indiana nursing quarterly

I N D I A N A

NursingMAY 2012

indystar.com/INQ QUA R T E R LY

CAREERS&TRAINING:Homehealthcare

YOURWORLD:

Compassionfatigue

• Health, Dental, Vision, andLife Insurance

• Employee AssistanceProgram

• 401(k)

• Tuition Assistance

• Paid Time Off

• Six Paid Holidays

• Short-term Disability

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OPPORTUNITIES EXISTTHROUGHOUT INDIANA.

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Inside

I N D I A N A

QUA R T E R LY

4 OnthePulse

5 Clips&Tips Medicaltechnology

CoverStory 8 2012SalutetoNurses

Careers&Training 16 HomeHealthcareNursing

YourWorld 20 Compassionfatique 23 Q&AwithBethTharp

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Indiana Nursing Quarterly • indystar.com/nursing • Spring 2012 3

Cover:BethTharpwasrecentlynamedNurseofTheYearatthe2012SalutetoNurses.

Coverphoto:MarcLebryk

AdvertisingOutsidesalesand CarrieBernhardteventssupervisor (317)444-7288 [email protected]

Insidesalesand MorrisBradleyeventsexecutive (317)444-7437 [email protected]

Healthcarespecialist SarahHarmon(317)[email protected]

Educationspecialist MandiKeeney(317)444-7267

[email protected]

Online nowNominatesomeoneforSalutetoNurses.Findanewjobinnursing.Subscribeforfreeemailalerts.Doitallatindystar.com/nursing.

Date: 4/17/12

Client: Indiana Wesleyan University

Market:

Contact: Kristin Higgins

Job # 2012121

Size: 1/6 page (2.25”x4.75”)

Publication: Salute to Nurses - Indy Star

Insertion Dates:

Online/Indiana/Kentucky/Ohio

INDWES.EDU866-498-4968

NURSINGDEGREES THATMAKE A STATEMENTIWU Online • Post-licensure (RNBSN) • MSN in Administration and Education • Certificate in Parish Nursing

Education Centers in Indiana, Kentucky, and Ohio* • Post-licensure (RNBSN) • MSN in Primary Care Nursing (Family Nurse Practitioner)

IWU campus in Marion, Indiana • BSN Degree – traditional 4-year program • BSN Degree – Transition to Nursing

* Not all programs available at all locations

A degree from Indiana WesleyanUniversity makes a statement.

Community Health Network is one of the largest health care providers in Indiana.

Nothing matters more to us than providing the highest quality, most compassionate care possible to our patients. And nothing is more critical to our ability to do so than hiring, training, supporting, and retaining a highly competent nursing staff .

We are proud to support our Community of Nurses, who make possible our ability to sustain our mission to enhance health and well-being for the communities we serve.

Visit eCommunity.com/nursing to learn more about our nursing team and our focus on Nursing Excellence. EOE.

eCommunity.com

Excited to salute ournursing community

IS-5939806

NURSE4

4 Indiana Nursing Quarterly • indystar.com/nursing • Spring 2012

[email protected] news to

On the Pulse Promotions, workshops, awards

■ AppointmentsMarilynYork,RN,hasbeennamedcardiac

servicelineleaderforIndianaUniversityHealthBallMemorialHospital.Shewillleadthecardiologyserviceline,whichincludescardiacservices,cardiology/neurology,cardiacrehabandrespiratoryservices.Yorkhasbeenwiththehealthcaresystemfor13years.

Dr.AnnWhitehasbeennameddeanoftheCollegeofNursingandHealthProfessionsattheUniversityofSouthernIndiana.SheisonlytheseconddeaninthehistoryoftheCollege.

Dr.NadineCoudretservedasdeanfrom1988to2012.

WhitejoinedtheUniversityin1990.ShepreviouslyservedtheCollegeofNursingandHealthProfessionsasprofessorofnursing,assistantdeanofnursing,andprogram

directorfortheDoctorofNursingPracticeprogram.

■ RecognitionMicheleKuntzWood,RN,managerofWomen’s

HealthServicesforFranciscanSt.FrancisHealth,wasrecognizedasa2012IBJHealthCare

Herointhenon-physiciancategory.ShehasbeeninmanagementatSt.Francisfor27ofher38yearsinnursing.

WoodhelpedorganizeIndianapolis’firstRacefortheCure;helped

formtheBreastHealthAwarenessLeagueandthentransitionittoCentralIndianaAffiliateofSusanG.KomenfortheCure;andspearheadedlegislationforthebreastcancerawarenesslicenseplate.

JessieA.Westlund,RN,chiefintegrationofficerforCommunityHealthNetworkandCEOofCommunityHomeHealthServices,wasaHealth

CareHerofinalist.WestlundjoinedCommunityHealthNetworkin1998andhasbeeninstrumentalinlaunchingseveralprogramsincludingLife’sJourneyforpeoplewithchronicdiseases,TouchpointforseniorsandTelehealth,

whichmeasuresthevitalsignsofat-homepatients.

— IBJ

IndianaUniversityHealthnamedMonaEulerasthefirstvicepresidentforitsnationallyrankedneuroscienceprogram,IUHealthNeuroscience.EulerwilloverseethegrowthanddevelopmentoftheIUHealthNeuroscienceCenter,afirst-of-its-kindinitiativethatwillcombinethenationallyrankedneuroscienceprogramsandresourcesofIUHealthandtheIUSchoolofMedicine.

