George Mason University.  Dr. Peppard is a distinguished nurse educator inspiring teacher, noted mentor, expert in curriculum design and innovative teaching methodologies, illustrious researcher and significant contributor to nursing education and nursing science.

Award in Nursing Education, Jesus Casida ’96

Dr. Jesus Casida ’96 is an extraordinary teacher who has demonstrated his remarkable skill in nursing education across both clinical and academic settings for nearly two decades.  He has a      gift for mentoring students and orienting nursing staff, and has an ability to develop interdisciplinary programs and standards in the clinical setting, which has stimulated his pursuit of an academic career in health care education.  He earned his PhD from Seton Hall University in 2007.

Dr. Casida’s expertise is grounded in his real world knowledge of clinical experiences, and an intuitive sense of what is essential to build effective layers of learning for students.  He pioneered full fidelity simulation as a teaching strategy in the acute and critical care courses at Seton Hall University and at Wayne State University, paving the way for its use now customary in colleges and schools of nursing nationwide.  He revised six courses for undergraduates, masters and doctoral students at Wayne State and the University of Michigan where he also reviewed the nursing curriculum and led the restructuring of basic sciences and clinical nursing foundation courses, resulting in improved outcomes for student learning. He also revised the school’s pharmacology course, focusing on the deficits and challenges of students, thereby insuring safer medication administration and better understanding of side effects.

Dr. Casida was appointed to lead an undergraduate honors program at Michigan for exceptional students. He refined the coursework and actively engaged students in scholarly and leadership activities.  The results were transformative, and he gained prestige within the university and at other schools nationally.  His innovative teaching and positive influence on undergraduate curriculum helped support his selection as a Robert Wood Johnson Foundation Nurse Faculty Scholar in 2009. Students and faculty have honored him with awards in Excellence in Teaching for his outstanding effectiveness as a mentor, teacher, and inspiration as a role model.

Dr. Casida’s scholarly excellence has been recognized by many publishers, particularly in simulation and critical care nursing.  He is an accomplished nurse researcher whose proposals have generated considerable financial grants for studies involved with tech devices for cardiac patients’ self-management, among other projects.  Dr. Casida exemplifies the ideal qualities of an academic nurse leader in the 21st century, for his passionate commitment to nursing education, science, practice and to his students.

 

How Columbia Nursing’s Arlene Smaldone Fulfills a Lifelong Passion to Help Foster Future Nurse Scientists

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It was a nurse who served in War World II that first inspired Arlene Smaldone, PhD, assistant dean of scholarship and research to enter the field of nursing. The nurse, who also happened to be her aunt, was the only person in Smaldone’s family to go to college. She said she knew as early as high school that she would one day follow in her aunt’s footsteps.

Now a nurse scientist, Smaldone says that back then, she never dreamed she’d be pursuing research and mentoring predoctoral nursing students. She spent many years working in clinical roles before returning to school to continue her education, and did so only after her youngest child graduated from high school. She decided to pursue PhD education at Columbia University School of Nursing, and went on to complete a postdoctoral training in behavioral research at the Joslin Diabetes Center and Harvard Medical School.

She currently directs the PhD program at Columbia Nursing, and also leads the Interdisciplinary Education Project for the Health Resources and Services Administration (HRSA) funded Faculty Development in General, Pediatric, and Public Health Dentistry program. Smaldone’s research centers on self-management of youth and adults with chronic health conditions. Her current research projects are funded by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and HRSA. A recently completed project was funded by the National Institute of Nursing Research (NINR).

Describe your role at Columbia Nursing.

My administrative role at the school is directing the school’s PhD program. That involves overall management and oversight of the program and its curriculum, and recruitment of students. It’s important to evaluate and revise curriculum on an ongoing basis to be sure that our program meets the needs of future nurse scientists.

In addition, I teach a course called “Translating and Synthesizing Evidence” to our PhD and DNP students. It’s a course about reading and appraising the literature. One of the things I try to do is to help students understand how to think critically about published research and its application to practice. I ask them: Is it well conducted? What do the results mean? And should this be something that they should be thinking about incorporating into their practice? Research as an isolated entity doesn’t really achieve its purpose. We conduct research to help inform practice, and also to inform policy.

Why did you choose to come to Columbia Nursing?

I wanted to work in an environment where people were actively doing research. That doesn’t happen in every school of nursing to the same extent that it does here. You want to be stimulated by ideas and interactions with your colleagues because that helps you to think about your own work in a very creative way.

One thing that has been fabulous about being here at Columbia is the connections I have made with scientists who are in other fields. It really enriches the work you can do. I have been very fortunate to work with researchers from other disciplines who have exposed me to different areas in my research that I wouldn’t have thought of otherwise. You must try to take advantage of opportunities, and I think Columbia Nursing offers you a lot of opportunities to do that.

You run the PhD program. How do you feel about shaping the careers of the next generation of nurse scientists?

It’s a privilege. When people think about education, they commonly think about students taking classes. Classes are certainly an important part of the curriculum, but not the most important part. We want to encourage what I call “experiential learning”. That means working with others on research projects as part of research teams, having exposure to interdisciplinary research through co-advisement from faculty in other departments and other fields, because that is going to help students think about what they should be looking for in their next career step following graduation.

One of the things we have done over the past couple of years is to offer grant writing workshops to help our students be better prepared for life as a nurse scientist. Following the workshop, students are encouraged to write a mentored proposal to fund their dissertation research, and whether or not it gets funding, it provides a vital learning opportunity. After all, in the world of research, not all good ideas get funded, at least not the first time.

Where do you see the nursing profession going in the next 15 to 20 years?

