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Fall
2007 |
Debra Gayer, assistant professor of clinical nursing, has pictures posted on an office cabinet. One young woman was a patient of Gayer's who was diagnosed with cystic fibrosis. She is one of only a few of her patients who are still living. In the past 40 years, cystic fibrosis (CF) patients have started living longer, and today they are expected to live until their mid-thirties. The responsibility for their care often falls on the shoulders of their mothers. Gayer studied three different types of family structures: first-marriage families, single-parent families and stepfamily households who all had children with CF. “Cystic fibrosis affects everyone in the family, but is more taxing on mothers because a majority of the treatment responsibility falls on them,” Gayer says. CF is transmitted through a recessive gene from both parents that causes abnormal mucous secretions. Treatments consist of chest taps (to break up the mucous), enzyme replacement medicine and breathing treatments (commonly given through a mask). Administering the treatments can take up to two hours a day. Single mother-headed households often take on the task of caregiving for the CF child on their own, Gayer says. Evidence also shows that mothers do not receive assistance in administering CF treatments from nonresidential fathers, even if the father is in regular contact with the child. “Single mothers may not fully carry out treatments because of their overloaded schedule. They're juggling many tasks and responsibilities in addition to caring for a CF child,” Gayer says. Gayer also hopes that nurses will be more attentive to the struggles of single mothers and offer their assistance more readily. She found that often nurses are not viewed as a resource, and that single mothers are reluctant to ask for help. “Nurses should be more aware of how they present themselves to the mothers and seek those single mothers out more,” Gayer says.
What's better than a cool, crisp fall day of golf? When the golf outing is also benefiting a great cause! Join us, October 1, 2007 as we host our 8th Annual Fund the Drive for Nurses Scholarship golf tournament at the Columbia Country Club. You can go on line at nursing.missouri.edu and download a registration form to submit a team – or to let us know your intention to become a sponsor. In the past five years alone, efforts surrounding this tournament have helped collect more than $96,000 in the scholarship fund by the same name. To date, students have benefited from the more than $23,000 in awards already given out. Last year, scholarship recipients were on hand to brave the rain and personally thank golfers for helping to make their education possible. Despite the dreary, cold and wet morning, the hearty golfers gave new meaning to the phrase “stay the course” and finished the 18 holes despite the rain. “Supporting students is why we are all here,” Dean Rose Porter says. “We are so grateful to those that share our vision to help offset the educational cost of our students through this important effort. In spite of the rain, we have had terrific support today for this wonderful cause.” The 12:30 shotgun start will be preceded by lunch and a silent auction. There will be trophies awarded for both the top three teams in the women's and men's/mixed team divisions. In addition, an individual trophy and prize will be awarded in each of the following specialty contests: Men's Closest to the Pin; Women's Closest to the Pin; Men's Longest Drive ; and Women's Longest Drive For more information, contact Tracy Feller, Director of Development, at (573) 884-0421. Complete tournament information
Some people claim that exercising with friends keeps them on the weight loss track. Now that circle of friends has grown to include man's best friend. A new program, “Walk a Hound, Lose a Pound,” aims to keep people and dogs fit. Participants do a group stretching sequence, get their dogs at the shelter and then walk to the Big Bear nature trail. They walk a mile (less or further as they like and are able) and then bring the dog back. On average, the study's researchers said 30 individuals per week are showing up to walk dogs. This includes families with young children, the elderly and those who are walking challenged. “Some participants are walking the entire three hours,” says Rebecca Johnson, Millsap Professor of Gerontological Nursing. “They walk one dog and come back over and over again to make sure all the dogs get their walk. Participants are committed to this program because they are committed to the dogs. They feel the dogs need this exercise and they enjoy helping them.”
