Liz Holliday

Communications Specialist
Archive for December, 2017

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

Flu Shot Week

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Nurse Practitioner Week 2017

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Nurse Practitioner Week 2017

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