I think it is an exciting time to be a nurse! Nursing has changed a lot over time. The role of advanced-practice nursing in primary care settings is one key example. No one knows our profession and patient needs better than we do. Well-prepared nurse scientists are needed to pursue important questions to improve health, because our work directly provides evidence to inform healthcare and health policy. Nurses will play all types of roles in healthcare, some which are yet to be envisioned. Columbia Nursing prepares graduates to assume these roles in supporting health.

Is there any current research you are working on that you’d like to share?

Let me tell you a little about a project that I’m excited about that recently received funding. I’m a co-investigator in a project with colleagues in bioinformatics to develop an informatics tool for self-management of chronic disease using personal self-monitoring data–in this case–for type 2 diabetes. We are looking at how to use fitness trackers that collect personal data ranging from physical activity, nutrition, to even sleep, and figure out a way to connect that with blood glucose monitoring data. We are currently devising ways to synthesize those different streams of information using sophisticated data science methods with the goal of providing adults with diabetes with very tailored self-management recommendations based on their own data. This is a great example of interdisciplinary work – each team member has different but complementary expertise to bring to the table.

In diabetes the goal is to maintain your blood glucose levels in a healthy range; this sounds easy but is often very hard for people to accomplish. They don’t see the bigger patterns in their behaviors. For example, on a morning when I don’t take a morning walk, I might notice that my blood glucose levels are higher. Our hope is to make it easier for people to see the connections between diet composition, activity, sleep and their effect on blood glucose levels. The new project is an extension of research I have contributed to for the past five years, to help underserved adults with diabetes improve their glycemic control and health.

Is there any advice you would give to an aspiring scientist?

I think the passion to want to be a scientist has to be inherent inside you. There are a lot of ways nurses can contribute to society, but if becoming a nurse scientist is your goal, my advice is to do it early in your career. That’s what I encourage people to do, and it is interesting because not everybody feels that way.

Nurses who seamlessly complete their education and graduate with a PhD degree will not have a lot of clinical experience but this is not a problem. They will partner with others, perhaps someone like me prior to completing my PhD, who have seen the problem, but don’t have the expertise regarding how to study it. We envision collaborative partnerships between nurses with PhDs, the research scholars, and DNPs, the clinical scholars, to inform and conduct the research needed to inform better outcomes. Having collaborations like that is really important because it makes research so much richer.

Standardized Patients: Actors Bring a Needed Layer of Reality to Simulated Learning

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Imagine you are a health care practitioner about to break the news to a patient’s adult son that there is nothing else you can do for his father. You explain all the steps taken in his care, and that some difficult decisions need to be made. The son, refusing to recognize how sick his father is, becomes irate. What’s your next move as a clinician?

This is the exact situation Todd Licea found himself in recently. Only the exchange wasn’t real, and he played the role of irate adult son, not clinician, for a student-simulated learning scenario. The 51-year-old has acted as a Standardized Patient (SP) since the 1990s, which means he is trained to act as a real patient or patient’s family member in order to simulate a set of symptoms or problems in the health care setting.

“Being the adult child of a sick parent and being confronted with all of these difficult decisions, like do not resuscitate, isn’t easy for the child or for the health care provider breaking the news,” Licea said. “Being able to practice these situations first, in a simulated environment, can help prepare students.”

While most simulated learning includes the use of manikins, or robotic patient simulators, Kellie Bryant, DNP, executive director of simulation at Columbia University School of Nursing, explains that bringing in experienced SPs like Licea adds a whole new level of learning for students.

“When you are a nurse practitioner you sometimes have to break bad news to a patient or a patient’s family,” Bryant said. “SPs play a crucial role in allowing students to deal with that difficult conversation in the safe environment of the simulation center versus having their first time be a real encounter with a real patient.”

It is exactly for this reason that Bryant says she will incorporate SP simulation into Columbia Nursing’s new state-of-the-art simulation center when it opens this fall.

“They can be used for evaluation purposes, they can be used for learning purposes,” Bryant said. “And while they can be used to deliver bad news or to practice communications, the majority of cases have SP’s playing the role of the actual patient. This involves memorizing medical histories and being examined by students.”

The Association of Standardized Patient Educators (ASPE) trains actors to play the role of a patient, with particular focus on how to best deliver feedback to students. However Bryant says most simulation centers offer their own training, tailor-made to the requirements of its students. At Columbia Nursing, each SP will receive a specialized training and simulation run-through prior to any interaction with students.

“That training is important,” Bryant said. “It enables us to help the SP define the role, and to guide what kind of feedback we want for our students.”

Licea first received his training from a simulation director at the University of Washington more than 20 years ago. While he began the work to supplement his income in-between acting gigs, he says he continues it as part-time work because of how much he loves the teaching component.

“When you are acting, generally your audience is not participating other than listening,” Licea said. “Being an SP goes a little deeper. It is a give and take with the student, and you need the ability to adjust your behavior based on what is going on.”

According to Bryant, SPs can also be used in collaboration with robotic manikins to create a sort of hybrid learning simulation.

“We can use the manikin as the patient, and then we can put an SP at the bedside to play the family member, because sometimes that is the hard part—especially with pediatrics,” Bryant said. “You may have taken care of a child, but you may not also have had the parent at the bedside who is worried about that child during the examination. You almost have two patients!”

Whether portraying the role of patient, family member, colleague or friend, Licea says at the end of the day it comes down to acting for an audience of one.

“What’s great is running into a student a couple of years later who recognizes me and says, ‘you were my SP a couple of years ago,’” Licea said. “The feedback I usually get is, ‘what you told me was so helpful!’”