Organizers of the community dog walking project aim to raise awareness concerning the high rate of obesity among adults and children, increase physical activity, educate the public about the health benefits of walking, increase community awareness about dogs available for adoption, and increase shelter dog adoption rates. “We know that walking is good for the physical heart,” Columbia Mayor Darwin Hindman says. “Walking these sheltered dogs, I hope, will exercise people's heartstrings. They'll get better health and a new best friend.” Johnson, who is also the director of the Research Center on Human-Animal Interaction at the College of Veterinary Medicine , will use this program in a research study and the findings could help other communities tailor similar programs to achieve maximum effectiveness. “This program will show people and help people see that we really do have an overpopulation problem. It also gives us an opportunity to educate potential owners about responsible pet ownership,” says Heather Duren, shelter relations coordinator and volunteer with Columbia Second Chance. There have been five adoptions since the program started in April, Johnson said. However, the benefits for those who are not able to own a pet due to finances or living arrangements are tremendous. “Individuals are making a commitment to these dogs without the commitment of ownership,” Johnson says. “And in doing so, they are exercising and becoming more fit themselves. Many walkers have also told me this is the way they are getting the connection they need to a pet without owning one.” top A $400,000 gift from The Roetheli Lil' Red Foundation will support the Research Center for Human-Animal Interaction (ReCHAI). “This extraordinary generosity will enable ReCHAI to develop a number of important initiatives,” says Johnson. “A central focus will be a program facilitating animal assisted therapy with older adults across Missouri .” The Center studies the human-animal interaction and how that interaction can provide non-pharmaceutical therapy and health benefits. Projects include measuring how visits with dogs can affect mood and perception of health among cancer patients, how pet attachment can enhance the health of ethnic elders, and how pets can help older adults relocate to nursing homes. ReCHAI Web site
Christine Vasquez, accelerated BSN student, takes a photo of classmates in front of the historic MU Columns after the May graduation ceremony. Vasquez is a student in the fourth accelerated class offered by the School since its inception in 2004.
Fellow of American Academy of Nursing Inductees At the annual American Academy of Nursing convention in Arizona this fall, Rebecca Johnson and Jill Scott-Cawiezell will receive the greatest honor bestowed in the nursing profession. They will be inducted as Fellows by their peers this November.
FAAN membership criteria includes recognition by one's peers of making outstanding contributions to nursing over and above those required in one's position of employment.
Each year U.S. News & World Report reports the results of surveys that score and rank graduate programs in U.S. colleges and universities. This year the School ranked 47th in the nation for its graduate program, which is the highest ranked school of nursing in Missouri . “This ranking is important because it shows our School is known for its outreach efforts and that the quality of our educational programs is solid,” says Roxanne McDaniel, associate dean of graduate and undergraduate programs at the school. “We have requests from employers nationwide for both our graduate and undergraduate students.” There is a direct correlation between the two independent rankings, McDaniel says (see chart below). The U.S. News & World Report base their rankings on expert opinion about program quality and statistical indicators that measure the quality of a school's faculty, research and students. So as the largest area of study in the graduate program, the Family Nurse Practitioner area of study's reputation influences the national ranking of the entire
“Those nurses who graduate from MU's FNP area of study have a 100 percent pass rate on their first attempt at the American Nurses Credentialing Center 's (ANCC) certification exam,” says Lila Pennington, instructor of clinical nursing and coordinator of the FNP and Gerontological Nurse Practitioner areas of study. “With the education they receive from MU, these advance practice nurses can meet the standards set for the certification exam. It also means that they will provide top quality care for their patients.” Since the mid-90s, the number of nurse practitioners has grown every year. In 1996, there were less than 40,000 nurse practitioners nationwide but nine years later the number had increased to 141,000 according to the U.S. Department of Health and Human Services. With the spiraling cost of health care, these professionals are playing a significant role by providing affordable alternatives for those who need it most. “Nurse practitioners take a very active role in providing primary health care,” Pennington says. “Eighty to 90 percent of health-care concerns that are seen in the primary care clinics could be handled by nurse practitioners.” Rankings in the School's educational and research programs attract qualified students from across the nation both at the undergraduate and graduate level thus working in tandem with the ranking scores. “Students come from out of state for our undergraduate programs because of our high pass rates on licensure exams,” McDaniel says. “We have also increased our national visibility due to the accelerated BSN , MS (N) and PhD nursing programs by attracting applicants from around the world. Overall, the quality of these programs is recognized by these rankings.”
Porter is a professor of nursing at the School whose research focuses on older widows' experience of living alone and how they handle their experiences of taking care of their home and health. Her descriptive phenomenological study of health-related experiences of these older women who live alone ties into issues pertinent to public health and public health policy. Porter's research has exposed issues that differ substantially from other research in two (see Table for One article):
The Faculty-Alumni Awards were started in 1968 by the MU Alumni Association to recognize the achievements of faculty and alumni.