EulercomestoIUHealthfromKindredHealthcarewheresheservedfor13yearsasthemarketchiefexecutiveofficer.SheholdsanursingdegreefromBallStateUniversityandamaster’sdegreefromIndianaWesleyanUniversity.

TheCancerNavigatorProgramatHendricksRegionalHealthnamedLiannaWillhite,RN,asitscancernavigator.Sheservesastheofficialliaisonbetweendoctors,hospitalservices,

patientsandtheirfamilies,ensuringthatpatientshavetheeducational,nutritional,emotionalandfinancialresourcestheyneed.

WillhitehasbeenanurseatHendricksRegionalHealthformorethantwodecades.

Forthepastseveralyears,shehasworkedintheradiologydepartmentwithpatientsundergoingdiagnostictestingforcancer.

InJune,AnneThomas,deanoftheUniversityofIndianapolis’SchoolofNursing,willbeinductedintotheFellowsoftheAmericanAcademyofNursePractitioners,whichrecognizesoutstanding

contributionstonationalandglobalhealth.Sheisbeingrecognizedforherworkinestablishingnewhealthclinicsandleadingthedevelopmentofnationalandinternationaleducationalcurriculum.Shecurrentlyishelpingto

developnationalstandardsfornursepractitionereducation,amongotherprojects.

TheSouthwestIndianaAreaHealthEducationCenterselectedDr.NadineCoudretforthisyear’sIndianaAHECNetworkHeroAward.For24years,CoudretservedasdeanoftheCollegeofNursingandHealthProfessionsattheUniversityofSouthernIndiana.TheawardisgiventoanindividualororganizationwhogoesbeyondthecallofdutytoensurethesuccessoftheIndianaAHECNetworkmission.

Content

Editor AngelaParker(317)[email protected]

Contributingwriters BrookeBaker,ShariHeld,AshleyPetry,HollyWheeler

Graphicdesigner JoeSoria

Photos MarcLebryk

Indiana Nursing QuarterlyisaproductofStarMedia,307N.PennsylvaniaSt.,Indianapolis,Ind.It’sdistributedelectronicallytonursesthroughoutcentralIndiana.

[email protected].

Besureyou’reintheknow.SignuptoreceiveemailalertswhentheeachquarterlyissueofINQgoesonline:indystar.com/nursing.

Get your INQ updates!

White

Willhite

Thomas

Westlund

Phot

o:P

ERRY

REI

CHAN

ADTE

R

Wood

White

You comfort. You help heal. You educate.

Are you ready to see where your nursing career can take you? At Medtech you can have the opportunity to:

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AD PROOF: (DH)Proof Due Back By: 01/27 2pmAd #: P21113-f-13680-3x4Deadline To Pub: 01/27 5pmFirst Run: 02/01/12Publication: SpecSection: n/aSpecs: 2.25 x 4.75

Approved as is.

Approved with revisions. Revise and resend.Initial _________ Date __________

NURSE5


Clips & Tips

■ While the traditional core values in nursing haven’t changed, the profession continues to evolve.

Here’s a look at the trends that are changing the profession some just emerging and some for the better, some not so much.

The rise of evidence-based medicine | Susan McRoberts, RN, MSN and chief nursing officer for

Franciscan St. Francis Health, recalled that in the past, considerable time was spent examining and trying to improve processes.

“Now we look at patient outcomes and

try to make them better,” she said. “I think that’s really been a positive for our patients.”

Evidence-based medicine has taken the practice in a different direction, and many of the things that have come out of it actually have streamlined processes. One example, based on evidence derived from a pilot program conducted by Wishard Health Services, is hourly rounding.

“Evidence shows that hourly rounding not only reduces call light usage, it decreases falls and increases nurses’ and patients’ satisfaction,” said Anne Wolfersberger, RN, and clinical manager for a med/surg and telemetry unit at Wishard Hospital. “While nurses think it is more time- consuming, it actually winds up saving them time.”

By Shari Held

McRoberts

“ Evidence shows that hourly rounding not only reduces call light usage, it decreases falls and increases nurses’ and patients’ satisfaction.”

—AnneWolfersberger,RNWishardHospital

Moving forward:

NURSE6


Clips & Tips Research, trends, tips

Technological tricks | Hand-held devices, electronic medical records, electronic medication dispensing systems — there’s no escaping technology.

Electronic medication dispensing frees nurses to focus on other

duties while EMRs place patient information at their fingertips.

“Electronic medical records aren’t time-saving for the nurse, but they are safer for the patient,” McRoberts said. “The nurse might be tired, but the computer never

gets tired.” EMRs provide more

comprehensive patient data — data that can be accessed simultaneously by multiple caregivers. The downside is

that interacting with technology means less time for traditional

bedside nursing. The challenge

is in balancing the two for the best outcomes for patients.

Improved collaboration with physicians | Twenty years ago, nurses did what physicians told them to do. Today, they operate as a team.

“Physicians seek a lot of feedback from us because we are with the patient most of the time,” Wolfersberger said.

The emphasis on obtaining magnet status also has helped drive that collaborative environment.

“Today, nurses are in shared governance structures where they help determine clinical policies and procedures and then are accountable for them,” McRoberts said.

A better-informed public | The Internet and Dr. Oz have made medical information readily available

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Visit Harrison.edu for more information. Or better yet, call 1-800-401-1497 and talk to a program specialist.

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NURSE7


Clips & TipsResearch, trends, tips

[email protected] news to

to the public. As a result, patients’ questions are more pointed and sophisticated — but there also is the potential for misinformation.