Though the practice of SPs is widely used in medicine, it is beginning to catch on in other fields as well ranging from police academies, law schools and more, according to Bryant. And with five years of experience incorporating SPs into simulation environments under her belt, she knows it will be a success at Columbia Nursing.

“It started out on a pilot basis, but students absolutely love it,” Bryant said. “In fact, sometimes students love the SPs more than the manikins because it facilitates genuine interaction, and they love the feedback that SPs give them.”

As for Licea, he says he can’t wait to work with Columbia Nursing students in their brand new home.

“Absolutely, I can’t wait,” Lucia said. “The brand new simulation center sounds fantastic.”

Patient Portals Can Help Patients With Self-Management, But Must Be Easy To Use and Access

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NEW YORK- April 27, 2017-Columbia University School of Nursing researchers found that utilizing patient electronic health records (EHR) to determine how far along a woman is in her pregnancy can support the automated delivery of content specifically targeted to their gestational age. The study found that Medicaid patients at the greatest risk of health disparities were able to get the information they needed to engage in better self-management during pregnancy.

In the qualitative, bilingual study, published in Generating Evidence & Methods to Improve Patient Outcomes (eGEMs), Adriana Arcia, PhD, author, analyzed how pregnant patients perceive or engage with maternity education delivered through their patient portals and personal health records using a research tool called Maternity Information Access Point (through Care Guide by Maternity Neighborhood). Eligible Medicaid participants were 18 or older, less than 35 weeks pregnant, able to speak English or Spanish, and had a Wi-Fi-enabled device.

Arcia discovered that usage varied widely, and that popular features of the portal included push emails and reminders, while forgetting passwords and lack of technological experience were barriers to use. She notes that users desire easy-to-access content, but that this ease must be balanced against the need to safeguard protected health information.

Few participants felt that all of their information needs were met by their care provider, and mentioned that the educational platform helped to prevent the need to cross-check multiple unaccredited online sources of information to triangulate and establish credibility of the information. All but one said that knowing content was vetted through their care provider increased their confidence in its trustworthiness.

“Pregnant women in our study were very receptive to receiving information based on how far along they are in their pregnancy as recorded in the electronic health record (EHR),” said study author and Columbia Nursing assistant professor Adriana Arcia. “Based on these results, we recommend exploring the use of other pieces of information from the EHR to push information to patients. For example, if the procedure codes in the EHR indicate that a patient just got stitches, they could automatically receive instructions on how to care for their wound.”

In the study’s focus group, participants said that they very much liked receiving pushed content weekly because they found the content to be relevant, easy to understand, and useful to them at their stage of pregnancy.

The paper, titled Time to Push: Use of Gestational Age in the Electronic Health Record to Support Delivery of Relevant Prenatal Education Content, is published in a special issue of Generating Evidence & Methods to Improve Patient Outcomes (eGEMs) highlighting electronic health data (EHD).

 

Study summary videos:

Helping Pregnant Women Get the Information They Need (link is external)(English)

Ayudando a las mujeres embarazadas a obtener información(link is external) (Spanish)

Student Nurses Want More Infection Prevention Education, Study Finds

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NEW YORK- April 25, 2017-A national survey from Columbia University School of Nursing finds that almost 40 percent of nursing students say they feel they need more instruction on preventing and controlling infection, especially in busy healthcare environments, despite believing that their nursing program emphasizes the importance of infection prevention. More than half of respondents also report observing breaches in prevention practices during clinical placements, yet have trouble addressing them because they feel unqualified or fear retaliation from others.

 “Student nurses overwhelmingly reported that they knew when and how to use various infection prevention precautions, but acknowledged that it was often difficult to perform these practices when busy, which speaks to the complexity of the healthcare environment,” said Columbia Nursing Assistant Professor Eileen J. Carter, PhD, lead author of the study, which appeared in the June 2017(link is external)issue of Nurse Education Today. “Education is important but education alone is not sufficient.”

Carter, along with Columbia Nursing colleagues Amanda Hessels, PhD, associate research scientist; Ana Kelly, PhD, postdoctoral research fellow; Elaine Larson, PhD, associate dean of research; and Diane J. Mancino, executive director, National Student Nurses’ Association (NSNA), interviewed a national sample of student nurses about their programs’ overall approach to infection prevention and control. Students assessed the amount of time devoted to infection prevention, the quality of instruction, and the settings (lecture, simulation lab, clinical rotations) where they received instruction. They rated the difficulty of adhering to infection-prevention practices when they were busy. They also described the difficulty they often felt addressing breaches in prevention protocol that they observed during clinical rotations.

Of the 3,678 respondents, 91 percent were female, 67 percent were working toward a bachelor’s of nursing degree, and 66 percent were age 29 or younger. Despite students’ believing that their program emphasizes infection prevention, nearly 40 percent said additional education was needed. The survey found a significant association between the self-reported amount of instruction students received in handwashing, wearing personal protective equipment such as gowns and gloves, following isolation precautions, and hygienically inserting and maintaining catheters and other invasive devices, and their ability to follow these procedures when they were busy. Those who received less than an hour of instruction––compared with those who received more––were significantly more likely to have trouble following prevention protocol when they were pressed for time. “Nearly 20 percent of respondents said they found it difficult to perform key prevention practices when they were busy,” Carter said.

The survey also found that 51 percent of respondents witnessed poor infection prevention and control practices during clinical rotations but often had difficulty addressing them. “A culture of safety depends on healthcare workers’ ability to express their concerns, she said, adding that “we need to empower nurses to speak up in order to improve patient care. That empowerment should start early in training, before nurses get their RN degree.”