Moving to a nursing home or assisted living facility, no matter how clean, well-run and pleasant, is not the intention of many older widows. There are some who live in their own homes well into their twilight years. Eileen Porter, a professor of nursing, talked with 25 of them during her five-year study of “Older Widows' Experience of Home Care.” The widows' perspective:
The four phenomena of home care that are common amongst widows:
Widows consider availability and suitability of their helpers for tasks
This type of consideration stems from their concerns for the helpers' well being. “They put the helper before the job,” Porter explains. “Some of these women intentionally shield their helpers from tasks they perceive are too difficult for them for one reason or another.” Patterns of mobilizing helpers:
“For example, if a relative is already in the house, these widows feel safer taking a bath knowing their helpers are there if they should fall,” Porter points out. Compared to what other researchers have found, Porter's ideas are
In a recently released USA TODAY/Gallup Poll, the nursing profession was heralded as honest and ethical. The annual poll reveals that nurses top the list of occupations rated for “Honesty and Ethical Standards” for the sixth consecutive year. How heartening to see continued evidence of the public's affirmation of the work nurses do and how they do it says a ANCC press release.
This spring, the School was honored to receive one of Kennedy's Dee Dee dolls for its Clinical Simulation Learning Center. During Kennedy's time as a peritoneal dialysis nurse at University Hospital she often wished for a doll that demonstrated the mechanics of CAPD as well as ease the fear of her small patients and their families. The doll is used to teach dialysis patients one of the three processes used to excrete excess fluid and waste products. Using Dee Dee, Kennedy and others were able to visibly show the installation and removal of the dialysate bag. This bag contains fluid with sugar levels that triggers the proper release of liquid waste by the body. This process is repeated four to five times a day. “Surprisingly, parents related to the doll with more enthusiasm than I expected,” says the '59 BSN and '86 MS(N) grad. “While practicing procedures, they frequently comment about how they are glad they are working on a doll.” The practice parents get with Dee Dee is invaluable from the standpoint of preventing infection. Abdominal membranes can become infected very easily, so extreme care in handling the dialysate bag and all the tubing can be a matter of life and death. Dee Dee allows the procedure to be practiced over and over again without the worrying of infection. Since Kennedy makes the dolls by hand, she wasn't able to send one home with each of her patients. But that didn't stop her from wishing that she could. Accessible health care is a major concern for rural Missourians. In many situations, people have to travel long distances to see a doctor. In order to address this concern, some nurse practitioners in the state are opening their own health clinics, and Mizzou is helping them get the skills they need.
“Nurse practitioners were not trained as business people but were trained as clinicians,” said Shirley Farrah, assistant dean for outreach and distance education for the School. “It's important to help them get the business skills that they need, provide networking opportunities and know the regulations that go along with owning your own clinic.” According to Farrah, there are fewer than 15 health clinics in Missouri that are owned and operated by nurse practitioners. MU Extension nursing programs show nurse practitioners in rural communities what it takes to start and operate a successful health clinic. “The patient care aspect is probably the easiest. It's the business aspect that a lot of nurses aren't taught,” said Laura Thiem, a nurse practitioner who owns a health clinic in Adrian, which is located 50 miles south of Kansas City. With the help of her family, Thiem turned an empty storefront on Main Street into the Adrian Clinic. In her first year, her practice has served 1,800 people with more than 4,000 patient visits. “That's pretty busy, and it's enough to keep the doors open. That tells me that there's a need here,” Thiem said. According to the American Association of Colleges of Nursing, health planners increasingly rely on nurse practitioners as the providers of choice for a range of front-line health services due to the growing pressure to balance quality and cost. Studies show that the quality of nurse practitioner care is equal to, and at times better than, comparable services by physicians and “About 80 to 90 percent of the patient issues that are seen in offices can be dealt with by nurse practitioners,” Farrah said. Since the mid-90s, the number of nurse practitioners has grown every year. In 1996, there were fewer than 40,000 nurse practitioners nationwide, but nine years later the number had increased to 141,000, according to the U.S. Department of Health and Human Services. According to the Missouri State Board of Nursing, there are 3,026 nurse practitioners in the state. With the spiraling cost of health care, these professionals are playing a significant role by providing an affordable “That number has got to more than double,” Thiem said. “If we have 10 to 20 now, 20 to 40 are not going to be enough. We need to have those in the hundreds. We have communities out there that could easily support a nurse practitioner.” Bottom Ranking for Health Care Choice and Access to APRNs In the wake of a recent study published in The American Journal for Nurse Practitioners1, the Missouri Nurses Association (MONA) is continuing efforts to win support for legislation that would extend prescriptive authority for nurse practitioners, clinical nurse specialists, and certified nurse midwives in collaborative practice with physicians to include schedule III – V controlled substances – including medications prescribed for sleep disorders, anxiety and other common health conditions. The study measured and ranked the regulatory environment for practice and consumer healthcare choice for the fifty (50) US states and the District of Columbia , and scored Missouri as 50th – ahead of only Alabama in composite scoring. Issues evaluated in the study included the environment affecting consumer access to APRNs, reimbursement and consumer access to related healthcare services and patients' access to prescription medications. Study authors note “with national statistics indicating an increasing shortage of both nurses and primary care physicians, state regulation continues to restrict the full scope of practice for [nurse practitioners].” In recent years, Missouri has been one of a few states nationally targeted by physician groups to restrict competition and the scope of practice of APRNs. “Unfortunately, some physicians attempt to frame their opposition in the context of patient safety – arguing that APRNs somehow provide inadequate care,” stated Glen Jett, BSN, RN,BC, MONA president. “However, the reality is that multiple scientific studies conclude that APRNs provide safe and cost-effective care at least comparable to that of physicians for the types of patients and health conditions which they treat. He and others indicate that the opposition is really based in the economics and competition for healthcare reimbursement dollars. APRNs are registered nurses (RNs) with advanced education and national certification in their clinical specialty. Although APRNs in the state have been safely prescribing medications other than controlled substances since 1993, Missouri remains one of only three (3) states in the US that excludes APRN prescriptive authority for all controlled substances. All states surrounding Missouri currently allow some form of controlled substance prescriptive authority for these health care providers. Significant negative impact to patients created by the current restriction on prescribing controlled substances, include:
MONA, a one-hundred year old association, is the only full-service professional organization representing Missouri 's 75,000+ RNs, and is a constituent member of the American Nurses Association (ANA). Its mission is to protect and enhance registered professional nursing practice in all environments to assure quality, affordable and accessible health care for people in Missouri . Additional information is available online at www.missourinurses.org, or by calling (573) 636-4623. 1 Lugo , N, O'Grady, E, Hodnicki, D, Hanson, C (2007). Ranking state NP regulation: practice environment and consumer healthcare choice. The American Journal for Nurse Practitioners, 11 (4), pp 8-9, 14-18, 23-24.
Some women may leave the beauty shop with more than a new hair style, thanks to a unique approach to bridge the gap between research and women. A MU study that follows women through the stages of breast cancer treatment and recovery was recently extended, and this time researchers realized that one important demographic was being ignored. They are turning to beauty shop owners for help. “In my research, I realized that I was not gathering sufficient information on the African-American woman's experience post-breast cancer,” says Jane Armer, professor of nursing. “This community is at risk of being underserved in terms of breast cancer screening and underrepresented in breast cancer research.” Armer is conducting research on the occurrence of lymphedema in breast cancer survivors because it affects nearly half of breast cancer survivors. She teamed with other health professionals and the beauty shop owners to disseminate information regarding the importance of early screening and detection, and the chance to participate in her study. While African-American women have a lower incidence of breast cancer, they do have a higher mortality rate. The five-year breast cancer survival rate for African-American women is 74 percent, compared to 88 percent for Caucasian women, according to the American Cancer Society. “The reason for mortality discrepancies may be due to cost, lack of insurance or lack of information available to them,” Armer says. “It is vitally important for us to reach out to this population so we can learn more about how to help them.” The study, funded by the National Institutes of Health's National Institute of Nursing Research, has followed more than 300 women diagnosed with breast cancer. The next phase of Armer's study will continue to follow the same women and 100 additional breast cancer survivors.