“Traditionally, the one thing that has stood through the years is that the nurse is the most trusted occupation in the U.S.,” McRoberts said. “So nurses have to really stay on top of [health care topics] and be lifelong learners to provide the best information to their patients.”

The role of long-term care facilities | The perception of long-term care also is changing: Nursing homes no longer are repositories where the sick and elderly wait to die.

“They come here and get better and they go back to their homes and pick up where they left off,” said Terry Jonas, RN, CDONA and director of nursing for Parkview Care Center in Evansville. “That’s very positive.”

Jonas said nursing homes also are admitting more acutely ill residents — an up-and-coming trend that stems from the growing senior population and changes in regulations that shorten hospital stays.

“Because of that, we, in turn, have to make sure our nurses receive more training and education on dealing with acute residents, versus long-term residents,” she said.

Parkview Care Center also hired an in-house physician to be on-site 40 hours per week. Such an addition should improve communication between long-term facilities and hospitals.

Expanded education expectations | A bachelor’s degree or greater is now expected, prompting many nurses to pursue advanced education and even doctorate degrees. Thanks to online coursework, that

education is more accessible. But an advanced degree doesn’t necessarily mandate a job change.

Wishard has a career advancement ladder that rewards nurses who continue their education but choose to remain at the bedside. Wolfersberger said it ensures a high level of competency on units and increases usage of evidence-based research.

In long-term care facilities, the push is on for nurses to be trained in caring for cardiac patients and those with congestive heart failure. That expertise allows those residents to receive care on-site.

Jonas said increased educational expectations and responsibilities have had a positive impact on wages.

“Years ago, the pay was pretty embarrassing when you tried to recruit people,” she said. “We’ve come a long way on that, although we still have a way to go.” ●

RHI provides personalized, compassionate care that enables individuals to regain hope and independence after life-changing injury or illnessCome talk with us about a specialty certification as CCRN.

We offer competitive wages and excellent benefits.Please visit our website at www.rhin.com to see our current job listing and complete an online application.

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NURSE8F l i g h t n u r s e s

By Holly WheelerCover Story

10th Salute to

Nurses was an

event to remember

The Indianapolis Star’s

10th Anniversary10th Anniversary10th Anniversary

NURSE9


F l i g h t n u r s e s

Cover Story

Salute to Nurses celebrates and honors those who choose a profession whose core is helping others.

This year marked the event’s 10th anniversary and brought together nearly 700 nurses, administrators, friends and families April 25 at the Indiana Roof Ballroom.

Elegance and excitement | Salute to Nurses is about honoring nurses, but the luncheon is about giving these men and women the royal treatment. The elegant setting, delicious food, flowers and prizes set the stage for the awards ceremony.

“It’s amazing to be there,” said Beth Tharp, Nurse of the Year. “That ballroom is so gorgeous and elegant. The minute I walked in the door everyone was so attentive and nice.”

The ceremony included an inspirational message from Anne Ryder, a freelance journalist, writer and speaker, who has spent years interviewing some of the world’s most loved caregivers, including Mother Theresa.

Several past Nurse of the Year winners also were in attendance, sharing their personal experiences and celebrating with this year’s honorees.

“We have a total of 78 nurses who have been award winners and thousands of nominated nurses,” said Carrie Bernhardt, The Star’s advertising sales and events manager. “The 10th annual had a great deal of heart. Something that always amazes me is how humble the nurses are, yet they are so deserving.”

Prizes included necklaces from Hofmeister Personal Jewelers, free car washes from Mike’s Express Car Wash, gift cards from Marsh, ZCoil, Natural Concepts, Applebee’s and McDonald’s, and overnight stays at Renaissance Indianapolis North.

10th Salute to

Nurses was an

event to remember

The Indianapolis Star’s


NURSE10


2012 Salute to Nurses award winners■ Nurse of the Year and Advancement in Nursing: Beth Tharp, RN, BSN, MBA,

CNO, Community Hospital Anderson ■ Community Outreach: Cheryl Howard, BSN, RN-BC, Franciscan St. Francis

Hospital–Mooresville■ Nurse Educator: Susan Moore, PhD, RN, IU School of Nursing, retired■ Lifetime of Caring: Janis Shook, LPN, Terre Haute Regional Hospital■ Inspiration: Sandra Evanoff, ASN, RN, CPAN, IU Health North

Honorable mentions■ Karen Yehle, PhD, MS, RN, Purdue University■ Rosemary Hobson, RN, Columbus Regional Hospital■ Sarah Horton-Deutsch, PhD, PMH, CNS, RN, IU School of Nursing

Student winnerAs the student winner, Alexis Martin, IU School of Nursing–Kokomo, received

an $8,000 scholarship “This year, The Indianapolis Star’s $3,500 scholarship was more than matched

by USA Funds,” Bernhardt said. ●

Thisyear’sSalutetoNurseswinnersinclude(fromleft):JanisShook,CherylHoward,SandraEvanoff,BethTharp(2012NurseoftheYear),SusanMoore,SaraHorton-Deutsch,RosemaryHobson,KarenYehleandAlexisMartin.

Cover Story

NewtwistsAnewaward—theCAREAward—wasintroducedforSalutetoNurses’10thanniversary.EventsponsorsatthesilverlevelandaboveeachchoseanursefromtheirfacilitywhoisCompassionateAboutReachingforExcellence.Thewinnerswere:

■StephanieIsenberg,RN,CommunityHealthNetwork

■LindaKendall,RN,HancockRegionalHospital

■KimMcGuire,RN,BSN,CMSRN,IUHealth-UniversityHospital

■ElaineShea,RN,MSN,WishardHealthServices

■TheresaWeisenbach,RN,BSN,MBA,OCN,FranciscanStFrancisHealth

NURSE11


Cover StoryThe Indianapolis Star’s


Celebrating a decade of excellence

NURSE12

12 Indiana Nursing Quarterly • indystar.com/nursing • Fall 2011

White, tan and brown fruits and vegetables contain

varying amounts of phytochemicals of interest to scientists.

theof health

Brought to you by:

For more information visit fruitsandveggiesmorematters.org marsh.net

Your Guide to the Many Benefits of Fruits & Vegetables...