The study’s findings are particularly important, given the critical role that nurses play in preventing nosocomial infections, which contribute substantially to patient morbidity and mortality, as well as healthcare costs, Carter said. “It will take collaboration across disciplines and institutions to have discussions about how to best support student nurses, which will ultimately improve the care they provide as students and professional nurses.”

New Global Health Research Director Aims to Expand Columbia Nursing’s LGBTQ Research in the US and Abroad

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Tonda Hughes, PhD, has spent her career fighting for visibility and long-term research involving the health of lesbian, gay, bisexual, transgendered, and queer (LGBTQ) communities. Long before most health disparities scholars recognized that sexual orientation contributed to inequities in health, Hughes was building a body of work that demonstrated how gender, gender roles, and sexual orientation impact health.

Hughes took on the role of director of Columbia Nursing’s Global Health Research in February, and holds appointments as Professor in both nursing and the department of psychiatry where her primary role will be to conduct research and also mentor students and faculty. Prior to Columbia Nursing, Hughes spent more than 25 years at the University of Illinois at Chicago (UIC), where she will continue to lead the longest running longitudinal study involving sexual minority women’s (SMW) health with a focus on alcohol use and mental health.

According to Hughes, it was Dean Berkowitz’s interest in developing a stronger focus on LGBTQ health in the school that drew her to the position. She is excited to channel her passion for LGBTQ health, both domestically and abroad, to continue the school’s commitment and leadership in the field.

What do you bring to your new role at Columbia Nursing?

With this new role, I hope to meld my expertise and passion for SMW’s health and global health. Columbia Nursing is the perfect setting to do this because of the strength of its LGBTQ program and its stellar global health and global nursing program led by Jennifer Dohrn, DNP, director of the Office of Global Initiatives.

I am also doing work with researchers in a number of other countries with the goal of increasing research and visibility about LGBTQ health not just in nursing, but in other disciplines as well. For example, I am currently a visiting professor at Oxford Brookes University in Oxford, England, and I also hold honorary professorships at Deacon University in Melbourne and the University of Technology in Sydney, Australia. In addition to my own work with faculty in those institutions, I hope to foster collaborations between nursing faculty in overseas institutions with faculty at Columbia Nursing as well.

Why is it so important to have a global eye on this issue?

LGBTQ health has made progress here in the United States, but we still have a ways to go. In a lot of other countries, especially countries that are not westernized, there is a real lack of visibility and harsh conditions for LGBTQ people. There are currently at least 75 countries where it homosexuality is illegal, and in about 10 countries it is punishable by death.

I think that people are afraid of what they don’t understand. Increasing visibility and understanding of LGBTQ people and LGBTQ people’s health concerns is critically important in changing some of these draconian laws and perceptions.

You are on faculty, but not yet in New York. Talk about why you are still based in Chicago:

I’ve been in Chicago for 33 years, and all of that time at the University of Illinois at Chicago (UIC) College of Nursing. I completed my PhD at UIC, and then joined the faculty. I lead a long-term longitudinal study of SMW’s health—focused on alcohol use and mental health—funded since 1999 and is currently funded until 2021.

The study is called the Chicago Health and Life Experiences of Women (CHLEW) study because we recruited our sample in Chicago. I’ve worked very long and hard to gain the trust of the women in my study, and having a presence in Chicago is important. I will be telecommuting to my job at Columbia Nursing until the summer, and then will move to the campus here once the new building opens.

The CHLEW is a landmark study; there is very little published longitudinal work on SMW’s health, and to my knowledge the CHLEW study is currently the longest-running study of sexual minority health that exists.

Is there anything else about your research you would like to share?

I am very proud of the research that I do because longitudinal work is so important—especially with stigmatized and marginalized populations where the knowledge base is relatively small. There’s not a lot of research out there on SMW, and the majority of research that does exist, only provides us with a snapshot in time of what is happening. Longitudinal research is essential to understanding the mechanisms underlying sexual-orientation-related health disparities.

In order to understand how societal attitudes and policies impact LGBTQ people’s health–and in my case SMW (lesbian, and bisexual) women’s health–you need to be able to track changes in health and well-being over time. I’m in this amazingly wonderful position where we have this longitudinal data set that includes tons of rich data collected before marriage equality (legal recognition of same-sex marriage). And now we are in the field, collecting new data to understand how these recent policy changes have impacted lesbian and bisexual women’s health and well-being. I feel privileged to be in a position to advance understanding of the impact of current societal changes–both positive and not so positive changes—on the health of this population.

What are you most looking forward to about your transition to Columbia Nursing?

Columbia Nursing gives me the ideal setting to do the work that I am passionate about. I’m very excited to work with the amazing people in nursing and in other disciplines who are doing such incredible work. Dean Berkowitz’s interest in, and support of, LGBTQ health research is fairly unusual. I’ve had a great experience at UIC, but the fact that Columbia Nursing is so interested in taking a leadership role in LGBTQ health was impossible to pass up.

My goal is that every nurse has a level of cultural competence and cultural humility around LGBTQ issues. All nurses should be able to work with and treat all people with dignity and respect. I prefer cultural humility to cultural competence because it is really not possible to be fully knowledgeable about cultures other than one’s own. But we can all be willing to look at ourselves and our gaps in understanding to be open to learning.

 

Lebanese Student Shadows Columbia Nursing NPs, Bringing Global Insight Abroad

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For three weeks in January Hanadi Saad lived out her dream of observing nurse practitioners (NPs) interact with patients in a clinical setting at ColumbiaDoctors Primary Care Nurse Practitioner Group. She described the experience as an “eye-opener” for someone whose home country doesn’t currently recognize the practice.