Causes & Symptoms of Lymphedema
Other Facts
Exercise Helps People with Diabetes
“In studies that focused on exercise only, blood glucose improved twice as much as in studies that focused on exercise, diet and medication adherence,” says Vicki Conn, professor and associate dean of research at the School. The meta-analysis considered data from 10,455 subjects in 103 research reports. No previous meta-analysis has compared exercise-only interventions with interventions including multiple diabetes self-management behaviors. Complications from diabetes are serious and can include: heart attacks, kidney disease or limb amputation. “One thing we found was that it doesn't matter how overweight you are or how poor your current blood glucose is at the start of the studies, the improvements from exercise were equal across the board,” Conn says. The study also found that women did not improve as much as men. However, both young and older adults had similar benefits from the physical activity intervention. “The censuses among these studies could mean that it is easier for people to focus on one thing at a time. It is easy for people to get overwhelmed when asked to make too many Starting last fall, Mizzou enrolled its first class in the Master of Public Health (MPH) program. All students will be educated in the core domains of public health and be highly qualified to enter the public-health workforce. MPH students will choose one of three concentration areas so they can tailor the program to fit their interests and skills. Dual degrees will be available in a number of areas including nursing, veterinary medicine, public affairs, health administration and social work. The MPH is the standard professional degree recognized throughout the world for public health practice. For more information or application materials, call (573) 884-7050 or e-mail SaffranL@health.missouri.edu. Concentration areas:
As a self described worker bee, Lisa (Kormanik) Osgood is being humble about the role she plays in people's lives. As the nurse clinician for the Ear, Nose and Throat Clinic at Truman Medical Center in Kansas City , Mo. , for the past 12 years, Osgood is the “go to person” for not only patients but the physicians, other nurses and other professionals she works with on a daily basis.
“I am the one talking with patients about their pre-operative instructions after they've been given a cancer diagnosis,” Osgood says. “Not only do I describe for them basic surgery instructions, where to they need to go to check in and what to do, I also explain their diagnosis, what they're up against and what it's going to be like after the surgery.” She is the front-line defense for those facing a scary diagnosis. That's why it is so important to Osgood that she be as open, forthcoming and caring as possible. “Patients are very afraid,” she says. “I explain how there are going to be lots of bells and whistles when they wake up. There are going to be heart monitors, trach tubes and ventilators, and this is scary for them. However, if I can talk with them at their level it helps them visualize the unknown.” In fact, that's one of Osgood's overarching philosophies — be willing to be open with patients because it's the golden rule. And she has found that if you are willing to take time and explain the details that patients go from an “I don't think I want surgery” attitude to making an informed decisions based on the facts. Another Osgood philosophy – being supportive of peers. “Nursing is all about supporting each other so we can give back to our patients,” she says. “Part of that is because you never take your nursing hat off. Nursing is a passion, not a job.” Even in her “off” time, Osgood's commitment to nursing still shows up. An active supporter of Boy Scouts, Osgood attends all the various meetings, events and camp outs with her husband, Brian, and their three sons.
She also tries to fit in knitting, but without long periods of down time all she manages to do it blind knit. So many baby hats have been done in camo and Kansas City Chiefs red, she says, and they find their way to the hospital's nursery. “I'm very popular with those who don't want the traditional pastel colors for their children,” this Lee's Summit resident says laughingly. Looking at her career, Osgood has always made the choice of being involved with patients. Even when she was in management she still made the choice to take care of patients. That's why she thinks she has the perfect career right here and now. “I get to do what I love doing — educating patients and being there for them during a difficult time in their lives,” she says. “I am an advocate for my patients and I feel very fulfilled when I look at my career. You have to love what you do and I do.” |
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Omicron Delta Kappa walked their hooded inductees across Francis Quadrangle as the Tap Day ceremonies began this spring. Six secret MU societies tapped their newest members during Mizzou's most sacred tradition, of which six nursing students were inducted into Mystic 7, Omicron Delta Kappa and Mortar Board. “While I was hooded, I could hear them calling School of Nursing ,” says Kiera Story, sixth-semester student. Joannie Welsh thought it was cool to hear the School's name being called three times before her name was announced. Although officially inducted several weeks before this ceremony, students from the different organizations don't know if their classmates were inducted until this point. 
Right: New inductees (from left) — Diana Meyer, Joanna Turner, Dean Rose Porter, Halley Watson, Kiera Story and Joannie Welsh. Not pictured, Dan Imhoff. 
Eileen Porter is receiving a MU Alumni Association Faculty Alumni Award this fall. This prestigious award recognizes her contributions to Mizzou.
In the mid 80s, Juanita (Dee Dee) Kennedy designed, created and delivered a doll that took the apprehension out of continuous ambulatory peritoneal dialysis (CAPD).
During her first trip back to the School since graduating in 1981, Osgood was the guest speaker at this year's Student Nurses Week. For the students, she summed up her philosophies about her career choices and life in general.
“I had noticed that one particular leader had had voice changes over the course of several years and I was concerned,” Osgood says. “There was no way I could leave that event without making sure he was seeing a specialist because voice change is a red flag in my world.”