Fill half your plate with fruits & vegetables. Getting a colorful variety of fruits and vegetables is

important! Why? Because colorful fruits and vegetables provide the wide range of vitamins, minerals, fiber and

phytochemicals your body uses to stay healthy and energetic, help maintain a healthy weight, protect against

the effects of aging and reduce the risk of cancer and heart disease.**Diets rich in fruits and vegetables may reduce the risk of some types of cancer and other chronic diseases.

Green fruits and vegetables contain varying amounts of

phytochemicals such as lutein and indoles, which interest

researchers because of their potential antioxidant,

health-promoting benefits.

Specific phytochemicals in the red group that are being

studied for their health-promoting properties include

lycopene and anthocyanins.

[ carbohydrates, proteins & fats ] Compounds found

in foods that the body uses to generate energy or build cells.

[ phytochemicals ] Natural plant compounds that may

provide a variety of health benefits. Many of the bright

colors in fruits and vegetables come from phytochemicals.

[ antioxidants ] Plant substances that protect

the body by neutralizing free radicals, or unstable oxygen

molecules, which can damage cells and lead to poor health.

[ vitamins & minerals ] Natural substances contained

in a wide variety of foods, long recognized as essential to

maintaining healthy body systems. Scientists have defined

specific daily amounts that are necessary for good health.

Blue/purple fruits and vegetables contain

varying amounts of health-promoting

phytochemicals such as anthocyanins and

phenolics, currently being studied for their

potential antioxidant and anti-aging benefits.

Yellow/orange fruits and vegetables contain varying

amounts of antioxidants such as Vitamin C as well

as carotenoids and bioflavonoids, two classes of

phytochemicals that scientists are studying for their

health-promoting potential.

NURSE13

White, tan and brown fruits and vegetables contain

varying amounts of phytochemicals of interest to scientists.

theof health

Brought to you by:

For more information visit fruitsandveggiesmorematters.org marsh.net

Your Guide to the Many Benefits of Fruits & Vegetables...

Fill half your plate with fruits & vegetables. Getting a colorful variety of fruits and vegetables is

important! Why? Because colorful fruits and vegetables provide the wide range of vitamins, minerals, fiber and

phytochemicals your body uses to stay healthy and energetic, help maintain a healthy weight, protect against

the effects of aging and reduce the risk of cancer and heart disease.**Diets rich in fruits and vegetables may reduce the risk of some types of cancer and other chronic diseases.

Green fruits and vegetables contain varying amounts of

phytochemicals such as lutein and indoles, which interest

researchers because of their potential antioxidant,

health-promoting benefits.

Specific phytochemicals in the red group that are being

studied for their health-promoting properties include

lycopene and anthocyanins.

[ carbohydrates, proteins & fats ] Compounds found

in foods that the body uses to generate energy or build cells.

[ phytochemicals ] Natural plant compounds that may

provide a variety of health benefits. Many of the bright

colors in fruits and vegetables come from phytochemicals.

[ antioxidants ] Plant substances that protect

the body by neutralizing free radicals, or unstable oxygen

molecules, which can damage cells and lead to poor health.

[ vitamins & minerals ] Natural substances contained

in a wide variety of foods, long recognized as essential to

maintaining healthy body systems. Scientists have defined

specific daily amounts that are necessary for good health.

Blue/purple fruits and vegetables contain

varying amounts of health-promoting

phytochemicals such as anthocyanins and

phenolics, currently being studied for their

potential antioxidant and anti-aging benefits.

Yellow/orange fruits and vegetables contain varying

amounts of antioxidants such as Vitamin C as well

as carotenoids and bioflavonoids, two classes of

phytochemicals that scientists are studying for their

health-promoting potential.

NURSE14


Careers & Training

Taking care of people and making a difference. These are our daily goals at CarDon & Associates, where we believe in the dignity and potential of every resident. Join us today and begin a career in which you can achieve personal success and make an important contribution to the care and well-being of our residents.The CarDon senior living communities and Health & Living Centers provide a full range of lifestyle and care options from independent living, assisted living and full-service continuing care retirement communities to rehabilitation, long-term care and memory support services

CarDon locations can be found throughout Central and Southern Indiana. We offer a variety of excellent Company benefits and our associates matter because they are the Difference Makers!

Apply online at

www.cardon.usLocations and contact information may also be found on our website.

Difference Makers

Master’smovingonlineIndianaUniversity-PurdueUniversity

FortWayneannouncedthatallfourareasofspecializationofthemasterofsciencewithamajorinnursingprogramwillmovetoanonlineformatthisfall.IPFWoffersmaster’sdegreesinadultnursepractitioner,women’shealthpractitioner,nurseeducatorandnurseexecutive.

AnopenhousewillbeheldWednesday,May16,attheGeorgetownBranchoftheAllenCountyPublicLibrary,6600E.StateBlvd.ThoseinterestedintheprogramwillbeabletospeakwithDebPoling,IPFWdirectorofgraduatenursingprograms.