“By law, NPs are not allowed to practice in Lebanon,” Saad said. “I knew NPs could practice in the U.S., and I was very interested in coming to Columbia Nursing to find out how. It’s been enlightening!”

The Lebanese master’s student shadowed Columbia Nursing’s nurse practitioner and Assistant Professor Dr. Elizabeth Hall, DP, as a short-term visitor at the school. She spent her time shadowing professors, going to the Nurse Practitioner Group–the faculty practice of Columbia Nursing–and observing patient care. Despite a short stay of only a few weeks, Saad said she learned a lot to take back home.

“Studying at Columbia Nursing allowed me to compare what I have in my country versus what there is in the world,” she said. “It’s one of my dreams to one day see nurse practitioners in Lebanon! I would even like to open my own clinic.”

Saad isn’t the only international student who will join Columbia Nursing under a “short-term visitor” status this year. The Program Manager of Columbia Nursing’s Office of Global Initiatives, Yu-Hui Ferng, says the school welcomes about 10 international students annually.

“Everyone comes here under different circumstances,” Ferng said. “In Hanadi’s case, the request came from her program director at the American University in Beirut, who is a collaborator of ours.”

The process works by fielding requests based on space and resources. It is important to make sure the faculty have the proper time to invest as mentors and that both parties are interested in the same specialty, according to Ferng.

“Columbia Nursing is a learning institution, and we want to foster that,” Ferng said. “It takes a lot of resources to allow someone to visit, so we want to make sure it is mutually beneficial. Even though we haven’t sent anyone to Lebanon yet, this experience opens doors for future global partnerships.”

In addition to clinical work, Ferng says Columbia Nursing also gets requests from international PhD students who want to come do a research practicum. The length of visits range from a few weeks to three months, and all visitors are offered the opportunity to tell their story at Columbia Nursing’s monthly Diversity Committee meeting.

“We do want our faculty, staff, and students to learn from our visitors,” Ferng said. “With Hanadi, she shared the NP’s role and the struggles they have with regulation and policy makers in Lebanon. It’s nice for us all to learn more about nursing practices around the world.”

From adolescent clinics to impressive follow up care plans for patients, Saad said it was an inspiration to see what the legalization of primary care NPs in Lebanon could mean for her community.

“The University I am studying at is fully accredited. The only thing stopping me from practicing as an NP is legislation,” she said. “When I was discussing it with people here, it seems American NPs had similar challenges many years ago. I hope we have the same outcome in Lebanon and will keep my fingers crossed that the laws change soon.”

Before leaving to go back home to Lebanon, Saad said her experience at Columbia Nursing was once in a lifetime.

“I was so impressed,” Saad said. “Dr. Hall spent so much time teaching me and making sure my time at Columbia Nursing was enriching despite the short stay. I felt so welcomed.”

The next international short-term visitors to Columbia Nursing will come this summer, thanks to a memorandum of understanding with the University of Navarra in Spain. The program will be an exchange, where four to six Columbia Nursing students will study in Spain in April and May, and then four to six Spanish students will travel to New York to study at Columbia Nursing.

Therapists First: Columbia Nursing’s Laura Kelly, PhD, Discusses her Path to the Psychiatric Mental Health Nurse Practitioner Program (PMH)

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Laura Kelly, PhD, will never forget the struggle of a family member who was dealing with severe postpartum psychosis. In fact, it was the stigma and lack of supportive resources surrounding the diagnosis that ignited Kelly’s passion to help vulnerable populations.

Kelly now runs Columbia University School of Nursing’s Psychiatric Mental Health Nurse Practitioner Program and is an associate professor. A proud advocate for LGBT health, Kelly serves mostly LGBT adults in her New Jersey private practice and has published research on the subject. She also acts as the clinical director of the Perinatal Mood and Disorder Clinic at the Robert Wood Johnson St. Barnabas Health System in Long Branch.

Kelly came to Columbia Nursing last year, and describes herself as a therapist first. She encourages Columbia Nursing Psychiatric Mental Health Nurse Practitioner students to understand that when it comes to psychiatric mental health, there are no quick fixes.

What first made you get into the psychiatric mental health field?

I always knew I wanted to be a psychiatric nurse practitioner, and I always knew I wanted to do therapy. However, the practice of reproductive psychiatry is really where I have spent most of my professional practice years. I have an aunt who is a psychiatric nurse. She had a terrible postpartum psychosis after her third baby, and back then it wasn’t something we were talking about at all. When it happened to her and she recovered, she started a support group to help other women who might feel isolated and alone in her rural area. Through the group she met women who could not name their own children. They weren’t bonding with their children. It was really an area of interest for me after that happened to her.

Tell us more about your specialties in mood disorders and LGBT health:

There is a high incidence of depressive disorders and anxiety disorders in the first six months of the postpartum period due to hormonal changes. I do a lot of work with reproductive psychiatry, which is mostly women who are pregnant or are in the first year postpartum.

Unlike when my aunt was diagnosed, today–by law–every mother who delivers a baby in New Jersey is now screened for depression and anxiety disorders in the postpartum period. If they show enough symptoms they are referred to the Perinatal Mood and Disorder Clinic. However, I also treat expectant women who have pre-existing mental health issues. New York does not yet have the same requirements for screening new mothers for depressive and anxiety disorders.

In my private practice I do more LGBT work. Quite often, the education that students and clinicians get in regards to taking care of transgender clients is not great. I think that is why I’m very concerned about and focused on LGBT health, especially given the current political climate. I think we should be pushing all nursing curriculums to at least introduce care of transgender patients. I’m proud that the school’s faculty practice, Columbia Doctor’s Primary Care Nurse Practitioner Group, is helping to lead the way by specializing in LGBT care as well.

You left a tenured position and a ten minute commute from your home on the Jersey Shore to join the Columbia Nursing faculty. What drew you here? 

Columbia Nursing has one of the oldest and most prestigious programs in the country, and I was looking for a change. A huge draw was the fact that the Psychiatric Mental Health Program is the only program, other than where I came from, that has a psychodynamic, philosophical framework. I really believe that is what makes psychiatric nurse practitioners different from other NPs. We are therapists first. The real role is psychotherapy.

Tell us more about the program here at Columbia:

We are lucky because other programs do not do therapy—that is to say–it is not a significant part of their curriculum. Columbia Nursing students engage in individual, group, and family therapy. They also engage in clinical work as well as take several theoretical courses to substantiate their clinical practice. On top of everything else, they spend 16 hours a week for a full academic year doing psychiatric assessment and medication management.

I love supervising students as they learn to become therapists. That is my favorite part of the program.

What do you hope your students at Columbia Nursing learn about psychiatric mental health?

I know that our students will recognize society’s push to have a quick fix, and there are many people who just want to take pills. That is not the way we treat clients. That is not how students at Columbia Nursing are taught to treat people with mental health issues.

Patients need to learn coping skills. They need to have a therapeutic relationship, and they need to be able to relate to other people. We cannot just numb away feelings so that people can avoid dealing with life. I think students learn that a quick fix, a quick pill, isn’t the answer. People have to work on feeling better.

Understanding of roles among interprofessional teams with nurse practitioners benefits outcomes

New York, NY – In a new study from the Columbia University School of Nursing, nurse practitioners (NPs) working in primary care teams report practice and team characteristics that allow them to maximize their skills in providing patient care.

“Primary care environments where NPs can practice to their maximum capacity is not just good for them and the profession, it’s also good for patients and our healthcare systems,” says Lusine Poghosyan, PhD, lead study author. “Well-functioning primary care teams that use every healthcare team member optimally will be able to care for more patients—this is very important as demand for healthcare continues to grow.”

Study investigators examined data from one-on-one NP interviews and a 314-person NP survey to get a picture of how NPs function within their healthcare teams.

NPs report strong collaborative relationships with physicians that includes sharing and even shifting responsibilities between them to meet patient needs. They also report good relationships with RNs other staff members.

NPs report less positive relationships with administrators, who they say are absent from day-to-day practice and less informed about the NP scope of practice. Half of the NPs reported no regular communication between NPs and administrators.

Poghosyan also noted that, “In environments where NPs have been practicing longer, their role appeared to be clearer.” When teams spend more time together, they develop better understanding, trust and respect for each other and their work.

The study, “Primary Care Nurse Practitioner Practice Characteristics: Barriers and Opportunities for Interprofessional Teamwork,” was published in the Journal of Ambulatory Care Management.

Multidrug-Resistant Organisms (MDRO) Infections and Nursing Homes: Columbia Nursing Study Shows Infrequent Isolation Precautions Taken

New research from Columbia University School of Nursing shows that isolation precautions are infrequently used for nursing home residents with multidrug-resistant organisms (MDRO) infections.

The Centers for Disease Control and Prevention (CDC) and the World Health Organization consider antibiotic resistance to be a serious threat, and past researchers have widely recommended isolation precautions be used to prevent transmission of antibiotic resistant organisms to other residents, visitors and staff. This study(link is external) shows such recommended isolation precautions to be infrequently used in nursing home settings despite the fact that multidrug-resistant organisms are passed through both direct and indirect contact.

Led by Catherine Cohen, PhD, a postdoctoral research fellow at Columbia Nursing studying with Patricia Stone, PhD, this analysis examined nation-wide data to determine how nursing homes were using isolation precautions when dealing with residents who had an MDRO infection. The study, published February 17, in the Journal of the American Geriatrics Society, looked at nursing homes with Centers for Medicare and Medicaid Services’ certification from October 2010 to December 2013.

Of the sample of 191,816 assessments of residents with MDRO infection, only 12.8% of these assessments also recorded isolation use. Moreover, 69% of the nursing homes with at least one MDRO infection in the past year did not use isolation precautions for these infections at all.

According to the authors, the study implications lend itself for additional training, policy, and research when it comes to isolation precautions of MDRO positive patients in nursing home settings.

Future research is needed to “inform policies, standardize, and perhaps simplify guidelines and thereby ensure consistent, high-quality care for nursing home residents,” the study concluded. As Centers for Medicare and Medicaid quality inspection citations “were associated with future isolation use, inspections may be a useful tool to align practice with new evidence and policies as they become available.”

 

Click here(link is external) to view the complete study.

Combining Two Loves: Technology and Teaching at Columbia Nursing’s New State-of-the-Art Fuld Simulation Center

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Dr. Kellie Bryant recently joined Columbia University School of Nursing and is responsible for day-to-day operations of the new state-of-the-art Helene Fuld Health Trust Simulation Center. The center will occupy two floors in Columbia Nursing’s new building and is expected to open to students in the fall of 2017. The new 16,000-sq-ft space more than quadruples the school’s current simulation laboratory.

In her new role, Bryant is responsible for the operation of the center including developing simulation activities, integrating simulation into the curriculum, faculty training, teaching simulation sessions and evaluating programs. The role is tailor-made for this self-described “techie” who also has a love of teaching. Her entry into simulated learning was somewhat by chance, but Bryant says she never looked back since that day in 2008. She was immediately intrigued by how simulated learning could not only augment, but enhance the student learning experience.