Newnursingdegreetargetsnewborncare

Amidthegrowingneedtoprovideintensivecarefornewborninfants,theUniversityofIndianapolis,theIndianaUniversitySchoolofMedicineandRileyHospitalforChildrenatIUHealtharecollaboratingonanewUIndymaster’sdegreeprogramthatwillbetheonlyoneofitskindinthestate.

TheNeonatalNursePractitionerprogramwillbeginthisfallwithamixofclassroominstruction,onlinestudiesandclinicalworkinlocalhealthcarefacilities,leadingtoaspecializedmaster’sdegree.Theprogramisdesignedforworkingnurses,andtheinstructorswillincludeactivepediatriciansandnursepractitioners.Hands-ontrainingandobservationwilltakeplaceatWishardHospital,IUHealthUniversityHospitalandRiley’sNeonatalIntensiveCareUnit.

“Forthestudentstohaveaccesstothosekindsofclinicalexperiencesisunprecedented,”saidAnneThomas,deanofUIndy’sSchoolofNursing.“Thesenewnursepractitionerswillbethoroughlypreparedtofillthegapincommunitiesthatsimplydon’t

haveenoughneonatalphysicianstomeetthedemand.”

CheriWalkosak,directorofneonatalnursepractitionersfortheIUSchoolofMedicine,saidsheneedsacontinualinfluxofnewtalenttomaintainherstaffof50nursepractitionersatRileyHospital.Nursepractitionersnotonlyprovidedirectpatientcare,butalsohelptrainnurses,therapistsandotherhealthcareworkersinthepreferredpractices.

ThedemandforsuchexpertisehasincreasedwiththeestablishmentofNICUsinSouthBend,FortWayne,Evansville,Lafayette,Bloomingtonandelsewherearoundthestateaslocalhealthcaresystemsprovideservicesclosetohome.

— University of Indianapolis

NURSE15

Careers & Training


UndergraduatenursingstudentsatIndianaStateUniversitysaytechnology,includingavideosoftwareprogramthatrecordslecturesforlaterreview,ishelpingthemmastercomplexcurriculumandstayontrackincompletingafour-yeardegree.

“Manyofusarevisuallearnersandtakingnotessometimesdoesn’tcutit,butifIgobackandwatchthevideoalongwithmynotes,itimprovesmychancesofsuccess,”saidseniorGayleGoodrick.

IndianaStateusesMcGrawHill’sTegrityCampus,anautomatedsystemthatallowsstudentstoviewrecordedlectures,searchandbookmarkcontent,takenotes,andcollaboratewithinstructorsandfellowclassmates.Thesystemisusedintraditional,hybridandonlinecourses.Itworksonapersonalcomputer,Macormobiledevice.

“Thistechnology...allowscontenttobeexploredinavarietyofotherwayswhileintheclassroomsetting,throughcasestudiesandotherapplicationtechniques,”saidMarceeEverly,assistantprofessorandchairofthebaccalaureatenursingprogram.

LikemanynursingstudentsatIndianaState

andelsewhere,Goodrickisanon-traditionalstudent.Asamarriedmotheroffour,shehastobalancefamilyandherclasses,butsaidTegrityhelpsensurethatshedoesn’tfallbehindinherpursuitofabachelor’sdegreeandalicenseasaregisterednurse.

“ThenursingprogramisrigorousandthingslikeTegritymakeoursuccessthatmuchmoreachievable,”Goodricksaid.

MeganMcGuire,aseniornursingmajorfromHillsboro,usedTegrityduringanobstetricsclassthatEverlyteaches.

“WithTegrity,youcanwatchalectureandpauseitwheneveryouneedtotakenotes,”shesaid.

EverlycreditedTegritywillhelpingtoimprovetheperformanceofrecentISUgraduatesontheNationalCouncilLicensureExaminationforregisterednurses.Nearly93percentofDecemberbachelor’sdegreenursinggraduatesfromIndianaStatewhotookthetestforanIndiananursinglicensepassed,animprovementoverpreviousyearsandafigurethatexceedsthemostrecentnationalrateof87.89percent.

— Indiana State University

Nursingstudentssaytechnologyimproveslearning

Careers & Training

NURSE16


By Brooke Baker

Home health nurses work

flexible hours and

set their schedules

around patients’

availability and their

own needs.

THIN

KSTO

CK

Careers & Training

NURSE17


■ Anyone who works in a hospital has seen the trend: Patients are sent home earlier and sicker as insurance companies change the metric for hospitalization.

But they probably haven’t seen the other side — the growth of the home health care industry.

Opportunities exist for nurses to work in all sorts of home health positions — field nurses, case managers, telehealth, administrators — and jobs are opening up as patient care shifts to the home. Some agencies focus on one sector, such as elder care, while others treat a variety of patients. In both cases, nurses interact with patients in their homes and have the chance to touch and influence all aspects of care.

The main difference between hospitalization and home care is that hospital stays are short term and staying at home is a long-term goal.

“We have patients who stay [at home] for years,” said Jan Roberts,

CEO and administrator for Alliance Home Health Care, which strives to keep elderly patients at home as long as possible.

A satisfying career | Roberts said turnover in home health care isn’t a problem because nurses tend to be

fulfilled in their careers and stay in their jobs until retirement. Most agencies provide job shadowing opportunities and an extensive interview process to give nurses a chance to

see what it’s like before they commit. However, because it’s so different from other sectors, the transition to home health can take some effort.