Bryant received her BS in nursing from Stony Brook University, graduated from the Advanced Practice Nursing Program in Perinatal Women’s Health Nurse Practitioner from SUNY Stony Brook and obtained her doctorate in nursing practice from Case Western Reserve University.

What is simulation?

Simulation in general is a strategy to replicate a real life situation. At Columbia Nursing, we are using simulation to replicate the clinical environment for students to practice the skills needed to become a healthcare provider. We are replicating everything from the hospital/outpatient rooms to the role of the patient using high-tech Human Patient Simulators (HPS), called manikins. In some cases we’re also using standardized patients, which are real people that come in and play the role of a patient or a patient’s family member. The learning activity involves students caring for these patients who have various medical conditions by using the knowledge and skills they have learned from the classroom and clinical setting.  Our goal is to allow them to enhance their skills in a safe learning environment. That way, students and new graduates will have an easier transition into clinical practice and their new roles.

How will the simulation center be used at Columbia Nursing?

The simulation center is one of the largest in this area, particularly for a nursing school. When a student walks into one of the simulation rooms in the new Helene Fuld Health Trust Simulation Center, it will resemble a real patient care environment. This includes rooms that meet the needs of all our different programs. We will have an operating room, labor and delivery suite, outpatient exam rooms, standard hospital rooms as well as rooms that are flexible for all different types of classes.

We’ll replicate various patient scenarios that students will encounter in the clinical setting. Students will have to care for their “patient” by obtaining their medical history, performing an assessment and administering medications, going all the way through to implementing a treatment plan. Students will be required to think critically and decide how to prioritize care for their patient. If the blood pressure is low, why is it low? Could the patient be hemorrhaging? What should I do next? In addition, simulation helps students to work on their communication skills such as how they interact with other members of the health care team and with family members. We replicate all of this in the simulation center. The more opportunities for students to practice these skills, the more confident and prepared they will feel in the clinical setting.

Our simulation program will also be inter-professional, so not only our students will be using it. We are looking forward to having simulations with other disciplines, such as medical students, nurses in the hospital setting, physical therapy, and occupational therapy.

Is there one part of the simulation center you are most excited about?

It is hard to say what my favorite is because I am excited about the entire simulation center! My specialty is women’s health so I guess I would say the labor and delivery suite will probably be my favorite. It’s fascinating to me that there is a manikin that can actually give birth.

What is it about simulation you are so passionate about?

I have always been a techie, and I have always had to have the newest gadgets. I got into simulation due to a former colleague who had a small grant to start a simulation program. The school had three manikins that had been sitting in a box for a while, and the grant enabled us to develop simulation curriculum.  I started working there one day a week and fell in love with simulation learning. The experience made me realize that simulation was a great way for students to learn. Eventually a full-time position opened up, and that is how I got my first job in simulation.  When I was in school, we learned a lot of skills for the first time with real patients. You can’t make mistakes there. If you were about to do something wrong, the instructors had to stop you because you were going to cause the patient harm. In simulation, students can learn from their mistakes in a safe environment. If they do something wrong, we can discuss a plan for improving their performance and provide students an opportunity to practice until they get it right.

Is there anything else you want people to know about the simulation center?

I can’t wait for the center to open! We will be a simulation center of excellence and the place where other nurse educators will want to learn about simulation. We want to be the best learning environment for our students and our other stakeholders and the community. As part of NewYork-Presbyterian/Columbia University Medical Center (CUMC), our simulation center is affiliated with one of the best hospital systems in the country. And being part of CUMC provides a great opportunity for our students to learn about, from, and with other health professionals to improve health outcomes. I think that is an important piece of the center. Oh, and research! I am very excited about collaborating with my colleagues to explore ways to incorporate the simulation center into the incredible research that goes on at Columbia Nursing.

The State Of Women In Prison

This post was ghost-written by Liz Holliday, on behalf of CCF’s Executive Director on August 4th, 2016. Find the original version here

The U.S. incarcerates far more people than any other country in the world, yet only recently have the stories of the nation’s incarcerated individuals begun to emerge. With the exception of a very popular Netflix show, the plight of women in prison continues to be overlooked and misunderstood, despite women making up the fastest growing population in US prisons today.

Our mothers, sisters, aunts, neighbors, and friends make up the more thanone million women currently under the supervision of the criminal justice system in the United States. Life for women behind bars is far from easy, especially when women face serious gender-specific issues that men simply do not.

Women are more likely to have issues with mental illness or addiction, and more likely to have minor children at home who depend on them. Instead of focusing on services to help women deal with the issues of livelihood and survival that landed them behind bars in the first place, we are incarcerating women for longer periods of time at a rate that is frankly disturbing.

The female U.S. prison and jail population has increased by over 700% over the past four decades, rising to 215,000 women, with black women more than twice as likely to be in prison than white women.

When we factor in the role of socioeconomics and lack of education to understand who is incarcerated and who’s not, we can see a disproportionate amount of female incarceration as the issue of class and race that it is. I should know. I’ve spent the last decade leading a non-profit called College and Community Fellowship, which helps formerly incarcerated women put education at the heart of reentry in order to reach their full potential.

Through the eyes of our students, I have seen firsthand the lifelong disadvantages—and systemic injustices—that have landed so many women in prison. I’ve spoken with women who have committed crimes to feed their kids, or as a result of mental illness and addiction, or in some cases because crime had become a cycle of survival in their families and communities.

According to The Sentencing Project, nearly half of women in state prisons have not completed high school. Sixty percent were not employed full-time when they were arrested, and nearly 1/3 had been receiving some kind of welfare benefits prior to arrest.