“I find that people either really like it or they really don’t,” said Karin Bridwell, RN, director of St. Vincent Home Health and Hospice. “It’s very unstructured, so nurses have to be very disciplined about starting their day on time and finishing the documentation on time. If someone isn’t really self-disciplined, they are

probably going to fall behind and not be happy with this type of work.”

Home health nurses work flexible hours and set their schedules around patients’ availability and their own needs. That’s an attractive benefit to those who don’t want to work rigid 12-hour shifts.

Confidence and well-honed clinical skills | Bridwell said some nurses have the impression that home care is a low-tech environment — taking blood pressures and hand-holding — but nothing could be further from the truth.

“That’s not the case at all,” Bridwell said. “Nurses are doing IV therapy in the home, chemotherapy, extensive wound care — it’s very high tech. And since the nurse is in the home by herself, she has to be really confident in her skills and abilities.”

Home-care nurses need to have some acute-care experience, and many come from med/surg backgrounds. They also have to trust their clinical instincts.

Home health nursing:

Flexible hours, ever-changing case loads and autonomy

Roberts

THIN

KSTO

CK

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“One of the things I love best about it is you have probably more autonomy in this type of nursing than you would in almost any other setting,” said Nicole Offutt, RN-BSN, COS-C, clinical manager for Visiting Nurse Service. “You’re the eyes and ears for the doctor out there. In a lot of other settings, the eyes and ears are the doctors themselves. Out here, we’re the ones making recommendations based on what we’re seeing.”

Independence and critical thinking | Val Kappes, RN, manager of St. Vincent Home Health in Indianapolis, said nurses who excel in home health care generally have a talent for critical thinking and the

self-confidence required to function independently.

“You need to be a very independent thinker and you need to be very, very flexible,” she said. “You definitely have to be very autonomous. You have to be comfortable with that, because there’s never another nurse or physician riding with you. It’s not like you can run down the hall and say, ‘Please come help me.’ ’’

RNs in most home health care agencies act as case managers. That means the RN is the point person who organizes the patient’s care. It’s a lot of responsibility but Kappes said it’s incredibly fulfilling because it gives nurses a chance to truly affect their patients’ lives. ●

NicoleOffuttClinicalManagerforVisitingNurseServiceispicturedinfrontofVNS’sfleetofToyotaPriushybridswhichcanbeseenallovertheIndianapolisarea.

Jobopportunitiesaren’tallfieldwork

Notallhome-healthnursingcareersareinthefield.Whilemostofthenursesareoutinthecommunitymakinghomevisitseveryday,therealsoareopportunitiesforthosewhopreferanofficesetting.

Manyadministrativejobsathomehealthcareagenciesarefilledbynurses,andnursesalsoareneededtotakereferralsandadmitpatients,whetherit’soverthephoneorinhospitalsbeforepatientsarereleasedintohomecare.

Telehealthemploysnursestomonitorpatientslong-distancethroughin-hometechnology.Theyeducatepatientsaboutthetelehealthequipment,monitorandcharttheinput,andhelpthecasemanagerdeterminewhetherinterventionisneeded.

WhilecasemanagersareRNs,therealsoareopportunitiesforLPNsandCNAs,bothintheofficeandinthefield.

NURSE19


jobs.stvincent.org

At St.Vincent, we bring cutting-edge technology to faith-based care. And we know that a dedicated nurse brings much more to the job than education and experience. We’re looking for the best and brightest nurses to join our growing family.

Did you know that St.Vincent:

• Offersflexiblescheduling• Hasvaluessteepedinfaith-basedtradition• Supportsyourclinicaladvancementgoals• Iscentrallylocatedforaneasycommute

HerO. Healer. Nurse.We’re looking for nurses who exceed expectations.

TolearnmoreaboutworkingforSt.Vincent,visitjobs.stvincent.org.

We invite you to go to ourwebsite formore information and to see our current employmentopportunities: www.johnsonmemorial.org or call our toll-free Jobline at: 877-695-4561. EOE

1125West Jefferson Street, Franklin, IN 46131 | Phone: (317) 736-3440 | Fax: (317) 738-7858

www.johnsonmemorial.org A hospital you can believe in.

E M P O W E R I N G P R O F E S S I O N A L SAt Johnson Memorial Hospital, when we hire you, we give you the support, technology, and training you need, and then we let you get to work. You won’trun into the kind of red tape you’re used to. We believe in our people and want them to grow. Enjoy the feeling of empowerment that comes with acareer at Johnson Memorial.

Registered Nurses - Critical CarePRN, Pool and Full-Time Night positions available in our Critical Care Unit. Requires currentIndiana RN licensure; BSN preferred. Critical Care (or related similar) experience required;minimum 18 months current critical care nursing experience. BLS and ACLS required.Successful completion of dysrhythmia recognition test at initial department orientation.

We are located just minutes south of Indianapolis in Franklin, IN. Johnson Memorial Hospitaloffers a competitive compensationand benefits package.

pdf

NURSE20


Your World By Ashley Petry

■ The nursing profession offers many rewards including job security, interacting with patients and their families, and knowing that your work is making a difference.

But there’s a darker side to nursing that no one mentions: seeing patients suffer and, not infrequently, watching

them die. Coming face-to-face daily with suffering and death takes an emotional toll on nurses. Left unchecked, that emotional strain can lead to compassion fatigue, a condition that prevents nurses from connecting emotionally with their patients.

Compassion fatigue is getting more attention from nursing leaders these days not only because it can diminish the quality of care patients receive,

Compassion fatigue:

Can nurses lose their ability to nurture?

THINKSTOCK

NURSE21


Your World

but also because it might push some nurses to leave the profession.