To me, the causes of crime are complex. It is clear that a lot of women in prison are people doing whatever they can do to feed their families and survive in a world where they have not been given quality education or opportunities to thrive. Whether they are deemed “criminals” by society or not, everyone deserves a second chance.

In a place like prison it isn’t easy to see a bright future upon release, but I want to ensure that every woman in prison knows that education can provide a beacon of light. The transformative powers of education have the ability to show that a future away from the criminal justice system is possible, and that whatever dreams women have for themselves prior to incarceration, don’t have to die with their sentencing dates. CCF understands that women need a gender-responsive, individualized approach to reentry, and that education is the strongest way to combat the stigma and barriers of a criminal conviction.

According to the White House, job applicants with a criminal record are 50 percent less likely to receive interview requests or job offers, a shocking number that only increases for applicants of color. We help combat that at CCF, by hosting college- and job-readiness workshops, focusing on self-confidence, and helping women emphasize their achievements when others try to reduce them to their past mistakes.

Yes, reform in this country needs to include better mental health and trauma services for women in the criminal justice system. Yes, we need to look at alternatives to incarceration that allow mothers in this country to rehabilitate themselves, while continuing to care for their children. And no, we cannot overlook the transformative powers education can have on those exiting the criminal justice system. We cannot funnel our reentering population into minimum-wage jobs with no regard for their personal skills and strengths.

However what women in prison need is more exposure. CCF is the only organization in the country that focuses on the intersection of criminal justice, higher education, and gender. We need more to be the voice of incarcerated women. We need more to discuss the needs, desires, and aspirations of incarcerated women, who have been ignored for too long.

We need to have an honest conversation about the state of women in prison, and discuss how we can help. On August 9th at 2PM EST, CCF will be hosting a Twitter TownHall on #WomenInPrison. I hope you will join us for the crucial discussion on the issues facing women in prison right now as well as the struggles that await them when they are released.

Quite often the biggest change, comes from a simple conversation, and we hope you will join us in ours on August 9th as we seek to not only raise visibility of the issues of #WomenInPrison, but to help galvanize collaborations and ideas for change.

The importance of education for incarcerated women

The Huffington Post: Permanent Pell In Prison: More Than Twenty Years After It Was Taken Away REAL Act brings hope for Higher Ed in prison

07/01/2016 06:25 pm ET | Updated 4 days ago Ghost-written for the Huffington Post on behalf of my non-profit’s Executive Director

From 1997 to 2001 I was incarcerated, without any way to improve myself. I already had my high school diploma, and some college credits, which meant there were no other educational programs available to me inside the prison I was assigned.

I managed to stay inspired through the tutoring of women in prison who didn’t have access to the quality education I did growing up on Long Island. I helped women with their reading, writing, and math; and encouraged them to go after their High School Equivalency, while dreaming of one day finishing my own college degree.

However access to in-prison education wasn’t always so rough. From its creation in 1972, up until a “tough on crime” agenda swept Congress in the mid-1990s, Pell Grants, a federal tuition assistance program, were available to all qualified students, no matter if they lived at home, on their own, or in prison.

That changed, when Congress passed the 1994 Violent Crime Control and Law Enforcement Act as part of the larger Omnibus Crime Bill, that then President Bill Clinton signed into law. The Act excluded students in prison from Pell grant access, and dramatically reduced in-prison education programs from 350 to just 12 by 2005.

This “tough on crime” rhetoric was especially disheartening given the fact that Pell Grants for incarcerated students did not “take away” grants for others. In fact in 1994, at the program’s highest rate of usage, the percentage of total Pell Grant funds awarded to incarcerated individuals was 0.0001%—in other words, only 6 cents out of every $10 Pell Dollars went to students in prison.

The removal of Pell in prison was a consequence Bill Clinton himself apologized for last year. However apologies don’t go far enough, and it is a time we as a nation separate the notion of punishing the incarcerated, and instead ask how we can equip them with necessary tools to ensure they don’t return to prison within three years of release.

This month, advocates rejoiced, when President Obama announced the 141 state and federal correctional institutions who will be able to use Pell grants to pursue two or four-year degrees from one of 67 approved colleges and Universities as a part of the Second Chance Pell Pilot Program. However while the initiative through the Department of Justice and Department of Education would reinstate Pell Grants to students in prison, it is only approved for a temporary 5-year term—a good start, but by no means a permanent solution.

Pell Grants were created to ensure every American in this country had the chance to educate themselves regardless of their circumstance or socioeconomic status. No one fits into that category more than many of the two million people currently incarcerated in the United States.

With 95% of individuals in prison one day set to be released, it is essential that we equip them with the critical thinking skills and self-confidence that comes with a higher education.

In the words of the late Senator Claiborne Pell, the founder of Pell Grants, “The strength of the United States in not the gold at Fort Knox or the weapons of mass destruction that we have, but the sum total of education and the character of our people.”

So instead of apologies, it would be more impressive if politicians actively showed support for current legislation that would right the wrong taken against incarcerated students more than 20 years ago.

We must support the Restoring Education and Learning (REAL) Act, S.3122 which was introduced in the US Senate on June 29th by Senator Brian Schatz (D-HI), and acts as the sister legislation of H.R. 2521 introduced in the House of Representatives by Rep Donna Edwards (MD-4) last May.

If passed the REAL Act would not only help incarcerated students get a higher education, but it’s ripple effects once they return home would lead to decreased reliance on public assistance, increased employment rates, increased public safety, an elevated quality of life for children, and stronger communities.

It’s time we get “REAL” and help the incarcerated students of American help themselves to a better future.