Defining compassion fatigue |Nursing experts still are debating the

definition of compassion fatigue. The term was coined in a 1992 research paper about nursing burnout, and it originally was defined as “loss of the ability to nurture.”

In “Compassion Fatigue: A Nurse’s Primer,” published last year in the Online Journal of Issues in Nursing, Barbara Lombardo and Caryl Eyre defined it as “a combination of physical, emotional and spiritual depletion associated with caring for patients in significant emotional pain and physical distress.”

“Part of the challenge in defining this particular construct is that it’s complicated, and it overlaps with many other ideas,” said Lucia

Wocial, a nurse ethicist with Indiana University Health. Wocial also is an adjunct assistant professor with the IU School of Nursing and a faculty member with the Fairbanks Center for Medical Ethics.

“[Compassion fatigue] occurs when your emotional boundaries get blurred,” she said. “The idea is that you may have unconsciously absorbed the emotional impact of the trauma for the person you’re taking care of.”

Put another way, compassion fatigue is an imbalance of empathy and objectivity — both of which nurses need to do their jobs well.

Symptoms | Wocial said compassion fatigue often is confused with other occupational hazards, such as burnout. Some research suggests that burnout is the result of conflict within the work setting, rather than the

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emotional challenges of caring for patients. Burnout tends to happen gradually, while compassion fatigue can result from a specific traumatic event.

It also is reasonable to think of burnout as the end stage of compassion fatigue, said Dr. Caroline Carney Doebbeling, an affiliated scientist with the Regenstrief Institute, who wrote a 2009 paper on the prevalence of compassion fatigue among cancer-care providers. One of the earliest symptoms of compassion fatigue, she said, is avoidance.

“One of the things that was described anecdotally was nurses just not wanting to go back in a patient’s room again, or not wanting to spend the time with patients that they had wanted to before,” Doebbeling said. “It’s the beginning of emotional withdrawal from their duties.”

NURSE22


Symptoms of compassion fatigue vary but also might include the following:

■Sadness,depression,feelingsofhopelessness

■Moodiness,irritability,anegativeattitude

■Decreaseinenjoymentofjob■Difficultysleeping■Emotionaldetachment,bothatwork

andinone’spersonallife■Substanceabuse(e.g.,drinking

excessivelyafterworkinanattempttoforget)

“Compassion fatigue can look like depression, but it can also make folks look like they’ve become cold or cynical to the work they’re doing,” Doebbeling said.

Nurses experiencing compassion fatigue also might complain of physical symptoms, such as stomach upset, exhaustion and frequent colds. In extreme cases, nurses experiencing

compassion fatigue might shift from being apathetic about their patients to being outright judgmental.

“They’re tired of caring so much, so they can’t step back and say, ‘That may be an unpleasant person, but they’re unpleasant because they’re in a crisis,’ ” Wocial said. “If the last five patients you worked with seemed unpleasant, ask yourself if maybe it’s you.”

As compassion fatigue gets more attention, employers are becoming increasingly aware of how the problem might affect patient care. Nurses with compassion fatigue often spend less time with patients and their families, meaning they might lack valuable insights into how best to care for those patients.

“When you’re out of balance, it’s virtually impossible for you to provide excellent care,” Wocial said. “You can do the tasks of nursing, but those are just tasks. That’s not the whole package.”

Your World

Thefirststepincombatingcompassionfatigueismakingsurenursestakecareofthemselves.WocialpointstothefifthprovisionoftheANAcodeofethics,whichsays“thenurseowesthesamedutiestoselfastoothers.”

Shesaidthat,toooften,nurseswork12-hourshiftswithouttakingbreaks,eventoeatorusetherestroom.Thatmeanstheyalsodon’thavetimetoemotionallyprocessthethingsthey’vewitnessed.

“There’sasurvivalistmentalityinnursing,andthat’snotgood,”Wocialsaid.“Recognizethatyou’renotarobot.You’rehumanandit’sOKtomeetyourownneeds.Infact,youneedtodothat.”

Nursesalsoneedtostrikeabalancebetweenhavingaprofessionaldemeanoranddealingwiththeiremotions.

“Nursesworkinasettingwhereemotionisn’tnecessarilyacknowledgedorallowed,”Doebbelingsaid.“Everyonehastohaveastiffupperlip,maintaincomposureandgo

throughthesituationasifit’snotaffectingthempersonally.There’snoabilityforthatpersontoreallydiscusstheirfeelingsorresponsestothesituation,anditjustkeepsrecurring.”

Nursingsupervisorscanhelppreventcompassionfatigueintwosimpleways:

1Makesurenursestakerealbreaks,andhelpthemdelegatecarefortheirpatientsduringthattime.

“Oneofthemostpowerfulthingsasupervisorcandoissay,‘Takeabreak,I’llwatchyourpatients,’andnotgivethenurseachoice,”Wocialsaid.“Thebestthingtheycandoisestablishacultureandanexpectationthatpeoplewilltakebreaks.”

2Createaculturethatencouragescommunicationaboutemotionaldifficulties.

“Don’twaitforthemtocometoyou,”Wocialsaid.“Youneedtopromoteanenvironmentthatit’sokaytotalkabout.”

Healingthehealers

Tracking the problem | Little research has been done on the prevalence of compassion fatigue among nurses. In 2011, 62 percent of nurses who responded to an American Nurses Association online poll indicated that they had experienced compassion fatigue.

But hard data on its prevalence in health care facilities is harder to come by. Doebbeling said nurses would probably be reluctant to admit the problem on surveys conducted by their employers.

“I would really love to see some good prevalence studies in different health care settings,” she said.

Based on anecdotal evidence, though, experts say they believe compassion fatigue is a bigger problem now than ever before.

“I’m pretty confident that compassion fatigue is on the rise,” Wocial said. “Nurses are being asked to do more with less all the time, and nursing as a profession is changing. Nobody does well when everything is changing.” ●

Moreadvancedinterventionsforcompassionfatigueincludediscussiongroupsandindividualcounseling.Someemployersaddresstheproblembyofferingretreatswherenursescanfocusontheiroriginalreasonsforchoosingtheprofession—andhopefullyreignitetheirpassionforit.

Doebbelingsaidnursesneedavenueinwhichtheycantalkaboutwhatthey’reexperiencingandfeeling,wheretheycansay,“Thisisreallyhard”butnotbejudgedforit.

Nursesalsocancombatcompassionfatiguebyfindingnondestructivewaystoletgooftheirworkattheendoftheday.

Wocialrecalledreadingaboutamorticianwhodidjustthat.Whenhearrivedhomeeachevening,heplacedhishandonthegaragedoorforamoment,asymbolthathewasleavingworkbehind.Thenextmorning,heplacedhishandonthedooragain,symbolicallyreclaimingthechallenges—andtherewards—ofcaringforothers.●

M23


About mePosition: Chiefnursingofficerat

CommunityHospitalAnderson

Education: ASN,AndersonCollege;BSN,IndianaWesleyanUniversity;MBA,AndersonUniversity

with Beth Tharp

Send an email to [email protected] Tell us about your world

Your WorldBy Holly Wheeler

Beth Tharp entered the Salute to Nurses luncheon knowing she would receive the Advancement

in Nursing award. What she didn’t know was that she also had been named Nurse of the Year.

Tharp, who said she’s “on cloud nine,” is looking forward to a year when she can share the honor with others at Community Hospital Anderson as the hospital celebrates its 50th anniversary.

Did friends or family attend the event with you?

“My son [a nurse manager], our other son, my mother, mother-in-law and father-in-law were there. It was very special for my mother-in-law because she is a retired RN.

I believe all of the nursing directors from our hospital were there and several others from Community Anderson. Our CEO and president escorted me up on stage. I think there were 70 folks from the Community Health Network there altogether. It was just a wonderful celebration of nursing.”

What happened when your name was announced as Nurse of the Year?

“I was totally shocked. I never would have imagined getting the Advancement in Nursing award, let alone the Nurse of the Year. It was probably a good thing that I was so shocked because I was able to give my speech without crying. I was tearing up a little. If I had made eye contact with my family or any of that bunch from the hospital, I probably would not have been able to get through my talk without crying.”

What did you say in your acceptance speech?

“When I spoke, I said — and I truly believe this — that I

accepted that award for all the folks I work with at Community in Anderson — as much for the nurses and the nursing leadership as for the support staff there.

“Some things — [establishing] the wound center and the research center — I had a lot to do with, but I certainly could not have done them without everyone being behind them. Then there are things that I had nothing or little to do with. I was just clearing the path and staying out of their way. That group of people really is a force and they’re making

a difference in the lives of our patients as well as our profession and our hospital.”

What are your next steps as Nurse of the Year?

“I truly believe that because of this, I have a huge responsibility to our profession. Doing what I

can, not only working with our staff, but also with schools of nursing in our community, to work on the advancement of practice in nursing. We’re going to be instrumental in however health care reform transpires.” ●

Inheracceptancespeech,BethTharpgavecredittohercolleaguesatCommunityHospitalAnderson.

M24

Joinour mission. Work alongside the greatest

healer of all time

INDIANAPOLIS STAR NEWS 5/1/20121ATM004423B

7.25 x 9.75” (4c process) KMURRAY JWISFR0361

jb Nursing Magazine

At St. Francis Health,

we believe

delivering healthcare

is more than a job.

It’s a calling.

If you have an angel’s

touch and a servant’s

heart, we invite you

to join our mission.

The people, the faith-based ministry, professionalism and compassionate care are what make St. Francis Health a great place to have a rewarding career in health care.

We are currently seeking candidates for the following positions:

Indianapolis Campus

RNs – Emergency Department, Intensive Care, Labor & Delivery, Resource Center, Operating RoomCurrent Indiana RN license is required. Previous experience within designated specialty is needed.

Nurse Practitioner – Emergency DepartmentThe qualified candidate must possess a current Indiana RN license and be a graduate of a MSN accredited program. We are seeking a Nurse Practitioner with an ED background and a minimum of one year experience as a Nurse Practitioner will be considered.

Manager, Franciscan St. Francis Working WellExperienced Nurse Manager/Nurse Practitioner with experience in Occupational Health is needed to provide leadership for Working Well. This individual will have the opportunity to become part of a growing entity with new business opportunities as well as leading staff through our growth process. RN, MSN, APN required. Must have management experience as well as OCC health experience.

Manager, Inpatient Rehab The qualified candidate must possess a Bachelor’s degree in Nursing and a current Indiana RN license. A minimum of 2 years of inpatient acute rehabilitation experience and 1 year of management experience is required. Must have CRRN certification or be willing to obtain within 1 year. CPR certification is needed.

Carmel Campus

RNs – Operating RoomCurrent Indiana RN license is required. Previous experience within designated specialty is needed.

Please visit our website at

www.stfrancishospitals.org/careers for a list of additional opportunities and to apply.

St. Francis Health is part of Franciscan Alliance. Equal Opportunity Employer

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